Objective To explore the possibility of early definitive operation for enteric fistulas. Methods In 37 selected enterocutaneous fistula patients, early definitive operation was performed during laparotomy for treating peritonitis within 10 days of fistula formation. Thorough irrigation of peritoneal cavity, effective sump drainage, fibrin glue sealant to reinforce anastomosis, appropriate nutritional support, and administration of growth hormone were key elements of perioperative management. Results Among 37 patients, 35 of them recovered uneventfully. Fistula recurred in 2 cases postoperatively; one fistula closed after conservative management, and another patient died of advanced gastric cancer 3 months postoperatively. The fistula operative closure rate was 94.5%. No operative death. Conclusion Advances in perioperative management can promote the success rate of early definitive operation for enteric fistulas. It may become a challenge to the present strategy of enteric fistula management.

Objective To explore the relationship of the ADAM33 gene Q-1,T2 single nucleotide polymorphism (SNP) and suffering from chronic obstructive pulmonary disease (COPD) in Xinjiang Kazakh and Han population. Methods Peripheral blood samples to extract DNA, and the single nucleotide polymorphisms of Q-1 and T2 in ADAM33 gene were detected by SNaPshot SNP genotyping. Results Case group compared with the control group, frequencies of Q-1 locus genotypes and alleles were significant differences in Kazak (P<0.05). In patient group, there were significant differences in ADAM33 gene Q-1 locus genotypes FEV1% predicted, FEV1/FVC of clinical indicators lung function in Kazak, Han(P < 0.05). Kazak Q-1 locus AA genotype,Han GA genotype than GG genotype were significant difference.Compare Kazak AA genotype,Han GA genotype with GG genotype is more likely to cause COPD in Q-1 locus(P<0.05). In the comparison of the case and control group the two ethnic, there was no significant difference between the frequencies of T2 locus genotypes and the frequencies of Q-1,T2 the alleles (P > 0.05). There were no significant differences in T2 locus genotypes and clinical indicators of lung function FEV1% predicted and FEV1/FVC in patient group (P > 0.05). Conclusion The ADAM33 gene Q-1 locus may be related to the COPD susceptibility in Xinjiang Kazak, Han.

Objective To explore the clinico-pathological features, immunophenotype, treatment and prognosis of urologic primary primitive neuroectodermal tumor (PNET). Methods The clinical data of 3 patients with urologic PNET were analyzed retrospectively. All patients were male, aged 29, 32 and 75 years respectively. Two of the lesions were located in the kidney, and the third was located in the bladder. The sizes of renal tumors were 7.7 cm×6.2 cm and 12.6 cm×9.4 cm respectively. Imaging examinations revealed a well-defined mass with inhomogeneous echo inside. The size of bladder tumor was 10.0 cm×10.0 cm. CT scan demonstrated irregular thickening of the bladder wall, and the density of the wall was inhomogeneous. In the 2 cases of renal PNET radical surgery was performed, while an emergency palliative surgery to remove a blood clot and biopsy were performed in the bladder PNET case. Results In light microscope, the tumors were characterized by uniform small round or oval cells and nest-like or dense sheet structures surrounded by sparse fibrovascular stroma. Homer-Wright rosettes or pseudorosettes were observed, as well as mitoses. Immunohistochemical study revealed that all cases showed positive staining for CD99, synaptophysin and vimentin. One of the renal tumor cells showed positive for CD56, and the other renal tumor and urocystic tumor cells were focally positive for chromogranin A. Additionally, in 1 of the cases of renal tumor there was a high positive rate of 80% for Ki67 staining while the other case showed less than 5%. All 3 cases were eventually diagnosed as PNET. The first renal tumor case was not treated with radiotherapy and chemotherapy postoperatively, and the patient died of recurrence 14 months after surgery. Both the second renal tumor case and the bladder tumor case underwent chemotherapy postoperatively, and they died 4 and 6 months after surgery respectively. Conclusions The urologic primary PNET is a very rare, highly malignant soft tissue tumor, and the diagnosis must be based on pathologic findings and immunohistochemical phenotypes. The multimodal treatment for urologic primary PNET consists of surgery, chemotherapy and radiotherapy.

One hundred and five patients with non-ST segment elevation acute coronary syndrome were followed up for 1 year.They were assigned to the event group or non-event group according to the presence of endpoint events(cardiac death and nonfatM myocardial infarction).B-type natriuretic peptide level was measured at 30 days and 1 year and compared between the two groups.The results showed that the level of B-type natriuretic peptide was higher in the event group[(235±107)μg/L vs(154±49)μg/L at 30 days;(259±100)μg/L vs(143±57)μg/L at 1 year].Thus,B-type natriuretic peptide is an important prognostic factor for patients with non-ST segment elevation acute coronary syndrome.

Wnt signals widely exist in live creatures,involved in many physical or pathological processes,including the cell prolif-eration, differentiation and apoptosis. Recent studies show that Wnt/β-catenin signaling pathway may play an important regula-tory role in the protective effects of neurovascular unit in ische-mic stroke. Some chemicals,such as sulindac and estradiol,and some compound traditional Chinese medicine which contains gly-coside( e. g. rhodiola rosea ) , volatile oil ( e. g. turmeric ) and compound prescription ( e. g. Dan Long Xing Nao Fang ) can protect the neurovascular unit by regulating the pathway. This aims to review the research progress of the protective effects of Wnt/β-catenin signaling pathway on the neurovascular unit in is-chemic stroke,with combination of chemicals and traditional Chi-nese medicine which can protect the neurovascular unit via Wnt/β-catenin signaling pathway. It aims to provide the methodology basis for elucidating the mechanism of drugs,and also provide a new idea for researching the new drug which can reduce the dis-ability rate caused by sequela of stroke.

Basic fibroblast growth factor (bFGF) has been used in wound healing, bone healing, vascular grafting, lens regeneration and limp regeneration. Anti-bFGF antibody is thought to be an major important reagent for bFGF research. This review summarizes the development of anti-bFGF antibody in recent years including preparation, screening, identification and application in order to provide reference to the studies of this field in our country.

Objective To evaluate pericardial devascularization with splenectomy (PCDV) for the treatment of cirrhotic portal hypertension. Methods From January 1994 to December 2004, 177 patients were treated by PCDS, among them posthepatitic cirrhosis was identified in 170 cases, and alcoholic cirrhosis in 7. One hundred and thirty two patients were operated on electively, 25 prophylactically, and 20 emergently. Results The bleeding control rate was 95% , the overall operative mortality rate was 4. 5%. The main causes of death were upper gastrointestinal bleeding, hepatic failure and intra-abdomimal hemorrhage. The mean follow-up time was 3. 6 years. The 5-year survival rate was 90%. The 5-year recurrent bleeding rate was 5. 1% , The rate of postoperative hepatic encephalopathy was 5. 1%. Conclusions This procedure has the advantage of high successful rate of bleeding control, low complication rate, and long term survival.

AIM: To study the effects of nuclear factor-kappa B decoy oligodeoxynucleotides on generation of nitric oxide and activated oxygen in lipopolysaccharide-induced mouse macrophages.METHODS: Mouse macrophage cell lines J774.1 cells were cultured with lipopolysaccharide and liposome-mediated oligodeoxynucleotides, and the level of nitric oxide, activated oxygen and inducible nitric oxide synthase were measured. RESULTS: Nuclear factor-kappa B “decoy”oligodeoxynucleotides decreased the activity of inducible nitric oxide synthase in lipopolysaccharide-induced macrophage, inhibited generation of nitric oxide and reactive oxygen species. The level of nitric oxide, activated oxygen and inducible nitric oxide synthase did not change in control group.CONCLUSION: Nuclear factor-kappa B “decoy”oligodeoxynucleotides decrease the generation of nitric oxide and activated oxygen in lipopolysaccharide-induced macrophages, which is probably due to inhibiting the binding sites of activated nuclear factor-kappa B specially.

AIM: To study the effect of NF-?B "decoy" oligodeoxynucleotides on TNF-? and IL-6 expression in LPS-induced mouse macrophages. METHODS: Mouse macrophage cell line J774.1 cells were cultured with LPS and liposome-mediated oligodeoxynucleotides, and the levels of TNF-? and IL-6 measured in the different culture supernatant by enzyme linked immunosorbent assay. RNA was extracted from macrophages, and the mRNA expression of TNF-? and IL-6 in macrophages was observed by RT-PCR. RESULTS: NF-?B "decoy" oligodeoxynucleotides decreased the expression of TNF-? and IL-6 in LPS-induced macrophages and inhibited generation of TNF-? and IL-6. The level of TNF-? and IL-6 did not change in control group. CONCLUSIONS: NF-?B "decoy" oligodeoxynucleotides inhibit the expression of TNF-? and IL-6 in LPS-induced macrophages, which is probably due to the specific inhibition of activated NF-?B binding sites .

Multimedia teaching and SimMan,which is a portable and advanced patient simulator for team training,were used to develop a new course for the medical students of grade four. This course was named "SimMan clinical techniques training". The course of Sim-Man clinical techniques training can help students comprehend truly all kinds of cases in clinical practices,improve their capabilities of clinical thoughts and clinical techniques,and it makes fine basis for their clinical practices in the hospitals.