Objective It has been demonstrated that para-operative fasting often induce gastrointestinal mucosal atrophy, that, together with the surgically-stress effects, deteriorate the intestinal harrier structure and may further cause gut-origin infection. Parenteral nutrition has been widely employed in the patients undergone surgery or with trauma as a standard nutritional support in many hospitals. It can provide sufficient nutrients, including calories, nitrogen, and minerals for the daily and extra needs during the stress. However, numbers of investigations have proven that long term parenteral nutrition support has no effects on preventing intestinal mucosa atrophy, but indeed, consistently result in down-regulation of mucosal structure. It has been widely accepted in the clinic that enteral nutrition should be chosen as a priority mean, as to parenteral nutrition, to support the patients whenever they can tolerant. However, there are few reports concerning earlier use of enteral nutrition in post-operative patients. The purpose of this study was to evaluate the effects of postoperative earlier enteral nutrition support (24～36 hours) on the patients undergone major surgery. The cases with earlier enteral nutrition feeding during last three years were reviewed and the feeding method, the effectiveness, and the complications of earlier feeding were investigated. In five cases, with two of proximal small intestine fistula, three of pancreas, duodenal injury, the total effectiveness was satisfactory. All patients gained wight and the nutritional states were much improved. The initial disease of the patients with earlier feeding were all cured within the time periods which were significantly shorter than those who had ordinary post-operative feeding. Only one case among five had mild nausea during the feeding, and was settled after anti-nauseas medications. Two cases with proximal small intestine fistula were recovered in four weeks time. We thus conclude that earlier enteral feeding post-operatively is a safe and effective method for those who have major surgery. It benefits bowel barrier function and further improves the recovery after surgery. Besides, earlier enteral feeding is less costly compared to parenteral nutrition, and easy to operate. A more case-based, prospective controlled clinical study should be organized in the future to further evaluate the usefulness of earlier enteral feeding in the patients with surgery.

OBJECTIVE: To explore the materials and selection of esophageal stents, and to discuss the application of covered stants in treating esophageal malignant stenosis.METHODS: CNKI and Medline databases were retrieved by computer for papers published from 1980 to 2009 with search terms of "esophageal carcinoma, esophageal stenosis, esophageal stent, and fabric-covered metallic stent". The language was limited for Chinese and English. A total of 61 iteratures were initial searched by computer, according to inclusive and exclusive criteria, 29 literatures were selected by the first author. Problems including esophageal stent category, material selection, as well as application of covered stents in treating esophageal malignant stenosis were reviewed and summarized.RESULTS: Totally 29 literatures were included in this paper. No concealed allocation or blinding method was described in the literatures. According to preparing materials, the stents could be divided into stainless metal stent, memory metallic stent and polyester plastic stent. As tissue-engineered materials, stents could be assigned into biodegradable polymer matrix stent and non-degradable biodegradable polymers stent. Each material stent possesses distinct advantage and disadvantage. The covered stents could relief esophageal stenosis effectively, interrupt tumor growth, and prevent restenosis. CONCLUSION: As a palliative therapy for treating esophageal malignant stenosis, covered stents can elevate patients' life quality and prolong survival times.

Replacement therapy of stem cells transplantation represents a potential treatment for neural retinal diseases.Despite the encouraging results in laboratory,the clinical application of cells replacement therapy is still difficult because the limitation of seed cells,immunologic rejection,oncogenicity and ethical problems,etc.Recent breakthrough in somatic reprogramming provides a promising solution overcoming these obstacles.Further researches on virus-free reprogramming will make the clinical application of stem cell replacement therapy possible.

The structure of collagen fibers in the loose and dense connective tissues, from various sources (central tendon of dog diaphragm, tentorium cerebelli of hen, pericardium of adult man, etc.) were investigated with light microscope (LM), transmitting electron microscope (TEM) with ultra thin sections cut after reembedding with epoxy resin following orientation under LM, and ultrathin section under TEM coordinated with the semithin section under LM. It was observed that: (1) The logitudinal striated structure within the so called collagen fibers and the collagen fiber without the logitudinal striated structure under LM are all the closely arranged collagen fibril bundle in which the space between the fibrils is narrower than 0.2?m under TEM. So that both must belong to the same grade. (2) The collagen fibrils in vivo may be singlely dispersed, or in double, or in bundles formed from 3 to hundreds of fibrils; the space between fibrils varied closely to several ?m. (3) The diameter of collagen fibrils is genera ly 20—200 nm, but there are also thicker or thiner fibrils. According to these and other previous works, we suggest the following points on the nomenclature: (1) The collagen fibril is the collagen structure which has generally the diameter of 20—200nm and the cross striations of 64—70nm along its longitudinal axis under EM It should no longer be Called the collagen microfibril. (2) The collagen fiber is the bundle which is composed of three or more closely arranging collagen fibrils bound by a small amount of cement substance. Under EM, the space between the bundles is larger than 0.2?m but the space between the fibrils within the bundle is narrower than 0.2?m. Under LM, the collagen fiber is the structure without the visible subunit filament and may branch and anastomose- each other. (3) The collection of collagen fibers should be called collagen fiber bundle. It includes the so called "collagen fibers" (old routine nomenclature) with the visible subunit filaments under LM. This nomenclature should remove the confusion on the structural grading of collagen fibers and unify the concept of collagen fiber under LM with that under EM.

41 biopsies of rami cutaneous dorsalis of nerve peronaeus superficalis in neuro-pathies(12 inherited,8 dysglobulinemia,8 infective,3 vascular,3 other,7 unknown)and 9 biopsies from normal man were observed under electron microscope.It wasfound that 10 oud of the 4 biopsies(24%)oud 4 of the 9 biopsies(44%)had theperineurial canalicular system.The perineurial canalicular system can be divided into 2gradations.(1)The perineurial microcanaliculus consists of 1-2 layers of the perineurialcells,the lumen was irregular;(2)The perineurial canaliculus consists of 1-3 layers ofthe perineurial cells,the lumen was more regular.The luminal surface of the perineu-rial cells had no basal lamina but the external surface of them had basal lamina.The density in the luminal contents obviously lower than that of outside and glyc-ogen-like granules and myelin-like substance could be seen within the lumen.Pino-cytotic vesicles in the perineurial cells of the canalicular wall opened into the lum-inal surface.These canaliculi extraordinarily twisted between the perineurial cells ofvarious layers and the diameter of the lumen was generally 0.1-2.7?m.The originof the canaliculi situated in the inner layer of perineurium was separated from thesubperineurial space with complete basal lamina and intercellular space that contain-ed basal lamina-like substance between perineurial cells.Their termination was notknown yet.The role and function of the perineurial canalicular system were discuss-ed.

Objective:To construct the plasmid containing short hairpin RNA(shRNA) of green fluorescent protein(GFP) to suppress the expression of GFP.Methods:A 20bp reverse repeated motif of GFP target sequence with 4bp spacer were synthesized,and inserted into pTZU6+1 to generate the pshRNA—GFP plasmid;pshRNA—GFP and pEGFP-C1 or pTZU6+1 and pEGFP-C1 were cotransfected into mammalian cells to detect effect of GFP expression separately.Results:pshRNA—GFP suppressed the GFP expression by 70%～85% in mammalian cells.Conclusion:The result shows that the short hairpin RNA of GFP can efficiently suppress its expression in HepG2 and SMMC-7721.

Objective:To clone and express survivin gene in mammalian cells.Methods:Coding sequence of survivin gene was amplified from HepG 2 cell mRNA by RT-PCR and then cloned into eukaryotic vector pEGFP-C1.The vector with survivin gene was transfected into HepG 2 and SMMC-7721.The expression of survivin was detected by GFP and Western blot.Results:The recombinant plasmid pEGFP-C1-survivin was successfully constructed and expressed in HepG 2 and SMMC-7721.Conclusion:The result shows expression of the anti-apoptosis gene survivin in mammalian cells.

Objective:This study was to investigate the interrelations between the acetylase activity and specialization rate of the differentiation of MSCs to the cardiac cells when histon deacetylase enzyme inhibitor trichostatin A (TSA)interferes in the cardiac cells. Method: MSCs of ratswere separated,The already labeled MSCs and cardiac muscle cells were put respectively into the MSCs interfered by different concentrations of TSA cultivated in mix tune with cardiac muscles. Adding TSA into the conventional culture of MSCs for the negative group.One week later,with the help of immunofluorescence,detecting the expression of the function proteinum,ie. myosin heavy chain (MHC)and Connexin43 (Cx43),of the cardiac muscle constitution in MSCs was detected. Results: ① There appeared sample differentiation of the cardiac muscle cells after the coculture of the MSCs and the pulsating cardiac muscle cells for one week,and the expression of the function proteinum of the cardiac muscle constitution;② In the positive group,in the mix culture of the cardiac muscle cells and the MSCs in which the TSA interfered for 48 h,there appeard sample differentiation of the cardiac muscle cells;③ In the negative group,part of the MSCs could express the function proteinum of the cardiac muscle constitution. During the 7 days of coculture, with the induction of TSA,MSCs was double-labeled by Brdu-DAPI. The differentiation rate of the fluorescent manifestation of the MHC and Cx43 in the MSCs was notably different expression that in the positive group,Conclusion: MSCs in which HDAC,the enzyme inhibitor,interferes are in the microenvironment of the cardiac muscle cells. HDAC,the enzyme inhibitor,functions as a promotion factor in the specialization of MSCs,suggesting the interrelation between the acetylase activity and the cell specialization rates.

Objective:To explore whether phonocardiogram exercise test(PCGET) or doppler echocardiography can sensitively and specifically detect the changes of cardiac reserve in patients with hypertension and whether there is a relationship between the two methods.Methods:The trail was performed with eighty volunteers, including twenty healthy persons as control group,and sixty hypertensive patients, which were divided into three subgroups:hypertension A, HA(patients without left ventricular hypertrophy,LVH and enlarged left ventricle);hypertension B, HB(patients with only LVH) and hypertension C,HC(patients with both LVH and enlarged left ventricle).The cardiac contractility reserve index(CCRI) was measured by PCGET, while the value of LV end-systolic and end-diastolic long and short axis dimensions, wall thickness and synchronous blood pressure were measured by the technique of simultaneous screen display of electrocardiography and synchronously monitoring blood pressure.According to the parameters measured by the latter technique, the values of maximum elasticity(Emax), the average maximum myocardial elasticity stiffness(maxEav) and ejection fraction(EF)were calculated by computer programmed process.Results:(1)Compared with control group,there was a statistically significant difference between the hypertension groups except HA group,and also an obvious difference between HB and HC about the indexes of Emax, maxEav and EF(P