Objective: To observe the role of alanylglutamine(Ala-Gln)-supplemented hypocaloric nutrition support in severe brain injury.Methods: 60 cases of severe brain injury were randomly divided into experimental group and control group.The experimental group was treated with peripheral parenteral nutrition support of 105 kJ/(kg?d) and administration of alanylglutamine for 8 days.The control group was treated with peripheral parenteral nutrition support of 146 kJ/(kg?d) for 8 days.Blood glucose,serum albumin,transferin,hemoglobin,nitrogen balance,IgA,IgG,IgM,CD4(%) and CD8(%)were detected before and after nutrition support.Results: Compared with control group,IgA,IgG,CD4(%),CD4/CD8 in experimental group increased significantly(P

Objective To investigate the effect of sodium valproate in suppression of cell proliferation and arrest of cell cycle of in human hepatoma cell line SMMOL/LC-7721 and pancreatic cancer cell line PaTu8988.Methods Hepatoma cell line SMMOL/LC-7721 and pancreatic cancer cell line PaTu8988 were inoculated on the culture plate,cultured in the DMEM medium,they were intervened with sodium valproate in concentration of 0.2 mmol/L (0.2 mmol/L group),1.0 mmol/L (1.0 mmol/L group),5.0 mmol/L (5.0 mmol/L group) and dimethyl sulfoxide (control group) for 48 h respectively.Absorbance was measured by enzymelinked immunosorbentassay equipment,and inhibition ratio was calculated.Cell cycle was detected by flow cytometry.Results The absorbance of hepatoma cell line SMMOL/LC-7721 and pancreatic cancer cell line PaTu8988 in 5.0 mmol/L group were significantly lower than those in control group and 0.2 mmol/L group (0.569 ±0.059 vs.0.706 ±0.033 and 0.760 ±0.020,2.068 ±0.178 vs.2.793 ±0.144 and 2.663 ± 0.078,P ＜ 0.05),the absorbance of pancreatic cancer cell line PaTu8988 in 1.0 mmol/L group (2.432 ± 0.084) was significantly lower than that in control group and 0.2 mmol/L group (P ＜ 0.05).With the sodium valproate concentration increased,inhibition rate of tumor cell increased gradually,the inhibition rate of hepatoma cell line SMMOL/LC-7721 and pancreatic cancer cell line PaTu8988 in 5.0 mmol/L group was 23.5％ and 25.9％ respectively.Compared with control group,with the sodium valproate concentration increased in 0.2,1.0,5.0 mmol/L group,the proportion of G1 phase cell increased gradually in hepatoma cell line SMMOL/LC-7721 [(49.25 ± 1.63)％,(65.26 ± 2.34)％,(83.13 ± 1.78)％ vs.(49.22 ± 4.35)％],the proportion of S phase cell decreased gradually [(26.84 ± 2.30)％,(17.76 ± 3.90)％,(3.38 ± 0.65)％ vs.(29.21 ± 2.35)％],cell cycle showed G1 phase arrest,there was significant difference (P ＜ 0.05).Compared with control group and 0.2 mmol/L group,the proportion of G2 phase cell increased in pancreatic cancer cell line PaTu8988 in 1.0 and 5.0 mmol/L group [(26.80 ± 1.50)％,(36.58 ± 3.78)％ vs.(12.00 ± 4.62)％,(16.54 ± 2.26)％],cell cycleshowed G2 phase arrest,there was significant difference (P ＜ 0.05).Conclusion Sodium valproate mightsignificantly suppress the cell proliferation in hepatoma cell line SMMOL/LC-7721 and pancreatic cancercell line PaTu8988 and induce cell cycle arrest,it is clinically promising antitumor drug.

Objective Discuss the clinical experience of laparoscopic common bile duct exploration and primary suture in operation for choledocholithiasis. Methods From August 2010 to December 2012, 53 patients with choledocholithiasis were treated with laparoscopic common bile duct exploration and primary suture laparoscopic common bile duct exploration and primary suture,not T tube drainage in Dept. of General Surgery First,Wenjiang branch courts of Sichuan provincial people's hospital. Their clinical data were selected and retrospectively analyzed. Results 53 cases have successfully operated (100%), the operated time was 100-180 minutes, and the postoperative hospitalization time was 6-12 days. 4 cases occured bile leakage (7.5%), but they were cured through abdominal cavity drainage. All the patients were follow-up visited in 2-14 months. There was no bile leakage, bile duct stenosis, bile duct bleeding or residual calculi. Conclusion Under the strict conditions for mastering operative indications, laparoscopic common bile duct exploration and primary suture is a safe, effective, more minimally invasive, faster recovery treatment for choledocholithiasis.

Objective: To study the effect of Astragalus-supplemented enteral nutrition on nutritional metabolism in type-2 diabetic patients with ischemic stroke . Methods: 64 cases of type-2 diabetic patients with ischemic stroke were randomly divided into treatment group and control group. The treatment group was treated with homogenized diet and Radix Astragalis(equivalent to 60g crude drug), and the control group was treated with homogenized diet. Two groups were treated with nutrition support of 105kJ/(kg?d) for 30 days. The levels of fasting and postprandial blood glucose、insulin、blood lipids、serum proteins and nitrogen balance were measured during enteral nutrition support. Results: ①Compared with the control group, insulin resistance index(HOMA-IR) was significantly improved (P

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Objective To investigate the expression and significance of P-glycoprotein in triple negative breast cancer (TNBC).Methods One hundred and seventy-one cases of breast invasive ductal carcinoma in our hospital were retrospectively analyzed.According to the expression of ER,PR,Her2,we categorized those paitents into triple negative breast cancer group (58 cases) and non triple negative breast cancer group (113 cases).The different expression of P-glycoprotein was detected by immunohistochemieal technology in two groups.We analyzed the relationship between the expression of P-glycoprotein and clinical and pathological features in TNBC,and investigated the effect of P-gp on the rate of recurrence and metastasis in 3 years.Results (1) The expression of P-gp in TN BC was significantly higher than that of NTNBC (53.45％ vs 37.17％) (P ＜ 0.05).(2) The expression of P-gp in TNBC was associated with TNM stage,histological grade,lymph node status and vascular invasion (P ＜ 0.05),but not with age and size of the tumor (P ＞ 0.05).(3) The rate of recurrence and metastasis in positive expression of P-gp in TNBC was 58.06％,which was significantly higher than negative expression of P-gp in TNBC (44.44％),but no statistically significant was found(P ＞ 0.05).Survival analysis showed that P-glycoprotein expression had no relationshiop to 3-year cumulative survival rate (P =0.161 ＞ 0.05).Conclusions The positive expression of P-gp in TNBC is associated with drug resistance and metastasis,but has no obvious significance to recurrence and metastasis,so as to 3-year cumulative survival rate.

Objective To compare the effect of two different treatment approaches on femoral shaft fractures in polytrauma patients.Methods One hundred and forty-eight polytrauma patients were selected as our subjects,who were hospitalized from Jan.2000 to Dec.2009.They were randomly divided into cast group and external fixation group.Patients in cast group were fixed with cast within the first 24 h after the injury and patients in external fixation group were stabilized with a unilateral external fix stent within the first 24 h after the injury.Results In cast group,71 of 75 patients were followed up and follow up periods was 26.4 months.Follow up data showed that 18 patients developed multiple organ failure (MOF) and 26 patients developed ARDS.The average healed periods was 5.9 month.Three patients developed nonunion and 4 cases developed wound infection.The average of the knee motion angle was 107 degrees (60 to 110 degrees).In external fixation group,68 patients were followed up and the follow-up period was 27.5 months.Of which,13 patients developed MOF and 12 patients developed ARDS.The average healed periods was 5.6 months.2 patients developed nonunion and 3 cases developed for.wound infection.The average of the knee motion angle was 120 degrees (60 to 140 degrees).Conclusion The damage control orthopedics surgery was proved as a safe and effective treatment approach for fractures of the shaft of the femur in selected multiply injured patients compared with cast methods.

OBJECTIVE To investigate the uses of antibacterials,the characteristics of bacterial distribution and the drug resistance and provide a foundation for reasonable application of antibacterials.METHODS Germs isolation and cultivation were carried out according to National Clinical Testing Operation Procedures(2nd edition).Germs definition and resistance test were carried out by using VITEK 2 Compact microbiological assay system.Statistical analysis was processed by using WHONET 5.4.RESULTS Totally 7815 strains of bacteria were isolated from clinical samples,most of which were Gram-negatives(G-)(58.0%,56.3% and 59.5%,respectively in the 3 years).The tendency of Gram-positives(G+) didnot charee obviously(about 20%).Theresistance were increasing.The resistance rate of Staphylococcus aureus was more than 70.0 % to the most antibacterials.Up to now,there was no vancomycin-resistant isolate.CONCLUSIONS We should use antibacterials reasonably and efficiently to delay and control drug resistance,according to the susceptibility test.

Objective To investigate the inhibiton effect of 4‐styrenesulfonic acid‐co‐maleic acid(PSM ) in HIV‐1 .Methods The inhibition effect of different doses of PSM on HIV‐1 in susceptible cells GHOST (3) X4/Hi5 was observed by Luciferase ,and so did the inhibitory effect of PSM on JR‐FL、HXB2、CNE6 ,CNE30 ,CNE50 ,CNE55 .The cellular toxicity of PSM on the VK2/E6E7 was also evaluated by CCK8 kit .The transcript level of tight junction proteins (ZO‐1 ,E‐cadherin and Occludin) of HEC‐1‐A were analyzed by qRT‐PCR .And then observed the effect of PSM on expression of genitourinary epithelial cells HEC‐1‐A ,so we could e‐valuated the effect of integrity of local mucosal indirectly .Results The results showed that PSM exhibited potent antiviral activity against a broad spectrum of HIV‐1 major isolates with different genotypes and biotypes (EC50 value of JR‐FL ,HXB2 ,CNE6 , CNE30 ,CNE50 ,CNE55 were 5 .78 ,0 .77 ,1 .85 ,3 .15 ,1 .70 ,2 .27 μg/mL respectively) .Meanwhile ,it had less cytotoxicity on VK2/E6E7 .qRT‐PCR showed that no obvious restrain effect on expression of ZO‐1 was observed and PSM increased the level of tran‐scription of E‐cadherin and Occludin .Conclusion PSM may be a potential agent for the prevention of HIV‐1 infection .

Objective To investigate the guidance role and effect of the thoracolumbar injury classification and severity score (TLICS) in the choice of anterior,posterior or combined surgery for thoracolumbar fractures.Methods Thirty-one consecutive patients with acute thoracolumbar burst fractures who were treated in an our unit were selected as our subjects who hospitalized from Oct.2006 to Sep 2010,There were 20 male and 11 female patients.The average age was 44.7 years (range from 35.0 to 56.0 of all patients 3 was injured T11,6 at T12,7 at L1,8 at L 2 and 7 at L3.The reasons of injury include motor vehicle accident (10 cases)and falling from a height (24).All patients had preoperative anteroposterior and lateral radiographs,computed tomography (CT) scan,and magnetic resonance imaging (MRI) examination to more fully assess vertebral pieces and nerve compression.According to the Classification of Maged,there were 8 cases with type A3,8 cases with B1,9 cases with B2,3 cases with C1,3 case with C2.Neurologic status based on Frankel classification showed that 4 cases were with grade A 8 with grade B,9 with grade C 6 with grade D and 4 with grade E.Of the 31 patients,11 received posterior surgeries,12 anterior surgeries,and 8 combined anterior and posterior surgeries.Results Twenty-eight cases were followed up with averaged 13.7 months (range from 12.0-17.0 months).The kyphosis angle was measured from the superior endplate to the inferior end plate of the fractured vertebral body using the Cobb technique.The mean cobb's angle was (23.7 ± 11.3) ° (range,13.0 ～ 38.0°) preoperatively,(5.8 ± 0.6°) (-4.0 ～ 6.0) ° lordotic post operatively and (11.3 ± 10.6) ° lordotic at the final observation.The average surgical time was 190 minutes (range,90-380 minutes).and blood loss was 1680 ml (range,1260-2540 ml),and hospital stay was 17.4 days (range,10-24 days).No eloosening or motion was observed in the final follow-up patients.Conclusion TLICS has facilitate treatment decision making of thoracolumbar spinal column injuries and proved to be an effective treatment for serious thoracolumbar fracture.