Volume 91  ·   Issue 04  ·  2011

The 20th century is the greatest century in human history, and many important changes have taken place in this century, and medicine is no exception. In the 20th century, human beings witnessed great progress in medical science and technology, such as the invention and use of antibiotics, the successful development of various vaccines, the rapid development of medical imaging technology, the implementation of human genome project and proteome project, etc. All have great influence on human health and medical undertakings.

Objective To examine the association between the side effects of oral anti-diabetic drugs (OAD) and self-reported mental health and quality of life among patients with type 2 diabetes mellitus (T2DM). Methods An observational, cross-sectional multicenter study with a retrospective medical chart review was conducted at 16 medical centers from around China. The T2DM patients were followed-up and treated with OAD alone prior to the index visit from January to September 2007. All subjects were ≥30 years old at the time of T2DM diagnosis and had received monotherapy or combination therapy of OAD for at least 6 months. Health-related quality of life was measured by the EuroQol-5D (EQ-5D) and Hypoglycemia Fear Survey (HFS) - Ⅱ. Results The symptoms of hypoglycemia were reported by 41.8% ( n = 203 ) of participants, and 19. 2% ( n = 93 ) experienced weight gain. For those reporting hypoglycemia, the scores were higher for HFS-Ⅱ [7.00(2.00 - 19.00)vs 0.00(0.00 -7.00), P ＜0.01] and lower for EQ-5D (0. 90 ± 0. 12 vs 0. 93 ± 0. 13, P = 0. 003 ) than those without hypoglycemic symptoms. According to the multivariate linear regression analysis, the symptoms of hypoglycemia were positively correlated with HFS- Ⅱ (β =5.78, P ＜0. 01 ) and negatively with EQ-5D (β = -0. 04, P ＜0. 05 ) after adjusting for patient and disease characteristics. Conclusion There is a high possibility of hypoglycemic risks among T2DM patients on OAD therapy. The self-reported hypoglycemia is associated with health-related quality of life and hypoglycemic fear. They may have an impact on the long-term prognosis.

：Objective To investigatethe detection rate of carotid artery plaque in Han, Uygur and Kazakh adult populations ofXinjiang. Methods During the period of October 2007 to March 2010, the present study wasperformed in 13896 Han, Uygur and Kazakh adults of Xinjiang aged 35 years old and over bya four-stage random sampling method. All subjects were investigated by a standardizedquestionnaire,physical, biochemical examination and ultrasonography of carotid arteries.Risk factors were analyzed by a logistic regression model. Results The prevalence ofcarotid artery plaque was 10.2% . After standardization, the detection rate of ChineseHan, Uygur and Kazakh populations was 2.46%, 2. 31% and 1.84% respectively. By theanalysis of multivariate logistic regression, age( OR 1.032, 95% CI 1.026-1. 037),smoking( OR 1. 358, 95% CI 1. 164 - 1. 585 ), total cholesterol ( OR 1. 075, 95% CI 1. 018-1. 135), blood glucose( OR 1. 050, 95% CI 1. 020 - 1. 081 ) and systolic blood pressure(OR 1.011,95% CI 1. 008 - 1. 014 ) were independent risk factors in the occurrence ofcarotid artery plaque. Females ( OR 0. 653, 95% CI 0. 545 -0. 738 ) and high-densitylipoprotein (OR 0. 864, 95% CI 0. 751 -0. 994 )were the protective factors in theoccurrence of carotid artery plaque. Conclusion The detection of carotid artery plaque inXinjiang increases substantially with age and difference exists between nationalities. Theassociated risk factors of the formation of carotid artery plaque include gender, age,smoking, high-density lipoprotein,total cholesterol, blood glucose and systolic bloodpressure. The effect of these factors is different between genders.

Objective To investigate the association of orthostatic hypertension and hypotension with hypertensive target organ damage in middle and old-aged hypertensive patients. Methods This crosssection study was conducted in 4711 hypertensive patients aged 40 - 75 years old in 7 communities of Xinyang County, Henan Province by a multistage cluster sampling method. All patients received a standardized questionnaire, physical and biochemical examinations, echocardiography, ankle-brachial blood pressure index and orthostatic blood pressure measurement. Orthostatic hypertension was defined as an elevation of systolic blood pressure by 20 mm Hg or more while orthostatic hypotension as a drop of blood pressure by 20/10 mm Hg or more. When an upright posture was assumed. Others not belonging to these two conditions were classified into orthostatic normotension. Results The prevalence of orthostatic hypertension and hypotension was 16.3% and 23.8% in hypertensive patients. Peripheral artery disease was significantly more frequent in hypertensives with orthostatic hypertension ( 10. 1% ) or hypotension ( 10. 7% ) than those with orthostatic nnrmoteasives (7.4%) ( both P ＜ 0. 05 ). Patients with orthostatic hypotension had more common left ventricular hypertrophy (53.0% vs 43. 2%, P＜0. 001 ) and a decreased estimated glomerular filtration rate ( 38.6% vs 34. 4%, P ＜0. 05 ) than did those with orthostatic nnrmotension. After controlling for age, gender, body mass index and other confounders, orthostatic hypertension was positively associated with peripheral arterial disease ( OR 1.39, 95% CI 1.05 - 1.84 ) while orthostatic hypotension was significantly associated with peripheral arterial disease ( OR 1.45, 95% CI 1.13 - 1.86) and left ventricular hypertrophy (OR 1.46, 95% CI 1.11 -1.84). But no independent association was found between orthostatic hypertenson or hypotension and a decreased estimated glomerular filtration rate in hypertensive patients. The adjusted odds ratios (OR) for left ventricular hypertrophy, as predicted by the quintiles of orthostatic systolic blood pressure changes, showed a J-shaped relationship in hypertensive women, and so did peripheral artery disease in untreated hypertensive patients. Conclusion Hypertensive patients with orthostatic hypertension or hypotension may have an elevated risk of developing target organ damage.

Objective To evaluate the characteristic and clinical significance of lower urinary tract symptoms (LUTS) caused by lumbar disk herniation. Methods A total of 80 male patients from February 2000 to April 2010 in our hospital with lumbar disk herniation underwent an urodynamic test. And they were divided into the normal bladder function group ( Group A), the early-stage of bladder dysfunction group ( Group B) and the late-stage of bladder dysfunction group (Group C) according to the urodynamic results.LUTS in these patients were assessed by the international prostate symptom score (IPSS) and quality of life (QOL) questionnaire. The results were analyzed statistically among these three groups. Results In Groups A ( n = 30), B ( n = 22) and C ( n = 28 ), the total IPSS scores were 9. 4 ± 4. 6, 11.3 ± 3. 3 and 15.0 ±3.4 while the QOL scores 2. 1 ± 1.1, 2. 2 ± 1.0 and 3.4 ± 1.3 respectively. The total voiding symptom scores were 3. 8 ± 2. 7, 6. 2 ± 2. 6 and 10. 4 ± 3. 1 respectively and the differences were significant ( all P ＜0. 05 ). The total storage symptom scores were 5. 6 ± 3.4, 5. 1 ± 2. 9 and 4. 6 ± 2. 3 in 3 groups respectively and the difference was insignificant (P ＞0. 05). Between Groups A and B, the differences of total voiding symptom score were significant ( P ＜ 0. 01 ) while those of the total IPSS and QOL score were insignificant (both P＞0. 05). Between Groups B and C, the differences of the total IPSS, QOL score and total voiding symptom score were significant ( all P ＜ 0. 05 ). Conclusions The LUTS caused by lumbar disk herniation are notable during the late stage of bladder dysfunction. As one typical early manifestation, the voiding symptom may aid an early diagnosis of the disease.

Objective To evaluate the effect of left ventricular ejection fraction (LVEF) on clinical outcomes in patients with acute ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention. Methods A total of 158 patients with acute ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention between January 2005 to December 2007were enrolled. They were divided into three groups: LVEF ≤40% ( n = 14), LVEF 41% - 55 % ( n = 46)and LVEF ＞ 55% group ( n = 98 ). The clinical follow-up end-point was major adverse cardiac event (MACE) including death, acute myocardial infarction, stent thrombosis and stent restenosis. The clinical follow-up duration was 43.1 ± 15.2 months. MACE occurred in 15 patients. Results The rates of infarction site, infarction relative artery, 1-vessel disease, 2-vessel disease, hypertension, diabetes, hyperlipidemia,smoking, obesity and aspirin use were not different in three groups (P ＞0.05). Average CTnI, CK,CK-MB and duration of clopidogrel use were not different in three groups ( P ＞ 0. 05 ). The rate of 3-vessel disease was significantly higher in the LVEF≤40% group than that in the LVEF 41% -55% and LVEF ＞55% groups (P =0. 0036). The rates of TIMI flow grades (Grade Ⅲ ) and complete revascularization were significantly higher in the LVEF 41% -55% and LVEF ＞55% groups than that in the LVEF≤40% group ( P =0. 0099 ,P =0. 0010). The rates of Killip classification ( classes Ⅱ , Ⅲ, Ⅳ ) and average symptomonset-to balloon-time (SOTB) were significantly lower in the LVEF 41% -55% and LVEF ＞55% groups than that in the LVEF ≤ 40% group ( P = 0. 0100, P = 0. 0087 ). The rate of drug-eluting stents was significantly lower in the LVEF≤40% group and LVEF 41% -55% group than that in LVEF ＞55% group (P = 0. 0242). Logistic regression analysis showed that LVEF was independent predictor for MACE in the follow-up period ( P = 0. 0029 ) . With LVEF decrease, incidence of MACE in the follow-up period significantly increased in LVEF ＞55% group ,LVEF41% -55% group and LVEF≤40% group(6. 12% vs 8. 7% vs 35.71%, P = 0. 0019). Incidence of total death and cardiac death in the follow-up period significantly increased in LVEF ＞55% group ,LVEF41% -55% group and LVEF≤40% group( 1.02% vs 4.35% vs 21.43% ,P=0.0090;1.02% vs 2. 17 vs 14.29% ,P=0.0060). Conclusion In patients with acute ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention,LVEF was independent predictor for MACE in the follow-up period. With LVEF decrease, incidence of MACE in the follow-up period significantly increased.

Objective To evaluate the value of the AKIN criteria of acute kidney injury (AKI) in the incidence and prognoses in critically ill patients, and to further identify risk factors associated with the prognoses of the critically ill patients. Methods We retrospectively studied 544 adult patients hospitalized for ≥ 24 h to a comprehensive ICU with 16 beds in teaching hospital from January 2008 to December 2009. Based on AKIN criteria, these patients were classified into four groups: NAKI (no AKI), AKI Ⅰ ,AKI Ⅱ , and AKI Ⅲ respectively. Results ( 1 ) Of the patients, 191 (35.5%) fulfilled the criteria for AKI ( 14. 8% had AKI Ⅰ 8. 2% had AKI Ⅱ and 11.9% had AKI Ⅲ ). (2)Mortality in the ICU was much higher in patients with AKI than in patients with no AKI (48% vs 11%, OR 7.48,95 % CI 4. 831 - 11. 587,P＜0. 001 ). The mortality rate was 37% for AKI Ⅰ group, 51% for AKI Ⅱ group and 60% for AKI Ⅲ group. (3)In multivariate analysis, each AKIN category was independently associated with ICU mortality.The other independent risk factors for ICU mortality included internal medical diseases, septic shock, preexisting chronic illness, APACHE Ⅱ score, the number of failed organs, mechanical ventilation and CRRT.Conclusions The AKIN category closely relates to the prognoses in critically ill patients, even the mild degree of AKI with a much higher mortality rate than the patients without AKI. The AKIN criteria has some direction significance to the early detection and classification of AKI and to the prediction of clinical outcomes in critically ill patients.

Objective To explore the predictive values of platinum-related genes in gastric cancer patients on oxaliplatin-based adjuvant chemotherapy. Methods A total of 126 gastric cancer patients received at least 6 cycles of modified FOLFOX4 adjuvant chemotherapy. Single nuclear polymorphisms (SNPs) in ERCC1 Asp118Asp, XRCC1 Arg399Gln, XPD Lys751Gln and GSTP1 Ile105Val were assessed with 5' nuclease allelic discrimination assay (TaqMan) by real-time polymerase chain reaction and direct sequencing. The genotypes were tested for an association with survivals in gastric cancer patients on an oxaliplatin-based adjuvant chemotherapy regimen. Results The genotypic analysis of all patients indicated the frequencies for the homozygous wild-type allele, heterozygous and homozygous polymorphic variant:64.29%, 28.57% and 7.14% for ERCC1-118; 56.35%, 38.89% and 4.76% for XRCC1-399;84. 92%, 15. 08% and 0 for XPD-751; and 68. 25%, 30. 60% and 3. 97% for GSTP1-105. Univariate analysis indicated that the ERCC1-118, the XRCC1-399 and the GSTP1-105 SNPs showed the predictive values for RFS ( relapse-free survival) (P ＜ 0. 001, P = 0. 001 and P ＜ 0. 001 respectively) and OS ( overall survival) (P ＜0. 001, P =0. 001 and P =0. 019 respectively). A multivariable analysis of Cox proportional hazard regression model suggested that ERCC1-118 had a significant predictive value for RFS (P＜0. 001,HR=2.362; 95%CI:1.458 -3.827) and OS (P=0.001; HR=2.388; 95%CI: 1.448 -3.937) and XRCC1-399 had only a significant predictive value for RFS. And XRCC1-399 (A/A + A/G) genotype could significantly decrease the recurrence risk of patients (P＜0. 001, HR =0. 569; 95% CI: 0. 341 -0. 949).Conclusion Gastric cancer patients with ERCC1-118 C/C genotype and XRCC1-399A/G or A/A genotype may benefit from an oxaliplatin-based adjuvant chemotherapy.

：Objective To discuss thecauses, diagnosis, prophylaxis and treatment of ischemictype biliary lesions (ITBLs)following orthotopic liver transplantation (OLT). Methods A retrospective analysis wasperformed for 326 OLT patients from January 2002 to January 2009. The post-OLT etiologicalfactors and treatment of ITBL cases were analyzed. Results ITBL occurred in 23 patients(7. 05% ). It included intrahepatic biliary lesions ( n = 9 ), extrahepatic lesions ( n =12 ) and diffuse extrahepatic and intrahepatic biliary lesions ( n = 2 ). Through a COXregression, the risk factors were independently associated with ITBL serious hepatitis asthe primary disease( RR:3. 204; P = 0.014)and cold donor ischemic time beyond 11.5 hours (RR: 4. 895; P = 0. 000). All ITBL patients underwent drug therapy,endoscopy(n = 10),operation (n = 6) or re-OLT(n = 7). And improvement was found in 17 patients. ConclusionAvoiding too long old ischemic time of donor liver and carefully evaluating theindications of recipients are effective preventive measures of ITBL. It is crucial toselect a proper treatment according to the conditions of each individual patient.

Objective To evaluate the relationship among the microalbuminuria, surgical stress and postoperative fluid balance after abdominal surgery. Methods A total of 191 patients undergoing an elective abdominal operation were studied. According to the extent of operative trauma, all patients were divided into 4 groups. Group Ⅰ: laparoscopic cholecystectomy ( n = 64); Group Ⅱ: laparotomy of cholecyst and biliary tract ( n = 36); Group Ⅲ: radical surgery of colorectal cancer ( n = 43 ); Group Ⅳ: distal subtotal gastrectomy (D2) or total gastectomy ( D3 ) or pancreaticoduodenectomy ( n = 48 ). The operative severities were predicated by surgical stress score (SSS). Urine albumin-creatinine ratio (ACR) was measured at both pre-and post-operation. The levels of ACR were compared by ANOVA among these 4 groups. The correlation of ACR and SSS was analyzed. In Groups Ⅲ and Ⅳ, body weight was measured by weight-bed simultaneously. The correlation of variation of ACR at 0 and 6 hours post-operation (△ACR) and the volume of positive fluid balance in the first 24 hour post-operation were studied. We also compared the varied durations of ACR levels returning to normal or the pre-operative level and body weight reaching peak values.Results The levels of ACR increased in all groups. The level of ACR was the highest in Group Ⅳ and the lowest in Group Ⅰ , significantly different from the levels of group Ⅱ and Ⅲ. There was a significant positive correlation between the increase in ACR and the severity of surgical trauma as measured by SSS. A positive correlation was observed between the volume of positive fluid balance in the first 24 hour post-ooeration and△ACR at 0 and 6 hours post-operation. The varied duration of ACR levels returning normal or the preoperative level was earlier than that of reaching the peak values. Conclusion ACR has a positive correlation with the extent of surgical stress and volume of positive fluid balance. The fact that the ACR comes earlier than the change of body weight indicates that the change of ACR is a more sensitive and simpler parameter than body weight to predict the onset of negative fluid balance.

Objective To assess the value of intraoperative radiotherapy (IORT) in the combined treatment of locally advanced pancreatic cancer. Methods All patients with locally advanced pancreatic cancer at our hospital from January 2007 to December 2009, judged as unresectable and confirmed by histology or cytology, were recruited into this prospective study. They were randomly assigned into the IORT group (n=31) and control group (n =34). The IORT group received IORT plus internal drainage or laparotomy. The control group had internal drainage or laparotomy only. The evaluation of adverse results of two groups included: intraoperative and postoperative adverse events, recent post-operative side effects,analgesic effect, the level of tumor marker such as CA19-9 and the long-term survival. Results There was no difference in operation duration, intraoperative hemorrhage and postoperative recovery. Significant differences were found in hematotoxicology, analgesic effect, tumor marker decreasing and long-term survival. Conclusion IORT is a safe, reliable and easy-to-master technique without any obvious side effect. Its analgesic effect is better than the control group. Also IORT can retard the tumor growth and improve the patient survival.

Objective To investigate the role of IL-18 and IL-18BP balance in the spleens of patients with primary immune thrombocytopenia (ITP). Methods A total of 12 active ITP patients and 10 normal controls were recruited. Their expressions of 1L-18 and IL-18BP were measured by immunohistochemistry (IHC) and immunofluorescence. The mRNA expressions of IL-18, IL-1 8 BP, IFN-γ and IL-4 were studied by reverse transcription-polymerase chain reaction (RT-PCR) in all subjects. Results The positive rate of IL-18 was higher in the ITP patients than that of the normal control group ( 100% vs 90. 0% ). And the positive rate of IL-18BP was higher in the ITP patients than that of the normal control spleen (83. 3% vs 60. 0% ). The relative amount of mRNA gene expression of IL-18 was increased 6. 0-fold in active patients compared to controls(P ＜ 0. 05). But the elevated mRNA content of IL-18BP failed to compensate for the sharply elevated content of IL-18. As compared with the normal control group, the expression level of IFN-γ mRNA expression was significantly increased 10. 2-fold in ITP patients ( P ＜0. 05). The decrease observed in IL-4 was 41.7% in active patients compared to controls ( P ＜ 0. 05).Conclusion The IL-18/IL-18BP imbalance plays an important role in pathogenesis of ITP and its correction may become a potential therapeutic target for ITP.

：Objective To detect theabnormalities of differentiation and expression of membrane hemopoietic cytokine receptorson CD34 + bone marrow cells in patients with myelodysplastic syndromes (MDS). MethodsForty-five newly diagnosed MDS cases from July 2008 to March 2010 in our hospitaland 30normal controls were enrolled. There were 17 low-risk and 28 high-risk patients. The CD34+ CD38 +and CD34 + CD38- bone marrow cells and the expressions of stem cell factorreceptor (SCF-R),erythropoietin receptor (EpoR), granulocyte colony-stimulating factorreceptors (G-CSFR) and thrombopoietin receptor (TpoR) on those cells were measured by flowcytometry. Results The mean percentage of CD34+ in karyocyte of MDS cases in high-riskpatients [0. 53% (0. 10% - 1.68% )] was significantly higher than that of control group[0. 13% ( 0. 08% - 0. 32% ), P ＜ 0. 01] . The mean percentagesof CD34 + CD38 + cells were significantly lower in low and high-risk groups (86. 3% ±8.5% and 82. 6% ± 11.1% ) than those in control group (92. 3% ± 3.4% ). And thepercentage of CD34+ CD38-cells was significantly higher in either low-risk or high-riskgroup ( 13.7% ±8. 5% and 17.4% ± 11.0% )than that in control group (7.7% ± 3.4%, both P＜ 0. 05 ). In control group, the mean percentage ofantigen expression of EpoR was significantly lower in CD34 + CD38 + cells than that inCD34 + CD38 - cells ( 18.7% ± 18. 3% vs 63. 6% ±20. 0%, P ＜0. 01 ). The expressions ofSCF-R, G-CSFR and TpoR were not significantly different between two cell populations. Theexpressions of EpoR on CD34 + CD38 + cells of low and high-risk MDS groups [9.0% ( 1.4% -12. 7% ), 5. 2% ( 1.1% - 14. 1% )] were significantly lower than those of control group[9. 6% (5.1% - 30. 1% ), both P ＜ 0. 05]. The expressions ofG-CSFR on CD34+CD38+ cells of low and high-risk MDS groups (29.8% ± 19. 1%, 28.7% ±21.1%) were significantly lower than those of control group (44.4% ± 23.4%, both P＜ 0. 05 ). The quantities of EpoR on CD34 + CD38 -cells of low and high-risk MDS groups ( 42. 2% ± 21.9%, 25.7% ± 15. 6% ) weresignificantly lower than those of control group ( 63. 6% ± 20. 0%, both P ＜ 0. 01 ). The expressions of TpoR on CD34+ CD38- cells of low andhigh-risk MDS groups (5.4% ± 4.7%, 4.1% ± 4.0%) were significantly lower than those ofcontrol group ( 10. 1% ± 8. 3%, both P ＜ 0. 05 ). The incidence of cytopenia with low expressionrates of hemopoietic cytokine receptors on CD34 + cells was higher than that of MDS withhigh expression rates. Conclusion The abnormalities of differentiation and membranehemopoietic cytokine receptors expression of CD34 + bone marrow cells in MDS areassociated with MDS cytopenia and may be useful for the diagnosis of MDS.

Objective To study the effect of Thromboxane A2 (TXA2) inhibitor on the proliferation of hypoxic pulmonary artery smooth muscle cells (PASMC) of porcines. Methods The methods of 3(4,5-dimethylthiazol-2-yl) -2,5-diphenyl tetrazolium bromide ( MTT), immunohistochemistry of Ki67 and TdTmediated dUTP nick end labeling(TUNEL) were employed to measure the proliferation, inhibition rate and apoptosis of PASMC. Results U46619, a thromboxane A2 agonist, could promote the proliferation and expression of Ki67 in PASMC under hypoxic and normal conditions. It could also inhibit the apoptosis of PASMC. Ozagrel, a thromboxane A2 inhibiter, inhibited the proliferation and the expression of Ki67 in PASMC under hypoxia. The inhibition rate was 71.4%, but it had no effect on the proliferation and expression of Ki67 in PASMC under normal conditions. It promoted the apoptosis of PASMC. Ozagrel could inhibit the action of U46619 in promoting the proliferation and expression of Ki67 in PASMC and inhibit the apoptosis of PASMC. Conclusion Ozagrel may be used in treating the pulmonary hypertension by inhibiting the proliferation of PASMC, pulmonary vascular remodeling, and promote the apoptosis of PASMC.

Objective To explore the role of homocysteine in the pathogenesis of alcoholic cardiomyopathy. Methods A total of 69 male Wistar rats were randomly assigned into two groups: alcoholfed group and the control. Cardiac function was assessed by pulse Doppler. Plasma Hcy levels were examined using automatic biochemical instrument (chemiluminescence). The protein expression of MMP-9 was evaluated using immunohistochemical method, and collagen fiber of myocardium was quantitative analyzed by Masson stain. Results After heavy drinking, the LVEDd of alcohol-fed group were larger than the control group [( 7. 0 ± 0. 6) mm vs ( 5.0 ± 0. 4 ) mm, P ＜ 0. 05], the LVEF and FS were lower in the 4thmonth(52%±8% vs 78%±4%,31%±3% vs 47%±2%,P ＜0.05), the data changed more significantly (P ＜0. 01 ) in the 6th month. The level of plasma Hcy from alcohol-fed group was significantly higher from the 2nd month than that before the experiment [( 18. 1 ± 3. 1 ) μ mol/L vs ( 9. 8 ± 2. 1 )μ mol/L,P ＜ 0. 01], and it was higher in 4th month than that in 2nd month [(26. 3 ± 4. 0) μmol/L vs (18. 1 ±3. 1) μ mol/L,P＜0.05], it was highest in 6 months. After 4-month and 6-month drinking, the expression of MMP-9 protein from alcohol group was higher than before the experiment (0. 161%±0. 019%,0. 263%±0. 014% vs 0. 050% ± 0. 008%, P ＜ 0. 0l ). Masson staining showed myocardial collagen of alcohol group was more after 4-month and 6-month drinking than those before the experiment ( 10. 23% ±1.20% vs 0. 50%±0. 09%; 22. 41% ± 2. 57% vs 0. 50% ± 0. 09%, P ＜ 0. 01 ). Plasma Hcy and cardiac tissue MMP-9 is a significant positive correlation ( r = 0. 848, P ＜ 0. 01 ). Conclusion Long-term and large drink liquor can lead to plasma Hcy levels significantly increased, and participate cardiac remodeling and the pathogenesis of ACM through increasing the expression of myocardial tissue MMP-9 protein.

The results of a study presented at the 33rd annual meeting of the Cancer Treatment and Research Center of Texas Health Sciences University in San Antonio and the American Society for Cancer Research (CTRC-AACR) (San Antonio Breast Cancer Symposium) held on December 8-12, 2010 in San Antonio, USA, showed that denosumab (a fully human monoclonal antibody against nuclear factor kB receptor activating factor ligand (RANKL), which affects nuclear factor kB receptor activating factor (RANK) binding and inhibits osteoclast activation and development) in the breast cancer and bone metastasis patients were delayed by 5 months compared with the zoledronic acid group.

When more than 90% of the kidney function is lost, patients need dialysis or kidney transplantation to maintain their life.According to reports, about 400,000 dialysis patients in the United States and about 2 million patients in the world need long-term dialysis treatment.About 90% of the patients in the United States and 70% of the patients in Canada receive hemodialysis.The usual hemodialysis is three times a week.The determination of this interval is related to the doctor's experience,patient acceptance and cost.

Clinical data The patient, male, 22 years old, student, was admitted to the hospital on December 27, 2008 due to "cough, expectoration, fever for 1 week and dyspnea for 3 days". The patient developed fever and cough after catching cold 1 week before admission, and his body temperature was about 38℃. Dyspnea developed after 3 days. The chest radiograph of the other hospital showed large infiltration of both lungs and right pleural effusion (Figure 1). After anti-inflammatory treatment (specific medication unknown), it was ineffective, and his condition progressively aggravated and was transferred to the respiratory intensive care (RICU) of the Third Hospital of Peking University. He was in good health and had no tobacco and alcohol habit.

Polyclonal anti-thymocyte/T-lymphocyte globulin (ATG) is prepared by immunizing animals with human thymocytes or lymphocytes, collecting antibodies from serum, isolating and purifying. Because of its powerful immunomodulatory effect, it is widely used to prevent and treat acute rejection of parenchymal organ transplantation, and it is also used in the pretreatment of allogeneic hematopoietic stem cell transplantation to reduce the risk of acute and chronic graft versus host disease (GVHD) after transplantation [1-5].