Cyclooxygenase-2 (COX-2) plays an important role in the development of leukemia.COX-2 inhibitor plays a certain anti-leukemia role in the process.Many studies show that COX-2 inhibitor plays antileukemia role by inhibiting the proliferation of leukemia cell,promoting apoptosis,affecting cell cycle,inhibiting cell metastasis and reversing cell drug resistance and so on.Therefore,the researches about the anti-leukemia mechanisms of COX-2 inhibitor will provide a new target in clinical prevention and treatment of leukemia.

Version 2015 of the National Comprehensive Cancer Network (NCCN) Guidelines for Uterine Neoplasms uses the 2009 International Federation of Gynecology and Obstetrics (FIGO) staging system.These NCCN guidelines divide pure endnmetrioid cancers into three categories to delineate treatment:(1) disease limited to the uterus;(2) cervical involvement;(3) extrauterinc disease.Surgery is recommended for medically operable patients.Continuous progestin-based therapy may be considered for highly selected patients with stage IA disease who wish to preserve their fertility.Preoperative chemotherapy can be considered if extrauterine disease is suspected.Factors that may influence the decision regarding adjuvant therapy include lymph vascular space invasion (LVSI),patient age,tumor volume,and lower uterine segment or surface cervical glandular involvement.When administering adjuvant radiotherapy,it should be initiated as soon as the vaginal cuff has healed,no later than 12 weeks after surgery.

[ABSTRACT]OBJECTIVETo investigate the effect of accurate airway humidification on hemorrhage, pharyngalgia, mucosal edema and sputum viscosity in patients with low-temperature plasma coblation-assisted tonsillectomy.METHODS58 cases were divided into three groups by using random numbers.In accurate airway humidification group, atomizing inhalation was carried out by AIRVOTM series apparatus; in oxygen atomizing group, budesonide suspension was used; in control group, saline was used. We evaluated the hemorrhage, pharyngalgia, mucosal edema and sputum viscosity in 3 consecutive postoperative days.RESULTSPharyngalgia in accurate airway humidification group and in oxygen atomizing group were both significantly reduced than that of the control group (P<0.001). Besides, in accurate airway humidification group, mucosal edema and sputum viscosity were significantly improved than that of the oxygen atomizing group (P<0.05) and control group (P<0.05).CONCLUSIONAccurate airway humidification could reduce the complications such as pharyngalgia, mucosal edema and purulent sputum after low-temperature plasma coblation-assisted tonsillectomy, and could accelerate recovery from surgery.

Objective To investigate the effect of high-flux hemodialysis (HFHD) on advanced oxidation protein products (AOPPs) in maintenance hemodialysis (MHD) patients.Methods 40 MHD patients (MHD group),50 non-dialytic chronic kidney disease (CKD) patients (CKD group) and 31 healthy subjects undergoing health examination survey received AOPPs detection.After lowflux hemodialysis (LFHD) for 3 months,HFHD was performed in MHD group for 3 months.Plasma AOPPs and other biochemical indicators were tested at the end of 0,3 and 6 months.AOPPs levels were detected in HFHD and LFHD dialysates.Results Plasma AOPPs level was higher in MHD group than in CKD and control groups,and plasma AOPPs level was higher in CKD group than in control group.Compared with before LFHD in MHD group,AOPPs and triglyceride (TG) levels had no significant differences after LFHD for 3 months(t=0.831,-0.191,both P＞0.05),while plasma cholesterol (CHO) and β2 MG levels were increased in MHD group after LFHD for 3 months(t＝-2.697,10.39,P＜0.05 or 0.001).There were significant differences in plasma AOPPs,TG,β2-MG and CHO levels before versus after HFHD for 3 months (t=4.292,2.271,8.297 and 2.295,P ＜0.001 or 0.05).No AOPPs were detected in HFHD and LFHD dialysates.Conclusions Plasma AOPPs levels are increased in CKD patients.LFHD can not effectively eliminate AOPPs,while long term HFHD can decrease the plasma levels of AOPPs,TG and CHO,and reduce β2-MG accumulation.

Objective:To assess the nursing care experiences and curative effects of the application of wound care technologies combined with other multiple treatments in the hepatolithiasis patient who suffered from postoperative severe intestinal fistula.Methods:The wound care difficult points were analyzed,the wound care technologies combined with other multiple treatments including multiple debridement methods were applied according to the severity of the intestinal fistula:multiple debridement, new skin protection, continuous flushing and drainage with double cannula, improved negative pressure closure drainage and wound pull-in technology, combined with systemic treatment and nursing intervention.Results:The intestinal fistula was treated for 12 days, and the wound infection was controlled for 24 days. Finally the wound was healed after 43 days and patient was discharged from hospital.Conclusions:In the case of severe intestinal fistula after hepatolithiasis operation, the application of wound nursing technology combined with treatment scheme provides a new treatment idea and scheme for intestinal fistula and wound healing.

Objective To screen the prevalence of celiac disease with serologic markers in the central Chinese population,specifically in patients with chronic diarrhea-predominant irritable bowel syndrome (D-IBS).Methods A total of 282 adult patients with D-IBS were selected based on ROME Ⅲ criteria with 296 age and sex matched consecutive healthy individuals as controls.A gluten-free diet (GFD) was advised in subjects positive for IgA/IgG anti-htTG/DGP antibodies and the serologic antibodies were retested after the GFD.Results Among the 578 study subjects,five D-IBS patients (5/282,1.77％) and two healthy controls (2/296,0.68％) were positive for anti-htTG/DGP antibodies.Among the seven positive cases,one was lost to follow-up and only four were evaluated during GFD therapy for an average of 5.2 months with clinical and/or serological manifestations improved.Conclusions The prevalence of celiac disease may not be uncommon in China.Compared with the healthy population,patients with D-IBS tend to be affected more.Thus,it is significantly important to conduct routine screening for celiac disease in patients with D-IBS.

Objective:To investigate the antiviral efficacy of direct-acting antiviral agents (DAAs) in the treatment of liver transplantation (LT) recipients with hepatitis C virus (HCV) infection.Methods:Twenty-two HCV-infected LT recipients treated with DAAs at Fifth Medical Center of Chinese PLA General Hospital from December 2014 to June 2018 were retrospectively analyzed, Twenty cases of HCV RNA gene type 1b were treated with sofosbuvir (400 mg/d) + ledipasvir (90 mg/d) or sofosbuvir (400 mg/d) + daclatasvir (60 mg/d) for 12 weeks or 24 weeks; 2 cases of gene type 2a were treated with sofosbuvir (400 mg/d) for 12 weeks. The effect of antiviral treatment, adverse reactions during treatment, and laboratory indicators such as HCVRNA quantification, blood routine, liver and kidney function during treatment and follow-up were studied.Results:The LT recipients of HCV infection included 16 males and 6 females, with a median age of 61.5 (36-71) years old, and the median time of antiviral treatment was 48 (2-117) months after transplantation. Among the 22 patients, 16 received a 12-week course of treatment. Except for 2 patients who did not get HCVRNA negative conversion at 4-week, all achieved a negative HCV RNA at 4-week and the end of the treatment. Six LT recipients received a 24-week course of treatment (gene type 1b), and HCVRNA was negative at 4-week and the end of treatment. All patients achieved end of treatment virological response and a sustained virological response (SVR) rate of 100% at 12 weeks and 24 weeks after the end of treatment. The serum levels of alanine aminotransferase (ALT) and creatinine were 71.5 (30, 110) U/L and (89.4±25.7) mmol/L before treatment, respectively. ALT decreased to 22 (17.8, 28.5) U/L after 4 weeks of treatment, and serum creatinine decreased to (77.4±11.5) mmol/L at 24 weeks after the end of treatment. The differences before and after treatment were statistically significant (all P<0.05). No serious adverse events occurred during the treatment. Conclusions:DAAs have a definite antiviral effect in the treatment of LT recipients with HCV infection, and long-term SVR can be obtained.

BACKGROUND:Endoplasmic reticulum stress participates in the occurrence and development of many diseases, such as atherosclerosis, diabetes, and Alzheimer’s disease. GRP78 is a marker of endoplasmic reticulum stress. The expression of GRP78 reflects the degree of endoplasmic reticulum stress.
OBJECTIVE:To investigate the effect of cyclic stretch on GRP78 expression of L6 rat myoblasts, and to identify the relationship between cyclic stretch and endoplasmic reticulum stress.
METHODS:In vitro culture-tensile stimulation models of myoblasts of L6 rats were established successful y. The expression of GRP78 of myoblasts exposed to cyclic stretch was determined by reverse transcription-PCR and western blot assay. Stretch groups were subjected to 15%surface elongation at a frequency of 10 cycles per minute, over a period of 1, 6, 12 and 24 hours. cells were simultaneously seeded on a plate in the control and experimental groups with no stimulation.
RESULTS AND CONCLUSION:The expression of GRP78 mRNA was continuously elevated over time after stretched treatment, and significant differences were detected as compared with the control group (P<0.05). GRP78 protein expression began to increase at 1 hour after stretched treatment, was significantly increased at 6 hours, peaked at 24 hours, and significant differences were visible as compared with the control group (P<0.05). In conclusion, cyclic stretch induced the occurrence of endoplasmic reticulum stress, which was enhanced with prolonged time. However, prolonged stretch caused severe endoplasmic reticulum stress and leaded to apoptosis of myoblasts.

BACKGROUND:The adaptive reconstruction of maxil ofacial muscles would happen when functional orthopedic treatment is done to cure micromaxil ary deformity. The myoblast is the main responder in the process of adaptive reconstruction, and cyclic stretch can induce apoptosis of myoblasts. Caspase-9 is an important factor in the mitochondrial apoptosis pathway.
OBJECTIVE:To investigate the expression of Caspase-9 in different cyclic stretch.
METHODS:Based on myoblasts cultured in vitro-mechanical stimulation model, the rat L6 myoblasts were loaded stretch for 1, 6, 12 and 24 hours through multi-channel cellstress loading system, while the control group received no stretch. The morphological change and growth of myoblasts were observed under inverted phase contrast microscope;the expression of the mRNA and protein of Caspase-9 were detected by RT-PCR and western blot analysis, respectively.
RESULTS AND CONCLUSION:Under inverted phase contrast microscope, the rat L6 myoblasts at cyclic stretch maintained a good growth state and biological characteristics;there was no celldegeneration;and the loss rate was extremely low, which could demonstrate that myoblast in vitro-mechanical stimulation model was established successful y. The results of RT-PCR and western blot analysis showed that, the expression of Caspase-9 mRNA and Cleaved Caspase-9 protein was significantly increased as the loading time prolonged, and the expression of Procaspase-9 protein was significantly decreased as the time. We can conclude that Caspase-9 is involved in the mechanical signal transduction of cyclic stretch.

Objective:To carry out a scoping review on feeding decision aids in patients with advanced dementia, clarify the characteristics, functions, and application effects of the tools, so as to provide reference for further clinical research.Methods:The research on feeding decision aids for patients with advanced dementia was systematically searched on China National Knowledge Infrastructure (CNKI) , VIP, WanFang Data, and the China Biomedical Literature Library, PubMed, Web of Science, Embase, and Cochrane Library. The search period was from database establishment to August 2022. Two researchers independently selected literature based on inclusion and exclusion criteria, extracted, summarized and analyzed data from the included literature.Results:A total of 8 decision aids were included. The main types included web-based decision aids, paper text decision support manuals, audio manual form decision aids, and a combination of various forms of decision aids. Decision aids provided dementia feeding related information to patients and surrogate decision-makers, analyzed the advantages and disadvantages of different feeding methods, helped clarify their value preferences, and assisted them in making feeding decisions. The evaluation of application effectiveness mainly included outcome indicators such as knowledge, decision conflict, decision regret, decision satisfaction, frequency of doctor-patient communication, and acceptability and effectiveness of decision aids.Conclusions:Decision aids have played a positive role in selecting feeding methods for dementia patients and surrogate decision-makers. Under the background of "Internet + nursing service", we can learn from the experience of foreign research and make full use of artificial intelligence technology to explore scientific and feasible personalized decision aids, so as to provide demand based decision support for patients and their surrogate decision-makers and improve the quality of decisions.