Tumor necrosis factor-related apoptosis inducing ligands (TRAILs) and their receptors can specifically express in hepatocellular carcinoma cells.TRAIL can specifically induce tumor cells apoptosis through death receptors (DRs) ; TRAIL combined radiation and chemotherapy can effectively overcome the TRAIL resistance of tumor cells,and promote the apoptosis of tumor cells,meanwhile the gene therapy of TRAIL on anti-tumor clinical treatment has been widely used.

Result of Bencaocogical studies on Changpu showed that it originated from two different source, one is Shuichangpu (Asorus calamas) while another is Shichangpu (A.tatarinowii and A.gramineus). Usually, Changpu grown on stony ground was referred to as Shichangpu.Jujiechangpu is a kind of Changpu with 9 nodal rings within an "inch" on its root stock,but that which is used in Northwest China is an cntirely different herb Anemone altaica.

[Objective]To probe the efficacy of total hip arthroplasty(THA)in the treatment of patients with ankylosing spondilitis(AS).[Method]Ninety-eight THA were performed in 56 patients who had AS,and 42 patients(76 hips)were analyzed retrospectively with an average follow-up period of 5.6 years(ranged,2.5 to 5.5 years).The clinical results were evaluated by the Harris hip scoring system and radiographic analysis.[Result]For the latest follow-up,the average Harris hip score improved from 26.8 points(ranged,4 to 51 points)preoperatively to 85.2 points(ranged,55 to 94 points)at the final postoperatively evaluation.89.5% of the patients had an excellent or good results evaluated by Harris hip scoring system postoperatively.One patient was revised for infection,fissured fracture of neck of femur or calcar femorale above the lesser trochanter happended in two patients,one patient had footdrop and recovered 3 months later,1 patient had deep vein thrombosis.There was no sign of loosening,dislocation or fracture of the prosthesis.According to the system of Brooker,the incidence of heterotopic ossification was 9.2 %(7 hips).[Conclusion]THA can greatly relieve the pain of the patients who have AS and reconstruct the function of hip joint.Compared with THA operated for other cause of disease,THA in AS leads to no high risk.

Objecitve To observe the effects of ursolicacid on contractile activity of uterine smooth muscle strips of virginal rats.Methods 20 Wistar virginal rats,weight 200-300g were selected,to record the effects of ursolicacid(1.0?10~(-8),2.0?10~(-8),3.0?10~(-8),4.0?10~(-8)g/L) on contractile activity of uterine smooth muscle strips with Biolap 410 Biological System.Diphenhydramine(2?10~(-6)mol/L),Phentolamine(2?10~(-6)mol/L),Verapamil(2?10~(-7)mol/L),Indomethacin(2?10~(-5)mol/L) were used as antagonists to study the mechanisms of ursolicacid on uterine smooth muscle strips.Results Ursolicacid could significantly potentiate uterine contractile activity of virginal rats.It could increase the frequencies,prolong the duration and enlarge the amplitude of contractile activity.The effect of which could be inhibited by the Indomethacin;but could not restrained by other antagonists.Conclusion The results of Ursolicacid may be mainly primarily with prostaglandin synthese or release,but not mediated by H_(1) receptor,? receptor and L-voltage-dependant calcium channels.

Objective To study the influence of sufentanil on analgesic effect and hemodynamics during recovery period of general anesthesia in elderly patients.Methods Eighty patients with general anesthesia were randomly divided into 4 groups (20 cases in each group).Ten min before surgery ended patients in each group were intravenous injected different dose of sufentanil:group S1 with sufentanil 0.2 μg/kg,group S2 0.4 μg/kg,group S3 0.6 μg/kg,and group C (control group) with saline 5 ml.The time of spontaneous breath restores,the time of summon opening eyes and extubation,the cases occurred cough,nausea,vomiting during recovery period were recorded and the VRS pain scores and Ramsay score 10 min after extubation were also recorded.Mean arterial pressure (MAP) and the heart rate (HR) were recorded before the anesthesia induction(T0),stopped anesthetic (T1),pre-extubation (T2),5 min and 10 min after extubation (T3 or T4)Results As group S1 and S2 compared with group C,there was no significant difference on the time of spontaneous breath restores,the time of summon opening eyes,and the time of extubation and leaving the operating room (P ＞ 0.05).However,there was significant difference on the time of spontaneous breath restores ((7.3 ± 4.1) min vs (10.2 ± 4.7) min),the time of summon opening eyes ((8.1 ± 3.1) min vs (11.2 ± 3.7)min),the time of extubation ((12.3 ± 3.1) min vs (16.3 ± 5.9) min),and the time of leaving the operating room((21.4 ±3.0)min vs (24.2 ±3.5)min) between the group S3 and group C(P＜0.01 or P ＜0.05)Patients occurred cough in group S1,S2 and S3 were less than those in group C (P ＜0.05),but there was no significant difference on the occurrence of nausea and vomiting between group S1-3 and group C (P ＞ 0.05)There was significant difference on VRS pain score and Ramsav score between group S1-3 and group C(P ＜0.01).MAP and HR were increased in all points of time as compared with T0 (P ＜ 0.05 or P ＜ 0.01).And there was significant difference on MAP and HR between group S1-3 and group C (P ＜ 0.05 or P ＜ 0.01).Conclusion Before the end of anesthesia sufentanil 0.2 ～ 0.4 μg/kg intravenous injection could be able to enhance analgesic effect,stabilize hemodynamics and do not affect regain consciousness in elderly patients.

Objective To investigate the relationship of parity and other reproduction-associated factors with metabolic syndrome(MS) in middle-aged and elderly women in Nanchang community.Methods Female permanent residents over 40 years old were sampled for a routine examination and a questionnaire survey covering basic information,5 894 subjects were enrolled and identified as effective cases.MS was diagnosed according to the standard of China Diabetes Society in 2004.Factors including age,education,profession,marital status,parity,child-bearing history of macrosomia,breastfeeding,menarche age,and menopausal age were analyzed in order to find their relationship with MS.The univariate logistic analysis was followed by binary logistic regression analysis if P＜0.05,and OR value and confidence interval were calculated.Results Univariate logistic regression analysis showed that age,education,profession,parity,breastfeeding,and menopausal age were influencing factors of MS (all P ＜ 0.05).There was no correlation to marital status,miscarriage history,child-bearing history of macrosomia,menarche age with MS(all P＞0.05).Binary Logistic regression analysis showed that the risk of MS increased with age:OR =1.51 (95 ％ CI 0.98-2.32) during 50-59 years,OR =2.10 (95 ％ CI 1.34-3.30) during 60-69 years,and OR =2.63 (95 ％ CI 1.61-4.31) in cases aged over 70 years,as compared to the group aged 40-49 years.The risk in non-manual workers increased about 34 percent OR =1.33 (95 ％ CI 1.04-1.70),compared with manual workers.The risk of MS increased with parity,being OR =1.46 (95％ CI 1.14-1.88),OR =1.78 (95％ CI 1.30-2.43),and OR =1.84 (95％ CI 1.24-2.72),with 2,3,and 4 child-bearings respectively as compared to cases with only one childbearing.The risk of MS was reduced with advancing menopausal age being about 6 percent reduction with each increased year of menopausal age(OR =0.94,95％ CI 0.90-0.99).There was no difference between education,breastfeeding and MS(P＞005).Conclusion Multiple parity,earlier menopausal age,less manual work,and aging seem to be the risk factors of MS in women.

Now,with the dramatic increase in Internet technology,we should focus on innovation teaching and learning,so it is necessary to set up a platform of Internet resources for education in order to reach optimization of teaching.

ObjectiveTo evaluate the modified Barcelona Clinic Liver Cancer (BCLC) staging system for predictability of intrahepatic recurrence for patients with hepatocellular carcinoma (HCC) following curative hepatectomy.MethodsA retrospective study was conducted on 197 consecutive patients with HCC who underwent curative hepatectomy in our department from Jan.2008 to Jan.2011.Univariate and multivariate analyses using Cox proportional hazard model were used to evaluate possible association between clinicopathologic factors and early postoperative intrahepatic recurrence (ER).Receiver operating characteristics (ROC) analysis with calculation of the area under the curve (AUC),sensitivity,and specificity were applied to define the cutoff point values for possible meaningful continuous variables where appropriate.A comparison between the differences in AUC was used to assess BCLC and a modified BCLC (M-BCLC) staging system for their predictive ability of ER.Risk stratification according to calculated M-BCLC was applied to find differences of ER at various time points after curative hepatectomy.ResultsDuring follow-up,111 patients developed ER.The 6-,9-,12-,18- and 24-month cumulative recurrent rates were 26.9％ (53/197),37.6％ (74/197),45.2％(89/197),53.8％ (106/197) and 56.3％ (111/197),respectively.Multivariate analysis revealed thatthe severity of concomitant cirrhosis,elevated AFP≥185.6 μg/L and BCLC staging were risk factors of ER.A M-BCLC was proposed based on the results of multivariate analysis.The severity of cirrhosis and elevated AFP values were included in the BCLC staging.This M-BCLC exhibited better performance.It predicted at different time points of ER at postoperative 9,12,18 and 24 months to be significantly better with M-BCLC than BCLC using AUC drawn from ROC.No significant difference was found with ER prediction at 6 months.The M-BCLC also demonstrated a ER prediction with AUC of 0.710 (95％ CI,0.630-0.790) and achieved a sensitivity of 83.0％,a specificity of 51.9％as calculated from ROC with M-BCLC≥2.913.Further risk stratification according to the M-BCLC at various cutoff point values revealed the ER occurrence rates amongst the different risk groups to be significantly different when compared with the median ER time (17.9 mons,9.9 mons vs 5.7 mons,x2=25.770,P=0.000,Log-Rank test).ConclusionA modified BCLC staging system based on multivariate analysis improved the predictability of ER following curative hepatectomy for HCC.

Objective To explore risk factors relating to occurrence of spontaneous rupture (SR)of hepatocellular carcinoma (HCC). Methods We retrospectively reviewed medical records of 409 HCC patients treated in our department from Jan. 1st 2005 to Aug. 31st 2009. Clinicopathologic factors were explored for their possible association with occurrence of SR by univariate and multivariate analysis using Logistic regression model. Results Among 409 patients, SR occurred in 40 patients (9. 8% , 40/409).Type of SR was defined according to presentation of acute abdominal emergency, especially unstable hemodynamic status. Nineteen cases (4. 7%, 19/409) were grouped as type of HCC-SR Ⅰ and 21 cases (5. 1% ,21/409) as HCC-SR Ⅱ. Patients in the two groups possessed similar hepatitis infection status,severity of background liver disease and tumoral factors except for tumoral location, while HCC-SR Ⅰ group often needed emergency treatment demonstrating elevated values of aspartate aminotransferase (AST) and WBC, decreased PLT counts and worse Child-Pugh classification. Patients in the HCC-SR Ⅱ group had more opportunities of receiving curative hepatectomy and had longer overall survival. The 1,2 and 3 year survival rates were 26. 3 % (5/19), 5. 3% ( 1/19 ) and 0% (0/19)in the HCC-SR Ⅰ group and 66. 7% ( 14/21 ),42.9% (9/21)and 19. 5% (5/21) in the HCC-SR Ⅱ group, respectively. Differences reached statistical significance( P = 0. 011,0. 009,0. 049). Multivariate analysis identified that severity of concomitant liver cirrhosis , WBC ＞ 10 × 109/L and AST level more than twice normal (2N) as independent risk factors associating with occurrence of HCC-SR Ⅰ , while elevated values of AFP and presence of tumor thrombi in portal vein branch related to HCC-SR Ⅱ. Conclusions HCC-SR includes two different types, since different risk factors predict occurrence of each HCC-SR type.

Objective To present the status of smoking control in the Health and Family Planning System in Hubei Province, and to provide scientific basis for smoking control through secret investigations. Methods During the period from July to August in 2015, 168 sanitary Health and Family Planning institutions were chosen by stratified selection to make questionnaires based on Evaluation Standards for Smoke-free Health and Family Planning Institutions issued by the National Health and Family Planning Commission of the People's Republic of China. Secret investigations were conducted in 165 sampled institutions and comparisons were made between smoke-free environment establishment as well as execution processes according to the fraction after converting into centesimal system (actual score/reserved portion × 100). Results The overall score for smoking control in Health and Family Planning System of Hubei Province has climbed to 79.29 ± 12.40.compared to that of 2011 has increased, but 1.6 lower than the national comprehensive evaluated score of 2014. The score of the city (82.14 ± 10.51) proved to be higher than that of the province (66.51±19.69) and the county, (75.35±13.40);disease control institutions (84.77± 9.45) enjoyed a higher score that the others with lowest scores in medical institutions (72.80 ± 14.95);Xianning won the highest score (88.52±5.12);Jingmen (69.81±5.16) and Xiaogan (67.92±7.98) proved to be the lowest in their scores. Nine regions in 17 embraced a lowest discrepancy of over 30 scores and the highest discrepancy of 50.94 scores between the highest score and the lowest among different institutions;12.73% (21/165) medical institutions had no publicity materials; 5/17 municipal institutions and 3/10 county level institutions were still found selling cigarettes, with only 46.06%(76/165) institutions reaching the standard of banning smoking in indoor places, 21.21%(35/165) institutions still have indoor smoking in non-working places, 1.82%(3/165) institutions have indoor smoking in working places. Only 18 (32.14%) institutions out of 56 medical institutions investigated have established smoking cessation clinics. Conclusions Banning-smoking work is less optimistic in general for Health and Family Planning System in Hubei Province, especially for substratum health and family planning institutions. All kinds of departments should take drastic measures to guaranttee the establishment of smoking-free environment.