Pancreatic cancer frequently infiltrates the portal vein system because of the close anatomical proximity between the head of the pancreas and the portal/superior mesenteric vein confluence,and the biological character of invasion. In these cases, pancreatectomy combined with portal vein/superior mesenteric vein resection is a potential treatment, but the outcome remains controversial. So far there is no significant evidence have shown that the pancreatectomy combined with portal vein/superior mesenteric vein resection improves the prognosis of pancreatic cancer patients. In order to establish clinical practice guidelines, as well as standardize operational indication and operational method, it is necessary to conduct large-scale, multicenter, randomized and controlled prospective clinical trials,and collect long-term follow up information.

Neurotrophic factors binds with their specific receptors tropomyosin-related kinase (Trk)to protect ischemic neurons during ischemic brain injury.The studies of the activation mode of Trk expression and its relationship with cerebral ischemia have important value.This article reviews the biological characteristics and action pathway of Trk,its relationship with cerebral ischemia,and its application prospect.

OBJECTIVE:To explore the components and style of the intervention performed by clinical pharmacists to facilitate communication between pharmacists and physicians. METHODS: The data about clinical pharmacists' medication intervention and the follow-up results on ICU physicians in general surgery department during Nov. in 2007 were collected for statistical analysis with regard to the components and style of the intervention. RESULTS: The components of clinical pharmacists' medication intervention included dosage and administration (36.1%),whether the drug use was in line with indications (27.8%),assessment on adverse drug reactions (22.2%). The style of intervention included timely intervention and delayed intervention,and 50%～66.7% of the timely intervention and 90.1%～100% of the delayed intervention were accepted by physicians. CONCLUSION: The intervention of clinical pharmacists should be based on sound evidence and reasons,meanwhile,an appropriate style should be adopted in communicating with physicians so as to improve its accepting rate by physicians.

Objective To explore the therapeutical effect of somatostatin(SST) on the damaged bowel barrier of 7-day-old SD rats with hypoxic-ischemic encephalopathy(HIE). Methods Total 7-day-old SD rats were randomly divided into untreated control group(n=6), sham-operated group(n = 6), HIE model group(n = 8) and SST-treated group(n = 8). After 6 hours of operation, abdominal aorta blood of the rats was collected to measure the level of D-lactic acid, the ileum was taken for pathological analysis and immunohistochemistry staining of SP. Results The level of D-lactic acid in HIE model group was obviously increased[(10.30 ± 1.70)mg/L], and there were significant differences compared to untreated control group, sham-operated group as well as SST-treated group respectively(P < 0.05, respectively). The cillia of ileum became widen and shorten, and the number of it decreased. At the same time, in the stratum mucosa and the neurofibrillary tangle, the expression of SP was increased (average optical density: 12.67 ± 5.46), and there were significant differences compared to untreated control group, sham-operated group as well as SST-treated group raspectively (P < 0.05,respectively).Compared with HIE model group,the level of D-lactic aeid decreased obviously[(7.35 ± 1.55) mg/L] in SST-treated group,and there were no differences compared to untreated control group and sham-operated group respectively. The intestinal villi became thinner and higher in the SST-treated group, even the number increased. Besides that, the expression of SP decreased(average optical density: 0.73 ± 0.09), and there were no differences compared to untreated control group and sham-operated group respectively. Conclusion The therapeutical effect of SST on the bowel barrier damage of 7-day-old SD rats with HIE is clear.

The etiological factors and pathogenesis of retinopathy of prematurity (ROP) are still unclear,which restricted its effective prevention and treatment.The current animal model widely used in ROP investigation is oxygen-induced retinopathy model,which is lack of specificity,and does not mimic the real pathogenesis status of human ROP patients.Thus,we should refresh our concept,seek breakthroughs in multi-disciplines,integrate more risk factors of ROP,utilize the rising technique in transgenic animal,and improve the evaluation system for improving the current models or explore new animal models of ROP.It is important for prevention and treatment of ROP.

Objective To investigate the outcome and the management of pregnant women with Eisenmenger syndrome during perinatal period to reduce the maternal fatality rate.Methods The clinical data of 23 pregnant women with Eisenmenger syndrome admitted into Beijing Anzhen Hospital Capital Medical University from January 1st,2001 to December 31st,2009 were retrospectively analyzed.Gestational week,primary disease of the heart,pulmonary hypertension,oxygen saturation and heart function of the patients were compared with Chi-square test or Fisher's exact test.Results (1) The gestational week of 23 patients with Eisenmenger syndrome were between 15 to 38 weeks,among which 11 cases in the midterm pregnancy and 12 in the last term pregnancy.The severity of pulmonary hypertension,heart function and pregnant outcomes have no difference in patients with differeut gestational weeks (P＞0.05).(2) Ventricular septal defect (VSD) were the most common disease (65.2％,15/23) among the four primary heart diseases of the patients.The heart function of the patients with VSD decreased most severely after pregnancy,and the fatality rate of the heart function Ⅳ was up to 73.3％ (11/15).The incidence of severe pulmonary hypertension was 20.0％ (3/15).The decreasing of the heart function of the patients with different primary heart diseases were different (P＜0.05).(3) Among the pulmonary hypertension patients,there were 7 mild cases (30.4％),12 moderate cases (52.2％) and 4 severe cases (17.4％).The severity of the pulmonary hypertension of the patients correlated to the incidence of postpartum heart failure and death (P＜ 0.05).The outcomes of four patients with severe pulmonary hypertension were the worst and all were reported to be dead (4/4).(4) Oxygen saturation related to the mortality of perinatal infants,incidence of premature birth and spontaneous abortion (P＜0.05).As oxygen saturation decreased to the lowest level,the fatality rate of perinatal infants increased to the highest (5.3 ％,1/19),so did the incidence of the premature birth (84.2％,16/19) and spontaneous abortion ( 10.5％,2/19).Conclusions The key point to increase the safety of patients with Eisenmenger syndrome during perinatal period was to strengthen monitoring,decrease the pulmonary hypertension and terminate pregnancy timely.

Objective Sigmoid mucosa specimens of the patients with ulcerative colitis ( UC ) at active stage and remission stage were respectively detected by real-time PCR for the contents of the six kinds of bacterial floras inclu-ding fusobacterium, enterococcus, lactobacillus, bifidobacterium, bacteroides, and escherichia coli. So the possi-ble roles and significance of the changes of intestinal mucosa associated bacterial flora in the pathogenesis of UC were discussed. Methods Sigmoid biopsy tissues were collected from 35 UC patients ( 20 cases were activities group while 15 cases were remission group) and 20 healthy cases( control group) . Specific primers were set accord-ing to the bacterial 16 SrDNA sequences. Bacterial DNA of the intestinal mucosa specimens was extracted, and re-al-time PCR was used to detect the numbers of different bacterial colonies. Results In sigmoid mucosa specimens of the UC group at activities group, escherichia coli colony was increased, while bifidobacterium, bacteroides, lac-tobacillus and fusobacterium, were reduced compared to the control group(P<0.05). But for enterococcus, there was no significant change(P>0.05). And in remission group, bacteroides and bifidobacterium were reduced com-pared with the control group(P<0.05), while no significant changes were found in escherichia coli, lactobacillus, fusobacterium and enterococcus( P >0.05 ) . The ration of bifidobacterium to escherichia coli ( B/E ) in UC pa-tients at active stage was less than 1, which was lower than the control group. While B/E values in UC patients at remission stage and the control group were both larger than 1 , with no statistically significant difference between them. Conclusion There were obvious changes of intestinal bacterial flora in UC patients, and the change is more obvious in the UC patients at active stage, showing that there is a close relationship between intestinal mucosa asso-ciated bacterial flora and the development of UC.

OBJECTIVE: To study the etiological factors of knee osteoarthritis and to provide the anatomical basis of corrective therapy for knee joint deformity by comparing the biomechanical differences of the knee joints between the osteoarthritis patients and the normal people. METHODS: The sexes, ages, heights, weights, painful characters and accompanied symptoms were recorded, and the femoral angle, tibial angle, femorotibial angle, joint space angle, and the height and width of condylus medialis and lateralis were measured for 29 selected knee osteoarthritis patients. And the biomechanical data of the patients were compared with those of the 19 normal people. RESULTS: The femoral angle of the osteoarthritis patients was smaller and the joint space angle was greater statistically than that of the normal people, and the ratios of height and width of condylus medialis and condylus lateralis of the osteoarthritis patients were greater than those of the normal people. CONCLUSION: In the patients, the gravity line of the lower limb inclines to the condylus medialis, so the condylus medialis is more vulnerable. And the configuration of the condylus of the patients, which is narrower and longer, is different from that of the normal people. It may be one of the etiological factors of knee osteoarthritis.

Objective To explore the difference in bacterial flora between faeces and mucosa of sigmoid colon,the possible role and significance of microbiota alteration in the genesis of ulcerative colitis (UC).Methods Fusobacterium, Enterococcus, Lactobacillus, Bifidobacterium, Bacteroides and Escherichia were selected as target bacteria colonies.The content of six target bacteria colonies in faeces and mucosa of sigmoid colon of 35 UC patients (20 active UC, and 15 UC in remission) and 20 health controls were detected by real-time fluorescent quantitative polymerase chain reaction (RT-PCR).Two independent samples t-test was performed to compare the differences in bacterial flora between faeces and mucosa of sigmoid colon.Variance analysis was used to compare the differences in bacterial flora among health controls group,active stage group and remission stage group.Results In health control group, the contents of Fusobacterium, Bacteroides, Enterococcus and Lactobacillus in faeces ((10.94 ± 0.29),(12.42±0.39), (8.73±0.84), (9.05±0.35), respectively) were higher than those in the mucosa of sigmoid colon ((9.36±0.66), (9.88±0.82), (7.70±1.17) and (7.96±0.68), respectively, t=9.83, 12.51, 3.20 and 6.35, all P＜0.05).However, the content of Escherichia was lower in faeces than that in the mucosa of sigmoid colon ((8.03±1.02) lg copy/g vs (8.91±0.52) lg copy/g, t=-3.44, P＜0.05).There was no difference in the content of Bifidobacterium between faeces and mucosa of sigmoid colon ((9.54±0.79) lg copy/g vs (9.42±0.98) lg copy/g, P＞0.05).For UC patients, the contents of Fusobacterium, Bacteroides, Enterococcus, Lactobacillus and Bifidobacterium in faeces ((9.62 ±± 1.13),(11.31±0.71), (9.33±0.65), (8.42±0.80) and (8.85±0.73) lg copy/g, respectively) were higher than those in the mucosa of sigmoid colon ((9.00±0.79), (8.80±0.66), (7.46±0.82), (6.82±1.07) and (8.40±0.72) lg copy/g, respectively, t=2.66, 15.28, 10.58, 7.12 and 2.56, all P＜0.05).The content of Escherichia was lower in faeces than that in the mucosa of sigmoid colon ((8.50 ± 0.52) lg copy/g vs (9.26±0.87) lg copy/g, t=-4.45, P＜0.05).Compared with health control group, the content of Fusobacterium, Lactobacillus, Bifidobacterium and Bacteroides ((8.83 ± 0.81), (7.48 ± 1.59), (8.55±0.79) and (11.11±0.88) lg copy/g) all decreased (F=84.45, 14.58, 10.43 and 24.91, all P＜0.05), while the contents of Enterococcus and Escherichia increased ((9.63 ± 0.39) and (8.74 ±0.53) lg copy/g, F=9.87 and 5.55,both P＜0.05).For remission stage group, only the content of Bacteroides decreased ((11.56±0.21) lg copy/g, P＜0.05).Compared with health control group, the contents of Fusobacterium, Bacteroides, Lactobacillus, Bifidobacterium ((8.52 ± 0.30), (8.34 ±0.29), (6.29±0.52) and (8.06±0.21) lg copy/g) all decreased in active stage group (F=16.99,35.98,22.28 and 16.08, all P＜0.05);the content of Escherichia increased ((9.68±0.56) lg copy/g, F=11.19,P＜0.05);there was no difference in the content of Enterococcus ((7.19±0.32) lg copy/g, P＞0.05).In remission stage group, the contents of Bacteroides fragilis and Bifidobacterium decreased ((9.42±0.48) lg copy/g and (8.87±0.89) lg copy/g, both P＜0.05), there was no difference in other bacterias (all P＞0.05).In both faeces and mucosa of sigmoid colon, the ratios of Bifidobacterium and Enterobacteriaceae (B/E value) in active stage group were less than 1 (0.98±0.13 and 0.84±0.05),which significantly decreased compared with health control group (1.21 ± 0.19, 1.06 ± 0.08;F=12.64,76.20, both P＜0.05).In remission stage group, B/E values were higher than 1 both in faeces and mucosa (1.14±0.08 and 1.02±0.04), and there was no difference compared with those of control group (P＞0.05).Conclusions The distribution of target bacteria in feces and sigmoid colonis differed between health controls and UC patients.There are obvious changes in fecal and mucosa associated bacterial flora in UC patients especially in active stage compared with healthy controls.

The human plasma lipoprotein-associated phospholipase A2 (Lp-PLA2) is secreted, by the mature macrophages and lymphocytes, which predominantly binds to low-density lipoprotein. Studies in recent years have demonstrated that Lp-PLA2 plays an important role in the process of atherogenesis. Its gene polymorphisms are associated with the occurrence of ischemic stroke, and its specific inhibitor has anti-atherogenic effects. Lp-PLA2 may be a novel independent risk factor and a therapeutic target for ischemic stroke.