Objective To observe the effects of 5-fluorouracil(5-FU) on prognosis of septic shock in rats.Methods Thirty female Wistar rats was randomly divided into three groups: control group, septic shock group, and 5-FU group. The septic shock model was established by peritoneal injection of 1.8?109cfu/ml E. coli at the volume of 1 ml/100 g weight. The 5-FU group rats were treated intraperitonealy with 5-FU 50 mg/kg weight at 40 minutes after the septic shock model was established. All rats were killed at 6 hours after operation.The mortality, the ascites rate, the lung tissue wet weight and the lung injury score(LIS) were measured.Results The mortality, the ascites rate, the lung tissue wet weight and LIS of the septic shock group was 60%, 90%, (1.55?0.17)g,and(8.00?2.54),respectively. In 5-FU group, these parameters were 0, 10%, (1.36 ? 0.14) g,and(5.20?2.39),respectively. Compared with septic shock group, the mortality and the ascites rate of 5-FU group were significantly decreased, and the lung tissue wet weight and LIS were improved.Conclusion 5-FU can decrease the ascites rate, relieve inflammation and tissue damage.

Objective To observe the effect of 5 fluorouracil (5 FU) on regulating the inflammatory and anti inflammatory cytokines in acute pancreatitis(AP) in rats, and to investigate the mechanism of treatment of AP with 5 FU. Method SD male rats were divided randomly into 3 groups:false operation group (n=6), AP group(n=24) and 5 FU treatment group(n=24). Then, AP group and 5 FU treatment group redivided respectively into 3 subgroups: After the AP model sut up or after 5 Fu treatment 2, 6 and 24 h subgroups (n=8). The animals were killed at the blood samples were taken for measurement of TNF ?, IL 1, IL 6, IL 10 and TGF ?. The wet weight of pancreatic tissue and blood amylase also were observed. Results Both serum inflammatory cytokines (TNF ?,IL 1 and IL 6) and anti inflammatory cytokines (IL 10 and TGF ?) in AP group increased significantly (P

Objective To intensify clinical evaluation on the manifestation, diagnosis and treatment of primary malignant duodenal tumors. Method The clinical data of 81 patients with primary malignant duodenal tumors from 1990 to 2002 were analyzed retrospectively. Result Tumors located above, around and below the duodenal papilla accounted for 16%, 78%, 6% respectively. The common clinical presentations were weight loss(72%)?abdominal pain(64%)?jaundice(45%)?alimentary tract bleeding(40%)?vomiting(33%) and anemia(24%). The preoperative diagnosis rate was 80%. Pancreatoduodenectomy was performed in 54 cases, bypass operation in 21 cases, segmental duodenectomy and simple laparotomy in 2 cases each. The postoperative 3- and 5- year survival rate was 36% and 21% for patients undergoing curative resection. In those with bypass operation, the survival time was between 1～18 months. Two cases undergoing segmental duodenectomy died within one year. Conclusion Patients usually lack special symptoms and signs, early diagnosis is fairly difficult, pancreaticoduodenectomy performed for purpose of curative resection could improve the prognosis of this malignancy.

Objective:To study the effects of Hedgehog signal transduction pathway on the cell proliferation, apoptosis and connexin 32 (Cx32)and connexin 43 (Cx43)membranous distribution of breast cancer cells,and to explore its mechanism in the cell proliferation and metastasis of breast cancer.Methods:The breast cancer MCF-7 cells at logarithmic growth period were divided into cyclopamine groups and blank control groups. The MCF-7 in cyclopamine groups were treated with 5,10,20,30 and 40μmol·L-1 for 24,48 and 72 h;MTT assay was applied to detect the inhibitory rate of proliferation of MCF-7 cells. After the MCF-7 cells were treated with 0 (negative control group)and 25μmol·L-1 cyclopamine for 48 h,flow cytometry was employed to determine the apoptotic rate and to analyze membranous distribution of Cx32 and Cx43 in the MCF-7 cells.Results:Compared with blank control group,the inhibitory rates of proliferation in cyclopamine groups were increased (P<0.05), and the inhibitory effect of proliferation was increased with the increasing of cyclopamine doses and prolongation of treatment time.After treated with 25μmol·L-1 cyclopamine,the apoptotic rate of MCF-7 cells was higher than that in blank control group (P<0.05).The positive expression rates of Cx32 and Cx43 48 h after treatment were higher than those in negative control group (P<0.05).Conclusion:Hedgehog signal transduction pathway can inhibit the apoptosis and mediate membranous distribution of Cx32 and Cx43 in breast cancer cells.

Objective To investigate the anatomic feature and special clinical manifestations of variant right intrahepatic bile duct draining into left hepatic bile duct near the umbilical portion. Methods Variant right intrahepatic bile ducts joining into left hepatic bile ducts near the umbilical portions were identified through cholangiograms in 52 patients, who were included in this study. Their history, clinical process and operations were reviewed. Results There were total 38 cases of intrahepatic gallstone in this group. High incidence of intrahepatic calculi was found in variant right intrahepatic bile ducts (23/38 cases, 60.52%) and left hepatic ducts (33/38 cases, 86.84%). Most of these cases were accompanied with dilatation and stricture of bile ducts in these area. The gallstones in the variant right intrahepatic bile ducts were not detected in 8 cases (8/23) and the rate of residual gallstone was as high as 86.95%(20/23). Injury of variant right intrahepatic bile duct took place when left hepatectomy was performed in one case. Conclusion Gallstone is very likely to be formed in the variant right intrahepatic bile duct due to derangement of bile hydrokinetics and compression of blood vessel. Special attention should be paid to the diagnosis and operation of this abnormity.

Objective To explore the relationship between the rs18004197 polymorphism in the 3'-untranslated region of adenomatous polyposis coli (APC) gene and colorectal cancer susceptibility.Methods Firstly,we collected the peripheral venous blood of 573 colorectal cancer cases and 588 controls,and then extracted DNA from blood samples,genotyped rs1804197 polymorphism using real-time PCR and assessed its association with the susceptibility of colorectal cancer.Results There were 387 CC (67.5％),153 AC (26.7％) and 33 AA (5.8％) genotypes in the colorectal cancer cases.In the control group,there were 427 CC (72.6％),144 AC (24.5％) and 17 AA (2.9％) genotypes.The AA genotype odds ratio (OR =2.14,95％ CI:1.17-3.91,P =0.011) and the A allele frequency (P =0.011) were significant difference in case and control groups.Further subgroup analysis showed that the differences of the frequency distribution in the male (P =0.048) and non-drinking (P =0.020) groups were statistically significant.In the male group,the risk of colorectal cancer was increased by 0.41 (OR =1.41,95％ CI:1.01-1.98) for individuals bearing the A allele.In the non-drinking group,the risk of colorectal cancer was increased by 0.22 (OR =1.22,95％ CI:0.91-1.64) for individuals bearing the A allele,but the result was not statistically significant.Conclusion The rs18004197 polymorphism in the 3'-untranslated region of APC gene is related to the susceptibility of colorectal cancer.The AA genotype may increase the susceptibility of colorectal cancer.

Objective To explore the effect of parvovirus B19 (VB19) infection on pediatric leukemia patients. Methods The pediatric leukemia patients were enrolled in the study in the Children's Hospital of Soochow University. Expression levels of VB19-DNA-PCR were detected using the polymerase chain reaction. Positive patients would be monitored and treated by conventional treatment as well until VB19 gene became negative. The data was compared according to the VB19 clearance time, clinical symptoms and blood counts to evaluate the effect. Results In the 3009 samples from 824 pediatric leukemia patients, there were 36 samples (1.2%) from 12 cases (1.5%) of pediatric leukemia paients with positive VB19 infection. Among the positive patients, 11 cases (1.9%) were from 582 with acute lymphoblastic leukemia (ALL) patients and 1 (0.45%) was from 212 with acute myeloid leukemia (AML). According to the treatment stage, 3 cases were in initially diagnosed period, 2 cases in early stage of consolidation chemotherapy, 4 cases in delayed enhanced chemotherapy period, and 3 cases in maintenance chemotherapy period. According to the treatment response, 4 cases were in continuous treatment, 2 cases were sensitive to treatment, and 3 cases were drug resistant. In the drug resistance group, 2 cases developed into the pure red cell aplastic anemia (PRCA). After treatment, one was recovered from PRCA with VB19 cleared, the other one remained PRCA with continuously positive VB19. Conclusions More VB19 virus infection in pediatric ALL happened in delayed enhanced chemotherapy period. The persistent presence of VB19 infection on pediatric leukemia patients is closely related with PRCA.

Objective To develop a Chinese version of Frommelt Attitude Toward Care of the Dying scale (FATCOD) and evaluate its validity and reliability to provide a tool for the field of hospice care and death education used among nurses.Methods FATCOD scale was adopted according to Brislin's translation model for cross-cultural research and its reliability and validity of the new Chinese version was tested in 126 nurses.Factor analysis and correlation analysis were applied to establish the validity and reliability.Results The Chinese version of FATCOD scale consisted of 30 items.The Cronbach's α coefficient of the scale was 0.828; split-half coefficient of the whole scale was 0.807; the varimax rotation factor analysis of the scale identified twelve principal factors and explained for 69.5％ variances.Conclusions The Chinese version of FATCOD scale is valid and reliable in the sample of nurses,and can be used in the field of hospice care and death education.

Objective: To evaluate the efficiency and safety of low intensity conditional regimen for children with Fanconi anemia (FA) receiving allogenic hematopoietic stem cells transplantation (allo-HSCT). Methods: Four patients diagnosed as Fanconi anemia were enrolled in this study. One patient received HLA-identical sibling donor hematopoietic stem cell transplantation, two patients underwent unrelated donor matched (UD) HSCT, and one patient received unrelated cord blood transplantation. The conditional regimen consisted of Busulfan with low dose of cyclophosphamide. Results: All 4 cases succeeded in allo-HSCT. The median time for neutrophils engraftment was 11(9-15) day, median time to platelets (PLT) engraftment was 12 (8-28) day. One case occurred with grade I of aGVHD, 1 case with hemorrhagic cystitis. No patient happened with hepatic veno-occlusive disease (VOD). Conclusion Low intensity of conditional regimen is efficient and safe which should be recommended for FA patients with HSCT.

The safety of decitabine as bridging treatment before allogeneic hematopoietic stem cell transplantation (allo-HSCT) in children with refractory hematological malignancies was evaluated.All 11 cases succeeded in hematopoietic reconstitution.The main adverse reaction was hematological toxicity.Neither did infections occur,nor drug-induced liver damage and renal impairment during decitabine administration.Most cases showed grade Ⅰ-Ⅱ gastrointestinal adverse events.One case was diagnosed as severe acute graft versus host disease and died of intracranial hemorrhage on day 61 after allo-HSCT.The other 10 patients survived.Decitabine bridge is a safe regimen before allo-HSCT in children with refractory hematological malignancies.