The aim of this study is to investigate the apoptotic inhibition and its molecular mechanism of dexamethasone (DEX) acting on cisplatin (CDDP)-induced apoptosis of human lung adenocarcinoma cell SPC-A1; SPC-A1 cells were pre-cultured in vitro for 24 hours with DEX in different concentrations and then CDDP was added in different concentrations for culturing for further 48 hours. The survival rates of the cells were determined by MTT. The expression of serum/glucocorticoid-induced kinase (SGK-1) and mitogen-activated protein kinase phosphatase-1 (MKP-1) in SPC-A1 cells after being cultured by 1 micromol/l DEX at different time was detected by semi-quantitative RT-PCR technology. The expression of glucocorticoid receptor (GR) in SPC-A1 cells was measured by immunohistochemistry (IHC) with biotin-labeled anti-GR. The results of MTT showed that SPC-A1 cells had resistance to CDDP-induced apoptosis with pre-cultured DEX and the resistance intensity presented DEX concentration-dependent. The expressing quantity of SGK-1 in SPC-A1 cells stimulated by DEX could be elevated and increased with intention of time, but the express of MKP-1 was not detected. Up-regulated expression of GR in SPC-A1 cells stimulated by DEX was detected by IHC. The number of cells expressing GR in SPC-A1 cells was significantly higher than that in the control group. The results showed that DEX inhibited apoptosis of SPC-A1 cells induced by CDDP. The possible molecular mechanism is that elevated expression of GR induced by DEX up-regulates the expression of SGK-1 which locates at the downstream of anti-apoptosis pathway. The apoptosis resistance of SPC-A1 cells may account for all above the factors.
Adenocarcinoma ; pathology ; Apoptosis ; drug effects ; Cell Line, Tumor ; Cisplatin ; pharmacology ; Dexamethasone ; pharmacology ; Dual Specificity Phosphatase 1 ; metabolism ; Humans ; Immediate-Early Proteins ; metabolism ; Lung Neoplasms ; pathology ; Protein-Serine-Threonine Kinases ; metabolism ; Receptors, Glucocorticoid ; metabolism ; Up-Regulation

Objective To investigate the correlation between levels of glycohemoglobin and cognitive function in elderly patients with type 2 diabetes. Methods Cognition function of 40 elderly patients with type 2 diabetes was assessed by Wechsler Memory Scale (WMS), Trail Marking Test and Wisconsin Card Sorting Test (WCST) and was compared with 40 healthy controls matched for age, gender, education level and profession. Meanwhile, the correlation between cognition function and levels of glycohemoglobin was analyzed by regression analysis.Results The scores of Wechsler Memory Scale in the patients were lower than that in normal controls (P＜0.01，P＜0.05). The patients needed much more time to complete the Trail Marking Test (P＜0.001). The scores of Wisconsin Card Sorting Test were significantly different between two groups (P＜0.01，P＜0.05). The regression analysis showed that there was an obvious correlation between serum level of glycohemoglobin and cognition functions in patients with type 2 diabetes(r=-0.38, -0.43, -0.48, -0.46, 0.41, P＜0.05). Conclusion Cognition function decreases and significantly correlates with the level of glycohemoglobin in the elderly patients with type 2 diabetes.

Objective:To evaluate the treatment effects of the half-columnar shaped mandibular block bone onlay grafting technique for augmentation of the resorbed maxillary anterior alveolar ridge after single tooth missing.Methods: A total of 15 sites of 14 patients received ridge augmentation surgeries.The recipient sites were prepared with trephines,the half-columnar shaped bone blocks were harvested from the ramus and external oblique ridges with trephines according to diameters of the recipient sites.The bone blocks were placed as lateral onlay grafts on recipient beds and secured by means of titanium screws.Particulate bone was added and absorbable membranes were used to stabilize and protect the grafts.After a mean interval of 4.5 months of healing the flaps were re-opened,the screws were removed and non-submerged implants were placed.The width and height of the alveolar ridges were recorded.After 3 months,implant-supported crowns were provided to the patients.One year later,the peri-impant condition and the marginal bone resorption on the proximal sites were observed.Results: Mean lateral augmentation obtained at the time of bone grafting was(3.8?0.8) mm(x?s),5 out of 15 sites exhibited a mean of 3 mm of vertical augmentation.The mean healing time was 4.5 months,the mean percentage of horizontal and vertical bone resorption in the mean time were 8% and 7% respectively.No major complications were recorded at donor sites.No implant was lost during the study period.Clinical parameters and probing depth(≤4 mm) demonstrated the presence of a healthy peri-implant mucosa after 1 year of prosthetic reconstruction.The clinical and radiographic bone observations showed no more than 1.2 mm of resorption after bone graft and implant placement.Conclusion: The half-columnar shaped mandibular bone graft(from the ramus and external oblique ridge) is a promising technique for bone augmentation in localized alveolar ridge defects after single tooth missing.This procedure offers easy access,good bone quantity for localized repair,low morbidity,decreased complaints of postoperative sensory disturbances or discomfort,minimal graft resorption,and a shorter healing time as compared with other methods for bone repair.

Objective To measure the setup errors and organ movements of patients with esophagus carcinoma during radiotherapy and find a reasonable margin from the clinic target volume (CTV) to the planning target volume (PTV). Methods (1) Set-up veri cation: Forty-two cases of untreated esophageal cancer were enrolled into this study. The physicist firstly made the planning according to the doctor requests and ensured the best distribution at the target. Thereafter, the 0° and 90° digitally reconstructed radiograph (DRR) was transmitted to the iView GT workshop. Meanwhile, two copies of cross-cut electronic portal image (EPI) were required before radiotherapy. Two doctors confirmed the variance of the osteal mark from the EPI and DRR,and output a 3D direction (left to right, superior to inferior, anterior to posterior) of the setup errors through the iView GT software. (2)Breathing motion:Ten cases of untreated esophageal cancer were enrolled into this study.Three distinct breathing levels were deflned: FB (free breathing), EBH (expiration with breath-held) and IBH (inspiration with breath-held). We gave the treatment planning in FB, then by moving the isocenter to EBH and IBH, we recalculated the dose distribution without changing the field angle, shape and weighing (Mus). Displacements were analyzed at four points (anterior, posterior, right lateral and left lateral) and five levels of target (upper, quarter, isocenter, three-quarter and lower). Results (1) The systematic setup errors were -0.23 cm, -0.02 cm and -0.06 cm, and the random errors were 0.44 cm, 0.45 cm and 0.44 cm at the direction of left to right(LR), superior to inferior (SI), anterior to posterior(AP), respectively. (2) The organ movements were 0.3 cm, 0.6cm and 0.3cm at the LR, SI, AP, respectively. Conclusions As an alternative, the root-sum-of-squares of set-up error and organ motion are suggested by σtot=√ (σITV2+σSM2). The CTV to PTV margins are 0.8cm left to right, 0.78cm superior to inferior, 0.5cm anterior to posterior.

An analysis is made according to policy documents of localities on capitation payment, and by means of literature review and the analysis framework of the World Bank,this paper reviewed studied the following:definition of service package,per capita rate,designated institutions,design of financial regulations,and service supervision.Given the attempts made at localities,most of the schemes are incomplete in design,and defective in capitation measurement methods and dynamic adjustment mechanisms.The authors recommend a systematic design of the capitation payment scheme for better outcomes.

Objective To observe the anesthetic effect of Sumianxin Ⅱcombined with chloral hydrate in plastic surgical operation on rabbit and explore the fast , safe and effective anesthetic methods .Methods A total of 82 Rabbits for operation were randomly divided into A , B and C groups.The A group was injected with SumianxinⅡintramuscularly (0.35 mL/kg by weight).The B group was injected with 10%chloral hydrate intravenously (2.5~3 mL/kg by weight).The C group was injected with Sumianxin Ⅱintramuscularly ( 0.2 mL/kg by weight ) combined with 10% chloral hydrate intravenously(1 ~1.5 mL/kg by weight).The anesthetic effect of induction and recovery time of anesthesia ,anesthesia maintaining time ,and anesthesia mortality rate were observed and compared .Results The anesthetic effect of induction of anesthesia,recovery time of C groups fall in between which of A and B groups ( P <0.05).However, as for anesthesia maintaining time , there was no significant difference between A and C group and both the two groups were longer than B group.Conclusion SumianxinⅡcombined with chloral hydrate possess the advantages of fast anesthesia induction and recovery effect , longer anesthesia maintaining time and low mortality .Therefore it is an easy to operate , expeditious , safe and effective anesthetization for plastic surgical operation on rabbit .

Objective To observe the effectiveness of introducing Diazepam into combined aesthesia of Sumianxin and ketamine hydrochloride .Method A total of 80 rabbits of both genders for operation were randomly divided into A , B and C groups .The A group was injected with Sumianxin intramuscularly ( 0.3 mL/kg by weight ) .The B group was injected with Sumianxin and ketamine hydrochloride intramuscularly ( 0.3 mL/kg by weight ) .The C group was injected with Diazepam intravenously ( 1.5 mL/kg by weight ) combined with Sumianxin and ketamine hydrochloride injected intramuscularly (0.3 mL/kg by weight).The aesthetic effects, induction time, anesthesia maintaining time, total anaesthetic dose and operation time were observed , recorded and compared .Result The induction time of the C group was significantly shorter than A and B groups (P<0.01).The initial anesthesia maintaining time of the C group was the longest among the three (P<0.01) with least total anaesthetic dose (P<0.01).The operation time of the C group was the least with best aesthetic effects (P<0.01).Conclusion Introducing Diazepam into combined aesthesia of Sumianxin and ketamine hydrochloride can improve the aesthetic effects .Therefore , this is an optional aesthetic method for time-consuming animal operation or sensitive surgical sites of rabbits .

Objective To analyze the factors for willingness to pay(WTP)in different quantiles and to provide evidence for formulating premium of minors covered by Urban Residents'Basic Medical Insurance.Methods In a field survey,the study adopted the contingent valuation method and quantile regression to measure and analyze the WTP.Results The influencing factors and degree of influence varied in different quantiles.Annual household income was significant in 10 of 11 quantiles with the maximum marginal effect of 350 yuan.Whether the insured comes from a village in a city affects 8 of the 11 quantiles whereas gender,age and health conditions of minors have minor effect on willingness to pay.Conclusion The premium standard should be raised from 40 yuan per person per year to 100 yuan.Minors can be categorized into subgroups and be set with distinct premiums in terms of the significant influencing factors and its influence degree.

Objective To investigate the clinical effect of minimally invasive percutaneous repair of acute closed Achilles tendon ruptures with intraoperative ultrasound assistance.Methods A retrospective case series study was made on 24 patients with acute closed Achilles tendon ruptures hospitalized between January 2013 and June 2015.There were 19 males and five females,aged 18-50 years (mean,30.5 years).MRI showed total Achilles tendon ruptures,and time from injury to operation was 1-3 days.All patients underwent minimally invasive percutaneous repair with high-frequency ultrasound assistance.Operation time and either intraoperative or postoperative complications were documented.At last follow-up,American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and Arner Lindholm system were used to evaluate ankle functional recovery.Results Operation time was 35-60 minutes (mean,42 minutes).No intraoperative injury to the major vessel and nerve occurred.Follow-up was conducted for 10-18 months (mean,14.5 months).No surgery-related complications were detected,including wound infection,skin necrosis and tendon reruptures.Ankle function was recovered to normal.AOFAS score were improved from preoperative 53-74 points [(61.5-± 6.7)points] to 91-100 points [(97.1 ± 3.2) points] at last follow-up (P ＜ 0.05).According to the Amer Lindholm system,the treatment outcome was excellent in 21 patients and good in three,with the excellence rate of 100％.Conclusion Ultrasound-assisted minimally invasive percutaneous technique improves the quality of tendon anastomosis,avoids injury to the sural nerve,minimizes the incidence rate of complications such as re-rupture,wounds infections or skin necrosis and hence is an ideal method for repair of acute closed Achilles tendon ruptures.

Objective To study the imaging findings of the normal acromioclavicular joint and acromioclavicular dislocation.Methods CR films of normal shoulder in 68 cases and normal chest in 400 cases were collected.The distances of the acromioclavicular joint were measured,and the inferior cortex line of the acromioclavicular joint was observed on CR.MRI in 30 cases with normal shoulder,24 cases with acromioclavicular dislocation and 7 cases with shoulder impingement syndrome were also presented.Results The normal distance of the acromioclavicular joint was (3.36±0.44) mm.There was an arch line on the inferior cortex of the acromioclavicular joint for normal subjects.According to the Rockwood classification,acromioclavicular dislocation included type Ⅰ in 7/24 cases,type Ⅱ in 5/24 cases and type Ⅲ in 12 cases.The distances of the acromioclavicular joint were increased(＞4.3 mm) in type Ⅱ and type Ⅲ,and the inferior cortex lines of the acromioclavicular joint were not continual in type Ⅲ.MR imaging showed that the intra-articular fibrocartilaginous disk,the capsular and acromioclavicular ligament structure were ruptured in type Ⅱ,and coracoclavicular ligament torn in type Ⅲ.Conclusion The distance and the inferior cortex line of the acromioclavicular joint are of important value in diagnosis and classification of acromioclavicular dislocation.MRI is the most significant method in diagnosis of acromioclavicular dislocation.