MicroRNA (miRNA) is an endogenous nonprotein-coding short-chain RNA,and it involves in the evolution of a variety of malignant tumors through targeted inhibition of mRNA translation or mRNA cleavage of gene expression regulation cancer or tumor suppressor genes,meanwhile,is also an important molecule in the occurrence and development processes of tumor.In the recent studies,miRNA has played an important role in the proliferation,apoptosis and invasion of cholangiocarcinoma cells,and it maybe become a new biomarker for the early diagnosis,assessment of prognosis and chemotherapy of cholangiocarcinoma.

Epithelial-mesenchymal transition is not only involved in generating normal embryonic development of organs and tissues,but also helps to improve cancer cell invasion and metastasis.When epithelial-nesenchymal is stimulated,cell-cell adhesion and cell polarity are disrupted by disappearance of adhesion molecules such as Ecadherin,resulting in the acquisition of a mesenchymal phenotype.Consequently,cells which have acquired mesenchymal function activate the migratory and invasion capability in cancer.Studies have shown that part of the transcription factors,growth factors and signaling pathways involved in epithelial-nesenchymal process,and miRNA may participates in the proliferation,apoptosis,invasion and metastasis of gastric cancer cells by regulating oncogenes or tumor suppressor genes,which also relates to the regulation of epithelial-nesenchymal.This article will be reviewed in recent years specific miRNA regulatory mechanisms of gastric cancer epithelial-nesenchymal.

Histone methyltransferase SMYD3 (SET and MYND domain containing 3) is a protein which has the function of histone methylation found in recent years,it has an important role in transcriptional regulation.The research shows that SMYD3 inhibit apoptosis and promote cell proliferation,invasion and metastasis.More and more data shows SMYD3 highly expressed in liver cancer and is low in normal tissues which is even undetectable.SMYD3 level was significantly associated with prognosis,and gene silencing experiments in SMYD3 tumor cell growth was inhibited.Therefor,SMYD3 is closely related with the development and prognosis of HCC occurrence,which suggests that people can suppress the expression SMYD3 to block tumor cell growth,migration and improve prognosis to provide new goals and direction for the future of cancer treatment.

Objective:To investigate the mortality-related factors affecting patients with gastrointestinal perforation who are transferred to the intensive care unit (ICU) and to establish a prediction model, and to evaluate the predictive performance of the model.Methods:A retrospective analysis was performed on the medical records of 306 patients who underwent gastrointestinal perforation surgery in Shanxi Bethune Hospital (Shanxi Academy of Medical Sciences) from January 2021 to January 2024 and were transferred to intensive care unit after surgery, including 176 males and 130 females, aged from 28 to 92 years with the average of (66.07±16.03) years. According to the prognosis, patients were divided into survival group ( n=264) and death group ( n=42). Clinical characteristics of the two groups were compared, univariate and multivariate Logistic regression was used to analyze the risk factors of perioperative death, and the related risk factors were selected to establish a nomogram prediction model, the subject work curve was drawn, and the area under the curve (AUC) was calculated. Evaluate its predictive effectiveness; The calibration chart and clinical decision curve were further used to evaluate the prediction accuracy and clinical application value of the model. Results:Clinical data analysis showed that age, white blood cell count, procalcitonin, lactic acid level, preoperative shock, preoperative underlying diseases (cerebral infarction, hormone history), intraoperative blood loss, postoperative lung infection in the death group were higher than those in the survival group ( P<0.05), and hemoglobin was lower than those in the survival group ( P<0.05). Multivariate Logistic regression analysis showed age ( OR=1.422, 95% CI: 1.205-1.680, P<0.001), hemoglobin ( OR=0.945, 95% CI: 0.904-0.987, P=0.012), white blood cell count ( OR=1.832, 95% CI: 1.341-2.501, P<0.001), procalcitonin ( OR=1.099, 95% CI: 1.012-1.192, P=0.024), lactic acid level ( OR=16.435, 95% CI: 3.729-72.425, P<0.001), reoperative shock ( OR=172.358, 95% CI: 13.059-2274.773, P<0.001), intraoperative blood loss ( OR=1.041, 95% CI: 1.017-1.065, P=0.001) and postoperative pulmonary infection ( OR=38.670, 95% CI: 3.449-433.553, P=0.003) was an independent risk factor for perioperative death in intensive care patients after DTP. Based on the screened independent risk factors ( P<0.05), a nomogram model was established and receiver operating characteristic (ROC) curve was drawn. The model area under the curve was 0.985. The accurate graph shows that the predicted results of the model are in good agreement with the actual clinical results, and the analysis of clinical decision curve indicates that the model has high clinical prediction value. Conclusion:Age>71.5 years, hemoglobin< 109 g/L, white blood cell count>17.9×10 9/L, procalcitonin>6.225 ng/mL, lactate level>2.25 mmol/L, preoperative shock, intraoperative blood loss>45 mL and postoperative pulmonary infection are independent risk factors for perioperative death in intensive care patients after DTP.