Objective:To observe the therapeutic effect and toxicity of capecitabine and temozolomide in the treatment of advanced pancreatic neuroendocrine tumors. Methods:A total of 14 patients with stageⅣwell-differentiated pancreatic neuroendocrine tumor (NET G1/G2/G3) were treated with oral CAPTEM regimen, and the response rate, PFS and adverse effect after treatment were analyzed. All data analyses were performed using software SPSS17.0. Results:These 14 patients were followed-up for more than 2 years. Till Oct 2016, one patient got CR, one patient got PR, four patients got SD. Median progression-free survival was 8.9 months. The two year survival rate was 85.7%. Only one patient experienced grade 3 adverse events. Conclusion:CAPTEM is an effective and well-tolerated salvage regimen for the treatment of advanced well-differentiated pNET.

Compelling evidences have shown that various types of cancer,including hepatocellular carcinoma,are originated from stem cells.The occurrenee,chemoresistance,metastasis and recurrence of hepatocellular carcinoma are associated with a small population of cells called cancer ster cells.Although the origin of hepatocellular carcinoma and hepatic cancer stem cells remain controversial after a decade of intensive investigation,increasing scholars tend to believe that hepatocellular carcinoma and hepatic cancer stem cells can derive from malignant transformation of hepatic stem cells being exposed to various kinds of carcinogens.In this review,we mainly focus on the recent progress on malignant transformation of hepatic stem cells.

The purpose of the present study is to establish the physical fitness service network for Shanghai citizens aged 20～69 years,based on the national physical fitness monitoring system and lab testing techniques.The established physical fitness testing network now is ready for use through internet in Shanghai to promote the Shanghai as a "Healthy City".

Objective To explore the intraoperative nusing risks in elderly patients with oral cancer, and summarize the nursing points. Methods Forty elderly patients with oral cancer were treated with radical resection and partial skin flap repair surgery. The intraoperative risk factors was analyzed and the corresponding nursing measures were performed. Results All the operations were successfully manipulated, with the operation time of 3~11 h, averaged (5.5 ± 0.4)h. Five patients developed with intraoperative blood pressure, 26 had low body temperature. All the symptoms were improved and cured. Conclusion The nursing in the operation room should analyze the nursing risks in details for the elderly patients with oral cancer radical operation and take effective measures to ensure the success of operation.

As to a nitrite-oxidizing bacterium screened in our laborator y, the effect of pH, nitrogen sources, carbon sources and sodium chloride on its g rowth was studied in order to obtain high cell density. It showed that the cult ure conditions of nitrite- oxidizing bacterium were 4500mg/L sodium nitrite, 1 .5g/L sodium carbonate, 0~0.5% sodium chloride and 0~0.1% glucose at 28℃~30 ℃, 110 r/min and pH 8.0~8.5. After cultivation for 9 days, the bacteria conc entration reached 4.6?109 MPN/mL and all NO-_2-N in the medium w as converted to NO-_3-N. But the transformation of nitrogen sources was inhibited while the sodium chloride concentration exceeded 0.5% or glucose con centration exceeded 0.1%. According to the test of NO-_2-N conversion with nitrite-oxidizing bacteria in a freshwater aquaculture pond, NO-_2 -N began to decrease on the third day of the moculation of this bacterium and t he concentration dropped from 1.47mol/L to 0.49mol/L after 18 days at 25℃ and pH 8.6.

Objective To present our experience in two-stage procedure immediate breast reconstruction,which aimed to retain local tissue condition for breast reconstruction,overcome the limitation of radiotherapy on implant reconstruction,and simplify the procedure as well as improve cosmetic result.Methods The proceduces of our method were divided into two stages:in the first stage,the round-shaped expander was implanted in the subpectoral major space during the procedure of mastectomy; at the same time as expander implanted,the first saline injection was performed; with 4 to 8 weeks of inflation,the tissue expander offered adequate tissue for breast reconstruction; in the second stage,silicon gel implant,latissimus dorsi muscle flap,extended latissimus dorsi muscle flap and deep inferior epigastic perforatior flap were used for breast reconstruction after the tissue expander was exchanged.Results Thirty-four patients had undergone the two-staged breast reconstruction using tissue expansion.The average time of therapy was 5.5 months.There were no postoperative complications such as implant exposure,additional scar,and flap necrosis.The follow-up time was 6 to 18 months and the result showed excellent contour of the breast at a satisfactory rate of 97.1％.Conclusions Two-staged technique using tissue expansion in breast reconstruction is easily done and the complications are rare.The technique possesses advantages such as avoiding affection of radiotherapy on silicongel implant and elasticity of skin,retaining maximal local tissue for breast reconstruction.There is no necessary for correction of skin defect and additional scarring,thus the patch-like appearance of breast is avoided.The patients need not to experience depression post mastectomy.Two-staged procedure immediate breast reconstruction is a safe and reliable technique that is especially applicable to the patients who need radiotherapy.

Objective To investigate the changes of cerebral regional glucose metabolism and regional homogeneity (ReHo) and their relation in patients with major depression disorder (MDD) using 18F-FDG PET/CT and functional MRI (fMRI).Methods A total of 18 MDD patients (6 males,12 females,age:(33.00±7.59) years) and 17 healthy controls (6 males,11 females,age:(34.59±8.96) years) underwent 18F-FDG PET/CT and fMRI.The changes of glucose metabolism on PET and ReHo on fMRI were analyzed individually by SPM and ReHo fMRI 1.0 software.Pearson correlation analysis was used.Results Compared with the glucose metabolism of control subjects,those of MDD patients decreased in the bilateral superior,middle and inferior frontal gyri,bilateral superior and middle temporal gyri,bilateral anterior cingulate cortices,bilateral putamina and caudate nuclei and the left pallidum.Meanwhile the glucose metabolism increased in the bilateral hippocampi and the left thalamus.The ReHo in MDD patients decreased in bilateral superior and middle frontal gyri,left pallidum,bilateral putamina,left anterior cingulate cortex,whereas increased ReHo was found in right hippocampus and right thalamus.The SUV of bilateral superior,middle and inferior frontal gyri,bilateral superior and middle temporal gyri,bilateral putamina,left caudate,left pallidum,left anterior cingulate cortex,bilateral hippocampi and bilateral thalami were correlated with ReHo (r =0.51-0.83,all P＜0.05).However,no correlation was found between the SUV and ReHo in right caudate and anterior cingulate cortex (r=0.41,0.37; both P＞0.05).Conclusion There may be relative characteristic models of abnormal cerebral metabolism and cerebral dysfunction impairment in MDD patients,and the changes of cerebral regional glucose metabolism may be correlated with the changes of ReHo.

AIM: To study the antiviral effect of Fufang Yemazhui Capsule(Eupatorium lindleyanum DC) in vitro and in vivo. METHODS: The influences on life span,death rate and lung index and lung histopathology of mice infected by influenza virus were observed. RESULTS: Fufang Yemazhui Capsule obviously inhibited influenza virus in vitro.Fufang Yemazhui Capsule could remarkably prolong life span,decrease lung index and inhibite the lung consolidation. CONCLUSION: Fufang Yemazhui Capsule shows significantly antiviral effect both in vitro and in vivo.

Objective To evaluate the outcomes of small (5 ～ 10mm),arterially enhancing nodules (SAENs)shown exclusively at the hepatic arterial phase of CT in a hepatocellular carcinoma(HCC) surveillance population and to determine risk factors for developing HCC.Methods The study population included 112 patients (maleifemale =100 ∶ 12 ; aged 36 ～ 92 years) with 1 7 5 SAENs who were at risk of HCC.We evaluated serial changes during follow-up(1.4 ～41.8 months,mean 35.7 months) and analysed the initial CT findings of SAENs and the accompanying lesions to elucidate the risk factors for HCC development.Results Of 175 SAENs,101 (57.7％) disappeared and 34(19.4％) persisted.Forty SAENs(22.9％) became HCC in 33 patients(29.5％).Presence of HCC treatment history(P =0.005,risk ratio =7.429),a larger size of SAEN(P =0.003,risk ratio =1.630),presence of coexistent HCC(P =0.021,risk ratio =3.777) and absence of coexistent typical arterioportal shunts (P =0.003,risk ratio =4.459) turned out to be independently significant risk factors for future development of HCC.Conclusion SAENs are frequently seen in an HCC surveillance population and have a 22.9％ probability of becoming HCC on a per-lesion basis.Risk increased particularly when the lesion is associated with a previous or concurrent HCC,a large size or found without a coexistent typical arterioportal shunt.

Objective To compare the efficacy and safety of two kinds of homemade sirolimus-eluting stents (Firebird and Excel) for treatment of acute ST segment elevation myocardial infarction (STEMI) in patients who underwent percutaneous coronary intervention (PCI). Methods The 249 consecutive patients with STEMI who underwent PCI were randomly divided into two groups: Excel group (n=136) and Firebird group (n=113). They were followed up for 6-24 months, and coronary angiography was reviewed average 12 months later. The primary endpoints were major adverse cardiac events, including death, reinfarction and target vessel revascularization. The second endpoints included late luminal loss and restenosis 12 months after treatment. Results There were no significant differences in baseline data, coronary arterial lesion before operation, and immediateness condition after PCI between the two groups (all P＞0.05). Within follow-up, there were 2 (1.47%) death cases and 1 (0.88%) death case, 1 (0.74%) and 1 (0.88%) nonfatal myocardial infarction case, 2 (1.47%) and 2 (1.77%) target vessel revascularization cases in the two groups respectively (all P＞0.05). There were no significant differences in late luminal loss of in-stent and in-segment, the rates of in-stent restenosis, in-segment restenosis and stent thrombosis, the in-stent minimal lumen diameter and in-segment minimal lumen diameter between the two groups (all P＞0.05). Conclusions The two kinds of homemade sirolimus-eluting stents may have similar efficacy and safety in patients with STEMI treated with primary PCI.