Unresectable or metastatic pancreatic cancer carries a poor prognosis,and systemic therapy with cytotoxic agents provides marginal benefit. Even the first-line chemotherapeutic agent, gemcitabine(GEM) has a modest survival benefit,and objective tumor response is rarely achieved. Combination of various cytotoxics did not produce a significant improvement either. For that reason,continuous search for better molecules targeted agents and/or combinations is inevitable. Erlotinib, an orally bioavailable small molecule inhibitor of the epidermal growth factor receptor tyrosine kinase, is the first of these targeted which compounds to be approved for use in combination with gemcimbine for patients with advanced pancreatic cancer. GEM with other targeted agents,including monoclonal antibodies: cetuximab or bevacizumab,also has been extensively evaluated,with limited success to date. Future research should continue to unravel the mechanism of pancreatic carcinogenesis and to identify key relevant molecular targets for therapeutic intervention.

Objective To analyze the effect of pain control with radiotherapy in bone metastases from malig-nancies. Methods A total of 72 lesions in forty-two cases with bone mestastases were received 6my X ray. The con-ventional radiotherapy was performed in 28 lesions in the way of 200cGy/fraction,5 fracties/week,total dose of 3000 ～5000cGy. The hypofractionation radiotherapy was.performed in 44 lesions in the way of 400cGy/fracfion,3 frac-tions/week,total dose of 2400～3600cGy. Results Overal pain relief rate was 90.28%, there were no significant differences between the two groups(P 0.05). The pain relief of hypofractionation radiotherapy was faster than anoth-er. Conclusion Radiotherapy is a very effective way to relieve pain in bone metastases from malignacies.

Clinical data of 365 patients with type 2 diabetes admitted from December 2010 to May 2011 were retrospectively analyzed,including 130 cases with fatty liver and 235 non-fatty liver cases.There were no differences in gender,age,disease course between two groups (P ＞ 0.05). BMI,glycated hemoglobin (HbAlc),blood pressure,TC,TG,LDL-C,large vessels complications and microvascular complications rate in fatty liver group were significantly higher than those in non-fatty liver group ( all P ＜0.01 ),while there was no difference in rate of peripheral neuropathy (P ＞ 0.05 ).The results indicate that blood glucose,blood pressure,BMI,abnormal blood lipid and chronic complications were closely related to type 2 diabetics with fatty liver.

In this paper,we exhaustively discussed the teaching design of basic life support in processing teaching materials,choosing the methods of teaching and learning,planning the teaching process and reflection after teaching and so on,to introduce how to use the pedagogy and the psychology principles to guide teaching design,for the purpose of improving the teaching quality.

Objective To retrospectively review our experience of treating hepatic biloma in the elderly.Methods Before cyst fenestration,the fistulas between the bile duct and biloma were ligated in the 6 patients.Result All the 6 patients were cured.On follow-up,there was no recurrence.Conclusion The procedure is feasible and safe in the treatment of biloma in the elderly.

ObjectiveTo investigate whether brain microbleeds is associated with antiplatelet-related intracranial hemorrhage (ICH). MethodsForty-three patients with antiplatelet-related ICH treated in our hospital from Jun 2005 to Jun 2010 were investigated in this study.Age, sex and hypertension matched controls with non-antiplatelet-related ICH; and without history of ICH on antiplatelet therapy were selected. ResultsMicrobleeds was more frequent in antiplatelet users with ICH than in matched antiplatelet users without ICH(31/43(72. 1％ ) vs 12/57(21.1％ ), x2 =6. 731, P =0. 011 ) and was more frequent in IHC patients with antiplatelet treatment than those with non-antiplatelet treatment (31/43 (72. 1％ ) vs 17/48 (35.4％), P =0. 030). The frequency of lobar microbleeds(27/43, 62. 8％ ) was significant high in antiplatelet-related ICH than that in non antiplatelet-related ICH (19/48, 39. 6％, x2 =4. 019, P =0. 042). The number of microbleeds was associated with the risk of antiplate-related ICH ( OR =1.38 per additional microbleed, 95％ CI 1.07-1.71, t =0. 806, P =0. 021 ). ConclusionBrain microbleeds are associated with antiplatelet-related ICH.

In recent years,biofeedback combined with nerve electrical stimulation therapy as a kind of new treatment has been generally applied in paediatrics,gastroenterology,proctology and rehabilitation.This paper is to review the application of the therapy in children with fecal incontinence,including its principle,clinical efficacy and prospects.

Toll-like receptor( TLR )is a newly discovered important innate immune receptor and signal transduction transmembrane receptor.By the TLR in the surface of immune cells,body can recognize conserved pathogen-associated molecular patterns,to stimulate the production of cytokine,increased costimulatory molecule expression of antigen-presenting cell,activating T cells,establishing a closely-linked bridge between the innate immunity and acquired immunity.TLR9 is a member of Toll-like receptor family,mainly identify viral or bacterial DNA containing unmethylated CpG dinucleotides.Studies have showed that TLR9 is in the immune system's recognition of EB virus,and it plays an important role in the infection and transformation of the EB virus.This paper reviews the studies of the interaction of TLR9 with EB virus.

Most academic information appears in the database and academic websites;in rencent years the blog and podcast also transmit academic information.Medical graduates need to check new information regularly after busy routine work,but how to effectively collect and manage academic information is a problem.This paper describes the new strategies and methods for them to use.

Energy metabolism varies in different periods during the lifetime or in different pathological states. Resting energy expenditure (REE) may increase in some patients with malignant tumors, but may also show no significant difference when compared with healthy people or patients with benign tumors. The alteration of REE may be related to tumor site, pathologic stage, methods of treatment, and/or laboratory tests. The efficacy of a certain therapy may also affect REE in patients with malignant tumors: when a therapy is effective, the value of REE can return normal; however, when the treatment fails, REE will not be improved or become even higher.Mechanism governing the abnormalities of REE in patients with malignant tumors may be associated with the abnormal nutrition metabolism and the regulations of relevant cytokines.