OBJECTIVE:To investigate the effect of thymosin α1 combined with chemotherapy on immune function in patients with advanced gastric cancer and quality of life. METHODS:90 patients with advanced gastric cancer were randomly divided into observation group and control group with 45 cases in each group. Control group was treated with FOLFOX4 chemotherapy plan(so-dium oxaliplatin+calcium folinate+fluorouracil),and observation group was additionally treated with thymosin α1 1.5 mg subcutane-ously,once a day,on the basis of control group. A treatment course lasted for 3 weeks,and both received 3 courses of treatment. The immune function and quality of life were evaluated in 2 groups. RESULTS:The effective rate of observation group was 57.8%,and that of control group was 53.3%;there was no significant difference between 2 groups (P>0.05). The incidence of leukopenia in observation group was 24.4%,which was significantly lower than control group (55.6%),with statistical signifi-cance(P<0.05). There was no statistical significance in CD4+,CD8+ and NK score between 2 groups before chemotherapy(P>0.05). After treatment,above index of observation were all higher than those of control group,with statistical significance (P<0.05). The total health QLQ-C30 EORTC score in observation group was higher than in control group after chemotherapy,with sta-tistical significance(P<0.05). CONCLUSIONS:Thymosin α1 combined with chemotherapy can significantly improve the immune function and quality of life.

Objective: To assess the effects of caffeic acid (CA) on MPP + induced cerebellar granule neurons (CGNs) apoptosis. Methods: CGNs were pretreated with caffeic acid at 55, 110 and 220 ?mol/L for 6 h, then treated with 100 ?mol/L MPP + for 24 h (concentration effect relationship). In addition CGNs were pretreated with caffeic acid at 110 ?mol/L for 0 h, 6 h, 12 h, and 24 h, respectively, then treated with 100 ?mol/L MPP + for 24 h (time response relationship). Besides, after treatment with MPP + for 24 h, CGNs were incubated with caffeic acid at 55, 110 and 220 ?mol/L,respectively. Cell viability was determined by 3 (4,5 dimethylthiazol 2 yl) 2,5 diphenyltetrazolium bromide (MTT) assay and caspase 3 activity was assayed by caspase 3 fluorometric assay kit. Results: MTT assay revealed that caffeic acid significantly inhibited cell viability decrease induced by MPP +, and caspase 3 fluorometric assay showed that caffeic acid efficiently suppressed caspase 3 activation in CGNs induced by MPP +. Conclusion: Caffeic acid (CA) can significantly protect CGNs from apoptosis induced by MPP + and may provide a useful therapeutic strategy for the treatment of Parkinson's disease.

Objective To build unattended in-patient deep venous thrombosis (DVT) assessment system through literature review and clinical practice.Methods Making out the first items through looking up literature review and guidelines and expert consultation,the unattended in-patients were chosen in hospital to scan the items,power the score and set degrees,then different suggestions were made for different degrees.Results The in-patient deep venous thrombosis assessment system included 13 items and 4 degrees.The value was increasing with the danger of deep venous thrombosis,and seven was the point of the curve of deep venous thrombosis incidence.The higher the score was,the higher the rate of composition,and the danger will be more probable.Hence we should pay more attention on patients who had two or more items.Conclusions The study assesses the items quantitatively and make suggestions according to different evaluation levels.The system help nurses to prevent deep venous thrombosis in early stage and make reference for clinical practice.

Objective To investigate the effect of enhanced recovery after surgery (ERAS) on stress hyperglycemia in patients after pancreaticoduodenectomy (PD). Methods Patients matched inclusion and exclusion standards were divided into two groups. The patients after PD before the implementation of ERAS programme were named as the control group (40 cases). The patients after PD with the implementation of ERAS programme were named as the experimental group (52 cases). The fast blood glucose (FBG) in postoperative day (POD) 1, 3, 7 and the volatility of capillary blood glucose during postoperative 3 days were compared between the two groups. Results The FBG in POD1, POD3, POD7 were (8.27 ± 1.99), (6.78 ± 1.22), (5.97 ± 1.21) mmol/L in the experimental group respectively, and the FBG in POD1, POD3, POD7 were (10.46 ± 5.17), (7.88 ± 2.98), (7.29 ± 2.94) mmol/L in the control group respectively, there were significant differences between two groups (t=2.545, 2.219, 2.683, all P<0.05). The volatility of capillary blood glucose during postoperative 3 days in the experimental group were (3.47± 1.98), (3.16 ± 1.46), (2.74 ± 1.49) mmol/L respectively, and the volatility of capillary blood glucose during postoperative 3 days in the control group were (4.13±2.36), (3.26±1.59), (4.07±2.74) mmol/L respectively, no significant differences were found in the volatility of capillary blood glucose in POD1 and POD2 between the two groups (t=1.479, 0.308, all P > 0.05), while significant differences were found in the volatility of capillary blood glucose in POD3 between the two groups (t=2.739, P<0.05). Conclusions It can be concluded that ERAS may be useful to decrease stress hyperglycemia and the volatility of capillary blood glucosein patients after PD, and accelerate the recovery of patients after PD.

To study the surgical management of primary hyperparathyroidism, we analysed 30 patients with primary hyperparathyroidism operated in our hospital from 1981 to 1990. A low collar transverse incision was done in all patients. A single parathyroid adenoma was found in 28 patients,and in 3 cases there were ectopic glands (1 in the mediastinum 2 intrathyroid). The adenoma was removed in all patients.In 1 case there was parathyroid hyperplasia, but only one gland was involved and it was excised. 1 case was diagnosed as parathyroid carcinoma which was located in the tracheo esophageal groove and had invaded the trachea and esophagus. An en bloc resection and tracheostomy were performed. 25 cases were followed up(including 1 case with parathyroid hyperplasia and 1 case with carcinoma) from 8 months to 19 years, there was no recurrence.These results suggest surgical management is the most effective treatment for primary hyperparathyroidism. Removal of the parathyroidoma and unilateral cervical exploration are adequate for the patients with parathyroid adenoma. Bilateral exploration is necessary when parathyroid hyperplasia is found. An en bloc resection is necessary for parathyroid carcinoma.

According to the large stray capacitance of the gate terminal of power MOSFET,this paper introduces the main characteristics and application of IC driver MAX626/7/8,especially designed for the high speed power MOSFET.The ultrasound generator made from that chip is simple in circuit,stable when working as well as small and light for carrying.

Objective To investigate the inhibitory mechanism of rabeprazole on acid secretion of parietal cells in rats. Methods Seventy two Spraque-Dawley rats were divided into control group(normal saline), low dose of rabeprazole group (rabeprazole 10 mg/kg) and high dose of rabeprazole group (rabeprazole 20 mg/kg) with 24 each. Four rats in each group were treated at 1 h, 2 h, 4 h, 6 h, 12 h and 24 h, respectively, pH value and activity of H+-K+-ATPase were tested by NaOH titrimetric method and chromatometry, respectively. The changes of ultrastructure of parietal cells were observed by electron microscope. Results Compared with control group(1.97±0.30), pH value in low (3.37± 0.97)and high (5.96±0.26)dose groups were significantly increased(P<0.01), and the activity of H+-K+-ATPase was inhibited obviously at 1 h after administration(3.28±0. 41 vs 1.47±0.27 and 0.92±0.07, P<0.05). Those differences could be found even at 12 h(P<0.01). The ultrastructural changes of parietal cells were consistent with the increase of pH value and decreased activity of H+-K+-ATPase. The significant difference was found in acid depression and excellent time between low and high dose of rabeprazole groups. Conclnsions The uhrastructural changes of parietal cells and the activity of H+-K+-ATPase can accurately reflect the acid secretion in rats. Rabeprazole has powerful and rapid effects in inhibiting acid secretion which correlates with the dosage.

Objective To investigate the expression of Delta-like 4 (DLL4) in pancreatic cancer and its clinical significance.Methods The expression of DLL4 in pancreatic cancer was examined by immunohistochemistry method.The microvessel density (MVD) was calculated after CD34 staining specifically for microvessel endothelium; and their correlations and relationship between them and clinicopathological parameters as well as prognosis of pancreatic carcinoma was investigated.Results The expression of DLL4 in pancreatic cancer was significantly higher than that in normal pancreatic tissue (68.3％ vs 20％,P ＜ 0.01).The over-expression of DLL4 in pancreatic cancer was related to degree of differentiation,TNM staging,lymph node metastasis and invasion depth,while not related to the size,location and histological types.The MVD in pancreatic cancer tissues was notably higher than that in normal tissues (34.9 ± 13.2 vs 18.9 ± 2.2,P ＜0.01).MVD was correlated to degree of differentiation,lymph node metastasis,but not related to the size,location and histological types.DLL4 expression was closely associated with prognosis.COX model analysis showed that TNM staging and DLL4 expression were independent prognostic factors for pancreatic cancer.Conclusions The over-expressions of DLL4 may play an important role in metastasis and invasion of pancreatic cancer.Expression of DLL4 and TNM staging is useful for predicting the prognosis of patients with pancreatic cancer.

Background:The goals for treatment of achalasia are reducing lower esophageal sphincter pressure (LESP)and alleviating esophageal obstruction and its related symptoms.Peroral endoscopic myotomy (POEM)is a promising option for treating achalasia.Aims:To assess the short-term efficacy of POEM for treating achalasia by analyzing the dynamic changes in esophageal manometry.Methods:A retrospective study was conducted in 39 achalasia patients receiving POEM in Nanjing Drum Tower Hospital from Dec.2011 to Oct.2012.Data of water-perfusion esophageal manometry and one-month follow up were collected and analyzed.Results:Thirty-eight patients accomplished the POEM procedure and esophageal manometry three days after treatment.The post-POEM LESP was significantly reduced as compared with the pre-POEMones (P <0.01),while no significant difference was seen in LES relaxation rate before and after POEM.With regard to the motility of esophageal body,absence of peristalsis and increased synchronous contraction were observed both pre-and post-operatively.One month after POEM,LESP was still significantly lower than that before treatment (P <0.05).Thirty-seven patients had their dysphagia alleviated with an efficacy rate of 94.9%.Conclusions:POEM can reduce LESP and alleviate clinical symptoms of achalasia patients but has no effect on esophageal peristalsis during the short-term follow up.Esophageal manometry is useful for evaluating the short-term outcome postoperatively.

Objective To evaluate the effect of ecoimmunonutrition on systemic inflammatory response in swine with acute necrotizing pancreatitis (ANP). Methods Swine model of ANP was induced by retrograde injection of 5% sodium taurocholate and trypsin into the pancreatic duct. 24h after the ANP models were established, eighteen swine were randomly divided into total parenteral nutrition (PN) group (n = 6), enteral nutrition (EN) group (n = 6), and ecoimmunonutrition (E1N) group (n = 6). Each of the three nutrition formulas was given to each group respectively for eight days. The level of plasma endotoxin and serum concentrations of TNF-α, IL-1β, IL-6 and IL-10 were measured before, 24 h after the induction of ANP and 1,2, 4, 8 d after nutrition support. Results 24 hours after the ANP models were established, the serum level of plasma endotoxin, TNF-α, IL-1β, IL-6 and IL-10, NF-κB activities in EIN group were ( 1.85 ± 0.18) EU/L,(461.59 ± 128.25 ) pg/ml, ( 185.49 ± 58.81 ) pg/ml, ( 354.26 ± 34.63 ) pg/ml, ( 110.32 s 25. 18 ) pg/ml,(51.06 ± 2.27 )%, respectively, which all were significantly higher than those before the ANP models were established, but there were no difference among three groups. Eight days after nutrition support, those levels in EIN group were (1.48 ±0.16 )EU/L, (30.11 ±9.12)pg/ml, (20.17 ±7.04)pg/ml, (36.42 ±7.24) pg/ml and ( 89.46 ± 13.54 ) pg/ml, (9.06 ± 0. 17 ) %, respectively, which all were significantly lower than those of TPN and EEN group ( P ＜ 0. 05 ). The ration of IL-10/IL-6 was 2.51 ± 0.42 in EIN group, and 2.28 ± 0. 19 before the ANP models were established. Conclusions EIN could attenuate endotoxemia, decrease NF-κB activities and serum concentrations of cytokines and maintained the balance of pro- and anti-inflammation.