After chemotherapy, the healthy qi of acute leukemia (AL) patients was severly demaged, remnant toxin with internal amassment, qi and blood deficiency, blood stasis, vertigo with syndrome of stagnation and blockade of phlegm-damp. The clinical symptoms with cold-heat intermingled together which are complicated and changable were quite similar to those of Jueyin disease. Therefore, this paper tried to explore the differentiation and treatment of AL after chemotherapy from Jueyin. It was concluded that the treatment of AL after chemotherapy should be treated with cold and heat method, attacking and supplementing together, with nourishing the liver as the main part. At the same time, it was importance to protect healthy qi. Combined with the basic pathogenesis of AL, it was proposed that Danggui-Sini Decoction was suitable for the treatment of AL after chemotherapy. All in all, the paper explored the differentiation and treatment of AL after chemotherapy from Jueyin in order to use more Chinese medicine therapy in the field of AL treatment.

Hypertrophic cardiomyopathy (HCM) is featured by asymmetry myocardial hypertrophy ,mainly involves interventricular septum ,and its clinical manifestations are left ventricular dysfunction and arrhythmia .It′s thera-peutic methods include medication ,intervention ,surgery ,dual chamber pacemaker (DDD) treatment and implant-able cardioverter /defibrillator (ICD) treatment etc .This article made following overview on treatment progress of HCM .

Purpose:To find out the clinical biology value of p53 overexpression on Chinese breast cancer by Meta analysis. Methods:Reviewed all the published studies during the recent 10 years regarding p53 and breast cancer, and used standard techniques of Meta-analysis to combine the results of these studies to produce a more precise estimate of the prognostic significance of p53 mutations.Results:the mean of p53 positive express was 45%,95% confidence interval (43-47)%:, p53 positive was related with node metastasis, recurrence after surgery, over survival, tumor size and nuclear grade, but not related with age and pathology type, p53 was a special and sensitive prognostic factor for breast cancer.Conclusions:p53 can be an independent molecular marker to definitive prognostic of breast cancer, and possibly can be a reliable marker for choice of standard and individulized therapy.

Objective To investigate the distribution and genetic characteristic of etiological agents among children with hand,foot and mouth disease(HFMD)in Shanghai and neighbor areas in 2008.Methods Throat swabs were collected from the inpatients with HFMD from May to June 2008 in Pediatrics Hospital affiliated to Fudan University,Shanghai,and Deqing,Zhejiang Province.Cerebral spinal fluid(CSF)from some patients were collected as well.Vero,MRC-5 and RD ceils were used to isolate the possible pathogens by observing cytopathic effect(CPE).Enterovirus genus,Coxsaekie virus group A type 16(CoxA16)and enterovirus type 71(EV71)were detected by reverse transcriptase-polymerase chain reaction(RT-PCR),and finally identified by sequencing.Results A total of 107 swabs and 22 CSF samples were collected from all 100 inpatients.Swabs of 50 children caused CPE observed.Among them,enteroviruses accounted for 74.0%(37/50),which including 26 (52.0%)of EV71,10(20%)of CoxAl6 and 1(2.0%)of CoxB3,and 13(26.0%)of other pathogens.All the 26 EV71 strains were similar with the isolates from Zhejiang Province and Fuyang,Anhui Province in 2008,which belonged tO genotype Cl all the 10 CoxAl6 strains belonged to genetic lineages C.Conclusions The causative agents of HFMD are complicated.CoxA16 and EV71 are predominant among children with HFMD in Shanghai and neighbor areas in 2008,while the pathogens of some patients are still unknown.

Objective To investigate whether paclitaxel can efficiently induce the apoptosis of ovarian cell HO-8910,and to study the relationship between the apoptosis of cells and the cell cycle.Methods With the treatment of paclitaxel with different concentrations and different time,the morphologic change of HO-8910 ovarian cells was observed using fluorescence microscopy and transmission electron microscopy(TEM),and the apoptosis of cells and the changes of cell cycle were determined by flow cytometry(FCM). Results The typical changes of HO-8910 cell apoptosis were observed by TEM and Fluorescence microscopy.With the treatment of paclitaxel,the HO-8910 ovarian cells were firstly arrested in G_2/M phase,and the typical ultrastructural changes of apoptosis were appeared only after the cells were apparently arrested in G_2/M phase.Conclusion Paclitaxel can induce the apoptosis of HO-8910 cells and the apoptosis is associated with the blockage of G_2/M phase in cell cycle.

Five groups were assigned to include intrahepatic cholangiocarcinoma ( ICC, n=30 ) , liver cirrhosis (LC,n=30),metastatic carcinoma (MCA,n=30) and 30 healthy subjects.The serum level of GPC3 was measured by a sandwich method of enzyme-linked immunosorbent assay ( ELISA ) and alpha-fetoprotein (AFP) by microparticle enzyme immunoassay (MEIA).The serum levels of GPC3 and AFP were significantly higher than those of other groups (P<0.05).At a cut-off value of 3.5μg/L,the sensitivity and specificity of GPC3 in the diagnosis of HCC was 83.3%and 76.7%respectively.The sensitivity of combined measurement of GPC3 and AFP was better than GPC3 or AFP alone.Detectable GPC3 was significantly correlated with the presence of viral hepatitis markers and tumor size.However there was no obvious difference in tumor thrombi in portal vein ( PVTT), tumor number, age, gender or hepatic function of HCC.Thus,as a sensitive serum diagnostic marker for HCC ,GPC3 may be a good supplement to AFP in differentiating HCC from non-malignant chronic liver diseases and other liver cancers.

Now the visiting physicians are usually trained without effective supervision and guidance mechanism.Since 2017,the Emergency Department of Peking University Third Hospital has adopted the training model under tutor system for visiting physicians.Tutors and visiting physicians are matched 1∶1.Personalized training program is made by tutors and visiting physicians depending on the level of the hospital where visiting physicians practice in,educational background,clinical experience,length and the goal of study.The training plan is refined according to the timeline in order to facilitate the tutor and training physician's own precise management.Since implementation of this training model,the visiting physicians say they are more efficient to complete the training program and learned more than before.The teaching ability of tutors has further been enhanced.

Objective:To investigate the clinical characteristics, risk stratification, thrombolytic effects and prognosis of 110 patients with acute pulmonary embolism (PE) treated with thrombolysis.Methods:The clinical data of 110 patients with PE admitted to Beijing University People's Hospital from May 2009 to March 2019 were retrospective analyzed. The clinical data including general information, symptoms and signs, blood pressure, artery blood gas, coaglulation, and radiography were collected. Inclusion criteria: high-risk and intermediate high-risk group. Exclusion criteria: intermediate low-risk and low-risk group. According to the prognosis and risk stratification, the patients were divided into survival group and non-survival group, high-risk group and intermediate high-risk group. The indicators above were compared between with χ 2 test, t test or nonparametric test where appropriate. Results:Of the 110 patients with PE, 49 patients were male and 61 female with an average age of 65±16 years old; and 12 patients were in the high-risk group and 98 in the intermediate high-risk group. The respiratory rate of the high-risk group was higher, and blood pressure, PO 2, SaO 2 before thrombolysis were more lower than the intermediate high-risk group ( P<0.05). One hundred and nine patients were treated with systemic recombinant tissue plasminogen activator (rtPA), 70 patients with 50 mg, and 39 patients with 100 mg. One patient, who was contraindicated to systemic thrombolysis (with active vagina bleeding), was treated with interventional local thrombolysis; another 5 patients treated with interventional local thrombolysis because the clinical symptom were not improved markedly. One hundred and two patients survived and 8 patients died, among which, 3 patients were in the high-risk group and 5 in the intermediate high-risk group. The age, heart rate, respiration rate of the non-survival group were higher than those in the survival group, and the PO 2 before thrombolysis, PCO 2 after thrombolysis were lower ( P<0.05). Bleeding complication were occurred in 22 patients: 18 patients with minor bleeding, such as bleeding gums, skin ecchymosis, and 4 patients with moderate-severe bleeding, such as cerebral hemorrhage, abdominal bleeding, gastrointestinal bleeding, and vagina bleeding. Thirteen of 70 patients in the 50 mg group and 9 of 39 patients in the 100 mg group occurred bleeding complication. The bleeding complication of the low dose group was lower than that of the standard dose group ( P<0.05). Conclusions:Thrombolysis is first-line therapy to high-risk PE. Thrombolysis is safe and effective in the intermediate high-risk group with a lower incidence rate of bleeding complication.

Objective:To investigate the effects and molecular mechanism of neuropilin and tolloid-like 2 (NETO2) on proliferation, migration, cell cycle, and apoptosis in gallbladder cancer (GBC).Methods:The NETO2 mRNA and protein expression in GBC-SD, ZJU-0430, NOZ GBC cells were detected by quantitative real-time polymerase chain reaction and Western blot. NETO2 overexpression and knockdown stable cell lines were constructed by plasmid transfection. Cell counting kit-8 assay, colony formation assay, transwell assay, flow cytometry and WB assay were performed to evaluate proliferation, migration, cell cycle, apoptosis, epithelial-mesenchymal transition (EMT) and changes of phosphatidylinositol-3 kinase/protein kinase B (PI3K/Akt) signaling pathway.Results:GBC-SD and ZJU-0430 cells with NETO2 gene overexpression and NOZ cells with NETO2 gene knockdown were effectively constructed. NETO2 overexpression in gallbladder cancer cell lines significantly improved cell proliferation and migration, advanced cell cycle progression from G0/G1 to S phase, and inhibited cell apoptosis. In the ZJU-0430 and GBC-SD cells, the clone number increased from (78.5±9.2), (217.0±6.4) to (213.5±10.3), (296.3±9.3)( t=10.98, 6.51; P=0.008, 0.023); The number of migrating cells increased from (198.6±8.4), (233.3±11.0) to (382.7±12.4), (379.0±7.3) ( t=16.98, 16.85, both P<0.001); The total apoptosis rate reduced from (29.7±0.9)%, (35.6±1.1)% to (19.2±0.5)%, (29.1±0.4)% ( t=9.74, 9.05; both P<0.001); The expression of EMT related proteins such as N-cadherin, Vimentin, Snail, and Slug were upregulated, while E-cadherin expression was downregulated. Phosphorylated PI3K (p-PI3K) and Akt (p-Akt) protein expression were significantly increased (all P<0.05). In contrast, NETO2 knockdown had the opposite effect on all these parameters. Conclusion:NETO2 influences the EMT process by regulating the PI3K/Akt signaling pathway, thus promotes GBC cell proliferation, migration and cell cycle progression, and inhibits cancer cell apoptosis.

Gallbladder carcinoma （GBC） is a type of malignant tumor with an extremely poor prognosis， and at present， surgical operation is the most effective treatment method for this disease. Unfortunately， due to a lack of typical symptoms in the early stage， most patients have progressed to the advanced stage at the time of confirmed diagnosis and lost the opportunity for radical surgery. Among the currently available adjuvant treatments， targeted therapy has higher specificity and fewer side effects and has improved the prognosis of a variety of malignancies. With reference to the latest research advances in targeted therapy for GBC， this article reviews the current research status， potential targets， and targeted medications of targeted therapy for GBC， in order to provide a reference for the clinical treatment of GBC patients.