Objective To compare PCR-SBT to IMS-ELISA in the HLA-B27 detection in the ankylosing spondylitis (AS)pa-tients.Methods Simultaneously,PCR-SBT and IMS-ELISA were used to detect the HLA-B27 expression in peripheral blood samples which were suspected patients with AS from 120 cases.Chisquare test of paired design and the area under curve of receiver operating characteristics of SPSS17.0 software were used to evaluate the value of PCR-SBT and IMS-ELISA in HLA-B27 detection of AS patients.Results Among 120 cases of suspected patients with AS,the positive rates of HLA-B27 detected by PCR-SBT and IMS-ELISA were 45.83%(55/120)and 37.50% (45/120),respectively.There was statistical difference between the two methods in the HLA-B27 detection (χ2 =59.455,P =0.000).The sensibility and spe-cificity of PCR-SBT were 96.36% and 96.92%,respectively.While the sensibility and the specificity of IMS-ELISA were 69.09% and 89.23%,respectively.Area under the curve of two methods were 0.966 and 0.792,respectively.Conclusion In comparison with IMS-ELISA,the sensibility and the specificity of PCR-SBT in HLA-B27 detection were higher in AS diag-nosis,that is to say,PCR-SBT is better in HLA-B27 detection and AS diagnosis.

Objective To investigate whether expression quantity of HLA-B27 and its subtypes associated with incidence of AS,the gene expression of HLA-B27 and its subtypes were detected in patients with AS.Methods 120 cases patients sus-pected with AS and 50 healthy subjects were enrolled in the study.Main demographic and clinical characteristics of the sub-jects were collected.Meanwhile total RNA was isolated from peripheral blood and real time RT-PCR was used to measure the quantitative expression of HLA-B27 gene.Besides RT-PCR,sequence-based typing (SBT)method was used to confirm the HLA-B27 subtype.All experimental data were analyzed by SPSS17.0 software and P values <0.05 were considered to be significant.Results Firstly,there were 55 subjects were finally diagnosed as AS patients among the 120 patients suspec-ted with AS.There were 53 subjects whose HLA-B27 was positive (96.36%)in 55 patients with AS.It showed that there was a correlation between BASDAI and expression quantity of HLA-B27 gene (r=0.845,P =0.000).Five subtypes were found and which were HLA-B27∶04 subtype (29/53,54.72%),HLA-B27:05 subtype (20/53,37.74%),HLA-B27 ∶02 subtype (2/53,3.77%),HLA-B27∶03 subtype (1/53,1.89%)and HLA-B27∶07 subtype (1/53,1.89%),respectively. Among the 50 healthy subjects,there were only one kind of subtype (2/50,4%),which was HLA-B27∶04.There were no statistical difference in the age (t=0.711,P =0.480),sex (χ2 =0.880,P =0.348),family history (χ2 =0.011,P =0.916) and treatment (χ2 =0.113,P =0.736)between the HLA-B27∶04 and HLA-B27∶05 subtypes.Conclusion HLA-B27∶04 and HLA-B27∶05 were primary subtypes in AS patients which HLA-B27 positive.There was a correlation between gene expression quantity of HLA-B27 and AS disease activity index.

Objective:To evaluate the short-term economic effects of four kinds of premixed insulin in newly diagnosed type 2 dia-betes mellitus. Methods:A total of 120 newly diagnosed patients with type 2 diabetes mellitus were divided into four groups according to the kind of premixed insulin, group A was treated with insulin aspart 30 injection, group B was treated with insulin lispro 25 injec-tion, group C was treated with isophane protamine biosynthetic human insulin injection and group D was treated with protamine zinc re-combinant human insulin injection. The course of treatment was three months. The therapy efficacy was assessed by the remission rate in three months. The short-term economic effect was evaluated by the cost-minimization analysis method. Results:The remission rate of group A, B, C and D respectively was 48. 39%, 48. 28%, 51. 61% and 51. 72% without significant difference (P>0. 05). The average cost per person of the four groups was 1195. 52, 1202. 41, 1220. 69 and 1258. 84 yuan, and the average medicine cost per person was 750. 52, 689. 41, 754. 69 and 764. 34 yuan, respectively. There was no significant difference in cost among the four groups (P >0. 05). Conclusion:All the four kinds of premixed insulin can be used for the starting treatment with the similar total cost, and in relative terms, aspart 30 injection and insulin lispro 25 injection are better for the initial treatment of diabetes.

Objective To investigate the mechanism of matrine in inhibition of proliferation the proliferation of human chronic myeloid leukemia (CML) K562 cells via MEK-ERK signaling pathway. Methods Western blot was used to detect the expression of MEK1, ERK1/2, Shc and SHP2 (the signal effect molecules of MEK-ERK pathway) in K562 cells. The transcription and translation of bcr-abl and target protein (bcl-xL, Cyclin D1, c-myc and p27) were detected by RT-PCR and Western blot. Results Matrine was able to significantly inhibit the phosphorylation of MEK1, ERK1/2, Shc and SHP2 in K562 cells and suppress the protein and mRNA expression of bcr-abl. Moreover, the expressions of bcl-xL, Cyclin D1 and c-myc were down-regulated significantly, while the expression level of p27 (a negative regulator of cell cycle progression) was increased markedly after matrine treatment. Conclusions Suppression of the growth of human CML K562 cells is related to the inhibition of bcr-abl-mediated MEK-ERK pathway activity. The down-regulation of phosphorylated proteins or protein kinases activity in signaling pathways might be an important molecular mechanism in control the activity of MEK-ERK pathway.

Objective:To explore the relationship between self-perceptions of aging and cognitive function, and the mediating and moderating effect of loneliness among them.Methods:A multi-stage stratified sampling was conducted in Jinzhou from September to November 2021, and 318 community-based elderly were included.General data questionnaire, the brief ageing perceptions questionnaire (BAPQ), UCLA loneliness scale(UCLA-LS) and mini-mental state examination (MMSE) were applied to all subjects.IBM SPSS 25.0 software was used to conduct independent sample t-test, analysis of variance and Pearson correlation analysis, and Bootstrap program of AMOS 22.0 was used to analyze the mediation effect.The model in SPSSAU on-line analysis program was used to test the moderating effect. Results:The average scores of self-perceptions of aging, loneliness and cognitive function were (44.85±12.48), (41.70±8.73) and (24.87±3.40) respectively.And 65 of 318 subjects had cognitive impairment, and the detection rate was 20.44%(65/318). Self-perceptions of aging, loneliness and cognitive function scores were significantly correlated between each other(all P<0.05). Self-perceptions of aging had a negative effect on cognitive function ( β=-0.467, P<0.01). Self-perceptions of aging had a positive effect on loneliness ( β=0.585, P<0.01). Loneliness had a negative effect on cognitive function ( β=-0.234, P<0.01). The indirect standardization effect of loneliness between self-perceptions of aging and cognitive function was -0.137, and the mediating effect accounted for 22.68% of the total effect.Loneliness played a moderating role between self-perceptions of aging and cognitive function ( β=-0.114, t=-2.26, P=0.025). Conclusion:Self-perceptions of aging and loneliness can predict the cognitive function in the elderly, and loneliness plays a mediating role between self-perceptions of aging and cognitive function.Early detection of negative senility emotion and loneliness of the elderly will play a positive role in preventing the occurrence of cognitive impairment.

Objective To explore the relationship between the increase of transmural dispersion of repolarization with ventricular arrhythmia,myocardial infarction degree and coronary events in elderly patients with myocardial infarction at T peak-T end interval in order to provide the guidance instruction for the assessment of prognosis of elderly myocardial infarction.Methods One hundred and twenty cases of senile myocardial infarction in the cardiology department of our hospital were selected,including 73 males and 47 females,the average age was (62.37 ± 11.34) years old.In addition,76 elderly cases of other heart disease were selected as the control group,including 42 males and 34 females,the average age was (59.56 ± 12.64) years old.The T peak-T end interval,dispersion and T peak-T end interval and dispersion after correcting the heart ratein different groups were analyzed.Results The T peak-T end interval,dispersion and T peak-T end interval and dispersion after correcting the heart rate had statistical differences between the control group and AMI group at admission and between the acute stage and recovery stage in the AMI group (P＜0.01);the T peak-T end interval and dispersion before and after correcting the heart rate had statistical differences among the patients with different ventricular arrhythmia (P＜0.01);the T peak-T end interval and dispersion before and after correcting the heart rate had statistical differences among the patients with anterior lateral wall,anterior wall,inferior wall,high lateral wall and multiple vessels infarction (P＜0.01);the case death after correcting the heart rate in different degrees and coronary event occurrence at admission had statistical difference (P＜0.01).Conclusion The T peak-T end interval has a close relation with malignant arrhythmia occurrence,which has an important predictive value for the short term prognosis in elderly patients with AMI.

Radiotherapy,as an important means of tumor treatment,plays a significant role in the treatment of cervical cancer.However,the ovaries are highly sensitive to radiation,which is prone to appear radiation-related injuries,leading to ovarian dysfunction and loss of fertility in young female patients,seriously affecting their physical and mental health.The degree of ovarian injury is influenced by various factors such as the dose,volume,and duration of radiation exposure to the ova-ries,as well as the patient's age.Ovarian displacement and advancements in radiotherapy techniques can significantly relieve radiation-related ovarian injury.Currently,drug protection techniques are still immature,and new fertility preservation methods are receiving increasing attention but require further improvement.This article reviewed the research progress in the molecular mechanisms,pre-vention strategies,and new fertility preservation techniques for ovarian injury related to cervical canc-er radiotherapy,aiming to provide a reference for ovarian function protection during radiotherapy for young cervical cancer patients.

Objective To investigate the efficacy of hypofractionated radiotherapy(HFRT)com-bined with programmed cell death protein-1/programmed cell death ligand-1(PD-1/PD-L1)inhibitors in sequential with granulocyte-macrophage colony-stimulating factor(GM-CSF)and interleukin-2(IL-2)for the treatment of advanced metastatic solid tumors.Methods A prospective single-center single-arm study was designed for patients failed standard treatments for advanced refractory solid tumors in the Department of Radiotherapy of Jiangyin Hospital affiliated to Nantong University,and eli-gible patients were given quadruple therapy:HFRT(5 to 8 Gy × 2 to 3 f)once every 21 days for at least 2 cycles;200 μg GM-CSF from the 1st to 7 th day of radiotherapy,and 2 million IU IL-2 from the 8thto 14th day.Within 1 week after the completion of HFRT,PD-1/PD-L1 inhibitors were used for treatment.The above treatment strategy was repeated.GM-CSF and IL-2 were treated for 6 cycles,fol-lowed by maintenance with PD-1/PD-L1 inhibitors until disease progression(PD)or intolerable toxici-ty occurred.Objective response rate(ORR)and treatment-related adverse events were analyzed.Results From January 9,2021 to June 15,2023,totally 40 patients were enrolled,with follow-up of 2.8 to 31.0 months and a median follow-up of 9.9 months,and 39 patients(97.5％)completed at least one time tumorsite evaluation within the non-radiotherapy target area.97.5％of patients had canc-ers,2.5％had soft tissue sarcomas,and 20.0％had received immune checkpoint inhibitors(ICIs)at baseline check.The ORR was 30.8％,and the disease control rate(DCR)was 71.8％;the ORR for non-small cell lung cancer(NSCLC)was 28.6％,and the DCR was 57.1％;the ORR for colorectal cancer was 14.3％,and the DCR was 71.4％;the ORR for gastric cancer was 16.7％,and the DCR was 66.7％;28 patients(70.0％)had treatment-related adverse events(TRAE),4 patients(10％)had TRAE≥level 3,and the most common types of TRAE were fatigue,fever and hypothyroidism.Conclusion The treatment of HFRT combined with immune checkpoint inhibitors in sequential with GM-CSF and IL-2 is well tolerated and toxicity accepted in patients with advanced metastatic solid tumors,which may provide a new method for salvage treatment of patients with ad-vanced metastatic solid tumors.

Objective To investigate the efficacy of hypofractionated radiotherapy(HFRT)com-bined with programmed cell death protein-1/programmed cell death ligand-1(PD-1/PD-L1)inhibitors in sequential with granulocyte-macrophage colony-stimulating factor(GM-CSF)and interleukin-2(IL-2)for the treatment of advanced metastatic solid tumors.Methods A prospective single-center single-arm study was designed for patients failed standard treatments for advanced refractory solid tumors in the Department of Radiotherapy of Jiangyin Hospital affiliated to Nantong University,and eli-gible patients were given quadruple therapy:HFRT(5 to 8 Gy × 2 to 3 f)once every 21 days for at least 2 cycles;200 μg GM-CSF from the 1st to 7 th day of radiotherapy,and 2 million IU IL-2 from the 8thto 14th day.Within 1 week after the completion of HFRT,PD-1/PD-L1 inhibitors were used for treatment.The above treatment strategy was repeated.GM-CSF and IL-2 were treated for 6 cycles,fol-lowed by maintenance with PD-1/PD-L1 inhibitors until disease progression(PD)or intolerable toxici-ty occurred.Objective response rate(ORR)and treatment-related adverse events were analyzed.Results From January 9,2021 to June 15,2023,totally 40 patients were enrolled,with follow-up of 2.8 to 31.0 months and a median follow-up of 9.9 months,and 39 patients(97.5％)completed at least one time tumorsite evaluation within the non-radiotherapy target area.97.5％of patients had canc-ers,2.5％had soft tissue sarcomas,and 20.0％had received immune checkpoint inhibitors(ICIs)at baseline check.The ORR was 30.8％,and the disease control rate(DCR)was 71.8％;the ORR for non-small cell lung cancer(NSCLC)was 28.6％,and the DCR was 57.1％;the ORR for colorectal cancer was 14.3％,and the DCR was 71.4％;the ORR for gastric cancer was 16.7％,and the DCR was 66.7％;28 patients(70.0％)had treatment-related adverse events(TRAE),4 patients(10％)had TRAE≥level 3,and the most common types of TRAE were fatigue,fever and hypothyroidism.Conclusion The treatment of HFRT combined with immune checkpoint inhibitors in sequential with GM-CSF and IL-2 is well tolerated and toxicity accepted in patients with advanced metastatic solid tumors,which may provide a new method for salvage treatment of patients with ad-vanced metastatic solid tumors.

Radiotherapy,as an important means of tumor treatment,plays a significant role in the treatment of cervical cancer.However,the ovaries are highly sensitive to radiation,which is prone to appear radiation-related injuries,leading to ovarian dysfunction and loss of fertility in young female patients,seriously affecting their physical and mental health.The degree of ovarian injury is influenced by various factors such as the dose,volume,and duration of radiation exposure to the ova-ries,as well as the patient's age.Ovarian displacement and advancements in radiotherapy techniques can significantly relieve radiation-related ovarian injury.Currently,drug protection techniques are still immature,and new fertility preservation methods are receiving increasing attention but require further improvement.This article reviewed the research progress in the molecular mechanisms,pre-vention strategies,and new fertility preservation techniques for ovarian injury related to cervical canc-er radiotherapy,aiming to provide a reference for ovarian function protection during radiotherapy for young cervical cancer patients.