Chemotherapy remains the main treatment for many cancer patients. However, P-glycoprotein (P-gp) mediated multidrug resistance poses severe challenges to current chemotherapies. As ideal vectors to overcome drug resistance, nanovehicles are extensively explored for cancer treatment by diverting P-gp mediated drug efflux mechanisms. Surface engineering of nanocarriers has attracted great attention for targeted therapeutic delivery. The folate receptors, one of the most researched targets in cancer therapeutics, are over-expressed in several carcinomas. And folate has become one of the most investigated ligands in cancer therapeutic direction due to its small size, easy conjugation to nanocarriers, nontoxic, nonimmunogenic nature, and well stability in storage or in circulation. This review discussed the current status of folate functionalized nanoparticles in diverting P-gp mediated drug efflux mechanisms.

Objective To evaluate the result of short-segment pedicle screw instrumentation plus pedicle screws inserted into the injury level for treatment of thoracolumbar burst fracture.Methods Fifty-six cases of thoracolumbar burst fracture treated from June 2008 to June 2011 were reviewed.There were 40 males and 16 females at mean age of 32.8 years (range,25-60 years).Twenty-four cases were injured from traffic accidents,19 cases from fall from the height,and 13 cases from fall of heavy objects.Fractured segments were T11 in 6 cases,T12 in 14 cases,L1 in 16 cases,L2 in 12 cases,L3in 5 cases,and L4 in 3 cases.Thirty cases underwent short-segment pedicle screw fixation through the level above the fracture to level below the fracture (Group A).Apart from this,26 cases were treated with additional transpedicular fixation at the fractured level (Group B).Anterior vertebral height ratio,sagittal Cobb' s angle,neurologic performance as evaluated by American Spinal Injury Association (ASIA) scale were assessed before operation,one week after operation,and one year after operation.Results Anterior vertebral height ratio and Cobb' s angle revealed no significant differences between the two groups before operation and one week after operation.At postoperative one year,anterior vertebral height ratio and sagittal Cobb' s angle were (87.2 ± 6.9)％ and (7.6 ± 3.2)°in Group A with significant differences from (93.3 5.7)％ and (5.7 ± 1.9) ° in Group B (P ＜ 0.05),but there was no statistical difference in ASIA scale of neurologic performance.Conclusion Short-segment pedicle screw instrumentation with stabilization at the level of fracture is an effective treatment for thoracolumbar burst fracture.

Objective To study the association between sympathetic skin response(SSR) and diabetic autonomic neuropathy(DAN), and explore its use as the objective base for its early diagnosis. Methods SSR was carried out in 30 patients with DAN and 30 healthy controls. Results The SSR indices of the patient with diabetic mellitus(DM) either with or without DAN were different from those of normal objects. Conclusion The SSR detection and analysis can detect the early dysfunction of the autonomic system in diabetic mellitus and may be a useful testing for early diagnosis of diabetic neuropathy.

Objective To study the effect of antimitochndrial antibody(AMA) and antinuclear antibodies(ANA) on anti-human immunodeftcfency vius(HIV) enzyme-linked immunosorbent assay(ELISA).Methods By differents the result of weatern blot(WB),the tests were divided into two groups:experiment and control groups.The experiment group was divided into 2 sub group(A,B).Results There was signiftcant difference between experiment group A and control groups(P

The current status and important advances in multi-disciplinary treatment for advanced gastric cancer,including surgery,chemotherapy and radiotherapy,were reviewed in this article.An operative scheme based on the stage and biologic behavior of the tumor is adopted with the D_2 procedure combined with intraoperative peritoneal hyperthermic chemotherapy(IPHC) for stage Ⅱ and Ⅲ patients.Accurate preoperative staging is of utmost importance in making an appropriate therapeutic strategy.For patients with stage Ⅲ_B and Ⅳ gastric cancer,neo-adjuvant chemotherapy followed by cyto-reductive surgery,is helpful to prolong survival and improve the quality of life.Besides the 5-FU,cisplatin and doxorubicin based regimen,combination regimens employing newer generation cytotoxic agents including oxaliplatin,irinotecan,taxanes provided more promising efficacy.Postoperative chemo-radiotherapy is presently under investigation.

Sorafenib is a novel oral multikinase inhibitor that inhibits Raf kinase because of its anti-proliferative property. Sorafenib also inhibits receptor tyrosine kinases of multiple proangiogenic factors, such as VEGFR-1/2/3 and PDGFR-β. The combina-tion of both its anti-proliferative and anti-angiogenic properties makes sorafenib an attractive agent in cancer treatment. To date, sorafenib is the only approved systemic treatment for patients with hepatocellular carcinoma. The most common adverse events of this inhibitor included hand-foot skin reactions, nausea, diarrhea, weight loss, and hypertension. These adverse events can severely affect patient compliance, which may negate the effect of therapy. Correct understanding and treatment of these adverse events can improve clinical outcome. This paper discusses the clinical aspect of sorafenib-induced adverse events and the molecular basis behind their toxic-ity. Recommendations for the management of the adverse effects are also provided.

Objective To observe the effect of high mobility group box-1 protein (HMGB1) on the expression of intestinal epithelial tight junction protein occludin in murine severe acute pancreatitis (SAP).Methods Rat SAP model was estabilished by retrograde injection of 5 ％ sodium taurocholate into choledochopancreatic duct.Healthy wistar rats were divided randomly (random number) into three groups:control group,SAP group,pyrrolidine dithiocarbamate (PDTC) therapy group.Levels of plasm amylase,lipopolysaccharide (LPS) and D-lactate were determined.The changes of morphological damage of pancreasand intestinal tissues were observed by microscopy.The distribution and expression of occludin protein were observed by SP immunohistochemistry. The mRNA expression of HMGB1 in the intestinal mucosa was detected by reverse-transcription polymerase chain reaction (RT-PCR).The expressions of HMGB1 and occludin were determined by western blotting. One-way analysis of variance was performed with SPSS Windows 13.0 statistical analysis software,and a difference was accepted as significant if P ＜ 0.05.Results In comparison with the other two groups,levels of plasma LPS and D-lactate in SAP group increased markedly at 24 h after operation,which indicated that the penetrability of intestinal mucosal barrier increased (P ＜ 0.05 ). The expression of HMGB1 in the intestinal mucosa of SAP group increased significantly compared with control group (P ＜ 0.05).Whereas,the expression of occludin was significantly lower than control group (P ＜0.05).Compared with SAP group,the expression of HMGB1 was lower and the expression of occludin was higher in PDTC group ( P ＜ 0.05).Conclusions The over-expression of HMGB1 could down regulate the expression of occludin in intestinal tissues of SAP rats,and thus mediate an increase in penetrability of intestinal mucosal barrier.As PDTC inhibited the expression of HMGB1,the expression of occludin protein was up-regulated and the function of intestinal mucosal barrier was improved.

BACKGROUND:For evaluation of risks of periprosthetic fractures in elderly patients aged>75 years old after hemiarthroplasty, we should perform dynamic observation of postoperative physical health status, quality of life, hip function and bone mineral density. Presently, there is lack of general investigation.
OBJECTIVE:To provide references for clinical diagnosis and prediction of periprosthetic fractures after hemiarthroplasty in elderly patients.
METHODS:On the basis of arranging the exploration results of recent studies on risk factors for periprosthetic fractures of hip joint, we analyzed the monitoring method of scholars concerning fracture-associated risk factors. Simultaneously, in combination of the development of modern inspection sciences, the method was applied in the clinic. Thus, we summarized general evaluation methods with clinical significance for risk factors of prosthesis fracture in elderly patients after hemiarthroplasty.
RESULTS AND CONCLUSION:For elderly patients with femoral neck or intertrochanteric fracture combined with various medical il ness, hemiarthroplasty is an effective manner presently. Fractures surrounding the prosthesis in elderly patients postoperatively gradual y increased. Once fracture appeared, it would bring a great attack on patients’ spirit, economy and even life. Therefore, early evaluation on the risk factors for fractures surrounding the prosthesis is a necessary measure for preventing and saving this disastrous consequence by selecting general correct prevention and treatment strategies. This wil greatly improve patients’ prognosis and elevated patient’s quality of life and survival rate. Present short-term smal-sample prospective fol ow-up studies suggested that comprehensive dynamic evaluation possibly has a certain clinical significance for the evaluation of risks of fractures after hemiarthroplasty in elderly patients, and deserves further investigations.

Objective:To investigate the effects of Yizhi Oral Solution on protein and RNA synthesis of brain tissue of mice. Methods: The radioactive intensities of 3H leucine in brain protein and 3H uridine in RNA of brain tissue of young mice were observed by the methods of incorporation in vivo and group control observation.Results: The radioaetive intensity of 3H leucine of Yizhi Oral Solution group was higher than that of cycloheximide pathological model group ( P

Objective:To compare the clinical effects between axillary approach, periareolar approach and inframammary fold approach in breast augmentation.Methods:Two hundred and eleven patients in our department from Jan. 2016 to Jan. 2018 were involved in this study. According to the surgical approach, the patients were divided into the axillary approach group, periareolar approach group and inframammary fold approach group. Postoperative pain, incision scar, drainage fluid and several complications were observed in three groups.Results:Postoperative VAS score of patients in inframammary fold approach and periareolar approach group was lower than that in the axillary approach group ( F=70.93, P<0.05), and postoperative drainage fluid was lower than in the axillary approach group. No diffrences were found in postoperative scar score among the three group ( P>0.05), and the nipple areola sensory disorder in the inframammary fold approach group was less. Conclusions:Breast augmentation of inframammary fold approach has the advantages of relatively hidden incision, short surgical approach, direct vision operation, mild pain, less surgical injury and low postoperative complications. It is worthy of being promoted.