Objective To investigate the influence of fast track surgery(FTS) on the concentrations of serum IL‐6 ,IL‐10 , and TNF‐αin pancreatic cancer patients ,and its clinical significance .Methods Eighty patients undergoing pancreatic cancer opera‐tion were divided into FTS nursing group and traditional nursing group .The concentrations of serum IL‐6 ,IL‐10 ,and TNF‐αin dif‐ferent times before and after operation ,and the same period between groups were measured .Results (1)The concentrations of ser‐um IL‐6 ,IL‐10 ,and TNF‐αwere no significantly difference in two groups before operation(P>0 .05);the concentrations of serum IL‐6 in the first and third postoperative day were higher than those before operation in the observation group (P<0 .05);there was no significant difference of the concentrations of serum IL‐6 between the fifth postoperative day and before operation(P>0 .05);the concentrations of serum IL‐6 after operation were higher than those before operation in the control group(P<0 .05);the concentra‐tions of serum IL‐6 in the same time after operation in the observation group were lower than those in the control group(P<0 .05);(2)The concentrations of serum IL‐10 in the first ,third and fifth postoperative day were higher than those before operation in the observation group(P<0 .05);the concentrations of serum IL‐10 in the first and third postoperative day were higher than those be‐fore operation in the control group(P<0 .05);the concentrations of serum IL‐10 in the same time after operation in the observation group were higher than those in the control group(P<0 .05);(3)The concentrations of serum TNF‐αin the first postoperative day were higher than those before operation in the observation group(P<0 .05);there was no significant difference of the concentra‐tions of serum TNF‐αbetween the third and fifth postoperative day and before operation(P>0 .05);the concentrations of serum TNF‐αin the first and third postoperative day were higher than those before operation in the control group(P<0 .05);there was no significant difference of the concentrations of serum TNF‐αbetween the fifth postoperative day and before operation in the control group(P>0 .05);the concentrations of serum TNF‐α in the first and third postoperative day in the observation were lower than those in the control group(P<0 .05) .Conclusion FTS could significantly reduce inflammatory reaction ,improve immunosuppres‐sion and helps to recover .

Aim To investigate the protective effect of compound total flavonoids on atherosclerosis in ApoE -/- knockout mice.Methods Seven-week old C57BL/6 mice considered of the normal group (n =1 5 );seven-week old ApoE -/- mice were fed with high-fat diet and were assigned randomly into 5 groups:model group,simvastatin group,the low com-pound flavonoids group,the middle compound fla-vonoids group and the high compound flavonoids group.After 1 6 weeks,mice serum and aortas were harvested.The formation of atherosclerotic plaque was analyzed by HE staining,The serum level of lipids pro-files and superoxide dismutase (SOD )were deter-rnined.The levels of IL-1 βand NF-κB in serum were detected by ELISA assay.Results Area of atheroscle-rotic lesion was significantly less in the compound fla-vones group than in model.The level of TC,TG,LDL-C,IL-1 β,NF-κB in serum of the compound flavonoids group were decreased significantly,while SOD and HDL-C increased significantly compared with the mod-el group,and the difference was significant (P <0.05).Conclusion The compound flavonoids have a good protective effect on early atherosclerosis in mice, which may be due to its alleviating effects on hyperlipi-demia and inflammation and oxidation.

Objective To explore the role of microRNA (miR)-22 and miR-1825 in the diagnosis and differential diagnosis of juvenile systemic lupus erythematous (JSLE).Methods The cases of JSLE hospitalized in Capital Institute of Pediatrics Teaching Hospital Affiliated to Peking University from June 2013 to May 2014 were selected as study group.The cases with systemic juvenile idiopathic arthritis (sJIA),nephrotic syndrome (NS),Kawasaki disease (KD),Henoch-Schonlein purpura(HSP) were selected as patients control group.The healthy children were selected as healthy control group.The expression levels of miR-22 and miR-1825 in the plasma of JSLE,sJIA,NS,KD,HSP and healthy children were detected by using real-time PCR respectively.Receiver operating characteristic curve (ROC) analysis was performed to evaluate the value of miR-22 and miR-1825 miRNA as a biomarker with the sensitivity and specificity.Three data bases,included Targetscan,PicTar and miRanda,were applied to predict the target gene.The target gene was analyzed by adopting Gene Ontology (GO) in terms of molecular function,biological process and cellular component,and by adopting Kyoto Encyclopedia of Genes and Genomes (KEGG) in terms of pathway.Results Compared with healthy children,the amount of miR-22 and miR-1825 in JSLE patients were lower,and there were significant differences(t =-3.076,-9.054,P ＜0.01,0.000 1).The levels of the miR-22 and miR-1825 miRNAs in controls of sJIA,NS,KD,HSP were significantly higher than those of JSLE (t =-4.410,-4.477,-4.494,-2.971,all P ＜ 0.000 1;t =-9.043,-6.045,-10.416,-8.712,all P ＜ 0.000 1),but there was no difference compared with healthy children(all P ＞ 0.05).The area under ROC curve(AUC) of miR-22 between JSLE and healthy children was 0.777.The AUC of miR-1825 between JSLE and healthy children was 1.000.The AUCs between JSLE and controls of sJIA,NS,KD,HSP of miR-22 were 0.731-1.000.The AUCs between JSLE and controls of sJIA,NS,KD,HSP of miR-1825 were 0.939-1.000.There was positive relation between the amount of miR-22 and complement C3 in plasma(r =0.493,P =0.027).Conclusions The amount of miR-22 and miR-1825 in the plasma of JSLE embrace the potential of distinguishing JSLE from healthy children,sJIA,NS,KD,HSP.MiR-22 has the ability to predict the activity of JSLE.

Objective To evaluate the value of 2D ultrasound and elastic strain ratio (SR) in diagnosis of thyroid nodule by fine needle aspiration (FNA).Methods 196 thyroid nodules were analyzed retrospectively with 2D ultrasound,elastography and FNA results,pathology results as the golden standard.A receiver operating characteristic (ROC) curve was used to identify the best cut-off point of SR.The Logistic regression analysis was used to evaluate the variables effectiveness on age,nodule echo,calcification and SR.Tried to discuss how to use SR before or after US-FNA in diagnosis of thyroid nodule.Results The SR of the malignant nodules group was significantly different from the benign nodules group,and the best cut-off point was 0.5 with sensitivity 91.7％,specificity 90.2 ％ and accuracy 90.8 ％.The Logistic analysis results were SR,age,echo,calcification according to the odds ratio.SR can screened nodules without puncture necessary before FNA,and increase the FNA sensitivity,specificity and accuracy after FNA.Conclusions SR has good application value in diagnosis thyroid malignant tumor.SR can reduce unnecessary FNA and make a supplementary diagnosis of FNA.

Objective To investigate the clinical effects of unilateral thyroidectomy via middle and lateral approaches in the treatment of benign thyroid tumor.Methods A total of 110 benign thyroid tumor patients underwent unilateral thyroidectomy were divided into medial approach group and lateral approach group,with 55 patients in each group according to different approaches,treated with medial approach,and lateral approach,respectively.Operation time,intraoperative blood loss,length of incision,operative drainage,postoperative hospital stay and postoperative complications rate were compared.Results The middle approach group had shorter operation time,length of incision,and postoperative hospitalization time,and less intraoperative blood loss than the lateral approach group (P ＜ 0.05),but intraoperative drainage had no significant difference (P ＞ 0.05).The middle approach group had lower incidence of complications than that in lateral approach group (P ＜ 0.05).Conclusion Compared to the lateral approach for unilateral thyroidectomy,middle incision has shorter operation time,smaller incision,less bleeding,faster postoperative recovery and less complications and has better therapeutic effect.

Objective To investigate the clinical effects of unilateral thyroidectomy via middle and lateral approaches in the treatment of benign thyroid tumor.Methods A total of 110 benign thyroid tumor patients underwent unilateral thyroidectomy were divided into medial approach group and lateral approach group,with 55 patients in each group according to different approaches,treated with medial approach,and lateral approach,respectively.Operation time,intraoperative blood loss,length of incision,operative drainage,postoperative hospital stay and postoperative complications rate were compared.Results The middle approach group had shorter operation time,length of incision,and postoperative hospitalization time,and less intraoperative blood loss than the lateral approach group (P ＜ 0.05),but intraoperative drainage had no significant difference (P ＞ 0.05).The middle approach group had lower incidence of complications than that in lateral approach group (P ＜ 0.05).Conclusion Compared to the lateral approach for unilateral thyroidectomy,middle incision has shorter operation time,smaller incision,less bleeding,faster postoperative recovery and less complications and has better therapeutic effect.

Objective To investigate the changes of CD4+ CD25+ CD127low regulatory T cells (Treg) in peripheral blood samples collected from the patients with cervical cancer and its clinical signifi -cance , and to evaluate the correlations between Treg cells and the infection of high-risk human papillomavir-us ( HR-HPV) .Methods Flow cytometry analysis was performed to measure the percentages of CD4+ CD25+ CD127low Treg cells among CD4+T cells in peripheral blood samples collected from 249 patients with cervical cancer , 30 patients with cervix intraepithelial neoplasia ( CIN) and 60 healthy subjects .The corre-lations between the levels of Treg cells and the clinicopathological features of cervical cancer were analyzed . Flow-through hybridization and gene chip technology ( HybriMax) were used to analyze the genotypes of HPV strains isolated from the 339 subjects.The correlations between Treg cells and HR-HPV infection were ana-lyzed.Results Compared with the healthy subjects , the patients with cervical cancer or CIN showed higher percentages of CD4+ CD25+ CD127low Treg cells and rates of HR-HPV infection (P<0.01).The percentages of CD4+ CD25+ CD127low Treg cells in patients with cervical cancer were significantly correlated with the sta-ges of cervical cancer , which was staged by the Federation International of Gynecology and Obstetrics (FIGO) staging system,and the degrees of differentiation (P<0.05).The percentages of CD4+ CD25+ CD127low Treg cells in the peripheral blood of patients with positive HR-HPV were significantly higher than those in patients without HR-HPV infection (P<0.01).Conclusion The CD4+ CD25+ CD127low Treg cells in peripheral blood might play an important role in the oncogenesis and development of cervical carcinoma , thus it could be used as a potential marker for the evaluation of disease progression .Moreover , the CD4+ CD25+ CD127low Treg cells were closely related to the HR-HPV infection.

Objective To evaluate the value of elastic strain ratio (SR) in ultrasound guided fine needle aspiration (US-FNA) of thyroid nodule.Methods A total of 222 thyroid nodules from 216 patients were reviewed and analyzed by Logistic regression of clinical data,2D ultrasound,and SR.The odds ratios of variables in the equation were compared to assess various variables,especially of SR in the diagnosis.The sensitivity,specificity,and accuracy of the SR method,US-FNA method,and combined method were calculated.Results Three statistically significant features finally entered the Logistic regression model,followed by SR,echo,and age according to the odds ratio.The sensitivity,specificity,and accuracy of the SR method,US-FNA method and combined method were 85.4％,82.1％,83.3％ ; 91.5％,82.1％,85.6％ ; 97.6％,94.3％,95.5％ respectively.Conclusions SR＜0.5 is the most important risk factor in differential diagnosis of thyroid malignant nodules from benign nodules.SR raises the sensitivity,specificity,and accuracy of US-FNA method and plays an important role in diagnosing thyroid nodules via US-FNA.

Objective: To test applicability of the Center for Epidemiological Studies Depression Scale (CES-D) in different age groups in urban China, and to develop age norms. Methods: In this cross-sectional study, the CES-D was administrated to 16047 community participants with average age of (37.7±21.3) years (age ranged 11～100) in 21 provinces, who were as the norming sample. Criterion validity was tested in 349 psychiatric patients with average age of (32.0±12.1) years (age ranged 16～81) in 4 cities. A subsample (199 workers, 100 col-lege students, and 30 teachers in Beijing, Dongguan, and Baotou) was drawn from the national sample to provide 8 week interval test-retest reliability. Results: The Cronbach α was 0.90 for the scale, and 0.68～0.86 for its fac-tors. The 8 week interval test-retest correlation was 0.49 for the scale (P <0.01) and 0.39～0.51 for factors (P<0.01) . The result of confirmatory factor analysis supported the original 4-factor structure (RMSEA=0.057, CFI =0.976, GFI=0.948) . Patients scored higher than community sample [(21.72±13.39 ) vs.(13.24±10.33),P <0.01], and depression patients scored the highest [(27.82±14.42), P<0.01] . Age difference was signifi-cant. Age groups over 60-year-old scored higher than all the other age groups under 60-year-old (P<0.01). Con-clusion: The Chinese version of CES-D shows good refiability and validity across all ages in urban population-

Objective To investigate the clinical characteristics and the optimal time of delivery in pregnant women with severe preeclampsia complicated with ascites. Methods A retrospective study was conducted on 179 severe preeclampsia mothers and their 195 neonates,presented in the First Affiliated Hospital of Wenzhou Medical College from Jan.2003 to Dec.2005,who were divided into two groups:32 complicated with ascites(ascites group)and 147 without(non-ascites group). The general conditions,mode of delivery and complications including eclampsia,hemolysis,elevated serum level of 1iver enzymes,and low platelets(HELLP syndrome),liver failure,renal failure,heart failure,hypoproteinemia,placental abruption,postpartum hemorrhage and puerperal infection,were also analyzed.Clinical data of all infants(38 from ascites group and 157 from non-ascites group)were analyzed.The incidence and mortality rate of small for gestational age(SGA)in both group within the same gestational age group and those between different gestational age groups in the ascites group were compared. Results (1)The average gestations at admission and delivery in the ascites group were earlier than the other[admission:(32.5±2.1)weeks vs(36.1±3.5)weeks;delivery:(34.1±2.3)weeks vs(37.2±1.5)weeks,P＜0.053.The rate of systemic antenatal care in the ascites group waslowcr than that of the non-ascites group(25.0%vs 53.7%,P＜0.05).More complications werefound in the ascites group than in the non-ascites group(hypoproteinemia:100.0%vs 47.0%;liver and renal failure:31.2%vs 8.2%;HELLP syndrome:9.4%vs 2.0%;postpartum hemorrhage:18.8%vs 2.0%;all P＜0.05).(2)The incidence of SGA in the ascites group was all higher than that in the non-ascites group,however,significant differences was only found between the tWO groups at＞36 weeks(7/9 vs 30.2%,P＜20.05).The perinatal mortalily rates of SGA in the ascites group at＜32 weeks and 32～34 weeks were significantly higher than that in the non-aseites group respectively(＜32 weeks:69.2%vs 19.2%,P＜0.05;32～34 weeks:2/7 vs 0,P＜0.05).(3)The highest perinatal mortality rate and the highest incidence of SGA in the ascites group were found in the groups of＜232 weeks and＞36 weeks,respectively. Conclusions The early onset of ascites and higher rate of complications in severe preeelamptie women implies the adverse maternaI and fetal outcomes.Ascites in severe preeclampsia cases should alert the clinicians.The optimal time for delivery might be at 32～36 weeks of gestations.