The estrogen receptor (ER) coregulators regulate the transcriptional activities of ER,and then affect the transcription and translation of target genes mediated by ER.ER coregulators not only plays an important role in the initiation,progression and metastasis of breast cancer,but also involves in the response to endocrine therapy of breast cancer via the genomic and nongenomic function.

Objective To study the clinical practical use of the model for end-stage liver disease(MELD) and assess its validity in predicting the prognosis of the.chronic severe hepatitis patients.Methods The clinical data of 391 patients with chronic severe hepatitis among 2003～2005 in our hospital were analyzed,and they were graded with MELD formula.These patients were divided into plasma exchange group and none plasma exchange group according to plasma exchange treatment or not.The death rate was observed within three months.The validity of the model in predicting the prognosis of the patients with severe hepatitis was determined by the concordance(c)-statistic.Results 236 patients died within three-months and the mortality was 60.6%.The mortality of patients in PE group whose MELD score were less than 30 and 30～40 was 25% and 75% respectively,but in non-PE group they were 42.0%,90.7% respectively,there were significant difference between PE group and non-PE group(P0.05).The optimal cut-off values of MELD to predict the prognosis of patients were 30 in PE group whose sensitivity and specificity were 66.7% and 86.4%,and its c-statistic was 0.823(95% CI 0.734～0.912);and in non-PE group they were 27,76.4%,79.1% and 0.832(95% CI 0.787～0.877) respectively.Conclusions The mortality of the patient with chronic severe hepatitis increases with the increase in the MELD score.The MELD can accurately predict the short-term prognosis of patients with chronic severe hepatitis.

Objective To identify homogenous clones of S.flexneri 2a, using gene distribution polymorphism of Shigella enterotoxinl and Shigella enterotoxin2 in a shigellosis outbreak by S.flexneri 2a. Methods 93 strains of S.flexneri 2a isolated from different areas, at different time were detected by Shigella enterotoxin1 and Shigella enterotoxin2 gene polymerase chain reaction to identify genetic type of S.flexneri 2a. Results The 93 strains of S.flexneri 2a were divided into 4 clones: ShET1(-)/ShET2(+)for 12 strains,ShET1(+)/ShET2(-)for 14 strains,ShET1(+)/ShET2(-)for 59 strains, ShET1(-)/ShET2(-)for 8 strains. Conclusions It is believed that Shigella enterotoxin1 and Shigella enterotoxin2 gene PCR analysis is a simple method for the primary screening of S.flexneri 2a.

Objective To observe the effects of different doses of dexmedetomidine combined with ropiva-caine for ultrasound-guided fascia iliaca compartment block on postoperative analgesia and rehabilitation in patients undergoing total hip replacement surgery. Methods 80 patients with ASAⅠ~Ⅱundergoing total hip arthroplasty were ramdonly divided into 4 groups. Records of patients with ultrasound guided fascia iliaca compartment block onset time,block fading time,VAS at 4 h,8 h,12 h,24 h,48 h;duration of operation,intraoperative remifent-anil and propofol requirement;24 h and 48h of sufentanil use;after the operation were recorded for the first time , ambulation time,hospitalization time and observe whether bradycardia,intraoperative awareness and other adverse reactions. Results Compared with group A and B,the onset time of C were shorter(P<0.05);the VAS was less (P<0.05);the remifentanil equirement was significantly was reduced(P<0.05);the amount of sufentanil after operation 24 h and 48 h was reduced(P<0.05);the first time out of bed time and total hospitalization time was shorter(P < 0.05);patient satisfaction increased(P < 0.05);The extubation time was significantly longer and the occurrences of tachycardia were significantly increased in group D compared to other groups respectively. Conclusion 1.0μg/kg dexmedetomidine combined with 0.3%ropivacaine ultrasound-guided fascia iliaca compart-ment block can provide better postoperative analgesic and recover rapidly with fewer side effects in total hip replace-ment surgery.

ObjectiveTo explore the influence of life events on the emotional state ot heart transplantation patients.Methods All the heart transplantation outpatients were interviewed by a certain psychiatrist in Zhongshan Hospital during Oct.2010 to Oct.2011.The demographic data,life events and the self-reported influenced degree were recorded by the same psychiatrist.A grounded theory-based approach with thematic content analysis of the field notes was used.ResultsEighty-eight patients were enrolled,including 69 males,and19 females.The average age of the patients was 46.5 ±14.3 years old.The average duration after operation was 39.3 ± 39.6 months.The life events were classified into 4 groups,which were medical financial problems,physical condition,family support and future life.The most frequently reported event was physical condition (50.2％ ) and the influenced degree was the highest (9.2 ±1.2),while most patients (96.6％) complained high medical and relevant cost and the influenced degree was (6.5 ± 2.1). Family support was reported by13.6％ patients and its influenced degree was (7.6 ±1.2).The age of the reporter of future life (6.8％) was under 33 years.ConclusionDifferent events have different influence to patients.Improving the social support of patients is helpful to improve quality of life.

Objective　To investigate the clinical results of the medial multiplex flap pedicled with the posterior tibial vessel. Methods　Twelve cases with soft tissue defects and bone defects of limbs were treated with the medial multiplex flap pedicled with the posterior tibial vessel from September 1992 to May 1999. Among them, bone and soft tissue defects following opened fracture in 7 cases, chronic ulcer following chronic osteomyelitis in 2 cases, melanoepithelioma in 2 cases, bone and soft tissue defects following osteoma resection in 1 case. The bone defect area was from 2.5 cm×5.0 cm to 4.5 cm ×11.0 cm. Free graft was performed in 5 cases, bridged transposition in 3 cases and reversal transposition in 4 cases, among them, periosteal myocutaneous flap with autogenous or allogeneic bone grafting in 8 cases, myocutaneous flap in 4 cases. The area of the flaps from 6 cm ×8 cm to 12 cm×25 cm. Results　All flaps were healed by first intention, but in the distal fragments of bigger flaps were partially necrosed in 2 cases. In 10 cases bone healing were obtained after 16 weeks of operation according to the X-ray photos. All cases were followed up from 6 to 18 months. All cases achieved satisfactory result but 1 case died because of lung metastasis of osteoma. Conclusion　The multiplex graft pedicled with the posterior tibial vessel is an ideal graft for repairing the large soft tissue defects and bone defects, because it has such advantages as adequate blood supply, big vascular diameter, long pedicle and big dermatomic area.

AIM:To investigate the relationship between serum ghrelin level and body composition including bone mineral content (BMC),fat mass(FM) & lean mass(LM) in premenopausal women with different thyroid functional status.METHODS:We measured the serum ghrelin levels by radioimmunoassay (RIA),the serum levels of free triiodothyronine (FT3),free thyroxine (FT4) and sensitive thyroid-stimulating hormone (sTSH) by chemiluminescene immune assay.The total body composition including total BMC,FM and LM was measured by dual-energy X-ray absorptiometry (DXA) in 71 premenopausal women with different thyroid functional status (33 hyperthyroidism,18 hypothyroidism and 20 normal subjects).RESULTS:(1) The level of serum ghrelin in patients with hyperthyroidism was significantly lower than that in patients with hypothyroidism (P0.05).The serum ghrelin level was correlated negatively with FT3(r=-0.318,P0.05).CONCLUSION:The serum ghrelin level in the premenopausal women with different thyroid functional status may correlate with the total BMC,LM and body weight.

OBJECTIVE:To try to establish a combined serum-pharmacology and electrophysiology method for the study of mechanism of chuanxiong extract in dilatating coronary artery.METHODS:Chuanxiong extract was intragastrically given to rats and mice,then the serum contents of tetramethylpyrazine(TMP)were determined by HPLC,which provided data for electrophysiological study.The action of chuanxiong extract on Ca 2+ -activated K channel(Kca)of smooth muscle of coronary artery in pigs was studied by patch clamp technique.RESULTS:The calibration curve of TMP was linear in the range of0.216～54?g/ml(r=0.9999).The recovery was100.7%～102.4%.The serum concentrations of TMP in rats and mice were(3.56?3.01)and(8.19?6.57)?g/ml respectively.The chuanxiong extract could not markedly activate the Kca of smooth muscle of coronary artery in patch clamp study.CONCLUSION:The established method for TMP determination is feasible and relieable.In order to improve the combined electrophysiology and serum pharmacology technique,high quality medical materials should be adopted and the bioavailability improved.

Objective To study immunological property of chimeric BPVL1 / HPV16 E7 virus-like particles (VLPs) in mice. Methods HPV16 E7 gene was cut into three fragments, ligated to BPVL1 sequence, respectively, and then expressed as chimeric VLPs. The ability of the chimeric VLPs to stimulate in vivo cytotoxic response was analysed with lymphocytes taken from mice C57BL/6J lymph nodes. Results A strong CTL response against C-2 cells (HPV16 E7 aa47-59 transfected EL-4 cell) was induced in mice immunised with chimeric VLPs BPVL1 / HPV16 E7(b). Furthermore, no CTL response was detected against EL-4 cells in immunized mice. Conclusions Chimeric BPVL1/HPV16 E7 VLPs, serving as antigens, can activate mouse T lymphocytes and elicit a strong antigen-specific CTL response. Chimeric BPVL1/HPV16 E7 VLPs could be used as an efficient antigen delivery system, and might provide a novel strategy for HPV16 vaccine design.

Objective To explore the expression of interleukin 13(IL-13) mRNA in peripheral blood mononuclear cells (PBMCs) and its association with serum C-reaction protein(CRP) in patients with ulcerative colitis(UC). Methods IL-13 mRNA expression in PBMCs was detected by RT-PCR in patients with UC(21 cases of active UC and 10 cases of quiescent UC)and 20 healthy subjects. At the same time, the serum level of CRP was detected by ELISA. Results The expression level of IL-13 mRNA in PBMCs of patients with active UC was significantly lower than that in PBMCs of patients with quiescent UC and healthy subjects (6.45?1.23 vs 14.72?2.12 or 15.17?2.38,P0.05). The expression level of IL-13 mRNA in PBMCs of active UC patients was negative correlation with serum level of CRP (r=-0.589,P