Objective To investigate the role and prognostic impact of E-cadherin( E-cad)on in-vasion and metastasis of gastric carcinoma by analyzing E-cadherin expression at DNA,RNA and protein levels. Methods RNA and protein expression of E-cad were tested in 60 cases of gastric carcinoma and adjacent tissues by streptavidin peroxidase( SP )immunohistochemistry and in situ hybridization. DNA methylation of E-cad was tested with methylation-specific polymerase chain reaction( MSP). Results The positive rates of E-cadherin protein and mRNA in gastric carcinoma were significantly lower than those in adjacent tissues. DNA methylation of E-cad negatively correlated with the E-cad protein and RNA expres-sion in gastric carcinoma respectively(r= -0. 355,r = -0. 271). DNA methylation of E-cad negatively correlated with the 5-year survival rate of gastric carcinoma(r = -0. 381,P ﹤0. 01). However,E-cad protein positively correlated with the 5-year survival rate of gastric carcinoma(r=0. 378,P﹤0. 01). Con-clusion The decreased expression of E-cad is one of the most important biological features in gastric car-cinoma. Methylation of E-cad DNA may be an important agent causing low expression of E-cad protein and mRNA and it can be used as an important indicator in predicting invasion and metastasis of gastric cancer.

Objective To analyze the clinical characteristics of coronary artery bypass graft sur-gery for elderly patients over the age of 70 years. Methods The clinical data of 232 elderly patients ( age﹥70 years)who underwent coronary artery bypass graft surgery were collected for analysis,including 208 cases of simple coronary artery bypass graft surgery,11 cases of additional mitral valve replacement or annuloplasty,6 cases of additional aortic valve replacement,1 case of additional mitral and aortic valve re-placement,5 cases of additional mediastinal or pericardial tumor resection and 1 case of additional aneu-rysm resection. Results There were eight cases of postoperative respiratory failure,six cases of poor wound healing,4 cases of secondary exploration for postoperative bleeding,2 cases of perioperative myocar-dial infarction,1case of third-degree atrioventricular block and 1 cases of cardiac tamponade. Deaths oc-curred in 2 cases. Conclusion For elderly patients over the age of 70 years,overall effect of coronary ar-tery bypass graft surgery is satisfied. It can improve the quality of life and prolong survival time.

Objective To evaluate the effects and security of single or combined sufentanil application on sedation and analgesia for mechanically ventilated patients in intensive care unit(ICU).Method A total of 160 ICU patients with mechanical ventilation were randomly allocated into four groups:sufentanil group,sufentanil plus midazolam group,sufentanil plus dexmedetomidine group and fentanyl group.Facial pain scale(FPS),Ramsay score and vital signs were employed to assess the effects of different therapies on organ functions and adverse reactions.Result After the treatment,FPS in all groups were significantly decreased and maintained around 3 points.Ramsay scores were significantly increased(P <0.001)and the score in group given sufentanil combined with midazolam or dexmedetomidine at the time points of30 min,1 h,6 h were even higher.Compared with the preoperative data,indicators of lung function(PaCO2and blood lactic acid),liver function(AST)and renal function(Cr)were decreased in all groups(P <0.05).Respiratory rate in the fentanyl group was significantly higher than the others.Total consumption ofsufentanil in group with combined sufentanil application was significantly lower.No significant differencesin adverse reactions were noticed among the groups(P >0.05).Conclusion For mechanically ventilatedpatients,sufentanil has efficient sedative and analgesic effects with less physiological interference and severe adverse reactions.Combined application is beneficial in decreasing total sufentanil consumption andinhibition to respiratory system,which is worthy of being spread.

Objective To research the effects of parenteral nutrition(PN)with high branchedchain amino acid(BCAA)content for critically ill patients in general ICU.Methods A total of60 patientsfrom the general ICU were randomly divided into the control group(30 cases)and treatment group(30 cases).The control group was given PN with balanced amino acids,while the treatment group received PNwith high content of BCAA.Therapeutic outcomes and the blood parameters were measured betweengroups.Results Total protein (TP),albumin (ALB),prealbumin (PA),arm muscle circumference(AMC)and arm circumference(MAC)of the treatment group increased significantly(P <0.05).In thecontrol group,the change of TP,ALB and PA after 7 days was statistically significant(P <0.05).Compared to the control group,the improvement of parameters in the treatment group was more obvious.Conclusion For patients in general ICU,parenteral nutrition with high BCAA content is able to provide effective nutritional support without relative sideeffects.

Objective To observe the pathomorphological changes and expressions of TNF-α, SOD1 and SOD2 in cardiac tissues of rats with abdominal aorta champing(AAC)and LPS attack.Methods Forty Wistar rats were randomly divided into four groups:sham operated group (Group S),ischemia reperfusion with AAC group(Group I /R),intraperitoneal injection of endotoxin group(Group LPS)and AAC +LPS group(Group I /R +LPS).Animals were sacrificed after 20 minutes of AAC and 8 hours of reperfusion.Cardiac tissues were observed with HE staining for pathmmorphological changes,and detection of TNF-α,SOD1 and SOD2 expressions were tested by immunohistochemistry.Results The mortality rate of Group I /R +LPS was highest.HE staining of the cardiac tissues revealed that the pathological changes of myocardial tissue were not obvious in Group S;myocardial cells were disordered and slightly swollen and red blood cell and inflammatory cells were observed in the intramuscular space of the Group LPS;these injuries were more serious in the Group I /R;the injuries of cardiac tissues were most serious in Group I /R +LPS.The results of immunohistochemical staining revealed that TNF-αexpression level of cardiac tissue increased as followings:Group S,Group LPS,Group I /R and Group I /R +LPS.Significant differences were observed among groups,except for the difference between Group LPS and Group I /R.The expression level of SOD1 decreased as followings:Group S,Group LPS,Group I /R and Group I /R +LPS. Significant differences were observed among groups,except for the difference between Group I /R and Group I /R +LPS.The expression level of SOD2 decreased as followings:Group S,Group LPS,Group I /R +LPS and Group I /R.Significant differences were observed among groups,except for the differences between Group LPS and I /R and Group I /R +LPS.Conclusion The mortality in rats with sepsis after abdominal aorta clamping is high.Obvious myocardial morphological changes and injuries exist either in ischemia reperfusion or sepsis state.At the same time,the expression of TNF-αis up-regulated while SOD1 and SOD2 are down-regulated.

Objective To investigate the diagnostic values of blood sedimentation and serum pro-calcitonin(PCT)in early infection after hip arthroplasty.Methods The clinical data of 15 patients with early infection after hip arthroplasty(infection group)and 17 patients without it(control group)in recent years were retrospectively reviewed.Preoperative and postoperative levels of blood sedimentation and serum PCT were analyzed for comparison.Results No significant differences in preoperative blood sedimentation were observed between the groups.Postoperative blood sedimentation increased in both groups,and level of the infection group was significantly higher(P <0.05).Preoperative serum PCT levels were similar be-tween the groups.Postoperative serum PCT level in the infection group elevated significantly,but the level of control group was not(P <0.05).Conclusion For early infection after hip arthroplasty,blood sedi-mentation and serum PCT are helpful indicators with certain sensitivity and specificity,and they may be commonly used for the early diagnosis of postoperative infection.

Objective To analyze the curative effects of total knee arthroplasty(TKA)for severe genu varus combined with flexion deformity.Methods The clinical data of 25 patients(36 knees),who had undergone TKA for severe genu varus combined with flexion deformity from January 2005 to October 2010,were retrospectively analyzed.There were 7 males and 18 females,aged from 55 to 80 years(average 70.5 years).The primary diseases were osteoarthritis in 22 cases and rheumatoid arthritis in 3 cases.HSS knee score was used before and after the operation to assess the efficacy of the TKA.Results All of the patients were followed up for 4 to 9 years(average 6 years).The degree of flexion deformity was reduced from (21 ±63)°to(1.1 ±2.3)°;the degree of the varus decreased from(210 ±4.8)°to(175.6 ±2.1)°;range of motion of the knee joint increased from(70.5 ±20.5)°to(115.1 ±5.3)°;knee score augmen-ted from(33.2 ±10.5)to(90.7 ±8.5);function score added from(35.5 ±14.2)to(85.6 ±10.5);there were 21 cases(8 knees)rated as excellent,2(3 knees)as good and 2(3 knees)as fair,and the excel-lent and good rate was 86%.Most of the patients had normal force line of the knee joint,but 2 patients re-mained varus deformity of 5°~10°.Conclusion Satisfying outcome can be achieved by TKA in treating severe genu varus combined with flexion deformity of the knee.

Objective To discuss the diagnostic values of transrectal ultrasound-guided puncture biopsy in prostate carcinoma(PCa).Methods A total of 238 patients with suspected PCa received tran-srectal ultrasound-guided puncture biopsy.Results Based on the results of biopsy pathology,88 cases (37.0%)were diagnosed as PCa,105 cases(44.1%)were benign prostate hyperplasia,15 cases (6.3%) were low-grade prostatic intraepithelial neoplasm,17 cases(7.1%)were atypical hyperplasia,8 cases(3. 4%)were adenomatoid tumor,and 5 cases(2.1%)were granulomatous prostatitis.Conclusion Tran-srectal ultrasound-guided puncture biopsy is accurate and safe.It is an effective method in diagnosing pros-tatic carcinoma.

Objective To observe the effects of penehyclidine hydrochloride(PHC)on lipopo-lysaccharide-induced neonatal cardiomyocyte damage.Methods After the primary cardiomyocytes culture of neonatal rat on postnatal day 1,the myocytes were randomly divided into 4 groups:the control group,the lipopolysaccharide(LPS)group,the low dosage PHC pretreatment group and high dosage PHC pretreatment group.Activities of myocardial enzymes and cardiac troponin and cell survival rate were measured.Expres-sion of NF-Κb(p65)and IκB-α(NF-κB inhibitor)phosphorylation were assessed using Western blot.Re-sults Compared with the control group,activities of myocardial enzymes and cardiac troponin in the LPS group were elevated but the survival rate were down-regulated.All these effects were reversed in the PHC pretreatment group.Results of Western blot showed that phosphorylation of IκB-αand p65 expression were up-regulated in the LPS group.In the PHC pretreatment group,phosphorylation of IκB-αand p65 expres-sion were down-regulated.Conclusion Penehyclidine hydrochloride can inhibit lipopolysaccharide-in-duced neonatal cardiomyocyte damage and the down-regulation of NF-κB activity might be involved.

Objective To establish and observe the effects of CD46-siRNA on proliferation,in-vasion and metastasis of MCF-7 human breast cancer cell.Methods The pEGFP-C1-CD46 siRNA was established and transfected into the MCF-7 cell.Changes in CD46 mRNA and protein expression were test-ed and variation of invasion and migration capacity in MCF-7 /CD46-siRNA cell was also observed.Results Compared with the control group and scrambled group,the expression of CD46 mRNA was significantly decreased(P <0.05)and CD46 protein expression was also suppressed in the MCF-7 cells of the silence group.Proliferation activity of MCF-7 cell in the control group and scrambled group was gradually in-creased with the time,but this phenomenon was not obvious in the silence group.At the 3th and 4th day af-ter transcription,differences in proliferation activity were significant among the groups,and activity in the silent group was significantly lower than the other two groups(P <0.05).Counts in invasion and migration of MCF-7 cell in the control group and scrambled group were significantly higher than the silent group (P <0.05 ).Conclusion The expression vector of pEGFP-C1-CD46 siRNA can suppress the CD46 mRNA and protein expression in MCF-7 human breast cancer cell and reduce the capacity in proliferation activity,invasion and migration.