Objective To study the immunoreactivity of fascin and Ki-67 proteins in bladder carcinoma and the correlation between their expression and the pathological features.Methods The immunohistochemistry of fascin and Ki-67 proteins were detected in 111 cases of bladder carcinoma and 42 cases of normal bladder tissues.The correlation between their expression and the pathological features were analyzed statistically.Results There was no expression of fascin and Ki-67 in normal bladder tissues.The immunoreactivities of fascin and Ki67 were detected respectively in 94 and 92 of 111 bladder carcinomas.The immunoreactivity of fascin was correlated with TNM staging and the size of the tumor(P<0.05),and had no correlation with age,gender and pathological classification(P>0.05).The expression of fascin was positively correlated with the expression of Ki-67 in bladder carcinoma(P<0.01).Conclusion Fasicn and Ki-67 were expressed in bladder carcinoma.The combined detection of fascin and Ki-67 expression might be helpful to assess the prognosis of bladder carcinoma.Targeting the fascin and Ki-67 pathway could be a novel therapeutic strategy of bladder carcinoma.

Objective To explore the influences of the final concentration and adding time of Cytochalasin-B (Cyt-B) on radiation-induced nucleoplasmic bridges (NPB) in cytokinesis-block assay.Methods Hunan peripheral blood samples were divided into 5 final concentration groups (group 2,4,6,8,10 μg/ml) according to different final concentrations of Cyt-B.Moreover,blood samples were divided into 4 adding time groups (group 0,28,40,44 h) according to different adding times of Cyt-B.Blood samples were irradiated with 0 (sham irradiation) and 2 Gy 60Co-rays in vitro,at a dose rate of 1 Gy/min.A cytokinesis-block assay was carried out to prepare NPB samples.The percentages of mononucleated,binucleated and multinucleated cells,as well as the frequencies of NPB and micronucleus (MN) in binucleated cells were analyzed using an optical microscope.Results Nuclear division index (NDI) and the percentages of binucleated cells increased with increased concentration of Cyt-B,and decreased with delayed adding time of Cyt-B (except group 0 h) in both final concentration groups and adding time groups.After exposed to 2 Gy,NPB frequencies were no significant difference (except group 0 h).MN frequencies had the trend of decreased with the increased concentration of Cyt-B,but no significant difference with adding time of Cyt-B.Conclusions In cytokinesis-block assay,different final concentration and adding time of Cyt-B may induce to the variation of NPB frequencies,but there was no significant difference.Appropriate increased final concentration or ahead adding time of Cyt-B can increase the percentage of binucleated cells that help to improve the efficiency of analysis.

AIM:To explore the mechanism by which over-expression of enhancer of zeste homolog 2 (EZH2) in a panel of gastric cancer cell lines is involved in tumorigenesis of gastric cancer .METHODS: Real-time PCR and Western blot were employed to examine the mRNA and protein levels of EZH 2, respectively.MTS assay, cell migration and soft agar assay were performed to investigate the role of EZH 2 in the regulation of stomach cancer behaviors .The effect of EZH2 on NF-κB target gene expression was determined by Luciferase reporter and real-time PCR.Co-immunoprecipitati-on was used to analyze the interaction of EZH 2 and p65 in HEK293T cells.RESULTS: The expression levels of EZH2 were significantly increased in the gastric cancer cells compared with normal gastric epithelial cells .Pharmacological inhibi-tion by DZNep or knockdown of EZH2 significantly compromised AGS and SNU-16 cell activity , cell migration and anchor-age-independent cell growth.Moreover, siRNA knockdown of EZH2 impaired NF-κB downstream targets, such as IL-8, CXCL5 and CCL20.In addition, the interaction of EZH2 and p65 was detected.CONCLUSION: EZH2 mediates the growth of gastric cancer cells through the regulation of NF-κB downstream gene expression .

Objective To improve the diagnosis and treatment of asymptomatic adrenal pheochromocytoma. Method The clinical data of 33 patients with asymptomatic adrenal pheochromocytoma were reviewed. Results All the patients were not preut with typical signs and symptoms of pheochromocytoma, 16 patients were found adrenal mass by routine physical examination, 15 patients presented with superior abdominal or flank pain, 1 patient was fever and 1 patient was diarrhea. Most of patients were prent with round mass with low density in the center of the tumor,5 patients had elevated level of plasma epinephrine and norepinephrine (16% ,5/31),24 hours urine CA and VMA were elevated in 6 patients (24%, 6/25) and 5 patients (20%, 5/25) respectively, 26 patients who were suspected pheochromocytoma preoperatively were treated with α-adrenergic blockade (prazosin) to control the blood pressure or with intravenous colloid fluids and blood transfusion to expand intravascular volume before operation. The tumors were removed successfully in 32 patients, and biopsy was done in 1 patient because of the serious invasion to the vena cava by the tumor. All the patients were diagnosed pheochromocytoma histopathologically,and followed up for 1 month to 7 years, no tumor recurrence. Conclusions The patients with asymptomatic adrenal pheochromocytoma have lower catecholamine excretion in their plasma and urine. Combination of modem imaging examinations are useful methods to diagnose asymptomatic adrenal pheochromocytoma. To lower the risk of operation, the control of blood pressure and the expanding of intravascular volume are important for the patients with huge adrenal mass or typical suspected appearance of pheochromocytoma.

Objective:To investigate the effect of virtual-simulation laparoscopic training system in the training of basic skills of endoscopic surgery in trainees with different clinical experience.Method:s Eight refresher physicians, eight residents who received standardized residency training, and eight undergraduate interns in five-year clinical medicine were selected. All of them received the training of endoscopic operations with the laparoscopic training box and the virtual-simulation laparoscopic training system for 30 minutes every day for 4 weeks. Data analyses were performed using SPSS 19.0 and t-test was adopted to compare the scores before and after training among the three groups.Result:s Before training, there were significant differences in endoscopic operations between the undergraduate intern group and the other two groups ( P<0.05); after 4 weeks of training, all three groups had significant increases in the scores and spent less time on training items ( P<0.05). There was no significant difference in simple operations among the three groups ( P>0.05), and the undergraduate intern group had a significantly higher score of complex operations than did the standardized residency training group and the refresher physician group ( P<0.05). Conclusion:The virtual-simulation laparoscopic training system can improve the laparoscopic skills of clinical trainees at different levels, therefore, it is worth being promoted in the teaching of clinical skills.

Objective:To analyze the risk factors of deep venous thrombosis (DVT) in patients with tibial plateau fracture during preoperative period.Methods:From July 2017 to October 2019, a total of 264 patients undergoing surgeries of tibial plateau fractures were enrolled. Duplex ultrasonography (DUS) during hospitalization was used to screen for DVT of the bilateral lower extremities. Patients were divided into DVT group and non-DVT group according to results of DUS. Data on demographics, comorbidities, injury-related data, fracture type, laboratory biomarkers were collected and compared between groups with and without DVT.Results:The incidence of preoperative DVT was 39.0% (103/264) among 264 patients with traumatic tibial plateau fractures, and distal thrombosis predominated in DVT group. There were 103 cases in DVT group. 55 were males and 48 were females. The average age was 54.00±11.12. According to the Schatzker classification of tibial plateau fractures, 7 cases belonged to type I, 37 to type II, 2 to type III, 11 to type IV, 29 to type V, and 17 to type VI. There were 161 cases in non-DVT group. 89 were males and 72 were females. The average age was 48.57±13.25. According to the Schatzker classification of tibial plateau fractures, 23 cases belonged to type I, 76 to type II, 2 to type III, 10 to type IV, 33 to type V, and 17 to type VI. Univariate analysis showed that age ( t=3.451, P=0.001), the type of tibial plateau fracture ( χ2=8.314, P=0.004), D-dimer ( χ2=18.552, P<0.001), APTT ( t=2.869, P=0.004), ALB ( t=2.292, P=0.023) and Hb ( t=1.983, P=0.048) were statistically different than those in non-DVT group. Multivariate analysis showed age ( OR=1.033, 95% CI: 1.009, 1.058; P=0.007), the type of tibial plateau fracture ( OR=1.829, 95% CI: 1.014, 3.299; P=0.045) and D-dimer ( OR=1.914, 95% CI: 1.057, 3.464; P=0.032) were independent risk factors. Conclusion:The incidence of DVT in patients with tibial plateau fractures during preoperative period is high, and distal thrombosis is the main part of venous thrombosis of lower extremity. The type of tibial plateau fracture, age and the level of D-dimer are independent risk factors of preoperative DVT in patients with tibial plateau fractures.

Objective:To investigate the effects of different chemotherapy dose intensity on the short-term efficacy and adverse reactions of patients with advanced colon cancer.Methods:A real-world database of patients with advanced colon cancer in Wangjing Hospital of China Academy of Chinese Medical Sciences and China-Japan Friendship Hospital from January 2017 to December 2020 was established, including 105 patients treated with the same chemotherapy regimen for two consecutive cycles. The patients were grouped according to the average relative dose intensity (ARDI) of chemotherapy, and the population differences, treatment regimens, short-term efficacy and adverse reactions of different chemotherapy dose intensities were evaluated. The receiver operating characteristic (ROC) curve was used to analyze the predictive value of ARDI for short-term efficacy.Results:There were 31 patients in the high dose intensity group (ARDI≥80%) , 34 patients in the medium dose intensity group (80%0.05) . ROC curve analysis found that the area under the curve predicting objective response was 0.70, the sensitivity was 92.30%, and the specificity was 52.10% when the chemotherapy ARDI threshold was 64%. Conclusion:In the real world, colon cancer patients receiving high dose intensive chemotherapy have better objective response rate, and tumor markers decreased significantly. The baseline status of colon cancer patients receiving low dose intensive chemotherapy is poor, but there is no statistically significant difference in disease control rate between patients receiving low dose intensive chemotherapy and patients receiving high dose intensive chemotherapy, and the adverse reactions are controllable.

Objective To explore the predictive value of immune inflammation combined with liver function hematological indicators for the metastasis of colorectal cancer.Methods A retrospective analysis of clinical data of 133 patients with colorectal cancer was conducted.The patients were divided into three groups based on disease progression after 24 months of postoperative follow-up:non-metastasis group(n=38),liver metastasis group(n=43),and non-liver distant metastasis group(n=52).The immune inflammatory markers and liver function hematological indicators of progression-free survival were analyzed.Nomogram prediction models were constructed using univariate and multivariate logistic regression analyses to identify risk factors for metastasis of colorectal cancer.The accuracy of the nomogram was validated using receiver operating characteristic(ROC)curve and calibration curve,and the clinical predictive efficacy was evaluated through decision curve and clinical impact curve.Results Univariate and multivariate logistic regression analyses showed that pan-immune-inflammatory value(PIV),prognostic nutritional index(PNI),and bile acid(BA)were independent predictors of colorectal cancer metastasis.The area under the ROC curve of the combined prediction of metastasis was 0.84;neutrophil/lymphocyte ratio(NLR)and BA were independent predictors of liver metastasis from colorectal cancer.The area under the ROC curve of the combined prediction of liver metastasis was 0.83;PIV and PNI were independent predictive factors for the occurrence of non-liver distant metastasis from colorectal cancer.The area under the ROC curve for the combined prediction of non-liver distant metastasis was 0.83.The calibration curve,decision curve,and clinical impact curve showed that the three models had good accuracy and net benefit value.Conclusion The nomogram constructed based on immune inflammation and liver function hematological indicators can predict the metastasis of patients with colorectal cancer and has high predictive efficacy and clinical application prospects.

Objective To explore the relationship between androgen level and adverse pregnancy outcome of pregnant women at advanced maternal age.Methods A total of 192 pregnant women who were admitted to Changzhou Maternal and Child Health Care Hospital for delivery from May to October 2022 were selected as the study objects.According to guidelines for diagnosis and treatment of hypertensive disorder complicating pregnancy and maternal age,the study objects were divided into simple pregnant women at advanced maternal age group,pregnant women at advanced maternal age complicated with hypertensive disorder complicating pregnancy,healthy control group and age-appropriate pregnant women complicated with hypertensive disorder complicating pregnancy group.Serum levels of five androgens[total testosterone(TT),sex hormone binding globulin(SHBG),free testosterone index(FTI),dehydroepiandrosterone sulfate(DHEAS)and androstendi-one(A2)]in each group were detected by chemiluminescence method.Results Compared with the healthy control group,TT,A2,FTI were significantly increased and SHBG was significantly decreased in the age-ap-propriate pregnant women complicated with hypertensive disorder complicating pregnancy group,the level of DHEAS was decreased in the simple pregnant women at advanced maternal age group,and the differences were statistically significant(P＜0.05).Pearson correlation analysis showed that TT was negatively correla-ted with age(P＜0.05),positively correlated with systolic blood pressure,diastolic blood pressure and body mass index(P＜0.05),and had no correlation with offspring sex and offspring weight(P＞0.05).Multivari-ate Logistic regression analysis showed that TT and body mass index were independent risk factors for hyper-tensive disorder complicating pregnancy in pregnant women(P＜0.05).Conclusion The level of androgen in pregnant women at advanced maternal age is related to the occurrence of hypertensive disorder complicating pregnancy.

【Objective】 To study the effect of air inlet modes on the temperature variation, fluctuation, uniformity and coefficient of variation(CV), so as to evaluate the stability and uniformity of the temperature field in refrigerated warehouse for blood. 【Methods】 The temperature changes of blood refrigerated warehouse under different modes of air inlet during compressor operation were analyzed. The stability of the temperature field in the storehouse was evaluated by the changes, fluctuation, uniformity, CV and deviation of temperature at each testing point. 【Results】 The average value of temperature in the storehouse, adopting air inlet via straight blow, was (4.98±0.92)℃, while that of air inlet via micro-hole mode was(4.15±0.25)℃, with significant differences between each other(P<0.05). As to the CV of temperature, air inlet via straight blow was significantly different from that via micro hole(P<0.01). The fluctuation, uniformity and deviation of temperature created by straight blow and micro hole were 1.85±1.11 vs 0.49±0.38, 1.00±0.68 vs 0.47±0.37, and 0.61±0.45 vs 0.27±0.21, respectively, with significant differences between each other(P<0.01). 【Conclusion】 Compared with straight blow, the mean temperature created by micro hole was closer to the median value (4℃) of the temperature range, i. e.(4±2)℃, during blood storage. Otherwise, micro hole demonstrated a smaller CV of temperature, and superior performance in fluctuation, uniformity and deviation of the temperature at the testing points, which was conducive to ensure the stability of storehouse temperature field.