Objective To evaluate the influence of partial parenteral nutrition on serum osmotic pressure,blood glucose,(biochemistry),bilirubin metabolism,immune function,growth and development of premature infants.Methods Seventy premature infants were randomly divided into control group and study group.On the base of enteral feeding,study group were offered parenteral nutrition, while the control group were supplied 10% glucose, fluid and electrolytes. Simultaneously, relevant indices were measured in 2 groups.Results 1.There were no significant difference in serum osmotic pressure,blood glucose and biochemistry before and after parenteral nutrition. 2.There were no significant difference in emerging and lasting time of jaundice between 2 groups.3.Serum IgG,IgA,IgM,C_3,CD4 and CD4/CD8 in study group were significantly higher than those in control group. 4.In study group the time of hospitalization and birth-weight regain were significantly shorter than those in control group.Conclusions There is no significant influence on serum osmotic pressure,blood glucose, biochemistry and bilirubin metabolism during partial parenteral nutrition. Parenteral nutrition may help gain weight, shorten the time of hospitalization, and improve immunological function of neonates.

Objective To investigate the risk factors for the prognosis of radical resection in elderly patients with colorectal cancer.Methods A total of 416 patients with colorectal cancer aged over 65 years were analyzed retrospectively,who came from Peking University First Hospital and Beijing Hospital from July 2008 to July 2011.Survival analysis was conducted by Kaplan-Meier and the survival rate was compared by Log-rank method.Multivariate analysis was conducted to analyze the prognostic factors by Cox regression.Results In this group of patients,the age was(74.3 ±5.4)years,and the post operative 5-year survival rate were 84.5％,77.3％,48.2％ respectively for staging Ⅰ,Ⅱ,Ⅲ patients.Univariate analysis showed that age,ASA score,co morbidity,preoperative hypohemia,preoperative hypoalbuminemia,postoperative complications,elevated preoperative carcinoembryonic antigen (CEA),intraoperative blood loss,perioperative blood transfusion,vascular cancer embolus,nerve invasion,depth of invasion,lymph node metastasis,tumor TNM stage and adjuvant therapy were correlated with the prognosis.Multivariate analysis showed that age ≥75 years,co morbidity,postoperative complications,preoperative albumin＜30 g/ L,depth of invasion,and lymph node metastasis,tumor TNM stage and adjuvant therapy were the independent risk factors for prognosis.Conclusions The risk factors for prognosis after radical resection in elderly patients with colorectal cancer include age≥75 years,co-morbidity,postoperative complications,preoperative albumin ＜30 g/L,depth of invasion,and lymph node metastasis,tumor TNM stage and adjuvant therapy.

Acute Disease ; Adult ; Bridged-Ring Compounds ; poisoning ; Female ; Humans ; Male ; Middle Aged ; Rodenticides ; poisoning

Classic problem-based learning ( PBL ) was applied in a medical microbiology course.The results of questionnaire survey showed most of the students were satisfied with the whole learning program.They thought the case was appropriate,and the discussing could increase their understanding of the knowledge.Based on the problems faced during the application and the students' feedback,the duty of the tutors,summary of the learning topic,arrangement of the course,application of different teaching methods,and selection of the tutors were discussed in detail.

Objective To report the therapeutic results of Hybrid external fixator in treatment of open metaphyseal fractures of the tibia.Methods From March 2000 to July 2004,19 cases of proximal tibial meta- physeal fractures and six cases of Pilon fractures were treated with Hybrid external fixators.By Gustilo classification, eight cases were of typeⅡ,10 typeⅢA,five typeⅢB and two typeⅢC.The wounds were closed directly after thorough debridement in 21 cases,and closed by pedicled flap transposition or free flap transplantation in four. Fasciotomy was performed in three.Closed indirect reduction of the fractures was done in 11 cases,while open reduction was carried out through an extended wound or a limited incision in 14.Anatomical reduction was done for the articular fractures,if any,and Hybrid external fixators were employed to stabilize fractures in all the cases in this series.Results All the patients had a mean follow-up of 15.7 months (ranging from 9 to 26 months) which re- vealed bone union of the fracture in all cases with a mean healing time of 8.8 months.Two patients had their external fixators replaced with plates and iliac bone graft to get fracture union.The fixators were removed 2.9 to 21 months (mean,9.4 months) after operation.Except for two cases of secondary healing,all the wounds healed primarily without serious complication,such as infection.The final follow-up revealed a knee motion range of more than 90?in 15 cases,less than 70?in four,whose knee motion range was improved to more than 90?after knee release performed one year later.In all the six cases of Pilon fractures,the ankle joint recovered normal range of motion.Traumatic arthritis occurred in two cases of Piion fracture 11 months after operation.Evaluation by Rasmussen's functional and radiological scoring system demonstrated excellent knee function in 13 cases,good in three,fair in two and poor in one,with a good to excellent rate of 84.2%.The ankle function was excellent in three cases,good in two and poor in one,with a good to excellent rate of 83.3%.Conclusions In treatment of open tibial metaphyseal fractures, the Hybrid external fixator can well maintain the stability of the fragments with a low incidence of soft tissue com- plications and insignificant interference with the knee motion.However the bone healing time can be prolonged with a definite rate of nonunion.

Objective To investigate the influence of hepatectomy combined with splenectomy on curative effect of primary hepatocellular carcinoma patients associated with hypersplenism.Methods Twenty three cases of primary hepatocellular carcinoma associated with hypersplenism were analyzed retrospectively and divided into hepatectomy combined with splenectomy group (n=10) and hepatectomy combined with ligation of splenic artery (n=13). Peripheral blood samples were collected 1 week before operation and 3 monthes after operation respectively. The levels of CD4, CD8, CD16, CD4/CD8, WBC and PLT in the blood were detected. Survival rate between the two groups was compared. Results There were not significant differences in the expressional levels of CD4, CD8, CD16, CD4/CD8,WBC and PLT before operation, bleeding quantity during the operation and rate of severe complications after operation in the two groups. The expressional levels of CD4, CD16, CD4/CD8, WBC and PLT of hepatectomy combined with splenectomy group were much higher in 3 months after operation than those in 1 week before operation and in hepatectomy combined with ligation of splenic artery group (P

Objective:To investigate the clinical and neuroimaging features of atypical teratoid/rhabdoid tumors (AT/RT) of the central nervous system and the survival prognosis in different locations.Methods:The clinical data of 27 patients with AT/RT confirmed by biopsy or postoperative pathology in Sanbo Brain Hospital of Capital Medical University from October 2012 to September 2020 were collected, including 17 males and 10 females, aged (7.6±10.0) years, ranging from 0.2 to 39.0 years old.The clinical features and the results of the first preoperative imaging examination were retrospectively analyzed.The patients were divided into supratentorial, infratentorial and trans supratentorial and infratentorial groups according to the location.The survival time of the three groups was compared by Kaplan-Meier survival curve.Results:All patients presented with headache, including 12 cases with vomiting.There were 12 cases of supratentorial, 10 cases of infratentorial and 5 cases of supratentorial and infratentorial.There were 20 cases of cystic degeneration, 7 cases of calcification, 6 cases of hemorrhage and 13 cases of peritumoral edema.The median survival time of patients with infratentorial AT/RT was longer than that of patients with supratentorial and transtentorial AT/RT (χ 2=7.353, P=0.025). Conclusion:Central nervous system AT/RT is easy to occur in young children, and the survival time of AT/RT patients is longer.

OBJECTIVETo determine the expression of Skp2 in different prostate cancer (PCa) cell lines and tissues, and explore its influence on the androgen receptor (AR) signaling pathway and development of castration-resistant prostate cancer (CRPC).

METHODSThe expression levels of Skp2 and AR in different PCa cell lines were detected by Western blot. After knockdown of Skp2 in the C4-2 and 22RV1 cells transfected with shRNA, the expressions of AR and P27 were determined and the activity of ARR3-Luc measured by dual-luciferase reporter gene assay following treatment with dihydrotestosterone (DHT). The expressions of AR and Skp2 in human naïve PCa or CRPC specimens were detected by immunohistochemical staining followed by analysis of their differences and correlation.

RESULTSThe Skp2 protein expression level was significantly higher in the C4-2 or 22RV1 cells than in the LNCaP cells. DHT treatment increased the expression of Skp2 in the C4-2 cells, but knock-down of Skp2 significantly up-regulated the expression of the well-known downstream protein P27 and down-regulated that of AR. Consistently, DHT treatment increased the activity of ARR3-Luc, while knockdown of Skp2 remarkably decreased it in the C4-2 and 22RV1 cells (P < 0.05). In addition, significantly higher expressions of Skp2 and AR were observed in the CRPC than in the naïve specimens (P < 0.05), with a positive correlation between the two proteins (r = 0.658 1, P < 0.05).

CONCLUSIONSkp2 can enhance the expression and transcription activity of the AR protein in CRPC cells or tissues and is promising to be a critical molecular therapeutic target.

Androgens ; pharmacology ; Cell Line, Tumor ; Dihydrotestosterone ; pharmacology ; Disease Progression ; Gene Knockdown Techniques ; Humans ; Male ; Neoplasm Proteins ; genetics ; metabolism ; Prostatic Neoplasms, Castration-Resistant ; metabolism ; Receptors, Androgen ; genetics ; metabolism ; S-Phase Kinase-Associated Proteins ; physiology ; Transcriptional Activation ; Up-Regulation

Objective To explore the role of the improved computer aided design of the digital three -dimensional titanium mesh in the repair of skull,to reduce the incidence of postoperative epidural hematoma and epidural fluid.Methods Retrospective analysis of 93 cases of skull repair using the three -dimensional titanium mesh was conducted.49 cases in the conventional group used the conventional three -dimensional titanium mesh. 44 cases in the observation group were given the improved three -dimensional titanium mesh.The clinical effect of the two groups was observed.Results In the conventional group,postoperative epidural hematoma occurred in 4 cases, 1 case of epidural fluid.All patients were fine in the observation group.The improved three -dimensional titanium mesh could reduce the incidence of epidural hematoma and effusion(χ2 =4.745,P =0.029).The conventional group and the observation group both had one case of infection after operation,there was no significant difference between the two groups(χ2 =0.001,P =1.000).Conclusion The improved three -dimensional titanium mesh can effective-ly reduce the incidence of postoperative complications and improve the curative effect of the operation.

Objective To understand the clinical features of hepatitis B virus(HBV)/hepatitis C virus(HCV)coinfected patients with different virological profiles.Methods The clinical data of 186 patients with HBV/HCV coinfection from May 1999 to May 2010 in the Third Affiliated Hospital of Sun Yat-Sen University were analyzed retrospectively.The demographic data,epidemiological data,laboratory results and pathological index were analyzed.The statistical analysis was done using t test and chi square test.Results A total of 186 patients were divided into 4 groups:66(35.5%)in HBV DNA(-)/HCV RNA(-)group,8(4.3%)in HBV DNA(+)/HCV RNA(+)group,68(36.6%)in HBV DNA(+)/HCV RNA(-)group and 44(23.7%)in HBV DNA(-)/HCV RNA(+) group.The gender composition,complication incidence,transmission among drug users,alanine aminotransferase(ALT)level,total bilirubin(TBil)level,prothrombin activity(PTA)and hapatitis B e antigen(HBeAg)negative rate were all significantly different among four groups(F or x2=11.578,8.451,11.738,2.669,5.102,4.254 and 18.413,respectively;all P<0.05).In groups of HCV RNA(-)and HCV RNA(+),the proportions of patients infected through drug abuse were 49.3%and 23.1%,respectively(x2=9.987,P:0.002)and blood transfusion transmission were 29.9%and 46.2%,respectively(x2=4.412,P=0.036).When HBV DNA was negative,the median ALT levels in HCV RNA(-)and HCV RNA(+)patients were 177 U/L and 62 U/L,respectively(t=2.200,P<0.05),median TBil levels were 133 μmol/L and 20μmol/L,respectively (t=3.608,P<0.05)and PTA were 70.6%±27.7%and 83.3%±27.8%,respectively(t=-1.982,P<0.05).The HBeAg negative rate was not affected by HCV RNA levels(t=0.707,P>0.05).The HBeAg negative rate in HBV DNA(-)patients was 85.5%,which was higher than that in HBV DNA(+)patients(59.2%)(x2=16.393,P<0.05).Conclusions HBV DNA(+/-)/HCV RNA(-)profile were major components in HBV/HCV confection.HBV DNA level is related to disease progression and prognosis,but not relate to disease severity.Liver function damage and disease severity are aggravated with HCV RNA level decreases.HBV DNA level is related to HBeAg negative rate,while HCV RNA level is not related to HBeAg seroconversion rate.