Objective To investigate the expression of Toll-like receptor 4 (TLR4) and myeloid derived suppressor cells(MDSC) in bone marrow cells in children with acute myeloid leukemia (AML),and to detect its relationship with the clinical features,the effect of chemotherapy and prognosis.Methods Twenty-nine cases of children with AML were collected from June 2013 to March 2014 in People's Hospital of Wuhan University,in which 11 cases of low-risk group,10 cases of middle-risk group,8 cases of high-risk group;and 17 cases of non blood disease was as the control group.The expressions of TLR4 and MDSC were detected by using reverse transcription-polymerase chain reaction (RT-PCR),Western blot methods,immunohistochemical staining,and flow cytometry,respectively,in the bone marrow cells of 29 children with AML.Results The mRNA and protein expression of TLR4 in the initial treatment group was higher than those in the complete remission group(t =3.092,3.393,all P ＜ 0.05).The mRNA and protein expression of TLR4 in the relapse group was higher than those in the complete remission group(t =4.013,4.279,all P ＜ 0.05).The positive expression rates of MDSC in the above 3 groups were (29.77 ± 1.39) ％,(5.19 ± 0.65) ％,(38.62 ± 3.54) ％,respectively,compared with the control group [(1.32 ± 0.27) ％] and there was significant difference(all P ＜0.05).The positive expression rates of TLR4 and MDSC in the initial treatment group,relapse group and complete remission group were significantly higher than those in the control group,with significant differences (initial treatment group TLR4:t =3.559,P ＜ 0.05;MDSC:t =3.727,P ＜ 0.05;relapse group TLR4:t =4.043,P ＜ 0.05;MDSC:t =4.125,P ＜ 0.05;complete remission group TLR4:t =2.798,P ＜ 0.05;MDSC:t =3.469,P ＜ 0.05).Pearson rank correlation analysis showed that there was a positive correlation between the expression of TLR4 and MDSC (r =0.673,P ＜0.01).Conclusions The expressions of both TLR4 and MDSC play an important role in onset,progression,curative effect and prognosis in children with AML,and the two may play an importment role in synergistic effect.

ObjectiveTo discuss the value of interrupted circular suture in hemostasis of placenta previa during cesarean section. Methods We summarized 54 caesarean section patients with placenta previa. Results The hemostasis was succeeded in all of the 9 patients and uterus was retained without postpartum complications. The duration of operation was obviously shorter than that of hysterectomy( P＜0.05). Bleeding and blood transfusion were less than that of hysterectomy, but without statistical difference (P＞0.05). ConclusionInterrupted circular suture is one of the efficient methods in controlling postpartum bleeding during caesarean section with placenta previa.

Objective To investigate the molecular mechanism underlying lymphocyte functionassociated antigen-1 (LFA-1) / intercellular adhesion molecule-1 (ICAM-1) mediated anti-neoplastic effects of cytokine induced killer (CIK) cells. Methods Lymphocytes isolated from peripheral blood of children leukemia were induced with interferon-gamma (IFN-y), anti-CD3 monoclonal antibody (CD3McAb) and interleukin-2 (IL-2) and co-cultured with dendrite cells (DC) to generate DC-CIK cells. When treated with LFA-1 monoclonal antibody, cytotoxicity of DC-CIK cells against leukemia cell lines was measured by the MTT assay, while RT-PCR and Western blotting were used to determine mRNA and protein expressions of GATA-3 and T-bet in DC-CIK cells, respectively. IL-12, IFN-γ and tumor necrosis factor-α (TNF-α) levels released by DC-CIK cells were quantified by ELISA. Results Induced DC-CIK cells were regular, round and transparent with variable cell volume and cellular aggregation. When treated with mouse anti-human LFA-1 monoclonal antibody, the cytotoxicity decreased mostly towards B95 cells under administration of 20 μg/ml LFA-1 monoclonal antibody in comparison with the control group(t =10.138, P ＜0.05). It led to a highest elevation of GATA-3 mRNA and protein levels (t =16.386, P ＜ 0.05; t =22.652, P ＜ 0.05) and a most decrease of T-bet mRNA and protein levels (t =17.728, P ＜0.05; t =17.452, P ＜0.05) under 20 μg/ml LFA-1 monoclonal antibody in B95 cells group in comparison with the control group. The expression levels of IL-12,IFN-γ, and TNF-o in supernatant were the lowest under 20 μg/ml LFA-1 monoclonal antibody in B95 cells group in comparison with the control group (t =21.621, P ＜0.05; t =13.739, P ＜0.05; t =15.278, P ＜0.05).Conclusion GATA-3 and T-bet were implicated in the LFA-1/ICAM-1 mediated anti-neoplastic effects of DC-CIK cells via activation of the Th1 pathway, with high secretion of Th1 cytokines, such as IL-12, IFN-γ and TNF-α.

Objective To explore the feasibility and advantages of transvaginal myomectomy(TVM).Methods A total of 65 patients with uterine myoma were treated with TVM from August 2002 to August 2004.The myomectomy was performed through a vaginal incision,which was transversely made through anterior or posterior fornix of the vagina.The uterus was exposed outside the incision with a pulling suture.The muscular layer covering the myoma was incised and the myoma was removed.Then the incisions of the uterus and vagina were closed respectively by using absorbable sutures.Results The TVM was successfully completed in all the 65 patients.The surgical time was 25~140 min(mean,56 ?19 min),the postoperative bleeding amount was 60~650 ml(mean,170?45 ml),and the length of hospital stay after operation,2~5 d.A follow-up was carried out for 2~12 months(mean,3.6?2 months) in 58 patients.The flow of menstrual cycle recovered to normal levels in 40 patients and was less than normal levels in 2 patients.Pressure symptoms of adjacent organs disappeared,and no residual tumors were detected on B-ultrasonography.Conclusions Transvaginal myomectomy is a safe and reliable procedure with little invasion and quick recovery.

Objective To investigate the correlation between Framingham stroke risk profile(FSRP) and vascular cognitive impairment in stroke-free patients with cerebrovascular risk factors.Methods One hundred and eighty-four stroke-free subjects,selected from Zhejiang hospital,were divided into low risk group (56 subjects),moderate risk group (70 subjects) and high risk group (58 subjects) according to their FSRP score,and their cognitive function including memory ability,attention,executive function and language ability were assessed by Montreal cognitive assessment (MoCA),auditory verbal learning test (AVLT),digit symbol test,trail making test(TMT),digit span and verbal fluency test.Results The total MoCA scores which were (7.2±4.6),(13.8±3.9),(29.6± 12.7) respectively,AVLT-delay recall scores which were(8.2± 1.6),(6.7± 1.4),(5.9± 1.5) respectively,and digit symbol test score which were(34.7±9.3),(32.6± 16.4),(29.7± 13.6) respectively in low,intermediate and high risk groups,decreased with the increasing risk of stroke(P＜0.05).The elapsed time in TMT-B which were (115.2 ±36.9) s,(147.6±44.8) s,(173.9±58.5) s respectively in low,intermediate and high risk groups,prolonged with the increasing risk of stroke (P＜0.05).FSRP was associated with cognitive function,but inversely related to MoCA,AVLT-delay recall,digit symbol test,TMT-B and digit span fall back (P＜0.05),but positively related to consuming time in TMT-B (P＜ 0.05).Multivariate regression analysis showed that advanced age,hypertension,diabetes and smoking were the risk factors for vascular cognitive impairment(P＜0.05).Conclusion Advanced age,smoking,hypertension and diabetes are the most important in vascular risk factors for cognitive impairment.Vascular risk factors can damage cognitive function with the increased risk of stroke,among which delayed recall and executive function are the main affected cognitive area.

OBJECTIVE:To provide reference for promoting the further development of pharmaceutical service in chain phar-macies and the regulation of related departments. METHODS:Field investigation and questionnaire survey were used to investigate the basic situation of pharmaceutical care in 5 chain pharmacies in Chengdu city and analyze the results. RESULTS:In terms of core service,it showed that 2 pharmacies had no suspension of pharmacists license and the pharmacist was not on-the-job;there was significant difference in the medication guidance frequency of pharmacists in those pharmacies(P<0.05);more than 50% sur-veyed consumers received medication guidance when buying drugs in pharmacy B,C and E. In terms of perceived service,3 phar-macies existed illegal drug advertising and 3 existed illegal promotion;drug partitions of all pharmacies were good;service archive material showed best in pharmacy C and worst in pharmacy D;in service advisory zone setting,setting of independent advisory zone was worse. In terms of extended service,5 pharmacies had different preferential ways for memberships except for the prefer-ence in membership day;the unbundling service in those pharmacies was worse,and no pharmacies had no less than 10 unbun-dling varieties. CONCLUSIONS:Pharmaceutical service in chain pharmacies in Chengdu city is barely satisfactory. Pharmacy should strengthen the assessment and management of pharmacists and improve pharmaceutical service,and regulatory authorities strengthen the supervision of advertising and promotion of drugs. What’s more,it is suggested to establish cloud supervision plat-form with the internet information technology,carry out remote service and cloud service and strengthen brand marketing service on the internet to improve the pharmaceutical service levels in chain pharmacies.

Objective: To observe the clinical efficacy of acupuncture treatment for migraine. Methods: Forty cases were randomly allocated to a treatment group and a control group, 20 cases in each group. Cases in the treatment group were treated with acupuncture, while cases in the control group were treated with oral Sibelium. After that, the changes of cerebral blood flow were observed before and after treatment. Results: There was significant difference in clinical efficacies between two groups (P<0.05). There were also significant differences in arterial blood flow velocities of before and after treatment. Acupuncture can produce substantial differences (P<0.05) in blood flow velocities of vertebral artery (VA), middle cerebral artery (MCA) and anterior cerebral artery (ACA) during an increased flow rate. It can also produce statistical differences in blood flow velocities of VA during a decreased flow rate (P<0.05). Conclusion: Acupuncture can effectively alleviate the pain of migraine sufferers and exert a two-way regulation on the cerebral blood flow.

Group A β-hemolytic streptococcus (GAS),namely Streptococcus pyogenes,is one of the most im-portant human pathogen.GAS can cause skin and mucous membrane superficial infectious diseases,life -threatening invasive disease,toxin -mediated diseases and immune -related diseases.Antibiotic is an effective mean to control GAS infection.The β-lactam antibiotics remain the first -choice treatment for GAS infection and the macrolides are often recommended as a replacement therapy for β-lactam antibiotics allergic patients or a means to blocking GAS exotoxin product.But with the widespread use of macrolides autibiotics,macrolide -resistant GAS spread in the world. This paper will elaborate the situation of macrolide -resistant clones.

The effects of tetrandrine (Tet) on blood pressure, plasma renin activity (PRA) and the contractility of the papillary mascle and portal vein were studied in rats. After 4 d administration of Tet 30 mg/kg, 2/d, ig, blood pressure was decreased markedly in anesthetized male SD rats, but there were no effects on heart rate and PRA. A single dose of Tet 15 mg/kg iv reduced blood pressure and heart rate significantly, while did not change PRA. This single dose produced similar hypotensive effect in rats with and without pretreatment of Tet 30 mg/kg, 2/d, 4d, indicating the absence of tolerance. Tet inhibited the paced papillary muscle contractility and the spontaneous portal vein contractility, and the EC50 were 5.33?10-6mol/L and 4.25?10-5 mol/L, respectively. So the vascular selectivity of Tet is 0.12.

Objective To investigated the effects of intermittent hypoxia on neuronal apoptosis and autophagy in hippocampus.Methods 30 Wistar rats were randomly divided into normal control group (NC),intermittent normoxia group (IN) and intermittent hypoxia group (IH).The spatial learning and memory function of the rat was assessed using Morris water maze test.The apoptotic cells and the ultrastructure of neurons in the hippocampus tissue were observed by TUNEL and transmission electron microscope,respectively.And the expression of autophagy marker protein LC3 and Beclin-1 were measured by Western blotting.Results The escape latency was significantly longer in IH than in NC and IN group.And the ratio of time spent in the target quadrant was lower in the IH group than in NC and IN group (P＜0.05).The apoptotic rate of rat hippocampal neurons (F =6.01,P=0.037),the amount of double-layer membrane structure-complicating autophagic vacuoles with karyopyknosis,and protein expression level of LC3 and Beclin-1 were significantly higher (all P ＜0.05) in intermittent hypoxia group than in IN and NC group.Conclusions Intermittent hypoxiainduced autophagy and apoptosis in rat hippocampus are significantly increased,which might be one of the possible mechanisms for cognitive dysfunction caused by intermittent hypoxia.