Objective: To investigate prognostic factors of survival of lung adenocarcinoma patients with brain metasta-ses.Methods: The clinical data of 109 lung adenocarcinoma patients with brain metastases were reviewed.Fifty-senven pa-tients survived more than 1 year, and 52 patients survived less than 1 year.The data were analyzed by SPSS 15.0 statisti-cal software.Results: Both the univariate analysis and multivariate analysis showed that patients' PS score, the interval be-tween diagnosis and brain metastasis, and multimodality treatment were independent prognostic factors for the survival of lung adenocarcinoma patients with brain metastases (P<0.05).Patients' gender, age, metastatic symptoms and extracrani-al metastases didn't significantly affect patient survival.Conclusion: Patients with PS score 0-1, the interval of more than 1 year between diagnosis and brain metastasis, and combined therapy have longer survival.The research provides an impor-tant guidance for the treatment of advanced lung adenocarcinoma patients with brain metastases.

Objective To evaluate the effect of laparoscopy in treatment of renal cysts.Methods Twenty- eight and thirty-five patients with renal cysts were performed with transperituneal and retroperitonel laparoscopy,re- spectively.Results A total of 62 patients were treated successfully,the average operation time was 60 minutes,no complications presented,and there was no recurrence in follow-up.Conclusion Laparoseopy survey had the advan- tages of less trauma and fewer complications and rapid recovery in treatment of renal cysts,which was suggested for clinical applications.

Objective To observe the role of cannabinoid receptor-2 (CB2) in acute experimental colitis in mice, and to explore its effect on the endoplasmic reticulum stress ( ERS ) in the intestinal mucosa . Methods 32 SPF mice were randomly divided into normal group,model group,CB2 agonist group and CB2 antagonist group. Disease activity index( DAI) and colon histopathological score( HS) were evaluatd. The levels of TNF-α and IL-10 in colon tissue were detected by ELISA. The expression of CB2 and ERS markers GRP78, CHOP in colon tissues were de-tected by immunohistochemical. The mRNA levels of GRP78 and CHOP were detected by RT-PCR. Results Com-pared with the normal group,the level of TNF-αwas significantly higher and the level of IL-10 was significantly low-er(P<0. 05) in the model group,the expressions of GRP78, CHOP and its mRNA were significantly higher(P<0. 05). Compared with the model group,the expression of CB2 in the CB2 agonist group was significantly higher(P<0. 05),the level of TNF-α dropped and the level of IL-10 increased(P<0. 05),and the expressions of GRP78, CHOP and its mRNA were significantly reduced(P<0. 05). The level of IL-10,TNF-α and ERS markers had no significant difference bewteen CB2 antagonist group and the model group ( P>0. 05 ) . Conclusion Severe endo-plasmic reticulum stress exists in intestinal mucosa of experimental colitis mice. The CB2 agonist activates CB2 ex-pression,reducing colitis in mice. Its mechanism may be related to inhibiting ERS in intestinal mucosa.

Objective To investigate the feasibility and technique of laparoscopic subtotal cholecystectomy(LSC).Methods Totally 168 patients were converted to LSC because of failure in laparoscopic cholecystectomy(LC).During the LSC,the Calot's triangle was separated and then the Hartmann's pouch was incised to decreased the intracystic pressure for the removal of the stones.Results Among the cases,5 patients were converted to open surgery for subtotal resection of the gallbladder.LSC was completed after clipping the cystic duct and artery in 122 patients;in the other 41 cases,the gallbladder was cut at the Hartmann's pouch to clip the bile duct and artery or suture the neck of the gallbladder,and then LSC was performed.The median operation time was(65.5?15.2)min,and the intraoperative blood loss was(71.5?15.5)ml.The time to resume the diet was(20.4?6.3)h postoperation.After the operation,7 patients developed local complications(4.2%),and the mean postoperative hospital stay was(4.2?2.6)d.Of the patients,105 were followed up for(25.5?6.5)months,during this period,5 patients had dyspepsia,3 had right shoulder pain,and 9 had right hypochondrium pain.Conclusions LSC is feasible for patients with complicated cholecystitis.It is important to control the perioperative hemorrhage and bile leakage.

Objective To investigate lipopolysaccharide (LPS) tolerance and its possible mechanism in experimental acute pancreatitis(AP) mice. Methods Two hundreds and ten C56BL/6J mice were randomized into normal saline(NS)+LPS group( n =105)and AP +LPS group( n =105). Both groups were subdivided into seven groups according to different dose of LPS. AP model was induced by intra- abdominal administration of cerulein (50 ?g/kg) for seven times at 1 hour interval. LPS was given 6 hours after first cerulein injection . Cerulein was replaced by NS in NS+LPS group. Ten mice in each sub- group were randomly selected to investigate mortality rate for 7 days. Another 5 mice were killed at 12 hours after the first cerulein injection. Liver, lung, kidney, pancreas and serum were reserved to evaluate pathological changes and measurement of amylase (AMS) and lactate dehydrogenase (LDH) levels. Gene expression profiles of leucocyte in NS+LPS(15 mg/kg)subgroup and AP+LPS(15 mg/kg)subgroup were studied with oligonucleotide microarrays of 12 479 full length mouse genes respectively for three times to screen the different genes between two groups. Results Mortality rates in both groups were increased, and correlated with the dosage of LPS. Mortality rate in AP+LPS group was significantly lower than that in NS+LPS group with the same LPS dose( P

Objective To investigate the effects of oxidized 1-palmitoyl-2- arachidonoyl-sn- glycero-3-phosphorylcholine (OXPAPC)in LPS signal pathway and acute necrotizing pancreatitis (ANP).Methods Eighty-eight SD rats were randomly divided into two groups:ANP group and ANP treat with OXPAPC group.ANP model was induced by injecting sodium taurocholate(5%)into pancreatic duct OXPAPC group was administered with OXPAPC at 0 hours and 6 hours after model establishment.Twenty rats from each group were separated to observe mortality.The others were killed at 12 hours,24 hours,48 hours and 72 hours respectively to detect serum levels of amylase and lactate dehydrogenase (LDH).Severity of pancreatitis was evaluated by histological score system.The activity of myeloperoxidase (MPO)in pancreas was determined by zymohistochemistry.Inflammatory factors mRNA hours after treated with OXPAPC were studied by semi-quantitative RT-PCP.Intracellular proteinase were investigated by western blot.EMSA was used to testify the activity of transcriptional factors.Results The mortality in OXPAPC group was significantly than that in ANP group. Serum amylase and LDH levels at significanfiy decreased the 12 hours and 24 hours after treated with OXPAPC.Histologically,OXPAPC reduced the severity of pancreatic injury including inflammatory cell infiltration and necrosis at 12 hours,24 hours,and 48 hours.There was a significant decrease of MPO activity in OXPAPC group compared to ANP group.Levels of inflammatory factors mRNA were reduced in OXPAPC group.Intracellular proteinase were down-regulated in OXPAPC group.EMSA showed that the activity of transcriptional factors weakened.Conclusion OXPAPC can block LPS signal pathway,so it can decrease the severity of ANP.

Objectives To analyze the role and mechanisms of mast cells in the inflammation and fibrosis of 2 ,4, 6-trinitrobenzene sulfonic acid (TNBS)-induced rat pancreatic fibrosis. Methods Rats were received the aseptic instillation of TNBS in ethanol via bilo-pancreatic duct, and then injected with nedocromil sodium, a mast cell stabilizer, and compound 18/80, a mast cell activator, or saline. Rats were sacrificed respectively on 3, 7, 14, 21 or 28 days. Pancreatic inflammation and fibrosis were assessed by gross and histopathological evaluation. Pancreatic fibrosis were observed by Van Gieson. Pancreatic mast cells distribution, number and their state of activation (toluidine blue) were evaluated. The activation of pancreatic stellate cells (PSCs) were assessed by the expression of a-smooth muscle actin (?-SMA) through immunohistochemistry. The expression of angiotensin Ⅱ AT1 and AT2 receptors and transforming growth factor (TGF) ? 1 raRNA, which were the factors of fibrogenesis, were also assessed. Results Typical pancreatic fibrosis changes occurred in the model of rats received TNBS at 4th week by morphological evaluation. The positive expression of ?-SMA and TGF?1 in the pancreatic tissues were detected at day 3, especially at 4th week. The expression of angiotensin Ⅱ AT1 and AT2 receptors mRNA increased gradually in all the three groups, also especially at 4th week. Compared to the control group, there were more higher expression of ?-SMA, TGF?1, angiotensin Ⅱ AT1 and AT2 receptor in the compound 48/80 group, while there were lower expression of these proteins in the nedocromil group. Conclusions Mast cells are involved in TNBS-induced pancreatic inflammation and fibrosis in rats. After being activated, mast cells will promote the activation and proliferation of PSCs and upregulate the expression of angiotensin Ⅱ AT1 receptor and AT2 receptor, and then lead to pancreatic fibrosis gradually.

Objective To investigate the current knowledge and attitudes towards people living with HIV/AIDS (PWHAs) in Chinese registered nurses (RNs) and describe the relationships between the nurses' HIV/AIDS related knowledge and attitudes towards PWHAs. Methods A cohort of 1350 RNs from 51 comprehensive hospitals in Hunan, China were studied over a 4-month period. A 3-stage random sampling method was used. Results The total correct rate in AIDS Knowledge Scale was 63.2%. Most nurses were good at conceptions of routes of AIDS infection and some basic characteristics, with more than 80% of the correct responses rate of relevant items. Their weakness was in the knowledge of some activities which would not transfer AIDS, such as "eating in a restaurant where the cook has AIDS may infect HIV", with less than 50% of the correct response rate of relevant items. As for attitudes, 94% of the nurses sympathized with HIV patients. About 82.7% of the nurses showed little sympathy to patients getting HIV by sexual promiscuity. Among all the AIDS related knowledge, nurses' conception of non-infectious activities was significantly related to their attitudes to HIV/AIDS.Conclusion Chinese nurses waster well about HIV/AIDS basic characteristics and the routes of infection, and most nurses sympathize with PWHAs. Their weakness is in the knowledge of non-HIV-infectious activities and they hold different attitudes to those patients getting HIV/AIDS in different ways. There are some barriers for Chinese nurses to take care of all patients equally. Professional development programs are urgently needed to remedy this situation including clarifying the nurses' misconceptions on AIDS related knowledge, developing non-judgmental professional attitudes, and using universal prevention measures when they take care of all patients.

BACKGROUND: Bone morphogenetic proteins (BMPs) are involved in the formation of various tissues including bone, cartilage, tendon, and ligament. Vascular endothelial growth factor (VEGF) promotes angiogenesis by increasing the permeability and migration of endothelial cells.OBJECTIVE: To construct a co-expressing vector of human bone morphogenetic protein 2 (BMP2) and vascular endothelial growth factor 165 (VEGF165), and observe the expression of BMP2 and VEGF165 in human bone marrow mesenchymal stem cells (hBMSCs).DESIGN: Observation control trail.SETTING: Department of Plastic Surgery, Affiliated Hospital of Luzhou Medical College and Plastic Surgery Hospital of Peking Union Medical College, Chinese Academy of Medical Sciences.MATERIALS: The MSCs derived from the healthy adult volunteers of marrow donors. pIRES-EGFP-hVEGF165 containing total length of cDNA sequence of human VEGF165 gene was provided by Dr. Cheng Ting from Plastic Surgery Hospital of Peking Union Medical College. pSP65-hBMP2 containing total length of cDNA sequence of human BMP2 gene was provided by Dr. Guo Ximin from the Academy of Military Medical Sciences. Enkaryotic expression vector pIRESneo (Clontech Company) Pyrobest DNA Polymerae, restriction enzyme, DNA ligase and plasmid extraction kit, DNA Fragment Purification Kit (TaKaRa Company), LiorfectamineTM liposome transfection kit, DMEM medium, trypase, TRIzoIRNA extraction kit (Gibco BRL), Omniscript RT kit (Qiagen), TaqplusDNA polymerase (Promega), PMSF, leupeptin, aprotinin, chymostatin (Sigma), protease inhibitor, PVDF membrane (Amersham-Pharmacia Biotech), rabbit anti-human BMP2 antibody and VEGF monoclonal antibody (Santa Cruz Company), goat anti-rabbit lgG-peroxydase (Wuhan Boster), G418 (Ameresco Company in U.S).METHODS: The experiment was conducted in the Affiliated Hospital of Luzhou Medical College and the Plastic Surgery Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences between June 2005 and April 2006.hBMP2 and hVEGF165 cDNA were directional cloned into multiple clone sites of the eukaryotic expression vector pIRESneo. The recombinant plasmid was identified by restrictive enzyme Xho Ⅰ/Bgl Ⅱ digestion analysis and DNA sequencing. Liposome-mediated gene transfer method was used to transfect hBMSCs. For observation, the transfected cells were divided into IRES-hBMP2-VEGF165 group, pIRES-hBMP2 group, pIRES-VEGF165 group and empty vector group, which were transfected with pIRES-hBMP2-VEGF165, pIRES-hBMP2, pIRES-VEGF165 and pIRES-neo. Meanwhile, the same number nontransfected cells were selected as blank control group. The reverse transcription polymerase chain reaction (RT-PCR) and Weszern blot were employed to observe the expression and secretion of hBMP2 and hVEGF165 gene and protein.expression vector hBMP2 and hVEGF165 gene sequence were the same as reported after restrictive enzyme EcoRI and Bgl Ⅱ digestion analysis and pIRES-BMP2 gene sequencing, which showed that the recombinant plasmid pIRES-hBMP2-VEGF165 highly expressed hBMP2-mRNA and VEGF165-mRNA, but the non-transfected or transfected with pIRES-hBMP2-VEGF165 or pIRES-hBMP2 secreted a great quantity of hBMP2, but that non-transfected or transfected with pIRES-VEGF165 or empty vector secreted only little.CONCLUSION: The co-expressing vector of hBMP2 and hVEGF165 can be expressed stably in hBMSCs.

Background The rat model of N-methyl-N-nitrosourea (MNU)-induced photoreceptor cell apoptosis is often used to study retinal degeneration.But the changes in the gene expression patterm in retinal degeneration in rats have not been reported.Objective This study was undertaken to investigate regulation of gene expression in the retina of MNU-induced retinal degeneration in rats by performing microarray analysis of retinal RNA.Methods Fifty 6-week-old SD rats were numbered and randomized into the normal group and the model group.The retinal degeneration model was established by a single hypodermic injection of 40 mg/kg of MNU,and the rats in the normal group received equivalent volume of physiological saline in the same way.The rats were sacrificed 12 hours or 24 hours after injection.Retinal sections from the right eyes were prepared for the measurement of the retinal thickness by histopathological examination,and retinas from the left eyes were used to confirm the differential gene expression as detected by microarray (normal group and 12 hours model group).Genes exhibiting changes in expression by ≥2.0 folds were further confirmed using real-time PCR.Results The whole thickness of the retina declined in the rats from the 24 hours model group compared to the normal group and 12 hours model group (t =9.926,P=0.002;t=2.736,P=0.028).The thickness of the outer nuclear layer was (26.58±2.90) μm in the 24 hours model group,showing a significant decrease in comparison with (38.11 ± 1.01) μm in the normal group and (35.07t3.03) μm in the 12 hours model group (t=6.028,P=0.009;t=6.839,P=0.006).However,there was no significant difference in retinal thickness between the normal group and the 12 hours model group (whole thickness:t=1.541,P=0.324;outer nuclear layer thickness:t=2.040,P=0.134).Microarray analysis of the rat genes showed that out of 17 000 genes,142 genes involved in biological process and 94 genes involved in molecular functions were differentially expressed,where most of them participate in the mitogen activated protein kinase signaling pathway,Tolllike receptor signaling pathway and apoptosis pathway.Real-time PCR analysis demonstrated that the expression of CCL2,IL-1b,CCL3,c-fos,c-myc,p53 and MMP3 were consistently up-regulated,conforming with the results from microarray analysis.Conclusions The changes in gene expression pattern appear in the early stage of MNUinduced retinal degeneration.These microarray results provided clues to understanding the molecular pathways underlying photoreceptor degeneration and indicating the directions for future studies.