PI3K-Akt signaling pathway plays a critical role in the regulation of cell proliferation,differentiation and apoptosis,and is closely related to the physiological function of cells and thus may cause certain diseases.The excessive activation of this pathway is found closely associated with the formation of drug resistance of tumors.Recent studies in vitro indicate that the combined chemotherapy drugs with PI3K-Akt signaling pathway inhibitors,can significantly enhance the efficiency of chemotherapy drug and lower the value of IC50.Therefore,PI3K-Akt signaling pathway has become an important target to inhibit tumor cell growth and reverse tumor drug resistance.

Objective To explore the expression level of thioredoxin (Trx) in acute myeloid leukemia (AML) cells,and its association with clinical features and prognosis,as well as the effects of diamide,an inhibitor of Trx,in inducing AML cells apoptosis.Methods Expression of Trx on AML cells and fresh bone marrow cells from healthy adults were analyzed by Western-blotting. The inhibition of proliferation was measured by MTT assay.The anti-leukemia effect of diamide was observed by morphology and agarose gel electrophoresis.Results 75 ％ (15/20) of AML patients expressed Trx,while no expression was observed in control group.Higher expression level of Trx was associated with higher WBC counts (x2 =9.375,P ＜ 0.05),which suggested that overexpression was associated with leukemogenesis.The inhibition of diamide on AML cells showed time and dose dependent by MTT assay.The IC50 values of diamide at 24 h,48 h and 72 h were 98.26 mg/ml,47.53 mg/ml and 8.34 mg/ml,respectively.After AML cells were treated with diamide,the apoptotic body appeared by morphology,and the typical DNA “ladder” bands were confirmed by agarose gel electrophoresis.Conclusion Trx expression level in AML cells is significantly higher than that of control group.Diamide inhibites the proliferation of AML cells by inducing apoptosis,which might be a potential agent for AML.

Objective To compare influences of enteral nutrition (EN) and parenteral nutrition (PN) on the inflammatory factors and immune functions in patients with systemic inflammatory response syndrome. Methods Totally 85 patients who were treated in the First Hospital of Shanxi Medical University, Shanxi Province People's Hospital, and Taiyuan Central Hospital from April, 2006 to April, 2010 were enrolled in this study and divided into EN group (n = 49) and PN group (n = 36) according to nutrition support modes. The changes of inflammatory factors and immune functions after nutritional supports were recorded and compared between these two groups. Results The weight, arm circumference, skin fold thickness of brachial triceps, total protein, and serum albumin were significantly improved on the 7th and 14th day after nutrition supports in both two groups compared with the baseline levels (all P ＜ 0.05). On the 14th day after nutritional support, the levels of total protein and serum albumin were significantly higher in EN group than in PN group. On the 7th and 14th day, the levels of tumor necrosis factor-α, Interleukin (IL)-8, and IL-1β in EN group were significantly lower than those in PN group and baseline levels (all P ＜ 0. 05). The blood CD4/CD8 and IgG in EN group were significantly increased compared with the baseline levels and those in PN group (both P ＜0. 05). Conclusions Both PN and EN can effectively improve the nutritional status of patients with SIRS. EN has superior effectiveness in EN group than in PN group in terms of improving nutritional status, ameliorating immune function, and reducing the release of inflammatory factors.

Objective:To investigate the significance of changes of neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in neoadjuvant therapy for rectal cancer.Methods:The data of 86 patients with rectal cancer who received neoadjuvant therapy from November 2013 to January 2015 in Shanxi Provincial Cancer Hospital were retrospectively analyzed, and the correlations of NLR and PLR changes with the patients' clinicopathological characteristics and therapeutic effects were also analyzed.Results:There were 43 cases of increased NLR and 43 cases of increased PLR after treatment. NLR and PLR changes before and after neoadjuvant therapy in patients with rectal cancer were not associated with age, gender, TNM stage, lymph node metastasis, number of cancer nodules, and tumor diameter (all P > 0.05). The increasing proportion of NLR and PLR after treatment in patients with the distance from the tumor to anus < 6 cm was higher than that in those with the distance≥6 cm [60.00% (30/50) vs. 36. 11% (13/36), χ2 = 4.778, P = 0.029; 64.00% (32/50) vs. 30.56% (11/36), χ2 = 9.364, P = 0.002]. The increasing proportion of NLR and PLR after treatment in patients with the body mass index (BMI) ≥28 kg/m 2 was higher than that in those with BMI < 28 kg/m 2 [81.82% (9/11) vs. 45.33% (34/75), χ2 = 5.108, P = 0.024; 90.91% (10/11) vs. 44.00% (33/75), χ2 = 8.444, P = 0.004]. The remission rate of patients in NLR reduction group after treatment was higher than that in NLR increase group [72.09% (31/43) vs. 51.16% (31/43), χ2 = 3.983, P = 0.046]. PLR changes were not associated with the therapeutic effects of neoadjuvant therapy before and after treatment ( P > 0.05). Conclusion:NLR changes are associated with therapeutic efficacy before and after neoadjuvant therapy for patients with rectal cancer.

Objective:To explore the effect of long-chain fat emulsion in parenteral nutrition therapy on the perioperative nutritional status of patients with low rectal cancer.Methods:A total of 204 patients who underwent rectal cancer surgery in the Third Hospital of Shanxi Medical University from January 2017 to June 2020 were retrospectively analyzed. The patients were divided into two groups according to the specific nutritional treatment methods, 100 cases in the study group used long-chain fat emulsion for parenteral nutrition support, and 104 cases in the control group used medium- and long-chain fat emulsion injection. After admission, the nutritional status of patients were evaluated according to the results of Scored Patient-Generated Subjective Global Assessment (PG-SGA) and related laboratory tests. At 7th day before the operation, the patients were treated with nutrition and electrolyte support. Parenteral nutrition and enteral nutrition combined treatment and early enteral nutrition were given after the operation. The albumin, prealbumin, retinol-binding protein, total cholesterol and body mass index (BMI) at 7th day before the operation, 1st day after the operation and 7th day after the operation and the patient's first exhaust time after surgery, occurrence of postoperative complications, postoperative fever and total hospital stay were recorded and compared between the two groups.Results:Postoperative first exhaust time [(42±11) h vs. (54±10) h], fever time [(48±8) h vs. (57±7) h], total hospital stay [(16.0±0.7) d vs. (18.0±0.9) d)], resting energy expenditure at the 7th day after surgery [(5 326±589) kJ/d vs. (5 840±599) kJ/d] and total cholesterol at the 7th day after surgery [(4.8±0.3) mmol/L vs. (5.0± 0.4) mmol/L] in the study group were lower than those in the control group, and albumin [(33±3) g/L vs. (28± 3) g/L], prealbumin [(0.189±0.041) g/L vs. (0.164±0.037) g/L] and retinol-binding protein [(0.039±0.016) g/L vs. (0.032±0.013) g/L] at the 7th day after surgery in the study group were higher than those in the control group, and the differences between the two groups were statistically significant (all P < 0.05). There was no statistical difference in other detection indexes between the two groups (all P > 0.05). Conclusion:The use of long-chain fat emulsion in low rectal cancer patients with malnutrition during the perioperative period may be more conducive to the recovery of the body.