Objective To evaluate the influence of tirofiban on myocardial perfusion through percutaneous coronary intervention (PCI) and platelet activation in patients with acute myocardial infarction (AMI). Methods Eighty patients with acute myocardial infarction who underwent emergency PCI within 12 hours were randomly divided into 2 groups due to the random number table method: tirofiban group (40 patients) and control group (40 patients). The control group received conventional anticoagulant therapy (aspirin + low molecular weight heparin + clopidogrel). The tirofiban group additionally received intracoronary tirofiban hydrochloride injection of 10 μg/kg PCI during PCI, intravenous maintenance dose of 0. 15 after PCI 15 mins, the changes of platelet activation before and after treatment 7 days,the bleeding complications and major adverse cardiac events (MACE) within 30 days after PCI. Results The TMPG 3 perfusion percentage of tirofiban group (97.5% ,39/40) after PCI 15 minutes was significantly higher than that (80. 0%,32/40) of the control group( x2 = 4. 507,P ＜ 0. 05 ) ;The expression positive rate of platelet activation CD62P,CD63, MPA of the tirofiban group after treatment of 7 days were ( 1.7 ± 0. 7 ) %, ( 1.5 ± 0. 7 ) % and ( 11.7 ±3.8)% ,respectively,which were significantly lower than those of before treatment ([7.2 ± 2. 5]%, [6. 9 ±1.8]% and [22. 0 ± 7. 8] %, respectivley) and those of the control group after treatment of 7 days ( [2. 9 ±1.2]% ,[3.9 ±0.6]% and [16.2 ±4.2]% ,respectivley)(t =5.463,16. 468 and 5.025, Ps ＜0.01 );The incidence of cardiovascular events of the tirofiban group (0) was significantly lower than that of the control group ( 15.0%, 12/40 ) after treatment of 30 days ( x2 = 4. 504, P ＜ 0. 05 ); The incidence of bleeding complications was not significant between the 2 groups ( x2 = 0. 180, P ＞ 0. 05 ). Conclusion The application of tirofiban hydrochloride in intervention in acute myocardial infarction can improve myocardial perfusion, and further inhibiting platelet activation and reduce the incidence of major adverse cardiac events after PCI while does not increase the incidence of severe bleeding.

Objective To investigate the induction of L-forms of Yersinia pestis by enrofloxacin,in order to know more about the formation conditions and biological characteristics of L-form Yersinia pestis.Methods Yersinia pestisEV were cultured in Hiss agar media containing 0,0. 5,5,10,50,100,500 and 1 000 ng/mL enrofloxacin respectively. The cultures containing 50 ng/mL enrofloxacin was subcultured in Hiss agar media without enrofloxacin for reversion. The colonial morphology of each sample was observed. The bacterial morphology was observed by Gram staining and cell wall staining,while the cell wall integrity by transmission electron microscope. Yersinia pestis EV and L-form Yersinia pestis were identified by 16S rDNA,analyzed for the homology and the phylogenetic tree were constructed.Results Enrofloxacin 0. 5 ng/mL contained in Hiss agar media caused morphological changes of Yersinia pestis,from typical short-rod to long-rod shape. When the concentration of enrofloxacin was 50 ng/mL,the cell wall of Yersinia pestis was deficient,and the bacteria could not divide and proliferate normally,but showed long-rod shape and coiled into a mass,with the colonial morphology like fried eggs. Enrofloxacin-induced L-form Yersinia pestis reversed in normal Hiss agar media,and displayed a typical Yersinia pestis short-rod shape. 16S rDNA identification showed that the homology between the induced strain and the parent EV strain before induction was 100%.Conclusion Enrofloxacin can induce the L-forms of Yersinia pestis.

BACKGROUND:Compared with mesenchymal stem cells from bone marrow and fat, human umbilical cord-derived mesenchymal stem cells, as one of the most potential cellsources to repair the central nervous system, are easy-based, more primitive, and not limited by ethical and legal.
OBJECTIVE:To explore differentiation of human umbilical cord-derived mesenchymal stem cells into neural stem cells induced by the recombinant human basic fibroblast growth factor and recombinant human epidermal growth factor.
METHODS:The human umbilical cord-derived mesenchymal stem cells were induced by basic fibroblast growth factor and epidermal growth factor in vitro. The cellmorphology was observed by invert microscope. The differentiation status was detected by immunofluorescence. The Nestin expression in mRNA level before and after induction was detected by real-time PCR.
RESULTS AND CONCLUSION:The neural stem cellbal s were observed after induction. And the Nestin was detected by immunofluorescence and real-time PCR. Nestin could further differentiate to the neuronal markproteins neuron-specific enolase, microtubule-associated protein 2 protein and glial fibril ary acidic protein. Results from this study show that basic fibroblast growth factor and epidermal growth factor can induce human umbilical cord-derived mesenchymal stem cells to differentiate to neural stem cells, neurons and glial cells.

As a novel branch of combinational chemistry, dynamic combinatorial chemistry (DCC) can be viewed as a technique which combines library synthesis and screening in one pot. By addition of molecular target, ligangds, which show binding affinity or strong interaction with the molecular target, can be amplified an young but rapidly growing branch of combinatorial chemistry, has been widely used in organic chemistry, biochemistry, material fields. Ligands in the library can be amplified, since synthesis of the library is screened by a molecular target. Therefore, these structures could be identified easily. Consequently DCC has been widely used in the lead discovery, material chemistry and other fields. On the basis of the principle and method of DCC, this review emphasizes the three factors of DCC, including molecular targets (bio-enzyme, lectin, nucleic acid, organic molecule, inorganic molecule); reaction (disulphide chemistry, ammoniation reduction reaction, hydrazone chemistry, etc.) and analytical method. Meanwhile, limitation, current situation and future development of DCC were also discussed in this paper.

Objective:To explore the relationship among clinical manifestations ,SⅠ QⅢ TⅢ feature of ECG ,plasma level of D‐dimer (DD) and diagnosis of pulmonary embolism (PE) .Methods :Clinical data of 212 inpatients ,who received pulmonary CT angiography (CTA) in our hospital from Jun 2012 to May 2014 ,were retrospectively ana‐lyzed .According to pulmonary CTA results ,patients were divided into PE group (n=56) and non‐PE group (n=156) .Basic hospitalization data ,including clinical manifestations ,ECG features and plasma DD level ,were collect‐ed and compared between two groups .Results:Compared with non‐PE group ,there were significant rise in percent‐ages of dyspnea (44.87% vs .75% ) and prolonged bedridden time (3.85% vs .14.29% ) ,significant reduction in percentage of no clinical manifestations (38.46% vs .3.57% ) in PE group , P<0.01 all .Percentage of ECG SⅠQⅢTⅢ feature in PE group was significantly higher than that of non‐PE group (50% vs .23.08% ) , P<0.01. Compared with non‐PE group ,percentage of plasma DD>10μg/ml significantly rose (19.23% vs .32.14% ) in PE group ,P<0.05 .Conclusion:Patients with dyspnea and/or prolonged bedridden time ,that cannot be explained by other car‐diopulmonary diseases ,and SⅠ QⅢ TⅢ feature of ECG ;plasma DD level significant rising (> 10 μg/ml) should be considered to be PE .

The Longhua Zhang's internal medicine,the famous clinical inheritance of Chinese medical schools in Shanghai,was well-known by their expert skills and high medical ethics during 370 years.This paper introduces the family origin and its academic characteristic.By studying the Shanghai local chronicles and the Longhua Zhang's genealogy,we learn how they innovating and improving the school.

Objective To estimate the effect of berberine on the proliferation of and expressions of apoptosisrelated factors Bax and Bcl-2 in a human skin squamous cell carcinoma cell line A431.Methods A431 cells were cultured in vitro,and classified into various groups to be treated with berberine at different concentrations (12.5,25,5,100 mg/L) or cisplatin at 250 mg/L (positive control group) for different durations (12,24,48 and 72 hours).The A431 cells remaining untreated served as the negative control group.Subsequently,methyl thiazolyl tetrazolium (MTT) assay was performed to evaluate cell growth,and inverted microscopy to observe cell morphology.Real time quantitative reverse transcription-PCR and an immunofluorescence assay were conducted to measure the mRNA and protein expressions of Bax and Bcl-2 respectively.Statistical analysis was done by multi-way analysis of variance (ANOVA) using the software SPSS 13.0.Results MTr assay showed that berberine inhibited the growth of A431 cells,and the inhibitory effect increased with the increase in concentration (F =1118.312,P ＜ 0.001) and treatment duration (F =510.927,P ＜ 0.001) of berberine.Moreover,there was a significant interaction between the concentration and treatment duration of berberine (F =70.239,P ＜ 0.001).Inverted microscopy revealed that when the concentration of berberine increased,cell density was reduced,and cell morphology changed from polygonal to round with cell body shrinkage.The ratio of bax to Bcl-2 mRNA was elevated with the increase in treatment duration and concentration of berberine,and there were significant differences in the mRNA ratio among cells treated with berberine for different time durations at same concentrations (F =226.231,1300.636,4325.139 for berberine at 25,50 and 100 mg/L respectively,all P＜ 0.001).Immunofluorescence staining indicated that the fluorescence intensity of Bax was enhanced,while that of Bcl-2 was weakened after berberine treatment.Conclusions Berberine inhibits the growth of A431 cells in a dose-and timedependent manner,and may induce the apoptosis of A431 cells via regulating the expressions of Bax and Bcl-2.

Objective To assess the predictive value of neutrophil gelatinase associated protein lipocalin (uNGAL) in urine for detection of acute kidney injury(AKI) in patients with severe traumatic brain injury. Methods Patients with severe traumatic brain injury from the ICU were collected from Jan. 2011 to May. 2013 in our hospital. 43 cases that met the RIFLE criteria for diagnosis of AKI in the ICU within 7 days were selected as AKI group. Another 43 cases that were matched for age ,gender ,illness severity , surgery method with AKI cases ,selected as non‐AKI group. The levels of uNGAL and Scr were measured when the patients admit‐ted in the ICU with 15 min ,at 24 h ,48 h ,72 h. the sensitivity and specificity of uNGAL and Scr for diagnosis for AKI were evalua‐ted by ROC curve. Results The incidence of severe traumatic brain injury AKI was 42. 16% (43/102). The uNGAL levels in the AKI group were higher when the patient stayed in the ICU longer and no obvious in the non AKI group. When admitted to the ICU 24 h ,the level of uNGAL(720. 32 ± 684. 25)ng/mL in AKI group was significantly higher than that (421. 92 ± 351. 20)ng/mL in non AKI group. The difference was statistically significant (P< 0. 05). The levels of Scr between two groups were not statistically significant. The area under ROC curve of uNGAL and Scr were 0. 879 (95% CI :0. 807 - 0. 949) and 0. 612 (95% CI :0. 493 -0. 731). When the cutoff value of uNGAL was 180 ng/mL ,the sensitivity and specificity were 0. 890 and 0. 823 respectively. The sensitivity was superior to Scr. Conclusion uNGALis superior to Scr for early diagnosis of AKI in patients with severe traumatic brain injury and it could be used as a biomarker for early diagnosis of AKI.

Objective To study the perioperative treatment of breast carcinoma complicated with hyperthyroidism.Methods The perioperative treatment of 76 cases of breast carcinoma complicated with hyperthyroidism in the period of 26 years was retrospectively studied.Results Hyperthyroidism was treated by surgical methods or medical methods in perioperative period.73 cases didn't have any correlative postoperative complications related to hyperthyroidism,3 cases showed postoperative thyroid crisis or clinical signs similar to thyroid crisis,and no death happened.Conclusions For breast carcinoma complicated with hyperthyroidism,if clinical symptoms of hyperthyroidism are apparent,hyperthyroidism should be treated first by surgical methods,and then breast surgery can be considered until basal metabolic rate resumes normal.If clinical symptoms of hyperthyroidism aren't remarkable,breast surgery can be performed directly on the premise of heart control.

Objective To understand the differences of virulence genes and molecular typing in Campylobacterjejuni isolates from poultry products and diarrhea patients in Shenzhen.Methods According to specific primers,four virulence genes (cdtB,cadF,flaA,virB1 1 )of C.jejuni were detected by polymerase chain reaction (PCR).Molecular typing for C.jejuni strains was performed by Pulsed-field gel electrophoresis (PFGE).Results There were no differences of gene distribution (cdtB+,cadF+,virB1 1-)between isolates from poultry products and diarrhea patients.Two virulence genes of cdtB and cadF were found in all of ten C.jejuni strains lacking virB1 1 .The carriage rate of flaA in food-borne isolates (3/5 )was higher than those in patient isolates (2/5).In the PFGE map,the clustering analysis of C.jejuni strains showed that a total of 5 to 9 DNA bands were observed in ten strains through the digestion of Sam I.There was high homology (above 85%) between food-borne isolates and patients isolates,but the distribution of flaA in these highly homologous strains was differ-ent.Conclusion So far,C.jejuni strains with cdtB,cadF and flaA were present in Shenzhen,and showed high diversity and homology.This implies that the occurrence of diarrhea in patients with C.jejuni was associated with the contaminated poul-try products by this pathogen.Their findings can provide basic data and evidences about diarrheal disease caused by food-borne C.jejuni for the local region.