Objective To investigate the correlation of CYP2D6 gene polymorphism and serum tamoxifen (TAM) and its active metabolites (4-hydroxy tamoxifen,4-OH-TAM) in terms of prognosis of breast cancer patients.Methods The oral mucosas and serum were obtained from 200 breast cancer patients receiving oral TAM from Jan 2008 to Oct 2010.Real-time RT-PCR was used to determine CYP2D6* 10 gene polymorphism.The relationship between CYP2D6* 10 gene polymorphism and clinicopathological features and prognosis was assessed by Chi-square test and Cox proportional model.Serum TAM and 4-OH-TAM concentration were determined by liquid chromatography-trap mass spectrometry (LC-MS).Results Of 200 breast cancer patients,CYP2D6 * 10/* 10 homozygotes were found in 94 cases (47％),CYP2D6 wt/wt wild type in 48 cases (24％) and CYP2D6 wt/* 10 heterozygote in 58 cases (29％).The concentration of serum 4-OH-TAM in patients with CYP2D6 wt/wt wild type and wt/* 10 heterozygote was significantly higher than that in patients with CYP2D6 * 10/ * 10 homozygote (F =4.31,P =0.01).CYP2D6 gene polymorphism was not related to clinicopathological features (P ＞ 0.05).Logrank test showed that patient's disease-free survival with mutational CYP2D6 (mean,47.2 months) was significantly shorter than that in patients without mutational CYP2D6 (mean,51.2 months) (P =0.018).Cox proportional model showed that CYP2D6 genotype was related to disease-free survival (HR =2.755,95％CI:1.230 ～6.173,P =0.014).Conclusions CYP2D6 *10/* 10 genotype is related to curative effect of TAM on breast cancer patients,detection of CYP2D6 * 10/* 10 genotype helps improve the choice of TAM therapy.

Objective To systematically evaluate the health status and intervention measures in the US Armed Forces, and to provide reference for the development of health promotion strategies in our army.Methods The PubMed, Medline, Springer, Elservier, HighWire and CNKI Database were searched electronically, with assigned search strategy for American military health status and intervention measures published from Jan.1997 to Dec.2015.Results There were 25 of pieces literature about training injury, low back pain, posttraumatic stress disorder, depression and cardiovascular disease that were screened.Conclusion The main health problems facing the US Armed Forces and the focus of the intervention measures involved training injuries, low back pain, mental illness and cardiovascular disease.Protection of military health is shifting from the single disease prevention to diversified comprehensive maintenance in the new era.

Objective To investigate the effects of simvastatin on the expression of lectin-like oxidized low-density lipoprotein receptor-1 (LOX-1) induced by oxidized low-density lipoprotein (ox-LDL) or Glucose in U937 macrophages, and explore the role of NF-κB in modulating of LOX-1 expression. Methods U937 macrophages were treated with PMA to induce differentiation, which were co-cultured with 50 mg/L ox-LDL or/and 25 mmol/L glucose. Pyrrolidine dithiocarbamate (PDTC) and simvastatin (1 μmol/L or 10 μmol/L) were used to treat cells. The expression of LOX-1 protein and NF-κB ac- tivity were detected by enzyme-linked immunosorbent assay technology. The expression of LOX-1 mRNA was measured by RT-PCR. Results The expression of LOX-1 was up regulated by ox-LDL, glucose and combination of both. The inhibitor of NF-κB PDTC suppressed this up-regulation. Simvastatin suppressed the expression of LOX-1 induced by ox-LDL, and showed a significant effect in the higher concentration. There was no significant effect of simvastatin on the expression of LOX-1 induced by glucose. The variation of NF-κB activity was similar to that of LOX-1 expression. Conclusion Simvas- tatin suppressed the expression of LOX-1 induced by ox-LDL, while no significant effect on the expression of LOX-1 in- duced by glucose. The expression and regulation of LOX-1 were related with NF-κB pathway.

Animals ; Dose-Response Relationship, Drug ; Female ; Male ; Rats ; Rats, Sprague-Dawley ; Toluene 2,4-Diisocyanate ; metabolism ; pharmacokinetics ; urine

OBJECTIVE: To study the effects of electroacupuncture and diet adjusting on insulin resistance in rats with nutrition obesity, and the role of electroacupuncture and diet adjusting in the treatment of obesity. METHODS: Obesity was induced in rats by high-fat diet. Rats with nutrition obesity were randomly divided into high-fat diet (HD) group, high-fat diet plus electroacupuncture (HA) group, normal diet (ND) group and normal diet plus electroacupuncture (NA) group, with another group of SD rats as normal control (NC). After 15 days, all the rats' body weight and length were measured, the Lee's index was calculated, and the levels of total cholesterol (TC), triglycerides (TG), free fatty acid (FFA), fasting plasma glucose (FPG), fasting insulin (FINS) and tumor necrosis factor-alpha (TNF-alpha) were detected. RESULTS: Compared with the HD group, food intake, body weight and viscera fat weight of the rats with nutrition obesity in the HA group and the NA group were markedly reduced (P<0.05). The levels of blood serum TC, FFA and IR index in the NA group were obviously lower than those in the HD group (P<0.01). The levels of TNF-alpha and FINS in the NA group were lower than those in the HD group (P<0.05). CONCLUSION: Electroacupuncture plus diet adjusting can decrease the levels of serum TNF-alpha and FINS of the obesity rats, and improve the state of insulin resistance.

Objective To explore the clinical value of tissue synchronization imaging(TSI) in assessment of the characteristics of myocardium asynchrony in patients with ischemic cardiomyopathy(ICM). Methods Thirty-eight patients with ICM were divided into two groups: 26 patients without left bundle branch block(LBBB) in group A, and 12 patients with LBBB in group B. The control group consisted of 26 normal healthy subjects. According to 2D color,the characteristics of myocardium motion in each group were compared by TSI. The time for reaching systolic velocity peak(Ts) and early diastole velicity peak(Te) were measured separately in 12 segments. Standard deviations of Ts(Ts-SD) and Te(Te-SD) as well as difference of Ts(Ts max-min) and Te(Te max-min) of all 12 segments were calculated. The myocardium synchronization were assessed in each group. Results ①91.8% segments in the control group showed normal, with only 8.2% segments were slightly prolonged. TSI of all the ICM patients showed an obvious uneven chroma distribution from green to yellow and then to red. There were far more yellow or red segments than in the control group. ②Ts-SD.Ts max-min of LV 12 segments were significantly prolonged in all ICM groups compared with that in the control group ( P <0. 05). Systolic asynchrony was more obvious in group B than in group A. ③Te-SD,Te max-min of LV 12 segments were significantly prolonged in ICM groups than in the control group ( P < 0. 05). Diastolic asynchrony was more obvious in group B than in group A( P < 0. 05). ④Compared with that in the control group, postsystolic shortening(PSS) was common in patients with ICM. 32. 4% segments of group A were detected PSS.and 56. 0% segments of group B were detected PSS. Conclusions Left ventricular systolic and diastolic mechanical asynchrony is obvious in patients with ICM and PSS is common among them. Systolic and diastolic mechanical asynchrony is more severe in ICM patients with LBBB. TSI is the optimal means to evaluate the characteristics of asynchronous myocardial contraction.

OBJECTIVE:To provide evidence for rational use and clinical monitoring of Alprostadil lipid-micro injection (Li-po-PGE1). METHODS:Adult inpatients receiving Lipo-PGE1 from hospital information system(HIS)of 159 hospitals were select-ed as research subject. Based on frequency statistics,population,clinical diagnosis,and average daily dose of Lipo-PGE1 were all studied. RESULTS:A total of 71687 adult inpatients were included,and the male was more than female,mostly aged 61-75. The hospitalization duration was 8-14 d(45.01%),most of patients were recovered(68.20%). Lipo-PGE1 was wildly used in the clin-ic,and was used for 871 kinds of clinical diseases in total;top 3 diseases were cerebral infarction(9.06%),non-insulin dependent diabetes mellitus (8.65%) and chronic ischemic heart disease (8.08%). The average daily dose of different diseases and different hospitals were significantly different,mostly≤12.5μg. CONCLUSIONS:As adjuvant drug,medical institutions and related super-vision departments should formulate reasonable monitoring index and strengthen medication guidance and evaluation of Lipo-PGE1.

Objective To study the meaning of breast cancer staging system by AJCC eighth edition to invasive lobular carcinoma and analysis the clinical pathological characteristics.Methods According to the eighth edition of the AJCC staging to evaluate the TNM stage and prognosis evaluation of invasive lobular carcinoma cancer patient in Peking University Shenzhen Hospital from 2011 to 2016,and compared with others in clinical pathological data.Results There were 21 cases of invasive lobular carcinoma,accounting for 2.7％ of all invasive breast cancer.We found that invasive lobular carcinoma shows no significant difference (P ＞ 0.05) in ages,menstrual status,molecular features and anatomic staging and prognosis staging with others;histological grade were significantly different (P ＜ 0.05).There were significant differences in the prognosis and staging of invasive lobular carcinoma.Conclusions Eighth AJCC staging systemn provides a new reference for the clinical treatment of breast cancer,should be evaluated with anatomic stage.Histological grade is relatively good in invasive lobular carcinoma and the prognosis is good,needs more research to the individualized treatment of invasive lobular carcinoma.

OBJECTIVE:To explore the effects and safety of dexmedetomidine combined with remifentanil on postoperative cognition and hemodynamics in patients underwent colon cancer surgery.METHODS:One hundred undergoing colon cancer sur gery in our hospital during Jun.2013-Apr.2016 were selected and divided into control group and observation group according to random number table,with 50 cases in each group.Control group was given Remifentanil hydrochloride for injection 2-4 μg/kg for anesthesia induction,with maintenance dose of 0.5-2 μg· kg/min;observation group was treated with Dexmedetomidine hydrochloride for injection 0.5 μg/kg and remifentanil 2-4 μg/kg for anesthesia induction,with maintenance dose of Dexmedetomidine hydrochloride for injection 0.4 μg·kg/h+Remifentanil hydrochloride for injection 0.5-2 μg·kg/min.MMSE score and the incidence of postoperative cognitive dysfunction (POCD) were observed in 2 groups 1,2,3 d after surgery,and the occurrence of ADR was record ed.RESULTS:The incidence of POCD in observation group 1,2,3 d after surgery were 16.0％,4.0％,6.0％,which was signifi cantly higher than 36.0％,12.0％,10.0％ of control group,with statistical significance (P＜0.05).There was no statistical significance in MMSE score between 2 groups 1,3 d after operation (P＞0.05).2 d after surgery,MMSE score of observation group was significantly higher than that of control group,with statistical significance (P＜0.05).There was no statistical significance in hemodynamic indexes,the incidence of ADR as blood pressure increasing,amyostasia,nausea and vomiting between 2 groups 1,2,3 d after surgery (P＞0.05).CONCLUSIONS:Dexmedetomidine combined with remifentanil can significantly improve postoperative POCD in patients underwent colon cancer surgery and have little effect on hemodynamics with good safety.

Objective To analyze the factors associated with the outcome of pyeloplasty in term of renal function and morphology improvement in children with unilateral ureteropelvic junction obstruction,in order to provide clinical evidence for the treatment of hydronephrosis in children.Methods Clinical data of 174 children who underwent unilateral dismembered pyeloplasty from January 2009 to June 2014 were retrospectively studied.Differential changes in renal function and renal morphology after pyeloplasty were assessed by serial renal scan and ultrasound.On the basis of preoperative split DRF,these patients were divided into three groups:group Ⅰ with DRF ≥40％ (n =99),group Ⅱ with DRF 30％-40％ (n =29) and group Ⅲwith DRF ＜ 30％ (n =46).According to their age at surgery,the children were divided into four groups,including group A aged 1-3 months (n =52),group B aged 3 months-3 years (n =44),groupCaged3-6years (n =37),and group D aged more than 6 years (n =41).Results Inall 174 children,postoperative complication occurred in 7 cases,including urinary tract infection in 6 cases and renal atrophy in 1 case.A significant improvement of both function and morphology was confirmed in most patients (P ＜ 0.01).Patients in group Ⅰ showed stable renal function after operation(DRF 48.46％ ±4.80％ vs.50.78％ ± 5.45％,P ＜ 0.01),of them who underwent pyeloplasty at 1-3 months of age showed the best obvious recovery of renal morphology.Renal function of patients in group Ⅱ recovered obviously and most of them reached to the initial values (DRF 35.18％ ± 2.95％ vs.43.91％ ± 6.89％,P ＜ 0.01).While renal function of patients in group Ⅲ recovered significantly after surgery,most of them failed to restore the initial values(DRF 20.70％ ± 6.90％ vs.33.78％ ± 12.49％,P ＜ 0.01),and among them,the aged 1-3 months group possessed the best recovery.Moreover,the morphological improvement was similar to the functional improvement.The time for hydronephrosis recovered to less than Grade 2 of Society for Fetal Urology(SFU)was 6,24 and over 24 months respectively in group Ⅰ,Ⅱ and Ⅲll,and the renal morphology gradually improved with the increasing duration of follow-up.Conclusions The renal function and morphology of most patients improved significantly after pyeloplasty.Recovery of renal function and morphology after surgery was significantly correlated with the preoperative DRF.Early surgical intervention may improve the function and morphology recovery of the involved renal unit.