Pancreatic cancer is characterized by high invasiveness,high malignancy and poor prognosis. Therefore,it is urgent to find biomarkers for early diagnosis and to develop targeting drugs for treatment of pancreatic cancer. MicroRNAs (miRNAs)are single-stranded,non-coding small RNA molecules with a length of 18-25 nucleotides and are highly expressed in pancreatic cancer. MiRNAs play important roles in cell proliferation,differentiation,apoptosis,invasion and metastasis,and are associated with adverse prognosis and resistance to chemotherapy in pancreatic cancer. As a new target for diagnosis and treatment of pancreatic cancer,miRNA-21 has become the hot spot of clinical research. This article reviewed the advances in studies on miRNA-21 in the pathogenesis,diagnosis and treatment of pancreatic cancer.

OBJECTIVE:To investigate the relationship between Tacrolimus blood concentration and effectiveness after renal transplantation and to find factors affecting Tacrolimus blood concentration METHODS:Steady-state trough concentrations of Tacrolimus were collected from 80 renal transplantation patients RESULTS:The effective blood concentration of Tacrolimus was associated with course of treatment CONCLUSIONS:The therapeutic concentration of Tacrolimus was between 12ng/ml and 15ng/ml during the first 2 weeks after renal transplantation,then should be 8ng/ml～15ng/ml

Objective:To explore the effects of different temperature settings on patients with acute hypoxic respiratory failure (AHRF) during application of high-flow nasal cannula (HFNC) .Methods:A total of 90 patients with AHRF who were admitted to the Department of Critical Care Medicine of Zhejiang Hospital and underwent HFNC from January 2019 to May 2020 were selected as research objects by the convenient sampling method. The patients were randomly divided into 3 groups by the random number table method, namely, group A (T=31 ℃) , group B (T=34 ℃) and group C (T=37 ℃) , with 30 cases in each group. The VAS and Borg Scale were used to compare the comfort and dyspnea of patients of 3 groups, and to compare the satisfaction of patients of 3 groups.Results:After applying HFNC for 2 h and 12 h, the scores of VAS and Borg Scale in group B were lower than those in groups A and C, and the differences were statistically significant ( P<0.01) . The VAS scores of the three groups after applying HFNC for 12 h were higher than that after applying HFNC for 2 h, and the scores of Borg Scale were lower than that after applying HFNC for 2 h, and the differences were statistically significant ( P<0.05) . The satisfaction of patients in group B was higher than that in group A and C, and the differences were statistically significant ( P< 0.01) . Conclusions:Different temperature settings of HFNC will affect the comfort, dyspnea and satisfaction of AHRF patients. Among them, 34 ℃ is a more suitable temperature. As time progresses, nursing staff should intervene in time to maintain the comfort of patients, reduce the degree of dyspnea and provide guidance for the clinical application of HFNC.

Imaging examinations such as CT,MRI and ultrasonography are of great importance for the diagnosis of digestive system neoplasms. However,some digestive system neoplasms are difficult to be detected at early stage and make qualitative diagnosis by conventional imaging techniques because of their unique clinical characteristics. Compared with conventional imaging techniques,endoscopic ultrasonography-guided fine needle aspiration (EUS-FNA)can not only detect the early lesions,but also make accurate qualitative diagnosis. The development and improvement of EUS-FNA greatly improve the diagnostic level of digestive system neoplasms. In this paper,the diagnostic value of EUS-FNA in digestive system neoplasms was reviewed.

Atherosclerosis is a leading cause of death worldwide, and its mechanisms are still unclear. However, various animal models have significantly advanced our understanding of the mechanisms involved in atherosclerosis and have allowed the evaluation of therapeutic options. The aim of this paper is to review those animal models (i.e., rabbits, mice, rats, guinea pigs, hamsters, avian, carnivores, swine, and, non-human primates) that have been used to study atherosclerosis. Though there is no single perfect animal model that completely replicates the stages of human atherosclerosis, cholesterol feeding and mechanical endothelial injury are two common features shared by most models of atherosclerosis. Further, with the development of genetically modified animals, these models are significantly broadening our understanding of the pathogenesis of atherosclerosis.
Animals ; Atherosclerosis ; epidemiology ; metabolism ; pathology ; Disease Models, Animal ; Humans

Background:Cholangitis is common in patients with advanced cholangiocarcinoma after endoscopic metal biliary endoprothesis (EMBE). Aims:To explore the effect of EMBE combined with endoscopic nasobiliary drainage (ENBD)on preventing post-ERCP cholangitis in patients with cholangiocarcinoma. Methods: A total of 263 advanced cholangiocarcinoma patients underwent EMBE were enrolled and divided into EMBE group and EMBE plus ENBD group. Incidence of post-ERCP cholangitis,adverse event rate and hospital stay were evaluated between the two groups. Results:Compared with EMBE group,incidence of post-ERCP cholangitis (2. 3% vs. 10. 8%,P ＝0. 032 )and hospital stay [(4. 68 ± 1. 43)days vs. (5. 18 ± 1. 45 )days,P ＝0. 011 ]were significantly lower in EMBE plus ENBD group, especially in patients with hilar cholangiocarcinoma [incidence of post-ERCP cholangitis:3. 5% vs. 15. 0%,P＝0. 045;hospital stay:(5. 18 ± 1. 44)days vs. (5. 68 ± 1. 39)days,P＝0. 033]. C-reactive protein,white blood cell count, percentage of neutrophil after 3,24,72 hours were significantly decreased in EMBE plus ENBD group than in EMBE group (P＜0. 05). No significant difference in procedure-related adverse event was found between the two groups (P＞0. 05). Conclusions:The combination of EMBE with ENBD is safe and effective in preventing post-ERCP cholangitis,especially in patients with hilar cholangiocarcinoma.

ObjectiveTo explore the establishment and evaluation methods of the rat model of acute myocardial infarction （AMI） in coronary heart disease with the syndrome of Qi and Yin deficiency by sleep deprivation （SD） combined with isoproterenol （ISO） and preliminarily explore its biological basis. MethodForty SD rats were assigned into normal （no treatment）， SD （treatment in modified multi-platform water environment for 96 h）， ISO （subcutaneous injection of ISO at 100 mg·kg^-1 once every other day for a total of 2 times）， and SD+ISO （injection of 100 mg·kg^-1 ISO after SD for 72 h and 96 h） groups. The cardiac function was detected by small animal echocardiography. The serum levels of creatine kinase （CK）， creatine kinase isoenzyme （CK-MB）， lactate dehydrogenase （LDH）， and cardiac troponin T （cTnT） were measured by biochemical methods. The pathological changes of the myocardial tissue were observed by hematoxylin-eosin staining. The general state， body weight， grip strength， body temperature， behaviors in open field test， serum levels of cyclic adenosine monophosphate （cAMP）， cyclic guanosine monophosphate （cGMP）， cAMP/cGMP ratio， red （R）， green （G）， blue （B） values of the tongue surface， and pulse amplitude were observed and measured to evaluate the modeling results. Enzyme-linked immunosorbent assay was employed to determine the serum levels of interleukin-18 （IL-18）， tumor necrosis factor-α （TNF-α）， superoxide dismutase （SOD）， malondialdehyde （MDA）， corticotropin-releasing factor （CRF）， adrenocorticotropic hormone （ACTH）， triiodothyronine （T3）， tetraiodothyronine （T4）， cluster of differentiation 4 （CD4）， and cluster of differentiation 8 （CD8）. ResultIn terms of disease indicators， the ISO and SD+ISO groups had lower cardiac function indicators than the normal group （P<0.01）. The levels of CK， CM-MB， LDH and cTnT elevated in each model group compared with the normal group （P<0.01）. The pathological changes of myocardial tissue were obvious in the ISO and SD+ISO groups. In terms of syndrome indicators， compared with the normal group， the SD and SD+ISO groups showed decreased body weight at each time point （P<0.01）， and the ISO group showed decreased body weight at the time points of 48 h and 72 h （P<0.05， P<0.01）. The paw temperature and rectal temperature increased in the SD group （P<0.01）. The model groups showed weakened grasp strength， lowered R， G， and B values of the tongue surface （P<0.01）， prolonged immobility time （P<0.01）， reduced total distance and number of entering the central area （P<0.01）， decreased average speed （P<0.05， P<0.01）， and increased cAMP and cGMP （P<0.05， P<0.01）. The cAMP/cGMP ratio was increased in the SD+ISO group （P<0.01）， and the pulse amplitude was decreased in the SD and SD+ISO groups （P<0.01）. In terms of serological indicators，compared with the normal group， the levels of IL-18， TNF-α， SOD and MDA were significantly increased in the ISO and SD+ISO groups （P<0.01）， the CRF， ACTH， CORT， T3， T4， CD4 and CD8 in the model groups were increased （P<0.05， P<0.01）. ConclusionSleep deprivation for 96 h combined with high-dose ISO can successfully establish a rat model of acute myocardial infarction in coronary heart disease with the syndrome of Qi and Yin deficiency. The model evaluation system can be built with disease indicators of western medicine， histopathological indicators， macroscopic indicators of traditional Chinese medicine， and serological indicators.