Volume 92  ·   Issue 20  ·  2012

The breakthrough in the understanding of the physiological function of vitamin D has benefited from the epidemiological investigation data and the research progress of basic medicine. The biological function of vitamin D has far exceeded the classical fields of calcium and phosphorus metabolism and bone health, and has risen to the category of body health. Except for intestinal epithelial cells, renal tubular epithelial cells, osteoblasts and osteoclasts, other tissues and cells of human body have also discovered vitamin D receptor and 1 α-hydroxylase, which have the ability to convert 25 hydroxyvitamin D into 1 α, 25-dihydroxyvitamin D, and become the target tissue or target cell of vitamin D. 1 α, 25-dihydroxyvitamin D exerts physiological function by activating vitamin D receptor and changing the transcription of target gene.

Breast cancer is one of the most common malignant tumors in women worldwide. According to relevant literature reports, an average of 1.15 million new breast cancer cases and 410,000 deaths every year from 1993 to 2001. Breast cancer is also a serious threat to women's health in China. In recent years, great progress has been made in the diagnosis and treatment of breast cancer. Drug treatment of breast cancer is an important part of breast cancer treatment. Among them, endocrine therapy is one of the main methods of systemic treatment of breast cancer. Tamoxifen is a modulator of estrogen receptor, and 5-year treatment with tamoxifen has been the standard endocrine adjuvant for hormone receptor positive early breast cancer. It has become the most commonly used endocrine therapy for premenopausal and postmenopausal women, while aromatase inhibitor (AI) only works for postmenopausal women. In the treatment of breast cancer, endocrine therapy is used for a long time, the time of monotherapy is usually 3~5 years for early breast cancer and 10~14 months for advanced breast cancer. Therefore, its adverse reactions have been paid more and more attention.

Neoadjuvant endocrine therapy refers to the adjuvant therapy of endocrine therapy for a period of time before the planned surgical therapy. The earliest research report can be traced back to 1986. Compared with neoadjuvant chemotherapy, the clinical studies of neoadjuvant endocrine therapy are relatively few [1-4]. At present, in clinical application, neoadjuvant endocrine therapy is used to obtain surgical opportunity for locally advanced breast cancer or breast-sparing surgical opportunity for operable breast cancer.

Endocrine therapy is one of the important systemic treatments for breast cancer. In the 1970s, the advent of tamoxifen became a milestone of endocrine drug therapy for breast cancer; In the 1990s, the advent of the third generation of aromatase inhibitors brought the endocrine therapy of breast cancer into a new era. In January 2005, some experts engaged in clinical work of breast cancer in China also discussed the role and position of endocrine therapy in the recurrence and metastasis of breast cancer, preoperative neoadjuvant therapy and postoperative adjuvant therapy, and reached a basic consensus [1].

Objective To evaluate the in vitro cytotoxic effects of cantide or herceptin on human breast cancer SKBR3 cells over-expressing HER2.Methods The distribution of HER2 and hTERT protein in SKBR3 cells and the effects of cantide and/or herceptin on the subcellular localization of HER2 and hTERT were observed by indirect immunnfluorescent assay.The inhibition rate of herceptin and/or cantide at different concentrations on SKBR3 cells was detected by MTT assay.And the apoptotic rate of cells was evaluated by flow cytometer.Results (1) The expressions of both HER2 and hTERT proteins in SKBR3 cells were found.HER2 protein was predominant in cell membranes while hTERT protein in nuclei.After the addition of herceptin,the cytoplasmic migration of HER2 was found while there was no distinct location change of cantide.(2) In MTT assay,the single use of cantide or herceptin and the combined use of both produced inhibitory effects on SKBR3 cells while the inhibition rate was higher for combined use.The inhibitory effects became additive in the combined use of 0.4 μmot/L cantide and 0.85 μg/ml herceptin.And there were synergistic effects in the combined use of 0.4 μmol/L cantide and 1.70,3.40,6.88 or 13.75 μg/ml herceptin.(3) The apoptotic rate was 25.75％ for cantide alone,11.26％ for herceptin alone and 41.41％ for their combined use (apoptotic cells predominant in advanced stage).Conclusion Due to different localizations,cantide and herceptin have different action sites in their combined use.When in single use,the inhibition rate is linearly correlated with the concentration of herceptin or cantide.And their combined use produces additive or synergistic antitumor effects on SKBR3 breast cancer cells.

Objective To investigate possible mechanism of silencing lysyl oxidase (LOX) gene by RNA interference affecting on invasion and metastasis of breast cancer cells.Methods LOX-RNAi-LV was designed and synthesized,which was transfected into breast cancer cell line MDA-MB-231.The expressions of LOX,MMP-2 and MMP-9 were determined by Real-time PCR in MDA-MB-231 cells,and the protein expression of LOX was determined by Western blot.The cells migration and invasion abilities were measured by cell migration and invasion test.111 eases of breast cancer tissue and cancer-adjacent breast tissues and 20 cases of benign lesion tissues of LOX,MMP-2 and MMP-9 were detected by immunohistochemistry,and the relationship of LOX and clinicopathological characteristics was analyzed.Results The expression levels of LOX mRNA and protein were down-regulated obviously after transfecting LOX-RNAi-LV,with the inhibition rate 89.2％±1.3％ and 84.4％±0.4％ repectively.The relative expressions of MMP-2 and MMP-9 mRNA were 0.496±0.021 and 0.571±0.099 in RNAi group,which was significantly lower than that in negative control group ( 0.846±0.047,0.786±0.042 ) and blank control group ( 1.000±0.000,1.000±0.000 ) ( both P＜0.05 ).Cell migration and invasion test showed the average cell numbers per field in the group RNAi were 47±2 and 63±2,was significantly lower than that in negative control group (100±1,118±2) and blank control group (100±1,118±2) (both P＜0.05).The expression of LOX protein in breast cancer,cancer-adjacent breast tissues and benign breast tumor were 48.6％ (54/111),26.1％ (29/111),20.0％ (4/20),the expression of LOX protein in breast cancer was significantly higher than that in cancer-adjacent breast tissues and benign lesion tissues (P=0.019).The expression of LOX protein was associated with clinical stage,lymph node metastasis,tumor size.Correlation analysis showed that LOX protein expression was significantly positive correlation with MMP-2 (r=0.262,P=0.005) and MMP-9 (r=0.424,P=0.000).Conclusion LOX can promote invasion and metastasis of breast cancer;LOX and MMP-2,MMP-9 may have a synergistic role in promoting invasion and metastasis of breast cancer.

Objective To investigate the clinical efficacy between mobile intraoperative magnetic resonance imaging (iMRI) navigation with a high field strength and routine surgical resection for malignancy of parapharyngeal space.Methods The surgical efficacy indexes of patients at our hospital during the time range from February 2010 to February 2011 were compared between two groups consisting of 29 or 42 individuals undergoing surgery with the assistance of the technique of iMRI navigation with a high field strength 1.5T or routine operation.Results No difference existed between two groups in terms of age,gender,maximal diameter of tumors,tumor stages,surgical approach or pathologic diagnosis (P＞0.05).The operative duration of the group by iMRI navigation was more than the group of routine operation( (3.1±0.6) h vs (2.7±0.7) h,P＜0.05 ).And the hemorrhagic loss ( ( 185±20 ) ml vs (230±22) ml),the volume of drainage in 72 hours,the positive rate of initial surgical margins,the postoperative hospital stay ( (9.1±2.1 ) d vs ( 10.3±2.3 ) d ) and the complication incidence rate ( 3.4％ vs 9.5％ ) were less ( all P＜0.05 ).Conclusion The operation by the iMRI navigation offers a much better clinical efficacy than the traditional surgery in the resection of malignancy of parapharyngeal space.

Objective To explore the potential relationship of cytomegalovirus (CMV),Chlamydia pneumoniae (CP) and herpes simplex virus type 2 (HSV-2) in inflammation and preeclampsia.Methods Fifty-two pregnant women with preeclampsia and 34 with uncomplicated pregnancy in the third trimester were recruited.The exclusions included uterine contractions,multiple pregnancies,rupture of membranes,symptomatic infectious diseases,medical diseases and antibiotics or hormones users.Samples of maternal blood were harvested from two groups.Serum levels of CMV,CP,and HSV-2 IgM and IgG antibodies as well as high-sensitivity C-reactive protein (hs-CRP) and interleukin-6 (IL-6) were determined by enzymelinked immunosorbent assay (ELISA) in preeclampsia and normal pregnancy controls.Results (1) Recent infections of CMV,CP and HSV-2 were not more common in patients with preeclampsia versus normal pregnancy.The prevalence rates of long-dated CMV,CP and HSV-2 infection were 94.2％ (49/52),53.9％ (28/52) and 3.9％ (2/52) in preeclampsia group versus 100.0％ (34/34),55.9％ (19/34) and 5.9％ (2/34) in control group.No significant difference existed between two groups ( P＞0.05 ).(2) Maternal serum concentrations of IL-6 and hs-CRP in patients with preeclampsia were significantly higher than that in normal pregnancy women ( (7.2±2.1 ) ng/L and ( 6.8±5.6 ) mg/L vs ( 6.2±1.8 ) ng/L and ( 4.6±3.0)mg/L,both P＜0.05 ).Conclusion Excessive inflammatory reactions are present in women with preeclampsia.But previous infections,as measured by IgM and IgG antibody seropositivity to CMV,CP and HSV-2,are not correlated with preeclampsia in the third trimester.

Objective To evaluate the value of positron emission tomography/computed tomography (PET/CT) in the preoperative assessment of hilar cholangiocarcinoma (HC).Methods A retrospective analysis was performed for 32 HC patients.There were 14 females and 18 males with a mean age of 56 years old.All cases were confirmed by surgery,pathology or other diagnostic modalities.18F-fluorodeoxyglucose (FDG) PET/CT was performed preoperatively in all patients.The images were interpreted and compared with the operative and pathological outcomes in each case.Results Among them,according to the Bismuth-Corlette classification,the number of types Ⅰ,Ⅱ,Ⅲ a,Ⅲ b and Ⅳ patients,were 3,2,4,8 and 15 respectively.Radical tumor resection was performed in 16 patients.Among them,3,2,1,7 and 3 patient belonged to types Ⅰ,Ⅱ,Ⅲ a,Ⅲ b and Ⅳ respectively.Seven patients underwent palliative surgery and 9 had only surgical exploration. The detecting accuracy of PET/CT in primary tumors Bismuth-Corlette classification reached 81.25％ (26/32).The sensitivity,specificity and accuracy of PET/CT in detecting lymph node metastasis and distant metastasis were 64.7％,86.7％,75.0％ and 41.7％,95.0％,75.0％ respectively.The concordance rate of preoperative evaluation of respectability by PET/CT and intraoperative evaluation was 75.0％. No significant difference existed between PET/CT and the surgical and histopathologic findings in the evaluation of curative resectability for HC ( x2 =0.125,P＞0.05 ).Conclusion 18 F-FDG PET/CT is of great value in the diagnosis of HC,as well as in detecting lymph node metastasis and distant metastasis.Thus 18F-FDG PET/CT is helpful in the preoperative assessment of resectability for HC.

Objective To detect the expression of hOCTI and ABCB1 in marrow cells and examine the efficacy of imatinib mesylate (IM) in patients with chronic myelocytic leukemia (CML).Methods hOCT1 and ABCB1 gene in 90 samples with chronic phase CML diagnosed at our hospital from January 2008 and June 2011 were detected by taqman probe real-time reverse transcription-PCR (RT-PCR).The samples were divided into 3 groups:drug-resistant group ( n =17),partial cytological remission (PCyR) group ( n =11 ) and complete cytogenetic remission (CCR) group ( n =62) according to IM efficacy and 3-6,7-12,13-24,25-48,＞48 months five groups ( n =21,8,15,29,17 ) according to IM treatment course.The relationship was explored between two genes and different disease states,course of treatment and time from first CCR.Results The h0CT1 gene mRNA expression of CCR group ( - 3.77±0.55 ) was higher than drug-resistant group ( -4.12±0.47 ) and PCyR group ( -4.24±0.35 ) (P =0.047,0.019).The ABCB1 gene mRNA expression of drug-resistant group ( -2.93±0.49 ) was higher than CCR group ( -3.02±0.56 ) and PCyR group ( -3.51±0.45 ) ( P=0.045,0.021 ).The hOCT1 and ABCB1 mRNA expressions showed no significant difference between five groups divided by IM treatment course ( P =0.270,0.367 ).The median follow-up time was 30( 3-117 ) months.In same IM treatment course patients,the CCR rates in hOCT1 and ABCB1 low-expression groups were higher than that in high-expression groups separately( P =0.006,0.049 ).Conclusions The expression levels of hOCT1 and ABCB1 vary in different disease states of patients on IM.And these two genes may influence the time from first CCR.But there is no significant relationship with course of the treatment.

Objective To determine the effects of therapeutic hypothermia(TH) in encephalopathic asphyxiated newborn infants on mortality,long-term neurodevelopmental disability and side effects by summarizing the data of hypoxic-ischemic encephalopathy (HIE) newborns undergoing mild hypothermia using meta-analysis.Methods The standard searching strategy of the Neonatal Review Group as outlined in the Cochrane Library was used to retrieve all clinical literatures about TH on HIE.RevMan 5.1 software was used to perform the meta-analysis of target papers.The primary outcome measure was a combination of death and severe major neurodevelopmental disabilities at 18-24 months of age.Secondary outcomes included mortality,cerebral palsy (CP),neurodevelopmental delay,blindness,deafness and main side effects of cooling therapy.Results A total of 276 papers fulfilled the search strategy and 11 trials were included.Overall TH resulted in a statistically significant and clinically important reduction in the combined outcome of death or major neurodevelopmental disabilities to 18-24 mouths of age (RR =0.76,95％ CI:0.68-0.84,P＜0.01 ),Moreover,as compared with the control group,TH significantly decreased the incidence of mortality( RR =0.76,95％ CI:0.65-0.90,P＜0.01 ),psychomotor development index( RR =0.69,95％CI:0.55-0.87,P＜0.01 ),mental development index (RR =0.66,95％ CI:0.53-0.83,P＜0.01 ),CP( RR =0.70,95％ CI:0.54-0.91,P＜0.01 ) and blindness ( RR =0.54,95％ CI:0.33-O.90,P＜0.05 ) except for severe hearing loss (deafness) ( RR =0.69,95％ CI:0.35-1.34,P =0.3000 ) in survivors.Adverse effects included significant thrombocytopenia in the TH group (P =0.0400)but without deleterious consequences.There were no significant differences in arrhythmia,coagulopathy,hypotension requiting inotropic supports,sepsis and pulmonary hypertension between the TH and control groups( all P＞0.05 ).Conclusions Mild hypothermia is effective in reducing death and major disabilities in infants with moderate-to-severe HIE without significant side effects.Infants presenting within the first hours after birth with the signs and symptoms of moderate-to-severe encephalopathy should be cooled in accordance with the established protocols of previous randomized controlled trials.

Objective To determine whether or not diaphragm electromyography recorded from chest wall surface electrodes (EMGsur) can be used to distinguish central from obstructive sleep apnea.Methods Ten patients ( age (44±10) years,body mass index (25.9±1.8) kg/m2 ) with suspected obstructive sleep apnea referred from Guangzhou Institute of Respiratory Disease were studied between January and September 2009. EMGsur and diaphragm electromyography from esophageal electrode (EMGeso) were recorded during conventional overnight full polysomnography. And chest-abdominal movement was measured with chest and abdominal bands.Results High-quality EMGsur and EMGeso were recorded in all subjects except for one who could not tolerate a multipair esophageal electrode.Excellent correlation was found between EMGsur and EMGeso during sleep including apnea events ( r=0.81±0.06,P＜0.05 ).The central sleep apnea events diagnosed by EMGeso were exactly the same as those diagnosed by EMGsur.However,the central sleep apnea events diagnosed by EMGsur were less than those diagnosed by conventional thoracic-abdominal bands ( 7±11 vs 28±31,P＜0.05 ).Conclusion EMGsur may be used to distinguish central from obstructive sleep apnea events.

Objective To explore the expression and significance of serum programmed cell death 5 (PDCD5) in patients with bronchial asthma.Methods From June to December 2011,a total of 40 adults with bronchial asthma treated in Peking University Third Hospital were enrolled.Among them,the categories were acute phase (n=12),chronic phase (n=14) and remission phase (n=14).Fifteen healthy adults were selected into the control group.The percentages of peripheral blood neutrophils and eosionphils were collected and detected for each patient.Serum PDCD5 was detected with enzyme-linked immunosorbent assay (ELISA) and asthma control test (ACT) questionnaire filled in.The relevant pulmonary functional indicators were analyzed with a pulmonary spirometer. Two-independent sample t-test and Pearson's correlation analysis were used for statistical analysis.Results No significant difference was found between two groups with regards to the percentages of peripheral blood eosinophils and neutrophils ( all P＞0.05 ).Serum PDCD5 was significantly higher in the patient group ( ( 47.7±29.6) vs ( 19.3±9.8 ) μg/L,P ＜0.05 ).Patients of chronic and acute phases showed a significant higher expression in PDCD5 than the remission phase ((55.2±24.5) & (68.5±22.1) vs (16.0±7.9) μg/L,both P ＜0.05).Serum PDCD5 of asthmatics showed a negative correlation with FEV1％,FEV1/FVC ratio and ACT scores (r =-0.539 to -0.798,all P＜0.05 ).Conclusions PDCD5 participates in the inflammatory process of asthmatic airway.Its abnormal expression may be associated with the uncontrolled state of asthmatics.It may serve as an indicator of assessing the levels of asthma control or a target for the treatment of asthma.

Objective To explore the depot-specific mRNA and protein expression of caveolin-1 ( CAV-1 ) in human subcutaneous and omental adipose tissues and analyze their relationship with obesity and insulin resistance.Methods A total of 41 subjects with normal glucose regulation were recruited.Among them,there were 29 cases with normal body mass index (BMI) and 12 cases with BMI≥24 kg/m2.All were scheduled to undergone selective abdominal operations.The levels of fasting insulin (FINS) were measured by chemiluminescence enzyme-linked immunosorbent assay (ELISA) kit.Fasting plasma glucose (FPG) was tested by glucose oxidase and home model insulin resistance index (HOMA-IR) calculated.Real-time polymerase chain reaction (RT-PCR) and Western blotting were employed to assess the relative mRNA and protein expression of caveolin-1 in subcutaneous and omental adipose tissues.And the mRNA and protein expression of caveolin-1 from different fat depots were compared and their correlations with BMI and HOMA-IR analyzed.Results (1)FINS and HOMA-IR were signfificantly higher in the overweight and obesity group than those in the normal BMI group ( FINS:(8.82±3.79) mU/L vs (6.43±4.38) mU/L,P＜0.05,HOMA-1 R:1.91±0.85 vs 1.36±0.72,P＜0.05).(2)The normal BMI group patients had the higher expression levels of caveolin-1 mRNA in omental adipose tissue than ovenweight counterparts (2.84±0.86 vs 1.02±0.36,P＜0.01).But the difference in subcutaneous adipose tissue was not significant ( P＞0.05 ).(3) The caveolin-1 protein expression in omental adipose tissue of the normal BMI group was higher than that of overweight patients ( 1.68±0.67 vs 0.73±0.29,P＜0.05 ).And the difference between two groups was not significant ( P＞0.05 ).(4) The expressions of caveolin-1 mRNA in omental adipose tissue were negatively correlated with BMI,waist circumstance,triglyceride and HOMA-IR ( r=-0.441,-0.615,-0.539,-0.688,P＜0.05).No correlations were found between the expressions of caveolin-1 mRNA in subcutaneous adipose tissue with BMI,waist circumstanee and HOMA-IR ( P＞0.05 ).Conclusion Differential depot-specific expressions of caveolin-1 are present in human subcutaneous and omental adipose tissues.A low expression of caveolin-1 in omental adipose tissue may contribute to the pathogenesis of obesity and insulin resistance.

Objective To iexplore the effect on biomechanical compliance after an addition of hyaluronic acid(HA)in transplantation of porcine acellular dermal matrix (PADM) with skin autograft.Methods Ten Japanese white rabbits were used as experimental animal,the dorsa of rabbits was symmetrically divided into four area,and then grouping was randomized.Full-thickness skin defects were created in Group A to Group C,and Group D was blank group with normal skin.The following procedures were performed:Group A:implanted with HA + PADM + thin skin autografts,GroupB:implanted with PADM + thin skin autografts and Group C:skin autografts,except for Group D. The wound tissue specimens were harvested at 70 days postoperatively,and they were recorded contracture rates of the grafts and the biomechanical compliance by Instron biomechanics tensiometer.The expression of collagens Ⅰ and Ⅲ in dermal fibroblasts of each group was determined by Western blot.Results On postoperation day 70,the grafts contracture rates in Group A to Group C were 10.2％±0.6％,36.6％±0.8％,32.7％±1.4％ respectively,there were notable significant difference among three groups ( P =0.000 ).Under the same tension,there was no significant difference in strain between Groups A and D ( (83±8) vs (81±5)kPa,P=0.552).Some significant difference in strain existed between Groups B and D ((215±9) vs (81±5 ) kPa,P=0.000).The strain of Group C ( ( 106±7 ) kPa) was between Groups B and D,and significant strain difference existed among them (P=0.000).The expressions of collagens Ⅰ and Ⅲ in Group A were higher than those in Group B,while the ratio of collagens Ⅰ to Ⅲ in Group A was lower than that in Group B.Conclusion Topical HA may be used to increase the expressions of type Ⅰ and Ⅲ collagen,decrease the ratio of collagen type Ⅰ / Ⅲ,and enhance the biomechanics performances of transplanted skin.

Objective To explore the effects of short- and long-term dietary hypercholesterolemia on contrast media-induced nephrotoxicity in rats.Methods The male Wistar rats were fed either a normal rodent diet or a high cholesterol diet.At the end of 2 and 8 weeks,8 rats from each group received a tail vein injection of either Iohexol injection (groups NC and HC) or vehicle (groups N and H).Blood lipid,renal function,renal hemodynamics,renal and urinary prostaglandin E2 (PGE2) and thromboxane B2 (TXB2),renal nitric oxide and malondialdehyde (MDA) were determined at Day 1 following the administration of contrast media.Results The dosing of contrast media induced obviously increased serum creatinine compared with normal rats ( (185±28) vs (53±3) μmol/L,P＜0.01 ) and severe renal tubular necrosis in rats with a high cholesterol diet for 8 weeks but did not in normal-diet rats or rats with a high cholesterol diet for 2 weeks.The renal and urinary levels of PGE2 and TXB2 increased significantly in rats of groups H and HC at the end of 8 weeks.The renal production of nitric oxide decreased while the concentration of MDA increased markedly in groups HC and H at the end of 8 weeks.Conclusion Long-term hypercholesterolemia appears to be a risk factor of contrast media-induced acute renal failure.And it may be associated with the disorder of intrarenal prostaglandins and the abnormality of renal nitric oxide system as induced by lipid peroxidation.

Objective To examine the toll-like receptor 4 (TLR4) expression of human peripheral blood mononuclear cells ( hPBMC ) treated with recombinant bacillus Calmette-Guérin (rBCG)and its role of immune activation.Methods hPBMC was treated with recombinant human interferon ( hIFN )-α-2b-BCG (rBCG)or wild BCG(wBCG) in vitro and the TLR4 expression detected by flow cytometry.The TLR4 functional blocking antibodies were applied for intervening the TLR4 signaling pathway of hPBMC Then rBCG,wBCG,hIFN-α-2b and phosphate-buffered solution (PBS) were used to stimulate the hPBMC of blocking and non-blocking groups.The changes of human tumor necrosis factor-alpha ( hTNF-α),human interleukin-12 (hIL-12) and hIFN-γ between the blocking and non-blocking groups by ELISA.Results The expression of TLR4 in hPBMC treated with rBCG or wBCG were stronger than that treat with PBS ( all P＜0.05 ).In TLR4 non-blocking groups the expressions of hTNF-α and hIFN-γ were rBCG group ＞ wBCG group ＞ hlFN-α-2b group ＞ PBS group,the expressions of hIL-12 was hIFN-α-2b group ＞ PBS group ＞rBCG group ＞ wBCG group( all P＜0.05 ).Application of TLR4 functional blocking antibodies to intervene hPBMC 48 h,comparing the changes in rBCG group,wBCG group,hIFN-α-2b group and PBS group,the expressions of hIFN-γin TLR4 blocking groups ( 27.3±1.2,20.6±0.9,20.3±0.8,18.4±0.7 ) were significantly inhibited than those in non-blocking groups ( 84.6±1.3,34.0±1.0,24.9±0.9,22.9±0.7 ) ( all P＜0.05 ).The expressions of hTNF-α in TLR4 blocking groups ( 1431±28,1032±21,104±6,109±4 )were significantly inhibited than those in non-blocking groups ( 1553±28,1065±31,343±6,299±4 ) ( all P＜0.05 ).The expressions of hIL-12 in TLR4 blocking groups ( 0.646±0.005,0.592±0.015,0.638±0.008,0.595±0.019 )were significantly inhibited than those in non-blocking groups ( 1.120±0.012,0.946±0.015,1.254±0.011,1.112±0.024 )( all P＜0.05 ).Conclusion rBCG regulates the secretion of Th1 cytokines through the TLR4 signaling pathway.

Although the incidence of neurological complications after off-pump coronary artery bypass (OPCABG) is decreasing year by year, once neurological complications occur, they have a high disability and fatality rate and seriously affect the prognosis of patients. When combined with ascending aortic calcification, the use of aortic lateral wall forceps for proximal graft anastomosis may lead to calcified plaque shedding in the diseased ascending aorta and increase the incidence of postoperative neurological complications. The clinical data of 63 patients who underwent off-pump coronary artery bypass surgery with ascending aortic calcification from September 2005 to September 2011 in the Department of Cardiac Surgery of Zhejiang Hospital are summarized. Through actively improving the surgical treatment strategy and using the proximal aortic anastomosis device, satisfactory surgical results are obtained, which are reported as follows.

Brugada syndrome (BrS) is a genetic disease with decreased sodium channel function. In 1992, two Brugada brothers first reported a group of cases of idiopathic polymorphic ventricular tachycardia and idiopathic ventricular fibrillation. The ECG showed persistent elevation of the right chest lead ST segment with or without right bundle branch block (RBBB), but the patients had no evidence of organic heart disease [1]. In 2002 and 2005, based on a large number of clinical and basic scientific research on BrS, two world-wide expert consensus meetings reached a consensus on the diagnostic criteria, the detection of risk factor stratification and the drug treatment of BrS [1-2].

Esophageal cancer is one of the most common malignant tumors in China. The incidence and mortality of esophageal cancer are 27.4/100,000 and 21.6/100,000 in males and 12.0/100,000 and 9.6/100,000 in females, respectively [1]. The incidence of esophageal cancer has obvious regional distribution characteristics, and the incidence rate is the highest in Linzhou City of Henan Province, Ci County of Hebei Province, Yangcheng County of Shanxi Province and Nan'ao County of Guangdong Province in China. The pathological types of esophageal cancer in China are mainly squamous cell carcinoma, but less adenocarcinoma. The incidence of esophageal cancer is related to environmental and genetic factors, among which environmental factors include contamination of fungal cord, excessive nitrite intake, deficiency of some nutrients, long-term hot food and drink, smoking and drinking, and virus infection. In recent years, more and more studies suggest that human papillomavirus (HPV) infection is an important risk factor for esophageal cancer.

The patient, a 62-year-old female, went to our outpatient clinic on July 20, 2011 due to the discovery of purpura and gingival bleeding throughout her body for 2 days. Physical examination revealed tenderness in sternum and multiple purpura throughout her body, the largest of which was located in the right knee joint, about 10 cm in diameter. Laboratory examination: white blood cell count 9.7×109/L, hemoglobin 132 g/L, platelet count 34×109/L, prothrombin time>100.0 s, partial thromboplastin time 48.3 s, thrombin time 32.6 s, plasma fibrinogen 0.32 g/L. On July 21, she was admitted to the hematology department with "acute leukemia?". On the second day after admission, cardiac ultrasound examination revealed space-occupying lesions in the left atrium. Considering "giant thrombosis, atrial myxoma waiting to be drained", she was transferred to the cardiac surgery department for surgical treatment. After arriving at the operating room, the patient sat and breathed, his lungs were full of wet rales, coughed pink foamy sputum, and was operated after anti-heart failure treatment.

The 2012 Beijing International Symposium on Lymphoma was successfully held in Beijing on March 23-25, 2012. This conference was sponsored by the Department of Lympho-Oncology of Peking University Cancer Hospital and Beijing Institute of Cancer Prevention and Treatment, and co-organized by the Northern China Lymphoma Collaborative Group and the Chinese Society of Clinical Oncology (CSCO). This conference was a large-scale academic exchange conference at home and abroad on the theme of malignant lymphoma in China. More than 400 representatives from all over the country attended this conference. This conference invited famous experts and scholars in the fields of clinical, pathological and basic research of lymphoma at home and abroad to discuss and exchange themes on the standardized diagnosis, treatment and research progress of lymphoma.