OBJECTIVE: To evaluate the association between Cystatin C levels change and the clinical outcomes of critically ill patients.METHODS: There were altogether 4642 patients in intensive care unit(ICU)of West China Hospital of Sichuan university from 28 th August 2009 to 16 th April 2010,and their general conditions were recorded,including sex,age,and being with or without diabetes mellitus;then the database was established accordingly.The patients were divided into four groups according to the change of Cys C values in ICU:high increase(>1 mg/L),slight increase(≤1 mg/L),high decrease(>1 mg/L)and slight decrease(≤1 mg/L).The difference in 30-day mortality in patients were compared.The patients were followed up for 8 years.RESULTS: One thousand and thirty-six patients were included in this study,272 cases died within 30 days,with the highest in patients of the group with high increase of Cystatin C(77.9%),followed the high-decrease group(33.3%);the mortality rate of group with slight decrease was the lowest among the four groups(16.5%).The 8-year survival of 764 patients who did not die within 30 days was 54.58%.CONCLUSION: The change of Cystatin C value is closely related to the 30-day mortality of critically ill patients.The lowest 30-day mortality of critically ill patients is the group with slight decrease of Cystatin C.

Objective:To explore the efficacy and safety of ticagrelor versus clopidogrel in acute coronary syndrome (ACS) Chinese patients using glycoprotein Ⅱb/Ⅲa inhibitor (GPI).Methods:The data from CCC-ACS (Improving Care for Cardiovascular Disease in China-ACS) project were systematically reviewed in ACS patients with GPI. The patients were divided into ticagrelor and clopidogrel groups. A logistic analysis and propensity score matching (PSM) were performed to compare occurrences of major cardiovascular events (MACE) and bleeding events between the two groups during hospitalization.Results:A total of 63 641 ACS patients were collected from 150 hospitals. Logistic regression analyses showed that there was no statistically significant difference in the reduction of MACE between ticagrelor and clopidogrel when using GPI ( OR=0.881, 95% CI 0.599-1.296; P=0.521). However, major bleeding rate was higher in the ticagrelor group than that in the clopidogrel group ( OR=1.401, 95% CI 1.075-1.852; P=0.013). Similar results were observed after PSM. No statistic difference in MACE between the ticagrelor and clopidogrel group ( OR=0.919, 95% CI 0.613-1.376; P=0.681). Major bleeding rate was higher in the ticagrelor group ( OR=1.559, 95% CI 1.130-2.150; P=0.007). Conclusion:In ACS patients with GPI, ticagrelor did not reduce MACE, but increased the major bleeding risk compared with clopidogrel.

OBJECTIVETo assess the HER-2 status in Chinese advanced gastric cancer patients and explore its correlation with clinical features, treatment response and prognosis.

METHODSA total of 107 patients with advanced gastric cancer treated in our hospital from December 2005 to November 2008 were included in this retrospective analysis. HER-2 status was determined by immunohistochemisty (IHC) and/or fluorescence in situ hybridization (FISH). The correlations of HER-2 status with tumor location, pathology, treatment response and prognosis were analyzed and the efficacy of different chemottherapy regimens was compared.

RESULTSThe overall positive rate of HER-2 expression was 14.7% (15/102). The HER-2 status was detected by both methods in 102 patients, and the concordance of the two methods was 66.5%. The tumor site distribution was gastroesophageal junction (GEJ) 28.0%, proximal stomach 19.4%, gastric corpus 16.1%, antrum 26.9% and whole stomach 9.7%, respectively. There was no significant difference of HER-2 status among different tumor sites (P = 0.726), and no significant correlation between HER-2 expression and differentiation (P = 0.110). Among the evaluable 51 patients treated by first-line chemotherapy, the total objective effective rate was 23.5%. The median time-to-progression was 7.47 months, and median overall survival time was 11.07 months. The effective rate was 43.8% in patients who received XP regimen chemotherapy (cisplatin + capecitabine), significantly higher than the 14.3% in patients treated with other regimens (P = 0.033). Their overall survival was 14.17 months and 9.53 months, respectively (P = 0.059). The TTP was 6.63 months in HER-2 positive patients and 7.47 months in HER-2 negative patients, with a non-significant difference (P = 0.510). However, there was a improving tendency in the efficacy and OS, showing a effective rate of 45.5% and 17.5% (P = 0.102) and OS of 14.17 months and 10.63 months, respectively (P = 0.205).

CONCLUSIONSHER-2-positivity rate in Chinese patients with advanced gastric cancer is similar to those reported in the literature. Along with the increasing use of targeted therapy and targeted agents, the efficacy and survival of gastric cancer patients is improving. HER-2-positive patients may benefit from it.

Adenocarcinoma ; drug therapy ; metabolism ; pathology ; Adult ; Aged ; Aged, 80 and over ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Capecitabine ; Cisplatin ; administration & dosage ; Deoxycytidine ; administration & dosage ; analogs & derivatives ; Disease Progression ; Esophagogastric Junction ; pathology ; Female ; Fluorouracil ; administration & dosage ; analogs & derivatives ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Neoplasm Staging ; Receptor, ErbB-2 ; metabolism ; Retrospective Studies ; Stomach ; pathology ; Stomach Neoplasms ; drug therapy ; metabolism ; pathology ; Survival Rate

Objective To investigate selcnium(Se) levels of environment and human body in Gaomi City and Zichuan District of Shandong. Methods Lijiaying Township in Gaomi City of Weifang City, Zhaili Township and Longquan Township in Zichuan District of Zibo City were selected. Two farming soil samples at different spot, local wheat and corn, residents nail samples from 3 to 4 families were collected in each natural village in the investigated towns. The contents of Se were detected by 2,3-diamino naphthalene fluorescence method. Results Se level of the soil, wheat, corn, and nails in Lijiaying [(0.054 ± 0.019), (0.022 ± 0.009), (0.018 ± 0.007), (0.365 ± 0.108)mg/kg] was significantly lower than that in Zhaili [(0.425 ± 0.080), (0.130 ± 0.043), (0.098 ± 0.026), (0.751 ± 0.134)mg/kg] and Longquan[(0.487 ± 0.153), (0.112 ± 0.030), (0.097 ± 0.029), (0.735 ± 0.145)mg/kg;P < 0.01]. In Lijiaying, Se was deficient in soil, wheat, corn(< 0.200, < 0.025 mg/kg), above Se deficiency diagnosis and below Se-adequate level in the nail, while in Zhaili and Longquan, the Se level in the soil (0.425, 0.487 mg/kg), wheat(0.130, 0.112 mg/kg), corn (0.098, 0.097 mg/kg), nails (0.751, 0.735 mg/kg) was adequate (≥0.400 mg/kg). Conclusions The external environment is Se-deficient in Lijiaying, Se-adequate in Longquan and Zhaili. The selenium level in human body is consistent with the external environment.

The effects of a non-selective inhibitor of cyclo-oxygenase (COX) indomethacin, and exogenous prostaglandin E(2) (PGE(2)) on A(delta) units and C units in the saphenous nerve of diabetic hyperalgesic rats were studied. The results showed that the conduction velocity of A(delta) units and C units and their mechanical threshold in diabetic hyperalgesic rats were obviously decreased, and a small number of A(delta) units (4/24) and C units (2/18) produced increased spontaneous activities. Intraperitoneal injection of indomethacin in diabetic hyperalgesic rats significantly relieved mechanical hyperalgesia, and resulted in a decrease in spontaneous afferent activities of the A(delta) units and C units. Subcutaneous injection of exogenous PGE(2) into the diabetic hyperalgesic and control rats produced a significant decrease in mechanical threshold of the A(delta) units and C units, and elicited discharge from 3 A(delta) units (3/24) and 1 C unit (1/18) in diabetic hyperalgesic rats and from 2 A(delta) units (2/13) in control rats. The present data suggest that the synthesis and release of PGs are increased in diabetic neuropathy, PGs can sensitize and /or activate A(delta) units and C units and elicit hyperalgesia and allodynia in diabetic rats.
Afferent Pathways ; drug effects ; physiopathology ; Animals ; Diabetes Mellitus, Experimental ; physiopathology ; Femoral Nerve ; drug effects ; physiopathology ; Hyperalgesia ; physiopathology ; Indomethacin ; pharmacology ; Male ; Pain Threshold ; drug effects ; Prostaglandin Antagonists ; pharmacology ; Rats ; Rats, Sprague-Dawley

OBJECTIVE: To explore the levels of sex hormones in female patients with systemic lupus erythematosus (SLE) and its role in the genesis of SLE. METHODS: The serum levels of estradiol, estriol, testosterone, progesterone, and prolactin were determined by electro-chemiluminescence immunoassay in 98 female patients with SLE and compared with those of 38 healthy women. RESULTS: The serum levels of estradiol, estriol, progesterone, and prolactin were significantly higher than those in the healthy women (P <0.05). The serum levels of estradiol, progesterone, and prolactin in patients with SLE in 25 to 34 year old group were higher than the other age groups and the control group (P < 0.05), and the serum levels of estradiol and prolactin in patients with active phase of SLE were significantly higher than those in patients with stable phase of SLE (P <0.05). CONCLUSION The levels of sex hormones have a close corretation with the genesis and development of SLE.
Adolescent ; Adult ; Estradiol ; blood ; Estriol ; blood ; Female ; Gonadal Steroid Hormones ; blood ; Humans ; Lupus Erythematosus, Systemic ; blood ; etiology ; Middle Aged ; Progesterone ; blood ; Prolactin ; blood

Danshensu is one of the main water soluble active ingredients of Salvia miltiorrhiza ,which has many phar-macological activities ,especially in cardiovascular system .T he cardiovascular pharmacological mechanism of Danshensu and its derivatives from the view of anti-apoptosis ,antioxidant ,inhibiting calcium overload and role in the inflammatory reaction path-ways etc .were summarized in this article .

Background::Baicalein has been shown to have anti-inflammatory and anti-tumor activities. However, the mechanisms underlying its anti-inflammatory effect on colitis remain unclear.Methods::A dextran sodium sulfate (DSS)-induced model of acute colitis was established in BALB/c mice (6-8 weeks old, weighing 18-22 g). Six groups of mice received: (1) water for 10 days (control), n = 6; (2) DSS 4% solution in the drinking water for 7 days, followed by normal water for 3 days, n = 7; (3), (4), and (5) as for group 2 plus baicalein (10, 20, 40 mg/kg) administered once daily starting on day 1, n = 6; and (6) as for (2) plus 5-aminosalicylic acid (50 mg/kg) administered once daily starting on day 1, n = 6. Body weights, stool consistency, and hematochezia were recorded, and the severity of colitis was evaluated using a disease activity index. On day 11, the mice were euthanized, and organs and blood were collected for analysis. Serum inflammatory factors were detected by enzyme-linked immunosorbent assay; CD11b-positive cells were analyzed by immunofluorescence microscopy; expression of retinoic-acid-receptor-related orphan nuclear receptor gamma, sphingosine kinase 1 (SPHK1), and phosphorylated signal transducer and activator of transcription 3 (p-STAT3) was detected by immunohistochemistry; and expression of nucleotide-binding oligomerization domain 2 (NOD2), SPHK1, sphingosine 1-phosphate receptor 1 (S1PR1), total STAT3, and p-STAT3 were detected by western blotting analysis. Inter-group differences were compared using Student’s t test. Results::Baicalein treatment dose-dependently reduced DSS-induced weight loss ( P < 0.01 or P < 0.05), splenomegaly ( P < 0.01), and colonic damage, as reflected by amelioration of diarrhea, rectal bleeding, and colonic ulceration, congestion, edema (shown as colon length, P < 0.05 or P < 0.01), and inflammatory cell infiltration. Baicalein also significantly decreased the levels of inflammatory mediators in the serum ( P < 0.01) and colon, and significantly inhibited expression of NOD2 SPHK1, S1PR1, and p-STAT3 in the colon ( P < 0.05). Conclusions::Baicalein treatment ameliorated colitis in mice by inhibiting S1P-STAT3 signaling, suggesting that this flavonoid might be beneficial in the treatment of colitis.

OBJECTIVE To evaluate the effect of dioscorea modified pill combined with western medicine and discontiguous naikan cognitive therapy on female patients with paranoid schizophrenia and to investigate optimal therapy for treatment. METHODS 120 female patients with paranoid schizophrenia in the recovery status were randomly divided into the study group and the control group with 60 cases in each group.Patients in the control group received the Western medicine therapy and dis-contiguous naikan cognitive therapy.Patients in the study group were additionally given dioscorea modified pill compared with the control group.The therapeutic effect,cognitive function and quality of life in two groups were evaluated after 16-week treatment.RESULTS ① After treatment,positive symptoms scale score,negative symptoms scale score,general psychopa-thology scale score and the PANSS total score of both the groups were declined,and the differences were statistically significant (P <0.05~0.01);the decline in the study group was more obvious than that of the control group(P <0.05~0.01).② Af-ter treatment,the scores of every dimensions in BACS were improved in patients of both the groups (P <0.05~0.01).The language fluency score,score of symbol coding sequence of numbers,tokens and sports in the study group were higher than those of the control group(P <0.05).③After treatment,SQLS,Scale total score and each factor score in SQLS Scale in the two groups were improved(P <0.05~0.01);and the total score of SQLS in the study group was lower than the control group (P <0.05).CONCLUSION Dioscorea modified pill therapy may enhance the effect for the treatment and improve cognitive function and quality of life of patients with paranoid schizophrenia.

OBJECTIVETo evaluate the correlation of clinical effect and prognosis between patients with metastatic colorectal cancer (mCRC) and different K-ras status.

METHODSThe clinical characteristics, chemotherapeutic regimens and survival of 153 mCRC patients with different K-ras status were analyzed retrospectively.

RESULTSThe median overall survival (OS) in patients without K-ras mutation were 31.7 months, significantly longer than 21.3 months in the patients with K-ras mutation (P = 0.037). The median progression-free survival (PFS) and OS in patients who received chemotherapy followed by anti-EGFR antibody treatment were 11.5 and 39.3 months, respectively, significantly longer as compared with the PFS and OS in those received chemotherapy in combination with anti-EGFR antibody concomitantly (5.7, P = 0.02, and 28.7 months, P = 0.034, respectively).

CONCLUSIONSK-ras status is a prognostic biomarker for mCRC patients treated with anti-EGFR antibody. The combination settings of anti-EGFR in combination with chemotherapy may improve survival of mCRC patients with wild-type K-ras status.

Aged ; Antibodies, Monoclonal ; therapeutic use ; Antineoplastic Agents ; therapeutic use ; Antineoplastic Agents, Phytogenic ; therapeutic use ; Camptothecin ; analogs & derivatives ; therapeutic use ; Colorectal Neoplasms ; genetics ; pathology ; surgery ; therapy ; Combined Modality Therapy ; Disease-Free Survival ; Female ; Follow-Up Studies ; Genes, ras ; Humans ; Liver Neoplasms ; secondary ; therapy ; Lung Neoplasms ; secondary ; therapy ; Male ; Middle Aged ; Mutation ; Organoplatinum Compounds ; therapeutic use ; Receptor, Epidermal Growth Factor ; immunology ; Retrospective Studies ; Survival Rate