Objective To evaluate the value of tumor necrosis factor -α( TNF-α) ,leptin ( LEP) ,interleu-kin-6 (IL-6) and carcinoma embryonic antigen (CEA) in both serum and pleural effusion in differential diagnosis of tuberculosis and malignant tumor .Methods Detection were performed on tuberculosis and malignant tumor patients,comparation was conducted on the level and positive ratio of TNF -α,LEP,IL -6 and CEA in different groups.Results The levels of TNF-α,LEP,CEA in serum decreased significantly compared with malignant tumor patients[(34.45 ±17.11)μg/L vs (70.26 ±19.31)μg/L,(490.71 ±197.58)μg/L vs (2 013.62 ±596.22)μg/L, (226.81 ±87.09)μg/L vs (5 329.62 ±1 523.58)μg/L;t=5.221,9.673,12.078;P=0.012,0.031,0.000],but IL-6 was not [(159.73 ±30.33)μg/L vs (22.31 ±3.20)μg/L;t=-16.114;P=0.001];The level of TNF-α, LEP,CEA in pleural effusion was decreased significantly compared with malignant tumor patients [( 20.31 ± 5.62)μg/L vs (42.06 ±14.07)μg/L,(702.46 ±375.01)μg/L vs (4 532.27 ±2 307.83)μg/L,(112.25 ± 48.72)μg/L vs (4 190.84 ±1 534.29)μg/L;t=5.017,12.096,12.236;P=0.022,0.016,0.033],but IL-6 was not [(92.15 ±32.64)μg/L vs (10.29 ±3.91)μg/L,t=-11.583;P=0.031].The positive ratio of TNF -α, LEP,CEA in serum was decreased significantly compared with malignant tumor patients (17.8% vs 72.2%,20.0%vs 91.7%,0.0% vs 100.0%;χ2 =24.341,41.145,81.000;P =0.000,0.000,0.000),but IL -6 was not (100.0%vs 0.0%,χ2 =81.000;P=0.000);The positive ratio of TNF -α,LEP,CEA in pleural effusion was decreased significantly compared with malignant tumor patients (28.9% vs 75.0%,4.4% vs 100.0%,0.0% vs 97.2%;χ2 =17.012,73.326,77.038;P=0.000,0.000,0.000),but IL -6 was not(97.8% vs 0.0%,χ2 =77.059;P=0.000).Conclusion The level and positive ratio of malignant tumor patients are higher than tuberculo-sis patients,but IL-6 is not,these indicators are helpful in diagnosing tuberculosis and malignant tumor .

Objective:Through gene cloning,expression and activity analysis of hBcl 2 to provide enough proteins for the development of new drugs on the basis of 3 D structue of hBcl 2 protein.Methods:Gene cloning using PCR amplification,identification with Western Blot and MALDI TOF MS.Results:hBcl 2 gene was cloned,inserted into pET28a(+) and solublely expressed in E.Coli.Its molecule weight was confirmed through MALDI TOF MS,which fits exactly with its theoretical value.After purification to reach electrophoresis homogeneity,it showed the ability of combining specifically with BH 3 domain of Bak,and then provide the basis for the further research on small chemical compounds which could specifically bind hBcl 2 protein.Conclusion:In this work hBcl 2 was successfully expressed and recovered its binding activity in a soluble form. [

Aim To investigate the direct effects and mechanism of carvedilol on HERG channel stably expressing in human embryonic kidney-293(HEK293) cells.Methods Whole-cell patch-clamp technique was used to record HERG current and kinetic curves in single cells.Western blot methods were used to investigate the expression of HERG channel in different concentration of carvedilol.Result Carvedilol decreased HERG current in a concentration-dependent manner with an IC50 539.6 nmol?L-1,Hillslope-0.64.The time constants of onset of inactivation and deactivation were accelerated.Other kinetcs(activation,inactivation,recovery from inactivation)had no significant changes.Based on western result,carvedilol had no effect on the generation and trafficking of HERG protein.Conclusion Carvedilol inhibits the transfected HERG channels by influencing the open state which is the probable anti-arrhythmic mechanism.There is no relationship between carvedilol and HERG channel expression.

Objective To study the expression and clinical significance of?-catenin and c-myc in gastric adenocarcinoma and corresponding para cancer gastric mueosa.Methods Two hundreds and ninety seven samples were collected from 102 cases of gastric adenocarcinoma,including 102 cancerous tissues and 195 para-cancerous tissues.Each sample was made into 282,156 and 156 dots tissue microarrays.Expressions of?-catenin and c-myc proteins were detected by immunohistochemical stain- ing.Results The expressions of?-catenin and c-mye were increased gradually in the process of gastric carcinogenesis.The rates of?-catenin and c myc expression were higher in carcinoma than that in intesti- nal metaplasia( P＜0.05,P＜0.001).The aberrant expression of?-catenin was closely related to the depth of invasion(P＜0.05),and the expression of c-myc was related to histological grade( P＜0.05). The aberrant expression of?-catenin was significantly correlated with the expression of c-myc in gastric adenocarcinoma(P＜0.05).Conclusions The aberrant expression of?-catenin may activate the expres sion of target gene c-myc,which plays a pivotal role in the carcinogenesis and progression of gastric adenocarcinoma.

Objective To investigate microRNA expression profiles of colonic cancer without lymph node metastasis and identify the specific microRNAs associated with carcinogenesis of colon.Methods Cancerous and para-cancerous tissues (5 cm from cancer tissues of the colon) confirmed without lymph node metastasis were collected from 3 patients. The microRNAs were extracted and isolated by mirVana RNA kit. Hybridizations were made by applying the microRNAs to Agilent microRNA microarray. Data analysis was done by software of Feacture Extraction. The discovered microRNAs were confirmed by real time PCR assay. Results Twelve out of 14 microRNAs associated with colonic cancer were up-regulated in colonic tissues. They were miR-106b, miR-135b,miR-18a,miR-18b,miR-196b, miR-19a, miR-224, miR-335, miR-424, miR-20a' , miR-301b and miR-374a. The rest two of miR-378 and miR 378* were down-regulated. Two up-regulated microRNAs (miR-18a and miR-135b) were detected in 3 pairs of cancerous and para-cancerous tissues. The expression level of miR-18a and miR-135b were accordant with the results of real time PCR.Conclusions microRNA.such as miR-106b,miR-135b.miR-18a.miR-18b,miR-196b,ect,were differentially expressed between cancerous and para-cancerous tissues.Many of these target genes are supposed to participate in the process of multiple tunmorgenesis.These microRNAs play an important role in the carcinogenesis of colon.

Objective:To investigate the standardized training needs of new nurses in Yunnan province and provide scientific basis for the formulation of standardized training programs for new nurses.Methods:From December 2019 to September 2020, nurses from all 5 provincial tertiary Class A hospitals in Yunnan Province were selected as the research objects. A questionnaire survey was conducted among 712 nurses selected by the convenience sampling method, among which 456 were new nurses and 256 were senior nurses. The questionnaire was designed by the research team based on the Training Outline for Newly Recruited Nurses, which mainly included three dimensions of knowledge, skills and attitude.Results:The total score of new nurses and senior nurses on standardized training requirements for new nurses were (575.32 ± 85.76) points and (583.16 ± 86.32) points, which were above the average level. There was no statistically significant difference between the scores of training theme needs of new nurses and those of senior nurses ( t value was -1.168, P>0.05). Conclusions:The total score of standardized training needs of new nurses is above the average level, and the demand for knowledge dimension in standardized training of new nurses is the strongest. It is suggested to develop a systematic and scientific standardized training plan for new nurses according to the training needs and training methods.

Objective:To investigate the application value of joint friction sounds in diagnosing meniscus injury of the knee based on machine learning models.Methods:A case-control study was conducted to analyze the clinical data of 17 patients with meniscus injury of the knee (meniscus injury group) admitted to Sir Run Run Shaw Hospital Affiliated to Nanjing Medical University from August 2020 to October 2022, as well as 75 recruited healthy subjects without knee joint diseases (healthy group). The knee joint friction sounds of the subjects were collected in a relatively quiet environment (peak value below 40 dB). The sounds collected in a flexion-extension-flexion mode of exercise were split and divided randomly with a ratio of 4∶1 into the training set (125 segments from the meniscal injury group and 187 segments from the healthy group) and the test set (33 segments from the meniscal injury group and 47 segments from the healthy group). The sounds obtained in a sit-stand-sit mode of exercise were split and divided randomly with a ratio of 4∶1 into the training set (81 segments from the meniscal injury group and 164 segments from the healthy group) and the test set (20 segments from the meniscal injury group and 40 segments from the healthy group). Four machine learning models were built, including support vector machine with linear kernels, radial basis function support vector machine, random forest, and extremely randomized trees. The learning training of the model was performed on the training set, and its model performance was verified with the test set. The time required in a single collection of joint friction sound from the subjects and the interpretation of data analysis was recorded. Knee function of the subjects were scored according to the Lysholm Score before and at 1 day after the test. The accuracy rates of diagnosis of meniscus injury with friction sounds under the two modes of exercise were compared based on the test results to yield an optimal one. The effectiveness of the four models was compared to find the best machine learning model fitting the data frame of this study according to the test results such as accuracy, sensitivity, specificity, F1 score, and area under the receiver operating characteristic curve (AUC) obtained with the optimal mode of exercise. The diagnostic accuracy, misdiagnosis rate and missed diagnosis rate of joint friction sound for meniscal injury under the optimal machine learning model with the optimal mode of exercise were observed.Results:The time required in a single collection of joint friction sound ranged from 5 to 10 minutes [(7.1±1.3)minutes], when the time required for interpretation of data analysis was approximately 1 minute. The Lysholm Score before and after the test was (75.6±4.0)points and (77.7±3.7)points respectively in the meniscal injury group ( P>0.05), and (99.6±0.9)points and (99.5±1.0)points respectively in the healthy group ( P>0.05). The diagnosing accuracy rates for flexion-extension-flexion of exercise and sit-stand-sit modes of exercise were 0.775 and 0.817 under the support vector machine model with linear kernels; 0.813 and 0.900 under the radial basis function support vector machine model; 0.800 and 0.867 under the random forest model; 0.800 and 0.900 under the extremely randomized tree model. The accuracy rates for sit-stand-sit mode of exercise were all higher than those for flexion-extension-flexion mode of exercise. In the sit-stand-sit mode of exercise, the extremely randomized tree model had an accuracy rate of 0.900, sensitivity of 0.900, specificity of 0.950, F1 score of 0.900, and AUC of 0.942, which were higher than those under the remaining 3 models, showing better machine learning efficacy. Under the extremely randomized tree model in the sit-stand-sit mode of exercise, 22 (18 true positive and 4 false positive) were diagnosed as meniscal injury and 38 (36 true negative and 2 false negative) as healthy out of 60 segments in the test set (20 from the meniscal injury group and 40 from the healthy group). The diagnostic accuracy of joint friction sounds in diagnosing meniscus injury of the knee was 0.900, with the misdiagnosis rate of 0.100 and the missed diagnosis rate of 0.100. Conclusion:Diagnosis of meniscus injury of the knee with joint friction sounds can shorten time and enhance safety during the examination process. The diagnostic model using machine learning-based artificial intelligence is faster and more stable, which can be used as a diagnostic marker for such injury.

ObjectiveTo investigate the therapeutic effect of Baihe Wuyaotang （BWT） on non-alcoholic fatty liver disease （NAFLD） and elucidate its underlying mechanism. MethodC57BL/6J mice were randomly assigned to six groups： normal control， model， positive drug （pioglitazone hydrochloride 1.95×10^-3 g·kg^-1）， and low-， medium-， and high-dose BWT （1.3，2.5 and 5.1 g·kg^-1）. Following a 12-week high-fat diet （HFD） inducement， the mice underwent six weeks of therapeutic intervention with twice-daily drug administration. Body weight was monitored weekly throughout the treatment period. At the fifth week， glucose tolerance （GTT） and insulin tolerance （ITT） tests were conducted. Subsequently， the mice were euthanized for the collection of liver tissue and serum， and the subcutaneous adipose tissue （iWAT） and epididymal adipose tissue （eWAT） were weighed. Serum levels of total triglycerides （TG） and liver function indicators，such as alanine aminotransferase （ALT） and aspartate aminotransferase （AST）， were determined. Histological examinations， including oil red O staining， hematoxylin-eosin （HE） staining， Masson staining， and transmission electron microscopy， were performed to evaluate hepatic lipid deposition， pathological morphology， and ultrastructural changes， respectively. Meanwhile， Western blot and real-time quantitative polymerase chain reaction （Real-time PCR） were employed to analyze alterations， at both gene and protein levels， the insulin signaling pathway molecules， including insulin receptor substrate 1/2/protein kinase B/forkhead box gene O1 （IRS1/2/Akt/FoxO1）， glycogen synthesis enzymes phosphoenolpyruvate carboxy kinase （Pepck） and glucose-6-phosphatase （G6Pase）， lipid metabolism-related genes stearoyl-coA desaturase-1 （SCD-1） and carnitine palmitoyltransferase-1 （CPT-1）， fibrosis-associated molecules α-smooth muscle actin （α-SMA）， type Ⅰ collagen （CollagenⅠ）， and the fibrosis canonical signaling pathway transforming growth factor-β₁/drosophila mothers against decapentaplegic protein2/3（TGF-β₁/p-Smad/Smad2/3）， inflammatory factors such as interleukin（IL）-6， IL-8， IL-11， and IL-1β， autophagy markers LC3B Ⅱ/Ⅰ and p62/SQSTM1， and the expression of mammalian target of rapamycin （mTOR）. ResultCompared with the model group， BWT reduced the body weight and liver weight of NAFLD mice（P<0.05， P<0.01）， inhibited liver lipid accumulation， and reduced the weight of white fat： it reduced the weight of eWAT and iWAT（P<0.05， P<0.01） as well as the serum TG content（P<0.05， P<0.01）. BWT improved the liver function as reflected by the reduced ALT and AST content（P<0.05， P<0.01）. It improved liver insulin resistance by upregulating IRS2， p-Akt/Akt， p-FoxO1/FoxO1 expressions（P<0.05）. Besides， it improved glucose and lipid metabolism disorders： it reduced fasting blood glucose and postprandial blood glucose（P<0.05， P<0.01）， improved GTT and ITT（P<0.05， P<0.01）， reduced the expression of Pepck， G6Pase， and SCD-1（P<0.01）， and increased the expression of CPT-1（P<0.01）. The expressions of α-SMA， Collagen1， and TGF-β₁ proteins were down-regulated（P<0.05， P<0.01）， while the expression of p-Smad/Smad2/3 was downregulated（P<0.05）， suggesting BWT reduced liver fibrosis. BWT inhibited inflammation-related factors as it reduced the gene expression of IL-6， IL-8， IL-11 and IL-1β（P<0.01） and it enhanced autophagy by upregulating LC3B Ⅱ/Ⅰ expression（P<0.05）while downregulating the expression of p62/SQSTM1 and mTOR（P<0.05）. ConclusionBWT ameliorates NAFLD by multifaceted improvements， including improving IR and glucose and lipid metabolism， anti-inflammation， anti-fibrosis， and enhancing autophagy. In particular， BWT may enhance liver autophagy by inhibiting the mTOR-mediated signaling pathway.