Abstract:Objective:Heart failure, as one of the major reason for cardiovascular death, has emerged as a new challenge for the burden of global cardiovascular disease. Medication therapy can relief symptoms and reduce mortality of heart failure patients. Recently, device-based therapy has been validated by large sample size of clinical trials to be effective treatment by reducing mortalities, reversing ventricular remodeling, and improving life quality of patients with severe heart failure. The present review discussed current device-based therapies for chronic heart failure including cardiac resynchronization therapy, implantable cardioverter defibrillator, cardiac contractility modulation, percutaneous ventricular restoration, vagus nerve and spinal cord stimulation.

Abstract:The new technology of device therapy for chronic heart failure is mainly focused on two aspects, improving the electrical mechanical conduction and improving the mechanical structure of the heart. For improvement of electro-mechanical conduction, cardiac resynchronization therapy (CRT) has become the standard therapy for patients with moderate or severe chronic heart failure and ventricular conduction block. However nearly 30% of the CRT non-respond rate makes it the clinical hope to improve the curative effect. New technology mainly lies in increasing the respond rate, including multisite pacing, left ventricular endocardia pacing, wireless left ventricular endocardia pacing, and pulmonary impedance monitoring. In addition, contractility modulation cardiac (CCM) has more and more clinical application since it was first implanted in 2001. To improve the cardiac mechanical structure, the progress of valve repair and left ventricular assist device has been widely mentioned in recent years. New technology in the treatment of chronic heart failure has developed rapidly in recent years. Especially the application of new tools has made the operation more convenient and minimally invasive. With the progress of more and more clinical trials, it is believed that the application of new technologies will be more and more extensive, and the efficacy of heart failure treatment will be further improved.

Abstract:Cardiac resynchronization therapy (CRT) is one of the most important non-pharmaceutical therapies for chronic heart failure. However,30% patients have poor or nonresponse to CRT. In this paper,we reviewed some main factors influencing the benefit of CRT. And the optimized strategies to improve the efficacy of cardiac resynchronization therapy were also reviewed,including indication,left ventricular pacing site,device programming,medicine and new pacing mode.

Abstract:Objective:Patients with chronic heart failure suffer high risk of sudden cardiac death(SCD),which has been proved to be efficiently prevented by implantable cardioverter defibrillator(ICD). There have been multiple guidelines proposing indications of ICD implantation for primary prevention of SCD. The number of ICD implantations in China is small and unsatisfying ,for various reasons. Actions should be taken in propaganda so that this therapy is better known by the public,or at least patients with higher risk of SCD than currently indicated(ie,those with class I indications concurrently with syncop or presyncope,or with lower LVEF,or with unsustained ventricular tachycardia,or with frequent premature ventricular contractions) should receive ICD therapy without delay.

Abstract:Chronic heart failure (HF) is associated with autonomic dysregulation characterized by as sustained increase in sympathetic drive and by withdrawal of parasympathetic activity. Experimental data have demonstrated that stimulation of the vague nerve is able to reverse ventricular remodeling of the failing heart. There is also evidence that increasing parasympathetic activity may stimulate the production of nitric oxide, reduce the devastating inflammatory process and increase the myocardial expression of gap junction proteins in HF. Several clinical trial s including CardioFit and ANTHEM-HF have proven the safety and effectivity of vague nerve stimulation (VNS) in HF patient. But recently published data from NECTAR-HF trial failed to demonstrate a significant effect on cardiac remodeling and function capacity in HF patient. A prospective randomized trial with a larger patient cohort is needed to confirm the beneficial results of VNS.

Abstract:Objective:To investigate the association between pulmonary capillary wedge pressure (PCWP)and clinical outcome of cardiac resynchronization therapy (CRT)in chronic heart failure patients. Methods:Chronic heart failure patients with an indication for CRT were included. We performed right heart catheterization to measure PCWP in those patients one week before they received a CRT device. Patients were stratified into two groups based on their response to CRT:responders and non-responders. Responders were predefined as patients with improvement of left ventricular ejection fraction (LVEF)by 5% or more and improvement by one or more NYHA functional class during 6-month follow-up. Receiver operating characteristic (ROC)curve was used to assess the efficiency of preoperative PCWP in predicting CRT response. Kaplan-Meier survival curve was applied to assess the efficiency of preoperative PCWP in predicting major adverse cardiac events (MACE). Results:Of 35 patients included,24 patients were responders,11 patients were non-responders. The mean PCWP was (11.9 ± 7.0)mmHg and (21.7 ± 9.1)mmHg,respectively. Non-responders had a significantly higher PCWP (P=0.006). When at the optimal cutoff point of 12.0 mmHg,the sensitivity and specificity of preoperative PCWP predicting response to CRT were 90.9% and 58.3%,respectively. Patients with preoperative PCWP 12.0 mmHg or less have better NYHA functional class-smaller left ventricle and lower PCWP after CRT compared with patients with preoperative PCWP 12.0 mmHg or more. Kaplan Meier survival curve demonstrated that compared with patients with preoperative PCWP 12.0 mmHg or less,patients with preoperative PCWP 12.0 mmHg or more had a trend towards being shorter MACE-free survival (P=0.079). Conclusion:Preoperative PCWP is associated with response to CRT. Lower preoperative PCWP may indicate longer MACE-free survival time in CHF patients.

Abstract:Objective:To establish mouse model of PP2AC gene specifical inactivation in pancreatic cells and investigate preliminary animal phenotype. Methods: The Ins-2 transgenic mice in which Cre enzyme was exclusively detected in pancreatic-cells bred with PP2ACαflox/flox mice to obtain PP2ACαflox/+:Ins-2 mice, then bred with the PP2ACαflox/flox mice again to obtain PP2ACαflox/flox:Ins-2 mice (KO mice). We identified the 2nd exon of PP2ACα knockdown by PCR and Western Blot. Interperitoneal glucose tolerance test (IPGTT) was performed in transgenic mice at 4 months, and PP2ACαflox/flox mice were employed with control. Results: PP2ACα transcripts were shorter in KO mice than those in control mice. The protein level of PP2AC expression in KO mice was significantly lower than that of control mice (P < 0.05). The results of IPGTT indicated that the blood glucose levels at 30 min, 60 min and 120 min were significantly higher than those of controls (P < 0.05). Conclusion: Specifical inactivation of PP2AC in pancreatic β-cells mouse model is successfully established, and glucose tolerance impairs at 4 months in PP2ACαflox/flox:Ins2-Cre mice.

Abstract:Objective:To establish a murine model of neural tube defects (NTDs) by inhibition of thymidylate synthase (TS) via a specific inhibitor, raltitrexed (RTX). Based on the model, The role of DNA damage, cell apoptosis and proliferation in RTX-induced NTDs were investigated. Methods: The adult C57BL/6J pregnant of 7.5 d mice were randomly divided into six groups: one was for control and the other five were RTX-treated groups. NTDs were induced by intraperitoneally injection of various doses of RTX (5.0, 10.0, 11.5, 13.5, 15.0 mg/kg body weight) on gestational day 7.5. Control mice were injected with 0.9% NaCl at equal volume. Neural tube closure was examined by hematoxylin-eosin (H&E) staining on gestational day 11.5 and TS activity was measured by radioactive method following RTX treatment. Levels of thymidylate (dTMP) and uridylate (dUMP) were detected by high performance liquid chromatography (HPLC). Western-blotting was performed to analyze the expressions of replication protein A2 (RPA2), γ-H2AX and caspase-3 in NTDs embryos induced by RTX. Cell proliferation was analyzed by immunohistochemical method. Results: At 11.5 mg/kg bw, RTX induced the highest incidence of NTDs (30.56%). TS activity was significantly reduced by RTX treatment. Besides, levels of dUMP were increased associated with decreased dTMP levels after RTX treatment. Furthermore, phosphorylation of RPA2 and γ-H2AX were significantly increased in RTX-induced NTDs. The expression of caspase-3 was significantly increased and cell proliferation was significantly decreased. Conclusion: Murine model of NTDs was successfully established by inhibition of TS via RTX. DNA damage and imbalance between apoptosis and proliferation were important events caused by impairment of dTMP biosynthesis, which may be one of the key mechanisms underlying the development of NTDs.

Abstract:Objective:To analyze the ultrastructure of autophagosome. Methods: We used transmission electron microscopy to analyze the cell samples of autophagy, and to find the characteristic structure of the autophagosome, and to identify the other cell structures which was similar to autophagosome. Result: Autophagosome had the characteristics of double layer or multilayer membrane and inclusions, it could be identified from the other cell structure. Conclusion: Double layer or multilayer membrane and inclusions are the characteristics of the autophagosome structure which contains mitochondria, endoplasmic reticulum, ribosome and other cytoplasm components.

Abstract:Objective:To investigate the effect of hepatocyte nuclear factor 4α (HNF4α) on the angiogenesis related genes of CBRH-7919 in vitro and in vivo. Methods: CBRH-7919 cells were transfected with HNF4α adenovirus vector. CBRH-7919 cell proliferation was detected by cell counting kit-8 (CCK8) assay and the migration and invasion were assessed by Transwell assays. The expressions of Angiopoietin-2 (Ang-2) and vascular endothelial growth factor (VEGF) were detected by RT-PCR and Western blotting assay. In vivo, CBRH-7919 cells, CBRH-7919-Null-Vector cells and CBRH-7919-HNF4α cells were respectively injected into the rest of the liver after establishment of subtotal hepatectomy model (70%). Four weeks later, the expressions of Ang-2 and VEGF in the liver tissues were detected by immunohistochemical assay. Results: In vitro study indicated that after transfected with adenovirus vector LV-HNF4α,the proliferation of CBRH-7919 was significantly inhibited (P < 0.05) and the invasiveness was also significantly inhibited (P < 0.05)compared with the control group,respectively. The result of RT-PCR suggested that the expressions of Ang-2 and VEGF were inhibited after transfected with adenovirus vector. In vivo study showed similar finding that the expressions of Ang-2 and VEGF were inhibited after transfected with adenovirus vector(P < 0.05). Conclusion: HNF4α can significantly inhibit proliferation and metastasis capability of CBRH-7919, as well as inhibits the expression of Ang-2 and VEGF in CBRH-7919.

Abstract:Objective:To investigate COX-2 inhibitor effect of celecoxib on proliferation, apoptosis and migration of human erythroleukemia HEL cells and its mechanism. Methods: The human erythroleukemia HEL cells were treated with different concentrations of celecoxib. The cell proliferation inhibition rate was calculated by CCK-8 test; the apoptosis rate was detected by Hoechst33342 fluorescent staining; cell migration ability was tested by transwell chambers. The expression levels of COX-2 and JAK2 mRNA were detected by Real-time PCR; the protein expression levels of COX2 and p-JAK2 were detected by Western blotting assay. Results: Celecoxib time and dose dependently inhibited the proliferation of HEL cells, the cell growth inhibition rates were (9.96 ± 0.82)%, (18.46 ± 2.01)% and (21.36 ± 2.48)%, respectively (P < 0.05), after treated with different concentrations (25,75,and 125 μmol/L, respectively) of celecoxib in HEL cells after 48 h. Hoechst33342 fluorescent staining showed that apoptosis increased significantly after treatment of 125 μmol/L celecoxib in HEL cells after 48 h; cell migration ability showed that the leakage after treated with 75 μmol/L celecoxib in HEL cells after 24 h was 22.13 ± 7.51, which was significantly lower than that of the control group (77.89 ± 6.94, P < 0.05); RT-PCR results showed that COX-2 mRNA was dependently decreased, while no significant effect on the JAK2 mRNA after treated with different concentrations of celecoxib; Western blotting assay showed that the expression of COX-2 protein in the experimental group was significantly lower than that in the control group (P < 0.05), but no obvious effect was found on p-JAK2 expression. Conclusion: Proliferation of HEL cells can be inhibited by celecoxib. It may be related to the inhibition of the expression of COX-2, but had no obvious effect on JAK2 signaling pathway.

Abstract:Objective: To explore the influence of salmeterol fluticasone plus tiotropium bromide and low dosage prednisone plus aminophylline on cardiac function in patients with chronic obstructive pulmonary disease (COPD) combined with chronic cor pulmonale. Methods: A total of 111 cases of COPD with chronic cor pulmonale patients in the stationary stage were recruited as subjects and randomly divided into three groups with 37 cases in each. Three groups received same routine treatment (diuretic drug, vasolidator, cardiac stimulant). The control group solely received routine treatment. The inhalation group had additional therapies of sameterol fluticasone (50/500 μg) twice daily plus tiotropium bromide once per day. The oral drug group had additional therapies of prednisone 5 mg once per day plus slow release aminophylline 100 mg twice per day based on the routine treatment. The right ventricular outflow tract, right ventricular internal diameter, right pulmonary artery trunk, pulmonary artery pressure, left ventricular ejection fraction (LVEF) and brain natriuretic peptide (BNP) in the three groups were measured and compared before and after 48 weeks of treatment, as well as the fasting blood glucose, plasma cortisol and lumbar spine bone mineral density in these three groups. Results: After treatment, all of the cardiac function indexes in patients of the inhalation group and the oral drug group were improved compared to those before treatment (P < 0.05) and those of the control group (P < 0.05). There were no significant differences existed in the pulmonary artery pressure of the inhalation group and oral drug group after treatment (P > 0.05). However, the right ventricular outflow tract, right ventricular internal diameter, right pulmonary artery trunk, LVEF and BNP in the inhalation group were more significantly improved than those in the oral drug group (P < 0.05). There were no significant differences among the fasting blood glucose, plasma cortisol and lumbar spine bone mineral density of these three groups before and after treatment (P > 0.05), and the levels of plasma cortisol in the three groups were all in normal level before and after treatment. Conclusion: Both of salmeterol fluticasone plus tiotropium bromide and low dosage prednisone plus aminophylline improve cardiac function in patients with chronic obstructive pulmonary disease combined with chronic cor pulmonale, and the former seems better.

Abstract:Objective:To study the influence of high frequency oscillatory ventilation (HFOV) on oxygen metabolism and inflammatory factors of patients with acute respiratory distress syndrome (ARDS). Methods: Seventy patients with acute respiratory distress syndrome (ARDS) were randomly divided into the HFOV group (35 cases) and continuous mandatory ventilation (CMV) group (35 cases). The HFOV group accepted HFOV treatment and the CMV group received CMV therapy. Oxygen metabolism and inflammatory factor levels of patients in the two groups were compared before and after treatment. Results: ①After 72 hours of treatment, hemodynamics (heart rate (HR), mean pulmonary arterial pressure (MPAP), APACHE Ⅱ score, multiple organ dysfunction syndrome (MODS) score, oxygen metabolism index (PaO2, PaCO2 and PaO2/FiO2) and inflammatory factor levels (hs-CRP, IL-6, PCT, and TNF-α) in the two groups were significantly improved compared with those before treatment (P < 0.01 or P < 0.05), the above indexes (except for PaCO2) in the HVHF group were more significant than those in the CMV group (P < 0.01 or P < 0.05). ②After 35 days of treatment, the application time of vasoactive drugs and ICU in the HFOV group were shorter than that in the CMV group (all P < 0.05), and no significant differences were found in the mechanical ventilation time and mortality of patients in the two groups (all P > 0.05). There were no complications such as air pressure injury in the two groups. Conclusion: HFOV can not only improve oxygenation function, bu also more effectively reduce the inflammatory response in the lungs, so as to reduce the lung tissue injury, decrease the APACHE Ⅱ score and MODS score, and shorten hospitalization time of vasoactive drug application time and ICU.

Abstract:Objective:To investigate the changes of adiponectin (ADPN),high density lipoprotein-cholesterol (HDL-C) and low density lipoprotein-cholesterol(LDL-C) level in male patients with obstructive sleep apnea syndrome (OSAS). Methods:103 habitual snorers,participated in the study voluntarily. All the patients were male. All the patients were divided into 4 groups,according to apnea hypopnea index(AHI). There were simple snorers group(vehicle,n=21,AHI≤5),mild OSAS group(n=25,540). AHI and transcutaneous saturation oxygen (SpO2) were mornitored during the whole night and the concentration of APDN,HDL-C and LDL-C in serum were evaluated in the next morning. Results:There was no significant difference of age among the four groups (P > 0.05). Compared with vehicle,AHI in all three OSAS groups increased obviously (P < 0.01),while minSpO2 decreased markedly (P < 0.01). Compared with vehicle,however there was a trend to change of HDL-C and LDL-C in mild OSAS group,ANOVA did not show any significance (P > 0.05). Compared with vehicle,HDL-C decreased significantly and LDL-C increased obviously in moderate and severe OSAS group (P < 0.05,P < 0.01). In OSAS patients,AHI was negatively correlated with ADPN(r=-0.521,P < 0.01) and HDL-C(r=-0.344,P < 0.05) significantly,while it was positively correlated with LDL-C(r=0.326,P < 0.05) markedly. minSpO2 was positively correlated with ADPN(r=0.519,P < 0.01)and HDL-C(r=0.337,P < 0.05) significantly,while it was negatively correlated with LDL-C(r=-0.309,P < 0.05) obviously. Conclusion:OSAS can lower the concentration of ADPN and HDL-C,meanwhile it can elevate LDL-C in serum. The effect is associated with the increased AHI and decreased minSpO2.

Abstract:Objective:To investigate serum PCSK9 and LDL-C level changes in obstructive sleep apnea-hypopnea syndrome(OSAHS),and assess the prediction for OSAHS combined with cerebral infarction. Methods:87 patients were admitted to this trial in our hospital,and they were divided into three groups:OSAHS combined with cerebral infarction group (group A),isolated OSAHS group(group B) and control group(group C). Serum PCSK9 concentration was measured by ELISA and LDL-C level were measured by automatic biochemical analyzer,and then they were applied SNK test to perform statistical analysis. Polysomnography(PSG) results of group A and group B were also compared. Furthermore,correlational analyses were conducted between the two factors and PSG results in OSAHS associate with cerebral infarction and isolated OSAHS patients respectively. Results:①Serum PCSK9 and LDL-C levels were higher in group A than those in group B and group C (P < 0.05). ②PSG results showed that patients in group A were more severe than that in group B (P < 0.05). ③Serum PCSK9 and LDL-C levels in OSAHS associate with cerebral infarction and isolated OSAHS patients were correlated positively with apnea hypopnea index (AHI),percentage of sleep time during apnea-hypopnea and percentage of sleep time below 90% oxygen saturation(SaO2 < 90%) respectively(P < 0.05),and those were correlated negatively with the lowest SaO2 and the average lowest SaO2 respectively (P < 0.05). Conclusion:The increasing amplitude of serum PCSK9 and LDL-C levels is interrelated with the degree of OSAHS,and can be seem as clinical predictors of OSAHS combined with cerebral infarction.

Abstract:Objective: To determine the consistency among TcPO2,TcPCO2,PaO2,PaCO2, in neonates treated with oxygen strategy, and to find the impact factors, in order to provide guidance for the transcutaneous monitoring as a substitute of blood gas analysis in neonates with oxygen strategy. Methods: We collected arterial blood gas of neonates during stable transcutaneous monitoring, and recorded TcPCO2 and TcPO2 5 min before and after collection, weight, pulse, gestational age, oxygen mode, fraction of inspired oxygen, arterial oxygen saturation (SaO2), and pH. Comparison was performed using descriptive statistics, Pearson correlation analysis and receiver operating characteristic (ROC) curve. Results: The factors including weight,inspired oxygen had no obvious impact on the consistency between TcPCO2 and PaCO2, and TcPCO2 was higher than PaCO2 in the cases with bad circulation. Statistical correlation and consistency was lower between TcPO2 and PaO2, especially in the lower oxygen index cases, there was no statistical correlation between them. The difference between TcPO2 and PaO2 was increased with the increase of birth weight and the increase of arterial oxygen partial pressure. Conclusion: TcPCO2 and PaCO2 have good consistency, even in very low birth weight. The correlation between TcPO2 and PaO2 is lower, for babies with oxygen strategy. There is no correlation between TcPO2 and PaO2 in high oxygen partial pressure, and TcPO2 is a better marker than PaO2 in revealing real arterial oxygenation, which is more valuable for the guidance of oxygen therapy in neonates.

Abstract:Objective:The aim of this study was to investigate the early left atrial (LA) performance in patients with systemic lupus erythematosus (SLE) by two dimensional speckle tracking imaging (STI) combined with real time three dimensional echocardiography (RT3DE). Methods: A total of 40 SLE patients and 38 healthy controls were enrolled. The mean strain rates during systole, early diastole and late diastole (mSRs, mSRe, and mSRa) were measured at each segment (anterior, posterior, lateral, and septal) by STI. LA active ejection fraction (LAAEF), LA passive ejection fraction (LAPEF) and atrial expansion index (AEI) were calculated by RT3DE. The correlations between the above LA functional parameters and strain rates were analyzed. Results: ①Early diastolic mitral annular velocity in the SLE group and the control group was(0.67 ± 0.12)m/s and (0.72 ± 0.11) m/s, respectively (P > 0.05). ②The mSRs in the SLE group and the control was (3.81 ± 1.02)/s and (4.09 ± 1.13)/s, respectively (P > 0.05); The mSRe was (-3.68 ± 1.70)/s and (-4.11 ± 0.79)/s, respectively (P < 0.05); and the mSRa was (-3.73 ± 1.56)/s and (-2.89 ± 0.79)/s, respectively (P < 0.01). ③LAAEF in the SLE group and the control group was (48.0 ± 8.9)% and (33.0 ± 7.4)%, respectively (P < 0.01); LAPEF was (37.1 ± 8.2)% and (49.5 ± 7.4)%, respectively (P < 0.01); and AEI was (85.7 ± 27.5)% and (95.3 ± 22.5)%, respectively (P=0.17). ④There were significant positive correlations among AEI and SRs (r=0.756, P < 0.01), LAAEF and SRa (r=0.816, P < 0.01), LAPEF and SRe (r=0.786, P < 0.01). Conclusion: LA functions are changed in early stage of SLE patients, demonstrating the impairment in conduit function, the decrease in storage function and the increase in pump function.

Abstract:Objective:To investigate the expression differences of erbB1 (EGFR) and erbB2 (HER2) in tissues of hepatolithiasis combined with bile duct carcinoma and its clinical significance. Methods: We collected 94 intrahepatic bile duct carcinoma tissues of patients with hepatolithiasis combined with intrahepatic bile duct carcinoma and 50 liver tissues adjacent to carcinoma samples. EGFR and HER2 were detected by immunohistochemical staining after biopsy. Then, we analyzed the expression differences between carcinoma tissues and tissues adjacent to carcinoma. EGFR molecule targeted therapy was performed in some patients (Erlotinib, 150 mg/d, one course of treatment), and 5-year-disease-free survival rate was analyzed. Results: EGFR positive expression rate of the two groups was 58.5% (55/94) and 26.0% (13/50), respectively, and the difference was statistically significant (P < 0.001); HER2 positive expression rate of the two groups was 33.0% (31/94) and 16.0% (8/50), respectivley, and the difference was statistically significant (P < 0.05). In the bile duct carcinoma group, tumor histologic grading, infiltrating depth and hilus lymph node metastasis of EGFR and HER2 positive patients were obviously higher than those of the negative patients, and the difference was statistically significant (P < 0.05). In patients with cholangiocarcinoma, 5-year disease-free survival rate of EGFR or HER2 positive patients was significantly lower than that of the negative patients (P < 0.05). Further found in the molecular targeted therapy, EGFR positive patients treated with erlotinib could extend survival, and 5-year disease-free survival rate was higher than that of EGFR and HER2 positive patients (81.3% vs. 59.4%), but there was no statistically significant difference (P > 0.05). Conclusion: EGFR and HER2 expression in patients with intrahepatic bile duct stone combined with the occurrence of intrahepatic cholangiocarcinoma may play an important role in the development, and the two high expression are closely related to the degree of malignant tumor and clinical prognosis, and may has a guiding significance in clinical molecular targeted therapy.

Abstract:Objective: This study was designed to investigate the relationship between vascular tumor embolus (VTE) and other risk factors for reasonable treatment. Methods: Clinical data of 1867 patients with esophageal squamous cancer were retrospectively reviewed. To analyze the relationship between VTE and other related factors including sex, age, blood type, tumor invasion depth (T) , lymph node metastasis(LNM) and positive lymph nodes ratio (PLNR). Results: VTE was closely related to T staging, LNM and PLNR (P < 0.01). Further analysis of T induced obvious difference between T1a and T1b~T4 as well as T1~T3 and T4 (P < 0.01). Conclusion: VTE is closely related to T staging, LNM and PLNR. The early stage of superficial esophageal cancer (T1a/T1b) with VTE should be treated with surgical resection.

Abstract:Objective:To investigate the relationship between the polymorphisms of folate metabolism—related enzyme genes(MTRR,rs1801394; MTR,rs1805087; MTHFR, rs1801133; FHTFD,rs2002287; FTHFD,rs2276731)and the risk and pathologic characteristics of breast cancer in Chinese women. Methods:This case-control study included 298 female patients with breast cancer and 298 healthy female controls. Sequenom MassArray was applied to detect the genotypes of the polymorphisms,and logistic regression was utilized to analyze their association with the risk and pathologic characteristics of breast cancer. Results:Significant differences were found in the frequencies of the rs1801394(χ2=9.900,P=0.007)between the case and control groups. The frequencies of AG genotypes were obviously lower in the control s(28.52%)than those in the cases (38.59%). Conclusion:The genotype of rs1801394 AG was associated with breast cancer risk,which was independ to the pathologic characteristics of tumor and of the level of estrogen receptor(ER),progesterone receptor(PR)and human epidermalgrowth factor receptor-2(HER2 and erbB-2).

Abstract:Objective:To investigate the expression and clinical significance of plasma miR-221 in patients with breast cancer. Methods: The expressions of plasma miR-221 in 20 cases of healthy volunteers and 56 patients with breast cancer were detected by real-time RT-PCR as well as miR-221 expression in 56 breast cancer and their matched non-tumor adjacent tissues; The relationship between plasma miR-221 expression and clinicopathological characteristics and drug resistance were further analyzed using statistical methods, including independent-samples t test, multiple logistic regression analysis. Results: The expression of plasma miR-221 in patients with breast cancer was significantly higher than that of the healthy volunteers (P < 0.05); The expression of plasma miR-221 in patients with breast cancer was positively correlated with miR-221 expression in breast cancer tissues (r=0.832, P < 0.001); Before the therapy, the expression of plasma miR-221 in breast cancer patients was positively correlated with lymph nodes metastasis and clinical stages, while it was positively correlated with drug resistance only after chemotherapy. Conclusion: MiR-221 highly expressed in plasma of patients with breast cancer reflecting the expression level of miR-221 in breast cancer tissues. The expression of miR-221 in plasma could be used as one of the indicators for clinical stages and the drug resistance.

Abstract:Objective:To investigate the expression and clinical significance of Treg markers in CD8+ T cells from peripheral blood and tumor tissues of ovarian cancer patients. Methods: Flow cytometry was used to detect the percentage of Foxp3, CD25, CD28, CTLA-4 and GITR in CD8+ T cells in tissues from 12 benign ovarian tumor patients, 14 ovarian cancer patients, in peripheral blood from 31 patients with ovarian cancer, 31 patients with benign ovarian tumor and 31 healthy volunteers. Results: Flow cytometry revealed that the expressions of Foxp3 and CTLA-4 in CD8+ T cells of ovarian cancer tissues were higher than those of benign ovarian tumor tissues (P < 0.05); The expression of CD28 in CD8+ T cells of ovarian cancer tissues was significantly lower than that of benign ovarian tumor tissues (P < 0.01); The expressions of Foxp3, CD25 and CTLA-4 gated on CD8+ T cells in peripheral blood of ovarian cancer patients were significantly higher than those of patients with benign ovarian tumor and healthy control subjects (P < 0.05), the expression of CD28 gated on CD8+ T cells in peripheral blood of ovarian cancer patients was significantly lower than that of patients with benign ovarian tumor and healthy control subjects (P < 0.05). Conclusion: Frequency of CD8+ Treg in ovarian cancer patients was higher than benign ovarian tumor patients and healthy controls. The expression of Foxp3 in CD8+ T cells in peripheral blood of ovarian cancer patients correlated with tumor stage, suggesting Foxp3 could be used as an important indicator of ovarian cancer progression.

Abstract:Objective:To investigate the type, distribution and drug resistance of 7 415 strains of bacteria in the lower respiratory tract of a teaching hospital in 2014, and to guide clinical rational drug use. Methods: The distribution of bacteria, the distribution and drug resistance of 7 415 strains of bacteria were analyzed by WHONET5.6 software. Results: The top 10 bacteria of 7 415 strains were gram negative bacilli, which accounted for 80.2% of the total. Among them, Pseudomonas aeruginosa (25.9%), Bauman Acinetobacter (20.5%), Klebsiella pneumoniae (18.3%) were with the top 3 positive rate. Gram-positive bacteria accounted for 7.9%, and the detection rate of Staphylococcus aureus was the highest, accounting for 6.6%. The number of pathogenic bacteria was highest in ICU (29.6%), followed by the Department of internal medicine (19.2%), Department of Neurosurgery (17.2%). The resistance rates of E. coli on cefazolin, cefotaxime, cefepime, ciprofloxacin and ofloxacin, moxifloxacin, trimethoprim-sulfamethoxazole, and tetracycline were both higher with more than 73.0%. The resistance rates of Klebsiella pneumoniae and Pseudomonas aeruginosa on ampicillin, amoxicillin/clavulanic acid, ampicillin/shu ba jotham, cefazolin, cefotaxime, ciprofloxacin and ofloxacin, and moxifloxacin were both higher with more than 60.0%. The resistance rates of E. coli and Pseudomonas aeruginosa on carbon penicillium alkene were below 50%. The resistance rate of Staphylococcus aureus on benzene Westwood was 75.4%, and its sensitive rate on vancomycin was 100%. Conclusion: Gram-negative bacilli take a major position in respiratory system infection. Having higher resistance to commonly used antibiotics, sensitive antimicrobial drug should be chosen for clinical medicine, and the abuse of antibiotics should be avoided.