180 U/L.CK-MB raised in only 5 cases(15.6%),and the highest was 28 U/L.Of the 218 MPP patients,only the 5 patients(2.3%) with raised CK-MB levels could be diagnosed as myocardial damage complicated with MPP.Conclusions The abnormal ECG is more important than myocardial zymogram in the diagnosis of myocardial damage complicated with MPP.Only higher level of certain myocardial zymogram without abnormal ECG can not be diagnosed as myocardial damage if lack of clinic and other objective evidences for myocardial damage.In watching out for myocardial damage,excessive examinations and treatments shall be avoided if possible.

Objective To explore the cellular and humoral immunity in children with recurrent respiratory tract infection(RRI).Methods Fresh peripheral blood samples were treated and run through the flow cytometry,the percentage of lymphocytes subsets were acquired using Simultest software simulaneously. Immunoglobulin IgA,IgG,IgM and complement C3 and C4 were measured.Results The levels of IgG and IgA in the RRI group were lower than the normal reference value in only 1 patient respectively.The level of IgM decreased in 7cases.Complement C3 and C4 decreased in 3 and 1 patients, respectively.The percentage of CD8 in the RRI group was higher than that in healthy control group(P=0),and the CD4/CD8 was obviously lower than that in healthy control group(P=0.002).Conclusions The disorder of cellular and humoral immunity are existing and cell-mediated immune disorder is more obviously in RRI.The immune-modulation agents are necessary in the prevention and treatment for RRI.

Aim Toclarifytheeffectofacteosideon proliferation of neural stem cells (NSCs ) from adult mice,as well as the involved signaling pathway.Meth-ods NSCswereisolatedfromthesubventricularzone (SVZ)of adult C57BL/6 mice,then identified by im-munofluorescence staining with Nestin,the marker of NSCs.NSCs were exposed to acteoside (5,10,20,40μmol·L-1 )in absence of mitogen(EGF/bFGF)for 24 h.We employed CCK8 assay to detect NSCs viability and BrdU staining to identify NSCs proliferation.We performed Western blot to quantify the expression level ofp-AktinducedbyacteosideonNSCs.Results With-out mitogen,acteoside increased NSCs proliferation by activating p-Akt,which can be blocked by LY294002, the inhibitor of PI3K/AKT signaling pathway.Conclu-sion ActeosidepromotestheproliferationofNSCsfrom adult mice by activating PI3K/AKT pathway.

OBJECTIVETo investigate effects of exogenous hydrogen sulfide ( H2 S) on the spatial memory disorder induced by cerebral anoxia in mice and explore related mechanism.METHODS Sodium nitrite (NaNO2) 120 mg·kg-1 was sc given to mice for4 d in model group.Sodium hydrosulfide (NaHS) 1 mg·kg-1 was ip given and NaNO2 120 mg·kg-1 simultaneously was sc given to mice for4 d in NaHS group.All drugs were given to mice immediately after Morris water maze experiment every day and escape latency.The number of crossings over the target area (NCTA) and search time in target quadrant (STTQ) were recorded.The activity of superoxide dismutase (SOD) and malondialdehyde (MDA) level in the brain was determined with colorimetry.The morphological alterations in hippocampus slices were assessed by microscope.RESULTSOn the third and fourth days in Morris water maze experiment,compared with ( 16.1 ±9.6)s and ( 11.1 ±6.2)s in normal control group,the escape latency in model group was longer,(26.0 ±7.3)s(P＜0.05) and (23.3 ±8.7)s(P＜0.01).On the fifth day,compared with 7.2 ± 1.6 and (28 ± 8) s in normal control group NCTA and STTQ in model group were 4.1 ± 1.9and (20 ± 8 ) s ( P ＜ 0.05 ),and they were obviously less.Compared with normal control group,SOD activity and M DA content of mice in model group were reduced by 12.6％ (P ＜ 0.01 ) and increased by 43.9％ (P ＜ 0.01 ),respectively.The neuron degenerative changes including karyopyknosis,dark cytoplasm and irregular pyramidal layer were observed in model group.On the third and fourth day,compared with model group,the escape latency in NaHS group was shorter,(17.9 ±7.0)s and (15.8 ±8.5)s (P＜0.05).Compared with model group,NCTA and STTQ in NaHS group increased to 6.7 ± 2.5 and ( 30 ± 9) s ( P ＜ 0.01 ).SOD activity and MDA content in NaHS group were increased by 8.9％ ( P ＜ 0.05 ) and reduced by 29.6％ ( P ＜ 0.01 ),respectively.Neuron degeneration was significantly attenuated in NaHS group (P ＜ 0.01 ).CONCLUSIONNaHS can attenuate the spatial memory disorder induced by cerebral anoxia and the mechanism may be related to the antioxidation effect and alleviation of neuron damage of H2S.

Postoperative pancreatic leakage remains a persistent problem after pancreaticoduodenectomy.For patients with a soft and nonfibrotic pancreas,double binding continuous hemstitch suture is an optimal method for anastomosis.From January 2011 to June 2012,92 cases of periampullary carcinoma with a soft pancreas underwent pancreaticoduodenectomy,and then a modified technique of pancreaticogastrostomy was performed with 2 continuous hemstitch sutures placed in the mucosal and seromuscular layers of the posterior gastric wall,respectively.The median time for pancreaticogastrostomy was 12 minutes,and only 15 patients had postoperative complications.Two patients developed pancreatic leakage(1 grade A and 1 grade B)postoperatively.Pancreaticogastrostomy with double binding continuous hemstitch sutures is a simple and safe reconstruction procedure for patients with a soft and fragile pancreas who received pancreaticoduodenectomy.

Objective To investigate the significance of 25 hydroxyvitamin D3 (25 (OH)D3) in patients with type 2 diabetes mellitus by comparing the differences of serum 25-hydroxyvitamin D levels between type 2 diabetes mellitus patients and healthy people.Methods One hundred and forty-seven patients with type 2 diabetes mellitus were selected as the T2DM group,and 135 healthy people were selected as the normal control (NC) group.The level of serum 25 (OH) D3 was detected by ELISA.Clinical data were recorded and biochemical indexes were also detected.Statistical analysis was performed.Results (1) Serum 25 (OH) D3 level in T2DM group was low,but there was no significant difference between two groups((23.10 ± 1.59) μg/L vs.(23.11 ± 1.65) μg/L; t =0.064,P =0.949),as well as between men and women in the 2 populations (T2DM men vs.women(23.22 ± 1.54) μg/L vs.(22.95 ± 1.65) μg/L; t =0.209,P ＞0.05; NC men vs women(23.03 ± 1.73) μg/L vs.(23.18 ± 1.59) μg/L; t =0.436,P ＞0.05) ; (2)The prevalence of vitamin D insufficient and deficiency in T2DM group was high,but it was not statistically significant between two groups (98.0％ vs.94.8 ％ and 2.0％ vs.5.2％ ; x2 =2.034,P =0.154) ; (3) Serum 25 (OH) D3 in T2DM group has a significant negative correlation with triglycerides (r =-0.218,P ＜ 0.01).Conclusion (1) Vitamin D level was low in both the healthy and T2DM populations in the southern region of China,the prevalence of vitamin D insufficient and deficiency was up to 90％.(2)Triglyceride is the only independent risk factor to T2DM population.

Objective To analyze the characteristics of bone scintigraphy in 117 cases with primary hyperparathyroidism (PHPT).Methods Of these 117 cases (50 males and 67 females),there were 116 parathyroid adenomas and 1 parathyroid cancer.Mean age was 61.1(12-86) years old.All had ~(99)Tc~m-methylene diphosphonate (MDP) bone scintigraphy.The bone images could be classified into 4 categories.Category Ⅰ:normal;category Ⅱ:localized abnormal,which could be subcategorized as Ⅱ A with skull and mandible involvement,and Ⅱ B with Ⅱ A characteristics plus metabolic derangement;category Ⅲ:systemic,whole-body incmased tracer uptake;category Ⅳ:systemic plus localized metabolic derangement.Data were analyzed statistically with X~2 and t-test (isolated samples).Results According to the scintigraphic findings,there were 47 cases(40.17%)of category Ⅰ,35 cases(29.91%) category Ⅱ (21/35cases Ⅱ A and 14/35 cases Ⅱ B),30 cases (25.64%) category Ⅲ,and 5 cases (4.27%) category Ⅳ.Combining categories Ⅱ、Ⅲ and Ⅳ together,there were 70 abnormal cases.These patients had history of abnormal bone images such as bone fracture (39 cases,55.71%),calculus (8 cases,11.43%),bone fracture plus calculus(7 cases,10.00%),osteoporosis (51 cases,72.86%) or ostalgia(26 cases,37.14%);however,in the 47 cases of category Ⅰ,only 1 (2.13%),0,0,10(21.28%)and 10 cases (21.28%),respectively,were found.Therefore.these case history characteristics were statistically significant (X~2=11.152,P=0.01).The tumor size,parathyroid hormone (PTH),blood calcium,blood phosphorus in the patients of abnormal PHPT categories Ⅱ to Ⅲ were(14.52±13.72)cm~3,(731.67±618.40)ng/L,(3.05±0.29) mmol/L and (0.71±0.14) mmol/L,respectively.with statistically significant difference compared to category Ⅰ:(0.78±1.33) cm~3,(112.04±62.98)ng/L,(2.56±0.42) mmol/L and (1.03±0.36)mmol/L(t=-5.724,-5.741,-7.274 and -6.451;all P＜0.01).Conclusions (1)Bone scintigraphy was normal in 40% of PHPT patients.(2)The bone images of PHPT could be classified into 4 categories and each could reflect the duration and severity of the disease status on bone.(3)The bone imaging characteristic could be useful for differential diagnostic purposes.

Objective To establish the sulfur mustard (SM ) induced tracheal injury model in rat and to investigate its mecha-nism .Methods Male rats (SD) were anesthetized and intra-tracheally intubated .The SM group was intra-tracheally injected by 2 mg/kg of diluted SM ,while the propylene glycol control group only by 0 .1mL of propylene glycol and the normal control group had no any treatment .The tissue and blood samples were taken for conducting the HE and immunohistochemical staining and measuring serum enzymes and andinflammatory factors .Results In the SM group ,a large number of lymphocytes infiltration in submucosa were observed;the positive expression of caspase-3 and caspase-9 were observed in epithelium and submucosa ;serum levels of TNF-α,IL-1β,IL-6 reached the peak in 24 h;serum levels of LDH ,GP ,BARS reached the peak in 6h ,so did GGT in 24 h .In the propyl-ene glycol control group and the normal control group ,lymphocytes ,macrophages and neutrophils were rare in submucosa .Conclu-sion The mechanism of SM (2 mg/kg) induced acute tracheal injury involves the inflammatory reaction ,apoptosis and oxidative stress ,moreover the lesion degree has the correlation with time .

Objective Head and neck cancer radiotherapy patients often appear a series of oral complications including mucositis, xerostomia, pain, dysphagia.The purpose of this study was to investigate whether personalization customized positioning oral stent was able to push normal tissue off the high dose target area and maintain accurate repeatable stable positions, thus protecting the normal tissue during radiotherapy of the nasopharyngeal carcinoma patients.Methods 15 newly diagnosed nasopharyngeal carcinoma patients were collected from March to August 2016 in Department of Radiation Oncology, Nanjing General Hospital of Nanjing Military Region and randomly divided into trial group and control group.Two groups of patients were treated with intensity modulated radiation therapy (IMRT).Trial group patients wear personalization customized oral positioning stents during radiotherapy while the control group did not wear.After radiotherapy, we compared the exposure doses of clinical target area(CTV) and normal oral tissue in two groups.ResultsThe left parotid gland radiotherapy doses of the trail group and the control group were 2223.557±294.549 cGy and 2900.563±374.660 cGy, the difference was statistically significant(t=3.847, P=0.002);the right parotid gland radiotherapy doses of the trail group and control group were 2284.957±256.673 cGy and 2994.670±339.264 cGy, the difference was statistically significant(t=4.512, P=0.001).The mean exposure doses of CTV in two groups were no statistically significant difference (6142.829±135.986 cGy vs 173.306±6221.825 cGy, t=0.971, P=0.349.Conclusion During the intensity modulated radiation therapy, patients with personalization customized oral positioning stents can keep the mandible in a precise repeatable stable position.And it can reduce the exposure dose of bilateral parotid without affect the radiotherapy effect of the clinical target area.