Volume 89  ·   Issue 06  ·  2009

Natural disaster is an unavoidable problem for human beings. Research shows that disaster not only threatens life and health, but also causes serious psychological trauma. If not treated in time, it will afflict people's life, change their personality, and even lead to extreme behaviors such as suicide and violence [1].

At 14: 28 on May 12, 2008, a magnitude 8 earthquake occurred in Wenchuan County, Sichuan Province. In this thrilling and smokeless war, the author, as a Chinese emergency relief medical team member, went to the disaster area and participated in the treatment of the wounded in the earthquake-stricken area.

Objective To investigate the distribution of pathogenic bacteria in the patients of injuries combined with infection after May 12 Wenchuan Earthquake and the drug resistance thereof. Methods Bacterial culture and identification were conducted on 139 clinical specimens from 108 patients with open injuries combined with infection. Drug-sensitive test was carried out by Kirby-Bauer method on the isolated strains. Results Ninety-six stains were isolated,79.86% of them were from the infected wound secretion and 58.33% were from thee department of orthopedics. The bacteria with high isolation rates included Acinetobacter spp. (20 strains),Enterobacter cloacae (20 strains),Escherichia coli ( 17 strains),and Staphylococcus spp. (13 strains). The isolated Gram negative bacteria showed lower resistance to imipenem,amikacin,and cefoperazone/sulbactam. Conclusion The Gram negative bacteria isolated from the wounds caused by earthquake show lower resistance to imipenem,amikacin,and cefoperazone/sulbactam. No Staphylococcus spp. is found resistant to glycopeptides.

Objective To investigate the DNA homology between the methicillin-resistant Staphylococcus aureus (MRSA) isolated from the wounds caused by earthquake and those from the patients from non-earthquake-stricken areas. Methods Five MRSA isolates were obtained from the wounds caused by earthquake of 5 in-patients admitted into the West China Hospital,and 6 MRSA isolates were obtained from the inpatient of the same hospital during the same period. DNA fingerprint alas was obtained by repetitive extragenic palindromic sequence-based PCR (Rep-PCR) and homolog analysis was conducted with the help of Rep-based DiversiLab Microbial Typing system. Results Five different patterns (A-E) were found among the 11 MRSA strains. The 5 strains isolated from the wounds caused by earthquake included subtype A (n=1),subtype B (n=2),subtype C (n=1),and subtype E (n=1). And the 6 stains isolated from the patient that come from non-earthquake-stricken areas included A (n = 3),subtype B (n =1),subtype C (n=1),and subtype D (n=1). Conclusion The MRSA stains isolated from the wounds caused by earthquake are highly homologous with those isolated from the patient from non-disastrous areas during the same period.

Objective To analyze the etiology of infections in the wounded victims of Wenchuan Earthquake. Methods 2135 smears of secretion were made from 1823 hospitalized wounded victims of Wenchuan Earthquake to detect the pathogens. Specimens were delivered to be cultured. The bacteria thus obtained were identified. Drug sensitivity test was conducted. Results 2002 specimens,1243 specimens of secretion (62.1% ),600 blood specimens (30.0%),102 specimens of pus or secretion of respiratory tract (5.1%),45 specimens from catheter (2.2%),and 12 urine specimens (0.5%). Pathogens were found in 725 cases. The top five pathogenic bacteria isolated within 1 month after the quake were Acinetobacter baumannii(16.7%),Staphylococcus haemolyticus (16.7%),Escherichia coli (12.5%),Klebsiella pneumoniae (12.5%),and Candida tropicalis (8.3%),quite different from the pathogen spectrum of the common in-patients within one month before the quake: Escherichia coli (18.2%),Staphylococcus aureus (11.4%),Candida glabrata (11.4%),Klebsiella pneumoniae (11.4%) and Staphylococcus epidermidis (9.1%). The isolation rate of methicillin resistant Staphylococcus aureus after the earthquake was significantly lower,and the isolation rates of extended spectrum β-lactamase-producing Escherichia coli,Klebsiella pneumoniae,and Klebsiella oxytoca were all significantly higher than those from the common surgical patients before the quake (all P < 0.05). There were not significant differences in the isolation rates of multi-drug resistant Pseudomonas alcaligenes and Acinetobacter baumannii before and after the quake. Conclusion Infection is frequent after natural disasters. It is necessary to summarize the changes of spectrum of pathogens and drug-resistant spectrum.

Objective To examine the epidemiologic characteristics of major cancers in Dafeng City,Jiangsu Province. Methods The cancer registry data 1999-2007 of Dafeng were analyzed retrospectively. Results Over the 9 years,the crude incidence of cancers was 244.99 persons per 100 thousand and the standard incidence ratio (SIR) was 175.48 persons per 100 thousand. The crude incidence and SIR of cancers of the males was 299.22 persons per 100 thousand and 214.41 persons per 100 thousand respectively,1.57 and 1.76 times as high as those of the females (190.92 per 100 thousand and 137.34 per 100 thousand respectively). The incidence of cancers increased remarkably since the age group of 509,peaked at the age groups 70 and 80,and decreased remarkably since the age group of 85. Stomach cancer ranked first for incidence among the males while esophageal cancer ranked first for the females. Conclusion The incidence of cancers,especially the lung cancer,shows a trend to increase in both the males and females in Dafeng. Priority should be paid to prevention and treatment of cancers of the digestive and respiratory systems.

Objective To discuss the diagnosis and treatment of adrenal cyst. Methods The clinical data of 15 patients with adrenal cyst,9 males and 6 females,aged 42 (32-65),diagnosed and treated 1995-2005 were reviewed. The average size of the cyst was 5.3 cm in diameter. Nine cysts were in the left adrenal gland and 6 cysts in the right. The diagnostic accuracy rates of MR imaging,CT,and B-mode ultrasonography were 100% (4/4),86.7% (13/15),and 73.3% (11/15 ) respectively. Thirteen patients underwent operation: unroofing in cyst via retroperitoneal laparoscopy (n = 9),adrenalectomy via laparoscopy (n = 1),or cystectomy via open surgery (n = 3). Results The average operative time of the 2 laparoscopy subgroups was (44 ± 11 ) min,significantly shorter than that of the open surgery group [ (75 ±40) min,P < 0.05]. The mean hospital stay after operation of the laparoscopy group was ( 5.1 ± 1.1 ) days,significantly shorter than that of the open surgery group [ (8.3 ± 1.5 ) days,P < 0.05]. Pathological examination showed 3 cases of epithelial cyst,4 cases of endothelial cyst,and 6 cases of pseudocyst. Conclusion MR is much more useful in diagnosis of adrenal cyst. The indications of surgery include the presence of symptoms,suspicion of malignancy,increase in the cyst size,and detection of functioning adrenal cyst. Unroofing in cyst via retroperitoneal laparoscopy may be the standard operation in treating this disease.

Objective To explore effective method to avoid iatrogenic bile duct injury during laparoscopic cholecystectomy (LC). Methods 10 492 patients underwent LC from May 1996 to May 2006,8566 of them were treated by the method to identify the cystic duct,common hepatic duct,and common bile duct during LC (tri-duct method group),and the left 1926 cases whose cystic duct failed to be exposed easily were treated with the method to identify at least two of the 4 structures (cystic lymph node,Hartmann's pouch,cystic artery,and emptiness of cystic triangle) so as to help identify the cystic duct (tri-duct plus tri-structure group). The operating time,amount of blood loss,open conversion rate,and morbidity were compared between these 2 groups. Results No cases of bile leakage or jaundice because of accidental injury of bile duct were found. The operating time of the tri-duct plus tri-structure group was (28 ± 12) (15±52) min,significantly shorter than that of the tri-duct group [ (38 ± 16) ( 15-92) min,P < 0.05 ]. The open conversion rate of the tri-duct plus tri-structure group was 1.8%,significantly lower than that of the tri-duct group ( 8.7%,P < 0. 05 ). There were no significant difference in the amount of blood loss and morbidity between the two groups (both P > 0.05). Conclusion The tri-structure method can not only confirm the cystic duct correctly,thus preventing iatrogenic bile duct injury,but also shorten the operating time and reduce the open conversion ratio during LC.

Objective To analyze the correlation of central compartment lymph node metastasis (CCLNM) with different clinical factors of papillary thyroid microcarcinoma (PTMC). Methods 117 patients of PTMC,27 males and 90 females,aged 45 (16 - 68),underwent total thyroidectomy ( or lobectomy) and central compartment lymph node dissection with or without lateral neck dissection. The correlation of CCLNM with age,sex,tumor size,tumor capsule,multifocality,and extrathyroid extension was analyzed. Results CCLNM was found in 42 of the 117 patients with the mean age of 40 ± 9,significantly lower than that of the patients without CCLNM [(45 ± 10),P <0.05],and with the median tumor diameter of 0. 75 cm,significantly longer than that of the patients without CCLNM (0.70 cm,P <0.05). Both univariate and multivariate analyses showed that age and tumor size were significantly correlated with CCLNM (both P < 0. 05). Classification tree analysis showed that the CCLNM rate of the patients younger than 43 was significantly higher than that of the patients older than 43. Sex,tumor capsule,muhifocality,and extrathyroid extension were not associated with CCLNM. Conclusion CCLNM occurs more frequently in the PTMC patients who are younger than 43 years and in those who have larger tumor.

Objective To evaluate the impact of FcγRⅢA gene polymorphism on the response to rituximab therapy in newly diagnosed diffuse large B-cell lymphoma (DLBCL). Methods Thirty-four patients with newly diagnosed,histologically proven CD20-positive DLBL received rituximab combined chemotherapy (CHOP regimen) for 6-8 courses of 21 days. Peripheral blood samples were collected from these 34 patients and 20 healthy blood donors. PCR was used to detect the Fcγ/RⅢA polymorphisms. The initial efficacy was evaluated based on the criteria for non-Hodgkin lymphoma by International Working Group. Results The FcγRⅢA phenotypes of the 34 patients included VV type (n = 11),FF type (n =5),and VF type (n = 18). After 6 courses of rituximab treatment combined with chemotherapy,the overall response rate was 79%,and the response rates were 82% and 83% in the VV type and VF type patients respectively,both significantly higher than that in the FF type patients (60%,P = 0. 04). Conclusion The most common FcγRⅢA polymorphism in DLCL is VF type,followed by VV and FF types. The patients with FcγRⅢA VV and VF types are more sensitive to the initial treatment of rituximab combined with chemotherapy compared to the patients with FF type.

Objective To better understand the neutrophil activation and protease imbalance in respiratory syncytial virus (RSV) bronchiolitis. Methods Pediatric patients with RSV bronchiolitis were collected,11 with the Lowell scores ≥ 10 (severe group),and 19 with the Lowell scores < 10 (mild group). 20 RSV bronchiolitis patients in convalescent group,24 patients with bacterial pneumonia,and 15 patients as control group. The percentages of neutrophils were detected. ELISA was used to detect the concentration of neutrophil elastase (NE) and interleukin (IL)-8,and the elastase inhibition capacity (EIC)/free neutrophil elastase activity were detected by colorimetry. Immunohistochemistry was used to examine the expression of α1 antitrypsin(α1AT) . Results The neutrophil percentage,the NE and IL-8 concentration of the RSV bronchiolitis group (0.528,6.39 × 107 kg/L and 13.62 × 109 kg/L)were all significantly higher than those of the control(0.074,2.53 × 107 kg/L and 2.64 × 109 kg/L) and convalescent groups(0.306,1.23 × 107 kg/L and 5.95 × 109 kg/L,all P < 0.05 ). The neutrophil percetage and IL-8 concentration of the convalescent group were both significantly higher than those of the control group ( both P < 0.05 ). Increased expression of α1 AT in RSV bronchiolitis was found when compared with convalesent infants(0. 49 vs 0.09,P < 0.05). The free elastase activity level of the bronchiolitis group was 6/30,not different with 7/24 of pneumonia group,and it was only one in convalesent infants. Conclusion Mass of neutrophil aggregation and activation exist in RSV bronchiolitis,as welt as protease system imbalance,and may play an important role in the inflammatory response and pathogenesis of RSV bronchiolitis.

Objective To investigate the expression levels of mucin-1 (MUC1) and β-catenin in papillary thyroid carcinoma,the significance thereof in the carcinogenesis and development of tumor. Methods Specimens of thyroid tissues were collected from 53 patients of papillary thyroid carcinoma,and 20 patients of nodular goiter,including 20 specimens of the tissues with thyroid nodules and 20 specimens of normal thyroid tissues adjacent to the nodules (as controls),Immunohistochemistry was used to detect the expression of MUC1 and β-catenin in these tissues. The correlation of the expression of MUC1/β-catenin with different clinico-pathological parameters of the papillary thyroid carcinoma patients was analyzed. Results The MUC1 expression level of the tissues of the papillary thyroid carcinoma tissue was ( 134 ± 10,gray scale),significantly higher than those of nodular goiter group ( 101 ± 7,gray scale) and the control group (99±6,gray scale) (both P <0.01 ). The positive expression rate of MUC1 in the tissues of papillary thyroid carcinoma was 56. 6%,significantly higher than those in the nodular goiter and control groups ( 15.0% and 5.0% respectively,both P < 0.01 ). The positive β-catenin expression rate of the papillary thyroid carcinoma group was 71.7%,significantly higher than these of the nodular goiter and control groups (40.0% and 20.0% respectively,both P <0.05). The positive MUC1 expression rate of the papillary thyroid carcinoma patients with lymph node metastasis was 68.4% (26/38),significantly higher than that of the patients without lymph node metastasis (26.7%,4/15,P < 0.05),however,there were no significant differences in the MUC1 expression rate among the papillary thyroid carcinoma patients different in sex,age,and tumor size ( all P > 0. 05 ). The β-catenin expression rates of the papillary thyroid carcinoma patients different in sex,age,tumor size,and lymph node metastasis status were not significantly different (all P > 0. 05). Binary Logistic regression analysis showed that abnormal expression of MUC1 and β-catenin were positively correlated with the pathogenesis of papillary thyroid carcinoma (all P < 0.05),and lymph node metastasis status and abnormal expression of β-catenin were positively correlated with MUC1 expression (P<0.05). Conclusion Playing an important role in the carcinogenesis and development of papillary thyroid carcinoma,MUC1 can be used as a biomarker in this carcinoma. There was a significant positive correlation between MUC1 expression and β-catenin expression.

Objective To explore the outcome of transnasal endoscopic optic nerve decompression (TEOND) for traumatic optic neuropathy (TON). Methods The clinical data of 155 consecutive patients with TON treated with TEOND after failure of mega-dose steroid therapy were retrospectively analyzed,their outcomes were summarized after follow-up,and then Logistic regression was used to analyze the prognosis-related information to explore the factors influencing prognosis. Results Patients were followed up for 3-60 months. The total effective rate of the 155 patients was 44.5%. The effective rate of the patients with light perception or better vision was 87.5%,much higher than that of the patients without light perception (29.6%). Eyesight was improved,mostly occurring 1-5 days after operation and lasting for 1 -3 months,in 69 patients. Residual vision degree after trauma (OR=0.04) and the interval between injury and surgery (OR=4.62) were significant prognostic factors of the general effect (P<0.01),and the gradual or immediate visual loss history (OR=0.22) and the interval between injury and surgery (OR = 6.34) were significant to the outcomes of the patients with no light perception (P<0.05). Sex,age,duration of coma after trauma,pre- and post-operative duration of steroid treatment,operators,fracture site of optic canal,and nerve sheath incision were not correlated to the outcomes of patients (all P>0.05). Intraoperative cerebrospinal fluid rhinorrhea and postoperative transient visual loss occurred in one and the other two cases,respectively,but these conditions were resolved successfully. Conclusion TEOND is effective and safe for TON patients,but the visual outcome is poor for the immediate blindness cases. The surgery is indicated for the patients with some residual vision or with a gradual visual loss and is suggested to perform early within seven days after injury.

Objective To investigate the impact of metabolic syndrome (MS) with or without hyperglycemia on stroke prevalence compared to that of diabetes alone. Methods 44 100 subjects,20 570 males and 23 530 females,aged 25-75,who had participated in the Chinese Residents Nutrition and Health Examination Survey held in the mainland of China 2002,underwent anthropometry,measurement of total cholesterol (TC),triglyceride (TG),high density lipoprotein cholesterol (HDL-C),high density lipoprotein cholesterol (LDL-C),fasting plasma glucose (FPG),and 2 hour plasma glucose (2 h PG) after 75 g oral glucose tolerance test (OGTT). 22 570 subjects,10 698 males and 11 872 females,were divided into 5 groups: control group without MS risk factors (n=17 518),Group of diabetes mellitus (DM) without MS (n=638),group of MS with normoglycemia (n=2501),Group of MS with mild hyperglycemia (n=1058),and group MS with DM (n =855). The relationship between MS and stroke was studied by multiple logistic regression analysis. Results The prevalence of MS increased along with age. The MS prevalence rates of the subjects with FPG≥ 5.6 mmol/L in the age groups 25-34,35-44,45-54,and ≥55 were 23.5%,37.2%,45.7%,and 53.0% respectively,all significantly higher than those of the subjects with the FPG <5.6 mmol/L (2.2%,4.7%,7.8%,and 9.5% respectively,all P< 0.01). The prevalence rates of stroke of the groups of DM,normal blood sugar with MS,mild hyperglycemia with MS,and DM with MS were 2.94%,2.27%,2.89%,and 4. 11%,respectively,all significantly higher than that of the control group (0.19 %,all P <0. 01 ). After adjustment for age,sex,smoking status,and LDL-C,no significant difference was observed between the neighboring MS groups (all P > 0.05). Compared to the group of MS with normoglycemia,the OR value for stroke of the DM with MS was 1.84 (95% CI 1.20 -2.83,P < 0.01 ),which was still significant after adjusting for LDL-C (P < 0.05). Conclusion (1) People with gloucose intolerance had very high prevalence of stroke than novmoglgcemic people. (2) Hyperglycemia in MS has an extremely important role in the impact of MS on stroke in Chinese. (3) Diabetes by itself has the same significance as the combination of MS components in the development of stroke.

Objeclive To analyze the mRNA expression of omentin mRNA level in subcutaneous and omental adipose tissues of normal,obese,and type 2 diabetic individuals and to investigate the relationship between omentin mRNA expression and serum omentin level,body fat parameters,glucose and Lipid metabolism,and insulin resistance indexes. Methods 36 patients with benign diseases undergoing selective abdominal operation,19 males and 17 females,aged 20 -65,included 12 with normal glucose regulation and normal weight ( NGR-NW group),12 with normal glucose regulation and overweight/obesity (NGR-OW/OB group),and 12 with type 2 diabetes and overweight/obesity (T2DM-OW/OB group). Abdominal subcutaneous and omental adipose tissues were obtained during operation. Real-time quantitative PCR was used to measure the omentin mRNA level . The level of fasting serum omentin was measured by ELISA. Meanwhile blood glucose,HbA1C,hpids and insulin levels were measured. Body weight,BMI and waist hip ratio (WHR) were evaluated and insulin sensitivity was assessed by homeostasis model assessment insulin resistance index (HOMA-IR). Results The omentin mRNA level in omental adipose tissue of the NGR-NW group was ( 1.52 ± 0. 32),significantly higher than that in subcutaneous adipose tissue [ (0.019 ±0.006) ,P <0.01]. The omentin mRNA level of the males was ( 1.46 ± 0.31 ),not statistically different from that of the female [(1.58±0. 29) ,P =0.416]. The omentin mRNA level of the NGR-OW/OB group was (1.18±0.29),significantly lower than that of the NGR-NW group [(1.52±0.32) ,P <0.05],and the omentin mRNA level of the T2DM-OW/OB group was (0.98 ± 0.37 ),both significantly lower than those of the other 2 groups (both P <0.05 ). Partial correlation analysis showed that the omentin mRNA was negatively correlated with HOMA-IR,body weight,WHR,triglyceride,BMI,and fasting insulin,and positively correlated to serum omentin level and HDL-C. Multiple linear regression analysis showed that serum omentin level,HOMA-IR,and body weight were independent variables of omentin. Conclusion Omentin mRNA is highly expressed in omental adipose tissue. The omentin mRNA expression level decreases in the overweight/obese individuals and decreases further when overweight/obesity is combined with type 2 diabetes. Omentin mRNA is positively correlated to serum omentin level,obese indexes,insulin resistance,and lipid metabolism parameters. Decreased omentin gene expression may contribute to the underlying pathophysiology of insulin resistance syndrome.

Objective To further identify the breast adenocarcinoma cell line T47D-tk stably expressing the suicide gene HSV1-tk,observe its growing characteristics,and establish an animal model of implanted breast adenocarcinoma. Methods Retroviral vector of HSV1-tk gene and breast carcinoma cell line T47D-tk stably expressing the HSV1-tk gene were established. Breast carcinoma cells of the lines T47D and T47D-tk were cultured,and observed by inverted microscope. Growth curve was drawn. Genomic DNA of T47D-tk cells was extracted,and amplified by PCR with HSV1-tk and HSV1-tk P2 as primers. Agarose gel electrophoresis was used to identify the HSV1tk gene. Suspensions of T47D and T47D-tk cells were inoculated subcutaneously at bilateral roots of foreleg of female BALB/c nude mice respectively. The growth of tumor was observed every day. Results PCR showed 1131 bp fragment in the T47 D-tk genome,but not in the T47D genome. The numbers of growing T47D cells on days 3,and 7 were ( 10.00 ± 1,30) × 103 and ( 19.25±0.66) × 103 respectively,not significantly different from those of the T47D-tk cells [(10. 25 ±0.90) × 103 and ( 19.00 ± 1.80) × 103 respectively,both P > 0. 05]. The time needed for tumor formation after the inoculation of T47D cells was (9.67 ± 0.33 )d,not significantly different from that of the T47D-tk cells [ (9.83±0.48) d,P >0.05 ]. The tumor size 19 days after inoculation of the T47D cells was (72. 17±25.88) mm3,not significantly different from that of the T47D-tk cells [ (70.66±22.16) mm3,P >0.05 ]. Conclusion The T47D-tk cells have integrated the HSV1-tk gene without changing its growing characteristics. An animal model of implanted breast cancer has been successfully established. The T47D and T47D-tk subcutaneous xenografts offer the foundation for further study of gene imaging and gene therapy.

Objective To study the effects of bone morphogenic proteins-7( BMP-7 )on the production of collagen from hepatocytes and hepatic stellate cells (HSC) during liver fibrosis,and the possible mechanism thereof. Methods Ten SD rats underwent repeated peritoneal injection of pig serum twice a week for 8 weeks so as to establish liver fibrosis models. Another 5 rats were injected intraperitoneally with normal saline as control group. Then the rats were sacrificed with their livers taken out. Primary hepatocytes and HSC were isolated from the fibrotic livers and cultured. BMPo7 at the concentrations of 10,50,or 100 mg/L was added into the culture media for 24 and 96 hours respectively. ELISA was used to detect the levels of collagen of type Ⅰ ,Ⅲ,and Ⅳ. BMP-7 at the concentration of 50 mg/L was added into the culture media for 96 h,then immunofluorescence staining was conducted on the cells to examine the levels of TβR-Ⅰ and TβR- Ⅱ ,TGF-β1 receptors on the cell surface,and the Smad2/3 level. Real-time RT-PCR was used to detect the TGF-β1 mRNA expression in the cells. Results The levels of collagen of type Ⅰ and Ⅲ in the HSC treated by BMP-7 were all significantly lower than those in the control group especially 50 mg/L BMP-7 decreased the expression of collagen Ⅰ by 40% ± 6% ( P <0.01 ) and decreased the collagen Ⅲ expression by 60% ± 8% (P < 0.01 ) ,however,the levels of type Ⅳ collagen in the hepatocytes treated by BMP-7 were not significantly different from those of the control group. The levels of collagen of type Ⅰ ,Ⅲ,and Ⅳ in the hepatocytes treated by BMP-7 were not significantly different from those of the control group. The impact of 50 mg/L BNP-7 on the HSC was stronger than that of the 10 mg/L BMP-7,however,not significantly different from that of the 100 mg/L BMP-7. There were not significant differences in the TβR- Ⅰ and TβR- Ⅱ levels in the HSC culture fluid treated by 50 mg/L BMP-7. 96 h after the treatment of 50 mg/L BMP-7 the Smad2/3 immunofluorecent strength in the HSC and hepatecytes decreased remarkably,and the TGF-β1 level in the HSC decreased to the level 88% as high as that before treatment. Conclusion BMP-7 inhibits the production of type Ⅰ,and Ⅲ collagen in activated HSC with the possible mechanism of inhibition of phosporylated Smad2/3 in HSCs and down-regulation of the expression of TGF-β1.

Objective To investigate the effects of sarcoplasmic reticulum calcium ATPase 2a (SERCA2a) overexpression on the endoplasmic reticulum stress (ERS) . Methods Ventricular cardiomyocytes were obtained from a neonatal rat,cultured,and then randomly divided into 6 groups: normal control group;hypoxia group cultured in an airtight chamber gassed with 95% N2/5% CO2 at 37℃ for 72 hours so as to induce ERS;tunicamyein group treated with 10 μg/ml tunicamycin so as to induce ElLS too;SERCA2a group transfected with recombinant adenovirus expressing the target gene SERCA2a (rAd-SERCA2a) ;SERCA2a+hypoxia group;and SERCA2a+tunicamycin group. Western blotting was used to detec the protein expression of SERCA2a,and glucose-regulated protein 78 (GRP78) and C/EBP homologous protein (CHOP) ,both the ERS markers. Flow cytometry was used to detect the apoptosis of the cardiomyocytes,and trypan blue staining was used to detect the survival rate of the cardiomyocytes. Results (1) The GRP78 expression level of the hypoxia group was 5.1 times as high as that of the control group,and the CHOP expression level of the hypoxia group was 2.5 times as high as hat of the control group. The GRP78 expression level of the tunicamycin group was 4.9 times as high as that of the control group,and the CHOP expression level of the tunicamycin group was 3.1 times as high as hat of the control group. SERCA2a overexpression was found to relieve the expression of GRP78 induced by hpoxia and tunicamycin (49.1% and 50.4% decrease respectively),and to inhibit the activation of CHOP (52.7% and 66.1% decrease respectively). (2) In comparison with the hypoxia group,the protein expression levels of GRP78 and CHOP of the SERCA2a overexpression + hypoxia group were significantly lower by 49.1% and 52.7% respectively,the apeptotic rate was significantly lower by 66.0%,and the cardiomyocyte survival rate was significantly higher by 13.4% (all P < 0.05). Compared with the tunicamycin group,the protein expression levels of GRP78 and CHOP of the SERCA2a overexpression + tunicamycin group were significantly lower by 50.4% and 66.1% respectively,the apoptotic rate was significantly lower by 54.0%,and the cadiomyocyte survival rate was significantly higher by 6.7% (all P < 0.05). Conclusion SERCA2a overexpression attenuates ERS induced by hypoxia or tunicamycin,and protects cardiomyocytes against ERS-mediated cellular injury.

A 34-year-old female was admitted to the emergency department for "intermittent right abdominal pain, diarrhea with fever for more than 1 month". One month ago, the patient developed persistent colic in the right upper and middle abdomen without obvious trigger, accompanied by abdominal distension and diarrhea. There was no nausea or vomiting. After 1 day of abdominal pain, fever appeared, which was relaxation fever, and the maximum body temperature was 40℃. There was no obvious improvement after penicillin and dexamethasone were given in the local hospital.

During brain development, the establishment of appropriate synaptic pathways is a key factor, in which synaptic inhibition plays a major role in calibrating neuronal activity [1]. The development of inhibitory pathways from the medial orthopedic nucleus (MNTB) to the lateral superior olive nucleus (LSO) is the focus of attention in the study of the development of sound source localization inhibitory synaptic pathways [2-5].

magnetic resonance imaging (MRI) has high accuracy in evaluating the morphology and structure of the heart, and has been widely used in predicting the epidemiological study of cardiac adverse events.

Smoking is the second leading risk factor of death worldwide. In 2000, about 4.83 million deaths were related to smoking worldwide. With a population of 1.3 billion people, China is the largest tobacco producer and consumer in the world, and smoking causes a large proportion of deaths.

Prophylactic use of antimicrobial drugs, such as selective digestive trot decontamination (SDD) and selective oropharyngeal decontamination (SOD), has been shown to reduce the incidence of respiratory tract infection, but its effect on the improvement of patients' survival rate is still lacking.

A 51-year-old male was admitted to hospital on July 3, 2008 due to lower abdominal pain accompanied by intermittent abdominal distension for more than 4 months. In February 2008, the patient developed persistent dull pain in the lower abdomen without obvious trigger, and felt abdominal fullness and discomfort when eating hard food or eating slightly more food.