Objective To evaluate the effect of late course accelerated hyperfractionation radiotherapy(LCAHR) for esophageal carcinoma. Methods Six clinical trials on LCAHR for esophageal carcinoma were reviewed by means of Meta analysis . Results The 1 and 3 year survival rates in the LCAHR group derived from the fixed effect model were 2.39 (1.58～3.62) and 3.05(1.96～4.74) times higher than the conventional fractionation group. With the random effect model,the 1 and 3 year survival rates in the LCAHR group were 2.43(1.54～3.82) and 2.99(2.08～4.30) times higher than the conventional fractionation group.Conclusion For esophageal carcinoma,the better outcome of LCAHR makes it advisable in extensive clinical practice.

Objective: To study the effects of mechanical strain on the proliferation of human osteoblasts. Methods: Cloned MG 63 human osteoblasts were cultured and seeded at 10 5/well in 6 well Bioflex cell cuture plates. Subsequently, the cells were exposed to mechanical strain stimulation (at 6%, 12% and 24% elongation rate respectively) for 24 hours using Flexercell 3000 Cell Stretching Unit. MTT colorimetric method was used to assess the proliferation of the cells. Results: The proliferation of MG 63 cells was significantly increased 24 h after mechanical strain treatment( P

Objective To observe cocultured TAMs cell U937 and NSCLC cell A549 effecting on MCP-1, MIP-1 expression under different conditions in vitro. Methods The cell UM937 of different concentrations (0,1,2,4,8×105/ml) was respectively selected to coculture with the cell A549 0f certain concentration (1.0×105/ml) for 24 hours, in situ hybridization was carried out to detect MCP-1, MIP-1mRNA positive expressions in cell A549 of every concentration group. Under the condition that both concentrations of cell A549 and cell U937 are l.0×105/ml, the same method was used to measure MCP-1, MIP-1mRNA positive expressions in cell A549 in different periods (4h, 8h, 16h, 32h, 48h). Results The positive expression ratios of MCP-1, MIP-1mRNA in cell A549 significantly increased along with addition of the cell U937 concentration and delay of the cocultural time, apparently higher than that of primary cocultured group that the cell U937 was 0×105/ml and that of contrast group at every period (all P<0.05). Conclusion The mutual interaction between TAMs and NSCLC cells has closely positive correlation with MCP-1, MIP-1mRNA positive expressions in cell A549, and depends on cocultural concentration and time.

OBJECTIVE:To investigate the function change of intestinal CYP3A4 and P-glycoprotein (P-gp) under diabetic conditions and its mechanism. METHODS:Caco-2 cells were respectively added with 25, 50 and 100 μmol/L midazolam (CYP3A4 probe substrate) for incubation for 15,30,60,120,180 min;with 0.1,0.2,0.4 μg/ml rhodamine 123 (P-gp sub-strate)for incubation for 15,30,60,90,120 min to determine the substrate concentrations and incubation time. Caco-2 cells were added with insulin,glucose and fatty acid (palmitic acid and oleic acid) at different concentrations,and then the production of 1′-OH-midazolam,the metabolite of midazolam,and the intake of rhodamine 123 were determined,in order to investigated the ef-fect on the function of CYP3A4 and P-gp. RESULTS:The optimal substrate concentrations and incubation time were as follows as 50 μmol/L midazolam,0.1 μg/ml rhodamine 123 and incubation for 2 h. With the increase in the concentration of insulin,glucose and palmitic acid,the production of 1′-OH-midazolam and the activity of CYP3A4 reduced;the intake of rhodamine 123 in-creased,and the efflux transport function of P-gp decreased. Oleic acid had no significant effect on the production of 1′-OH-mid-azolam or the intake of rhodamine 123. CONCLUSIONS:Under diabetes condition,the increase of insulin,glucose and palmitic acid may reduce the function of CYP3A4 and P-gp,while oleic acid has no effect on the function.

Objective To investigate the risk factors for drug resistance‐tuberculosis(DR‐TB) ,and to establish a clinical risk predictive model .Methods A total of 126 cases of DR‐TB patients and 126 cases of non‐DR‐TB patients treated in our hospital from January 2014 to January 2015 were included in this study .The clinical data of these patients were collected .We used univariate and multivariate logistic regression analysis to determine the independent risk factors and established a risk predictive model .The calibration and discrimination of the model were assessed by the H‐L test and the area under the ROC curve ,respectively .Results Statistical analysis showed that the risk factors included previous treatment ,a duration of first treatment of more than 8 months ,ad‐verse effects of anti‐TB medication ,more than three TB foci in the lung and diabetes mellitus .H‐L statistic(χ2 =8 .760 ,P=0 .363) . The area under the ROC was 0 .826 ,95% CI(0 .766 ,0 .886) .Conclusion Logistic regression model established in the study can pre‐dict the incidence of DR‐TB with high prediction accuracy .

Objective To infer its transmission origin and route through studying the feature of molecular epidemiology of an HCV outbreak in Guangzhou.Methods Serum samples 192 cases in an HCV outbreak incident were analyzed for 2a and 6a subtypes.Appropriate genotypes were selected as control group.Informatics software were used in the evolutionary analysis to construct time scale trees and infer the origin time of HCV infection.Results Of 119 patients in the HCV outbreak,66 cases were 2a and 110 cases were 6a subtype.No other genotypes were found.The evolutionary analysis indicated the isolates of 2a group and 6a group both originated from 2 ～ 5 years ago.Both of 2a group and 6a group were in line with the characteristics of iatrogenic infection.Conclusion 2a and 6a were the main sub-genotypes in the Guangdong HCV outbreak investigation and they were originated from 2 to 5 years ago,which were in line with the characteristics of iatrogenic transmission.With the extension of time,a large number of cases accumulated and led to outbreak.

Objective To explore the effects of ischemic postconditioning on myocardial apoplosis in the heart of diabetic rat and investigate (he signal transduction pathway changes induced by ischemia postconditioning. Methods Diabetic model was induced by streptozotozin (STZ)45 mg/kg. All rats were injected with STZ intravenously and randomly divided into 4 groups (n =8 /group):(1) Ischernia-reperrusion (IR) group:the rats were subjected to 30 minutes ischemia by left anterior descending coronary artery occlusion (LADO),and reperfusion without additional intervention; (2) IPost plus wortmannin group.after 30 minutes of LADO,rats were treated with wortmannin (15 μg/kg, iv) at 5 minutes before coronary reperfusion,and then followed by IPost treatment and 2 hours reperfusion; (3) IPost group:after 30 minutes of LADO,the coronary artery was occluded for 30 seconds and repeated 3 limes. The coronary artery was reperfused for 2 hours; (4)IR plus wortmannin group:at 5 minutes before coronary reperfusion, rats were treated with wortmannin (15 μg/kg,iv) and followed by 2 hours reperhision. Myocardial apoptosis was measured by TUNEL,and the myocardial Bcl-2,Bax, Phospho-Alct (ser473) and Akt expression were assessed by Western blot. Results Compared with other groups,myocardial apoptosis and Bax protein expression significantly reduced (P < 0.01),and the Bcl-2 protein expression,the ratio of Phospho-Akt (ser473) to Akt increased significantly (P< 0.01). Phosphatidylionsitol 3-kinase (PI3K) inhibitor wortmannin prevented the increase of Bcl-2 protein expression, the ratio of Phospho-Akt (ser473) to Akt. Conclu-sion Ischemic postconditioning can reduce the myocardial apoplosis in the heart of diabetic rat. The effects were partly mediated through PI3K/Akt signaling pathway.

Objective To provide the experiences with the application and perfection of Wechat public platform in class A hospitals by investing its application in domestic hospitals, especial in class A hospitals.Methods The mobile service provided on Wechat public platform and related problems in domestic hospitals were investigated by website survey.The general situation, menus, and functions of Wechat public platform in class A hospitals were described. Results Of the investigated 191 hospitals, 37 were class A hospitals and less than 4%of which opened their Wechat public platform.Conclusion The distribution of Wechat public platform is uneven in domestic hospitals.Importance is attached to the application of mobile service in hospitals of cosmetology, gynecology and ophthalmology.

Informed consent is the important thesis in life ethics and life law,which gives the patients and experimenters the right of self-decision making on medical procedures and experiments.As the development of public health and public health ethics,informed consent has been paid more attention,especially on informed consent problems in epidemiology and public health practice.The requirement of informed consent varies in different research fields.According to different practice purposes,the researchers choose relevant applicable methods.

Purpose　To evaluate the clinical effects of early lamellar corneoscleral transplantation in the management of severe alkali-burned eye.　Methods　The patients compatible with the Ⅲ or Ⅳ grades of Roper-Hall's standards were diveded into operating group and control group according to the post-burning interval which was less than 2 weeks or more.Depending on the presence or absence of scleral nacrosis,the patients in operating group were given a lamellar corneoscleral transplantation or a lamellar keratoplasty.The patients in control group did not receive any operation.The medication was the same in the two groups.　Results　During the following-up of 6 to 24 months,most cases in operating group had significantly improved vision postoperatively,less inflammatory congestion,lower incidence of corneal ulcertion,and less neovasculerization.No perforation occurred in any case of the operating group.Whilst in the control group,ulcerative perforation occurred in 6 of 10 eyes,leucoma accompanied by severe panus in 6 eyes,symblepharon in 5 eyes.　Conclusions　Debridement with early lamellar corneoscleral transplantation can effectively decrease the occurrence of corneal perforation,prevent symblepharon,shorten the time of inflammation,and improve visual acuity.