Objective To study the expressions and significances of leptin,estrogen and estrogen receptor (ER) in pulmonary squamous carcinoma and adenocarcinoma.Methods The expressions of leptin and estrogen receptor were detected in 58 cases of lung adenocarcinoma and 63 cases of pulmonary squamous cell carcinoma and 50 cases of normal lung tissue samples by immunohistochemical menthod,the levels of estrogen were also detected in patients with venous blood at the same time.Comparison of differential expression of leptin,estrogen and estrogen receptor in lung adenocarcinoma and lung squamous cell carcinoma,normal tissues,and explore their relationships with lung adenocarcinoma.Results Leptin,estrogen and estrogen receptor positive rates in lung adenocarcinoma group were 65.5％,36.2％ and 58.6％ respectively,and 33.3％,15.9％,30.2％ in lung squamous cell carcinoma group.There were a statistical difference between the two groups (x2 =4.324,P＜0.050;x2 =5.372,P ＜0.050;x2 =5.718,P ＜0.050).In the normal control group the positive rates were 24.0％,4.0％ and 0 respectively,and there was a statistical difference compared with lung adenocarcinoma group (x2 =7.126,P ＜0.010;x2 =9.683,P＜0.005;x2 =22.308,P ＜0.005).In lung adenocarcinoma group,leptin,estrogen and estrogen receptor positive rate have no relationships with tumor stage (x2 =0.001,P=0.950;x2 =0.061,P =0.900;x2 =0.178,P=0.750) and primary tumor size (x2=0.023,P=0.900;x2 =0.001,P=0.950;x2 =0.001,P=0.950).Conclusion Leptin,estrogen and ER were expressed highly in adenocarcinoma of lung tumor.The expressions of leptin,estrogen and ER may associated with the carcinogenesis,development and clinical type of adenocarcinoma of lung.

Objective To investigate the possible regulating effect of integrin-linked kinase (ILK) towards matrix metalloproteinase-9/tissue inhibitor of metalloproteinase-1 (MMP-9/TIMP-1) ratio in the process of transforming growth factor-β1 (TGF-β1)-induced epithelial-mesenchymal transition (EMT) in human kidney proximal tubular epithelial (HK-2) cells.Methods HK-2 cells were cultured and stimulated with 10 ng/ml TGF-β1.Specific ILK-small interfering RNA (ILK-siRNA) was used to inhibit ILK expression.The characteristic epithelial marker (E-cadherin) and mesenchymal marker (α-SMA) of EMT were examined by Real-time reverse transcription polymerase chain reaction (real-time RT-PCR) and Western blot.The expressions of ILK,MMP-9,and TIMP-1 were also examined,to determine the regulating effect of ILK towards MMP-9/TIMP-1 ratio.Results In the HK-2 cells cultured with TGF-β1,the expression of E-cadherin decreased,and α-SMA expression increased;overexpression of ILK and an abnormal changing of MMP-9/TIMP-1 ratio were observed.ILK inhibition by ILK-siRNA could adjust MMP-9/TIMP-1 ratio to near normal.Meanwhile,the overexpressed ILK and α-SMA were decreased.Conclusions Our data indicates that ILK-siRNA successfully inhibits ILK expression,which regulates the MMP-9/TIMP-1 ratio in HK-2 cells.The inhibition of ILK expression suppresses TGF-β1-induced EMT partially.

Objective:To develop the intelligent management system for diabetes medication knowledge base with the help of community hospital information platform.Methods:Based on the China Type 2 Diabetes Prevention Guide (2013 edition),National Essential Drugs (2012 edition) and the relevant package inserts,the knowledge base of diabetes medication was established.Results:The information platform could make interception beforehand,warning in the process of medication and provide attentions for physicians after treatment to determine rational medication.Conclusion:The intelligent management system for diabetes medication knowledge base can promote physicians to firmly grasp the principles of drug treatment,simplify treatment regimen,select effective drugs with reasonable prices and provide individualized treatment.

Lobaplatin is the third generation platinum anticancer drug,and has been listed for the clinical treatment of advanced breast cancer,small cell lung cancer and chronic myeloid leukemia.Studies have shown that lobaplatin as the latest third generation platinum anticancer drug,has good water solubility,broadspectrum anti-tumor,strong anti-tumor activity,no cross-resistance with other platinum drugs,low toxicity and many other features.Lobaplatin has shown a clear advantage.

Objective To explore the impact of enteral nutrition (EN)support on patients with advanced cancer.Methods 83 cases with advanced cancer were selected,the patients were randomly divided into two groups, 42 cases in the observation group,41 cases in the control group.The observation group was given EN support com-bined with parenteral nutrition (PN)support,while the control group was only given the PN support.Immune function CD +4 ,CD +4 /CD +8 ,IgA,IgG,nutrition indicators [serum albumin (ALB),transferrin (TF)and 24h urea nitrogen (24hUP)]before and 10d after surgery as well as complications were compared.Results The differences of CD +4 , CD +4 /CD +8 ,IgA,IgG,ALB,TF and 24h UP between the two groups before surgery were not statistically significant (P >0.05);10d after surgery,CD +4 ,CD +4 /CD +8 ,IgA,IgG levels in the control group were (52.4 ±4.4)%,(1.8 ± 0.3)%,(2.7 ±0.3)g/L and (11.4 ±2.1)g/L,which in the observation group were (55.9 ±5.6)%,(2.1 ± 0.5)%,(2.9 ±0.5)g/L and (12.9 ±2.3)g/L,CD +4 /CD +8 ,IgA,IgG were significantly higher in the observation group(t =2.408,2.521,2.332,2.359,all P <0.05);10d after surgery,ALB,TF and 24h UP in observation group were (36.6 ±2.3)g/L,(2.9 ±0.2)g/L,and (0.7 ±0.3)g/L,which were (32.4 ±1.5)g/L,(2.2 ±0.1)g/L,and (0.4 ±0.1)g/L in the control group,the differences were statistically significant (t =7.493,15.34,4.648,P <0.05).The incidence rate of complications in the observation group was 9.5% (4 /42),which in the control group was 26.8%(11 /41),the difference was statistically significant (χ2 =4.196,P <0.05).Conclusion EN support for patients with advanced cancer is benefit for immune function improvment and nutrition improvement,and can reduce the risk of complications.

Objective To evaluate the efficacy of angiotensin converting enzyme inhibitor (ACEI) and angiotensin receptor blocker (ARB) in the treatment of idiopathic pulmonary fibrosis through the method of system evaluation. Methods A computer-based online search of Pubmed, Embase, Cochrane Library, CNKI, CBM and Wanfang were used for database retrieval. Revman 5.0 was used to assess the bias of the included studies. The Stata 14.0 was used to evaluate the extraction indexes of efficacy, p (O2), p (CO2), DLco, FEV1 and VC. GRADE score was used to evaluate the level of evidence. Results A total of 17 articles (related with 1381 patients) were included in this study, including 14 studies using ARB and 3 studies using ACEI. Compared with the control group ACEI and ARB drugs showed advantages in the treatment of pulmonary fibrosis (RR=1.34, 95%CI:1.24-1.44, Z=7.81, P<0.001). Auxiliary index analysis showed that the test groups were treated with enalapril (SMD=0.72, 95%CI:0.21-1.22, Z=2.77, P=0.006), telmisartan (SMD=3.86, 95%CI:2.44-5.27, Z=5.35, P<0.001), valsartan (SMD=1.94, 95%CI:1.33-2.55, Z=6.27, P<0.001) and captopril (SMD=0.60, 95%CI:0.11-1.09, Z=2.41, P=0.016), the p(O2) levels were significantly improved in patients ≥65 years old (SMD=0.76, 95%CI:0.52-1.00, Z=6.18, P<0.001) and patients < 65 years old (SMD=3.97, 95%CI:2.61-5.32, Z=5.73, P<0.001), and disease duration≥5 years (SMD=1.39, 95%CI:0.45-2.33, Z=2.89, P=0.004) and disease duration<5 years (SMD=3.26, 95%CI:2.06-4.46, Z=5.34, P<0.001) compared with those of control group (SMD=2.95, 95%CI:1.95-3.94, Z=5.82, P<0.001). The curative effect of telmisartan was better than that of other drug groups (P < 0.001), and which was much better for patients under 65 years old (P<0.001). There was no significant difference in the disease duration between two groups (P=0.307). The p (CO2) levels were significantly improved in patients treated with telmisartan [SMD=-12.94,95%CI:(-14.01)-(-11.86),Z=23.51,P<0.001), valsartan [SMD=-1.95,95%CI:(-2.56)-(-1.34),Z=6.29,P<0.001] compared with those of control group [SMD=-11.13,95%CI:(-17.03)-(-5.24),Z=3.70,P<0.001]. The effect of telmisartan was better than that of valsartan (P<0.001). In addition, values of DLco (SMD=0.64, 95%CI:0.45-0.83, Z=6.72, P<0.001), FEV1 (SMD=1.19, 95%CI:0.52-1.86, Z=3.47, P<0.001) and VC (SMD=0.51, 95%CI:0.16-0.85, Z=2.85, P=0.004) were improved in test group compare with those of control group. And the GRADE scores of relevant indexes were low quality to moderate quality. Conclusion ACEI and ARB can improve the efficacy, the p (O2) and p (CO2) in the treatment of pulmonary fibrosis. Patients with age<65 years old and treated with telmisartan have the best curative effect, and which is not related to the disease duration.

ObjectiveTo explore the relative factors of the compliance in schizophrenic out-patients.Methods118 schizophrenic out-patients chosen randomly were investigate with the compliance and assessed with Clinical Global Impression-Severity of Illness (CGI-SI), Social Disability Screening Schedule (SDSS), Brief Psychiatric Rating Scale (BPRS) and Treatment Emergent Symptom Scale (TESS) by telephone. Logistic regression analysis was used to confirm the relative factors of the compliance.Results56.8% of all patients were of full compliance. The risk factors of compliance in schizophrenic out-patients were the frequency of medicine taken, the scores of CGI-SI and the insight of the illness. ConclusionIt is important to choose effective and convenient antipsychotic drugs and improve the insight of the illness to enhance the compliance of the schizophrenic out-patients.

Objective:To investigate the effect of heat shock protein B8 (HspB8) downregulation on retinal ganglion cell (RGC) and retinal function in the mice model of optic nerve injury (ONC).Methods:Adeno-Associated Virus (AAV) 2 AAV2-shHspB8-GFP was constructed to knockdown HspB8. 66 adult male C57/BL6 mice were randomly divided into the control group, the ONC group, the AAV2-shHspB8 group, the ONC+AAV2-shHspB8 group, and the ONC+AAV2-GFP group. There were 10, 20, 16, 10 and 10 mice respectively, and both eyes were used as experimental eyes. Western blot was used to evaluate the expression of HspB8 on day 3 and 7 after ONC. By GFP immunofluorescence staining, the efficacy of AAV2-shHspB8-GFP transfer was accessed. Moreover, it was possible to identify functional and RGC survival differences between groups by optomotor response (OMR), dark adapted full-field flash electroretinogram (ff-ERG), oscillatory potentials (OPs), photopic negative response (PhNR) and retinal flat-mount RGC counting 5 days after ONC. Comparisons between two groups were made using Mann-Whitney U test, unpaired t-test, unpaired t-test with Welch’s correction, one-way ANOVA, and Bonferroni t test. Results:Compared with the control group, the expression of HSPB8 protein in the retina of mice in ONC3 group was significantly increased, and the difference was statistically significant ( F=43.63, P<0.01). Compared with the control group, the ONC group showed obviously lower visual acuity ( P<0.01), lower a-wave, b-wave, OPs, PhNR amplitude, longer b-wave latency ( P<0.05), and the survival rates of RGC in ONC3 group, ONC5 group and ONC7 group decreased in a time-dependent manner( F=384.90, P<0.01). Transfection of AAV2 efficiency was highest on 4 weeks after IVT. Besides, there was no significant differences between the control group and the AAV2-shHspB8 group on visual acuity, ff-ERG, OPs, PhNR and RGC survival ( P>0.05). In comparison of the control group, we found that RGC survival of the ONC5+AAV2-shHspB8 group was significantly elevated ( F=10.62, P<0.01). Conclusions:Expression of HspB8 on the retina can be induced by ONC. The investigation of RGC counting, visual acuity, and ff-ERG revealed that optic nerve injury destructed functionality of mice retina and resulted to RGC death ultimately. The Most crucial finding of this research is that HspB8 knockdown had a neuroprotective effect in RGC after ONC.

Objective The frequency and the anatomic distribution of involved regional nodes in recurrent and locally advanced breast cancer were analyzed, in order to evaluate the rational of conventional regional node radiation technique and provide evidence for target definition of breast cancer . Methods Patients with recurrent or locally advanced breast cancer who were treated in our hospital from August 2003 to December 2009 were included in this study. 111 patients had contrast enhanced chest CT images of the whole regional nodes before treatment. The regional nodes were categorized into 8 anatomical substructures including medial and lateral supraclavicular nodes ( SC-M, SC-L), axilla nodes ( ALN )- Ⅰ , Ⅱ , Ⅲ,infraclavicular nodes (IFN), Rotter's nodes (RN) and internal mammary nodes (IMN). The frequency of involvement and anatomical distribution of the involved nodes on CT images were analyzed. Results A total of 111 patients were enrolled this study and 199 anatomical substructures with involved nodes were identified. The frequency of involvement were :SC-M 33, SC-L 21, ALN- Ⅰ 30, ALN-Ⅱ 25, ALN-Ⅲ + IFN 35, RN 27, IMN 28. Supraclavicular region and axilla were the most frequently involved area (72. 3% ).The average depth of the SC-M and SC-L nodes was 33.48 mm ± 10. 57 mm and 45.62 mm ±20. 45 mm,and 51.5% and 71.4% of the SC-M and SC-L nodes were located more than 3 cm deep from the skin. The axilla nodes were located cranial and caudal to the axillary vein in 5 and 20 locally advanced breast cancer patients and in 64 and 28 patients who received prior axillary dissection. The majority of involved IMN was located within the first 3 intercostal spaces (26/28). The average distance between the center of involved IMN and chest skin was 24. 23 mm ± 10. 28 mm. The average distance between the center of involved IMN and midline of the body was 29. 38 mm ±6. 7 mm. The center of involved IMN was 6.19 mm ±5.73 mm lateral and 5.73 mm ± 4. 56 mm posterior to the internal mammary vessels. Conclusions Conventional field design is unlikely to provide sufficient dose to the entire risk region because of individual differences.Individualized treatment planning based on CT would become feasible with increasing knowledge of natural risk of nodal involvement.

Objective To investigate prospectively the nutritional risks,undernutrition,and nutritional support in hospitalized patients with later but non-end-stage malignancies in a second grade hospital in Beijing.Methods All patients who were admitted in the department of oncology in this hospital from October 2011 to April 2013 were consecutively recorded.Nutritional Risk Screening (NRS 2002) was used for screening nutrition risks,the undernutrition assessment was performed on the first morning for patients meet the inclusion criteria,and nutritional support was evaluated until the discharge.For patients with no nutritional risk,NRS 2002 was repeated weekly during the hospitalization.Results A total of 305 cases of inpatients admitted,and 224cases meeting the inclusion criteria were screened by NRS 2002,among whom only 171 patients with non-endstage later stage cancer entered the final analysis.Among these 171 patients,116 (67.8％) were at nutritional risks.Furthermore,for different types of tumor,the nutritional risk was 45.7％ for lung cancer,89.4％ for digestive-tract cancers,81.3％ for liver-biliary and pancreatic cancers,and 83.3％ for head-and-neck cancers.The undernutrition rate was 12.3％ (21/171) if based on body mass index ＜ 18.5 kg/m2 and 19.9％ (34/171) if evaluated from the score of nutritional defect part of NRS 2002.Only 71 patients (61.2％) at nutritional risk received nutritional support,while 5 of 55 patients (9.1％) without nutritional risk received nutritional support.The average ratio of parenteral nutrition to enteral nutrition was 23∶ 1.Intravenous calories intake was 56.78 ± 8.20 k J/ (kg · d) ; the intake of nitrogen was 0.06 ± 0.01 g/ (kg · d),and the ratio of calories to nitrogen was 204∶ 1.Conclusions A large proportion of inpatients with non-end-stage later cancer were at nutritional risk,which is associated with tumor types.The application of nutritional support should be further standardized,particularly for patients at nutritional risk but with low nutritional support.Furthermore,whether the clinical outcome of inpatients at nutritional risk may be improved by nutritional support still requires further investigation.