Objective To investigate the expression of MMP-9 genes in primary hepatocellular carcinoma(HCC).Methods RT-PCR was used to detect MMP-9 mRNA in surgically extracted specimens from 28 patients with HCC.Results The expression of MMP-9 mRNA was significantly higher in tumor than in corresponding nontumoral tissue(P0.05).Meanwhile,the expression of MMP-9 mRNA in HCC was significantly correlated to the existence of portal vein tumor thrombus(P

The theory of Constructivism was applied in different aspects of clinical teaching of surgery.The lessons were designed according to the character of students.Problem solving was emphasized during the course of teaching.An interactive and cooperative atmosphere was constructed.And a variety of additional related materials were provided.All these measures made the teaching activity more accord with the objective rule of clinical knowledge learning.Hence a better teaching effect was achieved.

To improve the teaching quality of advanced students on minimally invasive surgery is important for the generalization of new techniques on this subject.The teaching plan should be made according to the academic level of these students.Both theory learning and clinical practice should be emphasized.Multimedia tools should be adopted and English teaching should not be neglected.All these means help to better the teaching quality of advanced students on minimally invasive surgery.

Objective:To explore the effects of neutrophilic granule protein (NGP) on the expression of lipocalin 2 (LCN2) in inflammatory macrophages and its mechanism.Methods:NGP-high-expressed RAW264.7 cells (NGP/RAW cells) and negative control RAW264.7 cells (NC/RAW cells) were cultured in vitro. Primary peritoneal macrophages of NGP-high-expressed mice and wild-type C57BL/6 mice were extracted, then cultured in vitro. The cell inflammatory model was established by stimulating with 10 mg/L lipopolysaccharide (LPS, LPS group), and the phosphate buffer solution (PBS) control group was set up. Enzyme-linked immunosorbent assay (ELISA) was used to detect the level of LCN2 in different types of cells. The protein expression of phosphorylated signal transduction and activator of transcription 1 (p-STAT1) was detected with Western blotting. Other NGP/RAW cells and NC/RAW cells were treated with 10 mg/L LPS, 5 mg/L STAT1 pathway inhibitor (fludarabine)+10 mg/L LPS, respectively. The PBS control group was set up. ELISA was used to detect the level of LCN2. Results:In different types of cells, the levels of LCN2 were increased significantly after LPS stimulation in the LPS group as compared with those in the PBS control group, and peaked at 24 hours (μmol/L: 25.61±1.02 vs. 0.46±0.02 in NC/RAW cells, 74.51±2.14 vs. 0.25±0.04 in NGP/RAW cells, 10.13±0.22 vs. 0.01±0.01 in primary macrophages of wild-type C57BL/6 mice, 28.35±0.61 vs. 0.08±0.01 in primary macrophages of NGP-high-expressed mice, all P < 0.05), indicating that the expression of LCN2 in macrophages altered during inflammation reaction. The level of LCN2 in NGP/RAW cells was found significantly increased at different time points after LPS stimulation comparing with that in NC/RAW cells (μmol/L: 8.32±0.22 vs. 3.12±0.11 at 6 hours, 23.12±0.86 vs. 8.12±0.32 at 12 hours, 74.51±2.14 vs. 25.61±1.02 at 24 hours, all P < 0.05), along with the expression of p-STAT1 was significantly up-regulated. The level of LCN2 in the primary macrophages of NGP-high-expressed mice was also significantly increased at 24 hours after LPS stimulation comparing with that in the primary macrophages of wild-type C57BL/6 mice (μmol/L: 28.35±0.61 vs. 10.13±0.22, P < 0.05). However, after pretreated with STAT1 pathway inhibitors, the production of LCN2 in NGP/RAW cells was decreased significantly comparing with that in the LPS group (μmol/L: 6.81±0.19 vs. 22.54±0.58, P < 0.05). But the inhibitors had no significant effect on LCN2 production in NC/RAW cells showing no significant difference as compared with LPS group (μmol/L: 8.04±0.20 vs. 7.86±0.15, P > 0.05), indicating that NGP could up-regulate the expression of LCN2 in macrophages stimulated by LPS by promoting STAT1 activation. Conclusion:NGP could positively regulate LCN2 expression in inflammatory macrophages by activating STAT1 pathway.

Objective To explore the risk factors of aspiration during hospitalization in patients with ischemic stroke(IS)and establish a predictive model.Methods Based on the case-control de-sign,clinical materials of 316 IS patients treated in the Department of Neurology of Suzhou Ninth Hospital Affiliated to Soochow University from March 2022 to October 2023 were retrospectively col-lected.According to incidence of aspiration during hospitalization,the patients were divided into case group with 89 cases(aspiration occurred during hospitalization)and control group with 227 cases(no aspiration occurred during hospitalization).Univariate and multivariate Logistic regression analyses were performed in both groups to screen out the risk factors of aspiration during hospitalization in IS patients.R software was used to extract 70％of the data from the two groups as the training set(es-tablishing a Nomogram model),and the remaining 30％data was used as test set.Value of predictive model was evaluated by area under the curve(AUC)of the receiver operating characteristic(ROC)curve,calibration curve,and decision curve.Results There were significant differences in the terms of age,the National Institutes of Health Stroke Scale(NIHSS)score,number of lesions,homocysteine(Hcy)level,spontaneous cough,and grading of Wada drinking water test between the case group and the control group(P＜0.05).Multivariate Logistic analysis showed that large age(OR=2.201,95％CI,1.254 to3.865),high NIHSS score(OR=4.816,95％CI,1.652 to 14.041),multiple lesions(OR=2.649,95％CI,1.249 to 5.613),high level of Hcy(OR=1.501,95％CI,1.044 to 2.158),weakened or absent spontaneous cough(OR=3.384,95％CI,1.639 to 6.987),and high grading of Wada drinking water test(OR=2.878,95％CI,1.422 to 5.783)were the risk factors of aspiration during hospitalization in IS patients(P＜0.05).In the training set,the AUC of the Nomogram model for predicting aspiration during hospitalization in IS patients was 0.872(95％CI,0.827 to 0.919),and was 0.859(95％CI,0.807 to 0.904)in the test set.The calibration curve analysis showed that P value was 0.869 in the training set and 0.898 in the test set.The decision curve analysis for both the training set and test set showed that the No-mogram model was of good clinical applicability.Conclusion The risk of aspiration during hospi-talization in IS patients is related to large age,high NIHSS score,multiple lesions,high level of Hcy,weakened or absent spontaneous cough,and high grading of Wada drinking water test.The Nomogram predictive model established on these factors can effectively evaluate the risk of aspiration during hospitalization in IS patients.

Objective To explore the risk factors of aspiration during hospitalization in patients with ischemic stroke(IS)and establish a predictive model.Methods Based on the case-control de-sign,clinical materials of 316 IS patients treated in the Department of Neurology of Suzhou Ninth Hospital Affiliated to Soochow University from March 2022 to October 2023 were retrospectively col-lected.According to incidence of aspiration during hospitalization,the patients were divided into case group with 89 cases(aspiration occurred during hospitalization)and control group with 227 cases(no aspiration occurred during hospitalization).Univariate and multivariate Logistic regression analyses were performed in both groups to screen out the risk factors of aspiration during hospitalization in IS patients.R software was used to extract 70％of the data from the two groups as the training set(es-tablishing a Nomogram model),and the remaining 30％data was used as test set.Value of predictive model was evaluated by area under the curve(AUC)of the receiver operating characteristic(ROC)curve,calibration curve,and decision curve.Results There were significant differences in the terms of age,the National Institutes of Health Stroke Scale(NIHSS)score,number of lesions,homocysteine(Hcy)level,spontaneous cough,and grading of Wada drinking water test between the case group and the control group(P＜0.05).Multivariate Logistic analysis showed that large age(OR=2.201,95％CI,1.254 to3.865),high NIHSS score(OR=4.816,95％CI,1.652 to 14.041),multiple lesions(OR=2.649,95％CI,1.249 to 5.613),high level of Hcy(OR=1.501,95％CI,1.044 to 2.158),weakened or absent spontaneous cough(OR=3.384,95％CI,1.639 to 6.987),and high grading of Wada drinking water test(OR=2.878,95％CI,1.422 to 5.783)were the risk factors of aspiration during hospitalization in IS patients(P＜0.05).In the training set,the AUC of the Nomogram model for predicting aspiration during hospitalization in IS patients was 0.872(95％CI,0.827 to 0.919),and was 0.859(95％CI,0.807 to 0.904)in the test set.The calibration curve analysis showed that P value was 0.869 in the training set and 0.898 in the test set.The decision curve analysis for both the training set and test set showed that the No-mogram model was of good clinical applicability.Conclusion The risk of aspiration during hospi-talization in IS patients is related to large age,high NIHSS score,multiple lesions,high level of Hcy,weakened or absent spontaneous cough,and high grading of Wada drinking water test.The Nomogram predictive model established on these factors can effectively evaluate the risk of aspiration during hospitalization in IS patients.