Objective To study the protective effect of estrogen on cerebral ischemia reperfusion injury in rat Methods 120 adult female rats were randomly divided into the intact, ovariectomized(OVX),OVX and estrogen(E 2) replacement groups In the OVX+E 2 group, E 2 valerate(200 ?g/kg) was subcutaneousely injected once a week after the OVX Four weeks after the OVX, all rats were subjected to model of ischemia reperfusion by MCAO Infarct volumes were measured.Pathological changes and apoptosis was detected, and serum estrogen concentration was analyzed Results For different time of ischemia reperfusion,cerebral infarct volume in the OVX+E 2 group was minimal,and in the OVX group was maximal(all P

Background and purpose: With the increase of aging population, elderly patients (age ≥70 years) with esophageal squamous cell carcinoma occurred more and more. However, few studies have focused on elderly esophageal squamous cell carcinoma patients. This study aimed to assess the outcomes and prognostic factors for elderly patients with esophageal squamous cell carcinoma treated after deifnitive chemoradiotherapy. Methods:We retrospectively analyzed 53 patients (age≥70 years) with esophageal squamous cell carcinoma and treated with deifnitive radiotherapy with or without chemotherapy from Fudan University Shanghai Cancer Center from Mar. 2009 to Dec. 2011. Results:Median age was 74 years. Twenty-nine patients underwent radiotherapy, 24 patients underwent radiochemotherapy. 1-, 2-, 3-, and 5- year survival was 62%, 44%, 33% and 19% respectively. Grade 2 and above acute radiation-induced esophageal toxicity and radiation pneumonitis occur rate was 6% and 9% respectively. No treatment-related deaths occurred and no patients experienced any grade 4 and above toxicities. Multivariate analysis identiifed treatment modality, tumor site and smoking history as independent prognostic factors for overall survival. Conclusion:Radiotherapy may be an acceptable treatment option for elderly patients with esophageal squamous cell carcinoma. In appropriately selected patients, concurrent chemotherapy could bring a better overall survival.

Objective To investigate the imaging diagnosis and surgical treatment of intestinal malrotation in adult patients. Methods The clinical data of 11 adult patients with intestinal malrotation who had been admitted to General Hospital of PLA from January 2003 to December 2007 were retrospectively analyzed. Multiple imaging modalities, including barium enema, gastrointestinal radiography, B sonography, computed tomography (CT) scan and mesenteric angiography were applied for diagnosis. All patients received Ladd procedure. Results Two patients were diagnosed by gastrointestinal radiography +B sonography, 4 by gastrointestinal radiography +CT scan, 1 by angiography, 1 by B sonography + CT scan, 1 by iodine radiography + CT scan and 2 by intraopera-tive examination. After the operation, 2 had renal insufficiency, 1 had intestinal fistula and 1 had short bowel syndrome and died at the third month after operation. Conclusion Combined application of multiple imaging modalities can improve the diagnostic rate, and Ladd procedure is effective and safe for adult patients with intes-tinal malrotation.

Objective To summarize the treatment experiences in gastrointestinal leaJcage atter gastrectomy for gastric cancer. Mehods From January 1997 to December 2006 the clinical data of 37 cases of gastrointestinal leakage including anastomotic leakage in 19 cases and duodenal stump leakage in 18 after gastrectomy for gastric cancer in People's Liberation Army General Hospital were analyzed retrospectively. Results All of the Cases were treated with abdominal drainage,continuous gastrointinal decomnression and parenteral nutrition combined with enteral nutrition.There were 32 cases receiving glutamine enrichment nutrition support,31 ases used somatostatin,13 cases received supplemented recombinarlt human growth hormone.Fistula healed in 21～30 d in 9 cases after gastrectomy,in the other 24 cases fistula healed in 30-60 d,while it healed in 60～81 d in the remaining 2 cases.Two died of leakage associated complications after gastrectomy for gastric cancer including anastomotlc leakage follwing esophagojejunostomy complicated by severe thoracic and lung infection in one and duodenal stump leakage complicated by severe abdominal cavity sepsis and hemorrhage in the other. Conclusion Patent and effective abdominal cavity drainage,continuous gastrointestinal decompression,parenteral nutrition combined with enteral nutrition,glutarnine,somatostafin and recombinant human growth hormone are the'mportant factors for the healing of gastrointestinal leakage after gastrectomy tor gastric cancer.

Objective To evaluate the clinical effectiveness of perioperative fast-track surgery(FTS)program and nutrition support in the elderly patients with gastric cancer.Methods Totally 42 patients were equally randomized into FTS group(receiving perioperative FTS program)and control group(receiving a conventional therapy).The postoperative first defecation time,postoperative hospital stay,hospitahzation expenditure,and postoperative complications were compared between these two groups.Results The postoperative first defecation time and postoperative hospital stay were(75.4±24.3)hours and(11.2±3.2)days in FIS group and(98.0±22.6)hours and(14.4±4.6)days in control group(P=0.0165,P=0.0004;respectively).The hospitalization expenditure was significantly lower in FTS group than in control group[(3.66±0.48)×104 vs.(4.56±0.78)×104 RMB yuan;P=0.0001].The incidence of postoperative complications in FTS group was also significantly lower than that in control group(9.5% vs.28.6%,P=0.0422).Conclusion Perioperative FTS program can accelerate postoperative rehabilitation,shorten hospital stay,lower hospitalization expenditure,and reduce the incidence of postoperative complications.

Objective To provide reference for anti-infection drugs in Zunyi area by analyzing the etiological characteristics of children with severe pneumonia.Methods The sputum, throat swabs and serum of children with severe pneumonia in pediatric intensive care unit of our hospital from January 2014 to December 2015 were collected in this study.The pathogen species which caused severe pneumonia were detected and identified by the method of pathogen culture,and typical pathogens were detected by RT-PCR and indirect immunofluorescence.Results A total of 337 children with severe pneumonia were included,the pathogen positive rate was 86.65%(292/337).The rate of viral infection(37.32%)was the highest,followed by bacterial infection accounting for 28.42%,then the mixed infection accounting for 27.74%,and the mycoplasma pneumoniae infection accounting for 6.50%.The respiratory syncytial virus type B accounting for 28.44% was the most common in viral infection,and there were significant differences in age distribution(P<0.05),the children under 3-years-old,especially the infants under 1-year-old had the highest susceptibility.Viral infection had certain seasonality,compared with spring and winter,autumn and winter(November to April) had higher viral detection rate and the difference was statistically significant(x2=29.28,P=0.001).The escherichia coli was the most common in bacterial infection,accounting for 21.69%.Klebsiella pneumoniae,Escherichia coli were more common in neonates and infants under 1-year-old,Haemophilus influenzae occured in 1~3 years old children,Streptococcus pneumoniae infection could occur in any age.Conclusion Viral infection is the most common pathogen in children with severe pneumonia in Zunyi area followed by bacterial infection,which is more common in children under 1-year-old,and with the high incidence in autumn and winter.Bacterial infection is more common in children over 3 years of age.Bacterial and viral mixed infection is common in children under 3 years of age,especially in children under 1-year-old.

Background Oxidative damage may cause the functional dysfunction and death of retinal vascular endothelial cells(RVECs),and further leads to the development of retinal vascular diseases.Fufang xueshuantong has a therapeutic effect on retinal vascular diseases,but little is known about its molecular mechanism.Objective The goal of this study was to investigate the protective effects and mechanism of fufang xueshuantong on injury of human RVECs induced by tert-butyl hydroperoxide(t-BHP).Methods Human RVECs were isolated from healthy donor eyes and primarily cultured and then identified by flow cytometry.The third to fifth generations of cells were used in this experiments.The fufang xueshuantong solution of 0.0625,0.1250,0.2500,0.5000 and 1.0000 g/L were added in the cuhure plate with 5 × 104/L cells respectively in the experimental groups,and t-BHP of 75,100,200 and 300 μ.mol/L were added in the model control groups.MTT was used to detect the A490and survival rate of RVECs.The apoptotic rate and death rate of the cells were evaluated by double staining of Annexin V-FITC/PI.Morphology of human RVECs were examined using invert microscopy and Hoechst33258 staining.The expressions of nitro tyrosine (a marker of oxidative damage of protein)and 8-OHdG(a marker of oxidative damage of DNA)in human RVECs were assessed by the immunofluorescence staining.Western blot was used to detect the expressions of nuclear factorkappa B(NF-KB),p53,bcl-2 and bax after 6,12,24 hours t-BHP action.This study was approved by the Ethic Committee of Zhongshan Ophthalmic Center.Results No significant difference was found in A490value among the normal control group,0.0625,0.1250,0.2500,0.5000 and 1.0000 g/L fufang xueshuantong groups(F =1.989,P＞0.05).The survival rates of the cells were lower in 75,100,200 and 300 μmol/L t-BHP groups compared with corresponding fufang xueshuantong groups(t =14.57,13.82,21.51,32.64,P＜ 0.01).The percentages of normal cells were evidently lower in 75,100,200 and 300 μmol/L t-BHP compared with corresponding fufang xueshuantong groups(t=14.908,5.495,17.165,26.330,P＜0.01).The numbers of deformation and death of the human RVECs increased as the elevated concentration of t-BHP,but those in fufang xueshuantong groups were less than the t-BHP groups under the invert microscopy.Compared with t-BHP groups,the expressions of nitro tyrosine,8-OHdG,NF-KB,p53 and bax were lower but the expression of bcl-2 was higher in human RVECs with the statistically significant differences(P＜0.05).Fufang xueshuantong at the concentration of 0.2500 g/L showed maximally protective effect on human RVECs.Conclusions Fufang xueshuantong protects human RVECs against the t-BHP-induced injury through downregulating the expression of NF-kB,p53,bax and up-regulating the express of the bcl-2 protein.

Objective To understand the status quo of the illness situation and the implementation of prevention and control measures on Kashin-Beck disease( KBD ) in Shandong Province , and provide a scientific basis for assessment and acceptance of the work on eliminating KBD. Methods In accordance with the requirements of the national “Implementation Scheme for Endemic Disease Control in 2012” and the “Shandong Provincial Technical Scheme for KBD Control in 2012”. In four towns of Qingzhou, three epidemic villages were selected as the surveying villages in each town in order to understand the implementation of measures for prevention and control of KBD; information such as population of investigating villages, per capita income, farming, food and the implementation of control measures,etc were included. In each investigating village, 7 - 12 years old children were selected to receive clinical and X-ray examination. When fewer than 50 people in a investigating village , one additional endemic village was included near the investigating village , and all children aged 7 to 12 of the village were checked. The number of cases of clinical degree Ⅰ, Ⅱ, Ⅲand the detection rates, X-ray positive detection rate, the number of cases of metaphysis, epiphysis, distal end of phalanx, carpal bone, triad and the detection rates were calculated, respectively. Clinical and X-ray diagnosis were based on “The Diagnostic Criteria of Kaschin-Beck disease”(WS/T 207-2010). Results A total of 14 epidemic villages were selected to survey in four towns of Qingzhou. In the recent three years in the epidemic areas, measures of supplying Se had not been implemented;measures of resettlement and off-site education had not been implemented either. In the epidemic areas , the main crops were wheat and corn; the staple food was flour which accounted for more than 80%, and the foreign food bought accounted for only 11%. The areas of returning farmland to forest (grass) accounted for 0.32%(36/11 151) of the original arable land, and the areas of replanting economic crops accounted for 1.17%(131/11 151) of the original farmland. A total of 536 children aged 7 to 12 were examined by clinical and X-rays. Patient of KBD was not detected clinically. Six positive patients with metaphyseal changes of KBD were detected by X-rays, and the average X-ray detection rate was 1.12%(6/536). Patients with abnormal epiphysis, distal end of phalanx and carpal bone were not detected by X-rays. Conclusions KBD in Shandong Province has been effectively controlled. Since the cause of KBD is still unknown, it is necessary to build a sustainable long-term control mechanism of KBD;further improve the monitoring system and dynamic monitoring work still need to be strengthened.

Cognition Disorders ; chemically induced ; Humans ; Manganese ; toxicity ; Manganese Poisoning ; epidemiology

Objective To investigate the resistance mechanisms and epidemiology of Enterobacteriaceae isolated from clinical with reduced susceptibility to imipenem or meropenem.Methods 18 strains of Enterobacteriaceae with reduced carbapenem susceptibility were collected during January to August in 2010.The MICs of these strains were determined using automated microbial identification system.ESBLs,AmpC and KPC were tested using the agar dilution method.PCR amplification and DNA sequence were performed to analyze the KPC genes,PFGE was used to examine the molecular epidemiology.Results All 18 strains were detected ESBLs and AmpC,14 strains were detected KPC-2.3 strains with EDTA paper method positive may produce other metal carbapenem,in which 2 strains harbor KPC-2.PFGE types indicate that there were six genotypes among 15 strains of Klebsiella pneumoniae.Conclusion Plasmid-mediated KPC-2 was the main reason which makes Enterobacteriaceae reducing carbapenem susceptibility and causes short-term epidemic in hospital.Clinical strains harboring KPC-2 gene may carry multiple resistance genes meanwhile.