Objective To study the effects of ischemic postconditioning and ischemic preconditioning on cerebral ischemia-reperfusion injury following middle cerebral artery occlusion in rats.Methods A reversible focal cerebral ischemia-reperfusion injury was modeled using middle cerebral artery occlusion. Thirty male Sprague-Dawley rats were randomized into three groups (n = 10 in each group) : a cerebral ischemia-reperfusion group, an ischemic postconditioning group and an ischemic preconditioning group. The impairment of neurological function was scored and the infarct volume, the activity of superoxide dismutase and malondiadehyde (MDA) content were measured after the operation.Results In the ischemic postconditioning and preconditioning groups the neurological function was better and the infarction volume was significantly smaller compared with the model group. In the preconditioning group both infarction volume and neurological function were significantly better than in the postconditioning group. In the brain tissues of the preconditioning and postconditioning groups MDA content was lower, while the activity of superoxide dismutase was significantly higher than in the model group.Conclusions lschemic postconditioning can attenuate pathological injury induced by focal cerebral ischemia and repedusion. The neuroprotective effect induced by ischemic preconditioning is stronger than that induced by ischemic postconditioning.

Objective To investigate the antenatal influencing factors associated with birth weight of twins and the risk factors for the occurrence of discordant twins. Methods Totally, 834 twins delivered at the Third Affiliated Hospital from January 2000 to December 2009 and the First Affiliated Hospital of SUN Yat-sen University, from January 2000 to June 2009, were recruited in the study. The diagnosis criteria of discordant twins was intrapair birth weight difference more than 25 %.Antenatal factors on birth weight were retrospectively investigated among twins and discordant twins respectively with Logistic analysis. Results (1) There were several factors associated with birth weight of twins, including maternal age, conceptive style, chorionicity, gestational diabetes mellitus and placental cord insertion ( P = 0. 021, 0. 000, 0. 000, 0. 012 and 0. 017, respectively). While hypertensive disorder in pregnancy, parity and fetal gender differences were not associated with the birth weight of twins (P＞0.05). Hypertensive disorder in pregnancy (OR=2. 600, 95% CI:1. 566-4. 316) and monochorionicity (OR= 1. 833, 95% CI: 1.010-3. 582) were risk factors of discordant twins. All 834 twin pregnancies were divided into 4 groups according to materal age, ＜25 yrs (n=69), 25-30 yrs (n=312), 30-35 yrs (n=325) and ≥35 yrs (n=128). The average birth weight of twins were (2205±483) g, (2347±406) g, (2381±439) g and (2352±455) g. Significant difference was found bewteen every two groups (P＜0. 05) except that between the 30-35 yrs and ≥35 yrs group (P＞0.05). Among twins of different gender (n=270), the average birth weight of boys and girls were (2416±-514) g and (2322±488) g, and that of female twins (n=272) and male twins (n=292) were (2301±418) g and (2381±428) g. Significant difference was shown between every two groups (P＜0.05) except that between the male twins and male fetus of twins of different gender (P＞0.05).Conclusions The fetal birth weight of twins decreases remarkably when maternal age ＜25, or monochorionicity twins, or complicated with marginal or velamentous placental cord insertion or female pairs.However, birth weight of twins would increase if the pregnancy conceived by assisted reproductive technology or complicated with gestational diabetes mellitus. Twin pregnancy complicated with hypertensive disorder in pregnancy or monochorionicity should alert the clinicians of discordance twins.

OBJECTIVE:To investigate clinical efficacy and safety of tiopronin combined with lamivudine in the treatment of pulmonary tuberculosis complicated with chronic hepatitis B. METHODS:150 cases diagnosed as pulmonary tuberculosis with chronic hepatitis B were randomly divided into group A(drug combination group),group B(lamivudine group)and the group C (control group),with 50 cases in each group. 3 groups were given isoniazid+rifapentine+ethambutol+levofloxacin(2HTELfx/4HT) anti-TB treatment and liver protection treatment,etc. Group B was additionally given Lamivudine tablet orally,0.1 g,qd;group A was additionally given Tiopronin tablet 0.3 g,tid,on the basis of group B. The treatment course of 3 groups lasted for 6 months. Liver damage,serum fibrosis indexes of 3 groups were observed in 3 groups before and after treatment as well as hepatitis B virolo-gy indexes,clinical efficacy and the occurrence of ADR after treatment. RESULTS:After treatment,serum levels of ALT,AST and TBIL weresignificantly increased in group C,significantly decreased in group A,with statistical significance(P<0.05).There was no statistical significance in above indexes of group B before and after treatment(P>0.05). Serum levels of ALT,AST and TBIL after the treatment:group A0.05). Serum fibrosis indexes of group A and B decreased significantly compared to before treatment,with statistical significance (P<0.05);serum fibrosis indexes after the treatment:group A0.05). CONCLUSIONS:Tiopronin combined with lamivudine can significantly reduce liver function damage caused by an-ti-TB drugs. It is conducive to the smooth progress of tuberculosis chemotherapy with fewer adverse reactions.

Objective To investigate the relationship between chronic gastropathy with intestinal metaplasia (IM) and caudal type homeobox genes 2 (Cdx2),tumor necrosis factor-α (TNF-α),Helicobacter pylori (Hp) infection.Methods Onehundred and thirty patients underwent gastroscopy were divided into 2 groups by typical pathological type:gastritis group (30 cases) and IM group [100 cases,including mild IM group (30 cases),moderate IM group (35 cases),severe IM group (35 cases)].Hp infection was confirmed.The expressions of Cdx2 and TNF-α protein was evaluated by immunohistochemistry.Results The positive expression rates of Cdx2 and TNF-α protein in IM group were significantly higher than those in gastritis group [78.0％(78/100) vs.6.7％(2/30),60.0％(60/100) vs.16.7％(5/30)],and there were statistical differences (P ＜ 0.01).The positive expression rates of Cdx2 and TNF-α protein in positive and negative Hp infection in IM group were significantly higher than those in gastritis group [Cdx2 protein:79.4％(50/63) vs.1/10,75.7％(28/37) vs.5.0％(1/20);TNF-α:74.6％(47/63) vs.4/10,35.1％(13/37)vs.5.0％ (1/20)],and there were statistical differences (P ＜ 0.01).The positive expression rate of Cdx2 protein in moderate IM group and severe IM group were significantly higher than those in mild IM group [80.0％ (28/35) and 97.1％ (34/35) vs.53.3％ (16/30)],in severe IM group were significantly higher th.an those in moderate IM group,and there were statistical differences (P ＜0.05).There were no statistical differences in the positive expression rate of Cdx2 protein of difference Hp infection among the 4 groups (P＞0.05).There were no statistical differences in the positive expression rate of TNF-α protein between mile IM group and moderate IM group (P ＞ 0.05).The positive expression rate of TNF-α protein in severe IM group was significantly higher than that in mild IM group and moderate IM group [80.0％(28/35) vs.40.0％(12/30) and 57.1％(20/35)],and there were statistical differences (P ＜ 0.05).The positive expression rate of TNF-α protein of positive Hp infection patients in gastritis group,mild IM group,moderate IM group and severe IM group were significantly higher than those of negative Hp infection patients (4/10 vs.1/20,47/63vs.13/37,10/18 vs.2/12,15/21 vs.5/14,22/24 vs.6/11),and there were statistical differences (P ＜ 0.05).Conclusions The expressions of Cdx2 and TNF-α protein and Hp infection are closely related with IM.Therefore,testing the level of Cdx2 and TNF-α protein expressions can help to judge the degree of IM,which provides a basis for reversing IM.

Objective To compare the efficacy of three solutions used in the patients who suffered chronic obstructive pulmonary diseases (COPD ) when combined with oral fungal infection,and to find the most suitable one. Methods Using randomized controlled trial method, 98 patients who suffered COPD complicated with fungal infection were randomly divided into three groups. Method 1, using 0.5% povidone for the oral care. Method 2, making 200 million U of nystatin powder dissolved in 2.5% NaHCO3 for the oral care.Method 3, gave oral care with 2.5% NaHCO3 first, then put 200 million U of nystatin powder into 20 ml glycerol and covered the oral spots with them. Three groups were observed in the effect of oral fungal infection and the feedback from patients and nurses. Results In the analysis of the white spots sharply disappeared or pharyngeal swab smear turned negative, method 1 and method 3 had no statistical difference, P>0.05, but method 2 and method 3 had statistical significance, t=3.892, P <0.01; the three groups had no significant difference of feedback from the patients’ oral comfort, P >0.05. The time made solution of method 1 occupied 41.7% of method 3, and the time made solution of method 2 occupied 54.4%of method 3, while there was no statistical significance in total time of three groups (P>0.05). Conclusions The oral care with 0.5% povidone had good effect on the patients who suffered COPD complicated with oral fungal infection,with good comfort,and most nurses saving time. Nystatin powder dissolved in 2.5% NaHCO3 worked later than nystatin powder dissolved in glycerol.

Objective To prepare sustained-release danshensu microcapsules by spray drying.Methods Encapsulation efficiency of different coating materials was compared.The spray process was optimized using a central composite design for two variables to obtain microcapsules with microcapsules yield.Furthermore, in vitro release of danshensu microcapsules was determined.Results PVA was chosen as coating material and the ratio of coating material to core material was 3:1.The inlet air temperature was 190℃,the feed flow rate was 36 r/min,encapsulation efficiency was 85.0%,and microcapsules yield was 56.1%.The particle size of more than 70%microcapsules was between 6—12?m.Conclusion The optimized conditions of spray drying are reasonable,danshensu microcapsules can be used as sustained-release preparation.

Objective To explore the bronchoscopic features of endobronchial tuberculosis induced by lymphatic fistula and the efficacy of interventional treatment. Methods The data on 31 patients with endobronchial tuberculosis induced by lymphatic fistula who had received bronchoscopic diagnosis and treatment in our hospital during the period of January 2010 to June 2013 were reviewed. The bronchoscopic features , along with the frequency of interventional therapies and duration of the therapies , were retrospectively analyzed; and the efficacy of the therapies and the related complications were assessed. Rusults The endoscopic appearance showed: granuloma (19.4%), necrosis (51.6%), granuloma with necrosis (25.8%), and fistulous opening (3.2%). Dark gray matter or carbon deposition inside the lesions was the characteristics of endobronchial tuberculosis induced by lymphatic fistula. There were 76 orificium fistulae in 31 patients , mostly in the right side. The median frequency of treatment was five in patients with single orificium fistulae and the median treatment duration was 65 days; whereas the median frequency of treatment was nine in patients with multiple fistulae and the median treatment duration was 108 days. There were significant differences between the two groups (P < 0.05 for both comparisons). The effectiveness rate of treatment was 98.7%. The therapy-related complication was of a small amount of bleeding, with a rate of 2.1%. Conlusions Endobronchial tuberculosis induced by lymphatic fistula shows certain characteristics under bronchoscopic examination. Bronchoscopic clamping combined with infusions with antituberculosis agents is a safe, simple, effective therapeutic method.

Objective To investigate the intrauterine growth characteristics of twins and birthweight discordant twins (discordant twins ).MethodsTotal of 1010 twin pregnancies (2020 fetuses) with complete delivery records from the Department of Obstetrics and Gynecology,the First and Third Affiliated Hospital of SUN Yat-sen University between January 1,2000 and July 31,2010 were studied retrospectively.One handred and ninteen cases (238 fetuses) with intrapair birthweight difference ≥25％ were determined as the discordant twins group,and the other 891 cases (1782 fetuses) with intrapair birthweight difference ＜ 25％ were identified as the concordant twins group.The singleton control group included 4042 singleton pregnancies in the same period.Results ( 1 ) Comparison of clinical data between the twins groups:the birthweight of larger-twin,smaller-twin and intrapair birthweight difference in the discordant twins group and the concordant twins group were ( 2090± 827 ) g,( 1392 ± 592 ) g,( 33.9 ±9.3 ) ％,and ( 2408 ± 543 ) g,( 2191 ± 505 ) g,( 8.9 ± 6.5 ) ％,respectively,with significant differences (P＜0.01).The incidence of discordant twins was 11.78％ (119/1010).Compared with the concordant twins group,the discordant twins group bad higher proportion of monochorionic twins,and higher prevalence of pregnancy complications such as late miscarriage,abnormal umbilical insertion,twin-twin transfusion syndrome and hypertensive disorders in pregnancy ( P ＜ 0.05 ).( 2 ) The characteristics of twin birthweight distribution:① In all the 2020 twins,80.05％ (1617/2020) fetuses had birthweight below the 50th percentile of the singleton control group,while 23.71％ (479/2020) feeuses got birthweight below the 10th percentile of the singleton control group.② After 19th gestational week,the 50th and 90th percentile of all twins' birthweight were lower than those of singletons.After 38th gestational week,the birthweight of singletons kept increasing and reached its peak at 41 th week,while the birthweight of twins reached its peak at 38th week,followed by a decline at 39 weeks,which was even lower than the 10th percentile of the singleton control group.③ The distribution of birthweight of larger- and smaller-twin in the discordant twins group:65 (54.6％,65/119) larger-twins and one (0.8％,1/119) smaller-twin had birthweight above the 50th percentile of all twins,while 5 (4.2％,5/119) larger-twins and 97 ( 81.5％,97/119 ) smaller-twins got birthweight below the 10th percentile of all twins.Conclusions ( 1 ) The patterns of birthweight curves for each gestational week are different between twins and singletons.In order to evaluate the growth of twins, birthweight reference for twins shoull be employed.( 2 ) According to the reference of twins birthweight,the most discordant twins are complicated with fetal growth restriction at least in one twin.

Objective To determine the mutant status of BRAF gene in Chinese colorectal cancer (CRC) patients and analyze the association with clinicopathological parameters.Methods 676 CRC samples were collected in Cancer Institute/ Hospital,Chinese Academy of Medical Science from December 2009 to December 2011.The direct sequencing was conducted to detect mutations in the BRAF (exon 15 and exon 11).The correlation between mutant status with clinicopathological parameters were analyzed.Results Beside 10 colorectal cancer samples,among the 666 colorectal cancer patients 4.35％ (29/666) of the tumors harbored a BRAF mutation,of which 1.94％ (13/669) in exon 15 (V600E),2.39％ (16/670) in exon 11.Statistical analysis revealed that BRAF15 mutations appeared to occur more frequently in poor-differentiation tumors than high or moderate-differentiation tumors (5.81％ vs 1.46％,r =0.105,P=0.040).But BRAF15 mutations were not correlated with age,gender,smoking and drinking history,tumor site,tumor type,tumor(T/N) staging,histological type,or distant metastasis [r equals to 0.007,-0.018,-0.049,-0.023,-0.098,-0.038,0.040(0.034/0.059),0.065,0.042,respectively,P ＞ 0.05] ; BRAF11 mutations appeared to occur more frequently in patients with drinking history (6.02％vs 1.81％,r =0.093,P =0.035).However,age,gender,smoking history,tumor site,tumor type,tumor differentiation,tumor(N) staging,histological type,or distant metastasis showed no significant correlation with this mutation [r equals to-0.004,0.047,0.020,0.042,0.029,0.040,0.006 (-0.008),0.008,0.030,respectively,P ＞ 0.05].Conclusion A higher proportion of BRAF15 (V600E) mutations occurred in poor-differentiation tumors among the Chinese patients with CRC; BRAF11 mutations appeared more frequently in patients with drinking history.

Objective To investigate the preventative effect of perioperative intervention to lower extremity deep venous thrombosis (DVT) after gynecologic surgery. Methods The 1062 patients, who received gynecologic surgery during 2007 June to 2008 June, were derided into intervention and nonintervention groups randomizely. According to the risk factors of DVT, the patients in intervention group were divided into 4 subgroups: low, mid, high and extremely high rise Each group had its own preventive measures. If patients had spontaneous pain, tenderness and swelling, positivity of Neuhof or Homan syndrome, and extension of one low extremity superficial vein, the low extremity color Doppler ultrasound would be carried out immediately. The ultrasound would also be routinely carried out in the high and extremely high risk groups in intervention group after 2 and 7 days after surgery. A prospective study was carried out investigating incidence of DVT and coagulation function perioperation. The vein blood samples were taken at in a week before surgery and 48 hours post-operation. Results The incidence of DVT of intervention group was 1.10% (6/546), and in nonintervention group, the incidence was 3.29% (17/ 516). There was significant difference between two groups (P<0.05). The incidence of DVT in extremely high risk subgroup was 21.05% (4/19), which was significantly higher than that of low(0), mid(0) and high risk groups[2.13% (2/94), P<0.05]. D-dimer, antithrombin-Ⅲ(AT-Ⅲ) post-operation were all higher than that pre-operation in the two groups, but there was no significant difference (P>0.05). The indexes of coagulation system, such as blood platelet count, prothrombin time (PT), active partial throraboplastin time (APTT), fibrinogen (Fbg), thrombin time (TT), tissue-plasminogen activator (t-PA), plasminogen activator inhibitor(PAI), were not significantly changed perioperation (P>0.05 in all pre-or post-operation indexes). Conclusions Perioperative intervention measurement according to different risk of DVT could cut down the incidence of DVT. DVT preventive intervention is suggested to high and extremely high risk people.