Objective: To evaluate the clinical effect of individualized enteral nutritional (EN) support in severe stroke patients.Methods: Totally 120 severe stroke patients with nutritional risk were divided into two groups according to single or double admission number.The 60 patients in the intervention group received an individualized EN with different formula and concentrations according to the clinical status,and supplemented trace elements as occasion required.In the routine group, the patients received EN with standard formula.The energy supply was 83-125 kJ· kg-1·d-1 in both groups.Blood albumin(Alb), pre-albumin(PA), hemoglobin(Hb) and vitamin C(VC) were examined before and after the 21-day nutritional support.The lung infection and gastrointestinal (GI) complications were observed, and the hospital stay and cost were recorded as well.Results: After 21 day''s nutrition support, the serum levels of Alb, PA and VC in the intervention group were not statisticly significant than before (P＞0.05), and the serum levels of Alb, PA and VC were significantly higher than those in the routine group(P＜0.05).The incidence of complications in the in the intervention group was lower than that in the routine group (P＜0.05), and the length of hospital stay and hospitalization was shorter than that in the routine group (P＜0.05).Conclusion: Individualized enteral nutritional support can significantly improve nutritional status, reduce inflammation reactions and GI complications in severe stroke patients, which is worthy of clinical use.

Objective To study the clinical application of the complete audiologic evaluation battery consisting of ABR,ASSR and behavioral audiometry in sound field for the identification of sensorineural losses in children.Methods In the study 48 children were divided as group PTA of the children assessed by pure tone audiometry and ABR and ASSR test,and group BA of the children unable to perform on behavioral evaluations.Results The analysis of the audiometric results of group PTA showed significant correlation between the ASSR thresholds and pure tone thresholds(P＜0.01) at various frequencies.The correlation coefficients were 0.75,0.76,0.76,and 0.83 at different frequencies.The ASSR-PTA linear regression was utilized.The comparison of the ABR and ASSR results of group BA indicated that 23 ears responded in ASSR but without responses in ABR.Those without ASSR responses also had no ABR There were 116 tests in total four frequencies for the 29 ears.83 responses were obtained from ASSR,89 responses from behavior audiometry and 96 from the use of the both tests.Conclusion The comprehensive audiologic evaluation battery could be used to test younger children with severe heating loss children as compared to the pure tone audiometry alone.More detailed data can be obtained thus from children to assist in rehabilitation in a more effective mariner.

Objective To study the expression and its clinical significance of Oct4 in prostate cancer.Methods The Oct4 mRNA expression levels in 2 normal prostate (NP) samples and 8 prostate cancer (Pca) samples were determined by reverse transcription polymerase chain reaction (RT-PCR) analysis.The Oct4 protein expression levels in 10 NP samples,10 benign prostate hyperplasia (BPH) samples and 45 Pca samples were detected by immunohisochemical analysis.Results The relative expression levels of Oct4 mRNA were 0.91,0.76,0.66,0.63,0.55,0.50,0.48,0.42 in 8 Pca samples and 0 in 2 NP samples,respectively.The positive rates of Oct4 protein expression was higher in Pca tissues than in NP and BPH tissues (91.1％ vs.0.0％,91.1％ vs.0.0％,both P＜0.05).The level of Oct4 protein was increased with higher hostologic grade and clinical stage of prostate cancer.The strong positive rates of Oct4 expression were 72.7％ and 30.0％ in Pca tissues with and without lymph node metastasis respectively,and there was a significant difference in the strong positive rate between them (P＜0.05).Conclusions The Oct4 expression is closely related to the differentiation and invasion of tumor.Oct4 might be an important index for the prognosis of prostate cancer.

50 days),whereas third party skin grafts were vigorously rejected.Conclusion Blockade of CD28-B7 and CD40-CD40 ligand interactions resulted in long-term allograft survival and donor-specific tolerance in mouse cardiac transplantation without chronic rejection.

Objective:To study the effects of recombinant human platelet-derived growth factor-BB(rhPDGF-BB)combined with recombinant human transforming growth factor-β1 (rhTGF-β1 )on the expression of FAK mRNA of osteoclasts in the alveolar bone on the pressure side of orthodontic teeth in rats.Methods:Orthodontic tooth movement model was established in 160 male SD rats.The rats in experimental group were treated by injection of 10 ng rhPDGF-BB and 5 ng rhTGF-β1 in the buccal submucosal area of the mo-lar every other day from day 1 afterburner,while those in control group received equivalent volumes of PBS.The rats were sacrificed at 1,4,7,10 and 14 days(n=16)after appliance placement.Specimens were collected.Osteoclasts in the alveolar bone on the pres-sure side of the orthodontic teeth were observed by TRAP staining,the FAK mRNA expression was quantified by quantitative RT-PCR.Results:rhPDGF-BB combined with rhTGF-β1 significantly promoted an increasing number of osteoclasts on the compressing side(P<0.05),increased the expression of FAK mRNA at day 4 and 7(P<0.05),then decresed it to the control level(P>0.05) at day 14.Conclusion:Combination of rhPDGF-BB and rhTGF-β1 can increase the number of osteoclasts in the alveolar bone on compressing side,and promote FAK mRNA expression in osteoclasts.

0.05). Conclusion Preproghrelin-Leu72Met is not significantly associated with T2DM and DN in Shanghai Han populations,while T2DM with AA genotype is characterized by significant declination in urine microalbumin when compared with CA and CC genotypes.Leu72Met polymorphism(C→A)may postpone the development of microalbuminuria in T2DM subjects.

Aim To determine the possibilities and mechanisms of EGFR, a receptor protein tyrosine kinase associated with many important cellular processes re-sponsible for cardiovascular remodeling in renovascular hypertensive rats. Methods 2K1C hypertensive rats were used in the present study. Blood pressure was measured with the tail-cuff method. LVMI and his-topathological changes in the cardiovascular system were analysed. EGFR expressions of aorta and myocar-dium as well as phosphorylation levels of ERK in hy-pertensive rats were detected by immunohistochemistry and Western blot analysis, respectively. Results Sys-tolic blood pressure was markedly increased 2 weeks after 2K1C surgery. Cardiovascular remodeling induced by hypertension was confirmed by elevated LVMI, pro-liferation of collagen fibers in myocardial interstitium, histopathological changes in cardiovascular system and increased IMT of thoracic aorta 6 weeks after 2 K1 C surgery. Compared with sham rats, EGFR expression in the ventricular myocardium of 2 K1 C rats was signifi-cantly increased at 6 weeks ( P<0. 05 ) , and the EG-FR/GAPDH ratio was higher in 2 K1 C rats with higher systolic blood pressure ( P < 0. 05 ) . Phosphorylation level of ERK 1/2 was upregulated correspondingly in 2 K1 C rats ( P <0. 01 ) . Increased EGFR expression was also found in aortas of 2K1C rats, particularly in tunica intima and media. Conclusion EGFR and its down-stream kinases ERK 1/2 are involved in cardio-vascular remodeling in association with the severity of hypertension in renovascular hypertensive rats.

Objective To assess the incidence,risk factors and mortality of acute kidney injury(AKI)in patients with chronic myelogeneous leukemia(CML)after myeloablative allogenetic hematopoietic stem cell transplantation(HSCT). Methods Renal function in 93 CML patients undergone myeloablative allo-HSCT was retrospectively analyzed by the RIFLE criteria. Results Thirty-nine patients (41.9%) developed AKI at a median of 40 days after allo-HSCT, including 24 AKI-R patients(25.8%), 10 AKI-I patients(10.8%) and 5 AKI-F patients (5.4%). The morbidity of AKI in patients with ≥Ⅲ acute graft-versus-host disease (aGVHD) and without ＜Ⅲ GVHD was (81.82±11.63)% and (36.59±5.32)% (P=0.0037)rospectively. The morbidity of AKI in patients with increased total bilirubin and without increased total bilirubin was (72.73±13.43)% and (37.04±5.37)%(P=0.0192) respectively. ≥Ⅲ aGVHD was peor-prognostic factor of AKI and RR was 2.773 [95%CI (1.073-7.167), P=0.035]. RR of AKI-I and AKI-F in patients with ≥Ⅲ aGVHD was 6.320195%CI (1.464-27.291), P=0.013]. The mortality within 100 days after allo-HSCT of patients with AKI was significantly different as compared to patients without AKI (P=0.001). Six-mouth survival rates of different class AKI patients after myeloablative allo-HSCT were (86.96±7.02)% (AKI-R), (70.00±14.49)% (AKI-I), 0 (AKI-F) (P=0.000)respectively. Conclusions AKI is one of the main complications in CML patients after myeloablative allo-HSCT. ≥Ⅲ aGVHD and increased total bilimbin are poor-prognostic factors of AKI, and higher morbidity of AKI-I and AKI-F can be found in patients with ≥Ⅲ aGVHD. With the deteriorated AKI, 6-month survival is decreased. RIFLE criteria is sensitive to the early diagnosis of renal function. Moreover RIFLE can monitor the progression of AKI and predict the clinical outcome.

Objective To study the protective effects of the coronary collateral circulation to ischemic myocardial regional function with coronary artery stenosis≥75%using 2D-strain technique.Methods Two-dimensional images of apical four-,two-chambers,long-axis views and LV short-axis views were obtained in 121 patients.According to the results of coronary angiogram,all the 121 patients were divided into 3 groups:group 1,with normal coronary artery;group 2,with stenosis≥75%in≥1 main coronary artery involved right coronary artery,left anterior descending branch and left circumflex branch and with the presence of coronary collateral circulation(CCC);group 3,with stenosis≥75% in≥1 main coronary artery but with no presence of CCC.The segments' systolic peak strain(Sps),strain rate (SRs),end systolic strain (Yes),early diastolic strain rate (SRe) and late diastolic strain rate (SRa) in longitudinal (L),radial (R),circumficial (C) directions and the rotation (Rot),rotation rate were analyzed with EchoPAC offline software.Results Compared with 1 group,LSps,LSes,LSRs,LSRa,RSRe,RSRa,CSRe,Rotsre,Rotsra of 2 group,LSps,LSes,LSRs,LSRa,LSRe,RSes,RSRs,RSRe,RSRa,CSps,CSes,CSRs,CSRe,CSRs,Rotps,Rotsrs,Rotsre,Rotsra of 3 group decreased significantly (P＜0.05) ;compared with 2 group,LSps,LSes,LSRs,RSes,RSRs,CSps,CSes,CSRs,CSRa,Rotps,Rotsrs,Rotsre of 3 group decreased markedly (P＜0.05).Conclusions Coronary collateral circulation provides a protection effection to ischemic myocardial regional function.2D-strain technique may serve as an efficient method to assess ischemic myocardial regional function.

Objective To analyze morbidity and prognosis of acute kidney injury (AKI) in patients with acute leukemia after myeloablative allogenetic hematopoietic stem cell transplantation (HSCT).Methods Renal function and related clinical data in 66 patients receiving myeloablative alloHSCT were retrospectively analyzed.Renal function was evaluated by RIFLE criteria,which defines AKI as three grades of severity-risk (AKI-R),injury (AKI-I) and failure (AKI-F).Results Thirtyseven recipients (56.1%) developed AKI at a median of 29 days after allo-HSCT,including AKI-R(19 recipients,28.8 %),AKI-I (11 recipients,16.7 %),AKI-F (7 recipients,10.6 %).Compared with baseline value,serum creatinine level in the recipients was significantly increased at the 21st day after transplantation (P＜0.05).During 100 days after HSCT,the morbidity of AKI-F in recipients with HVOD and without HVOD were respectively (55.56 ± 22.22)% and (9.01 ± 4.75)% (P＜0.01).The morbidity of AKI in recipients with or without increased total bilirubin was respectively (68.75 ± 24.54)% and (8.38 ± 4.17)% (P＜0.01).The morbidity of AKI in recipients with or without increased CsA concentration was respectively (66.67 ± 10.29) % and (44.44 ± 8.28) % (P＜0.05).100-day survival rate in recipients after myeloablative allo-HSCT without AKI,with AKI-R,AKI-I and AKI-F was respectively (89.66 ± 5.66) %,(83.88 ± 8.54) %,(81.82 ± 11.63) % and (42.86 ± 18.7) % (P＜0.05).Conclusion AKI is one of the main complications in patients with acute leukemia after myeloablative allo-HSCT.The influence of different class AKI on the mortality was different.The earlier diagnosis,prophylaxis and treatment of AKI by the RIFLF criteria might increase the survival rate in recipients with HSCT.