Orphan nuclear receptor steroidogenic factor 1 (SF-1) is a member of the nuclear receptor superfamily. It regulates the expression of multiple genes involved in adrenal and gonadal development,steroidogenesis,and reproductive function. Twenty five different mutations have been described and their clinical features are various. Detection of SF-1 gene may be contribute to the etiological diagnosis for 46, XY disorder of sex development patients.

Vildagliptin is a potent and specific inhibitor of dipeptidyl peptidase 4,which has been implicated to enhance and prolong the physiological actions of incretion hormones including glucagon-like peptide-1 and glucose-dependent insulinotropic polypeptide.Vildagliptin is an orally administered drug and has been licensed for the treatment of type 2 diabetes mellitus.Vildagliptin monotherapy or in combination with other drugs can effectively lower glycosylated haemoglobin levels to a great extent.In addition,vildagliptin acts in a glucose-dependent manner,explaining its low risk of hypoglycemia.This drug has been proved well tolerated with few gastrointestinal side effects or oedema.Therefore vildagliptin is a promising new option for type 2 diabetic patients,and these patients would achieve better glycemic control and fewer complications in the long run.

Points Fengfu(GV 16), Fengchi(GB 20) and Anmian were selected as main acupoints to treat painful heels and the total effective rate of 96.9% was got. The technique of lifting needle was the key to the therapy.

fulminant liver failure(FLF)is a rapid onset life-threatening emerency in which liver dysfunction,liver failure and hepatic encephalopathy occur within 8 weeks in previouslv norillal person.It has been confirmed by available clinical experience and literatures during the past decades that FLF patients are ideal recipients of liver transplantation.However,the prognosis of the FLF patients who accepted liver transplantation differed greatly according to the available reports because of the differences of supportive treatment during waiting period,the criterion for recipient assessment,the determination of operation chance,the use of critical techniques during operation and postoperative management between different transplantation centers.We probe the standardized clinical use of the aspects above mentioned in liver transplantation for FLF,particularly discuss the treatment of complications resulting from coagulopathy,determination of operation chance,significance of standardized etiological treatment and the indication of the use of veno-venous bypass technique during transplantation to provide better treatment strategy and improve the prognosis of FLF patients.

Objective To investigate the effect of Simoyinzi Decoction on serum 5-HT and inflammatory factors in the treatment of perimenopausal women with early onset of severe depression.Methods 82 cases of perimenopausal women with primary severe depression were selected and randomly divided into 2 groups, 41 cases of each group.Control group received basic medicine treatment, the research group received Simoyinzi Decoction treatment,serum neurotransmitter, inflammatory factor and sex hormone levels were detected before and after the treatment, and clinical symptom score and clinical curative effect were compared after the treatment.Results Compared with before treatment, levels of noradrenaline norepinephrine(NE), 5 serotonin(5-HT), dopamine(DA), glutamate(Glu) and N-methyl-D-aspartate(Asp) increased in 2 groups after treatment, levels of gamma amino acid (GABA) and glycine(Gly) decreased, levels of follicle stimulating hormone(FSH) and luteinizing hormone(LH) decreased, levels of estradiol(E2) increased, levels of IL-1β, IL-6, TNF-αand CRP decreased, scores of HAMD and Kupperman decreased, the differences were statistically significant (P<0.05), compared with the control group, levels of NE, 5-HT, Glu and Asp in the research group after treatment were higher, levels of GABA and Gly were lower, levels of FSH and LH were lower, levels of E2 were higher, levels of IL-1β, IL-6, TNF-αand CRP were lower, and scores of HAMD and Kupperman were lower, the differences were statistically significant(P<0.05), and the effective rate in the control group(70.73%) was lower than the research group ( 90.24%) ( P <0.05 ) .Conclusion Simoyinzi Decoction in the treatment of perimenopausal women with early onset of severe depression was curative effective, and it can improve the 5-HT and reduce the levels of inflammatory factors.

The formation of Staphylococcus epidermidis biofilm on the surface of medical biomaterials may resist the antibiotics treatment and cause chronic infection,which has become a research focus in recent years.Multiple genes constitute complex regulatory network which affect the biofilm formation,and play different roles in the different stages of biofilm formation.Accessory gene regulator (agr) is one of the most important genes in the process of biofilm formation.The process of bacterial biofilm formation,research status of regulation mechanism of agr system and its related genes in the formation of biofilm are reviewed,to provide reference of using agr as a target for the treatment of staphylococcus epidermidis biofilm related infections.

Objective To understand the antimicrobial resistance of common clinical pathogens to antimicrobial disks containing different ratios of cefoperazone/sulbactam,so as to provide basis for rational application of cefoper-azone/sulbactam in clinic.Methods 1 141 pathogens isolated from clinical specimens in a hospital in the first half year of 2014 were collected,disk diffusion method was adopted to detect antimicrobial activity of two kinds of cef-operazone/sulbactam disks (70/35 μg and 75/75 μg).Results Of 1 141 pathogenic strains,675 (59.16%)were En-terobacteriaceae,447 (39.18%)were non-fermentative bacteria,and 19 (1 .66%)were other gram-negative bacilli. Resistance rates of pathogens to 70/35μg and 75/75 μg cefoperazone/sulbactam antimicrobial disks were as follows:extended-spectrumβ-lactamases(ESBLs)-producing Escherichia coli (n=221)were 7.69% and 2.26% respective-ly,ESBLs-producing Klebsiella pneumoniae (n=92)10.87% and 3.26% respectively,imipenem-resistant Acineto-bacter baumannii (IRAB,n=295)54.92% and 11 .19%respectively;there were significant differences in antimicrobial activity between two ratios of antimicrobial disks(P <0.05).While antimicrobial resistance rates of ESBLs-negative Enterobacteriaceae (Escherichia coli ,n = 135;Klebsiella pneumoniae ,n =98),imipenem-sensitive Acinetobacter baumannii (ISAB,n=51),Pseudomonas aeruginosa (n=48 ),and Stenotrophomonas maltophilia (n=22)were not significantly different (all P >0.05).Conclusion Antimicrobial activity of two different ratios of cefoperazone/sulbactam antimicrobial disks to ESBLs-producing Enterobacteriaceae and IRAB is different,attention should be paid to ratios of cefoperazone/sulbactam during the treatment ,so as to achieve the desired therapeutic effect.

Objective To explore the diagnostic value of combination detection of carcino‐embryonic antigen(CEA ) ,cytokeratin 19 fragment 21‐1(CYFR21‐1) ,neuron‐specific enolase(NSE) in bronchoalveolar lavage fluid (BALF) for early lung cancer and its correlation with clinical effects .Methods 69 cases of lung cancer were included into the lung cancer group and 50 cases of benign pulmonary disease were included into the lung benign disease group .All the patients were given bronchoalveolar lavage(BAL) .The chemiluminescence immunoassay was adopted to detect the levels of CEA ,CYFR21‐1 and NSE in BALF .The changes of tumor markers levels were compared between the two groups and among different clinical curative effects in the patients with lung cancer . Results The levels of CEA ,CYFR21‐1 and NSE in BALF of the lung cancer group were significantly higher than those of the be‐nign pulmonary disease group ,the difference was statistically significant (P < 0 .05) .The levels of tumor markers in the stage Ⅱ of lung cancer were higher than those in the stage Ⅰ of lung cancer ,the difference was statistically significant (P< 0 .05) ;the levels of CEA ,CYFR21‐1 and NSE in BALF were gradually increased with the decrease of clinical effect (P< 0 .05) ;the sensitivity and spe‐cificity of the combined detection of three tumor markers were 62 .3% and 82 .0% respectively ,which were significantly higher than those of any single tumor marker (P< 0 .05) .Conclusion The levels of CEA ,CYFR21‐1 and NSE in BALF of early lung cancer patients are obviously increased ,moreover which is closely correlated with the pathological stage of lung cancer ,the combined detec‐tion could contribute to improve the detection rate of early lung cancer and guide the evaluation of clinical effect .

Background:The ability of tumor cells to evade destruction by immune system is known as tumor immune escape. Regulatory T cells( Treg cells)and myeloid-derived suppressor cells( MDSCs)are considered to be the most critical cell subsets participating in tumor immune escape. Aims:To determine the percentages of Treg cells and MDSCs in peripheral blood of patients with gastric cancer for investigating the effects of these two cell subsets on development and progression of gastric cancer. Methods:Peripheral blood specimens from 77 patients with gastric cancer and 20 healthy controls were collected for measurements of CD4+CD25+Foxp3+ Treg cells and MDSCs by flow cytometry. Correlations between Treg cells,MDSCs and clinicopathological characteristics of gastric cancer were analyzed. Results:Percentage of CD4+CD25+Foxp3 + Treg cells in peripheral blood CD4+ T cells and percentage of MDSCs in peripheral blood mononuclear cells were both significantly higher in gastric cancer patients than in healthy controls( Treg cells:4. 72% ± 1. 01% vs. 1. 57% ± 0. 99%,P<0. 01;MDSCs:21. 72% ± 10. 12% vs. 2. 90% ± 1. 80%,P<0. 01). Percentage of Treg cells in peripheral blood was correlated with the clinical stage,depth of invasion and lymph node metastasis of gastric cancer(P<0. 05), while percentage of MDSCs was correlated with the clinical stage of gastric cancer(P<0. 05). Furthermore,a significant positive correlation was observed between percentages of Treg cells and MDSCs in peripheral blood of gastric cancer patients ( rs =0. 681,P<0. 01). Conclusions:Gastric cancer patients are characterized by high expressions of immunosuppressive cells in peripheral blood,such as Treg cells and MDSCs,which might be related with the development and progression of gastric cancer via tumor immune escape.

Objective To evaluate the clinical therapeutic effects oftrimetazidine on the treatment of unstable angina (UA) as well as its effects on endothelin-I level and complications of patients. Methods One hundred and twenty patients with UA were randomized into the trimetazidine group (n =60) and the control group (n =60), the trimetazidine group was subjected to treatment with 60 mg trimetazidine everyday for six months plus conventional treatment, and the clinical symptoms, changes in electrocardiogram, changes in the number of plasma circulating endothelial cells (CEC) and endothelin-1 level of the two groups were observed after treatment for four weeks; and the incidence rates of cardiac arrhythmias, cardiac failure, hospitalization due to angina, myocardial infarction and sudden death were also observed after treatment for six months. Results 1) The total effective rate of integrative clinical therapeutic effects in the trimetazidine group and the control group after treatment for four weeks were 86.7% and 68.3%,respectively (P<0.05), and the excellence rates were 36.7% and 15% (P<0.01)respectively; the total effective rates for the therapeutic effects in electrocardiogram were 66.7% and 46.7%,respectively (P<0.05), and the excellence rates were 30.0% and 11.7%, respectively (P<0.01 ). 2) The number of plasma CEC and endothelin-1 level of the two groups after treatment for four weeks significantly decreased (P<0.05), but the decreases in the trimetazidine group were even significant (P<0.01). 3) The incidence rates for cardiac arrhythmia in the trimetazidine group and the control group after treatment for six months were 10% and 20% (P<0.05), respectively, and the incidence rates for cardiac failure were 8.3% and 18.3%, respectively (P<0.05), and the incidence rates for hospitalization due to angina were 10% and 15%, and the incident rates for myocardial infarction were 3.3% and 13.3% respectively (P<0.05). Conclusion Trimetazidine can significantly improve the symptoms of UA and myocardial ischemia, reduce the damages to blood vessel endothelium and complications, and improve the prognosis.