Objectives: In this study,we evaluated the influence of different nutritional support routes and nutrients on the intestinal barrier function and bacterial translocation in rats with gut I/R injury. Methods: Sixty male Sprague Dawley rats were made ischemic by clamping the superior mesenteric artery for 30 minutes and were divided randomly into four groups of fifteen animals each,i.e.standard parenteral nutrition (PN),gln enriched TPN (G PN),common enteral nutrition (EN),and enteral immunonutrient (IEN) groups. All the rats received isocaloric nutrition support for seven days.Rats were killed after 7 days'nutrition support.Spleen,liver,mesenteric lymph nodes (MLN),and blood samples were collected for bacterial culture. Endotoxin levels in plasma were also measured.The permeability of intestine mucosa was assayed by D lactate level in plasma.The small intestine was removed for studies.Mucosal thickness,villous height,crypt depth and villous surface area were determined.The gut immune barrier function was evaluated by the immunohistochemical staining method. Results: Atrophy occurred in small intestinal mucosa in PN group.The mucosal thickness,villous height,crypt depth and villous surface area were decreased significantly in PN group compared with other groups ( P

30% was considered sensitive and the rate ≤30% was considered resistant;and the 6 specimens were divided into 2 group according to the above standard.cDNA microassay combined with clustering analysis was used to screen for resistance-related genes.Semi-quantitative RT-PCR was used for verification of HDAC1 gene expression.Results:Three of the 6 glioma specimens belonged to the drug resistance group and the other 3 to the drug sensitive group.cDNA microarray analysis combined with cluster analysis screened out 21 genes,with 6 up-regulated and 15 down-regulated.High expression of gene HDAC1 was noticed in all the 6 specimens by semi-quantitative RT-PCR,and the trend was similar to that by microassay.Conclusion:The primary drug resistance of glioma may be associated with the 21 genes screened by cDNA microarray;the detailed mechanisms for drug controlling still need to discussed in the future.

Objective To evaluate the clinical value of multi-tomographic imaging mode of three-dimensional ultrasound combined with surface imaging in diagnosing and staging bladder tumors.Methods Seventy-five patients were examined with three-dimensional ultrasound and two-dimensional ultrasound.In addition,54 cases were undergone preoperative multislice spiral CT.All cases were proved by pathology after operation.Results The qualitation accuracy in the diagnosis of bladder tumor with two-dimensional ultrasound was 93.3%(70/75) and that of three-dimensional ultrasound was 98.7%(74/75).The staging accuracy rates with two-dimensional ultrasound and three-dimensional ultrasound were 83.5%(106/127) and 93.2%(123/132) respectively.The difference of bladder tumor staging between three-dimensional ultrasound and two-dimensional ultrasound was significant (P＜0.05).The qualitation accuracy in the diagnosis of bladder tumor with CT was 90.7%(49/54).The preoperative staging rate of CT was 79.7%(59/74),compared with that of three-dimensional ultrasound,the difference was significant(P＜0.05).Conclusions Multi-tomographic imaging mode of three-dimensional ultrasound combined with surface imaging can provide useful information and makes an improvement in detecting and staging bladder tumors.

Objective To evaluate the significance of color Doppler ultrasound examination of renal blood flow combined with the detection of bone morphogenetic protein-7(BMP-7)in early diagnosis of type 2 diabetic nephropathy.Methods Blood BMP-7 level was tested in 90 patients with type 2 diabetic nephropathy and 30 controls,and parameters of renal blood flow were measured by color Doppler ultrasound examination.Blood BMP-7 level as well as resistant index(RI)of segmental renal artery(SRA)and interlobar renal artery(IRA),were compared between these two groups.Results Compared with controls,blood BMP-7 level gradually decreased with the aggravation of diabetic kidney damage(P＜0.01).The peak systolic velocity(Vmax)and the end diastolic velocity(Vmin)of SRA and TRA were slowed gradually,while RI increased(P＜0.01).Blood BMP-7 level was negatively correlated with IRA's and SRA's RI of IRA and SRA(r =-0.603,P＜0.01;r =-0.652,P＜0.01).Conclusions Color Doppler ultrasound examination of renal blood flow combined with detection of BMP-7 might play an important role in early diagnosis of type 2 diabetic nephropathy.

Objective To evaluate the function of motor nerve in patients with diabetic sensory neuropathy (DPN) by estimating the motor units.Methods Fifty-four patients with DPN were divided into two groups according to the nerve conduction abnormality of ulnar nerve.The paresthosia group only included patients of 33 patients (20 male, 13 female) with abnormal sensory conduction.The admixture group included 21 patients (13 male, 8 female) with abnormal motor sensory conduction.The control group included 42 healthy people.A Keypoint4 electromyogram device was used to estimate the motor units of hypothenar muscle, and the fasting blood glucose and the duration of diabetes mellitus were documented.Results The motor units of hypothenar muscle in paresthesia group, admixture group and control group was 97.1±47.6, 63.3±22.3, 173.0±75.5 (F=21.259, P=0.000) respectively.The hypothcnar muscle motor units(84.0±42.8) in 54 patients with DPN had negative correlation (r=-0.414, P=0.002) with the duration of diabetes mellitus (1 month to 26 years) and had no evident correlation with fasting blood glucose (5.0-20.4 mmol/L).Conclusion There is clinical motor nerve damage in patients with diabetic sensory neuropathy, and the loss of motor units is impacted by the duration of diabetes mellitus.

Objective:To investigate the characteristics of phrenic nerve motor conduction (PNC)and motor evoked potentials of diaphragm elicited through magnetic stimulation (dMEP)in mechanical ventilation of patients with chronic obstructive pulmonary disease(COPD).Methods:PNC and dMEP were performed in 10 COPD patients with regular mechanical ventilation(the duration of mechanical ventilation≤7 d),10 COPD patients with prolonged mechanical ventilation(the duration of mechanical ventilation＞7 d),and 10 healthy subjects(control group).Results:There were significant differences in the latency and the common logarithm of the amplitude of PNC,cervical dMEP and cortical dMEP between three groups before and after weaning(P＜0.01 or P＜0.05).There were significant differences in central motor conduction time(CMCT)in three groups before and after weaning(P＜0.01).There was longer CMCT before weaning in two COPD groups than that of control group(P＜0.01).It showed no statistical difference in CMCT before weaning between two COPD groups(P＞0.05).There was a longer CMCT after weaning in prolonged mechanical ventilation than that of regular mechanical ventilation(P＜0.01).However,there was no statistical difference in CMCT after weaning between the regular mechanical ventilation group and the control group(P＞0.05).Conclusion:There were dysfunctions in the cortico-diaphragmatic pathway in COPD patients with mechanical ventilation,which may be aggravated by the prolonged mechanical ventilation.PNC and dMEP may help to define the cause of respiratory dysfunction in COPD patients with mechanical ventilation.

Objective To explore the value of virtual touch tissue quantification (VTQ ) in the diagnosis of pancreas early damage of patients with hyperuricemia(HUA) .Methods Sixty‐five cases of patients with normal glucose tolerance and HUA (HUA group) and 42 cases of patients with HUA and impaired glucose tolerance (IGT group) were included in the study ,and other 150 health subjects were taken as control group .After routine ultrasound examination ,the pancreas shear wave velocity values (Vs) of different groups were measured by VTQ technology ,and the results were analyzed .Results Compared with the control group ,the rate of the abnormai ultrasonogram of pancreas in IGT group showed obvious increasing trend but there was no significantly difference between the other groups(both P >0 0.5) .The Vs of the normal control group ,HUA group ,and IGT group were (1 2.1 ± 0 1.5)m/s ,(1 4.1 ± 0 1.3)m/s and (1 5.9 ± 0 1.5)m/s ,respectively .The Vs of HUA group and IGT group were higher than that of the control group (both P <0 0.5) ,and the Vs of IGT group was significantly higher than that of HUA group ( P <0 0.5) .Conclusions Hyperuricemia may cause pancreas damage ,and with the disease progress ,the pancreas damage became more serious ,and VTQ technology may play an important role on the diagnosis of pancreas early damage in HUA patients .

Aims To investigate the protective effects of noninvasive limb ischemic preconditioning (LIPC) on myocardial ischemia-reperfusion (I /R)injury,and to explore the mechanism.Methods Healthy male Wistar rats were divided randomly into I /R,I /R +LIPC,I /R +5-Hydroxydecanoate (5-HD)and I /R +LIPC +5-HD groups.The I /R +LIPC and I /R +LIPC-5-HD groups of rats were subjected to three cy-cles of LIPC induction per day with 5 min of reperfu-sion after occlusion for 5 min at the left hind limb for 3 days.All rats were subjected to myocardial I /R injury on the fourth day.The I /R +5-HD and I /R +LIPC-5-HD groups of rats were given the inhibitor of ATP-sen-sitive potassium channel 5-HD before and during myo-cardial I /R injury. Results Compared with I /R group,LIPC reduced myocardial infarct size (P <0.05),lowered cardiocyte apoptosis index and Fas, FasL positive cell number (P <0.01 ),increased the reduced nitric oxide (NO)/endothelin (ET)-1 ratio (P <0.05)in serum in I /R +LIPC group.5-HD a-bolished the protective effects induced by LIPC in I /R+LIPC-5-HD group.Compared with normal myocardi-al tissue,expression of mir-30a-3p was increased in I /R group (P <0.01 )and was decreased in LIPC group (P <0.01 ).Conclusion LIPC alleviates myocardial I /R injury and improves endothelial function. The mechanism may be related with the opening of ATP-sensitive potassium channel,regulating the balance be-tween NO and ET-1 and decreasing the expression of myocardial mir-30a-3p.

Objective To assess the clinical efficacy of human neural stem cell (hNSC) transplantation in the treatment of severe cerebral palsy (CP) in children.Methods hNSCs were obtained from the forebrain of 10 to 12-week-fetus.Forty children with CP were voluntarily received hNSC transplantation that were injected into cerebral ventricle.The development of motor and fine motor functions were evaluated by GMFM and PDMS-FM 1 month before hNSC transplantation.as well as 3 and 6 months after hNSC transplantation.Results Twenty six (65％) cases displayed improvement from day 5 to month 6 after hNSC transplantation.GMFM assessment showed that the percentage was (4.52±2.50) ％ 1 month before hNSC transplantation,(7.74±2.94) ％ 3 months after hNSC transplantation and (13.01±6.71)％ 6 months after hNSC transplantation,indicating a significant improvement by the treatment of hNSC transplantation(P＜0.05).The percentage in PDMS-FM evaluation was (15.01± 12.00)％,(20.34± 11.91) ％ and (30.02± 12.50) ％ one month before hNSC transplantation,3 and 6 months after hNSC transplantation,respectively,also suggesting a significant improvement induced by hNSC transplantation treatment (P＜0.05).Moreover,the developmental improvement was the most prominent among 1-3 months post hNSC transplantation.Then the development slowed down.Significantly,patients received no hNSC transplantation experienced serious adverse events or complications.Conclusions hNSC transplantation is an effective and safer therapy for severe CP.Future observations are needed to evaluate long-term clinical efficacy of the therapy.

Objective To investigate the correlation between posterior neck pain and lumbar epidural pressure (LEP)during percutaneous endoscopic lumbar discectomy (PELD).Methods A prospective study was performed on 86 patients undergoing PELD,46 males,40 females,aged 1 9-71 years,with ASA physical status of Ⅰ or Ⅱ.Each patient received lumbar epidural anesthesia.Lum-bar epidural pressure (LEP)was monitored continuously through a lumbar epidural catheter which was connected to a pressure transducer.LEP before the operation (LEPbase ),LEP at the time of pos-terior neck pain (LEPpain )and maximal LEP (LEPmax )were recorded.Results Thirty patients (34.9%)complained of posterior neck pain during the procedure.The lowest LEPmax was 31.0 mm Hg,and the highest LEPmax was 77.0 mm Hg.The LEPmax in patients with neck pain [(60.6± 8.8)mm Hg]was significantly higher than LEPmax in patients without neck pain [(50.7 ± 9.5 ) mm Hg](P <0.01 ).Patients with higher LEPmax had higher probabilities of having posterior neck pain (P <0.01).Conclusion Patients with higher LEPmax had higher probabilities of having posterior neck pain.