Matrix metallopeptidase 9 (MMP-9) is a group of enzymes that belong to the zine-metalloproteinases family involved in the pathophysiological process of various diseases,such as inflammation,angiogenesis and tumor invasion.Hypoxia-inducible factor-1 (HIF-1) is a nucleoprotein with transcription activity,which consists of two different subunits,α and β.It plays an important role in the process of the formation of new blood vessels following ischemic necrosis and the process of hypoxia induced cell apoptosis.Silent information regulator2-related enzymes 1 (SIRT1) is a NAD-dependent deacetylase sirtuin,which belongs to a member of the sirtuin family of proteins,also involved in many pathophysiologic processes,such as aging,cell death and tumorigenesis.This study aims to review the role of MMP-9,HIF-1 and SIRT1 in acute lung injury.

Objective To retrospectively evaluate effects of early dynamization of interlocking intramedullary nail on union of tibial shaft fractures.Methods From January 2002 to Septemher 2004,75 patients with tibial shaft fractures were treated in our department with internal fixation using static interlocking iutramedullary nails.Early dy- namization(6 to 10 weeks postoperative)was adopted in 32 patients (the dynamic group) according to the fracture con- ditions,while the other 43 patients were treated without early dynamization (the non-dynamic group).The healing time of fractures and the rate of delayed union in both groups were documented.Results All the cases were followed up for a mean duration of 6.5 months (range,4 to 13 months).The mean healing time was 115.6 days (range,105 to 126 days) in the dynamic group and 124.5 days (range,119 to 133 days) in the non-dynamic group.The difference was statistically significant between the two groups (P＜0.05).There were two cases (6.2%) of delayed union in the dynamic group and four (9.4%) in the non-dynamic group.The difference was not significant (P＞0.05). Conclusion Early dynamization of interlocking intramedullary nail can promote union of tibial shaft fractures.

Objective To investigate the correlation between clinical features of breast cancer and microsatellite instability(MSI).Methods 60 samples of breast cancer were eollected and 5 microsatellite polymorphism loci were selected.MSI analysis Was made after DNA isolation,PCR amplification,electrophoresis and EB staining.Results The rate of MSI was 33.3%in breast cancer and 0%in normal breast tissues.MSI in breast cancer was associated with carcinoma differentiation degree.Conclusion MSI is an early event during breast carcinogenesis and it plays an important role in estimation of malignant degree.

Deep venous thrombosis (DVT) is initiated intraoperatively and may display symptoms postopera- tively following total hip or total knee arthroplasties. Pulmonary embolism (PE) and DVT cause morbidity and mortality. It has been established that patients who undergo a major lower-extremity joint replacement should receive prophylaxis due to the increased risk of DVT. Despite use of thrombo-prophylaxis, elective replacement surgery carries a high risk of venous thromboembolic complications. The early detection of DVT and treatment with systemic anticoagulation to pre- vent DVT are essential in the management of patients undergoing total joint arthroplasty. Extended medical throm- bo-prophylaxis is indicated for some high-risk patients. Routine postoperative duplex surveillance for DVT may be clinically useful. In the early post-operative phase, combined prophylaxis such as low-molecular-weight heparins and mechanical methods may be more effective than single intervention measures. However, the efficacy and safety of an- ticoagulation therapy, using various medicines administered after total arthroplasty of large joints are still undetermined and controversial.We should also be alert to the frequency and extent of postoperative hematomas. There are still many uncertainties in treatments to prevent DVT in terms of safety and cost-effectiveness. Therefore, prospective, ran- domised, controlled and multicenter studies may be necessary to obtain valuable information according to evidence based medicine.

Objective To systematically review the literature evaluating efficacy and adverse events of propranolol for infantile hemangiomas (IHs).Methods We searched the Cochrane,Medline,Wiley,CNKI and Wanfang Databases for all studies on the response of IHs to propranolol only which were published between June 2008 and May 2013.Results A total of 23 studies were collected,including 14 case reports and 2 follow-up studies which were without random and control;another 6 studies were clinical controlled trials and 1 study was RCT.Total 716 patients were included,and never received other treatments before propranolol.Propranolol was initiated at a mean age of (4.5 ± 0.5)months at a mean dose of 2.1 mg/kg/day and for a mean treatment duration of (9.7±9.2) months.The effective rate for patients with IHs treated with propranolol was 97％ (691/716),and patients after treatment completion reported IHs recurred in 8.6 ％ of patients.The adverse effects rate was 31％(223/7167) which most common adverse events were changes in sleep (n=35),gastrointestinal reaction (n =52) and decreased heart rate (n =73),and 5 patients discontinued the treatment because of the serious adverse events.Conclusions This systematic review of 716 patients treated with propranolol for IHs show a high rate of efficacy and a low rate of serious adverse events,and it is a better treatment of infantile hemangioma,but we should pay more attention to the serious adverse events and strictly select indications.

Objective:CD4+CD25+regulatory T cells (Treg) may contribute to tumor progression by suppressing antitumor im-munity. The function of Treg in antitumor immunity regulation in the peritoneal microenvironment of ovarian cancer (OC) was investi-gated and compared with the circulating Treg to elucidate OC immune escape. Methods: Flow cytometry was used to determine the proportion of CD4+CD25+T cells in CD4+T cells in ascites of 27 patients with OC and in peripheral blood lymphocytes of 28 patients with OC. The samples were analyzed and classified in three stages:primary disease (PD), after chemotherapy (AC), and recurrence dis-ease (RD), according to the clinical conditions of the OC patients upon donating the samples. The percentage of Treg in the three groups was determined in ascites and blood. CD4+CD25+T cells were isolated from ascites and peripheral blood of patients with OC us-ing magnetic sorting (MACS) system. The cells were then tested for regulatory function through coculture with carboxyfluorescein diac-etate succinimidyl ester-labeled autologous CD4+ CD25- responder cells. Results:The proportion of CD4+ CD25+T cells in CD4+T cells significantly increased in ascites (28.25%± 14.06%) compared with that in blood (14.6%± 4.74%;P<0.0001). The Treg in ascites and blood in AC showed higher proportion (P<0.0001) than those in the PD and RD;the proportion in RD was higher than that in PD (P<0.0001). Moreover, the Treg in ascites mediated a significantly higher suppression compared with the Treg in peripheral blood (P<0.001). Conclusion:The frequency and suppressor function of Treg were significantly higher in ascites than in peripheral blood. This finding suggests more possibility for escape immune surveillance in the peritoneal microenvironment. Moreover, the proportion of Treg in AC was higher than that in PD or RD;the proportion in RD was higher than that in the PD. Chemotherapy may favor the expansion of Treg, which may promote the recurrence of cancer.

Objective: This research explores the relationship between the immuno-suppression function of regulatory T cells (Treg) in the ascites of ovarian cancer (OC) patients, the clinico-pathologic features of these patients, and the correlation of the function of Treg with initial treatment and relapse status of the patients to further investigate the specific mechanism of immuno-regulatory func-tion of CD4+ CD25+ Treg in the ascites of OC. Methods: Immuno-magnetic activated cell sorting (MACS) was conducted to sort CD4+CD25+Treg and autologous CD4+CD25-Treg from the ascites of 28 OC patients. Carboxyfluorescein-diacetate succinimidyl ester (CFSE) was used to label the autologous CD4+CD25-Treg. These labeled cells were then used as controls and co-cultured with autologous CD4+CD25+Treg at the ratio of 1∶1 or 1∶2. The mean inhibition ratio of Treg in specimens to the proliferation of autolo-gous CD4+ CD25-Treg was calculated after the flow cytometry of the CFSE expression and Modfit software analysis of the CD4+CD25-Treg proliferation index (PI) were performed. Anti-IL-10 and/or anti-TGF-β1 antibodies were neutralized to investigate whether the CD4+CD25+Treg-mediated immuno-suppression escaped through the ascites can produce a marked effect by the inhibitory cyto-kine IL-10 or TGF-β1. Results: The mean inhibition ratio of CD4+ CD25- Treg in the ascites of stage Ⅲ to Ⅳ OC patients was (75.72±17.04)%, which is significantly higher than that of stageⅠtoⅡOC patients (59.61±16.97)%;P<0.05. In addition, Treg in the as-cites of OC patients with recurrent disease showed a significantly higher inhibition ratio than that of patients with primary disease;P<0.001. Moreover, Treg in groups added into neutralizing anti-IL-10 and/or anti-TGF-β1 antibodies displayed significantly lower depres-sant effect than the control group;P<0.05. Conclusion:The immuno-suppression of CD4+CD25+Treg in the ascites of OC patients is correlated with the tumor staging and status of the primary or recurrent diseases. Moreover, Treg may indicate a suppressor function by secreting cytokine IL-10 and TGF-β1.

Objective To investigate the concentration of homocysteine (Hcy) and related factors of hyperhomocyste-inemia (hHcy,Hcy≥15μmol/L) among non-hypertensive people aged between 40-70 in Tianjin. Methods Non-hyperten-sive community residents aged 40-70 years were enrolled randomly from May 2011 to December 2012 in six districts in Tian-jin. Plasma Hcy was assessed by enzyme cycling method. Factors related to hHcy were analyzed in multivariate logistic re-gression models. Results Our study included 874 participants (mean age is 57 ± 6 years, 25.5%of all are males) and the con-centration of Hcy was 12.0 μmol/L. The OR (odds ratio)(95%CI; P)for hHcy were 1.048(1.015,1.083; P=0.004), 4.191 (2.359,7.448;P<0.001), 1.280(0.896,1.829;P=0.175), 0.460(0.259,0.816;P=0.008)respectively for age, male, smoking, exercise, and the odd ratio for hHcy were 0.290(0.179, 0.469;P<0.001), 0.168(0.092,0.309;P<0.001)for consumption of vegetable and fruits 250-500 g/d and>500g/d, compared with<250 g/d. Conclusion Male and age were adverse factors for hHcy, consumption of vegetable and fruits, and exercise were positive factors.

Background and purpose:Retinoic acid-induced gene G (RIG-G) is a tumor suppressor gene which is cloned by NB4 cell line from a acute promyelocytic leukemia cell. This study aimed to investigate the effect ofRIG-G in lung cancer cells A549 by constructing a lentiviral vector expressing RIG-G under doxycycline (DOX) regulation.Methods:RIG-G gene ampliifcation was performed by quantitative real-time PCR (qRT-PCR). pLenti6/TO/V5-GIM-RIG-G lentiviral vector withGFP was built by LR recombination system. The concentration of pLenti6/TO/V5-GIM-RIG-G lentiviral vector andTet-on lentiviral vector were measured by virus titer method. After infecting A549 cells, stably transfected lines were selected via limiting dilution analysis.RIG-G gene expression was examined by immunolfuorescence staining and Western blot assay. Cellular proliferation was determined by CCK-8 assay.Results:The concentrations of pLenti6/TO/V5-GIM-RIG-G lentiviral vector andTet-on lentiviral vector were 1.0×108TU/mL and 4×109 VP/mL, respectively. RIG-G was expressed in lentivirus infected A549 cells after adding DOX, and the amount of cells withGFP could be observed by lfuorescence microscopy.After the expression of RIG-G protein, the prolif-eration activity of A594 cell was signiifcantly inhibited compared to the control group (1.168±0.107vs 2.099±0.162, P<0.05).Conclusion:The regulated expression ofRIG-G gene was established in A549 lung cancer cell line. The RIG-G protein has potential abilities to inhibit the proliferation of lung cancer cell A549.

Objective To establish a TaqMan-MGB fluorescent probe characterized real-time polymerase chain reaction ( qPCR) method for detecting retinoic acid induced genes G ( RIG-G) in human acute promyelocytic leukemia ( M3 ) .Analyze RIG-G expression levels in peripheral blood of both normal persons and M3 patients and explore its diagnosis value for M 3.Methods Methodology establishment study.A detection method and standard curve of TaqMan-MGB real-time PCR were established after designing specific primers and TaqMan-MGB fluorescence probe of human RIG-G gene and using reverse transcription complementary DNA ( cDNA) as a template.The performance of this method was evaluated in specificity, accuracy, precision, analytical sensitivity and interference substances . Twenty clinical specimens with M3 were quantified RIG-G expression so as to evaluate the correlation between peripheral blood and bone marrow samples .Meanwhile , the results of RIG-G expression in peripheral blood of 40 normal specimens and 20 patients with M3 were analyzed by t-test.And receiver-operating characteristic curve ( ROC ) was used to analyze the detection efficiency of M 3.Results There was a good linear relationship between log value of RIG-G standard substance and threshold cycle number ( Ct ) ( standard curve equation:Y=-3.539X+42.952,R2 =0.999).New method was used to detect standard substance . The deviation between observed and expected values was <5% (r=0.999).Three concentration samples (107 ,104 ,101 copies/μl) were selected for precision test.Intra-assay coefficients of variation were 1.38%, 2.31% and 1.38%, respectively , and intre-assay coefficients of variation were 0.71%, 1.17% and 5.07%, separately.All were less than 10%.The sensitivity of this method was 101 copies/μl.There was a good correlation of RIG-G results between peripheral blood and bone marrow in M 3 patients(r=0.996, b=0.973).But there was no significant difference between this two group results (t=0.099, P>0.05). However , there was obvious difference of RIG-G value in peripheral blood between control group and M 3 patient group (U=18,P<0.001), 3.62 ×104(1.61 ×104 -4.90 ×104)copies/μl for controls and 7.10 ×102 (5.43 ×102 -2.21 ×103 ) copies/μl for M3 patients, respectively.Conclusions Successfully establishe a TaqMan-MGB real-time PCR method for detecting RIG-G gene in peripheral blood.The accuracy, precision, sensitivity and specificity are good .It could provide necessary help in early diagnosis and monitor treatment of clinical M3 patients.