The effects of L-arginine (L-Arg), the physiological NO precureor and NO synthetase inhibitor NG-nitro-L-arginine (L-NNA) on endogenous endothelin (ET) secretion and renal function were observed in a model of glycerol-induced acute renal failure (ARF) in rat. It was found that endogenous ET secretion was significantly increased, while serum NO was markedly decreased in ARF rats. The administration of L-NNA to the ARF rats induced significant increases in plasma ET and positive immunoreactive particles of ET in renal tubular epithelial cells(EP cells), and the impairment of renal function was exaggerated. L-Arg might effectively decrease the level of plasma ET and the positive immunoreactive particles of ET in renal tubular EP cells, suggesting the improvement of the renal function. It is suggested that the ability of NO in improving renal function may relatedto the inhibition of endogenous ET secretion in glycerol-induced ARF rats.

Primary duodenal adenocarcinoma (PDA)is a rare but aggressive digestive tract malignancy,and its incidence is increasing in recent years. Early diagnosis of PDA is challenging due to nonspecific symptoms. Hence,it is often detected at an advanced stage. Treatment strategies tends to favor aggressive surgical resection. Adjuvant chemotherapy and radiation are important components of multi-modality treatment for patients with high risk of recurrence, and molecular targeted therapy is still in the exploratory stage. The best adjuvant therapy after operation is not yet clear. Early diagnosis and treatment is of great significance for prognosis. This article reviewed advances in epidemiology,risk factors,diagnosis,treatment and prognosis of PDA.

Objective: To investigate the clinical features and prognostic factors of gastric cancer patients under the age of 40. Methods : The clinical data of 126 young gastric cancer patients under the age of 40 were retrospectively analyzed. Log⁃Rank test and Cox regression model were used to analyze prognostic risk factors ,respectively. Results: The average age of gastric cancer patients in our group was 33. 6 years ,and there were more female patients than male patients(female ∶ male = 1. 25 ∶ 1) , Upper abdominal pain and fullness discomfort were the most common clinical manifestations ,and the predominant sites were gastric antrum angle (43. 7% ) and gastric body (42. 9% ) . Lauren type was mainly diffuse type (89. 7% ) , Nakamura type was mainly undifferentiated type (91. 3% ) , and WHO type was the most common type of low⁃adherence carcinoma (46. 8% ) . 71. 4% of patients were diagnosed with advanced 46. 7% , respectively. The results of univariate analysis showed that the levels of serum CA199 ,tumor length ,depth of tumor invasion ,lymphatic metastasis ,vascular invasion ,and surgical approach were risk factors affecting the prognosis of patients. Multivariate analysis revealed that the levels of serum CA199 ,the depth of tumor invasion and surgical approach were independent prognostic factors. Conclusion Young gastric cancer has a high degree of malignancy and strong biological invasiveness. Most patients are diagnosed at the advanced stage of the tumor,and the overall prognosis is poor. The levels of serum CA199 ,the depth of tumor invasion and surgical approach were independent prognostic factors.