Viral myocarditis(VMC) has been threatening children's health severely.Its mechanisms are not completely clear and lack of dependable therapeutic methods.Studies have demonstrated that apoptosis occurs in VMC.The apoptosis pathways including death-receptor pathway and mitochondrial-mediated pathway participate in cardiocytes apoptosis in VMC.Endoplasmic reticulum pathway is a novel apoptosis pathway that takes part in cardiocytes apoptosis causing by other stress.And crosstalk exists in the three pathways.It may be of potential therapeutic value that these apoptosis pathways could be harnessed.

The mechanism of central nervous system injury is complex.Microglia cells participate in a variety of central nervous system diseases and damage processes.Toll-like receptor 4 (TLR4) mediates the microglial activation and the expression of inflammatory cytokines.It is one of the important receptor proteins for microglia cells performing their functions.This article briefly introduces the role of TLR4 signal pathway in the central nervous system injury.

Objective:To explore the quality on 64-slice CT coronary angiography with different injection rates of contrast agent.Methods: 120 patients who have been diagnosed or suspected coronary atherosclerosis were selected in our hospital and were randomly divided into group A(4.5ml/s), group B(5.0ml/s) and group C(5.5ml/s), with 40 cases in each group. We observed CT attenuation values, image quality, and adverse reactions of the three groups.Results: There were significant differences in the ascending aorta, descending aorta, left main, left anterior descending artery, circumflex artery and the right coronary artery and other parts of the CT attenuation value (F=6.838,F=4.002,F=7.261,F=5.992,F=8.281,F=5.790,F=6.126;P<0.05). In image quality, the group B with 34 cases was significantly better than group A with 12 cases and group C with 20 cases (x2=9.632,x2=5.475;P<0.05). The rate of adverse reactions was 30%, 7.5% and 22.5% with 12 cases in group A, 3 cases in group B and 9 cases in group C. The rate in group B was significantly lower than in group A and group C (x2=12.985,x2=10.236;P<0.05).Conclusion: Through the application of the same concentration of the contrast agent and scan conditions to coronary angiography, we can get a good vascular enhancement and high quality imaging when the injection rate of contrast medium is 5ml/s, while incidence of adverse reactions may be reduced.

Objective The genotoxicty and its molecular mechanism of environmental tobacco smoke (ETS) were discussed through the oxidative DNA damage induced by environmental tobacco side_stream smoke(ETSS). Methods DNA adduct 8_hydroxydeoxyguanosine (8_OHdG) was used as a biomarker of oxidative DNA damage. The level of 8_OHdG in DNA exposed to ETSS was detected by HPLC_EC.On the molecular biological level,the biological oxidative ability of ETSS on DNA molecule was studied.Organic and inorganic components in ETSS were analyzed by GC_MS and AAS respectively. Results Particles and VOCs in ETSS could directly induce oxidative DNA damage and form 8_OHdG.It was found that there were 123 and 84 kinds of organic compounds in particles and volatile organic compounds of tobacco smoke side stream,and 7 kinds of inorganic compounds in ETSS.Some components especially quinones and polyphenols in ETS,could produce free radicals in vitro by the auto_oxidation without any biological activity systems,and with the catalytic reaction of metals,the DNA aduct 8_OHdG was produced. Conclusion It was proved that ETS had biological oxidative ability on DNA and expressed direct genotoxicity.8_OHdG was a fine biomarker of effect of oxidative DNA damage.

Objective To study the efficacy and safety of pulse cyclophosphamide(CTX)therapy for refractory adult-onset Still's disease(AOSD).Methods Eleven patients with refractory AOSD received the treatment of intravenous pulse cyclophosphamide with 500～750 mg/m2 body surface area.The features of clinical manifestations and lab findings before and after the treatment were compared.The literatures associated with pulse CTX therapy were reviewed.Results After the first time of pulse CTX therapy,nine cases returned body temperature to normal within 72 hours,and the other two within 1week.Fever relapse was seen in five patients after the first time of pulse CTX therapy,and they returned body temperature to persistent normal after the second time of pulse CTX therapy.At the point of 1 week after the first time of pulse CTX therapy,serum C-reactive protein(CRP)significantly decreased when compared with that before treatment(P

Surgical resection is the primary treatment for locally advanced rectal cancer,but the local recurrence rate of surgical resection is still at a high level. Preoperative and postoperative chemoradiotherapy not only decreases the local recurrence rate of surgical resection,but also elevates the survival rate and life quality. Recently,adjuvant chemoradiotherapy has been applied as the standard therapy for locally advanced rectal cancer. The application of targeted drugs,new chemotherapy drugs and rapid changing radiotherapy technology provide more approaches to the treatment of locally advanced rectal cancer.

Objective To explore the value of virtual touch tissue quantification (VTQ) elastography and its influencing factors in identifying benign and malignant thyroid nodules.Methods A retrospective analysis was conducted in 210 cases of 240 thyroid nodules.Their images,including 2D ultrasound,color Doppler flow imaging (CDFI) and VTQ elastography,were reviewed,and the scanning view,the maximum diameter of the nodule,inside blood flow,calcifications and its depth beneath the skin were recorded.The value of shear wave velocity(SWV) in identifying benign and malignant thyroid nodules was calculated using receiver operating characteristic (ROC) curve.The influences of the maximum diameter of the nodules,calcifications,internal blood flow,the depth beneath skin and scanning views as well as type of pathology on the value of SWV were analyzed using multiple linear regressions (MLR).Results The sensitivity and specificity of VTQ in differential diagnosis of benign and malignant thyroid nodules was 74.8％ and 73.4％,respectively,and the area under ROC curve was 0.799.MLR indicated that the maximum diameter of the nodule,the type of pathology and internal blood flow were correlated with the SWV value (P ＜0.05),of which,the type of pathology was the important factor (standardized coefficient was-0.312).Microcalcifications,the depth of the nodules located and the scanning surface were not significantly related to SWV value (P ＞0.05).Conclusions VTQ can quantitatively provide the information on the hardness of thyroid tissue,which is of a definite value in the differential diagnosis of the nodules.The pathology of the nodule,its internal blood flow and maximum diameter are the factors that affect the value of SWV,and not its depth,scanning views and microcalcifications.

Objective Comparison of three different molecular assays for the detection and molecular characterization of circulating tumor cells in breast cancer .Methods The retrospective study compared three different molecular assays to detect CTC in the peripheral blood of 30 healthy individuals and 71 benign breast disease patients and 83 early and 84 metastatic breast cancer patients .All samples were collected at the outpatient , inpatient and physical examination department of Sichuan Provincial People ′s Hospital from January 2011 to June 2014.The same cDNAs were analyzed by:singleplex RT-qPCR assay for BCL-2, multiplex RT-qPCR for BCL-2, HER-2, HMAM, and a commercially available molecular assay (AdnaTest BreastCancer ) for GA733-2, MUC-1, HER-2.The positive of CTC were compared among healthy individuals and benign breast disease patients and breast cancer patients .Chi square test was used to compare the expression of gene markers among the three groups , and the agreement of Kappa test was used to evaluate the method.Results (1) Detection rates of early breast cancer by single RT-qPCR, Adna kits and multiple RT-qPCR were 13.3%, 16.9% and 18.1%, respectively , and the detection of metastatic breast cancer were 31.0%, 42.9%and 35.7%, respectively.There were significant differences in the positive of CTC by three molecular assays between healthy individuals and benign breast disease patients and early breast cancer patients ( The test values were 4.235 and 4.301, 5.367 and 5.474, 5.894 and 6.023 respectively, P<0.05).There were no differences between benign breast disease patients and early breast cancer patients (The test values were 0.891,0.748 and 0.701 respectively,P >0.05) .There were significant differences between metastasis breast cancer patients and healthy individuals and benign breast disease patients and early breast cancer patients ( The test values were 8.429,7.553 and 7.061;10.24, 9.025 and 8.745; 9.658, 8.417 and 8.201 respectively,P<0.05).(2) In early breast cancer: The concordance between AdnaTest and single RT-qPCR was 79.5%while between AdnaTest and multiplex RT-qPCR was 77.1%.No agreement was found among them ( The test values were 1.065 and 1.871, P were 0.371 and 0.258 ) .The concordance between single RT-qPCR and multiplex RT-qPCR was 80.7%.No agreement was found between them (The test values was 2.814, P was 0.156).(3) In patients with overt metastasis:The concordance between AdnaTest and single RT-qPCR was 78.6%( The test values was 10.986).While between AdnaTest and multiplex RT-qPCR was 80.9%( The test values was 9.251 ) . Agreements were found among them ( P was 0.002 and 0.005 respectively ) .The concordance between single and multiplex RT-qPCR was 88.1%( The test values was 12.364 ) .Agreement was found between them (P was 0.001).Conclusions No correlations were found among different molecular methods to detect CTC in the early primary breast cancer , but correlations were found in the metastatic breast cancer , suggesting that different rate of CTC caused by the number of CTC and its heterogeneity should be considered to the clinical diagnosis and treatment of breast cancer while molecular method is used .

To establish a consumables supermarket management system to realize the informatized management of the consumables supermarket. The system used SOA as the main architecture, and IIS manager as the pub-lishing tool. The system had the workload, materials and financial resources decreased while the efficiency in-creased, and made the supervisor master the sale information timely. Consumables supermarket informatized management may decrease the hospital's needs for current capital as well as the links, while increase the hospital effi-ciency greatly.

BACKGROUND: Recently, the survival rate of premature infants increases year by year, but the cerebral growth of premature infants is immature, so the intellectual development of premature infants is slower than that of normal infants.OBJECTIVE: To explore the effect of family-oriented early intervention,which took material nutrition, information stimulation and petting as main interventional content, on level of intellectual development in premature infants in infantile age.DESIGN: Randomized sampling controlled observation.SETTING: Department of Pediatrics, Clinical Medical College of ShanPARTICIPANTS: Totally 35 premature infants of 31-36 weeks (18 males and 17 females) were enrolled as early interventional subjects, who were born at Jinan Municipal Central Hospital between May 2000 and July 2002. Meanwhile, 33 premature infants of 31-36 weeks (18 males and 15females) born in the same period and 49 mature neonates (26 males and 23females) were enrolled in control group.METHODS: The family-oriented early intervention, which considered nutrition, information stimulation and petting as chief interventional content,were performed in premature infants, and health archives was established.Taction and point massage were conducted. Home visit was done twice in one month. One routine health examination was determined at 3, 6 and 10months in the two control groups. The level of intellectual development was assessed in infants of 10-month old of each group with Gesell Developmental Schedules (GDS) and Japanese S-M Social Living Ability Scale.MAIN OUTCOME MEASURES: Evaluation of level of intellectual development in infants of each group.RESULTS: In the premature interventional group, 1 premature infant died, 2 withdrew from the study, and 32 eligible cases with the eligible rate of 91.4%; Among the 33 premature infants in the premature control group, there were 3 withdrawing from the study, and 30 eligible cases with the eligible rate of 90.9%. Among the 49 infants in the term infant control group, there were 3 withdrawing from the study and 46 eligible cases with the eligible rate of 93.9%. ①Developmental quotient (DQ) at each area of Gesell and evaluation of Japanese S-M Social Living Ability Scale were significantly higher in the premature interventional group than those in the premature control group at 10 months old. There were extremely significant differences in suitability, fine activity, language and individual social behavior. ②DQ at each area of Gesell and evaluation result of Japanese S-M Social Living Ability Scale were lower in the premature interventional group than those in the term infant control group at 10 months old, which had obvious difference. ③Evaluation in premature infants aged oyer 35 weeks of the interventional group was lower than that in the term infant control group, but there was insignificant difference (P ＞ 0.05).CONCLUSION: Early intervention has a marked effect in improving the intellectual developme nt of premature infants, and some premature infants can recover to the level of term infants in intelligence development after intervention.