As an energy dependent membrane transporter, P-GP highly expresses in the organs which have the function of barrier and secretory.In the brain, P-GP mainly expresses in the cerebral vascular endothelial cells of blood brain barrier.In the state of brain injury diseases ( such as epilepsy and cerebral ischemia) , P-GP appears in the hippocampus, cortex and striatum of rat brain.At cellular level, it mainly exists in the cerebral vascular endo-thelial cells and also overexpresses in the neurons and glial cells.

Research progress of somatic mutations and the response to the treatment of de novo myelodysplastic syndromes (MDS) patients in the 57th American Society of Hematology (ASH) annual meetings was reviewed. The optimal methods and therapy time for patients with high-risk de novo MDS remained an area of ongoing investigation. The clinical prognostic scoring system does not include the molecular genetic abnormalities and DNA metlylation of histone/nuclear chromatin modifications, which may predict the effect of hypomethylation (HMA). Treatment of HMA may change the expression of genes related with prognosis, and the response rate to the HMA treatment was significantly increased for TET2-mutated patients with high-variant allele frequencies. The overall grade of recommendation for choosing HMA therapy over induction chemotherapy in high-risk MDS based on molecular genetic mutations was 2C, according to less-associated toxicity and increased responses primarily in TET2-mutated disease. Further prospective studies are needed to evaluate the long-term effects of HMA therapy, particularly in TET2-mutated patients.

Progress of World Health Organization (WHO) reclassification of myelodysplastic syndromes (MDS) in the 57th American Society of Hematology annual meetings were reviewed. A revision to the 4th edition of the WHO classification of MDS will be enacted in mid-2016. Based on recommendations of the Clinical Advisory Committee, proposals for change included abandoning the routine names of 'refractory anemia/cytopenia', expressing the prognostic significance of gene mutations in MDS, revising the diagnostic criteria for MDS entities with ring sideroblasts based on the detection of SF3B1 mutations, modifying the cytogenetic criteria for MDS with isolated del (5q), reclassifying the erythroid/myeloid type of acute erythroleukemia, and recognizing the familial link in some cases of MDS.

New progress of treatment of low-risk myelodysplastic syndromes (MDS) reported in the 58th American Socienty of Hematology (ASH) Annual Meetings was reviewed. Anemia is a single common symptom of low-risk MDS, and erythropoietic-stimulating agents (ESA) may be effective. The dose and duration of erythropoietic-stimulating agents (ESA) are critical to determine efficacy. If the treatment of ESA failed, the available options may include lenalidomide (approved for del5q positive cases), hypomethylating agents and a rather large number of experimental agents. The choice for the second-line treatment must consider the biologic, cytogenetic and molecular-identified characteristics of individual patient, as well as frailty and comorbidities. Other cytopenias rarely appear alone. Thrombomimetic agents for thrombocytopenia has been proposed in clinical trials, but there were some safety issues. Although neutropenia is targeted symptomatically with growth factor supportive care, the immunosuppressive therapy is indicated mainly for pancytopenic and hypoplastic low-risk MDS. Finally, hematopoietic stem cell transplantion is the curative option also for low-risk MDS, but it should be carefully evaluated to balancing toxicity and the possibility of survival advantage.

Objective To compare the differences in the use of effects of improved and traditional abdominal positioning locator card in the empty nest elderly diabetic patients with insulin pen injection. Methods 100 discharged cases of empty nest elderly diabetic patients with insulin treated were enrolled. They were divided into two groups by random digital table method, 50 cases in traditional positioning card injection group and 50 cases in improved positioning card injection group. Usage rate of two sets of locator cart, adverse reactions in local skin injection and blood glucose control were observed for 12 months. Results After 12 months, 44 cases occupied 88%in improved positioning card injection group were not about using positioning card while 30 cases occupied 60%in traditional positioning card injection group. The difference was statistical significance (P<0.05). After 12 months, only 3 cases in improved positioning card injection group appeared local injection site reactions which was significantly lower than 31 cases in the traditional positioning card injection group, and the difference was statistically significant (P<0.05);12 months later, fasting blood glucose (FBG), 2 hour postprandial blood glucose (2 h PBG), glycosylated hemoglobin (HbA 1c) of improved positioning card injection group and traditional positioning card injection group [(7.0 ±1.5) mmol/L and(7.8±1.9)mmol/L,(10.7±2.1)mmol/L and(12.3±2.2)mmol/L,(7.1±1.3)% and(7.7±1.5)%] were all decreased significantly than before. The difference was statistically significant (P<0.05). FBG,2 h PBG, HbA1c of improved positioning card injection group were decreased more significantly than that in traditional positioning card injection group and the difference was statistically significant (P<0.05). The standard rate of HbA1c [64% (32/50)] in improved positioning card injection group was higher than that in traditional positioning card injection group [42%(21/50)]. The difference was statistically significant (P<0.05). Conclusions The modified abdominal injection locator card can improve patients′positioning card usage rate, optimize insulin injection technique, reduce the occurrence of adverse reactions in local skin injection and improve the control of blood glucose.

Objective To observe the effects of tetramethyipyrazine(TMP) on retina to find out whether it can protect retina from glaucomatous damage. Methods Twenty-four rabbits were randomly divided into four groups. One eye of each rabbit was model eye induced by 2％ methylcellulous, and the other was control eye. Normal saline, TMP, timolol and a combination of timolol and TMP were administrated to group A, B, C and D respectively. At the end of 4th week, eyes were excavated for light and electron microscopic study. Results The numbers of ganglion cells (P ＜0. 01) and bipolar cells (P ＜0. 01) in model eye were different significantly between group A and B. In group A, the model eye ganglion cells were karyopyknosis, chromatin margination and nuclear membrane rupture; some in ner nuclear cells dcveloped marked lytic changes; outer segment appeared disorganized; but group B changed slight ly. Conclusion The results suggest that TMP may protect retina from glaucomatous damage.

The relationship of cause-result between low selenium (Se) and Kashin-Beck disease (KBD) was probed by the prospective study of epidemiological method with regarding low-Se as an exposure factor in this paper. 597 healthy children lived in KBD areas with low, middle and high prevalence were divided into the low-Se exposed group and the non-low-Se exposed group according to their Se content in hair. The low-Se exposed group was divided into three subgroups, such as Se content in hair≤110 ng/g, 110 ng/g＜Se content in hair≤150 ng/g and 150 ng/g＜Se content in hair≤200 ng/g, respectively. Six new cases of the total with KBD (incidence was 0.574% person-year) were found in the low-Se exposed group during three years period of the investigation. No new case was found in the non low-Se exposed group . KBD incidence was not significantly different between those two groups. Two new cases were found in children with Se content in hair kept below 110 ng/g during three years (incidence: 1.21% person-year). SMR in each group indicated that the new cases observed in the low-Se exposed group was remarkable lower than the new cases expected. It was not observed that the dose-response relationship between low-Se and KBD, and was not supported that the low-Se was a predominant factor to cause KBD.

Objective To investigate the value of FIESTA sequence for the abdominal scanning of the patient undergoing uneffective respiratory triggering. Methods 40 cases undergoing uneffective respiratory triggering were adopted as the subjects. GE SIGNA 1.5T and fat-suppressed technique got involved in. Two chief physicians and two associate chief technologists compared the image quality and the lesion detective rate. Results FIESTA sequence was better than FSE T2WI in the aspect of image quality, but worse in lesion detective rate. Conclusion FIESTA sequence is clinically valuable for the abdominal scanning of patient undergoing unffective respiratory triggering.

Objective To investigate the effects of ginkgo biloba extracts ( EGb761) on learning and memory and the protective effect on hippocampal neurons in rats with vascular dementia (VD). Meth-ods Ninety rats were randomly divided into sham-operated group,model group and EGb761-treated group, with 30 rats in each group. Rats in each group were examined at 15 days,1 month and 2 months,with 10 rats in each time point. VD model was established by bilateral carotid artery occlusion combinding with injection of sodium nitroprusside. Morris water maze test was used to detect the learning and memory function of rats. The expression of glial fibrillary acidic protein (GFAP) was observed by immunofluorescence. Western-blot was used to detect the protein expression of P-glycoprotein ( P-GP ), excitatory amino acid transporters 2 ( EAAT2),caspase-3 and cleaved caspase-3. RT-PCR was used to detect the mRNA expression of P-GP and EAAT2 in the hippocampus of rats in each group. Results Compared with sham-operated group,the escape latency (EL) was significantly prolonged at each time point in model group ( sham-operated group:15 days (15. 52±3. 23) s,1 month ( 14. 21 ± 2. 62) s,2 months ( 15. 37 ± 1. 66) s;model group:15 days ( 30. 35 ± 2. 30)s,1 month(40. 78± 3. 55) s, 2 months( 33. 88± 1. 47) s; all P<0. 01). The EL of EGb761-treated group was significantly shorter than that of the model group(EGb761-treated group:15 days(25. 69±2. 44)s, 1 month(20. 78±1. 72)s,2 months(18. 23±1. 67)s,all P<0. 01). Immunofluorescence showed that the ex-pression of GFAP in EGb761-treated group was lower than that of the model group (P<0. 01). Western blot showed that cleaved caspase-3 protein expression in EGb761-treated group at each time point was significant-ly lower than that in the model group (P<0. 01). Western-blot and RT-PCR results showed that the protein and mRNA expression of P-GP and EAAT2 in EGb761-treated group at 15 day and 1 month time points were significant increased than those in the model group (P<0. 01). At 2 month time point,which were lower than those in the model group (P<0. 01). Conclusion EGb761 can improve the learning and memory ability of VD rats,and regulate the protein and mRNA expression of P-GP and EAAT2 in hippocampus of VD rats at different time points (up-regulated in 1 month and down-regulated in 2 month),and down-regulate the ex-pression of cleaved caspase-3 and GFAP at different time points,thereby delaying the brain damage of VD rats and protecting neurons.

Objective:To investigate the correlation between adverse events and antiplatelet drug resistance after neurovascular intervention for cerebrovascular stenosis.Methods:A total of 148 patients with cerebrovascular stenosis who underwent neurovascular intervention at Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine from January 2020 to December 2020 were included in this study. The platelet function of patients before and 24 hours after antiplatelet drug treatment was recorded. Platelet drug resistance was analyzed. At 3, 6 months, and 1 year after neurovascular intervention, adverse events were recorded through follow-up. The patients were divided into the occurrence group and the non-occurrence group according to whether adverse events occurred or not using the case-control study method. The Spearman correlation coefficient was used to analyze the correlation between adverse events and antiplatelet drug resistance after neurovascular intervention for cerebrovascular stenosis.Results:After 1 year of follow-up, among the 148 patients, 29 patients lost their follow-up, and 119 were included in the final analysis. Of the 119 patients, 41 patients had adverse events and 78 patients had no adverse events. In the occurrence group, the expression levels of platelet membrane glycoprotein P-selectin and platelet activating complex were (20.22 ± 6.33)% and (68.80 ± 11.52)%, respectively, before drug treatment, and they were (15.77 ± 4.12)% and (43.19 ± 5.90%)%, respectively, after drug treatment, all of which were significantly higher than those in the non-occurrence group [before drug treatment: (16.85 ± 3.24)%, (62.34 ± 10.77)%, after drug treatment: (8.31 ± 2.97)%, (35.85 ± 5.14)%] (before drug treatment: t = 3.20, 2.97, both P < 0.05; after drug treatment: t = 10.28, 6.74, both P < 0.05). The incidences of aspirin resistance and clopidogrel resistance in the occurrence group were 51.2% (21/41) and 43.9% (20/41), respectively, which were significantly higher than 26.9% (8/78) and 19.2% (9/78) in the non-occurrence group ( χ2 = 24.47, 20.23, both P < 0.001). Spearman correlation analysis showed that both aspirin resistance and clopidogrel resistance were moderately positively correlated with adverse events after neurovascular intervention ( r = 0.45, 0.41, both P < 0.05). Conclusion:Adverse events after neurovascular intervention are moderately positively correlated with resistance to the antiplatelet drugs aspirin and clopidogrel.