Clinical application of PD-1/PD-L1 to prognosis prediction and treatment of triple-negative breast cancer / 上海交通大学学报（医学版）

Programmed death-1 (PD-1) receptor and programmed death-ligand 1 (PD-L1) as a pair of T cell immune response co-stimulatory molecules play a negative role in adoptive immunity by inhibiting T lymphocyte function. Blocking the PD-1/PD-L1 signaling pathway has been a hot spot of research and treatment of cancer. Triple-negative breast cancer (TNBC) is an aggressive subtype of breast cancer, and there is no approved targeted therapy. Immunotherapy represented by PD-1/PD-L1 blockers, is getting widely studied due to the medical potential of therapy for TNBC. Thereinto, the clinical researches of the monoclonal antibodies against PD-1 or PD-L1 have brought a promising future for the treatment of metastatic TNBC. Currently, there are several trials with anti-PD-1 or anti-PD-L1 monoclonal antibodies and their combination with other therapies in salvage, neoadjuvant, and adjuvant settings on going. In this article, the authors review the current studies about potential value of PD-1/PD-L1 in prognosis, prediction, and treatment in TNBC, intending to cast insight on future basic and clinical studies.

Clinical Features of Relapsing Polychondritis Patients Presented with Arthropathy / 中国医学科学院学报

Objective To explore the clinical characteristics of relapsing polychondritis(RP)patients presented with arthropathy. Methods We retrospectively analyzed the clinical data of 201 RP patients who were hospitalized in our center between December 2005 and February 2019.After 16 patients with co-existing other autoimmune diseases and malignancies were ruled out,185 RP patients entered the final analysis,among whom 16 RP patients were presented with arthropathy and 169 without arthropathy.The demographic data,clinical manifestations,laboratory findings,and prognosis were compared between these two groups. Results Five of the 16 RP patients with arthropathy at presentation were misdiagnosed as rheumatoid arthritis.Compared with RP patients without arthropathy at presentation,RP patients with arthropathy at presentation had a longer disease course[(37.50±66.50)months

Survey on physicians who engage in cancer diagnosis and treatment from third-grade class A hospitals regarding the perceptions of cancer patients' fertility preservation / 上海交通大学学报（医学版）

Objective: To explore the perceptions and current practice barriers of Chinese physicians who engage in cancer diagnosis and treatment from third-grade Class A hospitals regarding cancer patients' perceptions of fertility preservation (FP). Methods: A study was conducted in physicians from 4 third-grade Class A hospitals with different clinical specialties assisting cancer patients through a structured self-report questionnaire between January 2017 and December 2017. A total of 179 medical oncologists, 77 radiation oncologists and 79 surgeons were included. Their information on gender, age, title, education background and perceptions of FP was obtained. Logistic regression analysis was used to examine the correlation between the recommendation of FP and risk factors. Results: There were 335 physicians, including 88 male physicians and 247 female physicians, with an average age of (35.94±6.27) years (range from 23-59 years) in the current study. Although 96.4% of the physicians knew that chemotherapy and radiation had a profound effect on impairment of fertility and 85.1% of them thought it was necessary to recommend FP, only 28.1% of them gave FP-related recommendations to the cancer patients. The oncologists and surgeons, female physicians, and those with higher professional titles and education background were more likely to make the FP recommendation. Among 63.3% of the physicians knowing male FP, only 37.9% and 21.2% of them noted the exact methods and place for FP, respectively. Similarly, for the 65.1% of the physicians knowing female FP, the percentage was 49.9% and 24.5%, respectively. When it came to the barriers of FP decision-making, 32.8% of the oncologists reported their concerns on whether cancer patients were suitable to reproduce. Secondly, the physicians honestly admitted that they lacked expertise in FP and worried about that FP would delay cancer treatment. Conclusion: Physicians who engage in cancer diagnosis and treatment lack the awareness and knowledge background of FP recommendation for cancer patients. It is important to improve the perceptions of cancer patients' FP through standardize training.

Survey on physicians who engage in cancer diagnosis and treatment from third-grade class A hospitals regarding the perceptions of cancer patients' fertility preservation / 上海交通大学学报（医学版）

Objective · To explore the perceptions and current practice barriers of Chinese physicians who engage in cancer diagnosis and treatment from third-grade Class A hospitals regarding cancer patients' perceptions of fertility preservation (FP).Methods · A study was conducted in physicians from 4 third-grade Class A hospitals with different clinical specialties assisting cancer patients through a structured self-report questionnaire between January 2017 and December 2017.A total of 179 medical oncologists,77 radiation oncologists and 79 surgeons were included.Their information on gender,age,title,education background and perceptions of FP was obtained.Logistic regression analysis was used to examine the correlation between the recommendation of FP and risk factors.Results· There were 335 physicians,including 88 male physicians and 247 female physicians,with an average age of (35.94±6.27) years (range from 23-59 years) in the current study.Although 96.4％ of the physicians knew that chemotherapy and radiation had a profound effect on impairment of fertility and 85.1％ of them thought it was necessary to recommend FP,only 28.1％ of them gave FP-related recommendations to the cancer patients.The oncologists and surgeons,female physicians,and those with higher professional titles and education background were more likely to make the FP recommendation.Among 63.3％ of the physicians knowing male FP,only 37.9％ and 21.2％ of them noted the exact methods and place for FP,respectively.Similarly,for the 65.1％ of the physicians knowing female FP,the percentage was 49.9％ and 24.5％,respectively.When it came to the barriers of FP decision-making,32.8％ of the oncologists reported their concerns on whether cancer patients were suitable to reproduce.Secondly,the physicians honestly admitted that they lacked expertise in FP and worried about that FP would delay cancer treatment.Conclusion· Physicians who engage in cancer diagnosis and treatment lack the awareness and knowledge background of FP recommendation for cancer patients.It is important to improve the perceptions of cancer patients' FP through standardize training.

Role of miR-206/CDK4 in modulating the growth and chemotlerapy sensitivity of ovarian cancer cells / 南方医科大学学报

<p><b>OBJECTIVE</b>To explore role of miR-206 in modulating the growth and chemotherapy sensitivity in ovarian cancer cells.</p><p><b>METHODS</b>Real-time PCR was used to detect the expression of miR-206 in ovarian cancer and normal ovarian tissues. Ovarian cancer SKOV3 cells were transfected with a miR-206 mimic or a specific inhibitor of miR-206, and MTT assay and flow cytometry were used to detect the changes in cell growth and cell cycle transition. Western blotting and luciferase reporter gene assay were employed to identify the target gene and signal pathways of miR-206. The effect of miR-206 on the sensitivity of ovarian cancer cells to 5-Fu was assessed.</p><p><b>RESULTS</b>miR-206 was down-regulated in ovarian cancer tissues compared to normal ovarian tissues. Transfection of SKOV3 cells with the miR-206 mimic resulted in obvious growth suppression and delayed cell cycle transition from G1 to S phase by suppressing CDK4, c-Myc, and CCND1 expressions. Transfection with the miR-206 inhibitor obviously promoted the cell growth and significantly increased CDK4 expression in the cells. Luciferase reporter gene assay indicated that miR-206 could directly bind to the 3'UTR of CDK4 gene and reduce the activity of luciferase. Transfection of SKOV3 cells with miR-206 significantly lowered the ICof 5-Fu to enhance the chemotherapy sensitivity of the cells to 5-Fu.</p><p><b>CONCLUSION</b>As a potential tumor suppressor, miR-206 directly targets CDK4 to suppress the cell growth and enhance the chemotherapy sensitivity to 5-Fu in ovarian cancer cells in vitro.</p>

Types of Organ Involvement in Patients with Immunoglobulin G4-related Disease / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Immunoglobulin G4-related disease (IgG4-RD) is a newly recognized systemic disease that can involve multiple organs and various clinical phenotypes. The purpose of this study was to analyze different types of organ involvement in IgG4-RD patients in China.</p><p><b>METHODS</b>We conducted a prospective cohort study on IgG4-RD patients to analyze the clinical manifestations and rare features of IgG4-RD. Patients were grouped into different types according to organ involvement regarding organ number and organ site. The constituent ratio in different types was also analyzed.</p><p><b>RESULTS</b>A total of 200 IgG4-RD patients, with a male:female ratio of 2.08:1, were grouped into different types. Cases having involvement of two or three organs were the most common whereas the fewest number of patients had multi-organ (≥4) involvement. Serum IgG4 and IgE levels, IgG4/IgG ratio, and percentage of eosinophils increased as the number of involved organs increased. In addition, constituent ratio analysis revealed that patients with salivary gland/lacrimal gland swelling, who also constituted the largest number of IgG4-RD patients, had higher serum IgG4 concentrations and IgG4/IgG values, had higher percentage of Eos, and were more likely to have had a history of allergies relative to patients with internal organ involvement.</p><p><b>CONCLUSIONS</b>The characteristic feature of IgG4-RD is multiple organ involvement with various clinical manifestations and different types. Although serum IgG4 levels increased with the number of involved organs, serum IgG4 levels were higher for those patients with salivary gland/lacrimal gland swelling compared with those with internal organ involvement. Thus, valuable clues to the differential diagnosis of IgG4-RD could be obtained by examining the clinical patterns of organ involvement.</p>

Expression of CDK6 in early ovarian cancer and its clinical significance / 南方医科大学学报

<p><b>OBJECTIVE</b>To explore the expression of CDK6 in early ovarian cancer and explore its clinical significance.</p><p><b>METHODS</b>Real-time PCR and immunohistochemistry was used to examine the differential expression of CDK6 mRNA and protein in ovarian cancer and normal ovarian tissues. The correlation of CDK6 expression with the clinical characteristics and prognosis of the patients was analyzed.</p><p><b>RESULTS</b>The expression of CDK6 mRNA was obviously up-regulated in 36 ovarian cancer tissues as compared to that in 16 ovarian tissues. Immunohistochemistry demonstrated that CDK6 protein was expressed in both the cytoplasm and cell nuclei. Compared with the 48 normal ovarian tissues, the 121 ovarian cancer tissues showed significantly up-regulated CDK6 protein expression (P=0.044). Increased CDK6 protein expression was not significantly correlated with the clinical features of the patients with ovarian cancer, but showed a significant negative correlation with the patients' prognosis (P=0.006). Multivariate analysis suggested that CDK6 expression level was an independent prognostic indicator (P=0.008) for the survival of patients with ovarian cancer.</p><p><b>CONCLUSION</b>Increased CDK6 protein expression may promote the development and progression of early ovarian cancer.</p>

Diagnostic Value of T-cell Interferon-γ Release Assays on Synovial Fluid for Articular Tuberculosis: A Pilot Study / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Tuberculosis (TB) remains a major global public health challenge. Articular TB is an important form of extrapulmonary tuberculosis, and its diagnosis is difficult because of the low sensitivity of traditional methods. The aim of this study was to analyze the diagnostic value of T-SPOT.TB on synovial fluid for the diagnosis of articular TB.</p><p><b>METHODS</b>Patients with suspected articular TB were enrolled consecutively between August 2011 and December 2015. T-SPOT.TB was performed on both synovial fluid mononuclear cells (SFMCs) and peripheral blood mononuclear cells (PBMCs). The final diagnosis of articular TB was independent of the T-SPOT.TB result. The diagnostic sensitivity, specificity, predictive value, and likelihood ratio of T-SPOT.TB on SFMCs and PBMCs were analyzed.</p><p><b>RESULTS</b>Twenty patients with suspected articular TB were enrolled. Six were diagnosed with articular TB, and 14 patients were diagnosed with other diseases. Sensitivity and specificity were 83% and 86% for T-SPOT.TB on SFMCs, and 67% and 69% for T-SPOT.TB on PBMCs, respectively. The positive predictive value (PPV) and negative predictive value (NPV) of T-SPOT.TB on SFMCs were 71% and 92%, respectively. The PPV and NPV were 50% and 82% for T-SPOT.TB on PBMCs.</p><p><b>CONCLUSION</b>Sensitivity, specificity, and NPV of T-SPOT.TB on SFMCs appeared higher than that on PBMCs, indicating that T-SPOT.TB on SFMCs might be a rapid and accurate diagnostic test for articular TB.</p>

Association Study of a Proliferation-inducing Ligand, Spermatogenesis Associated 8, Platelet-derived Growth Factor Receptor-alpha, and POLB Polymorphisms with Systemic Lupus Erythematosus in Chinese Han Population / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Systemic lupus erythematosus (SLE) is a prototypic autoimmune disease with complex genetic inheritance. This study was conducted to examine whether the association of a proliferation-inducing ligand (APRIL), spermatogenesis associated 8 (SPATA8), platelet-derived growth factor receptor-alpha (PDGFRA), and DNA polymerase beta (POLB) with SLE can be replicated in a Chinese Han population.</p><p><b>METHODS</b>Chinese SLE patients (n = 1247) and ethnically and geographically matched healthy controls (n = 1440) were genotyped for the APRIL, SPATA8, PDGFRA, and POLB single-nucleotide polymorphisms (SNPs), rs3803800, rs8023715, rs1364989, and rs12678588 using the Sequenom MassARRAY System.</p><p><b>RESULTS</b>The Chinese Han SLE patients and controls had statistically similar frequencies of alleles and genotypes of four gene polymorphisms. Moreover, no association signal was detected on different genetic models (additive, dominant, and recessive, all, P> 0.05) or in SLE subgroups stratified by various clinical manifestations (all, P> 0.05).</p><p><b>CONCLUSIONS</b>Different genetic backgrounds from different ancestries and various populations may result in different genetic risk factors for SLE. We did not detect any significant association with SNPs of APRIL, SPATA8, PDGFRA, and POLB.</p>

Lupus Myocarditis: A Case-Control Study from China / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Myocarditis is an uncommon but serious manifestation of systemic lupus erythematosus (SLE). This study aimed to investigate clinical characteristics and outcomes of lupus myocarditis (LM) and to determine risk factors of LM in hospitalized Chinese patients with SLE.</p><p><b>METHODS</b>We conducted a retrospective case-control study. A total of 25 patients with LM from 2001 to 2012 were enrolled as the study group, and 100 patients with SLE but without LM were randomly pooled as the control group. Univariable analysis was performed using Chi-square tests for categorical variables, and the Student's t-test or Mann-Whitney U-test was performed for continuous variables according to the normality.</p><p><b>RESULTS</b>LM presented as the initial manifestation of SLE in 7 patients (28%) and occurred mostly at earlier stages compared to the controls (20.88 ± 35.73 vs. 44.08 ± 61.56 months, P = 0.008). Twenty-one patients (84%) experienced episodes of symptomatic heart failure. Echocardiography showed that 23 patients (92%) had decreased left ventricular ejection fraction (<50%) and all patients had wall motion abnormalities. A high SLE Disease Activity Index was the independent risk factor in the development of LM (odds ratio = 1.322, P < 0.001). With aggressive immunosuppressive therapies, most patients achieved satisfactory outcome. The in-hospital mortality was not significantly higher in the LM group than in the controls (4% vs. 2%,P = 0.491).</p><p><b>CONCLUSIONS</b>LM could result in cardiac dysfunction and even sudden death. High SLE disease activity might potentially predict the occurrence of LM at the early stage of SLE. Characteristic echocardiographic findings could confirm the diagnosis of LM. Early aggressive immunosuppressive therapy could improve the cardiac outcome of LM.</p>

Abnormal expression of CD43 in patients with systemic lupus erythematosus and its clinical significance / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Previous studies indicate that CD43 plays a role in regulating the adhesion of lymphocytes, cell mutation and activation, however, little is known about its effect on systemic lupus erythematosus (SLE). This study was designed to explore the clinical significance of CD43 in SLE patients.</p><p><b>METHODS</b>We used microarray and real-time PCR to detect the mRNA and protein expression of magnetic bead sorted T cells and B cells from peripheral blood mononuclear cells (PBMCs) of SLE patients, and analyzed the relationship between CD43 and the clinical indexes.</p><p><b>RESULTS</b>Both microarray and real-time PCR results showed that CD43 mRNA was significantly decreased in PBMCs of SLE patients compared with healthy controls (P < 0.001). There were no significant differences between lupus nephritis and non-lupus nephritis patients, and neuropsychiatric and non-neuropsychiatric patients. CD43 mRNA expression was significantly reduced in T cells but not in B-cells in SLE patients compared to healthy controls (P < 0.01). Compared with healthy controls, the percentage of CD43(+) cells in the PBMCs of SLE was significantly decreased (P = 0.004), and the CD43 fluorescence intensity in CD3(+)/CD43(+) cells and CD19(+)/CD43(+) cells was also significantly weaker than in healthy controls (P = 0.039 and 0.003). There was no significant difference in the percentage of CD3(+)/CD43(+) cells, CD19(+)/CD43(+) cells between the two groups. The CD43 fluorescence intensity in CD3(+)/CD43(+) cells was inversely correlated with the levels of IgG and IgM (r = -0.8 and -0.6).</p><p><b>CONCLUSIONS</b>Compared to healthy controls, both CD43 mRNA and protein expressions were reduced in T cells from patients with SLE, and were inversely correlated with IgG.</p>

An open-label trial on the safety of recombinant human tumor necrosis factor-Fc treatment in Chinese rheumatic diseases patients / 中华风湿病学杂志

Objective To compare the safety of recombinant human tumor necrosis factor-Fc (rhTNFR:Fc) and other DMARDs,in patients with rheumatoid arthritis (RA),ankylosing spondylitis (AS),juvenile idiopathetic arthritis (JIA) or psoriatic arthritis (PsA).Methods Patients who received rhTNFR:Fc 25 mg twice weekly from May 2006 to March 2009 were involved in this open-lable study.Safety assessments were carried out at regular intervals.Results Of the 2014 patients enrolled in the open-label trial,1388,421 and 232 were RA,AS or other diseases,such as JIA and P.sA respectively.Frequent adverse events included injection-site reactions (2.67％),rash (1.87％) and hyperamino transferase (1.80％) in RA patients.Similarly,injection-site reactions (5.23％),hyperaminotransferase (2.38％) and rash (0.71％) were frequent in AS patients.Upper respiratory infection was most frequent among infectious adverse events.There were no reports of patients with serious adverse events,dead case,TB infection and malignancies.Conclusion rhTNFR:Fc has shown a favourable safety profile in Chinese rheumatic disease patients.

Study on clinical characteristics and therapeutic outcomes of 173 patients with Takayasu arteritis / 中华风湿病学杂志

ObjectiveTo study the clinical features, arterial involvement, therapeutic strategies and outcomes of Takayasu arteritis (TA). MethodsThe clinical symptoms, arterial images, inflammatory parameters and follow-up information of 173 patients with TA were retrospectively studied. Comparisons between groups were performed by t-test. ResultsThere were 136 female and 37 male patients in this study. The mean age at onset was(26±11 ) years. Hypertension, pulse deficit or asymmetrical pulse, and fever were present in 46.6％, 41.1％, 28.7％ of patients, respectively. The distribution of arterial involvement were 64.7％in aorta, 9.8％ in pulmonary artery, 19.1％ in innominate artery, 65.9％ in common carotid arteries, 65.3％in the subclavian artery, 36.2％ in the renal artery, 12.1％ in the vertebral artery, and 5.8％ in coeliac axis.Elevated erythrocyte sedimentation rate(ESR) was found in 61.0％ patients. Active tuberculosis or history of tuberculosis was implicated in 45 patients(26.0％). Ten patients(5.8％) were hepatitis B virus carriers.Among 105 followed-up patients, 98 patients(94.2％) achieved persistent remission, 17 patients relapsed when corticosteroids were tapered. ConclusionCorticosteroids combined with or steroid alone, supplemented with endovascular intervention procedures or surgical bypass procedures when necessary, can effectively control the clinical symptoms and inflammatory parameters and improve the quality of life of patients.

Clinical research of low energy ultrasonic cavitation in treatment of solid tumors / 肿瘤

Objective: To observe the recent efficacy, long-term survival and the side effects of low energy ultrasonic cavitation in treatment of 53 patients with solid tumors. Methods: Fifty-three patients with solid tumors were randomly divided into three groups: group A (18 patients received low energy ultrasonic cavitation therapy combined with chemotherapy), group B (18 patients received chemotherapy alone) and group C (17 patients received low energy ultrasonic cavitation therapy alone). Low energy ultrasonic cavitation therapy was administrated five days in one week for 2 weeks or three times each week for 3 weeks. Results: All fifty-three patients were included in the analysis. In group A, one case achieved complete response (CR), 6 cases achieved partial response (PR) and 9 cases achieved stable disease (SD); the disease control rate (CR+PR+SD) was 88.61% (16/18). In group B, no cases achieved CR, 4 cases achieved PR and 7 cases achieved SD; the disease control rate was 61.11% (11/18). In group C, no cases achieved CR, 4 cases achieved PR and 6 cases achieved SD; the disease control rate was 58.82% (10/17). The difference of disease control rate between groups A and B was significant (P<0.05). One-year survival rates of these three groups were 66.67%, 44.44% and 41.18%, respectively, and two-year survival rates were 38.89%, 16.67% and 17.65%, respectively. The one- and two-year survival rates in group A were both higher than those in group B and group C (P<0.05), but the difference was not observed between group B and group C. The proportions of patients with improved quality of life in groups A, B and C were 83.33%, 55.56% and 58.82%, respectively. There was no blood toxicity in group C. The major toxicities were local pain and fever, which could be self-relieved. Conclusion: Low energy ultrasonic cavitation therapy in treatment of solid tumors is efficient and well-tolerated, and the quality.

Variation in STAT4 is associated with systemic lupus erythematosus in Chinese Northern Han population / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Recent studies have identified signal transducer and activator of transcription 4 (STAT4) as a susceptibility gene for systemic lupus erythematosus (SLE) in different populations. In order to examine whether the allele distribution of the single nucleotide polymorphism (SNP) in gene STAT4 rs7574865 in patients with SLE is different from those of healthy controls in Chinese Northern Han population, we investigated whether the variants of STAT4 rs7574865 were associated with any specific clinical features of SLE.</p><p><b>METHODS</b>We genotyped SNPs in STAT4 rs7574865 in 252 patients with SLE and 497 healthy controls. All subjects were from the Northern part of Chinese Han population. The genotypes in rs7574865 were determined by polymerase chain reaction (PCR) and consequence direct sequencing of PCR products in the DNA samples.</p><p><b>RESULTS</b>There was a significant difference in distribution of the SNPs in rs7574865 between the SLE patients and healthy controls. Compared with healthy controls, there was a significant correlation between TT genotypes in rs7574865 and the risk of SLE when GG genotype was used as a reference genotype after adjusting for gender and age. The frequency of T allele in the SLE patients was strongly significantly higher than that of healthy controls. Furthermore, there was a significant difference in the distribution of SNP in rs7574865 between male and female SLE patients, when compared with healthy controls. The frequency of T allele in rs7574865 in male patients was significantly higher than that of male healthy controls or female patients. There was no significant correlation between the frequencies of T allele in STAT4 rs7574865 and the clinical features of SLE.</p><p><b>CONCLUSIONS</b>The SNP rs7574865 in STAT4 is strongly associated with risk of SLE in the Chinese Northern Han population. The TT genotype and T allele in STAT4 rs7574869 are susceptibility factors for SLE, especially for male SLE patients.</p>

Clinical and prognostic characteristics of 573 cases of primary Sjögren's syndrome / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Primary Sjögren's syndrome (pSS) is one of the autoimmune diseases with high incidence. There were several clinical investigations in Caucasian but seldom in Chinese. The aim of this study was to compare the difference of clinical manifestations, immunological features and prognosis of pSS between Caucasian and Chinese pSS patients.</p><p><b>METHODS</b>Five hundred and seventy-three patients who fulfilled the 2002 international classification (criteria) for pSS from Peking Union Medical College Hospital between 1985 and 2006 were screened retrospectively and compared with other populations.</p><p><b>RESULTS</b>(1) The study consisted of 524 (91%) female and 49 (9%) male patients (female: male = 10.7:1). Mean age at the onset of the disease was (39.0 ± 13.7) years and in 169 (29.5%) patients the disease onset occurred before the age of 30 years. The average duration from disease onset to pSS diagnosis was 48 months (range, 1 - 552 months). It had been shortened during the recent five years. (2) Dry mouth (84.5%) and dry eyes (70.0%) were the most common symptoms, significantly lower than foreign patients (P = 0.000). Two hundred and seventy-two (47.5%) patients presented with rampant caries, 160 (27.9%) with parotidomegaly. The positivity of xerostomia, xerophthalmia and salivary gland biopsy were 91.9%, 94.8% and 90.7%, respectively. (3) Systemic involvement occurred in 91.4% patients. Compared with studies done outside China, higher prevalence of fever 41.0%, myositis 4.9%, pericardial effusion 14.8%, pulmonary involvement 42.3%, renal involvement 33.5%, thyroid involvement 32.7%, pancrease involvement 5.6% (P < 0.01) and lower prevalence of fatigue, lymphadenectasis and Raynaud's phenomenon (P < 0.01) were seen. (4) Risk factors of death include pulmonary artery hypertension, liver damage and interstitial lung disease.</p><p><b>CONCLUSIONS</b>Chinese pSS differs significantly from the non-Chinese cases in terms of the age of onset, systemic involvement, autoantibodies and proportional mortality rate. Lung and liver damage were found to be the highest risk factors of the disease prognosis.</p>

Expression of Oct-4 in gastric carcinoma and its clinical significance / 上海第二医科大学学报

Objective To investigate the expression of Oct-4 as a stem cell marker in gastric carcinoma tissues and its clinical significance. Methods From June 1996 to March 2006, 63 paraffin samples of gastric carcinoma tissues were obtained, and the expression of Oct-4 was examined by immunohistochemical staining. Another 58 normal tissues adjacent to gastric carcinoma and 10 normal gastric mucosa tissues were served as controls. The clinieopathologieal data of 63 patients with gastric carcinoma were retrospectively analysed, and their relationship with the expression of Oct-4 was analysed. Fifty of these 63 patients were followed up for 8 years, Kaplan-Meier method and Log-rank teat were employed to explore the correlation between Oct-4 expression and survival, and Cox Regression analysis was performed to evaluate the possibility of Oct-4 expression as an independent prognostic factor for gastric carcinoma. Results The positive expression rate of Oct-4 in gastric carcinoma tissues was 80.95% (51/63), significantly higher than that of normal tissues adjacent to gastric carcinoma (5.2%, 3/58) and normal gastric mucosa tissues (0) (P < 0.01). The expression of Oct-4 was positively correlated to the clinical stage of gastric carcinoma(P<0.01). There was no significant difference in the expression of Oct-4 among patients with different differentiation, age, and gender (P>0.05). Patients with higher expression of Oct-4 had significantly shorter survival time (P<0.05). The expression of Oct-4 was not significantly correlated with the prognosis of gastric carcinoma(RR, 0.554; 95% CI, 0.209-1.466). Conclusion The expression of Oct-4 is correlated with the clinical stage and survival time of patients with gastric carcinoma, however, it is not an independent prognostic factor for gastric carcinoma.

Character of breast cancer stromal cells and regulation on tumor cells / 上海第二医科大学学报

Contrary to being an idle bystander,the surrounding tumor microenvironment or stroma,actively participates in,and contributes to tumor progression directly or indirectly.It is evident that tumor stromal cells exhibit specific tumor-suppressive and tumor-promoting abilities that serve to regulate neoplastic growth of the epithelium.Due to the mounting evidence demonstrating the far-reaching effects of stroma during the process of malignant transformation,the involvement of stroma in cancer progression has become an area of intense investigations in recent years.

Mitogen-activated protein kinase pathway in antitumor effect of toremifene / 上海第二医科大学学报

Objective To study the antitumor effect of toremifene on MCF7 cell lines,and investigate the role of mitogen-activated protein kinase pathway. Methods Inhibitory effect of toremifene alone or combined with MEK inhibitor PD98059 on MCF7 cells was measured by SRB test,and that on phosphorylated ERK was detected by Western blotting.Results Toremifene exhibited a concentration-dependent inhibitory effect on the activity of MCF7 cells.Phosphorylated ERK was significantly inhibited by 5,10 and 20 mmol/L toremifene.Combined with PD98059,toremifene had a significantly enhanced cytotoxity effect,which exceeded that of application alone. Conclusion Mitogen-activated protein kinase pathway may play an important role in the antitumor effect of toremifene which is independent of estrogens.Combined with PD98059,the antitumor effect of toremifene can be reinforced,indicating a synergistic effect of these two drugs.

Correlation between PAK1 gene polymorphism and prognosis of endocrine therapy for breast cancer / 上海第二医科大学学报

Objective To investigate the correlation between p21-actived kinase 1(PAK1) gene polymorphism and prognosis of endocrine therapy for breast cancer. Methods Polymerase chain reaction-restriction fragment length polymorphism was employed to analyze the genotype of PAK1 gene rs2298793 T→C polymorphism and rs2844327 C→T polymorphism of 105 patients with breast cancer accepting endocrine therapy. Prognostic factors such as age, state of menses, magnitude of tumor, pathological type, condition of operation, clinical stage, estrogen receptor, progesteron receptor, Her-2 and endocrine therapy drug were comprehensively considered, and Cox model was employed to analyze the relation of PAK1 genotype with the time-to-tumor progression (TTP). Results As to rs2298793C→T polymorphism, the TTP of CT genotype was shorter than TT genotype (P