Through analysis of the anatomic and physiological characteristics and the pathophysiological changes of 84 obstructive sleep apnea syndrome (OSAS) patients,the risks and key points of nursing care during general anesthesia were summarized,such as careful assessment of the patient situation,preparations of first aid materials and drugs,close observation and cooperation with the procedure of anesthesia,timely detecting and dealing with the abnormal changes during anesthesia.

Objective To discuss the application value of the combination detection of serum cystatin C(CysC),serum amyloid A (SAA)and urinary microalbumin(malb)for the early diagnosis of diabetic nephropathy(DN).Methods 112 cases of diabetic melli-tus(DM)were selected and divided into the non-DN group(malb<25 mg/L)and the early DN group(malb 30-299 mg/L)according to the urinary microalbumin level.50 cases of healthy subjects were selected as the control group.The levels of serum CysC and malb were measured by immuno-scatter turbidmetry and SAA was measured by enzyme-linked immunosorbent assays(ELISA).At the same time,the biochemical indexes of GLU,Cr,HbA1C were detected too.Results The levels of CysC,SAA and malb in the DM two groups were significantly higher than those in the healthy control group with statistical differences(P <0.05 ),moreover which were increased with the renal damage aggravation;the levels in the early DN group were significantly higher than those in the non-DN group with statistical differences(P <0.05).The levels of GLU and HbA1C in the DM two groups had statistically signifi-cant differences compared with the healthy control group(P <0.05).Conclusion The levels of serum CysC and SAA in the DM pa-tients are increased with the urinary malb level increase.The combined detection of CysC,SAA and malb could increase the diagnos-tic rate of the renal damage in early DN.

Objective To observe the effects of chemo-endocrine therapy on gastric carcinoma (GC). Methods Cancerous tissues from 95 patients with primary GC were examined for the presence of estrogen receptor (ER) and progesterone receptor (PgR). Afterwards, 64 GC patients with recurrent or metastatic conditions were randomly divided into two groups: chemotherapy group and chemo-endocrine therapy group. Results A total of 34.38% ER positive and 16.30% PgR positive rates were found. For ER positive patients, the use of tamoxifen-EAP regimens was more effective than that of EAP alone (P

Objective To study the effects of inhibiting forkhead transcription factor O1 (FoxO1)expression by small interference RNA (siRNA) on the glucose utilization of insulin resistant HepG-2 cell line and the mechanism.Methods FoxO1 gene-targeted siRNA vector,which carried a red fluorescence,was constructed and then confirmed by DNA sequencing.HepG-2 cells were induced to a status of insulin resistance by being exposed to 10-6 mol/L insulin for 24 h.The study included 4 groups: HepG-2 cell group cultured with normal medium (group A) ; insulin resistant HepG-2 cell group (group B) ; insulin resistant HepG-2 cell group into which FoxO1 siRNA vector was transfected (group C) ; insulin resistant HepG-2 cell group into which Lipofectamine2000 was added (group D).The transfection efficiency could be estimated by observing the expression of red fluorescence.The expression of FoxO1 mRNA was analyzed by RT-PCR.The expressions of IRS-2 and tyrosine phosphorylation were detected by Western blot and immunoprecipitation.Results FoxO1 gene-targeted siRNA vector was built successfully.The expression of red fluorescence was the strongest at 48 h after transfection.Compared with group A,the glucose consumption and the expression of IRS-2 tyrosine phosphorylation of group B were decreased (P<0.01),and expression of FoxO1 mRNA was increased (P<0.05) in group B.There was no difference in the expressions of IRS-2 protein between A and B groups.Compared with group B,the expression of FoxOl mRNA was decreased (P < 0.01),and the glucose consumption and expression of IRS-2 tyrosine phosphorylation were significantly increased (P<0.05) in group C.There was no difference between group D and group B in glucose consumption, FoxO1 mRNA, IRS-2 protein and IRS-2 tyrosine phosphorylation expressions.Conclusions Inhibiting the expression of FoxO1 gene in insulin resistant HepG-2 cells seems to improve insulin sensitivity by feedback regulating the IRS-2 tyrosine phosphorylation expressions.

Objective To quantify the expression levels of calpain 1 and caspase-3 in lichen planus (LP) lesions and their relationship with the apoptosis in keratinocytes.Methods Biopsy samples were obtained from the lesions of 20 patients with LP and normal skin of 10 healthy controls,and embedded in paraffin.Terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL) was used to evaluate the apoptosis in keratinocytes,and immunohistochemical staining to detect the expressions of calpain 1 and caspase-3,in these tissue specimens.Data were processed by SPSS 13.0 software.Comparison analysis was carried out by t test for apoptosis index,and by rank sum test for the expressions of calpain 1 and caspase-3.Spearman correlation analysis was conducted to evaluate the relationship between these parameters.Results The apoptosis index of keratinocytes was higher in LP lesions than in the normal skin (67.59 ± 13.50 vs.28.26 ± 7.56,t =8.52,P ＜ 0.01).Significantly increased expressions of calpain 1 and caspase-3 were observed in the epidermis of LP lesions compared with the normal skin (T =78.00 and 77.00,respectively,both P ＜ 0.01).The expressions of both calpain 1 and caspase-3 were positively correlated with apoptosis index of keratinocytes (r =0.71 and 0.74,respectively,both P ＜ 0.01).Conclusions The expressions of calpain 1 and caspase-3 are upregulated in LP lesions,which may be closely associated with the accelerated apoptosis in keratinocytes.

Objective To investigate the application of ultrasound visualization in instantly evaluation and supplement therapeu-tics in the treatment of uterine fibroids and adenomyosis with high intensity focused ultrasound (HIFU ) .Methods 57 patients with 67 uterine fibroids and 31 patients with 41 adenomyosis were treated with JC-200 HIFU treatment system and monitored the blood flow change in the lesion with B-ultrasound .Evaluated the curative effect with ablation ratio and ablation ratio after supplement therapeutics .Results The average ablation ratio of 57 uterine fibroids was(84 .6 ± 16 .1)% and the increased to(87 .0 ± 10 .7)% af-ter supplement therapeutics to 9 lesions with blood flow in the border of all .The changes were no significance(P>0 .05) .The aver-age ablation ratio of 31 adenomyosis was(62 ± 22 .7)% and increased to(74 ± 14 .7)% after supplement therapeutics to 11 lesions with blood flow in the border of all .The changes were statically significance(P<0 .05) .Conclusion Ultrasound visualization could be used to evaluate the area and extent of ablation with HIFU therapy ,it can clear lesions remaining parts and guiding the supple-ment therapeutics to improve the ablation ratio .Ultrasound visualization provided an evidence of therapeutics in the early period .

Objective To investigate the expressions of TK1 (thymidine kinase 1) in PHC (primary hepatic carcinoma). Methods TK1 and AFP in serum of 33 cases of PHC (primary hepatic carcinoma), 38 cases of hepatic cirrhosis,36 cases of hepatitis and 35 cases of healthy people were detected by means of Western blot—enhanced chemiluminecence and electrochemiluminescence. Results The difference of TK1 level in PHC group indicated significance when compared with that in hepatic cirrhosis group , hepatitis group and control group (U value was 436.4, 352.1, 163.6, respectively, all P < 0.01). TK1 level in patients with PHC was related with differentiation (χ2 = 7.476,P < 0.05) and TNM stage (χ2 = 7.227,P < 0.05),but not with sex, age, tumor diameter, number of tumors, vascular invasion, lymph node metastasis (P > 0.05). Kaplan-Meier curve analysis revealed that PHC patients with TK1≤ 2.0 pmol/L had a significantly shortened overall survival when compared with those with TK1 > 2.0 pmol/L (χ2 = 3.954,P < 0.05). Multivariable Cox regression analysis indicated that the level of TK1 and TNM stage were the independent risk factors for patients with PHC (all P <0.05). Conclusions The detection of TK1 has a certain clinical value in the diagnosis, monitoring and evaluation of the prognosis of the PHC.

OBJECTIVETo determine the regulatory effects of the circadian clock gene Per1 on cell cycle-related genes and its influence on the proliferation, apoptosis, cycle, and tumorigenicity in vivo of human oral squamous cell carcinoma SCC15 cells.

METHODSThree groups of the short hairpin RNA (shRNA) of lentivirus recombinant plasmids were designed against the RNA of Per1 and then transfected to the SCC15 cells. The optimum interference group was screened through Western blot and quantitative real-time PCR (qRT-PCR) and assigned as the experimental group. The transfected lentivirus plasmid without an interference effect on any gene was set as the control group (Control-shRNA). Untreated SCC15 cells were set as the blank group. The mRNA expressions of cell cycle-related genes, namely, Per1, p53, Cyclin D1, Cyclin E, Cyclin A2, Cyclin B1, CDK1, CDK2, CDK4, CDK6, p16, p21, Wee1, cdc25, E2F, and Rbl1 in each group were detected through qRT-PCR. The cell proliferation, apoptosis, and cell cycle distribution in each group were evaluated through flow cytometry. The cells of the experimental group and the blank group were subcutaneously inoculated in nude mice to observe tumorigenesis.

RESULTSThree groups of Per1-shRNA lentivirus plasmids were constructed successfully. Among the groups, the Per1-shRNA- I group exhibited the highest interference effect, as indicated by qRT-PCR and Western blot analysis. As such, this group was set as the experimental group. The mRNA expression levels of CyclinD1, CyclinE, CyclinB1, CDK1, and Wee1 gene in the Per1-shRNA-I group were significantly higher than those in the Control-shRNA group and the SCC15 group (P < 0.05). By contrast, the mRNA expression levels of p53, Cyclin A2, p16, p21, and cdc25 in the Per1-shRNA-I group were significantly lower than those in the Control-shRNA group and the SCC15 group (P < 0.05). The mRNA expression levels of each gene between the Control-sLRNA group and the SCC15 group did not significantly differ (P > 0.05). The mRNA expression levels of CDK2, CDK4, CDK6, E2F, and Rb1 did not significantly differed in the three groups (P > 0.05). The proliferation index of the Perl-shRNA-I group was significantly higher than those of the Control-shRNA group and the SCC15 group (P < 0.05). The apoptosis index of the Per1-shRNA-I group was significantly lower than those of the Control-shRNA group and the SCC15 group (P < 0.05). The number of S-phase cells in the Per1-shRNA-I group was significantly lower than those of S-phase cells in the Control-shRNA group and the SCC15 group (P < 0.05). The number of G2/M-phase cells in the Per1-shRNA-I group was significantly higher than those of G2/M-phase cells in the Control-shRNA group and the SCC15 group (P < 0.05). Conversely, the proliferation index, apoptotic index, and cell cycle distribution of the cells in the Control-shRNA group did not significantly differ from those of the SCC15 group (P > 0.05). The tumorigenic ability in vivo was significantly enhanced in the Per1-shRNA-I group (P < 0.05).

CONCLUSIONPer1 is an important tumor suppressor gene. Per1 can regulate a large number of downstream cell cycle-related genes. The alteration of its expression can affect cell cycle progression, proliferation, apoptosis imbalance, and tumorigenic ability in vivo. Further studies on Per1 may elucidate cancer development and provide novel effective molecular targets for cancer treatment.

Animals ; Apoptosis ; Carcinoma, Squamous Cell ; Cell Cycle ; Cell Line, Tumor ; Cell Proliferation ; Circadian Clocks ; genetics ; Cyclin D1 ; Humans ; Mice ; Mice, Nude ; Mouth Neoplasms ; Period Circadian Proteins ; genetics ; Plasmids ; RNA, Small Interfering ; Real-Time Polymerase Chain Reaction ; Transfection

Objective:To investigate the clinical and genetic mutation characteristics of a pedigree with familial exudative vitreoretinopathy (FEVR) associated with a LRP5 gene mutation. Methods:A pedigree investigation was performed in a two-generation Chinese Han family with FEVR, which was diagnosed in The First Affiliated Hospital of Xi'an Jiaotong University.Three family members, the proband and his parents, underwent ophthalmic examination, including visual acuity, intraocular pressure, slit-lamp microscopy, fundoscopy and wild-field fundus fluorescein angiography (FFA), to clinically characterize the FEVR phenotype.Peripheral blood of the families were collected for high-throughput sequencing and bioinformatics analysis to identify the pathogenic gene.Sanger sequencing verification was conducted for the detected mutation.The pathogenicity of identified mutations was analyzed according to the guidelines of the American Association of Medical Genetics (ACMG) with software such as Mutation Taster, Polyphen-2, PROVEN and REVEL.This study adhered to the Declaration of Helsinki and was approved by an Ethics Committee of The First Affiliated Hospital of Xi'an Jiaotong University (No.2017-740). Written informed consent was obtained from each subject.Results:The proband was a 27-year-old male.Uncorrected visual acuity (UCVA) was 1.0 for his right eye and 1.2 for his left eye.Fundoscopy showed vascular tortuosity and vasodilation in the temporal peripheral retina of both eyes.FFA indicated that hairbrush-like vasculature and non-perfusion lesion in peripheral retina.The best-corrected visual acuity (BCVA) of the proband's mother, a 51-year old female, was 1.0 for the both eyes.Temporal retinal vascular tortuosity in her left eye was found with fluorescein leakage detected by FFA.The BCVA of the proband's father, a 56-year-old male, was 1.0 for both eyes.Leopard fundus and optic disc atrophy were visible.FFA result was normal.The result of genetic test showed that there were two novel gene mutations in the family with LRP5 gene c. 4110T>G(p.Cys1370Trp) and FSCN2 gene c. 1495G>A(p.Gly499Ser). According to guidelines of ACMG, LPR5 c. 4110T>G was a mutation with uncertain significance.Multiple software, such as MutationTaster, Polyphen-2, PROVEN and REVEL predicted that LRP5 c. 4110T>G mutation might cause detrimental effects on genes or gene products.REVEL scale was 0.93, which indicated that it might be a pathogenic variant. Conclusions:LRP5 gene c. 4110T>G(p.Cys1370Trp) may be a novel mutation for FEVR, which enriches the mutation spectrum of LRP5 gene.

Objective To detect the serum levels of 25‐hydroxy vitamin D[25‐(OH)D] ,homocysteine(HCY) andβ2‐microglob‐ulin(β2‐MG) in the patients with type 2 diabetes mellitus (T2DM ) and to investigate the relationship between serum HCY and β2‐MG with 25‐(OH)D and its clinical significance .Methods A total of 139 cases of T2DM were selected anddivided into 3 groups , the normal albuminuria group for [urinary albumin to creatinine ratio (UACR)< 30 mg/gCr ,45 cases] ,microalbuminuria group (UACR ≥ 30 mg/gCr and < 300 mg/gCr ,48 cases) and massive proteinuria group (UACR ≥ 300 mg/gCr ,46 cases) according to the urinary albumin to creatinine ratio (UACR) .Other 45 individuals undergoing the physical examination were selected as the con‐trol group .The serum 25‐(OH)D level was measured by electrochemiluminescence .Serum HCY level was determined by the enzy‐matic method .Serum β2‐MG level was measured by the latex enhanced immune turbidity method .At the same time ,the biochemical indicators of FBG ,HbA1C ,serum calcium and phosphorus were measured .Results The serum 25‐(OH)D level was decreased with the increase of urinary albumin in the DM patients .And the serum 25‐(OH)D level in the microalbuminuria group and the massive proteinuria group was significantly decreased compared with the normal albuminuria group and the control group ,the difference was statistically significant(P<0 .01) .The serum HCY and β2‐MG levels in the microalbuminuria group and the massive proteinuria group were significantly increased compared with the healthy control group ,the difference was statistically significant (P<0 .05) . Conclusion The serum 25‐(OH)D level is decreased with the increase of urinary albumin in the diabetic patients .The serum HCY andβ2‐MG levels are increased with the increase of urinary albumin and serum 25‐(OH)D level is negatively correlated with the HCY andβ2‐MG levels .