Pancreatic ductal adenocarcinoma is the most common pancreatic neoplasm characterized by latent morbidit,poor prognosis,high mortality rate and limited choice of treatment.Quitealot studies focused on its pathogenesis,and showed molecular genetic alterations,which derived of genetic and environmental factors and played an important role in tumorigenesis.Recently,more and more findings laid particular emphasis on the changes of gene molecule and some were confirmed in vitro and in vivo.In this paper,we made a review and summarized the marked molecular changes and signalings of the four major pathways to understand their functions in PDAC.

Adolescent ; Diagnosis, Differential ; Hepatectomy ; methods ; Humans ; Liver Cirrhosis ; congenital ; diagnostic imaging ; pathology ; surgery ; Male ; Tomography, X-Ray Computed

Pancreatic neuroendocrine neoplasm (pNEN)is a kind of rare neoplasms with high heterogeneity.Surgery is the first choice to cure local resectable tumor.However,for patients with local advanced tumor or distant metastasis, medical treatment is the main option. Medical treatment mainly encompasses biotherapy, targeted therapy and chemotherapy.Clinicians should make therapeutic option for patients based on the functional status and somatostatin receptor status of the tumor,tumor grade,tumor stage and drug toxicity profile.

Objective To evaluate the efficacy of supportive psychotherapy on patients with cardiac neurosis. Method 32 patients with cardiac neurosis were treated with a comprehensive measure consists of adequate drug therapy and supportive psychotherapy. Symptom Checklist 90 (SCL - 90) was rated. Result Among the 9 factors of SCL - 90, scores of somatization, obsessive - compulsive, interpersonal relationship, depression, anxiety and phobic anxiety factors were significanly higher than that of normal controls. After treatment, the scores of somatization, depression, anxiety and phobic anxiety were statistically reduced. Patient- reported improvement efficacy was 84. 38%.Conclusion Adequate drug therapy together with supportive psychotherapy has reliable efficacy on patients with cardiac neurosis.

Objective To investigate clinical significance of positive antineutrophil cytoplasmic antibodies (ANCA) in diagnosis for vasculitis or other diseases. Methods From January 2005 to December 2008, 104 patients with positive ANCA detected by enzyme-linked immunosorbent assay (ELISA) in People's Hospital of Peking University were randomly selected and their clinical features and diagnoses were analyzed retrospectively. Results Among 104 ANCA-positive patients, 22 were diagnosed as vasculitis and 13 as ANCA-associated vasculitis, and 82 (78. 8% )were diagnosed as non-vasculitis including 40 of connective diseases such as systematic lupus erythematosus (SLE) and rheumatoid arthritis (RA) and 42 of non-connective diseases with the most common of ulcerative colitis. According to the results of ANCA tests by ELISA, ANCA-positive patients could be divided into those with proteinase 3 (PR3)-positive and myeloperoxideaso (MPO)-positive. More organs were involved in MPO-positive patients (n =48 ) than that in PR3-positive ones ( n = 49), and more frequent involvement of the kidneys and less frequent involvement of the gastrointestinal tract in MPO-positive than those in PR3-positive ones (P < 0. 01 ). As compared to those with non-vasculitis, more organs (2. 28 organs vs. 3.55 organs in average) were involved in patients with vasculitis (P <0. 01 ) and more frequent involvement of the upper or lower respiratory tracts and the kidneys in vasculitis patients ( P <0. 01 or <0. 05, respectively). Elevated leukocyte count and accelerated erythrocyte sedimentation rate (ESR) were also more common in vasculitis patients than those in non-vasculitis ones (P <0. 01 and P <0. 05, respectively). Positive ANCA combined with number of organs involved, clinical manifestations and other laboratory findings, its positive predictive value (PPV) in diagnosis for vasculitis can be improved. Conclusions Spectrum of disease in patients with positive ANCA was varied. Diagnostic value of positive ANCA in diagnosis for vasculitis can be improved if combined with comprehensive analysis of their clinical features and laboratory examinations.

Objective To observe the dynamic levels of IL-2,IL-5 and IL-6 produced by Balb/ c mice infected with DEN_2 clinical strains and to study their relation.Methods The Balb/c mouse in- feetion model was established by multiple-site subcutaneous injection with various doses of DEN_2 clini- cal strain.Mouse plasma samples collected from different experiment groups at various time after in fection were tested for IL-2,IL-5 and IL-6 levels with sandwich ELISA.Results After primary in- feeted with DEN_2 B strain,the levels of IL-2,IL-5 and IL-6 of all experimental groups were not sig- nificantly higher than the normal control group while the levels of experimental groups increased sig- nificantly after re-infection.The level of IL-2 reached to peak[average value of(101 522.44?10 465.375)pg/ml]at the 4th day after re-infection(the 20th day after the primary infection),and then the level gradually reduced.The levels of IL-5 in the Balb/c mice of the group 1 and 2 reached to peak at the 1st day after re infection(the 16th day after the primary infection),and there was signifi- cant difference between these two groups and the control group(P＜0.05).The levels of IL-6 in all experimental groups reached to peak at the 1st and the 2nd day after re-infection.The peak value of the third group is the highest comparing with the normal control group(P＜0.05).Conclusion Th2 response was predominant in the second infection phase.

CD4 Antigens ; immunology ; Humans ; Interleukin-2 Receptor alpha Subunit ; immunology ; T-Lymphocyte Subsets ; immunology ; physiology ; T-Lymphocytes, Regulatory ; physiology

Adult ; Antiretroviral Therapy, Highly Active ; Female ; HIV Infections ; drug therapy ; Humans ; Lamivudine ; administration & dosage ; Male ; Middle Aged ; Treatment Outcome ; Zidovudine ; administration & dosage

Objective To explore the effect of bone marrow stromal cells (BMSC) transferred by Nell-1 gene combined with biomaterial fibrin glue (FG) to enhance segmental bone defect healing in dog mandible. Methods Nell-1 gene vector was reconstructed in retroviral vector and then transfected BMSC. The protein of Nell-1 gene in transferred cells was determined by immunohistochemistry. Segmental defects were created surgically in the dog’s mandible. The defect was repaired with BMSC transfected by Nell-1 retroviral granules in presence of FG,untransfected BMSC in combination with FG,and FG alone. The control group was left untreated. The defect-repairing capability for each treatment were assessed by gross observation,radiography,and histology at 8th week and 16th week. Results Cells transfected by Nell-1 retroviral granules expressed abundant Nell-1 mRNA and protein in the cytoplasm. Positive results were not found in those cells that were not transferred. The use of BMSC transferred by Nell-1 retroviral granules combined with FG materials exhibited the strongest defect-repairing ability. Gross observation,radiographical and histomorphometric analyses revealed a significantly greater total area of bone formation,increased amount of the new bone in the defects than in those treated with the untransfected BMSC. Conclusion Nell-1 gene transfection may be used to promote the osteogenic ability of BMSC.

Objective To integrate the present information systems such as HIS,EMR,LIS and UIS into an integrated medical information platform.Methods The drawbacks in point-to-point mode and mid-database mode were avoided in aspects of upgrading and maintaining,and medical data exchange technology was used to research the hot spots of hospital information construction.Results The practice has proved that the new technology in the Web Services and ZeroC ICE provides a more effective model for new generation middle ware technology and digital hospital construction.Conclusion Combined with the development of SOA technologies to analyze the development and evolution of technology,the construction direction of medical data exchange are put forward from double angle of technical and business.