AIM: To investigate the relationship of microRNA-7 ( miRNA-7 ) over-expression and epidermal growth factor receptor (EGFR)/phosphatidylinositol kinase-3 (PI3K)/protein kinase B (PKB, also called Akt) pathway in human nasopharyngeal carcinoma 5-8F cells.METHODS:The 5-8F cells were transfected with miRNA-7 mimics (car-rying by Lipofectamine 2000).The expression of miRNA-7 was detected by real-time PCR.The cell proliferation was ana-lyzed by CCK-8 assay.The cell colony-forming capability was determined by cell colony formation test.The expression of EGFR/PI3K/Akt at mRNA and protein levels was examined by real-time PCR and Western blotting.RESULTS:The ex-pression level of miRNA-7 was significantly increased in 5-8F cells compared with negative control ( NC) group and control group ( P<0.01) .The proliferation of NPC 5-8F cells was decreased extremely after tansfected with the miRNA-7 mimics (P<0.01), so did the result of the cell colony-formation test.The expression of EGFR/PI3K/Akt at mRNA and protein levels was significantly down-regulated compared with NC group and control group (P<0.01).CONCLUSION:Over-ex-pression of miRNA-7 significantly inhibits the proliferation and colony-forming ability of nasopharyngeal carcinoma 5-8F cells by down-regulation of EGFR/PI3K/Akt pathway.

Objective To investigate the diagnostic value of bone metabolic markers (BGP, β-CTX and PINP) for bone metastasis of non-small cell lung cancer (NSCLC) analyzed by Logistic regression combined with ROC curve.Methods A total of 65 patients with stage Ⅳ NSCLC were enrolled in this study.The patients were divided into two groups based on radiological imaging, includirg bone metastasis group (30 cases) and non-bone metastasis group (35 cases).The serum concentrations of BGP, β-CTX and PINP were measured by electrochemical method.Logistic regression and ROC curve were applied to analyze the data and evaluate the diagnostic values.Results The concentrations of β-CTX [(0.54±0.39) ng/ml] and PINP [(103.64±81.86) ng/ml] were significantly higher in bone metastasis group than those [(0.31±0.16) ng/ml and (48.37±27.76) ng/ml, respectively] in non-bone metastasis group (P ＜ 0.01), while the level of BGP did not differ between two groups (P ＞ 0.05).The area under the ROC curve (AUC) for β-CTX and PINP was 0.662 and 0.678, respectively.The AUC for the new predictive variables created by Logistic regression was 0.761.Conclusion Combined detection of β-CTX and PINP in the serum and application of Logistic regression combined with ROC curve analysis can increase diagnostic accuracy on bone metastasis of NSCLC.

AIM:To investigate the expression characteristics of TRIM 27 in human nasopharyngeal carcinoma tissues, nasopharyngeal carcinoma 5-8F cells and NP69 cells, and to observe the effect of TRIM27 on the proliferation, in-vasion and migration of 5-8F cells.METHODS:The levels of TRIM27 in the nasopharyngeal carcinoma tissues and normal nasopharyngeal epithelial tissues were observed by the method of immunohistochemistry .The mRNA and protein levels of TRIM27 in the 5-8F cells and NP69 cells were determined by real-time PCR and Western blot .TRIM27 siRNA was trans-fected into the 5-8F cells with Lipofectamine 2000.The relative mRNA expression of TRIM27 was detected by real-time PCR.The relative protein expression of TRIM 27 was detected by Western blot .The cell proliferation was analyzed by CCK-8 assay and cell colony formation assay .The change of cell invasion was examined by Matrigel invasion assay .The change of cell migration were examined by wound healing assay .RESULTS:The results of immunohistochemistry showed that the protein expression of TRIM27 in the nasopharyngeal carcinoma tissues was obviously higher than that in the normal nasopha -ryngeal epithelial tissues .The results of real-time PCR and Western blot showed that the mRNA and protein levels of TRIM27 in the 5-8F cells were obviously higher than those in the NP69 cells.The abilities of proliferation, invasion and migration in the 5-8F cells were significantly suppressed after TRIM27 gene silencing ( P <0.05).CONCLUSION:TRIM27 acts as a oncogene in the 5-8F nasopharygeal carcinoma cells .The abilities of proliferation , invasion and migration are significantly suppressed after TRIM27 gene silencing in the 5-8F cells.

Objective To explore the efficacy and adverse effects of nimotuzumab combined with chemotherapy and radiotherapy in the treatment of locally advanced cervical cancer.Methods Sixty patients with stage Ⅲ cervical cancer by the histopathologic diagnosis were collected,and they were randomly divided into two groups using the random number table method.The control group (n =30)using intensity-modulated radiotherapy,intracavitary afterloading therapy and periodic chemotherapy,the observation group (n =30)in addition to the intensity-modulated radiotherapy,intracavitary afterloading therapy and periodic chemotherapy, the nimotuzumab (200 mg)was given to the patients before weekly radiotherapy.All patients were received 6 to 7 times of treatment.Results The curative effects of all the patients were evaluated after radiotherapy 3 months.In the observation group,there were 20 cases of CR,5 cases of PR,4 cases of SD,1 case of PD,the total effective rate (CR +PR)was 83.3%.In the control group,there were 1 8 cases of CR,3 cases of PR,6 cases of SD,3 cases of PD,the total effective rate was 70.0%.The difference was statistically significant (χ2 =8.356,P <0.05).The main adverse reactions in the observation group and control group included slight radioactive proctitis (1 6.7% vs 1 3.3%),radioactive cystitis (1 0.0% vs 1 0.0%),nausea and vomiting (50.0% vs 46.7%),reduction of white blood cells (40.0% vs 43.3%),with no significant differences (χ2 =3.357,P =0.71 9;χ2 =2.71 7,P =0.925;χ2 =5.882,P =0.623;χ2 =4.728,P =0.687).There were no skin rashes and allergic reactions.Conclusion Nimotuzumab can enhance the locally stage cervical cancer patients′sensitivity on radiotherapy,which can increase the efficacy and doesn′t increase adverse
reaction obviously.

PURPOSE: The authors investigated the effect of lumbar facet tropism (FT) on intervertebral disc degeneration (DD), facet joint degeneration (FJD), and segmental translational motion. MATERIALS AND METHODS: Using kinetic MRI (KMRI), lumbar FT, which was defined as a difference in symmetry of more than 7degrees between the orientations of the facet joints, was investigated in 900 functional spinal units (300 subjects) in flexion, neutral, and extension postures. Each segment at L3-L4, L4-L5, and L5-S1 was assessed based on the extent of DD (grade I-V) and FJD (grade 1-4). According to the presence of FT, they were classified into two groups; one with FT and one with facet symmetry. For each group, demographics, DD, FJD and translational segmental motion were compared. RESULTS: The incidence of FT was 34.5% at L3-L4, 35.1% at L4-L5, and 35.2% at L5-S1. Age and gender did not show any significant relationship with FT. Additionally, no correlation was observed between DD and FT. FT, however, wasfound to be associated with a higher incidence of highly degenerated facet joints at L4-L5 when compared to patients without FT (p < 0.01). Finally, FT was not observed to have any effects upon translational segmental motion. CONCLUSION: No significant correlation was observed between lumbar FT and DD or translational segmental motion. However, FT was shown to be associated significantly with the presence of high grades of FJD at L4-L5. This suggests that at active sites of segmental motion, FT may predispose to the development of facet joint degeneration.
Adolescent ; Adult ; Age Factors ; Aged ; Aged, 80 and over ; Female ; Humans ; Intervertebral Disk Displacement/*etiology/pathology ; Joint Diseases/*complications/pathology ; Lumbar Vertebrae/*pathology ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Sex Factors ; Zygapophyseal Joint/*pathology/physiopathology

Objective To compare the difference of T-stage between Chinese 2017 staging system and the 2008 staging system for nasopharyngeal carcinoma,and to investigate the optimization of T-stage and provide suggestions for further revision.Methods The MRI data of 183 patients with histology-proven newly diagnosed nasopharyngeal carcinoma in our hospital were enrolled from September 2009 to May 2017.All the anatomic sites mentioned in the two staging systems were marked,and all patients were staged according to the 2017 staging system and the 2008 staging system for nasopharyngeal carcinoma.Comparisons of T-stage were made between the two staging systems.Results Involvement of oropharynx,nasopharynx,prevertebral muscles,cervical vertebra,hypopharynx and orbit were 100％ accompanied with other same or more advanced T-stage classifications.The invasion rates of the cervical vertebra,orbit and hypopharynx were very low (all ＜ 5.00％).The incidence of involvement of pterygoid structure was 15.30％,most of which incorporated with erosion of skull base,only 1 case was invaded alone.All cases of involvement of paranasal sinuses were incorporated with erosion of skull base.Compared with the 2008 staging system,the consti-tuent ratio of T1 + T2 in the 2017 staging system increased from 36.61％ to 61.75％,and that of T3 + T4decreased from 63.39％ to 38.25％,the constituent ratio of T-stage between the 2017 staging system and the 2008 staging system was significantly different (x2 =26.94,P ＜ 0.001).There was moderate consistency of T-stage between these two staging systems (Kappa =0.514,P ＜ 0.001).Conclusion The T-stage of 2017 staging system still has a larger simplification and optimization space.Therefore,according to the principle of concise,the T-stage parameters including oropharynx,nasopharynx,prevertebral muscles,paranasal sinuses,cervical vertebra,orbit and hypopharynx are recommend to delete,and it does not have an impact on the composition of T-stage.We suggest that the pterygoid structure shall combine with the skull base to be one anatomical structure.

Objective:To establish the HPLC fingerprint of MaRSDenia tenacissima; To evaluate the different origins of MaRSDenia tenacissima by combining chemometric methods.Methods:High performance liquid chromatography (HPLC) method was adopted, with DiKMA C18 column (250 mm× 4.6 mm, 5 μm), acetonitrile-0.05% phosphoric acid aqueous solution as mobile phase gradient elution, flow rate of 1.0 ml/min. The detection wavelength was set at 230 nm, the column temperature was 30 ℃, and sample size was 10 μl. Chromatographic information was imported into the similarity evaluation system for TCM chromatographic fingerprints (2012 version) for similarity analysis. SPSS Statistics 26 was used for system clustering analysis, and SIMCA 14.1 software was used for principal component analysis and partial least squares discriminant analysis (PLS-DA).Results:Totally 12 common peaks were identified. Two chromatographic peaks were identified as tenacissoside G and tenacissoside I. The relative similarity of fingerprints of 15 batches of samples and references ranged from 0.942 to 0.995. When the square Euclidean distance was 20, the samples could be grouped into two categories: S1-S3, S13-S15 were grouped into one category, and S4-S12 were grouped into another category. Principal component analysis (PCA) and partial least squares discriminant analysis (PLS-DA) showed that there were significant differences among 15 batches of MaRSDenia tenacissima, and there was a certain correlation with the origin.Conclusion:The results can provide a reference for analyzing the differences of MaRSDenia tenacissima from different producing areas and the quality standards of related formula granules in the later stage.

Objective:To investigate the effect of different ischemic preconditioning (IPC) modes on ischemia-reperfusion (IR) injury of skeletal muscle in rats.Methods:Forty male SD rats were selected to construct the model of IR injury of skeletal muscle by clamping one side of the femoral artery. In the IPC mode, the right femoral artery was clipped for 10 minutes, and reperfusion ensued for 10 minutes after the release of artery clamp. Such preconditioning procedure was repeated 3 times. The rats were divided into conventional IR group, IPC immediate group, IPC24-hour group, IPC48-hour group and sham operation group according to the random number table method, with 8 rats in each group.In conventional IR group, the right femoral artery was clipped for 3 hours and then the artery clamp was released to allow reperfusion for 3 hours. In IPC immediate group, the same treatment as conventional IR group was performed immediately after preconditioning. In IPC24-hour group, the rats received skin suturing after preconditioning and then fed in a cage for 24 hours before the same treatment as conventional IR group. In IPC48-hour group, the rats received skin suturing after preconditioning and then fed in a cage for 48 hours before the same treatment as conventional IR group. In sham operation group, the right femoral artery was bluntly separated but not clipped. At the end of reperfusion, the tibialis anterior muscle tissue, gastrocnemius muscle tissue and serum were collected. The ratio of wet weight to dry weight (W/D) of the tibialis anterior muscle tissue was calculated to evaluate tissue edema. After HE staining, histopathological changes of gastrocnemius muscle were observed and the injury severity of gastrocnemius tissue was scored. Serum levels of tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β) and malondialdehyde (MDA) were determined by ELISA. Expressions of hypoxia receptor (EGLN1) and hypoxia-inducible factor-1α (HIF-1α) in the gastrocnemius tissue were detected by real-time fluorescence quantitative PCR (qRT-PCR).Results:The degree of tissue edema was reduced under different IPC modes when compared with conventional IR group (all P<0.01). The W/D in conventional IR group, IPC immediate group, IPC24-hour group and IPC48-hour group were 6.05±0.19, 5.70±0.12, 5.25±0.13 and 5.50±0.08, higher than 3.80±0.08 in sham operation group (all P<0.01). IPC24-hour group had the least degree of edema when compared with IPC immediate group and IPC48-hour group ( P<0.05 or 0.01). The muscle fibers in sham operation group were neatly arranged with clear structure, and the muscle fibers in other groups showed different degrees of injury and inflammatory infiltration. The total scores for tissue injury severity in IPC immediate group, IPC24-hour group and IPC48-hour group were (8.15±0.15)points, (6.15±0.38)points and (6.90±0.19)points, lower than (9.60±0.50)points in conventional IR group and higher than (0.16±0.16)points in sham operation group (all P<0.01). The total scores for tissue injury severity in IPC24-hour group and IPC48-hour group were not significantly different ( P>0.05), but both decreased when compared with IPC immediate group ( P<0.05 or 0.01). ELISA showed that the levels of TNF-α, IL-1β and MDA under different IPC modes were higher than those in sham operation group (all P<0.01), and the order from high to low was conventional IR group, IPC immediate group, IPC48-hour group, IPC24-hour group and sham operation group. Levels of IL-1β, TNF-α and MDA in IPC24-hour group were decreased when compared with IPC immediate group and IPC48-hour group (all P<0.05). qRT-PCR showed that the expression of EGLN1 mRNA from high to low was conventional IR group, IPC48-hour group, sham operation group, IPC immediate group and IPC24-hour group and that the expression of EGLN1 mRNA in IPC24-hour group decreased when compared with conventional IR group, IPC immediate group and IPC48-hour group (all P<0.01). The expression of HIF-1α mRNA increased under different IPC modes when compared with sham operation group (all P<0.01), and the order from high to low was IPC24-hour group, IPC immediate group, IPC48-hour group, conventional IR group and sham operation group. The expression of HIF-1α mRNA in IPC24-hour group increased when compared with conventional IR group, IPC immediate group and IPC48-hour group ( P<0.05 or 0.01), but there was no significant difference between IPC immediate group and IPC48-hour group ( P>0.05). Conclusions:Different ischemic preconditioning modes can reduce IR injury of skeletal muscle in rats by reducing tissue edema, inflammatory symptoms and oxidative stress response, among which reperfusion 24 hours after IPC has the best effect on IR injury. EGLN1 and HIF-1α may be involved in IPC to alleviate IR injury of skeletal muscle in rats.

During coronavirus disease 2019 epidemic, the treatment of severe trauma has been impacted. The Consensus on emergency surgery and infection prevention and control for severe trauma patients with 2019 novel corona virus pneumonia was published online on February 12, 2020, providing a strong guidance for the emergency treatment of severe trauma and the self-protection of medical staffs in the early stage of the epidemic. With the Joint Prevention and Control Mechanism of the State Council renaming "novel coronavirus pneumonia" to "novel coronavirus infection" and the infection being managed with measures against class B infectious diseases since January 8, 2023, the consensus published in 2020 is no longer applicable to the emergency treatment of severe trauma in the new stage of epidemic prevention and control. In this context, led by the Chinese Traumatology Association, Chinese Trauma Surgeon Association, Trauma Medicine Branch of Chinese International Exchange and Promotive Association for Medical and Health Care, and Editorial Board of Chinese Journal of Traumatology, the Chinese expert consensus on emergency surgery for severe trauma and infection prevention during coronavirus disease 2019 epidemic ( version 2023) is formulated to ensure the effectiveness and safety in the treatment of severe trauma in the new stage. Based on the policy of the Joint Prevention and Control Mechanism of the State Council and by using evidence-based medical evidence as well as Delphi expert consultation and voting, 16 recommendations are put forward from the four aspects of the related definitions, infection prevention, preoperative assessment and preparation, emergency operation and postoperative management, hoping to provide a reference for severe trauma care in the new stage of the epidemic prevention and control.

Tetanus consists of neonatal tetanus and non-neonatal tetanus. Although neonatal tetanus in China has been eliminated since 2012, non-neonatal tetanus remains a serious public health problem. Non-neonatal tetanus is a potential fatal disease, and the mortality rate of severe cases is almost 100% in the absence of medical intervention. Even with vigorous treatment, the mortality rate is still 30~50% globally. In order to standardize the diagnosis and treatment of non-neonatal tetanus in China, this specification is hereby formulated. This standard includes etiology, epidemiology, pathogenesis, clinical manifestations, laboratory tests, diagnosis, differential diagnosis, classification, grading and treatment of non-neonatal tetanus.