OBJECTIVE: To summarize the advances in the genetic susceptibility to coronary artery disease (CAD) and explore the heritable basis of the disease.DATA SOURCES:Related articles in English from January 1990 to June 2006 were searched in Pubmed and EMCC databases with the terms "gene, coronary artery disease and myocardial infarction". Meanwhile, the CMCC database was searched for the relevant articles published between January 2000 and June 2006 in Chinese.STUDY SELECTrON: After the preliminary selection,relevant literatures on genetics of CAD and myocardial infarction(MI)were selected, and those with obvious indifferent contents or with less correlation were excluded.DATA EXTRACTION: Data of 49 articles were mainly extracted from the selected literatures providing solid evidence to elucidate the genetic susceptibility to CAD or MI.DATA SYNTHESIS: The involved 49 articles showed that CAD is a complex multifactorial disorder which is believed to result from the interplay between a person's genetic makeup and various environmental factors. The heritable basis is increasingly recognized as a crucial component in the development of CAD. Recent work in the field of genetics has lead to determining key genes associated with the susceptibility for CAD and MI through genome-wide linkage scans and large-scale gene-association studies as core human genetics approaches These susceptibility genes involve diverse functions, including dyslipidemia, vascular homeostasis, endothelial dysfunction, inflammation and immunity.CONCLUSION: The identification of genes that predispose to or directly cause CAD provides new insights into the pathogenesis of this disorder. However, the precise role of genetic factor in the CAD or MI events and the personalized gene-specific therapy await further investigation.

Treatment of chronic osteomyelitis has become a difficult problem in clinical medicine due to its extended pathological process,high occurrence of complication and recurrence of disease.The major pathogenesis mechanism is Gram-negative bacteria infection,such as staphylococci.LPS is an important substance found in the cell wall of Gram-negative bacteria and administration of LPS to skeleton relevant cells in vitro could simulate the pathological characteristics of osteomyelitis patients.The results of quantitative real-time PCR and Western blot showed that CHI3L1 was up-regulated obviously in the infected bone tissues of osteomyelitis patients and LPS-stimulated osteoblasts.Analysis of the luciferase activity of NF-?B reporter gene vector revealed that LPS could activate NF-?B.Bay11-7082,an inhibitor of NF-?B activation,suppressed the elevation of CHI3L1 expression induced by LPS.Pre-incubation of osteoblasts with anti-TNF-? antibody or silencing TNF-? receptor expression by siRNA inhibited the induction effect of LPS on CHI3L1.Inhibition of NF-?B activation also prevented up-regulation of TNF-? induced by LPS.In conclusion,LPS stimulated TNF-? expression through activating NF-?B,then TNF-? induced CHI3L1 expression.It was demonstrated for the first time that CHI3L1 expression is promoted in osteomyelitis and LPS-treated osteoblasts and investigates the molecular mechanism of LPS-induced CHI3L1 expression in osteoblasts.

Objective To investigate the related demographic and obstetrical factors of postpartum depressive symptoms.Methods The study was carried out in four hospitals selected by stratified sampling in Changsha city.The 320 nullipara women who met the designed including criteria at 6 weeks postpartum were recruited by cluster sampling from the four hospital.Three hundred and twenty nullipara women were assessed by using Edinburgh Postpartum Depression Scale(EPDS),self-designed demographic and obstetrical factors questionnaires.Results The study showed that the careers like cadre and clerisy were demographic risk factors(P=0.011,OR=0.886).There were four obstetrical risk factors,including assisted reproductive technology(ART)(P=0.005,OR=4.585),the time of the first stage of labor(P=0.024,OR=2.269),instrumental delivery(P=0.000,OR=49.767),and birth defect(P=0.000,OR=28.386).The normal delivery was a protective factor(P=0.003,OR=0.151).Conclusion Multiple factors are involved in the incidence of postpartum depression.Preventive intervention should be taken actively to prevent against postpartum depression.

Objective:To investigate the effect and elucidate the mechanism of the selective cyclooxygenase-2(COX-2)inhibitor NS-398 on apoptosis and survivin, XIAP and c-IAP1 expressions of hepatocarcinoma cell lines. Methods:The proliferation of hepatocarcinoma BEL-7402 cells treated with NS-298 at different concentrations were evaluated by MTT assay. The apoptosis was detected by flow cytometry (FCM) and TUNEL assay. Expressions of COX-2, survivin, XIAP and c-IAP1 were analyzed by immunocytochemical staining. Results: NS-398 significantly inhibited cell proliferation of BEL-7402 cells and induced apoptosis. Immunocytochemisty indicated that the expressions of COX-2, survivin, XIAP and c-IAP1 were significantly down-regulated in BEL-7402 cells by NS-398 treatment compared with untreatment group (P<0.01). Conclusion:NS-398 inhibits the proliferation and induced apoptosis of BEL-7402 cells. The mechanism may be related with down-regulation of the survivin, XIAP and c-IAP1 expression.

Objective To investigate the effection of Shenfu Injection (Ginseng-radix aconitum Injection)to the blood coagulation system and its prognosis in the patient of multiple trauma complicated with shock.Methods We prospectively studied 90 patients of multiple trauma complicated with shock,who came from the emergency center of the Second Affiliated Hospital of Medicine' s college of Zhe-Jiang University and emergency department of Lishui People' s Hospital from February 2007 to December 2011,and excluded those suffered with the dysfunction of coagulation system and uncontrolled ongoing bleeding before trauma.And then these eligible patients were randomly divided into two groups:treatment group ( 45 cases ) and control group (45 cases),the control group were received the routine treatment,the treatment group were received Shenfu Injection in early stage based on the routine treatment.The two groups were measured the platelet count (PLT),prothrombin time (PT),activated partial thromboplastin time (APTT),thrombin time (TT),fibrinogen (FIB) before treatment and 3,7 days after treatment.Results The differences of the PLT,PT,APTT,TT,FIB between the treatment group and control group at 3,7 d after the treatment was statistically significant (P ＜ 0.05 ). Conclusions Shenfu Injection has positive regulation to the coagulation system in the patient of multiple trauma complicated with shock.

Objective To investigate the possible association between the thrombospandin-1(TSP-1) gene GI678A (Ala523Thr)polymorphism and acute coronary syndrome (ACS) in a Chinese Han population.Method he ease cohort studied was compsed of 412 hospitalized patients with ACS recruited from four participating hospitals between November 2003 and May 2006.The diagnosis of ACS was based on the criteria of AHA/ACC set in 2002.The eontrul group was consisted of 319 age- and sex-matched subjects from partiei pating hospitals,and they were free from coronary artery disease judged by history,clinical examination,electrocardiography,exercise test and angiography.The TSP-1 GI678A polymorphism was determined by polymerase ehain reaction and restriction fragment length polymurphism analysis(PCR-RFLP).Results The prevalence OfAA genotype of the G1678A polymorphismin patients with ACS was significantly higher than that in the control subjects (49.5%% vs.40.4%,P=0.015).The frequencies of GA and GG genotypes were not significantly different between patients with ACS and controls (CA:39.3% vs.46.1%,P=0.070;CA;11.2% vs.13.5%,P=0.340).The frequencies of A allele in the ACS group and control group were 69.2% and 63.5%,respectively (P=0.022).Furthermore,multiple logistic regression analysis showed that the AA genotype was a significant risk factor for ACS (OR=1.52;95% CI:1.11～2.08;P=0.010).Conclusions The present findings suggest that the AA genotype in TSP-1 gene GI678A polymorphism may be associated with a risk factor for ACS in the Hart nationality of China.The AA genotype may be a genetic marker of the liability to the inheritance of AC,S.

Objective To evaluate the value of echocardiography method for diagnosis of the downward displacement of the posterior leaflet of tricuspid valve with apical right heart two chamber view (AP-RH-2CV). Methods Rotating the probe clockwise from apical four chamber view(AP-4CV) to AP-RH-2CV at the septial and posterior leaflet of tricuspid valve, the shape, moving and position of the posterior leaflet of the tricuspid valve were observed by displaying the degree of downward displacement of the septial and posterior leaflet of tricuspid valve. The location of the orifice of tricuspid regurgitation was examined by color Doppler flow imaging(CDFI). Results In 15 patients with Ebstein's anomaly from the AP-RH-2CV, the downward displacement of posterior leaflet of tricuspid valve was clearly observed at the AP-RH-2CV. These results of echocardiography were confirmed by surgery except one ease missing out mild downward displacement of the anterior leaflet of tricuspid valve. Moreover, all 15 patients showed the obvious downward displacement of the location of the orifice of tricuspid regurgitation from AP-RH-2CV by CDFI. Conclusions The AP-RH-2CV is an ideal view in diagnosis of the downward displacement of the posterior leaflet of tricuspid valve by echocardiography. The downward displacement of the location of the orifice of tricuspid regurgitation is a critical character for diagnosis of the downward displacement of the posterior leaflet of tricuspid valve by CDFI.

Objective To investigate the radiosensitization effect and underlying mechanism of Paeonol on human lung adenocarcinoma cell line A549 in vitro. Methods Cells were assigned to following groups:control,Paeonol alone,irradiation alone,Paeonol combined with irradiation.The effect of Paeonol on cell proliferation was evaluated by the MTT assay. Clonogenic assay was performed to measure the radiosensitization effect of Paeonol under three concentrations around 20％ IC50.Cell apoptosis was determined by TUNEL assay and flow cytometry (FCM).The expression of Survivin protein was analyzed by Western blot.Results Cell growth was inhibited by Paeonol in a dose-dependent manner and the IC50 of Paeonol was (25.2 ± 2.1 ) mg/L. Clonogenic assay showed that Paeonol could markedly enhance cell radiosensitivity and the sensitizing enhancement ratio (SER) was 1.29.After the pretreatment of Paeonol with different concentrations,radiation-induced apoptosis increased with the doses at 24,48,and 72 h post-irradiation ( t =4.95,3.03,3.78,4.59,2.88,3.70,5.54,P ＜ 0.05 ). Moreover,the protein expression of Survivin was obviously down-regulated by 22.6％ - 56.7％ ( t =4.15,7.30,13.47,P ＜0.05 ) due to the treatment of Paeonol.When the Paeonol-treated cells were further irradiated with 6 Gy X-rays,the expression of Survivin was reduced to 22.2％ - 69.4％ ( t =4.30,8.36,16.34,P ＜ 0.05 ).Conclusions Paeonol had radiosensitization effect on the human lung adenocarcinoma cell line A549 in vitro,where the down-regulated Survivin protein might be involved.

BACKGROUND:The ankle joint is capable of flexion and extension, including plantar flexion and dorsiflexion, to act as a support and a lever. An ankle injury, often accompanied by fracture and ligament injury, seriously threatens the ankle joint function. Previous diagnosis of ankle injury mainly relied on clinical signs and X-ray examination. However, X-ray examination is not accurate enough for ankle injury diagnosis because it cannot clearly diagnose damage to the surrounding ligaments, tendons and other soft tissues except for obvious fractures. Mutlisequence and multiplanar MRI is currently the optimal noninvasive method for high-resolution determination of soft tissue deformations, but little has been reported on the diagnostic accuracy of ankle ligament and tendon injury. OBJECTIVE:To observe the diagnostic value of MRI for ligament and tendon injury of the ankle in its normal position, and during complete plantar flexion and dorsiflexion. METHODS:It is a single-center, prospective, diagnostic trial that wil be completed at the First Hospital of Hebei Medical University, China. Sixty cases were recruited, including 30 cases of normal ankle joint and 30 cases of ankle ligament and tendon injury. MRI scans of the ankle joint in normal position, complete plantar flexion and complete dorsiflexion were performed in al the cases, and the multi-position MRI results were compared. The primary outcome measure is the sensitivity of MRI to ligament and tendon injury of the ankle during complete plantar flexion. The secondary outcomes include the specificity, positive predictive value, negative predictive value, positive likelihood ratio, and negative likelihood ratio of MRI to ligament and tendon injury of the ankle during the complete plantar position as wel as rate of correct diagnosis;specificity and sensitivity, positive predictive value, negative predictive value, positive likelihood ratio, and negative likelihood ratio in normal position or during the complete dorsiflexion as wel as rate of correct diagnosis;the morphology of the ankle on the multi-position MRI. This study design was registered at ClinicalTrial.gov (03049423) on February 8, 2017. This study protocol has been approved by the Medical Ethics Committee of Qinghai University Affiliated Hospital of China (approval No. 2015076) and wil be performed in accordance with the guidelines of the Declaration of Helsinki, formulated by the World Medical Association. Signed informed consent regarding trial procedure and treatment was obtained from each volunteer. DISCUSSION:This study aims to determine the rate of correct diagnosis of ankle ligament and tendon injury using the MRI, to clarify the diagnostic value of MRI for ankle ligament and tendon injury, and to provide a quantitative MRI diagnostic standard for developing a reasonable surgical treatment.

Objective To evaluate the clinical significance of minimal residual disease (MRD)detecion in ALL-B of children by flow cytometric (FCM).Methods 52 cases of children with ALL-B were performed bone marrow MRD by FCM analisis after induction therapy,3 moths therapy,and 6 moths therapy.After that,MRD detection was performed every 6 months. According to disease risks, three group were categorized,standard risk (SR),imidiete risk (IR) and high risk(HR).Results After 6 months,SR groups MRD positive cases were 4/21(19 ％),IR groups MRD position cases were 8/23 (35 ％),HR groups MRD position cases were 5/8 (63 ％).9 cases relapsed in all 52 patients.There were significant differrence in replased rate between the positive and negtive MRD (P＜0.001). Conclution The dynamic detection of MRD by FCM can be used to evaluate the therapeutic effect and prognosis of children with ALL-B. It is also useful in adjusting treatment strategy and for following up in children with ALL.