Objective To explore the role of LGR5 positive intestinal stem cells in repairing damage of intestinal mucosa resulting from endotoxemia and to determine whether the damaged intestinal mucosa can be repaired by regulating the proliferation and differentiation of intestinal stem cells.Methods Wistar rats were randomly divided into control group,lipopolysaccharide(LPS) group,and glucagon-like peptides 2(GLP-2) group.LPS was injected interaperitoneally into rats of the LPS group and GLP-2 group at a dose of 5 mg/kg(1 ml/kg) ; saline(1 ml/kg) was injected into the rats of control group.GLP-2 250 μg/kg(1 ml/kg) was rnjected into the rats of GLP-2 group 1 hour after the LPS injection.The terminal ilea were collected from 8 rats in each group at 6 h,24 h,and 72 h post-LPS injection.Structrral changes in the intestinal epthelium of every group were observed under the light microscope and electron microscope.The expression of LGR5 in intestinal stem cell was detected by immunohistochemical method and RT-PCR.Results In general,intestinal edema and hyperemia was observed in both LPS and GLP-2 groups at 6 h.Fracture and lodging of villi,infiltration of inflammatory cells,and visible exudate within the cavity were observed under light microscopy.The inflammatory injury was less severe in the GLP-2 group than in the LPS group at 6 h.The injury of intestina mucosa gradually repaired between 24 h and 72 h after injection of LPS in both LPS group and GLP-2 group.Importantly,samples taken from GLP-2 group and LPS group at the same time point indicated that the GLP-2 group recovered significantly better than the LPS group.And expressions of LGR5 mRNA in GLP-2 group at 6h,24h,72 h(0.13 ±0.05,0.16±0.05,0.16±0.04) were significantly higher than those in LPS group respectively (0.52 ±0.09,0.73 ±0.14,0.48 ±0.24),as shown by RT-PCR,and than that in control group(0.12 ±0.03) (P ＜ 0.05).Conclusion Exogenous GLP-2 may facilitate intestinal stem cell proliferation,thereby promoting the recovery of intestinal mucosa damaged by endotoxemia.GLP-2 appears to promote stem cell proliferation,differentiation,and gradual migration of stem cells from the intestinal crypts to the damaged mucosa.

Objective To evaluate the efficacy of video-assisted thoracoscopic surgery(VATS)for spontaneous pneumothorax.Methods From January 2003 to June 2006,VATS was carried out in 61 cases of spontaneous pneumothorax in our hospital.Resection or ligatation of pulmonary bullae,and pleurodesis were performed by using Endo-GIA.Results Among the cases,unilateral VATS was performed on 58 patients(an axillary small incision was made in one case),and bilateral VATS was done in 3.No conversion to open surgery or severe postoperative complications occurred in this series.Pulmonary bullae was detected in 56 of all the patients.The operation time was 35-55 min(mean,46 min)for unilateral VATS,and was 85,175,and 190 min respectively for the 3 cases of bilateral VATS.The mean blood loss for unilateral operation was 40 ml(range,30-45 ml),and the blood loss in the 3 cases of bilateral VATS was 55,60,and 200 ml.The thoracic-drainage volume was 230-500 ml(mean,390 ml)in the unilateral cases,and was 350,1030,and 1200 respectively in the 3 bilateral cases.The drainage tube was withdrawn 3-6 d(mean 4 d)later in the unilateral cases,and 3,4,and 5 d later in the 3 bilateral cases.The 61 patients were followed up for 4-24 mon(mean,8 mon),during which one patient experienced recurrent pneumothorax in 2 months and was cured by closed thoracic drainage.Conclusions VATS is safe and effective for patients with spontaneous pneumothorax.

Endocarditis, Bacterial ; Female ; Humans ; Hypertension, Pregnancy-Induced ; Pregnancy

Objective To investigate the clinical epidemiology and clinical features of patients with rubella. Methods Data of clinical epidemiology, clinical manifestations, laboratory findings of patients with rubella hospitalized in Second Affiliated Hospital of Harbin Medical University from 2002 to 2004 were retrospectively analyzed. Positive rates were analyzed using chi square test. Results Of the 408 patients with rubella,90.0% had histories of contacting with patients with rubella, and 75.5% were students. The common clinical manifestations were fever(71.1%),rash(100.0%),lymphadenectasis(90.0%).Laboratory findings were liver dysfunction(10.3%),myocardial enzyme abnormality(11.8%),WBC decrease(60.0%)and lymphocythemia(70.1%).The differences between adult group(n=125)and children group(n=283)were compared. The numbers of patients with eruption time within 1-2 days were 102 and 264,respectively(X~2=12.823.P＜0.01);those with deflorescence time within 1-3 days were 43 and 129,respectively(X~2=4.447,P=0.035);those with sporadic rash were 108 and 263,respectively(X~2=4.487,P=0.034);those with erythroic rash were 99 and 247,respectively(X~2=4.392,P=0.036);those with eruption order of head to trunk were 104 and 256,respectively(X~2=4.402,P=0.036);those with thrombocytopenia were 10.4% and 2.5%,respectively(X~2=11.686,P＜0.01);those with liver dysfunction were 17.6% and 7.1%,respectively(X~2=10.416,P＜0.01);those with myocardial enzyme abnormality were 20.0% and 8.1 %,respectively(X~2=11.774,P＜0.01),those complicated with broncho pneumonia were 0.8 and 6.7%,respectively(X~2=6.505,P=0.011);those complicated with hepatitis were 17.6 % and 7.1 %,respectively(X~2=7.117,P=0.008);those complicated with myocarditis were 18.4% and 7.1%,respectively(X~2=11.811,P＜0.01) and those complicated with arthritis were 12.0% and 2.8%,respectively(X~2=13.715,P＜0.01).Conclusions Compared with children patients with rubella, the constitutional symptoms of adult patients are more severe, and the proportion of liver and myocardial enzyme abnormality is higher, which should be paid more attention.

Objective To explore the nursing of polycystic ovary syndrome treated by transvaginal ultrasound small follicular puncture.Methods The treatment and nursing of 58 cases with polycystic ovary syndrome treated by transvaginal ultrasound small follic~ar puncture were summarized.Results Among 58 cases of polycystic ovary syndrome treated by transvaginal ultrasound small follicular puncture,21 cases obtained postoperative pregnancy,the pregnancy rate was 36.20％.Conclusions According to the psychological characteristics of patients with polycystic ovary syndrome treated by transvaginal ultrasound small follicular puncture,good psychological nursing and sufficient preoperative preparation are helpful to reduce the patients' psychological pressure,cooperate with the operation smoothly,and obtain satisfactory clinical effect.

Objective To evaluate the predictive value of electrocardiogram in localizing the occlusion site in the left anterior descending coronary artery(LAD) in acute anterior myocardial infarction(AMI).Methods According to the coronary angiogram,all patients with AMI were divided into two groups:one(the PS group) was a collection of patients(n=61) whose occlusion sites were proximal to the first septal branch(S1) and the other(the DS group) was a collection of patients(n=40) whose occlusion site were distal to S1.Diagnostic sensitivity and specificity in prediction of the occlusion site in LAD were calculated based on the measurements and incidence of ST segments deviation on electrocardiogram(ECG).Results The sensitivity and specificity for prediction of occlusion site being proximal to S1 in LAD using ECG were as follow:43% and 85%(P=0.004) for ST elevation in lead aVR,16% and 97%(P=0.031) for ST elevation≥1.5 mm in lead aVL,39% and 85%(P=0.009) for ST depression≥1.0 mm in lead Ⅱ,23% and 98%(P=0.005)for ST depression ≥2.0 mm in lead Ⅲ,38% and 88%(P=0.006) for ST depression ≥1.0 mm in lead aVF,20% and 86%(P=0.037) for ST depression in lead V5,18% and 100%(P=0.005) for ST elevation in lead aVR together with ST depression in leads V5,30% and 93%(P=0.008) for ST elevation in lead aVR together with ST depression in leads V6.The sensitivity and specificity for diagnosis of occlusion site being distal to S1 were 53% and 90%(P=0.000)ST elevation or unchanged in lead Ⅲ,50% and 82%(P=0.001) for ST elevation in lead V5.There were no significant difference in infarction size and left ventricle ejection fraction between the two groups.Conclusion(1) ST elevation in lead aVR together with ST depression in leads V5 and V6,obvious ST depression in the inferior leads,and ST elevation in leads I and aVL were all indication of occlusion in LAD proximal to S1.(2) ST elevation or unchanged in inferior leads(especially in lead Ⅲ),and marked ST elevation in lead V5 indicated that the occlusion site in LAD was distal to S1.

Objective To investigate the possible mechanisms of enhancing angiogenesis and arteriogenesis through the oberservation of the effect of gene transfer of angiopoietin-1 (Ang1) on its receptor Tie2 in rat models of acute myocardial infarction. Methods Myocardial infarction was induced in rats by left anterior descending artery ligation. Naked plasmid DNA encoding human angiopoietin-1 (phAng1) was delivered into the ischemic area (group A) by intramyocardial injection. On day 3, 7, 14 and 28 after the injection, the mRNA expression of Tie2 and its changes with time were determined by RT-PCR. The number of vessels and arterioles was examined by immunohistochemistry. The collagen was evaluated by Masson staining. Results RT-PCR showed that mRNA expression levels of Tie2 in group A were significantly higher than those in the control group, reached the highest level on day 7 post-injection, and gradually declined to normal level 28 days later. On day 7, 14 and 28, the vessel count showed the number of blood vessels (angiogenesis and arteriogenesis) in group A was greater than that of the control group at the same timepoint and the infracted myocardium in group A was significantly less than that of the control group. Conclusion Gene transfer of phAng1 enhances angiogenesis and arteriogenesis in acute myocardial infarction and reduces the infraction area probably by upregulating the expressions of Tie2 receptor.

The talent medical colleges cultivate are to serve the society, and the society also proves them .How tomerge medical education and social development together to shorten the social adaptive period of medical students is animportant issue to be studied earnestly in higher education.[

Objective To observe pulmonary fibrosis in severe acute respiratory syndrome (SARS) and to discuss the mechanisms of pulmonary fibrosis in SARS. Methods Hematoxylin and Eosin staining (H&E), histology staining and immuno-histochemical staining (SP methods) were used to investigate the lungs from 4 autopsy cases. Antibodies against collagen type Ⅲ, ?-smooth muscle actin(?-SMA), Fas, FasL and transforming growth factor ?1(TGF-?1) were used for immunohistochemical studies. Results All these four lung tissues showed different degree of pulmonary fibrosis, including the organization of exudative fibrin, glomerulus-like fibrosis in alveolar spaces, the thickening of the alveolar septum, proliferation of fibroblasts, the hyperplasia of collagen fibers and the consolidation of lungs. Sirius red staining and collagen type Ⅲ staining showed the type Ⅲ and the type Ⅰ collagen fibers were the main components of the hyperplastic collagen fibers. ?-SMA were expressed in fibroblasts, immunoreactivity to Fas, FasL, TGF-?1 were all positive and located in plasma of pneumocytes, macrophages and lymphocytes. Conclusions The pulmonary fibrosis can be observed early in SARS patients and the pathogenesis may be involved in the co-effect of many effective cells, inflammatory mediators and cytokines.

Objective We report the pathological features of lung in the dead patients with severe acute respiratory syndrome (SARS). Methods Post-mortem lung and pulomonary hilar lymph nodes tissues of 3 patients dead from SARS were studied by histology and immuhistochemistry with rabbit anti-Fas polyclonal antibody, mouse anti-PCNA, mouse anti- CD83,mouse anti-CD4 and mouse anti-CD8 monoclonal antibodies. Results The surface of lung from 3 cases were shown red or purplish red color. Histopathological examination showed that diffuse interstitial exudative or leakage inflammation and alveolar damages with a pronounced increase of of monocytes in the interval at various levels of progression and severity. There were hyaline-membrane formation, desquamation and apoptosis of type-2 pneumocytes in alveolar spaces. Fibrin thrombus and thrombo-embolism could be found in blood capillary and bronchial artery respectively. We observed some fibrin deposition in alveoli interval. No obviously giant-cell infiltrate within the alveolar lumen. The positive cell of proliferative cell nuclear antigen (PCNA) was rare. Fas antigen were expressed in a lot of type-2 pneumocytes, monocytes of the interval and pulomonary hilar lymph nodes. Comparison with the lymph nodes of chronic inflammation, there were obviously disorganization and attenuation of lymphocyte in lymph nodes of SARS. The proportion of CD4 positive lymphocytes were rare, but CD83 and CD8 positive lymphocyte seemed no decreased, relatively. The seminal changes such as decreased lymphocytes ,white pulp atrophy,hemorrhage and necrosis,and decreased expression of lymphocytes for CD4 antigen could also observe in spleen. Conclusions Severe damages of lung and immunological system damages might lead to death of patients with SARS.