The neonatal period is important for the dramatic increment as well as function improvement of islet β-cell.β-cell mass augmentation is primarily regulated by neogenesis,replication,and apoptosis.The mechanisms involve cell cycle related proteins and mitosis-promoting signaling pathways.This remodeling period has far-reaching effects on the body in adapting to the metabolic needs and regulating glucose homeostasis later in life.

Objective The patient started from St. Louis (U. S.), and reached Chengdu (China) after 3 days of flight(St. Louis- Tokyo- Beijing - Chengdu). The patient felt unwell, so he and the two relatives took a taxi to the Emergency Center of Sichuan Provincial People' s Hospital for treatment. The epidemiological survey showed that, the patient had been living in the University of Missouri in the United States, no pigs died locally, there were no markets for the living pigs, farmers markets, farms, and slaughterhouses, and he hadn't contact with pigs. But 4 days before the onset, he closely contacted with a schoolmate, who had cold symptoms. The pa-tient had never been to virus laboratory 7 days before the onset. Clinical examinations showed that, the patient had a fever (37.8 ～ 38.8℃), WBC 7.9×10-9 L-1, N 5.475 × 10-9 L-1, L 19.5% ;the chest X-ray shewed that texture increased and the heart shadow augmented on both lungs; the result of throat swab culture was negative. The result of virus nucleic aeid detected by Sichnan Provincial Center for Disease Control showed H1N1 influenza virus, suspected. Sichuan Province Health organization organized experts on the prevention and control of H1N1 influenza for consultation, and the patient was diagnosed as the first suspected H1N1 influenza case in mainland China based on the epidemiological investigation, symptoms and signs of the patient, the results of laboratory ex-amination, and the result of virus test. Confirmed by the experts from Chinese center for disease control and pre-vention and The Ministry of Health of the People's Republic of China, the patient was diagnosed as the first H1N1 influenza case in mainland China.

Objective To explore the diagnosis and surgical treatment of primary intestinal tumors, and improve the level of treatment. Methods Retrospective analysis of the clinical was made on the 68 cases of primary small intestinal tumors confirmed by pathological examination in our department in recent 20 years. HZ Results 34.8%(21/68) was benign tumors in 68 cases, and 69.1%(47/68) was malignancies. The common clinical prevsentations were abdominal pain (69.1%,47/68). gastrointestinal he morrhage (41.1%,28/68) and abdomen mass (13.2%,9/68). The preoperative misdiagnosis rate was 70.5%(48/68) .All the 68 cases performed operation, and no death. The 1 ,2 and 5 years survival rates of malignant tumors were 65.8%,42.1% and 29.3% respectively. Conclusions The clinical presertation of primary small intestinal tumor is non-spectific and the misdiagnosis rate is high. Kinds of diagnosis examinations should be done for the cases whose diagnosis are uncertain, and laboratory examinations should be considered if it is need. The main choice of treatment is surgery and the chemotherapy is necessary for malignant tumors also.

ObjectiveTo explore the influencing factors of mechanical ventilation time in esophageal cancer patients with lung infection after operation.Methods55 esophageal cancer patients with lung infection after operation requiring endotracheal intubation or tracheostomy and mechanical ventilation were included.According to duration of mechanical ventilation time, ＜ 7 days for early weaned from ventilator group, ＞ 7 days for late weaning group.60 esophageal cancer patients with lung infection after operation without mechanical ventilation served as controls.Various factors on the impact of mechanical ventilation were compared.ResultsEarly and late weaning patients were older than control group(P ＜ 0.05), particularly in late weaning patients(P ＜ 0.01).Compared with the control, FEV1 and MVV decreased significantly in early weaning patients(P ＜ 0.05).NFGNB infection in late weaning patients significantly increased than in early weaning patients and the control(all P ＜ 0.01).Logistic multivariate analysis showed that FEV1 was independent factors affecting early weaning (P ＜ 0.01), age (P ＜ 0.05) and NFGNB infection (P ＜0.01) affecting late weaning.ConclusionThe influencing factors of mechanical ventilation time in esophageal cancer patiens with lung infection after operation were FEV1 decreasing,age and NFGNB infection.

Wound secretion from 20 patients with gaseous gangrene was collected for Gram staining,bacterial culture and drug sensitivity tests.The results indicated that gaseous gangrene was caused by the co-infection of both aerobic and anaerobic bacteria.Gram-negative bacilli were slishtly more common than other aerobic bacteria in gageous gangrene wound,which was different from the findings of ordinary gaseous gangrene.

Objective To explore the effect of prevention of hemorrhagic cystitis (HC) after hematopoietic stem cell transplantation (HSCT) with hyperhydration, forced diuresis and alkalinizing plus infusion mesna. Methods 32 cases of patients receiving HSCT were included in this study. 2 cases of severe aplastic anemia (SAA) received total body irradiation (TBI)+cyclophosphamide(CTX)(TBI-CTX) regimen,and the remaining 30 patients were using the classic busulfan+CTX (BU+CTX) regimen. All patients were treated with mesna combined with hydration, forced diuresis and alkalization to prevent HC. Ganciclovir and acyclovir were used to prevent cytomegalovirus (CMV) and other viral infections and monitor CMV-IgM levels of the blood. Encourage patients to urinate every hour, testing urine pH value and the calculation of urine output, every 6 h review and testing of urine routine,central venous pressure (CVP), each of 8 h of serum electrolytes. Results Only 1 patient at 6 months after transplantation appeared delayed grade Ⅱ HC after hydration, alkalization, diuretic, hemostatic, anti-graft-versus-host disease (GVHD), and ganciclovir antiviral therapy. The HC patients cured at 35 d. The remaining patients did not suffer HC. Adverse effects such as acid-base balance disturbance did not appear clear. Conclusion Mesna joint hydration, forced diuresis and alkalization was effective and safe to prevent HC.

AIM: To investigate the influence of exogenous somatostatin (stilamin) on pancreatic blood flow in normal rats or rats with acute necrotizing pancreatitis (ANP).METHODS: Pancreatic blood flow (PBF) was detected with computerized tissue blood flowmeter and rats with ANP were triggered with sodium taurocholate. Metabolites of eicosanoids in plasma were determined with radioimmunoassay. Other laboratory tests including histopathologic observation under optical or electron microscope were used. RESULTS: There was a significant decrease in PBF in normal rats after stilamin administration in comparison with that before use of the drug. There was significant decrease in PBF after onset of ANP, but, compared with that in ANP group, significant increase was shown in SS(stilamin)+ANP group. Plasma thromboxin-B 2(TXB 2) in ANP group at 6 hours after ANP was significantly higher, with increase of 4.5 times, than that in Sham(sham operated) group while TXB 2, detected each time during the course of ANP, significantly decreased in SS+ANP group. 6-Keto-prostagland in F 1? (6-Keto-PGF 1? ) at 6 h after ANP was significantly higher, and the ratio of TXB 2/6-Keto-PGF 1? , significantly lower in SS+ANP group than that in ANP group. Lessened necrosis of acinar cells, along with much fewer microthrombi in microvessels in SS+ANP group, was shown by pathologic scoring or electron microscope than that in ANP group.CONCLUSION: Administration of exogenous somatostatin leads to the decrease in PBF in physiological setting but it attenuates pancreatic ischemia in SS+ANP group, which may be attributed to correction of abnormal metabolism of eicosanoids, improvement of pancreatic microcirculation and cytoprotection of acinar cells as well.

Objective To investigate the diagnosis and prognosis evaluation value of neutrophil elastase (NE) in ventilator-associated pneumonia (VAP).Methods A retrospective analysis was conducted.The data of patients undergoing mechanical ventilation admitted to Department of Central Intensive Care Unit (ICU) of Boai Hospital of Zhongshan City Affiliated to Southern Medical University from September 2012 to October 2015 were enrolled.The patients were divided into two groups according to whether they suffered from VAP or not.The content of NE in serum and bronchoalveolar lavage fluid (BALF) at the time of mechanical ventilation start,VAP diagnosis (the worst value from 48 hours after mechanical ventilation start to weaning in non-VAP patients),and at the time before mechanical ventilation weaning,as well as inflammation parameters,clinical pulmonary infection score (CPIS),duration of mechanical ventilation and prognosis were recorded.Receiver operating characteristic curve (ROC) was used to analyze the predictive value of NE on VAP diagnosis and prognosis.Results Finally 38 patients were enrolled in the VAP group,and 40 in non-VAP group,and baseline data was similar between the two groups.There was no significant difference in the content of NE in serum and BALF between VAP group and non-VAP group [serum NE (μg/L):67.04 (63.00,75.75) vs.69.00 (63.75,75.00),BALF NE (μg/L):96.26 (85.26,176.01) vs.95.26 (86.76,107.11),both P ＞ 0.05].From continuous monitoring,no significant change in the content of NE in serum and BALF during mechanical ventilation was found in the non-VAP group,but the content of NE in serum and BALF at the time of VAP diagnosis in VAP group was significantly higher than that at mechanical ventilation start [μg/L:157.00 (153.04,165.75) vs.67.04 (63.00,75.75),178.04 (153.00,188.25) vs.96.26 (85.26,176.01),both P ＜ 0.05],and NE content in serum and BALF was significantly decreased at the time after VAP clinical recovery and before mechanical ventilation weaning [μg/L:75.67 (64.51,110.55) vs.157.00 (153.04,165.79),95.50 (66.56,183.02) vs.178.04 (153.00,188.25),both P ＜ 0.05].The NE in the start time of VAP in VAP group was divided into four groups according to quartile,it was found that with the increase of NE content in serum and BALF,the CPIS was increased,the duration of mechanical ventilation was prolonged,and the prognosis was poor (all P ＜ 0.01).Compared with non-VAP group,white blood cell count (WBC),neutrocyte proportion,C-reactive protein (CRP),and procalcitonin (PCT) in VAP group were significantly increased (all P ＜ 0.01).NE in BALF was significantly positively correlated with WBC,neutrocyte proportion,CRP and PCT (r value was 0.507,0.432,0.779,and 0.519,respectively,all P =0.000),among which the highest correlation was CRP.NE in BALF used for VAP diagnosis has good accuracy,with sensitivity of 87.4％,and specificity of 90.6％,and sensitivity and specificity of NE in serum for VAP diagnosis was 78.6％ and 79.2％ respectively.Conclusion NE can be used as one of the indicators for VAP diagnosis,and it is related to the prognosis of VAP.

To determine the bufalin concentration in rats' plasma by establishing a high-performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) method, and to evaluate and compare the pharmacokinetic characteristics of bufalin-loaded bovine serum albumin nanoparticles (bufalin-BSA-NP) and bufalin.

Objective To investigate the effect of cystatin C (Cys C) on adventitia in rabbit abdominal aorta restenosis after angioplasty and its mechanism.Methods 48 New Zealand white rabbits were randomly divided into injury group (receiving balloon dilation of abdominal aorta),the treatment group (taking Cys C monoclonal antibody therapy) and the control group (receiving femoral artery puncture and catheter sheath without balloon dilation and intervention of Cys C monoclonal antibody injection),and each group had 16 rabbits.Peripheral vein blood was drawn to measure the serum level of cystatin C before and 8 h,1 day,1 week,3 weeks,6 weeks after the operation in all rabbits.After 6 weeks of operation,the abdominal aorta were taken and stained with HE.Vascular morphometry analysis and adventitial cell count were conducted.Smooth muscle actin (SM-actin) and proliferating cell nuclear antigen (PCNA) expressions in the adventitia were observed by immunohistochemical staining.The number of PCNA positive cell in the adventitia was counted and the PCNA proliferation index was calculated.The vascular remodeling index,vascular external elastic lamina area (EELA),internal elastic lamina area (IEIA) were used to evaluate the vascular remodeling and the residual stenosis and vascular cavity area was used to measure the vascular stenosis.Results Plasma Cys C level began to rise at 8h after operation and reached the peak at 1 week after operation,and continuously increased for 5 weeks in injury group,and reached to respectively at 3 weeks and 6 weeks after operation.The Cys C levels were significantly higher in injury group than in the treatment and control groups at different time points (all P＜0.05).There were no significant differences in Cys C levels at different time points between the treatment group and the control group.The injury group showed that the number of PCNA positive cells was higher in injury group than in treatment and control groups,both P＜0.05).Compared with the control group,the vascular luminal area,EELA and IELA were significantly increased (all P＜0.05).After treated with the monoclonal antibody Cys C intervention,the treatment group showed that lumen area,vascular EELA,IELA was significantly decreased (P＜0.05),and the vascular remodeling index and residual stenosis rate were decreased as compared with the injury group (0.871 vs.0.784,33.1％ vs.19.7 ％,both P＜0.05).Correlation analysis showed that Cystatin C level was positively correlated with the vascular lumen area,neointimal area,internal elastic lamina area,external elastic lamina area and the number of PCNA positive cells (r=0.812,0.797,0.876,0.932 and 0.822 respectively,all P＜0.01).Conclusions Plasma Cys C level is increased in rabbit after abdominal aorta balloon injury and has a positive correlation with the severity of arterial stenosis.High Cys C level can induce adventitial fibroblast activation,proliferation,phenotype transformation and migration,and accelerate the processes of atherosclerosis and stenosis.Cys C level is the independent risk factor for abdominal aortic stenosis.