Volume 89  ·   Issue 20  ·  2009

Colorectal cancer is a common malignant tumor, and its incidence rate ranks second among malignant tumors in western developed countries. With the continuous improvement of living standard and westernization of eating habits of Chinese residents, the incidence rate of colorectal cancer is also increasing year by year, and has jumped to the third ~ fifth place. The 5-year survival rate of colorectal cancer limited to intestinal wall after diagnosis and treatment can reach 90%; However, the 5-year survival rate of patients with lymph node metastasis is only 68% [1]. At present, most colorectal cancers are found in the middle and late stage, and the curative effect is often not satisfactory. Therefore, early detection and prevention of colorectal cancer are very important. In view of this, we should pay attention to the analysis of high-risk population of colorectal cancer. 　　

Objective To assess the clinical efficacy of cetuximab in the treatment of individuals with metastatic colorectal cancer. Methods Literature searches were performed on all clinical trails reported on target-therapy agent cetuximab in treating metastatic colorectal cancer prior to August 2008. The basic characteristics and clinical efficacy data of trials meeting the screening criteria were extracted. Date analysis was performed by RevMan 4.2 if the data came from randomized controlled trials with the same objective. Results According to the selection criteria, 22 clinical studies were included. There were 8 randomized controlled trials, 1 non-randomized controlled trial and 13 single group trials. Because of different study objectives of 8 randomized controlled trials, no data could be analyzed by the Meta-analysis method. Cetuximab plus irinotecan as second-line therapy for patients with EGFR-expressing metastatic colorectal cancer who had previously failed to respond to irinotecan-added therapy could reach a tumor response rate of 16.4%-23.0%, and median overall survival duration of 8.6-10.7 months. The addition of cetuximab to irinotecan as first-line therapy to treat metastatic colorectal cancer resulted in a tumor response rate of 42.0%-67.0%, and median overall survival duration of 33.0 months. The response rate of cetuximab combined with oxaliplatin/5-FU/LV as first-line therapy for metastatic colorectal cancer was 46.0%-72.0% and the median duration of overall survival was 28.2-30.0 months. Compared with the colorectal cancer population with mutant KRAS, the patients with wild-type KRAS could obtain a higher response rate and a longer progression-free survival. Conclusion Cetuximab in combination with chemotherapy has promising efficacy in the therapy of metastatic colorectal cancer, and status of gene KRAS is an independent predictive marker for response of cetuximab.

Objective To study the effect of allicin on invasion and metastasis of human colon cancer cell line LoVo in vitro and furthermore elucidate its anticancer mechanisms. Methods MTT assay was used to test dynamically the effect of cell growth inhibition.The inhibitory effects of allicin on movement, adhesiveness and invasiveness of LoVo cells were evaluated by the migratory test, adhesion test and Transwell chamber experiment.Quantitative real-time reverse transcription PCR (real-time RT-PCR) was performed to quantify the mRNA expression of MMP-2, TIMP-2, CD147, VEGF, nm23-H1, HPA and uPAR. Results Allicin had inhibitive effects on growth of LoVo cells in a dose and time-dependent manner.Allicin at non-cytotoxic concentration (3 and 6μg/ml) could obviously suppress the movement, adhesion and invasive capability of LoVo cells.In the allicin-treated group(3 and 6 μg/ml), after 24 hours, the inhibition rates of migratory time were 24% and 50%(t=4.543, 12.348, P=0.010, 0.001), the inhibition rates of adhesion were 19% and 28%(t=6.145, 6.355, P=0.004, 0.003), the inhibition rates of migration were 28% and 46%(t=8.065, 28.435,both P<0.01), and the inhibition rates of invasion were 44% and 65% respectively (t=21.274, 26.288, both P<0.01).Allicin at non-cytotoxic concentration could down-regulate the mRNA levels of VEGF, uPAR and HPA in a dose-dependent manner in LoVo cells (t=7.129, 6.764, 8.497, P=0.002, 0.002, 0.001) while the mRNA levels of TIMP-2, CD147 and nm23-H1 remained basically unchanged with the same treatment (t=0.341, 1.889, 0.914, P=0.059, 0.132, 0.412).The expression of MMP-2 had not been detected in LoVo cells. Conclusion Allicin in vitro inhibits invasion and metastasis of human colon carcinoma cell LoVo at non-cytotoxic concentration through down-regulating the expression of VEGF, uPAR and HPA mRNA.

Objective To investigate the expression of Cyclooxygenase(COX)-2 and the relationship between cox-2, mismatch repaire gene (MMR) proteins and microsatellite instability (MSI) in HNPCC.Methods Twenty-eight cases of adenomas and 14 cases of carcinomas were collected from 33 HNPCC families patients by colonoscopy. Sporadic adenomas (n=32) and carcinomas (n=24) were used as a control group. The expressions of COX-2 and mismatch repair gene hMLH1, hMSH2, hMSH6 proteins were examined by immunohistochemistry. MS1 were analyzed by using PCR with BAT25, BAT26, D2S123, D5S346 and D17S250 loci.Results The COX-2 high-expression rates were 53.6%(15/28)and 42.9%(6/14)in HNPCC adenomas and carcinomas,and were 62.5% (20/32) and 91.7% (22/24) in sporadic adenomas and carcinomas. COX-2 expression was lower in HNPCC carcinomas than that of sporadic carcinomas (P＜0.05). MMR deficiency rate and positive rate of MSI-H were both 71.4% (10/14) respectively in HNPCC carcinomas. It was higher than that in sporadic colorectal carcinomas [both 12.5% (3/24)]. Eight (80.0%) COX-2 low-expression were observed in 10 HNPCC carcinomas with MMR-deficient system while 4 cox-2 high-expression cases were observed in 4 HNPCC carcinomas with MMR-proficient system. COX-2 expression was lower in HNPCC carcinomas and adenomas, sporadic carcinomas with MMR-deficient system than that of MMR-proficient (P＜0.05). The COX-2 low-expression rates were 80.0% (8/10), 66.7% (12/18) and 66.7%(2/3) in HNPCC adenomas, HNPCC carcinomas and sporadic carcinomas with MSI-H. Cox-2 expression was lower in HNPCC and sporadic carcinomas (adenocarcinomas) with MSI-H than that of MSS (P＜0.05).Conclusion Compared with sporadic carcinomas, the COX-2 expression was lower in HNPCC carcinomas. There was negative correlation between COX-2 expression and MMR-deficient (MSI-H). The detection of COX-2, MMR protein and MSI is of important significance in further studying the pathogenesis and interventional therapy of colorectal neoplasms.

Objective To construct a RU486 inducible recombinant adenovirus of murine IL-12 protein and study its effect and safety on colonic cancer.Methods The replication-defective recombinant adenovirus were produced after cotransfection of shutter vector pDC-RUmIL-12 and adenovirus DNA helper plasmid pBHGloxΔE1,3Cre into HEK293 cells.The recombined adenovirus was purified by CsCl density gradient centrifugation and its titer was determined by end point dilution assay.Expression of this regulatable recombinant adenovirus vector in infected C26 colonic carcinoma cells was tested by ELISA kit in vitro.The tumor model was established by hypodermic inoculation of C26 cells.Sixty tumor-bearing mice were randomly divided into 4 groups: Ad-buffer group; Ad-RUmIL-12 group; Ad-RUmIL-12 + RU486 group and Ad-mIL-12 group, and the treatment effects and side effects were evaluated.Results The adenoviral vector containing murine IL-12 gene was identify by PCR.The viral titer of Ad-RUmIL-12 was 4.62×1010 pfu/ml.The expression of IL-12 protein was induced by the RU486 and the highest expression(516±43)pg/ml whereas no significant IL-12 protein was detected without inducer or getting rid of the inducer [(38±3)pg/ml and (42±5)pg/ml respectively].The tumor size increased rapidly in group Ad-buffer and group Ad-RUmIL-12(P>0.05).Administration of Ad-RUmIL-12+RU486 and Ad-mIL-12 were showed to delay markedly the growth of transplanted C26 tumor (P>0.05).Significantly necrosis was observed in both Ad-mIL-12 and Ad-RUmIL-12+ RU486 experimental groups, but the level of the serum alanine transaminase and the rate of side effect was higher in Ad-mIL-12 group (4/15 and 10/15 respectively, P<0.05).Conclusion A RU486 regulatable recombinant adenoviral vector containing IL-12 gene was successfully constructed.The expression of vector Ad-RUmIL-12, regulated by inducer RU486 in vivo, can obviously improve safety in tumor treatment and provide a good primer for further researches on in vivo gene therapy.

Objective To determine the method for locating the hemorrhagic site of biliary tract and assess the value of hepatectomy.Methods Clinical data of 23 patients with biliary tract hemorrhage undergoing liver segmentectomy between January 1998 and October 2008 were analyzed. There were infection of biliar tract or hepatolithiasis in 14 patients(60.9%), trauma in 6 (26.1%) and primary liver cancer in 3 (10.0%). Precise orientation was achieved by selective angiography in 5 patients and by bile duct exploration in 18. Operative approaches included left hemi-hepatectomy in 6 patients, left lateral lobectomy in 8, right hemi-hepatectomy in 4 and combined right segmentectomy in 5.Results All cases were successfully treated without any operative mortality. A majority of complications were bile leakage in 2 cases, subphrenic infection in 1, stress gastric ulcer in 1 and acute renal failure in 1. During the follow-up period of 8 months - 10 years in 15 patients, 3 died of recurrent or metastasis liver cancer and 2 biliary cirrhosis.Conclusion Hepatectomy is advocated for the management of biliary tract hemorrhage if bleeding is localized to a definite segment and the patient can tolerate the procedure.

Objective To explore the treatment of heparin-induced thrombocytopenia (HIT) in venous thromboembolism.Methods A total of 202 patients with venous thromboembolism without anticoagulation contraindications were enrolled. All of them were treated with low molecular weight heparin (LMWH) and/or unfractionated heparin (UFH). The peripheral blood cells were examined regularly.Results HIT occurred in 6 patients. And argatroban was used to treat HIT. The overall incidence rate of HIT in this study was 2.97%. The time of occurrence of HIT was about Days 3-9 after using heparin. The platelet recovered to the basic level at Days 3-7 after withdrawing heparin and initiating argatroban.Conclusion The count of platelet should be measured in the patients receiving regular LMWH and/or UFH therapy. And the above regimen should be discontinued timely when the platelet count declined progressively by over 50%. Argatroban was effective.

Objective To detect the germline TP53 gene mutation in a child with pediatric adrenocortical carcinoma (ADCC) in order to provide genetic diagnosis and counseling. Methods Genomic DNA was extracted from peripheral blood from a girl with ADCC and her parents. All TP53 exons and their flanking intronic sequences were PCR-amplified and subjected to automatic DNA sequencing. Results Direct sequencing of PCR products revealed a heterozygous G insertion between nucleotide 522 and 523 (c.522-523insG) in TP53 exon 5. This novel mutation is predicted to result in a frame shift at codon 175, producing a new reading frame ending in a stop at position 6 (p.R175AfsX6). The same heterozygous mutation was also found in her father, but not in her mother. Conclusion A novel germline mutation in the TP53 gene has been identified in one case with pediatric ADCC.

Objective To evaluate prospectively the clinical outcomes of trimetazidine(TMZ)in patients with acute ST segment elevation myocardial infarction(STEMI)without ST segment resolution(STR)after primary percutaneous coronary intervention(PPCI).Methods From August 2005 to October 2007, 138 acute STEMI patients without STR after PPCI were randomly assigned to either with TMZ therapy(TMZ group, n=70)or without TMZ (control group, n=68). Baseline characteristics, PCI features and clinical outcomes during hospitalization were compared between the two groups. Left ventricular ejection fraction(LVEF)and major adverse cardiac events(MACE, including death, re-infarction and target vessel revascularization)at Days 30 and 180 after discharge were also compared.Results The baseline clinical characteristics were comparable between the two groups. There was no significant difference in MACE rates at Days 30 and 180 between the two groups (10/70 vs11/68, P>0.05; 15/70 vs13/68, P>0.05, respectively). The LVEFs of TMZ group at Days 30 and 180 were significantly superior to the control group (51±8)% vs (45±7)%, P<0.05;(56±7)% vs (49±8)%, P<0.05, respectively).Conclusion Use of TMZ for patients with acute STEMI without STR after primary PCI can improve the left ventricular function at Days 30 and 180.

Objective To provide anatomic data for auditory brainstem implantation(ABI)through the retrosigmoid approach.Methods Simulated operations were performed on 30 wet adult head specimens and the structure around the foramen of luschka was observed.Both microscope and endoscope were employed.Results(1)The bony window,the most adjacent but not overlapping with sigmoid sinus,was a circle with a radius of 20 mm Its center was located behind midpoint of the line from parietal notch to mastoid apex with a distance of f26.42 4±1.29)mm.The distance between bony window and transverse sinus,mastoid apex,foramen of luschka,jugular foramen,posterior edge of internal auditory meatus androot entry zone of the IX cranial nerve were(22.45 4±1.41)mm,(35.51 4±1.65)mm,(43.86 4-2.20)m／n,(16.56 4±1.64)mm,(15.01±0.63)mm and(46.27 ±1.70)mm respectively;(2)The foramen of luschka can be spotted by using microscope or endoscope,especially 30.angled endoscope.By this way,we could obtain a more distinct visual field without over-retraction of cerebellum and achieve the goal of minimally invasive surgery.The distance between the foramen of luschka and internal acoustic porus was (15.01 ±0.53)mln;(3)The foramen of luschka Iies in the triangle formed by flocculus and the root entry gone of glossopharyngeal nerve and mstral margin of biventer lobule.Choroids plexus acts as a direct landmark.The Iength of lateral recess was(17.53±1.03)mm. The distance between acoustic tubercle and the foramen of luschka and the root of cochlea never wus(16.52 ±1.67)mm and(13.77 ±1.66)mm respectively.Conclusion Adjustment of the angle of skull bone window and clarification of cerebellopentine angle are the keys to positioning the foramen of lusehka.The usage of 30.awed endoscope can identify the foramen of luschka nlore accurately and expose the operation area more clearly.

Objective To evaluate the preventive effect of a new anastomotic technique upon pancreatic leakage-polypropylene mesh wrap around reinforced pancreatojejunostomy on soft pancreas.Methods From August 2005 to August 2008, polypropylene mesh wrap around reinforced pancreatojejunostomy was performed on 24 cases of pancreatodudeonectomy with soft pancreas.Results The operating duration was 5 to 7.5 hours. The mean duration of performing pancreatojejunostomy was 25 min. Blood loss was 200 to 1,500 ml. All patients recovered without pancreatic leakage.Conclusion The polypropylene-mesh wrap around reinforced pancreatojejunostomy is a feasible and reliable procedure to prevent pancreatic leakage of soft pancreas.

Objective To study the effects of self-expandable and orthotopically implanted percutaneous aortic valved stent on coronary artery flow in vitro. Methods Self-expandable valved stent was developed with nitinol stent and bovine pericardium. The ascending aorta of Chinese miniswine hearts was cut proximal to the brachiocephalic trunk. The right and left main coronary arteries were dissected. In vitro coronary flow tests were performed. Firstly, baseline coronary flow with the native aortic valve was measured (n=12). Secondly, the valved stent was deployed orthotopically. The commissures of prosthesis were positioned randomly. Through an endoscope, the effects of valved stent and native valve on coronary ostium were obtained and coronary flow measurements repeated (valve preservation group, n=12). Then the distance from coronary ostium to native leaflet free edge was measured. Native leaflets were removed before similar valved stent deployment. Coronary flow measurements and endoscopic inspections were repeated post-implantation (valve removal group, n=12).Results In valve preservation group, valved stent implantation resulted in a significant decrease in left coronary flow (29.46%, P<0.05). The obstruction was due to native leaflets sandwiched between the stent and aortic wall. The left ostia were obstructed totally in 3 and partially in 4. The flow of right coronary decreased 7.34% (P>0.05). The right ostia were obstructed partialy in 3. In valve removal group, 6.82% and 5.37% decrement in left and right coronary flow were observed after valved stent placement (P>0.05). The distances from right coronary ostia to annulus were farther than from left coronary ostia. In two groups, the commissures of prosthesis obstructed partially left coronary ostia in 4 and right coronary ostia in 1.Conclusion Orthotopic implantation of a percutaneous self-expandable aortic valved stent would obstruct the left coronary ostium with the native valve. Coronary ostium may be obstructed partly by the commissures of prosthesis.

Objective To investigate the role of ribavirin (RIB) in treating respiratory syncytial virus (RSV)-induced asthma exacerbation of mice.Methods (1)Cell experiment: 32 flasks of human airway epithelial cell 16HBEs were randomly divided into four groups: RSV group, RSV/RIB group, RIB group and control group. 16HBEs were infected with RSV at a multiplicity of infection (MOI) of 2. RIB 50 μg/ml was added in culture medium and Western blot used to detect the production of thymic stromal lymphopoietin (TSLP) protein; (2) Animal experiment: 32 female BALB/c mice were randomly divided into four groups: Ovalbumin (OVA) group, OVA/RSV group, OVA/RSV /RIB group and control group. Mice were sensitized by OVA and stimulated with nebulized OVA. RSV was inoculated into murine nasal cavity and RIB 10 mg/kg intramuscularly administered. BUXCO noninvasive murine lung function detection instrument was used to examine the airway response to metacholine; ELISA was used to detect IL-4, IL-5, IL-13 and IFN-γ in murine serum and TSLP in supernatants of bronchoalveolar lavage fluid (BALF);murine lung specimens were stained with HE to observe inflammation and immunohistochemical technique was employed to observe the production of TSLP in murine airway epithelial cells.Results The cell experiment demonstrated the productions of TSLP protein in RSV group, RSV/RIB group, RIB group and control group were 1.97±0.22, 1.16±0.19, 0.99±0.17 and 0.89±0.08 respectively, and the production of TSLP in RSV/RIB group was lower than that in RSV group(P＜0.01). The animal experiment demonstrated that the murine airway responsiveness in RSV/OVA/RIB group was lower than that in OVA/RSV group(P＜0.01). The levels of IL-4 [(109.7±41.9) pg/ml], IL-5 [(220.8±30.9) pg/ml], IFN-γ [(13.0±3.4) pg/ml] in murine serum and TSLP [(1945±82) pg/ml] in BALF of RSV/OVA/RIB group were significantly lower than those in OVA/RSV group [(274.2±103.7), (293.3±46.1), (30.1±5.7) and (2127±46) pg/ml respectively, all P＜0.01]; less infiltration of airway inflammatory cells in OVA/RSV/RIB group was observed than that in OVA/RSV group. Immunohistochemical staining of TSLP also showed a lower production of TSLP in airway epithelial cells of OVA/RSV/RIB group than OVA/RSV group.ConclusionRibavirin can inhibit the elevated production of TSLP after RSV infection and relieve RSV-induced asthma exacerbation in mice.

Objective To assess the role of calcium-independent phospholipase A2 (iPLA2) in human pancreatic islets.Methods The immunohistochemical analysis and Western blot were employed to examine iPLA2 expression in human pancreatic islets. Bromoenol lactone (BEL), a selective inhibitor of iPLA2, was used in a randomized controlled trial to compare its influence to glucose-stimulated insulin secretion.Results iPLA2 was expressed predominantly in islet cells co-stained by insulin but was barely detected in the exocrine acinar cells. Western blot results indicated that islet cells expressed an iPLA2-immunoreactive band at the 80 kDa region. Glucose-stimulated insulin secretory response was dramatically reduced in islets pretreated with BEL (0.8285±0.0803 ng·islet-1·h-1) as compared with the control (1.2264±0.0568 ng·islet-1·h-1) (P＜0.01). BEL inhibited glucose stimulated insulin secretion from isolated human islets.Conclusion iPLA2 signaling plays an important role in glucose-stimulated insulin secretion under the physiological conditions.

Objective To assess the effects of tongxinluo on vascular endothelial integrity and myocardial no-reflow in early reperfusion of acute myocardial infarction.Methods Forty mini-swines were divided into five groups randomly, sham group, control group, low dose (0.1 g*kg-1), medium dose (0.2 g*kg-1) and high dose (0.4 g*kg-1) groups of Tongxinluo. It was administered at 2 hours pre-reperfusion. Animals except in sham group were subjected to 1.5 hour of coronary occlusion followed by 3 hours of reperfusion. Content of VE-cadherin, β-catenin, matrix metalloproteinase (MMP)-2 and 9 in myocardium were evaluated; no-reflow area was examined with myocardial contrast echocardiography (MCE) at 1.5 hour of AMI and 3 hours of reperfusion.Results (1) Compared with that of normal myocardium, content of VE-cadherin and β-catenin decreased in reperfusion and no-reflow myocardium while MMP-2 and 9 increased significantly (all P<0.05); (2) Compared with that of control group, a high dose of Tongxinluo could increase significantly the content of VE-cadherin in both reperfusion and no-reflow myocardium, (22.2±3.2)% vs (32.0±3.9)% and (14.5±2.8)% vs (28.3±2.2)% respectively, β-catenin, (20.5±3.5)% vs (27.3±2.9)% and (13.3±2.1)% vs (20.6±2.4)%,while reduce MMP-2, (48.3±4.1)% vs (29.4±3.5)% and (57.3±4.3)% vs (38.2±4.0)% respectively, MMP-9, (55.6±4.0)% vs (34.3±3.5)% and (62.4±4.8)% vs (44.4±4.1)%,all P<0.05; (3) Compared with that of control group, a high dose of Tongxinluo could reduce significantly both no-reflow area, (6.6±1.7)cm2 vs (4.7±1.5)cm2, P<0.05, and percentage(90.8±3.8)% vs (71.4±4.1)%, P<0.05, at 3 hours of reperfusion.Conclusion A high dose of tongxinluo could effectively maintain the integrity of vascular endothelium and attenuate no-reflow area in early reperfusion of acute myocardial infarction.

Objective To investigate the differential expression profiles of microRNAs in the knockout Pax-8 mice by miRNA microarray analysis and study the function of microRNA during cardiac development.Methods The knockout Pax-8 mice model was established and the total RNA derived from Pax-8 KO-/- and Pax-8 KO +/-mice heart. MicroRNA microarray containing 567 mammalian microRNA probes was used to investigate the microRNAs differential expression between Pax-8 KO-/- and Pax-8 KO +/- mice. The candidates of microRNAs were confirmed by real time RT-PCR assay.Results The heart of pax-8 KO-/- mice became spheroidal. Left ventricle enlargement, left ventricular wall and interventricular septum thickening and papillary muscles in left ventricle enlargement were found. Furthermore, many apoptotic cells were discovered in left ventricular wall and interventricular septum in pax-8 KO-/- mice. The MicroRNA microarray result displayed 10 microRNAs differential expressions, in which 2 microRNAs became down-regulated and 8 microRNAs up-regulated by more than two folds in pax-8 KO-/- mice. This was in accordance with the result of real-time RT-PCR.Conclusion Some microRNAs may play important roles in cardiac development and ventricular septal defect pathogenesis.

Objective To study the effect of anti-type Ⅳ collagenase single-chain antibody scFv(3G11) on bleomycin (BLM)-induced pulmonary fibrosis. Methods C57BL/6 mice were divided into six groups (blank, saline control, BLM, low-dose treatment, intermediate-dose treatment, and high-dose treatment), the animal model of pulmonary fibrosis was induced with 400 ng/g intratracheal BLM. The day that treatment groups were injected with BLM was marked Day 0. Then at Days 1-7, scFv(3G11) was injected once intraperitoneally each day with three dosage [low-dose treatment (15 μg/g), intermediate-dose treatment (30 μg/g) and high-dose treatment (45 μg/g)]. At Day 21, 6 mice of each group (saline control, BLM, intermediate-dose treatment) were sacrificed and pathomorphological changes of left lungs evaluated with HE stained sections. Meanwhile, 6 mice of each group (blank, saline control, BLM, low-dose treatment, intermediate-dose treatment, and high-dose treatment) were sacrificed, the content of hydroproline was detected to measure the degree of collagen deposition. Macrophages were extracted from murine abdominal cavity and primarily cultured. And the inhibition of matrix metalloproteinase (MMP)-2 and MMP-9 excretion by different concentrations of scFv(3G11)(0, 15, 30, 45, and 60 μmol/L)was determined by gelatin zymography.Results By image analysis, the degree of fibrosis in the lungs of treated group was lighter than that of the BLM group. The percentages of the area of interalveolar septum (45.3% ± 3.2%) and the number of nucleated cells (451 ± 47) of treated group were remarkably reduced as compared with the BLM group(59.0% ± 3.0%, 599 ± 42, both P<0.01). The content of hydroproline of the intermediate-dose treatment group [(0.82±0.05) μg/mg] and high-dose treatment group [(0.80±0.03) μg/mg] was lower than that of the BLM group [(0.92±0.07) μg/mg,P<0.05,P<0.01]. The result of gelatin zymography demonstrated that the excretion of MMP-2 and MMP-9 by macrophage was inhibited by scFv(3G11) at the concentration of 15 μmol/L.Conclusion Single-chain antibody directed against type Ⅳ collagenase might inhibit the development of bleomycin-induced pulmonary fibrosis.

Objective To analyze the incidence and the variety of diseases at Olympic competition venues, non-competition venues and special control zones through the statistical analysis of medical data of Beijing 2008 Olympic Games.Methods The proportions of people contracting diseases among different groups, i.e. non-registered people, athletes, staff, media, VIPs and others were analyzed. At different venues the incidence proportions of diseases in cardiovascular system, stomatology, gastroenterolgy, ENT, respiratory system, surgery, neuropsychiatry, physical injury, genitourinary system and burns were calculated. And the disease spectrum and incidence proportions at specified venues were analyzed.Results (1) Among all groups of people involved in Beijing 2008 Olympic Games, the proportion of disease-contracting staff was the highest (44.83%) while that of VIPs the lowest (4.76%) so that the incidence proportions were different among different groups of people. (2) χ2=2427.803, (P<0.01)The statistical analysis of disease distribution indicates that people at different venues might contract different diseases. (3) The proportions of disease-contracting people at competition venues, non-competition venues, training venues and special control zones were 36.08%, 50.66%, 2.31% and 10.96% respectively, which was related to the number of people at a particular venue. (4) The incidence proportion of surgical diseases was quite high, especially maxillofacial and orthopedic diseases (orthopedic trauma) ranking as top 2 at all venues. Thus there should be surgeons at every venue, especially maxillofacial (for hockey) and orthopedic surgeons. At training venues, the number of people contracting E.N.T. diseases ranked No. 1, χ2=74.859 (P<0.01), compared with that of non-competition venues at No. 2. So the incidence proportion of ENT diseases was higher at training venues than at non-competition venues. The number of people contracting respiratory diseases was the largest in special control zones and the figure of competition venues ranked at No. 2, χ2=123.708 (P<0.01). Therefore the incidence proportion of respiratory diseases at special control zones was higher than that of competition venues.Conclusion The proportions of people contracting diseases were different among different groups of people and the staff ranked the first in this regard. People contracted different diseases at different venues so that the distribution of medical resources should cater to this situation. In case of such a large-scale international competition as the Olympic Games, the patients are mainly from competition venues and non-competition venues so these two places have the largest demand for medical staff. The incidence proportion of surgical diseases is quite high and it is important to have maxillofacial and orthopedic surgeons stationed at all the venues. The ophthalmological and ENT specialists are recommended at training venues and respiratory specialists at special control zones. Meanwhile, the gastroenterologic and stomatological specialists should be present at all venues.

Hyperglycemia is very common in critically ill patients treated in intensive care units, and severe hyperglycemia is associated with disability and mortality. Although the clinical results of intensive glycemic control are different, literature reviews and meta-analyses also draw different conclusions, many professional institutions recommend intensive glycemic control, and believe that normal blood glucose level is beneficial to patients. In order to confirm whether intensive glycemic control can reduce the 90-day mortality of critically ill patients, Australian and New Zealand scholars conducted a study, the results were published on 26 March 2009<New England Journal of Medicine >(N Engl J Med, 2009, 360:1283-1297). DOI: 10.3760/cma.j.issn.0376-2491.2009.20

Methicillin-resistant Staphylococcus aureus (MRSA) is a common pathogen of infections associated with nursing institutions, and 80% of bloodstream infections (BSI) are associated with central venous catheterization. In order to clarify the incidence of MRSA-induced central venous catheter-associated BSI, American scholars analyzed the data of MRSA infection in intensive care unit (ICU) over 10 years, and published the results in JAMA (JAMA, 2009, 301:727~736). 　　

The development and use of contrast agent (contrast agent) has promoted the progress of modern radiology and interventional diagnosis and therapy. Since then, with the increasingly widespread clinical application of contrast agent, contrast agent nephropathy (CIN) has become an important cause of renal failure and has attracted medical attention. Through in-depth research on the pathogenesis, it is found that viscosity, as an important physical and chemical index of contrast agent, has an important influence on the occurrence of CIN. 　　

A 57-year-old male was diagnosed with multiple primary tumors 10 years after surgery. Physical examination revealed a bulge between duodenum and jejunum for 5 days. Since the patient was diagnosed with colon cancer in 1998, multiple tumors were diagnosed in 10 years. Multiple intermittent surgery and pathology confirmed that except one recurrent tumor, all the remaining tumors were primary tumors, and 11 larger surgeries were performed. Physical examination before 5 days revealed a bulge between duodenum and jejunum. When admitted to hospital in September 2008, the patient was in general good condition. Physical examination: white blood cells 6.80×109/L, red blood cells 4.17×1012/L, hemoglobin 119 g/L, T cell subsets showed low CD3+ (0.196), CD8+ (0.153), normal CD4+ (0.35), and increased CD4+ /CD8+ (2.29). Carcinoembryonic antigen, alpha-fetoprotein, CA199 and CA125 were all normal, and four items of blood coagulation were normal.