Objective: To explore the effect of Slit2/ROBO1 protein (Slit2/ROBO1) signaling pathway in high glucose-induced epithelial-mesenchymal transdifferentiation (EMT) and its mechanism. Methods: Human renal tubular epithelial cells (HK-2) were cultured in vitro and subjected to high glucose concentration and time gradient experiments. First, for concentration gradient experiment, the sample was randomly divided into normal group, control group 1, control group 2, high glucose group 1, high glucose group 2. While for high glucose time gradient experiment, the sample was randomly divided into normal group, control group, high glucose 24 h group, high glucose 36 h group and high glucose 48 h group. Western blotting was used to detect the expression changes of Slit2, ROBO1, α-smooth muscle actin (α-SMA) and fibronectin in HK-2 cells, and then the optimal high glucose stimulation concentration and time were screened out. Slit2 over-expressed plasmid and negative control plasmid were transfected into HK-2 cells to verify the successful transfection, the cells were then randomly divided into normal group, control group, high glucose group, high glucose empty group and high glucose Slit2 group. The total protein was extracted after stimulation with optimal high glucose concentration and time, and Western blotting was then performed to detect the change in expression of fibronectin and α-SMA. Results: In the high glucose concentration gradient experiment, the expression of Slit2 declined significantly in high glucose group 1(0.647±0.048) and high glucose group 2(0.210±0.023) than in the normal group (1.000±0.050); the expression of ROBO1 declined significantly in high glucose group 1(0.703±0.041) and high glucose group 2(0.303±0.022) than in the normal group (1.000±0.057); while the expression of fibronectin increased significantly in high glucose group 1(1.953±0.042) and high glucose group 2(2.997±0.078) than in the normal group (0.990±0.059), and the expression of α-SMA increased significantly in high glucose group 1(1.767±0.012) and high glucose group 2(2.427±0.059) than in the normal group (1.033±0.067), all the differences were of statistical significance(P<0.05). Compared with the high glucose group 1, the expressions of Slit2 and ROBO1 decreased, and of fibronectin and α-SMA increased significantly in the high glucose group 2(P<0.05). In the high glucose time gradient experiment, compared with the normal group, the expressions of Slit2 in high glucose 36 h group and high glucose 48 h group decreased (0.943±0.032 vs. 0.557±0.020, 0.450±0.055, respectively), and the expression of ROBO1 decreased (1.000±0.058 vs. 0.600±0.023, 0.227±0.028, respectively). Compared with the normal group, the expression of fibronectin increased significantly in high glucose 24 h group, high glucose 36 h group and high glucose 48 h group (0.970±0.040 vs. 1.247±0.052, 1.733±0.084, 2.780±0.090, respectively), and the expression of α-SMA increased significantly in high glucose 24 h group, high glucose 36 h group and high glucose 48 h group (1.033±0.067 vs. 1.277±0.041, 1.767±0.120, 2.537±0.078, respectively), and the difference was statistically significant (P<0.05). Compared with high glucose 24 h group, the expression of Slit2 declined significantly in high glucose 36 h group and high glucose 48 h group(0.893±0.034 vs. 0.557±0.020, 0.450±0.055, respectively), and the expression of ROBO1 declined significantly (0.930±0.025 vs. 0.600±0.023, 0.227±0.028, respectively), the expressions of fibronectin and α-SMA increased significantly with statistical significance (P<0.05). Compared with high glucose 36 h group, the expression of Slit2 and ROBO1 declined significantly, and the expression of fibronectin and α-SMA increased significantly in high glucose 48 h group (P<0.05). In the high glucose environment, and achieving Slit2 overexpression and negative control plasmid transfection, the expression of fibronectin increased significantly in high glucose group, high glucose+empty group and high glucose+Slit2 group (2.760±0.012, 2.667±0.027, 1.460±0.034, respectively) than in normal group (1.000±0.058); the expression of α-SMA increased also in high glucose group, high glucose+empty group and high glucose+Slit2 group (2.487±0.048, 2.557±0.037, 1.270±0.017, respectively) than in normal group (1.000±0.050) with statistical significance (P<0.05). Compared with the high glucose+empty group, the expression of fibronectin and α-SMA declined significantly in the high glucose+Slit2 group(P<0.05). Conclusion: The decreased expression of Slit2 and ROBO1 is involved in the high glucose-induced renal tubular EMT. Overexpression of Slit2 may significantly inhibit the high glucose-induced EMT.

Objective To compare the functional and radiographic outcomes of modified dual plating and less invasive stabilization system(LISS)in treatment of patients with complex tibial plateau fractures.Methods From November 2003 to November 2004,84 patients with complex tibial plateau fracture were treated with modified dual plating or LISS fixation.Their functional and radiographic outcomes were reviewed to compare the differences in bone union time,full weight-bearing time,knee joint's HSS(The Hospital for Special Surgery)scores,complications, tibia plateau angle(TPA)and posterior slope angle(PA).Results The 84 cases had complete follow-up records and a mean tollow-up of 16.2 months(range,12 to 23 months).Nine complications occurred in the modified dual plating group.The mean full weight-bearing time and radiographic bone union time were 16.8 and 15.1 weeks respectively for this group which had a mean HSS score of 87.4 points.Six complications were found in the LISS group.The mean full weight-bearing time and radiographic bone union time were 14.1 and 13.8 weeks respectively for this group which had a mean HSS score of 89.6 points.There were no significant differences between the two groups in changes of TPA and PA.Conclusion LISS can provide as good fixation as modified dual plating can for most complex tibial plateau fractures,but additional medial plate fixation may be necessary for some special cases.

Objective To investigate the effects of estrogen on the expression of KLK6 mRNA and protein in human ovarian cancer cell line HO8910.Methods HO8910 cells were incubated for 72 hours in two groups:the test group with 17-?E_2 at different concentration(10~(-10)、10~(-9)、10~(-8)、10~(-7)mol/L)and the control group with Ethanol.Real-time fluorensence quantitive RT-PCR and flow cytometry were used to measured the expression of KLK6 mRNA and protein in the two groups.The cell proliferation was measured by 3-(4,5-dimethylthiazol-z-yl)-2,5-dipheny tetrazolium blue(MTT)calorimetric assay,while the cell cycle was determined by flow cytometry.Results The expression ofKLK6 mRNA(3.83?0.41、4.14? 0.49、6.26?0.38、7.28?1.82)and protein(10.62?0.35,10.89?0.12、11.88?0.28、12.07?0.15) in the test group of H08910 cells(10~(-10)10~(-9)10~(-8)10~(-7)mol/L)was higher than that in the ethanol control group(P

Objective To investigate the correlation between serum soluble epithelial cadherin (sE-cad) and postoperative recurrence and prognosis in patients with advanced gastric cancer.Methods The level of serum sE-cad in 85 patients with advanced gastric cancer (advanced gastric cancer group) was detected by ELISA technique preoperative and postoperative 1 month,and compared with 30 healthy controls(control group).The patients in advanced gastric cancer group were followed up for 3 years,the level of serum sE-cad in recurrent patients and non-recurrent patients was compared.Results The level of serum sE-cad in advanced gastric cancer group preoperative was significantly higher than that in control group [(24.3 ± 14.8) μ g/L vs.(9.4 ± 3.8) μ g/L,P ＜ 0.01].The level of serum sE-cad in advanced gastric cancer group was significantly decreased postoperative 1 month [(12.5 ± 6.4) μ g/L vs.(24.3 ± 14.8) μ g/L,P ＜0.01].The level of serum sE-cad in recurrent patients was significantly higher than that in non-recurrent patients and postoperative 1 month [(20.7 ±9.8)μg/L vs.(12.5 ±6.4),(14.8 ±6.2) μg/L,P＜0.01].Univariate analysis revealed that preoperative high serum sE-cad level was related with tumor size,differentiated degree,lymph node metastasis ratio,depth of tumor invasion (P ＜0.05),but had no relationship with histological type(P＞ 0.05).Elevated preoperative serum sE-cad level negatively affected the postoperative survival rate and recurrence rate.Multivariate Logistic regression anaiysis revealed that preoperative serum sE-cad level was an independent risk factor for postoperative 3 years survival rate in advanced gastric cancer (HR =2.068,P =0.013).Conclusions Preoperative elevated serum sE-cad level is related with pathologic features in patients with advanced gastric cancer,and may be an important prognostic factor.Postoperative monitoring the level of serum sE-cad is useful for evaluating the prognosis and recurrence.

Objective To review the complications after endovascular aneurysm repair (EVAR) of high-risk abdominal aortic aneurysms in our medical center.Methods Fifty eight elective high-risk EVAR cases from January 2008 to December 2013 were analyzed retrospectively.Results The technical success rate was 96.6％ (56 of 58 patients).The overall complication rate in perioperative period was 32.8％ (19/58).Eleven systemic complications (19.0％),16 primary endoleaks (27.6％),7 access of site complications(12.1％) were observed.The follow-up rate was 86.2％ (51/58).During the follow up period,the mortality was 7.8％ (4/51),the re-intervention rate was 7.8％ (4/51).The overall complication rate was 29.4％ (15/51),including systemic complications (2/51),secondary endoleak (9.8％) and graft-related complications (11.8％,6/51).Conclusions Endoleak,graft-related complications continue to be the main causes of re-intervention in high-risk aneurysm patients after EVAR.

A competency dictionary of advanced health informatization application persons was compiled by inter-viewing 20 health information persons with behavior events interview , their competency characteristics were coded By Nvivo, the coding frequency and characteristics score in good performance group and ordinary group were ana-lyzed by variance analysis, which showed 8 characteristics of key competency and 12 characteristics of basic compe-tency in advanced health information application persons.

Objective: To analyze emergency management measures in large public hospitals during epidemic prevention of corona virus disease 2019 (COVID-19) in order to promote control efficiency and quality of COVID-19 in the emergency room of public hospitals. Methods: A retrospective analysis was made on the amount of emergency visits and management measures of Shanghai Sixth People's Hospital, Shanghai Jiao Tong University from January to February, 2020, including optimizing the process of emergency treatment during epidemic prevention, strengthening the management of key areas such as pre-examination and triage, emergency room, observation room, fluid room and the intensive-care unit and so on, enhancing the management and education of patients, optimizing the deployment model of medical staff, strengthening personal protection and other management measures. Results: During epidemic prevention, there was no missed diagnosis of COVID-19 in the hospital and no nosocomial cross infection in the emergency room. Conclusion: Enhancement of emergency management model in large public hospitals during COVID-19 epidemic prevention can improve the screening of possible patients and triage of patients so as to prevent nosocomial infection.

Four salts of ticagrelor, ticagrelor-3,5-dinitrobenzoic acid, ticagrelor-pyrazinamide, ticagrelor-D-proline and ticagrelor-L-proline were prepared by solvent suspension and liquid-assisted grinding to improve the solubility of ticagrelor. The compounds were characterized by powder X-ray diffraction, Fourier transform infrared spectroscopy, differential scanning calorimetry, nuclear magnetic resonance spectroscopy, elemental analysis, and the intermolecular salt-bonding forces were analyzed. The equilibrium solubility of salts and pure drug in hydrochloride buffer pH 1.2 and phosphate buffer pH 6.8 were measured by high-performance liquid chromatography. Ticagrelor was salted with 3,5-dinitrobenzoic acid, pyrazinamide, D-proline, L-proline all in a stoichiometric ratio of 1∶1; with the exception of ticagrelor-D-proline, the solubility of the other three salts provided significantly improved solubility in hydrochloride buffer pH 1.2, and the equilibrium solubility of ticagrelor-3,5-dinitrobenzoic acid was increased by approximately 1.7 folds as compared to pure drug. Salt-forming technology is convenient and can improve the solubility of ticagrelor.

The nuclear transcription factor nuclear factor erythroid 2-related factor 2 (NRF2) plays a crucial role in maintaining cellular redox homeostasis. The aberrant NRF2 signaling confers enhanced antioxidant capacity, which is linked to tumor progression and therapeutic resistance. The current study investigates the biological effects and molecular mechanism of tribbles homolog 3 (TRIB3), a stress-induced protein, in regulating cell survival and apoptosis in lung cancer. This study first performed the RNA sequencing data analysis with 576 lung adenocarcinoma patients from the cancer genome atlas (TCGA) database. The NRF2- antioxidant response element (ARE) signature was enriched in patients with high TRIB3 expression. Dual-luciferase reporter assay and real-time quantitative polymerase chain reaction (PCR) were used to confirm the effect of TRIB3 on the kelch-like ECH-associated protein-1 (KEAP1)-NRF2 pathway. Abrogation of TRIB3 impaired NRF2 transcriptional activity and reduced the expression of its target genes. Moreover, TRIB3 enhanced NRF2 stability via blocking KEAP1-NRF2 interaction. TRIB3-depletion promoted reactive oxygen species (ROS) production, restrained cell proliferation, and enhanced carboplatin-induced apoptosis. In addition, NRF2 overexpression recovered the tumor inhibition effect of TRIB3-depletion. Consistently, TRIB3 failed to modulate apoptosis in NRF2 depletion cells. In summary, this study shows that TRIB3 inhibits the KEAP1-NRF2 interaction and upregulates the transcriptional activity of NRF2, thereby promoting lung cancer cell proliferation and reducing the sensitivity to chemotherapy. Targeting the TRIB3-NRF2 signal axis may become a new strategy for ROS homeostasis and lung cancer treatment.

Objective To develop a human immune-deficiency virus (HIV) infection risk appraisal model suitable for men who has sex with men (MSM) in Guangzhou,and to provide tools for follow-up the outcomes on health education and behavior intervention.Methods A cros-sectional study was conducted in Guangzhou from 2008 to 2010.Based on the HIV surveillance data,the main risk factors of HIV infection among MSM were screened by means of logistic regression.Degree on relative risk was transformed into risk scores by adopting the statistics models.Individual risk scores,group risk scores and individual infection risk in comparison with usual MSM groups could then be calculated according to the rate of exposure on those risk factors appeared in data from the surveillance programs.Results Risk factors related to HIV infection among MSM and the quantitative assessment standard (risk scores and risk scores table of population groups) for those factors were set up by multiple logistic regression,including age,location of registered residence,monthly income,major location for finding their sexual partners,HIV testing in the past year,age when having the first sexual intercourse,rate of condom use in the past six months,symptoms related to sexually transmitted diseases (STDs) and syphilis in particular.The average risk score of population was 6.06,with risk scores for HIV positive and negative as 3.10 and 18.08 respectively (P＜ 0.001 ).The rates of H IV infection for different score groups were 0.9％,2.0％,7.0％,14.4％ and 33.3％,respectively.The sensitivity and specificity on the prediction of scores were 54.4％ and 75.4％ respectively,with the accuracy rate as 74.2％.Conclusion HIV infection risk model could be used to quantify and classify the individual' s infectious status and related factors among MSM more directly and effectively,so as to help the individuals to identify their high-risk behaviors as well as lifestyles.We felt that it could also serve as an important tool used for personalized HIV health education and behavior intervention programs.