BACKGROUND:Great saphenous vein is the most common vascular material in coronary artery bypass grafting, however, the graft neointimal hyperplasia and subsequent atherosclerosis result in angiostegnosis, which affect the long-term efficacy. OBJECTIVE: To analyze the pathophysiology and mechanism of the angiostenosis, additionally, to construct smooth muscle cell specific SM22a promoter and SMHC enhancer. METHODS: The database of PubMed, HighWire and CNKI were retrieved with key words of "SM22α promoter, SMHC enhancer, stenosis, Pi3k and RNAi/RNA interference". The language was confined to English and Chinese. The literatures correlated with angiostenosis, VSMC-specific SM22α promoter and enhancer were selected. The reviews and overlapped researches were excluded. In vascular smooth muscle cell proliferation and apoptosis of graft neointimal hyperplasia, as well as the extent of graft thrombosis were considered as evaluation index. RESULTS AND CONCLUSION: More than 8 730 literatures were searched by the computer. According to inclusion and exclusion criteria, the SM22α promoter and angiostenosis were analyzed. The neointimal hyperplasia and thrombosis had a strong impact on prospective efficacy after coronary artery bypass grafting. The PI3K-Akt-mTOR pathway was a crucial signal passage which regulated cell proliferation and migration. RNA interference targeting Pik3cb can efficiently suppress the neointimal hyperplasia through down regulating the PI3K-Akt-mTOR pathway. The shRNA eukaryon expression plasmid vectors targeting rat Pik3cb were constructed using VSMC-specific SM22α promoter. On the one hand, it can suppress the neointimal hyperplasia, and on the other, it can prevent the occurrence of thrombosis.SM22a is a specific gene in vascular smooth muscle cell. The studies that applied VSMC-specific SM22α promoter/enhancer to vascular grafting provide a new strategy to prevent angiostenosis and thrombosis.

Objective To identify and clone rat aging-related genes to provide clues for human aging mechanism. Methods Improved different display reverse transcript-PCR method was applied to identify differentially expressed genes in cortex tissues of 4-month and 24-month old BALB/c mouse. Results Forty-two cDNA fragments with differential expression were identified, and 21 with increase and 21 with decrease of expression in old mice. Among them, 17 represented genes with known protein function, 12 represented known gene sequences but their protein function was unknown, and the other 13 probably belonged to new cDNAs. Among the genes with known protein function, 2 genes were associated with oxidative stress, 3 with energy production, and 4 with protein metabolism, respectively. Additionally, gene expression alterations were also found in those related to cell apoptosis, neurodegenerative disorder, and growth and development regulation. Conclusions Rat aging might be related with the alteration of oxidative stress status, energy production and protein metabolism.

Objective To investigate the effect of teaching achievement of humanities courses joined with disease in gerontology. Methods 95 medical students were randomly divided into two groups:experiment group(n=48) and control group(n=47). Students in experiment group accepted humanities courses joined with disease in gerontology,while control group accepted only traditional courses in gerontology without humanism. Both of the two groups were under the same teacher and study period,and the global minimum essential requirements of undergraduate medical education was adopted ao the final examination. The marks of two groups were tested by t-test. Results There are obvious differences of teaching achievement between the two groups(P

Objective: To observe the effects of Astragalus injection, astragaloside IV and formononetin on proliferation and Akt phosphorylation of basal-like human breast carcinoma cell lines MDA-MB-468 and MDA-MB-231. Methods: The effects of different concentrations of Astragalus injection, astragaloside IV and formononetin on proliferation of breast cancer cell lines were assayed by methyl thiazolyl tetrazolium (MTT) assay, and their effects on phospho-Akt were assayed by in-cell Western blot method. Results: The results of the MTT assay showed that the best concentrations of Astragalus injection, astragaloside IV, formononetin and astragaloside IV plus formononetin were 1 g/mL, 80 mug/mL, 40 mug/mL and 10 mug/mL plus 40 mug/mL respectively. After 1- or 2-day culture, Astragalus injection, astragaloside IV, formononetin and astragaloside IV plus formononetin decreased the expressions of p-Akt (Thr 308) and p-Akt (Ser 473) in MDA-MB-468 cells. Formononetin and astragaloside IV plus formononetin down-regulated the expression of p-Akt (Thr 308) protein in MDA-MB-231 cells after 1- and 2-day culture, but had no effects on the expression of p-Akt (Ser 473) protein in MDA-MB-231 cells. Conclusion: Astragalus injection, astragaloside IV and formononetin can inhibit proliferation of breast cancer cell lines MDA-MB-468 and MDA-MB-231, and the antiproliferation effects vary according to their concentrations. And the antiproliferation mechanisms may be related to their down-regulation effects on Akt phosphorylation.

Objective To investigate the clinical application of procalcitonin (PCT),pre-albumin (PA)and white blood cell (WBC)detections in children infectious diseases.Methods 116 children inpatients of infectious diseases in our hospital were select-ed for conducting the study and divided into the non-bacterial infection group (56 cases)and the bacterial infection group (60 cases) according to the different pathogenic microorganisms.Other 64 children with healthy physical examination in the outpatient depart-ment were taken as the control group.The blood PCT,PA levels and WBC count were detected in 3 groups,and which before and after treatment in the bacterial infection group were detected.The differences in PCT,PA levels and WBC count were compared a-mong the groups.Results The blood PCT level and WBC count in the bacterial infection group and the non-bacterial infection group were all higher than that in the control group,while the PA level in the bacterial infection group was lower than that in the non-bacterial infection group and the control group,the differences had statistical significance (P <0.05);the PCT level and WBC count after treatment in the bacterial infection groups were lower than those before treatment,while the PA level after treatment was higher than that before treatment with statistical difference (P <0.05).Conclusion The detection of PCT,PA and WBC count can be used as the indexes for diagnosing infectious diseases in children,and provides reference for the judgment of prognosis.

In recent years, the morbidity rate of pediatric asthma showed a rising trend.The typical symptom of recurrent wheezing(＞ 3 times/year) in infants is the starting point for the diagnosis of asthma in children and may be the early clinical manifestation of asthma.Chronic airway inflammation, which inducing airway hyperresponsiveness is the main pathophysiology of recurrent episodes of wheezing.Monitoring of fractional exhaled nitric oxide (FeNO) is a simple, fast, effective, and noninvasive marker of airway inflammation in asthma.The concentration of nitric oxide can effectively reflect the airway inflammation and is positively correlated with the severity of airway inflammation.Monitoring airway inflammation is helpful to diagnose and treat the asthmatic children, and for predicting asthma exacerbation, guiding and monitoring the asthma.Thus, this review will discuss FeNO measurements among wheezing infants and asthmatic that have been identified in large-scale studies recently.

Objective　To explore a new way of treating refractory residual gallstones by endoscopy. Methods　Choledochfiberscope(CHF) combined with air pressure ballistic lithoclast(APBL) under ureterscopy were used on 28 cases of large or impacted residual gallstones. Results　All refractory stones were crushed and extracted completely in 1-3 times, including sufficient once in 16, twice in 10 and thrice in 2. No severe complications were occurred in this series. Conclusions　This procedure is a safe, effective, simplicity, less complication and no heat injury methods. It is proved to be a new way of treating refractory residual gallstones, especially for large or impacted lithiasis. It is worthy for clinical application widely in the future.

ObjectiveTo summarize and investigate the occurrence,clinical features and treatment of cesarean scar pregnancy.Methods33 cases of cesarean scar pregnancy were retrospectively analyzed.Results10 cases of vaginal massive hemorrhage after uterine curettage,9 cases of subtotal hysterectomy,1 case was cured by MTX treatment,13 cases were cured by conservative treatment of uterine curettage after chemotherapy treatment,10 cases of successful uterus-saving by excision of lesion and uterine repair.ConclusionTransvaginal sonography was an important method in diagnosis of cesarean scar pregnancy and,the key to success was to select the appropriate individual treatment according to classification by transvaginal sonography.

Objective To investigate the effect of ectopic pregnancy tubal resection or common disease retention on female reproductive endocrine and menstrual traits.Methods 286 patients with ectopic pregnancy lapa-roscopic operation were selected.According to the different treatment methods,the patients were divided into resection group (n =199),retention group 87 cases,in surgical operation on the third day and the thirtieth day and tested for female reproductive hormone (P,LH,FSH,E2 )and human chorionic gonadotropin (hCG).Results Resection group in the third day after surgery of FSH[(8.5 ±4.9)IU /mL]was significantly higher than that of preserving group[(3.9 ± 0.9)IU /mL],with significant difference (t =5.44,P <0.05),the amounts of LH,E2 ,P and HCG were insignificant (t =0.56,1.24,0.82,all P >0.05).30 days after the surgery,there was no significant difference between the two groups in FSH,LH,E2 ,P and HCG (t =0.92,0.77,1.02,0.65,all P >0.05),but at the age of more than 40 years old and bilateral absence of fallopian tube in patients with,menorrhagia and menstrual cycle change obviously,and female ovarian endocrine function to reduce the clinical symptoms.Conclusion Tube resection has some influence on the ovarian function of tubal ectopic pregnancy,especially older,lack of bilateral fallopian tube.

With the development of medicine and health,the experts who have a good command of medicine and law are in great social need,so the major of medical law was introduced.This article,based on the experience and construction of medical law major in Kunming Medical College,put forward that the major of medical law must establish the cultivation goals curriculum system and projects of internship.It emphasizes the approaches to improving the students' knowledge of Arts and comprehensive abilities.