OBJECTIVE: To observe the effect of perioperative administration of rhubarb on the acute inflammatory response in patients with gastric cancer. METHODS: In this prospective, single-blinded, controlled clinical trial, thirty-one patients with gastric cancer operatively treated were randomly divided into two groups, with 14 patients in control group and 17 in study group. Patients in both groups were given an isocaloric and isonitrogenous enteral diet. The enteral diet was started 36 hours after operation, and continued for 6 days. Patients in the study group were fed with rhubarb before operation, and at 1 day and 2 days after operation. Indexes of acute inflammatory response such as serum C-reactive protein (CRP), interleukin-6 (IL-6) and tumor necrosis factor alpha (TNF-alpha), and indexes of nutritional status such as serum albumin (ALB), prealbumin (PA) and transferrin (TRF) were measured before operation, and at 1 day, 3 and 7 days after operation. RESULTS: Patients in both groups had acute inflammatory response, and the indexes of nutritional status decreased after operation.IL-6, CRP and TNF-alpha tested at 3 and 7 days after operation were lower in the study group as compared with those in the control group, and the recovery time of gastrointestinal motility such as borborygmus, gas elimination and defecation was shorter in the study group as compared with that in the control group. The indexes of nutritional status showed no significant differences between two groups after operation. CONCLUSION: Rhubarb can positively modulate the acute inflammatory response, promote the recovery of postoperative gastrointestinal motility, and benefit enteral nutrition support in patients who have undergone major operations for gastric cancer.

Objective To observe whether bone marrow mesenchymal stem cells (MSCs) can promote the repair of IgA nephropathy and to explore its possible mechanism. Methods Sprague-Dawley rats were randomly divided into three groups which were MSCs injection group, normal saline(NS) infusion group and healthy control group. IgA nephropathy model was established by the improving method with BSA +SEB +CCl4 in former two groups. MSCs of SD rats were continuously cultured in vitro and identified with specific surface antigens by flow cytometry and osteogenic and adipogenic differentiation. MSCs were labeled with bromodeoxyuridine (BrdU) in vitro before transplanted. At 1st and 4th week after MSCs injection, the changes of body weight, urine protein, renal function, histopathology and IgA immunofluorescence were observed. MCP-1, TGF-β1 in urine were detected by ELISA. The expression of MCP-1, TGF-β1 in kidney were examined by RT-PCR. The cytokines and BrdU labeled MSCs were detected by immunohistochemistry to observe the disposition in kidney. Results At the end of the first week of MSCs transplantation, MSCs group urine protein (36.86±4.78) mg/24 h, serum creatinine (53.50±6.28) μmol/L, and the NS group urine protein (66.98±5.86) mg/24 h, serum creatinine (82.50±8.36) μmol/L, the differences between two groups were significant (P<0.05). At the same time, the content of MCP-1, TGF-β1 in urine and expression in renal tissue of MSCs group were obviously less than those of NS group (P <0.05). At the end of the 4th week, the body weight, histopatholngy, IgA immunofluorescence of MSCs group were remarkably improved as compared with those of NS group. The content of MCP-1, TGF-β1 in urine and expression in renal tissue, and renal pathological change in MSCs group had no significant differences as compared with those of healthy control group. As the time passed, the disposition of BrdU-labeled MSCs in kidney was taper. Conclusions MSCs injection contributes to renal repair in rat IgA nephropathy. The mechanism may partly depend on adjusting the excretion of cytokines in renal microenvironment and/or other functions rather than completely depend on their differentiation to renal cells.

The combined teaching method of case-based learning and W2 H2 thinking-type learning was used in the comparative morphology experiment teaching.The teaching method can further strengthen the reform of the compar-ative morphology experiment teaching, and improve the quality of practice teaching.

Objective To investigate the effect of preoperative acute hypervolemic hemodilution with 6% hydroxyethyl starch 130/0.4(HES130/0.4)and polygeline on hemodynamic response and variance regularity of hemodynamic response in open-and close-thoracic cavity in undergoing thoracotomy patients. Methods Sixty patients undergoing thoracotomy,ASA physical status ⅠorⅡ,aged 20~65 yeansold,weighing 45~70kg,were randomly divided three group:HES130/0.4 group ( group A,n=20) ,Polygeline group ( group B,n=20) and Ringer's solution group (group C,n=20).They were respectively infused 20ml/ (kg?h) with HES130/0.4,polygeline and Ringer's solution in one hour before infuseing followed Ringer's 10ml/ (kg?h). The Blood Pressure (BP) and heart rate (HR) were recorded.RPP was calculated before induction(baseline),5min before and 10 min after open thoracic cavity,5min before and 10min after close thoracic cavity. And central venous pressure (CVP) was measured at immediately after deep venous puncture ,5min before and 10min after open thoracic cavity,5min before and 10min after close thoracic cavity. Results The changes of hemodynamics in Ringer's solution group in operation were obvious as compared with baseline before operation.HES130/0.4 and polygeline were relatively stable.Two groups had no significant difference.The CVP of HES130/0.4 and polygeline groups increased obviously before and after open thoracic cavity,but the blood pressure was relatively stable.Only systolic blood pressure increased obviously as compared with Ringer's solution group at 5min before open thoracic cavity. At 10min after open thoracic cavity,HR and CVP in three groups increased obviously as compared with 5 min before open thoracic cavity.At 5 min before close thoracic cavity,blood pressure and CVP in three groups decreased obviously as compared with 10 min after open thoracic cavity. Conclusion The preoperative acute hypervolemic hemodilution with HES 130/ 0.4 and polygeline in undergoing thoracotomy patients can keep hemodynamics more stable and improve tolerance of patients to withstand hypovolemics.

Objective To study the association between activity of hand,foot and mouth disease (HFMD) and the meteorological factors in Suzhou.Methods A total of 17 653 children diagnosed with HFMD in Children's Hospital Affiliated to Suzhou University during 2008 to 2011 were enrolled.The meteorological factors in(c)luding mean temperature,relative humidity,rainfall amount,sum of sunshine and mean wind velocity during Jan 2008 to Dec 2011 were collected monthly.Numeration data were analyzed using chi square or Fisher exact test.Normal distribution data were analyzed using Pearson correlation and non-normal distribution data were analyzed using Spearman rank correlation.Results HFMD could be found all over the year and had obvious seasonality which peaked in Summer,followed by Spring and Autumn and HFMD decreased markedly in Winter.The activity of HFMD was positive correlated with mean temperature(r=0.716,P＜0.01),wind velocity (r=0.630,P＜0.01),rainfall(r=0.477,P＜0.01) and sum of sunshine(r=0.311,P＜0.05).No statistical significance was observed between relative humidity and HFMD(r =0.276,P＞0.05).Multivariate stepwise regression analysis showed that only mean temperature and rainfall were associated with HFMD and mean temperature had stronger influence on HFMD than rainfall (t =4.687,P ＜ 0.01 ; t =2.258,P ＜ 0.05).Conclusions HFMD has obvious seasonality.Mean temperature and rainfall are the main factors affecting this seasonality.

Through the addition of discussion course associated with judicial expertise during the pre medical education, integration of true and typical forensic pathological cases into basic medical theory and experimental education, further addition of optional course of forensic medicine,and guiding the medical students applying the scientifically training projects about forensic pathology, students may improve their learning interesting and clinical thought, and are made early warning and increase the abilities of preventing and dealing with the suddenly medical tangles in the future, at the same time, the medical teachers also increase their professional levels and teaching qualities.These benefit the growing up of high quality medical doctors, decrease and even prevent the happening of medical tangles.

Objectives To explore the effects of nasopharyngeal bacterial colonization in children with acute bronchiolitis due to respiratory syncytial virus (RSV).Methods Hospitalized children of acute bronchiolitis were enrolled to detect pathogen and bacterial colonization.Their clinical data and laboratory results were collected and analyzed.Cases of elective surgery were also obtained as control group.Results Fifty-five percent of all children with bronchiolitis had a lower positive rate of nasopharyngeal bacterial culture (55.0％ vs.74.1％,P ＜0.01).Children with nasopharyngeal bacterial colonization had a higher rate of severe bronchiolitis (13.8％ vs.4.2％,P =0.018),presented dyspnea more frequently (19.8％ vs.9.5％,P =0.037) and had a longer hospital duration (8.2 vs.7.5 days,P =0.036) as compared with those without bacterial colonization.In terms of laboratory results,a higher proportion of C-reactive protein was found in children with bacterial colonization than those with non-bacterial colonizations (17.2％ vs.4.2％,P =0.003).Conclusion Bacterial colonization may be a predictor for severe bronchiolitis.

Objective To study the epidemiological and clinical features of human parainfluenza virus (HPIV) infection in children in Suzhou,and to provide the evidence-based foundation for early warning,diagnosis and treatment of respiratory infection in children.Methods The sputum specimens and medical history were obtained from children with acute respiratory tract infection hospitalized at the Childen's Hospital Affiliated to Soochow University from January 2006 to December 2015.Seven kinds of common respiratory viruses including respiratory syncytial virus,influenza virus A,influenza virus B,HPIV Ⅰ,HPIV Ⅱ,HPⅣV Ⅲ and adenovirus were detected by using the direct im-munofluorescence.Mycoplasma pneumoniae(MP),chlamydia pneumoniae,human bocavirns (hBoV) were detected by using fluorescence quantitative PCR.Rhinovirus and human metapneumovirus were detected by using reverse transcription-PCR.Sputum was cultured for bacteria.Results In 21 769 cases,the detection rate of HPIV positive was 3.21％ (829 cases),among which,HPIV Ⅰ,HPIV Ⅱ,HPIV Ⅲ were respectively detected in 113 cases (0.52％),16 cases (0.07 ％) and 700 cases (3.21％),respectively.There were 378 cases of simple infection and 428 cases of mixed infection,and the mixed infection was very common in Streptococcus pneumoniae,Haemophilus influenza,MP and hBoV.There was a difference in HPIV infection among genders,and the detection rate of the boys was higher than that of girls[4.14％ (563/13 591 cases) vs.3.25％ (266/8 178 cases),x2 =11.036,P =0.001].In the 28 d-1 year old and ＞ 1-3 year old group,the detection rate of HPIV was higher[4.71％ (494/10 476 cases) and 4.21％ (244/5 793 cases),respectively].In spring and summer,there was a higher detection rate of HPIV infection.The clinical manifestations with simple infection of HPIV Ⅰ and HPIV Ⅲ were cough,fever and wheezing.The rate of fever and shortness of breath in those of HPIV Ⅰ was 71.74％ (33/46 cases),10.87％ (5/46 cases),and that in HPIV Ⅲ was 40.12％ (134/334 cases),2.10％ (7/334 cases),HPIV Ⅰ infection was more likely to cause fever and shortness of breath than those of HPIV Ⅲ,there were significant differences (x2 =16.410,P ＜ 0.001;x2 =10.177,P =0.001).Pneumonia had the highest detection rate of viral infection.Conclusions HPIV Ⅲ is the leading pathogen among the types of HPIV in the hospitalized children in Suzhou area.Among the subtypes of HPIV,the peak of HPIV infection occurs in spring and summer.The children less than 3 years old are the most susceptible to parainfluenza virus,and the HPIV detection rate is gradually declines with age.

In monkey submandibular gland there were two types of capillary networks, which were apparently different in calibre and architecture, i. e. the capillary networks around the acini and the capillary networks around the striated ducts. They originate from their respective precapillary arterioles stemed from intralobular terminal arterioles. Between the two types of capillary networks they are connected by both capillaries and postcapillary venules. The latter were called portal vessels. The capillary networks around the striated duct have two types of draining vessels. First, they converged to form postcapillary venules, which continued to form intralobular veins. Second, they directly continued to form the capillary networks around the intralobular ducts. The capillary networks around the intralobular ducts directly supplied blood through precapillary arteioles around the duct besides they connected respectively with the capillary networks around the acini and striated ducts through capillaries. Furthermore, a ring-shaped constriction was observed distinctly at the intralobular terminal arteriole.

Objective To investigate The Th1/Th2 and Tc1/Tc2 polarization in the peripheral blood of first degree relatives of pemphigus vulgaris(PV) and healthy control individuals, and to approach the mechanism of the Dsg3-specific autoimmunity in PV. Methods The peripheral blood mononuclear cells (PBMC) from first degree relatives and healthy control was stimulated for72 h with Dsg3 and without Dsg3. Th1/Th2, Tc1/Tc2 was assessed by four-color flow cytometry. Results The mean frequency of Dsg3-spe-cific Th2 cells for PV antibody positive first degree relatives was 10.13%±3.72%, compared with stimula-tion without antigen 7.28%±3.58%, the difference was significant (P<0.05). The percentage Dsg3-spe-cific Th2 was markedly higher in the PV antibody positive first degree relatives group than that in the control group(10.13%±3.72% vs 6.10%±2.82%, P<0.05) , Tc2 was markedly higher also (20.01%± 10.43% v514.91%±8.06%, 20.01%±10.43% vs 9.58%±5.49%, P<0.05). Conclusion When Dsg3 stimulated PBMC were used to stimulate autologous T cells an increased amount of Th2 and Tc2 was observed, it is implied that the imbalance of Th1/Th2, Tc1/Tc2 might play an important role in the initia-tion of PV.