AIM: To investigate the effect of erythromycin on the level of transforming growth factor-?1(TGF-?1) and ?-glutaglutamylcysteine synthetase(?-GCS) in smoking rats,and to explore the antioxidate therapeutic role of erythromycin in chronic obstructive pulmonary disease.METHODS: Wistar rats were exposed to cigarettes smoking to establish the model.After passive smoking for 4 weeks,erythromycin intragastric intervention was administered continuously for 8 weeks.The expiratory airway resistance and lung compliance were assessed and the expression levels of TGF-?1 and ?-GCS proteins(and the mRNA) in airway endothelial cells and alveolar macrophages were observed respectively by immunohistochemical,immunocytochemical and(in situ) hybridization.RESULTS: The expiratory airway resistance was increased and the lung compliance was degraded significantly in smoking group and erythromycin group,compared to control group.In erythromycin group,the airway resistance was lower and the lung compliance was higher than that in smoking group(P

Objective To assess the efficacy and safety of over-the-scope clip(OTSC) system in treatment of the perforation ,fistula and bleeding of the digestive tract .Methods The data of 33 patients who were treated with OTSC in our department were analyzed retrospective-ly,and the technical success rate ,clinical success rate and complications were statistically analyzed .Among the 33 patients,there were 14 pa-tients with upper gastrointestinal bleeding , 8 patients with postoperative fistula , and 11 patients with endoscopic full-thickness resection (EFTR) of gastric or duodenal bulb.Results The technical success rate and clinical success rate of 33 cases were 96.97% and 93.94%respectively,and there was no complication in all patients .Among them,the clinical success rate of the upper gastrointestinal bleeding was 92.85%,the anastomotic fistula was 75.00%,and the EFTR was 100%.Conclusion As a new type of clinical endoscopic suture system , OTSC is safe and effective in gastrointestinal bleeding ,perforation and fistula .

FANCD2 is involved in DNA damage repair and maintenance of chromosome stability. The purpose of this study was to investigate the expression of FANCD2 in sporadic breast cancer tissues and its association with clinicopathological features. A total of 162 Chinese women with invasive breast carcinoma who had no family history in first-degree relatives and 12 normal breast tissues were examined. The expression of FANCD2 was detected by immunohistochemical staining based on a tissue microarray technique. SAS system was used to analyze the data. Twenty-one out of the 162 invasive breast cancers (13%) were negative for FANCD2. The mean percentage of FANCD2 positive cells was significantly lower in breast cancers than in controls (P<0.05). FANCD2 expression was significantly inversely associated with histological grade and TNM stage (P<0.05), but not with axillary lymph node status or other conventional prognostic markers such as ER, PR, Her-2 and PCNA (P>0.05). It was suggested that FANCD2 may play a critical role in breast carcinogenesis. It may become a valuable and independent marker for identifying women with sporadic breast cancer and evaluating the prognosis.

Objective To investigate the clinical and laboratory features of acute promyelocytic leukemia (APL).Methotis 513 APL patients in the last two decades were retrospectively analyzed in this research.We investigated the clinical features including age,sex,abnormality of peripheral hemogram before treatment.therapeutic effect and follow-up and laboratory data such as morphology,immunology,cytogenetics and molecular biology(MICM).Results The median age of the APL patients was 33 years old and the ratio of male and female was 1.21:1.Before treatment,the median level of WBC was 4.3×109/L and the deteetion rate of abnormal promyelocyte on blood film was 85.8%;with immunophenotypie detection,the expression levels of CD117、CD34、HLA-DR、CD7、CD14 and CD19 in APL were found to be lower and the expression 1evels of CD2、CD33 and MPO higher than those in other subtypes of acute myelocytie leukemia(AML)(beth P<0.01).Specific abnormal chromosome t(15;17)was detected in 91.7%of the patients,of whom 75.9%had standard translocation of t(15;17),being the most common one and 15.8% of the patients had t(15;17)with additional abnormal chromosome.There was only 7.5%of the patients with nolnlal karyotype.However,the presence of both simple translocation and complex translocation was seldom seen.With molecular biological detection.PML/RARα fusion gene positive rate was 99.6%.In a relativelv long clinical follow-up,we found that the complete remission(CR)rate in APL patients was 84.7%.incidence of DIC was 13.4%and five-year survival rate was 30.7%.111e median count of WBC in CR group was lower than that non-remission group(P<0.01).There were no significant differences on expressions of CD34 and CD2 and changes of cytogenetics between the two groups(P>0.05).Conclusions Comprehensive evaluation of MICM could be of important significance in the diagnosis and prognosis iudgrnent for APL patients.The CR rate in these patients with high WBC eount was considerable low.

Objective:To explore the external factors of the development of cancer hospitals under normalized epidemic prevention and control, and to propose targeted strategies in accordance with existing practice.Methods:PEST model was used to analyze the political, economic, social and technological environment of specialized cancer hospitals, with an overall strategy proposed based on the specific analysis of a cancer hospital.Results:In the era of normalized epidemic prevention and control, cancer hospitals were facing a new environment that was common or unique to other types of medical institutions. In response, the case hospital had adopted such strategies as integrating prevention and control with medical services, integrating offline with online services, and integrating internal and external resources to promote its recovery and development.Conclusions:Cancer hospitals and government should fully leverage the environmental changes incurred by the normalization of prevention and control, and formulate a more integrated development strategy covering short, medium up to long term conditions, based on the two major objectives of epidemic prevention and control and cancer prevention and medical services.

Objective To investigate the effect of acupuncture combined with antidepressant on behavioral changes and 5-hydroxytryptamine 1A and 2A receptor ( 5-HT1AR and 5-HT2AR) mRNA expression in nucleus raphes dorsalis (NRD) of sleep deprivation depression (SDD) rats. Methods Eight normal Sprague Dawley (SD) rats were caged together without any stimulus or treatment, serving as the normal group. Thirty-two SD rats were given solitary raise for 21 days, together with chronic unpredictable mild stress ( CUMS) and rapid eye movement ( REM) sleep deprivation to establish the model. Twenty-eight rats completed the modeling successfully, and were divided into model group, acupuncture group, medicine group, and combination group, 7 rats in each group. Rats in the model group were given modeling treatment but without any intervention. Rats in the acupuncture group were given acupuncture on acupoint Yintang, Shenting and bilateral Taichong, acupuncture stimulation lasting 15 s every 10 min and acupuncture retention for 20 min in each day. Rats in the medicine group were given gastric gavage of Zoloft solution (0.83 mg·kg-1·d-1) and Alprazolam solution (0.067 mg· kg-1·d-1) , and rats in the combination group were given both acupuncture and medicine intervention. The intervention for the three intervention groups lasted for 7 days. Results Compared with the normal group, body weight, Open-field scores and sucrose preference of the model rats were significantly decreased on modeling day 7, 14, 21 (P<0.05). On modeling day 28, body weight and Open-field scores of each intervention group were significantly increased compared with those of the model group (P<0.05), and Open-field scores of combination group differed from those of acupuncture group and medicine group ( P<0.05). Only sucrose preference of combination group was improved significantly compared with the model group (P<0.05). Compared with the model group, NRD 5-HT1AR mRNA expression level was increased in the combination group (P<0.05), and NRD 5-HT2AR mRNA expression level was down-regulated in all of the three intervention groups ( P<0.05). Conclusion Acupuncture and antidepressant treatment covering 7 days can evoke rapid effect on SDD rats, which can improve the slow effect of antidepressant.

OBJECTIVE: To explore the origin and mechanism of small supernumerary marker chromosomes (sSMC) in three fetuses. METHODS: The three fetuses were predicted to have carried chromosomal abnormalities by non-invasive prenatal testing (NIPT). G-banding chromosomal karyotyping analysis were carried out on amniotic fluid samples of the fetuses and peripheral blood samples from their parents. Single nucleotide polymorphism array (SNP-array) was used to determine the origin, size and genetic effect of sSMCs. RESULTS: In fetus 1, SNP array has detected two microduplications respectively at 4p16.3p15.2 (24.7 Mb) and 18p11.32q11.2 (20.5 Mb) which, as verified by fluorescence in situ hybridization (FISH), have derived from a balanced 46,XY,t(4;18)(p15.2q11.2) translocation carried by its father. Fetus 2 has carried a de novo microduplication of 15q11.2-q13.3 (9.7 Mb). The sequence of SMC in fetus 3 has derived from 21q11.2-q21.1 (8.3 Mb), which was inherited from its mother. CONCLUSION Both NIPT and SNP-array are highly accurate for the detection of sSMC. SNP-array can delineate the origin and size of abnormal chromosomes, which in turn can help with clarification of sSMC-related genotype-phenotype correlation and facilitate prenatal diagnosis and genetic counseling for the family.
Chromosome Duplication/genetics* ; Female ; Fetus ; Humans ; In Situ Hybridization, Fluorescence ; Male ; Polymorphism, Single Nucleotide ; Pregnancy ; Prenatal Diagnosis ; Translocation, Genetic/genetics*

FANCD2 is involved in DNA damage repair and maintenance of chromosome stability.The purpose of this study was to investigate the expression of FANCD2 in sporadic breast cancer tissues and its association with clinicopathological features.A total of 162 Chinese women with invasive breast carcinoma who had no family history in first-degree relatives and 12 normal breast tissues were examined.The expression of FANCD2 was detected by immunohistochemical staining based on a tissue microarray technique.SAS system was used to analyze the data.Twenty-one out of the 162 invasive breast cancers(13%)were negative for FANCD2.The mean percentage of FANCD2 positive cells was significantly lower in breast cancers than in controls(P＜0.05).FANCD2 expression was significantly inversely associated with histological grade and TNM stage(P＜0.05),but not with axillary lymph node status or other conventional prognostic markers such as ER,PR,Her-2 and PCNA(P＞0.05).It was suggested that FANCD2 may play a critical role in breast carcinogenesis.It may become a valuable and independent marker for identifying women with sporadic breast cancer and evaluating the prognosis.

Objective:To investigate the characteristics and influencing factors of esophageal stenosis after endoscopic submucosal dissection (ESD) for early esophageal carcinoma.Methods:Patients who underwent ESD in the Digestive Endoscopy Center of the Second Affiliated Hospital of Army Medical University from January 2011 to December 2018 were included. The data were obtained from medical records and follow-up. The influencing factors of stenosis were determined by single factor and Cox regression analysis.Results:A total of 654 patients underwent ESD and 79 (12.1%) of them developed postoperative esophageal stenosis. The median time of stenosis development was 27 (17, 43) days. The morphology and lesion circumferential proportion were independent factors for the occurrence of stenosis after ESD. The stenosis incidence of type Ⅱa was 6.601 times (95% CI: 1.518-28.709, P=0.012) compared with that of type Ⅱc. The incidence of stenosis in lesions with 75%-<100% and 100% circumference was 17.408 times (95% CI: 8.009-37.839, P<0.001)and 52.439 times (95% CI: 23.905-115.029, P<0.001) respectively compared with that of patients <75%. Among the 79 patients, 27 had severe stenosis, and the lesion circumferential proportion was an independent factor for stenosis. Compared with the group of lesion circumferential proportion of less than 75%, the incidences of stenosis of lesion circumferential proportion of 75%-<100% and 100% were 7.775 (95% CI: 1.977-30.577, P=0.003) and 70.062 (95% CI: 19.879-246.926, P<0.001) times respectively. Conclusion:The morphology and lesion circumferential proportion are two independent factors for the occurrence of esophageal stenosis after ESD. Additionally, lesion circumferential proportion is an independent factor for the occurrence of severe esophageal stenosis after ESD.

In response to calls of the state to share high quality medical resources with the primary levels for easier access of the local people to best medical care instead of pouring into tertiary hospitals in metropolitans, Xiamen city joined hands with Zhongshan Hospital of Fudan University to establish Xiamen Hospital affiliated to Zhongshan Hospital of Fudan University in an innovative model of " city-university cooperation and homogeneous management" . Open for full service in January 2018, the hospital is run by Zhongshan Hospital in a closed-type medical alliance, enjoying homogenous management in terms of administrative framework, quality of care, talent training and IT management. Thanks to this practice, the hospital has grown into one of the first pilot units of the national regional medical center program, rapidly upgrading medical service level of Xiamen city and its surrounding regions. This paper highlighted the practice of homogeneous management, and analyzed the challenges and solutions for references of building trans-regional closed-type medical alliances.