Objective: To investigate the state of calcium-phosphorus metabolism and serum intact parathyroid hormone (iPTH) levels in end stage renal disease (ESRD) patients, to analyze clinical characters, and to provide scientific basis for clinical treatment. Methods: The data of 100 ESRD patients who received hemodialysis in Peking University First Hospital from January 2000 to July 2003 were analyzed retrospectively. Results: (1) The levels of serum total calcium were adjusted by serum albumin. There were 15 patients with hypocalcemia and 85 patients with normocalcemia or hypercalcemia. 31.8% of the latter took calcium-containing phosphate binders or/and vitamin D. In the 14 patients with hypocalcemia and 58 patients without low serum calcium who did not take calcium-containing phosphate binders or/and vitamin D, we found the levels of carbon dioxide combining power (CO 2CP) were lower in the group of hypocalcemia (P

Objective To study the expression and the significance of phosphorylated P38(p-P38) and uPA in breast cancer tissues.Methods Immunohistochemistry(S-P) was used to test the protein expression of p-P38 and uPA in 60 specimens from 50 patients with breast cancer.Western blotting was adopted to detect the protein expression of p-P38 and uPA in breast cancer cells and uPA protein expression after incubation with SB203580,an specific inhibitor of P38 MAPK blocked P38 MAPK signaling pathway.Results The positive rates of p-P38 protein and uPA protein in breast cancer tissues were 56.7%and 60.0% respectively.The protein expression level of p-P38 and uPA in breast cancer tissues was significantly higher than that in adjacent normal tissues(P

Objective To investigate the difference between Asia-Pacific Colorectal Screening (APCS) scoring system and colorectal cancer sequential screening criteria issued by the Health Ministry of China (China sequential criteria) in the evaluation of high-risk colorectal neoplasm in patients undergoing coronary artery angiography (CAG) examination.Methods The data of 870 patients aged from 40 to 74 who underwent CAG examination were retrospectively analyzed.The measurement data were analyzed by t test and the count data were aralyzed by x2 test.Results There were 72 patients aged from 40 to 49 years old.Among them,eight patients were stratified as high-risk population according to the Chinese sequential criteria; however there was no high-risk population by APCS.There were 798 patients aged from 50 to 74 years old.There were 460 patients stratified as high-risk population by APCS.The percentage of CAG negative group (34.7％) was significantly lower than that of the coronary artery disease (CAD) group (68.0％,x2 =77.74,P＜0.01).According to the Chinese sequential criteria,and there were 134 patients stratified as high-risk population,and there was no significant difference between the CAG negative group (17.7 ％) and the CAD group (16.4％,P＞0.05).Among the patients aged from 50 to 74 years old without family history of colorectal cancer in first-degree relatives,72 cases (29.0％) of the CAG negative group and 316 cases (57.5％) of the CAD group were stratified as high-risk according to APCS,however not stratified as high-risk by the Chinese sequential criteria.About 90.5 ％ (351/388) of them were male smokers.According to APCS,30 cases (12.1％) of the CAG negative group and 32 cases (5.8％) of the CAD group were stratified as middle-risk population,however stratified as high-risk population by the Chinese sequential criteria.About 75.8％ (47/62) of them were female non-smokers.Conclusions The percentage of patients stratified as high-risk population by APCS was higher than that by the Chinese sequential criteria.In patients aged from over 50 to 74 years old and without family history of colorectal cancer in first-degree relative,APCS maybe overestimated the risk degree of colorectal neoplasm in male smokers and underestimated the risk degree in female non-smokers.

Objective To investigate the clinical typing of nasopharyngeal carcinoma in patients treated by intensity-modulated radiation therapy (IMRT).Methods A retrospective analysis was performed on 333 patients with nasopharyngeal carcinoma who were initially treated in our hospital from 2003 to 2006 ;they had no distant metastasis and received IMRT.These patients were divided into 4 clinical types according to their prognosis:type Ⅰ (without local-regional recurrence and without distant metastasis),type Ⅱ (with local-regional recurrence and without distant metastasis),type Ⅲ (without local-regional recurrence and with distant metastasis),and type Ⅳ (with local-regional recurrence and with distant metastasis).Results Of all the patients,70.0％ (233) were of type Ⅰ,12.9％ (43) of type Ⅱ,16.5％ (55) of type Ⅲ,and 0.6％ (2) of type Ⅳ.Of 57 patients with stage Ⅰ-Ⅱ nasophayngeal carcinoma,86％ (49) were of type Ⅰ,11％ (6) of type Ⅱ,4％ (2) of type Ⅲ,and 0％ (0) of type Ⅳ,and of 276 patients with stage Ⅲ-Ⅳ nasopharyngeal carcinoma,66.7％ (184) were of type Ⅰ,13.4％ (37) of type Ⅱ,19.2％ (53) of type Ⅲ,and 0.7％ (2) of type Ⅳ,with significant differences between the two patient groups (P =0.007).Of the 69 patients who received IMRT alone,80％ (55) were of type Ⅰ,12％ (8) of type Ⅱ,9％(6) of type Ⅲ,and 0％ (0) of type Ⅳ; of the 218 patients who received IMRT combined with neoadjuvant plus concurrent chemotherapy,68.8％ (150) were of type Ⅰ,13.8％ (30) of type Ⅱ,16.5％(36) of type Ⅲ,and 0.9％ (2) of type Ⅳ; of the 46 patients who received IMRT combined with neoadjuvant plus adjuvant chemotherapy,61％ (28) were of type Ⅰ,11％ (5) of type Ⅱ,28％ (13) of type Ⅲ,and 0％ (0) of type Ⅳ.Conclusions In patients with early and advanced nasopharyngeal carcinoma,type Ⅰ is the most common,and type Ⅳ is the least common;type Ⅱ is more frequent than type Ⅲ in early patients,while type Ⅲ is more frequent than type Ⅱ in advanced patients.The percentage of type Ⅰ patients increases,while that of type Ⅱ-Ⅳ patients decreases,as compared with the data of those treated by conventional radiotherapy.

Objective To evaluate previous gastroscopy before percutaneous coronary intervention (PCI) for the risks and benefits of concomitant use of proton pump inhibitors (PPIs) after PCI in patients with non-acute coronary syndrome (non-ACS).Methods The data of 673 non-ACS patients who underwent PCI with stenting were retrospectively analyzed.They were divided into concomitant use of PPIs group and non-PPIs group,then subdivided into high-,moderate-and low-risk groups according to risk factors associated with adverse upper gastrointestinal (GI) events.The incidences of adverse cardiovascular events and adverse upper GI events were compared among groups.Findings of previous gastroscopy were also included.Results Only 82 patients (12.2％) underwent gastroscopy within 5 years before PCI,of whom,27 (32.9％) were diagnosed as having peptic ulcer,and 55.6％ (15/27) of whom were in concomitant use of PPIs.Compared with the non-PPIs group,the rate of adverse cardiovascular events in the concomitant use of PPIs group was significantly higher (22.6％ vs.8.9％,P ＜0.01),and the highest rate (41.7％) was in the high-risk group.However,the corresponding rate of adverse upper GI events was the lowest (4.2％).In the moderate-risk group,90.5 ％ (344/380) of patients were older than 65 years with concomitant use of NSAIDs.The rate of gastroscopy within 5 years before PCI in these patients was remarkably lower than that in patients who had the history of upper GI disease with concomitant use of NSAIDs (concomitant use of PPIs group 14.1％ vs.54.5％ ; non-PPIs group 7.5％ vs.28.0％ ; P ＜ 0.01).In the concomitant use of PPIs group,the rate of adverse cardiovascular events in the former was notably higher than that in the latter (20.5％ vs.9.1％,P ＜0.01),but the rate of adverse upper GI events within 1 year after PCI were similar (9.0％ vs.9.1％).Conclusion Previous gastroscopy before PCI could provide the baseline information of upper GI disease,which may be helpful for the evaluation of concomitant use of PPIs after PCI so as to decrease the incidence of adverse cardiovascular events.Special attention should be paid to those patients older than 65 years in the moderate-risk group and concomitant use of NSAIDs.

Objective To investigate the status quo of the assurance and subsidy for severe diseases acquired by juvenile in rural areas in Qinghai, and provide evidences for building a subsidy system for such population. Methods Quantitative surveys were made to collect data on medical expenses and the compensation practice for such expenses for severe diseases of juvenile in the area, for a knowledge of the present medication and disease load in question; specialists in two hospitals were interviewed to learn the present treatnents for such a population, and their expenditures in case of such diseases. Results Juveniles in rural Qinghai rely on the new rural cooperative medical scheme, under which however the reimbursement rate was only 26% ～35%. Families with juvenile patients of severe diseases were found to suffer heavy burdens. As a result, a high percentage of the patients give up treatment. To make things worse, as only two hospitals in the provincial capital city can provide professional treatment for children with severe diseases, rural children have to pay heavy indirect costs other than medication such as heavy travel expenses. Conclusion It is critical to build a medical assurance system for juvenile with severe diseases. It is also imperative to build and strengthen the capacity of medical centers for such a population in Qinghai, and upgrade the diagnosis and treatment competence of local health providers, ensuring adequate medical resources for juvenile with severe diseases upon joint development of both healthcare providers and the medical insurance system.

Objective To study the expression of WWOX, ErbB2 and Ki67 protein in non-small cell lung cancer(NSCLC) and the relationships with cell proliferation. Methods WWOX and ErbB2 protein expressions were evaluated by immunohistochemistry in 81 NSCLC patients (50 squamous cell carcinomas,31 adenocarcinomas and 20 adjacent normal lung tissues) and the correlations with histopathologic cell proliferation were analyzed. Results WWOX expression was absent/reduced in 72.8% of NSCLC, while it was normal in 80.0% of adjacent normal lung tissues. WWOX expression was strongly associated with tumor histology, histologic grade and lymph node metastasis ( X2 = 5.44, P = 0.019 ; X2 = 4.740, P = 0.029, X2 = 4.51, P = 0.034 ), reduced WWOX expression was higher in squamous cell carcinomas and in poorly differentiated tumors. The overexpression of ErbB2 was associated with TNM stage and lymph node metastasis ( X2 = 6.90, P = 0.009 ; X2= 5.68, P=0.017). WWOX expression was negatively related to the overexpression of ErbB2 (r=-0.239, P <0.05 ). WWOX expression intensity was nega-tively related to the high index of cell proliferation (r=-0.252, P<0.05 ). Conclusion The loss of WWOX ex-pression plays different roles in tumorigenesis of NSCLC and is related to high aggressiveness of tumors. The loss of WWOX expression and the overexpression of ErbB2 can estimate the prognosis of NSCLC.

Objective To analyze the long-term efficacy,prognostic factors and radiation sequela of nasopharyngeal carcinoma(NPC)treated with radiotherapy at the end of last century.Methods From January 1995 to December 1998,1706 newly diagnosed NPC patients treated with radiotherapy were included in the retrospective clinical analysis.There were 1081 patients treated with radiotherapy alone,625 with two to three circles of chemotherapy(5-Fu and DDP)before radiotherapy,23 with thermotherapy during radiotherapy and 162 with braehytherapy by 192Ir after external beam radiation.Results The 5-year overall survival. local control survival and disease-free survival rates were 67.60%.84.20%and 64.22%.respectively.The 5-year survival of patients with stage Ⅰ,Ⅱ,Ⅲand Ⅳ(the Fuzhou Staging,1992)were 100%,75.93%,66.47%and 49.34%.respectively.Cox regression analysis showed that the TNM classification,radiotherapy discontinuance,chemotherapy,sex,age and anemia before radiotherapy were the significant factors of survival.Conclusions Our experience shows that the main factors for the long term survival of NPC patients after radiotherapy are early TNM stage,young age,female,non-anemia before radiotherapy, radiotherapy continuance and chemotherapy.

Objective To evaluate the clinical value of ultrasonography guided percutaneous core needle biopsy in pancreatic lesions. Methods Thirty-four patients with 36 pancreatic lesions in Shanghai First People′s Hospital Afifliated to Shanghai Jiao Tong University from February 2012 to November 2013 underwent conventional ultrasound-guided percutaneous core needle biopsy using automatic gun and 18-gauge biopsy needles. The site, size, internal and surrounding vascularity, the sampling number of the lesions, and whether the specimens′ quality was satisfied were recorded. Then specimens were sent for pathological examination, and all above observations were compared with the ifnal diagnosis. Results The number of lesions with 2, 3 and 4 samplings was 32, 2 and 2, respectively. The average number of sampling was 2.2 (mean, 2.17;standard deviation, 0.51) and the acquisition rate of satisifed specimens was 89%(32/36). The pathological results of biopsy were malignant in 31 of 36 lesions including 27 cases of ductal adenocarcinoma, 2 cases of lymphoma, 1 case of small cell neuroendocrine carcinoma and 1 case of uterine leiomyosarcoma metastasis. The other 5 lesions were non-malignant including 3 cases of benign lesion, 1 cases of atypical hyperplasia and 1 cases of granulation tissue. The 36 lesions were ifnally diagnosed as 34 cases of pancreatic malignancy, 2 cases of non-malignant neoplasm. The sensitivity, speciifcity, accuracy, positive predictive value and negative predictive value of ultrasonography guided percutaneous core needle biopsy in pancreatic lesions were 91%(31/34), 100%(2/2), 92%(33/36), 100%(31/31) and 40%(2/5), respectively. Youden index was 0.91. Two patients had mild upper abdominal pain and 1 patient had transient elevated serum amylase. No pancreatitis, pancreatic fistula, peritonitis, bleeding or dispersion of malignant cells along the penetrating channel or other serious complications occurred. Conclusion Ultrasonography guided percutaneous core needle biopsy is a simple, rapid, safe and effective diagnostic method in pancreatic lesions with high clinical value.

Objective To evaluate the influences of the genotypes,anther developmental stages,and cultural conditions on the efficiency of embryogenic callus induction and plant regeneration in the anthers culture of Bupleurum chinense.Methods The different effects such as four genotypes,plant growth regulators,and temperature condition were compared in the experiments.The histological study was performed with the process of the anther culture.Results The highest inducing rate of embryogenic calli were achieved for the genotypes Zhongcaiyihao(ZCYH),Z4,and Z5 at the early-to middle-uninucleate stages,except for genotype ZPM1 at the tetrad stage.Cold pretreatment increased the production of the embryogenic callus,in which 4-day cold pretreatment improved the production of embryogenic callus from 0% to 2.2% and 5.0% for genotypes ZPM1 and ZCYH,respectively.No embryogenic callus was induced in the medium containing less than 0.75 mg/L 2,4-dichlorophenoxyacetic acid(2,4-D).The highest regeneration rate (34.6%)was obtained in 1/2 MS salts regeneration medium supplemented with 0.1 mg/L 6-benzylmaminopurine (BA).The low concentration of BA was able to promote the embryogenic callus formation and subsequent plantlet regeneration via somatic embryogenesis.Chromosome counting of regenerated plantlets showed mostly diploid plant (2n = 12)with only one haploid plant(n = 6).Because of the low rate of microspore embryo formation,we only tracked the process of embryogenesis from the connective tissue,instead of microspore by histological observations.Conclusion This study establishes an efficient system for embryogenic callus induction and plant regeneration system.This is the first report on the haploid plantlet through the anther culture orB.chinense.