Pancreatic cancer remains a devastating disease with a 5-year survival rate of less than 5％.Recent advances in diagnostic methods and therapeutic approaches have increased the possibility of improving the existing poorprognosis.Recently,compounds from naturalsources receive ample attention as anti-cancer agents.Overwhelming in vitro evidence and clinical trials suggest that curcuminn,isothiocyanate,capsaicin,catechin may reduce the incidence of cancer.

Objective Evaluate the diagnostic value of PET/CT in the preoperative advanced gastric carcinoma comparing with mult;-slice spiral computed tomography. Methods Thirty-nine advanced gastric carcinoma patients taking PET/CT and abstract 40 advanced gastric carcinoma patients performing MSCT before operation,were done the TNM staging, and the Results were compared with the operation histopathology. Results For diagnosing primary lesions, regional lymph nodes, N3 lymph nodes ,PET/CT was accurate in 92.3% , 66.7% and 100.0%.Instead, MSCT was accurate in 82.0% , 50.0% and 62.5%. Conclusions (1) PET/CT and MSCT have high accuracy in diagnosing primary lesions and regional lymph nodes. But for detecting the N3 lymph nodes and distant metastasis, PET/CT has higher accuracy than MSCT. PET/CT combining abdominoscopy may decrease or avoid exploratory laparotomy.

Objective To explore the relationships of quality of life ( QOL ) and functional status in patients with malignant bone tumors after operation. Methods European organization for research and treatment of cancer quality of life questionnaire C30 (EORTC-QLQ-C30), social support revalued scale (SSRS) and Karnofsky performance scale (KPS) were used to investigate the levels of QOL, social support and functional status. The correlations between them were explored. Results The overall score by QOL was (58.33 ± 18.94). The score by KPS was positively related to somatic function, role function, social function, and general health status (P<0.01), but negatively related to tiredness, pains, insomnia and financial burden (P<0.01). Conclusions The QOL in patients with malignant bone tumors after operation is at a lower level and the function is at a medium level. Nurses should assess the function and make out interventional measures for them so as to improve their QOL.

Objective To observe the effect of drug combinations on the blood flow after reduction of the testicular torsion in rabbits.Methods From October 2014 to June 2015,36 male rabbits (weighing 1.8-2.4 kg,10-14 months of age) were randomly divided into experimental group and control group,18 in each group.Produced by surgical testicular torsion model (720° counterclockwise rotation of the left side testicle),every rabbit was accepted surgery reset after 9 hours and found all twisted testicles were dark.After fomentation with warm salt water,all the testicles were observed no significant improvement in colors,and no fresh blood flow after opening tunica albuginea,then all the testicles were retained and fixed.Low molecular dextran(5 ml/kg,ear marginal vein injection,1/d),papaverine(1.5 mg/kg,intramuscular,3/d) and low molecular weight heparin sodium (200 IU/kg,subcutaneous,l/d) were applied to promote testicular revascularization for 5 days in experimental group,and penicillin (40 000 U/kg,intramuscular,1/d) for 7 days.Control group was only given penicillin (40 000 U/kg,intramuscular,1/d) to prevent wound infection.Then Color Doppler ultrasound was used to observe the testicular blood flow siganals that were divided into 0,1,2,3 classes.Class 2 and class 3 could be considered as testicular survival.After each scrotum was opened,according to color,texture of testicle and whether the fresh blood flowing out when tunica albuginea was opened,to determine whether the testicle was alive.The testicle was ruddy,flexible,and fresh blood was observed,which could prove testicular survival.Results In experimental group,the testicular blood flow siganals:0 class 4 cases,1 class 3 cases,2 class 4 cases,3 class 7 cases.In control group,the testicular blood flow siganals:0 class 9 cases,1 class 2 cases,2 class 4 cases,3 class 3 cases.Surgical exploration found 11 cases of testicular survival in experimental group and 7 cases in control group,which was significantly difference (P ＜ 0.05).Conclusions The combined application of low molecular dextran,papaverine,low molecular weight heparin sodium can promote the recovery of testicular blood after reduction of testicular torsion,and improve testicular survival rate.

Clinical medicine is a comprehensive discipline integrating natural science and hu-manities and social science. Lemology is closely related with basic medicine and medical microbiology and medical immunology are the basis of lemology. Therefore, in the process of cultivating postgradu-ates of lemology, we should not only should attach importance to the cultivation of basic medical knowl-edge and clinical professional quality, but also pay more attention to the development of the intelligence factors and non-intelligence factors. Meanwhile education on humanity, social sciences and relevant laws and regulations should be enhanced to cultivate doctors' professional quality. Reverse thinking and lateral thinking in the clinical diagnosis should be strengthened to achieve the training objectives of cultivating international medical talents.

Objective To explore the influence of platelet aggregation rate, platelet response index in patients with coronary heart disease by domestic and imported aspirin and clopidogrel and its safety. Methods The date of 100 cases patients with coronary heart disease for angina pectoris from November 2012 to November 2013 were retrospectively analyzed in this study, according to different drug sources, they were divided into import group and domestic group, 50 cases each. Import group was treated with imported aspirin and clopidogrel, the domestic group was treated with domestic aspirin and clopidogrel. MPA, PRI before medication, medication discontinuation after 1, 2 weeks and 6 h, 12 h and 1 d after discontinuation between two groups were compared, treatment of cardiovascular and adverse drug reactions occur within 1 year were observed. Results There was no significant difference between two groups for MPA and PRI before treatment (P>0.05); MPA, PRI after treatment 1 week, 2 weeks in import group were lower than that in domestic group (P<0.05). 6 h after the drug was stopped, MPA had no difference between two groups (t=1.209, P=0.229>0.05), 12 h and 1 d after drug withdrawal, MPA in import group were higher than that in domestic group ( P<0 . 05 ); Discontinuation after 6 h , 12 h , PRI in domestic group were significantly higher than that in import group (P<0.05), after the withdrawal of 1 d, there was no statistical significance (t=1.332, P=0.186>0.05). The incidence of cardiovascular adverse events in import group were lower than that in the domestic group, with statistically significant differences (P<0.05). Team rash, abdominal pain, bruising rates in import group were lower than that in domestic group, the differences were statistically significant (P<0.05). Conclusion Compared with domestic, aspirin combined with clopidogrel plays a positive and effective role in resistting platelet clotting in patients with coronary heart disease for angina pectoris, and platelet function can be quickly restored after the drug is stopped, can significantly reduce the recurrence of myocardial infarction, angina pectoris, heart cerebrovascular accident prevention, reduce mortality.

Objective To compare the therapeutic effects between three-dimensional conformal radiotherapy (3DCRT) and intensity-modulated radiotherapy (IMRT) in patients with stage Ⅱ/Ⅲ esophageal cancer and investigate the prognostic factors.Methods Medical record of 2 132 patients with stage Ⅱ/Ⅲ esophageal cancer who underwent definitive radiotherapy with/without chemotherapy in 10 hospitals from January 2002 to December 2016 from were retrospectively analyzed.Among these patients,37.9％ of them were aged ≥ 70 years,33.9％ with neck and upper esophageal tumors and 66.1％ with middle and lower esophageal and borderline tumors.The median gross tumor volume (GTV) and lymph node gross tumor volume (GTVnd) was 41.6 cm3.Among them,32％ were stage Ⅱ] and 68％ were stage Ⅲ.A total of 723 patients received 3DCRT and 1 409 cases received IMRT.Patients received an equivalent dose in 2 Gy (EQD2) ≥ 60 Gy accounted for 86.1％,and 41.1％ of them received concurrent chemoradiotherapy.Results The median follow-up time was 60.8 months.The 1-,3-and 5-year overall survival (OS) of all patients was 73.9％,41.7％ and 32.6％,and the 1-,3-and 5-year progression-free survival (PFS) was 62.2％,37.3％ and 32％,respectively.Multivariate analysis demonstrated that age,primary tumor location,clinical stage,tumor target volume,EQD2 and concurrent chemoradiotherapy were the independent prognostic factors for OS.Age,primary tumor location,clinical stage,tumor target volume and EQD2 were the independent prognostic factors for PFS.The OS and PFS did not significantly differ among the low-risk,low-/moderate-risk,moderate-/high-risk and high-risk groups according to age≥70 years,tumor diameter＞5 cm,tumor volume ≥41.6 cm3 and stage Ⅲ (P＜0.001).After the propensity score matching (PSM) method,neither 3DCRT nor IMRT yielded significant advantages in OS or PFS (P=0.971;P=0.658).However,IMRT tended to yield survival benefits in low-risk patients (P=0.125).Conclusions Both 3DCRT and IMRT yield relatively high OS rate in patients with stage Ⅱ/Ⅲ esophageal cancer.The prognosis model established in this investigation can properly predict the survival of patients.Low-risk patients tend to obtain survival benefits from IMRT.

Objective To retrospectively analyze the effect of tumor length on the prognosis in stage Ⅱ/Ⅲ esophageal squamous cell carcinoma (ESCC) patients treated with definitive radiotherapy and to evaluate the role of tumor length in clinical stage for non-operative ESCC patients.Methods The data of 2 086 ESCC patients who were treated with definitive radiotherapy from 2002 to 2016 in 10 hospitals (3JECROG) were analyzed.The effect of tumor length on overall survival (OS) was analyzed and stratified analysis of tumor length was done in different stages of ESCC.Results The median OS and median progression-free survival (PFS) time of the whole group were 25.6 months and 18.2 months respectively.The Cox multivariate analysis showed that treatment moda,aga,alinical stage and tumor length were independent prognostic factors.The median,1-,3-,and 5-year OS were 28.9 months,77.3％,45.0％,and 36.3％ versus 21.9 months,69.9％,37.9％,and 28.1％ for patients with ≤ 5 cm and patients ＞ 5 cm respectively (P＜0.05).For stage Ⅱ patienta,abe median OS were 42.1 and 38.9 months respectively in ≤ 5 cm group and＞5 cm group (P=0.303).And for stage Ⅲ patienta,abe median OS were 23.9 and 19.3 months respectively in ≤5 cm group and＞5 cm group (P＜0.001).The median OS with N1was 24.1 and 18.4 montha,aespectively in ≤5 cm group and＞5 cm group (P＜0.001).Conclusions The tumor length was an independent prognostic factor for stage Ⅱ/Ⅲ patients treated definitive radiotherapy.The tumor length may be helpful in clinical staging of ESCa,aspecially for stage Ⅲ and N1.

Chicoric acid， a hydroxycinnamic acid with the molecular formula C₂₂H₁₈O₁₂， is an important active ingredient in Taraxacum mongolicum， Echinacea purpurea， Cichorium intybus and other natural plants， and it helps plants protect themselves from insects and infection from viruses， bacteria， fungi， and nematodes. Modern pharmacological research suggests that chicoric acid has significant bioactivities such as anti-inflammatory， antioxidant， immune-regulating， antibacterial， antiviral and anti-tumor properties. The first reported bioactivity of chicoric acid is its inhibitory effect on human immunodeficiency virus （HIV）. With the development and application of molecular biology and related technologies， the inhibitory activities of chicoric acid on other viruses as well as its mechanism of action have been frequently reported. Another study indicates that chicoric acid has significant inhibitory effects on different pathogenic bacteria. This paper summarized the research progress on the antiviral and antibacterial effects of chicoric acid through a comprehensive review of relevant literature in China and abroad in the past 20 years. Studies have shown that chicoric acid has significant inhibitory activities against various viruses such as HIV， hepatitis B virus （HBV）， respiratory syncytial virus （RSV）， and herpes simplex virus （HSV）， as well as different pathogenic bacteria such as Staphylococcus aureus， Yersinia enterocolitica and Mycobacterium tuberculosis. This study is expected to provide references for in-depth research on chicoric acid against pathogenic microorganisms and antiviral and antibacterial study of traditional Chinese medicine.

Objective To evaluate the survival and prognostic factors of esophageal cancer treated with definitive ( chemo ) radiotherapy by applying novel radiation techniques including three-dimensional conformal radiotherapy (3DCRT) or intensity-modulated radiotherapy (IMRT). Methods Clinical data of 2762 patients with non-operated esophageal squamous cell carcinoma who underwent definitive ( chemo ) radiotherapy from 2002 to 2016 in 10 hospitals were retrospectively analyzed.The prognostic factors were also identified and analyzed. Results The median follow-up time was 60. 8 months. The 1-, 2-, 3-and 5-year overall survival (OS) of all patients was 71. 4％,48. 9％,39. 3％,and 30. 9％,respectively.The 1-,2-,3-and 5-year progression-free survival (PFS) was 59.5％,41.5％,35.2％,and 30％,respectively.The median survival was 23 months.The median time to progression was 17. 2 months.Multivariate analysis demonstrated that age, primary tumor location, clinical stage, tumor target volume, EQD2 and treatment mode were the independent prognostic factors for OS.Primary tumor location,clinical stage,tumor target volume and EQD2 were the independent prognostic factors for PFS. Conclusions In this first large-scale multi-center retrospective analysis of definitive ( chemo) radiotherapy for esophageal squamous cell carcinoma in China, the 5-year OS of patients with esophageal squamous cell carcinoma is significantly improved by 3DCRT, IMRT combined with chemotherapy drugs. However, the findings remain to be validated by prospective clinical trials with high-level medical evidence.