Background and purpose:Inhibitor of apoptosis-stimulating protein of p53 (iASPP) is one of the ASPP family. It binds to p53 to inhibit the transcriptional activity of p53-target genes and cell apoptosis, which is asso-ciated with tumor formation. Previously, we found a new subtype of iASPP, iASPP splice variant (iASPP-SV), which is a nuclear protein containing 407 amino acid residues and can bind to p53, inhibiting p53 transcriptional activity. However, the relationship of iASPP-SV and breast cancer is still obscure. Therefore, the purpose of this research was to study the role of iASPP-SV on breast cancer tumorigenesis and progression.Methods:5’-rapid ampliifcation of cDNA ends (RACE) was used to identify the 5’-end of iASPP-SV mRNA in MCF-7 cells. HEK 293 cells were transfected with pFLAG-iASPP-SV and pFLAG-iASPP (828). Then Western blot was used to identify whether endogenous iASPP-SV was expressed in HEK 293 cells and 8 types of human tumor cell lines. This study established the stable clones of NIH 3T3 expressing FLAG-iASPP-SV and FLAG-iASPP (828). Cell proliferation assay, colony formation and soft agar colony formation assay were used to identify whether iASPP-SV and iASPP (828) can promote cell proliferation and iASPP-SV is an oncogene. Real-time lfuorescent quantitative polymerase chain reactive (RTFQ-PCR) was used to de-tect the levels of iASPP-SV and iASPP (828) mRNA in primary breast cancers. Luciferase assays were used to identify the relationships between iASPP-SV, iASPP (828), p53 and NF-κB p65.Results:The study identiifed that iASPP-SV was encoded by previously reported NF-κB p65 subunit (RelA)-associated inhibitor (RAI), and endogenously expressed in many human cancer cell lines. Analysis of cell proliferation, colony formation assay and soft agar assay for colony formation identiifed that similarly to iASPP (828), iASPP-SV promoted tumor cell proliferation and acted as an onco-gene. RTFQ-PCR result showed that the median values of iASPP-SV and iASPP (828) in breast cancers with wild-type p53 were more signiifcantly over-expressed than those of mutant p53. Luciferase assays showed that iASPP-SV and iASPP (828) could suppress NF-κB p65 transcriptional activity. Thus iASPP family may participate in the regulation of p53 and NF-κB activity, which imply that iASPP perhaps shows pro- or anti-survival activities when it interacts with different proteins.Conclusion:These ifndings indicate that iASPP-SV may be a potential target for breast cancer thera-py.

Objective To investigate the efficacy and safety of preoperative regional intra-arterial chemoembolization combined with systemic vein chemotherapy in the treatment of locally advanced gastric cancer.Methods The clinical data of 78 locally advanced gastric cancer patients treated by radical D2 gastretomy from January 2010 to December 2012 were retrospectively analyzed.Patients were devided into treatment group receiving regional intra-arterial chemoembolization combined with systemic vein chemotherapy (n =36),and those with preoperative systemic vein chemotherapy (n =42) 3 to 4 weeks before surgery.Systemic chemotherapy with mFOLFOX6 was started after 5 weeks of surgery in the two groups.Results The incidence of toxicity reaction and postoperative anastomotic leakage were lower in treatment group than in control group,all P ＜ 0.05.The 1-year recurrence and overall survival rate were similar between the two groups (all P ＞ 0.05).The 3-year liver metastasis rate was higher in treatment group than in control group (x2 =4.063,P ＜ 0.05).The 3-year survival rate was higher than that of the control group(x2 =4.396,P ＜ 0.05).Conclusions Preoperative systemic vein chemotherapy combined with regional intra-arterial chemoembolization decreases toxicity reaction,anastomotic leakage and liver metastasis,while prolonging 3-year overall survival.

Objective To model the newborn hypoxic-ischemic brain damage in rats. Methods 25 7-day-old healthy Wistar rats were divided into control group (n=12) and model group (n=13). 2 h after ligating and mutilating the unilateral common carotid arteries, the rats in the model group were put into an airtighted box with the volume fraction of 8% oxygen and 92% nitrogen for 2 h. 4 weeks after operation, all the rats were assessed behaviorally and pathologically. Results The footprint repeat space of rats were larger and more instable in the model group than in the control group (P<0.05). The time the rats crossing the balance beam was longer in the model group than in the control group (P<0.05). The escape latency of the water maze test was longer in the model group than in the control group (P<0.05). The right brain became smaller than the contralateral. HE staining showed that the cells around impaired periventricle were swelling, and cell number was less than the contralateral. The neurons decreased, some degenerated and necrosis neurocytes appeared in the impaired side. Conclusion The model of hypoxic-ischemic brain damage has been established.

Objective:To explore the real experience of "shadow" nurses acting as family members of hospitalized patients and provide references for improving patients' medical experience.Methods:From October to November 2019, a total of 19 "shadow" nurses from the the Affiliated Hospital of Qingdao University were given semi-structured interviews with the guidance of service quality gap model using the purposive sampling method and qualitative research. The phenomenological analysis method and Nvivo 11.0 Chinese software were applied to assist the data analysis.Results:The real experience of "shadow" nurses acting as family members of inpatients can be summarized into five thematic groups. Firstly, there was a gap between patients' and nurses' cognition of nursing service. Second, some current system standards could not meet the needs of patients. Third, nursing services didn't fully implement the established rules and systems. Fourth, there was a difference between patient perception and nursing services. The fifth theme was feelings and reflections.Conclusions:The "shadow" nurse experience activity can explore the medical experience and needs of inpatients, analyze the problems in nursing services and improve the medical experience of patients and meet their needs in a targeted manner.

Objective:To investigate the clinical difference between primary suture and T tube drainage in laparoscopic choledocholithotomy.Methods:The clinical data of 124 patients treated by laparoscopic choledocholithotomy in Suzhou Municipal Hospital from December 2018 to February 2020 were retrospectively studied. The patients were divided into the primary suture group (71 cases) and the T tube drainage group (53 cases) according to the different surgical methods, and the differences in the relevant treatment indicators were compared between the two groups.Results:There were no statistically significant differences between the two groups in gender, hypertension, diabetes mellitus, preoperative aspartate aminotransferase, preoperative alanine aminotransferase, preoperative total bilirubin, preoperative common bile duct diameter, postoperative length of stay, total cost of hospitalization, postoperative exhaust time, or postoperative biliary leakage, et al. Compared with the T tube drainage group, the primary suture group had more single choledocholithiasis before operation (33 cases vs. 15 cases), shorter operation time: (100.14 ± 38.90) h vs. (140.45 ± 54.17) h, less intraoperative bleeding: (35.70 ± 30.17) ml vs. (49.53 ± 34.58) ml, and later extraction time of Winslow hole drainage tube after operation: (7.15 ± 2.61) d vs. (5.45 ± 3.35) d, and the differences were statistically significant ( P<0.05). Conclusions:Under the condition of strictly controlling the indications of primary suture and being operated by general surgeons who can skillfully operate laparoscope and choledochoscope, laparoscopic choledocholithotomy for primary suture has better curative effect than T tube drainage, and has higher clinical application value.

Objective:To investigate whether hypoxia induces endoplasmic reticulum stress (ERS) through inositol-dependent enzyme 1α (IRE1α) and activates JNK pathway to participate in the proliferation and apoptosis of pulmonary artery smooth muscle cells in mice.Methods:Mouse pulmonary artery smooth muscle cell line (MPASMCs) was cultured in vitro to establish the hypoxic MPASMCs model. The expression of hypoxia-inducible factor-1α (HIF-1α), glucose-regulated protein 78 (GRP78) and JNK pathway genes were detected. The expression of IRE1α was knocked down by siRNA transfection, JNK pathway specific inhibitor 1, 9-pyrazoxanolone and pyrazoxanolone (SP600125) was used to inhibit JNK pathway, and XBP-1s plasmid was transfected to increase the expression of XBP-1s. CCK8 assay and proliferating cell nuclear antigen (PCNA) protein detection were used to observe the cell proliferation. Cell apoptosis was detected by flow cytometry and the expression of B-cell lymphoma-2 (BCL-2) and BCL-2 associated X protein (BAX) protein.Results:HIF-1αexpression was significantly up-regulated in MPASMCs cultured under hypoxia. The expression of GRP78, phosphorylated IRE1α (P-IRE1α) and phosphorylated JNK (P-JNK) increased after hypoxia, indicating that ERS and JNK pathways mediated by IRE1α were activated. When IRE1α expression was inhibited by si-IRE1a, the expression of P-JNK decreased, indicating that JNK pathway was inhibited. The expression of PCNA protein was up-regulated in the hypoxia group, and CCK8 assay indicated that the cell proliferation was up-regulated. The expression of BAX and BCL-2 protein were down-regulated in the hypoxia group, and the level of apoptosis was down-regulated. The above changes were delayed after SiIRE1a inhibited the expression of IRE1α. Treatment with SP600125 could also partially delay the pro-proliferation and anti-apoptosis changes induced by hypoxia. Overexpression of XBP-1s under normoxia activated the JNK pathway, accompanied by hypoxia-like changes.Conclusions:Hypoxia activates IRE1α-mediated endoplasmic reticulum stress, which promotes the proliferation and inhibits apoptosis of pulmonary artery smooth muscle cells through JNK pathway in mice.

Objective To evaluate pelvic peritoneum reconstruction with barbed suture and irrigation and negative pressure drainage in laparoscopy rectal anterior resection for locally advanced rectal cancer.Methods From 2014 to 2018 159 locally advanced rectal cancer patients treated by laparoscopy were derided into study group (n =76),and those received gravity drainage without pelvic peritoneum reconstruction (n =83).Results There were not significant difference in the operation time between the two groups [(165 ± 18) min vs.(160 ± 17) min,t =0.098,P =0.069].There were significant differences in postoperative drainage tube indwelling duration [(5.7 ± 2.4) d vs.(7.4 ± 3.7) d,t =3.309,P =0.001],intraabdominal infection (7％ vs.17％,x2 =3.991,P =0.046) and anastomotic leakage (4％ vs.13％,x/2 =4.280,P =0.039).There was no significant difference in anastomotic stenosis (5％ vs.10％,x2 =1.088,P =0.297) and intestinal obstruction (9％ vs.11％,x2 =0.117,P =0.732) between the two groups.Conclusion It is simple,safe and reliable to perform pelvic peritoneal reconstruction using barbed suture,combined with irrigation and negative pressure drainage,it can decrease drainage tube indwelling duration,reduce the incidence of intraabdominal infection and anastomotic leakage.

In recent years, the etiology of periodontitis has tended to be based on the theory of flora imbalance. That is, periodontitis is not caused by specific bacteria but by the breakdown of the oral flora balance, which leads to an immune imbalance. Imbalanced bacterial flora cooperate with each other to produce virulent factors that destroy organism tissues and induce immune cells to produce abnormal levels of cytokines, causing greater damage. This article reviews the initiation of a flora imbalance, the interaction between bacteria, the immune damage of the host and the prevention and treatment of the flora imbalance. The literature review shows that peroxidase released by inflammatory reactions, host immune responses to pathogenic microorganisms and some systemic factors, such as diabetes, can trigger flora imbalance. As a result, ion transport, substance synthesis and metabolism of bacteria change; virulence factors increase; and the oral flora balance is disrupted. Red complex bacteria enter gingival epithelial cells, produce adhesin, and selectively inhibit the expression of specific chemokines, which is beneficial for other pathogenic bacteria to enter gingival epithelial cells. Toxicity factors increase throughout the body, directly destroying body tissues and inducing innate and adaptive immune responses, thus causing related immune damage. The dysbacteriosis model of periodontitis provides a new idea for the prevention and treatment of periodontitis, such as using biological factors, bacteriophages, probiotics and other methods to reduce the number of periodontal pathogens to restore the steady state of periodontal flora.

Objective:To understand the loss to follow-up of children born to pregnant women with HIV infection (HIV-exposed children) and analyze its influencing factors in China in 2019.Methods:The data were collected from the follow-up records of pregnant women with HIV infection and their children reported by the national "Management Information System for the Prevention of HIV, syphilis and Hepatitis B Mother-to-Child Transmission" in 2019. HIV-exposed children were defined as those who were not followed up after birth or who were not followed up at 18 months of age and who were not followed up at 21 months of age. The univariate and multivariate influencing factors of loss to follow-up of children born to HIV-infected pregnant women were analyzed by χ2 test and logistic regression model. SPSS 25.0 software was used for statistical analysis. Results:The number of HIV-infected pregnant women was 5 039, the number of live-born children was 5 035, the number of loss to follow-up children within 18 months of age was 283, and the loss to follow-up rate children was 5.62%(283/5 035). The results of multivariate logistic regression analysis showed that the rate of loss to follow-up of exposed children born to pregnant women who worked as farmers (animal husbandry and fishery) (a OR=0.34, 95% CI: 0.22-0.53), unmarried (a OR=0.47, 95% CI: 0.24-0.93), first marriage (a OR=0.38, 95% CI: 0.22-0.67), remarriage (a OR=0.36, 95% CI: 0.20-0.67) and cohabiting (a OR=0.47, 95% CI: 0.23-0.97), and knew they had HIV infection before this pregnancy (a OR=0.53, 95% CI: 0.40-0.70) was lower. Han nationality (a OR=1.52, 95% CI: 1.09-2.13), primary school (a OR=2.06, 95% CI: 1.10-3.89) and junior middle school (a OR=1.81, 95% CI: 1.03-3.17) educational level, non-use of antiviral drugs (a OR=6.21, 95% CI: 4.32-8.93) and delivery in township (street) level midwifery institutions (a OR=5.72, 95% CI: 1.61-20.27) had higher rates of loss to follow-up among infants born to HIV-infected pregnant women. Conclusions:HIV-exposed children still have a specific rate of loss to follow-up in China in 2019. In order to further reduce the rate of loss to follow-up, it is of great significance to improve the detection rate of HIV before pregnancy and the rate of antiviral drugs used in pregnant women with HIV infection, which is of great significance for the effective implementation of comprehensive intervention measures of prevention of mother-to-child transmission of HIV.

Objective To analyze the gait characteristics of hip disarticulation amputees, and analyze the reasons for their differences from normal gait, so as to assist clinical diagnosis and evaluation. Methods Through the portable human motion capture device and plantar pressure analysis system, the kinematics and plantar pressure information of 5 hip amputees were collected and compared with 15 healthy volunteers in control group. Gait differences between the amputees and normal subjects and between the affected leg side and the healthy leg side of the amputees were compared. Results The proportion of double-support period for hip amuptees was higher than that of normal gait. Step length, step time, loading response period, mid support period, pre-swing period, proportion of the swing period for the affected leg side and healthy leg side of hip amputees showed significant differences with those of control group. The relative symmetry index of the gait for hip amputees was 0.60±0.05. Compared with the affected leg side, the support period of the healthy leg side was extended, the step length was shortened, the ground reaction force was greater than that of the affected leg side, and the center of pressure trajectory shifted to the affected leg side. Conclusions The gait of hip amputees is significantly different from that of normal people. Hip amputees have weak walking ability, poor gait symmetry, and they lack of continuity in the body’s center of gravity. The results provide experimental basis and theoretical analysis for the design of mechanical structure and control system of novel hip prosthesis.