0.05).Conclusion The serum cTnT is not useful for diagnosing the severity of anthracycline induced cardiactoxicity.

Objective To examine the effect of epigallocatechin gallate (EGCG) at different concentration (0,10,25, 50 and 100μmol/L ) on proliferation rate and apoptosis of nasopharyngeal carcinoma cell line C666-1 in vitro, and elucidate the role of silent information regulator 1 (SIRT1). Methods The proliferation rate in vitro of C666-1 cells stimulated by EGCG at increasing concentrations (0,10,25,50,and 100 μmol/L)for 24 h or at concentration of 50μmol/L for 0,6,12 h and 24 h were detected by cell counting kit-8 (CCK-8) assays. Cell were treated with EGCG at concentration of 0,25, 50 and 100 μmol/L for 24 h, cell apoptosis was anylysed by TUNEL assay and expression levels of SIRT1 protein was detected by western blotting. Results EGCG suppressed cell proliferation of C666-1 cell line in a concentration-dependent manner at concentration of 0 ,10,25,50,and 100μmol/L, and in a time-dependently when treated with 50 μmol/L for 12 to 24 h(P<0.05). After treated for 24 h with different concentration of EGCG at 0、25、50、100 μmol/L, cell apoptosis increased at concentration of 50 to 100μmol/L and expression of SIRT1 decreased in a concentration-dependently (P<0.05). Conclusion EGCG induced cell apoptosis of C666-1 cells by down-regulating SIRT1 expression.

Objective To analyze the clinical and pathological factors that affect the prognosis of gastric cancer patients after radical resection,and study the relationship between biological behavior of gastric cancer and clinical so as to provide clues to the basis for clinical diagnosis and treatment.Methods The clinical and pathological data of the gastric cancer patients who underwent radical resection from January 1999 to December 2009 were retrospectively analyzed.Of the 581 eligible patients were followed up in 179 cases.A database was established for SPSS 13.0 software analysis.Results Single factor analysis showed that the prognosis influencing factors in gastric cancer patients after radical resection were age,tumor location,tumor size,gross type,histological type,depth of invasion,TNM stage,surgical procedure,the cancerous remains of specimen surgical margin and the number of lymph node metastasis (P ＜ 0.05 or ＜ 0.01),no correlation was found between gender and prognosis (P ＞ 0.05).Multiple Cox regression analysis showed that TNM stage and number of lymph node metastasis were independent gastric cancer prognostic influencing factors,and the number of lymph node metastasis was found to be the more significant factor.Conclusions TNM stage and the number of lymph node metastasis are independent prognostic influencing factors in gastric cancer,and the number of lymph node metastasis is the more important factor in gastric cancer prognosis.Therefore,Union for International Cancer Control lymph node staging of gastric cancer is a better indicator for gastric cancer prognosis.

Objective To compare the efficacy and adverse reactions of intensity-modulated radiation therapy (IMRT) and conventional pelvic field radiation therapy for middle and advanced cervical cancer. Methods A total of 144 patients with stageⅡB-ⅢB cervical cancer from October 2007 to September 2012 were divided into IMRT group (72 cases), and routine radiotherapy group (72 cases) by using random number table method. The IMRT group was exposed to the 6 MV-X line 7 field, a dose of 46-50 Gy for planning target volume (PTV), 54-60 Gy for gross tumor volume (GTVnd) simultaneously integrated boosted, in 25-28 fractions. The central block of lead 4 cm was changed to 4 fields irradiation, adding to 46-54 Gy for the conventional group after 30-40 Gy of the whole pelvic field. The total dose for the two groups of patients was 30-45 Gy, after completed 30 Gy in vitro exposure, to the cavity irradiation, 5-7 Gy/fraction, and synchronous cisplatin (DDP) sensitization chemotherapy was done synchronously. Results The recent complete remission, partial remission, overall survival ratio of two groups were compared respectively, and the difference was not statistically significant (P > 0.05). The difference in 1 year survival rate of IMRT group and routine radiotherapy group was not statistically significant (χ2= 1.455, P> 0.05). The difference in 3 and 5 year survival rate was statistically significant [76.4 % (55/72) vs. 59.7 % (43/72); 72.2 % (52/72) vs. 55.6 %(40/72), P< 0.05]. Acute radiotherapy major adverse reactions included the digestive system, urinary system, skin response and haematological toxicity (bone marrow suppression). The incidence and degree of skin response in IMRT group was lower than that in routine radiotherapy group (P<0.05). The adverse effects of late radiotherapy were mainly rectal, bladder, skin response and hematological toxicity (bone marrow suppression). The incidence rectal and skin response in IMRT group was lower than that in routine radiotherapy group (P< 0.05). Conclusion The IMRT can improve the survival rate of advanced cervical cancer patients for 3-5 years, reduce the adverse effects of acute and terminal radiotherapy, and improve the quality of life.

We have reformed our patterns and methods of graduation examination of the medical majors. That is the multi-stage comprehensive graduation examination of the clinical interns, which consists of 70% close written test of clinical theories,20% practical test of clinical skills and also oral test of related theories, and 10% writing of the medical documents. It has proved that these measures have improved the interns' attitude toward practice, aroused their initiative and positivity, and led the practitioners to attach more importance to the combination of clinical practice and theories, thus leading to better clinical education.

Aim To study the effect of activating Sonic hedgehog( Shh) pathway on the function of endothelial progenitor cells ( EPCs ) in type 1 diabetic mice. Methods EPCs were isolated and cultured by density gradient method from diabetic mice. The effects of Shh N-terminal peptide and agonist SAG on EPCs prolifera-tion were evaluated by using the MTT colorimetric as-say. EPCs migration was measured by Transwell meth-od. EPCs tube formation ability was estimated by Matrigel . EPCs senescence activity was determined by β-galactosidase staining. Results Compared with control mice, the function of EPCs in type 1 diabetic mice was impaired. The proliferation, migration and tube formation of diabetic EPCs could be promoted by Shh peptide and agonist SAG. The senescence of dia-betic EPCs could be decreased by Shh peptide and ag-onist SAG. Conclusion Activating Shh signaling pathway can improve the impared function of diabetic EPCs in type 1 diabetic mice.

Fetal alloimmune thrombocytopenia (FAIT) is a severe perinatal complication, which can seriously affect fetal development, and may even lead to intrauterine hemorrhage and intrauterine death. There are controversies in the clinical diagnosis and treatment of the disease due to its low incidence and limited treatment experience. This paper reviews the progress to date in understanding the condition, incidence, screening of high-risk factors, prenatal and delivery management of FAIT based on domestic and foreign guidelines, in order to help obstetricians in the clinical management of FAIT.

Objective To investigate the diagnostic value of serum FER, AFP and AFP-L3 alone or in combination for diagnosis of primary hepatic carcinoma( PHC).Methods This was a case-control study.
Serum FER, AFP and AFP-L3 were determined in 212 patients with PHC ( StageⅠ45 cases, StageⅡ78 cases, StageⅢ81 cases, StageⅣ8 cases) , 127 patients with cirrhosis, 101 patients with chronic hepatitis and 98 controls in the Beijing Youan Hospital affiliated to Capital Medical University from January 2014 to December 2014.Levels of FER, AFP and AFP-L3 were measured by chemiluminescence, while serum samples were pre-treatment with affinity adsorption before AFP-L3 detection.FER, AFP and AFP-L3 levels were analyzed using the nonparametric Wilcoxon test among all groups.Diagnostic performance were analyzed among the groups with the three biomarkers independently and combined.Logistic regression, plotted ROC curve and calculated the area under ROC curve ( AUC) were applied to assess the diagnostic value of each index.Results Serum concentration of FER in PHC, cirrhosis, chronic hepatitis groups and healthy controls were 308.45 ( 148.98 -662.80 ) , 151.70 ( 51.44 -507.40 ) , 298.20 ( 157.30 -701.80 ) , 113.50( 54.98-221.38) μg/L, respectively.The concentration of AFP were 48.50(5.25 -748.40), 3.91(1.80-17.53), 4.76 (2.29-30.56), 2.57 (0.93-3.68) μg/L in each group.The serum levels of AFP-L3 in each group were 4.75(0.61-127.95), 0.61 (0.61-2.50), 0.61 (0.61-2.85), 0.61 (0.61-0.61) μg/L.The concentration of FER, AFP and AFP-L3 differs statistically in PHC, cirrhosis, chronic hepatitis group and healthy controls (χ2 =67.66,146.31,119.02,P<0.001).The content of serum FER, AFP and AFP-L3 increased gradually as the stage level aggravating ( StageⅠ-Ⅳ) , there was significant differences among groups (χ2 =21.63,22.68,21.98, P<0.001) .When using one serum marker, FER had the highest sensitivity (75.00%) , while AFP-L3 had the highest specificity (82.52%). While using two serum markers, FER/AFP had the highest sensitivity (89.15%) , FER+AFP-L3 and AFP+AFP-L3 had a higher specificity (86.20%).The combined detection of FER/AFP/AFP-L3 improved the sensitivity of the test to 89.15%, while FER+AFP+AFP-L3 had a specificity of 86.50%.The AUC of combination of FER, AFP and AFP-L3 was 0.803 ±0.019 (95% CI:0.765-0.841), which was higher than the AUC of either FER(0.748 ±0.022,95% CI:0.705-0.790, Z=4.67,P<0.001) and AFP-L3 (0.726 ±0.024,95% CI: 0.679 -0.772, Z=3.64,P<0.001).However, there was no significant difference in AUC between AFP alone ( 0.776 ±0.021, 95% CI: 0.735 -0.818 ) and the combined detection ( Z=1.34, P=0.18 ) .Conclusions FER was a potential marker for PHC diagnosis.The combination of FER, AFP and AFP-L3 has higher value of clinical applications than one of them independently.

Objective This study is to explore the differences in the curative effect of intra -abdominal infusion between Recombinant mutant human tumor necrosis factor and Dendritic cell -Cytokine induced killer . Methods We selected 48 advanced gastric cancer patients with ascites .Those patients were randomized into two groups:DC-CIK group and rmhTNF group .After one month treatment ,we observed the adverse events both two groups,and evaluated the clinical beneficial responses ,the responsive rate ,the tumor indicators′level,the immune indexes and the time of tumor progression .Results In the DC-CIK group,the RR and the CBR were 83.3%and 66.67%,respectively;while in the rmhTNF group,they were 58.33%and 75%,respectively.The difference between two groups was statistically significant (P<0.05).Only CA724 decreased after treatment in two groups (P=0.015).There were no significant differences of tumor markers between the two groups before and after treatment(P>0.05).The ratios of CD3 +、CD4 +、NK cells distinctly increased after treatment (P<0.05),but the ratio of CD8 +cell was no obvious difference in DC -CIK group(P=0.551);The ratio of NK cells increased obviously after treatment(P=0.027),but the ratios of CD3 +and CD4+were similar as previous in rmhTNF group(P>0.05).One year follow-up of the time to progression(TTP)was 7.1 months in DC-CIK group,and 5.8 months in TNF group,which was statistically significant (P=0.02).Conclusion Both rmhTNF and DC-CIK can improve the efficacy for the patients with malignant ascites caused by gastric cancer .However ,DC-CIK immunotherapy shows better active effect on improvement of specific immune function .

Objective To explore diagnostic value of multi-slice spiral CT imaging features with respect to pancreatic neuroendocrine tumors (pNET) of different histological grades. Methods A retrospective analysis of preoperative abdominal plain CT and dual-phased contrast-enhanced CT was performed in 21 patients (median age, 47 years;12 males and 9 females) with pathologically proven pNET. age, gender, endocrine function, location and size of lesion, cystic change or necrosis, completeness of capsule, calcification, dilation of pancreatic duct were evaluated.CT attenuation-related parameters (plain CT value, relative density index, and CT value, CT value difference, enhanced percentage and enhancement index on arterial and portal phase) of each tumor were measured or calculated. All tumors were pathologically classified into three histological grades (G1, G2 and G3) based on mitotic count and ki-67 index. Kruskal-Wallis test was performed to compare differences of age, gender, endocrine function, morphological features among different grades. CT attenuation-related parameters were evaluated using Kruskal-Wallis or one-way analysis of variance (ANOVA). Results Twenty four pNET foci [grade G1 (n=13), G2 (n=7) and G3 (n=4)] were seen in the 21 patients. The difference of age, gender among different grades demonstrated no statistical significance (P>0.05). Nine lesions of G1 and 1 lesion of G2 demonstrated endocrine function, and the difference of endocrine function among three grades was statistically significant (χ2=8.355,P=0.012). For G1, G2 and G3, 11, 5 and 2 lesions were seen in uncinate process, pancreatic head and neck, respectively while 2, 2 and 2 lesions in pancreatic body and tail, respectively. The median maximum diameter of pNET of G1, G2 and G3 was 1.5, 2.5 and 6.7 cm, respectively;For G1, G2 and G3, 13, 4 and 0 lesions demonstrated intact capsule, respectively while 2, 3, and 3 lesions cystic degeneration and necrosis, respectivel; 0, 2 and 2 lesions calcification,respectively, 0, 1 and 2 lesions dilation of pancreaticobiliary duct, respectively, 0, 1 and 4 lesions sign of malignancy, respectively. The difference of size of lesion, completeness of capsule, calcification, and dilation of pancreatic duct showed statistical significance (P< 0.05). The difference of location of lesion and cystic change or necrosis displayed no significance (P>0.05). In addition, pNET of different grades demonstrated similar density and relative density index on plain CT. Regarding CT value, CT value difference, enhanced percentage and enhancement index on arterial and portal phase, the pNET of G2 showed highest value, while pNET of G3 lowest value, however, the difference about CT attenuation-related parameters among three grades showed no significant difference (P>0.05). Conclusion pNET of different histologic grades have some specific CT imaging features, which can facilitate an accurate diagnosis of pNET prior to therapy.