Volume 89  ·   Issue 02  ·  2009

In the era of multidisciplinary comprehensive treatment of cancer, surgery is still an important means of breast cancer treatment, but the prolongation of breast cancer patients' survival is mainly due to the adjuvant therapy to prevent recurrence and metastasis after surgery, that is, the correct and rational use of chemotherapy, endocrine therapy and molecular targeted therapy.

Medical science should be the basic science of human spiritual civilization. The development of higher medical education is related to the national health undertakings, the health of the people and the development of national economy. Under the condition of market economy, the development of medical education depends on investment. The investment policy of higher medical education in China decides to influence the development of higher medical education.

Objective To evaluate the effects and toxicity of the neoadjuvant chemotherapy of docetaxel combined with epirubicin or piranbicin on breast cancer, and to investigate the influencing factors of the response to neoadjuvant chemotherapy. Methods 160 patients with stage Ⅱ/Ⅲ breast cancer, all females, aged 47 (22-66), were treated with docetaxel plus epirubicin or piraubicin with 3 weeks as a cycle. Two to six cycles of treatment were given before surgery. The clinical efficacy and toxicity of the treatment were evaluated, and the correlation between the influencing factors and the clinical parameters with treatment response was analyzed. Results The clinical response rate (RR) was 90% (144/160), the complete response (CR) rate was 26% (41/160), the partial response (PR) rate was 64 % (103/160). The stable disease (SD) rate was 8 % (13/160). The progress disease (PD) rate was 2% (3/160), the pathologically complete remission (pCR) rate was 7% (11/160), and the tumor-pathologlcal complete response (tpCR) rate was 2% (1.3/160).Univariate analysis showed that the tumor size, clinical stage, triple negative phenotype might be the meaningful parameters influencing the clinical response. The patients with smaller tumor size, low stage tumor, and being triple-negative were more likely to achieve CR (P=0.0371, 0.0013, and O. 0019 respectively). Age, histological rading, ER/PR atio, Her-2 status did not significantly influence the early response. Multivariate analysis showed that the disease stage might be the meaningful factors for better response (P = 0. 0030 ). The major toxic reactions of the therapy included neutropenia,　alopecia, nausea, and vomiting. Conclusion The combination neoadjuvant chemotherapy with　ocetaxel and epirubicin or piraruhicin is an effective method to treat breast cancer with tolerable toxicity. The meaningful parameter influencing the early response is clinical stage.

Objective To study clinicopathological characteristics and prognosis of elderly women with breast cancer. Methods The data of 399 patients with breast cancer over 65 years of age was analyzed retrospectively in the Cancer Hospital of Chinese Academy of Medical Sciences from January 1989 to December 2003. Results Curative resection was performed for all patients, including modified radical mastectomy 277 ( 69.4% ), radical mastectomy 12 ( 3.0% ), breast-conserving therapy 59 ( 15.8% ), mammectomy 24 (6. 0% ), breast segmentectomy 25 (6. 3% ) and breast segnaentectomy with sentinel node biopsy 2(0. 5% ). Major pathological type was invasive ductal carcinoma (337/399, 85.5% ). The positive rates of estrogen receptor (ER) and progesterone receptor (PR) were 71.4% and 69. 6%, respectively. The overall 5-and 10- year survival rates were 78. 9% and 56. 3% , respectively. Univariate analysis showed that ER status, PR status, T stage, lymph node status and histological grade were significant statistically ( P < 0. 05 ). The multivariate analysis showed ER status, lymph node status and histological grade were the independent prognosistic factors. Conclusion Elderly women with breast cancer should be given multimodality therapy. Surgery and endocrine therapy are crucial, but the surgical style should be iudividuation. ER status, lymph node status and histological grade were the independent prognosistic factors.

Objective To detect the prevalence of Breast Cancer Susceptibility Gene 1 (BRCA1) mutations and single nucleotide polymorphism (SNP) among young patients with breast cancer and to study the relationship between BRCAI gene mutation and susceptibility to breast cancer. Methods 30 samples of breast cancer tissue were collected from female patients with breast cancer diagnosed when they were aged 35 5 of which had at least one first-degree relative affected with breast cancer. Genomic DNA was extracted from the breast cancer tissues. The PCR products were amplified in the coding sequence of exon 2, 11C, 11F, 11L, 11I, 16, and 20 by using polymerase chain reaction. Then the PCR products were analyzed using DNA direct sequencing. The sequence was compared with the DNA Star-MagAlign software. Results A total of 14 sequence variations in BRCA1 gene were identified, including 3 frameshift mutations (cDNA2639, 2640delTA, 3343 delG, and 3398delT) and 11 spot mutations (cDNA 2570 C > T , cDNA 2620 A>T, 1473 A>G, 1561 C>T, 1594G >A, 2206 A>G, 2227 T>C, 2659 C>A, 2806T > C, 3307 A >G, and 3375 G > A). Three patients with these mutations had a family history of breast cancer. The mutation frequency of BRCA1 was 10% (3/30). No mutation was found in the exons 16 and 20. Conclusion Patients with breast cancer aged ≤35 have BRCA1 mutations located in the exon 11 mainly. The mutation frequency of the breast cancer patients aged ≤ 35 with breast cancer family history is higher than those without family history. Three frameshift mutation sites may be related to early onset of breast cancer.

Objective To investigate the safety and efficacy of circumferential pulmonary vein with additional linear ablation in treatment of persistent and permanent atrial fibrillation ( AF), and to identify possible predictors of recurrence of AF. Methods The clinical data of 127 patients with persistent and permanent AF who had undergone circumferential pulmonary vein with additional linear ablation from January 2006 to December 2006 in multiple electrophysiological centers were collected, success rate and recurrence rate, cardiac function and atrial arrhythmias after ablation, and complications were analyzed. The relationship between the recurrent AF and clinical and echocardiographic variables was investigated. Results A mean follow-up of 9±4 months showed that the success rate and recurrence rate were 68.5% and 31.5% respectively. After, both The left atrium diameter, left ventricnlar end diastole diameter , and left ventricular ejection fraction of the patients with successful ablation were (41±8) mm, (49±7) mm , and (61±8)% respectively, all not significantly different from those before ablation [ (43±7) mm, (48±6) mm, and (62±10)% respectively, all P >0.05]. After ablation the episodes of atrial tachyarrhythmias and atrial premature beat significantly increased ( P < 0. 05 and P < 0.01 ). The only complication was ecchymoma that occurred in 3 patients (2. 4% ). Female gender and left atrium enlargement were risk factors of recurrent AF ( P < 0. 05 and P < 0. 05 ). Conclusion Circumferential pulmonary vein with additional linear ablation is a safe and moderately effective treatment for persistent and permanent atrial fibrillation.

Objective To investigate the association of killer cell immunoglobulin-like receptors (KIR) genotype and haplotype with ankylosing spondylitis (AS). Methods Peripheral blood samples were collected from 105 AS patients, 62 patients of osteoarthritis (OA), and 412 randomly selected healthy controls. Polymerase chain reaction with sequence-specific primers (PCR-SSP) was used to detect the KIR genotype and haplotype. Results The genotype frequency of 3DL3-2DL3-2DL1-2DP1-2DLA-3DL1-2DS4-3DL2 (6.67%)was significantly lower in the AS patients than in the control subjects (20.15% ) and OA patients( 17.74%, P = 0. 001,0. 037 respectively). The genotype frequency of 3DL3-2DL3-2DL2-2DL1-2DP1-2DL4-3DL1-2DL5-2DS1-2DS2-2DS3-2DS4-2DS5-3DS1-3DL2 and 3DL3-2DL3-2DL2-2DL1-2DP1-2DL4-3DL1-2DL5-2DS1-2DS4-3DL2 of the AS patients (9.52% ,5.71% )was significantly higher than that of the controls (2.18 % ,0.49 % ; P = 0.001,0.001 ), and these two genotypes were not detected in the OA patients. There were not significant differences in the haplotypes A and B among the AS patients, OA patients, and healthy controls. Conclusion KIR genotypes may be associated with the susceptibility to AS.

Objective To develop a reasonable protocol for childhood rhabdomysarcoma (RS) to improve the prognosis of this disease. Methods The protocol RS-99, developed on the base of pathological examination, clinical staging and grouping was used for 30 RS patients, 15 male and 15 female, aged 53 mouths (15-180 months). For the low-risk patients the regimen VCP and IeV were used alternately for 6 treatment courses and then local radiotherapy was given, for the median and high risk patients, regimen AVCP and IEV were used alternately for 6 courses, local radiotherapy and selective operation were performed, and then DEV and IeV were used alternately for 6 courses, and for the high-risk patients DEV and IeV were used alternately for 18 courses in total and then hematopoietic stem cell transplantation was conducted. Results Twenty-three of the 30 patients reached complete response (CR) 17 of which remained in CR for 37 (32-92) months, and 7 of the 30 patients achieved partial response (PR) but their condition worsened later. Relapse was seen in 6 patients 15 (7-38) months later. The 5 year event-free survival (EFS) rate was 47% and the overall survival (OS) rate was 52%. All the 10 stage Ⅰ and Ⅱ patients, 5 of the 8 stage Ⅲ patients, and only 2 of the 12 stage Ⅳ patients still remained in CR. Conclusion The protocol RS-99 is effective on the RS at stages Ⅰ, Ⅱ, and Ⅲ ,however, is ineffective on the disease at stage Ⅳ.

Objective To investigate the value of Doppler tissue imaging (DTI) in evaluation the changes of cardiac function after neonatal asphyxia. Methods Sixty-two full-term neonates suffering from asphyxia at birth were divided into 2 groups according to Apgar scores : severe asphyxia group with the Apgarscores ≤3 (n = 31 ) and mild asphyxia group with the Apgar scores > 3 and ≤ 7 ( n = 31 ). Thirty normal neonates were used as control group. DTI was conducted 24, 48, and 72 hours after birth to measure the values of systolic peak myocardial motion velocity ( DTIs), early diastolic peak myocardial motion velocity (TDIe), late diastolic peak myocardial motion velocity (DTIa) and DTI e/a of anterior leaflet of mitral valve, and the values were compared with the left ventricular ejection fraction (LVEF) measured by M-mode ultrasound and the values of E, A, and E/A of mitral valve shown in pulsed Doppler echocardiogTaphy. Results The LVEF of the severe asphyxia group measured 24 h after birth was (62 ±4)cm/s, significantly lower than that of the control group (P < 0.05), while the values of DTIs 24, 48, and 72 hours of the severe asphyxia group were all significantly lower than those of the control group ( all P < 0. 05 ). In the severe asphyxia group the DTIs value 24 hours [ (3.9 ± 0.4) cm/s ] after the birth was significantly lower than those 48 and 72 hours after birth [ (5.3 ± 0.8 )cm/s, (5.0 ± 0.9 )cm/s, both P < 0.01 ]. The values of E and E/A of the severe asphyxia group(55 ± 12,0.94 ± 0.25 )72 h after birth of the mild asphyxia group (51 ± 10,0.89 ± 0.20) were both significantly lower than those of the control group ( both P < 0.01 ), the value of A 72 h after birth of the mild asphyxia group ( 60 ± 7 ) was significantly higher than that of the control group (P < 0.01 ). The values of DTIe and DTIe/a 24, 48, and 72 h after birth of the mild asphyxia group were all significantly lower than those of the control group, and the values of DTIa 24, 48, and 72 h after birth of the mild asphyxia group were all significantly higher than those of the control group ( all P <0.01 ). Conclusion After neonatal asphyxia, both the systolic function and the diastolic function of the left ventricle decrease; and the DTI indexes can reflect the cardiac function changes more sensitively than M-mode ultrasound indexes.

Objective To probe into grading management mode for chronic tinnitns victims, so as to improve the cost-effectiveness rate of tinnitus treatment. Methods According to the severity of patient's own feeling and the therapy demand, the authors managed 587 of chronic tinnitus victims using a progressive methods: Level 1 was primary evaluation, counseling and treatment for tinnitus victims, then determined if the victim require further clinical intervention . Level 2 was educational counseling about the knowledge of tinnitus. Level 3 was further evaluation for hearing function and the severity of tinnitus. Than the authors made and put in practice an individual integrative treatment project for every victim according to the assessment results. Results 75% (441/587) of the chronic tinnitus victims needed only educational counseling which can free them from the mystification and dread of tinnitus, the counseling helped them get habituation of tinnitus; the rest 25% ( 146/587 ) needed long-term integrative clinical treatment. Conclusion Effective grading management can hold the tinnitus severity level and the treatment desirability from the victims rapidly and exactly, then provided them multiple medalities treatment from counseling to long-term integrative therapy. The grading management mode improved the cost-effcetiveness rate of tinnitus treatment.

Objective To investigate the complication rate of lung biopsy in patients with idiopathic interstitial pneumonia (IIP) and the risk factors thereof. Methods The clinical data of 66 IIP patients underwent lung biopsy were analyzed. Of the 66 patients, 21 undergoing surgical lung biopsy ( SLB ) including open lung biopsy (OLB) (n = 11 ) and video-assisted thoracic surgery (VATS) (n = 10), and 45 patients undergoing biopsy other than SLB, including transbronchial lung biopsy (TBLB, n = 28 ) and CT or B mode ultrasonography-guided percutaneous transthoracic needle lung biopsy ( n = 17 ) . Results The general postoperative complication rate was 40. 9% (27/66), and the postoperative complication rate was 71.4% ( 15/21 ) in the SLB group, significantly higher than that of the non-SLB group (26.7% , 12/45, X2 = 4.55, P = 0. 03 ). The complications of the SLB group included prolonged air leakage (n = 10, 47.6% ), pleural effusion (n = 5, 23.8% ), acute pulmonary edema (n = 5, 23.8% ) , and postoperative pulmonary infection (n =4, 19.0% ), and the complications of the non-SLB group included pneumothorax after percutaneous transthoracic lung needle biopsy or TBLB (n = 12, 26.7% ), acute exacerbation (AE) ( n = 2, 4.4% ), respiratory failure requiring mechanical ventilation for more than 72 h ( n = 1, 2.2% ), and postoperative pulmonary infection ( n = 1, 2.2% ). The predicted diffusing capacity of the lings for carbon monoxide ( DLCO% ) of the SLB group patients with postoperative complications was (46. 83 ±17.01 )%, significantly higher than that of the SLB group patients without postoperative complication [ (75.93±25.62) %, t = 2.55, P = 0. 02 ]. However, there were not significant differences in the lung function and blood gas indexes among the patients undergoing different procedures of lung biopsy, with and without postoperative complications. Six of the 66 patents died within 90 postoperative days with a mortality of 9.1%, the causes of death of 3 of which were associated with lung biopsy. Conclusions The IIP patients undergoing SLB suffer from more postoperative complications than those undergoing other lung biopsy procedures with the lower DLCO% as the probable associated factor. AE in the IIP patients can be induced by CT-guided percutaneous transthoracic needle lung biopsy and TBLB, and results in death.

Objective To investigate the influence of polyester gauze on evaporation capacity and its clinical effect after escharectomy of deep burn wound and micro-skin grafting. Methods Twenty patients with deep burn admitted within 24 hours after injury underwent escharectomy and Meek skin grafting. Two surfaces of wound with the area of about 1% as the whole wound surface were used, one covered by Meek skin graft and polyester gauze as inner dressing (polyester gauze group), and the other covered by split-thickness skin sheet 0. 3 mm ×0. 3 mm in size and vaseline oil gauze as inner dressing (vaseline oil gauze group). Five days after skin grafting, the evaporation capacities of the surface of inner dressing, wound surface without dressing( nude wound), and normal skin near the wound were tested by evaporation test equipment. The complete healing time and survival rate of skin sheet in both groups were observed. The degree of pain during dressing change was evaluated with visual analog scale. Results The evaporation capacity of the inner dressing surface of polyester gauze group was ( 24. 8±5.2 ) ml · h-1· m-2 ,significantly lower than those of the vaseline oil gauze group [ (35.4±5.0) ml·h-1 · m-2, p <0.01 ] and nude wound [ (41.3±4.5) ml· h-1· m-2, P <0. 01 ], and similar to that of the normal skin near the _wound [ (21.1±5.1 ) ml· h-1· m-2 ,P >0.05]. The evaporation capacity of the inner dressing surface of vaseline oil gauze group was significantly lower than nude wound [(40. 7 ± 3. 6) ml·h-1· m-2 P <0.01 ], but significantly higher than the normal skin near the wound [ (21.2±3.8) ml· h-1· m-2, p <0.01 ]. The survival rate of skin sheets of the polyester gauze group was 98% ± 3%, not significantly different from that of the vaseline oil gauze group (98%±2% , P >0.05). The wound healing rates on days 10, 15, and 20 of the polyester gauze group were 80%±20%, 96%±7%, and 100% respectively,all significantly higher than those of the vaseline oil gauze group (70%±33%, 81%±21%, and 97% ±11% respectively, all P < 0. 01 ). The complete healing time of the polyester gauze group was ( 13.6± 1.9) days, significantly shorter than that of the vaseline oil gauze group [ ( 16.7±2.6) days, P <0. 01 ]. The pain scores during dressing change 5 and 10 days after grafting of the polyester gauze group were (3.2± 0.8) and (4.9± 0.4 ) respectively, both significantly lower than those of the vaseline oil gauze group [ (5.1 ±0.6) and (8.2± 0.5 ) respectively, both P < 0.01 ]. Conclusions Polyester gauze has quite good abilities to retain moisture and can promote the migration and proliferation of epithelial cells, relieves the pain caused by tearing of dressings off the wound, thus raising its acceptability. It is a relatively ideal cartier of skin grafting, as well as a new type of inner cover for the wound.

Objective To search the tissue biomarker in mycosis fungoides (MF) patients by surface enhanced laser desorption/ionization-time of flight-mass spectrometry (SELDI-TOF-MS). Methods Skin specimens were collected from 12 MF patients and 15 normal controls to prepare solution of protein. CM10 Proteinchip was used to detect the biomarkers for MF. Differentially expressed protein was identified by immunocapturing. Results The expression intensity levels of 24 proteins were different between the MF patients and controls. By searching in SWISS-PRO database and literature, the 3498 and 10 837 peaks were found to accord with HNP3 and S100A8 proteins respectively. By immunocapturing, 10 837 could be identified as S100A8 with a special antibody against S100A8. Conclusion A quick, easy, and high throughout proteome analytic method, SELDI-TOF-MS can identify the differential expressed proteins from MF tissue, thus offering a unique platform for biomarker detection of MF.

Objective To investigate the effects of antimicrobial agents on the Toll like receptors (TLRs) and myeloid differentiation protein (MD)-2 in liver tissue of alcohol-induced liver disease with Vibrio vulnificus (VV) sepsis. Methods Eighty SD rats were randomly divided into 2 groups: alcohol gastric lavage group ( n = 74) undergoing alcohol gastric perfusion once a day for 10 weeks and normal control group ( Group N, n = 6). 66 surviving rats in the gastric perfusion group were randomly divided into 6 equal subgroups: Subgroup A was alcohol-induced liver disease control subgroup. Subgroup AA, alcohol-induced liver disease and antibacterial drug control subgroup, underwent intraperitoneal injection of cefoperazone sodium and levofloxacin (LVFX), The other 9 subgroups underwent subcutaneous injection of VV to establish animal model of VV sepsis, the rats of 4 of which were killed 2, 6, 12, and 24 h later respectively with their livers taken out (Subgroups AV), and the rats of 5 of which underwent intraperitoneal injection of cefoperazone sodium and LVFX 4 h after VV injection twice a day( Subgroups AVA) and were killed 6, 12 , 24 , 36 h, and 1 week later with their livers taken out. The behavioral changed were observed. PCR was used to detect the mRNA expression of TLR2, TLR4, and MD-2 Results The mRNA expression levels of TLR2, TLR4, and MD-2 in liver 2, 6, 12, and 24 h after in Subgroups AV were all significantly higher than those of Group N (P <0.05 or P <0.01 )with the maximum level in the AV-12 h subgroup. The mRNA expression levels of TLR2, TLR4, and MD-2 in liver 6 h, 12 h, and 24 h after the VV injection of Subgroup AVA were all significantly lower than those of Group AV ( P < 0.05 or P < 0.01 ). Conclusion The mRNA expression levels of TLR2, TLR4, and MD-2 in liver tissue of alcohol-induced liver disease with VV sepsis, which may be reduced by treatment of cefoperazone sodium and LVFX, are associated with the development of VV sepsis. This treatment is effective on this disease. Dynamic monitoring of the mRNA expression levels of TLR2, TLR4, and MD-2 in liver tissue benefits observation of the VV sepsis progress and treatment.

Objective To study the apeptotic effects of arsenic trioxide on human coronary smooth muscle cells (HCSMCs). Methods HCSMCs were cultured and randomly divided into 5 groups to be treated by arsenic trioxide of the concentrations 1.0, 2.0, 3.0, 4. 0, and 5.0 μmol/L for 48 h. Cell growth curve was drawn by MTT method. DNA electrophoresis was used to observe the apoptosis. Western blotting was conducted to examine the protein expression of Bax, an apoptosis-promoting gene, and Bcl-2, an apeptosis-inhibiting gene. Other HCSMCs were cultured with 4.0 μmol/L arsenic trioxide for 48 h, then transmission electron microscopy was used to observe the ultra-structure and TUNEL was used to detect the percentage of apoptotic cells. HCSMCs not treated with arsenic trioxide were used as control group. Results Arsenic trioxide of different concentrations inhibited the proliferation of HCSMCs dose and time-dependendy. When the concentration of arsenic trioxide was 5.0 μmol/L the number of living cells was (4.41±0. 10) × 105/ml, significantly lower than that of the control group [(30. 11±0. 93) × 105/ml, P <0.05]. Apoptosis bodies were observed under the transmission electron microscope. DNA electrophoresis showed hazy ladders, especially when the concentrations were 3.0 ～ 4.0 μmol/L. When the concentration was 5.0 μmol/L the number of necrotic cells increased remarkably and apoptosis became less significant. TUNEL showed that the apeptotic cells increased from 16.0%±3.1% to 38.7%±2.7% (P <0.05) . MTr test showed that arsenic trioxide decreased the absorbence of HCSMCs dose and time-dependently. Western blotting showed that the Bcl-2 expression was decreased and the expression of Bax increased after treatment of arsenic trioxide. Conclusion Arsenic trioxide exerts an apoptotic effect on HCSMCs.

Objective To investigate the therapeutical effect of adenovirus-mediated vascular endothelial growth factor (VEGF)165 gene transplantation in treatment of hypoxic-ischemic brain damage. Methods Recombinant vector of adenovirus-mediated VEGF165 gene (Ad-VEGF) was constructed by bacterial homologous recombination technology. Sixty 7-day-old Sprague-Dawley rats were randomly divided into 3 equal groups: hypoxic-ischemic brain damage (HIBD) group undergoing ligation of the left common carotid artery and inhalation of 8% oxygen for 2 hours, Ad-VEGF group undergoing injection of Ad-VEGF into the left sensorimotor cortex with the help of stereo-positioner 3 days after hypoxia-ischemia ( HI), and sham operation group. Seven days after transplantation, 5 rats from each group were killed with their left brains taken out. The VEGF protein expression was detected by immunohistocbemistry, and the neuron apoptosis was detected by terminal deoxynucleotidyl transferase-mediated biotinylated deoxyuridine triphosphate nickel end labeling (TUNEL). Since the age of 28 days T-maze foraging test was conducted. At the age of 34 days, sensorimotor tests were performed. After the behavioral tests all the rats were killed. The number of neurons in the CA1 region of the hippocampus and cerebral cortex was detected by Nissl's staining. Results Immunohistochemistry showed that the density levels of VEGF positive cells in cerebral cortex and hippocampus of the Ad-VEGF group were (68.09 ±3.37) and (68.37±3.17) respectively, beth significantly higher than those of the HIBD group [ (24.65±3.14) and (25.14±1.86) respectively, both P < 0.05 ]. TUNEL showed that the number of apoptotic neurons of the Ad-VEGF group was ( 151.4 ± 21.7), significantly lower than that of the HIBD group [ (264.4 ±16.3), P <0. 05]. Behavioral tests showed the percentages of accuracy on day 4 of the Ad-VEGF and sham operation groups were both significantly higher than that of the HIBD group (both P <0.01 ). Nissl's staining showed that the numbers of neurons per unit area in the hippocampal CAI area and cortex of the Ad-VEGF group were (70.6±2.3) and (95.1±2.8) respectively, both significantly higher than those of the HI group [ (55.3 ± 2. 1 ) and (70.1 ± 2.7) respectively, both P < 0.05 ]. Conclusion Adenovirns vector-mediated VEGF gene therapy increases the VEGF protein expression, decreases neuron apeptosis, improves the long-term behavioral function after brain damage, and reduces hypoxic ischemic brain injury, thus possessing neuroprotective effects.

Objective To develop a method for long-term culture of human B cells from peripheral blood mononuclear cells (PBMCs) by means of human soluble CD40 ligand (sCD40L), and to investigate the proliferation and antigen-presenting function of the CD40-activated B cells. Method Peripheral blood sample of 30 ml was collected from a healthy person. PBMCs were isolated and cultured in the presence of sCD40L. Flow cytometry was used to examine the proliferation, DNA cycle, and cell surface markers: CD86, CD80, major histocompatibility complex (MHC) class Ⅱ, and MHC Class I of the B cells. The cells cultured for 45 days were divided into 2 groups : Group 1 incubated with the fluorescein isothiocyanate (FITC)-conjugated hepatitis-B core antigen (HBcAg-FITC) and Group 2 used as control group. Eighteen hours later cytometry and fluorescence microscopy were used to detect the peptide pulsing. Results The B cells could be cultured up to 50 days in the sCD40L culture system. The ratio of B cells in the PBMCs was 8.21% at the beginning, and increased to 70.67% by day 47, and the B cell absolute count was 6.56 × 105 at the beginning and increased to 8.61×106 at day 50, about 10 times higher, sCD40L promoted a strong up-regulation of cell surface markers, The expression rates of CD80, CD86, MHC- Ⅱ, and MHC-Ⅰ of the sCD40L-activated B cells were 83.97%, 84.73%, 99.59%, and 98.70% respectively. Flow cytometry showed that 98.10% of the B cells co-incubated with HBcAg-FITC were loaded with HBcAg. Fluorescence microscopy showed that the HBcAg was in the cytoplasm of the B cells. Conclusion A human sCD40L culture system has been developed with the ability to culture human peripheral blood B cells, thus realizing the long-term proliferation and activation of human peripheral blood B cells that function as antigen-presenting cells.

Almost all biological processes involve specific interactions between biological macromolecules, which depend on specific domains within the macromolecules. The zinc finger is an important domain that can bind to DNA.

Venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary thromboembolism (PTE), is a common disease and cause of death in internal medicine inpatients, and its prevalence is the third highest among cardiovascular diseases.

Although the mortality rate of cardiovascular disease is decreasing year by year, the proportion of sudden cardiac death (SCD) is increasing. The onset of SCD is sudden and often without any warning, so it is difficult to rescue and the mortality rate is extremely high. Finding a method that can predict and prevent SCD is the best choice to solve this public health problem. Both SCD-Herr and MADIT II trials have confirmed that implantable cardioverter defibrillators (ICD) can reduce the incidence of SCD in patients with decreased left ventricular systolic function. But is there any better clinical index to assess the risk of SCD in patients? We already know that SCD is often caused by ventricular tachyarrhythmia caused by cardiac electroanatomical changes accompanied by myocardial damage. High risk groups of SCD can be found by intracardiac electrophysiological examination, but its invasiveness restricts its widespread clinical development.

From November 21 to 23, 2008, the China Vascular Forum (CEC) and 2008 National Continuing Education Study Class jointly organized by the General Hospital of the People's Liberation Army, Zhongshan Hospital affiliated to Fudan University and Beijing Anzhen Hospital affiliated to Capital Medical University were held in Beijing. Adhering to the tenet of connecting academics and education, the conference attracted more than 600 delegates from all over the country to attend the conference, showing a strong academic atmosphere. Everyone unanimously reflected that this is a professional conference of vascular diseases in China with high academic influence. Its successful convening is a milestone of vascular diseases in China, and will effectively promote the development and improvement of vascular disease prevention, diagnosis and treatment technology in China.

From October 31 to November 2, 2008, the 10th National Academic Conference on Gastrointestinal Surgery, sponsored by the Gastrointestinal Surgery Group of the Surgery Branch of Chinese Medical Association, and co-organized by Zhongshan Hospital affiliated to Fudan University and the First People's Hospital affiliated to Shanghai Jiaotong University, was successfully held in Shanghai. The conference was presided over by Professor Sun Yihong, Deputy Director of General Surgery Department of Zhongshan Hospital affiliated to Fudan University.