Objective To evaluate the curative effect of stereotactic radiotherapy in pancreatic cancer in the elderly. Methods Retrospectively analyzed 65 elderly patients with pancreatic cancer were treated with stereotactic radiotherapy. The ages of patients were 60 to 86, with mean age of 71 2. The numbers of treatment were 8 to 12 times according to the tumor size and patients condition Fractional dose were 3 to 6 Gy, total dose were 32 to 54 Gy. The curve of isodose was 50%～80% Results The patients average alive time was 9 3 months after stereotactic radiotherapy The clinical benefit response rate was 61 2%. The CR+PR was 38 4% Conclusions The stereotactic radiotherapy is safe and effective method for treating elderly pancreatic cancer

Objective To investigate the effects of Bushen Yangxue decoction combined with hormone replacement effects on sex hormone level and symptom score in patients with premature ovarian failure .Methods 112 patients with premature ovarian failure from March 2014 to November 2015 in Zhejiang Tongde Hospital were divided into two groups with 56 cases in each group.The control group was treated with hormone replacement therapy , the combined group was treated with Bushen Yangxue decoction on the basis of the control group.The curative effect was compared between the two groups, the sex hormone, traditional Chinese medicine symptoms score, QOL score and endometrial thickness were compared between the two groups before treatment, at the end of treatment and 3 months after discontinuation.Results At the end of the treatment, there was no significant difference in total effective rate between the combined group (91.07%) and the control group (85.71%).At the end of the treatment, the scores of TCM symptoms and QOL scores were significantly lower in the two groups, and the endometrial thickness was significantly higher (P<0.05), compared with the control group at the end of treatment,the combined group TCM symptom score was lower(P<0.05), QOL score and endometrial thickness had no significant difference, after stopping drug for three months, there was no significant difference in the levels of TCM score, QOL score, endometrial thickness between the two groups.In the control group TCM score, QOL score were significantly higher, and significantly higher than the levels of the same period of the combined group, endometrial thickness was significantly lower, and the level of the same period was significantly lower than that of the combined group(P<0.05), at the end of treatment, the two groups of FSH, LH significantly decreased, E2 significantly increased(P <0.05), there was no significant difference between the two groups, after stopping drug for three months, there was no significant difference in the levels of E2, LH, FSH.The control group, LH and FSH levels were lower and E2 levels were higher in the control group at three months after discontinuation compared with those at the end of treatment (P<0.05).Compared with the control group, LH and FSH levels were lower and E2 levels were higher in the combined group after 3 months of drug withdrawal (P<0.05).Conclusion Bushen Yangxue decoction combined with hormone substitution method can significantly increase in patients with premature ovarian failure of sex hormone level, improve the recovery of patients with ovarian function.

Objective To explore the role of CD3 +CD8 +T cells in children with severe bacterial meningitis at early stage by studying the changes of CD3 +CD8 +T cells and its relationships with markers of inflammation and humoral immunity. Methods Thirty-nine cases aged ≤14 years old were enrolled in this retrospective study,who were admitted in our PICU from Aug 1. 2014 to Dec 31. 2015 with diagnosis of se-vere bacterial meningitis. The patients were divided into 2 groups according to the changes of CD3 +CD8 + T cells:group A:normal or elevated(≥190/mm3,n=22),group B:decreased( <190/mm3,n=17). Distribu-tion and differences of biomarkers of inflammation,humoral immunity and changes in cerebrospinal fluid be-tween the two groups were analyzed. Results The ratio of CD3 + CD8 + T cells were decreased in 17 (43. 6%)cases. Though there was no statisticly significant difference,the percentile of patients in group B (58. 8%) with Glasgow coma score lower than 8 was higher than that in group A(31. 8%). All the four death were in group B. The mean values of C-reactive protein and procalcitonin were 251. 0(26. 2,417. 0) mg/L,32. 7(0. 9,100. 0) ng/L in group B,which were higher than those in group A[106. 5(12. 0,458. 0) mg/L,4. 5(0. 1,200. 0)ng/L],respectively(P<0. 05). Six cases(35. 3%) in group B with WBC<4 × 109/L was more than 1 case(4. 6%) in group A,and 12 cases(70. 6%) in group B with ratio of neutrophils>80% was more than 7 cases(31. 8%) in group A,there were significant differences(P<0. 05). Fourteen cases(82. 3%) with glucose concentration lower than 2. 0 mmol/L in group B was more than 11 cases (50. 0%) in group A,the difference was significant(P<0. 05). Conclusion CD3 +CD8 +T cells might be suppressed in children with severe bacterial meningitis at early stage,and might associate to the damaging de-gree of brain,inflammation reaction and prognosis in those patients,which should be helpful in using of im-mune regulators for children with severe bacterial meningitis.

Objective To study skeletal muscle atrophy and the change of autophagy in skeletal muscle of patients with chronic kidney disease.Methods Mean muscle cross sectional area,mRNA and protein expression of autophagy markers Bcl-2-adenovirus E1B interacting protein 3 (LC3B),Bcl-2-adenovirus E1B interacting protein 3 (Bnip3),Beclin-1 were measured in rectus abdominis biopsies obtained from 22 consecutive patients with stage 5 CKD scheduled for peritoneal dialysis from 4 hospitals in Shanghai.Control biopsies were obtained from another 8 healthy subjects during elective surgery for adenomyosis and 6 subjects during elective surgery for abdominal wall hernias.Rectus abdominis muscles were obtained at the beginning of surgery.HE staining was performed and mean cross sectional area (CSA) was calculated.Electron microscopy was used to confirm the changes of autophagy.mRNA levels of LC3B,Beclin-1,Bnip3 were evaluated by RT-PCR and protein levels of those parameters were evaluated by Western blotting.Results Compared with control group,mean CSA of muscle fibers was decreased and the transcript levels of LC3B,Beclin-1,Bnip3 were up-regulated in CKD group.Similarly,protein levels of LC3BⅠ,LC3B Ⅱ,Beclin-1 and Bnip3 were increased in CKD group.Additionally,activation of autophagy was confirmed by the appearance of autophagosomes by electron microscopy.Conclusion Chronic kidney disease may cause skeletal muscle atrophy and lead to activation of autophagy,which may contribute to muscle atrophy.

Objective To identity whether there is muscle atrophy phenomenon in end-stage kidney disease patients and to detect the level of transcription factor Foxo1 and the activity of ubiquitin-proteasome system.Methods Twenty-two patients in chronic kidney disease (CKD) stage 5 were selected and their mean muscle cross sectional area was measured.mRNA and protein levels of Foxo1,Atrogin-1,MuRF1 in rectus abdominis biopsies obtained from consecutive patients were detected.Control biopsies were obtained from 8 healthy subjects during elective surgery for abdominal wall hernias and 6 subjects during elective surgery for adenomyosis.Results Compared with the control group,cross sectional area of muscle fibers decreased and the transcription and protein levels of Foxo1,Atrogin-1,MuRF1 were upregulated in CKD group(P＜0.05).Protein level of p-Foxo1 decreased in CKD group(P＜0.05).Conclusion There exist muscle atrophy phenomenon in CKD patients,which may associate with the upregulation of Foxo1 and activation of ubiquitin-proteasome system.

Objective To elucidate the association of the susceptibility for rheumatoid arthritis ( RA )and peptidylarginine deiminase 4(PADI4) genetic single nucleotide polymorphism (SNP) in Han population in Hebei province.Methods This hospital-based ease-control study included 105 untreated RA patients and 96 healthy controls.The genotypes and allele frequencies of padi4_92 gene polymorphisms were analyzed by PCR-RFLP method,and the analysis of linkage disequilibrium and haplotype construction were performed for padi4_92,padi4_94 and padi4_104 SNPs.The Peason Chi-square test and Woolf statistic method were used to analyze the odds ration (OR) and 95％ confidence interval (95％CI).Results Significant differences in the frequency of PADI4 alleles and genotypes between the cases and controls were observed.The combined effect of padi4_92,padi4_94 and padi4_104 SNPs was analyzed by SHEsis snd Genehunter software,and got three haplotypes,CCC,GTT and GCC.There was significant difference in haplotypes distribution of 3 SNPs of padi4 between the two groups.This analysis of haplotypes revealed that haplotype of PADI4 was a risk factor for RA The ORs for these three haplotypes for RA susceptibility were 0.634 (95％CI=0.425-0.946),1.306 (95％CI=0.864-1.975),4.286 (95％CI=1.274-14.424),respectively.Conclnsion The SNPs of PADI4 may contribute to genetic susceptibility to RA in Han population in Hebei Province.

Objective To explore the characteristics of cognitive impairments in euthymic patients with early-on?set or late-onset bipolar I disorder (BD-I). Methods Ninety-four with onset age less than 21 (early onset group), 41 eu?thymic patients with onset age above 35 (late onset group) and 135 normal controls with matched education and age were enrolled. Seven classical neuropsychological tests were used to assess attention, processing speed, working memory and executive functions. Results The early-onset group was significantly worse than its corresponding normal controls in 14 indexes of all tests, including digital symbol, digital span, visual graphic reproduction (c1 and c2), time of TMT-A and TMT-B, verbal fluency, number of sorting, error and preserved error in WCST, as well as total score, completed missions, planning time and executing time in TOH (P<0.05). Moreover the effect size of difference were more than 0.4 in verbal fluency, time of TMT-A and TMT-B, and executing time in TOH. Compared with its matched control group, the late-on?set group was significantly impaired in 9 indexes, including digital span, visual graphic reproduction (c1,c2 and total), time of TMT-A, number of error and preserved error in WCST, as well as total score and completed missions in TOH (P<0.05), merely two indexes of TOH with effect size more than 0.4, while the late-onset group was no significantly impaired in digital symbol, TMT-B and verbal fluency. Conclusions There are significant cognitive impairments in euthymic BD-I patients with no matter early-onset or late-onset. But it seems that the cognitive impairments in early-onset bipo?lar disorder are more extensive and serious.

Objective:To explore the changes of cerebral blood flow (CBF) perfusion caused by N 2O (laughing gas) abuse. Methods:From December 2017 to October 2018, the CBF perfusion images of 24 patients with laughing gas abuse (9 males, 15 females; age: 18-32(24.0±8.9) years) from China-Japan Friendship Hospital were analyzed retrospectively. The region uptake statistics of different brain regions of interest (ROI) (basal ganglia, central region, cerebellum, cingulate gyrus, frontal lobe, medial temporal lobe, occipital lobe, parietal lobe, temporal lobe) between patients with laughing gas abuse and normal people of the same age group from background software database were calculated automatically. Statistic>1.68 indicated the increase of local CBF perfusion, while statistic < -1.68 indicated the decrease of local CBF perfusion. The correlation between the statistics of bilateral brain regions and the correlation between statistical values and clinical indicators were analyzed by Pearson and Spearman correlation analyses.Results:The correlation of the statistics between bilateral regions of each brain area was significant( r values: 0.503-0.892, all P<0.05). The decreased CBF proportions of frontal and temporal lobes were 62.5%(15/24) and 70.8%(17/24), respectively. The highest proportion of increased CBF was cingulate gyrus (33.3%, 8/24). There were significant correlations between frontal lobe, central brain area and duration of laughing gas abuse ( rs values: 0.375, 0.305, both P<0.05). Conclusion:CBF perfusion imaging is helpful for understanding the changes of CBF in patients with laughing gas abuse.

Humans ; Lung Neoplasms ; diagnosis ; therapy ; Neoplasms, Multiple Primary ; diagnosis ; therapy ; Prognosis

Objective To analyze the risk factors of blood vessel invasion in stage Ⅰ non-small cell lung cancer (NSCLC).Methods A retrospective analysis of 166 patients with stage Ⅰ NSCLC who underwent surgical resection and pathological diagnosis from January 2016 to March 2018 in China-Japan Friendship Hospital was conducted.The presence of blood vessel invasion in tumor tissue was detected by immunohistochemistry.Clinicopathological factors which may affect blood vessel invasion were evaluated by univariate analysis and multiple logistic regression analysis.For statistically significant factors revealed by multivariate analysis,the diagnostic efficiency and best cut-off point were calculated by the receiver operating characteristic curve.Results The univariate analysis identified that the smoking history (P =0.020),maximum standardized uptake value (SUVmax) (P =0.001),tumor diameter (P =0.001),TNM stage (P =0.002),and lymphatic invasion (P =0.023) were factors affecting blood vessel invasion status.Multivariate analysis showed that SUVmax was an independent risk factor for blood vessel invasion (OR =1.097,95 ％ CI 1.014-1.187,P =0.021).The preoperative SUVmax of primary tumor was a predictor for blood vessel invasion with the highest diagnostic accuracy at a cut-off value of 4.85,the sensitivity and specificity were 66.0 ％ and 71.7 ％,respectively.Conclusion The SUVmax is an independent predictor for blood vessel invasion in stage Ⅰ NSCLC,and the risk of blood vessel invasion rises with the increase of SUVmax.