Objective To evaluate the efficacy and adverse effects of low doses gemcitabine chemotherapy combined with synchronous high-low oxygen radiotherapy in patients with locally advanced pancreatic cancer.Methods Fifty-six patients with locally advanced pancreatic cancer were randomly divided into two groups by envelop method:radio-chemotherapy group or chemotherapy group.Patients in radio-chmotherapy group were treated with low doses of gemcitabine chemotherapy ( 600 mg/m2 ) combined with high-low oxygen radiotherapy synchronously,paients in chmotherapy group were treated with full doses of gemcitabine chemotherapy ( 1000 mg/m2).The short-term effect,distant metastasis rate,clinical benefit rate,survival rate and adverse events of two groups were observed.Results There was one patient achievedcomplete relief and 15 patients achieved partial relief in radio-chemotherapy group with an overall effective rate of 66.7％ (16/24) ; there were 9 patients achieved partial relief in chemotherapy group with an overall effective rate of 36.0％ (9/25),the difference between the two groups was statistically significant (X2 =4.6082,P =0.0318 ).The clinical benefit rates were 83.3 ％ ( 20/24 ) and 60％ ( 15/25 ),respectively,the difference between the two groups was not statistically significant ( P =0.070).The distant metastasis rates were 66.7％(16/24) and 72％ (18/25),respectively,the difference between the two groups was not statistically significant (P =0.6855).The 12,24 months survival rates were 62.5％ vs 32％,37.5％ vs 12％,the difference between the two groups was statistically significant ( P =0.0325,0.0380).The incidence of serious adverse events was 45.8％ and 4 0 ％ without statistical difference.Conclusions Low doses of gemcitabine chemotherapy combined with high-low oxygen radiotherapy synchronously is better than full doses of gemcitabine chemotherapy with regard to total effective rates and 12,24 months survival rates,with no obvious increase in the incidence of serious adverse events.

Gastric cancer has a high incidence and accounts for a notable proportion of global cancer mortality.The pathogenesis of gastric cancer is complex involving multiple genetic and epige-netic alterations factors.In recent years,studies have also dem-onstrated the aberrant regulation of miRNAs in a variety of tumor pathological processes including the gastric cancer through af-fecting cell proliferation,differentiation and apoptosis.miRNA also plays important roles in gastric cancer growing,invasion, metastasis,and drug resistance of gastric cancers,which might become new biomarkers and potential therapeutic targets in the future.This paper summarizes several important miRNAs in-volved in gastric cancer and also discusses their function.

Objective To investigate the expression of caspase-3 in different post-traumatic intervals and severity of traumatic brain injury (TBI). Method Brain tissue samples of slight (n =24), moderate (n = 24) brain injury and control (n = 10) groups of rat were examined by immunohistochemical staining. Results Up-regulation of caspase-3 expression was found in tissues from traumatic brain injury as compared with controls in 1h after TBI, and lasted for 2 weeks. In tissues taken Ih, 12h, 24h, 72h, lweek and 2weeks after TBI there were different amount of positive celis in brain injuries of different severity. Con-clusion The expression of caspase-3 is different in brain injuries of different severity . These findings are valuable in appraising the severity of injuries.

Objective To assess the value of ultrasonic probe (USP) in the diagnosis of Submucous eminence of colorectume.Methods Sixty-eight patients with colorectal submucous eminence in 70 areas received USP under colonoscope.The accuracy of diagnosis was evaluated.Results Twenty carcinoid tumor were detected which manifested submucous hypoechoic ; Lipoma 12,located in right half colon which manifested submucous layer,clear boundaries hyperechoic; Cyst 12 manifested single or multi lattices no-echo on submucous which have integrated involucrum.Mesenchymoma or myoma levicellulare 12,most of them located inthe rectum manifested uniform or no-uniform hypoechoic on the muscularis mucosa or below and were difficult to discriminate.Malignant lymphoma,3 manifested muscularis mucosa and submucosa thickening,muscularis propria were seldom affected.Vascular diseases (hemangioma,varicosity) 3,manifested no-echoic on mucosa or submucosa,some medium,high echoic,circular or irregular,and also endometriosis 2,pigment deposition 1,appendix abscess 1,extramural compression 2,ultrasonic test is marched with clinic diagnosis.Accuracy rate is 100％.Conclusion USP can diagnose colorectal submucous eminence with high accuracy,and even provide information about the size,layer of origin,border of the colorectal submucous eminence and can distinguish benign or malignant tumor according to ultrasonic check,at the same time provide differentiation with extramural compressive lesions.

Objective:To explore the clinical signiifcance of the protection of superior petrosal vein (SPV) in the microneurosurgery for acoustic neuroma. Methods:From January 2009 to July 2011, 149 cases of acoustic neuroma microsurgery were observed. hTe difference in hematoma in surgical area, cerebellar hematoma and cerebellar edema were compared between a SPV without protection group (SPVWP group, n=8) and a SPV protection group (SPVP group, n=141). Results:In the 149 patients with acoustic neuroma, the SPV was reserved in 141 patients. In the SPVWP group (8 patients), hematoma in the surgery area occurred in 4 patients, cerebellar edema in 5, and cerebellar hemorrhage in 3. In the SPVP group (141 patients), hematoma in the surgery area occurred in 40 patients, cerebellar edema in 56, and cerebellar hemorrhage in 12. hTere was signiifcant difference in the incidence of cerebellar hemorrhage (χ2=3.84, P=0.05), no signiifcant difference in the incidence of hematoma in the surgical area (χ2=0.646, respectively, P=0.422), and no significant difference in the incidence of cerebellar edema (χ2=0.611, P=0.434) between the SPVWP group and the SPVP group. Conclusion:In acoustic neuroma surgery, the SPV should be protected, which may reduce the risk of cerebellar hemorrhage.

Objective Measuring job satisfaction level of community health workers,providing on the evidences for the design of the relevant policy and the evaluation of job effect.Methods 57 Community Health Service centers and 54 stations were randomly selected in 12 cities in Anhui province,and all staff on the job were investigated.The questionnaires were delivered to the working staff and anonymously filled in by them.Results The total job satisfaction average score of the staff is 110.84± 18.18.The average score of pay(10.05±2.99),welfare(10.35±3.17)and promotion(10.85±3.00)are rather low.The average score of coworkers(14.78±2.11),nature of work(14.60±2.69)and supervision (13.90±3.00)are quite high.Logistic regression analysis shows the staff's duration and title are the main factors affecting their overall job satisfaction.Conclusion The overall job satisfaction level of community health workers is not high.Establishing the reasonable system of pay,welfare mechanism and the predictable promotion space are feasible choices to promote job satisfaction of community health workers

Objective: To investigate the effect of nerve growth factor-β(NGF-β) on the proliferation and cell cycle of human pancreatic cancer MIA PaCa-2 cells. Methods: MIA PaCa-2 cells were treated with different concentrations of NGF-β and K252a (inhibitor of NGF-β receptor TrKA) alone or in combination. Clone forming rate, proliferation, and cell cycle of MIA PaCa-2 cells treated with different strategies were examined by clone formation assay, MTT, and flow cytometry, respectively. Results: NGF-β significantly increased the clone formation and proliferation of MIA PaCa-2 cells (P<0.05, P<0.01). K252a significantly inhibited the proliferation of MIA PaCa-2 cells (P<0.05), while NGF-β combined with K252a had no significant effect on the proliferation of MIA PaCa-2 cells. NGF-β arrested MIA PaCa-2 cell cycle in S phase, K252a arrested cell cycle in G_0/ G_1 phase, and NGF-β combined with K252a arrested cell cycle in S phase. Conclusion: NGF-β can enhance the proliferation of pancreatic carcinoma MIA PaCa-2 cells.

OBJECTIVE:To observe clinical efficacy and safety of capecitabine and tegafur gimeracil and oteracil potassium synchronous radiotherapy in the treatment of recurrence after radical resection of colon cancer. METHODS:A total of 150 patients with recurrent after radical resection of colon cancer in our hospital during Jan. 2012-Dec. 2012 were divided into group A and B ac-cording to random number table,with 75 cases in each group. Both groups received three-dimensional conformal radiotherapy. Group A was additionally given capecitabine 2.5 g. Group B was additionally given tegafur gimeracil and oteracil potassium,40 mg,bid for body surface area <1.25 m2,50 mg,bid for body surface area ranged 1.25-1.50 m2 and60mg,bid for body surface ar-ea<1.50 m2. Clinical efficacies of 2 groups were compared;1-year,2-year,3-year survival andⅢ-Ⅳdegree toxic effect were fol-lowed up. RESULTS:The total response rate of group B was 86.67％,which was significantly higher than 66.67％ of group A, with statistical significance(P<0.05). 1-year,2-year,3-year survival rates of group B were 93.335,72.00％,58.67％,which was significantly higher than 74.67％,53.33％,41.33％,with statistical significance(P<0.05). The median disease progression time of group A was 8.0 months,which was significantly shorter than 9.5 months of group B,with statistical significance (P<0.05). There was no statistical significance in Ⅲ-Ⅳ degree toxic effect between 2 groups (P<0.05). CONCLUSIONS:Compared with capecitabine,tegafur gimeracil and oteracil potassium combined with three-dimensional conformal radiotherapy show significant therapeutic efficacy for recurrence after radical resection of colon cancer,can control disease progression,prolong the survival time and don't increase the risk of toxic effects.

Objective To evaluate the clinical efficacy of three-dimensional conformal radiotherapy (3D-CRT) combined with thermochemotherapy in the treatment of locally advanced pancreatic cancer (LAPC).Methods From June 2008 to June 2011,70 patients with LAPC were divided into radiotherapy group (30 patients) and combination group (40 patients).Radiotherapy used 3D-CRT with a 90％ to 95％ isodose curve,a single dose of 1.8 to 2.OGy,and total radiation dose 50 ～ 70 Gy.The combination group patients received simultaneous thermotherapy at 41.5 ～43.5 ℃ (1 h/fraction,twice a week for 6 times),and hyperthermia given simultaneously injected using arsenic trioxide 20 mg,recombinant mutant human tumor necrosis factor(rmhTNF) intravenous infusion of 10 million U,4 to 6 times,or 3D-CRT at the same time and the treatment given after gemcitabine(0.6 ～ 1.0 g/m2) on Days dl and 8 and cisplatin (DDP) (20 ～ 30 mg/m2) on Days d1-3 intravenous infusion,repeated every 28 days for 3 ～ 6 cycles.Results At 3 months after treatment,the total response (complete remission and partial remission) rate was 70.0％ (49/70),the efficiency of radiotherapy combined with chemotherapy,and radiotherapy combined with thermo-chemotherapy were 56.5％ and 88.2％,and the radiotherapy alone group was 56.7％.There were significant difference in efficiency between radiotherapy combined with thermo-chemotherapy group compared to radiotherapy-chemotherapy group and radiotherapy group (x2 =4.68,4.98,P ＜ 0.05),the last two groups showed no significant difference (P ＞ 0.05).The 1-year and 2-year survival rate was 46.8％ and 20.3％,respectively.The 1-year and 2-year survival rates were 52.4％ and 26.7％ in combination group,and 42.5％ and 16.2％ in radiotherapy group (x2 =14.17,P ＜ 0.05 ; x2 =9.74,P ＜ 0.05).No serious complications such as perforation,bleeding,and high fever were seen during treatment and follow-up.Conclusions 3D-CRT combined with thermochemotherapy is well tolerated and is relatively effective for the LAPC patients.

Objective To discuss the preservation and clinical significance of petrosal vein in microsurgical operation of acoustic neuroma. Methods 147 patients with acoustic neuroma were operated, with internal decompression of the tumor firstly then dissected the tumor with surrounding structures, the petrosal vein were protected well in 143 cases and failed to protect in 4 cases. Results No hemorrhagic infarction in cerebellar was observed in 143 cases with intact petrosal vein. One case occurred with extensive cerebellar edema, which has gait disturbance after 18 months follow-up. The other three cases occurred with vein infarction and hemorrhagic edema after petrosal vein damage. One was dead and the other two were recovered well after decompression of posterior cranial fossa. One has no significant neurological deficit after 33 months follow-up, while the other has difficulty in line walking after 12 months follow-up. Conclusion Petrosal vein should be well protected in the operation of acoustic neuroma, the decompression of posterior cranial fossa should be considered if petrosal vein failed to protect.