Objective To investigate the expression and clinical significance of apoptosis inhibitory protein, Livin and Smac,in pancreatic carcinoma. Methods The expressions of Livin and Smac protein in 46 cases of pancreatic carcinoma tissues and 15 cases of insulinoma tissues and 14 cases of normal pancreatic tissues were examined by using immunohistochemical SP staining, and its relationship with clinicopathological parameters was analyzed. Results The positive expression rates of Llivin protein were 73.9％ ( 34/46),73.3％ (11/15) and 14.3％ (2/14) in pancreatic carcinoma, insulinoma and normal pancreatic tissue. Livin was highly expressed in pancreatic carcinoma and insulinoma, but there was no significant difference between the two groups, however, both were significantly higher than that in normal pancreatic tissues group ( P ＜ 0.05 ). The expression of Livin was significantly correlated with lymph node metastasis, histopathological grading and clinical staging (P ＜ 0.05 or P ＜0.01 ). The positive expression rates of Smac protein were 39.1％ (18/46), 100％ ( 15/15 ) and 92.9％ (13/14) in pancreatic carcinoma, insulinoma and normal pancreatic tissue. Smac was highly expressed in normal pancreatic tissues and insulinoma, but there was no significant difference between the two groups, however, both were significantly higher than that in pancreatic cancer group (P ＜ 0.05 ). The expression rote of Smac protein was significantly correlated with lymph node metastasis, histopathological grading, chnical staging and patients' age (P ＜0.05 or P ＜0.01 ).Conclusions Livin protein may play an important role in genesis and development of pancreatic carcinoma,but Smac protein may play a role in preventing the development of pancreatic carcinoma.

ObjectiveTo explore causes and prevention experience for neuropsychopathic symptoms after liver transplantation.MethodsThe clinical data of 62 patients who underwent transplantation in our hospital were retrospectively analyzed for the causes of neuropsychopathy symptoms and treatment experience was Summarized.ResultsSixteen patients(25.8％ ) had psychiatric symPtoms after liver transplantation in three weeks,four of them more severe.The common clinical manifestation was sleep disorders,mania,anxiety,depression,delirium and change of cognition.The pre-operation encephalopathy history,liver function,blood loss,time in the ICU after surgery,post-operation infection and the concentration of immunosuppressive agents were risk factors for psychiatric symptoms.All patients were cured.ConclusionsPsychiatric symptoms are commonly seen after liver transplantation and have a variety of etiology and clinical manifestations.Psychological counseling should be strengthened.The appropriate therapeutic measures for different etiology can improve patient outcomes.

Objective To study the efficacy of sacral nerve stimulation combined with tolterodine in patients with female idiopathic overactive bladder (IOAB).Methods A total of 200 female patients diagnosed with IOAB from January 2005 to January 2011 were included in the study,and according to random number table method were divided into treatment group and control group with 100 cases in each.Each group was divided into 3 subgroups according to urinary frequency and urgency,urge incontinence,and both of them together.In the treatment group,patients received percutaneous sacral nerve stimulation and tolterodine 2 mg orally,1 time/d,while in the control group,only given tolterodine 2 mg orally,1 time/d,treatment for 3 months.The voiding diary and urodynamics parameters were observed between the two groups before and after treatment and application of self-rating depression scale (SDS) and self-rating anxiety scale (SAS) to evaluate the psychology of concomitant depression and anxiety score.Results After treatment,the average number of urination,daily average unit urine,the single biggest urine and urine feel capacity (FDV),the maximum capacity of the bladder pressure (MCBC),maximum urinary flow rate (Qmax) in two groups were improved,and the daily average unit urine,single biggest urine and FDV,MCBC,Qmax in treatment group after treatment were higher than those in control group [daily average unit urine:urinary frequency and urgency (248 ± 46) ml/times vs.(150 ± 77) ml/times,urge incontinence (249 ± 69) ml/times vs.(144 ± 81) ml/times,both of them together (247 ± 69) ml/times vs.(170 ± 46) ml/times; the single biggest urine:(320 ± 87) ml/times vs.(212 ± 44) ml/times,(315 ± 65) ml/times vs.(211 ± 56) ml/times,(333 ±59) ml/times vs.(201 ±66) ml/times;FDV:(176 ±64) ml vs.(142 ±44) ml,(190 ±69) ml vs.(142±55) ml,(188 ±60) mlvs.(138 ±49) ml;MCBC:(265 ±46) ml vs.(203 ±50) ml,(288 ±48) ml vs.(197 ± 41)ml,(287 ± 43) ml vs.(189 ± 44) ml],there were significant statistical differences (P ＜ 0.01).The SDS and SAS scores were reduced in two groups after treatment,and the SDS and SAS scores in treatment group after treatment were significantly lower than those in control group [SDS scores:urinary frequency and urgency (33.0 ± 6.2) scores vs.(44.0 ± 5.9) scores,urge incontinence(31.1 ± 6.2) scores vs.(41.6 ± 6.1) scores,both of them together(33.4 ± 7.2) scores vs.(44.5 ± 5.0)scores;SAS scores:(30.3 ± 4.4) scores vs.(41.3 ±4.4) scores,(33.3 ±5.8) scores vs.(42.5 ±6.4) scores,(31.9 ±4.7) scores vs.(43.5 ± 5.6) scores],there were significant statistical differences (P＜ 0.01).Conclusions The combined treatment of tolterodine and sacral nerve stimulation can not only improve the voiding dysfunctions symptoms but also the concomitant depression and anxiety in patients with female IOAB,thus improving the patient's quality of life.

Objective To investigate the effect of terlipressin on hepatic and renal function in cirrhotic patients undergoing hepatectomy.Methods Aanlyze the clinical data of 57 patients following irregular hepatectomy for hepatocellular carcinoma with cirrhosis,according to whether use terlipressin or not after operation,which were divided into terlipressin group (A group,n =27) and control group (B group,n =30).Liver function parameters (ALT,AST,TB),ascites,urine volume and renal function parameters (Cr,BUN) preoperatively and on postoperative day(POD) 1,3,5 and 7 were compared between the two gruops.Results Compared with those of POD 1,the levels of ALT,AST and ascites on POD 3,5,7 were significantly lower in two groups (P ＜ 0.05),urine volume was significantly increased (P ＜ 0.05),Cr of POD 7 was significantly lower (P ＜0.05),but it is more remarkable in group A than group B.The levels of ALT in terlipressin group on POD 5,7 were (144.9 ±76.3) U/L,(100.5 ±61.5) U/L,which were lower than those of (267.2±91.2) U/L,(199.3 ±70.5) U/L in control group.On POD 3,5,7,the levels of AST,BUN,Cr and peritoneal fluid in terlipressin group,which were respectively(211.1 ±99.8) U/L,(80.4 ±54.6) U/L,(50.6 ±46.5) U/L,(6.6 ± 1.9) mmol/L,(6.5 ± 1.7) mmol/L,(6.3 ± 2.1) mmol/L,(74.3 ± 10.9) μmol/L,(71.5 ± 8.9) μmol/L,(58.7 ±4.1) μmol/L,(247.6±60.3) ml,(58.8±54.3) ml,(40.2±31.8) ml,were significantly lower than those in control group which were (298.7 ±131.2) U/L,(201.1 ±93.4) U/L,(114.7 ±70.3) U/L,(7.3 ± 1.9) mmol/L,(7.2±1.8) mmol/L,(7.1±1.7) mmol/L,(79.5±15.1) μmol/L,(76.9±16.2) μmol/L,(69.4±11.4) μmol/L,(275.2±88.1) ml,(191.7±71.6) ml,(93.2±50.2) ml.while urine volume of (2232.3±409.8) ml,(2270.5 ±395.8) ml,(2179.0±301.4) ml was much more than that of (1921 ± 510.4) ml,(2019.1 ±411.2) ml,(1978.7±323.7) ml in the control group,the differences in the two groups were statistically significant (P ＜ 0.05).There were 11 (36.7％) patients with hepatic and renal dysfunction and hepatorenal syndrome after operation in group B,while only 2 (7.4％) patients in group A.Conclusions The use of terlipressin after partial liver resection has a protective effect on hepatic and renal function in patients with cirrhosis,and can reduce postoperative ascites and prevent hepatorenal syndrome.

ObjectiveTo study the protective effects of terlipressin on the renal function of recipients afterlivertransplantation.MethodsAmong 35casesreceivingorthotopicliver transplantation (OLT),16 cases were given terlipressin (group T):continuous infusion of terlipressin (1mg) into the vein immediately after the operation,twice every day for 3-4 days;19 cases were given dopamine and procaine (group D):continuous infusion of dopamine (40 mg) and procaine (0.5 g) into the vein immediately after the operation,twice every day for 3-5 days.In both two groups,the serum creatinine and urea nitrogen levels were normal before the operation. Serum creatinine,urea nitrogen,serum β2 microglobulin and urine amount were determined.ResultsSerum creatinine,urea nitrogen,serum β2 microglobulin and urine amount were increased significantly at 5th day after operation in both two groups (P＜0.05).As compared with group D,urea nitrogen and serum β2 microglobulin were decreased,while the urine amount increased significantly at 5th day after operation in group D (P＜0.05).Three cases (18.8％) in group T,and10 cases (52.6％ ) in group D developed RFALT at 5th day after operation (P＜0.05).ConclusionTerlipressin can protect the renal function of recipients after liver transplantation,and it can more effectively provide good recovery conditions for the recipients who develop RFALT after liver transplantation.

The dissolution of nickel from nitinol alloy under different extraction conditions was investigated when biological tests of nitinol medical devices were carried out. It discussed the equivalence of these extraction conditions and found the best extraction conditions. In the experiment, two brands of nitinol were chosen and extracted under different extraction conditions according to GB/T 16886-12. Plasma emission spectrometer was used to analyse the concentration of nickel in extract liquid. The results show that there is no equivalence among these extraction conditions for nitinol materials. And it is suggested that (37 +/- 1) degree C, (72 +/- 2) h could be used as normal extraction condition and (70 +/- 2) degrees C, (24 +/- 2) h as accelerated extraction condition.
Alloys ; chemistry ; Biocompatible Materials ; Materials Testing ; Nickel ; chemistry ; Temperature ; Titanium

OBJECTIVETo elucidate the immunomodulatory mechanism of phenylethanoid glycosides from the seeds of Plantago asiatica by testing its effects on the maturing of murine bone marrow derived dendritic cells (DCs).

METHODMonocytes generated from bone marrow of Balb/cj mouse were cultured for 6 days in complete RPMI 1640 medium containing 10% FBS, rmGM-CSF and rmIL-4.50 mg x L(-1) acteoside or isoacteoside was added to cells on day 6 of culture for 24 h. The surface molecules expression level of DCs and their phagocytose ability were analysis by flow cytometry.

RESULTBoth acteoside and isoacteoside could increase the expression of CD11c, CD86, MHC II and CD80 on DCs surface. The ability of unstimulated DCs to uptake FITC-dextran was higher than that of phenylethanoid glycosides or LPS treated DCs.

CONCLUSIONBoth acteoside and isoacteoside could induce maturation of murine dendritic cells.

Animals ; B7-1 Antigen ; immunology ; metabolism ; B7-2 Antigen ; genetics ; immunology ; Cells, Cultured ; Dendritic Cells ; drug effects ; immunology ; Gene Expression ; drug effects ; Glycosides ; pharmacology ; Male ; Mice ; Mice, Inbred BALB C ; Phagocytosis ; drug effects ; Plant Extracts ; pharmacology ; Plantago ; chemistry ; Seeds ; chemistry

Objective:To investigate the relationship between plasma fibrinogen (FBG) level and p53 protein expression of tumor tissue in breast cancer, and to study the relationship between the parameters of plasma FBG level and p53 protein expression in tumor tissue and the prognosis of breast cancer.Methods:A total of 177 breast cancer patients who underwent surgery in the Second Affiliated Hospital of Hainan Medical University between Jan. 2012 and Oct. 2016 were included in the study. The data, including the general clinicopathological characteristics, the expression of p53 protein with immumohistochemical (IHC) staining, and plasma FBG level within 1 week before surgery, were collected. Chi-square test was used to analyze the relationship between the different levels of plasma FBG and the parameters of general clinicopathological characteristics and p53 protein, and binary Logistic regression was used for multivariate analysis. Kaplan-meier survival analysis and COX regression analysis were used for univariate analysis and multivariate analysis of IDFS, respectively.Results:Univariate analysis showed that plasma FBG>2.75 g/L had significant positive correlation with age>50 and positive p53 expression in tumor tissue ( P values were <0.001 and 0.006, respectively) . Multivariate analysis showed that positive p53 expression in tumor tissue ( OR 2.256, 95% CI 1.192 to 4.271, P<0.001) and age>50 years ( OR 3.712, 95% CI 1.967 to 7.002, P<0.001) were independent correlation factors for plasma FBG>2.75 g/L. Kaplan-Meier survival analysis results showed that the aged>50 years, T>2 cm, lymph node metastasis, Ⅲ stage, plasma FBG>2.75 g/L, positive p53 expression in tumor tissue were adverse prognostic factors of IDFS. COX regression analysis results showed that plasma FBG>2.75 g/L ( HR 6.226, 95% CI 3.863 to 10.033, P<0.001) , positive p53 expression in tumor tissue ( HR 1.864, 95% CI 1.133 to 3.066, P=0.014) and Ⅲ stage ( HR 10.382, 95% CI 5.942 to 18.141, P<0.001) were adverse prognostic factors of IDFS, and adjuvant endocrine therapy ( HR 0.427, 95% CI 0.275 to 0.663, P<0.001) was a favourable prognostic factor for IDFS. Conclusions:The expression of p53 protein was significantly correlated with high plasma FBG level in breast cancer. Both p53 protein expression and high plasma FBG level are associated with poor prognosis of breast cancer. On the basis of traditional pathological prognostic indicators, the detection of plasma FBG and p53 protein in tumor tissue may contribute to increase the prognostic information in breast cancer.

In recent years, a number of policies have been implemented to strengthen the cultivation of general practitioners in China. However, the development of community-level health professionals is still lagging behind, the development is uneven among regions, the overall number of general practitioners is insufficient, and the quality of medical services needs to be improved. Based on the Shanhai (Mountain and Sea) promotion project, with the close cooperation between the Second Affiliated Hospital and the medical consortium unit Suichang County People′s Hospital, a " Joint Cultivation by Dual-Teachers " model has been applied in training general practitioners for Suichang county community since March 2021. In this article we discuss the optimization and integration of medical and health resources through the outreaching assistance of high-quality personnel, management and system of medical service, to comprehensively upgrade the primary care and the quality of grass-roots general practitioners in remote mountainous areas.

Objective To investigate the clinical effect of transhepatic arterial chemoembolization(TACE)combined with tyrosine kinase inhibitors(TKIs)and programmed death receptors-1(PD-1)inhibitors(TACE+TKIs+PD-1 antibody)in the treatment of moderate advanced unresectable hepatocellular carcinoma(HCC).Methods The clinical data of 65 patients with moderate advanced unresectable hepatocellular carcinoma admitted to the Affiliated Hospital of North Sichuan Medical College from January 2020 to January 2022 were analyzed retrospectively.65 patients were treated with TACE+TKIs+PD-1 antibody.The observation indexes were tumor response,objective response rate(ORR),disease control rate(DCR),total survival time,progression free survival time,conversion operation rate and adverse drug reaction.Results The ORR of 65 p-atients with hepatocellular carcinoma was 49.2％(32/65),and the DCR was 89.2％(58/65).Among them,there were 2 patients with complete remission(CR),30 patients with partial remission(PR),26 patients with stable disease(SD),and 7 patients with progression disease(PD).Among 65 patients with hepatocellular carcinoma,18 patients were transformed into resectable hepatocell-ular carcinoma and underwent RO surgery.The conversion rate was 27.6％(18/65).65 patients were followed up for 3 to 22.4 months,The median follow-up time was 16.5 months.The median overall survival time and median disease progression free survival time of 65 patients were 14.5 months(95％CI:12.3～16.6 months)and 8.8 months(95％CI:6.9～10.6 months),respectively.After treatment,65 patients all had post embolism syndrome(abdominal pain,fever,nausea,vomiting and other symptoms),and some patients had transient abnormal liver function.Adverse drug reactions below grade 3 recovered within a few days.Some patients were associated with multiple adverse drug reactions.1 patient(1.5％)stopped using TACE because of stubborn vomiting,and 5 patients(7.6％)stopped using Lenvatinib because of severe liver function damage during treatment,2 patients(3％)stopped using Camrelizumab because of severe reactive capillary hyperplasia,one patient(1.5％)stopped using Tislelizumab because of severe hypothyroidism,one patient(1.5％)stopped the treatment of Lenvatinib and Sintilimab due to severe gastrointestinal bleeding.The adverse drug reactions of grade 3～4 occurred in other patients were alleviated after drug reduction,symptomatic treatment and hormone treatment.Conclusion TACE+TKIs+PD-1 antibody can obtain reliable clinical efficacy and anti-tumor activity in the treatment of moderate advanced unresectable hepatocellular carcinoma.