Objective To study prevalence and risk factors of anemia in adult patients with antineutrophil cytoplasmic antibody (ANCA) associated vasculitis.Methods The clinical data of 72 adult patients with ANCA associated vasculitis were studied retrospectively.According the age,the patients were divided into youth group (age ＜ 65 years,43 cases) and old group (age ≥ 65 years,29 cases).Baseline characteristics and lab measurements were recorded and analyzed.Risk factors of anemia were evaluated using Logistic analysis.Results In 72 adult patients with ANCA associated vasculitis,47 cases (65.3％)developed anemia.The prevalence of anemia in the youth group was 55.8％ (24/43),and that in the old group was 79.3％ (23/29).The prevalence of anemia in the old group was significantly higher than that in the youth group (P ＜ 0.01).When adjusted for confounders,age (increased 10 age,OR =1.23,95％ CI 1.12-1.95,P=0.001),diabetes (OR =1.34,95％ CI 1.14-1.89,P=0.013) and massive proteinuria (OR =1.11,95％ CI 1.05-1.76,P =0.011) were independently associated with increased risk of anemia in all patients.Conclusions The prevalence of anemia in the older patients is higher than that in the younger patients with ANCA associated vasculitis.Age(increased 10 age),diabetes and massive proteinuria are independently risk factor of anemia in adult patients with ANCA associated vasculitis.

Hepatitis B virus ( HBV) is an important pathogen threatening to human health. Up to date, various of cell infection models and animal models for HBV and the host are widely used in the exploring research of infection mechanism, new drug development and effective therapeutic method for HBV. However, these models have some defects, such as low infection rate, rather short infective stage, and comparatively large species differences with human, and so on. Among them, the biggest problem is that these models cannot completely simulate HBV infection process and pathological changes naturally occurred in human. Herein, the major HBV infection models developed in the past fifteen years, as well as the latest research progress, are presented as a brief review, to provide a reference for constructing novel HBV infection models in the future.

Objective To analyze the correlation between serum antinucleosome antibody (AnuA) and renal pathological characteristic,disease activity as well as some laboratory tests in patients with lupus nephritis (LN).Methods Serum AnuA levels were detected by enzyme-linked immunosorbant assay in 40 patients with LN (observation group) and 40 healthy people (control group).Renal biopsy was examined in all LN patients.The relationships between serum AnuA level and systemic lupus erythematosus disease activity index (SLEDAI),renal pathohistology,laboratory parameters were analyzed.Results The serum AnuA level in observation group before treatment was significantly higher than that in control group [ ( 110.23 ± 80.48) kU/L vs. ( 10.45 ± 8.20) kU/L,P ＜ 0.05 ].Four cases of renal biopsies were class Ⅱ,8 cases were class m,23 cases were class Ⅳ,and 5 cases were class V.Serum AnuA level had significant difference between each class by Kruskal-Wallis rank sum test (P ＜ 0.05),and serum AnuA level of class Ⅳ was the highest (P ＜ 0.05).Serum AnuA level had positive correlation with SLEDAI,urine protein quantitation and anti-double strands DNA antibody (r =0.462,0.521,0.394,P ＜0.05),negative correlation with complement C3 and C4 levels (r =-0.403,-0.489,P ＜ 0.05 ).Serum AnuA level after treatment [ (32.45 ± 18.31) kU/L] was significantly decreased than that before treatment [(110.23 ± 80.48) kU/L](P＜0.05).Conclusions Serum AnuA level is not only a good index of LN activity,but also reflect renal involvement.That serial measurement of serum AnuA level may provide better clinical strategies for the therapy.

Objective To evaluate the surgical technique,urinary continence and clinical efficacy of extraperitoneal laparoscopic radical prostatectomy for prostate cancer. Methods This series included 28 cases of prostate cancer aged 60 -75 years (mean,68 years). The PSA level ranged from 0. 7 ng/ml to 23. 6 ng/ml. TNM classification showed T1N0M0 tumor in 11 cases, T2N0M0 tumor in 15 and T3aN0M0 tumor in 2. All cases underwent extraperitoneal laparoscopic radical prostatectomy. The functional reconstructive technique consisted of preservation of the urethral and bladder outlet sphincter muscles, and reconstruction of the bladder neck. Results All the operations were successful. The operative time was 180 - 380 min( mean, 240 min) ,and the blood loss was 400 - 1200 ml( mean,800 ml) . All the catheter were removed 2 weeks after surgery. Mild urinary incontinence occurred in 3 cases, and it improved after supportive treatment. The PSA level was 0. 02 -0. 10 ng/ml 3 months after operation. No recurrence of prostate cancer was found during the follow-up of 1 month-2 years. Conclusions Extraperitoneal laparoscopic radical prostatectomy is safe and effiective for the treatment of prostate cancer. It can be widely applied in clinical practice.

Background and purpose:Carcinoma of the kidney is the most common malignant renal parenchymal carcinoma;its biological behavior is extremely complicated and is not sensitive to radiotherapy and chemotherapy.Studies have shown that the hypoxia-inducible factor HIF1-? and HIF2-? are related to the occurrence and development process of the clear-cell carcinoma of kidney.So,we intend to construct psilencer3.0-HIF-? siRNA recombinant plasmid in this study through RNA interference method,thereby providing an effective tool for further exploration of the role of HIF in the occurrence and development of clear-cell carcinoma of kidney.Methods:Design and chemically synthesize the DNA fragments of coding HIF-1? and HIF-2? siRNA and make them up into siRNA expression vector through gene recombination.Adopting the real-time quantitative PCR and Western blot tested the inhibitive effect of the constructed siRNA expression vector on mRNA and protein levels on the target gene expression.Results:After 786-0 cells transfecting with psilencer3.0-HIF-1?siRNA and psilencer3.0-HIF-2?,the inhibitory rate of mRNA expression of HIF-1? and HIF-2? reached 82.1% and 87.4% respectively,and OS-RC-2 cells transfecting psilencer3.0-HIF-1? siRNA and psilencer3.0-HIF-2?,the inhibition rate reached 91.2% and 81.2% respectively.The protein expression of the experimental group with 786-0 cells and OS-RC-2 cells transfecting HIF-1? interference plasmid and HIF-2? interference plasmid were lower at different levels than that from the blank control group.Conclusions:The constructed siRNA expression vector can effectively inhibit the expression of target gene HIF-1 and HIF-2 at mRNA and protein levels.

According to the amino acids sequence of OC-IdeltaD86 gene and Escherichia coli codon usage, we synthesized this gene by overlap extension PCR method with 7 oligonucleotides DNA fragments. The PCR fragment was inserted into pGEM-T-easy vector and the recombined plasmid was named pGEM-T-OC-IdeltaD86. Two oligonucleotides into which the BamH I and Xho I sites were introduced were designed and synthesized based on pGEM-T-OC-IdeltaD86 and pet21b, and the PCR fragment into which the BamH I and Xho I sites were introduced was obtained. After digesting it with BamH I and Xho I, OC-IdeltaD86 gene was cloned into the corresponding sites of pet21b and obtained prokaryotic expression vector pet21b-OC-IdeltaD86. OC-IdeltaD86 gene was expressed in E. coli (BL21(DE3)plysS) after IPTG(Isopropyl beta-D-1-thiogalactopyranoside) inducement for 5 hours. The fusion protein of OC-IdeltaD86:6His gene accounted for 11.4% of total protein and 16.4% of soluble protein, which had been successfully purified by Ni-NTA and concentrated by PEG20000. This protein can effectively inhibit papain activity in vitro and may be used in anti-nematode research in vivo.
Cloning, Molecular ; Cystatins ; biosynthesis ; genetics ; Cysteine Endopeptidases ; metabolism ; Cysteine Proteinase Inhibitors ; genetics ; Escherichia coli ; genetics ; metabolism ; Genes, Plant ; genetics ; Mutation ; Oligonucleotides ; chemical synthesis ; genetics ; Oryza ; genetics ; Papain ; antagonists & inhibitors ; Prokaryotic Cells ; metabolism ; Recombinant Fusion Proteins ; biosynthesis ; genetics ; metabolism

Objective To investigate whether the percutaneous ethanol injection (PEI)under sedation and analgesia can in-crease the energy deposition and curative efficiency of the high intensity focused ultrsound(HIFU)in treating unresectable middle and advanced stages of primary liver cancer.Methods Thirty-six cases of clinically diagnosed unresectable middle and advanced sta-ges of primary liver cancer were randomly divided into the PEI+ HIFU group(combination group,n = 23)and the simple HIFU group (HIFU group,n=13);10mL of the mixture of 99.7% ethanol and iodized oil (9:1)was given by intratumoral injection at 30 min before ablation in the PEI+HIFU group,while 0.9% physiological saline 10mL was replaced in the simple HIFU group.The ablation energy efficiency factor(EEF)and irradiation time were compared between the two groups.Results The ablation EEF in the PEI+HIFU group and the simple HIFU group were (13.82+4.26)J/mm3 and (25.63+6.31)J/mm3 respectively,the PEI+HIFU group was significantly lower than the simple HIFU group (P <0.05);the irradiation time were (1 468.28+253.21)s and (2 352.56+463.34)s respectively;which in the PEI+ HIFU group was significantly shortened (P <0.05).Conclusion PEI can enhance the HIFU ablation energy deposition and improve the efficiency of HIFU for treating unresectable primary liver cancer.

Objective To explore methods for performance appraisal of directors of municipal hospitals in Shanghai.Methods To assess the management performance of directors of 24 tertiary hospitals each year,measured by five dimensions of social satisfaction,management efficiency,capital operation,development sustainability and staff satisfaction,and 23 indexes.Results Implementation of the performance appraisal has witnessed constant improvement of patient satisfaction and quality of medical care,as well as rational control of medical expenses and cost.In 2014 for example,the cost of emergency/outpatients per visit at such hospitals were 312 yuan and 1 5 600 yuan per hospitalization respectively,with 7.6 days of stay in average.Also improved were service efficiency,clinical research output and hospital business performance in general.Conclusion Performance appraisal of directors of public hospitals proves an important means for guiding the hospitals to adhere to public welfare, consistent with the government medical institution operation target, and to strengthen internal management of such hospitals.

OBJECTIVETo explore the efficacy of unrelated umbilical cord blood transplantation (UCBT) in the treatment of Gaucher disease.

METHODThe clinical characteristics of three children with Gaucher disease underwent UCBT in our hospital between April 2013 and September 2014 were retrospectively analyzed. Literature on allogeneic hematopoietic stem cell transplantation (allo-HSCT) in the treatment of Gaucher disease was searched at Wanfang and Pubmed databases between 1983 and 2015 and was reviewed and summaried.

RESULTThree children with Gaucher disease, all were female, received UCBT. These patients' age at receiving transplantation was 3.8 years, 7.1 years and 2.6 years, respectively. The second case received the second transplantation. The first and third case received splenectomy before UCBT. The pretreatment regimen was busulfan (Bu)/fludarabine (Flu)/cyclophosphamide (CTX)/antithymocyte globulin (ATG), and for the patient received the second transplantation melphalan was added to the myeloablative conditioning regimen of Bu/Flu/CTX/ATG. Cyclosporine and mycophenolate mofetil (MMF) wee used for prophylaxis of acute graft versus host disease (aGVHD). The dose of cord blood stem cell nucleated cell counts was 9.7 × 10⁷ /kg,11.9 × 10⁷ /kg and 7.6 × 10⁷/kg respectively. The dose of cord blood stem cell CD34⁺ cell counts was 5.4 × 10⁵/kg , 3.5 × 10⁵/kg and 3.2 × 10⁵/kg respectively. The day of granulocytes exceeding 0.5 × 10⁹/L was day 11, 12 and 19 after transplantation, respectively. The day of platelets exceeding 20 × 10⁹/L was day 14, 33 and 74 after transplantation, respectively. At one month after transplantation the rate of chimerism was over 95% and all patients got donor complete chimerism. The level of β-glucocerebrosidase recovered to normal at one month after transplantation. During transplantation, all patients developed cytomegalovirus (CMV) and Epstein-Barr virus (EBV) viremia. In case 1 immune thrombocytopenia occurred at five month after transplantation unresponding to steroids and mesenchymal stem cells infusion was administered and his platelet in routine blood test recovered to normal. But the patient died because she was infected with varicella-zoster virus out of hospital at nine month after transplantation and the level of β-glucocerebrosidase was normal before death and chronic GVHD (cGVHD) was not found. The case 2 is now in 19th month after transplantation and his level of β-glucocerebrosidase was normal. cGVHD was not found. The patient is currently free of disease. The case 3 was in 9th month after transplantation and his level of β-glucocerebrosidase was normal. cGVHD was found at 112 day after transplantation and was localized and could be controlled by hormonal therapy. The patient is currently free of disease. Three patients' size of liver was significantly reduced after their level of β-glucocerebrosidase ecovered. There were 50 cases with Gaucher disease who were treated with allo-HSCT in the literature and none of them were reported from China. Disease-free survival rate of patients treated with allo-HSCT for Gaucher disease was 85%. In all reports, there were 31 cases who had information of typing of Gaucher disease, of whom 22 cases had type 1 and 9 cases had type 3. Twenty-nine cases had information of survival, of whom 24 cases survived and 5 cases died of infection. Fifteen cases had data of engraftment, 2 of whom had graft failure and one had late graft failure.Glucocerebrosidase recovered to normal in 25 of 31 cases who had relevant data, in one of whom with late graft failure the enzyme recovered to normal 3 month after transplantation, but his enzyme decreased to the initial level 9 month after transplantation. Along with enzyme level's recovery to normal, in a part of cases bone pain and hepatomegaly were relieved and growth delay was improved.

CONCLUSIONThe unrelated UCBT may be a form of treatment that offers the potential of permanent cure and a procedure with possible long-term benefits in patients with Gaucher disease.

Antilymphocyte Serum ; therapeutic use ; Busulfan ; therapeutic use ; Child ; Child, Preschool ; China ; Cyclophosphamide ; therapeutic use ; Cyclosporine ; therapeutic use ; Disease-Free Survival ; Female ; Gaucher Disease ; therapy ; Graft vs Host Disease ; Hematopoietic Stem Cell Transplantation ; Humans ; Mycophenolic Acid ; analogs & derivatives ; therapeutic use ; Retrospective Studies ; Transplantation Conditioning ; Vidarabine ; analogs & derivatives ; therapeutic use

Nowadays, more attentions have been paid on brown adipose tissue (BAT) because BAT plays a great role in individuals with obesity and metabolic diseases. 18F-fluorodeoxyglucose (FDG) PET/CT is noninvasive and sensitive to detect the location, volume, and metabolic activity of BAT. 18F-FDG PET/CT for BAT provides new insight for the prevention and clinical management of obesity and diabetes. The review summarizes the methods to activate BAT, the preparation of patients, 18F-FDG PET/CT imaging techniques and clinical application.