Objective To evaluate the changes of the level of cerebrospinal fluid T-tau protein andβ-amyloid 42 in mild cognitive impairment (MCI) patients. Methods Computer retrieval was preformed for cerebrospinal fluid (CSF) to-tal tau protein (T-tau) and β-amyloid 42 (Aβ 42) levels among MCI and healthy people in Pubmed, Cochrane Library, Ovid, CNKI, VIP Data and Wangfang Data. Meta-analyses were conducted on the T-tau and Aβ42 levels using Review Manager 5.2 software. Results Seventeen studies met inclusion criteria. Meta-analysis results showed that, CSF T-tau protein levels were significantly higher (MD:113.10;95%CI:87.93-138.26) and Aβ42 levels were significantly lower in the patients with MCI, (MD=-146.50;95%CI=-178.70- -114.29) compared with the control group (P<0.01). Conclu-sions T-tau significantly increases while Aβ42 significantly decreases in the CSF in patients with MCI.

Objective To explore the correlation and significance between adult nut-cracker phenomenon (NCP) and varicocele. Methods The clinical characters of 226 adult patient (including inpatients and outpatients)with NCP diagnosed by color Doppler ultrasound examination were analyzed retrospectively, whose chief complaints were asymptomatic bematuria or/and orthostatic proteinuria (microalbuminuria). The ratio of left renal vein inner diameter before and after being compressed≥2 was regarded as the criteria of diagnosis of NCP. Among 226 cases, 184 male NCP patients were taken as study group, and the incidence of varicocele was tested. One hundred and fifty-six male adults who had physical examination in the same period and whose ages matched with study group were taken as control group, they were not NCP patients examined by color Doppler ultrasound. The incidence of varicocele was compared between two groups. The indexes associated NCP were examined in detail in study group. Logistic regression analysis was used to study the correlation between NCP and left varicocele. Results There were 184 male patients in study group, among which there were 22 patients with left sub-clinical varicocele (accounted for 11.96%), 47 patients with left varicocele (accounted for 25.54%).The total incidence of varicocole was 37.50%(69/184). There were 156 male adults in control group, among which there were 13 patients with sub-clinical varicocole(accounted for 8.33%), 8 patients with varicocele (accounted for 5.13%).The total incidence of varicocele was 13.46%(21/156). The total incidence of varicocele in study group was significantly higher than that in control group (P=0.000). In study group, there were 22 patients with left sub-clinical varicocele,with average age (24.73±1.03) years. The inner diameter of left renal vein(LRV) in front of spine was (3.65±0.11) mm(a),the inner diameter of LRV at left side of spine was (8.41±0.11)mm(b), and b/a ratio was 2.31± 0.06. The angle between superior mesenterie artery (SMA) and abdominal aorta(AA) was (15.95±0.59)°. There were 47 patients with left varicocele, with average age(26.62±1.74)years. The inner diameter of LRV in front of spine was (3.43±0.08)mm(a),the inner diameter of LRV at left side of spine was (8.72±0.14) mm (b), and b/a ratio was 2.54±0.08. The angle between SMA and AA was (14.54±0.53)°. In study group, Lagistic regression analysis proved that male patients with NCP were complicated with varicocele easier when the angle between SMA and AA became smaller, the inner diameter of LRV at the left side of spine (b)and age increased. Conclusions Male adult patients with NCP are complicated with left varicocele, which is significantly higher than that in non-NCP male adults at the same age. It shows that NCP is one important cause for varicocele and there is a close correlation between NCP and varicocele in male adults.

ObjectiveTo evaluate the significance of CK19 mRNA monitoring in peripheral blood of breast cancer patients.MethodsPeripheral blood samples were collected from 137 breast cancer patients preoperatively,one day post-operation,7 days,1,3,6,12,18,and 24 months after operation.RTPCR was used to detect CK19 mRNA expression.The relationships were analyzed between CK19 mRNA expression and treatment result, between CK19 mRNA expression and clinicopathological parameters.ResultsThere was no significant difference between the level of CK19 mRNA as tested preoperatively,and 1,7 days postoperatively(P ＞ 0.05 ).From one month and thereafter,CK 19 mRNA decreased significantly when compared with that immediate perioperatives ( P ＜ 0.05 ). Postoperative peripheral CK19 mRNA expression increased in those found with recurrent or metastasized tumors ( P ＜ 0.01 ). CK19 mRNA expression does not correlate with patient's menstrual status,estrogen receptor expression,progesterone receptor expression,HER-2 expression and Ki67 proliferation expression (P ＞ 0.05 ). But there was statistically significant correlation between CK19 mRNA expression and tumour size,histology grading,pathological type,lymph node metastasis ( P ＜ 0.01 ).ConclusionsIn breast cancer patients peripheral blood CK19 mRNA expression is correlated with risk clinicopathological parameters, and increases in patients with postoperative recurrence and tumor metastasis.

AIM: To establish a method using HPLC with column switching for determination of Danshensu in human blood serums. RESULTS: A linearity range of 0.0248～0.3720?g was obtained. The recovery was 99.2%. CONCLUSION: The method is simple, sensitive and suitable for pharmacoknetics studies and clinical detection of Compound Danshen Dripping Pills

Objective To establish characteristic spectrum of ginsenosides in Panax quinquefolium from Liuba. Methods Using C_(18) solid phase-extraction cartridges, main ginsenosides from 40% ethanol extracts of P. quinquefolium were purified. Then the samples were analyzed by HPLC-EMS. Results(From the) total ion spectrum of P. quinquefolium, 3 stronger peaks were selected. Based on them, characteristic corresponding spectrum of ginsenosides in P. quinquefolium from Liuba was established. Conclusion This method has reliable reproducibility and precision. Its simple pretreatment, easily operation, and rapidly analytic procedure show that this method is suitable for identifying P. quinquefolium.

ObjectiveTo explore the methods of prevention and treatment of the iatrogenic biliary-tract injury.Methods22 cases with the iatrogenic biliary-tract injury were analyzed retrospectively.ResultsModified Roux-en-Y choledochojejunostomy was performed in 11 cases, end-to-end anastomosis of bile duct in 4 cases, repair of bile duct in 2 cases, a drainage of the inter bile duct and the abdominal cavity in 5 cases. Only 1 case of common bile duct injury after laparoscopic cholecystectoy was death from the toxic shock, another case of bile duct injury after conventional cholecystectoy with the drainage of abdominal cavity was death from multiple system organ failure, all of the other patients were cured.ConclusionThe iatrogenic biliary-tract injury may be causes variously, and should be discovered as soon as possible and be operated in time.

Objective To evaluate the efficacy and safety of biliary stent loaded with 125I seeds in treatment of hilar cholangiocarcinoma with malignant obstructive jaundice.Methods Totally 43 patients with malignant obstructive jaundice caused by cholangiocarcinoma were included.All the patients underwent percutaneous transhepatic puncture of the left and right side branch of the bile duct.In the hilar stenosis,the biliary stent with 125I seeds were implanted,and the biliary drainage tube had been kept in 3 to 5 days after procedures.The drainage tube was removed and the puncture road was closed after the patency of stents were confirmed by cholangiography.The changes of liver function before and after procedures were recorded,and the survival time was observed.Results Five biliary stents loaded with 125I seeds were implanted in type I (n=5),36 in type Ⅱ (n=18),8 in type Ⅲ (n=4) and 25 in type Ⅳ (n=16).The serum total bilirubin and direct bilirubin of patients before procedures were (145.54 ± 65.35) μmol/L and (124.73 ± 35.04) μmol/L,respectively,and (65.91±29.43)μmol/L and (35.50±15.12)μmol/L respectively after procedures.Compared with preoperative,the total bilirubin,direct bilirubin,alanine aminotransferase,aspartate aminotransferase,alkaline phosphatase,C-reactive protein and gamma glutamic transaminase decreased significantly (all P＜0.05).The lactate dehydrogenase had no significant difference before and after operation (P=1.050).The median survival time was 13 months (3.0 to 22.5 months).The serious complications such as biliary puncture,pancreatitis,severe biliary tract infection or biliary bleeding were not occurred.Conclusion Biliary stent loaded with 125 I seeds is an effective therapy to alleviate symptoms of jaundice and prolong the survival time of patients with malignant obstructive jaundice caused by hilar cholangiocarcinoma.

Objective To investigate the application value of early evaluation and monitoring of 125Ⅰ interstitial implantation in a pancreatic cancer xeuograft.Methods Xenograft models were created by subcutaneous injection of Sw 1990 human pancreatic cancer cell suspensions into the right hind limbs of the immunodeficient BABL/c nude mice.The tumors size were about 8-10 mm after two weeks.The mice were randomly divided into 3 groups,including control group (n = 4) ,empty seed implantation group (n = 4)and 125Ⅰ implantation group (n = 4).Before treatment and one week after treatment,18F-FDG Micro-PET/CT scan was performed and then maximum standardized uptake values (SUVmax),mean standardized uptake values (SUVmean),tumor size and necrosis rate were measured.HE staining and TK1 immunohistochemistry examination were carried out in the paraffin-embedded sample.Results Before treatment the SUVmax and SUVmean values of three groups did not reach statistical significance.One week after treatment the SUVmax and SUV values of three groups were 3.53 + 1.20 and 0.57±0.26 vs.3.83±2.13 and0.59 ±0.24vs.0.29±0.23 and0.016±0.001,respectively,with a significant difference (F =7.62,P =0.01 ; F = 10.34,P =0.005).The SUVmax and SUVmean values of 125Ⅰ implant group were significantly lower than empty seed implant group and control group and were significantly lower than before treatment.Before treatment,tumor necrosis rate of three groups were not significantly different.Immunohistochemical staining found the TK1 positive staining index of three groups were respectively (64.25±1.71) % ,(62.25±2.22) % and (38.25±1.71) % with statistically significant difference (F =233.67,P < 0.001).The TK1 positive staining index of 125Ⅰ implant group was significantly lower than empty seed implant group and control group.The SUVmax values had some positive correlation with TK1 positive staining index (r = 0.85,P = 0.001).Conclusions 18F-FDG Micro-PET/CT may be useful as a noninvasive imaging modality to assess early response to 125Ⅰ seed brachytherapy in a pancreatic cancer xenograft.

Objective To investigate the safety and clinical efficacy of CT-guided radioactive ~(125)I seed implantation treatment for advanced lung cancer. Methods The clinical data of thirty cases with lung cancer, which was proved by puncture biopsy, histology or cytology, were retrospectively analyzed. The pathologic diagnoses included squamous cell carcinoma (n= 13), adenocarcinoma (n= 8) and metastatic lung cancer (n= 9). Using treatment planning system (TPS) 3D images of the tumor were reconstructed, the number and the dose rate distribution of ~(125)I seeds were calculated. The matched peripheral dose (MPD) of ~(125)I seed implantation was 80-130 Gy. The median amount of implanted ~(125)I seeds was 35 (8-83) in number. Results Follow-up observation was made at 1, 3, 6 and 12 months after the treatment in all patients. The median survival time was 12 months (7-18 months). The cumulative survival rate at 6, 9 and 12 months was 100.0%, 80.0% and 23.3%, respectively. Follow-up CT images 12 months after the therapy showed that complete relief (CR) was seen in 9 cases, partial relief (PR) in 14 cases, no change (NC) in 4 cases and progression (PD) in 3 cases. The overall effective rate (CR + PR) of 1-month, 3-month, 6-month and 12-month was 83%, 80%, 80% and 77%, respectively. During following-up period, pneumothorax occurred in 3 cases and bloody sputum occurred in 7 cases. Conclusion CT-guided radioactive ~(125)I seed implantation treatment is a safe, effective and minimally-invasive treatment for lung cancer.

Objective To discuss the clinical efficacy of CT-guided radioactive ~(125)I seed implantation treatment for unresectable pancreatic cancer. Methods Forty patients with inoperable pancreatic cancer were enrolled in this study, including 25 males and 15 females with an median age of 69 years (38-89 years). Treatment planning system (TPS) was used to reconstruct 3-dimensional images of pancreatic tumor and to define the quantity and distribution of ~(125)I seeds. The radioactivity of ~(125)I seeds was 0.5-0.8 mCi/seed. The seeds were implanted into pancreatic tumor under CT guidance at intervals of 1 cm and were kept away from vessels, pancreatic duct and other adjacent important organs. The tumor matched peripheral dose (MPD) was 60-140 Gy. The median amount of implanted ~(125)I seeds was 36 (18-68) in number. CT scan was performed immediately after the procedure to check the quality of the seeds. In addition, 10 patients received concurrent chemotherapy with arterial infusion of gemcitabin and 5-fluororacil (5-Fu) for 3 to 4 therapeutic courses. Results The median diameter of the tumors was 4.9 cm. The follow-up period was 2 to 28 months. After the treatment the refractory pain was significantly relieved (P < 0.05), and Karnofsky score was dramatically increased (P < 0.05). Most patients experienced relief of pain within 2-5 days after implantation. Two months after treatment, on CT scans the tumors showed completed relief (CR) in 3 cases, partial relief (PR) in 20 cases, no change (NC) in 14 cases and progression (PD) in 3 cases. The overall effective rate (CR+PR) was 57.5%. The median survival time for all patients was 10.2 months, while it was 14.7 months, 10.9 months and 7.1 months for patients in stage Ⅱ, stage Ⅲ and stage IV respectively. For patients in stage Ⅱ, stage Ⅲ and stage Ⅳ, the 6-month cumulative survival rate was 100%, 88% and 62% respectively, while the 12-month cumulative survival rate was 70% , 41% and 0% respectively. After the therapy, liver metastasis occurred in 5 cases and chemoembolization was employed. In three patients, immigration of four radioactive seeds to the liver was found. No serious complications, such as upper GI bleeding, pancreatitis, pancreatic fistula formation and radiation colitis, occurred during the follow-up period. Conclusion CT-guided radioactive ~(125)I seed implantation is a safe, effective and minimally-invasive brachytherapy for unresectable pancreatic cancer with reliable short-term efficacy. It has an excellent anti-pain effect. The curative results can be further improved when chemotherapy is employed together. However, its long-term efficacy needs to be observed.