Objective To investigate the clinical value of joint detection of procalcitoninl (PCT ) ,C-reactive protein (CRP) ,and myocardial enzymes in patients with neonatal hyperbilirubinemia .Methods 30 cases of each cause were included in the study ,which were neonatal hyperbilirubinemia caused by sepsis ,pneumonia ,ABO hemolytic and breast milk jaundice .20 cases of each cause were selected including neonatal hyperbilirubinemia caused by neonatal hepatitis and low birth weight infants .All the cases involved in the study were diagnosed .30 healthy full-term newborns in the same period were recruited as control group .PCT ,CRP and myocar-dial enzymes (AST ,CK ,CK-MB ,and LDH) concentration in serum were determined .Results Compared with the control group , CRP and PCT concentration increased significantly in bacterial infected group (P< 0 .05) .Myocardial enzyme concentration in-creased significantly both in infected group and non-infected group(P<0 .05) .Among myocardial enzymes ,CK-MB concentration increased significantly in bacterial infected group ,low birth weight infants group and ABO hemolytic group(P<0 .01) and increased significantly in breast milk jaundice group and hepatitis group (P<0 .05) .AST and LDH concentration increased very significantly in hepatitis group(P<0 .01) .The specificity of PCT in bacterial infected group was significantly higher than that of CRP (P<0 .05) ,while its sensitivity was significantly lower than that of CRP in pneumonia group (P<0 .01) .Conclusion Changes of PCT , CRP and myocardial enzymes concentration are related to the occurrence and development of neonatal hyperbilirubinemia ,determi-nation of these indicators can be complementary .

OBJECTIVETo deepen the understanding of clinical manifestations and treatment of patients with positive lupus anticoagulant (LAC).

METHODSThe clinical data of 2 patients were analyzed and related literature were reviewed.

RESULTSCase 1, a 31-year-old female, diagnosed as lupus anticoagulant positive, secondary to undifferentiated connective tissue disease, was presented with menorrhagia and thrombocytopenia. Anti-nuclear antibody (ANA) was positive 1:1000 (homogeneous type) with anti-double stranded DNA positive, and dRVVT LA1/LA2 was 3.4. Coagulation function was alleviated after treatment with glucocorticoid and total glucosides of paeony. Case 2, a 59-year-old female was presented with gingival bleeding, hematuria with the level of F II:C 13%. dRVVT LA1/LA2 was 2.0. Anti-nuclear antibody (ANA) was positive 1:1000 (type of cytoplasmic granule), anti-double stranded DNA was positive. The patient was diagnosed as hypoprothrombinemia-lupus anticoagulant syndrome (LAHS) and acquired coagulation factor deficiency. The signs of hemorrhage were alleviated after treatment with methylprednisolone 40 mg/day and cyclophosphamide, while the level of F II:C was below normal.

CONCLUSIONSymptoms of patients with positive LAC are variable. The diagnosis relies on history of disease and laboratory test. Currently, there is no standardized treatment. Cases of LAHS should be thoroughly investigated for any known causes and related disorder.

Adult ; Blood Coagulation ; Cyclophosphamide ; therapeutic use ; Female ; Glucocorticoids ; therapeutic use ; Hematologic Tests ; Hemorrhage ; Humans ; Hypoprothrombinemias ; diagnosis ; Lupus Coagulation Inhibitor ; blood ; Methylprednisolone ; therapeutic use ; Middle Aged

Objective:To analyze the role of baseline mesorectal fascia (MRF) status and the correlation between MRF changes and prognosis after neoadjuvant therapy in patients with locally advanced rectal cancer.Methods:Totally 321 patients with locally advanced rectal cancer were retrospectively analyzed from January 2014 to December 2016 in Peking University Cancer Hospital. All patients underwent surgery after neoadjuvant radiotherapy and chemotherapy, and were followed up regularly after surgery. The MRF status, extramural vascular invasion (EMVI) status, tumor location, tumor stage and lymph node status were evaluated on baseline MRI. For patients with positive baseline MRF, preoperative MRF status was also evaluated. Chi-square test or independent t test were used to compare the characteristics between MRF positive and negative patients. Kaplan-Meier curve, log-rank test and multivariate Cox regression were used to analyze the correlation between imaging features and prognosis. Results:In all of the 321 subjects, 193 (60.1%) had positive baseline MRF, 54 (28.0%) of the 193 patiens had negative MRF after neoadjuvant therapy, and 139 (72.0%) of them still had positive MRF preoperatively. The postoperative pathological T and N stages were significantly higher in patients with positive baseline MRF than those with negative MRF, and the proportion of patients achieving complete pathological response was significantly lower than those with negative MRF (all P<0.05). The postoperative pathological T and N stages of patients with MRF negative conversion were significantly lower than those without MRF negative conversion. In patients with negative baseline MRF and patients with negative MRF conversion after neoadjuvant therapy, the proportion of positive MRI EMVI was significantly lower (all P<0.05). Univariate survival analysis showed that overall survival and metastasis free survival were poorer in patients with positive MRF at baseline, with a hazard ratio of 3.33 and 1.69, respectively. There was no significant correlation between negative MRF conversion after neoadjuvant therapy and overall survival, metastasis free survival and recurrence free survival. Multivariate Cox analysis showed that baseline MRF and EMVI status were independent factors for overall survival and metastasis free survival, with a risk ratio of 2.15 and 3.35 for overall survival, 1.13 and 2.74 for metastasis free survival, respectively. Conclusions:Baseline MRF status is one of the independent prognostic predictors in locally advanced rectal cancer patients with neoadjuvant therapy. However, the role of the change in MRF status after neoadjuvant therapy is uncertain for predicting prognosis.

Fritillaria thunbergii Miq. has been widely used in traditional Chinese medicine for its expectorant, antitussive, antiinflammatory and analgesic properties. Moreover, modern pharmacological studies have demonstrated that F. thunbergii Miq. has efficacy in the treatment of leukemia and cancers of the liver and cervix. Although the alkaloid, peimine, is largely responsible for these pharmacological effects, it has very low oral bioavailability. The aim of this study was to investigate the intestinal absorption of peimine in Caco-2 cell monolayers. Having demonstrated that peimine is non-toxic to Caco-2 cells at concentrations <200 μmol/L, the effect of peimine concentration, pH, temperature, efflux transport protein inhibitors and EDTA-Na2 on peimine transport were studied. The results show that peimine transport is concentration-dependent; that at pH 6.0 and 7.4, the P app(AP-BL) of peimine is not significantly different but the P app(BL-AP)) is; that both P app(AP-BL) and P app(BL-AP) at 4 °C are significantly higher than their corresponding values at 37 °C; that the P-glycoprotein (P-gp) inhibitors, verapamil and cyclosporin A, increase absorption of peimine; and that EDTA-Na2 has no discernible effect. In summary, the results demonstrate that the intestinal absorption of peimine across Caco-2 cell monolayers involves active transport and that peimine is a substrate of P-gp.