Objective To explore the association between estimated glomerular filtration rate (eGFR) based on creatinine and cystatin C and the SYNTAX score in old patients with coronary heart disease. Methods Two hundred and fifty-six consecutive old patients with coronary heart disease were included in this study. The patients were angiographically diagnosed with coronary heart disease between January 2013 and April 2014 at the Department of Cardiology.eGFR was caculated by using BIS2 equation based on creatinine and cystatin C.SYNTAX score was caculated by SYNTAX score algorithm. Multiple linear regression and ordinal logsitic regreesion was used to analyze the association between eGFR and SYNTAX score. Results In patients with normal of renal function [eGFR≥90 ml/(min·1.73 m2), 110 patients], mild renal insufficiency [60 ml/(min · 1.73 m2) ≤ eGFR<90 ml/(min · 1.73 m2), 98 patients], midrange and severe renal insufficiency[eGFR<60 ml/(min · 1.73 m2), 48 patients], with the decrease in renal function of patients, SYNTAX score increased: (15.42 ± 9.65), (25.24 ± 8.34), (33.73 ± 10.15) scores, P<0.01. eGFR was an independent predictor of SYNTAX score (r=-0.059, P<0.01).eGFR was negatively correlated with SYNTAX score (r=-0.457, P<0.01). Conclusions eGFR is an independent predictor of SYNTAX score and negatively correlated with SYNTAX score in old patients with coronary heart disease. This might be helpful to explain the increased risk of coronary heart disease events and mortality in old patients with renal dysfunction.

Objective To obtain the Tat-GFP fusion proteins with penetrating activity and labeled with green fluorescence protein (GFP), and to explore the cell membrane penetrating activity of Tat-GFP in MCF-7 cells. Methods The plasmid pET-24a-Tat-GFP was transformed into Escherichia coli BL21 cells. Different concentrations (0.5 and 1.0 mmol · L-1 ) of isopropyl-β-D-thiogalactopyranoside (IPTG ) and cell culture temperatures (22℃ and 37℃)were used to optimize the protein expression.The Tat-GFP proteins in supernatant were purified using Ni-IDA resins. Western blotting analysis was used to identify the Tat-GFP protein, and confocal laser scanning microscope (CLSM ) was used to examine the cell penetration of Tat-GFP protein. Results There was no significant difference in the Tat-GFP protein production induced by 0.5 and 1.0 mmol·L-1 IPTG;however,the low temperature (22℃)-induced BL21 cells expressed more Tat-GFP proteins than that at 37℃ induction.The Western blotting analysis results showed that GFP antibody could specifically recognize the proteins in PVDF membranes in dose-dependent manner;the CLSM results indicated the distribution of green fluorescence in cytoplasm and nucleus of MCF-7 cells.Conclusion The Tat-GFP protein highly expresses in the supenatant of Escherichia coli i BL2 1 cells at low temperature;the obtained Tat-GFP protein with green fluorescence preserves the cell penetrating activity.

Robotic system helps surgeons in performing surgery. Currently Da Vinci system is the most popular. Da Vinci system has been used for the stomach and bowel diseases in 27 cases(18 cases of stomach and 9 cases of colon and rectum) in the Zhongshan Hospital, Fudan University. Accurate preoperative staging is crucial, and Da Vinci system is advantageous in lymph node dissection, preservation of nerve plexus, and complete resection of mesorectum. Adoption of gastrointestinal tract reconstruction technique should depend on the operation and experience in surgery. Though Da Vinci system has limitations and the cost is high, it is believed to be the future trend.
Digestive System Surgical Procedures ; methods ; Humans ; Robotics ; methods

Genetic Techniques ; Genomics ; Humans ; Nucleic Acid Amplification Techniques ; Nucleic Acid Hybridization ; Sequence Analysis, DNA ; Viruses ; genetics ; isolation & purification

Objective To investigate the clinical efficacy of adefovir dipivoxil in antiviral treatment of chronic hepatitis B and its effect on peripheral blood T lymphocyte subsets.Methods 40 cases of patients with chronic hepatitis B were selected from The Fourth People’s Hospital of Qinghai in October 2009 to June 2012,the patients were given the antiviral treatment of adefovir dipivoxil.Before treatment,3 months,6 months and 12 months after treatment,the changes of liver function indicators of alanine transaminase(ALT),aspartate transaminase(AST)and total bilirubin(TBiL),and hepatitis B virus-DNA(HBV-DNA)were recorded;the total effective rate was observed;the peripheral blood T lymphocyte subsets changes was tested and analyzed by flow cytometry.Results The ALT,AST and TBiL of the patients all improved good,and the indicators of ALT,AST and TBiL after 12 months decreased significantly than before treatment,the HBV-DNA testing of the patients recovered negative,the difference was statistically significant (P<0.05 );the total effective rate of hepatitis B patients is 92.5%;the peripheral blood T lymphocyte subsets has no significant improvement in patients after antiviral treatment for 3 months.After the treatment for 6 months and 12 months,the CD4 +T and CD4 +/CD8 +T were significantly higher than those before treatment,there was no significant changes in CD3 +T and CD8 +T before and after treatment.Conclusion Adefovir dipivoxil has a good clinical efficacy in antiviral treatment of chronic hepatitis B,and can significantly improve the patients’liver function,improve peripheral blood T lymphocyte subsets imbalance.

Objective To investigate the clinical value of stereotactic biopsy in the diagnosis of the multiple intracranial lesions, and explore the operation methods, technical points and clinical experiences to reduce surgical complications. Methods Twenty-three patients in the first affiliated hospital of Kunming Medical University underwent stereotactic biopsy from January 2009 to June 2013 were analyzed retrospectively. The patients were aged between 11 and 73 years (the mean age of 34.6 years) . There were 12 males and 11 females. Operations were performed by thin thickness of spiral CT scan, ASA-602S and Leksell-Frame-G stereotactic frame, Sedan side-cutting needle, Backlund side-cutting needle and neuroendoscope of STORZ. Routine histopathological examinations of specimens were conducted. The immunohistochemical staining of the histopathological section of specimens was performed if necessary. Results The diagnostic yield was 91.3% (21 cases) . The result of pathological diagnosis was inflammatory granuloma in 1, inflammatory lesion in 1, calcification in 1, hyperplasia of colloid cells in 6, astrocytoma in 1 (WHOⅠ-Ⅱ), astrocytoma in 2 (WHOⅡ), astrocytoma in 1 (WHOⅡ-Ⅲ), mixed oligoastrocytoma in 1 (WHOⅠ-Ⅱ), glioblastoma multiforme in 3 (WHOⅣ), germinoma in 1, brain metastases in 1, diffuse large B-cell lymphoma in 1, intracranial granulomatousarteritis in 1 and negative in 2. There were no serious complications, such as coma, hemiparalysis, infection and intracranial hematoma. Conclusion Stereotactic biopsy is an important method in the diagnose of multiple intracranial lesions. It has the advantages of precise location, less damage, safe performance, and reducing the complication effectively. It is worth promoting.

Objective To understand the environmental estrogens contamination of tap water and source water. Methods Environmental estrogens in the water samples were concentrated by macroporous adsorption resin H103. The effect of environmental estrogens in concentrated samples was assessed by the recombinant yeast system. Results The results showed that some source water and tap water really contained environmental estrogens. The activity of environmental estrogens in concentrated samples of some source water increased as the volume of concentrated sample increased. The concentrate of 100 ml water sample could show the estrogenic effect. Conclusion Some source waters and tap waters in China have been contaminated by environmental estrogens. Environmental estrogens in source water can not be removed completely by drinking water treatment system of city.

OBJECTIVE: To figure out the regulatory models and concepts of FDA in drug review process that promotes surrogate endpoints development. METHODS: This paper made a thorough research to the FDA regulations, guidance documents and guidelines and literatures, and through historical retrospective of surrogate endpoints used in clinical drug trials and regulatory acceptance, interpretation of FDA's established development model in scientific use of surrogates, combined with the status quo surrogate endpoints in the field of serious diseases as cancer, AIDS, diabetes. RESULTS AND CONCLUSION: Then conclusion of FDA's experience in promoting regulation and utility of surrogate endpoints is summed up, including the development of guidelines to promote common understanding of specific use of surrogates; combining a variety of programs promote the development of surrogate endpoints; and using a risk-based classification in favor of the allocation of resources.

Abstract: Occupational epidemiology aims to explore the effect of occupational hazards on the health of workers and understand ， their mechanisms. It plays an important role in occupational health and occupational medicine.Currently occupational ， ， exposures in the workplace are complex and diverse and multiple factors affect workers´ health at the same time. Therefore it is important to elucidate the pathogenesis of occupational disease caused by occupational hazards and implement early - - intervention. System epidemiology collects data on multi level exposure and multi omics information to conduct network analysis - on the relationship amongrisk factors. and to study the mechanisms of exposures and health outcomes based on multi level data. ， ， ， ， Using the study design of system epidemiology occupational environmental lifestyle and social factors are combined as a ， system to evaluate the health of workers which can better evaluate the adverse health effects caused by occupational hazards. - ， ， The studies base on multi omics design will explore the pathogenesis of occupational diseases at the molecular cellular and tissue levels to evaluate the impact of occupational hazards on workers´ health and to explore interventions from multiple - perspectives to reduce the occurrence of occupational or work related diseases.

Objective To investigate the diagnostic and predictive value of spasticity in shunting patients with normal pressure hydrocephalus (NPH).Methods Twenty-three secondary NPH patients who received ventriculo-peritoneal shunt were retrospected. Increased muscular tension were quantified pre and post-shunting by modified Ashworth scale. The dilatated ventricle was measured by Evans' index.Results Four weeks after shunting, spasticity was relieved to some extent on all the identical limbs side of the primary impairment cerebral and 78% cases was improved to zero scale. on the contralateral side limbs, the relieved rate was 86% and 46% cases improved to normal scale. Evans' index improved 35%.Conclusion Increased muscle tonus could be measurement quantified and is readily available and sensitive as a diagnostic criteria in secondary NPH.