Objective To observe the effect of different calcium concentration peritoneal dialysate on calcium-phosphorus metabohsm in uremia patients under peritoneal dialysis. Methods Forty uremia patients who the first entered peritoneal dialysis were divided into two groups: standard calcium concentration group (20 cases), low calcium concentration group (20 cases). Treated with continuous ambulatory peritoneal dialysis (CAPD), combining with oral calcium carbonate, observing 12 months. Results When the first entering CAPD, serum calcium, phosphorus, calcium-phosphorus product, immunoreactive parathyroid hormone (iPTH) of the two groups had no differences. Hyperphosphatemia, lower iPTH were universal. After 6 months' treatment, hypercalcemia and hyperphosphatemia in standard calcium concentration group got increasingly serious.While in low calcium concentration group, serum calcium, phosphorus, calcium-phosphorus product all decreased significantly, moreover, they were also lower than post-treatment standard calcium concentration group(P<0.01). In the following 6 months, in low calcium concentration group,serum calcium, calcium-phosphorus product maintained at the normal level serum phosphorus also decreased to the normal level iPTH maintained about 150 ng/L. During the treatment, all patients had no hypotension and hyperspasmia. Conclusion Low calcium concentration peritoneal dialysate can ameliorate disorder of calcium-phosphorus metabohsm, delay the appearance of its comphcations.

Objective To explore effect of different postures for PICC intubation through basilic vein in very low birth weight infants. Methods Eighty infants from Oct. 2013 to Sep. 2014 with PICC via basilic vein were set as the control group in which traditional method of preventing catheter displacement was applied, another 80 cases from Oct. 2014 to Sep. 2015 were divided to the observation group. And improved method was applied in the experiment group besides the traditional method. The ectopic occurrence rates of the two groups were compared. Result The ectopic rate of PICC catheters in the observation group was significantly lower than that of the control group (P<0.05). Conclusion When the catheter tip reaches the shoulder of the very low birth weight infants, the method of raising their upper limbs slightly to the head can reduce the ectopic incidence of catheters and thereby improve the success rate of PICC intubation.

Objectives To investigate the characteristics of changes in serum metabolic profile before and after resection of carcinoma tissues to establish a disease distinguishing model,to analyze the changing trend of characteristic metabolites,and to determine the molecular mechanism and potential clinical value of characteristic metabolic markers for HBV-related liver cancer.Methods Ultraperformance liquid chromatography-mass spectrometry (UPLC-MS) was used to analyze the serum metabolites of 15 patients with hepatocellular carcinoma (HCC) before and after partial hepatectomy and on 25 healthy volunteers.The pattern recognition method and nonparametric test analyzes were used to analyze the data and to identify the specific metabolites and their changes after resection of carcinoma tissues.Results We established the principal component analysis (PCA) and orthogonal partial least squares-discriminant analysis (OPLS-DA) disease distinguishing model for HCC patients before and after operation as against the healthy volunteers.To distinguish between the liver cancer group and the normal control group,27 characteristic metabolites were selected from the patients before and after resection of carcinoma tissues.Eight moved towards the normal control after resection of carcinoma tissues.This indicated that liver carcinoma was an important impacting factor for these metabolites.Finally,7 metabolites were identified,and these metabolites had high diagnostic value as shown on ROC curves.Conclusions Through serum metabolic profiling of patients before and after resection of carcinoma tissues,a high correlation between metabolism and hepatocellular carcinoma was found.Researches on endogenous metabolites and pathways in liver diseases will provide a better understanding of the molecular mechanisms and provide further directions for clinical diagnosis and treatment.

[Objective] To investigate the variation of Q promoter (Qp) in nasopharyngeal carcinoma (NPC) cells, and to compare the existing two mutant sites [62 225 site(g→a)and 62 422 site (g→c) ] Qp in NPC cells with the Qp in B95.8 cell line in the functional and biological difference. [Methods] The Qp sequence was amplified in the samples from 29 cases of paraffin-embedded tissues of NPC suffers and 14 cases of peripheral blood of healthy adults by polymerase chain reaction (PCR) method (totally 43 cases). The point mutations on specified sites were analyzed and statistically compared from sequencing results. The sequences of variant and prototype Qp were amplified by PCR and cloned into luciferase reporter vector (pGL3-basic), then transfected into HaCat cells respectively. The transcriptional activity was compared between variant and prototype Qp using luciferase reporter system. The DNA binding affinity of mutant and prototype Qp to Sp1 was compared through chromatin immunoprecipitation (CHIP) method since mutation of nt 62 225 located in a Spl binding site. [Results] The mutation rate of Qp was significantly higher in NPC compared with healthy controls (P=0.039 5, <0.05), which suggested the variant Qp was closely associated with NPC. The transcription of the luciferase gene promoted by variant Qp was significant more than that of prototype Qp in transient transfection assay (2.5:1, P<0.05). The binding affinity of variant Qp to Sp1 was about 1.52 times higher than that of prototype Qp as determined by quantitative ChIP assay. [Conclusions] The transcriptional activity was enhanced in variant Qp in NPC cells compared with prototype, which possibly through the higher binding affinity to Sp1. We suggest that the mutated Qp may play an important role during the EBV infection and transformation of nasopharyngeal epithelium.

A high-altitude environment is characterized by low oxygen levels,low pressure,and low temperatures.Exposure to the plateau environment often causes damage to the body,leading to the occurrence of acute mountain sickness/chronic mountain sickness(AMS/CMS).Research indicates that acute or chronic exposure to the special environment can result in overall organ dysfunctions,such as those in the heart and gastrointestinal tract.The damage to the body caused by exposure to the plateau environment is closely related to acute and chronic hypoxia.Physiological maladjustment or disease is usually accompanied by changes in the structure of the gut microbiota.There have been reports on the correlations between the gut microbiota and bodily harm caused by high-altitude exposure.However,the specific types of bacteria involved and the mechanisms of action are still under investigation.This article reviews the intestinal tissue damage caused by low oxygen levels,immune activation,changes in microbial community structure,and differential metabolic products.The association and underlying mechanisms between bodily harm due to high-altitude exposure and the intestinal microbiota are also explored in hopes of stimulating new lines of thought related to the prevention and treatment of bodily harm caused by exposure to the plateau environment.

Objective To summarize our experience with tubular gastric elongation surgery for management of insufficient gastric length for high esophageal-gastric anastomosis following esophageal carcinoma resection. Methods From September, 2015 to October 2016, 5 patients with esophageal cancer were treated in our department, including two with cervical esophageal cancer and 3 with thoracic esophageal cancer. The patients with cervical esophageal cancer underwent pharyngeal resection, total laryngectomy, esophageal varus extubation and gastric oropharyngeal anastomosis, and the patients with thoracic esophageal cancer underwent esophageal cancer resection with incisions on the left neck, the right chest and the median abdomen. During the surgery, the length of the stomach was found insufficient to allow routine oropharyngeal anastomosis, and tubular gastric elongation was conducted to extend the tubular stomach to enable successful completion of the surgery. Results All the patients recovered smoothly after the surgery and were discharged after 2-3 weeks. Conclusion Tubular gastric elongation surgery can be a good choice for high esophageal-gastric anastomosis after resection of esophageal cancer in cases of insufficient tubular stomach length or high tension at the anastomosis.

Objective To summarize our experience with tubular gastric elongation surgery for management of insufficient gastric length for high esophageal-gastric anastomosis following esophageal carcinoma resection. Methods From September, 2015 to October 2016, 5 patients with esophageal cancer were treated in our department, including two with cervical esophageal cancer and 3 with thoracic esophageal cancer. The patients with cervical esophageal cancer underwent pharyngeal resection, total laryngectomy, esophageal varus extubation and gastric oropharyngeal anastomosis, and the patients with thoracic esophageal cancer underwent esophageal cancer resection with incisions on the left neck, the right chest and the median abdomen. During the surgery, the length of the stomach was found insufficient to allow routine oropharyngeal anastomosis, and tubular gastric elongation was conducted to extend the tubular stomach to enable successful completion of the surgery. Results All the patients recovered smoothly after the surgery and were discharged after 2-3 weeks. Conclusion Tubular gastric elongation surgery can be a good choice for high esophageal-gastric anastomosis after resection of esophageal cancer in cases of insufficient tubular stomach length or high tension at the anastomosis.

Objective: To explore the predictive value of ¹⁸F-fluorodeoxyglucose (FDG) PET conventional parameters and radiomics features for human epidermal growth factor receptor 2 (HER2) expression which was uncertain by immunohistochemistry (IHC) detection in invasive breast cancer. Methods: From April 2012 to December 2017, 76 patients (all were females, age: (50.8±10.9) years) with invasive breast cancer and with uncertain HER2 expression by IHC in Tianjin Medical University Cancer Institute and Hospital were enrolled retrospectively. The ¹⁸F-FDG PET/CT images before treatment were reviewed and the expression of HER2 were confirmed by fluorescence in situ hybridization (FISH). The tumor lesions were manually outlined, and the radiomics features from PET images were extracted. Wilcoxon test was used to determine whether there was difference in PET conventional metabolic parameters (maximum standardized uptake value (SUV_max), metabolic tumor volume (MTV) and total lesion glycolysis (TLG)) and radiomics features between HER2-negative and HER2-positive groups. The receiver operating characteristic (ROC) curve analysis was used to compare the predictive efficacy of PET radiomics features for HER2 expression. Results: There were 41 HER2-positive patients and 35 HER2-negative patients. No significant differences in PET conventional metabolic parameters between different HER2 expression groups were observed (U values: from -1.598 to 1.551, all P>0.05). A total of 38 PET radiomics features were extracted, and there were significant differences in gray mean, correlation, contrast, inertia, and inverse different moments between 2 groups(U values: from -2.413 to 2.527, all P<0.05). The area under the curve of the above 5 parameters for prediction of HER2 expression were 0.643, 0.638, 0.647, 0.644 and 0.643, respectively, and the contrast was the best parameter. Conclusions PET radiomics features can effectively identify HER2 expression in patients with invasive breast cancer to some extent, and the contrast may be the best. Conventional metabolic parameters have limited predictive value.

Clinical data from 11 previously diagnosed and treated patients with hyperthyroidism(Graves′ disease) complicated by liver failure were collected. Among them, 4 cases were drug-induced liver injury leading to liver failure, 1 case had a history of schistosomal liver cirrhosis combined with hyperthyroidism, and 6 cases had hyperthyroidism-induced liver injury(HILI) leading to liver failure. During hospitalization, all patients received supportive therapy and symptomatic treatment with β-blockers. Nine patients were treated with glucocorticoids and artificial liver support therapy. Among the 11 patients, 2 died, 8 patients achieved normal thyroid and liver function within 1-12 months after treatment, and 1 patient with liver cirrhosis had stable liver function in the later stage. After improvement in liver function, 7 patients received isotope therapy, 1 patient underwent total thyroidectomy, and 1 patient received medication. These results indicate that the clinical characteristics differ for drug-induced liver injury and HILI-related liver failure. Early initiation of artificial liver support therapy, in addition to β-blockers and glucocorticoids, is important in alleviating thyroid toxicity and liver damage, thus creating an opportunity for subsequent radioactive iodine or surgical treatment.