Fast-track recovery emphasize applicating a series of effective measures confirmed in the perioperative care of patients,the optimized combination generates synergy effect to maximize alleviating various physical and mental stress reaction in order to expedite patient recovery.Most successful example is the application of fast track colon surgery program.Its safety and effectiveness have been widely confirmed,but the report on pancreas surgery is limited.FTRP is aiming to improve medical and health work efficiency,reduce hospitalization time and hospitalization expenses,improve life quality of patients.Based on the application of FTRP in pancreatic cancer,the relation of morbidity,re-admission and peri-operative mortality rates and clinical significance are reviewed.

BACKGROUND:Pyrroloquinoline quinone is found to accelerate Schwann cel proliferation and growth factor secretion, but there is no report addressing its role in articular cartilage and chondrocytes.
OBJECTIVE: To investigate the role of pyrroloquinoline quinone in chondrocyte proliferation and interleukin-1β-induced chondrocyte apoptosis in the articular cartilage of knee joints and to verify the protective mechanism involved.
METHODS: Chondrocytes were isolated from New Zealand white rabbits (1 month of age), digested under aseptic conditions, and cultured in DMEM/F12 in the presence of 10% fetal bovine serum to alow for proliferation until passage 2. Adherent chondrocytes were cultured in serum-free DMEM/F12 medium with 0, 6.25, 12.5, 25.0, 50.0 and 100.0 μmol/L pyrroloquinoline quinone, separately. Proliferation activity was determined by MTT at 48 hours of pyrroloquinoline quinone administration. Cel cycle was determined by flow cytometry at 30 hours after pyrroloquinoline quinone administration. Apoptosis was determined by flow cytometry folowing 24 hours of pyrroloquinoline quinone pretreatment and 15 hours of interleukin-1β induction.
RESULTS AND CONCLUSION: Pyrroloquinoline quinone enhanced chondrocyte proliferation activity, increased percentage of S phase and G2/M phase in a dose dependent manner and reached the peak when the concentration of pyrroloquinoline quinone was 12.5-25.0 μmol/L (P< 0.05). Pyrroloquinoline quinone also inhibited interleukin-1β-induced chondrocyte apoptosis in early and late stage, and 25.0 μmol/L pyrroloquinoline quinone had the best effects (P < 0.05). These findings suggest pyrroloquinoline quinone can promote chondrocyte division and proliferation, and protect the cels from interleukin-1β-induced apoptosis.

Objective To explore the clinical significance of serum N-terminal pro-brain natriuretic peptide (NT-proBNP) and plasma D-dimer (D-D) in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and stable chronic obstructive pulmonary disease (COPD).Methods The clinical data of 76 patients with AECOPD (AECOPD group) and 68 patients with stable COPD (stable COPD group) were analyzed retrospectively.Serum NT-proBNP,plasma D-D levels and arterial blood gas analysis were measured and compared.Results The levels of serum NT-proBNP and plasma D-D in AECOPD group were (918 ± 271) ng/L and (0.269 ±0.048) mg/L,in stable COPD group were (264 ± 32) ng/L and (0.223 ± 0.042) mg/L.The levels of serum NT-proBNP and plasma D-D in AECOPD group were significantly higher than those in stable COPD group (P ＜ 0.01).The levels of serum NT-proBNP and plasma D-D were negatively correlated with arterial blood oxygen partial pressure (r =-0.181,P =0.030;r =-0.166,P =0.047),and were positively correlated with arterial blood carbon dioxide partial pressure (r =0.763,P ＜ 0.01;r =0.424,P ＜ 0.01).Conclusion Combined detection of serum NT-proBNP and plasma D-D has important clinical significance in evaluating severity of COPD,and may indicate AECOPD.

This article systematically introduces the basic conception,classification and physiological significance of anterior guidance for anterior prostheses.A customized incisal guidance table was introduced to record and transfer the individual value of the patient to a virtual full-adjustable articulator system.The clinic effects of the individual value and average value were also compared.

Objective To investigate the relationship between Ambulatory Arterial Stiffness Index (AASI)and kidney damage or carotid endarterectomy damage in hypertension patients.Methods One hundred and forty-nine patients with hypertension but without diabetes or other arteriosclerosis diseases were enrolled.Forty-eight healthy volunteers during the same period were enrolled as control group.All participants'24 h-ambulatory blood pressure monitoring(ABPM),urinary albumin/creatinine ratio(ACR)and IMT were recorded and AASI was calculated.Then the correlation between AASI and ACR or IMT were calculated.Results There were significant differences in the urinary albumin/creatinine ratio(46.34 vs.33.52)(P ＜ 0.05),microalbuminuria incidence(41％ vs.21％),Carotid intima-media thickness([0.90 ±0.21]mm vs.[0.83 ±0.20]mm),abnormal incidence(72％ vs.60％)and AAS1(0.50 ± 0.16 vs.0.42 ± 0.17)(P ＜ 0.01)between the subjects with hypertension and those without.The AASI were positively correlated with ACR and IMT in hypertension patients.Compared with healthy subjects,the AASI were significantly increased in the patients with abnormal CR and IMT(P ＜0.05 、P ＜0.01).Conclusion The AASI were correlated with kidney damage and carotid endarterectomy damage in hypertension patients.

Objective To investigate the related factors of central nervous system infection in patients who received invasive intracranial pressure monitoring.Methods The clinical data of 63 patients who received invasive intracranial pressure monitoring were retrospectively analyzed.Possible related factors including gender,age,disease,Glasgow coma scale score,emergency operation or selective operation,duration of the operation,drainage tube placement site,drainage tube lifetime,sensor insertion site,sensor indwelling duration,electrolytes,glucose and other complications were studied and compared retrospectively between patients with and without central nervous system infection.All data were analyzed with univariate analysis and multivariate Logistic regression analysis to identify the related factors and independent risk factors associated with central nervous system infection.Results In univariate analysis,drainage tube placement site (x2 =12.345,P =0.002),drainage tube lifetime ((2.5 ± 0.9) d and (6.3 ± 5.7) d in patients without and with central nervous system infection,respectively,t =-4.434,P =0.000),sensor insertion site (x2 =4.701,P =0.030),sensor indwelling duration ((6.5 ± 3.0) d and (8.9 ± 4.6) d in patients without and with central nervous system infection,respectively,t =-2.420,P =0.019) and other complications (x2 =13.086,P =0.000) were the relevant factors of central nervous system infection (P ＜0.05).In multivariate Logistic regression analysis,the sensor insertion site (OR =0.047,P =0.000) and other complications (OR =10.953,P =0.019) were the independent risk factors for the central nervous system infection.Conclusions There are a variety of factors related to central nervous system infection in patients with placement of intracranial pressure monitoring.The sensor insertion site and other complications were the independent risk factors for the central nervous system infection.

ObjectiveTo study the effects of angiogenesis inhibitor SU6668 on the growth and metastasis of colon cancer in vivo. MethodsMetastatic model of human colon cancer was established by orthotopic implantation of human tumor tissue into colon wall of nude mice. Mice were randomly divided into control, 5 Fu, SU6668, and combined treatment group (both 5 Fu and SU6668 i.p.) respectively. After six weeks tumor weight, inhibition rates, intratumoral microvessel density (MVD), apoptotic index (AI) and metastasis were evaluated. ResultsCompared with control, tumor growth was significantly inhibited in mice treated respectively with 5 Fu, SU6668 and 5Fu plus SU 6668 with an inhibition rate of 0%, 42 6%, 80 9% and 87 2% respectively. MVD decreased significantly in treated groups \[(13 8?5 2)?(12 3?4 5), (2 4?1 5) and (0 9?0 5)\]. AI increased significantly in treated groups \[(3 6?2 4)%? (7 1?5 7)%, (11 9?3 9)% and (19 9?8 6)%\]. The incidences of peritoneal and liver metastases was significantly inhibited in 5 Fu, SU6668 and combined treatment group (100%? 45 5%, 16 7% and 0; 75 0%? 36 4%, 16 7% and 0). The growth and metastasis of human colon cancer implanted in nude mice were significantly inhibited in the SU6668 group and combined group than that in control group and 5 Fu group ( P

Objective To study the change of mid-regional pro-adrenomedullin(MR-proADM) level in patients with chronic heart failure and its significance.Methods Randomly selected 330 patients with chronic heart failure,including 120 cases of grade Ⅱ and Ⅲ,90 cases of grade Ⅳ,90 cases were selected.,Within 24 h after the entry of the group and 7 d after symptom relieved,serum N-terminal pro-B-type natriuretic peptide(NT-proBNP),MR-proADM,cardiac ultrasound(left ventricular diameter(LVEDD) and left ventricular function(LVEF)) were measured.Ninety physical examination in the same period as healthy control during the same period.The change of MR-proADM level in patients with chronic heart failure and its significance were analyze.Results Compared with the healthy control group,the level of MR-proADM in patients with chronic heart failure(grade Ⅱ:(641.55±106.34) pmol/l;grade Ⅲ:(684.46±101.33) pmol/l;grade Ⅳ:(737.81±479.37) pmol/l) was significantly higher than that in the control group(610.22±60.84) pmol/l),the difference was statistically significant(F=5.33,P=0.001).At the same time,the level of MR-proADM was increased with the aggravation of heart failure,after drug treatment will decline((608.09±100.81),(617.64±94.32),(642.22±163.53) pmol/L).And MR-proADM levels were significantly positively correlated with NT-proBNP levels and NYHA classification in patients with heart failure(r=0.194,P=0.003;r=0.206,P=0.000).Conclusion MR-proADM has important guiding significance in the diagnosis,classification of patients with chronic heart failure.

Objective To detect mutation of mitochondrial DNA in a chinese pedgree with maternally inherited aminoglycoside antibiotic-induced deafness. Methods The mutation of mitochondrial DNA from all 18 family members of a chinese pedigree with maternally inherited aminoglycoside antibiotic-induced deafness was detected by PCR and DNA sequencing. Results Nine individuals in this pedigree carried A→G mutation at the 1555th bp of mitochondrial 125 rRNA, and the others did not have this mutation. Conclusion Mitochondrial DNA mutation may be one of major factors resulted in aminoglycoside antibiotic-induced deafness in this pedigree.

Objective To evaluate the efficacy and safety of immunosuppressive strategy of leflunomide (LEF) combined with calcineurin inhibitor and prednisone in Chinese renal transplant recipients.Methods Prospective clinical study was performed in 16 stable renal transplant recipients treated with calcineurin inhibitor, prednisone and either mycophenolate mofetil (MMF) or azathioprine (Aza), and MMF or Aza was replaced by LEF afterward. The loading dose of LEF was 50 mg/day for 3-5 days, and the maintenance dose was 20 mg/day. Prednisone was maintained 10 mg/day. The doses of CsA were adjusted according to its blood concentration.Results One patient dropped due to economic reason 1 mouth later, and continued to take Aza. Another one patient switched back to MMF due to a slight increase of serum creatinine (from 130 ?mol/L to 143 ?mol/L) 6 months after conversion. The remaining 14 patients were still on LEF. The mean observation time under LEF was (8.7?7.2) months (1～18 month). The mean serum creatinine was (103?24) ?mol/L before conversion, (95?26) ?mol/L at 6th month, and (108?27) ?mol/L at one year post-conversion. There was one episode of biopsy proved reversible acute rejection. The observed side effect was tolerable alopecia in 2 cases and rash in 1 case, but there were no significant increases in liver function, decrease of blood WBC count, deterioration of anemia, or any serious infection in any of the patients.Conclusion Immunosuppressive strategy of LEF+calcineurin inhibitor and prednisone is effective and safe in stable Chinese renal transplant recipients.