Objective To evaluate the stimulative role of the enhanced recovery program after surgery (ERAS) protocol in patients undergoing radical resection for gastric cancer.Methods A total of 102 consecutive patients undergoing elective gastric resection were included in either the ERAS (n =35,received ERAS perioperative treatment from June 2013 to June 2014) or the control group (n =67,received conventional perioperative treatment from June 2011 to June 2013).Outcomes related to nutrition index,stress index,and recovery index were measured.Results The nutritional index of patients (total lymphocyte count,serum albumin and prealbumin) in the ERAS group was improved on postoperative day (POD) 1 compared with that in the control group [(1.25±0.65) × 109/L vs (1.09±0.71) × 109/L,(36.4±5.2) g/L vs (31.3±4.1) g/L,(0.19±0.08) g/L vs (0.17±0.05) g/L,P ＜ 0.05,respectively].The level of negative nitrogen balance on POD 1 in the ERAS group was slightly lower than that in the control group (P ＞ 0.05),and the level of negative nitrogen balance on POD 7 in the ERAS group was higher than that in the control group (-0.93±2.17 vs -3.87±4.45,P ＜ 0.05).The postoperative cortisol level in the control group was elevated on both POD 1 (P ＜ 0.05) and POD 7 (P ＜ 0.05) compared to the preoperative level [(5.06±1.87) mg/L vs (3.60±1.5) mg/L],(5.15±1.33) mg/L vs (3.60±1.51) mg/L,P ＜ 0.05,respectively].However,the cortisol level was not increased until POD 7 in the ERAS group [(5.08±1.18) mg/L vs (3.20±1.43) mg/L,P ＜ 0.05].The level of IL-6 was elevated in postoperative period compared to preoperative period both in two groups (P ＜ 0.05).And the level of IFN-γin the ERAS group on POD 1 was reduced compared to the preoperative level (P ＜ 0.05).Whether in preoperative or postoperative,the level of IL-1β and TNF-α showed no statistical significance change.In addition,the postoperative recovery conditions (day of oral all-liquid recovery,first day of defecation,hospital stay,maximum pain on visual analogue scale) in the ERAS group were better than those in the control group (P ＜ 0.05).The incidence rates of complications between the two groups were 13.4 ％ (9/67) and 17.1％ (6/35) respectively (P ＞ 0.05).Conclusion ERAS protocol can alleviate surgical stress response and accelerate postoperative recovery without compromising patients' safety.

Objective To investigate the pollution status of heating-ventilating-air conditioning(HVAC) systems in Shenyang public place. Methods The dust samples were collected and examined from the HVAC system in twelve hotels and ten shopping malls in Shenyang in March-June, 2004. Results Among HVAC systems in Shenyang public buildings, 71.51% of them were moderately polluted and 27.37% were seriously polluted. The rate of serious pollution of hotels was higher than that of shopping malls, the volume of dust in the air pipes in hotels was lager, but the amount of bacteria and fungi was less than that of shopping malls. Conclusion The HVAC systems of Shenyang public buildings have been seriously polluted.

0.05).The lobular sign was markedly more in peripheral pulmonary squamous carcinoma than in other histopathological group(P0.05).Conclusion There are certain relation between spiral CT appearance and histopathology in peripheral pulmonary carcinoma.CT appearance may be one of the evidence in diagnosing the histopathological type in peripheral pulmonary carcinoma.

Objective To study the factors related to the infection induced by internal jugular catheterization and femoral vein catheterization.Methods Bacterial culture was conducted for samples collected from the outer section of catheters,the skin around the catheters and the puncture sites during different stages of the catheterization as well as the cathetor blood before removal and the catheter tips after removal in 75 cages after deep vein catheterization from March to August,2008.Statistic analysis was made on positive results.Results The positive rate of the bacterial culture in femoral vein group was obviously higher than the internal jugular group.Rank correlation analysis indicated:the positive rate of the bacterial culture for the puncture site was highly correlated with that for the outer section of the catheters and the skin around the catheters;and the catheter blood(at the tip)was in low positive correlation with that ofthe puncture site and the skin around catheters.And the positive rate apparently rose on the 3～7th days after the catheterization.Conclusions The catheter-related infection after CVC was closely correlated with the outer section of the catheters,the bacterial pollution to the akin around the catheters and different stages of the catheterization in addition to catheterizing location.It is suggested that nurses should choose proper catheterizing position according to different purposes while paying attention to the nursing work for the puncturing part and during the stage with hish risk of infection so as to reduce the occurrence of catheter-related infection.

The aim of the present study is to investigate the effects of sequoyitol (Seq) on expression of eNOS and NOX4 in aortas of type 2 diabetic rats. Type 2 diabetic rats induced by high fat and high sugar diet and low dose of streptozotocin (STZ, 35 mg x kg(-1)) and were administered Seq (12.5, 25 and 50 mg x kg(-1) x d(-1)) for 6 weeks. The fasting blood glucose (FBG) and body weight were tested. Acetylcholine (Ach) induced endothelium-dependent relaxation and sodium nitroprusside (SNP) induced endothelium-independent relaxation were measured in aortas for estimating endothelial function. Aortic morphological change was observed with HE staining. The level of serum insulin was measured by radioimmunoassay. The total antioxidative capacity (T-AOC), malondialdehyde (MDA) and NO levels in aortas were determined according to the manufacturer's instructions. In addition, the expressions of eNOS and NOX4 in aortas were measured by immunohistochemisty, real-time PCR or Western blotting. The results showed that Seq significantly decreased FBG and insulin resistance, and improved aortic endothelium-dependent vasorelaxation function. The expressions of NOX4 and MDA content were obviously decreased, while the expression of eNOS, the levels of NO and T-AOC increased significantly in aortas of diabetic rats with Seq treatment. In conclusion, Seq protects against aortic endothelial dysfunction of type 2 diabetic rats through down-regulating expression of NOX4 and up-regulating eNOS expression.

Objective:To study the expression of matrix metalloproteinase-2 (MMP-2) and tissue inhibitor of metalloproteinase-2 (TIMP-2) in hilar cholangiocarcinoma.To discuss the relationship of MMP-2 and TIMP-2 expression with the metastasis and prognosis of hilar cholangiocarcinoma.Methods:Immunohistochemical S-P method was used in the examination of MMP-2 and TIMP-2 expression in 78 hilar cholangiocarcinoma.The relationships of MMP-2 and TIMP-2 expression with the pathological differentiation,metastasis and prognosis were analyzed.Results:The positive rate of MMP-2 expression was 72% ,and that of TIMP-2 was 76%.According to Ridit analysis,the degree of MMP-2 expression were correlated with the pathologic differentiation and lymph-node metastasis of hilar cholangiocarcinoma.The high expression of MMP-2 existed in the low pathologic differentiation and the high rate of lymph-node metastasis of hilar cholangiocarcinoma.The high expression of TIMP-2 existed in the high pathologic differentiation and the low rate of lymph node metastasis of hilar cholangiocarcinoma. MMP-2 and TIMP-2 expression had a significance correlation(r=0.708,P

Purpose To investigate the expression of CD147,MMP-9 and VEGF and their relationships in lung adenocarcinoma.Methods The expression of CD147,MMP-9 and VEGF proteins was examined in 90 lung adenocarcinoma tissues by SP immunohistochemical method.The positive unit (PU) of CD147,MMP-9 and VEGF was assessed quantitatively using Imagepro Plus image analysis software.Results Positive intensity of CD147,MMP-9 and VEGF in lung adenocarcinoma was significantly higher than that in non-neoplastic internal controls and benign control tissues (P ＜ 0.001).The positive rates of CD147,MMP-9 and VEGF were 88.89％ (80/90),84.44％ (76/90),and 80％ (72/90),respectively.The expression of CD147,MMP-9 and VEGF was positively correlated with the degree of histologic differentiation,lymph node metastasis status and TNM stage (P ＜ 0.001).CD147 was correlated positively with MMP-9 and VEGF expression (rp =0.992,rp =0.984,P ＜ 0.001).Conclusion CD147,MMP-9 and VEGF may play an important role in the pathogenesis and progression of lung adenocarcinoma;CD147 may induce tumor invasion and metastasis by stimulating production of MMP-9 and VEGF,which is expected to be a potential promising target for immunotherapy.

To some problems on imaging teaching in traditional Chinese medical university,the countermeasures are as follows: the teacher team constructions and research work were perfected;the teaching contents were compiled by full time teachers;carefully preparing,supervising and guiding teachers could improve class teaching.The clinic should face to practice,society and future,the objective of which is to cultivate practical graduates with knowledge,skill and creativity who can adapt to clinic fast.The various examination forms were applied.By above means,imaging teaching quality has been improved perfectly.

The aim of the present study is to investigate the protective effect of chrysin (5,7-dihydroxyflavone) on right ventricular remodeling in a rat model of monocrotaline-induced pulmonary arterial hypertension (PAH). PAH rats were induced by a single injection of monocrotaline (60 mg x kg(-1), sc) and were administered with chrysin (50 or 100 mg x kg(-1) x d(-1)) for 4 weeks. At the end of experiment, the right ventricular systolic pressure (RVSP) and mean pulmonary artery pressure (mPAP) were monitored via the right jugular vein catheterization into the right ventricle. Right ventricle (RV) to left ventricle (LV) + septum (S) and RV to tibial length were calculated. Right ventricular morphological change was observed by HE staining. Masson's trichrome stain was used to demonstrate collagen deposition. The total antioxidative capacity (T-AOC) and malondialdehyde (MDA) levels in right ventricle were determined according to the manufacturer's instructions. The expressions of collagen I, collagen III, NADPH oxidase 4 (NOX4) and nuclear factor-kappa B (NF-κB) were analyzed by immunohistochemisty, qPCR and (or) Western blot. The results showed that chrysin treatment for 4 weeks attenuated RVSP, mPAP and right ventricular remodeling index (RV/LV+S and RV/Tibial length) of PAH rats induced by monocrotaline. Furthermore, monocrotaline-induced right ventricular collagen accumulation and collagen I and collagen III expression were both significantly suppressed by chrysin. The expressions of NOX4, NF-κB and MDA contents were obviously decreased, while the T-AOC was significantly increased in right ventricule from PAH rats with chrysin treatment. These results suggest that chrysin ameliorates right ventricular remodeling of PAH induced by monocrotaline in rats through its down-regulating of NOX4 expression and antioxidant activity, and inhibiting NF-κB expression and collagen accumulation.

BACKGROUND: A better understanding of medical students' attitude towards living liver donation in China would be of importance significance in the development of organ transplantation. OBJECTIVE: To investigate the medical students' attitude toward living liver donation in China and to analyze the factors that affect such an attitude.METHODS: A random sample of 250 medical students was taken and stratified by grades with 50 students in each grade. The attitude was evaluated by a modified psychosocial questionnaire from Spain. The questionnaire was completed anonymously and was self-administered. A bivariate analysis including the Student's t test and the Chi-square test was performed using SPSS software. RESULTS AND CONCLUSION: The questionnaire completion rate was 97.2% (n=243) for the medical students. Among the respondents, only 13.2% (n=32) of them were in favor of unrelated living liver donation. Another 66.3% (n=161) were only in favor if the donation was for a relative. Of the rest, 6.6% (n=16) did not agree with living liver donation, and the remaining 14.0% (n=34) were undecided. The factors related to this attitude were the decision of donating the organs of a family member (P=0.002), attitude toward deceased donation (P=0.000), a willingness to receive a donated living liver organ if one were needed (P=0.000), attitude toward living kidney donation (P=0.000). The medical students have a favorable attitude toward living liver donation in China. The students' attitude toward other types of organ donation and the willingness to accept living donated liver influence their attitude toward living liver donation. There is a great lack of education about the organ donation and transplantation for the medical students in China and more education programs should be incorporated into their traditional curriculum.