Objective To investigate the immune disorder in elderly patients with severe ischemic stroke and to explore whether a new type of diabetes-specific enteral nutrition formula can regulate the immune function of these patients.Methods In the randomized controlled prospective study,90 patients aged 60-80 years with acute ischemic stroke and NIHSS score more than 10 and dysphagia were randomized to two groups:receiving a new type(Group A) of,versus traditional(Group B) diabetes-specific enteral nutrition.30 Patients aged 60-80 years with acute ischemic stroke and NIHSS score ≥10 without dysphagia were enrolled as control(Group C).The immune function was observed,and the nutritional status and immunological function were compared between two different enteral nutrition groups at 7 days of treatment.Results After 7 day follow-up,the serum lipid stats significantly ameliorated in group A.An obvious suppression of immune state was observed in severe acute ischemic patients at onset of 7 days.At day 7 of treatment,the percentage of CD3+ T cells in group A was(69.25±9.93)％ after treatment vs.(63.36±7.79)％ at baseline(P＜0.001),and CD3 +CD4+T cells was(45.79±9.47)％ after treatment vs.(36.12±9.15)％ at baseline(P＜0.001),as well as CD4+/CD8+ cells were(2.27±1.40)％ after treatment vs.(1.70±0.82)％ at baseline(P=0.001).At 7 days of treatment,the percentage of CD3+ T cells was higher in group A (69.25 ±9.93) ％ than in group B(63.07± 9.47) ％ (P＜0.001),and the percentage of CD3 + CD4 cells was higher in group A(45.79 ± 9.47) ％ than in group B(41.32 ± 8.89) ％ (P=0.024).Conclusions Enteral nutrition preparations can provide sufficient energy support in the acute ischemic stroke.Immunosuppressive state exists in patients with acute phase of severe ischemic stroke.The new type of diabetic enteral nutrition formula can significantly improve immunosuppressive state in patients with acute severe stroke.

Objective The international multidisciplinary lung adenocarcinoma classification was published by IASLC/ ATS/ERS in 2011.This study aimed to explore the clinicopathologic characteristics of lung adenocarcinoma based on IASLC/ATS/ERS classification and validate its clinical diagnostic and therapeutic value.Methods 2 056 cases of surgical resection from Shanghai Chest Hospital were classified according to the new classification and clinical information were retrospectively reviewed.The clinicopathologic characteristics based on new classification were analyzed statistically.Results Our data indicated that women were in high risk of lung adenocarcinoma; The average age of onset was 59-year-old; the female patients were younger than the male patients (58.7 years vs 60.2 years,P ＜ 0.01) ; Average tumor diameter was 2.6 centimeter; right lung was more popular than left and superior lobe than the inferior one.Acinar predominant subtype and papillary predominant subtype were frequently observed.Micropapillary predominant subtype and solid predominant subtype were identified to be more aggressive than other histopathologic subtypes.Most patients were classified as stage Ⅰ(71.7％),which were predominantly stage Ⅰa (53.1％).Conclusion The new classification is superior to reflect the clinicopathologic characteristics of lung adenocarcinoma and satisfy clinical needs,especially contributing to change and update the surgical strategy of early stage lung adenocarcinoma.

Objective To study the radiosensitivity enhancement effects of recombinant adenovirus mediated retinoblastoma 94 gene on the growth of esophageal carcinoma cells EC109.Methods EC109cells was transfected with recombinant Rb94 gene adenovirus and irradiated by 137Cs γ-rays.The cohorts were divided into groups as blank control,Ad-LacZ,Ad-Rb94,radiation and Ad-Rb94 combined with radiation.Cell inhibition ratio,cell cycle and expression of retinoblastoma protein of EC109 cells were analyzed.Results The growth of EC109 cells transfected with Ad-Rb94,radiation and Ad-Rb94 combined with radiation group was all inhibited.The group of Ad-Rb94 combined with radiation resulted in greater inhibition of cells growth compared with Ad-Rb94 group and radiation group ( F =23.31,P ＜0.05 ).Cells of G2 phases of EC109 cancinoma cells for Ad-Rb94 combined with radiation group were the highest,which was 50％.The combination of Ad-Rb94 and radiation group resulted in the greatest expression of retinoblastoma protein,which reached 71％,significantly higher than Ad-Rb94 infection and radiation groups ( x2 =8.31,6.73,P ＜ 0.05 ).Conclusions Retinoblastoma 94 gene combined with ionizing radiation can enhance the radiation sensitivity of EC109 cells.

Objective To study the diagnosis and treatment of synchronous gastric cancer and gastric stromal tumor in 18 cases. Methods Clinical data of 18 cases of synchronous occurrence of gastric cancer and gastric stromal tumor from January 1996 to December 2009 were analyzed retrospectively.Results Clinical features of all cases were atypical. There was 1 case diagnosed preoperatively, 3 cases diagnosed intraoperatively and 14 cases diagnosed postoperatively. The mean size of gastric cancer and gastric stromal tumor was (3.3±2.3) cm and (0.9 ±0.5) cm respectively. There were 16 cases of gastric stromal tumor in low risk of malignance and 2 cases in moderate risk of malignance. All cases were operated without complications and the 1-year, 3-year and 5-year overall survival rate was 88.2%, 63.2% and 36. 1% respectively. Conclusions Clinical features of synchronous occurrence of gastric cancer and gastric stromal tumor are atypical, in this series most gastric stromal tumors are in early stage and of low risk of malignance. The prognosis of patients with synchronous occurrence of gastric cancer and gastric stromal tumor mainly depends on gastric cancer.

Objective To evaluate the early diagnostic value of circulating microRNA-1 (miR-1) on acute myocardial infarction (AMI). Methods A prospective cohort study was conducted. The patients with chest pain admitted to the Second People's Hospital of Wuxi from November 2012 to June 2015 were enrolled. According to AMI diagnostic criteria, the patients were divided into AMI group and non-AMI group, and healthy individuals during the same period were served as heath controls. The venous samples of the onset patients were collected within 3 hours after admission. The plasma miR-1 was determined by real-time quantitative reverse transcription-polymerase chain reaction (RT-PCR), and the levels of plasma cardiac troponin I (cTnI) and MB isoenzyme of creatine kinase (CK-MB) were measured by electrochemiluminescence. The correlation between plasma miR-1 and cTnI as well as CK-MB was performed by Spearman analysis. The early diagnostic performance of plasma miR-1, cTnI, and CK-MB for AMI was estimated by receiver operating characteristic (ROC) curve analysis. Results There were 127 patients in AMI group, and 107 in non-AMI group, including 82 patients with angina pectoris, 2 with pulmonary embolism, 3 with aortic dissection, 2 with acute pericarditis, 3 with myocarditis, 13 with acute heart failure, and 2 with peptic ulcer. Ninety volunteers were served as healthy controls. There was no difference in clinical characteristics including gender and hyperlipidemia between AMI group and non-AMI group. The expressions of plasma miR-1, cTnI and CK-MB were significantly increased in AMI patients as compared with those of the healthy controls [miR-1 (2-ΔΔCt): 4.32±2.60 vs. 1.44±0.75 and 0.98±0.18, cTnI (μg/L): 3.23 (0.63, 10.70) vs. 0.02 (0.00, 0.17) and 0.00 (0.00, 0.00), CK-MB (U/L): 32.40 (14.20, 95.40) vs. 14.40 (11.20, 17.10) and 8.90 (8.28, 9.50), all P < 0.01]. The expression of plasma miR-1 had a significantly positive correlation with cTnI and CK-MB in AMI patients (r1 = 0.395, r2 = 0.490, both P < 0.000). It was demonstrated by ROC curve analysis that the area under ROC curve (AUC) for the diagnostic value of miR-1 on AMI was 0.905 [95% confidence interval (95%CI) = 0.860-0.950, P = 0.000], the sensitivity was 86.6%, and the specificity was 95.4%; the AUC for cTnI was 0.908 (95%CI = 0.870-0.946, P = 0.000), the sensitivity was 81.9%, and the specificity was 95.9%; the AUC for CK-MB was 0.795 (95%CI = 0.736-0.854, P = 0.000), the sensitivity was 63.0%, and the specificity was 92.9%. Conclusions Plasma miR-1 has the capacity in early diagnosis of AMI, superior to CK-MB, and equal to cTnI. It can provide additional diagnostic information beyond cTnI. The diagnostic accuracy for early AMI can be improved with the combination of plasma miR-1 and cTnI.

Objective To study the dynamic air quality of clean ICU so as to provide evidence for hospital infection management in clean ICU.Methods Flat natural sedimentation method,six percussive determination of planktonic bacteria and dust particle counting method were used to get samples at three different time periods,different regions for four consecutive days in 100 000 air clean ICU.Results The counts of 0.5μm,5 μm dust particles at different time ( morning,afternoon,evening) were significantly different( F =78.85,89.94 ;P ＜ 0.01 ) and the monitor results of different regions( single rooms,double rooms,hall) were significantly different( F =20.21,16.17; P ＜ 0.01 ).The number of planktonic bacteria at different time (morning,afternoon,evening) were significant different(F =14.21,P ＜0.01 ),while there was no difference in different regions ( single rooms,double rooms,hall) ( F =0.98,P ＞ 0.05 ).There was significant difference of depositing bacterial counts at different time and regions( F =5.68,17.05,P ＜ 0.01 ) and there was a positively correlation between planktonic bacterial counts and depositing bacterial counts ( r =0.612,P ＜ 0.05 ).Each level of bacterial average counts of six percussive samplers measured was significantly different (F =8.35,P ＜ 0.01 ),with fifth grade most and fourth grade following.Conclusions Air quality of ICU is not good especially when making ward round; Less than 5 μm particles dominant; the counts of planktonic bacteria and depositing bacteria is increasing when dust particles counts increase,and the air quality of single rooms and double rooms is better than that of the hall.

Objective To investigate the effect of employers' respirator and hat wearing method on class 100 000 clean ICU air quality,in order to provide basis for hospital infection management in ICU.Methods For the control group,the first day (d1) and third day (d3),every employer was demanded to wear a respirator and a hat before entering the ICU.For the observation group,the second day (d2) and forth day (d4),employers were demanded not to wear any respirator or hat.During all four days,they must wear respirator and hat before any nursing operation.Air quality was sampled by class 100 000 clean air using flat panel natural settlement method,dust planktonic bacteria method and particle counting method.The amount of dust,plankton bacterium and descending bacteria were monitored for 4 days and compared between two groups.Results The difference of 0.5 μm dust particles in ICU between the control group and the observation group were statistically significant ( F =40.95,P ＜ 0.05 ).As to 5.0 μm dust particles,there was no significant difference between two groups (F =2.86,P ＞ 0.05 ).0.5 μm dust particles in ICU was lower at d1 and d3,and the difference was statistically significant ( F =40.95,P ＜ 0.05).The number of 0.5 μm dust particles had significant difference between different periods of a day:the morning time segmcnt＞ evening ＞ afternoon ( F =80.72,P ＜0.05 ).The number of 0.5 μm dust particles in the observation group was higher than that in the control group,and the difference was statistically significant ( F =68.84,P ＜ 0.05 ).The number of 5.0 μm dust particles had significant difference between different time periods of a day:the morning time segment ＞afternoon ＞ evening ( F =98.17,P ＜ 0.01 ).The number of dust particles at hall was larger than that at single and double rooms (P ＜0.01 ),but the number had no difference between single room and double room.More subsidence bacteria and floatingbacteria was detected during dl and d3 in the control group,and the difference was statistically significant ( P ＜ 0.01 ).Besides,the difference of the number of subsidence bacteria and floating bacteria in ICU between different time periods was also statistically significant ( P ＜ 0.05 ).Conclusions The number of 0.5 μm dust particles in ICU is smaller when workers wear hats and respirators,while the number of 5.0 μm dust particles remains the same.Under the other conditions remain unchanged,the mainly cause of number increase of dusts,planktonic bacteria and sedimentation bacteria in the morning rounds is the increasing number of working staff.ICU staff has no apparent effect on dynamic class 100 000 clean ICU air quality whether they wear respirators or hats.This kind of behavior is not the key management elements in clean ICU environment.

In this study, the inhibitory effect of jujuboside A (JuA) on a penicillin sodium (Na-PCN) induced hyperactivity model was investigated. Cortical EEG (electroencephalogram) and the concentration of hippocampal Glutamate (Glu) were monitored simultaneously in vivo as indicators of rat's excitatory state. Power spectral density (PSD) and gravity frequency of PSD were calculated. JuA (0.05 g/L and 0.1 g/L) inhibited the EEG excitation effect caused by Na-PCN by increasing the power of delta1 and delta2 bands (P<0.01 vs model) and lowering the gravity frequency of PSD (P<0.01 vs model). JuA also remarkably reduced the Glu elevation induced by Na-PCN (P<0.05 vs model). Diazepam also depressed Glu concentration and lowered the gravity frequency, but it showed a different EEG pattern in increased beta2-activity (P<0.01 vs model). EEG excitation caused by Na-PCN correlated with Glu elevation during the first hour. Neurophysiological inhibitory effects of JuA and diazepam were more persistent than their Glu inhibitory effects.
Animals ; Behavior, Animal ; drug effects ; Diazepam ; pharmacology ; Electroencephalography ; Glutamic Acid ; metabolism ; Hippocampus ; drug effects ; metabolism ; physiopathology ; Hyperkinesis ; drug therapy ; physiopathology ; Male ; Penicillins ; pharmacology ; Rats ; Rats, Sprague-Dawley ; Saponins ; pharmacology

Objective To investigate expressions and correlations of TLR2,TLR4,TLR7 and TLR9 in eosinophil-enriched cell populations from patients with allergic rhinitis (AR),and elucidate their roles in AR. Methods Peripheral venous blood samples were collected from healthy controls (HCs)and AR patients,and then incubated with crude extracts of Artemisia pollen,dust mite,and Platanus pollen,respectively.Levels of TLR2 , TLR4,TLR7 and TLR9 in blood eosinophil-enriched cells were detected by flow cytometry.Correlations between TLR2+,TLR4+,TLR7+and TLR9+eosinophils were analyzed by SPSS.Results Levels of TLR2+eosinophils from patients with AR were reduced by 4%,mean fluorescence intensity (MFI)of TLR4+eosinophil was elevated by 20%,and TLR7+eosinophils increased up to 4.8 folds compared with HCs when cultured with medium only (P＜0.05).Artemisia pollen extracts induced approximately 7 .8 % of increase in TLR2+eosinophils from AR patients.In addition,correlations between TLR2+and TLR4+eosinophils,TLR2+and TLR7+eosinophils,and TLR7+and TLR9+eosinophils were -0.670 (P＜0.01),-0.430 (P＜0.05)and 0.446 (P＜0.05),respectively. However,allergens had few effects on TLR2,TLR4,TLR7 and TLR9 expressions in HCs.Conclusion Eosinophil-derived TLR2 ,TLR4 and TLR7 are likely to play a key role in AR.TLR2 ,TLR4 and TLR7 might become the potential targets for AR treatment.

OBJECTIVETo explore safety, indications and advantages of mapping and ablation of arrhythmia in children guided by Carto and Ensite system.

METHODSGuided by Carto system, radiofrequency catheter ablation (RFCA) was performed on 8 pediatric patients with tachycardia whose mean age was (6.2 + or - 1.7) years, mean weight was (18.0 + or - 2.0) kg. Guided by Ensite system, RFCA was performed on 10 pediatric patients with arrhythmia, 8 of them were ablated guided by Ensite Array system: 6 cases with premature ventricular contractions (PVCs), 2 cases with right atrial tachycardia, their mean age was (11.3 + or - 1.2) years, and mean weight (40.0 + or - 5.0) kg. The other two cases with W-P-W syndrome were ablated guided by Ensite Navx system.

RESULTGuided by Carto system, 8 cases were successfully mapped and ablated: 6 cases had incision atrial tachycardia, 1 case had left atrial tachycardia and 1 case had right atrial tachycardia. In 1 case with incision atrial tachycardia the condition recurred after 3 months, and was ablated again successfully. Guided by Ensite Array system, 6 cases with PVCs (in 2 originating from the right ventricular inflow tract and in 4 originating from the right ventricular outflow tract) and 2 cases with right atrial tachycardia were successfully mapped and ablated, PVCs of the first 6 cases were reduced from (32 333 + or - 4509) 24 h to (0-4)/24 h after ablation. In 1 case with automatic atrial tachycardia, mapping could not be done by Ensite Array system, because P wave could not be identified from T wave. Single bolus of adenosine 20 mg was given within 30 s to let ventricles stop for 2 s (cardio-ventricular pacing standby) until T wave vanished, mapping and ablation were operated again successfully, but another atrial tachycardia occurred 1 day later. Guided by Ensite Navx system, 2 cases with W-P-W syndrome were successfully ablated, operation under X-rays lasted for 8 and 10 min. In none of the 9 patients the disease recurred after follow-up for 6 months.

CONCLUSIONCarto system is suitable for mapping and ablation in pediatric patients with continuous tachycardia, especially with incision atrial tachycardia; Ensite Array system fits children older than 10 years with right heart discontinuous arrhythmia; and Ensite NavX system can set up model and display endocardial anatomic structure quickly. Compared with two-dimensional mapping system, the three-dimensional mapping system (Carto and Ensite) can display the origin of arrhythmia and activation sequence clearly, decrease difficulty of operation efficiently and diminish operation time under X-ray.

Arrhythmias, Cardiac ; physiopathology ; surgery ; Catheter Ablation ; methods ; Child ; Child, Preschool ; Electrophysiologic Techniques, Cardiac ; methods ; Humans ; Imaging, Three-Dimensional ; Treatment Outcome