Psychogenic diseases is an important etiology thinking in traditional Chinese medicine,and it lays a solid foundation for the bio-psycho-social medical pattern to establish.Follows the principle of treatment based on syndrome differentiation,and bases on the basic pathogenesis of breast cancer stagnation of liver-qi attacking spleen,this article provides a brief overview of the relationship between emotional factors and breast cancer,and therapeutic principle of breast to enrich Chinese medicine theory of Qingzhi.

OBJECTIVE:To review the relationship between endothelial progenitor cells and the re-endothelialization of vascular prosthesis in order to find out some effective ways to solve the most frequent complications of asotransplantation,thrombogenesis and intima hyperplasia.DATA SOURCES:A computer-based online search was conducted to identify articles related to endothelial progenitor cells and the re-endothelialization of vascular prosthesis published in Pubmed,Ovid and MD Consult database from January 2000 to December 2006 using the key words of "endothelial progenitor cells,vascular prosthesis,endothelialization".Meanwhile,CNKI database was searched for related papers published between January 2000and December 2006,the keywords were "endothelial progenitor cells,vascular prosthesis,endothelialization" in Chinese.STUDY SELECTION:The literatures included all the related papers about the roles of endothelial progenitor cells in the re-endothelialization of vascular prosthesis.Inclusive criteria:the study types were randomized controlled trials,drug stress test and clinical drug effect test; the samples were both human and animals.Exclusive criteria:Reviews and literatures without controls were excluded.DATA EXTRACTION:Totally 115 related literatures were collected,and 24 were accorded with the inclusive criteria.The excluded were 91 papers of reviews and repeated trials or drug effect studies.DATA SYNTHESIS:These related literatures,including not only animal experiments but also clinical detections,analyzed the relationship between endothelial progenitor cells and the re-endothelialization of vascular prosthesis and correlative promoting mechanisms.CONCLUSION:It is concluded that endothelial progenitor cells play an important role in the endothelialization after vascular prosthesis is grafted in vivo.

Objective To observe the metabolism characters of plasma glucagon-like peptide 1 (GLP-1) in surgical critical ill patients.Methods Totally 64 selective surgical patients were prospectively enrolled and randomly divided into two groups:enteral nutrition (EN) group (50％ glucose 100 ml orally administered or through nasogastric tube on the next day after operation) and parenteral nutrition (PN) group (50％ glucose 100 ml intravenously infused on the next day after operation).Blood glucose and plasma GLP-1 were determined before operation,after operation,and 0 min,30 min,90 min,and 180 min after the 50％ glucose was used.Then,the EN group was divided into stress hyperglycemia (SH) subgroup and non-stress hyperglycemia (non-SH) subgroup.In both subgroups,plasma tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) were detected before operation,after operation,and the next day after operation.Blood glucose,plasma insulin,C-peptide,and GLP-1 were measured before operation,after operation,and 0 min,30 min,90 min,and 180 min after 50％ glucose was used.Results The plasma GLP-1 level (pmol/L) of EN group increased significantly after 50％ glucose was used,and reached the peak at the time of 30 min.In contrast,it did not change in PN group,and were significantly lower than EN group at the time of 30 min [(5.69 ± 2.92) pmol/L vs (33.52 ± 12.32) pmol/L,P ＜0.01] and 90 min [(5.71 ±2.14) pmol/L vs (15.92 ±6.63) pmol/L,P =0.00].Plasma insulin level in SH subgroup were significantly higher than in non-SH group after operation [(18.17±6.18) mU/Lvs (12.10±3.60) mU/L,P=0.01] and30 min [(56.02±14.78) mU/Lvs (43.39±15.60) mU/L,P=0.03] and 90min [(114.58±25.11) mU/Lvs (90.45±25.91) mU/L,P=0.03] after 50％ glucose was used.Plasma C-peptide level in SH subgroup was also significantly higher at the time of 30min [(6.86 ±1.15) μg/L vs (4.76 ± 1.06) μg/L,P=0.04] and 90 min[(12.17 ± 1.96) μg/L vs (9.81 ± 2.35) μg/L,P =0.03] after 50％ glucose was used when compared with non-SH subgroup.Plasma GLP-1 level in SH subgroup was significantly lower than in non-SH group at the time of 30 min [28.76 ± 9.61) pmol/L vs (37.36 ± 10.51) pmol/L,P =0.03] and 90 min [(13.49±4.26) pmol/Lvs (17.33±5.57) pmoL/L,P=0.04] after 50％ glucose was used.Conclusions Early post-operative PN increases plasma GLP-1 level and reduces the SH incidence.In SH patients,endogenous insulin expression increases while plasma GLP-1 level decreases.Post-surgery inflammatory reaction may result in low plasma GLP-1 level and high blood glucose level.

Objective To analyze the effect of bortezomib together with dexamethsone on the treatment of refractory multiple myeloma.Methods Bortezomib at 1.3 mg/m2 iv drop 1 d,4 d,8 d,11 d.Dexamethasonc 20 mg/d,1～4 d,8～11 d,17～20 d.21 days are used as a course.For bi-course dexamethasone was given by 20 mg/d,at 1～4 d.Results After 2～6 periods,3 cases achieved completely recovery(CR),4 cases are near to completely recovery(CR),3 cases got partially recovery(PR).Conclusion It is a good choice to treat refractory multiple myeloma by Bortezomib together with dexamethagone.

Objective To explore a method of establishing a canine model of intracerebral hemorrhage (ICH) by puncturing the main branch of middle cerebral artery (MCA) under ultrasonic guidance and proceed a pilot study of contrast-enhanced ultrasound (CEUS) of ICH.Methods Twelve adult healthy mongrel dogs were enrolled in the experiment.In the condition of bone window,the main branch of MCA was punctured to bleed under the ultrasonic guidance.CEUS of brain was performed every 30 minutes until hematoma formed and another CEUS was performed at 24 hours.Then brains were collected for pathologic examination after dogs were euthanized.Results Eleven of twelve dogs developed ICH successfully that located in the Out edge of basal ganglia,which was confirmed by CEUS and autopsy.One dog died within 6 hours due to intraventricular hemorrhage which was confirmed by autopsy.The hematoma diameters were measured as (22.4 ± 7.1)mm by CEUS before euthanasia and as (21.6 ± 6.9)mm on autopsy.There was no significant difference between the two methods of measurement (t =1.521,P =0.1565).The characteristics of active bleeding and hematoma on ICH were performed in the CEUS imaging.Conclusions A model of dog ICH by puncturing the main branch of MCA under the guidance of ultrasound was established successfully,and it proved to be simple,effective and repeatable.The imaging characteristics of this model are in good accordance with those of ICH in patients.

Objective To explore the value of percutaneous injection of hemostatic agents under the guidance of contrast-enhanced ultrasound(CEUS)for grade Ⅲ-Ⅳ hepatic trauma patients.Methods Eleven patients with severe hepatic trauma were treated using percutaneous focal injection of hemostatic agents.Five of these patients were hepatic injury of grade Ⅲ,and others were grade Ⅳ according to AAST.Results Out of all patients with severe hepatic trauma,9 patients were cured by once percutaneous injection of hemostatic agents under the guidance of CEUS,and 1 patient was cured by twice injection,and 1 patient was switched to surgery because of complicated pancreatic injury and the increase of free intraperitoneal fluid.Conclusions CEUS can display the site and severity of liver injury.Combining with interventional technology,injection of hemostatic agents under the guidance of CEUS can save life and avoid to resect organ,and it can win time for treating other compound injury.

Objective To investigate the effects of ketamine on neuronal nitric oxide synthase (nNOS) activity and carboxy-terminal PDZ ligand of nNOS (CAPON) expression in the prefrontal lobe of mentally depressed rats.Methods Adult male Sprague-Dawley rats,aged 2.5-3.0 months,weighing 210-260 g,were used in the study.Menial depression was induced by exposing the rats to chronic unpredictable mild stress.Twenty-four animals in which mental depression was successfully induced were randomly divided into 2 groups (n =12 each):mental depression group (group D) and ketamine group (group K).Another 12 rats were chosen and served as control group (group C).Group K received intraperitoneal ketamine 10 mg/kg once a day for 7 consecutive days,while groups C and D received intraperitoneal normal saline 10 ml/kg instead of ketamine.Sucrose preference test and open field test were performed before administration and at 1 day after the end of administration.The total distance,number of rearing and sucrose preference percentage (SPP) were recorded.The rats were sacrificed 1 day after the last test for determination of the expression of nNOS and CAPON protein (using immuno-histochemistry)and mRNA (by RT-PCR) in the prefrontal lobe.Results Compared with group C,the total distance was shortened,the number of rearing and SPP were significantly decreased,the expression of nNOS protein and mRNA was up-regulated and the expression of CAPON protein and mRNA was down-regulated in groups D and K (P ＜ 0.05).Compared with group D,the total distance was prolonged,the number of rearing and SPP were significantly increased,the expression of nNOS and mRNA was down-regulated and the expression of CAPON protein and mRNA was up-regulated in group K (P ＜ 0.05).Conclusion Ketamine can improve the depressive state through promoting the expression of CAPON and inhibiting nNOS activity in the prefrontal lobe of mentally depressed rats.

Objective To evaluate percutaneous injection of hemostatic agents under the guidance of contrast-enhanced sonography(CEUS) in controlling hemorrhage from severe splenic trauma. Methods Eight patients with splenic traumas of grade Ⅲ, Ⅳ were consecutively enrolled in this study. Percutaneous injection of hemocoagulase atrox and α-cyanoacrylate was performed by CEUS-guidance in all patients. Ultrasound examination was performed at 1,3,7 and 14 days after focal injection. Vital signs and hemoglobin (Hb) level were recorded. Results After the injection,immediate CEUS demonstrated that active bleeding from the injury sites disappeared. From 30 minutes after the injection arterial blood pressure began to ascend ( P <0. 05), and heart rate decreased to the normal level after the treatment ( P <0.05). Hb decreased at first and then gradually increased to the normal level. Conclusions Pereutaneous injection of hemoeoagulase atrox and α-cyanoacrylate under the guidance of CEUS can effectively control bleeding from a severe splenic trauma. CEUS can be helpful to the diagnosis of the suspected splenic trauma and to ensure hemostatic materials to be injected exactly into injury sites.

Objective To determine whether hemostatic agents directly injected into injury sites under the guidance of contrast-enhanced ultrasound(CEUS)can effectively control hemorrhage from hepatic or splenic trauma. Methods Healthy adult dogs were impacted by a impactor to create hepatic or splenic trauma. Among 32 dogs,28 had hepatic or splenic injury of grade Ⅲ～Ⅳ according to Injury Scale of the American Association for the Surgery of Trauma(AAST),which were divided into two groups,the treatment group and the control. In the treatment group,hemocoagulase and α-cyanoacrylate were injected respectively into the injury site and transected micro-vessel tinder the guidance of CEUS,while in the control group,normal saline was injected. Results All animals of the two groups survived after the injection. CEUS demonstrated that active hemorrhage disappeared in treatment group but still existed in the control group.In the treatment group,laparotomy showed that hepatic or splenic injury had been covered and adhered with clot and glue membrane of hemostatic agents and free intraperitoneal blood volume was significantly less than that in the control group(P=0.000),while in the control group injury bleeding did not stop after injection. Conclusions Hemostatic agents injected under the guidance of CEUS can effectively control hemorrhage from hepatic or splenic trauma of grade Ⅲ～Ⅳ. This therapy was simple,convenient and effective. It may be performed immediately after hepatic or splenic injury was diagnosed.

Objective To investigate the correlation between acquired drug resistance-related genes and mobile genetic elements from pandrug-resistant Acinetobacter baumannii. Methods Fifty-three horizontal transfer drug resistance-related genes ( β-lactamases,aminoglycoside and quinolones resistance related) and 12 mobile genetic elements (including zygosity plasmid,transposon,insertion sequence and integron) were detected by polymerase chain reaction (PCR) in 20 clinical isolates of pandrug-resistant Acinetobacter baumannii.Index cluster analysis was performed to explore the correlation.Results In 20 strains of pandrug-resistant Acinetobacter baumannii,there were 3 types of β-lactamases related genes (TEM-1,ADC-30,OXA-23 ),4 types of aminoglycoside modifying enzyme genes [ aac (3)-Ⅰ,aac(6′)-Ⅰ b,ant( 3″)-Ⅰ and aph( 3′)-Ⅰ ],and 5 kinds of mobile genetic elements ( int Ⅰ 1,tnpU,tnp513,IS26 and ISAba1 ). Index cluster analysis showed high correlations between resistance genes [TEM-1,ADC-30,aac( 6′)-Ⅰ b,ant( 3″)-Ⅰ,abeB,qacE Δ1] and mobile genetic elements ( int Ⅰ 1,tnpU,tnp513,IS26,ISAba1 ).Conclusion Clinical isolated pandrug-resistant Acinetobacter baumannii carries several acquired drug resistance-related genes and mobile genetic elements,and there may be a close association between them.