Objective:To compare the difference between the combined diagnostic effect of plasma Septin9(SEPT9) and polyligand Syndecan-2(SDC2) methylation with four serum tumor markers in the diagnosis of colorectal cancer.Methods:In this study, 128 patients who were treated in the affiliated Hospital of Xuzhou Medical University from March to December in 2019 were selected for a case-control study.All the subjects were examined by gastroenteroscopy.According to the pathological results, they were divided into three groups: colorectal cancer group( n=74) and colorectal adenoma group( n=7). The patients with no abnormal or inflammatory polyps or proliferative polyps examined by gastroenteroscopy were taken as the control group( n=47). The methylation levels of SEPT9 gene and SDC2 gene were detected by Roche Lightcycler 480 II real-time fluorescence quantitative polymerase chain reaction, and the concentrations of alpha-fetoprotein, carcinoembryonic antigen, carbohydrate antigen 125 and carbohydrate antigen 199 were detected by Roche Cobas 8000 electrochemiluminescence instrument.Chi-square test was used to compare the positive rate of each marker in the three groups.Medcalc was used to draw the receiver operating characteristic curve (ROC) curve of the subjects′ working characteristic curve, and the value of each index in the diagnosis of colorectal cancer was analyzed. Results:The positive rates of SEPT9 gene and SDC2 gene methylation were 81.1%(60/74) and 67.6%(50/74) respectively in colorectal cancer group, and increased to 85.1%(63/74) after combined detection.The positive detection rates of alpha-fetoprotein, carcinoembryonic antigen, carbohydrate antigen 125 and carbohydrate antigen 199 in colorectal cancer group were 1.4%(1/74), 33.8%(25/74), 6.8%(5/74) and 13.5%(10/74), respectively.When the four tumor markers were detected together, the positive detection rates were only increased to 43.2%(32/74), except for AFP and carbohydrate antigen 125(χ 2=3.847, 2.430, all P>0.05). The differences were statistically significant (χ 2=48.230, 30.487, 43.285, 3.847, 8.788, 6.988, 8.722, all P<0.05). The area under the curve (AUC) of SEPT9 methylation, SDC2 methylation, alpha fetoprotein, carcinoembryonic antigen, carbohydrate antigen 125 and carbohydrate antigen 199 were 0.854 (0.781, 0.910), 0.795 (0.715, 0.861), 0.575 (0.485, 0.662), 0.685 (0.597, 0.764), 0.603 (0.513, 0.689) and 0.631 (0.541, 0.715), respectively.The AUC of combined detection of two DNA methylation markers was better than that of alpha fetoprotein, carcinoembryonic antigen, carbohydrate antigen 125 and carbohydrate antigen 199, and the differences were statistically significant (alpha fetoprotein: Z=4.990, P<0.001; carcinoembryonic antigen: Z=3.743, P<0.001; carbohydrate antigen 125: Z=4.951, P<0.001; carbohydrate antigen 199: Z=3.983, P<0.001). The combined detection of two kinds of gene methylation was better than the combined detection of four kinds of serum markers in the diagnosis of colorectal cancer, and the difference was statistically significant ( Z=3.334, P<0.001). Conclusion:The combined detection of SEPT9 gene and SDC2 gene methylation in plasma is more suitable for non-invasive diagnosis of colorectal cancer than the combined detection of 4 serum tumor markers.

Objective To study the factors related with balance ability of the elder.Methods 37 persons above 60 years were assessed with the balanced function reflectoscope reflector,grouped according to their exercise practice.Results The length of locus and length/envelope area as eyes closed increased significantly compared with that as eyes opened in the less exercise group(P<0.05),while they were increased significantly compared with those in the more exercise group either when eyes closed or opened(P<0.05).Conclusion The exercise practice can improve the balances function of the old persons.

Objective To explore the effects of using proton pump inhibitors (PPIs) on the outcomes of hip fracture.Methods Searches were conducted through Medline,Embase,Cochrane Library and Chinese Biomedical Literature Database to identify the studies of the association between PPIs exposure and hip fracture.Quality of studies was assessed using the Newcastle-Ottawa Quality Assessment Scale.Pooled odds ratios (ORs) and 95％ confidence interval (CIs) were calculated for the risk of hip fracture associated with current exposure of PPIs.And several subgroups were analyzed by dosing duration,dose,osteoporosis and corticosteroid usage to explore potential study heterogeneities.All statistical analyses were performed with STATA software.Results Among 11 publications included for final analysis,there were a total of 1 107 577 subjects with an average age of over 60 years.A positive relationship existed between PPIs exposure and hip fracture with an OR of 1.46 (95％ CI:1.26-1.70,P =0.000) as compared with nonPPI-users,especially those on concurrent corticosteroid and PPIs.A significantly increased risk of hip fracture was found in the group of a short-term duration for under 1 year (OR =1.18,95％ CI:1.01-1.38,P =0.041),medium-term for 1-3 years (OR =1.23,95％ CI:1.01-1.49,P =0.038) and longer duration for over 6 years (OR =1.38,95％ CI:1.27-1.50,P =0.000).Furthermore,concurrent use of PPIs was not associated with an increased risk of hip fracture in a definite dose-response manner.As compared with non-PPI-users,no significantly increased risk of hip fracture was found in PPI-users with osteoporosis (P ＞ 0.05).Publication bias was not present.Conclusions Use of PPIs may be somewhat associated with an increased risk of hip fracture.Considering potential adverse effects,clinicians should prescribe cautiously PPIs for high-risk patients,especially elders.

BACKGROUND: Ultraviolet light (UVA) has a close relationship with photoaging, and mitochondrial damage is a basis of coil senescence and death.OBJECTIVE: To explore the influence of UVA on the mitochondrial deoxyribonucleic acid of human skin fibroblasts, in addition, to discuss whether transforming growth factor β1 (TGF-β1) could relieve mitochondrial DNA (mtDNA) deletion. DESIGN, TIME AND SETTING: The experiment was performed at Department of Plastic Surgery, the First Affiliated Hospital of Fourth Military Medical University from March 2007 to April 2008.MATERIALS: TGF-β1 was purchased from PerProtech Company; rnitochondrial DNA 4 977 bp primer was synthesized by Shanghai Sangon Biological Engineering Technology & Services Co., Ltd; UVA light was produced by Beijing Optical Instruments Factory; and the ultraviolet radiation meter was provided by Photoelectric Instrument Factory of Beijing Normal University.METHODS: Young adult's fibroblasts were obtained from 12 cases with posthectomy. Then the cells were divided into control,UVA irradiation (30, 60, 90 J/cm~2) groups. The mitochondrial DNA 4 977 bp deletion was detected by semi-quantitative PCR. After that, TGF-β1 with different doses (0.1, 1, 10 βg/L) were used to interfere the cells with UVA 90 J/cm~2 irradiation.MAIN OUTCOME MEASURES: DNA 4 977 bp deletion under different doses cumulative irradiation, as well as the effect of TGF-β1 on mtDNA 4 977bp deletion after irradiates UVA90 J/cm~2 were observed.RESULTS: Mitochondrial DNA 4 977 bp had deleted when irradiated with cumulative dose of 60 J/cm~2 UVA, the deletion was aggravated when the UVA dose arrived at 90 J/cm~2, The absorbance value, PCR electrophoresis and band scanning showed that the deletion of mitochondrial DNA 4 977 bp was reduced after adding TGF-β1 at 2 hours prior to irritation in the large dose (10 μg/L) group. However, the difference between the medium and small dose groups had no obviously significance.CONCLUSION: A certain dose of TGF-β1 (10 μg/L) has protective effect on mtDNA 4 977 bp deletion.

Objective To evaluate the effect of DHA on sevoflurane-induced activation of microglia.Methods N9 mouse microglia were seeded in culture plates (1 ml) or culture dishes (10 ml) at a density of 1 × 106 cells/ml and divided into 4 groups (n =18 each) using a random number table method:control group (C group),DHA group,sevoflurane group (Sevo group) and DHA plus sevoflurane group (DHA+Sevo group).Group C received no treatment.Cells were incubated in the culture medium containing 25 μmol/L DHA in DHA and DHA+Sevo groups.Cells were exposed to 2％ sevoflurane in Sevo and DHA +Sevo groups.At 24 h of culture,activated microglia were detected and counted by immunohistochemistry,the rate of CD11b positive cells was calculated,the expression of microglial biomarker CD1lb was detected by Western blot,and the concentrations of tumor necrosis factor-alpha (TNF-α) and interleukin1 beta (IL-1β) were determined by enzyme-linked immunosorbent assay.Results Compared with C and DHA groups,the rate of C D 11 b positive cells was significantly increased,the expression of CD11 b was upregulated,and the concentrations of TNF-α and IL-1β were increased in Sevo group (P＜0.05).Compared with Sevo group,the rate of CD11b positive cells was significantly decreased,the expression of CD11b was down-regulated,and the concentrations of TNF-α and IL-1β were decreased in DHA + Sevo group (P＜0.05).Conclusion DHA can decrease inflammatory responses through reducing sevoflurane-induced activation of microglia.