Objective: To compare the protective effect of Tea polyphenol with that of esmolol on vascular endothelial cells secreting endothelin induced by hypoxia combined Ang-2. Methods: Vascular endothelial cells were divided into 4 groups that included control group,hypoxia+Ang-2 group,hypoxia+Ang-2+tea polyphenol group,hypoxia+Ang-2+esmolol group,and each group comprised eight samples. The changes of endothelin expression level were measured with radioimmunoassay at the time of 0.5 h,6 h,and 24 h. Results: ①The level of endothelin expression in hypoxia+Ang-2 group was higher significantly than that in the control group(P0.05),but there was significantly different at the time of 6 h and 24 h after hypoxia combined Ang-2(P

Objective To evaluate the clinical value of myocardial perfusion imaging with dual-source dual-energy CT and a contrast agent at a low concen.tration in the diagnosis of myocardial infarction in the elderly Methods One-stop cardiac imaging with dual-source CT was conducted in 138 elderly patients diagnosed with myocardial infarction between October 2015 and May 2016.The patients were randomly divided into two groups,Group A and Group B,each with 69 patients.Myocardial perfusion was performed for coronary imaging,using 70 ml Visipaque(270 g/L)and 50 ml saline for Group A and 70 ml iopromide(370 g/L)and 50 ml saline for Group B.Myocardial transmural perfusion gradients(TPG)were calculated,and the total iodine dose and the rate of iodine infusion were compared between the two groups.Results The procedure was successfully carried out in all 138 patients.There was no statistically significant difference in TPG between the two groups in the right coronary artery,the anterior descending artery and the circumflex artery(P＞0.05).The total iodine dose for Group A was 18.5 g,27％ less than that for Group B(25.9 g).The rate of iodine infusion for Group A was 3.5 g/s,also 27％ less than that for GroupB(18.5 g/s).Conclusions Myocardial perfusion imaging with dual-source dual-energy CT and contrast agents at low concentrations is a promising approach,which is capable of achieving quality imaging for the assessment of myocardial infarction with reduced use of iodine and represents a clinically valuable option.

Objective To observe the effects of health promotion on tumor recurrence,quality of life and self feeling evaluation of patients with superficial bladder carcinoma.Methods 104 patients with superficial bladder carcinoma treated in our hospital from March 2002 to March 2005 were divided to two groups randomly.The patients in one group were treated by bladder irrigation with Bacille Calmette Guerin (BCG)simply,and those in the other group were treated by bladder irrigation and health promotion.Tumor recurrence,quality of life and self feeling evaluation between the two groups were compared.Results All patients were foUowed up for 7.3-36.0 months(mean 28.5 months).17 patients(15/51)in the simple BCG irrigation group had tumor recurrence in 0-12 months(2 patients),13-24 months(6)and 25- 36months(9)respectively.The recurrence rate in the first year was 3.9%.in the second year 11.8% and in the third year 17.6%.Eleven(11/53)patients had in the BCG irrigation and health promotion group.in 0-12 months(2),13-24 months(7),and 25-36 months(2)respectively.The recurrence rate in the first year was 3.8%.in the second year 13.2%.and in the third year 3.8%.There were no significant differences in the recurrence rates of the first and second year between the two groups(P>0.05).but there was significant difieFence in the recurrence rate of the third year between the two group(Y2=5.29,P< 0.05).There were no significant difierences in self feeling SCL-90 evaluation and quality evaluation of life after the first discharging between the two groups(P>0.05).After 3-year follow up,the life quality of the patients in the BCG irrigation and health promotion group was improved obviously compared with the simple BCG group(X2=6.47,P<0.05),and the bad negative emotion was diminished obviously compared with the simple BCG group(P<0.05).Conclusion Health promotion after operation on the patients with superficial bladder carcinoma can decrease the long-term tumor recurrence rate obviously,and improve the quality of life and self feeling significantly.

Objective To investigate the prevalence of impaired glucose-insulin metabolism in obstructive sleep apnea hypopnea syndrome (OSAHS); to examine the relation between severity of OSAHS and impaired glucose metabolism; and to evaluate the effectiveness of continuous positive airway pressure (CPAP) on impaired glucose metabolism.Methods A total of 214 patients who were free of diabetes at baseline underwent both nocturnal polysomnography (PSG),and 2-h oral glucose-tolerance test,insulin and hemoglobin Alc test.CPAP treatment for glucose-insulin metabolism ( + ) was given to OSAHS group after informed consent had been obtained.Results Eighty-eight patients and 17 patients with impaired glucoseinsulin metabolism were found in OSAHS group and the control group respectively.Impaired glucose-insulin metabolism was present in 54.3% of OSAHS group and 32.7% of control group.Logistic regression analysis showed a significant positive correlation with OSAHS ( AHI ≥ 10 times/h ) and impaired glucose-insulin metabolism in all patients (OR = 2.440,95% CI 1.201-4.958 ).Plasma glucose level changes had no significant differences between before and after CPAP treatment (P ＞ 0.05 ).ConclusionOSAHS is associated with a high frequency of impaired glucose metabolism.The relationship between OSAHS and impaired glucose metabolism is independent of obesity.Longest apnea time (LAT) and AHI are important contributors to impaired glucose metabolism in OSAHS patients.Short-term CPAP therapy has no significant improvement on glucose metabolism in patients with OSAHS.

As a classic therapy for periampullary carcinoma,pancreaticoduodenectomy (PD) is still high-risk and technique demanding in abdominal surgery.Recently,the chance of performing PD for non-pancreatic surgeons is decreased because of specifying studies in abdominal surgery.While in clinical practice,some abdominal surgeons usually meet nonpancreatic diseases which PD is necessary,so the basic skills of PD is also very important for non-pancreatic abdominal surgeons.In this review,the skills of disclosing portal vein and superior mesenteric vein,prevention of abdominal bleeding and iatrogenic injury,treatment of postoperative pancreatic fistula,management of portal vein invasion,and the techniques of pancreatic uncinate process carcinoma resection were introduced.

BACKGROUND:Breast cancer stem cels are relatively special cels in the body, which have the self-renewal and multi-differentiation ability to promote tumor formation and development, and maintain tumor growth for a long-term. Therefore, it is of great significance to analyze the expression of resistance proteins of breast cancer stem cels.
OBJECTIVE:To isolate breast cancer stem cels from human breast cancer tissues, to observe their differentiation and morphology characteristics and to analyze their resistance proteins.
METHODS:Thirty tumor samples of breast invasive ductal carcinoma were selected to separate single cel suspension using mechanical separation method, and breast cancer stem cels and differentiated cels were sorted with two-step immunomagnetic bead method. Two-step immunocytochemistry method was used to detect the expression of resistance proteins in breast cancer stem cels.
RESULTS AND CONCLUSION:Percentage of breast cancer stem cels had no significant correlations with age, long diameter of the tumor, lymph node metastasis and histological grading (P > 0.05). P-gp and GST-π positive rates in the breast cancer stem cels were significantly higher than those in the differentiated cels (P < 0.05); while TopoII and LRP positive rates in the breast cancer stem cels were significantly lower than those in the differentiated cels (P < 0.05). To conclude, breast cancer stem cels show stronger drug resistance than the differentiated cels by highly expressing P-gp and GST-π and lowly expressing TopoII and LRP, which may be the key reason for chemotherapy resistance in breast cancer.

Objective:To observe the clinical efficacy of acupuncture treatment for depressive symptom in diarrhea-predominant irritable bowel syndrome (IBS-D). Methods: A total of 70 patients with IBS-D accompanied by depressive symptom were randomized into a control group and an observation group, with 35 cases in each group. The control group was treated with oral intake of pinaverium bromide tablets, and the observation group was treated with regulating liver and spleen acupuncture treatment. The two groups were treated for 4 weeks. The scores of IBS symptom severity scale (IBS-SSS) and self-rating depression scale (SDS) were assessed before and after treatment. Results: After treatment, there were statistical significant differences in the scores of abdominal pain degree, abdominal pain frequency and defecation satisfaction level and the total score between the two groups (all P＜0.05). The SDS score of the observation group was obviously decreased, and the improvement was significantly superior to that in the control group (P＜0.05). Conclusion: Acupuncture treatment can significantly improve gastrointestinal symptom and depressive symptom in patients with IBS-D.

?-Synuclein (?-SYN ) .previously identified as a breast cancer specific gene, has a wildly tumor expression profile mainly in advanced stage. As a special chaperone,?- SYN stimulates the proliferation and metastasis of tumor cells through interacting with estrogen receptor and (or) BubR1. Meanwhile, it is also detectable in the serum or urine from tumor patients, which indicates that?- SYN could be potential as a tumor marker for diagnosis and prognosis.

In traditional Chinese medicine,medical practice is combined with qi,which forms special qi-theory.Body fluid which includes blood and Jin-ye is the fluid structure of human being.Nutrient qi and defensive qi depend on these two kinds of body fluid.Defensive qi not only maintains physiological functions of Jin-ye,but also participates pathomechanism such as Jin-ye consumption,retention,etc.The identity of defensive qi and Jin-ye plays an important role in theory and clinic.