Methotrexate (MTX)was linked covalently to monoclonal IgG antibody (AU_(14-1)) to a mouse uterine cervical cancer with the use of dextran T-40 as the intermediate carrier. The molar ratio of IgG: MTX was 1: 20 in the conjugate. The conjugate retained full antibody binding activity at the AU_(14-1) concentration of 3.75?10~(-8) M measured by an indirect membrane immunofluorescence assay. The in vitro experiments confirmed that the conjugate not only showed target-selective antitumor effecacy but also was proved to be more effective in inhibiting the growth of HeLa cells than the effect of U_(14) cells, so that it confirmed the "evolutionary antigen" theory. It is suggested that AU_(14-1)-Dex-MTX conjugate may have good potentiality in clinical application.

Objective To observe and study the influence state of ulinastatin for multi system function state of patients with acute abdomen during the the perioperative period.Methods 60 patients with acute abdomen treated with operation in our hospital during the time of October 2015 to July 2016 were selected as the research object, and they were randomly divided into control group ( conventional perioperative treatment group ) 30 cases and observation group(conventional treatment and ulinastatin group)30 cases,then the liver function,renal function,gastrointestinal function and immune function related indexes of two groups before the operation and at second,fifth and seventh day after the operation were detected and compared.Results The liver function,renal function,gastrointestinal function and immune function related indexes of two groups before the operation were compared ,,while the liver function,renal function,gastrointestinal function and immune function related indexes of observation group at second,fifth and seventh day after the operation were all significantly better than those of control group(P<0.05),those detection results of two groups after the operation all had significant differences.Conclusion The ulinastatin can effectively protect multi system function state of patients with acute abdomen during the the perioperative period,so its application value in these surgical patients is higher.

Objective To introduce the different therapeutic methods for the different types of traumatic pseudoaneurysms. Methods Traumatic pseudoaneurysm was treated in 8 patients. Intraarterial embolization was performed with gelfoam in 3 patients for terminal type. Endovascular covered stent graft was inserted in 2 patients with trunk type. One patient with branch type, we used metallic coils to embolize both broken ends. One patient with perforation in femoral artery was treated with compression. For 1 patient with huge haematoma and pseudoaneurysm, operation for elimination the haematoma was performed after embolization. Results Pseudo- aneurysm kept closed after treatment achieved in all 8 patients. Distal arterial pulse was normal in 2 patients treated with stent graft. A new pseudoaneurysm presented as a complication at puncture site in 1 patient due to other factors. There were no other symptomatic complications. Conclusions Pseudo- aneurysms can be treated effectively with interventional techniques instead of surgical operation.

Objective The evaluation and possibility of percutaneous fenestration for ischemic complications of aortic dissection were disccused. Methods A male patient with aortic dissetion (type: DeBakey Ⅲb) accompanyed by lower extremities pararises was undertaken percutaneous fenestration. Results Both the lower leg's blood flow was recovered with symptom free. Bilateral femoral and dorsal foot pulsations could be feeled. Conclusion Percutaneous fenestration for ischemic complications of aortic dissection is a safe and effective management, but should be done earlier.

Objective To study the clinical value of capsule endoscopy for small bowel diseases in pediatric and adolescent patients.Methods Clinical data of 61 pediatric and adolescent patients who underwent capsule endoscopy from February 2007 to April 2014 was respectively analyzed.The positive diagnostic results and safety were observed.Results Of 61 patients,the CE procedures were completed successfully in 58 patients,and failed in 3 patients because of the gastric stasis.Forty-one positive lesions were found in small intestine,and the detection rate was 70.69％.Positive findings included angiodysplasias,Crohn' s disease,Meckel diverticula,ulcer,P-J syndrome,protrusion lesion and enteritis,etc.Finally,29 patients were confirmed (50％),3 (5.17％) were misdiagnosed and 1 (1.72％) was missed.Twenty-two patients underwent other small bowel examinations besides the capsule endoscopy.And the accuracy of capsule endoscopy was 81.82％.All capsules were successfully swallowed by the patients and evacuated within two weeks.No complications such as capsule retention or intestinal obstruction occurred.Conclusion Capsule endoscopy is a safe and well tolerated procedure with high diagnostic rate,which has a prospective clinical value in small bowel diseases in pediatric and adolescent patients.

Objective: To observe influence of different risk factors on prognosis of patients with coronary heart disease (CHD) and normal myocardial perfusion imaging outcome.Methods: A total of 99 CHD patients with normal myocardial perfusion imaging outcome were selected.Left ventricular function indexes were measured by gated resting myocardial imaging in resting and stress state.All patients received telephone follow-up until natural death (died of other causes) or fatal or non-fatal heart attacks, or the termination of the experiment after 45 months.Cox proportion risk regression model was used to analyze risk factors of fatal and non-fatal heart attacks.Results: A total of 15 cases died during the 45-month follow-up.Mean all-cause mortality per year was 5.05%.Fatal heart attacks occurred in nine cases (9.09%), and non-fatal heart attacks occurred in 21 cases (21.21%).Cox proportion risk regression analysis indicated that smoking and left ventricular ejection fraction (LVEF) <50% were risk factors for fatal heart attacks (HR=4.887, 3.365, P=0.043, 0.002), while diabetes mellitus, dyslipidemia, smoking and LVEF<50% were risk factors for non-fatal heart attacks (HR=2.215~4.544, P<0.05 all).Conclusion: Incidence rate of cardiovascular events is higher in CHD patients with normal myocardial perfusion imaging.Smoking and impaired heart function suggest poor prognosis in these patients.

In this article,the authors analyzed the current status of the therapeutic effect evaluation of TCM and proposed some measures to improve the current therapeutic effect evaluation of TCM,quantificated messages from TCM four diagnostic methods,explored biological parameter reflected essence of diseases,introduced quality of life scale and PRO,in the hope of establishing a comprehensive system of therapeutic effect evaluation reflecting the superiority and characteristics of theory of body and spirit.

The article searched ancient literature from pre-Qin to Qing Dynasty,researched the character meaning,implication of physique and spirit,and the historical evolvement process of view of physique-spirit unity(ghost theory-sporadic physique and spirit theory-systemic view of physique-spirit unity-view of physique-spirit unity combined with Chinese medicine)so that the view of physique and spirit can be applied to medical domain preferably,which will help the clinic diagnosis and treatment.

Objective To study the features and reasons of violent events in medical staff and the public sentiments on them based on a network analysis. Methods The data of violent events in medical staff were down-loaded from Internet. The annual and geographic distribution and reasons of violent events in medical staff, casualties of medi-cal staff and the public opinions on the major Websites were analyzed. Results The number of violent events in medical staff increased to 31 in 2012 from 1 in 2003. The violent events were distributed in 18 provinces of China, the number of casualties was 105 , and 53% of the violent events occurred due to the unsatisfactory therapeutic out-comes in patients. Conclusion The public sentiments on violent events in medical staff tend to increase on Internet and characterized by no signs and direct conflict between patients or their family members before attacking medical staff, and against general medical staff. Public sentiments on violent events in medical staff are easy to become hot events with significant negative effects on the society. Medical institutions and hospitals should prevent such events and play an active role in guiding the public sentiments.

Background and purpose: Pancreatic intraepithelial neoplasia (PanIN) may be a precursor lesion of inifltrating pancreatic ductal adenocarcinoma. The mutation of the phenotypic impact of K-ras G12D alone, silencing of p53 and p16 could promote this process. The role of Smad4 in this progression was poorly understood. In our previous studies, we investigated that RNA interference silence of Smad4 to promote the PanIN cell malignant transformation. In the present study, we investigate. The further explores the siRNA interference of Smad4 expression on PanIN cells could lead to proliferation and metastasis in vitro and in vivo. Methods:Smad4 knock-down PanIN cells (PanIN-S) were established by stable transfection with lentiviral-mediated Smad4 RNA interference. In vitro,silence of Smad4 enhanced the proliferation of PanIN cells as determined by cell counting. A soft agar assay was used to assess the anchorage-independent growth ability of cells. Cell migration and invasion assays were performed using transwell chambers with or without Matrigel. In xenograft model experiments, PCNA, VEGF and MMP-9 staining was separately used to evaluate cell proliferation and angiogenesis and migration (VEGF and MMP-9). Results:Effect of siRNA of Smad4 gene in PanIN cells was conifrmed by real-time RT-PCR and western blot. In vitro, silence of Smad4 enhanced the proliferation of PanIN cells as determined by cell counting. Soft agar assay showed that there were more colony cell numbers in PanIN-S cells compared with PanIN cells (P<0.05). Using the transwell assay, we observed that PanIN-S cells migrated faster than PanIN cells and similar results were obtained by Matrigel assay (P<0.05). Furthermore, immunohistochemical analysis of the harvested tumors suggested that Smad4 silencing was associated with cell proliferation (PCNA reactivity) and angiogenesis and migration (VEGF and MMP-9), and the expressions of PCNA, VEGF and MMP-9 in PanIN-S group were signiifcantly increased (P<0.05). Conclusion:Silence of Smad4 in PanIN cells enhanced progression to invasive adenocarcinoma of the pancreas by promoting cell growth, migration and invasion. Smad4 might be a new diagnostic marker in pancreatic cancer and prove to be a feasible and novel target for therapeutic intervention.