Adenoviridae ; genetics ; Animals ; Apoptosis ; drug effects ; Carcinoma, Squamous Cell ; genetics ; metabolism ; therapy ; Cell Cycle ; drug effects ; Clinical Trials as Topic ; Genes, p53 ; Genetic Therapy ; Genetic Vectors ; Humans ; Mouth Neoplasms ; genetics ; metabolism ; therapy ; Mutation ; Tumor Suppressor Protein p53 ; genetics ; metabolism ; Viral Vaccines ; pharmacology ; therapeutic use

Objective To evaluate the efficacy of nasal intermittent positive pressure ventilation (nIPPV) in preventing extubation failure in very low birth weight infants (VLBWI) compared with nasal continuous positive airway pressure (nCPAP).Methods A single-center randomized controlled trial was conducted from Jun 2012 to Jun 2013 in the NICU of Children's Hospital of Hebei Province.Eighty-four cases of VLBWI (birth weight 700 ～ 1 500 g,gestational age 27 ～ 32 weeks) with respiratory failure and subjected to mechanical ventilation were eligible for the study if they needed non-invasive,assisted ventilation at the time of first extubation attempt.They were randomly assigned to receive nIPPV (40 cases) or nCPAP (44 cases) according to random number table method,using the rate of successful extubation as primary outcome.Blood gas data were obtained and PaO2,PaCO2,FiO2,PaO2/FiO2 were monitored at 0 h,24 h,48 h and 72 h after extubation as enrollment for oxygenation and duration,the rate of successful extubation and the incidence of adverse events including frequent apnea,bronchopulmonary dysplasia,intraventricular hemorrhage,periventricular leukomalacia and retinopathy of prematurity and mortality as secondary outcomes.Results There were no significant differences in the baseline characteristics including the proportion of primary disease,sex,weight,gestational age,score for neonatal acute physiology and application of pulmonary surfactant between nIPPV group and nCPAP group (P ＞ 0.05).There were no significant differences in PaO2,PaCO2 and PaO2/FiO2 ratio between the two groups at 0 h of enrollment (P ＞ 0.05).The values of PaO2 and PaO2/FiO2 ratio in nIPPV group were significantly higher[48 h:PaO2:(63.2 ± 3.6) mmHg vs (52.3 ±6.7) mmHg,PaO2/FiO2:(243.2 ±32.8) mmHg vs (187.6 ±34.0) mmHg;72 h:PaO2:(66.4 ±5.8) mmHg vs (51.8±5.9) mmHg,PaO2/EO2:(280.6 ± 16.8) mmHg vs (245.2 ±40.5) mrnHg;1 rnmHg =0.133 kPa],whereas PaCO2 lower[48 h:(40.3 ±4.8) mmHg vs (49.2 ±6.6) mmHg,72 h:(42.2 ±5.6) mmHg vs (57.3 ± 6.9) mmHg],than nCPAP group at 48 h and 72 h after extubation (P ＜ 0.05).The oxygenation status in nIPPV group were significantly improved at 48 h and 72 h after extubation compared with the intra-group data at 0 h (P ＜ 0.05).The total ventilation time was shorter in nIPPV group than nCPAP group[(130.9 ±46.7) h vs (180.5 ±50.1) h,P ＜0.05],but the oxygen exposure time had no significant difference[(190.6 ± 45.2) h vs (216.8 ± 54.4) h,P ＞ 0.05].The rate of successful extubation in nIPPV group was significantly higher as compared with nCPAP group[92.5％ (37/40) vs 75.0％ (33/44),P ＜ 0.05].The incidence of frequent apnea and bronchopulmonary dysplasia in nIPPV was lower than nCPAP group[15.0％ (6/40) vs 34.1％ (15/44) ;2.5％ (1/40) vs 15.9％ (7/44),P ＜ 0.05].There were no significant differences in the incidence of severe intraventricular hemorrhage,perivenwicular leukomalacia,retinopathy of prematurity,late of infections,necrotizing enterocolitis,patent ductus arteriosus,patent ductus arteriosus operation and mortality before discharge between the two groups (P ＞ 0.05).Conclusion nIPPV after extubation in VLBWI has beneficial effects as compared with nCPAP in improving oxygenation,shortening noninvasive ventilation time,improving the rate of successful extubation,and can reduce the incidence of frequent apnea and bronchial pulmonary dysplasia in VLBWI.

Objective To sum up the experiences in the prevention and treatment of systemic infection after burn injury. Methods 309 burn patients with systemic infection treated in our department from January 1990 to December 2003 were enrolled in this study. The patients were divided into two groups according to their hospitalized time: group 1(from 1990 to 1996) and group 2(from 1997 to 2003). The incidence and mortality of systemic infection were compared between the two groups, and the efficacy of different treatment strategies was analyzed. Results The morbidity of postburn systemic infection in the patients was 6.98%(309/4430). The incidence and mortality of systemic infection were 5.68% and 0.30% in the group 2, respectively, which were significantly lower than those in the group 1. Conclusion Rapid and adequate fluid resuscitation for burnshock, effective control of wound infection, early excision of crust and skin grafting for deep burnwounds, and reinforcement of organ support were key factors to decrease the incidence of systemic infection and increase the curative frequency. Once burn wound sepsis occurred, prompt removal of infectious necrotic tissues was a key means to ensure a good clinical outcome.

Objective To observe the effect of Zhuyun Capsule(Pregnant-promoting Capsule)on serum sex hormone and expres- sion of ovarian cytokine of polycystic ovary syndrome(PCOS)rats.Methods Progestogen plus human chorionic gonadotrophin (HCG)was adopted to make PCOS rat models.Totally 40 SD rats were randomized into control group,PCOS model group,Zhuyun Capsule group,and clomiphene citrate group with 10 in each.Radioimmune assay(RIA)was used to measure the sex hormone and immunohistochemical test was done to measure the expression of tumor necrosis factor-?(TNF-?)of ovarian tissue,insulin-like growth factors-1(IGF-1),and leukemia inhibitory factor(LIF)to analyze the relations among these factors.Results Zhuyun Capsule could reduce greatly serum testosterone(T)and luteinizing hormone(LH),decrease expression of TNF-?and IGF-1,but increase expres- sion of LIF.Conclusion Zhuyun Capsule could regulate endocrine function and expression of ovarian cytokine to improve gonad func- tions of PCOS rats and to promote the maturation of follicle and ovulation.

Objective To evaluate the effects of ischemic postconditioning on brain injury induced by myocardial ischemia-reperfusion (I/R) in diabetic rats.Methods Diabetes mellitus was induced by intraperitoneal streptozotocin 60 mg/kg and confirmed by blood glucose level ＞ 16.7 mmol/L.Thirty male Sprague-Dawley rats,weighing 220-280 g,in which diabetes mellitus was successfully induced,were randomly allocated into 3 groups (n =10 each) using a random number table:group sham operation (group S),group I/R and group ischemic postconditioning (group P).Myocardial I/R was induced by occlusion of the anterior descending branch of the left coronary artery in I/R and P groups.Group P received 3 cycles of 10 s reperfusion followed by 10 s ischemia at the end of myocardial ischemia.The rats were sacrificed at 120 min of reperfusion and the brains were removed for microscopic examination and for determination of cell apoptosis (by TUNEL) and expression of interleukin-6 (IL-6),IL-8,IL-10,glycogen synthase kinase-3 beta (GSK-3β) and phosphorylated GSK-3β (pGSK-3β) (by immuno-histochemistry).Apoptotic index was calculated.Results Compared with group S,apoptotic index was significantly increased,IL-6 and IL-8 expression was up-regulated,and IL-10 and pGSK-3β expression was downregulated in I/R and P groups (P ＜ 0.01).Compared with group I/R,apoptotic index was significantly decreased,IL-6 and IL-8 expression was down-regulated,and IL-10 and pGSK-3β expression was up-regulated in group P (P＜0.01).There was no significant difference in GSK-3β expression among the 3 groups (P ＞ 0.05).The pathologic changes were significantly attenuated in group P as compared with group I/R.Conclusion Ischemic postconditioning can attenuate brain injury induced by myocardial I/R in diabetic rats,and inhition of activity of GSK-3β may be involved in the mechanism.

Contents in orthopaedic are independent relatively and finding out the internal relations during them is helpful to improving the effect of orthopaedic teaching.Transfer theory is important tools for clinical teaching practice,and finding out the common characteristics between the orthopaedic chapters is primary for the theory.This research focuses on the following fields:fractures,nerve injury,infection,tumor and deformity.After the common characteristics between these chapters were analyzed and discussed,we concluded that the transfer theory is helpful in orthopaedic teaching practice,especially for students' comprehension and memory,but still we should avoid some negative effects in teaching process.

Objective To investigate the risk factors for carotid sinus reactions (CSR) during internal carotid artery stenting (CAS).Methods The clinical data of 36 patients treated with CAS were enrolled retrospectively.The patients were divided into either a CSR group or a non-CSR group according to whether they had CSR or not.The risk factors for CSR during procedure were analyzed using univariate and multivariate logistic regression analysis.Results Of the 36 patients,25 had CRS (7 simple hypotension,4 simple bradycardia,and 14 both co-existence).The constituent ratios of the patients of the age ≥ 75 years (64.00％ vs.27.27％ ;x2 =2.384,P =0.028),degree of CAS 70％ to 99％ (76.00％ vs.36.36％ ; x2 =4.430,P =0.035),symptomatic stenosis (72.00％ vs.36.36％ ; x2 =4.082,P =0.043),calcified plaque (76.00％ vs.36.36％ ;x2 =4.430,P =0.035),distance from stenosis to bifurcation ≤ 10 mm (72.00％ vs.27.27％ ;x2 =5.029,P =0.025) and balloon expansion (64.00％ vs.18.18％ ;x2 =44.483,P =0.000) in the CSR group were significantly higher than those in the non-CSR group.Multivariate logistic regression analysis showed that age ≥ 75 years (odds ratio [OR] 1.520,95％ confidence interval [CI] 1.376-4.369; P =0.034),distance from stenosis to bifurcation ≤ 10 wm (OR 2.432,95％ CI 2.423-3.421; P =0.041) and balloon expansion (OR 3.631,95％ CI 1.764-4.738; P=0.003) were the independent risk factors for occurring CSR during CAS.Conclusions CSR is a common perforrance during CAS.Advanced age,distance from stenosis to bifurcation ≤ 10 mm and balloon expansion are the independent risk factors for occurring CSR.

Objective To investigate the role of TL1A in the generation and differentiation of peripheral blood Th17 in rheumatoid arthritis.Methods The peripheral blood mononuclear cells (PBMCs) of RA were isolated and stimulated with PHA in the presence or absence of TL1A.Naive CD4+ T cells from RA was cultured under Th17-polarizing conditions with or without TL1A.The percentage of Th17 was detected by flow cytometry (FCM) analysis.The DR3 expression on CD4+ T cells from PBMCs of RA patients and healthy controls (HC) were analyzed by using FCM.Data were analyzed with t test and U test.Results TL1A could significantly up-regulate the percentage of Th17 in PBMCs of RA [(7.5±2.3)％ vs (5.2±1.5)％,t=2.647,P＜0.05].Compared to the HC groups,TL1A could significantly induce Th17 differentiation from naive T cells [(37.7±1.9)％ vs (29.5±2.0)％,t=6.455,P＜0.05].The percentage of CD4+DR3+ T cell in PBMCs of RA [(0.56±0.87)％] was significantly higher than that of HC [(0.13±0.04)％,P＜0.05].The percentage of CD4+DR3+ T cell in PBMCs when stimulated with PHA was increased in RA patients,[(4.51±1.34)％ vs (1.11±0.29)％,t=2.915,P＜0.05],but no obvious increase in HC [(0.199±0.104)％ vs 0.072％±0.029)％,t=1.644,P=0.1988].Conclusion TL1A can promote the generation and differentiation of Th17 in the PBMCs of RA,and this effect may be mediated by the binding of TL1A with DR3.

Objective To investigate the expression characteristics of Glypican3 ,MMP-9 and MMP-14 in primary hepatocellular carcinoma ,and to focus on their roles on the development ,progress and metastasis of tumor .Methods 102 cases of primary hepato-cellular carcinoma were taken as the observation group and 80 cases of normal liver tissues as the control group .The expressions of Glypican3 ,MMP-9 and MMP-14 were detected by the immunohistochemistry method and their expression difference in different clinicopathological characteristics and the correlation were investigated .Results The positive rates of Glypican3 ,MMP-9 and MMP-14 expressions in the observation group were significantly higher than those in the control group .The positive rates of Glypi-can3 ,MMP-9 and MMP-14 expressions were closely correlated with the tumor volume ,differentiation degree ,lymph node metasta-sis ,vessel infiltration ,membrane invasion and PCNA expression .The correlation analysis showed that the positive relationships were found between Glypican3 and MMP-9 ,between Glypican3 and MMP-14 and between MMP-9 and MMP-14 in the observation group(r=0 .48 ,P=0 .024 1 ;r=0 .46 ,P=0 .013 2;r=0 .43 .P=0 .031 3) .The survival analysis showed that expressions of Glypi-can3 ,MMP-9 and MMP-14 were correlated with the patient′s prognosis .Conclusion The higher-expressions of Glypican3 ,MMP-9 and MMP-14 may promote the occurrence and development of primary hepatocellular carcinoma .Detecting the postoperative expres-sions of Glypican3 ,MMP-9 and MMP-14 has certqain value to judge the prognosis in primary hepatocellular carcinoma .

There are many subjects related to anesthesiology and the band between anesthesiology and clinical practicevery is close. So students can not be proficient in anesthesiology by traditional teaching methods. The use of three-dimensional case teaching method in anaesthesiology teaching is a good attemptment. three-dimensional case teaching method integrate case method, multimedia technology and clinical case. It can help medical students analyze and solve clinical problems, improvetheir academic performance and enhance their clinical basic skills.