Objective To explore the correlation between the increasing of blood glucose and cytokines in malignant tumor patients after chemotherapy.Methods According to the blood glucose after chemotherapy,155 cases of malignant tumor patient were divided into 3 groups:euglycemia group,IGT(impaired glucose tolerance)group and DM(diabetes mellitus)group.The variance of cytokines in the 3 groups were analyzed.Results Compared with pre-chemotherapy,IL-6,TNF-αincreased greatly in IGT group and DM group,while IL-10 decreased greatly.The statistical difference were obvious compared with euglycemia group.Conclusion There are close correlation between the increasing of blood glucose and cytokines in malignant tumor patients after chemotherapy.

Objective To study the effect of Dahuang-Mudan decoctionby retention enemafor the thepatients with acute pelvic inflammation disease (APID) and toxic heat flourishing type. Methods Ninety patients with APID (toxic heat flourishing type) were randomly divided into treatment group and control group (45 case per group). The patients in both groups were given cefamandolenafate injection and tinidazole injection;and the Dahuang-Mudan decoction by retention enema was added to the treatment group.The C-reactive protein (CRP), tumor necrosis factor-α(TNF-α), interleukin-6 (IL-6) and clinical symptoms scores in both groups before treatment and after 2 weeks of treatment were observed. Results After treatment, CRP (3.16 ± 1.25 mg/L vs. 8.68 ± 1.45 mg/L, t=19.126), TNF-α(4.02 ± 1.06 ng/L vs. 9.64 ± 2.08 ng/L, t=15.966), IL-6 (60.34 ± 14.35 ng/L vs. 88.24 ± 12.16 ng/L, t=9.839), temperature recovery time (3.22 ± 1.13 d vs. 4.73 ± 1.36 d, t=5.638), abdominal pain disappeared time (5.26 ± 1.43 d vs. 7.45 ± 1.32 d, t=7.418), leukocyte recovery time (7.34 ± 2.06 d vs. 9.58 ± 2.26 d, t=4.834), hospital stay time (10.24 ± 3.42 d vs. 13.43 ± 4.38 d, t=3.791) in the treatment group were significantly lower than those in the control group (P<0.01). The clinical effect rate (77.27% vs. 48.84%, χ2=7.562) in the treatment group were significantly higher than that in the control group (P<0.01). Conclusions The treatment of APID (toxic heat flourishing type) with Dahuang-Mudan decoction by retention enema can reduce the inflammatory response of pelvic, promote the absorption of exudate and adhesion in pelvic.

ObjectiveTo investigate the resistance character and trend of bacteria strains producing extend spectrum β-lactamase (ESBLs) in clinic.MethodsThe ESBLs-producting K. pneumoniae and E.coli producing ESBLs isolated from Apr 2001 to Mar 2004 in our hospital were screened and confirmed according to NCCLs method.ResultsK. pneumoniae and E.coli with the ESBLs phenotype were increased in recent 3 years with the resistance rate and Gm(MIC) also higher than that not producing ESBLs.ConclusionThe dection of bacteria strains producing ESBLs will be enhanced in order to provide reasonable treatment information.

Objective To observe the biomechanieal properties of tendons repaired by five suture techniques in different stage of healing process.Methods After establishing the zone Ⅱ FDP transection model in 2nd,3rd,4th too of both feet in female fowls,the ruptured tendons were repaired with Modified Kessler ( M K ),Kessler plus running ( K +R ),double-strand Kessler ( DK ),double loop (DT) and modified double loop (MT) methods,respectively.Passive and active mobilizations were applied on the 3rd day and 21st day postoperatively.Animals were executed postoperatively,on the 14th,21st and 35th days,respectively and both feet were harvested for biomechanical test.Results Anatomical findings included: The breakage incidence of K+R group was smaller than that of MK group.The excellent and good results of K+R and DK groups were higher compared with that of MK group.Biomechanical results showed: The MK group had the poorest biomechanical results in every stage of tendon healing (P＜0.05) except that the results from MK group on the 35th showed no statistical difference compared with that of MT and DT in extreme load;K+R group exbited the greatest extreme load and tensile strength (P＜0.05);Biomechanical test results from all groups showed significant differences on different testing point: 35th day＞21st day＞14th day(P＜0.05 );No significant differences were found in all groups between the immediate postoperative results onlst day and that from 14th day.ConclusionDuring the recovery of tendon,biomechanical properties returned to the immediate postoperative level on the 14th day and increased along with time.K+R group shows the superiority to the other methods in biomechanical properties as well as low breaking incidence ratein every stage of tendon healing.Kessler plus running is an effective method with high strength against breakage and great resistance to adhesion formation.

Objective To compare the biomechanical effect of several commonly used internal fixators in treating the femoral neck fractures so as to provide clinical basis for the selection of ideal internal fixation.Methods Twelve artificial PMMA femoral models were selected,and the central neck of the specimens was sawn with an electric saw at Pauwels angle of 70° to form adduction type femoral neck fracture models.After anatomic reduction,the specimens were fixed with dynamic hip screw ( DHS),three hollow screws,proximal femoral nail (PFN) and dynamic sleeve three-wing screw according to the operative approach,respectively.Instron-8874 servo-hydraulic mechanical testing machine was used to fix the specimens which simulated uniped standing.Fifteen key points on proximal femur were selected as test points and were given gradation loading at speed of 10 mm/min with linear load 0-1 200 N.The strain of each point under 1200 N load,head sink displacement under different loads and the strain of eight points on principal pressure side were measured.Results There was a peak at the eight resistance strain gage at 1200 N load and the strain values of the DHS,three hollow screws,PFN and dynamic sleeve three-wing screw were (700 ±35) μεz,(756 ± 14) με,( 1362 ± 136) με and (3024 ± 127) με,with statistical significance (P ＜ 0.01 ).Under the same load,the head sink displacement in the group of dynamic sleeve three-wing screw was greater than that of the hollow screws group and the PFN group ( P ＜0.01 ),but smaller thau that of the DHS group ( P ＜ 0.01 ).The strain values at the eight resistance strain gage in the group of dynamic sleeve three-wing screw was larger than that of the other three groups under the same load (P ＜ 0.01 ),and the strain values increased with the increase of load at the same fixation group.Conclusion Dynamic sleeve three-wing screw has good biomechanical stability for treatment of femoral neck fracture,which can be applied in the clinical practice.

Objective To detect the nodal occult micrometastasis in stage Ⅰ non-small-cell lung cancer(NSCLC),and further investigate the main factor of affecting the nodal occult micrometastasis and the rule of micrometastasis in stage Ⅰ NSCLC. Methods Occult micrometastatic tumor cells by in hilar and subcarinal lymph nodes(LN)were detected immunohistochemistry (SP method),which were removed from 91patients with completely resected stage Ⅰ NSCLC.The monoclonal antibody muhicytokeratin(MCK)was used as a micrometastatic marker.Another 45 hilar LN removed from benign pulmonary lesion patients and 45 hilar LN removed from Ⅱ and Ⅲ stage NSCLC were detected, respectively by conventional histopathologic examination as negative and positive control.Results Micrometastasis was detected in all lymph nodes that were removed from stageⅡand Ⅲ NSCLC.but no one was detected in lymph nodes that were removed from benign pulmonary lesion patients.There were 45 positive cases in 91 patients.The rate of micrometastasis in stage Ⅰ NSCLC was 49%(45/91).among them 39 subcarinal lymph nodes and 11 hilar lymph nodes were detected as positive,5 cases were detected as positive both in subcrinal and hilar lymph nodes.Logistic regression analysis indicated that tumor size,stage and differentiation affected micrometastasis significantly,odd ratios(OR) were 8.444,6.946 and 14.566 respectively.The multivariate analysis indicated that cell difierentiation and T stage may be the adverse factors for nodal micrometastasis,odd ratios(OR)were 7.028and 14.509 respectively.Conclusion There is nodal micrometastasis in completely resected stage Ⅰ NSCLC patients.The micrometastasis frequency of stage ⅠB is significantly higher than stage ⅠA;It is necessary for stage ⅠB NSCLC to be given chemotherapy after operation;cell differentiation and T stage may be the adverse factors for nodal micrometastasis.The method of lymph node micrometastasis is from hilum to mediastinum.The skip micrometastasis may be taken place in adenocarcinoma.

Objective To develop a multiplex touchdown PCR for simultaneous detection of extended-spectrum β-lactamases (ESBLs )-producing Enterobacteriaceae and methicillin-resistant Staphylococcus aureus (MRSA ). Methods Blood culture positive specimens from 102 hospitalized patients were collected between March 2013 and September 2014,four pairs of specific primers were designed based on SHV,TEM,and OXA genes of ESBLs-pro-ducing Enterobacteriaceae and MecA gene of MRSA,drug-resistant genes were amplified with single touchdown PCR and multiplex touchdown PCR, the results were compared with Kirby-Bauer disk diffusion method. Results Each single PCR amplified a specific band,four drug-resistant genes were also detected by multiplex touchdown PCR;the lower detection limits of multiplex touchdown PCR for DNA of MecA,SHV,TEM,and OXA were 4.37 ng,2.19 ng,4.53 ng,and 3.59 ng,respectively.Compared with Kirby-Bauer disk diffusion method, the overall sensitivity and specificity of multiplex touchdown PCR were 100.00% and 88.24% respectively,for ES-BLs were 100.00% and 87.23% respectively,for MRSA were both 100.00%.Conclusion A higher sensitivity and specificity multiple touchdown PCR assay has been developed,and it can be used in the rapid diagnosis and epidemi-ology investigation of bloodstream infection caused by ESBLs-producing Enterobacteriaceae and MRSA,and is help-ful for guiding antimicrobial use in clinic.

[ ABSTRACT] AIM:To investigate the effects of cerebral ischemia and postconditioning on protein kinase R-like endoplasmic reticulum kinase (PERK) and glucose-regulated protein 78 (GRP78) in the hippocampus tissue of tree shrew during endoplasmic reticulum stress and the mechanism of post-conditioning protecting the brain from damage.METH-ODS:The focal cerebral ischemic model was duplicated by photochemical reaction in tree shrew and the postconditioning was induced by alternatively occluding and opening the carotid artery of ischemic side for 3 cycles (5 min each cycle) at 3.5 h after ischemia.The damage and ultrastructural changes of the hippocampal neurons were observed by HE staining. The expression of PERK and GRP78 at mRNA and protein levels in the hippocampal tissue at different time points after cer-ebral ischemia and postconditioning was determined by RT-PCR, immunohistochemistry and Western blot.RESULTS:The injuries of hippocampal neurons were aggravated with prolonged cerebral ischemia, which was most severe at 24 h after ischemia while the postconditioning alleviated these damages correspondingly.The expression of PERK at mRNA and pro-tein levels was upregulated at 4 h, 24 h and 72 h after ischemia (P<0.05), while postconditioning downregulated the ex-pressions of PERK at ischemia and postconditioning 4 h (IP4 h) gruop and IP24 h group (P<0.05).The expression of GRP78 at mRNA and protein levels was not changed at 4 h, 24 h and 72 h after ischemia, while postconditioning upregu-
lated the expressions of GRP78 at IP24 h group (P<0.05).CONCLUSION:The focal thrombotic cerebral ischemia ac-tivates the endoplasmic reticulum stress in ischemic hippocampus of tree shrews, leading to the changes in mRNA and pro-tein expression of PERK in the PERK/eIF2αsignal transduction pathway.The postconditioning treatment alleviates endo-plasmic reticulum stress and neuronal damages by downregulating PERK and upregulating GRP78, thereby protecting the brain from injury.

ObjectiveTo analysis the epidemic tendency of the methicillin-resistant Staphylococcus aureus(MRSA).MethodsClinical data of patients from August 2004 to August 2005 were analyzed retrospectively.Results62 Staphylococcus aureus were isolated,and the MRSA isolated rate was 59%.The MRSA patients tended to complex infection.ConclusionThe infection caused by MRSA is serious.It is necessary to take effective measures to control the MRSA prevalence.