Objective To investigate the causes of fever in systemic lupus erythematosas (SLE)patients and identify the characteristics of the fever caused by SLE fever infection after steroid therapy.Methods From January 2002 to May 2007, 487 SLE hospitalized patients with fever were admitted and their data were retrospectively studied. The clinical manifestations and medications were followed up. A case control design was carried out to identify the differences between fever caused by lupus and infection. Results Among all the 487 patients, 265 had infection, 206 had fever that was caused by SLE per se, fever caused by both lupus and concurrent infection was confirmed in 8 patients, malignancy and miscellaneous were the causes of fever in 4 respectively. The most common sites of infection were respiratory tract (61.3%), skin and mucosa (10.9%) and central nervous system (9.1%). The main microorganisms isolated were bacteria (77.4%), fungi (13.5%) and virus (7.8%). Prednisene ≤ 100 mg/d could suppress fever caused by lupus in 81.0% patients, usually within 1 to 5 days. In the case control study, lower C3, C4 and CH50, anemia, lymphocytosis, higher immunoglobulin levels, elevated anti-dsDNA antibodies, elevated anti-nuclear antibodies and higher SLEDA1 score were associated with SLE fever. Long SLE duration, old age, elevated CRP levels,leukocytosis, neutrophilia, high accumulated doses of prednisone and ever use of immunosuppressive medications were factors associated with infection. Conclusion The fever of in-patient SLE patients is mainly caused by infections and disease flare. Moderate dose of steroid therapy is effective to control the fever caused by lupus flare. The fever caused by SLE has different clinical features and laboratory results when compared to that caused by infection although both responses to steroid therapy.

Objective To investigate the expression of miR-218 in cervical cancer tissues and bioinformatically analyze the target genes of miR-218 to provide theoretical basis on further studies of miR-218 functions in cervical cancer.Methods miRNA array was applied to detect miRNA expression profile in cervical cancer tissues,and real-time RT-PCR was used for validation.The bioinformatic analysis of the target genes of miR-218 involved gene ontology and signal transduction pathway enrichment was performed.Results miR-218 expression significantly decreased in cervical cancer tissues compared with that of normal cervical tissues.The functions of predicted target genes of miR-218 were enriched in biological regulation,adhesion and motion,proteometabolism,cellular differentiation,protein binding and other biological processes and molecular functions.According KEGG pathway database,the predicted target genes involved in pathway in cancer,adherent junction,focal adhesion,prostate cancer,chronic myeloid leukemia,melanoma,and other signal transduction pathways.Conclusions miR-218 expression significantly decreases in cervical cancer tissues.Some of the predicted target genes of miR-218 are significantly enriched in tumor related with signaling pathways.

Objective To investigate the influence of RNAi gene silence on the chemosensitivity of human digestive system neo-plasms .Methods Esophageal cancer EC109 cells and gastric adenocarcinoma SGC-7901 cells were selected and divided into the transfection group and the blank control group for culturing .Two cell lines in the transfection group were transferred by siRNA and silenced the expression of Survivin ,giving cisplatin 5 mg/L to co-culture for 72 h .The blank control group was given the conven-tional culture and the same dose of cisplatin for co-culture for 72 h .The in vitro proliferation rate of cells in the two groups were measured by MTT and their sensitivities to the chemotherapy drug cisplatin were compared .Results After siRNA silencing the ex-pression of Survivin in SGC-7901 and EC109 cell lines ,the sensitivity of cells to cisplatin drugs was increased .MTT results sugges-ted that the proliferation activity of cells was significantly lower than that in the non-silence cell lines ,the difference showing statis-tical significance(P<0 .05) .Conclusion Adopting RNAi gene silencing technique can interfere the expression of Survivin gene ,in-hibit the proliferation of tumor cell ,and at the same time significantly improve the sensitivity of tumors to chemotherapy .

Objective To evaluate the effect of cell-penetrating peptide (protein transduction domain 4,PTD4) mediated copper-zinc superoxide dismutase (Cu/Zn SOD) on hypoxia/reoxygenation injury (HRI) in rat myocardial cells.Methods Rat myocardial cell H9C2 HRI model was prepared by using the anaerobic incubator (85% N2,10% H2,5% CO2).The HRI group (without adding any treating factor in HRI cell culture fluid),HRI+Cu/Zn SOD group (adding 10 μmol/L Cu/Zn SOD) and HRI+PTD4-Cu/Zn SOD group (10 μmol/L PTD4-Cu/Zn SOD) were set up.In addition,normally cultured myocardial cells served as the normal control group.After incubating for 30 min,the ultra microstructure of mitochondria was observed under transmission electron microscope.The mitochondrial membrane potential was detected by JC-1 kit.The myocardial cell apoptosis was detected by TdT mediated dUTP nick end labeling TUNEL technique.Results The mitochondria injury degree after 30 min incubation in the PTD4-Cu/Zn SOD group was significantly improved compared with the HRI group.Compared with the normal control group,the mitochondrial membrane potential in the HRI group was significantly decreased,while the mitochondrial membrane potential in the PTD4-Cu/Zn SOD group was lower than that in the normal control group,but compared with the HRI group,which was obviously recovered.The cardiomyocyte apoptosis in the HRI+PTD4-Cu/Zn SOD group was (10.20±2.77)%,which was significantly decreased compared with (28.40±2.41)% in the HRI group,the difference was statistically significant (P<0.05).Conclusion PTD4 mediated Cu/Zn SOD can attenuate HRI in rat myocardial cells.

Objective To investigate the change expression levels of secreted frizzled related protein 5 (SFRP5) mRNA and protein in human adipose,and muscle tissues and the relationship between SFRP5 and insulin resistance in different glucose tolerance subjects.Methods Twelve type 2 diabetes mellitus(T2DM) patients and 12 aged and sex-matched healthy control subjects were enrolled.T2DM patients were diagnosed by1999 WHO criterion.Under the same conditions,the omental adipose and muscle tissues from these patients undergoing elective abdominal surgery were obtained.Expressions of sfrp5 protein and mRNA in adipose and muscle tissues were determined by semi—quantitive RT-PCR and Western blot while body height,weight,waist circumference,hipcircumference,blood pressure,lipodemia,fasting plasma glucose,fasting insulin,glycosylated hemoglobin,fasting serum insulin(FINS),HOMA-β,HOMA-insulin resistance index(HOMA-IR) etc were investigated.Results 1.SBP,TG,FPG,2 h PG,Fins,HOMA-IR,HbA1C were significantly higher in T2DM groups than in the control group.2.The expressions of SFRP5 mRNA and protein in omental adipose tissues were significantly higher inT2DM group than in the control group(P ＜ 0.01).3.The level of SFRP5 mRNA and protein expressions were higher in omental adipose tissue than in the muscle tissues.Conclusions The fact that mRNA and protein expression level of SFRP5 was higher in adipose tissue than in muscle indicates adipose tissue may be the main source of SFRP5.The expressions of SFRP5 mRNA and protein were higher inT2DM group than in the control group indicates sfrp5 may play a role in insulin resistance.

Objective To explore the role of proton MR spectroscopic imaging(1H-MRSI)and diffusion tensor imaging(DTI)in the diagnosis of adrenoleukodystrophy and to demonstrate the involvement of fibers by using the technique of DTT.Methods 1H-MRSI,DTI and routine imaging examinations were performed in 6 patients with ALD.The values of NAA,Cho,Cr,ADC,and FA were evaluated in different regions of lesion.The involved fibers were demonstrated by using the technique of DTT.Results The ratios of NAA/Cr(0.55±0.19)and NAA/Cho(0.22±0.11)were lower(F=7.693,7.751),and Cho/Cr(2.54±0.37)was higher(F=6.348)in the initial lesions,where higher ADC values(1.49±0.36,F=5.226)and the lowest FA values(0.21±0.08,F=5.139)were also observed(P＜0.05).The decreases of NAA/Cr(1.16±0.03)and NAA/Cho(0.45±0.17)in adjacent regions were more distinct than those of remote regions(t=1.769,1.842,P＜0.05).In the developing regions,the ADC values(0.89±0.03)were lower and the FA values(0.45±0.07)were the highest.There was negative correlation between NAA/Cho and ADC values(r=-0.71,P＜0.05),and there was positive correlation between NAA/Cho and FA values(r=0.31,P＜0.05).Discontinuations and fragments of fibres were observed in corpus callosum and pyramidal tract.Conclusions Combination of 1H-MRSI and DTI can offer a sensitive method for the early diagnosis and monitor the progress of white matter.DTT can be used to directly observe the involvement of fibers.

Medical educational internationalization has already made teaching medical courses in English more and more important.Nephrology department in Tongji hospital affiliated to Tongji medical college,Huazhong university of science and technology has assumed the responsibility of teaching in English for medical students of five-year program,six-year program,seven-year program,eight-year program,and abroad student for several years.They practiced teaching in English in theory teaching,PBL teaching and clinical teaching according to the characteristics and requisitions of students in different educational systems.They accumulated some experiences,which was conducive to improving the quality of teaching in English.

Teaching urinary system diseases by problem-based learning method for eight-year program medical students was applied in nephrology department in affiliated Tongji hospital of Huazhong university of science and technology since 2008.They had accumulated experiences in compiling teaching plan,fostering teachers,practicing teaching and evaluating teaching.These steps may future intensify education reform on long schooling system and improve teaching quality of eight-year program.

Objective:To compare 5-year overall survival (OS) and disease free survival (DFS) between preoperative three dimensional conformal radiotherapy (3DCRT) and volumetric medulated arc therapy (VMAT) concurrently combined with chemotherapy for locally advanced rectum cancer (LARC), and analyze the value of induction and/or consolidation chemotherapy in these circumstances.Methods:334 patients with LARC treated with preoperative 3DCRT (172 cases) and VMAT (162 cases) concurrently combined with chemotherapy, main protocol XELOX (capecitabine plus oxaplatin), and subsequent surgery in Sun Yat-sen University from May 2007 to April 2013 were retrospectively analyzed. The radiation prescription dose for VMAT group was 50 Gy 25 fractions for planning target volume1(PTV 1), and 46 Gy 25 fractions for PTV 2. The radiation prescription dose for 3DCRT group was 46 Gy 23 fractions for PTV 2. One hundred and eighty-five cases of all received preoperative concurrent chemoradiotherapy (namely, CCRT group), 149 cases received preoperative concurrent chemoradiotherapy plus median 2 courses (1-7 courses) induction and/or consolidation chemotherapy (namely, CCRT±induction chemotherapy±consolidation chemotherapy group), whose main chemotherapy protocol was XELOX. Difference of 5-year OS and DFS between 3DCRT and VMAT group was compared. The rate differences of acute toxicity during chemoradiotherapy, postoperative complications, ypCR, and survival between CCRT group and CCRT±induction chemotherapy±consolidation chemotherapy group were analyzed. Results:After a median follow-up of 62.3 months (2.4-119months) for the 334 patients, no any significant difference for 5-year OS (79.0% vs. 83.2%, P=0.442) and 5-year DFS (77.0% vs. 82.1%, P=0.231) between 3DCRT and VMAT group was observed. There was no any significant difference for the Grade 3 hematological toxicity (7.0% vs. 12.1%, P=0.114) and non-hematological toxicity (14.1% vs. 16.8%, P=0.491) during chemoradiotherapy, postoperative complications (17.3% vs. 17.4%, P=0.971), ypCR rate (25.4% vs. 30.2%, P=0.329), 5-year OS (80.5% vs. 82.0%, P=0.714) and 5-year DFS (78.8% vs. 81%, P=0.479) between CCRT group and CCRT±induction chemotherapy±consolidation chemotherapy group. Conclusions:Compared with 3DCRT, the physics advantage of VMAT technique does not significantly convert into clinical benefits and improve 5-year OS and DFS, even further boosting radiation dose to the gross tumor volume. It is safe for median 2 courses of induction and/or consolidation chemotherapy before and or after preoperative concurrent chemoradiotherapy in the treatment of LARC, though it does not significantly improve ypCR rate and survival.