Objective To evaluate the protective effect of taurine on renal injury induced by high energy shock wave in rabbits.Methods Twenty rabbits were divided into the experimental (n=10)and the control group (n=10) at random.Both the groups were exposed to 1500 shock waves at 12.75 KV.In the experimental group, taurine (150 mg/kg) was given intravenously during the shock, while normal saline was given in the controls. Malondialdehyde(MDA) and superoxide dismutase(SOD) in serum were measured and the histological changes, the expression of heat shock protein 70(HSP70) in kidney were determined 3 days after the shocks.Results The level of MDA was(2.2±0.4) ,(2.1±0.4)mmol/L, and the level of SOD was (56.4±9.9) ,(55.8±10.1)μU/L respectively in the experimental and the control group before the shock.There was no significant difference between the two groups(P＞0. 05). After the shock, the level of MDA and SOD was (2.7±0.7)mmol/L, (55.3±5.7)μU/L respectively in the experimental group. There was no significant difference(P＞0.05) compared with the level of before the shock's. While in the control group, the level of MDA and SOD was (5. 7±0. 7) mmol/L, (33. 3±3. 5)μU/L respectively.There was significant difference (P＜0.05) compared with the level of before the shock's. The renal tubule scores of the experimental group and the control group after shocks were 7.2±0.8 and 31.8±1.9, respectively. And the HSP70 scores were 25.2±4.1 and 6.4±0.9, respectively. There was significant difference between the two groups (P＜0.05).Conclusions Taurine can effectively protect kidney from injury induced by high energy shock wave in rabbit.The mechanism may be related with its antioxidant capacity and inducing the synthesis of HSP70 in kidney.

Objective To understand the health knowledge needs of the patients with sequela of stroke and receiving infusion treatment in community service center.MethodsAn investigation on health-related needs of 300 infusion patients with sequela of stroke at Nanning Nanmian Beihu Community Health Center was performed with self-designed questionnaire.ResultsMore than 80% of patients wanted to know following knowledges: the cause of stroke and disease,treatment and more,and the name of the drug treatment,infusion of attention,and other matters.More than 80% of patients hoped to receive health education.The difference of the needs of patients with different profession for the health education was significant(P<0.01).ConclusionThe patients with sequela of stroke would like to know the disease-related knowledge,scientific guidance to health and health care in outpatient infusion clinics during treatment should be based on the needs of patients,to carry out the relevant health education.

Objective To compare the curative effects of intertrochantefie fractures in aged by two operative methods. Methods 85 cases of elderly patients suffered from intertrechanteric fractures were retrospectively ana-lyzed. Out of the 85 cases,45 cases were treated with dynamic hip screw(DHS) and 40 cases were fixed with Gamma nails. The curative effects and complications were compared simultaneously. Results The total excellent rate was 83.5% in 85 patients,the rates of DHS and Gamma nails group were 77. 8% and 90% (X2 = 2. 84, P 0. 05), re-spectively. The operative time (66. 4 ± 19. 4)min in DHS group were less than the Gamma nail group (875 ± 25.5) rain (t=2. 451 ,P < 0. 05), but the length of surgical incision (19. 6± 5. 1)cm greater than the Gamma nail group (10. 3 ± 4. 7) cm(t = 2. 501, P < 0. 05). The complications of DHS group (11.1%) were significanfly higher than that of Gamma nail group(2. 5%) (X2 =3.94,P<0. 05). Conclusion As long as the physical condition can toler-ate,surgery recommend the use of DHS and Gamma nail surgical techniques in aged patients with intertrechanteric fractures.

Purpose:To determine the efficacy and toxicity of gemcitabine plus cisplatin in anthracyclin- and taxane-pretreated patients with advanced breast cancer. Methods:Chemo-resistance was defined as no response while rece iving first-line and/or second-line chemotherapy. Patients with advanced and c hemo-resistant breast cancer, which was confirmed histologically, received gemc itabine 1,000 mg/m 2 on d1, 8 and cisplatin 25 mg/m 2 on d1-3, every 3 weeks.2 cycles were delivered at least. Results:30 female patients were enrolled in this trial. All pat ients were evaluable for response and toxicity. The median age was 46 years (ran ge, 34-58 years). After 2-4 (median, 3) cycles of chemotherapy, overall object ive response was 50.0%, with 5 CRs (Complete response 16.7%) and 10 PRs (Partial response 33.3%). Stable disease was seen in 13 patients (43.3%), and disease pr ogression in 2 patiens (6.7%). Toxicities included myelosuppression and gastroin testinal reaction mainly. Grade Ⅲ-Ⅳ toxicites developed in 50% patients. Ther e were no treat-related deaths. The median follow-up time was 12.5 (range: 2- 48) months. Median overall survival was 14 months, and median time to progressio n was 10 months. Conclusions:These data indicate that the combination of gemcita bine and cisplatin is an effective treatment for heavily pretreated breast cance r patients with manageable toxicity.

To investigate the relationship between the expression of early growth response gene 1 (EGR-1) and p38MAPK pathway in the paclitaxel resistance of ovarian carcinoma cells, the effect of p38MAPK inhibitor SB203580 on cell apoptosis was examined by using Hoechst 33258 staining. The intracellular Rh123 (Rhodamine 123) accumulation was detected by the flow cytometry (FCM). The 50% inhibition concentration (IC50) of paclitaxel for A2780/Taxol cells was determined by MTT method. Electrophoretic motility shift assay (EMSA) was employed to examine the EGR-1DNA binding activity. MDR1 and EGR-1 mRNA were assessed by RT-PCR. The expressed of p-gp, phosphorylated p53 and p38 were detected by Western blotting. SB203580 could remarkably promote the apoptosis of A2780/Taxol cells, and the cell apoptosis was in a time-dependent manner. Cellular Rh123 accumulation was increased, and the IC50 of paclitaxel for A2780/Taxol cells was decreased significantly. A2780/Taxol cell line after SB203580 treatment was shown to have a significantly higher level of EGR-1 DNA binding activity. SB203580 down-regulated the activity of p38MAPK pathway, but up-regulated EGR-1 expression. SB203580 significantly increased the level of cellular phosphorylated p53 protein, but decreased the p-gp protein level and MDR1 mRNA level in A2780/Taxol cells. There existed a close relationship between p38MAPK pathway and the paclitaxel resistance of ovarian carcinoma cells. The expression of EGR-1 mediated by p38MAPK pathway plays a critical role in paclitaxel resistance of ovarian carcinoma cells.

Forty two resident general practitioners (GPs) attending obstetrics and gynecology course in Beijing Hospital were divided into trial group and control group with 21 in each group. The 2-hour study content uterine fibroids was taught by the same teacher. For control group the traditional classroom teaching mode was used, while for the trial group the WeChat-based flipped classroom model was used. The teaching effectiveness was evaluated by means of paper examination, critical examination and questionnaire survey. The average scores and the clinical reasoning scores of trial were significantly higher than those of control group [(90.5±3.4) vs. (82.5±4.2) points and (94.5±1.5) vs. (84.5±2.0) points; t=4.28, P<0.05 and t=5.01, P<0.05, respectively]. Compared with the control group, the trial group presented more learning interest, higher learning efficiency and self-learning ability; and also the ability of expression and communication was improved, the ability of teamwork and the ability of analyzing and solving problems was enhanced more markedly in trial group (all P<0.05). The result indicates that WeChat-based flipped classroom teaching model can improve the learning efficiency in general practice residency training.

Objectives To study the effect of mesenchymal stem cells on the aging rat kidney and to explore the underlying mechanism. Methods Rat models of senile kidney were built with hypodermic injection of D-galactose daily. Injections of MSCs of 3 × 10<'6>were given to each rat through vena caudalis and CFSE was used as a tracing label to detect the distribution of MSCs in vivo. After 24 h, rats were dissected and their kidneys were frozen for section. MSCs were observed with Fluophot and quantitative analysis of the various parameters of kidney was performed under a light microscope with B12000 image analysis system.The contents of superoxide dismutase (SOD) and malondialdehyde (MDA) in serum and kidney were measured wtih hydroxylamine and chromatometry. The expression of VEGF and P16 mRNA in kidney tissue was detected with real-time PCR and Western blotting. Results MSCs was found homing in the rat kidney,and the glomerular size, sklerosis-rate and the average cell count of glomerulus in the treated group were different from those of the model group (P<0.05). In the treated group, the activity of SOD was significantly higher and the content of MDA was lower in serum and kidney than that in the model control group (P<0.05). The expression of VEGF mRNA and protein in the kidneys of MSCs group increased significantly as compared with the model group (P<0.05). The expression of P16 mRNA and protein in the kidney of MSCs group decreased significantly compared with the model group (P<0.05). Conclusion MSCs can increase the expression of VEGF while decrease the expression of P16, so as to play a key role in the anti-aging on rat kidney.

Objective To study the relationship and clinical significance of the serum level of Pro-gastrinreleasing peptide31-98 (ProGRP)and bronchoalveolar lavage fluid for small cell lung cancer of different TNM staging.Methods 96 cases of SCLC with definite pathohistological typing were divided into stage Ⅰ～Ⅱ SCLC group (n=30),stage ⅢSCLC group (n=31),stage IVSCLC group (n=35),and the benign cases (n=90)were taken as control.Using enzyme-linked immunoserbent assay ( ELISA),the serum levels of ProGRP and bronchoalveolar layage fluid of all patients were detected,meanwhile the neuronspecific enolase were served as controls.The relation between serum and bronchoalveolar lavage fluid ProGRP level and small cell lung cancer of different TNM staging was analyzed.Results The serum level of ProGRP in stage Ⅰ～Ⅱ SCLC group,stage Ⅲ SCLC group,stage Ⅳ SCLC group,and the benign group were (295.33±118.56),(421.13±196.66),(758.76±326.19)and (29.68±16.32)μg/mol,respectively (P＜0.01 ).The level in bronchoalveolar lavage fluid ProGRP were ( 516.67 ±208.45),( 1170.55±414.65 ),( 1739.12±696.08 )and (49.23±22.50)μg/mol,respectively (P＜0.01 ).The serum level of NSE in stage Ⅰ～Ⅱ SCLC group,stage Ⅲ SCLC group,stage Ⅳ SCLC group,and the benign group were (10.36±6.76),(24.19±10.88 ),(35.76±17.30)and (9.70 ±5.28)mg/mol.The level in bronchoalveolar lavage fluid NSE were (16.66±11.62),(45.47±20.74),(65.18±29.87)and (9.70±5.28)mg/mol,respectively (P＜0.01).The positive rate of serum ProGRP in stage Ⅰ～Ⅱ SCLC group,stage Ⅲ SCLC group,stage Ⅳ SCLC group,and the benign group were 0.6000,0.7097,0.8286 and 0.0667 ,respectively(P＜0.01).The positive rate in bronchoalveolar lavage fluid ProGRP were 0.6333,0.7419,0.8571 and 0.0444,respectively (P＜0.01).The positive rate of serum NSE in stage Ⅰ～Ⅱ SCLC group,stage Ⅲ SCLC group ,stage Ⅳ SCLC group,and the benign group were 0.2333,0.6774,0.8000 and 0.2222.The positive rate in bronchoalveolar lavage fluid NSE were 0.2667,0.7097,0.8286 and 0.2667 ,respectively(P＜0.01 ).Both the ProGRP level and positive rate in serum and bronchoalveolar lavage fluid were obviously higher in stage Ⅰ～Ⅱ,Ⅲ,and Ⅳ SCLC group than in benign group (P＜0.01 ),both the ProGRP and NSE level and positive rate in bronchoalveolar lavage fluid were obviously higher than that in the serum.The positive rate in serum and bronchoalveolar lavage fluid ProGRP in stage Ⅰ～Ⅱ SCLC group were obviously higher than that in the NSE (P＜0.01),but there was no significant difference in stage Ⅲ and Ⅳ SCLC group.Conclusion ProGRP level in serum and bronchoalveolar lavage fluid have great value to the diagnosis and clinical stages of SCLC,especially the early diagnosis,ProGRP is better than NSE;As to the diagnosis of small cell lung cancer of different TNM staging,ProGRP detection in bronchoalveolar lavage fluid is better than in serum.

Objective To investigate the prevention and management of anastomotic leakage in patients with middle and lower rectal cancer after neoadjuvant therapy.Methods In this study,50 cases of middle or lower rectal carcinoma underwent anus preserving radical resection and anastomosis after a 4 cycles of chemotherapy with FOLFOX and 46 Gy(2 Gy×23)radiotherapy.Anastomotic leakage,the prevention and management of this complication were analyzed retrospectively.Results All these 50 patients received low anterior resection after chemoradiotherapy,among the 19 cases receiving prophylactic ileac stoma simultaneously,there was no anastomotic leakage,whereas anastomotic leakage developed in 4 out of the 31 patients who did not receive prophylactic ileac stoma,including concomitant rectovaginal fistula in 2 cases.All these fistulae were cured conservatively.Conclusion Concomitant treatment of FOLFOX regimen and RT in neoadjuvant setting of rectal cancer could increase the rate of anal interior sphincter reservation,prophylactic ileac stoma helps to reduce the rate of anastomotic leakage after a anus-preserving low anterior resection of the cancer.

Objective To investigate the response of cryopreserved ovarian tissue after autologous implantation in mouse stimulated with gonadotrophin.Methods Thirty six female mice were randomly divided into three groups,with 12 mice in each group.In group of fresh ovarian tissue,fresh ovarian tissue was implanted into kidney capsule of mice:in group of cryopreserved ovarian tissue,ovarian tissue was implanted into kidney capsule of mice after cryopreserved by vitrification for two weeks.We investigated the response of ovarian tissue two weeks later after autologous implantation stimulated with gonadotrophin.Immunohistochemistry staining method was used to observe the expression of follicle stimulating hormone receptor.Results Before and after stimularian with gonadotrophin,the mature follicle rate of group of fresh ovarian tissue was 2.3%and 4.2%.that of group of cryopreserved ovarian tissue was 2.3%and 4.0%,and that of group of control was 2.6%and 5.8%.Regarding the percentages of mature follicle.there were significant differences after stimulation with gonadotrophin(P＜0.05).After stimulating with gonadotrophin the percentages of mature follicle were the same in the fresh tissue group,cryopreserved tissue group and control group(P＞0.05).The integrated optical density of follicle stimulating hormone receptor of fresh ovarian tissue in antrofollicle and pre-antrofollicle were 9408±2777 and 4531±1903.that of cryopreserved ovarian tissue were 9175±3093 and 4808±1386.and that of the control ovarian tissue were 8838±2064and 5516±1136 respectively.There was no significant difference between any two groups(P＞0.05).Conclusion The follicle stimulating hormone receptor is preserved by cryopreservation and transplantation,small pieces of ovarian tissue response to gonadotropin stimulation is normal.