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.

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.

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 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.

Tuberous sclerosis complex (TSC) is a genetic disorder affecting every organ system, but disease manifestations vary significantly among affected individuals.The diverse and varied presentations and progression can be life-threatening with significant impact on quality of life.The 2012 international Tuberous Sclerosis Complex Consensus Recommendations provide an evidence-based, standardized approach for optimal clinical care provided for individuals with TSC.

Objective To investigate the effect of a kind of tissue engineered bone implants on healing of segmental bone defects. Methods A 15 mm bone defect experimental model at the right radius of New Zealand white rabbit was made. 24 animals of this model were divided into three groups at random. PLGA scaffords loaded with 5 mg BMP and about 1?106 BMSCs were implanted in Group 1(n=10); PLGA scaffords loaded with 2.5 mg BMP and about 1?106 BMSCs were implanted in Group 2(n=7); PLGA scaffords loaded with 1 mg BMP and about 1?106 BMSCs were implanted in Group 3(n=7). The osteogenesis at the defect area was observed by regular roentgenography and X-ray analysis, histological changes at the bone defects at 4th, 8th, 12th weeks after operation were studied and the new bone formation was measured by image analysis. Biomechanical analysis was done 12 weeks after operation. Results A large quantity of callus was found in all the 3 groups 4 weeks after repair. At the 12th week, the complete bone healing rate was 7/8, 3/5, 3/5, respectively in Group 1, 2 and 3. Group 1 had the largest quantity of new bone measured by histopathological study and X-ray analysis, and at the 12th week, the medullary cavity in this group became united. The compress stiffness, torsion stiffness and the maximal load in Group 1 were better than those in other groups. Conclusion The tissue engineered bone contructed by PLGA scaffords that are loaded with 5 mg BMP and BMSCs is capable of repairing segmental bone defects.

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 investigate the effects of Oxytocin(OT) on hippocampal long-term potentiation(LTP) and FOS protein expression induced by peripheral stimulation.Methods Single stimulation pulses were delivered to the left sciatic nerves to evoke the field excitatory postsynaptic potentials (fEPSPs) in the right hippocampal CA1. Tetanic stimulation was used to induce hippocampal LTP. Different groups of rat were given NS,OT,Oxytocin antagonist-Atosiban + OT before tetanic stimulation,into lateral ventricle(LV) respectively. Expression of FOS protein was compared among the groups by histopathological and immunohistochemistry. Results Single stimulation evoked fEPSPs in hippocampal CA1,which average latency was (171.9?33.1)ms and average amplitude was (25.7?8.4)?V. Tetanic stimulation induced hippocampal LTP and increased the expression of FOS protein. Intracerebroventricular injection of OT inhibited hippocampal LTP and decreased the expression of FOS protein. This effect of OT was blocked by the pretreatment with Atosiban. Conclusion The results suggested that OT may play an inhibitory role in leaning and memory of rats and the effect is mediated by OT receptor.

Objectives To investigate the changes and signiifcance of serum tumor necrosis factor-α(TNF-α) and anti-ds-DNA antibody in systemic lupus erythematosus (SLE) and lupus nephritis (LN) in children. Methods Sixty-seven children with SLE among whom 52 children had LN were selected and 30 healthy children were selected as normal controls. The level of serum TNF-αwas measured by enzyme-linked immunosorbent assay, and the anti-ds-DNA antibody level was measured by radioimmunoassay. Results The serum levels of TNF-αand anti-ds-DNA antibody were signiifcantly higher in children with SLE or LN than those in healthy controls (P all<0.01). Furthermore, the serum levels of TNF-αand anti-ds-DNA antibody were signiifcantly higher in active phase than in stationary phase of SLE and LN (P all<0.01). The serum TNF-αlevel was positively correlated with SLE disease activity index score and serum anti-ds-DNA level in 67 SLE patients (P<0.05). Conclu-sions The serum levels of TNF-αand anti-ds-DNA antibody were increased in children with SLE and LN and were positively correlated with disease activity.