B7-H4 is a new member of costimulatory molecules,it negatively regulates T cell immunity by the inhibition of T cell proliferation, cytokine production, and cell cycle progression. Recent studies indicate that B7- H4 is associated with the generation and progression of tumor and is an important indication in the diag-nosis and treatment of tumor.

Objective To investigate the expression of miR-155 ,nuclear factor kappa B (NF-κB) and soluble intercellular adhesion molecule -1 (sICAM-1 ) in peripheral blood in patients with type 2 diabetes mellitus (T2DM ) ,and to explore the role of miR-155 in vascular lesions of T2DM. Methods A total of 165 T2DM patients and 60 health subjects from health examinations were enrolled in this study. All the subjects were divided into two groups :subjects without vascular lesions group and vascular disease group. Vascular disease group was further divided into microangiopathy group ,macroangiopathy group , microangiopathy+ macroangiopathy group ;based on 24 hUAlb level normal urinary albumin (NAU ) group ,microalbuminuria (MAU) group ,macroalbuminuria (MAAU) group. MiR-155 ,NF-κB and sICAM-1 in peripheral blood were tested by RT-PCR. Single factor analysis of variance was used for comparison among groups. Stepwise regression analysis was used for correlation factors analysis. Results The expression of miR-155 ,NF-κB and sICAM-1 were significantly higher in T2DM group than in NC group [(1.82 ± 0.71) vs (1.00 ± 0.12) ,(2.28 ± 0.66) vs (1.04 ± 0.33) ,(1.88 ± 0.80) vs (1.03 ± 0.30) ,P<0.05]. The level of miR-155 ,NF-κB ,sICAM-1 were significantly higher in T2DM vascular lesions group than in subjects without vascular lesions group [(1.95 ± 0.73) vs (1.34 ± 0.29) ,(2.40 ± 0.65) vs (1.65 ± 0.16 ) ,(2.01 ± 0.77 ) vs (1.07 ± 0.41 ) ,P < 0.05 ]. The expression of miR-155 was higher in microangiopathy+ macroangiopathy group than in macroangiopathy group [(2.36 ± 0.61 ) vs (1.77 ± 0.59) ,P < 0.05 ].The expression of NF-κB was also significantly higher in microangiopathy +macroangiopathy group than in microvascular disease group and macroangiopathy group (P<0.05). The level of miR-155 was significantly higher in group MAU group and MAAU group than in NAU group [(1.41 ± 0.49) ,(2.64 ± 0.52) vs (1.04 ± 0.20) ,P<0.05] ,and NF-κB and sICAM-1 were also higher than NAU group (P<0.05). Multiple stepwise regression analysis showed that miR-155 was positively correlated with NF-κB and sICAM-1(t=4.235 ,9.728 ,P<0.01). Conclusion The expression of miR-155 increases in T2DM patients with vascular complications ,and this trend is the same as NF-κB and sICAM-1. It suggests that miR-155 maybe involves in the pathogenesis of diabetic chronic vascular disease.

Objective To research the changes of calcium regulation hormone and bone mineral density (BMD) in type 2 diabetes mellitus (T2DM ) patients and analyze the main impact factors. Methods 117 T2DM patients (T2DM group ,M/F=52/65 ,age 40~79 years) and 63 age‐ and gender‐matched healthy people (NC group) were selected in this study. According to the course of diabetes ,blood glucose control and the value of BMD ,T2DM patients were divided into subgroups :course≤10 years ,and>10 years ;HbA1 c≤8% ,and>8% ;normal BMD ,osteopenia ,and osteoporosis (OP). Serum 25‐hydroxy vitamin D3 [25(OH)D3 ]and Parathormone (PTH) were measured and BMDs of lumbar spine (L1 ~L4 ) , femoral neck ,total hip ,and whole body were evaluated for all the subjects. Result (1)Compared with NC group ,the level of serum 25(OH)D3 and BMDs of femoral neck and total hip decreased significantly in T2DM group[ (35.57 ± 12.30)nmol/L ,(0.848 ± 0.136)g/cm2 ,(0.873 ± 0.150)g/cm2 vs(44.94 ± 17.40) nmol/L ,(0.927 ± 0.173)g/cm2 ,(0.934 ± 0.140)g/cm2 ,respectively ,P<0.01 or P<0.05)]. The level of PTH increased in T2DM group[ (8.50 ± 4.15) vs(5.62 ± 3.93)pmol/L ,P<0.01]. (2)Compared with the group duration of diabetes≤10 years ,BMD of femoral neck and total hip decreased in patients with duration of diabetes>10 years[ (0.814 ± 0.148) ,(0.840 ± 0.157) vs (0.882 ± 0.111) ,(0.908 ± 0.139) g/cm2 ,respectively ,P<0.05]. The level of PTH increased [(10.55 ± 9.09) vs (7.06 ± 3.74)pmol/L , P<0.05)]. 25(OH)D3 and total body BMD have no significant difference(P>0.05). (3)Compared with HbA1c≤8% group ,BMD of femoral neck and total hip in HbA1c> 8% group decreased [(0.830 ± 0.131) ,(0.832 ± 0.161) vs (0.891 ± 0.130) ,(0.949 ± 0.130)g/cm2 ,respectively ,P<0.05]. The level of PTH increased [(9.96±8.80) vs (7.21±3.98)pmol/L ,P<0.05]. 25(OH)D3and total body BMD have no significant difference(P> 0.05). (4)The rates of OP and osteopenia (41.03% ,47.86% ) in T2DM were higher than those in NC group (26.98% ,33.33% ) (χ2 =4.367 ,4.669 ,P<0.05). The duration of diabetes and the levels of HbA1c and PTH were longer or higher in OP group than those with normal BMD or osteopenia (P<0.05). (5)Logistic regression analysis showed that BMD negatively correlated with the duration of diabetes ,HbA1c ,and PTH (β= 0.076 ,0.213 ,0.112 ,respectively ,P< 0.05) ,and positively correlated with 25(OH)D3 (β= -0.043 ,P<0.05). Conclusion The values of BMD decreased and the incidence of OP is higher in T2DM patients ,particularly in patients with longer diabetic duration and poor glycemic control.

Myelodysplastic syndromes (MDS) are a heterogenous group of hematologic malignancies characterized by clonal expansion of BM myeloid cells with impaired differentiation. Of particular interest mutations is the recent recognition that genes involved in the regulation of histone function (EZH2, ASXL1,and UTX) and DNA methylation (DNMT3A,IDH 1/IDH2,TET2) are recurrently mutated in MDS,providing an important link between genetic and epigenetic alterations in this disease. Ongoing analysis of the seminal AZA-001study has taught many important lessons in the use of DNA methyltransferase (DNMT) inhibitors.Improved survival in patients with high-risk MDS treated with azacitidine extends to patients with any International Working Group-defined hematologic response.New information on the impact of DNMT inhibitors on the immune system and on stem cells will likely lead to novel uses of these drugs in MDS and other hematologic and nonhematologic malignancies. The immunomodulating drug thalidomide and its derivative lenalidomide have been used in the treatment of MDS,principally in lower-risk MDS.

Objective To investigate the expressions of Nanog and Oct4 (stem cell transcription factors) in endometriosis and adenomyosis, and to explore their potential functions in the development of endometriosis and adenomyosis. Methods The expressions of Nanog and Oct4 in the ectopic and eutopic endometrium of 50 patients with endometriosis and/or adenomyosis (ectopic endometrium group and eutopic endometrium group), and 21 patients free from endometriosis and adenomyosis (control group) were detected by immunohistochemical SABC methods. Statistical analysis was conducted for the correlation between the expressions of Nanog and Oct4 based on patients′ clinical pathological parameters. Results Nanog and Oct4 protein expressions in ectopic endometrium group were higher than that in control group (P<0.01);the expressions of Nanog and Oct4 in eutopic endometrium group and control group showed no significance (P > 0.05); there was positive correlation between the expressions of Nanog and Oct4 in ectopic endometrium group (r = 0.590, P < 0.01). Conclusion Nanog and Oct4 present high expression in eutopic and ectopic endometrium , which may play a important role in the development of endometriosis and adenomyosis.

This article provides the possible mechanism of acupuncture-moxibustion repair of gastric mucosal injury from central regulation and puts it forward that the nucleus of solitary tract is the primary regulation center for the injury repair and has the effect of collecting and integrating information. In addition, it is put forward that neural regulation is a main regulatory mechanism for the injury repair and besides, endocrine, immune and humoral regulations participates in the modulation and gastric mucosal repair involves a composite regulatory mechanism in which the central nervous system, neuroendocrine-immune network and neurohumoral regulation take part.

Alemtuzumab (Campath) was successfully injected in 21 kidney transplant patients,7 islet transplant patients and 1 simultaneous kidney and islet transplant patient for either prevention or treatment of graft rejection.Prophylactic administration was successfully completed in all patients without discontinuation.Adverse events were not observed in 11 patients (38%),but hypertension in 18 patients (62%),shivering in 3 patients (10.3%),high fever in 3 patients (10.3%),and bronchospasm in 1 patient (3%),respectively.All complications alleviated after proper therapy.During the prophylactic administration of alemtuzumab,strict,timely and proper ward-management was needed.Care for lung,perineum,skin,diet and psychological nursing were necessary.Neither graft acute rejection nor graft chronic rejection episode occurred in all patients during 6 months to 2 years follow-up.Therefore,long term effects of Alamtuzumab and consequences of lymphocytopenia need further observation.

Objective: To investigate the protective effect of moxibustion in initiating the endogenous protection information on gastric mucosa, and its relationship with the pathway of common peroneal nerve.Methods: Forty-eight Sprague-Dawley (SD) rats were randomly divided into a normal group (group A), a model group (group B), a moxibustion model group (group C) and a moxibustion model plus surgery group (group D), 12 in each group. Except for group A, rats in the other groups were treated with dehydrated ethanol and aspirin to prepare gastric mucosal damage model. The rats in group B were not treated with any interventions; rats in group C received moxibustion at Zusanli (ST 36), twice a day for continuous 3 d. The rats in group D were subjected to preparing the gastric mucosal damage model after the common peroneal nerve transection, followed by moxibustion at Zusanli (ST 36). After a 3-day intervention, ulcer index (UI) in each group was observed, and the levels of gastric mucosa-related repair cytokines of tumor necrosis factor-α (TNF-α), interleukin-4 (IL-4) and heat shock protein 70 (HSP70) were detected.Results: Compared with group A, the pathological changes and UI of group B were worse (P=0.000), but TNF-α in serum and tissue was changed significantly (P=0.000,P=0.002), IL-4 in serum and tissue was improved significantly (P=0.000, P=0.000). Compared with group B, TNF-α and IL-4 in group C and group D were significantly improved (TNF-α:P=0.003, P=0.016; IL-4:P=0.000,P=0.002). Compared with group C, the changes of UI in group B and group D were poor (both P=0.000); the levels of TNF-α and IL-4 in serum were significantly decreased (TNF-α:P=0.000,P=0.025; IL-4:P=0.000, P=0.034); and tissue HSP70 levels were decreased significantly (P=0.000,P=0.033).Conclusion: Zusanli (ST 36) can transmit information through the pathway of common peroneal nerve, regulate the release of gastric mucosal protective factors, and up-regulate the expression of cytothesis-related proteins, so as to achieve the effect in repairing gastric mucosa.

Objective To evaluate the effectiveness of peer support interventions on exclusive breastfeeding among primiparous women. Methods Randomized controlled trials (RCTs) that reportedthe effectiveness of peer support interventions on exclusive breastfeeding among primiparous women were retrieved in several electronic databases. Data were analyzed using RevMan 5.3 software after quality assessment and data extraction. Results A total of 9 RCTs which included 1435 patients were incorporated in this meta-analysis. The meta-analysis revealed that peer support interventions could increase the rate of exclusive breastfeeding(OR=2.84, 95％CI2.22-3.64, P<0.01), increase duration of exclusive breastfeeding(WMD=43.66, 95％CI28.04-59.27, P<0.01). Subgroup analysis showed that peer support increased the rate of exclusive breastfeeding atone month(OR=1.84,95％CI1.24-2.73, P<0.01), three months(OR=2.28, 95％CI1.67-3.12, P<0.01)and six months(OR=3.42,95％CI2.46-4.76, P<0.01) of postpartum. Conclusions Peer support interventions could increase exclusive breastfeeding rate and duration of exclusive breastfeeding. It is worth being popularized.

Objective: To explore the influence of body mass index (BMI) on postoperative complications and survival in patients with esophageal squamous cell carcinoma (ESCC) using propensity score matched (PSM) methods. Methods: We retrospectively analyzed clinical data of 533 patients with ESCC who were admitted for thoracic surgery in Shandong Provincial Hospital, between January 2011 and December 2012. After conducting PSM methods to balance the covariates, the incidence of postoperative complications and sur-vival rate were compared between the two groups. The effects of BMI on postoperative complications and survival were analyzed with multivariate Logistic regression and Cox proportional hazard analyses, respectively. Survival analysis was performed using Kaplan-Mei-er curves and Log-rank test. Results: After adjusting the PSM and confounding variables, the two groups were well matched (146 pa-tients each) without significant differences in baseline characteristics. The incidence of wound infection and respiratory system compli-cations in the H-BMI group (BMI≥25 kg/m2) were significantly higher than those in the N-BMI group (18.5-25 kg/m2) (P<0.05). H-BMI was an independent risk factor for wound infection and respiratory system complications. In the present study, no significant differ-ence was observed in the 3-year overall survival between H-BMI and N-BMI patients (54.1% vs. 47.8%, P=0.212). Patients with H-BMI had significantly better 5-year overall survival than those with N-BMI (39% vs. 25%, P=0.016). The subgroup analysis showed that pa-tients with H-BMI had a better overall survival than those with N-BMI in stages Ⅰ-Ⅱ (47.3% vs. 29.0%, P=0.032). However, this difference was not significant when patients were stratified into stages Ⅲ and Ⅳ (24.5% vs. 16.7%, P=0.393). Conclusions: H-BMI appears not to decrease the overall survival of patients with ESCC. Therefore, ESCC in patients with H-BMI can receive surgical treatment safely, but proper intraoperative management and close postoperative monitoring should be performed.