Sphingosine analogue FTY720 exerts good immune suppressive effect by inducing lymphocytes apoptosis and homing, which can be used for organ transplant rejection as well as anti-autoimmune disease treatment. Recent studies have found that FTY720 plays anti-tumor potential by inducing growth arrest and apoptosis as well as inhibiting tumor metastasis.

Hypoxia- inducible factor-1 ( HIF-1) promotes tumor deterioration, invasion and metasta-sis. Treatment targeting the HIF-1 signal pathway is becoming a hot research. In addition to uniquely selective inhibition of topoisomerase Ⅰ(Topo Ⅰ) ,the recent studies show that camptothecin compounds can regulate the activity of HIF-1 through decreasing HIF-1 protein translation and have been classified as a non-selective chemical inhibitor of HIF-1.

[Objective] Sorting and summing up Professor ZHANG 's clinical experience in the diagnosis and treatment of atlanto-axial joint subluxation, to develop the thought of clinical diagnosis and treatment of the disease. [Methods]Via studying with professor ZHANG, and collectting some cases,consulting the related literature and data.Finally, discuss and summarize it. [Results] Diagnosis found and appliedFour tenderness(Below the foramen magnum, trapezius muscle and at the junction of the skull,fengchi point,wangu point).Method combined with primary symptom and signs, X-ray. Treatment, application of error correction manipulation, light effect;And with local acupuncture point injection, menstruation invigorates the circulation of reinforcement. [Conclusion] Professor ZHANG's method of diagnosis and treatment of atlanto-axial joint subluxation is unique,clear, simple, has obvious curative effect, worth clinical application and promotion.

AIM:To establish a method for determining notoginsenoside R_1,ginsenoside Rg_1 and ginsenoside Rb_1 in Jingkang Capsules(Radix Rehmanniae praeparata,Radix Polygoni multiflori,Radix et Rhizoma Notoginseng,etc.). METHODS: A Diamonsil C_(18) column(250 mm?4.6 mm,5 ?m) with acetonitrile-water as the mobile phase was used for gradient elution,the flow rate was 1.0 mL/min and the UV detection wavelength was at 203 mn. RESULTS: There was a good linear relationship at a range of 0.327-2.180 ?g for notoginsenoside R_1(r=(0.999 4))(the average recovery was 98.23% with RSD of 1.53%(n=6)),0.909-6.060 ?g for ginsenoside Rg_1(r=1.0)(the average recovery was 99.04% with RSD of 1.00%(n=6)),0.672-4.480 ?g for ginsenoside Rb_1(r=0.999 8)(the average recovery was 98.17% with RSD of 1.31%(n=6)).CONCLUSION: The method is simple,quick and accurate.It can be used for the quality control of Jingkang Capsules.

OBJECTIVETo investigate the clinical therapeutic effects of anchors, peroneus brevis tendon augmentation and plantaris muscle tendon covering on the reconstruction of achilles tendon rupture caused by corticosteroids injection.

METHODSFrom March 2005 to April 2010, the clinical data of 10 patients with acute achilles tendon rupture repaired with suture anchors, peroneus brevis tendon augmentation and plantaris muscle tendon covering were retrospectively analyzed. The achilles tendon rupture was caused by corticosteroids injection. There were 8 males and 2 females with a mean age of (46.80 +/- 2.83) years old(ranged from 21 to 68 years). Postoperative complications, the range of movement of affected foot, number of consecutive heel raises and single leg jumpings were recorded. Functional recovery of achilles tendon were assessed according to ankle and hindfoot scores of the American Orthopedic Foot Ankle Society (AOFAS).

RESULTSAll patients were followed up for 12 to 18 months with an average of 13.5 months. No wound infection, re-rupture and rejection reaction were found. At the last follow-up, there was no significant difference in the range of movement between affected foot (54.5 +/- 6.3) degrees and unaffected foot (56.8 +/- 3.8) degrees (t = 0.989, P = 0.336). The affected foot could raise heel and do single-leg hops for 10 times continuosly. There was significant difference in AOFAS between preoperative score (67.3 +/- 7.6) and postoperative score (95.5 +/- 7.6) (t = 8.297, P = 0.000);and there was no significant difference between affected foot scores (95.5 +/- 7.6)and unaffected foot scores (98.5 +/- 6.3) (t = 0.961, P = 0.349). Function recovery of achilles tendon: 9 cases were good, 1 case was fine.

CONCLUSIONAnchors, peroneus brevis tendon augmentation and plantaris muscle tendon covering for the reconstruction of achilles tendon rupture caused by corticosteroids injection is a reliable and effective method, with advantage of simple operation, dependable fixation and less complications.

Achilles Tendon ; injuries ; physiopathology ; surgery ; Adrenal Cortex Hormones ; adverse effects ; Adult ; Aged ; Female ; Humans ; Injections ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; methods ; Recovery of Function ; Rupture ; surgery ; Tendon Injuries ; physiopathology ; surgery

Echinocandins ; therapeutic use ; Humans ; Infant, Newborn ; Infant, Premature ; Lipopeptides ; Mycoses ; drug therapy ; Sepsis ; drug therapy ; microbiology

Severe sepsis and septic shock is a clinical syndrome with sequential organ dysfunction or tissue hypoperfusion induce by sepsis.Although early,adequately and rapidly initial resuscitation plays pivotal role in the management,but infusion of albumin,plasma,red blood cell,platelet,gamma globulin and other blood products and the immunological support with ulinastatin combined with thymosin,blood purification and anti CD14 monoclonal antibody therapy also play an important role.

Objective To evaluate the clinical effects of continuous spinal anesthesia (CSA) with sufentanil for labor analgesia when compared with the effects of combined spinal-epidural analgesia (CSEA) and continuous epidural analgesia (CEA).Methods One hundred ASA Ⅰ or Ⅱ nulliparous patients who were at full term and who requested labor epidural analgesia,were randomly divided into 3 groups (n =40 each):continuous spinal analgesia group (group S),combined spinal-epidural analgesia group (group C) and continuous epidural analgesia group (group E).Labor analgesia was performed when the cervical dilation was 2-3 cm.In group S,the spinal catheter was placed at L3,4 interspace,and patient-controlled analgesia (PCA) with sufentanil was performed after a loading dose of sufentarnil 8 μg.PCA solution contained sufentanil 100 μg in 100 ml of normal saline.The PCA pump was set up with a 2 ml bolus dose,a 10 min lockout interval (volume was limited to 14 ml/h) and background infusion at a rate of 2 ml/h.In group C,CSEA was performed at L2,3 interspace,the patients received intrathecal sufentanil 8 μg via a spinal needle,the PCA solution contained 0.1％ ropivacaine 200 mg and 0.5 μg/ml sufentanil 100 μg in 200 ml of normal saline.The CSEA pump was set up with a 6 ml bolus dose,a 10 min lockout interval (volume was limited to 40 ml/h) and background infusion at a rate of 6 ml/h.In group E,CEA was performed at L2,3 interspace and the method was the same as in group C.The systolic pressure,diastolic pressure,HR,fetal heart rate (FHR) and intensity of uterine contraction were recorded beforeanalgesia and 5,10,15,30,60 and 120 min after beginning of analgesia,when the cervical dilation was 7-8 cm,and when the uterine cervix dilated absolutely.The side effects were recorded.Bromage scale was assessed at 10 min of analgesia.Apgar scores of the neonates were recorded at 1,5 and 10 min after birth.The analgesic effect was evaluated 24 h after birth.Results In group S,the hemodynamic parameters,FHR and intensity of uterine contraction were within the normal range,the analgesic effect was excellent or good,Bromage scale was 0,two cases had post-dural puncture headache,the incidence of pruritus was 42 ％ and pruritus was mild,Apgar scores of the neonates were 9.1 ± 0.4,9.6 ± 0.4 and 10 at 1,5 and 10 min after birth,respectively,no cardiovascular events occurred.There was no significant difference in the parameters mentioned above between groups C and S and between groups E and S (P ＞ 0.05).Conclusion CSA with sufentail is effective and suitable for labor analgesia and the efficacy is comparable with that of CSEA and CEA.

Epithelial-mesenchymal transition (EMT) is an important biological process in embryonic development and tumori-genesis. In this process, epithelial tumor cells can obtain mesenchymal phenotypes and promote tumor invasion and metastasis. EMT is controlled by multiple transcription factors, signal pathways, and microRNAs. EMT and cancer stem cells are closely related. EMT also promotes the self-renewal ability of tumor cells and the overexpression of EMT-related markers in tumor cells with stemness. Some mi-croRNAs can control EMT process and stemness. In this study, recent developments on EMT and cancer stem cells in tumor metastasis were summarized to provide new insights into target therapy of tumor metastasis and recurrence.

Objective To evaluate the value of (1 ,3)‐β‐D‐glucan(G test) in the diagnosis of invasive pulmonary fungal infection (IPFI)in patients with chronic obstructive pulmonary disease (COPD) .Methods 96 COPD patients with high risk of IPFI were en‐rolled in the study ,and were divided into IPFI group and non‐IPFI group .The G test were performed on those people while the tra‐ditional methods sputum smear and fungal culture were also performed .The (1 ,3)‐β‐D‐glucan concentrations of IPFI group and non‐IPFI group were compared ,and then the areas under receiver operating characteristic curve (ROC) were calculated .The sensi‐tivity ,specificity ,positive predictive value ,negative predictive value ,and the area under ROC of the two methods (G test and tradi‐tional methods) were compared .Results The sensitivity ,specificity ,positive predictive value ,negative predictive value of G test were 89 .5% ,89 .6% ,68 .0% ,97 .2% ,respectively ,when 20 pg/mL was the critical value .Areas under curve were 0 .942 for G test ,and 0 .790 for traditional method .Conclusion The detection of (1 ,3)‐β‐D‐glucan might be faster and with higher positive rate than traditional method ,and could be used for the early diagnosis of IPFI ,provide reference for the treatment .