Objective:To investigate the expressions of matrix metalloproteinase 9 (MMP-9), matrix metalloproteinase 2 (MMP-2), migration-inducing protein 7 (MIG-7) and filamin A (FLNa) in colon cancer tissues and their effects on prognosis.Methods:The tumor specimens and corresponding adjacent normal tissues of 899 colon cancer patients undergoing surgical resection in the Affiliated Huai'an No. 1 People's Hospital of Nanjing Medical University from January 2013 to December 2015 were collected. The expression levels of MMP-9, MMP-2, MIG-7 and FLNa in colon cancer tissues and adjacent normal tissues were measured by using enzyme-linked immunosorbent assay (ELISA), and the relationship between their expression levels and clinicopathological characteristics as well as prognosis of colon cancer was analyzed.Results:The expression levels of MMP-2, MMP-9 and MIG-7 in colon cancer tissues were (481±69) ng/ml, (262±85) ng/ml,(156±23) ng/ml, respectively, which were higher than those in adjacent normal tissues [(136±33) ng/ml, (191±21) ng/ml, (98±18) ng/ml], and the differences were statistically significant ( t was 41.591, 120.224, 59.896, all P < 0.01); the expression level of FLNa in colon cancer tissues was (19.5±3.2) ng/ml, which was lower than that in adjacent normal tissues [(65.4±8.3) ng/ml], and the difference was statistically significant ( t = 154.902, P < 0.05). The expression levels of MMP-9, MMP-2, MIG-7 and FLNa in colon cancer tissues were correlated with tumor diameter, Dukes stage, lymph node metastasis and degree of differentiation (all P < 0.05). Cox multivariate analysis showed that the high expressions of MMP-9, MMP-2, and MIG-7 and the low expression of FLNa were independent factors affecting the prognosis of patients (all P < 0.05). Kaplan-Meier analysis showed that the median overall survival time of patients with low expression of MMP-9, MMP-2 and MIG-7 was 55 months (95% CI 25-78 months), 56 months (95% CI 26-79 months) and 54 months (95% CI 25-78 months), respectively, which were longer than those with high expression, while the median overall survival time of patients with high expression of FLNa was 58 months (95% CI 27-80 months), which was longer than those with low expression, and the difference was statistically significant ( P < 0.05). Conclusions:MMP-9, MMP-2, MIG-7 and FLNa are closely related to the occurrence and progression of colon cancer. The high expression levels of MMP-9, MMP-2 and MIG-7 and the low expression level of FLNa have influences on the prognosis of colon cancer patients, and it can be used as important indicators for clinical prognosis judgement.

Objective To investigate the correlation between serum homocysteine (Hcy) and macrophage migration inhibitory factor(MIF) with carotid atherosclerosis and between serum Hcy and MIF ,and to study whether serum Hcy influence the carotid atherosclerosis formation by MIF .Methods 258 inpatients and outpatients were performed the color ultrasound examination to ob-serve the carotid arterial vascular anatomic form ,endomembrane circumstance ,plaque and the plaque echo nature ,and the carotid in-tima-media thickness(IMT) was measured .According to the results of color ultrasound ,the cases were divided into three groups :IMT normal group(control group) ,thickening group and plaque group .According to the plaque echo characteristics ,the plaque group was redivided into two subgroups :stable plaque group and unstable plaque group .Serum Hcy and MIF levels and biochemical parameters were measured simultaneously in all cases .The differences of serum Hcy and MIF levels were compared between groups .The correlation coefficients among serum Hcy levels ,MIF levels and IMT were calculated .Results The serum Hcy and MIF levels in the control group ,thickening group and plaque group were increased in turn ,the difference among groups was statisti-cally significant(P<0 .01);which in the unstable plaque group was significantly higher than that in the stable plaque group ,the difference between them was statistically significant (P<0 .01) .The positive correlation was found among serum Hcy levels ,serum MIF levels and IMT (r=0 .584 ,0 .562 ,0 .607 ,P<0 .01) .Conclusion The serum Hcy and MIF levels are closely related with the carotid atherosclerosis degree and the plaque stability ;the serum Hcy and MIF levels are positively correlated with the carotid arte-rial IMT ;serum Hcy is positively correlated with the MIF level ,Hcy may cause the carotid atherosclerosis formation via MIF .

Objective To investigate the predictive value of neutrophil to lymphocyte ratio (NLR) on admission for early neurological deterioration (END) in patients with lacunar stroke.Methods Patients with acute lacunar stroke admitted to the Department of Neurology,the Second People's Hospital of Lianyungang from June 2015 to October 2017 were enrolled retrospectively.END was defined as an increase of ≥2 in the National Institutes of Health Stroke Scale (NIHSS) score within 72 h of admission.Multivariate logistic regression analysis was used to determine the independent risk factors for END.The receiver operating characteristic (ROC) curve was used to analyze the predictive value of NLR for END in patients with lacunar stroke.Results A total of 309 patients with acute lacunar infarction were enrolled,including 180 males (58.2％),aged 59.7 ±7.3 years;65 patients (21.0％) in END group and 244 (79.0％) in non-END group.Multivariate logistic regression analysis showed that after adjusting for other confounders,NLR was an independent risk factor for END in lacunar stroke (odds ratio 4.508,95％ confidence interval 3.128-7.547;P＜0.001).ROC curve analysis showed that the area under the curve of NLR predicting END in patients with lacunar stroke was 0.725 (95％ confidence interval 0.671-0.776;P ＜ 0.001);the optimal cut-off value was 2.32,the sensitivity of predicting END was 61.21％,and the specificity was 72.54％.Conclusion The elevated NLR after admission is an independent risk factor for END in patients with lacunar stroke,which has certain value for early identification and prediction of END.

Objective: To evaluate the efficacy and safety of mesenchymal stem cells in allogeneic hematopoietic stem cell transplantation for patients with refractory severe aplastic anemia (R-SAA) . Method: The clinical data of 25 R-SAA patients receiving co-transplantation of mesenchymal stem cells combined with peripheral blood stem cells from sibling donors (10 cases) and unrelated donors (15 cases) from March 2010 to July 2018 in Zhengzhou University Affiliated Tumor Hospital were retrospectively analyzed. Antithymocyte globulin (ATG) treatment was ineffective/relapsed in 11 cases, and cyclosporine (CsA) treatment ineffective/relapsed in 14 cases. Results: There were 13 male and 12 female among these patients. One patient had a primary graft failure, one patient had a poorly engraftment of platelets, and the remaining 23 patients achieved hematopoietic engraftment. The median time of granulocyte engraftment was 12.5 (10-23) days and 15 (11-25) days for megakaryocyte. Incidences of grade Ⅰ/Ⅱ acute graft-versus-host disease (aGVHD) and chronic graft-versus-host disease (cGVHD) were 37.5% (9/24) and 21.7% (5/23) , respectively. There was no severe GVHD and no severe complications that related to transplantation. 21 of 25 (84%) patients were alive with a median follow-up of 22.9 (1.6-107.8) months. The 5-year overall survival rate after transplantation was (83.6±7.5) %. Conclusion The combination of mesenchymal stem cells is reliable and safe in the treatment of R-SAA in peripheral blood stem cell transplantation of unrelated donors and sibling donors, which could significantly reduce the incidence of GVHD and severe transplantation-related complications.

The efficacy and safety of co-transplantation of unrelated donor peripheral blood stem cells (UD-PBSCs) combined with umbilical cord mesenchymal stem cells (UC-MSCs) in refractory severe aplastic anemia-Ⅱ(RSAA-Ⅱ) were analyzed retrospectively. Fifteen patients with RSAA-Ⅱ underwent UD-PBSCs and UC-MSCs co-transplantation, among whom 14 cases had hematopoietic reconstitution without severe graft versus-host disease (GVHD). The 5-year overall survival rate was 78.57%. Combination of UD-PBSCs and UC-MSCs transplantation could be a safe and effective option for RSAA-Ⅱ.

Objective:To investigate the correlation between stress hyperglycemia ratio (SHR) and poor outcome of successful recanalization after endovascular treatment in patients with acute ischemic stroke.Methods:From January 2019 to October 2022, patients with acute ischemic stroke received endovascular treatment and successful recanalization in the Second People’s Hospital of Lianyungang were included retrospectively. SHR was defined as the fasting blood sugar and glycosylated hemoglobin ratio. At 90 d after procedure, the outcome of patients was evaluated using the modified Rankin Scale score. 0-3 was defined as good outcome, and >3 was defined as poor outcome. Multivariate logistic regression analysis was used to determine the independent risk factor for poor outcome. Receiver operating characteristic (ROC) curve was used to evaluate the predictive value of SHR for 90 d poor outcome in patients with successful recanalization after endovascular treatment.Results:A total of 159 patients were enrolled, including 98 males (61.6%), aged 69.8±8.9 years old. The baseline National Institutes of Health Stroke Scale (NIHSS) score was 12.6±4.3, and SHR was 1.17±0.46. One hundred and five patients (66.0%) had good outcome, while 54 (34.0%) had poor outcome. There were statistically significant differences in SHR, fasting blood glucose, glycosylated hemoglobin, baseline NIHSS score and the proportion of patients with poor collateral circulation and symptomatic intracranial hemorrhage between the poor outcome group and the good outcome group (all P<0.05). Multivariate logistic regression analysis showed that SHR was an independent predictor of poor outcome (odds ratio 2.254, 95% confidence interval 1.136-4.278; P<0.001). The ROC curve analysis showed that the area under the curve of SHR for predicting poor outcome was 0.726 (95% confidence interval 0.648-0.804; P<0.001), which was higher than fasting blood glucose and glycosylated hemoglobin. The optimal cutoff value for SHR was 1.21, and the sensitivity and specificity for predicting poor outcomes were 66.23% and 75.82%, respectively. Conclusion:SHR is associated with the poor outcome of successful recanalization after endovascular treatment in patients with acute ischemic stroke and can be used as a potential predictor.

Objeetive To investigate the associations of plasma homocysteine (Hcy) level and methylenetetrahydrofolate reductase (MTHFR) gene C677T polymorphism with white matter lesion (WML) in a Chinese Han population.Methods A toal of 104 patients with WML and 74 controls were recruited.Hcy level and MTHFR gene C677T polymorphism were determined.The degree of severity of the WML was evaluated using a modified Scheltens scale.Results The plasma Hcy level (median and interquartile range,16.81 [11.33-18.92] μmol/L vs.11.40 [8.28-14.23] μmol/L;Z =5.415,P =0.001) and the proportion (85.6％ vs.54.1％;x2 =28.535,P ＜ 0.001) of patients with hyperhomocysteinemia (HHcy) in the WML group were significantly higher than those in the control group.However,there were no significant differences in the frequencies of C677T genotype (x2 =1.255,P =0.534) and allele (x2 =1.057,P =0.304).There are 89 patients with HHcy and 15 patient with normal Hcy in 104 patients with WML.The modified Scheltens scale score in the HHcy subgroup was higher that in the normal Hcy subgroup (8.06 ±5.61 vs.5.80 ±2.98;t =2.324,P=0.027).Multivariate logistic regression analysis showed that age (odds ratio[OR] 1.090,95％ confidence interval [CI] 1.049-1.133;P=0.001),hypertension (OR 1.719,95％ CI 1.645-2.307;P ＜ 0.001),and HHcy (OR 1.128,95％ CI 1.044-1.219;P =0.002) were the independent risk factors for white matter lesions.Conclusions HHcy is an independent risk factor for WML,whereas the MTHFR gene C677T polymorphism is not associated with WML.

Objective To investigate the dosimetric feasibility of volumetric modulated arc therapy (VMAT)with a simultaneous integrated boost(SIB-VMAT58.75 Gy)for preoperative chemoradiotherapy in patients with locally advanced rectal cancer(LARC),and to provide a basis for clinical practice.Methods Nine patients with stage Ⅱ-Ⅲ rectal cancer who underwent preoperative concurrent chemoradiotherapy were involved in the study,and two plans were performed for each patient:SIB-VMAT58.75 Gy and VMAT50.00 Gy. For the SIB-VMAT58.75 Gy plan,the prescribed dose was 58.75 Gy(2.35 Gy/fraction)for the local rectal tumor and positive lymph nodes(GTV 58.75 Gy),and 50 Gy(2 Gy/fraction)for the regions at high risk of harboring microscopic disease(pelvic lymphatic drainage area)(PTV 50Gy).For the VMAT50.00 Gy plan,the prescribed dose was 50 Gy(2 Gy/fraction)for the regions at high risk of harboring microscopic disease(pelvic lymphatic drainage area)without a boost. The conformity index(CI),homogeneity index (HI),and dose for target areas and organs at risk(OAR)were assessed according to the dose-volume histogram. The paired t-test or nonparametric rank test was used to compare the differences between the two plans. Results Both plans met the prescription goal for PTV dose coverage. There was no significant difference in CI for the PTV between the two plans(1.0±0.0 vs. 1.0±0.0,P>0.05).The SIB-VMAT58.75 Gy plan had a worse HI than the VMAT50.00 Gy plan(0.2± 0.2 vs. 0.1± 0.0,P<0.05).There was no significant difference in V10-V50of the small intestine,bladder,femoral heads,and pelvis between the two plans(P>0.05),but D 2 cm3of the small intestine was significantly higher in the SIB-VMAT58.75 Gy plan than in the VMAT50.00 Gy plan(P=0.038). Conclusions The SIB-VMAT58.75 Gy plan for LARC achieves required target volume dose coverage and OAR dose constraints,which is safe and feasible in terms of dosimetry,and its clinical efficacy and adverse effects need further evaluation.

【Objective】 To investigate the prevalence of QTc prolongation and the risk factors in hospitalized breast cancer patients. 【Methods】 A total of 296 patients with pathologically diagnosed breast cancer admitted to The First Affiliated Hospital of Xi’an Jiaotong University in 2018 were retrospectively enrolled. The patients’ baseline data， 12-lead ECG， the prevalence of QTc （QTc max） prolongation and its risk factors were analyzed by the multivariate logistic regression. 【Results】 The prevalence of QTc prolongation in the hospitalized breast cancer patients was 13%； multivariate logistic regression analysis showed that increased heart rate （OR=1.04， P<0.05）， combined hypertension （OR=6.48， P<0.05）， and anthracycline administration （OR=3.96， P<0.05） were the risk factors of the prolongation of QTc interval in the breast cancer patients （P<0.05）. 【Conclusion】 The prevalence of prolonged QTc interval in the hospitalized breast cancer patients is increased， which may be due to the increased heart rate， hypertension， and the administration of anthracycline drugs in these patients.

OBJECTIVETo explore the experimental methods that the phage peptide library technology screening human osteoblast specificity polypeptide, which will provide the basis of the experiment of the Ti surface biolization modification.

METHODSHuman calvarial osteoblasts were used as the target cells for whole-cell biopanning from a 12-mer peptide phage-display library. Cell eluent and cell lysis buffer were cultivate and count respectively after washing. Then the target cells were analyzed by enzyme-linked immunosorbent assay (ELISA) and immunofluorescence detection to authenticate the positive phage clones by human gingival fibroblast as the absorber cells. The positive phage clones were deduced by DNA sequencing.

RESULTSAfter four rounds of screening, twenty-two positive phage clones were found out from randomly selected phage monoclonals, whose single-strand DNA were extracted and sequenced. Amino acid sequence of the highest frequency peptide was MGWSWWPETWPM.

CONCLUSIONSThe specific peptide against human osteoblasts can be obtained from a phage-display peptide library for use as a new research approach and experimental basis of the biolization modification of the titanium surface.

Amino Acid Sequence ; Base Sequence ; Enzyme-Linked Immunosorbent Assay ; Fluorescent Antibody Technique ; Humans ; Osteoblasts ; Peptide Library ; Peptides ; genetics ; Sequence Analysis, DNA ; Sequence Analysis, Protein ; Titanium