Objective:To investigate the diagnostic value of serum proliferating cell nuclear antigen (PCNA), tissue metalloproteinase inhibitor-1 (TIMP-1) levels combined with single photon emission computed tomography (SPECT) in lung cancer bone metastasis.Methods:82 patients with bone metastasis of primary lung cancer (observation group) and 82 patients without bone metastasis (control group) in Kashgar Prefecture Second People's Hospital from February 2017 to August 2019 were retrospectively analyzed. The levels of PCNA and TIMP-1 in serum were detected by enzyme-linked immunosorbent assay (ELISA); bone metastasis were detected by SPECT; Pearson method was used to analyze the correlation between serum PCNA, TIMP-1 levels and SPECT bone imaging grade; The diagnostic value of SPECT and serum levels of PCNA and TIMP-1 in bone metastasis of lung cancer was analyzed by drawing the receiver operating characteristic curve; the diagnostic value of SPECT combined with serum levels of PCNA and TIMP-1 in bone metastasis of lung cancer was analyzed by four grid table with magnetic resonance imaging (MRI) as the gold standard.Results:Compared with the control group, the serum levels of PCNA and TIMP-1 in the observation group were significantly higher ( P<0.05), and increased with the increase of the extend of disease (EOD) grade ( P<0.05). The AUC of serum PCNA and TIMP-1 levels in the diagnosis of bone metastasis of lung cancer were 0.835 (95% CI: 0.771-0.898) and 0.814 (95% CI: 0.746-0.882), respectively. When cutoff values were 388.76 pg/ml and 524.45 pg/ml, the sensitivity were 82.70%, 79.00%, and the specificity were 74.40%, 76.80%, respectively. The sensitivity and specificity of SPECT were 82.93% and 90.24% respectively. The sensitivity and specificity of serum PCNA, TIMP-1 levels combined with SPECT in the diagnosis of bone metastasis of lung cancer were 95.12% and 91.46%, respectively, which were higher than those of serum PCNA, TIMP-1 levels and SPECT alone. Conclusions:Increased serum PCNA and TIMP-1 levels are related to bone metastasis of lung cancer and its severity. Combined SPECT and serum PCNA, TIMP-1 detection is of high diagnostic value for bone metastasis of lung cancer.

Objective To analyze the differences in urinary stone components between Uyghur and Han patients with urolithiasis in Xinjiang,and to explore the related factors contributing to the observed differences.Methods The data of urinary stone compo-nents in 317 adult patients with urolithiasis (152 cases of Uyghur nationality and 165 cases of Han nationality)admitted to Xinjiang Uygur Autonomous Region People′s Hospital from June 2009 to June 2011 were retrospectively analyzed.The urinary stone compo-nents were analyzed by the infrared spectroscopy.Results There were significant differences in thestone component proportions of calcium oxalate monohydrate (COD),COD+carbapatite (CA)and uric acid (UA)between Uyghur and Han patients(P <0.05). Conclusion The characteristics of the urinary stone comppnents have significant differences between Uyghur and Han patients with urolithiasis,which may be related with ethnicity and the different dietary habits.

Objective To investigate the effects of Uyghur Medicine Munziq and Mushil's therapy on the metabolic changes in serum of patients with abnormal phlegmatic type psoriasis by NMR based metabonomic method.Methods NMR technology were used to detect serum of patients with abnormal phlegmatic type psoriasis before and after treated by Munzig and Mushil's therapy. OPLS-DA was used to study the differences of serum endogenous compounds between pre-treatment, post-treatment and normal control groups.Results Compared with normal control group, levels of some metabolites including VLDL, isoleucine, leucine, valine, lactate, threonine, alanine, methionine, acetic acid, glycoprotein, acetylcysteine, glutamine, acetone, carnitine, creatine, malonic acid,β-glucose,α-glucose, inositol, choline, glycine and LDL in serum increased significantly, while levels of tyrosine, histidine, and formic acid decreased significantly (P<0.05). Compared with before treatment, levels ofβ-glucose andα-glucose decreased significantly after treatment, with statistical significance (P<0.05).Conclusion The levels of amino acid metabolism, lipid metabolism and glucose metabolism in patients with abnormal phlegmatic type psoriasis are abnormal to different degrees. The treatment of Uyghur Medicine Munziq and Mushil's therapy may be achieved through regulating the disorder of glucose metabolism in the patient.

Macroautophagy is a catabolic pathway that degrades cellular components through the lysosomal machinery. Autophagy acts as a survival mechanism under energy depletion-or nutrition deficiency-caused stress as an intracellular quality management system by clearing damaged organelles like mitochondria and proteins. During the early and late stages of cancer development, the role of autophagy differs. In the very early stages of carcinogenesis, autophagy has an important function by reducing cancer initiating genetic instability and aberrant protein aggregates as well as promoting anti-cancer immune response. In established malignant tumors autophagy confers resistance against metabolic stress caused by nutrient deprivation and the rapid proliferation of carcinoma cells. This function of autophagy is also important for radiation and chemotherapy resistance in cancer. Autophagy not only promotes the survival of tumor cells but also in special condition leads to autophagic tumor cell death. During dysfunctional apoptosis this form of cell death mainly sensitizes cancer cells for therapy such as ionizing radiation. Therefore, the functions of autophagy during cancer progression and therapy are two-sided and further research is needed to understand them in greater detail. In this review the regulation and the role of autophagy in cancer and chemotherapy resistance are discussed.

Objective To investigate the effects of crude Fomes officinalis polysaccharide ( FOPS ) and its purified constituent ( FOPS-a) on mitogen-activated protein kinases ( MAPK) signaling pathway and se-cretion of tumor necrosis factor-α (TNF-α) in RAW264. 7 macrophages. Methods RAW264. 7 macrophages were treated with FOPS and FOPS-a respectively at different concentrations (50, 100, 200 μg/ml) for 24 h. RT-qPCR and Western blot methods were respectively used to detect the expression at mRNA level and the phos-phorylated proteins of p38, c-Jun NH2-terminal kinase ( JNK ) and extracellular signal-regulated kinase ( ERK) . Changes in the phosphorylation of these proteins and TNF-α secretion were respectively detected by Western blot and ELISA after treating the macrophages with MAPK-specific inhibitors ( PD98059, SP600125, SB203580). Results Compared with the blank control group, different concentrations of FOPS and FOPS-a could significantly increase the expression at mRNA level and the phosphorylation of p38 and ERK (P<0. 05). Three inhibitors of MAPK could markedly decrease the phosphorylation of ERK1/2 and p38 and TNF-αsecretion that were induced by FOPS and FOPS-a (P<0. 05). Conclusions FOPS and FOPS-a might have immunomodu-latory effects on RAW264. 7 macrophages through activating ERK1/2 and p38 MAPK signal transduction pathways.

Objective: To explore the influence of the lower extremity abnormal alignment and the joint surface, and to explore the surgical skills. Methods: Twenty-two cases of tibial plateau Schatzker Ⅵ fracture internal fixation failure revision from January 2012 to January 2017 in Department of Orthopedics, Shanghai 10^th Hospital.One year follow-up after initial surgery to make sure of failure.Three-dimensional CT scan, radiography, infection index, gait analysis, knee joint ROM, femur tibia angle, tibial plateau tibial shaft angle and posterior slope if tibial plateau were observed. The medial approach and bi-planer osteotoma were used.Autogenous iliac bone graft, postoperative fast recovery channel were used.Follow-up point included preoperative and postoperative 7 days, 6 weeks, 3 months, and 6 months.Obvervational index included double lower limbs radiography, knee society score(KSS), complications such as infection, skin necrosis, joint main passive activity, double lower limbs alignment the last follow-up SF-36 scale.Rate was compared by χ² test, measurement data using paired sample t test.Correlation was analyzed by Pearson correlation regression testing. Results: Twenty-two patients received follow-up.KSS, more than 21 cases were benign, with good gait.One case was poor, with claudication gait.Not skin necrosis, no deep infection cases, 1 case get blisters 2 days postoperatively, and disappear after 5 days with detumescence and cold therapy.Whether restoring force line affect the KSS significantly(χ²=22.000, P=0.000). Knee joint ROM, SF-36 score, KSS and lower limb alignment were improved significantly. In different individual the articular surface and anatomical angle recovered greatly but the posterior slope angle was quite difference which has no correlation with KSS and SF-36 scale(P>0.01). Conclusions Revision of Schatzker type Ⅵ tibial plateau fracture failure should focus on the recovery of lower limb alignment.moderate overcorrect bone cutting and joint surface height can bring benefits to the postoperative knee function.Revision surgery patients have greater psychological pressure, more early psychological intervention is necessary.

Objective To explore the significance of gene promoter methylation of CDH1 in breast invasive ductal carcinoma.Methods The gene promoter methylation of CDH1 and E-cadherin expression status in breast cancer tissues,adjacent tissues and normal breast tissues were detected by using methylation specific polymerase chain reaction (PCR) and immunohistochemistry (SP) method.The clinicopathological data (genetic background,age,tumor size,axillary lymph node metastasis,tumor cells grading,clinical staging and molecular subtype) were collected,and analysed the clinical significance of gene promoter methylation of CDH1 in breast cancer.Results Among the 250 patients with breast cancer,113 cases were found gene promoter methylation of CDH1,and the methylation rate was 45.20％.Compared with patients with unmethylated CDH1 gene promoter,the E-cadherin protein expression was reduced in patients with methylated CDH1 gene promoter,there was statistically significant difference (x2 =21.360,P＜0.01).The univariate analysis showed that statistically significant differences were found in axillary lymph node metastasis (x2=19.086,P＜0.01),histological grading of tumor (x2 =8.487,P=0.014),CerbB-2 expression (x2=9.475,P=0.002) and molecular typing (x2 =25.482,P＜0.01) between patients with methylated and unmethylated CDH1 gene promoter.The COX regression analysis showed that there was significant difference in 5-year survival rate between patients with methylated and unmethylated CDH1 gene promoter(P＜0.01).Conclusion Methylation of CDH1 gene promoter causes decreasedexpression of mRNA,and is associated with axillary lymph node metastasis in breast cancer,which suggests that methylation of CDH1 gene promoter plays a certain role in breast cancer progression.

Objective To investigate the effect of tumor-associated macrophage exosomes on glycolysis of pancreatic cancer cells and its mechanism.Methods The THP-1 cells were induced to differentiate into the M0 and M2 macrophages,and the exosomes(M0 exo and M2 exo)were extracted.The pancreatic cancer cells CAPAN-2 and ASPC-1 were divided into the PBS group,the M0 exo group,the M2 exo group and the M2 exo+siKRAS group,and co-incubated with equal volumes of PBS,10 μg/mL of M0 exo,10 μg/mL of M2 exo,and transfection of KRAS siRNA and 10 μg/mL of M2 exo,respectively.Transmission electron microscopy was used to observe the structure of exosomes;CCK-8 was used to detect the cell proliferation capacity;the kit was used to detect the glucose uptake rate and production level of lactic acid,and Western blot was used to detect the exosome markers expression,KRAS protein expression and ERK1/2 phosphorylation level.Results THP-1 was induced to differentiate into M2 macrophages expressing Arg-1 and IL-10 marker proteins.M0 exo and M2 exo had a bilayer membrane structure with a particle size of about 100 nm and expressed exosomal marker proteins of CD9,CD81,and TSG101.Compared with the PBS group,the cell proliferation,glucose uptake rate,production level of lactic acid of CAPAN-2 and ASPC-1 cells in the M2 exo group increased significantly(P<0.05),and the KRAS expression and ERK1/2 phosphorylation level were significantly increased(P<0.001).Compared with the M2 exo group,the proliferation,glucose uptake rate and production level of lactic acid of CAPAN-2 and ASPC-1 cells in the M2 exo+siKRAS group decreased significantly(P<0.05).Conclusion Tumor-associated macrophage exosomes can promote the glycolysis of pancreatic cancer cells via the activation of KRAS signaling pathway.

Objective:To construct a risk prediction score for the needs of coronary care unit (CCU) care in stable condition acute ST-segment elevation myocardial infarction (STEMI) patients who receive percutaneous coronary intervention (PCI) treatment.Methods:The clinical data of 805 STEMI patients who accepted PCI in the First Hospital of Jilin University from November 2017 to October 2018 were retrospectively analyzed. Among the patients, 654 patients from November 2017 to July 2018 were served as the modeling group, the patients with needs of CCU had 125 cases, and the patients without needs of CCU had 529 cases; 151 patients from August 2018 to October 2018 were served as the validation group, the patients with needs of CCU had 28 cases, and the patients without needs of CCU had 123 cases. Binary Logistic regression analysis was used to establish the risk prediction model and determine the score standards. The critical value was determined according to the best Youden index of receiver operating characteristic (ROC) curve.Results:Among 805 patients with STEMI, 153 cases (19.01%) had the needs of CCU, and the most common reason was pump failure (heart failure and cardiogenic shock, 113 cases). In the modeling group, age (60 to 74 years old, OR = 1.513, 95% CI 0.945 to 2.424, P = 0.085; ≥75 years old, OR = 2.740, 95% CI 1.371 to 5.478, P = 0.004), total ischemic time>4 h ( OR = 1.701, 95% CI 1.022 to 2.831, P = 0.041), admission shock index ≥0.8 ( OR = 1.910, 95% CI 1.178 to 3.099, P = 0.009), multi-vessel disease ( OR = 2.090, 95% CI 1.272 to 3.432, P = 0.004), preoperative diseased vessels thrombolysis in myocardial ischemia (TIMI) blood flow grade 0 ( OR = 2.099, 95% CI 1.313 to 3.353, P = 0.002), acute anterior myocardial infarction ( OR = 3.696, 95% CI 2.347 to 5.819, P<0.001) and previous history of stroke ( OR = 3.927, 95% CI 2.057 to 7.500, P<0.001) were independent risk factors for CCU needs in STEMI patients undergoing PCI. The scoring criteria were as followings: age<60 years old was given 0 score, 60 to 74 years old 1 score, ≥75 years old 2 score; total ischemic time>4 h in 1 score, admission shock index ≥0.8 2 scores, multi-vessel disease 2 scores, preoperative diseased vessels TIMI blood flow grade 0 2 scores, acute anterior myocardial infarction 3 scores, previous history of stroke 3 scores, and the total score was 15 scores. The patients with 0 to 6 scores were low-risk, and the patients with 7 to 15 scores were high-risk. ROC curve analysis result showed that, in modeling group, the area under curve (AUC) of risk prediction score for predicting the needs of CCU in STEMI patients was 0.740 (95% CI 0.692 to 0.788, P = 0.580); in validation group, the AUC of risk prediction score for predicting the needs of CCU in STEMI patients was 0.755 (95% CI 0.658 to 0.853, P = 0.755). Conclusions:A predictive risk score based on seven risk factors such as age, total ischemic time, admission shock index, multi-vessel disease, preoperative diseased vessels TIMI blood flow grade, acute anterior myocardial infarction and previous history of stroke is constructed in order to predict the needs of CCU in STEMI patients with stable condition who receive PCI treatment. It can be used to help doctors to identify high-risk patients before the admission to CCU, thus providing simple and practical clinical tool for rational allocation of limited CCU resources.

Objective:To investigate the knowledge and compliance status of prevention and control of brucellosis among high-risk populations in counties and districts with high incidence of brucellosis in Xinjiang Uygur Autonomous Region (Xinjiang for brief), and to provide scientific basis for prevention and control of brucellosis and health education for high-risk populations.Methods:Huocheng County, a high incidence county of brucellosis in Xinjiang, was selected as the survey site. Three to six townships were selected, and two to three administrative villages were selected from each township as the survey villages. People over 18 years old and engaged in livestock breeding such as cattle and sheep breeders, livestock product processors, veterinarians and medical personnel were selected as the survey subjects. Face-to-face surveys were conducted by professional trained investigators in autumn and winter (December 2019 to January 2020) and spring and summer (April to July 2020). The survey included general demographic information, awareness of brucellosis prevention and control knowledge and the use of protective equipment.Results:A total of 600 people were surveyed, and 597 people completed the questionnaire, with an effective response rate of 99.50% (597/600). The overall awareness rate of brucellosis prevention and control knowledge was 68.23% (10 184/14 925), among which the awareness rate of clinical symptoms of human infection with brucellosis was high, at 73.53% (3 073/4 179). There were statistically significant differences in the awareness rate of main source of infection, main transmission route and clinical symptoms of human infection with brucellosis among people of different gender, age, nationality, education level and occupation ( P < 0.05). Among them, the awareness rate of clinical symptoms of human infection with brucellosis among veterinarians and medical personnel was 85.38% (514/602). The utilization rate of protective equipment such as rubber shoes and work clothes was high, which was 63.48% (379/597) and 60.97% (364/597), respectively. There were statistically significant differences in the utilization rate of protective equipment among different nationality, education level and occupation ( P < 0.05). Among them, The utilization rate of work clothes was the highest among people with college education or above, veterinarians and medical personnel, which was 82.61% (57/69) and 93.02% (80/86), respectively. Conclusions:The overall awareness rate of brucellosis prevention and control knowledge in high-risk groups in Huocheng County of Xinjiang is low, especially among high-risk groups such as those who are illiterate or have little literacy, and farmers, the awareness rate is low and the awareness of prevention and control is weak. There is a risk of brucellosis infection. It is necessary to further strengthen the education of brucellosis prevention and control knowledge among these groups.