Chemokine CCL5 and its receptor CCR5,as one of the chemokine family,are involved in the processes of many diseases and especially play an important role in breast cancer.Recent researches show that chemokine CCL5 and its receptor CCR5 have an obvious impact on the tumorigenesis,invasion,metastasis,therapy and prognosis of breast cancer.

Objective:To investigate the diagnosis and treatment for incarceration of retroverted uterus in pregnant women.Methods:This study retrospectively recruited four gravidas with incarcerated retroverted uterus indicated by prenatal ultrasonography in Hunan Provincial Maternal and Child Health Care Hospital from August 2016 to February 2020. Clinical features, diagnosis, and treatment of these cases were described.Results:Vaginal bleeding or discharge were the main symptoms of the four cases and prenatal ultrasound suggested incarcerated retroverted uterus. Obstetric examination was performed for all cases, except one due to small gestational age, and bulging posterior fornix was found in one case. Three cases were diagnosed in the third trimester and one at 14 gestational weeks. In light of gestations, symptoms, and anterior uterine muscle thickness, three patients underwent planned cesarean sections with a median abdominal incision and a superior transverse uterine incision after fetal lung maturation acceleration. Uterus involution was good, and the incisions healed well in these three cases, with all neonates in good condition. Following a two-week knee-chest position treatment, the position of her uterus and bladder turned normal in case 4.Conclusions:Considering the atypical clinical presentations, clinicians should be aware of incarceration of retroverted uterus when related symptoms or signs were presented. Placenta previa might be the comorbidity and should be differentially diagnosed. The timing of a cesarean section is supposed to be determined based on multiple factors. Moreover, a median abdominal incision and a superior transverse uterine incision are recommended, and an anatomic landmark is often required for the latter's accurate position.

Objective To observe the influence of Buyang Huanwu Decoction ( BYHWD) on the inhibition of rat myocardial H9C2 cell activity and SH2-containing tyrosine phosphatase-1 ( SHP-1) activity induced by trastuzumab, and to explore the possible regulatory mechanism after observing the intervention of BYHWD on rat myocardial H9C2 cell transfected with SHP-1 or SHPC/S-1 gene. Methods The eukaryotic expression vectors pcDNA3.1 (+)- SHP-1 and pcDNA3.1 (+) -SHPC/S–1 were constructed and then were transfected to rat myocardial H9C2 cells using the method of liposome transfection. The cells with positive clones were screened out with G418, and then were cultured with trastuzumab for maintaining growth. Using quantitative RT-PCR, we detected the expression of SHP-1 gene and SHPC/S - 1 gene in rat myocardial H9C2 cells. The phosphatase activity analysis was used for observing the regulatory effect of BYHWD on SHP-1 in myocardial cells. Furthermore, we observed the apoptosis of rat myocardial H9C2 cells by methyl thiazolyl tetrazolium (MTT) assay after treatment with BYHWD. Results Sequencing results indicated the successful construction of eukaryotic expression vectors, which had stable expression in myocardial H9C2 cells even under the intervention of trastuzumab. The results of phosphatase analysis showed that H9C2-SHP-1 had the highest activities of phosphatase, but the activities were decreased after the intervention with BYHWD ( P<0.05) . The results of MTT assay also showed the apoptotic rate of H9C2-SHP-1 cells was decreased after treatment with BYHWD ( P <0.05) . Conclusion BYHWD can promote the proliferation of myocardial H9C2 cells inhibited by trastuzumab, and can regulate the expression of SHP-1 in myocardial cells, which will supply reference to the further study of treatment of trastuzumab-induced cardiac toxicity.

OBJECTIVE:To probe into the reasons for drug repercussion in ward area and find a solution.METHODS:The reasons for drug repercussion,the kinds of the returned drugs and the proportion of these drugs in the total in terms of amount of money between Oct.to Dec.in 2006 were analyzed and compared with the amount of money of returned drugs between 2005 and 2006 in our hospital.RESULTS:There were 2 674 cases of drug repercussion between Oct.to Dec.in 2006 in our hospital;the returned drugs totaled 192 kinds,and the drug repercussion was mainly due to patients' discharge,alteration of medical orders and input error.The rate of drug repercussion was 4.67%.CONCLUSION:There were drug repercussion cases in all the departments of our hospital,and the amount of the returned drugs were large,which resulted in increased difficulty of drug quality management and serious hidden dangers for medication safety,therefore,standard administration on which is much needed.

ObjectiveTo determine the validity of transcranial sonography (TCS) in the differential diagnosis of Parkinson's disease (PD) and essential tremor (ET). MethodsTCS was performed in 100 patients with PD, 33 patients with ET and 100 normal controls in a blind manner. The echo signal intensity of the substantia nigra was classified into grade Ⅰ-Ⅴ for semi-quantitative analysis.When the echo intensity was gradeⅢ or more,it was deemed as abnormal and the area of the substantia nigra hyperechogenicity would be measured and its ratio to the area of the whole midbrain ( S/M ) would be calculated. Results ( 1 ) Semi-quantitative analysis: the ratio of the persons whose echo intensity of the substantia nigra was grade Ⅲ or more was greater (76. 00％ ,76/100) in PD than ET (9. 09％, 3/33) and normal controls ( 13.00％, 13/100; x2 = 130. 622, P ＜0. 01 ). However, there was no difference between ET and controls. (2) Quantitative analysis: the median and quartile range of the area of substantia nigra hyperechogenicity and S/M were greater in PD patients ( O. 54 ( 0. 57 ), 11.03 ( 9. 00 ) ) than ET ( 0. 00(0.04), 0.00(1.55),H= 42.39,42.19, both P＜0. 01, respectively) and normal controls (0.00(0. 00), 0. 00 (0. 00 ), H = 121.86,121.47, both P ＜ 0. 01, respectively), and there was no difference between ET and controls. (3) Using the area of hyperechogenicity ≥0. 20 cm2 or S/M ≥ 7％ as a cut off for predicting PD, the sensitivity, specificity and accuracy were 85.39％, 78. 38％ and 81.50％ or 86. 02％,81.31％ and 83.50％ ,respectively. But there was no significant difference for the accuracy (Z = 0. 683,P ＞ 0. 05). ConclusionTCS might find the specific hyperechogenicity of substantia nigra in PD patients,providing useful information to distinguish PD from ET.

Objective To investigate the expressions of hypoxia inducible factor-1α (HIF-1α) and vascular endothelial growth factor-C (VEGF-C) and the correlations with clinic parameters,and to make sure the effects of the two genes in the lymphangiogenesis and lymph node metastasis of breast cancer.Methods The expressions of HIF-1α and VEGF-C were investigated by means of immunohistochemistry in samples from 78 cases with breast cancer and 20 cases with breast benign lesions.The density of the lymphatic microvessels immunohistochemically stained by D2-40 antibody was calculated.The relationships between HIF-1α,VEGF-C,LVD and clinicopathological parameters were analyzed statistically.Results HIF-1α expression occurred in 52 out of the 78 tumor samples (66.67％),while VEGF-C expression was observed in 41 out of the 78 tumor samples (52.56％).HIF-1α and VEGF-C expressions in breast cancer were significantly higher than those in beingn disease (15％ and 10％ ; x2 =17.26,P =0.000; x2 =11.71,P =0.001).The expressions of HIF-1α and VEGF-C were significantly correlated with regional lymph nodal involvement (x2 =5.80,P =0.016; x2 =7.26,P =0.007) as well as late TNM classification (x2 =8.51,P=0.004; x2 =6.02,P =0.014),disregarding the patient's age,tumor diameter,histological grade and pathologic type (P ＞ 0.05).In addition,HIF-1α expression was positively correlated with VEGF-C expression (r =0.254,P =0.025).Higher LVD was found in both high HIF-1α and high VEGF-C expression cases (t =2.19,P=0.017; t =3.25,P=0.001).Conclusion HIF-1α may play a crucial role in the lymphangiogenesis and lymph node metastasis by regulating the expression of VEGF-C in breast cancer.Therefore,HIF-1α may become a particularly promising target for controlling lymph node metastasis in breast cancer.

Objectives To construct reference range of fetal optic tract mean diameter and to report the measured optic tract mean diameter in fetuses with agenesis of the septum pellucidum (SP).Methods Three-dimensional volumes of the optic chiasm were acquired in 254 normal fetuses during routine sonographic examination at 21 ～ 40 weeks' gestation and the diameters of posterior left and right optic tracts were measured offline.A polynomial regression approach was used to calculate reference charts for the fetal optic tract mean diameter.In addition,16 three-dimensional volumes were acquired in fetuses with SP agenesis for offline measurement of optic tract diameter.The complete follow-up data were obtained in 7 of these 16 cases.Results In normal fetuses,the optic tract diameter increased linearly throughout gestation.Normal charts and equations were constructed.Among 7 fetuses with SP agenesis and complete follow-up,one had postnatal normal vision,two had hypoplastic optic tract,and four underwent termination of pregnancy.Three cases of normal childbirth were tested after the baby was born as a bundle of apparent dysplasia,including 1 case of neonatal characterized by lack of vision at the one year old and 2 cases of impaired vision.Four cases of termination of pregnancy included 1 case with tracking pathological confirmation of optic nerve hypoplasia,and the other 3 cases without tracking the pathological results.Conclusions We present new reference charts for fetal optic tract mean diameter.In fetuses with agenesis of the SP,sonography of the optic tract might be a useful tool to assess its development and may help prenatal counseling.

Advancements in technology have enhanced the performance of pacemakers but made the interaction between the pacemaker and the heart becoming increasingly complex, and its is difficult to interpret the paced ECGs (PGCGs). This paper introduces a brief method to interpret PECGs, which illustrate the timing intervals graphically and avoid using symbols and strings.

ObjectiveTo investigate the value of serum creatinine(SCr) to monitor the renal function of patients with spinal cord injury(SCI).Methods1298 SCI patients were investigated in Beijing Charity Hospital from January 2004 to May 2009. 249 healthy people were involved as control. The data of SCr were analysed.ResultsThe level of SCr for the SCI patients was (56.81±14.33) μmol/L with normal distribution, 95% CI was 28.73～84.89 μmol/L; The level of SCr for the healthy people was (75.98±11.34) μmol/L, 95% CI was 57.36～101.80 μmol/L. The level of SCr was significantly lower in the SCI patients comparing to the healthy people (P<0.01). Among the SCI patients, the level of SCr was (59.59±13.76) μmol/L for male while (46.41±11.31) μmol/L for female(P<0.05). There was no difference in level of SCr among different ages of the SCI patients(P>0.05). The characteristics were likely in the two groups. There was no difference in level of SCr between paraplegic (55.54±14.96) μmol/L and quadriplegic (57.67±13.83) μmol/L (P>0.05).ConclusionThe characteristics of level of SCr were likely in SCI patients and healthy people with normal distribution. The level of SCr was lower in SCI patients comparing to healthy people, which was higher for male SCI patients comparing to female SCI patients.

Objective To evaluate super-selective renal arterial embolization(SRAE)in treating severe renal hemorrhage when conservative treatment had failed. Methods SRAE was performed in 111 patients with severe renal hemorrhage who had failed to respond the conservative management.The clinical data,the way of embolization,the medication and the follow-up findings were retrospectively analyzed.Results Excellent results were obtained in all patients after SRAE and no serious complications occurred.The technical successful rate with single session was 95.5%(106/111).Gross hematuria disappeared within 1-4 days after the treatment.Two patients developed shock after renal embolization and had to receive surgery after the shock was controlled.Three patients had a recurrence of hematuria,the blood urine subsided after SRAE was employed again.A follow-up with a mean period of 37.4 months was carried out in 92 patients,and the follow-up checkups showed that the renal function was well preserved in all patients.Conclusion Super-selective renal artery catheterization and embolization is a safe and effective treatment for severe renal hemorrhage,it can maximally preserve the healthy renal parenchyma as well as the renal function.Therefore,this technique should be regarded as the treatment of first choice for patients with severe renal hemorrhage.