Objective To examine the expression of transforming growth factor β(TGF-β) activated kinase 1 (TAK1) in esophageal organization and the impact of TAK1 expression on clinicopathologic data. Methods Specimens from 80 patients with esophageal adenocarcinoma managed in our hospital were included in this study. Immunohistochemical staining was used to detect the expression of TAK1 in 80 cases of esophageal squamous cell carcinoma tissues and 80 cases of normal esophageal mucosal tissues. All the specimens were confirmed by pathology for esophageal squamous cell carcinoma or esophageal normal tissues. Results The positive expression rate of TAK1 in esophageal cancer organizations and normal esophageal mucosal tissues were 80% and 11.25%, respectively. The positive expression rate of TAK1 in esophageal cancer were significantly higher than those in normal esophageal mucosal tissue (P < 0.05). The positive expression rate of TAK1 in esophageal cancer organizations has nothing to do with the age, sex, tumor differentiation degree and size (P>0.05), but with lymph node metastasis and clinical stage (P<0.05). Patients with positive TAK1 expression had significantly lower five-year survival rate than those with tumors having positive TAK1 expression Conclusion TAK1 played an important role in the pathology and development of squamous cell carcinoma , and could be an important therapeutic target in the treatment of esophageal cancer.

Animals ; Dental Implantation, Endosseous ; adverse effects ; Dental Implants ; adverse effects ; Dental Prosthesis, Implant-Supported ; adverse effects ; Dentition ; Humans ; Malocclusion ; etiology ; Maxillofacial Development

OBJECTIVE To study the epidemiology and the sensitivity to antibiotics of bacteremia in intensive care unit,and provide the reference for the clinical antimicrobial agents usage. METHODS 465 cases of bacteremia from Jan 2005 to Dec 2007 in the First Affiliated Hospital,Medical College of Zhejiang University were retrospectively analyzed. RESULTS Totally 1465 strains of pathogens were isolated in three years,and the positive rates were 22.6%.From them 155 strains were fungi(10.6%),611 strains were Gram-positive bacteria(57.9%) and 392 strains were Gram-negative bacteria(37.1%).G + strains mainly included coagulase-negative Staphylococcus(CNS,43.0%) and Staphylococcus aureus(2.1%);the sensitive antibiotics were vancomycin and teicoplanin.G-strains mainly included Acinetobacter baumannii(8.6%);Stenotrophomonas maltophilia(6.6%);Pseudomonas(5.1%) and Klebsiella pneumoniae(5.3%),the sensitive antibiotics were cefoperazone/sulbactam. CONCLUSIONS The positive rates of blood culture are higher in intensive care unit than in others.We should pay more attention to CNS for its high infection rate.The sensitive antibiotics of G + are vancomycin and teicoplanin.The sensitive antibiotics of G-are cefoperazone/sulbactum.Antimicrobial therapy should be conducted according to susceptibility test.The candidemia caused by non-Candida albicans(NCA) is increaseing in recent 3 year.

Objective To evaluate the value of mini-thoracotomy for open heart surgery.Methods From December 1995 to January 2008,810 patients including 660 cases of congenital heart diseases,129 cases of valvular heart diseases and 21 cases of heart myxoma,underwent open heart surgery by mini-thoracotomy through cardiopulmonary bypass in our hospital.Among the cases,superior median sternotomy was performed on 36 patients,inferior median sternotomy was made on 59,right parasternal mini-thoracotomy was carried out in 3,right anterolateral thoracotomy was done on 658,and right axillary mini-thoracotomy was used in 54.A total of 382 patients received beating-heart surgery.Results The postoperative mortality in our patients was 1.5%(12 cases).In this series,the mean postoperative mechanical ventilation time,drainage volume,and hospital stay were(6.7?4.2) hours,(210?165) ml,and(7.4?4.9) days respectively.421 of the patients received no blood transfusion.None of the patients developed sternal dehiscence or mediastinal infection.Follow-up was available in 690(85%) of the patients up to a mean of(48.2?25.3) months,none of them died during the period.The cardiac function of the patients was significantly improved after the operation(preparation vs postoperation: 310 cases vs 478 cases for grade Ⅰ,438 vs 212 for grades Ⅱ-Ⅲ,and 62 vs 0 for grade Ⅳ,Z=-13.21,P=0.000).The mean cardiothoracic ratio was decreased significantly after the operation(0.51?0.11 vs 0.53?0.08,t=4.065,P=0.000),while the left ventricular ejection fraction was increased markedly(0.63?0.11 vs 0.57?0.11,t=-10.529,P=0.000).Conclusions The mini-thoracotomy is superior in cosmetic results and the postoperative morbidity rates of sternal malformation and infection.Proper selection of patients,good exposure of the surgical field,and skillful surgical procedures are crucial for the outcomes of the operation.

Adult ; Facial Nerve Diseases ; complications ; Female ; Humans ; Mastoiditis ; complications ; Neurofibroma ; complications

BACKGROUND:Cerebral hemorrhage can activate the proliferation and differentiation of neural stem cel s in the dentate gyrus of the hippocampus. Through continuous differentiation and proliferation, endogenous neural stem cel s can gradual y replace aging and damaged neurons, thus protecting the brain structure.
OBJECTIVE:To compare the difference of the proliferation and differentiation of neural stem cel s in the dentate gyrus of the hippocampus of rats with different ages.
METHODS:Ninety-six adult rats and 96 aged rats were randomly divided into normal group (n=18 per group), sham operation group (n=12 per group) and cerebral hemorrhage group (model group, n=66 per group), respectively. Cerebral hemorrhage models were made in the two model groups in which, the rats were subjected to cerebral hemorrhage for 6, 24, 48, 72 hours and 7 days, respectively. Then, brain tissues were col ected to measure brain water content. BrdU/NeuN and BrdU/GFAP double staining were performed at 3, 7, 14, 21, 28 days after surgery to calculate the number of positive cel s.
RESULTS AND CONCLUSION:For both adult and aged rats, the brain water content was significantly higher than that in the normal group and sham operation group (P<0.05), while in the normal and sham operation groups, the brain water content was significantly lower in the aged rats than the adult rats (P<0.05). The number of bilateral BrdU-positive cel s in the adult and aged model groups was significantly higher than that in the corresponding normal and sham operation groups (P<0.05), and moreover, the positive cel number at the hemorrhage side was significantly higher than that at the opposite side (P<0.05). In addition, the number of BrdU-positive cel s at the hemorrhage side in the adult rats was significantly higher than that in the aged rats at different time after cerebral hemorrhage (P<0.05). Results from immunohistochemical double staining showed that the BrdU/NeuN and BrdU/GFAP expression in the hippocampal dentate gyrus of adult rats with cerebral hemorrhage was significantly higher than that of normal adult rats. Al these experimental results show that there are a few neural stem cel s proliferating in the hippocampal dentate gyrus of normal rats, and the proliferation ability is stronger in the adult rats than the aged rats. Cerebral hemorrhage can significantly strengthen the proliferation of neural stem cel s in the dentate gyrus in the adult rats compared with the aged rats.

Objective To compare everolimus (EVR) with calcineurin inhibitor (CNI) minimization or withdrawal on renal function of liver transplant patients with standard CNI therapy.Methods A search was conducted on databases which included the PubMed,Embase and Cochrane library for randomized controlled trials (RCTs) comparing EVR with CNI with minimization or withdrawal (the EVR group) with standard CNI therapy (the standard CNIs group) on renal function of liver transplant patients.A metaanalysis was performed using RevMan 5.3 software.Results Five RCTs which included 1 264 patients were selected into this study.There were 790 patients in the EVR group and 474 patients in the standard CNIs group.On meta-analysis,the EVR group had significantly better renal function (SMD =0.36,95％ CI 0.09 ～ 0.64,P ＜ 0.05),but higher rates of infection (RR =1.37,95％ CI 1.08 ～ 1.74,P ＜ 0.05),dyslipidemia (RR =2.46,95％ CI 1.79 ～ 3.38) and leukopenia (RR =2.37,95％ CI 1.32 ～ 4.26).No significant differences were found on the mortality and the acute rejection rates between the two groups (all P ＜ 0.05).Conclusions EVR with CNI minimization or withdrawal after liver transplantation provided effective immunosuppression and improved patients' renal function.The treatment increased the rates of infection,dyslipidemia and leukopenia.

BACKGROUND:Previous studies showed that neurotrophic factor has a variety of functions, which can effectively maintain the survival of neurons after injury.
OBJECTIVE:To observe the effect of adenovirus-mediated brain-derived neurotrophic factor on the differentiation of endogenous neural stem cels after intracerebral hemorrhage in rats.
METHODS:A total of 90 Sprague-Dawley rat models of cerebral hemorrhage were made. At 12 hours after cerebral hemorrhage, 5-bromodeoxyuridine (BrdU) was intraperitonealy injected, twice a day, for 10 consecutive days. After model establishment, rats were randomly divided into three groups, 30 rats in each group, and were respectively subjected to brain stereotaxic injection of adenovirus vector, adenovirus-mediated brain-derived neurotrophic factor and physiological saline. At 1 day, 3 days, 1 week, 2 weeks, 3 weeks, and 4 weeks, neurological deficit score was evaluated. Absorbancevalue of growth associated protein around the area of hematoma after intracerebral hemorrhage was measured. At 4 weeks after injection, double immunostaining was used to detect the expression of BrdU/NeuN and BrdU/glial fibrilary acidic protein (GFAP).
RESULTS AND CONCLUSION:(1) With the passage of time, nerve function defect score decreased in the three groups. At 1-4 weeks after injection, nerve function deficit scoreswere lower in the adenovirus-mediated brain-derived neurotrophic factor group thanthat in the adenovirus vector group and saline group (P< 0.05). (2) With the passage of time, the average absorbance of three groups in the peri-hematoma region first increased and then decreased. The absorbance value was higher in the adenovirus-mediated brain-derived neurotrophic factor group than in the adenovirus vector group and saline group at 3 days-4 weeks (P< 0.05). (3) BrdU/NeuN and BrdU/GFAP rates were significantly higher in the adenovirus-mediated brain-derived neurotrophic factor group thanthat of adenovirus vector group and saline group (P< 0.05). (4) The results show that the brain-derived neurotrophic factor mediated by adenovirus, and intervention on cerebral hemorrhage in rats can effectively promote the differentiation of endogenousneural stem cels, and promote the recovery of neural function in animal.

Objective To conduct a systematic review on the safety and efficacy of enhanced recov -ery after surgery ( ERAS) in perioperative management of hepatectomy .Methods A literature search was conducted on databases which included the PubMed , Embase, Cochrane Library, Sinomed, Wangfang, VIP and CNKI for randomized controlled trials ( RCTs) on application of ERAS in patients after hepatectomy . The data collection ended in August 2015.A meta-analysis was performed using RevMan 5.3 software.Re-sults Eleven RCTs which included 1074 patients were selected into this study .There were 530 patients in the ERAS group and 544 patients in the control group .On Meta-analysis, when compared with the control group, the ERAS group had significantly shorter length of hospital day (WMD=-2.36, 95%CI: -3.19~-1.54 , P<0.05 ) , shorter time for functional recovery ( WMD=-2.30 , 95%CI: -3.77 ~-0.83 , P<0.05), lower total complication rate (RR=0.65, 95%CI:0.52~0.80, P<0.05), and significantly decreased rates of postoperative pulmonary infection (RR=0.36, 95%CI:0.14~0.91, P<0.05) and nausea and vomiting (RR=0.48, 95%CI:0.26~0.89, P<0.05).There were no significant differences between the two groups on the rates of postoperative bleeding , biliary fistula, abdominal infection, delayed incisional healing, wound infection and urinary tract infection (P>0.05).The ERAS group had significant-ly lower hospitalization cost (SMD=-1.61, 95%CI:-2.42~-0.80, P<0.05), but the differences between the two groups on mortality and re-admission rates were not significant (P>0.05).When compared with the control group , the drainage tube removal time ( WMD=-2.83 , 95% CI:-3.92~-1.76 , P<0.05), time to first mobilization (SMD=-2.34, 95%CI:-2.98~-1.70, P<0.05), time to first feeding ( SMD=-5.08 , 95%CI: -9.33~-0.83 , P<0.05) , time to passage of first flatus ( SMD=-3.60, 95%CI:-4.85~-2.34, P<0.05) in the ERAS group were significantly shorter , but there was no significant difference on the time to the first bowel motion ( P>0.05 ) .Conclusions ERAS in the peri-operative management of hepatectomy was safe and beneficial .

Objective To measure and analyze the radioactivity level of 210Pb in outdoor air in Beijing in spring.Methods Portable high flow air samplers were used to collect outdoor air at the ground level to analyze the 210Pb radioactivity in the aerosol filter samples using a laboratory-based high purity germanium (HPGe) γ spectrometer.Results The activity concentration of 210Pb outdoors ranged from 267.2 to 1 697.6 μBq/m3,with an average of (878.7 ± 386.7) μBq/m3.Statistical analysis showed that the activity concentrations 210Pb of outdoors varied with variable air quality.Conclusions The activity concentrations of 210Pb outdoors are detectable in Beijing,varying considerably but within the normal range.