Objective To investigate the clinicopathological features of gastrointestinal carcinoma with neuroendocrine differentiation (NED) and mixed adenocarcinoma of the pancreas and pancreas (MANEC). Methods Clinical and pathological data of 29 cases in Zhejiang Chinese medicine hospital with gastrointestinal pancreatic cancer with neuroendocrine branch and 7 cases with gastrointestinal pancreatic MANEC patients were analyzed retrospectively. Hematoxylin eosin staining of the tissue (HE) and immunohistochemistry (IHC) were observed, the relationship between IHC index and tumor distant metastasis and clinical pathological indicators between. Results Gastrointestinal pancreatic cancer with NED and MANEC in patients with various clinicopathological parameters and IHC expression rate difference was not statistically significant;neuroendocrine index expression difference between the positive rate and clinical pathological factors were not statistically significant; there was no significant difference between distant metastasis and clinical pathological factors. Conclusion Combined with morphological HE staining and immunohistochemical IHC staining, gastrointestinal carcinoma with NED and MANEC has high heterogeneity. Clinical staging and grading are the major prognostic factors. Early diagnosis and treatment can improve the prognosis of patients.

Objective To evaluate the infection rate and influencing factors of Hepatitis E Virus among different occupational population in nanjiang region of Xinjiang. Methods A cross-sectional survey was carried out in occupational population and non-occupational population having a close contact with livertock. Serum IgG antibodies against hepatitis E virus was tested by indirect enzyme-linked immunosorbent assay , and logistic regression model was used to analyze the risk factors of HEV infection. Results The result showed that the total positive rate was 51.88% and 317 out of 611 subjects were anti-HEV IgG positive. Non-occupational population had the lowest positive rate (35.90%), followed by the stock man of intensive nursery (24.14%), stock man of scattered nursery (76.00%), livestock and meat salesperson (79.37%) and slaughterman (81.53%). Multivariate logistic regression analysis showed that close contact with livestock , eating out and without frequent hand washing increased the risk of HEV infection . And HEV infection rate decreased in the population with professional training. Conclusion It is noticeable that promoting good health habits and cutting off animal-contact transmission are effective measures for the prevention of hepatitis E.

Objective:To investigate the infection status and influencing factors of hepatitis E virus infection among different occupational populations in Xinjiang region,and to provide a available evidence for control of hepatitis E.Methods:A randomly sampling survey was carried out in the population of public health practitioners, the serum IgG antibodies against hepatitis E virus in 1 720 samples were tested by indirect enzyme-linked immunosorbent assay,and the experimental data was analyzed with SPSS 19.0 software;the differences of infection rates between genders,ages and occupations were analyzed.Results:Among 1 720 subjects,440 persons were anti-HEV IgG positive,and the total positive rate was 25.58%;the positive rate of males (27.99%)was higher than that of females (23.35%),and the IgG positive rate was increased along with the age;there were significant differences of the anti-HEV-IgG antibody positive rates between the populations with different ages (χ2 =118.262, P = 0.000 ). There was a statistically significant difference of infection rate of hepatitis E between different occupational populations (χ2 = 98.262,P = 0.000),the slaughterman had the highest positive rate (81.53%), followed by the livestock and meat salesperson (79.37%),food service population (30%),supermarket population (11.21%)and others (9.03%).Conclusion:The hepatitis E infection rate is high among the public health practitioners in Xinjiang region,and occupation,age and gender are the major influencing factors of hepatitis E infection rate.

Objective To compare the hemostatic efficacies of radial artery balloon and spinning hemostat in elderly patients after radial artery intervention.Methods Eighty elderly patients undergoing transradial coronary intervention were randomly divided into balloon and spinning hemostat groups,with 40 cases in each group.After operation,balloons and spinning hemostats were used for hemostasis,respectively.The two groups were compared in terms of hemostatic effect,comfort degree and incidence of complications.Results These was no difference in hemostatic effect between the two groups(P>0.05).The balloon hemostat group was better than the spinning hemostat in respect of comfort degree.The incidences of ischemia and vagal reflex in the balloon hemostat group were significantly lower than the spinning hemostat group(P<0.05).Conclusion The balloon hemostat for radial artery intervention is more suitable for elderly patients undergoing oral treatment.

Objective To investigate the value of P-selectin,thrombomodulin (TM) and von Willebrand factor (vWF) in identifying severe acute pancreatitis (SAP) at an early stage of the disease.Methods 80 patients with acute pancreatitis (25 mild,30 moderate and 25 severe) were selected in this study when they were admitted within 24 hours of the onset of symptoms.20 healthy volunteers were collected as the healthy control.Enzyme-linked immunosorbent assay (ELISA) was used to determine the levels of vascular endothelial cell damage markers (P-selectin,TM and vWF) in SAP patients and the control group.Results The levels of 3 markers were significantly higher in SAP patients than in the mild and moderate acute pancreatitis patients and healthy volunteers (P＜0.05).P-selectin,TM and vWF were independent markers for the development of SAP and had higher discriminative powers than conventional marker tumor necrosis factor(TNF-α)(P＜0.05).They were similar to the APACHE-Ⅱ scoring system in distinguishing SAP at an early stage.Conclusions P-selectin,TM and vWF are independent markers to identify the development of SAP at an early stage.They are obviously superior to TNF-α and similar to the APACHE-Ⅱ scoring system.

Objective To observe the NTBC dependence of Fah-knockout mice and study the biological characteristics in order to use the model more effectively.Methods Examine the progressive changes in body weight, survival time, liver pathology and serological markers after the NTBC withdrawal.Results After removing of NTBC, Fah-knockout mice lost their body weight gradually, and finally died in 5 to 7 weeks, along with increased serum ALT, AST levels and deformation of the hepatocytes.Conclusions Fah-knockout mice have a strong drug dependence of NTBC and could be the ideal model to hereditary tyrosinemia type I and other liver injury.

3T3-L1 adipocytes were cultured and differentiated into mature adipocytes in vitro. The adipocytes were intervened by ACAT inhibitor( 2 μg/ml) and ox-LDL with various concentrations (0,25,50,75,and 100 μg/ml)for 48 h,ACAT inhibitor( 2 μg/ml) and ox-LDL( 50 μg/ml) at the 0,6,18,36,and 48 h,or ACAT inhibitor( 2 μg/ml),ox-LDL( 50 μg/ml),and TUDCA with various concentrations(0,100,200,and 400 μ mol/L)for 48 h,respectively.The levels of visfatin in supernatant were examined by ELISA and the expressions of protein GRP78 and CHOP in adipocytes were detected by Western blot.After the adipocytes were treated with ACAT inhibitor and ox-LDL at different concentrations for 48 h,the cholesterol concentration and the expressions of GRP78 and CHOP protein in adipocytes and the visfatin levels in the supernatant fluid were increased with the increase of the ox-LDL concentration.The differences had statistical significance in the experimental groups compared with blank control group( all P＜0.05 ).After the intervention with ACAT inhibitor and ox-LDL for different durations,the expressions of GRP78 and CHOP protein in adipocytes and the visfatin levels in the supernatant fluid were up-regulated in a timedependent manner.The differences between experimental groups and blank control had statistical significance( all P＜0.05 ).After the intervention with ACAT inhibitor,ox-LDL,and different concentrations of TUDCA for 48 hours,the expressions of GRP78 and CHOP protein in adipocytes and visfatin levels in the supernatant fluid were down-regulated in a dose-dependent manner and as compared with blank control group the difference were statistically significant( all P＜ 0.05 ).The increase of cholesterol load in adipocyte may promote the visfatin secretion,denoting that the mechanism might be due to the enhancement of endoplasmic reticulum stress in aidpocytes.

Objective To study the outcomes of two intervention strategies on the language development of young children with hearing loss greater than moderate degree by universal newborn hearing screening (UNHS) system.Methods Infants and young children,born from Jan 2002 to Dec 2007 in Shanghai and failed UNHS,were included in this study.They received audiometric evaluations at the Shanghai Children's Hearing and Speech Center.Among those diagnosed with hearing loss greater than moderate degrees,65 were intervened at 6 months and followed up subsequently.According to hearing loss degree and intervention strategies,20 of 65 were included in the hearing aid group(M_(HA)),19 was in the severe hearing aid group(S_(HA)),9 in the profound hearing aid group(P_(HA)),and 17 in the profound cochlear implamation group(P_(CI)).Other 36 were not intervened at 6 months old but followed up also.The control group was 36 normal hearing young children.The hearing losse and speech development were analyzed for statistical study.Results Between the group without intervention and the control group,between the group intervened and without intervention,statistically significant differences were noted (P＜0.05) in the average hearing threshold and the developmental scores.Between the control group and anyone group among M_(HA),S_(HA) and P_(CI),no statistically significant differences (P＞0.05) were noted in the developmental scores.For the same hearing level between the group P_(HA) and P_(CI),statistically significant differences (P＜0.05) were noted in the developmental scores.The developmental scores of P_(HA) was lower than that of P_(CI).Conclusion Early intervention is effective for infants and young children with hearing loss greater than moderate degree.Their speech development is noticeably faster than that of those without any intervention.According to hearing loss degree,it was very important for acquiring the best speech development that selected the most proper intervention mode.

Objective To evaluate the value of diffusion-weighted MRI in the functional study of kidney.Methods Fifteen volunteers as control group and 32 patients with chronic kidney disease(CKD) were underwent DW MR imaging in a dehydrated state.In CKD group,12 cases were with normal serum creatinine(Scr) level(CKD group 1) and 20 cases with Scr increased in different level(CKD group 2).Apparent Diffusion Coefficient(ADC) value of each kidney of all groups was measured and compared of their relationships with clinical data.Results The ADC values of 15 volunteers in different b values(50,100,400) were(405.366?35.9639)?10~(-5)mm~2/s,(339.646?23.0594)?10~(-5)mm~2/s,and(254.532?13.6763)?10~(-5)mm~2/s,respectively.The ADC values of CKD group 1 were(336.622?12.879)?10~(5)mm~2/s,(308.142?20.998)?10~(-5)mm~2/s,and(211.398?14.604)?10~(-5)mm~2/s,respectively.And of CKD group 2 were(307.717?84.930)?10~(-5)mm~2/s,(265.415?57.754)?10~(-5)mm~2/s,and(201.672?26.411)?10~(-5)mm~2/s,respectively.The ADC values in CKD group were lower than those of the normal kidneys(t values compared between the control group and CKD group 1 were 9.720,5.190,11.093 separately,between the control group and CKD goup 2 were 6.533,7.382,10.864 separately in different b values,with all P values less than 0.05).In CKD group 2,it had been showed negtive correlation between the level of Scr and ADC values of kidney,with mean level of Scr of(828.490?699.350) ?mol/L,but this was confirmed of no statistical meanings(the coefficient correlation were(-0.272、)-0.283、-0.023 separately in different b values,with p values more than 0.05).For the creatinine clearance rate(Ccr),it showed a weak positive correlation with ADC values of CKD group 2(the coefficient correlation were 0.511、0.430、0.335 separately,with P values less than 0.05).Conclusion(Diffusion-weighted) MRI imaging and in vivo measurement of ADC values have the potential for use as a noninvasive means to explore the functional status of the kidney.

The hospital spirit is not only the spiritual support and vital source for staff, but also the concentrat-ed expression of ideology and faith, value orientation, moral trait, psychology tendencies, culture stereotypes, the unified will and code of conduct for all kinds of personnel.The party organizations are the best helmsmen to culti-vate and carry forward the hospital spirit, which reveals distinctive and profound medical ethical principles and norms.In this paper, taking X hospital as an example, we describe the core function of the party committee′s lead-ership and results in the process of breeding, inheritance and innovation of hospital spirit and reflect ethically so as to provide good references for the current hospital spirit cultivation and promotion.