Objective To study the expressions of Hepcidin,bone morphogenetic protein 6 (BMP6) and hemojuvelin (HJV) in gastric cancer,and to explore their relationships with clinical pathological characteristics.Methods Hepcidin,BMP6 and HJV were detected by immunohistochemistry in 62 cases of gastric cancer patients,and the relationships among them and clinical pathological features were analyzed.Results Compared with normal gastric mucosa tissues,Hepcidin was highly expressed in gastric cancer tissues (13.3％ vs.56.5％,x2 =8.99,P ＜ 0.01),while the differences of the expression of BMP6 and HJV in the two groups were not statistically significant (60.0％ vs.40.3 ％,x2 =1.89,P ＞ 0.05;93.3％ vs.83.9％,x2 =0.88,P ＞ 0.05).The expression of Hepcidin was related to T stage (x2 =6.98,P =0.02),but it was not related to age,sex,lymph node metastasis,distant metastasis and anemia.The expressions of BMP6 and HJV were not related to T stage,age,sex,lymph node metastasis,distant metastasis and anemia.Hepcidin was not related to the expressions of BMP6 and HJV (r=0.13,P＞0.05;r=0.15,P＞0.05).Conclusion Hepcidin is highly expressed in gastric cancer tissues,which is related to the T staging of gastric cancer,and can be used as an objective indicator of the biological behavior of gastric cancer.There were no differences in the expression of BMP6 and HJV between normal gastric mucosa and gastric cancer tissues.

Objective To share the experience of surgical repair for cor triatriatum in chidren.Methods Between July 2008 and June 2013,24 children with cor triatriatum underwent surgical correction in Cardiac Center of Children's Hospital of Fudan University.The minimum age at the time of operation was 1 month,median age was 5 month;the minimum body weight at the time of operation was 3.5 kg,median body weight was 7.4 kg.Retrospectively analyzed their cardiac anatomy,clinical data,surgical procedures and follow-up data.Results Of all 24 patients,there were 4 patients diagnosed semplice cor triatriatum,and 20 patients diagnosed cor triatriatum associated with other malformation includes cardiac and non-cardiac issues.Procedures were performed on 22 patients to correct all cardiac defects in one stage.1 patient underwent surgical repair for cor triatriatum and Glenn procedure as well.1 patient,diagnosed as cor triatriatum and functional single ventricle S/P Glenn,underwent surgical repair for cor tiratriatum only.2 patients recovered from pulmonary artery hypertension crisis after operation.1 patient dead 17 days post procedure caused by respiratory failure.23 patients discharged from hospital.The longest follow-up was 73 months,at least 12 months after discharge.All alive patients were in New York Heart Association's function class Ⅰ-Ⅱ.Echo assessment revealed normal size of left atriums of almost all alive patients one year after discharge.Till April 2015,no postoperation intervention,no blood flow obstruction at level of pulmonary veins,left atrium or mitral valve.Conclusion Pediatric patients diagnosed cor tiratriatum sinister need intervention,no matter hemodynamic change occurs or not.Right time of surgery is important for successful treatment.

Total 406 community residents entered in fitness improvement program with “management by objectives model of health promotion” from 2009 to 2011.The fitness status was monitored by Xuhui Physical Constitution Center before and after entering the program.The results showed that the level of fitness assessment,the composite score,lung capacity and reaction time were improved with the years (P ＜ 0.01) ; the step index and sitting-and-reach test in 2010 was better than those in 2009(P ＜ 0.01) ; the grip strength in 2010 and 2011 was better than that in 2009 (P ＜ 0.01); the test of single leg-standing with closing eyes in 2011 was better than that in 2009(P ＜ 0.05).There was no difference in body mass index before and after program (P ＞ 0.05).The results indicate that physical fitness and overall health can be improved by management by objectives model for health promotion.

Objective To study the expression and significance of Neogenin,Hepcidin and serum ferritin(SF)in patients with cancer-related anemia.Methods To test the serum levels of Neogenin,Hepcidin and SF in 107 cases,including 55 cases with cancer-related anemia and 52 cases of non-anemia with tumor by ABC-ELISA.Results ①The serum levels of Neogenin in patients with cancer-related anemia were 0.77 ± 0.45 ng/ml,which were lower than 0.98 ± 0.60 ng/ml in non-anemia group (t=2.003 8,P <0.05).The serum levels of Hepcidin in patients with cancer-related anemia were 6.03±4.25 μg/ml, which was higher than 4.51±2.23 μg/ml in non-anemia group (t=2.319 5,P <0.05).②There were no difference in pa-tients between anemia and non-anemia (t=1.898 0,P >0.05).③In patients with cancer,there were positive correlation be-tween Neogenin and Hb (r=0.212 4,t=2.226 4,P <0.05),there were negtive correlation between Hepcidin and Hb (r=-0.310 1,t=3.345 2,P <0.01),but there were no correlation between SF and Hb (P >0.05).④There were positive cor-relation between Hepsidin and SF (r=0.486 6,P <0.01).Conclusion There were lower expression of Neogenin,higher ex-pression of Hepcidin in patients with cancer-related anemia is a complex process.The abnormal expression of Neogenin and Hepcidin which were lead to the loss of use of iron are the key factors attribute to anemia in patients with cancer.

Aim To investigate the effects of lentivirus mediated nerve growth factor ( NGF) gene silencing on pheochromocytoma cells ( PC12 ) and the possible mechanisms .Methods The NGF shRNA expression vector was constructed .PC12 cells were randomly divi-ded into five groups (n=3 each) as follows: negative control group ( NC ) , control lentivirus group ( LV CON) , lentivirus NGF shRNA1 group ( LV shNGF1 ) , lentivirus NGF shRNA2 group(LV shNGF2), lentivir-us NGF shRNA3 group(LV shNGF3).The cells in NC group were cultured in DMEM/HG and polybrene me-dium, while others were cultured in DMEM/HG, poly-brene and corresponding lentivirus medium .After the treatment, the infection efficiency was determined by fluorescent microscope .Relative expression of NGF , extracellular signal-regulated kinase ( ERK1/2 ) and p-ERK1/2 were assessed by Western blot .The expres-sion of NGF mRNA was analyzed by quantitative re-verse transcription polymerase chain reaction ( qRT-PCR) .The differentiation degree was valued according to the length of neuritis and max diameter of cells .The cell viability was detected by CCK-8.Results The in-fection efficiency in PC12 cells reached over 90%. Compared with NC group , the relative expression of NGF mRNA and NGF protein was significantly down-regulated ( P<0.05 ) .There was no difference in the expression of ERK1/2 protein and cell viability .The expression of p-ERK1/2 protein was markedly down-regulated in LV shNGF3 group ( P<0.01 ) .The cells morphology was changed , and the length of neuritis and max diameter of cells were strained in LV shNGF 3 group than those in NC group ( P<0.01 ) .Conclusion Lentivirus-mediated NGF gene silencing inhibits the differentiation of PC12 cells through suppressing the activation of ERK1/2.

ObjectiveTo investigate the variations and distributions of the plasmid-mediated quinolone resistance genes in clinical isolates of Shigella and their resistance to antimicrobial agents. Methodsqnr, aac(6')-Ib-cr and qepA genes were identified by polymerase chain reaction (PCR) in 137 clinical isolates of Shigella.DNA sequencing of gene-positive strains were analyzed and the conjugation experiment was performed. The minimal inhibitory concentrations (MIC) of Shigella isolates, recipient strains and transconjugants were tested by agar dilution method for quinolones and other antimicrobial agents. The genotype of transconjugants were determined by PCR and sequencing. ResultsFour (2.9％) strains of the 137 Shigella isolates were qnr gene positive, including 3 qnrS2 positive and 1 qnrB4 positive (GenBank accession numbers of the complete sequence were JF261185 and HQ917003, respectively).Furthermore,five (3.6％) aac ( 6')-Ib-cr gene-positive strains (GenBank accession number JF261186 ) and one (0.7％) qepA gene-positive strain were identified in all isolates. The conjugation experiments were successfully carried out in six out of ten PCR-positive isolates. The MIC of transconjugants against quinolones and other antimicrobial agents increased differently compared to recipient strains. Conclusions The plasmid-mediated quinolone resistance genes are lowly prevalent in clinical isolates of Shigella. However, these resistance genes have the characteristic of horizontal transfer, which indicates that more attention should be paid to this phenomenon.

Objective To study the relationship between serum erythropoietin(Epo)level and chemotherapy-induced hemoglobin(Hb)level in elderly patients with cancer. Methods　One hundred senile patients(aged≥60 years)with cancer and one hundred and seventy non-senile patients(aged＜60 years)with cancer were selected as aged group and control group,respectively.The serum Epo level was detected by enzyme-linked immunosorbent assay(ELISA). Results　(1)The average levels of the serum Epo in aged group and control group were(22.0±15.1)U/L and(30.4±21.8)U/L,respectively(t=1.2988,P＞0.05).A negative correlation was found between the levels of Epo and Hb in elder cancer patients(r=0.3700,P＜0.001).(2)The levels of serum Epo were(14.7±10.6)U/L,(20.2±9.0)U/L and(42.3±24.8)U/L in 55 cases with normal Hb level,22 cases with mild anemia and 23 cases with moderate to severe anemia,respectively(F=11.6886,P＜0.01).(3)The levels of Epo were(20.2±10.8)U/L,(45.2±39.1)U/L and(25.8±15.9)U/L before chemotherapy,after 4 treatment cycles and 2 treatment cycles respectively(F=4.5477,P＜0.01).The levels of Hb were(111.0±20.5)g/L,(96.8±16.6)g/L and(102.1±19.3)g/L before chemotherapy,after 4 treatment cycles and 2 treatment cycles respectively(F=4.0071,P＜0.01).Conelusions　There is no statistical difference in serum Epo level between senile patients with cancer and non-senile patients with cancer.but serum Epo levelis higher in patients with anemia than without anemia.There is a negative correlation between the levels of Epo and Hb.Chemotherapy can decrease the level of Hb and increase the serum 1evel of Epo in part of patients.The changes are correlated with the conditions of patients before chemotherapy and the time of chemotherapy.

Objective To investigate the clinical effect of nicorandil for treatment of patients with acute respiratory distress syndrome (ARDS).Methods A prospective randomized controlled trial was conducted. A total of 40 cases of patients with ARDS admitted to Department of Critical Care Medicine of Guizhou Provincial People's Hospital from October 2012 to October 2014 were enrolled, and they were randomly divided into two groups, 20 cases in each group. The two groups were treated with routine western medicine after admission. On this basis, the observation group was given nicorandil 10 mg, while the control group was given warm boiled water 10 mL, through gastric tubes 3 times a day, the therapeutic course being consecutive 5 days in both groups. The length of stay in intensive care unit (ICU), duration of mechanical ventilation after treatment, oxygenation index (OI), alveolo-arterial oxygen partial pressure difference (PA-aO2), positive end-expiratory pressure (PEEP), acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score, Glasgow coma score (GCS) before and after treatment, the predicted death rate (PDR) and 28-day mortality were compared between the two groups. The predicitive factors for 28-day mortality were screened by binary logistic analysis.Results The length of stay in ICU and duration of mechanical ventilation of control group were longer than those of observation group, but the difference was not statistically significant [ICU length of stay (day): 14.55±12.71 vs. 9.15±6.00, duration of mechanical ventilation (day): 13.25±12.27 vs. 7.75±5.32, bothP > 0.05]. After treatment, the GCS was higher than that before treatment in control group and observation group (11.95±3.98 vs. 10.75±4.89, 12.95±3.67 vs. 12.20±4.56), while APACHE Ⅱ score, PDR and PEEP were all lower than those before treatment [APACHE Ⅱ: 21.05±8.58 vs. 24.90±5.63, 18.70±11.21 vs. 26.65±7.67; PDR: (47.71±29.49)% vs. (61.00±23.29)%, (36.79±18.49)% vs. (56.12±18.16)%; PEEP (cmH2O, 1 cmH2O = 0.098 kPa): 4.40±3.14 vs. 5.75±2.59, 3.80±2.55 vs. 7.55±3.32], but there were no statistically significant differences between the two groups before and after treatment (allP > 0.05). After treatment, the OI was significantly higher and the PA-aO2 was significantly lower than those before treatment in the two groups, and the degrees of improvement of the observation group were more remarkable than those of the control group [OI (mmHg, 1 mmHg = 0.133 kPa): 224.72±85.12 vs. 141.37±45.82, PA-aO2 (mmHg): 132.60±46.64 vs. 204.30±121.2, bothP < 0.05]. The 28-day mortality of observation group was lower than that of control group, but no statistically significant difference was seen [15% (3/20) vs. 25% (5/20),χ2 = 0.156,P > 0.05). Binary logistic regression analyses showed that the PA-aO2 [odds ratio (OR) = 0.958,P = 0.013, 95% confidence interval (95%CI) = 0.927 - 0.991], APACHE Ⅱ score (OR = 0.882,P = 0.010, 95CI = 0.803 - 0.970), GCS (OR = 1.399, P = 0.004, 95%CI = 1.111 - 1.761) and PDR (OR = 0.907,P = 0.002, 95%CI = 0.853 - 0.965) after treatment were the independent predictors of 28-day mortality.Conclusion Nicorandil can significantly improve oxygenation, but cannot reduce 28-day mortality in patients with ARDS.

Objective To study the expression and clinical significance of Livin ( anti-apoptosis protein) and Smac (promoting apoptosis factor) in patients with the non-Hodgkin lymphoma (NHL).Methods The expression of Livin and Smac were detected by immunohistochemical staining(SP) assay in 31 patients with NHL, and the relationship between Livin/Smac and clinical staging, IPI and prognosis were analyzed. Results The patients with positive expression of Livin had B symptom, high risk IPI, late clinical staging (Ⅲ/Ⅳ stage) and short survival time, while the ones with positive expression of Smac had no B symptom, early clinical staging( Ⅰ /Ⅱ stage), low risk IPI and good prognosis. The expressions of both Livin and Smac were not related to gender and age. Expression of Livin was not correlated to that of Smac (r =0.003,P ＞0.05). Conclusion For patients with NHL, the expression of Livin protein was related to poor prognosis and adverse clinical features, whereas the expression of Smac protein was related to good prognosis and clinical feature.

ObjectiveTo analyze the clinical distribution and antimicrobial resistance profile of Serratia marcescens(S. marcescens), and to provide the scientific evidence supporting clinical diagnosis and treatment.MethodsThe antimicrobial susceptibility test was performed in 104 strains of S. marcescens by agar dilution method. The results were judged according to the criteria recommended by Clinical and Laboratory Standards Institute (CLSI) 2010.The data were analyzed by chi square test. Results The majority of S. marcescens were isolated from sputum specimens,accounting for 59.6％ (62/104). The bacteria were most frequently isolated from department of respiratory (33.7％,35/104),followed by intensive care unit (23.1％,24/104),department of gerontology (16.3％, 17/104). The results of antimicrobial susceptibility test showed that the resistance rates of S.marcescens against ampicillin,gentamicin and cephazolin were high,which were 90.4％,86.5％ and 79.8％,respectively; those against the 3rd generation of cephalosporins were 24.0％-43.3％. No imipenem and meropenem resistant strains were identified. Compared with cefoxitin-resistant strains,the resistance rates of non-cefoxitin resistant strains against piperacillin (82.9％ vs 28.6％),ceftazidime (63.4％ vs 9.5％),aztreonam (68.3％ vs 9.5％),amikacin (68.3％ vs 20.6％),ciprofloxacin (48.8％ vs 19.1％) and chloramphenicol (90.3％ vs 58.7％) were all lower (all P ＜ 0.05 ). Conclusions S. marcescens is one of the most common conditional pathogenic bacteria leading to nosocomial infections,which is resistant to many kinds of antimicrobial agents.The surveillance of antimicrobial resistance in S. marcescens should be strengthened for purpose of preventing the transmission of multidrug resistant strains.