Objective To summarize the experience in the diagnosis and treatment of adenosquamous carcinoma of the pancreas to better our understanding of this rare exocrine pancreatic neoplasm. Methods The clinical data of five cases of adenosquamous carcinoma of pancreas admitted between July 2002 and June 2008 were analyzed retrospectively, and relevant literature was reviewed and discussed. Results Pancreatic adenosquamous carcinoma was found in 3 men and 2 women with a mean age of 64 ± 18 years old. Tumor was located in the head of pancreas in 2 patients, body and tail in 3 cases. One patient was submitted to pancreaticoduodenectomy, three patients underwent distal pancreatectomy and splenectomy and one had cholecystojejunostomy and gastric bypass surgery, as well as 1251 implantation. The mean size of the tumor was 4.5 cm. One patient had posterior stomach wall, descending duodenum, portal vein involvement; spleen was invaded in 2 cases; neural and vessel invasion was present in 2 cases. Lymph node metastasis was present in 1 case. Pathologically primary tumor and liver metastasis were mixture of adenocarcinoma and squamous cell carcinoma. In all 5 patients with complete follow up, 3 died of tumor recurrence or liver metastasis with a mean postoperative survival time of 11.2 momths (8.5 ~ 13.5 months). The other 2 cases survived for 6 and 56 months , respectively. Conclusions Pancreatic adenosquamous carcinoma was likely to be found in patients in their 60s, and confirmative diagnosis was difficult. The prognosis of this rare tumor appeared to be dismal due to the high degree of malignancy.

NF-κB is a nuclear transcription factor with multiple adjustion. The activation of NF-κB can occur by three different mechanisms. The multiple NF-κB activation pathways are important due to the large number of genes that are regulated by NF-κB and their effects on cancer cells. These gene products can promote growth and tumori-genesis, inhibit apoptosis, allow metastasis and invasion, promote angingenesis, and cause chemoresistance. All of these roles in pancreatic cancer make NF-κB a promising target in treatment. Therefore, inhibiting the activity of NF-κB becomes a hot spot and novel idea of preventing and treating pancreatic cancer.

Objective To construct a simple method for the measurement of activity of S-homocysteine methyltransferase (HMT),and explore the best processing condition for HMT and the preservation of HMT.Methods HMT was expressed in pro-karyotic system by using genetic engineering technology,then was purified by using affinity and Sephadex G1 5 chromatography. Sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE)was performed to identify the physicochemical and bio-logical properties of target protein.Based on the principle of 5 ,5′-disulfide-double (2- nitro benzoic acid)(DTNB)could react with sulfydryl compounds rapidly,the reduction of homocysteine was detect to evaluate the activity of enzyme,then the best processing conditions of HTM were determined.Activity of enzyme,preserved in preservation solution with or without glycerol and preserved under different temperatures,was detected.Activity remaining ratios were detected and compared between HMT preserved in pres-ervation solution with different protective agents of different concentration and preserved by cryodesiccation.Results The purity of recombined HMT was above 95%,with molecular weight of 36 000 and excellent catalytic activity,and the catalytic activity was 2 000 U/mg.The optimum condition for the detection of biological activity was using HEPES buffer of pH 7.4 at 37 ℃ and reac-tion for 25 min.Glycerol could significantly prolong the preserving time of HMT,and half activity of HMT could be remained for six months.The reservation rates of activity of HMT,preserved in preservation solution with mannitol and trehalose,were 104%and 100%,respectively.Conclusion HMT could be obtained through genetic engineering.A simple test method of HMT was es-tablished,and the best processing conditions and preserving methods of HMT were determined,which laid a foundation for clinical application.

Pancreatic resection is the treatment choice for pancreatic malignancy and cer-tain benign pancreatic disorders. Althogh, pancreatic resection requires high techndogy whereas current mortality after a pancreaticoduodenectomy has dropped to below 3 % in expe-rienced high-volume centers and post-operative morbidity is still as high as 50%. At pres-ent, the single most significant cause of morbidity and mortality after pancreatectomy is the development of pancreatic leakage and fistula (PF). The occurrence of a PF increases the length of hospital stay and the cost of treatment, requires additional investigations and proce-dures, and can result in life-threatening complications. Early recognition of a PF and prompt institution of appropriate treatment is critical to the prevention of potentially devastating con-sequences; however there is no universally accepted definition of PF that would allow stand-ardized reporting and proper comparison of outcomes between different centers. The present article reviews the conlept evolution of PF and discusses the current preventive strategies.

Objective To observe the therapeutic role on monoclonal antibody of alkaline phosphatase(AAP) to vasogenic cerebral edema in rats(VCE).Methods 60 Wistar rats were randomly divided into 3 groups:normal group,VCE group and AAP group.VCE animal model was made by injecting AAP.Brain water content of gray and white matter were measured by Moistrue Analyzer respectively.The permeability of the blood brain barrier (BBB) was determined by Evan's blue(EB) extravasation.Results The brain water content of gray and white matter in AAP group was reduced markedly,so the permeability of BBB was reduced(P0.05). Conclusion AAP can treat VCE well. Morbidity mechanism of VCE is related to the activity of alkaline phosphatase.

Objective To investigate the occupational risk awareness levels of higher vocational nursing students before and after the clinic practice.Methods Five-year higher vocational nursing students were investigated by filling out questionnaires before and after the clinic practice.Results Nursing students' occupational risk awareness improved after the clinic practice.They hoped to acquire knowledge about occupational risk and thought that the school was supposed to offer professional ethics courses and strengthen the occupational risk education.Conclusions The majority of nursing students knew the protective measures of occupational exposure in nursing.But there were also someone who did not know these.Relevant knowledge was in high demand.Therefore,schools and internship units should provide a variety of ways to reduce the risks during the internship of nursing students.

Objective To observe the clinical efficacy of puerarin injection combined with levodopa in the treatment of Parkinson. Methods 126 Parkinson patients were grouped into two groups randomly. Control group was treated with levodopa and observation group was added to Gegensu injection. Results 3 months later, UPDRS scale score, ADL and HAMD score of observation group were lower than that of control group(P<0.05).Serum Hcy and plasma hs-CRP level of observation group were lower than that of control group( P<0.05).Adverse reactions of observation group was 6.35％ during treatment, compared with the control group 9.52％ had no significant difference. Conclusion Gegensu injection can help improve cognitive ability and improve self-care ability in patients with Parkinson, alleviate symptoms and medication safety.

0.05), as well as in the predicted fatality rate based on Ranson score. Conclusion ERCP is safe for the biliary pancreatitis patients, and it does not increase the fatality rate of acute pancreatitis.

Objective To explore the feasibility for applying passive individual samplers to determine NO2 and SO2 in the air simultaneously and to monitor the levels of them in the indoor and outdoor air. Methods Ten households were selected in urban and suburban area of Beijing respectively. Passive individual sampler made by Green blue Co. in Japan was used to sample and the ion chromatographic technique was used to determine the concentration of NO2 and SO2. Results There was no significant difference had been seen between the NO2 and SO2 level monitored by passive sampler and by the assay recommended by the national standard. It showed that the levels of NO2 and SO2 in ambient air were higher that that in indoor air, both indoor and outdoor air pollution in the urban area was more serious than that in the suburban area. The outdoor sulfur dioxide concentration in the urban area in winter was as 3.14 times high as that in the suburban area in 2001. The level of sulfur dioxide in the urban ambient air in 2002 was much lower than that in 2001. Conclusion Passive individual samplers with molecular diffusion will be suitable for environmental quantity monitoring.

Objective To understand the status of intensive care unit-acquired lower respiratory tract infection (ICU-LRTI),and the distribution characteristics of pathogens,so as to provide the basis for taking preventive and control meas-ures,and scientific diagnosis and treatment for patients.Methods Targeted monitoring data on healthcare-associated infec-tion (HAI)in ICUs of 32 hospitals in a province in 2013 were investigated retrospectively.Results The incidence of ICU-LRTI was 5.79%,ventilator usage rate was 31.25%,incidence of ventilator-associated pneumonia(VAP)was 26.93‰;There was no linear correlation between ventilator usage rate and incidence of VAP(r=0.160,P=0.380).A total of 1 593 pathogens causing LRTI were detected,the major were gram-negative bacteria (75.77 %,n=1 207),followed by gram-positive bacteria(18.21%,n=290),fungi(5.90%,n=94),Mycoplasma pneumonia and other pathogens(0.12 %,n= 1 for each).The top five detected pathogens causing LRTI were Acinetobacter baumannii ,Pseudomonas aeruginosa ,Staph-ylococcus aureus ,Klebsiella pneumoniae and Escherichia coli ,accounting for 25.49%,15.26%,14.63%,13.37% and 5.09% respectively.Conclusion Targeted monitoring on ICU is helpful for realizing healthcare-associated LRTI, each hospital should conduct targeted monitor to find out the causes of HAI,as well as improve the awareness of VAP among ICU health care workers.