Objective To identify differentially expressed proteins in keloid tissue and to explore the proteomic characteristics of keloid by utilizing capillary high-performance liquid chromatography (LC) and tandem mass spectrometry (MS).Methods Tissue specimens were obtained from the lesions of 5 patients with non-familial keloid and normal skin of 5 human controls.After extraction and in-solution digestion of proteins,the resultant peptides were separated and identified by LC-MS/MS.Label-free detection and quantitation of peptides were carried out by using the DeCyder MSTM software.Results A total of 570differentially expressed peptides were identified between non-familial keloid and normal tissue (all P ＜ 0.05),which correspond to 1221 proteins.A difference greater than 1.5 folds was observed in the expressions of 293 proteins,including 124 up-regulated and 169 down-regulated proteins in non-familial keloid tissue.Conclusion Differences exist in the expression of proteins between non-familial keloid and normal skin tissue.

Objective Using Doppler ultrasound measured in femoral artery flow velocity variation rate method to predict fluid responsiveness.Methods 80 patients were measured femoral artery flow velocity variation rate (△Vpeak)by mastering the ultrasound skills of the attending physician.Passive leg raising test (PLR)stroke vol-ume variation (△SV)was used to analyze the peak value of the femoral artery flow velocity,rate of femoral artery peak velocity of respiratory changes,and the results were compared with results of PICCO monitoring to predict patients with their response to the treatment capacity,to evaluate clinical feasibility.Results Reactive groups in the PLR test before the experiment and hemodynamic changes:PLR test reaction group in before the test and test process, HR,MAP,CAP index changes were not obvious (P >0.05),but ultrasonic detection and PICCO detection showed SV and CO varied significantly (t =15.24,P =0.00;t =13.64,P =0.00),the two kinds of methods to forecast results was consistent.In the absence of the anti should patients in PLR test before the experiment and hemodynamic chan-ges:PLR test unreacted group in before the test and test process,HR,MAP,CAP,SV and CO index change were not obvious (all P >0.05).Conclusion By ultrasonic method for measuring femoral artery flow speed variation rate can exactly evaluate the capacity status of critically ill patients,and effectively predict fluid responsiveness,the prediction results and PICOO monitoring results are highly consistent.It is a safe and efficient prediction method,which is worthy of promotion in clinical intensive observation.

Nineteen patients with low rectal cancer underwent laparoscopy-assisted anterior resection with prolapsing technique for sphincter preservation.The clinical data were retrospectively reviewed.Fecal continence was preserved successfully in all patients.There was no perioperative mortality,only two cases with anastomotic leak and one case with local recurrences.Laparoscopy-assisted anterior resection with a prolapsing technique for low rectal cancer is safe procedure and can be an alternative sphincter-preserving operation.

ObjectiveTo investigate the amount of bacteria and the expression of amylase and lipases in the drainage fluid in patients with intestinal fistulas with time courses.MethodsThe samples were collected from 16 patients with high intestinal fistulas from July 1998 to January 2008.The amounts of bacteria from the drainage fluid were measured 0,2 and 4 hours after taking out from the patients.At the respective time points,the intestinal juices were also collected to measure the amylase and lipase expressions.After reinfusion of succus entericus,thelevels of albumin,prealbumin,transferring,and fibronectin were measured at 0,7,and 14 days,ResultsThere was no significant increase of bacteria in the drainage fluid within 4 hours ( F(0,2) =18 812.50,P ＞ 0.05 ; F(0,4) =387 625.00,P ＞ 0.05).and there was no change in the expressions of amylase ( F(0,2) =190.60,P ＞ 0.05 ;F(0,4) =631.75,P＞0.05) and lipase within 4 hours (F(0,2) =204.10,P＞0.05; F(0,4) =1080.05,P＞0.05).After succus entericus reinfusion,the fibronectin (F(0,14) =74.24,P ＜ 0.01 ; F(7,14) =59.78,P ＜0.01),transferring (F(0,14) =0.46,P ＜ 0.01 ; F(7,14) =0.39,P ＜ 0.05 ),and prealbumin ( F(0,14) =54.37,P ＜ 0.05) were increased significantly.ConclusionsBacteria and enzymes do not increase in the drainage fluid within 4 hours in patients with intestinal fistulas.Therefore,it is safe and effective to reinfuse succus entericus.

Objective To investigate the epidemiological characteristics of occupational exposure to human immunodeficiency vi-rus (HIV) in Chongqing to provide the scientific basis for avoiding and reducing the HIV occupational exposures in the future . Methods All archival data of the exposed individuals came to our hospital for seeking post-exposure consultation and treatment during 2009-2012 were performed the classification and arrangement for conducting the descriptive analysis on the distribution characteristics of the age ,gender ,occupation ,working region ,exposure mode and severity of exposure .Results During this period , there were 135 cases of occupational exposure ,which ocurred in the medical institutions outside the main urban area (74 .18% ) , dominated by the nurses (57 .04% ) and doctors(33 .33% ) .21-30 years old (51 .85% ) and 31 -40 years old(33 .33% ) were the age groups with more occurrence of occupational exposure .The exposure routes were dominated by the sharp instrument injury (92 .59% ) and the exposure degree was mainly the secondary exposure ( 69 .63% ) .Conclusion The prevalence situation of HIV occupational exposure in Chongqing is stable in the total trend .The medical and health institutions outside main urban area should perfect the management system ,strengthen training ,put the standard prophylaxis principles to practice for reducing the occurrence of occupational exposure .

Objective To investigate the clinical, electrophysiological and pathological features of critical illness polyneuropathy and myopathy (CIPNM). Methods The clinical outcomes, electromyogram Results as well as pathological features in nerves and muscles of 3 patients with CIPNM were investigated and analyzed. Results 3 patients were all provided with assisted respiration after tracheal intubation. 7～10 d after intubation, all the patients emerged muscle strength and tendon reflexes of extremities weakening; while 14 days after that, 2 patients appeared amyotrophy of extremities. Electromyogram showed that the conduction of many motor and sensory nerves for extremities decreased, while the amplitude of compound muscle action potential (CMAP) of part of motor nerves decreased. Biopsy for nerves revealed decreased medullated nerve fibers and regeneration phenomenon of auxiliary fibers; while that for muscles showed neuralgic damage and myopathy-like changes. Conclusion CIPNM can complicate after tracheal intubation. The electrophysiological and pathological examinations for nerves and muscles can be helpful for the diagnosis.

Objective To summarize the clinical characteristics of adrenal tumors combined with renal carcinoma and to extend the clinical understanding of the situation.Methods To analyze the data of 1 100 patients with adrenal tumors hospitalized in Peking University First Hospital from Jan.1994 to Mar.2012 retrospectively,in the series there were 42 combined with renal carcinoma.Results There were 27 males,15 females,aged 29 to 83 years,mean 60.5 years old.In 42 renal carcinomas,there were 29 (69.0％) clear cell carcinomas,5 (11.9 ％) cystic renal carcinomas,2 (4.8％)clear cell with granulosa cell hybrid carcinomas,1 renal lymphoma,1 (2.4％) spindle cell tumor,1 acidophilic cell adenoma,and 1 undifferentiated type of renal cell carcinoma and pathologically not clear in 2 cases (4.8％).Clinical manifestations were not specific.In 42 adrenal tumors,20 situated in the left,and 17 right,and 5 were bilateral.35 cases were considered primary adrenal tumors,in which 3 were diagnosed primary hyperaldosteronism,32 were non-functional tumors.Other 7 were non-functional matastatic carcinomas.25 patients underwent resection of adrenal tumors,and pathology revealed 22 (88.0％) were primary,in which 12 (54.6％) were cortical adenomas,7 (31.9％) hyperplasia,1 (4.5 ％) pheochromocytoma,1 (4.5 ％) ganglioneuroma,1 (4.5 ％)adenoma with hyperplasia;2 (8.0％)metastatic tumors,and 1 (4.0％) non-Hodgkin' s lymphoma.The mean diameter of primary adrenal tumors was 1.9 cm,while that of metastatic carcinoma was 3.84 cm.25 underwent abdominal ultrasonography,40 underwent computed tomography (CT) scan,6 underwent magnetic resonance imaging (MRI) scan,positive rate was 72.0％,97.5％,and 100.0％ respectively.25 patients who underwent surgery were followed up,17 survived for 8 months-6 years,4 died,in which 1 metastatic carcinoma died of intraoperative bleeding,1 died of adrenal lymphoma,2 died because of other disease,4 were lost to follow-up.Conclusions The most common type of renal carcinoma combined with adrenal tumors was clear cell carcinoma,while majority of the adrenal tumors were primary with non-specific clinical manifestations and function.The adrenal tumors might be located in the same or the opposite side of renal carcinoma,also might be bilateral which were more common in metastatic carcinomas and always bigger than primary ones.CT/MRI scans were important in judging the nature of the tumors and pathology was the gold standard.The non-functioning primary adrenal tumors could be safely followed up,and the isolated metastatic carcinoma should be resected.Prognosis depends mainly on that of renal carcinoma.

Objective:To investigate the effect of intermittent hormonal therapy(IHT) for patients with different stage/grade prostate cancer(PCa).Methods:The number of cycles and the duration of ON/OFF therapy for 45 PCa patients receiving IHT were observed.Maximal androgen blockade(MAB) the-rapies were used for six to nine months,and then stopped until the serum prostate specific antigen(PSA) was decreased below 0.2 ?g/L,which lasted for three months.It was decided whether MAB went on according to the level of PSA.Results:The average follow-up time was 40.7?13.4 months.Forty-one patients started the second cycle of treatment,of whom,8 became androgen-independent and 7 were at T3-4M0 or M1 stages and the Gleason scores were above 8.Sixteen patients entered the third cycle,of whom,14 were at lower than stage Ⅲ and 13 had the Gleason scores below 7.From the first to the fourth courses of treatment,the average intervals were 8.7?5.4(47.1%),8.4?4.9(49.3%),7.0?3.4(43.7%),and 3.7?0.6(42.5%)months respectively.Five patients developed bone metastasis.No one died up to now.According to the evaluation criteria,patients were divided into tolerance(n=16) and intolerance groups(n=29).Compared with the intolerance group,the patients who tolerated the treatment well had lower Gleason scores(P=0.002),lower PSA levels(P=0.053) and lower tumor stages(P=0.001).There was no evidence that age,lymph node metastasis,bone metastasis and the state of recurrence were associated with an increased risk of the outcome.Non-conditional Logistic regression analysis showed that the proportion of patients at stage Ⅳ was the only independent risk factor for the tolerance of the treatment(OR=12.113,95%CI 1.330-110.312,P=0.027).Conclusion:Intermittent hormonal therapy is more effective and proper for the patient with highly differentiated tumor and at lower stages(≤Ⅲ).The patients who progressed to hormone-independence are mostly at stage Ⅳ with poorly differentiated tumor.Intermittent hormone therapy could be more adaptive for the patients at lower than stage Ⅲ.

BACKGROUND: The strength and elasticity of general starch can be enhanced dramatically after plastic blends. The major characters of this material are magnitude molecular weight, many enwinded points, extreme containment of small molecules,and great gelation ability. It can be used as a biodegradable replacement of alginate. Furthermore, by adding osteoinductive factors, thermoplastics starch (TP) can be used as an organic engineering material, which can provide dual functions:anti-bleeding and bone formation. TP can also be used as intraoral tissue formation membrane and burn dressings.OBJECTIVE: To evaluate the bio-safety of TP through a cytotoxicity test.DESIGN: A controlled observation.SETTING: Beijing Research Institute of Traumatology and Orthopaedics; Beijing Jishuitan Hospital; Beijing University of Chemical Technology; Peking Univesity School of Stomatology.MATERIALS: The experiment was conducted at the laboratory of Beijing Research Institute of Traumatology and Orthopaedics from April to October in 2006. TP sample was obtained by plasticization of corn starch (12 wt % water content) with glycerol in a Haake Rhenmix at 110℃ and with 80 rounds per minute for 25 minutes, elongation at break from 115.3% to 245.3%. It was prepared by Beijing Key Laboratory for Preparation and Processing of Novel Polymeric Materials, Beijing University of Chemical Technology. Mouse fibroblast L-929 cell strain was provided by the cell bank of Peking University Health Science Center.METHODS: 1 × 107 L-1 cell aqueous suspension was cultured into leaching liquor ( 50% ), serving for TP group, and routine culture medium served for negative control group. Effect of TP on relative growth rate of L-929 cell strain was quantitatively measured by MTI" assay. The cytotoxicity of TP was evaluated according to GB/T16175-1996. Morphological changes and proliferation of cells were observed after2, 4, and 7 days of culture in the medium through an inverted phase contrast microscope.MAIN OUTCOME MEASURES: Cytotoxicity, morphological changes and proliferation of cells, and cell relative growth rate.RESULTS: Cytotoxicity: After 2 and 4 days of incubation, the absorbance (A) value was lower in the TP group than in the negative control group. After 7 days of incubation, the A value was significantly higher compared to negative control group (P＜0.01). It indicated that after 2 and 4 days of incubation, the cytotoxicity in the TP group was larger than in the negative control group, while after 7 days of incubation, it was on the opposite. All the test time, TP's cytotoxicity grade ranged from 0 to 1. Morphological change and proliferation of cells: After 2 days of incubation, both groups of cells were not extended to the outside of the scope, with a majority shape of being round, triangle, and quadrangle in the TP group or fusiform cells in the negative control respectively. Four days later, there were gaps among cells in the TP group, while in the negative control group, there were hardly any distance between cells and some cells piled up. Seven days later, cells in starch medium suddenly grew up to such a degree that all the cells lapped over and presented with more bloom than the negative control. Cell relative growth rate: After 2, 4, and 7 days of incubation, relative growth rate increased with time, being 85.63%,82.22%, and 113.05%, respectively.CONCLUSION: TP has no evidence of cytotoxicity and has good bio-safety.

BACKGROUND: To repair bone defect, histocompatibility, growing characteristics, biodegradation and repairing mechanism of nanometer need to be further studied in clinic. OBJECTIVE: To observe the growing characteristics and histocompatibility of nano-hydroxyapatite (Nano-HA) for repairing jaw defect of rabbits.DESIGN: Randomized grouping animal study.SETTING: Beijing Jishuitan Hospital and Stomatology College of Jiamusi University.MATERIALS: A total of 24 New Zealand rabbits, either gender, weighing 2.5-3.5 kg, were provided by Animal Experimental Center of Jiamusi University. The animal experiment had got confirmed consent from local ethic committee. Nano-HA was provided by Material Engineering College of Jiamusi University and dealt with routine hyperthermia/hypertension sterilization. In addition, hydroxyapatite was provided by Wuhan Industry University, and the diameter was 1.0-2.0 μm.METHODS: The experiment was carried out in the Experimental Animal Center of Jiamusi University from November 2001 to May 2006. All rabbits were randomly divided into experimental group and control group with 12 in each group. Bone defect in the diameter of 1.0 cm was produced on body of mandible. Nano-HA was used to repair the bone defect of rabbits in the experimental group, while hydroxyapatite was used to repair the bone defect of rabbits in the control group. At 1, 4, 8 and 12 weeks after operation, all rabbits were sacrificed. In addition, medical imaging analysis system was used to analyze generative quantity of tissue in the two groups; meanwhile, histological quality and quantity were also analyzed so as to observe histocompatibility and newborn osteogenesis. MAIN OUTCOME MEASURES: Histocompatibility and newborn osteogenesis.RESULTS: With the time passing by, the amount of repairing materials was decreased because of the combination with newborn tissue into bone in bone defect-repaired region in the experimental group. When it was closed to normal bone, the amount was stable. However, bony callus was not able to grow in materials in the control group. Results of correlation analysis demonstrated that materials were negatively straight-line correlation with newborn bone (r = -0.912 0, P < 0.01). During the repairing procedure of bone defect, newborn bone was closely correlative with Nano-HA; while, with the increase of newborn bone, the amount of repairing materials was decreased because of the combination with newborn tissue into bone.CONCLUSION: Nano-HA can combine with newborn bone tissue so as to rapidly generate bone, while it has an excellent biocompatibility.