Fulminant myocarditis (FM)is a clinical accidant and emergency,and often endenger the lives of patients.Myocardium damage by virus infection and immune-mediated cellular damage are important for the development of FM.This paper discussed the role of the immune system in the FM,involving cellular immunity,humoral immunity and cytokine.Also this paper discussed the treatment of FM about the immunol-oregulation and immunosuppression.

AIM: To observe the efficacy of high concentrations of sodium hyaluronate ( 3g/L SH ) for moderate to severe dry eye.
METHODS: Forty moderate to severe dry eye patients were included in the study according to the diagnosis criteria and randomized into two groups. The patients of the trial group received topical administration of high concentration sodium hyaluronate (3g/L), and those of the control group received sodium hyaluronate ( 1g/L ) plus recombinant human epidermal growth factor. The dry eye symptom scores, ocular surface disease index ( OSDI) scores, tear film break-up time ( BUT) , SchirmerⅠ test and corneal fluorescein staining score were evaluated. All the indexes were compared between the two groups 2wk before and after treatment.
RESULTS: There were no significant differences of the indicators between the two groups before treatment. After 2wk treatment, the differences were statistically significant compared to former except for the SchirmerⅠtest. Compared with the control group, the symptom scores and the OSDI scores were lowered. No significant differences were found in the other indicators between these two groups.
CONCLUSION: Topical usage of highconcentrations of sodium hyaluronate (3g/L) is beneficial for remitting the ocular symptoms in moderate to severe dry eyes, and also improve the quality of life of patients.

Objective: To study the pharmacokinetics and factors influencing consecutive internal iliac arterial and intravenous infusion of 5-fluorouracil 5-FU and 4′ -O-tetrahydropyranyladriamycin (THP) and provide the experimental evidence to optimize intra-artery chemotherapy for pelvic malignant tumor. Methods:Mature female New Zealand rabbits were divided randomly into two groups. One group was consecutively infused by 5-FU and THP via internal iliac artery for 6 h. The other group was consecutively infused by 5-FU and THP via ear vein. The blood samples and the uterus tissue specimens were collected at various time points during the infusion period. At the end of infusion, the rabbits were sacrificed via intravenous air embolism and the heart, lung, and the node-rich pelvic adipose tissues were collected. The drug concentrations in plasma and tissue specimens were determined by high performance liquid chromatography methods. Results: The peak plasma concentration and AUC (area under curve) of intra-arterial infusion of 5-FU were a little lower than those via intravenous infusion. The peak concentration of intra-arterial infusion of 5-FU were 2-3 fold increased in uterus tissues and 5-fold increased in pelvic lymph node and adjacent tissues compared with those via intravenous infusion. The peak plasma concentration and AUC of intra-arterial infusion of THP were lower than those via intravenous infusion. The peak concentration and AUC of intra-arterial infusion of THP were not significantly different in uterus tissues between the two infusion forms. The peak concentration of THP was decreased by 50% in heart and lung tissues but increased to 5-fold in pelvic peripheral lymph node tissues by intra-arterial infusion than those by intravenous infusion. The serum to tissue vein distribution ratio of THP was several hundred times. Conclusions: Consecutive intra-arterial infusion of 5-FU and THP had some advantages compared with continuous intravenous infusion at different degrees. These advantages depended on the drugs' pharmacological properties.

OBJECTIVE: To examine and determine the contents of endothelin (ET) and nitric oxide (NO) in plasma, and to observe the effects of gastrodin injection on blood pressure, ET and NO levels in old patients with refractory hypertension. METHODS: A total of 63 old patients with refractory hypertension, 30 patients with common hypertension and 30 healthy people were included. The contents of ET and NO in plasma of patients in different groups and healthy people were examined and analyzed. The old patients with refractory hypertension were randomly divided into two groups: gastrodin-treated and routine treatment groups. Besides conventional hypotensive drugs, intravenous drip infusion of 1 000 mg gastrodin was administered to the patients in gastrodin-treated group for two courses (4 weeks), while the patients in routine treatment group were treated only with conventional hypotensive drugs. The changes of blood pressure, ET and NO levels before and after treatment in different groups were measured. RESULTS: The plasma level of ET in refractory hypertension group was higher than that in common hypertension group (t=3.27, P=0.008), while the level of NO was lower (t=-3.81, P=0.002). The systolic pressure and pulse pressure difference in gastrodin-treated group were decreased significantly after one course of treatment (t=1.85, P=0.03; t=1.74, P=0.04). The level of ET in gastrodin-treated group decreased gradually after treatment, but there were no significant difference between before treatment and two courses of treatment, while the level of NO in gastrodin-treated group was increased after treatment (t=-2.70; P=0.04). CONCLUSION: Gastrodin injection is beneficial to old patients with refractory hypertension, and can improve the balance of ET and NO levels in plasma.

Objective The diabetic foot ulcer has high incidence rate,many complications,and is difficult to heal.Methods We summary the treatment expericncc of 156 cases of diabetic foot wounds.On the basis of comprehensive standard medical treatment,according to the wound characteristics,blood supply,and the degree of tissue necrosis,we performed staging gnawing-away debridement for all tbe wounds,combining with pressure suction,new dressing,skin grafts and skin flaps.Results Of all the 156 cases,2 cases died,4 cases were lost to follow-up,the remaining 150 cases healed,with an average time of 56 days.Conclusions The treatment of diabetic foot ulcer must take into account both the systemic therapy and local processing,the wound should be debrided with different stage and progressively.When the wound microenvironment is gradually improved,it can be covered appropriately with skin grafts.The skin flap should be chosen cautiously.

Breast cancer is one of the most common cancers.The clinical treatment of breast cancer has made great progress,but the inherent or acquired drug resistance,tumor migration and tumor infiltration,which lead to poor treatment efficiency and eventually death,are still the urgent problems to be solved.As with the occurrence and development of common tumors,the abnormal proliferation,migration and infiltration of breast tumor cells and muhidrug resistance (MDR) are closely related to the abnormal expression of specific genes in the cell.At present,many studies have found that the occurrence and development of tumor is closely related to the abnormal expression of microRNA.Therefore,in order to better understand the molecular mechanism of the occurrence and development of breast cancer,it is necessary to study the function of microRNA in breast tumor cells.In this paper,the application of microRNA in the treatment of breast cancer was reviewed,striving for providing effective ideas for the future selection of new strategies to control the development of tumors.

The Pricing and Payment Regulation on Chinese Diagnosis Related Groups (C-DRG) was designed by National Health Development Research Center,directly under the leadership of Department of Finance,NHFPC (formerly Dept.of Planning and Finance,Ministry of Health),which organized a large study group consisted of nearly 1 000 experts since 2010.It introduced the general design of C-DRG and the principles and main points of applying C-DRG system,which could be referenced by all countries in carrying out the pricing and payment reform system.

BACKGROUND: The implanted cartilage calls can synthesize cartilage matrix as cartilage in cartilage tissue enginsedng, and the density of implanted cells is the key point.OBJECTIVE: To evaluate the effect of cell seeding concentration on the chondrogenic differentiation of the adipose dadved sromal cells (ADSCs).DESIGN, TIME AND SETTING: The in vitro cellular-scaffold observation was performed at the cytobiological laboratory of China Medical University from November 2007 to July 2008.MATERIALS: Six male SD rata with clean grade were supplied by the Experimental Animal Center of China Medical University.METHODS: Totally 5 g/L type ; collagen solution and 20 g/L chitosan was mixed in a mould with volume ratio of 7:3, after lyophillization, it was cut into pieces with 5 mm ～ 5 mm x 2 mm, followed by crosslinking with ethanol contained of 2% chondroitic acid at room temperature. After washing with double distilled water and freeze drying, the chitosan-collagen-chondroitin sulfate copolymar matrices scaffolds were harvested. ADSCs isolated from rat inguinal fat pads were digested with collagenase and trypsase. The prepared scaffolds were randomly divided into 3 groups, and the third passage cells with density of 2×10 9/L,2×10 109/L, and 2×10 11/L were seeded into chitosan-coflagen-chondroitin sulfate scaffolds, and cultured in chondrogenic medium for 3 weeks.MAIN OUTCOME MEASURES: The expression of cartilage specificity gene was detected by hematoxylin-eosin staining, type Ⅱ collagen immunohistochemical staining and RT-PCR.RESULTS: Hematoxylin-eosin staining showed that after 3 weeks of culture, the cell proliferated and differentiated well, especially in 2x101～/L group, more extrocelluer matrices were produced and cartilage lacuna-structure could be seen. The type Ⅱ collagen was positive expressed in each group, which showed a gradually increasing tendency with the cell seeding concentration increasing. RT-PCR showed that the expression of proteoglycen and type Ⅱ collagen mRNA were slowly increased. However the expression of Ⅹ collagen mRNA was decreased with increasing cell seeding concentration.CONCLUSION: The chitosan-collagen-chondroitin sulfate copolymer matrices can provide an appropdate environment for the generation of cartilage-like tissues and high call seeding concentration of 2×1010/L facilitate ADSCs to differentiate into cartilage.

Objective To evaluate the character of the collagen-chitosan-chondroitin sulfate scaffold seeded with rat adipose tissue-derived stromal cells. Methods A dipose tissue were harvested from 6 weeks old Wistar rats and the stromal cells were harvested by type Ⅰ collagenase and then cultured in vitro. Type Ⅰ collagen was fully mixed with chitosan, freeze-dried and cross-linked with chondroitin sulfate, then freeze-dried again and sterilized by ethylene oxide. The pore diameter, water content, porosity of the scaffold were tested. The adipose tissue-derived stromal cells were digested, seeded into the plates, scaffold, and cen-trifuged into pellet, and then induced into cartilage. MTT detection for cell proliferation was done. After 3 weeks, the cell morphology, and cell proliferation and adhesion were observed, and chondrngenic differenti-ation was also analyzed. Results The pore diameter, water content, porosity tested for the scaffold showed an appropriate form. Cell proliferation showed faster in the scaffold and pellet culture system after 5 day, there was still cell proliferation in the scaffold system after 14 days but no obvious changes in the pellet cul-ture system; ceils on the scaffold proliferated densely showed by histological staining, but there was a scaf-fold structure residues in the inner layer. The finding of type Ⅱ immunohistochemistry stain showed that cells express strong positive for type Ⅱ collagen in the scaffold and pellet culture system whereas it was weakly positive in the plate culture system; the specific mRNA for cartilage, type Ⅱ collagen, aggrecan and SOX-9 were expressed in all three systems showed by RT-PCR, but type X collagen was expressed continu-ously in the plate culture system and expressed after 21 days in the pellet culture system, whereas it was not detected in the collagen-chitosan-chondroitin sulfate scaffold system. Conclusion The parameters of the collagen-chitosan-chondroitin sulfate scaffold were suitable in our study. The results suggested that it can promote the adipose tissue-derived stromal cells proliferation and chondrogenic differentiation better than the plate and pellet culture systems and maintain the phenotype of chondrocytes well; it is the optimal choice for cartilage tissue engineering in the future.