Objective To investigate the effects of CD151 down-regulation combined with bevacizumab on colorectal cancer growth and microvessel density.Methods Human colorectal cancer cell line HT-29 and CD151--HT-29 cells strain(CD151 down-regulated HT-29 cells)were treated with bevacizumab.The cells were divided into four groups:control(HT-29)group,bevacizumab-treatment group,CD151--HT-29 group,and CD151--HT-29+bevacizumab-treatment group.Cell proliferation was observed in each group using the MTS assay.A subcutaneous xenograft model in nude mice was established,and the HT-29 control group and CD151--HT-29 group were treated with either 0.9％NaCl solution or bevacizumab.The growth of subcutaneous tumors in the four groups was ob-served,and the volume and weight of the tumors were recorded.Tumor tissues were collected for immunohistochem-ical staining of endothelial cells to assess microvessel density(MVD).Results Compared with the control group,cell proliferation was significantly reduced in the bevacizumab-treated group and CD151--HT-29 group(P<0.001).Cell proliferation in the CD151--HT-29+bevacizumab-treated group was slower than that in the single treatment groups(P<0.001).In the subcutaneous tumor model,the volume,weight,and MVD of tumors in the bevacizumab-treated and CD151--HT-29 groups were significantly reduced compared to the control group(P<0.01).In the CD151--HT-29+bevacizumab group,the tumor volume,weight,and CD34 expression were significantly lower than in the single treatment groups(P<0.01).Conclusions CD151 protein may play a role in the regulation of angiogenesis in colorectal cancer tissues and may have a synergistic effect with bevacizumab in in-hibiting microvessel formation in tumor tissues.

OBJECTIVES: To assess the biomechanical performance of a novel bridging plate for treating Rockwood III acromioclavicular joint dislocation. METHODS: A novel bridging plate structure was designed based on CT data from a patient with Rockwood type III acromioclavicular joint dislocation, and a finite element model of the bridging plate-acromioclavicular joint interaction was constructed. The stress and deformation characteristics and biomechanical compatibility of the plate under post-reduction, normal loading, and impact loading conditions were analyzed to evaluate its fixation mechanism and clinical advantages. RESULTS: The stiffness of the bridging system was 27.78 N/mm, close to that of acromioclavicular joint ligaments (26.05 N/mm) and meeting the requirements for flexible deformation. Under normal loading, the maximum stress in the bridging system was 88.29 MPa to sustain physiological activities; under impact loading, the maximum stress reached 480 MPa, and the cable underwent plastic deformation to dissipate energy and effectively buffer local stress concentrations, thereby reducing the risk of rigid bone fractures. The high-stress regions in the bone primarily occurred at the edges of the C1-C4 screw holes. The maximum bone stress was 0.762 MPa under normal loading and 5.963 MPa under impact loading, accounting for 2.86% and 1.66% of the corresponding bolt stresses, respectively. CONCLUSIONS The novel bridging plate is better adapted to biomechanical characteristics of the acromioclavicular joint compared to traditional internal fixation. This fixation system provides sufficient stability while allowing physiological micromotion to facilitate postoperative rehabilitation. Significant flexible deformation can occur at the connection between the fixation ring and the cable, and brittle materials should not be used in this region. The issue of stress concentration at the C1-C4 screw holes requires special attention in its clinical application.
Acromioclavicular Joint/surgery* ; Humans ; Bone Plates ; Biomechanical Phenomena ; Finite Element Analysis ; Joint Dislocations/surgery* ; Fracture Fixation, Internal/methods*

Objective:To evaluate the potential effects of serum lipid levels, appendicular skeletal muscle mass index (ASMI) and body mass index (BMI), together with its dynamic changes, on tumor progression in renal clear cell carcinoma patients, so as to inform body weight management.Methods:This prospective cohort study included a total of 100 patients with high-risk clear cell renal cell carcinoma. Serum lipid levels were detected, ASMI and BMI were measured using bioelectrical impedance analysis and the dynamic changes of BMI were tracked. The effects of BMI, ASMI and serum lipid levels on tumor progression within 2 years were explored.Results:Patients with normal BMI and low ASMI had 5.248 (95% CI: 1.946 to 14.153, P = 0.001) times higher risk of tumor progression than those who were overweight or obese. For every 0.1-unit increase in pre-operative HDL-C, the risk of tumor progression decreased by 0.771 (95% CI: 0.631 to 0.942, P = 0.011) times. Patients who experienced more than 5% decrease in BMI compared with baseline had 5.165 (95% CI: 1.735 to 15.370, P = 0.003) times the progression risk of patients whose BMI changed within ±5% from baseline. Conclusions:The advantage of obese clear cell carcinoma patients over normal-weight patients in tumor progression-free survival may be influenced by ASMI, pre-onset involuntary weight loss and lipid levels. Therefore, patient weight management should not merely focus on absolute BMI but tailor to individual characteristics, including cancer stage, body composition and metabolic status.

Kidney cancer usually requires multidisciplinary individualized treatments. No matter what kind of treatment, drugs are essential. According to the "six-step process" (prescription legitimacy review, patient basic information evaluation review, treatment protocol review, organ function and laboratory index review, pretreatment review, and unconventional prescription review) in prescription review proposed by the anti-tumor drug prescription review expert group and referring to domestic and foreign kidney cancer guidelines and drug instructions in recent years, this consensus selects 9 targeted drugs and 4 immunotherapeutic drugs that are currently commonly used in China and elaborates the key review points in patient basic information evaluation review, treatment protocol review, and organ function and laboratory index review of kidney cancer drug treatment, in order to provide reference for clinical front-line pharmacists to review prescriptions of kidney cancer patients and promote rational drug use in clinic.

Kidney cancer usually requires multidisciplinary individualized treatments. No matter what kind of treatment, drugs are essential. According to the "six-step process" (prescription legitimacy review, patient basic information evaluation review, treatment protocol review, organ function and laboratory index review, pretreatment review, and unconventional prescription review) in prescription review proposed by the anti-tumor drug prescription review expert group and referring to domestic and foreign kidney cancer guidelines and drug instructions in recent years, this consensus selects 9 targeted drugs and 4 immunotherapeutic drugs that are currently commonly used in China and elaborates the key review points in patient basic information evaluation review, treatment protocol review, and organ function and laboratory index review of kidney cancer drug treatment, in order to provide reference for clinical front-line pharmacists to review prescriptions of kidney cancer patients and promote rational drug use in clinic.

Objective: To establish primary immune thrombocytopenia (ITP) animal model induced by anti-platelet membrane glycoprotein GPⅠbα antibodies AN51 and R300. Methods: Twenty guinea pigs (6-8 week) were divided into 4 groups. Five guinea pigs in each group were intravenously injected with different doses of AN51 (0.05, 0.1, 0.2 μg/g) and 0.2 μg/g IgG as control. The whole blood was collected from inner angular venous plexus. Platelets number was determined by an automated cell counter and Swiss-Jim method. Then, the similar protocol was used to establish ITP nude mice model by intraperitoneal injection of different concentrations of anti-platelet GPⅠbα antibody R300, respectively. Results: ①Five minutes after intravenous injection of AN51 at 0.05, 0.1 and 0.2 μg/g, the platelet counts of guinea pigs reduced about 0-5%, 50%-60% and 70%-80% compared to the control group, respectively. The difference was statistically significant (P<0.01) . ②Six hours after intraperitoneal injection of R300 at 0.05, 0.1, 0.2 μg/g, the platelet counts of nude mice decreased about 20%-30%, 60%-70% and 80%-90% compared to the control group, respectively. The difference was statistically significant (P<0.01) . The nude mice, injected 0.2 μg/g R300 once a day for 2 weeks, showed typical ITP clinical manifestations including large number of petechiaes or ecchymoses on limbs, head and abdomen. Conclusion AN51 at 0.2 μg/g and R300 at 0.2 μg/g could establish stable ITP model in guinea pigs and nude mice respectively.

Objective To investigate status of the intravenous use of antibiotics in outpatients and emergency patients of a tertiary first-class hospital, and provide a reference for developing management measures in next step. Methods By a retrospective method,all the prescriptions using antibiotics by intravenous administration in outpatients and emergency department patients from a tertiary first-class hospital in 2013 were extracted from the hospital information system. The categories of antimicrobial agents,proportion of intravenous use of antimicrobial drugs,ranking of the antibiotic consumption sum and defined daily dose,and the top 10 clinical departments or wards intravenously using antimicrobial drugs were chosen to analyze. The data in 2014 were extracted as a comparison. Results Outpatients and emergency department patients respectively used 8 categories 31 kinds and 8 categories 30 kinds of intravenous antimicrobial drugs, with high consumption of cephalosporins and restricted antimicrobials such as sodium cefoxitin.Intravenous use of antimicrobial drug prescription proportion in emergency department is higher than that in outpatient department. Conclusion After intervention in 2014, antibiotic consumption is effectively controlled as compared that in 2013. But management should be strengthened and appropriate interventions should be taken to ensure the use of intravenous antibiotics in a safe,effective and economical manner.

Objective To compare the differences of quality of life ( QOL) between self-rating report and guardian′ report through evaluating and describing the QOL of minors with malignant bone tumors. Methods Totally 68 cases of minors with malignant bone tumors hospitalized in Peking Union Medical College Hospital and their parents were selected from October 2012 to October 2015, and were investigated by PedsQL 4.0 scale and PedsQL 3. 0 scale to collect the QOL of minors evaluated by patients and their parents. Results The overall QOL of minors with malignant bone tumors was at a low level. The results of QOL of parents′evaluation were consistent with the results of self-evaluation of minors ( P>0.05) . However, the scores of self-evaluation in physiology, pain, nausea and vomiting, operational anxiety, anxiety of treatment and worries were higher than those of results of parents′ evaluation (P<0.05), and the score of school function of self-evaluation was lower than that of parents′ evaluation ( P<0. 05 ) . Conclusions As for the QOL that evaluated by minors and parents, when the minors have difficulties in self-evaluation, the parents′ report has some reference value. As a individual, the QOL from minors themselves and from parents may be different, so in clinical work, we should provide comprehensive personized and high-quality nursing based on the fully combination of minors self-evaluation and parents′report.

ObjectiveTo investigate the expression of G protein-coupled ER (GPER) and ER in the activation of phosphatidylinositol 3-kinase (PI3K)/protein kinase B (Akt) induced by 17β-estradiol (17β-E2 )in endometrial carcinoma cells,Ishikawa and HEC-1A.Methods Expressions of GPER,Erα and Erβ protein in Ishikawa and HEC-1A cells were detected by immunohistochemical SP method.Levels of GPER,Erα and Erβ were examined by western blot in Ishikawa and HEC-1A cells after treated with 1 ×10-6 mol/L 17β-E2 at different time (0,15,30,60,120 minutes).ResultsGPER was positive expressed in Ishikawa and HEC-1A cells.Erα and Erβ were both positive expressed in Ishikawa cells.While,Erα was weakly expressed and Erβ was almost negatively expressed in HEC-1A cells.Western blot analysis showed that 1× 10-6 mol/L 17β-E2 treatment,the Ishikawa and HEC-1A cells GPER protein level for 15 minutes markedly increased (P ＜ 0.05 ),which Ishikawa 30 minutes,when cells reached the highest level (0.192 ± 0.004),HEC-1A cells for 15 minutes and reached the highest level (0.184 ±0.006) ; Ishikawa and HEC-1A cells,Akt,activation of 15 minutes from the treatment start was significantly increased (P ＜ 0.05 ),which Ishikawa cells for 30 minutes and reached the highest level (0.666 ± 0.021 ),HEC-1A cells for 15 minutes and reached maximum (0.788 ± 0.035); Ishikawa and HEC-1 A cells,Erα and Erβ protein expression did not change significantly ( P ＞ 0.05 ).Conclusion GPER likely involved in non-nuclear activation of PI3K/Akt signaling pathways in endometrial carcinoma cells,Ishikawa and HEC-1A.

Objective To study bacterial conditions in amniotic cavity of the third trimester and the delivery. Methods Patients underwent cesarean section due to various reasons were randomly enrolled in the study. Ten ml aqua amnii taken from using aspesis were cultured and the bacteria were identified and tested for drug sensitivity. All patients were not treated with antibiotics before and during operation,conventional antibiotics treatnent was used after operation. The patients were divided into 3 groups based on their status: 34 cases of premature rupture of membrane ( PROM ), thirty-four cases of labor without PROM, and 27 cases of pregnancy without PROM. The positive rate, species , distribution and drug sensitivity of bacteria in the 3 groups were analyzed. Results The positive rate was 61.8% (21/34) in PROM ,52. 9% ( 18/34 ) in labor without PROM,11.1% (3/27)in pregnancy without PROM. The positive rates were significantly different among the 3 groups (x2 = 17.29 ,P =0.000). However, there was no significant difference between the labor without PROM group and the pregnancy without PROM group ( x2 = 0.541 , P = 0.462 ). Staphylococcus epidermidis was the most common isolated bacteria, following by staphylococcus aureas, streptococcus, colon bacillus, and pseudomonas. There were no significant differences of bacterial species between labor without PROM and pregnancy without PROM( x2 = 11.9,P =0.535 ). The relative higher positive rate in the labor without PROM and PROM indicated that they were important inducement of bacteria infection. There were no significant difference on positive rate and bacteria species distribution between the PROM and labor without PROM group,which suggested that up-bound along vagina to amniotic cavity was the most common route of infection. Sensitive antibiotics should be given to the patients of PROM and labor without PROM targeted at staphylococcus,streptococcus, colon bacillus and monad. Antibiotics such as Cephems, Penicillins and Clindamycin were sensitive to various bacteria and safe to both mother and baby, thus were recommended. Quinupristin, Vancomycin,Furantoin, Fusidic ,Teicoplanin, Amikacin and Meropenem were also sensitive to various bacteria, but due to their side effects and the principle of ladder antibiotics using, they were recommended as second line antibiotics. Conclutions Up-bound along vagina to amniotic cavity is the most common route of infection. For rupture of membrane and labor without PROM patients, antibiotics should be given, and strict aseptic technique,washing cavity and incision, using antibiotics after operation are necessary to prevent infection.