Objectives To investigate and evaluate the effect of Nutrison-5Fu on immune function of perioperative patients with progressive gastrointestinal cancer,and simultaneously we also recommended the methods of application of Nutrison-5Fu.Methods Seventy eight cases were equally divided at random into three groups,26 cases in each group.⑴Nutrison-5Fu group:the patients were treated with Nutrison-5Fu.⑵Chemotherapy group:the patients only received 5-Fu.⑶Control group:there were not any chemotherapy and immunetherapy during the perioperation.The values of CD 3,CD 4,CD 8 and NKCC were determined in all cases.Results Values of CD 3,CD 4,CD/CD 8 ratio and NKCC in most patients were distinctly low,but the condition rapid improved by giving them Nutrison-5Fu.On the contrary,the values declined further after chemotherapy alone.Conclusion The treatment of Nutrison-5Fu not only can repress the development of the tumor,but also can improve the dystrophic status and immune function of the patients with cancer.

ObjectiveTo determine the relationship between the expression of bax and bcl-2 gene in mucous adenocarcinoma of rectum and patient′s prognosis.MethodsImmunohistochemical method was used to evaluate monoclone antibody of bax and bcl-2 protein in 38 cases of mucous adenocarcinoma of the rectum. ResultsThe positive-staining rate of bax was 77.8% in Dukes′ A and B stage compared to 45.0% in Dukes′ C stage( ? 2=4.260,P=0.039).The intensity of positive-staining of bax over bcl-2 was significantly correlated with tumor stage(P=0.04) and the survival (P=0.001).ConclusionThe expression rate of bax and bcl-2 gene was very high in mucous adenocarcinoma of large bowel, and it might have a prognosis implications in patients with colonic mucous adenocarcinoma.

0.05).The average fading time of the lymph nodes stained by PB and MB+PB was 13.06min and 82.13min,we observed the lymph nodes stained by MB 120 min,they were still stained deeply.There were dramatically differences among three groups(P=0.000).Conclusion Application of MB and PB possess their advantage and disadvantage in sentinel node biopsy.The mixture of patent blue and methylene blue could overcome the shortage of the two vital dyes in the experimental study and be an ideal tracer for the use.

ObjectiveTo understand the clinical characteristics and therapy of Huntington's disease (HD).MethodsThe clinical characteristics of five typical kindreds with HD were analysed. The therapeutic progression after reviewing literature was summarized.ResultsFive kindreds inherited in an autosomal dominant manner. They were all adult-onset HD.Progressive motor dysfunction,cognitive decline,emotional and behavioral disturbance were the key clinical presentations. At an early stage, manifestations include subtle emotional symptoms and involuntary movements.The reason of visiting doctor was chorea. CT scans demonstrated brain atrophy.ConclusionsTypical clinical manifestation and clear family history may be enough to make primary diagnosis. Psychological evaluation at risk individual may help to diagnose early. Gene testing may confirm the diagnosis of HD. The drugs and occupational,physical therapy and psychotherapy for HD patients can help maintain the highest level of function and improve the quality of life.

AIM: To investigate the effect of heme oxygenase on vascular remodeling in renal hypertension. METHODS: Male Wistar rats were randomly divided into sham-operated, 2K1C (two-kidney one-clip) and hemin-induced groups. Four weeks after the treatments, the thickness of aortic media and HO enzymatic activity of the aorta were determined. Immunohistochemical staining was carried out to detect protein of HO-1 in the aorta. RESULTS: The blood pressure in 2K1C renal hypertension rats started to increase two weeks after the surgery and stabled at a high level at the 4th week. Hemin, an inducer of HO-1, markedly inhibited the increase in blood pressure. Aortic medium thickness of the 2K1C rats at 4th week was 27 5% thicker than that in the sham-operated rats. The thickness of aortic medium of the hemin-induced rats was 16 1% less than that in 2K1C group. At the 4th week after operation, protein level and enzymatic activity of HO-1 in aorta were higher than that in 2K1C group compared to those in the sham-operated group. CONCLUSION: Renal hypertension caused vascular remodeling and the activation of HO-1. HO-1 induction decreased the blood pressure of renal hypertension and reduced vascular remodeling.

Objective To detect the expression of stem-cell related factors Nanog and CD44 in spheroid body-form?ing cells of gastric cancer cell line MKN-45. Methods The gastric cancer cell line MKN-45 was used to culture spheroid bodies in non-adherent condition in a serum-free medium supplemented with epidermal growth factor (EGF) and basic fibro?blast growth factor (bFGF). Using Western blot analysis, immunofluorescence staining and quantitative real time polymerase chain reaction(qRT-PCR), the expression levels of stem cell-related genes Nanog and CD44 were studied. Results In this study, we observed that MKN45 cells formed spheroid bodies in non-adherent condition in a serum-free medium, and the levels of Nanog and CD44 mRNA expression in spheroid body-forming cells were 2.34 ± 0.22 and 1.18 ± 0.04,respectively, which were higher than those in parental cells (1.00±0.00 and 1.00±0.05). The levels of Nanog and CD44 protein expression in spheroid body-forming cells were 0.18±0.02 and 0.24±0.04, respectively, which were significantly higher than those in pa?rental cells (0.07±0.02 and 0.18±0.01, P<0.05). Nanog protein was positively stained within the perinuclear and cytoplasm of the spheroid body-forming cells, and CD44 was positively stained mainly in the membrane. Dual staining of Nanog/CD44 indicated that the embryonal protein Nanog was co-localized with CD44 in the spheroid body-forming cells. Conclusion Spheroid body-forming cells developed from human gastric cancer cell line MKN-45 in serum-free medium supplemented with EGF and bFGF show characteristics of cancer stem cell (CSC). The cells co-expressed of CD44 and Nanog maybe a phe?notype of gastric CSCs.

BACKGROUND:Pretreatment is a dominant way to increase the histocompatibility of biomaterials,but many pretreatments are not satisfactory due to some reactions,such as calcification,cytotoxic reaction and reducing the tension resistance.OBJECTIVE:To investigate the effect of immunogenicity,scaffold tension and cell growth factor on the non-pretreated scaffold biomaterials,and to prepare the homograft decellularized scaffolds.DESIGN:Contrast observation for the histomorphology.SETTING:The experiments were carried out in the Department of General Surgery,Affiliated Hospital of Nantong University from June 2006 to March 2007.MATERIALS:Wistar rats of SPF grade were adopted in this study.Sodium dodecyl sulfate from BioteehGrade Company(U.S.A.);basic fibroblast growth factor (bFGF) and vascular endothelial growth factor (VEGF) from Peprotech Company(UK);dynamometer from Suzhou Electrical Element First Factory (China).METHODS:The vena cava inferior from rats were selected as experimental materials,we decellularized the epithelial cells from vein according to the improved Booth's methods with low osmotic Tris buffer containing sodium dodecyl sulplate,and then reserved the extracellular matrix.After fixing,the decellularized scaffold was stained by hematoxylin and eosin,the collagen fibers were observed and photographed by light microscope and scanning electron microscope.Changes of the intensity of the scaffolds were measured before and after decellularization.The deceilularized scaffolds were transplanted subcutaneously at homogeneity rats to observe whether the scaffolds had induced immunological rejection.In combination with bFGF and/or VEGF,the scaffolds were transplanted subcutaneously at homogeneity rats and took out two weeks later,in order to exam the new vessels in the scaffolds by immunohistochemistry.Dynamometer was applied to compare the change of the intensity of the scaffolds before and after transplantation.MAIN OUTCOME MEASURES:Change of the intensity of the scaffolds after decellularization and transplantation.Formation of new vessels in scaffolds.Local rejection of the scaffold subcutaneously transplanted into rats.RESULTS:The endothelial cells of the vein were completely removed when incubated with Tris buffer containing 0.03% sodium dodecyl sulfate for 48 hours.Results of hematoxylin and eosin staining,light microscope and scanning electron microscope showed that,the main components of extracellular matrix (collagen fiber) were reserved.There was no significant difference in the morphological structure and the intensity of collagenous scaffolds before and after decellalarization (P＞0.05).There was no apparent reject reaction at the embedded site,local incisions healed well.New vessels could be observed in the scaffolds two weeks later.There was no significant difference in the intensity of collagenons scaffolds before and after inoculation (P＞0.05).CONCLUSION:The low osmotic Tris buffer containing 0.03% sodium dodecyl sulfate is suitable for decellularizing the vein.The homograft collagenous scaffolds exhibit no rejection after transplantation,and the intensity of the scaffolds does not descend.VEGF and bFGF can improve the growth of new vessels in the decellularized scaffolds,and have a synergistic effect.

Objective To study the metastasis of lymph node of breast cancer patients in clinical T1-T2 N0 M0 and its clinical significance in (sentinel lymph node biopsy, SLNB). Methods A total of 276 pa-tients of breast cancer were enrolled in the study (T1 N0M0 cases =115 ; T2N0M0 cases = 161 ). The metas-tasis and distribution of axillary node by virtue of the location of primary tumor, ages and pathologic status were analyzed. Results The metastasis rate of axillary node in T1 N0M0 patients was less than T2 N0 M0 (P =0.027), while that in the central and lower outer quadrant's was higher than in other' s parts(P =0.004).When the tumor located in outer quadrant, the axillary node metastasis rate of Berg I was highest in the cen-tral, outer and inner quadrant(P =0.000). But the metastasis rate of Berg Ⅲ was lowest in the three quad-rants (P = 0. 000). For the pathologic status, the metastasis rate of invasive carcinoma-not otherwise speci-fied(NOS) was higher than early breast carcinoma and other pathologic categories (P =0.000). More than 2 groups axillary node metastasis was found in 6 of 9 patients with carcinoma simplex. The 90 cases with axilla-ry node metastasis were analyzed by age. Axillary node was easier for metastasis in those cases aged above 50years than those below 50 years(68.9% vs 31.1% )(P =0. 000). Two eases with skip metastasis were in T2 No Mo (invasive ductal carcinoma disease = 1, carcinoma simplex disease = 1 ). Conclusion The distri-bution of the metastasis of lymph node in clinical T1 ,T2 N0M0 breast cancer plays an important role in SLNB and formulating reasonable treatment protocols.

Objective To explore the methods of surgical treatment of patients with tumors in the body and tail of pancreas. Methods We analyzed the clinical data from 45 patients with tumors in the body and tail of pancreas who underwent surgical excision between 1984 and 2002 in our hospital. The 45 cases consisted of malignant tumors(n=33) and benign tumors(n=12). Operations performed included resection of the body and tail of pancreas(17 cases), combined-organ excision (24 cases) and local tumor resection(4 cases ). Results Pathological classification:carcinoma (33 cases), islet cell tumors (8 cases ), cystic adenoma (8 cases), epithelioid fibroma (1 case) and cystic teratoma (1 case). The average diameter-size of excised tumor was determined as follows: carcinoma in the body or tail of pancreas was(8.0?2.6)cm, and that of islet cell tumors was(6.5?2.4)cm. There were no operative deaths, but operation resulted in the following complications: pancreatic fistula (2 cases), subdiaphragmatic abscess (2 cases), pancreatic pseudocyst (1 case ), upper gastrointestinal bleeding(1 case) and infection or poor healing of incisional wound (3 cases). All of the complications were cured with conservative therapy. Conclusions Excision of the body and tail of pancreas is an effective method for the treatment of patients with tumors in the distal half of pancreas.Before operation, it is necessary to be routinely prepared to perform combined organ excision. Regarding the surgical handling of pancreatic stump, we select the use of ligation of main pancreatic duct plus mattress suture, which we believe could effectively prevent pancreatic fistula.

OBJECTIVE: To explore the effect of clinical pathway of emergency respiratory and cardiac arrest on management of patients with sudden respiratory and cardiac arrest. METHODS: The clinical data of patients with sudden respiratory and cardiac arrest admitted to Huashan North Hospital Affiliated to Fudan University from 1 year before to 1 year (started in July 2017) after the implementation of clinical pathway of emergency respiratory and cardiac arrest were retrospectively analyzed. The patients who managed by clinical pathway of emergency respiratory and cardiac arrest (from July 2017 to June 2018) were served as observational group, and those manually managed by 2015 American Heart Association cardiopulmonary resuscitation and cardiovascular emergency guide update and the procession in the management of emergency key diseases (from July 2016 to June 2017) were set as control group. The gender, age, underlying disease, the initiation time of cardiopulmonary resuscitation (CPR), the first time of defibrillation, the completion time of endotracheal intubation, the time of venous access, the usage time of the first dose of adrenaline, the usage time of vasoactive drugs, the completion rate of high quality CPR, the success rate of return of spontaneous circulation (ROSC) and the table procedure of clinical pathway were compared between the two groups. RESULTS: There was no statistically significant difference in gender, age or underlying disease between the two groups. Compared with the control group, the clinical pathway could effectively guide the decision-making of the emergency medical staffs, significantly reduce the variation in the procession of the resuscitation, the first time of defibrillation, the completion time of the deep vein catheterization, the usage time of norepinephrine and the completion time of the blood specimen delivery were significantly shortened [the first time of defibrillation (minutes): 1.28±0.86 vs. 2.93±1.61, the completion time of deep vein catheter (minutes): 15.13±2.73 vs. 17.25±3.02, the usage time of norepinephrine (minutes): 15.43±2.80 vs. 17.88±1.67, the completion time of blood specimen delivery (minutes): 7.81±1.42 vs. 9.00±1.03, all P < 0.05]. There was no statistically significant difference in the initiation time of CPR, the completion time of tracheal intubation, the time of peripheral venous access, the usage time of the first dose of adrenaline or sodium bicarbonate, or the success rate of ROSC between the two groups. However, the usage time of the first dose of adrenaline and sodium bicarbonate was shortened in the observation group [the usage time of the first dose of adrenaline (minutes): 3.81±1.22 vs. 4.00±1.32, the usage time of the first does of sodium bicarbonate (minutes): 8.94±3.49 vs. 11.19±3.54, both P > 0.05], and the success rate of ROSC was relatively increased as compared with those in the control group [15.04% (17/113) vs. 12.50% (12/96), P > 0.05]. CONCLUSIONS The clinical pathway of emergency respiratory and cardiac arrest could effectively guide the clinical decision-making of the emergency medical staffs, significantly reduce the variation in the procession of the resuscitation, improve the quality of the resuscitation, and ensure medical safety of emergency department.
Cardiopulmonary Resuscitation ; Case-Control Studies ; Critical Pathways ; Electric Countershock ; Emergency Service, Hospital ; Female ; Health Services Research ; Heart Arrest/therapy* ; Humans ; Male ; Retrospective Studies