The estrogen receptor (ER) coregulators regulate the transcriptional activities of ER,and then affect the transcription and translation of target genes mediated by ER.ER coregulators not only plays an important role in the initiation,progression and metastasis of breast cancer,but also involves in the response to endocrine therapy of breast cancer via the genomic and nongenomic function.

ObjectiveTo explore the influence of life events on the emotional state ot heart transplantation patients.Methods All the heart transplantation outpatients were interviewed by a certain psychiatrist in Zhongshan Hospital during Oct.2010 to Oct.2011.The demographic data,life events and the self-reported influenced degree were recorded by the same psychiatrist.A grounded theory-based approach with thematic content analysis of the field notes was used.ResultsEighty-eight patients were enrolled,including 69 males,and19 females.The average age of the patients was 46.5 ±14.3 years old.The average duration after operation was 39.3 ± 39.6 months.The life events were classified into 4 groups,which were medical financial problems,physical condition,family support and future life.The most frequently reported event was physical condition (50.2％ ) and the influenced degree was the highest (9.2 ±1.2),while most patients (96.6％) complained high medical and relevant cost and the influenced degree was (6.5 ± 2.1). Family support was reported by13.6％ patients and its influenced degree was (7.6 ±1.2).The age of the reporter of future life (6.8％) was under 33 years.ConclusionDifferent events have different influence to patients.Improving the social support of patients is helpful to improve quality of life.

Humans ; Infant ; Male ; Mycoses ; pathology ; Penicillium ; isolation & purification

Objective　To investigate the clinical results of the medial multiplex flap pedicled with the posterior tibial vessel. Methods　Twelve cases with soft tissue defects and bone defects of limbs were treated with the medial multiplex flap pedicled with the posterior tibial vessel from September 1992 to May 1999. Among them, bone and soft tissue defects following opened fracture in 7 cases, chronic ulcer following chronic osteomyelitis in 2 cases, melanoepithelioma in 2 cases, bone and soft tissue defects following osteoma resection in 1 case. The bone defect area was from 2.5 cm×5.0 cm to 4.5 cm ×11.0 cm. Free graft was performed in 5 cases, bridged transposition in 3 cases and reversal transposition in 4 cases, among them, periosteal myocutaneous flap with autogenous or allogeneic bone grafting in 8 cases, myocutaneous flap in 4 cases. The area of the flaps from 6 cm ×8 cm to 12 cm×25 cm. Results　All flaps were healed by first intention, but in the distal fragments of bigger flaps were partially necrosed in 2 cases. In 10 cases bone healing were obtained after 16 weeks of operation according to the X-ray photos. All cases were followed up from 6 to 18 months. All cases achieved satisfactory result but 1 case died because of lung metastasis of osteoma. Conclusion　The multiplex graft pedicled with the posterior tibial vessel is an ideal graft for repairing the large soft tissue defects and bone defects, because it has such advantages as adequate blood supply, big vascular diameter, long pedicle and big dermatomic area.

Objective To investigate the role and significance of E selectin in the pathogenesis of neonatal acute lung injury (ALI).Method Ninety neonatal Sprague Dawley (SD) rats (6 or 7 days after birth) were randomly assigned to the control group (n =10) and ALI group (n =80).The rats in the ALI group received intraperitoneal injection of lipopolysaccharide (LPS) at dose of 4 mg/kg and they were divided into eight subgroups with 10 rats in each group according to different sacrifice time (0.5 h,1 h,2 h,3 h,4 h,8 h,12 h and 24 h after injection).Rats in the control group were injected intraperitoneally the same volume of normal saline and they were sacrificed at 4 hours after injection.Expression of the E-selectin in lung tissue was detected dynamically by immunohistochemistry and the serum soluble endothelial selectin (sE-selection) was detected by enzyme-linked immunosorbent assay (ELISA).The pathological changes of the lung tissue and the wet/dry lung weight ratio (W/D ratio) were recorded.Result The strong expression of a large number of E-selectin was detected in the vascular endothelial cells of the lung tissue in the ALI group,while only moderate expression of E-selection was observed in the control group.The W/D ratio in the ALI group gradually increased from 0.5 h after intraperitoneal injection of LPS,reached the peak at 8 h,and then began to decline.The ratio was significantly higher in the ALI group than that of the control group from 4 to 12 h after injection (P ＜ 0.05).The mean optical density of E-selectin in lung tissue of ALI group was also higher than that of the control group and the average optical density of ALI group at 2 h,3 h,4 h and 8 h was significantly higher [2 h:(0.36 ±0.09),3 h:(0.38 ±0.01),4 h:(0.44 ± 0.06),8 h:(0.30 ± 0.09),control group:(0.24 ± 0.01),P ＜ 0.05].The level of serum sE-selectin gradually increased after intraperitoneal injection of LPS,reached the peak at 2 h,and then decreased gradually.The level of sE selection was significantly higher than that of the control group at the point of 2 h,3 h,4 h and 8 h (P ＜ 0.05).The level of serum sE-selectin increased along with the expression of E-selectin in lung tissues,and they were positively correlated (r =0.730,P ＜ 0.01).Conclusion The increased expression of E-selectin and the elevation of serum sE-selectin level may reflect the injury of pulmonary vascular endothelial cells induced by systemic inflammatory response.

Objective To observe the effects of different doses of dexmedetomidine combined with ropiva-caine for ultrasound-guided fascia iliaca compartment block on postoperative analgesia and rehabilitation in patients undergoing total hip replacement surgery. Methods 80 patients with ASAⅠ~Ⅱundergoing total hip arthroplasty were ramdonly divided into 4 groups. Records of patients with ultrasound guided fascia iliaca compartment block onset time,block fading time,VAS at 4 h,8 h,12 h,24 h,48 h;duration of operation,intraoperative remifent-anil and propofol requirement;24 h and 48h of sufentanil use;after the operation were recorded for the first time , ambulation time,hospitalization time and observe whether bradycardia,intraoperative awareness and other adverse reactions. Results Compared with group A and B,the onset time of C were shorter(P<0.05);the VAS was less (P<0.05);the remifentanil equirement was significantly was reduced(P<0.05);the amount of sufentanil after operation 24 h and 48 h was reduced(P<0.05);the first time out of bed time and total hospitalization time was shorter(P < 0.05);patient satisfaction increased(P < 0.05);The extubation time was significantly longer and the occurrences of tachycardia were significantly increased in group D compared to other groups respectively. Conclusion 1.0μg/kg dexmedetomidine combined with 0.3%ropivacaine ultrasound-guided fascia iliaca compart-ment block can provide better postoperative analgesic and recover rapidly with fewer side effects in total hip replace-ment surgery.

Objective To evaluate the efficacy of pneumocystoscopy for congenital malformation of the vesicoureteral junction. Methods A total of 18 children (male 11 and female 7, aged from 3 months to 7 years with a mean of 3.6 years) with congenital malformation of the vesicoureteral junction (22 ureters) were enrolled in this study. Among the patients, 9 had vesicoureteral reflux (4 of them had bilateral reflux), 2 had bladder diverticulum complicated with urethral stenosis, and 7 had urethral stenosis and ipsilateral hydronephrosis. After the bladder was insufflated with CO2 through a Foley catheter (16 mm Hg), three trocars were inserted into the bladder, and the bladder was fixed on the abdominal wall using silk thread. By pneumocystoscopy, the Cohen procedure was done through the trocars. A Foley catheter was indwelled at the end of the procedure. Results The procedure was completed in all but one patient, who was converted to open surgery because the contraction of the urethra. The mean operation time was 130 min (110 to 145 min) for unilateral cases (13), and 242 min (225 to 250 min) for bilateral cases. The patients were discharged form hospital 9 to 12 days after the operation, and were followed up fro 6 months to 5 years with a mean of 3.8 years. During this period, MUC showed no ureteral reflux. One of the cases developed mild infection of the urethra, and was cured by circumcision. Conclusion Pneumocystoscopy is effective for congenital malformation of the vesicoureteral junction.

Objective To study the clinical practical use of the model for end-stage liver disease(MELD) and assess its validity in predicting the prognosis of the.chronic severe hepatitis patients.Methods The clinical data of 391 patients with chronic severe hepatitis among 2003～2005 in our hospital were analyzed,and they were graded with MELD formula.These patients were divided into plasma exchange group and none plasma exchange group according to plasma exchange treatment or not.The death rate was observed within three months.The validity of the model in predicting the prognosis of the patients with severe hepatitis was determined by the concordance(c)-statistic.Results 236 patients died within three-months and the mortality was 60.6%.The mortality of patients in PE group whose MELD score were less than 30 and 30～40 was 25% and 75% respectively,but in non-PE group they were 42.0%,90.7% respectively,there were significant difference between PE group and non-PE group(P0.05).The optimal cut-off values of MELD to predict the prognosis of patients were 30 in PE group whose sensitivity and specificity were 66.7% and 86.4%,and its c-statistic was 0.823(95% CI 0.734～0.912);and in non-PE group they were 27,76.4%,79.1% and 0.832(95% CI 0.787～0.877) respectively.Conclusions The mortality of the patient with chronic severe hepatitis increases with the increase in the MELD score.The MELD can accurately predict the short-term prognosis of patients with chronic severe hepatitis.

OBJECTIVE:To try to establish a combined serum-pharmacology and electrophysiology method for the study of mechanism of chuanxiong extract in dilatating coronary artery.METHODS:Chuanxiong extract was intragastrically given to rats and mice,then the serum contents of tetramethylpyrazine(TMP)were determined by HPLC,which provided data for electrophysiological study.The action of chuanxiong extract on Ca 2+ -activated K channel(Kca)of smooth muscle of coronary artery in pigs was studied by patch clamp technique.RESULTS:The calibration curve of TMP was linear in the range of0.216～54?g/ml(r=0.9999).The recovery was100.7%～102.4%.The serum concentrations of TMP in rats and mice were(3.56?3.01)and(8.19?6.57)?g/ml respectively.The chuanxiong extract could not markedly activate the Kca of smooth muscle of coronary artery in patch clamp study.CONCLUSION:The established method for TMP determination is feasible and relieable.In order to improve the combined electrophysiology and serum pharmacology technique,high quality medical materials should be adopted and the bioavailability improved.

Objective To study immunological property of chimeric BPVL1 / HPV16 E7 virus-like particles (VLPs) in mice. Methods HPV16 E7 gene was cut into three fragments, ligated to BPVL1 sequence, respectively, and then expressed as chimeric VLPs. The ability of the chimeric VLPs to stimulate in vivo cytotoxic response was analysed with lymphocytes taken from mice C57BL/6J lymph nodes. Results A strong CTL response against C-2 cells (HPV16 E7 aa47-59 transfected EL-4 cell) was induced in mice immunised with chimeric VLPs BPVL1 / HPV16 E7(b). Furthermore, no CTL response was detected against EL-4 cells in immunized mice. Conclusions Chimeric BPVL1/HPV16 E7 VLPs, serving as antigens, can activate mouse T lymphocytes and elicit a strong antigen-specific CTL response. Chimeric BPVL1/HPV16 E7 VLPs could be used as an efficient antigen delivery system, and might provide a novel strategy for HPV16 vaccine design.