Inflammatory bowel disease (IBD) is a group of diseases characterized by recurrent episodes of chronic intestinal inflammation including ulcerative colitis (UC) and Crohn's disease (CD).The prevalence of IBD has shown a rapid growth in China.Malnutrition is often seen in IBD patients,especially in those with CD.Appropriate diets and supplementation of trace elements,calcium,vitamin D,and probiotics are beneficial for disease remission and control.Nutrition support therapy can improve the nutritional status and meanwhile may facilitate the induction and maintenance of remission in CD patients.

Objective To study the effects of diabetes on hippocampal synaptic plasticity in perforant path-dentate gyrus pathway (PP-DG) in rats. Methods 70 SD rats( 180±20) g were divided into 3 groups at random: control group, type1 diabetes group (DM1)and type2 diabetes group (DM2). After Morris water maze test, 15 rats that showed worse spatial memory ability were selected in each model group to investigate the variation of paired-pulse facilitation (PPF) and the range of synaptic plasticity. Field potentials were recorded in the dentate gyrus of the dorsal hippocampus by stimulating the perforant path. Results Contrast to the control group, diabetic rats' hippocampal LTP were depressed (P<0.05), and type1 diabetic rats' LTP reduced much more. Diabetic rats' PPF ratio was reduced contrast to the control group (P<0.05). Conclusion Type1 and type2 diabetes impaired synaptic plasticity of hippocampal PP-DG pathway in rats, which conformed the results of water maze test.

Objective To study the effect of diabetes on spatial memory ability and spatial associative memory ability in rats. Methods 70 SD rats( 180±20 g) were randomly divided into 3 groups: control group,type1 diabetes group and type2 diabetes group. Type1 and type2 diabetic rat models were set up by streptozocin (STZ) intraperitoneal injection and high fat forage raise. The blood glucose was determined. After rat diabetic model established 1 month and 3 months, respectively, the Morris water maze experiments were implemented,including 4 days' place swimming and 1 day's space exploration. Results After 1 month, diabetic rats' spatial memory ability and spatial associative memory ability were not affected. After 3 months, in place swimming test,the escape latency of two diabetic rat groups was obviously longer than that of the control group (P＜0.05). From the second day of the experiment, escape latency of the control descended sharply, while that of the diabetic group descended slowly. There was no difference between type 1 and type2 diabetic groups in escape latency (P＞0.05). After 3 months, in the space exploration test, when rats were put into the maze from I quadrant which already trained, swimming time in the platform quadrant was shorter, the other parameter scores were lower of the two diabetic model groups, contrast to the control group (P＜0.05). The parameter scores of type2 diabetic group were lower slightly than type1 diabetic group. When rats were put into the maze from IV quadrant for which never trained, the parameter scores of two diabetic groups were lower than that of the control group (P＜0.05) and the total score of type 1 group was lower than that of type2 group. Conclusion The spatial memory ability and spatial associative memory ability of type 1 and type2 diabetic rats descended. In the experiment, the spatial memory ability of type2 diabetic rats was more significantly affected than that of type1 diabetic rats. By contrast,type 1 diabetic rats' spatial associative memory ability descended greatly than that of type2 diabetic rats.

Objective To investigate the safety of thalidomide in the treatment of immune-related bowel diseases for providing clinical reference.Methods Thirty-five patients with immune-related bowel diseases (31 Crohn's disease,2 ulcerative colitis and 2 Behcet's disease) treated with thalidomide were enrolled in this study.The incidence,type,severity,duration of thalidomide related adverse drug reaction (ADR) and the dose-effect relationship of neurotoxicity were analyzed.Results All the patients were treated with a mean dose of thalidomide (109.29 ± 30.37) mg/d for (18.8 ± 12.4) months,and 33 occurred ADR.The three most frequent ADR were numbness [51.4％ (18/35)],somnolence [48.6％ (17/35)] and dermatitis [37.1％ (13/35)].The median time to development of these three ADR were 6.50,0.25,and 1.00 months,respectively.Severe ADR leading to withdrawal accounted for 20.0％ (7/35),including reasons of peripheral neuritis (3/7),dermatitis (2/7) and myelosuppression (2/7).The incidence of peripheral neuritis was not significantly related to the maximal and initial dose of thalidomide (P ＞ 0.05).Conclusions Although the incidence of ADR was relatively high during the treatment of thalidomide,most of them were mild and well tolerated.Thalidomide can be safely used in patients with immune-related bowel diseases under close monitoring.

Objective To investigate the iodide uptake by U251 glioma cell lines which were transfered with both human sodium/iodide symporter (hNIS) and human thyroperoxidase (hTPO) genes. Methods Recombinant adenosine virus AdTPO was constructed through cloning, recombination, packaging and amplifying. The viral titers were calculated after purification. The protein expression of AdTPO was tested by Western-Blotting and the recombinant plasmids PcDNA3. 1/hNIS were constructed. After hNIS gene was transfected into human glioma cell lines U251 through liposome, the cell lines with stable hNIS expression (hNIS-U251) selected by G418 antibiotics were defined as hNIS-U251 group. Then, hTPO was transducted into hNIS-U251 with adenosine virus (AdTPO-hNIS-U251 group). U251 cells with no plasmid were used as the control group (U251). Cultured cells from each group were studied for 125I uptake as well as 125I efflux rate. Student-Newman-Keuls in multiple range test was used. Results AdTPO-hNIS-U2.51 with stable expression was successfully established by transfecting hNIS and hTPO genes into human glioma cell lines. The 125I uptake by AdTPO-hNIS-U251, hNIS-U251 and U251 cell lines was (74 647.53 ±3605.88), (55 769.96 ±4353.26) and ( 507.67 ± 57.69 ) counts/min, respectively ( F = 836. 17, P ＜ 0.05 ). The uptake compacity by AdTPO-hNIS-U251 was 147 fold higher than that by U251 (q =55.64, P＜0.01 ) and 1.3 fold higher that by hNIS-U251 (q = 14. 17, P ＜0.01 ). 125I efflux rate was prolonged in AdTPO-hNIS-U251 group and its effective half time was 13 min. Conclusion Enhanced 125I uptake by the human glioma cell lines can be achieved with combined transfection of hNIS and hTPO genes.

Background The pathogenic mechanism of thyroid associated ophthalmopathy (TAO) is still unclear,which is considered to be an autoimmune disease.It is confirmed that interleukin-17A (IL-17A) plays an important role in the occurrence and development of many autoimmune diseases.It is unclear that whether IL-17A participates in the pathogenesis of TAO.Objective This study was to explore whether IL-17A secreted by coculture system of peripheral blood mononuclear cells (PBMCs) and orbital fibroblasts (OFs) participates in the pathogenesis of TAO and its possible mechanism.Methods Periphery blood and orbital connective tissue were obtained from 12 patients with TAO and 8 patients who received prosthesis implantation for eyeball atrophy in Xiangya Hospital during April to December 2014.PBMCs were isolated by density gradient centrifugation,and OFs were cultured by explant culture method.The purity of T leukomonocyte in PBMCs was tested by flow cytometry,and OFs were identified by Giemsa staining and immunochemistry.OFs and PMBCs were incubated into 96-well plate in a 1:20 proportion to establish co-culture system.Different concentrations of phytagglutinin (PHA) (0,1.0,2.5,5.0,10.0 μg/ml) was added for 72 hours,and IL-6,IL-17A levels in the co-culture system supernatant and IL-17A receptor (IL-17RA) of the total cell membranes in the co-culture system were assayed by ELISA.The differences of IL-6,IL-17A,IL-17RA levels in co-culture system were compared between the TAO group and control group.Results The mean purity of T leukomonocyte in PBMCs was (81.10±0.21)％ in the TAO group and (80.05 ±0.38)％ in the control group respectively,with no significant difference between them(t =0.923,P＞0.05).Cultured OFs showed the positive response for Vimentin expression and Giemsa staining.After stimulated by 1.0 μg/ml PHA,the proliferation of both PBMCs and OFs were increased in the co-culture system.Apoptosis exist in PBMCs and the number of OFs decreased when PHA was higher than 1.0 μg/ml.The growth of PBMCs and OFs was faster in the TAO group than that in the control group in the same concentration of PHA.The contents of IL-6,IL-17A and IL-17RA in co-culture system were significantly different among various concentrations of PHA subgroups (IL-6:Fgroup =12.561,P=0.000;F ion =23.356,P =0.001.IL-17A:Fgroup =12.037,P =0.000;Fconcentration =19.206,P=0.000.IL-17RA:Fgroup =16.216,P=0.000;Fconcentraction =4.627,P=0.018).The production of IL-6,IL-17A and IL-17RA reached peak in both TAO group and the control group after 1.0 μg/ml PHA stimulated.However,the concentrations of IL-6,IL-17A and IL-17RA reduced with the increase of PHA concentration.The concentrations of IL-6,IL-17A and IL-17RA in co-culture system were significantly higher in the TAO group than those in the control group under the stimulation of the same concentration of PHA (all at P＜0.05).Conclusions The co-culture system of PBMCs and OFs stimulated with PHA can be the imitation of TAO pathogenesis in vitro,and PHA can amplify its immune reaction to imitate TAO pathogenic processes intuitively.The IL-6,IL-17A and IL-17RA secreted by PBMCs and induced by PHA are increased in TAO patients,implying that IL-17A participates in the pathogenesis of TAO through magnifying cellular immune response and inflammatory reaction.

Objective To compare the effectiveness and safety of central venous catheters inserted from the left side and right side during peripheral inserted central catheterizations (PICC). Methods Totally 458 adult patients undergoing PICC between May 2007 and May 2008 were enrolled in this study and divided randomly into right-sided group (n = 228)and left-slded group (n = 230). Chest X-ray was performed immediately after catheterization to identify the initial tip locations. Other parameters were evaluated during follow-up. Results The rate of difficult insertion was significantly lower in right-sided group than in left-sided group (14.9% vs 24. 8% , P =0.003). The rate of tip projection angle ＞40°was also significantly lower in right-sided group (2.2% vs 23.4% ,P = 0. 000). The rate of tips reaching the central veins was not significantly different between two groups (54.4%vs 53.0% , P = 0. 538). Compared with right-sided catheters, the tip positions in the left-sided group was significantly less frequently located in the inferior segment of superior vena cave in the central tip locations (6. 6% vs 21.0% , P =0. 001)and more commonly positioned in the nominate vein in non-central tip locations (66. 7% vs 48.1% , P = 0. 008). In addition, the catheter detaining time (P = 0. 617), incidence of local phlebitis after puncture (P = 0. 561), catheter obstruction rate (P = 0. 774), and catheter-related infection rate (P = 0. 854)showed no significant differences between two groups. The incidence of swollen limb was significantly lower inright-sided group than in left-sided group (4. 4% vs 8.3%, P = 0. 043). Conclusions Right-sided catheters provide better outcomes than left-sided catheters. PICC through the right elbow veins should be preferred in clinical practices.

Objective To investigate enteral or parenteral nutrition therapy effects in the aspects of patients' postoperative nutrition status,incidence of complications and health economics indicators of pancreatic head carcinoma or periampullary carcinoma patients after pancreaticoduodenectomy.Methods The clinical data of patients underwent PD in the First Affiliated Hospital of Harbin Medical University from January 2010 to August 2015 were collected.According to different postoperative nutrition therapy,patients were divided into parenteral followed enteral nutrition group (treatment group) and parenteral nutrition group (control group).Observed indicators such as postoperative nutrition status,liver and kidney function,incidence of complications,length and total cost of hospitalization were assessed.Results This study enrolled 207 cases in treatment group and 92 cases in control group.There was no significant difference in preoperative NRS scores,surgical procedures,pathology and other preoperative clinical indicators (P ＞ 0.05).Postoperative bilirubin reduction(△TB1.10) in treatment group versus control group had significant difference (P ＜ 0.05).Compared with postoperative Day 1,the prealbumin level of Day 7 and Day 10 in treatment group recovered rapidly than control group(△PA7.1,△PA10-1),however the differernce was not significant (P ＞ 0.05).Postoperative complications (pancreatic fistula,post-pancreatectomy hemorrhage,inna-abdominal infection,delayed gastric emptying) in treatment group and control group had no significant difference (P ＞ 0.05).The average and median hospitalization in treatment group [(28 ± 11) d,26 d] versus control group [(32 ± 18) d,29 d] had significant difference (P ＜ 0.05).The total cost of hospitalization in treatment group and control group were not significantly different(P ＞ 0.05).Conclusions This study indicated that postoperative parenteral followed enteral nutrition therapy could significantly enhance the recovery of liver function,shorten the length of hospitalization in patients after PD.Moreover,parenteral followed enteral nutrition therapy did not significantly increase the postoperative complications.

Objective:To study the effect of molecular weight and degree of substitution (DS) of chitosan-poly-arginine (CS-R9) on transdermal penetration enhancement in vitro. Methods:Low molecular CS, medium molecular CS or high molecular CS was respectively used to synthesize CS-R9 with different molecular weight (LCS-R9-1, MCS-R9 and HCS-R9). Low molecular CS was used to synthesize CS-R9 with various degree of substitution by changing the mole ratio between R9 and CS (LCS-R9-1, LCS-R9-2 and LCS-R9-3). The in vitro transdermal penetration enhancement of the different CS-R9 on tinidazole ( TNZ) was studied using Franz diffusion cells. Results:According to the results of FTIR and 1 H-NMR, a series of target CS-R9 were synthesized including LCS-R9-1 with the DS of 2. 30, MCS-R9 with the DS of 2. 17, HCS-R9 with the DS of 2. 20, LCS-R9-2 with the DS of 8. 05 and LCS-R9-3 with the DS of 15. 87. Compared with the blank control group, Azone group, LCS group, R9 group and LCS+R9 group, LCS-R9-1 could enhance the in vitro transdermal penetration of TNZ significantly (P<0. 05). When the DS was unchanged, LCS-R9-1 and HCS-R9 showed similar enhancement in the first 12h, and the effects were both higher than that of MCS-R9 (P<0. 05). The enhancement of HCS-R9 was decreased during 12-24h, while compared with that of LCS-R9-1, the difference was not notable (P>0. 05). When the molecular weight of CS was unchanged, the effect was increased with the rise of DS in the first 21h, however, after that, the effect was decreased with the rise of DS. Conclusion:Molecular weight and DS both have significant effect on the in vitro transdermal penetration enhancement of CS-R9, and it is valuable to further study the in vivo transdermal penetration enhancement of CS-R9 and underlying mechanisms.

Objective To investigate the clinical application of pancreatic head resection with the second portion duodenectomy (PHRSPD). MethodsThe clinical data of 4 PHRSPD cases were analyzed retrospectively. ResultsThere were 3 benign and 1 low-grade malignant periampullary tumors. The mean surgical time was 417 min, mean blood transfusion was 533 ml, mean hospital stay was 28.6 days. Delayed gastric emptying was encounted in one case. There was no hospital morality or major surgical complications. All cases were alive in the follow-up ranging from 6 to 36 months. There was no newly developed diabetes mellitus or severe gastroenteral symptoms. No reccurrence was found in the case with low-grade malignant duodenal tumor after 26 months. ConclusionsPHRSPD is an efficient way to treat benign and low-grade periampullary neoplasm and accompanying massive bleeding episodes.