Objective:To analyze the therapeutic efficacy and adverse reaction induced by Jin Long Capsule (JLC) combined with TEC regimen (docetaxel+epirubicin+cyclophosphamide) in neoadjuvant chemotherapy of breast cancer. Methods:A total of 64 patients who had stagesⅡtoⅢbreast cancer were divided into two groups randomly:JLC combined with neoadjuvant chemotherapy group (JLC group, n=32) and conventional neoadjuvant chemotherapy group (control group, n=32). The chemotherapy cycle was 21 d equal-ly. Evaluations of therapeutic effects were made after three cycles of neoadjuvant chemotherapy and consequent operation. Results:The effective powers (complete response+partial response) of the JLC group and the control group were 84.38% (27/32 cases) and 56.25%(18/32 cases), respectively. The difference was statistically significant (P<0.05). The main adverse effects were gradesⅡtoⅢgastrointestinal tract indisposition and myelosuppression. WBC decrease and incidence rate of nausea and vomiting were obviously low-er in the JLC group than in the control group (P<0.05). The life quality of patients in the JLC group was greatly improved than that in the control group (P<0.05). Conclusion:The application of JLC combined with neoadjuvant chemotherapy can improve therapeutic ef-ficacy and reduce the poisonous side effects of chemotherapy, thereby improving the life quality of patients.

Objective To investigate the value of neutrophil-to-lymphocyte ratio in evaluation of prognosis in patients with early cervical cancer before radical resection. Methods A restropective study was performed in 76 patients who underwent radical resection for early cervical cancer in our hospital between 2007 and 2009. All patients were diagnosed by pathology. All patients did not accept neoadjuvant therapy , the median value of neutrophit-to-lymphocyte ratio (NLR) was 1.94 (0.73-9.31 in range). Based on this value of 1.94 as threshold, all patients were divided into 2 groups: a low NLR(≤1.94, n=38) group and a high NLR ( >1.94, n=38) group. Univariate and multivariate analyses were performed to assess the effectiveness of preoperative NLR to the prognosis in patients who underwent radical hysterectomy combined with pelvic lymph node dissection. Results The preoperative NLR was different significantly in the depth of stromal infiltration, lymphatic metastas, FIGO stage and pathological type between the low NLR group and the high NLR group. The high NLR group, lymphatic metastas, postoperative radiotherapy and FIGO stageⅡ were all risk factors for prognosis and disease-free survival in univariate analysis.Multivariate analysis revealed that NLR, lymphatic metastas and FIGO stageⅡwere independent risk factors for disease-free survival. FIGO stageⅡand lymphatic metastasis were independent risk factors for overall survivaI. Conclusion Preoperative NLR was found to correlate to unfavorable histopathologic features of cervical cancer. The preoperative NLR may be used as a useful and easy biomarker for disease-free survival in patients with cervical cancer, but not an independent risk factor for poor prognosis.

OBJECTIVE:To observe clinical efficacy and safety of sitagliptin combined with metformin in the treatment of type 2 diabetes complicating with metabolic syndrome. METHODS:Totally 80 patients with type 2 diabetes complicating with meta-bolic syndrome were divided into the observation group and control group with 40 cases in each group according to simple random sampling method. Both groups were given same diet and exercise plan;control group was additionally given metformin orally,0.5 g each time,tid;observation group was additionally given sitagliptin,100 mg each time,qd,on the basis of control group. Treat-ment course of 2 groups lasted for 12 weeks. The waist circumference(WC),body mass index(BMI),blood glucose,blood lip-id,fasting insulin (FINS) and serum adiponectin were detected in 2 groups,and steady-state model insulin resistance index (HOMA-IR)and whole body insulin sensitivity index(WBISI)were calculated. The occurrence of ADR was observed. RESULTS:Before treatment,there were no statistically significant differences between 2 groups in WC,BMI,systolic blood pressure,diastol-ic blood pressure,triglycerides,cholesterol,high-density lipoprotein cholester,low-density lipoprotein cholesterol,fasting plasma glucose,2 h postprandial blood glucose,FINS,HOMA-IR,WBISI and serum adiponectin(P>0.05). After treatment,the above indexes of 2 groups were obviously improved,and the improvement of observation group was significantly better than that of con-trol group,with statistical significance(P<0.05). 2 cases and 3 cases were withdraw from the study in control group and observa-tion group because of ADR,respectively.There was no statistically significant difference in the incidence of ADR between 2 groups (P>0.05). CONCLUSIONS:Sitagliptin combined with metformin shows significant clinical efficacy in the treatment of type 2 di-abetes complicating with metabolic syndrome. Its mechanism may be related to reducing insulin resistance,enhancing insulin sensi-tivity,decreasing patients’body weight and up-regulating serum adiponectin level.

Objective The aim of this study was to analyze the characteristics of upper gastrointestinal bleeding (UGIB) admitted on Ramadan or no-Ramadan.Methods We analyzed HuiNation patients' admissions of UGIB in Ningxia Medical University General Hospital from 2000 to 2013 (a total of 1192 admissions).Differences in etiological,transfusion undergo early esophagogastroduodenoscopy (EGD) and hospital stays between Hui-Nation patients on Ramadan.Results Ramadan admissions were associated with significantly higher hemorrhage rates than no-Ramadan admissions among Hui-Nation patients.Peptic ulcer (56％),esophageal varices (17％) and gastric erosive (12％) were the main reason of UGIB in Ramadan.Ramadan admissions were associated with significantly blood transfusion,less likely to undergo early EGD,mortality and long length of stay (p ＜ 0.05).Conclusions Ramadan admission of UGIH was higher than no-Ramadan.Doctor should pay more attention to this phenomenon.

Objective To analyze the correlation between the resistance of Acinetobacter baumannii and the utilization of antimicrobial agents in the hospitalized patients of Beijng Chuiyangliu Hospital,and provide the basis for clinical rational use antimicrobial agents.Methods A retrospective analysis was conducted for the drug resistance rate and specimen source of the 2 194 strains of Acinetobacter baumannii from 2010 to 2014 in the hospital and DDDs/DUI of antimicrobial agents was analyzed by Pearson correlation.Results The resistance rate of Acinetobacter baumannii was positively correlated with the DDDs and DUI of imipenem/cilastatin(r=0.991,0.994,all P<0.01), and was positively correlated with the DDDs of cefepime(r=0.934,P=0.020).The resistance rate of Acinetobacter baumannii to amikacin was positively correlated with the DDDs of etimicin(r=0.931,P=0.022).The resistance rate of Acinetobacter baumannii was negatively correlated with the DUI of levofloxacin(r =-0.986,P =0.002). Conclusion The resistance rate of Acinetobacter baumannii was high and there was correlation between the drug resistance and the utilization of some antimicrobial agents.

OBJECTIVETo study the absorption and transformation of N, P, K and plant growth as well as the accumulation of active ingredients in Angelica dahurica var. formosana from Sichuan province and provide basis for rational fertilization.

METHODSamples were collected in different growth phrases, and correlative morphological indexes, the contents and accumulations of N, P, K and active ingredients were determined.

RESULTThe vegetative growth period of A. dahurica var. formosana sowed in autumn could be preliminarily divided into three phases: seedling period, aerial-part peak growth period and root peak growth period. With the development, the plant height and aerial part dry weight increased at the earlier stage, and then decreased. But the root length, root diameter, and root dry weight increased. The absorptive capacity of N, P and K varied among different developing stages. In general, the absorptive capacity of N and K was the higher than that of P. The order of total nutrition accumulation was N > P > K, the accumulation of N, P and K in aerial part decreased gradually during the growth period, while the accumulation of N, P and K in root increased gradually. The concentration of imperatorin and isoimperatorin showed decreasing-increasing-decreasing-increasing trend, while the accumulation of them increased gradually. And the correlation analysis results showed that the accumulation of P and K in aerial part had positive correlation with the concentration of imperatorin in root, the accumulation of N, P and K in root had positive correlation with the concentration of isoimperatorin in root.

CONCLUSIONFrom late April, A. dahurica var. formosana from Sichuan province entered root peak growth period and the accumulation of N, P, K, imperatorin and isoimperatorin in root increased rapidly. So the balanced application of fertilizer should be considered.

Angelica ; chemistry ; growth & development ; metabolism ; China ; Fertilizers ; analysis ; Nitrogen ; analysis ; metabolism ; Phosphorus ; analysis ; metabolism ; Potassium ; analysis ; metabolism

A truncated mutant of the Open Reading Frame 2 (ORF2, aa384-606) was amplified from cDNA of genotype IV hepatitis E virus (HEV) by polymerase chain reaction (PCR), subcloned to expression plasmid pTO-T7, and expressed in Escherichia coli. SDS-PAGE and Western blotting were used to detect and identify the recombinant protein, namely rP24. After washing of inclusion bodies, dissolving in denaturing agents, refoldeding by dialysis, ion exchange chromatography and gel chromatography, dynamic light scatter was used to study the hydrated radius of rP24. Western blotting was applied to detect the immunoreactivity of rP24, and mouse immunity test and indirect enzyme linked immunosorbent assay (ELISA) were applied to evaluate the immunogenicity and the detection rate of HEV positive and negative serum. SDS-PAGE and Western blotting show that rP24 was highly expressed in the form of inclusion bodies after induction, and had strong immunoreactivity to monoclonal antibody (McAb) 15B2. After a multi-step purification of rP24, Western blotting indicated that the purified rP24 also had strong immunoreactivity to neutralizing McAb 8C11 and HEV positive serum, suggesting that rP24 simulated the nature structure of HEV capsid protein. Dynamic light scatter demonstrated that the average hydration radius of purified rP24 was 7.48 nm. The mouse immunity test showed that the purified rP24 also had good immunogenicity, and the period of serum antibodies converted from negative to positive was very short, but the antibodies maintained more than 20 weeks. Indirect ELISA tests showed that the detection rate of was the same as anti-HEV-IgG diagnostic kit (Wan Tai corporation). Taken together, the rP24 simulated the neutralizing epitopes of natural HEV, and had strong immunoreactivity and immunogenicity. It provided a basis for the further investigation of the difference of infection mechanism between genotype I and genotype IV HEV.
Animals ; Antibodies, Monoclonal ; Antibodies, Neutralizing ; Blotting, Western ; Capsid Proteins ; biosynthesis ; Electrophoresis, Polyacrylamide Gel ; Enzyme-Linked Immunosorbent Assay ; Epitopes ; Genotype ; Hepatitis E virus ; Mice ; Mutant Proteins ; biosynthesis ; Open Reading Frames ; Recombinant Proteins ; biosynthesis

Inquiry is the main method of history taking. The training should not be limited to the medical inpatients inquiry. Different training scenes should be taken. The outpatient history inquiry needs a similar clinic room and set time limit, and focuses on key point history inquiry as well as document writing. Some principles in emergency inquiry are introduced, such as SAMPLE principle. The key points of inquiry of different patients including elderly patients, child patients, traumatic patients and drug addiction patients are also introduced. Through the combination of theory and practice mode, the group discussion and role-play, different scenes design and standardized patients application, reasonable design of teaching hours and content distribution, as well as feedback in time, optimal teaching effect can be finally achieved.

BACKGROUND:Type 1 diabetes mel itus is an autoimmune disease, which is characterized as the selective destruction of pancreatic beta cel s in the body, resulting in the lack of insulin secretion. Umbilical cord blood stem cel s have the potential to differentiate into islet cel s in vitro and in vivo, which play a certain hypoglycemic effect. OBJECTIVE:To explore the effects of umbilical cord blood stem cel s on blood glucose levels and PDX-1 and MafA levels in the pancreatic tissue of type 1 diabetic rats. METHODS:Thirty Sprague-Dawley rats were randomly divided into three groups, with 10 rats in each group. In treatment and model groups, type 1 diabetes mel itus modes were established. After modeling, the treatment group was given a single tail vein injection of umbilical cord blood stem cel s;the normal control group was given the same volume of normal saline;the model group was given the same volume of umbilical cord blood stem cel buffer solution. Oral glucose tolerance test was adopted to assess the islet function of rats;hematoxylin-eosin staining was used to observe the pancreatic morphology of rats;western blot and PCR methods were employed to detect expressions of PDX-1 and MafA in pancreatic tissues at protein and mRNA levels. RESULTS AND CONCLUSION:(1) Compared with the normal control group, the levels of blood glucose in the model and treatment groups were significantly higher at 0, 30, 60, 90 minutes (P<0.05). At 120 minutes, the blood glucose level in the model group was significantly higher than that in the normal control group (P<0.05), but there was no difference between the treatment and normal control groups (P>0.05). (2) The number of islets in the model group was decreased, and the boundary was unclear and irregular;in the treatment group, the number of islets was decreased, but the boundary was stil clear. (3) The expressions of PDX-1 and MafA in the treatment group were similar to those in the normal control group (P>0.05), but significantly higher than those in the model group (P<0.05). These findings suggest that the umbilical cord blood stem cel transplantation can significantly reduce the blood glucose levels in type 1 diabetic rats, improve the function of islet and morphology of pancreas, and up-reuglate the expressions of PDX-1 and MafA.

BACKGROUND:Thrombospondin-1 is an important endogenous activator of transforming growth factor beta 1 in this experimental inflammatory kidney disease model. Transforming growth factor beta 1 is considered the major cytokine that causes tissue fibrosis in many different inflammatory disease processes, in particular in renal disease.
OBJECTIVE:To investigate the expression of thrombospondin-1 on renal fibrosis in rats.
METHODS:Healthy male Sprague-Dawley rats were randomly divided into sham surgery group and model group. In themodel group, right ureters of rats were ligated to construct models of renal fibrosis. 3 weeks after surgery, blood and urine were obtained weekly. Enzyme linked immunosorbent assay and Bradford method were used to detect the contents of serum creatinine,blood urea nitrogen and urinary protein. After rats were sacrificed, kidneys were fixed. Western blot assay was utilized to identify the expression of vascular endothelial growth factor, transforming growth factor beta 1 and thrombospondin-1 protein. Hematoxylin-eosin staining was applied to detect the changes in pathological structure of the kidney after surgery.
RESULTS AND CONCLUSION:(1) One week after model induction, urinary protein, serum creatinine and urea nitrogen levels were significantly higher in the model group than in the sham surgery group (P< 0.05). Three weeks later, the difference in each index was significant (P< 0.01), which showed that the injury of the kidney was aggravated. (2) Transforming growth factor beta 1 protein and thrombospondin-1 expression was significantly higher in the model group than in the sham surgery group, but vascular endothelial growth factor protein expression was significantly lower in the model group than in the sham surgery group. (3) Hematoxylin-eosin staining results demonstrated that severe pathological changes of renal tissue in rats were detected after ligation of renal tubule. (4) These results confirmed that thrombospondin-1 expression increased in renal tissue, and its expression was strongly associated with vascular endothelial growth factor protein and transforming growth factor beta 1, which may play an important role in the renal fibrosis.