Objective To study the expression feature and clinical significance of plasma Protein C(PC) in pre‐PICC placement and post‐PICC placement in patients with cancer .Methods The levels in plasma of PC was tested by ELISA in patients with cancer in one day before PICC placement ,in one day ,30 day ,and 90 day after PICC placement ,the change of feature and clinical signifi‐cance was analyzed .Results The levels of PC in one day after PICC placement were 3 .74 ± 1 .99 μg/L ,the levels was lower than the levels of in one day before ,and in 30 ,90 day after PICC placement ,which were 5 .00 ± 2 .40 ,4 .78 ± 2 .41 and 5 .35 ± 2 .71 μg/L (q=3 .74 ,2 .85 and 4 .58 respectively ,P<0 .05);There were no statistical significance both in D‐D levels and PLT count among pre‐PICC and post‐PICC placement(P>0 .05);There were no correlation both PC levels and D‐D levels ,and both PC levels and PLT count(r= -0 .024 1 and 0 .111 0 ,all P>0 .05) .Conclusion The PC levels in one day after PICC placement were lower ,but there were no correlation both PC and D‐D ,and PLT .PICC catheter were safety .

Objective To study the expressions of Hepcidin,bone morphogenetic protein 6 (BMP6) and hemojuvelin (HJV) in gastric cancer,and to explore their relationships with clinical pathological characteristics.Methods Hepcidin,BMP6 and HJV were detected by immunohistochemistry in 62 cases of gastric cancer patients,and the relationships among them and clinical pathological features were analyzed.Results Compared with normal gastric mucosa tissues,Hepcidin was highly expressed in gastric cancer tissues (13.3％ vs.56.5％,x2 =8.99,P ＜ 0.01),while the differences of the expression of BMP6 and HJV in the two groups were not statistically significant (60.0％ vs.40.3 ％,x2 =1.89,P ＞ 0.05;93.3％ vs.83.9％,x2 =0.88,P ＞ 0.05).The expression of Hepcidin was related to T stage (x2 =6.98,P =0.02),but it was not related to age,sex,lymph node metastasis,distant metastasis and anemia.The expressions of BMP6 and HJV were not related to T stage,age,sex,lymph node metastasis,distant metastasis and anemia.Hepcidin was not related to the expressions of BMP6 and HJV (r=0.13,P＞0.05;r=0.15,P＞0.05).Conclusion Hepcidin is highly expressed in gastric cancer tissues,which is related to the T staging of gastric cancer,and can be used as an objective indicator of the biological behavior of gastric cancer.There were no differences in the expression of BMP6 and HJV between normal gastric mucosa and gastric cancer tissues.

Objective To study the expression and significance of Neogenin,Hepcidin and serum ferritin(SF)in patients with cancer-related anemia.Methods To test the serum levels of Neogenin,Hepcidin and SF in 107 cases,including 55 cases with cancer-related anemia and 52 cases of non-anemia with tumor by ABC-ELISA.Results ①The serum levels of Neogenin in patients with cancer-related anemia were 0.77 ± 0.45 ng/ml,which were lower than 0.98 ± 0.60 ng/ml in non-anemia group (t=2.003 8,P <0.05).The serum levels of Hepcidin in patients with cancer-related anemia were 6.03±4.25 μg/ml, which was higher than 4.51±2.23 μg/ml in non-anemia group (t=2.319 5,P <0.05).②There were no difference in pa-tients between anemia and non-anemia (t=1.898 0,P >0.05).③In patients with cancer,there were positive correlation be-tween Neogenin and Hb (r=0.212 4,t=2.226 4,P <0.05),there were negtive correlation between Hepcidin and Hb (r=-0.310 1,t=3.345 2,P <0.01),but there were no correlation between SF and Hb (P >0.05).④There were positive cor-relation between Hepsidin and SF (r=0.486 6,P <0.01).Conclusion There were lower expression of Neogenin,higher ex-pression of Hepcidin in patients with cancer-related anemia is a complex process.The abnormal expression of Neogenin and Hepcidin which were lead to the loss of use of iron are the key factors attribute to anemia in patients with cancer.

Objective To study the relationship between serum erythropoietin(Epo)level and chemotherapy-induced hemoglobin(Hb)level in elderly patients with cancer. Methods　One hundred senile patients(aged≥60 years)with cancer and one hundred and seventy non-senile patients(aged＜60 years)with cancer were selected as aged group and control group,respectively.The serum Epo level was detected by enzyme-linked immunosorbent assay(ELISA). Results　(1)The average levels of the serum Epo in aged group and control group were(22.0±15.1)U/L and(30.4±21.8)U/L,respectively(t=1.2988,P＞0.05).A negative correlation was found between the levels of Epo and Hb in elder cancer patients(r=0.3700,P＜0.001).(2)The levels of serum Epo were(14.7±10.6)U/L,(20.2±9.0)U/L and(42.3±24.8)U/L in 55 cases with normal Hb level,22 cases with mild anemia and 23 cases with moderate to severe anemia,respectively(F=11.6886,P＜0.01).(3)The levels of Epo were(20.2±10.8)U/L,(45.2±39.1)U/L and(25.8±15.9)U/L before chemotherapy,after 4 treatment cycles and 2 treatment cycles respectively(F=4.5477,P＜0.01).The levels of Hb were(111.0±20.5)g/L,(96.8±16.6)g/L and(102.1±19.3)g/L before chemotherapy,after 4 treatment cycles and 2 treatment cycles respectively(F=4.0071,P＜0.01).Conelusions　There is no statistical difference in serum Epo level between senile patients with cancer and non-senile patients with cancer.but serum Epo levelis higher in patients with anemia than without anemia.There is a negative correlation between the levels of Epo and Hb.Chemotherapy can decrease the level of Hb and increase the serum 1evel of Epo in part of patients.The changes are correlated with the conditions of patients before chemotherapy and the time of chemotherapy.

Background and purpose:It was reported that erythropoietin may directly or indirectly induce the tumor cells to proliferate and result in diseases progression when recombinant human erythropoictin is used clinically in cancer-related anemia.Recently,the expression of erythropoietin-receptor(Epo-R)was detected in breast cancer.This study was done to detect the expression of Epo-R,estrogen receptor(ER),progesterone receptor(PR)and human epidermal growth factor receptor 2(Her-2)in breast cancer,and to investigate the relationships between these indexes and the clinical significance.Methods:Sixty breast cancer patients were analyzed,the expression of Epo-R and microvascular density(MVD)were detected by immunohistochernistry,in order to clarify the relationships between the expression level of Epo-R,MVD and ER,PR,Her-2.Results:The rate of Epo-R expression was 78.3%,the mean number of positive tumor cells was 39±24,while the tissue MVD was 25±9.The expression level of Epo-R was positively correlated with the MVD.Also,the level of MVD was higher in the group of Epo-R positive than the negative,which has significant difference(t=3.4252,P＜0.001).The expression level of ER,PR has no definite relationships with Epo-R,MVD.The expression level of Her-2 was both closely associated with Epo-R,MVD.The expression level of Epo-R has an obvious relationship with clinical stage,lymph node status and the size(P＜0.001).The value of MVD was positively correlated with lymph node status,while not with clinical stage and the size.Conclusion:The expression level of Epo-R was markedly higher in breast cancer,and has a positive correlation with the tissue MVD.The expression level of Epo-R and MVD were significantly associated with Her-2,but not with ER and PR.It may contribute to clarifying the clinicopathological characteristics and prognosis of breast cancer by detecting both the expression level of Epo-R and MVD.

Objective To investigate the clinical significance of compensatory angiogenesis and the angiosome-based revascularization strategy for endovascular procedures in treating infrapopliteal critical limb ischemia in elderly diabetic patients.Methods A retrospective study of 194 patients with diabetic feet (Fontaine Ⅳ) who had undergone endovascular procedures at our hospital from January 2005 to December 2014 was performed.Based on the angiosome concept,all subjects were classified into the direct revascularization group (DR group),the indirect revascularization through collaterals group (IR-tc group) and the indirect revascularization without collaterals group (IR-wc group).After one-year follow-up,the therapeutic effects were analyzed and compared between the three groups.Results During the one-year follow-up,the rate of unhealed ulcers,the re-intervention rate and the rate of major adverse limb events (MALE) were higher in the IR-wc group than in the DR and IR-tc groups (P=0.000 and 0.000,P=0.025 and 0.013,P=0.014 and 0.023,respectively).The IR-wc group presented a lower limb salvage rate as compared with those in the DR and IR-tc groups (P=0.011 and 0.027).Patients with a single recanalized branch had a higher rate of unhealed ulcers than those with multiple recanalized branches in the IR-wc group (93.9％ vs.71.0％,P=0.015).Conclusions The angiosome-based revascularization strategy has shown important value in guiding endovascular procedures for patients with diabetic foot disease and,in particular,the compensatory angiogenesis approach appears to be critical in generating favorable short-term clinical outcomes in the treatment of diabetic foot disease.

Objective To study the expression and clinical significance of Livin ( anti-apoptosis protein) and Smac (promoting apoptosis factor) in patients with the non-Hodgkin lymphoma (NHL).Methods The expression of Livin and Smac were detected by immunohistochemical staining(SP) assay in 31 patients with NHL, and the relationship between Livin/Smac and clinical staging, IPI and prognosis were analyzed. Results The patients with positive expression of Livin had B symptom, high risk IPI, late clinical staging (Ⅲ/Ⅳ stage) and short survival time, while the ones with positive expression of Smac had no B symptom, early clinical staging( Ⅰ /Ⅱ stage), low risk IPI and good prognosis. The expressions of both Livin and Smac were not related to gender and age. Expression of Livin was not correlated to that of Smac (r =0.003,P ＞0.05). Conclusion For patients with NHL, the expression of Livin protein was related to poor prognosis and adverse clinical features, whereas the expression of Smac protein was related to good prognosis and clinical feature.

Objective To study the expression and significance of B-cell activating factor(BAFF) and a proliferation-inducing ligand(APRIL) in patients with idiopathic thrombocytopenic purpur(ITP). Methods The serum levels of BAFF and APRIL in 27 cases with ITP were tested by ELISA.Results ①The serum levels of BAFF in ITP were higher than those of control group (3.92?1.88?g/ml vs 2.90?0.52?g/ml,P

Taking the Department of Obstetrics and Gynecology as an example, this paper expounds a series of practices of online education, in the process from pre-course training, platform selection, curriculum design, to student evaluation, etc. From that, we can provide a reference for carrying out online teaching in response to the epidemic for clinical medical colleges which have not been exposed to the online course. Furthermore, it is a new attempt to explore a way to make a change of the traditional teaching method and deepen the reform of clinical teaching in our hospital after the epidemic, not only in professional medical education, but also in the popularization of medical knowledge.