Glutamine(Gln) is the most abundant free amino acid in the circulation. However, Gln depletion is obviously increased in critically ill patients. The liver plays a key role in glutamine metabolism since it can either generate or consume Gln. A number of studies have demonstrated that administration of Gln can protect from liver damage during sepsis or chemotherapy. The mechanism may be that glutamine can be more efficiently transported across cell membranes for glutathione synthesis. Supplement of Gln to PN has been proven to maintain intestinal integrity and reduce bacterial translocation. As a gluconeogenic amino acid, Gln can decrease the portal insulin/glucagon ratio and prevent hepatic steatosis through stimulating glucagon secretion.

Background:Gastric cancer is the result of comprehensive interactions among Helicobacter pylori(Hp)infection, environmental factors and host genetic factors. It has been demonstrated that rs2294008 polymorphism in prostate stem cell antigen(PSCA)gene is associated with increased risk of non-cardia gastric cancer. Aims:To investigate the relationship between PSCA rs2294008 polymorphism and precursors of gastric cancer. Methods:A total of 398 patients with gastric intestinal metaplasia( n = 328)and intraepithelial neoplasia( n = 70)from Nov. 2009 to Nov. 2015 at the Qingdao Municipal Hospital were enrolled,and 416 healthy subjects were served as controls. Genotype of PSCA rs2294008 was determined by direct DNA sequencing of PCR products,and Hp infection was examined by rapid urease test. Results:Significant difference in frequencies of CC,CT and TT genotypes of PSCA rs2294008 was observed between case and control groups(P = 0. 011);the frequency of TT genotype was significantly higher in case group than in control group (16. 3% vs. 9. 4% ,P = 0. 003). Compared with individuals carrying CC genotype,TT genotype carriers were found to be associated with a higher risk of precursors of gastric cancer(oR = 1. 840,95% CI:1. 174 ~ 2. 886). Taken individuals negative for Hp infection and carrying C allele(CC + CT)as reference,risk of precursors of gastric cancer was significantly increased by Hp infection(oR = 2. 389,95% CI:1. 799 ~ 3. 173)and Hp infection in combination with TT genotype (OR = 3. 335,95% CI:1. 935 ~ 5. 749),whereas TT genotype alone only slightly increased the risk(OR = 1. 783,95%CI:0. 900 ~ 3. 530). Conclusions:PSCA rs2294008 polymorphism is significantly associated with susceptibility to precursors of gastric cancer and Hp infection might further increase the risk in TT carriers.

AIM: To observe the effect and safety of applying mitomycin C ( MMC ) in laser - assisted subepithelial keratomileusis ( LASEK) for extreme high myopia.
●METHODS:LASEK with 0. 02% MMC was performed in 364 eyes of 182 patients with extreme high myopia and spherical equivalent was-9. 0 to-10. 25 D. All the patients were divided into four groups according to the applying time of MMC. The time in Group l was 10s, in GroupⅡwas 25s, in Group Ⅲ was 40s and 55s in Group lV. Uncorrected visual acuity ( UCVA ) , residual refraction, Haze, healing time of corneal epithelium, density and variant index of corneal endothelium was examined in these patients and follow-up 6mo.
●RESULTS:At 6mo after surgery, 76. 3%, 94. 0%, 92. 3%and 93. 8% of the patients in Group l, GroupⅡ, GroupⅢ and Group lV respectively achieved the UCVA better than 15/20. There was significant difference of UCVA between Group l and the other three groups (χ2=19. 610, P=0. 000). Proportion of the residual refraction between ± 0. 5D in Group l (78. 8%) was lower than other groups (95. 2% in Group Ⅱ, 93. 3% in Group Ⅲ, and 92. 7% in GroupⅣ) at 6mo and there was significant difference (χ2=16. 329, P=0. 001). Group l had more Haze statistically than the other three groups at 6mo postoperatively ( Hc=50. 110, P=0. 000). The healing time of cornea epithelium seem to be no statistically difference between each group at 6mo (χ2=11. 611, P>0. 05). MMC had no influence on the density of corneal endothelium in each group postoperatively (P>0. 05), there were 3071. 3±284. 4 cells/mm2 in Group l, 3 105. 6 ± 337. 8 cells/mm2 in Group Ⅱ, 2 986. 3 ± 304. 1cells/mm2 in Group Ⅲ and 3 088. 7 ± 372. 5 cells/mm2 in Group lV respectively. The variant index of corneal endothelium calculated in each group at 6mo after surgery was 24. 72 ± 6. 52, 22. 93 ± 6. 74, 24. 38 ± 6. 63 and 23. 14±7. 22 repectively, compare with that preoperatively there were no statistically differences (P>0. 05).
●CONCLUSION: For extreme high myopia LASEK with 0. 02% MMC is effective and safe. The MMC applying time of 25s in LASEK can effectively reduce Haze after surgery and decrease potential complications.

AlM:To make a analysis of visual quality of iris location guided femtosecond laser assisted in situ keratomi ( LASlK) and iris location guided mechanical sub-bowman keratomileusis ( SBK) for high myopia treatment.METHODS:Femtosecond LASlK ( study group ) was performed in 102 eyes of 51 patients with high myopia and 70 eyes of 35 patients were received mechanical SBK ( control group ) from January to October 2013. The spherical refraction of all the patients was from -6. 00 ~-9. 50D. Best corrected visual acuity ( BCVA ) of the patients was ≥1. 0. Uncorrected visual acuity ( UCVA), BCVA, thickness of cornea flap, contrast sensitivity function ( CSF ) and senior ocular aberration were examined in these patients and follow-up was 1a.RESULTS: At 1a after surgery 94. 1% UCVA in study group reached ≥1. 0 and there was 94. 3% in control group. There was no significant difference between two groups (P>0. 05). Residual refraction of study group was-0. 08±0. 10 D and control group was -0. 10±0. 07 D. There was no significant difference of residual refraction between two groups (P>0. 05). C12 , C8 of senior ocular aberration and RMSH in study group was less than control group, amplification:0.1642±0.0519 and 0.2229±0.0382 (t=8. 077, P<0. 05), while C7 was equal in two groups:0. 1583 ±0.1921 and 0. 1436±0. 1536 (t=0. 556, P>0. 05). C8 was 0. 0950±0. 069 and 0. 1858±0. 095 (t=7. 261, P<0. 05). RMSh was 0. 3711 ± 0. 0847 and 0. 5622 ± 0. 1033 ( t= 12. 801, P<0. 05). CSF was no significant difference between study group and control group (P>0. 05). CONCLUSlON: Femtosecond LASlK and mechanical SBK is effective for high myopia. Compared to mechanical SBK, femtosecond LASlK shows more advantages in the senior ocular aberration and visual quality. The cornea flap is more regular from central to peripheral area with femtosecond laser.

Objective To evaluate the value of suprasternal long axis view in echocardiography for right pulmonary artery (RPA) lesions.Methods Echocardiography was performed in 31 patients with clinical suspicion of pulmonary vascular disease.Through suprasternal long axis view,RPA,right superior pulmonary artery and right inferior pulmonary artery were identified,and the vessel wall,intraluminal echoes,and location of the lesion were obtained.Blood flow in pulmonary artery was detected with color Doppler flow imaging.The results of echocardiography were compared with those of computer tomography of pulmonary angiography (CTPA) and clinical diagnosis.Results With suprasternal notch echocardiography,RPA lesions were identified in 27 patients.H owever,RPA could not be clearly identified in four patients.There were 22 patients with moderate or low echo mass in RPA,and five patients with intimal thickening and artery stenosis/obliteration.In the 27 patients with detected lesions,20 lesions were located in RPA,seven lesions were located in distal RPA or its branches.Among the results obtained with echocardiography,25 were in accordance with CT results,6 were not in accordance with CT results.Conclusions The suprasternal long axis view of RPA can be an important alternative imaging modality in identification of pulmonary vascular diseases.

Objective:To evaluate the clinical effects of amended concave position in gynecological laparoscopy surgery.Methods: Eighty ASAⅠ~Ⅱ patients with gynecological laparoscopy surgery were randomly divided into two groups, the patients in group A were adopted Trendelenburg position; the patients in group B were adopted amended concave position. The Ppeak and PETCO2 in the two groups were recorded during surgery, the time of extubation and the adverse effects as nausea, vomiting, shivering was recorded after surgery.Results: The Ppeak and PETCO2 of group A were higher than that of group B(t=2.526,t=2.838, t=2.881;P<0.05). The time of extubation of group A were higher than that of group B after surgery(t=2.515,t=2.436;P<0.05).Conclusion: Adopting amended concave position can reduce Ppeak and PETCO2 in gynecological laparoscopic surgery, and it is helpful for postoperative recovery of the patients with gynecological laparoscopy surgery.

Background:Of the diagnostic modalities of gastroesophageal reflux disease( GERD),radioisotopic examination is more physiological and non-invasive as compared with upper gastrointestinal endoscopy,24-hour esophageal pH monitoring and esophageal manometry. Aims:To examine the diagnostic value of 99m Tc-labeled single-photon emission-computed tomography(SPECT)for GERD. Methods:Ten erosive esophagitis(EE),10 nonerosive reflux disease(NERD)and 10 noncardiac chest pain patients were enrolled in this study. All of them had a high reflux disease questionnaire( RDQ)score (>12)and were positive for proton pump inhibitor(PPI)test. Ten volunteers without reflux symptoms served as controls. After the taking of 99mTc-labeled acidic drinks,SPECT scan was performed in esophageal region for indentifying the radioactivity at gastroesophageal junction. Through region-of-interest,the stomach and esophagus were outlined and the GERindex was calculated. Results:Radioactivity was observed in lower esophagus in 8 patients of EE group,including 6 spontaneous reflux and 2 induced reflux;in NERD group and noncardiac chest pain group,the corresponding data were 5,3, 2 and 6,2,4,respectively. No reflux was observed in control group. Positivity rates of reflux identified by SPECT in EE, NERD and noncardiac chest pain groups were all significantly higher than that in control group(80. 0%,50. 0% and 60. 0%vs. 0%,P<0. 05). Conclusions:99m Tc-labeled SPECT has clinical value for diagnosis of GERD and is potential for being used as a method of GERD examination in clinical practice.

Objective:To investigate the effect of heat shock protein 60(HSP60) on the functions of dendritic cells of ApoE-/-mice (mDCs) in vitro by signal transduction of mitogen-activated protein kinase (MAPK) family mediated by Toll-like receptors (TLRs).Methods:Myeloid mDCs were extracted in vitro from ApoE-/-mouse marrow,which were incubated as atherosclerotic animal model,and divided into three groups:HSP group,LPS group and control group.The three groups of mDCs were incubated to mature with mHSP60,LPS and normal saline,respectively and then examined the expression of TLR protein and mRNA by flow cytometry and real-time RT-PCR.In addition,the expression level of CD80 was examined by flow cytometry.The expression of MAPK family proteins was determined by Western blot analysis.The levels of cytokines secreted by mDCs,such as IL-6 and TNF-?,were analyzed by ELISA.Results:The expression of TLRs and MAPK families (p38 and ERK) was increased in the samples of HSP group,when compared with control group (P0.05).Conclusion:HSP60 is involved in activation of mDCs of atherosclerotic animal model by means of the signal transduction of MAPK family mediated by TLRs.

OBJECTIVE:To discuss what service marketing strategies the pharmaceutical enterprises in China should choose in the face of more and more fierce competition in pharmaceutical markets.METHODS:The service characteristics of both prescription drugs and over-the-counter(OTC)drugs were analyzed and new conceptions in pharmaceutical marketing such as the development and application of the service marketing were introduced as well.RESULTS&CONCLUSION:Di?versity,standardization,materialization are the right way the pharmaceutical enterprises should follow in the prescription drugs services;however,standardization,mechanics,brands are necessary for the OTC drugs services.

Bioreactor is a key equipment in bioengineering.The bioprocessing efficiency using bioreactors is significantly affected by the reactor configuration.It is apparent that research on the bioreactor structure is one of key issues in bioengineering.Along with industrialization of penicillin mechanically stirred bioreactor was developed,after that large quantity of bioreactors was invented for the sake of the development of mammal and plant cell cultivation,epiphyte cultivation and algae cultivation.Among these bioreactors mechanical stirred bioreactors and airlift bioreactors are very popular.Recent trends of studies on mechanically stirred bioreactors and airlift ones were reviewed.The focus is on the summarization and analysis of 11 kinds of novel bioreactors developed around the world.