Objective To study the clinicopathologic characteristics,the optimal therapy and prognosis of patients with pancreatic carcinoma with elevated serum alpha-fetoprotein (AFP).Methods CNKI,Wanfang database,VIP Database for Chinese Technical Periodicals,PUBMED and EMBASE were searched.Studies which met the inclusion criteria were evaluated.Results 24 reports were found which included 28 patients with pancreatic carcinoma with elevated serum AFP.The carcinoma was characterized clinically by a predilection for older male.The majority of patients had metastases at the time of diagnosis,especially liver metastases.Histopathologically,not all tumors were hepatoid carcinoma,and acinar cell carcinoma was most common.Surgical resection was the optimal treatment for patients at an early stage.Combined therapies were used on patients at an advanced stage.Patients with hepatoid carcinoma of the pancreas might be sensitive to treatment similarly to hepatocellular carcinoma.In AFP-producing pancreatic carcinoma,serum AFP level was a useful marker for diagnosis and evaluation of therapeutic response and recurrence.However,there were no sufficient evidence to support whether pancreatic carcinoma with elevated serum AFP was associated with a higher frequency of liver metastasis and poor survival.Conclusions Further studies are needed to identify the prognosis and the effective therapies for the AFP expression variance of pancreatic carcinoma with elevated serum AFP.Detecting AFP and variants of AFP are important for the early diagnosis of pancreatic carcinoma with elevated serum AFP,and increase in therapeutic response and prog nosis.

Objective To explore the role of adjustable and close persistent peritoneal drain in large ascites and acute renal insufficiency(ARI)in patients with primary nephrotic syndrome(PNS).Methods The adjustable and close persistent peritoneal drain tube were planted in 6 cases with PNS accompanied by large ascites and ARI during December 2005 and August 2006.On the basis of drain,they were treated by prednisone,anticoagulative agent,hypolipidic agent,antibiotics,antioxidant,microcirculation-improving agent and aweto preparation.Results After the treatment,ascites disappeared or decreased.ARI was cured in 5 cases.Among these patients,partial remission(PR)and no respone(NR)to treatment were present in 3 cases respectively during hospitalization.After the follow-up of 3~12 months,the complete remisson(CR)of PNS was found in 2 cases,PR in 3 cases and NR in 1 case respectively.Conclusion The adjustable and close persistent peritoneal drain may be applicable for PNS patients with large ascites and ARI and slight glomerular lesion.It can clear away the superabundant water,mitigate the renal interstitial edema and accelerate the recovery of ARI.It also makes the patients have the opportunity of the treatment which includes predenisone,anticoagulative agent and hypolipidic agent.

Objective To investigate mother-to-child transmission of HIV-1 and the factors that affect transmission. Methods 136 children who were born to HIV positive mothers in a high HIV prevalence region were interviewed and blood samples were examined for anti-HIV anti-HGV and HIV RNA or HIV DNA. Results Among 136 children who were born to HIV positive mothers, 50 were infected with HIV. The MTCT rate was 36.8% (50/136). Thirty eight DNA fragments of HIV-1 gag gene P17 obtained from HIV-1 seropositive mothers were amplified by PCR from uncultured peripheral blood mononuclear cells (PBMCs). Sequence analyses showed that all of them were HIV-1 B subtype. The HIV vertical transmission rate among mothers with AIDS (67.4%, 31/46) was significantly greater than among those with HIV alone (21.1%, 19/90), P

Objective To observe the relationship between blood stasis syndrome and clinical pathology in patients with IgA nephropathy (IgAN). Methods Clinical and pathological materials of 42 patients with blood stasis syndrome,and 73 patients with non blood stasis syndrome were analyzed. Result Patients with blood stasis syndrome are often female and accompanied with renal dysfunction. Compared with patients of non blood stasis syndrome,Lee’s grades were obviously higher,degrees of fibrinogen-related antigen (FRA) deposited in renal were stronger,and scores or ratio of tubular atrophy significantly were higher. Conclusion Blood stasis syndrome of IgAN is correlated with certain renal pathological changes. Blood stasis is the main etiological factor.

0.05).No severe adverse event occurred during the treatment,and the occurrence in the two groups was similar.CONCLUSION:Huangkui Capsule can effectively decrease the proteinuria just like fosinopril and improve clinical syndrome of patients of IgA nephropathy with damp-heat syndrome type,and shows no serious adverse reaction.

AIM:To observe the clinical effects of Huangkui Capsule (Abelmoschus manihot (Linn)Medic.)on the treatment of IgA nephropathy of damp-heat syndrome.METHODS: Sixty-four patients were assigned randomly into two groups: treatment group in which 32 cases were treated with Huangkui Capsule,and control group,in which 32 cases were treated with fosinopril.The therapeutic course for both groups was 12 weeks.The indexes of efficacy ,including damp-heat syndrome scores,24 h urinary protein,serum creatinine,urea nitrogen and the indexes of safety,including liver function,electrolyte and occurrence of adverse events were observed.RESULTS :There was no significant statistical difference between the two groups in aspects of baseline clinical figures,after 12 weeks of treatment,the content of 24h urinary protein significantly decreased by (0.49±0.78 )g/24 h and (0.4±0.76 ) g/24 h respectively in the two groups,showing significant difference in comparing with baseline,but insignificant difference between the two groups ( P ＞ 0.05 ),the scores of damp-heat syndrome in the two groups decreased by (0.88±1.43 ) scores and (1.94±1.63 ) scores respectively with significant difference as compared with baseline (P ＜0.05 ),and in comparison between groups(P ＜0.05 ).The total effective rate of 24 h urinary protein was 53.1% in the treatment group and 65.6% in the control group (P ＞ 0.05 ),The total effective rate of dampheat syndrome scores was 84.4% in the treatment group and 50% in the control group ( P ＞ 0.05 ).No significant change in levels of serum creatinine,urea nitrogen in the two groups was found (P ＞0.05 ).No severe adverse event occurred during the treatment,and the occurrence in the two groups was similar.CONCLUSION: Huangkui Capsule can effectively decrease the proteinuria just like fosinopril and improve clinical syndrome of patients of IgA nephropathy with damp-heat syndrome type,and shows no serious adverse reaction.

Objective To evaluate the antihypertensive effect and safety of domestic produced amlodipine(Lan Di) in the treatment of chronic renal insufficiency with mild-mnderate hypertension and to compare with the effect of imported amledipine.Methods Sixty-onc patients with chronic renal insufficiency(Scr:265～442 μmol/L,seated DBP 90 ～105mmHg and seated SBP≤170mmHg) were enrolled in this study.Patients were randomly assigned to receive Lan Di 5mg or novasc 5mg once daily for 4 weeks.Doses were titrating to 10mg/d for another 4 weeks in patients hating seated DBP≥80mmHg or SBP≥130mmHg at the end of 4 weeks.Blood pressure,heart rate,laboratory examinations were performed at baseline and the end of the trial,and side effects were assessed pre and post Lan Di or novasc treatment.Results Lan Di group(31 cases) and novasc group(30 cases) finished a 8 week clinical trial.At the end of 4,8 weeks,seated SBP and DBP were significantly lowered compared with those at baseline(P＜0.01 ).There was no significant difference in the reduction of seated DBP or SBP between the two groups at the end of 4,8 weeks(P＞0.05).At the end of 8 weeks ,the response rate was 87% in Lan Di group and 90% in novasc group.If the target value of blood pressure is below 130/80mmHg,the response rate was 36% in Lan Di group and 30% in novasc group.At the end of 8 weeks,no difference was found in laboratory findings compared with those at baseline in two groups(P＞0.05).Side effects were comparable during the period of treatment.Condusion Domestic produced amlodipine 5mg or 10mg daily is as effective and safe as imported amolodipine in chronic renal insufficiency patients with mild to moderate hypertension.

Objective To study the status of anxiety and depression on clinical decision-making participation of laryngeal cancer patients.Methods A total of 82 laryngeal cancer patients participated in the investigation by questionnaire to study the clinical decision-making participation by control preferences scale.The degree of anxiety and depression was investigated by self-rating anxiety scale and self-rating depression scale.Results During the clinical decision-making process,40.24％ of the patients were passive,29.27％ had their families as absolute representatives,20.73％ took part collaborating with their families and only 9.76％ were active.47.56％ had anxiety and 64.63％ depression,and the anxiety and depression influenced their participation in clinical decision-making postively and passively relatively.Conclusions Patients with laryngeal cancer are passive in clinical decision-making and most of them have anxiety and depression.Doctors should enhance the communication with patients,which can help to eliminate adverse psychological emotions and make satisfying clinical decision-making.

Objective To Evaluate the performance of serum adenosine deaminase assays of different manufacturers and explore the approach for harmonization of test results.Methods It was evaluated the indice including the limit of blank ,precision,linearity range and reference interval of 10 test systems.It was as the reference system by Mindray test system to evaluate the comparability and the difference of ADA results among 10 different systems.The evaluation was performed before and after calibration by a selected fresh serum assigned by the reference system.A commercial calibrator of the minimum matrix effect was selected from 8 different calibrators as the long-term calibrator to harmonize the ADA results of 10 systems.Results The results of LoB were 0.1-6.3 U/L,respectively.The within-run CVs and total CVs of 10 systems were all less than 5%and actual linearity ranges were conformed to claims of manufacturers.After calibration with fresh serum calibrator ,the averaged difference of 10 test systems was reduced from 14% to 3.0%, and the average difference was 1.8% after calibration with long-term calibrator.The common reference interval of all test systems was 5-24 U/L identically.Conclusions The comparability of ADA measurements can be improved by using a common human serum calibrator and the commutable commercial calibrator.And it is necessary and feasible to develop the standardzation of ADA.

Objective To study the prevalence of retinopathy of prematurity (ROP) in preterm infants in Xiamen, Fujian. Design Retrospective case series. Participants From Oct. 2004 to Dec. 2008, 375 infants with birth weights ≤2500g or gestational age ≤32w were screened in Xiamen the First Hospital. Methods Initial examinations with the binocular indirect ophthalmoscopy and the scleral depression began at 4～6 weeks after birth or at 32 weeks postconception. All infants were followed-up until a stable retinal situation was reached. Main Outcome Measures The prevalence of ROP. Results Retinopathy of prematurity was detected in 10.93% of 375 neonates, including 18 eyes of stage 1, 48 eyes in stage 2, 14 eyes in stage 3, 2 eyes in AP-ROP. The prevalence of ROP in the infants with the birth weight ≤1000g, 1001-1500g and 1501-2000g was 45%, 17.07%, 7.01%, respectively; the occurrence rate of ROP in the infants with the gestational age ≤28 weeks, 29-30 weeks, 31-32 weeks, 33-34 weeks was 34.48%, 2.07%, 12.71%, 8.25%, respectively. Conclusions Earlier screening for ROP is very important. Low birth weight and young gestational age are the most important risk factors in the development of ROP.