Multidrug resistance (MDR) is an important biological behavior of tumor cells in chemotherapy. And it is also one of the major causes of clinical chemotherapy failure. According to the literature at home and abroad, and combining with the results of authors' investigations, this paper mainly discusses the mechanism of tumor cells' MDR and its reversion by Chinese herbs.

Objective To investigate the acute effect of apolipoprotein E(apoE)on the intracellular free Ca~(2+) of rat cortical neurons. Methods The intracellular resting calcium level in cultured primary rat cortical neurons was measured by using confocal fluorescent imaging technique. MK-801, an N-methyl-D-aspartate (NMDA) receptor noncom-petitive antagonist, was employed to test potential function of apoE4 through blocking NMDN receptor. Results Acute application of apoE4, but not apoE3, significantly increased the resting [Ca~(2+)] i in a dose-and time-dependent manner (P <0. 01 or P <0. 05) , and MK-801 partly blocked the apoE4-induced elevation of resting [Ca~(2+)]i (P <0. 05 or P <0. 01). Conclusion Acute administration of ApoE4 disturbs calcium homeostasis, and the activation of NMDA receptor may play a critical role in the intracellular calcium overload induced by apoE4 and neurotoxicity.

Objective To investigate the acute effect of apolipoprotein E(apoE)on the intracellular free Ca2+ of rat cortical neurons.Methods The intracellular resting calcium level in cultured primary rat cortical neurons was measured by using confocal fluorescent imaging technique. MK-801,an N-methyl-D-aspartate (NMDA) receptor noncompetitive antagonist,was employed to test potential function of apoE4 through blocking NMDN receptor. ResultsAcute application of apoE4,but not apoE3,significantly increased the resting [Ca2+]i in a dose-and time-dependent manner (P

Objective To investigate the effects of Compound E-Jiao Slurry (CEJS) and Cyclophosphamide (CTX) on the inhibition of Lewis pulmonary carcinoma xenografts. Methods Tumor xenografts models were prepared and randomly divided into six groups by weight, including the control group,CTX, CEJS with the dosages of high, middle and low, with a total of ten mice in each group. The control mice were given normal saline 0.4ml by intragastric administration once daily, with a total of twelve times; The mice of CTX group were given CTX 0.2 ml by intraperitoneal injection every other day, with a total of six times; The mice of CEJS group were given CEJS 0.2 ml and saline 0.2 ml by intragastric administration; The mice of combination therapy group 1 were given CEJS 0.4 ml by intragastric administration once daily, and CTX 0.2 ml by intraperitoneal injection every other day; The mice of combination therapy group 2 were given CEJS 0.2 ml by intragastric administration once daily, and CTX 0.2 ml by intraperitoneal injection every other day; The mice of combination therapy group 3 were given CEJS 0.1 ml by intragastric administration once daily, and CTX 0.2 ml by intraperitoneal injection every other day. The weight of tumor xenografts were measured in the experiment,the inhibition rate of tumor xenografts were calculated according to the data after the dissection. Results The combination groups and CTX alone have an inhibition rate of over 50%, and the CEJS group 25.88%. In every experimental group, the weight of tumor showed statistical significance compared with the control (P<0.05). The value was(4.457±0.796)g, (2.105±0.651) g, (3.304±0.922) g, (1.668±0.267)g, (1.752±0.546)g and (2.075±1.061) g respectively according to the group sequence. There was no statistical significance of tumor weight in the groups of different dosages of CEJS plus CTX compared with the CTX group (P>0.05). Conclusion CEJS can't obviously enhance the sensitivity of tumor xenografts to CTX, but there is a trend for tumor inhibition.

Objective:To survey the enablement level of elderly patients in the community and its influencing factors.Methods:A total of 460 patients aged ≥60 years visiting Changfeng and Fenglin Community Health Service Centers of Shanghai during September 3 to 15, 2018 were invited for a questionnaire survey. A self-made health status questionnaire, Patient Enablement Instrument (PEI), Chinese Health Questionnaire (CHQ-12), the Consultation and Relational Empathy Measure (CARE) were applied for survey.Results:All valid 460 questionnaires were retrieved. The positive rate of patient enablement was 73.91% (340/460). The median score for PEI was 3, Q1 was 0 and Q3 was 6. The univariate analysis showed that patient′s gender( Z=-2.32, P=0.02), age ( H=9.73, P<0.01), reason for visit ( H=42.06, P<0.01), health status in the past year ( H=8.28, P=0.02), consultation time ( H=22.92, P<0.01), sufficiency of communication with the doctor as patient thought ( H=41.83, P<0.01), detailed inquisition ( H=81.11, P<0.01), attending a contracted doctor ( Z=-3.42, P=0.04), the satisfaction of the visit ( H=38.64, P<0.01), total score of CHQ-12 ( Z=-2.01, P=0.04) and the score of CARE were significantly associated with the enablement level of the patient after the visit ( H=288.06, P<0.01). Multivariate linear regression showed that age 60-79( P=0.03), visit for acute disease( P<0.01), good or moderate health status in past year ( P<0.01), communication with the doctor<3 min or 3-<5 min ( P<0.01), sufficient or moderate time for communication with the doctor as patient thought ( P<0.01), detailed or moderate inquisition( P=0.03 or P=0.01), attending a contracted doctor ( P<0.01), CHQ-12 ≥4 ( P<0.01), middle or high CARE score ( P<0.01)were associated with the enablement of elderly patients after visit, with a cumulative contribution rate of 73.40%( F=50.08, P<0.01). Conclusion:The level of enablement of elderly patients after visiting the general outpatient clinic of the community health service center is relatively low. Patient′s age, types of disease, health status and the time of communication with the doctor, the sufficiency of communication time as patient thought, the detailed inquisition, attending a contracted doctor, the mental health status, and the empathy expression of the doctor are associated with the enablement of patients.

Cooperation networks of nursing techniques were constructde by way of perspective practice so as to enhance the quality of nursing critical cases, the success rate of emergency treatments and patients' life quality. The measures included training in techniques for nmsing critical cases, making the rounds of wards and consultations, and enlarging the scope ofthe cooperation networks. Quantification methods were introduced into management, networks of critical case assessment were used in managing patients, and the system for assessing training in techniques for nursing critical cases was used in managing nursing personnel, thus improving the quality of the nursing pensonnel, ensuring the rational allocation of human resources and promoting the enhancement of the hospital's medical quality and its social and economic benefits. It is therefore not difficu1t to see that the cooperation networks are of application and dissemination value.

The frequent co-occurrence of metabolic syndrome (MS) and mental disorders has become increasingly common, which is known clinically as comorbidity. Epidemiological survey showed that schizophrenia and mood disorders are the most common co-existing psychiatric disorders of metabolic syndrome. The pathogenesis of comorbidity of mental dis-orders and MS is related with hypothalamic-pituitary-adrenal axis dysfunction, unhealthy lifestyles and related applications of antipsychotics. An important reason for the metabolic syndrome associated with schizophrenia is heredity. However, in-flammation is the key factor in the relationship of mood disorders and MS. The intervention of unhealthy lifestyle, psychologi-cal counseling and rational use of drug should all be included in the treatment of comorbidity of psychiatric disorders and MS. The follow-up of metabolic index in psychiatric patients and psychological conditions in patients of MS should be paid more attention during the whole course of treatment.

Liver has great ability in regeneration,and liver regeneration is closely related to the prognosis of patients who received liver surgeries.The mechanisms of liver regeneration include biochemical theory and hemodynamic theory.Portal perfusion with moderate pressure is an important factor for starting liver regeneration.Hepatic artery buffer response,fluid shear stress and gasotransmitter play important roles in the liver regeneration.Learning the mechanisms of hemodynamic signal is of great importance for the treatment of liver diseases.

Objective To study the changes and clinical significance of serum matrix metalloproteinase-9(MMP-9) ,tissue inhibi-tor of metalloproteinase-1(TIMP-1) and vascular endothelial growth factor (VEGF) in infants with early wheezing .Methods Ser-um levels of MMP-9 ,TIMP-1 and VEGF in 116 infants with early wheezing(wheeling group)and 36 healthy infant (control group) were detected by using ELISA .Results Serum levels of MMP-9 ,TIMP-1 and VEGF in wheeling group were significantly higher than those in control group(P<0 .05);In wheeling group ,there was a linear relationship between the level of MMP-9 and VEGF ;the ratio of MMP-9/TIMP-1 was significantly lower in wheeling groups than in control group(P<0 .05) .Conclusion The infants with early wheezing have the dangerous of airway remodeling .Detection of serum levels of MMP-9 ,TIMP-1 and VEGF is of a cer-tain significance for intervention therapy to wheezing infants as early as possible .

Cerebral smal vessel disease (CSVD) accounts for 25 to 30% of al strokes. It is a main cause of vascular cognitive impairment. Because of cerebral smal vessels can not easily be directly observed and studied in vivo and on imaging, so the term CSVD is generaly used to describe a syndrome of clinical, cognitive, neuroimaging, and neuropathological changes, and not focus on the pathological changes of the smal vessel wal itself that caused these syndromes. This article reviews the advances in research on CSVD, particularly its pathological changes of vessel wals.