Objective To describe the diagnosis and treatment of metastatic pancreatic cancer. Methods The clinical data of 10 cases of metastatic pancreatic tumor in the first affiliated hospital of China Medical University from July 1997 to July 2007 were analyzed retrospectively. Results The etiologies of primary tumors were lung cancer(n=3), colonic carcinoma(n=2), stomach cancer(n=2), renal cell carcinoma(n=2), nasopharyngeal carcinoma(n=1). The median interval between the diagnosis of primary tumor and pancreatic metastases was 40 months (range:0~192 months). All the metastases were located in the pancreatic heed and neck, and solitary metastasis was detected in one ease, while other 9 cases were multiple metastases. The mean maximum tumor size was 3.03 cm. The main clinical manifestations were abdominal pain, bloating, anorexia and jaundice. 2 cases underwent pancreaticoduodeneetomy, 1 case underwent arterial pancreatic perfusion chemotherapy, 1 case underwent percutaneous biliary stenting and 2 cases received systematic chemotherapy, 1 case received radiotherapy, 3 patients did not accept any therapy. 7 patients were followed-up, the median survival was 10.6 months (range:2~44 months). Conclusions Metastatic pancreatic cancer was rare and the clinical manifestation was non-specific, lndividuaized treatment should be selected on a case-by-case basis. Aggressive surgical resection should be offered to some selected patients.

ObjectiveTo investigate the prevention and treatment of pneumonia in patients with acute cervical spinal cord injury (CSCI).MethodsData of 278 patients with acute traumatic CSCI admitted from 1988 to 2004 were analyzed retrospectively.Results Pneumonia was the major complication following acute CSCI and discovered by radiography during the first 3—33 days after injury. The all cases were nosocomial pneumonia and G- bacilli were main pathogens, particularly pseudomonas aeruginosa. The incidence of pneumonia of patients with score ≤6 according to the criteria of American Spinal Injury Association (ASIA) was significantly higher than those with ASIA score >6 (P<0.001).ConclusionThe high incidence of pneumonia in the CSCI is associated with the level and completeness of the injury. The G- bacilli causing nosocomial infection are main pathogens.

Objective:To evaluate the effects of increasing end-tidal concentrations of sevoflurane and increasing stimulation voltage on motor evoked potentials,so as to provide evidence in making anesthesia plan for intraspinal tumor surgery.Methods:In the study,48 patients scheduled to undergo intraspinal tumor surgery [American Society of Anesthesiology,(ASA)Ⅰ-Ⅱ,18-65 years old]were enrolled. After general anesthesia induction,the patients were assigned to receive sevoflurane anesthesia of increa-sing end-tidal concentration in the sequence of 0.0%,0.5%,1 .0% and 1 .5% respectively,under a background of propofol and remifentanil.All the observations were done before the important steps of sur-gery.Remifentanil infusion rate was 0.2 μg /(kg·min),while the propofol infusion rate was adjusted to maintain the bispectral index values within the range of 30-50.At each concentration,4 stimulation voltages of 300 V,400 V,500 V and 600 V were employed to elicit motor evoked potentials (MEPs). The amplitude and latency of each MEP were compared.The success ratio was also recorded.Results:The concentration of sevoflurane and the stimulation voltage had impacts on the amplitude and latency of MEPs.Under each stimulation voltage,the MEPs amplitude decreased following increasing end-tidal sevoflurane concentrations,and significant differences were found in comparing 1 .5% sevoflurane (left 20.50 μV,70.71 μV,135.97 μV,190.00μV ,right 14.29 μV,50.71 μV,73.10μV,77.50μV) with 0.0% sevoflurane (left 143.00 μV,388.10 μV,484.53 μV,500.00 μV,right 176.00 μV, 407.60 μV,384.35 μV,451.00 μV)and 0.5% sevoflurane (left 100.00 μV,362.57 μV,444.05μV,435.00 μV,right 115.00 μV,207.15 μV,258.34 μV,358.50 μV),left χ2 =27.46,P<0.01,right χ2 =60.49,P<0.01;left χ2 =20.73,P<0.01,right χ2 =55.05,P<0.01;left χ2 =34.25,P<0.01,right χ2 =33.58,P<0.01;left χ2 =28.61,P<0.01 ,right χ2 =49.04,P<0.01;while there were no statistical differences in the latency changes (P =0.26 ).Under each end-tidal sevoflurane concentration,the MEPs amplitude increased following increasing stimulation voltages,and significant differences were found in comparing 300 V (left 143.00 μV,100.00 μV,61.50 μV,20.50μV ,right 176.00 μV,115.00 μV,41.07 μV,14.29 μV)with 400 V (left 388.10 μV,362.57μV,198.81 μV,70.71 μV,right 407.60 μV,207.15 μV,89.00 μV,50.71 μV)and 500 V (left 484.53 μV,444.05 μV,216.24μV,135.97 μV,right 384.35 μV,258.34μV,187.50μV,73.10μV)and 600 V (left 500.00 μV,435.00 μV,344.00 μV,190.00 μV,right 451.00 μV,385.50μV,156.00μV,77.50μV),leftχ2 =45.55,P<0.01,rightχ2 =25.73,P<0.01;leftχ2 =46.67, P<0.01,right χ2 =55.30,P<0.01;left χ2 =47.36,P<0.01,right χ2 =47.82,P<0.01;left χ2 =38.67,P<0.01,right χ2 =45.87,P<0.01;while the latencies were decreased,and significant dif-ferences were found in comparing 300 V with 400 V and 500 V and 600V(left F=7.50,P=0.01 ,right F=13.33,P<0.01),but the differences had little clinical significance.The success ratio decreased by increasing end-tidal sevoflurane concentration,and significant differences were found in comparing 1 .5%sevoflurane (left 43.8%,70.8%,77.1%,81.3%,right 37.5%,60.4%,75.0%,66.7%)with 0.0%sevoflurane (left 79.2%,87.5%,95.8%,93.8%,right 75.0%,95.8%,95.8%,95.8%)and 0.5%sevoflurane (left 72.9%,89.6%,95.8%,95.8%,right 66.7%,89.6%,95.8%,97.9%);the suc-cess ratio increased by increasing stimulation voltage,and significant differences were found in comparing 300 V(left 79.2%,72.9%,62.5%,43.8%,right 75.0%,66.7%,60.4%,37.5%)with 400 V(left 87.5%,89.6%,77.1%,70.8% ,right 95.8%,89.6%,79.2%,60.4%)and 500 V(left 95.8%, 95 .8%,9 1 .7%,77 .1%,right 95 .8%,95 .8%,8 1 .3%,75 .0%)and 600 V (left 93 .8%,95 .8%, 89.6%,81.3%,right 95.8%,97.9%,89.6%,66.7%),but there were no statistical differences in the success ratio of MEPs between the group with stimulation voltage of 600 V ,end tidal sevoflurane concen-tration of 1 .5% and the group with stimulation voltage of 300 V,end tidal sevoflurane concentration of 0.0% (P=0.22).Conclusion:Sevoflurane inhibited MEPs in a dose-dependent manner.It can de-crease the amplitudes and prolong the latencies.But increasing stimulation voltage will facilitate MEPs monitoring and increase the success ratio.Sevoflurane can be used in larger parts of MEPs monitoring surgery by increasing the stimulation voltage.

Objective To detect the expression of mitochondrial dynamics proteins (Mfn2 and Drp1) in thyroid squa?mous carcinoma cell line SW579 and the effects of Mitochondrial division inhibitor, Mdivi-1, on proliferation, apoptosis and invasion of SW579. Methods In SW579 and Nthy-ori 3-1 cell lines, the expression levels of Mfn2 and Drp1 were deter?mined by western blot while the transcription level of Mfn2 and Drp1 mRNA were measured by RT-PCR. Then, SW579 cells were divided into control group (DMSO, 0.1%) and Mdivi-1 low, medium and high dose groups (Mdivi-1 of 15,30 and 45μmol/L were incubated with cells for 16 hours respectively). Then the ability of cell proliferation was detected using MTT assay, the mitochondrial membrane potential was determined by fluorescence spectrophotometer, the expression levels of cy?tochrome C and Caspase-3 were quantified by Western blot and the transcription level of the Cyt C and Caspase-3 mRNA were determined by RT-PCR. The ability of invasion in each group was measured with Transwell assays. Results Com?pared with Nthy-ori 3-1, the mRNA transcription and protein expression levels of the Mfn2 was remarkably decreased, while the mRNA transcription and protein expression of the Drp1 was significantly increased in SW579 cells (P<0.01). Compared with control group, the cell survival rates and mitochondrial membrane potential of SW579 were decreased dramat?ically (P<0.01). The mRNA transcription and protein expression of the cytochrome C and Caspase-3 were increased dra?matically (P<0.01) and the capability of invasion was markedly decreased in all the Mdivi-1 groups in a dosage dependent manner compared with those in control groups (P<0.01). Conclusion Abnormal mitochondrial dynamics may be involved in thyroid squamous cell carcinoma SW579 cells;Mdivi-1 can inhibit the cell proliferation and invasion as well as induce apoptosis.

Objective:To investigate the effects of different phototherapy intensities on the levels of malondialdehyde, a peroxidation product of intralipid, vitamin C and vitamin E in parenteral nutrition for premature infants.Methods:The parenteral nutrition for premature infants was prepared under strict aseptic condition and was divided into four groups based on different phototherapy intensities in simulated clinical settings, which were indoor light group, single-, double-, and three-sided phototherapy group. According to whether the nutrient solution shielded for light or not, each group was further divided into two subgroups: exposure or non-exposure group. The levels of malondialdehyde, vitamin C and vitamin E in all groups before phototherapy and 6, 12, 18, and 24 h after phototherapy were measured. Ten samples of parenteral nutrient solutions were prepared for each group, of which 2 ml were extracted for test at different time points. Repeated measurement analysis of variance was used for data analysis and the results were adjusted using Greenhouse-Geisser method if failed in Mauchly sphere test.Results:With the increase of phototherapy time, the malondialdehyde level increased in the exposure and the non-exposure subgroups in the one-sided phototherapy group [before phototherapy: (3.777±0.112) vs (3.746±0.141) nmol/ml; phototherapy for 6 h: (3.808±0.122) vs (3.715±0.145) nmol/ml; 12 h: (4.546±0.138) vs (4.507±0.136) nmol/ml; 18 h: (6.116±0.151) vs (5.239±0.156) nmol/ml; 24 h: (7.569±0.136) vs (5.300±0.200) nmol/ml; all P<0.05], but the level of vitamin C [before phototherapy: (62.507±0.205) vs (62.341±0.144)μg/ml; phototherapy for 6 h: (51.211±0.086) vs (58.128±0.076) μg/ml; 12 h: (43.288±0.084) vs (55.351±0.050) μg/ml; 18 h: (35.758±0.113) vs (51.215±0.093) μg/ml; 24 h: (33.473±0.075) vs (48.473±0.080)μg/ml] and vitamin E decreased [before phototherapy: (4.101±0.132) vs (4.084±0.141) μg/ml; phototherapy for 6 h: (3.761±0.119) vs (3.904±0.075) μg/ml; 12 h: (3.654±0.092) vs (3.729±0.087) μg/ml; 18 h: (3.385±0.102) vs (3.582±0.119) μg/ml; 24 h: (3.313±0.127) vs (3.438±0.113) μg/ml, all P<0.05]. The same situation was also observed in indoor light group, double-, and three-sided phototherapy groups. The malondialdehyde level at different time in the exposure subgroups were higher but the vitamin C and vitamin E levels were lower than those in the non-exposure subgroups, regardless of the phototherapy intensities (all P<0.001). (2) The analysis of all exposure phototherapy subgroups showed that the higher the intensity of light therapy, the higher the malondialdehyde level, and the lower the level of vitamin C and vitamin E, with statistical significance differences in any pairwise comparison. Analysis of all non-exposure subgroups showed statistically significant differences in the malondialdehyde level in any pairwise comparison (all P<0.05) except for the comparison between indoor light group and single-sided phototherapy group ( F=2.383. P=0.140). Moreover, the greater the phototherapy intensities, the lower vitamin C level, with statistically significant differences in any pairwise comparison. And statistical significance differences were observed in the vitamin E level in any pairwise comparison (all P<0.05) except for the comparison between double- and three-sided phototherapy groups ( F=1.358, P=0.259). Conclusions:Phototherapy can increase the malondialdehyde level in parenteral nutrient solution for premature infants and the degree of intralipid peroxidation, but can also lead to vitamin C and vitamin E loss in the parenteral nutrient and weaken its antioxidant capacity.

The prescriptions including Polygoni Multiflori Caulis that built by Pro. Yan were collected to build a database based on traditional Chinese medicine (TCM) inheritance assist system. The method of association rules with apriori algorithm was used to achieve frequency of single medicine, frequency of drug combinations, association rules between drugs and core drug combinations. The datamining results indicated that in the prescriptions that including Polygoni Multiflori Caulis, the highest frequency used drugs were parched Ziziphi Spinosae Semen, Ostreae Concha, Ossis Mastodi Fossilia, Salviae Miltiorrhizae Radix Et Rhizoma, Paeoniae Rubra Radix, and so on. The most frequent drug combinations were "Polygoni Multiflori Caulis-parched Ziziphi Spinosae Semen", "Ostreae Concha-Polygoni Multiflori Caulis", and "Polygoni Multiflori Caulis-Ossis Mastodi Fossilia". The drug association rules of confidence coefficient 1 were "Ostreae Concha-->Polygoni Multiflori Caulis", "Poria-->Polygoni Multiflori Caulis", "parched Ziziphi Spinosae Semen-->Polygoni Multiflori Caulis", and "Paeoniae Alba Radix-->Polygoni Multiflori Caulis". The core drug combinations in the treatment of insomnia were Ossis Mastodi Fossilia, Polygoni Multiflori Caulis, Salviae Miltiorrhizae Radix et Rhizoma, Ostreae Concha, Polygalae Radix, Margaritifera Concha, Poria, and parched Ziziphi Spinosae Semen. And the core drug combinations in the treatment of obstruction of Qi in chest were Salviae Miltiorrhizae Radix Et Rhizoma, Polygoni Multiflori Caulis, parched Ziziphi Spinosae Semen, Trichosanthis Fructus, Allii Macrostemonis Bulbus, and Paeoniae Rubra Radix.
Data Mining ; methods ; Drug Combinations ; Drugs, Chinese Herbal ; chemistry ; pharmacology ; Humans ; Medicine, Chinese Traditional ; methods ; Plant Stems ; chemistry ; Polygonaceae ; chemistry ; Prescriptions

Adenocarcinoma ; blood supply ; metabolism ; mortality ; secondary ; Adult ; Aged ; Female ; Humans ; Lymphatic Metastasis ; Male ; Microcirculation ; Middle Aged ; Neovascularization, Pathologic ; metabolism ; pathology ; Prognosis ; RNA, Messenger ; biosynthesis ; genetics ; Receptors, Cell Surface ; biosynthesis ; genetics ; Receptors, Urokinase Plasminogen Activator ; Stomach Neoplasms ; blood supply ; metabolism ; mortality ; pathology ; Survival Rate ; Vascular Endothelial Growth Factor A ; metabolism

OBJECTIVETo observe the efficacy and safety of Qizhi Jiangtang Capsule (QJC) in treating stage 3b diabetic kidney disease (DKD) patients with macroalbuminuria.

METHODSPatients who conformed to the diagnostic criteria of stage 3b DKD were randomly assigned to two groups according to random digital table, the experiment group and the control group, 84 in each group. All patients received a two-week elution period, and then were treated with basic Western therapy. Patients in the experiment group took QJC, 5 pills per time, 3 times a day, while those in the control group took Valsartan Capsule 160 mg each time, once daily. The observation period of follow-ups was limited within 6 months, and the time points were set as the baseline, 1st month, 3rd month, and 6th month. Systolic blood pressure (SBP), diastolic blood pressure (DBS), 24 h urine protein quantitative (24 h UPQ), plasma albumin (ALB), and serum creatinine (SCr) were detected and recorded, and estimated glomerular filtration rate (eGFR) was calculated. The occurrence of hypoglycemic reaction, coagulation disorder, gastrointestinal tract reaction, allergy, hyperkalemia, doubling of creatinine, and overall adverse events were observed and recorded at same time.

RESULTSFinally 81 patients in the experiment group and 80 patients in the control group were effectively included. Compared with the baseline level, SBP and DBS obviously decreased in the control group at month 1 of treatment (P < 0.05), and more significantly decreased at month 6 of treatment (P < 0.01). SBP at month 1, 3, and 6 of follow-ups; DBS at month 6 of follow-ups was lower in the control group than in the experiment group (P < 0.05). At month 1, 3, and 6 of follow-ups, 24 h UPQ of the experiment group was significantly lower than the baseline level (P < 0.01). It was also significantly lower than the level of the control group at the same time point (P < 0.05). There was no significant difference in 24 h UPQ at month 1, 3, and 6 of follow-ups between the control group and the baseline level (P > 0.05). ALB of the experiment group showed an increasing trend. It was significantly higher than the baseline level at month 6 (P < 0.05), which was also higher than that of the control group at same period (P < 0.05). There was no significant difference in the ALB level in the control group (P > 0.05). SCr of two groups showed an increasing trend. SCr of the experiment group was significantly higher at month 1, 3, and 6 follow-ups than the baseline level (P < 0.05). But the increment of SCr was higher in the control group than in the experimental group, and obviously higher than the baseline levels (P < 0.05). eGFR of both groups showed a decreasing trend. The decrement was higher in the control group than in the experimental group (P < 0.05). The proportion of progression of renal functions at month 1, 3, and 6 of follow-ups in the experimental group was 0.0% (0 case), 9.55% (8 cases), and 21.4% (18 cases), while they were 8.3% (7 cases), 21.4% (18 cases), and 40.5% (34 cases) in the control group. There was no statistical difference in the proportion of progression of renal functions between the two groups at month 3 and 6 of follow-ups (P < 0.05). There was no statistical difference in the incidence of adverse reactions between two groups (P > 0.05).

CONCLUSIONQJC could effectively reduce urinary protein of patients with stage 3b DKD, and delay the progression of renal functions.

Adult ; Albumins ; analysis ; Albuminuria ; drug therapy ; Blood Pressure ; drug effects ; Creatinine ; blood ; Diabetic Nephropathies ; drug therapy ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Glomerular Filtration Rate ; Humans ; Male ; Middle Aged ; Tetrazoles ; therapeutic use ; Treatment Outcome ; Valine ; analogs & derivatives ; therapeutic use ; Valsartan

BACKGROUND: It is pointed in some experiment that acidic peptide improves learning and memory of model rat with Alzheimer disease (AD) by inhibiting the synthesis of toxic compounds of nitric oxide (NO).OBJECTIVE: Animal model with Alzheimer disease was established to observe the changes in the levels of NO, nitric oxide synthase (NOS) and acetylcholinesterase (AChE) treated with acidic peptide of various dose concentration.DESIGN: Randomized control and single experiment.SETTING: Teaching-Research Room of Biochemistry and Molecular Biology of Basic Medical College of Zhengzhou University.MATERIALS: The experiment was performed in 2nd Research Room and Experimental Animal Room of Teaching-Research Room of Biochemistry and Molecular Biology of Basic Medical College of Zhengzhou University.Totally 100 SD male rats were selected and some of them were excluded due to retarded response in step down test. Totally 84 rats were included in the experiment and randomized into 7 groups, named normal control,model group, physiological saline group (PS group), Piracetam group, acidic peptide groups of 15, 30 and 60 mg/kg, 12 rats in each group. Acidic peptide was a new small molecular peptide separated from bovine brain and is tripeptide composed of three glutamic acids.METHODS: Except normal control, in the rest groups, after 1 week routine breeding, cerebral stereotactic microinjection was used to inject 5 μg ibotenic acid in hippocampus of rats to destroy bilateral Meynert's nucleus basalis to establish AD model. In normal control and model group, no medication was applied. In PS group, physiological saline was used for gastric perfusion. In piracetam group, piracetam of 0.3 g/kg was used for gastric perfusion and in acidic peptide groupsof 15, 30 and 60 mg/kg,acidic peptide of 15, 30 and 60 mg/kg was applied for gastric perfusion successively, continuously for 20 days, once per day, 2 mL/time. On the expiration of gastric perfusion, the rats were sacrificed after anesthetized and the brain was collected on ice plate to prepare tissue homogenate. After centrifugated at 1 000 r/minute, 4℃ for 10 minutes, the supernatant was collected to assay the levels of NO, NOS and AChE with NO, NOS and AChE kits successively.MAIN OUTCOME MEASURES: Levels of NO, NOS and AChE in brain of rat in each groupRESULTS: Totally 84 rats were employed in the experiment and all entered result analysis. Comparison of levels of NO, NOS and AChE in rat brain of each group: compared with model group, NO levels in acidic peptide groups of 15, 30 and 60 mg/kg were reduced remarkably[(1.95±0.20), (1.39±0.10), (1.25±0.07), (1.00±0.04) mmoL/kg, P ＜ 0.05],NOS levels were reduced remarkably [(4.53±0.18), (3.39±0.09), (3.10±0.06),(2.97±0.06) μmol/kg, P ＜ 0.05] and AChE did not change remarkably[(0.67±0.12), (0.71±0.11), (0.72±0.08), (0.72±0.07) mmol/L, P ＞ 0.05].CONCLUSION: Acidic peptide reduces significantly the synthesis of NO and NOS in brain of AD rat, but it dose not affect AChE activity remarkably. It is suggested that acidic peptide improves learning and memory of rat with Alzheimer disease probably by inhibiting the synthesis of toxic compound of NO or its toxicity.

ObjectiveTo assess the current situation of postgraduates knowledge about medical research design and optimize the curriculum setting of research design.MethodsAn investigation was carried out in the postgraduates of 2011 using questionnaires in a medical university..The questionnaire ineluded basic information of participants and cognition of basic methods of research design.ResultsA total of 473 postgraduates participated in the investigation.Among them,311 systematically learned medical statistics before enrollment,and 275 ( 58.14％ ) once participated in scientific researches.Most of them ( ＞80％ ) knew about the 10 basic methods of research design listed in the questionnaire,but only a few of them were familiar with them,and some even didn't know about the methods.ConclusionWe should pay attention to the culture of scientific research thought in statistical design,strengthen the practice of research design teaching,and the curriculum of research design should be led into undergraduate course.