Child, Preschool ; Humans ; Influenza A Virus, H1N1 Subtype ; Influenza, Human ; virology ; Male

Objective:To summarize the curative effect in treatment of Raynaud's syndrome with chemical thoracic sympathectomy(CTS) guided by X-ray since 2001.Methods: From March 2001 to August 2007,97 patients with Raynaud's syndrome(186 limbs) were treated by CTS.Guided by X-ray,a needle was punctured through the back skin to the second thoracic sympathetic ganglion beside the thoracic vertebrae and 2 mL of 5%(v/v) phenol was injected.Results: The first CTS treatment produced a good effect on 146 limbs with an effective rate of 78.5%(146/186).The same treatment was performed on the limbs with no effect 1-2 days after the first treatment and produced good effect on 13 limbs with an effective rate of 32.5%(13/40).The total effective rate of the patients who were hospitalized for the first time was 85.5%(159/186).Of the 97 patients,78 patients(80.4%) were followed up for 47 months on an average with an effective rate of 69.5%.And the rate of complications was 11.4% for pheumothorax,and 3.9% for hydrothorax.Hyperalgesia on axillary region and anterior chest wall;Horner syndrome and sinus bradycardia were rare.Conclusion: CTS is minimally invasive and effective in treatment of Raynaud's syndrome.

Objective To investigate the role of early enteral nutrition on TLR 4 signaling pathway in rats with acute necrotizing pancreatitis (ANP).Methods Sixty SD rats were randomly divided into three groups:sham operation group ( SO group ) , total parenteral nutrition group ( TPN ) , early enteral nutrition group ( EEN ) .One day after ANP model induction , the serum level of amylase was measured .Nutrient solution was given for five days , then the rats were sacrificed , and the blood , pancreas and colon tissue were collected.The serum levels of IL-6, TNF-αwere detected by ELISA .Pathologic changes of pancreas were observed by HE staining.The intestinal TLR4, NF-κB expression was measured by Western blot .Results Mortality rates of SO group, TPN group, EEN group were 0, 50%, 25%, respectively; the serum levels of amylase were (744 ±41), (3 278 ±219), (2 227 ±169) U/L, respectively;the serum levels of TNF-αwere (81.57 ±18.25), (465.72 ±42.47), (223.21 ±29.94)ng/L, respectively; the serum levels of IL-6 were (362.83 ±41.32), (932.46 ±57.21), (628.62 ±142.24) ng/L, respectively; the pancreatic pathologic scores were (0.91 ±0.15), (11.1 ±0.61), (6.9 ±0.62);the intestinal TLR4 expressions were 0.7506 ± 0.003, 1.3404 ±0.004, 0.9544 ±0.004;the intestinal NF-κB expressions were 1.33 ±0.50, 6.92 ±1.06,2.93 ±0.89.The values of TPN and EEN group were significantly higher than those of SO group (P<0.05). The values of EEN group were significantly lower than those of TPN group (P<0.05).Conclusions EEN can inhibit TLR4 and NF-κB signal pathway in gut , then reduce IL-6 and TNF-αexpression and relieve inflammatory reaction of ANP , finally decrease the mortality of ANP .

Objective To investigate a new automatic inverse optimal solution based on VMAT optimization model and verify its result.Methods A variant of the new automatic inverse optimal solution was proposed in this study,which provided a solution to calculate treatment plan with the minimized number of beams and the minimized levels of their intensities on the basis of VMAT optimization model by customized software tools.The verifications were evaluated on the simulated head-neck phantom by dosimetric parameters.Results Compared with conventional IMRT/VMAT treatment plans,the adaptive optimization program(AOP)plan showed that plan20/40(20 fields with totally 40 sub-fields,m=2)made the best achievement and it was clinicable.Conclusions The proposed new optimization technique provides an effective way to reach an inverse treatment plan with the best compromise and less sub-fields compared with IMRT/VMAT plans.

Objective To assess the effect of family doctor team care on morbidity of disabled elderly in home care.Methods Eighty six disabled elderly patients with home care in Shanghai Xujiahui community were enrolled from February 2014 to January 2015.The patients were randomly divided into intervention group and control group with 43 cases in each.In intervention group,the family doctor team provided long-term,comprehensive and integrated care,and in control group the conventional home care was provided.The rates of morbidity and readmission to hospital were documented during the 3,6 and 12 monthfollow-up,and compared between two groups.Results The incidence rates of bedsore,pneumonia and deep vein thrombosis in intervention group was significantly lower than those in control group [after 6 months:4.9％ (2/41) vs.28.9％(11/38),x2 =8.311;2.4％ (1/41) vs.21.1％ (8/38),x2 =6.769;2.4％ (1/41) vs.15.8％ (6/38),x2 =4.353,respectively;after 12 months:2.4％ (1/41) vs.42.1％ (16/38),x2 =18.374;4.9％ (2/41)vs.28.9％ (11/38),x2 =8.311;7.3％ (3/41)vs.28.9％ (11/38),x2 =6.328,respectively;all P ＜0.05].The number of cases with bedsore healing(6/7 vs.0,x2 =18.555)and pneumonia recovery[5/6 vs.4.3％ (1/23),x2 =18.092] was significantly more and that with pneumonia deterioration (0 vs.52.2％ (12/23),x2 =5.340)was significantly less in intervention group than those in control group (all P ＜ 0.05).More cases with deep vein thrombosis improved(1/3 vs.0,x2 =3.949) and less cases with deep vein thrombosis deteriorated(0 vs.8/11,x2 =5.091) in intervention group than those in control group (P ＜ 0.05).And both the readmission rate for home care patients [2.4％ (1/41) vs.36.8％ (14/38),x2 =15.175] and for patients with complications [1/12 vs.43.8％ (14/38),x2 =4.872] was much lower in intervention group than that in control group (both P ＜ 0.05).Conclusion The family doctor team care can reduce the risk of complications and readmission to hospital,and also can improve the quality of life of home care disabled elderly,as well as reduce the burden of family and society.

[Summary] Diabetic nephropathy is one of the major chronic microvascular complications of diabetes ,which is the leading cause of end‐stage renal disease ,as well as the main cause of death in diabetic patients. Glomerular endothelial cell is an important component of the glomerular filtration barrier ,which is directly related to the materials of circulation ,and it can be easily damaged by glucose ,lipid and inflammatory factors. Under the hyperglycemia ,the PKC pathway ,the polyol pathway and oxidative stress were activated ,producing an excess of advanced glycation end products and reactive oxygen species ,which damage the endothelial nitric oxide synthase ,reduce the generation of nitric oxide ,while produce a large number of Ang Ⅱ. Ang Ⅱ damage the endothelial cell. In addition ,there are crosstalk between glomerular endothelial cells and endothelial cells ,which also cause endothelial cell injury. Here ,we reviewed the role of endothelial cell injury in the pathogenesis of diabetic nephropathy.

The clinical study on acupuncture-moxibustion of traditional Chinese medicine has been attracting more and more global attention. With the development of medical pattern, we hold that, to prove the therapeutic efficacy, not only modern clinical research methods should be adopted, but a scientific and standard evaluation method in accord with the features of acupuncture-moxibustion also needs to be developed. We also believe that, in the clinic of acupuncture-moxibustion, disease differentiation treatment and syndrome differentiation treatment share an equal role, as they are relatively independent but mutually unified, together boosting the completion of treatment for a type a disease in a dynamic variation process.

Background Researches showed that the content of nitric oxide (NO) and nitric oxide synthetase (NOS) increases in blood,aqueous humor and tear of cataract patient.But the function of NO and NOS in cataract formation is still elusive.Objective The aim of this study was to explore the prevention and treatment effect of NOS inhibitor,1-nitro-arginine methyl ester (L-NAME),on galactose cataract.Methods Sixty clean three-week-old Wistar rats were equally and randomly divided into 3 groups.0.9％ Normal saline solution (30 ml/kg) was subcutaneously injected every day for 30 days in the rats of the control group,and 50％ of D-galactose solution (30 ml/kg) was used in the rats of the model and L-NAME group at the same way.L-NAME eye drops was simultaneously administered in the L-NAME group 3 times per day for 30 days.The eyes of the rats were examined under the slit lamp in 10,20 and 30 days,and the degree of lens opacification was scored.Lenses of the rats were obtained at the end of this experiment for the detect of NO,NOS contents.Flow cytometry was used to assay the caspase-3 level of rat lens.Repeated measurement two factor analysis of variance was used to analyze the difference of lens opacification scores in different groups and different time points,and one-way ANOVA was used to analyze the differences of NO,NOS and caspase-3 contents in lens among the groups.Results Lens opacification appeared in 10 days after injection of 50％ D-galactose solution in the rats of the model group and L-NAME group.Lens opacification score was higher among the different groups and different time points (Ftime =435.251,P =0.000 ;Fgroup =395.120,P=0.000).NO content in the lens was (0.45±0.15) μmol/g,(2.67 ± 0.47) μmol/g and (1.68±0.34) μmol/g in the control group,model group and L-NAME group,showing a significant difference (F=58.872,P=0.000).The NOS contents in the lens was (0.0160±0.0020) U/ml,(0.0370±0.0040) U/ml and (0.0270±0.0010) U/ml in the control group,model group and L-NAME group,showing a significant difference (F =66.174,P=0.000).Caspase-3 contents in the lens was (339.4 ± 37.9),(697.7 ± 46.5) and (650.7 ± 53.1),Showing a significant difference among them (F =100.005,P =0.000).Conclusions The increase of NO,NOS and caspase3 levels are associated with lens opacification.Topical administration of L-NAME eye drops can down-regulate NOS content in lens,reduce the NO formation and inhibit the apoptosis of lens epithelial cells.

Objective To establish a human colon cancer multi-drug resistant cell line LS174T/5-fluorouracil(5-Fu) and to explore its biological characteristics. Methods A resistant human colon cancer line LS174T/5-Fu was established by stepwise increasing concentrations of fluorouracil selection from the parental cell line LS174T.Drug sensitivity was detected by MTT assay,and the changes of biological characteristics were determined by light microscopy,cell counting,flow cytometry and RT-PCR. Results LS174T/5-Fu cell line was developed after 6 months with stable resistance to 5-Fu and a resistance index of 40.24.The cells exhibited cross-resistance to cisplatin,etoposide,doxifluridine and hydeoxycamptothecin.LS174T/5-Fu cells grew more slowly than LS174T cells,which was longer than LS174T cell line.Cell cycle distribution of LS174T/5-Fu cells was changed compared with parental cells.The percentage of cells in G_(1) and S phase was increased,while in G_(2) phase was decreased.The level of MRP mRNA expression was increased according to the concentration of 5-Fu in resistant cell lines. Conclusion LS174T/5-Fu cells is a reliable multi-drug resistant cell subline of human colon cancer.The successful establishment of this cell subline has laid a solid foundation for further study of the multi-drug resistant mechanism of human colon cancer induced by 5-fluorouracil.

Objective To study the expression level of myostatin in the gastrocnemius muscle of cancer cachexia mice and to observe the improvement of the status and the influence on myostatin expression by use of meloxicam.(Methods The) tumor-bearing cachexia mice model was established by Lovo cell line subcutaneous inoculation.Twenty-four BALB/c mice were randomly divided into 3 groups(n=8 for each group):group A,control;group B,tumor-bearing mice plus saline;group C,tumor-bearing mice plus meloxicam(5 mg/kg).The food intake and body composition were documented.The expression of myostatin in the gastrocnemius muscle was investigated by RT-PCR and immunohistochemistry in all the animals,and the correlation analysis between serum TNF? and myostatin was conducted. Results The body weight of group B was about 60% of group A,and the average food intake was significantly declined(P