Objective:Until recently, no consensus has been reached about the treatment of primary tumor in patients with meta-static breast cancer, and whether or not to excise it has not yet reached agreement. This study aimed to evaluate the value of surgical and nonsurgical treatment of primary tumor by analyzing the clinical data of patients with metastatic breast cancer. Methods:This re-view includes the data of 120 metastatic breast cancer patients. Their clinical data in Xiangyang Central Hospital (Hubei province) from January 2005 to December 2012 were collected. All cases were divided into surgical and nonsurgical groups, and the overall survival and symptomatic local progression rates were analyzed. Results:The 120 patients had a median follow-up of 52 months (range=10-92 months). A total of 55 cases were in the surgical group, 30 of whom had surgery before the metastatic diagnosis, and 65 cases were in the nonsurgical group. No significant differences were observed regarding the tumor classification, lymph-node classification, and meta-static site of the tumor in the two groups. Patients in the surgical group experienced longer overall survival (49 months vs. 33 months, P=0.016) and lower rates of symptomatic local progression (14.5%vs. 46.2%, P<0.001). Conclusion:This study demonstrated that the overall survival and symptomatic local control in the surgical group were better than those in the nonsurgical group. However, this hy-pothesis remains to be proved by multicenter clinical trials.

OBJECTIVE: To explore the effects of psoralen (PSO) plus long-wave ultraviolet-A (PUVA) on apoptosis and expression of Fas ligand (FasL) in HL-60 leukemia cells. METHODS: The HL-60 cells were taken as the study objects and their apoptosis rates, ultrastructure changes and the expression of FasL were detected in order to observe the effects of PSO and ultraviolet-A (UVA) of wave length 360 nm. The factorial design and analysis of variance were used to analyze the interaction among the factors. RESULTS: PSO, UVA and PUVA all induced the apoptosis and the effects of PUVA were stronger than those of the other two. After HL-60 cells had been treated with PUVA, they all showed obvious ultrastructure changes due to apoptosis observed under the electron microscope. PSO, UVA and PUVA all decreased the expressions of FasL gene and protein. The effects of PUVA were stronger than those of the other two. CONCLUSIONS: PUVA can induce the apoptosis of HL-60 cells and the effects are stronger than those of PSO or UVA alone. The expression of FasL gene in HL-60 cells is down-regulated during the apoptosis induced by PUVA.

Objective To isolate specific humanized anti-D-dimer scFv(single chain Fv) antibody from scFv phage libraries. Methods Isolate anti-D-dimer positive clones from Tomlinson I + J phage libraries by three rounds of panuing, then sequence monoclonal genes by bideoxy-mediated chain termination and express soluble scFv antibody; Pick out anti-D-dimer antibodies with high specificity and affinity by ELISA.Results After three rounds of selection from human scFv phage libraries Tomlinson I and J, 38 monclonal specific anti-D-dimer scFv fragments were selected. By polyclonal and monoclonal phage ELISA and gene sequencing, 20 different full-length monoclonal scFv phages were identified, the result of soluble scFv ELISA showed that 20 full-length monoclonal scFv were expressed smoothly. According to the result of soluble scFv ELISA, in 5 scFv antibodies with high value of A450 selected, 3 scFv antibody fragments showed high specific and affinity. Conclusion Antibody phage display was an effective, rapid method to isolate anti-D-dimer antibodies with high specificity and affinity.

The hospital grade assessment is an effective approach to measure the comprehensive strength and the overall level of a hospital, and it is also an effective carrier which can promote the standardized management , improve the quality of connotation and accelerate the development of the hospital .This article aims to expound the effective and concrete methods for preparation in the hospi -tal grade assessment by introducing the practice and experience of Jinling Hospital in grade assessement .It also points out that:defi-ning the purpose of the assessment is the fundation , having a thorough grasp of the assessment criteria is the basis , having a compre-hensive knowledge of the hospital is the premise , establishing and implementing the plan strictly is the crux .All these might be helpful to promote the hospital grade assessment .

To study the effects of psoralen (PSO) with long wave ultraviolet light (PUVA) on apoptosis and mitochondrial membrane potential in K562 cells.

To explore the effects of inactivated rabbit serum containing compound realgar and natural indigo tablet (CRNIT) on cell line NB(4).

OBJECTIVE: To observe the effects of psoralen plus ultraviolet-A light (PUVA) on K562 cells and the relative mechanism. METHODS: The effects of psoralen, ultraviolet-A light and PUVA on K562 cells were assayed by monotetrazolium test (MTT). DNA content was analyzed by flow cytometry (FCM). The apoptotic rates of K562 cells treated with 40 and 80 microg/ml psoralen for 24 and 48 hours were assayed by Annexin-V-FITC/PI reagent kit on FCM respectively. The ultrastructures of apoptotic cells were observed by a transmission electron microscope (TEM). RESULTS: Either single psoralen therapy or single ultraviolet-A irradiation had inhibiting effect on K562 cells. The inhibiting effect of PUVA on K562 cells was stronger than that of the single psoralen therapy or single ultraviolet-A light irradiation (P<0.05). Apoptotic peak (AP) was detected by FCM. TEM test showed that K562 cells treated with PUVA were smaller, having condensed cell nucleus, assembled chromatin, disintegrated nucleus body and the majority of the cells appeared to be apoptotic conformation. CONCLUSION: Psoralen has inhibiting effect on K562 cells, and the effect of PUVA is more significant. It is suggested that 10 min irradiation and 40 microg/ml terminal concentration of psoralen be probably the best choice for PUVA. The inhibiting effect of PUVA is due to apoptosis.

Objective To quantify the correlation between isometric and isokinetic tests of core muscles during trunk rotation. Methods The strength of the core muscles of 38 healthy males was measured isometrically and isokinetically ( at 60°/s) during trunk rotation.The left and right peak rotation torque ( LPT,RPT) and the ratio of left to right torque (L/R) were analyzed using correlation and regression analysis and paired t-tests. Results The subjects' LPTs and RPTs were positively correlated ( rL =0.644,P ≤ 0.01 ;rR =0.566,P≤0.01 ) There were significant differences in the L/R ratios determined using the two tests (r=0.663,P≤0.01 ).The regression equations predicting LPT and RPT were yL =22.330 + 0.937x and yR =32.752 +0.847x,respectively.Paired t-tests showed that tL =4.562,P≤0.01 and tR =3.855,P≤0.01 during left or right rotation.There was a significant difference,but there was no significant difference in LPT/RPT. Conclusion Isometric and isokinetic tests of core muscles during trunk rotation give results which are strongly correlated.Either can correctly reflect the maximal strength of core muscles during trunk rotation.Clinicinas may reasonably choose either testing method to assess patients and guide treatment according to the patient's clinical symptoms and the severity of the problem.

Objective To explore the effects of psoralen(PSO)and long-wave ultraviolet chemical therapy(PUVA) on cell apoptosis and expressions of FasL in HL-60,K562,and NB4 leukemia cells.Methods The cells were taken as the studying objects and their apoptosis ratios,ultrastructure changes and the expressions of FasL were detected in or- der to observe the effects of PSO extracted from Chinese medicine and ultraviolet at 360 nm on human leukemia cells.The factor design and analysis of variance were used to analyze the interaction among the factors.Results(1)PSO,UVA and PUVA all induced the apoptosis and the effects of PUVA were stronger than the other two.(2)Obvious changes of ultra- structure of leukemia cells were found under electron microscope after treatment with PUVA.(3)PSO,UVA and PUVA down-regulated FasL gene and protein expression levels,and the effects of PUVA are the strongest.Conclusion PUVA can induce the apoptosis of human leukemia cells and its effects are the strongest.One of the pathway of PUVA to induce apoptosis is by down-regulating the expression of FasL gene.

Objective:To investigate the clinical characteristics as well as short-term and long-term prognostic factors of patients with Stanford type B aortic dissection (TBAD) with hypertension.Methods:Patients with TBAD who received thoracic endovascular aortic repair (TEVAR) admitted to Xiangyang Central Hospital from January 2014 to December 2018 were enrolled. The baseline data of patients admitted to the hospital were collected through the case management system, including gender, age, underlying diseases (hypertension, diabetes, coronary heart disease), smoking history, drinking history, duration of pain, vital signs at admission [heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP)], laboratory results [white blood cell count (WBC), platelet count (PLT), neutrophil/lymphocyte ratio (NLR), serum creatinine (SCr), C-reactive protein (CRP), D-dimer, ascending aorta diameter], etc. The clinical characteristics of TBAD patients with hypertension were analyzed. Logistic regression model and Cox proportional risk model were used to analyze the impact of hypertension on the short-term and long-term all-cause deaths after TEVAR in TBAD patients.Results:Among 227 TBAD patients, 160 cases (70.5%) were complicated with hypertension, while 67 cases (29.5%) were not. The average age, the proportion of diabetes and coronary heart disease, and the level of SBP, DBP and SCr at admission of TBAD patients with hypertension were higher than those of TBAD without hypertension [age (years old): 53.1±11.9 vs. 42.8±14.1, combined with diabetes: 8.8% vs. 1.5%, combined with coronary heart disease: 6.3% vs. 0%, SBP (mmHg, 1 mmHg = 0.133 kPa): 147.9±18.1 vs. 136.9±15.2, DBP (mmHg): 93.9±11.9 vs. 89.1±13.8, SCr (μmol/L): 97.8±25.4 vs. 89.8±23.6, all P < 0.05]. The short-term mortality of TBAD with hypertension group was significantly higher than that of TBAD without hypertension group [6.3% (10/160) vs. 0% (0/67), χ2 = 4.386, P = 0.036]. 227 patients with TBAD were followed up for 3-66 months, with a median follow-up time of 25 months. There was no significant difference in long-term mortality between TBAD patients with and without hypertensive during discharge follow-up [13.1% (21/160) vs. 9.0% (6/67), χ2 = 0.784, P = 0.376]. Further multivariate Logistic regression analysis and Cox regression analysis did not indicate that hypertension was an independent risk factor for short-term and long-term death in TBAD patients [odds ratio ( OR) and 95% confidence interval (95% CI) were 13.477 (0.541-330.215), 1.012 (0.990-1.035), both P > 0.05]. Age and HR were independent risk factors for the short-term mortality of TBAD patients [ OR and 95% CI were 15.287 (1.051-226.415), 0.026 (0.002-0.840), both P < 0.05]. Age, PLT and D-dimer were independent risk factors for the long-term mortality of TBAD patients [ OR and 95% CI were 1.808 (1.205-2.711), 0.555 (0.333-0.924), 1.482 (1.035-2.122), respectively, all P < 0.05]. Conclusions:The TBAD patients with hypertension have older age, high rates of diabetes or coronary heart disease. However, hypertension is not an independent risk factor for short-term and long-term mortality in TBAD patients.