Objective To describe the adequate feeding of early enteral nutrition in critical patients with cancer, and explore its influencing factors. Methods A retrospective analysis study was performed and 161 patients were involved. Results Nearly 57.14%patients got adequate feeding. The independent risk factors included complications (P < 0.05,OR=2.312,OR 95%CI 1.078-4.958), Acute Physiology and Chronic Health Evaluation Ⅱ (APACHEⅡ) scores (P < 0.05,OR=1.111,OR 95%CI 1.017-1.214) and hypoalbuminemia (P<0.05,OR=2.252,OR 95%CI 1.036-4.892) , and the protective factor was previous enteral nutrition experience (P<0.01,OR=0.123,OR 95%CI 0.021-0.494). Patients who got adequate feeding showed more increase in albumin levels, more decrease in APACHEⅡscores and shorter ICU stays. Conclusions Part of patients got inadequate feeding, due to comprehensive effects of many factors. And adequate feeding may be beneficial to the increase of albumin levels, also helps patients rehabilitate early and shorten the ICU stays.

Objective To investigate the risk factors and prognosis influential factors of acute kidney injury (AKI) after cardiac surgery.Methods The clinical data of patients who were hospitalized and underwent cardiac surgery from April 2009 to May 2011 were collected prospectively.Demographic characteristics,types of surgeries,preoperative renal function,pre-and intra-operative conditions and clinical outcomes,etc were recorded.Results A total of 4007 patients underwent cardiac surgery were recruited.The overall incidence of AKI was 31.2％ (1250/4007).The incidence of AKI requiring renal replacement treatment (AKI-RRT) was 2.6％ (104/4007).The overall hospital mortality was 1.9％ (77/4007),and was significantly higher in AKI group than in non-AKI group (5.4％ vs 0.3％,P ＜0.01).The hospital mortality of AKI-RRT group was 36.5％ (38/104).Grouped by type of surgery,cardiac transplantation had the highest AKI incidence (73.0％) and highest in-hospital mortality (18.9％),followed by coronary artery bypass grafting (CABG) combined with valve surgery (AKI incidence 57.8％,in-hospital mortality 6.1％) and aneurysm surgery (AKI incidence 52.0％,in-hospital mortality 5.5％).Multivariate logistic regression analysis showed that man,age,BMI,hypertension,chronic heart failure,pre-operative serum creatinine (SCr) ＞ 106.0 μmol/L,intra-operative cardiopulmonary bypass time,intra-operative hypotension and aneurysm surgery were the risk factors of AKI after cardiac surgery.Multivariate logistic regression analysis showed that pre-operative SCr ＞ 106.0 μmol/L and intra-operative hypotension were independent risk factors of renal recovery after cardiac surgery while recovery of urine output was the favorable factor.Conclusions Cardiac surgery usually induces high AKI incidence and poor prognosis,which closely associated with many risk factors in peri-operative stage.The incidence of AKI is related to a number of perioperative risk factors.Heart transplantation,aneurysm surgery,CABG combined valve surgery are high risk surgeries.

Objective To investigate the effect of the 5-HT1A receptor antagonist on synaptic plasticity in flurane-induced cognitive dys-function in aged rats.Methods Thirty 18-month-old Sprague-Dawley rats were randomly divided into control,model,and drug groups.The model group inhaled a 50%oxygen gas mixture(2 L/min)and 2%sevoflurane and were then treated with 5μL 0.9%NaCl;the drug group inhaled a 50%oxygen mixture(2 L/min)and 2%sevoflurane for 4 h and then the 5-HT1A receptor antagonist(3μg)was injected into the left ventricles of the rats;and the control group inhaled a 50%oxygen mixture(2 L/min)for 4 h.The water maze method was used to assess the learning memory of the rats and histopathological changes in the rat hippocampus were examined by HE staining.Nissl and Golgi staining were used to identify any changes to the neurons and synapses in hippocampal tissue.The MeCP2,p250GAP,PSD-95,GAP-43,and Syn expression levels were determined by immunofluorescence assay and the PKA,CREB1,and BDNFmRNA levels were determined using real-time PCR.Western blotting was performed to determine the PKA,CREB1,p-CREB1,and BDNF expression levels.Results The water maze data showed that the escape latency was significantly prolonged in the model group compared to the control group and,after treatment with the 5-HT1A receptor antagonist,the escape latency significantly decreased in the drug group compared to that of the model group(P<0.05).Moreover,the number of platform crossings was significantly lower in the model group than in the control group,but the number of platform crossings in the drug group was significantly higher than that in the model group(P<0.05).Compared to the control group,the hippocampal neurons in the model group had irregular morphology,loosely arranged and enlarged sur-rounding tissue gaps,deeply stained nuclei,a reduced number of Nissl bodies in the neurons,and a significantly reduced dendritic spine density and number of branches.After treatment with the 5-HT1A receptor antagonist,the hippocampal neurons in the drug group had a regular morphology,relatively complete structure,uniform arrangement,increased numbers of Nissl bodies in the neurons,and a signifi-cantly increased dendritic spine density and number of dendritic branches.Compared to the control group,MeCP2,PSD-95,GAP-43,Syn,PKA,CREB1,p-CREB1,and BDNF expression levels significantly decreased and p250GAP expression significantly increased in the rat brain tissue from the model group(P<0.05),but the PKA,CREB1,and BDNF mRNA levels significantly decreased(P<0.05).Furthermore,compared to the model group,the MeCP2,PSD-95,GAP-43,Syn,PKA,CREB1,p-CREB1,and BDNF expres-sion levels significantly increased along with the PKA,CREB1,and BDNF mRNA levels(P<0.05)in the drug group.However,the p250GAP protein expression level significantly decreased(P<0.05).Conclusion The 5-HT1A receptor antagonist improves learning memory in rats with sevoflurane-induced cognitive dysfunction.Specifically,it enhances PSD-95,GAP-43,and Syn expression levels,pro-motes synaptic remodeling,and protects rat hippocampal neuronal cells by activating the CREB/BDNF pathway.

OBJECTIVETo investigate the effect of microRNA-140 (miR-140) on the migration and invasion of colorectal cancer (CRC) cells and the possible mechanism.

METHODSmiR-140 mimics, miR-140 specific inhibitor or small interfering RNA (siRNA) against Smad3 were transfected into human CRC cell line RKO cells respectively, using Oligofectamine or Lipofectamine2000. Quantitative real-time PCR (real-time PCR) was used to measure the expression levels of miR-140 and Smad3 mRNA. Smad3 protein was analyzed by Western blot. The in vitro cell migrating and invasive abilities were determined by wound-healing and Transwell chamber assay after up-regulating or down-regulating miR-140 or knocking down Smad3.

RESULTSThe Western blot assays showed that the Smad3 protein level was significantly reduced after up-regulating miR-140 (0.04 ± 0.01), compared with that of (0.47 ± 0.02, P < 0.05) in the control group and that of (0.52 ± 0.06) in the negative control group (P < 0.05 for both). The results of real-time PCR indicated that no significant difference was found in the levels of Smad3 mRNA between miR-140 transfection and NC groups (1.11 ± 0.13 vs. 1.00 ± 0.06, P > 0.05). The wound-healing assay showed that the migrating ability was dramatically attenuated by miR-140 compared with that in the control and NC groups, whereas no significance was found when compared with that of the Smad3 siRNA transfected cells. The number of cells migrating through Transwell chamber without matrigel in the miR-140 group was (76.2 ± 4.4), remarkably lowered than that in the control (267.1 ± 4.9) and NC (336.1 ± 5.7) groups (P < 0.05 for both), but no significant difference between the miR-140 (76.2 ± 4.4) and Smad3 siRNA (83.5 ± 7.3) groups. Transwell chamber with matrigel assay showed that number of cells penetrating through the membrane was (109.5 ± 7.4) in the miR-140 group, significantly lower than that in the control (403.1 ± 5.1) and NC (392.6 ± 8.4) groups (P < 0.05 for both), while Smad3 siRNA transfection had a similar effect (138.8 ± 3.6)(P > 0.05). Down-regulation of miR-140 increased the level of smad3 protein expression, and partially reversed the inhibition of the cell migration and invasion mediated by miR-140. Co-transfection of miR-140 inhibitor and Smad3 siRNA had no significant effect on the Smad3 protein expression and the abilities of cell migration and invasion.

CONCLUSIONSmiR-140 regulates the Smad3 expression at the post-transcriptional level. miR-140 suppresses the migrating and invasive abilities of CRC cells, possibly through down-regulation of Smad3. The findings of this study suggest that miR-140 may have a unique potential as a possible biomarker candidate for diagnosis and therapy of tumor metastasis.

Cell Line, Tumor ; Cell Movement ; Cell Proliferation ; Colorectal Neoplasms ; metabolism ; Down-Regulation ; Gene Expression Regulation, Neoplastic ; genetics ; Humans ; MicroRNAs ; Neoplasm Invasiveness ; RNA, Messenger ; RNA, Small Interfering ; Real-Time Polymerase Chain Reaction ; Smad3 Protein ; genetics ; metabolism ; Transfection ; Up-Regulation

Objective To explore the association between BMI and the risk of developing cardiac surgery associated acute kidney injury (CS-AKI),mortality of AKI and AKI requiring renal replacement therapy (AKI-RRT) after cardiac surgery.Methods Clinical data of patients undergoing cardiac surgery from January 2011 to December 2015 in Zhongshan Hospital of Fudan University were prospectively collected.Patients were divided into four groups according to BMI classification of Chinese population.Adjustment for selection bias was further assessed using propensity score method (PSM) to evaluate the role of BMI in the development of AKI.Results A total of 8442 patients were enrolled,among which 1092 patients successfully matched through PSM.The AKI incidences were respectively 30.3％,33.3％,38.6％ and 46.8％ in four BMI groups (P ＜ 0.01) before PSM.The AKI incidences were respectively 31.9％,35.2％,42.5％ and 42.9％ in four BMI groups (P=0.016) after PSM.The risk of developing AKI increased by 19.9％ as the BMI increased per 5 kg/m2 (95％ CI:1.070-1.344,P=0.002).The hospital mortality of patient (overall,AKI,AKI-RRT) in four groups was not statistically different after PSM (P ＞ 0.05),but overweight group always had the lowest mortality.Conclusions BMI is a risk factor for AKI after cardiac surgery,and the AKI incidence increases with increasing BMI in a certain range.

ObjectiveTo determine the pathogenic cause in a foodborne diseases outbreak of Salmonella enteritidis in a company in Suzhou City， and provide evidence for epidemiological investigation and guidance for clinical treatment. MethodsRelevant specimens were examined for Salmonella， Shigella， Staphylococcus aureus and Vibrio parahaemolyticus. Furthermore， for the isolated Salmonella enteritidis， a micro broth dilution method was used for antimicrobial susceptibility testing， and pulsed field gel electrophoresis （PFGE） was used for molecular typing. ResultsA total of 44 strains of Salmonella enteritidis were detected from 43 anal swabs of the patients in the outbreak， 7 anal swabs of canteen employees， 31 retained food specimens and 6 environmental specimens. A total of 15 antimicrobial susceptibility testings showed that the 44 strains had the same antimicrobial resistance spectrum， which was 100% resistant to cefazolin， ampicillin， ampicillin/sulbactam， polymyxin E and nalidixic acid， suggesting a multi-drug resistance to more than three antibiotics. PFGE cluster analysis showed that the 44 strains had a 100% of genetic similarity. ConclusionThe outbreak is caused by the consumption of food contaminated with Salmonella enteritidis. The isolated strains have multi-drug resistance， which could guide appropriate antimicrobial treatment based on the antimicrobial susceptibility testing.