A 47-year-old male patient with bipolar disorder was given olanzapine tablets 10 mg orally once daily combined with lithium carbonate sustained-release tablets 0.3 g orally once daily due to manic episode. On the 6th day of medication, the patient received irbesartan and hydrochlorothiazide (containing irbesartan 150 mg and hydrochlorothiazide 12.5 mg in each tablet) 1 tablet orally once daily due to elevated blood pressure. Due to the aggravation of the patient′s manic symptoms, the dose of lithium carbonate was increased to 0.9 g/d from the 11th day of medication. After 13 days of combination therapy, the patient′s body temperature rised (up to 39.0 ℃) and headache and tremor of both hands appeared. Laboratory test showed that his lithium concentration was 1.58 mmol/L (target plasma concentration was 0.80-1.20 mmol/L) and lithium poisoning was diagnosed. Lithium carbonate sustained-release tablets and other oral drugs were stopped immediately and symptomatic and supportive treatments such as rehydration, cooling, and diuresis were given. Meanwhile, vital signs were monitored. On the 2nd day of drug withdrawal, the plasma lithium concentration decreased to 1.14 mmol/L, the body temperature returned to normal, and the tremor of hands was relieved. On the 8th day after drug withdrawal, the plasma lithium concentration decreased to 0.45 mmol/L, and the symptoms and abnormal signs disappeared.

A 47-year-old male patient with bipolar disorder was given olanzapine tablets 10 mg orally once daily combined with lithium carbonate sustained-release tablets 0.3 g orally once daily due to manic episode. On the 6th day of medication, the patient received irbesartan and hydrochlorothiazide (containing irbesartan 150 mg and hydrochlorothiazide 12.5 mg in each tablet) 1 tablet orally once daily due to elevated blood pressure. Due to the aggravation of the patient′s manic symptoms, the dose of lithium carbonate was increased to 0.9 g/d from the 11th day of medication. After 13 days of combination therapy, the patient′s body temperature rised (up to 39.0 ℃) and headache and tremor of both hands appeared. Laboratory test showed that his lithium concentration was 1.58 mmol/L (target plasma concentration was 0.80-1.20 mmol/L) and lithium poisoning was diagnosed. Lithium carbonate sustained-release tablets and other oral drugs were stopped immediately and symptomatic and supportive treatments such as rehydration, cooling, and diuresis were given. Meanwhile, vital signs were monitored. On the 2nd day of drug withdrawal, the plasma lithium concentration decreased to 1.14 mmol/L, the body temperature returned to normal, and the tremor of hands was relieved. On the 8th day after drug withdrawal, the plasma lithium concentration decreased to 0.45 mmol/L, and the symptoms and abnormal signs disappeared.

Objective To assess the association of single nucleotide polymorphisms ( SNPs) in SLCO1B3 gene with prognosis of breast cancer (BC) patients treated with neoadjuvant chemotherapy of TA regimen (taxane and antharcycline drugs). Methods 439 female BC patients were recruited and treated with neoadjuvant chemotherapy of TA regimen.A blood sample (2 ml) of peripheral blood was collected from each patient before chemotherapy. Tagging SNPs (tag?SNPs) were selected. We investigated the association of tag?SNPs with prognosis, by Sequenom Mass ARRAY system platform, characterizing tag?SNPs. The hazard ratio ( HR ) and 95% confidence interval ( CI ) for progression or death were calculated by multivariable?adjusted Cox regression model. Results Seven tag?SNPs ( rs11045689, rs200104106, rs3764006, rs3834935, rs4149117, rs7305323 and rs73241801) were selected for study. Compared with individuals carrying the rs11045689 GG genotype, individuals carrying rs11045689 AA genotype performed worse PFS and OS, with the HR (95% CI) for progression being 1.39 (1.11～1.75) and the HR (95% CI) for death being 1.38 ( 1.04～1.83). Compared with individuals carrying the rs73241801 CC genotype, individuals carrying rs73241801 TT genotype performed better OS (P＝0.041), with the HR (95% CI) for death being 0.65 (0.44～0.94). The number of risk allele was significantly associated with PFS (P＝0.012) and OS (P＝0.017) of BC patients by accumulation analysis. Compared with individuals carrying one or less than one risk allele, individuals carrying four risk alleles performed worse PFS and OS, with the HR (95%CI) for progression being 1.37 (1.09～1.72) and the HR ( 95% CI) for death being 1.36 (1.02～1.81). Conclusion The variations of rs11045689 and rs73241801 in SLCO1B3 gene were significantly associated with prognosis of BC patients treated with neoadjuvant chemotherapy of TA regimen, which might serve as biomarkers for predicting prognosis of BC patients treated with neoadjuvant chemotherapy.

Objective: To assess the association of single nucleotide polymorphisms (SNPs) in SLCO1B3 gene with prognosis of breast cancer (BC) patients treated with neoadjuvant chemotherapy of TA regimen (taxane and antharcycline drugs). Methods: 439 female BC patients were recruited and treated with neoadjuvant chemotherapy of TA regimen. A blood sample (2 ml) of peripheral blood was collected from each patient before chemotherapy. Tagging SNPs (tag-SNPs) were selected. We investigated the association of tag-SNPs with prognosis, by Sequenom Mass ARRAY system platform, characterizing tag-SNPs. The hazard ratio (HR) and 95% confidence interval (CI) for progression or death were calculated by multivariable-adjusted Cox regression model. Results: Seven tag-SNPs (rs11045689, rs200104106, rs3764006, rs3834935, rs4149117, rs7305323 and rs73241801) were selected for study. Compared with individuals carrying the rs11045689 GG genotype, individuals carrying rs11045689 AA genotype performed worse PFS and OS, with the HR (95% CI) for progression being 1.39 (1.11~1.75) and the HR (95% CI) for death being 1.38 (1.04~1.83). Compared with individuals carrying the rs73241801 CC genotype, individuals carrying rs73241801 TT genotype performed better OS (P=0.041), with the HR (95% CI) for death being 0.65 (0.44~0.94). The number of risk allele was significantly associated with PFS (P=0.012) and OS (P=0.017) of BC patients by accumulation analysis. Compared with individuals carrying one or less than one risk allele, individuals carrying four risk alleles performed worse PFS and OS, with the HR (95% CI) for progression being 1.37 (1.09~1.72) and the HR (95% CI) for death being 1.36 (1.02~1.81). Conclusion The variations of rs11045689 and rs73241801 in SLCO1B3 gene were significantly associated with prognosis of BC patients treated with neoadjuvant chemotherapy of TA regimen, which might serve as biomarkers for predicting prognosis of BC patients treated with neoadjuvant chemotherapy.

Objective To assess the association of single nucleotide polymorphisms ( SNPs) in SLCO1B3 gene with prognosis of breast cancer (BC) patients treated with neoadjuvant chemotherapy of TA regimen (taxane and antharcycline drugs). Methods 439 female BC patients were recruited and treated with neoadjuvant chemotherapy of TA regimen.A blood sample (2 ml) of peripheral blood was collected from each patient before chemotherapy. Tagging SNPs (tag?SNPs) were selected. We investigated the association of tag?SNPs with prognosis, by Sequenom Mass ARRAY system platform, characterizing tag?SNPs. The hazard ratio ( HR ) and 95% confidence interval ( CI ) for progression or death were calculated by multivariable?adjusted Cox regression model. Results Seven tag?SNPs ( rs11045689, rs200104106, rs3764006, rs3834935, rs4149117, rs7305323 and rs73241801) were selected for study. Compared with individuals carrying the rs11045689 GG genotype, individuals carrying rs11045689 AA genotype performed worse PFS and OS, with the HR (95% CI) for progression being 1.39 (1.11～1.75) and the HR (95% CI) for death being 1.38 ( 1.04～1.83). Compared with individuals carrying the rs73241801 CC genotype, individuals carrying rs73241801 TT genotype performed better OS (P＝0.041), with the HR (95% CI) for death being 0.65 (0.44～0.94). The number of risk allele was significantly associated with PFS (P＝0.012) and OS (P＝0.017) of BC patients by accumulation analysis. Compared with individuals carrying one or less than one risk allele, individuals carrying four risk alleles performed worse PFS and OS, with the HR (95%CI) for progression being 1.37 (1.09～1.72) and the HR ( 95% CI) for death being 1.36 (1.02～1.81). Conclusion The variations of rs11045689 and rs73241801 in SLCO1B3 gene were significantly associated with prognosis of BC patients treated with neoadjuvant chemotherapy of TA regimen, which might serve as biomarkers for predicting prognosis of BC patients treated with neoadjuvant chemotherapy.

Objective: To explore the associations between genetic variations of glutathione synthetase gene (GSS) and response to platinum-based chemotherapy of small cell lung cancer(SCLC), and to analyze the influencing factors on survival. Methods: Four haplotype-tagging single nucleotide polymorphisms (htSNPs) of GSS were genotyped by Sequenom MassARRAY methods in 903 SCLC patients who received platinum-based chemotherapy, and had different response and survival time. The associations between genotypes and platinum-based chemotherapy response were measured by odds ratios (OR) and 95% confidence intervals (CI), adjusted for sex, age, smoking, KPS, staging and chemotherapy regiments, by unconditional logistic regression model. The hazard ratios (HR) were estimated by Cox proportional hazards regression model. Results: Among the 903 patients, 462(51.2%) cases received cis-platinum and etoposide treatment while others were treated with carboplatin and etoposide. 656 patients were chemotherapy responders in the study with a response rate of 72.6%. Patients were followed up to get their survival information. The median survival time (MST) of these patients was 25.0 months.We found that rs725521 located in the 3′ near gene region of GSS was significantly associated with chemotherapy response. Compared with the T allele, patients with C allele had a worse chemotherapy response and an increased risk of no-responders (P=0.027). Rs7265992 and rs725521 of GSS were associated with the overall survival (OS) of SCLC patients who received platinum-based chemotherapy (HR=1.16, 95% CI=1.02-1.33, P=0.027; HR=1.17, 95% CI=1.05-1.31, P=0.006, respectively). The patients carrying 1 or 2 risk alleles and the patients carrying 3 or 4 risk alleles had worse MST than the patients without the rs7265992A and rs725521C risk alleles (24.0 and 22.0 versus 30.0 months), with the HR for death being 1.26 (95% CI=1.04-1.54) and with the HR of 1.52 (95%CI=1.18-1.97, P=0.001). Rs2025096 and rs2273684 were not associated with the OS of SCLC patients who received platinum-based chemotherapy. Age ≤ 56, KPS> 80, limited-stage, chemotherapy response and radiation therapy had a remarkably prolonged OS (all P<0.05). Conclusions These results suggest that GSS genetic polymorphism rs725521 plays an important role in the response to platinum-based chemotherapy, while rs7265992 and rs725521 have important effect on the prognosis of SCLC patients, which may be potential genetic biomarkers for personalized treatment of SCLC.

Objective To investigate the effect of overexpression of cartilage oligomeric matrix protein (COMP) on BMP-2 induced cell osteogenic and chondrogenic differentiation of mesenchymal stem cells (MSCs).Methods MSCs,transfected with plasmid DNA encoding recombinant human COMP,were induced to differentiate into osteocytes and chondrocytes by BMP-2.Realtime PCR of osteogenic related markers (Col1a1,RUNX2,OPN,BGP) and chondrogenic related markers (Col2a1,SOX9,Aggrecan) were performed to evaluate the process of cell differentiation.ALP staining,Alizarin red S staining for osteogenic differentiation and alcian blue staining for chandrogenic differentiation were conducted to evaluate the tendency of cell differentiation.Results Real-time PCR assay presented the significantly higher (P＜0.05) COMP expression of MSCs when COMP gene was transfected into cells.The expression level of OPN was significantly (P＜0.05) down-regulated at all the time points in experimental group compared with that in control group.A final significant (P＜0.05) up-regulation of expression appeared in experimental group at the late stage of induction (day 7,14) compared with that in control group,even though a decrease (P＜0.05) expression of Col1a1,RUNX2 and BGP in experimental group occurred at the early stage of induction (day 3).The expression of Aggrecan and Col2a1 in experimental group was up-regulated (P＜0.05) at different time points compared with that in control group.And a significant higher (P＜0.05) expression of SOX9 in experimental group only appeared at day 7 compared with that in control group.ALP staining and Alizarin red S staining were weakened while alcian blue staining was enhanced.Conclusion COMP may inhibit BMP-2 induced osteogenic differentiation and promote BMP-2 induced chondrogenic differentiation,which may provide new insight for cartilage tissue engineering.

Objective:To investigate the relationship between EGFR mutations and pulmonary tuberculosis in lung adenocarcino-ma. Methods:We detected EGFR mutations in 506 patients with lung adenocarcinoma by PCR amplification and sequencing and ana-lyzed the relationship between the mutations observed and pulmonary tuberculosis. Survival analysis was performed using the Ka-plan-Meier method with log-rank tests. Result:A total of 218 patients showed EGFR mutations;of these patients, 25 had a clinical his-tory of pulmonary tuberculosis. Compared with lung adenocarcinoma patients with no history of tuberculosis, patients with a history of pulmonary tuberculosis showed higher incidence rates of EGFR mutations, especially of exon 21 (P=0.047, P=0.002). Higher incidence rates of EGFR mutations, especially of exon 21, were observed in patients with lung cancer and tuberculosis in the same lobe or the same side of the lung than in those who had lung cancer and tuberculosis in opposite sides of the lung (P=0.02, P=0.03). Survival analy-sis showed that adenocarcinoma patients with a history of pulmonary tuberculosis have 2-year survival rates lower than that of adeno-carcinoma patients with no history of the disease (P=0.039). In patients adenocarcinoma associated with tuberculosis patients without EGFR-TKIs treatment, the 2-year survival rates of EGFR mutation patients and those without EGFR mutation showed no statistically significant difference (P=0.948). At the same time, we got the same results in adenocarcinoma associated with tuberculosis patients with EGFR-TKIs treatment (P=0.425). Conclusion:Lung adenocarcinoma patients with a history of pulmonary tuberculosis have high-er incidence rates of EGFR mutations, and EGFR mutations are not related to disease prognosis.

To study the characteristics of traditional Chinese medicine (TCM) syndrome factors of patients from different areas of China with human immunodeficiency virus (HIV) infection or acquired immunodeficiency syndrome (AIDS).

ObjectiveTo analyze the mental status of the patients with irritable bowel syndrome (IBS).MethodsSixty IBS patients were evaluated with Self Rating Anxiety Scale (SAS), Self Rating Depression Scale (SDS), Symptions Check List-90 (SCL-90) and self-edited scale.ResultsThe primary causes of mental disorder of IBS patients were the stress events and lacking knowledge for IBS; the average SAS scores of sixty IBS patients were 52.32±10.19, SDS scores were 54.90±11.70; the average scores of SAS and SDS in the groups of midlife and young people were significantly higher than that in the group of agedness ( P<0.05). The total scores of SAS and SDS were not significantly difference among the patients with different culture level and sex ( P>0.05); except the scores of crankiness and opposition, the average SCL-90 scores of the sixty IBS patients were significantly higher than the normal ( P<0.05).ConclusionIBS relates to mental status and stress, proper mental intervention can ease the symptom and improve the quality of the living.