Objective:To investigate the clinical characteristics, treatment, and evaluation of the prognosis of syndrome of inap-propriate anti-diuretic hormone (SIADH) in lung-cancer patients. Methods:We review the clinical data of six lung cancer cases, includ-ing four small cell lung cancer, one adenocarcinoma, and one squamous cell carcinoma, with SIADH complication. All six cases were treated in our hospital over the past three years. Results:Patients with various serum sodium levels were provided different therapeutic regimens. Symptoms of fatigue and nervous system disorders, plasma sodium, urine sodium, and plasma osmotic pressure were alleviat-ed. Conclusion:SIADH is a common complication of lung cancer, particularly in small lung cancer cases. Electrolyte disturbances indi-cate poor prognosis, high mortality rate, and delay in treatment because of clinical interest. After a final diagnosis has been made and ap-propriate treatment has been administered, clinical symptoms were relieved and blood sodium levels were quickly and significantly im-proved in these patients.

Objective To investigate the attitude of career in undergraduates of rehabilitation therapy. Methods 41 undergraduate students were investigated with questionnaire. Results 14.6% of the students preferred rehabilitative therapeutist, 53.7% knew little about the profession, 31.7% selected this profession for employment, 22.0% loved rehabilitation work, 41.4% would take rehabilitation work for life.Conclusion It is important for school to help the students understanding the profession of rehabilitative therapeutist correctly.

Objective To investigate the value of drug intervention for difficult weaning from mechanical ventilation. Methods A prospective single-blind randomized controlled trial was conducted. 120 patients with difficult weaning from mechanical ventilation encountered in Department of Critical Care Medicine of Peking University Third Hospital from January 2008 to December 2013 were included,and the patients were divided into treatment group and control group according to random number table,with 60 cases in each group. Patients received furosemide therapy in the treatment group 3 days before weaning up to 48 hours after weaning in order to control negative liquid balance. Enema was given the day before weaning to reduce abdominal pressure. On the weaning day,all of the patients received nitroglycerin and beta blocker or cedilanid to prevent or control elevation of blood pressure and heart rate in the process of weaning. All patients in treatment group received anisodamine in small dosage 2 hours before extubation.The patients in control group received conventional treatment without drug intervention. Baseline indexes of two groups were compared,including the heart rate,respiration rate(RR),mean arterial pressure(MAP),pulse blood oxygen saturation(SpO2),blood gas,hemoglobin(HG),albumin(ALB)and creatinine(Cr). The main reasons of difficulty in weaning,sedative and analgesic drug selection,presence of abdominal discomfort before weaning,interval between sputum suction before extubation,liquid balance at the beginning of the investigation and at time of weaning,24 hours and 48 hours after weaning,failures of spontaneous breathing test(SBT),length of mechanical ventilation,length of ICU stay,and total length of mechanical ventilation and total length of ICU stay during hospitalization. Results There was no statistically significant difference in the heart rate,RR,MAP,SpO2,blood gas,HG,ALB,Cr at the beginning of the investigation between the two groups. The main reasons for difficult weaning in both groups of patients were respiratory dysfunction,cardiac insufficiency,and central nervous system dysfunction. The use of propofol combined dexmedetomidine in the treatment group was more frequent than the control group〔16.7%(10/60)vs. 1.7%(1/60),χ2=8.107,P=0.004〕,and there was no statistically significant difference in the use of other combinations of sedative drugs between the two groups. Abdominal discomfort before weaning was milder in treatment group as compared with control group〔10.0%(6/60)vs. 25.0%(15/60),χ2=4.675,P=0.031〕. The interval between sputum suction before extubation in the treatment group was significantly longer than that of the control group〔hours:1(1,2)vs. 1(1,1),Z=-2.209,P= 0.027〕. SBT failure was less frequent in treatment group compared with control group〔times:0(0,1)vs. 1(1,2),Z=-6.561,P=0.000〕. Liquid balance was better in the treatment group than the control group at time of weaning,24 hours and 48 hours after weaning〔at time of weaning:-567.71 (-755.95,-226.41)vs. 1 256.76(472.48,1 796.63),Z=-9.038,P=0.000;24 hours after weaning:-5.03 (-530.28,245.09)vs. 342.28(125.36,613.25),Z=-4.711,P=0.000;48 hours after weaning:115.50(-450.26, 485.00)vs. 330.00(16.25,575.25),Z=-1.932,P=0.053〕. Compared with control group,length of mechanical ventilation〔days:1.0(1.0,2.0)vs. 2.0(2.0,3.0),Z=-6.545,P=0.000〕,ICU stay time〔days:3.0(3.0,4.0) vs. 4.0(4.0,5.0),Z=-6.545,P=0.000〕,and total length of mechanical ventilation〔days:8.0(6.0,12.0)vs. 11.0(8.0,15.0),Z=-4.091,P=0.000〕and total length of ICU stay during hospitalization〔days:12.5(9.2,19.0) vs. 17.0(12.0,29.5),Z=-2.722,P=0.000〕were all significantly shorter in the treatment group. Conclusions Adjuvant drugs therapy is helpful in patients weaning from the mechanical ventilation,and can shorten length of mechanical ventilation and ICU stay time. Propofol,combined dexmedetomidine,is helpful for weaning.

Objective To analyze the antimicrobial resistance profile and homology of the Acinetobacter baumannii strains isolated from Rushan People's Hospital in a three-year period for better control of hospital infections.Methods A.baumannii strains were isolated from clinical specimens during the period from 2013 to 2015.Homology analysis were conducted by pulsed field gel electrophoresis (PFGE) for 60 randomly selected isolates.Results A total of 567 A.baumannii isolates were isolated,85 isolates in 2013,156 in 2014,and 326 in 2015.These isolates were mainly from Department of Respiratory Diseases (47.4％) and ICU (23.8 ％).Overall,62.1％ of the isolates were from sputum specimens followed by secretions (15.2％).All isolates were sensitive to polymyxin B,but all resistant to sulfamethoxazole and ampicillin.The A.baumannii isolates showed increasing resistance rate to imipenem,meropenem,ceftriaxone,and trimethoprim-sulfamethoxazole over the 3-year period,but decreasing resistance rate to gentamicin.The 60 selected isolates were grouped into 4 types by PFGE.A-type was the main pattern.Conclusions A.baumannii strains were mainly isolated from inpatients with respiratory tract infections.The A.baumannii strains showed serious antimicrobial resistance associated with possible clonal spread in this hospital.

Objective To discuss the mechanism of obesity related glomerularpathology,we detect the expression of Podocin in glomerular podocytes of obesity rats induced by high fat diet.Methods The rats were divided into 2 groups:normal control group(Con group) and obesity group(Ob group).At the 14th week of molding,the body weight,body long,tail long,kidney weight,uria microalbumin,RBP,uria Cre,blood glucose,cholesterol,triglyceride,HDL-C,UA,Cre,BUN,and insulin were measured.The Lee's index,insulin resistance index,insulin sensitive index,Ccr and relative kidney weight were calculated.The tissue structures of the kidney of both groups were studied under light microscope and transmission electro microscope.The expression of Podocin in podocyte of rats' kidney was measured by immunohistochemistry and western blot.Results ①The difference had no statistical significance between the 2 groups in gender,weight,body length,tail length and Lee's index at the beginning (P ＞ 0.05).But after 14 weeks,the weight,body length and Lee's index of Ob group were significantly higher than those of Con group(P ＜0.05).②At the 14th week,the fasting plasma glucose of Ob group was higher than that of Con group (P ＜ 0.05),and the high density lipoproteins (HDL) of Ob group was lower than that of Con group(P ＜ 0.05).However,the difference had no statistical significance in urine acid (UA),serum Cre and blood urea nitrogen (BUN) between the 2 groups (P ＞ 0.05).③The urine protein and endogenous creatinine clearance rate(Ccr) in Ob group were higher than those of Con group (P ＜ 0.05,P ＜0.01).④The relative kidney weight of Ob group was lower than that of Con group(P ＜ 0.05).⑤For rats in Ob group,glomerular hypertrophy,the Bowman' capsule stricture,abnormality in the segmental capillary wall and extraglomerular mesangial cell were observed under light microscope.The glomerular podocytes became broader and foot process of podocyte in Ob group became microvillus-like in Ob group under transmission electro microscope.⑥Immunohistochemistry and western blot showed that the expression of Podocin in podocyte of kidney decreased in Ob group.Conclusions The expression of Podocin decreased in podocyte of kidney in obesity rats.At the same time,the ultrastructure of podocytes was changed.Those may be one of the reasons for protein urine related to obesity.

Objective Based on the previous research that the ethanolic extract from traditional Chinese medicine fructus forsythiae (Lianqiao) can obviously inhibit cancer cells in vitro, the article aimed to investigate the anti-proliferation effects of dammar-24-ene-3β-acetate-20S-ol (DM) extracted from fructus forsythiae on gastric cancer cells and its mechanism.Methods MTT assay was used to assess the anti-proliferation effects of DM on gastric cancer cells including SGC-7901, BGC-823, and MKN-45 in vitro.There were MKN-45 control group and its low dose and high dose groups, BGC-823 control group and its low dose and high dose groups, SGC-7901 control group and its low dose and high dose groups in the experiment.Flow cytometry was used to analyze the cell apoptosis rate.Cellquest software was used to analyze the results and record the ratio of cells at different cycles.DCFH-DA probe was applied to detect the ROS levels of blank control group, docetaxol group and DM group.The reaction system of microtubule assembly test was set with 10?mol/L docetaxol, 50 or 100 μmol/L DM final density and no medicine in blank control group.The readings of UV spectrophotometer were recorded.Microtubule assembly assay and microtubule immunofluorescence staining were applied to investigate the effects of DM on microtubule system.Results The inhibition ratio of 50 μg/L DM on the proliferation three gastric cell lines were all above 80%, with IC50s of MKN-45 11.72±1.35 μg/mL, BGC-823 17.19±0.82 μg/mL, SGC-7901 7.55±0.79 μg/mL.8 days′ low density culturing at 48 hours after 2 μg/mL DM treatment, compared with control group, the number of cell clones significantly reduced without much change in clone size, while 48 hours after 10 μg/mL DM treatment, besides a few clones of BGC-823, there were just several megascopic clones of SGC-7901 and MKN-45.In comparison with apoptotic cell ratio in MKN-45 control group[(21.1±2.5)%], its low dose group and high dose group resulted in significant rise of apoptotic cell ratio[(25.1±1.3)% and (55.2±2.3)%] (P<0.01).Compared with apoptotic cell ratio in BGC-823 control group[(13.2±2.5)%], its low dose group and high dose group resulted in significant rise of apoptotic cell ratio[(18.2±2.1)% and (41.8±2.1)%] (P<0.01).Compared with apoptotic cell ratio in SGC-7901 control group[(10.5±1.8)%], significant rise was observed in its high dose group[(41.8±2.1)%] (P<0.05) while no statistical significance was found in its low dose group[(12.3±1.6)%] (P>0.05).In comparison with MKN-45 control group, the ratio of cells at S phase decreased in its low dose group[(14.5±2.7)% vs (12.3±3.3)%,P>0.05].In comparison with BGC-823 control group, the ratio of cells at S phase increased in its low dose group[(12.2±5.4)% vs (20.2±2.1)%,P<0.05].In comparison with SGC-7901 control group, the ratio of cells at S phase increased in its low dose group[(21.5±3.8)% vs (31.3±2.6)%,P<0.05].From the detection of intracellular active oxygen after DM treatment, dose-dependent ROS level increased in all three cell lines 48 hours after 10μg/mL and 50μg/mL DM treatment.From the results of microtubule immunofluorescence staining, 48 hours after the treatment of IC50 docetaxol and 10μg/mL DM, the fluorescence signals were in local concentration and disorder.Conclusion Dammar-24-ene-3β-acetate-20S-ol demonstrated anti-proliferation effects due to the apoptosis induced by cell cycle arrest at S phase.

Recently, drug delivery materials have become the hotspot of medical study. Suitable delivery material plays an important role in constructing an excellent drug delivery system. Silk fibroin is a naturally occurring protein polymer with excellent biocompatibility, remarkable mechanical properties, biodegradability and outstanding processability. Due to its unique properties, silk fibroin has become a favorable carrier material for the incorporation and delivery of a range of therapeutic agents. Based on the structure and characteristics of silk fibroin, this article provides an overview of the recent research progress of silk fibroin used as drug delivery materials.
Biocompatible Materials ; Drug Delivery Systems ; Fibroins ; chemistry

Objective To explore the change of CD4+CD25+Foxp3+ regulatory T (Treg) cells during aging and the relation with lung tumor. Methods The Lewis lung cancer model was set up in C57BL/6 female mice, and the 36 mice were divided into young health group, middle-aged health group, elderly health group, young tumor group, middle-aged tumor group and elderly tumor group. The percentages of CD4+CD25+Foxp3+ Treg in CD4+ T cells in mice spleen cells were measured by flow cytometry, for reflecting the quantity of CD4+CD25+Foxp3+ Treg cells. And the level of Foxp3 mRNA in splenocyte was tested by real-time PCR method. Results The level of CD4+CD25+Foxp3+/CD4+ T cells and the quantity of Foxp3 mRNA were higher in tumor groups than in healthy groups(both P＜0.05 ). Besides, in the healthy groups, there were statistical differences in the level of CD4+CD25+Foxp3+/CD4+ T cells (F=47.70, P=0.000) and the quantity of Foxp3 mRNA among the different months groups. Accumulation of the CD4+CD25+Foxp3+ Treg cells was accompanied with aging, the elderly mice contained a significantly larger population of CD4+CD25+Foxp3+ Treg cells in their spleen when compared with the younger counterparts, and the highest was the elderly tumor group. So it was with the functional gene Foxp3 mRNA (F=6.56, P=0.009). Conclusions The results suggest a close relationship of the change of CD4+CD25+Foxp3+Treg cells with aging and the genesis and development of lung tumor.

Objective Using Mental Practice as a training method to train students grasping skills of minimally invasive surgery(MIS),and analyze the change of mental practice in training grasping skills of MIS.Methods 36 students were randomly divided into mental practice training group (MPTG) ( n =12 ),conventional training group (CTG) ( n=12),control group (CG) ( n=11 ).Under the uniform appraisal standards and conditions,using different training methods to teach the grasping skills of MIS,and analyze the results statistically.Results MPTG' s pre-training test results ( 16.18 ± 5.73 ) and post-training test results (79.47 ± 22.05 ) were significantly different(P ＜ 0.001 ),post-training and two weeks later test results ( 89.32 ± 31.56) displayed no significant difference(P=0.283) ; CTG' s pre-training test results ( 17.47 ±8.33) and post-training test results (57.18± 21.83 ) were significantly different (P ＜ 0.001 ),post-training and two weeks later test results (42.27 ± 24.64)had significant difference(P=0.048) ; CG's pre-training test results ( 18.19 ± 4.74) and post-training test results (38.04 ± 19.13 ) were significantly different(P =0.003 ),post-training and two weeks later test results (23.71 ±15.71 ) had significant difference (P=0.034).Compared with MPTG in pre-training test,CTG (P=0.632) and CG (P =0.464) neither had significant difference,but in the post-training test,CTG (P =0.014) and CG (P ＜0.001 ) both had significant difference compared with MPTG.In the two weeks later test,CTG and CG both (P＜0.001 ) had significant difference compared with MPTG.Conclusion Mental practice training method can improve the pedormance of gasping skills of MIS significantly and better durability,improve the learning curve,easy to implement in teaching,easy to master students,it will be a new method of MIS skills training in the future.

Objective To observe the protective effect of Panaxadiol Saponins (PDS)on rabbit heart failure model induced by acute alcohol infusion, and to explore its action mechanism of protecting myocardium. Methods 1 5 healthy rabbits were randomly divided into control group, model group and PDS group, 5 rabbits in each group.The rabbits in control group were given 0.2 g·mL-1 saline by intravenous drip at constant speed,the rabbits in model group were given 20% ethanol with same method, and the rabbits in PDS group were given 0.025 g·kg-1 PDS by intravenous injection before intravenous drip of 20% ethanol.The hemodynamic changes were observed by ventricular intubation;the levels of serum lactate dehydrogenase (LDH),creatine kinase (CK), and creatine kinase isoenzyme (CKMB)were determined by colormetric method.The level of malondialdehyde (MDA)in myocardial tissue homogenate,the activities of superoxide dismutase (T-SOD),glutathione peroxidase (GSH-Px)and catalase (CAT)were also detected.Results Compared with control group,the left ventricular end-diastolic pressure (LVEDP)of the rabbits in model group was significantly decreased at 30 min(P<0.05);the serum LDH,CK and CKMB levels were increased(P<0.05),the MDA level in myocardial tissue homogenate was increased(P<0.05),and the T-SOD,GSH-Px and CAT activities were decreased (P<0.05).Compared with model group,the LVEDP of the rabbits in PDS group was increased,the serum LDH,CK,and CKMB levels were decreased(P<0.05),the MDA level was decreased(P<0.05),and the activities of T-SOD,GSH-Px and CAT were increased(P<0.05).Conclusion PDS has protective effect on heart failure induced by acute alcohol infusion,and its mechanism may be related to the improvement of cardiac peroxidation.