Objective To observe the variety of liver and kidney function during lung transplantation and discuss its reference value of diagnosis and therapy in clinical acute rejection(AR).Methods The variety of TBIL, ALT and CRE were dynamically studied and analyzed before and after lung transplantation in 2 cases shared one same donor's lung block.Results During the use of CSA,TBIL diversely procedurally raised and it got right when AR was under control; when illness was worsen,ALT abnormally raised and CRE had no remarkably change.Conclusion TBIL is the sensitivity index of hepatotoxicity of immunity inhibitor CSA after lung transplantation. The abnormal change of ALT is the index of disease turnover.

To investigate the relationship of between p21wAF1 and PCNA expression and the patients' prognosis in breast carcinoma. MethodExpression of p21wAF1 and PCNA was determined by S-P immunohistochemical technique in 152 patients with breast carcinoma. ResultsPositive immunostaining of p21WAf1was detected in 61(40.1% ) primary breast carcinoma, in which 43(70.5% ) were low expression, and 18(29.5% ) over expression of 152 PCNA positive cases, 69(45% ) expressed with low index and 83(55% )expressed with high index. p21wAf1 expression level was correlated with tubule formation (γs＝ 0.341, P＜0.01 ),nuclear atypia(γs=0.516, P＜0.01), mitosis(γs=0.351, P＜0.01)and histological grade(γs=0.415, P＜0.01)in breast cancer tissue. Univariate analysis demonstrated less disease-free survival in patients with higher p21WAF1 (x2 = 6.92, P＜ 0.01 ) and PCNA (x2 = 5.14, P＜0.05)expression than in those with lower expression. The survival term of the patients with p21WAF1 -/PCNA low index, p21wAF1 +/PCNA low index, p21WAF1 +/PCNA high index and p21WAF1 -/PCNA high index groups was successively shortened. Conclusions( 1 ) Combined detection of p21wAF1/PCNA is helpful to judge the proliferating activity of the tumor cells and the patients prognosis. (2) Different expression level of p21WAF1in breast carcinoma is probably related the different regulating directions.

AIM: To observe the expression of transforming growth factor ? 1 (TGF-? 1), MAPK 1/3 and fibronectin (FN) in the development of renal tubulointerstitial disease. METHODS: Wistar male rats were randomly divided into normal control group, diabetic group of 1week, 2 weeks, 4 weeks and 8 weeks. Diabetic model was induced by peritoneal injection of streptozotocin. Immunohistochemistry was employed to detect the expression of TGF-? 1, MAPK 1/3 and FN in the kidney. TGF-? 1 protein in the renal cortex was checked by Western blot. BG, Scr and UP were analysed by biochemical methods, and the morphological changes in renal tubulointerstitium were also examined under microscopy on sections stained with HE and PAS. RESULTS: The expression of MAPK 1/3 and FN was observed, but not the expression of TGF-? 1 in normal renal tissue. Positive staining of TGF-? 1 was observed in the renal tubulo-interstitium in 1-week diabetic group and thereafter it increased in the course of diabetes. A continuous increase in the expression of MAPK 1/3 and FN was also observed in two - week diabetic rats. Chronologically the expression of TGF-? 1,MAPK 1/3 and FN and the ratio of KW/BW were positively correlative with each other in diabetic animals except one -week diabetic rats. There was also a positive correlation between MAPK 1/3 and FN in l -week diabetic rats. CONCLUSION: Our data suggest that TGF-? 1 appears in the renal tubulointerstitium in early period of diabetes and then its signal is mediated by MAPK 1/3 cascades to accelerate production of FN ,and in turn leads to renal hypertrophy and tubulointerstitial fibrosis. [

AIM: To explore the effect of Snail1 siRNA on high-glucose induced tubular epithelial-to-mesenchymal transition (TEMT). METHODS: Subconfluent renal tubular epithelial cells were incubated in serum-free DMEM for 24 h to arrest and synchronize the cell growth. Then cells were treated with normal glucose (5.5 mmol/L D-glucose) or high glucose (25 mmol/L D-glucose) for 72 h. Meanwhile 19.5 mmol/L D-manntiol was used as high osmotic control. Snail1 siRNA was transfected into tubular epithelial cells. In parallel, cells were transfected with non-specific siRNA which served as the control data sets. Cells were then treated with 25 mmol/L D-glucose for 72 h. RNA and cell lysates were collected to determine the protein and mRNA levels of Snail1, TGF-β_1, α-SMA, vimentin and E-cadherin. RESULTS: Transfection caused the decreases in Snail1 at mRNA and protein levels by 62% and 68% respectively as compared to those in untransfected cells cultured in high glucose medium. Western blotting exhibited that Snail1 siRNA transfection restored E-cadherin protein expression by 61% compared to that in high-glucose-treatment cells, whereas it inhibited high-glucose-induced induction of α-SMA protein by 58%. Similarly, RT-PCR revealed that Snail1 siRNA transfection dramatically suppressed the high-glucose-induced mRNA expressions of α-SMA and vimentin by 72% and 61%, respectively, while E-cadherin mRNA increased by 53%. CONCLUSION: Our study provides direct evidence that Snail1 is able to control TEMT.

Objective:To investigate current situation of overweight and obesity among population from coastal areas of Fujian province ,and study their correlation with blood pressure (BP) and blood lipids . Methods :A total of 3343≥30 years people from coastal areas of Fujian province were enrolled using cross -sectional survey .Body height and mass ,BP ,waist circumference (WC) ,blood glucose and blood lipids etc .were measured .The correlation among BP ,blood lipids and BMI were statistically analyzed . Results:Detection rates of overweight and obesity were 34.6% and 10.0% respectively .Overweight rate of men was significantly higher than that of women (40.4% vs . 30.7% , P<0.05);percentages of overweight and obese population gradually rose along with age increased before 70 years ,and it showed declining trend after 70 years .Compared with normal weight people of corresponding age , BP and WC significantly rose in overweight and obese young people (<40 years) , P<0.01 all;there were signifi‐cant rise in BP ,WC ,TC and LDL‐C levels ,and significant reduction in HDL‐C level in overweight and obese mid‐dle-aged and aged people (>40 years) , P<0.05 or <0.01. Partial correlation analysis indicated that BMI was positively correlated with WC ,SBP ,DBP ,TC ,LDL‐C and HbA1c levels ( r=0.701 ,0.218 ,0.238 ,0.068 ,0.120 , 0.135 ,P<0.01 all) ,and inversely correlated with TG and HDL‐C levels (r= -0.069 both ,P<0.01 both) .Mul‐tifactor linear regression analysis indicated that BMI was significantly correlated with WC ,sex ,age ,DBP ,HDL‐C and FBG levels .After controlling age ,sex and blood glucose etc .,binary Logistic regression analysis indicated that overweight (OR=2.283 ,95% CI 1.915~2.721) and obesity (OR=4.419 ,95% CI 3.329~5.865) were risk fac‐tors for hypertension and dyslipidemia [overweight (OR= 1.356 ,95% CI 1.160~ 1.584) ,obesity (OR= 1.691 , 95% CI 1.319~2.167 )] , P<0.01 all .Conclusion:Prevalence rates of overweight and obesity are high in coastal population in Fujian province .Percentages of hypertension ,dyslipidemia ,DM and cardiovascular risk factor aggre‐gation significantly rise among overweight and obese people ,so controlling body mass is of important significance for prevention and treatment of chronic diseases ,including hypertension ,DM and dyslipidemia etc .

OBJECTIVETo conduct a systematic review of the safety and efficacy of enhanced recovery after surgery(ERAS) program in perioperative management of pancreaticoduodenectomy.

METHODSA computerized search was performed in databases including PubMed, Embase, Medline, Web of Science, Cochrane Library, CNKI, Wanfang and VIP for randomized controlled trials (RCTs) or clinical controlled trials (CCTs) describing an ERAS program in patients undergoing pancreaticoduodenectomy published between January 1966 and May 2014. After assessment of methodological quality and data extraction, meta-analysis was performed using RevMan 5.2.0 software.

RESULTSSix RCTs and 8 CCTs including 2565 patients were selected for this study, including the study group(n=1366) and the control group (n=1199). Compared with the control group, the study group had a shorter length of hospital stay(WMD=-3.67, 95% CI:-5.66--1.68, P<0.05), lower postoperative complication rate(OR=0.73, 95% CI:0.56-0.95, P<0.05) and lower mortality(OR=0.63, 95% CI:0.44-0.91, P<0.05). However, no significant differences existed in mortality, readmission rate and re-operation rate between the two groups.

CONCLUSIONSEnhanced recovery after surgery programme in perioperative management of pancreaticoduodenectomy is safe and effective. But due to the medium quality of the literature. This still need more rigorously designed RCTs to prove the safety and efficiency of ERAS programme for the patients undergoing pancreaticoduodenectomy.

Objective To compare the efficacy of different rehabilitation models on acalculia after acquired brain injury. Methods 113 cases were randomly assigned to 3 groups: control group(n=37), computer-assisted training group(n=38) and face-to-face training group(n=38). The control group just received cognitive dysfunction evaluation. The training groups received cognitive rehabilitation training 5 days a week and 30 minutes a day which sustained for 6 weeks. And 33 patients were selected to prolong for 12 weeks. They were evaluated with Revised EC301Calculation and Number Processing Battery in Chinese version (EC301-CR) at the beginning, the 6th week point and the 12th week point respectively. Results 6-week after treatment, The performance of both the computer-assisted training group and face-to-face training group significantly improved(P<0.001); It showed that computer-assisted group>face-to-face group>control group(P<0.001) both 6 weeks and 12 weeks latter. Significant negative correlation was found between age and performance of EC301-CR(P<0.05).Conclusion The effect of computer-assisted training on acalculia is superior to face-to-face training; The first 6 weeks of training is the best period for rehabilitation; The younger the patient is, the better results are.