Objective To systematically assess the detection of K-ras gene mutation at codon 12 in pancreatic juice for diagnosis of pancreatic cancer.Methods A comprehensive electronic searching was performed to retrieve relevant studies on K-ras gene mutation in pancreatic juice for diagnosis of pancreatic cancer.Data on accuracy of included studies were extracted,Meta-DiSc1.4,Stata10.0,was applied for further heterogeneity exploring,meta-analysis and publication bias testing.Results Fifteen studies met the inclusion criteria.Heterogeneity was not found among these studies,including threshold effect,different test methods,randomization and blind.Pooled accuracy indicators like sensitivity,specificity and diagnostic odds ratio(DOR) were 0.61(95%CI 0.56-0.66),0.82(95%CI 0.77-0.86) and 6.28(95%CI 4.42-8.91),respectively.Area under curve(AUC) of SROC(summary receiver operating characteristics) was 0.8207 and Q index was 0.7542.Publication bias had little influence on meta-analysis with the fail-safe number of 694.0108.Conclusions This meta-analysis demonstrates that the detection of K-ras gene mutation in pancreatic juice has moderate effect for diagnosis of pancreatic cancer.It is not enough to be an early diagnosing or screening indicator for pancreatic cancer,but it can be used clinically as an important adjunct to cytology,imageology and enzymology in the diagnosis of pancreatic cancer.

Objective To develop a better method for preparation of porcine model of acute myocardial infarction by permanent occlusion of the left circumflex coronary artery and minimally invasive surgery, evaluate its validity and stability, and explore its application in experimental studies of ischemic heart diseases.Methods 25 healthy female 3-month-old Bama minipigs, body weight 25±3 kg, were used in this study.The porcine model of myocardial infarction was established by minimally invasive surgery and the left circumflex artery ligation at the site of OM1 posterior position under general anesthesia.Heart function was assessed by echocardiography at 15 min before surgery, 1 hour and 4 weeks after surgery.Pathological examination was performed at 4 weeks after the left circumflex artery occlusion.The mortality and cause of death were statistically analyzed.Results The 1-hour and 4-week postoperative cardiac function was considerably decreased, showing a decreased ejection fraction from 64.2±4.6% to 48.2±5.3% (1hour after MI) and 49.7±6.1% (4 weeks after MI) (P<0.01).Pathological examination revealed that the ventricular wall was thinner and the amount of collagens was increased in the infracted area.The ventricular fibrillation rate at 1-hour after myocardial infarction was 17.3% and the infarction area was 19.2%.Conclusions A pig model of acute myocardial infarction can be prepared by our modified left circumflex coronary artery ligation at the obtuse marginal artery (OM1) and minimally invasive surgery.This model exhibits advantages such as minimal surgical trauma, high stability of the model, and low mortality, therefore, provides an ideal and economic animal model for experimental studies on acute ischemic heart diseases.

Objective To prepare targeted microbubbles which load anti-VEGFR-3 and observe the targeting effect in vitro.Methods Targeted microbubbles loaded VEGFR-3 antibody were prepared and the targeting effect in vitro were tested by direct and indirect methods.Direct method took off-line analysis by image analysis software IPP and statistical analysed with SPSS software package.Indirect method took direct observation the target binding effect after incubation and centrifugal sedimentation.Results Image software IPP results showed that the quantity of microbubbles in targeted-group was obviously more than ordinary group.The average microbubbles per field in targeted-group was (151 ±20).The average microbubbles per field in ordinary group was ( 12 ±4 ) microbubbles, the numbers of combined microbubbles between targeted-group and ordinary-group had significant differences ( t=19.19,P<0.01).The indirect method results showed that, compared with ordinary group, the microbubbles in targeted-group could combined with cell gradually.Conclusion Targeted microbubbles load anti-VEGFR-3 have a better contrast effect than common microbubbles.

Objective Take frizzled class receptor 4(FZD4) as an example for exploring whether the transmembrane receptor protein is a suitable marker for wound age estimation. Methods A total of 78 Sprague-Dawley rats were divided randomly into the control group and the contusion groups of 4h, 8h, 12h, 16h, 20h, 24h, 28h, 32h, 36h, 40h, 44h, and 48h after injury (n=6). Using a drop-ball technique, a contusion was produced in the right lamb of rats. The samples were dissected from injury zones. Then the expression of FZD4 was detected using immunofluorescence, real-time PCR and western blot, respectively. Results FZD4 was located on the membrane of skeletal muscle cells. Compared to the control group, FZD4 mRNA showed a signiifcant increase (over 2-fold) in 8h, 12h, 36h, and 40h after injury by Real-time PCR (P<0.05), and FZD4 protein showed a statistical up-regulation (less than 2-fold) in 8h, 36h, 40h, 44h, and 48h post contusion by western blotting (P<0.05). Conclusion The expression of FZD4 mRNA and protein are both time-dependent during contused skeletal muscle repair. To some degree, FZD4 mRNA was more suitable than corresponding protein for determining wound age.

Objective To observe the impact of ningxinjieyu capsule on contents of monoamine neurotransmitters and their metabolites in cerebral cortex of chronic depression model rats.Methods The chronic stressed depression model rats were established by chronic unpredictable stress and separation.the model rats randomly divided into model group,ningxinjieyu high-dose group(10.8 mg/(kg · d)),mid-dose group(3.6 mg/(kg · d)),low-dose group(1.2 mg/(kg · d)) and Fluoxetine group(3.6 mg/(kg · d)) and the normal rats as the control group.Finally the changes of Noradrenaline (NE),Dopamine (DA),5-hydroxy tryptamine (5-HT),3,4-dihydroxyphenylacetic acid (DOPAC) and homovanillic acid (HVA) would be observed using HPLC-ECD technique.Results Compared with the control group,the contents of NE,DA and 5-HT were significantly lower in the model group (P＜0.01).Compared with the model group,the contents of DA were increased in the different concentrations of ningxinjieyue capsule groups,and the contents of 5-HT were higher in the low-dose and high-dose groups ((272.15± 129.89) ng/g,(445.08± 127.56) ng/g,(375.33±52.38) ng/g) ; the contents of NE were increased in the low-dose and mid-dose groups ((408.08 ± 89.55) ng/g,(530.12± 149.87) ng/g,(542.53 ± 96.10) ng/g) ; the contents of HVA were increased in the mid-dose and high-dose groups; the contents of DOPAC were increased in the low-dose group; the contents of 5-HT,DA and NE were increased in the fluoxetine group(P＜0.01 or P＜0.05).Conclusion Ningxinjieyu capsule has antidepressant effect,the mechanisms might be regulated to the contents of monoamine neurotransmitters and their metabolites in cerebral cortex.

Objective T o investigate the relationship betw een the expression of secreted frizzled-related protein 5 (SFR P5) m RNA and the tim e interval after skeletal m uscle injury in rats by real-tim e PC R . Methods A total of ninety SD rats w ere random ly divided into the contusion groups at different tim es including 4 h, 8 h, 12 h, 16 h, 20 h, 24 h, 28 h, 32 h, 36 h, 40 h, 44 h, 48 h after contusion, incision groups at different tim es including 4h and 8h after incision and the control group. T he sam ples w ere taken from the contused zone at different tim e points. T he total RNA w as isolated from the sam ples and re-versely transcribed to analyze the expression levels of SFRP5 m RNA . Results C om pared to the control group, the expression of SFRP5 m RNA in contusion groups w ere dow n-regulated w ithin 48 h after con-tusion and reached the low est level at 20 h, and the expression of SFRP5 m RNA gradually increased from 20 h to 48 h after contusion. T he expression of SFRP5 m RNA in the incised groups w ere signifi-cantly low er than that of the contusion groups at 4 h after injury. A t the tim e of 8 h, the expression levels betw een the contusion and incision groups show ed no statistically significant difference. Conclusion It is suggested that SFRP5 m RNA analysis m ay show regular expression and can be a m arker for estim ation of skeletal m uscle injury age.

This article was aimed to explore the effect ofSan-Huang (SH) decoction on improving chemosensitivity of MCF-7 cells to epirubicin and inhibition of Aurora kinase A, in order to discuss its underlying mechanism. The inhibition of MCF-7 cells proliferation on breast cancer by SH decoction was determined by CCK-8 assay. RT-PCR and western blot were used to detect the Aurora A, p53 mRNA and protein expression level of MCF-7 cells by SH decoction. The siRNA silenced Aurora A of MCF-7 cells. CCK-8 assay was used to detect the inhibition of MCF-7 cells proliferation. CCK-8 assay and AnnexinV-FITC/PI staining were used to detect the inhibition rate and apoptosis rate of MCF-7 cells treated by the combination of SH decoction and epirubicin. Western blot analysis was used to detect the expression of apoptosis-related proteins. The results showed that SH decoction inhibited the proliferation of MCF-7 cells in a dose-dependent manner (P< 0.05). The effect of 48 h medication was better than 24 h (P < 0.05). There was no statistical difference with medication for 72 h (P > 0.05). SH decoction can regulate the Aurora A, p53 protein and mRNA expression of MCF-7 cells. siRNA silenced Aurora A, which downregulated the inhibition rate of MCF-7 cells by SH decoction for 50.0% (from 49.2% to 24.8%). The combination of SH decoction and epirubicin enhanced the effect of epirubicin on inhibiting the proliferation rate and apoptosis rate of MCF-7 cell, regulated the expression levels of apoptosis-related protein such as c-PARP, c-Caspase 3, Bcl-2, Bax, as well as the protein level of Aurora A. It was concluded that SH decoction can increase the chemosensitivity of MCF-7 cells to epirubicin, which may be related to the inhibition of Aurora Kinase A by SH decoction.

Objective To study the value of ultrasound in operation for traumatic brain injury (TBI) in simulation field hospitals where computed tomography (CT) equipment is unavailable.Methods The wartime conditions were simulated, and the patients at age of 18-60 years were randomly selected.According to the principles of medical ethics, all patients received CT scanning.Two neurosur-geons from the field hospital who did not know the result of CT examination cooperated with another two neurosurgeons who got the results of the CT examination to determine whether operation should be ap-plied.Forty-five patients who needed emergency craniotomy were finally selected.The operations were performed by two neurosurgeons from the field hospital, with real-time ultrasound monitoring.The results of ultrasound were compared with that of CT scanning.Results A total of 64 lesions were found by ul-trasound , and 60 of which should be treated by operation.In the meantime, 82 lesions were found by CT scanning, 64 of which should be treated operatively.Epidural hematoma and subdural hematoma had high ultrasound detection rate, followed by intracerebral hematoma, subdural effusion and brain contusion.The overall detection rate of ultrasound was 87.1%.Conclusion Ultrasound plays an important role in correctly finding the focus so as to reduce blind operation and avoid omission of the focus in field hospi-tals, where CT equipment is usually unavailable.

IgG4-RD is a kind of chronic and systemic disease which is characterized by elevatedserum IgG4 level, abundant IgG4-positive plasma cell infiltration in the involved organs,storiform fibrosis and obliterative phlebitis. IgG4-RD responses well to corticosteroid treatment. Its complicated clinical manifestation and multidiscipline involve-ment make it easy to be misdiagnosed or misdiagnosed. In order to better understand this disease,in this article,we will review relevant literatures of this disorder.

Objective: Based on observational, longitudinal and intervention study of common diseases among students in Jiangsu Province, this paper presents the current progress of two year follow up of myopia cohort regarding the association between growth parameters with progression of myopia among children and adolescents in areas with rapid economic growth. Methods: This survey adopted the stratified cluster sampling method for school selection. The full automatic computer optometry (TOPCON RM800) was used to track myopia related parameters for all participants from 2019 to 2020 under the condition of mydriasis (compound topicamide eye drops). Relationship between growth parameters of children and adolescents and the incidence and progression of myopia was analyzed by using Cox regression multiple statistical model. Results: The myopia rates of students from grade 1 to grade 3 in 2019 were 5.4%, 21.5% and 37.3% respectively. After one year, the myopia rates of all school stages increased to 25.3%, 43.3% and 58.1% respectively( χ 2=53.59, 49.63, 32.52, P <0.01). The mean diopter of right eye and left eye after mydriasis were ( 0.30± 1.24/0.39±1.26)D in 2019 and (-0.33±1.54/-0.19±1.55)D in 2020, respectively based on Cox multiple regression results, age ( HR =1.21, 95% CI =1.09-1.34), naked eye vision ( HR =0.08, 95% CI =0.07-0.11), height ( HR =0.98, 95% CI =0.97-0.99) showed a strong correlation with the incidence and progression of myopia( P <0.05). Conclusion Myopia is growing rapidly in the central region of Jiangsu Province. It is suggested that diopter, axial length, naked eye vision, age, height and other indicators should be included in the refractive archives of children and adolescents in the region.