Psychogenic diseases is an important etiology thinking in traditional Chinese medicine,and it lays a solid foundation for the bio-psycho-social medical pattern to establish.Follows the principle of treatment based on syndrome differentiation,and bases on the basic pathogenesis of breast cancer stagnation of liver-qi attacking spleen,this article provides a brief overview of the relationship between emotional factors and breast cancer,and therapeutic principle of breast to enrich Chinese medicine theory of Qingzhi.

OBJECTIVE:To review the relationship between endothelial progenitor cells and the re-endothelialization of vascular prosthesis in order to find out some effective ways to solve the most frequent complications of asotransplantation,thrombogenesis and intima hyperplasia.DATA SOURCES:A computer-based online search was conducted to identify articles related to endothelial progenitor cells and the re-endothelialization of vascular prosthesis published in Pubmed,Ovid and MD Consult database from January 2000 to December 2006 using the key words of "endothelial progenitor cells,vascular prosthesis,endothelialization".Meanwhile,CNKI database was searched for related papers published between January 2000and December 2006,the keywords were "endothelial progenitor cells,vascular prosthesis,endothelialization" in Chinese.STUDY SELECTION:The literatures included all the related papers about the roles of endothelial progenitor cells in the re-endothelialization of vascular prosthesis.Inclusive criteria:the study types were randomized controlled trials,drug stress test and clinical drug effect test; the samples were both human and animals.Exclusive criteria:Reviews and literatures without controls were excluded.DATA EXTRACTION:Totally 115 related literatures were collected,and 24 were accorded with the inclusive criteria.The excluded were 91 papers of reviews and repeated trials or drug effect studies.DATA SYNTHESIS:These related literatures,including not only animal experiments but also clinical detections,analyzed the relationship between endothelial progenitor cells and the re-endothelialization of vascular prosthesis and correlative promoting mechanisms.CONCLUSION:It is concluded that endothelial progenitor cells play an important role in the endothelialization after vascular prosthesis is grafted in vivo.

Objective To observe the metabolism characters of plasma glucagon-like peptide 1 (GLP-1) in surgical critical ill patients.Methods Totally 64 selective surgical patients were prospectively enrolled and randomly divided into two groups:enteral nutrition (EN) group (50％ glucose 100 ml orally administered or through nasogastric tube on the next day after operation) and parenteral nutrition (PN) group (50％ glucose 100 ml intravenously infused on the next day after operation).Blood glucose and plasma GLP-1 were determined before operation,after operation,and 0 min,30 min,90 min,and 180 min after the 50％ glucose was used.Then,the EN group was divided into stress hyperglycemia (SH) subgroup and non-stress hyperglycemia (non-SH) subgroup.In both subgroups,plasma tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) were detected before operation,after operation,and the next day after operation.Blood glucose,plasma insulin,C-peptide,and GLP-1 were measured before operation,after operation,and 0 min,30 min,90 min,and 180 min after 50％ glucose was used.Results The plasma GLP-1 level (pmol/L) of EN group increased significantly after 50％ glucose was used,and reached the peak at the time of 30 min.In contrast,it did not change in PN group,and were significantly lower than EN group at the time of 30 min [(5.69 ± 2.92) pmol/L vs (33.52 ± 12.32) pmol/L,P ＜0.01] and 90 min [(5.71 ±2.14) pmol/L vs (15.92 ±6.63) pmol/L,P =0.00].Plasma insulin level in SH subgroup were significantly higher than in non-SH group after operation [(18.17±6.18) mU/Lvs (12.10±3.60) mU/L,P=0.01] and30 min [(56.02±14.78) mU/Lvs (43.39±15.60) mU/L,P=0.03] and 90min [(114.58±25.11) mU/Lvs (90.45±25.91) mU/L,P=0.03] after 50％ glucose was used.Plasma C-peptide level in SH subgroup was also significantly higher at the time of 30min [(6.86 ±1.15) μg/L vs (4.76 ± 1.06) μg/L,P=0.04] and 90 min[(12.17 ± 1.96) μg/L vs (9.81 ± 2.35) μg/L,P =0.03] after 50％ glucose was used when compared with non-SH subgroup.Plasma GLP-1 level in SH subgroup was significantly lower than in non-SH group at the time of 30 min [28.76 ± 9.61) pmol/L vs (37.36 ± 10.51) pmol/L,P =0.03] and 90 min [(13.49±4.26) pmol/Lvs (17.33±5.57) pmoL/L,P=0.04] after 50％ glucose was used.Conclusions Early post-operative PN increases plasma GLP-1 level and reduces the SH incidence.In SH patients,endogenous insulin expression increases while plasma GLP-1 level decreases.Post-surgery inflammatory reaction may result in low plasma GLP-1 level and high blood glucose level.

Point-of-care testing (POCT) of blood glucose has been widely used for continuous monitoring of glucose in clinic due to high sensitivity, convenience, accessibility and shorter TAT.It has been developed rapidly in recent years. But glucose POCT is often out of control and management from central laboratory and usually it was performed by non-laboratorians.It becomes the growing concerns that how to avoid the discrepancy between POCT results and central laboratory results, how to ensure POCT quality of each batch of blood glucose results, how to solve issues in the application and ensure that patients' results are accurate and reliable. The hospital should put the POCT management under the whole management system and improve the accuracy of POCT to achieve the complete quality assurance. This article introduced the management program experiences of glucose POCT in Huashan hospital according to the JCI accreditation and CAP-LAP.

Objective To explore the effect of recombinant pEGFP-N3-APC vectors carrying various APC functional domains on the expression of β-catenin in human colorectal cancer cells HT-29.Methods The recombinant plasmids were transfected into HT-29 cells mediated by lipofectamine~(TM) 2000, and detected by green fluorescence and RT-PCR. Western blot was applied to detect β-catenin expression level in HT-29 cells after transfection, and gray scales of electrophoresis strips were analyzed by SPSS 13.0.Results Green fluorescence and RT-PCR made clear that all 5 recombinant plasmids were successfully expressed in HT-29 cells. Western blot showed that β-catenin expression level in HT-29 cells was not affected after being transfected with pEGFP-N3-APC1, pEGFP-N3-APC2 and pEGFP-N3-APC3, and was distinctly affected after being transfected with pEGFP-N3-APC4 and pEGFP-N3-APC5, especially the later one. Conclusion The selected APC5 gene fragment with 15-amino acid repeats and SAMP repeats, which is relatively short, can degrade β-catenin level in HT-29 cells and may be applied in the gene therapy.

Objective Previous study showed that the histopathological basis of visual function damage caused by optical nerve injury is apoptosis of retinal ganglion cells(RGCs). This procedure is regulated by P53, bax and caspase 3 genes. Present study aimed to observe the expression of bax, P53 and caspase 3 mRNA in RGCs after traumatic optic nerve damage in the rats by SYBR green I fluorescence quantitative PCR method. Methods The animal model of optic nerve injury was established in the right eyes of 56 adult Wistar rats by a fluid percussion brain injury device (FPI) . Animal were killed on days 1, 3, 5, 7, 9, 14, 28 days separately after injury. Other 16 Wistar rats were divided into normal control group and sham operation group. The total RNA was isolated from rat fresh retina tissue by Trizol method and was treated by reverse transcription to cDNA using 01igo(dt) 18 as primer and then amplified. The target fragments of bax, P53 and caspase 3 cDNA were linked with carrier pTZ57 R/T to construct recombined plasmids which were transformated to E. Coli DH5α by T/A clone method. Recombined plasmids were extracted with alkaline lysis method and the plasmids were selected in white colonies by ampicillin screening, EcoR I restrictive enzyme analysis, and their specificity was evaluated using DNA sequencing. The standard curves were created by plasmid DNA and the precise expression level of target genes in samples were determined using software. The results were expressed as the ratios of target gene mRNA to GAPDH mRNA. Results The standard curve drawn by pTZ57R/T and target gene presented a good linear tendency with the higher sensitivity and specificity. The expression of P53 and bax mRNA began to increase on the third day after the injury of optic nerve and peaked on the fifth day and started to decline on the seventh day. The expression of caspase 3 mRNA increased from the fifth day through the ninth days after injury and declined on the fourteenth day. The significant differences were found in the expression of P53, bax and caspase 3 between model group and control group (P ＜ 0. 05) . Conclusion The pro-apoptotic protein P53, bax and caspase 3 play an important role in RGCs apoptosis.

Objective To analyze the effect of bortezomib together with dexamethsone on the treatment of refractory multiple myeloma.Methods Bortezomib at 1.3 mg/m2 iv drop 1 d,4 d,8 d,11 d.Dexamethasonc 20 mg/d,1～4 d,8～11 d,17～20 d.21 days are used as a course.For bi-course dexamethasone was given by 20 mg/d,at 1～4 d.Results After 2～6 periods,3 cases achieved completely recovery(CR),4 cases are near to completely recovery(CR),3 cases got partially recovery(PR).Conclusion It is a good choice to treat refractory multiple myeloma by Bortezomib together with dexamethagone.

Objective To develop a method for rapid and accurate detection and identification of bacterial pathogens directly from body fluid specimens and to evaluate its application in clinical laboratory.Methods Bacteria DNA was extracted from 205 body fluid specimens with column-based kit,and the high variable V1 and V3 regions of bacterial 16S rRNA gene were amplified with broad-range primers.Amplicons were analyzed by pyrosequencing and the generated sequences were searched in the bacterial identification database.Traditional culture-biochemical method was also used for these specimens and the results were taken as the golden standard.SPSS 11.0 was used to calculate the sensitivity,specificity,false positive/negative rate,positive/negative predictive value and positive/negative likelihood rate of pyrosequencing method.Results The positive rate of bacteria culture was 39.5％ (81/205),among which 71 were infected with single bacterium,and 10 were infected with two species of bacteria.Compared with the culture identification results,pyrosequencing had a 100.0％ (71/71) concordance when applied to detect and identify bacterial pathogens from specimens with single specie bacterium infected.To specimens with two species bacteria infected,7 out of 10 specimens were in concordance with the culture identification results.Besides,pyrosequencing detected 10 positive specimens and identified bacterial pathogens infected in the 124 culture-negative specimens.Taken bacteria culture as the standard method,the sensitivity of pyrosequencing for identifying bacterial pathogen in body fluid was 100.0％,and with a specificity of 91.9％,the false positive rate was 8.1％,the false negative rate was 0.0％,the positive predictive value was 89.0％,the negative predictive value was 100.0％,and the positive and the negative likelihood rate were 12.4 and 0,respectively.Conclusion Pyrosequencing can be used to detect and identify bacterial pathogens directly from body fluid specimens with the advantages of rapidity,high sensitivity,high accuracy and high throughput.

ObjectiveTo review the etiology and classification of cholangiectasia. MethodThe clinical data of 1098 patients with cholangiectasia treated from January 2000 to December 2009 were retrospectively analyzed. Results For the 1098 patients, 69 patients (6.3％) had congenital choledochal cyst, and 1029 patients (93.7％) had secondary cholangiectasia which were secondary to 22 diseases, The top 5 of the etiological diseases were bile duct stones (366 patients, 33.3 ％), pancreatic head carcinoma (137 patients, 12.5％), peri-ampullary carcinoma (122 patients, 11.1％), cholangiocarcinoma (68 patients,6.2％),and chronic pancreatitis or pancreatic head cyst (62 patients,5.6 ％). ConclusionsCholangiectasia can be divided into two major categories (congenital and secondary). Congenital choledochal cyst accounted for 6.0％, secondary cholangiectasia accounted for 94 ％.The most common etiologies were bile duct stones, pancreatic head carcinoma and peri-ampullar carcinoma.

Objective To investigate the prognostic risk factors for surgery in patients with cirrhotic portal hypertension.Methods One hundred and sixty one patients with cirrhotic portal hypertension who received surgery in our hospital in the past 10 years were studied.The data were entered into a pre-designed form.24 predictors including patients′ age,sex,degree of liver atrophy,ChildPugh classification,coagulation profile,splenic size,renal function,blood pH,base excess (BE),operative time,volume of ascites,and intraoperative and postoperative hemorrhage were recorded and analyzed.For each of the predictors,2-3 subgroups were compared.Results Seven predictors were clearly related to surgical prognosis:postoperative bleeding within 30h (B0.356,P＜0.001) and a bleeding volume ＞2 L were awarded 3 points; liver volume (B-0.160,P＜0.001) and severe liver atrophy (antero-posterior diameter of the left liver lobe ≤55 mm,oblique diameter of the right lobe ≤110 mm) were awarded three points; blood pH (B0.141,P＜0.001),pH＜7.35 was awarded 2 points; BE (B-0.123,P＜0.001),BE＜-3 (mmol/L) was awarded 2 points; decrease in PLT (B0.065,P =0.015),PLT＜ 3 (T/L) was awarded 2 points; intraoperative bleeding (B0.062,P=0.014),bleeding volume ＞2 L was awarded 2 points; decrease in RBC (B0.053,P=0.024),＜3(G/L) was awarded 1 point.Of the 147 patients who recovered from surgery,all had ≤3 points,except one who had 4 points.Of the 14 patients who died,all had ≥5 points except one who had 4 points.Conclusions Postoperative bleeding (＞2 L),severe liver atrophy (antero-posterior diameter of the left live lobe ≤55 mm,oblique diameter of the right lobe ≤110 mm),blood PH＜7.35,BE ＜-3 (mmol/L),PLT＜30 000(T/L),intraoperative major bleeding (＞2 L) and RBC＜3 (G/L) were significant prognostic risk factors for surgery.For patients who had a score of 5-6 points; death was likely following surgery.A score ≥8 points should be considered as a contraindication to surgery.To reduce operative mortality,active treatment should be given before surgery to keep the score to be 4 points or less.