Objective To investigate the curative effect and the clinical value of double intervention in treating recurrent cancer on the stump of stomach after radical operation of gastric antrum.Methods 11 patients with recurrent cancer and stricture on the stump of stomach were treated with stent implantation and celiac arterial chemotherapy. 2 patients with ascites were treated with intravenous chemotherapy at first ,3 patients with hepatometastatic carcinorma were treated by embolization with lipiodol.All patients were retreated with celiac chemotherapy according to their healthy state after three or four weeks. All patients were fllowed-up.Results After therapy 6 months,12 months and 18 months survival rate were 63 6%,45% and 18% respectively,average survive 12 months.Conclusions Celiac arterial chemotherapy and stent implantation can prolong the survival period of the patients with recurrent cancer on the stump of stomach after radical operation for carcinoma of gastric antrum and improve their living quality.

Objective To investigate the protective effect of glutamine(Gln) pretreatment on intestinal ischemia-reperfusion (I/R) injury and endothelial nitric oxide synthase (eNOS)/nitric oxide (NO) signaling pathway in rat model. Methods Thirty male Wistar rats were randomly divided into three groups(n=10 for each group):sham group, I/R group and Gln group. Animals were pretreated with 1 g/(kg·d)Gln by orogastric route for 7 days in Gln group, and normal saline was given to the other two groups in the same dose. Intestinal I/R was induced by 30 min occlusion of the superior mesenteric artery followed by 24 h of reperfusion. After the operation, the intestinal histopathological changes, the plasma endotoxin level, serum D-lactic acid, eNOS, inducible NOS(iNOS)activity and NO levels were detected by ultraviolet spectrophotometer. The mRNA expressions of myocardial eNOS and iNOS were detected by real-time fluorescence quantitative PCR (RT-PCR). Results After reperfusion, in IR group, extensive epithelial sloughing and mucosal ulceration of villous tips were observed, whereas these findings did not occur in Gln group and sham group. Compared with IR group, the serum NO, eNOS levels and eNOS mRNA expression of intestinal tissue were elevated in Gln group (P<0.01), but the plasma endotoxin level, serum D-lactic acid, serum iNOS and intestinal iNOS mRNA expression decreased in IR group(P<0.05). Conclusion Glutamine pretreatment has protective effects on intestinal ischemia-reperfusion injury in vivo. The mechanism may be related to the inhibition of iNOS expression and the increased expression of eNOS, thereby increasing NO activity.

Objective To apply teaching integration of theory and practice in curriculum integration of medical and surgical nursing,in order to improve staff-students' satisfaction and promote teaching quality of curriculum integration.Methods The teaching method was designed as the combination of autonomous learning,entering the clinical scene and centralized instructions,and was applied into teaching integration of theory and practice in curriculum integration of medical and surgical nursing in grade 2009 undergraduates.Teachers and students were investigated by the satisfaction questionnaire.Results The students got high average score which was (90.20±2.72) points in the examination of teaching integration of theory and practice.The total satisfaction degree showed significant difference between the normal teaching mode and the new one.Conclusions As an explored innovative teaching mode,teaching integration of theory and practice can well arouse staff-students' learning enthusiasm,promote teaching quality.It is the requirement of curriculum integration and be worthy of being developed.

AIM:To determine the effects of glutamine ( Gln) pretreatment on occludin protein in the rats with intestinal ischemia-reperfusion ( I/R ) injury.METHODS: Male Wistar rats ( n =30 ) were randomly divided into 3 groups (n=10):sham group, I/R group and Gln pretreatment group.The rats in Gln pretreatment group were pretreated with Gln at dose of 1 g? kg-1? d-1 by orogastric route for 7 d, and those in the other 2 groups were pretreated with the same volume of normal saline .Intestinal I/R was induced by 30-min occlusion of the superior mesenteric artery followed by 24 h of reperfusion.After the operation, the levels of IL-10, IL-2, TNF-α, SOD and MDA were measured.The occludin protein was determined by the methods of immunohistochemistry and Western blotting .RESULTS: The occludin protein level in I/R group was significantly lower than that in sham group and Gln group (P<0.05).The levels of MDA and TNF-αin I/R group were significantly higher than those in sham group and Gln group ( P<0.05 ) .The levels of SOD , IL-10 and IL-2 in I/R group were significantly lower than those in sham group and Gln group ( P<0.05 ) .CONCLUSION:Glutamine has a protective effect on occludin protein in intestinal ischemia-reperfusion injury .The mechanism may be rela-ted to oxidative stress response and inflammatory inhibition .

AIM:To determine the effects of glutamine ( Gln) pretreatment on intestinal ischemia-reperfusion (I/R) injury in the rats.METHODS: Thirty male Wistar rats were randomly divided into 3 groups (n=10): sham group, I/R group and Gln pretreatment group .The rats in Gln pretreatment group were pretreated with 1 g· kg -1 · d-1 Gln by orogastric route for 7 d, the rats in the other 2 groups were pretreated with normal saline .Intestinal I/R was induced by 30-min occlusion of the superior mesenteric artery followed by 24 h of reperfusion .After the operation , the plasma endo-toxin, serum D-lactic acid, superoxide dismutase ( SOD) and malondialdehyde ( MDA) levels were measured .The intesti-nal mucosal injury was observed with HE staining and evaluated using Chiu 's scoring.RESULTS: Serum D-lactic acid, endotoxin level , MDA level and Chiu's score in I/R group were significantly higher than those in sham group and Gln group (all P<0.05).Serum SOD activity was significantly lower than that in sham group and Gln group (P<0.05).CON-CLUSION:Glutamine has a protective effect on the intestines during ischemia-reperfusion injury .The mechanism may be related to oxidative stress response .

Objective To explore the possibility of using 131I as a targeted therapy method for malignant glioma by infecting U87 and U251 cells with conditionally replicative adenovirus Ad-Tp-E1a-Gp-NIS.Methods Human telomerase reverse transcriptase (hTERT) promoter and glial fibrillary acidic protein (GFAP) promoter were cloned and their transcriptional activities were detected by luciferase assay.The conditionally replicative adenovirus Ad-Tp-E1 a-Gp-NIS was constructed,purified,and transfected into U87 and U251 glioma cells.For these transfected cells,the selective replication ability was evaluated by plaque forming assay,and protein expression was detected by Western blot assay.125I-iodide uptake and exflux,the clonoy formation of 131I-iodide treated cells were also measured.Results Transcriptions activity of the GFAP and hTERT promoters was 59.75％-62.10％ (F =11.89,P ＜ 0.01) in U87 cells and 37.31％-49.00％ (F =5.87,P ＜ 0.05) in U251 cells.The Ad-Tp-E1a-Gp-NIS could be selectively replicated and the hNIS gene was successfully expressed in the hTERT-positive and GFAP-positive glioma cells which showed two protein bands with relative molecular mass of 120 × 103 and 49 × 103 in Western blot assay.After infection with Ad-Tp-E1a-Gp-NIS,the cell ability of 125I uptake was increased by 78.80 (F =2 914.58,P ＜0.01) and 92.48 (F =2 275.91,P ＜0.01) times in U87 and U251 cells,respectively.The GFAP-negative MRC-5 cells could not take in 125I.The in vitro clonogenic assay indicated that,after 131I treatment,more than 90％ of the transfected cells were killed,while only about 65％ (t =11.73-78.33,P ＜ 0.01) of control cells were killed.Conclusions The Ad-Tp-E1a-Gp-NIS has a good ability in selective replication and the enhancement of antitumor therapy effect by increasing tumor-specific iodide uptake in malignant glioma cells.

Objective To evaluate the efifcacy of endoscopic Over-The-Scope-Clip system (OTSC) system for the acute iatrogenic digestive tract perforation. Methods To collect 11 cases with digestive tract perforation closed with the OTSC system, including 7cases of gastric perforation, 1 case of duodenal perforation,3 cases of colorectal perforation. Results 11 cases were successfully closed with OTSC system in time, the average time needed for the endoscopic closure is 6~15 min. And the perforation diameter is 0.6~3.7 cm, average diameter is (1.89 ± 0.27) cm. No intraoperative bleeding and delayed hemorrhages, no deaths occurred. Conclusion Endoscopic OTSC system is a successful method for the digestive tract perforation and is worth to popularize.

Objective To study the effect of imbalance of proliferation and apoptosis in the development of colorectal carcinoma(CRC),and the molecular mechanism of the dynamic change.Methods ORC was(induced) with dimethylhydrazine(DMH) in male mice of Kimming strain.The mice were killed in batches in the 12th,18th and 24th weeks of carcinoma induction.The distribution and extent of proliferation and(apoptosis) of the colorectal mucosa,at various intervals,were dynamically observed.Three genes,p21waf1,Bax and Gadd45 were analyzed by RT-PCR,immunohistochemistry and Western blot.Results During the course of carcinoma induction,the mucosas of the model mice showed sequential changes of atypital(hyperplasia),adenoma,and carcinoma.Compared with control group,the PCNA expression of the model group mice was significantly higher(P

Objective To investigate the efficacy and influential factors of 131I treatment for lung metastases from DTC.Methods Fifty patients (18 males,32 females;age (40.8±13.2) years) with lung metastases from DTC who underwent 131I treatment from October 2007 to December 2012 were retrospectively analyzed.The efficacy of 131 I treatment was assessed using 131I imaging and determination of serum Tg level after 6 months.The possible factors affecting efficacy included patients' age,gender,operation method,pathological classification,the diagnostic time of pulmonary metastasis,serum Tg level at diagnosis,131I uptake pattern,characteristics of other imaging modalities,cervical lymph node metastases and extrapulmonary distant metastases (assign 1 for metastases,0 for no metastases).Univariate and multivariate analyses (Student t test,Fisher exact test and logistic regression) were performed to investigate the factors.Results The rates of complete remission,partial response and invalid of 131I treatment were 20％ (10/50),74％ (37/50) and 26％ (13/50) respectively.Univariate analysis showed that age(t =2.019,P＜0.05),gender (P =0.032),serum Tg level at diagnosis (t =2.646,P＜ 0.05),findings of other imaging modalities (P =0.039),and extrapulmonary distant metastases(P=0.023) were the factors influencing outcome of 131I treatment.Multivariate logistic regression analysis showed that the influential factors included age,serum Tg levels and extrapulmonary distant metastases.The regression equation was as follows:logit P =2.127-0.056× age-0.163×Tg level-1.280×extrapulmonary distant metastasis (x2=10.484,P＜0.001).Aged patients,a significant increase of Tg level and extrapulmonary distant metastases indicated a poor prognosis.Conclusions 131I treatment is an effective method for lung metastases from DTC.The patients with younger age,lower Tg levels,no other distant metastases had good response to 131I treatment.

Objective To investigate the effects of isoliquiritigenin on the invasive ability of human gastric carcinoma SGC7901 cells, and its molecular mechanisms thereof. Methods The logarithmic phase human gastric carcinoma SGC7901 cells were divided into control group (normal cell culture fluid) and isoliquiritigenin group (isoliquiritigenin solu?ble in cell culture fluid, the concentrations were 10, 25, 50 and 100 μmol/L respectively). Each group had four repeated holes. The proliferation of SGC7901 cells were detected with MTT assay after 24 h, 48 h and 72 h of culture. The experimen?tal drug concentration and action time were researched for the subsequent experiments. The in vitro invasion abilities of SGC7901 cells were assessed with Transwell test. The expression levels of MMP9, Akt and P-Akt were detected by Western blot assay. Results The proliferation of SGC7901 cells were inhibited by 10μmol/L isoliquiritigenin, which can be signifi?cantly inhibited by 25, 50 and 100μmol/L isoliquiritigenin in a concentration-dependent and time-dependent manner. The half inhibitory concentrations (IC50) of 24, 48 and 72 h were 52.48, 44.49 and 32.50μmol/L, respectively. Therefore, the 25, 50 and 100μmol/L isoliquiritigenin were selected as the subsequent experimental drug concentration, and 24 h was used as the action time. Compared with the control group (209.75±9.29), the membrane cell number of 25μmol/L (138.50±10.15), 50μmol/L (89.50 ± 16.56) and 100μmol/L (45.00 ± 8.08) decreased gradually (F=267.948,P<0.05). There was no signifi?cant difference in the expression level of Akt protein between four groups (F=1.492). The expression levels of P-Akt and MMP9 were gradually decreased with the increase of the isoliquirigenin concentration (F=359.219 and 431.324,P<0.05). Conclusion Isoliquiritigenin can obviously inhibit invasion ability of SGC7901 cells, which may be related to the down reg?ulation of the signal transduction pathway protein PI3K/Akt and the down steam protein MMP9.