Objective To explore the influence of all-trans retinoic acid(ATRA) on in-vitro proliferation of human lung adeno-carcinoma cell line A549 and to preliminarily study its mechanism .Methods The human lung adenocarcinoma cell line A549 was taken as the experimental group .The cells in the experimental group and the control group were detected by using 3-(4 ,5-dimethyl-thiazol-2-yl)-2 ,5-diphenyltetrazolium bromide(MTT) assay for calculating the cell growth inhibition rate ;the microstructure of the cultured cells was observed by the transmission electron microscope technique ;the expression of cyclooxygenase-2(COX-2) in the cell supernate was detected by the enzyme linked immunosorbent assay .Results The different concentrations of ATRA for treating A549 cells could produce the inhibiting effect on A 549 cells to some different degrees ,furthermore ,after 72 h ,the expression of COX-2 in cytoplasma among the various concentrations groups was significantly decreased ,which was positively correlated with the concentration ,the difference showing statistical significance (P< 0 .05);at the same time ,by detecting TRAIL expression level in the experimental group(1 × 10-5 mol/L ,1 × 10-4 mol/) ,the expression of TRAIL in the A549 cell supernate after ATRA treatment was increased .Conclusion ATRA has the significant anti-tumor effect on the lung adenocarcinoma cell line A549 with the concen-tration-time dependence;ATRA in lung cancer tissue may play its anti-tumor effect by inducing apoptosis ,which can provide the theoretical basis for the treatment of lung cancer .

Granulocyte colony-stimulating factor (G-CSF) has been demonstrated to have neuroprotective effects in rat model with focal cerebral ischemia through anti-apoptotic pathways and by promoting proliferation of neural stem cells. In the present study, we examined the neuroprotective effect of G-CSF in an acute focal cerebral ischemia rat model with lipid metabolism disorder. Eighty male SD rats were randomly divided into normal diet control group (NC group) and high-fat diet group (HFD group) (n = 40 in each). In HFD group, rats were fed on high fat diet to induce atherosclerosis. After 29 days, 4 rats from each group were sacrificed to evaluate the effects of different diets, and the middle cerebral artery occlusion (MCAO) was performed in the rest of the rats. MCAO rats received either G-CSF (50 μg·kg(-1)·mL(-1)) or phosphate buffered saline (PBS) injection through the external jugular vein for 5 days, which was followed by 5-bromo-deoxy uridine (BrdU, i.p., 50 mg/kg) injection for another 7 days. To evaluate the effects of G-CSF treatment on neurological function, the modified neurological severity score (mNSS) was calculated. The vascular distribution, ischemic cells proliferation, cell apoptosis and the expression of vascular endothelial growth factor (VEGF) were measured to determine the effects of G-CSF treatment. Our results showed that G-CSF-treated rats had a lower mNSS than PBS-treated rats in both NC group and HFD group. G-CSF injection promoted endothelial cell proliferation and vascular regeneration, and inhibited cell apoptosis. The serum and tissue levels of VEGF were significantly increased after G-CSF treatment. It is concluded that G-CSF exerts its neuroprotective effect in focal cerebral ischemia rats with hyperlipidemia by enhancing angiogenesis, promoting cells proliferation, decreasing cell apoptosis, and increasing local VEGF expression.

Objective To explore the clinical significance of neutrophils/lymphocyte(NLR)and platelet/lymphocyte ratioof (PLR)peripheral blood in patients with primary biliary cirrhosis.Methods Retrospectively analyzed 62 patients with PBC and three subgroup patients according to Child-pugh,who were hospitalized in Shanghai Changhai Hospital and Shanghai Changzheng Hospital from January 2010 to July 2015.Enrolled 59 healthy controls.Baseline data and laboratory indicators were extracted,and the correlation between PLR and NLR and disease activity were analyzed.The changes of NLR in 3 pa-tients with PBC were analyzed.3 patients were followed up and their NLRs were recorded before and after therapy.Results Compared with healthy controls,NLR was significantly increased in PBC patients (P<0.05),and not PLR (P>0.05). NLR was positively correlated with TBIL and Mayo risk (R=0.35,0.30,P<0.05),and not ALT,AST or ALP (P>0.05).After therapy,NLRs were significantly reduced in three PBC patients (P<0.05).Conclusion NLR may be a useful biomarker for assessing clinical therapy in PBC patients.

Objective To investigate the expression of Circulating tumor cells ( CTCs ) in peripheral blood cells of patients with different stages of Small-Cell Lung Cancer ( SCLC) ,and to evaluate its significance in early diagnosis of lung cancer metastasis.Methods Thirty-five patients with SCLC ( 12 in limited stage and 23 in extensive stage ) and 25 patients with benign lung disease were recruited at the Shanghai Changhai Hospital from April 2011 to April 2013.Samples were prepared from 7.5 ml peripheral venous blood and collected in CellSave tubes.The CTC counts were determined using CellTracks AutoPrep fluorescence scanning system according to the manufacturers′instructions.The expression of CTCs in peripheral blood of SCLC patients and benign lung disease patients were analyzed.The expression of CTCs in different stages of SCLC was measured and compared.Furthermore, samples were prepared from 2 ml peripheral venous blood by centrifugation.The serum levels of NSE Neuron specific enolase were measured.The relationship between the expression of CTC and NSE was analyzed.Results CTCs positive rates in SCLC were significantly higher than in benign lung disease controls [ Positive rates of CTC≥1 were 80.0%and 12.0%(χ2 =27.003,P<0.000 1),CTC≥5 were 51.4%and 0 (χ2 =18.367,P<0.000 1), CTC≥10 were 34.3%and 0(χ2 =10.714,P<0.001),CTC≥50 were 17.1 and 0(P=0.036,P<0.05), respectively ].CTCs positive rates in SCLC extensive stage were significantly higher than limited-stage [Positive rates of CTC≥1 were 58.3% and 91.3%(P=0.033,P<0.05), CTC≥5 were 65.2% and 25.0%(P=0.035,P<0.05), respectively].The expression of CTCs was significantly correlated with NSE (r=0.743 7, P<0.000 1).Conclusion The expression of CTC in SCLC patients is significantly higher than those in control group , and is closely related to clinical stages , which may provide new clues to early predicting of SCLC metastasis and deterioration.

Objective To explore the abnormal changeof the polysomnography(PSG) in the patientwith traumatifrontal lobe injury .MethodTotally 16 patientwith traumatifrontal lobe injury accompanying sleep disorde(brain traumgroup) and 20 individualof physical examination (control group) were performed the whole nighPSG .ResultCompared with the control group ,the incubative stage of sleep in the brain traumgroup waprolonged ,while the sleep time and slow wave sleep time were shortened .The rapid eye movemen(REM) time and the periodicity of REM had statistical differencebetween the two group,buthe REM incubative stage ,density and intensity of REM had no statistical differencebetween the two goup.Conclusion The changeof PSG in the patientwith traumatifrontal lobe injury are dominated by the extension of the REM time and the shorten-ing of REM periodicity .

Objective To observe the clinical curative effect of drug combined with psychological treatment on patients with sleep disorders after stroke.Methods A total of 180 cases of eligible patients with sleep disorders were included and randomly di-vided into control group and treatment group.Control group were treated with conventional vascular drug(estazolam,2 mg,before sleep);treatment group increased anxiolytic and sedative hypnotic drugs(venlafaxine,dexzopiclone)compared to control group.Af-ter 14 days,sleep quality,NIHSS were compared both within the treatment group and between the two groups.Results The Bar-thel index,NIHSS and PSQI of two groups had significant differences,and those index of treatment group before and after treat-ment had significant differences too(P <0.05).Conclusion Combined conventional cerebrovascular drugs with Venlafaxine,dexzo-piclone as well as psychological treatment significantly improved sleep quality of patients with acute stroke.

ObjectiveTo investigate the role of active protein C (APC) in lipopolysaccharide (LPS) induced microglia activation.MethodsMicroglia from one day old Sprague-Dawley newborn rat was collected, purified and identified by primary culture and immunofluorescence staining, and then was randomly divided into four groups including LPS group (1.0μg/ml LPS plus 10μl phosphate buffered saline 12 h later), LPS+ APC group (1.0μg/ml LPS plus 0.1μg/ml APC 12 h later), APC group (10μl phosphate buffered saline plus 0.1μg/ml APC 12 h later) and control group (10μl phosphate buffered saline at each time point). The morphology of micaroglia in all groups was observed under microscope, and the expression of tumor necrosis factor-α (TNF-α) and protease-activated receptor-1 (PAR-1) were determined by immunofluorescence staining. One-way analysis of variance and LSD test were applied for statistical analysis.ResultsPrimary culture microglia was successful and the purity was no less than 99%. In LPS group, the microglia morphology was activated, and the expression of TNF-α was increased significantly than the control group (2.11±0.35 vs 1.38±0.28, LSD test,P=0.002). In LPS+APC group, the microglia morphological change was reversed, and the expression of TNF-α had no significant difference with the control group (1.35±0.36 vs 1.38±0.28, LSD test,P>0.05). The expression of PAR-1 in LPS+APC group was higher comparing with that in the control group (4.60±0.84 vs 2.64±0.41, LSD test,P=0.008) and the LPS group (2.44±0.86, LSD test,P=0.002). The expression of PAR-1 in APC group and LPS group had no obvious difference with control group (2.62±0.69, 2.44±0.86 vs 2.64±0.41, LSD test, bothP>0.05).ConclusionsBy increasing the level of PAR-1 in microglia, active protein C could inhibit the activation of miciroglia and the expression of TNF-α induced by lipopolysaccharide, therefore, protecting the brain tissues from inflammation-induced damage.

Purpose To compare the pathological differences between cervical high-grade intraepithelial lesions (CHGIL) positive resection surgical margin after cold knife conization and total hysterectomy,and to explore how to take further clinical treatment measures.Methods The pathologic results of 74 patients with CHGIL positive surgical margin after cold knife conization and hysterectomy were analyzed retrospectively.Results There was a correlation between positive cervical incision margin and residual uterine lesion (P ＜ 0.01).Age,menopause status,gland involvement did not related to residual uterine lesions(P ＞ 0.05).There was significant correlation between the lesion-related quadrant and the residual rate of uterine lesion (P ＜ 0.01).Conclusion Cold knife conization and hysterectomy are safe and effective treatments for CHGIL.However,for the positive resection surgical margin after cold knife conization cases,hysterectomy should be carefully chosen and may choose conservative treatment or re-cone cutting.

AIM:To study the effect of posterior sub - Tenon's capsule injection of triamcinolone acetonide ( TA ) in treatment of patients with diffuse diabetic macular edema ( DME) before panretinal photocoagulation ( PRP) .
METHODS:Retrospective analysis of the clinical data of 96 cases (96 eyes) with DME treated in our hospital from October 2008 to May 2012, and the patients were divided into the study group and control group, each group with 48 cases ( 48 eyes ) , the control group were only treated with PRP, and for the study group, TA was injected one week before PRP. At 6mo after treatment, best-corrected visual acuity ( BCVA) and retinal thickness changes of two groups were compared, the changes of intraocular pressure in two groups was analyzed.
RESULTS:After treatment, two groups were followed up for 6mo, compared with before treatment, the expression of BCVA in control group was reduced, and rise in the study group, with significant difference between the two groups (P<0. 05), and during the follow-up period, IOP change was in the normal range for the two groups, with no the difference (P>0. 05), the study group had foveal thickness reduction of 9. 6μm, the control group was increased by 31. 9μm, with significant difference (P<0. 05), parafoveal thickness in the study group decreased 5μm, significantly increased 22. 1μm in the study group, centre concave surrounding thickness increased 0. 4μm in study group and 19. 4μm for the control group, with no significant difference (P>0. 05).CONCLUSION:TA injection in patients with diffuse DME before PRP is safe and effective, and it is superior to simple PRP therapy, and it can be applied in primary hospital.

Objective To learn the existing state of Keshan disease and its trend in Baoji City,and to provide a scientific basis for control of the disease.Methods Feng,Qianyang,Linyou and Long Counties,the Keshan disease affected areas were selected to carry out the case study,and Keshan cases were searched from all registered cases of myocardial patients of the past three years at county-level medical institutions and hospitals of townships(towns).Thirteen villages affected by Keshan disease in Qianyang,Fengxiang,Feng,Linyou and Long Counties were selected as monitoring points to carry out a intensified monitoring.All subjects were surveyed by comprehensive clinical physical examination and 12-lead ECG tracings,and they were diagnosed according to the Keshan disease diagnostic criteria.Ten households were selected randomly in each monitoring point(village),and self-produced wheat samples and adult subject's occipital hair samples were collected for detecting selenium levels.Results Seven hundred and forty-six cardiac cases which containing 17 cases of chronic Keshan disease were discovered in 32 medical institutions,and there were no acute and subacute type of Keshan disease patients.Five thousand seven hundred and twenty-three subjects were examined in the 13 monitoring sites,and 65 cases of Keshan disease were diagnosed which including 17 cases of slow and 48 cases of potential Keshan disease,and no acute or subacute case was found.The total detection rate was 1.14％,and the detection rate ranged from 0 to 2.86％.Hair selenium mean was 0.420 mg/kg; wheat selenium mean was 0.079 mg/kg.Conclusions The Keshan disease detection rate of Baoji City is at a low level.The selenium level of local residents has reached the level of non-endemic area.Constant detection of patient with Keshan disease means various control measures should be reinforced.The comprehensive monitoring program,such as monitoring people's in vivo and in vitro selenium level and others,should be established as soon as possible.