Multidrug resistance (multidrug,resistance,MDR) is the result of joint action of a multi mechanism results,including the abnormal expression of multidrug resistance gene,drug targets down etc.MDR is one of the main reasons for the failure of cancer chemotherapy,so the study of MDR reversal agents has become a research hotspot at home and abroad.Due to chemical medicine reversal agent toxicity,target is single,limited application,Traditional Chinese medicine is safe and effective,multi targets and low cost advantage,This paper summarizes the research progress of Chinese medicine to reverse MDR in breast cancer.

Objective To investigate the relationship between the whole blood detection of 0-13 years old children infected with trace elements of magnesium ,zinc ,copper ,ferrum and calcium ,and infectious diseases .Methods we were measured the whole blood trace elements by the atomic absorption spectrometry in a population of 1 183 cases of infectious diseases ,the infection group were made up of the male 638 cases and female 545 cases ,according to the different infection system was divided into 828 infectious cases of the respiratory system ,251 cases in digestive system infection ,104 cases in other system infection .The control group used earlier to our hospital outpatient department of Pediatrics voluntary to examine for the healthy children in 160 cases ,including male 96 ca‐ses ,female 64 cases .Results Zinc ,ferrum and calcium that infectious diseases group compared with the control group was obvious difference(P<0 .05) .The trace elements that compared with the different age groups or the different infectious diseases were also difference ,In the middle of infectious diseases the lack of zinc ,ferrum ,calcium children aged 0-13 years old accounted for 14 .2% , 10 .3% ,6 .7% .Magnesium and copper′s deficiency is rare .Conclusion Children of infectious diseases aged 0 to 13 years show the lack of zinc ,ferrum ,calcium ,so we could have reasonable supplement according to the specific circumstances .

BACKGROUND:With the development of minimal y invasive technique, more and more forearm fracture, especial y in children, was treated by elastic stable intramedul ary nailing. Recently, elastic stable intramedul ary nailing was also used in elder children, even adults. In particular, this technique has obtained good curative effects for open fracture and unstable fracture. OBJECTIVE:To evaluate the clinical effectiveness and safety of elastic intramedul ary nail and plate fixation for double fracture of forearm using evidence-based medicine. METHODS:We retrieved PubMed, Embase, Cochrane Library, China Biology Medicine, VIP, China National Knowledge Infrastructure, WanFang, and other electronic databases. The quality of the included studies was assessed using Cochrane Systematic Review. The analysis was performed using RevMan 5.2 software. RESULTS AND CONCLUSION:A total of 7 randomized control ed trials involving 468 cases were included. The results of meta-analyses showed that compared with plate fixation group, effective rate was higher in the titanium elastic nail group (P<0.000 1), the time of fracture healing was shorter (P<0.000 01), and the hospitalization time was shorter (P<0.000 01). In the aspect of adverse reactions, incidence of refracture (P=0.03) and breakage of internal fixation (P=0.03) was significantly lower. These indicated that compared with plate fixation, titanium elastic nail can improve the total effective rate, shorten the time of fracture healing on X-ray and the hospitalization time, at the same time, can effectively reduce the complications of refracture and breakage of internal fixation.

Objective To establish a method for measuring serum content of gentiopicroside in Beagle dogs and to explore its internal pharmacokinetic features. Methods The rapid and sensitive HPLC method was adopted as external standard. After intravenous injection of gentiopicroside, serum samples of the Beagle were collected and measured on C18 reverse-phase chromatographic column after liquid -liquid extraction. Results The linear range of gentiopicroside was 0.1343～687.375 ?g?mL-1(r2=0.99993). The recovery was within 81.15 %～97.99 %. The limit of detection (LOD) was 0.1343 ?g?mL-1. Conclusion The pharmacokinetic process of gentiopicroside can be described as one-compartment model with intravenous injection , t1/2 = 1.1324 h, Ke = 0.5811 h-1, V= 0.5316 L?kg-1, CL = 0.3274 L?kg-1?h-1. This indicates that gentiopicroside can be quickly distributed and eliminated and is not liable to be accumulated in the body.

Objective To systematically study the chemical constituents in the roots of Gentiana macrophylla from Shaanxi Province. Methods Various column chromatographic techniques were used for isolation and purification of the principles. The structures were elucidated on the basis of spectral data (UV, IR, MS, (~1H-NMR), (~(13)C-NMR), (~1H-~1H COSY) and (~1H-~(13)C COSY), HMBC, and HMQC) and identified by comparing with the authentic substance. Results Five compounds were got from fat-soluble fraction. They are identified as: N-pentacosyl-2-carboxy-benzoyl amide (Ⅰ), 5-carboxyl-3, 4-dihydrogen-1H-2-benzopyran-1-one (Ⅱ), erythrocentaurin (Ⅲ), roburic acid (Ⅳ), oleanolic acid (Ⅴ). Conclusion Compounds Ⅰ and Ⅱ are two novel ones. They are named as qinjiaoamide and erythrocentauric acid, respectively. Compound Ⅲ is isolated from the plants of Gentiana L. for the first time.

Objective Establishing a fingerprint method to identify the characteristic chemicals in the roots of Gentiana macrophylla and evaluate their quality.Methods RP-HPLC was developed for fingerprint analysis and determination of four ingredients in G macrophylla roots from different sources.LC-ESI-TOF-MS was employed to identify the chromatographic peaks of the fingerprint.Results Five common peaks were identified by comparing their retention time with reference secoiridoid glucosides.Eight major peaks in chromatographic fingerprint were analyzed by on-line LC-ESI-TOF-MS.Four secoiridoid glucosides were identified based on their MS data.Conclusion The method is specific and could be served for the quality identification and comprehensive evaluation of G macrophylla.

Objective: To determine the anti rejection effects of CTLA 4 Ig fusion protein on cardiac allografts in mice and to discuss its mechanism in vivo . Methods: BALB/c recipients were performed cervical heterotopic heart transplantation to receive C57BL/6 donor hearts with a cuff technique. BALB/c recipients were intraperitoneally injected with CTLA 4 Ig [100 ?g/d?15 times], control immunoglobins and PBS to observe the survival time of allografts with ECG. The hyporesponsiveness of splenic T cell, the polarization of the T subsets were analyzed after the recipients treated with CTLA 4 Ig. Results: After treated with CTLA 4 Ig, the survival of cardiac grafts was significantly prolonged compared with the control groups, and more than 40% cardiac grafts survived over 2 months. The splenic T cells isolated from recipients did not respond to restimulation of donor splenocytes in MLR, but did exhibit the capacity to proliferate in response to C3H splenocytes(third party).The levels of IL 2 and IFN ? decreased and the level of IL 10 increased in CTLA 4 Ig treated mice. Conclusion: Administration of CTLA 4 Ig can induce donor specific tolerance, which induce T subsets to polarize toward Th2 subset and hyporesponsiveness to alloantigen, and prolong the survival time of the cardiac grafts effectively. [

Objective To compare the effect of oxycodone,sufentanil and fentanyl on immune function in patients with colon cancer under postoperative analgesia,provide guidance and basis for clinical medication.Methods Ninety patients 49 males and 41 females,aged <65 years,ASA physi-cal status Ⅰ or Ⅱ,were enrolled and randomly divided into 3 groups using a random number table (n=30):oxycodone group (group O),sufentanil group (group SF)and fentanyl group (group F).All patients underwent the same way to maintain anesthesia.The PCIA pump recipe were as follows:group O,oxycodone 2 mg/kg+granisetron 3 mg,added normal saline to 100 ml;group SF,sufen-tanil 0.002 mg/kg+granisetron 3 mg,added normal saline to 100 ml;group F,fentanyl 0.02 mg/kg+granisetron 3 mg,added normal saline to 100 ml;The background volume of PCIA electronic pump was 2 ml/h,the amount of each press was 2 ml,the lock time was 1 5 min,the pump time lasted for 24 h and maintained for 2 days after operation.The percentage of CD4+,CD8+and NK cells in venous blood were recorded at the end of surgery,6 h,12 h,24 h and 48 h after surgery.Results In CD4+,in the time points of 6 h,12 h,24 h after surgery,it was significantly higher in group O than that in groups SF and F (P<0.05);CD8+in group O was higher than that of group F,and CD8+in group F was higher than group SF at the time of 6 h after surgery.The group O was significantly higher than that of the groups SF and F at the times of 12 h,24 h after surgery (P<0.05);In NK cells,at the time points of 12 h,24 h and 48 h after surgery,it was significantly higher in group O than in groups SF and F (P<0.05).Conclusion Three analgesic drugs caused decline in immune function.Sufentanil and fentanyl have the similar effects on immunity,but oxycodone have a relatively small effect on immunity.Oxycodone is a more appropriate analgesic drug for colon cancer under postoperative analgesia.

Background: Prediabetes leads to declines in physical function in older adults, but the impact of prediabetes progression or regression on physical function is unknown. This study assessed this longitudinal association, with physical function objectivelymeasured by grip strength, walking speed, and standing balance, based on the Health and Retirement Study enrolling United States adults aged >50 years. Methods: Participants with prediabetes were followed-up for 4-year to ascertain prediabetes status alteration (maintained, regressed, or progressed), and another 4-year to assess their impacts on physical function. Weak grip strength was defined as <26 kg for men and <16 kg for women, slow walking speed was as <0.8 m/sec, and poor standing balance was as an uncompleted fulltandem standing testing. Logistic and linear regression analyses were performed. Results: Of the included 1,511 participants with prediabetes, 700 maintained as prediabetes, 306 progressed to diabetes, and 505 regressed to normoglycemia over 4 years. Grip strength and walking speed were declined from baseline during the 4-year followup, regardless of prediabetes status alteration. Compared with prediabetes maintenance, prediabetes progression increased the odds of developing weak grip strength by 89% (95% confidence interval [CI], 0.04 to 2.44) and exhibited larger declines in grip strength by 0.85 kg (95% CI, –1.65 to –0.04). However, prediabetes progression was not related to impairments in walking speed or standing balance. Prediabetes regression also did not affect any measures of physical function. Conclusion Prediabetes progression accelerates grip strength decline in aging population, while prediabetes regression may not prevent physical function decline due to aging.

Objective: In this study, black tea and Citrus maxima (BT-CM), yellow tea and C. maxima (YT-CM), green tea and C. maxima (GT-CM) as subjects, the active ingredient content and antioxidant activity of three tea and C. maxima (T-CM) were analyzed. The effects of three T-CMs on apoptosis of liver cells in vitro and its mechanism were further explored. Methods: National standard method and HPLC were used for active ingredient analysis. MTT, cell flow cytometry and Western blot were used to analyze the effects of three T-CMs on cell proliferation, apoptosis, and its underlying molecular mechanism. Results: The content of tea polyphenols, free amino acids, ratio of polyphenols and amino acids, ester catechins, non-ester catechins and caffeine in YT-CM and GT-CM was significantly higher than that of BT-CM. The in vitro antioxidant capacity of YT-CM and GT-CM was also significantly stronger than that of BT-CM. Three T-CMs had the effects of inhibiting proliferation, arresting cell cycle and inducing apoptosis in HepG2 and Bel7402 cells, especially YT-CM and GT-CM. Western blot analysis showed three T-CMs activated PI3K/AKT/mTOR signaling pathway and regulated the expression levels of apoptosis-related proteins Bax, Bcl-2 and Caspase-3/9. YT-CM and GT-CM had better ability to change the signal pathway than BT-CM. Conclusion: In short, T-CMs, which combined different degrees of fermentation tea with C. maxima, were rich in nutrients and biologically active substances. T-CMs, especially YT-CM and GT-CM, are healthy drinks that help to prevent and treat liver cancer.