Objective To make clear of the mechanism of metastasis and recurrence of primary liver cancer, and to make sure of the preventive value of transeatheter arterial immun- ehemoembolization (ICE) in treatment of liver cancer. Methods The study is a double-blinded, controlled, prospective, randomized trial. 146 patients were randomly divided into 3 groups. Group A: regular surgery of primary liver cancer;group B: TACE 1month after surgery, treatment proposal was: ADM + DDP + 5-Fu + LP; group C:transeatheter arterial immun-chemoembolization 1 month after surgery, treatment proposal : ADM + DDP +5-Fu+LP+Octreotide+IFN. Results CD3+, CD4+, CD4+/CD8+ increased 1 month after surgery in group A; In group B: CD3+, CD4+, CD4+/CD8+ decreased but CD8+ increased 1 week after TACE; CD3+, CD4+, CD4+ /CD8+ increased but CD8+ decreased 4 weeks after TACE(P<0.05); In group C: CD3+ , CD4+, CD4+/CD8+ increased slightly 1 week after TACE, but increased significantly 4 weeks later(P<0.05). In group A, the level of VEGF was high before surgery but decreased 1 month after surgery; In group B, the level of VEGF decreased 1 week after TACE, decreased more significantly 4 weeks after TACE than that in group B(P <0.05). 1 year survival rate, 2 year survival rate and 3 year survival rate in group C ware higher than those in group A; 1 year survival rate was higher in group B than that in group A, however, 2 year survival had and 3 year survival rate had no differ-ences between group B and group A. Conclusion Transcatheter arterial ICE can prevent metastasis and recurrence after surgery of primary liver cancer increase the 1,2,3 year survival rate. It not only has the role of TACE,but can increase the immunefunction,and inhibit tumor angiogenesis, then increase the therapeutic effect.

AIM: To investigate the effect of peroxisome proliferator-activated receptor ? (PPAR?) activator rosiglitazone on myocardial ischemic-reperfusion injury in rats. METHODS: Forty-two SD rats were randomly divided into three groups: sham group (n=14), I/R group (n=14) and I/R+rosiglitazone group (n=14). Myocardial infarct size was assessed by NBT staining. Plasma and myocardial angiotensin and aldosterone as well as plasma renin activity were detected by radioimmunoassay. RESULTS: Compared with I/R group, myocardial infarct size was reduced by 23.9% (P

Objective To systematically review the effectiveness and safety of transcutaneous electricalnerve stimulation (TENS) on symptomatic diabetic neuropathy (DNP). Methods Electronic databases such asPUBMED, EMBASE, Cochrane Central Register of Controlled Trials, and Chinese Biomedical Database weresearched by using such mesh and text keywords as "TENS" and "diabetic neuropathy". Randomized controlled trials(RCTs) on the effect of TENS on symptomatic diabetic neuropathy were included. Studies were selected and availa-ble data was extracted independently by two reviewers. Meta-analysis was performed using RevMan 4.2.8 software.Results Three RCTs involving 78 patients were included in this study. Compared with sham-stimulation, TENStherapy significantly reduced the score in pain (SMD -2.35, 95% CI [-4.24, -0.46 ] ) and the score in numb-ness (WMD -0.18, 95% CI [-0.32, -0.05 ] ). Subgroup analysis shows that TENS therapy was associated with a significant reduction in the score of pain in both 4-week treatment duration ( SMD - 5.37, 95% CI [ - 6.97,- 3.77 ] ) and 6-week treatment duration ( SMD - 1.01, 95% CI [ - 2.01, - 0.01 ] ), but not 12-week treatmentduration (SMD - 1.65, 95% CI [ -4.02, 0.73 ] ). Conclusion TENS therapy is a promising and safe strategyfor treatment of symptomatic diabetic neuropathy. More studies are still warranted to accumulate the evidence of theeffect of TENS therapy on DNP.

Objective To explore β-sodium aescinate on vascular endothelial function ( FMD ) , homocysteine ( Hcy ) and hypersensitive C-reactive protein ( hs-CRP) and clinical efficacy in patients with acute cerebral infarction.Methods 198 acute cerebral infarction patients from March 2013 to April 2015 were randomly divided into observation group (n=100) and control group (n=98).Control group were treated according to the condition of the disease, observation group were treated by β-sodium aescinate base on control group, 20mg was added to 250mL saline for intravenous drip,one times per day.Continuous used 14d for one treatment courses.Compared the change of vascular endothelial function, Hcy and hs-CRP and clinical efficacy.Results The total effective rate of observation group was 90.00%, which was significantly higher than that of 71.42% in control group (χ2 =11.01,P<0.05).Post-treatment the value of FMD significantly increased, Hcy and hs CRP were significantly decreased both in observation group and control group respectively, which the difference had a statistically significant as compared with Pre-treatment (P<0.05);but, the value of FMD was significantly higher, Hcy and hs CRP was significantly lower in observation group than that of control group (P<0.05).Conclusion It has a significant β-sodium aescinate clinical effect in treatment of acute cerebral infarction, and FMD are significantly higher, Hcy and hs-CRP are significantly decrease.

OBJECTIVE:To explore drug quality dynamic evaluation mechanism based on analysis of drug quality announce-ment data. METHODS:The sorts and types of drugs,places of origin,quantity of production enterprises and frequency distribu-tion of being mentioned were analyzed on the basis of drug quality announcement issued by CFDA and provincial administration in 2013. RESULTS & CONCLUSIONS:Frequency of TCM being mentioned (0.75%) was higher than that of chemical drug (0.30%). Among drugs mentioned more than 10 times,the most chemical drugs were injection (70%) and the most TCM were tablet(66.7%). Among all types,drug types produced by more than 100 enterprises accounted for 62.5%,and those produced by more than 50 enterprises accounted for 93.75%,which indicated the frequency of problems was in relatively direct proportion to the quantity of drug manufacturing enterprises. Top 10 provinces in the list of the number of drug quality announcements showed different characteristics of problem type distribution. In compassion,the quality problems of TCM in Jilin,Guangxi,Mongolia,Si-chuan were prominent,and reference number proportion of involved TCM were 85%,80%,97% and 69%,respectively;the quality problems of chemical drugs in Henan,Shanxi,Jiangsu,Guangdong,Anhui,Shandong should be paid attention,and refer-ence number proportion of involved chemical drugs were 62%,61%,95%,57%,86% and 65%,respectively. It is suggested that the government should carry out the dynamic risk assessment system based on data of drug quality announcement,and strength-en standard management of data collection of local drug quality announcement.

Objective To investigate clinical characteristics and emergency managements of postrenal acute renal failure(ARV)induced by melamine in infant.Method Fluid therapy for urine alkalization and hydration,cistoscope drainage and peritoneal dialysis step by step were exerted in those who had both a history of certain milk intake and ARF according to the definition of pediatric ARF which developed by Pediatric Nephrology Assembly of Chinese Pediatric Association in 1994.Results Thirty-four postrenal ARF cases with anuria due to melamine in Nanjing Children's Hospital of Nanjing Medical University were involved in the study.Seventy cases(50%)re-ceived fluid therapy only.Nine cases(26.5%)received fluid thempy and eistoscope drainagemand 4 cases (11.8%)received fluid therapy and cistoscope drainage and peritoneal dialysis.Four cases(11.8%)received ur-gent peritoneal dialysis due to severe hyperkalemia.All cases(100%)survived.The urine pH at the first day.the second day,and after the second day in those who just pass away urine were 6.1±1.0、6.5±0.7.5.3±0.4,respectively(F=4.563,P=0.026).Conclusions Fluid therapy for urine alkalization and hydration and stop sequential thempy are effective in infant with postrenal ARF induced by melamine.

OBJECTIVE:To provide reference for exploring the strategy of promoting TCM formula granules.METHODS:The questionnaire was designed to investigate the cognition and attitude of TCM practitioners from different grades to TCM formula granules in our university,and the investigation data were analyzed statistically.RESULTS:A total of 312 questionnaires were collected and 306 questionnaires were collected with recovery rate of 98.08％.Among them,305 questionnaires were effective with effective rate of 99.67％.46.89％ of interviewed practitioners were found to know and understand about TCM formula granule,52.46％ knew but did not understand;the higher the grade,the higher the proportion of the known and the better understanding (P＜0.05);the cognitive channels included diagnosis and treatment course (69.64％),took by others (65.02％),took by oneself (51.49％).TCM formula granules were easy to take without decoction (95.71％) and easy to carry (87.13％),the advantage of which had high popularity,but there was not much knowledge about other advantages.7.54％ of interviewed practitioners fully appreciated TCM formula granules and 69.18％ recognized them;the higher the grade,the higher the degree of recognition (P＜ 0.05).89.51％ were willing to learn more about TCM formula granules.60.98％ said they would prescribed TCM formula granules in the furure.Among the influential factors for the attitude of the practitioners to TCM formula granules,the three factors with the highest influence were the influence of the teachers,the influence of the patients and their own practice.CONCLUSIONS:The practice of TCM practitioners in our university in Beijing is not ideal for the cognition of TCM formula granules.There is still a great room for improvement in the attitude to TCM formula granules.The teachers and patients are key influential factors for the attitude to TCM formula granules.

Objective:To investigate the changes of circulating tumor DNA (ctDNA), circulating B cell-specific Moloney leukemia virus insertion site 1 mRNA (Bmi-1 mRNA) and microRNA-21 (miR-21) before and after treatment with epidermal growth factor receptor (EGFR) monoclonal antibody in advanced colorectal cancer, and analyze their association with treatment response.Methods:The clinical data of 98 patients with advanced colorectal cancer from March 2019 to March 2021 in Yantai Yuhuangding Hospital were retrospectively analyzed. After treatment with cetuximab, complete remission was in 4 cases, partial remission in 26 cases, stable disease in 39 cases, and progressive disease in 29 cases. The patients with complete remission and partial remission were classified as remission group (30 cases), the stable disease and progressive disease were classified as non-remission group (68 cases). Before treatment and after 2 cycles of treatment, the plasma level of ctDNA was detected by high-throughput sequencing; the levels of Bmi-1mRNA and miR-21 were detected by real-time fluorescence quantitative polymerase chain reaction. Spearman correlation was used to analyze the relationship between ctDNA, Bmi-1mRNA, miR-21 and treatment responsiveness after 2 cycles of treatment; multivariate Logistic regression was used to analyze the independent risk factors affecting treatment responsiveness; receiver operating characteristic (ROC) curve was drawn to evaluate the value of ctDNA, Bmi-1mRNA and miR-21 in predicting remission after 2 cycles of treatment.Results:There were no significant differences in ctDNA, Bmi-1mRNA and miR-21 before treatment between 2 groups ( P>0.05); the ctDNA, Bmi-1mRNA and miR-21 after 2 cycles of treatment in remission group were significantly lower than those in non-remission group: (10.03 ± 3.32) μg/L vs. (15.33 ± 5.14) μg/L, 0.13 ± 0.04 vs. 0.19 ± 0.05 and 0.81 ± 0.26 vs. 1.08 ± 0.24, and there were statistical differences ( P<0.01). Spearman correlation analysis result showed that ctDNA, Bmi-1mRNA and miR-21 were negatively correlated with treatment response ( r = -0.500, -0.506 and -0.531; P<0.01). Multivariate Logistic regression analysis result showed that, after controlling for the number of distant metastatic organs and clinical stage, ctDNA, Bmi-1mRNA and miR-21 were still independent risk factors for treatment response in patients with advanced colorectal cancer ( OR = 3.342, 2.725 and 1.838; 95% CI 3.116 to 3.584, 2.647 to 2.805 and 1.768 to 1.911; P<0.01). ROC curve analysis result showed that the area under the curve (AUC) of ctDNA, Bmi-1mRNA combined with miR-21 after 2 cycles of treatment to predict the treatment response was the largest with 0.922. Conclusions:The changes of ctDNA, Bmi-1mRNA and miR-21 in patients with advanced colorectal cancer before and after treatment with EGFR monoclonal antibody are related to the treatment response. Combined detection is helpful for screening patients sensitive to EGFR-targeted therapy, and can provide reference for new targets of molecular intervention.

Objective To investigate the effect of silenced RBM8A gene on the biological behavior (proliferation, migration, and apoptosis) of human endometrial cancer HEC-1A cells and its possible mechanism. Methods The hairpin shRNA targeted by the RBM8A gene was designed, and the best shRNA silencing fragment was screened. The recombinant lentiviral interference vector carrying the target gene was constructed and used to infect HEC-1A cells. Cells with stable knockdown of RBM8A gene were screened by puromycin as the experimental group (shRBM8A), while the shRNA of nonsense sequence was designed as the control group (shControl). CCK-8 method was used to detect cell proliferation, and flow cytometry was used to detect cell apoptosis. Transwell assay was used to detect cell migration and invasion. Western blot was used to analyze the expression of apoptosis-related proteins and EMT signal transduction pathway related proteins. Results In comparison with the shControl group, after RBM8A knockdown, HEC-1A cell proliferation was reduced, apoptosis was increased, migration and invasion ability were significantly inhibited (P < 0.05), the expression of apoptosis-related proteins cleaved caspase 9 and caspase 3 increased, EMT-related protein E-cadherin expression increased, and Vimentin expression decreased. Conclusion RBM8A gene silencing can inhibit the proliferation, migration, and invasion and promote the apoptosis of endometrial cancer cells. The inhibition of EMT signal transduction pathway may be its mechanism.

OBJECTIVETo investigate the accuracy and consistency of the detection of BCR-ABL tyrosine kinase domain point mutation among different laboratories.

METHODSEvery one of 6 laboratories prepared 10 cDNA samples from tyrosine kinase inhibitors resistant BCR-ABL (P210 or P190) positive patients'bone marrow or peripheral blood. Each cDNA sample was divided into 6 aliquots and delivered to the laboratories. All 6 laboratories tested BCR-ABL point mutations of 60 samples according to their own protocols. Peking University People's Hospital analyzed the comparison results based on both the reports and sequencing chromatogram from all laboratories.

RESULTSAll laboratories reported the same nucleotide and corresponding amino acid mutations in 37 samples (61.7%）. Of 60 samples, 53 had confirmed mutation types, and a total of 23 types were included; 1 had no mutation; mutation types of 6 samples could not be determined because of the big differences among chromatograms from different laboratories. Low percentages of mutants were significantly related to results inconsistency (P=0.008). Inconsistent result of one sample was caused by the unique chromatogram of the mutant L248V, and one by the non-coverage amplification of PCR product from different laboratories. Amplification was failed in 3 samples. Testing or sequencing mistakes occurred in 7 samples. The differences in the mutant percentages among laboratories were less than 20% in the 80.6% of samples with confirmed results. Low internal control gene copies (ABL<10 000) were significantly related to both failed amplification and big differences among chromatograms from different laboratories (P=0.005 and <0.001, respectively).

CONCLUSIONProblems in the clinical routine detection of BCR-ABL point mutation could be exposed and improvement could be achieved by sample exchange and comparison. Low percentage of mutant is the main reason which causes the discrepancy of BCR-ABL point mutation results among different laboratories.