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Since 2010, the incidence of severe fever with thrombocytopenia syndrome (SFTS) has been increased. Owing the progress in diagnosis and treatment, the overall mortality of SFTS in China has decreased, while the mortality in critical SFTS patients is still high. In order to provide guidance and working procedures for clinicians to diagnose and treat critical SFTS, the National Medical Center for Major Public Health Events invited experts to discuss and formulate this consensus based on their experience and up-to-date knowledge on SFTS.
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Objective To examine the value ofprocalcitonin (PCT) in differential diagnosis of bloodstream infections (BSI) caused by coagulase-negative Staphylococcus (CNS) from contamination in Department of Hematology.Methods One hundred and fifty-six patients with bloodstream or intravenous catheter-related CNS infection were included in this study.The patients were treated in Department of Hematology,the First Affiliated Hospital of Soochow University during the period from January 2013 to December 2015.The patients were divided into CNS bloodstream infection group (n=66) and blood culture contamination group (n=90).The two groups were compared in terms of sex,age,diagnosis,length of hospital stay,duration of neutropenia,neutrophil count and lymphocyte count,peak fever,C-reactive protein (CRP) and PCT.The receiver operating characteristic (ROC) curve was plotted with SPSS 21.0 software to analyze the value of PCT in differential diagnosis.Results Age,sex,clinical diagnosis,length of hospital stay,duration of neutropenia,neutrophil count and lymphocyte count did not show significant difference between bloodstream infection group and contamination group (P＞0.05),while peak fever (P＜0.001),CRP (P=0.002) and PCT (P=0.018) were significantly higher in bloodstream infection group than in contamination group.ROC analysis indicated that PCT provided optimal discrimination between these two groups at cnt-offvalue of 0.374 μg/L,with sensitivity of 54.5％ and specificity of 94.4％.The area under the curve (AUC) was 0.830±0.032 (95％ CI:0.767-0.893,P＜0.001).Conclusions PCT may be a good marker for differentiating CNS bloodstream infection from contamination with higher specificity than the commonly used marker CRP.This finding may help clinicians reduce the overuse of antibiotics.
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Lesch-Nyhan syndrome(LNS) is a congenital X-linked recessive inherited disorder caused by mutations in the hypoxanthine guanine phosphoribosyl transferase (HPRT) gene.A deficiency of the HPRT enzyme is responsible for the disease.The main clinical manifestation includes hyperuricemia, juvenile-onset gouty arthritis and neurological developmental disorders.Studies have reported there are more than 400 HPRT gene mutation sites, but the incidence of LNS in the Chinese population is extremely low.Here we report a 16-year-old male patient who suffered neurological dysfunction at an early age and gouty arthritis in his youth.DNA of patient and his family members were extracted from peripheral blood lymphocytes.The coding region and the intron-exon boundaries of HPRT gene were sequenced by standard methods.We found a mutation in exon 3 of the HPRT gene of the patient and his mother (Exon3:c.143G>A), which resulted in an arginine to histidine (p.R48H) substitution in the encoded protein.No activity of the enzyme HPRT was detected in the erythrocytes.The same mutation was reported in several European families, but was found in Chinese family for the first time.Clinicians in China have poor experience in diagnosing LNS case, due to the low incidence in China.Therefore LNS screening for infants or adolescents with hyperuricemia, gouty arthritis and neurological dysfunction should be performed.
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Objective@#To analyze the incidence and microbiological features of blood stream infections (BSI) of patients with hematopoietic stem cell transplantation (HSCT) and to provide laboratory data for empirical use of antibiotic for the HSCT patients with BSI.@*Methods@#The incidence of bloodstream infection, the positive rate of blood culture, bacterial spectrum and drug resistance were analyzed in 1 265 HSCT recipients during 2013 and 2015 were retrospectively studied.@*Results@#Of 1265 patients undergoing HSCT, 1 422 cases of suspected BSI occurred in 784 patients (61.98%) , and 464 patients (59.2%) were in the stage of agranulocytosis (ANC<0.5×109/L) . The detection rate of pathogens in 2013-2015 was about 20% and increase year after year. Of the 401 strains detected, 221 were Gram-negative (G-) bacteria (55.1%) , 165 Gram-positive (G+) bacteria (41.2%) and 15 fungi (3.7%) . Escherichia coli (16.0%) , Staphylococcus epidermidis (15.5%) and Klebsiella pneumoniae (11.2%) were listed the top three. The proportion of multidrug resistant Acinetobacter Bauman and Stenotrophomonas maltophilia was 64.70% and 63.64% respectively, and methicillin resistant Staphylococcus aureus (MRSA) was more than half (57.14%) . The ratio of vancomycin resistant Enterococci (VRE) and carbapenem resistant Enterobacteriaceae (CRE) was 14.29% and 6.78% respectively. More than 40% Enterobacteriaceae bacteria were resistant to three or four generation cephalosporin antibiotics, and less were resistant to the carbapenems (6.4%) . However, many non-fermentating bacteria were highly resistant to these antibiotics and showed diversity among different strains, with a rate of 47.8% resistance to carbapenems. All the Staphylococcus were sensitive to vancomycin, teicoplanin and linezolid.@*Conclusions@#The incidence of BSI in patients with HSCT was high, and the pathogens were mainly G- bacteria. In addition to Enterobacteriaceae, the proportion of non-fermentative bacteria was quite high. No Staphylococcus detected were resistant to vancomycin, teicoplanin and linezolid.
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AIM: To investigate the effects of TNF receptor-associated death domains (TRADD) of latent membrane protein 1 (LMP1) on the proliferation of nasopharyngeal cancer SP18 cells.METHODS: The SP18-LMP1 cells and SP18-LMP1TRADD cells, which expressed LMP1 and LMP1 TRADD proteins, respectively, were established.The proliferation of SP18 cells affected by LMP1TRADD was detected by cell counting to analyze the cell growth curve, and by colony formation assay, soft agar formation assay, and flow cytometry.Moreover, the expression profile of differential genes between SP18-LMP1 cells and SP18-LMP1TRADD cells was analyzed by gene chips.RESULTS: The cell growth curve, and the results of colony formation and soft agar formation displayed that the growth velocity and colony forming ability of SP18-LMP1 cells were stronger than those of SP18-LMP1TRADD cells (P<0.01).The results of flow cytometry analysis showed that the proliferation index of SP18-LMP1 cells was higher than that of SP18-LMP1TRADD cells (P<0.01).Sixty-three differentially expressed genes associated with cell proliferation were screened out, in which 33 genes were up-regulated and 30 were down-regulated in the SP18-LMP1TRADD cells.CONCLUSION: TRADD active region is an important functional site of LMP1 to promote the proliferation of SP18 cells.LMP1 may improve the cell proliferation index and induce the proliferation of SP18 cells through TRADD.
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Two eases of Hashimoto's encephalopathy (HE) are reported and relative literature is reviewed in this article.Both cases were female,with disturbance of consciousness and dementia as initial symptoms.Marked increase of anti-thyroid antibodies was found in serum of the patients.The symptoms disappeared after steroids and maintenance therapies.A total of 126 cases of HE in Chinese literature were retrieved from 2006 to 2015 through the databases of China National Knowledge Infrastructure and Wanfang Med Online.The male/female radio was 1 ∶ 6 with an average age of 51.3 years.The clinical manifestations included cognitive impairment (44.5％),epilepsy (38.3％),psychiatric disorders (27.3％),stroke-like symptoms (25.8％),disturbance of consciousness (24.2％),and extrapyramidal symptoms (20.3％).Good response to steroids was observed in 77.2％ HE patients.Analysis indicates that HE is an autoimmune disease with the presence of neurological and psychiatric manifestations,elevated titers of anti-thyroid antibodies in serum and well response to steroids,with a good prognosis.
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Objective To investigate the relationship between the changes of expression of T lymphoma invasion and metastasis inducing factor 1 (Tiam1) mRNA and lymph node micrometastasis and prognosis in patients with node-negative colorectal cancer(CRC).Methods From June 2008 to August 2010,a total of 63 patients with lymph node-negative CRC,20 patients with lymph node-positive CRC and 25 patients with colorectal benign lesions were enrolled.The relative quantity expression (RQ) of Tiam1 mRNA in CRC cancer tissues and colorectal benign lesions were detected by real-time quantitative polymerase chain reaction (PCR).The lymph node micrometastasis was determined by cytokeratin 20 detection in lymph nodes tissues.The five-year postoperative prognosis was evaluated by followed-up in the patients with lymph node-negative CRC.The correlation between the expression of Tiam1 mRNA and lymph node micrometastasis and prognosis was analyzed.The t-test,univariate analysis,multivariate analysis and Log-rank test were performed for statistical analysis.Results Lymphnode micrometastasis occurred in 33 from 63 patients with lymph node-negative CRC.The RQ of Tiam1 mRNA in the patients with lymph node-positive CRC was 9.84±-2.36,which was higher than that of patients with lymph node-negative CRC (5.15±3.58),and the difference was statistically significant (t=5.479,P＜0.01).The RQ of Tiam1 mRNA of these two groups were both higher than that of colorectal benign lesion (0.30± 0.21),and the difference was statistically significant(t=20.169,6.745;both P＜0.01).The RQ of Tiam1 mRNA of positive lymph node micrometastasis group was 6.30±1.95,which was higher than that of negative lymph node micrometastasis group (3.88 ± 1.63),and the difference was statistically significant (t=5.330,P＜0.01).In the patients with lymph node-negative CRC,the lower degree of tumor difference,the deeper invasion,the shorter survival time after surgery and postoperative recurrence and metastasis were related with the higher RQ of Tiam1 mRNA in tumor tissues (t=2.536,3.112,3.213,2.676;all P＜0.05).Univariate analysis revealed that the expression of Tiam1 mRNA in cancer tissues was correlated with lymph node micrometastases(x2=11.878,P =0.001).Multivariate analysis showed that it was an independent risk factors of lymph node micrometastases in CRC (relative risk:9.782).The five-year postoperative cumulative survival rate of high Tiaml mRNA expression group was 75.8 ％,which was lower than that of low expression group (97.1 ％),and the difference was statistically significant (x2 =4.575,P＜0.05).Conclusions Tiam1 may participate in the regulation of lymph node metastasis in CRC.Elevated expression of Tiam1 promotes lymph node metastasis and is closely relatived with poor prognosis of node-negative CRC,and which can be considered as an indicator of prognosis.
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Objective To investigate the relationship between quantitative detection of T lymphoma invasion and metastasis inducing factor (Tiaml) mRNA and invasion,metastasis and prognosis of patients with colorectal cancer.Methods The quantitative expression of Tiam1 mRNA in cancer tissues in colorectal cancers (n =97),in tissues of colorectal adenomatous polyposis (n =49) and normal control (n =30) were detected with real-time fluorescence quantitative-polymerase chain reaction (PCR).The relationship between the quantitative expression of Tiam1 mRNA in colorectal cancer tissues and the invasion,metastasis and the prognosis were analyzed.Results The levels of Tiam1 mRNA expression in the colorectal cancer group,were significantly higher than those in colorectal adenomatous polyposis group and normal controlgroup [(14.45±4.87)2-△△△Ct vs (3.77 ±3.15)2-△△Ct,(1.06 ±0.65)2-△△Ct,P ＜0.01].The levels of Tiam1 mRNA expression in the adenomatous polyposis with high grade intraepithelial neoplasia were signifiCantly higher than those in the adenomatous polyposis with low grade intraepithelial neoplasia [(5.26 ±2.45)2-△△Ct vs (3.78 ±2.19)2-△△Ct,P ＜0.01],which were both significantly higher than those in the adenomatous polyposis with no intraepithelial neoplasia [(2.13 ± 1.64)2-△△Ct,P ＜0.05 or P ＜ 0.01].The levels of Tiam1 mRNA expression in colorectal cancer group were positively related to the differentiated degree of tumor,depth of invasion,lymph node metastasis,tumor node metastasis (TNM) stages and the postoperative recurrence (P ＜ 0.01),and were negatively related to the postoperative survival time (P ＜0.01).Multivariate Cox regression analysis revealed that levels of Tiam1 mRNA expression in cancer tissues were independent prognostic factor for colorectal cancer (Exp =4.043).Conclusions The high Tiam1 mRNA expression levels in cancer tissues are closely related to invasion,metastasis and poor prognosis of colorectal cancer,and may be a prognostic indicator of colorectal cancer.The increase expression of Tiam1 mRNA in colorectal adenomatous polyposis may be related to colorectal tumorigenesis.
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[Summary] The efficacy of the combining therapy of methylprednisolone and methotrexate on the Graves ophthalmopathy ( GO) was observed. Whether selenium supplement is beneficial based on this combining therapy scheme was evaluated. The results showed that the combining therapy of methylprednisolone and methotrexate was effective for the patients with moderate-to-severe GO. Selenium supplement did not further improve the remission of GO.
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Objective To investigate the correlation between quantitative detection of human telomerase reverse transcriptase (hTERT) mRNA in peripheral blood and metachronous liver metastasis and prognosis of colorectal cancer (CRC).Methods The quantitative expression of hTERT mRNA in pre-and post-operative peripheral blood were detected with real-time fluorescence quantitative real-time polymerase chain reaction (RT-PCR) in 168 patients with CRC and normal controls.The postoperative 3 years,prognosis of the CRC patients were followed-up.The relationship between peripheral blood hTERT mRNA expression levels and the metachronous liver metastasis and prognosis of CRC were analyzed.Results The hTERT mRNA expressions in preoperative,6 month postoperative peripheral blood in postoperative liver metastases group were significantly higher than those in the postoperative non-metachronous liver metastases group in the same term [(8.35 ± 5.86) (2-△ △Ct) vs (4.42 ± 2.88) (2-△ △Ct),(1.87 ± 1.85) (2-△ △Ct) vs (1.03 ± 0.92) (2-△△Ct),P ＜ 0.01].The hTERT mRNA expressions in preoperative peripheral blood of CRC group were positively related to the differentiated degree of tumor,tumor size,lymph node metastasis(P ＜ 0.05 or P ＜ 0.01),and were negatively related to the postoperative survival(P ＜ 0.01).Univariate analysis revealed that hTERT mRNA expressions in preoperative and 6 months postoperative peripheral blood were all correlated with postoperative liver metastases from CRC.Multivariate Cox analysis showed that they were independent risk factors for postoperative CRC liver metastases(EXP =4.282,9.171).The 3 year survival rate of the postoperative CRC liver metastases group was significantly lower than that of the postoperative non-CRC liver metastases group.Conclusions hTERT mRNA expressions in preoperative peripheral blood are related to the important pathologic feature,postoperative liver metastasis and prognosis of CRC.hTERT mRNA expressions in preoperative and 6 months postoperative peripheral blood might be a predictive biomarker for CRC metachronous liver metastases.The elevation of hTERT mRNA expression levels in postoperative peripheral blood were related to postoperative CRC liver metastasis.
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Objective To investigate the correlation of the expression of human telomerase reverse transcriptase (hTERT) mRNA in peripheral and portal vein blood to liver metastasis and prognosis of patients with colorectal cancer (CRC).Methods From January 2009 to April 2011,a total of 181 patients diagnosed as primary CRC and received radical resection were enrolled.The relative quantitative expression of hTERT mRNA in preoperative peripheral blood and intraoperative portal vein blood were detected by real-time fluorescence quantitative reverse transcription-polymerase chain reaction (RT-PCR).All the patients were followed up for three years after operation.The relative quantitative expression of hTERT mRNA in peripheral blood before operation and intraoperative portal vein blood were compared between patients with synchronous liver metastasis (18 cases) and without synchronous liver metastasis (163 cases); between metachronous liver metastases (29 cases) and without metachronous liver metastases (152 cases).The relationship between the expression of hTERT mRNA in intraoperative portal vein blood and clinicopathological features of patients with CRC was analyzed.The t-test was used.Univariate and Multivariate Cox analysis were used for risk analysis of metachronous liver metastases.Log-rank test was used for comparisons of survival rate between the group with high hTERT mRNA expression in intraoperative portal vein blood during operation and the group with low expression.Results The relative quantitative expression of hTERT mRNA in preoperative peripheral blood and intraoperative portal vein blood in synchronous liver metastases group (8.04±3.79 and 11.88±4.19) was higher than that of no synchronous liver metastases group (4.30±2.81 and 4.94±3.37,t=5.159 and 8.084; both P＜0.01).The relative quantitative expression of hTERT mRNA in preoperative peripheral blood and intraoperative portal vein blood in metachronous liver metastases group (7.16±3.08 and 9.83 ± 2.96) was higher than that of no synchronous liver metastases group (4.11±2.58 and 4.56±3.09,t=5.648 and 8.467;both P＜0.01).The hTERT mRNA expression in intraoperative portal vein blood of patients with CRC changed significantly with the differentiated degree of tumor,tumor size,different invasion degree of tumor,lymph node metastasis,recurrence after operation,survival time (t =2.987,2.281,2.135,5.070,5.431 and 6.803,all P＜0.05).Univariate analysis revealed that the expression of hTERT mRNA in preoperative peripheral blood and intraoperative portal vein blood both were correlated with postoperative metachronous liver metastases (x2=9.522 and 16.393,both P＜0.01).Multivariate Cox analysis showed that both of them were independent risk factors (relative risk (RR)=4.286 and 9.783).The two-and three-year survival rates of the patients with high hTERT mRNA expression levels in intraoperative portal vein blood were 64.6 ％ and 52.3 ％,and those of low expression group were 91.4 ％ and 85.3 ％,and the differences between two groups in two-and three-year survival rate were statistically significant (x2 =5.313,P＜0.05; x2 =8.925,P＜0.01).Conclusions The expression of hTERT mRNA in intraoperative portal vein blood was closely correlated with the important pathologic features,prognosis and liver metastasis of patients with CRC and its predictive value of postoperative CRC metachronous liver metastases was higher than the expression of hTERT mRNA in preoperative peripheral blood.The hTERT mRNA in intraoperative portal vein blood can be a postoperative prognostic marker of patients with CRC.
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Objective To compare the application value and the clinical curative effect of longitudinal incision and tarsal sinus minimal-ly invasive approach in treatment of patients with intra-articular calcaneal fractures. Methods A retrospective statistical analysis was made by collecting and comparing the clinical data of 67 patients with intra-articular calcaneal fractures from March 2008 to March 2012,and they were divided into the longitudinal incision minimally invasive approach group ( ZW group,36 patients,37 feet) and the tarsal sinus minimally invasive approach group ( FW group,31 patients,33 feet) . The Bohler angle, Gissane angle before and after operation,complications healing time,and AOFAS scores were compared. Results The healing time,Bohler angle,Gissane angle of ZW group and other indicators were better than those of the FW group,but there was no significant difference between the two groups (P>0. 05). The infection of incision and compli-cations in ZW group was obviously less than those of the FW group (P0. 05). Conclusion The two kinds of treatments are of no obvious difference,but the longitudinal small incision minimally invasive approach could receive better effect in terms of soft tissue damage,healing time,and postoperative complications.
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Objective To investigate the correlation between expression of human telomerase reverse transcriptase (hTERT) mRNA in peripheral blood and postoperative recurrence and prognosis in the patients with advanced colorectal cancer (CRC).Methods The preoperative and 1 month postoperative quantitative expression of hTERT mRNA in peripheral blood in 85 patients with advanced CRC were detected with real-time fluorescence quantitative real-time fluorescence quantitative polymerase chain reaction (RTPCR).The quantitative expression of hTERT mRNA in peripheral blood in 30 normal controls were also detected.The postoperative prognosis was followed-up,and the quantitative expression of hTERT mRNA in peripheral blood in the patients with recurred CRC and the patients without recurred CRC were detected repeatedly.The factors that affected the preoperative hTERT mRNA expression were analyzed.The relationship was investigated between the hTERT mRNA expression levels and postoperative recurrence and prognosis in the patients with advanced CRC.Results The hTERT mRNA expression levels in peripheral blood in advanced CRC group were significantly higher than those in the normal controls [(6.22 ±5.85)2-△△Ct vs (0.45 ±0.27)2-△△Ct,(P ＜0.01)],and were significantly decreased at the time point of 1 month after the operation (P ＜ 0.01).The hTERT mRNA expression levels in the postoperative recurred CRC group were significantly higher than those in the 1 month postoperation group and no recurrence CRC group [(5.07 ± 2.87)2-△△Ct vs (1.83 ± 1.08)2-△△Ct,(2.15 ± 1.49)2-△△Ct,(P ＜0.01)].Univariate analysis revealed that preoperative high hTERT mRNA expression levels in peripheral blood were related to the differentiated degree of tumor,tumor size,lymph node metastasis ratio,and liver metastasis (P ＜ 0.05 or P ＜ 0.01).Multivariate logistic regression analysis revealed that differentiated degree of the tumor,lymph node metastasis,and liver metastasis were independent risk factors for the elevation of preoperative hTERT mRNA expression in the advanced CRC.Elevated preoperative hTERT mRNA expression was positively related to the postoperative recurrence rate,and was negatively related to postoperative survival rate.Conclusions Preoperative hTERT mRNA expression levels in peripheral blood were related to the important pathologic features in patients with advanced CRC,and might be a valuable prognostic factor.Postoperatively elevated hTERT mRNA expression in peripheral blood was related to recurrence of advanced CRC.
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Objective To investigate the role of endoscopic retrograde cholangiopancreatography (ERCP) management in the diagnosis and treatment and illustrate clinical features of non-iatrogenic hemobi lia.Methods A total of 35 patients diagnosed as hemobilia via endoscope from August 2009 to September 2012 were reviewed retrospectively.Patients with iatrogenic causes of hemobilia were excluded in this study.Results The clinical features of hemobilia mainly included jaundice (77.1％),abdominal pain (62.9％),hematemesis (5.7％),melena (2.9％) and hematochezia (2.9％).Quincke triad was found in 4 patients with hemobilia.Hemobilia were caused by hepatobiliary malignancies in 29 patients and benign biliary tract diseases in the other six.Biliary obstruction caused by hemobilia was successfully ameliorated by ERCP in 34 patients.Postoperative pancreatitis ocurred in 1 patient.Conclusion The common noniatrogenic causes of hemobilia were hepatobiliary and pancreatic malignancies.ERCP is recommended as the initial management to confirm the hemobilia and solve biliary obstruction.
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The immunoregulatory effect of thalidomide on peripheral blood mononuclear cells in patients with thyroid-associated ophthalmopathy (TAO) was investigated.The resuhs showed that thalidomide (50 μg/ml)inhibited the proliferation of PBMC significantly.Thalidomide inhibitied tumor necrosis factor-α,IFN-γ,and interleukin-6 secretion,as well as mRNA expressions.
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ObjectiveTo study the correlation between preoperative serum angiopoietin-2 (Ang2) levels and lymph node metastasis in early gastric cancer(EGC).MethodsPreoperative serum Ang-2 and CEA levels in 62 patients with EGG and 30 normal controls were measured by ELISA technique respectively.The metastasis of lymph node in these cases were determined by HE staining.The relation between preoperative serum Ang-2 levels and lymph node metastasis in EGC and pathologic characterization was investigated.ResultsCompared with normal controls,preoperative serum Ang-2 levels in EGC group were significantly elevated [( 282.5 ± 110.6 ) μg/L vs ( 187.4 ± 32.7 ) μg/L,P ＜ 0.01].Preoperative serum Ang-2 levels in node-positive gastric cancer group was significantly higher than that in the node-negative gastric cancer group [(34 7.2 ± 79.5 ) μg/L vs (265.6 ± 90.2) μg/L,P ＜ 0.01],while CEA levels changed a little.Preoperative serum Ang-2 levels in the EGC group presented marked correlation with the differentiated degree of the tumor tissue,tumor size,depth of tumor invasion but it had no correlation with the histological type.Preoperative serum Ang-2 levels were an independent high-risk factor of lymph node metastasis in EGC according to multivariate logistic regression analysis.ConclusionsPreoperative serum Ang-2 levels may be a good clinical predictor for lymph node metastasis of EGC,which is useful for the treatment direction.
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Objective21 -hydroxylase deficiency ( 21-OHD) patients are at high risk of developing metabolic syndrome.Low dose of glucocorticoid is crucial in the treatment.This study is to investigate the effect of glucocorticoid therapy on potential metabolic disorders.Methods Thirty-two treated and 31 untreated 21-OHD patients were recruited.The components of metabolic syndrome were investigated in both groups.Results Serum testosterone [ (0.61 ±0.12 vs 4.10±0.66) ng/ml,P＜0.01 ],17-(OH) progesterone[ 17-OHP,( 14.83±3.48 vs 48.52±4.72 )ng/ml,P＜0.01 ],dehydroepiandrosterone sulfate[ DHEAS,(55.7±23.6 vs 405.2±65.7 ) μg/dl,P＜0.01 ],and ACTH[ ( 105.8±44.7 vs 617.4± 163.3 ) pg/ml,P＜0.01 ] levels were significantly reduced,whereas body mass index [ ( 23.2±0.9 vs 21.1 ±0.5 ) kg/mz,P＜0.05 ],systolic blood pressure [ ( 120.5 ± 1.3 vs 115.5 ± 1.8 ) mm Hg,P＜0.05,1 mm Hg =0.133 kPa ],serum triglyceride [ ( 1.8±0.2 vs 1.1 ±0.1 ) mmol/L,P＜0.05 ],and homeostasis model assessment for insulin resistance [ HOMA-IR,( 2.07 ± 0.27 vs 1.16 ± 0.12 ),P ＜ 0.01 ] were markedly increased in glucocorticoid treated group.Multivariates regression analysis showed that body mass index was the most important risk factor for HOMA-IR.The correlation of glucocorticoid replacement and HOMA-IR was not observed after adjustment of age and body mass index.ConclusionGlucocorticoid treatment increases body weights,which leads to insulin resistance and metabolic disorders for 21-OHD patients.More attention should be paid to control BMI and metabolic disturbances in 21-OHD patients.
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ObjectiveTo understand the behavioral characteristics,strength on suicide ideation and mental disorder diagnosis among suicide attempers,so as to provide consultation for crisis intervention of suicide.Methods232 suicide attempters from emergency of 5 general hospital in south-west of Shandong province were enrolled.They were assessed using questionnaires on attempted suicide behaviors and scale on the strength of suicide ideation,and were diagnosed using the Structured Clinical Interview for DSM-Ⅳ Disorders axis Ⅰ for patient (SCID/I-P).Results( 1 ) In the total of 232 cases,female was more than male with the gender ratio of 2.87 (female vs male).The highest proportion rate (56.9％) existed between 16 years old to 35 years old.Oral application pesticide was the most commom suicide pattern (83.2％),91.4％ of the suicide attempt occurred in the their homes.The top three reasons leading to suicide were family contrary (61.2％),depressive mood (15.1％)and fail in love (9.5％).(2) In all cases,83.6％ did not think if they were found,84.1％ did not adopted any precaution measures,over 60.0％ did not tell anyone their attempted plans,and 90％ had no dying structions and /or dying testaments before their attempted behaviors.At the moment of attemp behaviors,62.9％ did not contact with someone.The 60.0％ of all the cases had wanted strongly to die,otherwise 7.3％ had wanted to manipulate others.(3) The diagnosis rate of mental disorder on DSM-Ⅳ was 45.3％,in which the mood disorder was most.ConclusionThere are no changes on the behavioral characteristics among the suicide attempters in the south-west rural area of Shandong province.Their strength of suicide ideation are moderate,and a certain proportion of suicide attempters may be impulsive suicide attempters.There is more relationship between mental disorder and suicide attempt.
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Objective To study the difference and clinical significance of serum Angiopoietin-2 (Ang-2) level in gastric cancer, precancerous disease and the changes in post operation follow-up patients.MethodsSerum Ang-2 and CEA levels were detected with ELISA method in 158 gastric cancer patients, 31 chronic astrophic gastritis patients, 38 gastric adenomatous polyp patients, 28 chronic gastritis patients with benign gastric ulcer and 30 healthy controls.The changes of serum Ang2 levels in 131 patients with radical gastrectomy were measured in 2-year post-operational followed-up and the prognosis was also evaluated.The correlation between serum Ang-2 level and the pathologic character of gastric cancer was analyzed.ResultsThe serum Ang-2 and CEA levels of gastric cancer group were (331.8± 64.3) μg/L and (42.6 ± 37.3) μg/L, respectively, which were significantly higher than those of healthy control group [(187.4±32.7) μg/L and (4.2±3.1) μg/L]and benign gastric ulcer group [(197.3±35.4) μg/L and (4.5±3.2) μg/L](all P ＜0.01).The serum Ang-2 level in chronic astrophic gastritis group was also markedly increased (P＜0.05), however there was no significant change in CEA level.There was no obvious change of Ang-2 and CEA level in gastric adenomatous polyp group (P＞0.05).Pre-operation serum Ang-2 levels of the relapse group and the metastasis group were significantly higher than that of no relapse group (P＜0.05).Post-operation serum Ang-2 level of no relapse group decreased to normal range in 1 month and without obvious increase in 2 years follow-up.The serum Ang-2 level of the relapse group also decreased to normal range in 1 month post-operation, while which was significantly higher than that of no relapse group and normal control group from 6 months to 2 years after operation (P＜0.01).Serum Ang-2 level of the metastasis group was markedly higher than that of no relapse group and normal control group during 2 years after operation (P＜0.01).The 2-year survival rate of no relapse group was significant higher than that of relapse group and metastasis group.The change of serum Ang-2 level was correlated with in the gastric cancer differentiation degree, TNM pathologic classification, lymphatic metastasis, distant metastasis, the depth of invasion and the tumor size (P＜0.01), however not correlated with histopathology type and the location of tumor.ConclusionSerum Ang-2 level may be a new and valuable gastric cancer marker, which will help to monitor tumor relapse, migration and prognosis assessment.