Objective To explore the changes of serum sFas levels and its clinical significance in patients with myasthenia gravis(MG).Methods T cell subsets and sFas levels in serum of 45 MG patients and 40 controls were measured by using flow cytometry and enzyme-linked immunosorbent assay each.Besides,the sFas levels variety of 24 MG patients using glucocorticoid(GC) were observed.Results(1) The percentage of CD~+_8T cells was much decreased in MG group[(21.50?2.21)%] compared with control group[(27.75?3.00)%]((P

0.05),the overall response rate was 56.0% .Symptoms(18/25) related to cancer improved and side-reactions were tolerable. Conclusions:Treatment of relapse and metastatic colorectal cancer with combined chemotherapy based on oxaliplatin,irinotecan and 5-Fu by arterial intervention and iv drip is safe and effective,with only slight side-effects. This treatment can improve the symptoms and life quality of patients.

Objective To explore the change of serum uric acid(UA) levels in patients with multiple sclerosis(MS) and its clinical significance.Methods A quantitative enzymatic assay according to the manufacturer's protocol was adopted to detect serum UA levels in 43 patients with MS and 45 normal.Results The mean serum UA level in patients with MS was significantly lower in comparison with controls( P

Objective To investigate the predictive value of breast cancer susceptibility gene 1 (BRCA1) and class Ⅲβ-tubulin protein expression in tumor tissue for the efficacy of taxol and cisplatin combined chemotherapy (TP) in stage Ⅲβ/Ⅳ non-small cell lung cancer(NSCLC) patients. Methods A total of 92 stage Ⅲβ/Ⅳ NSCLC patients were recruited with 87 patients evaluated. Bronchoscopy or lung puncture tumor biopsy samples were obtained with BRCA1 and class Ⅲβ-tubulin protein expression examined immunohistochemically before chemotherapy. The patients were randomly assigned to be received 4 to 6 cycles of TP chemotherapy regiments and followed up until death or lost. Response rate (RR) , overall survival (OS) and time to tumor progression (TTP) were assessed. Results Among the 87 evaluated patients, the positive expression rates of BRCA1 and class Ⅲβ-tubulin were 57. 5% (50/87) and 48. 3%(42/87) respectively. There was no significant difference in clinical characteristics among patients with different positive expression rate. According to different expression of BRCA1 and class Ⅲβ-tubulin, the patients were divided into four groups: group A (low expression of both BRCA1 and class 1 p-tubulin) ,group B (high expression of both BRCA1 and class Ⅲβ-tubulin) , group C (high expression of only BRCA1) and group D (high expression of only class Ⅲβ-tubulin). The RR was higher in group A than other three groups (60. 7% , 34. 8% , 9/19 and 6/17 respectively). The OS and TTP were longer in group A than other three groups [OS: (539. 4 ± 17. 6) days, (267. 2 ± 20. 5) days, (325. 6 ± 24. 1) days and (283.7±26.2) days respectively ; TTP: (256. 9 ± 28. 4) days, (143.8±17.6) days, (179. 3 ± 19. 8)days and (152. 6 ±23. 5) days respectively]. There were no significant differences among the other three groups. Conclusions The expression level of BRCA1 and class Ⅲβ-tubulin in tumor tissue is probably a predictor for the efficacy of TP chemotherapy in NSCLC patients. TP chemotherapy is more suitable for the NSCLC patients with lower expression of both BRCA1 and class Ⅲβ-tubulin. Our study may provide a new sight for tailored chemotherapy in NSCLC patients.

Objective To explore the effects and mechanisms of urokinase-type plasminogen activator (uPA) on high glucose-induced rat mesangial cells proliferation and phenotype transformation. Methods Rat mesangial cells were cultured and incubated in media containing either 5 mmol/L D-glucose or 30 mmol/L D-glucose with or without addition of wortmannin, or uPA (105 U/L) for different time periods. At the end of the incubation period, mesangial cells proliferation was assessed by MTT assay and flow cytometric analysis. Cyclin-dependent kinase 2 (CDK2) and p27kip1 expression and activation of Akt were evaluated by Western blotting and Akt kinase assay respectively. Furthermore, the expression and distribution of α-SMA were detected with laser confocal microscopy. Results MTT assay and flow cytometric analysis demonstrated that high glucose induced mesangial cells proliferation (P＜0.05) and an incresed proportion of cells in G2/M+S stage after 24 h incubation (P＜0.01), which were attenuated by uPA or wortmannin (P＜0.01). High glucose induced the enhance of Akt activity after 3 h (P＜0.05), and the effect was inhibited by wortmannin or uPA (P＜0.01). High glucose did not alter CDK2 expression (P＞0.05),but significantly inhibited p27kip1 expression (P＜0.05), which was attenuated by wortmannin or uPA (P＜0.01). High glucose induced the up-regulation of α-SMA expression and perinucleus location in mesangial cells after 24 h (P＜0.01), which were alleviated by wortmannin or uPA (P＜0.01). Conclusion uPA up-regulates p27kip1 expression and counteracts high glucose-induced mesangial cells proliferation and phenotype transformation via blocking PI3K-Akt signaling pathway.

Objective:To investigate and compare the effects of oxaliplatin combined with gemcitabine administered in a fixed dose rate and that administered in a more standard infusion in advanced biliary tract cancer patients on chemotherapeutic efficacy, toxicities, and survival time. Methods:A total of 93 cancer patients were recruited from February 1, 2010 to December 12, 2012 in the First Hospital of Huai'an City Affiliated Nanjing Medical College. Those recruited were either newly diagnosed unresectable advanced biliary tract cancer patients by percutaneous liver biopsy or relapse or metastatic biliary tract cancer patients after operation. The patients were randomly divided into two groups. The first group was the study group in which the patients received chemotherapy with gemcitabine in a fixed dose rate of 10 mg/m2 per minute combined with oxaliplatin regimens. The other group was the control group in which the patients received chemotherapy with gemcitabine in a more standardized infusion within 30 min combined with oxaliplatin regimens. Each patient received four cycles, with at least two cycles of chemotherapy with GEMOX regimens every 21 d, with follow-up until death. The chemotherapeutic efficacy was evaluated. Toxicities were documented after each cycle. Results:The clinical characteristics of the two groups were well balanced before chemotherapy (P>0.05). The response rate (RR) and clinical benefit response of the study group were higher than those of the control group (P<0.05). The overall survival (OS) and time to progress (TTP) of the study group were longer than those of the control group (P<0.05). With respect to adverse events, the major side effect was hematological toxicity. The rate of gradeⅢ/Ⅳleucocytopenia and thrombocytopenia in the study group was remarkably higher than that in the control group (P<0.05). However, the rate of non-hematological toxicity was similar (P>0.05). Conclusion:Gemcitabine in a fixed dose rate combined with oxaliplatin regimens is a feasible and effective scheme in treating advanced biliary tract cancer patients. RR is higher and OS and TTP are longer under this scheme. Non-hematological toxicities are also well tolerated. However, hematological toxicity is distinguished. These results guide us to be prudent in utilizing this regimen. The investigation of the value of gemcitabine in a fixed dose rate combined with oxaliplatin in treating advanced biliary tract cancer patients is worth pursuing in future clinical trials.

In order to fully educe the targeting and evaluation role of examinations to teaching, and promote normal and rapid development of rehabilitation therapy specialty through years of practice, Capital Medical University School of Rehabilitation Medicine has established series test banks in specialized courses, formed noviciate testing methods and comprehensive test and appraisal model in graduation practice, built a clinical stage examination system.

A rapid method has been developed based on the sample preparation procedure named as QuEChERS (Quick,Easy,Cheap,Effective,Rugged and Safe),combined with reversed-phase high performance liquid chromatography with fluorescence detector and C18 column after precolumn derivatization using o-phthalaldehyde and 2-mercaptoethanol to determine dopamine in porcine muscle.Methanol and deionized water (0.1％ acetic acid,v/v) with a ratio of 60∶40 was used as mobile phase.The flow rate was 0.8 mL/min and dopamine was eluted within 15 min.The linearity range was 0.003-8 μg/mL with r=0.9992.The detection limit for dopamine was 4 μg/kg and the quantification limit was 9 μg/kg.Recovery studies were carried out at 0.1,0.5 and 1.0 mg/kg fortification levels and the average recoveries obtained ranged from 90.4％ to 98.2％ with relative standard deviations between 3.5％ and 8.1％.The method was found to be suitable for detection of dopamine in animal product tissues at the maximum residue level.

In order to improve the clinical outcomes and promote the development of enhanced recovery after surgery(ERAS),a full-time specialized role of nurse navigator(NN) was established in Department of Surgery in February,2016. Clinical pathway for ERAS was designed,and role functions,core competencies and responsibilities of NN were formulated. According to the functions and the working frame,NN connected and coordinated teamwork activities,monitored the implementation of ERAS during the overall process. After implementation,the NN had dealt with 10 unusual incidents,the execution efficiency of the 14(82.4%) measurements were 100%,1 measurement was 97%,2 measurements were 94.1%,and 33 patients and 42 medical staff thought highly of the NN. This practice effectively promoted the development of ERAS team and specialist nurse role in our hospital.

A rapid method has been developed based on the sample preparation procedure named as QuEChERS （Quick, Easy, Cheap, Effective, Rugged and Safe）, combined with reversed-phase high performance liquid chromatography with fluorescence detector and C18 column after precolumn derivatization using o-phthalaldehyde and 2-mercaptoethanol to determine dopamine in porcine muscle. Methanol and deionized water （0.1% acetic acid, v/v） with a ratio of 60：40 was used as mobile phase. The flow rate was 0.8 mL/min and dopamine was eluted within 15 min. The linearity range was 0.003-8 μg/mL with r=0.9992. The detection limit for dopamine was 4 μg/kg and the quantification limit was 9 μg/kg. Recovery studies were carried out at 0.1, 0.5 and 1.0 mg/kg fortification levels and the average recoveries obtained ranged from 90.4% to 98.2% with relative standard deviations between 3.5% and 8.1%. The method was found to be suitable for detection of dopamine in animal product tissues at the maximum residue level.