Recent studies show that the abnormalities of dickkopf-1 (DKK-1)are closely related to the bone metastasis and therapeutic effect of breast cancer,prostatic carcinoma,multiple myeloma,neuroblastoma and non-small cell lung cancer.Clinical researches of large sample on the relationships between serum DKK-1 concentration and malignant tumors bone metastases have important clinical significance for evaluating the value of DKK-1 as a clinical biological biomarker of bone metastases and understanding the tumor mechanisms of bone metastases.

Objective To compare clinical effects among three techniques of multifetal pregnancy reduction(MFPR) guided by transvaginal ultrasonography through vaginal approach.Methods Under the guidance of transvaginal B-ultrasonography,99 cases of multiple pregnancy following assisted reproductive technique underwent three different methods of embryo reduction: drug injection directly to the pregnancy sac(Drug Group),simple embryonic bud aspiration(Aspiration Group),and combined use of drug and aspiration(Combination Group).Results The gestational age at the procedure ranged 41~88 days(mean,58.9?8.7 days).The success rate of the procedure on one session was 100%(99/99).Short-term outcomes included 3 cases of abortion(3.0%).On continuing follow-up observations in 73 cases,the incidences of abortion and premature delivery were 11%(8/73) and 12%((9/73)),respectively.No statistical differences were seen among the three groups in rates of abortion,premature delivery,and full-term delivery(?~2=1.131,P=0.889).In the Aspiration Group,however,the exposure time to B-ultrasound and the operative time were significantly shorter than those in the other two groups.The gestational age at the procedure was 61.7?8.2 days in the Drug Group,48.8?2.7 days in the Aspiration Group,and 56.7?7.2 days in the Combination Group,respectively,with significant differences between the Aspiration Group and other two groups(F=19.36,P=0.000).The number of embryos reduced was associated with pregnancy outcomes: the abortion rate was remarkably higher in patients receiving the reduction of more than two embryos than only one embryo(?~2=6.415,P=0.040).Conclusions Ultrasound-guided multifetal pregnancy reduction is a safe,effective and microinvasive procedure.It is recommended that simple embryonic bud aspiration be used for multifetal pregnancy before 7 gestational weeks,combined use of drug injection and aspiration for multifetal pregnancy at 7~9 gestational weeks,and drug injection to the pregnancy sac for multifetal pregnancy after 9 weeks.

Objective To discuss the role of endometrial blood flow screening measured by color Doppler energy(CDE) in the prediction of outcomes in patients receiving in vitro fertilization and embryos transfer(IVF-ET).Methods A total of 182 women below the age of 38 years old undergoing IVF-ET in this center from November 2005 to December 2005 were recruited in this prospective study.The endometrial thickness,echo pattern,and blood flow status were detected by transvaginal ultrasonography on the day of hCG injection(8 hours before injection).The patients were divided into three groups: Group A,the endometrial blood flow could not be detected;Group B,only sub-endometrial blood flow could be detected;and Group C,both endometrial and sub-endometrial blood flow could be detected.All the patients were re-divided into three groups according to their outcomes of IVF-ET: Group 1,no pregnancy;Group 2,intrauterine pregnancy with live fetus and Group 3,other conditions(including biochemical pregnancy,embryonic diapause,ectopic pregnancy,and spontaneous abortion) were encountered.Results The clinical pregnancy rate with live fetus and the implantation rate were significantly higher in the Group C(62.2% and 65.6%) than in the Group A(0 and 0) and the Group B(17.1% and 20.7%),respectively(P

Objective To investigate the effects of rhG-CSF on the improvement of cognitive impairment and anti-apoptosis of Alzheimer disease (AD) induced by Aβ1-42 in rat. Methods Healthy male Wistarirats were randomly assigned to the Aβ group, treatment group and sham operation group. Aβ1-42 (10μg) was injected into bilateral hippocampus to create the rat model of AD. Rats in rhG-CSF group were subcutaneously subjected to 50μg/(kg · d) rhG-CSF for 5 days, while rats in Aβ group were subjected to normal saline. Morris water maze tests were done and expressions of caspase-3 protein were determined by immunohistochemical method on the 7th, 14th, 21st, and 28th day after administration. Results (1) The avoiding latent periods of rhG-CSF group ( ( 34. 33 ±6. 47 ) s, (42. 08 ± 6. 36 ) s, (46. 88 ± 7. 66 ) s, respectively ) were shorter than that of Ap group ((49.79 ±4.87)s, (50.25 ±6.81 )s, (51. 33 ±6.90)s, respectively). The percentages of swimming distances in the target quadrant in rhG-CSF group ( (41.00 ±7.62)% ,(43.33 ±8. 16)% ,(44. 67 ±8.07)% ,respectively) were increased comparing with Ap group((25.33 ±6.89)% , (23. 83 ±4.67)% ,(21.50 ±4.64)% ,respectively). The differences were all statistically significant (P<0.05). (2) Compared with sham operation group,the positive rate of caspase-3 protein in rat's hippocampus of Ap group significantly increased after injecting Aβ1-42 The positive rates of caspase-3 protein in rhG-CSF group on the 7th, 14th day ( (7. 93 ±6. 33) and (8. 83 ±5. 94) were lower than Aβ group ( ( 10.43 ±7. 16) and ( 11. 34 ± 5. 17 ) . The differences were statistically significant (P< 0.05). Conclusion RhG-CSF can improve the cognitive impairment of Alzheimer Disease (AD) induced by Aβ1-42 in rat, decrease the apoptosis of hippocampal neurons and delay the decline of its learning and memory ability to some extent.

Objective:To explore the clinical effect of negative pressure wound therapy and to discuss the ethi-cal issues in this therapy and seek a solution. Methods:Sixty patients with negative pressure wound therapy in our hospital were invited to participate in this study. Patients were all with deep pressure ulcers or diabetic foot, of which the Wagner Scores were graded as three or four. They were divided into two groups randomly. The subjects in control group received standard treatment, while those in experimental group were treated by self -designed closed negative pressure drainage settings. The wound healing time, the cost of the treatment and comfort were compared between the two groups. Results:The cost of wound care in the experimental group was less than those in the control group (P<0. 001). There was no significant difference in comfort between two groups (P>0. 05). But the wound healing time was longer in the experimental group than those in the control group. Conclusion:Self-designed closed negative pressure settings can decrease the cost of patient care with the equal patient comfort and acceptance as the standard negative pressure, however, the wound healing time has been extended. So before using negative pressure technique, the medical staff should comprehensively analyze, be guided by medical ethics and choose the appropriate treatment for different patients.

Objective To investigate the protective effects of extract of Periplaneta americana (APA) against carbon tetrachloride (CCl4)-induced hepatic fibrosis in rats. Methods Seventy SD rats were divided into five groups:normal con-trol group (C), model control group (M), extract of APA 1 group (APA1), extract of APA 2 group (APA2) and reduced glutathi-one group (R). The liver fibrosis model was induced by injecting 40%CCl4-olive solution subcutaneously for seven weeks in M, APA1, APA 2 and R groups. Drugs were given at the same time. Rats were killed at 7-week (C, M, APA1 and R groups), and were killed at 9-week (APA2 group). The serum values of transaminase (ALT, AST), albumin (ALB), hyaluronic acid (HA) and laminin (LN), and hepatic inflammation and fibrosis were detected respectively. The expressions of apoptotic relat-ed gene Bcl-2 and Bax protein in central veins and portal areas of hepatic lobules were detected by immunohistochemical method. Results Rats showed poor nutritional status, and significantly increased transaminase, HA and LN in M group, but the serum level of ALB was significantly lower than that in C group. There was extensive necrosis of liver cells, obviously fi-brosis or cirrhosis in model rats’liver tissues. The serum contents of ALT, AST, HA and LN were significantly decreased, the serum level of ALB were significantly increased in APA1,APA2 and R groups (P<0.05). There were complete hepatic lobule and no obvious fibrous tissue hyperplasia in liver biopsy of APA1 and R groups. The values of Bcl-2/Bax proteins in central vein of liver tissues were significantly higher in APA1,APA2 and R groups than those of M group (P<0.05), but the ratio of Bcl-2/Bax was lower in periportal area of liver tissues (P<0.05). There were significantly higher body weight and ALB levels in APA1 group than those in R group (P<0.05). The level of transaminase was slightly higher in APA1 group than that of R group. The degeneration of liver cells was found mostly in R group. Conclusion The extract of Periplaneta americana has a role in protecting liver cells, inhibiting the progression of hepatic fibrosis, and improving the nutritional sta-tus of trial rats.

Objective To design a kind of aseptic drainage device with safe practice and accurate measurement for clinical nurses. Methods The experiment group included 63 cases using drainage device with accurate measurement,and control group included 63 cases using disposal drainage bag with scale of visual measurement.The accuracy of drainage liquid measurement was compared between two groups,and bacterial culture was made for the drainage liquid of two groups.Results The measurement error of experiment group and control group was(3.31±1.8)mL and(56.0±5.8)mL,respectively.The difference was significant(t=-4.593,P<0.01).The bacterial culture results showed no obvious difference between two groups(positive rate were 15.9%vs 17.5%,χ2=0.057,P>0.05). Conclusion The accurately measured aseptic drainage device is convenient for nurses to practice in clinics,and its application can reduce workload of nurses and decrease the occurrence of pollution.

To investigate the changes of serum ghrelin levels and their relationship with body mass index (BMI) ,waist-to-hip ratio(WHR) ,thyroid function, blood glucose, insulin, and insulin resistance parameters in different thyroid functional status. The fasting serum ghrelin, insulin, glucose, and thyroid hormone levels were determined, BMI, WHR, and homeostasis model assessment for insulin resistance index (HOMA-IR) were calculated in 50 hyperthyroid and 30 hypothyroid patients at diagnosis and after normalization of thyroid function. 30 euthyroid subjects served as control. The ghrelin levels in hyperthyroid patients before treatment were lower than that in control group [(63.2±9.6) ng/L vs (80.9±13.9) ng/L,P<0.01]. Multiple regression analysis showed that HOMA-IR was an independent factor related to fasting ghrelin levels (r = -0.314, P = 0. 027). The ghrelin levels were similar in hypothyroid patients and the controls before and after the treatment. It suggests that insulin resistance might be an important factor in regulating serum ghrelin levels in different thyroid functional status.

Animals ; Antihypertensive Agents ; pharmacology ; Heme Oxygenase (Decyclizing) ; drug effects ; metabolism ; Losartan ; pharmacology ; Rats ; Water-Electrolyte Balance

Objective:To explore the protective effect of ellagic acid on the acute liver injury induced by carbon tetrachloride (CCl4) of the mice,and to explore its possible mechanism.Methods:A total of 50 mice were randomly divided into normal control group,model group,low,medium and high doses of ellagic acid groups (n=10).The mice in normal control group and model group were treated with 1% sodium carboxymethyl cellulose solvent by intragastic administration,and the mice in ellagic acid groups were treated with 160,320,and 480 mg·kg-1 ellagic acid by intragastic administration,respectively.After 14 d,the mice in model group and different doses of ellagic acid groups were intraperitoneally injected with 10 mL·kg-1 0.1% CCl4,while the mice in normal control group were intraperitoneally injected with 10 mL·kg-1plant oil.16 h later,all the mice were sacrificed and the body weights and the liver indexes of the mice were detected;the serum levels of alanine transaminase(ALT),aspartate transaminase(AST) were detected;the activities of superoxide dismutase(SOD) and levels of GSH-Px,malonalde hyde(MDA) and catalase(CAT) in liver tissue of the mice were detected.Results:There were no significant differences of the body weights of the mice between each group before and after treatment(P>0.05).Compared with normal control group,the liver indexes and the levels of serum ALT and AST of the mice in model group and different doses of ellagic acid groups were significantly increased (P<0.05).Compared with model group,the liver indexes of the mice in different doses of ellagic acid groups were decreased(P<0.05);the serum levels of ALT and AST of the mice in high dose of ellagic acid group were significantly decreased (P<0.05),while the CAT level in liver homogenate was significantly increased (P<0.05);the levels of GSH-Px in liver homogenate of the mice in medium and high doses of ellagic acid groups were significantly increased (P<0.05);the activities of SOD in liver homogenate of the mice in different doses of ellagic acid groups were significantly increased (P<0.05),and the MDA levels were significantly decreased (P<0.05).Conclusion:The ellagic acid has the protective effect on acute chemical liver injury in the mice induced by CCl4 and the most effective dose is 480 mg·kg-1;its mechanism may be related to the anti-oxidation.