BACKGROUND:Morinda has been reported to promote the proliferation, the secretion of alkaline phosphatase and osteocalcin, and mRNA expression of transforming growth factor of osteoblasts. However, little information is available addressing the effects of Morinda on receptor activator of nuclear factor-κB expression in osteoclasts in rats with osteoporosis. OBJECTIVE:To study the effects of Morinda on receptor activator of nuclear factor-κB expression in osteoclastsofosteoporosis rats. METHODS:Thirty Sprague-Dawley rats were equaly and randomly divided into Morinda and 17β-estradiol groups. Rat models of osteoporosis were established by bilateral ovariectomy, and then 5 mL of Morinda decocta(1.0mmol/L)and 17β-estradiol (1×10-6mmol/L) were administered intragastricaly to rats in Morinda and 17β-estradiol groups for 3 consecutive months, respectively. Primary osteoclasts were isolated from rats in both groups, andthen cultured for 3, 6 and 9 days folowed by TRAP staining andcelcounting. Bone mineral density of the proximal and distal femur, urine and serum levels of Ca2+and progesterone, and receptor activator of nuclear factor-κB expression in osteoclasts ofrats in both groups were determined. RESULTS AND CONCLUSION:Osteoclast fusion was reduced in Morinda group. In contrast, number of osteoclastswas increased andcels becamemore maturein the17β-estradiol group. Bone mineral density of the proximal and distal femur bilateraly, urine and serum levels of Ca2+and progesterone were significantly increased, while receptor activator of nuclear factor-κB expression was significantly decreased in osteoclasts in Morinda group compared with 17β-estradiol group (P< 0.05). These results indicate that Morinda reduces receptor activator of nuclear factor-κB expression in osteoclasts in osteoporosis rats, thereby inhibiting the development and progression of osteoporosis.

As a heteronomy,the code of medical ethics plays an important role in sustaining the trust between physicians and patients.Based on a comparative analysis of the domestic and foreign codes of medical ethics,and field survey on such trust at tertiary hospitals in Beijing,as well as medical providers’moral characteristics,this article analyzed the causes that “goodwill”is insufficient in the trust in terms of internal and external factors;and then,in respect of heteronomy as a basis,it put forward suggestions to improve code of medical ethics in order to rebuild such trust.

Physician-patient trust is the basis of informed consent,and the informed consent institution is supposed to strengthen the trust.However,it affects trust in an opposite way in practice. This research aimed to analyze the relationship between informed consent and physician-patient trust,and provide with the advice,recommending on such rebuilding.

The study found that the physician-patient trust crisis results from overreliance on technology trust instead of interpersonal trust and institutional trust. The alleged “Paternalistic government innovation”in healthcare service has caused wastes of healthcare resources and gap below public expectancy due to its incompetence in resolving social problems,further eroding institutional legality and intensifying such crisis.This research aimed to identify government accountabilities in building such trust from three aspects.

Objective To evaluate the safety,effectiveness,and middle or long-term efficacy of endovascular stenting of internal carotid artery stenosis at the cavernous segment. Methods Thirty-two patients underwent endovascular stenting at the cavernous segment of internal carotid artery from January 2012 to February 2015 were enrolled retrospectively. Angioplasty and stenting were conducted using Apollo or Winspan stent system. The improvement of internal carotid artery cavernous segment stenosis and perioperative safety and the results of the medium and long-term follow-up of the 2 kinds of stents were observed. Results All the 32 patients achieved technical success. The symptoms of cerebral ischemia of the patients were relieved significantly. The length of the stenosis at cavernous segment of the internal carotid artery was 4 to 13 mm (mean,7. 2 ±2. 9 mm). The stenosis rate from 82 ± 7% before treatment decreased to the 24 ± 7% . One patient had perioperative complication (4. 7%),26 of them were followed up with DSA,and 6 were lost to follow-up. The follow-up period ranged from 7 to 29 months (mean,16 ± 7 months). During the follow-up period,1 patient had intracerebral hemorrhage,1 had cerebral infarction,and none of them died. Four patients had in-stent restenosis,three of them used Winspan stents, and 1 used Apollo stents. Conclusion The patients should be screened strictly,particularly paying attention to the length of lesions. Endovascular stent angioplasty for the treatment of internal carotid artery cavernous segment stenosis is a safe and effective method.

Background and purpose:Tumor suppressor gene P53 has long been studied in tumors, including breast cancer. More studies focused on the relationship between P53 and prognosis of breast cancer and found that P53 overexpression suggested a bad prognosis. However, the effect of P53 on early stage postmenopausal patients with ER-positive breast cancer has not been clariifed yet. This study was to investigate the role of P53 plays in aromatase inhibitor (AI) resistance among early stage postmenopausal patients with ER-positive breast cancer patients. Methods:A total number of 293 operable breast cancer patients who received surgical treatment during Jul. 2000 to Jul. 2006 in Fudan University Shanghai Cancer Center were enrolled into this study. All patients received AI treatment. The SPSS 12.0 software was used to estimate the survival rate. Univariate and multivariate analysis were also performed via above software. Results:The median follow-up time is 72 months (6-140 months). The 5 year disease free survival (DFS) of P53 positive and negative were 78%and 89%. The results showed that P53 overexpression (HR=1.729, 95%CI:1.038-2.880, P=0.035), pathological stage (HR=2.270, 95%CI:1.399-3.681, P=0.001);histological grade (HR=2.328, 95%CI:1.312-4.133, P=0.004); age (HR=1.988, 95%CI:1.511-2.617, P<0.005) were still the independent risk factors of recurrence and metastasis in breast cancer patients treated with AI. Conclusion:P53 overexpression correlated strongly with AI resistance in early stage postmenopausal patients with ER-positive breast cancer patients who were treated with AI and conifrmed the relevance of previously described prognostic factors. It is reasonable to take P53 expression into account when we evaluate the risk of breast cancer patients and decide the anti-cancer treatment strategy.

Obej ctive Abnormal proliferation of T cells plays an important role in the development of autoimmune diseases. The article aimed to study the inhibitory effect of small molecule compound BD691 on T cell proliferation and its mechanism. Methods Human peripheral blood T-lymphocytes were isolated and purified by the immunomagnetic microbeads,then T cells were ac-tivated with anti-CD3/CD28 mAbs or alloantigen.The inhibitory effect of BD691 on activated T cell proliferation, the cytotoxic effect BD891 on resting T cells and the expression of activated T cells marker CD25 were measured by flow cytometry.Furthermore, ELISA was used to detect the secretion of cytokines associated with T cell differentiation. Results BD691 significantly inhibited the prolif-eration of T cells being stimulated by anti-CD3/CD28 mAb or alloantigen in a dose-dependent manner, and IC50 values are (8.5 ± 1.5)μmol/L and (7.2 ±1.3)μmol/L, respectively.However, BD691 had no obvious cytotoxic effects on resting T cells and periph-eral blood mononuclear cells, even at a high concentration ( up to 100μmol/L) .In T cells which were not activated by anti-CD3/CD28 mAb, the percentage of CD25+T cells is only 1.6%of the total cells, while the number increased to 68% after activating treatment.Mean-while, in T cells which were activated by 0, 3.3, 10, 30μmol/L BD691, no obvious change of CD25 expression were observed, while immunosuppressant FK506 (0.1μmol/L) significantly decreased the expression of CD25 +T cells (14.9%).In unactivated T cells, 95.6%cells were at G0/G1 phase, while after activation, the percentage of cells at G0/G1 phase reduced to 57.7%.In addition, BD691 inhibited the secretion of IFN-γ, IL-6 and IL-17 in activated T cells, but had no effects on the secretion of IL-2, IL-4 and IL-10. Co nclusion BD691 exerts no effects on T cell activation, but it inhibits T cell proliferation by inducing T cell cycling arrest at G0/G1 phase.Moreover, BD691 inhibits the secretion of key cytokines (such as IFN-γ, IL-6, IL-17) closely related to the differ-entiation of Th1 and Th17 cells.The results suggest that BD 691 is a potential lead compound to develop a new immunosuppressant for the inhibition of abnormal proliferation and differentiation of T cells.

Objective:To understand the status of outpatients′medical care and their impact on the doctor -pa-tient trust in Beijing .Methods:Three tertiary hospitals were selected due to most concentrated high -quality medi-cal resources , the largest number of patient visits , universalism and particularism trust could be compared , taking field observations , personal interviews and questionnaires methods .Results:The main factors affecting clinical doctor-patient trust are time, the doctor skills, medical ethics, medical and prescription drug division , etc.are appropriate and effective .Conclusion:Play the role of pyramidmedical system′s overall effectiveness , and es-tablish a patient-centered system for outpatient care as soon as possible a comprehensive grasp of the overall con -struction team doctor , continue to strengthen the standardized management of medication .

Objective Benzothiazole derivative BD960 has immunosuppressive activity after cell -based assays for high-throughput screening.The paper aimed to investigate the involved mechanism of BD960 on T cell proliferation. Methods Human peripheral blood T-lymphocytes were isolated and purified by the immunomagnetic microbeads.Then the T cells were activated by anti-CD3/anti-CD28 mAbs or alloantigen.The effect of BD960 on activa-ted T cell proliferation, the cytotoxic effect BD960 on resting T cells and the expression of activated T cells marker CD25 were measured by flow cytometer.Cytokine levels, including IL-2, IL-4, IL-6, IL-10, IL-17A and IFN-γ, were determined by ELISA. Results BD960 significantly inhibited the proliferation of T cells stimulated by anti-CD3/anti-CD28 mAb or alloantigen in a dose-dependent manner.The IC50 value is (2.3 ±0.3)μmol/L or (2.5 ±0.3)μmol/L, respectively.Moreover, BD960 had no obvious cytotoxic effects on rest-ing T cells and peripheral blood mononuclear cells, even at a high concentration ( up to 100μmol/L) .The ratio of CD25 expression on T cell was 69.7%after stimulated by Anti-CD3/CD28 mAbs with 72 h, the concentration (0.625、2.5、10)μmol/L of BD960 also had no potent effects on the ratio, but 0.1μmol/L FK506 could inhibit CD25 expression as low as 9.4%.The G0/G1 phase of activated T cells was 58.5%after stimulated by BD960 with 96 h.BD960 could induce cell cycle arrest at the G0/G1 phase in activated T cells with the increase of concentration and RAPA in the concentration of 0.1 μmol/L was 91.5%.In addition, BD960 (0.625、2.5、10)μmol/L could inhibit the secretion of IFN-γ, IL-6 and IL-17 in activated T cells with the increase of concentration, without any effects on the secretion of IL-2, IL-4 and IL-10. Conclusion BD960 not only exerts the inhibition on the late stage of T cell activation of cell proliferation but also inhibits the secretion of inflammatory cytokines, such as IL-6, IL-17 and IFN-γ, while the mechanism of BD960 on T cell proliferation was not the same as FK506.As a result, BD960 has the potential to be the lead compound to develop a new immunosuppressant.

Objective:To evaluate the safety and feasibility of endovascular recanalization for non-acute internal carotid artery occlusion (NA-ICAO), and to propose a new angiographic classification.Methods:From April 2015 to October 2019, 95 consecutive patients with symptomatic NA-ICAO who received endovascular recanalization were retrospectively analyzed in Beijing Tiantan Hospital, Capital Medical University. All the patients were divided into four groups according to DSA: type Ⅰ, petrous segments were distally reconstituted by collateral vessels; type Ⅱ, cavernous segments were distally reconstituted by collateral vessels; type Ⅲ, ophthalmic segments were distally reconstituted by collateral vessels; type Ⅳ, communicating segments were distally reconstituted by collateral vessels. Study data including clinical characteristics, surgical details, lesion classification, recanalization rate and perioperative complications. For the counting data, the χ 2 test was used to compare between groups. For the quantitative data, the ANOVA was used for the normal distribution data, otherwise the Kruskal-Wallis H test was used. The primary safety outcome was any stroke or death within 30 days. Results:Among the 95 patients, 67 (70.53%) had successful recanalization. The recanalization rates of type Ⅰ－Ⅳ were 92.31% (36/39), 81.82% (18/22), 47.83% (11/23) and 18.18% (2/11) respectively (χ2=29.557, P<0.001). And the complication rates of the four types were 5.13% (2/39), 13.64% (3/22), 21.74% (5/23) and 9.10% (1/11) respectively. The incidence of perioperative ischemic stroke was 2.11% (2/95). No other serious stroke and death occurred. Conclusions:Endovascular recanalization may be feasible and safe for carefully selected patients with NA-ICAO and therefore represents an alternative treatment. The patients with type Ⅰ and Ⅱ lesions had higher recanalization rates, while the patients with type Ⅳ lesions had significantly lower recalculation rate. The new angiographic classification is conducive to the selection of suitable patients and difficulty in grading.