AIM:To investigate the expression of long non-coding RNA maternally expressed gene 3 (MEG3) in colorectal cancer ( CRC) cells, and to observe the effect of MEG 3 on the invasion and migration of CRC cells .METH-ODS:The levels of MEG3 in human normal colon cell NCM 460 and CRC cells SW48 and LoVo were detected by real-time PCR.MEG3 was over-expressed by plasmid transfection , and the effects of MEG 3 on the invasion and migration of SW 48 and LoVo cells were analyzed by Transwell assay and wound healing assay .The expression of matrix metalloproteinase ( MMP) family proteins was determined by Western blotting .RESULTS:The level of MEG3 was down-regulated in CRC cells compared with normal colon cell NCM 460.The invasion and migration of CRC cells were reduced after MEG 3 over-ex-pression.Transwell invasion and migration assays showed that the numbers of transmembrane SW 48 and LoVo cells were smaller in MEG3 over-expression group than control group (P<0.05).The cell spaces were broader after MEG3 over-ex-pression in the wound healing assay , indicating that MEG3 over-expression inhibited the mobility of CRC cells .Meanwhile, over-expression of MEG3 reduced the expression of MMP-2 and MMP-9, and elevated the expression of tissue inhibitor of metalloproteinase-2 (TIMP-2).CONCLUSION:The expression of MEG3 is down-regulated in CRC cells.Over-expres-sion of MEG3 inhibits the invasion and migration of CRC cells .TIMP-2, MMP-2 and MMP-9 might play an important role in this regulation .

Objective To improve the diagnosis of germinomas in basal ganglia area by analysing the imaging manifestations.Methods Clinic,pathologic and medical imaging data of 8 cases of germinomas in basal ganglia area confirmed pathologically were analyzed retrospectively.Results 8 cases were all men,the age ranged from 5~13 years old with mean age of 10.5 years.All cases had change of muscle strength on one side of extremity,and one case accompanied by intracranial hypertension,this case was showed the effect of space occupying of the tumor obviously and hydrocephalus on CT and MRI.The findings of CT and MRI showed cystic degeneration in 4 cases,slight edema around the tumor in 2 cases,cortex atrophy of the same side of tumor in 2 cases and calcification in the tumor in 2 cases.All cases were enhanced greatly.The pathologic specimen with rich supply of blood was gray-red,and cystic degeneration was seen in 4 cases.Conclusion CT and MRI features of germinomas in basal ganglia area are quite characteristic,the improvement of diagnosis can be achieved in combination with clinical manifestation.

Objective:To investigate the effect of PTS on the related pathophysiological changes and serum IL-6 level at different time points after the middle cerebral artery occlusion (MCAO) in rat’s brain.Methods:The model of focal cerebral ischemia of rat was established by the suture-occluded method.The effect of PTS on the behavioral disturbance,the pathological change of ischemia tissue and the level of serum IL-6 at different time points(3d,7d,28d) after MCAO and cerebral ischemia in rats were studied.ResultsAfter MCAO,different degrees of motion disturbances were observed in all rats.The infarct spot can be observed in all groups except the normal.The nerve cell necrosis can be found in all rats after 24 hour of MCAO.The result showed that PTS could improve the degree of motion disturbance,reduce the infarct spot obviously;after MCAO,the serum IL-6 were increased obviously but could be reduced by PTS.Conclusion:PTS can protect the neurons,reduce and eliminate the infiammatory reaction of cerebral ischemia cascade reaction effectively,which may relate to its inhibiting effect on cell factors such as IL-6 production after cerebral ischemia.

Objective To investigate the safety of rituximab combination chemotherapy in the treatment of B-cell non-Hodgkin' s lymphoma (B-NHL) complicated with hepatitis B virus (HBV) infection,and assess the incidence of HBV reactivation reduced by prophylactic lamivudine.Methods A retrospective study of HBV-related markers,HBV-DNA and liver function was performed before and after rituximabcontaining treatment in B-NHL patients.Thirty nine B-NHL patients with HBcAb(+)/HBsAb(-) were divided into prophylactic group (14 cases) and control group (25 cases).The incidences of HBV reactivation,functional damage of liver were measured.Results Among the 108 B-NHL patients who received rituximab combinatio nchemotherapy,15 (13.89 ％) were HBsAg (+) and 39 (36.11％) HBsAg (-) / HBcAb (+).Of the 15 HBsAg (+)patients,2 (13.3 ％) experienced reactivation of HBV.The prevalence of HBV reactivation was 7.7 ％(1/13) in patients who received prophylactic antiviral treatment and 50 ％ (1/2) in those who did not receivelamivudine.Among the 39 HBsAg (-) / HBcAb (+) patients,3 cases (7.7 ％) experienced reactivation of HBV.The prevalence of HBV reactivation was 0 in patients who receivcd prophylactic lamivudine treatment and 12 ％ (3/25) in those who did not receive this antiviral drug.Conclusion Prophylactic lamivudine before rituximab combination chemotherapy can reduce HBV reactivation obviously.

Objective To analysis long-term effects and safety of arsenic trioxide (ATO)-based induction and maintenance therapy in newly diagnosed acute promyelocytic leukemia (APL). Methods Retrospective analysis induction remission and post-remission treatment of 62 newly diagnosed APL patients was performed. These cases were followed up for 5 and 7 years. Results The complete remission (CR) rate was similar in ATO/all-trans retinoic acid (ATRA) induction group and ATRA/chemotherapy induction group.However, the former group has the shorter time to CR. The negative rate of PML-RARα fusion gene after induction without ATO was less than that of ATO group (86.2 % vs 56.3 %, P ＜0.05). After CR, the 5-year overall survival (OS) between ATO-base rotation maintenance group and chemotherapy-base rotation maintenance group showed that the former was (94.4±5.4) %, the latter is (45.5±10.2) %; 7-year OS was (52.5±23.7) % and (27.3±9.3) %; 5-year disease free survivals (DFS) was (94.7±5,5) % and (41.3±10.1) %; 7-year DFS was (52.6±23.7) % and (27.5±9.4) %. There was significant different in 5-year or 7-year OS and DFS between two groups (P ＜0.05). The relapse rates of the two groups in post-remission treatment were 14.7 % and 37.0 % (P ＜0.05). Conclusion ATO combined ATRA induction therapy increased the negative rate of PML-RARα fusion gene. ATO-base rotation maintenance improved long-term outcome and decreased the rate of relapse. Furthermore, ATO appeared to be generally safe and well tolerated.

Whether children can exercise their medical decision-making power has always been a controversial topic in law and ethics, and it is also the focus of attention of people from all walks of life. In this regard, combined with the problems existing in the exercise of children’s medical decision-making power, such as conflict with the right to life and health, insufficient guarantee of the right to informed consent system, and the legal guardian’s exercise of children’s medical decision-making power may not be in the best interests of children. This paper discussed the dilemma and feasibility of children’s exercise of medical decision-making power from three aspects: children’s right to life and health, the evaluation of informed consent and medical decision-making ability, and the thinking of children’s informed consent and medical decision-making ability, and pointed out that children who are able to make self-determination should be fully endowed with legal medical decision-making power, so as to ensure their best interests in medical clinic.

Whether children can exercise their medical decision-making power has always been a controversial topic in law and ethics, and it is also the focus of attention of people from all walks of life. In this regard, combined with the problems existing in the exercise of children’s medical decision-making power, such as conflict with the right to life and health, insufficient guarantee of the right to informed consent system, and the legal guardian’s exercise of children’s medical decision-making power may not be in the best interests of children. This paper discussed the dilemma and feasibility of children’s exercise of medical decision-making power from three aspects: children’s right to life and health, the evaluation of informed consent and medical decision-making ability, and the thinking of children’s informed consent and medical decision-making ability, and pointed out that children who are able to make self-determination should be fully endowed with legal medical decision-making power, so as to ensure their best interests in medical clinic.

Objective To examine the compliance of and factors affecting target attainment of serum trough concentration of norvancomycin in ICU patients,and the effects of different trough concentrations on clinical efficacy and renal impairment.Methods Adult patients admitted to the Department of Critical Care Medicine of Huangshan People's Hospital and receiving intravenous infusion of norvancomycin from January 2020 to December 2022 were included.The dosing regimens and steady-state trough concentrations of norvancomycin were analyzed.The clinical efficacy and renal impairment were compared between different trough concentration levels.The compliance of trough concentration in critically ill patients with different renal functions was examined.Logistic regression analysis was performed to profile the factors possibly affecting the trough concentration of norvancomycin.Results A total of 97 patients were included.The target serum trough concentration(10-20 mg/L)was reached in only 33.0％(32/97)of the critically ill patients.The serum trough concentration was below the target in 51.5％(50/97)of the patients,above the target in 15.5％of the patients.The clinical cure rate and incidence of renal impairment were significantly different among the three groups of patients with different trough concentrations(P＜0.05).The compliance with target serum trough concentration varied with different renal function tests(P＜0.05).Augmented renal clearance and normal renal function were associated with trough concentrations lower than the target.As renal dysfunction got worse,serum trough concentration was more probably higher than the target(P＜0.05).Univariate analysis showed that daily dose,age,gender,height,weight,body mass index(BMI),APACHE Ⅱ score,sequential organ failure assessment(SOFA)score,blood creatinine,urea nitrogen,procalcitonin,concomitant septic shock,and use of norepinephrine were significantly correlated with trough concentrations of norvancomycin(P＜0.05).Multivariate logistic regression analysis indicated that age,SOFA score,blood urea nitrogen,gender,and norepinephrine use were independent factors affecting the serum trough concentration of norvancomycin(P＜0.05).Conclusions The serum trough concentration of norvancomycin varied with renal function states in ICU patients.It is difficult to achieve the steady-state target trough concentration(10-20 mg/L).The clinical cure rate is lower when the trough concentration is lower than the target.As the trough concentration increases,the incidence of renal impairment increases.Age,SOFA score,urea nitrogen,gender,and norepinephrine use are independent factors affecting the serum trough concentrations of norvancomycin.

Objective: To compare the clinical efficacy of icotinib and gefitinib in the treatment of advanced(stage Ⅳ) lung adenocarcinoma patients with epidermal growth factor receptor(EGFR) sensitive gene mutation. Methods: Fifty-four advanced(stage Ⅳ) lung adenocarcinoma patients with EGFR sensitive gene mutation were selected.According to the random number table method, the patients were divided into two groups, with 27 cases in each group.The icotinib group received icotinib hydrochloride targeted therapy, and the gefitinib group was orally given gefitinib.The clinical efficacy, quality of life score, adverse reactions, progression free survival(PFS) were compared between the two groups. Results: There were no statistically significant differences in clinical curative effect between the two groups[complete remission(0 cases vs.0 cases), partial remission(9 cases vs.8 cases), stable(12 cases vs.14 cases), progress disease(6 cases vs.5 cases), objective response rate(33.3% vs.29.6%), disease control rate(77.8% vs.81.5%), Z=1.060, χ²=0.143, 0.100, all P>0.05]. After treatment, the differences of body function, social function, psychological function, common symptoms and side effects, specific modules in the gefitinib group were not statistically significant compared with those before treatment(t=1.402, 1.199, 1.840, 1.860, 1.275, all P>0.05). The icitinib group had better body function, psychological function, common symptoms, side effects and specific modules than before treatment(t=2.525, 3.335, 4.477, 3.778, all P<0.05). The psychological function, common symptoms and side effects, specific module life quality scores in the icotinib group were (39.72±4.23)points, (38.84±4.67)points, (38.94±4.56)points, respectively, which were higher than (37.08±5.14)points, (35.48±5.02)points, (35.85±4.97)points in the gefitinib group(t=2.061, 2.546, 2.380, all P<0.05). The incidence rate of Ⅰ-Ⅱ grade adverse reactions between the two groups had no statistically significant difference (χ²=4.667, P>0.05). The incidence rate of Ⅲ-Ⅳ grade adverse reactions of the icotinib group was 7.4%, which was lower than 25.9% of the gefitinib group(χ²=9.000, P<0.05). The total incidence rate of adverse reactions of the icotinib group was 40.7%, which was significantly lower than 70.4% of the gefitinib group(χ²=25.694, P<0.05). There was no statistically significant difference in mean PFS between the two groups in the 19delete mutation of EGFR gene(t=0.795, P>0.05). The average PFS of the icotinib group under EGFR gene 21L858R mutation was (14.62±3.85)months, which was longer than (10.73±5.61)months of the gefitinib group(t=2.971, P<0.05). Conclusion Icotinib, gefitinib in the treatment of advanced(stage Ⅳ) lung adenocarcinoma patients with EGFR sensitive gene mutation has similar clinical effect, but icotinib has higher safety, better tolerability, and can significantly improve the quality of life of patients, prolong the EGFR mutation of the 21L858R gene under the survival of patients.

Objective:Diabetic retinopathy (DR) is the most common cause of adult blindness in China. Screening of DR is important for early detection, prevention, and treatment. However, there is still controversy in the research on the prevalence and risk factors of DR in China. This study was designed to evaluate the prevalence of DR and related risk factors in patients with type 2 diabetes mellitus in Beijing City.Methods:A cross-sectional survey was conducted in in Dongcheng District and Tongzhou District, Beijing City. Patients with type 2 diabetes aged 18-80 years were selected from four communities, and all subjects underwent questionnaires, physical examinations, laboratory examinations and fundus photography. The logistic regression model was used to analyze the associated factors of DR.Results:A total of 1 531 subjects were included, with the median age of 66 years old and the average age of (65.6±7.4) years old, and the glycosylated hemoglobin level in the subjects was 7.2%±1.3%, and the glycosylated hemoglobin compliance rate was 56.0%(857/1 531). A total of 254 patients with diabetic retinopathy were detected, and the prevalence of DR was 16.6%(254/1 531). Among them, there were 218 cases of non-proliferative diabetic retinopathy and 36 cases of proliferative diabetic retinopathy. Compared with the non-DR group, there were statistically significant differences in fasting blood glucose ( Z=-3.74, P<0.001), glycosylated hemoglobin( Z=-10.664, P<0.001), urinary microalbumin excretion rate( Z=-7.767, P<0.001), low-density lipoprotein cholesterol( Z=-2.589, P=0.01), and duration of diabetes( Z=-10.189, P<0.001) between the DR group and the non-DR group. Multivariate regression analysis showed that the duration of diabetes ( OR=1.08, 95% CI: 1.06-1.10, P<0.001), glycosylated hemoglobin ( OR=1.38, 95% CI: 1.23-1.55, P<0.001), and FPG ( OR=1.11, 95% CI: 1.03-1.19, P=0.008) were associated factors for DR. Conclusion:In this study, the prevalence of DR in 4 communities of type 2 diabetes in Beijing City was 16.6%. Besides, this study further confirmed that the duration of diabetes, fasting blood glucose levels, and glycosylated hemoglobin are associated factors for DR in patients with type 2 diabetes.