Objective Systemic chemotherapy for metastatic pancreatic cancer is still a difficult problem in clinical practice. The standard chemotherapy of pancreatic cancer has been gemcitabine, but the response rate is low. Therefore, it is in urgent need to explore an effective clinical therapy for this cancer. This paper, a case report, is aimed at discussing the effectiveness of vinorelbine and cisplatin combined with endostatin as the first-line therapy for metastatic pancreatic cancer. Methods A 52-year-old female patient was diagnosed with pancreas cancer with liver metastasis at the time of the first visit to our hospital. Systemic chemotherapy with vinorelbine and cisplatin combined with endostatin was conducted. Results Liver metastases almost disappeared after the first cycle of chemotherapy. The primary tumor decreased by one third in size after four cycles and disappeared after the sixth cycle according to the CT scan evaluation. Conclusion Vinorelbine and cisplatin combined with endostatin can be a promising regimen for metastatic pancreatic cancer.

Objective To study the effects of diet and physical activity factors on blood pressure in nine provinces, using the multilevel model. Methods Data was collected in the China Health and Nutrition Survey (CHNS). A total of 6706 men and 7140 women aged above 18 who attended at least one of the surveys in the year of 1997,2000,2004 and 2006 were selected, and a two-level male and female random intercept-slope growth models were applied to estimate the relationship between the intake of daily salt, vegetable, fruit, fat, protein as well as the time spent on the moderate or heavy physical activity and blood pressure. Results After controlling for age,education, BMI, drinks and total energy intake, mean of the daily salt intake per person was positively associated with systolic blood pressure in women ( β= 0.0481, s-x= 0.0178, P＜0.01 ). Mean of the daily vegetable intake per person was negatively associated with systolic blood pressure in men and women, with the regression coefficients as -0.0063,-0.0068 respectively, indicating that if mean of the daily vegetable intake per person increased by 100 g, the systolic blood pressure would decrease by 0.6 mm Hg (1 mm Hg=0.133 kPa) or more. In addition, the daily vegetable intake was also negatively associated with diastolic blood pressure (P＜0.01). Daily fruit intake was negatively associated with systolic blood pressure both in men and women, with regression coefficients as -0.0029 and -0.0031 respectively. Time spent on the moderate or heavy physical activity was also negatively associated with systolic blood pressure in both men and women, and diastolic blood pressure in women (P＜0.05). No relationship was found between daily fat, protein intake and blood pressure. Conclusion Daily salt, vegetable, fruit intake, time spent on the moderate or heavy physical activity were associated with blood pressure in both men and women. Programs on integrated lifestyle modifications including dietary salt reduction, eating more vegetable and fruits, increasing physical activity level, plus weight control were critical for the control of high blood pressure.

OBJECTIVETo evaluate the correlation of venous return disturbance (VRD), bone marrow edema (BME) and the amount of joint fluid with clinical symptoms in osteonecrosis of the femoral head (ONFH).

METHODSTwenty patients (25 hips) with ONFH proved by pathology were parallelly examined by 1.5 T MR and medullograph.

RESULTIn total 25 hips VRD was observed in 16 hips with medullograph and 13 hips with the clinical symptoms (P <0.05). BME was found in 17 with MRI (P <0.01), and the was found in 15 hips with MRI (Spearman=0.949). VRD were found in 16 hydrarthrus.

CONCLUSIONONFH patients with clinical symptoms have VRD, BME and the hydrarthrus. The medullograph is of value in monitoring the development of ONFH.

Adult ; Bone Marrow ; pathology ; physiopathology ; Edema ; pathology ; Female ; Femur Head ; blood supply ; Femur Head Necrosis ; pathology ; physiopathology ; Hip Joint ; pathology ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Regional Blood Flow ; physiology ; Veins ; physiopathology

OBJECTIVETo investigate the prognostic significance of metastatic lymph node ratio in patients with colorectal cancer.

METHODSThe clinicopathological data of 303 surgically treated patients with colorectal cancer were retrospectively analyzed. Spearman correlation analysis was used to determine the correlation coefficient. The survival was analyzed using Kaplan-Meier method, and the survival difference was assessed by Log-rank test. Multivariate analysis was performed using Cox proportional hazard regression model in forward stepwise regression. Receiver working characteristic curve was used to compare the accuracy of the metastatic lymph nodes ratio in predicting the death of patients at 5 years postoperatively with that of the number of metastatic lymph nodes.

RESULTSThe MLR was not correlated with the total number of dissected lymph nodes (Spearman correlation coefficient: -0.099, P > 0.05), but the positive rate of metastatic lymph nodes did (correlation coefficient: 0.107, P < 0.05). Kaplan-Meier survival analysis revealed that the MLR significantly influenced the postoperative survival time (Log-rank chi(2) = 42.878, P < 0.01), even in the patients with less than 12 resected lymph nodes. The 5-year survival rates for rN0, rN1, rN2 and rN3 were 90.9%, 68.9%, 54.7% and 39.4%, respectively. There was a significant difference between the different stages (P < 0.01). Cox proportional hazard regression model analysis showed that the metastatic lymph node ratio was an independent prognostic factor. (EXP(B) = 7.809, P < 0.01). There was no significant difference between metastatic lymph node ratio and the number of metastatic lymph nodes in predicting the death of patients at 5 years postoperatively based on the area under the receiver working characteristic curve.

CONCLUSIONThe metastatic lymph node ratio in colorectal cancer patients is not correlated with the total number of dissected lymph nodes. The metastatic lymph node ratio is a major independent prognostic factor for patients with colorectal cancer. The ability of metastatic lymph node ratio in predicting the death of colorectal cancer patients at 5 years postoperatively is the same as that of the number of metastatic lymph nodes.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Colonic Neoplasms ; pathology ; surgery ; Female ; Follow-Up Studies ; Humans ; Lymph Node Excision ; Lymphatic Metastasis ; pathology ; Male ; Middle Aged ; Neoplasm Invasiveness ; Neoplasm Staging ; Proportional Hazards Models ; Rectal Neoplasms ; pathology ; surgery ; Retrospective Studies ; Survival Rate ; Tumor Burden ; Young Adult

This study was purposed to investigate the immunoregulatory effect of endothelial cells derived from mesenchymal stem cells (MSC). The human MSC was induced to differentiate into endothelial cells for one week. The phenotypes were evaluated by flow cytometry, the cell morphologic feature was observed by invert phase-contrast microscope and analysis of capillary formation was performed by using the in vitro angiogenesis kit. The immunoregulatory effect was detected by lymphocyte transformation test. The result indicated that during the differentiation cells grew fast and there was no significant change in the phenotypes, i.e. CD73, CD105, HLA-ABC were positive and CD34, CD80, CD86, HLA-DR, CD31 were negative. Immunofluorescence analysis showed typical expression of the von Willebrand factor. Differentiated MSCs formed capillary-like structure. Endothelial cells derived from MSC also revealed immunosuppressive effect on T cell proliferation in a dose-dependent manner. It is concluded that endothelial cells derived from MSC also harbor immunoregulatory effect on T lymphocytes.
5'-Nucleotidase ; metabolism ; Cell Differentiation ; physiology ; Cells, Cultured ; Child ; Endothelial Cells ; cytology ; immunology ; Humans ; Mesenchymal Stromal Cells ; cytology ; metabolism ; T-Lymphocytes ; immunology ; von Willebrand Factor ; metabolism

Objective To manifest the imaging appearances of the pulmonary mucormycesis in patients with acquired immunodeficiency syndrome(AIDS).Methods The radiographic and hiish resolution computed lomography(HRCT)features of the pulmonary mucormycosis in 13 patients with AIDS were retrospectively analyzed.Results On radiography,the infiltrative lesions were found in 5 patients,7 cases had reticular pattem,4 cages had pleural effusion,4 cages had enlarged hilar and mediagtinal lymph nodes,3 cases had diffuse milliary lesions,3 Cages had masses,2 cases had ground-slags shadows,2 cages had cystic lesions,cavity,pleural thickening,pericardia]effusion and focal pneumothorax Wag presented in 1 cage respectively.On HRCT,7 cages had enlarged mediagtinal lymph nedes,7 cages had interlobular septal thickening,the infiltrative lesion were found in 6 patients,5 cages had diffuse milliary lesions,4 cages had pleural effusion,3 cases had inasses,2 cages had ground-glass shadows,2 cases had cystic lesions,cavity,pleural thickening,focal bronchiectagis,pericardial effusion and focal pneumothorax was presented in 1 case respectively.Conclusion The main imaging appearances of the pulmonary mucormycesis in patients with AIDS include diffuse milliary lesion,enlarged hilar and mediagtinal lymph node,interiobular septal thickening,infiltrative lesion,pleural effusion and mass.

Human placental decidua basalis-mesenchymal stem cells (PDB-MSCs) are multipotent cells from the human term placenta, which are ethically conducive, easily accessible and high-yielding source. PDB-MSCs can differentiate into adipogenic, osteogenic and neurogenic cells under appropriate conditions, which may be an attractive and alternative source of seed cells for tissue engineering. To investigate the effect of hypoxia (1% O2) on human PDB-MSCs and the expression of cytokine, PDB-MSCs were isolated from human placenta by density gradient centrifugation and cultured in the Dulbecco's modified Eagle's medium-high glucose (DMEM-HG) containing 10% fetal bovine serum (FBS), and the fifth passage of PDB-MSCs were taken. PDB-MSCs were divided into 4 groups according to the concentrations of O2 and FBS: 20% O2, 10% FBS; 20% O2, 0% FBS; 1% O2, 10% FBS; 1% O2, 0% FBS. The proliferation and apoptosis of PDB-MSCs were detected by MTT and flow cytometric analysis at the time points of 6 h, 12 h, 24 h, 48 h, 72 h, and 96 h, respectively. Vascular endothelial growth factor (VEGF) released from PDB-MSCs was detected by enzyme-linked immunosorbent assay (ELISA) at the same time points. The results showed that hypoxia enhanced the proliferation of PDB-MSCs at 12 h under the condition of 10% FBS, while at 24 h under the condition of 0% FBS (P<0.01, n=3). In normoxia, the cells cultured in 10% FBS displayed a significant proliferation compared to those cultured in 0% FBS. However, in hypoxia, the number of cells cultured in 0% FBS (serum deprivation) increased significantly compared to that cultured in 10% FBS at 24 h and 96 h respectively (P<0.05, P<0.01, n=3). With the flow cytometric analysis of cell apoptosis under the condition of hypoxia and serum deprivation, we found that hypoxia and serum deprivation did not induce PDB-MSCs apoptosis (P>0.05, n=3). This conclusion may relate to the expression of VEGF which needs further research. In conclusion, the results obtained indicate that PDB-MSCs are able to bear hypoxia and serum deprivation, suggesting that PDB-MSCs can be used as seed cells for ischemia related tissue engineering.
Apoptosis ; Cell Hypoxia ; Cell Proliferation ; Cells, Cultured ; Decidua ; cytology ; Female ; Humans ; Mesenchymal Stromal Cells ; cytology ; Placenta ; cytology ; Pregnancy ; Tissue Engineering ; Vascular Endothelial Growth Factor A ; metabolism

OBJECTIVETo study the relationships among magnetic resonance imaging (MRI), histological findings, and insulin-like growth factor-I (IGF-I) in steroid-induced osteonecrosis of the femoral head in rabbits.

METHODSThirty rabbits were randomly divided into experimental Group A (n=15) and control Group B (n=15). The 7.5 mg/kg (2 ml) of dexamethasone (DEX) and physiological saline (2 ml) were injected into the right gluteus medius muscle twice at one-week intervals in animals of Groups A and B, respectively. At 4, 8 and 16 weeks after obtaining an MRI, the rabbits were sacrificed and the femoral head from one side was removed for histological study of lacunae empty of osteocytes, subchondral vessels, and size of fat cells under microscopy, and the femoral head from the other side was removed for enzyme-linked immunoadsorbent assay (ELISA) for IGF-I.

RESULTSAt 4, 8 and 16 weeks after treatment, no necrotic lesions were detected in Group B, while they were detected in Group A. Light microscopy revealed that the fat cells of the marrow cavity were enlarged, subchondral vessels were evidently decreased, and empty bone lacunae were clearly increased. The IGF-I levels in Group A were significantly higher than those in Group B. At 8 weeks after the DEX injection, the MRI of all 20 femora showed an inhomogeneous, low signal intensity area in the femoral head, and at 16 weeks, the findings of all 10 femora showed a specific "line-like sign". The MRI findings of all femora in Group B were normal.

CONCLUSIONMRI is a highly sensitive means of diagnosing early experimental osteonecrosis of the femoral head. However, the abnormal marrow tissues appeared later than 4 weeks when the expression of IGF-I increased. This reparative factor has an early and important role in response to steroid-induced osteonecrosis of the femoral head, and provides a theoretical foundation for understanding the pathology and designing new therapies.

Animals ; Dexamethasone ; Disease Models, Animal ; Femur Head Necrosis ; chemically induced ; metabolism ; pathology ; Insulin-Like Growth Factor I ; metabolism ; Magnetic Resonance Imaging ; Rabbits ; Steroids

Objective To evaluate the effect on the booster immunization of different dosage of hepatitis B vaccine among children and to provide suggestions for booster immunization.Methods Children aged 5 -1 4 years old were randomly selected who had received the primary immunization of hepatitis B vaccine under 1 year old but had not received the booster immunization in Yuhuan county.A total of 547 children received 5 μg hepatitis A and B combined vaccine boost immunization and 688 children received 1 0 μg hepatitis B vaccine boost immunization in 2009.The anti -HBs levels before and after the boost immunization were detected.Results The anti -HBs positive rates of children received 5 μg and 1 0 μg vaccine boost immunization were 97.81 % and 96.08% respectively and the positive rates in the antibody negative children were 94.78% and 93.62% respectively.While the Geometric Mean Titer (GMT) of anti -HBs were 1 433.1 8 mIU /mL and 21 1 1 .43 mIU /mL respectively,which were both significantly higher than those before the boost immunization (P <0.001 ).The increase of GMT of children received 1 0 μg hepatitis B vaccine was significantly higher than that of children received 5 μg hepatitis A and B combined vaccine (P <0.05).Conclusion Both dosages of hepatitis B vaccine booster immunization are effective for children aged 5 -1 4 years old and 1 0 μg hepatitis B vaccine boost immunization has the better effect.

OBJECTIVETo compare the detection rates of Mycoplasma pneumoniae (MP) from nasopharyngeal aspirates (NPA) and bronchoalveolar lavage fluid (BALF) in children with pneumonia.

METHODSA total of 164 hospitalized children with pneumonia were enrolled. NPA and BALF of these children were collected within 24 hours of admission, and MP-DNA was detected by fluorescence quantitative PCR. Venous blood samples of all these children were collected within 24 hours of admission and on days 7-10 of treatment, and serum MP-IgM was detected using ELISA.

RESULTSThe positive rate of MP-DNA in NAP of the 164 cases was 51.8% , which was lower than 63.4% as the detection rate of MP-IgM in serum (P=0.044), and the two detection rates were moderately consistent with each other (Kappa=0.618, P<0.01). The positive rate of MP in BALF was 71.3%, which was not significantly different with that of MP-IgM in serum (P>0.05), and the detection rates were well consistent (Kappa=0.793, P<0.01). The detection rate of MP in NPA was lower than that in BALF (P<0.01), with moderate consistency between two of them (Kappa=0.529, P<0.01). The median MP copy number in BALF was significantly higher than that in NPA (P<0.01). The MP detection rates in NPA and BALF were significantly different among different courses of disease (P<0.05). As the course of disease extended, the MP detection rates in both NPA and BALF showed a declining trend; children with MP pneumonia of 1-2 weeks' duration and 2-4 weeks' duration had a higher MP-DNA detection rate in BALF than in NPA (P<0.05).

CONCLUSIONSMP-DNA in BALF has a high sensitivity, with a great significance for early diagnosis of MP pneumonia, while NPA MP-DNA tests may lead to a missed diagnosis.

Adolescent ; Bronchoalveolar Lavage Fluid ; microbiology ; Child ; Child, Preschool ; DNA, Bacterial ; analysis ; Female ; Humans ; Infant ; Male ; Nasopharynx ; microbiology ; Pneumonia, Mycoplasma ; diagnosis