Efficacy of chemotherapy for advanced gastric cancer is unsatisfactory. Molecular targeted therapies have emerged as a novel approach to the treatment of advanced gastric cancer in recent years.These therapeutic strategies include targeting EGFR signal transduction pathway,anti-angiogenesis therapy,multi-target molecular targeted drugs. Targeted drugs such as trastuzumab,cetuximab,bevacizumab,apatinib,sorafenib sunitinib,lapatinib and everolimus which are targeting HER2,EGFR,VEGF and mTOR pathway,are applied in the comprehensive treatment of advanced gastric cancer,and their therapeutic effects are encouraging.

Objective To study the visfatin level changes in patients with rheumatoid arthritis (RA), and to study the correlation of visfatin level and atherosclerosis in RA.Methods Fifty cases of patients were divided to the plaque group (33 cases) and plaque-free group (17 cases) according to the carotid intima media thickness checked by carotid ultrasonography.In addition, their blood lipid level, homeostasis model assessment of insulin resistance (HOMA-IR), rheumatoid factors (RFs), anti-CCP, visfatin etc.were measured.Fifty healthy people were set as the control group.The correlation between the visfatin level of RA patients and atherosclerosis was analyzed.The statistical analysis was carried out with independent t-test,analysis of variance, Spearman correlation analysis and multiple stepwise regression.Results The serum visfatin level of RA plaques group was obviously higher than that of the plaque-free group [(47±22) μg/L vs (34±19) μg/L, t=4.361, P＜0.01].The serum visfatin level of RA patients was positively correlated to HOMA-IR (r=0.567, P=0.001), RF (r=0.502, P=0.003), anti-cyclic peptide containing citrulline, (anti-CCP) (r=0.420, P=0.038) and carotid artery IMT (r=0.596, P=0.001).High-density lipoprotein-C (OR=1.009, P=0.020), HOMA-IR (OR=1.450, P=0.006), anti-CCP (OR=1.005, P=0.014) and visfatin (OR=0.971, P=0.008) were independent relevant factors affecting carotid artery IMT.Conclusion The serum visfatin level of RA patients is closely related to atherosclerosis.

We retrospectively analyzed the clinical manifestations,treatments and prognosis of infective endocarditis (IE)associated with renal lesions in children.There were 23 confirmed IE cases who were admitted to the Capital Institutes of Pediatrics from 1992 to 2012.There were 6 cases (26％) with renal lesions.Renal lesions included asymptonatic microscopic hematuria(1 case),asymptomatic proteinuria (1 case) and acute nephritic syndrome (4 cases).There were 3 cases of acute renal injury (AKI) resulted from nephritis accompanied with acute heart failure.The serum level of C3 was lower in patients with renal lesions than patients without renal lesions (P ＜ 0.05),but the clinical manifestations,physical signs and other laboratory findings were the same.Patients of both groups were treated with antibiotics.All patients were recovered and discharged.The average hospital days were (39.2-± 15.2)days for patients with renal lesions and (34.9-± 19.2) days for patients without renal lesions (P ＞ 0.05).Renal lesions secondary to IE are relatively common in IE patients in children.Most of renal lesions can be improved by effective antibiotics.Prognosis of those patients accompanying with AKI is bad.

Objective To study the effects on berberine hydrochloride on the mitochondria membrane potential and free intracellular calcium of HaCaT cells, and elucidate the mechanism of action of berberine on keratinocytes. Methods Rhodamine-123 fluorescence (very sensitive to mitochondria membrane potential) and Fluo-3/AM fluorescence (suitabe to detect free intracellular calcium in single HaCaT cell) were measured by laser scanning confocal technique. Results Fluo-3/AM fluorescence intensity of HaCaT cells was persistently increased after treating with berberine at concentrations of 5 ? 10-5M, 2.5 ? 10-5M and 1.25 ? 10-5M, and significant differences were observed as compared with the PBS control. The intensity of rhodamine-123 fluorescence in HaCaT cells was decreased immediately when exposed to berberine, with significant difference from that of the PBS control. Conclusions It is suggested that berberine could increase free intracellular calcium and decrease mitochondria membrane potential of HaCaT cells, induce overload of intracellular calcium, influence energy metabolism, and then inhibit the proliferation of keratinocytes.

Objective To investigate the expression of calpain small subunit 1 (Capn4) in breast cancer and its clinical significance. Methods The cancer tissues and the paraffin-embeded specimens of the corresponding adjacent normal tissues from 12 patients with breast cancer between May 2015 and July 2015 in Shanghai General Hospital were collected. The expression of Capn4 was detected by using immunohistochemistry. The paraffin-embeded specimens of cancer tissues from 70 breast cancer patients in Shanghai General Hospital between January 2009 and September 2011 were also collected. And the expression of Capn4 was detected. The correlation between Capn4 expression level and TNM stage, pathological grade, molecular markers as well as the prognosis of breast cancer was also analyzed. Results The expression of Capn4 in breast cancer tissues was higher than that in the corresponding adjacent normal tissues. The expression level of Capn4 was correlated with TNM stage (P = 0.002), T stage (P = 0.004), N stage (P = 0.004), M stage (P = 0.025), estrogen receptor (ER) status (χ 2 = 4.787, P = 0.029) and survival status (χ 2 = 5.826, P = 0.016). Kaplan-Meier survival analysis revealed that the median survival time in the higher expression of Capn4 group 90 months was shorter than that in the lower expression of Capn4 group (not reaching the median survival time), and there were statistical differences (χ 2 = 4.351, P = 0.037). Conclusions The expression of Capn4 in breast cancer tissues is upregulated. The expression difference is correlated with TNM stage, pathological grade, ER status and the prognosis of breast cancer, suggesting that it may become a new target and molecular marker for breast cancer treatment.

Objective: To investigate the efficacy and safety of using pegylated recombinant human granulocyte-colonystimulating factor (PEG-rhG-CSF) in preventing neutropenia in multiple chemotherapy cycles. Methods: A multicenter, prospective, open-label, singlearmstudy was designed. Patients with malignant tumors, such as lung, ovarian, and colorectal cancers, who received multiple cycles of chemotherapy with the prophylactic use of PEG-rhG-CSF for 2-4 consecutive cycles participated in the study. Results: After the prophylactic use of PEG-rhG-CSF, the incidence of grade IV neutropenia decreased from 4.76% (13/273) in the first cycle to 1.83% (5/273), 1.15% (2/174), and 2.08% (2/96) in subsequent cycles. Meanwhile, the incidence of grade III neutropenia decreased from 11.36% (31/ 273) in the first cycle to 6.23% (17/273), 2.87% (5/174), and 3.13% (3/96) in subsequent cycles. The incidence of febrile neutropenia (FN) during the first cycle was 0.73% (2/273). The duration of FN was 2 days in one case and 5 days in another case. FN was not observed during the second, third, or fourth cycle. After the secondary prophylactic use of PEG-rhG-CSF, the incidence of grade IV neutropenia decreased from 25% (7/28) to 3.57% (1/28), 0% (0/28), and 6.67% (1/15) in subsequent cycles. Meanwhile, the incidence of grade III neutropenia decreased from 71.43% (20/28) to 10.71% (3/28), 14.29% (4/28), and 0% (0/15) in subsequent cycles. The proportion of patients who received antibiotic therapy during the entire chemotherapy period was 10.48% (44/420). Conclusion: The application of PEG-rhG-CSF once per chemotherapy cycle can effectively reduce the occurrence of neutropenia in patients under multiple cycles of chemotherapy treatment with good safety.