Background and purpose:Venous thromboembolism (VTE) is the second common cause of death in cancer patients. The clinical data from VTE patients in Fudan University Shanghai Cancer Center were collected and analyzed during the last 5 years in this study to increase awareness for diagnosis and prevention of VTE in cancer patients and to improve their prognosis.Methods:The clinical data from 196 VTE patients among the 207 514 cancer patients were analyzed during the period from Jul. 2009 to Jun. 2014, and the clinical characteristics of cancer patients with VTE were investigated to understand the inlfuence of risk factors and symptoms in VTE patients.Results:The incidence of VTE in cancer patients was 0.94‰. Adenocarcinoma was the most common type of gynecological cancer (56.5%), gastrointestinal tract cancer (91.7%), lung cancer (71.4) and pancreatic cancer (80%). Logistic regression analysis showed adenocarcinoma was the high risk factor in cancer patients with pulmonary embolism (PE, OR=0.36, 95%CI: 0.146-0.885,P=0.026). Compared with patients who received 2 cycles of chemotherapy, patients who received 3 cycles of chemotherapy had higher incidence of VTE (χ2=10.976,P=0.001). The incidence of VTE in operative group was higher than that in non-operative group. The patients bearing gynecological cancer with ascites (>2 000 mL) had higher VTE incidence compared with the patients with less ascites. Besides, 78%-88% of the VTE patients were diagnosed because of the deep vein thrombosis (DVT) symptom during postoperative recovery and chemoradiotherapy.However, 59.1% of the preoperative VTE patients were diagnosed by the compression venous ultrasonography (CUS) in lower extremity. Physical therapy was adopted to prevent thrombus in 15 postoperative patients.Conclusion:The incidence of cancer-associated VTE in Fudan University Shanghai Cancer Center is lower compared with those reported in other epidemiologic investigations. The VTE incidence in postoperative patients is higher than that in preoperative patients. The patients with adenocarcinoma were inclined to be accompanied by PE. The examination should be taken in asymptomatic cancer patients and gynecological cancer patients with massive ascites. The physical measurement should be adopted actively to prevent thrombus in our hospital.

Background and purpose:Previous researches have shown that procalcitonin differentiates infec-tious from non-infectious fever and assesses the severity of infectious diseases. This study aimed to investigate the clin-ical value of procalcitonin in patients with chemotherapy-induced febrile neutropenia.Methods:A total of 147 patients with chemotherapy-induced febrile neutropenia admitted to intensive care unit from Jan. 2012 to Dec. 2014 were di-vided into infectious group and fever of unknown origin group according to clinical symptoms, signs and etiology. The infectious group was divided into sepsis, severe sepsis, and septic shock groups according to the severity of infection. The procalcitonin levels were compared between different groups.Results:A procalcitonin cut-off value>0.935 ng/mL provided a sensitivity of 90.0%, speciifcity of 90.0% and AUC=0.905. The procalcitonin level of the infectious group was signiifcantly higher than that of the fever of unknown origin group [1.805 (1.268-2.523) ng/mLvs 0.555 (0.398-0.818) ng/mL,P<0.001]. There is a signiifcant difference between the severe sepsis group and the sepsis group [13.885 (7.600-17.961) ng/mLvs 1.805 (1.268-2.563) ng/mL,P<0.001]. Compared with the severe sepsis group, the value of procalcitonin in the septic shock group was signiifcantly higher [23.800 (20.050-30.478) ng/mLvs 13.885 (4.955-19.133) ng/mL,P<0.001].Conclusion:Plasma procalcitonin is a useful marker for diagnosing neutropenia in patients with infection. Meanwhile, procalcitonin can be used to assess the severity of infection in patients with neutropenia.

Objective To investigate the anti- inflammatory and analgesic a ctions of Huangqi Guizhi Wuwu Decoction (HGWD) and its compositions and to study its rule of compatibility.Methods Analgesic action of HGWD and its compositio ns were observed by hot- plate method and acetic- acid- induced body twist me thod. Anti- inflammatory action of HGWD and its compositions were observed on t he models of xylene- induced auricular swelling in mice, celiac capillary perme ability in mice, cotton- induced granuloma in rats, albumem- induced arthritis and adjuvant arthritis in rats.Results HGWD and its drug pairs could inhibit the acute inflammation induced by albumen and xylene and rat adjuvant arthriti, decrease the celiac capillary permeability, inhibit the proliferation of granu loma, increase the pain threshold in mice and reduce the frequencies of body tw ist induced by acetic acid.Conclusion HGWD has significant anti- inflammatory and analgesic actions, so does single drug; Radix Astragali alone, but when Ra dix Astragali is used with the other drugs in HGWD, its effect can be enhanced.

AIM: To investigate the inhibitory effect of L-carnitine on high glucose-induced apoptosis of human aortic endothelial cells (HAECs) and the molecular mechanisms.METHODS: The apoptosis of HAECs was induced by high-glucose incubation.HAECs were treated with L-carnitine at different concentrations (50, 100 and 200 μmol/L).The cell viability was measured by MTT assay.The cell apoptosis was assessed by Hoechst 33258 staining and flow cytometry.Colorimetric method was employed to detect the caspase-3 activity in the HAECs.The protein expression and phosphorylation levels were determined by Western blot.RESULTS: High-glucose incubation dramatically decreased the cell viability and induced apoptosis.The protein kinase R-like endoplasmic reticulum kinase (PERK), inositol-requiring enzyme-1 (IRE1) and activating transcription factor 6 (ATF6) signaling pathways of endoplasmic reticulum stress were activated to induce cell apoptosis via down-stream caspase-4/3 cascade.However, L-carnitine treatment significantly attenuated the cell apoptosis and increased the cell viability in a concentration-dependent manner.L-carnitine also significantly suppressed endoplasmic reticulum stress and ATF6 signaling in high glucose-incubated HAECs without attenuating PERK and IRE1 signaling.The expression of site-1 protease (S1P) and site-2 protease (S2P) was inhibited by L-carnitine treatment, thus decreasing pro-apoptotic factor ATF6 p50 produced by ATF6 cleavage.CONCLUSION: L-carnitine inhibits high glucose-induced apoptosis of HAECs by inhibiting ATF6 signaling.

Objective To study the relationship between the prevalence of thyroid dysfunction and components of metabolic syndrome.Methods A total of 10 461 working and retired employees aged 20 to 90 years in a Petrochemical Corporation in Ningbo were included.Body mass index ( BMI),waist circumference,blood pressure,fasting blood glucose,blood lipid profile,serum thyroid-stimulating hormone (TSH),free thyroxine ( FT4 ),and free triiodothyronine (FT3 ) were measured in all subjects. Metabolic syndrome was diagnosed according to the International Diabetes Federation(IDF) criteria.Results ( 1 ) The prevalences of metabolic syndrome and overall thyroid dysfunction were 10.2％ and 4.6％,respectively. ( 2 ) 18.1％ petrochemical employees had abdominal obesity with at least one component of metabolic syndrome.( 3 ) There was no significant difference in the prevalence of metabolic syndrome among the groups with lowered,normal,and elevated TSH. (4) Logistic regression analysis revealed that lowered high density lipoprotein cholesterol ( HDL-C ) was associated with lowered TSH ( OR =0.313,95％ CI 0.184-0.530 ),and raised triglyceride was associated with elevated TSH ( OR =0.767,95％ CI 0.595-0.991 ). ( 5 ) There were significant associations between serum TSH levels and lipid parameters such as total cholesterol in males,triglyceride and low density lipoprotein cholesterol in females,and HDL-C in both genders.Conclusion The prevalence of thyroid dysfunction was not associated with central obesity,hypertension,and hyperglycemia.Lipid disorder was correlated with serum TSH levels.

Objective To investigate the metabolism characteristics and the potetial biomarker candidates of osteonecro?sis of the femoral head (ONFH) using metabolomic technology. Methods The femoral head specimens from 23 ONFH patients (25 necrotic femoral heads) and 18 normal femoral heads from femoral neck fracture patients were collected for histopathological examination to confirm the diagnosis of all samples. All the metabolites of bone trabecula were extracted for ultra-high perfor?mance liquid chromatography-MS/MS analyzed. The measured variables was pretreat, and PCA (principal component analysis), PLS?DA (partial least squares?discriminant analysis) and OPLS?DA (orthogonal?partial least squares?discriminant analysis) models were employed to confirm the difference between these two groups after UPLC?MS/MS (ultra?high performance liquid chromatogra?phy?mass spectrometry/mass spectrometry) analysis. At last, the differential variables were screened out by PLS?DA and variate analysis (Kruskal?Wallis H test). The changed metabolites were confirmed by MS and MS/MS aligned in HMDB (human metabolo?mic database) and Massbank. The changed metabolites with the most obviously changed peak abundance, D?arginine, L?proline and L?glutamine, were picked out as the potential diagnostic biomarkers. After binary logistic regression analysis, the combined biomarkers candidates were further analyzed by receiver operating characteristic (ROC) curve to evaluate the significance of the combined biomarkers. Results Significant distinction of metabolites expression mode can be seen in PCA, PLS?DA and OPLS?DA models scoring plots between ONFH and control groups. Twelve changed metabolites in ONFH bone trabeculas were con?firmed by multi?variate statistical analysis and variate statistical analysis. Compared with the femoral neck fracture patients, the in?creased metabolites included D?arginine, L?proline, L?glutamine, creatine, uracil, uridine, LysoPC(20∶4(5Z, 8Z, 11Z, 14Z)), Ly?soPC(16∶0), PC(20∶1(11Z)/18∶3(6Z, 9Z, 12Z)) and PE(P?16∶0e/0∶0). The decreased metabolites were reticulataxanthin and β?cryptoxanthin. According to the change fold of peak abundance and variable weight projection in PLS?DA, the most obviously dif? ferential metabolites were picked out as the biomarker candidates of ONFH. The potential biomarkers candidates were identified as D?arginine, L?proline and L?glutamine. The area under the curve of D?arginine, L?proline and L?glutamine ROC were 0.873, 0.712 and 0.862. The area under the curve of ROC was 0.946 after combining D?arginine, L?proline, L?glutamine using binary lo?gistic regression analysis. Conclusion PCA, PLS?DA and OPLS?DA models were used to find out the differential variables in the metabolites of bone trabeculas in ONFH and femoral neck fracture patients. Twelve metabolites were identified by MS/MS, and 3 obviously changed metabolites, D?arginine, L?proline, L?glutamine, were indicated as biomarker candidates. These 3 obviously changed metabolites showed a good diagnostic significance.

Objective To explore the efficacy and safety of glucocorticoids+cyclophosphamide+tacrolimus capsules (GC+CTX+FK506) in the treatment of patients with type Ⅲ+V and Ⅳ+Vlupus nephritis. Methods The 31 cases with first diagnosis as systemic lupus erythematosus (SLE) with type Ⅲ+V and Ⅳ+Vlupus nephritis (LN) were selected, then divided into group A (CTX+GC) with 16 cases and group B (FK506+CTX+GC) with 15 cases. The group A received CTX+GC during treatment, group B received GC+CTX+FK506 for the first three months, and received FK506+GC for the last three months. The patients were followed up once monthly to observe the efficacy and safety,the efficacy was analysed after 6 months. Results After treatment, the total efficacy in group B was significantly higher than group A (86.7%vs.50.0%, P<0.05). The 24 h urine protein of group B was lower than group A(P<0.05). The plasma albumin of group B was higher than group A (P<0.05). After treatment, the systemic lupus erythematosus disease activity index (SLEDAI) in two groups were lower and C3 level was higher than those pre-treatment(P<0.05), but there was no significant difference in above indicators between two groups. There was one case menelipsis in group A, and one case with transient increasing of creatinine. Conclusion The FK506+CTX+GC could reduce urine protein sifnificantly compared with CTX+GC without serious adverse reaction.

Objective To compare three dimensional arterial spin labeling(3D-ASL) and dynamic susceptibility contrast-perfusion weighted imaging(DSC-PWI) in evaluating the cerebral hemodynamic of Moyamoya disease. Methods Approved by the institutional review board, 26 cases of Moyamoya patients who were diagnosed by DSA were enrolled. Diffusion weighted image, 3D-TOF-MRA, 3D-ASL, DSC-WPI, and T1WI were performed in 3.0 T MR scanner. ROI were positioned in the abnormal perfusion areas and the control area according to the arterial dominant territory to obtain quantitative parameters of perfusion. Perfusion parameters including cerebral blood flow(CBF) of ASL, cerebral blood flow(CBF), cerebral blood volume(CBV), mean transit time(MTT), and time to peak(TTP)of DSC-PWI , and relative parameters (ASL-rCBF, DSC-rCBF, DSC-rCBV, DSC-rMTT, DSC-rTTP) that the ratio of abnormal perfusion area and the control area were calculated. Meanwhile, the areas of the lower perfusion region of ASL and TTP images in the same slice were measured. Difference of the above-mentioned parameters and areas was processed by paired Student′ t test. Furthermore, correlation of relative values of perfusion parameters(ASL-rCBF, DSC-rCBF, DSC-rCBV, DSC-rMTT, and DSC-rTTP) was processed by Pearson correlation test. Results There were significant statistics differences between values of ASL-CBF, DSC-MTT, and DSC-TTP in abnormal perfusion [(28.18 ± 10.19)ml · 100 g-1 · min-1,(7.98 ± 2.22)s,(29.93 ± 3.95)s] and the control areas [(49.50 ± 11.37)ml · 100 g-1 · min-1,(6.07 ± 1.11)s,(27.34 ± 2.58)s] (t=-12.818, 4.193, 6.163, all P<0.01). There was no significant statistics difference in the lower perfusion area between ASL-CBF [(5 729.63 ± 4 563.79) mm2]and DSC-TTP[(5 875.33 ± 4 723.08)mm2](t=-1.774,P>0.05). Furthermore, the Pearson correlation test showed significant linear dependence between ASL-rCBF(0.56±0.14)and DSC-rMTT(1.34± 0.42), and DSC-rTTP(1.09 ± 0.69)(r=-0.630,-0.748, P<0.01). Conclusions There is a correlation between 3D-ASL and DSC-PWI in assessing the magnitude and areas of the reduction of blood perfusion of Moyamoya patients. Moreover, the ASL technique possesses advantages of non-invasion use of the gadolinium contrast.

Objective To investigate the changes of estrogen receptor expression in mast cells of bronchial mucosa from female asthmatic patients.Methods 12 cases of female asthmatic patients and 9 cases of control female patients were enrolled in this study.The bronchial mucosa was obtained from the third grade bronchial by fiexible bronchofiberscope.Mast cells were marked by anti-mast cell tryptase monoclonal antibody,the expression of estrogen receptor(ER)were detected by anti-human estrogen receptor(ER)monoclonal antibodies.Results Mast cells and estrogen receptor positive cells of bronchial mucosa in female asthmatic patients were significantly higher than that in control group(P＜0.01).Coincident with the known features of bronchial asthma,the cells positive for estrogen receptor were morphologically similar to the mast cells.The cells stained for estrogen receptors by dual immunostaining coincided exactly with cells labeled as mast cells.Conclusion The result suggested the estrogen may be involved in the pathogenesis of female asthmatic patient through the changes of estrogen receptor expression in mast cells of bronchial mucosa.

Objective Kunming strain(KM) mice were used as animal models. Nontoxic dextran conjugated with tetramethylrhodamine(TMR)and fluorecein isothiocyante(FITC)was microinjected to two of the 2-cell blastomere as molecular probe to trace the development fate of the blastomere ,in order to figure out the mechanisms of the formation of Em-Ab axis. Methods FITC- dextran was injected to zygote in order to make sure if it is noxious. Two blastomeres of 2-cell embryo were injected FITC- dextran and TMR- dextran respectively. Results When labeled embryo develeped to blastocyst, distribution of progeny of 2-cell embryo blastomeres can be detected.Conclusion The cells of blastomere randomly distributed either embryonic parts or extraembryonic parts of blastocyst.