BACKGROUND:Glial-derived neurotrophic factor has a specific effect on brain neurons, and is an important neurotrophic factor in the treatment of cerebral apoplexy. OBJECTIVE:To investigate the neuroprotective effect of glial-derived neurotrophic factor gene modified neural stem cels on rat cerebral apoplexy. METHODS:The recombinant human plasmid pAdEasy-l-pAdTrackCMV was constructed, and the neural stem cels were isolated and cultured from the cortex of neonatal rats. The neural stem cels were transfected with the recombinant adenovirus of glial-derived neurotrophic factor, and the cel suspension was injected into the right brain ventricle of rats with transient cerebral ischemia (2 hours). Meanwhile, neural stem cel transplantation group and control group were set up. RESULTS AND CONCLUSION:Compared with the neural stem cel transplantation group, the modified neurological severity score of combined transplantation group was reduced significantly 2 and 3 weeks after reperfusion, and the area of cerebral ischemia injury was also significantly decreased at 7 days after reperfusion (P< 0.05). The number of neural stem cels in the neural stem cel transplantation group was significantly less than that in the combined transplantation group (P < 0.05). The expression of Syn, PSD-95 proteins in the two transplantation groups, especialy in the combined transplantation group, was higher than that of the control group (P < 0.05). However, there was no significant difference between the two transplantation groups (P > 0.05). The results show that the neural stem cels modified by glial-derived neurotrophic factor can play a better role in the neuroprotection against cerebral apoplexy in rats, and the effect is better than that of simple neural stem cels.

Objective To investigate the surgery timing for patients with intermittent exotropia.Methods Far and near stereopsis of 36 patients with intermittent exotropia were measured preoperative and postoperative six months respectively,and the results were analyzed.Results Near stereopsis were measured preoperative in 30 cases (83.3％,30/36) with intermittent exotropia.But far stereopsis were measured preoperative in 7 cases (19.4％,7/36) with intermiuent exotropia.There was statistic significance (P ＜0.05).Near stereopsis were measured preoperative in 30 cases (83.3％,30/36) with intermittent exotropia and postoperative in 35 cases (97.2％,35/36).There was statistic significance (P＜0.05).Far stereopsis were measured preoperative in 7 cases (19.4％,7/36) with intermittent exotropia and postoperative in 14 cases (38.9％,14/36).There was statistic significance (P＜ 0.05).Conclusions Far stereopsis would be an important factor to choice the surgery timing for patients with intermittent exotropia.Operation is beneficial to restore far and near stereopsis.

Objective To study the expression and significance of neuronal nitric oxide synthase(nNOS) in ureteropelvic junction obstruction(UPJO).Methods Specimens of the narrow segment of the ureteropelvic junction(UPJ) were obtained from 36 cases of UPJO(without aberrant vessels,adhesive band compression and high insertion of ureteral junction).Furthermore,the light microscopic examination demonstrated that smooth muscle fascicles were sparse and thin,and fibrous connective tissues between them were deposited.Control UPJ specimens were taken from 20 cases of renal neoplasm,and tissues were confirmed histologically to be unaffected.Immunohistochemical staining(SABC method) was performed to detect the expression of nNOS in specimens of the 2 groups.Quantitative analysis was made using image analysis technique. Results Immunoreactivity to nNOS was predominantly present in the smooth muscle cell cytoplasm of UPJ.The mean density of nNOS in UPJO and control groups was 0.208?0.014 and 0.230?(0.016),respectively,which were significantly different between the 2 groups(P

Objective Tostudy the effects ofRheu compositus (Dachengqi Decoction, DD) on the NF-κBactivity of alveolar macrophages in ARDS rats and its inflammatory cytokine expression, and hence to explore the molecular mechanism of the anti-inflammatory effects of DD. Method The 65 male Wistar rats were randomly di-vided into the control group (n = 12), the ARDS model group (n = 21), the DD treatment group (n = 16) and the dexamethasone treatment group (n = 16). The rots of model group received 1 mg/(kg·0.5 mL) LPS injected intra-poritoneally and LPS in dose of 5 mg/(kg·0. 5 mL) was administrated by slow dropping endotracbeally 16 hours later. Modeling was successfully established 6 hours later evidenced by arterial gas analysis. The rats of con-trol group received 0.5 mL normal saline injected intravenously through tail vein instead of LPS. Three days after establishment of modeling, DD was given to rats of DD treatment group by intragastric instillation for 3 days in dose of 2.31 g/(kg·d),in which the weight of drug was calculated on the basis of dried herbal medicine. In dexam-ethasone treatment group, rats had intra-peritoneal injection of 2 mg/kg dexamethasone for 3 days after modeling was established. Seventy-two hours later, the arterial blood gas analysis and pathological study were carried out, in rats of all groups, and the findings were graded. The levels of TNF-α, IL-1 and IL-10 both in the plasma and in the brenchoalveolar lavage fluid were determined by using the enzyme linked immunosorbent assay (ELISA). Besides the nucleopretein concentration of pulmonary alveolar macrophage (PAM) was maeasuredwith the BAC method, and the NF-κB activity was determined with the Western Blotting, and with the evaluation of the DD' s effect on the transcription activity of PAM inflammatory cytokines. All the experimental data were processed by the SPSS 13.0 for statistical analysis. The analysis of variance was used for the comparison between groups, and P < 0. 05 showed the statistical significance of the difference. Results DD didn' t significantly reduce the TNF-α level [(510.97±76.20) pg/mL,(476.16±98.03) pg/mL, P >0.05], but significantly deceased the plasma IL-1 level [(381.99±34.30) pg/mL, (300.69 ± 50.99) pg/mL, P <0.05]. At the same time, there was no signif-icant changes in the plasma IL-10 level [(345.96 ± 67.72) pg/mL, (345.30 ± 78.52) pg/mL, P > 0.05]. Whereas TNF-α level in BALF was significantly decreased [(130.94 ± 33.51) pg/mL, (106.59 ± 26.64) pg/ mL, P < 0. 05, so was the IL-1 level in BALF (82.5 ± 25.36) pg/mL, (63.89 ± 22.96) pg/mL, P < 0. 05], but IL-10 level in the BALF was significantly increased[(77.09 ± 26.05) pg/mL, (148.05 ± 53.50) pg/mL, P <0.01]. DD significantly reduced the nueleoprotein level of PAM[(5.35 ± 2.44) μg/μL, (3.54 ± 2.01) μg/ μL, P < 0.05]and significantly inhibited the NF-κB activity [electrophoretic band optical density × area/consult mtio:(1.45±0.71),(1.11±0.28), P <0.05]aswell. Conclusions DD regulated systemic pro-inflammato-ry media/anti-inflammatory media balance in rats with ARDS by mainly reducing the level of IL-1. The regulatory effects of DD on the local lung injury not only inhibit the producing of TNF-α and IL-1 level,but also increase the IL-10 level to reestablish the local pro-inflammatory factors/anti-inflammatory factors balance so as to inhibit the lo-cal excessive irranune response. DD inhibits the NF-κB activity in the PAM of ARDS rats so as to restrain the pro-duction of pro-inflammatory cytokines (TNF-α and IL-1). This kind of multi-target bidirectional regulation plays an active role in regulating the immune balance and protecting the target organ from the excessive injury.

Objective To sum up the experience on diagnosis and treatment of Hashimoto disease and its concurrent thyropathy. Methods Clinical data were analyzed on 52 cases of Hashimoto disease(HD) surgically found to have concurrent thyropathy from Jan 1984 to Jun 2001 out of 138 HD cases undergoing surgery. Results Thyroid nodules were found in all 52 HD cases, among which 17 were with thyroid cancer, 2 with malignant lymphoma, 5 with thyroid adenoma, 2 with hyperthyroidism, and 26 with nodular goiter. Thyroidectomy of different extent was performed. Postoperatively all cases were given thyroxine. On follow-up a patient with malignant lymphoma died, and one patient suffered hypothyroidism. Conclusion HD is a ubiquitous disease. The clinical diagnosis of is still difficult. HD cases complicated with thyroid nodules should be treated surgically to exclude malignant tumors. Intraoperative frozen section is a reliable diagnostic method and may guide the surgical modality.

Background:Gastroesophageal reflux disease( GERD)that does not respond satisfactorily to standard proton pump inhibitor is defined as refractory gastroesophageal reflux disease( rGERD). Combined therapy is used to treat rGERD, however,the addition of baclofen is rarely studied. Aims:To investigate the efficacy of baclofen combined with esomeprazole and mosapride on rGERD. Methods:Seventy-two patients with rGERD from March 2013 to April 2014 at the First Hospital of Putian City were enrolled and randomly divided into group A and group B. Patients in group A were orally administrated with esomeprazole 20 mg bid + mosapride 5 mg tid + baclofen 5 mg tid. Patients in group B were treated with esomeprazole 20 mg bid + mosapride 5 mg tid. The treatment course was 8 weeks. The efficacy on symptoms, esophagitis under endoscopy and adverse effects were compared between the two groups. Results:After 8-week treatment, score of heartburn,regurgitation,retrosternal pain,dysphagia and overall symptom were significantly decreased in the two groups than before the treatment. The overall symptom alleviating rate was significantly higher in group A than in group B (90. 6% us. 70. 0%;χ2 =4. 585,P=0. 032). Esophagitis under endoscopy in the two groups was significantly improved, the effective rate was significantly higher in group A than in group B(93. 8% us. 75. 0%;χ2 =4. 500,P=0. 034). The main adverse effects of baclofen were somnolence,dizziness and fatigue,all the patients were well tolerated. Conclusions:Baclofen combined with esomeprazole and mosapride is an efficient option for rGERD.

Objective To study the expressions of epithelial symbol factors including E-cadherin,?-catenin,and ?-catenin related to epithelial-mesenchymal transition(EMT) in C57 mice Lewis lung cancer and its mRNA expression affected by Feiyanning Decoction(Decoction for lung cancer).Methods The Real-Time PCR method was adopted to observe the E-cadherin,?-catenin,?-catenin mRNA expression of C57 mice with transplanted tumor in the right armpit and distal metastases and the affection of Feiyanning Decoction on the expression.Results The lung transplanted rate in the Feiyanning group was clearly lower than that in the model group(P

60 yrs) were associated with a higher prevalence of malnutrition (47 6%) than those of 60 yrs and younger (31 5%) Malnutrition was more frequently encountered in cancer patients than other patients (64 5% vs 22 4%) Patients with digestive tract disease had higher rates of malnutrition than those without (52 6% vs 30 0%) FFM, FM, BCM, TBW and ICF was significantly lower in malnourished male and female patients than well nourished patients Conclusion The prevalence of malnutrition in hospitalized surgical patients is high

Objective To study the expression of programmed death 1(PD-1) on the peripheral T lymphocytes and the serum cytokine levels in different phases of hepatitis B virus (HBV) infection (immune tolerance,immune clearance and non-replicating phases).Methods A total of 105 HBV infected patients in different phases of infection were enrolled in Wuxi No.5 People's Hospital from Apr to Sep 2011,and divided into three groups:the immune tolerance group (35 cases),the immune clearance group (35 cases) and the non-replicating group (35 cases).Meanwhile,20 healthy people were enrolled as controls.The peripheral blood was collected and PD-1 expressions on the surface of T lymphocytes were assessed by flow cytometry.The cytokine levels in different groups were analyzed by enzyme-linked immunosorbent assay (ELISA).The data were analyzed by t test and Pearson correlation analysis.Results The PD-1 expression on surface of CD8+ T lymphocytes of HBV infected patients was (12.35± 3.48)％,which was significantly higher than healthy control group [(4.65±1.21) ％] (t=9.76,P＜0.01).The PD-1 expression on CD4+ T lymphocytes was (4.95±2.87) ％,which was not significantly different from the healthy controls [(4.08±2.14) ％] (t =1.29,P＞0.05).The PD-1 expressions on CD8+ T lymphocytes of patients in the immune tolerance group,the immune clearance group and the non-replicating group were (15.87±3.18)％,(7.69±3.64)％and (10.12±2.84) ％,respectively; that in the immune tolerance group was higher than the immune clearance group (t=10.01,P＜0.01) and that in healthy control group was lower than those in the other 3 groups (t=15.12,3.61 and 8.17,respectively; all P＜0.01).The PD-1 expression on the surface of CD8+ T lymphocytes in chronic HBV infected patients was positively correlated with the serum interleukin-10 (IL-10) level (γ=0.377,P＜0.05),while that was negatively correlated with interferon-γ (IFN-γ) level (r=-0.620,P＜0.05).Conclusions PD-1 is up-regulated on the surface of CD8+ T lymphocytes from chronic HBV infected patients.And PD-1 is negatively correlated with serum IFN-γ levels and positively correlated with serum IL-10 levels.The expression of PD-1 on the surface of CD8+ T lymphocytes influences the balance of helper T cell (Th)1/Th2,which might play a role in the persistence of HBV infection.

Objective To investigate the effect of early application of aldosterone receptor blockade-spironolactone on cardiac remodeling in patients with acute myocardial infarction.Methods A total of 616 patients were enrolled in this prospective study,who were admitted to the CCU Division of the First Affiliated Hospital of Harbin Medical University from January 2008 to January 2010.Inclusive criteria were as follows:First-onset STEMI according to the diagnostic criteria in ST-segment elevation acutemyocardial infarction diagnosis and treatment guidelines and admitted within 24 hours from onset.Exclusive criteria were as follows:Non-STEMI,only right ventricular infarction and old myocardial infarction; cardiac function Killip Class Ⅳ or hypotensive state; renal dysfunction(serum creatinine ＞ 221 μmol / L); serum potassium ＞5.0 mmol / L; longer than 24 hours from onset and older than 75 years of age.All the patients were randomly divided into a control group of standard therapy and a treatment group of standard therapy combined with spironolactone 20 mg per day.Totally 528 patients were observed completely,including 266 patients in the control group and 262 patients in the treatment group.There was no statistical difference of clinical characteristics between the two groups,including age,gender,past medical history,admission situation,and treatment(P ＞ 0.05).The effect of spironolactone on cardiac remodeling、left ventricular function、renal function and blood levels of potassium were evaluated by detecting echocardiography,serum potassium and serum creatinine at one month and one year follow-up.Results Compared with the control group,the echocardiography indicators such as LVESD,LVEDD,LVEF,LAD-ML and LAD-SI were significantly improved in treatment group at one year(P ＜ 0.05).In treatment group,LVESD,LVEDD,LVPWT,LVEF,LAD-ML and LAD-SI were significantly improved at one year than one month(P ＜ 0.05,and P =0.007 to LVEF),and LVEF was significantly improved at one year than one month in control group(P =0.0277).There were no statistical differences of serum potassium and serum creatinine between the two groups.Conclusions On the basis of conventional treatment,the early combination of low dose spironolactone(20 mg/d)could inhibit cardiac remodeling at late stage and prevent heart failure.