mTOR signaling pathway is closely related to cell proliferation,cell cycle and other pathological processes about tumor.Rapamycin plays an anti-tumor effect through inhibiting mTOR,but it prone to drug resistance,which leads to limited clinical application.Its resistant mechanism is related with the activation of PI3K-Akt,which is regulated with negative feedback.Dual inhibitors of related proteins of mTOR pathway are expected to reverse the drug resistance.

Post-hepatitis cirrhosis (PHC),which results from either hepatitis B virus (HBV) or hepatitis C virus (HCV) infection,and its associated with hemodynamic changes may cause the spleen to become functionally hyperactive-a condition known as hypersplenism.Hypersplenism is associated with anemia,leukopenia,thrombocytopenia and splenomegaly.There are several effective methods to treat hypersplenism with the development of medical technology and the main purpose is the remission of hypersplenism,reducing the portal hypertension and decreasing the risk of hemorrhage.However,complete splenectomy or partial treatment of the hyperactive spleen is still controversial all over the world.This may be caused by the lack of the knowledge on the pathophysiological characteristics and clinical significance of treating hypersplenism.This review is a comprehensive discussion on the recent research which investigates hypersplenism caused by PHC.

Objective Toinvestigatetheclinicalfeaturesofrecurrentbiliarypancreatitisandrelatedpredisposingfactors.Methods Ato-tal of 272 patients with biliary pancreatitis who were admitted and treated in Jiangbei District People′s Hospital from January 2008 to Decem-ber 2014 were enrolled and divided into recurrence group (56 patients with recurrent biliary pancreatitis)and primary group (216 patients with primary biliary pancreatitis).Clinical features and predisposing factors were compared between the two groups.Comparison of continu-ousdatabetweenthetwogroupswasmadebyttestandcomparisonofcategoricaldatewasmadebychi-squaretest.Results Therewere no significant differences in age and mortality between the two groups (both P>0.05 ).Compared with the primary group,the recurrence group had a significantly higher proportion of males,a significantly increased APACHE-Ⅱscore,significantly increased incidence rates of moderate-to-severe pancreatitis and common bile duct stones,significantly higher rates of stenosis of the common bile duct orifice and hy-perlipidemia,and a significantly higher rate of surgical treatment (all P<0.05).In the recurrence group,the type of pancreatitis differed significantly between patients with 2 times of recurrence and those with >2 times of recurrence (recurrence for more than 2 times)(P=0.040).Compared with the primary group,the recurrence group had a significantly higher proportion of patients with known predisposing factors (80.36%vs 58.33%,P=0.002),as well as significantly higher rates of high-fat diet and drinking (both P<0.05).However, the rates of biliary tract infection and oral administration of drugs showed no significant differences between the two groups (both P>0.05). Conclusion Recurrentbiliarypancreatitisiscommonandsevereinmales,andisoftencomplicatedbycommonbileductstones,stenosisof the common bile duct orifice,and hyperlipidemia,with a high rate of surgical treatment.High-fat diet and drinking are important predispo-sing factors for recurrent biliary pancreatitis.

Aim To investigate the immunoregulative action of polysacchrides of Spirulina platensis ( PSP ) on peripheral blood mononuclear cells ( PBMCs) in pa-tients with chronic hepatitis B virus infection. Meth-ods Proliferation and cycle of PBMCs from patients with chronic hepatitis B virus infection were measured by MTT colorimetry and flow cytometry respectively. The concentration of IFN-γ, IL-2 , IL-4 in supernatants of PBMCs were examined by ELISA. The mRNA ex-pression of IFN-γin PBMCs from patients with chronic hepatitis B virus infection was detected by RT-PCR. Results PSP could induce proliferation of PBMCs in patients with chronic hepatitis B virus infection. In ad-dition, PSP could increase the protein expression of IFN-γ and IL-2 in supernatants of PBMCs in patients with chronic hepatitis B virus infection, and PSP could also enhance the mRNA expression of IFN-γof PBMCs in patients with chronic hepatitis B virus infection. However, PSP inhibited the protein expression of IL-4 of PBMCs in patients with chronic hepatitis B virus in-fection. Conclusion PSP can promote the immune function and plays an important immunoregulation function on patients with chronic hepatitis B virus in-fection.

The risk factors of diastolic heart failure include among others: hypertension,diabetes,myocardial ischemia and aging.The underlying mechanisms for this cardiac complication are incompletely understood.With the increase of aging of the population,the prevalence and mortality of diastolic heart failure is rising gradually.It seriously affects the life quality and life span of people.In order to more truly reveal the underlying mechanisms of diastolic heart failure and to develope novel therapeutic strategies,the experimental animal models are extremely important.The present review focuses on providing an overview of the characteristics of these models for the growing number of investigators who seek to understand the pathology of diastolic heart failure.

OBJECTIVE:To provide reference for reasonable iron supplement during pregnancy. METHODS:5023 iron sup-plement prescriptions for 800 delivery women receiving antenatal care and childbearing in our hospital in 2014 were analyzed retro-spectively. According to international authoritative guideline for gestational iron supplement,the rationality of iron supplement for pregnant women in our hospital was investigated in terms of timing,duration and dosage. RESULTS:The iron supplement timing and duration of 800 pregnant women all met the criteria;among 5023 iron supplement prescriptions,62 prescriptions of preventive iron supplement and 3875 prescriptions of iron supplement for iron deficiency were up to the standard. CONCLUSIONS:The dos-age of gestational iron supplement are unreasonable in our hospital at a certain extent. It is necessary to strengthen clinical medica-tion management to guarantee safe and rational iron supplement in pregnant women.

Objective To compare the value of ultrasound International Ovarian of Tumor Analysis (IOTA) simple rules and gynecologic imaging reporting and data system (GI-RADS) ultrasonographie stratification in the diagnosis of adnexal masses.Methods A total of 463 patients with adnexal masses were classified according to IOTA simple rules by senior doctor.The benign and malignant masses were enrolled in the study.Then the masses were judged according to GI-RADS classification and IOTA simple rules by senior and junior doctors.And junior doctorn in diagnosis of adnexal masses with IOTA was group A1,senior doctor in diagnosis of adnexal masses with IOTA was group B1,junior doctor in diagnosis of adnexal masses with GI-RADS was A2,senior doctor in diagnosis of adnexal masses with GI-RADS was B2.The efficacy of the two methods were compared.Results Among the 463 cases,there were 411 cases (411/463,88.77％) of benign mass and malignant mass by IOTA and 52 cases (52/463,11.23 ％) of uncertain mass.The specificity,positive predictive value,diagnostic accuracy had statistical differences between groups A2 and B2,A1 and A2 (all P＜0.05),and sensitivity and negative predictive value had no statistical differences (all P＞0.05).Diagnostic efficacy index had no statistial signifi cance between group A1 and B1,B1 and B2 (all P＞0.05).Conclusion The diagnostic efficacy of IOTA simple rules and GI-RADS is high and similar in diagnosis of benign and malignant adnexal masse.IOTA simple rules do not depend on experience,but they are not suitable for the diagnosis of all adnexal masses.

This study was aimed to evaluate the clinical effectiveness of Ban-Xia Hou-Po (BXHP) decoction in the treatment of globus hystericus. Related literatures were systemically searched in the China National Knowledge Infrastructure (CNKI, 1979-2013), Weipu Database for Chinese Technical Periodicals (1989-2013), and PubMed/Medline. The methodological quality of included trials was assessed based on the Jadad scale. The available data was analyzed with RevMan software (version 5.2.0) provided by the Cochrane collaboration. The results showed that a total of 6 randomized controlled trials (RCTs), which contained 649 globus hystericus cases, were included. The meta-analysis showed that compared with modern medicine, the total therapeutic effect of BXHP decoction was RR=1.15, 95%CI (1.08, 1.23); compared with modern medicine treatment alone, the total therapeutic effect of combination between BXHP decoction and modern medicine was RR=1.43, 95%CI (1.19, 1.73). It was concluded that the current clinical evidences showed that the effectiveness of BXHP decoction alone or combined with modern medicine in the treatment of globus hystericus was higher than the treatment only with modern medicine. And there was no obvious side effect. However, due to the low-quality studies and small amount of samples, the results still required to be confirmed with more high-quality, multi-center, and large sample RCTs.

Objective To test the reliability and validity of the Chinese version of Quality-of-Life Questionnaire for Mechanically Ventilated Patients (QOL-MV). Methods The English version of QOL-MV was revised and translated into Chinese version. The reliability and validity of the Chinese version of QOL-MV was tested in 120 mechanically ventilated patients. Results The Cronbachαcoefficient of the Chinese QOL-MV was 0.904. The item-level content validity index of Chinese QOL-MV were 0.86-1.00 and the scale-level content validity index of Chinese QOL-MV was 0.92. Two factors were extracted by factor analysis and the cumulated variance was 80.18%. The dimensional factor loading of each item was greater than 0.565. The correlation coefficient between the score of Chinese QOL-MV and the Euroqol Group′s 5-domain 3 Level Questionnaire (EQ-5D) and Richards Campbell Sleep Questionnaire (RCSQ) was 0.947 and 0.561 respectively (P<0.01). Conclusions The Chinese version of QOL-MV has been proved to be reliable and valid.It can be used to measure the quality-of-life for mechanically ventilated patients.

Objective To investigate the risk factors of peripartum hysterectomy in placenta previa through retrospective study of 3 840 placenta previa cases. Methods The clinical data of 3 840 patients with placenta previa who delivered in West China Second University Hospital between Jan 2005 and June 2014 were analyzed retrospectively. The relationship of certain factors and peripartum hysterectomy was analyzed, including maternal age, residence place, parity, prior curettage, prior cesarean section, twin or multiple pregnancy, antenatal vaginal bleeding, type of placenta previa, suspected placenta accreta, antenatal level of hemoglobin and gestational age at delivery. Results The prevalence of placenta previa was 4.84% (3 840/79 304) in West China Second University Hospital during the study period, and the incidence of preipartum hysterectomy in patients with placenta previa was 2.76% (106/3 840). One-factor analysis demonstrated that residence place, parity, times of prior curettage, prior cesarean section, prenatal vaginal bleeding, anterior placenta, type of placenta previa, placenta accreta, antenatal anemia and gestational age at delivery were potential risk factors for peripartum hysterectomy (P<0.01). Variables with P<0.1 in one-factor analysis were introduced to multi-factor logistic regression analysis, which suggested that one prior cesarean section (OR=12.9,95%CI:6.3-26.3), two or more prior cesarean sections (OR=14.4, 95%CI:3.9-53.2), anterior placenta (OR=4.8, 95%CI:2.1-10.7), complete placenta previa (OR=5.9, 95%CI:1.8-42.5), placenta accreta (OR=11.2, 95%CI:6.8-18.6), antenatal hemoglobin<100 g/L (OR=1.7, 95%CI:1.0-2.8) and delivery before 34 gestational weeks (OR=3.2, 95%CI:1.6-6.3) were independent risk factors of peripartum hysterectomy in patients with placenta previa (P<0.05). Conclusions Prior cesarean section, anterior placenta, complete placenta previa, placenta accreta, antenatal anemia and delivery before 34 gestational weeks are high risk factors of peripartum hysterectomy in placenta previa patients. Perinatal care and risk evaluation before cesarean section are important to improve perinatal outcomes and reduce peripartum hysterectomy.