Objective To observe the application effect of comfortable nursing in percutaneous coronary intervention for patients with acute myocardium infarction.Methods 112 patients with acute myocardium infarction receiving the treatment of percutaneous coronary intervention were randomly divided into the observation group and the control group,each group including 56 cases.The control group was given conventional nursing,and the observation group was given comfortable nursing.Hospitalization time,nursing satisfaction degree,psychological status before and after treatment and life quality for patients in two groups were evaluated.Results The nursing satisfaction degree,nursing effect and life quality for 56 patients in the observation group were higher evidently than those in the control group.And the average hospitalization time of the observation group was lower than that of the control group.The comparison between two groups had statistical significance.Conclusions Comfortable nursing in percutaneous coronary intervention for patients with acute myocardium infarction can evidently improve medical quality,and can provide strong guarantee for the life and safety of patients.

Objective To investigate whether caspase-8 regulates Bcl-2 expression in Fas and Actinomycin D(AD) induced apoptosis in Bel-7402 cells.Methods Bel-7402 cells were divided into four groups randomly,that is:control,Fas group,Fas-AD group and Ac-IEFD-cho group,and treated with Fas-AD in the presence/absence of caspase-8 inhibitor Ac-IEFD-cho.The expressions of caspase-8 and Bcl-2 were determined with Western Blot and RT-PCR,respectively.Results Compared with control group and Fas group,after Bel-7402 cells were treated with Fas-AD,typical apoptosis morphology was clearly observed,the expression of activated caspase-8 increased significantly,and the Bcl-2 expression decreased apparently.However,after Bel-7402 cells were treated with Fas-AD in the presence of the caspase-8 inhibitor Ac-IEFD-cho,the expressions of activated caspase-8 decreased while the Bcl-2 expression increased.Conclusion Activated caspase-8 can regulate Bcl-2 in Fas-and AD-induced apoptosis in Bel-7402 cells.

OBJECTIVE:To systematically review the efficacy and safety of Magnesium isoglycyrrhizinate injection versus 4 comnon medicines in the treatment of drug-induced liver damage,and to provide evidence-based reference for clinic treatment. METHODS:Retrieved from PubMed,EMBase,Cochrane Library,CBM,CJFD,Wanfang Database and VIP Database,random-ized controlled trials (RCT) about Magnesium isoglycyrrhizinate injection versus other medicines in the treatment of drug-induced liver damage were enrolled. Meta-analysis was performed by using Rev Man 5.3 software after literature selection,data extract and quality assessment. RESULTS:A total of 13 RCTs were included,involving 1 093 patients. Results of Meta-analysis showed clini-cal effective in magnesium isoglycyrrhizinate group was significantly higher than tiopronin group[RD=0.29,95%CI(0.17,0.42), P<0.001] and diammonium glycyrrhizinate group [RD=0.07,95%CI(0.01,0.12),P=0.02],compared with glutathione group and compound ammonium glycyrrhetate group,there were no significant differences ;incidence of adverse reactions in magnesium iso-glycyrrhizinate group was significantly lower than diammonium glycyrrhizinate group [RD=-0.07,95%CI(-0.11,-0.03),P<0.001] and compound ammonium glycyrrhetate group[RD=-0.21,95%CI(-0.38,-0.04),P=0.02],compared with triopro-nin group and glutathione group,there were no significant differences among 3 groups. CONCLUSIONS:Magnesium isoglycyrrhiz-inate injection has better efficacy and safety than other 4 commons hepatoprotective medicines in the treatment of drug-induced liver damage. Due to the limit of methodological quality,more large-scale and long-term follow-up studies with strict designed are need-ed for the further verification of the conclusion.

ObjectiveTo unify the definitions of colonoscopic characteristics of Crohn disease (CD) and intestinal tuberculosis ( ITB),and to evaluate colonoscopic and clinical features in the differential diagnosis of CD and ITB.MethodsA collaborative group composed of 10 experts from 5 hospitals voted to identify and confirm the colonoscopic characteristics.Clinical and colonoscopic characteristics were analyzed,thereafter,characteristics were scored based on different diagnostic specificity.ROC curve was used for determining the cutoff point to differentiate CD from ITB.ResultsFirstly,standard endoscopic images and descriptions were determined.Secondly,colonoscopic parameters which were significantly different between the CD and ITB patients included the follows:involvement of more than four intestinal segments,anorectal involvement,longitudinal ulcers,cobblestone appearance and transverse ulcers.Clinical findings which were significantly different between the CD and ITB patients included active pulmonary tuberculosis,PPD-test strong positive,anal fistula/perianal abscess and extra-intestinal manifestations in CD.4.4％(6/136) patients were confirmed by histological evidence of caseating granulomas.By using our scoring system,39.7％ (54/136) confirmed diagnoses and 18.4％ (25/136) suspected diagnoses were made in patients without histological evidence.ConclusionIdentification of colonoscopic characteristics and unification of the colonscopic diagnostic criteria were helpful in the differential diagnosis between CD and ITB.The differential diagnosis rate could he improved by using the scoring system.Half cases could not be confirmed even with combined pathology and the scoring system,so a more comprhensive scoring system would be warranted.

Objective The objectives of this study were to compare the clinicopathological features of different Lauren type gastric cancer,to carry out survival analysis,and to screen the prognostic factors.Methods The clinical pathologic data of gastric cancer patients who underwent surgical treatment at the Affiliated Tumor Hospital of Harbin Medical University from January 1,2007 to June 30,2007 were retrospectively analyzed.The 633 cases of gastric cancer patients were divided into intestinal type gastric cancer and diffuse type of gastric cancer groups,which were analyzed clinical and pathological characteristics and survival.Results Compared with diffuse type of gastric cancer,the proportion of intestinal type gastric cancer was slightly high(51.66% vs. 48.34%),the proportion of male was also high(2.94:1 vs.2.03:1,P=0.035).These could be more often in elderly patients age(≥60 years)(54.43% vs.35.94%,P<0.001).The prognosis of intestinal type gastric cancer was significantly better than diffuse gastric cancer(median survival time:90.9 months vs.37.33 months, P=0.014).Multivariate analysis showed that age ≥60 years old,CA199 abnormalities,larger tumors,poor differ-entiation,serosal invasion,initial lymph node metastasis,palliative surgery and non-pyloric resection were poor prognostic factors in gastric cancer.Conclusion Lauren type can be better respond to the clinicopathological fea-tures of different gastric cancer and guide to the prognosis.

Objective To explore the clinical value of portal exposure in laparoscopic treatment of children with type Ⅲ biliary atresia (BA).Methods From June 2013 to October 2017,30 infants with type Ⅲ BA who treated with laparoscopic portoenterostomy in Huai'an Women and Children's Hospital were selected.A percutaneous suture was used to snare the round ligament and retract the liver,other percutaneous stay sutures were then introduced and fundus and neck of gallbladder were sutured to elevate the liver to expose the portal hepatis.The fibro cord and hepatic vessels were mobilized,and then two rubber bands were put around the left and right portal veins and hepatic arteries.The portal hepatis was exposed by laterally stretching the two elastic rubber bands.The fibro cord was removed and then laparoscopic portoenterostomy was accomplished.In 20 cases,the liver was enlarged,part of hepatic lobus quadratus was removed laparoscopiclly for exposure of the portal hepatis.Results There were 30 cases in this group,2 cases were converted to open surgery by a micro transverse incision.There was no surgical death.Time of laparoscopic procedure varied from 210 to 280 min.All cases survived the surgery without any intraoperative complications.Blood loss during operation was minimal,without necessity for blood transfusion.One case died of respiratory failure one week after surgery.Two cases were lost follow-up.Twenty-five cases were followed up for 3～51 months(mean 22.4 months).Three cases died because of repeated cholangitis and liver failure at 10,16,35 months postoperatively.Nineteen patients' total bilirubin had dropped to normal,three others' bilirubin levels dropped significantly after surgery.Conclusion The technique of laparoscopic hepatic porta exposure can help to complete hepatic portoenterostomy successfully,reduce the conversion rate of laparoscopic surgery,and improve the surgical effect.

Cystatin, a cysteine protease inhibitor found in many parasites, plays important roles in immune evasion. This study analyzed the molecular characteristics of a cystatin from Fasciola hepatica (FhCystatin) and expressed recombinant FhCystatin (rFhcystatin) to investigate the immune modulatory effects on lipopolysaccharide-induced proliferation, migration, cytokine secretion, nitric oxide (NO) production, and apoptosis in mouse macrophages. The FhCystatin gene encoded 116 amino acids and contained a conserved cystatin-like domain. rFhCystatin significantly inhibited the activity of cathepsin B. rFhCystatin bound to the surface of mouse RAW264.7 cells, significantly inhibited cell proliferation and promoted apoptosis. Moreover, rFhCystatin inhibited the expression of cellular nitric oxide, interleukin-6, and tumor necrosis factor-α, and promoted the expression of transforming growth factor-β and interleukin-10. These results showed that FhCystatin played an important role in regulating the activity of mouse macrophages. Our findings provide new insights into mechanisms underlying the immune evasion and contribute to the exploration of potential targets for the development of new drug to control F. hepatica infection.

Objective:To explore the correlation between functional constipation （FC）and its related factors with acute appendicitis（AA）in children，so as to provide a reference for the prevention and clinical diagnosis and treatment of children with AA. Methods:A case-control study was conducted on 170 children diagnosed with AA in the Department of Pediatrics，the Second Affiliated Hospital of Air Force Military Medical University，from August 2022 to March 2023，and 170 non-AA children during the same period were selected as control objects.The clinical data，incidence of FC，symptoms related to FC，Bristol stool classification，past constipation history and other information were compared between two groups.Results:The incidence of FC in 170 children with AA was 22.9%（39/170），which was significantly higher than 10.6%（18/170）in the non-AA group（ P<0.01）；For children under four years old，the proportion of faecal retention in AA group was higher than that in non-AA group（25.6% vs. 9.3%, P<0.05）；For children ≥ 4 years old，the proportion of faecal retention and dyschezia in AA group were higher than those in non-AA group（28.2% vs. 6.9%，29.0% vs. 16.4%，respectively,all P<0.05）.The proportion of past constipation history in AA group was higher than that in non-AA group（29.4% vs.14.1%）.The duration of constipation in AA group was longer than that in non-AA group [0.00（0.00，1.25）month vs. 0.00（0.00，0.00）month,all P<0.01].The proportion of children with low Bristol stool classification in AA group was higher than that in non-AA group（ P<0.01）.Multivariate Logistic regression analysis showed that faecal retention[ OR=6.186（95% CI 2.336~16.380）] and long constipation time [ OR=1.310（95% CI 1.095~1.567）]were independent risk factors for AA in children（all P<0.05）. Conclusion:The incidence of faecal retention in children with AA is higher than that in children without AA，and the median duration of constipation is longer than that in children without AA.Fecal retention and long-term constipation are independent risk factors for AA in children.

Objective:To investigate the efficacy and adverse reactions of whole-lung low-dose radiotherapy (LDRT) in patients with severe/critical coronavirus disease 2019 (COVID-19).Methods:Eight patients with severe/critical COVID-19 treated in the Jiangyin Hospital Affiliated to Nantong University from January to June 2023 who were treated with whole-lung LDRT after deteriorating or failing to improve post-medical treatment were enrolled in this single-arm phase I clinical trial. They received anterior-posterior penetrating radiation in a supine or prone position, with a total dose range from 0.5 to 1.5 Gy and a dose weight ratio of 1∶1. The oxygenation status, inflammatory markers, and imaging changes before and after radiotherapy were analyzed, and patients were followed up for acute radiation-induced adverse reactions.Results:One week after LDRT, the SaO 2/FiO 2 or PaO 2/FiO 2 indices increased in seven patients (87.5%), inflammatory markers such as C-reactive protein (CRP) and interleukin-6 (IL-6) decreased in seven patients (87.5%), and chest CT/chest radiographs revealed a significant reduction in the extent of pneumonia involvement in 5 patients (62.5%). No evident acute radiation-related adverse reactions were observed. Conclusions:Whole-lung LDRT with a dose range from 0.5 to 1.5 Gy can reduce inflammatory markers, improve clinical symptoms, and promote inflammatory absorption in patients with severe/critical COVID-19 who responded poorly to medical treatment while not inducing acute adverse reactions.

Objective To investigate the effect of phenformin combined with hexokinase inhibitor 2-deoxyglucose (2-DG) on the treatment of triple-negative breast cancer cell lines 4T1 and MDA-MB-231. Methods Following treatment with phenformin, 2-DG or phenformin combined with 2-DG on 4T1 and MDA-MB-231 cells for 48 h, the cell proliferation in each group was detected by SRB and the apoptosis of cells was detected by flow cytometry. The concentration of glucose and lactic acid in cell culture supernatant was detected by ELISA. The activity of mitochondrial respiratory chain complex Ⅰ was detected by FlexStation3 and the mitochondrial oxygen consumption (OCR) was assayed with the Seahorse X Fe Analyzer. Results The hexokinase expression (4.6±0.17,3.73±0.21), glucose consumption (356±31，397±42) μg/10⁵ cells , Lactic acid concentration (5.59±0.52, 7.83±0.78) μmol/L in the supernatant of 4T1 and MDA-MB-231 cells in Phenformin group were higher than that in control group ( 1±0.15，1±0.12 ) , ( 289±25，301±32) μg/10⁵cells , ( 2.37±0.18，4.01±0.45) μmol/L (P < 0.01). Even if the dose was reduced by 90%, the cell viability of phenformin combined with 2-DG group (64.63±2.28, 51.97±2.29) % was still higher than that of phenformin group (86.70±1.83, 85.53±1.46) % (P<0.001). The combination of the two drugs significantly promoted the apoptosis of 4T1 and MDA-MB-231. In addition, compared with the phenformin group (5.59±0.52, 7.83±0.78) μmol/L, the phenformin combined with 2-DG group (3.46±0.37, 5.18±0.62) μmol/L cell lactic acid production also greatly reduced (P<0.01). Compared with the phenformin or 2-DG single-drug group, the phenformin combined with 2-DG group can significantly inhibit the growth rate of tumors in tumor-bearing mice (P<0.01). The median survival time of tumor-bearing mice in the phenformin combined with 2-DG group was 72.5 d, which was higher than that in the phenformin group 57 d and 2-DG group 55.5 d (P<0.01). Conclusion Hexokinase inhibitor 2-DG significantly enhances the therapeutic effects of phenformin on triple-negative breast cancer cells.