Background and purpose:The genesis and progression of cervical cancer are closly related to E6 and E7 oncogenes of HPV.Special ribozyme and antisense oligonucleotide could inhibit the expression of E6 or E7.but both of them were not the best methods.The aim of this study was to investigate the inhibitive effect of chemically synthetic siRNA on E6 gene in the cervical cancer cell line SiHa and the following biological changes of SiHa cells.Methods:Three specific siRNAs targeting to HPV16 E6 were synthesized and transfected into SiHa cells by lipofectamine.The level of E6 mRNA was tested by RT-PCR,proliferation activities,the cell cycle distribution,expression of p53 protein and the ultramicrostructure changes of SiHa cells were detected by MTT,FCM,immunochemistry and TEM respectively.Results:All the 3 siRNAs could inhibit the level of E6 mRNA singificantly,among which siRNA1 was most effective.Decreased cellular proliferation activity was observed by MTT,especially when the cells were transfected with siRNA1 at 50 nmol/L concentration.Flow cytometry revealed obvious G1 arrest in cell cycle.The expression of p53 protein in transfected cells(0.75?0.06)was increased compared to the control group(0.43?0.03),the difference was singificant.Cell-substance concentration and vacuolus were found in endochylema by TEM.Conclusions:Chemically synthetic siRNA can interfere in the expression of E6 mRNA in SiHa cells specifically and induce the biological changes of the target cells.

Objective To investigate the effects of extended care on the treatment compliance and the quality of life on discharged elderly patients with chronic heart failure. Methods One hundred and eight patients were randomly assigned to the experimental group and the control group with 54 patients in each, the experimental group received extended care for 1 year, including regular telephone and visit follow-up, supporting medical care, diet care, rehabilitation exercises and supervision of self-care. The control group underwent routine health education before discharge. Medical compliance and self-management ability were compared three months, six months and 1 year after discharge, evaluation score of life quality were also compared at discharge and one year after discharge between the two groups. Results There were no significant differences in medication, diet and regular follow-up visits between the two groups. However, the patients in the experimental group showed better compliance than the control group in the self-testing of urine, body weight,and recording of symptoms, body signs and required exercises. Additionally, the patients in the experimental group had higher scores than the control group in the daily life-skills, happiness and the quality of life. Conclusions The extended care significantly improved the treatment compliance and the quality of life in the elderly patients with chronic heart failure.

Objective:To explore the application of failure mode and effects analysis (FMEA) in low-energy X-ray intraoperative radiotherapy (IORT), analyze its potential risks in IORT, and preliminarily explore the feasibility of FMEA in optimizing IORT management and reducing the occurrence of potential risks.Methods:An FMEA working group was established by the IORT team (1 radiologist, 1 radiology physicist, 2 surgeons, and 2 nurses) to apply the FMEA methodology to conduct a systematic risk assessment. The process modules were established, the potential failure modes and causes for each module were analyzed, the severity (SR), frequency of occurrence (OR) and likelihood of detection (DR) of failure modes were scored and the risk priority number (RPN) was calculated: RPN= SR × OR × DR. The possible errors and potential clinical impact of each part of the radiotherapy process were prospectively analyzed and understood, the causes and current measures were analyzed for each failure mode and preventive measures were proposed and risk management measures were taken accordingly.Results:The IORT process was divided into 8 modules with 14 failure modes. The highest OR value was unsatisfactory target area confirmation (7 points), the highest SR value was equipment failure to discharge the beam (10 points), the highest DR value was wrong key entry after dose calculation (7 points), the highest RPN values were unsatisfactory target area confirmation (210 points) and ineffective protection of endangered organs (180 points). Weaknesses were corrected according to priorities, workflows were optimized and more effective management methods were developed.Conclusion:FMEA is an effective method of IORT management and contributes to reducing the occurrence of potential risks.

Objective To develop a model of malignant risk prediction of solitary pulmonary nodules(SPN) with the metabolic characteristics of the lesion.Methods A total of 362 patients (291 malignant cases and 71 benign cases;194 males,168 females;median age:61 years) who underwent PET/CT imaging from January 2013 to July 2017 were analyzed.The diagnosis of malignant SPN was based on pathological results,and that of benign SPN was based on pathological or follow-up results.Differences of clinical/imaging characteristics in patients with benign and those with malignant SPN were analyzed.Risk factors were screened by multivariate non-conditional logistic regression analysis.The self-verification of the model was done by the receiver operating characteristic (ROC) curve analysis,out-of-group verification was performed by k-fold cross-validation.Results There were statistically significant differences in age,maximum standardized uptake value (SUVmax),size,lobulation,spiculation,pleural traction,vessel connection,calcification,vacuole,and emphysema between patients with benign and malignant nodules (all P＜0.05).The risk factors for malignant nodules included age,SUVmax,size,lobulation,calcification and vacuole.The odds ratio (OR) values (95％ CI) were 1.040(1.007-1.075),1.612(1.287-2.017),1.149(1.074-1.230),4.650(2.138-10.115),0.216(0.085-0.548),and 3.043(1.302-7.111),respectively.The logistic regression model was as follows:P=1/(1+e-x),x=-5.583+0.039×age+0.477×SUVmaxx+0.139×size+1.537×lobulation-1.532×calcification+ 1.1 13×vacuole.The estimated area under the curve (AUC) for the model was 0.915(95％ CI:0.883-0.947),sensitivity was 89.7％,specificity was 78.9％.K-fold cross-validation showed that the training accuracy was 0.899±0.011,the predictive accuracy was 0.873±0.053.Conclusions The risk factors for malignant nodules included age,SUVmax,size,lobulation,calcification and vacuole.After verification,the model has a satisfactory accuracy.It may help clinics make accurate decisions.

Objective To study regulatory mechanism of osteopontin (OPN) in rheumatoid arthritis (RA). Methods The expression of OPN in peripheral blood mononuclear cells (PBMC), synovial fluid cells (SFMC) and synovium tissue (ST) and T cell subsets from RA patients were detected by real time PCR. The concentration and relative rate of inflammatory factors in the synovial fluid from RA patients were analyzed by ELISA. Results The mRNA expression of OPN in synovial fluid and tissue was higher than that of PBMC in the same RA patient. The OPN expression was found mainly on CD4+T. The OPN concentration was higher in the synovial fluid than that of in the same patient′s serum. Meanwhile, the concentration of IL-10, IFN-? and TNF-? was higher than that of in the serum from same patient. Also, the concentration of IL-18 and IL-12 were higher than that of normal individual serum. Conclusion OPN may control secretion of inflammatory factors of synovium tissue and synovial fluid and induce the inflammatory response.

【Objective】 To investigate the predictive value of high preoperative neutrophile-lymphocyte ratio (NLR) for the prognosis of nonurothelial carcinoma of the bladder (NUBC) after radical cystectomy (RC). 【Methods】 Clinical and follow-up data of NUBC patients undergoing RC during Jan.2005 and Dec.2020 were collected. The optimal cut-off value of NLR was determined with the receiver operating characteristic (ROC) curve. The survival curve was drawn with Kaplan-Meier method to compare the differences in cancer specific survival (CSS) and overall survival (OS) between the high-NLR and low-NLR groups. The independent risk factors of CSS and OS were screened with Cox proportional hazard regression model. 【Results】 Of the 62 eligible cases,34 (54.8%) were diagnosed with adenocarcinoma,17 (27.4%) with squamous cell carcinoma, 6 (9.7%) with small cell carcinoma and 5 (8.1%) with sarcoma. Kaplan-Meier analysis results showed high NLR was associated with poor CSS (P=0.001) and OS (P<0.001). Cox regression results indicated that high NLR (HR=2.42, 95%CI: 1.12-5.23, P=0.025) and advanced pathologic tumor stage (HR=3.21, 95%CI:1.53-6.74,P=0.002) were independent risk factors of unfavorable CSS. Similarly, high NLR (HR=2.75, 95%CI: 1.35-5.56, P=0.005) and advanced pathologic tumor stage (HR=2.81, 95%CI:1.43-5.57, P=0.003) were independent risk factors of unfavorable OS. 【Conclusion】 As an independent risk factor of unfavorable CSS and OS in NUBC patients undergoing RC, high preoperative NLR is of great value in the prediction of long-term prognosis and may help to optimize individualized treatment.