Objective To explore the effect of related factors on survival of patients with unresectable pancreatic cancer aged 70 years and over. Methods Fifty-seven patients with unresectable locally advanced or metastatic pancreatic cancer aged 70 years and over were enrolled.Their survival time were analyzed with SPSS 13.0 by taking account of gender, age, smoking history,alcohol history, pancreatic disease history, diabetes mellitus history, Eastern Collaborative Oncology Group (ECOG) scoring, chemotherapy, radiotherapy, CEA and CA199 levels. Results Gender,ECOG scoring, chemotherapy and radiotherapy had relationship with overall survival. The median survival time was 8.9 months and one-year survival rate was 28.1%. The median survival was (10.7±5.4) months in male group and (5.5±2.3) months in female group (P=0.000). The median survival was(10.1±5.8) months in patients with ECOG 0～1 group and(7.3±3.8)months in patients with ECOG 2 group (P=0.040). The median survival was(7.76±5.27) months in nochemotherapy group and(11.5±5.0)months in chemotherapy group (P=0.038). The median survival was(8.87±5.36)months in no radiotherapy group and (13.7±3.8) months in radiotherapy group (P=0.048). Conclusions The patients who have better ECOG performance status and receive chemotherapy or radiotherapy show better survival.

Objective To investigate the prevalence of human papilloma virus (HPV) infection of women in Yangzhou region , and to analyse characteristics of genetypes and ages distribution .Methods A total of 4 422 cervical exfoliated cell specimens were collected from women in different age groups ,from January 2014 to February 2015 ,recruited by gynaecologic department of this hospital .And 21 kinds of HPV genetypes were detected by using the dot blot hybridization reverse‐gene chip technique .Results The positive rate of HPV was 38 .60% .The rate of high risk HPV infection was 18 .23% ,while the positive rate of multiple HPV subtypes infection was 13 .61% .The genetypes mainly were HPV‐16 ,52 ,58 ,53 ,11 .The positive rate of HPV in women under 30 years old was slightly higher than that in women 30- <40 years old ,and the positive rate was elevated with the increase of age . Conclusion The dominant genetypes are HPV‐16 ,52 ,58 in women with HPV infection in Yangzhou region ,and the positive rate of multiple HPV subtypes infection is relatively high .Additionally ,the positive rate is elevated with the increase of women′s age .It is necessary to carry out HPV nucleic acid detection and genotyping detection for women in different age groups and the susceptible population .

OBJECTIVE To study the resistant phenotype and molecular biology character of 106 clinical isolates of Enterobacteriaceae.METHODS The 106 clinical isolates of Enterobacteriaceae were studied by agar dilution method,mutiplex PCR and DNA sequencing methods were used in further study.RESULTS The AmpC ?-lactamase was detected in 35 isolates of Enterobacteriaceae(accounted for 33.02%),34 of 35 AmpC-producing isolates were resistant to cefoxitin,1 of 35 AmpC-producing isolates was intermediate-susceptible to cefoxitin,the susceptibility to cefepime and imipenem was 68.50% and 97.10%,respectively.CONCLUSIONS A new plasmid mediated AmpC ?-lactamase is detected in one isolate of Enterobacteriaceae.The antibiotic resistance is closely associated with antibiotic resistance genes.

Objective To investgate the value of various parameters obtained from monoexponential, biexponential, and stretched exponential diffusion?weighted imaging models in the differential diagnosis of breast lesions. Methods A retrospective study performed in 54 patients with pathologically confirmed malignant tumors(n=30), benign lesions(n=34) and normal fibroglandular tissues (n=30). All patients underwent T1WI, T2WI, dynamic enhancement and diffusion weighted MRI with multi?b values at a 3.0 T magnetic resonance imaging unit. All parameters were measured at a workstation. ADC was calculated by using monoexponential analysis(b=0, 800 s/mm2). Slow apparent diffusion coefficient (ADC?slow), fast apparent diffusion coefficient (ADC?fast), and perfusion fraction (f) were calculated using the biexponential model. Distributed diffusion coefficient (DDC) and water molecular diffusion heterogeneity index (α) were obtained from diffusion?weighted images using the stretched exponential model. All parameters were statistically compared among normal fibroglandular tissues, benign lesions and malignant tumors using Kruskal?Wallis rank sum test. Mann?Whitney U test were used for further comparisons between specific group pairs. ADC values were compared with ADC?slow and DDC for different groups by paired Wilcoxon test. Correlations between ADC?value, ADC?slow and DDC were assessed by using Spearman rank correlation coefficient. Receiver operating characteristic curve was used to analyze and compare the ability of these parameters in differentiation of benign and malignant breast lesions. Results The ADC, ADC?slow, f, DDC and α values were significantly different among the normal fibroglandular tissues, benign tumors and malignant tumors (P<0.05). Further differential comparisons of the four parameters between each pair showed that the ADC, ADC?slow, f, DDC and α values were significantly lower in malignant tumors than both in normal fibroglandular tissues and benign tumors(P<0.016 7). The ADC values of normal fibroglandular tissues, benign tumors and malignant tumors were significantly higher than ADC?slow and DDC (P<0.05). The f and DDC had higher area under the receiver operating characteristic curve (0.688 and 0.657 respectively). The optimal cutoff values for ADC, ADC?slow, f, DDC and α were 1.235 × 10-3mm2/s, 0.428 × 10-3mm2/s, 57.8%, 1.175 × 10-3mm2/s and 0.721, respectively. Theαvalue showed higher specificity (65.5%) and the f value had higher sensitivity (82.9%). Conclusion The parameters derived from biexponential and stretched exponential DWI could be helpful for differentiation between benign and malignant breast tumors.

ObjectiveTo investigate the effect of follow-ups on medical compliance behaviors and quality of life of patients with gastroesophageal reflux disease (GERD).Methods One hundred GERD patients who were hospitalized in our department from June 2012 to June 2013 were divided into intervention group (n=50) and control group (n=50) according to the random number table. Both groups received the same drug treatment and conventional nursing during hospitalization.The control group received periodically outpatient follow-ups,while the intervention group received professional follow-ups by trained nurses after discharge from hospital. The compliance behaviors and quality of life in these patients were assessed and statistically analyzed after 6 months nursing intervention or outpatient follow-up.Results With the implement of follow-up in patients with GERD,the intervention group was better than the control group in compliance behaviors,including the decrement of smoking and drinking,strong tea,coffee,having midnight snack and spicy food (P<0.05),but there was no difference in the behavior of staying-up between the two groups.Concerning the quality of life,the intervention group was significantly better than the control group in the 6 items excluding the physical and physiological functions (P<0.05).Conclusion Professional follow-ups can improve compliance behavior and quality of life of GERD patients.

We expressed 17-hydroxysteroid dehydrogenase10 (17β-hsd10) recombinant protein, prepared anti-17β- hsd10 polyclonal antibodies and established sandwich enzyme linked immunosorbent assay (ELISA) test for detection of 17β-hsd10. RT-PCR was used to get the gene of 17β-hsd10 of mouse liver, and a prokaryotic protein expression system pET 15b-17β-hsd10/Escherichia coli BL21 (DE3) which induced with isopropyl-1-thio-β-galactopyranoside (IPTG) for recombinant protein expression was constructed subsequently. The target protein purified using His-Binding-resin column was used to immunize BALB/c mice and rabbits, serum total IgGs from immunized animals were purified by ammonium sulfate precipitation method. We established a Double-antibody Sandwich enzyme linked immunosorbent assay about 17β-hsd10 using the two antibodies we prepared. We got the concentration of 1.5 mg/mL of 17β-hsd10 protein with molecular weight of 29.5 kDa, and polyclonal antibodies from mouse and rabbit with the tite 1.25 x 10(4) and 2.5 x 10(4) respectively. The concentration of 0.1 g/mL of 17β-hsd10 can be detected by the Double-antibody Sandwich ELISA we established, and the assay was sensitive and specific. It can be widely used in clinical and experimental study.
3-Hydroxyacyl CoA Dehydrogenases ; genetics ; immunology ; Animals ; Antibodies ; immunology ; Cloning, Molecular ; Enzyme-Linked Immunosorbent Assay ; methods ; Escherichia coli ; Immunization ; Mice ; Mice, Inbred BALB C ; Rabbits ; Recombinant Proteins ; genetics ; immunology

Aim To investigate endoplasmic reticulum stress ( ERS)-mediated high-fat diet and palmitic acid-induced insulin resistance ( IR) in skeletal muscle and interventional effects of fenofibrate both in vivo and in vitro tests. Methods Female SD rats were randomly subjected to a standard control diet ( SCD) or high-fat diet ( HFD) for 20 weeks, then the HFD group was di-vided into high-fat-diet group and high-fat-diet group treated with fenofibrate ( HFD +FF, 30 mg · kg-1 · d-1 ) for another 8 weeks. The changes of IR and ex-pression of peroxisome proliferator-activated receptor α( PPARα) , glucose regulated protein 78 ( GRP78 ) and transcription factors GADD153 ( CHOP ) were as-sessed respectively. C2C12 myotubes were divided into normal control group ( NC ) , model group ( palmitic acid, PA) , postive control drug group ( tunicamycin, TM) and treatment group ( fenofibric acid, FA+PA) , the expressions of GRP78 and CHOP were assessed re-spectively. Insulin-stimulated phosphorylation of Akt was also analyzed to detect changes of insulin sensitivi-ty in C2 C12 . Results The high-fat diet induced obvi-ous IR and upregulated ERS markers GRP78 and CHOP in skeletal muscle of rats, and these responses were attenuated by treatment with fenofibrate. Incuba-tion of myotubes with palmitic acid or tunicamycin sig-nificantly increased expression of ERS markers GRP78 and CHOP. Meanwhile, insulin-stimulated phosphoryl-ation of Akt was inhibited obviously. Pre-incubation with FA markedly inverted PA-induced ERS and insu-lin-stimulated phosphorylation of Akt. Conclusion Fenofibrate ( fenofibric acid) has obvious effects of IR on skeletal muscle tissues and cells, which may be re-lated with reduced expression of GRP78 and CHOP in ERS.

Aim To study the SHV genotype and analyze resistance of extended-spectrum ?-lactamases (ESBLs)-producing Klebsiella pneumoniae (Kpn) and Escherichia coli (Eco) strains isolated from clinical patients in Hefei during 1999~2000. Methods Ninety-eight strains of Klebsiella pneumoniae and Escherichia coli conserved by Anhui center for surveillance of bacterial resistance were collected from four general hospitals, including First affiliated hospital of Anhui medical university, Anhui province hospital, first people′s hospital of Hefei and the 105th hospital of PLA, from September 1999 to September 2000. The encoding genes of SHV ?-lactamases produced by ESBLs-producing isolates were amplified by PCR. The purified PCR products were cloned into pGEM-Teasy vectors and sequenced by sanger′s dideoxy chain termination composition method recommended by CLSI. Their resistances to 11 antimicrobial agents were tested by agar dilution. MICs of the antimicrobial agents against clinical isolates and the transconjugants were determined. Results Twenty-nine out of ninety-eight ESBLs-producing isolates produced SHV ?-lactamases. Of twenty-nine isolates producing SHV ?-lactamases, eight strains produced SHV-1, five strains produced SHV-11, eleven strains produced SHV-12, one strain produced SHV-18, one strain produced SHV-28, and three produced a novel SHV type SHV-89 (Accession No. DQ193536). All the strains had the same susceptible pattern, with the low susceptibility rate to piperacillin, ceftriaxone and cefotaxime. All the strains were susceptible to imipenem. Compared with clinical strains, the transconjugants showed higher resistance to many antimicrobial agents. Conclusions The rates of SHV ?-lactamases-producing klebstella. pneumoniae and Escherichia coli reach a high level in hospitals in Hefei. This is the first report on SHV-89 in China. The high resistance may be present in these clinical isolates in Hefei area.

Postoperative surgical site infection (SSI) can lead to adverse clinical outcomes in patients, such as prolonged hospital stay, increased medical costs, and severe economic burden on patients and on society.In addition, it may also cause nosocomial cross-infection.Therefore, it has aroused the high attention of medical workers.The development of SSI is closely related to a variety of factors, including patient factors, such as blood glucose levels, smoking, systemic use of steroids, obesity and malnutrition, and perioperative related factors, such as long preoperative hospital stay, preoperative skin preparation and prophylactic use of antibiotics of patients, hand hygiene and asepsis principles of medical staff, operation-related factors, anesthetic management and operation related factors, operating room environment factors and postoperative factors.Through reading a large number of relevant literatures published in recent years and according to the work characteristics of anesthesiologists, the author summarized the influential factors and preventive measures for postoperative SSI for the reference of fellow doctors.

Objective　To analyze the effects of flexible ureteroscopic Holmium laser lithotripsy on renal function in the treatmen of renal calculi.　Methods　From October 2010 to March 2012,41 cases of solitary renal calculi (24 males and 17 females) were treated with flexible ureteroscopic Holmium laser lithotripsy ( FURL).Patient's mean age was 51.9 ± 15.9 years ( range from 31 to 88 years).Locations of renal calculi detected by image study were 22 cases in middle and upper calyx,9 cases in lower calyx,10 case in renal pelvis.The mean size of calculi was 16.9 ±6.0 mm (range from 10 to 28 mm).Blood samples (2 h pre-operatively,and then 2 h,12 h,24 h,48 h,72 h post-operatively) were collected and serum　NGAL,serum Cys-C were tested　Results　The measured levels of pre-operative NGAL and Cys-C were 3.5 ± 0.6μg/L,501.7±121.3 μg/L,and levels of post-operative NGAL at 2 h,12 h,24 h,48 h and 72 h were 4.2±0.8 μg/L,5.0±1.0 μg/L,4.9±1.4 μg/L,4.3± 1.1 μg/L and 3.8 ±0.1 μg/L,while the according levels of Cys-C were ( 516.4 ± 126.2 ) μg/L,( 723.8 ± 134.8 ) μg/L,( 770.4 ± 162.8 ) μg/L,(671.7 ± 138.3 ) μg/L and 574.0 ± 116.7 μg/L.Serum NGAL began to increase 2 hours after operation (P ＜0.05,and reached the peak in 12 hours,it began to decline 12 hours after surgery,but it was still higher at 72 hours than pre-operative level (P ＜ 0.05.Serum Cys-C showed no obvious ascent 2 hours after operation in FURL group ( P ＞ 0.05 ),but increased obviously 12 hours after operation and lowered down after the peak that occurred 24 hours after surgery.Serum Cys-C still remain above the baseline 72 hours after operation (P ＜0.05).　Conclusions　Flexible ureteroscope lithotripsy can cause reversible damage to renal function after surgery.