Volume 92  ·   Issue 34  ·  2012

At present, influenza A/H1N1pdm09 virus is co-circulating with other seasonal viruses (A/H3N2, A/H1N1, B) in the community [1-2]. Human infection with highly pathogenic avian influenza (A/H5N1) also continues to threaten many Asian regions [3]. Typical severe influenza patients often show lower respiratory symptoms and pneumonia, resulting in respiratory distress and hypoxemia. In most cases of A/H5N1 avian influenza, some cases of A/H1N1 influenza and a few seasonal influenza, the disease deteriorates rapidly: patients may need mechanical ventilation because of refractory hypoxemia, and develop acute respiratory distress syndrome (ARDS), multiple organ failure and even death [2-3]. Recent clinical studies have confirmed that some clinical manifestations of severe influenza, such as high fever, shortness of breath, decreased blood oxygen saturation, persistent progression of pneumonia, and many serious complications (such as ARDS, encephalopathy, hemophagocytic syndrome) and even the risk of death, are related to the inflammatory factor storm [4-6].

Breast cancer is one of the common malignant tumors in women, and its incidence is increasing year by year, which seriously threatens women's health. With the progress of early diagnosis and comprehensive treatment of breast cancer, the mortality rate of breast cancer has decreased year by year. In comprehensive treatment, adjuvant chemotherapy after breast cancer operation plays an important role. However, more than 2 billion people in the world have been infected with hepatitis B virus (HBV), and more than 350 million of them are chronically infected [1]. Chronic HBV infected patients are prone to HBV reactivation in the course of immunosuppressive therapy or cytotoxic chemotherapy. For patients receiving adjuvant chemotherapy for breast cancer, the incidence of HBV reactivation is high, ranging from 26% to 56%, which is similar to the incidence of HBV reactivation in hematological malignant tumors [2-3]. Meanwhile, among patients with HBV reactivation, 50% to 70% of patients will postpone chemotherapy or even interrupt chemotherapy, which will affect the prognosis of patients [4]. The clinical diagnosis, treatment and basic research of HBV reactivation in breast cancer patients should be paid attention to in China from the following aspects.

Objective To explore the potential roles of mitochondrial DNA somatic mutations in benign breast disease based on the entire genome of mitochondrial DNA and elucidate the relationship between benign breast disease and breast cancer.Methods The genomic DNA of tumor tissue and peripheral blood in 28 benign breast disease patients with an average age of 33 years ( range:30 - 50) were extracted respectively. According to the revised Cambridge reference sequence and phylogenetic tree reconstruction,the mutations were identified and distinction was made between somatic mutations and private mitochondrial DNA mutations by haplogroup.Results Seven somatic mutations were detected.One mutation was located in the control region whereas the other six lied in the coding region. Further analyses revealed that,out of these 6 coding-region mutations,4 were non-synonymous and would introduce the changes of amino acids.Conclusion The mutations of mitochondrial DNA may play potential roles in the occurrence and development of benign breast disease.

Objective To explore the expression and significance of p53,p21Cip1/WAF1 and Gadd45α protein in breast cancer and their correlations with clinicopathologic features and prognosis in breast cancer.Methods The expressions of p53, p21Cip1/WAF1 and Gadd45α proteins were determined by immunohistochemical staining.The relationship between these three proteins and clinicopathologic features in breast cancer was analyzed by x2 test and Spearman's rank correlation analysis. And the survival analyses were performed with the Kaplan-Meier method and Cox regression.The differences between the curves were examined with the two-tailed Log-rank test.Results In 133 cases of invasive breast cancer,the positive rates of p53,p21Cip1/WAF1 and Gadd45α protein were 58.6％,47.4％ and 41.4％ respectively. The expressions of p21Cip1/WAF1 and p53 in cancer were significantly higher than those in the adjacent mammary gland tissue (P ＜ 0.05 ) while the expression of Gadd45α was lower than that in the control mammary gland tissue (P ＜ 0.05 ). The positive rate of p21Cip1/WAF1 was correlated with the histological stage,local recurrence and positive C-erbB-2. And the positive rate of Gadd45α was correlated with the histological stage,lymph node metastasis,metastasis aud positive estrogen receptor/progesterone receptor (ER/PR).The positive rate of p53 was correlated with the lymph node metastasis and TNM stage.Spearman's rank correlation analysis showed that p21Cip1/WAF1 was correlated positively with p53,p53 negatively with Gadd45αwhile p21Cip1/WAF1 had no correlation with Gadd45α.With the follow-up data,Kaplan-Meier analysis showed that p21 Cip1/WAF1,Gadd45α,p53,lymph node metastasis,C-erbB-2 positive and TMN stage were associated with prognosis.Furthermore,Cox stepwise hazard analysis shows that p21Cip1/WAF1,Gadd45α,C-erbB-2 and TMN stage were correlated with prognosis of breast cancer.Also the Kaplan-Meier analysis showed that p53 ( + ) Gadd45α ( - ) and p53 ( + ) p21Cip1/WAF1 ( + ) were correlated with a poor prognosis of breast cancer.Conclusions The expressions of p21Cip1/WAF1, Gadd45α and p53 are associated with the clinicopathologic features and prognosis in breast cancer. Indicating a poor prognosis of breast cancer,p53 ( + ) Gadd45α ( - ) and p53 ( + ) p21Cip1/WAF1 ( + ) may become independent indices for prognostic evaluations.

Objective To discussion the in vitro molecular mechanism of leptin promoting the expression of hTERT in breast cancer cells.Methods The hTERT mRNA expression of STAT3 knockdown on leptin-induced hTERT was measured by reverse transcription-polymerase chain reaction ( RT-PCR ).Determine the expression of hTERT protein after different treatments in MCF7 by Western blot. Chromatin immunoprecipitation assay ( ChIP ) was performed to detect the binding of STAT3 to hTERT promoter in MCF7.Luciferase assay was used to confirm the effects of leptin and STAT3 phosphorylation inhibitor on the transcriptional activity of hTERT promoter.Results The RT-PCR analysis showed that knockdown of STAT3 significantly reduced the leptin-induced transcription of hTERT.Western blot showed that the expression of hTERT were 3.109 ± 0.051 and 1.025 ± 0.031 after leptin or both of leptin and AG490 treatments.The results of CHIP showed that the mRNA of control and leptin (160 ng/ml) treatment were 1 and 3.311 ± 0.017.Leptin increased the combination of STAT3 and hTERT promoter.Luciferase assay showed that when the concentration of leptin was 160 ng/ml,the hTERT promoter activity was 80.98 ± 0.18 while the control was 20.76 ± 0.31.After AG490 treatment,the hTERT promoter activity was 18.65 ± 0.32,significantly reduced the leptin-induced activity of hTERT promoter.Conclusion Leptin/STAT3 signaling is a novel pathway for the up-regulation of hTERT expression in breast cancer cells.

Objective To explore the relationship between the status of PI3K/mTOR pathway and the therapeutic efficacies of neoadjuvant chemotherapy for breast cancer.Methods A total of 105 patients receiving 4 -6 cycles of taxane-based neoadjuvant chemotherapy at our centre between January 2009 and November 2010 were recruited into this retrospective study.The expressions of PTEN,p-AKT (Ser473) and p-mTOR (Ser2448) were detected by immunohistochemistry before neoadjuvant chemotherapy. We employed pathology to evaluate the therapeutic efficacies and considered complete response (G4) & pathologic complete response (PCR) as efficacious.Fourfold table Chi-square test and binary Logistic regression were used to analyze the relationship between the above features and therapeutic efficacies.Results The overall efficacy rate of neoadjuvant chemotherapy was 58.1％ (61/105) and the PCR rate 27.6％ (29/105).The positive expression rates of PTEN,p-AKT and p-mTOR were 52.4％ (57/105),68.6％ (72/105) and 43.8％ (46/105) respectively.Fourfold table Chi-square test showed the difference between p-mTOR and therapeutic efficacy was significant statistically ( P =0.003 ) and also the difference between pmTOR and PCR ( P =0.001 ). Binary Logistic regression showed the difference between p-mTOR and therapeutic efficiency was significant statistically,and also the difference between p-mTOR and PCR (both P ＜ 0.01 ).The differential expressions of p-mTOR and p-AKT were statistically significant (P =0.000) and so were those of p-AKT and PR (P =0.035).Conclusions The status of p-mTOR has predictive values for taxane-based neoadjuvant chemotherapy. The patients with a low level of p-mTOR are more responsive to thermotherapy while those with a high level of p-mTOR have a worse efficacy.

Objective To elucidate the significance of anti-oxidant protein peroxiredoxin 6 (Prx6) expression in gastric cancer (GC) tissue.Methods Eighty-six GC tissues and 69 para-cancer tissues from surgically resected specimens were included. And the clinico-pathological data were collected by reviewing medical records. Tissue microarray and immunohistochemistry (IHC) were used to detect Prx6 protein expression in tissues.Results Prx6 protein was predominantly expressed in cytoplasm.Its expression rate in GC tissues (32.6％,n =28) was significantly lower than that in para-cancer normal tissues (94.2％,n =65,P ＜ 0.05). And its protein overexpression rate in well and moderately-differentiated GC tissues was significantly higher than that in lowly-differentiated ones (39.6％ (21/53) vs 6.1％ (2/33),P ＜0.05).Prx6 expression in gastric cancer tissues was not significantly related to age and sex of patients,lesion site,depth of invasion,clinical staging,vascular invasion and liver metastasis.Conclusions The level of Prx6 protein is lower in GC tissues than that in normal para-cancer ones.And it is significantly correlated with the differentiation degree of GC.

Objective To explore the influencing factors of platelet transfusion effects in cancer patients.Methods A total of 363 cases of cancer patients undergoing platelet transfusion at our hospital from January 1,2010 to June 30,2011 were enrolled. Only one transfusion was randomly selected for each patient for single-factor analysis.Then a binary Logistic regression analysis was performed with transfusion effects as a dependant variable and the variables with P≤0.2 as covariates in single-factor analysis.Results Among them,there were 280 effective and 83 ineffective transfusions with an overall effective rate of 77.1％.The single-factor analysis revealed that the P values were ＜ 0.05 for age,platelet transfusion history,fever and antibiotic.Logistic analysis of multiple variables showed that platelet transfusion history( 1 -4 times compared to none,OR =1.969,95％ CI:1.135 - 3.417; ≥ 5 times compared to none,OR =5.260,95％ CI:2.344 - 11.806),antibiotic( OR =2.020,95％ CI:1.139 - 3.583),fever( OR =1.789,95％CI:1.015 -3.153) and storage days of platelets(OR =1.559,95％ CI:1.112 - 2.186) wereindependent risk factors.Conclusions Influenced by multiple factors,the effects of platelet transfusion may be improved through reducing unreasonable transfusions,using fewer storage days of platelets and avoiding transfusions during fever and antibiotic uses.

Objective To retrospectively analyze the cytomegalovirus (CMV) antigenemia test and re-test after antiviral chemotherapy in patients with autoimmune and non-autoimmune diseases.Methods CMV Brite kit and indirect immunofluorescence were used to detect CMVpp65 antigenemia in 6471 peripheral blood leukocyte specimens from 5325 clinic and hospitalized patients with clinically suspicious CMV infections from May 2008 to February 2012. And the positive results were defined as episodes of systemic CMV activity.Results In 6471 EDTA- treated peripheral blood specimens,948 ( 14.6％ ) were found with positive CMV antigenemia.The average positive rate from 13 kinds of autoimmune diseases was 34.9％ (670/1922) in which systemic lupus erythematosus patients had the highest (52.4％,551/1052).Meanwhile,the average positive rate from 12 kinds of non-autoimmune diseases was only 6.1％ ( 144/2367 )in which it was 17.3％ (27/156) in patients with respiratory/acute renal failure, acquired immunodeficiency syndrome (MDS) and kidney transplant recipients. And 189 patients with positive antigenemia were re-tested after antiviral chemotherapy and only 64 (33.9％) were converted negatively.Conclusions Patients with autoimmune diseases have replaced traditionally imnunocompromised patients,e.g.AIDS and kidney transplant recipient,to become the highest risk group of systemic CMV activity.Negative conversion rate of CMV antigenemia is low after antiviral chemotherapy.

Objective To evaluate the risk factors of recurrent pulmonary thromboembolism (PTE) through Meta-analysis.Methods Chinese Journal Full-text Database, Chinese Biomedical Database,PubMed and Foreign Medical Journal Full-Text Service were searched for the paper relating to the risk factors of recurrent PTE from January 1995 to May 2011. And the references of these studies were also examined.Observational studies (cohort & case control) were assessed according to the method of quality assessment suggested within the references. Randomized control trials (RCTs) were assessed by the Jadad scale.Software RevMan 5.1 was used to examin the heterogeneity of trials.The fixed or random effect model was pooled to calculate the risk ratio (RR).And the results were expressed by RR (95％ CI).Results Fortytwo trials including 36 909 cases of PTE and/or deep vein thrombosis were analyzed. And the following factors were relative to recurrence:elevated D-dimer ( 1.77 ( 1.34 - 2.36 ),P =0.000 ),idiopathic PTE (1.82(1.61 -2.05),P =0.000),right ventricular dysfunction (RVD) (persistent RVD vs RVD regression (8.71 (2.38 - 31.91 ),P =0.001 ) ; persistent RVD vs non-RVD (2.45 ( 1.26 - 4.76),P =0.008),short anticoagulation duration ( 1.73 ( 1.32 - 2.28),P =0.000),increased endogenous thrombin generation capacity ( 1.89 ( 1.39 - 2.56 ),P =0.000 ),elevated factor Ⅷ ( 1.96 ( 1.40 - 2.74 ),P =0.000),positive antiphospholipid antibodies (5.64 (4.09 - 7.77 ),P =0.000),anti-thrombin defect (2.45(1.26-4.76),P=0.008) and males (1.47(1.06-2.03),P=0.020),etc.When multiple factors co-existed,the risk of recurrence became more obvious.Conclusions Elevated D-dimer,idiopathic PTE and many other factors may influence the recurrence of pulmonary embolism. And most recurrent patients have two or more factors.

Objective To explore the clinical features and prognostic factors of newly-diagnosed multiple myeloma ( MM ) with extramedullary ( EM ) involvements.Methods The clinical features,efficacies,survival rates and prognostic factors were retrospectively analyzed in 46 MM patients with EM (group A) from January 2000 to October 2011.And another 53 MM patients without EM (group B) were selected as the controls.Results The median age of Group A was 58 years.Compared with group B,the incidence of EM was associated with a higher level of β2-microglobulin ( β2-MG ) and extensive bone disease.The most common location of EM was soft tissues.And the total effective rates of groups A and B were 58.5％ (24/41) and 78.8％ (41/52) respectively.The difference was statistically significant ( P =0.042).The median follow-up time was 28 (2 -88) months.The estimated overall survival (OS) of the patients with EM was significantly shorter than those without EM (42.6 vs 53.9 months,P =0.009).Logrank univariate analysis showed that the number of osteolytic lesions ≥3,β2-MG≥5.5 mg/L,hemoglobin ≤110 g/L and albunin ≤30 g/L were poor prognostic factors in MM patients with EM. Multivariate analysis with Cox model showed only the number of osteolytic lesions ≥ 3 ( OR =2.327,95 ％ CI:1.282 - 4.224 ) and β2-MG≥ 5.5 mg/L ( OR =2.677,95％ CI:1.092 - 6.566 ) were statistically significant.Conclusions Multiple EM lesions may be involved in MM patients.For the patients with EM,the response to conventional chemotherapy is poor and the prognosis is unfavorable,especially for those with a high level of β2-MG or the number of osteolvtic lesions ≥ 3.

Objective To compare the different establishing conditions of hyperinsulinemic euglycemic clamp technique among the groups of normal glucose tolerance (NGT),hyperinsulinemia with normal glucose (HINS) and impaired glucose tolerance (IGT).Methods The hyperinsulinemic-euglycemic clamp technique was applied to the study of methodology in 10 NGT,11 HINS and 10 IGT subjects.Different establishing conditions were compared through variance analysis (ANOVA) among three groups.And the influencing factors resulting in these differences were analyzed through stepwise regression analysis.Results The serum insulin concentration of three groups were acutely raised and maintained at above 100 mU/L. During the steady stage,the blood glucose level remained stable and all coefficient variations were under 5％. The secretion of endogenous insulin and hepatic glucose production were completely inhibited during the test.Under these steady-state hyperinsulinemic-euglycemic conditions,the glucose infusion rate (M value) was equal to glucose disposal rate by all tissues in body,M value of three groups were as follows:( 11.6 ± 1.7),(6.1 ± 1.9) and ( 6.0 ± 1.5 ) mg · kg-1 · min - 1 During clamping,the peak and steady-state serum insulin concentrations of IGT and HINS groups were significantly higher than those of NGT group. Although the peak and steady-state serum insulin concentration of HINS group were higher than those of IGT group,the differences had no statistical significance (P =0.34,0.11 ). The independent influencing factor of peak serum insulin concentration was waist-to-hip ratio (WHR) while the independent influencing factors of steady-state serum insulin concentration included insulin metabolic clearance rate (MCR) and body mass index (BMI).The peak and steady-state serum insulin concentrations were not the independent influencing factors of M value.Conclusion During the establishment of hyperinsulinemic-euglycemic clamp technique, the differences in peak and steady-state serum insulin concentrations existed among NGT,HINS and IGT groups.But the differences do not influence the use of M value in the evaluation of insulin resistance.

Objective To explore the relationship of the impairment of human umbilical vein endothelial cell (HUVEC) with amyloid-β.Methods HUVECs were cultured in the serum of patients with type 2 diabetes mellitus (DM) or serum of healthy control (HC),while fetal bovine serum (FBS) was used as a negative control.The proliferative activity of HUVEC were assessed by thiazoyl blue tetrazolium bromide (MTT) after 72 h. The supernatant concentrations of superoxide dismutase (SOD),maleic dialdehyde (MDA),nitric oxide (NO),amyloid-β40 (Aβ40) and Aβ42 were measured after 0.5,3 and 72 h respectively.Results Glycosylated hemoglobin values,fasting plasma glucose and fasting plasma Aβ40 concentrations of diatbetic patients were higher than those of healthy counterparts ( P ＜ 0.01 ).Proliferativeactivity of HUVECs in group DM were significantly lower than that of group HC.Both group and the time of intervention had crossover effects on the levels of MDA,SOD,NO and Aβ40 ( ( 163 ± 64 ),(207 ±69 ),(286 ±75) ng/L in group DM; (146 ±76),(154 ±75),(161 ±72) ng/L in group HC after 0.5,3 and 72 h,P ＜0.05) and Aβ42 ( (48 ±46),(54 ±43),(79 ±44) ng/L in group DM; (41 ± 12),(44 ±16),(48 ± 12) ng/L in group HC after 0.5,3 and 72 h,P ＜0.05).With the elongating time of intervention,the levels of SOD and NO decreased significantly in group DM and reached the lowest after 72 h while increased significantly in groups HC and FBS and peaked after 72 h.The concentrations of MDA,Aβ40 and Aβ42 increased significantly in all three groups while the fastest and marked increments were found in group DM ( P ＜ 0.01 ).Pearson correlation analysis showed that SOD was negatively correlated with Aβ40 (r=-0.482,P=0.02)and Aβ42 (r=-0.422,P=0.02) while MDA positively with Aβ40 (r=0.418,P＜0.05) and Aβ42 (r=0.833,P＜0.05) after72 h.Conclusion Oxidative stress of vascular endothelial cells may be correlated with Aβ40 and Aβ42 in diabetes.

Objective To identify the novel mutations in the GATA6 gene associated with tetralogy of Fallot (TOF). Methods The clinical data and blood samples from 120 unrelated Han Chinese TOF patients and 200 unrelated ethnically matched healthy controls were collected.The coding exons and flanking splice junctions of GATA6 gene were amplified by polymerase chain reaction and sequenced by the technique of di-deoxynucleotide chain termination. The acquired sequences were aligned with those derived from GenBank by the aid of program BLAST to identify the sequence variations. The software ClustalW was applied for the conservation analysis of altered amino acids. The pathogenic probability for each sequence variation was predicted automatically by software MutationTaster.Results Three novel heterozygous missense GATA6 mutations were identified in 3 TOF patients.Specifically,the triplet substitutions of CTC for CCC at codon 73,CGC for AGC at codon 364 and GGC for GCC at codon 591,predicting the transitions of proline into leucine at amino acid residue 73 (p.P73L),serine into arginine at amino acid residue 364 (p.S364R) and alanine into glycine at amino acid residue 591 (p.A591 G),were detected.None of three mutations was observed in 200 healthy controls. A cross-species alignment of GATA6 encoded protein sequences showed that the mutated atnino acids were highly conserved evolutionarily and all 3 mutations were predicted to be pathogenic.Conclusions Novel mutations are identified in the GATA6 gene associated with TOF.Such a finding may contribute to an early prophylaxis and therapy of TOF.

Objective PPARα,which is expressed in the liver,heart,skeletal muscle,and kidney,regulates lipid and lipoprotein metabolism. The aim of this study was to investigate the association between the PPARα gene and essential hypertension (EH) using a haplotype-based cohort study in a Chinese-Han population.Methods 820 subjects (270 males,550 females) were genotyped for the three single-nucleotide polymorphisms used as genetic marker for the PPARα gene (rs1800206,rs4253778 and rs135539). Individual polymorphism and haplotype data were available for analyses.Results In the dominant model,the presence of the G allele of rs1800206 and the C allele of rs135539 were at a decreased risk of EH (OR=0.48,95％CI0.40-0.64,P＜0.01; OR=0.75,95％CI0.62-0.93,P＜0.01,respectively).A 3.16-fold increase (95 ％ CI 1.86 - 6.94,P =0.002) in the risk of the development of EH was observed in homozygous genotype (CC) of rs4253778 compared to carriers of GG genotype (co-dominant model). The A-G-V and C-G-V haplotype (established by rs135539,rs4253778, rs1800206) was associated with a statistically significant decreased risk of EH ( OR =0.56,95％ CI0.33 - 0.83,P =0.027; OR=0.53,95％CI0.30-0.84,P=0.033,respectively).Conclusion These results may help to clarify the role of PPARα gene in EH and the evaluation of its polymorphisms and haplotypes as being characterized as genetic decreased risk factors for EH.

Objective To explore the mechanism and effectiveness of inducing severe acute pancreatitis (SAP) with saline saturated hydrogen in rats.Methods Based on a random number table,54 Sprague-Dawley rats were divided into 3 groups:control,SAP and treatment (n =18 each).The model of SAP was established by a retrograde injection of 5％ sodium taurocholate into biliary -pancreatic duct.The treatment group received an injection of 5 ml/kg hydrogen-rich saline into tail vein at 1 h post-modeling.The control group underwent only pancreatic tipping. All rats were exsanguinated under anesthesia by aortal puncture after 24 hours.The serum levels of tumor necrosis factor-alpha (TNF-α),interleukin-6 (IL-6) and interleukin-18 (IL-18) in 3 groups were measured by enzyme-linked immunosorbent assay (ELISA).The expression of TNF-αmRNA in pancreatic tissue was measured by reverse transcription ( RT)-PCR.And intercellular adhesion molecule-1 (ICAM-1) in pancreatic tissue was measured by immunohistochemistry.The pancreatic tissues were harvested to examine the microscopic changes.The levels of malonic aldehyde (MDA),myeloperoxidase (MPO),superoxide dismutase (SOD) and glutathione (GSH) in pancreatic tissue was measured by specific kits.Results The pathological scores of pancreatic tissue were significantly lower in the treatment group than those in the SAP group(9.7 ±2.0 vs 13.2 ±2.5,P ＜0.05).The serum level of TNF-αwas significantly lower in the treatment group than that in the SAP group ((88 ± 17) vs ( 1171 ± 18) pg/ml,P ＜ 0.05). And the serum levels of IL-6 and IL-18 were lower in the treatment group than those in the SAP group ((25.2 ±5.9) Vs (37.3 ±4.6) ng/L,(401 ± 100) vs (439 ± 103) ng/L,both P ＜ 0.05). As compared with the SAP group,the levels of MDA and MPO decreased significantly in the treatment group ( (8.2 ± 2.8 ) vs ( 14.7 ± 2.7) nmol/mg,(0.040 ± 0.011 ) vs (0.170 ± 0.071 ) U/g,both P ＜0.05).However,the levels of SOD and GSH significantly higher than those of the treatment group ((22.1±1.3) Vs (15.1 ±1.7) U/mg,(4.8±0.4) Vs (2.5±0.3) U/mg,both P＜0.05).The expressions of TNF-α mRNA and ICAM-1 in pancreatic tissues were lower than those of the treatment group (0.33 ± 0.17 vs 0.94 ± 0.31, 2.0 ± 0.4 vs 2.8 ± 0.8, both P ＜ 0.05). Conclusion Hydrogen-rich saline can decrease the levels of inflammatory mediators and reduce the pathological damage of pancreas through the inhibition of oxidative stress.

A 70-year-old male was admitted to the Department of Endocrinology of Peking Union Medical College Hospital on February 24, 2011 due to repeated fatigue, anorexia, dizziness and dizziness. The patient developed fatigue, anorexia, dizziness, irritability, unsteady walking, headache, vomiting, blurred vision and disturbance of consciousness without inducement in early August 2010. The blood sodium was significantly decreased (114 mmol/L), blood chloride was decreased (83.1 mmol/L), blood glucose was increased (11.1 mmol/L), glycosylated hemoglobin was increased (9.7%), 24-h urinary sodium was increased (267.9 mmol), blood neuron-specific enolase (NSE) was increased (44.01 μ g/L), carcinoembryonic antigen (CEA) was increased (7.36 μ g/L), and the posterior pituitary signal on pituitary MRI:T1 weighted image was decreased.

Statins are inhibitors of 3-hydroxy-3-methylglutaryl-coenzyme A (HMG CoA) reductase, and are the most classical and effective lipid-lowering drugs at present. They have been widely used in the prevention and treatment of cardiovascular and cerebrovascular diseases. Recent studies have shown that statins have anti-atherosclerotic effects, anti-inflammatory response, anti-oxidative damage, immunoregulation and even inhibition of pathogenic microorganisms, and systemic or local inflammatory response, immune disorder and pathogenic microorganism infection are involved in the pathogenesis of chronic obstructive pulmonary disease (COPD), acute lung injury/acute respiratory distress syndrome (ALI/ARDS) and pneumonia.

In the theoretical genealogy of the reconstruction of professional spirit, the status (role) agreement of "sacredness" of medicine (which implies the "purity" of doctors) is the most worthy of further study. It is the foundation of love and dignity and the cornerstone of professional spirit. The general moral argument is biased towards simplicity, that is, because of the sacredness of individual life, only because of the sacred life trust, medicine (doctors) must repay the sacredness (purity). Obviously, this explanation is not enough to reveal the richness of medical ethical circumstances. Why medicine is sacred should become an independent value proposition, not only a transmission of life value.