Malnutrition in patients with acute stroke is quite common. It is an independent risk factor affecting stroke prognosis. Early enteral nutrition can improve the nutritional status of the stroke patients, lower infection rate and mortality, promote recovery of neurological function, and improve the quality of life. Therefore, under the premise of the gastrointestinal tolerance, the patients with severe stroke should select early enteral nutrition as early as possible.

AIM: To explore the feasibility of culturing human umbilical vein endothelial cells ( HUVEC ) on acellular corneal stroma and performing the posterior lamellar endothelial keratoplasty ( PLEK ) treating corneal endothelial decompensation.
METHODS: Thirty New-Zealand rabbits were divided into three groups randomly, 10 rabbits for experimental group, 10 for stroma group and 10 for control group. Corneal endothelial cells were removed to establish animal model of corneal endothelial failure. PLEK was performed on the rabbits of experimental group and stroma group, and nothing was transplantated onto the rabbits of control group with the deep layer excised only. Postoperative observation was taken for 3mo. The degree of corneal edema and central corneal thickness were recorded for statistical analysis.
RESULTS:Corneas in experimental group were relieved in edema obviously compared with that in stroma group and the control group, and showed increased transparency 7d after the operation. The average density of endothelial cells was 2 026. 4±129. 3cells/mm2 , and average central corneal thickness was 505. 2±25. 4μm in experimental group, while 1 535. 6±114. 5μm in stroma group and 1 493. 5±70. 2μm in control group 3mo after operation.
CONCLUSION:We achieved preliminary success in our study that culturing HUVEC on acellular corneal stroma and performing PLEK for corneal endothelial decompensation. HUVEC transplanted could survive in vivo, and have normal biological function of keeping cornea transparent. This study provides a new idea and a new way clinically for the treatment of corneal endothelial diseases.

Objective: To observe the presence of dentritic cells (DC) in lung tissues of rat models of chronic obstructive pulmonary disease (COPD) and the influence of budesonide and ipratropium bromide on the number of DCs. Methods: Sixty male SD rats were randomly divided into four groups(n=15): control group, COPD model group, budesonide treatment group and ipratropium biomide treatment group. The COPD rat models were established by intratracheal instillation of lipopolysaccharide (LPS) twice and exposure to tobacco smoke for 4 weeks. Drug inhalation group received inhalation of budesonide (Pulmicort) or ipratropium bromide (Atrovent) since the second week. The rats were sacrificed at the 31th day. Lung slices were observed with H-E staining for pathological changes and the status of DC were determined by immunohistochemical method. Results: The COPD model group, budesonide treatment group, and ipratropium biomide treatment group all had the pathological changes of COPD, and their DC numbers were significantly higher than that in the control group (P<0.01). DC number in Pulmicort treatment group was significantly less than that in the COPD model group (P<0.01), and there was no significant difference between the Atrovent treatment group and the COPD model group. Conclusion: The pulmonary DCs play an important role in the pathogenesis of COPD. Pulmicort can decrease the number of DCs in rat model of COPD, and ipratropium bromide has no obvious effect on DC number.

Objective To evaluate the nighttime blood pressure(BP) control status of hypertensive Chinese chronic kidney disease (CKD) patients and related risk factors.Methods This cross-sectional study enrolled 337 hypertensive CKD in-patients.The clinical and ambulatory BP monitoring (ABPM) data were retrieved from the electronic database of the hospital.High ambulatory BP were defined as ＞130/80 mmHg (average 24-hour BP) and ＞135/85 mmHg (daytime)/＞120/70 mmHg (nighttime),respectively.Multivariable analysis was used to evaluate the risk factors for lack of nighttime BP control and circadian rhythm.Results There were 38.6％ of the whole population had average 24-hour BP controlled.But only 22.8％ of them achieved nighttime BP control,which was far less than the 50.7％ of daytime BP control (P ＜ 0.01).Even among those patients who achieved average 24-hour BP control shown by ABPM,there were still 44.6％ of them with uncontrolled nighttime BP.Multiple analyses showed urinary protein excretion (OR:1.151,95％CI:1.035-1.279) was independent risk factor for lack of nighttime BP control.About 80％ of patients presented with nondipping BP pattern,among whom 37.3％ were presented with reverse-dipper pattern.Lack of nighttime BP control was independent risk factor for lack of normal circadian rhythm (both P＜0.001).Conclusions Lack of nighttime BP control was common in hypertensive CKD patients and contributed to the abnormal circadian rhythm.ABPM should be performed more commonly in clinical practice to help nighttime BP control in the future.

Objective To compare the results of three methods for measuring C reaction protein.Methods 100 patients were collected from our hospital,and three different methods for measuring C reaction protein were used to analyze the level of C reaction protein.Results Correlation analysis showed that the correlation between immunoturbidimetric assay and immunochromatography was higher.The differences of three methods assayed the C reaction protein were significant (P <0.05 )among normal people by the variance analysis,but had not statistical significance among abnormal people (P >0.05).The differences among all of test peo-ple were significant(P <0.05).Conclusion Detection of C reaction protein was important for diagnose inflammatory diseases.

Objective To discuss the application of minimally invasive surgery in the treatment of esophageal leiomyoma. Methods Clinical data of 26 patients with esophageal leiomyoma from September 1996 to October 2002 treated by minimally invasive surgery were reviewed retrospectively. Results Video-assisted thoracoscopic leiomyoma enucleations were performed in 23 patients, and a conversion to mini-thoracotomy was required in 3 of them because of dense pleural adhesion (2 patients) or location failure of tumor (1 patient). The remaining 3 patients underwent transjugular leiomyoma enucleation (2 patients) or esophagoscopic resection of leiomyoma (1 patient), respectively. All the procedures were completed smoothly and the postoperative recovery was uneventful, without mortality or severe complications. All the patients were pathologically diagnosed as leiomyoma after surgery. Follow-up for 2 ～ 73 months (mean,32.3months) found no recurrence. Conclusions Video-assisted thoracoscopic enucleation can be the first choice for the esophageal leiomyomas that derived from lamina propria, while esophagoscopic removal may be considered for those from muscularis mucosa.

Objective:To explore important signaling pathways and effects on neurovascular unit of Buyang-Huanwu Decoction in the treatment of ischemic stroke. Methods:Used TCMSP database, Chinese Medicine and Chemical Composition Database of Shanghai institute of Organic Chemistry and searched related literature to obtain and screen the active compounds and their targets of Buyang-Huanwu Decoction. DrugBank database, OMIM database, TTD database and GeneCards database were used to obtain targets of ischemic stroke. Metascape database was used to carry out KEGG pathway enrichment analysis on therapeutic targets. AlzData database was used to analyze the gene expression of therapeutic targets in different cells. Results:Through network analysis, the key targets of Buyang-Huanwu Decoction in the treatment of ischemic stroke were obtained, including PTGS2, PTGS1, CHRM1, ADRB2, CHRM2, F10, F7, HIF1A, PDE3A, ADRA1B and CHRM3, etc. Through enrichment analysis, multiple key signaling pathways of Buyang-Huanwu Decoction in the treatment of ischemic stroke were obtained, including PI3K-Akt signaling pathway, calcium signaling pathway, IL-17 signaling pathway, platelet activation, Apelin signaling pathway, NF-κB signaling pathway, AMPK signaling pathway and arachidonic acid metabolism, etc. Through gene expression analysis, the effect of Buyang-Huanwu Decoction on different cells was analyzed, and it was found that the targets regulate a variety of biological processes, cellular components and molecular functions in endothelial, astrocytes, microglia, oligodendrocytes, oligodendrocyte precursor cells (OPCs) and neurons. Conclusion:Buyang-Huanwu Decoction is characterized by multiple components, multiple targets, multiple pathways and complex connections in the treatment of ischemic stroke, and its effect is closely related to neurovascular units (NVU) at the cellular expression level of genes, and the mechanism of therapeutic effect included neuroprotection, neurogenesis, antithrombotic, vascular regeneration, glial cell regulation, etc.

In order to study the effect of mechanical strain on mesenchymal stem cells (MSCs) differentiation into osteogenic, the cyclic substrate deformation instructment was applicated to MSCs line (D1 cell) in osteogenic media for different strain and times. The cells were cyclically stretched for periods of 1, 2, 3, 5 and 10 min and treated with cytochalasin B(CB) and EGTA. Ca2+, which were loaded with (15 ?l) Fluo-3 AM , were detected by confocal laser scanning microscope(CLSM). The signaling inhibitors, such as SB203580(p38MAPK specific inhibitor), PD98059(MEK-1/2MAPK specific inhibitor), LY294002(PI3Ks specific inhibitor), cytochalasin B(microfilament specific inhibitor), EGTA (Ca2+ specific inhibitor), were used to investigate mechanical signaling pathway by (3% 0.5Hz) Cyclic strain. The results indicated that 3% strain stimulus could induce increasement of [Ca2+] i - dependent fluorescence at 2 min. Its fluorescence intensity were 143.68,which were significantly different compared with 1,3,5,10min groups and 1% and 10% strain groups (P

Animals ; Basic Helix-Loop-Helix Transcription Factors ; metabolism ; physiology ; Cadherins ; metabolism ; Cell Transformation, Neoplastic ; metabolism ; pathology ; Epithelial Cells ; pathology ; Homeodomain Proteins ; metabolism ; physiology ; Humans ; Mesenchymal Stromal Cells ; pathology ; Neoplasm Invasiveness ; Neoplasm Metastasis ; Neoplasms ; metabolism ; pathology ; Snail Family Transcription Factors ; Transcription Factors ; metabolism ; physiology ; Zinc Finger E-box-Binding Homeobox 1

Objective To investigate the cerebral infarction patterns and pathogenesis in patients with internal carotid artery (ICA) and middle cerebral artery (MCA) severe stenosis (the degree of stenosis 70％- 99％ ) or occlusion in order to provide evidence for the individualized prevention and treatment strategies. Methods Seventy-six patients with acute cerebral infarction who showed the responsible lesions at the corresponding MCA territory on diffusion-weighted imaging (DWI) were analyzed retrospectively. The patients were divided into ICA lesion, MCA lesion and negative result on digital subtraction angiography and CT angiogaphy (NR) groups according to the vascular examinations. Their infarcts were divided into single and multiple infarctions. According to the positions, the former was divided into perforating artery infarct (PAI), pial infarct (PI), and border-zone infarct (BZ). Results The infarct morphologies in the MCA territory were divided into 9 types. The different lesions caused infarct morphologies were different (x2 =34. 000, P =0. 001). The distribution pattern of multiinfarcts accounted for 73.68％ of all patients (56/76). The distribution pattern of PAI + PI in the ICA lesion group was significantly more than that in the NR goup (17/42 vs. 1/16,x2 =6. 837, P =0. 009). There were some correlations between the degree of artery stenosis and the infarct morphology. The severe ICA lesions mostly showed PAI with PI (7/17 vs. 1/16,x2 =5. 475, P =0. 019), and the severe MCA lesions mostly showed PAI with BZ (3/8 vs. 1/17,x2 =4. 046, P =0. 040). Conclusions In patients with cerebral infarction of ICA or MCA severe stenosis or occlusion, most of them showed multiinfarct pattern. This suggested that the different mechanisms of stroke onset might be associated with the arterial-arterial embolization or hypoperfusion.