Many epidemiological data and study of experiment show that adminstration of NSAIDs in long term can prevent the carcinogenesis of colorectal cancer, its mecanism can be associated with the inhibition of PG which is produced by Cox 2 way, in addition, promoting apoptosis and anti oxidation were also one of the mecanisms of NSAIDs, the new selective Cox 2 inhibitor without gastrointestinal side effect would become the chemopreventive drugs of colorectal tumor.

Objective To observe the effect of foam dressing and polyurethane gel pad in prevention of pressure ulcer for surgical patients.Methods 140 patients in neurosurgery department were randomly divided into the control group and the experimental group with 70 patients in each group.The control group received foam-rubber cushion for conventional nursing,the experimental group used foam dressing and polyurethane gel pad to prevent pressure ulcer.Instantly after the operation and 30 min later,the situation of skin pressure ulcer was recorded respectively,the maximum diameter of erythema was measured and the process was put into phases.24 hours after the operation,patients of the above two groups were visited and the situation of skin pressure ulcer was recorded.The skin pressure ulcer and the maximum diameter of erythema were compared between the two groups.Results Cases with phase Ⅰ and phase Ⅱ pressure ulcer in the experimental group were less than those of the control group at three time points,which were instantly after the operation,30 min and 24 hours later.The diameter of erythema at three time points was also less than the control group.Conclusions Foam dressing and polyurethane gel pad could effectively prevent or alleviate pressure ulcer after operation and therefore is worthy of clinical application.

Objective To report immune-reconstruction in two patients with acute radiation sickness due to 60Co radiation accident after stem cell transplantation.Methods Patient “A” and “B” were diagnosed as intestinal form of acute radiation sickness(ARS)and extremely severe degree bone marrow form of ARS,respectively.Peripheral blood stem cell transplantation was successfully performed in these two patients.During their whole disease course,absolute lymphcyte count,neutrophil leukocyte count,T-lymphocyte subsets,natural killer(NK),and immunoglobulin were sequentially determined.Results Immunoglobulin was decreased after irradiation without any recovery tendency after the transplantation.After irradiation,absolute lymphcyte count decreased rapidly,but recovered partially after the transplantation(maintained at 0.5?109/L).Neutrophilic leukocyte count rose rapidly to normal after the transplantation.NK was lowered obviously after irradiation,and it rapidly recovered to normal level after the transplantation,and maintained at a level higher than normal.After irradiation,the proportion of CD4/CD8 showed a transient rise,followed by an abrupt lowering.After the transplantation,it showed a tendency of elevation,but it did not recover to normal.Conclusions The tendency of lowering of immunoglobulin,lymphocyte count,NK cell count,and CD4/CD8 ratio indicate that there is a rapid deterioration of both cellular and humoral immunity after irradiation.Following the homogeneic peripheral blood transplantation,neutrophil count and NK cell count showed a rapid recovery,lymphocyte count and CD4/CD8 ratio also showed a tendency of slow elevation,but there is no sign of recovery of immunoglobulin.The results indicate that there is a faster recovery of cellular immunity.

Objective To investigate the significance of HLA haploidentical peripheral blood stem cell transplantation for the treatment of intestinal form of acute radiation sickness. Methods Patient “A” from Shandong province suffered from a 60 Co radiation accident with a dose of 20-25Gy, and was diagnosed as intestinal form of acute radiation sickness. On the 3rd day after irradiation, total environmental protection (TEP), antibiotics treatment and emergency HLA zygosity with his elder sister were done, and HLA haploidentical peripheral blood stem cell transplantation was performed with a preconditioning regimen of “CTX+ATG+Flu”. The regimen for protecting from GVHD was “CsA/FK506+MMF+CD25+MSC”. Results WBC began to increase on the 17th day after treatment, and WBC recovered to 5.1?109/L on the 19th day, platelet to over 30?109/L, and RCT to normal. Bone marrow image showed hematopoietic recovery of the three cell lineages. Continuously detection of the implantation ratio of donor's cells by STR-PCR, sexual chromosome analysis and HLA zygosity showed stable complete donor-derived chimera. No GVHD was observed. On the 19th days after treatment, chest X-ray films and CT suggested that a mixed bacterial and fungous infection existed in the patient's lungs. The severest skin damage occurred on the 25th day which occupied 14% of whole body surface. The functions of lung, kidney and heart were damaged sequentially. The patient died of multiple organ failure (MOF) 33 days after admission. Conclusion It is the first time to report a successful HLA haploidentical peripheral blood stem cell transplantation for the treatment of intestinal form of acute radiation sickness in China. A successful transplantation might be a key for prolonging the survival period of such a patient.

Objective To report the diagnosis and treatment of an extremely severe bone marrow form of acute radiation sickness complicated with disseminated Trichosporon Asahii in Jining,Shandong province, China.Methods An extremely severe bone marrow form of acute radiation sickness was transfered to our hospital 3 days after the accident on October 24,2004.The patient was performed allogeneic stem cell transplantion from his brother and soon acquired hematogenesis recovery, however, refractory disseminated Trichosporonosis(mainly lung) then occured in the patient.after the hemato-reconstitusion,and gradually aggravate.Result Strong support treatment and high dosage combination of drug therapy were used to combat fungi ,the accumulative dose of Ampghotec (amphotericin B) was 2965mg, the accumulative dose of itraconazole was 4000mg, and the accumulative dose of Caspofungin(concidas) was 3020mg. The refractory disseminated Trichosporon Asahii was once partially controlled, but the radiation injury and infection were still becoming worse even after many kinds of antiinfection drugs, the patient then died of multiple organ failure on d75 after the accident. Conclution The combination of Ampghotec with Caspofungin and Itraconazole in the treatment of disseminated Trichosporon Asahii was effective, no related toxicity occured, which has not been reported before. However, with continuously injury of radiation, we couldn’t cure the Trichosporonosis thoroughly, and the patient finally died of multiple organs failure related with radiation and infection.According to the clinical treatment of the patient, we also acquired the experience that when we resolve the hematogenesis, to promote the immunologic reconstitution and the tissue damage repair, control the whole body radiation damage and infection will be the key point for this kind of patient to survive.

Objective To observe the changes of serum high-sensitivity C-reactive protein (hs-CRP) in 2 patients diagnosed as acute radiation sickness, and to evaluate its clinical significance. Methods Two victims from Shandong province, China were accidentally received a 60 Co irradiation from a dropped 60 Co source in 2004. They were exposed to more than 20Gy (patient A) and 9Gy (patient B) of X-ray irradiation respectively. The patient A was diagnosed as extremely severe bone marrow form of acute radiation sickness (ARS), and patient B was diagnosed as having developed intestinal form of ARS. The two patients successfully got HLA-haploidentical (patient A) and HLA-identical (patient B) peripheral blood stem cell transplantation, and their hematopoiesis recovered, but they cached serious bacterial infection in whole clinical course. Hs-CRP was quantitatively detected by automatically immunoturbidimetric assay. Result The serum level of hs-CRP in the two patients elevated quickly when they suffered from serious bacterial infection, and declined markedly when the infection was controlled effectively. The serum level of hs-CRP also increased slightly when the patients suffered from severe damage on organs or skin function. There existed 3 peak values of hs-CRP level in patient A when kept in the hospital, with a highest value of 188.8mg/L; there existed 4 peak values of hs-CRP level in patient B when kept in the hospital, with the highest value of 377.2mg/L. Conclusion The present results suggested that hs-CRP may be a good indicator to acute radiation sickness complicated with serious bacterial infection, for the hs-CRP levels may fluctuate following the bacterial infection and effectively controlling.

Aim To build a simple experiment model of rat colon injury induced by acetic acid in vitro and to observe the effects of melatonin on this model.Methods On the basis of the establishment of rat colon injury model with acetic acid in vitro,we observed the colon mucosal damage caused by different concentrations of acetic acid(0,0.1%,0.2% and 0.4%) for different time(5,10,15,20,25 and 30 min),determined the content of lactic dehydrogenase(LDH),malondiadehyde(MDA) and mucus in medium,and examined the histological changes of colon mucosa by Alacian Blue method.On the basis of the establishment of this model,the experiment was designed into normal group,model group(acetic acid of 0.4%,time for 30 min) and melatonin treatment group(the final concentration 0.1,1.0、10 mmol?L~(-1)),and the indicators described above were detected to investigate the protective effects of melatonin.Results The LDH content of medium elevated gradually and the colon mucosal epithelial cells were injured by acetic acid in dose-and time-dependent manner,the mucosal edema,colon-wall depth and epithelium lose were observed at the same time,the MDA content of medium enhanced and mucus reduced correspondingly,but no significant change of the mucin expression in mucosal epithelial cells were observed.Pretreatment with melatonin reduced the release of LDH and MDA while promoted the secretion of mucus.Conclusion Colon mucosa of rats was injured by acetic acid in dose-and time-dependent manner in vitro.Acetic acid can impair the mucosal-mucus barrier by oxidating injured cell memberane.Melatonin can strengthen the barrier function of colon mucosa by its anti-oxidant action,attenuate the direct damage on colon mucosa of acetic acid.

Objective To compare the results of mobilization of peripheral stem cells of two different G-CSF dosage schedules in 30 healthy donors. Methods In one group 15 healthy subjects received 5?g/kg filgrastim once daily subcutaneously (SC), while in the other group another 15 individuals received 2.5?g/kg of filgrastim twice daily SC. Peripheral blood stem cells were collected after five days of filgrastim administration, and flow cytometric immunophenotyping was performed for the first harvest. Results The MNC count was 2.93?10 8/kg donor body weight in the 5?g/kg Qd group compared with 4.42?10 8/kg in the 2.5?g/kg bid group (P0.05). Conclusion Administration of filgrastim twice a day at 2.5?g/kg instead of once a day at 5?g/kg is more efficient in mobilizing stem cells without obvious side effect.