Metabolic syndrome (MS) is a complex polygenic inheritance disease, caused by the accumulative effect of multiple genes and some environmental factors. Insulin resistance is the pathophysiologic foundation of MS. From the viewpoint of TCM, phlegm is the basic pathological factor of MS. In different periods and different symptoms of the disease, phlegm can be found during the whole disease course. Genes as an important component of the innate factors, play an important role in the formation of phlegm syndrome. Researches on correlation between susceptibility genes and phlegm syndrome in MS are important to enrich the connotation of phlegm syndrome and improve the level of diagnosis and treatment for this disease.

Objective To summarize the experiences of the diagnostic and therapeutiec approach of hepatic trauma.Methods Referencing to the literature of recent years,we retrospectively analyzed the clinieal data of 55 cases of liver trauma.Results Among the 55 cases.18 eases of stage Ⅰ～Ⅱ.1 5 cases of stage Ⅲ,17 eases of stage Ⅳ and 5 cases of stage V,Thirty-one cases received non-operative treatment.and 24 cases reeeived operative therapy.In non-operative treatment group,the cure rate was 100%.In operation Ireatmenl group the cure rate was 91.7%.Conclusions Focused abdominal sonography for trauma (FAST) and diagnostic peritoneal paraeentesis are the initial methods for diagnosis of liver trauma and are largely used nowadays.When the patient is hemodynamically stable,CT scan or simuhaneous contrast-enhanced scan are important to decide for conservative ur surgical treatment.Today.treatment of hepatic lesions takes in account mainly two aspects:hemodynamically stability and the mechanism for trauma(blunt or penetrating).Liver injmy score of patienlS is not as important as the hemodynamie status for determining conservative management.Nonoperative management under close continuous observation for the hemodynamically stable patients with stage Ⅰ and Ⅱ and some eases of stage Ⅲ blunt hepatic injury has become the stamlard of care.The decision for surgical intervention should be given in time according to the variance of hemodynamically stability and the presence of trauma (blunt or penetrating).Some cases of stage Ⅲ and all cases of stage Ⅳ to Ⅴ hepatic injury shouht preferably undergo surgieal treatment.The effective preventive measures to decrease mortality in patients with severe hepatic trauma include early remedy to henmrhagie shock.effective hemostasis,complete abdominal drainage and prevention of pnstoperative enmplieations.

FOXM1 (Forkhead box M1), one factor of the Forkhead family, has three subtypes (FOXM1a, FOXM1b, FOXM1c). The current study focuses on FOXM1b and FOXM1c. FOXM1 regulates transcription of prolifemtion-nssociated genes and plays a vital role in embryogenesis as well as reorgani-zation. Recent studies have shown that FOXM1 is closely related with tumor occurrence and development. Tumors with high expression of FOXM1 are often poorly differentiated, highly malignant, distantly metastat-ic, poorly predicted. FOXM1 has a influence on the tumor proliferation, invasion, metastasis and angiogene-sis through regulating its downstream tumor-related genes. At present, the synthesis and study of the anti-tumor chemicals targeting FOXM1 offer a possibility of the FOXM1 in clinical applications. More and more researchers attach importance to its tumor therapeutic value both at home and aboard. This paper will make a review about the lastest FOXM1 research in oncology.

BACKGROUND: Statins can block many intracellular signal transductive pathways and suppress the proliferation of various cells by affecting the synthesis of mevalonic acid and the translation following modification of some membrane-connecting proteins.OBJETCIVE: To investigate the influence of simvastatin on the proliferation of lung fibroblasts, the synthesis of collagen and the secretion of matrix metalproteinase-2 (MMP-2).DESIGN:Completely randomized controlled study.SETTING: At Organ Transplanting Research Institute of Fuwai Cardiovasular Diseases Hospital, Peking Union Medical College.MATERIALS: This study was carried out at the Laboratory of Cardiology of Beijing Union Medical College hospital, Peking Union Medical College from June 2004 to October 2004. Lung fibroblasts derived from neonatal SD rats were co-cultured in vitro with different dosage of simvastatin of 0, 1, 5, 10,50 μmol/L, and 50 μmol/L simvastatin + 200 μmol/L mevalonic acid.METHODS: Lung fibroblasts deriving from neonatal SD rat were co-cultured with different dosage of simvastatine in vitro. Methyl thiazolyl tetrazolium colorinetry was used to detect the cell proliferation, and cell immunohistochemical assay was used to determine the collagen synthesis and meanwhile,MMP-2 content in supernatant was examined with enzyme-linked immunosorbent assay.MAIN OUTCOME MEASURES: The proliferation of fibroblasts, the synthesis of collagen and the secretion of MMP-2 due to different dosage of simvastatin intervention and simvastatin combined with mevalonic acid.presenting the expression of type Ⅰ, Ⅲ of collagen in lung fibroblasts and the level of MMP-2 in 5, 10, 50 μmol/L simvastatin group were obviously lower than those of 0 μmol/L simvastatin group (0. 520 ± 0.010, 0. 334 ± 0.011,0.260±0.012, 0.111±0.011; 0.508±0.011, 0.324±0.014, 0.232±0.015, 0. 083 ±0. 015; 0.445 ±0. 017, 0. 305 ±0. 015, 0.216 ±0. 015,0.068±0.012; 0.561±0.013, 0.361 ±0.012, 0.289±0.012, 0.140value, the mean absorbency( A value) in lung fibroblasts and the level of MMP-2 in 50 μmol/L simvastatin + 200 μmol/L mevalonic acid group were obviously higher than that of the 50 μmol/L simvastatin group(0. 567±0.015, 0.354±0.014, 0.283±0.012, 0.138±0.011, t=4.715-10.950, P ＜ 0.01).CONCLUSION: Simvastatin could suppress the fibroblast proliferation and collagen synthesis, attenuate the secretion of MMP-2 and suppress consequently the adhesion and migration of lung fibroblasts; moreover, it has the capability of anti-cell proliferation by affecting the mevalonic acid pathway.

Objective To understand the clinical features,differential diagnosis,treatment and prognosis of postpartum hemolytic uremic syndrome (PHUS). Methods Three PHUS cases and relevant literature were reviewed. Results Three patients were admitted because of microangiopathie hemolytic anemia,thrombocytopenia and acute renal failure.which occurred within 3 days after cesarean section.All of them received plasmapheresis and hematodialysis.Now,one of the patients recovered,and the other lives on hematodialysis. Conelusiom Early diagnosis and proper treatment of PHUS ensures a better outcome.

Objective;To explore the mechanism ofSimiaosan drug-containing serum on prevention and treatment of renal fibrosis.Methods Human renal tubular epithelial cells (HK-2) were divided into blank group, model group, control group, and drug-containing serum high dosage group, medium dosage group and low dosage group. The expressions of CTGF and BMP-7 were determined by real-time PCR assay and immunocytochemistry.Results After the HK-2 cell was induced by uric acid (UA), the expression of CTGF significantly increased (P<0.05), the expression of BMP-7 significantly decreased (P<0.05). After intervened bySimiaosan, the expression of CTGF significantly decreased (P<0.05), the expression of BMP-7 significantly increased (P<0.05) and present dosage dependent.Conclusion Reducing the expression of CTGF and up-regulation the expression of BMP-7 and controlling epithelial-myofibroblast transdifferentiation may be the mechanism ofSimiaosan on prevention and treatment of renal fibrosis.

Aim To construct the eukaryotic expression vector of hIL-24 cDNA,and express it in CHO cells and detect its anti-tumor effect of recombinant hIL-24 protein.Methods Constructed pcDNA3-hIL-24 was identified by endonucleases digestion & PCR.The recombinant expression plasmids were transfected into CHO cells,human hIL-24 expressed in CHO cells was detected with RT-PCR.The apoptosis-inducing activities of recombinant protein hIL-24 was tested by MTT assay,Hoechst& FCM assay,and the expression of IL-6 and IFN-? from PBMC induced by rhIL-24 was tested by ELISA.Results The eukaryotic expression vector pcDNA3-hIL-24 was constructed correctly.Stable expression of human IL-24 in CHO cells was identified with RT-PCR.The apoptosis of A549 cells induced by hIL-24 was proved by Hoechst & FCM assay,and the expression of IL-6 and IFN-? from PBMC induced by rhIL-24 was identified with ELISA.Conclusion The successful stable expression & experimental study of apoptosis effect of human IL-24 gene lay the foundation for the further study of molecular mechanism of hIL-24 on anti-tumors and potential application.

Objective To explore the imaging features of breast cancer by CR mammography,in order to improve the diagnostic level. Methods The CR mamographic features of 37 patients with breast cancer confirmed surgically and pathologically were analysed retrospectively. Results In the 37 cases of breast cancer,the following abnormal signs were found in CR mammograms: mass(n=29),without mass(n=8),calcification(n=15),abnormal vascularity(n=7),inverted nipple(n=6),thickened skin(n=3),sign of tower's tine(n=3),sign of funnel(n=1),focal structural disorder and small focus of increased density(n=3). Conclusion The masses and calcificationsare the main radiological features in breast cancer,CR mammography may show the characteristics of breast cancer,it is one of the mosteffective means in diagnosis of breast cancer.

Objective To evaluate the short-term effects of total knee arthroplasty ( TKA) , and to detect the causes and prevention of major complications. Methods It was a retrospective study since January 2010 to December 2013. There were 63 patients with 70 knees re-ceived primary TKA. KSS knee scores, HSS knee scores, and range of motion ( ROM) before the operation and during the follow-up were as-sessed and analysed. Results According to the results of follow-up and the X-ray observation, the anteroposterior radiographs showed that the artificial prosthesis were placed well and the joint gap were balanced;the lateral radiographs showed that the artificial joint prosthesis we-rer of appropriate size, good tilt angle, and good package effect. There were two cases developed peroneal nerve palsy and they gradually re-stored in 4 to 6 months after surgery. 5 cases were of poor postoperative ROM (0~60 ± 10)°. Strong analgesic medication-assisted release were conducted in 2 to 3 weeks after surgery. 1 case had patellar pain and resorted by arthroscopic lateral ligament of patellar releasing sur-gery. During the follow-up period, TKA significantly improved HSS and KSS scores compared to preoperative scores. ROM was increased from (78. 3 ± 18. 6)° preoperatively to (109. 2 ± 19. 9)° postoperative (P<0. 01). Conclusion TKA was effective to release knee pain, improve ROM and reduce the incidence of postoperative complications.

Objective:To study the antitumor effect and mechanism of cocultured CIK cells modified with IL-24 gene and autologous DCs on HL-60 cells in vitro.Methods:DCs and CIK cells were prepared routinely from human peripheral blood mononuclear cells ( PBMC).IL-24 gene was transferred into CIK cells via electroporation.The cells obtained were named CIK-IL24.RT-PCR and ELISA were used to evaluate expression of IL-24 gene in transfected CIK cells.The phenotypic changes of CIK cells were identified by flowcytometry analysis.The concentration of IFN-γ and TNF-α in supernatant of CIK was determined by ELISA.FCM was used to determine the cytotoxicity of cocultured CIK cells modified with IL-24 gene and autologous DCs against HL-60 cells.Results:Eukaryotic expressing plasmid pcDNA3.0-IL24 was transferred into CIK cells successfully via electroporation.The expressing rate of CD3~+、CD3~+CD56~+ cells had no significant change in CIK cells.However,the rate of CD4~+CD25~+ cells was significantly decreased compared with that of the control group.Expression of adhesion molecules CD54,CXCR4 were significantly increased on CD3+CD56+ cells.CIK-IL24 cells produced markedly higher levels of IFN-γ and TNF-α as compared with the CIK cells.By comparison with non-transfected CIK cells co-cultured with DCs,transfected CIK cells co-cultured with DCs had a significantly higher lytic activity against HL-60 cells.Conclusion:IL-24 gene modification can enhance the anti-tumoral immunity of CIK cells,the mechanism of which might be related to the increased secretion of IFN-γ,TNF-α,up-regulation of adhesion molecule expression,and reduction of the rate of CD4~+CD25~+ cells in CIK cells.