Recent researches have shown that resectable pancreatic cancer can benefit from post-operative adjuvant chemoradiation, regardless its surgical margins, tumor size, lymph node involvement and the level of cell differentiation. Several phase Ⅱ clinical trials indicated a good tolerance to preoperative chemoradiation. Although there is no gold standard for treating locally advanced unresectable pancreatic cancer, gemcitabine-based chemotherapy or chemoradiation therapy can increase survival rate compared with best supportive care.

Adult ; Animals ; Ear Auricle ; parasitology ; Female ; Humans ; Male ; Tick Infestations ; Ticks

Objective To explore the early clinical characteristics of multiple system atrophy (MSA) in the elderly,and provide the basis for early diagnosis.Methods Totally 102 cases with probable MSA in elderly patients were retrospectively analyzed to understand the beginning symptom,clinical features and assistant examination results,combined with the literature review.Results Among the 102 cases diagnosed as probable MSA (61 cases were male and 41 cases were female),57cases (55.9％) were diagnosed as parkinsonism dominant MSA (MSA-P) subtype and 45 cases (44.1％) as cerebellar dominant MSA (MSA-C)subtype.In the beginning symptom,27 cases appeared autonomic dysfunction,including 15 cases (26.3％) in MSA P subtype and 12 cases (26.6％) MSA-C subtype; 14 cases manifested as dysuresia,11 cases as orthostatic hypotension,and 8 cases as sexual dysfunction.Parkinsonism as the beginning symptom was in 49 cases,among whom 24 cases were of abnormal gait,3 cases of resting tremor,16 cases of muscle rigidity,and 15 cases of slowed movement.Cerebellar symptoms as the beginning symptom were in 33 cases,with gait and limb ataxia of 27 cases,dysarthria of 6 cases,nystagmus of 2 cases.Pyramidal tract signs as the beginning symptom were in 2 cases.There was early misdiagnosis of 36 cases (35.3％).Conclusions As wide variety of early clinical features,MSA can be easily misdiagnosed.The clinical features and assistant examination should be paid attention to improvement of the accuracy of early diagnosis.

BACKGROUND:With respect to mesenchymal stem cels from other sources, synovial mesenchymal stem cels are rich in source, and moreover, the synovial tissue can regenerate quickly after partial hepatectomy and lead to fewer complications, in recent year, which have become a hot spot in stem cel research. OBJECTIVE:To observe the proliferation and directional differentiation of synovial mesenchymal stem cels from osteoarthritis patients. METHODS:Synovial mesenchymal stem cels were isolated and cultured. MTT assay was used to detect cel proliferation ability. Alkaline phosphatase activity was detected quantitatively at 7 days of osteogenic induction, and osteogensis-related gene expression was measured at 7, 14, 21 days of osteogenic induction. Alizarin red staining was performed at 21 days of induction. RESULTS AND CONCLUSION:(1) Passage 3 synovial mesenchymal stem cels proliferated faster, which were in latent period at 1, 2 days after inoculation, in logarithmic growth phase at 3-6 days, and then entered into the plateau phase at 7 days. (2) The activity of alkaline phosphatase was significantly higher in the induction group than the control group at 3, 7, 10 days after osteogenic induction (P < 0.05). The cels were positive for alizarin red staining at 21 days of osteogenic induction, and there were calcium deposits and calcium nodules in the extracelular matrix. (3) Bone-binding protein and Runx2 were visible at 7 days of osteogenic induction, and reached the peak at 21 days. These findings indicate that synovial mesenchymal stem cels from patients with advanced osteoarthritis have strong proliferation ability, which can differentiate into osteoblasts under in vitro induction.

Objective To investigate the factors influencing the lipid control success rate among patients with coronary heart disease (CHD).Methods Questionnaire and clinical data reviews were conducted to investigate the general information,disease characteristics and patients controlling blood lipid and by blood biochemical tests were done to detect the lipid levels.The relationships between lipid control success rate and general information,disease characteristics and patients' behaviors were analyzed by chi-square test and logistic regression analysis.Results The blood lipid success rate was only 67.09％ in patients with CHD combined dyslipidemia.The education level,cardiovascular disease risk grading,complications,body mass index,medication compliance and dietary evaluation were the main factors influencing the patients' success in blood lipid control.Conclusion The lipid control success rate can be raised by taking measurements to help patients with CHD and dyslipidemia control weight and increase medication compliance and dietary behavior.

Liver volume can reflect the change of parenchyma volume and functional reserve of liver.Liver volumetry is commonly achieved by imaging methods such as ultrasound,CT and MRI,while CT volumetry is most commonly used in clinical practice.This article discussed the decision making among different liver volumetry methods and associated applications in hepatectomy.

Post-traumatic stress disorder ( PTSD) is an anxiety disorder that can develop following a traumatic event.Neuro-imaging techniques offer a noninvasive means to elucidate the brain circuit underlying PTSD, and may help to find effective biomarkers for diagnosis and treatment evaluation of this disorder.In this article, we review recent brain structural MRI studies in PTSD.Problems of the current research and possible directions for future research are also presented.

China ; Humans ; Medicine ; methods ; trends ; Medicine, Chinese Traditional ; trends

Objective There are still different news on the preemptive analgesia. We aimed to investigate the preemptive analgesic effect of rofecoxib on the tetrodotoxin-resistant (TTX-R) sodium current in dorsal root ganglion (DRG) neurons m a rat model of acute pain. Methods Seventy-five male SD rats weighing 100-140 g were randomly divided into five groups with 15 animals in each group: (A) sham operation + placebo group; (B) operation control group received placebo orally before operation; (C) preoperatine rofecoxib group received oral rofecoxib 10mg?kg-1 h before operation; (D) and (E) postoperatire, rofecoxib group Ⅰ and Ⅱ received oral rofecoxib 10mg?kg immediately (D) and 1 h (E) after operation. Acute pain was produced by an 1 cm long incision in the plantar surface of the right hindpaw through skin, fascia and muscle. Pain threshold to mechanical stimulation with von Frey filament was measured before (baseline) and 2, 6,12, 48, 96 h after operation. The animals were killed by cervical dislocation before and 24, 48, 96 h after incision. DRGs at L3.5 on the operated side were isolated and minced. DRG neurons were isolated by digestion with collagenase Ⅰ A and trypsin TTX-R Na-current density in DRG neurons were measured by using whole-cell patch clamp technique. Results There was no significant change in pain threshold to mechanical stimulation and Na-current density in DRG neurons during the experiment in group A, The withdrawal threshold to mechanical stimuli was significantly decreased after operation compared to the baseline in the four groups ( B, C, D, E). The decrease in pain threshold was significantly less in group C,D,E than that m group B at 2, 6, 12, 24, 48 h after operation and was the least in group C Current density (pA/pF) was significantly increased at 24 h and 48 h after operation compared to baseline in group B, C, D, E. The increase in current density was significantly less in group C, D, E than in group B and was the least in group C.Conclusion Rofecoxib given before operation has preemptive analgesic effect in a rat model of acute pain. Stronger inhibition of TTX-R Na-current m DRG neurons may contribute to the underlying mechanism.

OBJECTIVE:To discuss the general rules and characteristics of adverse drug reactions(ADRs)of lamivudine.METHODS:43national case reports of ADRs of lamivudine between1999and2005were classified and analyzed statistically.RESULTS:The affected patients ranged in age from8years to45years,with more males than females.There were no rules in the onset time of ADRs.The ADRS were mainly characterized by nervous system responses and aggravation of hepatitis in clinic.CONCLUSION:Great importance should be attached to ADRs of lamivudine to ensure the safety of drug use in clinic.