Two stage polymerase chain reaction(restricted fragment length polymorphism was used to study K ras mutations and chemiluminescence immunoassay was used to detect CA19 9 in plasma from patients with pancreatic adenocarcinoma, some samples were analyzed by direct seqencing. The results showed 18 (60%) of 30 patients with pancreatic adenocarcinoma had K ras mutations in plasma, and 25 (83 3%) of 30 had elevated CA19 9 in plasma. The former was less sensitive than the latter, but the diagnostic rate of combined analysis was 100%. It is concluded that combined analysis of molecular tumor markers and protein tumor marker is more sensitive than protein tumor markers alone, it might overcome Lewis blood type limitation to protein markers.

Objective To investigate the incidence of diabetes mellitus and risk factors for the disease in chronic pancreatitis (CP) patients.Methods A historical cohort study on subjects with painful CP who were admitted to hospital from Jan.1997 to July 2007 were conducted.A life-table method was used to estimate the cumulative probability of the development of diabetes mellitus once clinical onset of abdominal pain.Cox proportional-hazards model was used for multivariate analysis of the variables including age,sex,drinking and smoking habits,etiological factor,presence of pancreatic masses,pancreatic calcifications,measure of intervention,diarrhea,weight loss and degree of pain.Results Data were obtained from 354 patients (239 males,mean age at onset of pain (38.1±17.6) years;alcoholic origin 18.1%) with painful CP.The mean follow-up period was (45.2±32.9)months.The rate of diabetes mellitus in CP patients was 16.1%.There was a high incidence (29.8%)of diabetes mellitus 1 year before the episodes of abdominal pain.The cumulative risk of diabetes mellitus in subjects 5 and 10 years after the episodes of pain was 9.3% and 20.7%,respectively.Cox proportional-hazards model selected smoking (＞10 pack years) (hazard rate (HR)= 3.3),mild abdominal pain (HR=5.2),weight loss (HR = 2.6) and pancreatic calcifications (HR = 2.2) as variables identifying subjects with diabetes mellitus in patients with painful CP before they were performed therapeutic endoscopy or surgical intervention.Smoking (＞10 pack years) (HR = 3.0),weight loss (HR= 2.8) and distal pancreatectomy (HR =7.3) were identified with an increased risk of diabetes mellitus in these cases after they received therapeutic endoscopy or surgical intervention.Conclusion The risk factors of diabetes mellitus for CP appears to be independent of smoking (＞10 pack years),mild abdominal pain,weight loss,pancreatic calcifications and distal pancreatectomy.

Objective To investigate the expression of DNA-methyltransferases 3B(DNMT3B)gene in human pancreatic carcinoma and to evaluate its relationship with elinicopathologic parameters.Methods 42 samples of pancreatic carcinoma tissues and 42 para-carcinoma tissues and 10 normal pancreatic tissues were collected and the expression of DNMT3B mRNA and protein Was detected by real.time PCR and immunohistochemistry techniques.Results The expression of DNMT3B mRNA(RQ level)in human pancreatic carcinoma tissues and para-carcinoma tissues,normal pancreatic tissues was 9.4±5.9,1.02±0.71 and 0,respectively,and the difference was statistically significant(P<0.05).The rate of expression of DNMT3B protein in human pancreatic carcinoma tissues,para-carcinoma tissues and normal pancreatic tissues were 83.3%,14.3%and 10%,respectively,and the difference wag also statistically significant(P<0.01).The expression of DNMT3B mRNA correlated significantly with clinical staging,differentiation degree of the tumor and lymph node metastasis(P<0.01 or P<0.05).The expression of DNMT3B protein correlated significantly with the location ofthe tumor and lymph node metastasis(P<0.01 or P<0.05).The expression of DNMT3B mRNA and protein Was not assecimed with age,sex,neural invasion,tumor size,sernm CEA and CA19-9.Conclusions Highly expressed DNMT3B mRNA and protein may indicate the lymph node metastasis and poor prognosis in human pancreatic carcinoma.

Objective To evaluate different operative modalities for sphincter-preserving procedures in patients of lower rectal cancer. Methods A total of 137 patients with lower rectal cancer underwent sphincter-perserving surgery between January 2003 and January 2008. In the operation, the proximal colon with satisfactory blood supply was pulled down to reestablish intestinal continuity without any tension. Results Among the 137 patients, 102 patients underwent low anterior resection by double stapling technique, 16 patients were dealed with the Parks operation, 19 patients were dealed with the modified Bacon operation. In the double-stapling technique group, the distance between the anal verge and inferior margin of the tumor was 6-8 cm in 91 patients and 5-6 cm in 11 patients whose tumors were located at posterior rectal wall. In the other two groups, the distance between the anal verge and inferior margin of the tumor was 5-6 cm. In the Parks operation, the sigmoid colon was anastomosed with the anus in all of 19 patients. In the modified Bacon operation group, the descending colon was pulled through anus in all of 16 patients. Conclusions The low anterior resection with double stapling technique can be applied to a patient if the distance from the inferior margin of the tumor to the anal verge is 6 cm to 8 cm. The Parks operation or the modified Bacon operation can be applied to a patient if the the distance from the inferior margin of the tumor to the anal verge is 5 to 6 cm, The Parks operation can be performed with the sigmoid colon being anastomosed with the anus if the length of the sigmoid colon is long enough to reach the anus, the modified Bacon operation can be performed with the descending colon being pulled through the anus by mobilization of splenic flexure or left colon if the length of the sigmoid is not long enough to reach the anus.

Objective To evaluate and compare the effects of surgical and endoscopic therapy for common bile duct stenosis (CBDS) induced by chronic pancreatitis (CP). Methods A historical cohort study of CBDS subjects induced by CP, who underwent endoscopic or surgical treatments at Changhai Hospital from Januraryl997 to July 2007, was performed. Results Of 514 cases of CP, CBDS occurred in 51 (9.9%), in which complete follow-up data were available in 41 survived patients with a mean follow-up period of 42.9±28. 3 months. The mean ages of first onset and hospitalization were 46. 3±14.0 and 49. 8±11.9 years, respectively. Endoscopic therapy was applied in 13 patients, including bile duct stenting in 7, 6 of whom presented with cholangitis, cholestasis and/or jaundice. Surgery was performed in 26 patients, in which 7 also underwent endoscopic therapy, and occupying lesion in pancreatic head was found in 14. The other 2 patients were treated without endoscopy or surgery. At the end of the follow-up, all symptoms including cholangitis, cholestasis and jaundice were relieved and no recurrence or choler cirrhosis was recorded.Conclusion Surgical approach is the main treatment for CBDS induced by CP. Endoscopic therapy is an alternative for patients unfit for surgery, especially for those who had jaundice, cholestasis or cholangitis.

Objective To explore the treatments and their effects on painless chronic pancreatitis (CP) in adult. Methods A historical cohort study of adult subjects with CP, who were hospitalized in our center in the last decade, was performed, and the clinical data were analyzed. Results There were 56 cases of adult painless CP, and 46 (82.1%) (31 males and 15 females, age 51.6±14.5 years) were followed up(34.5±27.1 months). Imaging findings showed 26 cases of pancreatic duct stones and morphological changes. These patients received endoscopic intervention therapy(n=14), surgical procedures(n=7), combined endoscopic and surgical treatment(n=3) and conservative treatment(n=2). Another group of 18 cases of pancreatic or peripheral occupying lesions received surgery. During follow-up of the above 2 groups, 1 patient died of pancreatic cancer in each group. The symptoms of diabetes and diarrhea were not relieved, but there was improvement of general condition in some patients. Stones re-occurred after surgery in one patient. Two patients with pancreatic duct dilation and cysts underwent endoscopic treatment(n=1) and surgical procedure(n=1), respectively. But the latter patient experienced gastric bleeding, cirrhosis and jaundice with unknown reason after the surgery. Conclusion In adult patients with CP, endoscopic and surgical procedures had similar effect in patients with pancreatic duct stones and dilation. Surgical procedures are preferably performed in those with pancreatic occupying lesions. Further study is needed in those only with pancreatic duct dilation. The above treatments can improve general conditions in some patients. Intensive surveillance is suggested to the patients with painless CP.

Objective To investigate the gene expression of connexin43(Cx43) and its effect on gap junction intercellular communication(GJIC) of acute leukemia bone marrow stromal cells(ALBMSCs).Methods After ALBMSCs were transfected by recombinant adenovirus Ad-Cx43-GFP,the expression of report gene GFP and the transfection efficiency were monitored by fluorescent microscopy.RT-PCR,Western blot and immunocytochemical method were used to detect the mRNA and protein expressions of Cx43.Dye transfer procedure was performed to examine the GJIC function.Results After transfected by Ad-Cx43-GFP for 24 h,the expression of GFP in ALBMSCs was detected by fluorescent microscopy and the transfection efficiency was(82.7?2.16)%;The mRNA and protein expressions of Cx43 in ALBMSCs transfected by Ad-Cx43-GFP were higher than those not transfected by Ad-Cx43-GFP(P

Objective To analyse the clinical characterization of intraductal papillary mucinous neoplasm of pancreas (IPMNs) and to improve the understanding of IPMNs.Methods Three hundred and sixty-one patients with IPMN at Shanghai Changhai Hospital between 1993 and 2012 were retrospectively analyzed.Results Among 361 cases of IPMNs,241 were men and 120 were female,with a female to male ratio of 2.6∶1.Mean age of the patients was 62 years old (16 ～ 87 years old).The duct type included the main duct in 102 patients (28.3％),a branch duct in 109 (30.2％),and mixed ducts in 150 (41.6％).The most common symptom at presentation is pancreatitis,which occur in 167 patients (46.3％).The sensitivity for the detection of IPMN was 80.2％ by ERCP,76.9％ by MRCP,63.9％ by CT,and 50.5％ by EUS.One hundred and twenty-nine patients (35.7％) were operated and diagnosed with 87 (67.2％) IPMA,21 (16.4％) IPMB,10(8.2％) IPMC(CIS) and 10 (8.2％) had invasive carcinomas.The 5-year survival rates of IPMA,IPMB,IPMC,and invasive carcinomas were 100％,100％,66.5％,and 44.7％,respectively.Conclusions IPMNs were fregrently occured is 60 years old,half of patients had acute pancreatitis history and the frequtly attack,mixed type is most anatomy type,and the outcome after surgery is good.

OBJECTIVETo assess the role of oxidative metabolism and nitric oxide synthesis for elucidating their pathophysiological mechanisms in a Tibetan patient with essential hypertension.

METHODSThe serum levels of total superoxide dismutase (T-SOD), malondialdehyde (MDA), total antioxidant capacity (T-AOC), nitric oxide (NO) and nitric oxide synthase (NOS) were assayed in sixty native Tibetans (thirty hypertensive patients and thirty healthy volunteers as control).

RESULTSThe levels of T-SOD, T-AOC, NO and NOS were significantly lower in the patient group than in the control group (P < 0.01); MDA was significantly higher in the patient group than in the control group (P < 0.01). The level of MDA had a strong negative correlation with T-SOD, T-AOC, NO and NOS (r = -0.82, -0.76, -0.79, -0.73, respectively, P < 0.001 for all).

CONCLUSIONTibetan patients with essential hypertension (EH) may have underlying oxidative metabolism dysfunction and depressed NO synthesis, both responsible for the hypertensive process.

Adult ; Altitude ; Endothelium, Vascular ; physiology ; Female ; Humans ; Hypertension ; etiology ; Male ; Middle Aged ; Nitric Oxide ; biosynthesis ; Oxidation-Reduction ; Tibet

Objective: To understand the correlation between myopia related health belief and screen time of primary and secondary school students in Jing-an District of Shanghai, and to provide suggestions for reducing screen time and preventing myopia. Methods: Using the method of cluster sampling,1 585 students from grade one to grade eight of a primary school and a junior high school in Jing-an District were selected for a questionnaire survey regarding myopia related health belief, screen time and the correlation between them. Results: About 18.8%-44.4% of the students perceived themselves as myopia susceptible,which increased with grade (χ 2=33.25,P<0.01), 51.5%-78.0% of the students were aware of the adverse health impart of myopia, 39.3%-55.6% of the students were aware of unhealthy behaviors associated with myopia and 48.7%-77.5% of the students. More than 47.6% of the students daily screen time was more than 2 h/day, and daily screen time increased with grade (χ 2=12.18, P<0.01). Perceived susceptibility for myopia, awareness on adverse health impact of myopia and unhealthy behaviors associated with myopia, as well as self-efficacy associated with myopia prevention were associated with screen time of students. Conclusion The primary and middle school students in Jing an District show low lever of knowledge on myopia susceptibility and threat, but higher lever of knowledge on myopia severity and self-efficacy of preventing myopia. nearly half of the students use electronic screens too long or too close to their eyes. Awareness on myopia susceptibility, myopia-related behaviors and health impacts of myopia and self-efficacy, combined with screen time reduction might help myopia prevention.