Objective To explore the changes and its clinical significance of frontal lobe magnetic resonance spectroscopy(1H-MRS) in patients with Parkinson's disease(PD).Methods 1H-MRS localized to both frontal lobe,was carried out in 36 patients with PD(14 patients with Hoehn-Yahr stageⅠ,8 patients with Hoehn-Yahr stage Ⅱ,8 patients with Hoehn-Yahr stage Ⅲ,and 6 patients with Hoehn-Yahr stage Ⅳ) and 20 age-matched healthy control subjects.The metabolite ratios of N-acetylasparatate(NAA)/creatine(Cr),and choline-containing compounds(Cho)/Cr in patients with PD on different stage were compared with those in normal control group.Results NAA/Cr ratios were reduced significantly and Cho/Cr ratios were increased significantly in both frontal lobe in patients with Hoehn-Yahr stageⅢ and Ⅳ compared to those in normal control group(P

Objective To analyze and summarize the skills and complications of extracorporeal membrane oxygenation( ECMO) cannu-lation and vein intubation. Methods The clinical data of 21 patients of V-A or V-V ECMO in our hospital from January 2009 to July 2014 were analyzed retrospectively. And the techniques of different catheter sites were summarized. Results Three cases were successfully insert-ed catheter by jugular vein puncture with one time. Four patients with ascending aorta intubation died from uncontrolled severe hemorrhage. Eight peripheral catheter site had a small amount of bleeding,with no more bleeding after pressurized bandage. There were no complications like bleeding, hematoma, hemothorax and pneumothorax in the period of ECMO. Conclusion In the process of the ECMO catheter, the standardized operation could reduce the incidence of serious complicaions including bleeding.

Objective　To investigate the role of suramin in inhibiting the angiogenesis of lung cancer. Methods　The protei n expression of VEGF and its receptor fms-like tyrosine kinase(Flt), kinase ins ert domain-containing receptor(KDR) in lung cancer cell A549 and ECV-304 was studied with immunohistochemical technique. The anti-angiogenesis effect of su ramin was evaluated with immunohistochemical technique and cell culture. Results　Suramin showed no effect on the production of lung cancer cel ls and their secretion of VEGF. No possitive expression of Flt, KDR in A549 was found in the suramin interfered group and non-interfered group, but VEGF w as e xpressed in both groups. The Flt and KDR expressions in ECV-304 cells were decr eased significantly after the treatment of suramin at 0.25 ng/ml and 2.5 ng/ml r espectively. There was no effect on proliferetion of A549 and ECV-304 after sur amin in terference. Conclusion　The mechanism of inhibiting-angiogenes is of suramin is pro bably due to reducing the VEGF receptor expression in vascular endothelial cells and inhibiting the binding of VEGF and its receptors.

Combined transplantation of fetal pancreas and thymus was performed in 10 patients suffering from severe diabetes I. They were closely followed for over one year, and it was found that among them 7 showed spectacular clinical improvement, including 2 with total discontinuation of insulin, and 5 with average reduction of insulin by 82%. In 3 patients, the dosage of insulin was reduced by an average of 56.9%. The average reduction of insulin for the 10 patients in 2 months, 6 months and one year after the transplantation was 68.3%, 74.5%, and 78.4%, respectively. The effect of warm ischemia of different durations on the donor tissues was studied with electron microscopy. The significance of combined transplantation and the relationship of the techniques of procuring the donor tissues and transplantation is discussed.

Objective To analyze incidence of thyroid carcinoma and to explore and conclude the principle of its diagnosis and treatment.Methods One hundred and forty six patients of thyroid carcinoma in our hospital were analyzed and discussed with literature.Results 101 cases were diagnosed as thyroid carcinoma by pathological diagnosis of fast frozen sections,the positive ratio is approximately 93.5%.totle resection of affected lobe and isthmus was performed on 35 cases,total resection of affected lobe and isthmus and majority of opposite lobe was done on 37 cases.The lymph node metastasis was found by postoperative pathological diagnosis with a rate of 32.5%.Conclusions Preoperative diagnose of thyroid carcinoma is rarely available,diagnosis of thyroid carcinoma by fast frozen sections is optimal.total resection of affected lobe and isthmus or total resection of affected lobe and isthmus and majority of opposite lobe are the main operation patterns.

Objective To evaluate the curative effect of potassium magnesium aspartate on arrhythmia and heart function in valve replacement postoperative patients of rheumatic heart disease. Methods Two hundred and eighty patients with rheumatic heart disease were divided into 2 groups in random,with no statistical significance. Treatment group (n=155) were received i.v. potassium magnesium aspartate 40 ml every day and control group (n=125) were only given conventional therapy. At the same time they were given same treatment. Blood magnesium level,blood potassium levels,arrhythmia incidences and heart function were also observed. Results Blood magnesium and potassium levels of the treatment group were higher than those of the control group (P

Objective To explore the effect of different doses of dobutamine on acute lung injury (ALI) in rabbits with septic shock and to clarify the possible mechanism.Methods The rabbits model of septic shock was made by cecal ligation and puncture combined with intravenous injection of endotoxin,70 male New Zealand white rabbits were randomly divided into five groups (14 rabbits in each groups):shamc operation group (group A),ALI group (group B),dobutamine low-dose group (group C),dobutamine medium-dose group (group D) and dobutamine high-dose group (group E),7 rabbits from each group were sacrificed 3 h and 6 h after septic shock.The level of cyclic adenosine monophosphate (cAMP) in lung tissue was detected by ELISA.The expression of aquaporin 5 (AQP5) protein was determined by western blotting.The wet to dry weight (W/D) ratio was measured.The pathological and ultrastructural changes of lung tissue were evaluated by optical microscopy and electron microscope,and lung injury score was assessed.The differences among the different groups were analyzed by one-way ANOVA (LSD test).Results The level of cAMP and expression of AQP5 protein in lung tissue at 3 h and 6 h were dramatically lower in group B than those in group A (3.53 ±0.43) pmol/mLvs.(21.18 ±0.62) pmol/mL; (0.44 ± 0.04) pmol/mLvs.(0.99±0.06)pmol/mL; (2.71±0.56)pmol/mLvs.(21.78±0.62)pmol/mL; (0.29 ±0.05) pmol/mLvs.(0.91 ±0.06) pmol/mL; all P ＜0.001,while the W/D ratio was obviously higher in group B than those in group A (all P ＜0.001).Compared with group B,the level of cAMP and AQP5 protein expression in lung tissue were significantly increased at 6 h in group C (8.48 ±0.61) pmol./ mLvs.(2.71±0.56) pmol/mL,P＜0.01; (0.49 ±0.04) pmol/mLvs.(0.29 ±0.05) pmol/mL,P=0.001 and at3 hand6 hin groupDandE (10.86±0.66) pmol/mLvs.(3.53±0.43) pmol/mL; (0.60±0.05) pmol/mLvs.(0.44±0.04) pmol/mL; (13.80±0.49) pmol/mLvs.(2.71±0.56) pmol/mL; (0.64 ± 0.03) pmol/mLvs.(0.29 ± 0.05) pmol/mL; (15.57 ± 0.60) pmol/mL vs.(3.53±0.43) pmol/mL; (0.91 ±0.05) pmol/mLvs.(0.44 ±0.04) pmol/mL; (19.30±0.42) pmol/mL vs.(2.71 ±0.56) pmol/mL; (0.89 ±0.08) pmol/mL vs.(0.29 ±0.05) pmol/mL; all P ＜ 0.01,while the W/D ratio in group E was decreased obviously (P =0.002; P =0.001).Compared with group C and D,the level of cAMP and the expression of AQP5 protein at 3 h and 6 h in group E increased significantly (all P ＜0.01.The pathological and ultrastructural changes of lung tissue were more intensive in group B than those in group A and the lung injury scores were obviously higher (P ＜0.01).The degree of lung pathological and ultrastructural lesion was ameliorated after administration of dobutanmine.Additionally,histological scores decreased significantly (P ＜ 0.01).Conclusions Our study demonstrated that dobutamine could improve ALI induced by endotoxin,the mechanism of protective effect may involve in increasing the level of cAMP and up-regulating the AQP5 protein expression,and high-dose dobutamine had better effects.

Objective Construct the finite element model of vertebral pedicle screw fixation in thoracolumbar fractures can obtain the intuitive systematic mechanical effects under different motion conditions, it has a very important significance to the patients' rehabilitation, evaluation of system stability and prognosis.In this study, the biomechanical effects of different motion states of thoracic and lumbar spine fracture models were analyzed by the finite element analysis method.Methods We selected 1 orthopedic health volunteers from Nanjing General Hospital of Nanjing Military Region in June 2014, established the finite element model by the CT scan data of the healthy volunteer, used the geometric cutting method for fracture simulation and replacement, assembled posterior orthopedic internal fixation system of vertebral pedicle screw, simulated the different motion states and obtained the stress nephogram and displacement graph of the nail-stick system..Results For the six-nail and two-rod internal fixation system of posterior nail-stick system which set nails through injured vertebrae, we used the finite element operation method to simulate the biomechanical characteristics of different modes of motion in space, it combined by the movement of six directions(flexion, dorsiflexion, left side bend, right side bend, left twist, right twist).The maximum stress(94.99±1.72MPa) and the maximum displacement(0.1854±0.0052mm) and the of the dorsiflexion were significantly lower than that of flexion[(126.82±5.56)MPa、(0.2502±0.0050)mm]、left side bend[(152.18±9.13)Mpa、(0.3172±0.0048)mm]、right side bend[(159.58±13.54)Mpa、(0.3315±0.0051)mm](P<0.05).Conclusion The method of finite element analysis can obtain clear and intuitive biomechanical data, which provides effective evidence for the evaluation of surgical efficacy, the development of postoperative rehabilitation methods and the evaluation of the stability of thoracolumbar spinal system.

Objective To explore the effect of suramin on the epithelial-mesenchymal transition (EMT) and the excretion of transforming growth factor-β1 (TGF-β1) in peritoneal mesothelial cells (PMCs) induced by high concentrations of glucose solution (GS).Methods Cultured PMCs were divided into three groups:(1) normal control group; (2) GS-treated group:cells were treated with 1.5％,2.5％,4.25％ GS for 12 h,24 h,48 h,respectively; (3) Suramin-treated group:PMCs cultured with 4.25％ GS were exposed to different doses of suramin (25,50,100 μmol/L) for 48 h.Expression levels of α-smooth muscle actin (α-SMA) and E-cadherin were detected by Western blotting and the concentration of TGF-β1 in the culture supernatant was determined by ELISA.Results Compared with normal control group,GS-treated PMCs exhibited a time-dependent increase in the expression of α-SMA,and decrease in the expression of E-cadherin.GS also stimulated PMCs to secrete TGF-β1.In the presence of suramin,GS-induced α-SMA expression and TGF-β1 production were reduced,E-cadherin expression was increased.Conclusions Suramin can inhibit high glucose-induced EMT of PMCs by down-regulating the expression of TGF-β1.Suramin may be a novel therapeutic agent for the treatment of peritoneal fibrosis.

Objective To study the effects of recombinant human growth hormone(rhGH) on the treatment for valve replacement postoperative in rheumatic heart disease associated cardiac eaehex.Methods Fortytwo patients with rheumatic heart disease associated cardiac eachexia were divided into two groups.Group one(n=20,rhGH group) received standard enteral nutrition (15 kal·kg-1 · d-1)with rhGH 10U injection subeutaneously from postoperation day 7 to day 14 and group two(n = 22,eontrol group) received standard enteral nutrition (15 kal·kg-1· d-1) for the same period.Haemoglobin, serum total protein, serum albumin, blood glucose, handgrip exercise and triceps skin_fold thickness were determined.Meehanieal ventilation, hypostatie pneumonia incidence rate, and length of stay were observed.Results The levels of serum total protein, serum albumin and blood glucose eoneentration in the rhGH group at the 14th day were inereased significantly compared to that in the control group(P <0.01).Haemoglobin, triceps skinfold thiekness and handgrip exercise in rhGH group were significantly different from those in the control group(P <0.05).Postoperative meehanieal ventilation time, intensive care unit time, hospital stay time were signifieantly shorter than those in the eontrol group (P < 0.05), and hypostatie pneumonia was significantly lower than that in the eontroi group(P < 0.01).Conclusions The rhGH can obviously improve anabolie effects of patients with rheumatic heart disease associated cardiac eachexia whieh can reduce hypostatie pneumonia and shorten postoperative hospital stay time.