Objective To investigate the effect of hyperlipidemia (HL) on the pancreatic injuries during acute necrotizing pancreatitis (ANP) as well as the activation of nuclear factor kappa B ( NF-κB) and pancreatic acinar cell apoptosis. Methods Fifty SD male rats were randomly divided into control group, hyperlipidemia ( HL) group, ANP group and HL + ANP group. Rats in control group were fed with balanced diet for 2 weeks, and underwent opening and closing of the abdomen. Rats in HL group received fat emulsion lavage, and then underwent opening and closing of the abdomen. Rats in ANP group were fed with balanced diet for 2 weeks, and were induced by retrograde injection of sodium taurocholate into the bili-pancreatic duct to establish the ANP model. Rats in HL + ANP group received fat emulsion lavage for 2 weeks, and were induced by retrograde injection of sodium taurocholate into the bili-pancreatic duct to establish the ANP model. NF-κB p65 and Fas, FasL protein expression were determined by immunohistochemical method and the apoptosis in pancreatic acinar cell were detected by TUNEL. Results Two weeks after fat emulsion lavage, rats in HL and HL + ANP group had significantly higher serum level of lipid. Lipid vacuoles were present in some pancreatic cells in the rats of HL group, and middle number of inflammatory cells infiltration was found, the activation of NF-κB was slightly enhanced; and the expression of Fas, FasL was also enhanced. Apoptosis index increased from (0.62 ±0.28)% to (3.3S ±1.12)%. Massive pancreatic tissue necrosis, large amount of inflammatory cells infiltration was found in ANP group. NF-κB p65 was present in large number of pancreatic nucleus. The expression of Fas and FasL was also increased; the apoptosis index was (2.20±1.78)%. The degree of pancreatic necrosis was greater in HL + ANP group than that in ANP group (3.4 ± 0.7 vs. 2.4 ± 1.1, P <0.05). The positive rate and density of NF-κB expression was higher than that in ANP group; and the expression of Fas and FasL was decreased more than that in ANP group; the apoptosis index was (0.93 ± 0.87)% , which was significantly lower than that in ANP group (P <0.05). Conclusions High level of lipid can increase the activation of NF-κB and inhibit the acinar cell apoptosis, and decrease the expression of Fas and FasL, increase the pancreatic tissue necrosis, therefore in order to attenuate the injury of pancreas, it is essential to control blood lipid.

Objective To investigate the clinical effect of pedicle screw internal fixation with different surgical approach in the treatment of thoracolumbar vertebral fractures. Methods Fifty?three cases with thoracolumbar vertebral fracture without nerve injury were selected as our subjects,who were hospitalized in the Central Hospital of Chaoyang from January 2008 to December 2013. They were randomly divided into observation group(27 cases) and control group(26 cases). The patients in the observation group were treated with pedicle screw internal fixation with Wiltse paraspinal approach and the patients in the control group were treated with pedicle screw internal fixation with traditional posterior open approach. The duration of operation,intraoperative blood loss,volume of drainage and length of hospital stay of all patients were recorded and the ratio of anterior vertebral body height to normal height before and after operation was compared between the two groups. Visual analog scores( VAS) for pain severity and Cobb’ s angle of the vertebrae was compared between the two groups 1 year after operation. Results The duration of operation and length of hospital stay of patients in both groups had no statistically significant differences ( P>0. 05 ) . The intraoperative blood loss and volume of drainage in observation group were less than that in control group respectively((146. 3±25. 1) ml vs. (240. 2±28. 7) ml, (73.1±15.3) ml vs. (150.5±20.1) ml;P=0.034,0.023).The ratio of anterior vertebral body height to normal height 1 week after operation was higher than that before operation in the observation group ( ( 93. 1 ±5.1)% vs. (70.3±8.6)%,P=0.048) and in the control group((93.0±6.0)% vs. (71.8±9.8)%,P=0. 049),the difference between two group had no statistically significant(P>0. 05). The Cobb′s angle of the vertebrae 1 year after operation was less than that before operation in the observation group((10. 10±4. 00)° vs. (19. 10±7. 81)°,P=0. 045) and in the control group ((9. 97±3. 78)° vs. (18. 87±6. 90)°,P=0. 045),the difference between two group had no statistically significant(P>0. 05). The VAS for pain severity 1 year after operation was less than that before operation in the observation group(1. 1±0. 5 vs. 6. 0±0. 9,P=0. 023) and in the control group ( 1. 7 ± 0. 6 vs. 5. 9 ± 0. 7, P= 0. 038 ) , the difference between two group had statistically significant( P=0. 046) . Conclusion Pedicle screw internal fixation with Wiltse paraspinal approach in the treatment of thoracolumbar vertebral fractures without nerve injury has advantages with traditional posterior open approach in less trauma, less bleeding, rapid recovery and reduces the incidence of postoperative lumbar pain. The treatment has a good clinical effect and is worthy of clinical application.

Nodal signals play important roles in mesendoderm induction, establishment of left-right asymmetry and anteroposterior patterning of the neuroectoderm during vertebrate embryogenesis. It is aimed at identifying Nodal-regulated genes in zebrafish embryos, particularly those encoding transcription factors. A (Affymetrix) genechip analysis was performed using RNAs derived from embryos injected with squint mRNA, MZoep mutant embryos that are deficient in Nodal signaling, and wildtype embryos at the 30% epiboly stage. Transcripts (genes) with at least two-fold changes in expression level between wildtype and the other samples were identified. In squint mRNA-injected embryos, 265 transcripts show an increased expression level and 111 have a decreased expression level; in MZoep embryos, the expression of 1 495 transcripts increases while 550 transcripts express at a decreased level. Furthermore, overexpression of squint causes increased expression of 26 and decreased expression of 11 annotated transcription factor genes; in MZoep embryos, the number of transcription factor genes showing an increase and decrease of expression are 69 and 30, respectively. These results would provide useful information for further studying mechanisms and biological functions of Nodal signal transduction.

Objective To evaluate the clinical application of Nutritional Risk Screening 2002 (NRS 2002) in inpatients.Methods Totally 400 inpatients who were admitted to Tianjin Tianhe Hospital from Novem- ber 2008 to March 2009 were enrolled in this study.Physical examinations,including body height and body meas-urement,were performed the next morning after admission.The nutritional status was evaluated with NRS 2002.Results In all 400 inpatients.NRS 2002 was strongly practicable in 306 patients (76.5%) and weakly practica-ble in 94 patients (23.5%);Ninety-six patients (24.0%) had nutritional risks,which were most common in the department of internal medicine and the Department of neurology.The average age of patients with nutritional risks was (79.0±11.4) years,which was significantly higher than that of patients without nutritional risks [(58.1±15.8) years] (P<0.01).Conclusion NRS 2002 is effective and practicable in evaluating the nutritional status of inpatient.

AIM:To study whether albumin overload in proximal tubular epithelial cells(PTCs)induces epithelial to myofibroblast transdifferentiation(EMT).METHODS:Rat renal proximal tubular cell line NRK52E was cultured on 6 well plates.When the cells reached 70% confluens or complete confluens,cells were serum starved for 24 h.Different concentrations of delipidated bovine serum albumin(dBSA),ranging from 0-30 g/L,were then added to the cells.The media was changed every 48 h until the end of 144 h.Cell shapes were monitored by light microscope during experiment.Cell structures were detected by electron microscopy.Epithelial cell markers:E-cadherin,?-catenin,and myofibroblast marker:?-smooth muscle actin(?-SMA)were detected by immunofluorescent microscopy and Western blotting.RESULTS:dBSA overload induced the expression of ?-SMA in sub-confluent NRK52E,and a few cells elongated,but the induced expression of ?-SMA was not in a dose dependent manner.dBSA overload did not induce the expression of ?-SMA in complete confluent NRK52E,cell shape did not change either.dBSA overload did not inhibit expression of E-cadherin or ?-catenin both in sub-confluent and complete confluent NRK52E.The electron microscope showed that these cells retained epithelial phenotype,with microvilli and tight junction.CONCLUSION:Albumin overload induces PTCs expressing myofibroblast marker ?-SMA and promotes EMT.However,complete EMT does not achieve.Complete confluens(cell-cell contacts)inhibits albumin induced ?-SMA expression in PTCs.

OBJECTIVE:To reduce the error rate of inventory in the automated pharmacy of our hospital. METHODS:Activi-ties were designed and implemented by the management method of quality control circles(QCC)-PDCA(Plan,Do,Check and Ac-tion)cycle. The reasons for the errors of inventory in the automated pharmacy were analyzed to investigate and implement counter-measures. Visible and invisible achievements were evaluated,and then standardized processes were made. RESULTS:The errors of inventory in the automated pharmacy mainly included those of drug dispensing,drug shelving,drug return sheet,automatic medi-cine dispensing machine and system. In view of the above reasons,relevant standards were formulated and performed,including the process of warehouse-out check and shelving of drugs,drug dispensing process for the automated pharmacy,the process of sec-ondary check,etc. After the implementation of the activities,the error rate of inventory in the automated pharmacy reduced from 9.17% to 3.77%,which was visible achievement;and the above-mentioned standardized processes could ensure continuous run-ning of PDCA cycle. The practice,sense of responsibility,communication and coordination of management members in PDCA cy-cle namely invisible achievements were improved to some extent. CONCLUSIONS:The management method of QCC-PDCA cycle is feasible in reduction of the error rate of inventory in the automated pharmacy,which can provide a reference for automated phar-macy management.

BACKGROUND: Bracket dropping is often seen in clinic. Can these shed brackets be used again; what should be done to treat these brackets; is the bond strength of these recycled brackets different from those new ones, these questions are often concerned by orthodontists in their clinic and are the purpose of our study as well.OBJECTIVE: To evaluate the shear bond strength and compare two base-cure methods of recycled brackets. DESIGN: Grouping control study. SITTING: Department of Orthodontics, the Affiliated Hospital of Medical College, Qingdao University; Department of Materials, Dental School, Beijing University. MATERIALS: The teeth were collected from Oral Surgery, the Affiliated Hospital of Medical College, Qingdao University. The age was from 11 to 19 years. The gender was half male and half female. Intact enamel of the crown was required, but decayed, fracture, tetracycline pigmentation teeth or fluorosis teeth were excluded. Patients provided the confirmed consent for this experiment.METHODS: The experiment was carried out in Stomatology College of Peaking University in December 2005. Thirty ex vivo teeth were selected randomly from those prepared enamel surfaces, used as sample for rebounding. The edgewise brackets of swallow-tailed brackets were bonded on each tooth and rebonded after 24 hours. The teeth were cleaned and divided randomly into 3 groups. There were 10 teeth in each group. Group 1 was bonded with new brackets; group 2 with recycled brackets whose adhesive remnant were burned and got rid of; group 3 with recycled brackets whose adhesive remnant in the groove of the base were stored. Bracket was provided by Standard edgewise, Orsu Company, Hangzhou, China. After 24 hours, the shear bond strength was tested with material testing machine (Autogragh, Shimadzu, Japan). Adhesive remnant index (ARI) was added up. MAIN OUTCOME MEASURES: Shear strength of old metal bracket after rebonding and adhesive remnant.RESULTS: ① Shear bond strength: The shear bond strengths were (10.094±3.158 9) in group 1, (10.266±2.406 0) in group 2 and (8.898±1.365 9) in group 3. There were no statistically significant differences among the three groups (P > 0.05). ② ARI scores: ARI scores were 51.7%, 58.3% and 35.0% in the three groups, respectively. There were statistically significant differences between group 2 and 3. CONCLUSION: In vitro study indicates that the recycled metal brackets can reach good bond strength and that maybe there is chemical bond between new and old adhesive.

BACKGROUND: Umbilical cord blood (UCB) with limited karyocytes is mainly used in child patients. Recently, physicians have tried to mix two units of cord blood in the treatment of adults with hematological system diseases.OBJECTIVE: To monitor quantitatively the dynamic changes and the development rules of engraftment, chimera types and relative amount after allogeneic transplantation of mixed UCB from two units in adults with leukemia.DESIGN: Donors and the recipient were regarded as observational subjects in umbilical cord blood transplantation (UCBT). DNA extracted from blood samples of donors and the recipient before and after transplantation was considered as detecting samples. Short tandem repeat (STR) loci were as observational measures.SETTING: Key Laboratory of Immunology and Genetics of Institute of Transfusion Medicine of Shenzhen Blood Center.PARTICIPANT: A 43-year male patient with acute myeloid leukemia (AML), 75 kg, who was hospitalized at Shenzhen Hospital of Peking University, was enrolled in June 2005. The patient received two units of human leucocyte antigen (HLA), one locus mismatched unrelated UCBT (2.5×107 kg-1 karyocytes in UCB 1, and 1.53×107 kg-1 karyocytes in UCB 2) at month 6 after complete remission from first chemotherapy. UCB was collected from Guangzhou umbilical cord blood bank. The patient signed the informed consent.METHODS: The adult with AML received two units of HLA, one locus mismatched unrelated UCBT (2.5×107 kg-1 karyocytes in UCB 1, and 1.53×107 kg-1 karyocytes in UCB 2). Nine STR loci of the blood sample were determined before and after transplantation by quantitative technique of fluorescence labeling with multiplex polymerase chain reaction (MPCR), while the engraftment and chimera types were qualitatively evaluated by comparing differential loci between the recipient and the donors. The relative amount of two units of UCB was calculated in the patient after transplantation according to the differential gene peak areas of two donors with 377XL DNA sequencer after fluorescence scanning. The engraftment level and the development rules of donors' cells were analyzed quantitatively. In addition, the results were also compared with that of HLA loci distinct analysis for engraftment.MAIN OUTCOME MEASURES: After UCBT, transition process of nine STR loci of the recipient and two donors was observed, and engraftment was quantitatively and qualitatively described.RESULTS: Two units of UCB at day 15 after transplantation were engrafted simultaneously and revealed a complete chimera of the two. The relative amounts of UCB 1 and UCB 2 were 51.3% and 48.7%, respectively. Subsequently, UCB 1 went up to 70.0% and UCB 2 declined to 30.0% at day 30. However, only the genotype of UCB 1 was detected at day 52, and engraftment turned to a complete chimera of a single donor. The one with fewer karyocytes was rejected and the one with more karyocytes was engrafted for a long term.CONCLUSION: To detect quantitatively STR chimera with fluorescence labeling and MPCR can show precisely the engraftment level and the change of two units of UCB. It provides an accurate and reliable experimental basis for clinical UCB application and donor selection. It is proved that adult transplantation at the same time with mixed UCB from two units HLA one locus mismatched unrelated donors is feasible.