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.

ObjectiveTo evaluate the mid-term clinical effect of nano-hydroxyapatite and polyamide 66 (n-HA/PA66) intervertebral fusion cage in treatment of thoracolumbar burst fractures.Methods A total of 87 patients with thoracolumbar burst fractures were managed by thoracolumbar body resection combined with n-HA/PA66 intervertebral fusion cage from December 2007 to September 2008.The clinical effect, safety and radiographic outcomes were evaluated.Results No nerve damage was deteriorated in all the patients.The neural function was improved for 1-2 grade except for four patients at Frankel grade A.The patients were followed up for mean 21.3 months (17-24 months).The kyphosis was (14.4 ± 12.6)° preoperatively, (3.7 ± 8.7) ° immediately after surgery and (4.0 ± 8.3)° at final follow-up.The distance between the upper and lower vertebral bodies was (96.9 ± 17.2) mm preoperatively, (109.5 ± 17.1) mm immediately after surgery and (108.3 ± 16.4) mm at final follow-up.No cage replacement, internal fixation breakage or neurologic impairment were observed during follow-up period.There were 58 patients with grade E fusion, 22 with grade D fusion and 7 with grade C fusion.ConclusionsAnterior decompression combined with n-HA/PA66 intervertebral fusion cage is an effective method for treatment of thoracolumbar burst fracture.The kyphosis is rectified and the intervertebral distance is corrected, with a high rate of fusion.

Objective:To eveluate and study the anatomic basis of the posterior contour sign of lumbar intervertebral disc.Methods:The most protruding length of the soft tissue mass behind intervertebral spase on lumbar plain film were measured in 100 cases and compared with CT or MR findings.Results:41 posterior contour sign of the interlumbar disc were fined in 39 cases,of which there were 25 in L4/5(61.0%),15 in L3/4(15.6%)and 1 in L2/3(2.4%).The protruding was less than 0.2 cm in 26 and larger than 0.2 cm in 15,there were 10 lumbar disc protruding confirmed by CT or MR ,7 of which the pesterior contour ≥0.2 cm,and 3＞0.3 cm,none was ≤0.2 cm.Conclusion:The adipose tissue in the posterior border of lumbar body and disc was the anatomic basis of the sign,and it was an importent sign for diagnosing of lumbar disc hernia on plain film.

Objective To assess the reliability and validity of the Tree-Drawing Test in medical college students.Methods The study randomly selected 312 aged 19 to 23-year-old medical students to take part in TreeDrawing Test.In addition,a total of 275 college students were selected to receive re-test,30 days late and Pearson correlation coefficient of two tests were calculated.The three raters were invited to assess 30 trees painting score,analyzing the Kendall coefficient of concordance between the scores to verify raters' reliability; parts of students also participated in the 16PF test,SAS,SDS test,analyzing the correlation coefficient between the various test results,in order to assess the effectiveness of the Tree-Drawing Test.Results The re-test reliability in different time was 0.570-0.733 and 0.341-0.713 (P＜0.05),the raters' reliability was 0.491 ～ 0.626(P＜0.05),there are some correlations between Tree-Drawing Test and 16PF,SAS,SDS.Conclusion The Tree-Drawing Test has good reliability and validity; it can be applied to the detection of college students' psychological assessment and psychological problems.

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 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.

Objective To investigate the effect of isoflurane preconditioning on the nuclear factor kappa B (NF-kB)activity of leukocytes in patients undergoing cardiac valve replacement with cardiopulmonary bypass (CPB).Methods Twenty ASAⅡorⅢpatients of both sexes aged 20-60 yrs undergoing cardiac valve replacement under CPB were randomly divided into 2 groups(n=10 each):control group(C)and isoflurane preconditioning group(I).Anesthesia was induced with midazolam 0.08-0.12 mg?kg~(-1),fentanyl 5-10?g?kg~(-1) and vecuronium 0.1 mg?kg~(-1).The patients were mechanically ventilated(FiO_2=100%)after tracheal intubation.Anesthesia was maintained with intermittent i.v.boluses of fentanyl and midazolam in group C or with 2 MAC isoflurane and intermittent i.v.boluses of fentanyl and midazolam in group I before CPB.Systolic BP was kept between 90-120 mm Hg,diastolic BP between 50-80 mm Hg and HR between 60-90 bpm in both groups. Isoflurane was discontinued at the initiation of CPB.Arterial blood samples were taken after tracheal intubation and before inhalation of isoflurane(T_0)at 30 min(T_1),1 h(T_2)and 2 h(T_3)after aortic unclamping for determination of NF-kB activity of leukocytes using electrophoretic mobility shift assay(EMSA).The amount of fentanyl,midazolam,dopamine and sodium nitroprusside(SNP)consumed during operation and the rate of recovery of spontaneous heart beat in both groups were recorded.Results The NF-kB activity was significantly increased after aortic unclamping in C group but there was no significant difference in NF-kB activity before CPB (T_0)and after aortic unclamping(T_(1-3))in I group.The NF-kB activity was significant lower at T_(1-3) in group I than in group C.The total amount of fentanyl consumed was 40-60?g?kg~(-1) in C group and 20-30?g?kg~(-1) in group I. Significantly less amount of dopamine was used in group I than in group C.There was no significant difference in SNP consumption between the 2 groups.The rate of recovery of spontaneous heart beat was significantly higher in group I than in group C(P＜0.01).The amount of dopamine consumed was positively correlated with the highest level of NF-kB activity in both group[r=0.962 in group C;r=0.908 in group I(P＜0.01)].Conclusion Isoflurane preconditioning can attenuate the NF-kB activity of leulocytes in patients undergoing cardiac valve replacement under CPB.

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.