Objective To study the comprehensive quality of pre-hospital care of patients with acute coronary syndrome (ACS) in our country,and the factors affecting the efficiency of medical intervention of pre-hospital care.Methods An epidemiological investigation with target population-based cross-sectional study was carried out,and specifically designed questionnaire for determining the efficiency of pre-hospital care of patients with ACS was used to collect information of 272 patients from 13 emergency pre-hospital care centers.Results After analysis of the data from 13 majormedical centers,it could be classified into 4 patterns of pre-hospital care,namely directive pattern,pre-hospital pattern,dependent pattern and independent pattern.The results of analysis showed that the distance for ambulance driving in directive pattern was shorter than that in dependent pattern,but the call-response in directive pattern was quicker than that in pre-hospital pattern and dependent pattern,while the call-arrival time in directive pattern was longer than that in independent pattern and dependent pattern.The analysis of the on-site preliminary treatment in four patterns of pre-hospital care showed that there were differences in the establishment of intravenous access,aspirin,nitrate and ECG ( P ＜ 0.05 ).The total effective rate of pre-hospital care for ACS was 48％,while effective rate of independent pattern reached 70％.Factors affecting therapeutic effect on ACS resulting in better outcomes included pre-hospital pattern ( OR =4.097 ),directive pattern ( OR =5.158 ),and use of nitrate ( OR =3.045 ) and oral administration of medicine ( OR =8.215 ). Conclusions Independent pre-hospital pattern had the best therapeutic effect in the pre-hospital care of patients with ACS,and pre-hospital pattern had the best on-site preliminary disposal.Use of nitrate and oral administration of medicine showed the best benefit to the therapeutic effect.

Objective To investigate the inducing effects of selenium dioxide(SeO2 ) on the apoptosis in human cervical carcino-ma cell line Hela and its influence on the expression of apoptosis-related proteins caspase-3 and P53 .Methods Hela cells were trea-ted with different concentrations of SeO2 for 24 h in vitro ;the morphological changes of Hela cells were observed by the optical mi-croscope;the influence of SeO2 on the cell proliferation and vitality was examined by the MTT assay ;the flow cytometry was em-ployed to detect the cell apoptosis rate ;the expressions of caspase-3 and P53 proteins in Hela cells were determined by the Western blot analysis .Results Under the optical microscopy ,SeO2 generated the obvious influence on the cell growth morphology ,a large number of cells became rounded and shrunken ,and lost the normal form ,while the adherence cell number was evidently decreased and the proliferation was slowed down ;the MTT results showed that SeO2 markedly inhibited the cell proliferation and viability in a dose-dependent manner ,in which ,the cell apoptosis rates induced by the 0 ,1 .875 ,3 .750 ,7 .500 ,15 .000 and 30 .000 μmol/L con-centrations of SeO2 were 3 .12% ,30 .56% ,33 .42% ,37 .50% ,45 .43% and 69 .38% respectively ,which revealing the obviously in-creasing trend;the Western blot assay revealed that SeO2 could up-regulate the caspase-3 and P53 levels ,and reached the peak value at the concentration of 7 .500μmol/L .Conclusion SeO2 could induce the cervical cancer cell apoptosis possibly by up-regulating the expressions of caspase-3 and p53 in Hela cells .

Objective To study the differentially expressed microRNA (miRNA) between pancreatic ductal adenocarcinoma (PDAC) and para-cancerous tissues,and determine related target genes.Methods Nine fresh PDAC tumor tissues and 3 adjacent normal pancreatic tissues were collected,then Agilent miRNAmicroarray with 713 miRNA loci was used to identify the differentially expressed miRNA.Real-time PCR method was applied to verify the up-regulated miRNA.TargetScan 5.1 and miRandaV5 software were used to analyze the related target genes.Results miRNA microarray identified 11 PDAC related miRNAs,among them,the expressions of miR-194*,miR-192*,miR-602,miR-194 were up-regulated,while the expressions of miR-139-3p,miR-513a-5p,miR-630,miR-30c-1 *,miR-887,miR-508-5p,miR-516a-5p were down-regulated.The expressions of miR-192,miR-194 and their homolog were verified in 31 PDAC tumor tissues.After software analysis,it was found that target genes of miR-192 were ZEB2,CXCL-2,EEF1A1,ERCC3,and target genes of miR-192 * were DCC,SMAD4,FAS,and target genes of miR-194 included DACHI,IGSF11,PTPN2,RBBP4,while target genes of miR-194 * included CD40LG,CIDEB,FHL1.Conclusions Eleven differentially expressed miRNAs are present in PDC,and they may be involved in the occurrence and development of PDC.

Objective To investigate the risk factors for prognosis of severe acute pancreatitis (SAP).Methods The clinical data of 563 patients with acute pancreatitis (AP) treated from January 2008 to December 2014 were analyzed retrospectively.There were 334 patients with mild acute pancreatitis (MAP),and 198 patients with moderately severe acute pancreatitis (MSAP),and 31 patients with severe acute pancreatitis (SAP).Risk factors associated with MAP and MSAP + SAP group,MSAP and SAP group were determined by univariate logistic regression,and multivariate analysis was used to determine the risk factors for severity of AP.Results Univariate logistic regression analysis showed that age,WBC,serum glucose,calcium,urea nitrogen arterial partial pressure of oxygen (PaO2),SIRS,pleural effusion,peripancreatic fluid collection were associated with severity of AP in MAP and MSAP + SAP patients;age,serum calcium,PaO2,SIRS,pleural effusion,peripancreatic fluid collection were associated with severity of AP in MSAP and SAP patients.Multivariate logistic regression analysis showed that age,serum calcium,PaO2 and peripancreatic fluid collection were risk factor of MSAP and SAP;age,serum calcimm and SIRS were risk factors of SAP patients for persistent organ failure and pancreatic necrosis.Conclusions For elderly AP patients,measurement of arterial partial pressure of oxygen and serum calcium,peripancreatic fluid collection can help evaluate the severity of AP and early recognition.For SAP patients,the presence of SIRS,high serum urea nitrogen,and low serum calcium and peripancreatic fluid collection raise the concerns of persistent organ failure and pancreatic necrosis.

Objective To evaluate uterine cavity of the patients who accept the treatment in vitro fertilization‐embryo trans‐fer(IVF‐ET)and determine the clinical value of hysteroscopy for the patients .Methods Between January 2012 and May 2014 ,539 cases who accepted the IVF‐ET and hysteroscopy ,were divided into two grops ,group A(258 patients examinated before IVF‐ET cycle) and group B(281 patients after the IVF‐ET failure) ,and retrospective analysis was performed for their uterine cavity and cervix canal data .Results The total incidence of abnormal hysteroscopic findings was 49 .54% ,and group B was significantly high‐er than that in group A(54 .10% vs .44 .57% ,χ2 =4 .5 ;P=0 .043) .The percent of abnormal cervix canal was 18 .74% ,and there wasn′t significant difference between the two groups .Conclusion The incidence of abnormal hysteroscopic findings in IVF‐ET is higher than that in normal patients ,so hysteroscopy has an important clinical value for diagnosis and evalution ,especially for pa‐tients with failure of IVF‐ET .

There are a lot of feasibility studies, using sentinel lymph node biopsy SLNB instead of Alex lymph node dissection (ALND), having got a conseusus that SLNB is a safe and useful method in the treatment of breast cancer. But in clinical practice, there are much false negative rate (FNR) which need to be carefully dealt with for SLNB. In order to diminish the FNR, how many nodes should be the perfect number to lower the FNR? If positive detection was found in the SLN, should ALND always be needed? And when micro metastasis was found in the post operation HE staining? Does it need further treatment? We make a review to discuss those matters.

Objective To generate of human induced pluripotent stem cells from umbilical cord matrix cells(UMC).Methods Sox2 and Klf4 and Oct4 and c-Myc were transfected into UMC cells with retrovirus,and thcn UMC cells was reprogrammed to iPS cells.Gene expression was confirmed with RT -PCR and the integration was confirmed with cell karyotype.iPS cells were further validatcd with cell alkaline phosphatase detection and immunofluorescence staining,differentiating into teratomas in vivo and embryoid bodies in vitro.Results iPS cells were similar to embryonic stem cells (ES).The expression of Nanog,Oct4,Rex1 and Sox2 in iPS cells were higher than UMC cells,and Sox2,Klf4,Oct4,c-Myc silenced in iPS cells.Exogenous genes were inserted into the nucleus of iPS cells,which was confirmed by 1％ agarose gel electrophoresis.iPS ccll karyotype was normal,alkaline phosphatase activity increased,ES cell-specific proteins,including SSEA3,SSEA4,TRA-1-60,TRA-1-81 and Nanog,were expressed.iPS cells were differentiated into a teratoma in vivo and embryoid bodies in vitro.Conclusions iPS cells were similar to ES cells,which had pluripotency.

To study thyroid hormone receptor β(THRβ)gene mutation in a pituitary-resistance to thyroid hormone syndrome family. The peripheral blood samples of the patient, his sister, parents, and 4 maternal relatives were collected. Then serum was isolated for detecting thyroid hormone levels with chemiluminescence immunoassay, and DNA was extracted for PCR, and 10 exons of THRβ gene were sequenced. The patient and his mother had the hyperthyroid symptom for many years and his mother with atrial fibrillation. The G→A heterozygous transition mutation was confirmed by exon sequencing at nucleotide 949 within exon 9 of THRβ gene in the patient and his mother, which was a missense mutation causing a substitution of Alanine to Threonine(A317T). No mutation was found in THRβ gene in other family members. This is the first Chinese family reported with pituitary thyroid hormone resistance syndrome caused by a A317T mutation in the thyroid hormone receptor β gene.

ObjectiveGeneration of human induced pluripotent stem cells from human skin fibroblasts.MethodsSox2, Klf4, Oct4, c-Myc were transfected into HSF cells with retrovirus, and then HSF cells was reprogrammed to iPS cells.Detecting cells endogenous and exogenous gene, analyzing karyotype,cells alkaline phosphatase staining and immunofluorescence staining, differentiating into teratomas in vivo and embryoid bodies in vitro were performed.ResultsiPS cell morphology was similar to embryonic stem cells (ES).The expression of Nanog, Oct4, Rex1, Sox2 in iPS cells were higher than HSF cells, and Sox2, Klf4, Oct4, c-Myc were silenced for the iPS cells.Exogenous genes were inserted into the nucleus of iPS cells, which was confirmed by 1％ agarose gel electrophoresis.iPS cell karyotype was normal, alkaline phosphatase activity increased, ES cell-specific protein expressed.iPS cells were differentiated into a teratoma in vivo and embryoid bodies in vitro.ConclusionsiPS cells were similar to ES cells, which have pluripotency.

Objective To evaluate endoscopically insertion of feeding tube via nose(EIFTN). Method Jejunal feeding tube was placed endoscopically via the nose in all 136 coma patients. Results This procedure was successful in all patients. The procedure took an average time of 5 minutes. In patients with deep coma,the procedure had no influence on HR,MAP, ECG and SaO2; In semicoma patients, HR and R increased during the procedure (t=3.902, P