Resection margin involvement of pancreaticoduodenectomy is an key prognostic factor for pancreatic head cancer.However,there is a wide variation of reported microscopic margin involvement (R1) rate in the literature,and there is discrepancy between the R1 rate and clinical outcome.Recent studies indicate that the variation and the discrepancy are caused by confusing nomenclature,controversy regarding the difinition of R1,lack of standardization of pathological examination,and inaccurate diagnosis for the pancreatic head mass.This review summarizes the composition and nomenclature of the circumferential resection margin,the difinition of R1,the method of pathological examination,the relationship between R1 rate and prognosis,and the relationship between resection margin involvement and tumor origin.

Caveolae are cholesterol-rich pits on the surface of cell membrane,and participate in various physiological processes.Caveolin-1 is an important membrane protein constituting caveolae.It exerts biological effects through binding a variety of signaling proteins.In the pathophysiological processes of cerebrovascular disease,caveolin-1 participates in maintaining the integrity of blood-brain barrier and stability of atherosclerotic plaques,and has regulating the release of inflammatory mediators and neuroprotection.This article reviews the associated advances in research on the correlation between caveolin-1 and cerebrovascular disease in order to provide a new idea for clinical therapy.

ObjectiveTo explore the clinical characteristics of pregnancy and delivery in older pregnant women. MethodsRetrospectively analyzed the clinical deta of old group ( age ＞ = 35, n = 636) and non-old group ( age ＜ 35, n = 4 202) in same time, compared the incidence of pregnant complications and delivery complications, situation of perinatal infants between the two groups. ResultsThe incidence rates of gestational diabetes,hypertension disease, placenta previa, cesarean section, postpartum hemorrhage, fetal macrosomia were higher in old group and neonatal deformity,neonatal asphyxia were not different in two groups. CondusionThe complications during pregnancy and delivery increased in older pregnant women,which had no benifits for mother son.

Tau is a multifunctional protein that are originally identified as a microtubule-associated protein. Tau is mainly expressed in neurons. There is a protein phosphorylation/dephosphorylation imbalance and tau is abnormally hyperphosphorylatied in the brain of patients with AD and in this form it is the major protein subunit of paired helical filaments/neurofibrillary tangles(PHF/NFT). The modulation of the activities of phosphatase(PP)-2A, PP1 and tau kinase, such as GSK-3, cdk5 and MAPK effect tau protein hyperphosphorylation. It is unclear about the relation between tau and A? in AD, increased or altered A? production may be an initiating event in the pathogenic process in AD; but aberrant alternations in tau function are likely necessary for the subsequent neuronal dysfunction and death. Therefore, clearly defining the metabolism and function of tau in both normal and disease states is necessary for our understanding of AD and the development of appropriate therapeutic interventions.

Cervical cancer was the most common gynecological malignant tumor, and endanger the lives of women. In recent years, research on antioxidant system confirmed that the antioxidant system of defects was closely related with the risk factors of cervical cancer. The lack of antioxidants that generates excessive reactive oxygen species, damaged the cervix cells. Human papilloma virus (HPV) infection was the main pathogenic factor of cervical cancer.Epidemiological studies had shown that including oxidative stress and antioxidant defects may prompt some auxiliary factors of HPV infection were finally for the development of cervical cancer. Because the oxidation has small side effects, safety, etc, so its anti-tumor effect was becoming more and more attention. Recently, on the antioxidant therapy in the treatment of cervical cancer research has made great achievements. This article expounds the antioxidant system defects and relationship between occurrence and development of cervical cancer, also reviewed the antioxidant therapy of cervical cancer research foundation and the latest clinical research.

Objective:To observe the curative effect and safety of salvia miltiorrhiza ligustrazine combined with alprostadil injec-tion in the treatment of diabetic nephropathy. Methods: Totally 84 patients with diabetic nephropathy admitted in our hospital from January 2012 to December 2013 were randomly divided into the observation group and the control group with 42 cases in each. Alpros-tadil injection was applied in the control group, and salvia miltiorrhiza ligustrazine combined with alprostadil injection was used in the observation group. The clinical efficacy of the two groups was compared. Results:The total effective rate was 95. 2% in the observa-tion group, which was significantly higher than that (83. 3%) in the control group (P<0. 05). BUN, Scr and urine former protein levels after the treatment were significantly lower than those before the treatment (P<0. 05), and the renal function in the observation group was significantly better than that in the control group (P<0. 05). Conclusion:Salvia miltiorrhiza ligustrazine combined with al-prostadil injection in the treatment of kidney disease is effective to promote the discovery of renal function, which is worthy of promoted application in clinical practice.

Objective To explore the clinical value of serum Ang-1,Ang-2 and IL-8 in ARDS prediction.Methods Totally 283 critically ill patients admitted in EICU of the Hunan Provincial People's Hospital from January 2012 to July 2013 were enrolled in this study and divided into the non-ARDS group (n =251) and ARDS group (n =32) depending on the development of ARDS.According to the occurrence of death in the following 60 days,the non-ARDS group and the ARDS group were further subdivided into the non-ARDS survival group,the non-ARDS death group,thc ARDS survival group and the ARDS death group.The differences in serum Ang-1,Ang-2 and IL-8 concentrations between these four groups measured by ELISA on admission were analyzed by statistical methods and ROC curve.Results The EICU stays,duration of mechanical ventilation,APACHE Ⅱ score、serum Ang-2 and IL-8 levels in the ARDS group were significantly higher than those in the non-ARDS group,while the Ang-1 level in the ARDS group was significantly lower than that in the non-ARDS group.The serum Ang-2 and IL-8 concentrations in the ARDS death group were significantly higher than those in the non-ARDS survival group and the non-ARDS death group,and the serum Ang-2 concentrations in the ARDS death group were also significantly higher than those in the ARDS survival group.Further ROC curve analysis showed that the area under the curve of Ang-2 for ARDS diagnosis and ARDS death prediction were 0.907 and 0.899 respectively and their diagnostic sensitivity and specificity were 0.969 and 0.725,0.907 and 0.882 respectively,illustrating that Ang-2 possess the best diagnostic efficiency.Conclusions Ang-2 functions as a valuable biomarker for early diagnosis and prognosis of ARDS.

New oral anticoagulants,including direct thrombin inhibitors and factor Xa inhibitors.They have overcome several shortcomings of warfarin.The efficacy of preventing stroke and systemic embolism is superior to or not inferior to warfarin in patients with non-valvular atrial fibrilhtion,and they can decrease the risk of bleeding (especially intracranial hemorrhage).However,no agent can efficiently reverse its anticoagulant effect now.This article reviews the pharmacological characteristics,clinical efficacy,complications,and its management of the commonly used new oral anticoagulants at present.

Based on the brief introduction of the concept of evidence - based medicine and the importance of its education, the paper analyzes the advantages of launching this kind of education in medical library. Contents and modes are described in detail. It proposes va-rious forms of education should be carried out according to different user groups, so as to further promote the development of evidence-based medicine education.

Cardiovascular Diseases ; genetics ; Humans ; Polymorphism, Genetic ; Receptors, Adrenergic, beta-1 ; genetics