Secreted rotein acidicand rich in cysteine (SPARC), belonging to a family of matricellular proteins, is a multifunctional calcium-binding glycoprotein. In tumors, it functions as de-adhesion, antiproliferation, and regulation of extracellular matrix (ECM) interactions. But in different tumors,SPARC performances different biological effects, as in melanoma, breast cancer, esophageal cancer, etc, SPARC is associated with a highly aggressive tumor phenotype, while in ovarian cancer, cervical cancer, non-small cell lung cancer,SPARC may function as a tumor suppressor.

Objective To observe the effect of small dose reteplase thrombolytic therapy on old patients with acute myocardial infarction(AMI).Methods Eighty-two old patients with AMI were divided into two groups by random digits table,each group had 41 cases.Control group was treated with recombinant streptokinase,and observation group was treated with small dose reteplase.The clinical effect,1 h and 2 h coronary artery recanalization rates between two groups were compared.Results After treatment 24 h,there was no significant difference in total effective rate and death rate between two groups(P＞ 0.05).The 1 h and 2 h coronary artery recanalization rates in observation group were significantly higher than those in control group[56.1％(23/41)vs.26.8％(11/41),63.4％(26/41)vs.39.0％(16/41)](P＜ 0.05).The mild bleeding incidence in observation group was significantly higher than that in control group(P ＜ 0.05),while there was no significant difference between two groups in severe bleeding incidence(P ＞ 0.05).Conclusion Small dose reteplase thrombolytic therapy on old patients with AMI is effective,which provide a safe and effective method for elderly patients unwilling or unable to accept the coronary angioplasty.

According to the records in Neijing (Internal Classic), this article discusses the relationship during the connotative evolution of mai (vessel) and jing (meridian) in the three aspects, named mai (vessels), the evolution from mai (vessel) to jing (meridian), and the connotation replacement of jing (meridian) with mai (vessel). The study results show that the connotation of Jingmai is originated from mai (vessel), but more enriched, which cannot be confused with each other. The recognition on the connotation of jingmai from mai (vessel) to jing (meridian) is the process of TCM understanding from concretization to abstraction, and from the entity to the concept. Jing (meridian) represents the law on the longitudinal and invariable running course of meridian, differenti from the perspective in western medicine in human body. This law results from the naive observation and is based on the rational summary and thinking, and it stands up the approval from practice. The description of jing (meridian) as mai (vessel) is just the superficial description of this term. In fact, its concept infers to the connotation of meridian.
China ; History, Ancient ; Humans ; Medicine in Literature ; Meridians ; Qi ; history

It has widely spread thta critical li lness is characterizedas a sat te of immunosuppression and inflammation,and patients are unable to provide their own nourishment.So it has lead to the ed velopment of un tritional support por ducts or interventions designed to enhance the host immune response and/or suppress the inflammation.But there′s still a lot of controversy about immunonutrition in critically ill patients.This pa-per reviewed the research status of immunonutrition and nutritional support products.

AIM: To investigate the effect and mechanism of Mingjing decoction combining with argon laser on the levels of plasma vascular endothelial growth factor (VEGF) in patients with diabetic retinopathy(DR).
METHODS:The 66 patients(118 eyes)with DR at Ⅲ ~ Ⅴstage were randomly divided into two groups (treatment group and control group). The control group (33 patients with 56 eyes ) was treated with argon laser, and the treatment group (33 patients with 62 eyes) was treated with mingjing decoction combining with argon laser, and a blank group(30 eyes) was set up. The levels of plasma VEGF were detected by enzyme linked immunosorbent assay (ELISA). The results of best corrected visual acuity and fundus fluorescein angiography(FFA) were analyzed, as well as detected glycosylated hemoglobin ( HbA1c), blood coagulation function and the function of liver and kidney.
RESULTS: Patients with DR had significantly risen plasma VEGF before treatment when compared with blank control group ( P < 0. 05 ). After 3mo of combined treatment, the levels of plasma VEGF significantly reduced and HbA1c decreased in patients treated with mingjing decoction and argon laser, there were statistically significant difference compared to control group ( P < 0. 05 ). In the treatment group, the best corrected visual acuity and FFA were significantly improved in patients treated with mingjing decoction combining with argon laser compared to patients treated with argon laser alone after 3mo of combined treatment. CONCLUSION: Mingjing decoction combining with argon laser for DR can effectively reduce the level of plasma VEGF, stabilize blood sugar levels, improve the function of retina, and delay DR progresses.

Objective To evaluate the value and significance of testing megakaryocyte micronuclei in bone marrow smears for hematopathy diagnosis.Methods Bone marrow smears from a total of 863 cases of patients with hemopathy were collected from 2002 to 2009 at the second affiliated hospital of zhejiang university school of medicine.Smears from 25 healthy individuals were used as control.The bone marrow smears were subjected to Wright-Giemsa staining.The number of megakaryocytes, morphous and positive rate of megakaryocyte micronucleis were recorded by using low power lens and immersion objective.Statistical differences of positive rate in the different diseases, pathologic subtypes, total number and type of megakaryocyte were analyzed.Results The megakaryocyte micronucleis were round or oval with varying size, distributed in paranuclear or away from nuclear and even free in extracellular, which could be observed in large and medium megakaryocytes.The positive rate of megakaryocyte micronucleis was highest in myeloid leukemia, particularly in the subtype of M6, M2, M4 and M5b with dyshaematopoiesis.Megakaryocyte micronucleis could also be found in MA, infection and benzolism, but rarely observed in the lymphocytic leukemia.Conclution The detection of megakaryocyte micronuclei was related with its amount, size and type.There is significant difference of the postive rates of megakaryocyte micronuclei testing among the different hematopathies and pathologic subtypes.Megakaryocyte micronuclei testing should be valuable in the the diagnoses of hematopathy.

[Summary] Obesity is the most important risk factor of essential hypertension.Obesity-related hypertention has become a worldwide problem.Many clinical studies show that bariatric surgery has significant therapeutic effect on essential hypertension, but the specific mechanism of the condition remains to be fully understood.This paper tried to explain the mechanism of the treatment of bariatric surgery for essential hypertension from the following two aspects: the reversal of the sympathetic disorder and the decline of plasma leptin.

To observe whether human aortic smooth muscle cells (SMC) may expressHLA-DR and DP antigens, we used ?-IFN and lymphocytes conditioned media (LCM) to induce SMC in vitro. The results showed that ?-IFN increased HLA-DR and HLA-DP expression on SMC by 80% and 73%, and LCM did so by 74% and 70% respec-tively. HLA-DR and DP (11% and 7%) in both groups were significantly higher thanthat of the control group. These results suggested that activated T lymphocytes may in-crease HLA-DR and HLA-DP antigens expression on human SMC by secreating ?-IFN (orwith other cytokines), which may play certain important roles in atherogenesis.

Objective To investigate the clinical effect of psychological intervention combined with insulin and glimepiride on the the treatment of elderly patients with diabetes. Methods 150 cases of elderly patients with diabetes in our hospital from July 2012 to March 2017 were treated as the research object, the single and double number (hospital admission order) 150 cases of elderly patients with diabetes were randomly divided into study group (n=75) and control group (n=75). The control group of elderly diabetic patients receiving insulin combined with glimepiride treatment in the study group received the basic treatment combined with psychological intervention. Results After treatement, 2 hPG, FBG and HbAlc were better than those in the control group (P<0.05). HAMD score in the study group after treatment decreased significantly than that before treatment(P<0.05). The difference of HAMD score in the control group had no statistically significant. Conclusion Psychological intervention combined with insulin and glimepiride on the treatment of elderly patients with diabetes can improve the depression, has a positive significance to improve the effect of blood glucose.

Objective To explore the use of mosapride citrate in treating reflux esophagitis and nursing intervention spitley effect. Methods In 40 cases of reflux esophagitis in patients with routine therapy, and classified as the control group, the other 40 patients in the control group based on the use of mosapride citrate. And classified as the observation group, two groups of patients were in our hospital from June 2015 to January 2017. Results The study in the treatment of the two groups of patients with effective rate of 95.0%, the observation group was significantly higher than the control group 80.0%, between the two groups showed significant differences (P<0.05). The adverse effects of more than two groups found, two groups of patients with adverse reaction incidence was no significant difference, that shows no significant difference. Conclusion Mosapride citrate in reflux esophagitis treatment and intervention effect analysis found that the compared with conventional therapy, can be in At the same time, it can improve the curative effect of the patients, and will not increase the possibility of adverse reactions, so it is worthy of clinical reference.