Pancreatic cancer is the highest degree of malignancy in the digestive system tumors,longterm prognosis is poor.Pancreatic head cancer has the highest proportion of pancreatic cancer,so its treatment is the focus of the treatment of pancreatic cancer.Radical pancreaticoduodenectomy is the hope of patients with pancreatic head cancer to be cured,but also is the most important treatment for patients with long-term survival.Choosing the appropriate surgical methods and techniques can improve the rate of radical resection of the tumor and reduce the postoperative complications.Combined with timely and appropriate adjuvant therapy,it may improve the quality of life and prolong the survival of resected pancreatic head cancer patients.

Objective To investigate the drug resistant genes and genotypes of carbapenem-resistant Klebsiella pneumoniae in Tianjin First Center Hospital. Methods A total of 52 strains of carbapenem-non-susceptible Klebsiella pneumoniae were collected from 2012 to 2015. The MICs of antimicrobial drugs were detected using agar dilution methods. Phenotypes of carbapenemases were screened using modified Hodge test. Drug resistant genes were detected by multiplex-PCR assay. Multilocus sequence typing ( MLST) was used to determine the genotypes and homology of these carbapenem-resistant Klebsiella pneumoniae strains. Results Susceptibility of antimicrobial agents indicated that all these strains with multiple drug resistance. The resistance rate to piperacillin/tazobactam, ceftriaxone, ceftazidime, cefepime, aztreonam imipenem,meropenem was 100%( 52/52 ) . The resistance rate of ST11 type to amikacin was 93. 5%( 43/46), ciprofloxacin was 97. 8%(45/46), levofloxacin was 97. 8%(45/46), compound sulfamethoxazole was 17. 4%(8/46), tigecycline was 0. The resistance rate of ST101 type to amikacin was 3/3, ciprofloxacin was 2/3, levofloxacin was 3/3, compound sulfamethoxazole was 3/3, tigecycline was 0. The resistance rate of ST709 type to amikacin was 1/1, ciprofloxacin was 1/1, levofloxacin was 1/1, compound sulfamethoxazole was 1/1, tigecycline was 0. The resistance rate of ST1393 type to amikacin was 1/1, ciprofloxacin was 1/1, levofloxacin was 1/1, compound sulfamethoxazole was 1/1, tigecycline was 0. The resistance rate of ST2068 type to amikacin was 1/1, ciprofloxacin was 1/1, levofloxacin was 1/1, compound sulfamethoxazole was 1/1, tigecycline was 0. PCR results showed that 43 isolates were blaKPC-2 positive and 5 isolates were blaOXA-48 positive, 1 isolate was blaDNM-1 positive. There were 46 strains of ST11 type. The 43 strains of Klebsiella pneumoniae producing KPC-2 type carbapenemase were all ST11. While among 5 strains of Klebsiella pneumoniae carrying OXA-48 carbapenem resistant gene, 3 strains were ST101, 1 was ST709, 1 was ST1393. One strain of Klebsiella pneumoniae harboring DNM-1 type carbapenemase was ST2068. Conclusions Drug resistant genes of carbapenem-resistant Klebsiella pneumoniae were KPC-2 dominant, OXA-48 and DNM-1 were sporadical;the genotype was mainly ST11 by MLST in the hospital. The research provided effective basic and reference for the hospital infection t control.

Objective To analyze the chromosome aberrations induced by partial radiation in human peripheral blood lymphocytes in vitro.Methods Heparinized whole blood samples were exposed to 2 Gy ~(60)Co 7-rays at 37℃ ,and then mixed with non-irradiated blood by different ratio.The slides were prepared after culturing and the unstable aberrations were analyzed.Results The chromosome aberrations had a good relationship with the ratio of irradiated blood.The chromosome aberrations in partial irradiated group were higher than that in the irradiated group.The estimated dose was 1.27 Gy when the ratio was 1 : 1 ,greater than the dose of 1 Gy.The estimated dose was 0.93 Gy when the ratio was 0.5＝1,also greater than 0.5 Gy.But when the ratio was 1:0,the radiation dose was accordant with the estimated dose.Conclusions Chromosome aberrations could be a biomarker for estimating the uneven irradiation.

ObjectiveTo study the effect of a fast-track surgery (FTS) program on the clinical outcomes in cirrhotic patients with portal hypertension.Methods42 cirrhotic patients with portal hypertension were randomly allocated into the FTS group (n=21) and the conventional therapy control group (n=21).The postoperative time to first defecation,hospital stay,hospitalization cost,and postoperative complications were compared between the two groups.ResultsCompared with the control group,the postoperative time to first defecation was significantly shorter in the FTS group (P=0.0287).Furthermore,the postoperative hospital stay was significantly shorter in the FTS group than the control group (P=0.002).Additionally,hospitalization cost was significantly lower in the FTS group than the control group (P＜0.001).The postoperative complication was also significantly different between the two groups (7.15 ％ vs 21.5 ％,P=0.001).ConclusionA FTS program contributed to better postoperative rehabilitation in cirrhotic patients with portal hypertension.

AIM The effects of GW501516, a peroxisome proliferator-activated receptor β (PPARβ) agonist, in long term diet induced obesity (DIO, high fat and maltose diet for 4 months) mice were evaluated, and the efficacy of GW501516 against insulin resistance and the involved mechanism was investigated. METHODSMice were divided into 3 groups: normal control, DIO model and DIO model+GW501516. GW501516 (10 mg·kg-1·d-1) was administered by ig once a day for 14 d. During the treatment, body weight and food intake were monitored every other day. The oral glucose tolerance test, and the serum biochemical parameters including the serum triglyceride, total cholesterol and high density lipoprotein cholesterol (HDL-C) levels were measured according to the specifications. To confirm the GW501516-mediated PPARβ activation, the mRNA levels of downstream genes related to glucose, lipid metabolism and energy expenditure was measured. RESULTS GW501516 treatment effectively improved the glucose intolerance, increased the area under the glucose curves[DIO model, (32.4±4.6) mmol·h·L-1 compared with DIO model+GW501516, (23.4±2.5) mmol·h·L-1, n=7-8, P<0.05], normalized the fasted blood glucose, and increased serum HDL-C level, besides, histological analysis revealed the decreased hepatic lipid accumulation and hypertrophy of hepatocyte in DIO mice. Moreover, RT-PCR results indicated that carnitine palmitoyltransferase 1b, uncoupling protein 2, uncoupling protein 3 and glucose transport protein 4 were all upregulated. CONCLUSIONGW501516 significantly ameliorates glucose intolerance, decreases fasted blood glucose and hepatic steatosis, which might be related to ① the enhancement of fatty acid oxidation and energy uncoupling in muscle, and ②the improvement of insulin-stimulated glucose transportation in skeletal muscle in the long term DIO mice.

Objective To explore the effect of radon and its progeny on the expression and mutations of p53 in lung tissue of mouse model. Methods Apoptosis was detected by terminal deoxynucleotidy transferase-mediated dUTP-biotin nick end labeling. The expression of p53 gene was analyzed by immunohistochemistry, Western blot and realtime-PCR. PCR-SSCP was used to detect the mutation of p53 in lung tissues. Results Compared with those in the control group, the apoptotic index were increased significantly in 30 WLM and 60 WLM groups( t = 18.11, -10.30,P ＜ 0.05 ). The p53 protein was increased significantly ( t = -11.08, P ＜ 0.05; t = - 7.00, P ＜ 0.0 ) ) in 30 WLM and 60 WLM groups. The mutation of p53 gene was not detected in lungs of radon-exposure mice. Conclusions Lung and bronchus might be the targets of radon and its progeny, and p53 gene plays an important role in the progression of radon-induced lung injury.

Objective To explore the role of γ-synuclein(SNCG) siRNA in the radiosensitivity of breast cancer T47D cells.Methods SNCG siRNA was synthesized according to the coding sequence of SNCG mRNA and then transiently transferred into T 47D cell with lipofectamine .The expression of SNCG gene and protein was detected by RT-PCR and Western-blot, respectively.Cells were divided into three groups, SNCG siRNA interference group , negative control group and blank control group , which were irradiated with different doses of 60 Coγ-rays.Cell radiosensitivity was evaluated by colony formation assay , cell proliferation was assayed by CCK-8 kit, and the protein expressions of phosphorylated-AKT and mTOR were detected by Western blot assay .Results Compared with blank control cells , the expressions of SNCG gene and protein in the SNCG siRNA transferred T 47D cells were efficiently diminished .Cell colony formation results showed that , under 4, 6, 8 Gy irradiation, the cell survival of siRNA transfection group was lower than that of control group (t=5.449, 8.882, 21.503, P<0.05).CCK-8 experiments showed that the cell proliferation abilities of siRNA group at 24, 48, 72 h after 6 Gy irradiation were lower than those of control group (t=5.603, 4.839, 6.115, P<0.05).In addition, after 6 Gy irraddaition, the AKT and mTOR phosphorylation levels in the siRNA group were more obviously reduced compared with blank groups , but the total AKT and mTOR had no changes .Conclusions Transfection of SNCG siRNA can enhance the radiosensitivity of breast cancer cells probably by inhibiting p -AKT signal pathway .

Objective The expression of agr and sigB regulation system in Staphylococcus aureus with different infection types were assessed by analyzing the characteristics of m /z value generated by MALDI-TOF-MS.Methods A total of 50 isolates with specific genotypes were collected from Tianjin First Center Hospital during Jun 2013 to Feb 2014 for retrospective study .The pattern profiles of these isolates were obtained by MALDI-TOF-MS with RUO model, and the m/z value was also analysed to evaluate the expression the agr and sigB regulation system .The phylogenetic tree based on mass spectrum peak feature was constructed using SARAMIS software .Results A total of 50 strains of Staphylococcus aureus were divided into two groups: acute infection and chronic persistent and recurrent infection .The expression of delta toxin in acute infection and in chronic infection was 99.2 ±4.1 and 60.5 ±10.1 ( t =16.83, P<0.05), respectively.The regulation of stress proteins of sigB system was enhanced in chronic persistent and recurrent infections , and the expression intensities of SAS 030, SAS049 and SA0772 were 27.1 ±14.7, 54.8 ±21.5 and 51.6 ±19.2, respectively; while in acute infections , those were 4.9 ±1.9, 12.4 ±2.8 and 15.7 ±6.9, respectively.The t values between the two groups were -6.88 (P<0.05),-8.98 (P<0.05) and -1.87 (P<0.05), respecitively.The expression of phenol-soluble modulins (PSMs) was inconsistent , and the relative strength of PSMα3 was 100%in the colony variants small strains .Conclusions Different types of the Staphylococcus aureus infections could be evaluated through the assessment of the agr and sigB regulation system .The m/z value obtained by MALDI-TOF mass spectrometry is a marker for the expression of agr and sigB regulation system .The application of this technology needs further development .

Objective To investigate the expressions of lung cancer related genes and miRNA in peripheral blood of the residents surrounding the extremely high radon hot springs in Ruoergai County,Sichuan Province. Methods Peripheral blood samples were collected from the local residents.Expressions of lung cancer related genes (p53,k-ras) and miRNA (let-7a,miR-34a/b) were detected by real-time PCR and the protein expressions of p53 and k-ras were detected by Western blot.Results The expressions of p53 and k-ras mRNA of the residents in high radon area were 0.97 and 1.33 times of the control respectively (t =0.13,-1.12,P ＞0.05),and the p53 and k-ras protein levels were 0.70 and 1.23 times of the control respectively (t =0.72,0.46,P ＞ 0.05).The let-7a of the residents in high radon area was lower (t =1.63,P ＞ 0.05 ) while the miR-34a and miR-34b were significantly higher than those of the controls (t =- 3.20,- 3.32,P ＜ 0.05).Conclusions Based on the expressions of p53 and k-ras gene and miRNA,it can be concluded that the residents surrounding the high radon hot springs received radiation damage.

Objective To investigate the influences of miR-34a on the radiosensitivity of H1299 cells.Methods CCK-8 kit was used to examine the viability of H1299 cells which were exposed to different doses (0,2,4,6 and 8 Gy) of 60Co γ-rays after transient transfection of pre-miR-34a.Apoptosis rate and cell cycle were measured with flow cytometry.The expression levels of miR-34a target genes,bcl-2,bax,CDK4,CDK6 and cyclinD1 were analyzed by real-time PCR.Results Compared to the control group of negative transfection,the cell viability in pre-miR-34a transfection group decreased significantly after irradiation at0,2,4,6,8 Gy (t=-2.39,-3.12,-4.98,-4.03,-3.06,P＜0.05) in a dose-dependent manner.After being irradiated with 6 Gy γ-rays,the apoptotic rate in pre-miR-34a transfection group was significantly increased (t =7.06,P ＜ 0.05) together with an accumulation of G0/G1 phase (t =3.94,P ＜ 0.05) and a reduction of S phase (t =6.23,P ＜ 0.05).The gene expression levels of bcl-2,CDK4 and CDK6 in pre-miR-34a transfection group were respectively decreased (t =3.39,12.88,6.21,P ＜ 0.05) of negative control.cyclinD1 was also decreased but no significance,while bax was increased to 1.94 times of negative control (t =-4.35,P ＜ 0.05) together with a decrease of bcl-2/bax.Conclusions miR-34a could promote cell apoptosis,induce G0/G1 phase accumulation,suppress cell activity,and in turn increase the radiosensitivity of H1299 cells.