Objective To investigate the changes of intestinal mucosal barrier function and protection of alanyl-glutamine(Alm-Gln) dipeptide during early stage of postthoracotomy in aged patients.Methods A prospective,randomized and controlled trial was conducted and 20 aged patients who underwent non-digestive thoracotomy were randomized into two groups,experimental group (intravenous administration of Aln-Gln dipeptide,0.5 g/(kg · d),for 4 days,n =10) and control group(equal amount saline as placebo,for 4 days,n =10).The indices of boby temperatures,heart rates,respiration and white blood cell count of all patients were daily recorded during administration.Serum concentrations of glutamine (Gln),D-lactate,diamine oxidase (DAO) and tumor necrosis factor-α(TNF-α) were measured before and after operation.Results There were no statistically significant differences in the patients' general information between experimental group and control group including age,gender and body weight.Plasma Gln concentration in postoperative 5 days was higher than that of pre-operation of experiment group ((478.32 ± 47.42) μmol/L vs.(372.67 ± 29.14) μmol/L,P =0.021).The plasma Gln level of control group at 5th day after operation was higher than that in pre-operation ((431.12 ± 42.27) μmol/L vs.(386.29 ± 19.73) μmol/L,P =0.017).The plasma level of Gln in experimental group was significantly higher than that in control group after operation((478.32±47.42) μmol/L vs.(386.29 ± 19.73) μmol/L,P =0.012).There were no significantly differences between the two groups in terms of the plasma level of DAO and D-lactate before operation (P ＞ 0.05).Meanwhile the levels of DAO and D-lactate in both group at 5th day after operation were significantly higher than that at before operation(DAO:(2.53 ±0.47) U/ml vs.(1.66±0.32) U/ml,P =0.003;D-lactate:(6.82 ±1.91) mg/L vs.(4.92 ±1.57) mg/L,P =0.024),and the levels of them in experimental group were significantly lower than that in control group(DAO:(1.10 ± 0.23) U/ml vs.(2.53 ± 0.47) U/ml,P =0.013 ; D-lactate:(4.87 ± 1.33) mg/L vs.(6.82 ± 1.91) mg/L,P =0.019).The concentration of TNF-α was significant increase in both two groups at first day after operation,but decreased at the third day.The concentration of TNF-α in experimental group at 5th day after operation was lower than that in control group ((6.89 ± 5.21) pg/L vs.(13.04 ± 4.46) pg,/L,P =0.003).The morbidity of systemic inflammatory response syndrome (SIRS) was significantly decreased in experimental group and the rate of SIRS was also lower than that in the control group(P ＜ 0.01).Conclusion Intestinal mucosal barrier function was damaged after thoracotomy in aged patients.Administration of Aln-Gln dipeptide could increase the level of serum Gln,protect the intestinal barrier and attenuate the systemic inflammatory response.Aln-Gln dipeptide can be used to help aged patients recover rapidly.

Objective To investigate the changes of expression of N-methyl-D-aspartate receptor(NMDAR)and mitogen activated protein kinase(MAPK)in Alzheimer disease(AD)rat model. Methods AD rat model was established by injection of amyloid-beta protein 1-40 1?l(10 g/L)into hippocampus of rat.NMDAR-mRNA and MAPK protein were immunostained by in situ hybradization histochemistry and immunohistochemistry respectively.Learning and memory ability,LTP were determined by Morris water maze and electrophysiological methods respectively. Results The escape latent was prolongated in Alzheimer rats two weeks after injection of A? than in control rats and in rats before the injection of A?(P

ObjectiveTo observe the effect ofZuogui Jiangtang Jieyu Formula on the expressions of glutamate, NR2A and NR2B in hippocampus of diabetic rats with depression;To explore the mechanism of protective effect. Methods Diabetes with depression rat models were established and then were randomly divided into the model group, positive medicine group, high-, medium- and low-doseZuogui Jiangtang Jieyu Formula groups. Normal rats acted as normal group, 16 rats per group. After 28 days of administration, Open-field test was used to detect the behavior of the rats;glutamate content of hippocampus was detected by ELISA;the expressions of NR2A and NR2B in rat hippocampus were detected by immunofluorescence.Results Compared with normal group, automatic activity times of rats in model group decreased significantly (P<0.01);both glutamate content (P<0.01) and expressions of NR2A, NR2B (P<0.01) increased significantly. Compared with the model group, automatic activity times of rats in positive medicine group and high-doseZuogui Jiangtang Jieyu Formula group significantly increased (P<0.01);glutamate content dropped (P<0.01);expressions of NR2A and NR2B decreased (P<0.05).ConclusionZuogui Jiangtang Jieyu Formula can improve depressive behavior of diabetic rats with depression, which may be related to the regulation of glutamate content and expressions of NR2A and NR2B in hippocampus.

Objective To evaluate morphological structure of uterosacral ligament (USL) and cardinal ligament (CL) in patients with severe pelvic organ prolapse (POP) by MRI technology, and to analysis and discuss its clinical significance. Methods From November 2013 to February 2014 in Peking University People′s Hospital, 26 elderly patients withⅢ-Ⅳdegree of POP were selected as the POP group and 18 healthy elderly volunteers were selected as the control group during the same period. Pelvic MRI examination were performed in the two groups. The morphological characteristics of left and right side of the uterosacral-cardinal ligament on MRI and the attachment site of the starting and ending points between two group were described and compared. Results In POP group, 25 cases of left USL starting point were located in the sacrospinous ligament/coccygeal muscle complex [58% (15/26)] or coccygeal muscle [38%(10/26)], ending point were located in the cervix and vagina [58%(15/26)] or cervix [38%(10/26)];24 cases of right USL starting point were located in the sacrospinous ligament/coccygeal muscle complex [31%(8/26)]or coccygeal muscle [62%(16/26)], 26 cases of right USL ending point were located in the cervix and vagina [62% (16/26)] or cervix [38% (10/26)]; the left and right CL in the POP group and the control group were both from the sacroiliac joint at the top of the greater sciatic foramen from the ipsilateral pelvic side wall;1 case (4%, 1/26) of left CL in the POP group completely connected to the bladder, 10 cases (38%, 10/26) partly connected to the bladder;14 cases (54%, 14/26) of right CL partly connected to the bladder, the rest ending points of left and right CL were located in cervix and (or) vagina. In the control group, 17 cases of left USL starting point were located in the sacrospinous ligament/coccygeal muscle complex (10/18) or coccygeal muscle (7/18), ending point were located in the cervix and vagina (12/18) or cervix (6/18);18 cases of right USL starting point were located in the sacrospinous ligament/coccygeal muscle complex (10/18) or coccygeal muscle (8/18), ending point were located in the cervix and vagina (13/18) or cervix (5/18);8 cases (8/18) of left CL partly connected to the bladder;15 cases (15/18) of right CL partly connected to the bladder, the rest ending points of left and right CL were located in cervix and (or) vagina. There was no significant difference between the two groups on the starting and ending points (P>0.05). Conclusions The observation of MRI could be consistent with the clinical anatomy on the starting and ending points, direction of travel in the uterosacral-cardinal ligament. The starting and ending points of the left and right side USL and the ending points of the left and right side CL are not completely symmetrical, the variation degree is large, some CL could be completely or partly inserted to the bladder.

Objective To establish the finite element model of uterosacral ligament (USL) and cardinal ligament (CL) and analyze the stress distribution and deformation with USL and CL under different working conditions. Methods Patients with stage Ⅲ-Ⅳpelvic organ prolapse (POP) and healthy female volunteers were selected for research subject, and divided into anterior uterus group and posterior uterus group. Two POP patients and two volunteers were selectd into the anterior uterus group and posterior uterine group respectively. Pelvic MRI scan was performed in two groups. Based on the original MRI data sets, the finite element model of USL and CL was constructed by using the software such as the Mimics, and the stress distribution and deformation of USL and CL were simulated. Results Under the premise of the elastic modulus fixed and three different working conditions such as 60 cmH2O, 99 cmH2O and 168 cmH2O (1 cmH2O=0.098 kPa) with abdominal pressure generated by maximum Valsalva maneuver, according to the present conditions and the simulation, the trend was analyzed: the stress and deformation of the uterus, anterior vaginal wall, USL and CL in two groups were mainly distributed in the middle and lower part of the anterior vaginal wall or the ligament and the cervix-vagina junction, the maximum stress and the maximum displacement were mainly concentrated in the lower region of the anterior vaginal wall. With increasing of abdominal pressure generated by the maximum Valsalva maneuver, the maximum stress values of the POP patient in anterior uterus group under three different working conditions were: 0.027 9, 0.046 0, 0.078 0 MPa, and the maximum displacement values were: 9.145 5, 15.090 0, 25.607 0 mm. The maximum stress values of the volunteer in anterior uterus group under three different working conditions were:0.012 6, 0.020 8, 0.035 3 MPa, and the maximum displacement values were: 1.816 7, 2.997 5, 5.086 7 mm. The maximum stress values of the POP patient in posterior uterine group under three different conditions were: 0.069 4, 0.114 6, 0.194 5 MPa, and the maximum displacement values were:11.658 0, 19.236 0, 32.643 0 mm. The maximum stress values of the volunteer in posterior uterus group under three different working conditions were:0.009 1, 0.015 1, 0.025 6 MPa, and the maximum displacement values were:2.581 6, 4.259 6, 7.228 4 mm. The maximum stress values and the maximum displacement values were all increased with increasing of abdominal pressure in the two groups. The maximum stress values and the maximum displacement values of the POP patients were greater than those of volunteers. Under different working conditions, the maximum stress values and maximum displacement values of the posterior uterus POP patient were all greater than those of the anterior uterus POP patient. Conclusions The finite element model of USL and CL is completely based on the MRI technology and the model is real and reliable. The increase of abdominal pressure will produce a larger stress and deformation of USL and CL, which is one of the reasons causing the injury of the ligament.

Objective To investigate the clinical manifestations and diagnosis of patients with abnormal signal of bilateral pontine brachium on magnetic resonance imaging (MRI),in order to improve the understanding of diseases involving bilateral middle cerebellar peduncles.Methods Combined with auxiliary examination,we compared the clinical manifestations of five patients and analyzed the characteristics of diseases involving bilateral middle cerebellar peduncles.Results MRI was similar in all five patients.Symmetrical T2-weighted,FLAIR-weighted images of bilateral middle cerebellar peduncles were seen on MRI,with corresponding hypointensity on T1 WI of all five patients.No obvious enhancement has been showed.But there were different clinical manifestations and diagnosis of them.The first patient manifested as dizziness,visual rotation,slurred speech and inactivity of right limb.She was diagnosed with acute cerebral infarction.The second patient only manifested as dizziness.Combined with the history of cerebral infarction,he was diagnosed as Wallerian degeneration.The third patient manifested as blindness in the left eye,vision blurred in right eye and numbness of limbs.She was diagnosed with neuromyelitis optica.The forth patient manifested as lisp,walking instability,talk rubbish and hyperspaamia.She took heroin for dozens of times,and was diagnosed with heroin encephalopathy finally.The final patient manifested as ataxia,slurred speech,choking,dysphagia,less facial expression and urinary retention.He was diagnosed with olivopontocerebellar atrophy.Conclusions The etiology of bilateral pontine brachium lesion is complex.Cerebrovascular diseases,demyelinating diseases,infectious and toxic diseases,and neurodegenerative diseases can be involved.The mechanism of bilateral pontine brachium lesions is not very clear and needs to be further explored.

Primary central nervous system lymphoma (PCNSL) is a rare,extranodal form of non-Hodgkin lymphoma that is confined to the central nervous system.It mainly involves the deep brain white matter,the lateral ventricle and the corpus callosum.A decline in cognitive function and headache are the typical clinical manifestations of the disease.We report a patient with PCNSL in bilateral middle cerebellar peduncles,whose clinical manifestations were only dizziness and unstable walking.Brain MRI manifestations were not typical in early time,with symmetrical hypointensity lesions on T1-weighted imaging,hyperintensity lesions on T2-weighted imaging,and edema zone around on FLAIR imaging.Enhanced scan showed marginal contrast enhancement,but no significant occupying effect.These changes were similar to the multiple characteristics of multiple sclerosis.The history of autoimmune diseases and cerebrospinal fluid examination highly indicated demyelinating disease.The differences of clinical manifestations,MRI characteristics,diagnosis,treatment and prognosis between PCNSL in bilateral middle cerebellar peduncles and multiple sclerosis were analyzed to imorove the understanding of the disease in clinical practice.

Resistance to breast cancer (BCa) chemotherapy severely hampers the patient's prognosis. MicroRNAs provide a potential therapeutic prospect for BCa. In this study, the reversal function of microRNA34a (miR34a) on doxorubicin (Dox) resistance of BCa and the possible mechanism was investigated. We found that the relative level of miR34a was significantly decreased in Dox-resistant breast cancer cell MCF-7 (MCF-7/A) compared with Dox-sensitive MCF-7 cells. Transfection with miR34a significantly suppressed the invasion, migration, adhesion of MCF-7/A cells without inhibiting their growth obviously. The combination of miR34a and Dox could significantly inhibit the proliferation, migration, invasion and induce the apoptosis of MCF-7/A cells. The synergistic effect of this combination on resistant MCF-7/A cells has no obvious relation with the expressions of classical drug-resistant proteins P-GP, MRP and GST-