Pancreatic neuroendocrine neoplasms (pNENs) are clinically rare,however,it shows an in creasing trend recent years.Surgical management,such as radical resection or debulking,plays an important role in this field.Different procedures can be applied to tumors with different types,locations,and developing stages.The optimal clinical management of pNENs involves a multidisciplinary approach in order to improve prognosis.

Objective To investigate the inhibitory effects of oridonin combined with gemcitabine on pancreatic cancer SW1990 cells in vitro, and the potential mechanisms thereof. Methods The pancreatic cancer SW1990 cells were treated with vehicle alone and various concentrations (10,20,40,80 and160μmol/L) of oridonin, followed by 24, 48 and 72 h cell culture. Effects of oridonin on cell proliferation were determined by using a CCK-8 kit. SW1990 cells were treated with oridonin (40μmol/L) and gemcitabine (20μmol/L) alone or together for 48 h, and the untreated cells were used as the con-trol. The cell survival rate was detected by CCK-8 assay. Apoptosis induction was assessed by using Annexin V-FITC kit. Semi-quantitative RT-PCR was used to examine the changes of NF-κB mRNA and XIAP mRNA expressions. Results Oridonin inhibited the growth of pancreatic cancer SW1990 cells in a dose-and time-dependent manner. Compared with the other groups, the cell survival rate was significantly lower in the combination group (P<0.05). Oridonin combined with gemcitabine induced a higher percentage of apoptosis in pancreatic cancer cells than that of oridonin or gemcitabine alone (P<0.05). Moreover, the expressions of NF-κB and XIAP mRNA in pancreatic carcinoma cells were obviously down-regu-lated in combination group (P<0.05). Conclusion Oridonin can enhance the antitumor effect of gemcitabine on pancreatic cancer in vitro, which may be related to through the down-regulation of NF-κB and its downstream of XIAP, and then induc-ing cell apoptosis in pancreatic cancer.

Objective To observe the effect of electroacupuncture of Siguan on contents of hippocampal monoamine neurotransmitter NE, DA and 5-HT in post-stroke depression rats, and throught it to probe the possible mechanism of anti-depressive.Methods 60 rats were divided into five groups randomly, as the normal group, MCAO group, PSD group, Siguan group, and fluoxetine group. Except the normal group, the rats of other groups were used to establish left side of the MCAO models by modified Longa filament method. PSD model was prepared by living alone in combination with mild stimulation by chronic unpredictable after stroke model success 7 days. The Siguan group was received electroacupuncture at Siguan point, and the fluoxetine group was gastrically perfused with fluoxetine, and all rats were received sugar consumption experiment in different period of treatment. After continuous treatment for 21 days, contents of NE, DA and 5-HT in hippocampal tissue were measured with RP-HPLC-fluorescent method. Results At the seventh day, compared with PSD group, the ratio of sugar water consumption(51.09%± 3.68%vs. 38.97%± 4.07%)has a significant increase in the Siguan group(P<0.01), while no significant changes in the fluoxetine group. At the fourteenth day, the ratio of sugar water consumption(68.25%± 4.69%vs. 39.64%± 4.49%)continued to rise in the Siguan group, the fluoxetine group also had significantly increased compared with the PSD group, the two groups were significantly higher than those in the PSD group (P<0.01), but the Siguan group was higher than that of the fluoxetine group(P<0.01).At the twenty-first day, the ratio of sugar water consumption (41.56%± 2.12%vs. 41.56%± 2.12%)increased further in the Siguan group and the fluoxetine group, which was significantly higher than those in the PSD group (P<0.01), but the Siguan group and fluoxetine group had no obvious difference(P>0.05). Compared with the PSD group,the contents of NE(244.93 ± 44.57 ng/g vs. 129.27 ± 11.68 ng/g), DA(86.80 ± 14.64 ng/g vs.44.22 ± 7.60 ng/g), 5-HT(526.31 ± 54.41 ng/g vs.221.56 ± 39.57 ng/g) in the hippocampus tissues were significantly higher than many in the Siguan group and fluoxetine group(P<0.01), but the difference between the two groups was not obvious(P>0.05). Conclusion The symptoms of PSD rats pleasure disappeared can be improved by electroacupuncture atSiguan. Its mechanism may be related with the increased contents of monoamine neurotransmitters in the hippocampus of rats.

Objective To evaluate the safety and efficacy of laparoscopic distal pancreatectomy in treatment of insulinoma.Methods Clinical data of 8 cases of insulinoma treated by laparoscopic distal pancreatectomy from Apr.2015 to Apr.2017 were retrospectively reviewed.Results Locations of the insulinoma in distal pancreas were all identified preoperatively by enhanced CT,MRI or somatostatin receptor scintigraphy (SRS).Laparoscopic distal pancreatectomy was applied to 8 cases,including combined splenectomy to 1 case.The operation time,bleeding volume,and postoperative hospital stay was (159±44) min,(125±119) ml and (5.5±1.4) days,respectively.Grade B fistula happened to one patient after surgery.The level of postoperative blood glucoses was normal in all cases.Conclusion Laparoscopic distal panreatectomy is safe,effective,and less invasive in treating insulinoma,with quick recovery and high efficacy in spleen preservation.

Objective To observe the biocompatibility of a biomimetic designing of a multi-grade compositions in repairing articular cartilage and subchondral bone in animal bodies and repair the fullthickness defects in articular cartilage with the compositions and to study the regenerated cartilage histomorphologically. Methods Biocompatibility study: Acute general toxicity test, Haemolysis test, subcutaneous implantation test and chronic toxicity test. Articular cartilage defects repaired experimental study :The models of defects in articular cartilage were made artificially in both condylus lateralis femoris of mature rabbits. Implanted with the biomimetic designing of a multi grade compositions randomly at one side as the experimental group and the other side were untreated as the control group. The rabbits were killed at 4, 6, 8and 12 weeks after operation, respectively, with 6 ones at each time, and the macroscopic, histological, ultrastroctural examinations and semi-quantity cartilage scoring employing Wakitanifa repaired cartilage value system were performed. Results Biocompatibility study: (1) The rabbits' weight in experimental group kept growing .(2) Haemolysis rate of rats to different concentrations of diffusion solution was＜5%.(3) In chronic toxic reaction, rabbits' liver and kidney function was not different compared with the control groups at 12weeks and the index before operation. Articular cartilage defects repaired experimental study: 4-8 weeks after operation, the defects in the experimental group were partly filled with hyaline cartilage. Twelve weeks after operation, the defects in the experimental group were completely filled with mature hyaline cartilage.However, fibrous tissues were seen in the control group all the time. At 4, 6, 8, and 12 weeks postoperatively, the Wakitanifa cartilage scores were (7.60±0.98), (5.69±0.58), (4.46±0.85) and (4.35±0.12), respectively,in the experimental group and (10.25±1.05), (9.04±0.96), (8.96±0.88) and (8.88±0.68), respectively, in the control group. Differences between the control group and the experimental group were significant. Conclu sion The biomimetic designing of a multi-grade compositions has good biocompatibility and may induce cartilage regeneration to repair the full-hickness defects of articular cartilage.

Objective To analyze the cause of puncturing failure in ultrasonography guided minimal-invasive percutaneous nephrolithotomy (MPCNL). Methods A retrospective analysis involved total 612 patients with upper urinary tract lithialisis treated with MPCNL from May 2005 to May 2010.382 cases were acupunctured by traditional G18 puncturing instrument (group A),and the other 230 cases were performed by the improved ARROW Raulerson blue syringe (group B).The average renal pelvis range was 24 mm vs.21 mm before operation,and largest diameter of renal calculi was 3.7 cm vs.3.8 cm (P ＞ 0.05).Success rate and time cost as well as therapeutic effect were compared between the 2 groups. Results There were 29 cases of puncturing failure in group A (totally 382 cases) while only 2 in group B (totally 230 cases).The successful rate of establishment of working channel was significantly higher in group B (P ＜ 0.05).Average time of puncture procedure was 5.1 min and 4.8 min respectively (P ＞ 0.05).There was no puncturing-related severe complication in any group.The unsuccessful cases in the group A and related causes were:5 cases for obesity,13 cases for puncture needle slipping,9 cases for channel dropout,and 2 cases for needle route dropout.However,only 2 cases failed in group B,the accurate position of calculi was at upper and lower calyx.One case was over-weighted,another was because of pathway-loss during the calculi elimination processs.And the one-off puncture successful rate of A and B group was 92.4％ vs.99.1％,and the one-off puncture successful rate was significantly higher in group B. Conclusions Overobesity of patients is an important cause of puncturing failure for sonographically MPCNL.The establishment of working-channel with ARROW Raulerson blue syringe could be feasible and the success rate was significantly higher.

BACKGROUND: CpG oligonucleotide has been shown to strengthen the function of peripheral blood mononuclear cells (PBMCs), but its effects on type 1 diabetes mellitus has been rarely reported. OBJECTIVE: To investigate the effects of CpG oligonucleotide on the expression of interferon γ (IFN-γ), interleukin (IL) -12 and IL-10 in PBMCs in patients with type 1 diabetes mellitus versus healthy controls. METHODS: PBMCs were isolated from patients with type 1 diabetes mellitus and healthy controls and then cultured in RPMI-1640 with non-stimulator (control group) and CpG oligonucleotide (CpG oligonucleotide group), respectively. The mRNA expression of IFN-γ, IL-10, and IL-12 in PBMCs was detected by reverse transcription-polymerase chain reaction. RESULTS AND CONCLUSION: mRNA expression of IFN-γ and IL-10 was significantly lower in patients with type 1 diametes mellitus than in healthy controls (P < 0.01). In the CpG oligonucleotide group, the mRNA expression of IFN-γand IL-12 was significantly higher than in the healthy control group (P < 0.01), but the mRNA expression of IL-10 was similar to that in the healthy control group (P > 0.05). These findings demonstrated that CpG oligonucleotide can promote the production of IFN-γ and IL-12 in PBMCs of type 1 diametes mellitus.

AIM: To make hyperglycemia models and observe the effects of hyperglycemia on expressive type transformation of vascular smooth muscle cell (VSMC) in rats METHODS: Using tissue culture and radioactivity analysis methods RESULTS:①Hyperglycemia group was lower than control group in NO - 2 content, nitric oxide synthase activity and cGMP content;②Hyperglycemia group was higher than control group in endothelin, insulin, total chdesterol and [ 3H]-TdR penetrated rate of VSMC CONCLUSION: It was possible that hyperglycemia reduces the expressive type of VSMC to change and promotes VSMC proliferation

OBJECTIVETo explore whether microRNA-200a (miR-200a) could be used as a novel biomarker of liver cancer using a rat model system.

METHODSDiethylnitrosamine abdominal injection was applied to induce liver cancer in the F344 rat strain (n =40); ten unmodeled rats served as controls. In addition, human subjects with normal healthy liver (n =10), liver cirrhosis (n =10), and liver cancer (n =10) were enrolled in the study. Blood samples from both rats and patients and rats' livers were collected for analysis. Real-time quantitative PCR and enzyme-linked immunosorbent assay were used respectively to measure the expressions of serum miR-200a and alpha-fetoprotein (AFP) for all rat and human subjects. In situ hybridization was used to detect the miR-200a expression in the rats' livers.

RESULTSComparison of normal rats and the liver cancer modeled rats showed that the latter had significantly lower expression of miR-200a (P less than 0.05), with decreasing expression following the progression of liver injury to cancer (liver cirrhosis rats less than early liver cancer rats less than advanced liver cancer rats); in contrast, the AFP levels were significantly higher in the liver cancer modeled rats only at the early and advanced stages of the liver cancer (P less than 0.05). These

RESULTSsuggested that miR-200a expression decreases during the developmental process of liver cancer, while AFP expression increases distinctly at the stage of tumor formation. Analysis of the human subjects' clinical samples showed that miR-200a expression was decreased in both liver cirrhosis patients and liver cancer patients (vs. normal liver subjects, P less than 0.05), while AFP showed abnormal expression only in the patients with liver cancer. Comparison of the normal rats and modeled rats using in situ hybridization showed the positive rates for miR-200a expression were 1.00% +/- 0.01% in rats with normal liver, 0.37% +/- 0.03% in rats with fibrotic liver, 0.14% +/- 0.01% in rats with cirrhotic liver, 0.05% +/- 0.00% in rats with early stage liver cancer, and 0.01% +/- 0.00% in rats with advanced stage liver cancer.

CONCLUSIONMiR-200a may play an important role in liver cancer development and may have diagnostic value for indicating early liver cancer.

Adult ; Aged ; Animals ; Case-Control Studies ; Female ; Humans ; Liver ; metabolism ; Liver Neoplasms ; blood ; metabolism ; Male ; MicroRNAs ; blood ; metabolism ; Middle Aged ; Rats ; Rats, Inbred F344 ; Young Adult ; alpha-Fetoproteins ; metabolism

Modern medical imaging techniques,such as computed tomorgraphy (CT),magnetic resonance imaging (MRI) and position emission tomorgraphy/computed tomorgraphy (PET-CT) can accurately delineate the gross target volume (GTV) of hepatocellular carcinoma (HCC).Comparison of postoperative pathological subclinical lesions,imaging and clinical parameters contributes to the precise delineation of clinical target volume (CTV).Moreover,radiotherapy-assisted techniques,such as fourdimensional computed tomography (4DCT),compression of abdomen,active breathing control and respiratory gating,can minimize the internal target volume (ITV).In addition,immobilization with vacuum cushion and body membrane can reduce the set-up error,minimize the planning target volume (PTV) and avoid or decrease the irradiation error or missing irradiation.All these approach can minimize the target volume,elevate the dose and reduce the complications during radiotherapy for HCC.In this article,the research progress on the target delineation for external beam radiotherapy in HCC patients was reviewed.