Objective To explore the mechanism of HIF-1α promoting malignant development of nasopharyngeal carcinoma by upregulating PD-L1 expression under hypoxic conditions. Methods CNE2 cells were divided into normoxia (20%O₂), hypoxia (1%O₂), HIF-1α-siRNA+hypoxia and NC-siRNA+hypoxia groups. Cell proliferation, apoptosis, the mRNA levels of HIF-1α, STAT3 and PD-L1, the protein levels of HIF-1α, PD-L1, STAT3 and STAT3 phosphorylation were detected by MTT assay, flow cytometry, RT-PCR and Western blot, respectively. Results Cell proliferation of hypoxia group was significantly higher than that of normoxia group (P=0.000). The cell proliferation rate of HIF-1α-siRNA+hypoxia group was significantly lower than those in other groups (P=0.000). The apoptosis rate of HIF-1α-siRNA+hypoxia group was remarkably higher than those in other groups (P=0.001). RT-PCR detection showed that the mRNA levels of HIF-1α, PD-L1 and STAT3 in the HIF-1α-siRNA+hypoxia group were significantly lower than those in hypoxia group and NC-siRNA+hypoxia group. The protein expression of HIF-1α, PD-L1 and STAT3 showed similar tendency in Western blot assays compared with the mRNA levels. The pSTAT3 protein expression level in HIF-1α-siRNA+hypoxia group was significantly lower than those in hypoxia group and HIF-1α-siRNA+hypoxia group (P=0.001). Conclusion Under hypoxic microenvironment, HIF-1α may up-regulate the expression of PD-L1 through STAT3, thereby promoting the immune escape of cancer cells, leading to the malignant development of nasopharyngeal carcinoma.

Incontinence-associated dermatitis is one of the common complications in critically ill patients.This paper reviews the research progress of risk prediction models for incontinence-associated dermatitis in critically ill patients,introduces and compares the characteristics and application effects of different risk prediction models.The purpose is to provide ideas for constructing a localized risk prediction model and provide evidence for medical staff to identify risk factors of incontinence-associated dermatitis at an early stage and take preventive measures.

Objective:To investigate the risk factors of diabetic kidney disease (DKD) in type 2 diabetes mellitus (T2DM) patients in plain-sand areas and loess hilly areas of Gansu province.Methods:A total of 1 599 T2DM patients who participated in chronic disease and risk factors monitoring and basic public health service management were selected by multi-stage stratified random sampling method in the sandy plain areas and loess hilly areas of Gansu province. Questionnaire survey, physical measurement and laboratory tests were performed. Multivariate binary logistic model was used to analyze the influencing factors.Results:The prevalence of DKD was 22.1% (174/787) among T2DM patients in the sandy plain areas and 19.1%(155/812) in the loess hilly area, respectively. Hypertension ( OR=3.022), hyperuricemia ( OR=2.114) and HbA1c≥7%( OR=2.231) were the risk factors for DKD in the plain-sand areas, and the risk of DKD increased with age. In the loess hilly areas, female sex ( OR=0.379) was the protective factor for DKD; while duration of disease≥10 years ( OR=2.476), hyperuricemia ( OR=1.907), HbA1c≥7% ( OR=1.927) were the risk factors for DKD; and the risk of DKD increased with the increase of age, and decreased with the increase of per capita monthly income. Conclusions:The prevalence of DKD and its influencing factors are different between sandy plain areas and loess hilly areas in Gansu province. The prevention and treatment of hypertension should be given more attention in sandy plain areas. In addition, the screening of DKD should be conducted among T2DM patients, particularly for those with old age, hyperuricemia and HbA1c≥7% in both areas of the province.

Objective To provide the experimental basis for the subsequent genetic diversity research through establishing and optimizing the inter-simple sequence repeat PCR (ISSR-PCR) reaction system of Gnaphalium affine. Methods The single-factor experimental method and full experimental method were used to optimize the ISSR-PCR reaction system of Gnaphalium affine. Under the optimal system, after screening primers and corresponding annealing temperatures, the systematic feasibility was verified. Results The optimal ISSR-PCR reaction system was consisted of 10 μl Premix Taq DNA polymerase, 0.3 μmol/L primer, 10 ng DNA template, and sterilized water added to 20 μl. Finally, 10 primers were screened from 100 universal primers, and verification results indicated the system had high stability, good reproducibility, and the selected primers had good polymorphism. Conclusion The ISSR-PCR amplification system of Gnaphalium affine was established for the first time and the primers with appropriate annealing temperatures were filtered out, which provided a reference for the subsequent genetic diversity research of Gnaphalium affine.

Hepatic venous pressure gradient (HVPG) is the "gold standard" for diagnosing portal hypertension and determining its severity, but its wide clinical application is limited due to its invasiveness and difficulties in operation. The replacement of HVPG by noninvasive methods has become a research hotspot in recent years; however, the accuracy of the existing serological and imaging methods remains to be discussed, and such methods cannot completely replace HVPG in clinical practice. Liver biopsy has been widely used in clinical practice for many years and is still an indispensable method for the diagnosis of some liver diseases. Recent studies have found that several pathological indicators after liver biopsy, such as collagen area, fibrous septal thickness, nodule size, microvascular density, and density and area of bile ducts and lymphatic vessels, can not only judge the severity of liver fibrosis, but also have a good correlation with portal venous pressure, which provides new ideas for diagnosing cirrhotic portal hypertension and evaluating the severity of portal hypertension.