Intrinsic or acquired chemo-resistance is the main reason for chemotherapy failure, and thus finding ways to reverse chemo-resistance has become an interesting topic for research. Studies have revealed that immunomodulatory molecules are involved in cancer chemo-resistance. Hence, interventions that target immunomodulatory molecules to reverse chemo-resistance have attracted a great deal of concern from domestic and foreign scholars. Immunomodulatory molecules, such as PD-L1, B7-H3, HMGB1, TRAIL, MyD88, and Cytokines (TNF-α, IFN-α, IL-6), have been proven to take part in regulating immune function and tumor drug-resistance characteristics, thereby providing new ideas to the reversal of tumor chemo-resistance. This artide reviews the progression of immuno-modulatory molecules with the change in cancer chemotherapy sensitivity to provide a theoretical basis for the application of new thera-peutic regimen of bio-chemotherapy.

Objective To compare prognosis of esophageal cancer patients with simple radiation or chemoradiotherapy.Methods Retrospective analysis 266 cases of esophageal cancer patients from June 2005 to June 2007 of,including 128 with simple radiotherapy,138 with chemotherapy during the same period,157 cases of general radiotherapy,intensity-modulated radiotherapy,109 cases of Kaplan-Meier method for calculation of survival,Log-Rank method on the clinical factors of single factor analysis,Cox regression model with factor analysis.Two groups,clinical material and adverse reaction were compared with chi-square test.Results The median survival time of the radiation group was 25 months,chemoradiotherapy group of the median survival time was 28 months.Follow-up with 1,3,5 years were 231,106,82 cases.The 1,3,4 years OS rate were 86.8 ％ (200/231),12.8 ％ (14/106),9.0 ％ (7/82).Disease-free survival (DFS) rates were 39.8 ％ (92/231),7.9 ％ (8/106),15.8 ％ (13/82).No local relapse survival (LRFS) rates were 30.8 ％ (71/231),16.2 ％ (17/106),23.7 ％ (19/82).No distant metastasis (DMFS) survival rates were 47.0 ％ (109/231),11.3 ％ (12/106),13.9 ％ (11/82).Single factor analysis results show that age,disease length,X-ray parting,different radiation method were 5 years OS independent prognostic factors.Age,disease length were DFS independent prognostic factors.Lesion length,different radiation method were LRFS independent prognostic factors for survival,lesion length and X-ray parting were without distant metastases independent prognostic factors for survival.Multiple factors analysis results showed that age,disease length,pathological type were 5 years OS related factors,and age,disease length,different treatment methods were DFS related factors,only lesions length was DMFS related factors,lesion length,different chemotherapy method was DMFS related factors of survival.The rate of serious adverse reaction of the chemoradiotherapy group was higher than radiotherapy group,the difference had statistical significance.Conclusion The chemoradiotherapy increase DFS rate,and at the same time,the incidence of adverse reaction also increases,but 5 years OS rate doesn't increased obviously.

Objective To investigate the influence of deoxyschizandrin (Deo) on P-glycoprotein (P-gp).Methods The effect of P-gp on Deo (20,40,80 μg·mL-1) was studied in the Caco-2 cell model in vitro,and the apparent permeability coefficient (Papp) of Deo (20-160 μg·mL-1) on a P-gp substrate,rhodamine123 or cyclosporine A,was calculated.Healthy male Sprague-Dawley rats were randomly divided into five groups:blank control group,verapamil group,low-,medium-and high-dose Deo group (8 rats in each group).Rats in the low-,medium-and high-dose Deo group were intragastrically administered once daily with Deo at 8,16 and 32 mg·kg-1 for 3 consecutive days,while rats similarly received gavagewith verapamil (4 mg·kg-1) in the verapamil group and equal volume of purified water in the blank control group.Thirty minutes after the rats were treated with their respective drugs,rhodamine123 (5 mg· kg-1) was orally administrated.Then the pharmacokinetic profiles of rhodamine 123 were analyzed to evaluate the inhibitory ability of Deo on P-gp in vivo.Results The bidirectional transport rates of Deo (20,40,80 μg·mL-1) were similar,with non-selectivity.Deo (20-160 pg·mL-1)significantly inhibited the basolateral→apical(BL→AP) directional transports of rhodamine 123 and cyclosporine A in Caco-2 cell model (P ＜ 0.05) in a concentration-dependent manner.And Deo (8-32 mg· kg-1) also dose-dependently decreased the peak concentrations (Cm.) and the area under the plasma concentration-time curve (AUC0-t) of Rho123.Conclusion Deo can inhibit P-gp in vitro and in vivo,but it is not a P-gp substrate.

To investigate the mechanism of detrusor instability, using an apparatus to measure energy regulated tonicity and length of muscle strip in vitro , detrusor instability in bladder outlet obstruction (BOO) and spinal cord injuries (SCI) after pharmacological intervention was studied. The detrusor of both groups contracted under definite tension. Contraction of DI strips occurred under lower tension and under same tension the frequency of contraction was higher in DI detrusor than the normal one. There were no obvious changes when the detrusor strips were treated with M receptor antagonists, ATP or VIP. Muscarinic receptor agonist could increase the excitability of detrusor. The increase of detrusor excitability plays a major role in the occurrence of DI. The excitability is independent on neurogenic factors.

Objective To investigate the relationship between muscarinic receptor subtypes and detrusor hyperreflexia. Methods Spinal cord was transected in male Wistar rats at L 1～2 level, changes of urodynamics were monitored 3 weeks later by cystometric studies.Spontaneous contraction frequency and strength of detrusor strip mustarded by carbachol (muscarinic receptor agonist), atropine (nonselective M antagonist), methoctramin (M 2 receptor selected antagonist) and 4 DAMP (M 3 receptor selected antagonist) were measured. Results Bladders after SCI showed littler capacity, lower compliance and hyperreflexia. Detrusor of all groups contracted at a definite tension. The contraction frequency in the hyperreflexia group (4.797?0.257 times/min) was higher than in the control's(3.227?0.173 times/min).There were no obvious changes while detrusor strips were mustarded by different muscarinic receptor antagonists.Carbachol could increase detrusor contraction frequency( 6.316 ?0.409 times/min) and the effect could be blocked by atropine(5.304?0.095 times/min) and 4 DAMP(5.046?0.089 times/min). Conclusions Detrusor is a rythmatic tissue at a difinite tension.Excitability rise of detrusor is the main cause of hyperrefexia. M 3 receptor can enhance the excitability of detrusor causing direct contraction.The function of M 2 receptor is still unclear.

Background Aberrant proliferation of residual lens epithelial cells (LECs) is one of main causes of posterior capsular opacification (PCO).Researches indicated that Wnt3a signaling pathway promote proliferation of epithelial cells,but its effect on LECs is still unclear. Objective The present study was to investigate the effects of Wnt3a on proliferation of human LECs and its mechanism and to provide a new gene target in the prevention and treatment of PCO. Methods Human LECs line (SRA01/04 cells ) was cultured and then incubated to 6-well plate at the density of 4×105/well.A human Wnt3a cDNA expressing vector targeted human LECs was constructed to increase the Wnt3a expression in SRA01/04 cells,and pcDNA3-HA expression vector was used as the control group.The expression of Wnt3a was identified by Western blot assay after transfected.The growth and proliferation of SRA01/04 cells were detected by MTT and flow cytometry (FCM).The expressions of β-catenin,cyclin D1 and c-myc in the cells were detected by Western blot assay.β-Catenin expression was localized using immunofluorescence assay,and the expression and localization of proliferating cell nuclear antigen ( PCNA ) were analyzed by immunocytochemistry for the exploration of the active mechanism of Wnt3a to proliferation of LECs.Results Human Wnt3a cDNA expression vector was designed successfully and transiently transfected to SRA01/04 cells,and Wnt3a/SRA01/04 cells and pcDNA3-HA/SRA01/04 cells were obtained.The expression of Wnt3a was verified in the Wnt3a transfected group compared with the control group.MTT indicated that the cell proliferating rate was significantly different between the Wnt3a transfected group and the control group ( Fgroup =15.235,P =0.005 ;Ftime =369.677,P =0.000),and that in various time points after transfected was significantly different (t =20.843,P=0.001 ;t =26.214,P＜0.001 ;t=25.177,P=0.001 ;t =35.516,P＜0.001 ;t =615.056,P＜0.001 ).The proportion of SRA01/04 cells in G1 phase was 51.74％ in the Wnt3a cDNA transfected group,with a significantly decrease in comparison with 79.44％ of the control group.However,the proportion of SRA01/04 cells in S phase in the Wnt3a cDNA transfected group was higher than that of the control group (36.23％ versus 12.34％ ).The positive expression rate of PCNA protein in SRA01/04 was (47.00％ ±7.58％ ) in the Wnt3a cDNA transfected group and ( 16.00％ ±3.61％ ) in the control group with a significant difference between them (t =8.256,P＜0.01 ).After 48 hours of transfection of the Wnt3a cDNA,the expression amount of β-catenin proteins was higher and the immunofluorescence was stronger in cell nucleus,and the expressions of cyclin D1 and c-myc proteins were elevated in Wnt3a/SRA01/04 cells. Conclusions The overexpression of Wnt3a activates the Wnt/β-catenin signaling pathway and downregulates the expression of a subset of target genes,including cyclin D1 and c-myc,which plays an important role in promoting the proliferation of human LECs.

Objective To evaluate the efficacy of modular flexible ureteroscopy combined with holmium laser lithotripsy for the treatment of renal and upper ureteral stones . Methods A total of 97 patients with renal and upper ureteral stones were treated with modular flexible ureteroscopy combined with holmium laser lithotripsy in our hospital from October 2012 to February 2016.Under general anesthesia (90 cases) or epidural anesthesia (7 cases), a flexible ureteroscope was used to find renal or ureteral calculus and holmium laser lithotripsy was applied at a maximum energy of 1.2-1.6 J/10 -12 Hz (12-20 W).F6 or F7 double-J stents and catheters were routinely placed postoperatively .B-ultrasonography , KUB or CT were performed to evaluate the stone free rate 4 weeks after operation . Results Two patients suffered ureteral perforation due to stenosis and tortuosity of the ureter , and were given double-J stent placement under rigid ureteroscopy for 2 weeks and then flexible ureteroscopic treatment .Six patients underwent staged operations because of ureteral strictures .The operations were successful in the remaining 89 patients.Except for unsuccessful exploration in 3 cases of lower calyx calculi , the operation time of other 94 patients was 30-190 min (mean, 100 min).The stone detection rate was 96.9%(94/97), and the stone free rate was 88.6% (86/97).The stone free rates were 100.0% (25/25) for upper and middle calyx calculi, 75.0%(9/12) for lower calyx calculi, and 85.1% (23/27) for pelvis and multiple calyx calculi. Ureteral perforation was encountered in 2 cases.No massive hemorrhage occurred .Postoperative high fever was seen in 5 cases, with a body temperature of 38.5-39.3℃, which were cured after anti-infection treatment for 2 -7 d.The patients were discharged from hospital in 2-7 days (mean, 3.3 days) after operation.Review with B-ultrasonography, KUB or CT at 4 weeks after operation found 5 cases of residual stones >4 mm, including 3 cases located in lower calyx and 2 cases in multiple calyx . Conclusion Modular flexible ureteroscopy combined with holmium laser lithotripsy is effective and safe for the treatment of renal calculi .

Objective:To investigate the effects of schizandrin B on P- glycoprotein by a classical in vitro cell model. Methods:Caco-2 cell model was used as the carrier,and rhodamine 123 and cyclosporin A were employed as the P-gp substrates, the transmembrane transportation of schizandrin B,rodamine 123 and cyclosporin A were detected by HPLC and a liquid scintillation counting assay,and the apparent permeability coefficient and permeability directional ratio were calculated. Results:The bidirectional transportation rates of schizandrin B(20 μg·ml -1 ,40 μg·ml -1 and 80μg·ml-1 )were similar,and showed non-selective difference. Schizandrin B(20-160 μg ·ml -1 )significantly inhibited the BL → AP directional transportation of rhodamine 123 and cyclosporine A in Caco-2 cell model(P < 0. 05) in a concentration-dependent manner. Conclusion:Schizandrin B is a P-gp inhibitor,while it isn’t a P-gp substrate.

Objective:To evaluate the efficacy and safety of low molecular weight heparin and unfarction heparin in patients with coronary heart disease during percutaneous coronary intervention by investigating the MACE beteewn the percutaneous coronary intervention procedure and post percutaneous coronary intervention 72 hours.Methods:200 patients with coronary heart disease who accepted percutaneous coronary intervention were investigated in this study.According to the anticoagulants,these patients were divided into LMWH subgroup(117 cases) and UFH subgroup(83 cases).According to conventional method,the MACE what happened during percutaneous coronary intervention procedure and post percutaneous coronary intervention 72 hours come from each group of patients was investigated and these statistics were analysised so that evaluate the efficacy and safety of low molecular weight heparin and unfarction heparin.Results:(1) There were no statistical significance in baseline characteristics between the each group (P＞0.05).(2) There were statistical significance in the incidence of TIMI flow slows between the each group (P＜0.05),low molecular weight heparin is superior to unfarction heparin in terms of efficacy.(3)There were no statistical significance in death between the each group (P＞0.05),but there were statistical significance in bleeding / hematoma complications,and other (pericardial tamponade,chest pain,cardiogenic shock,cardiac rapture,ventricular septal perforation,ventricular tachycardia,ventricular fibrillation,cardiac arrest,Aspen attack,stent thrombosis and so on) between the each group (P＜0.05),low molecular weight heparin less adverse reactions,higher safety.Conclusion:Low molecular weight heparin in the percutaneous coronary intervention effect is more significant,and less than UFH adverse reactions and high safety,more suitable for percutaneous coronary intervention anticoagulant therapy.

Objective To evaluate Feridex(superparamagnetic iron oxide,SPIO)enhanced MRI in the diagnosis of hepatic lesions.Methods Feridex-enhanced MRI was performed in 31 patients with CT,or MRI proved or suspected hepatic lesions.T 2WI signal intensity of hepatic parenchyma,lesion and background noise was measured before and after enhancement separately.SNR and CNR of parenchyma and lesion before and after enhancement were calculated.The number of lesions on plain and enhanced scans were observed and alalyzed.Results Post-enhancement SNR of liver significantly decreased (?0.05).Post-enhancement lesion-liver CNR increased significantly (?