Objective To observe the effects of bundles intervention in intrahospital transport of critically ill patients.Methods The grouping was performed with the intrahospital transport time periods,the intrahospital transport cases from January to March 2015 were set as the control group and adopted the conventional method;those from April toJune 2015 were set as the observation group and adopted the bundles intrahospital transport strategy.The random sampling was conducted by using the proportion of 5％.The sampling results were 110 cases in the control group and 116cases in the observation group.The occurrence situation of adverse events were observed and compared between the two groups.Results No significant differences were found in the status before intrahospital transport between the two groups(P＞0.05).The incidence rate and grade of adverse events during intrahospital transport process in the observation group were lower than those in the cantrel group with statistical difference between the two groups(P＜0.05);in the analysis of the adverse events causes,the factors such as staff,equipments,disease condition and flow process had statistical difference between the two groups (P＜0.05).Conclusion The bundles intervention can reduce the adverse event occurrence of intrahospital transport of critically ill patients and increases the transport security.

This assay reviewed the feeding arteries of CHL and summarized the mechanism,technologic method and common embolization agent of interventional therapy,as well as its effect,indications,contraindications and complications.

Immune-checkpoint blockers(ICBs)have been well received in a variety of tumors,and the quality of patient life has improved significantly.However,the reasons why not all patients treated with ICBs benefit from lesion control,symptom improvement,and survival time.Many patients are resistant to the first time when they have been using ICBs for a period of time.This is a clinical challenge.This review lists possible causes of primary drug resistance and acquired resistance to ICBs.The primary resistance is associated with several mechanisms,including tumor microenvironment,cancer cells themselves and other related factors.The acquired resistance includes nonclassical immunoprecipitation molecules secondary overexpression,abnormalities of antigen presenting signal pathway and dysfunction of T cell activation killer.Finally,we have described a variety of possible new combination of treatment,including combined radiotherapy and chemotherapy,and combined targeted therapy with other measures.

Objective To explore the clinical significance of serum vascular endothelial growth factor (VEGF) level in nasopharyngeal carcinoma patients. Methods Serum VEGF level of 55 nasopharyngeal carcinoma patients were measured by sandwich enzyme?- linked immunosorbent assay (ELISA). 40 normal healthy volunteers served as control. Results Serum VEGF level of nasopharyngeal carcinoma patients was significantly higher than that of control group (P =0.000); Serum VEGF level was significantly higher in advanced nasopharyngeal carcinoma stage (stage Ⅲ ~Ⅳ) than that in early stage(stageⅠ ~Ⅱ) (P =0.003); Serum VEGF level with nasopharyngeal carcinoma patients with lymphnode metastasis was significantly higher than that of patients without lymphnode metastasis. There was no significant relationship compared serum VEGF level in nasopharyngeal carcinoma patient's gender, age and pathological types. Conclusions Serum VEGF can be used as a marker of nasopharyngeal carcinoma for diagnosis and monitoring the progress and the prognosis of the disease.

Objective To investigate expression of CXCR4 and CXCR7 protein and mRNA, which are the receptors of stromal cell derived factor-1α(SDF-1α), in the bone marrow mesenchymal stem cells (BMSCs);to explore the role of SDF-1α/CXCR4/CXCR7 axis in migration of BMSCs in vitro and the possible mechanism .Method BMSCs were isolated from rats and cultured in vitro.CD29, CD44 and CD34 of the cells were identified by flow cytometry .CXCR4-selective antagonist AMD 3100 and CXCR7-specific neutralizing antibody were applied to block CXCR 4 and CXCR7 respectively.The expressions of CXCR4 and CXCR7 mRNA and protein on BMSCs were detected with RT-PCR and Western blotting .Transwells chamber test was used to observe the migration of BMSCs .The BMSCs were divided into the BMSCs group ( A ) , the AMD3100 pretreated BMSCs group ( B ) , the CXCR7-specific neutralizing antibody pretreated BMSCs group(C), the AMD3100 +CXCR7-specific neutralizing antibody pretreated BMSCs group ( D).Result Flow cytometry showed that the expressions of CD 44 and CD29 were positive, while the expression of CD34 was negative in the third passage of BMSCs (P3-BMSCs).CXCR4 and CXCR7 protein and mRNA were both expressed in P3-BMSCs. Compared with the A group, the expression of CXCR4 and CXCR7 protein declined significantly in the B group and the D group;the protein expression of CXCR7 in the C group was lower compared with the A group (P<0.05).However, the expression of CXCR4 mRNA and CXCR7 mRNA had no significant difference between groups .SDF-1αfactor promoted migration of BMSCs ( P <0.05 ).Compared with the 0μg/L group, the numbers of migrated cells were increased significantly in both of the 10μg/L group and the 100μg/L group ( P<0.01 ) .The number of migration of BMSCs was significantly higher in the 100μg/L group than that of the 10μg/L group ( P <0.01 ) .AMD3100 and CXCR7-specific neutralizing antibody both inhibited significantly the migration of BMSCs ( P<0.05 ) , and the attenuate effect was more significant when they worked together ( P<0.05 ) .Conclusion CXCR4 and CXCR7 receptors are co-expressed in P3-BMSCs;the SDF-1αfactor can promote the migration of BMSCs in the concentration dependent manner ;SDF-1α/CXCR4/CXCR7 axis is involved in the migration of BMSCs , and both of the CXCR4 and CXCR7 receptors have a synergistic promoting effect to the BMSCs migration .

AIM To study the influence of ginkgo biloba exocarp polysaccharides(GBEP) on p53 gene expression and telomerase activity of human gastriccancer SGC 7901 cells in vitro . METHODS The p53 gene expression level of human gastriccancer SGC 7901 cells were measured by immunohistochemistry ABC. The telomerase activity of human gastriccancer SGC 7901 cells were measured by TRAP ELISA. RESULTS GBEP(80～160 mg?L -1 ,48 h) inhibited the expression of mutated type p53 genes and telomerase activity of human gastriccancer SGC 7901 cells. CONCLUSION The action mechanism of GBEP that inhibited the proliferation of SGC 7901 cells may relate to its down regulation effect on the expression of p53 genes and telomerase activity of human gastriccancer SGC 7901 cells.

Objective To study the clinical and prognostic value of CK19 mRNA-positive circulating tumor cells in early breast cancer patients. Methods We analyzed the peripheral blood in 50 patients with early breast cancer after surgery and before the initiation of any adjuvant treatment for the presence of CK19 mRNA-positive circulating tumor cells using a nest reverse polymerase chain reaction assay. All patients were followed up. Results CK19 mRNA-positive cells were detected in 40.0 %(20/50) of patients with early breast cancer, 12.5 %(3/24) of patients with breast benign lesions, but 5 %(1/20) in healthy individuals (P =0.017,P =0.004); 11 to 20 of them relapsed during the follow-up period (P =0.002). There was no significant association between the detection of CK19 mRNA-positive cell and the patients' menstrual status, tumor stage, tumor size, etc (P ＞0.05). Detection of peripheral-blood CK19 mRNA-positive cells was associated with reduced median relapse-free interval in early breast cancer patients (P =0.007). Conclusion CK19 mRNA is one of the molecular markers for the detection of circulating tumor cells in early breast cancer. Detection of peripheral blood CK19 mRNA-positive cells might be an important predictive value as a marker of relapse in early breast cancer patients.

BACKGROUNDIt has been known that vascular endothelial growth factor (VEGF) and its receptor (VEGFR2) play important roles in tumor angiogenesis. The aim of this study is to investigate whether an oral DNA vaccine against VEGFR2 has the inhibition effect on tumor growth and angiogenesis, and explore its mechanism in vivo.

METHODSC57BL/6 mice were respectively given the DNA vaccine encoding VEGFR2 (vaccine group), pcDNA3.1 (plasmid group) and saline (saline group). All the mice were then inoculated with Lewis lung carcinoma 3LL cells. Weight, size and microvessel density (MVD) of transplanted tumors were observed. The levels of CD3+ and CD8+ T cells in peripheral blood of mice were detected by flow cytometry.

RESULTSWeight of transplanted tumors in vaccine group was significantly smaller than those in plasmid and saline groups (P < 0.05), and MVD was significantly lower in vaccine group than that in plasmid and saline groups (P < 0.05). After inoculated with 3LL cells, CD3+ and CD8+ T cell levels of vaccine group were markedly higher than those of plasmid and saline groups (P < 0.05).

CONCLUSIONSThe oral DNA vaccine can significantly inhibit angiogenesis and growth of transplanted tumor in mice. It may act through killing endothelial cells of tumor.

Objective:To investigate effects of capecitabine metronomic chemotherapy combined with exemestane on the proliferation of breast cancer MCF-7 cells and PI3-K/AKT signaling pathway.Methods:MCF-7 cells cultured in vitro were divided into the control group (adding DMEM without drugs), 30 μmol/L exemestane group, capecitabine metronomic chemotherapy combined drugs group [30 μmol/L exemestane combined with different concentrations (50, 33, 17 μmol/L) of capecitabine]. CCK-8 assay was used to detect the cell proliferation inhibition rate, the half-maximal inhibitory concentration ( IC50) was calculated, and the changes of cell cycle and apoptosis rate of MCF-7 in different drug groups were assessed by using flow cytometry. The related-protein expression of PI3K-AKT signaling pathway of MCF-7 cells was detected by using Western blot. Results:The IC50 of capecitabine and exemestane on MCF-7 cells for 72 h was 101.2 μmol/L and 60.6 μmol/L, respectively. The proliferation inhibition rate of MCF-7 cells in 30 μmol/L exemestane for 24 h and 48 h combined with 50, 33 and 17 μmol/L capecitabine group was higher than that in 30 μmol/L exemestane group (all P<0.01). The apoptosis rates were (18.1±2.6)%, (34.6±3.0)%, (27.6±1.3)%, (23.1±1.6)%, respectively in 30 μmol/L exemestane group, 30 μmol/L exemestane + 50 μmol/L capecitabine group, 30 μmol/L exemestane + 33 μmol/L capecitabine group, 30 μmol/L exemestane + 17 μmol/L capecitabine group, and the difference was statistically significant ( F = 23.652, P<0.01). Compared with the control group, the proportion of MCF-7 cells in phase G 2 of 30 μmol/L exemestane group was increased [(16.7±2.6)% vs. (10.6±2.2)%], while that in phase G 1 was decreased [(53.3±4.0)% vs. (56.3±3.2)%]. The proportion of MCF-7 cells in phase S of 30 μmol/L exemestane + 50 μmol/L capecitabine group was increased [(39.0±3.6)% vs. (33.1±2.0)%]. MCF-7 cells of 30 μmol/L of exemestane + 33 μmol/L capecitabine group were more blocked in phase S [(51.7±4.1)%], and cells in phase G 2 were nearly disappeared [(1.2±0.5)%]; the cell proportion MCF-7 cells in phase G 2 of 30 μmol/L exemestane plus 17 μmol/L capecitabine group was increased [(26.2±3.1)%]. Western blot analysis showed that low dose capecitabine metronomic chemotherapy promoted exemestane to inhibit the expression of PI3K, motivated AKT serine phosphorylated at protein 473 [the increased expression of p-AKT (473)], promoted S6 protein expression at downstream of signaling pathway and increased its phosphorylation level (the increased expression of p-S6), thereby activating apoptosis signal. Conclusion:Capecitabine metronomic chemotherapy combined with exemestane can synergistically inhibit the proliferation of breast cancer MCF-7 cells and activate apoptosis mechanisms of MCF-7 cells through affecting PI3K-AKT signaling pathway.

Objective To evaluate the effects of total intravenous anesthesia on the circadian rhythms in the patients undergoing cardiac transcatheter closure.Methods Thirty patients undergoing cardiac transcathe-ter closure under elective intravenous anesthesia were included in this study.Paired t-tests were performed to com-pare the mRNA levels of the genes encoding circadian locomotor output cycles kaput(CLOCK),brain and mus-cle ARNT-1 like protein-1(BMAL1),cryptochrome1(CRY1),and period circadian clock 2(PER2),the Munich Chronotype Questionnaire(MCTQ)score,and the Pittsburgh Sleep Quality Index(PSQI)score be-fore and after anesthesia.Multiple stepwise regression analysis was performed to screen the factors influencing sleep chronotype and PSQI total score one week after surgery.Results The postoperative mRNA level of CLOCK was higher[1.38±1.23 vs.1.90±1.47;MD(95％CI):0.52(0.20-0.84),t=3.327,P=0.002]and the postoperative mRNA levels of CRY1[1.56±1.50 vs.1.13±0.98;MD(95％CI):-0.43(-0.81--0.05),t=-2.319,P=0.028]and PER2[0.82±0.63 vs.0.50±0.31;MD(95％CI):-0.33(-0.53--0.12),t=-3.202,P=0.003]were lower than the preoperative levels.One week after surgery,the pa-tients presented advanced sleep chronotype[3:03±0:59 vs.2:42±0:37;MD(95％CI):-21(-40--1),t=-2.172,P=0.038],shortened sleep latency[(67±64)min vs.(37±21)min;MD(95％CI):-30.33(-55.28--5.39),t=-2.487,P=0.019],lengthened sleep duration[(436±83)min vs.(499±83)min;MD(95％CI):62.80(26.93-98.67),t=3.581,P=0.001],increased sleep efficiency[(87.59±10.35)％vs.(92.98±4.27)％;MD(95％CI):5.39(1.21-9.58),t=2.636,P=0.013],decreased sleep quality score[1.13±0.78 vs.0.80±0.71;MD(95％CI):-0.33(-0.62--0.05),t=-2.408,P=0.023],and declined PSQI total score[6.60±3.17 vs.4.03±2.58;MD(95％CI):-2.57(-3.87--1.27),t=-4.039,P＜0.001].Body mass index(BMI)(B=-227.460,SE=95.475,t=-2.382,P=0.025),anesthesia duration(B=-47.079,SE=18.506,t=-2.544,P=0.017),and mRNA level of PER2(B=2815.804,SE=1080.183,t=2.607,P=0.015)collectively influenced the sleep chronotype,and the amount of anesthesia medicine(B=0.067,SE=0.028,t=2.385,P=0.024)independently influenced the PSQI one week after surgery.Conclusions Total intravenous anesthe-sia can improve sleep habits by advancing sleep chronotype.BMI,anesthesia duration,and mRNA level of PER2 collectively influence sleep chronotype one week after surgery.The amount of anesthesia medicine independently influences the PSQI total score one week after surgery.