Objective Effect of artemisinin and its derivatives on multi-drug resistance of tumor cells. Method The inhibition of cell proliferation and RI (reversal index) were determined by MTT method. Results The inhibitory effect of dihydroartemisinin and artemisunate on the proliferation of tumor cell is stronger than that of artemisinin. Artemisinin could partly improve KBv200 cell sensitivity to VCR in different concentrations. Conclusion Artemisunate and dihydroartemisinin effectively inhibited the proliferation of KBv200. Artemisinin could partly improve KBv200 cells sensitivity to chemotherapy medicine.

Objective To explore the relationship between blood lipid level and primary open angle glaucoma(POAG)and intraocular pressure(IOP).Methods A retrospective case-control study was designed.80 POAG patients from EYE & ENT hospital of FUDAN university were collected as a case group from January 2015 to May 2016.Meanwhile 80 age and gender matched healthy people were collected as a control group.The differences of gender in men subgroup (POAG:44,Control:39) and female subgroup (POAG:36,Control:41) showed no statistic significance.Serum total cholesterol(TC),total triglyceride(TG),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),apolipoprotein A(Apo A) and apolipoprotein B(Apo B) were measured using Roche automatic biochemical analyzer.The analysis of the above mentioned lipid levels between POAG group and control group was conducted by independent student′s T test and multivariate logistic regression.The relationship between lipid level and IOP was analysied using Pearson correlation test.Results The TG level was (1.40±0.71)mmol/L in the POAG group,(1.00±0.37)mmol/L in the control group.The difference had statistic significance (t=4.467,P<0.001).The HDL-C level in the POAG group was (1.22±0.36)mmol/L,(1.38±0.25)mmol/L in the control group.The difference also had statistic significance (t=-3.228,P=0.002).Comparison between the men subgroup and female subgroup found that the TG level in the POAG group of men was (1.47±0.71)mmol/L,(1.01±0.36) mmol/L in the control group and the HDL-C level were (1.14±0.31) mmol/L,(1.32±0.20)mmol/L in two groups.Both the level of TG and HDL-C had statistic significance in men (t=3.717,P<0.001;t=-3.240,P=0.002).The TC,TG level in the POAG group and control group of women respectively were (4.59±0.81)mmol/L,(1.33±0.72)mmol/L and (4.21±0.64)mmol/L,(0.99±0.38)mmol/L.Both blood level were significantly higher than the control group in women (t=2.278,P=0.026;t=2.503,P=0.016).Logistic regression analysis showed that the TG level correlated with POAG (P=0.004,OR=2.831,95% CI=1.392-5.759)and both POAG in the men and women (P=0.025,OR=3.223,95% CI=1.156-8.989;P=0.045,OR=2.554,95% CI=1.020-6.395).Pearson test showed that the TG level of POAG patients was positively associated with IOP in spite of gender(P<0.05).Conclusion The peripheral blood level of TG was significantly increased in the POAG patients and significantly correlated with IOP,which indicated that the increased peripheral blood level of TG may be the independent risk factor for the POAG..

Objective To describe a new technique with mini-open reconstruction of lateral ligaments of ankle with partial tendon of its peroneus brevis and evaluate its effect in treatment of chronic lateral ankle instability. Methods A total of 11 cases of chronic lateral ankle instability;at mean age of 27.6 years(16-42 years),were treated with mini-open reconstruction of the lateral ligaments of the ankle with partial tendon of its peroneus brevis.The mean delay between the initial episode of ankle sprain and the surgery was 10.3 months(4-32 months).Postoperatively,all cases were examined with MRI,stress X-rays and comparative stability of bilateral ankle inspection at clinical follow-up.The function of the ankle were evaluated bv American Orthopaedic Foot & Ankle Society (AOFAS)score and ankle-hind foot scale. Results The average duration of follow-up was 17.5 months(12-37 months).The mean AOFAS ankle-hindfoot score was 88.3 points(72-96 points)at the time of the latest follow-up,including excellent result in 6 cases(55%),good in 4(36%)and fair in 1(9%).MRI results showed that the ruptured lateral collateral ligaments of the ankle were repaired and remodeled very well in all patients.There was no recurrence of the ankle instability or other complications. Conclusion Mini-open reconstruction of the lateral ligaments of ankle with partial tendon of its peroneus brevis is safe and effective for treatment of chronic lateral ankle instability.

OBJECTIVE:To analyze the situation of antiarrhythmic drugs used in40hospitals of Guangdong Province.METHODS:To investigate antiarrhythmic drugs used during the past three years in aspect to the sum of money of consumption,DDDs and daily cost.RESULTS:The increasing rate of consumption sum of antiarrhythmic drugs during the pe?riod2000～2002has been lowered year by year,while the share of market of domestic drugs showed an increasing tendency,the imported drugs decreased year by year,the drugs produced by joint ventures kept steady.Metoprolol and potassium magnesium aspartate were much more frequently used than others.Metoprolol occupied the first place in the list of sum of mon?ey.CONCLUSION:The marketing of antiarrhythmic drugs will further expand in China and the pharmaceutical factories should strengthen the development of new antiarrhythmic drugs.

Objective To observe the effect of digestive load from senna on the adaptive thermogenesis in hypothyroid rats.Methods After being born(d1),rats were given the intraperitoneal injection with a series ratio of 131Ⅰ at neutral temperature 28℃ and a graded developmental hypothyrosis was resulted in.Since d56,they were fed with higher lipid 24 h then fasted 24 h interval to make them sensitive to digestive load.Since d70,senno sides were given intragastrical administration for 14 d to resulted in the digestive load with its empting function of the bowels.Pre-(d67-69)and post-(d85-86)administration of senna under the neutral environmental temperature,all changes of rat temperature,included peaks(℃)and areas under curve(℃?h),were measured and recorded with physiography,during 180 min after being injected with 106 ?g?kg-1 isoprenaline intravenously.The correlation between the effect and the logarithmic dose of 131Ⅰ(nCi?g-1)was analyzed.As well as EC50,the decreased thermogenesis induced by 131Ⅰ,was calculated with peaks and areas under curve respectively.The correlative analysis between the digestive load and the adaptive thermogenesis was performed especially with senna.Results Before and after administrated senna,it was negative correlation between rat temperature change(peaks and areas under curve)induced with isoprenaline and the degree of hypothyrodism(P

Objective To investigate the clinical outcome of arthroscopic percutaneous cannulated screw fixation with subtalar fusion in the treatment of post-traumatic subtalar arthritis. Methods The study involved 12 patients (five males and seven females) with severe post-traumatic subtalar arthritis admitted to our hospital from April 2006 to December 2009. The patients were at age range of 28-68 years ( mean 45.6 years). All patients had the history of conservative treatment but failed in pain alleviation.Then, the percutaneous cannulated screw fixation plus subtalar fusion was selected. The ande and hind foot of all patients were evaluated preoperatively and postoperatively by the American Orthopedic Foot and Ankle Society (AOFAS) scoring system. Imaging assessment was carried out by X-ray examination.Results The patients were followed up for mean 21.2 months (range 6-48 months), which showed thatthe mean AOFAS ankle-hindfoot scale was increased from (54.67 ± 5.28 ) points (range 43-61 points)preoperatively to (89.17 ±3.56) points (range 78-95 points) at final follow-up, with excellence rate of 93%. Eleven patients got good fusion with the mean time of 12.4 weeks (range 9-15 weeks). Only one patient had nonunion, with the pain in the lateral malleolus. The subtalar joint of the patient got union after plaster immobilization for three months, which was proved by X-ray examination. Conclusions The arthroscopic percutaneous cannulated screw fixation and subtalar fusion can acquire good clinical outcomes and hence is a recommended procedure for post-traumatic subtalar arthritis.

Objective To explore the surgical skill and curative effect of Scarf combined with modified Mcbride osteotomy for treating moderate to severe hallux valgus.Methods Thirty-eight patients (47 feet) with moderate to severe hallux valgus in the Southwest Hospital of Army Military Medical University from July 2014 to June 2015 were selected and treated by Scarf combined with modified Mcbride osteotomy,among them,31 cases(38 feet) were followed up.The cases of phalanx proximal articular angle(PAA) enlargement were added with Akin osteotomy hallex proximal phalanx,and 2,3 plantar Weil osteotomy was used in the patients with 2,3 plantar bone metastasis pain.The hallux valgus angle (HVA),1,2 intermetatarsal angle (IMA),distal metatarsal joint fixed angle(DMAA),PAA were compared between before and after surgery by the erect position,anteroposterior position and lateral X-ray films.The therapeutic effects were assessed by adopting the American Orthopedic Foot and Ankle Society(AOFAS) scoring system.Results The follow-up time was 12～18 months(average 16.42 months).HVA was decreased from preoperative(41.82±5.28)° to postoperative(17.03±4.04)°,IMA was decreased from preoperative(19.00 ± 3.78)°to postoperative(9.24 ± 1.98)°,DMAA was decreased from preoperative(19.42±5.65)°to postoperative(8.71±2.74)°,PAA was decreased from preoperative (5.66± 3.27) ° to postoperative (3.82 ± 2.09) °,and AOFAS score was increased from preoperative (41.47 ± 6.29) to postoperative (84.82 ± 6.43),the differences were statistically significant (P＜0.05).Conclusion Scarf combined with modified Mcbride osteotomy has satisfactory effect for treating moderate to severe hallux valgus.

OBJECTIVE:To provide suggestions for standardizing and protecting the off-label drug use. METHODS:Accord-ing to the field interviews with pharmacists and lawyers,the present situation of off-label drug use in judicial practice at home and abroad,and relevant countermeasures were put forward. RESULTS & CONCLUSIONS:At present,there was no mechanism for off-label drug use in the laws and regulations in China;there was only"special circumstances"statement in sporadic terms,while lacking explanation. In judicial practice of medical disputes,judges had different identifications in various references,such as the le-gality of routine and guidelines,teaching medical materials,clinical pathways,and internal regulations of medical institutions pre-pared by authoritative departments. Meanwhile,the judicial environment of hearing cases by identification made the off-label drug use had impartial adjudication. Legislation in 6 countries,including America,allows reasonable off-label drug use;FDA required off-label drug use must be for the benefit of patients rather than clinical trials,and it also should protect the patient's right to know. China should establish the authority specification of off-label drug use,providing scientific identification procedures,protect the patient 's informed consent by law. Medical institutions should develop relevant management system and processes to regulate medical prac-tices and ensure off-label drug use in line with the interests of doctors and patients.

Objective To evaluate the clinical effect of treating the medial osteochondral lesions of the talus (OLTs) using the malleolar osteotomy and bone grafting with periosteum.Methods A total of 28 patients who underwent medial malleolar osteotomy,lesions debridement and bone grafting with periosteum between January 2014 and August 2015 were reviewed retrospectively.The oblique medial mal leolar osteotomy was performed to expose the talar lesion,followed by cyst debridement and bone grafting with periosteum,then the medial malleolus fracture was fixed.X-rays and MRI examination were conducted before and after the operation.MRI was used for the measurement of radiographic parameters such as the length,width and depth of the edema area.The patients were also evaluated using the American orthopaedic foot and ankle society (AOFAS)-ankle and hindfoot score questionnaires.Results Twenty-three subjects completed the follow-up over a mean period of 15 months (range,10～28 months).According to X-rays,the mean time for osseous union was 11 weeks (range,9-14 weeks).MRI results showed significant reduce in the bone marrow edema area after the operation,except for one case of fibrous cartilage higher than the surrounding articular cartilage,and two with the chondro cyst not disappearing completely.The arthroscopy of 6 patients revealed 5 good integrations with similar color and smoothness.The AOFAS ankle-hindfoot scores increased significantly after the surgery (P＜0.05).No wound pain,infection,and failure of internal fixation were observed during the follow-up period.Conclusions The combination of medial malleolar osteotomy,lesions debridement and bone grafting with periosteum can be used to treat patients with stage Ⅲ～Ⅴ OLTs,as this technique can effectively relieve pain and enhance the joint function.

Objective In order to explore the association between complement C3 and primary open angle glaucoma (POAG),the serum complement C3 level was detected and the polymorphism of the C3 exon gene was analyzed in patients with POAG.Methods A prospective case-control study was designed.A total of 45 patients with POAG visiting Eye &ENT hospital of Fudan University were collected from December 2014 to December 2015,and 45 age-/gender-matched healthy subjects from yearly health screening were collected as normal controls.Serum C3 concentration was detected by immunoturbidimetric assay.Meanwhile,genomic DNA was extracted from peripheral blood leukocytes,and sequencing for C3 exons was followed with PCR to analyze the gene polymorphism.Statistical analysis was performed by use of SPSS 20.0 software.Student's t test was used to evaluate the difference of serum C3 level between two groups.Chisquare test was used to analyze the difference in the distribution of C3 exon gene polymorphism between two groups.The one-way ANOVA was utilized to analyze the difference of serum C3 level among different genotypes of C3 exon.Results The serum level of C3 in POAG (104.81 ± 29.15)mg/dl was significantly lower (t =-3.162,P =0.002) compared to controls (121.06 ± 18.39) mg/dl.There were a total of seven single nucleotide polymorphisms (SNPs) (rs2230201,rs2230204,rs2230205,rs428453,rs423490rs7951,rs539822147) within the C3 exon gene region,but no mutation was detected.There was no difference in the frequency and distribution of these SNPs between POAG and controls,as well as,there was also no significant difference in serum C3 level among these SNPs genotypes.Conclusions Decreased serum C3 level in POAG patients indicated that complement C3 might be involved in the pathomechanism of glaucoma.No significant abnormality of C3 exon gene was detected,so the gene polymorphism having an impact on serum C3 level could be excluded as a reason probably.