Pharmacogenomics refers to all the genes encoding drug-metabolizing enzymes,drug transporters,and other drug targets. Studying the relations betweeen gene polymorphisms and drug effects as well as the prediction of adverse reactions at the gene level will be a new method for the clinical therapy of digestive system diseases. Therefore,pharmacogenomics will be a complement of traditional methods for forming and administering drugs regimens.

28 days after injury (P < 0.05). In the fracture+spinal cord injury group, the level of serum transforming growth factor beta 1 had a rapid increase on the 7th day, and reached the peak on the 14th day, and then, this level had no significant decrease until the 28th day. In the simple fracture group, the level of serum transforming growth factor beta 1 began to increase on the 2nd day, reached the peak on the 7th day, and then decreased gradualy. Remarkable changes of serum transforming growth factor beta 1 levels in patients with bone fracture combined with spinal cord injury may be associated with fracture healing in different periods.

BACKGROUND:In the animal model of spinal cord injury associated with fractures, the trauma is severe and postoperative survival rate is low. The improved Al en method and open femoral osteotomy method for making animal model has many advantages, such as simple operation, no need of special equipment, quick establishment, shortened operation time and reduced intraoperative bleeding, so they are suitable for preparing a femoral fracture model combined with spinal cord injury.
OBJECTIVE:To design an animal model of femoral fracture combined with spinal cord injury, which can maintain long time survival, meet clinical features, and is simple and easy.
METHODS:Forty-eight male Sprague-Dawley rats were randomly divided into simple femoral fracture group and femoral fracture merging spinal cord injury group. Femoral fracture model was caused by opening osteotomy to cause transverse fracture and implantation of internal fixator in femur. According to the improved Al en method, a self-made blow device was applied to cause acute T 10 segment contusion injury of spinal cord in rats. Thus the femoral fracture model merging spinal cord injury was successful y established. The rats in two groups were grossly observed at different time points after the modeling, and the fracture healing at 4 weeks was detected.
RESULTS AND CONCLUSION:Al the animal models of femoral fracture with spinal cord injury survived, which exhibited the loss of sensory and motor function of the lower limbs, but could slowly creep forward by the upper limbs. In the first 3 days, the rats had poor appetite and few activity, with tail suspension at night there were no ischemia and necrosis of the limb fracture. At 4 weeks, one rat in simple femoral fracture group died, while four rats in femoral fracture merging spinal cord injury group died, with the survival rate of 83.33%, intramedul ary fixation were not prolapsed. In the two groups, continuous bone cal us formation was found in the fracture, and the bone cal us volume in femoral fracture merging spinal cord injury group was significantly higher than those in simple femoral fracture group. The results demonstrated that combining the improved Al en method with smal lateral incision open femoral osteotomy is a simple and feasible method for the establishment of femoral fracture model merging spinal cord injury, and the models survive for 4 weeks.

[Objective]To evaluate the effect of post-operative rehabilitative nursing of patients repaired with acellular nerve allograft.[Method]From April 2003 to April 2006,39 inpatients with peripheral nerve defect were subjected to receive acellular nerve allograft in order to repair nerve defect.The patients were rehabilitated with special nursing after being operated and discharged.Among of them,21 patients were followed up over 6 months,the effect of treatment was analyzed.[Result]Among 21 patients,16 people had excellent and good effect of treatment and the efficient rate was 71.4%.[Conclusion]Post-operative rehabili tative nursing is important and effective for rehabilitation patients of peripheral nerve injuries repaired with acellular nerve allograft.

BACKGROUND:Platelet-derived growth factor has the ability of wound repair, and relevant studies mainly focus on bone tissue repair. However, there are less studies about the effect of platelet-derived growth factors in skin wound healing. OBJECTIVE:To investigate the role of platelet-derived growth factor to promote wound healing by the regulation of bone marrow mesenchymal stem cels to the wound. METHODS:Bone marrow mesenchymal stem cels from rats were cultured. Immunofluorescence method was conducted to detect cel surface markers of CD34 and CD44 in bone marrow mesenchymal stem cels. Thirty healthy male SD rats were divided into five groups at random. Bone marrow mesenchymal stem cels labeled with PKH-26 were injected into the rat caudal vein in each group. The rats were anesthetized 1 week after injection. On the center of rat back, a 3-cm incision was made to establish a wound healing model. Different concentrations of platelet-derived growth factor were injectedvia multi-points on the skin wound after modeling, and the control group was treated with the same volume of normal saline. Skin wound tissues were taken for relevant parameter measurement at 14 days after injection. RESULTS AND CONCLUSION: Under the fluorescence microscope, platelet-derived growth factor could induce the migration and accumulation of bone marrow mesenchymal stem cels to the trauma in a dose-dependent manner and promote the wound healing. Masson staining showed that, with the concentration increase, platelet-derived growth factors could reduce inflammatory cel infiltration and increase the number of colagen fibers. Results from western blot assay showed that platelet-derived growth factor could inhibit the expression of matrix metaloproteinase-1, promote the expression of tissue inhibitor of matrix metaloproteinase 1 in the wound, and inhibit the colagen degradation, thereby promoting skin wound healing indirectly.

Objective To investigate the changes of fractalkine (FKN) in rat model of acute liver failure (ALF) and the role of FKN in liver inflammatory injury.Methods SD rats were divided into tWO groups:6 in normal group and 36 in model group.D-galactosamine(D-Gal) was used to induce ALF in model group.The sera and hepatic tissue samples were collected at 12,24,48,72,120 andl68 h.After D-Gal injection.FKN mRNA and nuclear factor(NF)-kB mRNA in hepatic tissue samples were detected by reverse transcription-polymerase chain reaction (RT-PCR).Results The levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) at 12 h were(208.3±43.5)U/L and (375.2±117.3)lJ/L,respectively,which were both significantly higher than those in normal group[(31.8±2.9)U/L and (90.8±3.1)U/L](t=-9.912 and-5.935,respectively,both P<0.01);the levels of ALT and AST peaked at 72 h after D-Gal injection.The levels of FKN mRNA(O.086±0.009)in model group at 12 h were significantly higher than those (O.044±0.009) in normal group(t=-7.999.P<0.01),and peaked at 72 h (O.333±0.033),then decreased obviously at 120 h. The levels of NF-KB mRNA in the liver of normal rats were very little;and the levels in model group were increased gradually over time,then peaked at 72 h (O.583±0.i01,t=-12.607,P<0.01).FKN mRNA and NF0kB mRNA were positively correlated (r=0.760,P<0.01).Conclusion The FKN expression may play all important role in liver inflammatory injury in rat model of acute liver failure, which could provide a new approach for ALF therapy.

Objective To investigate the imaging features of splenic littoral cell angioma (LCA)and correlate with pathological findings.Methods Ten patients of LCA with pathologically confirmed diagnosis were included in this study.A retrospective review of clinical data and imaging findings on CT and MRI was performed,along with review of the literature.Results Splenic littory cell angiomas presented with multiple nodules of varying sizes with a predoninance of small ones.Nine of 10 patients had clinical symptoms of splenomegalia and hypersplenia.MR T2WI and DWI showed masses with high-signalintensity.The CT and MRI enhancing pattern of LCA was similar to splenic hemangioma.There were many mammiliform structures pointing inside in the wall of the vascular channels,a hallmark feature allowing its differentiation from splenic hemangioma pathologically.Conclusion The CT and MRI findings of LCA can show some of its characteristic signs,especially on DWI,which can assist to identify LCA in clinical practice.

Objective To study the clinical values of polyvinyl alcohol chemoembolization and bronchial arterial infusion(BAI) in interventional therapy of central bronchogenic carcinoma.Methods 45 pathologically proved cases of central bronchogenic carcinoma in mid or late period were randomly divided into two groups(control group in 24 cases and experimental group in 21 cases).After detecting the nourishing arteries of bronchogenic carcinoma with angiography,the treating processes were performed.Control group : anticancer drugs were poured into bronchial artery.Experimental group : the feeding arteries of tumors were co-axially superselective catheterized with microcatheters,the anti-neoplasm agents were poured into everyone of feeding arteries according to the blood supply,then the feeding arteries were embolized by polyvinyl alcohol.Results Control group : the obvious effective rate(CR+PR) was 50%.Experimental group:the obvious effective rate was 90.4%.Two cases in control group obtained the chances of radical operation and chemotherapy were performed after operation,the other 22 cases were undergone synthetic treatment.Seven cases in experimental group obtained the chances of radical operation and chemotherapy were performed after operation,14 cases were undergone synthetic treatment.Three cases in control group died and none of in experimental group died in the follow-up of 2~24 months.Conclusion The short-term effect of polyvinyl alcohol embolization is better than those of BAI for interventional therapy of central bronchogenic cancer,but the long-term effect needs a large number of cases to access the real clinical value.

From August 6 to 8, 2010, the 23 rd "Nutritional risk, malnutrition, nutritional support, outcome, and cost-effective" workshop was held in Beijing. There were 30 participants from Beijing, Tianjin,Chongqing, Chengdu, Kunming, Guiyang, Guangzhou, Songyuan, Weifang, Guilin, Urumqi, Qingdao, Yueyang, and Qinhuangdao. The workshop has 2 sections. Section 1: Learn the published papers from ( 1 ) Jie B,Jiang ZM, Nolan MT, et al. Impact of nutritional support on clinical outcome in patients at nutritional risk: a multicenter, prospective cohort study in Baltimore and Beijing teaching hospitals. Nutrition, 2010, (9); (2)Braga M, Gianotti L. Preoperative immunonutrition: cost-benefit analysis. JPEN J Parenter Enteral Nutr,2005, 29 ( 1 Suppl): S57-S61; and ( 3 ) Jiang ZM, Wilmore DW, Wang XR, et al. Randomized clinical trial of intravenous soybean oil alone versus soybean oil plus fish oil emulsion after gastrointestinal cancer surgery. Br J Surg, 2010, 97 (6): 804-809. Section 2: Discuss two protocols for cohort study and for randomized clinical trial (RCT). The cohort study is to continue the investigations of the impact of nutritional support for inflammatory bowel disease (IBD) on outcome and cost/effectiveness, and the RCT protocol is to plan a new protocol about the impact of fish oil on postoperative outcome and cost/effectiveness. The second protocol also asked Professor Kondrup to join with as the co-principal investigator. At the pilot period, the fish oil study is an open RCT because the costs of nutrients need to be paid by patients himself (herself). To apply the support for nutrients is on the schedule. The 24th workshop will bo held on December 17-19, 2010 in Beijing.

Objective To assess the results of colonoscopy surveillance in 5 years after polypectomy of non-advanced colorectal adenoma and to identify its risk factors. Methods Patients undergoing colonosco-py and followed up with colonoscopy within 5 years between January 2003 and December 2013 were retro-spectively analyzed.No substance or only small quantity of clear water left in the intestinal tract and colono-scopes accessing ileocecus were regarded as complete examination. The initial colonoscopy was regarded as the baseline colonoscopy. Patients with non-advanced adenomas were assigned to the case group and those without were to the control group. Data of clinical characteristics and colorectal findings were estimated and risk factors were identified. Results A total of 828 patients were included,374 patients in the case group and 454 in the control group on baseline colonoscopy.The case group had a low incidence of advanced adeno-mas at a 1 to 5 years interval when compared with the control group,both with adequate baseline examination [1. 5%(5/ 326)VS 2. 2%(9/ 408),P = 0. 51]. The detection rates of advanced adenomas on follow-up colonoscopy at 1 to 3 years and 3 to 5 years in case group were 1. 7%(3/ 178)and 1. 4%(2/ 148),respec-tively(P>0. 05).Regression analysis showed age≥50 years old and being male were the independent risk factors for advanced adenomas recurrence within 5 years follow-up. No colon cancer was found in 828 patients during the follow-up. Conclusion Surveillance colonoscopy intervals within 5 years is of little benefit to pa-tients who had adequate polypectomy. Too early reexaminations due to concerns about advanced adenomas recurrence can be avoided.