0.05). The level of serum IL-8 and expression of TNF ? in the colonic mucosa decreased at the 7th day ( P

Objective To investigate the characteristic,diagnosis and treatment of the nipple discharge.Methods The clinical data of 174 cases who were diagnosed as nipple dlscharge from January 2001 to December2006 were collected and analyzed retrospectively.Results Among those 174 cases,136 cases were confirmed histopathologieally to be intraduetal papilloma.The confirmed diagnosis rate of intraduetal papilloma by galaetograghy was 85.00%.Carcinoma-charge rate of the intraduetal papilloma was 5.17%.Conclusion Nipple discharge was the most common symptom in the intraductal papillomatesis.The galaetography was a valuable method in the diagnosis of the intraduetal papilloma.There was carcinoma-charge possibility in the intraduetal papilloma.

Objective To construct pseudotyped retroviral vector MuLV/VSV-G and transfer it into rabbit smooth muscle cells (SMC) in order to provide a high-efficiency vector for SMC gene transfer. Methods We constructed pseudotyped retroviral vector MuLV/VSV-G containing the previously reported gene lacZ, determined the titer, and determined the efficiency of gene transfer into SMC mediated by pseudotyped retroviral vector MuLV/VSV-G. Finally the transfer efficiency was compared with that by MuLV. Results MuLV/VSV-G vector was constructed. The titer of the vector was 6-7.8×10~6CFU, the transfer efficiency was (92±12)% by using MuLV/VSV-G vector and (24±5)% by MuLV vector. Conclusion Pseudotyped retroviral vector MuLV/VSV-G which was constructed successfully is a kind of high-efficiency gene transfer vector in smooth muscle cells.

AIM To identify potential amino acid residues that contribute to different catalytic characteristics of CYP2A6 and CYP2A13 enzymes in nicotine metabolism. METHODSWild type of CYP2A6 and CYP2A13 and their mutants CYP2A6V117A, CYP2A6G164H, CYP2A6I208S, CYP2A6R372H, CYP2A6S465P and CYP2A13A117V, CYP2A13H164G, CYP2A13S208I, CYP2A13H372A and CYP2A13P465S, were subjected kinetic analysis in nicotine 5'-hydroxylation. RESULTS For CYP2A6, substitution of isoleucine 208 to serine caused dramatic kinetic property changes with K_m and V_( max) varied from 62.25 μmol·L~(-1) and 6.53 mol·min~(-1)·moL~(-1) to 345 μmol·L~(-1) and 2.19 mol·min~(-1)·moL~(-1). However, the corresponding serine 208 to isoleucine mutation did not heavily affect the enzyme activity in CYP2A13. The histidine 372 to arginine mutation resulted in a remarkable catalytic efficiency decrease with K_m and V_( max) changes from 26.01 μmol·L~(-1) and 24.51 mol·min~(-1)·moL~(-1) to 148.7 μmol·L~(-1) and 6.11 mol·min~(-1)·moL~(-1) in CYP2A13, but the switching of argenine 372 to histidine did not show expected corresponding crucial influence in CYP2A6 activity. Substitutions on the other positions changed enzyme activities in different rates. CONCLUSION The isoleucine 208 is crucial to human CYP2A6, while the 372 histidine is a key amino acid residue for CYP2A13 in nicotine 5'-hydroxylation.

Objective:To study the expression of P selectin in the colonic mucosa and on surfaces of platelets in circulation, and determine its association with IL 8 and TNF ? in trinitrobenzene sulphonic acid (TNBS) induced colitis in rat, in order to investigate the effects of P selectin on inflammation and thrombosis in inflammatory bowel disease Methods:TNBS was instilled into the colon of the rats to induce colitis Animals were sacrificed at the 24th hour, the 1st and the 2nd week after production Blood and colonic tissues were obtained P selectin on the platelets were detected by radioimmunoassay IL 8 in serum was detected by ELISA method Expression of P selectin and TNF ? in colonic mucosa were assessed with immunohistochemistry Results:P selectin in mucosa was increased in different time points compared with control group The positive expression was above 50% P selectin on the platelets wasn't increased at the 24th hour, but increased at the 1st and 2nd week (P

Background and purpose:Methylene tetrahydrofolate reductase (MTHFR) plays an important role in metabolism of folate and DNA methylation. This study aimed to investigate the relationship between methylene tetrahydrofolate reductase (MTHFR) C677T polymorphism and chemotherapy side effects in advanced non-small cell lung cancer (NSCLC) patients. Methods:A total of 100 patients with advanced NSCLC conifrmed by pathology were included into this study in Zhejiang Cancer Hospital from Jun. 2007 to May. 2009. All patients received the combined chemotherapy of platinum drug and gemcitabine. MTHFR genotypes were determined by allele-specific-PCR technology. Results:In the 100 cases, genotype frequency of MTHFR C677T T/T, T/C and C/C were 20%, 44%and 36%, respectively. Compared with patients of T/T and T/C genotype, patients of C/C genotype were correlated with decreased rate of thrombocytopenia to chemotherapy (P=0.039). No signiifcant differences were observed concerning gastrointestinal toxicity. Conclusion:MTHFR C677T gene polymorphism can be used to predict the adverse reactions to platinum-based chemotherapy in patients with advanced NSCLC.

Objective To study epidemiology, clinical findings, diagnosis and treatment of sepsis caused by Vibrio vulnificus. Method Patientss with Vibrio vulnificus sepsis were collected from 1995 to 2008. The medical records including epidemiological and clinical data were analyzed. Results The male-to-female ratio of 34cases was 4.7:1 and 76. 5% of these patients suffered from chronic liver disease. Most patients occurred from April to October with signs of abrupt fever, characteristic cutaneous lesions, hypotension and progressive multiple organ disfunction syndrome (MODS). The mortality was over 47.1% . The criteria proposed for early diagnosis of Vibrio vulnificus sepsis were abrupt onset with fever during the period from April to November, characteristic cutaneous lesions, such as the most commonly occurred haemorrhagic bullae on the extremities or even extensive necrosis of skin and muscular tissue, progressive hypotension or shock accompanied by MODS, pre-existing liver disease or chronic abuse of alcohol, and consumption of raw seafood or exposure to seawater within 12 week. Early administration of the third-generation cephalosporins with the quinolones in full dosage, aggressive wound debridement,appropriate dermoplasty and supportive care contribute to a better outcome. Conclusions Vibrio vulnificus sepsis progresses rapidly with high mortality. Early diagnosis, rapid treatment with prompt antibiotics and aggressive surgery treatment are very important to improve the outcome.

Objective To analyze the correlative factors of anemia in patients with non-small-cell lung cancer (NSCLC), and to explore the impact of anemia on prognosis.Methods The clinical data of 473 patients with NSCLC treated at the first time from January 2008 to November 2012 in the Fourth Hospital of Hebei Medical University were analyzed retrospectively.Results There were 273 patients (57.72 ％) with anemia.Anemia occurred in different age (x2 =3.459, P =3.459), different albumin level (x2 =70.648, P =70.648), different PS score (x2 =10.222, P =10.222), whether recent surgery (x2 =4.956, P =4.956), whether recent chemotherapy (x2 =3.627, P =0.037), and other factors.By multiple factors analysis, hypoalbuminemia was an independent risk factor for anemia (P ＜ 0.05).The median OS of the anemia patients was shorter than that of the patients without anemia (15 months vs 17 months, P ＜ 0.05).Conclusions Hypoalbuminemia is the independent risk factor for emergence of anemia.Anemia is the prognosis indicator of shorten survival period, which is an independent factor of prognosis in the NSCLC.

1.CONCLUS-ION:The use of hypoglycemics in Guangzhou is basically in line with the rational level,except for few cases in improper use of combination therapies.

Objective To explore the effect of giving sedatives according to the circadian rhythm in prevention of occurrence of delirium and the prognosis of patients undergoing mechanical ventilation in intensive care unit (ICU). Methods A prospective double-blinded randomized controlled trial (RCT) was conducted. The patients admitted to Department of Critical Care Medicine of the Second Hospital of Lanzhou University from July 2014 to February 2015, undergoing invasive mechanical ventilation over 12 hours were enrolled. All the patients were given fentanyl for analgesia, and they were randomly divided into simulated circadian clock group (study group, n = 35) and non-simulated circadian clock group (control group, n = 35). The patients in each group were subdivided into three subgroups according to the kinds of sedative drugs, namely dexmedetomidine group (n = 8), propofol group (n = 14), and dexmedetomidine combined with propofol group (combination group, n = 13). Visual analogue scale (VAS) standard and Richmond agitation-sedation scale (RASS) were used to control the analgesic and to quantify the depth of sedation by titrating the dose of sedative drugs, the simulated circadian clock was set to control the RASS score at 0-1 during the day, and -1 to -2 at night in study group. The RASS score in the control group was set at -1 to -2 day and night. The urine 6-hydroxy acid melatonin (aMT6s) levels at different time points in the first diurnal rhythm (06:00, 12:00, 18:00, 24:00) were determined by enzyme linked immunosorbent assay (ELISA). The incidence of delirium, severe hypotension, severe bradycardia and other adverse reactions, duration of mechanical ventilation and the time of extubation, length of ICU stay, amount of sedative and analgesic drugs used were recorded. The correlation between delirium and other indexes was analyzed by using Spearman correlation analysis. Results ① There were no significant differences in gender, age, acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) score among groups. ② Urine aMT6s levels did not show circadian rhythm in both groups, aMT6s level at 06:00 in study group showed an increasing tendency as compared with the control group, but the difference was not statistically significant. ③ Compared with the control group, the incidence of delirium was significantly lowered in the study group (14.3% vs. 37.1%, P = 0.029), but no significant differences were found in the incidence of severe hypotension or severe bradycardia (20.0% vs. 25.7%, 11.4% vs. 20.0%, both P > 0.05). In simulated circadian clock group, the incidence of delirium in dexmedetomidine group was significantly lower than that of the propofol group (6.3% vs. 32.1%, P < 0.05). ④ Compared with control group with the same sedative, the duration of mechanical ventilation, extubation time, length of ICU stay were significantly shortened, and the dosage of sedative drugs used was reduced in study group (all P < 0.05). In simulated circadian clock group, the duration of mechanical ventilation in dexmedetomidine group was significantly shorter than that of propofol group and combination group (hours: 75.75±26.78 vs. 102.00±26.31 and 100.31±25.38, both P < 0.05), and the length of ICU stay was significantly shorter than that of propofol group (days: 5.75±1.04 vs. 7.00±1.52, P < 0.05). ⑤ The occurrence of delirium was positively correlated with duration of mechanical ventilation (r = 0.705), extubation time (r = 0.704), length of ICU stay (r = 0.666, all P = 0.000), and no correlation was found between the occurrence of delirium and aMT6s level at 06:00, 12:00, 18:00, and 24:00 (r = -0.135, r = 0.163, r = 0.269, r = -0.077, all P > 0.05). Conclusions Administration of sedatives according to simulating circadian time could decrease the duration of mechanical ventilation, extubation time, and the length of ICU stay, decrease the dosage of sedative drugs, and reduce the incidence of delirium. Dexmedetomidine could reduce the incidence of delirium, and improve the prognosis of patients. Trial registration Registration of clinical trials in China, ChiCTR-IPR-15006644.