The cell adhesion molecule CD44 antigen correlates with the antineoplastic agents resistance of breast neoplasms closely. Its high expression can enhance the invasion of the breast neoplasms. CD44 mole-cule can affect the expression of the TGF-β of breast neoplasm cells to induce the resistance to tamoxifen. The influence on erbB-2 cell signal pathway result in the resistance to the trastuzumab. CD44 can strengthen the re-sistance to anthracene nucleus by inducing expression of protein MRP2 and inhibiting the topoismerase. The modulation of survivn and multidrug resistance gene intensifies the resistance to paclitaxel.

Objective To discuss the clinical efficacy of comprehensive therapy in children with amblyopia.Methods A total of 137 eyes of 87 children were observed.They were given glasses,cover,fine training on the basics of their corrected visual acuity after mydriasis with atropine and optometry.According to amblyopic type,all subjects were divided into three groups,ametropic amblyopia group (96 eyes),anisometropic amblyopia group (28 eyes) and strabismic amblyopia group(13 eyes).According to treatment-starting age,they were divided into 3-6 years old group (95 eyes),7-9 years old group (25 eyes),and 10-12 years old group (17 eyes).According to amblyopic degree,they were divided into mild group(61 eyes),medium group (60 eyes) and serious group (16 eyes).According to fixation nature,they were divided into central fixation group (93 eyes),paracentral fixation group (44 eyes).Results All of subjects' eyes,87 eyes (63.50％,87/137) were basically cured,40 eyes (29.20％,40/137) were improved,and 10 eyes (7.30％,10/137) were unimproved.The total effect rate was 92.70％ (127/137).The efficacy of treatment was closely related to amblyopic type,treatment-starting age,amblyopic degree and fixation nature.Efficacy of the treatment on anisometropic amblyopia was the highest among all three types.The younger the treatment-starting age,the better the efficacy of the treatment.There was a positive correlation between the mildness of amblyopia and the efficacy of the treatment.Efficacy of central fixation group was better than that of paracentral fixation group.Differences between efficacies of treatment on each group were significant (P ＜ 0.01).Conclusion Comprehensive therapy in children with amblyopia can achieve satisfactory effects.

Diabetic foot is one of the most common and serious complications of diabetes. Early detection and prompt treatment is of great significance to the prevention of diabetic foot. Imaging is the most convenient and effective method for making an early diagnosis of diabetic foot, and imaging examination can directly and accurately reveal the peripheral vascular disorders, peripheral neuropathy, soft tissue complications, muscle and tendon lesions, bone complications, etc. thus the lesion’s extent can be exactly evaluated, which provides reliable basis for the selection and evaluation of the clinical therapeutic scheme. This paper aims to make a general review about the recent imaging research progress in diabetic foot.

Objective To investigate imaging features and clinical characteristics of the small coronary-bronchial artery fistula (CBF). Methods By retrospective analysis of image data from May 2007 to November 2011 for coronary angiography in 30 284 patients without chronic lung or pulmonary vascular disease patients, 13 cases of small CBF (diameter of the end of fistula near coronary artery< 2 mm) were detected. Incidence of CBF was counted, its morphology was described, and its clinical features were preliminarily analyzed and summarized. Independent sample t test and χ2 test were used to compare diameters and incidences of CBF originatng from left and right coronary arteries. Results In this study primary CBF detection rate was 0.043%(13/30 284). The ends of CBFs near coronary arteries were slender and their diameter average was (1.57 ± 0.75) mm. In this study all of the CBF were from the right coronary artery and left circumflex coronary artery, finding no cases starting from the left anterior descending coronary artery. There was no significant difference between incidence of CBFs originating from the right coronary artery and left circumflex coronary artery coronary and the diameters of CBFs. In 13 cases of CBF, 9 cases of myocardial ischemic symptoms were caused by coronary artery stenosis, which was proven by angiography;Four cases without myocardial ischemic symptoms or with very atypical symptoms were finally diagnosed as cardiac neurosis. After branching, the CBF diameters of these coronary arteries were seen no evindently reduced, which suggested that the coronary bypass had less blood flow, and therefore had no significant hemodynamic significance. Conclusions Congenital CBF can exist in populations without chronic lung or pulmonary vascular disease. The main image features are that their diametes were small and all originate from the right coronary artery and left circumflex coronary artery. The most fundamental clinical features are that there're no symptoms of myocardial ischemia due to coronary artery steal and no obviously hemodynamic significance. It is important to well recognize this type of CBF for enriching radiographic knowledge, identifying various anatomic variations, and carrying out clinical diagnosis and treatment.

OBJECTIVE:To investigate the role of clinical pharmacists in the therapy for patient with pulmonary aspergillosis complicated with rhabdomyolysis(RM). METHODS:Clinical pharmacists participated in the therapy for RM patients with pulmo-nary aspergillosis,and assisted physicians to optimize and improve therapy plan from RM therapy,anti-infection and liver protec-tion:stop taking Bicyclol tablet,continue Micafungin for injection 50 mg,ivgtt,qd for anti-infection;suspend liver-protective drug Compound glycyrrhizin;closely monitor therapeutic efficacy and ADR. RESULTS:Physicians adopted the suggestions of clini-cal pharmacists,and the situation of RM were improved. The patient were discharged from hospital 24 d later. CONCLUSIONS:Clinical pharmacists participate in therapy for RM patient with pulmonary aspergillosis and assist physicians to improve therapy plan,which contribute to rational drug use and the safety of drug use.

BACKGROUND:A large number of studies have verified that propofol could effectively reduce secondary nerve injury by improving microenvironment of spinal cord injury. OBJECTIVE: To study the effects of propofol on spinal cord edema and electrophysiology of the hind limb in rats with spinal cord injury. METHODS: Rat models of acute spinal cord injury were established by using the modified Alen method. A total of 40 rat models were randomly divided into spinal cord injury group and propofol group (n=20). Rats in the propofol group were injected with propofol through the caudal vein. The spinal cords of an additional 20 rats were exposed in the sham surgery group. Motor function was evaluated using BBB score and inclined plate test before modeling, 1, 3 days, 1-4 weeks after modeling. Neuronal apoptosis was detected after spinal cord injury using TUNEL assay at 72 hours after modeling. AQP4/9, matrix metaloproteinases 9/2 mRNA and protein expressions were measured using RT-PCR and western blot assay. At 4 weeks after modeling, pathological changes of the spinal cord were observed using immunohistochemistry and hematoxylin-eosin staining. Neurophysiological recovery was analyzed using motor evoked potentials and somatosensory evoked potentials. RESULTS AND CONCLUSION: (1) At 1-4 weeks after modeling, BBB score and inclined plate test score were higher in the propofol group than in the spinal cord injury group (P < 0.05), but lower than in the sham surgery group (P < 0.05). (2) The number of apoptotic cels was significantly more in the spinal cord injury group than in the propofol group (P < 0.05). No apoptotic cels were found in the sham surgery group. (3) At 72 hours after spinal cord injury, AQP4/9 and matrix metaloproteinases 9/2 mRNA and protein expression was higher in the propofol group than in the sham surgery group (P < 0.05). AQP4/9 and matrix metaloproteinases 9/2 mRNA and protein expression was significantly reduced in the propofol group (P < 0.05). (4) At 4 weeks after modeling, the spinal cord was loose, and the cavity was smal. Partial neuronal necrosis could be seen. The degree of nerve fiber density in the propofol group was between the sham surgery group and spinal cord injury group. (5) Motor evoked potentials and somatosensory evoked potentials were obviously recovered, the latency was short, amplitude was increased in the propofol group, which showed significant differences as compared with the sham surgery group and the spinal cord injury group (P< 0.05). Results suggested that propofol can reduce apoptosis in rat neurons after spinal cord injury, reduce spinal cord edema-related gene expression, and improve electrophysiological function and limb motor function.

Immune response is one of the main reasons causing neurological deficits in the patients with cere -brovascular diseases , which activates microglia , induces inflammatory reaction and finally results in serious neuronal and endothelial injury .MicroRNAs take part in the regulation of immunoreaction , and simultaneously regulates many target genes and induces faster post-transcriptional regulation to its target genes compared with the traditional transcriptional regu -lation.For providing a basis for the clinical use of microRNAs and applying new therapy , this review mainly focuses on the function and mechanism of microRNAs in the regulation of the immunoreaction caused by cerebrovascular diseases .

Malignant tumor is a serious threat to human health and its pathogenesis is complex , which caused by interaction of a variety of carcinogenic factors in the human body .SALL4 gene is a kind of newly dis-covered gene and it plays an important role in function of embryonic stem cell due to its protein transcription fac -tor with C2H2 zinc finger domain.Studies found that this gene mutation often results in occurrence of malignant tumor.This paper will summarize the molecular mechanism of SALL 4 in the occurrence and development of malig-nant tumor and its diagnosis and treatment on malignant tumor .

Objective: To evaluate the application of CT in the diagnosis of fracture position and the cause of diplopia after orbital trauma. Methods:The CT findings and the clinical informations of orbital fractures accompanying diplopias in 68 patients (70 orbits) were retrospectively analysed. Results: Orbital fractures in 70 orbits were diagnosed by CT. There were burst orbital floor fractures in 45 orbits ( among them orbital floor fracture combined with medial wall fracture in 15 orbits), non-burst obital floor fractures in 10, medial orbital fractures in 5, zygomatic-orbital fractures in 5, orbit roof fractures in 5. The accuracy of CT in diagnosing orbital fracture was 100 percent. In 68 cases, there were 64 patients with vertical diplopia and 4 with horizontal diplopia . Conclusion: CT can correctly locate the orbital fracture and diagnose the cause of diplopia.