Previous studies have revealed Twist,a basic helix-loop-helix transcription factor,plays an important role in breast cancer metastasis.To clarify the molecular mechanism of its involvement in cancer metastasis,Twist was silenced by RNAi in highly metastatic 4T1 cells.Then microarray chips were used to investigate the gene-expression pattern of the Twist-knockdown 4T1 cells and the normal 4T1 cells.The results indicated that silencing of Twist significantly suppressesed lung metastasis of 4T1 cells in vivo.Direct comparison of gene-expression profiles showed that 167 genes in Twist-knockdown cells differed dramatically in expression levels from those in control cells.Among the 167 genes,26 well-known tumor-associated genes,including 15 up-regulated and 11 down-regulated genes were found.These genes appear to be regulated by Twist during breast tumorigenesis.The findings provide new insights into the mechanism by which Twist is involved in tumorigenesis.

Objective: To evaluate the eruption of mandible third molar in orthodontic patients with non-extraction or extraction of the lower premolars. Methods: We selected 3 group of the orthodontic patients. One group consisted of 23 subjects (12 males, 11 females, average age 13.5 years) with non-extraction. One group consisted of 23 subjects (12 males, 11 females, average age 13 years) with lower first premolar extraction. One group consisted of 21 subjects (11 males, 10 females, average age 14.07 years) with lower second premolar extraction. The panoramic radiography was taken. The lower third molar angulation and eruption space were measured before and after the orthodontic treatment. The comparison of treatment changes in 3 groups were performed by means of a paired-sample t test using SPSS 17.0 software package. Results: The RS, LS, Rratio and Lratio increased significantly after treatment in patients with lower first premolar extraction(P<0.01). The RM3 and LM3 increased(P<0.05) and RS, LS, Rratio and Lratio increased significantly(P<0.01) after treatment in patients with lower second premolar extraction(P<0.05). Conclusion: The mandibular third molars show improvement in eruption space and inclination in the orthodontic patients with lower premolar extraction.

Objective To explore the clinical value of serum procalcitonin(PCT)and C-reactive protein(CRP)combination detec-tion in early diagnosis of liver cirrhosis complicating spontaneous bacterial peritonitis(SBP).Methods The peripheral blood sam-ples were collected from 30 cases of liver cirrhosis complicating SBP,30 cases of simple ascites liver cirrhosis (non-SBP)and 45 healthy subjects as control group.The serum PCT level was detected by the dry immunofluorescence quantitation method and the serum CRP level was detected by the immunoturbidimetry.The sensitivity and specificity of PCT,CRP and PCT combined with CRP in diagnosing liver cirrhosis complicating SBP were compared and the relationship between PCT levels and prognosis was ana-lyzed.Results Compare with the healthy control group and the non-SBP group,the serum PCT and CRP levels in the SBP group were markedly increased(P <0.05).The sensitivity of PCT,CRP and PCT combined with CRP in diagnosing liver cirrhosis compli-cating SBP was 93.3%,90.0% and 96.6% respectively,and the specificity was 90.0%,75.0% and 95.0% respectively.Conclusion The combination detection of serum PCT and CRP can increase the sensitivity and specificity of the diagnosis and has more clini-cal value in early diagnosing liver cirrhosis complicating SBP.

Objective To investigate the influence of left ventricular-arterial coupling(VAC) on clinical prognosis of elderly patients with septic shock.Methods A total of 56 elderly septic shoek patients were enrolled in this study,all of whom were admitted to Department of Intensive Care Unit in Zhejiang Hospital from August 2014 to October 2015.The patients were divided into two groups according to the status of left ventricular-arterial coupling when septic shock was diagnosed,which were left ventricular-arterial uncoupling group(UC group) and left ventricular-arterial coupling group(C group).Various parameters were recorded,including blood lactate level,central venous oxygen saturation(ScvO2),serum level of N-terminal pro-brain natriuretic peptide(NT-proBNP) and cardiac troponin Ⅰ (cTN Ⅰ),dose of vasoactive drugs,the total fluid volume and urine volume per hour within 24 hours.The 28-day survival rate was a key index of prognosis.Multivariate logistic regression was taken to analyze risk factors related to death within 28 day.Results Compared with C group,UC group had lower values of left ventricular ejection fraction[(42.43 ±4.76)％ vs (53.17±3.01)％;P＜0.01] and cardiac index[(2.36±0.68) L· min-1 · m 2vs (2.93±0.45)L · min-1 · m-2;P ＜0.01].Yet serum levels of NT-proBNP[lg NT-proBNP 3.93 ±0.53 vs 3.40 ±0.63;P =0.004] and cTN Ⅰ [lg cTN Ⅰ-0.16 ± 0.68 vs-1.03 ± 0.69;P ＜ 0.001] in UC group were higher than those in C group.Moreover,the total fluid volume within 24 hours [(3 806.3 ± 831.4) ml vs (3 142.0±770.0) ml;P =0.016],blood lactate level[(5.61 ±2.68) mmol/L vs (3.93 ± 1.59)mmol/L;P =0.043] and dose of norepinephrine[(0.630 ±0.300) μg · kg-1 · min-1 vs (0.292 ±0.234)μg · kg-1 · min-1;P =0.001] in UC group were greater than those in C group,while ScvO2 [(60.75 ±2.91)％ vs (64.42 ±2.19)％;P＜0.001] and urine volume per hour[(0.518 ±0.358) ml vs (0.926 ±0.678) ml;P =0.007] were less than those in C group.Compared with C group,UC group had a lower 28-day survival rate [43.2％ (19/44) vs 9/12;P =0.049].Ea/Ees ratio was negatively correlated with LVEF,ScvO2 (r =-0.686,P ＜ 0.001;r =-0.411,P =0.002),positively correlated with NT-proBNP,cTN Ⅰ (r =0.294,P =0.028;r =0.363,P =0.006),yet no obvious correlation was noticed with blood lactate level (r =0.170,P =0.21).Multiple logistic regression analysis showed that VAC(OR =11.187,95％ CI 2.489-50.285;P =0.002),lactate level (OR =1.727,95 ％ CI 1.164-2.563;P =0.007) and lg cTN Ⅰ (OR =0.247,95 ％ CI 0.079-0.779;P =0.017) were independent risk factors affecting 28-day mortality.Conclutions In elderly patients with septic shock,left ventricular-arterial uncoupling indicates a lower 28-day survival rate,worse cardiac function and tissue perfusion.Ea/Ees ratio might sever as a predictive indicator of 28-day mortality.

0.05).Conclusions Fluid therapy guided by functional hemodynamic index SVV in elderly patients with severe sepsis under MV is safe and more effective than that guided by CVP.SVV is valuable in prodicting the response to fluid treatment in elderly patients with severe sepsis.

Objective To investigate the effects of sevoflurane pretreatment on renal ischemia-reperfusion (I/R)-induced apoptosis in kidney in rats. Methods Thirty pathogen-free male SD rats weighing 220-260 g were randomized into 3 groups (n=10 each):group control (group C);group I/R and group sevoflurane(group S). Renal I/R was induced by clamping the left renal pedicle for 45 min in I/R and S groups. In group S inhalation of 2.2% sevoflurane in O2 was started at 30 min before operation and maintained throughout the experiment.Venous blood samples were taken at 3 h of reperfusion for determination of serum BUN and Cr concentrations. The animals were then sacrificed and the left kidneys were removed for microscopic examination, detection of apoptosis(by TUNEL)and determination of heme oxygenase-1(HO-1) mRNA and protein expression (by RT-PCR and Western blot).Results Renal I/R significantly increased serum BUN and Cr concentrations, apoptotic index(percentage of apoptotic cells) and the severity of necrosis of renal proximal convoluted tubules (0=normal,4=necrosis of whole segment of proximal convoluted tubules).Sevoflurane inhalation attenuated the I/R-induced changes mentioned above.HO-1 mRNA and protein expression was up-regulated by I/R and HO-1 mRNA expression was further up-regulated by sevoflurane inhalation.Conclusion Sevoflurane pretreatment can protect kidney against I/R injury by attenuating cell apoptosis.Up-regulation of HO-1 mRNA expression may be involved in the mechanism.

Objective To explore the significance of the plasma procalcitonin (PCT) level for directing antibiotic therapy in elderly patients with ventilator-associated pneumonia (VAP).Methods The 50 elderly patients with VAP were randomly separated into the regular therapy group and the PCT-directed therapy group. The regular therapy group was given regular antibiotic therapy, while the antibiotic therapy was decided according to the plasma level of PCT in the PCT-directed therapy group. The used time and utilization rate of antibiotics, as well as inflammatory indicators including white blood cells, neutrophils, C-reactive protein (CRP) and clinical pulmonary infection score (CPIS) were compared between the two groups. Results After treatment, there were no significant differences in white blood cells, neutrophils and CRP between the PCT-directed therapy group and regular therapy group [(8.9 ± 3.5 ) × 109/L vs. (9.4 ± 3.7) × 109/L, 0.62 ± 0.04 vs.0.60±0.04, (18.7±8.5) mg/Lvs. (21.6±6.0) mg/L, t=0.47, 1.84 and 1.37, allP＞0.05],but the CPIS was markedly lower in PCT-directed therapy group than in regular therapy group [(4.0± 1.4) scores vs. (4.7± 1.0) scores, t= 2. 18, P＜0.05]. The neutrophils, CRP and CPIS were significantly lower after treatment than before in the both groups. The concentration of PCT was decreased after treatment than before [(0.5 ± 0.9) mg/L vs. (1.7 ± 0.7) mg/L]. Meanwhile, the time using antibiotics was longer in regular treatment group than in PCT-directed therapy group [(8.72±1.32) d vs. (5.17±0.72) d, t=11.96, P＜0.01], the utilization rate of antibiotics was higher (95.2 % vs. 55.2 %, χ2 = 12.41, P＜0.01) in regular treatment group. Conclusions Using PCT levels for directing treatment in elderly patients with VAP can achieve better curative effect and reduce the use of antibiotics.

Objective To evaluate the predictive value of brain natriuretic peptide (BNP) on mortality in elderly patient with severe sepsis or septic shock. Method Eighty-three elderly patients meeting with criteria of severe sepsis or septic shock by the American College of Chest Physicians and the Society of Critical Care Medicine (ACCP/SCCM) in 2001, admitted in Intensive Care Unit (ICU) of Zhejiang Hospital during May 2004 to June 2007, were enrolled, and patients with chronic renal failure were excluded. The patients were divided into survivor and non - survivor group according to whether they survived within 28 days staying in ICU, the difference of plasma BNP level,serum C-creative protein (CRP) concentration, APACHE II and SOFA scores on admission day and BNP level on the third day between the two groups were compared; thereafter, the relationship between muhiple variables including age, admission day, BNP, CRP, APACHE 11 and SOFA scores, the 3rd day BNP level and 28-day mortality were analyzed by Logistic regression, and meanwhile the independent predictors for ICU moaality among which were determined. Results BNP levels on both admission day and the 3rd day were significantly higher in nomurvivor group than those in survivor group[ ( 1056.38±676.34) pg/ml vs. (611.59±610.02) pg/ml,p =0.002 and (1448.48+891.11) pg/ml vs. (522.41±575.20) pg/ml, P<0.001, respectively]. By Logistic regression analysis, BNP level on the 3rd day and SOFA score on admission day were independent predictors of ICU mortality, The receiver operating characteristic (ROC) curves indicated that values of areas under the curve of the admission day and the 3rd day BNP levels for 28-days mortality were 0.735 (95% CI,0. 621～0. 848, P <0.001) andO.836 (95% CI, 0.746～0,926,P<0.001), respectively. Conclusions Plasma BNP inereaseds in majority of eldedy patients with severe sepsis or septic shock, which may serve as irdex for prognosis in elderly severe septic paients.

Objective To evaluate the curative effect of stretching therapy combined with oral administration of Chinese herbal medicine Tongjing Powder in treating dysmenorrhea patients with Qi stagnation and blood stasis. Methods Sixty dysmenorrhea patients were randomly divided into two groups, 30 cases in each group. Treatment group was given oral use of Tongjing Powder (mainly composed of Radix Angelicae Sinensis, Rhizoma Chuanxiong, Radix Paeoniae Alba, Rhizoma Cyperi, Aspongopus, Radix Salviae Miltiorrhizae, Pollen Typhae, Faeces Trogopterori, Rhizoma Curcumae, and Semen Persicae) combined with stretching therapy. The control group was given oral use of Tongjing Powder alone. Each group was treated for 3 menstrual cycles. Visual Analogue Scale (VAS) scores of dysmenorhea were observed during the treatment and 3-month follow-up after treatment. Before and after treatment, pulse index (PI), resistance index (RI), the ratio of systolic peak value to the diastolic peak value (A/B) of uterine artery blood flow in the two groups were detected. And the clinical efficacy of the two groups was evaluated after treatment. Results (1) The VAS scores of the two groups after treatment and at the end of the third menstrual cycle after treatment were significantly lower than those before treatment(P<0.05), and the decrease in the treatment group was superior to that in the control group(P < 0.05).(2) After treatment for 3 menstrual cycles, the total effective rate was 96.7％ in the treatment group, which was higher than that in the control group(76.7％). And the difference was statistically significant(P < 0.05). (3) The color Doppler energy (CDE) imaging results showed that PI, RI, A/B of uterine artery blood flow in the two groups were decreased after treatment (P < 0.05 compared with those before treatment) , but the differences between the two groups were insignificantly(P > 0.05). Conclusion Stretching therapy combined with oral administration of Chinese herbal medicine Tongjing Powder exerts certain short-term and long-term effect in treating dysmenorrhea patients with Qi stagnation and blood stasis, with good safety and feasibility.

A plan of constructing a platform of excavating and protecting characteristic technology of diagnosis and treatment in research-based hospital of TCM was put forward by Shuguang Hospital Affiliated with Shanghai University of Traditional Chinese Medicine and Research Institution of Characteristic Technology of Diagnosis and Treatment Affiliated with Shanghai Academy of Traditional Chinese Medicine. The platform has begun to take shape on the basis of previous theoretical thought and preliminary practice. It has its own management system and working standards and contents with a clear and definite developing direction. Its working contents include excavating and protecting clinical experience of famous and aged practitioner of Chinese medicine, folk proved recipe and technology of diagnosis and treatment of TCM, intangible cultural heritage of TCM. Some problems appeared during the work, such as the evaluation criterion of the folk proved recipe and technology of diagnosis and treatment, the management of clinical proving projects, the issue of intellectual property protection and so on, which must be further solved.