Objective To understand the current status of nosocomial infection after renal trans plantation. Methods106 patients after renal transplantation were randomly divided into the laminar flow ward group (54 cases)and the ICU group (52 cases).The nosocomial infection situation of the twogroups was compared.ResultsThe rate of nosocomial infection in the laminar flow ward group was lower than that in the ICU group.The number of bacterial colony in laminar flow wards was less than that in ICU.Conclusions The rate of nosocomial infection in the laminar flow ward was lower than that in the ICU after renal tranaplantation.Patients after renal transplantation should he admitted in laminar flow ward in order to reduce the rate of nosocomial infection.

AIM:To investigate the effect of RNA interference (RNAi)-mediated insulin-like growth factor 1 receptor ( IGF1R) gene silencing on the growth , migration, and invasion of hepatocellular carcinoma cells .METHODS:The most effective siRNA targeting IGF1R gene was designed and screened .After lentiviral expression vector pLVX-shR-NA2-IGF1R carrying the most effective siRNA sequence was constructed , it was transfected into 293T cells and packed into pLVX-shRNA2-IGF1R lentivirus.Huh7 and Hep3B cells were infected with the pLVX-shRNA2-IGF1R lentivirus to screen the positive clone Huh7 cells and Hep3B cells with the lentivirus .These Huh7 cells and Hep3B cells were cultured to ana-lyze the mRNA level of IGF1R, cell proliferation, cell cycle, cell apoptosis, cell migration/invasion, and the protein levels of IGF1R, Ki-67, p-AKT, p-ERK1, Gli1,β-catenin, cyclin D1, p21 and BCL-XL.RESULTS:The mRNA expression of IGF1R in Huh7 cells and Hep3B cells with pLVX-shRNA2-IGF1R lentivirus was significantly reduced .The proliferation of these cells was remarkably inhibited , and the number in G 1 phase was increased significantly .The percentages of apop-totic cells were increased markedly , and the number of cell migration/invasion was decreased markedly .The protein levels of IGF1R, Ki-67, p-AKT, p-ERK1, Gli1,β-catenin, cyclin D1, p21 and BCL-XL were decreased significantly compared with the blank control group and negative control group .CONCLUSION:The RNAi-mediated IGF1R gene silencing sig-nificantly suppresses the growth and the malignant biological characteristics of Huh 7 cells and Hep3B cells, which may be involved in the reduced protein levels of the above genes induced by down -regulation of IGF1R expression.

Objective To compare the effects of patient's tolerance to laryngeal mask airway (LMA) and tracheal tube (TT) on the appropriate level of sevoflurane anesthesia.Methods Eighty ASA Ⅰ or Ⅱ patients aged 30-60 yr weighing 50-70 kg undergoing elective thyroid or breast surgery were randomly divided into 2 groups (n=40 each):LMA group and TT group.Anesthesia wag induced with propofol 1.6mg/kg,fentanyl 3μg/kg and recuronium 0.6mg/kg.LMA or tracheal tube was inserted,and the patients were mechanically ventilated.Anesthesia was maintained with inhalation of 1.5%-3.0% sevoflurane and 50% N2O in O2 in group LMA,and with 2.5%-5.0% sevoflurane and 50% N2O in O2 in group TT.The flow of O2 and N2O was 0.7-1.0L/min,and the concentration of sevofluranee was adjusted to maintain AAI at 15-25.ECG,HR,MAP,SpO2,PETCO2,AEP and end-tidal sevoflurane concentration were continuonsly monitored.The end-tidal sevoflurane concentration was recorded at 1,5 and 10 min after LMA/TT was placed (T1-3),at 1h after skin incision (T4) and at the end of operation before removal of LMA or extubation (T5).The recovery time of consciousness,adverse cardiovascular events and adverse reactions were recorded.Results The end-tidal sevoflurane concentration was significantly lower,the recovery time of consciousness and removal of LMA or extubation time were shorter,and the incidence of adverse cardiovascular events and adverse reactions was lower in LMA group than in TT group.Conclusion At the same depth of anesthesia (AAI 15-25),sevoflurane concentration is significantly lower in LMA group than in TT group,with fewer complications and smaller cardiovascular reaction.

BACKGROUND:Bone marrow mesenchymal stem cels (BMSCs) have the ability of multi-directional differentiation. Polygonatum sibiricum polysaccharide can promote osteogenetic differentiation of mouse BMSCs by activating Wnt/β-catenin signaling pathway, which is expected to become a new drug for the treatment of osteoporosis.
OBJECTIVE:To investigate the effects of Polygonatum sibiricum polysaccharide on Wnt/β-catenin signaling pathway in the osteogenic differentiation of mouse BMSCs.
METHODS:The mouse BMSCs were cultured and induced in osteoblast medium containing final concentrations (5, 10, 25, 50mg/L) of Polygonatum sibiricum polysaccharide. The mouse BMSCs treated without Polygonatum sibiricum polysaccharide was set as the negative control group. The morphological changes of cels were observed under an inverted microscope. Alkaline phosphatase (ALP) activity assay was performed by PNPP method. The mineralization nodules were observed and stained with alizarin red S and the number and area fraction were recorded under an inverted microscope. The mRNA expressions of osteogenesis-related genes ALP, Runx2, and osteocalcin were evaluated by quantitative real-time PCR (qRT-PCR). qRT-PCR and western blot were used to determine the expression level of β-catenin. The downstream β-catenin/TCF transcriptional activity was evaluated with the Dual-Luciferase Reporter Assay System.
RESULTS AND CONCLUSION: Compared with the control group, polygonatum sibiricum polysaccharide significantly enhanced the alkaline phosphatase activity, the mineralization ability of cels, and the mRNA expression of ALP, Runx2 and osteocalcin in the differentiated BMSCs in a dose dependent manner (P <0.05). After induction, the mRNA expression of β-catenin was the highest on the 3rd day. Polygonatum sibiricum polysaccharide significantly increased the expression of β-catenin (P < 0.05) in the process of promoting the differentiation of BMSCs into osteoblasts, and also promoted the high-level expression of luciferase reporter gene (TOPFlash) which contains wild type TCF binding sites (P < 0.05). These results demonstrate that Polygonatum sibiricum polysaccharide can promote the osteoblast differentiation of mouse BMSCs by activating the Wnt/β-catenin signaling pathway.

Objective:To investigate the effects of total flavonoids from Cycas Revolute on expression of vascular endothelial growth factor (VEGF),basic fibroblast growth factor (bFGF),Hypoxia inducible factor-1α (HIF-1α) and nuclear factor-κB(NF-κB) in model mice of Lewis lung cancer.Methods: The expressions of VEGF,bFGF,HIF-1α and NF-κB in tumor tissues were detected by immunohistochemistry and Western blot.The expression of VEGF,VEGF and NF-κB in tumor tissues were detected by fluorescent quantitative PCR.BFGF,HIF-1α and NF-κB mRNA were detected by immunohistochemistry.Results: The results of immunohis-tochemistry,Western blot and Real-time PCR showed that the results were basically the same,compared with model group,the expression of VEGF,bFGF,HIF-1α,NF-κB mRNA and the expression of VEGF,bFGF,HIF-1α and NF-κB were decreased,the difference was highly significant (P<0.05).Conclusion: The mechanism of total flavonoids from Cycas Revolute in the treatment of lung cancer may be through inhibition of the expression of VEGF,bFGF,HIF-1α,NF-κB in invasion and metastasis,and further inhibit the expression of VEGF,bFGF,HIF-1α and NF-κB in invasion and metastasis-related proteins,thus play a role of anti-lung cancer invasion and metastasis.

Objective To investigate abnormal glucose metablism of patients with stroke in hospital in Foshan in order to design more reasonable diagnostic and treatment plans.Methods Our study was conducted in 557 patients with stroke who were in hospital in Neurology Department of the First Hospital of Foshan from June 2007 to April 2008 (all were consistent with diagnostic criteria of stroke).Sex,age,history of diabetes mellitus and smoking,height,weight,blood pressure,waist circumference,random blood glucose,fasting blood glucose and oral glucose tolerance test of all were recorded when they were in hospital Results All 368 individuals (66.1%) had abnormal blood glucose,including 185 cases (33.2%) of diabetes,183 cases (32.9%) of impaired glucose tolerance and 189 cases (33.9%) of normal sugar tolerance.Furthermore,about 89.1% (189/368) cases with impaired glucose regulation and 14.1% (26/185) cases of diabetes were misdiagnosed if they did not undergo oral glucose tolerance test.Conclusions Most of patients with stroke in Foshan have impaired glucose regulation,who have been diagnosed by oral glucose tolerance test,in favour of us to better design more reasonable diagnostic and treatment plans.

Objective To observe the different cerebral activations between pre-administration and post-administration of tryptophan-depleted amino acid mixture (TRP-)/balanced amino acid mixture (BAL) in healthy volunteers through functional magnetic resonance imaging (fMRI) when they received electrical stimulation at the same time. Furthermore, the effects of 5-hydroxytryptamine (5-HT) were explored in pain modulation network. Methods Two-phase crossover design was adopted. Six right-handed healthy volunteers participated in the experiment. TRP- and BAL were administered to each participant according to the Young's method. Volunteers were scanned under fMRI with or without administration of TRP- or BAL when receiving electrical stimulation simultaneously. Analysis of functional neuroimages (AFNI) software was used to show the different activations in the human brain between pre- and post-administration of TRP-/BAL. Then all the results were analyzed by SPSS 14.0. Results (1) Bilateral primary somatosensory cortex (SⅠ) and secondary somatosensory cortex (SⅡ) were activated during pre-administration and post-administration of TRP-, but the activated volumes of bilateral SⅠ and SⅡ during post-administration of TRP- were found significantly larger than that during pre-administration of TRP (P＜0.05). (2) All the activated regions showed no difference between pre- and post-admini-stration of BAL. (3) There were significant differences of pain threshold between pre- and post-admini-stration of TRP- (P＜0.01), which meant that pain threshold reduced remarkably after TRP- administration, while it showed no difference between pre- and post-administration of BAL (P＞0.05). Conclusion 5-HT plays an important role in pain modulation in the central nervous system, TRP- causes acute tryptophan depletion (ATD) through reducing the level of 5-HT in the human brain, which can induce the decrease of volunteers' pain threshold. The activated volumes of bilateral SⅠ and SⅡ display signi-ficant difference between pre- and post-administration of TRP-, suggesting these brain areas may not only involve in the 5-HT related activities but in pain modulation network as well.

Objective To detect differentially expressed genes between human normal skin and photoaging skin, and to investigate the molecular and biological mechanisms of human skin photoaging at transcriptional level. Methods Full-thickness skin specimens were obtained during full-face rhytidectomy from sun-exposed (anterior ear skin) and sun-protected (retroauricular skin) sites of 6 patients with facial photoaging from 2007 to 2008. Genomic microarray analysis was conducted to identify differentially expressed genes between the two groups of specimens followed by gene-cluster analysis. Results The normalization of microarray data showed that the number of differentially expressed genes was 2163 between skin samples from sun-exposed and sun-protected sites in one patient, significantly higher than that in the other 5 patients (less than 200);therefore, the data from the patient with 2163 differentially expressed genes were excluded from further analysis.Totally, 172 differentially expressed genes were identified with Beadarray chip, including 99 up-regulated genes and 73 down-regulated genes. Based on Genebank research, 118 functionally classified genes werefound, which were associated with a series of biological processes, including cell adhesion, receptor regulation,signal transduction, metabolism, and so on. Conclusions There are a lot of differentially expressed genes between human photoaging skin and normal skin. Rhytidectomy may be associated with the differential expression of skin photoaging-related genes.

Objective:To analyze a Risk Scale for Emergence Agitation After General Anesthesia in Children (the EA risk scale) into simplified Chinese and evaluate the reliability and validity in children with strabismus correction surgery.Methods:After obtaining the authorization of the original author, the English version of the EA risk scale was translated, translated back and culturally debugged to form the Chinese version of the EA risk scale. Then 279 children with strabismus correction surgery were selected from a tertiary hospital of ophthalmology in Tianjin and were investigated to validate the scale.Results:The correlation coefficients of each item and the total score of the scale were respectively 0.768 (item 1) ,0.717(item 2), 0.676(item 3), 0.634(item 4) (all P < 0.01). Content validity index of the scale was 0.920, and each item was 0.80-1.00. One factors including 4 items were identified using exploratory factor analysis, accounting for 62.052% of the total variance. The optimal cut-off value for the EA risk in children was 10, with the AUG was 0.816, specificity of 0.704, and sensitivity of 0.839. The Cronbach α coefficient for the total scale was 0.819, and the intraclass correlation coefficient value between the scorers was 0.835. Conclusion:The Chinese version of the EA risk scale has good reliability and validity. The items are concise, clear, and easy to understand. It is suitable for clinical departments as a preliminary screening tool to identify emergence agitation after general anesthesia on children with strabismus correction surgery and to assess the risk of its occurrence.

Objective To discuss the clinic characters of clear cell papillary renal cell carcinoma ( CCPRCC) and the efficacy of related laparoscopic surgery.Methods From October 2013 to December 2015, 4 cases were treated as CCPRCC including 3 male and 1 female.Their age ranged from 34 to 67 years old ( mean 53 years old) .The duration of illness ranged from 7 days to 3 months, which the average duration was 1.5 months.The location of tumor included left side in 2 cases and right side in other 2 cases.All tumors were found incidentally, without symptoms or positive sign.Ultrasound showed that 2 cases were solid, and the other 2 cases were cystic solid with low, high or mixed echo and rich blood flow signals.The tumors were enhanced in CT arterial phase, and calcification showed in one case.MRI showed heterogeneous signal.The mean size of tumor was 3.0 cm,ranging 2.3 to 4.5 cm.After preoperative examination, all cases underwent retroperitoneal laparoscopic partial nephrectomy.During the operation, 2 cases were confirmed as cystic solid tumors, and the other 2 cases were solid tumors.Renal artery and renal mass were dissociated , then the artery was blocked.The tumor was complete resected, and kidney was sutured. Results All surgery was performed successfully without conversion.The operation time was 137-191 min (average 157 min).The blood loss was 10-100 ml (average 45 ml) without blood transfusion.The warm ischemia time was 15-35 min ( mean 22 min) .The postoperative hospitalization time stay 6-8 d ( average 7 d).Pathologic report was CCPRCC, including 3 cases of WHO/ISUP grade 1, and 1 case of WHO/ISUP grade 2.2 cases were cystic solid tumor, and other 2 cases were solid tumor.Bland-appearing tubules and occasional small papillae, and uniform small nuclei are arranged in a linear manner away from the basal aspect of the tubules in microscope.Immunohistochemistry showed that CA IX, CK7, 34 E12 were positive, but CD10 , P504S and CD117 were negative.The mean duration of postoperative follow-up was 14 months, ranging 4 to 30 months.No recurrence was found in those patients.Patients were followed up for 4-30 months ( average 14 months) without recurrence or metastasis.Conclusions CCPRCC is a rare subtype of renal tumor, which mainly diagnosed by pathological diagnosis . Retroperitoneal laparoscopic partial nephrectomy is an effective method for the treatment with good prognosis.