Objective To investigate the safety and effect of fast track surger (FTS) y in repair of upper digestive tract perforation in emergency department.Methods According to the digital table,64 patients with upper digestive tract perforation were randomly divided into the observation group (n =34) and control group (n =30).The control group received conventional perioperative treatment.The patients in the observation group were given related processing of perioperation under the guidance of the concept of fast track surgery.The C reactive protein (CRP) level preoperation,postoperative 1 day,postoperative 3 days,postoperative incidence of adverse reaction and complications,exhaust defecation time,hospital stay and cost of hospitalization were compared between the two groups.Results Postoperative 1 day and 3 days,the CRP levels of observation group were (85.8 ± 17.5)mg/L and (67.1 ±15.6) mg/L,which were significantly lower than (112.4 ± 12.9) mg/L and (92.7 ± 25.4) mg/L of the control group (t =1.043,3.189,all P ＜ 0.05).After operation,the appeared exhaust defecation time,total length of hospital stay in the observation group were (54.6 ± 5.3) h,(66.2 ± 4.8) h and (4.1 ± 0.5) d,which were significantly shorter than those of the control group (t =2.534,3.013,2.252,all P ＜ 0.05).The cost of hospitalization of the observation group was (5 900 ± 300) thousand,which was significantly less than (7 000 ± 800) thousand of the control group (t =1.641,P ＜ 0.05).No significant differences between the two groups in appeared probability adverse reaction and complication after operation (P ＞ 0.05).Conclusion FTS in the repair of emergency upper gastrointestinal perforation is safe,economic,effective,and can accelerate the progress of rehabilitation.

Overt hyperthyroidism and hypothyroidism can induce hypertension.Recent studies found that mild thyroid dysfunction including subclinical thyroid diseases and increased TSH during normal reference range also had effect on blood pressure which had not been agreed with others.The mechanism is complex and not yet very clear.The basic treatment for the patients with thyroid diseases and hypertension is to treat thyroid diseases.Beta-receptor blocking agents and diuretics are preferable drugs for hyperthyroidism.

AIM: Respiratory tract cilia are difficult to harvest and observe due to weak transparence, which results from their location in thick mucosa, so people always try to obtain ciliated cells with many methods. This study was designed to apply manual microdissection to isolate ciliated cells from guinea pig's nasal epithelium and offer pure cells to further research. METHODS: The experiment was carried out at the Institute of Otolaryngology Head and Neck Surgery in Chinese PLA General Hospital from March of November in 2007. Twenty healthy white guinea pigs were recruited in this study. The ciliated cells layer was isolated from submucous layer by instruments for microsurgery under the light microscope. The isolated mucosa and untreated mucosa layer were stained with hematoxylin-eosin in order to verify the isolated layer is mucous ciliated cells layer. The protease-treated ciliated cells layer was viewed under low magnification microscope, to count number of single ciliated cells and impure cells, as well as size of ciliated cells group. The morphology of ciliated cells was observed under high magnification microscope. RESULTS: Result of hematoxylin-eosin stain confirmed that the cell layer by manual microdissection was ciliated cells and basal cell layer, which were thin without submucous layer. Under low magnification microscope after manual microdissection, the density of isolated ciliated cells was larger, number of single ciliated cells was more and size of ciliated cells group was smaller. There were about 7 ciliated cells in a cell group, and no other cells were observed. Under high magnification microscope, the isolated ciliated cells by manual microdissection were smooth, good in light refraction, and active for cilia beat. The survival time was prolonged obviously, still 50% cells were alive 24 hours later. Compared with conventional isolation technique, manual microdissection was significantly predominant in the purity and activity of cells (P

Objective To investigate the prevalence and influencing factors in senile cataract in Huzhou city.Methods 1 680 cases of healthy physical examination elderly population were selected as the research subjects in Huzhou city.To investigate the prevalence of cataract in the elderly population.The correlation of the prevalence of senile cataract,visual impairment and sex,age was studied.The correlation of the prevalence of senile cataract and diabetes,hypertension,smoking was analyzed.At the same time,Logistic regression analysis was used to analyze the influence factors of senile cataract.Results In 1 680 cases of elderly people,299 cases of cataract,the prevalence rate of cataract was 17.79%.With age increased,the prevalence of senile cataract was gradually increased.The preva-lence of cataract in female was 21.80%,which was higher than 15.82% in male,and the difference was statistically significant (χ2 =9.083,P <0.01).The visual acuity of senile cataract patients would increase with age.Moreover, the visual acuity of female patients was higher than that of male patients.The prevalence of cataract in diabetic group was 64.58%,which was higher than 17.89% in non -diabetes group,the difference was statistically significant (χ2 =65.457,P <0.01 ).The prevalence of cataract in hypertension group was 61.48%,which was higher than 14.31% in non -hypertension group,and the difference was statistically significant (χ2 =163.538,P <0.01).The prevalence of cataract in smoking group was 80.39%,which was higher than 16.94% in non - smoking group,the difference was statistically significant (χ2 =130.046,P <0.01).Logistic regression analysis showed that gender,age, diabetes,hypertension,smoking,and so on were the factors affecting the incidence of cataract in the elderly popula-tion.Conclusion The prevalence of cataract in the elderly population in Huzhou city need to pay attention to the local health department.

OBJECTIVE:To prepare andrographolide phospholipid compound,optimize its formulation technology and charac-terizeit. METHODS:Andrographolide phospholipid compound was prepared with solvent method. Using compound rate as index, the effects of reaction solvent,reaction time,reaction temperature,drug concentration,the ratio of reactants and other single fac-tors on compound rate were investigated. The ratio of reactants,reaction temperature and drug concentration were optimized by or-thogonal test and validated. The dissolubilities of andrographolide,andrographolide phospholipid physical mixture and androgra-pholide phospholipid compound in water,soybean oil and Lauroglycol FCC were compared and characterized with UV and DSC. RESULTS:The optimal preparation technology was tetrahydrofuran as reaction solvent,reaction time of 4 h,reaction temperature of 50 ℃,drug concentration of 10 mg/ml,ratio of andrographolide to phospholipid 1:3. The compound rate of andrographolide phospholipid compound was 83.2%(n=3). Compared with raw material and physical mixture,phospholipid compound significant-ly improved the dissolubility of andrographolide in water,soybean oil and Lauroglycol FCC. UV and DSC showed that compound had been prepared. CONCLUSIONS:Andrographolide phospholipid compound is prepared successfully.

Objective To explore the influence of intermittently inhaled budesonide on wheezing improvement and recurrent in infants,assess their body height and weight development status.Methods 138 wheezing infants were selected.They were randomly divided into the treatment group and the control group,69 children in each group.The treatment group received budesonide therapy when upper respiratory infection symptoms infection,the control group was given ribavirin injection spray treatment.After two weeks treatment,the number of severe wheezing and systemic corticosteroids were observed,the asthma relapse frequency in one year and height and weight were assessed.Results The severe wheezing number and the application of systemic corticosteroids number of the treatment were 1 case (1.50%)and three cases (4.35%),which were lower than the control group 8 cases (11.59%)and 11 cases (15.94%).The difference was statistically significant (χ2 =8.71,P <0.05).The frequency of wheezing within one year of the treatment group was (2.39 ±0.41)times,which was lower than (4.56 ±0.45)times of the control group, the difference was statistically significant (t =9.06,P <0.05).Comparison of height and weight of the two groups after one year,the differences was not statistically significant (t =1.45,1.18,all P >0.05).Conclusion Budesonide in the treatment of intermittent wheezing infants can significantly improve the wheezing and reduce the use of systemic corticosteroids,reduce the relapse rate.It has no effect on the growth and development of infants.

Post-translational modification by ubiquitin and ubiquitin-like modifiers(Ubls) is one of the most important mechanisms regulating a wide range of cellular processes in eukaryotes.Previous research showed that,through covalently modification by ubiquitin or ubls,the substrate proteins can be regulated in many different ways like stability,subcellular localization,enzymatic activity,protein-protein interaction and so on.Therefore,we believe,that ubiquitin and ubls play very important roles in cellular and biological processes by modifying plenty of proteins.To better understand the ubiquitin and ubls system,proteomic approaches have been developed to purify and identify more protein substrates.Large-scale idendification of ubiquitin/ubls-modification sites by mass spectrometry is particularly important for understanding the molecular mechanism and function of ubiquitin/ubls modification.Upto the present,more and more scientists are getting interested and participating in proteomics research of ubiquitin/Ubl modifications.This review summarizes the rencent results in this field.

Objective:To explore the effects of exosomes derived from bone-marrow endothelial progenitor cells(EPCs-Exos)on the angiogenesis and collagen deposition in vitro,and to illustrate the possible mechanism for EPCs-Exos to accelerate the cutaneous deficiency repair.Methods:The endothelial progenitor cells (EPCs) were isolated, cultivated and identified;at the same time, the EPCs-Exos were also isolated and identified.The EPCs-Exos uptake in EPCs was observed and analyzed.16 rats were randomly divided into 4 groups, and then the models of skin defect were established, respectively.The equal volume of PBS and 50, 100, 150 mg·L-1 EPCs-Exos were injected into the area around skin defect of the rats in 4 groups.The wound closed sizes on the 0, 3rd, 7th and 14th days were measured, and Masson''s trichrome staining and CD31 immunofluorescence staining were performed on the 14th day for evaluating the tissue healing efficacy after EPCs-Exos treatment.In vitro,the mediums containing PBS and 50, 100, 150 mg·L-1 EPCs-Exos were used to culture the human umbilical vein endothelial cells (HUVECs), respectively.Scratch test and tubule formation assay were used to detect the migration and capillary network formation of HUVECs.At the same time, Western blotting was used for analyzing the expression level of angiogenesis related gene vascular endothelial growth factor A (VEGFA) in HUVECs.Results: The primary EPCs were isolated and identified successfully, and EPCs-Exos were purified and characterized.The CD31 immunofluorescence staining and double staining of DiL-ac-LDL and FITC-UEA-I of EPCs were positive.The electron microscope results showed that EPCs-Exos were nearly spheroidal, with the diameter about 40-100 nm.For the models of rat skin injury treated by EPCs-Exos, with the increasing of injection doses, the sizes of skin defect scar were gradually reduced, the degrees of scar healings were gradually increased,and the differences between various groups were statistically significant (P< 0.05).EPCs-Exos promoted the collagen maturity of healing skin in a dose-dependent manner;on the 14th day, the effect in 150 mg·L-1 EPCs-Exos group was the most significant.In vitro, EPCs-Exos promoted the migration and capillary network formation of HUVECs and increased the expression level of VEGFA;the migration rate,the net number of branches and the expression level of VEGFA in 150 mg·L-1 EPCs-Exos group were significantly higher than those in 50 mg·L-1 EPCs-Exos group and PBS group (P< 0.05).Conclusion: EPCs-Exos can promote the repair of traumatic skin defect of the rats by positively regulating the vascular endothelial cell function.

Objective To observe the effects of ginkgolide B (GB) on mRNA expression of foxgl and proliferation of cells in brain tissue of newborn rats with hypoxic-ischemic brain damage (HIBD).Methods A total of 128 clean 7-day-old healthy SD rats were randomly divided into sham operation group,the model group,the low-GB dose and the high-GB dose treatment groups.Classic Rice method were used to establish HIBD models in the latter 3 groups.Four hours after operation,and GB in dose of 5 mg/kg and 10 mg/kg was given to rats in the low and the high dose treatment groups by intraperitoneal injection postoperatively,once a day for 5 days,while sham operation and model groups were treated with equal physiological saline.All groups were respectively sacrificed on 3 d,7 d,14 d,28 d respectively.Quantitative real-time fluorescent polymerase chain reaction was employed to detect expression of Foxg1 gene.Then the number of 5-bromodeoxyuridine positive cell in subgranular zone was investigated by immunolluorescent stairning.Results The Foxg1 mRNA expression was observed 3 days after HIBD,peaked on 7th day,and then declined gradually; the levels of Foxg1 mRNA in the 2 treatment groups were higher than that of the HIBD group (all P ＜ 0.01) ; The expression of Foxgl at 7 d,14 d,28 d,in high-dose group were higher than those in the low-dose group (all P ＜ 0.01).The number of 5-bromodeoxyuridine positive cell was increased after HIBD,and the levels in the low-and the high-dose treatment groups were all higher than that of the model group (all P ＜ 0.05) ; the number of positive cell in high-dose treatment groups were higher than that in the low-dose treatment groups (P ＜ 0.05).Conclusions GB can promote the expression of Foxg1 gene and improve the proliferation of cells in Brain tissue after HIBD,which shows more significant efficacy in high-dose group than in low-dose group.

Objective To evaluate the treatment of ilioinguinal approach surgery associated acute iatrogenic deep venous thrombosis (DVT).Methods The clinical data and treatment of 11 patients with ilioinguinal approach surgery associated acute iatrogenic DVT were analyzed.Results These 11 patients initially suffered from complicated acetabulum fracture,7 cases were treated by single ilioinguinal approach surgery and the other 4 cases were combined with Kocher-Langenbeck approach.In 3 days after surgery,DVTs were found by Doppler sonography,and all the DVTs were proved having closed relationships with ilioinguinal approach through digital subtraction angiography(DSA):iliac-femoral veins appeared stenosis at ilioinguinal segment in all the 11 cases,DVTs were found distal to the stenosis in 9 cases,both sides in 2 cases (1 case combined extensive iliac vein emphraxis and the other case combined extensive femoral vein emphraxis).After retrievable inferior vena cava filters were implanted,11 patients received catheter-directed thrombolysis for 5-12 days.Complete thrombolysis was achieved in 8 cases and thrombi residual left in 3 cases.The iliac-femoral veins were recanalized completely.After (10 ± 4) month fellow-up,no DVT recurred and no PTS appeared.Conclusions Ilioinguinal approach surgery seriously effects iliac-femoral veins,and is a important precipitating factor of DVT.Early catheter-directed thrombolysis under the protection of inferior vena cava filter is an effective treatment.