Objective To investigate the antitumor activity of the oncolytic adenovirus expressing lipocalin 2 gene for colorectal cancer in vivo.Methods BALB/C nude mice subcutaneously inoculated by SW620 cells and grown tumors were treated with injection of ZD-55 virus, Ad-lipocalin 2 virus and ZD55- lipocalin 2 virus respectively.The weight of implanted tumors and the tumor inhibition rate were calculated to evaluate the anti-tumor effect.Cell apoptosis was determined by TUNEL and the protein expression of VEGF and MVD were determined with immunohistochemistry.Results ZD55-lipocalin 2 inhibited the growth of transplanted tumor more significantly than ZD-55 virus and Ad-lipocalin 2 virus ( P ＜ 0.05 ).Tumor cell apoptosis was upregulated and the MVD reduced significantly in ZD55-lipocalin 2 group in contrast to the other two groups (P ＜0.05).Conclusions ZD55-lipocalin 2 induces apoptosis of colorectal tumor cells and inhibits tumor microvascular formation, slowing down the growth of transplantation tumors.

Objective To study the changes in mRNA and protein expression of ubiquitin and to explore the relationship of apoptosis in the skeletal muscle of mouse with emphysema.Methods Emphysema model was established by passive cigarette smoking in mouse.Apoptosis was detected with TUNEL staining.The reverse transcriptase-polymerase chain reaction (RT-PCR) and immunohistochemical assay were used to determine the mRNA and protein level of ubiquitin.Results Apoptotic cells were increased in skeletal muscle of mouse with emphysema.The mRNA and protein level of ubiquitin were significantly higher in mouses with emphysema (0.48±0.02 and 0.23+0.05,respectively) than in control group (0.17±0.01 and 0.14+0.01,t=6.223、4.093,both P ＜0.05).Conclusions The increase of apoptosis in skeletal muscle of mouses with emphysema may be associated with high expression of ubiquitin.

Objective To explore the significance of mediastinum drainage tube in prevention and treatment of intrathoracic anastomotic leak after esophagectomy. Methods The morbidity and prognosis of intrathoracic anas-tomotic leak after esophagectomy in 180 patients with esophageal or cardia carcinoma (group A) who used mediasti-num drainage tube in operation from 2006 to 2008 was studied retrospectively,and were compare with 154 patients (group B) without mediastinum drainage tube from 2004 to 2006. Results The morbidity of intrathoracic anasto-motic leak after esophagectomy was 1.67% (3/180) in group A,and 4.55% (7/154) in group B,but no difference between them(χ2=1.4807, P>0.05) were found. Compared to group B, the final diagnosis of anastomotic leak in group A was early [(6.7±0.6) vs (10.0±2.1) days after operation (t=2.62, P<0.05)] and the duration of fe-ver was short [(5.3±1.5)vs (43.0±20.9) hours (t=4.39, P<0.01)]. The prognosis of 3 cases in group A was well, who all recovered without operation and had shorten hospital days than group B [(23.7±5.9)d vs (45.3± 5.0)d,t=4.86,P<0.01)]. In 7 cases of group B,there were 5 cases underwent second operation,but only 3 cases recovered, the case fatality rate was 2.60% (4/154), higher than in group A (0, Fisher, P<0.05). Conclusions Although the mediastinum drainage tube used or not used in esophagectomy is unrelated with the occurrence of anas-tomotic leak, and the significance to use it is that it can help to discover anastomotic leak early, and control mediasti-num infection effectively without reoperation,and improve patients' prognosis.

Objective To evaluate the clinical effect of laparoscopy in the modified nerve painesparing radical hysterectomy (NPSRH) of early stage cervical cancer.Methods From January 2014 to December 2015 in our hospital,38 patients with early cervical caucer were enrolled and randomly divided into NPSRH group and laparoscopic radical hysterectomy (LRH) group in the study.The surgery general situations of two groups were compared,and postoperative intestinal and bladder function of these patientswere also assessed.Results All of 38 patients were successfully completed the operation,without significant intraoperative or postoperative complications.There were no significant differences in the bleeding volume,pelvic lymph dissection number,cut length of main ligament and sacral ligament,cut length of anterior vaginal wall,and posterior vaginal wall between two groups (P ＞ 0.05).The mean operation time in NPSRH group was longer than in LRH group,but the duration of postoperative hospital stay was shorter than the latter (P ＜ 0.01).Compared to control group,the catheter retention time,residual urine volume,maximal micturition volume,and Qmax in the NPSRH group recovered better,and with lower rate of nocturia mnd dysuria (P ＜ 0.05).The exhaust time and anal defecation time in the NPSRH group were significantly shorter than the LRH group,and lower rate of constipation additionally (P ＜ 0.05).Conclusions The laparoscopy in the modified nerve paine-sparing radical hysterectomy is a safe and effective measurement for the treatment of early-stage cervical cancer patients.It can significantly reduce the duration of postoperative hospital stay,promote the functional recovery of bladder and rectum,and improve the patients'postoperative quality of life.

Objective To summarise the experience of surgical treatment of invasive pulmonary fungal infection in patients with hematologic malignancies.Methods From Jan.2000 to Dec.2012,78 hematologic patients with invasive pulmonary fungal infections,including 49 males and 29 females with average age of 29.6 years,underwent surgical treatment.Preoperatively,all patients with 1 to 3 courses of chemotherapy had received average 4 weeks antifungal treatment.There were 58 cases received conventional open thoracic surgery and 20 cases received VATS including lobectomy,segmentectomy,wedgectomy.Results The procedures were successful,the average operation time w as(125.3 ± 35.7) min and intraoperative blood loss was(253.1 ± 42.8) nl.There were no severe postoperative complications.The main complications were excessive effusion (10.2％) and persistence airleak (7.7％).The hospital days was(7.8 ± 2.5) days,no reoperation and death case in 30 days after operation.The follow-up was from 6 to 24 months,38 cases(48.7％) received prophylaetic antifungal treatment,no ease with fungi spread and recurrence.Conclusion The surgical treatment is safe and useful for the hematologic patients with invasive pulmonary fungal infections,when internal medicine conservative treatment is invalid.

Objective:To understand the current situation of physicians′ competency in China and statistically analyze its influencing factors, hence providing referential evidences for promoting their competency.Methods:The evaluation scale for Chinese physicians′ competency was developed by referring to sophisticated overseas evaluation frameworks. Based on the electronic platform of the medical alliance, stratified sampling was conducted at 39 hospitals in 13 provinces, from which 2 156 physicians were surveyed, and statistical analysis was made on the current situation and influential factor of their competency in 6 dimensions(medical knowledge, diagnosis and treatment, scientific research and teaching, interpersonal communication, spirit of professionalism, population health)Results:The score range in multiple dimensions of physicians′ competency was between 2.85 and 3.89(5 in total), among which spirit of professionalism dimension scores the highest, and teaching and research dimension scores the lowest. Logistic regression analysis shows that their competency level in 6 dimensions is correlated to a range of factors, including gender, degree, title, supervisor qualifications, standardized training program of specialist physicians, and affiliation or not to teaching hospitals( P<0.05). Conclusions:Their overall competency is expected to be elevated. To name a few, they are lack of teaching and research abilities, and need to conduct clinical-oriented scientific research; they are expected to enrich knowledge structure, and need to embrace a wider concept of health; they need to improve their non-technical service abilities, and should further emphasize their humanistic quality; physicians′ practice competency depends upon their extent of medical education, and ensuring the quality of standardized training becomes the key measure.

OBJECTIVETo prove the clinical effect and mechanism of Bushen Huoxue Qubi Decoction on treatment of knee-osteoarthritis.

METHODNinty-six knee-osteoarthritic patients accompanied with symptoms of liver and kidney deficiency and blocked main and collateral channels were divided into two groups randomly. Patients in the treatment group (n = 48) were administrated by Bushen Huoxue Qubi Decoction one bag/day for four weeks; and those in the control group (n = 48) were given diacerein (50 mg Bid, Po) and celecoxib (0.2 Qd, Po) for four weeks. The changes of VAS score, Womac score, relative viscosity, aggregation index and IL-1beta, NO, iNOS, LPO, SOD in serum were observed. Adverse effects were determined during follow-up visit and detection for blood routine and hepatic and renal functions.

RESULTIts clinical control rates as per Western medicine and TCM standards for treatment of knee-osteoarthritis and effective rate were 33.3%, 37.5% and 97.9% respectively, which was remarkably higher than those in the control group (18.8%, 20.8% and 95.5%). Their difference showed statistical significance, P<0.05 or 0.01. Bushen Huoxue Qubi Decoction had an effect in obviously improving hemarheological index in 42 days and inhibiting IL-1beta, NO, iNOS and LPO better than the control group, by the contrast of 58.6% vs 47.3%, 50.1% vs 36%, 55.1% vs 41.9% and 46.7% vs 20.6% (P<0.05 or P<0.01). The treatment group also displayed a higher SOD capability the control group (2 514.71 +/- 812.65) vs (2 013.41 +/- 781.3), (P<0.01). Both groups reported no adverse effect.

CONCLUSIONBushen Huoxue Qubi Decoction has a better efficacy on knee-OA than traditional treatment methods (diacereinand + celecoxib) and showed no adverse effect.

Aged ; Antioxidants ; adverse effects ; pharmacology ; therapeutic use ; Case-Control Studies ; Drugs, Chinese Herbal ; administration & dosage ; adverse effects ; therapeutic use ; Female ; Hemodynamics ; drug effects ; Humans ; Interleukin-1beta ; blood ; Male ; Middle Aged ; Nitric Oxide ; blood ; Nitric Oxide Synthase Type II ; blood ; Osteoarthritis, Knee ; drug therapy ; metabolism ; Treatment Outcome ; Tumor Necrosis Factor-alpha ; blood

Objective:To investigate the correlation of GNG4 with DNA damage repair and chemosensitivity of ovarian cancer cisplatin-resistant A2780/DDP cells.Methods:A2780/DDP cells were divided into 500 ng/ml cisplatin group (cDDP group), short hairpin RNA (shRNA)-GNG4 silencing GNG4 expression group (shRNA group), 500 ng/ml cisplatin and shRNA-GNG4 intervention group (shRNA+cDDP group), and non cisplatin and shRNA-GNG4 intervention group (blank control group). Western blot was used to detect the expressions of GNG4 and γH2AX proteins in each group; DNA damage in each group was detected by single cell gel electrophoresis. The focus formation of γH2AX gene at the injury site was detected by immunofluorescence. The ability of cell clone formation was detected by plate clone formation experiment.Results:Compared with the other three groups, the expression level of GNG4 protein in shRNA+cDDP group was the lowest, the expression level of γH2AX protein was the highest, and the differences were statistically significant (all P < 0.01). Single cell gel electrophoresis assay showed that the comet tail DNA% in blank control group, cDDP group, shRNA group and shRNA+cDDP group were (7.7±2.5)%, (12.3±3.6)%, (20.1±2.1)%, (38.6±2.8)%, respectively, and Olive trailing distance were 5.12±1.89, 8.23±2.97, 14.99±3.65, 22.43±3.17, respectively, the comet tail DNA% and Olive tail distance in shRNA+cDDP group were higher than those in the other three groups, and the differences were statistically significant (all P < 0.05). Immunofluorescence assay showed that the focus numbers of γH2AX in each cell of blank control group, cDDP group, shRNA group and shRNA+cDDP group were 4.2±0.7, 5.1±0.5, 26.8±3.3, 71.3±6.2, respectively, the shRNA+cDDP group was higher than the other three groups, and the differences were statistically significant (all P < 0.05). The clone formation rates of blank control group, cDDP group, shRNA group and shRNA+cDDP group were (78.27±5.01)%, (45.67±3.29)%, (26.20±5.76)%, (1.56±0.21)%, respectively, the shRNA+cDDP group was lower than the other three groups, and the differences were statistically significant (all P < 0.001). Conclusions:Down-regulation of GNG4 expression can increase the cisplatin sensitivity of ovarian cancer A2780/DDP cells, which may be achieved by inhibiting the DNA damage repair function induced by cisplatin.

Objective:To explore the effect of the problem-originated clinical medical curriculum (PCMC) combined with feedback theory in nursing teaching of the Department of Endocrinology.Methods:From January 2018 to January 2020, convenience sampling method was used to select 150 nurses who interned in the Department of Endocrinology of Shanxi Provincial People's Hospital as the research subjects. The control group consisted of 76 nurses who interned from January 2018 to January 2019, and the observation group consisted of 74 nurses who interned from February 2019 to January 2020. The control group was taught using traditional teaching methods, while the observation group implemented PCMC combined with feedback theory on the basis of the control group. Before and after intervention, nursing assessment results, nursing ability and teaching satisfaction were compared between the two groups.Results:After intervention, the scores of theoretical knowledge, clinical practice, specialized nursing, job responsibility of the two groups were higher than those before intervention, and the scores of the observation group were higher than those of the control group, with statistically significant differences ( P<0.05). After intervention, the scores of problem detection, emergency response, problem-solving, and team collaboration of the two groups were higher than those before intervention, and the scores of the observation group were higher than those of the control group, with statistically significant differences ( P<0.05). After intervention, the satisfaction scores of nursing teaching content, teaching form, teaching attitude, and teaching ability of the observation group were higher than those of the control group, with statistical differences ( P<0.05) . Conclusions:PCMC combined with feedback theory applied in nursing teaching of the Department of Endocrinology shows good application effects, which can improve the nursing teaching effectiveness of the Department of Endocrinology and the satisfaction of intern nurses. It is worthy of clinical promotion and practice.

Objective To assess the tear film stability and morphological characteristics of the tarsal gland in myopic children.Methods In this prospective descriptive study,myopic children who performed refractive examinations in the Pediatric Ophthalmology & Refraction Clinic,Jinan Mingshui Eye Hospital from November 2021 to November 2022 were in-cluded.An Ocular Surface Disease Index(OSDI)questionnaire survey was carried out;tear meniscus height(TMH),non-invasive first breakup time(NIf-BUT)and images of the tarsal glands were obtained by OCULUS Keratograph 5M compre-hensive ocular surface analyzer.In addition,the atrophy and tortuosity of tarsal glands were scored to analyze the tear film stability and clinical characteristics of tarsal glands in myopic children.Results A total of 48 myopic children(91 eyes)aged from 7 to 16(10.25±2.23)years were recruited,including 27 males(56.25％)and 21 females(43.75％).The aver-age TMH was(0.19±0.04)mm(95％CI:0.18-0.19)and the average NIf-BUT was(5.40±2.62)s(95％CI:4.90-5.94);the TMH was positively correlated with NIf-BUT(r=0.223,P=0.034).The tarsal gland atrophy score was 1(0,1).The tortuosity score of the upper and lower tarsal gland was 0(0,1)and 0(0,0),respectively,with a statistically significant difference(Z=3.692,P＜0.001).In all subjects,49 eyes(53.85％)had tarsal gland atrophy,and 37 eyes(40.66％)had tarsal gland tortuosity.There were significant differences in TMH and NIf-BUT between children aged＜12 years and children aged &ge;12 years(both P＜0.05).There was a significant difference in TMH between children with an OSDI score＜13 and children with an OSDI score &ge; 13(t=2.305,P=0.026).There was a significant difference in NIf-BUT between mild and moderate myopia children(t=2.300,P=0.024);the spherical equivalent was positively correlated with NIf-BUT(r=0.283,P=0.023).Conclusion Children with mild to moderate myopia show low tear film stability and a certain proportion of abnormal morphology in tarsal glands.In addition to the refractive status of children,attention should also be paid to ocular surface health in the refraction clinic.