To promote the understanding and practice of evidence-based medicine (EBM) in coronary artery bypass grafting (CABG). The transition of CABG graft materials from saphenous vein to arterial conduits were perceived using the principles of EBM. The arterial conduits were increasingly performed based on the principles and practice of EBM, therefore the postoperatively long-term graft patency rate, survival rate, and free cardiac event rate were significantly improved. CABG outcomes can be significantly improved by using arterial conduits based on principles of EBM.

BACKGROUND: Bag-1 is a multifunctional and anti-apoptotic gene. Its anti-apoptotic ability is enhanced when binding to bcl-2 to form a complex.Now it is considered as a predictive biomarker for the early diagnosis of breast cancer. However, whether it is useful in the assessment of the prognosis of breast cancer is still elusive.OBJECTIVE: To explore the expression of bag-1 in breast cancer and its role for prognosis.DESIGN: A controlled study with breast cancer, benign breast tumor and normal breast tissues as subjects.SETTING: The Vascular and Endocrine Surgery Department of Xijing Hospital of the Fourth Military Medical University of Chinese PLA.MATERIALS:Totally 100 breast cancer specimens were obtained form May 1995 to May 2000. Ten benign breast tumor and 10 normal breast tissues were used as control. All the specimens were paraffin-embedded and came from the Pathological Department of Xijing Hospital Affiliated to Fourth Military Medical University of Chinese PLA.METHODS: Immunohostochemical strept avidin-biotin complex(SABC) method was adopted to detect bag-1 expression in these specimens.pression levels of bag-1.RESULTS: The positive expression rate of bag-1 in breast cancer (85%) was significantly different form those of benign breast tumor (10%) and normal breast (10%) (χ2= 29.98, P = 0.00). While the positive expression rates in breast cancer of different stages (stage Ⅰ, stage Ⅱ and stage Ⅲ ) were 88%, 82% and 88%, respectively, which has no significant difference (χ2 = 0. 61, P = 0.75) . In duct carcinoma, lobular carcinoma and special carcinoma, bag-1 positive expression rate was 86%, 85% and 80%,which was also no significantly different (χ2 =0.16, P =0.95). In the 94followed patients, the 5-year survival rate of positive bag-1 expression was 79% and that of negative bag-1 expression was just 9%. The difference was significant (χ2 = 0. 07, P = 0.04).CONCLUSION: High bag-1 expression exists in breast cancer and its level is not associated with the clinical stages or pathological types of the cancer.Therefore, bag-1 may be used as a predictive marker for the prognosis of breast cancer.

Child ; Critical Illness ; Humans ; Status Epilepticus

Child ; Child, Preschool ; Coronary Vessels ; pathology ; Female ; Follow-Up Studies ; Humans ; Infant ; Male ; Mucocutaneous Lymph Node Syndrome ; diagnosis ; pathology ; therapy ; Retrospective Studies

With the development of medical education,the traditional cell biology teaching modes and methods need constant adjustment to adapt to the current teaching.In view of the present high-speed development of cell biology,we seriously picked some representative themes to carry out thematic teaching.Students were encouraged to read some references about the corresponding content and thought primarily before the class.After the lesson,the teacher guided students to discuss and find the answers to the questions they asked before.Participation in class discussion and homework completion accounted for 10％ of the final assessment results.The thematic teaching helped to optimize classical teaching contents and frontier progress.This teaching mode not only stimulated learning interest but also fully exercised learning ability.

Objective To discuss the clinical manifestation and pathology of papillary renal cell carcinoma (PRCC).Methods From January 2007 to January 2012,the clinical and pathologic data of 25 patients (17 males and 8 females with average age of 54 years ranging from 24-76 years) with PRCC were retrospectively analyzed in combination with review of literature.The clinical stages of the tumor were as follows,Ⅰ in 16 cases,Ⅱ in 5 cases,Ⅲ in 4 cases.And the radiographic inspections of PRCC were compared with that of 100 randomly selected clear renal cell carcinoma (CRCC).Results All the PRCC cases had different imaging presentations compared with CRCC.CT attenuation of CRCC was higher than that of PRCC in corticomedullary,nephrographic and excretory phase (P＜0.05).Heterogeneous enhancement was most commonly seen in CRCC than PRCC (P＜0.05).There were 21 patients underwent radical nephrectomy,and 4 patients underwent laparoscopic nephron sparing surgery.The pTNM stages of the tumor were as follows,pT1N0M0 in 16 cases,pT2N0M0 in 5 cases,pT3aN0M0 in 2 cases,pT1N1M0 in 1 case,,pT2N1M0 in 1 case.Of these 25 patients,8 (32％) and 17 (68％) were diagnosed as type Ⅰ and type Ⅱ PRCC,respectively.All the 25 cases of patients were followed up from 6 to 60 months.One case died of metastasis,1 case died of cerebrovascular disease and the other 23 patients survived with tumor-free.Conclusions PRCC is a special type of RCC with low morbidity.Radiological examination can be used in the differential diagnosis of CRCC and PRCC before surgery.The prognosis after surgical treatment is good,but the adjuvant systemic treatment is to be study.

Objective To investigate the relationship of the activation of nuclear factor kappa B(NF-kB) with myocardial neutrophil infiltration and injury in human open heart surgery,and to observe the inhibiting effect on the activation of NF-kB and protecting effect on myocardium of the coenzyme Q10,a scavenger of oxygen free radicals.Methods Forty-seven adult patients undergoing open heart surgery were randomly divided into two groups,the control and the treatment.CoenzymeQ10 tablets were given to the treatment group 5 days before operation.Biopsy of right atrium for myocardial pathology,activated NF-kB detection and ultrastructure observation were done prior to cardiopulmonary bypass,45 minutes of ischemia and 45 minutes of reperfusion.The dynamic indexes,vasomotor drug dosage,and outcomes were observed postoperatively.Results Upon 45 minutes of ischemia and 45 minutes of reperfusion,in control group there were neutrophil accumulation and adhesion of vascular endothelium,ultrastructural damages,and positive expression of NF-kB both in nuclei and cytoplasm,in myocardium.In treatment group,there were only mild neutrophil infiltration and ultrastructural damages,and weak positive expression of NF-kB both in nuclei and cytoplasm.However,the dynamic indexes,vasomotor drug dosage,and outcomes of two groups were not significantly different.Conclusion NF-kB plays an important role in pathophysiological process of myocardial ischemia and reperfusion in open heart surgery.CoenzymeQ10 has obvious inhibiting effect on activation of NF-kB and protecting effect on myocardium.

At present,transplantation has been the predominant way to solve most of the end-stage diseases,ensued by the use of immunosuppressive drugs.Since the immunosuppressive drugs have narrow therapeutic index,the blood drug concentration is needed to mornior.Pharmacogenetics is one subject which focuses on the interaction between gene and the metabolism of the drug,providing great help for designing the regime of achieving the target drug concentration.Meanwhile,it facilitates the realization of individual therapy.This review thus focuses on the latest advancement on the pharmacogenetics of those immunosupprressants,hoping to provide help for the treatment.

Objective To investigate the expression level of miRNA-146a (miR-146a) in retinal pigment epithelial (RPE) cells aging and age-related macular degeneration (AMD),and discuss its regulation mechanism of AMD by repressing VEGF-A.Methods The expressions of miR-146 and VEGF-A were examined by qRT-PCR in RPE cells in mice aged 2 months,8 months,12 months,18 months or 24 months,and in RPE cells from 75 years old AMD patients.The protein level of VEGF-A was also detected by Western Blotting.Finally,the effects of overexpression of miR-146a in APRE-19 cell line on expression of VEGF-A was checked.Results MiR-146 was up-regulated to 8 times or 24 times at 18 months or 24 months aged mice,and the expression of VEGFA was down-regulated in aging RPE from 1.5 times to 0.8 times.However,the expression of miR-146 decreased to 14.5 times and VEGF-A increased in RPE cells of AMD.In cultured cells,overexpression of miR-146a inhibited the expression of VEGF-A.Conclusion Up-regulation of miR-146a in aging RPE cells and its down-regulation in AMD suggest a potential of miR-146a as molecular marker.MiR-146a overexpression inhibits the expression of VEGF-A,supporting a potential clinical treatment of miR-146 in AMD.

Objective To observe the growth characteristic of bulge-originated cells from human hair follicles in vitro. Methods The bulges which were isolated from human hair follicles by dispase and microdissection were cultured. The morphological and biological characteristic of the cultured bulge cells were observed by light microscopy and immunocytochemistry (ICC). Results Proliferated cells could be observed in the second day after being inoculated. The number of these cells, with greater proliferation potential, reached the peak at the sixth day and maintain several days. In addition, the mitotic figures appeared and the cells behave the similar morphologic features, meanwhile the cells strongly expressed K19 and showed a descensive tendency in long-time growth.Conclusion The cultured bulge cells kept the primitive characteristic, which suggested that the putative follicle stem cells resided in the bulge area.;