Objective To summarize the clinical characteristics and investigate the prognostic factors of primary duodenal carcinoma.Methods The clinical data of 122 patients with primary duodenal carcinoma who were admitted to the Shengjing Hospital Affiliated to China Medical University from November 2007 to May 2013 were retrospectively analyzed.All the patients received different operations according to the characteristics of tumors.Primary duodenal carcinomas of patients were confirmed by the postoperative pathological diagnosis.All the patients were followed up by outpatient examination, telephone interview and correspondence till November 30,2014.The treatment process, results of imaging examination and laboratory examination and postoperative survival were recorded.The clinical features, diagnostic criteria, therapeutic regimens and prognostic factors were analyzed.The survival rate and survival curve were analyzed and drawn by the Kaplan-Meier method.The univariate analysis was done using the Log-rank test, and multivariate analysis was done using the COX regression model.Results Among the 122 patients with primary duodenal carcinoma, jaundice as the first symptom was detected in 57 patients, abdominal pain and upper abdomen discomfort in 37 patients, gastrointestinal obstruction in 14 patients,anorexia and reduction of body weight in 4 patients, gastrointestinal hemorrhage in 3 patients, diarrhea in 3 patients, pyrexia in 3 patients and abdominal mass in 1 patient.The positive rates of CT examinations, endoscopic examinations, magnetic resonanced cholangio-pancreatography (MRCP), B-ultrasound examinations and upper gastrointestinal contrast examinations were 69.67％ (85/122), 85.56％ (77/90), 79.76％ (67/84), 12.73％ (7/55) and 75.00％ (36/48), respectively.Among the 122 patients, anemia was detected in 48 patients,positive fecal occult blood test in 94 patients, increasing level of CA19-9 in 71 patients, increasing level of CEA in 22 patients and increasing level of AFP in 9 patients.The tumors located at the descending part of duodenum,duodenal bulb and horizontal part of duodenum were detected in patients of 86.07％ (105/122), 7.37 ％ (9/122) and 6.56％ (8/122), respectively.The mean diameter of tumors was 2.3 cm (range, 1.0-15.0cm).All the 122 patients received operation.Pancreaticoduo-denectomy was performed in 100 patients, including combined with jejunostomy in 17 patients, pylorus-preserving pancreatoduodenectomy in 7 patients, segmental resection of duodenum and gastrojejunostomy in 5 patients, local resection of duodenal papilla in 6 patients and palliative gastrojejunostomy in 11 patients.Nineteen patients with complications were cured by symptomatic treatment.Of the 122 patients, adenocarcinoma, carcinoid tumor, lymphoma, small cell carcinoma, intraepithelial neoplasm combined with differentiated rhabdomyoma and with undifferentiated rhabdomyoma were detected in 116, 2, 1, 1,1 and 1 patients, respectively.The Ⅰ , Ⅱ , Ⅲ and Ⅳ stage of tumors were detected in 10, 4, 74 and 34 patients.There were 100 patients without lymph node metastasis, 13 patients with 0 ＜ metastatic lymph node ratio (MLR) ≤0.2, 4 patients with 0.2 ＜ MLR≤0.4 and 5 patients with MLR ＞ 0.4.One-hundred and twelve of 122 patients were followed up for 1-70 months with a median follow-up time of 20 months.The postoperative survival time, a median of survival time, postoperative 3-and 5-year survival rates were 1-70 months, 18 months, 36.6％ and 13.5％ , respectively.The results of univariate analysis showed that the lymph node metastasis, differentiated grade of tumor, MLR and with invasion of pancreas were risk factors affecting the prognosis of patients (x2 =8.465, 57.355, 16.232, 20.112, P ＜ 0.05).The multivariate analysis showed that the low-differentiation of tumor, invasion of pancreas, lymph node metastasis and MLR ＞ 0.4 were independent risk factors affecting the prognosis of patients (RR =3.330, 3.718, 2.623, 95％ confidence interval: 1.861-5.956, 1.292-10.696,1.624-4.236, P ＜ 0.05).Conclusions Most of the primary duodenal carcinomas are located at the descending part of duodenum without specific clinical symptoms in the early stage.The joint usage of assistant examinations can improve the diagnostic rate of primary duodenal carcinoma, and surgery is mainly therapeutic method.The low-differentiation of tumor, MLR ＞ 0.4 and invasion of pancreas are independent risk factors affecting the prognosis of patients.

Objective To analyze the efficacy of prophylactic dexamethasone in the treatment of aortic dissection with stent graft.Methods The clinical data of 87 patients who received aortic dissection with stent implantation were retrospectively analyzed.The treatment group(39 cases)was treated with dexamethasone on the basis of antibiotic prophylaxis to prevent infection,and the control group(48 cases)received antibiotics to prevent infection perioperatively.The curative effect was compared between the two groups.Results The degree of inflammatory reaction in the treatment group significantly reduced,and the treatment group had obvious curative effect(x2=54.88,P<0.01).The total effective rate,significant effective rate and effective rate of the treatment group were 92.31%,61.52%,7.70%,respectively,which were significantly higher than those of the control group(13.00%,6.25%,6.25%),the difference was statistically significant(x2=54.88,P<0.01).Conclusion Prophylactic use of dexamethasone in the treatment of systemic inflammatory response after aortic dissection with stent implantation has significant effect.

AIM:To study the correlation of serum uric acid ( UA) level with carotid plaques and arterial stiff-ness in the patients with essential hypertension ( EH) , and to explore the predictive value of serum UA for evaluating EH preclinically .METHODS:A total of 92 patients with EH and 30 healthy individuals were enrolled .The value of UA and other indicators were detected .B-mode ultrasound examination was performed to measure the common carotid artery intima -media thickness ( IMT) and the sites of plaque in the internal carotid-artery, external carotid artery and carotid bifurca-tions.Carotid-femoral arterial pulse wave velocity ( CFPWV) was assessed by Complior?atherosclerosis measurement in-strument.RESULTS:The serum level of UA in the patients with EH was higher than that in control group [(361.51 ± 83.81) μmol/L vs (317.03 ±62.22) μmol/L, P<0.05].The mean value and abnormal rate of IMT between hyperten-sion group and control group were significant difference [(0.69 ±0.14) mm vs (0.60 ±0.12) mm, 42.39%vs 10.00%, P<0.05].In 92 EH patients, 45 cases had carotid plaques .These 45 cases were divided into 3 groups according to the plaque severity, among which the serum UA level had statistically significant differences [(285.25 ±78.41) μmol/L, (341.19 ±63.99) μmol/L and (401.33 ±88.49) μmol/L, P<0.05].Compared with rigid plaque group ( n=34), the serum UA level in soft plaque group (n=11) was significantly higher [(389.00 ±69.45) μmol/L vs (323.03 ± 72.71) μmol/L, P<0.05].A stepwise multiple linear regression analysis demonstrated that age ( r=0.414), systolic blood pressure (r=0.224), pulse pressure (r=0.270) and uric acid (r=0.219) were predisposed factors for higher CFP-WV (P<0.05).CONCLUSION:UA is one of the risk factors causing hypertension .Serum UA level may reflect the sever-ity and stability of carotid plaques .The increased arterial stiffness is closely related to the increased serum UA level in EH .

Objective investigate the correlation between plasma soluble receptor for advanced glycation endproducts (sRAGE) and arterial stiffness in patients with different types of metabolic syndrome (MS).Methods A total of 180 subjects were drawn from a epidemiologic follow-up study,including 60 cases non-metabolic syndrome (NMS),60 cases metabolic syndrome without diabetes mellitus (NDMMS),60 cases metabolic syndrome with diabetes mellitus (DMMS).Carotid femoral arterial pulse wave velocity (CFPWV) was assessed by the French KangPuLe atherosclerosis measurement instrument,and plasma sRAGE levels were measured by ELISA.Comparison of mean in multiple groups was conducted by analysis of variance.Multivariate analysis was done with multiple linear stepwise regression analysis.P ＜ 0.05 was considered as statistically significant difference.Results Compared with NMS group,plasma sRAGE levels were significantly lower in DMMS and NDMMS groups [(635.07 ± 229.20) pg/mL vs.(671.17 ± 358.16) pg/mL vs.(992.99 ± 427.83) pg/mL,P =0.001].CFPWV of DMMS group was significantly higher than that of NMDMS and NMS groups (14.22 ±3.14) m/s vs.(12.15 ±2.79) m/s vs.(11.66 ± 2.52) m/s,P =0.002).Plasma sRAGE level was negatively correlated with CFPWV (r =-0.278,P =0.005).(3) Multiple linear regression analysis demonstrated that age (β =-0.091,95％ CI-0.096 ～-0.095,P =0.031),HDL-C (β =1.295,95％ CI 1.231 ～ 1.360,P =0.022) and sRAGE (β =0.119,95％ CI 0.118 ～ 0.130,P =0.032) had a significant effect on CFPWV.Conclusions The increased arterial stiffness is closely related to the discreased plasma sRAGE levels in MS.Plasma sRAGE maybe a novel target for vascular disease prevention and treatment in patients with metabolic syndrome.

Trichinella spiralis nudix hydrolase (TsNd) gene encoding a 46 kDa protein was expressed in Escherichia coli and the potential of recombinant TsNd protein (rTsNd) as an antigen for the serodiagnosis of trichinellosis was investigated by ELISA and compared with those of ELISA with T. spiralis muscle larval excretory–secretory (ES) antigens. The sensitivity of both ELISA was 100% (30/30), for the detection of anti-Trichinella IgG antibodies in sera of the experimentally infected mice, and the specificity of rTsNd-ELISA and ES-ELISA was 100% (54/54) and 98% (53/54), respectively (P>0.05). Serum anti-Trichinella antibodies were firstly detected by rTsNd-ELISA at 14 days post infection (dpi), then continued to increase with a detection rate of 100% at 36 dpi. The anti-Trichinella antibody levels at different times after infection were statistically different (P<0.05). The results showed that the rTsNd might be a potential candidate antigen for specific serodiagnosis of trichinellosis. But, it needs to be further evaluated with sera of the patients with trichinellosis and other helminthiasis.

Objective To summarize the epidemiological feature of plague cases oceuwed in China.Methods The epidemiological and clinical data from 1981 to 2006 year in China were analyzed with descriptive study method.Result Nine hundred and seveneteen human plague cases were diagnosed in 9 provinces(regions) from 1981 to 2006 years,105 cases died,the mortality rate being 11.45%,and they distributed in 69 counties (cities or banners).In Qinghai Province 108 cases were diagnosed,the mortality rate was 46.30%(50/108),the cases distributed in 17 counties(cities);137 cans in Guizhou,distributing in 2 counties(cities);517 cases in Yunnan,distributing in 26 counties(cities).Plague cases peaked separately in 1983,1990,1996 and 2000 years,they were 25,75,98 and 254 separately.The principal spreading ways were breathing flying particles,touching,skinning and eating marmot in Qinghai;750 cases were of bubonic plague,among whom 4 cases in Tibet died,the fatality rate was 0.53(4/750);121 cases were of pneumonic prague,among whom 65 cases died,was accounting for 53.72%(65/121);31 cases were of septieaemic plague,and 30 cases died(one cases was cured in Inner Mongolia),accounting for 96.77%(30/31).Others were brain plague,intestinal plague,tonsil plague and plague cellulites,which were cured.Conclusion From 1990,human plague epidemical scope and intensity is enlarging continuously compared with 1980-1990 and there is a trend of going up gradually in China.

OBJECTIVETo investigate the effects of ethyl acetate extract of Huanglian Jiedu decoction (EAHD) on hyphae development of Candida albicans.

METHODInverted microscope, fluorescence microscope, SEM were applied to inspect the Morphological change of C. albicans treated by EAHD at different concentrations. Solid agar plate was utilized to evaluate the colony morphology. Quantitative Real-ime PCR(qRT-PCR) was adopted to observe the expression of hyphae-specific genes such as HWP1, ALS3, UME6, CSH1, SUN41, CaPDE2.

RESULTEAHD with concentration of 312 and 1 250 mg . L-1 could inhibit formation of hyphae and colony morphology. The expression of HWP1, ALS3, UME6, CSH1 were downregulated 4. 13, 3. 64, 2. 46, 2. 75 folds ,while the expression of SUN41 were upregulated 7. 26 folds, CaPDE2 keep unchanged.

CONCLUSIONEAHD could inhibit formation of hyphae and colony morphologies of C. albicans through downregulating HWP1, ALS3, UME6 and CSH1.

Acetates ; Biofilms ; drug effects ; growth & development ; Candida albicans ; cytology ; drug effects ; genetics ; growth & development ; Down-Regulation ; Drugs, Chinese Herbal ; pharmacology ; Fungal Proteins ; genetics ; Gene Expression Regulation, Fungal ; drug effects ; Hyphae ; Medicine, Chinese Traditional ; Microscopy, Fluorescence ; Reverse Transcriptase Polymerase Chain Reaction

Objective To observe the injury of some chief organ induced by paraquat (PQ) poisoning in rats, and to explore the mechanism. Method A total of 60 inbred line SD rats were randomly divided into experimental group (n = 30) and control group (n = 30), and each group was further divided into 6 subgroups (n =5) as per the sacrifice of rats at different intervals. The rats of experimental group received the intra-abdominal injection of paraquat (1 mg/mL, 18 mg/kg), and the rats of control group were treated with the same amount of saline solution instead. The rats of each subgroup were sacrificed separately 2 h,6 h, 12 h,24 h,72 h and 120 h after administration of PQ or saline. Lungs, livers and kidneys were taken for histopathological study. Results There was noticeable exudate in lung tissue of rats in experimental group in the early stage. And then the cystic changes in the liver of rats in experimental group were found. A noticeable hemoglobin was found in the renal tubules 24 h after modeling. But the exudation in lung decreased 24 h later, and in the mean time, the disorganization of pulmonary alveoli was obvious and some remarkable collagen appeared in the interstitial tissue of lung, and it was significantly obvious 72 h after modeling. In the liver of rats in experimental group, the injured tissue had some extent of repair in 72 h after modeling, and recovered gradually. But the injury of kidney was exacerbated 72 h after modeling. In the control group, the lung, liver and kidney were not changed in all stages after modeling.Conclusions The paraquat could induce failure of some chief organs in SD rats. The injury was most remarkable in the lung in a progressive way. The kidney injury was not more severe than that of lung tissue, but the pathological changes of the kidney became worse and worse as time taken. The injury of liver induced by paraquat was slight, and the injury could heal up gradually.

AIM:To explore the effect of Vaccinium vitis procyanidin on the growth of glioma cells .METH-ODS:Glioma C6 cells were cultured and divided into control and 10, 20 and 40μg/L Vaccinium vitis procyanidin groups . The influence of Vaccinium vitis procyanidin on the growth of C 6 cells was measured by MTT assay and the observation un-der inverted microscope .The apoptotic rate was detected by Annexin V/PI staining .The protein expression of Bcl-2 and Bax was determined by immunocytochemistry .The protein levels of Bcl-2, Bax and caspase-3 were also examined by West-ern blotting .RESULTS:The growth of C6 glioma cells was inhibited by Vaccinium vitis procyanidin at concentrations of 10, 20 and 40 μg/L.The growth was significantly inhibited in 40 μg/L Vaccinium vitis procyanidin group at 24 h and 48 h, and in 20 and 40 μg/L Vaccinium vitis procyanidin groups at 72 h (P<0.01).The density of the cells was decreased when the concentration of Vaccinium vitis procyanidin increased .The apoptotic rate was increased when the concentration of Vaccinium vitis procyanidin increased either .The expression of Bcl-2 was decreased and Bax was increased after 10, 20 and 40 μg/L Vaccinium vitis procyanidin treatments .The ratio of Bax/Bcl-2 was increased when the dose of Vaccinium vitis pro-cyanidin increased (P<0.05 or P<0.01).The expression of Bcl-2 was decreased (P<0.01), and Bax and caspase-3 were increased after 10, 20 and 40 μg/L Vaccinium vitis procyanidin treatments .The ratio of Bax/Bcl-2 was increased when the dose of Vaccinium vitis procyanidin increased (P<0.01).CONCLUSION:Vaccinium vitis procyanidin inhibits the growth of glioma cells by down-regulating Bcl-2 protein and up-regulating Bax protein to activate caspase-3, thus indu-cing apoptosis .

Objective To study the prognostic predictive value of quantitative dectroencephalography (qEEG)for patients with large middle cerebral artery infarction (LMCAI).Methods The scores of routine electroencephalography (EEG),qEEG and the Glasgow Coma Scale (GCS) of the patients within 72 hours after symptom onset were recorded.The short-term prognosis (death or survival) was evaluated at 1 month after the onset.The long-term prognosis (good or poor) was evaluated at 3 months after the onset.All the observed data in each prognostic group were compared.Results A total of 105 patients were included in the study.There were significant differences in the margin of amplitude integrated electroencephalogram (aEEG) (upper margin:19.11 ± 7.80 μV vs.11.87 ±6.41 μV;t =2.392,P =0.019; lower margin:11.90 ± 4.78 μV vs.7.58 ± 4.15 μV; t =3.327,P =0.022),Synek-classification (x2 =48.114,P =0.000) between the short-term survival group and the death group; in patients with left LMCAI,there were significant differences in the absolute energy of the β-activity (13.16 ±12.66 μV2 vs.19.20 ±17.96 μV2;t =-2.781,P =0.039),spectral edge frequency 95％ (SEF95％) (9.17 ± 3.24 Hz vs.10.36 ± 3.76 Hz; t =-5.614,P =0.002) between the short-term survival group and the death group.There were significant differences in the age (59.33 ±13.67 years vs.68.87± 10.473 years; t =-3.215,P =0.002),GCS scores (10.86±2.80 vs.9.21 ±2.51;t =2.511,P =0.015),SEF95％ (13.80 ±5.40 Hz vs.10.93 ±4.68 Hz; t ＝2.311,P =0.024) and sides of infarction (x2 =4.737,P =0.030) between the long-term good prognosis group and the poor prognosis group.Conclusion qEEG can be used as an effective means of monitoring for evaluating the prognosis of patients with LMCAI.