0.05).The mean hospital stay of PCN group was significantly shorter than that of conservative treatment group(4.5 days and 16.5 days respectively(P

Objective To explore the effects of mild hypothermia (MH) on the nitric oxide (NO) and water content of brain tissues (WBT) in rats with traumatic brain edema (TBE). Methods Fifty-four Wistar rats were divided into a control group (group C), a normithermal traumatic group (NT group) and a mild hypothermia traumatic group (MHT group). The NT and MHT groups were then divided into 4 subgroups for study at 30 min, 2 h, 4 h and 8 h post-trauma. TBE models were established according to Yuan Shaoji′s method. The concentration of NO in the jugular vein was measured using chemical luminescence, and water in the brain tissues was calculated with Elliot′s formula. Results Compared with those in the group C, the concentrations of WBT and NO were significantly increased 30 min post-trauma in the NT group, and reached a peak 8h after trauma. These levels were markedly decreased in the MHT group in comparison with the NT group. Conclusions NO levels might play an important role in the development of TBE, and change synchronously with WBT. TBE could be mitigated by MH, which might promote early rehabilitation of TBE by reducing NO.

Objective To investigate the effect of ghrelin on PAI-1 secretion in HepG2 cells induced by TNF-αand the effect of p-38 MAPK.Methods HepG2 cells were cultured.The concentration of TNF-α used to treat the HepG2 cells wag selected.The effect of ghrelin on PAI-1 secretion induced by TNF-α was detected by ELISA,the p-38 MAPK expression was investigated by Western blot.Results The concentration of PAI-1 was increased when cells were exposed to different concentration of TNF-α.The p-p38 MAPK expression was increased when the cells were exposed to TNF-α,ghrelin could inhibit the increase of PAI-1 secretioN induced by TNF-α.The expression of p-p38 MAPK was decreased when the cells were pretreated with ghrelin.Conclusion PAI-1 secretion were increased after TNF-α in-creasing.Ghrelin could inhibit PAI-1 secretion via p38 MAPK.

OBJECTIVETo explore the role of S100A4 in the epithelial-mesenchymal transition (EMT) in esophageal squamous cell carcinoma and its possible molecular mechanism.

METHODSThree chemically synthesized S100A4 siRNA sequences were transiently transfected into esophageal carcinoma EC9706 cells. EC9706 cells transfected with negative siRNA, lipofectamine 2000, and vacant EC9706 cells were used as control. Fluorescence quantitative RT-PCR and Western blot were used to detect the inhibition rate of S100A4 siRNA. S100A4 siRNA2 with the best inhibition rate was chosen to transiently transfect into EC9706 cells under the same conditions. The EC9706 cells transfected with negative siRNA, lipofectamine 2000 and vacant EC9706 cells were also used as control. Fluorescence quantitative RT-PCR and Western blot were used to detect the mRNA and protein expressions of E-cadherin, vimentin and snail. The morphology of EC9706 cells was observed under an inverted microscope. Boyden chamber and scratch test were used to detect the invasion and migration ability of EC9706 cells, and CCK8 assay was used to detect the proliferation ability of EC9706 cells. EC9706 cells transfected with S100A4 siRNA2 were further transfected with snail eukaryotic expression vector. The EC9706 cells transfected with S100A4 siRNA, EC9706 cells transfected with snail eukaryotic expression vector and vacant EC9706 cells were used as control. The above indexes of all the groups were observed, too.

RESULTSThe S100A4 mRNA and protein expression levels of the S100A4 siRNA2 group were 0.417 ± 0.041 and 0.337 ± 0.039, the transmembrane cell number was 61.608 ± 8.937, the scratch healing distance was (0.216 ± 0.064) mm, the A value was 0.623 ± 0.084, the E-cadherin mRNA and protein levels were 0.619 ± 0.032 and 0.495 ± 0.034, the vimentin mRNA and protein levels were 0.514 ± 0.032 and 0.427 ± 0.028, the snail mRNA and protein levels were 0.573 ± 0.029 and 0.429 ± 0.041. These data were significantly different with the liposome group, the negative control group and the blank group (P < 0.05 for all). After the S100A4 siRNA2 treatment for 24 h, the appearance of EC9706 cells changed to epithelial cell morphology. The transmembrane cell number and the scratch healing distance of the S100A4 siRNA2+snail eukaryotic expression vector group were (69.382 ± 9.666) cells and (0.274 ± 0.029) mm, the A value was 0.823 ± 0.101, the snail mRNA and protein levels were 0.704 ± 0.037 and 0.625 ± 0.031, the vimentin mRNA and protein levels were 0.712 ± 0.046 and 0.609 ± 0.038, and these data were significantly higher than those of the Sl00A4 siRNA2 group (P < 0.05 for all). The E-cadherin mRNA and protein levels of the S100A4 siRNA2+eukaryotic expression vector group were 0.437 ± 0.038 and 0.381 ± 0.031, significantly lower than those of the S100A4 siRNA2 group (P < 0.05 for all). However, snail had no effect on the morphology of EC9706 cells.

CONCLUSIONSS100A4 may be involved in the EMT process of esophageal squamous-cell carcinoma by regulating the expression of snail and then plays a role in the invasion and metastasis of esophageal carcinoma.

Cadherins ; analysis ; Carcinoma, Squamous Cell ; metabolism ; pathology ; physiopathology ; Cell Line, Tumor ; Epithelial Cells ; Epithelial-Mesenchymal Transition ; Esophageal Neoplasms ; metabolism ; pathology ; physiopathology ; Humans ; Indicators and Reagents ; Lipids ; RNA, Messenger ; analysis ; RNA, Small Interfering ; analysis ; physiology ; S100 Calcium-Binding Protein A4 ; S100 Proteins ; antagonists & inhibitors ; genetics ; physiology ; Snail Family Transcription Factors ; Transcription Factors ; analysis ; genetics ; Transfection ; Vimentin ; analysis ; genetics

Objective To observe the anatomy of the perforator flap of the posterolateral midforearm. Methods Lateral condyle of the humems wag taken as the observation mark on 30 specimens of adult upper limb perfused with red latex.The surgical magnifier Wag used to obse~e the origin,branches and distribution of the perforating branches of the posterolateral midforearm as well as alanagtomosis between perforating branches and peripheral vessels.Mimic operation WaS performed on the two sides of the fresh specimen.Results The perforating branches of the posterolateral midforearm originated from the radial musculoculancous branches of the posterior interosseous artery,the intermuscular branches of the radial artery and the direct periosteal branch of the radial artery had relatively stable location of piercing the deep fascia.Then,the perforating branches of the posterolateral midforearm pagsed through the deep fascia to the subcutaneous part among the spatium intermusculare of extensor digitorum and extensor carpi radialis brevis,supinator and abductor pollicis longus(within 12.5-15.8 cm below the lateral condyle of the humerus).Large number of small blood Vessels were also separated and closely aligned with the musculoculancous branches vascular,perineural and neural stem vascular chain of lateral branches of posterior antebrachial cutaneous nerve.Then,the vascular plexus was formed along the spatium intermusculare and lateral branches of posterior antebrachial cutaneous nerve longitudinal axis between extensor digitorum and extensor carpi radialis brevis. Conclusion The axial pattern flaps or cross-regional blood supply skin flap pedicled with the perforating branches of the posterolateral midforearm Can be formed to repair the soft tissue defect of tlle forearm and wrist.

Objective This study is to understand the interpersonal conflict management styles of head nurses and its related factors. Methods A cross- sectional survey was conducted in 440 head nurses in Shanghai Hospital, using"personal information table"and the "Rahim Organizational Conflict Inventory- Ⅱ"as the tools for data collection. Results When dealing with conflicts, "integrating"is the most commonly used approach of head nurses, while "dominating"the least used one. Age, education, work experience and other factors were statistically significant with the conflict management styles head nurses used. Conclusions The most commonly used conflict management style of head nurses tends to a winwin way. Age, education, work experience and other factors can affect the ways of managing conflict.

Purpose To investigate the protein expression of breast cancer susceptibility gene (BRCA1) in triple negative breast canc-er ( TNBC) and to analyze the prognostic impact on outcome of TNBC by BRCA1 protein. Methods The expression of BRCA1 and p53 in 95 cases TNBCs was detected by immunohistochemistry. The correlation analysis and evaluation of prognosis were conducted in consideration of patients clinical and pathological characteristics. Results The positive rate of BRCA1 protein expression in TNBCs was 31. 6%. Compared with BRCA1 negative expression, those patients with BRCA1 positive expression were associated with younger age (P=0. 047) and higher expression of p53 (P=0. 001). There was no significant difference in outcome between BRCA1 positive and negative expression (HR=1. 10,95%CI=0. 552~2. 235, P=0. 769). Conclusion The expression of BRCA1 protein may have no impact on the outcome of TNBC. There is possible correlationship between p53 pathway and BRCA1 in inhibiting tumor growth.

Objective To understand the status quo of the prevention and treatment of hepatitis B in rural area ,to analyze the shortages in prevention and treatment strategy ,to explore the corresponding prevention countermeasures and to provide the scientif‐ic basis .Methods The inhabitants were randomly sampled from 6 natural villages in the rural area of Zhangjiakou as the research subjects .The venous blood HBsAg and HBsAb were detected .The respondents were divided into 2 groups according to the distance of residence place from cities and towns .The distribution differences of HBsAg and HBsAb were compared among different age groups for analyzing the influence of age and public health conditions on the HBV control effects .Results The HBsAg positive rate averaged 5 .92% and the HbsAb positive rate averaged 33 .73% ,with the age increase ,the HBsAg positive rate showed the increas‐ing trend and the anti‐HBsAb showed the decreasing trend ;the anti‐HBsAb positive rate in the inhabitants aged under 15 years near town was higher than those far from town .Conclusion It is needed to increase the input and support intensity to the rural areas in the aspects of finance and manpower ,improve the public health conditions of the rural area with the planned immunity as the main thing ,enlarge the hepatitis B vaccine inoculation range ,strengthen the publicity of HBV harm ,prevention and treatment knowledge , increase the neonatal hepatitis B vaccine inoculation rate and the 24 h timely inoculation rate of hepatitis B vaccine ,accomplish the immune blocking in pregnant women with HBsAg positive ,and preventing the HBV communication during feeding process in in‐fants .

Objective To investigate the influence of neoadjuvant chemotherapy on the occurrence of postoperative nausea and vomiting ( PONV) after radical mastectomy. Methods A total of 286 breast cancer patients, aged 18-60 yr, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, scheduled for elective modified radical mastectomy under general anesthesia in our hospital, were divided into either non?chemotherapy group ( n=106 ) or neoadjuvent chemotherapy group ( n=180 ) . General anesthesia was induced with iv propofol 2 mg∕kg, rocuronium 0. 6 mg∕kg and sufentanil 0. 2 μg∕kg. The patients were endotracheally intubated. The concentration of sevoflurane inhaled was adjusted according to the value of bispectral index, and bispectral index value was maintain at 40-50. Ondansetron 8 mg and flurbiprofen axetil 100 mg were injected intravenously at 30 min before the end of surgery. If vomiting occurred for 2 consecutive times, and continuous nausea and vomiting appeared from the time point after extubation to 24 h after surgery, and the patients required treatment, rescue medication was used. The occurrence and severity of PONVwithin 24 h after surgery and requirement for rescue medication were recorded. Results Compared with non?chemotherapy group, the incidence of PONV within 24 h after surgery and requirement for rescue medication were significantly increased, and the severity of PONV was aggravated in neoadjuvent chemotherapy group (P<0.05). Conclusion Neoadjuvant chemotherapy before surgery can increase the risk and severity of PONV after modified radical mastectomy.

Objective To evaluate the preoperative nutritional status of patients with gastric cancer by using patient-generated subjective global assessment (PG-SGA) its relationship with postoperative results.Methods Make a preoperative nutrition assessment by using PG-SGA for 87 patients with gastric carcinoma who can be treated with operation.Analyze the effects of the postoperative complication,survival rate and the hospitalization time on patients.Results The number of patients of this group who can process the preoperative nutrition assessment by using PG-SGA accounts for 100％ of the total.There are 37 patients with moderate or severe malnutrition before operation (account for 39.1％).The complication incidence of patients with moderate or severe malnutrition before operation and the patients with no or mild malnutrition are 52.9％ and 5.7％ separately (P ＜ 0.01).The sensitivity and specificity of PG-SGA score for predicting complications are 85.7％ and 75.8％ respectively.And we should implement the analysis of regression to verify that the PG-SGA grade is the independent risk factor of postoperative complication by applying multiple Logistic(P ＜ 0.01).The average hospital stays of patients with moderate or severe malnutrition before operation and the patients with no or mild malnutrition are (21 ± 6) d and (16 ± 4) d separately (P ＜ 0.01).Conclusion According to the PC-SCA results,patients with moderate or severe malnutrition before operation have increased susceptibility to complication and the extension of hospital stays after the operatiou.Therefore,it is important to supply the proper nutrition support to these patients.