Objective To evaluate the role of early growth response gene1 (Egr-1) in liver injury in taurocholate-induced acute pancreatitis rat model. Methods Twenty-four male rats were divided into 4 groups. Egr-1 immunohistochemistry staining and pancreatic pathologic scoring were assessed, and the serum levels of AST, LDH, TNF-? and IL-1 ? were measured. Egr-1 mRNA levels of primary hepatocyte culture stimulated with TNF-? and pretreated primary hepatocytes with PD98059 followed by TNF-? stimulation were also observed. Results Egr-1 expression of liver correlated with degree of liver injury in acute pancreatitis in rat, and high Egr-1 mRNA expression of primary hepatocyte was observed when hepatocyte injury occurred. After pretreated with PD98059, TNF-?-stimulated hepatocytes showed a lower level of Egr-1 mRNA compared with hepatocytes without pretreatment. Conclusions Egr-1 may play an important role in liver injury in acute pancreatitis, and this effect depended partly upon extracellular signal-regulated kinase 1/2 (ERK1/2) pathway.

Objective To investigate the incidence and the correlative factors of diabetic retinopathy (DR) in patients with diabetes mellitus(DM)who lives in Beixinjing blocks, Shanghai. Methods Residents with DM were enrolled according to resident health archives. The data of disease history, visual acuity, eye disease and introcular pressure were collected by inquiry and examination. Photography of ocular fundus was used to confirm the diagnosis of DR. Results A total of 535 residents excepted the examination with the participating rate of 90.68%, in whom 146 (27.29%) were identified as with DR. The incidence of single and proliferative DR was 22.29% and 4.30%, respectively. Duration of DM was the independent risk factor of DR, while long duration of DM, accompanied with peripheral neuropathy and body mass index was the in-order independent factor of proliferative DR. Conclusions The incidence of DR is high in residents with DM. Monitoring DR progress in DM residents with risk factors is recommended.

Objective To review the prevalence of nosocomial infection and the change of drug resistance in a comprehensive intensive care unit (ICU) and to provide theoretical basis for clinical prevention and treatment.Methods The strains of bacteria and fungi were isolated from ICU and their drug resistance was retrospectively analyzed from Jan.1st,2010 to Dec.31th,2011.Results The main pathogen of nosocomial infection were Gram-negative bacteria ( 73.3％ ),Gram-positive bacteria ( 17.9％ ) and fungi ( 8.7％ ).In bacterial infection,Gram-negative and G-positive bacteria accounted for 80.3％ and 19.7％ respectively.In Gram-negative bacteria,pseudomonas aeruginosa was the major type (21.7％).In Gram-positive bacteria,staphylococcus aureus (31.4％) was most prominent.Drug resistance of bacteria was severe,while that of fungi was mild.Conclusion Bacteria has severe drug resistance and exhibits multi-drug resistance for commonly used antibiotics.The principle of antibiotics application should be mastered and antibiotics should be chosen according to drug-sensitivity tests.

Background Measurement of corneal thickness is important for the early diagnosis and treatment of some eye disorders,including corneal diseases and refractive errors.However,the corneal parameters from schoolage population are rarely reported.Objective The aim of this survey was to characterize the central corneal thickness (CCT),minimum corneal thickness (MCT) and paracentral corneal thickness in healthy Chinese schoolage population.Methods A cross-sectional study was designed in this study.Children aged 7 to 15 years with the diopter of-3.00 D to +3.00 D were recruited from two primary schools in Baoshan district in Shanghai based on random cluster sampling under the approval of Shanghai First People's Hospital and informed consent of child custodian.Routine examinations were firstly performed to determine the healthy participants.CCT (within 2 mm range away the corneal vertex),MCT and paracentral corneal thicknesses (2 to 5 mm zone away the cornea vertex in superior,inferior,nasal and temporal quadrants) were then measured by RTVue Fourier optical coherence tomography (OCT) for the comparison between both eyes and different gender.The subjects were grouped into the 7-9,10-12 and 13-15 years groups,and the correlations between age and CCT,MCT and paracental corneal thicknesses were analyzed.The coordinate position of the thinnest cornea was determined.Results A total of 147 children were enrolled in the study.The mean CCT value of the right eyes was (537.77±29.33) μm,and that of the left eyes was (539.22±29.16) μm,showing a significant difference between them (t =-3.21,P =0.00).The paracentral corneal thicknesses of the right and left eyes were (565.52±30.11) μm and (568.42±31.07) pm in the superior quadrant,and those in the temporal quadrant were (549.01 ±30.46) μm and (547.24±30.23) μm,with significant differences between them (t =-2.47,P =0.01 ; t =2.12,P =0.04).No significant difference was found in the CCT,MCT,paracentral corneal thicknesses from various quadrants (all at P＞0.05).In addition,no considerably correlation was seen between age and CCT,MCT and paracentral corneal thickness (all at P＞0.05).The thinnest cornea area was located in the inferotemporal region in 40.82％ right eyes and 57.82％ left eyes.The distance of thinnest cornea area away corneal vertex was (0.62±0.33)mm in the right eyes and (0.91±0.63)mm in the left eyes,with a significant difference between them (t =-5.17,P =0.00).Conclusions The central,superior and temporal corneal thicknesses are significantly different between the right and the left eyes among healthy Chinese school-age children,but corneal thickness change is not associated with age or gender.The thinnest corneal area does not locate at the vertex.

Objective To find out the pathologic changes and possible influencing factors in the process of spontaneous regression of plane warts.Methods One hundred and five lesional specimens taken from patients with plane warts were observed microscopically.Results The histologic features indicated slight hyperkeratosis,acanthosis and ballooning degeneration of keratinocytes in stable lesions;a combination of tower-peak shaped hyperkeratosis,cuneate hypergranulosis and ballooning degeneration in progressively increasing lesions;and infiltration of lymphocytes and necrosis of keratinocytes in inflammatory icthing lesions.Conclusions Specific cell-mediated immunity against keratimocytes may be involved in the process of regression of plane warts.There is a positive correlation between the activity of skin lesions and the induction of cellular immunity.

Medical whole-body positron emission tomography (PET), one of the most successful molecular imaging technologies, has been widely used in the fields of cancer diagnosis, cardiovascular disease diagnosis and cranial nerve study. But, on the other hand, the sensitivity, spatial resolution and signal-noise-ratio of the commercial medical whole-body PET systems still have some shortcomings and a great room for improvement. The sensitivity, spatial resolution and signal-noise-ratio of PET system are largely affected by the performances of the scintillators and the photo detectors. The design of a PET system is usually a trade-off in cost and performance. A better image quality can be achieved by optimizing and balancing the key components which affect the system performance the most without dramatically increases in cost. With the development of the scintillator, photo-detector and high speed electronic system, the performance of medical whole-body PET system would be dramatically improved. In this paper, we report current progresses and discuss future directions of the developments of technologies in medical whole-body PET system.
Humans ; Positron-Emission Tomography ; trends

Objective To observe the effectiveness of early enteral nutrition (EEN) in managing ICU mechanically ventilated patients.Methods Totally 47 patients who had been ventilated for more than one week were randomly divided into EEN group and control group.The EEN group was supplied with enteral nutrition (EN) 12-24 hours after ICU admission,whereas the control group received EN 72 hours-5 days later.The function of intestinal mucosal barrier was evaluated by the reabsorb concentration of disaccharides lactulose/mannitol (L/M).In addition,the body mass index (BMI),body temperature,urine L/M ratio,serum albumin,pre-albumin,and ventilation days were recorded or calculated.Results On the seventh day,the L/M ratio was (0.036 ±0.004) in the EEN group,which was significantly lower than that (0.108 ±0.020) in the control group (t =2.746,P ＜0.01) ; the average body temperature was significantly lower in the EEN group than in the control group [(38.25 ± 1.20) ℃ vs (38.92 ± 1.40) ℃ ; t =2.683,P ＜ 0.05)] ; the incidences of adverse reactions such as constipation and diarrhea were significantly lower in the EEN group [16.7％ (4/23) vs 27.3％ (6/22),P＜0.05].The weaning rate within 2 weeks also favoured the EEN group [90％ (18/20) vs 80％ (16/20),P ＜ 0.05].Compared with the control group,the nutritional status of serum albumin and pre-albumin also showed a favourbale trends in the EEN group.Conclusions EEN can improve intestinal mucosal barrier and increase the weaning possibility in patients with mechanical ventilation.

Objective To assess the efficacy and tolerability of continuous low-dose cyclophosphamide and prednisone regimen(CP)as salvage therapy for multiple myeloma patients with severe complications.Methods The CP regimen consisted of oral cyclophosphamide at 50 mg and oral prednisone at 15 mg daily.The patients were withdrawn if the response was invalid or not improved after 6 months,and follow-up was carried on if CR maintained for 6 weeks.A total of 23 consecutive patients received the CP regimen,with 18 patients having severe complications,and 5 patients unwilling to accept conventional chemotherapy because of severe infection.All patients had received one to four regimens before.Results Among 23 patients with CP regimen,the overall response rate(CR+VGPR+PR)was 61%,with 1 CR,4 VGPR,9 PR,3 MR and 6 PD.The quality of life and physical conditions were improved significandy.Conclusion Our data showed that CP was an effective,well-tolerated,and convenient regimen as salvage therapy for MM with severe complications.

Background Epidemiologieal survey suggests that visual impairment in teenagers is a worldwide public health problem,and its leading cause is uncorrected refractive error.To conduct an extensive screening of visual impairment in teenagers and analyze the relevant affecting factors are significant works for the prevention and management of refractive errors.But high-quality epidemiological data on visual impairment and refractive error from large groups of children are lacking in Shanghai.Objective This study was to investigate the prevalence of ametropia and visual impairment in schoolchildren aged 6 to 12 years old.Methods In this cross-sectional study,4 686 students from 6 elementary schools in Baoshan District of Shanghai,a rural-urban fringe zone,China were selected by clustering sampling from May 2010 to April 2011.The eye examinations included visual acuity,ocular surface,ocular anterior segment,ocular media,fundus and intraocular pressure measurement,and the data autorefraction under cycloplegia and eye position were recorded.The cause of visual impairment was evaluated.Results A total of 4 594 students received examination with the response rate 98.0％,and autorefraction under cycloplegia was completed in 84.8％ schoolchildren (3 975/4 594).The prevalence rate of uncorrected visual acuity 0.5 or worse in both eyes was 14.4％ (662/4 594),with the wearing glasses rate 51.8％ (343/662).The percentage of students with the uncorrected visual acuity 0.5 or worse in at least one eye was 22.4％ (1 031/4 594).The prevalence rate of refractive error in the visual impaired students was 96.9％ (999/1 031),followed by amblyopia (37/1 031,3.6％).The prevalence rate of myopia,hyperopia,and astigmatic in the pupils after cycloplegia was 31.1％,4.3 ％ and 33.0％,respectively.In addition,the prevalence rate of myopia in public elementary schools was higher than that in migrant elementary schools (33.9％ versus 30.3％) (x2 =5.46,P =0.02).Logistic regression analysis showed that myopia was associated with age (OR =1.60,95 ％ CI:1.53-1.68,P ＜ 0.01) and female (OR =1.33,95％ CI:1.16-1.54,P＜0.01).Conclusions The leading cause of vision impairment is myopia in the elementary school students in Shanghai,China.The screening-ratio of refractive error and the coverage of refractive correction in the elementary school students in Shanghai are matters of urgent concern.

Objective To assess the clinical efficacy and safety of proton pump inhibitors (PPI)for preventing recurrence of non-steroidal anti-inflammatory drugs (NSAIDs)-indueed upper gastrointestinal ulcers using meta-analysis. Methods Mono- or multicenter randomized controlled clinical trials related to NSAIDs-indueed ulcers were retrieved from database of China Biological Medicine and Medline from 1966 to 2007. The data were analyzed by RevMan 4. 2 software using random or fixed effects model. Results Ten randomized controlled trials including 3361 patients were included, The recta-analysis revealed that PPI treatment significantly reduced the recurrent rate of NSAIDs-associated ulcers (8. 7%) in comparison with controls (17. 2%, P = 0. 03). Those who received esomeprazole (4. 4%) or lansoprazole (18. 0%) had a low recurrence of peptic ulcers compared with controls (14.7% or 28.7%, P value= 0.01 or 0.05). But there was no significant differencebetween omeprazole and controls (P= 0. 16). The recurrence of NSAIDs-associated ulcers in patients treated with esomeprazole 20 mg or 40 mg and tansoprazole 15 mg were 4.4%, 4.3% and 19.7 % respectively. The stratify analysis showed that PPI therapy could effectively reduce recurrentce of non-selective NSAIDs-induced ulcer (P= 0. 009), but failed to selective cyclooxygenase (COX)-2 inhibitor induced ulcer. No severe adverse reactions were found in PPI groups. Conclusion PPI is effective and safe in prevention of NSAIDs-related ulcers without discontinuation of NSAIDs.