Background and purpose:Paclitaxel and cisplatin were demonstrated to be effective and well-tolerated for advanced gastric cancer.The clinical efficacy of hyperthermic intraperitoneal perfusion(CHPP) has been established in numerous studies in recent years.The purpose of the study was to evaluate the efficacy and toxicities of paclitaxel combined with CHPP with cisplatin in the treatment of patients with advanced gastric cancer.Methods:51 patients with advanced gastric cancer were randomized into systemic chemotherapy group(25 patients) who received paclitaxel 70 mg/m2,iv,1/wk?8wk,DDP 25 mg/m2,iv,d1-3,reapeated every 3 weeks for 4 cycles and systematic plus CHPP group(26 patients)who received paclitaxel 70 mg/m2,iv,1/wk?8wk,DDP 60 mg/m2,CHPP,d1,8,22,29,and abdomen hyperthermia treatment twice a week in the whole chemotherapy period.Results:The response rate(CR+PR),the clinical benefitial response(CBR) in systematic plus CHPP group were 65.4% and 92.3%,and those in systemic chemotherapy group were 36.0% and 68.0%.There was obviously a statistical difference between two groups(P0.05).The major toxicities were myelo-suppression and nausea/vomiting.There was no significant difference in side-effect between the two groups.Conclusions:Paclitaxel administered by weekly infusion combined with hyperthermic intraperitoneal perfusion chemotheraphy with cisplatin in the treatment of advanced gastric cancer is effective and tolerable.It is worth studying in the future.

Renal function was studied in 55 prematures (PTS) without complication, 28 male and 27 female. All PTS were divided into three groups according to age of days(AD), gestational age(GA), and body weight(BW)。BUN and SCr were significantly correlated conversely with AD, GA and BW (P

Objective To evaluate the effect of comprehensive experiments on multiple trauma emergency rescue in intensive training before nursing practice. Methods 772 students were divided into groups, 16 to 18 students in each group,each team distributed teaching notes, designed experiment scheme toget her, selected and played roles, undertook tasks, practiced independently before the class,then performed comprehensive training in class. Results 94.8% of the nursing students and 100.0% of the training teachers supported this method of comprehensive experiments in intensive training. Conclusions Nursing comprehensive experiments can shorten the gap between the clinical practice and class teaching, improve the students' professional ability and general quality. It is a popular education mode on intensive training before clinical practice.

Objective To evaluate the potential value of IgG antibodies against recombinant PPE65 protein (rPPE65) of Mycobacterium tuberculosis in serodiagnosis of tuberculosis.Methods The gene encoding PPE65 protein of M.tuberculosis was cloned into the PET-28a vector and then expressed in Escherichia coli.The rPPE65 was purified with Ni-NTA affinity and ion exchange chromatography.After dialysis renaturation, the concentration of rPPE65 was determined using Lowry assay.ELISA was used to detect the levels of specific IgG against rPPE65 and recombinant PstS1 protein (rPstS1) in sera from 144 patients with pulmonary tuberculosis (PTB patients), 144 health controls, and 56 patients with non-tuberculosis pulmonary diseases.ROC curves were used to determine cut-off values with the results of IgG antibodies against rPPE65 and rPstS1 for 144 PTB patients and 97 controls with negative PPD skin test.The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of rPPE65 and the combination of rPPE65 and rPstS1 were counted.Results The PPE65 protein of M.tuberculosis was successfully expressed in E.coli. The purity and concentration of rPPE65 were 95% and 0.5 mg/ml, respectively.ROC analysis showed that the cut-off of ELISA using rPPE65 was 0.64.The sensitivity, specificity, PPV, NPV, and accuracy of rPPE65 were 34.7%(50/144), 93.5%(187/200), 79.4%(50/63), 66.5%(187/287), and 68.9%(237/344), respectively.The sensitivity, specificity, PPV, NPV, and accuracy of the combination of rPPE65 and rPstS1 were 59.0%, 91.0%, 82.5%, 75.5%, 77.6%, respectively.Conclusions The rPPE65 of M.tuberculosis appears to be a candidate antigen for serodiagnosis of tuberculosis.Detection of IgG antibodies against the combination of rPPE65 and rPstS1 can increase the sensitivity of serological test for tuberculosis.

The most common metastatic site of prostate cancer is the bone, followed by the lung, bladder, liver, and adrenal gland. We report on a rare case of pancreatic metastasis from prostate cancer. A 52-year-old patient was admitted to the hospital with epigastric pain for 20 days. PET-CT showed malignant lesions in the prostate and pancreas, and prostate and pancreas puncture biopsies were performed, respectively. The patient was diagnosed as prostate cancer with pancreatic metastasis according to the pathological findings. After undergoing androgen deprivation therapy and docetaxel chemotherapy for 6 cycles, reexamination revealed that the pancreatic metastases had disappeared.

Objective To explore the effect of Fas, Fas ligand (FasL), soluble Fas (sFas) and their clinical significance in KD. Methods The expression of Fas, FasL in peripheral blood lymphocytes (PBLC) were detected with flow cytometery at acute and remission stages in patients with KD; and the serums Fas was detected by double antibody sandwich ELISA in the patients with KD at acute and remission stage, meanwhile erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) were also tested. Results The expression of Fas, FasL in PBLC in patients with KD at acute stage was (14.2±0.5)% and (1.61±0.09)% respectively , which were significantly lower than those at remission stage [(15.7±0.5)%, (1.95±0.09)% respectively (P<0.05 and P<0.01)]. The expression of Fas in PBLC in the patients with KD at acute and remission stage was both significantly lower than that in normal control group (20.8±0.5)% (P<0.01 both);The expression of FasL in PBLC in patients with KD at acute and remission stage was both significantly lower than that in normal control group (20.8±0.5)% (P<0.01 both); the serum sFas in patients with KD at acute and remission stage was (1906±55)μg/L and (1622±52)μg/L respectively , which was significantly higher than that in normal control group (1151±51)μg/L (P<0.01 both); the serum sFas at acute stage was obviously higher than that at remission stage (P<0.01); there was positive correlation between sFas and ESR, CRP (P<0.01 both). Conclusion There are abnormal expressions of Fas/FasL in PBLC and sFas in patients with KD. Fas/FasL is lower and sFas is higher than that of the controls. The abnormal expression of Fas/ FasL in lymphocytes and the apoptosis triggered by sFas are probably involved in the immunological aberrance and pathogenesis of KD. sFas may be used as a marker to evaluate the disease activity and therapeutic efficacy.

OBJECTIVETo explore the mischief mechanism of oxidative stress in the varicocele (VC).

METHODSSerum was taken from the spermatic and peripheral veins on ligation of the internal spermatic veins in 28 infertile males with VC. Experimental VC was established in male rats by partial ligation of the left renal vein. And testis tissue was taken three months after operation. The nitric oxide(NO), nitric oxide synthetase (NOS), xanthine oxidase (XO), lactic acid(Lac) and lactic dehydrogenase (LDH) in the serum of 28 infertile males with VC and the testis tissue of the VC rats were detected by spectrophotometry.

RESULTSNO, NOS, XO and Lac in the serum of internal spermatic veins in the infertile males with VC were significantly higher than in the serum of peripheral veins in the VC patients (P < 0.01, P < 0.05). LDH was lower than that in peripheral serum. NO and XO of the left testis tissue in the VC rats were higher compared with the control group (P < 0.01). Lac in the left testis of the VC rats was lower than that in the control group rats (P < 0.01).

CONCLUSIONNO, NOS and XO in the serum of the VC patients and in the testis tissues of the VC rats were increased, and Lac and LDH were changed obviously, which might not only disturb spermatogenesis, but also inhibit sperm motility. Therefore they might be one of the causes of infertility in VC patients.

Adult ; Animals ; Humans ; Infertility, Male ; etiology ; Male ; Nitric Oxide ; analysis ; Nitric Oxide Synthase ; analysis ; Oxidative Stress ; Rats ; Rats, Wistar ; Varicocele ; complications ; metabolism ; Xanthine Oxidase ; analysis

Objective: To investigate the clinical significance of monitoring ETV6-RUNX1 fusion gene in children with acute lymphoblastic leukemia (ALL) after allogeneic stem cell transplantation (allo-HSCT) . Methods: Clinical data of 13 children received allo-HSCT in Peking University Institute of Hematology from May 2009 to March 2016 were retrospectively collected. The ETV6-RUNX1 gene was examined by real-time quantitative polymerase chain reaction (RQ-PCR) . The correlation between its expression level and the disease status was analyzed. Results: Of 13 enrolled ALL cases, the ETV6-RUNX1 expression of 7 patients converted to positive after transplant at a median time of 137 days (range, 28-270 days) . The expression level of the first positive sample was 0.034% (range, 0.004%-0.061%) . The duration from ETV6-RUNX1 positive to hematological relapse was 196 days (range, 28-666 days) . Four patients experienced relapse at a median time of 294 days (range, 104-803 days) after allo-HSCT. The ETV6-RUNX1 expression converted to positive prior to MRD. Patients with positive ETV6-RUNX1 gene expression pre-transplantation would be more likely to relapse. Conclusion Monitoring ETV6-RUNX1 by RQ-PCR could be used to evaluate MRD status after allo-HSCT. Patients with positive ETV6-RUNX1 after transplant had a poor prognosis.

Objective: To investigate the clinical significance of minimal residual disease (MRD) monitoring by using WT1 gene and flow cytometry (FCM) in patients with myelodysplastic syndrome (MDS) who receiving allogeneic stem cell transplantation (allo-HSCT). Methods: WT1 gene and MDS-related abnormal immunophenotype were examined by real-time quantitative polymerase chain reaction (RQ-PCR) and FCM, respectively. The bone marrow samples were collected from patients with MDS who received allo-HSCT from Feb, 2011 to Oct, 2015 in Peking University People’s Hospital before and after transplantation. Results: Among 92 MDS patients, 40 (48.2%) patients were positive for WT1 (WT1⁺) and 9 (10.8%) patients were positive for flow cytometry (FCM⁺). 27 patients (29.3%) met the criteria of our combinative standard, MRDco (MRDco⁺). Only FCM⁺ post-transplant (P<0.001) and MRDco⁺ (P=0.017) were associated with relapse. The cumulative incidence of relapse (CIR) at 2 years were 66.7% and 1.2% (P<0.001) in FCM⁺ and FCM^- groups. MRDco⁺ group had a 2-year CIR of 23.0% while MRDco^- group had a 2-year CIR of 1.6% (P=0.004). The specificity of post-transplant WT1, FCM and MRDco to predict relapse was 59.0%, 96.4% and 74.7%, respectively. The sensitivity of these three MRD parameters to predict relapse was 66.7%. Conclusion Post-transplant FCM and MRDco are useful tools to monitor MRD for MDS after transplantation. The preemptive intervention based on MRDco is able to reduce the relapse rate.

Objective:To assess the accuracy of lung ultrasound(LUS) to predict pneumonia in pediatric patients using meta-analysis.Methods:The PubMed, the Cochrane Library, EMbase databases from January 2015 to March 2020 were searched.The retrieved outcome data to evaluate the efficacy of LUS for the diagnosis of pneumonia in patients under 18 years of age were included.Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies.Meta-analysis was then conducted using MetaDisc 1.4, RevMan 5.3 and Stata 15.0 softwares.Results:Twelve diagnostic studies were included, which involved 2 484 patients.The results of meta-analysis showed that compared with the gold standard, the sensitivity, specificity, positive and negative likelihood ratios, diagnostic odds ratio of LUS were 0.90(95% CI 0.88-0.91), 0.88(95% CI 0.85-0.90), 8.64(95% CI 3.79-19.72), 0.12(95% CI 0.06-0.26) and 77.58(95% CI 28.39-211.99), respectively.The area under the summary receiver operating characteri stic curve was 0.96.Subgroup analysis showed that there was no difference in LUS′s diagnostic accuracy for pneumonia with different department, different diagnostic gold standard, and different level of sonographer training. Conclusion:Current evidence shows that LUS has a high accuracy in the diagnosis of pneumonia in children.