Objective: To analyze the structure changes of New Rural Cooperative Medical System(NCMS) patients ’ hospitalization costs in a county-level city, and provide references for controlling hospitalization cost. Methods: Collect the cost details of NCMS patients in May from 2012 to 2013, and analyze the structure changes of hospitalization costs though the analysis method of structure variation degree. Results: Specialized hospital has the largest structure change of hospitalization cost, followed by first-level hospitals. Different cost items at hospital of different levels have a different direction of structure changes. Drug and examination are the major factors posing the changes in structure of hospitalization costs. Conclusion: There are significant results on the cost control since the implementation of new NCMS. Although the role of Chinese medicine to be prominent, there is still insufficient. The control of examination cost is a link which could not be ignored in future.

Objective To observe the effect of 5-Aza-CdR on the proliferation and apoptosis of colon cancer cells and the expression of PTEN and to explore its mechanism Methods Different concentrations of 5-Aza-CdR (1, 2, 5,10 μmol/L) were used in vitro on HT-29 cells and the proliferation was detected by MTT assay and the apoptosis was detected by flow cytometry. PTEN mRNA and protein expression changes were observed by real-time PCR and Western blot. Results Different concentrations of 5-Aza-CdR (2, 5,10 μmol/L) could inhibit the proliferation of HT-29 cells with dose and time dependent manner. With the increase of time and dose, the inhibition rate of HT-29 cells increased gradually and the difference was significant. (P < 0.05). After 5-Aza-CdR treated for 48h , the apoptosis rates of HT-29 cells in control and 1 , 2 , 5 , 10 μmol/L group were 2.443 ± 0.210 1, 3.900 ± 0.665 1, 14.07 ± 1.206, 24.70 ± 2.506, and 30.60 ± 2.390 respectively, which were significantly increased and the apoptosis rate increased with the increase of dose , which was statistically significant (P < 0.05). The PTEN mRNA and protein expression of HT-29 cells were gradually increased when treated by different concentrations of 5-Aza-CdR. Conclusion 5-Aza-CdR might induce the expression of PTEN by demethylation and then inhibit the proliferation and induce apoptosis of HT-29 cells.

Objective:To investigate the effect of enteral nutrition support one week before surgery and postoperative periods on the postoperative immune function and nutritional status in old patients with gastric cancer. Methods:A retrospective analysis was con-ducted on 77 stomach cancer patients who were admitted and received surgical treatment in our hospital. Among the patients, 38 re-ceived enteral nutrition support one week before surgery and early period of postoperation, and were labeled as the experimental group. The remaining 39 patients did not receive enteral nutrition support one week before surgery and early period of postoperation, and were named as the control group. The levels of prealbumin, albumin, transferrin, CD4+T (%), CD8+T (%), and CD4+/CD8+cells were also an-alyzed before surgery and 1 d and 8 d after surgery. Results:No statistical differences in the gender, age, site of tumor, TNM staging, and differentiated degree were found between the two groups. All operations were successful and the patients recovered well after sur-gery. In the nutritional status, the levels of prealbumin, albumin, and transferrin in the patients of the two groups had no significant dif-ference (P>0.05). On the first day after the surgery, the levels of prealbumin, albumin, and transferrin were significantly low in both groups;the control group had lower levels than the experimental group (P<0.05). No differences in the levels of CD4+T (%), CD8+T (%), and CD4+T/CD8+T cells were found between the two groups (P>0.05). On the first day after surgery, the levels of CD4+T (%), CD8+T (%), and CD4+T/CD8+T cells were significantly low in both groups;the control group had lower levels than the experimental group (P<0.05). Conclusion:Elderly patients with gastric cancer who receive appropriate enteral nutrition support one week before sur-gery would have better immune function and nutritional status after surgery than those who did not, and the recovery of old patients im-proved.

Objective: To construct and identify a lentiviral vector harboring RNAi sequence targeting the human high mobility group A1(HMGA1) gene.Methods: The effective sequence of siRNA targeting the HMGA1 gene confirmed in our previous study,the complementary DNA containing both sense and antisense Oligo DNA of the targeting sequence was designed,synthesized and cloned into the pGCL-GFP vector diced by the restriction enzyme of HpaⅠ and XhoⅠ,which contained the U6 promoter and green fluorescent protein(GFP).The resulting lentiviral vector containing HMGA1 shRNA was named LV-sh HMGA1 and confirmed by PCR and DNA sequencing.A total of 293T cells were cotransfected with LV-sh HMGA1,pHelper 1.0 and pHelper 2.0.All the virus stocks were produced by Lipofectamine2000-mediated transfection.The titer of the virus was tested according to the expression level of GFP.Results: PCR analysis and DNA sequencing demonstrated that the RNAi sequence targeting the human HMGA1 gene was successfully inserted into the lentiviral vector.The titer of the recombinant lentiviral vector was 5?107 TU/ml.Conclusion: The successful construction of the lentiviral vector of HMGA1 has prepared the ground for further studies on the functions of the HMGA1 gene with the RNAi technique.

Objective To establish reference values for blood pressure in cynomolgus monkeys in different ages.Methods The blood pressures and blood lipids indexes were detected in 521 cynomolgus monkeys using an American BECKMAN-CX4 automatic biochemical analyzer and a wrist electronic blood pressure monitor.Statistical tests were performed to analyze the data.Results Significant differences were found in blood pressure values of cynomolgus monkeys in different ages.Blood pressure values in the elderly group were higher than those of other groups.The morbidity of hypertension in the elderly group was higher than those of the other groups.Body mass index (BMI) in the hypertension group was higher than that of normal group in the same age.The incidence of hypertension in the elderly group with hyperlipemia was higher than that of other groups.Logistic regression analysis showed that age, BMI and hyperlipidemia in the hypertensive group were 1.435, 1.218, and 2.337 times higher than those of the normal group when predicting the risk of hypertension.Conclusions We have initially established reference values of blood pressure in cynomolgus monkeys in different ages.Age, BMI and hyperlipidemia are risk factors of spontaneous hypertension in cynomolgus monkeys, and the measurement of blood pressure may provide a basis for the screening of cynomolgus monkey model of spontaneous hypertensive and related research.

Objective To assess the worldwide research status and the development trend of colorectal cancer. Methods Based on the papers of colorectal cancer indexed in SCI-E database from 2000 to 2019, the year of publication, countries, institutes, sources of journals, discipline fields, highly cited papers in ESI and research hotspots were analyzed by the bibliometric method. Results A total of 160183 papers on colorectal cancer were retrieved, and the number of papers increased year by year. The top 10 countries were USA, China, Japan, Germany, the United Kingdom, Italy, South Korea, France, Netherlands and Canada. Harvard University in the USA had a significant advantage on the research of colorectal cancer. The rank of the journals, institutes and highly cited papers were absolutely dominated by USA. Global research activities on the colorectal cancer displayed the characteristics of interdisciplinary development. The research hotspots mainly focus on the gut microbiota, genetic testing, targeted therapy, immunotherapy and so on. Conclusion It is necessary to strengthen the close combination of basic research and clinical application, and carry out colorectal cancer research in interdisciplinary collaboration with clinical problems.

AIM:To investigate the activation and inactivation of nuclear factor kappa B(NF-κB)when tumor necrosis factor-related apoptosis-inducing ligand(TRAIL)is applied to induce the apoptosis of androgen-independent prostate cancer cell line PC-3M.METHODS:After the treatment of TRAIL or LPS at different doses,we tested the nuclear translocation of NF-κB by cell immunohistochemical staining and electrophoretie mobility shift assay(EMSA),and evaluated the level of IκB by RT-PCR under pyrrolidine dithiocarbamate(PDTC)treatment.RESULTS:EMSA and cell immunohistochemical analysis showed that the translocation of NF-κB was significantly activated when PC-3M cells were treated with TRAIL or LPS(P＜0.05).The pretreatment of PDTC upregulated the expression of IκB and blocked the nuclear translocation of NF-κB.CONCLUSION:TRAIL remarkably stimulates the activation of nuclear NF-κB in androgen-independent prostate cancer cells.On the other hand,the translocation of NF-κB can be significantly and efficiently inhibited in PC-3M cells by pretreatment with PDTC.The increased expression of IκB might be a clue for this inhibition,which means the possible way to enhance the effect of TRAIL in the apoptosis of prostate cancer cells.

Objective To explore the correlation of the pan-immune-inflammation value (PIV) and the prognosis of patients with resectable colorectal cancer (CRC) and establish a predictive model. Methods A total of 753 patients who underwent primary lesion resection and were pathologically diagnosed with CRC were enrolled. They were randomly divided into training (n=527) and test (n=226) cohorts. The best cutoff value of PIV was determined by the time-dependent receiver operator characteristics curve, and patients were divided into high- and low-level groups to analyze the relationship between the high- and low-level groups of PIV and the clinicopathological characteristics and survival of patients. Chi-square test, Kaplan-Meier survival analysis, and Cox regression analysis were used to evaluate the prognosis. The accuracy of the model was evaluated by C index and Brier score. Results In the univariate model of overall survival (OS), high (> 231) baseline PIV (HR=1.627; 95%CI: 1.155-2.292, P=0.005) suggested that PIV level might be an independent prognostic factor for OS. The nomogram plotted according to PIV had a C index of 0.823. Its calibration curve showed good agreement between predicted and observed outcomes for one- and three-year OS probabilities, with Brier score of 0.035 and 0.068 for OS, respectively. Conclusion PIV can be used as a prognostic marker in patients with resectable CRC, and a novel prognostic model to guide clinical decision-making in CRC is successfully established.

Objective To explore the relationship of plasma NT-proBNP and age in elderly patients with severe heart failure with left ventricular ejection fraction (LVEF) preserved. Methods According to LVEF, 450 inpatients with severe heart failure (NYHA III-Ⅳ) were divided into two groups.They were LVEF≥50%(LVEF preserved) group and LVEF<50%(LVEF decreased) group. Clinical data were compared and analysed between the two groups. Linear correlation analysis was applied between Log (NT-proBNP) values of patients and ages. Results LVEF preserved group of elderly patients with severe heart failure were 183 cases. LVEF decreased group of elderly patients with severe heart failure were 267 patients. LVEDD and Log(NT-proBNP) values in LVEF preserved group of elderly patients with severe heart failure were lower than that in LVEF decreased group(P<0.01). Log(NT-proBNP) values of LVEF preserved group of elderly patients with severe heart failure were positively correlated with ages (r=0.207, P<0.01). Conclusion Diagnostic value of plasma NT-proBNP on LVEF preserved patients in elderly with severe heart failure was far inferior to LVEF decreased patients in elderly with severe heart failure. The level of plasma NT-proBNP increased with age.

Objective:To compare the clinical efficacy of laparoscopic inguinal lymph node dissection(L-ILND)and open inguinal lymph node dissection(O-lLND)in the treatment of penile cancer after radical penile cancer surgery. Methods:The clinical outcomes of 63 patients who were diagnosed with penile cancer(TNM staging:T1_3,N0-3,M0)and received L-ILND(41 cases)or O-ILND(22 cases)after radical penile cancer surgery in Department of Urology,Hubei Cancer Hospital,Tongji Medical College,Huazhong University of Science and Technology from 2008 to 2020 were retrospectively studied.The primary endpoint of this study was overall survival,and the secondary endpoints were 5-year overall survival and 5-year cancer-specific survival.The different clinical characteristics were compared between the L-ILND group and O-ILND group.Univariate and multivariate logistic regression analysis was used to study the risk facotrs for postoperative wound complications.Kaplan-Meier method was used for prognosis analysis.COX regression analysis was used to investigate the factors for overall survival prediction. Results:Among the 63 penile cancer patients studied,41 patients received L-ILND and the remaining 22 received O-ILND.There were no statistically significant differences in the baseline characteristics between the two groups of patients.The median overall survival(78 months vs 72 months,P=0.844),5-year overall survival rate(74.5％vs 78.3％,P=0.144),5-year cancer-specific survival rate(77.2％vs 71.4％,P=0.228)showed no obvious difference between L-ILND and O-ILND group.The rate of postoperative wound complications in the O-ILND group was significantly higher than that in the L-ILND group(74％vs 15％,P=0.01 2).The result of multivariate COX regression analysis showed that tumor grade[hazard ratio(H-R)=2.774,P=0.021]and lymph node pathological stage(HR=1.482,P=0.024)were significantly correlated with patients'prognosis. Conclusion:The clinical efficacy of L-ILND and O-ILND is similar,but L-ILND has a higher safety profile and lower incidence of postoperative wound complications.Therefore,L-ILND is a more ideal surgical approach for inguinal lymph node dissection after radical penile cancer surgery.