Objective To study the effects and mechanisms of major immune nutrients and to introduce the progresses of clinical applications about enteral immunonutrition.Methods The related literatures about the effects and clinical applications of enteral immunonutrition were reviewed.Results Infection rate can be reduced and the hospitalization can be shortened as a result of the improved nutritional status and immune competence of patients which can be enhanced by reasonable enteral immune nutrition.Most of the patients suffering from serious diseases can benefit from enteral immunonutrition,such as gastrointestinal cancers,post-transplantation complications,chronic liver disorders,acute pancreatitis and so on.However,as a new nutrition therapy,the clinical use of enteral immunonutrition in critically ill patients is still controversial.Conclusions Enteral immunonutrition plays an important role in the nutritional support of patients with serious diseases,such as gastrointestinal cancers,organ failures.However,much work remains to be done.

Osteogenic differentiation of mesenchymal stem cells (MSCs) is an important link of bone metabolism and bone repair, the mechanism of which is usually complicated. Recent studies have found that BMP, FGF, Wnt, Hedgehog, NELL1, IGF, Notch and othersignaling molecules are involved in the regulation of osteogenic differentiation of MSCs. These signaling molecules themselves have been shown to have a strong ability to promote osteogenic differentiation. They can activate the corresponding receptors by specific ligands, thus initiating the specific signal transduction pathways in the cell, and finally promote the transcription and translation of the genes related to bone formation. Furthermore, all the signaling pathways form a complex network which regulates and influences the osteogenic differentiation ofMSCs. Further researches on the mechanism of the interaction of these signaling pathways is of great significance in promoting the development of bone tissue engineering and the treatment of bone metabolic diseases.

Object:To investigate the expression of cell cyclin G2 (CCNG2) in glioblastoma tissues and to explore the correla-tion of CCNG2 expression with clinicopathological parameters and clinical significance. Methods:Surgical specimens of glioblastoma were collected from a total of 129 cases. The expression of CCNG2 in 109 specimens with complete clinical data was examined via QRT-PCR and immunohistochemistry. Results:The expression of CCNG2 was significantly decreased in higher stages of glioblastoma compared with those in lower stages. Therefore, CCNG2 is inversely correlated with the stage of the disease. The expression of CCNG2 was associated with tumor stage, sensitivity to chemotherapy and radiotherapy, as well as survival times (P<0.05). CCGN2 was not cor-related with gender and age (P>0.05). Conclusion: CCNG2 expression may be associated with the development, treatment efficacy, and prognosis of glioblastoma. In addition, CCGN2 can be used to evaluate the malignant behavior of glioblastoma.

Objective To explore the relationship between Lp (a)level and age,gender in Nanjing area.Methods 8 442 ser-um specimens from examination individuals were collected in the First Affiliated Hospital of Nanjing Medical University in 2014.Lp (a)was measured by immune turbidimetry method.All the subjects were divided into six groups:15~29,30~44, 45~59,60~69,70~79 and ≥80 years old.SPSS21.0 software was used to carry out statistics.Results The Lp(a)level in female [134±197 mg/L (M±QR,the same below)]was higher than that in male significantly (U =8 355 137,P <0.001). LP (a)levels from people of different sex correlated with the age weakly (r =0.154,P <0.001),and increased with age groups.Lp(a)of six groups in male were 106.5± 151.0,119.0± 170.0,128.0± 179.0,159.0±206.0,145.0±200.0 and 162.0± 190.0 mg/L respectively.The difference was statistically significant between between 1 and 2 groups,2 and 3 groups,3 and 4 groups,theU value were 645 152.5,1 006 572.0,197 595.0 respectively;P all<0.05.The difference was not statistically significant between 4 and 5 groups,5 and 6 groups,3 and 4 groups,theU value were 59 127.0 and 15 959.5 respectively,P >0.05.Lp(a)of six groups in female were 128.0 ± 194.0,128.0 ± 187.0,139.0 ± 207.0,157.0 ± 228.0, 173.5±227.0 and 150.0±201.0 mg/L.The difference was statistically significant between 2 and 3 groups,theU value was 641 147,P =0.006,respectively.The difference was not statistically significant between 1 and 2 groups,3 and 4 groups,4 and 5 groups,5 and 6 groups,theU value were 783 676,92 442.5,16 069.5 and 3 038,respectively;P all>0.05.Conclusion Lp (a)level in healthy population in Nanjing area is related to gender and age groups,it is necessary to establish different reference ranges.

Objective To isolate the rat insulin gene enhancer binding protein 1(Islet-1)gene and construct plEGFP-C1-Islet-1 recombinant retroviral expression vector.Methods The cDNA encoding the rat Islet-1 gene was isolated by RT-PCR method,the cDNA was first cloned into PGET-1 TA vector to facilitate the sequence and then subcloned into the retroviral vector plEGFP-C1.plEGFP-C1-Islet-1 was transfected into PA317 packaging cells with lipofectamine 2000.Transformants were selected in medium containing G418.Results A 1 050 bp DNA fragment was obtained by RT-PCR;plEGFP-C1-Islet-1 recombinant retroviral expression vector was identified by restrictive enzymes digestion,PA317 cells transfected with recombinant vector expressed enhancer green fluorescent protein(EGFP).Conclusion The gene encoding the rat Islet-1 is obtained and plEGFP-C1-Islet-1 expression vector is constructed successfully.

Objective To investigate the probabilities of brain-derived stem cells from fetal rats differentiating into neurons and astrocytes by velvet antler polypeptide(VAP) in vitro. Methods Neural stem cells from E12-14d rats were cultured for 7 days until neural stem cells (NSCs) aggregations were formed into neurospheres. The neurospheres were cultured at different concentrations of VAP, and immunocytochemistry was used to detect the differentiation of neural stem cells. Results The differentiated cells in 50?g/L VAP group are more than that in control group; the number of NSE positive cells in 50?g/L,100?g/L and 200?g/L groups is more than that in control group.Conclusion Neural stem cells can be successfully induced into neurons by VAP in vitro, which could provide a basis for regeneration of nerve system.;

Objective PB840 ventilator to explore non-invasive ventilation (NIV) in the ICU of the application,efficacy and safety.Methods Application PB840 Ventilator-Non-invasive mechanical ventilation in the treatment of the seven cases of different causes of respiratory failure patients,non-invasive ventilation in the treatment of 4 h,the blood gas (PaO2,PaCO2 and pH value) analysis and analysis of clinical symptoms to improve the situation.Results Patient before and after treatment of PaO2,PaCO2 and pH compared to the value there is significant difference.Target to improve the blood after treatment significantly (P<0.05),reduce or alleviate the symptoms of sick;cyanosis improved.However,leakage is still a major disadvantage,some patients can not tolerate when there is need to immediately replace invasive mechanical ventilation.Conclusion PB840 ventilator mode non-invasive ventilation can improve the patient′s respiratory failure and clinical symptoms of blood-gas target,but most critically ill patients should be carefully applied.

BACKGROUND: Surface roughness of implants can directly influence cellular proliferation, differentiation, and gene expression. OBJECTIVE: To observe the early attachment of periodontal ligament cells (PDLCs) to pure titanium with different surface roughness levels, and to study the effect of surface performance on cell differentiation. DESIGN, TIME AND SETTING: Randomized controlled observation/multi-sample comparison study, which was performed at Center of Science and Technology, Gannan Medical College between January 2005 and July 2006. MATERIALS: Pure titanium stick was cut into pieces, of 10 mm diameter and 2 mm thickness, using cutting-off machine, and there were 24 sections in total. Then, the titanium sections were randomly divided into four groups: simple mechanical processing, nitric acid processing, sand blasting processing, and combination group, with 6 sections per group. METHODS: TR240 portable-type surface roughness meter was used in this study. In the simple mechanical processing group, sections were scoured by sand paper alone; in the nitric acid processing group, sections were etched with 65% HNO3 for 1 hour at 100 ℃ after scoured by sand paper; in the sand blasting processing group, sections were sandblasted by 100 μ m AI203 after scoured by sand paper; in the combination group, sections were etched with 65% HNO3 for I hour at 100～C after scoured by sand paper and sandblasted by 100 μ m Al2O3. MAIN OUTCOME MEASURES: Samples were maintained in DMEM for 30 minutes, and the third-passage cells were inoculated. Then, titanium sections were taken out at different time points of 30, 60, 120, 240 minutes, 1, 3, and 7 days. Surface roughness and early attachment of PDLCs were detected under fluorescent microscope. RESULTS: O Quantitative analysis: Surface roughness was (599.5±8.3) nm in the simple mechanical processing group, (406.5 +4.6) nm in the nitric acid processing group, (358.8±11.8) nm in the sand blasting processing group, and (8.7±2.0) nm in the combination group. On the other hand, surface roughness in the simple mechanical processing group was significantly higher Fluorescence observation exhibited that number of PDLCs attaching to pure titanium surface was increased, and the proliferation was greater with the time passing by. in addition, surface roughness of pure titanium was positively associated with number of PDLCs. CONCLUSION: The lighter the surface roughness is, the more the early attachment of PDLCs is, benefiting for cell adhesion and proliferation.

Objective To seek a method to correct the bent cartilaginous vault.Methods This study included 18 patients (12 women,6 men,aged 18-45 years) suffering from the bent cartilaginous vault with the various degrees of nasal obstruction from January 2005 to December 2009.A open surgical approach was adopted to allow correction of the dorsal and caudal deviations of the nasal septum without weakening its structural support to the dorsum or nasal tip.The approach depended on full mobilization of deviated cartilage,removal of the deviated part of the quadrangular cartilage,followed by straightening of a caudal septal extension graft and its fixation in the corrected position.Rhinoplasty was performed to correct bent cartilaginous vault.Results A satisfactory result was gained in all clinical cases,except a septum still to remain light tilt (not affect the breathing function).Follwing-up for 3-24 months,all cases dorsum of nose was straighten and nasal septum situated mediately.All patients indicated cosmetic satisfaction of nasal dorsum and tip and improvement in nasal obstruction.No nasal deformity and septum tresis was found in all patients.Conclusions ()pen rhinoplasty is a helpful technique in the treatment of the bent cartilaginous vault.Septal surgery is necessary in the patients with cartilage framework,not only to improve breathing but also to achieve a straight,symmetrical and external nose as well.

Objective To investigate the effects of the low-dose ketamine on the minimum alveolar concentration (MAC) of sevoflurane in patients undergoing gynecological abdominal surgery.Methods Fifty-one ASA Ⅰ or Ⅱ patients aged 36-49 yr with body mass index ≤ 30 kg/m2 scheduled for gynecological abdominal surgery were randomly divided into control group (group C, n = 29) and ketamine group (group K, n = 22) . The paitents were unpremedicated. In group K, a loading dose of ketamine 0.2 mg/kg was injected intravenously followed by infusion at a rate of 14 μg·kg-1 ·min-1 , while equal volume of normal saline was given in group C. Anesthesia was induced with inhalation of sevoflurane (end-tidal concentration 4%-5%, maintaining for 5 min) in both groups. Endotracheal intubation was performed. The patients breathed sevoflurane until the predetermined target end-tidal sevoflurane concentration was reached for at least 15 min before skin incision. Occurrence of body movement was determined by any visible contraction of the muscle bundle of trunk, limbs, head and neck during skin incision and/or within 60 s after skin incision. The initial end-tidal concentration of sevoflurane was set at 1.8 % .If body movement occurred, the end-tidal concentration of sevoflurane was increased by 0.2% , while if not, decreased by 0.2% . MACs of sevoflurane were calculated. Results The MAC of sevoflurane was 1.51% (95% confidence interval 1.45%-1.58%) in group K, and 2.49% (95% confidence interval 2.40%-2.57%) in group C, and there was significant difference between the two groups ( P < 0.05) . Conclusion Intravenous infusion of the low-dose ketamine can enhance the anesthetic effect of sevoflurane in patients undergoing gynecological abdominal surgery.