BACKGROUND:The self-renew and regeneration capacity of the injured spinal cord is thought to be limited. Accordingly, cel transplantation is one potential strategy for promoting functional recovery after spinal cord injury. OBJECTIVE:To explore the effects ofPTEN silencing on the biological properties of bone marrow mesenchymal stem cels, hoping to offer better seed cels for tissue engineering. METHODS:Bone marrow mesenchymal stem cels were transfected with specific siRNA-silencedPTEN gene using the liposome method, and then RT-PCR was used to detect the mRNA expression ofPTEN. Variation of biological properties ofPTEN-transfected cels were detected by the way of MTT assay, cel cycle analysis, and Transwel assay. RESULTS AND CONCLUSION:PTEN is expressed highly in bone marrow mesenchymal stem cels, which is successfuly interfered by siRNA.PTEN-silenced cels have stronger survival, proliferation and migration abilities, which become a kind of better seed cels for tissue engineering.

Objective:To investigate the diagnostic value of the promoter methylation of plasma RNF180 gene and its protein ex-pression for the detection of gastric cancer. Methods:Methylation-specific polymerase-chain reaction (MSP) and enzyme-linked immu-no-sorbent assay (ELISA) were performed to detect DNA methylation and protein expression of the RNF180 gene, respectively. The correlations of DNA methylation and protein expression of the RNF180 gene with the clinico-pathological parameters of gastric carcino-ma were then separately analyzed. Results:MSP showed that the methylation rates of the RNF180 gene were 62.75%and 21.88%in the plasma of patients with gastric carcinoma and healthy volunteers, respectively;this result indicated that the two groups significantly differed (P<0.01). The methylation of the RNF180 gene was associated with tumor size, clinical stage, tumor differentiation, lymph node metastasis, and distant metastasis (P<0.05). ELISA results showed that the protein expression of the RNF180 gene [(23.22 ± 1.36)μg/mL] was significantly lower (P<0.01) in the plasma of patients with gastric carcinoma than in the plasma of healthy volunteers [(34.25 ± 2.44)μg/mL]. However, the protein expression of the RNF180 gene was not associated with clinicopathological parameters (P>0.05). Conclusion:The RNF180 gene is expressed at a hypermethylation rate, and the corresponding protein expression level is de-creased in the plasma of individuals with gastric carcinoma. Therefore, RNF180 gene methylation in plasma could be applied to detect microinvasion for the clinical diagnosis of gastric cancer.

Objective To summarize the stomach via laparoscopic and natural orifice transluminal endoscopic surgery (NOTES) Clinical application of abdominal exploration and peritoneal biopsy unexplained ascites. Methods A retrospective analysis of our hospital clinical datum of unexplained ascites patients, 20 cases were undergone single port laparoscopic operation from January 2014 to October 2015 and 11 cases were undergone NOTES from May 2015 to July 2016. Operation time, hospitalization expenses, intraoperative bleeding, postoperative hospital stay, postoperative abdominal pain score, fever and leukocyte on the 3rd postoperation were compared in tow groups. Results Laparoscopy group 20 cases, 11 cases diagnosed as tuberculous ascites, 8 cases malignant ascites, 1 case was still unknown;NOTES group 11 cases, 9 cases diagnosed as tuberculous ascites, 1 case malignant ascites and 1 case liver cirrhosis. In two groups, 30 cases were accurate diagnosed (96.8%), tuberculous ascites 20 cases (64.5%), malignant ascites nine cases (29.0%). Laparoscopy group compared with NOTES group, operation time was longer and hospitalization expenses was more, there were statistical signiifcant differences (P<0.05);postoperative hospital stays were higher (P < 0.05); intraoperative bleeding, postoperative abdominal pain score, fever and leukocyte on the 3rd postoperation were no statistical difference (P>0.05). Conclusion The two methods were able to quickly and accurately diagnose ascites reason, in order to facilitate treatment and surgical trauma, less serious complications. Comparison of laparoscopy, NOTES may be more advantageous in ascites diagnosis.

Background and purpose:Colorectal cancer (CRC) is a malignancy which is the third incidence and the fourth mortality in the worldwide. The main reason for the development of CRC is that the changes of genetic and epigenetic causes the tumor suppressor gene methylation silencing. This study aimed to investigate the plasma and stool GATA5 gene promoter methylation was detected in clinical diagnosis of CRC. Methods: To collect the paired plasma and stool specimens of 34 cases of healthy and 43 cases of patients with CRC. Methylation speciifc PCR (MSP) was respectively detected the GATA5 gene methylation levels of GATA5 gene in plasma and stool. And then separately analyzed their correlations with clinical and pathological parameters in gastric carcinoma. Results: The result of MSP showed that GATA5 gene promoter methylation rates in plasma and stool of CRC patients were 60.74%, 76.60%, respectively, were higher than those of healthy persons (6.47%, 32.35%). And the differences were statistically signiifcant (P=0.006 7, P=0.000 2, respectively). GATA5 gene methylation rates in plasma of CRC patients were closely related to clinical stage (P=0.000 5) and lymph node metastasis(P=0.020), while GATA5 gene methylation rates in stool of CRC patients had no signiifcant with clinical and pathological parameters. Conclusion:Detection of faecal GATA5 gene methylation level and supplemented plasma GATA5 gene methylation level can become a simple, non-invasive, sensitive and speciifc method for clinical diagnosis of CRC.

BACKGROUND: The preparation and antibacterial activity of metal ionic zirconium phosphates has been systemically investigated now, but the applications are limited owing to the discoloration or the low antibacterial activity. Here we prepared new antibacterial agents of quaternized zirconium phosphates by introducing quaternary ammonium salt bactericidal agent with high-effective, broad-spectrum and low-toxic into sodium zirconium phosphate through an ion-exchange method.OBJECTIVE: To explore the component structure and antibacterial activity of quaternized zirconium phosphates.DESIGN, TIME AND SETTING: An in vitro observational experiment was performed at Research Laboratory of Department of Chemistry, Jinan University from June to August 2009.MATERIALS: Quaternized zirconium phosphates were prepared by introducing dodecyl dimethyl benzyl ammonium chloride into sodium zirconium phosphate through an ion-exchange method.METHODS: The mol ratios of quaternary ammonium cations to cation exchange capacity of sodium zirconium phosphate in reaction solutions were 0.25: 1,0.5: 1, 1.0: 1, and 1.5 : 1, respectively, and four kinds of quaternized zirconium phosphates containing different contents of quaternary ammonium cations (QZrP-1, QZrP-2, QZrP-3, QZrP-4) were prepared through an ion-exchange method.MAIN OUTCOME MEASURES: The component structure and heat resistance of samples were measured by using an IR spectrometer, an elemental analyzer and a thermal analyzer, respectively. The minimum inhibitory concentrations (MICs) and minimal bactericidal concentrations (MICs) of the samples against Escherichia coli (E. co/i) and Staphylococci aureus (S. aureus) were estimated by a tube broth method.RESULTS: Quaternized zirconium phosphates were prepared, and the quaternary ammonium cation content increased with increasing the concentration of quaternary ammonium cations in reaction solution. The mass fraction of quaternary ammonium cations of QZrP-1, QZrP-2, QZrP-3, and QZrP-4 was 3.70%, 5.00%, 6.96%, and 10.01%, respectively. The onset temperatures of the decomposition for quaternary ammonium cations in quaternized zirconium phosphates were all higher than 345 °C, and they were preferable thermal stability. The antibacterial activity was higher when the quaternary ammonium cation content of quaternized zirconium phosphates increased. For quaternized zirconium phosphates QZrP-3 containing 6.96% mass fraction of quaternary ammonium cations, showed excellent antibacterial activity against E. coli and S. aureus.CONCLUSION: Quaternized zirconium phosphates QZrP-3 containing 6.96% mass fraction of quaternary ammonium cations,exhibited excellent thermal stability and antibacterial activity.

Objective To explore the clinical value of transgastric natural orifice transluminal endoscopic surgery(NOTES)in diagnosing unexplained ascites.Methods The clinical data in 12 cases of unexplained ascites diagnosed by adopting transgastric approach NOTES and performed abdominal exploration and peritoneal biopsy in our hospital from November 2015 to July 2016 were retrospectively analyzed.The operative risk and clinical application value were evaluated by statistically analyzing the postoperative complications occurrence and the diagnosis rate of disease.Results The definite diagnosis rate reached 100％ verified by pathology after abdominal exploration and peritoneal biopsy,in which 8 cases(66.7％)were tuberculous peritonitis,2 cases(16.7％)were liver cirrhosis,1 case(8.3％)was peritoneal mesothelioma,1 cases(8.3％)was peritoneal metastatic carcinoma;2 cases appeared abdominal pain after operation,including 1 case of neutrophil ratio increase,symptoms and persistent time of abnormal laboratory indexes did not exceed 24 h,the incidence rate was 8.3％;no complications of abdominal cavity infection,incision bleeding and puncture site fistula occurred.Conclusion The transgastric NOTES for conducting abdominal exploration and peritoneal biopsy in the diagnosis of unexplained ascites has the advantages of small trauma,less complications and rapid postoperative recovery,possesses an important clinical application value.

Objective:To explore the effect of scientific research group-based model on the improvement of nursing scientific research ability in a county-level hospital.Methods:A nursing research group was established, the composition of team members and work contents of the group were clarified, tiered focused scientific research training was implemented through progressive research content and flexible training methods, and individual and progressive research guidance was provided through research counseling application forms, while literature reading activities were conducted through article reports and literature debriefings. Retrospective analysis of the nursing research practice, the number of scientific research outputs, and research capacity were applied to evaluate the effect of the nursing research group-based model.Results:Within 2 years of the establishment of the nursing research group, 37 training programs were conducted, 33 scientific research materials were pushed to the WeChat public account, 23 scientific research projects were tutored, and 6 research projects were successfully declared. The scientific research ability score of nursing staff participating in literature reading debriefing increased from 44.24±19.12 to 53.57±13.86( P<0.001). Conclusions:The application of the nursing research group-based model can improve the nursing scientific research ability of the county-level hospital.

Objective:To investigate the risk factors for anastomotic leakage after laparo-scopic lower anterior resection (LAR) of rectal cancer, and the application value of its risk assess-ment scoring model.Methods:The retrospective case-control study was conducted. The clinico-pathological data of 539 patients who underwent laparoscopic LAR of rectal cancer in 13 medical centers, including 248 cases in Renji Hospital of Shanghai Jiaotong University School of Medicine, 35 cases in Ningbo First Hospital, 35 cases in Changzhou Second People's Hospital, 32 cases in the First People's Hospital of Nantong, 32 cases in Linyi People's Hospital, 31 cases in Changzhou Wujin People's Hospital, 28 cases in Jiading District Hospital of Traditional Chinese Medicine, 27 cases in the First Hospital of Taizhou, 26 cases in Shanghai Pudong Gongli Hospital, 21 cases in the People's Hospital of Rugao, 11 cases in Central Hospital of Fengxian District, 7 cases in Ningbo Hangzhou Bay Hospital and 6 cases in Jiangsu jianhu People's Hospital, from January 2016 to November 2020 were collected. There were 157 males and 382 females, aged (62.7±0.5)years. Observation indicators: (1) follow-up; (2) risk factors for anastomotic leakage after laparoscopic LAR; (3) establishment of risk assessment scoring model for anastomotic leakage after laparoscopic LAR. Follow-up was conducted by outpatient examination or telephone interview. Patients were followed up at 1 week after discharge or 1 month after the operation to detect the anastomotic leakage. Measurement data with normal distribution were represented as Mean± SD, and measurement data with skewed distribution were represented as M(range). Count data were represented as absolute numbers or percentages, and comparison between groups was analyzed using the chi-square test. Univariate analysis was conducted using the chi-square test and multivariate analysis was conducted usong the Logistic regression model. The area under curve of receiver operating characteristic curve was used to estimate the efficiency of detecton methods. The maximum value of the Youden index was defined as the best cut-off value. Results:(1) Follow-up: 539 patients were followed up at postoperative 1 week and 1 month. During the follow-up, 79 patient had anastomotic leakage, with an incidence of 14.66%(79/539). Of the 79 patients, 39 cases were cured after conservative treatment, 40 cases were cured after reoperation (ileostomy or colostomy). (2) Risk factors for anastomotic leakage after laparoscopic LAR. Results of univariate analysis showed that sex, age, body mass index, smoking and/or drinking, tumor diameter, diabetes mellitus, hemoglobin, albumin, grade of American Society of Anesthesio-logists (ASA), neoadjuvant chemoradiotherapy, distance from anastomotic level to dentate line, the number of pelvic stapler, reinforced anastomosis, volume of intraoperative blood loss, placement of decompression tube, preservation of left colic artery, operation time and professional doctors were related factors for anastomotic leakage after laparoscopic LAR ( χ2=14.060, 4.387, 5.039, 4.094, 17.488, 33.485, 25.066, 28.959, 34.973, 34.207, 22.076, 13.208, 16.440, 17.708, 17.260, 4.573, 5.919, 5.389, P<0.05). Results of multivariate analysis showed that male, tumor diameter ≥3.5 cm, diabetes mellitus, hemoglobin <90 g/L, albumin <30 g/L, grade of ASA ≥Ⅲ, neoadjuvant chemoradiotherapy, distance from anastomotic level to dentate line <1 cm, the number of pelvic stapler ≥3, non-reinforced anastomosis, volume of intraoperative blood loss ≥100 mL and no placement of decom-pression tube were independent risk factors for anastomotic leakage after laparoscopic LAR ( odds ratio=2.864,3.043,12.556,7.178,8.425,12.895,8.987,4.002,3.084,4.393,3.266,3.224,95% confidence interval as 1.279?6.411, 1.404?6.594, 4.469?35.274, 2.648?19.459, 2.471?28.733, 4.027?41.289, 3.702?21.777, 1.746?9.171, 1.365?6.966, 1.914?10.083, 1.434?7.441, 1.321?7.867, P<0.05). (3) Establishment of risk assessment scoring model for anastomotic leakage after laparoscopic LAR. based on the results of univariate analysis, clinicopathological factors with χ2>20, χ2>10 and ≤20 or χ2≤10 were defined as scoring of 3, 2, 1, respectively. The cumulative clinicopatho-logical factors scoring ≥6 was defined as an effective evaluating indicator for postoperative anastomotic leakage. The risk assessment scoring model (6-321) for anastomotic leakage after laparoscopic LAR was established. The cumulative value ≥6 indicated high incidence of anastomotic leakage, and the cumulative value <6 indicated low incidence of anastomotic leakage. Conclusions:Male, tumor diameter ≥3.5 cm, diabetes mellitus, hemoglobin <90 g/L, albumin <30 g/L, grade of ASA ≥Ⅲ, neo-adjuvant chemoradiotherapy, distance from anastomotic level to dentate line <1 cm, the number of pelvic stapler ≥3, non-reinforced anastomosis, volume of intraoperative blood loss ≥100 mL and no placement of decompression tube are independent risk factors for anastomotic leakage after laparoscopic LAR. The risk assessment scoring model (6-321) is established according to the above results.The cumulative value ≥6 indicates high incidence of anastomotic leakage and the cumulative value <6 indicates low incidence of anastomotic leakage.

Objective:To evaluate the potential effects of serum lipid levels, appendicular skeletal muscle mass index (ASMI) and body mass index (BMI), together with its dynamic changes, on tumor progression in renal clear cell carcinoma patients, so as to inform body weight management.Methods:This prospective cohort study included a total of 100 patients with high-risk clear cell renal cell carcinoma. Serum lipid levels were detected, ASMI and BMI were measured using bioelectrical impedance analysis and the dynamic changes of BMI were tracked. The effects of BMI, ASMI and serum lipid levels on tumor progression within 2 years were explored.Results:Patients with normal BMI and low ASMI had 5.248 (95% CI: 1.946 to 14.153, P = 0.001) times higher risk of tumor progression than those who were overweight or obese. For every 0.1-unit increase in pre-operative HDL-C, the risk of tumor progression decreased by 0.771 (95% CI: 0.631 to 0.942, P = 0.011) times. Patients who experienced more than 5% decrease in BMI compared with baseline had 5.165 (95% CI: 1.735 to 15.370, P = 0.003) times the progression risk of patients whose BMI changed within ±5% from baseline. Conclusions:The advantage of obese clear cell carcinoma patients over normal-weight patients in tumor progression-free survival may be influenced by ASMI, pre-onset involuntary weight loss and lipid levels. Therefore, patient weight management should not merely focus on absolute BMI but tailor to individual characteristics, including cancer stage, body composition and metabolic status.

Cryptogenic multifocal ulcerous stenosing enteritis（CMUSE） is a rare and difficult disease characte-rized by chronic recurrent intestinal obstruction and gastrointestinal bleeding caused by multiple ulcers and strictures of the small intestine. There is still a lack of mature and systematic guidance for the treatment of the disease. This paper reported a case of CMUSE mainly manifested as fatigue， abdominal distention， and edema of both lower limbs ， who is treated by integrated traditional Chinese and western medicine. In western medicine treatment， hormone and symptomatic treatment are mainly used. In traditional Chinese medicine treatment， the method of fortifying spleen and reinforcing healthy qi is taken as the basis； during the active stage of the disease， the method of moving qi and removing stagnation， clearing and removing dampness and heat， astringing and engendering flesh should be combined with， while during the remission stage， it is advised to unite with the method of diffusing lung and moving water， regulating and harmonizing zang-fu （脏腑） organs； simultaneously， replenishing qi and invigorating blood can be used throughout the treatment， and attach importance to the maintenance therapy of the traditional Chinese medicine immunomo-dulatory agent Tripterygium glycosides. After more than 2 years of treatment， the patient's clinical symptoms were significantly relieved， and all indicators basically restored to normal， having a stable condition.