Objective To study the relationship among apoptosis,NF-KB activation and uPA expres- sion in human colon carcinoma cell line HCTll6 induced by 5-fluorouracil,and to observe the effect of in- hibiting activity of NF-KB by PDTC on apoptosis as well as expression of uPA.Methods Cell apoptosis was analysed by Annexin V-FITC.Fluctuation of NF-KB and uPA was detected by semi-quantitative immuno- histochemistry.Results 5-fluorouracil could induce apoptosis and activate NF-KB.PDTC could significantly increase the apoptosis and suppress the activation of NF-KB induced by 5-fluorouracil.There was a positive correlation between the changes of uPA and NF-KB.Conclusion 5-fluorouracil could induce apoptosis,ac- tivate NF-KB and up-regulate expression of uPA of HCT116 cells.The mechanism of enhanced apoptosis by PDTC may be related to suppressing activation of NF-?B and down-regulating expression of uPA.

OBJECTIVETo study effect of von Willebrand factor (vWF) on the proliferation, adhesion and migration of human colorectal cancer cells.

METHODSHuman colorectal cancer cell line SW480 was cultured in vitro, and the expression of vWF in SW480 cells was detected by immunocytochemistry. SW480 cells were treated with vWF antibody (vWFAb), and the morphological change was examined by inverted microscope. Cell proliferation and ability to adhere extracellular matrix IIII( collagen were detected with MTT. Migration ability of SW480 cells was assayed by Transwell.

RESULTSThe human colorectal cancer cell line SW480 expressed vWF which was mainly in nucleus and slightly in cytoplasm. vWFAb significantly inhibited the proliferation ability of SW480 cells in dose- and time-dependent manner (P<0.05). After vWFAb treatment, SW480 cells adhesion decreased significantly (P<0.05), and transmembrane migration of cells significantly decreased (54.60+/-11.01 vs 97.27+/-10.01, P<0.01).

CONCLUSIONSHuman colorectal cancer cells can express vWF. vWF in human colorectal cancer cells plays an important role in promoting proliferation, adhesion, and migration.

Apoptosis ; Cell Adhesion ; Cell Line, Tumor ; Cell Movement ; Colorectal Neoplasms ; metabolism ; pathology ; Humans ; Neoplasm Metastasis ; von Willebrand Factor ; metabolism

Objective To investigate the value of A2DS2 score in predicting stroke-associated pneumonia (SAP) in patients with anterior and posterior circulation ischemic stroke. Methods The clinical data of patients with acute ischemic stroke admitted to the Department of Neurology, Heze Municipal Hospital from June 2011 to March 2016 were analyzed retrospectively. The independent risk factors for SAP were determined by binary multivariate logistic regression analysis. The value of A2DS2 score in predicting SAP in patients with anterior and posterior circulation ischemic stroke was evaluated by the receiver operator characteristic (ROC) curve. Results A total of 530 patients with acute ischemic stroke were enrolled, 90 of them (16. 98％) had SAP. There was no significant difference in SAP incidence between the patients with anterior circulation stroke (n = 430) and posterior circulation stroke (n = 100)(17. 2％ vs. 16. 0％; χ2 = 0. 084, P = 0. 772). Binary multivariate logistic regression analysis showed that the A2DS2 score was an independent risk factor for SAP in patients with ischemic stroke (odds ratio [OR] 1. 644, 95％ confidence interval [CI] 1. 097-2. 426), anterior circulation stroke (OR 1. 593, 95％ CI 1. 086- 2. 387), and posterior circulation stroke (OR 1. 463, 95％ CI 1. 064-2. 174). The ROC curve showed that the area under the curve of the A2DS2 score predicting SAP in patients with ischemic stroke, anterior circulation and posterior circulation stroke were 0. 826 (95％ CI 0. 792-0. 869), 0. 821 (95％ CI 0. 783-0. 858), and 0. 832 (95％ CI 0. 781-0. 923), respectively. The best cut-off value was 5. There was no significant difference in the area under SAP curve of the A2DS2 score for predicting SAP between patients with acute anterior circulation and posterior circulation ischemic stroke (Z = 0. 259, P = 0. 394). Conclusion A2DS2 score could predict SAP in patients with anterior circulation and posterior circulation stroke without difference, both of the cut-off value was 5.

Objective To evaluate the efficacy and safety of recombi-nant human granulocyte colony-stimulating factor ( rhG-CSF) used for chemotherapy-induced myelosuppression in small cell lung cancer (SCLC) patients. Methods Two hyndreds twenty-two cases suffering from small cell lung cancer of PLA General Hospital from 2002 to 2006 were chosen in our retrospective study, and 62 of these cases, used rhG-CSF after chemotherapy,were included in a statistics analysis. Results rhG-CSF was effective for chemotherapy-induced myelosuppression reactions and increasing significantly the number of neutropenia leukocyte and WBC (white blood cell). Average duration of recovery was 3 days and the effective rate was 95. 2%. Conclusion rhG-CSF showed high overall response rate of chemotherapy-induced myelosuppression reaction with only a few adverse reactions. But dosage and administration should be adjusted to different patients in different situations.

Objective: To investigate the value of platelet count in predicting the efficacy of rituximab treatment in chronic primary immune thrombocytopenia (ITP). Methods: A retrospective study was conducted in 103 chronic ITP patients hospitalized in our medical center between January 2011 and December 2014. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) of platelet count in different time points were analyzed for the predictor of treatment response. Optimal cutoff values were established using ROC analysis. Results: A total of 103 patients were included in the study. There were 46 males and 57 females, with a median age of 30 (18-67) years. At day 1, 3 and 7 after the first dose of rituximab, there was no significant difference in platelet counts between the success group (PLT≥50×10(9)/L after treatment) and the failure group (PLT≤50×10(9)/L after treatment) (P>0.05). At day 14 after rituximab treatment (PTD 14), platelet counts became significantly different in the success and failure groups[41(8-384)×10(9)/L vs 23(0-106)×10(9)/L, P=0.003], and remained different thereafter, with increasing significance in the subsequent follow-ups. Patients were divided further using an optimal cut-off platelet count of 50×10(9)/L on PTD 14, PTD 30, and PTD 60, and PPV and NPV values were calculated for predicting eventual success and failure. Conclusion: Response can be predicted by obtaining platelet counts at 14, 30 and 60 days after rituximab treatment. The study proposed a protocol that guides patient monitoring and management planning.
Adolescent ; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Platelet Count ; Purpura, Thrombocytopenic, Idiopathic/drug therapy* ; Retrospective Studies ; Rituximab/therapeutic use* ; Treatment Outcome ; Young Adult

Objective To understand the change in distribution and antimicrobial resistance of bacteria isolated from blood specimens of Hunan Province,and provide for the initial diagnosis and treatment of clinical bloodstream infection(BSI).Methods Data reported from member units of Hunan Province Antimicrobial Resistance Survei-llance System from 2012 to 2021 were collected.Bacterial antimicrobial resistance surveillance method was imple-mented according to the technical scheme of China Antimicrobial Resistance Surveillance System(CARSS).Bacteria from blood specimens and bacterial antimicrobial susceptibility testing results were analyzed by WHONET 5.6 soft-ware and SPSS 27.0 software.Results A total of 207 054 bacterial strains were isolated from blood specimens from member units in Hunan Province Antimicrobial Resistance Surveillance System from 2012 to 2021,including 107 135(51.7％)Gram-positive bacteria and 99 919(48.3％)Gram-negative bacteria.There was no change in the top 6 pathogenic bacteria from 2012 to 2021,with Escherichia coli(n=51 537,24.9％)ranking first,followed by Staphylococcus epidermidis(n=29 115,14.1％),Staphylococcus aureus(n=17 402,8.4％),Klebsiella pneu-moniae(17 325,8.4％),Pseudomonas aeruginosa(n=4 010,1.9％)and Acinetobacter baumannii(n=3 598,1.7％).The detection rate of methicillin-resistant Staphylococcus aureus(MRSA)decreased from 30.3％in 2015 to 20.7％in 2021,while the detection rate of methicillin-resistant coagulase-negative Staphylococcus(MRCNS)showed an upward trend year by year(57.9％-66.8％).No Staphylococcus was found to be resistant to vancomy-cin,linezolid,and teicoplanin.Among Gram-negative bacteria,constituent ratios of Escherichia coli and Klebsiella pneumoniae were 43.9％-53.9％and 14.2％-19.5％,respectively,both showing an upward trend(both P＜0.001).Constituent ratios of Pseudomonas aeruginosa and Acinetobacter baumannii were 3.6％-5.1％and 3.0％-4.5％,respectively,both showing a downward trend year by year(both P＜0.001).From 2012 to 2021,resistance rates of Escherichia coli to imipenem and ertapenem were 1.0％-2.0％and 0.6％-1.1％,respectively;presenting a downward trend(P＜0.001).The resistant rates of Klebsiella pneumoniae to meropenem and ertapenem were 7.4％-13.7％and 4.8％-6.4％,respectively,presenting a downward trend(both P＜0.001).The resistance rates of Pseudomonas aeruginosa and Acinetobacter baumannii to carbapenem antibiotics were 7.1％-15.6％and 34.7％-45.7％,respectively.The trend of resistance to carbapenem antibiotics was relatively stable,but has de-creased compared with 2012-2016.The resistance rates of Escherichia coli to the third-generation cephalosporins from 2012 to 2021 were 41.0％-65.4％,showing a downward trend year by year.Conclusion The constituent ra-tio of Gram-negative bacillus from blood specimens in Hunan Province has been increasing year by year,while the detection rate of carbapenem-resistant Gram-negative bacillus remained relatively stable in the past 5 years,and the detection rate of coagulase-negative Staphylococcus has shown a downward trend.

Objective To investigate changes in the distribution and antimicrobial resistance of bacteria isolated from cerebrospinal fluid(CSF)specimens in Hunan Province,and provide reference for correct clinical diagnosis and rational antimicrobial use.Methods Data reported by member units of Hunan Province Antimicrobial Resistance Surveillance System from 2012 to 2021 were collected according to China Antimicrobial Resistance Surveillance Sys-tem(CARSS)technical scheme.Data of bacteria isolated from CSF specimens and antimicrobial susceptibility tes-ting results were analyzed with WHONET 5.6 and SPSS 20.0 software.Results A total of 11 837 bacterial strains were isolated from CSF specimens from member units of Hunan Province Antimicrobial Resistance Surveillance Sys-tem from 2012 to 2021.The top 5 strains were coagulase-negative Staphylococcus(n=6 397,54.0％),Acineto-bacter baumannii(n=764,6.5％),Staphylococcus aureus(n=606,5.1％),Enterococcus faecium(n=465,3.9％),and Escherichia coli(n=447,3.8％).The detection rates of methicillin-resistant coagulase-negative Staphyloco-ccus(MRCNS)and methicillin-resistant Staphylococcus aureus(MRSA)were 58.9％-66.3％and 34.4％-62.1％,respectively.No Staphylococcus spp.were found to be resistant to vancomycin,linezolid,and teicoplanin.The de-tection rate of Enterococcus faecium was higher than that of Enterococcus faecalis,and the resistance rates of En-terococcus f aecium to penicillin,ampicillin,high concentration streptomycin and levofloxacin were all higher than those of Enterococcus faecalis(all P=0.001).Resistance rate of Streptococcus pneumoniae to penicillin was 85.0％,at a high level.Resistance rate of Escherichia coli to ceftriaxone was＞60％,while resistance rates to enzyme inhibitors and carbapenem antibiotics were low.Resistance rate of Klebsiella pneumoniae to ceftriaxone was＞60％,to en-zyme inhibitors piperacillin/tazobactam and cefoperazone/sulbactam was＞30％,to carbapenem imipenem and me-ropenem was about 30％.Resistance rates of Acinetobacter baumannii to most tested antimicrobial agents were＞60％,to imipenem and meropenem were 59.0％-79.4％,to polymyxin B was low.Conclusion Among the bac-teria isolated from CSF specimens,coagulase-negative Staphylococcus accounts for the largest proportion,and the overall resistance of pathogenic bacteria is relatively serious.Bacterial antimicrobial resistance surveillance is very important for the effective treatment of central nerve system infection.

Objective To evaluate the process risk of the implementation of prevention and control measures for surgical site infection(SSI)after colorectal surgery,and explore the application effect of failure mode and effects analysis(FMEA)based on action priority.Methods FMEA based on action priority was adopted to evaluate the whole process of the implementation of prevention and control measures for SSI after colorectal surgery.Prioritiza-tion ranking was conducted according to whether optimized measures were taken.Standard-reaching rate of comp-liance to SSI prevention and control measures as well as SSI incidence before and after the implementation of FMEA were compared.Results After evaluation,there were 7 high-priority and 22 medium-priority prevention and control measures for SSI.The control of medium-priority measures was strengthened,with a focus on developing further preventive and detectable measures for high-priority measures.The re-evaluation results after improvement showed that 7 high-priority measures have been downgraded to medium priority,and 16 medium-priority measures have been downgraded to low priority.Standard-reaching rate of compliance to SSI prevention and control measures in-creased from 77.15％(2 566/3 326)to 92.47％(3 096/3 348),and SSI incidence decreased from 6.04％(58/960)to 2.54％(60/2 364).Conclusion Application of FMEA based on action priority can effectively evaluate the risk of prevention and control process of SSI after colorectal surgery,and adopting preventive risk control measures accord-ing to the current situation can reduce the incidence of SSI after colorectal surgery.

The type 2 diabetes rat model was induced with high-sugar and high-fat diet combined with low-dose STZ. This study investigated the hypolipidemic mechanism of Coptis chinensis and C. deltoidea. After 30 days of administration, HOMA-IR and the content of TG in serum were detected, and the expressions of SCAP, SREBP-1c were tested by the method of Western blot and Real-time PCR analysis. The test results showed that both components can significantly alleviate insulin resistance and down-regulate the expressions of SREBP-1c and SCAP in liver tissue of type two diabetes mellitus. Compared with the control group, there were significant differences in relevant protein expression (<0.05, <0.01). This indicates that the inhibition of SREBP-1c and SCAP expressions may be the hypolipidemic mechanism of Coptidis Rhizoma on type 2 diabetes mellitus. The results also showed that C. deltoidea has a better efficacy in lipid elimination, but a weaker hypoglycemic effect against C. chinensis.

As new evidence emerges, treatment strategies toward the functional cure of chronic hepatitis B are evolving. In 2019, a panel of national hepatologists published a Consensus Statement on the functional cure of chronic hepatitis B. Currently, an international group of hepatologists has been assembled to evaluate research since the publication of the original consensus, and to collaboratively develop the updated statements. The 2.0 Consensus was aimed to update the original consensus with the latest available studies, and provide a comprehensive overview of the current relevant scientific literatures regarding functional cure of hepatitis B, with a particular focus on issues that are not yet fully clarified. These cover the definition of functional cure of hepatitis B, its mechanisms and barriers, the effective strategies and treatment roadmap to achieve this endpoint, in particular new surrogate biomarkers used to measure efficacy or to predict response, and the appropriate approach to pursuing a functional cure in special populations, the development of emerging antivirals and immunomodulators with potential for curing hepatitis B. The statements are primarily intended to offer international guidance for clinicians in their practice to enhance the functional cure rate of chronic hepatitis B.