Multidrug resistance (MDR)has been a main reason for the failure of leukemia chemotherapy.The generation of MDR in leukemia is directly related to the transportation of drug efflux of P-glycoprotein (P-gp)on cell membrane surface.Many signaling pathways such as MAPK、NF-κB、Hedgehog、Wnt/β-catenin、 and PI3K/Akt involves in regulating of P-gp expression.Meanwhile, regulation factors including Stats、 microR-NA、TRAIL and HDACs are closely related to the P-gp expression.This review briefly discusses the progress of the regulatory mechanisms of P-gp in MDR of leukemia.

Objective To provide a specific,sensitive,reproducible HPLC method for the determination of doxepin in urine and whole blood with doxapram as the internal standard.Methods The sample preparation was simple and time-saving by using an Oasis pretreatment cartridge.Separations were achieved by a Lichrospher  100 RP-18e (250mm?4.0mm,5?m)column kept at 50 ℃,and the DAD detector was set at 230nm and 250nm.Results The detection limit was 2 ng/ml in urine and whole blood.The results showed excellent linearity.The relative standard deviation of between-day and within-day assay was Less than 6.75%,and absolute recoveries were higher than 85%.Conclusion The method for determination of doxepin in urine and whole blood is effective,simple and reliable,which may be applicable to the practical cases.

Shanghai University of Traditional Chinese Medicine(T.C.M) researches into the measures of educating innovational students in order to heighten teaching energy and adapt to society need.The content refers to course plan,teaching content,teaching material,clinical teaching,teaching admin,campus culture and so on.According the result of research,we will keep on innovating to inspire innovational energy of students.

ObjectiveTo investigate the degree of acceptance of Emergency Medicine and the abilities of first aid in senior medical students, and study the methods of how to improve their abilities and skills.MethodsA random sample survey methodology.ResultsA total of 146 medical students of clinical medicine were surveyed.99.32％ of student believed that emergency medicine was essential and necessary in their learning process.The knowledge of first aid would play important role for their future work.55.48％ of students considered that there were partial overlaps in teaching content in emergency medicine and internal medical and surgery.Senior medical students accessed to knowledge mainly through books,followed by the Internet,television and newspapers and their first aid knowledge and skills were poor.ConclusionEmergency medical teaching should be focused on highlighting its characteristics.The visualization of the operation and standardized assessment will help to strengthen students' mastery of first-aid knowledge and skills.

OBJECTIVE:To optimize freeze-drying technology of albendazole nanosuspension so as to prepare albendazole nanometer powder. METHODS:By adopting freeze-drying method,with particle size and Zeta potential as the indexes,single fac-tor test and verification were made on pre-freezing temperature and the type,ratio and mass fraction of cryoprotectants,and then the albendazole nanosuspension prepared by liquid phase precipitation method was made into albendazole nanometer powder. RE-SULTS:When the pre-freezing temperature was-20℃and the cryoprotectant was 4%glucose-mannitol(3∶7),the average parti-cle size of the prepared nanometer powder was (208.03 ± 2.13) nm,and average Zeta potential was (-15.53 ± 0.18) mV. CON-CLUSIONS:Albendazole nanometer powder with better particle size and potential can be prepared by freeze-drying technology.

Objective To observe the tendency of the plasma concentration of plasminogen activator inhibitor type-1 (PAI-1) and thrombin activatable fibrinolysis inhibitor (TAFI) before and after thrombolytic treatment of acute ST elevation myocardial infarction (STEMI) and to explore their recanalization predictive value of PAI-1 and TAFI for acute myocardial infarction patients with thrombolytic treatment.Methods Sixty patients,who received thromobolytic treatment from January 2007 to March 2009,were prospectively recruited.The blood sample were collected within 2 hours of thromobolytic treatment ( 0,0.5 h,1 h,1.5 h and 2 h).The plasma concentration of TAFI and PAI-1 were test by ELISA.16 healthy people were recruited as control group.Results The plasma levels of PAI-1 in STEMI patients before thrombolytic treatment were higher than those of Control group ( P ＜0.01 ),however the same significant change of TAFI level was not seen.The levels of TAFI were no significant difference before and after thrombolytic therapy during whole observation periods.However,the level of PAI-1 increased at 1.5 h and 2 h after thrombolytic therapy (P ＜ 0.01 ).The plasma PAI-1 levels of no - revascularigation group at 2 h after thrombolytic therapy were significant higher than that in revascularization group ( P ＜ 0.05 ).The levels of TAFI were not significantly different between two groups (P ＞ 0.05).Conclusions The decrease of plasma PAI-1 from high level within 2 hours after thrombolysis treament may be exploring the predictive value for revascularization.The tendency of TAFI can' t forecast the result of revascularization.

Objective To investigate the in vitro inhibitory effects of regulatory T cells ( Treg ) from unpregnant mice and pregnancy-induced regulatory T cells ( piTreg) on the proliferation of na?ve T cells and their differences .Methods The numbers of piTreg cells from allogeneic pregnant mice ( C57/B6 fe-male×BALB/c male) on day 12.5 (E12.5d) of gestation and Treg cells from unpregnant C57/B6 mice were detected respectively by flow cytometry .The percentages of piTreg cells and Treg cells in CD 4+T cells of age-matched female mice and their intracellular expression of Foxp 3 were analyzed .The in vitro inhibitory effects of piTreg cells and Treg cells on the CFSE-labeled na?ve T cells ( effector cells ) were compared in a one-way mixed lymphocyte culture system using mitomycin C-inactivated CD4-T cells as stimulator cells . Results The level of piTreg cells in splenic mononuclear cells was significantly higher than that of Treg cells (P<0.001) from normal mice.Foxp3 was highly expressed in both piTreg cells and Treg cells , howev-er slightly increased in piTreg cells .Moreover , piTreg cells had a significant stronger in vitro inhibitory effect on na?ve T cells proliferation than that of Tregs cells (P<0.006), which was in a cell-dependent manner. Conclusion The present study suggests that the piTreg cells have a stronger inhibitory effect on na ?ve T cell proliferation as compared with Terg cells from unpregnant mice , The differential activity of CD 4+CD25+Treg might be mediated by the paternal antigens during pregnancy .

The present study examined the protective effect of the ethanol extract of Sarcopyramis nepalensis (EESN) on agents-induced hepatotoxicity in mice and the possible mechanism. Acute liver injury was induced by administration of either CCl(4) or D-GalN. The animals were divided into 5 groups in terms of different treatment: normal group, CCl(4) or D-GalN group, silymarin or bifendate group, low dose EESN group (10 mg/kg) and high dose EESN group (30 mg/kg). Liver function was evaluated by detecting the levels of serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST). The oxidize stress markers were measured, including malondialdehyde (MDA), glutathione peroxidase (GSH) and superoxide dismutase (SOD). Liver tissues were histopathologically examined by hematoxylin-eosin (H&E) staining. The acute toxicity study revealed that there was no toxicity of EESN at the dose of 5 g/kg in mice. The levels of ALT and AST in serum, and the MDA level in live tissues were significantly increased and the activities of SOD and GSH substantially decreased in mice after CCl(4) or D-GalN treatment. These biochemical and oxidize stress markers were profoundly improved after treatment with EESN at different doses, which was similar to the results of silymarin or bifendate treatment. The histophathological examination revealed the significant improvement in the pathological changes of the liver in EESN-treated mice as compared to those in CCl(4) or D-GalN group. It was concluded that EESN possesses potential antioxidant and hepatoprotective properties and has therapeutic potential for liver diseases.

Objective:To explore the effects of WeChat-based home exercise intervention on the rehabilitation of elderly patients with knee osteoarthritis (KOA) .Methods:A 24-week quasi-experimental research was conducted from August 2019 to January 2020. Totally 6 communities were selected from Haidian District, Beijing by convenient sampling and randomly divided into the control group ( n=3) and the observation group ( n=3) using the envelope method. Patients in the intervention group ( n=46) were received WeChat-based home exercise intervention (including knowledge explanation, exercise skill education, and behavioral motivation) , while patients in the control group ( n=43) received WeChat-based knowledge explanation. The objective knee function (including muscle strength of lower limbs, range of motion of knee joints, balance function, and mobility) and subjective KOA symptoms (including pain, stiffness, and difficulty in daily activities) were collected from the two groups of patients at 0, 8th, and 24th weeks. Results:Within 24 weeks of intervention, the muscle strength of both lower limbs of the two groups increased with time, and the improvement in the intervention group was better than that in the control group, and the difference was statistically significant ( P<0.05) . At the 8th and 24th weeks after intervention, the range of motion of knee joints in the intervention group improved better than the control group, and the differences were statistically significant ( P<0.05) . Within 24 weeks of intervention, the balance function of the two groups improved with time, and the improvement of the intervention group was better than that of the control group, and the difference was statistically significant ( P<0.05) . Within 24 weeks of intervention, the mobility of the two groups increased with time, but the intervention group had better mobility than the control group only in the 8th week, and the difference was statistically significant ( P<0.05) . There was no statistically significant difference in the total scores of the Western Ontario and McMaster University Osteoarthritis Index (WOMAC) and scores of pain, stiffness, and difficulty in daily activities between the two groups in the 8th and 24th weeks ( P>0.05) , except the difficulty in daily activities between the two groups in the 24th week. Conclusions:WeChat-based home exercise intervention can improve the objective knee joint functions of elderly KOA patients, such as muscle strength of lower limbs, range of motion of knee joints, balance function and mobility, but it has no obvious effect on the subjective symptoms of patients.

Objective:To evaluate the effects of different position interventions in patients with acute respiratory distress syndrome (ARDS) undergoing mechanical ventilation from the aspects of effectiveness and safety using the method of network Meta-analysis.Methods:Randomized clinical trials (RCTs) related to the therapeutic effect of position interventions in adult ARDS patients undergoing mechanical ventilation were retrieved in PubMed, Embase, Cochrane Library, Web of Science, CINAHL, China Biomedical Literature Database, China National Knowledge Infrastructure, VIP and WanFang Data. The search time limit was from the establishment of the database to January 2021. According to the literature inclusion and exclusion criteria, literature was screened and the quality evaluation and data extraction were carried out. StataSE 15 and Addis 1.16.6 were used for network Meta-analysis.Results:A total of 31 RCTs were included, involving5 positions of prone, semi-recumbent, side-recumbent, supine and sitting, and 3 738 patients. The prone position compared with the semi-recumbent position, the semi-recumbent position compared with the supine position could reduce the 28-day all-cause mortality of the patient, and the difference was statistically significant ( P<0.05) . Compared with the semi-recumbent position and the supine position, the prone position could reduce the length of time the patient stayed in the ICU, and the difference was statistically significant ( P<0.05) . The prone position could increase the oxygenation index of patients compared with the supine position, and the difference was statistically significant ( P<0.05) . For the total incidence of adverse events and adverse reactions, there was no statistically significant difference between any two positions ( P>0.05) . The network Meta probability ranking of all the outcome indicators showed that the prone position and the side-recumbent position had advantages, and the supine position and the semi-recumbent position had no obvious advantages. Conclusions:Current evidence shows that the prone and side-recumbent position interventions are effective and safe for the treatment of ARDS patients undergoing mechanical ventilation, and are good choices among several positions.