Objective To investigate the efficacy and safety of stereotactic body radiation therapy (SBRT) for very elderly patients with pancreatic cancer.Methods The clinical data of a total of 149 patients aged from 75 to 90 years with locally advanced or metastatic pancreatic cancer treated by SBRT in Changhai Hospital from January 2012 to December 2016 were retrospectively reviewed.Prescription doses ranged from 3.6-9Gy/fractions,and the total doses were 19.5-49Gy in 3-8 fractions.The level of serum cancer antigen 19-9(CA19-9) before and 3 months after treatment was compared and the radiotherapy biological effective dose (BED10) was calculated.The adverse events of the radiotherapy were observed.Overall survival (OS) and progression-free survival (PFS) were recorded through follow-up,and the factors influencing the patients' survival were investigated by univariate and multivariate analysis.Results All the patients' median OS and PFS were 12.9and 8.3 months,respectively.One-year OS and PFS rate were 55.9％ and 19.5％,respectively.Tumor stage and the decrease of CA19-9 levels ＞50％ at 3 months after treatment and BED10 were independent factors of OS and PFS.No grade 3 or higher toxicities were recorded in all the patients.Conclusions SBRT is safe and effective for very elderly patients with locally advanced or medically inoperable pancreatic cancer.Tumor stage,the decrease of CA19-9 levels after treatment and BED10 were associated with prognosis.

ObjectiveTo investigate the risk factors for gallstones complicated by acute biliary pancreatitis (ABP). MethodsA retrospective analysis was performed for the clinical data of patients who were admitted to Department of General Surgery, The First Affiliated Hospital of Harbin Medical University, from January 2014 to September 2017 due to abdominal pain and then diagnosed with gallstones. The chi-square test was used for comparison of categorical data between groups, and the binary logistic regression analysis was used as multivariate analysis. ResultsA total of 700 patients with gallstones were enrolled, among whom 167 were complicated by ABP, resulting in an incidence rate of 23.86%. The univariate analysis showed that sex, gallbladder size, gallbladder wall thickness, gallstone size, the number of gallstones, and presence or absence of common bile duct stones were associated with the development of ABP (all P＜0.05). A multivariate analysis was performed for the factors with statistical difference identified by the univariate analysis, and the results showed that male sex (odds ratio ［OR］=1.879, 95% confidence interval ［CI］: 1.279-2.758, P＜0.05), abnormal gallbladder size (OR=0.282, 95%CI: 0.184-0.434, P＜0.05), gallbladder wall thickness ≤3 mm (OR=2.245, 95%CI: 1.490-3.383, P＜0.05), gallbladder stone diameter ＞1 cm (OR=0.438, 95%CI: 0.249-0.769, P＜0.05), single gallstone (OR=0.222, 95% CI: 0.130-0.378, P＜005), and presence of common bile duct stones (OR=2.775, 95%CI: 1.694-4.546, P＜0.05) were significantly associated with the development of ABP. ConclusionMale sex, normal gallbladder size, gallbladder wall thickness ≤3 mm, gallbladder stone diameter ≤1 cm, multiple gallstones, and presence of common bile duct stones are independent risk factors for ABP in patients with gallstones.

Objective To discuss the safety of inhaled nitric oxide (iNO)for bronchopulmonary dysplasia (BPD).Methods We analysed 65newborns diagnosed as BPD from January 2012to December 2013in Maternal and Child Health Hospital of the Guangxi Zhuang Autonomous Region.They were divided into iNO group(n=35)and control group(n=30)according to whether administering iNO or not.The heart rate,blood pressure,oxygen supply time,assisted ventilation time,hospital stay,concentration of NO2 and methemoglobin,and the changes of coagulation function were observed dynamically before and after iNO treatment.Results There were significant differences in oxygen supply time[(37±9)d vs.(55±7)d], assisted ventilation time[(29±7)d vs.(35±9)d],hospital stay [(45±9)d vs.(54±7)d]between iNO group and control group(P﹤0.05).There were no obvious changes in heart rate,blood pressure and co-agulation function before and after iNO treatment(P﹥0.05).The incidences of the complications had no sig-nificant differences between the two groups (P﹥0.05).Conclusion Long-time iNO can shorten oxygen therapy time and assisted ventilation time,iNO therapy in BPD doesn′t found serious adverse effect to cardio-vascular function as well as coagulation function,and doesn′t increase the risk of intracranial hemorrhage and retinopathy of prematurity.

Triptolide, a compound extracted from the traditional Chinese medicine preparation of Tripterygium wilfordii Hook F., has been reported to have anti-inflammatory and anti-cancer activities. However, its effect on ovarian cancer invasion is unknown. We observed that MMP7 and MMP19 expression increased in ovarian cancer tissue. Triptolide treatment inhibited the migration and invasion of ovarian cancer cells SKOV3 and A2780 at the concentration of 15 nM. We also observed that triptolide suppressed MMP7 and MMP19 promoter activity in a dose-dependent manner, down-regulating the expressions of these promoters on mRNA and protein level. Moreover, triptolide enhanced E-cadherin expression in ovarian cancer cells. In vivo, triptolide inhibited tumor formation and metastasis in nude mice, and suppressed MMP7 and MMP19 expression; it also enhanced E-cadherin expression in tumor in a dose-dependent manner. Over expression of MMP7 and MMP19, or suppression of E-cadherin expression partially abolished the inhibitory effect of triptolide on invasion of ovarian cancer cells. To summarize, triptolide significantly inhibited the migration and invasion of ovarian cancer cells by suppression of MMP7 and MMP19 and up-regulation of E-cadherin expression. This study shows that triptolide is a good candidate for the treatment of ovarian cancer and reduction of metastasis.
Animals ; Antineoplastic Agents, Alkylating/*pharmacology ; Cadherins/*genetics/metabolism ; Cell Line, Tumor ; Cell Movement/drug effects ; Cell Proliferation/drug effects ; Cystadenocarcinoma, Serous/*drug therapy/pathology ; Diterpenes/*pharmacology ; Epoxy Compounds/pharmacology ; Female ; Gene Expression Regulation, Enzymologic/drug effects ; Humans ; Matrix Metalloproteinase 7/genetics/*metabolism ; Matrix Metalloproteinases, Secreted/genetics/*metabolism ; Mice ; Mice, Inbred BALB C ; Mice, Nude ; Neoplasm Invasiveness ; Ovarian Neoplasms/*drug therapy ; Paclitaxel/pharmacology ; Phenanthrenes/*pharmacology ; Promoter Regions, Genetic ; Up-Regulation/drug effects ; Xenograft Model Antitumor Assays

Objective To review the epidemiology, etiology,pathology,clinical presentation,diagnosis and treatment,recurrance and prognosis of Mondor disease.Methods Literatures on Mondor disease were reviewed,and our study of Mondor disease was also included.Results Mondor disease is difficult to diagnose,but is with good prognosis in most patients.It's unclear whether Mondor disease is associated with the etiology of breast cancer.Conclusion The diagnosis and therapy of Mondor disease are important,especially when it is accompanied with breast cancer.

The new medical model which is more emphasis on patient-centered concept and the patient's state of mind and mental health has brought a lot of new challenges to medical students who are about to become the medical workers while also put forward new tasks to the medical educational workers.Medical professionalism and doctor-patient communication are very important for the students to handle.Medical professionalism is the professional guidelines of the doctors,which is an important guarantee for the interests of the patients and the embodiment of noble character of doctors.Doctor-patient communication is basal to create a harmonious doctor-patient relationship and is a key means to ensure the medical quality.In addition to lay a solid theoretical foundation,medical students should also learn to establish correct medical professionalism and grasp effective communication skills to become qualified doctor.

AIM To study the influence of four extracts of traditional Chinese medicinal materials(sodium cantharidinate, matrine, cinobufotain and sodium ferlate) on the proliferation of human lung cancer A549 cell line and breast cancer MCF7 cell line;the possible mechanism of sodium ferlate on the inhibition of A549 cells. METHODS The inhibition of cell proliferation was determined by MTT assay and cell cycle was determined by flow cytometry. RESULTS All four extracts of traditional Chinese medicinal materials showed growth inhibition to breast cancer MCF7 cells while only sodium ferlate showed inhibition to lung cancer A549 cells. Synergistic inhibition was found when sodium ferlate was combined with each of the three commonly-used chemotheraputic drugs. Sodium ferlate could induce A549 cell apoptosis. CONCULSION The inhibition of cell proliferation induced is by sodium cantharidinate, matrine, and cinobufotain is quite different between different cancer cell lines. Sodium ferlate can inhibit cancer cell proliferation and show synergistic action while combined with chemotheraputic drugs. The mechanism of sodium ferlate on A549 cell proliferation seem to be related to the cell apoptosis.