Objective To study the changes of intestinal epithelial barrier function in rats with aging.Methods SD rats were divided into 3 groups:3-month-old group (group A),12-month-old group (group B) and 24-month-old group (group C,established by D-galactose injection with the dose of 0.125 g· kg-1 · d-1subcultaneously for 6 weeks) (n=10,each).The terminal ileum was obtained to make microtome section,and the morphology of small intestine mucous membrane,trophonema altitude and thickness were observed under light microscope.Occludin and ZO-1 protein expressions in terminal ileum mucous membrane were detected by immunohistochemistry.The expressions of Occludin and ZO 1 mRNA were determined by semi-quantitative reverse transcription polymerase chain reaction (RT-PCR).Results The small intestinal mucosa thickness and villus height were lower in group C and B than in group A [thickness:(87.6± 6.32) μm,(131.8± 5.22) μm vs.(162.9±7.28) μm; villus height:(56.4±5.38) μm,(76.7±5.40) μm vs.(108.1±6.42) μm;both P＜0.05].The small intestinal mucosa thickness and villus height was lower in group C than in group B (both P＜0.05).Occludin and ZO-1 protein expressions in small intestine tissue were reduced in group C and B as compared with group A [Occludin protein:(2.23±0.60)％,(4.21±0.61)％ vs.(12.31±0.94)％; ZO-1 protein:(2.03±0.54)％,(4.02±0.65) ％ vs.(12.21±0.81)％ ; both P＜0.05],and Occludin and ZO-1 protein expressions were less in group C than in group B (both P＜0.05).The levels of Occludin and ZO-1 mRNA in small intestine tissue were reduced in group C and B as compared with group A [Occludin:(0.20±0.03),(0.38±0.02) vs.(0.66±0.03) ; ZO-1:(0.18±0.03),(0.37±0.02) vs.(0.63±0.03); both P＜0.05],and Occludin and ZO-1 mRNA expressions were less in group C than in group B (both P ＜ 0.05).Conclusions The small intestinal mucosa thickness and villus height are reduced,the levels of Occludin and ZO-1 expressions are significantly decreased in small intestinal mucosa,and the intestinal barrier function is impaired with rat aging.

Objective To investigate in knowledge rate of 120 first aid and satisfaction rate with emergency services among Nanchong citizens. Methods 360 patients who received prehospital first aid from three hospitals and their accompanies were selected from January to June 2010. The investigation content included knowledge rate of 120 first aid and satisfaction rate with emergency services. Results Results showed that about half of those surveyed still did not know the emergency phone"120" and its function, lacked self-help and self-protection knowledge, some respondents felt quite helpless upon daily life of electric shock, gas poisoning, coma and traumatic accidents. The attitude of the majority of emergency personnel was good or better, but still very stiff or irresponsible attitude existed in those few. This undermined the "120" and the image of credibility and emergency personnel. Conclusions There is an urgent need for universal coverage of on-site first aid knowledge and enhance awareness of first aid. Full-time staff in emergency department must pay close attention to the knowledge of first aid training, mastering the technique of bleeding control and bandaging, fixing, handling and CPR, as well as the use of instruments and equipment equipped in vehicles. Only in this way can we continuously improve the treatment of critically ill patients and increase survival rate.

Objective To evaluate the influence of gestational diabetes mellitus (GDM) on maternal and perinatal outcomes in twin pregnancies. Methods We retrospectively analyzed the clinical features of both twin and singleton pregnancies, which delivered in Guangzhou Women and Children's Medical Center between January 1, 2012 and December 31, 2013. The twin pregnancies were divided into two groups:those with (GDM-T, n=51) and without GDM (non-GDM-T, n=130), which were matched by maternal age and delivery time (within one month) in a ratio of 1∶2 among singleton pregnancies with (GDM-S, n=102) and without GDM (non-GDM-S, n=102), respectively. The differences of adverse maternal and perinatal outcomes among these four groups were examined. The overall assessment of pregnancy outcomes was completed using Delphi method. Statistical analysis was performed with one-way analysis of variance, t test, Kruskal-Wallis test, rank test, Chi-square test or Fisher's exact test. Results (1) When compared to GDM-S and non-GDM-S group respectively, less women conceived with the help of assisted reproductive technology, higher proportion of women underwent and gestational age at delivery tend to be earlier in GDM-T and non-GDM-T group (all P<0.01). In oral glucose tolerance test,the fasting blood glucose level of GDM-T group was higher than the other three groups (F=21.716, P<0.01), the glucose levels at 1 and 2 h were higher than non-GDM-T and non-GDM-s respectively (both P<0.01), but no significant difference was found when compared with GDM-S group (P>0.01). Similarly, no significant difference was found in prenatal glycosylated hemoglobin value between GDM-T and GDM-S group (P>0.01). (2) There was no significant difference in the incidences of hypertensive disorders of pregnancy, anemia, premature rupture of membranes, oligohydramnios, placental abruption, postpartum hemorrhage, asphyxia neonatorum, small for gestational age, hypoglycemia of newborn, hyperbilirubinemia of newborn and perinatal death between GDM-T group and the other three groups(all P>0.01). Higher incidences of hypertensive disorders of pregnancy and postpartum hemorrhage were shown in the GDM-T group than in the GDM-S and non-GDM-S groups, respectively (both P<0.01). The incidences of preterm birth in GDM-T and non-GDM-T group were both higher than that in GDM-S and non-GDM-S, respectively [54.9%(66/102), 53.8%(140/260), 5.0%(10/102) and 3.0%(6/102), all P<0.01], while no significant difference was found between GDM-T and non-GDM-T group (P>0.01). (3) The overall assessment of pregnancy outcomes did not show any difference between GDM-T group and the other three groups (χ2=6.707, P>0.01). However, the score for fetal outcomes in the GDM-T group was higher than in the GDM-S and non-GDM-S group, but lower than in non-GDM-T group [M(Q)=1.0(2.3), 0.0(3.0), 0.0(0.0), 1.0(2.8) score, χ2=122.818, P<0.01]. Conclusions GDM does not increase the risk of adverse pregnant outcomes in twin pregnancies.

Objective: To assess the trends of clinical characteristics, diagnostic and treatment conditions and outcomes for in-hospital patients with ST-segment elevation myocardial infarction (STEMI) in eastern rural China from 2001 to 2011.
Methods: Through a two-stage random sampling, a representative in-hospital STEMI patient group in eastern rural China of 2001, 2006 and 2011 were enrolled. In 1st step, a simple random-sampling procedure was conducted to identify the collaborating hospitals and in 2nd step, a systematic sampling procedure was performed to select representative patients from those admitted to each collaborating hospital for STEMI during the study period. Then we obtained patients’ clinical information from their medical records. Finally, we weighted the ifndings for each year to represent the overall situation.
Results: A total of 2820 STEMI medical records from 32 collaborating hospitals were enrolled. From 2001 to 2011, the median age of STEMI patients increased from 66 to 68 years, P<0.01, the percentage of female patients elevated from 31.4%to 35.8%, P<0.05. The ratios of cardiovascular risk factors were gradually increased. Among the patients without documented contraindications, application of percutaneous coronary intervention (PCI) increased from 0%to 27.5%, P<0.01, reperfusion increased from 49.7%to 58.8%, P<0.01. Administration of aspirin elevated form 80%to 87.8%, Clopidogrel from 0%to 72.6%, statins from 16.7%to 89.6%;administration ofβ-blockers within 24 h of admission elevated from 41.5%to 55.5%, P<0.05 and ACEI/ARB from 58.3%to 69%, P<0.01. In 2001, 2006 and 2011, the in-hospital mortality within 7 days were 6.8%, 8.3%and 5.7%respectively;mortality plus treatment withdrawal because of terminal status at discharge were 10.2%, 12.4%and 9.5%respectively. After adjustment, the above ratios did not change signiifcantly.
Conclusion: From 2001 to 2011, application of PCI grew from nothing and effective medication was improved for in-hospital STEMI patients in eastern rural China. However, there were still obvious gaps for diagnosis and treatment from the guideline requirement;the patient outcomes have not been improved.

Objective:To establish and identify humanized-SCID mouse model(hu-SCID).Methods:SCID mouse was treated by CTX to inhibit the hemocytopoiesis. With successive 4-day injection, human peripheral blood mononuclear cells(PBMC) were engrafted into SCID mouse through intraperitoneal injection. After 4, 8 and 12 weeks of engraftment, peripheral blood, spleen and liver tissues of engrafted SCID mouse were harvested. Human CD3~+, CD19~+ cells in peripheral blood were analyzed by inflorescence microscopy and FCM, human CD3~+, CD19~+ cells in spleen and liver tissues were observed by immune histochemistry, and human IgG level in SCID mouse serum was measured by ELISA.Results:After engraftment of 4, 8 and 12 weeks, human CD3~+, CD19~+ cells in SCID peripheral blood were identified by inflorescence microscopy and the percents were 31% and 10% respectively by FCM analysis. And these cells could be evidenced after 12 weeks later. Through immune histochemistry human CD3~+、CD19~+ cells were detected in mouse spleen but not in liver tissue. Furthermore the titer of human IgG in mouse serum was 390,1 100 and 1 040 ?g/ml at each time point respectively.Conclusion:Our experimental results demonstrated that a bona fide humanized SCID model was established.

Objective:To study the clinicopathological features and differential diagnosis of metaneph-ric adenoma (MA).Methods:The clinicopathological data of 16 cases with MA diagnosed and treated in Peking University First Hospital from 2004 to 2016 were retrospectively analyzed,and the clinical characteristics,pathologic parameters,differential diagnosis,treatment options and prognosis of MA were analyzed with literature review.Results:The patients included 10 females and 6 males.The age of pa-tients ranged from 14 to 83 years (mean =33.7 years).The partial nephrectomy was carried out for most patients.All cases were located in renal codex with 3 growing into the renal sinus.Histologically,the tumor was composed of tubules,papillary or glomeruloid structures and psammoma bodies were focally seen.Immunohistochemical study showed that all the cases expressed vimentin,and 94% cases ex-pressed CD57,63% WT1,75% AE1 /AE3,19% cytokeratin 7 (CK7 )and 13%α-methylacyl-CoA racemase (AMACR),and negative expressions for MA included CD10,neuron-specific enolase (NSE) and CD56.Follow-up information from 1 to 125 months was available in all the patients;and none of the patients showed any evidence of recurrence and metastasis.Conclusion:The benign tumor characteris-tics of MA are not obvious for preoperative imaging diagnosis,and the diagnosis of MA should be based on the unique pathological features.Positive immunostain of CD57 is a useful indicator for MA diagnosis and differential diagnosis.The partial nephrectomy surgical treatment can achieve good clinical cure with good prognosis.

Objective To analyze factors influencing short-term effect of presurgical pharmacological thera-py and transsphenoidal microsurgery for somatotropinomas. Methods The clinical data of 53 patients underwent presurgical pharmacological therapy and transsphenoidal surgery for somatotropinomas were retrospectively analyzed in order to search for factors influencing effect of presurgical pharmacological therapy and transsphenoidal surgery for somatotropinomas. Results Serum GH inhibition rates decreased<50.00%from baseline in 62.26%of patients receiving presurgical pharmacological therapy. Statistical analysis concerning the influence of sex , neuropathological evaluation, tumor size and presence of invasion on presurgical pharmacological therapy effect were performed using a chi-squared test, no significant correlation was found among these factors and presurgical pharmacological therapy effect. Total remission rates were 43.40%, Statistical analysis concerning the influence of sex , neuropathological e valuation, tumor size, presence of invasion and presurgical pharmacological therapy effect on remission rate were performed using a chi-squared test, a significant correlation was found among tumor size, presence of invasion, presurgical pharmacological therapy effect and remission rate , while no significant correlation was found among the rest of the factors. Further Logistic regression analysis demonstrated a significant correlation among tumor size , presence of invasion and remission rate , while no significant correlation was found between presurgical pharmacolog-ical therapy effect and remission rate. Conclusions Presurgical pharmacological therapy effect revealed no signifi-cant correlation with sex, neuropathological evaluation, tumor size or presence of invasion. Total remission rate cor-related with tumor size and presence of invasion. A better presurgical pharmacological therapy effect may indicated a better outcome, while postoperative remission rate revealed no significant correlation with presurgical pharmacologi-cal therapy in our series.

BACKGROUND:Atopic individuals predispose to alergic rhinitis after contacting with an alergen, which is mainly released by IgE-mediated histamine. Alergic rhinitis is a kind of non-infectious inflammatory disease that involves a variety of immune cels and cytokines and is related to Th1 and Th2 immune imbalance. Interferon γ is a cytokine secreted by Th1 cels, while interleukin-4 is a cytokine secreted by Th2 cels. OBJECTIVE:To establish a stable 129Sv mouse model of alergic rhinitis, so as to lay the foundation of establishing gene knockout 129Sv mouse models of alergic rhinitis, and to observe the concentration variation of IgE, interleukin-4 and interferon γ. METHODS: Twenty-four mice were randomly divided into 2 groups: model and control groups. Mice in the model group were sensitized by intraperitoneal injection of ovalbumin to establish mouse models of alergic rhinitis. Mice in the control group were subjected to intraperitoneal injection of PBS. After successful modeling, pathological changes of nasal eosinophils and plasmocyte infiltration were evaluated by nasal mucosa staining. Interleukin 4 and interferon γ levels and ovalbumin-specific IgE antibody concentration were detected by enzyme-linked immunosorbent assay. RESULTS AND CONCLUSION:Enzyme-linked immunosorbent assay showed that compared with the control group, serum ovalbumin-IgE and interleukin-4 concentrations were significantly increased, and Interferon γ concentration was significantly lower in the model group (P < 0.05). Hematoxylin-eosin staining results showed that cilia lodging and submucosal serous gland hyperplasia, eosinophils and plasmocyte infiltration were obvious. These results confirm that a mouse model of allergic rhinitis was successfully constructed in this study and the pathogenesis of allergic rhinitis was related to Th1/Th2 imbalance.

Blood-brain barrier (BBB) is a kind of important barrier system in the body. It can have a choice to prevent certain substances from entering the brain, in order to maintain the relative stability of internal environment of the central nervous system (CNS). However, it also became an important restriction factor for the treatment of CNS diseases. Traditional Chinese medicine (TCM) had good curative effects on several kinds of CNS diseases, which illustrated that effective composition of TCM can pass through or influence the function of BBB. This paper summarized the research progress of literatures on current pharmacological and clinical trials for the effect of TCM on BBB.

Objective: To assess the trends in clinical characteristics and treatments for in-hospital patients with ST-segment elevation myocardial infarction (STEMI) in western rural China from 2001 to 2011. Methods: A two-stage random sampling procedure was used in our study. In 1st stage, stratiifed random sampling was applied to identify the participating hospitals and in 2nd stage, random sampling was applied to determine the patients to be studied. Taking 2001, 2006 and 2011 as 3 time points to study the in-hospital records for STEMI treatments. The results in each year were analyzed by weighted calculation in order to adjust the proportional impact by different sampling and therefore, to relfect the entire condition in western rural area. Results: A total of 32/35 hospitals with 1028 STEMI records were enrolled. From 2001 to 2011, the admitted STEMI patients from 64 (54-70) years of age increased to 67 (56-75) years,Ptrend<0.05, while gender composition was similar, the risk factors for cardiovascular disease such as hypertension, dyslipidemia and smoking substantially increased. Among patients without contraindications, the ues of following medications increased from 2001 to 2011: aspirin from 73.6% to 89.9%, clopidogrel from 0% to 66.5%, β-blockers from 25.4% to 64.3% and statins from 7.5% to 89.8%, allPtrend<0.01. From 2001 to 2011, the rates of primary PCI application were from 0% to 0.3%,Ptrend=0.51, the rates of thrombolytic therapy increased from 33.4% to 55.4%,Ptrend<0.01. At the year of 2001, 2006 and 2011, the reperfusion rates were 33.4%, 50.7% and 55.4%, Ptrend<0.01; the mortality within 7 days of admission were 3.0%, 10.1% and 6.7%, the rates of death or treatment withdrawal because of terminal status were 5.3%, 12.3% and 10.9%, there was no signiifcant trend in the above 2 rates after adjustments. Conclusion: The quality of medical care for STEMI was signiifcantly improved in western rural China from 2001 to 2011, while there are still gaps between western rural area and other regions.