Objective To observe the detection methods of cerebral vasospasm after traumatic brain injury and the impact on prognosis.Methods Twenty patients with traumatic brain injury underwent transcranial Doppler ultrasound were divided into cerebral vasospasm group and control group.Results There were 7 patients combined with cerebral vasospasm and 13 patients without cerebral vasospasm.Two patients died in cerebral vasospasm group and 1 patient died in control group.The fatality rate between two groups had significant difference (P ＜0.05).All surviving patients followed up for 1 year after being discharged.According to the Glasgow Outcome Scale,in cerebral vasospasm group,3 patients were with severe disability,1 patient was with moderate disability,1 patient restored good function.In control group,2 patients were with severe disability,2 patients were with moderate disability,8 patients restored good function.The rate of restored good function between two groups had significant differences (P ＜ 0.05).Conclusions Cerebral vasospasm can increase mortality in traumatic brain injury patients,and the functional evaluation in survival patients are even worse.Prevention of cerebral vasospasm after traumatic brain injury has important clinical significance.

This paper introduced the current situation of cardiac interventional therapy and put forward the fol-lowing points that medical staffs should pay attention to:the patient's right to know, right to be informed, right of communication, right of privacy, and etc. On this basis, it is suggested to solve the ethical issues in cardiac inter-ventional therapy through the implementation of clinical pathway, effective communication, humanistic care, the construction of occupational ethics, strict feedback and supervision.

Objective To study the relationship between the level of serum total bile acid(TBA)and fetal distress of intrahepatic cholestasis pregnancy(ICP).Methods 357 patients with ICP were devided into two groups,fetal distress group and non-fetal distress group.Their levels of TBA were collected retrospectively.Results The incidence rates of fetal distress rose with the increasing level of TBA.As the level of TBA was over 35umou/L,the incidence rates of fetal distress rose significantly.Conclusion The study suggest that the level of TBA maybe one of sensitive marker to preditect fetal distress.

MicroRNAs (miRNAs) are small non-coding RNA molecules with 21 to 24 nucleotides in length, which can regulate post-transcriptional gene expression by interacting with the 3' untranslated regions of the target mRNAs. MiRNAs are widely expressed in eukaryotic cells and involved in a variety of biological processes, such as in the development, differentiation, proliferation, and apop-tosis of cells. They also play essential roles in cell cycle regulation, migration, and tumor development. MicroRNA expression varies in different human tumors and is considered a powerful potential biological indicator in the development, diagnosis, treatment, and progno-sis of cancers. Breast cancer is one of the most common malignancies, and miRNA expression has been found to be differentially ex-pressed in various types of breast cancer. The expression and function of some miRNAs involved in breast cancer development, metasta-sis, and treatments are briefly summarized in this review.

BACKGROUND: Post-stroke depression(PSD) is the most common emotional change after stroke. It has high morbidity, which also seriously affects the near and long term functional prognosis of the patients and affects the quality of life (QOL) of the patients during convalescence.OBJECTIVE: To investigate the impacts of integrated rehabilitative therapy on post-stroke depression and ability of daily life(ADL) through interventional therapy in patients with post-stroke depression.DESIGN: A randomized controlled study with the patients as subjects basedon diagnosis.SETTING: Department of cadre in a university hospital.PARTICIPANTS: Sixty cases including 34 males and 26 females hospitalized in the Department of Cadre of the General Hospital Affiliated to Tianjing Medical University between October 2001 and March 2002 were randomly divided into rehabilitation group( n = 30) and control group( n = 30).INTERVENTIONS: Patients of rehabilitation group received both routine medication and integrated rehabilitative therapy (cinesiotherapy + psychotherapy) while the patients of control group only received routine medication(decompression, improving cerebral circulation and symptomatic therapy) . Barthel index(BI) and Hamilton rating scale for depression(HAMD)were used to assess the patients at admission, the 3rd month and the 6th month during the course of the disease.MAIN OUTCOME MEASURES: BI and HAMD score at the 3rd and 6thmonth in patients of rehabilitation group and control group.RESULTS: BI at 3rd month or 6th month was (68.0 ± 2.9) or (70.0 ± 3.5)in patients of rehabilitation group, which was significantly higher than (62.0±3.3) at 3rd month and (65.0±3.8) at 6th month in patients of control group( P ＜ 0. 001, 0. 01) . HAMD score at 3rd month or 6th month was(8.9 ±4.9) or(8.7 ±5.1) in patients of rehabilitation group, which was significantly lower than(15.2 ±5.6) at 3rd month or(14. 9 ±8. 1) at 6th month in patients of control group ( P ＜ 0.05).CONCLUSION: Integrated rehabilitative therapy can effectively improve the ADL of patients with post-stroke depression and relieve depression.

AIM:To investigate the role of imperatorin in reversing the resistance of the PC 9 CD133+cell sub-sets to gefitinib.METHODS:MTT assay was performed to evaluate the viability of PC 9 cells treated with imperatorin and gefitinib.The expression of c-met, activation of caspases and phosphorylation of epidermal growth factor receptor (EGFR), PI3K and AKT in the PC9 cells treated with imperatorin and gefitinib were determined by Western blot .The percentage of CD133 +cell subsets population and the apoptotic rate of the PC 9 cells treated with imperatorin and gefitinib were analyzed by flow cytometry .RESULTS:The sensitivity of the PC 9 CD133 +cell subsets to gefitinib was significantly lower than that of the PC9 CD133 -cell subsets.Treatment with gefitinib alone significantly inhibited the protein levels of EGFR /PI3K/AKT in the PC9 CD133 -cell subsets but not the PC 9 CD133 +cell subsets .Treatment with gefitinib alone increased the percentage of CD133 +cell subsets population in the PC9 cells.However, combination of gefitinib with imperatorin signifi-cantly inhibited the enrichment of CD 133 +cell subsets population .Imperatorin down-regulated c-met expression , sugges-ting the c-met was the target of imperatorin in the PC9 CD133 +cell subsets.The results of MTT assay, Western blot analy-sis and flow cytometry indicated that imperatorin increased the gefitinib induced inhibition of PI 3K/AKT protein levels by down-regulating the expression of c-met, which subsequently induced the cleavage of caspases and apoptosis in the PC 9 CD133 +cell subsets.CONCLUSION:Imperatorin increases the sensitivity of lung cancer CD 133 +cell subsets to gefitinib by down-regulating the expression of c-met, and the synergistic anti-tumor effect exists between imperatorin and gefitinib .

Background and purpose:Lung cancer is one of most common diseases,The number of new cases of lung cancer are more than 500 000 per year in the world and it has been ranked as number one in terms of incidence of malignant tumors in China.Unfortunately about 40 percent of the patients were diagnosed as locally advanced unresectable non-small cell lung cancer(NSCLC).Elderly patients with NSCLC also showed an increasing trend in the past years.The purpose of this study was to evaluate the efficacy and safety of gemcitabine(GEM) and carboplatin(CBP) used as induction regimen in the treatment of elderly patients with locally advanced unresectable NSCLC.Methods:42 cases of elderly patients have been cytologically and pathologically confirmed with locally advanced unresectable NSCLC,the age of the patients ranged from 65 to 75.The patients were treated with the combined regimen of gemcitabine and cisplatin.GEM 1 000 mg/m2 intravenously injected by drip on the 1st,8th day and the dosage of CBP was AUC 5 that was used on the 1st day,21 days apart to each cycle,most patients received 2-3 cycles.Treatment response was evaluated according to the criteria of RECIST(Response Evaluation Criteria in Solid Tumor),the side effect of the regimen was judged based on WHO criteria.Results:42 patients were evaluable and received a total of 89 cycles chemotherapy.There were no complete regression that could be observed,but 17 cases had partial regression(PR),22 cases with no change(NC) and 3 cases with progression disease(PD).The overall response rate was 40.5%.The main side effects were hematological toxicity.Conclusions:The GC regimen could be used as induction treatment for elderly patients with locally advanced unresectable NSCLC,and the regimen could be well tolerated and is safe in terms of side effects.

Objective:To study the vaccine potency of gene-modified tumor cells. Methods:The EL-4 lymphoma was transduced with recombinant retrovirus containing the murine B7-1 gene. The effect of gene transduction on antitumor immunity was investigated.Results:The appearance, growth rate and surface marker of MHCⅠand MHCⅡ molecules of EL-4 cells transduced with B7-1 gene were the same with control cells except for CD80 positive in B7-1 gene transduced cells. B7-1 gene transduced EL-4 cells resulted in remarkable loss of tumorigenicity in syngenetic mice. EL-4/B7-1 cells could induce system protective immunity. Therapeutic vaccine of EL-4/B7-1 cells could retard the growth of established early-stage EL-4/Wt tumor significantly, but not retard the growth of late-stage EL-4/Wt tumor. Irradiated EL-4/B7-1 vaccine showed weak effect against challenged EL-4 cells.Conclusion:B7-1 gene transduced EL-4 cells can induce system protective immunity. It suggested that this vaccine have a potential application value in human cancer treatment.

Objective To investigate the effects of low-concentration lidocaine on the persistent sodium currents enhanced by hypoxia in isolated rat CA1 hippocampal neurons. Methods Brains were harvested from 10-14 day old SD rats of both sexes. Hippocampi were immediately isolated and cut into slices (400-500 ?m) which were incubated in artificial cerebral-spinal fluid (ACSF) at 31 ℃ for 1-1.5 h. CA1 regions were isolated and hippocampal neurons were prepared by enzymatical digestion. The experiment was performed in 7 groups ( n = 10 each): hypoxie control group (C) and lidocaine 1, 3, 6, 10, 20, 30 ?mol groups (L1-6). The isolated neurons were transferred to the recording chamber. The persistent sodium currents were recorded using whole-cell patch clamp technique first under normal condition. The normal perfusion solution was then replaced with hypoxie and glucose free perfusion solution within 20 seconds. The persistent sodium currents were recorded again after being perfused with hypoxie and glucose free solution with and without lidocaine. Results The persistent sodium current was greatly enhanced after 5 min hypoxia as compared to the baseline value before hypoxia. The persistent sodium current in group L1-6 was significantly lower than that in group C after 5 min hypoxia. The inhibitory effect of lidocaine on the persistent sodium current enhanced by hypoxia was dose-dependent. Conclusion Low concentration lidocaine can inhibit the persistent sodium current enhanced by hypoxia.

Objective To investigate the polymorphism of peroxisome proliferator-activated receptors-?2(PPAR-?2) and its association with obesity in Chinese population.Methods According to BMI,89 subjects who are in normal body weight range and 116 overweighted and obese subjects were included in this study.Their Pro12Ala mutation in the PPAR-?2 gene was detected by PCR restriction fragment length polymorphism.Results Allele frequency of Ala mutation of PPAR-?2 in overweighted and obese subjects(qA=11.64%) was significantly higher than that of normal body weight group(qA=5.06%,P