Multidrug resistance (MDR) plays a major obstacle to successful gastric cancer chemotherapy. The purpose of this study was to investigate the MDR reversal effect and mechanisms of hyperthermia in combination with neferine (Nef) in adriamycin (ADM) resistant human SGC7901/ADM gastric cancer cells. The MDR cells were heated at 42°C and 45°C for 30 min alone or combined with 10 μg/mL Nef. The cytotoxic effect of ADM was evaluated by MTT assay. Cellular plasma membrane lipid fluidity was detected by fluorescence polarization technique. Intracellular accumulation of ADM was monitored with high performance liquid chromatography. Mdr-1 mRNA, P-glycoprotein (P-gp), γH2AX expression and γH2AX foci formation were determined by real-time PCR, Western blot and immunocytochemical staining respectively. It was found that different heating methods induced different cytotoxic effects. Water submerged hyperthermia had the strongest cytotoxicity of ADM and Nef combined with hyperthermia had a synergistic cytotoxicity of ADM in the MDR cells. The water submerged hyperthermia increased the cell membrane fluidity. Both water submerged hyperthermia and Nef increased the intracellular accumulation of ADM. The water submerged hyperthermia and Nef down-regulated the expression of mdr-1 mRNA and P-gp. The water submerged hyperthermia could damage DNA and increase the γH2AX expression of SGC7901/ADM cells. The higher temperature was, the worse effect was. Our results show that combined treatment of hyperthermia with Nef can synergistically reverse MDR in human SGC7901/ADM gastric cancer cells.

BACKGROUND:A series of inflammatory signal pathways are activated accompanied by increasing expressions of inflammatory factors after periodontal tissues being stimulated by exogenous substances like bacterium. Inflammation is closely related to periodontal tissue repair and regeneration.
OBJECTIVE:To il ustrate the correlation of immune response of periodontitis and periodontitis-related inflammatory cytokines to p38 mitogen activated protein kinase (p38MAPK) pathway, and to provide a new idea and method for the treatment of periodontitis in the future.
METHODS:The related literatures of periodontitis and p38MAPK pathway published from January 1990 to January 2016 were retrieved from the databases of CBM, CNKI, SWIC and PubMed. The research and progress of periodontal tissue repair and regeneration after periodontitis were analyzed.
RESULTS AND CONCLUSION:Total y 36 literatures were enrol ed final y. Inflammation-regulated and inflammation-associated signaling pathways as wel as subsequent expression of inflammatory mediators can partly control the excessive disease-induced inflammation and immune responses of the host, among which p38MAPK signaling pathway may be involved in the occurrence and development of periodontitis. More studies, however, are needed to validate these findings. The regulation of p38MAPK signaling pathway is stil of great significance in the treatment of periodontal disease, and we hope to provide a new insight and basis for clinical diagnosis and treatment of periodontitis.

Objective To investigate outcome and prognosis of isolated mild fetal ventriculomegaly (IMV) of fetus in uterus. Methods From Jan. 2006 to Dec. 2009, 18 200 singleton pregnancy women from 20 weeks gestation underwent prenatal ultrasonography examination in Department of Obstetrics and Gynecology, Second Affiliated Hospital of Wenzhou Medical College. One hundred and forty-eight women with IMV (transverse diameter of the atrium of the lateral ventricle measuring between 10 and 15 mm with no other abnormalities) were studied prospectively, which were divided into two groups: 99 women with transverse diameter of the lateral ventricle of 10 - 11 mm in group A and 49 women with transverse diameter lateral ventricle of 12 - 15 mm in group B. The changes of ventriculomegaly and the associated intracranial and extracranial anomalies were observed regularly every 2 or 4 weeks until delivery. The development of neurological system was also followed up. Results ( 1 ) The overall incidence of IMV was 0. 08% (148/18 200). The rate of bilateral ventriculomegaly were 20% (20/99) in group A and 51% (25/49) in group B, which reached statistical difference (P＜ 0. 05). (2) Prognosis of fetus: 139 cases with 2 or more ultrasonographic examinations, IMV resolved throughout pregnancy in 41. 7% (58/139) ,regressed in 7. 9% (11/139) ,remained stable in 36. 7% (51/139)and progressed in 13. 7% ( 19/139). Five cases in group A and 11 cases in group B present progress, which reached significantly difference (P ＜ 0. 05). (3) One hundred and eleven cases infant were followed up for 5-12 months,the rate of psycho-motor developmental delay was 5. 4% (6/111). The rate of neuro-developmental delay in progressed group (3/15) was higher than 2. 5% ( 1/40) in resolved group, 0 (0/8) in regressed group and 4. 2% (2/48) in remained stable group, which reached significantly difference (P＜0. 05). Conclusions About 85% of cases of IMV resolved, regressed or remained stable in utero would exhibited good prognosis. IMV with a transverse atrial size ≥ 12 mm or progression in utero was usually associated with a poor prognosis, which should be observed carefully.

Objective To improve the understanding of clinician' treatment of pregnancy with acute lymphoblastic leukemia. Method To analyze tretrospectively the diagnosis and treatment process of 1 case with acute lymphoblastic leukemia from December 13, 2016, and discuss the selection of the timing of termination of pregnancy. Results The patient was a 28 years old female. She was dignosed for acute lymphocytic leukemia in the third trimester. She bore a healthy baby boy in caesarean section after a dexamethasone treatment for two days. Then she recevied a series of standard chemotherapy. But she suffered a cerebral hemorrhage during treatment, and surgical pathology made a definite dignosis of central nervous system leukemia.Finally, She was out of danger after rescue. Conclusion Postoperative chemotherapy is a feasible option for the treatment of acute leukemia after the termination of pregnancy.

Objective To investigate the diagnostic value of transbronchial lung biopsy (TBLB) under virtual bronchoscopic navigation (direct path), endobronchial ultrasonography with a guide sheath (GS) and rapid on-site evaluation (ROSE) for solitary pulmonary nodules (SPNs). Methods One hundred and seventy-eight patients who were underwent transbronchial lung biopsy in the Tianjin Medical University General Hospital between January 2015 to December 2016 were retrospectively evaluated. CT images of all patients showed solitary pulmonary nodules surrounded by lung tissue, and ROSE was undergone during the procedure. The patients were divided into conventional (C-TBLB) group, virtual bronchoscopic navigation (VBN) group, endobronchial ultrasonography with a guide sheath (GS) group, and virtual bronchoscopic navigation combined with endobronchial ultrasonography with a guide sheath group (combination) depending on the different devices. The diagnostic yield and the location or the effect of lesion on the diagnostic rate were compared between four groups. The coincidence rate of ROSE and the histopathological findings of TBLB were compared. The value of ROSE for the early diagnosis of disease was further evaluated. Results The diagnostic rates were 32.5％(13/40), 66.7％(24/36), 68.2％(30/44) and 75.8％(44/58) for C-TBLB group, VBN group, GS group and combination group, respectively. There were significant differences in diagnostic rates between C-TBLB group and other tree groups (χ2=8.853, 10.677 and 18.293, P<0.008). But there were no significant differences in diagnostic rates between VBN group, GS group and combination group (P>0.008). The diagnostic rates for peripheral pulmonary nodules were 12.5％ (2/16), 42.9％ (6/14), 40.0％ (4/10) and 75.9％(22/29) in C-TBLB group, VBN group, GS group and combination group. The diagnostic rate was significantly higher in combination group than that of other three groups (χ2=17.434, P<0.05). The result of ROSE was consistent with result of histopathology (Kappa = 0.775, P<0.001). The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of ROSE during transbronchial biopsy for solitary pulmonary nodules were 90.7％, 87.0％, 86.7％, 90.9％ and 88.8％, respectively. No pneumothorax, hemoptysis or other serious complications were found in patients. Conclusion Virtual bronchoscopic navigation, endobronchial ultrasonography with a guide sheath for solitary pulmonary nodules by transbronchial lung biopsy can improve the diagnostic rate of solitary pulmonary nodules.

Objective To evaluate the safety and effectiveness of a new hemostatic clip with sutures for ESD suspension method in animal models.Methods A total of 20 porcine stomachs were randomly divided into the experimental group (n=10) and the control group (n=10).ESD was done respectively in antrum greater curvature and antrum back wall of porcine stomach in vitro.All procedures were completed by the same endoscopist and nurse.The incidence of perforation,mucosa diameter,total operation time (T),dissection time (T1),the average number of submucosal injection,and one-time complete dissection rate were compared between two groups.Results Procedures were done successfully in antrum of 40 poccine in vitro and all mucosa were dissected completely in one procedure.No perforation occurred.Compared with the control group,the mucosa diameter difference was not statistically significant (P =0.368).The total operating time [(34.70± 1.06) min VS (37.1 0± 2.23) min,P =0.009],dissection time [(31.40± 2.00) min VS (34.80± 2.20) min,P=0.817] and the average number of submucosal injection[(7.60± 1.00) VS (10.60± 1.00),P＜0.001] in antral greater curvature ESD of the experimental group were significantly less than those of the control group.As for the antrum back wall,the mucosa diameter difference was not statistically significant.The total operation time [(37.00± 1.25) min VS (39.60± 1.65) min,P＜0.001],dissection time[(34.50± 1.35) min VS (37.00± 1.25) min,P＜0.001],the average number of submucosal injection [(7.60± 1.27) VS (11.40± 1.00),P＜0.001] were also significantly less than those of the control.Conclusion The new hemostatic clip with sutures for suspension can significantly shorten the operation time,reduce the number of submucosal injections and the difficulty in ESD.

Objective To investigate the characteristics of left and right ventricular volume and systolic function of tetralogy of Fallot(TOF)children by real-time three-dimensional echocardiography (RT-3DE).Methods Forty-five TOF children and 46 normal age-matched children were recruited in this study. Full volume imaging of left and right ventricle were obtained by RT-3DE and analyzed off-line by TomTec LV-Analysis and RV-Function.The measurements including:end-diastolic volume (LVEDV/RVEDV),end-systolic volume (LVESV/RVESV),ej ection fraction (LVEF/RVEF),peak systolic volume rate (LVPSVR/RVPSVR),stoke volume (LVSV/RVSV),cardiac output (LVCO/RVCO).And the volumetric parameters were indexed by BSA(indexed EDV,indexed SV,indexed CO).The measurements were compared between TOF group and normal group.The left and right ventricular measurements were also compared with each other within group.Results Compared with control group indexed LVEDV reduced in TOF group(P =0.000),while indexed RVEDV increased (P =0.002 ).For systolic function indexes:LVEF,RVEF, LVPSVR and RVPSVR in TOF group were both lower than that in normal group (P <0.05 ),indexed LVSV and indexed LVCO were also reduced (P <0.05 ),while indexed RVSV had no difference with normal(P >0.05)and indexed RVCO was increased (P =0.016).The volume and function comparision between left and right ventricle demonstrated:in normal group no difference were found in biventricular EDV,PSVR,SV,CO(P >0.05),except that LVEF was a litter higher than RVEF(P =0.000).In TOF group RVEDV,RVSV,RVCO were all greater than that of left ventricle(P <0.05),but RVEF was lower than LVEF(P =0.039).Conclusions In TOF group biventricular systolic function were both impaired and lost banlance between them.Under the volume and pressure overload the right ventricle improved pumping function by increasing heart rate.

Objective To investigate the effect of special CT monochromatic images on improving imaging quality in Budd-Chiari Syndrome.Methods 40 patients with Budd-Chiari Syndrome underwent CT venography (CTV)with gemstone spectral imaging (GSI).Using the optimal contrast to noise ratio (CNR)curve of GSI software,the optimal CNR monochromatic images of the infe-rior vena cava and hepatic vein were chosen.The CT value of the intrahepatic segment of inferior vena cava,hepatic vein and the same level liver tissue were measured,and the CT value of the same region were measured on 140 kVp mixed energy images and 70 keV images.CNR on the optimal monochromatic images,the 140 kVp mixed energy images and 70 keV images were calculated respectively,and the image quality of the optimal monochromatic image,the 140 kVp mixed energy images and 70 keV images were subjective scoring.One-way ANOVA was used for statistical analysis using SPSS1 7.0 software.Results The optimal keVs from monochromatic images were distributed at 40 keV (50%)and (5 1 ± 1 )keV (50%)for IVC and 40keV (25%)and (53 ± 3)keV (75%)for HV.The CNR and CT value and subjective score of IVC/HV got from the optimal monochromatic images were signifi-cantly higher than those from 140 kVp mixed energy images and 70 keV images respectively(P <0.01 ).Conclusion The optimal monochromatic images provide higher image quality of IVC and HV in patientswithBudd-Chiari syndrome.

Objective:To explore predictive value of arterial velocity-pulse index (AVI) and arterial pressure-volume index (API) for early atherosclerosis (AS) in middle-aged population.Methods:A total of 138 middle-aged patients hospitalized in our hospital from May 2016 to Nov 2016 were enrolled.According to coronary angiography (CAG) outcomes, they were divided into AS group (n=86) and non-AS group (n=52).Before CAG, AVI, API and brachial-ankle pulse wave velocity (baPWV) were collected in two groups.General data and arterial stiffness indexes were compared between two groups, and the correlation among AVI, API, baPWV and general data were analyzed.Results:Compared with non-AS group, there were significant rise in AVI [(20.4±4.2) vs.(22.8±5.3)] and baPWV [(14.0±2.5) m/s vs.(16.3±3.0) m/s] in AS group,P<0.01 both.AVI was significant positively correlated with age, SBP, DBP, mean arterial pressure (MAP), pulse pressure (PP), API and baPWV (r=0.219~0.471, P<0.05 or <0.01);API was significant positively correlated with age, BMI, SBP, DBP, MAP, PP, brain natriuretic peptide (BNP), AVI and baPWV (r=0.213~0.726, P<0.05 or <0.01);baPWV was significant positively correlated with age, BMI, SBP, DBP, MAP, PP, AVI and API (r=0.201~0.472, P<0.05 or <0.01).Multi-factor linear regression analysis indicated that SBP was influencing factor for AVI (B=0.162,P=0.001), SBP, DBP and HDL-C were influencing factors for API (B=-0.166~2.146,P<0.05 or <0.01), SBP and HDL-C were influencing factors for baPWV (B=0.116,-3.009,P<0.01 both).Conclusion:Both elevated AVI and baPWV can predict atherosclerosis in middle-aged population

Objective Through observing the clinical effect and the changes of gastrointestinal hormones caused by the treatment of different moxibustion time of the superficial gastritis patients due to the spleen and stomach weakness,to investigate the regulation of the dose-effect relation and the adjustment function on gastrointestinal hormone of serum of patients caused by the warming and nourish effect with moxibustion.Methods Eighty-four superficial gastritis Patients due to the spleen and stomach weakness were divided into group 1(treated by warming moxibustion for twenty minutes)(n=28),group 2(treated by warming moxibustion for forty minutes)(n=28),and drug(n=28)groups.The changes of the content of the Prostaglandin E2(PGE2)、Somatostatin(SS)and Epidermal growth factor(EGF)were observed before and after treatment between 3 groups and the clinical effect in different time.Results ①All 3 groups were compared after treatment,their clinical effect had no significant difference(P＞0.05):②Compared with pre-treatment,the superficial gastritis symptom score had a very significant difference after the treatment(3.07±1.54)、(3.11±1.40)、(3.79±2.25)and during the 1 month follow-up(2.25±1.32)、(2.57±1.10)、(4.11±2.48),(P＜0.01);③After treatment,the content of the PGE2 of the serum was increased obviously,compared with pre-treatment.There was a significant difference in each group(33.751±1.267)pg/ml、(33.774±8.583)pg/ml、(32.583±8.259)pg/ml,(P＜0.05);After warming moxibustion for forty minutes,the content of the EGF of the serum was increased obviously,compared with pre-treatment,showing a significant difference(1.331±0.823)pg/ml,(P＜0.05).Conclusion ①All of the three treatment methods had significant curative effect,and the curative effect had no significant difference among these 3 groups.But the moxibustion groups were markedly higher than the drug group in long-term result;②The moxibustion had established adjustment function on gastrointestinal hormone of the superficial gastritis patients due to the spleen and stomach weakness,which suggested that the gastrointestinal hormone may participate in its onset and the process of pathology and physiology.