Objective To investigate the influence of focal ischemic preconditioning on the expression of heat shock protein 70(HSP70) and ischemic tolerance Methods 42 SD rats were divided into 3 groups in which control group received sham operation only, and the other two groups received 2 hours of middle cerebral artery occlusion(MCAO) followed by 22 hours of reperfusion with or without 10 minutes of ischemic preconditioning 3 days before Infarct volume and HSP70 immunoreactivity were evaluated in each group Results Compared with the sham operated group, there was a smaller infarct volume( P

Objective To confirm the vancomycin loaded gelatin/β-TCP composite porous scaffolds could be used as sustained-release system,and investigate its efficiency of eliminating infections and repairing bone defects for the treatment of infected bone defects in rabbit.Methods The biodegradable gelatin sponge containing different contents (0,10％,30％,50％) of β-tricalcium phosphate ceramic (β-TCP) was prepared for the controlled-release of vancomycin and labeled with G-0 TCP,G-10 TCP,G-30 TCP and G-50 TCP respectively.Examinations of scanning electron microscopy,porosity analyses and mechanical test were performed.The K-B method was used to investigate the controlled release of vancomycin.Chronic Methicillin-resistant Staphylococcus aureus osteomyelitis models of rabbit were established.After thorough debridement,the infected bone defects were treated in four different groups:blank control group,G-0 TCP group,G-10 TCP group,and G-30 TCP group.At 4 and 8 weeks after implantation,X-ray and histological examinations were carried out to investigate the efficiency of eliminating infections and repairing bone defects.Results The prepared gelatin/β-TCP scaffold exhibited a homogeneously interconnected-3-D porous structure.And the β-TCP granules were localized evenly on the walls of the composite scaffold.There were no significant differences in the pore size of different scaffolds.However,the β-TCP granules can improve the interconnection.The porosity exhibited an obvious increase in G-10 TCP and G-30 TCP composite scaffolds compared with G-0 TCP scaffold.In contrast,too high content of β-TCP granules decreased the porosity.And the porosity exhibited an obvious reduction in the G-50 TCP composite scaffold.The compressive modulus of the vancomycin loaded scaffolds increased with the increase of the β-TCP amount.The scaffold G-0 TCP exhibited the longest duration of vancomycin release and the duration reached 8 weeks.With the increased content of β-TCP granules,the release duration shortened obviously.Compared with the G-50 TCP composite scaffold,the G-10 TCP and G-30 TCP composite scaffolds revealed a better controlled release of the drugs,and the total amount of the drugs was released within 7 weeks.However,the total amount of vancomycin released from the G-50 TCP composite scaffold lasted for 3 weeks.In the treatment of chronic MRSA osteomyelitis of rabbits,the G-30 TCP composite scaffold showed a better performance in the eliminating infections and bone defects repair.At 8 weeks after implantation,signs of osteomyelitis,including osteolysis,development of periosteal reactions,and sequestral bone formation were observed in the animals of blank control group.Signs of infection were absent in other treatment group.In the group treated with G-30 TCP composite scaffold,the bonedefects were repaired completely at 8 weeks after implantation.However,in the groups treated with G-0 TCP and G-10 TCP composite scaffold,the bone defects were not repaired.Conclusion The composite scaffolds could achieve local therapeutic drug levels over an extended duration.And the gelatin with 30％ β-TCP granules composite scaffold had optimal porosity,interconnection,mechanical properties and controlled release performances.It exhibited good performances in infection control and bone defect repair in the chronic MRSA osteomyelitis model.

Objective:A study was conducted to observe and compare the efficacy and safety of endostar combined with peme-trexed in elderly patients with advanced lung adenocarcinoma. Methods:Sixty advanced lung adenocarcinoma (ⅢB-Ⅳ) patients who never received any therapy were included. The patients were divided into two groups. One group comprised endostar treatment com-bined with pemetrexed (26 cases of males, 15 cases of females, and 11 cases of individuals aged 65 years old to 78 years old), and the other group comprised pemetrexed only (34 cases of males, 20 cases of female, and 14 cases of individuals aged 65 years old to 78 years old). The two groups were treated for 4 to 6 cycles, and evaluation of treatments was performed every two cycles. Results:The endostar group was re-treated for 80 cycles, and the average cycle was 3.1. The group without endostar was re-treated for 115 cycles. The short-term effects are as follows. The total effective rates (RRs) in the experimental and control groups were 23.1%and 14.7%, re-spectively, and the difference was statistically significant (P<0.05). The disease control rate (DCR) was not significantly different (P>0.05). For pleural effusion, RR and DCR were significantly better in the experimental group than in the control group (P<0.05). In the experimental group, compared with PD, the microvessel density (MVD) in the DCR showed higher expression, and a statistically signif-icant difference (P=0.03) was observed. In the control group, compared with PD, the MVD in the DCR also showed higher expression, but no significant difference (P=0.73) was observed. The long-term effects were as follows: median progression-free survival (PFS), median survival, and side effects between the two groups were not significantly different (P>0.05). Conclusion: Endostar combined with pemetrexed showed increase in total efficiency in elderly patients with lung adenocarcinoma, and malignant pleural effusion was controlled without increasing the toxicity of chemotherapy. MVD can be used as a predictor of Endostar application.

Objective To evaluate the efficacy of laparoscope, choledochoscope and duodenoscope in the treatment of extrahepatic bile duct stones. Methods The clinical data of 610 patients with extrahepatic bile duct stones who had received the treatment with laparoscope, choledochoscope and duodenoscope in our hospital from September 1997 to January 2007 were retrospectively analyzed. Patients with bile duct stones received ERCP or EST, and patients with cholecystolithiasis + choledocholithiasis underwent the treatment with laparoscope+ duodenoscope, or laparoscope + choledochoscope, or laparoscope + duodenoscope + choledochoscope. Results The operation was successful in 589 patients, with the successful rate of 96.6%. The duration of hospital stay was 7-28 days (mean, 13 days). No severe complications such as bile leakage, duodenal leakage, duodenal papilla bleeding, acute cholangitis occurred. Four hundred and eleven patients had been followed up for 1 to 3 years (mean, 13 months), and no bile duct stone recurrence or other complications occurred. Conclusions For patients with bile duct stones, the treatment with ERCP or EST is appropriate. Laparoscope + endoscopes in the treatment of cholecystolithiasis combined with choledocholithiasis is safe and effective.

A case of varicella pneumonia, hepatitis and pancreatitis after kidney transplantation was retrospectively analyzed. One week after kidney transplantation, the patient had a papule with pruritus, which was diagnosed as varicella by dermatologist as well as high-throughput sequencing. The patient was found to have pneumonia, hepatitis and pancreatitis. The individualized treatment regimen was used, including the dosage reduction of immunosuppressive agents, the blood drug concentration monitoring, antiviral therapy, anti-infection therapy, supportive treatment, and symptomatic alleviation for complications. The treatment was adjusted according to the indicators'variation. The timely review of the indicators and immunosuppressant blood concentration were performed to protect the transplanted kidney function, and the patient recovered in time. This rare case of postoperative complications of kidney transplantation were summarized and analyzed in order to accumulate clinical experience for the treatment of renal transplantation.

Objective To explore the clinical characteristics of mycoplasma pneumonia with pulmonary atelectasis and lavage interventional effect through fiberoptic bronchoscopy in children.Methods During Jun 2012 to Apr 2013,fifty-three children diagnosed of mycoplasma pneumonia with pulmonary atelectasis who received fiberoptic bronchoscopy were enrolled as the experimental group.Thirty-five children diagnosed of mycoplasma pneumonia without pulmonary atelectasis were chosen as control group.According to the lavage interventional time of fiberoptic bronchoscopy,we divided the patients in the experimental group into two groups,the early group and late group.Clinical data and laboratory finds were collected and analyzed.Results The duration of fever,hospital stay and C-reactive protein (CRP) of the experimental group were significantly higher than those of the control group (P ＜ 0.05).The location of pulmonary atelectasis in the experimental group were usually in the right middle lobe (18 cases,33.9％).Under fiberoptic bronchoscope,all patients had obviously bronchial mucosa congestive edema.Some of them had follicular hyperplasia (9 cases,17.0％),mucosal erosion (3 cases,5.7％),mucus plug formation (7 cases,13.2％) and poor ventilation of segmental bronchi (4 cases,7.5 ％).Neutrophils (43 cases,81.1％) increased and phagocytic cells (31 cases,58.5％) dereased obviously in bronchoalevolar lavage fluid.After treatment in the experimental group,52 children (98.1％) got complete recruitment of atelectasis.The average duration of fever and hospital stay of the early group were significantly shoter than those of late group (P ＜ 0.05).Conclusion Children diagnosed of mycoplasma pneumonia with pulmonary atelectasis had longer fever duration and higher CRP level.Bronchoscopic interventional therapy promoted the recovery of pulmonary atelectasis.Using bronchoscop early in shorten the duration of fever and hospitalization in children diagnosed of mycoplasm pneumonia with pulmonary atelectasis.

Objective To explore the effects of lamotrigine on the cognitive function and the quality of life in epilepsy patients.Methods This was a prospective study and 91 newly diagnosed epilepsy patients were enrolled.The neuropsychological tests score and the quality of life in epilepsy inventory(QOLIE-31) were obtained before and after the treatment with lamotrigine.A battery of neuropsychological tests comprised the auditory verbal learning test(AVLT), the logical memory test(LMT), the digital symbol test(DST), the stroop color word test(SCWT), the trail making test(TMT), the verbal fluency test(VFT), the WAIS block design test(WBDT), the WAIS digital span test(WDST)and the Boston naming test(BNT). Results The repeated assessments in the patients taking lamotrigine were associated with significant improvements in many domains.The greatest changes were observed in the immediate and delayed recall of AVLT, DST, the time consuming of SCWT card C and TMT test A and B, the immediate and delayed recall of LMT, VFT, WBDT and BNT.For the quality of life, significant improvements were recorded in the fields of the seizure worry(38.81?16.06 vs 45.68?15.18), the overall quality of life(59.12?13.50 vs 64.99?13.33), the social function(64.59?25.14 vs 69.41?22.70)and the self-health evaluation (71.18?13.73 vs 76.75?11.30).Conclusion Improvements of the cognitive function and the quality of life can be observed in the initial period of medication with lamotrigine in epilepsy patients.

Objective: To investigate the influence of fast tract surgery on the humoral immunity and the chief clinical index of gastric cancer patients.Methods: 56 patients with gastric cancer from December 2007 to June 2008 were randomly divided into two groups: experiment group(fast tract surgery group, n=28)and control group(conventional treatment group, n=28 ). The changes of serum levels of humoral immunity and the chief clinical index were analysed and compared.Results: The serum levels of humoral immunity in both group were decreased. The serum levels of C3 and C4 on the postoperative 1st day were(0.845±0.126)g/L and(0.212±0.070)g/L respectively(P<0.05) in FTS group.The serum levels of IgA, IgM and IgG on the postoperative 3rd day were(1.603±0.468)g/L,(0.845±0.187)g/L,(9.548±1.920)g/L respectively(P<0.05) in FTS group. The duration of antibiotic use, first passage of flatus, the lengh of hospital stay, the occurance of postoperative complications in FTS group were also significiantly lower than those in control group (P<0.01, P<0.05).Conclusion: Fast tract surgery affectes on the humoral immunity of gasrtic cancer patients, and it might contribute to the improved outcomes of postoperative patients.

Objective To observe the changes of bone mass in reloaded rats after tail-suspension,and the effect and mechanism of simvastatin on this process.Methods Twenty-four 5-month old rats were divided into 4 groups of 6 animals in each group: Control (CL) group without tail-suspension,unloaded (UL) group with tail-suspension for 6 weeks,other 12 rats received tail-suspension for 3 weeks,then reloaded for subsequent 3 weeks (UL+RL) or combined with simvastatin treatment (UL+RL+SIM) at a dose of 10 mg/kg/d.All rats were sacrificed 6 weeks later,and the left femur was used for examination of bone mineral density,left tibia was used for bone histomorphometry analysis,the right femur and tibia were harvested for biomechanical test,and expression levels of type I collagen by real-time PCR and Western blot,respectively.Results 1.BMD of the CL group was significantly higher than those of the other three groups (P<0.05),and was markedly lower than those in the UL+RL and UL+RL+SIM groups (P<0.05).2.The bone histomorphometry showed that BV/TV in the CL group was significantly higher than those in the other 3 groups,and the UL+RL and UL+RL+SIM groups showed a significantly higher BV/TV than that of UL group (P<0.05).The Tb.Th was significantly higher in the CL group than in the UL group.The Tb.Sp in the CL group was significantly lower than those in the other 3 groups (P<0.05).The UL+RL and UL+RL+SIM groups showed significantly lower Tb.Sp than that of the UL group (P<0.05).3.Biomechanical test showed that the maximal load and elastic modulus in the CL groups were significantly higher than those of the other three groups (P<0.05).4.Real-time PCR showed that no significant difference in the mRNA expression level of Col I was found between any two groups.5.Western blot showed that the IOD of Col I is significantly lower than that in the CL group.Conslusions Bone loss,destruction of trabecular bone micro-architecture and biomechanical properties and reduction of type 1 collagen are present in tail-suspension treated rats,which are partially restored after reloading,and this recovery process is not enhanced by simvastatin treatment.

Objective To investigate the clinicopathological significance of expression of insulin like growth factor 1 receptor (IGF1R) protein in primary gastrointestinal stromal tumors (GIST) and their impacts on prognosis.Methods Between January,2005 and January,2011,84 primary GIST patients underwent surgery.Immunohistochemical analysis was performed based on tissue microarray to estimate expression pattern of IGF1R in tumor cells and nomal controls.Association of IGF1R expression with clinicopathological features and relapse-free survival (RFS) were also analyzed.Results The negative,weakly positive,positive,and strong positive expression rates of IGF1 R protein in GIST group were 20％,14％,48％ and 18％,respectively;while in the control group were 32％,40％,20％ and 8％,respectively (x2 =30.663,P ＜ 0.001).The 5-year overall survival (OS) rate was 93％.1-year,3-year and 5-year RFS rate were 99％,76％ and 60％,respectively.As shown by univariate analysis the following factors were poor prognostic indicators for RFS,non-gastric tumor location (P =0.017),large tumor size (P =0.022),high mitotic index (P ＜ 0.001),high cellularity (P =0.012),tumor rupture (P =0.013),absent or low expression of IGF1R (P =0.022).Tumor size (HR5.1-10 ≤5 cm =1.86,95％ CI:0.67-5.15;HR＞10 ≤5cm =6.71,95％ CI:0.67-5.15,overall P =0.023),and mitotic index (HR5.1-10/50HPFsvs.≤5/50HPFs =5.72,95％ CI:2.09-15.64;HR＞10/50HPF ≤5/50HPFs =3.44,95％ CI:1.13-10.45,overall P =0.002) were negative independent risk predictors by multivariate analysis.Conclusions High expression of IGF1R may be involved in the occurrence,development and poor prognostic of primary GIST.Expression of IGF1 R is correlated with high risk potential and may predict early recurrence.