Objective:To investigate the alterations in brain functional activity before and after chemotherapy in breast cancer patients with chemotherapy-related cognitive impairment (CRCI) using resting-state functional magnetic resonance imaging (rs-fMRI) and their relations with cognitive impairment.Methods:A prospective observational study was performed; female breast cancer patients with CRCI admitted to Department of Oncology, Affiliated Hospital 6 of Nantong University were recruited, and age- and education level-matched female healthy controls were chosen. Before and one month after chemotherapy, statuses of cognitive function, depression and anxiety in breast cancer patients with CRCI were evaluated by Montreal cognitive assessment (MoCA), functional assessment of cancer therapy-cognitive function (FACT-cog), self-rating depression scale (SDS), and self-rating anxiety scale (SAS); subsequently, conventional MRI and resting-state functional magnetic resonance imaging (rs-fMRI) were conducted. The healthy controls accepted MoCA, SDS, and SAS, followed by conventional MRI and rs-fMRI. Differences in clinical data and amplitude of low-frequency fluctuation (ALFF, rs-fMRI brain spontaneous neural activity index) were compared between breast cancer patients with CRCI before chemotherapy and healthy controls, and in the breast cancer patients with CRCI between before and after chemotherapy. Taking the brain regions with significant differences in ALFF before and after chemotherapy in breast cancer patients with CRCI as seed points, the difference in whole-brain functional connectivity (FC) before and after chemotherapy was compared in breast cancer patients with CRCI. Pearson or Spearman correlation tests were used to analyze the correlations of ALFF and FC in brain regions with significant differences in ALFF with cognitive function scores in breast cancer patients with CRCI.Results:(1) A total of 22 breast cancer patients with CRCI and 22 healthy controls were enrolled. Compared with the healthy controls, the breast cancer patients with CRCI before chemotherapy had significantly higher SDS and SAS scores ( P<0.05). Compared with breast cancer patients with CRCI before chemotherapy, the breast cancer patients with CRCI after chemotherapy had significantly lower MoCA, FACT-cog-perceived cognitive impairment, FACT-cog-comment from others on cognitive function, and FACT-cog-perceived cognitive ability ( P<0.05). (2) Compared with those before chemotherapy, breast cancer patients with CRCI after chemotherapy exhibited significantly increased ALFF in the right precuneus, right middle occipital gyrus, and left superior frontal gyrus, while statistically decreased FC in the right middle occipital gyrus-left middle temporal gyrus, right precentral gyrus-right middle temporal gyrus, and left superior frontal gyrus-left fusiform gyrus ( P<0.05). (3) ALFF in the right precentral gyrus in breast cancer patients with CRCI after chemotherapy was negatively correlated with difference value of FACT-cog before and after chemotherapy ( r=-0.497, P=0.018) and difference value of PCA before and after chemotherapy ( r s=-0.436, P=0.042); FC in the left superior frontal gyrus-left fusiform gyrus was positively correlated with score of FACT-cog-perceived cognitive impairment ( r=0.621, P=0.002). Conclusion:Chemotherapy induces compensatory enhancement of spontaneous neural activity in multiple brain regions in breast cancer patients with CRCI, accompanied by FC disruption at specific brain areas, which are associated with cognitive impairment.

Objective:To investigate the relationship between CXCL6 expression and prostate cancer,as well as its effects on the malignant progression of PC-3 cells and the underlying mechanisms.Methods:Multiple databases were used to analyze CXCL6 expression in prostate cancer.And survival analysis,GO,and KEGG enrichment analysis were conducted.According to the concentration of CXCL6,PC-3 cells were divided into 0,100 and 200 ng/ml CXCL6 groups.The effects of up-regulated CXCL6 expression on PC-3 cell proliferation,migration,apoptosis,cycle,and related genes were investigated using CCK-8,EdU assay,scratch test,flow cytometry,and prostate cancer-targeted PCR array.Results:Database analysis revealed that CXCL6 was significantly down-regulated in prostate cancer(P＜0.05),and patients with low CXCL6 expression had a worse prognosis(P＜0.05).In prostate cancer,proteins associated with CXCL6 expression included CXCL1 and CXCL2,and related genes included MIR325 and RASSF6.GO analysis indicated that differentially expressed genes(DEGs)of CXCL6 were primarily enriched in processes such as response to chemokines and the tubular endoplasmic reticulum network(P＜0.05).KEGG analysis showed that DEGs were mainly enriched in signaling pathways such as the Hippo signaling pathway(P＜0.05).CCK-8,EdU assay,scratch test,and flow cytometry results demonstrated that compared with the 0 ng/ml CXCL6 group,the 100 and 200 ng/ml CXCL6 groups exhibited significantly reduced proliferation and migration rates(P＜0.05),significantly increased apoptosis rate(P＜0.05).And the proportion of S-phase cells in the 200 ng/ml CXCL6 group was lower compared to the 0 ng/ml CXCL6 group(P＜0.05).PCR array results showed that compared with the 0 ng/ml CXCL6 group,the expression of genes such as CDH1 and HAL was increased in the 200 ng/ml CXCL6 group,while the expression of genes such as CD5L and EDNRB was decreased.Conclusion:CXCL6 plays a significant role in the malignant progression of PC-3 cells,and its mechanism may be associated with the methylation of promoters of genes such as RASSF1,RARB,and CDH1.

Objective:To investigate the relationship between CXCL6 expression and prostate cancer,as well as its effects on the malignant progression of PC-3 cells and the underlying mechanisms.Methods:Multiple databases were used to analyze CXCL6 expression in prostate cancer.And survival analysis,GO,and KEGG enrichment analysis were conducted.According to the concentration of CXCL6,PC-3 cells were divided into 0,100 and 200 ng/ml CXCL6 groups.The effects of up-regulated CXCL6 expression on PC-3 cell proliferation,migration,apoptosis,cycle,and related genes were investigated using CCK-8,EdU assay,scratch test,flow cytometry,and prostate cancer-targeted PCR array.Results:Database analysis revealed that CXCL6 was significantly down-regulated in prostate cancer(P＜0.05),and patients with low CXCL6 expression had a worse prognosis(P＜0.05).In prostate cancer,proteins associated with CXCL6 expression included CXCL1 and CXCL2,and related genes included MIR325 and RASSF6.GO analysis indicated that differentially expressed genes(DEGs)of CXCL6 were primarily enriched in processes such as response to chemokines and the tubular endoplasmic reticulum network(P＜0.05).KEGG analysis showed that DEGs were mainly enriched in signaling pathways such as the Hippo signaling pathway(P＜0.05).CCK-8,EdU assay,scratch test,and flow cytometry results demonstrated that compared with the 0 ng/ml CXCL6 group,the 100 and 200 ng/ml CXCL6 groups exhibited significantly reduced proliferation and migration rates(P＜0.05),significantly increased apoptosis rate(P＜0.05).And the proportion of S-phase cells in the 200 ng/ml CXCL6 group was lower compared to the 0 ng/ml CXCL6 group(P＜0.05).PCR array results showed that compared with the 0 ng/ml CXCL6 group,the expression of genes such as CDH1 and HAL was increased in the 200 ng/ml CXCL6 group,while the expression of genes such as CD5L and EDNRB was decreased.Conclusion:CXCL6 plays a significant role in the malignant progression of PC-3 cells,and its mechanism may be associated with the methylation of promoters of genes such as RASSF1,RARB,and CDH1.

Objective:To investigate the alterations in brain functional activity before and after chemotherapy in breast cancer patients with chemotherapy-related cognitive impairment (CRCI) using resting-state functional magnetic resonance imaging (rs-fMRI) and their relations with cognitive impairment.Methods:A prospective observational study was performed; female breast cancer patients with CRCI admitted to Department of Oncology, Affiliated Hospital 6 of Nantong University were recruited, and age- and education level-matched female healthy controls were chosen. Before and one month after chemotherapy, statuses of cognitive function, depression and anxiety in breast cancer patients with CRCI were evaluated by Montreal cognitive assessment (MoCA), functional assessment of cancer therapy-cognitive function (FACT-cog), self-rating depression scale (SDS), and self-rating anxiety scale (SAS); subsequently, conventional MRI and resting-state functional magnetic resonance imaging (rs-fMRI) were conducted. The healthy controls accepted MoCA, SDS, and SAS, followed by conventional MRI and rs-fMRI. Differences in clinical data and amplitude of low-frequency fluctuation (ALFF, rs-fMRI brain spontaneous neural activity index) were compared between breast cancer patients with CRCI before chemotherapy and healthy controls, and in the breast cancer patients with CRCI between before and after chemotherapy. Taking the brain regions with significant differences in ALFF before and after chemotherapy in breast cancer patients with CRCI as seed points, the difference in whole-brain functional connectivity (FC) before and after chemotherapy was compared in breast cancer patients with CRCI. Pearson or Spearman correlation tests were used to analyze the correlations of ALFF and FC in brain regions with significant differences in ALFF with cognitive function scores in breast cancer patients with CRCI.Results:(1) A total of 22 breast cancer patients with CRCI and 22 healthy controls were enrolled. Compared with the healthy controls, the breast cancer patients with CRCI before chemotherapy had significantly higher SDS and SAS scores ( P<0.05). Compared with breast cancer patients with CRCI before chemotherapy, the breast cancer patients with CRCI after chemotherapy had significantly lower MoCA, FACT-cog-perceived cognitive impairment, FACT-cog-comment from others on cognitive function, and FACT-cog-perceived cognitive ability ( P<0.05). (2) Compared with those before chemotherapy, breast cancer patients with CRCI after chemotherapy exhibited significantly increased ALFF in the right precuneus, right middle occipital gyrus, and left superior frontal gyrus, while statistically decreased FC in the right middle occipital gyrus-left middle temporal gyrus, right precentral gyrus-right middle temporal gyrus, and left superior frontal gyrus-left fusiform gyrus ( P<0.05). (3) ALFF in the right precentral gyrus in breast cancer patients with CRCI after chemotherapy was negatively correlated with difference value of FACT-cog before and after chemotherapy ( r=-0.497, P=0.018) and difference value of PCA before and after chemotherapy ( r s=-0.436, P=0.042); FC in the left superior frontal gyrus-left fusiform gyrus was positively correlated with score of FACT-cog-perceived cognitive impairment ( r=0.621, P=0.002). Conclusion:Chemotherapy induces compensatory enhancement of spontaneous neural activity in multiple brain regions in breast cancer patients with CRCI, accompanied by FC disruption at specific brain areas, which are associated with cognitive impairment.

Objective:To observe and evaluate the clinical efficacy and safety of albumin-bound paclitaxel as first-line treatment for patients with advanced pancreatic cancer in China, and to explore the prognosis-related molecules in pancreatic cancer based on next-generation sequencing (NGS) of tumor tissues.Methods:From December 2018 to December 2020, patients with locally advanced or metastatic pancreatic cancer were recruited to accept albumin-bound paclitaxel as first-line treatment in the oncology departments of 24 hospitals in East China. The primary endpoints were overall survival (OS) and treatment related adverse events, and the secondary endpoint was progression-free survival (PFS). Adverse effects were graded using Common Terminology Criteria for Adverse Events 5.0 (CTCAE 5.0). NGS sequencing on the primary or metastatic tissue samples of pancreatic cancer obtained through surgical resection or biopsy was performed.Results:This study recruited 229 patients, including 70 patients with locally advanced pancreatic cancer (LAPC) and 159 patients with metastatic pancreatic cancer (mPC). The disease control rate was 79.9% and the objective response rate is 36.3%.The common adverse effects during treatment were anaemia (159 cases), leucopenia (170 cases), neutropenia (169 cases), increased aminotransferases (110 cases), and thrombocytopenia (95 cases), and the incidence of grade 3-4 neutropenia is 12.2% (28/229). The median follow-up time was 21.2 months (95% CI: 18.5-23.1 months). The median PFS (mPFS) was 5.3 months (95% CI: 4.37-4.07 months) and the median OS (mOS) was 11.2 months (95% CI: 9.5-12.9 months). The mPFS of patients with LAPC was 7.4 months (95% CI: 6.6-11.2 months), and their mOS was 15.5 months (95% CI: 12.6-NA months). The mPFS of patients with mPC was 3.9 months (95% CI: 3.4-5.1 months), and their mOS was 9.3 months (95% CI: 8.0-10.8 months). Multivariate Cox regression analysis showed that clinical stage ( HR=1.47, 95% CI: 1.06-2.04), primary tumor site ( HR=0.64, 95% CI: 0.48-0.86), Eastern Cooperative Oncology Group Performance Status (ECOG PS) score ( HR=2.66, 95% CI: 1.53-4.65), and whether to combine radiotherapy ( HR=0.65, 95% CI: 0.42-1.00) were independent influencing factors for the PFS of these patients. The primary tumor site ( HR=0.68, 95% CI: 0.48-0.95), ECOG score ( HR=5.82, 95% CI: 3.14-10.82), and whether to combine radiotherapy ( HR=0.58, 95% CI: 0.35-0.96) were independent influencing factors of the OS of these patients. The most frequent gene mutations in these advanced stage pancreatic patients were KRAS (89.66%), TP53 (77.01%), CDKN2A (32.18%), and SMAD4 (21.84%) by NGS of tumor tissues from 87 pancreatic cancer patients with sufficient specimens. Further analysis revealed that mutations in CDKN2B, PTEN, FGF6, and RBBP8 genes were significantly associated with an increased risk of death ( P＜0.05). Conclusion:Albumin-bound paclitaxel as first-line treatment demonstrated feasible anti-tumor efficacy and manageable safety for patients with advanced pancreatic cancer in China.

Objective:To observe and evaluate the clinical efficacy and safety of albumin-bound paclitaxel as first-line treatment for patients with advanced pancreatic cancer in China, and to explore the prognosis-related molecules in pancreatic cancer based on next-generation sequencing (NGS) of tumor tissues.Methods:From December 2018 to December 2020, patients with locally advanced or metastatic pancreatic cancer were recruited to accept albumin-bound paclitaxel as first-line treatment in the oncology departments of 24 hospitals in East China. The primary endpoints were overall survival (OS) and treatment related adverse events, and the secondary endpoint was progression-free survival (PFS). Adverse effects were graded using Common Terminology Criteria for Adverse Events 5.0 (CTCAE 5.0). NGS sequencing on the primary or metastatic tissue samples of pancreatic cancer obtained through surgical resection or biopsy was performed.Results:This study recruited 229 patients, including 70 patients with locally advanced pancreatic cancer (LAPC) and 159 patients with metastatic pancreatic cancer (mPC). The disease control rate was 79.9% and the objective response rate is 36.3%.The common adverse effects during treatment were anaemia (159 cases), leucopenia (170 cases), neutropenia (169 cases), increased aminotransferases (110 cases), and thrombocytopenia (95 cases), and the incidence of grade 3-4 neutropenia is 12.2% (28/229). The median follow-up time was 21.2 months (95% CI: 18.5-23.1 months). The median PFS (mPFS) was 5.3 months (95% CI: 4.37-4.07 months) and the median OS (mOS) was 11.2 months (95% CI: 9.5-12.9 months). The mPFS of patients with LAPC was 7.4 months (95% CI: 6.6-11.2 months), and their mOS was 15.5 months (95% CI: 12.6-NA months). The mPFS of patients with mPC was 3.9 months (95% CI: 3.4-5.1 months), and their mOS was 9.3 months (95% CI: 8.0-10.8 months). Multivariate Cox regression analysis showed that clinical stage ( HR=1.47, 95% CI: 1.06-2.04), primary tumor site ( HR=0.64, 95% CI: 0.48-0.86), Eastern Cooperative Oncology Group Performance Status (ECOG PS) score ( HR=2.66, 95% CI: 1.53-4.65), and whether to combine radiotherapy ( HR=0.65, 95% CI: 0.42-1.00) were independent influencing factors for the PFS of these patients. The primary tumor site ( HR=0.68, 95% CI: 0.48-0.95), ECOG score ( HR=5.82, 95% CI: 3.14-10.82), and whether to combine radiotherapy ( HR=0.58, 95% CI: 0.35-0.96) were independent influencing factors of the OS of these patients. The most frequent gene mutations in these advanced stage pancreatic patients were KRAS (89.66%), TP53 (77.01%), CDKN2A (32.18%), and SMAD4 (21.84%) by NGS of tumor tissues from 87 pancreatic cancer patients with sufficient specimens. Further analysis revealed that mutations in CDKN2B, PTEN, FGF6, and RBBP8 genes were significantly associated with an increased risk of death ( P＜0.05). Conclusion:Albumin-bound paclitaxel as first-line treatment demonstrated feasible anti-tumor efficacy and manageable safety for patients with advanced pancreatic cancer in China.

Objective: To describe the distribution and drug resistance of pathogens at hematology department of Jiangsu Province from 2014 to 2015 to provide reference for empirical anti-infection treatment. Methods: Pathogens were from hematology department of 26 tertiary hospitals in Jiangsu Province from 2014 to 2015. Antimicrobial susceptibility testing was carried out according to a unified protocol using Kirby-Bauer method or agar dilution method. Collection of drug susceptibility results and corresponding patient data were analyzed. Results: The separated pathogens amounted to 4 306. Gram-negative bacteria accounted for 64.26%, while the proportions of gram-positive bacteria and funguses were 26.99% and 8.75% respectively. Common gram-negative bacteria were Escherichia coli (20.48%) , Klebsiella pneumonia (15.40%) , Pseudomonas aeruginosa (8.50%) , Acinetobacter baumannii (5.04%) and Stenotropho-monas maltophilia (3.41%) respectively. CRE amounted to 123 (6.68%) . Common gram-positive bacteria were Staphylococcus aureus (4.92%) , Staphylococcus hominis (4.88%) and Staphylococcus epidermidis (4.71%) respectively. Candida albicans were the main fungus which accounted for 5.43%. The rates of Escherichia coli and Klebsiella pneumonia resistant to carbapenems were 3.5%-6.1% and 5.0%-6.3% respectively. The rates of Pseudomonas aeruginosa resistant to tobramycin and amikacin were 3.2% and 3.3% respectively. The resistant rates of Acinetobacter baumannii towards tobramycin and cefoperazone/sulbactam were both 19.2%. The rates of Stenotrophomonas maltophilia resistant to minocycline and sulfamethoxazole were 3.5% and 9.3% respectively. The rates of Staphylococcus aureus, Enterococcus faecium and Enterococcus faecalis resistant wards vancomycin were 0, 6.4% and 1.4% respectively; also, the rates of them resistant to linezolid were 1.2%, 0 and 1.6% respectively; in addition, the rates of them resistant to teicoplanin were 2.8%, 14.3% and 8.0% respectively. Furthermore, MRSA accounted for 39.15% (83/212) . Conclusions Pathogens were mainly gram-negative bacteria. CRE accounted for 6.68%. The rates of Escherichia coli and Klebsiella pneumonia resistant to carbapenems were lower compared with other antibacterial agents. The rates of gram-positive bacteria resistant to vancomycin, linezolid and teicoplanin were still low. MRSA accounted for 39.15%.

Objective To explore the change characteristics of early renal blood infusion in patients with diabetes and its relation-ship with fasting blood sugar by using multi-slice spiral CT (MSCT)perfusion scan.Methods Thirty cases of T2DM patients within five years of disease course that meet clinical diagnostic criteria (poor DN glycemic control group and good DN glycemic control group with 1 5 cases in each group)and 1 5 cases in the control group underwent bilateral renal perfusion scan using 64-detector spiral CT,thus obtaning their cortical perfusion parameters of bilateral kidneys,including blood flow (BF),blood volume (BV),mean transit time (MTT)and capillary permeability surface (PS).At the same time,for each case,fasting glucose,blood urea nitrogen, serum creatinine and blood uric acid value on the third days after and before perfusion were also measured;the glomemlar filtration rate (C-GFR)was estimated.Statistical analysis was performed on all of these obtained values.Results (1).For the poor DN gly-cemic control group,the average BF value,average BV value and average PS value were reduced,average MTT was prolonged sig-nificantly,and compared with normal group,average BF value and average MTT were statistically significant (P <0.05);for good DN glycemic control group,average BF value and average BV value were increased,the average MTT was prolonged,and compared with the normal group,the difference was statistically significant (P <0.01);compared with the good DN glycemic control group, the average BF value and average BV value of the poor DN glycemic control group were significantly reduced,and the average MTT was significantly prolonged.(2).Fasting blood glucose had the highest correlation with average BF and average MTT and was linear-ly dependent with renal perfusion parameters.(3).The glomemlar filtration rate was not statistically significant (P >0.05)for both normal control group and DN groups in the third day before and after renal CT perfusion imaging examination.Conclusion BF,BV and MTT of MSCT perfusion scan can reflect the characteris-ticsof early renal blood infusion in patients with diabetes.And changes of fasting blood sugar in patients with diabetes may influence mean BF and mean MTT of kidney.

Objective To investigate effective MSCT perfusion index and evaluate its significance in the renal function of diabetic nephropathy patients.Methods The 64-slice spiral CT perfusion scanning was performed on experimental group with 25 cases dia-betic nephropathy patients and control group with 25 cases healthy volunteers.The index including the dual-renal blood flow (BF), blood volume (BV),mean transit time (MTT),and permeability of surface (PS)were measured.At the same time,the levels of microalbumin and urinary protein (mg/24 h)were quantitated,and the blood urea and serum creatinine were measured on diabetic nephropathy patients one day before and the second day after renal CT perfusion scanning.Results All indexes of renal MSCT per-fusion,which are BF,BV,MTT and PS,were associated with 24 h quantitative urinary protein and fasting blood-glucose.Only BF and MTT were related to microalbumin and in a good correlation with indexes of diabetic nephropathy (microalbumin,24 h quantita-tive urinary protein,and fasting blood-glucose).Within them,the BF value was negatively correlated to the indexes,and the MTT was positively correlated.The area below the ROC curve of BF and MTT was more than 0.8,it indicated the good effect for the in-dexes in diagnosis of diabetic nephropathy.The usage of non-ionic contrast agent in the renal perfusion scanning process has no sig-nificant impact on the measured index values.Conclusion MSCT renal perfusion index can be used to evaluate the renal function of diabetic patients.BF,BV and MTT could be used in prediction,diagnosis and screening of DN patients,among them BF and MTT indexes were the optimal.

OBJECTIVE: To investigate and analyze the characteristics of early adverse drug reaction (ADR) of 131I in the treatment of hyperthyroidism. METHODS: 468 hyperthyroidism patients treated with 131I were followed up for 1 year. RESULTS: After 2～7 days of treatment, different reactions occurred in 54 cases (11.50%) including rash, itch of skin and alopecia of 16 cases (3.40%), paroxysmal muscle spasm of 19 cases (4.10%), eye discomfort of 13 cases (2.80%), aggravated symptom of 3 cases (0.60%) and thyroid pain of 3 cases (0.60%). These ADRs can last about 2 weeks to one year, and then relieved themselves. CONCLUSION: 11.50% of hyperthyroidism patients treated with 131I complain early systemic or local adverse reactions which are relieved within several months.