Objective To investigate the cytotoxic effects of IL-2 combined with different dosages of sorafenib on renal cellular carcinoma cell line 786-0. Methods Renal carcinoma cell 786-0 was cultured. Then , IL-2 (20 μmol/L) combined with different dosages of sorafenib (6.9, 13.8, 20.8 μmol/L) were used to treat tumor cell 786-0. The inhibitory effect on cell proliferation was determined by MTT assay. Cell apoptosis was measured by Annexin V-FITC kit. The tumor-bearing mice models were established and divided into four groups. Results The tumor cell growth was inhibited with the time-course correlation in all groups. In the 48-hour high doses group, the inhibitory rate was up to (74.67±1.87) %. The rates of cell proliferation inhibition and cell apoptosis were higher in the high dosages group than those in the other groups. Conclusions Immunotherapy combined with target therapy could significantly inhibit the growth of renal cellular carcinoma. But we should find a proper dosage, which could improve the clinical effect and reduce the adverse effect.

Objective: To screen out DNA binding proteins specifically recognizing CpG immunostimulatory sequence (ISS) for further investigating the molecular mechanisms of ISS. Methods: Yeast one hybrid system was adapted in screening a human bone marrow cDNA library using 4 copies of ISS as bait. The ISS binding activity of the positive clone was confirmed by electrophoretic mobility shift assay (EMSA). Results: Four dual positive colonies were obtained, two of them encoded proteins with unknown functions. The other 2 encoded light chains of immunoglobulin with amino sequences homology to anti DNA Ab and HBsAb respectively. EMSA showed HBsAb specifically bound to CpG ODN at pH6.4 and pH 5.8. Conclusion: HBsAb may have ISS specific DNA binding activity.

Confronted with similar problems and difficulties in mainland,Taiwan reformed its medical education. The reform included setting up flexible program,formulating objective and detailed rotary guide,making the best of the resources,implementing medical humanities education based on the reality and forming unique cultivation system and mode. These measures can be taken as references for medical education reform in mainland.

Objective: To analyze the strengths, weaknesses, opportunities and threats of the construction on intelligent vaccination clinics in Zhejiang Province, so as to provide countermeasures for promoting the construction of intelligent vaccination clinics in Zhejiang Province. Methods: By reviewing the annual reports of Zhejiang immunization planning, survey data from Zhejiang Centers for Disease Control and Prevention and Immunization Intelligent Service System, data of human resources of immunization planning, vaccine procurement, construction progress of intelligent vaccination clinics and vaccination were collected. The relevant literature was searched to gather information on the construction standards and norms of intelligent vaccination clinics. The analysis of the strengths, weaknesses, opportunities and threats (SWOT) of the construction of intelligent vaccination clinics was conducted, and corresponding countermeasures and suggestions were proposed. Results: The National Immunization Program reported vaccine rate in Zhejiang Province is more than 99%, and standardized vaccination clinics have been popularized throughout the province. The vaccination staff are professional, and a province-wide intelligent immunization service information system has been established, providing the resources and conditions for the construction of intelligent vaccination clinics. However, there are problems such as low data quality and matching efficiency in vaccination, insufficient data interoperability and sharing, unbalanced regional capabilities in intelligent transformation, and uneven distribution of talent and resources. It is crucial to seize the opportunities presented by the development of big data and artificial intelligence, rely on the regional development of the Internet and health industry, seize the opportunity of rapid growth in demand for intelligent vaccination services and high public acceptance, accelerate the construction of intelligent vaccination clinics, and establish intelligent vaccination service standards as soon as possible. Conclusion We should seize the opportunities presented by the digital reform and development, fully utilize the existing vaccination resources and strengths, address the shortcomings, and accelerate the construction of intelligent vaccination clinics in Zhejiang Province.

Objective: To explore the relationship between parent child relationship and rebelliousness of junior middle school students in boarding schools and to provide a scientific basis for preventing the occurrence of youth rebellion. Methods: A cluster sampling method was used to investigate parent child separation, family intimacy, and rebellion among 1 790 junior high school students in one boarding middle school in Lujiang County, Hefei City, Anhui Province in January 2020, and the influence of parent child relationship on students rebelliousness was analyzed by Chi square test and binary Logistic regression. Results: The detection rate of rebelliousness among participants was 21.45%(384/ 1 790 ). Junior middle school students who were in senior grade (second and third grades), reported higher household economic status and no communication with parents during the past month were more likely to have rebelliousness( OR=1.83, 1.89, 1.80, 1.77 , P <0.05); Junior middle school students with higher parental warmth and intimacy were less likely to have rebelliousness( OR=0.52, 0.71, P <0.05); Gender, length of boarding, maternal education, frequency of meeting parents during boarding, and childhood experience of separation with parents showed no statistical significance on rebelliousness( P >0.05). Conclusion The detection rate of rebellious psychology among junior high school students in boarding schools is high, and good parent child relationship is the protective factor of rebellious psychology. Parents should pay attention to contact with their boarding children and strengthen communication to reduce rebelliousness among them.

During the occurrence, development and treatment of gynecological tumors, mainly including cervical cancer, endometrial cancer and ovarian cancer, patients are prone to sleep disorders which seriously affect the quality of life. At present, there are few relevant studies on gynecological tumors associated with sleep disorders, and there is a lack of research on TCM syndromes, so there is no targeted treatment plan. This article mainly introduces the present situation of diagnosis and treatment of sleep disorders caused by gynecological tumors in Chinese and western medicine, to provide reference for further study.

Objective To compare the pathological status of gastric mucosa and the expression of HH-PTCH-SMO-GLI(Hedgehog signaling pathway)and NOX/NF-κB/STAT1 signaling pathways in Hp and non-HP infected CAG patients,and to explore the biological mechanism of Hp promoting the"inflammatory cancer transformation"of CAG.Methods 43 patients with CAG who met the criteria were enrolled and divided into CAG with Hp infection group(Hp+ CAG group,n=21)and CAG without Hp infection group(HP-CAG group,n=22).The histological changes of gastric mucosa were observed by hematoxylin-eosin(HE)staining.Western blot was used to detect the relative expression levels of NOX1,NOX2,NOX4,STAT1,P65 and P-P65 in gastric mucosa.Real-time fluorescence quantitative PCR(RT-qPCR)was used to detect Gli1 mRNA,Gli2 mRNA,Gli3 mRNA,Shh mRNA,Smo mRNA,Ptch mRNA,NOX1 mRNA,NOX2 mRNA,NOX4 mRNA and NF-κB mRNA in gastric mucosa The mRNA level.Results HE staining results of gastric tissues in the two groups:In the Hp+CAG group,gastric epithelial cells were partially necrotic and shed,the surface was not smooth,the number of glands was reduced and disordered,intestinal metaplasia was observed,and diffuse lymphocyte and neutrophil infiltration were observed in the lamina proper.The degree of lymphocyte and neutrophil infiltration in HP-CAG group was lighter than that in Hp+CAG group.RT-qPCR results:Compared with HP-CAG group,the levels of Gli1 mRNA,Shh mRNA,Smo mRNA and Ptch mRNA in gastric mucosa of Hp+CAG group were significantly decreased(P<0.01).The levels of Gli2 mRNA,Gli3 mRNA,NOX1 mRNA,NOX2 mRNA,NOX4 mRNA and NF-κB mRNA were significantly increased(P<0.01).Western blot detection results:Compared with hP-CAG group,the relative expression levels of NOX1/GAPDH,NOX2/GAPDH,NOX4/GAPDH and P-P65/GAPDH in gastric mucosa of Hp+CAG group were significantly increased(P<0.01),and the STAT1 level was significantly decreased(P<0.01).There was no significant difference in the relative expression of P65/GAPDH between the two groups(P>0.05).Conclusion Hp infection may cause long-term inflammation of gastric mucosa,promote atrophy and intestinal metaplasia,and increase the risk of cancer by inhibiting hH-PTC-SMO-GLi signaling pathway and abnormal activation of NOX/NF-κB/STAT1 signaling pathway.

Objective To investigate the correlation between serum leptin level and body mass index(BMI)in in-fants with cyanosis congenital heart disease,and the relationship between leptin and Ob gene receptor(Ob-R)and hypoxia-inducible factor 1α(HIF-1α)in myocardium.Methods A total of 52 children under 6 months of age with congenital heart disease who underwent surgical treatment in the Department of Congenital Heart Surgery,Fuwai Hospital from January 2019 to October 2020 were included in this study.According to the arterial partial pressure of oxygen(PaO2)of 90 mmHg,they were divided into cyanotic group(n=30)and acyanotic group(n=22).Their height and weight were collected to calculate BMI.The serum leptin level was measured by ELISA.The ex-pressions of HIF-1α and Ob-R in myocardial tissue were detected by RT-PCR and Western blot.In animal mod-el,SD rats were divided into normoxia group and hypoxia intervention group,which were subjected to continuous hypoxia(10％ O2)for 4 weeks.The hypoxia intervention group received intraperitoneal injection of HIF-1α in-hibitor digoxin(2 mg/kg)daily from the 14 th to 21st day of hypoxia,respectively.The body weight of rats was recorded,and the expressions of HIF-1α and Ob-R were detected by RT-qPCR and Western blot.Results Com-pared with the acyanosis group,the cyanosis group had a significantly lower BMI(P<0.05)and a lower leptin/BMI ratio(leptin/BMI)(P<0.05).Spearman correlation analysis confirmed that serum leptin in the circulatory system was positively correlated with BMI(P<0.05).In the cyanosis group,the expression of Ob-R increased with the upregulation of HIF-1α,showing a positive correlation.In animal model,with the down-regulation of HIF-1α expression in digoxin injection,the Ob-R level was significantly lower than that in the control group(P<0.05),the trend of weight loss was significantly inhibited(P<0.05).The right ventricular hypertrophy in-dex was significantly lower than that in the control group(P<0.05).Conclusions HIF-1α regulates the expres-sion of Ob-R in myocardial tissue,and the mechanism of its association with leptin and Ob-R may help to find new therapeutic target for improving the prognosis of infants with congenital heart disease.

Malignant pleural effusion is a heterogeneous disease,usually caused by metastasis of other tumors to the pleura,which belongs to the terminal state of malignant tumors.Compared with distant metastases from other sites,malignant pleural effusion brings more pain and difficulty in clinical management,and malignant pleural effusion caused by lung cancer is more common.How to choose personalized treatment for these patients is a problem that has attracted wide attention and controversy at present.Accurate prediction of the survival time and prognosis of patients with malignant pleural effusion can provide a breakthrough for these problems.In this paper,several mature and widely accepted prediction models of malignant pleural effusion are introduced,and some common problems are summarized,in order to provide new ideas for survival prediction of lung cancer with malignant pleural effusion.

Objective:To investigate the expression of cancer-associated fibroblasts(CAFs) marker proteins in papillary thyroid carcinoma(PTC) using immunohistochemistry and explore their correlation with clinicopathological characteristics.Methods:The clinicopathological data of 90 PTC patients at Tianjin Medical University General Hospital from December 2019 to January 2021 were retrospectively analyzed. Surgical pathological cancer tissue samples were selected for immunohistochemical staining, and control group tissues were obtained from normal thyroid tissue adjacent to the tumor lesion. Four CAFs marker proteins, including fibroblast-activated protein(FAP), α-smooth muscle actin(α-SMA), Vimentin, and platelet-derived growth factor receptor-α(PDGFR-α), were stained and scored, followed by statistical analysis.Results:The immunoreactivity score of the CAFs marker proteins were correlated with extrathyroid invasion, lymph node metastasis, and multi-focality of PTC. FAP and α-SMA demonstrated better performance in this regard. Multivariate logistic regression analysis and receiver operating characteristic(ROC) curve analysis showed that high immunoreactivity scores of FAP and α-SMA were risk factors for poor clinical pathological features, with good predictive sensitivity and accuracy.Conclusion:Strong expression of CAFs was the risk factor for extrathyroid invasion, lymph node metastasis, and mutli-focality of PTC. FAP has the highest clinical value compared with other CAFs marker proteins.