Primary biliary cirrhosis (PBC)is an autoimmune disease.Ursodeoxycholic acid (UDCA)is the only safe and effective drug for the treatment of PBC,as proved by randomized controlled clinical trials,so it is advocated as first-line therapy.Alternative therapies are urgently needed for patients with poor response to UDCA.In addition to the efficacy of UDCA,the classification of alternative and adjuvant therapies for UDCA nonresponders and the latest research progress in these therapies are reviewed;the efficacy of existing drugs and treat-ment prospects are evaluated,but more long-term clinical studies are needed to confirm the efficacy of immunosuppressants such as budes-onide and etanercept and other drugs.A number of novel molecular therapies for PBC are also undergoing clinical trials.There is currently no consensus on the medical treatment for patients with poor response to UDCA.Although studies have shown that some drugs can improve liver function and liver biochemistries,there is no definitive evidence that they improve long-term outcome.

Objective: To elucidate the relationship between Notch3 expression and chemosensitivity of human colon carcinoma cell line SW620 to topotecan. Methods: Notch3 siRNA was transfected into SW620 cells, and the expression of Notch3 in SW620 cells was examined by Western blotting. After transfected with Notch3 siRNA for different time peri-ods, SW620 cells were further treated with topotecan, and the proliferation of SW620 cells was detected by MTT assay; the apoptosis of SW620 cells was detected by Hoechst 33342 staining and flow cytometry. Caspase-3 activation in SW620 cells was examined by caspase-3 activation kit. Results: Notch3 siRNA transfection remarkably inhibited Notch3 protein expression in SW620 cells. The IC_(50) of topotecan in Notch3 siRNA-transfected group was significantly decreased compared with that in the Ctrl siRNA group (P <0.05). Silence of Notch3 expression in SW620 cells by Notch3 siRNA remarkably promoted apoptosis (P < 0.05) and caspase-3 activation (P < 0.05) of SW620 cells induced by topotecan. Conclusion: Notch3 down-regulation by siRNA in SW620 cells can enhance the chemosensitivity cells to topotecan.

Objective:To construct pEGFP-C1-Smad4 expression vector and to observe the influence of Smad4 over-expression on the proliferation of human gastric cancer SGC7901 cells and its relationship with nuclear factor kappa B (NF-?B). Methods:Recombinant expression vector pEGFP-C1-Smad4 was constructed and was used to transfect human gastric cancer SGC7901 cells. EGFP expression in transfected cells was detected by fluoroscopy. Smad4 and NF-?B expression in transfectant was examined by Western blotting. Effect of Smad4 over-expression on activation of NF-?B and proliferation of transfected SGC7901 cells were examined by electrophoretic mobility shift assay (EMSA) and MTT assay,respectively. Results:Expression of EGFP in transfected SGC7901 cells was observed under fluorescence microscope. Smad4 was over-expressed in transfected SGC7901 cells,accompanied by down-regulation of NF-?B p65 expression in the tranfectants. EMSA and MTT demonstrated that Smad4 over-expression significantly inhibited the activation of NF-?B and the proliferation of SGC7901 cells (P

Objective To explore the regulatory function of over-expression of NOTCH-1 in TNF?-induced apoptosis of gastric carcinoma carcinoma BGC-823 cells.Methods BGC-823 cells were infected with retrovirus recombined with intracellular domain of NOTCH-1.The cell clones,into which objective genes had been transfected,were obtained after screening with G-418.Before and after incubation with TNF?,MTT assay,flow cytometry,Western blot and EMSA were used to detect cell growth,apoptosis,expressions of NOTCH-1,NF-?B and caspase-3 activity.Results There was stronger expression of NOTCH-1 and its target gene HES-1 in the cells transfected with NOTCH-1 gene than that of control.After TNF? treatment,the rates of killing and apoptosis in NOTCH-1-transfected cells were all lower than those in control cells.Moreover,we showed over-expression of NOTCH-1 suppressed caspase-3 activation induced by TNF?.However,TNF?-induced activation of NF-?B was not affected by over-expression of NOTCH-1.Conclusion Over-expression of NOTCH-1 significantly protects BGC-823 cells from apoptosis and growth suppression induced by TNF?.This effect is mediated,at least in part,through inhibition of caspase-3 activation independent of NF-?B.

Objective To investigate the intervention of Chinese herb Shengjiang San(SJS)for the imbal-ances of serum Th1/Th2 cells and related regulatory factors in sepsis patients. Methods Fifty-five sepsis patients were randomly divided into two groups:conventional treatment group of 27 cases and SJS group of 28 cases. Nine cases of healthy volunteers were enrolled as control group in the study. Cases of conventional group were treated with western medicine only and cases of SJS group were treated with both western medicine and Chinese herb SJS (100 mL twice one day). The therapy course of both groups was 3 days. Score of Chinese medical syndromes ,se-rum level of leukocyte count,C reactive protein(CRP)and procalcitonin(PCT),serum T-bet,GATA-3,Th1&Th2 cells in the proportion of whole CD4+Th cells and Th1/Th2 ratio were compared respectively in each group be-fore and after treatment. Results There were significant differences between SJS group and conventional group in score of Chinese medical syndromes,serum level of leukocyte count,T-bet,GATA-3,Th1&Th2 cells in the pro-portion of whole CD4+Th cells and Th1/Th2 ratio(P<0.05 or P<0.01). There were no significant differences be-tween the two groups in serum level of CRP,PCT and GATA3. Compared with control group,there were signifi-cant differences in all indicators except GATA3 of the two groups(P<0.01). Conclusion Chinese herb Shengji-ang San has an effective benefits to Chinese medical syndromes,inflammatory reaction,the imbalance of serum Th1/T2 and related regulatory factors(T-bet&GATA-3)in sepsis patients.

Objective:To analyze the clinical applicability of the sixth edition of nursing measures classification in children's general surgery, to provide a basis for standardizing clinical nursing terms and to promote the clinical use of standardized terminology of nursing measures.Methods:The research method of this study was mapping method. The electronic nursing records of the general surgery of Shanghai Children′s Medical Center Affiliated to Shanghai Jiaotong University School of Medicine from October 1st to December 31st, 2018, including the records of care records for free entry and the records of nursing measures related to medical orders were selected. The degree of matching between electronic care records and classification of nursing measures (sixth edition of nursing measures classification) was compared with conceptual consistency. Difficulties and time-consuming analysis of the characteristics of the standardized care measures obtained by matching.Results:A total of 4 560 independent electronic care records mapped 86 treatments in seven areas. Among them, 98.84% (4 507/4 560) of the nursing records were completely matched with the nursing measures, 0.83% (38/4 560) of the nursing records were partially matched with the nursing measures, and 0.33% (15/4 560) of the nursing records did not match the nursing measures. Difficulty and time-consuming were expressed as standard deviation, which were 2.20±0.45 and 2.03±1.25 respectively.Conclusions:The classification of nursing measures can be used to describe the daily behavioral activities of the children's general surgery nurses, and can also solve the standardization problem of the nursing records in the presentation, and is suitable as a standardized nursing language for the nursing records of children's general surgery.

Objective To investigate the changes of VCAM-1 and ICAM-1 levels in tumor and peripheral blood in pancreatic cancer patients. Methods 28 cases with pancreatic cancer were selected from August 2013 to Octorber 2014 as experiment group,28 cases with acute pancreatitis who needed removal of pancreas as control group,28 healthy people as normal group.ICAM-1 and VCAM-1 in tissue were compared and sVCAM-1 and sICAM-1 in serum were compared.Results ICAM-1 and VCAM-1 in tissue of experiment group were significantly higher than normal group(P<0.05), sICAM-1,sVCAM-1 in serum of experiment group were higher than control group and normal group(P<0.05),there were no correlation between CEA and sICAM-1,sVCAM-1 in serum of experiment group(r=0.116,P>0.05;r=0.093,P>0.05),there were positive correlation between CA19-9 and sICAM-1,sVCAM-1 in serum of experiment group(r=0.573,P<0.01;r=0.435,P<0.05).Compared with pre-operation, the serum concentrations of sVCAM-1 and sICAM-1 were lower(P<0.05).Conclusion ICAM-1 and VCAM-1in pancreatic cancer patients are significantly higher than that in acute pancreatitis patients and healthy people, the correlation of ICAM-1 and VCAM-1 expression in pancreatic cancer, early diagnosis and treatment of pancreatic cancer has important significance.

BACKGROUND:Cam-type femoroacetabular impingement can impose elevated mechanical loading in the hip, and may eventual y result in hip osteoarthritis, while mechanical mechanism on how this deformity leads to osteoarthritis is stil unclear.
OBJECTIVE:To analyze intra-articular mechanical environment of Cam-type femoroacetabular impingement in hip joint using three-dimensional finite element method, and to further understand the features of pathological mechanics.
METHODThree-dimensional geometry models of normal and Cam-type femoroacetabular impingement joints were constructed using Mimics and Hypermesh software with the CT data of normal hip joint. These hip models were imported into LS-DYNA analysis system, then dynamic loads and motions for standing up and sitting down were applied to al joint models. Intra-articular cartilage contact pressures and stresses were analyzed in normal hip joint and hip joint with Cam-type femoroacetabular impingement.
RESULTS AND CONCLUSION:Based on CT data, models of normal hip joint and hip joint with Cam-type femoroacetabular impingement including articular cartilage for three-dimensional finite element analysis were accurately constructed. Peak contact pressures were 4.43 and 4.59 MPa at the anterosuperior region of the acetabular rim during sitting down and standing up. The peaks of Cam-type femoroacetabular impingement hip joint were 14.96 and 14.86 MPa. Peak pressures and stress concentration were found at the anterosuperior area of acetabular rim. High contact pressure at the acetabular cartilage may be the mechanical mechanism of osteoarthritis induced by Cam-type femoroacetabular impingement.

BACKGROUND:Alpha-calcium sulfate hemiydrate/biphasic bioceramics (α-CSH/BCP) as a bone repair material has been widely used in the clinic, but there are stil some deficiencies. OBJECTIVE:To observe the effect of α-CSH/BCP on the repair of bone defects of the radius in rabbits. METHODS:The unilateral radius of 18 adult New Zealand white rabbits was selected to establish bone defect models, and then these rabbit models were randomized into three groups that were treated with α-CSH,α-CSH/BCP, BCP materials, respectively. At 4, 8, 12 weeks after implantation, bone samples were taken for gross and X-ray observations. RESULTS AND CONCLUSION: (1) Gross observation: At 12 weeks of implantation, the bone defect was completely repaired in the α-CSH/BCP group, and the defected radius recovered basicaly; in the α-CSH group, bone defects were visible; and in the BCP group, there was stil some material for filing and coverage. (2) X-ray observation: In the α-CSH group, the degradation of implanted materials was faster than new bone formation, and bone defects were visible; in the α-CSH/BCP group, bone defects were healed, cortical bone remodeling was good, and the bone marrow cavity was re-canalized; in the BCP group, the implanted materials were stil visible, and bone defects were not repaired. These findings indicate that the α-CSH/BCP bone repair material can significantly promote the repair of bone defects of rabbit radius, with a better repair effect than α-CSH or BCP alone.

To investigate the damage on macrophage of the commercial peritoneal dialysis solution(CDS). Methods Macrophages were seperated from peritoneal fluid remained overnight of seven CAPD patients and TNF-a level of supernatant was determined and compared with those macrophages from uremic patients not yet recieving peritoneal dialysis. Results TNF-a levels of different glucose concentration decreased obviously in experimental group compared with control group, especially lower in 2.5% and 4.25% group. Conclusion In vivo experiment confirms that CDS possesses a long time inhibition on macrophage and this inhibition varies with different glucose concentrations.