Mammalian target of rapamycin ( mTOR) is a kind of Ser/Thr kinase existing in mammalian cells can regulate cell proliferation, migration and angiogenesis.mTOR including two different complex forms as mTORC1 and mTORC2 .Rapamycin and rapalogs were soon found to have powerful immunosuppressant prop-erties and thus be valuable for preventing the progress of the artery atheromatous by inhibiting the function of mTORC1.But long-term rapalogs administration may increase the side actions such as mTORC1 resistance, mTORC2 inhibition, dyslipidemia.The clinical application of drug combination and dosage optimization may reduce adverse events.

Background and purpose:Recently, it was reported that tanshinoneⅡA (TanⅡA) could inhibit proliferation, induce differentiation and apoptosis of human cancer cells. Previous studies also indicated that TanⅡA could inhibit the migration and invasion of osteosarcoma. However, the effects of TanⅡA on the migration and invasion of gastric cancer and the mechanism remains unclear. The aim of this study was to investigate the effect of TanⅡA on gastric cancer cell SGC7901 migration and invasion of in vitro. Methods:After different concentrations (0.5, 1, 2, and 4μg/mL) of TanⅡA treatment for 24, 48, and 72 h respectively, MTT assay were developed to detect the cell proliferation of SGC7901. The wound healing assay and 3D-transwell assay were used to observe the migration and invasion of SGC7901 cells, respectively. Expression of intercellular adhesion molecule 1 (ICAM-1), matrix metalloproteinase-2 (MMP-2), matrix metalloproteinase-9 (MMP-9), and tissue inhibitor of metalloproteinase 2 (TIMP-2) mRNA and protein were measured with real-time PCR and Western blot. Results: 1, 2, and 4 μg/mL Tan ⅡA showed a dose-and time-dependent growth inhibition on SGC7901 cells. 2μg/mL TanⅡA showed a time-dependent migration inhibition of SGC7901 cells. 1, 2, and 4μg/mL TanⅡA could inhibit the invasion of SGC7901 cells. Real-time PCR and Western blot showed a reduction in expression of ICAM-1, MMP-2, and MMP-9, as well as an increase in expression of TIMP-2 (P<0.05).Conclusion:TanⅡA inhibits human gastric cancer SGC7901 cell migration and invasion in vitro. TIMP-2 upregulation and, ICAM-1, MMP-2, MMP-9 downregulation might be one of the mechanisms of anti-tumor of TanⅡA.

Objective To Evaluate the performance of serum adenosine deaminase assays of different manufacturers and explore the approach for harmonization of test results.Methods It was evaluated the indice including the limit of blank ,precision,linearity range and reference interval of 10 test systems.It was as the reference system by Mindray test system to evaluate the comparability and the difference of ADA results among 10 different systems.The evaluation was performed before and after calibration by a selected fresh serum assigned by the reference system.A commercial calibrator of the minimum matrix effect was selected from 8 different calibrators as the long-term calibrator to harmonize the ADA results of 10 systems.Results The results of LoB were 0.1-6.3 U/L,respectively.The within-run CVs and total CVs of 10 systems were all less than 5%and actual linearity ranges were conformed to claims of manufacturers.After calibration with fresh serum calibrator ,the averaged difference of 10 test systems was reduced from 14% to 3.0%, and the average difference was 1.8% after calibration with long-term calibrator.The common reference interval of all test systems was 5-24 U/L identically.Conclusions The comparability of ADA measurements can be improved by using a common human serum calibrator and the commutable commercial calibrator.And it is necessary and feasible to develop the standardzation of ADA.

Objective To analyze the nutritional status of patients with continuous ambulatory peritoneal dialysis and explore reasonable and effective nursing measures.Methods Nutritional assessment was performed in 60 patients with continuous ambulatory peritoneal dialysis,using subjective integrated nutritional assessment,dietary analysis,measurement of biochemical indexes of the human body to analyze the factors that might affect the nutritional status of patients.Results 60 cases of malnutrition occurrd in 20 patients (33.3per cent),mainly due to insufficient protein and energy intake,inadequate dialysis,peritoneal inflammation,metabolic acidosis,psychosocial factors and not using erythropoietin,and so on.Conclusions Measures such as emphasis paid to malnutrition status of continuous ambulatory peritoneal dialysis patients,giving guidance of rational diet,performing full implementation of nursing measures according to the related factors,can improve the nutritional status of patients and improve patients' quality of life.

Objective: To investigate the relationship between chemosensitivity to L-OHP and expressions of multidrug resistance (MDR) associated factors in lymph node metastases (LNMs) of gastric carcinoma. Methods: The chemosensitivity to L-OHP was measured by MIT assay, and the expressions of P-gp, GST-π, P53, Survivin and Bcl-2 were determined by immunohistochemistry in 54 paired primary tumor (PT) and LNMs of gastric carcinoma. Results: The inhibition rates of LNMs cells for L-OHP were lower than those of PT (P<0.05). The expressions of P-gp, GST-π and Bcl-2 were higher in LNMs than in PT (P<0.05), and no signifi-cant difference was found in the expression of P53 and Survivin between LNMs and PT (P>0.05). Positive cor-relations among P-gp, P53 and Bcl-2 were found in PT and LNMs (r=0.3424, 0.7123, 0.4548, P<0.05). There was no significant difference in the expression of GST-π and Survivin between PT and LNMs (P>0.05). There was statistically negative correlation between inhibition rates and expression of P-gp, GST-π, and Survivin in PT (P<0.05). In LNMs, only Survivin was negatively correlated with inhibition rates of L-OHP (P<0.05). Conclu-sion: The LNMs of gastric carcinoma are heterogeneous with PT in respect to chemosensitivity to L-OHP and expression of multidrug resistance associated factors. The main factors that affect chemosensitivity to L-OHP are also significantly different between PT and LNMs. Effective adjuvant chemotherapy after surgery and re-version to multidrug resistance (MDR) of gastric carcinoma depend on targeting the metastatic lesions of gas-tric carcinoma.

OBJECTIVE To explore the role of P38MAPK inhibitor on the soft palate reconstruction of the rats with chronic intermittent hypoxia. METHODS The animals were divided into normal control group, hypoxia control group and SB203580+hypoxia group (every group 20 rats). After 5 weeks, the expressions of p38MAPK and p-p38MAPK protein on the soft palate of the rats were detected with immunohistochemical techniques and western blot. RESULTS Compared with the normal control group, the soft palate tissue thickness of the hypoxia group were increased most obviously; Levels of p38MAPK were increased in hypoxia control group; Compared with the hypoxia control group, the levels of p-p38MAPK group were decreased in SB203580+hypoxia group. CONCLUSION p38MAPK may play important roles in the soft palate reconstruction of the rats with chronic intermittent hypoxia.

Objective To discuss the feasibility of enzymatic reference methods in Routine Chemistry external quality assessment (EQA)inlaboratorymedicine.Methods Samplesofthe1stEQAin2012byNationalCenterforClinicalLaboratories(NCCL)and patients′sera were measured by reference methods and 5 clinical analytic systems for the catalytic activity of CK ,LDH ,ALP ,ALT , AST ,GGT and AMY ,then the results of 5 clinical systems were compared with the reference methods′or target value of NCCL by calculating the bias ,and evaluated them according to the criteria of EQA by NCCL .Results The results of EQA samples measured by reference methods was within ± 10% compared with NCCL target value .Compared with the results of reference method ,the through put was 100 .0% for wet clinical chemistry systems measuring both EQA samples and patients′serum ,and the dry clinical chemistry systems was 77 .1 for EQA samples and 97 .1% for patients′serum according to the criterion of EQA ,and the through put was 72 .9% and 63 .6% of wet clinical chemistry systems according to the standard of enzymatic trueness of NCCL .Conclusion Reference method could be applied to EQA ,and will be a great help for the trueness of clinical testing .

Objective:To investigate the clinically relevant factors of progressive disease (PD) after neoadjuvant therapy for locally advanced gastric cancer.Methods:From Jun 2011 to Mar 2016, 569 patients with locally advanced gastric cancer(cT3/4N0/+ M0) admitted to the Fourth Hospital of Hebei Medical University were retrospectively analyzed .Results:All 569 patients completed neoadjuvant therapy, 59 patients (10.4%) had PD. Univariate analysis showed that tumor size (χ 2=10.091, P=0.001), pathological type (χ 2=4.110, P=0.043), Borrmann type (χ 2=91.941, P=0.001), pre-treatment cT stage (χ 2=7.980, P=0.005) were associated with PD after neoadjuvant therapy for gastric cancer. The results of multi-factor regression analysis showed that pathological type, Borrmann type, pre-treatment cT stage were independent factors influencing the occurrence of PD after neoadjuvant therapy for advanced gastric cancer. The overall survival and progression-free suruival time of patients with PD is significantly shorter than that of patients without PD . Conclusion:The pathological type, Borrmann typing and pre-treatment cT stage are the influencing factors for the occurrence of PD after neoadjuvant treatment in advanced gastric cancer, and the prognosis of PD patients is poor.

Objective:To retrospectively analyze the relationship between patterns of local recurrence and radiotherapy target dose after adjuvant radiotherapy for the pancreatic ductal adenocarcinoma(PDAC), aiming to provide reference for exploring reasonable target and dosage.Methods:Clinical data of 138 patients with T 1-4N 0-2M 0 PDAC who underwent adjuvant radiotherapy after radical resection from April 2012 to December 2020 were analyzed retrospectively. The influencing factors of local recurrence and the correlation between local recurrence site and radiotherapy target dose were analyzed. Results:The median follow-up time was 37.2 months. The median overall survival (mOS) was 29.9 months. The 5-year OS rate was 27.4%. And the median progression-free survival (mPFS) was 13.9 months. There were 24 cases of local recurrence (17.4%), and 10 cases of local recurrence complicated with distant metastasis (7.2%). The correlation between local recurrence site and radiotherapy target dose could be evaluated in 19 patients with complete clinical data. The first local recurrence occurred near the para-aortic (Ao), the celiac axis (CA) and the superior mesenteric artery (SMA) were 8, 5 and 4 cases, respectively. The radiotherapy doses of 8 patients with local recurrence only in the PTV field were above 45 Gy. There were 8 cases of local recurrence both in and out of the PTV field, including 3 cases with dose line between 40 and 52 Gy, 2 cases with dose line between 20 and 47.5 Gy, and 3 cases with dose line between 0.5 and 52.5 Gy. There were 3 cases of local recurrence out of the PTV field, and the dose line ranged from 0 to 20 Gy.Conclusions:The local recurrence rate of PDAC after radical surgery combined with postoperative radiotherapy is low, but a small number of patients have recurrence in the high-dose range of radiation field and regional recurrence out of the field. For these patients, it may be necessary to explore a more appropriate target dose and range for adjuvant radiotherapy.

Objective:To observe the efficacy and safety of calcipotriol betamethasone ointment,calcipotriol ointment and mo-metasone furoate cream respectively combined with narrow-band ultraviolet B(NB-UVB)in the treatment of psoriasis vulgaris. Methods:Ninety patients of psoriasis vulgaris were randomly divided into three groups,with 30 cases in each group.Thirty pa-tients in the treatment group were treated with calcipotriol betamethasone ointment;thirty patients in the control group A were treated with calcipotriol ointment,and thirty patients in the control group B were treated with mometasone furoate cream.All the three groups were given specific medications once daily by applying to the skin lesions.NB-UVB treatment was applied three times a week during the period of medication treatment.The duration of treatment was four weeks.Efficacy was observed once a week during the treatment.Results:At week 2 of the treatment,the effective rate in the treatment group was 36.67%, which was higher than that in the control group A(13.33%)and control group B (13.33%).The difference was significant (P <0.05)Observation at week 4 showed that the efficacy of the treatment group was better than that of the two control groups.The difference was statistically significant (P < 0.05).Adverse events of the treatment group mainly included skin burning sensation and erythema which could be tolerated.Conclusions:Calcipotriol betamethasone ointment,calcipotriol oint-ment and mometasone furoate cream respectively combined with NB-UVB were efficacious and safe in the treatment of psoriasis vulgaris.However,calcipotriol betamethasone ointment takes faster and better effect,and less adverse reaticons.