Objective Wnt signal is very important to control the gastrointestinal mucosal proliferation, but its role in the gastric mucosal proliferation after acidified ethanol injury is not clear yet,neither is the relationship with cyclooxygenase 2 (COX-2). Methods X-gal staining was used to measure the expression of Wnt signaling; Western blot and RT-PCR were used to measure the expression of TCF4 and P-Catenin in the gastric mucosa before and after acidified ethanol injury. We also used TOP/flash plasmid to further indentify the relationship between COX-2 and Wnt signal pathway. Results After acidified ethanol injury, the expression of LacZ signal, β-Catenin and TCF4 increased only in the wild type mouse. The expression of β-Catenin and TCF4 protein increased about (3.52 ±0.52) times and (3.02 ±0.62) times separately, and the expression of β-Catenin and TCF4 mRNA increased about (19. 85 ±3.63) times and (17.82 ±4.82) times separately. Without ethanol injury, the expression of TOP/flash plasmid was inhibited by COX-2 inhibitor (NS398) about 80% and promoted by prostaglandin E2(PGE2) about 50%.After 1% ethanol injury, the expression of plasmid was inhibited by NS398 about 25% ; on the contrary,PGE2 promoted the expression about 10%. Conclusion Wnt signal in gastric mucosa is activated after acidified ethanol injury. COX-2 may work through modulating Wnt signal to control the proliferation of gastric mucosa.

There are many kinds of research methods in proteomics of breast cancer,one of them is mass spectrometry and have made a great progress.With more progress in proteomics studies,diagnosis and prognosis of the specific markers for breast cancer continue to be found,there would be great benefits for patients with breast cancer in diagnosis and prognosis.

Objective To explore the incidence and distribution features of neonatal phenylketonuria(PKU) and congenital hypothyroidism(CH) in Lianyungang area.Methods The heel blood samples dried on filter paper was collected from newborns after 72 hours.As the screening indicators,PKU was detected through serum phenylalanine concentration(Phe) detection by Guthrie′s bacterial inhibition assay and CH was detected through serum thyroid stimulating hormone(TSH) levels detection by time-resolved fluorometry(TRFIA) or enzyme linked immunosorbent assay(ELISA).Results Sixty-four children with CH were diagnosed and the rate of CH was 1∶2423,41 patients were examined by thyroid gland nuclein kinescope picture,among which there were 23 patients whose thyroid glands were unusal.These patients lived in 45 towns(streets),which had no difference between men and women,city and country side.A couple of twins were screened for CH;15 cases of PKU was detected with an incidence of 1∶10 339.These patients′ parents were neither consanguineous marriage nor dominance hereditary family history.Their physical and mental development were similar to the same age children after interventive treatment.Conclusions The distribution of CH and PKU is diffuse in Lianyungang.Neonatal screening is the only valid means to find patients with CH and PKU.

Objective To investigate the molecular epidemiology of CRAB isolated from children in wuhan. Methods Forty non-repetitive strains of CRAB were collected from hospitalized children of emergency department, neonatal medicine, cardiothoracic surgery, bone surgery, respiratory medicine and renal medicine in Wuhan children's hospital during December 2008 and May 2009. MIC values were PFGE; KPC, IMP, GIM, SPM, SIM, OXA-23, VIM genes and integrase gene were amplified by PCR and then sequenced to confirm the genotypes.; Plasmid conjugation experiment was used to study the transfer method of bacterial resistance and southern blot hybridization was used to target the resistance genes. Results Susceptible rates of 40 strains to gentamicin, tobramycin, amikacin, ciprofloxacin, levofloxacin, trimoxazole were 20%, 5%, 93%, 93%, 95%, and 23% respectively. Eleven types of clone were detected by PFGE,including 29 strains of type A clone, 2 strains of type B clone, and 1 strain for each type of C to K clone. Eleven isolates produced both IMP-4 and OXA-23 carbapemase. Twenty-six isolates only possessed OXA-23 carbapemase. Thirty-six strains carried class Ⅰ integron. The results of southern blot hybridization showed that Intl, IMP-4 and OXA-23 type were located on chromosome. Conclusions Type A clone of CRAB is the most common. OXA-23 and IMP-4 type are the major acquired carbapemases, especially the OXA-23 is the most common type. The horizontal transmission of OXA-23 and IMP-4 gene mediated by Int1 and the spread of type A resistant clone is the major way of the spread of carbapenem-resistant Acinetobacter baumannii in the region.

Objective To summarize clinical experience in removal of residual metallic foreign body in the soft tissue.Methods Clinical data of 742 cases with residual metallic foreign body in the soft tissue were analyzed.All the patients were forward from other hospitals with failed removal of the foreign body.Second surgery was performed in our hospital by grasping forceps using 3D-locator under the guidance of the C-shaped arm X-ray machine.Results Foreign body,such as scrap-iron,broken needle,nails,wine and so on located at different regions of soft tissues including neck,chest and abdomen,pelvis,and the four limbs were all successfully taken out.Removal rate of the foreign body was 100％.No complications such as bleeding,infection and nerve damage was occurred.The mean time of the procedures and radiation exposure for the removal surgery was 5 minutes.Conclusion Using 3D-locator and grasping forceps under the guidance of the X-ray,the residual metallic foreign bodies can be removed safely and efficiently.

Objective To investigate the distribution of acquired carbapenemases in carbapenemresistant strains of Klebsiella pneumoniae, and explore its role in epidemiology of nosocomial infection. Methods From November 2008 to March 2009, twenty clinical isolates of carbapenem-resistant Klebsiella pneumoniae were collected from children hospitalized in Wuhan children's hospital. MICs of antibiotics were tested by DNA of Klebsiella pneumoniae. Modified Hodge test was used to screen strains producing carbapenemases,combined imipenem(IPM)-EDTA , meropenem(MEM)- EDTA and ceftazidime(CAZ) - EDTA double-disk synergy test (DDST) were used to detect metallo-β-lactamase-producing. PCR amplification of the carbapenemase and integrase genes, and sequencing were performed. Plasmid conjugation transfer experiments and Southern hybridization were applied to study the mode of drug resistance transmission. Results Four types of Klebsiella pneumoniae were detected by PFGE, type A consisted of 5 strains, including 3 strains of type Al and 2 strains of type A2), type B (2 strains), type C (12strains) and type D (1 strain). Type A and C were the main drug resistant clones. Eight strains of Klebsiella pneumoniae carried both KPC-2 and IMP-4 genes, 10 strains carried IMP-4 gene, 2 strains carried KPC-2 gene. None of NDM-1 ,GIM, SPM, SIM, OXA-23, and VIM carbapenemase genes was detected in 20 isolates. All of 20 isolates carried lntl which were found to be located on bacterial chromosome by Southern blot. Conclusions KPC-2and IMP-4 genes are the major carbapenemase genes in Klebsiella pneumoniae isolated in Wuhan.Transmission of drug resistance is mainly through vertical transmission of type C resistant clone and horizontal transmission of Intl on bacteria chromosome.

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Objective To examine the hemodynamic changes and oxygen metabolism during off-pump coronary artery bypass grafting (OPCABG) .Methods Twenty patients (18 male, 2 female) aged (60?8)yr, weighing (71?9)kg undergoing OPCABG were studied. The patients were premedicated with diazepam 10 mg PO 2h before operation and morphine 10 mg and scopolamine 0.3 mg im 30 min before operation. Anesthesia was induced with midazolam 0.1-0.2 mg?kg-1, fentanyl 5-10 ug?kg-1 and vecuronium 0.12-0.15 mg?kg-1 and maintained with 0.5%-2% isoflurane inhalation, fentanyl 10-20 ug?kg-1 and intermittent iv boluses of vecuronium and in some patients propofol infusion. Radial artery was cannulated. Swan-Ganz catheter was placed via internal jugular vein into pulmonary artery. Hemodynamic parameters including MAP, HR, cardiac index (CI), stroke volume (SV), MPAP, PCWP, SVR, left ventricle stroke work index (LVSWI) and RVSWI; oxygen metabolism including oxygen delivery (DO2) , oxygen consumption (VO2) and oxygen extraction ratio (ERO2); regional cerebral oxygen saturation (rSCO2) and arterial blood lactate level (ABL) were measured and recorded before skin incision (A), when pericardium was incised before operation on the heart (B), during operation on the heart (C), 10 min after operation on the heart (D) and at the end of surgery (E) . Results During surgical manipulation on the heart (C) MAP, SV and CI decreased while CVP and HR increased, but the decrease in CI and SV was not significant. During manipulation on the heart(C) DO2 decreased whereas ERO2 increased, but there was no significant change in VO2. After manipulation on the heart (D) DO2 and ERO2 returned to the pre-manipulation level. Arterial blood lactate concentration increased at E. Conclusion OPCABG can be performed uneventfully under our general anesthetic regimen. During operation while the beating heart is being manipulated MAP tends to decrease while CVP and HR increase. The changes are of short duration and do not result in any serious consequeaces.

BACKGROUND:Tai Chi exercise can relax the affected muscle of patients, increase muscle flexibility and strength, promote normal movement patterns of stroke patients, inhibit abnormal posture and spasm patterns, improve patient motion control and balance function. OBJECTIVE:To systematicaly assess the effectiveness of Tai Chi on the movement, emotional disorder and quality of life in patients with stroke. METHODS: Al extracted data from databases of PubMed, EMbase, Web of Science, EBSCO, Google Scholar, CNKI, VIP and Wangfang were obtained, which were the randomized controled trials addressing the effects of Tai Chi on the movement, emotional disorder and quality of life in patients with stroke. The retrieval time was from database establishment to July 1st, 2015. According to the inclusion and exclusion criteria, two reviewers independently screened, extracted data and assessed the methodological quality of the included literatures. Then the meta-analysis was conducted using RevMan 5.3 software. RESULTS AND CONCLUSION:A total of 15 randomized controled trials involving 1016 patients were included. The results of Meta-analysis suggested that: Tai Chi was superior to the conventional rehabilitation in improvement of balance function [mean difference (MD)=7.87, 95% confidence interval (CI) (4.56, 11.18),P < 0.000 01], gait speed [MD=0.27, 95%CI (0.04, 3.94),P=0.02], anxiety [standardized mean difference (SMD)=-0.47, 95%CI(-0.89,-0.04),P=0.03] and quality of life [SMD=0.65, 95%CI(0.10, 1.19),P=0.02], and there were statistical differences. But there was no statisticaly significant difference in the improvement of depression and functional walking ability. These findings indicate that Tai Chi is superior to the conventional rehabilitation in the improvement of balance function, gait speed, anxiety and quality of life. However, large-sample, high-quality randomized controled trials are needed to provide more reliable evidence for the effect of Tai Chi in depression and functional walking ability.

OBJECTIVE:To comprehensively understand autopharmacotherapy.METHODS:The benefits and risk factors of autopharmacotherapy were analysed and the countermearsure against its risk were put forward.RESULTS&CONCLU?SION:OTC medication is safe and effective in acurate use of route dosage,but in autopharmacotherapy,there are risks as a result of influence of various factors.The safety of OTC medicines should be the matters of common concern of patients,physicians and pharmacists,and a safety mornitoring system for OTC should be established.