Objective To investigate the relationship between infection of helicobaeter pylori(Hp) and iron deficiency anemia(IDA) and to explore effective clinical treatments for patients with Hp associated IDA . Method 1. The Hp infection ratio of 40 chronic gastritis with IDA and 42 patients without IDA were counted up respectively. 2. 36 patients with Hp-positive chronic gastritis were divided into two groups randomly. One group was treated by using Hp eradication therapy in conjunction with oral iron supplement and the other using iron supplement only. The hema-tological parameters before and after treatment are measured and the effectiveness of the treatment was evaluated. Re-sult The Hp infection ratio in chronic gastritis patients with IDA is |figher than that in patients without IDA and the difference is significant. After Hp eradication therapy in conjunction with iron supplement Hb. serum iron and serum ferritin level in Hp associated IDA patients are increased significantly while that for patients treated by using iron sup-plement only have no significant improvement. Conclusion It appears that Hp infection may be related to IDA. When iron supplement treatment has no obvious effect to an IDA patient,lt may suggest a ease of Hp associated IDA. The i-ton supplement treatment has positive effects to IDA patients after Hp eradication.

Objectives To investigate the practical application of modified peritoneal equilibration test (modified PET) employing 4.25% glucose exchange in peritoneal dialysis patients and to assess the reference values and clinical significance of the test. Methods Modified PETs were performed in 97 patients without peritonitis for at least 4 weeks. Mass transfer area coefficient (MTAC) was calculated according to the Garred model. Creatinine D/P concentration ratio at 4 hr (4 h D/Pcr), sodium D/P concentration ratio at 1 hr (1 h D/PNa+) and net ultrafiltration (nUF) were also assessed. Ultrafiltration 0.05). 4 h D/Pcr and MTACcr of modified PET were significantly correlated with 4h D/Pcr of standard PET (P

Objective To evaluate the impact of the intrauterine device (IUD) insertion on the mental state of women.Methods From Jan.2009 to Jun.2010,a multi-center clinical observational study was performed.Totally 641 women were selected in the six provinces' 18 family planning service stations and hospitals for IUD insertion surgery study.Analysis of the change of women's mental state which was evaluated by symptom checklist-90 (SCL-90) scale before and after IUD insertion surgery.Results Before and after IUD insertion surgery,10 factors' scores in SCL-90 of the observed objects were between 1.1 to 1.2,total scores were 107 ± 27 and 105 ± 25,respectively.Before and after surgery,total average score both were 1.2,the average score of positive items both were 2.1.The difference of the above results were not statistically significance (all P ＞0.05).Preoperative and postoperative,the rate of positive items was 9.2％-19.6％ and 7.7％-17.6％,respectively.In addition to anxiety and fear,the rate of other factors' positive items postoperative was significantly lower than those in the preoperative (all P ＜ 0.05).The incidence of the observed objects postoperative of each factor score,deteriorated was in the range of 4.9％ to 23.0％,improved was in the range of 26.3％-50.1％.The incidence of total scores,deterioration was 28.8％ (166/575),improved was 45.6％ (262/575).The incidence of the average score of positive items,deterioration was 3.7％ (21/575),improved was 52.3％ (301/575).Logistic analysis showed that,in addition to unit level,there were no other significant influencing factors for women' mental state of postoperative (all P ＞ 0.05).Conclusion IUD insertion surgery has no adverse effect on women's mental state.

The effects of epigenetic modification on the differentiation of islet cells and the expression of associated genes (Pdx-1, Pax4, MafA, and Nkx6.1, etc) were investigated. The promoter methylation status of islet differentiation-associated genes (Pdx-1, Pax4, MafA and Nkx6.1), Oct4 and MLH1 genes of mouse embryonic stem cells, NIH3T3 cells and NIT-1 cells were profiled by methylated DNA immunoprecipitation, real-time quantitative PCR (MeDIP-qPCR) techniques. The histone modification status of these genes promoter region in different cell types was also measured by using chromatin immunoprecipitation real-time quantitative PCR methods. The expression of these genes in these cells was detected by using real-time quantitative PCR. The relationship between the epigenetic modification (DNA methylation, H3 acetylation, H3K4m3 and H3K9m3) of these genes and their expression was analyzed. The results showed that: (1) the transcription-initiation-sites of Pdx-1, MafA and Nkx6.1 were highly methylated in NIH3T3 cells; (2) NIH3T3 cells showed a significantly higher level of DNA methylation modification in the transcription-initiation-site of Pdx-1, Pax4, MafA and Nkx6.1 genes than that in mES cells and NIT-1 cells (P<0.05); (3) NIT-1 cells had a significantly higher level of H3K4m3 modification in the transcription-initiation-site of Pdx-1, Pax4, MafA and Nkx6.1 genes than that in mES cells and NIH3T3 cells (P<0.05), with significantly increased level of gene expression; (4) NIH3T3 cell had a significantly higher level of H3K9m3 modification in the transcription-initiation-site of Pdx-1, Pax4, MafA and Nkx6.1 genes than that in mES cells and with NIT-1 cell (P<0.05), with no detectable mRNA expression of these genes. It was concluded that histone modification (H3K4m3 and H3K9m3) and DNA methylation might have an intimate communication between each other in the differentiation process from embryonic stem cells into islet cells.

Objective To investigate the microbiological trends and antibiotic susceptibility of peritoneal dialysis(PD)-related peritonitis (PDAP).Methods All patients who developed PDAP between 2004 and 2015 in Renji Hospital,Shanghai Jiao Tong University School of Medicine were enrolled.Demographic data,results of dialysate pathogen culture and drug susceptibility test were recorded.The trend of peritonitis incidence was measured by Poisson regression and the chi-square test or Fisher exact test method was used to compare the composition of causative organisms and their antimicrobial susceptibilities over time.Results During the study period,a total of 711 episodes of PDAP were occurred in 386 patients.The culture positive rate of pathogens rose from 52.0％ in 2004 to 77.0％ in 2015 (P ＜ 0.001).The distribution of causative organisms of the culture positive peritonitis was gram-positive bacteria (270,59.5％),followed by gram-negative bacteria (129,28.4％),polymicrobial(39,8.6％),fungi (15,3.3％) and mycobacteria (1,0.2％).From 2004 to 2015,the incidence of peritonitis decreased from 0.214 to 0.160 episodes/patient·year (P=0.034).The incidence of coagulase-negative staphylococcus peritonitis decreased from 0.049 to 0.027 episodes/patient · year (P=0.025),while others had no significant change;A significant decline was observed in the sensitivity of Gram-positive strains to the first generation cephalosporin and ampicillin/sulbactam in 2010-2015 group compared with those in 2001-2009 group (61.3％ vs 88.2％,P ＜ 0.001;61.7％ vs 85.5％,P=0,001),whereas the sensitivity to vancomycin remained the same.The sensitivity of Gram-negative strains to ceftazidime and amikacin showed no significant change.As for the gram-positive peritonitis treated with cefradine as empirical treatment,compared with those in 2004-2009 group,in 2010-2015group the proportion of patients requiring to change their treatment regime was significantly higher,and the treatment course was longer.Conclusions A gradual decline is observed in the incidence of PDAP and the culture positive rate of pathogens improves.Peritonitis caused by coagulase-negative staphylococcus decreases overtime.The present empirical treatment protocols may need re-evaluation considering the decreased rate of the first generation cephalosporin sensitivity in recent years.

Objective To fulfill high-efficient expression of rTMP-GH,a recombinant fusion protein of thrombopoietin mimetic peptide and human growth hormone,in Pichia pastoris.Methods cDNA fragment coding for rTMP-GH was amplified by PCR,and subsequently cloned into the expression vector pPIC9K.The linearlized plasmid pPIC9K-rTMP-GH was transformed into Pichia pastoris GS115 cells and screened in MD/MM plates under pressure of G418.The recombinant fusion protein rTMP-GH was identified by Western blotting,and its biological activity was analyzed by its ability on colony formation of megakaryoblasts.Results The pPIC9K-rTMP-GH expression plasmid was successfully constructed.GS115 cells with high expression of rTMP-GH was screened out,and the rough purified rTMP-GH showed promotive effect on megakaryoblast colony formation.Conclusion High-efficient expression of rTMP-GH in Pichia pastoris is achieved.

Objective To discuss the correlation between shock index (SI) and severity and the values to forecast the prognosis in patients with septic shock. Methods 127 patients with septic shock admitted to intensive care unit (ICU) of Zhejiang Provincial People's Hospital from January 1st, 2016 to October 31st, 2017 were enrolled, and they were divided into survival group and death group according to the outcomes after 28-day hospitalized. The vital signs, laboratory indexes, acute physiology and chronic health evaluation Ⅱ(APACHEⅡ), sequential organ failure assessment (SOFA), lactate clearance rate (LCR) of 3 hours after fluid resuscitation, and shock index on admission (SI1) and shock index of 3 hours after fluid resuscitation (SI2) were compared between the two groups. The correlation among SI and APACHE Ⅱ, SOFA, LCR was analyzed. The receiver operating characteristic curve (ROC) was drawn to evaluate the prognostic value of SI in patients with septic shock. Results A total of 127 patients were included, 52 in survival group (40.9%) and 75 in death group (59.1%). The SI1, SI2, APACHE Ⅱ and SOFA in the death group were significantly higher than those in the survival group (SI1: 1.62±0.46 vs. 1.35±0.32, SI2: 1.36±0.24 vs. 0.93±0.15, APACHEⅡ:17.5±4.0 vs. 13.6±3.5,SOFA: 9.5±2.3 vs. 6.3±1.5), and LCR was significantly lower than that in the survival group [(14.4±5.2)% vs. (28.6±8.6)%], with statistically significant differences (all P < 0.01). The correlation analysis showed that SI1was significantly positively correlated with APACHEⅡ (r = 0.458, P = 0.000) and SOFA (r = 0.535, P = 0.000), SI2was also significantly positively correlated with APACHEⅡ (r = 0.624, P = 0.000) and SOFA (r = 0.656, P = 0.000), while SI1and SI2were significantly negatively correlated with LCR (r values were -0.348, -0.435, both P = 0.000), and the SI2were more remarkable. ROC curve analysis showed that the area under ROC curve (AUC) of SI1for predicting the prognosis of septic shock was 0.720 [95% confidence interval (95%CI) = 0.620-0.831, P < 0.05]; when SI1= 1.68, the sensitivity, specificity, Yoden index, positive predictive value and negative predictive value were 79.5%, 65.6%, 0.451, 0.759 and 0.636, respectively. The AUC of the SI2to predict prognosis of septic shock was 0.826 (95%CI =0.739-0.826, P < 0.05); when SI2= 1.37, the sensitivity, specificity, Yoden index, positive predictive value and negative predictive value were 85.7%, 87.6%, 0.733, 0.893 and 0.902, respectively. Conclusion Compared with SI1, SI2was more correlated with the severity in patients with septic shock and it had more values to predict prognosis.

Objective To study early diagnostic index of septic acute kidney injury(AKI) and protective effect of rhubarb on septic AKI. Methods Sixty rats were randomly divided into the following 3 groups:model group (A), treatment group (B) and control group (C). Each group contains 20 rats. Rats from group A were received a intraperitoneal injection of lipopolysaccharide (LPS) at a dose of 5 mg/kg to induce AKI. Rats from group B were given rhubarb powder solution by oral administration immediately after LPS injection. Rats from group C were treated with the same volume of normal saline (NS) by intraperitoneal injection. Both serum level of creatinine (Scr) and urinary levels of Netrin-1 and KIM-1 of rats in 3 groups were detected in the different time points of treatment (0 h, 1 h, 6 h and 24 h). Results The levels of KIM-1 and CR in rats treated with LPS were obviously increased at the time point of 6 h (P<0.05). The urinary lev-el of Netrin-1 began to increase at the time point of 1 h and reached the highest level at the time point of 6 h, then gradually decreased at the time point of 24 h after the injection of LPS. In group B, the levels of Scr, Netrin-1 and KIM-1 were significantly lower as compared with group A (P<0.05). Conclusion The urinary level of Netrin-1 might has early diagnostic value in septic acute kidney injury. Rhubarb could protect the kidney of AKI model rats by de-creasing the serum level of Scr, urinary levels of Netrin-1 and KIM-1.

Breast Neoplasms ; diagnosis ; Female ; Humans ; Image Processing, Computer-Assisted ; Immunohistochemistry ; Spectrum Analysis

Objective To explore the role of night waking in the cognitive development of infants and young toddlers. Method A total of 116 infants aged 2 to 30 months were randomly selected in Yiwu, Zhejiang from December 2011 to February 2013. Social-demographic factors were investigated through questionnaire;sleep information were collected via the Brief Infant Sleep Questionnaire (BISQ);Cognitive development was assessed in all infants using Baley development scale. Results The mean age was 12.99 month-old. 50.86%(59/116) were males. Ocassional night waking was reported in 5.26%, one night waking in 29.82%, multiple night waking accounted in 64.91%of children under one year old. Ocassional night waking was reported in 32.20%, one night waking in 45.76%, multiple night waking in 22.03%of children over one year old. The frequency of night waking was signiifcantly different between children under one year old and children over one year old (P<0.01). The average duration of waking was 0.49±0.31 h in children under one year old, and 0.31±0.48 h in children older than one year old, and the difference was signiifcantly different (Z=4.35, P<0.001). In children over one year old, the more frequent night waking, the lowered MDI scores (F=3.98, P=0.024). The waking duration was negatively correlated with MDI scores in children over one year old (r=-0.26, P=0.035). Neither night waking duration nor night waking frequency had signiifcant correlation with MDI scores in children under one year old. Multivariable linear regression conifrmed that night waking was an independent inlfuential factor of MDI and PDI scores in children over one year old. Conclusions Persistent night waking should warrant attention.