Endothelium, Vascular ; cytology ; Humans ; Mucocutaneous Lymph Node Syndrome ; complications ; pathology ; Neovascularization, Pathologic ; Stem Cells ; cytology

Objective To investigate the value of peripheral blood for the prognosis of patients withbloodstream infection. Methods A retrospective analysis of patients with bloodstream infection was conducted inthe intensive care unit (ICU) of Mianyang Central Hospital of Sichuan from January 2012 to October 2016. Accordingto the 28-day survival, the patients were divided into survival group and death group. The white blood cell (WBC),neutrophils count (NEU), lymphocyte count (LYM), neutrophil/lymphocyte ratio (NLR), monocyte count (MO), eosinophilcount (EO), basophil count (BA), hemoglobin (Hb), platelet count (PLT) and procalcitonin (PCT) in peripheral bloodwere recorded when patients were diagnosed with blood infection. Receiver operating characteristic curve (ROC),Kaplan-Meier survival analysis and Cox regression were used to evaluate the value of these risk factors for predictingthe outcome. Results 305 patients were enrolled. 182 patients survived while 123 patients died during the 28-dayperiod. ① There was no significant difference in gender, age and comorbidities between the two groups. There was nosignificant difference in infection rate between the two groups except for fungal infection rate. The fungal infection ratein the death group was significantly higher than that in the survival group (9.8% vs. 3.3%, P = 0.019). ② The LYM,MO, EO and PLT in the death group were significantly lower than those in the survival group [LYM (×109/L):0.58 (0.29, 0.93) vs. 0.76 (0.44, 1.23), MO (×109/L): 0.47 (0.19, 0.80) vs. 0.58 (0.30, 0.94), EO (×109/L):0.00 (0.00, 0.01) vs. 0.03 (0.01, 0.09), PLT (×1012/L): 89 (47, 148) vs. 126 (82, 186), all P < 0.05]. The NLR in the death group was significantly higher than that in the survival group [17.09 (7.60, 33.51) vs. 12.86 (6.51, 24.85), P < 0.05]. There was no significant difference in the WBC, NEU, BA, Hb and PCT between the two groups. ③ It was shown by ROC curve analysis that the maximum area under the ROC curve (AUC) of EO was 0.755. When the best cut-off value was 0.015×109/L as a predictor of death in 28 days, the sensitivity was 80.3%, and specificity was 64.7%. ④ It was shown by survival analysis that the 28-day survival rate in the patients with EO < 0.015×109/L was significantly lower than that of patients with EO > 0.015×109/L [38.3% (62/162) vs. 83.9% (120/143), χ 2 = 56.999, P = 0.000]. ⑤ It was shown by Cox regression that EO was the independent factor for 28-day survival (β = 1.466, χ 2 = 39.535, P = 0.000). Risk of death was 4.331 times greater in patients with EO < 0.015×109/L than in those with EO > 0.015×109/L [hazard ratio (HR) = 4.331, 95% confidence interval (95%CI) = 2.743-6.840]. Conclusions Compared to other parameters in peripheral blood, EO has the best correlation with the prognosis of bloodstream infection. EO is the independent prognostic predictor for 28-day survival.

Background:Recently,studies have shown that piperlongumine( PL)selectively killed cancer cells by elevating reactive oxygen species(ROS)in various cancers. However,the effect of PL on gastric cancer cells remained to be further studied. Aims:To investigate the effect of PL on proliferation and apoptosis of human gastric cancer cell line MKN45 and its underlying mechanism. Methods:MKN45 cells were treated with different doses of PL,caspase inhibitor,antioxidant, and their combinations,respectively. Cell viability was assessed by CCK-8 assay;cell cycle,apoptosis and intracellular ROS level were measured by flow cytometry;and Western blotting was employed to determine the expression of apoptosis-related proteins( XIAP,cleaved-caspase3,7,9 and cleaved-PARP),p53 and its downstream target genes( p21, GADD45α and PUMA). Results:PL inhibited the proliferation of MKN45 cells in a dose- and time-dependent manner. In MKN45 cells treated with PL,the proportion of cells in G1 phase,apoptotic rate and intracellular ROS level were significantly increased,the expression of inhibitor of apoptosis protein XIAP was down-regulated,and the caspase-dependent apoptosis pathway,p53 and its downstream target genes were activated. Pretreatment with antioxidant NAC or Z-VAD-FMK, a general caspase inhibitor could partially abolish the effect of PL on ROS production and its antitumor effect. Conclusions:PL can inhibit cell proliferation and induce cell cycle G1 phase arrest and apoptosis in MKN45 cells. Its antitumor effect may be associated with a ROS-mediated p53 activation and subsequent triggering of caspases cascade of cell apoptosis.

Objective:To explore the effect of transcatheter arterial chemoembolization (TACE) combined with percutaneous microwave coagulation therapy(PMCT) on treatment of patients with hepatic carcinoma.Methods: The clinical data of 60 cases of liver cancer patients in our hospital in TACE combined with PMCT were analyzed. Results:The operation was successfully performed, no serious complications and death. Efficacy: 4 CR cases, 38 PR cases, 16 SD cases, 2 PD cases, the total efficiency of treatment was 70.0%; After 1, 2, 3 year, survival cases (ratio) were respectively: 46(76.7%), 35(58.3%), 31(51.7%); The levels of Serum alpha fetoprotein (AFP) after operation was significantly reduced, after treatment, the patient's liver function improved significantly; The diameter of the lesions was significantly reduced.Conclusion: TACE combined with PMCT is an effective therapy for hepatic carcinoma.

Objective To compare the efficacy and safety of standard or reduced doses of bortezomib combined with adriamycin and dexamethasone in patients with multiple myeloma (MM).Methods Fifty-two newly diagnosed,refractory and relapsed patients received bortezomib [1.3 mg/m2 (standard dose group,26 patients) or 1.0-1.1 mg/m2 (reduced dose group,26 patients) on day 1st,4th,8th and 11 th],and adriamycin (10 mg/m2) plus dexamethasone (40 mg/d) on day 1 st-4th,and were treated for 1-6 courses.Adverse events were graded and compared.Results After treatment,the overall response rate of standard dose group [80.8％(21/26)] and reduced dose group [88.5％(23/26)] had no significant difference (P =0.739).The rate of neutropenia and thrombocytopenia in two groups had no significant difference[23.1％(6/26) vs.15.4％(4/26),P=0.281 ; 11.5％(3/26) vs.7.7％(2/26),P=0.620].The rate of Ⅲ-Ⅳ grade peripheral nerve disease,herpes zoster,lack of power and abdominal distension in standard dose group were significantly higher than those in reduced dose group [15.4％(4/26) vs.3.8％(1/26),P =0.038;26.9％(7/26) vs.7.7％(2/26),P =0.029;38.5％(10/26) vs.15.4％(4/26),P=0.045; 19.2％(5/26)vs.3.8％ (1/26),P =0.028].Conclusion Reduced dose of bortezomib appears to result in similar overall response rate,but better tolerance and safety compared with standard dose.

This report was to retrospectively analyze clinical data of 29 hyperthyroid patients with concurrent hematocytopenia.Our findings demonstrated that 5 patients developed cytopenia without any antithyroidism drugs(ATDs),while the other 24 cytopenia patients were only found after taking ATD.In the drug intervention group,17 patients received methimazole(MMI)and 7 took propylthiouracil(PTU).Most cytopenia was dose-dependent and occurred within the first 6 months of medication.Twenty subjects received radioiodine therapy,with no impact on blood cells.We suggested that cytopenia might occur at the early stage of ATD therapy and be related with drug and its dose.Blood cell amount should be monitored,especially for initial ATD therapy.As for interaction between PTU and MMI,alternative radioiodine therapy might seem to be relatively safe.

Objective To investigate the role of local aldosterone system in oncofetal fibronectin ( oncofetal FN) mRNA expression and reactive oxygen species (ROS) production in human mesangial cells (HMCs) exposed to short-term intermittent high glucose and the effect of Fenofibrate.Methods The HMCs were divided into 8 groups:normal glucose(NG) ;osmotic fluctuation(OF) ;mean glucose load (MGL) ;stable high glucose (SHG),short-term intermittent high glucose (IHG) ; intermittent high glucose plus eplerenone (IHGE) ; intermittent high glucose plus fenofibrate(IHGF) ; and normal glucose plus fenofibrate (NGF) groups.The mRNA expression levels of Aldosterone synthase ( CYP11 B2 ),11 β-hydroxysteroid dehydrogenase type 2 ( 11βHSD2 ) and oncofetal FN were determined by RT-PCR.The expression of CYP11B2 protein was determined by western-blot.Aldosterone level in cell culture supernatant was detected by radioimmunoassay.The expression and translocation of mineralocorticoid receptor (MR)protein were assayed with confocal laser scanning microscopy. ROS levels were determined by Fluorescence microscopy and fluorescence microplate reader.Results ( 1 ) MGL,SHG,and IHG groups showed a 2.41,3.63,and 4.45 times increase in CYP11B2 mRNA expression,and a 1.83,2.15,and 2.78 times increase in CYP11B2 protein expression,respectively,compared with NG group (P ＜ 0.05 ).The aldosterone levels of HMCs culture supernatant in MGL,SHG,and IHG groups were also increased,being 1.49,2.04,and 2.54 times of that in NG group ( P＜0.05 ),and the degree of elevation in IHG group was more marked than that in SHG group( P＜0.05 ).MR was activated and translocated from cytosol to nucleus in MGL,SHG,and IHG groups.Quantitative analysis showed the ratioes of cytosol/nucleus fluorescence intensity in MGL,SHG,and IHG groups were 15％,38％,and 53％ decreased as compared with that in NG group,and the decrease was more marked in IHG group ( P＜0.05 ).(2) Oncofetal FN mRNA expression and ROS levels in MGL,SHG,and IHG groups were increased,being 1.54,2.31,3.65 and 1.26,1.91,2.48 times of those in NG group,respectively ( P＜0.05 ),and this increase was more marked in group IHG ( P＜O.05 ).Compared with IHG group,oncofetal FN mRNA expression and ROS levels in group IHGE were significantly decreased by 54％ and 53％,and in group IHGF by 45％ and 39％. ( 3 ) CYP11B2 mRNA,protein,and aldosterone levels in IHGF group were decreased by 74％,59％,and 50％,and the activation of MR in group IHGF was inhibited when the ratio of cytosol/nuclear fluorescence intensity was increased 1.88 fold as compared with that in group IHG ( P＜0.05 ).Conclusions Increased expressions of oncofetal FN and ROS by HMCs induced by short-term intermittent high glucose were nore marked than those induced by stable high glucose.The mechanism was associated with activation of local aldosterone system.Fenofibrate may inhibit the activation of local aldosterone system and alleviate the injury to HMCs induced by intermittent high glucose.

Childhood malignant solid tumors exhibit a wide variety of vagueness signs and symptoms in the early stage,which are usually nonspecific,therefore the diagnosis of childhood malignant solid tumor can be challenging when the disease is in the early stage.As a result,the delay of diagnosis causes mistreatment,and which makes childhood malignant solid tumors become a leading cause of death in children.Physicians should recognize the early warning signs of childhood cancer,and a good clinical history and careful physical examination can help physicians determine whether the children have cancer and make referrals in time.Some children with possible cancers require immediate initial treatment before referral to be stabilized in order to make the referrals possible and increase the chance of receiving appropriate treatment in time and the possibility of being cured,saving more children with malignant solid tumors to the maximum extent.

Objective Too investigate the application value of procalcitonin(PCT)and high sensitivity C-reactive protein(hs-CRP)in early diagnosis of neonatal septicemia and disease condition assessment.Methods 48 patients with neonatal septicemia treated in the hospital from November 2011 to May 2013 were collected.The data of PCT,hs-CRP and blood culture were recorded and performed the comparative analysis with the serum PCT,hs-CRP detection results in contemporaneous 48 neonates without septicemia.Results The serum PCT and hs-CRP was 93.75% and 10.42% in the neonates with septicemia,which were signifi-cantly higher than 79.17% and 50% in the neonates without septicemia(P <0.05),the positive rate had statistical difference be-tween the two groups.Conclusion PCT and hs-CRP have remarkable change in the early stage of neonatal sepsis,the combination detection of serum PCT and hs-CRP can be used as the indicators for early diagnosis of neonatal sepsis,moreover the sensitivity and specificity of PCT for diagnosing neonatal septicemia are higher the those of hs-CRP,their combined detection can provide fast and accurate diagnostic basis for clinic.