Objective:This study was aimed to investigate the influence of CDK7 siRNA on the sensitivity of endometrial carci-noma cell line HEC-1-A to cisplatin (DDP)-based chemotherapy. Methods:Different CDK7 siRNA fragments were synthesized based on the designs of the CDK gene sequence and were transfected into HEC-1-A. Real time reverse transcription polymerase chain reac-tion (RT-PCR) and Western blot analysis were employed to demonstrate the effects of transfection. The best CDK7 siRNA was chosen to specifically silence CDK7 expression in HEC-1-A.The sensitivity of the cells to DDP therapy before and after transfection was deter-mined by methyl thiazol tetrazolium (MTT) cytotoxicity assay, flow cytometry, and Hoechst/PI double-staining fluorescence microsco-py. Results:A total of four different CDK7 siRNA segments were designed and successfully transfected into HEC-1-A cells. The inter-ference effect in each group was confirmed by real time RT-PCR and Western blot assays. CDK7-423 was determined as the best per-forming CDK7 siRNA (over 70%) to transfect into HEC-1-A cells. MTT cytotoxicity test showed that IC50 of DDP decreased to a range from 45.122 μg/mL and 3.200 μg/mL after inhibition of CDK7 expression. DDP toxicity to the endometrial carcinoma cells sig-nificantly increased (P<0.05). Flow cytometry revealed that the average cell apoptosis rate significantly increased after the inhibition of CDK7 expression (11.66%to 37.57%, P<0.05). Similar results were observed using Hoechst/PI double-staining fluorescence microsco-py, and the number of apoptotic corpuscle demonstrated an apparent increase in the low CDK7-expressing group compared with the pa-rental cells. Conclusion:After the downregulation of CDK7 expression by CDK7 siRNA transfection, DDP chemotherapy sensitivity and apoptosis of endometrial carcinoma cells significantly increased. Further research is anticipated on the use of CDK7 as a new treat-ment target for endometrial carcinoma.

Objective To evaluate the applied value of bedside chest radiography in the intensive care unit ( ICU ) . Methods One hundred and ninety-three cases with 507 chest radiographs (CXRs) in the ICU were analysed retrospectively. The appearances of cardiopulmonary abnormalities were analysed.Results 97.4% of the CXRs were satisfied for diagnosis. 83.9% of the CXRs showed cardiopulmonary abnormalities, including atelectasis, pneumonia, pulmonary edema, ARDS, pneumothorax, mediastinal and subcataneous emphysema,pleural effusion,pericardial effusion and pulmonary thromboembolism, and 6.2% out of these positive cases was discovered accidentally. The chest radiograph has moderate accuracy (77.9%) in visualizing cardiopulmonary abnormalities at the initial CXR including atelectasis,pneumonia,pulmonary edema and pleural effusion. Misdiagnosis occurred mainly on the patients with a small quantity of pneumothorax and pulmonary thromboembolism. About one-third cases of cardiogenic edema and ARDS were indistinguishable.Conclusion Bedside chest radiographs are of significant value for the patients in the ICU.

Objective To assess the contribution of the portable chest computed radiography (CR) in evaluation of monitoring devices of the patients in the intensive care unit (ICU). Methods One hundred and sixty-two cases with 387 chest radiographs in the ICU were analysed retrospectively. The location of the catheters of monitoring devices and complications were observed.Results The malposition of the catheters was detected in 47 cases(16.9%),including the endotracheal (ET) tubes too deep at the position, the central venous catheters placed into the internal jugular veins,and the position of the thoracic drain tubes to be deep not enough causing the drain to fall.The complications after operation of monitoring devices were not common,including pneumothorax caused by ventilatory assistance,atelectasis and pneumonia caused by malposition of the ET tubes,totally in 11 cases.10 cases with cardiopulmonary abnormalities were discovered accidentally in all 162 cases(6.2%) when evaluation of monitoring devices.Conclusion Bedside chest CR not only can show the catheter position and the complications of the monitoring devices ,but also the cardiopulmonary abnormalities of patients in the ICU.

Objective To evaluate prognostic indicators in severe traumatic brain injury and intracania hamatomas with hernia and analyze which is the most important indicator.Methods Data of 84 cases with severe traumatic brain injury were retrospectively analyze .Age,GCS,pupil reflex,midline shift,compression of the cisteme,decompression time and complex injury were considered as possible prognostic indicators.SPSS13.0 was employed to analyze the data,Logistic regression(Forward conditional)analysis was done to confirm which are the most important prognostic indicators for severe traumatic brain injury and to evaluate the practical value in predicting prognosis(X2= 22.92,P＜ 0.01).Results 48 patients died and 36 survived.56(67%)patients had a bad prognosis(GCS≤3)and 28(33%)had a good prognosis(GCS ＞3).Those who had a shorter decompression time(≤3h)had a better prognosis than those who had a longer decompression time(＞3h),with the mortality rate of 11% and 67% respectively.Lesser cisteme compression predicts better outcome.GCS,pupil reflex,midline shift,and complex injury didn' t enter the logistic regression equation.According to compression time,90.5% of the cases' prognosis was accurately predicted,according to compression time and cisterne compression,95.2% was accurately predicted.Conclusion The mortality rate of severe traumatic brain injury with hernia was high and surgical intervention was effective.Decompression time and cisteme compression were the most important factors affecting prognosis in severe traumatic brain injury and they could predict prognosis of most cases correctly.

Objective To study the effects of injecting recombinant human granulocyte colony stimulating factor (rhG-CSF) and basic fibroblast growth factor (bFGF) alone or combined on actue myocardial infarction(AMI).Methods AMI models were induced by ligation of the left anterior descending artery.The survived rats were divided into four groups randomly:AMI group (MI),rhG-CSF group (G),bFGF group (B),combined group (GB).Respectively,saline,rhG-CSF,bFGF,and rhG-CSF plus bFGF were injected intraperitoneally 24 h after AMI.Also,sham-operated group (S) was established with only chest-opeaned,without ligation,and no drugs intervention. The white blood cells (WBC) and mononuclear cells (MNC) proportion in peripheral blood were counted 1 week before and 1 week after the intervention,and the number of CD34+ cells was observed with immunohistochemical staining 1 week after AMI in order to compare the situation of mobilization in peripheral blood;the capillary density was evaluated by HE staining both 1 and 4 weeks after AMI;their cardiac fuction was determined in vivo,the infarction size in each group was calculated,and the pathological changes in rat myocardium were observed by HE staining 4 weeks after AMI.Results Compared with MI group,the number of WBC and MNC% in peripheral blood 1 week after AMI in G,B and GB groups were higher(P

Objective To find the way of inducing the bone marrow mesynchymal stem cells(MSCs)into cardiac cells with pacemaking function in vitro.Methods Dissociate the rat MSCs and induce them with 5AZA,bFGF+EGF,HGF,SCF and lysate of the sinoatrial cells respectively.The morphological changes were observed,and the expressing of protein cTnT,connexin 43 and HCN2/4 were analyse by immunohistologic and flowcytometry techniques.The pacmaking current If were evaluted by patch clamp techniques.Results All the methods can induce the bone marrow MSCs to differentiate into cardiac cells,which expressing cardiac cell specific protein and HCN2.Cells induced by 5AZA,bFGF+EGF and SAN CMs show higher rate of HCN2 expressing(22.9%,22.3%,11%).The cells of these groups have the pacmaking current If.Conclusion Lysate of the sinoatrial cells are ideal methods of inducing the bone marrow MSCs to differentiate into cardiac cells with pacemaking function in vitro.HCN is a promising marker protein to select pacmaking cells out of the differentiated cells.

Objective:The present study aims at setting up an evaluation index system aiming at providing a set of measurement tools for population & health informatization developing level for administrative departments. Meth-ods: Delphi method, analytic hierarchy process, Synthetic Index Method and some mathematical or statistical meth-ods were used respectively to select the primary indexes, calculate the weight and combined weight of each index, build up the synthetic evaluation mode,and test the evaluation system. Results:According to the results of this work, the evaluation index system has been established which is composed of 6 level 1 indexes, 16 level 2 indexes, and 33 level 3 indexes, and it covers 6 aspects, such as information resources construction, information infrastructure con-struction, information technology application, informatization talents and the information policy, planning, and stand-ards. The weights of these indexes were also calculated. The synthetic evaluation model has been built. Finally, the reliability, the validity and the discrimination of the evaluation system were tested. Conclusions:The evaluation index system has been established, which is able to be used in the evaluation, and to some extent guide the work of popula-tion & health informatization construction.

Objective To observe the clinical curative effect of fumigation and steaming with traditional SHE medicine and life intervention on women patients with metabolic syndrome( MS) .Methods 60 women with MS were randomly divided into treatment group and control group,30 cases in each group.The control group was orally given western medicine.The treatment group used fumigation and steaming with traditional SHE medicine and life interven-tion on the basis of oral western medicine therapy,3 days every 1 time,10 times for a period of treatment.The changes of triglyceride(TG),high-density lipoprotein cholesterol(HDL-C),fasting plasma glucose(FPG),blood pressure, body mass,waist circumference,body mass index(BMI),abdominal fat thickness and body fat percentage(PBF) before and after treatment were observed.Results Before treatment,there were no statistically significant differences in TG,HDL-C,FPG,blood pressure,body mass,waist circumference,BMI,abdominal fat thickness,PBF between the two groups.After treatment, TG, HDL -C, FPG, SBP, DBP, body quality, waist circumference, BMI, abdominal fat thickness and body fat in the treatment group were (1.52 ±0.32) mmol/L,(1.36 ±0.31) mmol/L,(6.12 ± 0.31)mmol/L ,(140.67 ±9.32)mmHg,(82.23 ±7.03)mmHg,(65.50 ±11.35)kg,(79.09 ±19.67)cm, (21.30 ±6.12) kg/m2,(26.63 ±3.77) mm,(23.6 ±3.18)% respectively,which in the control group were (1.76 ±0.31) mmol/L,(1.18 ±0.32) mmol/L,(6.40 ±0.32) mmol/L,(150.83 ±12.10) mmHg,(86.50 ± 6.97)mmHg,(71.57 ±12.07)kg,(89.65 ±20.92)cm,(25.15 ±7.41)kg/m2,(30.40 ±3.22)mm,(26.5 ± 3.32)%respectively.The differences between the two groups were statistically significant( t=2.950,2.211,3.414, 3.644,2.362,2.007,2.014,2.194,4.165,3.455,all P<0.05).Conclusion It has obviously improved clinical curative effect for patients with MS,and has certain advantages in the reshape by fumigation and steaming with tradi-tional SHE medicine and life intervention.

Objective To investigate the change of indications of emergency obstetric hysterectomy and the clinical application of intraoperative interventions. And to provide evidence for prevention of hysterectomy and improvement of obstetric quality. Methods Clinical data were collected from 97 patients who received emergency obstetric hysterectomy at Shengjing Hospital of China Medical University between January 1st, 2004 and December 31st, 2013. The patients were divided into two groups by the time point of January 1st, 2009: the first group was cases treated between January 1st, 2004 and December 31st, 2008, while the second group was cases treated between January 1st, 2009 and December 31st, 2013. The clinical indicators, surgical indications, intraoperative interventions, and blood loss between the two groups were analyzed retrospectively. Results (1) Incidence:54 857 women delivered at Shengjing Hospital of China Medical University between January 1st, 2004 and December 31st, 2013. Of them, 97 patients received emergency obstetric hysterectomy, with an incidence of 0.177% (97/54 857). (2) The 17 patients delivered vaginally (18%,17/97) and 80 by caesarean section (83%,80/97). Forty-nine patients experienced repregnancy with scar uterus (51%, 49/97). About 41 patients underwent abdominal total hysterectomy (42%,41/97) and 56 received subtotal hysterectomy (58%,56/97). (3) The number of patients were comparable between the two groups (50 vs 47;P>0.05). (4) The main surgical indication was uterine inertia (45%, 44/97). The main causes of uterine inertia were excessive uterine tension (45%, 20/44) and placental abruption due to gestational hypertension (32%, 14/44). Of all the indications, 29 patients in the first group (58%, 29/50) and 15 patients in the second group (32%, 15/47) suffered from postpartum hemorrhage. Pathological placenta embedment occurred in 15 patients in the first group (30%, 15/50) and 25 patients in the second group (53%, 25/47). The incidences of postpartum hemorrhage due to uterine inertia or pathological placenta embedment were significantly different between the two groups (both P<0.05), respectively. (5) In the first group, the average preoperative blood loss was (2 900±1 900) ml, and the average intraoperative amount of infused white&red blood cells was (5.9±3.5) U, with the average operation time of (2.2 ± 1.8) hours and the average in-hospital duration of (7.8 ± 2.3) days. In the second group, the average preoperative blood loss was (3 100± 2 200) ml, and the intraoperative amount of infused white&red blood cells was (6.2± 5.2) U, with the average operation time of (2.5± 2.1) hours and the average in-hospital duration of (7.9 ± 2.9) days. There was no significant difference between the two groups in any of these indicators (P>0.05). Postpartum hemorrhage was usually treated with uterine packing in the first group, but was preferentially treated with potent uterine contraction agents, arterial ligation, uterine balloon compression or B-Lynch suture in the second group. The therapeutic effects of these new treatments were significantly better than uterine packing (P<0.05). Conclusions The incidence of emergency obstetric hysterectomy did not change significantly in the past decade. However, the indications and intraoperative interventions have changed significantly in the second five years compared with the first five years. The main surgical indications were uterine inertia and postpartum hemorrhage due to pathological placenta embedment. Therefore, strict control of caesarean section indications was important to reduce emergency obstetric hysterectomy.

Objective To explore the clinical features of sentinel polyps (rectal polyps with proximal colon carcinoma) and its correlation with proximal colon carcinoma.Methods From January 2003 to December 2013,the clinical features of 963 hospitalized patients with rectal polyps were retrospectively analyzed.According to whether the patient with colon carcinoma,the clinical data of rectal polyps patients were divided into pure polyps group (n=855) and sentinel polyps group (n 108).The characteristics under endoscopy,clinical pathological features,treatment and prognosis of the two groups were observed.Chi square test was performed for differences comparison between groups.Results The length of stay in hospital of 963 patients was from four to 33 days,the average age was (49.7 ± 9.4) years,and the majority of the patients were male (n=610,63.3％).A total of 785 patients (81.5％) had non-specific abdominal symptoms,such as frequency or habit change of defecation,hematochezia,abdominal pain,abdominal distension.The relatives within three generation of 78 patients (8.1 ％) were diagnosed with tumor and some relatives of the patients diagnosed with familial adenomatous polyposis (2.2％,21/963).The positive rate of tumor marker of sentinel polyps group was higher (69.4％,75/ 108) than that of pure polyps group (6.8％,58/855; x2 =316.285,P＜0.01).The proximal colon carcinoma of patients with sentinel polyps appeared as neoplasma with circumferential growth,there was no specific appearance between distal rectal polyps and proximal colon carcinoma.When compared with pure polyps group,most polyps of sentinel polyps group were in maximum diameter over 1 cm (61.1％ (66/108) vs 46.9％ (401/855)),multi polyps (n＞5,38.9％ (42/108) vs 11.8％ (101/855)) and adenomatous polyp (83.3％ (90/108) vs 35.6％(304/855),x2=7.752,55.595 and 90.544,all P＜ 0.01).Majority of the proximal colon carcinoma with rectal polyps was papillary adenocarcinoma and tubular adenocarcinoma which was account for 75.9％ (82/108).Some were mucinous carcinoma and signet ring cell carcinoma.Most of the proximal colon carcinoma with rectal polys did not penetrate the serosa layer (Duk A-+Duk B,59.3％,64/108) and with little distant metastasis (Duke D,17.6％,19/ 108).Ninty-five point six percent (817/855) of patients with pure polyps underwent endoscopic treatment and all of them were cured and discharged.Forty-one point seven percent (45/108) of patients of sentinel polyps group accepted the radical operation and 19.4％ (21/108) received endoscopic submucosal dissection.Conclusions If multiple,maximum diameter over 1 cm and adenomatous rectal polyps were detected under colon endoscope,the possibility of carcinogenesis of the polyps or the proximal colon should be awared.If the endoscope is difficult to go further or the patient can not tolerate the whole colon examination,the patient should be followed up in short-term and complete the whole colon examination.