Objective:To observe the therapeutic effect and toxicity of capecitabine and temozolomide in the treatment of advanced pancreatic neuroendocrine tumors. Methods:A total of 14 patients with stageⅣwell-differentiated pancreatic neuroendocrine tumor (NET G1/G2/G3) were treated with oral CAPTEM regimen, and the response rate, PFS and adverse effect after treatment were analyzed. All data analyses were performed using software SPSS17.0. Results:These 14 patients were followed-up for more than 2 years. Till Oct 2016, one patient got CR, one patient got PR, four patients got SD. Median progression-free survival was 8.9 months. The two year survival rate was 85.7%. Only one patient experienced grade 3 adverse events. Conclusion:CAPTEM is an effective and well-tolerated salvage regimen for the treatment of advanced well-differentiated pNET.

Aim To study the effect of resveratrol on proliferation of liver cancer SMMC-7721 cells and the relevant mechanism.Methods SMMC-7721 cells were treated with different concentrations of resveratrol.Cell proliferation was tested by cell proliferation assay and colony-forming experiment.The effect of resveratrol on cell cycle of SMMC-7721 cells was detected by flow cytometry.The activation of mTOR/p-mTOR proteins was detected by Western blot.Results Compared with control group, resveratrol inhibited SMMC-7721 cell proliferation in a dose-dependent manner(P<0.01);cell cycle detection showed that SMMC-7721 cells were arrested at G0/G1 phase by resveratrol;Westren blot assay showed that resveratrol down-regulated p-mTOR expression.Conslusion Resveratrol inhibits human SMMC-7721 cell proliferation and arrests the cell cycle at G0/G1 phase, while the inhibition mechanism may be related to activation of mTOR signaling pathway by resveratrol.

Objective To observe the effects of Compound Uncaria Hypotensive Tablets on expressions of MCP-1 and MMP-9 of vascular remodeling in spontaneously hypertensive rats (SHR); To discuss it possible mechanism of action. Methods Totally 24 12-week old male SHR were randomly divided into SHR model group, Compound Uncaria Hypotensive Tablets group, and positive medicine group, with 8 rats in each group. Another 8 WKY rats were set as normal control group. Medication groups were given relevant medicine for gavage for successive 6 weeks. Noninvasive tail cuff method was used to observe blood pressure; morphological changes in thoracic aorta and renal artery were observed by HE staining; immunohistochemistry was used to detect the protein expressions of MCP-1 and MMP-9 in thoracic aortic wall. Results Protein expressions of MCP-1 and MMP-9 in thoracic aortic wall of SHR model group were significantly higher than those of normal control group (P<0.01); Compared with the SHR model group, protein expressions of MCP-1 and MMP-9 in thoracic aortic wall decreased significantly in the medication groups (P<0.05, P<0.01); Compared the Compound Uncaria Hypotensive Tablets group and positive medicine group, there was no obvious difference in protein expressions of MCP-1 and MMP-9 in thoracic aortic wall. Conclusion Compound Uncaria Hypotensive Tablets can reduce the blood pressure of SHR, reduce inflammation reaction, and regulate vascular remodeling, which mechanism may be related to down-regulation of expressions of MCP-1 and MMP-9 in SHR aortic endothelial cells.

In this paper,through the questionnaire analysis of teachers' teaching quality,the author got to know the students were contented with the teaching quality and there were some problems in the classroom teaching. Moreover,the author offered a few advises to improve the teaching level and teaching quality.

ObjectiveOne hunred and twenty-four To probe into application value of ultrasound guided Catheterization in internal jugular vein. MethodsOne hundrel and twenty-four guided by ultrasound puncture holder, single-channel or three-channel catheter was embedded into jugular vein. ResultsThe catheter was inserted successfully by only one procedure in all the 124 patients. There was no complication. ConclusionsThe catheterization becomes safer, convenient and quickly with ultrasound puncture holder guidance, decreasing failure rate and complication of the procedure.

Objective To discuss the clinical efficacy of surgery for chronic subdural hematoma assisted by rigid neuroendoscope and its surgical techniques. Methods Clinical data of 161 patients with chronic subdural hematoma from August 2009 to December 2015 was analyzed retrospectively. 74 of them experienced surgeries assisted by rigid neuroendoscope (endoscope group) and other 87 cases were operated without neuroendoscope (routine group) during the same period. Results Although there were significant difference in operative duration between the two groups, complications, ratio of total removal of hematoma after surgery, postoperative inpatient duration and recurrent rate of hematoma were more advantageous in endoscope group. The operative duration of endoscope group with (112.68 ± 34.86) min was longer than that of routine group with (74.11 ± 28.23) min (t = 7.75, P = 0.000), while the postoperative inpatient duration of endoscope group with (8.23 ± 2.01) d was shorter than that of another group with (10.79 ± 5.02) d (t = -4.12, P = 0.000). There were no surgical associated complications in endoscope group, but 1 patient in routine group experienced intracerebral hematoma of frontal lobe and associated aphemia. Total removal of hematoma was confirmed in endoscope group with 98.65% (73/74), which was higher than that in routine group with 86.21% (75/78) (χ2 = 8.34, P = 0.004). Hematoma recurrence was found in 16 cases of routine group (18.39%), but more superiority in endoscope group with 1.35% (χ2 = 12.29, P = 0.000). Outpatient follow-up was carried out in all patients from 6 to 38 months with an average duration of 30.06 months. In 17 cases with recurrent hematoma during follow-up, 15 of them were cured by a second surgery, and another 2 patients were cured by atorvastatin. Conclusion As a simple, safe and effective technique, the application of rigid neuroendoscope during surgery for chronic subdural hematoma is more advantage than routine surgery. A self-made suction with adjustable soft curved tip is suitable for such procedure.

Objective To explore the sonographic characteristics and to evaluate its diagnostic value of hepatic lymphoma (HL). Methods The clinical data and abdominal sonographic ifndings of 18 consecutive patients with histological proven diagnosis of lymphoma with liver involvement were reviewed, including contrast-enhanced ultrasound (CEUS) images. Results The liver sonographic features of 18 HL were differentiated as three types including nodular, diffuse and mixed type. Nodular type showed well-deifned hypoecho lesions in 6 cases with penetrating vascular lfow signals in 2 cases and no vascular lfow signals in 6 cases by color Doppler imaging. In 3 cases by CEUS, all the hepatic focal nodulars showed variable arterial enhancement but wash-out in the portal venous and late phases. For diffuse type cases, hepatomegaly without nodule was showed in 11 cases. Vasular in liver showed normal in 8 cases and abnormal in 3 cases. For mixed type cases, hepatomegaly and multiple ill-deifned hypoechoic lesions with normal vascular in liver were showed in 1 case. Hepatosplenomegaly and abdominal lymphoadenopathies were identiifed in 11 cases. Conclusions The characteristics and the types of sonographic ifndings may be helpful in differentiating HL from other liver lesions.

Objective To evaluate the value of contrast-enhanced uhrasound(CEUS)for liver fibrosis.Methods Ninty-two chronic hepatitis B patients with histology diagnosis and fifteen health control were detected by CEUS,dynamic images and the time-intensity curve were analyed.Results Hepatic veinartery transit(HV-ATT)became shorter in the early hepatic cirrhosis patients [(7.5±2.1)s]compared to the control[(11.8±2.7)s].However,there was no difference between the fibrosis patients [(13.0±2.2)s]and the control.Furthermore,HV-ATT of the fibrosis patients with S1 to S3 stage were(11.7±2.7)s(S1),(11.8±3.0)S(S2),(11.8±2.3)s(S3)without significant difference.Conclusions CEUS is valuable in diagnosing earlier hepatic cirrhosis,but not fibrosis.

Objective To investigate the regional cerebral stimulation after central analgesics nasal spray and its mechanism with pharmacological functional magnetic resonance imaging (phfMRI). Methods Eighteen healthy right-handed volunteers participated. Butorphanol tartrate nasal spray was used as the experiment agent. Ethological experiment was carried out to record the participants' subjective feeling and the onset time of the analgesics, followed by the functional MRI (fMRI) scan two weeks later. Block design was adopted. Two phases of fMRI scan were performed at 7 min and 25 min after the nasal spray, respectively. Participants were also given pain stimulation in the dorsum of hand during the fMRI scanning. The data were post-processed with Matlab 6.5 and SPM 2. Results ①Onset time of butorphanol tartrate was 15-35 min after nasal spray administration, which was consistent with its concentration-time curve. ②After nasal spray, activations were observed in the cerebral cortex, including frontal lobe (orbitofrontal gyrus, medial frontal gyrus, superior frontal gyrus), temporal lobe (insula, middle temporal gyrus, inferior temporal gyrus), parietal lobe (precuneal gyrus), limbic system (anterior cingulate gyrus, middle cingulate gyrus, hippocampus, parahippocampal gyrus);subcortical region (globus pallidus) and cerebellum (6-9 of cerebellar cortex, cerebellar peduncle, vermis). ③The number and activation intensity of the second phase were more obvious than those of the first phase (P<0.01). Conclusion The feasibility of phfMRI study on cerebral stimulation and the mechanism of nasal spray is demonstrated. The study of butorphanol tartrate further validates the main distribution of opioid receptors in the central nervous system and the possible mechanism of central analgesia.

Objective To review the survival outcomes in patients with endometrial stromal sarcoma(ESS)in Cancer Hospital，Peking Union Medical College，Chinese Academy of Medical Sciences，and to discuss prognostic factors and the role of post-operative adjuvant radiotherapy and chemotherapy.Methods Hospital records and pathology reports for 97 patients with ESS were reviewed.Among 97 patients，69 had low-grade ESS(LGESS)，16 had high-grade ESS(HGESS)and 12 had unclear grade.The median age at diagnosis was 44.0 years.The median follow-up time was 62 months(5-277 months).Atypical vaginal bleeding(43％)and prolonged and increased menses(36％)were the main symptoms.Results Totally 2-year and 5-year cumulative survival rates were 93％and 84％，respectively.Cumulative survival curves were significantly different between LGESS and HGESS，and so did cumulative survival curves between stage Ⅰ-Ⅱ and stage Ⅲ-Ⅳ(P＜0.05).Totally，34 patients(37％)had local or distant recurrence.The median time-to-recurrence(TTR)was 27 months.The recurrence rates of the patients with or without preserve of ovary were 89％and 24％，respectively(P=0.000).The local-control-rates of the patients who received or did not receive post-operative radiotherapy were 81％and 43％，respectively(P=0.011).Conclusions The prognosis of HGESS is obviously worse than that of LGESS.The risk of recurrence of patients with preserve of ovary was remarkably higher than that of patients without preserve of ovary.Postoperative radiotherapy could increase the local-control-rates.