Objective To observe the expression of estrogen receptors (ERαand ERβ) on gastric cancer cells and evaluate the effect of Tamoxifen(TAM) on the cell proliferation and expression of serine proteinase inhibitor 9(PI9) of gastric cancer cells . Methods PI9 positive expression(MNK45 ,SGC7901)and negative expression (BGC823)of gastric cancer cell lines were from pre‐liminary screened ,the expression of ERα and ERβ detected by immunofluorescence chemical method ,the cell proliferation and ex‐pression of PI9 were tested by CCK8 assay and reverse transcription‐PCR after intervention of TAM .Results ERαprotein expres‐sion was noted in MNK45 and SGC7901 ,ERβwas noted in BGC823 ,but the expression of ERαand ERβwere not appear to be obvi‐ous after the intervention of TAM .Tamoxifen could obviously inhibited cell proliferation of MNK45 and SGC7901 at concentration of 0 .1-100 .0 μmol/L ,the differences were statistically significant compared with negative control group (P<0 .05) ,but showed no dose‐dependent to the proliferation of BGC823 and MNK28 .After treating with TAM ,the expression of PI9 mRNA of SGC7901 (0 .402± 0 .020) and MNK45(0 .359 ± 0 .048) were obviously lower than that in the negatwe control group(P< 0 .05). Conclusion Tamoxifen could significantly inhibit the proliferation of PI9 positive expression than PI9 negative expression of gastric cancer cell lines ,and showed obviously dose‐dependent ,its role in inhibiting proliferation might closely related to immune tolerance improved by PI9 .

Objective To investigate the risk factors,clinical characteristics and outcomes in patients with acute myocardial infarction and history of stroke. Methods A total of 771 patients with acute myocardial infarction diagnosed and admitted to Xuanwu Hospital,Capital Medical University from January 2005 to March 2012 were analyzed retrospectively. They were divided into either a stroke group (n=387)or a control group (n=384)according to whether they had previous ischemic stroke or not. The risk factors for cardiovascular disease,clinical characteristics of the disease,and clinical outcomes of the patients in both groups were compared through the case control analysis. The endpoint events observed were acute ischemic stroke,cerebral hemorrhage,and cause of death during hospitalization. Results (1)The median age of the patients in both stroke and control groups was 71 (37-91 )and 62 (29-90 )years respectively. The female patients in the stroke group were more than those in the control group (n=125 vs. n=91). The incidence of complicated with hypertension (72. 9%[n=282]and 47. 6%[n=183]) and type 2 diabetes mellitus (39. 0%[n=151]and 20. 8%[n=80]respectively)were high. There was significant difference between the two groups (P<0. 01). (2)The time from the onset to admission in patients of the stroke group was longer than that in patients of the control group (median 11 h vs. 4 h). The incidence of non-ST segment elevation myocardial infarction (16. 0%[n = 62 ]and 1. 8%[n = 7 ] respectively)was higher. The incidences of complicated with gastric stress ulcer (7. 0%[n =27 ]and 2. 1%[n=8]respectively),atrial fibrillation (10. 6%[n=41]and 3. 9%[n=15]respectively),and acute pulmonary edema-cardiac function Killip class≥Ⅱ(51. 9%[n =201 ]and 37. 8%[n =145 ] respectively)were more higher. The findings of coronary angiography in patients of the stroke group were that the incidence of left main coronary artery or 3 -branch lesion higher than that of the control group (52. 9%[126/238]and 32. 4%[97/299]respectively). There was significant difference (P <0. 05). (3)The incidence of new stroke in patients of the stroke group (5. 7%[n =22 ]and 1. 8%[n =7 ] respectively)and in hospital mortality (13. 7%[n=53]and 7. 6%[n=29]respectively)were higher than those of the control group. There were significant differences (P<0. 01). Conclusion The age of the patients with acute myocardial infarction with previous identified history of stroke is older. The incidence of female patients is higher than that of the non-stroke patients,and most of them have risk factors that complicated with hypertension and diabetes mellitus. These patients often have the complications with peptic ulcer disease and heart failure,and their coronary angiography often show multi-branch lesions,and they are more prone to ischemic cardio-cerebrovascular events during the hospitalization.

Objective To investigate the status of research and research utilization in practice among nurses of hospital of Traditional Chinese Medicine.Methods Two hundred and sixty nurses of hospital of Traditional Chinese Medicine were selected to fill out the questionnaire.Results The rates of involvement of research activities and research utilization among nurses of hospital of Traditional Chinese Medicine were low.The score of every factor ranged from the higher to the lower were communication,organization,research and nurse.Conclusions Involvements of research activities and research utilization among nurses of hospital of Traditional Chinese Medicine are insufficient.Most factors associated with nurses' low extent of research utilization are objective factors.It is pivotal for nursing managers to construct supportive professional environment,improve nurses' research and information skills and the capacity of the research utilization.

A method for the determination of cinoxacin and nalidixic acid in human plasma by reverse-phase high performance liquid chromatography is introduced. The single separation system involves a RP-C18 column, a ultraviolet detector at 254 mn and CH3CN-CH3OH-0.01 mol/L HOOCOOH (30:5:65;pH 4.55). The influence of two kind of buffer (phosphate buffer and oxalate buffer) in mobile phase on the separation were studied. Oxalate buffer can improve tailing peak and decrease detection limits. Three pH values (pH 2.80,4.08,4.55) were studied, pH 4.55 can give best separation result. The detection limits of cinoxacin and nalidixic acid were 0.14 ng and 0.24 ng, respectively.

Objective To evaluate the efficacy and safety of combination chemotherapy with vinorelbine and cisplatin in the treatment of metastatic breast cancer resisting to anthracycline and taxane.Methods 20 patients with advanced metastatic breast cancer were given following regimen:Vinorelbine 25mg/m2 was given intraveniously in day 1 and day 8,cisplatin 75mg/m2 was given intraveniously in day 1 or 25mg/m2 was given intraveniously in day1 to day 3,repeated every 3 weeks.Evaluation of response and adverse reactions were practiced every 2 cycles.Results 20 patients were evaluable,among them,2 cases reach CR,8 cases PR,4 cases SD and 6 cases PD,with a median followup of 6 months(4 ～ 18months),16 patients survived and 4 patients died.The median time to progression and the median survival time was 5 months(3 ～ 15 months) and 8 months(4 ～ 18 months) respectively.The treatment well tolerated,The main toxicity was myelosuppression and gastrointestinal reaction with WHO grade Ⅲ～Ⅳ gastrointestinal reaction,neutropena and thrombocytopenia being in 25% 、65% and 10% .Conclusion The regimen of NP is safe and effective in treating advanced metastatic breast cancer resisting to anthracycline and taxane.In addition,it was able to improve survival rate and adverse reactions could be tolerated.

Objective To evaluate the value of the RIFLE criteria of acute kidney injury (AKI) for predicting the incidence and prognosis in critically ill patients and to identify the risk factors associated with the outcomes of those patients.Methods All ICU patients admitted over three years and 6-month period were retrospectively studied at Subei People's Hospital.Based on RIFLE criteria,AKI patients were diagnosed and classified into four groups:NAKI (non-AKI),R (risk),I (injury),F (failure)groups.Results (1) AKI occurred in 404 of the 2472 patients (16.3％) during their ICU stay.The mean age of the patients was (61.4 ± 17.4) years.Infectious disease,pulmonary disease,neurological disease and trauma were the major cause of AKI.(2) Mortality in the ICU was much higher in patients with AKI than in patients without AKI (47.3％ vs.23.0％,P ＜ 0.05).The mortality rate was 35.6％ in R group,48.9％ in I group and 60.6％ in F group.(3) The logistic regression suggested that MODS and septic shock were the independent risk factors of AKI,but continuous renal replacement therapy (CRRT) are the independent protective factor of AKI.Conclusions In these ICU patients,AKI is associated with increased hospital mortality.The RIFLE classification is a simple and useful diagnosis tool to detect and stratify the severity of AKI and aid in predicting outcome of patients.

Objective To investigate the correlation between serum biochemical parameters and Parkinson's disease (PD) risk in the elderly.Methods The 277 inpatients with PD as PD group in Jiangsu Province Hospital from January 2009 to December 2013 were selected,at the same time,the 277 age and gender-matched healthy persons were enrolled as control group.The levels of total cholesterol (TG),total bilirubin (TB),uric acid (UA),low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) were detected and compared between the two groups.Results The levels of TG,UA,TB,HDL-C and LDL-C were significantly lower in PD group than in control group [(4.35±1.13) mmol/L vs.(4.95±0.98) mmol/L,t=6.63;(278.00± 101.89)μmol/L vs.(380.90 ± 108.28) μmol/L,t =12.44;(13.02 ± 7.56) μmol/L vs.(17.39 ± 7.30)μmol/L,t=7.09;(1.26±0.37) mmol/L vs.(1.34±0.28) mmol/L,t=3.38;(2.59±0.79) mmol/L vs.(3.17±0.91) mmol/L,t=7.42,all P＜0.05].Logistic multiple regression analysis showed that the decreased levels of TB,UA and LDL-C were independently associated with prevalence risk of PD (OR=0.940,0.991 and 0.219,all P＜0.001).The combined score of TB,UA and LDL-C was constructed by using the linear weighted method.ROC curve was drawn to select the higher diagnostic validity index among TB,UA,LDL-C and combined score.The area under the ROC curve for TB,UA,LDL-C and combined score was 0.713,0.765,0.682 and 0.809 (all P＜0.001),and the value of combined score was the highest.Conclusions The decreased levels of TB,UA and LDL-C are independently associated with PD.They possess certain clinical value in evaluating the prevalence risk of PD.

Objective To evaluate the role ofpleth variability index (PVI) by passive leg raising (PLR) test in volume responsiveness and volume status prediction in patients with septic shock.Methods A prospective randomized controlled trial (RCT) was conducted.Eighty-seven patients suffering from septic shock undergoing mechanical ventilation in Department of Critical Care Medicine of Subei People's Hospital from June 2012 to September 2014 were enrolled.The hemodynamic changes before and after PLR were monitored by pulse indicated continuous cardiac output (PiCCO) and PVI monitoring.Responsive group:positive fluid response was defined as an increase in cardiac index (CI) ≥ 10％ after PLR.Unresponsive group:negative fluid response was defined as an increase in CI ＜ 10％ after PLR.The hemodynamic parameters,including heart rate (HR),mean arterial pressure (MAP),central venous pressure (CVP),stroke volume variation (SVV),CI and PVI,and the changes in cardiac parameters (△ HR,△ MAP,△ CVP,△ SVV,△ CI,and △ PVI) before and after PLR were determined.The relations between hemodynamic parameters and their changes with △ CI were analyzed by the Pearson analysis.The role of the parameters for volume responsiveness prediction was evaluated by receiver operating characteristic (ROC) curves.Results 145 PLRs in 87 patients with septic shock were conducted,with 67 in responsive group and 78 in unresponsive group.There were no statistically significant differences in HR,MAP,CVP and CI before PLR between the responsive and unresponsive groups.SVV and PVI in responsive group were significantly higher than those in the unresponsive group [SVV:(16.9± 3.1)％ vs.(8.4±2.2) ％,t =9.078,P =0.031; PVI:(20.6±4.3)％ vs.(11.1 ±3.2)％,t =19.189,P =0.022].There were no statistically significant differences in HR,MAP,CVP,SVV,and PVI after PLR between the responsive group and unresponsive group.CI in the responsive group was significantly higher than that in the unresponsive group (mL·s-1·m-2:78.3±6.7 vs.60.0±8.3,t =2.902,P =0.025).There were no statistically significant differences in △HR,△MAP,△ CVP between responsive group and unresponsive group.△ SVV,△ CI and △ PVI in responsive group were significantly higher than those in the unresponsive group [△ SVV:(4.6 ± 1.5)％ vs.(1.8 ± 0.9)％,t =11.187,P =0.022;△ CI (mL·s-1·m-2):18.3 ± 1.7 vs.1.7 ± 0.5,t =3.696,P =0.014; △ PVI:(6.4 ± 1.1)％ vs.(1.3 ± 0.2)％,t =19.563,P =0.013].No significant correlation between HR,MAP or CVP before PLR and △ CI was found.SVV (r =0.850,P =0.015) and PVI (r =0.867,P =0.001) before PLR were correlated with △ CI.It was shown by ROC curve that the area under ROC curve (AUC) for SVV fluid responsiveness prediction was 0.948,and cut-off of SVV was 12.4％,the sensitivity was 85.4％,and specificity was 86.6％.The AUC for PVI fluid responsiveness prediction was 0.957,and cut-off was 14.8％,the sensitivity was 87.5％,and specificity was 84.8％.It was higher than other hemodynamic parameters (HR,MAP,CVP).Conclusions PVI and SVV can better predict fluid responsiveness in mechanically ventilating patients with septic shock after PLR.PVI as a new continuous,noninvasive and functional hemodynamic parameter has the same accuracy as SVV.

Objective To evaluate the clinical effects of PiCCO in the treatment of COPD patients with sepsis shock.Methods 43 COPD patients with sepsis shock were randomly divided into two groups.The control group (n =23) were guided fluid resuscitation according to CVP.The study group (n =20) were placed PiCCO,and according to the PiCCO for fluid resuscitation.The average amount of fluid resuscitation,the amount of norepinephrine and the blood lactate level in 24 hours were observed.The average duration of mechanical ventilation and ICU mortality were also observed.Results After 24 hours,the average amount of fluid resuscitation was (3 986.2 ± 542.1) ml of control group and (4 927.9 ± 761.8)ml of study group,the difference between the two groups was statistically significant (t =-4.71,P ＜ 0.05).The average norepinephrine dosage was (0.38 ± 0.21) μg · min-1 · kg-1 of control group and (0.14 ±0.08)μg · min-1 · kg-1 of study group,the difference between the two groups was statistically significant (t =2.45,P ＜ 0.05).The blood lactate level was (4.79 ± 1.95) mmol/L of control group and (3.44 ±1.45) mmol/L of study group,the difference between the two groups was statistically significant(t =2.59,P ＜ 0.05).Five patients died in control group(mortality 21.7％),and three patients died in study group(mortality 15.0％).Mortality between the two groups was not statistically different (x2 =0,03,P ＞ 0.05).The duration of mechanical ventilation in the control group was (101.22 ± 44.77) h,that in the study group was (74.71 ± 20.25) h,the difference between the two groups was statistically significant (t =2.234,P ＜ 0.05).Conclusion Long-term COPD patients maybe have right ventricular dysfunction,and CVP is difficult to truly reflect the volume status of patients,PiCCO can make up for deficiencies in CVP.PiCCO used to guide these patients with fluid resuscitation,which could guide fluid management of patients,reduce the amount of vasoactive drugs,improve tissue hypoxia,and could reduce the duration of mechanical ventilation.

Objective To explore the effect of the gene silencing of phosphatidic acid-preferring phospholipase A1 (PA-PLA1) on insulin secretion in mouse insulin-secreting cell line MIN6. Methods The siRNA expression vector of mouse PA-PLA1 gene targeting was constructed using mouse PA-PLA1 mRNA sequence available in GenBank, and MIN6 cells were transfected with the vector. Fluorescence quantitative PCR and Western-blotwere applied to screen efficient RNAi-vector. After transfection with obtained efficient RNAi-vectors for 48 hours, glucose-stimulated insulin secretion experiments were conducted, and the changes of insulin secretion were examined. Results Four siRNA expression vectors of mouse PA-PLA1 gene targeting were confirmed to be successfully constructed by the analyses of enzyme cleavage and sequencing. The results of fluorescence quantitative PCR and Western blot analyses indicated that the siRNA expression vectorpGPU6-PA-PLA1-1885was the most effective RNAi-vector in the four vectors. The expression levels of the PA-PLA1 mRNA and protein of the MIN6 cells transfectedwith pGPU6-PA-PLA1-1885 decreased to 46.3% and 33.9% of that of the control, respectively, and meanwhile the insulin secretion levels of the cells decreased to 65.0% of that of the control (P < 0.05). Conclusion The gene silencing of phosphatidic acid-preferring phospholipase A1 might decrease insulin secretion in MIN6 cells.