OBJECTIVE Topreparealipidderivativeofgemcitabine(Gem)anditspolymericmi-celles to overcome the disadvantages of Gem.METHODS N-benzyl-3′-acetyl-gemcitabine(BAG)was synthesized.A BAG-loaded poloxamer polymeric micelle (BAG∶poloxamer 188 =10∶1 ,mol/mol)was prepared using an injection method.The micelles were characterized with a laser particle size and elec-tric charge instru ment and negatively-stained trans mission electron microscopy.Hu man breast cancer cells MCF-7 were cultured with Gem or BAG polymeric micelles of 5,10,20,30,50,70,90 μmol·L-1 for 24,48 and 72 h,respectively.The inhibitory rate of cells was measured with an MTT method.The MCF-7 cytotoxicity of BAG polymeric micelles was investigated.A pharmacodynamic study was per-formed on the mice bearing mouse hepatocellular cancer cells H22.Intravenous (iv)and oral (ig)ad-ministration was used at the dose of Ge m 40 mg·kg -1 or BAG polymeric micelles 62 mg·kg -1 .The mice were administered on the 1 st,4th and 7th day and sacrificed on the 8th day.Tumor inhibitory rates were measured.RESULTS TheBAGstructurewasidentifiedbythinlayerchromatograph,1Hand13C NMR,infrared ray chromatograph and mass spectrum.The appearance of BAG micelles was a slightly blue suspension.The micelles were spheres according to the electron microscopic observation.Their size was 62.82 nm and the zeta potential was -18.8 mV.The half inhibition concentration (IC50)of Gem and BAG polymeric micelles was 40.6 and 90.0 μmol·L-1 ,5.0 and 14.9 μmol·L-1 ,5.0 and 1 3.6 μmol·L-1 at 24,48 and 72 h,respectively according to the MTT results.According to the in vivo results,compared with the tumor model group,Gem (ig),Gem (iv)and BAG polymeric micelles (iv and ig)had significant effect on the tumor weight of H22 cell xenograft mice (P<0.01 ).As for anti-tumor efficiency,BAG polymeric micelles (ig)were better than Gem (ig)(P<0.05);BAG polymeric micelles (iv)were better than BAG polymeric micelles (ig)(P<0.05),and BAG polymeric micelles (iv)were almostequaltoGem(iv).CONCLUSION ThelipidderivativeofGemcanbeloadedinthepoloxamer 1 88 polymeric micelles.BAG polymeric micelles show in vitro MCF-7 cell inhibition and in vivo inhibition of mouse H22 xerografts;iv or ig.BAG polymeric micelles (ig)show better anti-tumor effect than Gem (ig),indicating that BAG polymeric micelles are a promising novel anti-tumor oral preparation.

Objective To investigate the effect of three blood purification techniques on minerals disorder in maintenance hemodialysis patients,and provide clinical guidance for patients to choice the blood purification techniques.Methods Eighty-eight maintenance hemodialysis patients were divided into three groups according to the blood purification techniques:hemodialysis (HD) group (30 cases),hemodiafiltration (HDF) group (30 cases),and hemoperfusion (HP) group (28 cases).Serum urea nitrogen,creatinine,calcium,phosphorus,intact parathyroid hormone (iPTH),ftbroblast growth factor (FGF)-23 and so on before and after treatment were measured and compared among the groups.Results The serum phosphorus in HD group,HDF group and HP group before treatment were (1.93 ±0.44),(2.11 ±0.54) and (2.17 ±0.59)mmol/L,and after treatment were (1.01 ±0.23),(0.84 ±0.19),(0.99 ±0.27) mmol/L.There were significant differences in serum phosphorus level after treatment compared with that before treatment in the three groups (P ＜0.05).There were no significant differences in the descend rate of serum phosphorus among the three groups (P ＞0.05).There were no significant differences in clearance index of serum phosphorus among the three groups (P ＞ 0.05).The serum iPTH in HD group before treatment was (48.8 ± 42.9) pmol/L,and after treatment was (49.9 ± 42.9) pmol/L.The serum iPTH in HDF group and HP group before treatment were (64.7 ± 45.4) and (50.4 ± 45.9) pmol/L,after treatment was (46.2 ± 37.8) and (35.8 ± 36.5) pmol/L.There were significant differences in serum iPTH level after treatment compared with that before treatment (P ＜ 0.05).There were no significant differences in the descend rate and clearance index of serum iPTH in HDF group and HP group (P ＞ 0.05).There was no significant difference in serum FGF-23 in HD group before and after treatment (P＞ 0.05).The serum FGF-23 in HDF group and HP group before treatment were (782.5 ± 105.8) and (879.5 ±97.2) ng/L,after treatment were (712.0 ±98.1),(823.5 ± 89.1) ng/L.There were significant differences in serum iPTH level after treatment compared with that before treatment in HDF group and HP group (P ＜ 0.05).The descend rate of serum FGF-23 in HD group,HDF group and HP group were (5.7 ±2.8)％,(12.3 ±6.2)％ and (9.1 ±4.6)％,and there was significant difference among the three groups (P ＜0.05).The clearance index of serum FGF-23 in HD group,HD F group and HP group were 0.06 ± 0.05,0.19 ± 0.11 and 0.12 ± 0.08,and there were significant differences among the three groups (P ＜ 0.05).There were no significant differences in the descend rate and clearance index of serum urea among the three groups (P ＞ 0.05).Conclusions HD can only clear serum phosphorus.HDF and HP can clear serum phosphorus,iPTH and FGF-23 effectively,while HDF has better clearance effect on FGF-23.The HDF and HP blood purification can reduce minerals disorder in maintenance hemodialysis patients and has important clinical significance in improving the long-term prognosis of the patients.

Objective To investigate the value of kinetic features measured by computer-aided diagnosis (CAD)for breast MRI.Methods One hundred and sixty four lesions diagnosed pathologically by operation or biopsy comprised the analysis set.Automated lesion kinetic information from CADStream programs for breast MRI was identified.Three CAD variables were compared for benign and malignant lesions: initial phase peak enhancement (greatest percentage of signal intensity increase on first contrast enhanced sequence),delayed phase enhancement categorized by a single type of kinetics comprising the largest percentage of enhancement (washout,plateau,or persistent),and delayed phase enhancement categorized by single most suspicious type of kinetics (any washout ＞ any plateau ＞ any persistent).Morphological characteristics of breast lesions were described according to breast imaging and reporting data system (BI-RADS).Initial phase peak enhancement mean values between benign and malignant breast lesions were compared by using Wilcoxon rank-sum test,delayed phase enhancement categorized by a single type of kinetics comprising the largest percentage of enhancement or by single most suspicious type of kinetics between benign and malignant breast lesions were compared by using Chi-square test.Results There were 72 benign and 92 malignant breast lesions.A total of 123 (75.0％) mass lesions were identified,and the other 41 (25.0％) lesions showed no mass.Thirty lesions were BI-RADS-MRI 2,68 lesions were BI-RADS-MRI 3,43 lesions were BI-RADS-MRI 4,23 lesions were BI-RADS-MRI 5.Initial phase peak enhancement mean values of benign and malignant lesions were 237％ (69％ to 629％)and 336％ (86％ to 793％),respectively.There was no significant difference between benign and malignant lesions in initial peak enhancement mean value (Z =-1.626,P =0.104).Delayed phase enhancement categorized by single most suspicious type of kinetics (any washout ＞ any plateau ＞ any persistent) for benign and malignant lesions were 15,10,47 and 2,3,87 respectively.There was a significant difference between benign and malignant lesions (x2 =23.562,P =0.000).Initial peak enhancement value ＜ 100％ or ≥100％ were 5 and 67 for benign lesions,3 and 89 for malignant lesions,respectively.There was no significant difference between benign and malignant lesions at 100％ threshold (x2 =1.181,P =0.277).Delayed phase enhancement categorized by a single type of kinetics comprising the largest percentage of enhancement (washout,plateau,or persistent) for benign and malignant lesions were 48,6,18 and 47,15,30 respectively.There was no significant difference between benign and malignant lesions (x2 =4.496,P =0.106).Conclusions Of CAD kinetics analyzed,only delayed enhancement categorized by most suspicious type is helpful for the differentiation between benign and malignant lesions.However,there is significant overlap between initial peak enhancement at 100％ threshold or delayed kinetics categorized by largest percentage enhancement types of benign and malignant lesions,so lesion morphologic features should be considered.

BACKGROUND: Spherical Toric intraocular lens can effectively correct the preoperative astigmatism of cataract patients, but it is unclear whether the aspheric Toric lens is better than the spherical Toric lens to improve the quality of vision. OBJECTIVE: To evaluate the optical quality after implantation of aspheric toric intraocular lens in cataract surgery. METHODS: Seventy-three cataract patients with corneal astigmatism (80 eyes) were enrol ed, including 37 males and 36 females, aged 47-83 years. Among them, 36 cases were implanted with aspheric Toric intraocular lens (test group), and the other 37 cases were implanted with spherical Toric intraocular lens (control group). Postoperative examinations were performed at 3 months, including axial intraocular lens, uncorrected visual acuity, corrected visual acuity, residual astigmatism, contrast sensitivity, and wavefront aberration. RESULTS AND CONCLUSION: Three months after implantation, the axial view, uncorrected visual acuity, corrected visual acuity and residual astigmatism showed no differences between the two groups; no shape deviation and lens decentration occurred; there was no case required to remove the lens or subjected to secondary adjustment. In the test group, the moderate and high spatial frequency contrast sensitivity at the scotopic or scotopic glare state was significantly higher than that in the control group (P < 0.05), the total higher order aberrations and spherical aberrations at a pupil diameter of 5.0 mm and spherical aberration at a pupil diameter of 3.0 mm were significantly less than those in the control group (P < 0.05). Additional y, there were no differences in scattering index, cut-off frequency of the modulation transfer function, Strehl ratio and visual acuity at 9%, 20% and 100% contrast between the two groups. These findings indicate that the aspheric and spherical toric intraocular lenses have similar effects in improving the astigmatism and raising the uncorrected visual acuity, but the former one is superior to the latter one in improving scotopic vision, and total higher order aberrations and spherical aberrations.

BACKGROUND: Studies have found that chondroitin sulfate proteoglycans degradation with chondroitinase canpromote the migration of Müller cells on the retina, but whether it could promote the migration of adipose-derivedmesenchymal stem cells in retinal degeneration rats is unclear.OBJECTIVE: To investigate the effect of chondroitin sulfate proteoglycans degradation with chondroitinase on adipose-derived mesenchymal stem cell treatment for retinal degeneration in rats.METHODS: Human adipose-derived mesenchymal stem cells were isolated and cultured. A retinal degeneration ratmodel was established followed by administration of adipose-derived mesenchymal stem cells+chondroitinase into thesubretinal space. The migration of adipose-derived mesenchymal stem cells and retinal cell apoptosis in rats aftertransplantation were observed.RESULTS AND CONCLUSION: The human adipose-derived mesenchymal stem cells could be successfully cultured.The labeling rate of BrdU to the human adipose-derived mesenchymal stem cells was more than 90.0%. At 7 days aftermodeling, the outer nuclear layer of the retina was collapsed, and a large amount of photoreceptor cells were dissected.The outer nuclear layer was attached to the Bruch''s membrane, and the retina was arched. The central retina andperipheral retina were damaged. In normal rats, the retinal layers were clear, and the photoreceptor cells arrangedregularly; and the retinal pigment epithelium was complete. The migration rate of adipose-derived mesenchymal stemcells in adipose-derived mesenchymal stem cells+chondroitinase group was higher than that in adipose-derivedmesenchymal stem cells group (P < 0.05). There was no significant difference in the apoptotic rate of retinal cellsbetween the two groups (P > 0.05). These experimental findings show that chondroitin sulfate proteoglycans degradationwith chondroitinase can enhance the migration ability of human adipose-derived mesenchymal stem cells on the retina.

Objective To discuss the effect and feasibility of BiPAP in refractory asthma patients. Methods A total of 15 coses of refractory bronchial asthma admitted by our hospital during Feb 2003 to May 2006 were treated by BiPAP in addition to medical therapy。 The symptoms、signs and the arterial blood gases were observed and analyzed。Results Among 15 patients,2 gave up treatment,13 patients were successfully treated with the BiPAP therapy。There were significant improvement of PaCO2、PaO2、pH and respiratory rate ,heart rate after 2h BiPAP。Conclusions Ventilation in BiPAP is an effective method for refractory asthma ,which can save the patients life and decrease the complications.

Objective To discuss the effect and possibility of NIPPV in ILD combined with respiratory failure. Methods A total of 37 cases of ILD combined with respiratory failure admitted by our hospital during Feb 2004 to Oct 2007 were divided into treatment group (20 cases) and control group (17 cases). Routine pharmaceutical intervention was adopted in both groups while NIPPV was given in the patients of treatment group. The symptoms、signs and the arterial blood gases were observed and analyzed. Results Among 20 patients,3 gave up treatment , 17 patients were successfully treated with the NIPPV therapy. There were significant improvement of PaCO2、PaO2、pH and respiratory rate ,heart rate after 2h NIPPV. Conclusion NIPPV is an effective method for ILD combined with respiratory failure,which can save the patients life and decrease the complications.

Objective To investigate the status quo of psychological pressure in female infertility patients so as to provide the basis for carrying out the psychological counseling aiming at these patients .Methods The random sampling was adopted and the questionnaire survey was conducted on 1 760 female infertility patients .Results The patients with psychological pressure accounted for 84 .43% of the investigated patients .The cases number of psychological pressure in the patients with in‐vitro‐fertilization and embryo transfer(IVF‐ET) treatment was significantly more than that in the patients with pregnancy‐guiding and artificial insemina‐tion (P<0 .01);the cases number of psychological pressure in the patients with higher educational degree was more than that in the patients with lower educational degree (P<0 .01);the cases number of psychological pressure in technicians ,teachers ,staffs ,cadres and civil servants was more than that in the workers ,farmers ,merchants and the people with the other occupations (P<0 .01);the cases number of psychological pressure in the patients with 2-5 year infertility was more than that in the patients with the other infertility years (P<0 .01);the cases number of psychological pressure in the patients with visiting doctors for twice or over was more than that in the patients with visiting doctors for the first time (P< 0 .01) .Conclusion The female infertility patients in Chongqing have large psychological pressure .The doctor should actively communicate with patients ,answer the patient doubt ,ease the patient emotion ,mobilize the patients′family and society to care the patients .

Objective To investigate the therapeutic effect of ambroxol in bleomycin-induced pulmonary fibrosis of rats.Methods Sixty Wistar rats were divided into three groups:The normal control group(group N),the model group treated with bleomycinA5(group B)and the group treated with ambroxol(group A).Pulmonary fibrosis was induced by intratracheal instillation of bleomycin.Then the rats received daily ambroxol 35mg/kg(group A),or normal saline(group B).Five rats in each group were killed on 3.7.14 and 28 days after intratracheal instillation.Histological changes of the lungs were evaluated by HE stain and Masson's trichrome stain.The levels of tumor necrosis factor-?(TNF-?)in lung homogenates were measured by radioimmunoassay.Results Pulmonary fibrosis of Group A was significantly improved as compared with that of Group B(P