Evidence based medicine is not quite the same as traditional medicine, as the former stresses the combination of evidence and doctors experience, failure to achieve which will be disadvantageous to patients. In recent years, evidence based medicine has been growing silently in China. At present the ideology of evidence based medicine is being widely applied to the treatment of cardiovascular disease, including hypertension, arrhythmia, heart failure, myocardial infarction, etc. and the regulation of fat metabolism. Some medications harmful to patients have been discarded and curative effects have been improved. Of course, there are still some shortcomings. Yet evidence based medicine has also exerted an effect on people in the medical circle and the making of medical decisions.

Objective To explore the influence of long -term oral hydroxychloroquine on the blood lipids and left ventricular function in patients with systemic lupus erythematosus (SLE).Methods A total of 110 patients with SLE,who treated in our hospital from January 2012 to December 2013,were selected as the research subjects. They were divided into study group (n =55 )and control group (n =55 )according to the random number table method.The control group received conventional drug treatment,while the study group was orally given hydroxychloroquine on the basis of the control group therapy.The course of treatment was 18 months for the two groups.Then,the changes of blood lipids,left ventricular structure and function indexes before and 6,12,18 months after treatment were observed.Results The levels of TG[(1.7 ±0.3)mmol/L,(1.6 ±0.3)mmol/L,(1.2 ±0.2)mmol/L],TC[(4.5 ± 0.5)mmol/L,(4.3 ±0.4)mmol/L,(4.0 ±0.4)mmol/L],HDL -C[(1.4 ±0.4)mmol/L,(1.5 ±0.3)mmol/L, (1.6 ±0.3)mmol/L],LDL -C[(2.8 ±0.5)mmol/L,(2.3 ±0.4)mmol/L,(2.0 ±0.3)mmol/L],LVEDD[(40.3 ± 3.3)mm,(39.4 ±3.0)mm,(38.5 ±2.9)mm],LVESD[(29.4 ±2.6)mm,(28.3 ±2.3)mm,(26.7 ±3.0)mm], LVST[(9.7 ±0.4)mm,(9.5 ±0.6)mm,(9.5 ±0.5)mm],LVPWT[(10.2 ±0.4)mm,(10.0 ±0.3)mm,(9.8 ± 0.4)mm],FS[(31.4 ±6.8)%,(32.6 ±7.0)%,(32.7 ±7.7)%),LVEF[(60.4 ±5.4)%,(60.7 ±5.7)%, (61.4 ±5.6)%],E /A[(0.8 ±0.2),(0.9 ±0.3),(1.1 ±0.3)]in the study group 6,12,18 months after treat-ment were significantly better than before treatment[(2.0 ±0.4)mmol/L,(4.8 ±0.8)mmol/L,(1.1 ±0.3)mmol/L, (3.4 ±0.4)mmol/L,(42.4 ±3.8)mm,(30.7 ±3.5)mm,(9.9 ±0.6)mm,(11.2 ±0.5)mm,(30.1 ±5.7)%, (55.8 ±4.6)%,(0.7 ±0.1 )],and which were all better than those in the control group,the differences were statistically significant(tTG =2.529,2.828,2.735;tTC =3.609,3.122,3.317;tHDL -C =3.651,3.419,3.733;tLDL -C =2.008,2.144,2.338;tLVEDD =8.933,8.347,8.282;tLVESD =6.445,6.628,6.594;tLVPWT =3.015,3.331,3.905;tLVST =4.571,4.583,4.861;tLVEF =11.021,11.328,10.163;tFS =7.915,8.048,8.253;tE /A =1.886,1.769,1.537;all P <0.05).Conclusion Long -term oral hydroxychloroquine in the treatment of patients with SLE not only can improve the blood lipids situation,but also is good for the left ventricular structure and function,which may avoid the occurrence of vascular events,and it is worthy of clinical promotion.

SUMO (small ubiquitin-related modifier) is involved in the post-translational modifications of proteins,and this process is referred to as SUMOylation.SUMOylation plays an important role in the regulation of cellular activities such as strengthening the stability of the protein,nucleocytoplasmic transport,DNA repair,DNA replication,mitotic and meiotic chromosome behavior,et al.SUMOylation is a dynamic process and can be reversed by SUMO-specific proteases (SENP).Once the balance between SUMOylation and de-SUMOylation is broken,there will be an aberrant expression of SUMO or SENPs in cells to happen,which may lead to the tumor occturtrence.

Objective To investigate the therapeutic effect of transplantation of limbal epithelial cells and decellularized porcine cornea construct in rabbits with corneal alkali burn.Methods Allogeneic rabbit limbal epithelial cells were cultured and identified.Porcine cornea scaffold was fabricated by decellularization.The LECs-DPC construct was cultured and transplanted to the alkali-burned corneal surface of rabbits(4month follow-up).Results Immunocytochemistry and RT-PCR analyses revealed the presence of ABCG2 positive limbal stem cells.A general view showed the corneas were clear and vessel-free postoperatively.HE and Masson Trichrome staining results indicated the epithelial stratification,fewer cellular infiltration,DPC' integration into host corneal tissues,and more regular collagen configuration.Transmission electron microscopy exhibited formation of desmosomes and microvilli.Conclusion Allogeneic limbal epithelial cells transplantation using DPC as a carrier can restore corneal clarity after alkali burn in a rabbit model.

Aberrant promoter methylation in special genes such as tumor suppressor genes is early eventin carcinogenesis of lung cancer. Aberrant methylation, resulting in corresponding mRNA silence or overexpression , closely relates to carcinogenesis, development, treatment response and prognosis of lung cancer and it may become a potential biomarker. Methylation of special genes may provide evidences for individual treatment of lung cancers.

Multidrug resistance is a common form of drug resistance of tumors and one main reason for chemotherapy′s failure and recrudescence of acute leukemia. In recent years,substantial studies addressed the different aspects about MDR1,including MDR1 genetic polymorphism,mRNA/protein expression as well as the function of its coding protein (P-gp).This paper reviewed recent advances about the relation between MDR1 genetic polymorphism and acute leukemia prognosis with the aim to improve acute leukemia curing and chemotherapy outcome evaluating in China.

Objective To evaluate the expression and clinical significance of cyclin dependent kinase (CDK)-activating kinase (CAK) complex including CDK7, cyclin H and accessory protein menage a trios 1 (MAT1) in estrogen receptor-positive breast cancer.Methods A total of 40 patients with estrogen receptor-positive breast cancer from Department of Galactophore, Baoji Maternal and Child Care Service Centre of Shaanxi Province were investigated in this study.Breast cancer tissues and adjacent normal tissues were obtained from patients undergoing surgery.The mRNA expressions of CDK7, cyclin H and MAT1 in two types of tissues were measured by real-time fluorescent quantitative (qRT)-PCR, and their correlations with clinicopathologic features of patients were analyzed.Results The expressions of CDK7, cyclin H and MAT1 in cancer tissues were 2.54±0.78, 2.21±0.56 and 2.46±0.58, while those in adjacent normal tissues were 1.26±0.30, 1.16±0.42 and 1.17±0.39, and there were significantly differences between different types of tissues (t=9.654, P<0.001;t=9.433, P<0.001;t=11.741, P<0.001).The higher expressions of cyclin H and MAT1 in patients′ cancer tissues had the lower clinical stage, with significant correlations (U=3.17, P=0.01;U=2.53, P=0.01).In addition, the tumors were smaller in patients with higher expression levels of MAT1 (χ2=14.16, P=0.01).Conclusion The expressions of CAK complex CDK7, cyclin H and MAT1 are elevated in estrogen receptor-positive breast cancer patients.Cyclin H and MAT1 are closely associated with clinical grade, and MAT1 is also significantly associated with tumor size.

Objective To evaluate the excursion of the diaphragm and analyze the value in predicting weaning from mechanical ventilation in intensive care unit patients.Methods The patients with mechanical ventilation (＞48 hours) in ICU at Hebei Forth Medical University Hospital from June 2014 to December were classified into a success group or a failure group according to the weaning outcome.T-piece spontaneous breathing (SBT),airway occlusion pressure at 0.1 sec (P0.1) and maximal inspiratory pressure (MIP),rapid shallow breathing index (RSBI) and P0.1/MIP were measured or calculated.During the period of the 1 st hour SBT,the excursion of diaphragm was measured with ultrasonography.The predictive value of each parameter to weaning was evaluated with ROC curve.Results A total of 98 patients were enrolled in this study,including 74 successfully weaning and 24 failed.There were significant differences between two groups (success group and failure group) in P0.1 [(2.00 ± 2.00) cmH2O (1 cmH2O =0.098 kPa) vs (3.00 ±2.75)cmH2O,P ＜0.05],RSBI (39.14 ± 16.81 vs 52.00 ± 19.18,P ＜0.05),left diaphragmatic excursion [(1.12 ± 0.97) cm vs (0.69 ± 1.00) cm,P ＜ 0.001],right diaphragmatic excursion(1.87 ± 0.75) cm vs (1.17 ± 0.76) cm,P ＜ 0.001] and mean value of left and right diaphragmatic excursion [(1.57 ± 0.52) cm vs (0.83 ± 0.53) cm,and P ＜ 0.001].The ventilation time [2.00 (2.00-4.00) d vs 4.00 (2.00-5.00) d],ICU hospital lengths of stay [4.50 (3.00-7.25) d vs 8.50 (6.25-15.25) d] and total hospital lengths of stay [20.00 (15.00-25.25) d vs 25.00 (20.25-37.25)d] were also statistically significant in success group and failure group respectively (all P ＜ 0.05).The cutoff value of diaphragmatic excursion for predicting successful extubation was determined to be 1.14 cm by ROC curve analysis.The sensitivity of diaphragmatic excursion to predict successful weaning was 89.2％ and the specificity was 75.0％,the AUCROC was 0.849.Conclusion As an early predictor of diaphragmatic dysfunction,diaphragmatic excursion is probably superior to the traditional parameters in predicting weaning from ventilator in ICU patients.

Objective:To study the effect and underlying mechanism of rosmarinic acid in the apoptosis of HepG2 cells. Meth-ods:An MTT method was used to determine the inhibitory effect on the growth of HepG2 cells treated with rosmarinic acid for 48 hours. Flow cytometry was used to detect the cell apoptosis after treated with rosmarinic acid at different concentrations for 24 h and 48 h. Western Blotting was used to detect the expression of P53 and c-Myc protein after treated with rosmarinic acid for 48 h. Results:When HepG2 cells were treated with rosmarinic acid at the concentrations of 12. 50, 25. 00, 50. 00 and 100. 00 μg·ml-1 for 48 h, the cell growth was inhibited and the half-inhibitory concentration (IC50) was 43. 48μg·ml-1. By comparing HepG2 cells treated with rosma-rinic acid at different concentrations for 24 h and 48 h, rosmarinic acid had the effect on the early apoptosis of HepG2 cells after the 48-hour treatment. When treated with rosmarinic acid at the different concentrations for 48 h, the expression of c-Myc decreased with the concentration increase of rosmarinic acid, and the expression of P53 increased with the concentration increase of rosmarinic acid. Con-clusion:The inhibitory effect of rosmarinic acid on the proliferation of HepG2 cells is in a dose-dependent manner, and it can promote the apoptosis of HepG2 cells through the activation of P53 and the cleavage of proto-oncogene c-Myc protein.

Objective To examine the segmental bone defects healing by ? TCP/rhBMP 2 composites with different degradation rate and discuss the relationship between osteogenesis and degradation of ? TCP in vivo. Methods Three kinds of ? tricalcium phosphate(? TCP) with different degradation rate (? TCP1-3) were prepared by means of different techniques. ? TCP/rhBMP 2 composites with different degradation rate(? TCP1/rhBMP 2 and ? TCP2/rhBMP 2)were obtained by combining ? TCP1, ? TCP2 with recombinant human bone morphogenetic protein 2(rhBMP 2), respectively. ? TCP1/rhBMP 2, ? TCP2/rhBMP 2, ? TCP1, ? TCP2 and ? TCP3 were used to repair 15 mm radial segmental defects in 81 Chinese rabbits. When the samples were harvested in 4, 8, 16 and 24 weeks after surgery, a series of examination were carried out, including the roentgenographical, histomorphological, biomechanical and computerized graphical analysis, energy dispersion analysis X ray (EDAX), and measurements of inorganic contents. Results Roentgenographically and histologically, all of the defects that had been treated with implants exhibited new bone formation, increasing with time. The quantity and rate of new bone formation in ? TCP1/rhBMP 2 group and ? TCP2/rhBMP 2 group were higher than those in group of ? TCP alone. The ability of new bone formation in ? TCP1/rhBMP 2 group was strongest. At 24 weeks the defects in ? TCP1/rhBMP 2 group were bridged with the appearance of marrow cavities, the inorganic contents and ratio of calcium to phosphate and biomechanical property in implants approached to those of normal bone. Although degradation occurred to some extent in ? TCP alone the degradation were faster in ? TCP/rhBMP 2 composites. At 24 weeks the degradation rate in ? TCP1/rhBMP 2 group and ? TCP2/rhBMP 2 group were 97.4%and 73.4%, respectively. The defects in blank controls were repaired only by fibrous tissue at 24 weeks. Conclusion ? TCP/rhBMP 2 composites with different degradation rate could repair segmental bone defects, and osteogenesis could accelerate the degradation of ? TCP in vivo.