OBJECTIVES: To propose a hypothesis that aloe-emodin may inhibit scar tissue fibrosis through thrombospondin-1(THBS1)-PI3K-Akt pathway. METHODS: By cultivating fibroblasts derived from scar tissue after cleft palate surgery in humans, aloe emodin of different concentrations (10, 20, 30, 40 and 50 μmol/L) was added to the cells which activity was detected. At the same time, transcriptome sequencing was performed on scar tissue and cells, and bioinformatics methods were used to explore potential targets and signaling pathways of scar tissue fibrosis. RESULTS: Aloe-emodin had a concentration dependent inhibitory effect on fibroblast proliferation,with the 40 μmol/L concentration group showing the most significant effect. The results of tissue and cell sequencing indicated that differentially expressed genes were significantly enriched in extracellular matrix-receptor interaction pathway, and shared a common differential gene which was THBS1. The ORA analysis results indicated that differentially expressed genes, including THBS1, were significantly enriched in the PI3K-Akt signaling pathway. CONCLUSIONS Aloe emodin may inhibit the PI3K-Akt pathway by downregulating THBS1, thereby reducing the proliferation activity of fibroblasts derived from postoperative palatal scar tissue.
Thrombospondin 1/genetics* ; Humans ; Signal Transduction/drug effects* ; Fibroblasts/cytology* ; Proto-Oncogene Proteins c-akt/metabolism* ; Fibrosis ; Phosphatidylinositol 3-Kinases/metabolism* ; Cicatrix/metabolism* ; Cell Proliferation/drug effects* ; Anthraquinones/pharmacology* ; Cells, Cultured

Objective:To investigate genetic variation profiles of δ-globin (HBD gene) and hematological phenotypes in Guangdong population.Methods:Retrospective case analysis was performed in this study. Blood samples of 11 616 couples who participated in free thalassemia screening in Guangzhou from July 2020 to December 2022 were collected which underwent blood routine tests and hemoglobin (Hb) capillary electrophoresis. According to the results, 154 samples were enrolled in this study: (1)group of 35 cases with HbA 2 <2.0% but no HbF band; (2)group of 64 cases with HbA 2 < 2.0% and HbF band; (3)group of 25 cases with HbA 2 <2.0% and suspected HbA 2 variants; (4) group of 25 cases with HbA 2 ≥2.0% and <3.5% and HbF band, as well as abnormal blood routine report [mean corpuscular volume (MCV) <82 fl and/or mean corpuscular hemoglobin (MCH) <27 pg]; (5)group of 5 cases with HbA 2 ≥2.0% and <3.0% accompanied with β thalassemia gene carriers Sanger sequencing was used to detect single nucleotide variants of δ-globin. Results:(1) A total of 22 genetic variations were detected, including 6 de novo variations, and the top 3 genetic variations were respectively c.-127T>C (57.02%, 65/114), c.-80T>C (9.65%, 11/114), c.349C>T (7.89%, 9/114). (2) In group of patients with HbA 2 <2.0% but no HbF band, 22 cases (62.85%, 22/35) had HBD gene variation, including 7 cases with MCV and MCH lower than reference values, 4 cases with α thalassemia; 13 cases had no HBD gene variation, including 12 cases with lower MCV and MCH. Among 19 cases with abnormal blood routine test results, levels of HbA 2 in patients (7 cases) with HBD gene variation were lower compared with those without HBD gene variation (12 cases) ( P<0.01%). (3)In group of patients with HbA 2<2.0% with HbF band, 59 cases (92.18%, 59/64) had HBD gene variations whose mutations all occurred in promoter region, and the HbF were all lower than 5.0%; 5 cases with HbF >5.0% had no HBD gene variation. (4) In group of patients with HbA 2 <2.0% and suspected HbA 2 variants, the detection rate was 100% (25/25) and δ-globin variants <1.0%. (5) In group of patients with HbA 2 ≥2.0% and <3.5% and HbF band accompanied with abnormal blood routine results, no HBD gene variation was found. (6) In group of 5 patients with HbA 2 ≥2.0% and <3.0% with β thalassemia gene carriers, HBD gene variation were found in all cases, and the level of HbA 2 was (2.62±0.17)% and HbF was (3.62±2.22)%. Conclusions:There are various genotypes of HBD gene variation, among which HBD: c.-127T>C is the most common in Guangdong population in China. Mutations in the promoter region may cause decrease in HbA 2 and increase in HbF which is mostly less than 5% but exceeds 5.0% when combined with β thalassemia. Our study enriched the gene mutation profiles of HBD gene in Guangdong population.

Rectal cancer is one of the common digestive tract malignant tumors in China. In particular, middle and low rectal cancers are the most common. The treatment goal is to preserve anal function as much as possible through tumor radical resection. Owing to anatomical and biological explorations and the widespread application of new surgical equipment, the possibility of anal function-preserving anastomosis in low rectal cancer has gradually increased. This article reviews the research progress on anastomosis for low rectal cancer surgery and discusses its characteristics and operational difficulties.

Radiation-induced cognitive dysfunction (RICD) has an insidious onset and there is a lack of effective prevention and treatment measures. The efficacy of memantine hydrochloride as a classical treatment drug is limited, and it is inevitable to seek multi-target combination drugs. In recent years, the protective effect of vitamin E and vitamin D on cognitive function has been widely recognized. Several basic studies have shown that vitamin E can play a role in the combination of medication by protecting neurons and reducing the adverse effects caused by memantine hydrochloride; Vitamin D and memantine hydrochloride have also become a hot topic of research due to their significant synergistic effects. The combination of memantine hydrochloride and vitamin therapy is expected to bring additional benefits to RICD patients.

Lung cancer is the most common malignant tumor. As the first-generation oral small-molecule tyrosine kinase inhibitor independently developed in China, apatinib can block many kinds of signaling pathways with high selectivity, and play an anti-tumor effect by inhibiting tumor angiogenesis, and the adverse reactions are controllable. More and more studies have shown that apatinib can be used for the second-line and beyond treatment of patients with advanced non-small cell lung cancer. This article reviews the mechanisms and clinical studies of apatinib in treatment of lung cancer.

Objective:To investigate the correlation between hyperuricemia and hypertension in hospital employees.Methods:A cohort was constructed from staff participating health checkups at the Xiangya Hospital of Central South University, baseline health examinations and questionnaires were conducted from February 1, 2011, to January 29, 2012; 502 participants were excluded according to the nadir criteria, and 3 525 participants were followed-up from February 1, 2012, to December 31, 2018, according to the results of annual employee checkups. The participants were divided into the normal uric acid (3 232 cases) and hyperuricemia groups (293 cases) according to the baseline examination results. The presence of hyperuricemia was used as an observation index and occurrence of hypertension within 7 years was used as an outcome indicator. Age, sex, body mass index, creatinine, LDL cholesterol, triacylglycerol, HDL cholesterol, fasting glucose, marriage, education, job position, smoking, alcohol consumption, and exercise status were used as confounding factors to construct five Cox regression models and calculate their HR values, adjusted HR values, and 95% CI to analyze the relationship between hyperuricemia and the occurrence of hypertension in the overall population and female and male populations. Results:The follow-up of the study participants was conducted for a period of (6.19±1.25) years, with a total of 21 831 person-years of follow-up. The 7-year cumulative prevalence of hypertension was 16.5% in the total population, 12.5% in the female population, 30.1% in the male population, 14.1% in the normal uric acid group, and 42.0% in the hyperuricemia group. The prevalence density of hypertension was 26.6, 19.6, 53.8, and 22.4 per 1 000 person-years in the total, female, male, and normouricemic groups, respectively. Without adjusting for any confounding variables, the risk of hypertension was higher in the total population, female population, and male population in the hyperuricemia group than in the normal uric acid group [ HR=3.86, 5.69, 1.60, (95% CI: 3.17-4.72, 4.36-7.43, 1.18-2.16)] (all P<0.05); after gradually adjusting for confounders, this correlation was only manifested in the female population [adjusted HR=1.91 (95% CI: 1.08-3.36)] (all P<0.05), and the difference was not statistically significant in the male population ( P>0.05). Conclusion:Among female hospital employees, hyperuricemia is an independent risk factor for the development of hypertension.

Objective:To evaluate the safety of two inactivated COVID-19 vaccines in a large-scale emergency use.Methods:Based on the "Vaccination Information Collection System", the incidence data of adverse reactions in the population vaccinated with the inactivated COVID-19 vaccines developed by Beijing Institute of Biological Products Co., Ltd and Wuhan Institute of Biological Products Co., Ltd, respectively, in emergency use were collected, and the relevant information were analyzed with descriptive epidemiological and statistical methods.Results:By December 1, 2020, the vaccination information of 519 543 individuals had been collected. The overall incidence rate of adverse reactions was 1.06%, the incidence rate of systemic adverse reactions was 0.69% and the incidence rate of local adverse reactions was 0.37%. The main systemic adverse reactions included fatigue, headache, fever, cough and loss of appetite with the incidence rates of 0.21%, 0.14%, 0.06%, 0.05% and 0.05%, respectively; the main local adverse reactions were injection site pain and injection site swelling with the incidence rates of 0.24% and 0.05%, respectively.Conclusion:The two inactivated COVID-19 vaccines by Beijing Institute of Biological Products Co., Ltd and Wuhan Institute of Biological Products Co., Ltd showed that in the large-scale emergency use, the incidence rate of general reactions was low and no serious adverse reactions were observed after the vaccinations, demonstrating that the vaccines have good safety.

Objective:To investigate the correlation between serum uric acid level and non-alcoholic liver disease (NAFLD).Methods:A medical examination cohort of our hospital′s staff was constructed. From February 1, 2012 to January 29, 2013, a total of 3, 479 staff without NAFLD were selected as research subjects, and baseline data were collected through a questionnaire survey, physical examination, abdominal ultrasound examination, blood lipid, blood glucose, liver and kidney function, and other laboratory tests. From February 1, 2013 to December 31, 2018, the patients were followed up during the annual physical examination for six years. The serum uric acid level was used as the observation index and divided into four groups from A to D according to the quartile. With the occurrence of NAFLD as the outcome indicator; the four groups of uric acid as the observation indicator; and age, body mass index, hyperlipidemia, hyperglycemia, hypertension, creatinine, and alanine aminotrans ferase as confounding factors; four Cox regression analysis models were constructed to explore the relationship between groups of different blood uric acid levels and NAFLD. Stratified by gender, three Cox regression analysis models were constructed to investigate the relationship between blood uric acid level grouping and NAFLD between different genders.Results:The six-year cumulative incidence of NAFLD in groups A, B, C, and D was 1.2%, 3.1%, 4.9%, and 12%, respectively (χ 2=114.710, P<0.05). Among the female workers, the six-year cumulative incidence rates in groups A, B, C, and D were 1.0%, 2.9%, 4.1% and 10.9%, respectively (χ 2=71.241, P<0.05). The incidence risk of NAFLD in groups B, C, and D was 2.04 (1.01-4.11), 2.24 (1.13-4.44), and 3.89 (1.94-7.80) times that of group A, P<0.05, respectively. The incidence risk of NAFLD in groups B, C, and D was 2.21 (1.02-4.77), 2.39 (1.10-5.19), and 4.49 (1.99-10.15) times that of group A, all P<0.05, respectively. Conclusion:The risk of NAFLD increased with the increase of serum uric acid level, and this trend was mainly manifested in female employees.

Cetuximab has become an important molecular targeted drug for the treatment of metastatic colorectal cancer (mCRC), which increases the curative effect of chemotherapy and prolongs the survival time. However, some patients develop insensitiveness or resistance to cetuximab, while the complicated molecular mechanisms are not quite clear. With the deep research in epidermal growth factor receptor (EGFR) signaling pathway, the genetic alteration of KRAS, BRAF, PTEN and PIK3CA and polymorphism of microRNA (miRNA) have been proved to associated with cetuximab resistance. Wnt signaling pathway with its negative regulator RNF43 is also considered to be related with cetuximab resistance in recent studies. The review of the progress on molecular mechanisms of cetuximab resistance in mCRC can establish theoretical basis for finding out reasonable drugs to overcome the resistance.

Objective The aim of this study was to explore the clinical safety, feasibility and short?term effect of overlapped delta?shaped anastomosis in total laparoscopic transverse colectomy. Methods The records, which were based on China National Cancer Center, of 20 and 31 patients who underwent total laparoscopic transverse colectomy with overlapped delta?shaped anastomosis and laparoscopic?assisted transverse colectomy with conventional extracorporeal anastomosis, from March 2017 to May 2018 were reviewed retrospectively. Data regarding surgical outcomes, postoperative recovery, pathological outcomes and perioperative complications were collected and compared. Results There was no difference between the two groups in overall operation time, anastomosis time and intraoperative blood loss (P＞0.05), however, the length of incision was significantly shorter in overlapped delta?shaped group [(4.7±0.6) cm vs.(5.5± 1.0) cm,P＝0.002]. The time to ground activities, first flatus and postoperative hospitalization did not differ between the two groups ( P＞0.05). The postoperative visual analogue scale was lower in the overlapped delta?shaped group than the control group on postoperative day 1 ( 3.7± 0.7 vs. 4.2 ± 0.9,P＝0.015) and postoperative day 3 (2.7±0.5 vs. 3.2±0.9,P＝0.040). The perioperative complication rates were 10.0% and 12.9% in the overlapped delta?shaped group and the control group, respectively, and the difference was not significant ( P ＝ 0. 753 ). Conclusion Compared to conventional extracorporeal anastomosis, total laparoscopic transverse colectomy with overlapped delta?shaped anastomosis was a safe and feasible procedure with satisfactory short?term effect, shorter incision and less postoperative pain.