Objectives:This study was to evaluate the role of nasogastric feeding as early nutritional support in geriatric patients with brain injury. Methods:Thirty one geriatric patients with brain injury were randomly assigned to two groups,one supported with enteral nutrition(16 cases) and another with parenteral nutrition(15 cases).The serum glucose level,liver function and serum albumin levels were determined.The relative complications were recorded daily. Results:In early enteral nutrition group,there were less complications. Conclusions:The early enteral nutrition is well tolerated in the geriatric patients with brain injury.

Differentiated cells can be induced into pluripotent stem cell by reprogramming with defined fators. The new method of stem cell technology marks a major breathrough. This paper reviews the establishment, identification and research progress about induction of pluripotent stem cell.

The National Surgical Adjuvant Breast and Bowel Project (NSABP) is a cooperative group to conduct clinical trials in breast and colorectal cancer research. In this article, we review NSABP breast cancer clinical trials.

Objective: To observe the differential expression of epithelial membrane antigen (EMA) and renal cell carcinoma marker (RCC-Ma) in early renal carcinoma and corresponding adjacent (0.5, 1.0, and 2.0 cm) tissues, so as to estimate the safe margin of laparoscopic partial nephrectomy for renal tumors. Methods: Tissue microarrys, including 44 tissues of clear cell renal cell carcinoma[A] and normal renal cortex tissues of different distances to the tumor: 0.5 cm[B], 1.0 cm[C] and 2.0 cm [D], were constructed. The expression of EMA and RCC-Ma was examined by immunohistochemical staining in the four groups. Results: Intensive membranous and (or) cytoplasmic staining of EMA and RCC-Ma was observed in the cancer and adjacent tissues. The positive rate in group A was significantly higher than those of the other three groups (A [15.91%/ 18.18%], B[84.09%/79.55%], C[86.36%/77.27%] and D[79.55%/75.00%], P<0.01). The positive rates of EMA and RCC-Ma expression were not significantly different between the group B, C, and D(P>0.05). Conclusion: Our data denote that, when laparoscopic partial nephrectomy is done for early renal carcinoma, at least 5 mm of normal parenchyma tissue beyond the pesudocapsule should be excised with the tumor.

Objective To observe the levels of Ang - 1 and NF-κB in lung tissue and to aseess the severity of ALI induced by phosgene in order to clarify the mechanism of the protective effect of Ang - 1 on phosgene induced ALI.Method Rats were randomly divided into phosgene group and air group.Another rats were randomly (random number) divided into phosgene group,phosgene + PDTC group and air group.Lung tissue was collected to weigh and calculate the wet / dry weight ratio,measure BALF,white blood cell count,total protein and Ang-1 at given time after exposure to phosgene/air and PDTC.The Ang - 1 and NF-κB levels in lung tissue were measured with Western blot and immunohistochemistry.Data were analyzed by using SPSS 16.0 statistical package and comparisons between groups were carried out byusing One-Way ANOVA analysis and LSD -t test,α ＜ 0.05.Results Serum angiopoietin -1 level became lesser within 48 hours after exposure to Phosgene.The severity of ALI became worser with time elapsing.Ccompare with air group,the severity of ALI in phosgene group was worser with time elapsing ( P ＜ 0.05).Compared with phosgene + PDTC group,the serum angiopoietin -1 and arterial oxygen partial pressure in phosgene group were lower ( P ＜ 0.05).The severity of ALI of rats in phosgene group were worser than that in phosgene + PDTC group ( P ＜ 0.05).Serum angiopoietin -1 and partial pressure of oxygen of rats in phosgene group were higher than those in phosgene + PDTC group ( P ＜ 0.05).Immunohistochemistry test showed that the expression of Ang-1 in lung tissue in air group were normal,and Ang-1 in phosgene group were significantly reduced,and Ang-1 in PDTC intervention group was higher than that in phosgene group and lower than that in air group.The above results were confirmed by Western blot test which was consistent with the results of immunohistochemistry test.Similarly,the levels of NF-κB in lung tissue determined by using both Western - blot and immunohistochemistry were consistant,and results of both methods showed that the expression of NF - κB in air group was normal,and it increased in phosgene group,and the expression of NF-κB in phosgene + PDTC group was lower than that in phosgene group.Conclusions The serum level of Ang-1 was decreasing within 48 hours after ALI.Ang-1 was negatively correlated with the sevfity of phosgene induced ALI.Ang-1 likely had an effect on NF-κB signaling pathway,ameliorating the inflammation mediated by cytokines,reducing lung endothelial permeability and in turn lessening the severity of ALI.

Objective To investigate the clinical value of urinary retinol binding protein(RBP) and N-acetyl-β-glucosaminidase(NAG) for evaluating renal function in preterm neonate.Methods 89 neonates in our NICU were selected,divided into three groups:the asphyxial preterm group (18 cases),the no-asphxial preterm group (25 cases),and the control group (46 term infants without asphyxia).All objects were detected the urinary RBP,NAG and creatinine(Cr).The levels of RBP/Cr and NAG/Cr and blood urea nitrogen(BUN),Cr were observed within 48h after birth after birth.The fluctuations of urinary RBP/Cr and NAG/Cr in no-asphxial preterm group also were observed in 0~48h,~96h,~168h after birth respectively.Results The urinary RBP/Cr levels in asphyxial preterm group [(0.951±0.629)g/mol] were higher than those in no-asphxial preterm group[(0.389±0.281)g/mol] and the control group[(0.119±0.081)g/mol](P<0.05).The urinary RBP/Cr levels in no-asphxial preterm group were also significantly higher than those in the control group(P<0.05).The levels of urinary NAG/Cr in the asphyxial and no-asphxial preterm groups were both higher than those in the control group(P<0.05),but there was no difference betwteen the former two groups(P>0.05).The levels of serum Cr and BUN were no significant difference in the three groups(P>0.05).The urinary RBP/Cr level had non-linear correlation with either postnatal or gestational age in no-asphyxial preterm group.While the urinary NAG/Cr levels negative correlated with the gestational age(r=-0.625,P<0.05).And the correlation between the urinary NAG/Cr and postnatal age was postive(P<0.05).Conclusion The determination of urinary NAG/Cr and RBP/Cr provides a sensitive and reliable method to evaluate the renal function of neonates,especially in preterm infants.The RBP/Cr is affected by asphyxia more than NAG/Cr,which is rather correlated with gestational age.

Objective To investigate the clinical characteristics of sever acute pancreatitis (SAP) with high triglyceride(TG). Methods 82 patients with onset of SAP within 72 hours were involved in this study. These patients were divided into high TG group (n=26) and normal TG group (n=56) according to serum TG lev-els tested (high TG group≥1.7 mmoL/L;normal TG group<1.7 mmol/L on admission). Results 31.71% (26/82) SAP patients were discovered with high TG APACHE-Ⅱ grade of high TG group was higher than that of normal TG group on admission[(14.62±7.58) vs (10.68±5.21),P<0.01]. Within the onset of 72 hours,the incidence of cardiac,pulmonary and kidney dysfunction in high TG group was higher than those of normal TG group (34.62%,34.62% and 19.23% vs 5.36%,3.57% and 1.79%,P<0.01),and the incidence of pancreatic pseudocysts was higher in high TG group than that of normal group(42.31% vs 7.14%,P<0.01). No emergency and early-stage surgical cases in high TG group but 13 cases(23.21%) in normal group. There were 2 cases of high TG group and 4 of normal group averting to operation. Conclusion SAP patients with high TG have high incidence of early-stage organ dysfunction and local complication,in this case nonsurgical intervention is the first choice.

Objective To explore the underlying mechanism of potential effect of sildenafil on porcine pulmonary artery smooth muscle cells (SMCs) proliferation induced by serotonin. Methods Porcine pulmonary artery SMCs at 3-5 passages were randomly divided into 4 groups: control group (CON), 5-HT group (HT), sildenafil group (SIL) and sildenfil-5HT combined group (S-HT). Pulmonary artery SMCs at exponential growth phase were serum starved with 0.2% FBS for 72 h, followed by sterile PBS, serotonin (10 μmol/L) and sildenafil (1 μmol/L) incubation in CON group, HT group and SIL group, respectively. In combined group (S-HT): pulmonary artery SMCs were serum starved and then exposed to sildenafil for 20 min, followed by serotonin incubation for indicated time. The phosphorylation of extracellular signal regulated kinase (ERK1/ERK2) was measured by Western blot at indicated time points. Flow active cell sorting (FACS) was used to evaluate the ratio of S phase cells in the cell cycle after 24 h of treatment. MTT color metric method was used to analyze SMCs proliferative index after 72 h of treatment. Results Compared with CON group, the phosphorylation of ERK1/ERK2, the percentage of cells in S phase, and the cell proliferation index increased remarkably after incubation with 5-HT (P<0.05). Preincubation with sildenafil followed by serotonin enhanced the phosphorylation of ERK1/ERK2 (p-ERK1/ERK2) and further elevated the percentage of cells in S phase and the cell proliferation index compared with that of HT group. While the total ERK1/ERK2 (t-ERK1/ERK2) was not statistically different among these groups. Conclusions Sildenafil potentiates the proliferative effect of serotonin on pulmonary arterial SMCs via upregulating phosphorylation of ERK1/ERK2.

Purpose: To study the influence of estrogen on the proliferation of human carcinoma cells. Methods: Treated with different concentrations of estrogen, the influence of estrogen on MCF7 was detected by MTT test. Several proteins related with cell cycle, tumor suppressor, proliferation and apoptosis were detected by the method of Western blot. Results: MTT test showed that estrogen could promote the proliferation of MCF7. Cyclin Dl was increased at the same time. But the protein level of PTEN, a tumor suppressor gene, was not changed by estrogen. Furthermore, as an anti -apoptotic protein, PKB protein level was also unchanged. Conclusions: Estrogen can promote the proliferation of human carcinoma cells by certain pathways including cyclin Dl, but not including PKB.

[Objective] To evaluate the therapeutic effect of early composite treatment in patients with cervical spinal cord injury(SCI) caused by diving injury.[Method]27 patients of SCI caused by diving injury,including complete SCI in 15 patients and incomplete SCI in 12 patients,were analyzed.Early composite treatment scheme were as follows:(1) systemic treatment: respiratory support and effective circulation volume for maintenance of systolic pressure more than 90mmHg and oxygen saturation more than 90%.(2) Early pharmacological treatment such as methylprednisolone and dexamethasone.(3) Immobilization and reduction of the injured cervical spine by skull traction.(4) Early cervical decompression,reduction,graft and internal fixation.(5) Early hyperbaric oxygen therapy after operation.The stability and fusion of the injured segments and the complications of the hardware were observed on the X-ray film postoperatively.The spinal cord function was evaluated with ASIA grades and sensorymotor scores.[Result]All 27 patients were followed up for 12 to 36 months,with an average of 28 months.No intra-operative and post-operative complications,the incision healed well.The injured segments were stable and all bone grafts acquired fusion in 3 months,no plates or screws broken or loosen.The neurological recovery were detected in 13 patients.The neurological recovery rate was 20% in complete SCI,83.3% in incomplete SCI,48.1% in the total.The ASIA grades of the sensory and motor scores could hardly be improved postoperatively in complete spinal cord injury while in incomplete spinal cord injury the ASIA grades and sensorymotor scores increased significantly.[Conclusion]Early composite treatment of cervical spinal cord injury caused by diving injury can significantly improve neurological function of the cervical spinalcord injury patients.