Objective To compare the gemcitabine (GEM) plus S-1 and gemcitabine alone in the treatment of advanced pancreatic cancer (PC) by meta-analysis.Methods Articles were searched in PubMed,Cochrane library,Embase,CNKI,and CBM up to August 1st,2013.Only randomized controlled trails (RCTs) for GEM + S-1 and GEM alone in advanced PC were included.Two reviewers retrieved and collected data respectively.Data were selected basing on inclusion and exclusion criteria.The meta-analysis was base on survival advantage (include overall survival and progress free survival),object response rate,disease control rate and adverse reaction.Results A total of 3 trials with 772 cases were included.Meta-analysis demonstrated that GEM plus S-1 significantly improved the progress free survival (HR:0.64,95％CI:0.54-0.75,P ＜ 0.000 01) and overall survival (HR:0.81,95％CI:0.68-0.96,P =0.01),improved object response rate (RD:0.16,95％ CI:0.10-0.21,P ＜ 0.000 01) and disease control rate (RD:0.10,95％ CI:0.03-0.17,P =0.009) also.However,the incidence of WHO 3/4 grade adverse reaction was increased significantly in the GEM + S-1 group.Neutropenia,thrombocytopenia,and gastrointestinal reaction were increased by 18％ (P =0.02),18％ (P =0.008) and 8％ (P ＜ 0.000 01)respectively.Conclusion GEM combined with S-1 can improve the chemotherapy effect compared with GEM alone.The adverse reactions also increase significantly,but the overall survival is benefit.

AIM:To explore the effects of miR-21 on biological behavior of colon cancer cells and their sensi-tivity to epidermal growth factor receptor monoclonal antibody cetuximab .METHODS:Lentiviral vectors were constructed to generate up-and down-regulations of miR-21 lentiviruses (LV-miR-21 and LV-anti-miR-21, respectively), and the cor-responding negative control viruses (LV-miR-21 NC and LV-anti-miR-21 NC, respectively) were also constructed.The vi-ruses were used to infect human colon cancer RKO cells .The changes of the miR-21 expression level , the cell prolifera-tion, the colony-forming ability, the cell apoptosis and the sensitivity of the cells to cetuximab were detected by real -time PCR, MTT assay, soft agar colony assay , flow cytometry and CCK-8 assay.RESULTS: The lentivirus titers of LV-miR-21, LV-miR-2 NC, LV-anti-miR-21 and LV-anti-miR-21 NC were 3.0 ×1012 TU/L, 6.0 ×1011 TU/L, 2.0 ×1012 TU/L and 8.0 ×1011 TU/L, respectively.The infection efficiency was over 80% by the observation of green fluorescence .The miR-21 expression level , the cell proliferation , and the colony-forming ability in LV-miR-21 group were significantly higher than those in LV-anti-miR-21 group.The early apoptotic rate and the inhibitory rate of cetuximab for the cells in LV-anti-miR-21 group were higher than those in LV-miR-21 group.CONCLUSION: miR-21 promotes the proliferation of colon cancer cells.Down-regulation of miR-21 enhances the sensitivity of the colon cancer cells to the targeted therapy drug cetuximab.

Objective To establish a method of primary culture of human preadipocyte in a serum-free medium. Methods Collangenase digestion was used to dispart preadipocyte.The cells were identified by microscopy stained by oil red O and determination of the activity of Glycerol-3-phosphate dehydronase(G-3-PDH). Results The primary cultured human preadipocyte proliferated in the aserum-free medium successfully.In the differential serum-free medium the cells turned to be round on the 4 th day.The adipose drops began to cumulate in the cells,and to the most quantity until the 21 st day.Conclusion The human preadipocyte can be primarily cultured and induced to differentiate in serum-free medium,which is the base for researching the effects of hormones and factors to the proliferation and differentiation of preadipocyte.

Objective To make a clinical summary of the variation of cystic duct so as to collect 20 years of operative experience and to provide evidence for preventing injury of bile duct in laparoscopic cholecystectomy. Methods A retrospective analysis were made for 20 000 patients experienced laparoscopic cholecystectomy in the second affiliated hospital of Chongqing medical university and Chonggang General Hospital from April,1993 to December,2011. Results There were 3 265 cases of cystic duct variation which occupied 16. 33% of the 20 000 patients. And there were 3 200 cases of variation in the junction of cystic duct, 51 cases of short cystic duct;and 14 cases of gall-bladder surrounded by the liver. Most of the variation were found in the junction of cystic duct, including 371 cases (11. 36%) of cystic duct accompanied the common hepatic duct and then made a lower confluence;995 cases (30. 47%) of cystic duct traversed above the com-mon hepatic duct and then made a confluence, 643 cases (19. 69%) of cystic duct traversed below the common hepatic duct and then made a confluence;963 cases (29. 49%) of gallbladder neck attached to the common bile duct;and 228 cases (6. 98%) of higher confluence of cystic duct and common bile duct. Conclusion The rate of cystic duct variation accounted for a high rate, and most of the patients were found with a variation in the junction of cystic duct. Being familiar with the categories of cystic duct, discriminating the anatomic structure carefully, using choledochoscopic examination when necessary, and masterting reasonable time to make a transfer to laparocholecystotomy were reliable methods for coping with the injury of bile duct caused by variation of cystic duct.

Objective To observe the clinical effects of external application of Chinese medicine ion introduction through acupiont in the prevention and treatment of hyperamylasemia and pancreatitis following endoscopic retrograde cholangio pancreatography (ERCP). Methods Three hundred subjects were divided into treatment group and control group randomly, and treated with routine therapy after surgery, moreover, treatment group was treated with external application of Chinese medicine ion introduction through acupiont. The incidence of hyperamylasemia and pancreatitis, the time of serum amylase returned to normal in patients with hyperamylasemia and pancreatitis was observed, and the abdominal pain after ERCP was scored. Results Excluding 17 cases according to the exclusion criteria, the treatment group included 142 cases and the control group included 141 cases. The hyperamylasemia and pancreatitis happened less frequently in the treatment group than in control group, but there was no significant difference (P>0.05). The time of serum amylase returned to normal in patients with pancreatitis was (4.25±0.95)d in treatment group and (5.28±1.11)d in control group, with no significant difference (P>0.05). The time of serum amylase returned to normal in patients with hyperamylasemia was (2.88 ± 0.78)d in treatment group and (3.81±1.62)d in control group, showed a significant difference (P<0.05). The score of abdominal pain was 0.95±1.04 in treatment group and 1.21±1.12 in control group, showed a significant difference (P<0.05). Conclusion External application of Chinese medicine ion introduction through acupoint can promote the recovery of the patients postoperative ERCP combined with hyperamylasemia or pancreatitis, and can better alleviate abdominal pain.

Objective To investigate the clinical characteristics of primary thyroid lymphoma(PTL) and its prognostic factors.Methods Clinical and pathological data of 7 cases diagnosed as primary thyroid lymphoma were retrospectively analyzed.Results All of the 7 patients were diagnosed on thyroidectomy and presented with thyroid nodules,of whom 6 cases were middle-aged to elderly women and some had locally oppressive symptoms.Four cases were diagnosed as diffuse large B non-Hodgkin's lymphoma (DLBCL) and 3 were mucosa-associated lymphoid tissue B-cell lymphoma (MALT).Pathological subtype of mucosa-associated lymphoid tissue B-cell lymphomas and younger patients had better prognosis.Conclusion The possibility of PTL must be kept in mind in the differential diagnosis of thyroid nodules in middle-aged to elderly women.Age and pathological subtype are important prognostic factors.

Objective:To explore the clinical application of NanoString fluorescent barcode technology in the molecular subtyping of diffuse large B-cell lymphoma (DLBCL), and to analyze the correlation between the cell-of-origin subtype and prognosis of patients.Methods:The tumor tissue samples of 12 patients with DLBCL at the Third People's Hospital of Datong of Shanxi Province and 8 patients with DLBCL at Peking University, Health Science Center between January 2014 and December 2019 were collected. According to Hans algorithm, all patients were divided into 1 case of germinal center-derived B-cell (GCB) type and 19 cases of non-GCB type. NanoString platform was used to analyze the expression level differences of 15 genes-related to Lymph2Cx molecular subtyping of all samples at mRNA level. Hierarchical clustering was used to subgroup 20 DLBCL cases and to contrast the prognosis in different subgroups according to the subtyping.Results:NanoString fluorescent barcode technology was used to detect samples of 20 DLBCL cases and hierarchical clustering analysis was performed, and then subtyping results showed that 11 cases were GCB-like type and 9 cases were activated B cell (ABC)-like type. Based on Hans algorithm, 10 GCB-like cases were non-GCB type. According to the survival analysis, GCB-like group had a better overall survival compared with that in ABC-like group ( P=0.019). Conclusion:NanoString fluorescent barcode technology can be successfully applied to the cell-of-origin subtyping of DLBCL, and the molecular subtyping strategy can effectively predict the prognosis of patients.

Objective:To investigate the expression of miR-92a in colorectal cancer (CRC) and its effect on the regulation mechanisms of tumor angiogenesis. Methods:The miRNA-92a expression in 25 CRC tissues and HT29, SW620, SW480, and HCT116 CRC cells was detected using quantitative real-time polymerase chain reaction. The CD31 positive expression of blood microvessels in CRC tissues was measured by immunohistochemistry. Pearson correlation analysis was used to analyze the relationship between miR-92a and tu-mor angiogenesis. The miR-92a mimic or inhibitor was transfected into HCT116 and SW620 cells in vitro to upregulate or downregu-late the miR-92a expression. The effect of miR-92a overexpression or suppression on the formation of human umbilical vein endotheli-al cell (HUVEC) tubules was detected by tube formation assay. Changes in phosphatase and tensin homolog (PTEN) protein expression were measured by Western blot. Results:The expression level of miR-92a in CRC tissues was significantly higher than that in matched adjacent tissues (P<0.01). The expression levels of miR-92a in HT29, SW480, SW620, and HCT116 colon cancer cell lines were signifi-cantly higher than that of the normal colorectal epithelium control (P<0.05). The number of CD31 positive expression of microvessel density (MVD) in CRC tissues was significantly higher than that in adjacent tissues (P<0.01), and the miR-92a expression level was posi-tively correlated with the MVD in CRC tissues (r=0.580, P=0.01). The cell culture supernatant of HCT116 with miR-92a overexpression could significantly promote the formation of HUVEC tubules (P<0.05). The upregulation of miR-92a expression could significantly inhib-it the expression of PTEN protein in CRC cells (P<0.01). Conclusion:The miR-92a was highly expressed in CRC cells and tissues, which was closely related to the formation of tumor angiogenesis in CRC. The miR-92a could promote tumor angiogenesis in CRC by inhibit-ing PTEN expression.

To evaluate the efficacy and safety of Changjishu soft elastic capsule, a new Chinese herbal medicine for smoothing liver, invigorating spleen and regulating qi activity, on diarrhea-predominant irritable bowel syndrome (D-IBS) patients with liver-qi stagnation and spleen deficiency syndrome.

Objective: To investigate the effect of exercise intervention on sleep quality of female college students with anxiety, and to further explore the mediating effect of negative emotions in this association. Methods: Seventy female college students were randomly divided into experimental group (34 patients) and control group(36 patients). The experimental group received eight-week aerobic exercise and yoga training. The control group received no training. Sleep Quality Scale, Negative Emotion Scale and Anxiety Self-rating Scale were used to assess the level of sleep and negative emotion before and after exercise intervention. Results: After exercise intervention, sleep quality (4.31±1.26), anxiety (36.41±7.32) and negative emotion (2.37±0.50) in the experimental group significantly improved(P<0.01), no similar changes were found in the control group(P<0.05). By examining the mediating effects, negative emotions played a partial mediating role in the association between exercise and sleep quality(t=6.77, P<0.01). Conclusion Exercise intervention significantly improved the quality of sleep and negative emotion among female college students with anxiety. Negative emotions play a partial role in the positive effect of exercise on sleep quality.