Objective To observe the clinical effects of Naloxone and Methylprednisolone(MPS) on therapy of severe bronchiolitis. Methods 98 cases of severe bronchihtis were randomly divided into 2 groups,the Naloxone/MPS treating group and the control group,the later only give regular treatment. Results The Naloxone/MPS treating group scored significantly lower at the time of 48 hours and 5 days(P＜0.001),according to cough,dyspnia and other respiratory symptoms,and the efficacy of Naloxone/MPS treatment is appreciately higher than control(P＜0.01). Conclusion Naloxone and MPS therapy shows remarkable clinical beneficial effects on severe bronchiolitis.

Objective To study a improved technique by releasing the orbicularis retaining ligament in orbicularis oculi muscle supension blepharoplasty. Release of the orbicularis retaining ligament could cut off the contact between orbitomalar skin and periosteum at inferior orbital rim, and carry the point of tightening orbitomalar skin in orbicularis oculi muscle supension blepharoplasty. Methods There were 409 patients with apparent orbitmalar fold. The methods of releasing orbicularis retaining ligament and orbital septum fixation were added to improve the orbicularis oculi muscle supension blepharoplasty. Results 409 cases were treated using this method over the past 3 years. All results were satisfactory. No complications were observed. Conclusion This improved method of orbicularis oculi muscle supension blepharoplasty is useful for orbitomalar skin rolling, especially for orbitmalar fold. The release allows effective redraping and upward mobilization of the orbicularis of the lower lid and the premalar soft tissues. This method is a simple, safe and effective procedure for the correction of tear trough deformity and well-demarcated lid/cheek junction in lower eyelid belpharoplasty. It is one of the best choices for lower eyelid blepharoplasty.

Objective To evaluate the impact of early enteral nutrition (EEN) compared with parenteral nutrition (PN) on patients after hepatectomy. Methods Seventy-eight patients undergoing liver resection were randomized prospectively into two groups: EEN group receiving early enteral nutrition (n=35) and PN group receiving parenteral nutrition (n=43). The patients in both groups received isocaloric and isonitrogenous nutritional formulas 24 h after operation and the formulas were stopped on postoperative day 7. The general conditions, liver function tests, clinical complications,and clinical nutritional variables at three time points that included preoperative phase, postoperative day 1 (POD 1) and postoperative day 8 (POD 8) were observed. Results No significant differences were found in length of hospital stay, liver function and clinical nutritional variables between the 2 groups. In the EEN group, the serum prealbumin level almost returned to the preoperative level on POD 8. The nutritional complication rate of the EEN group was increased significantly but it was milder than that of the PN group. The time of gut function recovery in the EEN group was shorter than that of the PN group. The costs of nutritional drugs showed a significant decrease in the EEN group.Conclusion Early enteral nutrition is safe, rational and effective in patients who have undergone hepatectomy. Early enteral nutrition is better than parenteral nutrition in promoting liver function recovery, liver protein synthesis, postoperative recovery of gut function and decreasing costs of nutritional drugs.

Objective To evaluate the effects of branched-chain amino acids-enriched early parenteral and enteral nutrition on the liver function and serum aminograms in cirrhotic rats after partial hepatectomy. Methods In this prospective randomized controlled study, 24 cirrhotic rats, induced by thioacetamide, were randomized into three groups: enteral nutrition (EN) group, EN + branched-chain amino acid (BCAA) group, and parenteral nutrition (PN) + BCAA group. After receiving partial hepatectomy, rats in all three groups were nutritionally supported with equal amount of calorie and nitrogen contents from the 1st postoperative day ( PO day 1 ) to PO day 5. On PO day 6, parameters including body weight, liver functions, prealbumin, transferring, and serum aminograms were measured or determined, and the level of liver albumin mRNA was detected by reversal transcription-polymerase chain reaction and morphological examinations such as HE staining and immunohistochemical staining, which were assessed by index of Ki67 protein index. Results Body weight was significantly decreased in all three groups on PO day 6 (P ＜0.05 ). Compared with EN + BCAA group, serum aspartate aminotransferase, alanine aminotransferase, and alkaline phosphatase after partial hepatectomy were significantly higher in PN + BCAA group (P ＜0.05 ). Serum alkaline phosphatase level was significantly higher in PN + BCAA group than in EN group ( P ＜0. 05). The level of prealbumin was significantly lower in PN + BCAA group when compared with EN group or EN +BCAA group ( both P ＜ 0. 05 ), although no such significant difference was noted in terms of transferrin ( P ＞0. 05 ). The levels of leucine and isoleucine elevated while those of tyrosine, phenylalanine, arginine and tryptophan declined in PN + BCAA group or EN + BCAA group when compared with EN group ( P ＜ 0. 05 ). Aminograms were not significantly different between EN + BCAA group and PN + BCAA group ( P ＞ 0. 05 ). Levels of total amino acid and aromatic amino acid (AAA) were significantly lower while BCAA and ratio between BCAA and AAA (BCAA/AAA) were significantly higher in PN + BCAA group or EN + BCAA group than in EN group (P ＜ 0. 05 ).Significantly lower level of albumin mRNA and index of Ki67 were observed in PN + BCAA group than in EN group or EN + BCAA group (P ＜ 0.05 ) on PO day 6. Conclusions BCAA-enriched EN or PN reverses amino acid disequilibrium and restores BCAA/AAA in cirrhotic rats after partial hepatectomy. Compared with PN, EN is superior in improving postoperative liver function, promoting protein synthesis, and speed up tissue regeneration in the postoperative liver. However, it still can not restore serum albumin in a short term.

ObjectiveTo investigate the application value of negative pressure sucking technique in the elderly after nasal septal reconstruction. MethodsForty elderly patients after nasal septal reconstruction were divided into two groups randomly, with twenty patients in each. The cases in observing group received negative pressure sucking technique while those in controlling group received nasal packing with vaseline gauze following the surgery. The amount of bleeding of the first 24 hours after operation, the comfort degrees evaluated by using visual analogue scale (VAS),hematoma of nasal septum, edema in nasal cavity and duration of hospitalization after operation were compared between the two groups. ResultsThe amount of bleeding of the first 24 hours afteroperation was more in observing group than in controlling group[(14.2±8.1)ml vs. (7.2±4.1)ml, P<0.05]. The VAS score and the number of cases who felt discomfortable moderately or severely were significantly less in observing group than in controlling group at 6 h, 12 h and 24 h after operation(all P<0.05). The nasal cavity gap were significantly wider in observing group at the 3rd day after operation(P=0.001), and the duration of hospitalization after operation was significantly shorter in observing group [(4.5±0.9) d] than in controlling group [(5.42±0.9) d](P=0.042)Conclusions Negative pressure sucking technique applied in the elderly after nasal septal reconstruction can significantly relieve the distress of patients, reduce the edema in nasal cavity and shorten the duration of hospitalization, but does not increase the risk of hemorrhage.

BACKGROUNDDrug-resistance of tumor is the main reason of the failure of che-motherapy. Much attention has been paid to the expression of multidrug resistance-associated protein (MRP) and its mechanism of drug-resistance in non-small cell lung cancer (NSCLC). Results of this research will contribute to reversing drug-resistance and improving curative effect. The aim of this study is to investigate the relationships between the expression of MRP and clinicopathological parameters and prognosis in patients with NSCLC.

METHODSExpression of MRP was detected in 62 cases of paraffin-embedded NSCLC samples by streptavidin-biotin-peroxidase complex immunohistochemistry method, as well as in 30 fresh cases of NSCLC samples and corresponding normal lung tissues by immunohistochemistry and Western blot.

RESULTSMRP expression of NSCLC tissues was significantly higher than that of normal lung tissues. The survival time of patients with negative MRP expression was (69.81±17.41) months, and that of patients with positive MPR expression was (25.38±4.46) months (P=0.0156). This statistically significant relationship between the survival time and prognosis was also showed in squamous cell carcinoma patients (P=0.015), but not in adenocarcinoma. Multivariate COX model analysis suggested that the survival time was significantly related to lymphatic metastasis (P=0.038) and expression of MRP (P=0.035).

CONCLUSIONSMRP expression in NSCLC is significantly higher than that in the normal lung tissues. The mean survival time of patients with negative MRP expression is remarkably longer than that of patients with positive MRP expression. MRP expression may be an independent prognostic factor.

BACKGROUND: Endoplasmic reticulum (ER) stress has been proved to be related to the occurrence of diabetes, dilated cardiomyopathy and neurodegenerative diseases. Indeed, it is closely associated with osteoarthritis. OBJECTIVE: To explore the effect of ER stress on the chondrocyte viability as well as the occurrence and development of osteoarthritis in rats. METHODS: Rat chondrocytes were isolated and cultured, and the ER stress in the rat chondrocytes was by 10 mg/L tunicamycin. The expression levels of ER stress markers C/EBP-homologous protein and 78 kDa glucose-regulated protein were detected by western blot assay, and the proliferation and apoptosis of chondrocytes were detected by cell counting kit-8 assay and AnnexinV-FITC flow cytometry, respectively. In the in vivo experiment, 15 Sprague-Dawley rats were selected and subjected to anterior cruciate ligament transection and medial meniscectomy to establish an animal model of osteoarthritis. Tunicamycin, tauroursodeoxycholic acid and PBS (blank control group) were respectively injected into the articular cavity, and then the progression of osteoarthritis was assessed by hematoxylin-eosin staining at 4 weeks after treatment. RESULTS AND CONCLUSION: After addition of tunicamycin, the expression levels of C/EBP-homologous protein and 78 kDa glucose-regulated protein were significantly upregulated, the viability of chondrocytes was decreased gradually, while the apoptotic rate was increased significantly. Results from gross observation and hematoxylin-eosin staining suggested that tunicamycin promoted the progression of osteoarthritis and tauroursodeoxycholic acid delayed the deterioration of cartilage in the rats. These findings indicate that ER stress results in the decreased chondrocyte viability and increased apoptosis, which may be an important pathogenesis of osteoarthritis. Additionally, tauroursodeoxycholic acid can effectively alleviate osteoarthritis induced by ER stress.

Cholangiocarcinoma is a malignant tumor originating from the bile duct epithelium, with the increasing incidence year by year. Its early symptoms are atypical and the diagnosis rate is low. Most of the patients are already in advanced stage when they are diagnosed, losing the best surgery period. Currently, the conservative treatments for unresectable extrahepatic cholangiocarcinoma include stent placement, radiofrequency ablation, radiotherapy and chemotherapy, targeted and immunotherapy and other systemic treatments. But due to the high malignancy of biliary tract tumors, the tendency to develop drug resistance and the limited population benefited from the emerging treatment modalities, we urgently need to explore new treatment strategies to break this bottleneck. As a new treatment for cholangiocarcinoma, photodynamic therapy has attracted much attention for its clinical application and therapeutic effects. In this paper, we summarize the principles of photodynamic therapy, the combination of photodynamic and other therapeutic modalities, especially the combination of photodynamic with emerging immune and targeted therapies, and describe the current hotspot directions of photodynamic therapy research at home and abroad to provide reference for clinical treatment and research.

PURPOSE: Endothelial progenitor cells (EPCs) play a key role in tissue repair and regeneration. Previous studies have shown that infusion of human umbilical cord blood-derived endothelial colony-forming cells improves outcomes in mice subjected to experimental traumatic brain injury (TBI). However, the efficiency of cell transplantation is not satisfactory. Oxidative stress plays a significant role in the survival of transplanted cells following ischemic reperfusion injury. This observational clinical study investigated the correlation between the number of circulating EPCs and plasma levels of superoxide dismutase (SOD) and malonyldialdehyde (MDA). MATERIALS AND METHODS: Peripheral blood samples were collected from 20 patients with mild TBI at day-1, day-2, day-3, day-4, and day-7 post TBI. The number of circulating EPCs and the plasma levels of SOD and MDA were measured. RESULTS: The average of circulating EPCs in TBI patients decreased initially, but increased thereafter, compared with healthy controls. Plasma levels of SOD in TBI patients were significantly lower than those in healthy controls at day-4 post-TBI. MDA levels showed no difference between the two groups. Furthermore, when assessed on day-7 post-TBI, the circulating EPC number were correlated with the plasma levels of SOD and MDA. CONCLUSION: These results suggest that the number of circulating EPCs is weakly to moderately correlated with plasma levels of SOD and MDA at day-7 post-TBI, which may offer a novel antioxidant strategy for EPCs transplantation after TBI.
Animals ; Brain Injuries* ; Cell Transplantation ; Clinical Study ; Endothelial Progenitor Cells* ; Humans ; Malondialdehyde ; Mice ; Oxidative Stress* ; Plasma ; Regeneration ; Reperfusion Injury ; Superoxide Dismutase ; Transplants ; Umbilical Cord

Objective To explore the situation and question of standardized training of residents/graduate students in cardiac surgery by questionnaire survey. Methods From September 2010 to May 2012, 61 resident physicians/graduate students were chosen as research objects in Department of Cardiac Surgery, Peking University Third Hospital. A total of 61 questionnaires were sent out, with a recovery rate of 100%,and an effective rate of 95.1%.The contents of investigation included standardized training content design, standardized training management, the time and"environment" pressure, compliance training effect analysis,student opinion and others,a total of 14 options.EpiData 2.1a software was used to sort and record the data. SPSS 17.0 software was used for statistical analysis. The enumeration data were compared by chi square test.Results During the period of training,the most expected teaching method was"small lecture", accounting for 63.8%; The most difficult part of the process of cardiac surgery training was "postoperative care", accounting for 69%; 100% of the trainees thought that it would be helpful for future work through cardiac training;8.3% of the trainees thought the teachers of cardiac surgery teaching consciousness was not strong; resident weekend "in the hospital" was higher than the proportion of graduate students, and most graduate students chose weekend "in the experiment and research work", the difference was statistically significant (P<0.05). Conclusion Appropriate standardized training program should be combined with the students' background; Teaching team construction and clinical reasonable and effective clinical skills train-ing system is an important link to ensure the quality of teaching.The combination of residents' standardized training and postgraduate education of professional degree remains to be tracked and evaluated in a long time.The feedback from all aspects of the training should be paid more attention to,and the training details should be improved.