Fourteen critical patients were treated by total parenteral nutrition(TPN) or en- teral nutrition(EN) and good results were achieved.Among the1 4patients,1 0 cases were suffered from MSOF.The results suggest thatnutritional support is very im- portant for the critical patients,especially for their rehabilitation and prognosis.The use of TPN is not limited by the gastroin- testinal function.TPN should be sellected preferably when a patient is critical and se- rious.EN should be used when gastroin- testinal function have recovered in order to reduce the translocation of bacteria and en- dotoxin in the gut and decrease gastroin- testinal bleeding.

Purpose:To study the effect of recombinated human granulocyte colony-stimulating factor (rhG-CSF,filgrastim) on leukopenia induced by chemotherapy.Methods:Ten cases of leukopenia of grade Ⅳ induced by chemotherapy of malignant tumor were treated with rhG-CSF . When WBC2.5?109/L, rhG-CSF was stopped.Results:All patients with leukopenia of grade Ⅳ recovered to normal after treatment with rhG-CSF , the average time of usage was 6.8 days. The infection rate was 60%(6/10). Conclusions:Filgrastim is effective in the treatment of leukopenia of grade Ⅳ after chemotherapy, rhG-CSF decreases infection and facilitates chemotherapy.

High-intensity focused ultrasound (HIFU) is a newly-developed noninvasive technique recently. Being a safe, non-radioactive and reproducible therapy, high-intensity focused ultrasound has been extensively used in the clinical treatment for a variety of solid tumors such as uterine adenomyosis. This paper aims to make a comprehensive review about this technique, focusing on the mechanism, clinical indications and contraindications, safety, efficacy and the complications of HIFU for the treatment of uterine adenomyosis.

Kawasaki disease is an acute self-limiting systemic vasculitis syndrome and usually occurs in children.The small and medium arteries of the whole body are mainly invaded, and marked with coronary arteries.Coronary artery dilation and aneurysm formation mainly occur in the early period.Thrombi, intimal hyperplasia, and calcification could be formed during the later period.Consequently, sometimes, it develops intochronicischemic cardiopathy or myocardial infarction.In that, Kawasaki disease has become the leading cause of acquired heart disease for children in developed countries.Presently, the treatment of coronary artery lesions caused by Kawasaki disease includes drug therapy, and interventional and surgical treatment.However, medications usually fail to solve severe coronary conditions, and only interventional and surgical treatment can we choose.Therefore, the development and indications of interventional and surgical treatment of coronary artery lesions caused by Kawasaki disease were reviewed in this article.

Objective To explore the relationship between single nucleotide polymorphisms (rs12953-717) of SMAD7 and susceptibility of non-small cell lung cancer (NSCLC) in Chinese Han population.Methods A single nucleotide polymorphisms (rs12953717) from SMAD7 was detected via Sequenom system in 528 NSCLC cases and 762 healthy controls.Data was statistically analyzed by unconditional Logistic regression method.Results rs12953717 had significant differences between non-small cell lung cancer patients and the controls.Compared with CC/TT (CC combined with TT) genotype,the adjusted odds ratio for the CT genotype was 4.107 (95％ CI:3.206 ～ 5.260,P =0.000 1).Smokers had a 2.004 odds ratio (95 ％ CI =1.583 ～ 2.537,P =0.000 1) of NSCLC compared with the controls.There was a 10.074-fold increased risk of NSCLC among the subjects with CT genotype and smokers.Conclusion The polymorphism of rs12953717 may have relation with risk of NSCLC.Heterozygote (CT) is a susceptibility genotype of NSCLC.Smoking is one of the risk factors of NSCLC.Smoking and CT genotype have synergistic effects on NSCLC susceptibility.

BACKGROUND: Kainic acid (KA)-induced hippocampal injury in rodents is a good model for studying human neurodegenerative diseases. Although many studies have evidenced that inflammatory molecules and responses participate in and accelerated the process of disease, it is still unclear whether adaptive immune response, especially immune competent cells, such as T and B cells, is involved in the pathogenesis of neurodegenerative diseases.OBJECTIVE: To observe the roles of B and T cell subsets in KA-induced hippocampal neurodegeneration.DESIGN: Randomized controlled animal trial.5ETTING: Department of Otolaryngology and Head, and Department of Neurology, First Hospital, Jilin University; Division of Geriatrics, Department of Neurotec, Huddinge Hospital, Karolinska Institute.MATERrALS: This trial was conducted in the Department of Neurotec, Huddinge Hospital, Karolinska Institute during June to September 2000. Twenty male C57 BL/6 mice (wide-type), and knockout mice CD4(-/-) (n =17), CD8(-/-)(n =19), CD4/CD8(-/-) (n =15) and Igh-6(-/-) (n =14) of C57BL/6 background were involved in this trial. They were aged 5 to 6 weeks,weighing 18 to 20 g. Three age- and body mass-matched C57BL/6 mice received water as controls. Reagent and instruments: KA (Sigma, USA). Bicolor flow cytometer and CellQuest (Becton Dickinson, CA, USA).METHODS: ① Eighty-five anesthetized mice were slowly administrated with 7.69 g/L KA by micropipette which was connected to nose of mouse at the dose of 48 mg/kg. Three control C57BL/6 mice received the same amount of water intranasally. ②Clinical symptoms of mice were monitored. Seizures were graded using a 6-point scale, 0: normal; 6: death.③After 4 to 5 hours of administration of KA, surface immunofluorescence staining of spleen cells was measured with flow cytometer. ④After 7 days of administration of KA, all the mice were anesthetized, and their brains were harvested,then fixed and embedded. For assessment of the severity and extent of hippocampal neurodegeneration by Nissl's staining, the sections were scored by a semiquantitative grading system with a 6-point scale: 0: normal; 6: severe loss of neurons (more than 40% neuron loss in area CA3); ⑤One-factor analysis of variance was used for the comparison of difference among groups and students' t test was used between two groups.MAIN OUTCOME MEASURES: Clinical grade, hippocampal neuropathological changes and the molecular expression of splenic monocytes of mice in each group.RESULTS: Eighty-five mice were involved in the result analysis. ① Clinical grade: All CD4 (-/-) mice displayed severe seizures, and their clinical symptoms were significantly severer than those of wild type mice (P ＜ 0.01). Clinical scores of CD4/CD8 (-/-) mice were significantly lower than those of wide-type mice (P ＜ 0.01). However, the responses of CD8 (-/-) and Igh-6 (-/-) mice did not differ notably from those of the wild-type mice. The clinical grade of control mice was the lowest. ②Hippocampal neuropathological changes: Neurodegeneration was the mildest in CD4/CD8 (-/-) mice and severest in Igh-6 (-/-) mice. ③ Spleen cell subsets changes: the number of splenic CD4+T cells was significantly increased in CD8(-/-) mice and wide-type mice (before and after administration of KA: 8.4%,14.2%;18.2%,31.5%); CD8+T cells were up-regulated in Igh-6(-/-) mice ( before and after administration: 2.1% and 7.4%); B cells rose numerically in CD4(-/-) (Before and after administration: 22.7% and 32.8%).CONCLUSION: Aadaptive immune response is involved in the KA-induced hippocampal neurodegeneration in mice, and B and T cell subsets contribute differently to the pathogenesis.

Objective To investigate the efficacy of injectable osteoinductive material with fibrin sealant(FS) as a carrier compounded with bovine bone morphogenetic protein(bBMP) and bovine fibroblast growth factor(bFGF) for radial defect in dogs.Methods A total of 12 dogs were used in this study.The animals were randomly divided into treatment and control groups with 6 in each.We created a 20-mm bone defect at the upper radius of each dog,and then sutured the subcutaneous tissues and skin around the lesion.After the operation,FS(control) and FS+bFGF+bBMP were given to the two groups respectively by percutaneous injection.To compare the efficacy of the injections,we examined the animals by radiography in 4,8,16,and 24 weeks.The dogs were sacrificed in 24 weeks to obtain the specimens of the bone defect for histological examination and bone mineral density(BMD) determination.Results Radiography showed callus formation in 4 weeks and then osteoneogenesis in 24 weeks in the treatment group;whereas,in the control group,no callus was found around the defect in 24 weeks.In the treatment group,the mean BMD of the diseased radius was significantly higher than that of the healthy leg and that in the control group [(456.33?13.74) mg/cm2 vs(433.33?6.77) mg/cm2(t=2.57,P=0.00) and 0 mg/cm2].By histological examination,the new-formed bone in the treatment group was confirmed integral and dense with intact cortex and continuous marrow cavities in 24 weeks,while the bone defect of the controls were repaired with connective tissues without remodeling of the bone.Conclusion It is effective to repair bone defect in dogs by using injectable osteoinductive material with FS as a carrier compounded with bBMP and bFGF.

Objective To investigate the expression and the significance of the MDR1, breast cancer resistance protein, lung cancer resistance protein mRNA and corresponding proteins P-gp, BCRP and LRP in breast cancer tissues and adjacent breast tissues. Methods RT-PCR was used to exam the expression of MDR1, BCRP, LRP mRNA in 42 breast cancer tissues and 42 adjacent tissues. IHC was used to exam the expression of P-gp, BCRP and LRP in 126 breast cancer tissues and 42 adjacent tissues, and theirs relationships with clinicopathological parameters in breast cancer, axillary lymph node status and 5-year recurrence and metastasis. Results The relative expression levels of MDR1, BCRP and LRP mRNA were 0.81 ±0.17,0.78 ±0.14,0.79 ±0.13 in breast cancer tissues and 0.33 ±0.11,0.45 ±0.09,0.36 ±0.10 in adjacent tissues respectively. There were significant differences between cancer tissues and adjacent tissues ( t = 4.613, 4.850 and 8. 089, P < 0.01 ). The positivities of P-gp, BCRP and LRP were 41% ( 52/126) ,39% (49/126) and 66% (83/126) in breast cancer tissues. There were significant differences between cancer tissues and adjacent tissues (x2 = 10.147, 7.020, 27.820, P < 0.01 ). The expression of MDR1 mRNA/P-gp was significantly associated with tumor stage and lymph node metastasis ( r = 0.369,0.398, P < 0.05 ). The expression of BCRP (mRNA/protein) was significantly associated with lymph node metastasis (r = 0.355, P < 0.05 ) . The positivities of P-gp were significantly different between 39 recurrence/metastasis patients occurred in 5 years and 32 unrecurrence/nonmetastasis patients in 5 years (x2 = 11.771, P < 0.01 ). The positivities of BCRP and LRP were not significantly different in these two groups(x2 =2.261,0.078,P >0.05). The coincidence rates for expression of MDR1 ,BCRP,LRP mRNA and their proteins in breast cancer tissues were 90.48% ,92.85% and 85.71% respectively (the Kappa values were 0.806,0.751 and 0.697, P < 0.01 ). Conclusions Multidrug resistance is common in breast cancer. The three drug resistance genes and proteins are involved in the formation of multidrug resistance of breast cancer. Detection of multidrng resistance genes in breast cancer may be useful to choose chemotherapy,especially patients with P-gp positive expression are not advised to use the CAF chemotherapy.

Aim To investigate the effect on antagonism of benthiactzine and atropine against the function of muscarinic acetylcholine receptors by desensitization of nicotinic acetylcholine receptors. Methods The whole cell recording configuration of patch-clamp technique was used and the cell model was rat SCG neurons. To identify antagonists' antimuscarinic effect, mAchRs mediated IM-inhibition was measured and nicotine and oxotremorine were used. Results After de sensitization of nAChRs,the antimuscarinic effect ofboth benthiactzine and atropine decreased compared to the normal condition. The decreased antimuscarinic effect of benthiactzine was weaker than that of atro-pine. The antimuscarinic effect of both benthiactzine and atropine recovered gradually with the recovery of nAChRs from desensitization. Conclusion Desensiti-zation of nAChRs weakens the antagonists' antimuscarinic effect.