Humans ; Consensus ; Pancreatic Neoplasms/therapy* ; Neuroendocrine Tumors/therapy*

Adenoid cystic carcinoma (ACC) is a salivary gland malignant tumor which mainly occurs in the head, neck and the mammary gland, and is characterized with easy invasion of peripheral nerves, local easy recurrence after resection and painless distant metastasis. The treatment of ACC is usually based on surgical resection combined with postoperative radiotherapy. Patients with advanced disease usually cannot be cured, so far there is no ideal treatment regimen. Some studies have suggested that some targeted drugs show advantages in ACC patients who are insensitive or resistant to conventional therapy. This paper summarizes the research progress of molecular targeted therapy for ACC of salivary gland in order to provide new treatment options for ACC patients especially for those at advanced stage.

Minimally degenerative nephropathy is one of the common types of primary nephrotic syndrome, and it is currently believed that B lymphocytes are closely related to its pathogenesis. Patients with refractory small degenerative kidney disease require treatment with glucocorticoids combined with immunosuppressant. Rituximab is a monoclonal antibody that consumes B cells. Its use in the treatment of patients with refractory microdegenerative kidney disease can reduce recurrence rate, prolong remission period, and reduce hormone exposure. However, there is no consensus on the treatment plan and adverse reaction response measures, and multicenter, prospective, and large-scale research answers are still needed. This article summarizes the latest progress of rituximab in the treatment of refractory minimal degenerative kidney disease, hoping to provide assistance for the development of clinical treatment strategies.

Guided bone regeneration technology applied in alveolar bone defect regeneration is based on the barrier function and space maintenance of the barrier membrane. Therefore, traditional development strategies for barrier membranes focus on their physical barrier function, degradation characteristics and biocompatibility to avoid immunogenicity. However, not only does the barrier membrane passively block connective tissue, it is recognized as a “foreign body”that triggers a persistent host immune response, known as a foreign body reaction. The theories of osteoimmunology reveal a close relationship between the immune system and bone system and emphasize the role of immune cells in bone tissue-related pathophysiological processes. Based on these findings, we propose a novel development strategy for barrier membranes based on immune microenvironment regulation: by manipulating mechanical properties, surface properties and physiochemical properties, barrier membranes are endowed with an improved immunomodulation ability, which helps to regulate immune cell reactions to induce a favorable local immune microenvironment, thus coordinating osteogenesis and osteoclastogenesis as well as barrier membrane degradation to increase the efficiency of barrier membranes in GBR applications. In this paper, we review the development of barrier membranes and their close relationship to the immune microenvironment concerning bone regeneration and membrane degradation. Additionally, the outcomes of research on barrier membranes based on the regulation of the immune microenvironment have been summarized to improve the osteogenesis efficiency of barrier membranes and solve the problem of the regeneration and repair of bone defects, especially alveolar bone defects.

Objective Investigate the effect of valsartan combined with statins on coronary heart disease and its effect on BNP and CRP.Methods 92cases of patients with coronary heart disease were selected, which were treated in hospital from March 2015to March 2017, and were divided into the study group (46cases) and control group (46cases) .The patients of all two groups were treated with conventional treatment.The patients of control group were treated with valsartan (40mg/d, oral;if no hypotension after 3days of treatment, the dose increased to 80mg/d) , and on the basis of control group, the patients of study group were treated with atorvastatin calcium capsules (20mg/d, in 0.5hafter dinner) .The patients of two groups were all treated for 6months in a row.Compare the adverse reactions and changes of the levels of blood lipids, coronary plaques, BNP, CRP and LVEF of two groups.Results After the appropriate treatment, the TG, TC, LDL-C levels of the study group were significantly lower than those of the control group, and the HDL-C, LVEF levels of the study group were significantly higher than those of the control group (P<0.05);the lipid plaque, fibrous plaque, calcified plaque, mixed plaque levels of the study group were significantly lower than those of the control group (P<0.05);The BNP, CRP levels of the study group were significantly lower than those of the control group (P<0.05);There were acute myocardial infarction, unstable angina, heart failure and other adverse events occurred in both two groups, and the difference was statistically significant between the two groups (P<0.05) .Conclusion Valsartan combined with statins in the treatment of patients with coronary heart disease can improve blood lipid levels, reduce coronal plaque area, inhibit inflammatory response, which makes it worthy of clinical promotion.

Objective To explore indicator value of blood flow of uterine arteries in second trimester uterine artery by Doppler ultrasound and early diastolic notch in the prediction of preeclampsia development,and to analyze the relationship between these values and pregnancy outcomes and neonatal prognosis.Methods A total of 89 puerperae cases with preeclampsia underwent pregnant examinations in our hospital were retrospectively reviewed,and were divided into mild preeclampsia (group A) and severe preeclampsia (group B),and 100 women with normal singleton pregnancies were selected as control group(Group C).Four-dimensional ultrasound was adopted to detect pulsatility indices (PI),resistance indices (RI) and early-diastolic notch of bilateral uterine arteries in the three groups from 20 to 26 gestational weeks.The pulsatility index (PI) and resistance index (RI) of the uterine artery were measured,and the number of early diastolic waves was recorded.The relationship between these values and the outcomes of pregnancy and neonates was analyzed.Results Neonatal prognosis of Group B was worse than that of group A and group C (P ＜ 0.05);The uterine artery PI and RI of group B were higher than that of group A and group C (P ＜ 0.05).The early diastolic notch of group A and group B was higher than that of group C (P ＜ 0.05).Conclusion The indicator value of blood flow in uterine artery and the early diastolic notch in the second trimester could monitor the occurrence of preeclampsia,especially severe preeclampsia and they are useful to predict preeclampsia severity and prenatal prognosis.

Objective To explore indicator value of blood flow of uterine arteries in second trimester uterine artery by Doppler ultrasound and early diastolic notch in the prediction of preeclampsia development,and to analyze the relationship between these values and pregnancy outcomes and neonatal prognosis.Methods A total of 89 puerperae cases with preeclampsia underwent pregnant examinations in our hospital were retrospectively reviewed,and were divided into mild preeclampsia (group A) and severe preeclampsia (group B),and 100 women with normal singleton pregnancies were selected as control group(Group C).Four-dimensional ultrasound was adopted to detect pulsatility indices (PI),resistance indices (RI) and early-diastolic notch of bilateral uterine arteries in the three groups from 20 to 26 gestational weeks.The pulsatility index (PI) and resistance index (RI) of the uterine artery were measured,and the number of early diastolic waves was recorded.The relationship between these values and the outcomes of pregnancy and neonates was analyzed.Results Neonatal prognosis of Group B was worse than that of group A and group C (P ＜ 0.05);The uterine artery PI and RI of group B were higher than that of group A and group C (P ＜ 0.05).The early diastolic notch of group A and group B was higher than that of group C (P ＜ 0.05).Conclusion The indicator value of blood flow in uterine artery and the early diastolic notch in the second trimester could monitor the occurrence of preeclampsia,especially severe preeclampsia and they are useful to predict preeclampsia severity and prenatal prognosis.

Objective To compare the anesthetic effect of ropivacaine and bupivacaine in combined spinal-epidural anesthesia(CSEA)for cesarean section,and their influence on the incidence rate of supine hypotension syndrome(SHS).Methods 200 patients with cesarean section surgery in our hospital from February 2016 to July 2016 were randomly divided into observation group and control group,all of cases were given CSEA.100 patients in the observation group(the group L)were given ropivacaine in spinal anesthesia,the other 100 patients in the control group(the group B)were given bupivacane in spinal anesthesia.Recorded the relevant indicators,compared the incidence rate of SHS,the effect of anesthesia and neonatal score.Results The incidence rate of SHS of the group L was lower than the group B(χ2 =9.261,P<0.01).The effect of anesthesia and Apgar score of two groups had no statistically significant differences(all P>0.05).Conclusion The application of ropivacaine in CSEA for cesarean section not only has exact anesthesia effect,but also can effectively prevent SHS without any side effects.

Objective To investigate the clinical features and influencing factors of somatic symptoms in patients with acute stroke.Methods Patients with acute stroke were enrolled in the study.Using the scores of symptom checklist 90 (SCL-90)-somatization factor part,the patients were divided into either a somatic symptom group (≥24) or a control group (＜24).Their age,gender,economic level,education level,underlying diseases,Hamilton Anxiety Scale (HAMA),Hamilton Depression Scale (HAMD),NEO Five-Factor Inventory scores,Social Support Rating Scale scores-simplified Chinese version,Mini-Mental StateExamination (MMSE) scores,National Institute of Health Stroke Scale (NIHSS) scores were documented and analyzed.Results A total of 70 patients with acute stroke were enrolled,and 33 (47.1％) of them had somatic symptoms.There were no significant differences in demographic characteristics,education level,family income,occupation,marital status,living alone,residence,medical expenses payment methods and social support scores between the somatic symptom group and the control group.There were also no significant differences in the types of stroke,lesion side,baseline NIHSS score,MMSE score,and NEO Five-Factor Inventory score between the 2 groups.There was significant difference in lesion side between the somatic symptom group and the control group (x2 =0.161,P=0.006).The comparison of neuropsychological test results showed that the proportion of patients with an anxiety state of the somatic symptom group was significantly higher than that of the control group (24.2％ vs.5.4％;x2 =5.055,P =0.025),but there was no significant difference in the proportion of patients with depression status;after excluding the cases who met the anxiety and depression criteria,HAMA (8.08 ± 3.12 vs.5.58 ± 3.06;t =-3.059,P =0.003) and HAMD (10.80 ± 4.81 vs.7.73 ± 3.88;t =-2.694,P =0.009) scores of the somatic symptom group (n =25) were significantly higher than those of the control group (n =33).The number of somatic symptoms of the somatic symptom group was significantly more than that of the control group (Z =-5.817,P ＜ 0.001),and was more likely to have pain symptoms (97.0％ vs.73.0％;x2 =7.584,P =0.006).The correlation analysis showed that there was a significant positive correlation in the 12-item scores of the SCL-90 somatic factors and HAMA (r =0.494,P ＜0.001) and HAMD (r=0.369,P=0.002) scores in patients.Multivariate logistic regression analysis showed that HAMA score was an independent risk factor for somatic symptoms after stroke.(odds ratio 1.286,95％ confidence interval 1.060-1.560;P=0.011).Conclusions The incidence of somatic symptoms is high after acute stroke,especially in patients with cortical stroke.The somatic patients after stroke are prone to have pain-related symptoms.The patients with anxiety and depression status after stroke are prone to have somatic symptoms after stroke;HAMA score is an independent risk factor for having somatic symptoms after stroke.

Objective To screen the potential biomarkers in plasma of rats with acute paraquat (PQ) poisoning using gas chromatography-mass spectrometry (GC-MS) based metabonomics technology,and to provide concrete evidence for early diagnosis.Methods Eight Sprague-Dawley (SD) rats were randomly divided into PQ poisoning group (intragastricly administrated with PQ solution 100 mg/kg) and control group (intragastricly administrated with the same volume of normal saline) according to the random number table,with 4 rats in each group.The general situation of rats was observed at 2,24 and 48 hours after administration.The blood of eye sockets was collected,the endogenous small molecule metabolites in plasma were determined with GC-MS method,and metabolic profile analysis and random forest analysis were performed to filter the potential biomarkers.Results ① The rats in PQ poisoning group gradually appeared lack movement,tachypnea,abdominal seizure and other symptoms of poisoning.In control group,the vital signs were stable.② The metabolites in plasma of rat were analyzed with GC-MS analysis,and the diagrammatic figure was plot as combined with principal component analysis (PCA) and partial least squares-discriminated analysis (PLS-DA) model,which showed that the distribution of plasma metabolism in PQ poisoning group was more diffuse but in the control group was more intensive,indicating that the metabolic patterns in two groups were different.From 2 hours after PQ administration,the metabolic trajectory in PQ poisoning group was significantly deflected compared with that of the control group,which was similar to control group until 48 hours,indicating that the metabolites in plasma of rat showed obvious difference in the early period.Five kinds of potential biomarkers with large weights were selected by random forest method which were serine,L-asparagine,hexadecanoic acid,octadecanoic acid,and arachidonic acid,the retention time was 15.259,24.345,33.334,37.695,and 40.254 minutes,respectively.The levels of serine,L-asparagine,arachidonic acid in PQ poisoning group were significantly higher than those of the control group,peaked at 48,48 and 24 hours,respectively (40.884-5.38 vs.28.85±2.32,6.61±1.31 vs.0.76±0.65,14.21±4.28 vs.4.42±1.19,all P ＜ 0.01),and the levels of hexadecanoic acid and octadecanoic acid were significantly lowered,reached tough at 48 hours (39.09 ± 10.23 vs.83.99 ± 20.49,44.03 ± 3.60 vs.140.76 ± 73.91,P ＜ 0.05 and P ＜ 0.01).The changes in these biomarkers were related to the toxicity of PQ,indicating that PQ could interfere the energy and lipid metabolism in rats.Conclusion Combine with the metabonomics analysis,screened plasma serine,L-asparagine,arachidonic acid content in PQ poisoning rats increased significantly,and hexadecanoic acid and octadecanoic acid content decreased significantly,which can preliminary diagnose acute PQ poisoning with animal general performance.