Objective To investigate the clinical significance of CUL4B and interleukin?6( IL?6) levels in patients with multiple myeloma(MM).Methods The mRNA of CUL4B and IL?6 were detected by real?time relative quantitative PCR and enzyme?linked immunosorbent assay( ELISA) in 46 cases of MM and 40 cases of non hematologic cancer patients.Results CUL4B concentrations in patients with MM were 3.455(2.098,4. 768).IL?6 concentrations in patients with MM were significantly higher than those of the normal control group ((23. 985(23. 015,26. 878) ng/L vs. 6. 205(5. 405,10. 215) ng/L,Z=-8. 262,P=0. 000). The expression of CUL48 mRNA in Stage Ⅰ,Ⅱ,Ⅲ was 2. 424 ( 1. 881, 3. 583 ) , 3. 594 ( 2. 093, 5. 738 ) , 4. 300 ( 2. 928, 7. 272) respectively, and IL?6 was 23. 115 ( 22. 723, 23. 568 ) , 23. 630 ( 22. 860, 26. 625 ) , 26. 35 ( 24. 995, 30. 550) ng/L respectively,with the increase of clinical stage,the level of CUL4B and IL?6 showed increasing trend( P<0. 05) . CUL4B concentrations were significantly decreased in MM patients after treatment than before treatment(1. 665(1. 420,2. 298) vs. 3. 455(2. 098,4. 768),Z=-4. 955,P=0. 000). IL?6 concentrations were significantly decreased in MM patients after treatment than before treatment( 15. 160( 11. 705,17. 195) ng/L vs. 23. 985(23. 015,26. 878) ng/L,Z=-7. 981,P=0. 000). CUL4B level in patients was positively correlated with IL?6( r=0. 386,P=0. 008 ) . Conclusion It is of great significance to detect CUL4B and IL?6 in patients with MM on clinical stage,the condition of judgment and efficacy observation.

Objective To study the inhibitory mechanism of soliquiritigenin on tyrosinase.Methods The inhibition effect and inhibitory kinetics of tyrosinase induced by oliquiritigenin were investigated.The effect of isoliquiritigenin on A375 melanoma cell were preliminarily indicated.Results The inhibitory effect of isoliquiritigenin on monophenolase and diphenolase of tyrosinase was good, IC50 was (11.22 ±0.92) μM and (48.53 ±4.75) μM, isoliquiritigenin was a competitive inhibitor, the value of inhibition constant ( Ki ) was ( 12.14 ±0.54 ) μM.Isoliquiritigenin could inhibit the prolifevation of A375 cell significantly, and the tyrosinase activity and melanin synthesis decreased.Conclusion Isoliquiritigenin as a tyrosinase inhibitor, plays an important role in the regulation of melanin, which provides the theoretical basis for the clinical anti skin cancer.

Objective To investigate the role of a small RNA interference against VEGF in radiation sensitivity in melanoma .Methods A375 human melanoma cell lines were transplanted into nude mice ,which with malignant melanoma were randomly divided into control group , VEGF negative plasmid group and VEGF positive plasmid group, followed by 4Gy irradiation twice a week for 2 weeks.The volume of tumor was calculated twice a week, the area of tumor necrosis was assayed by HE,the expression of VEGF in tumor was determined by Western-blot and Immunohistochemical. ResuIts The expression of VEGF in VEGF positive plasmid group decreased significantly (P<0.05), VEGF positive group had more tissue necrosis, tumor growth was significantly inhibited (P<0.05).ConcIusion siRNA-VEGF in tumor injection liposome encapsulated in malignant melanoma has a role in the radiation sensitization, which provides an experimental basis for the clinical development of targeted therapy combined with radiotherapy for the treatment of VEGF gene.

Objective To investigate hospital acquired infections in patients with liver cirrhosis caused by relevant factors.Methods From July 2008 to June 2013,the clinical data of 470 cases of hospital acquired infections patients with chronic hepatitis B virus (HBV) infection were retrospectively analyzed by case-control study for the effective factors.Results Hospital acquired rate was 29.1％ (137/470).By logistic regression analysis,the effective factors were length of stay (OR =27.824,95％ CI 7.187-98.386),invasive operation (OR =17.201,95％ CI 4.245-71.303),a complication (OR =2.138,95％ CI 1.030-4.377),preventive use of antibiotics(OR =2.741,95％CI 1.816-4.010),drinking history(OR=34.248,95％CI 13.045-82.328),serum albumin(OR =17.258,95％ CI 6.242-53.162),quantitative PCR-HBVDNA (OR =4.859,95％ CI 3.214 -7.625),white blood cell (OR =4.271,95 ％ CI 1.520-12.157),c holinesterase (OR =2.761,95 ％ CI 1.523 -3.787) and anti virus medicine(OR=0.128,95％CI 0.041-0.375) (P＜0.05).Conclusion This study shows that length of stay,invasive operation history,complications,low white blood cell,low serum protein,low cholinesterase,the prophylactic use of antibiotics,hormone,high PCR-HBVDNA quantitative and drinking are the important risk of hospital acquired infections infection factors of patients of impact chronic HBV infection.Applications of antiviral drugs are effective in the prevention of chronic HBV infection protection factors of hospital acquired infections infection patients.

Objective:To investigate the application of 3.0T high resolution magnetic resonance imaging(HR-MRI)in acute ischemic stroke(AIS)and the influence factors of prognosis.Methods:A total of 92 AIS patients who underwent treatment in Hainan General Hospital from January 2019 to June 2022 were selected as the research objects.All patients were treated by thrombolytic therapy,and they were divided into favorable prognosis group(mRS scores≤2 points,n=66)and poor prognosis group(mRS score>2 points,n=26)according to modified Rankin Scale after they received 90d treatment.All of patients underwent Magnetom Trio type of 3.0 T HR-MRI examination within 1 week after they hospitalized,and the changes of luminal stenosis rate,the luminal area at the narrowest point,the plaque load,T2WIsignal intensity index,T1WI signal intensity index,plaque enhancement rate and other parameters were compared.The receiver operating characteristics(ROC)curve was adopted to analyze the predictive value of 3.0T HR-MRI parameters on the AIS prognosis.Binary Logistic regression model was used to analyze the risk factors that affected the prognosis of AIS patients.Results:The difference of infarction diameter between two groups was statistically significant(x2=6.574,P<0.05).The lumen area at the narrowest point in the poor prognosis group was significantly lower than that in the favorable prognosis group,while the T2WI signal intensity index,T1WI signal intensity index and plaque enhancement rate in the poor prognosis group were significantly higher than those in the favorable prognosis group(t=-3.378,4.443,4.413,3.890,P<0.05),respectively.ROC curve analysis showed that the area under curve(AUC)values of T2WI signal intensity index,T1WI signal intensity index,lumen area at the narrowest point and plaque enhancement rate in predicting the AIS prognosis were respectively 0.743,0.739,0.706 and 0.748.The Logistic regression analysis showed that infarction diameter>3.0cm,T1WI signal intensity index,T2WI signal intensity index,lumen area at the narrowest point and plaque enhancement rate were respectively independent risk factors that could affect AIS prognosis(OR=3.889,257.151,105.073,4.091,1.121,P<0.05).Conclusion:3.0T HR-MRI has higher efficiency in the assessment for the prognosis of patients with AIS,which can provide guidance for the judgement of prognosis and the formulation of treatment scheme through observes the changes of a series of parameters include T2WI signal strength index,T1WI signal strength index,the lumen area at the narrowest point,plaque enhancement rate.The above parameters are risk factors that affect the prognosis of patients,which often represent the progress of patients'conditions.

Objective Based on Chinese guidelines for the management of ischemic stroke, a standardized stroke management program was performed to provide intensive education and training for medical physicians, aiming to enhance their knowledge and ability for ischemic stroke prevention and treatment, thereby reducing patients′ in-hospital cost and length of stay, and improving patients′ clinical prognosis. Methods This study was conducted in 20 general hospitals throughout Hainan province. A total of 163 physicians from 20 hospitals involved in the management of stroke patients were trained by highly experienced physicians based on the Chinese guidelines for diagnosis and treatment of acute ischemic stroke 2014 and the Chinese guidelines for secondary prevention of ischemic stroke and transient ischemic attack 2014. Prior to and post the standardized stroke management training, the data of 3218 and 3367 patients with ischemic stroke were respectively collected. Quality of life assessments including the Barthel index (BI) and the modified Rankin Scale (mRS) score of all patients were recorded at baseline and after discharge. The length of stay and in-hospital cost were directly collected from the hospital information system. Results Physicians′ knowledge and ability manifested as testing scores were significantly improved after training (78.2 ± 15.5 vs 55.6 ± 10.7, t=69.1, P<0.01). The average length of stay of post-training patients was significantly shorter than that of pre-training patients ((8.7 ± 0.9) vs (11.7 ± 1.5) days, t=97.9, P<0.01). The average in-hospital cost of post-training patients was significantly less than that of pre-training patients ((7681.7 ± 1397.7) vs (11846.2 ± 2514.6) Yuan, t=82.5, P<0.01). Both BI (68.2 ± 3.2 vs 43.5 ± 5.3, t=227.7, P<0.01) and mRS score (2.74±0.51 vs 3.65±0.71, t=59.5, P<0.01) were significantly improved for post-training patients. Multivariate linear regression analysis illustrated that standardized stroke management was negatively associated with in-hospital cost (r=-0.461, P<0.01), length of stay (r=-0.357, P<0.01) and mRS score (r=-0.298, P<0.01), and was positively associated with levels of BI (r=0.376, P<0.01). Conclusion Standardized stroke management program might be a cost-effective choice for the management of ischemic stroke as it reduces the in-hospital cost and improves patients′BI and mRS levels.

Objective To investigate the characteristics of multimodal MRI of breast cancer with different molecular subtypes and the correlation between each molecular type and MRI findings. Methods Multimodality MRI date of 87 patients with breast cancer confirmed by pathology were retrospectively analyzed. According to the expression of estrogen receptors(ER),progesterone receptors(PR)and human epidermal growth factor receptor-2 (HER-2),the tumors were classified into triple-negative breast cancer,HER-2 overexpression,Luminal A and Lu-minal B subtypes. The MRI features of breast cancers of different molecular subtypes were compared. Results Among the 87 cases of breast cancer,luminal type A accounted for 29.9%(26/87),luminal type B accounted for 36.8%(32/87),HER-2 type accounted for 19.5%(17/87),and triple-negative type accounted for 13.8%(12/87). The average ADC value is 0.97 × 10-3 mm2/s;those whose irregular or edge burr like mass were more often Lu-minal type MRI,triple-negative breast cancer showed the edge smooth,clear boundary,annular enhancement, more easily showed enhanced mode of TIC type Ⅲ. The mean ADC values of type Luminal and HER-2 over-expres-sion were lower than the mean ADC values of the triple-negative type. Conclusion The different molecular sub-types of breast cancer MRI morphologic and hemodynamic characteristics and the value of ADC has certain charac-teristics. The MRI features of breast cancer can be predicted to analyze the molecular typing,providing a reference for clinical treatment.