Objective:Through the ale tissue in patients with rheumatic heart disease ( RHD) autoantigen cells change and pe-ripheral blood indicators of detection and IL-10,TGF-beta 1 discusses the relationship between serum concentration.Methods:cases of RHD patients and 63 healthy volunteers in the morning on an empty stomach acquisition anticoagulation peripheral venous blood,used flow cytometry assay of CD4+CD25+,signature molecules of regulatory T cells ( Foxp3 Treg) for testing,the proportion of the ELISA de-tection of IL-10,concentration of TGF-beta 1;Corresponding antigen gene expression library construction of rheumatic heart disease screening.Results:The autoantigen RHDAG1 has obvious differences with the control,RHD patients serum Treg ratio is lower than the control group in the sample data,IL-l0,TGF-beta 1 has the difference between the concentration of serum,compared the statistically difference between groups.Conclusion:Autoantigen RHDAG1 have certain effect on the development of the expression of RHD, the concentration and Treg cells on peripheral blood related indexes change detection has a certain clinical significance to the diagnosis of RHD.

24 h) was the main cause of high emergent perioperative death rate. There was a rationale for prophylactic surgery.

Objective The study focused on the relationship between neopterin (NP),Gensini score and high-sensitivity C-reactive protein (hs-CRP) to explore the important role of the neopterin in patients with coronary heart disease.Methods Total of 442 patients,admitted to the Department of Cardiology at Renmin Hospital,Wuhan University from January 2012 to September 2012,were enrolled in this study.There were 176 patients in the control group and 266 patients with coroary disease in the experimental group.The Gensini score was used to assess the severity of the coronary lesions in the patients with coronary heart disease.The enzyme-linked immunosorbent assays (ELISAs) were used to measure the serum NP level.The other indicators were assessed by use of fully automatic biochemical and coagulation analyzers.The data were analyzed by using of SPSS19.0.T-test was used for analysis of the results between the control group and the experimental group.One-factor analysis variance (ANOVA) was used for comparisons of the results among the 3 groups,and Spearman correlation analysis was used for the correlation analysis between the NP level and Gensini score as well as hs-CRP level.Results The serum NP level was higher in the experimental group than that in the control group [(1.99 ± 0.37) vs (1.48 ± 0.29) ng/ml,P ＜0.05],and the NP level was positively correlated with the severity of coronary heart disease.Compared with the stable angina (SA) group,the serum NP level was significantly increased in the unstable angina (UA) group (2.00 ± 0.37) ng/ml and the acute myocardial infarction (AMI) group (2.10 ± 0.43) ng/ml (t =2.38,P ＜ 0.05).In addition,the serum NP level was positively correlated with the Gensini score (r =0.687,P＜0.001) as well as with the level of hs-CRP (r=0.190,P＜0.001).Conclusions The serum level of NP was significantly higher in patients with coronary heart disease and was positively correlated with the severity of coronary artery disease.Thus,NP may become a new indicator for the assessment of the inflammatory response in coronary atherosclerosis.

The properties of polyethyleneimine-cholesterol cationic lipopolymer (PEI-Chol) as gene carries and its gene transfer efficiency in vitro with lipid microbubbles were presented in this paper. PEI-Chol lipopolymer was synthesized by linking cholesterol chloroformate to the amino groups of branched poly(ethyleneimine) (PEI) of 1 800. The structure and molecular weight of PEI-Chol were confirmed by IR, 1H NMR and MADI-TOF-MS (matrix-assisted laser desorption/ionization time-of-flight tandem mass spectrometry), respectively. The average molecular weight of PEI-Chol was approximately 2 000. The gene delivery system of bubble/PEI-Chol/DNA was constructed by mixed PEI-Chol/pDNA (N/P 10:1) complexes with lipid microbubbles (2-8 microm) which were prepared by DPPC, DSPE-PEG2000 and perfluoropropane with the reverse phase evaporation technique. pEGFP-Cl (enhanced green fluorescent protein) was used as report gene to investigate the DNA condensing ability of PEI-Chol lipopolymer by agarose gel electrophoresis. And their cytotoxicity and in vitro transfer efficiency of different complexes were compared with each other in A549 and MCF-7. The results indicated PEI-Chol lipopolymer can condense plasmid DNA when N/P ratio upto 4, PEI-Chol complexes and bubble/PEI-Chol/DNA complexes were nontoxic to A549 and MCF-7 when formulated at the N/P ratio of 10/1 as determined by MTT assay. This bubble/PEI-Chol/DNA delivery system provided good transfer efficiency with other desirable characteristics such as against-precipitation of plasma proteins. In conclusion, bubble/PEI-Chol/DNA complex is a novel non-viral gene delivery system.

Objective To study the effect of laparoscopic cholecystectomy endoscopic sphincterotomy combined with Oddi lithotomy (EST) treatment of gallbladder stone on common bile duct stones. Methods A retrospective analysis between May 2003 and June 2009 ,the combined treatment of LC and EST in 78 patients with common bile duct stones was retrospectivelly analyzed. First, bile duct stones were removed by EST, then laparoscopic cholecystectomy was performed within 5 days. Results EST was performed successfully in 76 cases (97%), failure in 2 cases, 1 case abdominal choledochojejunostomy due to the end of bile duct stenosis; one cases of common bile duct stone diameter of 1.6 cm, firm, failure of mechanical lithotripsy received common bile duct ploration T-tube drainage 76 cases of laparoscopic operation is successful, without obvious bleeding, bile leakage and other severe complications. Conclusions The advantages of EST + LC for the gallbladder stones and common bile duct stones with less trauma, faster recovery, fewer complications, and no T-tube drainage, etc; this is a safe and effective treatment.

[ ABSTRACT] AIM:To investigate the cardiac AMP-activated protein kinase ( AMPK) activity and the effects of AMPK activator on cardiac structure and function in the mice with different β-adrenoceptor (β-AR) stimulation patterns . METHODS:Male BALB/c mice were subcutaneously injected with AMPK activator ( AICAR, 250 mg· kg -1 · d-1 ) or saline, and infused with β-AR agonist isoproterenol (ISO, 5 mg· kg-1· d-1) for 14 d.The cardiac functions were evalu-ated by echocardiography or hemodynamic method , and the hearts were harvested after infusion cessation immediately or 3 d later.Phosphorylated AMPK ( p-AMPK) was measured by Western blot .RESULTS:Sustained ISO infusion increased p-AMPK level.AICAR did not further increase p-AMPK but attenuated ISO-induced increase in heart weight .Sustained ISO infusion increased cardiac systolic function as indicated by left ventricular fractional shortening ( FS) and maximum rate of pressure rise (+dp/dtmax).The cardiac systolic function was not further increased by AICAR .The cardiac diastolic func-tion as indicated by left ventricular end-diastolic pressure (LVEDP) was not different in each group .In contrast, cardiac p-AMPK level was similar between the control mice and the mice with sustained ISO infusion and ceased infusion for 3 d. In this model, AICAR improved the cardiac systolic and diastolic functions , which were impaired by ISO.Moreover, the increased pattern of p-AMPK level was similar with that of heart rate upon ISO stimulation .CONCLUSION: Sustained ISO infusion increases p-AMPK.After ISO infusion cessation for 3 d, p-AMPK is decreased to the basal level .β-AR-in-duced inotropic effects should be avoided to investigate the cardioprotective role of AMPK activation in the β-AR stimulation models.

Objective To explore the diagnostic value of MRI special use of breast and uhrasonography in axillary lymph node metastasis of early breast cancer.Methods Clinical data of 136 Ⅰ-Ⅲ A breast cancer patients accepted MRI examination before surgery had been retrospectively studied,analysing diagnostic value of MRI and ultrasonography in axillary lymph node metastasis of early breast cancer.Results The sensitivity,specificity,and accuracy obtained by MRI were 83.3％,88.6％ and 86.3％.And these data of ultrasonography were 73.1％,76.7％ and 75.0％.The sensitivity,specificity,and accuracy obtained MRI were better than that of ultrasonography.The sensitivity,specificity,and accuracy of ≥ 50 years old patients were 70.0％,77.8％ and 75.0％.And ＜ 50 years old patients were 85.7％,92.3％ and 88.9％.The sensitivity,specificity,and accuracy of ＜ 50 years old patients were better than ≥ 50 years old patients.Conclusions The MRI special use of breast have an important value in axillary lymph node metastasis of early breast cancer,especially to gounger than 50 years old patients.It can provide a scientific basis of the clinical accurate treatment for early breast cancer patients.

Objective Resarech on the value of body mass index (BMI) predicting efficacy of neoadjuvant chemotherapy and prognostic in breast cancer.Methods Clinical data of 99 patients who received neoadjuvant chemotherapy Ⅱ B-Ⅲ C stage breast cancer patients was collected between January 2007 and December 2013 in Women and Children Hospital of Guangdong Province.Anaslysing the relation of BMI and efficacy of neoadjuvant chemotherapy and prognosis.Results In the study, Clinaical complete ressiom was 12.1％ (12/99), partal ressiom was 68.7％ (68/99), stable disease or disease progression was 19.2％ (19/99), respone rate was 80.8％ (80/99), pathlogic complete ression was 9.1％ (9/99).BMI was significantly associated with response rate(P =0.039), but not with pathlogic complete ression (P =0.454).Univariate and multivariate analysis showed that BMI was not significantly associated with disease free survival and overall survival(P ＞ 0.05).Conclusions BMI was significantly associated with response rate, overweight or obese patients would prodict poorly efficacy of neoadjuvant chemotherapy.The relationg of BMI and prognosis of breast cancer who accepted neoadjuvant chemotherapy is not clear, for further study.

Objective To study the incidence of ventilator-associated pneumonia(VAP)and antimicrobial resistance of pathogens in an intensive care unit(ICU).Methods The occurrence of VAP in hospitalized patients with mechan-ical ventilation>48 hours between January 2011 and December 2012 were investigated,species and antimicrobial re-sistance of pathogens causing early onset-VAP (E-VAP,mechanical ventilation≤4 d)and late-onset VAP(L-VAP, mechanical ventilation>4 d)were compared.Results A total of 1 76 patients were investigated,incidence of VAP was 44.32% (78 cases);With the prolongation of mechical ventilation,incidence of VAP increased gradually (χ2=52.561,P<0.001).The incidence of L-VAP was significantly higher than E-VAP (58.33% [70/120]vs 14.29%[8/56])(χ2= 30.02,P<0.001).A total of 178 pathogens were isolated,gram-negative bacteria,gram-positive bac-teria and fungi were 104(58.43% ),46(25.84% ),and 28(15.73% )isolates respectively;97(54.49% )multidrug-resistance/pandrug resistance organisms (MDRO)were isolated. MDRO isolation rate in L-VAP patients was high-er than E-VAP patients([58.86% ,n= 93]vs [20.00% ,n= 4]),resistance rate of major pathogens causing L-VAP was significantly higher than E-VAP patients(allP<0.05).Fungi infection only occurred in L-VAP patients,the total antimicrobial resistance rate was 12.14% .Conclusion The prolongation of mechanical ventilation can increase the incidence of VAP,and resistance rate of pathogen in L-VAP is high.

Objective To investigate the role of the predictive prognostic value of BRCA1 screened by whole genome expression profiling in ductal carcinoma in situ.Methods Collected 4 cases of breast ductal carcinoma and 4 cases of breast invasive ductal carcinoma fresh samples from January 2014 to June 2014,and the difference of BRCA1 expression on whole genone expression profiling was analyzed by microarray comparative genomic hybridization.The expression of BRCA1 was detected by immunohistochemistry in 70 cases of ductal carcinoma in situ of the breast,and the prognosis of intraductal carcinoma was evaluated.Results BRCA1 gene differentially expressed in invasive ductal carcinoma and ductal carcinoma in situ by screening.The positive rate of BRCA1 protein in breast ductal carcinoma in 14.3％ (10/70),its expression had no significant relationship with age (P =0.959),menopause (P =0.959),tumor size (P =0.627),axillary lymph node status (P =1.000),HR status (P =0.958),HER-2 status (P =1.000),P53 expression (P =0.460).ductal carcinoma with micro-infiltration ratio in BRCA1 negative group was higher than BRCA1-positive group (P =0.043).The median follow-up of 47 months,Disease-free survival rate of all was 97.1％.Disease-free survival of BRCA1 negative group and BRCA1-positive group had no significant difference (96.7％ vs 100％,P =0.569),over all survival of BRCA1 negative and positive groups was 100％.Conclusions BRCA1 expression may not predict the prognosis of intraductal carcinoma,but ductal carcinoma in situ with microinvasion group ratio in BRCA1 negative was higher than ductal carcinoma in situ group,BRCA1 may take affect within ductal carcinoma infiltration process work.