Objective To investigate the effects of sodium tanshinone ⅡA injection on myocardial enzymes and heart function of patients with acute myocardial infarction, and to explore its therapeutic mechanism. Methods A total of 217 patients with acute myocardial infarction in Taihe Hospital emergency department were randomly divided into control group (n=110) and the Tanshinone group (n=107). The control group was treated by thrombolysis, vascular dilation, antihypertension, anti-shock and other conventional treatment. On the basis of control group treatment, Tanshinone group added the intravenous injection 20mg sodium tanshinone injection. The ELISA was used to test serum creatine kinase (CKMB), superoxide dismutase (SOD), malondialdehyde (MDA) and cardiac troponin I (CTNI) and other enzymes indexes before and after treatment. The heart function were assessed by measuring the left ventricular patient of maximum rising/ falling rate (± LVdp/dtmax),left ventricular end-diastolic diameter (LVDD), left ventricular ejection fraction (LVEF),systolic blood pressure (SP), diastolic blood pressure (DP), pulse pressure (PP ) and heart rate (HR) and other indicators. Results After treatment, the CK-MB (10.76 ± 1.02 mmol/L vs. 15.17 ± 1.21 mmol/L, t=3.724), CTNI (0.11 ± 0.02 ng/ml vs.1.51 ± 0.05 ng/ml, t=2.570), MDA (4.54 ± 0.23 nmol/ml vs. 9.98 ± 1.37 nmol/ml, t=5.035) in the Tanshinone group were significantly lower than those in the control group (P<0.05). The SOD (452.27 ± 21.56 U/L vs. 209.50 ± 15.43 U/L, t=3.935), LVDD (50.74 ± 5.36 mm vs. 44.91 ± 5.31 mm, t=2.454) and LVEF (4.59% ± 0.17% vs. 3.64% ± 0.11%, t=4.052) in the Tanshinone group were significantly higher than those in the control group (P<0.05). The heart function of +dp/dtmax (3742 ± 162 mmHg/s vs. 3948 ± 193 mmHg/s, t=3.731), -dp/dtmax (3512 ± 135 vs. 3847 ± 181, t=3.025), PP (30.5 ± 5.3 mmHg vs. 35.8 ± 5.1 mmHg, t=2.902), DP (99.2 ± 8.8 mmHg vs. 117.3 ± 10.8 mmHg, t=4.079) in the Tanshinone group were significantly lower than those in the control group (P<0.05). The total effective rate was 98.14% (105/107), the control group was 87.2%(96/110), and there was significant difference between the 2 groups (χ2=10.417, P<0.05). Conclusions The Tanshinone ⅡA sodium injection can improve myocardial enzymes and heart function of patients with acute myocardial infarction, which refered to its protective effect on acute myocardial infarction.

Objective To study the clinicalpathological characteristics,surgical treatment andprognosis of the gastrointestinal stromal tumor(GIST).Methods The clinical data of 160 cases of pathologically confirmed GIST were retrospectively reviewed.Clinical features,pathological characteristics andimmune markers were studied by multiple factor analysis.Results There were no intraoperative or deathsin 140 patients who underwent radical resection.Univariate analysis of survival revealed significant differences in the main tumor pathological characteristics,including mitotic figure and metastasis and Fletcher'sclassification(P <0.05).Immunohistochemical results showed that the positive rates of KIA and CD133were 97.6% and 81.3% respectively,and their influences to survival prognosis were of statistical significance(P <0.05).A total of 145(90.6%)patients finished the follow up and 53 cases of them had multiple liver metastasis.These patients received imatinib mesylate(400 mg/d)and the efficacy was significant(P <0.05).Multivariate regression analysis showed that Fletcher's classification and imatinib mesylatewere the independent risk factors affecting prognosis.Conclusion Fletcher's classification is an effectivemethod for evaluating the prognosis of GIST.Radical resection and imatinib mesylate can reach a remarkable curative effect in treating original and metastatic lesions of the GIST patients.

At present,transplantation has been the predominant way to solve most of the end-stage diseases,ensued by the use of immunosuppressive drugs.Since the immunosuppressive drugs have narrow therapeutic index,the blood drug concentration is needed to mornior.Pharmacogenetics is one subject which focuses on the interaction between gene and the metabolism of the drug,providing great help for designing the regime of achieving the target drug concentration.Meanwhile,it facilitates the realization of individual therapy.This review thus focuses on the latest advancement on the pharmacogenetics of those immunosupprressants,hoping to provide help for the treatment.

Objective To analyze blood-CSF barrier and cerebrospinal intrathecal IgG synthesis in patients of multiple sclerosis, and explore the Protis software, IgG index and IgG synthesis rate in the and evaluation for cerebrospinal intrathecal IgG synthesis and blood-CSF barrier dysfunction. Methods 134 patients with neurological diseases were divided into threes groups, including multiple sclerosis group (34 cases), disease control group(80 cases) and control group(20 cases). IgG and ALB concentration of CSF and blood was detected by BN-Ⅱ. The oligoclonal IgG was detected by immunofixation electrophoresis. The relationship between Protis software results and IgG index or IgG synthesis rate was calculated and analyzed. Results The function of blood-brain barrier was almost normal in multiple sclerosis group,QALB was 4.5×10-3[(3.1-7.6)×10-3], there was no significance compared with control group (D=5.25, P>0.05). there were 31 patients with oligaclonal bands in cerebrospinal fluids in multiple sclerosis group (34 patients) with the positive rate of 91.2%. In multiple sclerosis group the intrethecal IgGIF, IgG index and IgG synthesis rate of 24 hours were 31.25% (11.65%-71.45 %), 0.93% (0.80%-1.04%), 24.25 mg/24 h(15.25-46.15 mg/24 h) ,the results were all higher than that in control group (D=175.5, 112.5,103.4,P<0.05). And in multiple sclerosis group there was no significant difference among the intrethecal IgGIF, IgG index and IgG synthesis rate of 24 hours, the positive rate of oligaclonal bands (P>0.05). In disease control group(80 patients) QALB Was 35.2×10-3[(18.5-55.5)×10-3] ,the result was significantly higher than control group (D=102.7, P<0.05), the oligaclonal bands were all negative, IgG index and IgG synthesis rate of 24 hours were 0.75(0.69-0.82) ,44.29 mg/24 h(20.35-65.98 mg/24 h) were both higher than control group(D=85.6,98.5,P<0.05). In disease control group the positive rate of intrathecal IgGIF, IgG index and IgG synthesis rate of 24 hours were 0 (0/80), 40.0% (32/80), 72.5% (58/80) respectively, IgG index and its positive rate both increased alone with the lesion degree of blood-brain barrier increasing (P<0.05). And there was similar trend in the IgG synthesis rate of 24 hours. There were significant correlations among intrathecal IgGIF, IgG index and IgG synthesis rate of 24 hours in multiple sclerosis group (r=0.788, 0.695 ,P<0.05). However there was no correlation among intrathecal IgGIF, IgG index and IgG synthesis rate of 24 hours in disease control group (r=0.000,P>0.05). Conclusions The Protis software can be used to analyze the intrathecal IgGIF and reflect the actual status of intrathecal IgG synthesis more accurately. Protis software has great application value for clinical diagnosis for nervous system disease.

Objective To explore the short‐term effect of chronic periodontitis patients after implant treatment .Methods Selected 60 cases of tooth loss in chronic periodontitis patients as research group ,a total of 75 implants were placed ,and 50 cases of periodontal healthy teeth missing patients as control group ,a total of 67 implants were placed .Compared two groups of modification sulcus bleeding index(mBII) ,papilla index score(PIS) ,modification plaque index(mPLI) and probing depth(PD) 6 months after op‐eration ,and detected implant sulcular fluid IL‐2 ,IL‐8 content in two groups before and after operation .Results Research group 75 implants had 2 off on their own ,implant loosening degrees 0 ,implant survival rate was 97 .3% ;the control group had no implant failure ,implant loosening of implant survival rate was 100% ,two groups of implant survival rate was no significant difference(χ2 =2 .737 ,P= 0 .098) .The mSBI ,PIS ,mPLI ,PD in research group and control group had no statistically significant(P > 0 .05) .Re‐search group sulcular fluid IL‐2 ,IL‐8 content was significantly higher than those in control group before and after the operation (P< 0 .05) .Conclusion The short‐term effect of implant treatment in chronic periodontitis patients is satisfactory ,without increas‐ing the risk of peri‐implantitis ,and worth of clinical promotion .

Objective To evaluate the ability of high resolution pleuropulmonary ultrasonography and bedside chest X-ray in identifying different pathologic abnormalities in patients with dyspnea,using thoracic computed tomography (CT) as a gold standard.Methods Bedside pleuropulmonary ultrasonography was performed in 350 dyspneic patients in the emergency department and ICU,111 patients were enrolled in the study with pleuropulmonary ultrasonography,chest X-ray and chest CT examination performed within 24 hours.Pathologic entities were evaluated:pleural effusion,consolidation,atelectasis,pneumothorax,pulmonary interstitial fibrosis,and pulmonary edema.The sensitivity,specificity,negative and positive prediction value of pleuropulmonary ultrasonography and chest X-ray were compared with the corresponding CT scan results.Results Pleuropulmonary ultrasonography was highly concordant with chest X-ray.Overall ultrasonography exhibited higher sensitivity than chest X-ray and CT for pleural effusion.For atelectasis and pulmonary edema,the sensitivity of ultrasonography was up to 100%.In the diagnosis of pulmonary interstitial fibrosis,the sensitivity of pleuropulmonary ultrasonography was higher than that of chest X-ray,but the specificity was slightly lower.The sensitivity of pleuropulmonary ultrasonography was slightly higher than that of chest X-ray in pneumothorax,and the specificity was coincident with chest X-ray.Although the sensitivity of ultrasonography was slightly lower for consolidation,it was still higher than chest X-ray.The ability of chest X-ray for differentiating pleural effusion from atelectasis or consolidation was worse than that of ultrasonography.Conclusions Our study demonstrates a high concordance between ultrasonography with radiography.The diagnostic performance of bedside pleuropulmonary ultrasonography is better than that of chest X-ray.

Objective To explore the relationship between the Interleukin 6 , matrix metalloproteinases 2 and early embryo arrest. Methods Real time-PCR was used to measure the mRNA expression of IL-6 and MMP-2 and immunohistochemistry (IHC, SP method)was used to measure the location and expression of the two different kinds of protein in villus. ELISA was used to measure the level of IL-6 in serum. Results Real-time PCR and IHC showed that the expression levels of IL-6 was significantly lower in experimental group than in control group, and MMP-2 was significantly higher than the control group (P < 0.05). Differenc of IL-6 level in serum between the two groups was not statistically significant (P > 0.05). Conclusion Proper expressions of IL-6 and MMP-2 in the villus tissue play a key role in the maintenance of early pregnancy.

BACKGROUNDCytotoxic lymphocytes play an important role in anti-tumor immune. CD₃+CD₅₆+NKT cells, which are a new type of cytotoxic cells, are mainly focused on anti-tumor effect in hematologic malignancy, however its cytotoxic effects on solid tumor are not clear. The aim of this study is to explore the clinical expression and significance of peripheral CD₃+CD₅₆+NKT cells and CD₃-CD₅₆+NK cells in patients with solid malignant tumors.

METHODSPeripheral T cell subsets and CD₃+CD₅₆+NKT cells and CD₃-CD₅₆+NK cells in 118 patients with malignant tumors (55 lung cancers and 63 breast cancers) and 46 healthy volunteers were analysed by flow cytometer.

RESULTSCompared with healthy control, both peripheral CD₃+T lymphocytes and CD₃+CD₄+ T lymphocytes in patients with lung cancer or breast cancer significantly decreased, but CD₃+CD₈+T lymphocytes only increased significantly in patients with lung cancer (P < 0.01). Further analysis of CD₃+CD₅₆+NKT cells and CD₃-CD₅₆+NK cells indicated that there was difference between lung cancer group and breast cancer group. In patients with lung cancer CD₃+CD₈+T cells and CD₃+CD₅₆+NKT cells increased significantly, and in patients with breast cancer CD₃+CD₅₆+NKT cells and CD₃-CD₅₆+NK cells increased obviously.

CONCLUSIONSIn patients with lung cancer or breast cancer, CD₃+CD₅₆+NKT cells play the important role in anti-tumor effects, however, the anti-tumor effects of CD₃+CD₈+CTL and CD₃-CD₅₆+ NK cells were different.

Objective To detect carbapenemase production in enterobacteriaceae by using modified Hedge test (MHT) and investigate the distribution of carbapenemase genes.Methods A total of 3 718 isolates from enterobacteriaceae were collected from 4 hospitals,including Second Affiliated Hospital of Zhejiang University,People's Hospital of Dongyang,Beijing Hospital,and Huaxi Hospital of Sichuan University.Susceptibility of enterobacteriaceae to ertapenem was tested by K-B method.MHT was used to detect carbapenemase in enterobacteriaceae and the common carbapenemase genes were amplified by using PCR.Results The total resistance rate ( resistance and intermediate resistance) of enterobacteriaceae to ertapenem was 3.04％ (113/3718) and there were differences in resistance rate of enterobacteriaceae to ertapenem among 4 hospitals (5.09％,2.15％,2.59％,and 1.72％,respectively).Of the 3718 isolates,2.29％ (85) were positive to MHT,and there were differences in positive rate to MHT among 4 hospitals (4.73％,1.21％,1.06％,and 1.58％,respectivdy).Of 113 non-susceptible isolates to ertapenem,82 were positive to MHT and 31 were negative.Of 85 MHT-positive isolates,82 were resistant or intermediate resistant to ertapenem and only 3 were susceptible.Of 82 MHT-pesitive and non-susceptible isolates to ertapenem,65 were positive to KPC gene,15 were positive to IMP gene (two of them were positive to both KPC and IMP),and 4 were negative to all tested carbapenemase genes.Thirty-one MHT-negative and nonsusceptible to ertapenem and 3 MHT-positive and susceptible isolates to ertapenem were negative to all tested carbapenemase genes.Conclusions MHT is used to detect carbapenemase in enterobacteriaceae with high sensitivity and low false positive rate.KPC gene is the most occurred gene to be dominant in the production of carbapenemase in enterobacteriaceae, and the IMP gene is also responsible to the genesis ofcarbapenemase in enterobacteriaceae..

Objective To investigate the effects of metformin and exaliplatin on proliferation and apoptosis of gastric cancer cell line SGC-7901. The antitumor effects of metformin combined with exaliplatin on gastric cancer cell line SGC-7901 were compared. Methods SGC-7901 cells were cultured in vitro. The proliferation inhibition rate of cancer cell after treatment with various concentrations of metformin(5.0,10.0,15.0 mmol/L)、exaliplatin(2.5,5.0,10.0 μmol/L)or 15.0 mmol/L metformin combined with 10.0 μmol/L exaliplatin was analyzed via MTT colorimetric assay at 24,48,72 h.After 24 h, the SGC-7901 cell apoptosis was detected by flow cytometry, and the relative activity of caspase-3 and bax was detected by western blot. Results The co-administration of metformin and exaliplatin or single agent treatment could increase the proliferation inhibition rates of SGC-7901 cell in a time-and dose-dependent manner, while there was a significant higher proliferation inhibition rate in co-administration versus single-agent treatment (P < 0.05). The apoptosis rate induced by 15.0 mmol/L metformin and 10.0 μmol/L exaliplatin and combined treatment was (16.0 ± 2.1)%, (19.0 ± 2.7)%, (29.0 ± 3.5)%, higher than that in blank control group (10.0 ± 1.1)%, and there was significant difference (P <0.05). Both of metformin and exaliplatin could increase caspase-3 and Bax activity.Caspase-3 and Bax activity in the combination of metformin and exaliplatin was significantly higher than that of metformin group and exaliplatin group (P < 0.05). Conclusions Metformin combined with exaliplatin has synergistic effect in inhibiting the growth and inducing apoptosis of gastric cancer cell line SGC-7901.Enhancing caspase-3 and Bax expression may be the related mechanism