Objective To evaluate the value of serum CA 19-9 levels in predicting resectability of pancreatic cancer. Methods Serum CA 19-9 levels of 52 patients with pancreatic cancer who were possible to be curatively resected according to the imaging were determined; the gold standard was respectability. An receiver operating characteristic (ROC) curve was constructed for the CA 19-9 levels; the point that lies closest to the upper left-hand comer of the graph is chosen as the cut-off point, the sensitivity, specificity,positive and negative predictive values were calculated. Results There were 29 (55.8%) resectable and 23 (44.2%) inoperable cases of pancreatic cancers. The CA19-9 level in resectable patients was (159.6±170.9)U/ml, and it was (944.4 ±773.4) U/ml in inoperable cases. The area under the ROC curve was 0. 918 ( ＞ 0.9, P ＜ 0.01 ), 95% confidence interval were 0.843 ～ 0.992. The CA19-9 level was (353.2) U/ml according to the cut-off point, the sensitivity and specificity was 93.1% and 78.3%, respectively; positive and negative predictive values was 84. 4% and 90. 0% , respectively. Conclusions Preoperative serum CA19-9 level may be a useful marker for further evaluating the respectability of pancreatic cancer who are possible to be resected according to the imaging studies.

Objective To evaluate the expression of immunohistochemistry markers p53, p16 and Ki-67 in penile cancer and penile intraepithelial neoplasia (PIN). Methods 33 patients who suffered penile cancer and received organ-sparing surgery from Jan 2004 to Dec 2013 were retrospectively analysed. The expression of p53, p16 and Ki-67 were detected by EnVision/HRP two steps immunohistochemistry. Results The positive expression rates of p53 in normal penile epithelium, low-grate penile intraepithelial neoplasia, high-grate penile intraepithelial neoplasia, well-differentiated squamous cell carcinoma and poor-differentiated squamous cell carcinoma were 0, 16.7 %, 38.5 %, 30.0 % and 66.7 % respectively. The expression rates of p16 were 20.0 %, 50.0 %, 53.8 %, 70.0 % and 33.3 % respectively. The expression rates of Ki-67 were 0, 16.7 %, 61.5 %, 65.0 % and 75.0 % respectively. Conclusions The combined detection of p16 and Ki-67 can contribute to discover PIN and penile carcinoma much more earlier. p53 may be related to the occurrence and development of low differentiated squamous cell carcinoma, and p16 may be related to the occurrence and development of well-differentiated squamous cell carcinoma.

Objective: To explore the psychological status and therapeutic efficacy of peri-operative psychological intervention among patients with oral carcinoma.Method: psychological statuses of 60 patients with oral carcinoma were investigated,and specific peri-operative psychological interventions were performed according to features and initiating factors of their psychological crisis,in order to provide references for the therapy of oral carcinoma.Result: Common psychological crises among patients with oral carcinoma such as anxiety and fear have been dramatically decreased by proper psychological investigation and peri-operative psychological intervention.Conclusion: Psychological investigation contributes to a great improvement of psychological status of patients with oral carcinoma.Therefore,in addition to routine peri-operative medical treatment,an effective psychological investigation is also crucial for patients with oral carcinoma to cure the disease and regain health.

There is an increasing interest and popularity of Chinese herbal medicine worldwide, which is accompanied by increasing concerns about its effectiveness and potential toxicity. Several ingredients, such as polyphenolic compounds berberine, flavonoids, and curcumin, have been studied extensively by using various animal models. Effectiveness of treatment and amelioration of metabolic syndromes, including insulin resistance and dyslipidemia, has been demonstrated. This review summarizes the major checkpoints and contributing factors in regulation of exogenous and endogenous lipid metabolism, with particular emphasis centered on triglyceride-rich and cholesterol-rich lipoproteins. Available experimental evidence demonstrating the lipid-lowering effect of berberine, flavonoids and curcumin in cell culture and animal models is compiled, and the strengths and shortcomings of experimental designs in these studies are discussed.

Objective To sum up the therapeutic experiences and to analyze the causes of multiple organ dysfunction syndrome (MODS) occurred in a patient who subjected to an accidental 60 Co exposure. Methods The patient was diagnosed as MODS by clinical manifestation, the auxiliary examinations and pathologic autopsy. In therapeutic aspects, intensive care, ventilator-assisted breathing, anti-infection, nutritional support treatment and protection management of important organs were given. Results After a successful transplantation of HLA-identical allogeneic peripheral blood stem cell, the complaints of MODS emerged repeatedly as fever, lung infection, respiratory failure, cardiac arrhythmia, circulatory failure, hepatic injury, decreased urine output and paralytic ileus. At last, the patient died of multi-organ failure 75 days after exposure to radiation. The results of auxiliary examinations showed enlargement of heart and cardiac arrhythmia. Biochemical examination also indicated the increased hyper-sensitive C-reactive protein. The results of pathologic autopsy indicated the existence of fungous infections in whole body, pulmonary fibrosis, myocardium degeneration and necrosis and radiation enteritis. In addition, congestive hepatopathy, renal hemorrhage and intracerebral hemorrhage were also found in the examination. Conclusion Some special clinical features were found in this case, and the cause of MODS is mainly related to radiation injury of important organs, low level of immunity and infection. So the measures of anti-infection and protective treatment of multiple organs should be taken. The key and difficulty for preventing such a kind of MODS might be to improve the patient's immunity and to help the tissue reparation after radiation injury.

Objective To observe the effects of early pulse therapy with large dose of methylprednisolone associated with cyclosporine A on mortality and incidence of pulmonary fibrosis in the patients with peroral paraquat poisoning.Methods Initial pulse therapy with large dose of methylprednisolone associated with cyclosporine A was given in early period,in addition to regular gastric lavage and hemoperfusion,after acute peroral paraquat poisoning in 38 patients.The indexes of arterial blood gas analysis,findings of lung CT,and the function of kidney and liver were all monitored periodically.At the same time,the data of mortality and incidence of pulmonary fibrosis of the patients with peroral paraquat poisoning were statistically analyzed.Results 13 of 38 patients died,the mortality was 34.2%.Among the dead,12 patients died of multiple organ failure within 1 week after paraquat poisoning,and the remaining one died of pulmonary fibrosis.During hospitalization of the other 25 patients who survived,blood oxygenation index declined in different degrees in 18 cases,the thoracic computed tomography showed interstitial changes in the lung in 17 cases,and dysfunction of more than two organs(lung,liver and kidney)was found in 13 cases.Conclusion The pulse therapy of large dose of methylprednisolone associated with cyclosporine A given in early period may markedly improve the prognosis of patients with acute peroral paraquat poisoning.But a large sample with randomized double blind study is needed in order to further evaluate the clinical efficacy.

Objective To investigate the diagnostic criteria, clinical management and prognostic factors of primary central nervous system (CNS) histiocytic sarcoma (HS). Methods An adult patients with primary CNS HS was reported, and literature on the rare entity were reviewed. Results The patient had no previous history of disease. Magnetic resonance imaging (including magnetic resonance spectroscopy) suggested a mass in the frontal lobe with obvious vasogenic edema, which was considered glioma. Surgery was the initial treatment and the tumor was totally removed. The histological findings revealed the HS. The patient received concomitant chemoradiotherapy postoperatively and currently lived without recurrence. Conclusions Primary CNS HS is extremely rare hematopoietic malignant tumor. The pathological feature and comprehensive immunophenotype panel are the useful ways to establish the diagnosis till now. Primary CNS HS should be treated intensively with surgery, chemotherapy, and/or radiation therapy. However, prognosis is disappointed in most of patients. Concomitant chemoradiotherapy might be an alternative treatment.

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Objective To investigate the prevalence,radiological features and the association between HRCT changes and different diseases or clinical features in interstitial lung disease(ILD)caused by diffuse connective tissue diseases(CTD).Methods Retrospective analysis was performed based on the medical records of 412 in-patients with the diagnosis of diffuse connective tissue diseases from June 2003 to June 2005 in our hospital.268 cases were SLE,83 cases were SS,40 cases were DM/PM,21 cases were SSe.All patients had chest X-ray and the suspected cases had HRCT exam.The distribution of ILD among different diffuse CTD.the appearance between X-ray and HRCT appearances were compared.The correlation among HRCT appearance,different diseases and clinical features was studied.Results①In the 412 cases of CTD,ILD de- tected by HRCT was 9.7%(40 case in total),3,9% by X-ray.Among the 40 cases,DM/PM had the highest rate of ILD(25%),23.8% in SS,9.6% in SS and 6.3% in SLE.②The consensus rate between HRCT and X-ray was 40%.The rate of mis-diagnosis of ILD was 60% by X-ray.③The changes of interstitial involvement de- tected by HRCT were:ground glass change(41.0%),consolidation(32.8%),reticular change(16.4%)and hon- eycomb change(9.8%).The concomitant presence of two of the above changes were very common.④More level respiratory symptoms such as cough,panting,chest distress and chest pain and high level of complement were observed in patients with ground glass and consolidation changes,while high CRP level was seen in patients with consolidation and honeycomb changes(P

Biodegradable PLGA [poly(lactide-co-glycolide acid)] have shown significant potential for sustained and targeted delivery of several pharmaceutical agents, including DNA. We reviewed the formulating approaches of PLGA nanoparticles/microspheres as DNA carriers and utilization for gene therapy and vaccine adjuvant.