Objective: To investigate the relationship between the Smad4-independent pathway of TGF-?1 and drug-resistance of pancreatic cancer. Methods: The sensitivities of Smad4 homozygous-deleted pancreatic cancer cell line BxPC3 to different kinds of anti-cancer drugs (5-Fu, Gemzar, Oxaliplatin, Cisplatin, CPT-11 and Epirubicin) were observed by MTT assay before and after they were transfected with full-length cDNA of TGF-?1 or treated with TGF-?1 (5 and 10 ng/ml) solution. Western blot was used to detect p170 protein expression after stimulation with different concentrations of TGF-?1. Results: Cisplatin had the most powerful killing effect on BxPC3 cells, followed by Oxaliplatin, 5-Fu and CPT-11 with moderate effect and Gemzar and Epirubicin with the least effect. Cells transfected with full-length cDNA of TGF-?1 or treated with TGF-?1 solution became less sensitive to Cisplatin. Western blot revealed upregulation of p170 expression by TGF-?1. Conclusion: The Smad4-independent pathway of TGF-?1 can increase the drug resistance of pancreatic cancer cells through upregulating expression of p170.

Objective:To investigate the expression of PKC? and TGF-? proteins in exocrine pancreatic carcinoma and their relationship. Methods: Forty-two specimens of pancreatic carcinoma and their adjacent tissues were examined for PKC? and TGF-? expression by tissue microarray technique and immunohistochemistry. Results: The expressions of TGF-?1 in the pancreatic carcinoma tissues and their adjacent tissue were 80. 9%(34/42) and 19. 1%(8/42), respectively(P

Objective To explore and build a real, objective, comprehensive clinical nursing individual performance indicators architecture model,and check the rationality and validity for prize distribution by clinical application. Methods The methods included that discuss new ideas of nursing performance management by multi- disciplinary experts,developed clinical personal nursing staff performance evaluation program,worded out indicators and methods for the clinical assessment of individual nurses and nurse managers respectively,then applied research in the pilot departments and hospital step by step. Results A personal performance evaluation framework model was constructed, which include clinical nurses and nursing managers. Experimental results show that the nursing staff in this regard performance program have a high degree of recognition, 98.82% (1 741/1 762) nursing staff understanding of the purpose and significance, 97.15%(1 712/1 762) nurses think the performance model structure is reasonable. After the implementation of the performance program, the outstanding rate of personal performance appraisal of nurses was 93% (1 639/1 762). Conclusions The application of scientific performance appraisal programs can play a positive role in helping improve the quality of clinical care, and promote the stable development of the care team.

Objective To study the chemical constituents of Epimedium brevicornum.Methods Compounds were isolated with various chromatographic techniques,their structures were elucidated by physicochemical methods and spectral analysis.Results Ten compounds were obtained and identified as p-nitroethylphenol(Ⅰ),salidroside(Ⅱ),5,7,4'-trihydroxy-8,3'-diprenylflavone(Ⅲ),kaempferol-3-O-?-L-dirhamnoside(Ⅳ),baohuoside-Ⅰ(Ⅴ),sagittatoside B(Ⅵ),2″-O-rhamnosylicariside Ⅱ(Ⅶ),7,3',4',5'-tetrahydroxyflavanol(Ⅷ),desmethylicaritin(Ⅸ),and 1-O-?-glucopyransosyl-1,4-dihydroxy-2-(3'-hydroxy-3'-methylbutyl)benzene(Ⅹ).Conclusion Compounds Ⅰ,Ⅱ,Ⅳ,and Ⅹ are isolated and identified from the plants of Epimedium L.for the first time and compound Ⅵ is isolated from the title plant for the first time.

Objective:To observe the clinical curative effect of integrated traditional Chinese and western medicine in the treat-ment of patients with ocular herpes zoster. Methods:Seventy patients with ocular herpes zoster in our hospital were selected during De-cember 2011 to December 2013. According to random number table,the patients were divided into two groups. The patients in the con-trol group were treated with ganciclovir 5. 0 mg·kg-1 ·h-1 , ivd, qd and ganciclovir ophthalmic gel, qid. The patients in the observa-tion group were treated with Banlangen granules and acupuncture additionally. The clinical efficacy, the time of blistering, pain and crusting and adverse reactions in the two groups were observed and compared. Results:After the treatment, the effective rate of the ob-servation group was 94. 29% , while that of the control group was 77. 14% (P<0. 05). The time of blistering, pain and crusting in the observation group was significantly shorter than that in the control group (P<0. 05). The incidence of adverse reactions of the ob-servation group was 2. 86%, while that of the control group was 11. 43%(P>0. 05). Conclusion:The clinical efficacy of integrated traditional Chinese and western medicine in the treatment of ocular herpes zoster is obviously better than that of western medicine treat-ment alone with fewer adverse reactions and shorter time of blistering, pain and crusting.

Objective To investigate the values and characteristics of 75 g oral glucose tolerance test (OGTT) in pregnant women.Methods A total of 6 103 singleton pregnant women aged (30.4±3.8) years (18-49 years) who delivered in Peking University First Hospital between May 1,2011 and December 31,2012 underwent the 75 g OGTT at gestational age of 24-28 weeks.They were divided into five groups based on maternal age:＜25 years (n=222,3.6％),25-years (n=2 485,40.7％),30-years (n=2 573,42.2％),35-years (n=683,11.2％),and ≥ 40 years (n=140,2.3％).The normal values of the fasting,1 h and 2 h blood glucose were lower than 5.1,10.0 and 8.5 mmol/L.Gestational diabetes mellitus (GDM) was diagnosed when blood glucose of any point was higher than or equal to normal value.Comparison between groups was tested by analysis of variance and LSD test.Logistic regression was used to calculate the risk for GDM in different age groups.Results (1) The fasting,1 h and 2 h blood glucose levels were in Gaussian distribution.The （-x）+2s were 5.51,11.12 and 9.49 mmol/L.The 97.5 percentile were 5.63,11.32 and 9.95 mmol/L.Fasting plasma glucose of ＜ 25,25-,30-,35-,and ≥ 40 years were (4.53±0.40),(4.60±0.40),(4.67±0.43),(4.74±0.46) and (4.82±0.49) mmol/L.The 1 h blood glucose were (6.98± 1.70),(7.55± 1.60),(7.92± 1.63),(8.30± 1.71) and (8.76± 1.86) mmol/L.The 2 h blood glucose were (6.11±1.33),(6.53±1.27),(6.89±1.33),(7.23±1.50) and (7.57±1.60) mmol/L.Therewas statistical difference in the blood glucose levels at a same time-point test among different age groups (F=29.61,60.17 and 72.29,all P＜0.01).(3) The total prevalence rate of GDM was 21.1％ (1 290/6 103) ; and the prevalence rates were 9.9％ (22/222),16.7％ (414/2 485),22.7％ (583/2 573),32.1％ (219/683) and 37.1％ (52/140) among the five age groups,respectively,with significant differences (x2=120.68,P=0.00).Compared with the group aged ＜25 years,the OR (95％CI) of the prevalence among 25-,30-,35-,and ≥40 years group were 1.82 (1.16-2.86),2.66 (1.70-4.18),4.29 (2.69-6.86) and 5.37 (3.08-9.39),respectively.Conclusions Advanced age is a risk factor for GDM.The risk of GDM increases significantly after 35 years old and pregnancy in women aged ＜ 35 years can reduce the risk of GDM.

Benzene ; poisoning ; Chronic Disease ; Humans ; Occupational Diseases ; chemically induced ; Occupational Exposure ; adverse effects

Objective To evaluate the efficacy and side effects of extensive regional field radiotherapy concurrent with chemotherapy for locally advanced esophageal cancer.Methods Of the 101 patients with locally advanced esophageal cancer patients,44 patients were treated by involved field radiotherapy alone,29 patients treated by involved field radiotherapy combined with chemotherapy,and 28 patients received extensive regional field radiotherapy combined with chemotherapy,the total dose of radiotherapy was 60 Gy.The clinical target volume (CTV) of involved field included the gross tumor volume (GTV) plus a 0.8 cm lateral margin,the tumor plus a nominal 3-5 cm cephalad and caudal margin.Extensive regional field radiotherapy was delivered in two steps:the CTV included the CTV of the involved field plus elective nodal region in the first step;in the second step,the CTV definition was same with the CTV of the involved field.Synchronous chemotherapy regimens included TP and NP.Results 90.1％patients completed planned radiotherapy,all patients in the concurrent chemotherapy groups completed at least one cycle of chemotherapy.The follow-up rate was 99％.Twenty-four and 42 patients completed followed-up more than 24 months in the radiotherapy alone and concurrent chemoradiotherapy group,respectively.The median survival time of the involved field radiotherapy group,involved field chemoradiotherapy group and extensive regional field chemoradiotherapy group was 13,21 and 19 months,respectively;the 2-year overall survival (OS) rate was 15％,48％ and 46％,respectively for the three groups.The 2-year OS rate was improved significantly in the chemoradiotherapy group (x2 =6.83,P =0.033).Compared with radiotherapy alone group,the incidence of grade three or four bone marrow suppression was higher in the concurrent chemoradiotherapy group (53％: 0 ％,x2 =32.94,P =0.000),the remaining adverse events (acute radiation pneumonitis,acute radiation esophagitis,esophageal fibrosis,late radiation lung injury) had no significant intergroup differences (x2 =5.56,6.70,2.39,0.42,P =0.235,0.349,0.881,0.981).Conclusions Compared with radiotherapy alone,concurrent chemoradiotherapy can improve the survival rate for locally advanced esophageal cancer.The side effects of the extensive regional field radiotherapy combined with chemotherapy is well tolerated.But the efficacy of the extensive regional field radiotherapy combined with chemotherapy needs further research.

Objective To investigate the occurrence, prevention and management of surgical complication of contralateral C7 nerve root transfer through the prespinal route to repair the brachial plexus nerve root avulsion injury. Methods From Feb. 2002 to Aug. 2009, 425 patients were performed the contralateral C7 nerve root transfer through the prespinal route with this procedure. There were 379 males and 46 females,with the average age of 21 years (range, 3 months to 56 years). The contralateral C7 nerve root was sectioned at the distal of the middle trunk in 15 cases, at the distal of the anterior and posterior division in 410 patients. The surgical complications related to the health C7 nerve root section and the make of tunnel through the prespinal route and others were analyzed retrospectively. Results The incidence rate of complication was 5.2%(22/425). The surgical complications related to the make of prespinal route including 2 cases had the severe bleeding during the operation because of vertebral artery injury; transitory laryrecurrent nerve palsy occurred in 5 cases, the pain and numbness occurred on the donor upper limber in 4 cases when the patients swallowed. The complications related to the section of contralateral C7 nerve root including the extension of finger and thumb was dysfunction in 5 patients after the operation, 3 cases had the severely pain on the health upper limber, Horner's sign occurred on donor side in 2 children suffered birth palsy, and C6 nerve root was mistaken sectioned as C7 in 1 case. Other serious perioperative complication including the thromboses of the cerebral trunk occurred in 1 case 42 hours postoperative and died in hospital 38 days after the operation. Conclusion The procedure of contralateral C7 nerve root transfer through the prespinal route is safe. The effective method to prevent this complication occurrence is to expose the origin segment of vertebral artery when making prespinal route.

Objective To observe therapeutic effects of HuGanJieXian decoction on rats hepatic fibrosis induced by tetrachloride. Methods Rat models of hepatic fibrosis were constructed by intraperitoneal injection of tetrachloride.HuGanJieXian decoction composed of low, middle, and high dose curcumin were given to these rats respectively at the same time. Sho-saiko-to compound treatment group and Fufangbiejiarangan Tablets treatment group were made as positive control groups. After twelve weeks, all rats were executed. Serum samples were kept for measuring serum levels of PC-Ⅲ, LN, and HA. Left livers were extirpated for pathologic examination including H.E and Masson stainings. Grade of hepatic fibrosis were evaluated according to SSS system. The levels of superoxide dismutase (SOD) and malondialdehyde (MDA) of supematant centrifugated from hepatic tissue homogenate were detected. Results Serum levels of PC-Ⅲ, LN, and HA were depressed obviously in decoction groups compared with those of fibrotic group (P<0.05) , especially in the low-dose curcumin group.HuGanJieXian Decoction could increase the level of SOD and decrease the level of MDA (P<0.05) , especially in the low-dose curcumin group. Staining of H. E and Masson showed that degrees of hepatic fibrosis in decoction groups were improved obviously compared with that of the fibrotic group. Conclusion HuGanJieXian Decoction can improve rat hepatic fibrosis, the mechanism of this effect may be associated with protecting hepatic cell membrane and anti- peroxidative damage.