Purpose To investigate the expression of secreted frizzled-related protein 4 (SFRP4) and to evaluate its clinical significance in pancreatic ductal adenocarcinoma (PDAC).Methods RT-PCR was performed to analyze SFRP4 mRNA expression level in 30 paired PDAC lesion and matched adjacent non-tuimor tissue.Immunohistochemistry staining detection of 205 matched cases tissue microarray was conducted to explore SFRP4 protein expression pattern.The correlation between SFRP4 and clinical characteristics was also analyzed,including overall survival.Results SFRP4 expression pattern both at mRNA and protein level in PDAC lesion was higher than that in matched adjacent non-tumor tissue.At mRNA level,to found that expression of SFRP4 was elevated in 90％ (27/30) of PDAC tissues (P =0.007 2).To found that high expression of SFRP4 was detected in 56.5％ (116/205) of PDAC tissue,while only 28.8％ (59/205) in the adjacent non-tumor tissue.Moreover,no significant association was observed between SFRP4 expression and clinical characteristics.Kaplan-Meier survival analysis showed high level of SFRP4 expression was correlated with poor overall survival (x2 =3.467,P =0.024).Conclusion SFRP4 can be a novel prognostic biomarker in PDAC.

Objective To summarize the clinical features,diagnosis and surgical strategies of the acute and subacute nontraumatic spinal cord injury.Methods We analyzed retrospectively 46 cases of patients with acute and subacute nontraumatic spinal cord injury,who were admitted in the southwest hospital between January 2010 and december 2015.We summarized the clinical data and the effects of the surgical treatments.Results Among the 46 patients,There were 27 males and 19 females with mean age of 40.7 years (10-70).They were followed up for more than 3 months.Neurological function of ASIA at the initial admission included A in 9 cases,B in 6,C in 12 and D in 19.There were 5 hematoma patients (10.9％),11 neurilemmoma cases(23.9％),4 cases of acute disc herination (8.7％),Vascular Malformation 7 cases (15.2％),5 meningioma patients (10.9％),glioma 10 cases(21.7％) and enterogenous cyst 1 case(2.2％).46 patients underwent preoperative MRI examination,followed by spinal canal exploration,lesion resection and/or decompression.Operation within 8 hours,the signs and symptoms were improved in 6 cases.Operation within 8-24 hours were improvement in 2 cases,Operation after 24 hours improvement in 25 cases.Conclusion Early MR imaging and emergency spinal canal exploration and lesion resection with or without lamina decompression surgery is effective for the treatment of patients with acute and subacute nontraumatic spinal cord injury.

ObjectiveTo expose the effects of toes movement treating on the improvement of motor function of the patient s' affected lower limb.Methods36 patients with hemiplegia were divided into twe groups,22 patients for treating group in which toes treatment was applied, and 14 patients for comparative group in which no toes treatment was applied.After two months treatment, the effect was judged using Japanese Motor Function Test.Results22 patients in the treating group had gotten level 8 or higher (100%), while 7 patients in the comparative group had gotten that(50%).ConclusionToes movement treating is important in the recovery of functional movement of the hemiplegia patients.

Castleman Disease ; genetics ; pathology ; surgery ; Diagnosis, Differential ; Female ; Gene Rearrangement, B-Lymphocyte, Heavy Chain ; Humans ; Hyperplasia ; Lung ; pathology ; surgery ; Lung Diseases ; genetics ; pathology ; surgery ; Lymph Nodes ; pathology ; Middle Aged

Acupuncture Therapy ; Animals ; Animals, Newborn ; Brain ; metabolism ; Hypoxia-Ischemia, Brain ; metabolism ; therapy ; Malondialdehyde ; metabolism ; Nitric Oxide ; metabolism ; Rats ; Rats, Sprague-Dawley

Objective To evaluate the diagnostic value of intraductal ulstrasonography(IDUS)in non-opaque bile duct stones.Methods Between January 2009 and August 2010 in the Department of Gastroenterology at Shanghai 10th People's Hospital,a total of 183 patients(male:102 cases,mean age 69 years； female:81 cases,mean age 71 years)were enrolled,who were suspected of bile duct stones or stenosis which could not be diagnosed by abdominal CT,MRI,and abdominal B-mode ultrasound.All the patients underwent endoscopic retrograde cholangiopancreatography(ERCP)first,and then patients with non-opaque bile duct stones followed by IDUS.Results A total of 134 cases (73.2％)of bile duct stones were diagnosed by ERCP,49 cases(26.8％)were negative.And then the 49 patients underwent IDUS,of whom 24 patients with sand-like stones,11 patients with lowdensity stones,6 patients with ampullary cancer,2 patients with pancreatic cancer,6 patients with sclerosing cholangitis.The diagnostic accuracy of IDUS in the position and quality of bile duct stones was 100％,higher than that of ERCP,which was 80％.After ERCP,pancreatitis occurred in 3 patients and improved after conservative treatment,there was no complications like perforation and bleeding.Conclusion The diagnostic accuracy of IDUS in the position and quality of bile duct stones is high,which can make up for the misdiagnosis by ERCP without increasing the complications.IDUS can provide reliable basis for the diagnosis of clinical bile duct stones.

ObjectiveTo investigate the effect of clinical pathway teaching methord in nursing practice teaching. Methods80 junior college nursing students were randomly divided into control and experimental groups. Traditional clinical teaching method was given to control group, while the clinical pathway teaching method was given to observation group. Scores of comprehensive quality after departmental rotation and satisfaction rates of nursing students to teaching method in these two groups were evaluated. ResultsThe experimental group was significantly better than the control group ( P＜0.05 ), and the difference was statistically significant. ConclusionThe clinical pathway can significantly improve the quality of nursing practice teaching.

Objective To explore the construct validity of the Chinese version of Kinesthetic and Visual Imagery Questionnaire (KVIQ)-20 and KVIQ-10 in stroke patients and normal people. Methods From October, 2012, to March, 2014, 60 stroke patients and 60 nor-mal people with matched gender and age participated in this study. They were assessed with the Chinese version of KVIQ-20 and KVIQ-10. The construct validity was investigated with factor analysis. Results Two factors were extracted from KVIQ-20 for stroke patients after vari-max rotation, that accounted for 62.4%of the variance, as well as KVIQ-10 with 67.6%of the variance. Two factors were extracted from KVIQ-20 for normal people with 76.1%of the variance, as well as the KVIQ-10 with 69.6%of the variance. The factors could be named as visual imagery and kinesthetic imagery. Conclusion The Chinese version of KVIQ-20 and KVIQ-10 has good construct validity for assess-ing motor imagery from the dimensions of visual imagery and kinesthetic imagery, both in patients with stroke and normal people.

Objective To evaluate the pancreaticojejunostomy procedures selection strategy after pancreaticoduodenectomy.Methods The clinical data of 305 cases who received pancreaticoduodenetomy at Shanghai Renji Hospital from Jan 2010 to Jan 2013 were retrospectively analyzed.For patients with pancreatic duct diameter≥3 mm,duct-to-mucosa pancreaticojejunostomy was applied(120 cases).For duct diameter ＜ 3 mm,modified Child pancreaticojejunostomy was applied to 80 cases when pancreatic stump was large,or binding pancreaticojejunostomy procedures was applied to 105 cases while pancreatic stump was small.Results The diameter of the pancreatic stump in modified Child group was significantly larger than that in the binding group (F =5.78,P ＜ 0.05).The overall incidence of pancreatic fistula was 11.1％ (34/305).There were no significant differences in the incidences of pancreatic fistula,peritoneal bleeding,abdominal infection,digestive dysfunction rate,the mean duration of hospital and the death cases among the three groups (x2 =1.51,2.78,1.16,3.75,1.94,F=2.13,P＞0.05).Conclusions Three different pancreaticojejunostomies based on the size of pancreatic duct and pancreatic stump are equally safe and effective as a reconstructive method after pancreaticoduodenectomy.

Objective High mobility group box-1 protein ( HMGB1) plays an essential role in regulating energy metabolism of tumor cells via affecting mitochondrial autophagy .The aim of this study was to explore the effect of HMGB 1 on mitochondrial biogene-sis and cell energy metabolism in anoxia environment . Methods HepG2 cells were divided into normoxia control group ( cells were cultured in a culture box containing 5%CO2) , hypoxia control group ( cells were cultured in a culture box containing 1%O2+5%CO2+94%N2 ) , hypoxia HMGB1 siRNA group ( cells were cultured in a culture box containing 1% O2+5% CO2+94% N2 after transfected with HMGB1 siRNA) and hypoxia NC siRNA group ( cells were cultured in a culture box containing 1%O2+5%CO2+94%N2 after trans-fected with negative control siRNA ) .MTS assay was carried out to measure cell proliferation rate .The alterations of mitochondrial bio-genesis associated proteins were detected by RT-PCR and western blot.Mitochondrial density and morphology were determined by transmission electron microscopy (TEM).The ATP content in whole cell extracts was determined with a colorimetric ATP detection kit . Results Compared with the hypoxia control and hypoxia NC siR-NA group, the proliferationof hypoxia HMGB1 siRNA group was significantly inhibited, especially in 48 h and 72 h(P<0.05).Com-pared with hypoxia control group and hypoxia NC siRNA group , the expression of PGC 1α, NRF1and TFAM in hypoxia HMGB1 siRNA group were decreased significantly ( P<0.05) .Western blot results showed that , compared with normoxia control group , the expressions of PGC1α(0.494±0.210 vs 0.090±0.020), NRF1(1.080±0.470 vs 0.581±0.190)and TFAM(1.585±0.340 vs 0.792±0.350) protein in hypoxia 24 h group were increased obviously ( P<0.05) .Compared with hypoxia control group and hypoxia NC siRNA group , the expres-sions of PGC 1α, NRF1 and TFAM protein in hypoxia HMGB1 siRNA group were significantly decreased (P<0.05).Compared with hypoxia control group , the content of ATP in the HMGB 1 siRNA hypoxia group was significantly decreased , and hypoxia 12 h and 24 h were the most obvious ( P<0.05) . Conclusion HMGB1 could maintain cell energy metabolism by regulating mitochondrial biogene-sis so that cells could continue to proliferate in adverse anoxia environment .