Objective To evaluate the effects of fraction of inspired oxygen (FiO2) and positive end-expiratory pressure (PEEP) on the gradient between arterial and end-tidal carbon dioxide (D(a-ET)CO2).Methods Sixty ASA Ⅰ or Ⅱ patients (body mass index ＜ 30 kg/m2),aged 25-50 yr,weighing 45-75 kg,scheduled for elective gynecological laparoscopic surgery,were randomized into A,B and C groups (n =20 each).The patients were mechanically ventilated with pure oxygen in group A,and with air and O2 (FiO2 =50％) in groups B (PEEP =0) and C (PEEP =5 cm H2O).PETCO2 was monitored during mechanically ventilation.Blood samples were obtained from the radial artery immediately after tracheal intubation (T1) and at 1 h of pneumoperitoneum (T2) for blood gas analysis.D(a-ET) CO2 and Qs/Qt were calculated.Results D(a-ET) CO2 and Qs/Qt were significantly lower at T2 in groups B and C than in group A (P ＜ 0.05).Compared with group B,D(a-ET)CO2 was significantly decreased at T2 (P ＜ 0.05),and no significant change was found in Qs/Qt in group C (P ＞ 0.05).Conclusion Decreased FiO2 and PEEP of 5 cm H2O can decrease D(a-ET)CO2 and increase the accuracy of PErCO2 for reflection of PaCO2,which is due to reduced intrapulmonary shunt.

Objective　To evaluate the expression of MAGE-1 gene in esophageal carcinoma and determine whether esophageal carcinoma patients should be eligible for MAGE-1 antigen-based vaccine therapies． Methods　 MAGE-1 mRNA expression in esophageal carcinoma was assessed by reverse transcription and polymerase chain reaction amplification． The PCR products were then digested by restriction endonucleases and inserted into the pET-30a(+) vector． The sequence of the inserted gene fragment was confirmed by DNA sequence analysis． Results　Out of the 30 esophageal carcinomas studied, 43% of the esophageal carcinomas tissues expressed MAGE-1 gene and no expression was found in matched adjacent normal esophageal mucosae． The entire cDNA of the gene was cloned． Conclusion　Owing to the high frequency of MAGE-1 gene expression in esophageal carcinoma and MAGE-1 antigen can be recognized by cytolytic T lymphocytes when presented by class-I HLA molecular, a large proportion of these patients might be suitable candidates for immune therapy involving tumor specific antigens encoded by MAGE-1 gene．

OBJECTIVETo investigate the the expression and hypoxic regulation of vascular endothelial growth factor(VEGF) and matrix metalloproteinase-9.

METHODSVEGF mRNA and MMP-9 mRNA were examined by reverse transcription-polymerase chain reaction (RT-PCR) in 43 esophageal carcinoma specimens including 18 para-tumorous esophageal tissues. The expression of VEGF protein and mean microvessel density (MVD) in 56 specimens were examined by immunohistochemical stain. The effect of hypoxia on VEGF and MMP-9 expression in esophageal cancer cell lines was quantitatively determined by enzyme linked immunosorbent assay (ELISA).

RESULTSThe VEGF expression in the tumorous tissue, being significantly correlated with MVD in the tumor, was remarkably higher than that in the para-tumorous tissue. VEGF and MVD expression in the tumor was significantly associated with stage and metastasis of esophageal carcinoma. The MMP-9 expression in the tumorous tissue, being uncorrelated with vessel count and clinicopathologic features in esophageal carcinoma, was significantly higher than that in the para-tumorous tissue. Hypoxia significantly increased the VEGF expression in esophageal cancer cell lines but did not affect the MMP-9 expression.

CONCLUSIONSThe expression of VEGF plays an important role in the angiogenesis and metastasis of esophageal cancer, which is regulated by hypoxia. VEGF may serve as a predictor of progression in esophageal carcinoma and a potential target for antiangiogenic therapy of esophageal carcinoma.

Endothelial Growth Factors ; biosynthesis ; genetics ; Esophageal Neoplasms ; metabolism ; Female ; Gene Expression Regulation ; Humans ; Hypoxia ; Lymphokines ; biosynthesis ; genetics ; Male ; Matrix Metalloproteinase 9 ; biosynthesis ; genetics ; Middle Aged ; Oxygen ; metabolism ; RNA, Messenger ; biosynthesis ; Reverse Transcriptase Polymerase Chain Reaction ; Vascular Endothelial Growth Factor A ; Vascular Endothelial Growth Factors

Objective: To investigates the role of piwi-interacting RNAs (piRNA) in the occurrence and development of hepatocellular carcinoma. Methods: Second-generation small RNA sequencing was performed on cancer and paracancerous tissues, metastatic and non-metastatic liver cancer tissues of patients with liver cancer, and the sequencing data were filtered out for the common RNA sequences to be repeated. The piRNA predictor was used to forecast the possible new piRNA merged with the downloaded known piRNA to screen out distinction. A miRanda algorithm was used to predict the corresponding target genes and functional enrichment analysis. piRNA was selected for experimental functional (migration) analysis. An independent t-test was used to compare means between the two groups. Results: 66 772 piRNAs (known 149) were obtained by sequencing. 241 piRNAs were found in cancer and paracancerous tissues, and 1 634 piRNAs were found in metastatic and non-metastatic tumors. Analysis of the GO and KEGG pathways of the target genes of differential piRNAs revealed that they were mainly involved in cell adhesion. An experimental functional analysis was performed on the selected Pirna (PIR1/97), which showed that it promoted the migration of hepatoma cells (LM3: t = 8.829, P < 0.05; PLC: t = 7.318, P < 0.05). Conclusion The expression levels of piRNA in hepatocellular carcinoma patients with cancer and paracancerous tissues, metastasis and non-metastatic liver cancer tissues are different and it could be entailed in the metastasis process of hepatocellular carcinoma. Hence, experimental functional analysis is required for research and experimental confirmation.

Objective:To explore the classification characteristics of sense of work gain of diabetes specialist nurses in Anhui Province, and analyze the influencing factors among different latent profiles.Methods:From January to March 2023, 305 diabetes specialist nurses in Anhui Province were selected by convenience sampling. The nurses were surveyed using the General Information Questionnaire, Employees' Sense of Work Gain Scale, Role Stressors Scale, and Behavioral Trust Inventory. Latent profile analysis was used to explore the latent classes of sense of work gain of diabetes specialist nurses. Multi classification unordered Logistic regression was used to analyze influencing factors.Results:The sense of work gain of diabetes specialist nurses in Anhui Province could be divided into three latent profiles, including low gain-low salary satisfaction type, medium gain-medium to high dignity type, and high gain-high capacity perception type. Multi classification unordered Logistic regression analysis showed that age, participation in or hosting the project, role overload, perceived trust form superiors were the influencing factors of different latent classes of sense of work gain of diabetes specialist nurses, and the difference was statistically significant ( P<0.05) . Conclusions:There is heterogeneity in the sense of work gain of diabetes specialist nurses in Anhui Province. Nursing managers should intervene with different types of diabetes specialist nurses according to the influencing factors to improve their sense of work gain.

Objective:To analyze the expression of cell division cycle associated protein 5 (CDCA5) in pancreatic cancer tissues and its correlation with prognosis based on the bioinformatics.Methods:The RNA sequencing data (HTSeq-FPKM) and corresponding clinical information of 168 pancreatic cancer samples from January to December 2021 were downloaded from the Cancer Genome Atlas (TCGA) database, and the data of 179 pancreatic patients from January to December 2021 were downloaded from the GEPIA2 database, and 171 normal pancreatic tissues from TCGA and GTEx databases were simultaneously integrated. The relative expression level of CDCA5 mRNA in pancreatic cancer patients in GEPIA2 database and its relationship with overall survival (OS) and disease-free survival (DFS) were explored. Combined with the clinical data of the patients, univariate and multivariate Cox regression model analysis was used to analyze the factors influencing the OS of pancreatic cancer patients. Gene set enrichment analysis (GSEA) was performed to investigate the possibly involved signal pathways of CDCA5 in pancreatic cancer.Results:In the GEPIA2 database, the relative expression level of CDCA5 mRNA in pancreatic cancer tissues was higher than that in normal pancreatic tissues, and the difference was statistically significant ( P < 0.05). The pancreatic cancer patients were divided into the high CDCA5 mRNA expression group (89 cases) and the low CDCA5 mRNA expression group (89 cases) according to the median of relative expression level of CDCA5 mRNA (the case equal to the median value was not subgrouped). Survival analysis showed that patients with high CDCA5 mRNA expression had shorter OS ( P = 0.024) and DFS ( P = 0.025) compared with those with low CDCA5 mRNA expression. Multivariate Cox analysis showed that in TCGA database, N staging ( HR = 2.15, 95% CI 1.24-3.72, P = 0.006) and CDCA5 expression ( HR = 1.71, 95% CI 1.23-2.38, P = 0.001) were independent influencing factors of OS for pancreatic cancer patients. The results of GSEA enrichment analysis indicated that high CDCA5 mRNA expression was enriched in 13 biological pathways [all P < 0.05, false discovery rate (FDR) < 0.005] including cell cycle, DNA replication, homologous recombination, pyrimidine metabolism, mismatch repair, pentose phosphate pathway, glycolysis gluconeogenesis and p53. The expression of CDCA5 mRNA was positively correlated with the expressions of HK2, PKM, PGK1, ALDOA, EN01 and LDHA (all P < 0.05). Conclusions:CDCA5 is highly expressed in pancreatic cancer tissues and is associated with poor prognosis of patients, and it can be used as a prognostic marker for pancreatic cancer.

Objective To investigate the safety and feasibility of laparoscopic wedge resection for gastric gastrointestinal stromal tumors ( GIST ) . Methods One hundred GIST patients treated in our department between 2010 and 2014 were retrospectively enrolled, and their clinicopathological data were reviewed. Fifty patients underwent laparoscopic wedge resection, and open surgery cases were 1 ∶ 1 matched by tumor diameter. The clinicopathological characteristics, perioperative related factors, postoperative nutritional status and short?term outcome were compared between the two groups. Results Among the clinicopathological characteristics, only the age was of statistical significance (61.58±10.43 vs. 56.40±9.82, P=0.012) . Over fifty percent of the tumors occurred in the gastric body. Although the short?term survival did not show statistical significance, the laparoscopic group showed predominant advantages in estimated blood loss [(48.60±48.89) ml vs. (137.60±140.69) ml, P<0.001], average hospital stay[ (12.14±4.32) d vs.(17.22±7.11) d, P<0.001], oral intake time[ (3.76±1.73)d vs. (6.28±3.73)d, P<0.01], decline of prealbumin [(0.07±0.04)g/L vs. (0.11±0.05)g/L, P<0.001)], decline of transferrin [(0.51±0.29)g/L vs. (0.64±0.30) g/L, P=0.034] and complication (2.0% vs. 14.0%, P=0.027). Conclusion Laparoscopic wedge resection is feasible and safe for GIST surgery, allows a rapid recovery and having a better nutritional status in patients, and is a less invasive approach for patients.

Objective To investigate the safety and feasibility of laparoscopic wedge resection for gastric gastrointestinal stromal tumors ( GIST ) . Methods One hundred GIST patients treated in our department between 2010 and 2014 were retrospectively enrolled, and their clinicopathological data were reviewed. Fifty patients underwent laparoscopic wedge resection, and open surgery cases were 1 ∶ 1 matched by tumor diameter. The clinicopathological characteristics, perioperative related factors, postoperative nutritional status and short?term outcome were compared between the two groups. Results Among the clinicopathological characteristics, only the age was of statistical significance (61.58±10.43 vs. 56.40±9.82, P=0.012) . Over fifty percent of the tumors occurred in the gastric body. Although the short?term survival did not show statistical significance, the laparoscopic group showed predominant advantages in estimated blood loss [(48.60±48.89) ml vs. (137.60±140.69) ml, P<0.001], average hospital stay[ (12.14±4.32) d vs.(17.22±7.11) d, P<0.001], oral intake time[ (3.76±1.73)d vs. (6.28±3.73)d, P<0.01], decline of prealbumin [(0.07±0.04)g/L vs. (0.11±0.05)g/L, P<0.001)], decline of transferrin [(0.51±0.29)g/L vs. (0.64±0.30) g/L, P=0.034] and complication (2.0% vs. 14.0%, P=0.027). Conclusion Laparoscopic wedge resection is feasible and safe for GIST surgery, allows a rapid recovery and having a better nutritional status in patients, and is a less invasive approach for patients.

【Objective】 To investigate the establishment of multi-center haemovigilance (HV) and the monitoring of adverse reactions to blood donation (ARBD), in order to provide basis for the management of blood donors. 【Methods】 The operation of HV was investigated by questionnaire. The total number of blood donations (including plateletpheresis) and ARBD cases occurred in each blood center from 2014 to 2018 were analyzed. 【Results】 Among the 24 blood centers in this survey, only nine got HV operated. The incidence of ARBD of 19 blood centers that fulfilled the questionnaire was in the range of (0.003~1.151) %. The change trend of number and incidence of ARBD cases were indeterminate. 【Conclusion】 Most blood centers did not got HV established. The incidence of ARBD varied greatly and was indeterminate. The application of HV should be further improved to strengthen ARBD management.

Objective: To clarify the situation of the detection of upper gastrointestinal cancer and precancerous lesions in the Feicheng city and discuss the possible influencing factors. Methods: A cluster sampling method was used to determine the participants. A unified questionnaire was used to investigate the basic information including history of alcohol intake, smoking and chinese tea, as well as other eating habits, medical history of digestive tract and cancer. Endoscopy was used to to screen the patients with upper gastrointestinal cancer and precancerous lesions. Influential factors were explored by non-conditional logistic regression model. Results: 911 of 7 291participants were positive, and the total detection rate was 12.49%. The total positive detection rate of male and female was 17.94% and 8.71%, respectively (P<0.001). Multivariate logistic regression analysis showed that the sex (OR=0.527, 95%CI: 0.440-0.631), age (OR=2.037, 95%CI: 1.849-2.245), smoking (OR=1.240, 95%CI: 1.014-1.516) and alcohol consumption (OR=1.232, 95%CI: 1.012-1.500) , meat and protein intake (OR=0.794, 95%CI: 0.638-0.987) and drink tea (OR=1.233, 95%CI: 1.056-1.440) may be influencing factors of the total detection rate of upper gastrointestinal cancer and precancerosis. Conclusions In Feicheng city, intake of meat and protein is the protective factor of the upper gastrointestinal cancer and precancerous lesions. Men, aged, smoking, drinking and tea will increase the risk of upper gastrointestinal cancer and precancerous lesions.