Objective To evaluate the efficacy and safety of sunitinib versus sorafenib in the first-line treatment of advanced renal cell carcinoma.Methods Forty-two patients with advanced renal cell carcinoma were divided into two groups according to the therapeutic method.Twenty patients were treated with sunitinib (50 mg, oral administration, once a day, for 4 weeks, drug withdrawal of 2 weeks, 6 weeks was a cycle) and 22 patients were treated with sorafenib (400 mg, oral administration, twice a day, until the disease progression, 6 weeks was a cycle).The efficacy and toxicity were evaluated every 2-cycle treatment.Results All 42 patients could be evaluated.The disease remission rate (RR), disease control rate (DCR) of sunitinib group and sorafenib group were 30.0％ (6/20), 22.7％ (5/22), 90.0％ (18/20), 77.3％ (17/22) respectively,the median progression free survival (PFS) were 10.8, 6.2 months, the median overall survival (OS) were 25.6, 18.6 months respectively.There were no statistical differences in the RR (x2 =0.287, P =0.592) and DCR (x2 =1.222, P =0.269) between the two groups.There were statistical difference in the PFS (x2 =6.041, P =0.014) and OS (x2 =11.245, P =0.001) between the two groups.The most common toxicities of the sunitinib group were diarrhea, fatigue, oral mucositis, nausea, vomiting, all these toxicities were mainly Ⅰ-Ⅱ degree, and could be well tolerated.The hand-foot syndrome rate of the sorafenib group obviously exceeded the sunitinib group (59.1％ vs.25.0％ , x2 =4.972, P =0.026).Conclusion Sunitinib has good efficacy in the first-line treatment of advanced renal cell carcinoma with less toxicity than sorafenib, so it is worthy of popularization.

Objective To analyse effect of Erigeron breviscapus oral liquid on peripheral blood CRP and MMP-9 in patients with acute coronary syndrome.Methods 56 patients who were diagnosed with acute coronary syndrome were collected.All patients were randomly divided into experimental group and control group, 28 cases in each group.Patients in control group received conventional treatment with western medicine, patients in experimental group were given Erigeron breviscapus oral liquid of oral treatment on the basis of control group treatment, after the treatment, the serum levels of CRP,MMP-9 and clinical curative effect were detected in all patients.Results Compared with before treatment, the levels of CPR and MMP-9 in two groups decreased after the treatment(P<0.05); Compared with control group,the serum level of CRP was lower in experimental group(P<0.05); the serum level of MMP-9 was lower in experimental group(P<0.05);the total effective rate was higher in experimental group(χ2 =4.08,P<0.05).Conclusion Erigeron breviscapus oral liquid can significantly reduce the serum levels of CRP and MMP-9 in patients with acute coronary syndrome,improve clinical therapeutic effect.

SUMMARY Diffusion spectrum imaging ( DSI) , a newly developed MRI technique, affords the capacity to map complex fiber architectures in tissues with sufficient angular resolution by imaging the spectra of tissue water diffusion. By contrast, diffusion tensor imaging (DTI) , the currently widely used technique based on the 2nd order tensor model, obtains an approximation of the complex diffusion, and provides only one global maximal direction corresponding to the primary eigenvector for each voxel. As a generalized model-free diffusion imaging technique, firstly, DSI employs the probability density function to describe the diffusion process in each voxel; secondly, a sufficient dense signal sample derived from repeated applications of diffusion-weighed gradients ensures its capability to resolve the diffusion probability density function; thirdly, specific computer visualization techniques are used to extract the diffusion information and reconstruct the geometrical properties of tissue microstructure. The capacity to unravel complex tissue architecture, recent improvements in hardware and ongoing optimization of sequence design and algorithm enable a rapid growth of DSI for research use and future incorporation into clinical protocols. This paper introduces the basic principles of DSI and then compares the characteristics of DSI and DTI schemes. Finally, the typical applications of DSI to date are reviewed.

Objective To investigate and analyze the health care seeking behavior,financial burden and relative factors of patients with rheumatic diseases in Fujian Province.Methods Patients diagnosed with rheumatic diseases were investigated in Fujian Provincial Hospital from December 2013 to February 2014,including demographic data,health care seeking behavior and financial burden.Relevant factors were analyzed by Logistic regression.Results ① In this study,474 patients were enrolled.The ratio of male to female was 1∶2.38.② At the onset of symptoms,51.9％(246 cases) of patients visited a doctor as soon as possible,and 36.1％(171 cases) of them went to hospital within a month after disease onset.③ 74.1％(351 cases) of patients could adhere to medication regimen prescribed by doctors,and the most common reason for stopping medication was symptoms relieved (33.3％,41 cases).④ 63.1％(299 cases) of patients learned about the knowledge of rheumatic diseases from hospitals and doctors.⑤ 34.2％(162 cases) of patients spent 1 000-5 000 yuan every month on treatment.⑥ Insurance type could affect the time of first visit to hospital (P=0.004),while income and cost of therapy might impact patients' compliance (P=0.013,P=0.004).Conclusion Most patients will go to hospital as soon as possible and adhere to treatment.Economic situation is the main factor influencing health care seeking behavior of patients with rheumatic diseases.

The abdominal visceral fat content in obese SD rats induced by high fat diet for 10 weeks was significantly higher than that in control group [(26±6 vs 13±3)g,P<0.01] ,along with increased CRP mRNA expression in abdominal visceral fat (0.901±0.085 vs O. 402±0.036, P<0.01). As compared with normal control group, in the high fat group the concentrations of CRP in portal vein [(743.8±95.8 vs 558.3 ±118.3) mg/L, P<0.01] and peripheral vein[(596.3±38.9 vs 485.8±30.2) mg/L,P<0. 05] were higher. The concentration of CRP in portal vein was significantly higher than that in peripheral vein in high fat diet group(P<0.01) ,but this was not evident in control group. These results suggest that the increased CRP expression in visceral adipose tissue may partially account for the elevation of serum CRP in obesity.

AIM:To discuss the technique for preparing high-purity solanesol from tobacco. METHODS:The pre-treated tobacco leaves were extracted with mixed solvent of petroleum ether and ethanol,and saponified to obtain solanesol extract; The solanesol extract got through redissolution and dewaxing,then crystallized in the temperatare of -18 ℃; Finally purified by macroporous resin(YPR-Ⅱ,D-1300,HZ-816,HZ-802). RESULTS:The ratio of mixed solvent of petroleum ether and ethanol was 1 ∶ 4,ratio of liquid to materials was 1 ∶ 12,solanesol purity was about 32% after saponification,then crystallization made the purity up to 63. 4% ,finally purified through macroporous resin,the solanesol purity reached above 93. 6%. CONCLUSION:Through the general solvent extraction,saponification,crystallization and macroporous resin adsorption process,the solanesol purity of the product reaches higher than commonly expected values.

Objective:To analyze the correlation of single nucleotide polymorphisms ( SNP) of ATP binding cassette transporter A1 gene (ABCA1) and lower extremity atherosclerotic disease (LEAD). Methods: The clinical data and peripheral blood were col-lected from 630 participants (314 LEAD cases and 316 normal controls) in Han population of Minnan. The 9 SNP genotypes in the ABCA1 gene were detected by Sequenom MassArray. Results:Among the 9 SNP genotypes, rs2980083 was rejected because it wasn' t in accordance with Hardy-Weinberg equilibrium. Obvious linkage disequilibrium was found between rs2066714 and rs2066715, rs1800976 and rs2246293, rs2246293 and rs2980083, and rs1800976 and rs2980083(D′>0. 9,r2 >1/3). There were no significant differences (P>0. 05) in 6 haplotypes of ABCA1 gene groups between the LEAD cases and the normal controls. No significant differ-ences (P>0. 05) were found in frequency distribution between the LEAD cases and the normal controls in 8 SNP according to the re-sults of genotype statistics. There was no onset risk of LEAD according to the gene logistic regression analysis. Conclusion:The SNPs of rs10124755, rs2980083, rs1800976, rs4149341, rs2066714, rs2066715, rs2066716, rs2230808 and rs2246293 might not correlate with the susceptibility of LEAD in Han population of Minnan.

Objective To investigate the visualization and quantitation of hemodynamic variables at carotid artery bifurcation in vivo by combining computational fluid dynamics(CFD)and vascular imaging. Methods A healthy volunteer underwent CT angiography of left carotid artery by SIEMENS multi-slice CT. Parameters of hemodynamics at this carotid bifurcation were calculated and visualized by combining vascular imaging post-processing and CFD.Results (1) The average range of flow velocity was 0.04～0.36 m/s. A region of high velocity was seen at medial wall of internal carotid artery (ICA) and medial wall of external carotid artery (ECA), respectively. The largest contiguous region of low velocity occurred at the carotid bulb. (2)The average range of absolute pressure, static pressure and dynamic pressure was 100 266.70～101 615.90 Pa, -1058.34～290.88 Pa, and 6.12～553.25 Pa, respectively. (3) The average range of wall shear stress (WSS) at the bifurcation was 0.59～5.35 Pa. There was a large region of low WSS at carotid bulb and posterior wall of ICA, with the lowest value of 0.25 Pa. Also there was a small region of low WSS at anterior and lateral wall of ECA.Conclusion CFD combined with vascular imaging can calculate and visualize the parameters of hemodynamics at carotid bifurcation in vivo individually. It is an interdisciplinary science of computer, radiology and hemodynamics and provides a new method to investigate the relationship of vascular geometry and flow condition with atherosclerotic pathological changes.

Objective To set up a new diagnostic platform based on microarray exon-capture and next-generation sequencing for detecting small mutations in dystrophin gene.The sensitivity and specificity of the method were assessed in clinical settings and the distribution of small mutations in Chinese Duchenne muscular dystrophy/Becker muscular dystrophy (DMD/BMD) patients were also analyzed.Methods Forty-one DMD/BMD patients diagnosed by the clinical criteria without large deletion or duplication (≥ 1exon) were recruited from Peking Union Medical College Hospital consecutively.Genomic DNA was extracted from blood samples.The libraries were prepared.Then exon and intron-exon flanking sequences of DMD gene were captured by custom microarray.Targeted next-generation sequencing and Sanger Sequencing were conducted.The patients who were not detected any disease-causing mutation were performed muscle biopsy.Results Thirty-eight subjects were detected small mutations in DMD gene.All single nucleotide variants (SNVs) and insertion & deletions (INDELs) were validated by Sanger sequencing.Twenty-one novel mutations were reported.The distribution of SNVs and INDELs was similar to other international DMD databases.Upon immunohistochemistry staining of dystrophin protein,1 of 3 mutation-undetected patients was diagnosed as DMD,2 of them were excluded.The specificity of the method was 100％,while the sensitivity was 97.4％.Conclusions Our microarray-captured next-generation sequencing assay could detect SNVs and INDELs with high sensitivity and specificity.Its advantages are economic,time-saving and stable.The platform is suitable for clinical gene diagnosis.

Objective　To evaluate whether the stimulation on eyes of bendazac lysine eyedrops could be reduced by cold storage.Methods　 Mate design scheme and double-blind clinical trial were performed. 160 healthy eyes was divided into two groups: the test group was given bendazac lysine eyedrops which was stored in refrigerator at 4℃ over night, and the control group was given it which was stored at room temperature.Results　ln the control group and the test group, the occuring rate of stimulation was 19.30% and 6.25%. The cases of B、C stimulation degrees were 31 and 10; the average stimulation degrees of each group were 1.21 and 1.07, the scoring change for eye stimulation were 1.57±1.50,0.79±1.40,all respectively. The statistical difference was significant (P＜0.05 or P＜0.01).Conclusion　The eye stimulation of bendazac lysine eyedrops can be reduced by cold storage.