Objective To evaluate the effects of blood perfusion(HP)combined with hemodialysis(HD)on micro inflammation and malnutrition status in patients with maintenance of hemodialysis(MHD). Methods Eighty MHD patients admitted to blood purification center of Wuhan Puai Hospital in Hubei Province were enrolled and randomly divided into two groups. Pure HD group underwent conventional HD for 4 hours,3 times a week,and based on the weekly HD series,the HD+HP group took additionally HP once a week,the therapeutic course in both groups being consecutive 12 weeks. Blood was collected before and after treatment for detection of interleukin-6. (IL-6) and tumor necrosis factor-α(TNF-α) levels by enzyme-linked immunosorbent assay (ELISA), and the serum high sensitivity C-reactive protein (hs-CRP) and homocysteine (Hcy) levels were determined with electrochemiluminescence immunoassay,and the changes in nutritional indexes of hemoglobin(Hb),total protein(TP), albumin(Alb),transferrin(TRF)were observed. Results Compared with the indexes before treatment,in HD+HP group,hs-CRP(ng/L:5.65±2.21 vs. 13.91±2.10),IL-6(ng/L:50.10±6.65 vs. 101.22±21.32),TNF-α(ng/L:80.21±9.41 vs. 197.64±25.47),Hcy(μmol/L:13.31±2.21 vs. 40.96±9.42)were significantly decreased (all P<0.05),and Hb(g/L:106.65±22.21 vs. 92.01±12.10),TP(g/L:62.10±22.65 vs. 51.22±11.32),Alb (g/L:38.21±6.41 vs. 30.84±5.47),TRF(μg/L:196.31±22.21 vs. 161.96±15.42)were significantly increased (all P<0.05);but the above parameters in HD group did not change significantly(all P>0.05). There were statistical significant differences in above indexes after treatment between HD+HP group and HD group〔hs-CRP (ng/L):5.65±2.21 vs. 13.22±1.10,IL-6(ng/L):50.10±6.65 vs. 100.32±25.24,TNF-α(ng/L):80.21±9.41 vs. 196.87±24.54,Hcy(μmol/L):13.31±2.21 vs. 37.23±8.33,Hb(g/L):106.65±22.21 vs. 94.22±13.10,TP (g/L):62.10±22.65 vs. 51.32±12.32,Alb(g/L):38.21±6.41 vs. 32.87±4.54,TRF(μg/L):196.31±22.21 vs. 162.23±15.33,all P<0.05〕. Conclusion HP combined with HD in the treatment of MHD can improve the micro inflammation and malnutrition state in patients with MHD.

Autophagy is a degradation process of intracellular composition.It can be divided into four different stages,including initiation,elongation,maturation and autophagosome breakdown.Its role is associated with the degree of cell damage.Moderate activation of autophagy in the case of starvation and hypoxia can promote cell survival; whereas excessive activation during cerebral ischemia can cause cell lysis and promote cell death.Preconditioning may produce ischemic tolerance by appropriate activation of autophagy.Autophagy is strictly regulated by a variety of protein kinases,apoptotic molecules and oxidative stress pathways.

Objective To investigate the correlations between plasma indoxyl sulfate and p-cresyl sulfate in the pathogenesis of cardiovascular complications in maintenance hemodialysispatients.Methods A total of 145 maintenance hemodialysis patients were selected.The researchers measured the physiological parameters of the subjects,including pre albumin,albumin,hemoglobin,blood urea nitrogen,creatinine,uric acid,calcium,phosphorus,alkaline phosphatase,total cholesterol,triglyceride,low-density lipoprotein cholesterol,high-density fat cholesterol,intact parathyroid hormone,C-reactive protein,apolipoprotein,lipoprotein,homocysteine,beta 2-microglobulin,sulfuric acid indoxyl,sulfuric acid cresol,serum iron,transferrin,ferritin,and N-terminal pro brain natriuretic peptide carrier.Subjects underwent cardiac ultrasound examination.Results The researchers used heart structure and function as the dependent variable.The single factor Cox regression analysis showed that the risk of heart structure and function changes increased with the increase of systolic blood pressure,N-terminal B-type natriuretic peptide,and left ventricular mass index.This study also showed that the risk of heart structure and function changes in patients with previous history of coronary heart disease also increased.The researchers took the systolic blood pressure,coronary heart disease history,N-terminal brain natriuretic peptide,and the left ventricular mass index as the dependent variables.Multifactor Cox regression analysis showed that the history of coronary heart disease,the high left ventricular mass index and the change of the heart structure and function of the patients with acute coronary heart disease were the independent predictors of the change of heart structure and function.The researchers used cardiovascular complications as the dependent variable.Cox regression analysis showed that,with the increase in patient's age,dialysis duration,elevated high C-reactive protein and sulfuric acid p-cresol,patients suffering from the risk of fatal cardiovascular complications rise.The researchers used the complications of cardiovascular deaths as dependent variable,age,duration of dialysis,C-reactive protein,and sulfuric acid p-cresol as covariates,multivariate Cox regression analysis of the results showed that with increasing age,dialysis duration increased,high sulfate of cresol and C-reactive protein,patients suffering from the risk of death from cardiovascular complications rise.Conclusions The history of coronary heart disease,left ventricular mass index,systolic blood pressure,indoxyl sulfate,Nterminal brain natriuretic peptide,age,dialysis age,high C-reaction protein,and p-cresol sulfate are the independent risk factors for cardiovascular complications.The relationship between indoxyl sulfate and sulfuric acid serum concentration of p-cresol and adverse cardiovascular events is most closely.

ATP-sensitive potassium channel congenital hyperinsulinism (KATP-HI) is the most common and most severe type of congenital hyperinsulinism,accounting for 40％-45％.It is due to the inactivating mutations of the ABCC8 and KCNJ11 gene which encode the ATP-sensitive potassium channel.Diazoxide is the main and preferred therapy for KATP-HI.For KATP-HI children who are unresponsive to medical therapy usually need different degrees of pancreatectomy to maintain normal blood sugar level.

Objective To investigate and analyze the perioperative nursing of patients with breast cancer, and explore the effectiveness of the application of mind map in perioperative nursing care of patients with breast cancer. Methods The cluster sampling method was employed, and 265 patients with breast cancer receiving radical mastectomy treatment from department of general surgery of the First Affiliated Hospital of Liaoning Medical University were gathered according to the inclusion and exclusion criteria. 137 cases were assigned to test group (May 2014 to April 2015), and 128 cases were assigned to control group (May 2013 to April 2014 ). Nursing work was improved by establishing research group, discussing the design of perioperative nursing mind map and applying mind maps. Effect was evaluated by evaluating the incidence of postoperative complications in patients with breast cancer, the quality of patient′s life and the patient′s satisfaction. Results The incidence of bleeding, seroma, flap necrosis, upper extremity swelling and other postoperative complications of patients with breast cancer in test group was 26.28%(36/128),and that in control group was 73.44%(94/137). The differences between the two groups were of statistical significance (χ2=58.891, P<0.01). The perioperative survival quality scores of physiology, society/family, emotions, function, additions and total in the test group were (2.43 ± 1.09), (2.64±0.97), (2.85±0.97), (2.43±1.09), (2.22±1.12),(2.34±1.13), and that in the control group were (1.89± 1.09), (1.89 ± 1.06), (1.78 ± 0.92), (1.89 ± 1.09), (1.76 ± 1.05), (2.00 ± 1.09)respectively. The differences between the two groups were statistically significant (t=4.664-10.829,P<0.01). The proportion of patient satisfaction in test group was 94.89%(130/137),and that in control group was 82.03%(105/128), respectively. The differences between the two groups were statistically significant (χ2=10.900, P < 0.01). Conclusions Application of mind map in nursing intervention is able to help nurses to grasp the key content and direction of perioperative nursing on patients with breast cancer. More importantly, not only can it improved patients′quality of life and reduce the incidence of postoperative complications, but also increases patients′satisfaction.

Objective Heart failure is due to a variety of reasons cause of the heart to lose their official duty. The heart will not be able to work properly to meet the needs of the body, it is called pump failure. It significantly reduces the patients living ability and quality of life. Appropriate exercise training as an adjuvant therapy of heart failure can make these conditions have been improved. The present study reviewed the influence of moderate exercise training to patients with heart failure′s related factors( e. g. cardiac function,quality of life, medical expenses,etc) .

Objective To measure the operative length of the radioactive source with RL_HZJ18 afterloading machine.Methods The ways of direct measurement and treatment plan are both collected to measure.Results Both of the ways can measure the operative length,and the error of length can be accurate to 1mm.Conclusion The way is simple,practical,good maneuverability,it is worth the trial and promotion.

Objective To discuss the influence of the progress and result in gastic cancer operation through application of neo-adjuvant chemotherapy in multi-disciplinary team (MDT).Methods Clinical data of the patients treated in MDT model 45 cases and non-MDT model(78 cases) were respectively analyzed,and the index about pathologic change,histologic transform and operative result between the two groups were compared.Results In the index of pathologic change,the incidence of abdominal adherence and ascites and pyloric obstruction in MDT model group were obviously less than non-MDT model group( P ＜0.05 ).In the index of histologic transform,texture of mesentery in MDT model group was more fragile than non-MDT model group( P ＜0.05).In the index of operative results,the operative duration and intra-operative bleeding in MDT model group were less than non-MDT model group (P ＜0.05).Conclusion Neo-adjuvant chemotherapy has certain influence in gastric caneer operation,but the successful operations were performed by standard and correct procedures.Therefore,optimizing combined therapy in MDT model and constructing preoperative evaluation system with neo-adjuvant chemotherapy.

BACKGROUND:Brain-derived neurotrophic factor (BDNF) has widespread effects on dopaminergic neurons, cholinergic neurons and other neurons, which can promote more differentiation of stem cells into neuron-like cells. Hypoxia inducible factor-1α(HIF1α) can improve tissue and cellviability in the ischemic environment and maintain the local microenvironment of hemangioblasts, which has a more far-ranging physiological role than genes. OBJECTIVE:By constructing double gene recombinant adenovirus vector with BDNF and three points mutant HIF1αto complete the transfection of adenovirus vector into rats mesenchymal stem cells and then study the promoting nerve regeneration and angiogenesis effect of these two genes to spinal cord injury in vitro in constant oxygen conditions. METHODS:(1)We finished the site-directed mutagenesis of 402, 564 and 803 amino acids in human HIF1αgene CDS region by PCR method and we finished recombination of mutation posterior HIF1αgene and BDNF into adenovirus pAdEasy-1 system. Packaging viral and titration determination were also finished. (2)Four kinds of virus fluids and blank group were selected for subsequent experiments. We observed transfection efficiency after transfection of virus into bone marrow mesenchymal stem cells and detected the expressions of BDNF and HIF1αmRNA and protein in transfection cells. (3) The protein expression of vascular endothelial growth factor, downstream formation vascular gene of HIF1α, in cells in al groups was detected by western blot assay. RESULTS AND CONCLUSION:(1)The site-directed mutagenesis of 402, 564 and 803 amino acids to alanine in coding sequence region was successful. The construction of four kinds of adenoviral recombinants was successful and identification of packaging was completed. (2)The level of BDNF gene mRNA and protein expression in experimental and positive control 1 groups was significantly higher than that in the other groups (P<0.05). The level of HIF1αmRNA and protein expression in experimental and positive control 2 groups was significantly higher than that of the other groups (P<0.05). The level of vascular endothelial growth factor protein was also increased in the experimental and positive control 2 groups, which was significantly different from other groups (P<0.05). These findings indicate that the BDNF and HIF1αproteins are largely and efficiently expressed in constant oxygen conditions after single vector double gene adenovirus system transfection into mesenchymal stem cells and high-efficiency expression of vascular endothelial growth factor protein is promoted so that this is a new direction for treatment of spinal cord injury by gene therapy combined with celltransplantation.

Objective EpCam and Wnt/ β-catenin pathway in colon carcinoma and its clinic-pathological significance of the distribution,studying the relationship between EpCam and Wnt / β-catenin.Methods Retrospective analysis detected by immunohistochemistry 60 cases of colon cancer,20 cases of adjacent atypical hyperplasia,60 normal colon tissue EpCam and Wnt / β-catenin protein expression.Results (1)normal colon tissue,cancer tissue and cancer tissue showed positive expression EpCam clear upward trend,were 23.5％,62.3％,96.5％ ; with normal colonic mucosa to cancer transformation,β-catenin in the membrane expression of the positive rate decreased,while the cytoplasm is followed by increased expression rate in poorly differentiated carcinoma or even nuclear expression,EpCam strong positive expression of Wnt / β-catenin cytoplasmic-positive rate of histological type,depth of invasion,lymph node metastasis; (2)the EpCam with the Wnt / β-catenin expression showed a positive correlation (r =0.653,P ＜0.05) ;(3)high expression EpCam and Wnt / β-catenin in patients with colon significant increase in cancer recurrence rate and 5-year survival rate was significantly reduced.Conclusion EpCam and Wnt / β-catenin pathway in colon cancer positively is correlated,EpCam and Wnt / β-catenin is connected with high expression and tumor invasion,metastasis and prognosis.