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 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.

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 results of hearing screening in newborns and infants so as to explore the appropriate clinical strategy of hearing screening among newborns and infants. Methods Transiently evoked otoacoustic emission(TEOAE) was used to examine the hearing of newborns and infants. Those who fail the initial screening underwent secondary screening with TEOAE. Acoustic brain-stem response(ABR) was used to monitor the hearing of those who failed the secondary screening. Results A total of 6 150 infants were taken hearing screening but only 5 597(91%) passed the first screen,A total of 103 newborns were hearing screening but only 93(90. 29%)for the first screen. Conclusion Hearing screening in the procedure with TEOAE helps identify infants with hearing loss as early as possible so as to conduct appropriate intervention and pormote development of speech and language.

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.

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.

Clinic genetic testing have make rapid progress in recent years , and have been widely applicated in genetic disease diagnosis , infection disease diagnosis and personalized treatment .The aim of this article is to pay attention to the ethical issues raised by genetic testing .The important ethical problems are proposed accompany with prenatal , adolescent, and adult genetic testing respectively .We should adopt responsible best ethical practices in the provision of genetic testing , promote the widely application of gene detection in clinic orderly.

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 study the effect of selenium chitosan on differentiation of HL60 cells and its relationship with the c-myc and c-fos protein expression of cells. METHODS:HL60 cells were divided into 5 groups,i.e. 25 mg?L-1 selenium chitosan group,50 mg?L-1 selenium chitosan group,100 mg?L-1 selenium chitosan group,blank control group and positive control group (dimethy sulfoxide). The differentiation of HL60 cells was measured by NBT-reduced method after administration and amount of positive cells was detected. FCM was used to examine the c-myc and c-fos protein expression of cells. RESULTS:As compared with blank control group,differentiation effect of selenium chitosan groups were similar to that of positive control group; NBT-reduced positive cells were increased while c-myc protein expression of cells was decreased(P

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.