Purpose:To observe the curative effect and the clinical-benefit-response of patients with advanced pancreatic cancer who used a combine of Gemcitabine,5-FU and PDD.Methods:The treatment with Gemcitabine (800 mg/m 2) was followed by 5-FU(600 mg/m 2) and DDP (30 mg/m 2),administered on days 1,8 and 15 of 28-day schedule. The curative effect was estimated according to the standard of WHO and the clinical benefit response was evaluated at the same time. The standard of CBR included pain,physical states and body weight. Results:Twenty-five (25/29) patients received over two cycles chemotherapy. 6(24%) partial response (PR), 12 (48%) stable disease and 7(28%) progressive disease were observed. According to the standard of CBR, 18(62.1%) patients achieved the clinical-benefit-response level. Therapy was well tolerated. The main toxicities included that the alimentary tract reactions and the marrow depression. Grade 3-4 thrombocytopenia was reported in 8 (27.6%) patients. Conclusions:The combination of GEM, 5-FU and DDP is a moderatedly active treatment with tolerable side-effects. It has definite response rate and high CBR rate in pancreatic cancer.

Objective:To explore the immunosuppression effects and tocolysis of fructus polygoni orientalis on abortion mice induced by LPS.Methods:Mice of Kunming (55 mice) were divided into control group (group A ,10 mice) and experimental group. Experimental group were divided into group B ( intraperitoneal injection LPS ) , group C ( ingestion fructus polygoni orientalis ) , and group D (ingestion fructus polygoni orientalis and intraperitoneal injection LPS ),each group of 15 mice.Then the pregnancy results were observed ,the positive of α-NAE+and the varity of CD 14+and CD204+macrophages ,TNF-αin the uteri were identified by enzyme-histochemistry ,immunohistochemistry and ELISA.Results:The abortion rate and the embryo resorbing rate were all 100%( P<0.01 ) in group B.But there was the decreased abortion rate of 13.33% in group D .The embryo resorbing rate decreased to 10.39%.The number and positive cell area of α-NAE+and CD14+macrophages in the uteri of gestation mice of group B was greatly increased comparing with group A ( P<0.01 ) .These effects outside of myometrium of group D were remarkably increased comparing with group A (P<0.01),but there was no distinct difference in the inside of myometrium and function layer.The number and positive cell area of CD204+macrophages in group C and D was greatly increased comparing with group A and B ( P<0.01 ) .The TNF-αcontents in the uteri of mice in group B were greatly increased comparing with group A (P<0.01),but the positive cell area of CD14,CD204 were close to normal levels in group D.Conclusion:The effect of miscarriage induced by LPS is antagonized by fructus polygoni orientalis through inhibiting the phenotype ,activity and function characteristics of macrophages in the uteri of gravidity mice.

Objective:To explore the adjustment factors to the migration and functional activity on macrophages in the uterine of inflammatory mice induced by LPS.Methods:150 Kunming female mouse were divided into control group (group A),LPS model group (group B),MCP-1 blocking-up group (group C),the mice uterines were extracted separately at hour 1,3,6,12,24.The number of CD14+ macrophages and the expression of CD14 macrophages were detected by Immunohistochemistry,ELISA detects the expression of TNF-α and MCP-1.Results:①Compared with group A,the number of CD14+ macrophages and the expression of CD14 in endometrium,myometrium,perimrtrium of group B were highly significantly increased (P<0.01) at every time points,the endometrium,myometrium of group C were closely to normal level at 1,3,6 h;compared with group B,the number of CD14+ macrophages and the expression of CD14 were highly significantly decreased(P<0.01)at 1,3,6 h of perimrtrium of group C and every time points of endometrium,myometrium of group C.②Compared with group A,the content of TNF-α and MCP-1 were highly significantly increased (P<0.01) at every time points of group B and 12,24 h of group C;compared with group B,the content of TNF-α and MCP-1 of group C were highly significantly decreased(P<0.01) at every time points.Conclusion:The migration of macrophages and the expression of CD14 and TNF-α in the uterine of inflammatory mice induced by LPS were regulated by MCP-1.

Objective To establish a Juema minipig model of myocardial infarction, to evaluate the clinical indi?ces in the model pigs, and to explore the relationship between gene expression and metabolic decompensation. Methods 13 male Juema minipigs were randomly divided into control (Sham, n=5), myocardial infarction (MI, n=5) and normal control (for evaluating the recovery condition after surgery, n=3) groups. In the MI group, the ligation was done at the left descending coronary artery around the 1/3 distance to heart apex. Four weeks after the surgery, the cardiac function and serum biochemistry was analyzed. The histological changes and gene expression profiles in the myocardium in the peri?infarct area were exanimated. Results Ultrasonic images showed that the infarction was formed, the ejection fraction and fraction shortening were significantly reduced in the MI group ( ~32% and ~40% less than those of the sham group). Histological examination showed that myocardial fibers at the peri?infarct area were broken, dissolved, and there was con?nective tissue hyperplasia with increased neutrophil and lymphocyte infiltration. Microarray analysis revealed that two myo?cardial remodeling and pathology mediating pathways, three inflammation?related pathways, and 8 metabolic pathways ( in?cluding fatty acid, amino acid, and glucose metabolic pathways) were significantly changed. Conclusions We have suc?cessfully established a Juema minipig model of myocardial infarction. The less branches of the left descending coronary ar?tery allow us to establish a stable model by surgery with comparable characteristics in the clinic indices. The results of this study provides useful reference characteristics of an animal model with characteristic changes in the peri?infarct area.

Objective To study the effect of rapid rehabilitation nursing measures in elderly patients with hip fracture and its effect on postoperative pain and quality of life.Methods A total of 82 elderly patients with hip fractures were divided into control group and observation group by random number table method,with 41 cases in each group.The patients in the control group were treated with routine nursing intervention,and the patients in the observation group underwent rapid rehabilitation nursing intervention based on conventional fracture care.The pain degree,hip function and prognostic quality of life of the two groups were compared.Results The VAS score of the observation group was lower than that of the control group at 1 week and 1 month after surgery (P ＜ 0.05).The Harris scores of the two groups were higher than that of the control group at 1,5 month after operation,and observation group was higher than the control group (P ＜ 0.05).At 5 months after operation,the scores of psychological status,physical function and daily social life of the observation group were higher than that of the control group (P ＜ 0.05).Conclusion Rapid rehabilitation nursing measures can reduce postoperative pain,accelerate the recovery of the hip function and improve the quality of life of elderly patients with hip fracture.So it is worthy of clinical application.

Objective To study the effect of rapid rehabilitation nursing measures in elderly patients with hip fracture and its effect on postoperative pain and quality of life.Methods A total of 82 elderly patients with hip fractures were divided into control group and observation group by random number table method,with 41 cases in each group.The patients in the control group were treated with routine nursing intervention,and the patients in the observation group underwent rapid rehabilitation nursing intervention based on conventional fracture care.The pain degree,hip function and prognostic quality of life of the two groups were compared.Results The VAS score of the observation group was lower than that of the control group at 1 week and 1 month after surgery (P ＜ 0.05).The Harris scores of the two groups were higher than that of the control group at 1,5 month after operation,and observation group was higher than the control group (P ＜ 0.05).At 5 months after operation,the scores of psychological status,physical function and daily social life of the observation group were higher than that of the control group (P ＜ 0.05).Conclusion Rapid rehabilitation nursing measures can reduce postoperative pain,accelerate the recovery of the hip function and improve the quality of life of elderly patients with hip fracture.So it is worthy of clinical application.

Objective To explore the effect ofpolycyclic aromatic hydrocarbons (PAHs) and p16,FHIT gene CpG island methylation,as well as their interaction in cervical intraepithelial neoplasias.Methods Objects of this study were from a cohort of cervical lesions study in Yangqu county of Shanxi province.All the patients were diagnosed pathologically,that including 83 patients with high-grade cervical intraepithelial neoplasia (CIN Ⅱ/Ⅲ),86 patients with low-grade cervical intraepithelial neoplasia (C1N Ⅰ) and another 91 women under normal cervical (NC) condition.1-hydroxy pyrene in the urine was detected by high performance liquid chromatography (HPLC)while CpG island methylation status of tumor suppressor gene p16 and FHIT were measured by methylation-specifc polymerase chain reaction (MSP).Data were analyzed with Kruskal-Wallis H test,chi-square test and trend of chi-square test.Logistic regression models were used to estimate the odds ratio (OR) and corresponding 95％ confidence intervals (95％CI) between influencing factors and the cervical disease by using the SPSS statistical software (version 20.0).The interaction under study was evaluated by using the generalized multifactor dimensionality reduction (GMDR) model.Results Level of 1-hydroxy pyrene (H=50.743,P＜0.001) and the high exposure rate of 1-hydroxy pyrene (trend x2=20.146,P＜0.001) were gradually increasing along with the severity of cervical intraepithelial neoplasia.The CpG island methylation rates ofpl6,FHIT in CIN] and CIN Ⅱ/Ⅲl group were higher than that in NC group,and gradually increasing along with the severity of cervical intraepithelial neoplasia (trend x2=9.75,P=0.002;trend x 2 =10.39,P=0.001).Results from the GMDR model showed that interaction existed among the high exposure of l-hydroxy pyrene and the CpG island methylation ofpl6,FHIT in CIN Ⅰ and CIN Ⅱ]/Ⅲ group.Conclusion Under the high exposure of 1-hydroxy pyrene and the CpG island methylation of p16,FHIT appeared to have increased the risk of cervical intraepithelial neoplasia and causing synergistic effect in cervical intraepithelial neoplasia.

Objective To explore the effect of Src on cervical cancer cells through ERK signal transduction pathway.Methods Experimental study was carried out in vitro.Cervical cancer cell lines Hela (HPV-positive) and C33A (HPV-negative) were treated with Src kinase inhibitor PP2.Then,the cell cycle and apoptosis of each group were evaluated by using flow cytometry (FCM).Western blotting and Real-time PCR were used to detect the levels of the expression of ERK 1/2,c-Fos and c-Jun mRNA and protein respectively.The database was established and analyzed with SPSS statistical software (version 20.0).Results After down-regulating Src,the cell proliferation was inhibited and cell apoptosis was induced.The proportions of G0/G 1 stage of Hela and C33A cell in cell cycle increased while G2/M and S stages decreased.Meanwhile,the mRNA levels of ERK 1,ERK 2,c-Fos and c-Jun increased.And the expression levels of ERK 1/2,phosphorylated ERK 1/2 (p-ERK 1/2)and phosphorylated c-Fos (p-c-Fos) protein decreased,while c-Jun and phosphorylated c-Jun (p-c-Jun)protein expression increased.In addtion,the change level of Hela cell,p-ERK 1/2 and c-Fos protein were lower than that of C33A cell before and after the Src inhibition.Conclusions Src,involved in regulating the expression of key factors of the ERK signal transduction pathway including p-ERK 1/2 and p-c-Fos,might be capable of promoting the proliferation of cervical cancer cells and inhibiting their apoptosis.The infection with HPV might have adjustable effect on this process.

AIM: To analyze the influencing factors of postoperative dry eye complication after corneal transplantation and to build a nomogram prediction model.METHODS: Clinical data were collected on 117 patients who underwent corneal transplantation at our hospital from March 2021 to February 2023. They were divided into dry eye group(n=96)and non-dry eye group(n=21)according to whether there was a postoperative dry eye. The risk factors of postoperative complication of dry eye after corneal transplantation were analyzed, the nomogram prediction model for predicting postoperative complication of dry eye after corneal transplantation was constructed, and the internal validation of the model and the prediction efficacy were assessed by calibration curves and decision curves, respectively.RESULTS: Comorbid diabetes mellitus, comorbid sleep disorders, comorbid meibomian gland dysfunction, chronic eye drop abuse, chronic corneal contact lens wear, interleukin-6(IL-6), and tumor necrosis factor-α(TNF-α)were the risk factors for the complication of dry eye after corneal transplantation(P<0.05). The nomogram model predicted a C-index of 0.890(95% CI 0.877-0.903). The nomogram model had a threshold >0.07, and the nomogram model provided higher net clinical benefit than the single index in all cases.CONCLUSION: The nomogram model built in this study based on the factors affecting the complication of dry eye after corneal transplantation has a good predictive value for the complication of dry eye after corneal transplantation.

Objective:To explore the efficacy of adjusting the dose of imatinib dose in the context of therapeutic drug monitoring (TDM) in patients with gastrointestinal stromal tumors (GISTs) who are receiving adjuvant therapy after complete resection of their tumors.Methods:This was a descriptive study. Inclusion criteria were (1) complete surgical resection with a pathological diagnosis of GIST, (2) postoperative adjuvant therapy with imatinib and dosage adjustment, (3) multiple TDM of imatinib, and (4) complete clinical, pathological, and follow-up data. The data of 70 patients with GISTs treated at Union Hospital, Tongji Medical College, Huazhong University of Science and Technology between January 2015 and December 2023 were collected retrospectively. The study cohort comprised 15 (21.4%) men and 55 (78.6%) women of median age 60 years (range: 25–82). Of the eligible patients, 49 (70.0%) were at high-risk, 14 (20.0%) at intermediate-risk, six (8.6%) at low-risk, and one (1.4%) at very low risk. Patients were followed up by the gastrointestinal stromal tumor clinic every 2–3 months and their plasma concentrations of imatinib were checked. The dose was adjusted to 300 mg/d or 200 mg/d depending on whether they had had ≥ grade III adverse reactions, and whether the first plasma concentration of imatinib was ≥ 1,500 μg/L or between the expected range of 760 μg/L–1,100 μg/L. Studied indicators included adverse reactions, quality of life before and after dose adjustment, and overall survival and recurrence-free survival (RFS) after dose adjustment.Results:Before dose adjustment, all 70 patients received 400 mg of imatinib daily, with initial TDM values of 1,900 ± 568 μg/L, for a median duration of 8.3 months. After dose adjustment, 60 patients received 300 mg daily, with a TDM of 1,216 ± 350 μg/L, whereas 10 received 200 mg daily, with a TDM of 1,023 ± 269 μg/L. The median duration of treatment after dose adjustment was 23.4 months. Compared with those whose dosages were not adjusted, the incidence of bone marrow suppression was significantly lower (74.3% [52/70] vs. 51.4% [36/70], χ 2=9.202, P=0.010); as were the incidences of edema (95.7% [67/70] vs. 50.0% [35/70], χ 2=40.526, P<0.001); skin reactions (70.0% [49/70] vs. 32.9% [23/70), χ 2=22.495, P<0.001); and gastrointestinal reactions (38.6% [27/70] vs. 10.0% [7/70], χ 2=15.899, P<0.001) in those whose dosages were adjusted. The average total scores for physical health before and after dose adjustment were 76 ± 5 and 88 ± 4, respectively; whereas the mental health scores were 75 ± 6 and 89 ± 4, respectively. The median follow-up period was 36 months (range 6–126). During the first 3 years of follow-up, five high-risk patients with non-gastric GISTs developed recurrences. The 3-year overall survival rate was 100%, and the 3-year RFS rate was 92.8%, high-risk patients having a 3-year RFS rate of 89.8%. Conclusion:The adverse reactions and quality of life of GIST patients with severe adverse reactions to adjuvant imatinib therapy after complete resection can be mitigated by appropriately reducing the dosage of imatinib under the guidance of TDM.