Objective To discuss the rehtionship between lipoprotein [Lp (a)],homocysteine (Hcy) and coronary artery disease (CAD) in men.Methods Two hundred and twenty-two male patients admitted for coronary angiography were classified into CAD positive group (111 cases) and CAD negative group (111 cases).The clinical data and plasma Hcy and Lp(a) levels were recorded in both groups.Logistic regression analysis was used to analyze males CAD risk factors.Results Lp (a) ≥0.3 g/L was a risk factor for CAD (OR =5.04,95％ CI 1.88-13.51,P =0.001),whereas Hcy was not related to CAD (OR =1.35,95％ CI 0.63-2.89,P =0.443).However,when both factors were considered together in an interaction model,plasma high Hcy and high Lp (a) levels were risk factors for CAD (OR =11.54,95％ CI 2.62-45.61,P=0.003).Conclusion Plasma Lp (a) and Hcy levels may increase the incidence of male CAD process.

Objective To study the relationship of the university students' procrastination and big five personality factors.Methods 461 university students were assessed by the simple edition of tuckman procrastination scale(TPS) and the big five personality inventory short form(NEO-FFI).Results TPS score of the student was (48.51 ± 7.66).There were 89.4% students respectively had different level of procrastination behavior.There were no significant differences in university students by the gender(47.95 ±7.84 vs 48.95 ± 7.43 ) ,whether one-child students(48.64 ± 7.49 vs 48.45 ± 7.81 ) and grades.There were significant positive correlation between procrastination and the personality factor of neuroticism( r=0.235, P＜0.01 ) and significant negative correlation with extraversion ( r=-0.180, P ＜ 0.01 ) and conscientiousness ( r =-0.198, P ＜ 0.01 ).The big five personality factors of neuroticism,extraversion and conscientiousness could explain the 14.0% variation of procrastination of university students.Conclusion Procrastination is a very common phenomenon in the university students.The students with higher neuroticism, lower extraversion and conscientiousness of big five personality have more procrastination behavior.

Purpose Ovarian dysgerminoma has no specific symptoms or physical signs, which is thus prone to misdiagnosis before treatment. This paper aims to investigate CT and MRI clinical features of ovarian dysgerminoma, so as to provide an accurate basis for its clinical treatment and also improve patients'' life, quality.Materials and MethodsThe CT and MRI data of 13 patients with ovarian dysgerminoma proved by pathology were retrospectively analyzed. Three patients underwent plain and enhanced CT scan, 6 took plain and enhanced MRI scan on T1WI and T2WI with different angles of views, and 4 other patients were performed both CT and MRI scan.Results①Twelve patients had single lesions, and 1 was bilateral multiple ones. The diameter of the lesions ranged from 5.5 cm to 16.5 cm, with mean of (9.5±3.8) cm; in terms of pathological type, 11 belonged to single type and 2 were mixed.②The CT results showed that 6 were solid mass and 1 was cystic. On enhanced CT scan, 6 cases showed heterogeneous light-to-moderate enhancement, 4 had tumors with significantly enhanced blood vessels, and 1 showed heterogeneous significant enhancement at arterial phase; all cases presented continuous enhancement at venous phase.③The MRI manifestations demonstrated 8 were with solid mass, which displayed iso- or slightly hypointense signal on T1WI, and iso- or slightly hyperintense signal on T2WI. The enhanced scan showed that 5 cases had heterogeneous mild enhancement, 3 had moderate enhancement, and 4 were seen with tortuous tumor vessels at arterial phase; all displayed continuous enhancement at venous phase. In the one case of cystic mass, solid component had moderate enhancement at arterial phase and continuous enhancement at venous phase. In another case of multilocular cystic mass, the tumor separate and cyst were significantly enhanced at arterial phase, and were continuous enhanced with hyperintense at venous phase.Conclusion Ovarian dysgerminoma tumors present features such as large lesions with clear boundaries. Tumors of single type are likely to be solid mass with central necrosis; the plain CT scan shows isodensity; the plain MRI scan mainly shows isodensity on T1WI, and iso- or slight hyperintensity on T2WI; the enhanced scan presents slight to moderate enhancement. Tumors of mixed type demonstrate cystic mass; the solid and separate parts are significantly enhanced. The comprehensive analysis of imaging features of ovarian neoplasms could help to make a correct diagnosis before surgery.

Background and purpose: Recent studies have shown that, the new gene PRR11 had abnormal expression in lung cancer, stomach cancer, speculated that it might be correlated with tumor progression. This study aimed to detect the expression of PRR11 protein in human pancreatic carcinoma, and to analyze the relationship between PRR11 protein level and the clinical pathological parameters of pancreatic carcinoma. Methods: Immunohistochemistry (SP) method was used to detect the expression of PRR11 protein in 32 cases of human pancreatic cancer tissues, 20 cases of paracancerous tissues and 6 cases of normal pancreatic tissue. Chi Square test was used to analyze the relationship between the expression levels of PRR11 protein and the clinical pathological parameters (age, gender, the size of tumor, the location of tumor, differentiation, lymph node metastasis and TNM stage). Results:The positive expression rates of PRR11 protein in pancreatic cancers, paracancerous tissues and normal pancreatic tissues were 78.1%(25/32), 5.0%(1/20) and 0.0%(0/6), respectively. The expression level of PRR11 in pancreatic cancer tissues was significantly higher than those in paracan-cerous tissues or normal tissues. The positive expression rate of PRR11 protein in pancreatic carcinoma was significantly associated with cell differentiation degree and TNM stage (P<0.05), but not associated with patient age, gender, the size of tumor, the location of tumor and lymph node metastasis (P>0.05). Survival analysis demonstrated that the survival rate in the patients with PRR11 protein positive expression was significantly lower than the patients with negative expression (P<0.05). Conclusion:PRR11 protein can be a possible prognostic indicator of pancreatic cancer.

AIM Xiaobuxin-Tang (XBXT) is a traditional Chinese herbal decoction which is composed of Haematitum, Flos Inulae, Folium Phyllostachydis Henonis and Semen Sojae Preparatum. The present study was to investigate if the total flavonoids extracted from XBXT (XBXT-2) had antidepressant effect. METHODS Forced swimming tests in mice and rats, and learned helplessness (LH) model of rats were adopted to affirm the antidepressant effect of XBXT-2 with the test on spontaneous motor activity. Plasma corticosterone level in the LH rats was measured with ELISA. RESULTS Single administraton of XBXT-2 at the doses of 50 and 100 mg·kg-1 (ig) significantly decreased the duration of immobility time in the forced swimming tests in mice and rats. Researches on LH model of rats indicated that XBXT-2 at doses of 50 and 25 mg·kg-1 markedly reduced the number of escape failure in shuttle box. Meanwhile, the plasma corticosterone level of the LH rats was significantly decreased. XBXT-2 50-200 mg·kg-1 had no effects on spontaneous motor activity in mice. CONCLUSION XBXT-2 possesses significant antidepressant-like effect. The mechanism may involve the inhibition of the hyperaction of the hypothalamic-pituitary-adrenal axis.

Objective To discuss the operative methods and cnrative effect of calcaneal tuberosity fracture.Methods The data of 15 patients with calcaneal tuberosity fracture was retrospectively analyzed who received treatment between January 2008 and June 2011.There were 9 males and 6 female,with the age ranging from 31 to 68 years (average,51.4 years).All the patients had unilateral acute injury,with the left foot in 7 cases and the right foot in 8 cases.According to the Beavis classification,there were 3 cases in type Ⅰ and 12 cases in type Ⅱ.All the cases in type Ⅰ and 10 cases in type Ⅱ were treated with open reduction and screw fixation.The other 2 cases in type Ⅱ with larger fragment involving a portion of the subtalar joint were treated with plate and screw fixation.The effect of the treatment was assessed according to the ankle and hindfoot score system of American Orthopaedic Foot and Ankle Society (AOFAS) after the operation.Results Ten patients were followed up for 12 to 36 months (average,20 months).The healing time in these patients ranged from 8 to 25 weeks (average,12 weeks).The postoperative score ranged from 47 to 100 points (average,91.1 points).There were 7 cases which received excellent effect,2 cases,good,and 1 case,poor.The rate of excellent and good was 90％.Necrosis of skin and soft tissue and exposure of the plate happened to one patient,who eventually healed after 3 weeks by debridement with plate preserved and peroneal artery perforator flap transplantation.Loss of reduction happened to another patient,who was treated with the revision surgery by open reduction and screw fixation again.Conclusion To patients with obvious Fracture displacement whose soft tissues are irritated severely.Emergency open reduction and internal fixation operation should be offered to prevent the necrosis of the flaps as far as possible.To patients with small fractures,it is advisable to choose open reduction and large diameter screw fixation,while plate and screw fixation may be better for patients with larger tuberosity fragment,especially when the fracture line extends to the facet of the subtalar joint.

Objective To retrospectively assess clinical outcomes of buttress plating in fixation of posterior pilon fractures.Methods The study involved 16 cases of posterior pilon fractures that had undergone buttress plate fixation between January 2005 and December 2009.There were 11 males and 5 females,at mean age of 37.6 years (range,23-62 years).All cases received radiography,CT scan and three-dimensional reconstruction preoperatively.Posterior malleolar fragments were reduced and fixed through posterolateral approach or combined approach (posteromedial plus posterolateral approaches) based on effect area of fracture line on CT films.Clinical and radiographic examinations were performed in postoperative follow-up.Clinical outcomes were evaluated by American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and visual analogue scale (VAS).Results Posterior pilon fractures were classified into 3 types according to CT scans.Fourteen cases were followed up for average 37.6 months (range,16-52 months).Mean AOFAS score was 86.4 points (range,70-98 points) and mean VAS score was 1.4 points (range,0-3 points).All cases received favorable functional outcomes without hardware failure,except that one patient still suffered from peri-ankle swelling and long term walking discomfort two years after operation.Conclusion Buttress plating is effective in treatment of posterior pilon fractures and can facilitate early weight-bearing functional exercise.

Objective To investigate the effects of the cyclooxygenase-2 (COX-2) inhibitor (celecoxib) on angiogenesis and peritoneal function of uremic peritoneal dialysis rats.Methods Forty-eight male SD rats were selected,and they were randomly divided into five groups:normal control group(n =8),sham operation group(n =8),uremia group(5/6 nephrectomy,n =8),PD group [4.25％ PD solution,2 weeks PD model(n =8) and 4 weeks PD model(n =8)],PD + celecoxib intervention group[treated by celecoxib(20 mg/kg) via oral gavage,n =8].The peritoneum of uremic peritoneal dialysis rats was observed in different dialysis time from peritoneal structures,functions,peritoneal tissue capillary density (microvessel density,MVD) and COX-2,vascular endothelial growth factor (VEGF) expression level,and the impacts of celecoxib on uremic peritoneal dialysis rats peritoneal angiogenesis and peritoneal function were study.Results With the conduct of the peritoneal dialysis,peritoneal thickness increased,the inflammatory cells infiltrated,peritoneal equilibration test (PET) showed that ultrafiltration volume decreased significantly (P ＜ 0.05),the amount of glucose transport rate rised significantly (P ＜ 0.05),but the celecoxib could improve net ultrafiltration volume (P ＜ 0.05),and reduce the glucose transport rate (P ＜ 0.05).The peritoneal tissue MVD and COX-2,VEGF expression were significantly increased in uremia group and PD group compared with that in the normal control group (all P ＜ 0.05),were significantly lower in PD + Celecoxib intervention group than that in uremia group (P ＜ 0.05).The correlation analysis showed that the level of COX-2 protein expression with MVD,VEGF protein expression was positively correlated (both P ＜ 0.05),the level of VEGF protein expression and MVD was positively correlated (P ＜ 0.05).Conclusions In vivo high glucose dialysate and uremia environmental can stimulate the COX-2 and VEGF expression raised,and the capillaries production increased in peritoneal tissue.Celecoxib can alleviate the change of peritoneal tissue morphology and function in long-term peritoneal dialysis rats.Celecoxib inhibits the peritoneal neovascularization of uremic peritoneal dialysis rats,possibly through inhibition of COX-2 expression to reduce the production of VEGF.

Objective To investigate the effects of cyclooxygenase-2 (COX-2) inhibitor on peritoneal lymphangiogenesis and peritoneum function in uremic rat.Methods Uremic rats treated by peritoneal dialysis were intragastric administration celecoxib.Structures of peritoneum,peritoneal function,peritoneal lymphatic vessel density (LVD) were detected in every group.The mRNA of vascular endothelial growth factor-C (VEGF-C),lymphatic vessel endothelial hyluronan receptor-1 (LYVE-1) and COX-2 were tested by RT-PCR.The protein expressions of LYVE-1,VEGF-C,COX-2 were tested by western blot.Results With the extension of the duration of dialysis,the peritoneum thickness was increasing,inflammatory cell infiltrated obviously,uhrafiltration volume decreased significantly.But the celecoxib could increase uhrafiltration volume and reduce the glucose transport rate(P ＜0.05).Compared with the normal group,the levels of LVD,COX-2,VEGF-C,and LYVE-1 mRNA and protein were significantly up-regulated in uremic and dialysis groups (P ＜0.05).Compared with the uremic dialysis group,the levels of LVD,COX-2,VEGFC and LYVE-1 mRNA and protein were significantly down-regulated in the celecoxib group.There was a positive correlation between COX-2 and VEGF-C,LVD in protein levels,as well as VEGF-C and LVD (all P values ＜ 0.05).Conclusions Hyper glucose dialysis solution and uremic condition could up-regulate the expression of COX-2,VEGF-C,LYVE-1 in gene and protein level and stimulate lymphangiogenesis.COX-2 inhibitor could delay the change of peritoneal structures and function.COX-2 inhibitor could prevem the lymphangiogenesis in uremic rat treated by peritoneal dialysis,which might down-regulate the expression of VEGF-C by COX-2 depended manner.

Objective To evaluate the efficacy,adverse events of gemcitabine vs.5-FU with radiotherapy for locally advanced pancreatic carcinomas.Methods Between January 2007 and January 2011,a total of 56 patients with locally advanced pancreatic carcinomas was included and clinical data were retrospectively analyzed.All patients received 3-DCRT radiotherapy with individual dose of 1.8 ～ 2 Gy,5 times per week,and total dose of 45 ～ 50.4 Gy for 25 ～ 28 fractions,and received concurrent chemotherapy (5-FU or gemcitabine).The patients (n =30) in gemcitabine group were treated with gemcitabine (500 rng/m2 at the 1st,8th,15th,22nd day,at 10 mg · (m2)-1 · min-1,through micro-pump) during radiotherapy; 3 weeks after radiotherapy the patients received gemcitabine infusion at a dose of 800 mg · (m2)-1 · d-1,one time per week,for 3 or 4 cycles.The patients (n =26) in 5-FU group were treated with 5-FU (500 mg/m2 at the 1 ～ 5th day per week,IV),the cycle was repeated every 2 weeks during radiotherapy; 3 weeks later the patients received 5-FU infusion at a dose of 800 mg · (m2)-1 · d-1,the 1st ～5th day per week,the cycle was repeated every 2 weeks ; with a total of 3 or 4 cycles.The efficacy and adverse events were observed,and the patients were followed until June 2013,and the median survival,1 year and 2 year survival was calculated.Results Of the 56 patients,the overall response (CR + PR) rate was 73.2％,and it was 65.3％ in radiotherapy with 5-FU group,80.0％ in radiotherapy with gemcitabine group (P ＜ 0.05).The overall one and two year survival rate was 48.2％ and 14.3％,while median survival was 15.2 months,and the corresponding values were 42.3％,11.5％,13.3 months in radiotherapy with 5-FU group,and 53.3％,16.7％,16.6 months in radiotherapy with gemcitabine group,and the survival difference between the two groups was not statistically significant (P =0.071).At the end of treatment,the pain-relief rate (VAS score ＜4) of the 56 patients was 83.3％,it was 75.0％ in 5-FU group and 90.0％ in gemcitabine group.In radiotherapy with gemcitabine group,the incidence of 3～ 4 grade myelosuppression was significantly higher than that in radiotherapy with 5-FU group,and the difference between the two groups was statistically significant (20.0％ vs 7.6％,P ＜ 0.05).Conclusions For the locally advanced pancreatic carcinomas,radiotherapy with gemcitabine can improve pain-relief and prolong survival compared with radiotherapy with 5-FU,but the incidence of adverse event of myelosuppression is higher.