In more than ten years, hematopoietic factors have been approved to be effective in the treatment of radiation sickness. But there are still some problems in the clinical application, such as suitable cases, dosage, administrative timing, and drug combination. Due to those problems, the efficacy was undermined. Our experimental treatment study showed that hematopoietic factors should be administered early after the radiation exposure. The efficacy of early administration group is better than the one treated in acute phase of radiation sickness. There is also a limit of application duration but not the longer the better. RhTPO along can not induce the granulocytopoiesis and rhG-CSF can not improve the recovery of megakaryopoiesis. Hematopoietic factors do not increase the chromosome mutation rate of tumor cells. We did not observe bone marrow stem cell or progenitor cell exhaustion after we treated those animals for a second cycle of hematopoietic factors or exposed those treated animals to radiation again. RhG-CSF is more effective in the recovery of granulocytopoiesis than rhGM-CSF. RhIL-11 can increase the recovery of three cell lines of bone marrow, especially megakaryopoiesis. We recommended the combination of hematopoietic factors in the treatment of acute radiation sickness. RhG-CSF plus rhIL-11 is a preferred combination.

Objective To investigate the relationship between metabolic syndrome (MS) and education level in Su-Xi-Chang area to provide evidence for healthcare policy making. Methods A clustered sampling of 6798 subjects from Su-Xi-Chang areas of Jiangsu Province was included. Questionnaires and physical examinations were completed to collect clinical data. Logistic regression was used to analyze weather education level could be an independent risk factor of MS. Results Significant differences were found in waist circumstance (WC) ,systolic blood pressure (SBP) and fasting blood glucose (FBG) among participants with different education level. Significant differences were also existed in triglyceride and diastolic blood pressure (DBP) between subjects with higher and lower education level ( P＜0. 05 ). In single-factor or multivariate analysis, education level was negatively correlated with the prevalence of MS (P＜0. 05 ). Conclusions Education level may be an independent risk factor of MS. People with low and moderate education level have higher risk of MS. Therefore,it is recommended that health-related information should become an integral part of the compulsory education system.

Objective To understand the radiation protection effect of pre-irradiation administrations of nilestriol on the mice with bone marrow type of acute radiation syndrome after irradiation with 60Co γ-rays,along with its mechanisms for improvement of hematopoiesis.Methods The nilestriol administration protocols were prepared by analysis of peripheral blood cell counts and survival rate experiment on mice.The mechanisms by which the pre-irradiation twice administrations improved the post-irradiation recovery of bone marrow hematopoiesis were studied by the analysis of the surface marker of bone marrow hematopoietic stem/progenitor cells of mice and by the inspection of hematopoietic progenitor cell colony and by using histopathological assessment of bone marrow.Results Pre-irradiation administration of nilestriol at two-or three-day intervals had been shown to increase survival rates up to 100％ in mice exposed to 9.0 Gy γ-rays,which was superior to a single administration (20％,x2 =21.66,21.66,P ＜0.05).The pre-irradiation administration both at one-day or two-day intervals were capable of improving the recovery of peripheral blood counts,including white blood cell (WBC),red blood cell (RBC),and platelet in mice exposed to 6.5 Gy (F =21.33,100.9,49.34,19.19,P ＜ 0.05),showing the better effects than a single administration (F =17.11,63.38,21.89,14.37,P ＜ 0.05).The two-day-interval administration of nilestriol could significantly increase the numbers of bone marrow hematopoietic stem/progenitor cell counts (t =8.58,2.80,P ＜ 0.05) in mice on day 10 after 6.5 Gy irradiation.This also could be capable to significantly improve colony formation,with there being statistical difference compared with single administration(t =4.29,6.34,P ＜ 0.05).Also the administration at two-day-interval were also usefull in reconstruction of hematopoietic cell hyperplasia of bone marrow of irradiated mice.Conclusions As compared with conventional single admination,the pre-irradiation multiple administrations of nilestriol showed significantly improved radiation protection effects.Considering a nuclear medical emergency rescue,it is recommended to follow the pre-irradiation administration of nilestriol at two-day interval,which could obtain the best protection effects at minimum administration frequency.

Objective To investigate the effects of different chemoradiotherapy ( CRT) schemes on the prognosis of extensive?stage small?cell lung cancer ( SCLC ) . Methods A retrospective analysis was performed in 322 patients with extensive?stage SCLC who were admitted to our hospital from 2011 to 2015.All patients received standard EP/CE ( etoposide+cisplatin/carboplatin) chemotherapy. According to RECIST criteria, the efficacy of chemotherapy was divided into complete response, partial response, stable disease, and progressive disease ( PD). A total of 232 patients without PD after chemotherapy were enrolled as subjects and divided into radiotherapy group (n=187) and non?radiotherapy group (n=45).The patients undergoing radiotherapy were further divided into early radiotherapy group ( before 3 cycles of chemotherapy, n=65) and late radiotherapy group (after 3 cycles of chemotherapy, n=122),or concurrent CRT group ( n=45 ) and sequential CRT group ( n=142 ) . The survival rates were analyzed using the Kaplan?Meier method. Between?group comparison was made by log?rank test. The Cox regression model was used for multivariate prognostic analysis. Results In all the patients, the median overall survival ( OS ) , progression?free survival (PFS),and local recurrence?free survival (LRFS) time was 13?2,8?7,and 14?6 months, respectively. The non?radiotherapy group had significantly shorter median OS, PFS, and LRFS time than the radiotherapy group ( 8?7 vs. 15?0 months, P=0?00;5?6 vs. 9?8 months, P=0?00;5?9 vs. 19?2 months, P=0?00).There were no significant differences in median OS, PFS, or LRFS time between the early radiotherapy group and the late radiotherapy group ( 15?4 vs. 14?6 months, P=0?720;8?0 vs. 10?8 months, P=0?426;19?2 vs. 18?1 months, P=0?981) . The concurrent CRT group had significantly longer median OS time than the sequential CRT group (19?4 vs. 13?8 months, P=0?036),while there were no significant differences in median PFS or LRFS time between the two groups ( 10?8 vs. 9?8 months, P=0?656;19?8 vs. 17?8 months, P= 0?768 ) . Generally, patients undergoing radiotherapy had increased incidence rates of adverse reactions than those without radiotherapy (P=0?038).However, the incidence rates of grade ≥3 adverse reactions were similar between the two groups ( P=0?126) . Conclusions In the treatment of extensive?stage SCLC, thoracic radiotherapy improves the treatment outcomes without increasing the incidence rates of severe adverse reactions. When to receive radiotherapy has nothing to do with the prognosis. Concurrent CRT may further improve the treatment outcomes, which still needs further studies.

Objective To investigate the effects of different metastatic sites on the prognosis of extensive?stage small cell lung cancer ( SCLC ) . Methods A retrospective analysis was performed among 322 patients pathologically or cytologically diagnosed with extensive?stage SCLC ( stage ⅠV defined by the seventh edition of the American Joint Committee on Cancer) who were admitted to our hospital from 2011 to 2015. In those patients, 246 had primary lesions with distant metastasis and 76 primary lesions with non?regional lymph node metastasis;261 had single?organ metastasis and 61 multi?organ metastases. Survival rates were calculated using the Kaplan?Meier method. Between?group comparison of the survival was made by the log?rank test. A multivariate prognostic analysis was made by the Cox proportional hazard model. Results In all the patients, the median survival time ( MST) was 11. 7 months;1?and 2?year overall survival ( OS) rates were 47. 9% and 19. 5%, respectively. The patients with single?organ metastasis had significantly longer MST and significantly higher 1?and 2?year OS rates than the patients with multi?organ metastases ( 12. 4 vs. 8. 9 months;52. 5% vs. 30. 5%;21. 9% vs. 11. 2%;P=0. 014) . In the patients with single?organ metastasis, those with liver metastasis had the worst prognosis with a MST of 8. 5 months, while those with non?regional lymph node metastasis had the best prognosis with a MST of 14. 5 months ( P= 0. 001 );there was no significant difference in the prognosis between patients with metastasis to different organs other than the liver ( P=0. 139) . In the patients with multi?organ metastases, those with liver metastasis and bone metastasis had the worst prognosis ( P=0. 016,0. 006);there was no significant relationship between brain metastasis and the prognosis of extensive?stage SCLC with multi?organ metastases ( P=0. 995) . There was no significantdifference in the prognosis between those with liver metastasis only and multi?organ metastases ( P=0. 862) . Conclusions Liver metastasis predicts the worst prognosis in patients initially diagnosed with extensive?stage SCLC and single?organ metastasis. Liver metastasis and bone metastasis predict the worst prognosis in patients with multi?organ metastases. Brain metastasis has no significant effect on the prognosis. There is no significant difference in the prognosis of extensive?stage SCLC between patients with single?and multi?organ metastases once liver metastasis occurs.

Objective To investigate the mRNA expression and methylation status of IL-13 receptor(IL-13R)α1 gene in peripheral T lymphocytes of patients with systemic lupus erythematosus(SLE).Methods Venous blood samples were obtained from 10 SLE patients(5 in active phase,5 in inactive phase)and 6 normal human controls.CD4+ and CD8+ T cells were isolated from these samples via magnetic activated cell sorting(MACS).Real-time quantitative PCR was used to test the mRNA expression of IL-13Rα1 gene,and methylation specific PCR to detect the methylation status.Results The expression level of IL-13Rα1 mRNA was 2.224±0.251,1.712±0.132.and 1.104±0.044 in CD4+ T cells of active SLE patients,inactive SLE patients and controls,respectively;the difference between the three groups was statistically significant(all P＜0.05).The expression level of IL-13Rα1 mRNA in CD8+T cells was significantly higher in active SLE patients than that in the normal controls(1.672±0.142 vs 1.238±0.106,P＜0.05),while no difference was noted between inactive and active SLE patients or normal controls.The methylation index of IL-13Rα1 gene was 0.454±0.023.0.635±0.065.0.844±0.097 in CD4+T cells of active SLE patients,inactive SLE patients and normal controls,respectively,and the difference between the three groups was significant(all P＜0.05),while no significant difference was observed in the methylation index in CD8+T cells among these groups(P＞0.05).The IL-13Rα1 mRNA expression in CD4+T and CD8+T cells was positively correlated with SLE disease activity index(SLEDAI)score(r=0.79,0.76,P=0.007,0.02 respectively).A negative correlation was found between the methylation level Of IL-13Rα1 in CD4+T cells and SLEDAI score(r=-0.89.P＜0.0 1).as well as between the IL-13Rα1 mRNA expression and its methylation level(r=-0.84,P＜0.0 1).Conclusion The development of SLE may be related to the overexpression of IL-13Rα1 gene induced by DNA hypomethylation in T cells.

Objective To study the effect of RNA interference on the expression of CTGF in skin fibroblasts of systemic sclerosis(SS). Methods Four CTGF specific siRNAs and a negative control siRNA were designed and then synthesized by in vitro transcription. siRNAs labeled with carboxyfluorescein-6-succimidyl ester (FAM) were transiently transfected into SS skin fibroblasts. Forty-eight hours after the fibroblasts were treated with siRNAs, the mRNA and protein expression of CTGF was detected by semiquantitative RT-PCR and Western blot analysis, respectively. Results The mRNA and protein expression of CTGF in fibroblasts was significantly down-regulated by 4 and 3 CTGF specific siRNAs (both P

This study aims to develop a new method for the detection of KRAS mutations related to colorectal cancer in cfDNA, and to evaluate the sensitivity and accuracy of the detection. We designed a method of cfDNA based KRAS detection by droplets digital PCR (ddPCR). The theoretical performance of the method is evaluated by reference standard and compared to the ARMS PCR method. Two methods, ddPCR and qPCR, were successfully established to detect KRAS wild type and 7 mutants. Both methods were validated using plasmid standards and actual samples. The results were evaluated by false positive rate, linearity, and limit of detection. Finally, 52 plasma cfDNA samples from patients and 20 samples from healthy people were tested, the clinical sensitivity is 97.64%, clinical specificity is 81.43%. ddPCR method shows higher performance than qPCR. The LOD of ddPCR method reached single digits of cfDNA copies, it can detect as low as 0.01% to 0.04% mutation abundance.

PURPOSE: The efficacy of helmet continuous positive airway pressure (CPAP) in hypoxemic acute respiratory failure (hARF) remains unclear. The aim of this meta-analysis was to critically review studies that investigated the effect of helmet CPAP on gas exchange, mortality, and intubation rate in comparison with standard oxygen therapy. MATERIALS AND METHODS: We performed a meta-analysis of randomized controlled trials (RCTs) by searching the PubMed, Embase, Cochrane library, OVID, and CBM databases, and the bibliographies of the retrieved articles. Studies that enrolled adults with hARF who were treated with helmet CPAP and measured at least one of the following parameters were included: gas exchange, intubation rate, in-hospital mortality rate. RESULTS: Four studies with 377 subjects met the inclusion criteria and were analyzed. Compared to the standard oxygen therapy, helmet CPAP significantly increased the PaO2/FiO2 [weighted mean difference (WMD)=73.40, 95% confidence interval (95% CI): 43.92 to 102.87, p<0.00001], and decreased the arterial carbon dioxide levels (WMD=-1.92, 95% CI: -3.21 to -0.63, p=0.003), intubation rate [relative risk (RR)=0.21, 95% CI: 0.11 to 0.40, p<0.00001], and in-hospital mortality rate (RR=0.22, 95% CI: 0.09 to 0.50, p=0.0004). CONCLUSION: The results of this meta-analysis suggest that helmet CPAP improves oxygenation and reduces mortality and intubation rates in hARF. However, the significant clinical and statistical heterogeneity of the literature implies that large RCTs are needed to determine the role of helmet CPAP in different hypoxemic ARF populations.
Acute Disease ; Adult ; *Continuous Positive Airway Pressure ; Hospital Mortality ; Humans ; *Oxygen Inhalation Therapy ; Randomized Controlled Trials as Topic ; Respiratory Insufficiency/mortality/*therapy

Objective: To investigate the value and feasibility of C reactive protein (CRP) in predicting postoperative anastomotic leakage in rectal cancer patients with enhanced recovery after surgery (ERAS) for safer implementation of this ERAS. Methods: A cohort study on serum CRP of 455 rectal cancer patients undergoing laparoscopic radical resection according to the ERAS procedure at Gastrointestinal Unit of General Surgery Department, Guangdong General Hospital from August 2014 to June 2017 was retrospectively carried out. The serum CRP level was measured before operation and at postoperative days 1-7, and the serum CRP level of the groups with and without anastomotic leakage was compared to analyze its prediction for anastomotic leakage. Diagnostic standard of anastomotic leakage was based on the definition of postoperative anastomotic leakage in rectal cancer from International Study Group of Rectal Cancer (ISREC) : (1) Postoperative localized or diffuse peritonitis occurred, or fecal liquid was found from the abdominal drainage tube; (2) When anastomotic leakage was uncertain, peritoneal or pelvic computed tomography scan should be used to confirm. Results: All the 455 patients underwent surgery successfully, and 41 patients (9.0%) had anastomotic leakage postoperatively. Patients with anastomotic leakage were diagnosed (4.0 ± 2.0) days postoperatively, of whom 8 cases (19.5%) were diagnosed more than 5 days postoperatively. Serum CRP levels in patients with anastomotic leakage continued to increase within 1-4 days postoperatively[ (50.04 ± 27.98) mg/L to (122.75 ± 52.98) mg/L]and decreased 5 days postoperatively[ (92.02 ± 58.26) mg/L], both were higher than those of non-anastomotic leakage group, and the difference was statistically significant (all P < 0.05, except postoperative day 2) . The serum CRP level of non-anastomotic leakage group reached the peak on the second postoperative day[ (83.10 ± 37.45) mg/L] and decreased 3 days postoperatively[ (48.01 ± 27.59) mg/L]. The ROC curve was drawn with the anastomotic leakage as the state variable, and the CRP level as the detection variable. The area under the curve (AUC) at postoperative 1, 2, 4, 5, 6 and 7 days was 0.74, 0.58, 0.83, 0.82, 0.65, and 0.70, respectively. The maximum was at postoperative day 3[0.93 (95%CI: 0.86-0.99) ]. The Youden index was 0.72, and the threshold of CRP was 80.09 mg/L, as the cut-off point to predict anastomotic leakage, with sensitivity, specificity, and positive predictive value of 79.3%, 92.3%, and 74.2%, respectively. Conclusions Monitoring the postoperative serum CRP level can help predict the occurrence of anastomotic leakage after laparoscopic surgery for rectal cancer. When the serum CRP level is > 80.09 mg/L on the third postoperative day, the CRP level has the largest value in predicting postoperative anastomotic leakage, and the safety of ERAS has a certain clinical significance as well.