Anesthesia safety plays an important role in the medical safety of the perioperative.At present the medical institutions in many countries apply crew resource management model for training and assessment in anesthesiology,surgery and emergency.It emphasizes the training of nontechnical skills,called crisis resource management(CRM).This article analyzes the causes of human error incidents and preventive measures and introduces CRM principles in medical principles and anesthesia correlation and applications.CRM helps to foresee the crisis of environment and deal with the crisis source to ensure the safety of patients.

【Objective】 To explore a method for the construction of antitumor suicide-gene therapeutic system. 【Methods】 The thymidine kinase gene of herpes simplex virus type 1 (HSV1-tk) was orientationally cloned into the retroviral vector plasmid (pLXSN) by DNA recombinant technique, and then the recombinant plasmid of pLXSN-tk was identified by restriction endonuclease cutting and DNA sequencing. Introduced by PolyFect Transfection reagent, the recombinant plasmid was transfected into the packaging cell line PT67. Screened by G418, a cell line, which could produce virus stably, was obtained. The virus was transfected into human gastric carcinomatous cell strain SGC-7901 and the transfected SGC-7901 was applied to evaluate an anti-tumor effect. 【Results】 The identification with restriction endonuclease cutting and DNA sequencing showed that HSV1-tk was successfully inserted into the recombined plasmid of pLXSN-tk. The stable cloned PT67/tk was obtained by screening with G418 and then its amount was enlarged by culture, the titer of the PT67/tk solution being 4?10~4 cfu/mL. The anti-G418 cloned cell line SGC-7901/tk was got by infecting SGC-7901 with the virus. Anti-tumor experiment showed that GCV had an obvious toxic effect on SGC-7901/tk but had no effect on SGC-7901, indicating recombinant retroviral HSV1-tk expressed HSV1-tk gene which had biological activity. 【Conclusion】 Cloning HSV1-tk into the retroviral vector is effective in obtaining the recombinant retroviral HSV1-tk which can express HSV1-tk gene, and also effective in establishing an antitumor suicide-gene therapeutic system. This research naturally lays a foundation for further studying of Chinese medicines having synergistic anti-tumor action with suicide gene.

Objective To investigate the radiosensitizing effect of 17AAG-cypate micelles on human non-small cell lung cancer A549 cells and its possible mechanism.Methods (1) A single-hit multi-target model formula was used to analyze the radiosensitizing effects of 17AAG-M and 17AAG-cypate-M.(2) The effects of 17AAG-cypate-M on the viability of A549 cells under laser and X-ray irradiation were analyzed by MTT assay.(3) The effect of the drugs on the cell senescence was observed by β-galactosidase staining assay.(4) The effects of different treatment conditions on DNA damage repair were analyzed by γ-H2AX immunofluorescence staining assay.(5) The expression of p-Erk1/2 and p-Akt was measured by Western blot.The paired t test was used for analyzing the differences between groups.Results Compared with the X-ray irradiation group,the X-ray+17AAG-cypate-M group had a lower mean lethal dose and a sensitization enhancement ratio greater than 1,indicating that 17AAG-cypate-M had a radiosensitizing effect.Compared with the 17AAG-M group,the 17AAG-cypate-M group showed significantly lower cell viability (P<0.01),a significantly higher percentage of aging cells (P<0.01),and significantly further delayed DNA damage repair (P<0.01).And the 17AAG-cypate-M group had lower expression of p-Erk1/2 and p-Akt than the 17AAG-M group.Conclusions Compared with 17AAG-M,17AAG-cypate-M has a higher radiosensitizing effect on A549 cells.The mechanism might be inducing the cell senescence,delaying DNA damage repair,and inhibiting the expression of p-Erk1/2 and p-Akt.

Objective To investigate the effect of salinomycin on cancer stem cell formation of prostate cancer cell line DU145 and its possible mechanisms,providing theoretical basis for the clinical application of salino-mycin. Methods (1)DU145 cells were treated with salinomycin. The percentage of ALDH+cells,which was used as the marker of cancer stem cells,was detected by flow cytometry.(2)After treated with salmonin,DU145 cells were subjected to Western-Blot analysis for the expression of mTORsignal pathway-related proteins such as p-70s6k, p-p70s6,p-s6 and so on. 3)DU145 cells were treated with salinomycin combined with mTOR signal pathway inhibi-tor rapamycin,and the ALDH+cancer stem cells were detected using flow cytometer. Results (1)Salmonomycin significantly inhibited ALDH-positive cancer stem cells in DU145cell line(inhibition rate in 77.8%),which was twice as high as that of traditional anticancer drug paclitaxel(which has a inhibition rate of 38.64%). This results suggesting that salinomycin would have the effect of inhibiting cancer stem cells. (2)The expression ofm-TOR p-70s6k,p-p70s6 and p-s6 in mTOR signaling pathway was inhibited by salinomycin in a time-dependent and dose-dependent manner,suggesting that salinomycin would inhibite mTOR signaling pathway.(3)Salinomycin combined with rapamycin can decrease the proportion of ALDH-positive DU145 cancer stem cells(inhibition rate in 77.95%), suggesting that salinomycin may inhibit ALDH-positive DU145 stem cells through the mTOR signaling pathway. Conclusion Salinomycin may play an important role in inhibiting cancer stem cells by inhibiting mTOR pathway signaling.

To study the relationship of oxidative, antioxidative constituents and antioxidases in blood with chronic cholecystitis containing gallstone, levels of lipoperoxides (LPO), nitric oxide (NO), vitamin C(VC), vitamin E (VE) and β-carotene (β-CAR) in plasma as well as level of LPO, activities of superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GSH-Px) in erythrocytes were investigated by spectrophotometric assay in 107 patients with this condition (PCg) and 100 healthy volunteers (HVs). Compared with HVs group, the average value of LPO and NO in plasma and that of LPO in erythrocytes of PCg group were significantly increased (P<0.0001), while that of VC, VE and β-CAR in plasma and the average activities of SOD, CAT and GSH-Px in erythrocytes were significantly decreased (P<0.0001). Linear regression and correlation analysis for 107 preoperative PCg showed that the value of LPO and NO in plasma and that of LPO in erythrocytes of PCg gradually increased (P<0.0001), representing a significant linear positive correlation. The value of VC, VE and β-CAR in plasma and that of SOD, CAT and GSH-Px in erythrocytes of PCg gradually decreased (P<0.0001), representing a significant linear negative correlation. Stepwise regression and correlation analysis for 107 preoperative PCg suggested that the closest correlation was observed between the course of disease and the value of NO and VC in plasma and that of SOD, GSH-Px and LPO in erythrocytes, r=0.7306, F=32.1408, P<0.0001. Compared with the preoperative PCg group, the average value of LPO and NO in plasma and that of LPO in erythrocytes of the postoperative PCg group were significantly decreased (P<0.0001). Furthermore, the average value of VC in plasma and that of SOD, CAT and GSH-Px in erythrocytes of the postoperative PCg group were significantly increased (P<0.0001), whereas no significant difference was found between their average value of VE and β-CAR in plasma. These findings suggested that oxidative stress was an aggravating pathological condition in PCg group. Therefore, we recommend that in treating PCg, antioxidants such as VC, VE, β-CAR should be given in order to alleviate their potential oxidative damages.

The rhizome of Panax japonicus var. major have been used as the natural medicinal agent by Chinese traditional doctors for more than thousand years. Most of the therapeutic effects of P. japonicus var. major had been reported due to the presence of tetracyclic or pentacyclic triterpene saponins. In this study, Illumina pair-end RNA-sequencing and de novo splicing were done in order to understand the pathway of triterpenoid saponins in this species. The valid reads data of 15. 6 Gb were obtained. The 62 240 unigenes were finally obtained by de novo splicing. After annotation, we discovered 19 unigenes involved in ginsenoside backbone biosynthesis. Additionally, 69 unigenes and 18 unigenes were predicted to have potential function of cytochrome P450 and UDP-glycosyltransferase based on the annotation results, which may encode enzymes responsible for ginsenoside backbone modification. This study provides global expressed datas for P. japonicus var. major, which will contribute significantly to further genome-wide research and analysis for this species.
Gene Expression Profiling ; Panax ; genetics ; Saponins ; biosynthesis ; Sequence Analysis, RNA

As propose of organ repair stem cell therapy technology, articular cartilage cannot be repaired by itself has become one of the research hotspots, repair of articular cartilage with mesenchymal stem cells has shown obvious advantages for the treatment. The scholars have made a preliminary study on the role of mesenchymal stem cells from different sources in the repair of knee articular cartilage, and with the combination of transplantation and cartilage tissue engineering, these technologies improved the human cartilage repair effect of bone marrow, adipose, synovium, cord blood derived stem cells, which achieved good clinical curative effect. Due to the different sources, the dominant and recessive factors, each stem cell will have certain advantages and disadvantages. At present, the clinical research is still in the experimental stage, there is no definite conclusion on which kind of stem cell or technology is more suitable for human cartilage repair. This requires the validation of large-scale or combining with new processing technology clinical trials and the long-term clinical effect, it also provides for the basis for further clinical research.

OBJECTIVETo explore the changes of surface antigen and function of rituximab on dendritic cells derived from patients with Primary immune thrombocytopenia (ITP) to further understand the effective mechanism of immunotherapy.

METHODSThe peripheral blood mononuclear cells (PBMCs) were isolated from remission patients with ITP before and after low-dose rituximab infusion, and the PMNCs were stimulated for 5 days by rhGM-CSF and rhlL-4 in 5% CO2 air at 37°C incubator. Then all of DCs were cultured with TNF-α for 48 hours. The morphology of DCs was monitored under inverted microscope daily, and the surface antigens of the DCs were analysed by flow cytometry, meanwhile the levels of IL-12p70 and TGF-β1 in supernatants were detected by ELISA, mix lymphocyte reaction was performed by MTT assay.

RESULTS(1) Rituximab-treated-DCs showed no obvious tree-like protruding compared with untreated-DCs. The former cells were small and most of nucleus were centric. (2) The expressions of HLA-DR, CD80, CD83 and CD86 on rituximab-treated-DCs \[56.37 ± 3.95)%, (36.41 ± 2.82)%, (30.45 ± 4.61)% and (41.98 ± 4.17)%, respectively\] were significantly lower than those untreated-DCs \[(73.71 ± 7.61)%, (55.14 ± 7.30)%, (80.91 ± 7.09)% and (59.03 ± 3.43)%, respectively\](all P < 0.05), the concentration of IL-12p70 was significantly lower, \[(66.87 ± 4.29)% vs (50.17 ± 14.52)%\], while that of TGF-β1 \[(9.70 ± 0.31)%\] higher than the untreated-DCs \[(2.70 ± 0.36)%\] (P < 0.05). (3) The abilities to activate T cells proliferation of rituximab-treated-DCs reduced compared with untreated-DCs.

CONCLUSIONThe surface antigen of ITP-DCs and the concentration of IL-12p70 reduced after the low-dose rituximab infusion. The abilities to activate T cells proliferation reduced while the concentration of TGF-β1 increased. Rituximab may achieve its therapeutic effect on ITP by downregulating the immunoreactivity of DCs.

Antibodies, Monoclonal, Murine-Derived ; administration & dosage ; therapeutic use ; Cell Proliferation ; Cells, Cultured ; Dendritic Cells ; cytology ; metabolism ; secretion ; Female ; Humans ; Interleukin-12 ; metabolism ; Lymphocyte Activation ; Male ; Rituximab ; T-Lymphocytes ; immunology ; Thrombocytopenia ; drug therapy ; immunology ; metabolism ; Transforming Growth Factor beta1 ; metabolism

This study was purposed to investigate the effect of high-dose dexamethasone (DXM) on function and Toll like receptor 9 (TLR-9) expression of plasmacytoid dendritic cells (pDC) in peripheral blood of patients with immune thrombocytopenic purpura (ITP). 15 newly diagnosed patients with ITP received high dose DXM at single daily doses of 40 mg for 4 consecutive days. The peripheral blood plasmacytoid dendritic cells from 13 remission patients and 15 normal controls were separated by immunomagnetic beads and then induced by CpG-OND2216. 24 h later, the levels of IFN-α, IL-6 and TNF-α in the supernatant were detected by enzyme linked immunosorbent assay (ELISA). The expression of TLR9 mRNA of pDC was detected by real-time quantitative PCR. The results indicated that the levels of IFN-α, IL-6 and TNF-α produced by pDC in ITP patients were significantly higher than those in normal controls (P < 0.05). After high dose DXM treatment, the levels of IFN-α, IL-6 and TNF-α decreased without significant difference compared with normal controls (P > 0.05). The expression of TLR9 mRNA in pDC of untreated patients was significantly higher than that in control group (P < 0.05), and significantly reduced after treatment without difference from that in control group (P > 0.05). It is concluded that pDC may play an important role in ITP by their TLR9 and secreted cytokines; dexamethasone may down regulate the expression of TLR9, inhibit pDC function, and thus play a therapeutic role.
Adolescent ; Adult ; Case-Control Studies ; Dendritic Cells ; immunology ; metabolism ; Dexamethasone ; administration & dosage ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Purpura, Thrombocytopenic, Idiopathic ; blood ; drug therapy ; immunology ; RNA, Messenger ; genetics ; Toll-Like Receptor 9 ; genetics ; metabolism ; Young Adult

OBJECTIVETo investigate the proportion of Th17 cells in the peripheral blood of the patients with acute myeloid leukemia (AML) and evaluate the potential association of Th17 cells with AML.

METHODSThe cytokines IL-17 and TGF-β1 in the peripheral blood of AML patients before therapy (group 1), AML patients in complete remission (AML-CR, group 2) and healthy donors (group 3) were measured by enzyme-linked immunosorbent assay (ELISA). The proportion of Th17 cells of each group was evaluated by flow cytometry. The level of IL-17 mRNA of each group was examined by reverse transcription-PCR (RT-PCR).

RESULTSThe percentage of Th17 cells and the level of IL-17, IL-17 mRNA in group 1 \[(10.502 ± 1.071) ng/L, (0.935 ± 0.140)% and 0.262 ± 0.510\] and group 2 \[(11.345 ± 0.987) ng/L, (1.091 ± 0.159)% and 0.307 ± 0.031\] was significantly lower than that in group 3 \[(16.852 ± 1.198) ng/L, (2.586 ± 0.235)% and 0.501 ± 0.060\]. The percentage of Th17 cells and the level of IL-17, IL-17 mRNA in group 1 was lower than that in the group 2. But the level of TGF-β1 in the group 1 (29.963 ± 1.588) ng/L and the group 2 (25.163 ± 1.848) ng/L was significantly higher than that in group 3 (13.366 ± 1.565) ng/L. However, the level of TGF-β1 in the group 3 was higher than that of the group 2.

CONCLUSIONTh17 cells might be negatively correlated with the AML development. The overexpression of TGF-β1 in AML patients might suppress the differentiation of Th17 cells.

Enzyme-Linked Immunosorbent Assay ; Humans ; Interleukin-17 ; Leukemia, Myeloid, Acute ; Prevalence ; Th17 Cells ; Transforming Growth Factor beta1