A variety of molecular markers are related to the prognosis of gastric cancer,such as the the loss expression of AT rich interactive domain 1A (ARID1A),the overexpression of CD133 and survivin are releated to the incidence and poor prognosis of gastric cancer; leptin,CD44 and microRNA (miRNA) are releated to the invasion and metastasis of gastric cancer; the low expression of secreted protein acidic and rich in cysteine (SPARC) contributes to the angiogenesis of gastric cancer,but the relationship between SPARC and prognosis needs further study; the expression and gene polymorphism of excision repair cross-complementing 1 (ERCC1) may be useful for choice of medication in the treatment of gastric cancer.

Objective To discuss the diet balance by the enteral nutritional support for patients after hematopoietic stem cell transplantation. Methods We divided 47 patients after hematopoietic stem cell transplantation into the balanced-diet group and the ordinary-diet group. The balanced-diet group received diet according to "diet exchange share" method and took food by the proportional share of 5 kinds of food. The ordinary-diet group took food according to the habits of patients.The effect of nutritional support was compared between the two groups. Results The body weight,white blood cell,hemoglobulin,platelet,total protein and proprotein in the balanced-diet group at the 90th day were different from those at the 30th day after transplantation(t value were -8.5,-4.7,-4.2,-10.2,-3.9,-14.1 and -80.9),P ＜ 0.01.In the ordinary-diet group only body weight,platelet and proprotein at the 90th were statistically different from those at the 30th day after transplantation (t value were -4.5,-4.6 and -14.9), P ＜ 0.01. Conclusion Balanced diet contributed to the rehabilitation and nutritional support after hematopoietic stem cell transplantation.

Objective To determine the role and mechanism of peroxisome proliferator activated receptors (PPAR) α in a mouse model of D-galactosamine/lipopolysaccharide (D-GalN/LPS)-induced acute liver failure(ALF).Methods Firstly,C57BL/6 mice were randomly divided into control group(n =8),ALF 2h group(n =8),ALF 4h group (n =8),ALF 6h group (n =8).Secondly C57BL/6 mice were randomly divided into control group(n =8),ALF group(n =8),WY14643 group(n =8).To induce ALF,the mice were injected intraperitoneally with D-GalN (700 mg/kg) and LPS (10 μg/kg).WY14643 (6 mg/kg),the selective agonist of PPAR α,was administered via tail vein two hours prior to D-GalN/LPS exposure.Two,four,and six hours after D-GalN/LPS treatment in the first study,mice were anesthetized and blood was collected,6h after D-GalN/LPS treatment in the second study,blood was collected.The liver tissue was harvested for histology and mRNA extraction.Serum levels of ALT and AST were measured to evaluate the hepatic damage.Inflammatory cytokines (TNFα,IL-1β,IL-6) and chemokines (CXCL-1,CXCL-10) were detected by real-time quantitative PCR.Differential protein expression of p-NF-κBp65,p-JNK,p-ERK,p-p38 in inflammatory pathways was detected by Western blotting.Significance of inter-group differences was assessed by one-way ANOVA,and pairwise comparison was performed by the least significant difference test.Results The gene and protein expression of PPAR α were gradually reduced during the development of ALF.Compared with the model group,the liver architecture was better preserved almost with normal morphology in WY14643-treated mice.Serum ALT and AST levels in WY14643-treated group were significantly lower [ALT:(555 ±62)U/L vs (2 898 ±822) U/L,P ＜0.05; AST:(791 ±58) U/L vs (3 013 ±997)U/L,P ＜ 0.05].The expression of proinflammatory cytokines and chemokines was significantly suppressed during the activation of PPAR α.In the second study,the levels of gene expression of proinflammatory cytokines and chemokines were detected in control group,ALF group and WY14643 group respectively as followings:TNFα (0.161 ± 0.085,7.996 ± 1.068,3.346 ± 0.94,P ＜ 0.05),IL-1β(0.041 ±0.002,3.657 ±0.904,0.176±0.089,P＜0.01),IL-6 (0.018 ±0.008,1.762 ±0.589,0.163±0.0487,P ＜0.05),CXCL-1 (0.063 ±0.008,7.881 ±0.966,2.737 ±0.864,P ＜0.01),CXCL-10 (0.054 ±0.005,5.671 ±0.948,2.578 ±0.804,P ＜0.05).Conclusion Our findings first demonstrate that PPARα protects liver from injury in an ALF mouse model by suppressing inflammatory response,indicating PPARα as a potential new therapeutic target for ALF.

Objective To investigate the association of SLC34A1 ( rs6420094 ) and RGS14 (rs4074995) polymorphisms with serum level of phosphorus in chronic hepatitis B virus (HBV) infection patients following long-term adefovir dipivoxil ( ADV ) treatment.Methods Ninety one patients with chronic HBV infections admitted in Third Hospital of Hebei Medical University during October 2012 and August 2013 were enrolled in the study.All patients received ADV treatment ( monotherapy or combination therapy) for at least two years, among whom 31 had hypophosphatemia and 60 had normal serum phosphorus levels.rs6420094 and rs4074995 were genotyped by polymerase chain reaction-restrictive fragment length polymorphism ( PCR-RFLP ) analysis.The relationship between allele frequency and serum phosphorus concentration was analyzed by Chi-Square test.Results In hypophosphatemia group, there were 13, 13, and 5 patients with genotype A/A, A/G and G/G at rs6420094, respectively;while in patients with normal serum phosphorus levels, there were 35, 24 and 1 patients with genotype A/A, A/G and G/G at rs6420094.The frequency of allele A at rs6420094 in patients with normal serum level of phosphorus was higher than that in hypophosphatemia group ( 78.3% vs.62.9%, χ2 =4.947, P <0.05 ).In hypophosphatemia group, there were 2, 11, and 18 patients with genotype A/A, A/G and G/G at rs4074995, respectively;while in patients with normal serum phosphorus level, there were 1, 21 and 38 patients with genotype A/A, A/G and G/G at rs6420094.There was no difference in the frequencies of alleles at rs4074995 between two groups (χ2 =0.625, P >0.05).Conclusion The polymorphism of rs6420094 gene may be associated with the serum level of phosphorus in patients with chronic HBV infections following long-term treatment of ADV.

Objective To explore the effect of comprehensive intervention on anxiety in patients of acute myocardial infarction (AMI) undergoing intra-aortic balloon pump (IABP). Methods 50 patients with AMI undergoing IABP with the score of Hamilton Anxiety Rating Scale (HAMA) more than 14 points, were divided into conventional intervention group (n=25) and comprehensive intervention group (n=25). The conventional intervention group received all the conventional nursing measures including cognitive behavioral intervention, and the comprehensive intervention group received propofol intravenous pumping in addition with Ramsay sedation at II-III level. The vital signs, HAMA scores, major cardiovascular events, and vascular complications were recorded before and the 1st-5th days after intervention. Results The HAMA scores, systolic blood pressure, diastolic blood pressure and mean pressure decreased in most of the time points after intervention in the comprehensive intervention group (P<0.05). And there was no complication such as low blood pressure, respiratory depression. The incidence rates of cardiac arrhythmias, puncture hematoma/bleeding and catheter displacement were lower in the comprehensive intervention group than in the conventional intervention group (P<0.05). Conclusion Comprehensive intervention can improve the symptoms of anxiety in the patients with AMI undergoing IABP, and reduce the incidence of arrhythmia, vascular complications and catheter displacement.

AIM: To study the effect of ligustrazine on the cardiacmyocyte lesion in rats with type 2 diabetes mellitus.METHODS: Male Wistar rats were injected with STZ via tail vein under high-glucose and high-fat feeding for 4 weeks to establish the animal model of type 2 diabetes mellitus.Ligustrazine at different doses was used to treat the diabetic rats.The body weight, blood glucose and the morphology of heart tissues were observed.The myocardial levels of IL-1β, IL-6 and TNF-α were detected by ELISA, and the protein expression of IKKβ and NF-κB in the myocardium was determined by Westeren blotting.RESULTS: Ligustrazine at high dose alleviated the body weight reduction and blood glucose elevation cause by diabetes, and reduced pro-inflammatory factors IL-1β, TNF-α and IL-6.Moreover, the protein expression of IKKβ and NF-κB was significant decreased by ligustrazine.CONCLUSION: Ligustrazine inhibits the myocardial inflammation caused by diabetes through anti-inflammatory pathway.

Objective To study the profile of peripheral blood cortisol concentration in patients with hepatitis B virus (HBV)-related acute on chronic liver failure (ACLF) and its association with disease severity and predictive value on prognosis.Methods Forty-five patients with HBV-related ACLF,including 15 patients in early-stage,15 in medium stage and 15 in end-stage; and 15 patients with severe chronic hepatitis B (CHB) were also enrolled.Peripheral blood cortisol concentration was tested by chemiluminesence immunoassay.SPSS version 18.0 was used to compare peripheral blood cortisol concentration among different groups and analyze its correlation with prothrombin activity (PTA),total bilirubin (TBil),albumin (Alb),alanine aminotransferase (ALT),aspartate aminotransferase (AST),HBV DNA,international normalized ratio (INR) and model for end-stage liver disease (MELD) scores.The independent risk factors of prognosis in patients with HBV-related ACLF were determined by performing Logistic regression analysis.Results The concentrations of peripheral blood cortisol in severe CHB group,early stage ACLF group,medium stage ACLF group and end-stage ACLF group were (595.6±114.0),(496.0±87.2),(303.9±81.1),and (183.8±71.8) nmol/L,respectively.A decreasing trend was observed and the differences among groups were statistically significant (F =63.93,P ＜ 0.01).Peripheral blood cortisol concentration were significantly different among subgroups of patients with MELD＜30,followed by 30-40 and ＞40(F 9.01,P＜0.01).Peripheral blood cortisol concentration in patients with ACLF was positively correlated with PTA level (r=0.83,P＜0.01),and inversely correlated with TBil (r =-0.34,P＜0.05),MELDscore (r =-0.60,P＜0.01),AST/ALT (r =-0.35,P＜0.05),and INR (r=-0.59,P＜0.01).Association with Alb,ALT,AST and HBV DNA was not observed.According to multivariate Logistic regression analysis,MELD score,cortisol level,Alb and total cholesterol were independent risk factors of prognosis for patients with ACLF.Serum cortisol concentration in survival group of HBV-related ACLF was higher than that in death group,while the death group exhibited a gradually decreasing trend.Conclusions The peripheral blood cortisol concentration decreases in patients with HBV-related ACLF,which is related to the degree of liver dysfunction,disease severity and prognosis of patients.Moreover,the lower level of cortisol concentration indicates poor short-term prognosis in patients with HBV related ACLF.

Objective To observe the expressions of interferon gamma (IFN-γ) and IFN-γ-inducible protein 10 (IP-10) at different stages of chronic hepatitis B virus (HBV) infection,and to investigate the relationship between IP-10 with hepatic inflammation activity and hepatitis aggravation.Methods Fifteen chronic hepatitis B (CHB) patients,15 asymptomatic HBV carriers (AsC) and 15 chronic severe hepatitis B (CSHB) patients were enrolled in the study from January 2010 to December 2011 in the Third Hospital of Hebei Medical University.The liver samples were collected by percutaneous needle biopsy or from liver transplantation.The IFN-γ and IP-10 mRNA expressions were measured by quantitative real-time polymerase chain reaction (PCR).Localization and hemi-quantitative analysis of IFN-γand IP-10 proteins were performed by immunohistochemistry staining.Concentrations of serum IFN-γ and IP-10 were quantified by enzyme linked immunosorbent assay (ELISA).HBV markers and liver function were also evaluated for each patient.Results Serum IFN-y and IP-10 concentrations increased significantly in CHB [(415.27±145.52) ng/L and (6.98± 1.12) ng/L,respectively] and CSHB [(658.33 ± 213.52) ng/L and (10.78 ± 1.19) ng/L,respectively] patients compared with AsC [(142.09 ± 47.64) ng/L and (2.4 7 ± 0.60) ng/L,respectively] patients,and were highest in CSHB patients (F=43.48,256.98 ;both P＜0.05).Meanwhile,intrahepatic IFN-γ and IP-10 mRNA and protein expressions paralleled with IFN-γ and IP-10 concentrations in the serum,which was highest in CSHB patients,followed by CHB and AsC patients (F＝693.85,210.21,433.05,214.46; all P＜0.05).Furthermore,Spearman linear correlation analysis showed that serum IP-10 level was positively correlated with both hepatic inflammation activity and serum IFN-γ concentration in CHB and CSHB patients (r =0.76 and r 0.77,respectively;both P ＜ 0.05).Conclusions IP-10,one important immunologic marker of regulating anti HBV activation,indicates progression from immune tolerance phase to immune clearance phase.Furthermore,it may affect the degree of inflammation and hepatitis aggravation.

Objective To explore the correlation between the efficacy of lamivudine (LAM)therapy and changes of T lymphocyte subsets,CD4+ CD25+ regulatory T lymphocytes (Treg),and levels of interleukin-10 (IL-10)and interferon-gamma (IFN-γ)in the peripheral blood of patients with chronic hepatitis B (CHB).Methods Ninety CHB patients were enrolled in this study.T lymphocyte subsets in the peripheral blood were detected by flow cytometry at baseline and week 52 of LAM therapy.The frequencies of CD4+ CD25+ Treg in the peripheral blood were detected by flow cytometry and levels of IL-10 and IFN-γ were detected by enzyme-linked immunosorbent assay (ELISA)at baseline,week 12,24,36 and 52.The comparisons of overall means between groups and within groups were done by analysis of variance or Dunnett's test.The comparison of means before and after LAM therapy was done by paired t test.Results In 32 complete-responders of 90 CHB patients,the proportions of CD4+ T lymphocytes,CD8+ T lymphocytes and CD4+/CD8+ ratio were increased significantly after LAM therapy (t=4.055、3.267、2.328,all P＜0.05); the frequencies of CD4+CD25+ Treg at baseline,week 12,24,36 and 52 were (5.40±0.60)%,(4.99±0.59)%,(4.54± 0.72)%,(3.86±0.95)% and (3.44±0.76)%,respectively; the levels of IFN-γ,IFN-γ/IL-10 ratio were increased,while the IL-10 level was decreased after LAM therapy.In 43 partial-responders,the proportion of CD4+T lymphocytes and ratio of CD4+/CD8+ were increased after LAM therapy (t= 3.484,2.018,both P＜0.05); the proportion of CD8+ T lymphocytes was not changed significantly after therapy; the frequencies of CD4+ CD25+ Treg at baseline,week 12,24,36 and 52 were (5.65±0.60)%,(5.23±0.63)%,(4.65±0.98)%,(4.42±0.97)% and (4.32±0.82)%,respectively;IFN-γ level,IFN-γ/IL-10 ratio were increased,while IL-10 level was decreased.In 15 non-responders,the proportion of T lymphocyte subsets,the frequency of CD4+ CD25+ Treg,the levels of IFN-γ and IL-10 were not changed significantly after LAM treatment.Conclusions In CHB patients who have achieved response after LAM therapy,the frequency of CD4+ CD25+ Treg in the peripheral blood is decreased,while ratios of CD4+/CD8+ and IFN-γ/IL-10 in the peripheral blood are increased.

Objective To know the faculty experiences of patients in ICU during the course of oretracheal intutation, analyze the influence of related stressor in ICU on patients, and then carry out certaincounter nursing measures according to the results.Methods Phenomenological approach was adopted in this research, 8 patients with orotracheal intubtion received interviews, the data collected from the interviews were analyzed thematically. Results Three themes were showed: a series of mental and psychiatric symptom, obviously emotional change and the aggravation of local irritation. Conclusions Scientific ICU should be build by related nursing managers, the individualization and humanization nursing cares should be used for patients in ICU to promote nursing quality.