Pancreatic cancer frequently infiltrates the portal vein system because of the close anatomical proximity between the head of the pancreas and the portal/superior mesenteric vein confluence,and the biological character of invasion. In these cases, pancreatectomy combined with portal vein/superior mesenteric vein resection is a potential treatment, but the outcome remains controversial. So far there is no significant evidence have shown that the pancreatectomy combined with portal vein/superior mesenteric vein resection improves the prognosis of pancreatic cancer patients. In order to establish clinical practice guidelines, as well as standardize operational indication and operational method, it is necessary to conduct large-scale, multicenter, randomized and controlled prospective clinical trials,and collect long-term follow up information.

Intervening animals by pathogen of traditional Chinese medicine (TCM) to establish animal model is the most common and easiest method to determine syndrome attribute of an animal model. However, the underlying prob-lem of this modeling method is that the concept of wind, cold and dampness in the nature are confused with the syn-drome of wind-cold-dampness summarized by abnormal appearance of clinical patients. The typical animal model establishment are through the methods of wind blowing, low temperature freezing, cold water immersion, environmen-tal humidity increasing. Modern medical modeling methods, such as chemicals, organ resections, are also used in the establishment of animal models. Then, the syndrome-attribution of modeling animal is evaluated by physicochemical indexes of modern medicine which is one of modeling methods that have been used by academia in early times. But animal model established by this method is a kind of disease model which is lack of sufficient theoretical and clini-cal evidences. Therefore, the syndrome-attribution should be reappraised among this kind of animal models.

Objective To investigate the myocardial protection effect of dexmedetomidine hydrochloride during off-pump coronary artery bypass graft surgery. Methods Forty patients undergoing off-pump coronary artery bypass grafting were randomly divided into two groups:control group (group C) and dexmedetomidine group (group D).Dexmedetomidine hydrochlo-ride was given at a loading dose of 0. 5 μg?kg-1 to patients in group D, and then infused continuously at a rate of 0.5 μg?kg-1?h-1.The same amount of saline was given to patients in group C. After loading dosing,general anesthesia was per-formed with TCI technique.Trans-esophagus Doppler monitoring was conducted to monitor the blood volume and heart function, and close monitoring of fluid infusion to maintain stable circulation.Invasive blood pressure and heart rate were recorded every 5 min. Blood samples were taken for detection of cTnI,CK-MB,TNF-αand IL-6 contents at the following time points:after induction ( t0 ) ,before operation ( t1 ) ,after operation ( t2 ) ,12 h postoperation ( t3 ) and 24 h postoperation ( t4 ) . Results The blood pressure and heart rate decreased significantly at t0 and t1 in group D compared with group C,and there were no significant differ-ences in the two indexes at other time points between the two groups.Blood CK-MB,cTnI and inflammation factors TNF-α,IL-6 were much higher at t2,t3,t4 than at t0 and t1 in both groups(P<0.05).They were significantly decreased at t2,t3,t4 in group D relative to group C (P<0.05).Vessel active medicines were less given after the operation in group D (P<0.05). Conclusion Dexmedetomidine hydrochloride can mitigate the inflammation responses caused by off-pump coronary artery bypass grafting,re-duce the myocardial injury and improve the cardiac function of the patients.

Study of traditional Chinese medicine (TCM) syndromes is a key to the research of TCM modernization, and the core is the classification and diagnostic criteria of syndromes. The purpose of this article is to review the usage of classification algorithms of data mining in TCM syndrome researches, and comprehensively analyze the main features of algorithms and their applications. The appropriate classification algorithm should be chosen according to different research purposes. Rough sets and cluster analysis are suitable for exploratory research without requiring a prior knowledge. Fuzzy sets theory, neural networks and decision tree are suitable for syndrome diagnostic criteria research when the classification goal is clear, because they require a prior knowledge. Among them, fuzzy sets theory could be used in combination with other classification algorithms. Thus, some new methods such as fuzzy clustering, fuzzy rough sets or fuzzy decision tree might be more suitable for TCM algorithm classification research. It is suggested that some novel classification algorithms need to be developed to fit the condition of TCM syndrome, based on the interdisciplinary theories and technologies.

Objective To study effect of Tongbiling (TBL) on VEGF mRNA expression in RA synovlcytes cultured in vitro and explore its mechanism. Method Synovial cells from the knee joint in patient with RA were digested, divided and separately cultured after arthroscopy. Blank controls:DMEM culture containing 10% FBS in saline;Low-dose admission group of TBL:DMEM culture containing 10% FBS in 50 mg/L TBL;High-dose admission of TBL:DMEM culture containing 10% FBS in 200 mg/L TBL. RNA were distilled. Expression of VEGF mRNA were detected with RT-PCR. Result Compared with control group, expression of VEGF mRNA in low and high-dose admission groups of TBL both decreased (P

0.05) . Four weeks after culture,both transcription factor NKX-2.5 and GATA4 were expressed in the 5-azacytidine group. Additionally,?-mysion heavy chain but not ?-mysion heavy chain expression was observed. CONCLUSION:5-azacytidine induced the differentiation from bone marrow mesenchymal stem cells into myocardial-like cells;in addition,simulated biological microenvironment in both indirect contact group and myocardial cell lysate group also induced the same differentiation. The differentiated cells were cardiac possesses which were between mature cells and cardiac progenitor cells.

Objective To investigate the clinical manifestations and treatment regiment of children with juvenile dermatomyositis(JDM).Methods The clinical manifestation,changes of serum muscale enzyme,myopathic laboratory examination,treatment and prognosis of 15 children with JDM retrospectively admitted from Jan.1990 to Jan.2004 were analyzed.Results All of the children had symmetrical weakness of the proximal muscles.The most frequent features were heliotrope and Gottron's papules.Elevated muscle enzymes were noted in all cases.Electromyography revealed typical change of myopathic type and muscle biopsy was compalible with myositis in all cases.Most of patients achieved normal muscle enzymes within 1 month and had improved muscle strength with 2.5 monthes of the initiation of corticosteroid therapy.Conclusion It is very important to know the clinical features of JDM,and prompt diagnosis and treatment will result in an improved prognosis.

Objective To investigate the renal function of the patients with acute myocardial infarction (AMI) and its effect on patients' outcome.Methods The renal function of 680 patients with AMI,received the conventional therapies, such as thrmbolysis, antiplatelet and antianginal therapies were investigated. According to it, 228 patients with renal dysfunction[GFR ＜90ml · min-1 · ( 1.73m2 ) -1]were divided into observation group,while the others[GFR≥90ml · min-1 · (1.73m2) -1]were divided into control group. To analyse their clinical characteristics、the inhospital mortality、one year mortality and the heart ocurrence rate in one year. Results Compared with the patients in the control group,the patients in the observation group were older、more likely to be women、and more likely to have hypertension、diabetes mellitus、coronary heart disease. The inhospital and one year mortality were higher ( 17. 8％ vs 9.74％ ,P ＜0. 01 ;25.00％ vs 14. 44％ ,P ＜0. 01 ) and the heart ocurrence rate was higher(57. 14％ vs38. 96％ ,P ＜ 0. 01 ) in one year in the observation group than that in the control group. ConclosionThe AMI patients with renal dysfunction were more likely to have concomitant diseases, worse ill condition and outcome. Renal dysfunction was an independent risk factor for the outcome in the patients with AMI.

Objective To explore the clinical curative effect on non-small cell lung cancer (NSCLC) patients by cinobufacini injection combined with first-line chemotherapy.Methods Eighty patients with NSCLC from January 2013 to January 2015 in our hospital were selected as the research objects.Then they were divided into the observation group (n =40)and the control group (n =40)by random number tables.The patients in control group accepted docetaxel and cisplatin combination chemotherapy regimens (TP).While the observation group accepted cinobufacini injection on the basis of the control group.Then the local control, adverse reactions and prognosis of the two groups were compared.Results The local control of observation group was 77.5%,while the control group was 62.5%,the local control of observation group was obviously higher than that of the control group (χ2 =5.36,P =0.03).Leucopenia incidence of the observation group was 27.5%,the control group was 50.0%,and the incidence of the observation group was obviously lower than that of the control group (χ2 =4.27,P =0.04).There was no statistically significant difference between the two groups in diarrhea,stomachache,vomiting,tinnitus (17.5% vs.27.5%,χ2 =1.15,P =0.28;25.0% vs.45.0%,χ2 =3.52,P =0.06;5.0% vs.7.5%,χ2 =0.34,P =0.56;7.5% vs.10.0%,χ2 =0.16,P =0.69).There was statistically significant difference between the two groups in median survival time (97 d vs.45 d,HR =8.934,χ2 =9.928,P <0.05).Conclusion The cinobufacini injection combined with docetaxel can effectively reduce the incidence of myelosuppression,and improve survival and local control with high safety,and the clinical effect is remarkable and can improve the prognosis of patients.

Objective To evaluate if expression of serum retinol-binding protein 4 (RBP4) concentrations in cholesterol gallstone disease.Methods Serum RBP4 levels of 100 cholesterol gallstone disease patients (cholesterol gallstone disease group) and 147 healthy controls (healthy control group) were measured by enzyme-linked immunosorbent assay and further correlated with clinical and biochemical characteristics,including insulin resistance and renal function.The chemical composition of gallstones was determined by postoperative pathology.Results The level of RBP4 in cholesterol gallstone disease group was significantly lower than that in healthy control group [(30.57 ± 13.64 ) mg/L vs.(41.52 ± 20.25 ) mg/L](P＜ 0.01 ).The level of RBP4 was also associated with gallstone occurrence (OR =0.93,95％ CI:0.88 -0.96,P =0.004).Serum RBP4 levels of all subjects were positively correlated with total cholesterol,triglyceride,creatinine,insulin resistance and albumin ( P ＜ 0.05 or ＜ 0.01 ),and negatively correlated with aspartate aminotransferase (P ＜0.01).In multivariate analysis,cholesterol gallstone formation was significantly associated with a lower serum RBP4 level (OR =2.97,95％ CI:1.15 -7.68,P =0.025 ).Both gallstone patients and controls were subdivided into two groups according to ceatinine:≥ 88.40 μ mol/L group and ＜ 88.40 μ mol/L group.Patients with gallstones were found to have significantly lower serum RBP4 levels than controls in both subgroups (P =0.012,0.045 ).According to GFR,both gallstone patients and controls were subdivided into ≥ 90 ml/(min· 1.73 m2) group,60 - 89 ml/(min· 1.73 m2) group and ＜60 ml/ (min· 1.73 m2) group.It showed that a lower GFR was associated with greater serum RBP4 level in healthy control group.This trend was not noted in cholesterol gallstone disease group.Conclusions Serum RBP4 decreases in cholesterol gallstone disease independent of renal function.The relationship between liver function and RBP4 level in these patients deserves further investigation.