Objective To discover the diagnose value of the urinary α1-microglobulin (α1-mG)\,albumin to the early lupus nephritis.Methods In 31 patients with systemic lupus erythematosus (SLE),the urinary α1-mG\,β2-microglobulin (β2-mG) and albumin were measured and compared with normal group.Results The results showed that the levels of α1-mG\,β2-mG and albumin were markedly increased in the SLE group.Either urinary RT is normal or not,the urinary α1-mG\,β2-mG and albumin is markedly increased compared with normal group.Conclusion The urimary α1-mG、albumin content might be used as a sensitive marker for early lupus nerphritis.

Objective To investigate the clinical efficacy of allogeneic cross-linked dermal dressing (ACLD) for the treatment of enteroatmospheric fistula (EAF) in patients with open abdomen (OA).Methods The clinical data of 44 patients with experienced trauma who received OA at Nanjing General Hospital of Nanjing Military Command from January 2011 to January 2014 were retrospectively analyzed.All patients received temporary abdominal closure (TAC) by modified sandwich-vacuum package (MSVP).From January 2011 to December 2012,33 patients with OA received vaseline gauze as abdominal cover layer (VG group),and from January 2013 to January 2014,11 patients with OA received allogeneic cross-linked dermal dressing as abdominal cover layer (ACLD group).Patients were followed up via outpatient examination or telephone interview till October 2014.The incidence of EAF,time for skin-grafting,hematologic indexes in 2 weeks after surgery (white blood cell counts,percentage of neutrophil,the mean value of procalcitonin and C reactive protein),the duration of postoperative hospital stay,hospital expenses and survival rates in the 2 groups were analyzed using t-test,repeated measures analysis of variance and Fisher's exact test.Results The incidence of EAF in the VG group and ACLD group was 42.4％ (14/33) and 0,respectively,with a significant difference between the 2 groups (P ＜ 0.05).The duration of skin-grafting was (15 ±6) days in the VG group and (11 ±3)days in the ACLD group,with a significant difference between the 2 groups (t =2.10,P ＜ 0.05).The mean values of preoperative procalcitonin and postoperative procalcitonin at day 1,3,7,14 in the VG group were (1.20 ± 0.60)pg,/L and (2.50-± 0.90)pg,/L,(1.70 ± 0.30) pg/L,(1.90 ± 0.40) μg/L and (2.70 ± 0.60) μg/L,which were significantly higher than that of (0.90 ± 0.30) μg/L and (1.80 ± 0.60) μg/L,(1.30 ± 0.50) μg/L,(0.60 ± 0.20) μg/L and (0.30 ± 0.07) μg/L in the ACLD group (F =8.50,P ＜ 0.05).The white blood cell counts and percentage of neutrophil and the percentage of C reactive protein between the 2 groups were changed from (13.8 ±2.4) × 109/L,(12.9 ± 2.1) × 109/L,0.90±0.09,0.88 ±0.06,(81 ± 19)mg/L,(136 ±28)mg/L to (16.2 ±3.3) × 109/L,(7.9 ± 3.0) x 109/L,0.85 ±0.12,0.79 ±0.09,(131 ±30)mg/L,(59 ±22)mg/L at postoperative day 14,showing no significant difference between the 2 groups (F =3.10,0.50,1.20,P ＞ 0.05).Duration of hospital stay and hospital expenses in the VG group and ACLD group were (137 ±32)days,(638 831 ± 113 670) yuan and (82 ± 44)days,(474 839 ± 78 543)yuan,respectively,with a significant difference between the 2 groups (t =3.60,4.43,P ＜ 0.05).The time of follow-up and overall survival rate in the VG group and ACLD group were 29 to 38 months and 81.8％ (27/33),and 10 to 20 months and 90.9％ (10/11),respectively,with no significant difference (P ＞ 0.05).Conclusion Allogeneic cross-linked dermal dressing as abdominal cover layer can effectively decrease EAF in patients with open abdomen.

The effectiveness and safety of acupuncture combined with western medicine for angina of coronary artery disease are evaluated. Databases including Pubmed, Embase, Cochrane Library, CBMDisk,. CNKI, Wanfang, Chinese Clinical Trial Registry, etc. are searched with search time from beginning of the database establishment to January of 2014. As a result, totally 15 articles of acupuncture for angina of coronary artery disease that met the inclusive criteria were collected, involving 11 researches and 1 232 patients. The results of Meta-analysis indicate that based on regular western medicine, additional use of acupuncture could further improve symptoms of angina, increase efficacy of electrocardiogram (ECG) and reduce the dosage of nitroglycerin, in the meanwhile the hemorheology could be ameliorated, and the contents of C reactive protein (CRP), malondialdehyde (MDA), lipid peroxide (LPO), endothelin (ET) could be reduced, while the contents of superoxide dismutase (SOD) and nitric oxide (NO) could be increased; besides, the occurrence rate of cardiovascular event could be reduced without causing obvious adverse events. Except for certain outcomes (including dynamic ECG and blood viscosity) those have no statistical significance between treatment group and control group, the differences of remaining outcomes are: statistically significant. It is believed that acupuncture combined with regular treatment of western medicine are effective treatment plan for angina of coronary artery disease, which are superior to regular treatment of western medicine, but the results of this systematic review be taken with caution, and more clinical trials with high quality are looking forward to be included into Meta-analysis to increase the level of evidence.
Acupuncture Therapy ; Combined Modality Therapy ; Coronary Artery Disease ; drug therapy ; therapy ; Female ; Humans ; Treatment Outcome

Objective To explore the clinical value of human acellular dermal matrix (HADM) in giant complex abdominal wall reconstruction (GCAWR) after open abdomen.Methods The retrospective crosssectional study was conducted.The clinical data of 6 patients with severe trauma who were admitted to the Nanjing General Hospital of Nanjing Military Command of Nanjing University School of Medicine between January 2013 and January 2014 were collected.After open abdomen,fascia of the abdominal wall was fully freed using the component separation,and abdominal wall defects were reconstructed using HADM in the rectus abdominis anterior sheath and peritoneal layers bridge-type suture.Observation indicators:(1) intra-and post-operative situations:operation time,volume of intraoperative blood loss,removal time of postoperative drainage-tube,postoperative complications,duration of hospital stay and hospital expenses;(2) follow-up situations:recurrence of abdominal wall hernia at postoperative year 2.Follow-up using outpatient examination and telephone interview was performed to detect the recurrence of abdominal wall hernia up to April 2016.Measurement data with normal distribution were represented as ~±s.Results (1) Intra-and post-operative situations:6 patients underwent successful surgery.Operation time,volume of intraoperative blood loss and removal time of postoperative drainage-tube were respectively (77±9)minutes,(225±57)mL and (8±3)days.Two patients with postoperative seroma were cured by conservative treatment.One patient with postoperative anastomotic leakage received continuously irrigation and drainage,and leakage was stopped using the biomedical fibrin glue.There was no abdominal bulge of the 6 patients in hospital.Duration of hospital stay and hospital expenses were respectively (10±3) days and (12±7) × 104 yuan.(2) Follow-up situations:6 patients were followed up for 14-28 months,with a median time of 23 months.Two patients had relaxation and bulge of HADM in peritoneal layer at postoperative 2 years,without bulge of HADM in the rectus abdominis anterior sheath layer.There were no occurrence of abdominal wall hernia,chronic pain,paraesthesia,swelling in the local area and other adverse reaction.Conclusion Using of HADM in the rectus abdominis anterior sheath and peritoneal layers bridge-type suture is safe and feasible for GCAWR,with good short-term outcomes.

Colorectal cancer (CRC) is one of the leading causes of death worldwide. Thus, the development of new therapeutic targets for CRC treatment is urgently needed. SGK1 is involved in various cellular activities, and its dysregulation can result in multiple cancers. However, little is known about its roles and associated molecular mechanisms in CRC. In present study, we found that SGK1 was highly expressed in tumor tissues compared with peri-tumor samples from CRC patients. In vitro experiments revealed that SGK1 overexpression promoted colonic tumor cell proliferation and migration and inhibited cell apoptosis induced by 5-fluorouracil (5-FU), while SGK1 shRNA and inhibitors showed the inverse effects. Using CRC xenograft mice models, we demonstrated that knockdown or therapeutic inhibition of SGK1 repressed tumor cell proliferation and tumor growth. Moreover, SGK1 inhibitors increased p27 expression and promoted p27 nuclear accumulation in colorectal cancer cells, and p27 siRNAs could attenuate the repression of CRC cell proliferation induced by SGK1 inhibitors. Collectively, SGK1 promotes colorectal cancer development via regulation of CRC cell proliferation, migration and survival. Inhibition of SGK1 represents a novel strategy for the treatment of CRC.
Animals ; Apoptosis ; Cause of Death ; Cell Proliferation ; Colon ; Colorectal Neoplasms* ; Fluorouracil ; Heterografts ; Humans ; In Vitro Techniques ; Mice ; Repression, Psychology ; RNA, Small Interfering

Objective To analyze the clinical value of postoperative radiotherapy for node-positive middle thoracic esophageal squamous cell carcinoma ( TESCC ) and to modify the target volume .Methods A total of 286 patients with node-positive middle TESCC underwent radical surgery in Cancer Hospital, Chinese Academy of Medical Sciences, from 2004 to 2009.In addition, 90 of these patients received postoperative intensity-modulated radiotherapy.The Kaplan-Meier method was used to calculate survival rates, and the log-rank test was used for survival difference analysis.The Cox model was used for multivariate prognostic analysis.The chi-square test was used for comparing the recurrence between patients receiving different treatment modalities.Results The 5-year overall survival ( OS) rates of the surgery alone ( S) group and surgery plus postoperative radiotherapy ( S+R) group were 22.9%and 37.8%, respectively, and the median OS times were 23.2 and 34.7 months, respectively ( P=0.003) .For patients with 1 or 2 lymph
node metastases (LNMs), the 5-year OS rates of the S group and S+R group were 27.3%and 44.8%, respectively ( P=0.017);for patients with more than 2 LNMs, the 5-year OS rates of the S group and S+R group were 16.7%and 25.0%, respectively (P=0.043).The peritoneal lymph node metastasis rates of N1 , N2 , and N3 patients in the S group were 2.9%, 10.9%, and 20.0%, respectively ( P=0.024) .The S+R group had a significantly lower mediastinal lymph node metastasis rate than the S group ( for patients with 1 or 2 LMNs:8.0%vs.35.3%, P=0.003;for patients with more than 2 LNMs, 10.0%vs.42.3%, P=0.001) , and had a prolonged recurrence time compared with the S group ( 25.1 vs.10.7 months, P=0.000) .However, for patients with more than 2 LNMs, the S+R group had a significantly higher hematogenous metastasis rate than the S group (46.7%vs.26.1%, P=0.039).Conclusions Patients with node-positive middle TESCC could benefit from postoperative radiotherapy.The target volume can be reduced for patients with 1 or 2 LNMs.Prospective studies are needed to examine whether it is more appropriate to reduce the radiotherapy dose than to reduce the target volume for patients with more than 2 LNMs.A high hematogenous metastasis rate warrants chemotherapy as an additional regimen.

Tibetan medicine is an important part of traditional Chinese medicine with a long history，complete theories and rich contents. As the core of the sustainable development of Tibetan medicine，the reserve of Tibetan medicine is an important strategic resource of the country. The Stainless Crystal Minrror：A Tibetan Materia Medica is based on the classic book Crystal Pearl Materia Medica. Combined with modern Tibetan medicine，it has collected and introduced more than 1 430 Tibetan medicines and equipped with more than 1 200 colorful pictures of medicinal materials，which has important reference value for the research of Tibetan medicines and the establishment of quality standards. This paper starts from three perspectives of "data analysis-plant distribution-Tibetan medicine classification". Based on The Stainless Crystal Minrror：A Tibetan Materia Medica，the database of plant Tibetan medicine was constructed and analyzed statistically，and the correlation between regional distribution，medicinal parts，altitude and medicinal properties of plant Tibetan medicine was explored. The results showed that The Stainless Crystal Minrror：A Tibetan Materia Medica contained 711 plant medicines，involving 127 families and 368 genera. Angiosperms accounted for 94.1%，among which compositae had 34 genera and 74 species，occupying the first place. There are 10 medicinal parts of plant Tibetan medicine，of which 327 species （44.9%） use whole grass.The average altitude of Tibetan medicine is 3 500 m，among which 81.0% grow above 3 000 m.There is a relationship between altitude and medicinal parts and taste Classification of Tibetan medicines is usually based on the classification of the general drug name，Tibetan name，primitive and family. The analysis of plant medicine resource varieties in The Stainless Crystal Minrror：A Tibetan Materia Medica is beneficial to the effective utilization of Tibetan medicine plant resources.

Objective:To investigate the distribution and antimicrobial resistance profile of clinical bacteria isolated from blood culture in China.Methods:The clinical bacterial strains isolated from blood culture from member hospitals of Blood Bacterial Resistant Investigation Collaborative System (BRICS) were collected during January 2016 to December 2017. Antibiotic susceptibility tests were conducted by agar dilution or broth dilution methods recommended by US Clinical and Laboratory Standards Institute (CLSI) 2019. WHONET 5.6 was used to analyze data.Results:During the study period, 8 154 bacterial strains were collected from 33 hospitals, of which 2 325 (28.5%) were Gram-positive bacteria and 5 829 (71.5%) were Gram-negative bacteria. The top 10 bacterial species were Escherichia coli (34.7%), Klebsiella pneumoniae (15.8%), Staphylococcus aureus (11.3%), coagulase-negative Staphylococci (7.4%), Acinetobacter baumannii (4.6%), Pseudomonas aeruginosa (3.9%), Enterococcus faecium (3.8%), Streptococci (2.9%), Enterobacter cloacae (2.7%) and Enterococcus faecalis (2.5%). Methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-resistant coagulase-negative Staphylococcus (MRCNS) accounted for 34.2%(315/922) and 77.7%(470/605), respectively. No vancomycin-resistant Staphylococcus was detected. The resistance rate of Enterococcus faecium to vancomycin was 0.6%(2/312), and no vancomycin-resistant Enterococcus faecium was detected. The ESBLs-producing rates in Escherichia coli, Klebsiella pneumoniae and Proteus were 55.7%(1 576/2 831), 29.9%(386/1 289) and 38.5%(15/39), respectively. The incidences of carbapenem-resistance in Escherichia coli, Klebsiella pneumoniae were 1.2%(33/2 831), 17.5%(226/1 289), respectively. The resistance rates of Acinetobacter baumannii to polymyxin and tigecycline were 14.8%(55/372) and 5.9%(22/372) respectively, and those of Pseudomonas aeruginosa to polymyxin and carbapenem were 1.3%(4/315) and 18.7%(59/315), respectively. Conclusion:The surveillance results from 2016 to 2017 showed that the main pathogens of blood stream infection in China were gram-negative bacteria, while Escherichia coli was the most common pathogen; the MRSA incidence was lower than other surveillance data in the same period in China; carbapenem-resistant Escherichia coli was at a low level during this surveillance, while carbapenem-resistant Klebsiella pneumoniae is on the rise.