Background and purpose:Regulation of MMR activity under hypoxia may play an important role in genetic instability of cancer,but the mechanism is still unclear.We investigated the expression of DNA mismatch repair genes MLH1 and MSH2 in human SCLC cell line H446 under hypoxic condition and explore the role of promoter methylation of genes in hypoxia.Methods:RT-PCR and Western blot were applied to detect MLH1 and MSH2 expression in human SCLC cell line H446 at the mRNA and the protein level,respectively,under either hypoxic condition or after 5-Aza-CdR treatment.Meanwhile,methylation-specific PCR(MSP)was used to determine promoter methylation of MLH1 and MSH2.Results:The expression of MLH1 and MSH2 in H446 cells significantly decreased both at the mRNA and the protein level under hypoxic condition.5-Aza-CdR treatment led to the restoration of MLH1 and MSH2 expression,while,both MLH1 and MSH2 were down-regulated again after removing 5-Aza-CdR.Conclusions:The promoter methylation of MLH1 and MSH2 may play an important role in its defective expression in H446 cells under hypoxic condition.And 5-Aza-CdR could restore MLH1 and MSH2 expression.

Objective: To investigate the expression difference of TRAIL and its receptors between resting and activated peripheral blood lymphocytes, and to study their role in cellular growth and proliferation. Methods: Expression of TRAIL and its receptors were detected by RT PCR and DNA sequencing. Results: Neither the expression of TRAIL nor its receptors were detected in resting peripheral blood lymphocyte. However, both expression were found in activated peripheral blood lymphocytes of various degree. Conclusion: TRAIL and its receptors may play a role in regulation and control of the activated lymphocytes in immune reaction.

Objective To evaluate the treament of central retinal artery occlusion by thrombolysis infusion via super selective ophthalmic artery catheterization.Design Retrospective,observational case series.Participants 21 eyes of 21 patients with CRAO. Methods 21 patients with CRAO were diagnosed by stereoscopic color fundus photography and flouorescein fundus angiography, and were treated by urokinase infusion via super select ophthalmic artery catheterization seldinger technique.Main Outcome Measures Visual acuity and the postoperative complications.Results In the 21 patients,10 had showed the occlusion of ophthalmic arterial trunk by super selective internal carotid artery angiography,the others can be found the appearance of ophthalmic arterial trunk and all patients had undergone thrombolysis therapy successfully.Imaging times of central retinal artery before and after thrombolysis infusion treatment are 38.18?10.86 seconds,12.65?3.30 seconds(t=-11.89,P=0.000).Mean foflow-up time is 3.23?1.26 months.After the treatment,the visual acuity was more than 0.25 in 4 patients,improved to different extent in 9 and remained unchanged in 8. Conclusions Super selective arterial catheterization with thrombolysis for CRAO can improve the visual acuity of the patients,a speedy execution of all internal,neurological,and ophthalmology diagnostic measures;and a prompt therapy are necessary.

Objective To investigate the role of methylated DNA mismatch repair gene MLH1 and MSH2 in the acquired multidrug-resistance of human small cell lung cancer cells H446.Methods The reverse transcription polymerase chain reaction(RT-PCR)and Western blot were applied to measure MLH1 and MSH2 mRNA and protein expressions of the multidrug-resistant cells H446/DDP and its parental cells H446.The promoter methylation status of the genes was assessed by methylation-specific PCR(MSP).Results The expressions of MLH1 and MSH2 significantly decreased both in mRNA level and protein level.Promoter methylation of MLH1 was observed in H446/DDP cells but not in H446 cells.Promoter semi-methylation of MSH2 in H446 cells was transformed to methylation in H446/DDP cells.Conclusion The downregulation of DNA mismatch repair gene MLH1 and MSH2 induced by its promoter methylation may play an important role in the acquired multidrug resistance of human small cell lung cancer.

OBJECTIVETo research the application and clinical effect of titanium elastic nails (TEN) for the treatment of closed clavicular fracture in elder children.

METHODSFrom October 2010 to December 2012,16 elderly children with clavicular fracture of elder children were treated with internal fixation, including 9 boys and 7 girls with an average age of 14.2 yeats old ranging from 9 to 17 years. The mean time between injury and surgery was 2 to 6 days. Thirteen patients had a transverse fractures; 3 patients had a oblique fractures, excluding the long-oblique patients. Neer function score after 3 months follow-up and the shoulder activity degree after 3 weeks followed were compared respectively between the injured side and healthy side. Fracture reduction and healing were followed up by X-rays to analyze internal fixation with TEN technique.

RESULTSAll patients were healed well after surgery. There were 2 cases with soft tissue irritation. No cases of infection, TEN broken, delayed healing or skin bursting were observed. All patients were followed up for 3 to 10 months,with an average of 7.2 months. There were no significant differences (t=2.12, P>0.05) between the healthy side (98.75±2.70) and injured side(96.69±6.22)of Neer score at 3 months during followed up. The shoulder activity at 3 weeks during followed up was different between both sides (P<0.05). The intramedullary nail was removed after X-rays at 12-18 weeks during followed up showed good bone healing,and the shoulder function was recovered well.

CONCLUSIONInternal fixation with TEN for the treatment of clavicular fracture has advantages of a limited invasion, beauty, safety and reliability. This technique provides an ideal fixation option for the treatment of clavicular fracture in elder children.

Adolescent ; Bone Nails ; Child ; Clavicle ; injuries ; surgery ; Elasticity ; Female ; Fracture Fixation, Internal ; methods ; Fractures, Bone ; surgery ; Humans ; Male ; Titanium

85 mL/min),CL=6.0?(WT/60)~(0.52).④The increased volume of peripheral distribution (V_2) was observed when norvancomycin was co-administered with diuretics;④Reduced drug clearance,prolonged t_(1/2),and increased values of AUC_(24) were found in elderly patients.Conclusions Renal function impairment and age have significant impact on PK parameters of norvancomycin.Dosing regimens of norvancomycin were finally established for different patients on the basis of important PPK parameters generated from different groups of patients.

Objective To analyze the expression of Yes-associated protein and risk factors in differentiated thyroid carcinoma. Methods Clinical data of 152 patients with differentiated thyroid carcinoma and 27 cases of benign thyroid tumor from Changji Hui Autonomous Prefecture People’s Hospital of Xinjiang, were analyzed retrospectively. According to the expression levels of Yes-associated protein in differentiated thyroid cancer and benign thyroid tumor, univariate Chi-square test and multivariate Logistic regression methods were used to analyze the relationship between Yes-associated protein and gender, age, thyroid stimulating hormone(TSH) level, nodule size, capsule integrity, histological type and lymph node metastasis, in order to find out risk factors in differentiated thyroid cancer. Results The positive rate of expressed Yes-associated protein in benign thyroid tumor group was 66.7%(18/27), which was significantly higher than 31.58%(48/152) of differentiated thyroid cancer group, and the difference was statistically significant(χ2=12.127, P<0.01). Under an optical microscope, changes of Yes-associated protein were found to be mainly located in the nucleus and cytoplasm , and in benign thyriod tumor the degree of staining was deep, strong positive or moderately positive; differentiated thyroid carcinoma was lightly stained or no staining, weakly positive or negative. Chi-square test showed that the expression of Yes-associated protein was not affected by sex, age and pathological type(χ2= 0.419, 0.221, 0.315, all P >0.05); TSH level, nodule size, capsule integrity, lymph node metastasis had an impact on the expression of Yes-associated protein which was down regulated (χ2=4.020, 8.424, 4.386, 6.673, P<0.05 or<0.01). Logistic regression analysis showed that the nodule size was not a risk factor ( odds ratio , OR ) of Yes-associated protein expression (OR=1.929, P>0.05); TSH levels above 4.5 mU/L, lymph node metastasis and envelope incomplete were risk factors that down regulated the expression of Yes-associated protein (OR=2.167, 2.665, 3.048, all P<0.05). Conclusion Yes-associated protein is down regulated in differentiated thyroid cancer. Elevated TSH levels , incomplete capsule and lymph node metastasis are risk factors of Yes-associated protein down expression and differentiated thyroid cancer.

Objective To explore the effect of total flavonoids of astragalus (TFA) on the apoptosis of endothelial cells induced by serum of uremia patient .Methods The serum of 22 healthy volunteers and 25 uremia patients receiving regularly hemodialysis were enrolled in the study .HUVECs were used as research objects ,which were divided into control group(adding serum of healthy people when cell synchronized) and uremia group (adding serum of uremia patient when cell synchronized ) .Low dose ,moderate dose and high dose group were prepared by adding 0 .5 ,1 .0 ,2 .0 mg/mL TFA respectively 6 h before cell synchronization .After 24 hours′culture since the serum were added ,the morphological change of endothelial cells were observed by microscopy ,proliferation activities were tested by using MTT ,SOD activities were tested by using xanthine oxidase method ,NO levels were measured by u-sing nitrate reductase colorimetric method ,DNA damage was detected by using comet assay ,the morphological change of apoptosis was observed by using TUNEL method .Results Compared with the control group ,the proliferation activity ,SOD activity ,NO lev-els were lower in uremia group(P< 0 .01) ,DNA tailing rate ,apoptosis index(AI) significantly increased (P<0 .01) .Compared with cells of uremia group ,cell proliferation activity of all the TFA intervention groups increased (P<0 .05) ,NO levels also in-creased (P<0 .01) .Compared with uremia group ,moderate and high dose group′s SOD activity increased (P<0 .05) ,DNA damage tailing rate decreased (P<0 .05) .Conclusion Total flavonoids of astragalus reduces apoptosis of HUVECs induced by serum of uremia patient ,the possible mechanism is associated with the decrease of oxidative stress .

Objective To explore the main factors affecting medical expenses of patients with colorectal cancer(CRC)and reduce such expenses by optimizing the clinical pathway of CRC according to the influencing factors.Methods Data of 467 discharged and medical insured CRC patients at Shanghai Cancer Center,Fudan University,were collected from 2009 to 2010.A multiple linear regression model was applied to analyze the influencing factors of medical expenses.The clinical pathway of CRC was optimized,and medical expenses before and after optimization were compared.Results Our data found days of stay and complications had impact on the medical expenses.Also,medical expenses were decreased accordingly with optimization of clinical pathway of CRC.Conclusion This study provides evidence for decision-making on single disease payment and medical insurance compensation on CRC.It is also meaningful to reduce the economic burden of patients with CRC.

Objective To investigate the availability and usefulness of echocardiography in piglet of experimental carotid-jugular shunting pulmonary hypertension.Methods Fifty-one 1-month-old piglets were randomly divided into surgical shunt group(CA-JV,n =45) and sham group(n =6).In shunt group,left CA-JV shunt was esteblished by end-to-side vascular anastomosis from left carotid artery to jugular vein.Piglets in sham group received a sham operation.Periodic hemodynamic evaluation of the carotidjugular shunt and heart were performed by ultrasound examination post-surgery.Tricuspid regurgitation and pulmonary regurgitation were monitored for evaluating pulmonary systolic pressure and mean pressure.Results In CA-JV group,32 piglets survived to end point of experiment and 27 maintained a persistent shunting (success rate 60％).Tricuspid regurgitation and pulmonary regurgitation occurred increasingly and pulmonary pressure had risen gradually since 4 months post-surgery (P ＜ 0.05).Those were coincided with the results of right catheterization and pulmonary pathology.Conclusions Ultrasound can monitor experimental carotid-jugular shunting pulmonary hypertension that shows practical value for further study in the mechanism and treatment of pulmonary hypertension due to increased pulmonary blood flow.