Objective To study the expression of epidermal growth factor receptor (EGFR) in cervical car-cinoma and cervical intraepithelial neoplasia(CIN),and to elucidate its relation with the genesis, infiltration, metas-tasis and prognosis of cervical carcinoma. Methods EGFR was determined by means of S-P immunohistochemistry in tissue of 100 cases of cervical carcinoma,60 cases of CIN and 40 cases of controls. Results The overexpression rates of EGFR were 0% (0/40), 51.67% (31/60),78.00% (78/100), respectively in normal cervical epithelium, CIN and cervical tumor tissues. The overexpression rate of EGFR was significantly higher in cervical tumor tissue than in control group(P<0.01). The overexpression of EGFR didn't demonstrate significant association with clinical staging, tumor size, pathological type, differentiation, cervical invasion depth, cervical canal invasion, lymphnode me-tastasis or the prognosis of cervical neoplasm (P>0.05). Conclusion Overexpression of EGFR is worsened with the severity of cervical lesion, suggesting that overexpression of EGFR is correlated with the genesis of cervical neo-plasms,which may be a valuable biological indicator of cervical carcinoma,but is not correlated with clinical patho-logical features and prognosis of cervical carcinoma.

Objective: To observe the clinical efficacy of Xingnao-Kaiqiao acupuncture("醒脑开窍"针法) on patients with cerebral infarction.Methods: Sixty-three patients with the disease were randomly divided into treatment group(n=32) treated with Xingnao-Kaiqiao acupuncture and control group(n=31) with(traditional) acupuncture.In addition,routine medicine therapies were given to the two groups(including(dehydration),(decrease) of intracranial pressure,enhancement of nerve nutrition and supportive treatment).(Xingnao-)(Kaiqiao acupuncture) was used and adjusted the number of points with different syndromes in the treatment group,main points were as follows: Neiguan(内关PC6),(Rengzhong)(人中GV26),Sanyinjiao((三阴交)SP6) and vice points were Jiquan(极泉HT1),Chize ((尺泽LU5)),Weizhong(委中BL40),Fengchi(风池GB20),Yintang (印堂EX-HN3),Shangxing((上星DU23)-through-Baihui)(百会GV20).Traditional acupuncture was used in the control group.Points at the upper limbs were Jianjing(肩井GB 21),Quchi(曲池LI 11),Waiguan(外关(S)51),Hegu(合谷LI 4) and at the lower limbs were Zusanli(足三里ST36),Yanglingquan(阳陵泉GB34),Huantiao(环跳GB30),Fenglong(丰隆ST40),Kunlun(昆仑BL60) etc..Acupuncture was given twice a day for 15 days in both groups.Before and after therapy,the hemorrheology,blood lipid,blood,urine,stool and biochemical routine examinations,white blood cell (WBC) count in(peripheral) blood and neurological deficit score(NDS) were(determined).Curative effects of two groups after treatment were observed.Results: After treatment,the total effective power was 93.75% in the treatment group,while it was 67.74% in the control group,the difference being significant (?~2=4.85,P

Nutrition therapy is considered as the basis for prevention and management of chronic kidney disease (CKD), throughout the three-tier prevention strategies of CKD. The primary objective is to delay the disease progression, correct metabolic disorders, and improve the outcomes of CKD. Low protein diet has been recognized as an important therapeutic measure in CKD, but the quantity, quality and source of protein are always the points of contention. Recently, both domestic and foreign guidelines have been updated on the amount of protein intake. In addition to quantity, attention has been paid to the type and diversity of proteins. With the rise of plant-based food consumption and the concept of vegetarian diet, the scientific community began to review the benefits of plant protein again, and a plant-based diet is recommend extensively. Whether the plant-based dietary pattern is also suitable for CKD patients who need a low-protein diet, and whether it could meet the nutritional needs of CKD patients are hot topics, this article reviews the recent progress of these research hotspots.

Objective To evaluate the prevalence and distribution characteristics of fatigue in maintaining hemodialysis in China. Methods Literature search was conducted to collect cross-sectional studies on the prevalence of fatigue in maintenance hemodialysis in PubMed,The Cochrane Library, Embase, Web of Science,China National Knowledge Internet,China Biology Medicine and Wan Fang Data. The studies were selected according to the exclusion and inclusive criteria and the qualities of studies were evaluated. Meta-analysis was performed with software of Stata 14.0. Results A total of 19 studies, including a total size of 3171 and 2253 patients of fatigue,were eligible for inclusion in the review.The prevalence of fatigue by analyzing the effect size was 72.1％(95％ CI 63.6％-80.6％),the prevalence of mild to moderate fatigue by analyzing the effect size was 15.8％(95％ CI 7.0％-24.7％), 43.6％(95％ CI 40.1％-47.1％) and the prevalence of severe fatigue was 19.8％(95％CI 12.0％-27.6％).Subgroup analyses indicated that the fatigue rate of female maintenance hemodialysis was higher than male,the prevalence level estimated by the Piper Fatigue revised scale was higher than other tools(80.8％),the prevalence level estimated by the Vitality Subscale of the SF-36 (SF-36 VS), Short-Form Health Survey was lower than other tools(46.8％).The fatigue rate in the central and western areas were higher than that of the eastern region.The harder the economic was,the higher the prevalence of fatigue was.The prevalence of fatigue in the population dialysis aged 6 to 10 years was lower than that in dialysis age≤5 and dialysis age>10 years. Sensitivity analysis showed that the pooled effect size had good stability and reliability. ConclusionS The prevalence of fatigue in maintenance hemodialysis in China is high,which suggest that we should paymore attention to this situation.There are differences in the prevalence of fatigue in maintenance hemodialysis patients on different scales, areas, sex, dialysis years, and economic.

Objective To investigate the clinical efficacy and safety of high-dose caspofungin (70 mg/d)as initial or salvage treatment for invasive pulmonary aspergillosis.Methods Twenty-one patients with proven or probable invasive pulmonary aspergillosis from June 2014 to October 2017 in Huashan Hospital,Fudan University were retrospectively reviewed.According to the anti-fungal treatment before high-dose caspofungin application,patients were divided into initial treatment group and salvage treatment group.Patients' clinical data and laboratory data were collected.The characteristics,clinical efficacy,adverse reactions,one-year survival rate and the overall effective rate were evaluated.The prognosis of the two groups was compared by Kaplan-Meier analysis.Results Twenty of the 21 patients opportunistic acquired invasive pulmonary aspergillosis during the treatment of underlying diseases.Five patients were initially treated with high-dose caspofungin for 68 (62) days.At week 12,one patient achieved complete response,3 patients achieved partial response,and the overall effective rate was 80％ (4/5).Sixteen patients received caspofungin as salvage therapy for 66.50 (58) days,of which one patient got complete response at week 12,10 had partial response,and the overall effective rate was 68.75％ (11/16).One-year follow-up showed that no patient died in the initial treatment group,and the one-year survival rate was 100％ (5/5).In salvage treatment group,3 patients died of pulmonary bacterial infections and the one-year survival rate was 81.25％ (13/16).During treatment,one patient had elevated total bilirubin,which was possibly associated with high-dose caspofungin.Conclusions High-dose caspofungin regimen has good efficacy and safety,both for initial treatment and salvage therapy in patients with invasive pulmonary aspergillosis.

Objective:To investigate the clinical characteristics and prognosis of cryptococcal meningitis patients with anti-granulocyte-macrophage colony-stimulating factor (GM-CSF) autoantibodies.Methods:A total of 216 non-acquired immunodeficiency syndrome (AIDS) related cryptococcal meningitis cases with positive cultures of Cryptococcus, hospitalized at Huashan Hospital, Fudan University during January 2014 and December 2021, were retrospectively included. The serum anti-GM-CSF autoantibodies were detected by enzyme linked immunosorbent assay, and the clinical characteristics and prognosis were compared between patients with and without anti-GM-CSF autoantibodies. Statistical comparisons were mainly performed using the chi-square test or Fisher′s exact test. Cox proportional-hazards model was used to analyze the risk factors associated with prognosis. Results:Among 216 enrolled patients, 23 patients were positive of anti-GM-CSF autoantibodies, with a positive rate of 10.6%. Among 23 patients, seven cases were infected with Cryptococcus gattii, and 16 cases were infected with Cryptococcus neoformans. In the group with positive anti-GM-CSF autoantibodies, 30.4%(7/23) of the patients were infected with Cryptococcus gattii, which was higher than that of 1.6%(3/193) in the group with negative anti-GM-CSF autoantibodies, and the difference was statistically significant ( χ2=38.82, P<0.001). In the group with positive anti-GM-CSF autoantibodies, 30.0% (6/20) had mass lesions with a diameter greater than three centimeters in the lungs, and the one-year all-cause mortality rate was 50.0% (10/20), which were both higher than those of 3.4%(5/145) and 16.1% (29/180) in the negative group, respectively. The differences were both statistically significant (both Fisher′s exact test, P<0.01). Age≥60 years (hazard ratio ( HR)=4.146, P=0.002), predisposing factors ( HR=3.160, P=0.021), epilepsy ( HR=6.129, P=0.002), positive anti-GM-CSF autoantibodies ( HR=2.675, P=0.034), white blood cell count of cerebrospinal fluid (CSF)<100 ×10 6/L ( HR=2.736, P=0.039), the titers of cryptococcal capsular polysaccharide antigen of CSF≥1∶1 280 ( HR=4.361, P=0.009) were independent risk factors for one-year all-cause mortality in patients with cryptococcal meningitis. Conclusions:In non-AIDS related cryptococcal meningitis patients, the positive rate of serum anti-GM-CSF autoantibodies is as high as 10.6%. Patients with anti-GM-CSF autoantibodies could be infected with both Cryptococcus neoformans and Cryptococcus gattii, and they have higher proportion of lung mass lesions than patients with negative anti-GM-CSF autoantibodies. The one-year survival rate decreases significantly in patients with anti-GM-CSF autoantibodies, which is an independent risk factor for the prognosis of cryptococcal meningitis.