Tumor necrosis factor-related apoptosis-inducing ligand(TRAIL) is a new anti-tumor biological agents which is very hot in recent years through its death receptor-induced apoptosis of tumor cells,and non-toxic to normal cells,and has synergy with the chemotherapy drug,but there is also resistance mechanisms.This article will review the biological characteristics of TRAIL and its receptors,TRAIL-induced apoptosis of tumor cells,as well as the mechanism of TRAIL in leukemia in the progress of treatment.

Objective To evaluate the effect of preadministration phenylephrine on the hemodynamics result from oxytocin during caesarean section.Methods One hundred parturients,ASA Ⅰ-Ⅱ,with single baby at full term in vertex presentation scheduled for cesarean section under continuous epidural anesthesia were randomly divided into 4 groups,each group was 25 cases.All parturients received injection 10 U of oxytocin in the uterus after delivery,followed by an oxytocin rapid infusion of 10 U (less than 5 min),meanwhile,through the other intravenous channel,injection of phenylephrine 1 μ g/kg in group 1,2 μ g/kg in group Ⅱ,3 μ g/kg in group Ⅲ,while injection of 0.9％ sodium chloride 1 ml in groupⅣ as control.The mean arterial pressure (MAP) and heat rate (HR) at preanesthesia (T0),the time of oxytocin injection after dehvery (T1) and after oxytocin injection 30 s (T2),1 ain (T3),3 min (T4),5 ain (T5),10 min(T6) was recorded.Results There were no significant difference in MAP at T0 and clinical data among the groups (P ＞ 0.05).The level of MAP in group Ⅰ and Ⅳ at T3-T5 was significantly lower than that at T0[(82 ± 7),(79 +5),(83 ± 6) mm Hg(1 mm Hg =0.133 kPa) vs.(90 ± 7) mm Hg,(84 ±7),(76 ± 5),(82 ±7) mm Hg vs.(91 ±7) mm Hg] (P ＜0.05).The level of MAP in group Ⅲ at T2-T3 was significantly higher than that at T0[(93 ± 8),(103 ± 10)mm Hg vs.(91 ± 8) mm Hg] (P ＜ 0.05).Compared with group Ⅳ,the level of MAP in group Ⅱ at T3-T5 was significantly higher,the level of MAP in group Ⅲ at T2-T5 was significantly higher,there was significant difference (P ＜0.05).The level of HR had no significant difference in T0 among the groups (P ＞ 0.05).The level of HR in four groups at T3-T5 was significantly higher than that at T0[(98 + 12),(105 + 12),(96 + 9) times/ain vs.(79 ± 8) times/ain,(89 ± 10),(96 ± 13),(92 + 12) times/min vs.(80 ± 11) times/min,(88 ± 10),(94 ± 12),(90 ± 9) times/min vs.(83 ± 10) times/min,(94 ± 12),(112 ± 13),(102 ± 1 1) times/ain vs.(82 ± 9) times/min](P ＜ 0.05 or ＜ 0.01),and reached to peak value at T4(P＜ 0.01),then gradually declined to the baseline values (T1) except in group Ⅳ at T6.Compared with group Ⅳ,the level of HR in group Ⅲ and group Ⅲ was significantly decreased at T4-T5(P ＜ 0.05).The rate of MAP decrease range above 30％ in group Ⅳ was 24％(6/24),and significantly higher than that in group Ⅱ (0) and group Ⅲ (0),there was significant difference(P＜ 0.05).The rate of nausea in group Ⅳ was significantly higher than that in group Ⅱ and group Ⅲ,there was significant difference (P ＜0.05).The scores of Apgar scale after delivery 1,5 min had no significant difference among four groups (P ＞0.05).Conclusion Haemodynamic stability can be obtained by administration 2 μ g/kg of phenylephrine when parturients received injection 10 U of oxytocin in the uterus after delivery,and followed by an oxytocin rapid infusion of 10 U during cesarean section.

Objective To investigate the evaluation of cardiopulmonary exercise test (CPET) in the patients with chronic obstructive pulmonary disease (COPD), and the relationship with the pulmonary function test (PFT). Methods 26 COPD patients and 30 normal controls were examined with CPET and PFT. Results The parameters of CPET, including maximum oxygen uptake (VO2max), anaerobic threshold (AT), maximum minute ventilation (VEmax) and breathing reserve (BR) were lower in COPD group than those in control group (P<0.05). There were no significant differences in Wmax, oxygen pulse (O2pulse) between two groups (P>0.05). VO2max, AT, VEmax and BR were positively correlated with forced expiratory volume in one second (FEV1) and peak expiratory flow (PEF) in COPD group （P<0.05）, but were not correlated with forced vital capacity (FVC) and FEV1/FVC (P>0.05).Conclusion The pulmonary function of COPD patients can be evaluated with CPET, especially VO2max, AT, VEmax and BR.

Objective To investigate the placental transfer and neonatal effects of dexmedetomidine during the cesarean section under general anesthesia.Methods Thirty-eight nulliparous parturients,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,aged 22-37 yr,weighing 56-82 kg,who were at full term with a singleton fetus,scheduled for elective caesarean section under general anesthesia,were randomly divided into 2 groups (n=19 each) using a random number table:dexmedetomidine group (group D) and normal saline group (group N).In group D,dexmedetomidine was infused in a loading dose of 0.6 μg/kg starting from 10 min before induction of anesthesia,followed by an infusion of 0.4 μg · kg-1 · h-1 until peritoneal closure.Group N received the equal volume of normal saline.Blood samples were collected from the maternal artery (MA),umbilical vein (UV),and umbilical artery (UA) for blood gas analysis and for determination of plasma dexmedetomidine concentrations (CMA,CUV and CUA) by high-performance liquid chromatography-mass spectrometry,and CUV/CMA and CUA/CUV were calculated.Apgar scores were recorded at 1 and 5 min after delivery,and the occurrence of respiratory depression was also recorded.The I-D interval (the time from administration of anesthetics to delivery) and U-D interval (the time from incision of the uterus to delivery) were recorded.Results There were no significant differences in the blood gas analysis parameters in blood samples collected from the MA,UV and UA,I-D interval,U-D interval,and Apgar scores between the two groups (P＞0.05).No neonatal respiratory depression was found in both groups.In group D,CMA,CUV and CUA were 471±119,359±88 and (321±78) ng/ml,respectively,CUV/CMA was 0.76±0.06,and CUA/CUV was 0.89±0.03.Conclusion Although the metabolism of dexmedetomidine is little after easy placental transfer,dexmedetomidine has no adverse effects on the newborn during the cesarean section under general anesthesia.

Objective To explore the neonatal effects and efficacy of dexmedetomidine on haemodynamics during cesarean section under general anesthesia.Methods Thirty-eight ASA Ⅰ or Ⅱ parturients with a single baby at full term in vertex presentation,scheduled for cesarean section under general anesthesia,were randomly divided into 2 groups (each group of 19 patients) by random digits table method:dexmedetomidine group and normal saline group.The patients in dexmedetomidine group received an intravenous infusion loading dose of 0.6 μ g/kg of dexmedetomidine,starting 10 min before induction of anesthesia,following with an intravenous infusion 0.4 μ g/ (kg ·h) of dexmedetomidine until peritoneal closure.The patients in normal saline group received an intravenous infusion of isovolumic of normal saline.Recording the systolic blood pressure (SBP),diastolic blood pressure (DBP) and heart rate (HR) before infusion (T0) and 10 min after the start of infusion (T1),at tracheal intubation (T2),at delivery of the baby (T3),15 min after delivery (T4),at end of operation (T5),at extubation (T6) and 15 min after extubation (T7).The blood of umbilical vein and umbilical artery was drawn for gas analysis,and the Apgar scores at 1 and 5 min were also recorded after delivery.Results The level of SBP,DBP and HR at T0 had no significant difference between two groups (P ＞ 0.05).In dexmedetomidine group,the level of SBP,DBP and HR were significantly higher at T2 than those at T0 [(136 ± 12) mmHg (1 mmHg =0.133 kPa) vs.(124 ± 9) mmHg,(83 ± 10) mmHg vs.(72 ± 6) mmHg,(93 ± 11) times/min vs.(81 ± 8) times/min] (P ＜ 0.05).In normal saline group,the level of SBP,DBP and HR at T2-6 [(151 ± 14),(137 ± 11),(132 ± 10),(132 ±9),(142± 13)mmHgvs.(125 ±9)mmHg;(94±13),(85±9),(80±8),(80±9),(86±11)mmHgvs.(74 ±7) mmHg; (122 ±15),(105 ±12),(90 ±9),(89 ± 10),(97 ±11) times/min vs.(81 ±9) times/min] were significantly lower (P ＜ 0.05).Compared with normal saline group,the level of SBP,DBP and HR were lower in dexmedetomidine group at T2-6(P ＜ 0.05).There were no significant difference not only about the blood gas analysis of umbilical vein and umbilical artery,but also about the Apgar scores at 1 and 5 min after delivery (P ＞ 0.05).Conclusion Administration of dexmedetomidine is effective in maintaining the maternal haemodynamic during the cesarean section under general anesthesia without adverse neonatal effects.

Objective To investigate the influence of very late antigen-4 (VLA-4) antibody and VLA-4 antibody combined with VP_(16) in vitro on childhood leukemic cells' apoptosis and explore the protection of bone marrow stromal cells (BMSC) upon leukemic cells and its related mechanisms. Methods Leukemic bone marrow stromal cells were isolated by human lymphocyte separation medium and in vitro culture of BMSC (adherent) and leukemia cells (suspended) BMSC+leukemic cells group were as control. Then VLA-4 antibody and/or VP_(16) were added respectively to VLA-4 antibody group, VP_(16) group and VLA-4 antibody combined with VP_(16) group to detect the apoptosis of leukemic cells in different groups through Annexin V-FITC double-labeled flow cytometry and the expression of Survivin, bcl-2 genes in each group of leukemic cells detected by RT-PCR. Results The results showed by flow cytometry that compared with the control groups, for 12 h or 24 h, the early and total apoptosis rates of leukemic cells of the three experimental groups were significantly increased(P <0.05); the early and total apoptosis rates of leukemic cells treated with VLA-4 antibody combined with VP_(16) group was markedly increased, compared with the control group (P <0.05); the comparison of the early and total apoptosis rates for the three experimental groups between 12 h and 24 h was significantly different (P<0.01). Moreover, RT-PCR results showed that the expression of Survivin and bcl-2 genes of leukemic cells in three experimental groups was reduced in varying degrees and the reduction of VLA-4 antibody combined with VP_(16) group was the most obvious. Conclusion BMSC plays a protective role on leukemic cells, and VLA-4 antibody can block the adhesion between BMSC and leukemic cells promoting leukemic cells apoptosis and enhance the sensibility of apoptosis of leukemic cells induced by chemotherapeutics.

Objective To evaluate the efficacy of dexmedetomidine mixed with ropivacaine for epidural anesthesia in the patients.Methods Forty-six patients, of ASA physical status Ⅰ or Ⅱ , aged 36-58 yr, weighing 48-77 kg, scheduled for elective hysterectomy under epidural anesthesia, were randomly divided into 2 groups (n =23 each) according to the random number table: normal saline + ropivacaine group (R group) and dexmedetomidine + ropivacaine group (DR group).Epidural anesthesia was performed at L2,3interspace.The catheter was inserted into the epidural space.A mixture of 0.75％ ropivacaine 15 ml and dexmedetomidine 1 μg/kg was injected epidurally in DR group.A mixture of 0.75％ ropivacaine 15 ml and normal sline 2 ml was injected epidurally in R group.The onset time of sensory block, maximum level of sensory block, and duration of sensory block were recorded.The modified Bromage scale, Ramsay sedation score and intraoperative traction reaction were assessed.The occurrence of dexmedetomidine-related cardiovascular events and respiratory depression, and epidural anesthesia-related adverse events within 2 h after operation was recorded.Results Compared with R group, the onset time of sensory block was significantly shortened, the duration of sensory block was prolonged, the maximum level of sensory block and Ramsay sedation score were increased, the degree of intraoperative traction reactions was lessened, and the incidence of shivering was decreased in DR group (P ＜ 0.05).No patients developed dexmedetomidine-related adverse events.Conclusion Epidural dexmedetomidine 1 μg/kg significantly optimize the efficacy of ropivacaine when used for epidural anesthesia in the patients.

Objective To study the optimal dose of dexmedetomidine for preventing of shive-ring during caesarean section under epidural anesthesia.Methods One hundred and twenty ASA Ⅰ orⅡ parturients with a single baby at full term in vertex presentation,scheduled for caesarean section under continuous epidural anesthesia,were randomly divided into 4 groups (n=30 each):group D1, group D2,group D3 and group N (control group).After delivery of the baby,The group D1,group D2 and group D3 were received an intravenous infusion loading dose of 0.2μg/kg,0.5μg/kg and 0.8μg/kg of dexmedetomidine within 10 minutes respectively,and following with an intravenous infusion 0.4 μg·kg-1·h-1 of dexmedetomidine until peritoneal closure.The group N received an intravenous infusion 0.1 ml·kg-1·h-1 of normal saline.Results The incidence and degree of shivering in group D2 and group D3 were lower than those in group D1 and group N(P<0.05),but there were no statistics differences between group D2 and group D3.Conclusion Administration of dexmedetomidine can re-duce the occurrence of shivering during caesarean section under epidural anesthesia,and a loading dose of 0.5 μg/kg of dexmedetomidine is the optimal dose.

Objective To investigate the effects of Livin antisense oligonucleotide (ASODN) on the proliferation and apoptosis of human leukemia (K562) cells. Methods Specific phosphorothioate ASODN and missense oligonucleotide (MSODN) target Livin mRNA were synthesized and transfected into K562 cells following cationic liposome. The proliferation inhibition of K562 cells was assessed by MTT. The apoptosis rate of each group was detected by Annexin V-FITC. The expression of Livin mRNA was detected by reverse transcription polymerase chain reaction (RT-PCR). Results ASODN at a final concentration of 600 nmol/Lcould inhibit the K562 cells proliferation (IR) was (52.99t2.67) % and the expressions of Livin mRNA (ODR)was (59.75±3.24) %, the apoptosis rate was apparently increased [(36.89±1.08) %] (P ＜0.01); but the difference between Lip-MSODN group, Lip control group and cell control group was not statistically significant (P ＞0.05).Conclusion Livin ASODN may decrease Livin gene expression, suppress K562 cells proliferation effectively, and induce significant apoptosis of K562 cells.

Objective The aim of this study is to evaluate clinical application of BODE (body mass index, airflow obstruction, dyspnea, and exercise capacity) index in patients with chronic obstructive pulmonary disease (COPD). Methods Forty patients with stable COPD in Xuanwu Hospital of Beijing during September 2003 to December 2007, were recruited in the study, including 25 men and 15 women, aged 38 to 85 years (with a mean of 62 ± 13 years). BODE index was measured for each patient, one year and three years after recruitment, respectively. Severity of COPD, including number and duration of episodes, length of each hospital stay and times of hospitalization due to acute exacerbation of COPD (AECOPD), were recorded. All data were statistically analyzed with SPSS 13.0 software for windows. Results ①There was a remarkable difference in COPD severity between patients with BODE score equal to or greater than five and these with less than five (P <0.01 ). ①BODE score inversely correlated with forced expired volume at the first second ( FEV1 ) in COPD patients (P < 0.01 for those with BODE score equal to or greater than five and P <0.05 for these with BODE score less than five, respectively). ③BODE score positively correlated with number and duration of acute exacerbation, length of hospital stay and times of hospitalization due to AECOPD (P <0. 01 for those with BODE score equal to or greater than five and P < 0. 05 for those with BODE score less than five, respectively). For patients with COPD, their BODE score in the first year positively correlated with that in the third year ( r = 0.834, P < 0.01 ). Conclusions BODE index is a better indicator to evaluate their condition severity in patients with COPD.