Objective To assess the effects of transfection of plasmid pcDNA3.1-p16 containing the wild-type(wt) INK4a gene on the radiotherapy sensitivity of human lung adenocarcinoma cell line A549. Methods Using cationic liposome, the recombinant eukaryotic expression vectors pcDNA3.1-p16 were introduced into A549 cell line and named as A549-p16, in which the gene site INK4a was lost. By RT-PCR, immunocytochemistry and Western blotting after G418 selection, A549 cells stably expressing p16 were obtained. The parental cell and negative control cell with plasmid pcDNA3-LacZ were used as controls.The colony formation rate and 50% inhibition dose(ID_ 50) were measured and analyzed after radiation. Results As compared with the parental cell and negative control cell, re-expression of p16 in A549 induced the cell arrest at G_ 0/G_ 1. The growth rate and the colony formation rate decreased and the ID_ 50 decreased slightly in A549-p16. Conclusion The exogenous introduction of wtINK4a gene into lung adenocarcinoma cells A549 increased the radiosensitivity.

Objective:To evaluate the curative effect of combination therapy of acid inhibitory drugs and prokinetic agents for mycotic esophagitis.Methods:60 patients with low-grade or moderate-grade mycotic esophagitis were randomly divided into two groups.The experimental group(30 cases)were treated with acid inhibitory drugs plus prokinetic agents;the control group(30 cases) were treated with antimycotic drugs.All of these patients were treated for 2 or 4 weeks.The clinical symptoms were observed at weeks 2 and 4 after treatment .The results were evaluated by gastric endoscopy,mycotic examination,and pathology.Results:The effective treatment results were observed and all clinical systoms in all these patients disappeared.The test for fungus was negative.In the experimental group,there were 21 cases of cure at week 2,8 cases of cure and 1 case of improvement at week 4.In the control group,there were 25 cases of cure at week 2,5 cases of cure at week 4.There was no significant different in clinical efficacy and pathological change between the experimental group and the control group.The side-effect in the experimental group was significantly lower than that in the control group(P

OBJECTIVE： To compare between two different modes of stability test for norgestrienone acetate.METHODS： HPLC(Resolve C18 column， 5μ m ID， 4.6mm× 250mm as fixed phase， a mixture of methanol and purified water (7∶ 3) as mobile phase， detecting wavelength 243nm， flow rate 1ml/min) and TLC.RESULTS： Two tests obtained the same result.CONCLUSION： The methods used are feasible for stability test.

Background:Gastroesophageal reflux disease( GERD)that does not respond satisfactorily to standard proton pump inhibitor is defined as refractory gastroesophageal reflux disease( rGERD). Combined therapy is used to treat rGERD, however,the addition of baclofen is rarely studied. Aims:To investigate the efficacy of baclofen combined with esomeprazole and mosapride on rGERD. Methods:Seventy-two patients with rGERD from March 2013 to April 2014 at the First Hospital of Putian City were enrolled and randomly divided into group A and group B. Patients in group A were orally administrated with esomeprazole 20 mg bid + mosapride 5 mg tid + baclofen 5 mg tid. Patients in group B were treated with esomeprazole 20 mg bid + mosapride 5 mg tid. The treatment course was 8 weeks. The efficacy on symptoms, esophagitis under endoscopy and adverse effects were compared between the two groups. Results:After 8-week treatment, score of heartburn,regurgitation,retrosternal pain,dysphagia and overall symptom were significantly decreased in the two groups than before the treatment. The overall symptom alleviating rate was significantly higher in group A than in group B (90. 6% us. 70. 0%;χ2 =4. 585,P=0. 032). Esophagitis under endoscopy in the two groups was significantly improved, the effective rate was significantly higher in group A than in group B(93. 8% us. 75. 0%;χ2 =4. 500,P=0. 034). The main adverse effects of baclofen were somnolence,dizziness and fatigue,all the patients were well tolerated. Conclusions:Baclofen combined with esomeprazole and mosapride is an efficient option for rGERD.

Objective To investigate the clinical effects of reconstruction by using the free iliac flap with nerve anastomosis to repair the composite tissue defects of heel.Methods From March 2009 to August 2012,five cases with the composite tissue defects of heel,including 2 cases with the bottom defects and 3 cases with the tibial defects of heel,were repaired by the free iliac flap,and the feeling of the heel were reconstructed by nerve anastomosis of the flap.The ventral wound were sutured simply.Results All iliac flaps survived and the wound healed in one stage.Patients were followed up from 6 months to 12 months.Appearance and function recovered and the feeling recovered from S2-S3.The foots walked freely.The skin of iliac abdomen were scarred and lead to hyperpigmentation.Conclusion Using the free iliac flap with nerve anastomosis could repair the bone and soft tissue defects of heel and reconstruct the sensation of warmth and sense of pain of the heel.With the characteristics of hidden wound and little damage,the clinical effects was satisfied.

Objective To study the chimerism formation in kidney transplantation recipient receiving peripheral blood stem cells (PBSCs) of the donor after the patient received preoperative total lymphoid irradiation (TLI). Methods 5 patients of living donor kidney transplantation were involved in present study. The mean age of donors was 40 and that of recipients was 27. There was one patients with 4 HLA antigen mismatches out of 6 HLA-A, B, DR antigens, two patients with 3 HLA-mismatches, and two patients with 1 HLA-mismatch. The patients received TLI in doses 90cGy/d from day -5 to day -1. The immunosuppression protocol for these patients during operation and afteroperation was similar to that for other cases, but the dosage was slightly reduced. Donor PBSCs were harvested twice via leukapheresis after the administration of human recombinant granulocyte colony stimulating factor (G-CSF). PBSCs were infused intravenously to the recipients on postoperative day 4 and 7. Chimerism of peripheral blood cell in recipients was detected by PCR-SSP assays. The grafted kidney function, acute rejection frequency and GVHD episodes were also observed. Results After 5 days of G-CSF based mobilizing regimen, the average number of PBSCs harvested from donors was 34?10~6. At 1 month post-transplantation, donor type HLA-DR gene was detected in all the recipients. At 2 and 3 months post-transplantation, chimerism was not detectable in the recipient with 4 HLA antigens (including 2 HLA-DR) mismatched donor kidney and in the recipient with 3 HLA (including 2 HLA-DR and 1 HLA-B) mismatched donor, respectively. In the other 3 recipients, chimerism was still positive 3 months post-transplantation. There were no symptoms of GVHD or infections after infusion of PBSCs. Transplanted kidneys functioned normally and no rejection episodes were observed till the end of the study. The immunosuppressant dosage was lower for these 5 cases than those after conventional cadavar renal transplantation. Conclusions Non-myeloablative TLI conditioning regimen is a safe and effective method which can promote the engraftment of donor PBSCs and induce hemopoietic chimerism. Chimerism can alleviate rejection of the transplanted kidney and reduce the immunosuppressant dosage. Collection and infusion of PBSCs are simple, convenient, effective, and inexpensive, and it is an optimal source of hemopoietic stem cells.

Objective To investigate the safety and effectiveness of the application of an immunosuppressing primed total lymphoid irradiation (TLI) of the recipient in kidney transplantation of living donor kidney graft. Methods 5 recipients, 3 males and 2 females with the average age of 27, underwent the primed regimen of TLI. As to 6 HLA-A, B, DR antigens of donors and recipients, 4 HLA antigen mismatches were found in one case, 3 mismatches in two cases, and 1 mismatch in two cases. The donor grafts were procured by the technique of hand-assisted transperitoneal laparoscopic living donor nephrectomy (HLDN). The primed regimen of TLI was carried out 5 days before the operation in a dosage 90 cGy/d. The intra- and postoperative immunosuppressant protocols for these cases were similar to that for the other cases, but the doses were reduced slightly. WBC, total T cell, CD4~+ and CD8~+ T cell subsets and Th1/Th2 immune deviation were examined in recipients periodically. The function of the grafted kidney, acute rejection frequency, and side effects of TLI were also observed. Results In the recipients undergone TLI, the total WBC and T cell, CD4~+ and CD8~+ subsets were reduced to a base value at 1-2 weeks post-transplantation and did not restore to the pre-transplantation levels until the investigation was ended. A particular phenomenon showing that in TLI based regimen T cells were shifted from Th1 to Th2 cells was observed. No side effects of TLI, such as infection, were found during the observation. Transplanted kidneys functioned normally and no rejection episodes were observed up to the end of the study. The immunosuppressant doses for those 5 cases were lower than that of conventional protocol. Conclusions TLI based non-myeloablative primed regimen is a safe and effective method for immunosuppression without serious side effects, and it can markedly alleviate kidney transplant rejection and reduce the dosage of immunosuppressive drugs.

Objective To evaluate the condition of living renal donors with 3-dimensional volume rendering computed tomography (3D-CT) in preoperation. Methods 10 consecutive cases received hand-assisted transperitoneal laparoscopic living donor nephrectomy (HLDN) from December 2001 to July. Total patients underwent 3-dimensional volume rendering computed tomography before operation for assessing the condition of the anatomical location, number, anomalies and spatial interrelationships of the renal arteries and veins. These 3D-CT were directly compare with intraoperative surgical findings at laparoscopy and the harvested kidney ex vivo to value the sensitivity and accuracy of 3D-CT. Results The CT digital data of 10 cases were reconstructed to 3D-CT with volume rendering technique, and HLDN were performed successfully in all the cases. The 3D-CT accurately identifies renal vascular anatomy. Conclusions Not only the 3D-CT accurately identifies renal vascular anatomy but also tridimensional images reconstructed by the enhanced CT digital data of arterial phase, venous phase and renal parenchymal phase are viewed by surgeon in any position. It is a manner that may facilitate renal hilar dissection during laparoscopic donor nephrectomy. The 3D-CT should be a routine examination for living donor in preoperation

Objective To evaluate the efficacy and safety of self-management anticoagulation treatment for low pulmonary embolism severity index (PESI) outpatient with acute pulmonary embolism (APE).Methods Sixty-eight patients with APE of PESI grade Ⅰ-Ⅱ were divide into inpatient group and outpatient group with 34 cases each by random digits table.All the patients were treated with low molecular heparin followed by oral anticoagulation,and self-management was used in outpatient group.The efficacy was observed within 14 days and 3 months.The efficacy outcome included recurrent venous thromboembolism (VTE),standardization time of international normalized ratio (INR),VTE-related emergency department visit times,bleeding events and total mortality.Results There were 2 cases(5.9％,2/34) in inpatient group and 1 case (2.9％,1/34) in outpatient group with recurrent VTE,and there was no statistical significance between two groups (P ＞ 0.05).Standardization time of INR in inpatient group [(8.5 ± 2.9) d] was shorter than that in outpatient group [(16.1 ± 4.4) d],and there was significant difference (P＜ 0.01).There was no significant difference in the VTE-related emergency department visit times between two groups (P ＞ 0.05).There was 1 case with major bleeding and 1 death respectively in outpatient group.Conclusion It is effective and safe to give early self-management anticoagulation treatment to APE patients with PESI grade Ⅰ-Ⅱ,which could shorten time spending in hospital and release burden both physically and mentally.

Sperm associated antigen 9(SPAG9),a new member of the c-Jun NH2-terminal kinase (JNK)interacting protein(JIP)family. plays a role in sperm-egg fusion and mitogen-activated protein kinase (MAPK)signaling pathway.Researches have shown that SPAG9 is closely related to the biological behavior of human malignant tumors, and plays an important role in the development of tumor.