Pathologist Dixit in American Michigan University found a gene induced by cytokine from human umbilical vein endothelial cells in 1990.This gene is increased in a variety of cells rapidly and coded a special kind of the zinc finger protein when being stimulated by interleukin-1 (IL-1),PLS and tumor necrosis factor (TNF).The gene was named as zinc finger protein A20 gene,and its coding protein was named as zinc finger protein A20.A20 is a kind of endogenous regulatory protein,inhibiting the inflammatory reaction and cell apoptosis through the inhibition of NF-kappa B activity.This article mainly reviewed the structure,function and clinical significance of A20.

In the light of mathematical maximum likily hood method, the conditioned probability of clinical manifestations in TCM syndrome of asthenic heart qi - and blood and control group were calculated to establish a " List of Quantitative Diagnostic Index of TCM Manifestations Differentiation for Qi and Blood in Heart Disease". Based on the scoring of the above list, the rate of coincidence of retro - spective test of the three signs were 92. 70%, 93. 20%, 94. 98% respectively, and that of prospective test were 84. 61%, 81.82%, 87. 50% respectively. Authors' address: Institute of diagnostics, Hunan College of TCM, Changsha, Hunan 410027

Objective Transesophageal Doppler monitoring ( TDM) has been widely applied to fluid therapy in some major op-erations but rarely used in aortic valve replacement.The purpose of this study was to assess the value of TDM in fluid therapy, vasoactive drugs use, and left ventricular function in patients undergoing aorta valve replacement after cardiopulmonary bypass. Methods This study included 40 patients undergoing aotic valve replacement after cardiopulmonary bypass in Anhui Provincial Hospital from March 2014 to June 2015, which were randomly assigned to a TDM and a control group of equal number.TDM was used for the guidance of fluid infu-sion and vasoactive drug administration for the patients in the former group, while central venous pressure, mean arterial pressure, and heart rate were employed for those in the latter.The fluid volume infused, urine volume, blood loss, hemodynamics, arterial blood lac-tate, and outcomes were compared between the two groups. Results Compared with the control, the TDM group showed significantly increases in the colloidal fluid volume ([303 ±60] vs [373 ±65]mL, P<0.05), crystal fluid volume ([533 ±87] vs [596 ±83]mL, P<0.05), and urine volume ([274 ±95] vs [338 ±84]mL, P<0.05), but remarkable decreases in the red blood cell count, blood plasma vol-ume, postoperative extubation time, doses of dopamine and dobu-tamine, and length of hospital stay (all P<0.05).The hemodynamics were more stable and arterial blood lactate was lower in the TDM group than in the control (P<0.05). Conclusio n Transesophageal Doppler monitoring can timely and exactly manifest the hemodynamic changes and left ventricular function of the patient undergoing aotic valve replacement and provide precise guidance for fluid therapy and vasoactive drug administration.

Objective To explore the effects of Shenfu injection combined with low-dose hydrocortisone on plasma lev?els of human leukocyte antigen (HLA)-DR and procalcitonin (PCT) in patients with septic multiple organ dysfunction syn?drome. Methods A total of 118 patients with septic multiple organ dysfunction syndrome were divided into three groups:control group (n=39), experimental group 1 (n=39) and experimental group 2 (n=40). The control group received conventioanl medicine therapy, while the experimental group 1 received Shenfu injection (100 mL, 2/d, for 7 d) combined with conventio?anl medicine therapy, and the experimental group 2 received Shenfu injection combined with low-dose hydrocortisone (200 mg/d, for 14 d) besides conventional medicine therapy. The peripheral blood samples were collected for the detection of HLA-DR, PCT and lipoperoxide (LPO) before treatment, 1 d, 3 d amd 7 d after treatment. The mortality in 14 d was record?ed. Results The mortality rates in 14 d were 61.5%(24/39), 41.0%(16/39) and 25.0%(10/40) for control group, experimen?tal group 1 and experimental group 2 (χ2=8.15, P<0.05). There were no significant differences in PCT, HLA-DR and LPO levels before treatment and 1 d after treatment between the three groups (P>0.05). The plasma levels of PCT and LPO were significantly decreased in control group, experimental group 1 and experimental group 2 after 3-d and 7-d treatment, but the levels of HLA-DR was significantly increased (P < 0.05). Conclusion The combination therapy of Shenfu injection and low-dose hydrocortisone can effectively reduce PCT level and increase HLA-DR level, which promotes the improve?ment of patients with septic multiple organ dysfunction syndrome.

Aim To study the effects of Quercetin on the angioge ne sis and cultured human vascular endothelial cells (HUVEC).Methods In vivo, the effects of Quercetin on angiogenesis induced by vascular en dothelial growth factor (VEGF) and basic fibroblast growth factor(bFGF), were observ ed by chorioallantioic membrane (CAM) test. The effects of quercetin on proliferation of human vascular endothelial cells (HUVEC) were assessed by MTT assay. The effects of Quercetin on cell cycle of HUCEC were observed by flow cytometer (FCM ).Results The angiogenesis induced by VEGF in CAM was strongly inhibited by Quercetin with 0.1, 0.05 and 0.025 mmol?L -1; The angiogen esis induced by bFGF in CAM. was strongly inhibited by Quercetin with 0.1 and 0 .05 mmol?L -1. Quercetin markedly inhibited the proliferation of HUVEC with 240,120,60 and 30 ?mol?L -1. The inhibition rate was 67.0%,58.1% ,39.7% and 20.7% respectively. Quercetin at the concentration of 240 ?mol? L -1 and 120 ?mol?L -1 resulted in S,G 2 arrest of HUVEC. Conclusion Quercetin has substantial inhibitory effects on angiogenesi s induced by VEGF and bFGF, and on proliferation of HUVEC.

AIM: To study the effects of insulin and glucose on tissue-type plamingen activator (tPA) and its inhibitor-1 (PAI-1) secretion in cultured human endothelial cells. METHODS: Human endothelial cell line ECV-304 was cultured with glucose and/or insulin at different concentrations with or without hypoxic exposure. RESULTS: The tPA, PAI-1 secretion and ratio of tPA/PAI-1 increased in endothelial cells during hypoxia. Insulin and glucose increased the tPA and PAI-1 secretion in endothelial cells exposed to hypoxia, and increase in tPA/PAI-1 ratio was also observed at 4 h and 8 h. CONCLUSION: Hypoxia stimulates the release of tPA and PAI-1. Insulin and glucose also stimulate the tPA and PAI-1 secretion during hypoxia.

Objective To explore the efficiency of temporary cardiac pacing on the acute poisoning patients with serious bradycardia.Methods Thirty-eight cases of the acute poisoning patients with serious bradycardia were treated randomly with temporary cardiac pacing (pacing group, 18 cases) and drug therapy (control group,20 cases) and followed with treatment for poisoning. Results Right ventricular pacing were successfully performed in 18 cases and the temporary cardiac pacemaker were placed. With the further treatment of poisoning, in the pacing group, the efficiency of anit-bradycardia and the poisoning cure rate was 100% and 88. 9% , respectively, whereas being 60% and 65.0% in the control group, respectively. The efficiency of anit-bradycardia and the poisoning cure rate were significantly different between the two groups (P < 0.01 or P < 0.05 ). Conclusions The treatment of temporary cardiac pacing has effect on the acute poisoning patients with serious bradycardi. It can effectively improve the rate of patients' resuscitation.

The medical records of all 12 patients diagnosed as chronic active Epstein-Barr virus (CAEBV) infection at our hospital were analyzed retrospectively.There were 7 males and 5 females with a median onset age of 28 years.CAEBV was characterized by fever,splenomegaly,hepatomegaly and lymphadenopathy,etc.The abnormalities of laboratory examination included liver dysfunction,thrombocytopenia,anemia and leucopenia.EBV-DNA detected by real-time polymerase chain reaction was (1.7 × 103-3.5 × 107) copies/μg DNA in peripheral blood mononuclear cell.Among them,the outcomes were death (n =5),lost to follow-up (n =2) and T cell lymphoma (n =1).It is necessary to improve our awareness of CAEBV infection because of its poor prognosis and high mortality.

Objective To explore the applied value of thyroid imaging reporting and data system (TI-RADS) strati?fication in diagnosing thyroid nodules in patients with different ages.Methods A total of 527 patients with thyroid nod?ules (aged 26-65) were divided into four groups:aged 26-35 group, aged 36-45 group, aged 46-55 group and aged 56-65 group. TI-RADS was used to evaluate patients in four groups. The results of TI-RADS were compared with the pathologic di?agnostic analysis. Results For the low aged groups (aged 26-35 group and aged 36-45 group), the positive predictive val?ue, the negative predictive value and accuracy rate were more than 90%. With regard to the patients aged 46-55, the positive and negative predictive values and accuracy rate were 81.5%, 87.5%, and 81.9%, respectively. The positive and negative predictive values, accuracy rate were 76.6%,88.8%and 77.9%for patients aged 56-65 group. The diagnostic rate of TI-RADS in patients with thyroid lesions was lower in aged 56-65 group than that of other groups. Conclusion TI-RADS method is affected by age. The diagnostic rate is lower in the high age group than that of the low age group.

Objective To explore the relationship of molecular biology characteristic and the treatment outcome,and influence factors of neoadjuvant chemotherapy (NAC) in inflammatory breast cancer (IBC).Methods The clinicopathological data of 103 IBC patients who were treated with NAC from January 2005 to June 2013 were analyzed retrospectively.Immunohistochemical method was used to detect the expression of estrogen receptor (ER),progesteron receptor (PR),human epidermal growth factor receptor 2 (HER-2) and E-cadherin.The treatment outcome were evaluated.Results In 103 IBC patients,ER negative was 48 patients,PR negative was 51 patients,HER-2 positive was 45 patients,E-cadherin positive was 66 patients.The effective rate of chemotherapy was 72.8％ (75/103).The effective rate of chemotherapy in taxane-based group was significantly higher than that in anthracycline-based group [80.6％ (50/62) vs.61.0％(25/41)],and there was significant difference (P ＜ 0.05).The effective rate of chemotherapy in ER,PR,E-cadherin negative patients was significantly higher than that in ER,PR,E-cadherin positive patients [83.3％ (40/48) vs.63.6％ (35/55),82.4％ (42/51) vs.63.5％ (33/52),83.8％ (31/37) vs.66.7％ (44/66)],and there was significant difference (P ＜ 0.05).The effective rate of chemotherapy in taxane-based group with E-cadherin positive patients was significantly higher than that in anthracycline-based group with E-cadherin positive patients [77.5％ (31/40) vs.50.0％ (13/26)] (P ＜0.05).No correlation existed between the expression of HER-2 and the treatment outcome of chemotherapy (P ＞ 0.05).Conclusion ER,PR and E-cadherin negative patients with IBC is chemosensitive to NAC.The positive expression of E-cadherin may be an important factor of chemotherapy resistance.For the patients with E-cadherin positive,taxane-based chemotherapy regimen can achieve a better effective rate.