Objective: Our purpose was to study the effect of L-arginine (L-Arg) on the kidneys of rats with obstructive jaundice and the underlying mechanism. Methods: Forty male Sprague-Dowley rats, weighting 200 to 230 g, were randomly assigned to four groups (n=10): sham-operation group, control group, L-Arg group, L-NG-nitroarginine methyl (L-NAME) group.Except the sham-operation group,the other groups rendered jaundiced by doubly ligating the common bile duct. Fourteen days later,we administrated L-Arg to L-Arg group,and L-NAME to L-NAME group for 7 days.On the 21st day after bile duct ligation, we measured the amount of nitric oxide (NO), malondrialdehyde (MDA), and superoxide dismutase (SOD) in the kidneys, and assessed the changes of the renal function.We also observed the morphological changes of the kidneys. Results: In the control group,the amount of NO and MDA increased while that of SOD decreased (P<0.01, P<0.01and P<0.01), and the renal function and the nephric tissue were impaired on the 21st day after bile duct ligation compared with the sham-operation group.In the L-Arg group, the amount of NO and SOD increased significantly (P<0.01, P<0.01), whereas that of MDA decreased (P<0.05), and the damage in the nephric tissue and renal function was alleviated,as compared with the control group.On the contrary, the amount of NO in the L-NAME group decreased significantly (P<0.05) compared with the control group.Although there was no significant difference in the levels of SOD, MDA, and the parameters of the renal function between the L-NAME group and control group,those indexes in the L-NAME group tended to be aggravated. Moreover, the damage in the nephric tissue of the L-NAME group was not alleviated. Conclusion: L-arginine may protect the kidney from impairment in rats with obstructive jaundice through L-Arg-NO pathway.

Objectives:To explore the effect of L-glutamine(Gln) on intestinal injury following total hepatic inflow occlusion.Methods:Male Wistar rats were assigned randomly to three groups(n=40) :Group A,sham-operation;Group B,control group,rats were pretreated with 4 ml 0.9% saline intraperitonally twice per day on 5 consecutive days;Group C,rats were pretreated with Gln dissolved in 4 ml 0.9% saline intraperitoneally twice per day on 5 consecutive days.The rats in group B and C underwent total hepatic inflow occlusion for 35min by the pringle' s manoeuvre.Ten rats from each group were randomly sacrificed before occlusion and at 2,4,24h after reperfusion respectively.The levels of MDA,SOD,GSH in intestine tissue were measured.The levels of serum TNF-? and portal vein endotoxin were detected.Results:Compared with group A,the levels of GSH and SOD decreased after reperfusion(P

Objective:To explore the effect of L-glutamine(Gln) on liver Bcl-2mRNA expres sion and apoptosis after total hepatic inflow occlusion in rats.Methods:Male Wistar rats were assigned randomly to three groups(n=40):Group A sham-operation group,group B control group,rats were pretreated with 4 ml 0.9% saline intraperitonally twice per day on 5 consecutive days,group C,rats were pretreated with Gln dissolved in 4 ml 0.9% saline intraperitoneally twice per day on 5 consecutive days.The rats from group B and C underwent total hepatic inflow occlusion for 35min by the pringle's manoeuvre.Ten rats from each group were randomly chosen and killed before the initiation of occlusion at 2 h,4 h,24 h after reperfusion respectively.The levels of MDA,GSH in liver tissue were measured.The serum concentrations of ALT,AST,LDH were assayed on a standard biochemistry autoanalyser.The expression levels of Bcl-2 mRNA in liver were assessed by RT-PCR.The apoptosis of liver were observed by DUTP method.The percentage of apoptosis was analyzed.Results:Compared with group B,the levels of GSH in group C increased after reperfusion(P

Background and purpose:Triple negative breast cancer (TNBC) is with high invasion, poor prognosis and lack of usefull treatment. This study investigated expression status of ICAM-1 protein in TNBC in order to explore its relationship with clinicopathological features and outcome in patients.Methods:Fifty-nine tissue samples of TNBC were collected while 50 cases of para-carcinoma tissue samples were used as negative controls. Immunohistochemical staining was conducted to detect expression level of ICAM-1 protein. The relationship of ICAM-1 protein expression with clinicopathological features (age, tumor size, subtype, grade, status of lymph node metastasis, TNM stage, vascular tumor thrombus, nerve inifltration, Ki-67, p53 and E-cadherin expression) and outcome in patients were analyzed.Results:The ICAM-1 protein expression of TNBC was signiifcantly higher than that in adjacent tissues (P=0.000). ICAM-1 expression was related to status of lymph node metastasis, grade and TNM stage (with aP-value of 0.036, 0.027 and 0.048, respectively), while demonstrated an undeifned relationship with tumor size, subtype, vascular tumor thrombus and expression of Ki-67, p53 and E-cadherin. The disease-free survival (DFS) of ICAM-1 high expression set was shorter than that of the lower one but has nothing to do with overall survival (OS). In addition, Cox proportional hazards model showed that ICAM-1 expression and lymph node metastasis were independent risk factors of DFS in patients (HR=3.2, 95%CI: 1.6 to 6.4, HR=2.7, 95%CI: 1.28 to 5.9,P<0.05).Conclusion:ICAM-1 could serve as a predictive factor for differentiation status of TNBC. The high expression of ICAM-1 in TNBC may indicate poorer prognosis.

Objective To study the effect of clinical nursing path with graph and text instructions (GTI) on health education to patients with complex retinal detachment.Methods Toally 76 inpatients with complex retinal detachment were enrolled in the study:38 of them hosptalized from March to August 2015 were put in the control group received routine treatment and the others hosptalized from September 2015 to March 2016 as the experiment group treated with GTI.The clinical outcomes were compared.Result The patients treated with GTI were better in the knowledge of the complex retinal detachment and moreover,they felt significantly more satisfied compared to that of the control group (P＜0.05).Conclusion It is beneficial to use GTI in the patients with complex retinal detachment.GTI is effective for improving their knowledge on the disease,and increasing their satisfaction with the clinical nursing.

Objective To evaluate the effects of dexmedetomidine on the cellular immune function during analgesia with morphine after radical resection for esophageal cancer in the patients.Methods Sixty patients of both sexes,of ASA physical status Ⅰ or Ⅱ,after radical resection for esophageal cancer under general anesthesia,were randomly divided into 2 groups (n =30 each) using a random number table:control group (group C) and dexmedetomidine group (group Dex).Patient-controlled intravenous analgesia (PCIA) was performed immediately after operation in the two groups.In group C,the PCIA solution (150 ml) contained morphine 0.48 mg/kg.In group Dex,the PCIA solution (150 ml) contained morphine 0.48 mg/kg and dexmedetomidine 1 μg/kg.The postoperative visual analogue scale (VAS) scores were maintained ≤ 3.The consumption of morphine was recorded within 24,48 and 72 h after operation.The adverse effects such as nausea,vomiting,pruritus,bradycardia,hypotension,oversedation and respiratory depression were also recorded after operation.Before induction of anesthesia (T0),immediately after extubation (T1),and at 24,48 and 72 h after operation (T2-4),venous blood samples were obtained for determination of the levels of T-lymphocyte subsets (CD3+,CD4+,CD8+) and natural killer (NK) cells by flow cytometry.CD4+/CD8+ ratio was calculated.Results Compared with group C,the consumption of morphine within 24,48 and 72 h after operation and incidence of nausea,vomiting and pruritus after operation were significantly decreased in group Dex.The levels of CD3+,CD4+,CD4+/CD8+ ratio and NK cells were significantly lower at T1-4 than at T0 in the two groups.The levels of CD3+,CD4+,CD4+/CD8+ ratio and NK cells were significantly higher at T1-4 in group Dex than in group C.Conclusion Dexmedetomidine can improve the cellular immune function during analgesia with morphine after radical resection for esophageal cancer in the patients.

Objective To evaluate the efficacy of dexmedetomidine and dezocine used to supplement awake tracheal intubation assisted by fiberoptic bronchoscope (FOB) in elderly patients.Methods Sixty elderly patients aged 65-77 yr,of ASA physical status Ⅱ or Ⅲ (Mallampati grade Ⅰ or Ⅱ),scheduled for elective surgery under general anesthesia,were randomly divided into 3 groups (n =20 each) using a random number table:dezocine group (group DEZ),dexmedetomidine group (group DEX) and dezocine combined with dexmedetomidine group (group DEZ+DEX).Dezocine 0.1 mg/kg was injected intravenously in group DEZ.Dexmedetomidine 0.4 μg/kg was infused intravenously over 10-15 min in group DEX.In group DEZ+DEX,dexmedetomidine 0.4 μg/kg was infused intravenously over 10-15 min,and dezocine 0.1 mg/kg was injected simultaneously.Laryngeal mucous membrane was sprayed with 2％ lidocaine for topical anesthesia during infusion in all the three groups.In addition,1％ tetracaine 3 ml was injected into trachea through cricothyroid membrane.Awake tracheal intubation was performed and assisted by FOB after the end of administration in all the three groups.Cardiovascular response (MAP or HR＞30％ of baseline values) and respiratory depression (SpO2＜90％ and RR＜8 bpm) were recorded during the period between induction of anesthesia and 3 min after intubation was completed.The intubation time was recorded.The tolerance of tracheal tube was assessed in the patients.At the time of topical anesthesia,when epiglottis came into view,immediately after tracheal tube was successfully inserted into trachea,and at 3 min after successful intubation,perfusion index and Ramsay sedation score,and patients' satisfaction with the sedation (Ramsay sedation score 2-4) were recorded.Results Compared with group DEZ or DEX,the tolerance of tracheal tube was significantly enhanced,intubation time was shortened,the rate of satisfactory sedation was increased,perfusion index and the incidence of cardiovascular response were decreased in DEZ+DEX group.There was no significant difference in respiratory depression among the three groups.Conclusion Dexmedetomidine and dezocine can provide better condition for awake tracheal intubation assisted by FOB than dexmedetomidine or dezocine alone in elderly patients.

Objective To explore a 3D printing model of fracture restoration which can be used in preoperative planning and design for distal tibiofibular fractures.Methods A retrospective analysis was performed of the 35 patients with distal tibiofibular fracture who had been treated from October 2015 to September 2016 at our department.Bilateral tibiofibular CT scan was performed in all the cases to obtain Dicom data.Using Mimics 15.0 software,cross sections were created at 5 cm,10 cm and 15 cm above the knee joint at the bilateral upper tibiae and marked as PT5,PT10 and PT15.The long and short axles on the left and right sides were measured and compared (LL vs.RL;LS vs.RS).After the STL files for 3D models were generated using Mimics 15.0 software,a real-sized 3D model of the distal tibiofibular fracture and a mirror model of the contralateral tibiofibula were printed.The fracture lines were drawn and preoperative manoeuvre was performed on the mirror 3D printed model.The real operation used the implants preoperatively designed;the actual screw lengths were measured and compared radiographically with those designed in the preoperative manoeuvre.Results All the data were collected of the long and short axles on the 3 cross-sections (PT5,PT10 and PT15) of the left and right sides of the proximal tibia.The samples were paired into 6 groups.The correlation coefficients of paired samples were greater than 0.95,showing an extremely strong correlation.The differences between the left and right sides showed no statistically significance in paired samples of LR-RL and LS-RS groups on PT5,PT10 and PT15 cross-sections (P ＞ 0.05).All the 35 cases received surgical operation.The postoperative X-ray review showed fine agreement between actual surgery and preoperative design in terms of screw length and accuracy.The deviations were in an allowable range,leading to satisfactory internal fixation.Conclusions A mirror 3D model of the healthy side is of clinical value to some extent because it can serve as one for an anatomically reduced fracture which can be used for preoperative manoeuvre and preparation of implants.The contrasts between the long and short axles on the 3 cross-sections may simplify and facilitate comparisons of bilateral similarity,avoid the blindness in direct application of the health side mirror model for preoperative planning.

Objective:To explore the effects of miR-27a on the phenotype and cytokine secretion in LPS-stimulated dendritic cells.Methods:Murine bone marrow-derived dendritic cells were transfected with miR-27a mimics and negative control mimics,and then stimulated by LPS for 24 hours.Dendritic cells exposed to LPS were collected for analysis of the DC immunophenotype by flow cy-tometry and supernatants were collected to determine cytokine lever.Moreover,the capability of stimulating allogeneic CD4 T+cell prolif -eration was measured by MLR ( mixed lymphocyte reaction) .Results: The levels of MHCⅡ, CD80, and CD86 were significantly increased in LPS-stimulated dendritic cells when compared with imDC ( P<0.001).Transfection with miR-27a mimics resulted in sig-nificantly lower expression levels in levels of MHCⅡ,CD80,and CD86 (P<0.001).For cytokine secretion,transfection with miR-27a mimics enhanced IL-10 production (P<0.01) and reduced the production of IL-12 (P<0.05).For MLR,transfection with miR-27a mimics suppressed allogeneic CD4+T cell proliferation.Conclusion: MiR-27a may play critical roles in regulating the maturation process and cytokine secretion in LPS-stimulated dendritic cells.

Objective To investigate the anti-tumor effect of interferon-?(IFN-?) gene therapy on colon cancer. Methods BALB/c mice were inoculated subcutaneously with CT26 (murine colon carcinoma cell line) cells to prepare an in vivo tumor model. Eight days after tumor inoculation,the tumor-bearing mice were divided into 3 groups and injected intra-tumorally with one of the following preparations: pcDNA3-IFN-?/Lipofectamine,pcDNA3 /Lipofectamine,and PBS respectively. The expression of IFN-?,the immunity function of mice,the histological changes of the tumor,the tumor volume in tumor-bearing mice were tested after gene therapy. ResultsThe level of IFN-? in the serum and the CTL activity increased significantly( P