Objective To study the molecular mechanism of medulloblastoma.Methods The cell line with PARP-1 and P53 null mutation was established and characterized.Mouse medulloblastoma cell line derived from PARP-1/P53 double knockout mice was established.We analyzed cell characters after 30 passages,using neuronal cell-specific markers by immunofluorescence.The cells were transfected with pEGFP-C1-Hparp-1 and pEGFP-C1 plasmids,the expression of PARP-1 protein was detected by immunofluorescence stainning and Western blot.Results The cells showed positive immunoactivity for the neuronal-specific markers such as Vimentin,Dcx and ?Ⅲ-Tubulin,and cells were negative for PARP-1 protein.Exogenous PARP-1 expression was visualized by immunofluorescence and Western blot analysis after pEGFP-C1-Hparp-1 transfection.Conclusion Mouse medulloblastoma cell line with defective function for DNA damage recovery has been successfully established,which provides a useful tool for further dissecting the molecular mechanism and pathogenesis of medulloblastoma.

Objective To study lobular involution of tissues around breast tumor,and to assess the consistency of lobular involution of tissues from different parts of the breast.Methods 22 patients receiving breast conservation surgery in Breast Surgery Department of Peking Union Medical College Hospital from Dec.1 st,2010to Dec.1 st,2011 were collected.88 pieces of HE staining were measured in terms of lobular area and number of acini per lobular,and lobular involution was evaluated.Bivatiate correlation analysis was applied to explore correlation between lobular area and acini per lobular.ANOVA,crosstabs and reliability analysis were applied to explore involution consistency of different parts of breast (P ＜ 0.05).Results The average area of lobuli was (90 248.5 +56 909.4) μm2 and the number of acini was 25.68 ± 18.86 per lobular.The lobular area and number of acini were correlated with each other significantly(Pearson r =0.78,P ＜ 0.01).Involution status of different parts of breast had good consistency(for lobular area 19 cases showed no difference in ANOVA analysis and for lobular area/number of acini 18 cases showed no difference; Kappa coefficient =0.65; ICC =0.73).Conelusions Lobuli around breast tumor have comparatively poor involution,with big lobuli and large number of acini,which are correlated with each other.Involution status of different parts of a breast has good consistency.Biopsy from one site to evaluate involution extent of the whole breast is practicable.

Objective To implement and evaluate evidence-based guidelines for enteral nutrition support in acute stroke patients with dysphagia.Methods This study is a prospective before and after comparison study.Collected 200 acute stroke patients with dysphagia and divided them into test group (trained medical staffs) and control group(untrained medical staffs) equally according to the time order.Two groups of 100 patients were surveyed using a checklist before and after implementation of 10 guidelines about nutrition support.Before the implementation of guidelines,the staffs were enforced training,and summarized regularly.Compliances with guidelines by doctors and nurses were compared,and outcomes of patients were assessed.Results Compared with the control group,the correct implementation of the project significantly improved in the experimental group on nutritional risk screening (92.0％,64.0％; x2 =22.840),nutritional supplements selection (80.0％,48.0％; x2 =22.220),nutrition infusion methods (90％,18％ ; x2 =1.040) and nutrition infusion adjustment (abdominal distension/adjusted:21/10,6/4;x2 =9.634,constipation/adjusted:41/40,57/53 ; x2 =5.122,all P ＜ 0.05).The mortality rate,poor prognosis and length of stay in department of neurology intensive care unit and in hospital were not significant different between the experimental group and the control group.The incidence of hospital-acquired pneumonia was significantly lower in the experimental group (44.3％) than that in the control group (67.5％,x2 =7.281,P =0.007),but other patient outcomes were unaffected significantly.Conclusion Implementation of evidence-based guidelines for enteral nutrition support in acute stroke patients with dysphagia is associated with improvements in clinical quality and selected patient outcomes.

BACKGROUNDThe brain death confirmation tests occupy a different position in each country's diagnostic criteria (or guideline); the choices of tests are also different. China brain death criteria include clinical judgment and confirmation tests. This study aimed to confirm the preferred confirmatory test and complementary confirmatory tests.

METHODSWe did a clinical brain death determination on deep coma patients, and then divided them into brain death group and non-brain death group. According to the Chinese standards for determining brain death, both the groups accepted confirmatory tests including electroencephalograph (EEG), somatosensory evoked potentials (SEP), and transcranial Doppler (TCD). The sensitivity, specificity, false positive rate, and false negative rate were calculated to evaluate the accuracy of the confirmatory tests.

RESULTSAmong the 131 cases of patients, 103 patients met the clinical criteria of brain death. Respiratory arrest provocation test was performed on 44 cases and 32 cases (73%) successfully completed and confirmed that they have no spontaneous breathing. Of the three confirmation tests, EEG had the highest completion rate (98%) and good sensitivity (83%) and specificity (97%); TCD had followed completion rate (54%) and not good sensitivity (73%) and specificity (75%); SEP had the lowest completion rate (49%), good sensitivity (100%), and not good specificity (78%). After the combination of SEP or TCD with EEG, the specificity can increase to 100%.

CONCLUSIONSThe completion rate of respiratory arrest provocation test remains a problem in the clinical diagnosis of brain death. If the test cannot be completed, whether to increase a confirmatory test is debatable. SEP had an ideal sensitivity, and the specificity will reach 100% after combining with TCD or EEG. When a confirmed test was uncertain, we suggest increasing another confirmatory test.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Brain Death ; diagnosis ; physiopathology ; Evoked Potentials, Somatosensory ; physiology ; Female ; Humans ; Male ; Middle Aged ; Ultrasonography, Doppler, Transcranial ; Young Adult