92 type 2 diabetics with DPN were treated by cobamamide (n=46) vs vitamin B12 (n=46) for 4 weeks.Cobamamide improved the spontaneous pain, numbness of limbs, nerve reflection and nerve conduction velocities in higher rates as compared with vitamin B12 treatment, and did not cause obvious adverse reactions.

Objective To study the relationship between liver fibrosis degree and widths of portal vein(TPV) and spleen vein(SPV).Method Liver specimens from 151 patients with chronic viral hepatitis were divided into 4 groups from S 1 to S 4 according to the liver fibrosis degree.The diameters of TPV and SPV were measured by ultrasonic B.Results The diameters of TPV and SPV of groups S 1,S 2,S 3 and S 4 were (11 89?1 39)mm and (5 78?1 33)mm,(12 22?1 19)mm and (6 25?1 28)mm,(12 43?1 26)mm and (7 03?1 54)mm,(13 07?1 23)mm and (8 0?1 80)mm,respectively.The differences of diameter of TPV between group S 4 and group S 1,S 2 were significant(all P

92 type 2 diabetics with DPN were treated by cobamamide (n=46) vs vitamin B12 (n=46) for 4 weeks.Cobamamide improved the spontaneous pain, numbness of limbs, nerve reflection and nerve conduction velocities in higher rates as compared with vitamin B12 treatment, and did not cause obvious adverse reactions.

Objective To investigate the efficacy of sequential ERCP and laparoscopy for acute biliary pancreatitis (ABP).Methods A total of 80 patients with ABP were randomly divided into 2 groups to receive sequential ERCP and laparoscopy (observation group,n=40) or traditional surgery (control group,n=40).Clinical data including abdominal pain relief time,recovery time of white blood cell,blood amylase and liver function,hospital stay,complication rate and mortality were analyzed.Results ERCP failed in 1 patient in observation group,and the remaining 39 patients (97.5％) were recruited into the study.There were significant differences between 2 groups in regarding of abdominal pain relief time (7.7±2.7 d vs.11.4±3.7 d),recovery time of white blood cell ( 9.7±2.6 d vs.13.3±3.9 d ),blood amylase ( 8.2±2.1 d vs.12.5±3.3 d ),liver function ( 12.5±5.1 d vs.21.3±6.5 d ),hospital stay ( 16.1±5.1 d vs.23.3±7.6 d ) and rate of complication ( 12.8％ vs.30.0％ ).There was no significant difference in morbidity between 2 groups (5.1％ vs.7.5％).Conclusion Sequential ERCP and laparoscopy is effective for ABP.

Surgery is so far the most widely used and effective treatment of neoplastic diseases.However,residual tumour cells during surgery remain a major trigger of cancer recurrence and matastasis.Although intraoperative rapid pathological R0 resection can be achieved based on preoperative imageological examination,but for small satellite lesions and the naked eye can not find the error quickly and so often cause pathological presence of residual tumour cells.Thus,quick and accurate identification of residual cancer cells is crucial for prognosis of cancer patients.Indocyanine green (ICG) is a new type of fluorochrome that can stain tumours under the near-infrared fluorescence during surgery,the paper will be reviewed latest developments in the reagent for fluorescence in tumours.

Objective To summarize our preliminary experience of selective fetieide with bipolar coagulation in complicated monochorionie twins(MCT),and discuss the clinical application of feticide in discordant MCT.Methods Three MCT with one twin anomaly.in which 2 had severe twin-twin transfusion syndrome(TTTS),stage Ⅳ ,and 1 had acardiac twin,were identified in the second trimester of pregnancy.To terminate the abnormal twin and isolate the co-twin's circulation completely.selective feticide was performed by umbilical cord occlusion with bipolar coagulation under guidance of ultrasound and fetoscopy.After each invasive procedure,serial monitoring was performed,including procedural complications,Doppler of fetal middle cerebral artery and umbilical artery.Pregnancies were followed up every 2 weeks for fetal growth until delivery.After birth the placentas and the terminated fetuses were examined.Result Cord occlusion was successfully accomplished in all 3 targeted fetuses,at 21,22 and 24 weeks of gestation respectively.One case with TTTS was complicated with rupture of the membrane in the terminated fetus at the 7th day after the procedure.and a healthy baby was born at 32 weeks.The other case with TTTS delivered a boy by cesarean section at 38 weeks.The third case with TRAP is at 35 weeks of gestations and under regular follow-up.Monochorionicity was confirmed by placental examination after delivery.and the effects of bipolar coagulation were observed at the,cord of terminated fetuses.Conclusions Umbilical cord occlusion witll bipolar coagulation is an effective procedure for selective feticide in MCT with one twin anomaly.The outcome of normal fetus can be favorable.

OBJECTIVETo examine the global effects of Mycobacterium tuberculosis (M. tuberculosis) infection on macrophages.

METHODSThe gene expression profiling of macrophage U937, in response to infection with M. tuberculosis H(37)R(a), was monitored using a high-density cDNA microarray.

RESULTSM. tuberculosis infection caused 463 differentially expressed genes, of which 366 genes are known genes registered in the Gene Bank. These genes function in various cellular processes including intracellular signalling, cytoskeletal rearrangement, apoptosis, transcriptional regulation, cell surface receptors, cell-mediated immunity as well as a variety of cellular metabolic pathways, and may play key roles in M. tuberculosis infection and intracellular survival.

CONCLUSIONSM. tuberculosis infection alters the expression of host-cell genes, and these genes will provide a foundation for understanding the infection process of M. tuberculosis. The cDNA microarray is a powerful tool for studying pathogen-host cell interaction.

Objective:To explore the relationships between serum lipids, CA153 level and breast cancer incidence and clinicopathological features of patients.Methods:A total of 198 patients with breast cancer diagnosed and treated at Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School were enrolled as the case group, and 198 healthy women were selected with 1∶1 age pairing as controls. Five milliliters of fasting venous blood was collected to measure serum lipids levels in all subjects and CA153 levels in breast cancer patients. The difference of serum lipids levels between the two groups was compared. Logistic regression model was used to analyze the risk factors of breast cancer. For 165 breast cancer patients who did not receive neoadjuvant chemotherapy, independent sample t-test was used to compare serum lipids and CA153 levels in breast cancer patients with different pathological features, and Pearson correlation analysis was used to calculate the correlation between variables and CA153. Results:The triglyceride (TG) levels in the case group and the control group were (1.22±0.73) mmol/L and (1.06±0.52) mmol/L respectively, and the difference was statistically significant ( t=2.559, P=0.011); the total cholesterol (TC) levels were (4.47±0.86) mmol/L and (4.99±0.80) mmol/L respectively, and the difference was statistically significant ( t=-6.228, P<0.001); the high-density lipoprotein cholesterol (HDL-C) levels were (1.32±0.34) mmol/L and (1.53±0.38) mmol/L respectively, and the difference was statistically significant ( t=-5.913, P<0.001). Higher TC and HDL-C levels were independent protective factors for breast cancer ( OR=0.350, P<0.001; OR=0.531, P=0.013). The TC levels in lymph node positive and lymph node negative patients were (4.36±0.73) mmol/L and (4.67±0.83) mmol/L respectively, and the difference was statistically significant ( t=-2.518, P=0.013); low-density lipoprotein cholesterol (LDL-C) levels were (2.53±0.58) mmol/L and (2.77±0.70) mmol/L respectively, and the difference was statistically significant ( t=-2.312, P=0.022). The TC levels in patients with stage Ⅰ and stage Ⅱ/Ⅲ were (4.90±0.89) mmol/L and (4.46±0.76) mmol/L respectively, and the difference was statistically significant ( t=2.855, P=0.005); LDL-C levels were (2.95±0.71) mmol/L and (2.60±0.63) mmol/L respectively, and the difference was statistically significant ( t=2.705, P=0.008). The level of CA153 in triple-negative breast cancer patients [(14.94±7.45) U/ml] was significantly higher than that in non-triple-negative breast cancer patients [(11.96±5.96) U/ml], and the difference was statistically significant ( t=2.359, P=0.020). The level of CA153 was positively correlated with the level of TG ( r=0.167, P=0.032). Conclusion:Dyslipidemia is associated with an increased risk of breast cancer. The levels of serum lipids vary among patients with different lymph node status and tumor stages. CA153 level is positively correlated with TG level to some extent.

Objective:To explore the expression of programmed cell death-ligand 1 (PD-L1) in invasive breast cancer and its relationship with clinicopathological characteristics.Methods:A total of 651 paraffin-embedded specimens of newly diagnosed invasive breast cancer patients including 98 cases of triple-negative breast cancer (TNBC) in the Affiliated Nanjing Drum Tower Hospital of Medical School of Nanjing University from January 2018 to August 2019 were collected. The immunohistochemical EnVision method was used to detect the expression of PD-L1 protein in tumor cells of breast invasive cancer and infiltrating lymphocytes. The expression rate of PD-L1 in tumor cells of cancer section tissues and tumor interstitial lymphocytes ≥1% was positive and < 1% was negative.Results:The positive expression rate of PD-L1 expression in breast invasive carcinoma was 47.0% (306/651), among which the positive expression rate of TNBC was 69.3% (68/98). PD-L1 had a high positive expression rate in patients with high World Health Organization (WHO) grade, large tumor size, vascular invasion, advanced pathological stage, negative estrogen receptor (ER) expression, negative progesterone receptor (PR) expression, positive p53, positive CK5/6, positive epidermal growth factor receptor (EGFR), and high Ki-67 value (all P < 0.05). In TNBC, PD-L1 had a high positive expression rate in patients with high WHO grade, invaded nerves, high Ki-67 value, positive CK5/6, and positive EGFR (all P < 0.05). Multivariate analysis showed that WHO grade ( HR = 1.511, 95% CI 1.139-2.003, P = 0.004), Ki-67 value ( HR = 1.847, 95% CI 1.259-2.709, P = 0.002), p53 expression ( HR = 2.083, 95% CI 1.487-2.916, P < 0.01), and EGFR expression ( HR = 3.490, 95% CI 2.002-6.086, P < 0.01) were independent influencing factors of PD-L1 expression. Conclusions:PD-L1 is highly expressed in invasive breast cancer, especially in TNBC. It could be used as a potential treatment target for patients with invasive breast cancer.

Objective To analyze the clinical characteristics and survival prognosis of patients with AIDS-related malignant tumor. Methods We retrospectively analyzed the data of 354 patients with AIDS-related malignant tumor. Univariate analysis was conducted by Log rank test and multivariate analysis was conducted by Cox proportional risk regression model. Results The average age of the patients was 54.10±12.96 years old. The ratio of male to female patients was 2.1:1. The number of patients with AIDS complicated with lymphoma was the most, accounting for 28.25%. The 1-, 3- and 5-year survival rates were 78.48%, 62.13% and 55.31%, respectively. Univariate analysis showed that there were statistical differences in prognosis of patients with different types of malignant tumor, age, gender, medical insurance type, number of admissions after diagnosis of AIDS, average length of stay, radiotherapy or not, leaving hospital according to medical advice. Multivariate analysis showed that gender, number of admissions after diagnosis of AIDS, average length of stay, proportion of out-of-pocket and leaving hospital according to medical advice were independent risk factors affecting the survival and prognosis of patients. Conclusion AIDS is easily complicated with lymphoma, lung cancer and cervical cancer. The patients received insufficient anti-tumor courses in hospital.