Objective To investigate the expression of hypoxia-inducible factor-1 alpha (HIF-1 α),vascular endothelial growth factor-A (VEGF-A) and vascular endothelial growth factor-D (VEGF-D)in hypoxic environment as well as the relationship between HIF-lα and VEGF-D.Methods Human esophageal cancer cell line EC9706 was cultured under hypoxia environment for 6,12 and 24 h,the cell radiosensitivity was evaluated by survival curve.HIF-1 α siRNA was constructed and transfected into human EC9706 cells.Protein expressions of HIF-1 α,VEGF-A and VEGF-D were analyzed by Western blot before and after RNA interference.Results EC9706 cells under hypoxia showed radioresistance with a SF2 of 0.62 higher than that of normoxic cells of 0.43.Moreover,the protein expressions of HIF-1α,VEGF-A and VEGF-D were all increased (F =205.24,227.88,130.55,P ＜0.05) due to hypoxia treatment.On the contrary,after HIF-1α siRNA transfer,the protein expressions of HIF-1α,VEGF-A and VEGF-D in EC9706 cells were not influenced by hypoxia treatment.Conclusions EC9706 cells in hypoxic environment was radioresistance,and the upexpressions of HIF1α,VEGF-A and VEGF-D may be involved.

Objective To study the effect of thrombin on proliferation and invasion of esophageal cancer cell line Eca109, and to explore its possible mechanism. Methods The proliferation and invasion of Eca 109 cells treated with thrombin were detected by MTT and Transwell assay, respectively. The activity of matrix metalloproteinase 2 (MMP-2) and MMP-9 in the supernatant of Eca109 cells was detected by gelatin zymography. Reverse transcription polymerase chain reaction (PCR) and immunocytochemistry were used to study the mRNA expression of protease-activated receptor 1 (PAR-1), the important receptor of thrombin, and subcellular localization of PAR-1 protein in Eca109 cells, respectively. Results Thrombin could promote Eca109 cells proliferation in a dose-dependent manner. Cell proliferative rates of 0.5 U/ml and 1.0 U/ml thrombin were 34.38 % and 57.19 %, respectively (P< 0.05). Compared to that of control group, the number of Eca109 cells incubated with 1.0 U/ml thrombin invading through the basement membrane of Transwell was increased (303.33 ±6.66 vs. 116.33 ±11.51, P< 0.05). When treated with various concentrations of thrombin for 24 h, the activities of MMP-2 and MMP-9, especially MMP-9, in the supernatant of Eca109 cells were increased in a dose-dependent manner. Eca109 cells expressed PAR-1 mRNA, and PAR-1 protein was mainly located on the cellular membrane. Conclusion Thrombin increases proliferation and invasion of esophageal cancer Eca109 cells and enhances the activities of MMP-2 and MMP-9 in cells supernatant, which might be induced by activation of PAR-1 located on cellular membrane.

Objective:To investigate the efficacy of Silybinin meglumine on hepatic fibrosis rats and possible mecha -nisms.Methods:The liver fibrosis rats were randomly divided into 4 groups,the model group,Silybinin meglumine 120 mg/kg group, Silybinin meglumine dose group 60 mg/kg and Silybinin meglumine low dose group 30 mg/kg,and the control group.All groups had been treated for 4 groups.Results:No deaths rat.Compared with the control group ,the reduced body weight ,less dynamic,dark hair, decreased liver and spleen indexes ,increased ALT,AST,TBIL,TG,TC and LDLC,and the decreased ALB, and the increased LXRαand SREBP1c had been observed in the model group (P<0.05).Compared with the model group ,better activity and body weight ,the in-creased liver and spleen indexs decreased ALT ,AST,TBIL,TG,TC and LDLC,and the increased ALB , and the decreased LXRαand SREBP1c had been observed in the Silybinin meglumine groups (P<0.05),in a way of dose-depended.Conclusion: The Silibinin meglumine can treat liver fibrosis ,by improving liver function,lowing lipid and decreaseing LXRαand SREBP1c expression in liver tis-sue.But the mechanism of two proteins reduced remains for further investigation .

Objective To explore the correlation of ABO blood group and serum cystatin C level and decompensated hepatitis B cirrhosis.Methods Retrospectively analysed the clinical data of 472 patients with decompensated hepatitis B cirrhosis,and compared with 681 healthy control volunteers.All the informations such as gender,age,family history of liver disease,hepatitis B virus infection,hepatic function classification,complications of portal hypertension and the distribution of ABO blood group were observed.Results The highest incidence of decompensated hepatitis B cirrhosis was found in A blood group.There was no significant difference in the distribution of ABO blood group for patients with different age (P ＞ 0.05).Significant correlations were observed between AB blood group and family history of hepatitis B patients,expansion of the portal veines ＞ 1.5 cm,esophageal varices,cirrhosis complications,hepatic function classification (P ＜ 0.01).C ystatin C expression was increased with hepatic function classification (P ＜ 0.05).Conclusions The risk of liver cirrhosis is increased in patients with A blood group.Compare with other blood group,patients with AB blood group has a serious progression.The level of nitrogen,creatinine,cystatin C in decompensated cirrhosis are significantly higher than healthy controls.The level of cystatin C expression is increased with hepatic function classification.Cystatin C may be a potential marker in the classification of hepatic function.

Objective To explore the relationship between case mix index ( CMI ) and the bed allocation in clinical departments, and to evaluate the performance of bed scale of departments at tertiary hospitals based on CMI. Methods Based on the HIS system of a tertiary hospital, the authors collected the disease treatment information and bed allocation information of each clinical department in 2015. The CMI value was calculated by means of diagnosis-related group( DRG) , while the proportion of cases and average daily beds occupancy corresponding to the quartile of the CMI value of each department was also counted. Then the bed occupancy and distribution of various patients were analyzed. Results The hospital′s overall CMI value, DRG groups, DRG cases at the departments, days of stay, DRGs, CMI values and its quartiles were calculated. It was found that the medical and surgical CMIs had a linear relationship with the critical proportion (r=0. 998, 0. 996, P<0. 001). The main influencing factors of average daily bed occupancy were ranged from high to low as followed: the number of cases that were allocated in the group, employee numbers and CMI (F=87. 656, P<0. 001). Conclusions CMI is an ideal indicator for the difficulty of medical services at different departments and for evaluating the bed scale performance. Hence it can be used as an important reference for bed number adjustment in hospitals.

Gastric cancer has become a major public health problem in China because of its high prevalence. CircRNA could stably exist in various human body fluids, providing the innate advantage for the liquid biopsy, which makes it a research hotspot in the field of precision therapy in recent years. Based on the biological characteristics of circRNAs, we summarize the research progress of circRNAs in the early diagnosis, treatment monitoring and prognosis assessment of gastric cancer through literature retrieval in mainstream databases such as PubMed, Web of Science and CNKI. We also discuss the possibility and reliability of circRNA as an emerging liquid biopsy biomarker, to offer a vision for the development and clinical transformation of circRNA as a molecular marker of the diagnosis, treatment, evaluation and prognosis of gastric cancer in the future.

Objective To observe the changes of cerebral vascular morphology and blood flow after craniocerebral trauma so as to investigate the role of transcranial Doppler sonography (TCD) combined with CT angiography (CTA) in judgment of the operative effect and prognosis of severe craniocerebral trauma.MethodsA total of 56 patients with craniocerebral trauma were monitored dynamically by using TCD before and after surgery.Dynamic CTA of head was also performed by using 128-slice spiral CT.Results TCD and CTA indicated that both the cerebral blood flow and vascular morphologychanged after craniocerebral trauma.CTA manifested mainly the vascular displacement or angiostegnosis and TCD showed mainly the high-resistance blood flow,indicating good operative effect.For the patients with vasospasm,the TCD manifested high-resistance flow (relatively good operative effect) or nail flow(mostly poor operative effect). The patients with vascular occlusion were associated with nail flow on TCD,with poor operative effect.ConclusionsTCD shows the velocity of cerebral blood flow and CTA shows the morphological change of cerebral vessels.Thereby,the combination of TCD and CTA can effectively judge the cerebral perfusion and provide a promising way for validating the operative effect and prognosis of craniocerebral trauma.

Objective To evaluate the predicting value of circulating miRNAs for sepsis secondary to pneumonia in elderly patients.Methods From April 2016 to January 2017,44 cases with sepsis secondary to pneumonia,52 elderly patients with pneumonia and 21 healthy older adults as control were involved in this study.The expression levels of MiRNA-150 5p,miRNA-25-3p,miRNA-122 5p and miRNA-223-3p in plasma were evaluated by fluorescence quantitative PCR.The demographic characteristics,sequential organ failure assessment (SOFA)scores,prognosis and days stayed in ICU were recorded.The area under the receiver operating charaeteristic(ROC)curve was used to calculated the specificity and sensitivity of miRNA in identifying sepsis-associated pneumonia.Results There were significantly differences among levels of circulating miRNA-223-3p in pneumonia,sepsis and healthy control groups(F =36.441,P =0.000),△CT values were 2.39 ± 1.36,1.44± 1.43,and 4.58 ± 0.91,respectively.The relative expression levels of miRNA-223-3p in the three groups were significantly different (P =0.000),which were 0.189 (0.107,0.367),0.361 (0.221,0.735),and 0.044 (0.022,0.061),respectively.The AUC of miRNA-223-3p for predicting sepsis from pneumonia was 0.964(95 ％CI =0.925 1.000).At a cutoff value of 2.759,miRNA-223-3p yielded a sensitivity of 82.9％ and a specificity of 100.0％.Conclusions MiRNA-223-3p expression is up-regulated in patients with sepsis secondary to pneumonia compared to that of patients with pneumonia,and it could be used to predict sepsis associated pneumonia.

Objective: To investigate the clinical presentation, clinicopathologic features, diagnosis and differential diagnosis of adult T cell leukemia/lymphoma (ATLL). Methods: Four cases of ATLL from Fujian Cancer Hospital between October 2017 and May 2018 were analyzed using hematoxylin-eosin and immunohistochemical stains and polymerase chain reaction (PCR) for HTLV-1 provirus genes. The relevant literature was reviewed. Results: There were two males and two females, age range 38-80 years. All patients were from coastal cities of Fujian province. Clinical presentations including lymphadenopathy, hepatomegaly and splenomegaly were detected in most patients; skin lesion, hypercalcemia and lymphocytosis were also commonly detected.Histologically, there was diffuse effacement of the normal architecture by tumor cells infiltration. The inflammatory background is usually sparse, with scanty eosinophils. The atypical lymphoid cells were typically medium to large sized with pronounced nuclear pleomorphism, irregular nuclei, chromatin clumping and prominent nucleoli. Blast-like cells with transformed nuclei were present in variable proportions. Giant cells with convoluted or cerebriform nuclear contours may be present. Rare cases may be composed predominantly of anaplastic tumor cells. Characteristic "flower cells" with large multi-lobated nuclei can be seen. The tumor cells were strongly positive for CD2, CD3, CD5, CD4 and CD25, but negative for CD7, CD8 and cytotoxic molecules (including TIA-1, Granzyme B and perforin). In three cases, the large transformed cells were positive for CD30. In one case, the anaplastic large cells were diffusely and strongly positive for CD30. All cases were negative for EBER, but positive for HTLV-1 provirus. Conclusions ATLL is a rare type of T cell lymphoma with unique clinical and pathological features, and should be distinguished from peripheral T cell lymphoma, NOS, ALK negative anaplastic large cell lymphoma and mycosis fungoides. Hypercalcemia, systemic disease, characteristic "flower cells" and specific immunophenotypic profile of CD3⁺, CD4⁺, CD25⁺, and CD7^- are highly suggestive. However, ATLL can only be confirmed if the presence of HTLV-1 provirus.

Objective    To investigate the clinical effect of 3D computed tomography bronchial bronchography and angiography (3D-CTBA) and guidance of thoracoscopic anatomic pulmonary segmentectomy by Mimics software system. Methods    A retrospective analysis was performed on patients who underwent thoracoscopic segmentectomy in the Department of Thoracic Surgery of Affiliated People's Hospital of Jiangsu University from June 2020 to December 2022. The patients who underwent preoperative 3D-CTBA using Materiaise's interactive medical image control system (Mimics) were selected as an observation group, and the patients who did not receive 3D-CTBA were selected as a control group. The relevant clinical indicators were compared between the two groups. Results    A total of 59 patients were included, including 29 males and 30 females, aged 25-79 years. There were 37 patients in the observation group, and 22 patients in the control group. The operation time (163.0±48.7 min vs. 188.8±43.0 min, P=0.044), intraoperative blood loss [10.0 (10.0, 20.0) mL vs. 20.0 (20.0, 35.0) mL, P<0.001], and preoperative puncture localization rate (5.4% vs. 31.8%, P=0.019) in the observation group were better than those in the control group. There was no statistically significant difference in the thoracic tube placement time, thoracic fluid drainage volume, number of intraoperative closure nail bin, postoperative hospital stay, or postoperative air leakage incidence (P>0.05) between the two groups. Conclusion    For patients who need to undergo anatomical pulmonary segmentectomy, using Mimics software to produce 3D-CTBA before surgery can help accurately identify pulmonary arteriovenous anatomy, reduce surgical time and intraoperative blood loss, help to determine the location of nodules and reduce invasive localization before surgery, and alleviate patients' pain, which is worthy of clinical promotion.