Objective To review the research advance of intestinal barrier changes and its pathogenesis in stress conditions.Methods The literatures in recent years on the changes of the intestinal barrier,and its pathogenesis in stress conditions were reviewed.Results In some severe stress conditions, such as trauma, severe inflammation and acute severe pancreatitis, etc, a series of pathophysiologic disorders of intestinal barrier, even systemic inflammatory response syndrome and multiple organ dysfunction syndrome or multiple organ failure were induced. The pathogenesis was a result of a series of neurologic, immunologic and endocrine factors making one another. Conclusion Recognizing the changes and pathogenesis have an important clinical significance for treating and preventing the intestinal barrier dysfunction induced by stress.

Endostatin is an antitumor molecular targeting angiogenesis of tumor and plays an inhibitory role in tumorigenesis through inhibiting pathological angiogenesis, proliferation and metastasis of tumor. As increasing drugs for targeting therapy aim in clinic, endostatin has become one of hot spots of research on combined treatment of cancer in recent years.

Objective To evaluate long-term efficacy and safety of Topiramate in patients with various types of epilepsy.Methods 115 patients with epilepsy were underwent open-label experience with Topiramate as monotherapy or add-on therapy. The efficacy was assessed after 6 months. The rates of seizure-free and Topiramate retention were estimated after 1 and 2 years, and side effect were also evaluated during open-label treatment period.Results (1) After 6 months, total effective rate was 83.9% in monotherapy group and 66.1% in add-on therapy group. Topiramate was proved to be effective on various types of epilepsy, but there were not significant differences in seizure-free rate and total effective rate between the different types. (2) The optimal dosage was ( 105.72?48.28) mg/d in children and ( 176.26?62.81) mg/d in adults. (3) The seizure-free rate was 40.0% at 1 year and 28.7% at 2 years, and retention rate was 67.8% at 1 year and 46.1% at 2 years. (4) Side effects were observed in 34 patients (29.6%), including mild to moderate events related to central nervous system, anorexia and weight decrease.Conclusion Topiramate is a widespread antiepileptic drug with high efficacy and safety for long-term administration.

Hypoxia inducible factor-1α (HIF-1α)-vascular endothelial growth factor (VEGF)-vascular endothelial growth factor receptor-2 (VEGFR-2) signaling pathway plays a vital role in the regulation of neovascularization,and the activation of this pathway is closely related with tumor invasion and metastasis.

Objective To investigate the radiosensitizing effect of tetrandrine in human esophageal carcinoma cells (TE1) in vitro and its related mechanisms. Methods The cell proliferation was assessed by MTT assay. Colony formation was used to analyze radiosensitivity enhancement by tetrandrine in TE1cells. Western blotting was preformed to measure the cyclin B1 protein levels. Results Tetrandrine inhibited cell growth in a concentration and time depedant manner. The inhibition of proliferation was observed when cells were treated by 1.0, 5.0 and 10. 0 μg/ml tetrandrine for 24 h after irradiation ( P ＜0. 05;F= 3.09, 10.43 and 24. 00, respectively). The inhibition was more significant when cell were treated by 0. 1, 1.0, 5.0 and 10. 0 μg/ml tetrandrine for 48 h than 24 hours after irradiation (F =4. 12,12. 77, 44. 28, and 48.53 respectively ,all P ＜ 0. 01 ). The D0, Dq and SF2 decreased with the increase of the tetrandrine concentration. The maximal sensitizing enhancement ratio was 1.60 with 0. 5 μg/ml tetrandrine. Tetrandrine upregulated the expression of cyclin B1 and removed G2 / M arrest . Conclusions Tetrandrine can enhance radiosensitivity of TE1 cells. This effect may be associated with the increase of cyclin B1 expression to remove G2/M arrest.

Objective To explore the radiosensitization effect of thalidomide combined with X-ray on esophageal carcinoma TE1 cells.Methods Cell scratch assay Was used to detect the inhibition ability of different concentration of Thalidomide on cell invasion and metastasis.H3-TdR incorporation assay Was used to investigate the inhibition of DNA synthesis in TE1 cells by treated with Thalidomide singly or combination with X-rays.The colony formation assay Was used to analyze the radiosensitization of Thalidomide effect on TE1 cells.Results Thalidomide had obvious inhibition effect on TE1 cell metastasis.DNA synthesis and colony formation,which were correlated with drug concentration.The values D0,Dq and SF2 in TE1 cells were gradually decreased with thalidomide concentration increased.When the concentration of thalidomide was 100μg/ml,the SERD0 and SERDq were(1.4±0.2)and(1.5±0.1),respectively,While the concentration of thalidomide Was 1 50μg/ml,the SERD0 and SERDq were metastasis,DNA synthesis,and significantly enhance the radiosensitizing effect on esophageal carcinoma TE1 cells.

Objective To study the radiation sensitive enhancement ratio (SER) of NS398 on esophageal cancer stem cells and adherent tumor cells and analyze the radioresistance related protein expressions.Methods ECA109 esophageal cancer stem cells were cultured in serum-free medium.Expression levels of cell surface maker CD44 + and CD271 + were analyzed by flow cytometry.MTT assay was used to detect cell proliferation after the treatments with NS398 and irradiation(0,4 and 8 Gy).The sensitization effects of NS398 on the parental cells and its spheroid were evaluated by clone formation assay.Western blot assay was performed to determine protein expressions.Results Serum-free medium was successfully applied to isolate the cancer stem cells with spherical properties.CD271 + in the spheroid cells was notable higher than that in the parent cells (t =3.81,P ＜ 0.05).After irradiation,the proliferation rate of parental cells was higher than that in spheroid cells.After the combination treatment of NS398 and irradiation,SF2 value of parental cells was lower than spheroid cells(t =2.91,P ＜ 0.05)and the SER of NS398 on parental cells was greater than spheroid cells.The expressions of Bmi-1,c-Myc,β-catenin and Cyclin D1 in spheroid cells were higher than those in parental cells (t =8.09,7.90,7.50,7.15,P＜0.05).Cyclin D1 expression levels under both cell situations increased after 4 Gy irradiation (t =9.74,6.67,P ＜0.05).Compared to the 4 Gy irradiation alone group,the β-catenin and Cyclin D1 expression levels in both parental cells (t =10.15,12.12,P ＜ 0.05) and spheroid cells (t =3.23,7.45,P ＜ 0.05) decreased in the combination group.Conclusions Esophageal cancer stem cells with high level of CD271 can be isolated with serum-free medium and it is radioresistant where β-catenin and its downstream proteins may be involved.

The related curriculum knowledge system was constructed according to the orientation and goal of the three oriented medical personnel training. In order to provide important foundation for further formulating curriculum standards, revising basic requirements of curriculum, compiling relevant teaching materials and innovation of curriculum reform. This study constructs three oriented curriculum system mainly from the following six aspects: medicine and humanity, patient and doctor, innovation and practice, medical foundation and clinical application, teachers and learning promotion, quality control and teaching evaluation. The reference to teaching innovation of integrated curriculum will be provided.

AIM:To observe the change of nitric oxide(NO)and hydrogen sulfide(H_2S)in blood and lung homogenate of hypoxic pulmonary hypertension(HPH)rat model,and to discuss the meaning of inhalation sodium nitrite and these factors in the treatment of HPH. METHODS:Fifty healthy male Wistar rats were assigned randomly into 5 groups(10 rats each):normoxia control group(NC),normoxia sodium nitrite group(NNI),hypoxic control group(HC),hypoxic normal saline group(HNS)and hypoxic sodium nitrite group(HNI). The mean pulmonary arterial pressure(mPAP),weight of right ventricle,weight of left ventricle plus septum,and the ratio of the weight of right ventricle to that of left ventricle plus septum(right ventricle hypertrophy index,RVHI)were also determined. The serum level of NO and plasma level of H_2S were measured,and at the same time the levels of NO in the lung homogenate were detected. The structures in pulmonary arteries were examined using optical microscope. RESULTS:After model established,compared to that in the normoxia groups,the body weight decreased significantly in hypoxia groups(P<0.05),although no difference of body weight in five groups before producing model was observed. Compared to that in normoxia groups,the levels of mPAP and RVHI increased significantly in hypoxia groups,and compared to that in hypoxia control groups and hypoxia normal saline group,mPAP and RVHI levels decreased significantly in hypoxia sodium nitrite group(P<0.05). Compared to that in normoxia groups,the serum level of NO decreased significantly in hypoxia groups(P<0.05). NO level in lung homogenate decreased significantly in hypoxia control group and hypoxia normal saline group as compared to that in normoxia groups(P<0.05),and no obvious difference between hypoxic sodium nitrite group and normoxia groups was found. The plasma level of H_2S was decreased significantly in hypoxia groups(P<0.05)as compared to that in normoxia groups. H_2S level increased significantly in hypoxia sodium nitrite group as compared to that in hypoxia control groups and hypoxia normal saline group(P<0.05). Observation under optical microscope,the lumen structure of lung in normoxia control group was normal. No significant change in normoxia sodium nitrite group was found. The proliferation of smooth muscle cells(SMCs),the collagen fiber deposition in the vessel wall and every caliber thickening was observed in hypoxic control group. The same changes were also observed in hypoxic normal saline group. The thickened caliber was relieved significantly in hypoxic nitrite group. CONCLUSION:Pulmonary hypertension and right ventricle reconstitution can be relieved by inhalation of sodium nitrite,and can be regulated by the level of NO and H_2S in rats. Above all,inhalation of sodium nitrite may degrade HPH directly or by affecting the externalization and synthesizing of gas signaling molecule indirectly.

Objective To study the left atrial appendage (LAA) function and haemodynamics by transesophageal echocardiography,and predict high risk of thrombosis.Methods Eighty-nine consecutive patients were studied using transesophageal echocardiography.According to with spontaneous echo contrast (SEC) or not,all patients were divided into SEC group (n =17) and non-SEC group (n-=72).LAA emptying peak flow velocity (LAA-EV),filling peak flow velocity (LAA-FV) were measured by pulsed Doppler.The middle segment of the LAA medial wall systolic peak velocity (LAA-TSV) and diastolic peak velocity (LAA-TDV) were obtained by tissue Doppler imaging.LAA color Doppler and M-mode color Doppler images were acquired and derived the LAA emptying flow propagation velocity (LAA-EPV).Results LAA-EV,LAA-FV,LAA-TSV,LAA-TDV,LAA-EPV of SEC group were lower than those of non-SEC group (P ＜0.05).LAA M-mode color Doppler had four characteristic patterns,N pattern (normal pattern) which flow eject from LAA apical to LAA orifice,R pattern (reverse pattern) which flow eject from LAA orifice to LAA apical,V pattern (vertical pattern) vertical signals seen in systole and without efficient flow,S pattern (stasis pattern) almost no flow signal.V,R and S patterns may indicate high risk of SEC and thrombosis.LAA-EPV had strong correlation with LAA-EV (r =0.742,P ＜0.001),and moderate correlation with LAA-TSV (r =0.462,P ＜0.01),LAA-EV had strong correlation with LAA-TSV (r =0.600,P ＜0.01).Conclusions LAA dysfunction would result in hypokinetic LAA wall motion and reduced blood flow velocity.Emptying abnormalities of LAA might be the important reasons for blood stasis and thrombus formation.Emptying characteristic low patterns of V,R and S might be novel methods to predict high risk of thrombus.