Objective To investigate the value of serum concentration of VEGF-C in the prognosis of advanced pancreatic cancer. Methods Thirty-five patients with advanced pancreatic cancer were selected from Aug. 2006 to Feb. 2008, ELISA method was used to detect the serum level of VEGF-C, CA19-9 and KPS score was calculated, and survival was analyzed by Kaplan Meier method. The survival difference was calculated by log rank. Cox regression model was used to perform univariate and multivariate analysis. Results The mean serum concentration of VEGF-C was ( 1309 ± 542 ) pg/ml in patients with advanced pancreatic cancer, which were significantly higher than that those in normal control [ (278 ±115) pg/ml, P <0.01 ]. In Cox regression, KPS score, serum CA19-9 and VEGF-C were independent factors (x2 =7.208, 6.908, 3.867, P = 0.007, 0.009, 0.049). In multivariate analysis, serum VEGF-C and KPS score were independent factors (x2 =4.873, P=0.027, x2 =5.274, P =0.022). Using serum concentration of VEGF-C at 1280 pg/ml as the cut-off point, the mean survival of patients with VEGF-C ≤1280 pg/ml was 10.0 months, and the median survival was 11.3 months, 1 year cumulative survival was 50.0% ; while they were 6.0 months, 6.3 months and 5.9% in patients with VEGF-C > 1280 pg/ml, and the difference was statistically significant (x2 = 9.400, P= 0.002). Using KPS score 70 as the cut-off point, the mean survival of patients with KPS <70was 6.0 months, and the median survival was 6.6 months, 1 year cumulative survival was 21.4% ; while they were 9.0 months, 10.1 months, 33.3% in patients with KPS score ≥70,and the difference was statistically significant (x2 =4.040, P =0.044). The difference of the median survival, 1 year cumulative survival in patients with CA19-9 ≤200 U/ml or >200 U/ml was not statistically significant (10.0 months vs. 7.8 months, 37.5% vs. 21.1% ; x2 =1910, P=0. 167). Conclusions Serum concentration of VEGF-C can used as an independent factor for predication of prognosis of patients with advanced pancreatic cancer.

Objective To investigate the effects of hypoxia on the features and chemoresistance of cancer stem cells in Hep-2 cells and underlying mechanism. Methods The shRNA interference recombinant plasmid targeting HIF-1α was synthesized and transfected into Hep-2 cells. The HIF-1αknockdown Hep-2 cells were established after clonal selection and the expression of HIF-1α was measured.The cellular features including proliferation,clonal formation,cell cycle,apoptosis and CD133 phenotype were measured in Hep-2 cells cultured under hypoxic condition in vitro. CD133 + cells were sorted from Hep-2 cells with flow cytometry. Clonal formation test and cisplatin treatment were carried out,and theexpressions of related genes( Oct-4,suvivin and p53 ) in CD133 + cells were measured.Results HIF-1αknockdown Hep-2 cells was successfully established,as evidenced by the reduced mRNA and proteinexpressions of HIF-lα. The Hep-2 cells cultured under hypoxic microenvironment showed higher proliferation and clonal formation activity,cell cycle arrest in G0/G1,lower apoptosis,up-regulated CD133,however the effects of hypoxia reduced in HIF-1α knockdown Hep-2 cells.CD133 + cells were successfullysorted from Hep-2 cells,and the CD133+ cells showed increased clonal formation activity and cisplatintreatment resistance in hypoxia. Also the effects of hypoxia on CD133 + cells decreased with HIF-1αknockdown,showing down-regulated Oct-4 and survivin and up-regulated p53.Conclusions Hypoixa caninduce the features of cancer stem cells in Hep-2 cells and increase proliferation,differentiation and chemoresistant ability of CD133 + cells,which might be correlated with the changes in expressions of HIF-1 αand related genes regulated by HIF-1 α.

Objective To explore how to apply the teaching mode combined flipped class with PBL teaching method to improve college students' ability of English reading and writing and the effectiveness of classroom. Methods In the class of college English reading and writing, students at grade 2015 were randomly divided into two groups. The experimental group (43 students) was adopted the class teaching with " flipped class and PBL teaching method"and the control group (43 students) was adopted traditional class teaching mode taught by the same teacher. The teaching effects of two groups were studied in a comparative way. The students' final grade, related data in the learning process, students'view of the two teaching modes are studied by analysis of basic data and questionnaire. Results At the end of the semester, the results of the experimental group are better than those of the control group. In the survey of the two class teaching modes, the students in the experimental group spent more time in the learning process than that of the control group.Students think that the teaching mode combined flipped class and PBL teaching method not only improves their autonomic learning ability, classroom participation, the English reading and writing ability, but also helps them perform better in the average scores in the final exam compared to the traditional classroom. Students are more satisfied with the new classroom teaching mode than with traditional one. Conclusion The teaching mode combined flipped class with PBL teaching method can promote the students'autonomous learning, contribute to absorb and internalize knowledge, improve the students'learning interest and learning efficiency, and improve teachers teaching ability.

Objective To evaluate the effects of different dosages of rocuronium on abdominal wound closure under general anesthesia.Methods Ninety ASA class I or II patients scheduled for elective abdominal surgery under general anesthesia were randomized into three groups with 30 cases each.Each group received rocuronium 1 time of ED95 (0.3 mg/kg),0.5 time of ED95 (0.15 mg/kg),0.2 time of ED95 (0.06 mg/kg) respectively when closing the abdominal wall.TOF recovered to 25%, 75%, 90%, time of eye-opening on command, time of head-lift for more than 5 seconds,extubation time, the rate of upper airways obstruction after extubation and the satisfaction score for the muscle relaxation to general surgeons were recorded.Results TOF values had no significantly different among the three groups before abdominal wound closure (P＞0.05).Compared with group A and group B,time of TOF in group C was significangtly increased after administration of rocuronium (P＜0.05) . Time of TOF recovery to 25%, 75%, 90%in group C were significangtly decreased (P＜0.01).Compared with group A and group B, time of eye-opening on command ,head-lift for more than 5 seconds and extubation time were significantly shorter in group C.There were 8,4,0 patients undwent upper airways obstruction among each group respectively after extubation (P＜0.05).The satisfaction score for muscle relaxation among three groups had no significant difference.Conclusion An additional administration of 0.2 time of ED95 (0.06 mg/kg) rocuronium before abdominal wound closure in abdominal surgery can achieve satisfactory muscle relaxation for surgeons.

This study examined the incidence, neuropsychological characteristics and risk factors of cognitive impairment 3 months after stroke in China. Five regions that differed in geography and economy in China were selected. Patients from the hospitals located in the five regions were prescreened at admission, and the demographic data, vascular risk factors and clinical characteristics of stroke were obtained. A battery of cognitive-specific domain tests was performed in the patients who failed to pass cognitive screening 3 months post stroke. Patients were diagnosed as having post-stroke cognitive impairment (PSCI) or no cognitive impairment (NCI) based on the results of the neuropsychological tests. Univariate analysis was performed for suspect risk factors, and significant variables were entered in multivariable logistic regression analysis. Our results showed that a total of 633 patients were recruited 3 months after stroke; complete cognitive tests were performed in 577 of the stroke patients. The incidence of PSCI in these Chinese patients was 30.7%. There were 129 (22.4%) patients with visuospatial impairment, 67 (11.6%) with executive impairment, 60 (10.4%) with memory impairment and 18 (3.1%) with attention impairment. The risk factors associated with PSCI were older age (odds ratio [OR] 1.76, 95% confidence interval [CI] 1.20-2.58), low education level (OR 2.45, 95% CI 1.65-3.64), depressive symptom (OR 1.69, 95% CI 1.09-2.61), obesity (OR 2.57, 95% CI 1.41-4.71), stroke severity 3 months post stroke (OR 1.62, 95%CI 1.10-2.37) and cortex lesion (OR 1.55, 95% CI 1.04-2.31). It was concluded that PSCI occurs commonly 3 months after first-ever stroke in Chinese patients. Visuospatial ability may be the most frequently impaired cognitive domain for the patients with stroke. The critical risk factors of PSCI are older age, low education level, depressive symptom, obesity, stroke severity 3 months post stroke and cortex lesion.

Electroencephalography ; Female ; Humans ; Infant ; Male ; Spasms, Infantile ; physiopathology

Objectives: To investigate the relationships between the stability of carotid plaque and serum Lp-PLA2, A-FABP levels in hypertensive postmenopausal women. Methods: 195 postmenopausal women with hypertension were selected and divided into non-plaque group, stable plaque group and unstable plaque group according to the results of carotid intima-media thickness (IMT) and plaque types derived from color doppler ultrasonography. In addition, 40 healthy postmenopausal women were recruited as normal control group. The serum Lp-PLA2 and A-FABP levels of all subjects were measured. Lp-PLA2 and A-FABP levels were compared among four groups by One-Way ANOVA. Spearman correlation analysis and multiple logistic regression analysis were also performed. Results: Plaque group included 123 subjects (unstable plaque group: 29 cases; stable plaque group: 94 cases), and non-plaque group included 72 subjects. The average serum A-FABP level was significantly higher in unstable plaque group [(172.60±33.70) ng/L] than in non-plaque group[(133.04±29.49) ng/L], P<0.05. Serum Lp-PLA2 level was similar between the four groups, P>0.05. Serum A-FABP level was positively correlated with the carotid plaque (r=0.3446, P=0.0049);serum Lp-PLA2 level was not correlated with the carotid plaque (r=0.2058, P=0.0996). Multiple logistic regression analysis showed that high A-FABP level was associated with stable plaque in hypertensive postmenopausal women (P=0.040, OR=1.017, 95%CI: 1.001~1.033), which was also associated with unstable plaque in this population (P=0.003, OR=1.031, 95%CI: 1.010~1.052). Conclusions: The level of A-FABP is a determinant responsible for the occurrence and stability of carotid plaque among hypertensive postmenopausal women. There was no correlation between Lp-PLA2 level and the stability of carotid plaque in this patient cohort.

Objective To establish an in vitro model of mouse cochlear basilar membrane impairment using cisplatin, and observe the protective effect of methionine on the hair cells. Methods The cochlear basilar membrane samples of thirty two Kunming mice were harvested on the 2nd day after birth and randomly divided into four groups. Each group had 16 samples. Overnight preincubation the cochlear organ followed by appropriate treatment respectively as follows: the serum-free culture medium, the serum-free culture medium with methionine and cisplatin, the cisplatinum-containing serum-free culture medium, and the methionine-containing serum-free culture medium. The protective effect of methionine for injury of cochlea hair cells induced by cisplatin was observed by myosin-Ⅵ immunofluorescence, lightmicroscop,laser confocal scanning microscope and hair cells counting. Results The outer hair cells(OHC) and inner hair cells(IHC) of control group and methionine group were not damaged. The outer and inner hair cells of cisplatin group were damaged in various degree, and had remarkable difference compared with control group and methionine group(P ＜ 0. 05). The outer hair cells and inner hair cells of cisplatin + methionine group were damaged less than the cisplatin group with remarkable difference (tIHC = 3. 929, tOHC = 8. 582, P ＜0. 05). Conclusions Cisplatinum could damage the cochlear hair cells of the basal membrane in Kunming mice. Methionine might protect against cisplatin's damage on the cochlear hair cells.

Objective To detect the expression of hypoxia inducible factor 1 alpha (HIF-1α),glucose transporter protein-1 (GLUT-1) and vascular endothelial growth factor (VEGF) in human laryngeal carcinoma tissue,and to study the relationship between hypoxia and HIF-1α,GLUT-1,VEGF in human laryngeal carcinoma Hep-2 cells and to explore the effect of HIF-1α,GLUT-1 and VEGF as endogenous hypoxic markers on laryngeal carcinoma.Methods The expression levels of HIF-1α,GLUT-1 and VEGF were detected in 35 cases of laryngeal carcinoma by SP immunohistochemical methods and in Hep-2 cells by SP immunocytochemical methods.The relationship between HIF-1 α and GLUT-1,VEGF protein expression was analyzed.Results Of the 35 cases,16 cases expressed HIF-1α,16 cases expressed GLUT-1,19 cases expressed VEGF.The expression of HIF-1α and VEGF were closely correlated with pathologic grading and lymphnode metastasis.GLUT-1 was correlated with lymphnode metastasis.The expression levels of HIF-1 α,GLUT-1 and VEGF in Hep-2 cells under hypoxic condition were higher than those under normoxiccondition.Conclusion HIF-1α may promote the expression of GLUT-1 and VEGF in laryngeal carcinoma,furthermore promote tumor angiogenesis,invasion,and metastasis of the laryngeal carcinoma.

Objective To analyze the temporospatial characteristics of traumatic brain injury (TBI) caused by Wenchuan earthquake, the distribution of the complex injuries, and the surgical timing and approaches. Methods The clinical data were retrospectively analyzed among 92 patients sustaining TBI in Wenchuan earthquake admitted in our department within 20 days after the injury. Results All the 92 patients came from the northwest Chengdu Champaign. Seventy-six patients were admitted within the initial 12 hours after earthquake, and 10 patients underwent surgical procedures. Forty-seven patients were cured, 31 were transferred to other provinces for further medical care, and 3 died. Conclusions Early TBI accounted for a large proportion of the TBI cases in Wenchuan earthquake, characterized by rapid progression of the condition. Early emergency surgeries can significantly improve the success rate of operations and lower the mortality rate.