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.

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.

Adult ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Medicine, Chinese Traditional ; Peripheral Vascular Diseases ; drug therapy ; Phytotherapy ; Takayasu Arteritis ; drug therapy

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.

Based on new material and technic, the design of general structure, stretcher fixture, vibration isolation, carriage baffle fixture, ergonomical parameters selection for a new kind of stretcher suspension named added equipment for transporting the wounded on the truck is carried out. The results of mechanical performance experiment, reliability experiment, road adaptability test, road comfort test, application experiment by troops indicate that the added equipment is safe, reliable, convenient for use and fairly comfortable to persons lying on it. Thus a new kind of equipment fit for the army to transport the wounded on the truck under the field condition is developed.

Objective To study the clinical value of capsule endoscopy for small bowel diseases in pediatric and adolescent patients.Methods Clinical data of 61 pediatric and adolescent patients who underwent capsule endoscopy from February 2007 to April 2014 was respectively analyzed.The positive diagnostic results and safety were observed.Results Of 61 patients,the CE procedures were completed successfully in 58 patients,and failed in 3 patients because of the gastric stasis.Forty-one positive lesions were found in small intestine,and the detection rate was 70.69％.Positive findings included angiodysplasias,Crohn' s disease,Meckel diverticula,ulcer,P-J syndrome,protrusion lesion and enteritis,etc.Finally,29 patients were confirmed (50％),3 (5.17％) were misdiagnosed and 1 (1.72％) was missed.Twenty-two patients underwent other small bowel examinations besides the capsule endoscopy.And the accuracy of capsule endoscopy was 81.82％.All capsules were successfully swallowed by the patients and evacuated within two weeks.No complications such as capsule retention or intestinal obstruction occurred.Conclusion Capsule endoscopy is a safe and well tolerated procedure with high diagnostic rate,which has a prospective clinical value in small bowel diseases in pediatric and adolescent patients.

Objective To investigate the association between single nucleotide polymorphisms (SNP)and expression levels ofα-adducin(ADD1)gene in coronary artery disease (CAD)patients.Methods Extracted DNA and RNA samples of peripher-al blood white cells from 114 CAD patients and 116 healthy individuals in Jan 2011 to Oct 2013 from the General Hospital of the PLA Rocket Force.SNPs of rs3775067 and rs1263359 mutations in the ADD1 gene were analyzed with allele-specific flu-orogenic oligonucleotide probes combining hybridization.The gene expression levels were analyzed with fluorescence labeled and capillary electrophoresis technology.Results The frequencies of the genotypes and alleles of the two SNPs in the ADD1 gene were not significantly different between the two groups (χ2=0.018~1.317,all P>0.05).The ADD1 gene expression levels of CAD group (0.226±0.284)were obviously higher than that of control group (0.153±0.144,P<0.05).The gene expression levels of TC genotype of rs3775067 were obviously higher in CAD group (0.250±0.319)than that of control group (0.154±0.156,P<0.05),but the levels of the other genotypes had no significant difference between the two groups (t=0.557~1.867,all P>0.05).Conclusion The elevated ADD1 gene expression level would be risk factor for CAD.The polymorphisms of rs3775067 and rs1263359 had no relevance with CAD susceptibility.

Objective To explore the relationship between the level of mental stimulation and the suicide attempts of rural residents in Shandong Province. Methods A 1:1 matched case?control study was designed to collect 1 200 cases from a survey of three suicide attempts in rural areas of Shandong Province. Controls were selected according to the following matched factors: age difference within 3 years, same gender, same village or neighboring village, no blood relationship, no suicide history. The basic characteristics of all subjects were collected through the questionnaire, and the level of mental stimulation of life events was measured. Multivariate conditional logistic regression model was used to analyze the relationship between the level of mental stimulation of life events and suicide attempts. Results The mean age of the case group and the control group was both (36.6±0.3) years old, and 35.8% (430/1 200) were males in each group. The low?medium level of mental stimulation of negative life events in the case group was 16.7% (200/1 200) and 61.7% (740/1 200), respectively, which was higher than that in the control group, about 2.5% (30/1 200) and 29.3% (352/1 200) (all P values<0.05), respectively. A total of 11.1% (133/1 200) of the case group had positive life events, which was lower than that of the control group [16.8% (201/1 200)] (all P values<0.05). Multivariate logistic regression model analysis showed that after the adjustment of gender, age, place of residence, education level, marital status, occupation, family income, somatic disease, mental disorders, family history of suicide, and opposite life events, the low?medium and high level of mental stimulation of negative life events were risk factors for suicide attempts, with OR (95%CI) as 5.88 (4.53-7.64) and 13.94 (8.15-23.86), respectively. Mental stimulation of positive life events was protective factor of suicide attempts, with OR (95%CI) as 0.58 (0.41-0.82). Conclusion Mental stimulation of negative and positive life events were risk and protective factors for suicide attempts.

Objective To explore the relationship between the level of mental stimulation and the suicide attempts of rural residents in Shandong Province. Methods A 1:1 matched case?control study was designed to collect 1 200 cases from a survey of three suicide attempts in rural areas of Shandong Province. Controls were selected according to the following matched factors: age difference within 3 years, same gender, same village or neighboring village, no blood relationship, no suicide history. The basic characteristics of all subjects were collected through the questionnaire, and the level of mental stimulation of life events was measured. Multivariate conditional logistic regression model was used to analyze the relationship between the level of mental stimulation of life events and suicide attempts. Results The mean age of the case group and the control group was both (36.6±0.3) years old, and 35.8% (430/1 200) were males in each group. The low?medium level of mental stimulation of negative life events in the case group was 16.7% (200/1 200) and 61.7% (740/1 200), respectively, which was higher than that in the control group, about 2.5% (30/1 200) and 29.3% (352/1 200) (all P values<0.05), respectively. A total of 11.1% (133/1 200) of the case group had positive life events, which was lower than that of the control group [16.8% (201/1 200)] (all P values<0.05). Multivariate logistic regression model analysis showed that after the adjustment of gender, age, place of residence, education level, marital status, occupation, family income, somatic disease, mental disorders, family history of suicide, and opposite life events, the low?medium and high level of mental stimulation of negative life events were risk factors for suicide attempts, with OR (95%CI) as 5.88 (4.53-7.64) and 13.94 (8.15-23.86), respectively. Mental stimulation of positive life events was protective factor of suicide attempts, with OR (95%CI) as 0.58 (0.41-0.82). Conclusion Mental stimulation of negative and positive life events were risk and protective factors for suicide attempts.

Objective To investigate the effects of baicalein (Bai) on acute lung injury (ALI) induced by intestinal ischemia/reperfusion (I/R) and its mechanism in mice.Methods Twenty-four male C57BL/6J mice were divided into three groups by random number table:namely sham group,I/R group and Bai+I/R group,with 8 mice in each group.Intestinal I/R induced lung injury model was reproduced by clamping superior mesenteric artery for 90 minutes,followed by reperfusion.Bai (100 mg/kg) was intraperitoneally injected 1 hour before ischemic challenge in the Bai+I/Rgroup.The mice in sham group underwent the similar procedure with I/R group but without vascular occlusion.All mice were sacrificed at 4 hours of reperfusion,and blood was collected from inferior vena cava and lung tissues were harvested.Lung tissues were stained with hematoxylin-eosin (HE),and histological changes were examined under light microscope for pathological score.Lung wet/dry (W/D) ratio was calculated.Lung cell apoptosis was determined by TdT-mediated dUTP nick end labeling (TUNEL) technique.Serum levels of tumor necrosis factor-α (TNF-α) and interleukin-6(IL-6) were determined by enzyme-linked immunosorbent assay (ELISA).The mRNA expressions of TNF-α and IL-6 in lung tissues were determined by real-time quantitative reverse transcription-polymerase chain reaction (RT-PCR).The protein expression levels of cytoplasmic inhibitory factor-α of nuclear factor-κB (IκB-α) and nucleus NF-κB were determined by Western Blot.Results Under light microscope,a normal lung tissue structure was shown in the sham group and no evidence of obvious lung injury was found.In the I/R group,the alveolar structure was seriously damaged.The alveolar wall was widened and there was significant interstitial edema and leukocytes infiltration.In the Bai+I/R group,pathological damage was significantly decreased as indicated by reduced lung tissue edema and leukocytes infiltration.Compared with the sham group,the lung pathological scores,W/D ratio and cellular apoptosis in the I/R group were significantly increased.Bothserum TNF-α and IL-6 contents and lung TNF-α and IL-6 mRNA expressions were significantly increased.Furthermore,I/R significantly resulted in a decrease of IκB-α in the cytoplasm and an increase of NF-κB in the nucleus.Notably,Bai treatment significantly attenuated ALI induced by intestinal I/R injury.Compared with the I/R group,the lung pathological scores and W/D ratio in the Bai+I/R group were significantly decreased (lung pathological score:4.59±1.17 vs.6.27±1.34,W/D ratio:3.79±0.28 vs.4.32±0.57),cellular apoptosis was significantly decreased [(4.85 ± 2.47)％ vs.(8.15 ± 2.33)％],both serum TNF-α and IL-6 contents and lung TNF-α and IL-6 mRNA expressions were significantly decreased [serum TNF-α (pg/L):124.18±30.49 vs.167.72 ± 38.65,IL-6 (ng/L):1.65 ± 0.69 vs.2.43 ± 0.57;lung TNF-α mRNA (2-△△Ct:4.75 ± 2.38 vs.7.69 ± 2.32,IL-6 mRNA (2-△△ Ct):16.45 ±4.39 vs.27.69 ± 6.82],additionally,Bai pretreatment significantly increased cytoplasmic IκB-α protein expression (gray value:0.47 ± 0.11 vs.0.27 ± 0.09),while decreased nuclear NF-κB protein expression (gray value:0.57 ± 0.13 vs.1.07 ± 0.14,all P ＜ 0.05).Conclusion Bai could attenuate intestinal I/R injury induced ALI via the inhibition of inflammation and apoptosis.