Objective To assess the clinical significance of changes tumor necrosis factor(TNF)-alpha level and the relationship between serum TNF-? and glucose levels in patients with gestational diabetes mellitus(GDM). Methods 71 patients with gestational diabetes mellitus were enrolled.40 normal pregnant women were assigned to be control group.Then the concentrations of blood glucose and TNF-? were determined. Results Blood TNF-? level in GDM patients was signficantly higher than that in normal pregnant women(P

Integration of heterogeneous systems is the key to hospital information construction due to complexity of the healthcare environment. Currently, during the process of healthcare information system integration, people participating in integration project usually communicate by free-format document, which impairs the efficiency and adaptability of integration. A method utilizing business process model and notation (BPMN) to model integration requirement and automatically transforming it to executable integration configuration was proposed in this paper. Based on the method, a tool was developed to model integration requirement and transform it to integration configuration. In addition, an integration case in radiology scenario was used to verify the method.
Cooperative Behavior ; Health Information Systems ; Humans ; Models, Theoretical ; Systems Integration

Objective; To investigate the cytotoxicity of monocytes/macrophages against Tca8113 cells in hypoxic microenvironment in vitro. Methods; Peripheral blood mononuclear cells were extracted from healthy person^ blood and cultivated to transform into monocytes/macrophages. The monocytes/macrophages were cultured with Tca8113 cells in hypoxic microenvironment (O_2 < 1%) and in normal microenvironment (20% O_2). The cytotoxicity of monocytes/macrophages against Tca8113 cell was examined by MTT assay. Results;The cytotoxicity of monocyles/macrophages against Tca8113 cells in hypoxic microenvironment was lower than that in normal environment(P<0.05). Conclusion; In hypoxic microenvironment, the cytotoxicity of monocytes/macrophages against Tca8113 cells is decreased. Bui the mechanism of monocytes/macrophages' function in tumors need further research.

Objective To investigate the clinical manifesfations and diagnostic and therapeutic features of cholangiocarcinoma associated with hepatolithiasis.Methods The clinical data, the diagnotic and therapeutic featares of 54 cases of cholangiocacinoma associated with hepatolithiasis were retrospectively analyzed.Results The occurrence rate of hepatolithiasis concomitant with hepatocholangiocarcinoma was 11.8%.Due to a lack of specific clinical manifestations, the preoperative diagnosis of this condition was difficult. In this series, the (correct) diagnotic rate of hepatocholangiocarcinoma before operation was only 11.1%. The radical resection rate was 51.8%. Radical resection of the tumor had a better prognosis than that of non-resection of tumor.(Conclusions) Patients with long-term recurrent hepatolithiasis tended to have associated cholangiocarcinoma. Early diagnosis of the disease was difficult, and the treatment results and prognosis were poor. Therefore, (patients) with hepatolithiasis, espesially those with recurrent attacks, should undergo operation early. In cases diagnosed as hepatic cholangioearcinoma at operation, a radical resection should be performed, if possible, and a favorable outcome may be attained.

Objective To study the effects of anti-oncogene WWOX on cell growth of epithelial ovarian cancer,in order to find a new approach of gene therapy for ovarian cancer.Methods A eukaryotic expression vector containing WWOX was transfected into ovarian cancer cell line HO8910 in vitro (recombinant plasmid group),and positive cell clones were selected and amplified.Expression of WWOX protein was detected by western blot. Untransfected cell(blank contrast group) and transfected empty plasmid cell(empty plasmid group)were served as control groups.In vitro,the biology effect of WWOX on HO8910 cell was analyzed throush the methyl thiazolyl tetrazolium test,transwell chamber cell invasion assay in vitro,agarose clony-formation and flow cytometry.In vivo,the cell of transfection was transplanted intraperitoneally in to BALB/c nude mice.The survival time and growth ability of nude mice were observed.Results (1)Recombinant plasmid group cell could steadily express WWOX protein,while in empty plasmid group and blank control group the expression of WWOX protein were not detected.(2)The growth rate of recombinant plasmid group cell was inhibited.(3)The agnrose clony-formation rate of recombinant plasmid group(19.8%)was significantly lower than that of the empty plasmid group(54.5%)and blank control group(56.0%,P＜0.05).(4)Flow cytometry showed that(72.08±0.39)% of cells was arrested at G0/G1 stage in recombinant plasmid group, while in empty plasmid group and blank control group G0/G1 stage cells were at (41.02±1.08)% and (39.31±0.67)% (P＜0.05). (5) In vitro invasion assay showed that invasion cell number in recombinant plasmid group (89.7±3. 1 ) was not significantly different from that of empty plasmid group(91.2±1.3) and blank control group(91.4±1.3, P ＞0. 05). (6) In vivo test in nude mice showed that WWOX gene could inhibit tumor growth of the HO8910 cells. Conclusions Tumor suppressor gene WWOX could interfere with the cell cycles of ovarian cancer cell and inhibit cell proliferation. As a new valuable tool,it premises to have application in the gene therapy of ovarian cancer.

Objective To explore the expression and clinical significance of sine oculis homeobox homolog 4(SIX4)in endometrial carcinoma and its effect on the invasion and migration of Ishikawa cells.Methods Real-time quantitative polymerase chain reaction(RT-qPCR)was used to detect the expression level of SIX4 in endometrial carcinoma tissue(endometrial carcinoma group)and normal endometrial tissue(control group).The correlation between the expression level and the clinicopathological characteristics of endometrial carcinoma patients was analyzed.Ishikawa cells were divided into normal group(blank control group),negative control group(transfect-ed with siRNA-NC group)and inhibition group 1(transfected with siRNA-1 group),inhibition group 2(transfected with siRNA-2 group),inhibition group 3(transfected with siRNA-3 group),RT-qPCR was used to detect the expression of SIX4 in each group.Western blot was used to detect the protein expression level of SIX4,E-cadherin and N-cadherin in Ishikawa cells of each group;Tran-swell test and scratch test were used to detect the invasion and migration ability of Ishikawa cells in each group.Results Compared with the control group,the expression level of SIX4 was higher in endometrial carcinoma group(P<0.05).The high expression of SIX4 was correlated with the clinical stage of endometrial carcinoma,the depth of muscular invasion and lymph node metastasis(P<0.05),but not with age,tissue type and differentiation degree(P>0.05).After SIX4 expression was inhibited by siRNA,RT-qPCR showed that inhi-bition group 2 had the best interference effect.Western blot showed that the expression of E-cadherin in inhibition group was higher than that in normal group and negative control group,while the expression of SIX4 and N-cadherin was lower.Transwell and scratch experi-ments showed that the invasion and migration of cells in the inhibition group were significantly lower than those in the normal group and negative control group(P<0.05).Conclusion SIX4 is highly expressed in endometrial carcinoma tissues,and its high expression is related to the adverse pathological features of endometrial carcinoma.siRNA targeted inhibition of SIX4 expression can inhibit the invasion and migration ability of endometrial cancer cells through epithelial mesenchymal transition pathway.

Objective To explore the protective effects of cannabinoid analogues WIN55212-2 on paraquat poisoned mice. Methods Totally 35 healthy male C57BL/6 mice were randomly(random number) divided into four groups: PQ group (paraquat poisoned, n=10), WIN 1 mg group (PQ+WIN55212-21 mg n=10), WIN 2 mg group (PQ+WIN55212-22 mg, n=10), control group (n=5).The PQ poisoned animal models were established in the PQ group, WIN 1 mg group and WIN 2 mg group by intraperitoneally injection of paraquat with a concentration of 20 mg/kg. Intraperitoneal injection of WIN55212-2 (containing Tween 80 cosolvent) at the concentration of 1 mg/kg and 2 mg/kg was performed 1 h before PQ exposure in the two interfered groups. Equivalent volume of saline was given to the control group. WIN55212-2 was injected twice a week from the second week. In the acute phase (14 d), 5 mice were randomly sacrificed in the PQ group, WIN 1 mg group and WIN 2 mg group, and 3 mice were sacrificed in the control group to obtain blood sample, bronchoalveolar lavage fluid (BALF) and lung tissue. All the remaining mice were executed on day 28, and the tissue samples were collected as mentioned above. HE staining and Masson staining were performed to observe the changes of lung tissues after PQ poisoning. Changes of TNF-α, IL-6 and TGF-β in plasma and BALF were measured by ELISA. Results In the acute phase, the pathological sections of lung tissues in the PQ group, WIN 1 mg group and WIN 2 mg group showed diffuse inflammation, which was improved after the intervention of WIN5522-2, especially in the WIN 1 mg group. IL-6 levels of BALF in the PQ group, WIN 1 mg group, WIN 2 mg group and the control group were (1024.77±124.74)U/L, (620.48±99.76)U/L, (823.29±157.88) U/L, and (180.42±20.22)U/L, respectively. IL-6 levels in the WIN 1 mg group and the WIN 2 mg group were statistically lower than those in the PQ group (P=0.021, P=0.016). However, no difference was found between the two intervention groups(P=0.114). The similar condition was also found in TNF-α in BALF and plasma. In the chronic phase, mice in the PQ group, WIN 1 mg group and WIN 2 mg group showed fibrosis in tissue by HE and Masson staining, and the inflammatory condition was improved after the intervention of WIN5522-2, which was more obvious in the WIN 1 mg group. In BALF, TNF-α level was (321.64±50.54)U/L, (260.23±48.19)U/L, (278.89±29.40)U/L, (89.76 ± 10.87)U/L in the PQ group, WIN 1 mg group, WIN 2 mg group and the control group. Differences were found between the WIN 1 mg group and the control group and the WIN 2 mg group. Similar differences were also observed in plasma TNF-α, but not in TGF-β. Conclusions A small dose of WIN55212-2 can improve the general condition of PQ poisoning mice, and reduce the inflammatory and fibrosis-related cytokines levels in PQ poisoning mice.

Objective: To compare the effects of modified Thrombolysis in Cerebral Infarction score (mTICI) 2b and mTICI 3 reperfusion on lesions′ changes and prognosis in patients who underwent endovascular therapy within six hours after onset. Methods: A retrospective analysis was conducted on 94 patients with acute large intracranial artery occlusion of the anterior circulation who achieved reperfusion sucesssfully by endovascular therapy within 6 hours after onset in the Department of Neurology, Nanjing First Hospital from October 2016 to March 2019. The effects of mTICI 2b and mTICI 3 reperfusion on lesions′ changes and prognosis of patients were compared. The primary endpoint was the modified Rankin Scale (mRS) score at 90 days; the secondary endpoints were the early neurological deficit score, the mortality at 90 days, the volume of infarction at 24 hours, the changes in infarct volume for 24 hours and the rate of symptomatic intracerebral hemorrhage (sICH) , reocclusion and hemorrhagic transformation. Results: In all patients, 35 cases received mTICI 2b reperfusion and 59 cases received mTICI 3 reperfusion. Compared with mTICI 2b group (10.00 (3.00, 16.00)), the early neurological deficit score at seven days of mTICI 3 group (6.00 (1.00,11.50)) was lower (Z=-2.004, P=0.045) . However, there were no statistically significant differences in mRS score at 90 days, early neurological deficit score at 24 hours and 3 days, mortality at 90 days, volume of infarction at 24 hours, the changes in infarct volume for 24 hours, and the rate of sICH, reocclusion, and hemorrhagic transformation between the two groups. Conclusion For patients with large intracranial artery occlusion of the anterior circulation within six hours after onset, achieving mTICI 3 reperfusion after endovascular therapy can improve the early neurological function more effectively, but the effects on 90-day functional outcome are similar to that of mTICI 2b reperfusion.

Objective To explore the prognostic factors of middle and advanced esophageal neoplasms treated by traditional Chinese medicine combined with radiotherapy.Methods A total of 462 esophageal neoplasms patients treated by traditional Chinese medicine combined with radiotherapy from March 2009 to March 2012 in Civil Administration Hospital of Hebei Province were retrospectively analyzed.The overall median survival time and the survival rate of 1,3 and 5 years were calculated by using life table.Log-rank test was used for single-factor analysis and Cox model was used for multiple-factor analysis.Results The median survival time of 462 esophageal neoplasm patients was 24.2 months (12.9-36.6 months).The survival rate of 1,3 and 5 years was 80.3 ％,30.6 ％ and 10.5 ％ respectively.Single-factor analysis showed that the age (x2 =89.773,P =0.000),tumor diameter (x2 =102.373,P =0.000),clinical staging (x2 =128.903,P =0.000),concomitant with other diseases (x2 =65.366,P =0.000) and the short term effect (x2 =64.948,P =0.000) were associated with prognosis of middle and advanced esophageal neoplasms treated by traditional Chinese medicine combined with radiotherapy.Multiple-factor analysis showed that the age (RR =1.625,95 ％ CI 1.251-2.111,P=0.000),clinical staging (RR =2.437,95 ％ CI 1.874-3.168,P=0.000),concomitant with other diseases (RR =1.1.628,95 ％ CI 1.278-2.076,P =0.000) and the short term effect(RR =1.865,95 ％ CI 1.594-2.182,P =0.000) were the independent prognosis factors for middle and advanced esophageal neoplasms treated by traditional Chinese medicine combined with radiotherapy.Conclusion Elderly patients,esophageal neoplasms in stage Ⅲ,concomitant with other diseases and poor short-term effect could influence the prognosis of the patients with middle and advanced esophageal neoplasms treated by traditional Chinese medicine combined with radiotherapy.

Objective:To study the effects of docetaxel, cisplatin and fluorouracil (TPF) regimen simultaneous intensity modulated radiotherapy (IMRT) on immune function and survival prognosis of patients with advanced esophageal cancer.Methods:A total of 93 patients with advanced esophageal cancer were screened in Hebei Veterans General Hospital from June 2015 to December 2017, and were divided into two groups using randomized envelope method. The observation group (47 cases) was given synchronous TPF regimen and IMRT, and the control group (46 cases) was given synchronous PF regimen (cisplatin combined with fluorouracil) and IMRT. Esophageal barium meal, chest and upper abdominal CT were reviewed within 1 month after treatment to assess the short-term efficacy and compare the immune function of the two groups before and after treatment. Kaplan-Meier survival curve was plotted to evaluate the long-term efficacy based on overall survival (OS). The incidence of adverse reactions in the two groups was collected to evaluate their safety.Results:After treatment, the T cell subgroup CD8 + level of the observation group was higher than that of the control group [(33.55±4.46)% vs. (29.06±3.61)%, P<0.05], while CD3 + [(51.29±5.22)% vs. (56.04±6.10)%, P<0.05], CD4 + [(28.27±3.63)% vs. (30.35±3.52)%, P<0.05] and CD4 + /CD8 + (0.84±0.25 vs. 1.04±0.08, P<0.05) levels were lower than those of the control group. The effective rate of recent treatment in the observation group was 82.98% (39/47), while the effective rate in the control group was only 63.04% (29/46), with a statistically significant difference ( χ2=4.70, P=0.030). The median OS of the observation group was 25.3 months (95% CI: 17.9-26.1), and that of the control group was 18.2 months (95% CI: 14.4-25.5), with a statistically significant difference ( χ2=3.28, P=0.038). Adverse reactions during the follow-up period of the two groups of patients were mainly nausea/vomiting, fatigue, anorexia, hematological toxicity, esophagitis and pneumonia, etc., which were mostly grade 1-2, and disappeared after symptomatic treatment or termination of treatment. Compared with the control group, the incidence of nausea/vomiting (46.81% vs. 78.26%, χ2=9.80, P=0.002), anorexia (44.86% vs. 71.74%, χ2=6.99, P=0.008), leukopenia (36.96% vs. 73.91%, χ2=13.37, P<0.001) and esophagitis (61.70% vs. 82.61%, χ2=5.05, P=0.025) adverse reactions was lower in the observation group. Conclusion:TPF combined with IMRT has high efficacy and low adverse reactions, which can be used as an effective treatment to improve the survival prognosis of patients with advanced esophageal cancer.