Fast-track recovery emphasize applicating a series of effective measures confirmed in the perioperative care of patients,the optimized combination generates synergy effect to maximize alleviating various physical and mental stress reaction in order to expedite patient recovery.Most successful example is the application of fast track colon surgery program.Its safety and effectiveness have been widely confirmed,but the report on pancreas surgery is limited.FTRP is aiming to improve medical and health work efficiency,reduce hospitalization time and hospitalization expenses,improve life quality of patients.Based on the application of FTRP in pancreatic cancer,the relation of morbidity,re-admission and peri-operative mortality rates and clinical significance are reviewed.

Objective To explore the clinical significance of serum N-terminal pro-brain natriuretic peptide (NT-proBNP) and plasma D-dimer (D-D) in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and stable chronic obstructive pulmonary disease (COPD).Methods The clinical data of 76 patients with AECOPD (AECOPD group) and 68 patients with stable COPD (stable COPD group) were analyzed retrospectively.Serum NT-proBNP,plasma D-D levels and arterial blood gas analysis were measured and compared.Results The levels of serum NT-proBNP and plasma D-D in AECOPD group were (918 ± 271) ng/L and (0.269 ±0.048) mg/L,in stable COPD group were (264 ± 32) ng/L and (0.223 ± 0.042) mg/L.The levels of serum NT-proBNP and plasma D-D in AECOPD group were significantly higher than those in stable COPD group (P ＜ 0.01).The levels of serum NT-proBNP and plasma D-D were negatively correlated with arterial blood oxygen partial pressure (r =-0.181,P =0.030;r =-0.166,P =0.047),and were positively correlated with arterial blood carbon dioxide partial pressure (r =0.763,P ＜ 0.01;r =0.424,P ＜ 0.01).Conclusion Combined detection of serum NT-proBNP and plasma D-D has important clinical significance in evaluating severity of COPD,and may indicate AECOPD.

This article systematically introduces the basic conception,classification and physiological significance of anterior guidance for anterior prostheses.A customized incisal guidance table was introduced to record and transfer the individual value of the patient to a virtual full-adjustable articulator system.The clinic effects of the individual value and average value were also compared.

BACKGROUND:Pyrroloquinoline quinone is found to accelerate Schwann cel proliferation and growth factor secretion, but there is no report addressing its role in articular cartilage and chondrocytes.
OBJECTIVE: To investigate the role of pyrroloquinoline quinone in chondrocyte proliferation and interleukin-1β-induced chondrocyte apoptosis in the articular cartilage of knee joints and to verify the protective mechanism involved.
METHODS: Chondrocytes were isolated from New Zealand white rabbits (1 month of age), digested under aseptic conditions, and cultured in DMEM/F12 in the presence of 10% fetal bovine serum to alow for proliferation until passage 2. Adherent chondrocytes were cultured in serum-free DMEM/F12 medium with 0, 6.25, 12.5, 25.0, 50.0 and 100.0 μmol/L pyrroloquinoline quinone, separately. Proliferation activity was determined by MTT at 48 hours of pyrroloquinoline quinone administration. Cel cycle was determined by flow cytometry at 30 hours after pyrroloquinoline quinone administration. Apoptosis was determined by flow cytometry folowing 24 hours of pyrroloquinoline quinone pretreatment and 15 hours of interleukin-1β induction.
RESULTS AND CONCLUSION: Pyrroloquinoline quinone enhanced chondrocyte proliferation activity, increased percentage of S phase and G2/M phase in a dose dependent manner and reached the peak when the concentration of pyrroloquinoline quinone was 12.5-25.0 μmol/L (P< 0.05). Pyrroloquinoline quinone also inhibited interleukin-1β-induced chondrocyte apoptosis in early and late stage, and 25.0 μmol/L pyrroloquinoline quinone had the best effects (P < 0.05). These findings suggest pyrroloquinoline quinone can promote chondrocyte division and proliferation, and protect the cels from interleukin-1β-induced apoptosis.

Rat's adrenal medulla(AT group)or adrenal medulla soaked with monosialogan-glioside(AGT group)were transplanted into the head of striatum of rat model of Parkinsonism.Apomorphine induced greater improverment in rotational behavior in AGT group than in AT group with significant difference.Immunocytochemical staining with Chromagranin A showed that a lot of positively stained cells were distributed in the graft area and some cells developed process in AGT group. Our results showed that the monosialoganglioside had effects of increasing the survival of chromaffin cells and inducing the cells to develop processes.

Objective To investigate the relationship between Ambulatory Arterial Stiffness Index (AASI)and kidney damage or carotid endarterectomy damage in hypertension patients.Methods One hundred and forty-nine patients with hypertension but without diabetes or other arteriosclerosis diseases were enrolled.Forty-eight healthy volunteers during the same period were enrolled as control group.All participants'24 h-ambulatory blood pressure monitoring(ABPM),urinary albumin/creatinine ratio(ACR)and IMT were recorded and AASI was calculated.Then the correlation between AASI and ACR or IMT were calculated.Results There were significant differences in the urinary albumin/creatinine ratio(46.34 vs.33.52)(P ＜ 0.05),microalbuminuria incidence(41％ vs.21％),Carotid intima-media thickness([0.90 ±0.21]mm vs.[0.83 ±0.20]mm),abnormal incidence(72％ vs.60％)and AAS1(0.50 ± 0.16 vs.0.42 ± 0.17)(P ＜ 0.01)between the subjects with hypertension and those without.The AASI were positively correlated with ACR and IMT in hypertension patients.Compared with healthy subjects,the AASI were significantly increased in the patients with abnormal CR and IMT(P ＜0.05 、P ＜0.01).Conclusion The AASI were correlated with kidney damage and carotid endarterectomy damage in hypertension patients.

Objective To summarize the clinical feature and diagnosis experience of sliid pseudopapillary tumor of pancreas (SPT).Methods Clinical manifestations,laboratory examination imageology,operative procedure,pathology of 22 patients from January 2000 to December 2008 were retrospectively analyzed.Results Clinical presentation included a palpable abdominal mass in 3 cases,abdominal pain in 1 cases,abdominal distention in 5 cases,13 cases were asymptomatic.Tumor markers in all patients were negative.Abdominal imaging showed solid and solid cystic masses in pancreas or abdominal cavity.Ten cases located in the head of pancreas,8 cases in the body of pancreas,4 cases in the tail of pancreas.The correct diagnosis proportion of MRI and CT was 33.3％(2/6) and 18.2％(4/22) respectively.Conclusion SPT is one of rare pancreatic neoplasm with low malignant potential,affecting primarily young women.Typital image characteristic contributes to the diagnosis of SPT.

Objective To observe the effects of calcitonin on osteoclast activity and expressions of osteoprotegrin (OPG) and receptor activator of NF-?B ligand (RANKL) in vitro. Methods Osteoclasts and their precursors were mechanically isolated from long bones of SD rats and incubated on bone sheet in MEM with different concentration of calcitonin. Number, morphology of the osteoclasts were detected with tartrate-resistance acid phosphatase (TRAP) staining. Image-Pro Plus counted the resorption pits and areas on slices, stained by toludine blue. RT-PCR was used to examine the expressions of OPG and RANKL of osteoclast. Results Number of osteoclasts were decreased with increasing CT concentrations. After incubation for 5 days, resorption pits were decreased in a concentration-dependent manner (P

Objective To evaluate the efficacy and safety of immunosuppressive strategy of leflunomide (LEF) combined with calcineurin inhibitor and prednisone in Chinese renal transplant recipients.Methods Prospective clinical study was performed in 16 stable renal transplant recipients treated with calcineurin inhibitor, prednisone and either mycophenolate mofetil (MMF) or azathioprine (Aza), and MMF or Aza was replaced by LEF afterward. The loading dose of LEF was 50 mg/day for 3-5 days, and the maintenance dose was 20 mg/day. Prednisone was maintained 10 mg/day. The doses of CsA were adjusted according to its blood concentration.Results One patient dropped due to economic reason 1 mouth later, and continued to take Aza. Another one patient switched back to MMF due to a slight increase of serum creatinine (from 130 ?mol/L to 143 ?mol/L) 6 months after conversion. The remaining 14 patients were still on LEF. The mean observation time under LEF was (8.7?7.2) months (1～18 month). The mean serum creatinine was (103?24) ?mol/L before conversion, (95?26) ?mol/L at 6th month, and (108?27) ?mol/L at one year post-conversion. There was one episode of biopsy proved reversible acute rejection. The observed side effect was tolerable alopecia in 2 cases and rash in 1 case, but there were no significant increases in liver function, decrease of blood WBC count, deterioration of anemia, or any serious infection in any of the patients.Conclusion Immunosuppressive strategy of LEF+calcineurin inhibitor and prednisone is effective and safe in stable Chinese renal transplant recipients.

Objective To detect mutation of mitochondrial DNA in a chinese pedgree with maternally inherited aminoglycoside antibiotic-induced deafness. Methods The mutation of mitochondrial DNA from all 18 family members of a chinese pedigree with maternally inherited aminoglycoside antibiotic-induced deafness was detected by PCR and DNA sequencing. Results Nine individuals in this pedigree carried A→G mutation at the 1555th bp of mitochondrial 125 rRNA, and the others did not have this mutation. Conclusion Mitochondrial DNA mutation may be one of major factors resulted in aminoglycoside antibiotic-induced deafness in this pedigree.