Objective To explore the clinical significance of APACHE Ⅱ score on risk stratification in patients with acute myocardial infarction.Methods One hundred and forty-two patients with acute myocardial infarction were included in the study who were admitted to hospital consecutively from Jan.2011 to Dec.2012.High risk group and low risk group were divided by the APACHE Ⅱ score.Some clinical variables at the first 24 h after admitted to hospital and occurring during the following 1 year were recorded Results The age in high risk group was 78.9 ±8.1,significantly higher than that in low risk group (65.8 ± 10.2;t =6.835,P ＜ 0.001).The cases with Killip Ⅲ and Ⅳ in high risk group were 10(29.4％) and 2(1.8％),lower than in low risk group (6 (1.8％) and 0 (0％) ; x2 =21.950,15.777 ; P ＜ 0.005).The level of creatine kinase-MB (CK-MB) and cardiac troponin Ⅰ in high risk group were (147.7 ±21.5) U/L and (105.5 ± 17.6) U/L,higher than in low risk group((105.5 ± 17.6) U/L,(42.9 ± 6.3) U/L; t =11.541,5.785 ; P ＜ 0.001).The incidence of severe cardiac events(malignant arrhythmia,heart failure,non fatal myocardial infarction and death from any cause in high risk group were 58.8％ (20/34),47.0％ (16/34),17.6％ (6/34) and 17.6％ (6/34),higher than in low risk group (29.6％ (32/108),3.7％ (4/108),6.4％ (7/108) and 6.4％ (7/108) ; x2 =8.274,36.665,3.876 and 3.876 ; P ＜ 0.05).Conclusion APACHE Ⅱ score is likely to be a simple and practical tool for risk stratification in patients with acute myocardial infarction.

Background and purpose: Unbalance of apoptosis regulation plays an important role in tumor initiation and progression. Survivin and caspase-3 all take part in the regulation of cell cycle and apoptosis. The expressions of survivin and caspase-3 were detected in the tissues of gastric cancer to explore their association with the carcinogenesis of gastric cancer. Methods: The expressions of survivin and caspase-3 in 79 cases of gastric cancer and 30 cases of adjacent were detected by using reverse-transcription PCR (RT-PCR) and immunohistochemistry. Results: The expressions of survivin mRNA and caspase-3 mRNA were significantly related with the depth of invasion, lymph-node metastasis and TNM stage (P<0.05). The expressions of survivin mRNA and caspase-3 mRNA had significantly differences in gastric cancer (P<0.01). Conclusion: Survivin and caspase-3 are both important factors that cause tumorigenesis of gastric cancer, while survivin may promote the progression of gastric cancer through inhibiting the expression of caspase-3.

This paper presented the conventional methods for signal detection of adverse drug reactions (ADRs) and their applications, the research progress in ADRs signal mining based on healthcare big data, and briefed the methods and uses of ADRs prediction using machine learning technology in the era of healthcare big data.The conclusion was that deep learning, as a fast growing tool in machine learning, will become hotspot of research, expected to help with ADRs signal mining and rational clinical drug use.

ObjectiveTo evaluate prognostic factors and the surgical results of pulmonary carcinoid tumors.Methods We retrospectively reviewed the medical records of 62 patients who were diagnosed as pulmonary carcinoid tumors between January 2000 and October 2010 at Department of Thoracic Surgery,Shanghai Chest Hospital.The following information was available for each of the 62 patients:age,sex,pathological type,and TNM stage.ResultsThere were no operative death.The 3-year and 5-year survival rates after surgery were 92.1％ and 77.8％,respectively.Of the 62 patients,42 were diagnosed as typical carcinoid tumor,and among them,4 patients (8.3％) had lymph node metastases.Their 3-year and 5-year survival rates were 97.8％ and 94.7％,respectively.The remaining 20 patients were diagnosed as atypical carcinoid tumor,and among them,6 patients (37.5％) had lymph node metastases.Their 3-year and 5-year survival rates were 84.4％ and 58.8％,which were statistically significant compared with typical carcinoid tumor( P =0.0047 ).There was significant difference in survival rate between the patients with lymph node metastases and the patients without lymph node metastases (P =0.0048).CondusionThe main risk factors affecting survival rate of those patients who were diagnosed as pulmonary carcinoid tumors were pathological types and lymph node metastases.

BACKGROUND: MyoD gene is one of family members of muscle transcription factors. Transfection MyoD gene can switch on the procedure of differentiation of muscles, and transit non-muscle cells into muscle cells.The MyoD gene only expresses in skeletal muscles. Based on the same contractive structure in myocardial cells and skeletal muscle cells, it is imagined that the conversion from exogenous MyoD gene-induced fibroblast in local myocardium into skeletal muscle cells that had contractive function may become another method in the treatment of congestive heart failure on clinic.OBJECTIVE: To construct and identify a recombinant adenoviral vector carrying MyoD gene for further studies on the recovery function of MyoD gene in myocardial injury.DESIGN: Single sample experiment.SETTING: Department of Cardiology, First Affiliated Hospital, Nanjing Medical University.MATERIALS: The experiment was conducted at the Laboratory of Microbiology and Immunology, Nanjing Medical University between September 2004 and September 2005. MyoD gene and non-replicating form expressive vector of adenovirus were taken as research materials.METHODS: MyoD cDNA fragments were extracted from plasmids pEMSV-MyoD with polymerase chain reaction (PCR), and PCR was used to clone the whole-length gene of MyoD. After adding CACC sequence at 5' end, MyoD gene was cloned by orient topology into transfer ventor, pENTR/D-TOPO. Objective gene was transferred into adenoviral expression vector DNA via pENTR/D-TOPO vector. The recombinant adenoviral vectors transfected into HEK293A cells by using lipofectamine were packaged and amplified.MAIN OUTCOME MEASURES: Evaluation of PCR and DNA sequencing were used for confirming the size of segment and correctness of rank of MyoD cDNA and detecting the titre of virus.RESULTS: MyoD recombinant adenovirus contained target segment with precise length confirmed by PCR and DNA sequence that was correct. The titre of virus was 1.3×1011 pfu/mL.CONCLUSION: The recombinant adenoviral vector carrying MyoD gene is constructed successfully.

Recently,as the exposure of the incident of‘octuplet’in Guangdong province,China's underground surrogate market has once again surfaced and led to a wide range of discussion.In this paper,the connotation and characteristics of surrogacy were analyzed and related laws and regulations of surrogacy in foreign countries were discussed.The main types of surrogacy-related legislation and regulations abroad are autonomy of private law,governmental regulation and complete prohibition.This paper carried out thorough legal analysis on whether to prohibit strictly or establish an authoritative legal system in view of the existing and ineffectively prohibited underground surrogate market in our country.

Objective To develop a duplex fluorescence RT-PCR assay for detection of scavenger receptor class B, typeⅠ(SRBⅠ) knockout mice. Methods Primers and probes were designed according to knockout region of SRBⅠgene and related substituted sequence. DNA samples were extracted from tails of mice and performed amplification using real-time PCR. SRBⅠgenotypes of mice were analyzed according to amplification curves of FAM and CY5 channels. Finally, the sensitivity of the method was detected and the accuracy was verified by the direct sequencing. Results The homozygous SRBⅠwild genotype showed an amplification curve only in FAM channel. When the homozygous SRBⅠknockout genotype was present, the typical S amplification curve appeared only in the CY5 channel. Heterozygous genotype showed two typical S amplification curves in both FAM and CY5 channels, respectively. The results showed that the sensitivity reached 4×101 copies/μL, and there was complete concordance between this method and direct DNA sequencing. Conclusion The new method is simple, rapid and accurate, which is suitable for genotyping SRBⅠknockout mice.

· AIM: To search an easy and simple way for intraocular implantation after the eye evisceration.· METHODS: Fifteen healthy New Zealand rabbits were divided into 5 groups according to the sacrifice time, and each group included 3 rabbits; the left eye received the injection of polymethyl methacrylate (PMMA) bone cement (2g per mL), while the right eye served as control. Under general anesthetia, a 3mm incision was made on the sclera,and the eye contents and pigment tissues were extruded out with fingers. Then, PMMA bone cement (2g per ml) was injected through the scleral incision. Both the operated eye and control eye of the rabbits were enucleated and weighed,The reaction of the operated eye (macroscopically and histopathologically) was noted at frequent interval. The obtained data were then analyzed with ANOVA (SPSS11.5).· RESULTS: There was swelling of eyelids and conjunctiva at the early time after the injection, but no significant difference between the weight of the left and right eyes was noted,Histopathologic examination showed scleral and other tissues necrosis at early period, and then the tissues reaction turned into a great deal of cell proliferation and finally into extensive fibro-connective tissues. Three months after the operation,neovascularization was observed in the cornea of the operated eyes. Histopathologic examination showed formation of fibro-membrane around the intraocular implant,and disappearance of the inflammation.· CONCLUSION: The method of injecting PMMA bone cement (2g per ml) to form an intraocular implant is quite simple and economical; this method is also easy to use clinically.

MRCP can be applied to display three-dimensional morphology of the biliary tract clearly.Laparoscopic surgery via cystic duct for choledocholithiasis possesses obvious advantages, but it is not suitable for all cases because there are great variations in the cystic duct.So how to make proper choice of the therapeutic strategy becomes very important.In this prospective study, different surgeries were administrated in patients with common bile duct stone based on the 4 categories of cystic ducts in 96 cases judged by MRCP images.These findings demonstrated that according to the cystic duct morphological type,LCTBDE is suitable for thick-straight type, and LCBDE is fit for thin-crooked type.Be careful to choose laparoscopic surgery in the other two types considering their individual features.Thus, this classification will be propitious to maximize the advantage of laparoscopic operation as a minimally invasive treatment.

National Health Information System is mainly used to support decision-making and to improve the current national health situation.Its importance to display the current national health situation and its problems in developing countries were analyzed with the need to construct its effective evaluation framework system pointed out.Construc-tion of UML-based evaluation framework system for National Health Information System was proposed in order to support decision-making and to provide evidence for the health policy makers by comparing the evaluation frame-work systems for National Health Information System in developing countries .