Objective To evaluate the factors influencing early diagnosis and prognosis in patients with pancreatic carcinoma.Methods The clinical data of 280 patients who had complete follow-up data with pancreatic carcinoma treated from January 2002 to January 2007 were reviewed retrospectively.The medical history and follow-up data were collected from all patients.Survival rate was calculated by the life table method and the Kaplan-Meier estimation.Log-rank test was used for univariate prognostic analysis and Cox regression was used for multivariate prognostic analysis.Results 91.8%of the patients were more than 40 years old and the peak age was 50～73 years old;the major presentations were abdominal pain and jaundice.Major imaging tests included B-ultrasound and CT,the sensitivity was 70.6%,95.3%,respectively;89.3%of patients had combined B-ultrasound and CT examination.The sensitivity of CA19-9 was 81.1%.The median survival time was(7.0±0.5)months.Overall survival rates at 1～5 year survival rates were 28%,9%,6%,2%,and 1%.Univariate analysis suggested that age＞65 years old,CA19-9＞mean value,TNM Ⅲ or Ⅳ stage,lymph nodes invasion,vascular invasion,and metastasis of two or more organs,non-surgical treatment,KPS score＜60 points,weight loss≥5 kg were poor prognostic factors;Cox multivariate analysis showed that treatment modalities,age,TNM stage,KPS score and ascites were independent risk factors for dismal prognosis.Conclusions The age,ascites,tumor stage and treatment modalities affected the prognosis of patients with pancreatic cancer.Early diagnosis and treatment was important to improve the survival time of patients with pancreatic cancer.

Objective To observe the activities of serum peroxidase capacity,and lipid peroxidation of children from Kaschin-Beck disease (KBD) areas of Xinghai county in Qinhai province,and to explore the relationship between antioxidant capacity and KBD.Methods Sixty four KBD and forty six health subjects without KBD were chosen from KBD endemic areas,which included primary schools of Tangnaihai,Xialujuan and Qushian of Xinghai county in Qinghai province,and fifty nine age-matched healthy control subjects without KBD were from a non-KBD endemic area,Nanfan primary school of Chang'an county in Shaanxi province.Twenty patients with KBD and twenty control subjects from KBD areas and non-KBD area were extracted by simple random sampling method.2,3-DAN fluorescence technique was used to test the hair and blood selenium.The biochemical techniques were used to test the indicators of oxidative stress including malondialdehyde(MDA),antioxidant enzyme activities,total antioxidant capacity(T-AOC),serum superoxide dismutase(SOD),catalase(CAT) and glutathione peroxidase(GSHPx).ResultsAll patients with KBD had significantly lower serum GSH-Px activities[ (59.53 ± 25.23)kU/L] and selenium levels in hair[ (67.64 ± 17.28)μg/L] and blood[(36.27 ± 13.29)μg/L],respectively,than that of control subjects from KBD areas [ ( 91.88 ± 22.99 ) kU/L,( 153.32 ± 24.31 ) μg/L,( 63.06 ± 13.66) μg/L ] and nonKBD areas[ ( 122.68 ± 41.74)kU/L,(242.35 ± 38.56)μg/L,(98.93 ± 17.18)μg/L,all P ＜ 0.05].Serum MDA levels in KBD patients[ (4.64 ± 1.11 )μmol/L] were significantly higher than that in control subjects from KBD [(3.31 ± 1.22)μmol/L] and non-KBD areas[ (3.43 ± 1.29)μmol/L,all P ＜ 0.05].On the other hand,T-AOC,SOD and CAT activities were significantly higher in both KBD[(19.80 ± 6.64),(55.80 ± 8.14),(16.45 ± 5.61 ) kU/L] and control subjects[ (21.71 ± 8.82),(57.45 ± 6.96),(15.63 ± 9.18)kU/L] from KBD areas than that of control subjects from non-KBD area[ (13.56 ± 5.38),(42.79 ± 8.10),(6.05 ± 2.71 )kU/L,all P ＜ 0.05 ].Hair selenium levels,blood selenium levels and GSH-Px activity of control subjects from KBD areas were,respectively,significantly lower than that in control subjects from non-KBD area(all P ＜ 0.05).Conclusions These findings strongly confirm the evidence that KBD patients are susceptible to oxidative stress.The results also show the increase in antioxidant enzymes,which could probably be due to adaptive response to pro-oxidant in KBD state.Hence,there seems to be an imbalance between oxidant and antioxidant systems in KBD patients.

Objective To study the influence of the small interfering RNA (siRNA) interference TMPRSS4 expression on human pancreatic cancer SW1990 cell's proliferation and invasion. Methods The four eukaryotic expression vector of TMPRSS4 gene were synthesized in vitro and were transfected transiently into human pancreatic cancer SW1990 cells. TMPRSS4 mRNA expression of transfected cells was detected by real-time RT-PCR. The most efficient eukaryotic expression vector was used to be transfected into SW1990 cells. By using G418, cell strain that can silence TMPRSS4 gene stably was screened. The TMPRSS4 mRNA expression of the stable cell strain was detected by real time PCR TMPRSS4 protein expression was detected by western blot. The proliferation ability of transfected SW1990 cells was detected by CCK-8 method. By Transwell, the invasion change of SW1990 cell was detected. Results A stable cell strain, SW1990/psi TMPRSS4, was successfully constructed, in which the expression level of TMPRSS4 could be reduced stably by RNA interference. Cell transfection efficiency was 82.9%. Compared with the control group, the TMPRSS4 mRNA and protein levels were reduced by 80.1% and 60% ,and number of penetrating cells was 118.6 ±13.4 in SW1990/psi TMPRSS4 group, which was significantly lower than those in the negative control group (157.4 ± 12.9) and control group (157.0±9.5, P <0.01). Cells invasion inhibitory rate was 24.5% in SW1990/psi TMPRSS4 group. The cell proliferation was not significantly different among all the groups. Conclusions A stable cell strain is screened successfully in which the expression level of TMPRSS4 can be reduced stably. The down-regulation of TMPRSS4 gene expression level can inhibit the invasion of SW1990 cells, but has no effect on cell proliferation.

OBJECTIVETo explore the effect of a self-made guiding needle of steel wire in guiding the wire through the tibial tunnel for the treatment of avulsion fractures of tibial posterior cruciate ligament with open reduction and wire fixation.

METHODSFrom February 2011 to June 2014, a total of 22 patients with avulsion fractures of tibial posterior cruciate ligament underwent surgical treatments were analyzed, including 14 males and 8 females with an average age of 35.6 years old (ranged, 17 to 63 years old). According to Meyers classification, 9 patients were classified as type II, 13 patients were classified as type III. All the patients underwent open reduction and wire fixation with medial knee "L" shape approach. A wire guiding needle was used to guide the wire through the tibial tunnel during operation.

RESULTSWith the assistance of wire guidance needles, wires passed through the tibial tunnel rapidly during the operation in all the 22 patients. All the patients were followed up, X-ray imagings 6 months after operation showed the fractures healed well. The average follow-up time in all patients was 6 months (ranged, 6 to 12 months). The averaged Lysholm knee score in 22 knee was 92.7 +/- 3.4. All patients' posterior drawer test were negative.

CONCLUSIONSelf-made wire guiding needle can simplify the operation procedures in which the wires pass through the tibial tunnel, shorten the operation time, reduce the surgical trauma and complications, and be worthy of clinical application.

Adolescent ; Adult ; Bone Wires ; Female ; Follow-Up Studies ; Fracture Fixation, Internal ; Humans ; Male ; Middle Aged ; Posterior Cruciate Ligament ; injuries ; surgery ; Tibia ; injuries ; surgery ; Tibial Fractures ; surgery ; Young Adult

Objective To study the exact function of human gene 5 transactivated by pre-S1 protein of hepatitis B virus(PS1TP5)by investigating the gene expression of PS1TP5 in yeast cells. Methods Reverse transcription-polymerase chain reaction(RT-PCR)was performed to amplify the gene of PS1TP5 using the mRNA of HepG2 cells as template and the gene was cloned into pGEM-T vector.The gene of PS1TP5 was cut from pGEM-T-PS1TP5 vector and cloned into yeast expressive plasmid pGBKT7,then pGBKT7-PS1TP5 was transformed into yeast cell AH109.The yeast protein was isolated and analyzed with sodium dodecyl sulfate-polyacrylamide gel electrophoresis(SDS-PAGE) and Western hybridization.Results PS1TP5 gene was successfully amplified and identified by DNA sequencing.The digested fragment was cloned into pGBKT7 vector and transformed into yeast cell AH109.The results of SDS-PAGE and Western assay showed that the relative molecular weight of the expressed product was about 36 950,and PS1TP5 protein existed in yeast cells.Conclusion The findings suggest that PS1TP5 can be successfully expressed in yeast cell.

OBJECTIVETo investigate the relationship between simple exposure to chrysotile and lung cancer.

METHODSThe nested case-control study method was used. All of lung cancer cases collected from a male fixed prospective cohort with follow-up of 30 years served as cases and a 1:4 matched proportion was used to select non-cancer case as controls. Controls matched for sex age (+/-5 years old), work time (+/-5 years) and smoking were collected in the same cohort.

RESULTSForty cases died of lung cancer in the study cohort, and the incidence was higher than the average incidence (SMR =1.77). The top four work types of death density were raw material (741.5), combing and spinning (424.3), weaving (365.0), and repairing (285.5), which was consistent with exposed level. According to the exposed level of chrysotile, the research objects were divided into the high level group and the low level group. The result demonstrated that lung cancer incidence of the high exposed level group of chrysotile was higher (OR = 3.7 95% CI 2.30 approximately 8.16), compared with the low exposed level group.

CONCLUSIONSimple exposure to chrysotile can increase the risk of lung cancer for workers who are exposed to chrysotile.

Aged ; Aged, 80 and over ; Asbestos, Serpentine ; adverse effects ; Case-Control Studies ; Humans ; Lung Neoplasms ; epidemiology ; etiology ; Male ; Middle Aged ; Occupational Exposure ; adverse effects

Authors raised that staging based strategies and practice of integrative medicine (IM) by combining syndrome typing and disease identification, and choosing suitable measures in accordance with different persons and seasonal conditions after more than ten years' clinical practice and researches. Radical operation as prior (as evil eliminating) and strengthening vital qi in perioerative period are best strategy for promoting rapid rehabilitation of early stage prostate cancer patients. Strengthening body resistance to eliminate evil was used in treating advanced prostate cancer patients. For example, a comprehensive treatment program for hormone-dependent patients was combined with endocrinotherapy and Chinese herbs for synergisic efficacy-enhancing actions. In this way, these patients' quality of life (QOL) were improved and time to castration resistant prostate cancer (CRPC) was delayed, even some patients were clinically cured. There are lack of effective medicines and methods for CRPC patients. Greatly tonifying original qi is mainly used for improving their clinical symptoms and prolonging survivals. Practice has proved staging based strategies and practice of IM has favorable advantages in treating prostate cancer, especially showing prospect in prolonging survival and postponing progression of advanced prostate cancer patients. Besides, it also could provide beneficial considerations and inspiration for combination of syndrome typing and disease identification.
Disease Progression ; Humans ; Male ; Medicine, Chinese Traditional ; Neoplasm Staging ; Prostatic Neoplasms, Castration-Resistant ; diagnosis ; Quality of Life

OBJECTIVETo evaluate the effect of treatments with the molecular adsorbents recirculating system (MARS) on liver failure patients of severe hepatitis B, in order to seek a safe and effective therapeutic method which contribute to the improved survival rate for severe hepatitis patients.

METHODS52 liver failure patients of severe hepatitis B were performed intermittent MARS therapy for 6 to 8 hours per time in addition to standard medical treatment. Parameters in blood chemical data were collected before and after every treatment and analyzed in comparison with those parameters from controlled groups by means of plasma exchange and standard medical therapy.

RESULTSMARS therapy achieved a remarkable improvement in clinical symptoms and physic signs, accompanied with a significant decrease in serum bilirubin, ammonia, urea nitrogen, fragrant amino acid, endotoxin, IL-6, and TNF-alpha levels (0.05); at the 72 hours bilirubin rebounding analysis. MARS treatments resulted in a significant decrease of bilirubin rebounding level in comparison with what PE did (0.01 ), though the bilirubin removal efficiency between two groups was not statistically significant. The overall survival rate of MARS therapy was 50% (26/52), which was better than that of standard medical therapy (40.5%, 17/42, P less than 0.05).

CONCLUSIONThe results indicated that MARS was a safe and promising technology in the field of liver support therapy. It might be associated with considerable improved survival rate for liver failure patients.

Adult ; Female ; Hepatitis B ; complications ; Humans ; Liver Failure ; blood ; mortality ; therapy ; Male ; Renal Dialysis ; Sorption Detoxification ; Survival Rate

OBJECTIVETo observe the effect of Tanshinone II A on the expression of epidermal growth facter (EGF) and epidermal growth facter recepter (EGFR) in human hepatocellular carcinoma cell line SMMC-7721.

METHODSThe human hepatocellular carcinoma SMMC-7721 cells cultured in vitro was treated with different concentrations of Tanshinone II A. The proliferation of the cells was measured by MTT assay, and the apoptosis of the cells was investigated by flow cytometry and cytochemical staining with Hoechst 33342. The expression of EGF and EGFR was detected by immunocytochemistry method. The levels of EGF in medium were measured by radioimmunoassay.

RESULTTanshinone II A inhibited the growth of SMMC-7721 cells remarkably in a dose-dependent manner. The inhibitory rate reached the peak (72.5%) after 0.5 microg/ml Tanshinone II A was used for 48 h, which was significantly higher than that in the controls (P<0.05). FCM analysis showed that when SMMC-7721 cells were treated with 0.5 microg/ml Tanshinone II A, the apoptosis rates for 24 h, 48 h and 72 h were (4.06+/-0.27)%, (7.58+/-0.56)% and (5.23+/-0.13)%, respectively which were markedly higher than those in the controls (all P<0.01). SMMC-7721 cell apoptosis with cell shrinkage, nuclear chromatin concentration and fragmentation as well as the formation of apoptotic bodies were observed by cytochemical staining when treated with Tanshinone II A. The immunocytochemistry showed that the expressions of EGF and EGFR were down regulated while the concentration of Tanshinone II A was increasing. The high expression rates for EGF and EGFR were 10%, 20%, respectively, and the gray scale was 181.52+/-1.63, 179.37+/-1.59, which were markedly higher than those in the controls (all P<0.05). The levels of EGF in medium measured by radioimmunoassay were decreased significantly after Tanshinone II A treatment.

CONCLUSIONTanshinone II A can inhibit cell proliferation and induce apoptosis in hepatocellular carcinoma cell line SMMC-7721, which may be related to the down-regulation of EGF and EGFR protein expression.

Antineoplastic Agents, Phytogenic ; pharmacology ; Apoptosis ; drug effects ; Carcinoma, Hepatocellular ; metabolism ; pathology ; Cell Line, Tumor ; Cell Proliferation ; Diterpenes, Abietane ; Down-Regulation ; drug effects ; Epidermal Growth Factor ; genetics ; metabolism ; Humans ; Liver Neoplasms ; metabolism ; pathology ; Phenanthrenes ; pharmacology ; Receptor, Epidermal Growth Factor ; genetics ; metabolism

OBJECTIVETo analyze the epidemiologic characteristics of severe acute respiratory syndrome (SARS) and to evaluate the effectiveness on its major control measures in Tianjn.

METHODSAdopting two case reports 1 and 2, designed by the Tianjin Centers for Disease Control and Prevention to develop a unified case-tracing table including the map of the distribution of close contacts to SARS patients. With those methods, investigation on patients and their close contacts at hospital wards, families, communities and institutions of the patients were carried out.

RESULTSFrom April 13 through May 8, 2003, there were 175 SARS cases including imported ones, were identified with an incidence rate of 1.9 cases per 100,000. Among them, 14 died with a fatality of 8.0%. The whole process of epidemic in Tianjin was less than one month with the following features: (1) 93.7% of the total SARS cases in Tianjin were directly or indirectly transmitted by a super-spreader. (2) 68.6% of the total SARS patients were concentrated in 3 hospitals A, B and C which was menifastated in 'clustering'. Through study on the rest of the SARS patients, results showed that 16.8% of them were transmitted through family close contact and 2.3% due to contact to colleagues. However, 12.6% of the patients were not able to show evidence that they had any contact to a diagnosed SARS patient. At the early stage of the epidemic, a number of medical practitioners were infected, taking up 38.2% of the total SARS cases. Among the total number of 1 975 medical workers who participated in the SARS medical cares and treatments, 3.4% of them got infected. During the outbreak, all index cases and chains of transmission seemed to be clear, with only 3 patients not able to be traced for the source of infection, taking up 2% of the total SARS patients in Tianjin. Among the 10 index cases, only the super spreader and another one index case transmitted the virus to their contacts but the rest of index cases did not cause any secondary infection.

CONCLUSIONThough SARS is clinically severe and can be spreaded quickly, the epidemic can be under control within a short period of time if chains of SARS transmission are broken down and effective measures as isolation and quarantine against patients as well as underscoring awareness among the publics in a scientific way, being carried out.

Adolescent ; Adult ; Aged ; China ; epidemiology ; Contact Tracing ; Cross Infection ; transmission ; Disease Outbreaks ; Family Health ; Female ; Humans ; Incidence ; Infectious Disease Transmission, Patient-to-Professional ; Male ; Middle Aged ; Severe Acute Respiratory Syndrome ; epidemiology ; mortality ; transmission ; Surveys and Questionnaires