Objective To compare the efficacy and toxicity of in patients with advanced colorectal cancer. Methods Seventy-six patients were enrolled in this study.38 patients(treatment group)received chemotherapy regimen of sodium cantharidate 0 3mg,CF 200mg/m 2, and 5-Fu 375mg/m 2 intravenous infusion from the first day to the tenth day. 38 patients(control group)received chemotherapy regimen of CF 200mg/m 2 and 5-Fu 375mg/m 2 intravenous infusion from the first day to the tenth day. ALL patients underwent two cycles of the therapy at least. Results The efficacy of the treatment group and control group was 39 5% and 18 4% respectively, which had a significant difference. The hematologic toxicities in the treatment group, especially leukopenia and anemia, were significantly than those in the control group less. Conlusion The results indicated that sodium cantharidate combined with 5-FU and CF treatment of colorectal cancer had moderate activity and less toxicity, further clinical investigation of which should be performed.

Objective To evaluate the renal involvement and therapeutic effect on ANCA-associated vasculitis(ASV) . Methods Fifty-six cases were diagnosed as ASV from Oct 1997 to Mar 2001. Among them, 21 cases received renal biopsies. According to disease activity and severity, Use following treatment protocols were choosed: (1) double pulse therapy; (2) single pulse therapy; (3) oral prednisone and/or low dose of CTX; (4) blood purification technique and/or immunosuppressive therapy. Remission rate was also analyzed. Results 96. 4% of case suffered with renal involvement. 91. 1% with acute renal failure, 96.4% with severe renal failure, 98. 2% with multiple organs involvement. The mortality was 19. 6% and the remission rate 67. 9%. 12. 5% of cases lost follow-up. ConclusionsRenal involvement is common and serious in ASV patients. Individualized and early therapy, as well as valuable urgent renal biopsy are necessary. To those who have entered ESRD, immunosuppressive agents could be used to decrease the extra-renal complication.

Objective To investigate the effect of hypoxia on renal tubular cells and the mechanism of renal interstitial fibrosis. Methods Effect of chronic hypoxia on the proliferation, cell cycle and expression of TGF-?1 mRNA in cultured MDCK cells was examined. Quiescent cells were exposed to hypoxia (3%O2) or normoxia (18%O2) for 24, 48, 72 and 96 hours. At the end of each incubation, cellular proliferation and cell cycle were assessed by MTT method and flow cytometry, respectively. TGF-?1 mRNA level of cells were analyzed by semi-quantity RT-PCR. Results Exposure of MDCK cells to hypoxia induced a significant increase in proliferation and a significant decrease in the percentage of G0-G1 stage and a significant increase in the percentage of G2-M stage at 24, 48 and 72 hours. Meanwhile, TGF-?1 mRNA expression increased in a time-dependent manner as compared with normoxia group when MDCK cells were stimulated with 24, 48, 72 and 96 hours in hypoxia condition. Conclusion Chronic hypoxia-induced proliferation of MDCK cells is associated with increased expression of TGF-?1. Chronic hypoxia of renal tubular cells may be one of the causes of renal interstitial fibrosis.

Objective To investigated the inhibitory effect of an IgG-Fc region specific inhibitory peptide on the ANCA-accelerated apoptosis of neutrophils. Methods The peptide was prepared by solid-phase peptide synthesis and its biological activity was identified by rosette formation assay. ANCA was prepared from the sera of active Wegener's granulomatosis (WG) and microscopic polyangiitis (MPA) patients. Neutrophils isolated from the blood of healthy volunteers were primed with TNF-?(2 ng/ml) then incubated with ANCA. At different intervals(3, 6, 12, 18 hours) the neutrophils were harvested to assess the apoptosis by flow cytometric analysis of JC-1 staining, Sub-G1 population and fonnation TUNEL technique. Results Tg19320 bound tightly to human IgG dose-dependendy and inhibited statistically the rosette formation between SRBC-IgG and U937 cells(20.3% vs 53.2% ,P

Objective To investigate the expression of metastin and its significance in benign breast disease,normal breast tissue and breast carcinoma.Methods SP immunohistochemistry was used to determine the expression of metastin in 16 benign breast disease,12 normal breast tissue and 56 breast carcinoma.Results The positive rates of metastin in benign breast disease,normal breast tissue and breast carcinoma were 68.8%,75% and 30.4%,respectively.The expression of metastin in breast carcinoma was much lower than that in benign breast disease and normal breast tissue(P

Objective:To determine the prevalence of sarcopenia and explore related influencing factors of sarcopenia in maintenance hemodialysis (MHD) patients.Methods:MHD patients aged ≥18 years old and receiving therapies of ≥3 months from March 2019 to December 2019 in Blood Purification Centre of Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine were retrospectively enrolled in this study. General data of the patients were collected. Grip strength was measured by the Jamar dynamometer and the chair stand was measured by a chair of standard height to assess skeletal muscle strength and appendicular skeletal muscle mass was measured by dual energy X-ray absorptiometry. Baseline data between MHD patients with and without myasthenia were compared. Logistic regression analysis method was used to analyze the influencing factors for sarcopenia in MHD patients.Results:A total of 125 MHD patients were enrolled, with 68 males (54.4%), age of (59.4±14.9) years and median dialysis age of 51.0(23.5, 101.0) months. Sarcopenia was diagnosed in 39 cases (31.2%). Compared with MHD patients without sarcopenia, age, tumor necrosis factor-α, von Willebrand factor (vWF) and proportion of using α ketones were higher, and serum carbondioxide combining power (CO 2CP), prealbumin, albumin and proportion of regular exercise were lower in MHD patients with sarcopenia (all P<0.05). Multivariable logistic regression analysis results showed that low CO 2CP ( OR=0.717, 95% CI 0.576-0.892, P=0.003), high vWF ( OR=1.037, 95% CI 1.016-1.058, P<0.001) and no regular exercise ( OR=0.309, 95% CI 0.118-0.810, P=0.017) were independent influencing factors of sarcopenia in MHD patients. Conclusions:The prevalence of sarcopenia in MHD patients is high. Low CO 2CP, high vWF and no regular exercise are independent influencing factors for sarcopenia in MHD patients.

Objective Intradialytic hypotension (IDH) is one of the common complications during hemodialysis,however its diagnostic criteria are highly controversial at present.In order to fully understand the prevalence of IDH in our center and figure out which diagnostic criteria is better for Chinese maintenance hemodialysis (MHD) patients,we choose several IDH definitions by reviewing published literatures and analyze their association with mortality.Methods The patients were recruited from Blood Purification Center of Ruijin Hospital undergoing hemodialysis during July 2012.Pre-,intra-and post-dialysis blood pressure were recorded.Patients' clinical characteristics,laboratory results and cardiac ultrasound results were collected.Based on several IDH definitions,we investigated the prevalence rate of IDH and its frequency among MHD patients.SPSS 23.0 was used to analyze data and conduct survival analysis.Results Totally 219 MHD patients underwent 16084 hemodialysis in 6 months.The prevalence rate,overall and individual frequency of IDH fluctuated between 45.21％-100.00％,4.64％-37.60％ and 0.00％-33.00％ respectively.For every IDH criteria,the patients were recruited into the group IDH(+) if they ever met the corresponding definition,otherwise the group IDH(-).Survival analysis found that IDH (the criteria of an absolute systolic blood pressure (SBP) ＜ 90 mmHg or with a decrease of SBP≥ 20 mmHg) could decrease the risk of patients' cardiovascular mortality but was not relevant to all-cause mortality.Further analysis showed these patients had better cardiac functions mainly reflecting in lower Pro-BNP (2880 ng/L vs 6909 ng/L),lower prevalence rate of left ventricular hypertrophy (52％ vs 83％) and higher left ventricular ejection fraction (65.0％ vs 62.5％) than IDH(-) patients.No correlation was found between other IDH criteria and mortality.Conclusions The prevalence rate,overall and individual IDH frequency of IDH are of high variability when diagnosed by different IDH criteria.All IDH episodes defined by our selected definitions are of no association with all-cause mortality.An absolute SBP ＜ 90 mmHg or with a decrease of SBP≥20 mmHg can decrease the risk of cardiovascular mortality due to their better cardiac function.Large scale researches should be conducted to find optimal IDH definition and explore the association of IDH and mortality.

Objective To investigate the effects of tg19320,a small peptide,interfering with IgG-FcγR interaction on the adhesion of neutrophils to endothelium and the expression of intercellular adhesion molecule 1 (ICAM-1)in endothelial cells and its possible mechanism.Methods Tg19320 was prepared by solid-phase peptide synthesis.ANCA IgG was isolated from the serum of active ANCA-associated systemic vasculitis(AASV)patients.When primary human umbilical vein endothelial cells(HUVEC)grew into connuence in cytokine-free eonditions,the cells were stimulated with TNF-α,human normal IgG,ANCA IgG and ANCA IgG+tg19320 respectively.HUVEC were pretreated with tg19320 for 45 minutes before being stimulated by ANCA IgG.Non-activated neutrophils was added to treat HUVEC and adhesion was measured by cell count.The expression of ICAM-1 mRNA and protein was assessed by real-time PCR and Western blot respectively.Soluble ICAM-1(sICAM-1)was determined using ELISA technique.Phosphorylation of IκB-α was assessed by Western blot. Results ANCA IgG significantly up-regulated the expression of ICAM-1 in HUVEC and promoted sICAM-1 release(P＜0.05),and TNF-α enhanced the effect of ANCA.These effects were almost completely abolished by tgl9320 both at protein and mRNA level.Furthermore,ANCA IgG increased the IκB-α phosporylation in HUVEC and tg19320could inhibit the effect. Conclusions ANCA IgG can modulate the expression of ICAM-1 and sICAM-1 release in endothelial cells.FcγR probably play a critical role in the ICAM-1 expression up-regulated by ANCA,which is mediated in part through NF-κB signaling pathway.Tg19320 has protective effect on endothelium in AASV in vitro.

Objective To evaluate the effect of dexmedetomidine on gastric mucosal injury induced by intestinal ischemia-reperfusion (I/R) in rats.Methods Thirty-six healthy male Sprague-Dawley rats,aged 4-5 months,weighing 200-250 g,were randomly divided into 4 groups (n =9 each) using a random number table:sham operation group (group S),intestinal I/R group (group I/R),low-dose dexmedetomidine group (group LD),and high-dose dexmedetomidine group (group HD).Intestinal I/R was produced by occlusion of the superior mesenteric artery for 1 h followed by 2 h reperfusion in anesthetized rats.Dexmedetomidine 2.5 and 5.0 μg · kg-1 · h-1 were infused via the caudal vein for 1 h starting from 1 h before ischemia in LD and HD groups,respectively.The rats were sacrificed at 2 h of reperfusion,and the gastric mucosa was obtained for examination of the pathological changes (with light microscope) and for determination of the expression of serine/threonine kinase (Akt),phosphorylated Akt (p-Akt),activated caspase-3 and caspase-3 (by Western blot).The ratio of p-Akt to Akt (p-Akt/Akt)was calculated to reflect the phosphorylation of Akt.The ratio of activated caspase-3 to easpase-3 (activated caspase-3/caspase-3) was calculated to reflect the activation of caspase-3.Results Compared with group S,the expression of Akt was significantly up-regulated,the expression of p-Akt was significantly downregulated,the phosphorylation of Akt was significantly decreased,and the activation of caspase-3 was significantly increased in group I/R,and the expression of p-Akt was significantly up-regulated,and the phosphorylation of Akt and activation of caspase-3 were significantly increased in LD and HD groups (P＜0.05).Compared with group I/R,the expression of Akt was significantly down-regulated,the expression of p-Akt was significantly up-regulated,the phosphorylation of Akt was significantly increased,and the activation of caspase-3 was significantly decreased in LD and HD groups (P＜0.05).The degree of gastric mucosal injury was significantly lower in LD and HD groups than in group I/R,and there was no significant difference in the degree of gastric mucosal injury between group LD and group HD.Conclusion Dexmedetomidine can attenuate gastric mucosal injury induced by intestinal I/R,and the mechanism may be related to activation of PI3K/Akt signaling pathways and inhibition of cell apoptosis in rats.

Objective To analyze the clinical features and pulmonary radiological findings of primary anti-neutrophil cytoplasmic antibody(ANCA)-associated vasculitis (AAV).Methods Clinical data of 271 ANCA positive primary AAV patients admitted in Shanghai Ruijin Hospital from January 2003 to November 2015 were retrospectively analyzed.Among 271 patients,there were 211 myeloperoxidase (MPO)-ANCA positive cases (MPO subgroup),52 proteinase 3 (PR3)-ANCA positive cases (PR3 subgroup),and 8 dual positive cases (dual subgroup) according to ANCA classification.The demography,clinical characteristics,pulmonary radiological manifestation and renal function were compared among three subgroups.Results MPO subgroup had more renal (x2 =4.968,P =0.026) and constitutional symptoms (x2.=8.901,P =0.003) than PR3 group,while PR3 group had more ENT symptoms (x2 =19.843,P ＜ 0.001),cough (x2 =6.623,P =0.010),hemoptysis (x2 =8.656,P =0.003),dyspnea (x2 =5.127,P =0.024),buccal and ocular mucosal symptoms (x2 =4.818,P =0.028) than MPO group.In lung radiology,interstitial manifestations were displayed more frequently in MPO than PR3 group (x2 =4.237,P =0.040),while pulmonary nodules was more frequent in PR3 than MPO group (x2 =4.503,P =0.034).Dual subgroup tended to have more nervous,respiratory and renal impairment.Renal function showed that MPO subgroup had higher creatinine (Z =-5.529,P ＜ 0.001),urea (Z =-4.646,P ＜ 0.001) and uric acid levels (Z =-2.331,P =0.020) than PR3 subgroup.Dual subgroup had higher creatinine (Z =-3.251,P =0.001) and urea (Z =-2.882,P =0.004) levels than PR3 subgroup,but there was no difference with MPO subgroup.Conclusion There are significant differences in both clinical and pulmonary radiological manifestations between the MPO and PR3-ANCA subgroup of primary AAV.