Research progress in gut-skin axis and its association with traditional Chinese medicine theory / 中国中药杂志

Currently, the gut-organ axis has become a hot research topic. As increasing attention has been paid to the role of gut microbiota in the health of organs, the complex and integrated dialogue mechanism between the gastrointestinal tract and the associated microbiota has been demonstrated in more and more studies. Skin as the largest organ in the human body serves as the primary barrier protecting the human body from damage. The proposal of the gut-skin axis has established a bidirectional link between the gut and the skin. The disturbance of gut microbiota can lead to the occurrence of skin diseases, the mechanism of which is complex and may involve multiple pathways in immunity, metabolism, and internal secretion. According to the theory of traditional Chinese medicine(TCM), the connection between the intestine and the skin can be established through the lung, and the interior disorders will definitely cause symptoms on the exterior. This paper reviews the research progress in the gut-skin axis and its correlation with TCM theory and provides ideas and a basis for cli-nical treatment and drug development of skin and intestinal diseases.

Gene mutation spectrum and clinical characteristics analysis of 178 patients with essential thrombocytosis / 中华血液学杂志

Objective@#To analyze the gene mutation spectrum, clinical features, and the factors of disease progression and prognosis in patients with essential thrombocytosis (ET) .@*Methods@#A retrospective analysis was conducted on 178 newly diagnosed ET patients admitted from February 1st, 2009 to November 1st, 2018.@*Results@#Of the 178 patients, 89 were male and 89 female, and the median diagnosis age was 49.5 (3-86) years old. JAK2V617F, CALR and MPL mutations frequencies were 16.45% (1.67%-43.90%) , 40.00% (10.00%-49.15%) and 25.10% (25.00%-40.00%) , respectively. Compared with patients with CALR mutations, patients with JAK2V617F mutation had higher diagnosis age (P=0.035) , higher white blood cell count (P=0.040) , higher hemoglobin concentration (P=0.001) , and lower platelet count (P=0.002) , respectively. Of them, 47 patients (27.01%) developed thrombotic events before diagnosis, and 3 ones (1.72%) experienced thrombotic events after diagnosis. Multivariate analysis revealed age >60 years (P=0.013, OR=4.595, 95%CI 1.382-15.282) and cardiovascular risk factors (CVF) (P<0.001, OR=8.873, 95%CI 2.921-26.955) as risk factors for thrombotic events, CALR mutation (P=0.032, OR=0.126, 95%CI 0.019-0.838) as a protective factor for thrombotic events. Age >60 years (P=0.042, OR=4.045, 95%CI 1.053-15.534) was found to be a risk factor for the overall survival (OS) of ET patients. OS of age ≤60 years and age>60 years were calculated by Kaplan-Meier analysis to be (115.231±1.899) months and (83.291±4.991) months (χ2=6.406, P=0.011) , respectively.@*Conclusion@#Age>60 years and CVF were risk factors for thrombotic event. CALR mutation was a protective factor for thrombotic event. Age >60 years was a risk factor for OS in ET patients.

Symptomatic Profiles of 173 Chinese Patients with Essential Thrombocythemia / 中国实验血液学杂志

OBJECTIVE@#To explore the symptomatic burden of patients with essential thrombocythemia (ET) and its relation with clinical characteristics including the mutation status, therapeutic protocols and sex.@*METHODS@#Total of 173 Chinese ET patients were selected and grouped on the basis of disease characteristics (mutation status, therapeutic pro to- cols, and sex).@*RESULTS@#All the groups showed low-to-high symptom burden, with the highest in the Hu (hydroxyurea)-group (total symptom score [TSS], 14.7; range, 7.6-14.7). In the JAK2V617F-positive, Hu-treated, and female groups TSS and independent symptom scores were higher than those in the control group. The CALR-positive and IFN-α-treated groups had lower overall and individual scores as compared with groups lacking the corresponding characteristics. As the number of characteristics (JAK2V617F-positive, Hu-treated, and female) increases, the severity of symptoms gradually increased.@*CONCLUSION@#The different characteristics have various effects on symptom burden in ET patients. The accumulation of certain characteristics will lead to more severe symptom burden, thus the patient＇s symptom burden should be considered comprehensively when making up the treatment schemes and prognosis.

Effect of the shared care-based diabetes management among patients with type 2 diabetes / 中国实用护理杂志

Objective@#To explore the effect of shared care model on diabetes management among patients with type 2 diabetes mellitus (T2DM), therefore, to establish a more efficient education and management model for patients with T2DM.@*Methods@#Through convenient sampling, a total of 210 patients with T2DM were recruited from the outpatient clinic of the endocrinology center at Luhe Hospital, Capital Medical University, Beijing, from August to October, 2017. Patients were equally divided into two groups (n=105/group): intervention group and control group.The intervention group completed 103 cases and the control group 100 cases.The intervention group adopted the shared care education model, while the control group followed the conventional education management model. The follow up time of the intervention group was 12 months. The levels of glycosylated hemoglobin (HbA1c), Body Mass Index (BMI) and diabetes self-management behaviors were collected at baseline and at 12-months and compared between two groups. Measurement data were examined by t-test and rank-sum test; Count data were examined by chi square test, P<0.05 was thought to be statistically significant.@*Results@#At 12-month following the implementation of the management models, the HbAlc and BMI of the intervention group were (6.47 ± 0.66)%, (22.28 ± 2.41) kg/m2, and those of the control group were (6.90 ± 0.61)%, (23.49 ± 1.59) kg/m2, respectively. There were significant differences between the two groups (t=-4.63, 0.00, P< 0.01). The intervention group had healthy diet, exercise, self-blood sugar monitoring, blood sugar monitoring in compliance with doctor's advice, self-foot examination and medication scores of (6.08 ± 1.34), (6.06 ± 1.59), (5.18 ± 2.00), (5.28 ± 1.99), (4.64 ± 2.54), (6.80 ± 0.55) respectively, while the control group had (5.43 ± 1.71), (5.46 ± 1.89), (4.27 ± 1.64), (4.23 ± 1.64), (3.57 ± 2.74), (5.30 ± 2.68) respectively. There were significant differences between the two groups (t=-4.03--2.73, P<0.05).@*Conclusion@#Compared with the traditional education and management model, the shared care model with a multi-disciplinary approach is more patient-centered, and could provide systematic, standardized and personalized management for patients with T2DM and showed greater improvement in diabetes management.

Analysis of Application of Puerariae Lobatae Radix in Health Food / 中国实验方剂学杂志

There are 486 kinds of health food with Puerariae Lobatae Radix as the main raw material, mainly including health food for protecting liver, health food for regulating blood lipid, health food for adjusting blood pressure, health food for regulating blood sugar, and health food for regulating immunity.Based on the establishment of a health food recipe database with Puerariae Lobatae Radix as the main raw material, the Apriori algorithm in association rules was used to explore the formula rule of health food of Puerariae Lobatae Radix.The results showed that among the 174 kinds of hepatoprotective health food, the most used raw materials were Noveniae Fructus and Schisandrae Chinensis Fructus;the common combinations of three raw materials were Puerariae Lobatae Radix-Gardeniae Fructus-Paeoniae Radix Alba, Puerariae Lobatae Radix-Gynostemmatis Pentaphylli Herba-Cassiae Semen, etc.Among the 91 kinds of health food for regulating blood lipid, the most widely used raw materials were Cassiae Semen and Gynostemmatis Pentaphylli Herba;the common combinations of three raw materials were Puerariae Lobatae Radix-Cassiae Semen-Chrysanthemi Flos, Puerariae Lobatae Radix-Alismatis Rhizoma-Mori Folium, etc.Among the 41 kinds of health food for regulating blood pressure, the most widely used raw materials were Eucommiae Cortex and Salviae Miltiorrhizae Radix et Rhizoma;the common combinations of the three raw materials were Puerariae Lobatae Radix-Cassiae Semen-Ostreae Concha, Puerariae Lobatae Radix-Salviae Miltiorrhizae Radix et Rhizoma-Sophorae Flos, etc.Among the 105 kinds of health food for regulating blood sugar, the most widely used raw materials were Dioscoreae Rhizoma and Astragali Radix;the common combinations of three raw materials were Puerariae Lobatae Radix-Notoginseng Radix et Rhizoma-Lycii Cortex, Puerariae Lobatae Radix-Dioscoreae Rhizoma-Poria, Puerariae Lobatae Radix-Dioscoreae Rhizoma-Lycii Cortex, etc.Among the 75 kinds of health food for regulating immunity, the most widely used raw materials were Astragali Radix and Lycii Fructus;the common combinations of three raw materials were Puerariae Lobatae Radix-Gastrodiae Rhizoma-Eucommiae Cortex, Puerariae Lobatae Radix-Mori Fructus-Lonicerae Japonicae Flos, Puerariae Lobatae Radix-Panacis Quinquefolii Radix-Crataegi Fructus, etc.

Effect of the shared care-based diabetes management among patients with type 2 diabetes / 中国实用护理杂志

Objective To explore the effect of shared care model on diabetes management among patients with type 2 diabetes mellitus (T2DM), therefore, to establish a more efficient education and management model for patients with T2DM. Methods Through convenient sampling, a total of 210 patients with T2DM were recruited from the outpatient clinic of the endocrinology center at Luhe Hospital, Capital Medical University, Beijing, from August to October, 2017. Patients were equally divided into two groups (n=105/group): intervention group and control group.The intervention group completed 103 cases and the control group 100 cases.The intervention group adopted the shared care education model, while the control group followed the conventional education management model. The follow up time of the intervention group was 12 months. The levels of glycosylated hemoglobin (HbA1c), Body Mass Index (BMI) and diabetes self-management behaviors were collected at baseline and at 12-months and compared between two groups. Measurement data were examined by t-test and rank-sum test; Count data were examined by chi square test, P<0.05 was thought to be statistically significant. Results At 12-month following the implementation of the management models, the HbAlc and BMI of the intervention group were (6.47 ± 0.66)%, (22.28 ± 2.41) kg/㎡, and those of the control group were (6.90 ± 0.61)%, (23.49 ± 1.59) kg/㎡, respectively. There were significant differences between the two groups (t=-4.63, 0.00, P<0.01). The intervention group had healthy diet, exercise, self-blood sugar monitoring, blood sugar monitoring in compliance with doctor's advice, self-foot examination and medication scores of (6.08 ± 1.34), (6.06 ± 1.59), (5.18 ± 2.00), (5.28 ± 1.99), (4.64 ± 2.54), (6.80 ± 0.55) respectively, while the control group had (5.43 ± 1.71), (5.46 ± 1.89), (4.27 ± 1.64), (4.23 ± 1.64), (3.57 ± 2.74), (5.30 ± 2.68) respectively. There were significant differences between the two groups (t=-4.03--2.73, P < 0.05). Conclusion Compared with the traditional education and management model, the shared care model with a multi-disciplinary approach is more patient-centered, and could provide systematic, standardized and personalized management for patients with T2DM and showed greater improvement in diabetes management.

Research Progress on Reversing Multidrug Resistance in Tumors by Using Chinese Medicine / 中国结合医学杂志

Multidrug resistance (MDR) is a major cause of cancer chemotherapy failure, and it is important to develop suitable reversal agents to overcome MDR. A majority of chemical reversal agents have acceptable reversal effects. However, the toxicity and adverse reactions associated with these agents restricts their clinical use. Chinese medicines (CMs) have lower toxicities and adverse reactions and are associated with multiple components, multiple targets and reduced toxicity. CMs have several advantages and could reverse MDR, decrease drug dosage, enhance patient compliance and increase efficacy. This review summarizes the current progress of CM reversal agents..

Formula Derivation for the Probability Distribution of IBS Score in Unrelated Individual Pairs / 法医学杂志

OBJECTIVES@#To derive the probability equation given by STR allele frequencies of identity by state （IBS） score shared by unrelated individual pairs.@*METHODS@#By comparing the STR genotypes of two unrelated individuals, three mutually exclusive combinations could be obtained： （1） sharing 2 identical alleles, a₂=1, otherwise a₂=0; （2） sharing 1 identical allele, a₁=1, otherwise a₁=0; （3） sharing 0 identical allele, a₀=1, otherwise a₀=0. And the IBS score of the one STR locus in this unrelated individual pair could be given by the formula： ibs=2a₂+a₁. The probability of a₂=1 （p₂）, a₁=1 （p₁） and a₀=1 （p₀） were derived and expressed in powers of the allele frequencies. Subsequently, for a genotyping system including n independent STR loci, the characteristics of binomial distribution of IBS score shared by a pair of unrelated individuals could be given by p₂l and p₁l （l=1, 2, …, n）.@*RESULTS@#All the general equations of p₂, p₁ and p₀ were derived from the basic conceptions of a₂, a₁ and a₀, respectively. Given fi （i=1, 2, …, m） as the ith allele frequency of a STR locus, the general equations of p₂, p₁ and p₀ could be respectively expressed in powers of fi： [Formula: see text],[Formula: see text] and [Formula: see text]. The sum of p₂, p₁ and p₀ must be equal to 1. Then, the binomial distribution of IBS score shared by unrelated individual pairs genotyped with n independently STR loci could be written by： IBS~B（2n, π）, and the general probability, π, could be given by the formula： [Formula: see text].@*CONCLUSIONS@#In the biological full sibling identification, the probability of null hypothesis corresponding to any specific IBS score can be directly calculated by the general equations presented in this study, which is the basement of the evidence explanation.

Identification and screening of cardiac glycosides in Streptocaulon griffithii using an integrated data mining strategy based on high resolution mass spectrometry / 中国天然药物

The present study was designed to develop a practical strategy to tackle the problem of lacking standard compounds and limited references for identifying structure-related compounds in Streptocaulon griffithii Hook. f., especially those in trace concentrations, with a focus on antitumor activity. The cardiac glycosides (CGs)-enriched part was determined using in vitro bioactive assays in three cancer cell lines and then isolated using macroporous resins. The MS and MS/MS data were acquired using a high performance liquid chromatography coupled with hybrid quadrupole-time of flight (HPLC-Q-TOF-MS) system. To acquire data of trace compound in the extract, a multiple segment program was applied to modify the HPLC-Q-TOF-MS method. A mass defect filter (MDF) approach was employed to make a primary MS data filtration. Utilizing a MATLAB program, the redundant peaks obtained by imprecise MDF template calculated with limited references were excluded by fragment ion classification, which was based on the ion occurrence number in the MDF-filtered total ion chromatograms (TIC). Additionally, the complete cleavage pathways of CG aglycones were proposed to assist the structural identification of 29 common fragment ions (CFIs, ion occurrence number ≥ 5) and diagnostic fragment ions (DFIs, ion occurrence number < 5). As a result, 30 CGs were filtered out from the MDF results, among which 23 were identified. This newly developed strategy may provide a rapid and effective tool for identifying structure-related compounds in herbal medicines.

Identification and screening of cardiac glycosides in Streptocaulon griffithii using an integrated data mining strategy based on high resolution mass spectrometry / 中国天然药物

The present study was designed to develop a practical strategy to tackle the problem of lacking standard compounds and limited references for identifying structure-related compounds in Streptocaulon griffithii Hook. f., especially those in trace concentrations, with a focus on antitumor activity. The cardiac glycosides (CGs)-enriched part was determined using in vitro bioactive assays in three cancer cell lines and then isolated using macroporous resins. The MS and MS/MS data were acquired using a high performance liquid chromatography coupled with hybrid quadrupole-time of flight (HPLC-Q-TOF-MS) system. To acquire data of trace compound in the extract, a multiple segment program was applied to modify the HPLC-Q-TOF-MS method. A mass defect filter (MDF) approach was employed to make a primary MS data filtration. Utilizing a MATLAB program, the redundant peaks obtained by imprecise MDF template calculated with limited references were excluded by fragment ion classification, which was based on the ion occurrence number in the MDF-filtered total ion chromatograms (TIC). Additionally, the complete cleavage pathways of CG aglycones were proposed to assist the structural identification of 29 common fragment ions (CFIs, ion occurrence number ≥ 5) and diagnostic fragment ions (DFIs, ion occurrence number < 5). As a result, 30 CGs were filtered out from the MDF results, among which 23 were identified. This newly developed strategy may provide a rapid and effective tool for identifying structure-related compounds in herbal medicines.

Clinical Experience of WANG Yan-gang in Using Huazhuo Jiedu Method for Treating Stomach Cold / 中国中医药信息杂志

This article briefly discussed the academic thoughts and clinical experience of Professor WANG Yan-gang in treating the stomach cold from the theory of Zhuodu. According to the theory of Zhuodu, Professor WANG Yan-gang usesHuazhuo Jiedumethod to relieve or significantly ease the symptoms of stomach cold by exploring the reasons through syndrome differentiation and treatment based on reason.

The research progress of Gli1 in the regulation of epithelial mesenchymal transition in oral squamous cell car-cinoma / 口腔疾病防治

@#HH (hedgehog) signal pathway consists the hedgehoge ligand (Shh、Ihh and Dhh), the Patch and Smo membrane protein complex and Zinc finger transcription factor Gli (Gli1, Gli2, Gli3). In HH (hedgehog) signaling pathway, Gli1 not only plays a dominant and decisive role in the zinc finger transcription factor Gli (Glioma-associated oncogene homolog) family, but also includes epithelial-mesenchymal transition (EMT) and oral squamous cell carcinoma, tumor invasion and metastasis. The research on oral squamous cell carcinoma and Shh/Gli1 signal axis is rare. In this paper, the squamous cell carcinoma of oral epithelial mesenchymal transformation and correlation study of quality Gli1 is reviewed.

Plasma Metabolic Profile Determination in Young ST-segment Elevation Myocardial Infarction Patients with Ischemia and Reperfusion: Ultra-performance Liquid Chromatography and Mass Spectrometry for Pathway Analysis / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>This study was to establish a disease differentiation model for ST-segment elevation myocardial infarction (STEMI) youth patients experiencing ischemia and reperfusion via ultra-performance liquid chromatography and mass spectrometry (UPLC/MS) platform, which searches for closely related characteristic metabolites and metabolic pathways to evaluate their predictive value in the prognosis after discharge.</p><p><b>METHODS</b>Forty-seven consecutive STEMI patients (23 patients under 45 years of age, referred to here as "youth," and 24 "elderly" patients) and 48 healthy control group members (24 youth, 24 elderly) were registered prospectively. The youth patients were required to provide a second blood draw during a follow-up visit one year after morbidity (n = 22, one lost). Characteristic metabolites and relative metabolic pathways were screened via UPLC/MS platform base on the Kyoto encyclopedia of genes and genomes (KEGG) and Human Metabolome Database. Receiver operating characteristic (ROC) curves were drawn to evaluate the predictive value of characteristic metabolites in the prognosis after discharge.</p><p><b>RESULTS</b>We successfully established an orthogonal partial least squares discriminated analysis model (R2X = 71.2%, R2Y = 79.6%, and Q2 = 55.9%) and screened out 24 ions; the sphingolipid metabolism pathway showed the most drastic change. The ROC curve analysis showed that ceramide [Cer(d18:0/16:0), Cer(t18:0/12:0)] and sphinganine in the sphingolipid pathway have high sensitivity and specificity on the prognosis related to major adverse cardiovascular events after youth patients were discharged. The area under curve (AUC) was 0.671, 0.750, and 0.711, respectively. A follow-up validation one year after morbidity showed corresponding AUC of 0.778, 0.833, and 0.806.</p><p><b>CONCLUSIONS</b>By analyzing the plasma metabolism of myocardial infarction patients, we successfully established a model that can distinguish two different factors simultaneously: pathological conditions and age. Sphingolipid metabolism is the top most altered pathway in young STEMI patients and as such may represent a valuable prognostic factor and potential therapeutic target.</p>

Bacteria community in different aged Coptis chinensis planting soil revealed by PCR-DGGE analysis / 中国中药杂志

In order to reveal the cause of disease occurred in the process of Coptis chinensis growth, this paper studied the bacterial species diversity index of different aged rhizospheric and non-rhizospheric soil planting normal or sick C. chinensis by using PCR-DGGE technique. The representative DGGE bands were chosen to be cloned, and sequenced, the phylogeny were constructed. The results showed that the bacterial communities were very different between the normal and diseased soil samples of C. chinensis, and the diversity index (H) of diseased soil samples were higher than that of normal soil samples. Sequencing analysis of representative cloned DGGE bands showed that the unculturable bacteria were the dominant groups, and bacteria belonged to genus Bacillus, Acidovorax, Acinetobacter, uncultured Kluyvera, and uncultured Comamonas were also existing, but the reported plant pathogenic bacteria were not found in the C. chinensis planting soil. The density and brightness of clone band d in diseased soil samples was higher than that in normal soil sample, and sequencing analysis showed that it belonged to genus Acidovorax. Obviously, during the process of C. chinensis growth, the rhizospheric bacteria population changed, and the quantity of bacteria belong Acidovorax increased, which probably resulted in the disease occurred during C. chinensis growth.

Clinical research on corneal perforation / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To study the clinical characteristics of corneal perforation ( CP) . METHODS:A retrospective analysis in July 1995 to July 2010 the First Affiliated Hospital of Fujian Medical University diagnosed CP 72 patients ( 72 eyes ) , clinical characteristics of all the patients were analyzed. RESULTS: The incidence of corneal ulcer perforation rised year by year, the morbidity of male and female was 17:7, the onset age focused on 48 years old. Of 23 industrial workers ( 32%) with clear history of trauma, pathogeny identification results:top two:fungal infection and Acanthamoeba keratitis. A using history of glucocorticoid was found in 10 cases. CONCLUSION:There are plenty of primary causes of CP such as traumas, fungal infection, Acanthamoeba keratitis, eroded keratitis, etc. CP happens in middle-aged males in Fujian province, most traumas are the causes, the main pathogenic bacteria is fungal infection.

Study of attribution of multicomponent original medicinal materials in gegen qinlian decoction with intestinal permeability / 中国中药杂志

The complex level of constructing biopharmaceutics classification system of Chinese materia medica CMMBCS) was the study of traditional Chinese compound, on the premise of insisting that the multicomponent simultaneous determination, when carrying out the study of intestinal permeability, the primary task was to define the source of the components that was absorbed through the intestinal wall, namely, which medicinal material the components belonged to in traditional Chinese compound. The technology of chemical fingerprint and in vitro everted gut sac model were used in this research to make multicomponent an intuitive source attribution which permeated the intestine in the classic formula Gegen Qinlian decoction, and to lay the foundation for the further qualitative and quantitative research of intestinal permeability.

Combination analysis of new drug discovery with "Xiaohe Silian" method and traditional Chinese medicine clinical pharmacy / 中国中药杂志

With the kernel of efficacy, "Xiaohe Silian" was a pattern and method for new drug discovery which was constituted with "metabolism-efficacy, toxicity-efficacy, quality-efficacy and structure-efficacy". Its connotation was in keeping with traditional Chinese medicine (TCM) clinical pharmacy. This paper systematically summarized the research method of new drug discovery practice process for TCM. To avoid western drug like in TCM new drug discovery, we carried out combination analysis with TCM clinical pharmacy. The correlation analysis between basic elements of "Xiaohe Silian(n) and TCM clinical pharmacy was studied to guarantee this method could integrate closely with TCM clinic from all angles. Hence, this method aimed to provide a new method for TCM new drug discovery on the basis of TCM clinical pharmacy with insisting on holistic view of multicomponent study, kinetic view of metabolic process when the curative effect occurred and molecular material view of quality control and structure-activity exposition.

The expressions of uPA and PAI-1 in patients with breast cancer and their clinical significance / 肿瘤

Objective: To investigate the expressions of uPA (urokinase-type plasminogen activator) and PAI-1 (plasminogen activator inhibitor-1) in human breast cancer tissues and their clinical significance. Methods: The expressions of uPA and PAI-1 in breast cancer tissue samples from 252 patients with breast cancer were detected by immunohistochemistry. The associations between the expressions of uPA and PAI-1 with the clinicopathological factors were evaluated by using Kruskal-Wallis rank sum test. The correlation of uPA expression and PAI-1 expression was examined by using Spearman's rank correlation test. The survival analysis was conducted to assess the impacts of uPA and PAI-1 expressions on the prognosis of patients with breast cancer. Results: The expressions of uPA and PAI-1 were related to nuclear grade, tumor size, axillary lymph node status and Ki67 expression (P < 0.05), and the expression of uPA was also related to HER-2 (human epidermal growth factor receptor 2) expression (P < 0.05). In breast cancer tissues, the expressions of uPA and PAI-1 showed a positive relationship (rs = 0.773, P = 0.000). In subgroups of patients with lymph node-negative and lymph node-positive breast cancer, a positive relationship (rs = 0.760, P = 0.000; rs = 0.780, P = 0.000) was also seen between uPA and PAI-1 expressions. The tumor size (P = 0.023), nuclear grade (P = 0.008), axillary lymph node status (P = 0.000) and the expressions of HER-2 (P = 0.033), uPA (P = 0.005) and PAI-1 (P = 0.023) were associated with DFS (disease-free survival). Of these factors, axillary lymph node status was an independent prognostic factor for patients with breast cancer. The result of subgroup analysis revealed that the expressions of uPA and PAI-1 could influence the DFS of patients with lymph node-negative breast cancer (P = 0.000; P = 0.045). Conclusion: The results of this study suggest that uPA and PAI-1 may be used as prognostic markers and also be helpful to make treatment decisions, especially for patients with lymph node-negative breast cancer. Copyright © 2013 by TUMOR.

Glycated haemoglobin in diagnosis of diabetes mellitus and pre-diabetes among middle-aged and elderly population: Shanghai Changfeng study / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To investigate the optimal glycated haemoglobin (HbA1c) cut off points and evaluate the impact of HbA1c on diabetes and pre-diabetes in middle-aged and elderly population.</p><p><b>METHODS</b>Subjects were recruited from Shanghai Changfeng Study. A total of 1973 community-based participants (age ⋝45) without known diabetes underwent oral glucose tolerance test (OGTT) by using a 75-g oral glucose load and HbA1c was measured by using high performance liquid chromatography (HPLC). Subjects were classified as normal glucose tolerance (NGT), pre-diabetes(impaired glucose regulation, IGR) and new diagnosed diabetes (NDD) per 1999 WHO criteria. Two tests are compared with receiver operating characteristic curve (ROC).</p><p><b>RESULTS</b>Among 1973 subjects, 271 (13.7%) were diagnosed as NDD and 474 (24.0%) as IGR by using OGTT. HbA1c was 5.7%±0.7% in this population. Use of 6.5% as the HbA1C cutoff point has sensitivity of 38.7% and specificity of 98.5%. We recommend 6.0% as a better cutoff value for diagnosis of diabetes in this population (AUC 0.829, 95% CI 0.798-0.860, P<0.001) with its sensitivity and specificity as 66.1% and 86.8%. For IGR, the results showed low sensitivity (44.9%) and specificity (66.7%) with an AUC of 0.571 for HbA1c when 5.8% was used as the cutoff point. Participants detected with HbA1c⋝6.0% were associated with nearly the same metabolic characteristics, including body mass index (BMI), blood pressure, lipid profile and urine albumin-creatinine ratio (uACR) compared with diabetic subjects detected by OGTT.</p><p><b>CONCLUSION</b>The optimum HbA1c cutoff point for diabetes in our study population was lower than ADA criteria, and HbA1c may not be used to identify IGR.</p>

Application of predictive and high- quality nursing in partients with pulmonary embolism or having risk factors of pulmonary embolism / 中国实用护理杂志

Objective To summarize the effect of predictive nursing combined with high-quality nursing in patients with pulmonary embolism or having risk factors of pulmonary embolism (PE).Methods A retrospective analysis of nursing in 57 PE patients was camied out,Nursing flow chart was established.For patients with high risk factors of PE,predictive nursingwas administered,including analysis of risk factors,health education,general nursing and pertinent nursing.For PE patients,holistic nursing was administered,including emergeney nursing,basic nursing,observation of illness,nursing of thrombolytic therapy,psychological nursing and rehabilitation nursing, Results All patients accorded with thrombolysis indication and received thrombolysis treatment. Conclusions Predictive and high-quality nursing should be used in PE patients in order to improve treatment effect.