Objective:To study the expression and significance of cyclinD 1 in 45 cases of transitional cell carcinoma of bladder.Methods:The expression of cyclinD 1 was detectde by immunohistochemistry(SP).Results: Expression of cyclinD 1 was found in 55.56% of TCCs and none of controls,and 78.57% of T a～T 1,11.76%of T 2～T 4.Approximately,85% of G 1,46.67% of G 2 and 10% of G 3 with the progress of tumors clinical stages and grades ,and the positive rates of cyclinD 1 expression decreased. There was no significant correlation between cyclinD 1 expression and number of lesions and postoperative reccurance.Conclusions: CyclinD 1 overexpression can play an important role in the early stage of bladder tumorgenesis.There was significant relativity between cyclinD 1 expression and the biological behaviour of bladder TCCs.

Surgical nutrition therapy is a novel course for undergraduates who are major in food hygiene and nutrition.In this study,the purpose,content,model and specific teaching approaches of the course were discussed,and the essentials of clinical practice for surgical nutrition therapy were pointed out.We hope that our experience would be helpful for the development of the course.

Objective To study the association of MIF-173 locus polymorphism and the risk of prostate cancer (PCa) in China. Methods A case control study including 259 PCa patients and 301 age-matched controls was conducted. The polymorphisms of MIF-173 locus were analyzed by poly-merase chain reaction restriction fragment length polymorphism (PCR-RFLP) technique using genomic DNA isolated from peripheral blood lymphocytes. The correlations between the susceptibility to PCa and different genotypes were compared. The effect of age, smoking method and family history of canc-er were also analyzed. Results The rate of the MIF-173 * C variant allele of the PCa patients(n=259) was significantly higher than that of the controls (n=301) (36.0% vs 15.0%). The MIF-173 *C variant allele could significantly increase the risk of PCa (OR=2.96,95%CI: 1.92-4.57). Peo-ple with older age (age>70) or family history of cancer, who carried MIF-173 * C allele demonstra-ted a significantly increased risk in comparison with those carrying wild genotype of G/G(OR=3.66, 95%CI=2.02-6.62;OR=3.26, 95%CI=1.24-8.55). Conclusion These results suggested that polymorphisms of MIF-173 locus appear to influence the risk of PCa and may have synergistic effect with age and family history of cancer.

Objective To investigate the effect of physician guidance on cigarette cessation in current smokers with chronic obstructive pulmonary disease(COPD).Methods Cigarette cessation education and routine telephone follow-up was provided for 70 COPD patients.Pulmonary function and exhaled carbon monoxide level were detected every 3 months.Results After 6 months' follow-up,28 participants(40.00%) successfully quitted cigarette smoking.Seventeen subjects (24.28%) experienced relapse,with mean cessation time(3.08±0.33) months.Once receiving physician guidance,5 re-attempted to quit cigarette smoking,and 12 reduced tobacco consumption. Sixteen subjects(22.86%) did not quit smoking,although the mean cigarette consumption per day was decreased by 60%.Nine participants (12.86%) showed no change in smoking habit. Conclusion Physician guidance could impreve the rate of cigarette cessation in COPD patients.Intensive intervention may be correlated with successful smoking cessation.

OBJECTIVE To evaluate the clinical outcome of submucosal inferior turbinectomy and outfracture surgery of inferior turbinates. METHODS All patients receiving two different operations were measured by acoustic rhinometry and questionnaire of QOL at preoperative 1 week and postoperative 12 months, seperately. RESULTS Forty-seven patients with inferior turbinate hypertrophy were enrolled in this study. Evaluation of SNOT-20 discovered both surgeries could improve patients' QOL with similar outcome. Preoperative '5 important items' in patients with inferior turbinate hypertrophy were 'lack of a good night's sleep', 'need to blow nose', 'thick nasal discharge', 'fatigue' and 'dizziness'. Postperative '5 important items' were 'postnasal discharge', 'runny nose', 'sneezing', 'reduced concentration' and 'reduced productivity'. Both surgeries could make acoustic rhinometry parameters change obviously, such as minimal cross-sectional area, 0-5 cm nasal volume(NV) and 2-5 cm NV. Furthermore, submucosal inferior turbinectomy produced more volume in nasal cavity than outfacture surgery, (7.28±2.01)cm3 vs (6.01±1.22)cm3, (5.99±1.87)cm3 vs (4.23±1.08)cm3(P<0.05), seperately. There was no correlation between the data of SNOT-20 and acoustic rhinometry. CONCLUSION We recommend outfracture surgery of inferior turbinate as the preferred surgical choice for patients with mild inferior turbinate hypertrophy.

Non-alcoholic fatty liver disease(NAFLD)is a series of diseases characterized by hepatic steatosis and is also a metabolism-associated disease and an important factor for liver fibrosis,liver cirrhosis,and hepatocellular carcinoma.Endoplasmic reticulum is a core organelle for the regulation of lipid metabolism,and unfolded protein response is an important process of endoplasmic reticulum stress(ERS).Based on the important stress role of endoplasmic reticulum in metabolism-associated diseases,this article explores the influencing mechanism between ERS and NAFLD and reviews the research advances in lipid metabolism,inflammatory response,hepatocyte death,fibrosis,and ERS-targeted therapies in the pathological development of NAFLD.

Objective:To explore the feasibility and clinical efficacy of oblique lateral interbody fusion (OLIF) in the treatment of adjacent segment disease (ASDis).Methods:Retrospective analysis was conducted on the data of 31 patients with ASDis treated by OLIF in four medical centers from June 2015 to December 2018. There were 17 males and 14 females. The average age was (65.7±3.4) years (range, 59 to 75 years). 19 cases received single-segment fixed fusion, 11 cases received double-segment fixed fusion and 1 case received three-segment fixed fusion. Original fixed fusion site: 1 case of L 1, 2, 3 cases of L 3, 4, 11 cases of L 4, 5, 4 cases of L 5S 1, 6 cases of L 3-L 5, 5 cases of L 4-S 1, and 1 case of L 3-S 1. The time from the initial fixation and fusion to this admission was 82.5±45.5 months (rang, 24 to 180 months). ASDis occurred at the proximal end of the fixed fusion segment in 28 cases and at the distal end in 3 cases. The types of ASDis: degenerative disc disease in 11 cases, lumbar spinal stenosis in 15 cases, degenerative spondylolisthesis in 2 cases, and degenerative scoliosis in 3 cases. The location of ASDis: 6 cases of L 2, 3, 12 cases of L 3, 4, 6 cases of L 4, 5, 3 cases of L 1-L 3, 1 case of L 2-L 4, and 3 cases of L 1-L 4. At admission, 3 cases of lumbar internal fixation had been removed and 28 cases of internal fixation remained. Stand-alone OLIF was performed in 19 cases, OLIF combined with pedicle screw fixation in 8 cases, and OLIF combined with cortical screw fixation in 4 cases. Visual analogue scale (VAS) and Oswestry disability index (ODI) were used to evaluate the low back pain and lumbar function before operation and at the last follow-up, and the imaging results and complications were observed. Results:All patients were followed up. The follow-up time was 23.6±9.6 months (range, 12 to 60 months). The operation time was 73.8±25.3 mins (range, 40 to 180 min), and the intraoperative blood loss was 86.2±67.4 ml (range, 20 to 310 ml). The average blood loss in each segment was 24.8 ml. During the operation, there were 1 case of segmental vein injury, 7 cases of endplate injury, 2 cases of transient iliopsoas muscle weakness, 1 case of thigh pain and numbness, and 1 case of incomplete intestinal obstruction. There was no incision necrosis and infection. The VAS score of low back pain decreased from 5.9±1.9 before operation to 1.4±0.6 at the last follow-up, with a statistically significant difference ( t=8.47, P<0.001). The ODI index recovered from 45.2%±5.7% before operation to 13.8%±4.7% at the last follow-up, with a statistically significant difference ( t=7.92, P<0.001). The height of intervertebral space increased from 8.7±1.6 mm before operation to 11.4±1.9 mm after operation and 9.9±1.8 mm at the last follow-up. There was a statistically significant difference between postoperative and preoperative height of intervertebral space ( F=4.15, P=0.007). There was a statistically significant difference between the last follow-up and postoperative height of intervertebral space ( P=0.011). During the follow-up, there were 13 cases of fusion cage subsidence, 1 case of fusion cage displacement, and no case of internal fixation loosening or fracture. The intervertebral fusion rate was 94%(29/31) and the complication rate was 42%(13/31). Conclusion:ASDis is a common complication after lumbar fixation and fusion, and requires surgical treatment. OLIF is a reliable method to treat ASDis as it has advantages of small trauma, high fusion rate and low complication rate.

Objective:To investigate the effectiveness and advantage of visual laryngoscope in the treatment of patients with sudden cardiac arrest who need spontaneous respiration tracheal intubation.Methods:Totally 60 patients who suffered from cardiac arrest and needed spontaneous respiration tracheal intubation were enrolled from June 2020 to February 2021 in the Affilicated Hospital of Chifeng University. Theywere randomlydivided into two groups-traditional laryngoscope (TL) group and visual laryngoscope (VL) group, with30 patients in each group. Then the success rate of glottis exposure, the operative time, success rate and complication rate of tracheal intubation were compared between the two groups. Subgroup assessment between the junior emergency resident doctor (A group) and the senior emergency resident doctor (B group) was conducted.Results:According to Cormack Lehan grades, the success rate of glottis exposure in VL group was higher than that in TL group ( P>0.05), and the success rate of Grade I in VL group was significant higer than that in TL group: 56.70%(17/30) vs. 30.00%(9/30), P<0.05. The trial times of successful intubation cases and the operative time of successful intubation cases were significantly less than those in TL group (1.30 vs 1.67, P = 0.049) and (56.37 s vs 67.12 s, P<0.05). In the subgroup, the one-time success rate of tracheal intubation in A-TL group was significantly lower than that in B-TL group (4/15 vs. 11/15, P<0.05), while the one-time success rate of tracheal intubation in A-VL group was 60.00%, which is lower than that in B-VL group ( P>0.05). The operative time consumed for successful intubation in A-TL group was significantly longer than that in B-TL group: 78.00 s vs. 55.57 s, P<0.05, while the operative time in A-VL group was a little longer than that in B-VL group ( P>0.05). Conclusions:Visual laryngoscope used in spontaneous respiration tracheal intubation can not only increase the success rate of glottis exposure, decrease trial times and shorten operative time of intubation, but also improve the success rate and decrease the complication rate of emergency tracheal intubation.

Objective To study the expression and clinical significance of neural Wiskott-Alrdich syndrome protein(N-WASP)in pla-centas with preeclampsia.Methods This study included a total of 65 pregnant women:15 in the early-onset preeclampsia group,15 in the early-onset control group,15 in the late-onset preeclampsia group,and 20 in the late-onset control group.Real-time fluorescence quan-titative PCR(RT-qPCR)was used to detect the relative expression of N-WASP mRNA in placental tissues.Western blotting and immu-nohistochemistry were used to detect the expression and position of N-WASP protein in placental tissues from each group.Results RT-qPCR revealed significantly lower N-WASP mRNA expression levels in the placental tissue of the early-onset preeclampsia group compared to those in the early-onset control group(0.50±0.19 vs.0.93±0.73,P＜0.05).The N-WASP mRNA expression levels in late-onset preeclampsia placenta were significantly lower than those in the late-onset control group(0.83±0.34 vs.1.15±0.34,P＜0.05).Western blotting revealed significantly lower N-WASP protein expression in the placental tissue of early-onset preeclampsia compared to that in the early-onset control group(0.35±0.17 vs.0.72±0.21,P＜0.05).The N-WASP protein expression in late-onset preeclampsia placenta was significantly lower than that in the late-onset control group(0.39±0.16 vs.0.76±0.20,P＜0.05).The N-WASP mRNA expression in the placenta negatively correlated with the occurrence of early-onset(r =-0.37,P = 0.042)and late-onset preeclampsia(r =-0.39,P = 0.019).Immunohistochemistry revealed that N-WASP protein was localized in the cytoplasm of syncytiotrophoblasts,cytotrophoblasts,villous stromal cells,and vascular endothelial cells.Conclusion The low expression of N-WASP may be closely associated with preeclampsia.

【Objective】 To investigate the preoperative anemia and perioperative blood transfusion in patients with duodenal papillary carcinoma who underwent Whipple surgery. 【Methods】 The clinical data of 1 959 cases with duodenal papillary carcinoma, subjected to Whipple surgery, were retrospectively analyzed. 【Results】 The rate of anemia in preoperative patients with duodenal papillary carcinoma was 54.87%(1 075/1 959). The incidence rate of anemia in the three age groups from low to high was 44.92% (≤50 years old, 190/423), 52.82% (51~64 years old, 506/958), and 65.57% (≥65 years old, 379/578) (P<0.05), and the highest rate of anemia occurred in patients aged above 65. There was a significant statistical difference among patients with different body mass index (BMI)(P<0.05). Patients with moderate or severe anemia received more red blood cells than patients with mild anemia during the perioperative period (P<0.05). The average hospitalization time of the blood transfusion patients was 27.25 days, and that of non-transfusion patients was 22.22 days (P<0.05). The amount of blood loss and hospitalization time of patients underwent laparoscopic and robotic surgery were significantly lower than those underwent open surgery patients (P <0.05). There were only 24.09%(186/772) treated with drugs for anemia intervention and the majority of patients (75.91%, 586/772) were treated with blood transfusions to interfere with anemia during hospitalization. 【Conclusion】 There are significant differences in the incidence rate of preoperative anemia among patients with duodenal papillary carcinoma who undergone Whipple surgery. Low BMI, abnormal WBC, and perioperative blood transfusion are high-risk factors for prolonged hospital stay, whereas anemia is not associated with prolonged hospital stay.