Objective To Investigation of serun lipid levels of professional population in Qingpu District. Methods The serun levels of total cholesterol (TC) , triglyceride (TG), high density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) were measured in 9 846 professional individuals. Results The prevalence of abnormal serum lipid levels of 9 846 professional individuals was 20.53%. It was 31.97% among male group, 7.86% among female group(P < 0.01). Conclusion The prevalence of abnormal serum lipid level among the professional population in Qingpu, Shanghai was rather high. The prevalence of abnormal serum lipid levels a-mong men was higher than women.

Objective To evaluate right ventricular (RV)systolic function in type-2 diabetes mellitus (T2DM)patients.Methods Fifty T2DM patients and fifty normal controls were included in the study and underwent echocardiographic examinations.The following parameters were measured:1 ) Right heart dimensions,pulmonary artery (PA)diameter,pulmonary acceleration time (AT)and PA systolic pressure (PASP);2)RV systolic function:RV fractional area change (RVFAC),tissue Doppler-derived tricuspid lateral annular systolic velocity (S'),tricuspid annular plane systolic excursion (TAPSE),longitudinal strain of six RV segments by 2-dimensional speckle tracking imaging (2D-STI);3 )RV diastolic function:E,A ratio of the tricuspid inflow spectrum (E/A),E,E'(peak early diastolic velocity of the tricuspid annulus) ratio (E/E');4)RV Tei index.Results Statistic analysis showed that T2DM patients had thicker RV walls,wider PAs and shorter AT than the control group (P =0.000,0.001 and 0.000),while their right heart chamber sizes and PASP remained unchanged.Among systolic parameters,absolute values of RV longitudinal strain at the lateral wall-mid (lat-m),septum-mid (sep-m)and septum-basal (sep-b)segments were significantly lower in the diabetic group than the control group (P =0.001 ,0.000 and 0.005),whereas strain of the other three RV segments and RVFAC,TAPSE.S'were not significantly different.Moreover, E/A,E/E'and Tei index were all significantly different between the two groups (P = 0.000,0.000 and 0.006),indicating declined diastolic and general function of RV in the T2DM group.Conclusions RV myocardial strain by 2D-STI is more sensitive in detecting RV systolic dysfunction than TAPSE,S' and RVFAC.Among the six segments of RV walls,lat-m,sep-m and sep-b are better locations for 2D-STI than the other three.

Objective Henoch-Sch?nlein purpura(HSP)is a common multisystemic vasculitis in children ,but the exact pathogenesis remains unknown. Pentraxin 3(PTX3),a new kind of inflammatory cytokines,has a strong inflammatory effect,and is involved in occurrence and develop-ment of a variety of autoimmune diseases. The objective of this study is to evaluate the expression of PTX3,interleukin-8(IL-8),tumor necrosis fac-tor-α(TNF-α)and high sensitivity C-reactive protein(hs-CRP)in children with HSP,and explore the clinical significance of PTX3 in HSP devel-opment. Methods Thirty-six children(HSP group)and 17 healthy children(control group)were enrolled in the study. Serum levels of PTX3,IL-8 and TNF-α were detected by enzyme-linked immunosorbent assay. Serum hs-CRP levels were measured by automatic biochemical analyzer. Re-sults The serum levels of PTX3,IL-8,TNF-α,and hs-CRP were up-regulated in HSP group compared with the control group(P<0.05). The levels of PTX3,IL-8,TNF-α,and hs-CRP in patients with joint symptoms,or/and gastrointestinal symptoms,or/and kidney injury were significant-ly higher than those patients without joint symptoms,or/and gastrointestinal symptoms,or/and kidney injury(P<0.05). The expression of PTX3 was positively correlated with the expression of IL-8 and TNF-α(r=0.514,0.833,all P<0.05),but there was no correlation between PTX3 and hs-CRP(r=0.292,P>0.05). The expression of PTX3,IL-8,TNF-α and hs-CRP in HSP patients had no gender difference(all P>0.05). Con-clusion The high expression of PTX3 is related to the degree of inflammation in children with HSP. The up-regulated expression of PTX3 may play an important role in pathogenesis of HSP in children.

ObjectiveTo investigate the changes of major causes of death of patients with systemic lupus erythematosus(SLE).MethodsDeath cases with SLE from January 1986 to May 2011 in Peking Union Medical College Hospital were retrospectively analyzed.ResultsOut of 3554 patients with SLE,252 patients died,including 223 women and 29 men.The mortality rate was 7.2％ among female and 6.2％ among male,the overall mortality rate was 7.1％.The mortality rate in SLE patients had dropped steadily in the past 25 years,but there was a mild increase of mortality in 2006-2011 compared with that in 2001-2005 (5.7％vs 5.3％ ).In addition to infection,neuropsychiatric lupus and lupus nephritis had become the most common causes of death in SLE patients during the past 25 years.Furthermore,diffuse alveolar hemorrhage,severe pulmonary hypertension,coronary heart disease,thrombocytopenia,interstitial lung disease,lupus pneumonia,gastrointestinal hemorrhage, intestinal obstruction and multiple organ failure were the common causes of death,accounting for 4.4％,4.4％,3.2％,2.8％,2.4％,2.0％,2.0％,1.2％ and 1.2％ of all the death cases respectively.From 1986 to 2005,infection,neuropsychiatric lupus and lupus nephritis were the most common causes of death in patients with SLE,whereas the cases dying from lupus nephritis had decreased obviously and severe pulmonary hypertension had become the third most frequent causes of death during the past 5years.From 1986 to 1990,lupus nephritis,infection and neuropsychiatric lupus accounted for 31.4％,25.7％and 25.7％ of death cases respectively.From 1991 to 1995,lupus nephritis,infection and neuropsychiatric lupus accounted for 27.6％,24.1％ and 24.1％ respectively.From 1996 to 2000,infection,neuropsychiatric lupus and lupus nephritis took up 31.6％,21.1％ and 15.8％ respectively.From 2001 to 2005,infection,neuropsychiatric lupus and lupus nephritis took up 34.9％,20.6％ and 7.9％ respectively.From 2006 to 2011,infection, neuropsychiatric lupus and pulmonary hypertension accounted for 60.3％, 11.8％ and 7.4％ respectively.The mortality in the first year was the highest in the whole disease course,accounting for 32.5％ of patients.Deaths caused by neuropsychiatric lupus and infection happened most frequently during the first year,accounting for 41.9％ and 32.9％,whereas deaths caused by lupus nephritis occurred most frequently 10 years later,accounting for 32.3％.Age and gender had significant association with the major causes of death.The male patients took up 50.0％ of the total patients dying from coronary heart disease,in which 75.0％ of patients were older than 50 years.ConclusionInfection,neuropsychiatric lupus and lupus nephritis are the three most common causes of death in SLE patients fron 1986 to 2005.Severe pulmonary hypertension has become the third most frequent causes of death during the past 5 years instead of lupus nephritis.Severe infection has increased significantly and has been the leading cause of death in SLE patients in recent 5 years.

Objective To investigate the location and the pathogens of systemic lupus erythematosus (SLE) patients who died from infection.Methods Dead cases of hospitalized SLE patients in Peking Union Medical Hospital from January 1986 to May 2011were retrospectively analyzed.Results Severe infection was an important cause of mortality in patients with SLE.There were 252 dead cases of SLE in total from 1986 to 2011,in which 97 cases died from severe infection.The proportion of patients died from infection was gradually increased during the past 26 years,which was 25.7％,24.1％,31.6％,34.9％ and 60.3％ in 1986-1990,1991-1995,1996-2000,2001-2005 and 2006-2011respectively.Lung was the most common site of infec-t ion,accounting for 65％ of all dead cases.Among the 31cases with identified microorganism,14 patients had single microorganism infection and 17 patients had mixed infections.In the single microorganism infection patients,fungal infection contributed to the cause of death in 9 out of 14 (64％) patients,of which 4,2,1,1,and 1 cases were infected with Pneumocystis carinii, Aspergillus fumigates,Fusarium,Candida tropicalis and Cryptococcus respectively.There were 3 cases of bacteria infection,including 2 cases with Methicillinresistant staphylococcus,aureus and 1case with Klebsiella pneumoniae infection.Two patients died from pulmonary tuberculosis.In 17 patients with mixed infection cases, 14 deaths were caused by bacteria infection,including Acinetobacter baumannii, Eschefichia coli, Enterococcus, Klebsiella pneumoniae,Pseudomonas aeruginosa and Enterobacter cloacae.Eleven patients died from mixed fungus infection,including 6 cases of Aspergillus fumigates,3 cases of Candida tropicalis,3 cases of Pneumocystis carinii,2 cases of Aspergillus flavus,1 case of Soil Aspergillus,2 cases of Candida albicans,1 case of Candida glabrata and Candida Krusei.In addition to bacteria and fungi infection,cytomegalovirus infection occurred frequently in SLE death cases.Conclusions Severe infection has been the most frequent cause of death in SLE patients,in which lung infection is the leading cause.Pneumocystis carinii,Aspergillus fumigates,Acinetobacter baumannii and cytomegalovirus are the major pathogens that cause death in SLE patients.

Objective To assess the value of transesophageal echocardiography (TEE) in left atrial appendage (LAA) closer with Amplatzer Cardiac Plug (ACP).Methods Consecutive 32 atrial fibrillation patients (CHADS2≥1) with high risk bleeding underwent LAA occlusion with ACP LAA occlusion device under the guidance of TEE.Measurements of LAA anchoring area diameter (AAD) and LAA anatomical orifice diameter (AOD) including maximum,minimum values,and LAA depth on 2 dimentional TEE (2D TEE) were conducted before closer device implantation.The outcomes of LAA occlusion were analyzed.Results Among 32 patients,27 cases achieved successful LAA occlusion,including 2 cases with peripheral leakage ≤5 mm,and 5 cases failed occlusion.Among 5 failed closed patients,3 cases with LAA AAD≥ 30 mm,1 case with LAA of short depth,and 1 case with anatomical variation of LAA of low position that access sheath could not be positioned in the LAA.LAA AAD maximum,minimum and LAA depth were (25.9±4.9)mm,(20.0±3.8)mm,(31.0±5.6)mm,respectively,and LAA AOD maximum,minimum diameters were (26.2±6.2)mm,(19.4±4.3)mm,respectively.Among 10 cases with LAA AAD≥30 mm,7 cases achieved successful LAA occlusion,but 3 cases failed.The implanted device diameter was (26.4±3.8)mm,and device compression rate was (7.6±5.5)%.The coefficient of correlation between device diameter and large LAA AAD and AOD is 0.770 and 0.717,respectively.There was no complication but 1 case with pericardial effusion.Conclusions Two dimentional TEE measurements of LAA have clinical guiding significance in the selection of proper size of ACP LAA occluder.The AAD of 2D TEE has the good correlation with ACP occluder′s size,the AADs are important factors which affect the success of LAA occlusion.

Objective To investigate the expression of cyclin dependent kinases 5(CDK5)in the temporal lobes of the epilepsy patients and to explore the possible roles of CDK5 in the pathogenesis of refractory epilepsy.Methods The brain tissues of intractable epilepsy(IE)were studied by fluorescence quantative polymerase chain reaction(FQ-PCR)for CDK5 mRNA,while immunohistochemistry and Western blot were used to study the protein expression.Nonepileptogenic control brain tissues were used for comparison.Results FQ-PCR analysis showed that the expression of CDK5 mRNA in epilepsy patients was significant higher than those in the control group.And immunohistochemistry showed that the protein mainly existed in the neuron and glial.At the 35000 relative molecular mass,Western blot could been seen that there is a limpid strap.The optical density of CDK5 in IE(temporal lobe 1.4293?0.1839,hippocampus 2.0733?0.4738)was significantly higher than that in the control(temporal lobe 0.9680?0.4147, hippocampus 1.4030?0.6160,P

Objective To investigate expression of extracelluar signal regulated protein kinase(ERK)and phosphorylation ERK(p-ERK)in the temporal lobe from patients with DR-TLE so as to explore the possible roles of ERK in the pathogenesis of DR-TLE.Methods Expression of ERK was detected with Western blot and immunohistochemistry in 32 patients with DR-TLE(24 temporal lobe,8 hippocampi),as compared with 12 controls(9 temporal lobe,3 hippocampi).Results ERK and p-ERK expression in DR-TLE was significantly higher(0.2266?0.0613,0.2097?0.0183 and 0.1924?0.0054,respectively)than those of controls(0.1840?0.0023,0.1974?0.0056 and 0.1825?0.0063,respectively,all P

Background::Programmed death 1 (PD-1) blockade plus chemotherapy has become the new first-line standard of care for patients with advanced non-small-cell lung cancer (NSCLC). Yet not all NSCLC patients benefit from this regimen. This study aimed to investigate the predictors of PD-1 blockade plus chemotherapy in untreated advanced NSCLC.Methods::We integrated clinical, genomic, and survival data from 287 patients with untreated advanced NSCLC who were enrolled in one of five registered phase 3 trials and received PD-1 blockade plus chemotherapy or chemotherapy alone. We randomly assigned these patients into a discovery cohort ( n = 125), a validation cohort ( n = 82), and a control cohort ( n = 80). The candidate genes that could predict the response to PD-1 blockade plus chemotherapy were identified using data from the discovery cohort and their predictive values were then evaluated in the three cohorts. Immune deconvolution was conducted using transcriptome data of 1014 NSCLC patients from The Cancer Genome Atlas dataset. Results::A genomic variation signature, in which one or more of the 15 candidate genes were altered, was correlated with significantly inferior response rates and survival outcomes in patients treated with first-line PD-1 blockade plus chemotherapy in both discovery and validation cohorts. Its predictive value held in multivariate analyses when adjusted for baseline parameters, programmed cell death ligand 1 (PD-L1) expression level, and tumor mutation burden. Moreover, applying both the 15-gene panel and PD-L1 expression level produced better performance than either alone in predicting benefit from this treatment combination. Immune landscape analyses revealed that tumors with one or more variation in the 15-gene panel were associated with few immune infiltrates, indicating an immune-desert tumor microenvironment.Conclusion::These findings indicate that a 15-gene panel can serve as a negative prediction biomarker for first-line PD-1 blockade plus chemotherapy in patients with advanced NSCLC.

Humans ; Aminoquinolines/therapeutic use* ; Carcinoma, Non-Small-Cell Lung/genetics* ; Lung Neoplasms/genetics* ; Mutation/genetics* ; Standard of Care