Objective To discuss the feasibility and safety of early enteral nutrition (EN) on treatment of severe acute pancreatitis (SAP) and its influence. Methods The advancement about application of early EN on treatment of SAP in recent years were reviewed. Results In patients with SAP, early EN via catheter placed in the jejunum could protect the integrity of intestinal barrier and reduce infectious complications. But no consensus had been reached about the starting time, ingredient and infusion mode yet. Conclusion Early EN may have positive effects on treatment of SAP, but further researches are still needed.

Objective To explore the correlation of the gene polymorphism of the two single nucleotide polymorphisms(SNPs)rs1443434andrs925489onforkheadboxEl(FOXE1)withthehighnormalthyroidstimulating hormone ( TSH) level in Chinese Han population. Methods 1 400 subjects with normal serum TSH and thyroid peroxidase antibody(TPOAb) levels were included. According to TSH or TPOAb levels, the subjects were divided into high normal TSH group(H-TSH group,n=195) and normal TSH control group(TSH control group,n=1 205) or high normal TPOAb group ( H-TPOAb group, n=711 ) and low normal TPOAb group ( L-TPOAb group, n=689 ) , respectively. The genotypes on the two SNPs of all the subjects were performed by whole-genome genotyping chips. Results There were significant differences in rs925489 genotypic distributions and allele frequencies between H-TSH group and TSH control group(both P<0. 05). The genotype TT and allele T in H-TSH group were significantly higher than those in TSH control group(89. 75% vs 83. 15%, 94. 62% vs 91. 29%). The normal TSH levels were positively associated with rs925489 genotypic distributions after adjustment for sex, age, and high density lipoprotein cholesterol(P<0. 01). There were no significant differences in rs1443434 genotypic distributions and allele frequencies between two TSH groups or two TPOAb groups. Conclusion FOXE1 rs925489 gene polymorphism may be correlated with the high normal TSH level in Chinese Han population.

Objective To investigate the clinical and genetic characteristics of a progressive symmetric erythrokeratoderma (PSEK).Methods The clinical and genetic characteristics of a PSEK were compared and analyzed with clinical collection and review of 17 PSEK families reported in China since 1980.Results PSEK was consistent with autosomal dominant inheritance.PSEK had the feature with incomplete penetrance and variable expression.The clinical features included hyperkeratotic plaques with distinct border and strikingly symmetric distribution pattern on the extremities.Part of patients was extended to other areas of the body.The onset of the disease commonly started in infancy or childhood.The general health condition was not affected.PSEK might be associated with other clinical symptoms.The diseased potential increased in the family of consanguineous marriage.Conclusions PSEK has genetic heterogeneity.Its causative genes have not been determined.Further studies are needed.

Objective To explore the role of type Ⅶ collagen (COL7A1) gene in the pathogenesis of pretibial dominant dystrophic epidermolysis bullosa (DDEB-Pt).Methods Peripheral blood samples were obtained from a sporadic Chinese patient of Han nationality with DDEB-Pt,his parents and 100 healthy human controls.A modified salting-out method was used to extract genomic DNA from the blood samples,and PCR was performed to amplify 118 exons of the COL7A1 gene followed by DNA sequencing.Results A G→A mutation was identified at position 6109 (G6109A) in exon 78 of the COL7A1 gene in this patient,which caused a change from GCT to ACT at codon 2037 in the triple helix region,and resulted in the substitution of glycine (Gly) by arginine (Arg) (p.Gly2037Arg).Conclusion A novel glycine substitution mutation was identified in the COL7A1 gene in the patient with DDEB-Pt,which may be a pathogenic mutation.

Objective To study the effect of fluoride on bone metabolism in rats, and to understand the mechanism of pathogenesis of skeletal fluorosis. Methods A total of 80 Wistar rats were randomly divided into 4 groups that included control group (distilled water), low-dose group(NaF, 50 mg/L), medium-dose group (NaF,100 mg/L) and high-dose group(NaF, 150 mg/L), respectively. After being bred for 12 weeks, the rats were put to death (etherization). Incidence of dental fluorosis was estimated, and serum was collected. Radioimmunoassay was employed to detect the levels of osteocalcin (BGP), parathyroid hormone (PTH) and calcitonin (CT), respectively.Colorimetry method was employed to determine the levels of alkaline phosphatase (ALP) and acid phosphatase (ACP). Results Incidence of dental fluorosis between the four groups was significantly different statistically(x2 =82.81 ,P ＜ 0.01 ). The incidence was significantly different(x2 = 22.67, 40.00, 40.00, all P＜ 0.01 ) between low-dose ( 80%, 16/20), medium-dose ( 100%, 20/20), high-dose groups ( 100%, 20/20) and control group (0,0/20),respectively. Serum levels of BGP, PTH, CT were significantly different between the groups(F = 38.614, 20.778,3.023, P ＜ 0.01 or ＜ 0.05). There was no significant difference between the four.groups of ALP and ACP in serum (F = 0.609,2.895, all P ＞ 0.05 ). Serum BGP in low-dose, medium-dose and high-dose groups[ ( 19.60 ± 12.79),(33.41 ± 10.81 ), (39.46 ± 9.51 )mg/L, respectively] was significantly higher than that of the control group[ (7.35 ± 3.22)mg/L, all P ＜ 0.01 ]. Serum PTH in low-dose, medium-dose and high-dose groups[ (72.27 ± 25.38), (67.80 ± 12.01), (106.52 ± 36.37)pmol/L] was significantly higher than that of the control group[(47.08 ± 9.22)pmol/L,all P ＜ 0.01 ]. Serum PTH of the high-dose group was significantly higher than that of the low-dose and the mediumdose groups(all P ＜ 0.01 ). Serum CT in medium-dose and high-dose groups[ ( 13.39 ± 2.07), ( 15.05 ± 4.77)pmol/L ] was significantly lower than that of the control group[ (26.06 ± 28.31 ) pmol/L, all P ＜ 0.05 ] and also significantly lower than that of the low-dose group [ (24.49 ± 14. 10) pmol/L, all P ＜ 0.05 ]. Conclusions Fluoride affects bone metabolism in rats, BGP, PTH and CT play a key role in the pathogenesis of skeletal fluorosis.

AIM: To evaluate the effects of over-expression of cellular repressor of E1A-stimulated genes(CREG) mediated by retrovirus on neointima formation in injured rat carotid.METHODS: The pluronic F127 containing pLNCX/CREG or pLNCX/GFP retroviral vectors was placed around the injured rat carotid.The neointima,media areas and the intima to media ratio were calculated.Expressions of CREG,SM ?-actin and Ki-67 were detected.RESULTS: The GFP expression was observed at day 2 in pLNCX/GFP groups.The expression of exogenous CREG was also significantly increased in arteries at day 2 after pLNCX-CREG infection.Over-expression of CREG significantly suppressed neointima formation,attenuated the expression of Ki-67 and up-regulated SM ?-actin expression.CONCLUSION: Over-expression of CREG inhibits VSMCs proliferation and promotes VSMCs differentiation after vascular injury.It suggests that modulation of CREG expression or activity may be a viable approach to treat neointimal restenosis after percutaneous coronary intervention.

Objective To investigate the effects of low-dose,sustained release oral theophylline on the chronic obstructive pulmonary disease (COPD) patient.Methods Fifty-six patients with stable COPD were randomly divided into two group:theophylline group (n =35) that was treated with slow-release theophylline(100 mg,twice daily),and control group (n =21) that was given with placebo.A series of parameters including lung function,quality of life scores,body mass index,airflow obstruction,dyspnea,and exercise capacity index (BODE) score,exercise tolerance,exacerbations,satisfaction with treatments and adverse effects were tested before and 12 weeks after the treatments.Results Forty two patients completed the study,25 cases in the slow-release theophylline group,and 17 cases in the placebo group.The differences of two groups before the treatment were not prominent except the age (P ＞ 0.05).After treated with slow-release theophylline,the forced expiratory volume in one second (FEV1),forced vital capacity (FVC) and the symptom score were slightly increased,but there were no statistically significant differences (P ＞0.05).After theophylline therapy,the quality of life score,including activity ability score,disease activity score and total score,and BODE index score were significantly decreased(P ＜0.05),but 6 minutes walk test (6 MWT) differences were no significant (P ＞0.05).The differences in pulmonary function test,the quality of life score,BODE index score and 6 minutes walk test were no significant between before and after the treatment with the placebo (P ＞ 0.05).Compared to the cases who treated with the placebo group,the patients in slow-release theophylline group reduced the frequencies of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) (3/25 vs 7/17,x2 =4.748,P ＜0.05),and increased the efficacy satisfaction (Z =-2.579,P ＜ 0.05).Slightly adverse reaction was observed in 3 cases in slow-release theophylline group,but it could relieve by oneself,and not affect the common treatment.There was no adverse reaction in the placebo group.Conclusions Low dose,sustained release oral theophylline was efficient in improvement of the quality of life scores and BODE index score.

OBJECTIVE:To investigate the effects of neoadjunctive chemotherapy(NAC)of docetaxel and epirubicin com-bined with cyclophosphamide on clinical efficacy and tumor markers of breast cancer patients with different molecular types. METH-ODS:A total of 88 female patients with locally advanced breast cancer collected from our hospital during Jan. 2014-Jan. 2016 were divided into Luminal A type(23 cases),Luminal B type(21 cases),basal-like type(11 cases),HER2-over expressing type(18 cases)and normal breast-like type(15 cases)according to molecular type. All patients were given Docetaxel injection+Epirubicin hydrochloride injection+Cyclophosphamide for injection for consecutive 6 cycles(21 d as a cycle). Total response rates and patho-logical complete remission(pCR)rates were compared among breast cancer patients with different molecular types. The expression of serum tumor markers [CEA,CA125,CA153] were compared before and after treatment,and the occurrence of ADR was record-ed. RESULTS:Total response rate of 88 patients was 63.64%,among which that of basal-like breast cancer patients was 72.73%, significantly higher than other molecular types,with statistical significance(P<0.05). There was no statistical significance in total response rates of pairwise molecular type comparison(P>0.05). The pCR rate of 88 patients was 27.27%,and that of basal-like breast cancer patients was the highest(45.45%). There was statistical significance in pCR rates of pairwise molecular type compari-son(P<0.05),except there was no significant difference in pCR rate between HER2-over expressing type and normal breast-like type(P>0.05). Before treatment,there was no statistical significance in the expression of CEA,CA125 and CA153 in breast can-cer patients with different molecular types(P>0.05). After treatment,the expression of CEA,CA125 and CA153 in different mo-lecular types were decreased significantly,with statistical significance(P<0.05). There was no statistical significance in the expres-sion of above markers among different molecular types(P>0.05). There was no statistical significance in the incidence of ADR among different molecular types(P>0.05). CONCLUSIONS:NAC plan of docetaxel and epirubicin combined with cyclophospha-mide can reduce the expression of tumor markers and shows certain therapeutic efficacy for breast cancer patients with different mo-lecular types. Total response rate and pCR rate of basal-like type are better than those of other molecular types,so NAC plan is the preferred treatment for basal-like type breast cancer.

Objective To investigate the anti-inflammatory effects of low-dose and sustained release oral theophylline on the chronic obstructive pulmonary disease (COPD) patients.Methods Thirty four patients with stable COPD were randomly divided into two groups:theophylline group (n =18) was treated with slow-release theophylline (100 mg,twice daily),and placebo group (n =16) was given with placebo.Healthy non-smokers (n =12) were taken as control.The course of treatment was 12 weeks both of theophylline group and placebo group.The percentages of Neu/Leu and Mφ/Leu in sputum were detected before and after treatment and the concentrations of interleukin (IL)-17,IL-8,and tumor necrosis factor-α (TNF-et) were detected with enzyme linked immunosobent assay (ELISA).Results (1) Compared to pretreatment with theophylline group,the Neu/Leu was increased [(89 ±4.14)％ vs (83.4 ±6.98)％,P ＜0.05] and the Mφ/Leu was decreased [(6.4 ± 4.11) ％ vs (12.3 ± 6.96) ％,P ＜ 0.05] in the post-treated theophylline group.No significant changes in both Neu/Leu and Mφ/Leu were observed before and after placebo-treatment (P ＞ 0.05).(2) Compared to the control group,the concentrations of TNF-α,IL-8,and IL-17 in the sputum supernatant were significantly increased in both pretreatment and posttreatment with the theophylline or the placebo.Sputum TNF-α,IL-8,and IL-17 levels were significantly decreased in COPD patients who were given theophylline.Compared to pre-treatment with placebo group,the IL-8 and IL-17 levels were significantly increased in the post-treated placebo group (P ＜0.01).There was no significant change in TNF~ level between before and after treatment with the placebo.(3) The concentrations of IL-17,IL-8,and TNF-α in the sputum supernatant were positively correlated with the Neu/Leu counts (r =0.471,0.652,0.466,respectively,all P ＜0.01),negatively correlated with the forced expiratory volume in one second (FEV1 ％) (r =-0.516,-0.652,-0.496,respectively,all P ＜ 0.01).Conclusions Low-dose and sustained-release oral theophylline was efficient in improving airway inflammatory cells and inflammatory mediators,which plays an anti-inflammatory effect.

Objective To investigate the effect of recombinant human bone morphogenetic protein 2 (rhBMP-2) on the osteogenic activities of human osteosarcoma cell line SaOS-2. Methods SaOS-2 cells were exposed to rhBMP-2 for 12,24,48 h at 0(control) ,2,20,200 μg/L, respectively. The mRNA expression of alkaline phosphatase(ALP) and bone gla(BCP) were detected by real time polymerase chain reaction. Results The mRNA expression of ALP and BGP of SaOS-2 cells increased gradually with rhBMP-2. The mRNA expression of ALP of the 20 μg/L group exposed for 48 h(1.60 ± 0.64), and the 200 μg/L group exposed for 12,48 h(1.70 ± 0.41, 1.80±0.19) were significantly higher than those of control (12 h: 0.80±0.25, 48 h: 0.74±0.21, allP<0.05). The mRNA expression of BGP of the 2 μg/L group exposed for 24 h(1.67 ± 0.33), the 20 μg/L group exposed for 12,24 h(2.42 ± 0.13,1.82 ± 0.14) and the 200 μg/L group exposed for 12,24 h(1.46 ± 0.11,1.24 ± 0.07) were significantly higher than those of control( 12 h: 1.01 ± 0.14, 24 h: 0.84 ± 0.12, all P< 0.05). Conclusions rhBMP-2 can promote the mRNA expression of ALP and BGP of SaOS-2 cells. They have a dose-response relationship, but represent a different dose-response effect.