Objective To investigate the clinical and CT characteristics of metastatic brain carcinoma and the differential diagnosis with other intracranial lesions and promote diagnostic level one step more,and to diminish misdiagnosis.Methods 106 cases metastatic brain tumor confirmed by CT and other methods in our hospital from 1990 to 2005 were retrospectively studied about clinical appearance and the relationship with anatomy and physiology,characteristics of CT and the main point of differential diagnosis.Results Metastatic brain carcinoma mainly could be devided to three following types based on clinical expressions,among them,apoplexic type dominated 46 cases(43.4%),epileptic type 26 cases(24.5%),brain tumor type 24 cases(21.6%),the clinical expressions correlated to anatomy and phyiology of lesion in each type,CT plain scan most appeared low density or equal density space occupying enhanced CT scan foci showed different degree stronger in lesion,and characteristic of perifocal edema.Conclusion The clinical appearance of brain metastatic carcinoma is various,easily misdiagnosed in early stage,looking for the primary tumor is the rather important diagnostic dependencies,enhanced CT scan is an important diagnostic method.

Objective:To investigate the effects of two different routes of nutrition support on the treatment of severe pneumonia in elderly patients.Methods:From January 2015 to January 2016,84 elderly patients with severe pneumonia in our hospital were randomly divided into two groups,42 patients in each group.The enteral nutrition (EN) group was treated with nasogastric feeding and another group was defined as combined treatment group.After 4 weeks of treatment,the nutritional status of two groups of patients was compared.The incidence of complications during treatment were documented.Results:After treatment,the hemoglobin was (111.34 ± 20.33) g/L,and the albumin was (23.33 ± 5.09) g/L in the EN group.The hemoglobin was (132.13 ±24.39) g/L,and the albumin was (35.43 ±9.12)g/L.There was significant difference between the two groups (P ＜ 0.05).The cure rates of the two groups were 92.86％ and 95.24％,respectively,and there was no significant difference (P ＞ 0.05).Conclusion:For elderly patients with severe pneumonia,the combination of enteral and parenteral nutrition is more likely to improve the nutritional index,and has a lower incidence of adverse events.

Objective To observe the expression of triggering receptor-1 on myeloid cells (TREM-1) of mice with acute lung injury (ALI) in oder to find out its regularity and significance in inflammatory response of or-ganisms. Method Thirty BALB/C mice were randomly(random number) divided into normal control group (n =6) and ALl group (n = 24). The models of ALI were made with intraperitonal injection of lipopolysaccharide (LPS) in dose of 10 mg/kg. Specimens from peripheral blood and lung tissue were collected 6 h, 12 h, 24 h and 48 h after LPS injected. The fluorescent real-time quantitative reverse transcriptiun-polymerase chain (RT-PCR) was used to detect TREM-1 mRNA, and ELISA was employed for detection of TREM-1 protein and TNF-α protein, and HE staining was made doe the pathological Smith lung score under light microscope. Analysis of variance was used for comparison of TREM-1 mRNA, TNF-α and Smith lung injury score between two groups. Spearman corre-lation analysis was made to find out the relationship among these three variables. Results The expressions of TREM-1 mRNA in lung tissue of ALI mice 6 h, 12 h, 24 h, and 48 hours after injection of LPS were 6.61±0.08,34.71±0.83, 61.85±14.05 and 56.46±8.89, respectively which were higher than that in control group (1.00±0.00, P = 0.017, 0.009, 0.002 and 0.003, respectively). The expressions of TREM-1 mRNA in blood were 14.01±3.24, 47.07±0.98, 8.18±0.43 and 8.06±0.05, respectively which were higher than that in normal control group (1.00±0.00, P = 0.010, 0.004, 0.011 and 0.011, respectively). The expression of TREM-1 rnRNA in tissue began to increase 6 hours after modeling and reached its peak 24 hours later, and expres-sion of TREM-1 mRNA in blood reached its peak after 12 hours. The levels of TREM-1 protein in lung tissue of ALl mice 6 h,12 h,24 h and 48 hours after LPS injected were 997.8±114.62, 1579.70±45.92, 1123.9±108.2 and 429.8±89.96 pg/mL, respectively which were higher than that of mice in control group (279.22±4.62 pg/mL, P = 0.024, 0.007, 0.011 and 0.04, respectively). The level of TREM- 1 protein reached the peak 12 hours after LPS injected, but it had no significant correlation with the expression of TREM-1 mRNA (P =0.14). The levels of TNF-α protein in lung tissue of ALI mice 6 h, 12 h, 24 h and 48 hours after LPS injection were 313.16±39.50, 491.91±96.65, 388.48±29.84 and 282.5±52.76 pg/mL, respectively which were sig-nificantly higher than that of mice in control group (256.6±28.31 pg,/mL, P = 0.037, 0.019, 0.032 and 0.043, respectively). The TNF-α concentration was positively correlated with TREM-1 levels in lung tissue and with Smith pathological score (r = 0.795, P = 0.001: r = 0.499, P = 0.034), but not with the expression of TREM-1 mRNA (P = 0.176). Conclusions The expression of TREM-1 mRNA in lung tissue of mice with ALI is elevated, and the expression of TREM-1 mRNA is related to the level of TNF-α and the severity of the ALI in in-flammatory responses in lung. The expressions of TREM- 1 gene are not consistent with the levels of TREM- 1 pro-tein, suggesting another new functional proteins involved in immune regulation.

Objective To explore the effect of 25% insulin lispro( Mix 75/25) intensive treatment on plasma glucose and pancreatic function in newly diagnosed type 2 diabets. Methods Sixty patients with newly diagnosed type 2 diabetes were treated by 2 months 25% insulin lispro(Mix 75/25) treatment. The level of fasting plasma glucose (FPG) ,2 hours postprandial glucose (2hPG), glycosylated hemoglobin A1c (HbA1c), the fasting insulin and Cpeptide, insulin resistance index (HOMA-A), insulin secretion index (HOMA-B), insulin sensitivity index (ISI) and the ratio of fasting insulin to fasting glucose(FINS/FPG) were compared before and after 25% insulin lispro(Mix 75/25) treatment. Results After the treatment,FPG,2hPG,HbA1c and HOMA-A were significantly decreased( all P＜0. 01 ) ;the fasting insulin and C-peptide,FINS/FPG, HOMA-B and ISI greatly increased( all P＜0. 01 ). Conclusion 25% insulin lispro( Mix 75/25) intensive treatment can effectively improve plasma glucose and pancreatic function in newly diagnosed type 2 diabetes.

Objective To investigate and analyze the effect and insulin dosage of insulin pump in type 2 diabetes. Methods 63 hospital patients with type 2 diabetes(FPG≥12mmol/L), who had poorly controlled blood glucose, were treated by insulin pump for 14 days, without hypoglycemic agents. The treatment days when blood glucose was well controlled and the insulin dosage at that time were observed. FPG, CBG, HbA1c, FINS/FPG, ISI, Homa-B and Homa-IR were measured before and after insulin pump. Results When blood glucose were well controlled, the mean time was (5.4+1.6) days, the insulin was (0.6+0.2)U/kg, the basal insulin was 38%. The dosage of insulin was decreased after blood glucose were controlled. Reaction of hypoglycemia was (0.6+0.2). After 2 weeks insulin pump intensive treatment, the result of FPG, CBG, HOMA-IR and HbA1c were significantly decreased (all P<0.01); FINS/FPG, HOMA-B and ISI were incleased (all P<0.01). Conclusion The excellent glycemic control and improvement of beta-cell function can be induced by short-term insulin pump intensive therapy in diagnosed type 2 diabetic patients with severe hypoglycemia.

BACKGROUND: With the rapid development of tissue engineering, a single biological scaffold material is hard to meet the needs of tissue engineering. Therefore, composite scaffolds with excellent performance will be obtained by combining two or more kinds of materials.OBJECTIVE: To detect the adherence and proliferation of dental pulp stem cells on the Chitosan-fibrin composite scaffold.METHODS: Dental pulp stem cells were isolated and extracted from C57 neonatal rats through modified enzyme-digestion method, and subcultured to the third generation, followed by adipogenic and osteogenic induction in vitro. Then, induced cells were identified. The chitosan-fibrinogen composite scaffold was prepared, and the pore size and porosity were determined. The chitosan-fibrin composite scaffold was co-cultured with passage 3 dental pulp stem cells to observe the cell proliferation by MTT assay, and the morphology of the composite scaffold, cell adhesion,proliferation and extracellular matrix secretion were observed under scanning electron microscope. In addition, the cells were inoculated directly on the bottom of culture plate as controls.RESULTS AND CONCLUSION: The dental pulp stem cells were successfully isolated and cultivated, and positive for osteogenic and adipogenic differentiation. The pore size and porosity of the composite scaffold was (105.32±22.10) μm and (87.714±1.276)%, respectively. The S-shaped proliferation curve in the experimental group was similar with that in the control group; the proliferation rate in the experimental group was significantly higher than that in the control group after 4-8 days of culture (P < 0.05). At the 2nd day after co-culture, the cells adhered tightly and grew well onto the composite scaffold; at the 4th day, enlarged cells began to proliferate obviously with abundant extracellular matrix; the surface and pores of the scaffold were full of cells at the 6th day. These results indicate that the chitosan-fibrin composite scaffold is suitable for the adhesion and proliferation of dental pulp stem cells.

Objective To investigate the effective method of the treatment of leg fracture with severe sofe tissue defects by microsurgery. Methods Seventy-five cases of the leg fracture with severe sofe tissue defects were treated by completed debrided,used different fracture fixation and surgical flaps. Results Only partial necrosis happened in 1 case,and all the other flaps survived. The appearance and functions were achieved after 6 months to 4 years of follow-up. Conclusion Selecting different fracture fixation and microsurgical techniques flap improve successful rates,markedly reduce the deformity rates and complications of leg fracture with severe sofe tissue defects.

Adaptive physiological changes during pregnancy lead to increased fragility of the liver, impaired buffer capacity, and rapid disease progression, and such changes may weaken the signals or clinical manifestations of liver diseases, which increases the difficulties in early diagnosis and treatment. However, severe liver disease is a dynamic process, and timely identification of early signs of liver disease during pregnancy and establishment of early diagnosis and disease severity scoring system based on big data are the basis for determining the diagnosis and treatment of liver disease during pregnancy and deciding the timing and mode of delivery, as well as the key to improving the cure and reducing the mortality rate of liver disease during pregnancy.

Objective To investigate the safety and therapeutic effects ot a novel multi-layer flat-plate bioartificial liver (BAL) for patients with liver failure.Methods Thirty-eight patients with liver failure from Dec.2010 to Dec.2011 were treated with a novel BAL based on multi-layer flatplate bioreactor and the co-cultured cells of the porcine hepatocytes and mesenchymal stem cells.A total of 48 treatments was performed,4 h each time.The clinical signs and symptoms,liver function,ammonia,coagulation function and complete blood count were evaluated before,during and after the treatment.DNA in the collected PBMCs was extracted for PCR with PERV specific primers and the porcine specific primer Sus scrofa cytochrome B.The RT activity was detected as well.Levels of xenoantibodies (IgG,IgM) were determined by using ELISA kit. Titers of complement were quantified by CH50 kit.Results All treatment procedures were completed successfully without any adverse reaction. All samples presented negative PERV DNA and RT activity. The levels of antibodies were similar before and after treatment.Treatment was associated with a temporary decline in levels of complement,and then the levels were recovered quickly.The clinical symptoms such as acratia,anorexia and abdominal distension were improved.The stage of hepatic encephalopathy in 16 patients was decreased. The liver function and ammonia was reduced disproportionately. Seven patients in all were bridged to liver transplantation,2 patients died and 2 patients gave up the treatment,and the others were turned better.After the outcome judgment according to the standard developed by the Artificial Liver Group,and Chinese Association of Infectious and Parasitic Diseases,there were 9 patients with clinical healing,25 patients with improvement and 4 patients with no effect,and the cure-improvement rate was 89.5％.Conclusion The novel multi-layer flat-plate BAL could be used as a safe and effective therapy for patients with liver failure.

cryopreservation periodontal tissue. METHODS:Periodontal tissue was scraped from healthy human teeth and divided them into three equal parts:fresh group, harvesting periodontal ligament stem cel s from fresh tissue;5%dimethyl sulfoxide group, 5%dimethyl sulfoxide added into the cryopreservation system;10%dimethyl sulfoxide group, 10%dimethyl sulfoxide added into the cryopreservation system. One month later, periodontal ligament stem cel s were extracted from the cryopreserved periodontal ligament from the latter two groups. RESULTS AND CONCLUSION:In the time that cel s swam out of tissue mass and cel harvest amount, the 5%dimethyl sulfoxide group was inferior to the fresh group but better than the 10%dimethyl sulfoxide group (P<0.05). No differences were found among the three groups in the fol owing aspects (P>0.05):colony formation rate of passage 1 periodontal ligament stem cel s, cel survival rate, proliferation ability of passage 3 periodontal ligament stem cel s, cel growth curve and surface marker expression of periodontal ligament stem cel s. The results suggest that the 5%dimethyl sulfoxide added cryopreserved system for periodontal ligament tissue cannot only shorten the time of periodontal ligament stem cel s amplification in vitro, ensure cel harvest and maintain basic cel ular biological characteristics, but also reduce the total amount of the dimethyl sulfoxide and the direct damage to the cel s caused by repeatedly frozen cel s, thereby providing a more secure guarantee for the future implementation of clinical transplantation therapy. So, the 5%dimethyl sulfoxide added cryopreserved system may be the new selection for donor tissue storage.