Fourteen critical patients were treated by total parenteral nutrition(TPN) or en- teral nutrition(EN) and good results were achieved.Among the1 4patients,1 0 cases were suffered from MSOF.The results suggest thatnutritional support is very im- portant for the critical patients,especially for their rehabilitation and prognosis.The use of TPN is not limited by the gastroin- testinal function.TPN should be sellected preferably when a patient is critical and se- rious.EN should be used when gastroin- testinal function have recovered in order to reduce the translocation of bacteria and en- dotoxin in the gut and decrease gastroin- testinal bleeding.

Kawasaki disease is an acute self-limiting systemic vasculitis syndrome and usually occurs in children.The small and medium arteries of the whole body are mainly invaded, and marked with coronary arteries.Coronary artery dilation and aneurysm formation mainly occur in the early period.Thrombi, intimal hyperplasia, and calcification could be formed during the later period.Consequently, sometimes, it develops intochronicischemic cardiopathy or myocardial infarction.In that, Kawasaki disease has become the leading cause of acquired heart disease for children in developed countries.Presently, the treatment of coronary artery lesions caused by Kawasaki disease includes drug therapy, and interventional and surgical treatment.However, medications usually fail to solve severe coronary conditions, and only interventional and surgical treatment can we choose.Therefore, the development and indications of interventional and surgical treatment of coronary artery lesions caused by Kawasaki disease were reviewed in this article.

High-intensity focused ultrasound (HIFU) is a newly-developed noninvasive technique recently. Being a safe, non-radioactive and reproducible therapy, high-intensity focused ultrasound has been extensively used in the clinical treatment for a variety of solid tumors such as uterine adenomyosis. This paper aims to make a comprehensive review about this technique, focusing on the mechanism, clinical indications and contraindications, safety, efficacy and the complications of HIFU for the treatment of uterine adenomyosis.

Purpose:To study the effect of recombinated human granulocyte colony-stimulating factor (rhG-CSF,filgrastim) on leukopenia induced by chemotherapy.Methods:Ten cases of leukopenia of grade Ⅳ induced by chemotherapy of malignant tumor were treated with rhG-CSF . When WBC2.5?109/L, rhG-CSF was stopped.Results:All patients with leukopenia of grade Ⅳ recovered to normal after treatment with rhG-CSF , the average time of usage was 6.8 days. The infection rate was 60%(6/10). Conclusions:Filgrastim is effective in the treatment of leukopenia of grade Ⅳ after chemotherapy, rhG-CSF decreases infection and facilitates chemotherapy.

Objective To explore the relationship between single nucleotide polymorphisms (rs12953-717) of SMAD7 and susceptibility of non-small cell lung cancer (NSCLC) in Chinese Han population.Methods A single nucleotide polymorphisms (rs12953717) from SMAD7 was detected via Sequenom system in 528 NSCLC cases and 762 healthy controls.Data was statistically analyzed by unconditional Logistic regression method.Results rs12953717 had significant differences between non-small cell lung cancer patients and the controls.Compared with CC/TT (CC combined with TT) genotype,the adjusted odds ratio for the CT genotype was 4.107 (95％ CI:3.206 ～ 5.260,P =0.000 1).Smokers had a 2.004 odds ratio (95 ％ CI =1.583 ～ 2.537,P =0.000 1) of NSCLC compared with the controls.There was a 10.074-fold increased risk of NSCLC among the subjects with CT genotype and smokers.Conclusion The polymorphism of rs12953717 may have relation with risk of NSCLC.Heterozygote (CT) is a susceptibility genotype of NSCLC.Smoking is one of the risk factors of NSCLC.Smoking and CT genotype have synergistic effects on NSCLC susceptibility.

Abdominal Pain ; Cough ; Humans

Objective To investigate the expression and the significance of the MDR1, breast cancer resistance protein, lung cancer resistance protein mRNA and corresponding proteins P-gp, BCRP and LRP in breast cancer tissues and adjacent breast tissues. Methods RT-PCR was used to exam the expression of MDR1, BCRP, LRP mRNA in 42 breast cancer tissues and 42 adjacent tissues. IHC was used to exam the expression of P-gp, BCRP and LRP in 126 breast cancer tissues and 42 adjacent tissues, and theirs relationships with clinicopathological parameters in breast cancer, axillary lymph node status and 5-year recurrence and metastasis. Results The relative expression levels of MDR1, BCRP and LRP mRNA were 0.81 ±0.17,0.78 ±0.14,0.79 ±0.13 in breast cancer tissues and 0.33 ±0.11,0.45 ±0.09,0.36 ±0.10 in adjacent tissues respectively. There were significant differences between cancer tissues and adjacent tissues ( t = 4.613, 4.850 and 8. 089, P < 0.01 ). The positivities of P-gp, BCRP and LRP were 41% ( 52/126) ,39% (49/126) and 66% (83/126) in breast cancer tissues. There were significant differences between cancer tissues and adjacent tissues (x2 = 10.147, 7.020, 27.820, P < 0.01 ). The expression of MDR1 mRNA/P-gp was significantly associated with tumor stage and lymph node metastasis ( r = 0.369,0.398, P < 0.05 ). The expression of BCRP (mRNA/protein) was significantly associated with lymph node metastasis (r = 0.355, P < 0.05 ) . The positivities of P-gp were significantly different between 39 recurrence/metastasis patients occurred in 5 years and 32 unrecurrence/nonmetastasis patients in 5 years (x2 = 11.771, P < 0.01 ). The positivities of BCRP and LRP were not significantly different in these two groups(x2 =2.261,0.078,P >0.05). The coincidence rates for expression of MDR1 ,BCRP,LRP mRNA and their proteins in breast cancer tissues were 90.48% ,92.85% and 85.71% respectively (the Kappa values were 0.806,0.751 and 0.697, P < 0.01 ). Conclusions Multidrug resistance is common in breast cancer. The three drug resistance genes and proteins are involved in the formation of multidrug resistance of breast cancer. Detection of multidrng resistance genes in breast cancer may be useful to choose chemotherapy,especially patients with P-gp positive expression are not advised to use the CAF chemotherapy.

Idiopathic pulmonary fibrosis (IPF) is a specific form of chronic, progressive, fibrosing interstitial pneumonia of unknown etiology , a median survival time of which is 2 to 3 years.The diagnosis and treatment are important for IPF in time.Krebs von den lungen-6(KL-6), Surfactant protein-A(SP-A) and Surfactant protein-D(SP-D) are acceptable biomarkers in clinical for idiopathic pulmonary fibrosis in Japan,which have shown good sensitivity at diagnosis IPF and predict the prognoses for patients with IPF . However , the differential diagnosis of IPF from other interstitial lung diseases is still challenging .Other biomarkers are being developed , one of which would have the best specificity and sensitivity at diagnosis IPF.Those biomarkers about pathogenesis of IPF includes alveolar epithelial cell dysfunction , fibrogenesis and immune dysregulation are shown .They are potential to account for underlying disease mechanisms , accelerated drug development and advance clinical management.

ObjectiveTo explore the role and mechanism of NGAL in the process of hypoxia/ reoxygenation (H/R) injury in human renal tubular epithelial cell (HK-2).MethodsThe H/R model of HK-2 cells was established in vitro (oxygen concentration ＜ 0.1％ ).The expressions of NGAL in the cells of H/R group and control group were determined by WB and real-time RT-PCR.The cell models were treated with 50,100,200,400 and 1 000 ng/ml of recombinant NGAL respectively.Cell proliferation and apoptosis of the treated groups and control group were detected by the MTT assay and Annexin V-FITC/PI staining to determine the appropriate NGAL concentration.The cell cycle distributions in the H/R group,NGAL treated H/R group and control group were detected by flow cytometry,and the expressions of bax/bcl-2 and caspase-3 were measured by real-time RT-PCR.The experiments were triplicated to obtain the mean values.Results The protein expression of NGAL/actin in H/R group (5.875 ±0.081 ) was higher than that of the control group ( 1.513 ±0.032),the differences between the two groups had statistic significance (t =96.89,P ＜0.05). While the gene expressions of NGAL/actin in HL/R groups (12.32 ± 1.27 ) and control group ( 1.00 ±0.00) had statistical significance of difference ( t =15.40,P ＜ 0.05 ).In MTT assay,the absorption values of the H/R group and control group were 0.97 ± 0.03 and 0.56 ± 0.04,the differences had statistic significance( t =18.680,P ＜ 0.05 ).And the absorption value of cells treated with different concentrations of NGAL (50,100,200,400,1 000 ng/ml) were 0.56±0.04,0.53 ±0.03,0.56 ±0.04,0.53 ± 0.03,0.54 ± 0.02,respectively.There were no significant differences between the H/R group and NGAL treated groups ( F =0.978,P ＞ 0.05 ),but the differences of absorption values in the control group and other groups had statistical significance ( F =105.20,P ＜ 0.05 ).The ratios of early apoptotic cells ( Annexin V positive,PI negative) in the control group and the H/R group were ( 1.0 ±0.2) ％ and ( 27.6 ± 1.4 ) ％ respectively with a statistical significance of difference ( t =33.590,P ＜0.05 ).After the treatment of NGAL ( 50,100 ng/ml),the ratios were ( 27.8 ± 1.1 ) ％ and ( 26.4 ±1.3 ) ％ and there were no significant differences compared to the H/R group ( t =0.250,P ＞ 0.05 ).When the H/R model was treated with 200 ng/ml of NGAL,the ratio of early apoptotic cells dropped to ( 19.4 ± 0.6) ％,leading to a statistical significance of difference ( t =10.350,P ＜ 0.05 ).However,in the H/R model treated with high concentration of NGAL (400,1 000 ng/ml),the ratios were ( 19.3 ± 1.1 )％ and ( 18.9 ±0.5 ) ％,which had no significant differences compared to the cells treated with 200 ng/ml of NGAL (t =0.130,0.630; P ＞0.05).Thus the study chose 200 ng/ml as the appropriate treating concentration of NGAL.In the control group,H/R group and 200 ng/ml,NGAL treated HR group,PI values were (30.2 ±0.4)％,(22.1 ± 2.7 )％ and (23.2 ± 3.7 )％ respectively.There were no significant differences between the H/R group and NGAL treated group (t =0.510,P ＞0.05),but there was still statistical significance in difference among the control group and the treated groups ( F =8.28,P ＜ 0.05 ).The ratio of bax/bcl-2 and the expression of caspase-3 detected by real-time RT-PCR were 1.00 ± 0.00,1.00 ± 0.00 in the control group,5.83 ±0.33,8.13 ±0.20 in the H/R group and 2.52 ±0.07,1.89 ±0.02 in the NGAL treated H/R group.The bax/bcl-2 ( F =485.30,P ＜ 0.05 ) and caspase-3 ( F =3456.78,P ＜ 0.05 ) did have statistical significances of difference among the three groups.ConclusionsNGAL acts as a protective factor against hypoxia-reoxygenation injury by regulating pro-apoptotic genes.It provides a new idea and evidences for the treatment of AKI caused by ischemia-reperfusion injury.

Objective To explore the methodology of choosing the volume and shape of the mammary implant.Methods The changes of the volume and shape were analyzed in 502 cases of breast augmentation,to find out how to select the volume and shape of the mammary implant.Results The thoracic width H was the most important factor of choosing width of the implant; the SN was the important factor of choosing the height of the anatomic implant; After setting the diameter and height of the implant,a bigger breast could be achieved by increasing the projection of implants.For those very thin females with flat chest, anatomic implants were the better choice. Conclusions Thoracic width,breast volume and other data are the most important factors in choosing the mammary implant.Round and anatomic mammary implants have their specific indications.