Objective To investigate the relationship between hepatitis B virus (HBV) infection and hepatic metastasis from colorectal cancer.Methods Published literatures and unpublished conference papers from January 1990 to December 2011 were searched in PubMed,Cochrane library,Wanfang Database and CNKI.Data of the literatures were extracted by a table.All the patients with colorectal cancer were divided into the infected group and the control group according to the patients whether infected by HBV or not.The hepatic metastatic rate was analyzed.The Meta analysis was carried out by using the Review Manager 5.0 software,and the heterogeneity between studies was analyzed using the I2.Random effect regression model or fixed effects regression model was used according to the P value.The funnel plot was drawn to assess the potential for publication bias.The count data were presented by odds ratio (OR) and 95％ confidence intervals (95％ CI).Results Fifty-six articles were retrieved,and 11 of which met the criteria.The number of patients with colorectal cancer was 5622,and 924 were in the infected group,4698 in the control group.There was no statistical difference in the heterogeneity between all the articles (I2 =0,df=10,P ＞ 0.05).The hepatic metastatic rate was 10.61％ (98/924) in the infected group,which was significantly lower than 23.84％ (1120/4698) of the control group (OR =0.35,P ＜ 0.05).The funnel plot showed that there was no obvious publication bias in these studies.Conclusion Patients with colorectal cancer and infected by HBV have lower incidence of hepatic metastasis.

Background and purpose:Advanced pancreatic cancer is characteristic of poor treatment eff icacy and short survival time. Gemcitabine is considered as front-line therapy for advanced pancreatic cancer. Gemcitabine combinations have shown a favorable impact on survival. We compared gemcitabine-based combination cheme therapy and gemcitabine(GEM) alone in patients with advanced pancreatic cancer through Meta analysis in phase Ⅲ clinical trials. Methods:MEDLINE and EMBASE searches were supplemented by information from trial registers of phase Ⅲ randomized controlled trials(RCTs) for GEM-based combination therapy and GEM alone for advanced pancreatic cancer. A quantitative meta-analysis was carried out by two reviewers based on the inclusion criteria from all available RCTs. The Meta-analysis involved 6-months and 1-year survival rate and objective remission rate(ORR) . Results:The Meta-analysis included 20 RCTs. The result of our Meta-analysis showed that there was signifi cant improvement in the GEM combination group with regard to the 1-year survival rate(RR:0.87,95%:(0.78,0.96) ,P=0.008) . The other result of our meta-analysis showed no signifi cant difference between two groups. Conclusion:GEM-based combination therapy may be effective with regard to the survival rate compared with GEM alone.

Objective To investigate the influence of lidocaine on systemic inflammatory response to cardiopulmonary bypass (CPB) in patients undergoing coronary artery bypass grafting (CABG) .Methods Twenty ASA Ⅱ or Ⅲ patients of both sexes (13 males, 7 females) aged 47-67 yrs weighing 62-82 kg undergoing CABG were randomly divided into 2 groups of 10 each: control group (C) and lidocaine group (L). In group L lidocaine infusion was started as soon as the pericardium was cut open and maintained at 4 mg?min-1 until the end of the surgery. Another dose of lidocaine (4 mg?kg-1) was added to the prime. In control group normal saline (NS) was given instead of lidocaine in the same volume and at the same speed. Blood samples were taken from radial artery before CPB (T0, baseline) and at 1, 10 and 60 min after release of the aortic cross-clamp (T1,2,3) for determination of plasma concentration of TNF-?, IL-6, IL-10 and PMN count. Plasma lidocaine concentration was determined at 10 and 60 min after initiation of CPB and at the end of surgery in 5 patients in group L. Results The two groups were comparable with respect to age, sex ratio (M/F), body weight, CPB time and aortic cross-clamping time. The mean plasma lidocaine concentration was (4.1?0.5)?g?ml-1, (4.6?0.7) ?g?ml-1 and (5.9?0.9)?g?ml-1 at 10, 60 min of CPB and end of surgery respectively in group L. Plasma concentrations of TNF-?, IL-6, IL-10 and PMN count were significantly increased at T1,2,3 as compared to the baseline values at T0 in both groups. The plasma concentrations of TNF-? and IL-6 were significantly lower while those of IL-10 were significantly higher at T1-3 in group L than in group C. Conclusion Lidocaine can inhibit the inflammatory response induced by CPB in patients undergoing CABG.

AIM: To improve the acute cumulative death rates method (ACD method) in animal by oral administration. METHODS: A mathematic model was established to evaluate the dose-toxic effect relationship by twice oral administration and the experimental steps were improved too. The methodological quality was explored using the simulation data from computer program and the real experimental date from the reference paper. RESULTS: The results showed that the experimental data could be fitted to its theoretical data from LD_5/2 to LD_ 95/2. Concentration-time curve after po ordinary powder of Semen Strychni in mice were fitted to a one-compartment with T_ 1/2(ka)= 1.136 h,T_ 1/2(ke)= 7.100 h,and T_ max= 3.576 h. CONCLUSION: The improved ACD method can be used in the pharmacokinetics of TCM by oral administration.

Objective To explore the clinical characteristics and risk factors of strokeassociated pneumonia (SAP) in patients with acute cerebral hemorrhage.Methods A total of 375 patients with acute cerebral hemorrhage were selected from the department of neurology and neurosurgery during January 2013 to December 2015 in our hospital.According to the incidence of SAP,they were divided into the observation group (complicated with SAP,n =79) and control group (not complicated with SAP,n =296).Clinical data were collected,and clinical characteristics and related risk factors of SAP complicated with acute cerebral hemorrhage were analyzed.Results Among all the 79 SAP patients in observation group,there were 38 cases with gram-negative bacterial infections,25 cases with gram-positive bacterial infections,16 cases with mixed infections.The SAP incidence in patients with massive hemorrhage was higher than that in patients with nonmasive hemorrhage (x2 =11.301,P＜ 0.01),and was higher in patients with cerebellum,brainstem,ventricle,thalamus and multifoeal hemorrhage than that in patients with basal ganglion and brain lobe hemorrhage(x2 =4.023,P＜0.05).The hospitalization days of the observation group was longer than that of the control group [(32.7 ± 16.2) versus (17.3 ± 6.7),t=2.93,P＜ 0.01].The mortality of the observation group was higher than that of the control group (24.1％ versus 3.7％),(x2 =8.720,P＜ 0.01).Multivariate Logistic regression analysis showed that age≥ 65 (OR =4.87),underlying lung diseases (OR =5.30),bulbar paralysis (OR =7.39),disorder of consciousness (OR=4.11),NIHSS score ＞ 4 (OR =3.96),invasive airway operations (OR=3.78),gastric tube (OR =4.37),H2-receptor blocking agents application (OR =2.09) were independent risk factors for SAP in acute intraerebral hemorrhage patients.Conclusions Gram-negative bacteria are the main pathogens of SAP in patients with acute cerebral hemorrhage.The patients complicated with SAP after acute cerebral hemorrhage have poor prognosis including prolonged hospitalization period and higher mortality.SAP in acute intraerebral hemorrhage patients is closely related to the following factors:age≥65,underlying lung diseases,bulbar paralysis,disorder of consciousness,NIHSS score ＞ 4,invasive airway operations,gastric tube,H2-receptor blocking agents.

Objective To compare the safety and effectiveness of three types of intrauterine device (IUD) inserted immediately after artificial abortion.Methods A randomized controlled clinical trial was performed in 4 family planning service stations in Pudong New Area from January to December 2012.Total 1 200 eligible women were randomly assigned to receive three types of IUD:MYCu,TCu380A or G-Cu200 (n =400 in each group) immediately after vacuum aspiration.All subjects were followed up for 12 months.The cumulative rates of termination of three IUD after 12 months were analyzed with WHO LTA 2.0 life table.Results Total 1 199 subjects were followed up for 12 months with a drop-out rate of 0.08％ (1/1 200).No any uterine perforation was found.During the 12 months the pregnancy rates with IUD in situ in MYCu,TCu380A and G-Cu200 groups were 0.26/100 women year,0 and 0.52/100 women year,respectively (x2 =1.951,P ≥ 0.2).The rates of expulsion in three groups were 0.26/100 women year,1.84/100 women year and 2.05/100 women year,respectively(x2 =5.539,P =0.066).The remove rates related to bleeding and paining in three groups were 1.26/100 women year,7.29/100 women year and 2.76/100 women year,respectively (x2 =21.625,P =0.001).The discontinuation rates related to IUD use in there groups were 3.25/100 women year,9.00/100 women year and 5.50/100 women year,respectively(x2 =12.191,P =0.004).The rates of Abnormal position in three groups were 1.51/100 women year,0 and 0.26/100 women year,respectively (x2 =8.649,P =0.014).Conclusion Three IUDs inserted immediately after vacuum aspiration are all effective.Among three IUDs,MYCu shows lower expulsion rate,lower discontinuation rate related to IUD use and higher continuous rate; but the abnormal position rate of MYCu is higher than other two types IUD.

Objective:To explore the significance of next-generation sequencing to detect gene mutations for diagnosis of patients with unexplained pancytopenia.Methods:The next-generation sequencing was used to detect 32 common hematological tumor gene mutations in 113 patients with unexplained pancytopenia in Huazhong University of Science and Technology Union Shenzhen Hospital from February 2016 to February 2019.Results:The next-generation sequencing results showed that of the 32 genes tested in 113 patients, 69 mutations occurred in 25 genes. Among them, 105 patients (92.9%) carried at least 1 gene mutation, and the median number of mutations was 2 (1-5). Fifty-one patients were diagnosed with myelodysplastic syndrome (MDS), and the related mutant genes were detected; 62 patients were diagnosed with atypical aplastic anemia or cytopenia of unknown significance. The total effective rate of treatment for 113 patients was 65.5% (74/113).Conclusion:The next-generation sequencing helps to diagnose patients with unexplained pancytopenia, and provides targeted strategies for finding new treatments and prolonging the overall survival of patients.

Objective To measure the level of diamine oxidase (DAO), and observe the intestinal motor and mucosal barrier injury after acute spinal cord injury (SCI) in rats. Methods A total of 45 Sprague-Dawley rats were randomly divided into SCI group (group A, n=15), sham group (group B, n=15) and control group (group C, n=15). SCI model was established with Allen's strike mode (10 g × 25 mm) by striking T10 spinal segment in rats. One day, three days and seven days after SCI, hind limb motor function was assessed with Basso-Beat-tie-Bresnahan (BBB) Scale in each group, the myoelectric slow wave and ileum smooth muscle contractility were measured in rats, ileum tis-sues were tested with HE staining, and the DAO content of serum was tested with ELISA kit. Results One day, three days and seven days af-ter SCI, the BBB score was significantly lower in group A than in groups B and C (P<0.001). One day, three days after SCI, the frequency and amplitude of both slow wave and contractility were lower in group A than in groups B and C (P<0.05);seven days after SCI, there was no significant difference among three groups (P>0.05). Group A showed ileal mucosal edema, lodging, inflammatory cell infiltration, and submucosal gap increase. The Chiu's score of intestinal mucosal injury was higher in group A than in groups B and C (P<0.05), as well as the serum DAO content one day and three days after SCI (P<0.05), and no significant difference was found in the serum DAO content among three groups seven days after SCI (P>0.05). Conclusion Serum DAO content may respond to the intestinal motor function and mu-cosal injury after acute SCI in rats.

AIM:To investigate the mammalian target of rapamycin ( mTOR) signaling pathway as the center playing a role in the crizotinib-induced apoptosis of non-small cell lung cancer (NSCLC) cell line H2228, which represents positive echinoderm microtubule-associated protein-like 4 (EML4)-anaplastic lymphoma kinase (ALK) fusion gene. METHODS:H2228 cells were processed according to different purposes .Fluorescence quantitative PCR is used to ob-serve the gene states .MTT assay is used to detect the cell inhibition rates .The cell apoptosis and cell cycle were analyzed by flow cytometry .The expression and activation levels of the key proteins in the mTOR signaling pathway were determined by Western blotting .RESULTS:Crizotinib promoted the apoptosis of H 2228 cells in a time-and dose-dependent manner . Crizotinib blocked the H2228 cells staying at the G1 phase.In apoptotic H2228 cells processed with crizotinib, the activa-tion level of mTOR was decreased , and the activation levels of the key proteins in upstream and downstream of mTOR path -way were both declined .The expression level of the fusion protein EML 4-ALK variant 3 was not affected , but its active form of p-ALK was significantly suppressed .CONCLUSION:mTOR signaling pathway has a certain relationship with the crizotinib-induced apoptosis of lung cancer cell H 2228, which represents positive EML4-ALK fusion gene.

Objective To analyze the mutation distribution of phenylalanine hydroxylase(PAH)gene in pa-tients with phenylketonuria(PKU)in Ningxia,and understand the hot spots and regions of PAH gene. Methods First-ly,6 hot mutation exons including 3,5,6,7,11,12 and their surrounding introns of the PAH gene in 30 patients with PKU in Ningxia were directly sequenced. And then the last 7 exons of 1,2,4,8,9,10,13 were sequenced for the patients in which 2 mutant alleles were not characterized. Multiplex ligation - dependent probe amplification (MLPA)was performed for the identification of uncharacterized mutant alleles after PAH sequence analysis of patients with PKU. Results Among 60 alleles,there were 58 mutant alleles(96. 7% ). Forty - six(81. 6% )mutant alleles were found in the exons 3,5,6,7,11,12. A total of 23 various mutations were detected,including missense(n = 9), splicing(n = 9),nonsense(n = 2),small deletion(n = 2)and large deletion(n = 1). The most common mutations were R243Q(18. 3% ),IVS4 - 1G ﹥ A(11. 7% )and R111X(11. 7% ). Among them,a novel mutation N393del was detec-ted in exon 11. MLPA identified a large deletion(c. - 1932 + 3402del)in 3 patients,1 of them was homoallelic muta-tion,and the others were heteroallelic mutation. Conclusions There are obvious hotspots and hot spot areas of PAH gene in PKU patients in Ningxia. There is a large deletion mutation in PKU patients in Ningxia. The MLPA is an effec-tive assay to detect large deletion in PAH gene.