Objective To study the expression of KGF and E-cadherin in pancreatic adenocarcinoma and their clinical significance.Methods The expression of KGF and E-cadherin in 45specimens of paraffin-embeded pancreatic adenocarcinoma and 22 normal pancreas amund tumors was detected by using immunohistochemistry staining(sP)and compared with clinicopathological data.Results The increased expression of KGF in pancreatic adenocarcinoma was significantly higher than that in normal pancreas,the positive rate of KGF was 77.8%(35/45),and there was a relationship between hish KGF expression and the differentiation of carcinoma and the clinical stages(P＜0.05,0.05,respectively).The decreased expression of E-cadherin in pancreatic adenocarcinoma was lower than that in normal pancreas.The higher rate of expression was 35.6%(16/45),and a significant relationship was observed between low Ecadherin expression and the differentiation of carcinoma.the metastasis of lymph nodes and the clinical stages (P＜0.05,0.05,0.01,respectively).The expression between KGF and E-cadherin had a significant relation in pancreatic adenoeareinoma (P＜0.01).Conclusion The level of KGF and E-cadherin may be a sensitive predictor of proliferation,differentiation,invasion and metastasis of pancreatic adenocarcinoma.

Objective To examine the expression change of HIF-1α and VEGF in protein levels and the corelation of them in Q8C939 cell line under chemical hypoxia induced by CoCl2 in vitro. Methods ELISA and immunohistochemical technique were used to examine the change of VEGF and HIF-1α protein level in QBC-939 line in different concentrations (200, 150, 100, 50, 0 μmol/L) of COCl2 and different periods (6 h, 12 h, 24 h, 48 h) in hypoxia. Results CoCl2 can up-regulate the expression of HIF-1α and VEGF at least partly in a dose and time dependent pattern. ELISA demonstrated that the level of VEGF protein in different concentrations and different hypoxia periods, the result showed that the VEGF protein was in different concentration groups over contrast group (P<0.05). The VEGF protein also increased continuously with the growing of hypoxia time (P<0.05). Immunohistochemical detection of concentrations of different groups, HIF-1α, VEGF protein in the average gray compared with the control group was different(P<0.05). Different time periods of hypoxia HIF-1α, VEGF protein in the average gray, any two group comparisons have difference (P<0.05). Different concentrations, the normal control group, different time period HIF-1α and VEGF protein expression of relevance were analyzed. The correlation coefficient was 0.830, P <0.01, 0.909, P <0.01. Conclusion In QBC939 cell line of hypoxia, there is up-regulation HIF-1α and VEGF.HIF-1α regulated the expression of VEGF.

Epithelial-mesenchymal transition is not only involved in generating normal embryonic development of organs and tissues,but also helps to improve cancer cell invasion and metastasis.When epithelial-nesenchymal is stimulated,cell-cell adhesion and cell polarity are disrupted by disappearance of adhesion molecules such as Ecadherin,resulting in the acquisition of a mesenchymal phenotype.Consequently,cells which have acquired mesenchymal function activate the migratory and invasion capability in cancer.Studies have shown that part of the transcription factors,growth factors and signaling pathways involved in epithelial-nesenchymal process,and miRNA may participates in the proliferation,apoptosis,invasion and metastasis of gastric cancer cells by regulating oncogenes or tumor suppressor genes,which also relates to the regulation of epithelial-nesenchymal.This article will be reviewed in recent years specific miRNA regulatory mechanisms of gastric cancer epithelial-nesenchymal.

MicroRNA (miRNA) is an endogenous nonprotein-coding short-chain RNA,and it involves in the evolution of a variety of malignant tumors through targeted inhibition of mRNA translation or mRNA cleavage of gene expression regulation cancer or tumor suppressor genes,meanwhile,is also an important molecule in the occurrence and development processes of tumor.In the recent studies,miRNA has played an important role in the proliferation,apoptosis and invasion of cholangiocarcinoma cells,and it maybe become a new biomarker for the early diagnosis,assessment of prognosis and chemotherapy of cholangiocarcinoma.

The main functions of modern Clinical Engineer(CE) is discussed. By combining experience of clinical engineering in developed country with clinical practice in our country, the work character problem of clinical engineering was proposed. According to the reality of equipment management and operation, the function of CE is not only to ensure medical equipment to run normally but also estimate the value of equipment in before buying or abandoning, PSS and technology study. Through the efforts of CE, the main functions of equipment can be made the best, medical therapy and new method research is more efficient.

Objective To investigate the safety and feasibility of laparoscopic pancreaticoduodenectomy (LPD). Methods Clinical data of 9 patients who underwent LPD operation from September 2014 to February 2017 in the first hospital of Shanxi Medical University were analyzed retrospectively. Results 9 patients attempted LPD, while one required conversation to open procedure. Two cases underwent hand assisted laparoscopic surgery .The average operative time was (553 ± 86.1) minutes, the average amount of bleeding was (333.3 ± 304.1) ml, and the average hospitalization time after operation was (25.3 ± 8.9) d. Postoperative bowel sound recovery time was (3.5 ± 1) d. Postoperative complications included pancreatic leakage in 4 cases (A grade pancreatic leakage in 1 cases, B grade in 3 case), lymph leakage in 1 case, abdominal hemorrhage in 1 case , gastric emptying in 2 cases , and bile leakage in 1 case. All patients with postoperative complications were cured by non operative treatment. Postoperative pathological examination showed that 5 cases had duodenal papillary adenocarcinoma, 1 case had pancreatic ductal carcinoma, 2 cases had common bile duct disruption differentiation of carcinoma, and 1 case had pancreatic head retention cyst. Patients were followed up 3 to 24 months after operation. 1 case of pancreatic duct died 17 months after operation. One case of middle bile duct carcinoma 12 months after surgery had liver and retroperitoneal lymph node metastasis. The remaining 7 cases had no complications. Conclusions laparoscopic pancreaticoduodenectomy is minimally invasive, safe and feasible.

r cirrhosis. NO and ET-1 are involved corporately in the development of liver cirrhosis, but not the main factors facilitating hypoxemia of liver cirrhosis.

Objective To investigate the clinical significance of serum P-selection,TNF-α,hs-CRP,IL-1β, ICAM in patients with diabetic renal microangipathy, and the therapeutic mechanism of Simvastatin combined with aspirinon in treating renal microangipathy. Methods The serum levels of P-selection,TNF-α, hs-CRP, IL-1β, ICAM were determined by ELISA in all groups. Patients with diabetic renal microangipathy treated with simvastatin and as-pirinon. Results ① The serum levels of P-selection,TNF-α,hs-CRP,IL-1β,ICAM in DM groups were higher than those of normal controls(P<0.01). ②After treatment with simvastatin and aspirinon for 8 weeks in patients with di-abetic nephropathy,the serum levels of P-selection, TNF-α, hs-CRP, IL-1β, ICAM were all decreased significantly compared with those before treatment respectively (P<0.01). After treatment for 16 weeks the above indices re-mained decreased until treatment for 21 weeks (P<0.01). Conclusion ①The plasma levels of Poselection,TNF-α and hs-CRP, IL-1β, ICAM are correlated to the occurance and development of diabetic renal microangiopathy, becom-ing predicted factors in early stage of diabetic renal microangiopathy. ②The therapeutic mechanism of simvastatin and aspirinon in patients with diabetic nephropathy lies probably in the inhibition of these factors expression, thus di-rectly or indirectly affecting the prolffer-ation of mesangial cells and mesangial matrix.

Objective To investigate the clinical significance of serum sialic acid (SA) in the diagnosis and treatment of IgA type multiple myeloma (MM). Methods The level of serum SA in 50 healthy subjects and 70 patients with MM were determined. Results In MM group, there were 25 cases of IgA type, 51 cases of other than IgA type (40 cases of IgG type, 7 cases of light chain type MM, 4 cases of non-secreting type MM). In healthy subjects, patients with IgA, IgG, light chain, non-secreting types and other than IgA type, the serum SA levels were (570.33 ± 67.72) mg/ L, (1289.24 ± 325.42) mg/ L, (585.88 ± 159.12) mg/L, (600.77 ± 126.90) mg/L, (590.50 ± 100.86) mg/L, and (588.39 ± 150.90) mg/L. The serum SA level of IgA type patients was higher than those of healthy subjects and other types (all P<0.01), and there was no significant difference among the other groups (all P> 0.05). The serum SA level of IgA type patients had positive correlations with serum IgA, globulin, bone marrow smear myeloma cell population and ESR (r values were 0.699, 0.753, 0.504, and 0.732, all P< 0.05); the serum SA level of IgA type patients had negative correlations with serum albumin, IgG, hemoglobin and platelet (r values were -0.712, -0.505, -0.629, and -0.596, all P< 0.05). The serum SA level of IgA type patients had no correlation with leukocyte, serum creatinine, serum IgM, lactic dehydrogenase, serum calcium, C-reactive protein and β2-microglobulin (all P>0.05). The level of serum SA in IgA type patients decreased with the improvement of the condition, and increased with the severity of the disease. Conclusions In MM patients, serum SA level in IgA type is high. The serum SA is an index for reflecting the tumor load capacity, and can evaluate the therapeutic efficiency of IgA type MM patients.