Objective　To make clear the effect of gastrointestinal tract ischemia on multiple organ dysfunction syndrome (MODS). Methods　The literature in the recent years was reviewed. Results　The low-flow states of gastrointestinal tract and decrease of gastrointestinal intramucosal pH, which occured following a variety of insults (sever trauma, hemorrhagic shock, et al), as well as overgrowth of enterobacteria, may result in a significant increase of permeability of bowel and lead to endotoxemia and bacterial translocation. Ischemia also resulted in release of TNF, IL-6 into the systemic circulation, dysfunction of gastrointestinal tract motility, and activation of neutrophile which was integral in local and distant organ damage. Conclusion　These data suggest that the management of correct ischemia of gastrointestinal tract, which include fluid infusion to replacement of blood volume, early enteral nutrition, improvement of gastrointestinal movement, could contribute to improve the intestinal barrier function, and prevent the development of MODS.

Objective To study the role of matrix metalloproteinase-9 (MMP-9) and tissue inhibitor of metalloproteinase-1 (TIMP-1) in extracellular matrix remodeling in rat model of chronic obstructive pulmonary emphysema .Methods Seventy Wistar rats were randomly subdivided into the control group and the smoking groups which were randomly subdivided into one month to six month smoking group again.The smoking groups were exposed to cigarette smoke for one to six months, The expressions of MMP-9 and TIMP-1 mRNA and proteins in lung tissue were detected by in situ hybridization and immunohistochemistry respectively.In lung tissue the expression of collagen Ⅳ was assessed by method of immunohistochemistry.Results Compared with the control group,the expressions of MMP-9 and TIMP-1 mRNA and proteins in lung tissue from the smoking groups were remarkable elevated(P

Objective To study the expression of matrix metalloproteinase-9 (MMP-9) and tissue inhibitor of metalloproteinase-1 (TIMP-1) in the lung tissues of smoking cessation rat model. Methods Fifty Wistar rats were randomly divided into the normal control rats which were exposed to room air for 4 and 6 months respectively(groups A and C), the smoking rats which were exposed to cigarette smoke for 4 and 6 month respectively(groups B and D), and the smoking cessation group which was exposed to room air for 2 months after 4 months' smoke exposure.The expressions of mRNA and proteins of MMP-9 and TIMP-1 in the lung tissues were detected by in situ hybridization and immunohistochemistry respectively. The collagen Ⅳ expression in the lung tissues was assessed by immunohistochemistry. Results Compared with groups A and C, the expression levels of MMP-9 and TIMP-1 in the lung tissues of groups B and D significantly elevated(P

Objective To investigate the adjustment of immunosuppression and prevention of infections in lung after renal transplantation.Methods 253 cases of pulmonary infections after renal transplantation between January 1999 to March 2004 were analyzed. After 2003, postinduction period, the blood concentrations of CsA and FK506 were maintained at 0.125~0.166 ?mol/L and 5 ?g/L respectively. The oral dose of MMF was 1 g every day. Results The creatinine levels were stable 253 patients after treatment. Among 253 cases, 229 cases were cured (90.51 %) and 24 died (9.49 %). After adjustment of immunosuppressants, common pulmonary infections and severe pulmonary infections were decreased.Conclusions Infection in lung was a severe complication after renal transplantation. Timely treatment, nursing care and adequate adjustment of immunosuppression may achieve satisfactory effects in preventing lung infection.

Objective To discuss the value of the mammography in the diagnosis of ductal carcinoma in situ (DCIS) and guidelines ofthe operation.Methods 107 pathologically proved DCIS were retrospectively reviewed.Results There were 62 microcacifications(57.9%),the range of microcacifications was varied , of them,13 were masses or local compact with microcacifications ; 17 were localized infiltration and bad structure (15.9%);20 were masses (18.7%) ;1 papillae enhancement (0.9%),7 were normal(6.5%).Conclusion Multiplicity microcacifications are the most frequently appearance of X-ray in DCIS;mammography could find the early microcarcinoma and the early carcinoma , especially the DCIS ; mammography could exactly reflect the multifocus , it is of value in confirming the range of the operation.

ObjectiveTo summarize the nursing experience of postoperative liver biopsy in patients after liver transplantation. Methods89 patients undergoing postoperative liver biopsy after liver transplantation from June 2010 to April 2011 were retrospectively analyzed.Their nursing experience was summarized. Results81 patients were confirmed of having rejection reaction.89 patients had no severe complications,only 28 cases(31.5％)had mild local pain. ConclusionsSufficient preoperative preparation,good nursing cooperation during the operation,close postoperative observation and nursing can prevent and timely detect and cope complications,thereby reduce the risk of liver puncture.

Objective To explore the effect of different additional filters on radiation dose and image quality in digital mammography.Methods Hologic company's Selenia digital mammography machine and the post-processing workstations and 5 M high resolution medical monitor were used in this study.Mammography phantoms with the thickness from 1.6 cm to 8.6 cm were used to simulate human breast tissue.The same exposure conditions,pressure,compression thickness,the anode were employed with the additional filters of Mo and Rh under the automatic and manual exposure mode.The image kV,mAs,pressure,filter,average glandular dose (AGD),entrance surface dose (ESD),signal-to-noise ratio (SNR),contrast-to-noise ratio (CNR) and image score according to ACR criteria were recorded for the two additional filters.Paired sample t test was performed to compare the indices of Mo and Rh groups by using SPSS 17.0.Results AGD and ESD of Rh and Mo group were both higher with the increase of the thickness of all the phantoms.AGD,ESD and their increased value of Rh filter(1.484 ± 1.041,7.969 ± 7.633,0.423 ± 0.190 and 3.057 ± 2.139) were lower than those of Mo filter(1.915 ± 1.301,12.516 ± 11.632,0.539 ±0.246 and 4.731 ± 3.294),in all the phantoms with different thickness (t values were 4.614,3.209,3.396 and 3.605,P ＜0.05).SNR,CNR,and image score of Rh and Mo group both decreased with the increase of the thickness of all the phantoms.There were no statistical difference (P ＞ 0.05).Conclusions Compared with Mo filter,Rh filter could reduce the radiation dose,and this advantage is more obvious in the thicker phantom when the same image quality is required.

Objective To evaluate the role of breast MRI in detecting the primary malignancy in patients presenting solely with axillary lymph node metastases. Methods Thirty-three patients with axillary lynph node metastases but negative findings on either physical examination or mammography underwent breast MRI to identify occult breast carcinoma. MRI of the breast was assessed according to BI-RADS criteria. The pathologic diagnosis was made according to the standard criteria by the WHO Classification of Tumor. Results Among 33 patients presenting solely with axillary metastases, 30 patients underwent modified radical mastectomy. Primary breast carcinoma was proven in 17 patients. MRI detected lesions in 16 patients, including 10 masses and 6 non-mass lesions. Size of the masses ranged from 0. 5 to 2. 6 cm (mean 1.5 cm). Six lesions were smaller than 1.5 cm in size. Non-mass lesions showed ductal enhancement in 4 cases and segmental enhancement in 2 cases. One patient with tumor detected by histopathology showed no abnormal enhancement on MRI. No tumor was found at mastectomy in the other 13 womeu, and negative MR findings were revealed in 9. Four cases with suspicious enhancement on MRI had no corresponding primary foci on pathology. Three patients didn't undergo surgical procedure. The sensitivity, specificity, and accuracy of MRI in the diagnosis of the primary malignancy were 94. 1%,69. 2%, and 83.3%, respectively. Conclusions Small size of mass and ductal or segmental enhancement of non-mass lesion were common MR features of occult malignancy. MRI showed high sensitivity and accuracy in diagnosing occult breast carcinoma. Breast MRI should be taken in search of occult malignancy in patients with axillary metastases.

Objective To detect the levels of Th17 and regulatory T(Tr)cells in Imripheral blood mononuclear and tumor tissue from patients with cervical cancer and analyze the relationship hetween Th17 and Tr cells in cervical cancer progression.In addition.the significance of the Th17/Tr cells ratio in cervical cancer pathogenesis was discussed.Methods The expression levels of Th17 and Tr cells were determined by flow cytometry from 32 patients with cervical cancer and 15 health people.The mechanism of involvement of Th17 and Tr cells proportionality in cervical cancer pathogenesis and the correlation between Th17 and Trwas assessed by bivariate correlation analysis.Results The expression levels of both Th17 and Tr in patients were higher than control groups,especially in late stage patients Th17 and Tr proportionality lower than early group,and there was a negative correlation between them.Conclusion Th17 and Tr cells proportionality may be involve in the development of cervical cancer so as to provide novel strategies for tumor immunotherapy.

Objective To explore the role of matrix metalloproteinase 9(MMP-9)and tissue inhibitor of metalloproteinase-1(TIMP-1)in patients with acute exacerbation of severe chronic obstructive pulmonary diseases (AECOPD)treated with glucocorticoids.Methods The serum levels of MMP-9 and TIMP-1 were measured by ELISA in 41 patients with AECOPD before and after treatment with glucocorticoids and in 40 patients with regular methods(control group).Results ①After treatment with glucocorticoids,the serum levels of MMP-9(189.25±52.38)μg/L、TIMP-1(198.38±43.45)μg/L,ratio of MMP-9/TIMP-1(0.92±0.37)were decreased significantly than before((246.10±68.64)μg/L,(217.63±62.34)μg/L,(1.09±0.23))(P<0.01,P<0.05,P<0.05);but there were no differences(P>0.05)in regular methods(control group);② After treatment with glucoeorticoids, FEV_1、FEV_1%((0.83±0.35)L,(46±17)%)were impmved than before((0.72±0.48)L,(34±15)%)(P<0.05).Conclusions After treatment with glucocorticoids,the serum levels of MMP-9、TIMP-1、ratio of MMP-9/TIMP-1 from patients with COPD were decreased significandy,and FEV_1、FEV_1%were improved significant;Glucocorticoids can alleviate severs AECOPD to some degrees,which might be related to improving the imbalance of MMP-9/TIMP-1.