Objective To explore the early diagnostic marker and mechanism of the injury of in- testinal mucosal barrier induced by intestinal ischemia-reperfusion in rats.Methods Sixty male Wistar rats were randomly divided into six groups:the sham operation group(SO),the ischemia 15 minutes group(A),the ischemia 45 minutes group(B),the ischemia 45 minutes plus reperfusion 2 hours group (C),the ischemia 45 minutes plus reperfusion 6 hours group(D),and the ischemia 45 minutes plus reperfusion 12 hours group(E).Using clamping and then releasing superior mesenteric artery the model of intestinal ischemia-reperfusion in rats was made.The sham operation group only underwent laparotomy. At different time points after ischemia and reperfusion the levels of serum CK,LDH,D-lactate and intes- tinal fatty acid binding protein(IFABP)in each group were examined.The morphological changes of in- testinal tissues were observed with light microscopy.Results Compared with group SO,the level of se- rum IFABP in group A was(374.74?48.85)pg/ml,significantly higher(P＜0.01),but the level of CK,LDH and D-lactate had no significant difference(all P＞0.05).In group B,the level of CK was (1090.40?187.51)u/L,peaking at 45 minutes after ischemia,meanwhile,D-lactate and IFABP levels were significantly increased(P＜0.01,respectively).In group C,D-lactate and IFABP were (2.51?0.19)?g/ml and (1601.42?286.81 )pg/ml,respectively,peaking at 2 hours after reperfusion (P＜0.01).At 6 hours after reperfusion,compared with ischemia 45 minutes,CK level was significantly de- creased(P＜0.01),LDH had no significant difference(P＞0.05),but the levels of D-lactate and IF- ABP were(2.03?0.24)?g/ml and(1443.76?174.52)pg/ml,respectively,all sustained a high lev- el(P＜0.01 ).At 12 hours after reperfusion,D-lactate and IFABP levels were gradually decreased(P＜0.01).At 45 minutes after ischemia the morphological changes of intestinal mucosa could be observed. At 6 hours after reperfusion part of the mucous layer appeared necrotic,some intestinal mucosal cells shed to enteric cavity,and submucous layer had hyperemia and edema obviously.Injury scores of intestinal mucosa were significantly correlated to the serum level of D-lactate and IFABP,correlation coefficients were 0.456,0.612(P＜0.01).Conclusion The monitoring of serum IFABP combined with D-lac- tate is a early,sensitive and specific biochemical marker in the diagnosis of intestinal mucosal barrier in- jury after ischemia-reperfusion.

Objective:To establish a rapid method to detect drug-resistance genotypes of extended spectrum-β-Lactamases (ESBLs) produced by gram negative bacillus using the real -time fluorescence quantitative PCR. Methods: According to clinical common genotypes of ESBLs, SHV, TEM.CTX-M.OXA and their homology, 9 pairs of specific primers were designed including SHV, TEM, CTX-M-1, CTX-M-2, CTX-M-8, CTX-M-9, OXA-1, OXA-2 and OXA-10. To extract DNA template by boiling assay, and then establish and grade up SYBR GREEN I real-time fluorescence quantitative PCR reaction system, finally definite real-time fluorescence quantitative PCR method. Its precision and range of linearity were tested. With established assay 51 multi- drug resistant ESBLs- E. coli K. pneumoniae were detected and compared with improved three dimensional extract tests. Results: Except OXA-2, 8 genotypes SHV, TEM, CTX-M-1, CTX-M-2, CTX-M-8, CTX-M-9, OXA-1 and OXA-10 were amplified by quantitative PCR from 39 ESBLs+ and 51 multi-drug resistant ESBLs-E. coli K. pneumoniae and confirmed by sequence testing. The range of linearity was 3×10~3-3×10~8 copies/mL, r =-0.994 7. Repetitive experiments showed that the average coefficient of variation between -runs was 9.6%. Comparing with three dimensional extract test, there was no significant difference (χ2 = 1.125,P> 0.05). Conclusion: Testing drug-resistance genotypes of ESBLs with SYBR GREEN I real-time fluorescence quantitative PCR is a rapid,specific and sensitive method, which is capable of inspecting genotypes of ESBLs from clinical strains.

Objective:To study the biocompatibility of porous Ti processed by laser solid forming(LSF)with osteoblasts.Methods:SD rat osteoblasts were seeded on porous Ti surface processed by LSF.Adhesion,proliferation and ALP activity of the osteoblasts were measured at different time,and all samples were observed under SEM.Dense sand-blasted Ti sheets were used as the controls.All data were statistically analyzed.Results:Adhered cells on porous Ti were more than those on nonporous Ti sheets after 2 and 3 hours of culture(P <0.05).At 4 and 7 days,cell proliferation and ALP activity were significantly higher on porous Ti than those on the controls(P <0.05).Conclusion:Porous Ti processed by LSF possesses good biocompatibility with osteoblasts.

OBJECTIVE:To evaluate the current status and future trend of antibacterials utilization in our hospital.MET-HODS:A retrospective analysis was conducted on the use of antibacterials in our hospital in 2003～2005,covering sales value and application density(AD).RESULTS:Antibacterials as used in our hospital had been high in AD for the three years.In ran-ked order,the top three subcategories were quinolones,macrolides and lincosamides,represented respectively by levofloxacin,azithromycin and clindamycin.CONCLUSIONS:Antibacterials as used in our hospital are high in AD.Administration of antibacterials use during the perioperative period should be specially strengthened to avoid irrational combination medication.

Objective To investigate the therapeutic effect of total mesorectal excision(TME) for low rectal cancer.Methods One hundred nineteen patients with rectal cancer,located on an average within 8 cm of the anal verge,were included in the study.Fifty-four patients underwent traditional operation,and sixty-five patients underwent total mesorectal excision.Operation time,loss of blood at operation and local recurrence rates were compared between the two groups.Results The average operation time and blood loss were 118 minutes,and 100mL respectively in TME group,and they were 182 minutes,and 340 ml respectively in traditional operation group.There were significant differences between them(all P0.05).Conclusions In TME group,operation time was shorter,operative blood loss was less,and local recurrence rate was lower.TME should be applicated for patients with low rectal cancer.

BACKGROUND: The gut is capable of inducing multiple organ dysfunction syndrome (MODS). In the diagnosis and treatment of critical ill patients, doctors should pay particular attention to the protection or recovery of intestinal barrier function. However, no reliable diagnostic criteria are available clinically. This study aimed to assess the changes of intestinal mucosal barrier function in surgically critical ill patients as well as their significance. METHODS: Thirty-eight surgically critical ill patients were enrolled as a study group (APACHE II>8 scores), and 15 non-critical ill patients without intestinal dysfunction were selected as a control group (APACHE II<6). General information, symptoms, physical signs, and APACHE II scores of the patients were recorded. The patients in the study group were subdivided into an intestinal dysfunction group (n=26) and a non-intestinal dysfunction group (n=12). Three ml venous blood was collected from the control group on admission and the same volume of plasma was collected from the study group both on admission and in the period of recovery. The plasma concentrations of endotoxin, diamine oxidase (DAO), D-lactate, and intestinal fatty-acid binding protein (iFABP) were detected respectively. The data collected were analyzed by the SPSS 17.0 software for Windows. RESULTS: The levels of variables were significantly higher in the study group than in the control group (P<0.01). They were higher in the intestinal dysfunction group than in the non-intestinal dysfunction group (DAO P<0.05, endotoxin, D-lactate, iFABP P<0.01). In the non-intestinal dysfunction group compared with the control group, the level of endotoxin was not significant (P>0.05), but the levels of DAO, D-lactate and iFABP were statistically significant (P<0.05). The levels of variables in acute stage were higher than those in recovery stage (P<0.01).The death group showed higher levels of variables than the survival group (endotoxin and D-lactate P<0.01, DAO and iFABP P<0.05). CONCLUSION: The plasma concentrations of endotoxin, DAO, D-lactate, and intestinal fatty-acid binding protein (iFABP) could reflect a better function of the intestinal mucosa barrier in surgically critical ill patients.

OBJECTIVETo study the effects of kneepad on expression of Bcl-2 and p53 mRNA of chondrocyte in white rabbits with knee osteoarthritis, so as to explore and treatment mechanism of OA kneepad on apoptosis of chondrocytes of rabbits with knee osteoarthritis in molecular degree.

METHODSForty-four Japanese healthy 6-month-old rabbits (equal male and female,the weight ranging from 2 to 2.2 kg) were used to establish knee osteoarthritis models by modified Hulth method. The rabbits were randomly divided into 6 groups: normal group, model group, control group (microwave), experimental group 1 (electricity), experimental group 2 (thermal), experimental group 3 (kneepad). Ten rabbits in the normal group were breed with conventional method; 9 rabbits in the model group were breed with conventional method after model made; 9 rabbits in the control group were treated with microwave for 30 minutes, one time daily; 9 rabbits in the experimental group 1 were treated with electricity (density wave) for 30 minutes,one time daily;8 rabbits in the experimental group 2 were treated with hot (hot soft membrane) for 30 minutes, one time daily; 9 rabbits in the experiment group 3 were treated with electrothermal (OA knee pad) for 30 minutes, one time daily. All the rabbits were treated for 16 weeks and then sacrificed. The expressions of Bcl-2 and p53 mRNA of chondrocytes in knee joint were detected by using fluorescence quantitative RT-PCR method.

RESULTSAt the 16 hthek,th e OD260/OD280 value range of total RNA extracted from rabbit articular cartilage tissue in each group were all at 1.80 to 2.00,wh ich indicates high RNA purity. The p53 relative mRNA in articular cartilage cells of model group,th e control group,th e experimental group 1 ,r oup 2,gr oup 3 were overexpressed,an d Belc2 mRNA expression levels of articular cartilage cells were low expression,an d compared with the normal group there were significant differences (P < 0.01). Belc2, p53 mRNA expression in articular cartilage cells,th ere were significant differences (P < 0.01) between the control group, experimental group 1, group 2, group 3 and model group. The results between the control group, experimental group 1 ,group 2 and group 3 had significant differences (P < 0.01).

CONCLUSIONOA-kneepad can up-regulate the mRNA expression of Bcl-2 as well as down-regulate the mRNA expression of p53, thereby to inhibit the apoptosis of cartilage cells and delay the degeneration of articular cartilage changes.

Animals ; Apoptosis ; physiology ; Disease Models, Animal ; Female ; Knee Joint ; metabolism ; pathology ; Male ; Osteoarthritis, Knee ; genetics ; pathology ; therapy ; Protective Devices ; Proto-Oncogene Proteins c-bcl-2 ; genetics ; Rabbits ; Random Allocation ; Reverse Transcriptase Polymerase Chain Reaction ; Tumor Suppressor Protein p53 ; genetics

ObjectiveTo evaluation the intervention effects of hand hold hands method in brick tea borne fluorosis.MethodFour to six grade pupils were selected in brick tea borne fluorosis areas,and health education knowledge questionnaire investigation was conducted.Drinking tea related health behaviors were also surveyed by the method of questionnaire.Then health education lecture on brick tea borne fluorosis was carried out,and health education material and low fluoride brick tea were provided to the pupils,the students were also requested to tell their parents brick tea related knowledge and supervise them to get rid of harmful drinking tea behavior,and cultivate healthy lifestyle.One year later pupils' health knowledge questionnaire and parents health related behavior questionnaire were carried out once again.The knowledge awareness rates of students before and after the intervention were compared.Health related behavior change rates of the parent between different ages and education levels were compared,and the implementation rates of different brick tea related behaviors before and after the intervention were compared.ResultsAfter 1 year of health education,the student's knowledge awareness rate on brick tea fluorosis was [94.3％ (33/35)],compared with the rate before intervertion [14.3％ (5/35)] increased significantly(X2 =46.111,P ＜ 0.01 ).The overall behavior change rate of health related behavior was 68.6％.After the intervention,the implementation rate of whether drinking tea,drinking overnight tea,drinking boiled for a long time tea decreased(P ＜ 0.01).But the behavior implementation rates of drinking tea with milk,drinking and buying low fluoride brick tea significantly increased(P ＜ 0.05).Implementation rate of whether drinking brick tea did not change significantly(P ＞ 0.05).ConclusionsThrough hand hold hands health education intervention,the knowledge awareness of students on brick tea fluorosis increases,and their parents can actively change bad tea drinking habits,and cultivate healthy lifestyle.

Apoptosis ; Cyclophosphamide ; Interferon-gamma ; Mesenchymal Stem Cells

Objective The aim of the present study was to evaluate the clinical application of 2 μm thulium laser in pulmonary nodules resection under VATS.Methods 61 patients,undergoing thoracoscopic resection of pulmonary nodules in thoracic department of Xuanwu Hospital,were identified between January and December of 2016.Of those,30 underwent 2μm thulium laser dissection and 31 were treated with standard technique by using staplers.In terms of clinical characteristics,including gender,age and smoking history,there is no significant difference between the laser group and the stapler group,but the lesion size was slightly larger in the stapler group compared with the laser group.The lesions of the two groups were almost evenly distributed on the five lobes.Results All the procedures were performed successfully under VATS.The intraoperative evaluation of air leaks demonstrated that less than or equal to 2 grade air leaks were observed in 28 cases in the laser group and in 30 cases in the stapler group.Grade 3 air leaks requiring a rescue treatment were observed in 2 cases in the laser group and in 1 case in the stapler group.There were no significant differences in the postoperative hospital stay and total hospital stay between two groups.Chest tube duration was lower in the laser group compared with the stapler group even if it was not statistically significant (2.71 vs 3.55 days).Hospitalization costs was significantly lower for the laser group.Conclusion The use of 2um thulium laser to prevent intra-and postoperative air leaks and bleeding is effective and makes patients recover quickly,which allows a minimally invasive,accurate and safe application during thoracoscopic resection of pulmonary nodules.