Objective To investigate the clinical significance of matrix metalloproteinase-9(MMP-9)in the pathogenesis of Kawasaki disease(KD)and its complications of coronary arterial lesions(CAL).Methods Twenty-three inpatients with KD were admitted in hospital from Jan.2005 to Dec.2006,whose venous blood samples were obtained during the acute and convalescent stage respectively,and CAL was detected with 2-Dechocardiography.Twenty-seven venous blood samples(12 febrile children and 15 normal physical examination children)were collected as healthy controls.Serum levels of MMP-9 were measured by enzyme-linked immunoadsorbent assay(ELISA).According to the results of echocardiography,children were divided into 2 groups:with CAL group(n=13)and without CAL group(n=10).Results During the acute stage,serum MMP-9 levels were significantly higher in KD than those in controls(Pa

OBJECTIVE: To explore the effects of Gymnadenia conopsea alcohol extract (GcAE) on the collagen synthesis in rat lungs exposed to silica and the influence on antioxidase activities, level of lipid peroxidation (LPO). METHODS: One hundred and twenty rats were randomly divided into control group, silica group, and GcAE-treated group. Silicotic animal models were established by direct tracheal instillation of silica into rat lungs surgically. From the second day of model establishment, rats in GcAE-treated group were orally given GcAE [8 g/(kg x d) corresponding to raw herb]. At 7, 14, 21, 28 and 60 days after establishment of the animal model, eight rats in each group were sacrificed, and samples were collected. The malondialdehyde (MDA) content, superoxide dismutase (SOD) and glutathione peroxidase (GPx) activities in plasma were assayed by a spectrophotometer. Types I and III collagen were detected by Sirius red polarization and microscopy, and measuered by Image-Pro Plus Version 4.5 for Windows software. RESULTS: GcAE could reduce the lung/body weight ratio of rats exposed to silica, the synthesis of types I and III collagen of the lungs and the level of lipid peroxidation, increase the activities of SOD and GPx. CONCLUSION: GcAE can ameliorate the silica-induced pulmonary fibrosis by increasing the activities of antioxidase and alleviating the damage of lipid peroxidation to the lungs.

Objective To explore the early diagnosis, option of the surgical procedures, preven-tion and treatment of the complications in patients with pancreatic trauma.Methods All patients with pancreatic trauma during the past 20 years were studied retrospectively in respect of sex, age, cause of injury, grade by AAST, style of operation, therapeutic efficacy, complications and factors for death etc.Statistical analysis was made with Chi-square test.Results In all 148 cases of the present series, 132 underwent surgical interventions including simple suture or external drainage alone, distal pancre-atectomy, distal pancreaticojejunostomy or other internal drainage, diverticularization, Whipple's pro-cedure, and Damage Control Surgery (DCS) etc.Postoperative morbidity was 27.83% with a signifi-cant difference of the incidence of pancreatic fistula between pancreas grade Ⅲ-Ⅴ injuries and grade Ⅰ-Ⅱ(P＜0.01).The mortality rate was 11.49%.The cause of the deaths was mainly massive bleed-ing due to severe associated injuries(76.47%).Among various grades, the difference of the mortality was not significant (P＞0.05).Conclusion To improve the survival rate, it is important to control massive hemorrhage from associated injuries precedes dealing with pancreas trauma.Selection of surgi-cal procedures should be based on whether the main duct is injured.The removing of devitalized tis-sue, adequate external and internal drainage are essential for treatment of pancreatic injuries.Early recognition of pancreatic injury and correct choice of surgical procedures may obviously decrease the in-cidence of postoperative complications.

Objective To observe the effect of rhTRAIL on survivin gene expression of human lung adeno-carcinoma A549 xenografted tumor in nude mice,and investigate the possible inhibitory mechanism of rhTRAIL on the implanted-tumor growth.Methods The solid tumor model was formed in nude mice with human lung adeno-carcinoma cell line.A549.24 mice were randomly divided into the four groups,rhTRAIL single treated group (1 μg/mL),rhTRAIL combined with cisplatin (DDP) treated group,cisplatin treated (1.5mg/kg) and 0.9％ sodium chloride injection(NS) control group.The rhTRAIL and DDP were injected once every other day by intraperitoneal injection to mice in the treated groups,lasting eight times,the same volume of saline solution was injected to the control group.After these,mice were killed and dissected completely.The expression level of survivin mRNA and protein in the tumor tissues was detected by real-time polymerase chain reaction (RT-PCR) and immunohistochemistry,respectively.And the expression of survivin gene in serum of each group was tested by ELISA.Results The expression levels of survivin mRNA in implanted-tumor tissues in rhTRAIL,rhTRAIL combined with DDP,DDP and NS group were (48.7 ± 2.5) ％,(53.1 ± 4.6) ％,(99.1 ± 5.3) ％ and (95.6 ± 3.7) ％,respectively.While the protein expressions of survivin gene in those groups were (0.319 ± 0.025),(0.483 ± 0.058),(0.635 ± 0.041) and (0.619 ± 0.017),respectively.Moreover,the serum levels of survivin were (71.9 ± 7.05),(80.26 ± 10.80),(112.75 ± 15.41) and (105.03 ± 20.37),respectively.The data showed that the expression levels of rhTRAIL and rhTRAIL combined with DDP group were lower than that of DDP-treated group or the NS control group (P ＜ 0.0 5).Compared with the rhTRAIL combined with DDP group,the survivin gene expression level of rhTRAIL-single treated group decreased a little lower,but the difference was not significant (P ＞ 0.05).Conversely,the survivin gene level was increased to some degree compared with the NS control group,and uniformly there was no significant difference (P ＞ 0.05).Conclusion rhTRAIL can downregulate the expression level of survivin gene of human lung adeno-carcinoma A549 xenografted tumor in nude mice.It may be one of the possible inhibitory mechanisms of rhTRAIL on the implanted-tumor growth that rhTRAIL can downregulate survivin gene expression and promote tumor cell apoptosis.

Objective Lymphedema is a common complication interrupting a large percentage of breast cancer survivors .How to release the breast cancer survivors from the pain of lymphedema remains a question to breast surgeons .The rapid development of the super-microsurgical measurement allows lymphaticovenular anasto-mosis to become a better way to treat breast cancer related lymphedema .Methods We followed a breast cancer related lymphedema case amd offered super-microsurgical lymphaticovenular anastomosis to her .Results The surgery lasted 4.5 h, and contained 11 anastomosis of lymph ducts .Improvement of edema could be seen during the surgery and the measurement of the upper limb became smaller just one day after surgery .Conclusion Su-per-microsurgical lymphaticovenular anastomosis is a safe improvement for extremity lymphedema after mastectomy and it can provide a better prognosis and appearance .

Objective To investigate the feature of diabetic foot ulcer and the relative mechanism, and to analyze its predilection site. Methods The precipitating factors and the areas of ulcer were analyzed in 121 diabetic patients with foot ulcer. The peripheral neuropathy was diagnosed by measuring the skin sensation, tendon reflex, electromyogram or vibration perception threshold (VPT). The diabetic peripheral neuropathy (DPN) was evaluated by positive symptoms, ultrasound or magnetic resonance angiography. According to morbid changes, the patients were divided into neuropathic ulcer group (n = 33), ischemic ulcer group (n = 27), and mixed type ulcer group (n = 61). Results The ulcers of 97 cases (80. 2%) were distributed in digital pedis and plantar pedis. In neurogenic ulcer group, there were 48.5% lesion at planta pedis, 30.3% at dorsum pedis, and 21.2% at digiti pedi. In ischemie ulcer group, there were 59.3% at digiti pedis, 29.6% at dorsum pedis, and 11.1% at planta pedis. In mixed type ulcer group, there were 49. 2% at digiti pedis, 41% at planta pedis, and 9.8% at dorsum pedis. The difference of ulcer distribution was apparent in these groups. Among these three groups, patients in mixed type ulcer group was the oldest, and had the longest duration of diabetes (P<0.05) and the largest area of ulcer at diagnosis. However, the BMI and blood pressure in isehemic ulcer group were higher than those of the other groups (P>0.05). Conclusions The difference of lesion basis affects the position of diabetic foot ulcer, and the thumbs and plantar pedis are the predilection area of diabetic foot.

Objective The aim of this study is to explore the application of virtual patient system in medical educa-tion in China .Methods Forty-one medical students were recruited to take part in a 5-week pilot use of PUMC-DxR Clinician system , and to finish ten virtual cases totally .At the end of the pilot use , all students were required to complete a survey about PUMC-DxR Clinician system.Results General assessment scored 3.71 ±0.72,novel-ty scored 4.66 ±0.62 ,usability scored 3.51 ±0.87 ,practicality scored 4.00 ±0.87 ,and all of them were over 3 points.According to the survey, 95.1% students agreed that this kind of virtual patient system was suitable for clerkship, intern, or junior resident, and 80.5%students agreed that it was suitable to teaching.Conclusions PUMC DxR Clinician system shows good practicality and usability in this pilot use , whose value is mainly based on the training of clinical reasoning .

Objective To evaluate the safety and feasibility and clinical effectiveness of living relative donor kidney transplantation(LDKT)and summarize its clinical experience. Methods The clinical data of 30 cases of LDKT were retrospectively analyzed.Except for 2 cases being donated by spouse,the others were donated by blood relative donors.6 cases shared two haplotypes,and 22 cases shared one haplotype,and one case 4 mismatched,and 1 fully mismatched.All donors underwent open nephroectomy,in which 7 cases donated right kidneys and 23 donated left kidneys.In 30 cases of recipients,1 case received cadaver donor kidney transplantation and lost her allograft because of superacute rejection.Triple-combined immunosuppressive protocols consisted of calcineurin inhibitor (CNI),mycophenolate mofetil(MMF)or azathioprine(AZa)and steroid. Results All donors'hospital stay was 7 to 10 days postoperatively without any surgical complications. All donors kept their normal kidney function within 3 to 6 months'follow-up.Except for 1 case of death because of lung in fection,29 cases of recipients survived,in which 28 cases kept their normal function kidney within 1 to 4 years of follow-up and 1 case occurred chronic allograft nephropathy after one year.Except one case of DGF,29 cases of recipients retained their normal kidney function in 3 to 5 days postoperatively.Rejection episodes occurred in 4 cases,of which 3 cases were reversed by methylprednisone and 1 case by antithymocyte globulin(ATG)and Tacrolimus.Pneumonia developed in 3 cases,of which 2 cases were cured and 1 case failed.Hematoma was found around allograft in 1 case and wag surgi cally removed.Urinary leakage was happened in 2 cases of recepients and were cured by conservative treatment. Conclusions LDKT is safe and feasible with good long-term results and more advantages such as optimal HLA matches and less ischemia time and lower acute rejection,low-dose immunosup pressants.

Forest musk deer (Moschus berezovskii), a rare wild medicinal animal, is listed under the category of the state key protected wildlife list of China. Musk, secreted by the musk glands, is with high economic and medicinal value and used as precious traditional medicine in China. In order to meet the needs of musk in Chinese traditional medicine, forest musk deer farming was conducted in 1950s, but the research progress on musk secretion mechanism was slow. Therefore, by reviewing the histological and anatomical structure of forest musk deer musk gland, the relationship between sex hormones and the musk secretion process, and the molecular mechanism of the musk secretion, the existing problems in investigating the musk secretion mechanism were analyzed and the development trends in this field were also discussed, in order to provide a reference for further studies on the musk secretion mechanism and improve musk production of forest musk deer.
Animals ; Deer ; metabolism ; Exocrine Glands ; anatomy & histology ; chemistry ; secretion ; Fatty Acids, Monounsaturated ; chemistry ; metabolism ; Male

Objective To discuss the effect of dry powder from stone of Garcinia oblongifolia in south of the Five Ridges on refractory Ⅲ and Ⅳ stage bedsore.Methods 120 cases of patients with refractory Ⅲ and Ⅳ stage pressure sore were randomly divided into the treatment group and the control group with 60 cases in each group.The treatment group applied dry powder from stone of Garcinia oblongifolia in south of the Five Ridges,while the control group used conventional infrared irradiation plus chloramphenicol powder treatment method.The treatment effect was compared between two groups.Results There were significnat differences in clinical efficacy,pain relief and cure time between the treatment group and the control group,and the treatment group acquired better effect than the control group.Conclusions The clinical efficacy,pain relief and healing time of the treatment group in the treatment of refractory Ⅲ and Ⅳ stage pressure ulcer was superior to the control group,and without skin lesions and human adverse reaction,and with the advantages of simple operation,quick,good curative effect,no pain to the patient,easy to accept and no toxic side effect.