Objective To achieve the software automatic updates and maintenance in the local area network which is developed based on the C/S structure. Methods Based on the existing software and hardware development platform,we use PowerBuilder to exploit and compile a program which can determine whether the software need to update automatically or not under the premise of unchanging the existing LAN software system. Results When the user terminal in the local area network runs this program,they can update it automatically whenever they need. Conclusion This method will greatly reduce the later maintenance software,upgrade works and also improve the work efficiency and accuracy.

Objective To investigate the in vivo effects of glutamine(Gln) on inflammatory cytokine release in murine peritoneal macrophages during sepsis. Methods Sixty Kunming mice were randomly divided into sham-operation group(Sham group,n=20),operation control group(Con group,n=20) and Gln-treatment group(Gln group,n=20).Sepsis was induced by cecal ligation and puncture in Gln group and Con group,and Gln(0.75 g/kg) or saline was immediately administered via single tail vein injection.Serum was collected and macrophages were harvested from peritoneal lavage at 6 h in these three groups.Intracellular and serum cytokines of tumor necrosis factor-?(TNF-?),interleukin(IL)-6 and IL-10 were detected by ELISA.The expression of TNF-? mRNA in macrophages was analyzed by RT-PCR,and the expression of heat shock protein(HSP) 72 in macrophages was evaluated by Western blotting. Results Gln group demonstrated significantly lower intracellular TNF-? and IL-6 levels than Con group(P0.05).The serum TNF-? level was significantly lower in Gln group than in Con group(P

Objective To explore the reason for remedy radical operation after endoscopic submucosal dissection (ESD) for early gastric cancer.Methods The clinical data of 26 early gastric cancer cases who received remedy radical gastrectomy after ESD between January 2012 to March 2015 in Nanjing Drum Tower Hospital were analyzed retrospectively.Results All cases were followed up and mid follow-up was 25 months.There was no death nor tumor reccurence cases during the follow-up.Three cases suffered from complications in radical surgery for gastric cancer including afferent jejunal loop obstruction,adhesive intestinal obstruction,stomach paralysis respectively,all were cured by conservative therapy.Postoperative pathology found lymph node metastasis in 3 cases.Conclusions En bloc resection and negative resection margin,as well as free lymphatic metastasis are two important factors determing the survival of early gastric cancer patients undergoing ESD treatment.

The clinical, neuroelectrophysiological, neuropathological characteristics and outcome of a case of acute sensory axonopathy are reported. The patient was a 32-year-old female. She presented with acute onset sensory abnormalities, sensory ataxia, pseudoathetosis and areflex. Lab testing showed cerebrospinal fluid albumin cytologic dissociation. Electromyography studies and sural nerve pathology were consistent with acute sensory axonopathy. Treatment including intravenous immunoglobulin and steroid therapy was provided. Her symptoms recovered slowly without relapse, so did tibial H-reflex amplitudes.

Objective:Investigating the expression of HIV-1 co-receptors CXCR4,CCR5 and chemoking SDF-1 in human placentae and trophoblasts is to explore the mechanism of in-utero transmission of human immunodeficiency virus type 1(HIV-1).Methods:Using semi-quantitative reverse transcriptase-polymerase chain reaction,detected the transcripts of CXCR4,CCR5 in placenta tissues and trophoblasts.Immunocytochemistry and immunohistochemistry analysis revealed the expression of CXCR4,CCR5 in primary cultured first trimester trophoblasts and villous tissue.Also the expression of SDF-1 in villi of first trimester,and the presence of SDF-1 in the culture of isolated trophoblasts were examined by in situ hybridization,immunohistochemistry and enzyme-linked immunosorbent assay.Results:CXCR4 and CCR5 mRNA were detected in placentae of various gestational phases and in first trimester trophoblasts.However,primary cultured trophoblasts were found to be reactive only with antibodies against CXCR4.In the villous tissue sections,CXCR4 was found in trophoblasts,while CCR5 in stromal cell and/or Hofbauer cell.First trimester trophoblasts expressed SDF-1 strongly and secreted SDF-1 in vitro.Conclusion:CXCR4 and CCR5 were expressed in placentae.Hence,they maybe involved in in-utero transmission of HIV-1 as co-receptors.However,SDF-1 expressed in trophoblasts may protect fetus from being invaded by X4-HIV-1.R5-HIV-1 may infect CCR5+ stromal cells and/or Hofbauer cells through placental disruptions.

OBJECTIVE:To observe the effects of alprostadil combined with papaverine on blood coagulation indexes and complications in uremic hemodialysis patients after initial arteriovenous fistula.METHODS:One hundred and eighteen uremic hemodialysis patients undergoing initial arteriovenous fistula in our hospital during Feb.-Jun.2015 were divided into control group and observation group according to random number table,with 59 cases in each group.Both groups received local irradiation with hemodialysis internal fistula repair instrument 30 min,tid,from 3 days before surgery to 10 days after surgery.Control group was treated with Alprostadil injection 10 μg,iv,qd,immediately after surgery.Observation group was additionally treated with Papaverine in jection 30 mg,iv,qd,on the basis of control group.Both groups received treatment for 10 d.The orificium fistulae blood flow,hemodialysis blood flow and the time of initial hemodialysis were compared between 2 group.The plasma prothrombin time (PT),activated partial thromboplastin time (APTT),fibrinogen (Fib),platelet count (PLT) and C-reactive protein (CRP) levels were observed in 2 groups before and after surgery.The occarrence of postoperative complications was observed.RESULTS:The orificium fistulae blood flow and hemodialysis blood flow of observation group were significantly higher than those of control group,and ini tial hemodialysis time was significantly shorter than control group,with statistical significance (P＜0.05).Before surgery,there was no statistical significance in PT,APTT,Fib,PLT and CRP between 2 groups (P＞0.05).After surgery,APTT and CRP of 2 groups were increased significantly,Fib was decreased significantly;the above indexes of observation group was significantly better than that of control group,with statistical significance (P＜0.05).There was no statistical significance in PT,PLT between 2 groups (P＞0.05).There was no statistical significance in the incidence of internal fistula infection and postoperative wound bleeding volume＞ 10 mL between 2 groups (P＞0.05).The incidence of internal fistula occlusion and orificium fistulae thrombus in observation group were significantly lower than control group,with statistical significance (P＜0.05).CONCLUSIONS:The application of alprostadil combined papaverine on uremic hemodialysis patients after initial arteriovenous fistula can effectively prevent inflammation reaction,fistula thrombus formation and fistula occlusion,and improve the maturation of fistula.

AIM To investigate the effect of cisplatin on apoptosis in Scaber cell. METHODS The apoptotic cells were detected by TUNEL,HE,eletronic micrpscopy. RESULTS Treatment of Scaber cells with CDDP resulted in characteristics typical of apoptosis. CDDP induced apoptosis of Scaber cells in time and concentration dependent manner. To further investigate the mechanism of apoptosis induced by CDDP, the expressions and activity of apoptosis associated proteins such as bcl 2, bax and caspase 3 were examined using S P method.The results showed: CDDP caused time and concentration dependent decreases in bcl 2 and increased in bax proteins.CDDP bcl 2 and its translocation to perinuclei and nuclei. The expression of caspase 3 in Scaber cell were determined during apoptosis induced by CDDP. CONCLUSION Our investigetion showed that the apoptosis induced by CDDP is related to the increase of bax protein, and the decrease of bcl 2 protein. and its translocation to perinuclei and nuclei.

Objective To study cost-effectiveness of primary cerebral infarction patients. Methods The neural function of primary cerebral infarction patients was studied by the National Institutes of Health Stroke Scale (NIHSS) with rank test and multiple regression analysis. Results After treatment in hospitals of different grades, no obvious difference was detected in the NIHSS score, but difference was found in therapy cost and therapy time; the NIHSS score and therapy time of primary cerebral infarction patients in different attack positions were obviously different, but therapy cost had no significant statistical difference. The NIHSS score of primary cerebral infarction patients with different treatments was obviously different, but therapy cost and therapy time was not. Conclusions Patients are advised to choose grade hospitals in nearby cities for treatment. Clinician are expected to choose low-cost treatment plan to relieve patients' economic burden.

Objective To compare volume-controlled ventilation (VCV) versus pressure-controlled ventilation (PCV) improved by PEEP during one-lung ventilation (OLV).Methods Fifty ASA physical status Ⅰ-Ⅲ patients,aged 25-64 yr,weighing 40-80 kg,undergoing elective thoracotomy,were randomly divided into 2 groups (n =25 each) using a random number table:VCV + PEEP group (group Ⅴ) and PCV + PEEP group (group P).Those in group Ⅴ underwent OLV initially with VCV for 20 min followed by 4cm H2O PEEP for 20 min and then PEEP was removed.Those in group P underwent OLV initially with PCV for 20 min followed by 4cm H2O PEEP for 20 min and then PEEP was removed.At the beginning of two-lung ventilation before chest opening (T1),at 20 min of OLV before PEEP (T2),and at 20 min of ventilation with PEEP (T3),arterial blood samples were collected for blood gas analysis and the peak airway pressure (Ppeak) and development of SpO2 ＜ 95 ％ from beginning of OLV to T3 were recorded.Results Compared with group P,Ppeak at T2,3 and PaO2 at T3 were significantly increased in group Ⅴ (P ＜ 0.05).Compared with the baseline value at T1,PaO2 was significantly decreased and Ppeak was increased at T2.3 in Ⅴ and P groups (P ＜ 0.05).The incidence of SpO2 ＜ 95％ was significantly decreased and PaO2 was increased at T3 than at T2 in Ⅴ and P groups (P ＜ 0.05).Conclusion 4 cm H2O PEEP can improve VCV and PCV during OLV and the improved efficacy is better for VCV in patients undergoing thoracotomy.

Objective To report the clinical and pathological features of chronic graft-versus-host disease-related polymyositis by summarizing the clinical data of the patient with chronic graft-versus-host disease-related polymyositis. Methods One patient with chronic graft-versus-host disease-related polymyositis was hospitalized in our hospital on December 29,2010.The patient,40 years old,female,underwent allogeneic haematopoietic stem cell transplantation because of acute granulocytic-monocytic leukemia.Fourteen months later she manifested as slowly progressive muscle weakness and myalgia in all limbs.Serum creatine kinase level was between 426-1948 U/L. Myositis antibody EJ was strongly positive.Electromyogram showed a neurogenic impairment and slow peripheral nerve conduction speed.Muscle biopsies were carried out in the left biceps brechii.In addition of standard histological and enzyme histochemical staining for the muscle sections,immunohistochemical workup was performed with mouse antiCDs,anti-CD20,anti-CD68 and anti major histocompatibility complex- Ⅰ ( MHC- Ⅰ ) monoclonal antibodies as first antibodies.Results The muscle biopsy showed large variation of fiber size,with muscle fiber necrosis,regeneration.Some angular fibers distributed in small cluster.The inflammatory cells infiltrated around the small vessel or in the endomysium,mainly CD8+ T-lymphocytes and CD6+8 macrophages.The most muscle fibers were MHC-Ⅰ positive. Conclusion The graft-versus-host disease-related polymyositis manifests as chronic myositis process with neurogenic lesions.