Objective To investigate the expression of miR-424* in 2 and 4 Gy X-ray irradiated A549 cells in vitro and in vivo,as well as in clinical lung tissues and serum sample of non-small cell lung cancer(NSCLC) patients,and to explore its potential role in the diagnosis and prognosis of lung cancer.Methods A549 cells were irradiated with 2 and 4 Gy X-rays,and some of irradiated cells were injected into nude mice through tail vein.Real time quantitative PCR (RT-qPCR) assay was employed to detect the expression of miR-424 * in 2 and 4 Gy X-ray irradiated A549 cells in vitro and in vivo,as well as in clinical lung tissues and serum sample of lung cancer patients.Results Compared with the control group,the expression of miR-424* was up-regulated significantly in X-ray irradiated A549 cells at 1,2,12,24 and 48 hpost irradiation,respectively (2 Gy:t =-45.886--6.709,P ＜0.05;4 Gy:t =-29.087--7.833,P ＜ 0.05).Furthermore,the expression of miR-424 * was up-regulated in the lung and serum of nude mice with injection of 0,2 and 4 Gy X-ray irradiated A549 cells,compared with control group (fold change was 9.72,8.58 and 4.7 with 2 Gy irradiation and 11.93,9.22 and 8.99 with 4 Gy irradiation,t=-13.243,-12.409,-9.833 in lung andt=-6.436,-3.052,-3.609 in serum,respectively,P ＜ 0.05).Out of 11 tissue samples of NSCLC patients,6 were detected with up-regulated miR-424* expression,and no significant discrepancy of miR-424* expression was detected in two type of NSCLC tissue samples.On the contrary,43 serum samples were detected with up-regulated miR-424* expression out of 84 serum samples (51.20％) of NSCLC patients (fold change range 1.97 to 17.71),and significant discrepancy of miR-424* expression was shown in two subtypes of NSCLC serum samples [adenocarcinoma:39.10％ (18/46) and squamous carcinoma:65.8％ (25/38)],as well as in serum samples of NSCLC patients with radiotherapy [41.5％ (22/53)] and without radiotherapy [67.7％ (21/31)] (t=5.919,5.387,P ＜0.05,respectively).Conclusions 2 and 4 Gy X-ray irradiation could up-regulate the expression of miR-424* in A549 cells,which might be correlated with the enhanced metastasis of A549 cells induced by X-ray in vivo and in vitro.Furthermore,the expression of miR-424* was up-regulated in over 50％ of the tissue and serum samples of NSCLC patients,which might be correlated with the diagnosis of NSCLC subtype and prognosis of radiotherapy.

Objective To investigate the effect of continuous blood purification (CBP) on peripheral blood monocyte membrane CD14 (mCD14) expression and inflammatory response in patients with traumatic sepsis Methods A retrospective case control study was conducted on the clinical data of 50 patients with severe sepsis after trauma treated between January 2015 and December 2016. There were 34 males and 16 females, with an average age of 45.37 years (range, 16-73 years). Patients were divided into CBP group (25 cases) and non-CBP group (25 cases) according to whether they agreed to receive CBP treatment. The peripheral blood samples were collected at 0, 12, 24, 48, and 72 hours after treatment, and the mCD14 and leukocyte elastase (HLE) expressions were detected by flow cytometry and by ELISA, respectively. The peripheral blood mononuclear cells were isolated from the two groups 24 h after treatment and cultured in vitro. The variations of mCD14 expression in mononuclear cells were measured at 4, 8, 12, 24, 48, and 72 h after stimulation with lipopolysaccharide (LPS). The expression levels of tumor necrosis factor (TNF) -a, interleukin (IL) -6, and IL-10 in mononuclear cells were detected by ELISA. Results At 12, 24, 48, and 72 hours after treatment, the leukocyte elastase levels in the two groups were lower than those before treatment (P ＜ 0.01), and the decrease in CBP group was significantly greater than that of non CBP group(P＜0.01). At 12, 24, 48, and 72 hours after treatment, the mCD14 levels in both groups were up-regulated before treatment (P ＜0.01), and the increase in CBP group was significantly greater than that of non CBP group (P ＜ 0.01). The mCD14 expressions before treatment, 4 h after treatment, and 8 h after treatment in CBP group were all higher than those in non CBP group at the same time points. At 4, 8, 12, 24, and 48 hours after the re-stimulation with LPS on the mononuclear cells in both groups, the levels of TNF-α and IL-6 in CBP group were significantly higher than those in non-CBP group (P ＜0.01), and there was no significant difference in IL-10 levels between the two groups (P ＞0.05). Conclusions CBP treatment can increase monocyte mCD14 expressions through eliminating inflammatory factors and pro-inflammatory mediators and reducing HLE directly or indirectly in patients with traumatic sepsis. When the body is stimulated again, its anti-inflammatory response ability is markedly stronger than that of patients who have not received CBP treatment.

Objective To examine the effects of gross tumor volume (GTV) and radiation dose on the prognosis of hepatocellular carcinoma (HCC) patients treated with whole body gamma knife.Methods The clinical data of 69 HCC patients who underwent body gamma knife treatment from January 2012 to June 2015 in the Radiotherapy Center of the PLA General Hospital were retrospectively reviewed.Based on a 50% or 60% isodose coverage of the planning target volume (PTV), patients were treated with a radiation dose of 4-5 Gy per fraction, and a total marginal dose of 36-50 Gy (median dose 45 Gy).Short-term efficacy, overall survival (OS), and the adverse effect of the treatment were evaluated.The optimal cut-off tumor volume was identified using the receiver operating characteristic curve, and survival was determined by the Kaplan-Meier method.Univariate and multivariate analyses were performed using the log-rank test and Cox proportional hazards regression model, respectively.Results The overall short-term response rate of the 69 patients was 67%.The 1-and 2-year OS rates were 62% and 40%, respectively, with a median survival of 18.6 months.The multivariate analysis showed that gross tumor volume (GTV)<93 cm3(P=0.013) and short-term efficacy of radiotherapy (P=0.000) were significant independent prognostic factors for survival.When GTV was<93 cm3, prognosis was significantly better in patients treated with a dose of ≥45 Gy than in those with<45 Gy (P=0.019).In contrast, radiation dose had no significant effect on survival among patients with GTV>93 cm3(P=0.665).Conclusions GTV is an independent prognostic factor for overall survival of HCC patients.Although high-dose radiotherapy provides survival benefits to patients with small GTV, it is not necessarily suitable for patients with large GTV.

Objective:To analyze the differences in esophageal motility between patients with gastroesophageal reflux disease (GERD) and functional esophageal disorders by comparing the esophagogastric junction (EGJ) barrier function, esophageal body motor function and results of provocative test.Methods:From December 2016 to December 2018, the 100 patients with typical symptoms of GERD, who visited The First Aftiliated Hospifal of Zhejiang Chinese Medical Universtiy wese selected. According to the Rome Ⅳ standand and the Lyon consensus, and the results of endoscopic examination, 24 h multichannel intratuminal impedante pH (MII-pH) monitoring and esophageal high resolution manometry (HRM), the patients were divided into GERD group ( n=32), hypersensitivity(RH) group ( n=33) and functional heartburn(FH) group ( n=35). According to the results of esophageal HRM, the differences in esophageal dynamics among the groups were analyzed. T test, variance analysis and Chi square test were performed for statistical analysis. Results:The lower esophageal sphincter (LES) resting pressure of GERD group was lower than that of FH group ((19.37±7.92) mmHg vs. (25.35±12.38) mmHg (1 mmHg=0.133 kPa)); the EGJ-contractile integral of GERD group and RH group was lower than that of FH group ((20.84±21.52) mmHg·cm and (20.72±19.35) mmHg·cm vs. (35.93±36.82) mmHg·cm), and the level of distal contractile integral of GERD group was lower than that of FH group and RH group ((802.35±496.86) mmHg·s·cm vs. (1 316.84±853.92) mmHg·s·cm and (1 141.65±607.93) mmHg·s·cm), and the differences were statistically significant ( t=-2.377, -2.069, -2.149, -3.045 and -2.467, all P<0.05). There were no major motility disorders in patients of the three groups. The incidence of ineffective oesophageal motility of GERD group was higher than that of RH group and FH group (62.5%(20/32) vs. 39.4%(13/33) and 25.7%(9/35)), and the differences were statistically significant ( χ2=4.440 and 9.214, both P<0.05). Conclusions:GERD patients have abnormal esophageal motility, which is mainly manifested by reduced LES resting pressure, decreased EGJ barrier function, and abnormal peristalsis of the esophagus. Patients with RH also have decreased EGJ barrier function.

Objective To evaluate the methods in early warning of schistosomiasis and elimination of snails in an ecological public forest in Yexie Town of Songjiang District, and provide the basis for monitoring and controlling snails in forest land in the future. Methods The monitoring data of snails, schistosomiasis and snail elimination in the public forest were collected to evaluate the effect of controlling snails. Results The area with existence of snails was found to be 10.47 hm², and it was decreased by 98.28% after three times of snail elimination.A total of 1 904 serological tests was performed (test rate of 88.76%) with the positive rate of 0.16%.Pathogenic test result was negative in 3 subjects examined.Serological samples of 11 dogs and 1 sheep were all negative for the test.None of the 1 480 live snails tested was found to be positive in infection.The awareness rate of schistosomiasis control knowledge and behavior formation in 275 students were 98.2% and 95.3%, respectively. Conclusion The snails in the public forest in Yexie Town have been effectively controlled, but there are still scattered living snails.The measures in eliminating and monitoring of snails should be continued and strengthened.

OBJECTIVE To improve uptake and cytotoxicity of the drug on MCF-7 cells by developing a poly (N-isopropylacrylamide) (PNIPAm) nanogel for Quercetin (Que) METHODS The PNIPAm nanogel was optimized by an orthogonal design and its structure was confirmed by FT-IR.A single factor experiment was used to optimize the formulation of quercetinloaded nanogel (Que-PNIPAm).The particle size,surface morphology and drug loading were characterized and the in vitro release behavior was investigated.Cytotoxicity of MCF-7 cells induced by Que-PNIPAm was investigated by CCK-8 method.The qualitative and quantitative cellular uptake studies were investigated by fluorescence microscope and flow cytometry,respectively.The mechanism of cellular uptake was investigated by the inhibitor method.RESULTS The particle size and drug loading of Que-PNIPAm were measured as (166.1±2.87)nm and 3.18％,respectively.Nanogel exhibited spherical morphology and uniform size distribution observed by electron microscopy.Compared to free Que,Que-PNIPAm significantly increased inhibition rate of MCF-7 cells.Que-PNIPAm also showed higher cell uptake efficiency and more effective antitumor activity at 42 ℃.Colchicine and 2-deoxyglucose have an inhibitory effect on MCF-7 cells uptake.CONCLUSION The prepared nanogel shows small particle size,thermosensitive property,which could significantly enhance the capacity of cellular uptake and tumor cytotoxicity.The mechanism of cellular uptake demonstrates tubulin is involved in the internalization of the nanogel into MCF-7 cells.

Objective:To analyze the characteristics of pancreatic metastatic tumors and evaluate the clinical value of endoscopic ultrasound-guided fine-needle aspiration or biopsy (EUS-FNA/B) in their diagnosis.Methods:A retrospective analysis was conducted on clinical, radiological, and pathological data of 11 cases with pancreatic metastatic tumors diagnosed by EUS-FNA/B at the First Affiliated Hospital of Naval Medical University between January 2011 and December 2020. Tumor size, number of lesions, time interval between diagnosis of metastatic lesions and primary tumors, radiological and EUS findings and pathological types were recorded, and success rate and diagnostic rate of EUS-FNA/B were analyzed.Results:The 11 patients with pancreatic metastatic tumors had an age range of 43 to 76 years, including 7 males and 4 females. Eight cases presented with symptoms of abdominal pain and poor appetite, 1 case had cervical lymph node enlargement, and 2 cases were detected during routine physical examination. Five cases had abnormal serum tumor markers. All patients had a confirmed history of primary tumors, and the median time interval between diagnosis of pancreatic metastatic lesions and primary tumors was 24 months (-1-124 months). Seven cases had solitary lesions, and 4 cases had multiple nodules under EUS. Eight cases were initially diagnosed clinically as pancreatic lesions or tumor, while 3 cases were considered as pancreatic metastatic tumor. All of 11 cases underwent EUS-FNA/B and were histologically confirmed as pancreatic metastatic tumors. The most common pathological type was lung small cell neuroendocrine cancer ( n=4), followed by renal cell carcinoma ( n=3), and esophageal squamous cell carcinoma ( n=1), pulmonary squamous cell carcinoma( n=1), malignant melanoma ( n=1), and gastric adenocarcinoma ( n=1). Conclusions:The pancreas is not a common target site for tumor metastasis.EUS-FNA/B is a relatively safe minimally invasive method for the diagnosis of pancreatic metastatic tumors.

OBJECTIVE:To investigate the situation of hospital pharmaceutical administration in China,and provide basis for developing measures in improving the quality and safety of medication in hospitals. METHODS:According to the organization of National Health and Family Planning Commission,National Quality Control Center of Pharmaceutical Administration drafted the re-search indicators,and adopted internet survey to screen,confirm and statistically analyze the data about pharmacy staffing and drug use management of hospitals in 2014 that was completed and reported as requested by the secondary general hospitals and above in each area selected by Health and Family Planning Commission in provinces (cities,districts). RESULTS:The rates of pharmacy technicians in secondary and tertiary general hospitals were 5.2% and 4.4%,the numbers of clinical pharmacists per hundred-bed were 0.42 and 0.44 person,the numbers of dispensing prescription per person in a day were 119 and 173 in pharmacist in outpa-tient;the monitoring rates for key patients were 1.8% and 6.9%,the rates of intravenous infusion in outpatients were 12.8% and 10.1%,and inpatient were 93.1% and 90.4%;the rates of intravenous infusion of antibiotics in inpatients were 51.8% and 44.3%,and the rates of intravenous infusion of TCM were 34.7% and 29.0%,respectively. CONCLUSIONS:The problems exist-ing in pharmaceutical quality administration in China include lacking of pharmacy technicians,large workload,lacking of clinical pharmacists,imperfect pharmaceutical care model,non-standardized choice and use of intravenous infusion,etc. For these prob-lems,it is suggested to increase the propaganda of health education and management efforts of intravenous drugs,equipped with ad-equate pharmacy technicians and clinical pharmacists,continuously improve the quality evaluation system of hospital pharmaceuti-cal administration in China.

Objective To investigate the expressions of miR-21 in clinical lung tissues,serum of lung cancer patients and X-ray irradiated A549 cells in vitro and in vivo.Methods A549 cells were irradiated with 2 and 4 Gy X-rays,and pulmonary metastasis model of lung cancer in nude mice was established to detect the expression of miR-21 in vitro and in vivo,as well as in clinical lung tissues of different pathological types serum sample of lung cancer patients and NSCLC patients whether or not received radiotherapy.The survival rate was further analyzed in the above mention NSCLC patients.Results The miR-21 expressions was up-regulated in 60.0％ of tissue samples of NSCLC patients,and it was up-regulated in 50.5％ serum samples of lung cancer patients (52 out of 103).The miR-21 expressions in lung adenocarcinoma and squamous cell carcinoma had significant difference (x2 =5.766,P ＜ 0.05).In the serum samples of 87 NSCLC patients,miR-21 was detected in 66.7％ samples from the patients of radiotherapy but only 39.6％ of patients without radiotherapy (x2 =6.321,P ＜ 0.05).Kaplan-Meier curves showed that the survival rate of patients with low miR-21 expression was higher than that with high miR-21 expression (P ＜ 0.05).Multivariate Cox regression analysis demonstrated that the miR-21 expression,regional lymph node metastasis and radiotherapy were independent prognostic factors for NSCLC patients.The expression of miR-21 was up-regulated significantly in X-ray irradiated A549 cells at different time-points after irradiation (t =-7.552--1.206,P ＜ 0.05).Furthermore,the expression of miR-21was up-regulated in the serum and lung of nude mice (t =-47.845--2.356,P ＜ 0.05).Conclusions The X-ray irradiation could up-regulate the expression of miR-21 in A549 cells in vitro and in vivo,which might be correlated with the enhanced metastasis of A549 cells.

Objective:To detect the mRNA expression and methylation status of leucine rich repeat containing 55(LRRC55) gene in pancreatic carcinoma tissues, and discuss the clinical value.Methods:Resected pancreatic ductal adenocarcinoma and normal adjacent specimens from 37 patients admitted in General Surgery of First Affiliated Hospital of Naval Medical University were collected from May 2019 to May 2021. Another two normal pancreas specimens and two blood samples from healthy adults were also collected. All patients′ age, gender, tumor location, tumor size, tumor differentiation, TNM staging, lymphatic metastasis, CEA and CA19-9 level were recorded. Bisulfite treatment of genomic DNA and sequencing analysis was used to study methylation patterns in CpG islands of the promoter for LRRC55 gene in fresh tissues from 2 pancreatic adenocarcinoma and adjacent tissues, 2 normal pancreatic tissues, 2 pancreatic cancer cell lines (PaTu8988 and ASPC1). LRRC55 mRNA in 35 pancreatic adenocarcinoma and adjacent tissues was detected by real-time quantitative PCR and the correlations with clinical parameters were analyzed.Results:CpG islands of LRRC55 in pancreatic adenocarcinoma tissues and pancreatic cancer cell lines was highly methylated and the mean methylation rate was 53% and 71%, respectively; while LRRC55 gene in pancreatic adjacent tissues and normal pancreatic tissues was lowly methylated, and the mean methylation rate was 8% and 11%. The relative expression in the pancreatic adenocarcinoma tissues and the paired adjacent normal tissues was 0.21 (0.02, 1.00 ) and 0.98 (0.33, 3.66 ), respectively; the former was significantly lower than the later and the difference was statistically significant ( P=0.003). Correlation analysis showed that LRRC55 mRNA expression level was related to tumor differentiation and CEA, but not correlated with patients′ age, gender, tumor location and size, CA19-9 level, lymphatic metastasis and TNM staging. Conclusions:Pancreatic cancer tissue and cell lines had abnormal methylation of LRRC55 gene; LRRC55 gene hypermethylation was related with its lower mRNA expression level in pancreatic cancer, which was correlated with the tumor differentiation and CEA level. LRRC55 may be a potential suppressor gene for pancreatic cancer.