Studies have shown that erythropoietin (EPO) may have neuroprotective effect on cerebral ischemia, and exogenous EPO may also exert neuroprotective effect on cerebral ischemic injury through blood-brain barrier. Its mechanisms may include the upregulation of the expressions of apoptosis inhibiting genes bcl-2 and bcl-xl, the expression of key proteases during the process of inhibiting apoptosis, inhibiting nitric oxide oversynthesis, protecting against glutamate-induced excitotoxicity, etc.

AIM To explain the variation of blood vessel factors on pulmonary hypertension(PH) induced by monocrotaline(MCT). METHODS Rats were given an injection of MCT ih(60 mg?kg -1 ). The concentration of endothe line(ET), nitric oxide(NO), thromboxane B 2(TXB 2) and 6 keto prostaglandin F 1? (6 keto PGF 1? ) were measured by radioimmunoassay and colorimetric analysis after the model had been set up successfully for 4 wk. RESULTS MCT either raised 6 keto PGF 1? and NO or prevented the progression of ET and TXB 2. CONCLUSION The mechanism of PH induced by MCT probably associated with the variation of those blood vessel factors.

Objective To research the expression and correlation between erythropoietin(EPO)mRNA and hypoxia inducible factor-1?(HIF-1?)mRNA in rats with brain ischemic tolerance induced by ischemic preconditioning.Methods Models of cerebral ischemic preconditioning and ischemic-reperfusion(preconditioning group)were made by twice suture method,after the short ischemic preconditioning 1 d,3 d,7 d,14 d and 21 d respectively,the models were underwent ischemic-reperfusion again.The infarct volume was measured by tetrazolium chloride(TTC)staining,the expressions of HIF-1? mRNA and EPO mRNA in the different time(1～21 d)of ischemic-reperfusion were detected by reverse transcriptase polymerase chain reaction(RT-PCR)and compared with non-preconditioning group.Results The infarct volume in the 1 d,3 d and 7 d subgroups of preconditioning group were significantly smaller compared with non-preconditioning group(all P

Objective:To observe the effect of photodynamic therapy(PDT)on apoptosis of human lung adenocarcinoma cell line A549.Methods:Human lung adenocarcinoma cell line A549was used and the optimal parameters of PDT were se-lected by MTT colorometric assay.The experiment was divided into2groups:control group and PDT group.Twenty-four hours after PDT(HPD concentration10mg/L,laser dosage10J/cm 2 ),cell cycle and apoptosis rate were estimated by flow cytometry;agarose gel electrophoresis and TUNEL were used to observe the DNA fragments and apoptosis index(AI).Re-sults:The killing effect was saturated when HPD was10mg/L and laser was10J/cm 2 .Under the same laser(10J/cm 2 ),A549cells were exposed to6different duty time fabrications and the outcomes showed that their D 492 had no statistical differ-ence.Agarose gel electrophoresis of DNA showed DNA ladder,a biochemical hallmark of apoptosis in the PDT group.Flow cytometry showed that PDT group had G 0 /G 1 stage arrest.The apoptosis rate was(18.443?7.122)%in PDT group vs (0.301?0.361)% in control group(P

60 years, 13.3% of the total sarcoidosis patients) diagnosed as sarcoidosis based on national criteria from the year 1965 through 1999 were reviewed. Results The clinical degree was as follows: phase I, 8 cases; phase Ⅱ, 6 cases; phase Ⅲ, 2 cases. The elderly sarcoidosis patients manifested variously, with misdiagnosis rate being 50%. The active degree of pulmonary sarcoidosis was correctly evaluated after the diagnosis was confirmed and the patients was strictly observed during the treatment since it was very important for avoiding the occurrence of complications. Conclusions The early diagnosis in elderly patients with sarcoidosis should be emphasized to prevent them from missing and misdiagnosis. The elderly patients with treating indications in phases Ⅱ and Ⅲ could be given steroids and constant observation and regular examinations are important during the treatment.

Objective To analyze the influencing factors for fungal infection in hospitalized patients with acquired immunodeficiency syndrome(AIDS),and provide basis for taking preventive and control measures.Methods Clini-cal data of 112 inpatients with AIDS in a tertiary first-class hospital from January 2010 to October 2015 were ana-lyzed retrospectively,related risk factors were analyzed in patients with fungal infection,univariate analysis was performed byχ2 or t test,and multivariate analysis was performed by logistic regression analysis.Results Among 112 AIDS inpatients,41 (36.61%)had fungal infection.Candida albicans was the main pathogen (n=52, 76.74%)and was mainly isolated from lower respiratory tract (n=29,42.65%).Univariate analysis showed that invasive procedures,duration of antimicrobial use,combined antimicrobial use,and decreased CD4+ T lymphocyte count in peripheral blood were risk factors for fungal infection in AIDS inpatients(all P<0.05),while oral cleaning care and systemic antiviral therapy were protective factors for fungal infection(all P<0.05);multivariate analysis showed that decreased CD4+ T lymphocyte count in peripheral blood(OR,1.017[95% CI,1.009-1.025])and combined antimicrobial use(OR,3.975[95%CI,1.093-14.448])were independent risk factors for fungal infection in AIDS inpatients,while systemic antiviral therapy was independent protective factor for fungal infection (OR, 0.288[95%CI,0.099-0.841]).Conclusion There are many factors influencing fungal infection in AIDS patients, rational use of antimicrobial agents,systemic antiviral therapy,and increasing serum albumin concentration are main methods to prevent fungal infection,avoid unnecessary invasive procedures and application of preventive antifungal therapy for high-risk patients are also effective to prevent fungal infection.

Objective:To explore the expression of indoleamine 2, 3-dioxygenase 1(IDO-1), lymphocyte-activation gene 3 (LAG-3) and T cell immunoglobulin domain and mucin domain-containing molecule 3 (TIM-3) in differentiated thyroid cancer (DTC), and the value of them on prognosis.Methods:From May 2014 to November 2015, 119 DTC patients (33 males, 86 females, media age: 42 years) who underwent surgical treatment in Shanghai Sixth People′s Hospital were retrospectively analyzed. The expressions of IDO-1, LAG-3 and TIM-3 in the specimens were analyzed by immunohistochemistry and the expression differences between cancer tissues and normal tissues were analyzed by χ2 test. The correlation of IDO-1, LAG-3 and TIM-3 with clinical characteristics were analyzed using logistic regression analysis. The patients were followed up for 5 years, and the relationships of the progression-free survival (PFS) rate with the expressions of the three immune checkpoints were analyzed by Kaplan-Meier method, log-rank test and Cox proportional hazard models. Results:The overall 5-year PFS rate for 119 DTC patients (median follow-up time: 55(2-66) months) was 76.47%(91/119). The positive expression rates of LAG-3 and TIM-3 in cancer tissues were 21.85%(26/119) and 78.15%(93/119) respectively, which were significantly higher than those in normal thyroid tissues (7.34%(8/109) and 62.39%(68/109); χ2 values: 9.43, 6.81, both P<0.05). While the positive expression rate of IDO-1 was 70.59%(84/119) in cancer tissues, which did not show a significant difference from that in normal thyroid tissues (64.22%(70/109); χ2=1.05, P>0.05). Factors associated with the positive expression of LAG-3 included tumors with a single lesion (odds ratio ( OR)=0.248, 95% CI: 0.086-0.716, P=0.010). Log-rank test ( χ2=4.96, P=0.026) and multivariate Cox regression analysis (hazard ratio ( HR)=2.239, 95% CI: 1.013-4.592, P=0.046) suggested that LAG-3 positive expression was an independent risk factor of PFS. The same analysis of TIM-3 found no clinicopathological factors related to TIM-3 positive expression ( OR: 0.309-3.084, all P>0.05) and no association between TIM-3 positive expression and PFS ( χ2=0.008, P=0.929). Conclusion:The expressions of LAG-3 and TIM-3 are significantly increased in DTC tissues, and the higher expression of LAG-3 is associated with the worse prognosis, suggesting that LAG-3 may be a potential target for immunotherapy in DTC patients.

Objective To analyze the distribution and antimicrobial resistance of pathogenic strains in wound infec-tion,and provide scientific evidence for rational use of antimicrobial agents in treatment of wound infection as well as reducing the emergence of drug-resistant organisms.Methods Data about pathogenic strains isolated from wound specimens of patients with wound infection in a hospital between June 2011 and April 2014 were analyzed retrospectively.Results A total of 965 pathogenic strains were isolated from wound specimens,the main infection sites were limbs(50.47%);infected patients mainly distributed in department of orthopaedic surgery(44.97%);trauma and incisional wound infection were the major infection types(47.98%,36.48%,respectively).Among iso-lated pathogens,gram-positive bacteria,gram-negative bacteria,and fungi accounted for 37.20%,59.59%,and 3.21 % respectively.The main gram-positive bacteria were highly susceptible to vancomycin,teicoplanin,and linezolid,the main gram-negative bacteria were highly resistant to most commonly used antimicrobial agents except cefoperazone/sulbactam,piperacillin/ tazobactam,imipenem,and meropenem.Conclusion Patients with wound infection are mainly distributed in department of orthopedics,the main infection types are trauma and surgical site infection,antimicrobial resistant rates of the major gram-positive and gram-negative bacteria are both high.Sur-geons,especially orthopedics surgeons,should pay attention to the culture of pathogens and monitoring of antimi-crobial susceptibility,use antimicrobial agents rationally,and strengthen the prevention and control of surgical site infection,so as to reduce the infection incidence and occurrence of drug-resistant organisms.

BACKGROUNDTo observe the effects of photodynamic therapy (PDT) on human lung adenocarcinoma cell line A549 in vitro.

METHODSHuman lung adenocarcinoma cell line A549 was used to investigate the killing role of PDT with hematoporphyrin derivative (HPD) as photosensitizer and semiconductor successive laser as light source. The cultured cell was treated with different concentrations of HPD and different do-sages of laser, then MTT colorometric assay was applied to measure the OD492.

RESULTS5 mg/L of HPD was confirmed no effect. 10 mg/L of HPD could produce a marked therapeutical effect under the condition of same laser dosage. When the concentration of HPD was increased, the effect was not risen obviously. 10 J/cm² of laser could lead OD492 to decrease to platform under the condition of same HPD concentration. So the killing effect was saturated when the PDT parameters were selected as 10 mg/L of HPD and 10 J/cm² of laser. Under the same laser capacity density of 10 J/cm², A549 cells were exposured to three different duty-time fabrications which were 214 mw×10 min, 428 mw×5 min and 714 mw×3 min.The outcomes showed that OD492 had no statistical difference.

CONCLUSIONSPDT has a significant killing effect on human lung adenocarcinoma cell line A549. 10 mg/L of HPD and 10 J/cm² of laser were the best parameters of this experiment. The PDT effect is not influenced by different duty-time fabrications under the best laser capacity density.

Objective To investigate germline mutation of breast cancer susceptibility genes BRCA1/2,TP53 and PTEN in Chinese breast cancer patients. Methods All of128 female breast cancer patients in Peking University People′s Hospital from January 2016 to August 2018 were selected as objects. Among them,44 cases were sporadic breast cancer and 84 werebreast cancer patients with genetic high risks. Germline mutations of BRCA1,BRCA2,TP53 and PTENwere detected by NGS.χ2 test was used to analyze the difference of pathogenic mutation rates between sporadic breast cancer group and breast cancer with high genetic risks.Groups were divided according to the clinical features of the patients(family history, triple-negative breast cancer,age and bilateral breast cancer).Among them,there were 42 cases with family history of breast cancer,34 cases of triple-negative breast cancer,33 cases of early-onset breast cancer and 7 cases of bilateral breast cancer. Fisher′s exact probability test compared the relationship between pathogenic mutations of BRCA1/2 gene and clinical characteristics of breast cancer patients with hereditary risk factors. Results In 128 cases of breast cancer,30 germline mutations of BRCA1/2 were detected, including 13 pathogenic mutations and 3 newly discovered mutations(BRCA1:c. 4760C>G,BRCA2:c. 44134414del and BRCA2:c. 64826485del). The new mutations may be unique mutations of Chinese population. There were 3 cases of TP53 mutations,including 1 pathogenic mutation. All of the 3 mutations were found in early-onset breast cancer. Germline mutation of T53 has important detection significance for early-onset hereditary breast cancer. There were 5 cases of PTEN mutations,including 3 pathogenic mutations. Among 84 breast cancer patients with genetic high risks,the carry mutation rate was 40.5％(34/84)and the pathogenic mutation rate was 15.4(13/84). Among 44 sporadic cases,the carry mutation rate was 9％(4/44). The pathogenic mutation rate was 6.8％(3/44). Breast cancer susceptibility genes were carried at a higher rate in breast cancer patients with genetic high risks(P<0.001). BRCA1/2 mutations did not show statistical differences among groups of breast cancer patients with hereditary high risk factors . Conclusion Germline mutation detection of breast cancer susceptibility genes by next-generation sequencing is of great significance in breast cancer risk prediction and prognosis evaluation.