Objective To explore the clinical value of serum tumor markers including CEA,AFP,CA199,CA125,CK19,CA242 and CA724 in diagnosis of pancreatic adenocarcinoma in the elderly.Methods Totally 158 elderly and 102 middle-aged patients with pancreatic adenocarcinoma were selected.Pancreatic adenocarcinoma in all patients were confirmed by pathological examination,cytological examination and CT.100 elderly and 100 middle-aged patients with benign diseases were selected as control groups.The levels of serum tumor markers were detected and their sensitivities and specificities were calculated and compared between groups.Results The levels of serum CEA,CA199,CA125,CK19,CA242 and CA724 were higher in elderly patients with pancreatic adenocarcinoma than in the elderly control group [(70.9±11.4) g/L vs.(1.6±0.4) g/L,(158.9±19.1)U/mlvs.(12.6±3.2)U/ml,(53.9±15.4)U/mlvs.(11.6±1.1)U/ml,(70.2±16.3)U/ml vs.(1.4±0.2)U/ml,(96.4±18.5)U/ml vs.(7.9±2.2)U/ml,(57.6±13.6)U/ml vs.(4.4± 0.6)U/ml,t=26.13,31.63,17.57,19.03,20.95,15.59,respectively,all P＜0.05].The sensitivities of serum CEA,AFP,CA199,CA125,and CA242 were higher in the elderly patients than in the middle aged patients (61.72％ vs.48.69％,19.56％ vs.4.13％,80.31％ vs.69.55％,70.21％ vs.46.77％,75.24％ vs.59.44％,x2=4.28,12.63,3.94,14.32,7.23,respectively,all P＜0.05).The specificities of serum CEA,AFP,CA199,CA125,and CA242 had no significant differences between the elderly and middle aged patients (all P＞0.05).Conclusions Serum tumor markers may provide effective reference for the clinical diagnosis of pancreatic adenocarcinoma in the elderly,which has important value for pancreatic adenocarcinoma control and reversal.

Objective To evaluate the value of quantized diffusion-weighted imaging (DWI)in diagnosis of focal liver lesions. Methods A retrospective analysis was performed in 120 patients with focal liver lesions and in 12 healthy controls who underwent DWI and routine non-enhanced MRI at 3.0T.In 120 patients,there were 1 79 focal liver lesions including 53 hepatocellular carcinomas (HCC),61 metastatic tumors,32 hemangiomas and 33 cysts.The DWI and apparent diffusion coefficient (ADC)maps and ADC val-ues of the lesions and the normal liver were analyzed and measured with a b value of 800 s/mm2 ,and the statistical differences be-tween two groups were compared.Results DWI showed 33 hepatic cysts with low signal,and 5 1 hepatocellular carcinomas,61 he-patic metastases and 32 hepatic hemangiomas with high signal,thus the signal difference between hepatic cyst and other lesions was significant (P <0.05).The ADC images of HCC and metastatic tumors were cold colour,and those of hepatic cysts and hemangio-mas were hot colour.The ADC value between HCC,liver metastatic tumors,hepatic hemangioma and cysts were significant different (P <0.05).However,there were no significant differences in ADC value between HCC and metastatic tumors (P >0.05).In addit-on,the ratios of the ADC values of lesion to background liver between hepatocellular carcinoma and metastases were significantly dif-ferent (P <0.05).Conclusion DWI and ADC maps,and ADC value can provide importantly additional information for the diagnosis and differential diagnosis of focal liver lesions.

Nucleolin is implicated in many pathological processes,particularly in inflammatory diseases,viral infection and neoplasms.Nucleolin levels are increased in several neoplasms and its localization changed,which play important roles in cell proliferation,apoptosis and metastasis of neoplasms.

Objective To establish a satisfactory method of isolating,culturing and determining gut neural crest stem cells,which may provide theoretical basis for clinical application.Methods The guts of embryonic mice removed and dissociated were plated into serum-free DMEM/F12 medium.The mitogen-free DMEM/F12 medium supplementd with 10% fetal bovine serum was used to induce differentiation of GNCSCs.Neurospheres and their derivations were determined with immunocytochemical and immunofluorescent staning.Results Neurospheres were generated in the simplified serum-free medium.The staining results showed that enteric neurospheres were GNCSCs and could differentiate into neurons,glial cells and smooth muscle cells by serum-induction.Conclusion GNCSCs have the capacity of self-renewal and proliferation,and give rise to neurons,glial cells and myofibroblasts.

Objective To analyze the effect of combined detection of serum tumor markers, Ki-67 and P-glycoprotein (PGP) in lymph node metastasis and postoperative recurrence of colorectal cancerpatients. Methods The clinical data of 517 colorectal cancer patients who had underwent surgicaltreatment were retrospectively analyzed. Among them, lymph node metastasis was found in 165 cases(lymph metastasis group), and 352 cases did not have lymph node metastasis (non lymphoid metastasis);postoperative recurrence was found in 224 cases (postoperative recurrence group), and 293 cases did havepostoperative recurrence (non postoperative recurrence group). The serum tumor markers levels of cancerantigen 19- 9 (CA19- 9), carcinoembryonic antigen (CEA), cancer antigen 125 (CA125) and theexpressions of Ki-67, PGP were compared. The correlation between the serum tumor markers levels andthe expressions of Ki-67, PGP was analyzed. Results The serum levels of CEA, CA19-9 and CA125 and the positive expression rates of Ki-67 and PGP in lymph metastasis group were significantly higher than those in non lymph metastasis group:(21.39 ± 3.15)μg/L vs. (10.12 ± 2.48)μg/L, (68.48 ± 5.82) U/L vs. (35.26 ± 3.51) U/L, (82.16 ± 7.53) U/L vs. (32.46 ± 6.24) U/L, 69.70% (115/165) vs. 13.64% (48/352) and 72.73%(120/165) vs. 14.77%(52/352), and there were statistical differences (P<0.01). The serum levels of CEA, CA19-9 and CA125 and the positive expression rates of Ki-67 and PGP in postoperative recurrence group were significantly higher than those in non postoperative recurrence group:(18.26 ± 2.34)μg/L vs. (9.18 ± 1.26)μg/L, (47.52 ± 4.85) U/L vs. (21.43 ± 2.18) U/L, (59.16 ± 4.25) U/L vs. (33.17 ± 3.46) U/L, 60.27% (135/224) vs. 9.56% (28/293) and 6.70% (15/224) vs. 7.51% (22/293), and there were statistical differences (P<0.01). The correlation analysis results showed that the positive expression rates of Ki-67 and PGP were positive correlated with the serum levels of CEA, CA19-9 and CA125 (P<0.05). Conclusions The levels of serum tumor markers and the positive expression rates of PGP and Ki-67 in colorectal cancer patients with lymph metastasis and postoperative recurrence are high. The levels of tumor markers are closely related to the positive expression rates of Ki-67 and PGP, which indicates that the combined detection of these indexes has a good effect on evaluating lymph metastasis and postoperative recurrence of colorectal cancer patients.

Objective To study the application value of microvascular density (MVD)in determination of transrectal ultrasound hemodgynamics in the differential diagnosis of prostate cancer and chronic prostatitis, and to provide imageological basis for their differential diagnosis.Methods A total of 6 1 patients suspected of prostate cancer underwent transrectal ultrasound scan and ultrasound guided biopsy.38 cases of prostate cancer and 23 cases of chronic prostatitis were confirmed by pathology and retrospectively analyzed.The peak systolic blood flow velocity (Vs)and blood flow classification of the suspicious lesions were compared and analyzed.The MVD was observed by Weidner method with monoclonal antibody CD34 immunohisochemistry staning. Results The Vs and the blood flow classification of the suspicious lesions in prostate cancer group were significant higher than those in chronic prostatitis group (P<0.05).The MVD in prostate cancer group and chronic prostatitis group were 46.70±13.87 and 34.38±7.28,respectively(P<0.05);the MVD in prostate cancer (C+D)stage and (A+B)stage were 56.99±12.85 and 39.97±10.21,respectively(P<0.05);the MVD in prostate cancer with high Gleason score group and low Gleason score group were 53.79±13.30 and 36.96±7.24,respectively(P<0.05).The Vs and the blood flow classification of the suspicious lesions of prostate cancer had a significantly positive correlation with the MVD (r=0.793,P<0.05;r=0.723,P<0.05).Conclusion The Vs and the blood flow classification of prostate cancer by ultrasound can well reflect the changes of the micrangium in tumor tissue. The Vs and blood supply grade of suspicious lesions in the patients with prostate cancer are significantly higher than those in the patients with chronic prostatitis.They may be useful for the identification of prostate cancer and chronic prostatitis.

AIM: To investigate the involvement of calcineruin (CaN) signal pathway mediated by angiotension Ⅱ (Ang Ⅱ) in the myocardial remodeling mechanism in patients with congestive heart failure (CHF). METHODS: 39 patients of mitral valve disease with CHF were randomly selected and 30 cases of healthy persons were included as controls. Cardiac function parameters were measured by echocardiography. Concentration of Ang Ⅱ in plasma and myocardial tissues were determined by radioimmunoassay. Immunoprecitipation was used to assay the protein expression and phosphorylation CaN, nuclear factor of activated T cells (NFAT_3),zinc finger transcription factor (GATA_4) in myocardial tissues. The mRNA expression of ?-myosin heavy chain (?-MHC) was measured by RT-PCR. RESULTS: The Ang Ⅱ concentrations in patients with CHF were positively correlated with the parameters of the cardiac dialtion respectively, but negatively correlated with the paremeters of cardiac function. Compared to the control group, protein of CaN and GATA_4, phosphorylation of CaN, and ?-MHC mRNA expression in myocardial tissues in CHF groups were highly expressed and their expression were positively correlated to the levels of CHF, but the phosphorylation of NFAT_3 was negatively correlated with the levels of CHF. CONCLUSION: CaN signal pathway may play important roles in the myocardial remodeling in CHF.

Objective To use a simple bedside technique to verify the pathophysiological mechanism of pulmonary hypertension (PH) in different races. Method The Valsalva maneuver (VM) was performed in patients referred to a specialty PH clinic. The blood pressure response of patients to VM was in different fashions. The blood pressure (BP) was measured by using cuff and stethoscope. When the cuff was inflated to 15 mmHg above the systolic pressure, sound could be heard by auscultation during VM and when the cuff was deflated the sound disappeared over 3 heart beats which was considered as abnormal BP response, and less than 3 heart beats defined as normal BP response. The right heart catheterization in patients with PH as a part of the standard evaluation. Results This study included 84 patients with a mean age of (63 ± 16) years. Those with abnormal BP response to VM had higher pulmonary artery wedge pressure (PAWP) [(22.5±6.6) vs. (11.9±4.3) mmHg, P ＜0.0001] and lower pulmonary vascular resistance [(5.8 ± 4.0) vs. (8.1 ± 4.6 ) WU, P = 0.01]. Blood pressure response to VM did not correlate with mean pulmonary artery (PA) pressure [(46.2 ± 9.9) vs. (43.4 ±10.4) mmHg, P =0.20] or cardiac index (both 2.4 ± 0.6 L/min/m2). The abnormal BP response to VM had high sensitivity (89.4%), specificity (86.1%) and accuracy (86.9%) for determining PAWP＞ 15 mmHg.Conclusions BP response to Valsalva maneuver provides important information about left heart filling pressures in patients with PH.

Objective To investigate the effects of ketogenic amino acid ( KAA) replacement diet on insulin resistance in mice fed with high fat diet(HFD) and to analyze the possible mechanism. Methods C57BL mice were fed with a control diet, HFD, and KAA-fortified HFD(HFDKAAR)from the age of 8 weeks, and 8 weeks after HFD initiation, the HFD-fed mice were divided into two groups:one group of mice were fed the same HFD, the other group were fed HFDKAAR ( HFD→HFDKAAR ) . The metabolic evaluations were performed at the end of 16 weeks. Blood glucose levels were measured at 0, 15, 30, 60, 90, and 120 min after the injection of glucose ( 1 g/kg BW intraperitoneal glucose tolerance test, ipGTT) . The insulin,β-hydroxybutyrate, and acetoacetate levels in the plasma were measured via ELISA. The insulin resistance index ( IRI) and area under curve ( AUC) were calculated. The expression of hepatic LKB1 ( liver kinase B1 ) , AMP-activated protein kinase ( AMPK ) , and mTOR ( Mammalian target of rapamycin ) protein, and mcp-1 mRNA were measured by western blot and real-time PCR respectively. Results HFD-fed group of mice displayed significantly heavier body weight,heavier intra-abdominal fat weight, and significant deterioration of glucose tolerance at the end of 16 weeks in addition to higher insulin levels( all P<0. 05), HFDKAAR-fed mice exhibited significantly ameliorated high fat diet-induced obesity and glucose intolerance compared to the HFD-fed mice, which was associated with decreased insulin levels, IRI, AUC, and mcp-1 mRNA expression (all P<0. 05). HFD suppressed hepatic LKB1 and AMPK phosphorylation expression, and increased mTOR phosphorylation levels compared to the control diet-fed mice(all P<0. 05). In contrast, treatment with the HFDKAAR diet increased LKB1and p-AMPK expression, which was associated with suppressed p-mTOR levels compared to the HFD-fed mice(all P<0. 05). Conclusion KAA may ameliorate high fat diet-induced obesity, glucose intolerance, via normalizing the hepatic LKB1-AMPK-mTOR nutritional signal passageway. KAA replacement diet seems to be a potential nutritional intervention for the treatment for patients with metabolic defects, such as obesity, glucose intolerance, as well as metabolic syndrome.

Objective To evaluate the effect of dexmedetomidine on myocardial injury induced by renal ischemia-reperfusion (I/R) injury in rats.Methods Twenty-four male Wistar rats,weighing 280-300 g,were randomly divided into 3 groups (n =8 each):sham operation group (group S),group I/R and dexmedetomidine group (group Dex).Renal ischemia was induced by occlusion of bilateral renal arteries for 45 min followed by reperfusion in I/R and Dex groups.At 20 min before ischemia,dexmedetomidine 50 μg/kg was injected intraperitoneally in group Dex,and the rest procedures were similar to those previously described in group I/R.The rats were sacrificed at 24 h of reperfusion and myocardial specimens were obtained for determination of malondialdehyde (MDA) content and superoxide dismutase (SOD) activity.The apoptosis in cardiomyocytes was examined by flow cytometry.Apoptosis index was calculated.The expression of Bcl-2 and Bax was detected by immunohistochemistry,and Bcl-2/Bax ratio was calculated.Results Compared with group S,apoptosis index and MDA content were significantly increased in I/R and Dex groups,Bcl-2/Bax ratio was decreased in group I/R,and Bcl-2/Bax ratio was increased in group Dex.Compared with group I/R,apoptosis index and MDA content were significantly decreased,and SOD activity and Bcl-2/Bax ratio were increased in group Dex.Conclusion Dexmedetomidine can attenuate myocardial injury induced by renal I/R in rats,and the mechanism may be related to inhibited apoptosis in cardiomyocytes and reduced lipid peroxidation.