The best characterized methotrexate (MTX) transporter is the reduced folate carrier (RFC),whose gene polymorphism is one of the reasons causing MTX resistance. Based on the studies in rencent years,we have known that synthesis of mutant RFC or loss of RFC transcripts and proteins results in antifolate resistance due to incomplete inhibition of cellular enzyme targets and insufficient substrate for polyglutamate synthesis. So additional human RFC structural and mechanistic studies are absolutely essential. This paper summarizes an association between the polymorphisms of RFC and MTX resistance, which can provide a basis for clinical treatment.

The breast cancer stem cell theory provides a theoretical basis for explaining phenotypic and functional heterogeneity of breast cancer. These breast cancer stem cells(CSCs)promote tumor growth and are closely related to breast cancer intrinsic drug resistance. Therefore,targeted therapy of breast CSCs has become a hot area in basic and clinical research. There is growing evidence that nanoparticles can kill cancer by targeting breast CSCs ,such as targeted tumor stem cell-specific expressed surface markers(AL-DH1,CD44,and CD90),tumor stem cell stemness-related NOTCH,Hedgehog and TGF-βsignaling pathways. In this review,we summarized the characteristics and research status of breast CSCs ,and the application of nanotechnology in the treatment of breast cancer.In addition,we also summarized the research status of epigenetic drugs aimed to restrain the reprogramming of breast cancer cells.

Objective To investigate the effect of controlled intensive blood pressure reduction on acute cerebral hemorrhage.Methods Eighty-eight patients with acute cerebral hemorrhage were divided into controlled blood pressure reduction group (controlled group,48 cases) and general blood pressure reduction group(general group,40 cases) by random number table method.Respectively given positive blood pressure reduction and according to the guidelines for treatment.The intracranial hematoma volume after admission,Glasgow coma scale (GCS) score,the United States national institutes of health stroke scale (NIHSS) score,surgery rate within 24 h after admission and fatality rate within 30 d after admission in two groups were compared.Results The initial blood loss between two groups had no significant difference(P ＞0.05).The intracranial hematoma volume,growth rate of intracranial hematoma,intracranial hematoma enlargement ratio in controlled group on 24 h after admission were lower than those in general group,there were significant differences [(19.3 ± 11.6) ml vs.(30.5 ± 10.9) ml,(17.8 ± 12.7)％ vs.(37.1 ±25.7)％,16.7％ (8/48) vs.47.5％ (19/40)] (P ＜ 0.05 or ＜ 0.01).The GCS and NIHSS score between two groups on admission and 1,7,14 d after admission had no significant difference(P ＞ 0.05).The surgery rate within 24 h after admission in controlled group was lower than that in general group [8.3％ (4/48) vs.25.0％ (10/40)],there was significant difference (P ＜ 0.01).The fatality rate within 30 d after admission between two groups had no significant difference (P ＞ 0.05).Conclusion Cerebral hemorrhage early control of blood pressure can not change its recent neural functional recovery and reduce the fatality rate,but may be significantly delayed hematoma enlargement and reduce the rate of surgery.

Objective To investigate a sonic wave device including micro-oscillator and microphone for real-time monitoring the situation of the esophageal motility of lower esophageal sphincter (LES). Methods A micro-oscillator that can actively send sound waves was located at one side of LES, and a microphone located at the other side can be to capture the sound generated from the oscillator. This device was tested in vitro by utilizing a LES simulator in quiet and noisy environment, as well as in vivo in a pilot model corresponding to moments A-D. Results In the in vitro test, the sound can be captured by the microphone, and its power strength was correlated with closing and opening of LES. The measurements showed statistically significant Pearson correlation coefficients. In the in vivo test, the LES was open and closed by an endoscope, which was monitored in real-time by another endoscope inserted into the distal stomach from the duodenum. The sound power strength corresponding to moments A-D were (-89.63 ± 0.79) dB, (-84.74 ± 0.97) dB, (-82.37 ± 1.93) dB and (-89.86 ± 0.75) dB. Conclusion The LES dynamics can be monitored by the acoustic interrogation device, which has the potential to become an effective minimally-invasive technique for studying LES dysfunction.

Objective To perform the research on the domestic hospital marketing. Methods Through deep discussion,data analysis and marketing survey,we conducted a research on the market positioning and marketing strategies for Shanghai Ruijin-Harvard Heart Center which is a Sino-foreign joint venture. Results The demand is much bigger than the current supply in the market for cardiovascular diseases.The establishment of the center meets the demands of the market. Conclusion The center will focus on the adult patients in Shanghai and Yangtze Delta,and combine the external,internal and interactive marketing strategies.It may provide some useful experience for the Chinese hospital management,especially for hospital marketing.

Objective To investigate the value of transvaginal ultrasound in the diagnosis of endometrial polyps. Methods One hundred and ten patients diagnosed as endometrial polyps by transvaginal ultrasound and undergone operative hysteroscopy and histologic examination, were analyzed retrospectively.Results Among 110 cases 75 cases (68.2%) were accurately diagnosed by transvaginal ultrasound,while 35 cases (31.8%) were misdiagnosed.The diseases misdiagnosed included endometrium hyperplasia,intrauterine adhesions and submucousmyoma.Conclusions Combining clinical symptoms with ultrasonogram characters and optimal time of detection can reduce the misdiagnostic rate of endometrial polyps.

With the rapid growth of incidence of non-small cell lung cancer (NSCLC),more and more studies have been made about its occurrence,development and metastatic mechanism m recent years.Researches about Fas/FasL protein expression and Fas/FasL-mediated apoptosis,immune escape mechanism and their roles in the pathogenesis,progression and prognosis of lung cancer are constantly emerging.Discussion about the roles of Fas/ FasL system in NSCLC could provide evidence for early diagnosis,prognosis prediction and new treatment of NSCLC.

Objective To compare expression and distribution of CD68 protein and TRAP positive protein in ankylosing spondylitis (AS), rheumatoid arthritis (RA), osteoarthritis (OA), and normal synovial tissues to study the differentiation of osteoclast in synovial tissues obtained from AS patients and its role in the pathogenesis of bone destruction in AS. Methods Immunohistochemical analysis was performed using CD68 monoclonal antibody to detect CD68 expression, and the distribution of TRAP positive cells in the synovial tissues was examined by enzyme histochemistry in 13 AS, 16 RA, 17 OA patients and 6 healthy controls. The above two variables were quantified in the labeled sections by digital image analysis and semiquantitative analysis to compare the expression of CD68 positive cells in different patient groups and normal subjects. Results Positive CD68 staining was seen in synovial cells from all the patients with AS, RA, OA and normal subjects, and the expression levels of CD68 from patients with AS and RA were higher than those from OA patients and healthy subjects. The CD68 positive cells were abundant mainly in lining layer. In areas where elevated RANKL expression levels were present, the number of TRAP positive cells was found significantly increased in AS and RA synovium. TRAP positive cells were rarely observed in synovium from OA patients and normal controls. There was positive correlation between the number of TRAP positive cells and the RANKL expression (r=0.442, P=0.043) in RA patients. Conclusions An obvious increase in the number of CD68 positive cells and TRAP positive cells in synovium may provide a main source of osteoclastogenesis in AS patients. The up-regulation of activity and quantity of osteoclast may have an important role in peripheral articular destruction in patients with AS.

Objective To evaluate the value of clinical application of the three dimensional (3D) and multiplanar reconstruction (MPR) with multislice spiral CT(MSCT) in skull and maxillofacial fracture. Methods Twenty patients with skull and maxillofacial fracture were examined with MSCT, then MPR and three-dimensional surface shaded display (3D-SSD) were performed in work-station. Results MSCT MPR imaging clearly showed all fractures in 20 patients, and were more accurate than 3D-SSD in displaying tiny fracture and fracture of deep structure. 3D-SSD imaging could stereoscopically and directly show the fracture location, type, range, the course of irregular fracture line and fragment displacement. Conclusion MSCT MPR imaging in combination with 3D imaging is of high value in diagnosis and treatment of skull and maxillofacial fracture.

Objective To study the expressions of MCM5 and Ki67 in cervical intraepithelial neoplasia (CIN) and cervical cancer and their clinical significance. Methods Immunohistochemistry (S-P method) was used to detect the expressions of MCM5 and Ki67 in 50 CIN and 49 cervical cancer. Results The positive expression rate of MCM5 and Ki67 in normal cervical epithelium, CIN Ⅰ-Ⅱ, CIN Ⅲ and cervical cancer were 26.7%, 72.0%, 80.0%, 97.9% and 10.0%, 32.4%, 84.0%, 97.9% respectively. The positive expression rate of MCM5 was significantly different between CIN and cervical cancer (P