The major progress on the study of etiology of the Hirschsprung's disease is the genetic factots and the aherations of microenvironment in primarily embryogenic period.The genetic factors comprise of RETGDNF system.EDNRB.EDN3 system,and many other genes involving in the formulation of the tormer two svstems.such as SOX10,NRG-1, FoxD3,PHOX2B,HOXB5,ZFHXIB,all of which file essencial for the migration and differentiation of neural crest cells(NCC).The alterations of microenvironment in primarily embryogenic period include interstitial ceLls of cajal(ICC),cell adhesion molecules(CAMLl),Ca2+ and so on.Definitely,CAML1 plays as the basis of NCC's migration and differentiation,and the decline of the Ca2+dependent channel's expression brings about the anolnaloug contraction of smooth muscle.

Objective To investigate whether the effect of pioglitazone on TNF-α-induced insulin resistance is associated with altering IRS-1-induced signaling. Methods 3T3-L1 adipocytes were treated with TNF-α for 24 hours with or without being pretreated with 10μM piglitazone for 6 hours or with pioglitazone alone.Insulin-stimulated glucose uptake of 3T3 adipocytes was measured by using 2-deoxy 3H glucose.The Western blot was used to measure IRS-1, PKB, PKC-λ protein and tyrosine phosphorylation on IRS-1, PKB and PKC-λ phosphorylation. Results Both TNF-α and pioglitazone increased glucose uptake of 3T3 adipocytes under basal status.On TNF-α treated cells, insulin-stimulated glucose uptake was decreased by about 50%, accompanied with the reductions of IRS-1 protein level, tyrosine-phosphorylation of IRS-1 and PKB phosphorylation.TNF-α treatment had no effect on PKC-λ phosphorylation. Pioglitazone pretreatment was able to antagonize TNF-α-induced insulin resistance in 3T3 adipocytes partly reverse IRS-1 protein, increase insulin-stimulated tyrosine phosphorylation of IRS-1,and increase phosphorylations of PKB and PKCλ. Conclusion TNF-α-induced insulin resistance in 3T3-L1 adipocytes is related to impaired tyrosine phosphorylation of IRS-1. Pioglitazone antagonizes the above TNF-α induced insulin resistance.

Objective To analysis the prognosis of esophageal carcinoma patients with anemia before radiotherapy. Methods 137 patients with esophageal carcinoma treated with three-dimensional conformal radiation therapy (3D-CRT) in the Second Peopleˊs Hospital of Jiaozuo over the past five years were retrospectively analyzed. There were 40 patients with anemia and 97 cases without anemia before radiotherapy. The prognosis of patients with anemia and the relationship with other clinical factors were evaluated by survival analysis. Results The 3-year and 5-year overall survival (OS) rates in non-anemic group were 43.6 % and 35.7 %, respectively, and 21.0 % and 16.4 % in anemic group. The 3-year and 5-year disease-free survival (DFS) rates in non-anemic group were 38.5 % and 25.3 %, respectively, and 13.1 % and 9.2 %in anemic group. The Kaplan-Meier method showed that both 3-year and 5-year OS and DFS rates in non-anemic group were significantly higher than those in anemic group (P< 0.05). Conclusion Anemia is the independent prognostic factor for patients with esophageal carcinoma in many clinical factors.

MicroRNAs (miRNAs) are small endogenous non-coding RNA molecules.They regulate negatively the expression of target genes at post-transcriptional stages by means of affecting the stability of target mRNA or interfering with the transcriptional process.Recently,there is evidence demonstrating that miRNAs play important roles in the gene expressions of thyrotoxic heart diseases.Elevated levels of thyroid hormones profoundly influence the cardiovascular system through the renin-angiotensin system (RAS).As a principal active component of RAS,angiotensin Ⅱ receptor 1 (AT1 R) interacts with miRNAs in promoting or extenuating the progress of thyrotoxic heart disease.In this article,the roles of AT1R-associated miRNAs,miR-21,miR-155,miR-208a/b,and miR-499 in thyrotoxic heart disease were reviewed.

Objective To explore the right timing of mechanical ventilation in patients with bronchial asthma in emergency room.Methods A total of 67 patients with bronchial asthma undergoing mechanical ventilation were admitted into our Emergency Intensive Care Unit (EICU) from January 2010 to December 2012.According to PaCO2 before intubation,they were divided into 3 groups of low levels of PaCO2 [PaCO2 ≤35 mmHg (1 mmHg =0.133 kPa)] (n =19),normal PaCO2 (35 mmHg ＜ PaCO2 ＜ 45 mmHg) (n =21) and high PaCO2 (PaCO2 ≥ 45 mmHg) (n =27).Their clinical data were retrospectively analyzed.Results The in-hospital mortality of three groups were 5.3％ (1/19),9.5％ (2/21) and 14.8％ (4/27) and the difference was not statistically significant (x2 =1.16,P ＞ 0.05).However the average duration of mechanical ventilation of three groups were (5.6 ± 1.7),(8.3 ± 2.1) and (13.5 ±3.6) days and the difference was statistically significant (F =3.36,P =0.042).The average ICU treatment time was (7.4 ± 2.1),(11.5 ± 3.3) and (16.4 ± 3.5) days and the difference was statistically significant (F =3.23,P =0.047).PaCO2 levels before intubation was positively correlated with the duration of mechanical ventilation and the ICU treatment time (r2 =0.366,0.316,P =0.031,0.029).Conclusion The patients with bronchial asthma undergoing intubation in right time in emergency room will affect the duration of mechanical ventilation and ICU treatment time.

ObjectiveTo evaluate the relationship between microalbuminuria(MAU) and cardiac autonomic neuropathy in diabetes.MethodsThe urinary albumin excretion (UAE) was measured,and the cardiac autonomic function was detected using 24 hour ambulatory ECG spectral analysis of heart rate variability (HRV) in 46 patients with diabetes and 31 normal control subjects.ResultsParameters of time and frequencydomain of HRV were reduced in patients with diabetes.The high frequency at night reflecting the cardiac vagus nerve function was significantly lower in diabetic patients than control group.In diabetic patients with MAU,the detected values of HRV were significantly decreased,combined vagosympathetic impairment occurred,and 24 hour rhythm from day to night in autonomic nervous activity disappeared.ConclusionMAU in diabetes is related with HRV.

OBJECTIVE:To provide reference for medication consultation Wechat platform in the hospital. METHODS:The medication consultation Wechat platform of our hospital was introduced,including main method,content and effect. The consulting pharmacist team was set up,and Wechat public number was applied and operated experimentally;information pharmacist was re-sponsible for its daily maintenance. We released pharmacy news,accumulated consumers and expanded influence through other me-dia at regular intervals. RESULTS & CONCLUSIONS:According to the medical practice,two modules“medication consultation”and“pharmacy news”were set up. From Dec. 2014 to Jul. 30th 2015,medication consultation system had accumulated 1 121 con-sumers,with an increase of 5 to 8 ones everyday;average number of consultation records was 10 everyday;we also had published 22 batch of medication news(79 messages),including 31 original messages and 3 video messages. Several messages gained much attention from network media and offline media. As new pharmaceutical care mode,Wechat platform contribute to realize a individ-ual,convenient and mobile medication consultation service,medication health science popularization,and improves medication compliance of patients and the awareness of medication safety in field of pharmaceutical administration Wechat platform,so as to improve pharmaceutical care effect of“taking patients as the center”and promote the propaganda of hospital brand. Thus it has a good prospect of application and popularization.

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 .

Drug-induced immune hemolytic anemia has complicated manifestations and pathogenesis, and therefore clinicians should know its etiology and pathogenesis for safe medication. In this paper, we made a discuss on the etiology and pathogenesis of drug-induced immune hemolytic anemia from both traditional Chinese and western medicine viewpoint hoping to provide references for clinical physicians.

Objective:To investigate glucose uptake and IRS-1-associated signaling pathway by stimulated insulin under TNF-? treatment.Methods:3T3-L1 adipocytes were treated with TNF-? within 6 hours and 24 hours respectively. 2-deoxy ~3H glucose was used to measure glucose uptake and western blot was used to measure IRS-1, PKB protein, tyrosine and serine307 phosphorylation on IRS-1, and PKB phosphorylation.Results:On basal status, glucose uptake of 3T3-L1 cells and phospho-tyrosine of IRS-1, PKB phosphorylation, and serine307 phosphorylation on IRS-1 were all low. Insulin stimulation induced glucose uptake and IRS-1 tyrosine phosphorylation, serine307 phosphorylation, PKB phosphorylation rapidly. TNF-? inhibited insulin-induced glucose uptake, tyrosine phosphorylation of IRS-1 and PKB phosphorylation. Rapamycin reversed the effects of TNF-?. Treated with TNF-? within 6 hours increased serine307 phosphorylation but had no effect on IRS-1 protein level. TNF-?-induced serine307 phosphorylation of IRS-1 was not affected by rapamycin. IRS-1 level was decreased under 24 hours TNF-? treatment and rapamycin can reverse the effect.Conclusion:TNF-? induced insulin resistance in 3T3-L1 adipocytes mightbe related to impaired IRS-1 tyrosine phosphorylation, rapamycin could reverse the effects of TNF-?. Treated with TNF-? within 6 hours stimulate phosphrylation of serine307 of IRS-1 and 24 hours treatment decreased IRS-1 protein level. Rapamycin antagonist TNF-?-induced loses of IRS-1.