Objective To investigate the pro-apoptotic effects of an ?1-adrenergic inhibitor,doxazosin,in HeLa cells and the role of transcription factor activator protein-2? (AP-2?) in the process.Methods The HeLa cells were treated with doxazosin (0,10,40 or 60 ?mol/L) for 16 h,and cell apoptosis was detected by flow cytometric analysis.After doxazosin (60 ?mol/L) treated the HaLa cells,the cells transfected with AP-2? overexpressing constructs or an antisense oligonucleotide against AP-2? for 16 h,the apoptosis was analyzed with FCM.The expression of AP-2? and caspase-3 in above 3 groups of cells was detected by relative quantitative RT-PCR and Western blot analysis,respectively.Results Doxazosin increased the apoptotic rate and total cell death rate of the HeLa cells,and upregulated the expressions of AP-2? and caspase-3 in a dose-dependent manner.Overexpressing AP-2? improved the increased apoptotic rate and total cell death rate induced by doxazosin,and enhanced the increased expression of caspase-3.Whereas doxazosin-induced apoptosis and the total cell death in HeLa cells were decreased by antisense AP-2?,and antisense AP-2? in part abolished the increased effects of doxazosin on caspase-3 expression.Conclusion Doxazosin induces apoptosis in HeLa cells in a dose-dependent manner,and transcription factor AP-2? is functionally involved in this process.

10.3969/j.issn.1007-3969.2013.05.007

A total number of 2221sera collected from different kinds of subjects , i.e.patients with various stages of schistosomiasis. normal individuals, persons with other parasitic diseases or non-parasitic diseases, were detected with Dot Immunogold Filtration Assay (DIGFA) using anti-SVLBP IgG as capturig antibody. Positive rate of 70 sera from patients with acute schistosomiasis was 100%, and that of 307 sera with chronic schistosomiasis was 68.4% .None of 200 sera from normal individuals showed false positive reaction. No obvious cross reaction was found in sera from other parasitic/non-parasitic diseases except sera from patients with paragonimiasis.2 batches of sera were detected with DIGFA by single-blindness method. Results showed that sensitivities to chronic schistosomiasis were 69.4% and 68.9%, and 100% to acute schistosomiasis while specificities were 98.9%-99% .508 samples from residents in endemic areas were tested with DIGFA and Kato-Katz. Positive rate of circulating arrtigen was 20.9% with DIGFA while 65 samples were positive with stool examination.46 samples were positive both by DIGFA and by Kato-katz.The coincidental rate was 70.8% .These results indicated that DIGFA showed sensitive and specific in the detection of circulating antigen. It will be useful in mass application and vahuable in epidemiological stuvey.

This paper summarized practices and experiences of other countries in coordinated care delivery system building,and described the care delivery systems used in various healthcare fundraising patterns.It is found that most countries have defined duties and service coverage of healthcare institutions at all the levels and measures to ensure rational patient flow.In the end,the paper concluded found experiences of these countries and inspirations for China.

Objective To evaluate the arc renal parenchyma incision of pelvis within renal sinus and renal posterior lib for the removal of complex staghorn renal calculi.Methods Arc renal parenchyma incision of pelvis within renal sinus and renal posterior lib was performed to remove stones in 86 cases (97 sides) with complex staghorn renal calculi.Among the 86 cases,42 had stones on the right side;33,on the left side;11,on bilateral sides.Seventeen cases had concomitantly calculi in the ureter,and 54 had calculi in upper and mid calyx or multiple renal calculi.As for comorbidity,11 cases had hypertensions;4,diabetes; and 5,hepatitis B.Twenty-five cases had renal insufficiency,with BUN of 12.3 -76.0mmol/L and Cr of 231 -1721?mol/L.The procedure was performed as follows:the kidney was dissected free and the pelvis within renal sinus was isolated.Two rows of bottom style sutures were made on the renal parenchyma with 2-0 plain catgut along mid-lower 1/3 of the dorsal surface of kidney free of vessels from the renal posterior lib to the plane of lower major calyx.The renal parenchyma was opened.Then,the incision was developed from the plane of lower through the middle major calyx to the plane of upper major calyx.The renal parenchyma and mid-low calyx along the incision were opened,suturing while incising,so that all the stones could be easily removed with hook.Results The calculi were completely removed in all 86 cases (97 sides).The opera- tive time was 105-187min ( mean,129min).The intraoperative blood loss was 120-460 ml ( mean,220 ml).Forty-three cases needed intraoperative blood transfusion of 120 -200 ml (mean,140 ml).One month after operation,KUB+IVU and ultrasonic findings were normal with improved hydronephrosis,no intrarenal stricture and no residual calculi.Conclusions This procedure has the advantages of less bleeding,slight impairment of renal function,simple handling,clear operative field,high clearance rate,therefore is indica- ted for the removal of complex staghorn calculi.

Because of its specificity , significant effect , low side effect , molecular targeted therapy has been applied in the treatment of breast cancer .Recently, various molecular targeted drugs have been exploited including targeted HER family, VEGF, multi-targeted therapeutic drugs , and drugs combination .

Objective: To analyze influencing factors of in-stent restenosis after coronary artery stent implantation, to provide theoretical support for clinical prevention of restenosis. Methods: Clinical data of 123 patients, who received coronary artery stent implantation in our hospital from Mar 2011 to Sep 2013 and received coronary angiography follow-up one year after operation, were retrospectively analyzed. In-stent restenosis was regarded as stenosis of inner diameter of implanted stent≥50%, so patients were divided into restenosis group (n=35) and non-restenosis group (n=88). Multi-factor Logistic regression analysis was used to analyze influencing factors of coronary in-stent restenosis. Results: Compared with non-restenosis group, there were significant reductions in serum level of total bilirubin [(14.02±6.76) μmol/L vs. (10.90±4.51) μmol/L] and stent diameter [(3.06±0.86) mm vs. (2.87±0.44) mm] in restenosis group, P<0.01 both. Multi-factor Logistic regression analysis indicated that blood glucose level was independent risk factor for restenosis after coronary artery stent implantation (OR=2.545, P=0.035), while stent diameter and serum level of total bilirubin were its protective factors (OR=0.857, 0.850, P<0.05 both). Conclusion: Blood glucose level is an independent risk factor for restenosis after coronary artery stent implantation, while stent diameter and serum level of total bilirubin are its protective factors.

Objective To provide the anatomic basis of flap which was anatomized to the ankle by Anatomy study of vascular net around ankle joint.Methods 32 lower limbs were infiltrated into red emulsion;4 perfusions of lower limbs,artery;2 cases of radiography;1 lower limb was infiltrated into black ink.Application anatomy was observed the origin,track-way,branches and configuration in ankle and foot.Results The blood provision in ankle includes three parts;All the patients recovered well after treatment by careful flap-design.Conclusion The vascular net around anatomy of the ankle can provide help for the design,the choice and the operation of ankle's,tissue flap,and the function's,recovery after surgery.

Objective To retrospectively analyze the cardiovascular outcomes of the elderly patients with obstructive sleep apnea syndrome (OSAS) and the influence factors. Methods According to polysomnography examination, 79 OSAS patients and 60 patients without OSAS were selected and divided into 3 groups: elder OSAS group [39 patients older than 65 years, respiratory apnea index (AHI)≥5], non-elder OSAS group (40 patients less than 65 years old, AHI≥5) and elder control group (60 patients older than 65 years, AHK5). All patients were followed up by telephone and clinic consulting. The median follow-up duration was 25 months. All patients received the following studies: (1)Flow-mediated vasodilation (FMD), which was assessed by high-resolution ultrasound technique. (2)The sleep-related breathing events and serum biochemical indexes. (3)The death due to cardiovascular disease (CVD), angina, myocardial infarction and stroke. Results (1) FMD was significantly lower in elder OSAS group than in elder control group (P<0. 01). (2)In elder OSAS group versus elder control group, BMI was significantly higher (P<0. 01), while both lowest pulse oxygen saturation (LSpO_2 ) and mean series pulse oximeter ( MeanSpO_2 ) were significantly lower (P< 0.01 and P<0. 05, respectively). Multiple logistic regression analysis showed that impaired fasting plasma glucose was the primary injury factor for FMD (OR=1. 83, 95% CI:1. 11～3.03), and LSpO_2 was the secondary injury factor (OR = 0.92, 95% CI: 0. 85～1. 00). (3) The incidence of cardiovascular events in the 3 groups: the incidence of cardiovascular events was significantly higher in elder OSAS group than in the other 2 groups (χ~2= 7. 339, P<0. 05). Multiple logistic regression analysis showed that FMD (OR=1. 33, 95% CI:1. 06～1. 66)and hs-CRP (OR = 0.51, 95% CI: 0. 34～0.76) were closely related with prognosis. Conclusions Compared with non-elder OSAS group and elder control group, vascular endothelial function impairment is more serious and the incidence of cardiovascular events is higher in elder OSAS group. So OSAS may influence the prognosis of the patients by injuring the vascular endothelial function.

Objeetive To investigate the clinical efficacy of treating stomach cance belonging to spleen and stomach deficient cold type with self-designed formula and chemotherapy.Methods 100 patients of stomach cancer belonging to stomach and spleen deficient cold were randomly grouped into a control group and a treatment group,with 50 cases in each group.The control group was only treated with chemotherapy,and the treatment group was additionally treated with self-designed Chinese formula on the basis of the control group.After 3 months' treatment,the curative effect,the improvement of life quality,the changes of body weight,the improvement of peripheral blood and immune function,and the occurrence of adverse reaction were observed.The survival rate of patients after 1,3 and 5 years' treatment was investigated.Results ① Short term curative effect:the total effectiveness of the control group and the treatment group was 60.0％ (30/50) and 30.0％ (15/50) respectively,with the treatment group being better than the control group(Z=-2.100,P＜0.05);② life quality:theimprovement rate of life quality in the treatment group and the control group was 64.0％ (32/50) and 20.0％ (10/50) respectively,with the treatment group being better than the control group (Z=-3.259,P＜0.05); ③ body weight:the improvement rate of body weight in the treatment group and the control group was 24.0％ and 16.0％ respectively,and there was no significant difference (Z=-1.815,P＞0.05) ; ④ peripheral blood:the peripheral blood abnormality rates of treatment group was obviously lower than the control group (Z=-4.286,P＜0.05) ;⑤ immune function changes:CD4+、CD8+、and the activity of NK cell of two groups after the treatment [the treatment group was (40.8 ± 4.1)％,(26.1-3.2)％,(83.57-2.52)％ respectively; the control group was (31.7±2.9)％、(33.8±3.0)％、(92.88±3.83)％ respectively] wasobviously improved compared with the same group before the treatment [the treatment group was (34.2±3.5)％,(31.0±2.0)％,(85.01±2.92)％ respectively; the control group was (34.0±3.2)％,(30.9±2.2)％,(85.02± 3.48) ％ respectively].The immune indexes (CD4+、CD8++、CD4+/CDg+and the activity of NK cell)in the treatment group presented significant difference (P＜0.01) than the control group after the treatment.⑥adverse reaction:compared with the control group,the occurrence rate of adverse reaction of the treatment group was obviously lower than the control group,and there was significant difference (Z=-5.297,P＜0.05).⑦survival rate:the survival rate of patients after 1,3 and 5 years' treatment in the treatment group was better than the control group,and there was significant difference (x2=5.263,12.96,7.895,P＜0.05).Conclusion The combination of self-designed Chinese formula and chemotherapy could effectively relieve the clinical symptoms,improve the immunity,reduce the occurrence of adverse reaction,and improve the life quality of patients with stomach cancer belonging to stomach and spleen deficient cold type.