Objective To determine wherher acarbose could decrease the risk of recurrent stroke in impaired glucose tolerance(IGT)patients with ischemic stroke.Methods Four hundred and sixteen patients with transient ischemic attack(TIA)or minor ischemic stroke were selected into this trial and participated 75g oral glucose tolerance test(OGTT)1 month after their diagnosis and recovery of the disease.One hundred and nineteen IGT patients were randomly divided into two groups.Patients in pharmaceutical intervention group were treated with acarhose while those in the observation group were not.Seventy patients were selected randomly in those patients without IGT(control group).All patients of the three groups were administered low dose aspirin.Results During 3 years follow-up,8 patients (13.33%)experienced a stroke in pharmaceutical intervention group.The risk of recurrent stroke was decreased significantly compared with that in observation group(P＜0.05),and there Was no significant difference between pharmaceutical intervention group and control group (P＞0.05). Conclusion Acarbose can degrade the risk of recurrent stroke in IGT patients with ischemic stroke.

The value of prophylactic cranial irradiation (PCI) for small cell lung cancer (SCLC) remains controversial. From Nov.1987 to Jan. 1993, thirty-one patients with small cell lung cancer received PCI. PCI was given for complete remission SCLC patients after chemotherapy and chest radiotherapy. The total dose of PCI was 40Gy in 26 cases, 30～

Objective To investigate the relationship between vascular cognitive impairment(VCI) and the angiotensinogen(AGT) gene ( G-6A and M235T) polymorphism. Methods Randomnized controled study was ap- plied in the study. AGT gene G-6A and M235T genotypes of 67 cases with VCI and 71 normal controls were deter- mined by polymerase chain reaction (PCR). Results For the location of M235T, the frequencies of T allele(0.73 I and TT genotype ( 0.52 ) were observed in VCI compared with control group ( 0.68,0.45, P > 0.05 ). The odds ratio associated with TT/MM genotype was 0.544 ( 95% CI 0.208～1. 424 ,P > 0.05 ). For the location of G-6A ,the fre- quencies of A allele(0.69) and AA genotype (0.48) were observed in VCI compared with control subjects (0.63, 0.39,P > 0.05). The odds ratio associated with AA/GG genotype was 0.602 ( 95% CI 0.252～1. 738, P > 0.05 ). There was no difference in allele distribution between 67 VCI patients and the controls. Conclusion There is no correlation between vascular cognitive impairment and AGT gene polymorphisms of M235T and G-6A. AGT gene pol- ymorphism is not included in the risk factors for development vascular cognitive impairment.

PurposeConventional gastric CT provides poor contrast for gastric cancer lesions, the purpose of this study is to investigate the application value of dual energy CT image fusion technology in the improvement of lesion contrast in gastric cancer.Materials and Methods Abdominal dual energy contrast-enhanced CT images of 30 gastric cancer patients were retrospectively analyzed, dual-energy images were reconstructed with different linear and nonlinear fusion settings, contrast between lesions and normal gastric wall, lesion contrast to noise ratio (CNR) were compared among 100 kVp, 140 kVp and different fusion groups, and image quality was evaluated subjectively.Results There were statistically significant differences among the gastric cancer contrast and CNR of 100 kVp, 140 kVp and three linear blending images (F=29.6 and 26.1,P<0.001), with M=0.7 linear fusion group showing the highest CNR. The gastric cancer contrast and CNR was signiifcantly higher with a bandwidth (BW) of 0 HU when compared among the three groups of nonlinear blending images (F=268.5 and 49.5,P<0.001). Moreover, the nonlinear group with a width of 0 HU had a 36% and 47% increase in lesion contrast and CNR over that of a linear blending image. In the subjective evaluation of images, the BW=0 HU nonlinear fusion image was most frequently estimated as the most preferred images for lesion observation of gastric cancer.Conclusion Nonlinear blending with a BW of 0 HU improves display of gastric cancer, and has the potential clinical value to increase the accuracy of staging.

Purpose To detect the HER2 gene amplification by fluorescence in-situ hybridization(FISH) and to explore its clinicopathologic relationship with the breast cancer.Methods A prospective study was conducted in 50 cases of breast invasive ductal carcinoma from Beijing Toren Hospital. Clinicopathologic data were summarized and FISH was performed in the paraffin-embedded sections for HER2 gene amplificayion using DNA probe, and immunohistochemical stain for ER, PR and HER2.Results The average age of the patients was 55.5 years. The pathologic grading showed that 11 cases were in grade Ⅰ, 30 cases in grade Ⅱ, and 9 cases in grade Ⅲ. The TNM staging showed that 13 cases were in stage Ⅰ,15 cases in ⅡA,13 cases in ⅡB,6 cases in ⅢA,2 cases in ⅢB,and 1 case in ⅢC.The median metastasis rate of lymph node was 6.91%.33 cases were positive for ER,and 32 cases positive for PR.For HER2 detection, 40 cases were positive by IHC and 33 positive by FISH. HER2 gene amplification by FISH was closely related with the expression of HER2 protein by immunohistochemistry, but not significantly related with pathologic grading, The TNM staging, median lymph node metastasis rate, ER and PR status (P>0.05). FISH test was positive in 3 cases of tumor embolus and 3 cases of multiple primary tumors. Conclusions FISH and immunohistochemistry for detecting HER2 have a good conformance, HER2 gene amplification may be related with tumor embolus and multiple primary tumors, but it can not be used as an indirect marker to predict the prognosis.

Purpose To investigate the effects and the mechanism of oleum curcumae wenchowensis (OCW) with different concentrations (0, 2.5, 5, 10 and 20 mg/mL) on chronic myeloid leukemia cell line K-562 cells in vitro.Methods The apoptosis of K-562 cells was dyed by Hoechest 33258 and detected by flow cytometry marked with Annexin V/PI. The Expression of Fas/FasL, bcr/abl, bcl-2 and p53 was detected by semi-quantity reverse transcript-polymerase chain reaction (RT-PCR) and Western blot.Results The results showed that the apoptosis rates were gradually elevated. The expression of Fas and FasL protein was increased in a concentration dependent manner, while bcr/abl, bcl-2 and p53 had no significant changes.Conclusion OCW could induce the apoptosis of K-562 cells by up-regulating the expression of Fas/FasL protein.

Objective:To investigate the clinicopathological characteristics and treatment strategies of undifferentiated carcinoma with osteoclast-like giant cells of pancreas (UCOGCP).Methods:The retrospective and descriptive study was conducted. The clinicopathological data of 5 patients with UCOGCP who were admitted to Peking University First Hospital from January 2004 to January 2019 were collected. There were 1 male and 4 females, aged from 33 to 71 years, with a median age of 56 years. Patients underwent preoperative laboratory test, imaging and histopatho-logical examinations. Patients with pancreatic head tumors underwent pancreaticoduodenectomy, and those with tumors in the body or tail of pancreas underwent distal pancreatectomy combined with splenectomy. All patients underwent standard lymph node dissection. Postoperative adjuvant therapy was individually decided by a multidisciplinary team. Observation indicators: (1) preopera-tive examination and treatment; (2) postoperative histopathological situations; (3) follow-up. Follow-up using outpatient examination and telephone interview was performed to detect tumor recurrence of patients up to January 2020. Measurement data with normal distribution were represented as Mean± SD. Measurement data with skewed distribution were described as M (range). Count data were described as absolute numbers. Results:(1) Preoperative examination and treatment: of the 5 UCOGCP patients, CA19-9 was elevated as 65.43 U/mL in only 1 patient preoperatively, while the CA19-9 was normal in other 4 patients. Four patients showed a solid cystic mass on preoperative contrast-enhanced computed tomography (CT) scan, and 1 patient showed a delayed peripheral enhancement of the solid tumor with central necrosis. The magnetic resonance imaging (MRI) scan showed hypointense signals on T1, T2 and weighted diffusion sequences in all 5 patients. Three of the 5 patients were resectable according to imaging data, 1 patient had locally advanced tumor, infiltrating the transverse colon, stomach, and partial small intestine, with the portal vein thrombus, and 1 patient had pancreatic head tumor with a liver metastatic lesion of 0.4 cm diameter which was detected on position emission tomography CT and was diagnosed as UCOGCP by endoscopic ultrasound-guided fine-needle aspiration biopsy. All patients underwent radical resection. Of the 3 patients with resectable tumors, 2 patients underwent pancreaticoduo-denectomy and 1 patient underwent distal pancreatectomy combined with splenectomy. One patient with locally advanced tumor in the body and tail of pancreas underwent distal pancreatectomy + transverse colostomy + partial gastrectomy + portal vein thrombectomy, and 1 patient with pancreatic head tumor and liver metastasis underwent pancreatoduodenectomy combined with left lateral hepatectomy. Of the 5 patients, 2 received postoperative adjuvant chemotherapy with single-agent gemcitabine, 1 received albumin-paclitaxel+gemcitabine combination chemotherapy, 1 received S1 as single agent chemotherapy, and 1 did not receive adjuvant chemotherapy. (2) Postoperative histopathological situations: of the 5 patients, 4 cases showed a cystic solid appearance of gross specimens, and 1 case had a solid appearance with central hemorrhagic necrosis. The tumor diameter was 5.2 cm(range, 2.0?14.0 cm). All the 5 patients achieved negative margins. Of the 5 patients, there was 1 case with portal vein invasion, 2 cases with vascular invasion, 3 cases with perineural invasion, and 2 cases with regional lymph node metastasis. One patient may had multiple tumor invasion and metastasis. Four of 5 patients had paraffin specimens available for immuno-histochemical staining. Four patients were positive for both CD68 and vimentin stains, while 3 patients were positive for programmed death ligand-1 (PD-L1), including 2 samples with 5% positive cells and 1 sample with 25% positive cells. Postoperative pathological examination showed a large number of spindle histiocytoid sarcoma cells scattered with osteoclast like giant cells and pleomorphic carcinoma giant cells. The tumor mutation burden in the 4 patients was 3.23 Muts/Mb(range, 2.61?21.77 Muts/Mb). Microsatellite status was stable in 4 patients. The next generation sequencing of 4 patients showed that all patients had KRAS mutation which was the most frequently mutation in pancreatic ductal adenocarcinoma. Of the 4 patients, 1 case had germline pathogenic mutation in TP53, 1case had somatic mutation in TP53, 1 case had somatic mutation in TP53, BLM, CDKN2A, and 1 case had somatic mutation in ARID1A. (3) Follow-up: 5 patients were followed up for 14?173 months, with a median follow-up time of 46 months. During the follow-up, 4 patients achieved disease-free survival and 1 patient had local recurrence at postoperative 11 months.Conclusions:UCOGCP is a rare variant of pancreatic tumor that exhibits a cystic solid mass in imaging examinations. High expression of PD-L1 is common in UCOGCP. The prognosis for UCOGCP is favorable following radical surgery. Patients may benefit from extended radical surgery even if the tumor has locally progression or distant metastasis.

Objective_To study the effect of Y-27632 on invasion and motility of SGC-7901 gastric carcinoma cells, and to find whether Y-27632 excerts the effect by attenuating SRF expression.Methods_SGC-7901 gastric carcinoma cells were divided into 3 groups:1)blank control group;2)Y-27632 group;3)siRNA-SRF-1107 group. Transfected siRNA-SRF or incubated by Y-27632 48 h.The effect of Y-27632 on proliferation suppressions of SGC-7901 gastric carcinoma cells was detected by CCK-8 assay.Cell invasion was examined by Transwell and wound healing test.The expression of SRF, ROCK1, E-cadherin, β-catenin, F-actin, MRTF-A and Cyclin D1 were detected by Western blot.Results_Y-27632 inhibited invasion (P<0.05)but had no effect on proliferation of SGC-7901 gastric carcinoma cells.Y-27632 reduced ROCK1, MRTF-A, F-actin, SRF protein expressions by 37.0%, 44.3%, 62.7%and 62.7%respectively, and E-cadherin protein expression was up-regulated by 2.64 folds(P<0.05).Conclusions_The inhibition of ROCK and up-regulation of E-cadherin by Y-27632 can inhibit the invasion and migration of SGC-7901 gastric carcinoma cells that is explained at least, in part, by attenuating SRF expression.

Objective:To determine children ’ s health status and influential factors in Nujiang prefecture , Yun-nan.Methods:Rickets morbidity rate , growth retardation rate , and low-weight rate were selected as the key indica-tors to calculate the sample size by using four-stage-sampling procedure .The data was collected through questionnaire survey, in-depth interviews, and focus-group discussions .χ2 test and qualitative analysis were used to analyze the quantitative and qualitative data .Results:The infant mortality rate was 13.14 %in 2011, which was 1.1 and 1.15 times more than the national and provincial average .The mortality rate of children under five was 16.35%in 2011, which was 1.05 and 1.13 times more than the national and provincial average .It was also 2.19 times more than the average in developed countries .The prevalence of medium and severe malnutrition in children under five was 2 .32%, which was 1 .54 times more than the national average .The incidence of low birth weight was 1 .41%.The research shows that the rates of rickets , growth retardation , and low-weight were 36.13%, 25.81%and 20.98%,and nutritional diseases are more serious .Conclusion:There are serious health problems for children in Nujiang pre-fecture, especially nutritional diseases .Influential factors include health policy and system , economic development, customs, geography, health service capacity , and parental health knowledge Suggestion:The government should im-prove top-level design , strengthen policy support , and develop the local economy in order to solve the social and poli-cy environment factors .Institutions and human capacity should be strengthened , access and quality of services should be improved , health education should be popularized , and health awareness and behaviors should be improved .

In this paper , we summarize the theoretical models and research progress about program evaluation and practical situation of children ’ s health in Nujiang prefecture .We then develop a framework for comprehensively evaluating the intervention for children ’ s health based on program theory .This framework comprises the outside pro-gram environment , intervention action modules and change modules , and assessment techniques environment .The e-valuation mainly includes leading agencies , implementing agencies , coordinating agencies , coordination/implementa-tion personnel , intervention and service standards , the environment and atmosphere , target populations , interven-tions, determinants, outcome and effect .