Objective To discuss the value of percutaneous dilatational tracheotomy(PDT) for cardiosurgery in intensive care unit by comparing its outcomes with that of open tracheotomy(OT).MethodsA prospective study was conducted on 40 severe patients undergoing cardiosurgery.The patients were divided into PDT(treated from January 2002 to July 2003) and OT groups(treated from August 2003 to February 2008) with 20 cases in each.The operation time,length and heal time of the incision,blood loss,vital signs,and postoperative complications were compared between the two groups.ResultsThe operation time,length and heal time of the incision in the PDT group were significantly different from that in the OT group [(8.8?2.2) min vs(21.5?5.3) min,t=-9.897;(1.3?0.2) cm vs(3.4?0.5) cm,t=-17.440;and(3.9?0.9) d vs(5.9?1.2) d,t=-5.963;P=0.000].One patient in the PDT group(5%) had Ⅱ degree blood loss during the operation that was significantly less than those in the OT group(13 patients,65%,?2=15.824,P=0.000).The level of the vital signs change in the PDT group was significantly milder than those in the OT group [MAP: 1-5 mm Hg(median 2) vs 1-20 mm Hg(median 3.5),Z=-2.959,P=0.003;heart rate: 3-12 beats/min(median 5.5) vs 7-70 beats/min(median 10),Z=-3.956,P=0.000;SpO2: 0-4%(median 2%) vs 0-31%(median 3.5%),Z=-3.548,P=0.000].Furthermore,the rate of incisional leakage of sputum and overall rate of complications in the PDT group were significantly lower than those in the OT group.[1(5%) vs 8(40%),?2=5.161,P=0.023;and 1(5%) vs 12(60%),?2=13.789,P=0.000].ConclusionsPDT is a safe and minimally invasive technique with a high rate of success and low rate of complications.The method is easy to operate,and thus could be a good choice for severe patients after cardiovascular surgeries.

AIM:To investigate the effects of 17-AAG on apoptosis and cell cycle of HCT-15 cells and to clar-ify the related mechanisms .METHODS: MTT method was employed to evaluate the inhibitory effects of 17-AAG with Aifferent time and different doses on the proliferation of HCT-15 cells.The cells were stained with Annexin V-FITC/propid-iumiodide and measured by flow cytometry .The expression of STAT3, cyclin D1, Cyt C, caspase 9 and caspase 3 at mR-NA and protein levels was determined by RT-PCR and Western blotting .RESULTS:Treatment with 17-AAG at concentra-tion of 1.25~20 mg/L for 24 h and 48 h significantly inhibited the activity of HCT-15 cells at both time-and concentra-tion-dependent manners .Treatment with 17-AAG at concentrations of 0.425, 0.85 and 1.7 mg/L for 48 h significantly in-duced apoptosis and cell cycle arrest of HCT-15 cells.The exposure of 17-AAG at concentrations of 0.425, 0.85 and 1.7 mg/L for 48 h to the HCT-15 cells significantly down-regulated the expression of STAT 3 and cyclin D1 at mRNA and pro-tein levels, but up-regulated Cyt C, caspase 9 and caspase 3 mRNA and protein in a concentration-dependent manner . CONCLUSION:17-AAG inhibits the cell activity , induces apoptosis and G 1 arrest by down-regulating the expression of cyclin D1, and promoting the mitochondria apoptosis through STAT 3 pathway.

ObjectiveTo investigate mutations in exons 19, 20 and 21 of epidermal growth factor receptor (EGFR) gene in elderly patients with non-small cell lung cancer (NSCLC). MethodsEGFR gene mutations in exons 19, 20 and 21 were detected by nested PCR amplification and DNA sequencing in 46 elderly patients with non-small cell lung cancer. The relationship between mutations and clinical characteristics of these patients was analyzed. ResultsEGFR gene mutations were found in 56.5% (26/46) patients and 41.3% (19/46)were non-silent mutations. Mutation of exon 19 was detected in 6 cases (13.0%), mutation of exon 20 in 13 cases(28.2%) and that of exon 21 in 14 cases (30.4%). Seven patients among them had double mutations and the rest only had a single mutation. The incidence of EGFR gene mutations was higher in non-smokers than in smokers(P＜ 0.01). Higher EGFR mutation rate in exon 19, 20 and 21 were found in patients with clinical benefit who were treated with tyrosine kinase inhibitor(TKl)(P＜0.05). There was no difference in EGFR mutation rate between 60～69 age group and 70～85 age group. ConclusionsThe data suggest that the characteristics of EGFR gene mutations in elderly patients with NSCLC is the same as in the general NSCLC patients. The forecast informations of TKI treatment can be obtained by gene detection in elderly NSCLC patients.

Objective To discuss adhesion blocking experiment of vascular endotelial cells with platelets.Methods The expression,regulation and adhesion of CD226 on vascular endothelial cells incubated by sera from 10 PIH patients and 10 normal pregnant women repectively was detected by flow cytometry,then incubated with interacted platelets by PTA1/Ig protein.Results The positive rate of CD226 in PIH group was significantly higher than that in normal pregnant woman group(P

Objective To investigate whether overexpression of VHL can inhibit the growth and metasta-sis of colon cancer .Methods Adenovirus vectors containing VHL were used to overexpress VHL protein in vitro and in vivo.The proliferation,apoptosis and migration of colon cancer cells CT 26 were examined in vitro.The ex-pressions of related proteins were detected by Western blot analysis .Subcutaneous and liver metastasis of colon cancer models were established and the therapeutic effects were evaluated .Results Overexpression of VHL pro-tein inhibited the proliferation and invasion of CT26,and promoted the apoptosis of CT26 via the regulation of COX-2,Bcl-2 and MMP-9.Overexpression of VHL protein inhibited the growth of subcutaneous colon cancer and liver metastasis in vivo .Conclusion Overexpression of VHL protien can inhibit the growth and metastasis of colon cancer ,and enhance the apoptosis of colon cancer ,indicating that VHL can be used as a potential target for colon cancer therapy .

AIM:to investigate the effects of extract of ginkgo biloba (EGB) on human tubular epithelial-mesenchymal transition induced by transforming growth factor-?1.METHODS: HK2 cells were induced to epithelial-mesenchymal transition by transforming growth factor-?1 (TGF-?1, 10 ?g/L). EGB was added into the medium of HK2 cells 2 h before TGF-?1 was added. The expressions of E-cadherin, ?-smooth muscle actin (?-SMA), NADPH oxidase p67phox and superoxide dismutase (SOD) were determined by Western blotting. Malondialdehyde (MDA) in the mediums of HK2 cells was detected. RESULTS: EGB significantly attenuated the downregulation of E-cadherin, the upregulation of ?-SMA and p67phox, the downregulation of SOD and the upregulation of MDA in HK2 cells induced by TGF-?1.CONCLUSION: EGB significantly attenuates human tubular epithelial-mesenchymal transition induced by TGF-?1, and its underlying mechanism is that EGB attenuates the upregulation of p67phox and the downregulation of SOD induced by TGF-?1.

Objective To investigate the sustained release of BSA from chitosan-OREC/BSA films coated mats in vitro.Methods The negatively charged cellulose acetate (CA) fibrous mats were modified with multilayers of the positively charged chitosan or chitosan-OREC intercalated composites and the negatively charged bovine serum albumin (BSA) via electrostatic layer-by-layer (LBL) self-assembly technique.The adsorption and rinsing steps were repeated until the desired number of deposition bilayers was obtained.The in vitro BSA encapsulation and release experiments demonstrated that OREC could affect the degree of protein loading capacity and release ficiency of the LBL films coating.Results In the pH-gradient release assay,only a small amount of BSA was released from the mats in 1 h.As the time increased,the release rate of BSA of all the samples gradually went up to the maximum data within 8 h.For the samples with identical number of bilayers and record time,obvious increasing of the release amount could be seen in pH 7.4,in comparison with pH 1.2.Besides,doubling bilayers film-coated mats generally.Meanwhile,it was slightly distinguishable between 5 and 5.5 as well as 10 and 10.5 bilayers (t=0.651～ 1.324,P＞0.05).Interestingly,it could be seen that protein release of the chitosan-OREC/BSA films coated mats remarkably increased compared with that of chitosan/BSA films coated mats(t=2.264～ 2.305,P＜0.05).Conclusion The release of protein in the initial time could be controlled by adjusting the number of deposition bilayers,the outmost layer and the composition of coating bilayers.

Objective To investigate causes and treatment approaches for postoperative complications after laparoscopic adjustable gastric banding(LAGB).Methods Clinical and follow-up data of 302 cases were reviewed.The body mass index (BMI),percent excess weight loss (％ EWL),operation time,intraoperative blood loss,the incidence of complications and management were analyzed and summarized.Results There were no conversion to open surgery.The overall complication rate was 6.29％ including 2 cases of gastric wall injury,5 cases of gastric banding slippage (recovered by reoperation).There was no gastric parietal banding corrosion,tube bursting leakage,pulmonary embolism,micronutrient deficiencies,nor mortality.Conclusions The majority of patients were satisfied with the operation effect,still,there were substantial postoperative complications including gastric wall injury,gastric banding slippage.