Perineural invasion(PNl) is regarded as a factor associated with local recurrence and an important prognostic factor in pancreatic cancer.Little is known about the mechanism of PNI in Pancreatic cancer.This review summarizes the role of innervation, clinicopathologic factors, lymhatic vessels, vascularity, cytokines, adhesion molecules, some immunoglobulin superfamily members and mucin in PNI.Because PNI is often followed by poor survival.An ear-lier diagnosis can improve pancreatic cancer prognosis.IPEUS,CT scan and immunostaining CK-19, K-ras gene a-nalysis can be used to diagnose perineural invasion pre-, in-tra-or postoperatively.A wide surgical exeresis with an enough lymph nodes clearance together with surrounding connective and nervous tissue can get a better long term survival rate.

Objective To study the effect of mesylate ropivacaine programmed intermittent epidural injection for labor analgesia. Method 100 cases of ASA I or II single cephalic term primiparae , randomly divided into epidural rules intermittent administration group (Group A) and continuous epidural infusion group (Group B), 50 cases of each group. Two groups were treated with 0.12%mesylate ropivacaine and 2 μg/mL fentanyl. The two groups were observed in different stage of labor , uterine contraction analgesic effect , mode of delivery , fetal distress and neonatal asphyxia. Result Compared with Group B, the VAS scores of women in Group A were decreased significantly and the difference was statistically significant (P < 0.05) after they had the labor analgesia 60min later, the mouth of the uterus opened to 5-6cm and all. There is no statistical significance in the mode of delivery and Apgar score. Conclusion Ropicacaine mesilate epidural programmed intermittent bolus are safe and effective for labor analgesia. Compared with continuous epidural infusion analgesia in labor , maternal satisfaction is higher and there is no significant adverse effects on mother and infant.

In order to investigate the influence of angiotensin II on hematopoietic system, CD34+ cells in cord blood were purified, and the effects of angiotensin II in combination with various cytokines on their growth and differentiation were studied by cell culture in vitro. It was found that angiotensin II in suspending medium could stimulate both BFU-E and CFU-GM expansion. The number of BFU-E and CFU-GM was increased with the increases of angiotensin II concentrations during a certain range. In addition, the expansion fold of CFU-GM was increased from 2.3 +/- 0.8 times to 7.8 +/- 2.3 times when angiotensin II was added in the presence of SCF+G-CSF+GM-CSF+IL3 cytokines mixture. Similarly, the expansion fold of BFU-E was increased from 3.1 +/- 1.8 times to 9. 2 +/- 2.3 times with angiotensin II in the presence of SCF+EPO+TPO+IL-3. In the semi-solid medium, angiotensin II could stimulate CFU-GM expansion but had no effect on the growth of BFU-E. In conclusion, angiotensin II had some stimulating effects on cord blood hematopoietic progenitors expansion in vitro in the presence of other cytokines.
Angiotensin II/*pharmacology ; Antigens, CD34/*metabolism ; Cells, Cultured ; Colony-Forming Units Assay ; Fetal Blood/*cytology ; Granulocyte-Macrophage Colony-Stimulating Factor ; Hematopoietic Stem Cells/*cytology

Transcutaneous immunization(TCI),the topical application of antigen and adjuvant directly onto intact skin,which can safely and effectively elicit systemic and celluar immune responses in mice and humans against a variety of antigens,is a novel method of vaccine delivery.Not only the skin has evolved as a barrier to prevent external agents,including pathogens,from entering the body,but also it has a complex and efficient immune system,which includes Langerhans′ cells and dendritic cells.The skin is an attractive target for vaccine delivery.By targeting the body′s natural defense system,TCI attempts to produce an efficient immune response.All these results highlight the likelihood that TCI will play an important role in vaccine applications in the future.

Objective:To research the influence and mechanism of Toufeng capsule (TFC) on the concentratioin of blood active substance and single amine neurotransmitter in the brain and blood of magraine mice.Methods: We chose animal disease model of migraine made by hypodermic nitroglycerin and measured the concentration of 5 HT. NE and DA in the rat's brain and blood by means of enzymeimmunoassay experimental methods.Results: TFC could obviously increase the concentration of 5 HT and NE in the bloold and of 5 HT, DA and NE in the brain.Conclusions: TFC might improve neurosystematic regulation functions and enhance the neurotransmitters' secretion and metabolism.

Objective: To investigate the sleep promoting effect of Gastrodia elata on mice and its effect on the central dopamine (DA) system, and study the mechanisms of gastrodin, the active constituent of G. elata. Methods: Five groups of mice were treated by gavage with saline, gastrodia, olive oil, gastrodia mixed with olive oil and positive control Estazolam, respectively, for 20 d (10 mice per group). Hypnosis induced by suprathreshold and subthreshold doses of Pentobarbital sodium were used to evaluate the effect of G. elata on sleep in mice. Sleep latency, occurrence rate and duration were recorded at the 7th and 20th day. The DA content in the brain tested by ELISA and the expression of DA receptor subtypes detected by qRT-PCR were used to determine the effect of G. elata on central DA system. Western blotting was further used to detect the expression levels of ERK pathway related protein. Results: After 20 d of gavage, the sleep latency of mice was significantly shortened, the sleep occurrence rate was increased, the sleep duration was prolonged, and the content of brain DA was significantly increased. At the same time, the expression levels of all the dopamine receptor subtypes were significantly up-regulated. Furthermore, the gastrodin, the active constituent of G. elata, could activate the dopamine receptor D2 rather than the D1-mediated signaling pathway. Conclusion: G. elata might regulate sleep by up-regulating the activity of central DA system. Gastrodin, the active constituent of G. elata, could play a regulating role through D2-mediated signaling pathway.

Objective To investigate the survival of advanced stage periampullary carcinoma and its prognostic factors.Methods The clinical data and follow up of 134 patients with advanced stage periampullary carcinoma admitted to our hospital between January 2007 and December 2010 were retrospectively collected and analyzed.Results Of 134 patients,there were 83 males and 51 females.The mean age±S.D.was 62.49±11.41 (28-83).For the 86 patients who underwent surgery,32 had extensive peritoneal metastases on surgical exploration,27 had metastases/involvement of the liver or stomach,and 27 had major vessel infiltration.For these 86 patients,55 received surgical exploration,whereas 31 had surgical exploration plus bypass anastomosis. 45 patients received chemotherapy,while 67 received chemotherapy plus radiotherapy.The improvements in quality of life and in clinical response rate after concurrent chemoradiotherapy or chemotherapy alone were 73.1％ and 57.8％,respectively.The overall survival was 14.27±1.06 months.The median survival time was 11 (8.95±13.05) months.The 1- and 3-year survival rates were 43％ and 10％,respectively.Karnofsky performance status,and the presence or absence of jaundice co-related with poor prognosis on single factor analysis.The Karnofsky performance status was an independent survival predictor on multifactor analysis.Conclusions The prognosis of patients with advanced stage periampullary carcinoma was poor.Chemotherapy with or without radiotherapy had similar impact on overall survival,Karnofsky performance status was an independent survival predictor.

Objective　To compare the effects of mild hypothe rmic cardiopulmonary bypass (CPB) and moderate hypothermic cardiopulmonary bypas s in pediatric cardiac surgery. Methods　A total of 118 cas es of less than 3 years of age that had undergone open heart surgery were review ed, in which 46 patients received moderate hypothermic CPB(group 1) and 72 patie nts received mild hypothermic CPB(group 2). The CPB duration, incidence of low c ardiac output and postoperative concentration of CK-MK, etc, were compared with each other betwee n the two groups. Results　Duration of bypass and postoperative mechanical respiratory assistance of group 2 was shorter than that of group 1 ( P<0.05). Transfusion requirements, incidence of low cardiac output syndrome, concentration of CK-ME and percentage of metabolic acidosis were lower in grou p 2 than in group 1 (P<0.05), while the index of oxygenation was higher in g roup 2(P<0.05). Conclusion　The mild hypothermic CPB is saf er and more effective and therefore is superior to moderate hypothermic CPB in p ediatric cardiac surgery.

Objectives To investigate the role of lymphangiogenesis in the perineural micrometastasis of pancreatic adenocarcinoma. Methods The clinical data of 30 pancreatic adenocarcinoma patients who were admitted from Sep. 2005 to Oct. 2006 for extended radical surgery were collected. The samples including pancreatic cancer, adjacent tissue, lower bile duct, pancreatic tail, the structure surrounding the SMA (peripancreatic nerve plexus) and lymph nodes were collected during operation. They were subjected to conventional pathological examination. The lymphatic capillaries weredetected by double immunohistochemical staining and the lymphatic vessel density ( LVD) was measured. Results Intra-pancreatic and/or peripancreatic neural invasion was observed in 25 patients (83. 3% ) , of which 20 were found to have both the peri-pancreatic and intra-pancreatic neural invasion. The other 5 only had the intrapancreatic neural fiber invasion and there was no single patient with peri-pancreatic neural fiber invasion only. Peri-neural invasion was not significantly associated with patients' age, gender, lymph node metastasis, tumor size and the location (P > 0.05) , but was obviously associated with JPS clinical staging ( P < 0. 05 ). The mean intratumoral LVD was (4.2 ±3.4) per field, which was significantly lower than (11.3 ±6.9) per field of adjacent tissue and (10.8 ±4.4)per field of normal pancreatic tissue(P<0.01). The mean intratumoral LVD between adjacent tissue and normal pancreatic tissue was not statistically different. Lymphatic vessel invasion was observed in non-malignant tissues in 18 patients, and there was a distribution correlation between lymphatic vessel invasion and extra-pancreatic neural plexus invasion (P<0.05). Conclusions The incidence of peri-neural invasion was high, peri-neural invasion was associated with JPS clinical staging and lymphatic vessel invasion, which suggested the possibility of the cancer spreading by peritumoral lymphangiogenesis route into the peri-SMA neural plexuses.