ObjectiveTo estimate the value of serum soluble scavenger receptor CD163 (sCD163) to the prognosis of patients with stroke associated pneumonia (SAP).Methods A prospective study was conducted. The clinically suspected SAP patients admitted to Department of Intensive Care Unit (ICU) and Emergency ICU (EICU) in Zhejiang Province Zhuji City Chinese Medicine Hospital from February 2014 to January 2015 were all enrolled. According to clinical pneumonia severity index (PSI), they were divided into SAP group and non SAP group according to the presence or absence of SAP, the patients of SAP group were subdivided into mild SAP group (PSI grade Ⅰ-Ⅲgrade) and severe SAP groups (PSI grade Ⅳ-Ⅴ grade) and according to the 28-day prognosis, the patients were subdivided into hospitalized death group and survival group. The clinical data were collected, including gender, age, history of stroke presence or absence, present stroke pattern, National Institutes of Health Stroke Scale score (NIHSS) on the day of stroke suspect diagnosis, Glasgow coma scale (GCS) score, acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ) score, clinical pulmonary infection score (CPIS), PSI score, body temperature, result of chest X-ray film, oxygenation index (PaO2/FiO2), result of sputum culture, serum levels of white blood cell (WBC) and C-reactive protein (CRP) in a period of 7 days after the suspected diagnosis, PCT, sCDl63 levels on days 1, 3, 5, 7 days, length of stay in ICU, the total time of hospitalization and 28-day survival situation, etc. The ability of each index to evaluate the prognosis of SAP was analyzed by the receiver operating characteristic curve (ROC curve). The risk factors influencing the prognosis of SAP patients were analyzed by multivariate logistic regression analysis.Results ① Seventy-eight patients were finally enrolled in the study, 44 patients were diagnosed as SAP, 34 were non SAP. In 44 patients with SAP, there were 28 cases of severe SAP and 16 cases of mild SAP. On the first day of the suspected diagnosis, the NIHSS score [13 (7, 22) vs. 8 (4, 17), the CPIS score [6 (4, 9) vs. 4 (3, 5), sCD163 [mg/L: 0.80 (0.59, 1.32) vs. 0.33 (0.22, 0.46)], CRP [mg/L: 84.2 (50.8, 114.9) vs. 51.4 (26.2, 79.9)] and 28-day mortality [38.6% (17/44) vs. 11.8% (4/34)] in SAP group were significantly higher than those in non SAP group (allP < 0.05), and other basic indexes between the two groups were all of no statistical significant differences (allP > 0.05). ② The levels of sCD163 reached the peak value on the third day after the suspected diagnosis among SAP group and non SAP group, mild SAP group and severe SAP group, survival group and death group and then began to fall; the levels of sCD163, WBC, CRP, PCT within 7 days in SAP, severe SAP and death groups were higher than those in non SAP, mild SAP and survival groups (allP < 0.05). ③ROC curve analysis indicated: sCDl63 showed a better capacity for evaluating the 28-day prognosis of SAP [ROC curve (AUC) =0.673, 95% confidence interval (95%CI) = 0.515-0.807, sensitivity and specificity were 41.2% and 96.3% respectively and the cut-off was 2.65 mg/L]. However, the levels of other inflammatory indexes and scores on the first day after the suspected diagnosis had no value for early prognosis of SAP. The multiple logistic regression analysis showed that the level of sCD163 on the first day after the suspected diagnosis was the independent risk factor of death in hospital of SAP patients [dominance ratio (OR = 1.27, 95%CI = 1.06-1.52,P < 0.05]. Age (OR = 1.04, 95%CI = 1.01-1.06,P = 0.015), NIHSS score (OR = 2.86, 95%CI = 1.64-4.92,P = 0.010), CPIS score (OR = 1.52,95%CI = 1.28-1.90,P < 0.001) and APACHEⅡ score (OR = 2.06, 95%CI = 1.53-3.07,P < 0.001) were also the risk factors of influencing the death of patients with SAP.Conclusions Early sCD163 level is an independent risk factor in predicting the 28-day mortality of patients with SAP, and it has a certain value for the prognosis of SAP.

Objective To investigate the expression of STAT3 signaling pathway genes including Survivin and COX-2 in cholangiocarcinoma,as well as the relationship between expression of these genes and prognosis of patients with cholangiocarcinoma.Methods The tumor and normal tissue samples were respectively collected from 43 patients with cholangiocarcinoma and 12 patients with intra-and extrahepatic bile duct stones or hepatic duct injury in the Affiliated Provincial Hospital of Anhui Medical University from September 2007 to July 2012.The expression of STAT3,phosphorylated-STAT3 (p-STAT3),Survivin and COX-2 were examined using immunohistochemistry,and the relationship between the expression of these genes and the clinical pathological features and prognosis of patients with cholangiocarcinoma was analyzed.Patients were followed-up through outpatient examination and telephone interview until March 2014.Categorical data were analyzed using the chi-square test.Correlation analysis was done by Spearman's method.The survival curve was generated using the Kaplan-Meier method,and the survival analysis was conducted using the log-rank test.Results The positive expression rates of STAT3,p-STAT3,Survivin and COX-2 in the tumor samples were 69.8％ (30/43),65.1％ (28/43),72.1％ (31/43),79.1％ (34/43),respectively,which were compared with 41.7％ (5/12),8.3％ (1/12),16.7％ (2/12) and 41.7％ (5/12) in the normal tissue samples,showing a significant difference for the last 3 indexes (x2=12.136,9.811,4.679,P ＜ 0.05).Overexpression of p-STAT3,Survivin and COX-2 protein was correlated with lymph node metastasis (x2 =14.700,5.959,4.075,P ＜ 0.05).Overexpression of p-STAT3 was also related to neural invasion (x2=10.384,P ＜ 0.05).Expression of Survival and COX-2 protein was not associated with lymph invasion (x2=2.718,3.024,P ＞ 0.05).Expression of p-STAT3,Survivin and COX-2 was however not associated with gender,age and tumor location,differentiation and diameter (x2=0.148,0.720,1.835,1.040,0.236 ; 0.001,0.009,0.029,1.863,0.197 ; 0.433,0.686,0.002,2.974,0.029,P ＞ 0.05).Expression of Survivin and COX-2 protein was positively correlated to p-STAT3 protein (r =0.524,0.583,P ＜ 0.05).All the 43 patients were followed up for 6-60 months.Among the 17 patients with hilar cholangiocarcinoma,the median survival time was 7,9,9 months for patients with positive expression of p-STAT3,Survivin and COX-2 protein,compared with 18,11 and 11 months for patients with negative expression of these proteins.The survival rates of the patients with positive and negative expression of p-STAT3 protein were 33.3％ and 68.6％,respectively,with a statistical significance for p-STAT3 protein (x2=12.916,P ＜ 0.05).Of the remaining 26 patients with common bile duct carcinoma,the median survival time was 9,10 and 9 months for patients with positive expression of p-STAT3,Survivin and COX-2 protein,compared with 20,20 and 20 months for patients with negative expression of these proteins.The survival rates of the patients with positive expression of p-STAT3,Survivin and COX-2 protein were 20.8％,9.4％ and 8.5％,which were lower than 37.5％,37.5％ and 50.0％ of patients with the negative expression of these proteins,with a statically significance for all the 3 proteins (x2=12.787,6.245,11.161,P ＜ 0.05).Conclusions The p-STAT3,Survivin,COX-2 proteins are highly expressed in the cholangiocarcinoma and the expression levels of these proteins are positively correlated.The survivin and COX-2 may be the downstream genes of STAT signaling pathway,which are involved in the progression and prognosis of cholangiocarcinoma.

Objective In this paper,we selected the ultrasound features of the malignant thyroid nodules to evaluate the preoperative diagnostic value of ultrasound-guided fine needle aspiration biopsy ( US-FNAB )in the preoperative evaluation of thyroid nodules.Methods Thirty-nine patients with thyroid nodules managed in the department of otolaryngology-head and neck surgery,Beijing Tongren Hospital,Captial Medical University from Dec.2010 to Aug.2011 were studied.All of them were undertaken the ultrasonic examination,ultrasound-guided fine needle aspiration biopsy and surgical treatment subsequently.The ultrasonic features,fine needle aspiration biopsy results and postoperative pathological results were analyzed to draw out the characteristics of sonographic features of thyroid malignant nodules.Results The sensitivity,specificity,misdiagnosis and missed diagnosis of fine needle aspiration biopsy were 80.0％,89.4％,11.0％ and 20.0％ respectively.Solid nodules,shape/dimension ratio ≥ 1,calcifications ＜ 2 mm,irregular shape,blurred margins,type Ⅲ vascularity were correlated significantly with the malignant nodules of thyroid.The specificity of shape to dimension ratio and outline of the nodules were relatively higher than others (90.5％and 85.7％ respectively).But there were no single ultrasound feature that could carry a high sensitivity and positive predictive value in the diagnosis of thyroid nodules.Conclusions Two ultrasonographic characteristics could be used together as a select indicator to screen malignant nodules which can reduce the chance of undertaking the fine needle aspiration biopsy in thyroid nodules.

ObjectiveTo discuss the effects of apoptosis and invasion of RBE cells caused by miRNA 21 suppression and further investigate the potential role of miRNA-21 plays on target mRNA regulation. MethodsThe RNAi technology was employed to suppress the expression of RBE cells.The changes in RECK mRNA and protein expressions were detected by RT-PCR and Western blotting respectively. Changes occurred in apoptosis was closely monitored by flow cytometry (FCM). The invasion of RBE cells was analyzed in vitro by invasion assay (transwell). ResultsThe expression of miRNA-21 was clearly suppressed while the RECK mRNA and protein were over-expressed. The rate of apoptosis was significantly accelerated and there was a dramatic decrease in RBE cells' ability to invade after miRNA-21 knockdown. ConclusionThrough miRNA-21 suppression, the rate of apoptosis of RBE cells was accelerated whereas their invasion ability was greatly reduced. RECK was found to be the target gene of miRNA-21 which participates in the regulation process of regulation.

Objective To investigate the short and long-term outcomes and risk factors after open surgery or and endoscopic hepatolithotomy for hepatolithiasis. Methods A retrospective study was made on cases of hepatolithiasis who underwent hepatolithotomy by open surgery or endoscopically from Jan 2001 to Dec 2008.Of 254 patients,189 were followed-up including 127 after open surgery and 62 endoscopically.The univariate and multivariate analyses were performed to determine the risk factors. Results Complete stone clearance was achieved in 85.0 ％ ( 108/127 ) of open surgery including hepatecomy,61.3 ％ ( 38/62 )of endoscopic treatment.After a median follow-up period of 6.0 years (2.5 to 10.5 years),stone recurred in 32.8％ (62/189) of patients,biliary cirrhosis in 7.4％ ( 14/189),cholangiocarcinoma in 7(3.7％ ),all cancer cases were dead with a mortality rate of 7(3.7％ ).Bile duct stricture (OR:7.522,95％ CI:2.642 -21.415),stones in both lobes (OR:11.630,95％ CI:3.989 -33.912),and endoscopic treatment ( OR:21.374,95％ CI:6.713 - 68.056 ) were independent risk factors ( P ＜ 0.05 ) for incomplete stone clearance by unconditional Logistic regression analysis.In addition,recurrent stones and/or cholangitis were associated with residual stones ( OR:3.059,95％ CI:1.307 - 7.159),stricture ( OR:3.702,95％ CI:1.567-8.745) and endoscopic therapy (OR:4.841,95％ CI:1.946 - 12.043) (P ＜ 0.05).Conclusions Stricture,stone in both lobes and endoscope therapy were independent risk factors for residual stones; Residual stones,bile duct stricture and endoscope therapy were independent risk factors for recurrent stones and/or cholangitis.

OBJECTIVETo seek an effective drug for treatment of human hyperplastic scar through studying the effects of curcumin on fibroblast growth and collagen synthesis.

METHODSFibroblasts derived from scar tissue and from normal epidermal tissue were isolated and cultured separately with tissue-block method, their morphology were observed under invert phase contrast microscope, their growth curve was drawn respectively to determine the speed of growth. Then, fibroblasts from scar were stimulated with curcumin in different concentrations (0, 12.5, 25, 50 and 100 micromol/L) for detecting the inhibitory effect of curcumin on growth of fibroblasts using MTT methods and that on activity of procollagen alpha-1 gene transcription in fibroblast was detected by RT-PCR.

RESULTSThe cell growth curve showed that double-multiplying time was 5 days in fibroblasts from scar and 4 days in those from normal dermis, showing significant difference between them (P < 0.05). MTT showed that curcumin in 12.5 micromol/L showed a cell proliferation enhancing trend, and its absorbance value was significantly higher than that in the normal group, but the effect turned to inhibition when concentration increased to over 25-100 micromol/L, and became significant inhibition at concentration of 50 and 100 micromol/L. Besides, curcumin also showed markedly inhibition on collagen type I synthesis in fibroblasts (P < 0.01).

CONCLUSIONHigh concentration curcumin can inhibit effectively the fibroblast proliferation and collagen I synthesis in hyperplastic scar, therefore, may has therapeutic effect on the disease in human being.

Cell Proliferation ; drug effects ; Cells, Cultured ; Cicatrix, Hypertrophic ; metabolism ; pathology ; Collagen Type I ; biosynthesis ; Curcumin ; pharmacology ; Fibroblasts ; drug effects ; metabolism ; pathology ; Humans

Objective To summarize the experience of diagnosis and treatment for pancreatic neuroendocrine neoplasms (pNENs).Methods Forty-seven patients with pNENs who were treated at Anhui Province Hospital during January 2002 to December 2013 were retrospectively analyzed.They were followed by telephone or clinic interview,and the deadline date was January 31st,2014.Survival was analyzed with the Kaplan-Meier method,and the prognostic factors for survival were identified.Results Among the47 patients,there were 13 males and 34 females,aged from 16 to 74 years old,with a median age of 45 years,There were 17 cases of non-functioning pNENs,30 cases of functioning pNENs.The detection rate of B ultrasound,CT,MRI was 71.8％ (28/39),92.7％ (38/41),75.6％ (6/8).Forty-six patients underwent radical surgery,and 1 patient underwent palliative surgery.The pathologic type included 41 cases of pancreatic neuroendocrine neoplasms,6 cases of neuroendocrine cancer.There were 22,19,6 cases of grade G1,G2,G3 lesions,respectively.There were 32,11,4 cases of TNM staging Ⅰ,Ⅱ,Ⅲ,respectively.Vascular structure was invaded in 15 cases,and nerve was invaded in 18 cases.Lymph node was examined in 15 cases,and 5 were found to have metastatic lesion.After surgery,pancreatic fistula occurred in 9 patients,ascites in 4 patients,wound infection in 4.The follow-up period ranged from 2 to 144 months.The overall 1,3,5-year survival rates were 94.9％,88.4％,and 84.4％.The 5-year survival rates of patients with grade G1,G2,G3 were 100％,73.3％,60％;and the 5-year survival rates of patients with TNM staging Ⅰ,Ⅱ,Ⅲ were 100％,70.0％,33.3％.It was showed that TNM staging system,WHO classification,lymph node metastasis,vascular and neural invasion were associated with the prognosis.Conclusions CT is the imaging test of choice for pNENs,while surgery is the first choice for treatment.Surgical resection of pNENs results in long-term survival.TNM staging,WHO classification,lymphatic metastasis,vascular and neural invasion are closely related to the prognosis of pNENs.

It is the objective of this study to develop dynamic predictive model for the extraction process of red Ginseng using NIR spectroscopy. NIR spectroscopy was collected online and PLSR models were developed for total quantity of ginsenosides. The performance of NIR prediction model achieved R, RMSEC, RMSEP of 0.996 09, 0.018 9, 0.016 8, respectively. A first order dynamic mass transfer model was combined with NIR prediction of the quality indicator to predict the trajectory of the extraction process based upon the initial 3 or 4 data points. The results showed good agreement with actual measurements indicating reasonable accuracy of the predictive model. It could potentially be used for advanced predictive control of the extraction process.
Chemical Fractionation ; methods ; Ginsenosides ; chemistry ; isolation & purification ; Models, Theoretical ; Panax ; chemistry ; Spectroscopy, Near-Infrared

Objective To observe the effects of extracellular signal-regulated kinase (ERK) 1/2 and protein kinase B (Akt) signal pathway in cholangiocarcinoma cells invasion and migration promoted by microRNA-21 (miR-21).Methods The experimental study was adopeted.QBC939 cholangiocarcinoma cells were cultured in vitro,through constructing and synthesizing unrelated sequence,miR-21 mimics and miR-21 inhibitor which were transfected into cells,and these cells were allocated into 4 groups,including growing naturally cells in the cell group,cells transfected by unrelated sequence in the 21-NC group,cells transfected by miR-21 mimics in the 21-M group and cells transfected by miR-21 inhibitor in the 21-Ⅰ group.Besides,cells in the 21-M group were allocated again into the 2 groups,20 μmol/L LY294002 and 10tμmol/L U0126 were respectively added in order to dispose 48 hours for follow-up experiments.Indicatiors of the test:(1) real-time quantitative polymerase chain reaction (RT-qPCR) was used to detect the expression of miR-21 in each group of cholangiocarcinoma cells.(2) Werstern blot was performed to detect the relative expressions of PTEN,ERK and Akt proteins in each group of cholangiocarcinoma cells.(3) Scarification assay was executed to test the migration of each group of cholangiocarcinoma cells.Transwell experiment was conducted to examine the migration and invasion of each group of cholangiocarcinoma cells.The measurement data with normal distribution were presented by x-s.The means of the 2 groups were compared by the t test.The means among groups were compared by the ANOVA,and pairwise comparison was analyzed by the Bonferroni test.The repeated measurement data were analyzed by the repeated measures ANOVA.Results (1) The relative expression of miR-21 in the cell group,21-NC group,21-M group and 21-Ⅰ group were 1.010 ±0.010,0.980 ± 0.050,4.900 ± 0.350 and 0.260 ± 0.010,respectively,with a statistically significant difference among the 4 groups (F =78.23,P ＜ 0.05),with no statistically significant difference between the 21-NC group and cell group (P ＞0.05).There was increased expression between the 21-M group and cell group,decreased expression between the 21-Ⅰ group and cell group and significant difference between 21-M group or 21-Ⅰ group and cell group (P ＜ 0.05).(2) The relative expressions of PTEN,ERK,p-ERK,Akt and p-Akt proteins in the cell group,21-NC group,21-M group and 21-Ⅰ group were 0.360 ± 0.020,0.400 ± 0.030,0.140 ± 0.010,0.680 ± 0.110 and 0.045 ± 0.126,0.470 ± 0.140,0.460 ± 0.060,0.440 ± 0.110 and 0.310 ± 0.020,0.380 ± 0.040,0.590 ± 0.060,0.160 ±0.010 and 0.400 ±0.010,0.390 ±0.080,0.410 ±0.090,0.380 ±0.070 and 0.440 ±0.110,0.510 ± 0.120,0.980 ± 0.150,0.190 ±0.010,respectively,showing statistically significant differences among the4 groups (F =10.23,12.78,18.11,P ＜ 0.05).There was no significant difference in the relative expressions of PTEN,ERK,p-ERK,Akt and p-Akt proteins between the cell group and 21-NC group (P ＞0.05).Compared with cell group,there was decreased PTEN expression and increased p-ERK and p-Akt expressions in the 21-M group,showing statistically significant differences (P ＜ 0.05).Compared with cell group,there was increased PTEN expression and decreased p-ERK and p-Akt expressions in the 21-Ⅰ group,showing statistically significant differences (P ＜ 0.05).(3) The change of migration rate of cells from 6 hours to 48 hours were from 12.0％ ± 3.0％ to 23.0％ ± 5.0％ in the cell group,from 21.0％ ± 4.0％ to 43.0％ ± 7.0％ in the 21-M group,from 6.0％ ±1.0％ to 18.0％ ±4.0％ in the miR-21 + LY294002 group and from 9.0％ ±2.0％ to 26.0％ ± 6.0％ in the miR-21 + U0126 group,respectively.The migration rate of cells in the 21-M group at each time point was higher than that in the cell group (F =16.23,P ＜0.05).The migration rate of cells in the miR-21 + LY294002 group and miR-21 + U0126 group were lower than that in the 21-M group (F =25.21,P ＜ 0.05),and there was the interaction effects between the change of migration rate of cells of the 3 groups and time,with a statistically significant difference (F =35.31,P ＜ 0.05).(4) The numbers of migration cells in the cell group,21-M group,miR-21 + LY294002 group and miR-21 + U0126 group were 198 ± 32,248 ± 39,187 ±23 and 174 ± 28,respectively,with a statistically significant difference among the 4 groups (F =8.48,P ＜ 0.05) and between the 21-M group and cell group (t =4.13,P ＜0.05).Compared with the 21-M group,the numbers of migration cells in the miR-21 + LY294002 group and miR-21 + U0126 group were decreased (F =21.98,P ＜0.05).The numbers of invasion cells in the cell group,21-M group,miR-21 + LY294002 group and miR-21 + U0126 group were 102 ± 22,211 ± 36,55 ± 9 and 67 ± 13,respectively,showing a statistically significant difference among the 4 groups (F =11.32,P ＜ 0.05) and between the 21-M group and cell group (t =6.67,P ＜ 0.05).Compared with the 21-M group,the numbers of invasion cells in the miR-21 + LY294002 group and miR-21 + U0126 group were decreased (F =36.23,P ＜ 0.05).Conclusion ERK and Akt signal pathway participate in the cholangiocarcinoma cells invasion and migration promoted by miR-21,PTEN could mediate the process of promoting cholangiocarcinoma cells invasion and migration through ERK and Akt signal pathway promoted by miR-21.

OBJECTIVETo evaluate the efficacy and safety of Chinese herbal medicine combined with systemic chemotherapy and/or regional arterial perfusion for pancreatic cancer with liver metastases (PCLM).

METHODSWe retrospectively selected 292 patients with PCLM who were treated by Chinese herbal medicine combined with systemic chemotherapy and/or regional arterial perfusion at Tianjin Medical University Cancer Hospital from January 2001 to December 2010. All patients were assigned to the Western medicine treatment group (157 cases) and the integrative medicine treatment group (135 cases). Patients in the Western medicine treatment group were treated with gemcitabine (GEM)-based chemotherapy, and partial of them received regional arterial perfusion. Those in the integrative medicine treatment group additionally took Chinese herbs of clearing heat and eliminating mass for at least 4 weeks. The median survival time (MST) , adverse reactions and the incidence of complications were observed.

RESULTSThere was no statistical significance in general data between the two groups (P > 0.05). There was statistical difference in MST between the two groups (4.8 months vs 5.5 months, P < 0.05). No death occurred during chemotherapy or regional arterial perfusion. All toxic or adverse reactions were tolerable.

CONCLUSIONChinese herbal medicine combined with systemic chemotherapy and/or regional arterial perfusion was effective and safe, and it could be optimally selected as palliative therapy for PCLM.

Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Complementary Therapies ; methods ; Deoxycytidine ; analogs & derivatives ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Liver Neoplasms ; drug therapy ; secondary ; Pancreatic Neoplasms ; drug therapy ; pathology ; Retrospective Studies