Objective To explore the mechanism of the reversal of breast cancer resistant protein-mediated multidrug resistance by 17?-estradiol. Methods Two BCRP expressing cell lines of MCF-7/MX20 and MCF-7/BCRP were established in which breast canrcer resistant protein(BCRP) was promoted by BCRP promoter and cytomegalovirus(CMV) promoter respectively.These drug resistant cell lines were cultured in medium containing 17?-estradiol.Fourty-eight hours later,cytotoxicity assay,mitoxantrone efflux assays,quantitative RT-PCR were performed to observe the reversal function of BCRP by 17?-estradiol on MCF-7/MX20 and MCF-7/BCRP respectively. Results After being treated with 17?-estradiol,the intensity of mitoxantrone in MCF-7/BCRP was weaker than that in MCF-7/MX20 and the BCRP mRNA level in MCF-7/BCRP was high than that in MCF-7/MX20.The results of these experiments revealed that 17?-estradiol could reverse the BCRP mediated multidrug resistance(MDR) in MCF-7/MX20 cells but not in MCF-7/BCRP ones.Conclusion 17?-estradiol may reverse the phenotype of BCRP through regulation of the promoter of BCRP gene but not acted as the substrate of BCRP.

Objective To investigate the clinicopathologic and immunohistochemical features of gastric stromal tumors.Methods A total of 105 cases with gastric stromal tumors were included in the study.The expression of cluster of differentiation 117 (CD117),cluster of differ entiation 34 (CD34),smooth muscle actin (SMA),S-100 protein and Ki-67 in gastric stromal tumors specimens was detected by immunohistochemistry.The clinico-pathologic features of gastric stromal tumors were also analyzed.Results Of 105 gastric stromal tumors specimens,90 were positive for CD117 [85.7 ％ (90/105)],98 positive for CD34 [93.3 ％ (98/105)],21 positive for SMA [20.4 ％ (21/105)],60 positive for Ki-67 [56.1％ (60/105)],13 positive for S-100 [12.4 ％ (13/105)].Conclusion Combined detection of CD117 and CD34 can improve the diagnostic accuracy of gastric stromal tumors.The expression of Ki-67 can be used as a prognostic parameter for gastric stromal tumors as it is correlated with tumor size,risk and mitotic.

Objective To observe the long term results of intertrochanteric varus medial displacement osteotomy(IVMDO) for Perthes disease. Methods Thirty eight patients with Perthes disease treated with IVMDO were reviewed. The results were evaluated based on a criteria made by the authors including clinical and radiographic parameters. The duration of follow up ranged from 3 to 15 years, with an average of 7 years. Results Fifteen patients were evaluated as having excellent result, 17 good, 3 fair and 3 poor respectively. The overall excellent or good rate was 84.2%. Considering the relationship between the outcome and staging of the disease, the overall excellent or good rate was 94.7% in stage Ⅱ lesion, 85.7%in stage Ⅲ lesion, and 40.0% in stage Ⅳ lesion. Conclusion The treatment of Perthes disease with IVMDO has the advantages of simple manipulation, less trauma and good results, and is worthy of populariztion.

Purpose To study the effect and mechanism of miR-199a-5p on the invasion of breast cancer MDA-MB-231 cells. Meth-ods miR-199a-5p mimic was transfected into MDA-MB-231 cells. Influence of miR-199a-5p on the invasion of MDA-MB-231 cell was displayed by Transwell, the expression of epithelial-mesenchymal transition ( EMT) molecular markers ( E-cadherin, vimentin) regulated by miR-199a-5p was determined using immunofluorescence and Western blot. Western blot was employed to assess the levels of ERK5, pERK5, EGF and SP1 in MDA-MB-231 cells dealt with miR-199a-5p mimic and LNA-siRNA. Chromatin immunoprecipita-tion (CHIP) was applied for displaying the reaction of SP1 with ERK5 promoter. Results miR-199a-5p could inhibit the invasion of MDA-MB-231 cells, decrease the expression of vimentin and enhance E-cadherin. Meanwhile, miR-199a-5p decreased the expression of ERK5 and pERK5, the levels of EGF and SP1 were also downregulated. On the contrary, the levels of EGF, SP1, ERK5 and pERK5 were enhanced by employing LNA-siRNA targeting miR-199a-5p. SP1 could bind with ERK5 promoter. Conclusions miR-199a-5p could reduce the expression of ERK5 and pERK5 through regulating EGF and SP1, which functioning the inhibitory effect on invasion of MDA-MB-231 breast cancer cells.

Infected pancreatic necrosis (IPN) is a serious complication which may cause organ failure and death in patients with acute pancreatitis. Surgical debridement is an important therapeutic approach for IPN. With the development of evidence-based medicine, more and more high-level evidences emerge for surgical debridement of pancreatic necrosis tissue, and the traditional treatment strategy has also changed. In the era of minimally invasive surgery, whether 'delayed surgery' should still be executed and how to achieve 'delayed surgery' are the research hotspots in the treatment of IPN. Research evidences reveal that the 'step-up' strategy is not the best strategy for all IPN patients, and alternatives should be explored. In addition, the indications, advantages and disadvantages of open surgery, surgical minimally invasive surgery and endoscopic surgical debridement of pancreatic necrosis tissue have been widely discussed in recent years, and no consensus has yet been reached. At present, the personalized, multidisciplinary, and minimally invasive treatment of IPN is still the mainstream development direction. The authors investigate the timing and strategy of surgical treatment for IPN in order to provide theoretical basis for clinical practice.

Objective To explore the surgical indication, the operative procedure and effect of breast-conserving surgery plus combined treatment for the patients with early breast cancer. Methods 51 patients with early breast cancer were treated with breast-conserving surgery (BCS) plus radiotherapy, chemotherapy and hormonotherapy postoperatively. The result of breast-conserving group was compared with 56 patients treated by modified radical mastectomy (control group). Results 25 patients underwent quadrant resection plus axillary lymph node dissection (ALND), 15 patients were subjected to local resection plus ALND, and 11 patients received quadrant resection only. All patients were followed-up for an average of 16.9 months. In BCS group, one patient was found to have local recurrence, and the distant metastasis rate was 0%. In the control group, no patient had local recurrence and the distant metastasis rate was 3.6%. The operative complication rate in BCS group and control group was 13.7% and 33.9% respectively (p﹤0.05). Conclusion Breast-conserving surgery plus combined treatment is safe and satisfactory for early breast cancer. It can be considered as the first choice for the treatment of patients with breast cancer in early stage.

Objective To explore the effectiveness of the timed up and go test (TUGT) and the maximum walking speed test (MWST) in evaluating stroke patients' motor function.Methods Twenty-two stroke patients were assessed using the TUGT and MWST,and the temporal-spatial parameters of their gait were also assessed.The correlations among the TUGT times,walking speed and the gait parameters were quantified using Pearson correlation coefficients.Results The TUGT time was (18.57±7.41) s,significantly correlated with step length and velocity (P＜0.05).Walking speed showed a significant positive correlation with step length,velocity and step length (P＜ 0.05).The TUGT times were negatively correlated with walking speed (r=-0.712,P=0.000).Conclusion The MWST and TUGT both can assess stroke patients' motor function effectively.

Objective To analyze the survival rates of gastrointestinal stromal tumors (GISTs),and the influence of surgical treatment and imatinib to the survival times.Methods The clinical data of 132 patients with GIST who were admitted to Peoples Liberation Army Hospital from January 2003 to December 2013 were retrospectively analyzed.Results All the patients were followed up with a median time of 22 months (1-83 months).The survival rates of 1-year,3-year,5-year were 99 ％,96 ％,92 ％ in this study.The tumor located at cardiac part,fundus of stomach,greater curvature,lesser curvature and pylorus part was 19 cases (14.4 ％),34 cases (25.8 ％),38 cases (28.8 ％),38 cases (28.8 ％) and 3 cases (2.3 ％),respectively.The positive rates of CD117,CD34 and Ki-67 was 116 cases (87.9 ％),119 cases (90.2 ％),51 cases (38.6 ％).According to Fletcher risk classification,the patients of high-low risk,low risk,intermediate risk,and high risk were 10 cases (7.6 ％),34 cases (25.8 ％),14 cases (10.6 ％),and 74 cases (56.1％),respectively.The differences of survive rates in the different excision method and imatinib treatment had statistics significance (P =0.000).The differences of survive rates in Fletcher risk classification had statistics significance (P =0.028).However,the differences of survive rates in location of gastric GIST showed no significant difference (P ＞ 0.05).Conclusions GIST in different parts of gastric have not obviously different survival rates,respectively.The total resection and imatinib treatment could raise the survival rates of patients with GIST.

Objective:The feasibility of a minimally invasive cosmetic transbilical laparotomy was studied in fifty-seven pediatric patients.The advantages of this technique will be discussed.Methods:The circumferential incision was made following the ring fold of the right umblilicus,which was less than 2700.The peritoneum was opened in the midline via rectus abdominis.Intra-peritoneal lesions were detected and explored.The surgical procedures were able to be carried out either inside or outside of the peritoneum.After closure of peritoneum,the umbilical incision was closed subcutaneously with an absorbable suture.Results:From January 2001 to January 2005,58 procedures via transumbilical route have been done in 57 pediatric patients.None of those cases required conversion to a traditional abdominal incision.The duration of surgery was from 20 to 170 minutes.All patients were discharged five days postoperatively and follow-up was conducted from 3 months to 4 years.No complications were observed in all but one patient.This patient had a leaking anastamosis.No visible scars were present and the cosmetic results were excellent.All patients had shorter hospital stay and lower operating cost.Conclusion:Transumbilical approach is a feasible,safe,economical,minimally invasive procedure with excellent cosmetic results which appears to be superior to traditional procedures.It suggests that the transumbilical route should be widely used clinically and might be applicable for elder children and possibly would be of benefit in the treatment of other conditions.

Aim To explore the relationship between Snail and P-gp in breast cancer cell,and to reveal the effect of epithelial-mesenchymal transformation(EMT)on the multidrug-resistance(MDR)of breast cancer cell.Methods The eukaryotic expression vector pCDNA3.1-Snail was constructed, and then transfected into human breast cancer cell line MCF-7 to constuct MCF-7/Snail.Both cell lines MCF-7 and MCF-7/Snail were induced by adriamycin(ADM).Cell cytotoxicity assay and ADM efflux assay were used to measure the ability of drug resistance.The positive rate of P-gp of the two cell lines was detected by flow cytometry;the mRNA of MDR1 and Snail was evaluated by real-time PCR.Results MCF-7,the expression of MDR1 mRNA and Snail mRNA in MCF-7/Snail cell lines significantly increased;the expression of P-gp was increased too;the RR increased to 109.2;fluorescence intensity intracellular was reduced to 7.1.Conclusion After transfected the eukaryotic expression vector,the capacity of MCF-7/Snail strongly increases compared with that of MCF-7.