[Objective]To compare the therapeutic effect on femoral intertrochanteric fractures with dynamic hip screw(DHS) and proximal femoral nail antirotation(PFNA).[Method]A retrospective study of 483 patients with femoral intertrochanteric fractures in Changhai Hospital from December 2001 to January 2008 were carried out.Totally 109 patients were treated with PFNA,while 374 patients were treated with DHS.The data of operative time,blood loss,walking time,union time and hip function scores were recorded.[Result]All the patients were followed up for 6～38 months(15.3 months in average).There were significant differences in operative time,blood loss and walking time between two groups.There were no significant difference in union time.There were no significant difference in the excellent rate between the two groups in stable femoral intertrochanteric fractures.The excellent rate of PFNA group was significantly higher than DHS group in unstable femoral intertrochanteric fractures.[Conclusion]Each of them have its own advantages and indications.Both are effective ways to treat stable femoral intertrochanteric fractures.PFNA has more advantages to treat unstable femoral intertrochanteric fractures.

Objective To explore the specific anti-tumor effect of cytokine-induced killer cell (CIK) activation by dentritic cells (DC) loaded with the tumor antigen from human lung cancer cell line A549. Methods CIKs and DCs derived from the health donor's peripheral blood monocyte (PBMC) were isolated and induced by the cytokine in vitro. DCs were generated by culture of adherent cells from PBMC for 7days in the presence of IL-4 and GM-CSF. CIKs were generated by culture of non-adherent cells for 7 or 14 days in the presence of INF-?, IL-2, IL-1?, and mouse anti-human CD3 monoclonal antibody. The phenotype of DC and CIK was analyzed by FCM. The activity of DC was evaluated by MLR; and the cytotoxicity of CIK was assayed by MTT. The CIK expression profile of cytokine and signal transduction genes were detected by the DNA micro-array under different circumstances. Results Phenotypic analysis indicated that CD3+CD56+NKT cells were predominant in the CIK cells generated in the current study, and that DC cells expressed high levels of CD40, CD80, CD86 and HLA-DR. As demonstrated by MTT assay, the CIK cells proliferated rapidly, and the DC cells were able to induce an MLR. Both antigen-pulsed and unpulsed DC stimulated the proliferation of CIK cells, and no significant difference was found between the two kinds of DC cells. Unpulsed DC cells did not enhance cytotoxicity mediated by CIK cells even though they were able to stimulate CIK proliferation. Antigen-pulsed DC, however, stimulated CIK cells to specifically kill target cells. The specific antitumor effect was also observed in nude mice bearing tumors. Conclusion One of the major effects of antigen-pulsed DC is to activate CIK cells and to make them specific in killing tumor cells.

Objective The patients with non-small cell lung cancer ( NSCLC) are still at risk of brain metastasis after surgi-cal treatment.The study was to investigate the clinical characteristics and the risk factors for postoperative brain metastasis in patients with NSCLC in order to provide references for prophylactic cranial irradiation ( PCI) . Methods The clinical and prognostic data of 213 patients with NSCLC in our department of oncology from February 2008 to February 2012 were retrospectively analyzed.The occur-rences of postoperative brain metastasis in NSCLC patients with different characteristics were observed.Cox model was used to investi-gate the risk factors for postoperative brain metastasis in patients with NSCLC. Results The overall cumulative rate of brain metasta-sis was 23.9%(51/213) and the rates of brain metastasis at 1-year, 2-year, 3-year after surgery were 6.1%, 14.1%, 22.5% re-spectively.Univariate analysis showed that the rates of postoperative brain metastasis in NSCLC patients with different ages, histological types, tumor stages and CEA levels were statistically significant (P<0.05).Cox regression showed that adenocarcinoma (HR=2.00, 95%CI:1.11~3.64), lung cancer stageⅢ(HR=3.70, 95%CI:1.67~8.25) and high CEA (≥5.0μg/L)(HR=3.16, 95%CI:1.60~6.25) were risk factors for postoperative brain metastasis in patients with NSCLC.The survival time in NSCLC patients with brain metastasis was remarkably lower than that in patients without brain metastasis (P<0.05). Conclusion The NSCLC pa-tients with adenocarcinoma, III stage disease, or high CEA are more likely to develop brain metastasis after surgery, which should be the focus of PCI.

Objective To explore the application of experienced teaching method in the teaching of Fundamentals of Nursing.Methods The feasibility and validity of experienced teaching method was evaluated by expounding the utilization and result of role-play method and practice experienced method.Results The experienced teaching method received good result and proved appropriate in the teaching of Fundamentals of Nursing.Conclusion The experienced teaching method overcame the disadvantages of mere traditional teaching method and aimed at the improvement of quality and ability of students.It contributed to developing the critical thinking ability and other abilities of students.

Objective To investigate the expressions of thymidylate synthase (TS) and adenosine triphosphate (ATP)-binding cassette superfamily G member 2 (ABCG2) in advanced gastric cancer (GC) and to explore their correlation with clinical pathological features.Methods A total of 80surgical specimens of advanced gastric cancer patients were collected.The expressions of TS and ABCG2 in gastric cancer tissues and adjacent normal gastric tissues were detected by immunohistochemical method.The expression of P-glycoprotein in gastric cancer tissues was also examined.The correlations between TS,ABCG2 and clinical pathological features and P-glycoprotein were analyzed.Chi-square test was performed for two groups comparison and Kruskal-Wallis H test were used for multi-groups comparison.Results The positive rates of both TS and ABCG2 in gastric cancer tissues [85.0％ (68/80) and 90.0％ (72/80)] were higher than those of adjacent normal gastric tissues [62.5 ％ (50/80) and 78.7 ％ (63/80)],the differences were statistically significant (x2 =11.466 and 16.463,P=0.009 and 0.001).There were close correlation between the expression of TS,ABCG2 and tumor TNM stage,differentiation status,invasion depth (TS:x2 =30.686,61.470 and 40.545 ; ABCG2:x2=48.192,63.150 and 47.512; all P＜0.01).The later the tumor staged,the worse the cells differentiated and the deeper the tumor invaded,the higher level they expressed.Both TS and ABCG2expressions in gastric cancer tissues were correlated with the expression level of P glycoprotein (x2 =43.977and 29.509,both P＜0.01).Conclusion TS and ABCG2 may be potential indexes to predict the degree of malignancy,progression,drug resistance and prognosis in gastric cancer.

OBJECTlVE To investigate the myocardiaI toxicity of doxorubicin on the myocardium of rabbits and mechanism. METHODS Doxorubicin 2 mg·kg-1 was injected once a week for eight weeks. After discontinuation of doxorubicin,observation was performed for another 8 weeks. Every weekend, uItrasound examination,cardiac catheterization,angiotensinⅡ(AngⅡ)Western bIotting and pathoIogi-caI examination were performed to anaIyze eject fraction( EF),maximaI rate of rise of Ieft ventricuIar pressure(+dp/ dtmax ),AngⅡexpression IeveI,apoptosis index(AI)and the structure of the myocardium. RESULTS At the 7th injection,EF decreased( P ﹤0.05),but reached the bottom vaIue at the 8th injection. At the 3rd injection,Ieft ventricuIar +dp/ dtmax decreased( P ﹤0.05)and reached the bottom vaIue one week after withdrawaI. After that,it increased and reached a high vaIue six weeks after withd-rowaI. But it was stiII Iower than before administration. At the 2nd injection,AngⅡ expression increased (P﹤0.05). At 1 week after withdrawaI,it reached the top vaIue,but than decreased and reached a Iow vaIue six weeks after withdrowaI,but was stiII higher than before administration. At the 1st injection,AI increased( P ﹤ 0.05). At 1 week after withdrawaI,it reached the top vaIue,but then decreased and reached a Iow vaIue 5 weeks after withdrawaI. But it was stiII higher than before administration. CONCLUSlON Doxorubicin cardiac toxicity can induce an eIevated IeveI of myocardiaI AngⅡ,possibIy associated with increased aIdosterone and myocardiaI tension. Increased Ang Ⅱ may induce further myocardiaI structuraI damage and ventricuIar remodeIing through the ROS and caIcium imbaIance.

Objective To observe the treatment effect of nicardipine for the presence of hypertension responses during thyroidectomy under cervical plexus nerve block.Methods Patient without hypertension before the operation was brought into if he received thyroidectomy under cervical plexus nerve block,and with the presence of hypertension responses during the operation,and without effect after injected innovar one dose or dolantin 50mg by vein when the blood pressure was over 160/90mmHg.20 patients according to the criterion mention above were dripped nicardipine 20?g/kg by vein.The SBP,DBP,MAP,HR,SpO_2 and ECG were recorded at 3min,5min,15min,30min,45min after injection and the side effects were also recorded.Results The SBP,DBP,MAP of all patients were fallen distinctly at 3min after injection,and reached lowest at 5min.The blood pressures were steady at other points.There was significantly difference between the point before and after injection(P

Objective To observe the therapeutic effect of tramadol combined with fentanyl in patient controlled intravenous analgesia after nucleotomy of intervertebral disc.Methods 60 patients under general anesthesia,scheduled for nucleotomy of intervertebral disc,were randomly divided into three group(n=20):group tramadol(group T),group fentanyl(group F) and group tramadol+fentanyl(group TF).All patients were received patient controlled intravenous analgesia by loading dose+background dose+PCA bolus dose.The BP,HR,RR,VAS at 6,12,24,48h of postoperation were observed.The sedation score in 24h,average effective-press times and drug dose in 48h of postoperation were recorded.The incidence of nausea and vomiting during 24h of postoperation were observed.Results It had no significantly difference of BP,HR,RR,VAS among three groups.The average effective-press times of group TF (8?2) were significantly less than those of group T (14?3) and group F (12?3).The drug dose of 48h was tramadol (17.9?1.5)mg/kg(group T),fentanyl (16.8?1.5)?g/kg(group F) and tramadol (11.5?0.7)mg/kg+fentanyl (9.1?0.7)?g/kg(group TF).The drug dose of group TF showed significant difference compared with others.The sedation score in group F was the highest,it had significant difference compared with the other two group.The frequency of nausea and vomiting in group T was significantly more than that in others.Conclusion Tramadol or fentanyl gived alone can afford the same satisfied analgesic effect on nucleotomy of intervertebral disc.But there is high nausea-vomiting frequency in tramadol and strong sedation frequency in fentanyl.Tramadol combined with a little opioid fentanyl can afford more satisfying analgesic effect,and is provided with advantage in less drug and side-effect.

BACKGROUND:Tumor stem cels are found to be involved in the recurrence, metastasis and drug resistance of the tumor.
OBJECTIVE:To explore the relationship between cel activity and multidrug resistance of CD44+CD24-/low breast cancer stem cels.
METHODS:CD44+CD24-/low breast cancer stem cels sorted from multidrug resistant breast cancer cel line MCF-7/ADR were detected as percentage using flow cytometry. P-gp fluorescence intensity of the cel membrane and MDR mRNA expression in sorted cels and MCF-7/ADR were detected using flow cytometry and RT-PCR, respectively.
RESULTS AND CONCLUSION: After sorting by flow cytometry, the proportion of CD44+CD24-/low breast cancer stem cels was more than 90%, indicating that the sorted cels could meet the needs of the subsequent experiment. CD44+CD24-/low cel subsets exhibited stronger ability to form microspheres than non- CD44+CD24-/low cel subsets. The P-gp fluorescence intensity and MDR mRNA expression of CD44+CD24-/low cels were significantly higher than those of MFC-7/ADR cel line (P < 0.05). These experimental findings suggest that CD44+CD24-/low breast cancer stem cels sorted from MCF-7/ADR cel lines have a strong ability to form cel microspheresin vitro, and significantly raise the level of P-gp protein and MDR mRNA expression, which may be one of the causes of multidrug resistance.

Objective To synthesize a novel vector of chitosan-particles loaded with gadolinium (Gd-CPs) and observe the adhesion and absorption of the particles in the colon wall of mice with MR imaging in-vivo.Methods Chitosan particles (CPs) with and without gadolinium loaded were synthesized with the emulsion-droplet coalescence method.Sixteen mice were randomly classified into two groups.The suspension with Gd-CPs or with CPs was infused into the rectum of the 8 mice of each group,respectively.MR scans were performed before,during and 40 minutes after infusion for each mouse.Samples of the colon correlated to the enhanced area were obtained for electron microscopy examination.Signal intensity (SI) of ROIs in the wall of rectum or colon,muscles of the pelvis near the rectum and background were measured and corresponding relative SIs were calculated.Relative SI values between the two groups and pre- and post- infusion were compared with pared t test.Results Dimension of the Gd-CPs was about 500 nm,and content rate was about 30%. Values of relative SI of the rectum for pre- and post- infusion in the Gd-CPs group were 0.84±0.06 and 0.98±0.09(t=4.327,P＜0.01),respectively,while those in CPs group were 0.83±0.04 and 0.84±0.05(t=0.658.P＞0.05). The medial value of signal increase rate for CPs group was 19.0%.Gd-CPs particles were found inside the mucosal cells under the electron microscopy.Conclusion MR imaging in-vivo can reveal the phenomenon of adhesion and absorption of mucosa targeted chitosan particle carriers. Clinical MR imaging based on small animal coil is a good method to monitor colon mucosa targeted particle vectors in-vivo.