Angiogenesis plays a very important role in the development and metastasis of breast cancer. Low-dose metronomic chemotherapy based on the traditional chemotherapy drugs has antiangiogenic effect. As far as its mechanism, low toxicity or low incidence of drug resistance is concerned, it is feasible for breast cancer therapy. It displayed the validity and feasibility in the pre-clinical studies and clinical trials, which provided a new treatment strategy for the breast cancer.

Objective To observe the clinical efficacy of acupuncture at the trigger points on the back in treating cardioneurosis. Methods Fifty patients with cardioneurosis were selected to receive syndrome differentiation of traditional Chinese medicine, and then were evaluated for the improvement of symptoms respectively after first acupuncture treatment at the trigger points on the back and after 3~5 acupuncture treatments. Results Of the 50 cardioneurosis patients, 30 showed marked effect, 14 showed effective, 6 failed in the treatment, and the total effective rate was 88.0%. The total effective rate was 96.2%in patients of deficient heart yang, and was 75.0%in those of excessive fire due to yin deficiency, 83.3%in those of qi stagnation due to liver depression, and 83.3%in those of deficient heart yin. The improvement rate of subjective symptoms after 3~5 treatments was significantly different from that after the first treatment (P<0.05). Conclusions Acupuncture at the trigger points on the back is an effective approach in treating cardioneurosis, and it can achieve a marked efficacy with successive 3~5 sessions.

Objective To investigate the effects of prostaglandin E1 (PGE1) on renal cell apoptosis in rats with diabetic nephropathy(DN). Methods Totally 55 male Wistar rats were intraperitoneally injected with streptozotocin (STZ) to develop DN model.46 successfully established DN rat models were randomly divided into 4 groups:PGE1 group received PGE1 intravenously at dose of 10 μg · kg-1 · d-1 for 10 d (n=12),angiotensin converting enzyme inhibitors(ACEI) group given ACEI orally at dose of 10 mg kg-1·d-1 for 8 W(n=12),PGE1+ACEI group given both PGE1 and ACEI (n=11),DN control group(n=11) and normal control group(n=10) given saline only.All rats were killed after 8 weeks and blood samples or kidney tissue were collected.Blood urea nitrogen (BUN),serum creatine(Scr),albuminuria of 24 h were detected.Renal pathological morphology and apoptosis of renal cells were observed by HE staining and terminal deoxynucleotidyl transferase-mediated dUTP nick-end-labeling (TUNEL) test. Results At 8 week after treatment,the 24-hour urinary albumin levels were decreased significantly in the following order:DN control group＞ PGE1 group ＞ ACEI group ＞PGE1+ ACEI group＞ control group[(374.6±54.1)μg,(570.0±72.5)μg,(253.1±28.9)μg vs.(1123.4±106.2)μg,P＜0.01 or P＜0.05].BUN[(9.3±2.6)mmol/L,(11.0±3.5)mmol/L,(8.4±2.2)mmol/Lvs.(15.1±4.0)mmol/L]and Scr [(74.5±19.2) umol/L,(83.5± 15.8)μmol/L,(64.6±17.3) μmol/L vs.(117.7±33.0)μmol/L]levels after treatment were also reduced in PGE1,ACEI and PGE1 + ACEI groups as compared with DN control group (P＜0.01or P＜ 0.05). Pathological manifestations of all treatment groups showed better results than DN group,and PGE1 + ACEI group was the best.There was no obvious apoptosis in glomerular area with on significant differences between groups.While apoptosis of renal tubules was observed in DN rats. Conclusions Renal tubule but not glomerular cell apoptosis may play some role in Prostaglandin E1 reduciug albuminuria.

AIM: To explore the influence of CD47 molecules on the maturation and function of cultured dendritic cells (DCs). METHODS: Monocyte cell-derived DCs were propagated in granulocyte-macrophage colony-stimulating factor (GM-CSF) and lipopolysaccharide (LPS) plus interleukin (IL)-4, in the presence or absence of anti CD47 monoclonal antibodies (anti-CD47 mAbs). Flow cytometry was used to detect the cell surface phenotype. The concentration of IL-12P70 in supernatant was measured by ELISA technique. The antigen-presenting functions of DCs were determined in one-way mixed leukocyte reaction by Brdu-ELISA. Electrophoretic mobility shift assays (EMSA) was used to examine NF-?B activity. RESULTS: The anti-CD47 mAbs markedly suppressed the expression of CD80,CD86,CD83,CD1a,HLA-DR on the surface of DCs (P

AIM: To investigate the effects of transforming growth factor ?1 (TGF-?1) on murine-derived dendritic cells (DC). METHODS: Murine bone marrow cells were cultured with GM-CSF and TGF-?1 to develop TGF ?-DC. Then they were stimulated by lipopolysaccharide (LPS). Their phenotypes were assessed by flow cytometry (FCM). The allogeneic stimulating capacity of DC was measured by mixed lymphocyte reaction (MLR) using BrdU ELISA method. IL-12 p70 protein was detected by ELISA and the expressions of Toll like receptor 4 (TLR4) on DCs were measured by semi-quantitative RT-PCR and FCM. RESULTS: Compared to immature DC (imDC) cultured with GM-CSF alone, the expressions of CD_80, CD_86, I-A~b and CD_40 in TGF ?-DC were lower. The TGF ?-DC was resistant to maturation by LPS. Maturation resistance was evident from a failure to up-regulate CMs, to stimulate larger T cell proliferation and to increase secretion of IL-12 p70. Down-regulation of TLR4 expression on TGF ?-DC was also found. CONCLUSION: TGF-?1 inhibits the expression of co-stimulatory molecules on DC. It is resistant to maturation stimulus (LPS) and might be linked with TLR4 down-regulation.

By analyzing data from a questionnaire survey on bilingual teaching, we evalueted the results of bilingual teaching for seven-year medical students and the main problems of bilingual teaching and solutions accordingly. An uneven English level on the part of teachers and students and imperfect materials etc. affect the overall results of bilingual teaching. Therefore persistent efforts need to be made in enhancing the teachers' English level, improving teaching methods and compiling proper textbooks so as to genuinely improve the bilingual teaching program.

Objective To evaluate the clinical, endocrinologieal and pathological characteristics of adrenal incidentaloma. Methods Ninety-seven patients (53 males and 44 females) diagnosed with adrenal incidentaloma confirmed by pathology were retrospectively analyzed in this study. The mean patient age was 45 years old. Thirty-eight cases had left adrenal lesions, 52 cases had right adrenal le-sions and 7 cases had bilateral adrenal tumors. Of these patients, 74 cases had accepted full range en-docrinological investigations. The tumor size was measured by uhrasonography (US) in 8 cases, CT scanning in 54 cases and MRI in 35 cases, respectively. Results Of these 97 adrenal incidentalomas, 20 cases(20.6%) were malignant tumors (12 adrenoeortical carcinomas, 3 malignant pheochromocyto-mas, 2 metastatic cancers, 1 sarcoma, 1 neuroblastoma and 1 malignant sehwannoma), 21 cases (21.6%) were benign pheochromocytomas, 26 cases (26.8%7 were adrenal adenomas, 9 cases (9.3%) were myelolipomas,13 cases(13.4%) were adrenal cysts, 5 cases(5.2%) were ganglioneuro-ma and 3 cases(3.1%) were neurofibroma. Endoerinological study showed that 21 (28. 4%) of the in-cidentalomas were functional. Forty patients(41.2%) had hypertension. Tumor size less than 4 cm in diameter were found in 25.8%cases,tumor size ranged from 4 to 6 em were found in 34.0% cases and tumors larger than 6 em were found in 40.2% cases. The average diameter of malignant tumors was 9.9±4.6 cm which was significantly larger than the average diameter of benign tumors, 5.6±3.2 cm (P=0.01). Tumor size greater than 6 cm was more frequently found in patients with malignant tumor (75.0% vs 35.1%, P=0.001). Only 4% of the ineidentalomas less than 4 cm selected surgery were malignant tumors. Weight loss was more frequently found in patients with malignant tumor than that in benign tunor(25.0% vs 2.6%, P =0.004). Conclusions Adrenal adenomas, benign pheochro- mocytomas and malignant tumors are the main types of adrenal incidentaloma. The endocrinological evaluation should be performed in all adrenal incidentalomas. In patients with normal endoerinologieal study, tumor size less than 4 cm is an important eharaeteristie for benign tumors.

Objective To study the analgesia effect and adverse reactions of epidural and subcutaneous multimodal analgesia in thoracotomy esophageal cancer resection operation .Methods Forty patients undergoing elective esophageal cancer resection op‐eration were randomly divided into the epidural and subcutaneous analgesia group (group A) and the subcutaneous analgesia group (group B) ,20 cases in each group .The group A adopted 0 .15% ropivacaine and 0 .00002% sufentanil by continuous pumping infu‐sion before and during operation for continuous analgesia ,then intravenous tramadol was given before closing chest ,tramadol and sufentanil subcutaneous patients self‐control analgesia (PCA)were used after operation for analgesia .The group B was given intra‐venous tramadol before closing chest ,then tramadol and sufentanil patient subcutaneous controlled analgesia after operation were used for analgesia .The scores of the visual analogue scale(VAS) ,comfort scale ,sedative scores ,dose of analgesics ,pressing fre‐quency and pressing frequency ratio of PCA ,vital signs and adverse reactions were assessed at different time periods .Results The VAS scores and pressing frequency of PCA at rest and movement in the group A were remarkably decreased compared with the group B ,while the comfort status score and pressing frequency ratio of PCA were obviously increased ,the differences were statisti‐cally significant(P<0 .05);the occurrence rates of adverse reactions such as the vital signs ,sedative scores ,nausea ,vomitting ,skin itch ,chest distress after operation had no statistically significant differences between the two groups .Conclusion Epidural and sub‐cutaneous multimodal analgesia is a better multimodal analgesia scheme in thoracotomy esophageal cancer resection operation .

The toxicity of HCN inhaled via the respiratory tract in dogs and the therapeutic effects of DMAP and AmNO2 for such form of HCN intoxication were studied. The LD50 of HCN when inhaled was 850.4?80.4?g/kg.When the dosage of 2?LD50 of HCN was given to the experimental animals, the signs of intoxication developed rapidly. Uneasiness, struggling, strident barking, and respiratory excitation were observed several seconds after the exposure. Subsequently there was spasm of the extensors and rigidity of the extremities. Finally general inhibition and paralysis ensued. Respiration and heart beat stopped 6 and 7 minutes after exposure. If DMAP (3.25 mg/kg intramuscularly) or AmNO2 (2 ampules through inhalation) was administered 15 seconds after exposure, the survival rate of the animals was 90% or 100% respectively.When the dosage of 4?LD50 of HCN was inhaled and the two drugs were administered 45 seconds after exposure, the survival rate of the animals treated with DMAP remained as high as 90% (9/10) .But the survival rate of those treated with two ampules of AmNO2 or even three ampules reduced to 20% or 40% respectively.The amount of HCN inhaled during respiratory intoxication, the problems of early diagnosis and the administration of DMAP at the site of accident were analyzed and discussed.

Objective To investigate the influence of bushenhuoxue drug-containing serum on PI3K and Akt signaling pathway in purified retinal ganglion cell (RGCs) in vitro of Sprague-Dawley (SD) rats,and to explore the protective mechanisms of bushenhuoxue recipe on RGCs.Methods At first,bushenhuoxue drug-containing serum was prepared,and the RGCs of SD rats were purified;after the apoptotic model of pressurized and purified RGCs was established successfully in vitro using open pressure control system,RGCs were dealt with 50 g · L-1,100 g · L-1,200 g · L-1 concentration gradient of bushenhuoxue drug-containing serum.Then the subjected cells were divided into normal culture group (N group),control group (C group),50 g · L-1 bushenhuoxue group (50 g · L-1 BSHX group),100 g · L-1 bushenhuoxue group (100 g · L-1 BSHX group),200 g · L-1 bushenhuoxue group (200 g · L-1 BSHX group).Finally,cell apoptotic rate was detected by Annexin V-FITC/PI staining,while real-time quantitative PCR (qRT-PCR) and Western blot were used to detect the mRNA and protein expression of PI3K and Akt in each group respectively.Results The results of qRT-PCR detection showed that PI3K,Akt mRNA expression level in C group (0.04 ±0.01) was decreased compared with N group (1.00 ± 0.04),and the difference was statistically significant (all P＜0.05),while PI3K,Akt mRNA levels in 50 g · L-1,100 g · L-1 and 200 g · L-1 BXHX group (0.18 ±0.01,0.21 ±0.02,0.22 ±0.01,0.36 ±0.01,0.84 ±0.10,1.07 ± 0.17) were increased compared with the C group,and the difference was statistically significant (all P ＜0.05).The Western blot results of each group showed that PI3K,Akt protein expression level in C group was decreased compared with N group,with statistical difference (all P ＜ 0.05),while PI3 K,Akt protein expression levels in 50 g · L-1,100 g · L-1 and 200 g · L-1 BSHX group were increased compared with C group,with staffstical difference (all P ＜ 0.05).Conclusion Bushenhuoxue drug-containing serum may inhibit the RGCs apoptosis induced by pressure,which may be related to the activation of PBK/Akt signal transduction pathway.