Objective:To investigate the effect of sodium hyaluronate on chronic periodontitis and its influence on serum hyper sensitive C-reactive protein(hs-CRP), interleukin 8(IL-8) and tumor necrosis factor-α(TNF-α).Methods:Using the random number table method, 98 patients with chronic periodontitis from March 2017 to March 2019 in Hangzhou Xixi Hospital were randomly divided into observation group (49 cases) and control group (49 cases). The control group was treated with tinidazole tablets, and the observation group was treated with sodium hyaluronate on the basis of the control group. The course of treatment was 4 weeks. The total effective rate was compared and the gingival index(GI), sulcus bleeding index (SBI), plaque index (PLI), and the levels of serum hs-CRP, IL-8, TNF-α before and 4 weeks after treatment were compared between the two groups.Results:The total effective rate of the observation group was higher than that of the control group:93.88%(46/49) vs. 71.43%(35/49), the difference was statistically significant ( χ2=8.612, P<0.05). After treatment of 4 weeks, the scores of GI, SBI and PLI in the observation group were lower than those in the control group: (1.10 ± 0.23 vs. 1.63 ± 0.36, 0.38 ± 0.10 vs.0.71 ± 0.15, 0.83 ± 0.29 vs. 1.36 ± 0.21), the differences were statistically significant ( P<0.05). After treatment of 4 weeks, the levels of hs-CRP, IL-8 and TNF-α in the observation group were lower than those in the control group: (4.53 ± 1.29) mg/L vs. (7.65 ± 1.82) mg/L, (6.17 ± 1.08) ng/L vs. (9.98 ± 1.56) ng/L, (2.27 ± 0.26) μg/L vs. (3.98 ± 0.32) μg/L, the differences were statistically significant ( P<0.05). No obvious adverse reactions occurred in the two groups. Conclusions:Sodium hyaluronate has a significant clinical effect on chronic periodontitis. It can reduce the levels of hs-CRP, IL-8, TNF-α and alleviate the inflammatory reaction.

Objective To establish a novel method for detecting circulating tumor cells (CTCs) in phripheral blood of lung cancer patients with high sensitivity and specificity.Methods Experimental study.42 cases of initial treatment patient who underwent resection and diagnosed to be non-small cell lung cancer by biopsy were studied,including 7 patients at stage Ⅰ,9 patients at stage Ⅱ,16 patients at stage Ⅲ and 10 patients at stage Ⅳ.As a control group,20 cases of healthy volunteers were selected.A series of experiments was conducted to determine the efficiency of tumor cells isolation,in which varied concentration (50,100,200,500,1000 cells) of A549 cells spiked into 2 ml peripheral blood drawn from healthy donors.The blood was removed of unwanted erythrocytes by lysis buffer,and made the rest of nucleated cells incubate with anti-EpCAM magnetic beads,then separated and enriched by a specific detector.All epithelia cells were retained on a slide because of a magnetic force and identified by H&E staining protocol.On the basis of cell recovery rate we calculated the sensitivity of tumor cells isolation.20 blood samples taken from healthy individuals were also detected to validate the specificity of this method.Samples of 42 patients with lung cancer were assayed for CTCs detection by above method.The correction of CTCs quantity with the patients' clinical features,for example,ages,gender,clinical stage,tumor size was analyzed in lung cancer patients by chi-square statistics.The correction of recovery cells with the spiked cells were assayed by linear correlation.Results The recovery rate was ranging from 68％ to 82％ by spiking varying numbers of A549 lung cancer cells into 2ml blood samples of healthy volunteers.Regression analysis of number of recovered vs.spiked A549 cells yielded a regression equation of Y =0.6419X + 8.8875.The number of CTCs detected has signification correlate with the cells spiked (R2 =0.9916,P ＜ 0.05),Eighteen of the 42 patients (43％) were found have CTCs in peripheral blood.The detection rate of lung cancer cells was 0 at stage Ⅰ,the detection rate of lung cancer cells was 11.1％ at stage Ⅱ,the detection rate of lung cancer cells was 62.5％ at stage Ⅲ and the detection rate of lung cancer cells was 70％ at stage Ⅳ.The positive rate of CTCs has no signification correlate with ages and gender of patients and tumor size (P ＞ 0.05),has signification with the clinical stage (P ＜ 0.05).None of the peripheral blood samples of the 20 healthy subjects analyzed was found to have CTCs.Conclusions This novel immunomagnetic separation technology is a sensitive and specific method,which provides a new tool allowing for feasible and specific detection of CTCs in lung cancer patients.The level of CTCs increases with the clinical stage and tumor size increased,which has important value to discover the early stage micrometastasis and redefine the clinical stage.But further multicenter and large sample clinical research are needed to confirm its clinical value.

The aim of this study was to investigate the effect of Paris saponin I (PS I) on human gastric carcinoma cell growth and apoptosis and to explore the potential mechanisms. The proliferation of SGC7901 cells was monitored by the MTT cell viability assay, while the nuclear morphology of apoptotic cells was assessed by Hoechst 33258 staining. Flow cytometry was performed to analyze the cell cycle progression of propidium iodide (PI)-stained SGC7901 cells and the apoptotic rate of annexin V/PI-stained cells. Western blotting was used to examine the expression of several cell cycle proteins, including cyclin B1 and Cdk1, and the apoptosis-regulated proteins Bcl-2, Bax, cytochrome c, procaspase-9, and procaspase-3. The MTT assay demonstrated that PS I could induce significant dose- and time-dependent inhibition of SGC7901 cell proliferation. Marked morphological changes, including condensation of chromatin, nuclear fragmentation and apoptotic bodies were clearly shown on Hoechst 33258 staining. PSI treatment also resulted in the disruption of the cell cycle at G(2)/M and the induction of apoptosis. Following PSI treatment, the cell cycle-related proteins cyclin B1 and Cdk1 were down-regulated. Expression of the pro-apoptotic protein Bax was increased, while anti-apoptotic protein Bcl-2 decreased. PSI treatment resulted in elevated cytoplasmic cytochrome c and activation of the apoptotic proteases caspase-9 and caspase-3. These data indicate that PS acts as an inhibitor of proli I feration in SGC7901 cells by inducing cell cycle arrest and mitochondria-dependent apoptosis. PSI is a potential therapeutic agent against human gastric carcinoma.

ObjectiveTo investigate the effect of Glutamine (Gln) on the expression of PCNA in intestinal tissue of neo-natal rats with necrotizing enterocolitis (NEC), and to explore the protective mechanism of Gln in intestinal mucosa.Methods Forty-eight neonatal rats at the age of 48 hours were selected, and divided into 4 groups, control group, Gln group, NEC group, NECGln group. Each group had 12 rats. Control group were fed mice milk substitutes; Gln group were fed mice milk substitutes mixed with Gln; NEC group were fed mice milk substitutes and had cold/ hypoxia exposure twice a day for 3 days; NECGln group were exposed to cold stress, hypoxia and treated with Gln mixed in the milk. The expression of PCNA was detected using immunohistochemical method.Results Compared with control group were and Gln group, the general condition was worse, and the weight was decreased in NEC and NECGln group. The inifltrated inlfammatory cells, congestion, edema, intrinsic layer separation were observed in intestinal mucosa in NEC and NECGln group. The intestinal villus was lost in severe in NEC and NECGln group. The PCNA index was 34.17±5.78, 34.42±5.38, 15.00±1.94, 30.67±3.14 in control, Gln, NEC and NECGln group respectively, with signiifcant difference between each groups (H=24.32,P=0.000). The expression of PCNA in NEC group was lower than that in normal, Gln, and NECGln group (P<0.008). The expression of PCNA had no signiifcant difference among normal, Gln, and NECGln group (P>0.008).Conclusions The expression of PCNA in intestinal mucosa was decreased in NEC rats. Gln supplement could raise the expression of PCNA in intestinal mucosa of NEC rats, and accelerate the speed of intestinal mucosa repair.

Objective To investigate the relationship between the dynamic changes of interleukin-1β (IL-1β) levels and severity and complications of patients with multiple trauma at the early stage.Methods Among 97 patients with multiple trauma in Emergency Department of Shanghai Jiao Tong University Affiliated Sixth People's Hospital between August 2015 and May 2016,12 patients were excluded as follows,(1) with burns or chemical injuries;(2) pregnancy or menopausal women;(3) had bacterial infection a week ago;(4) with chronic diseases.The other 85 patients with multiple traumas were classified into three categories according to the injury severity score (ISS).That is,the slight group (22 cases,9≤ ISS ＜ 15),moderate group (35 cases,15 ≤ ISS ＜ 25) and severe group (28 cases,ISS ≥ 25).Their venous blood samples were collected at 6,12,24,48 and 72 hours after trauma respectively,and the serum IL-1 β levels were measured using a specific immunoluminometric assays.The basal conditions including age,the hospitalization days and so on among these three groups were compared via ANOVA.The mean IL-1 β levels at above time intervals among three groups were compared.Finally,the relationship between the peak concentration of IL-1β and injury severity and complications was analyzed by multiple Logistic regression.Results (1) As the increasing severity of trauma,the patients with longer days of hospitalization and higher rate of multiple organ dysfunction syndrome (MODS) (P ＜ 0.05).(2) The levels of IL-1 β in the moderate and severe groups were remarkably higher than those in the slight group (P ＜ 0.02).(3) The IL-1β levels in each group peaked at 6 hours after trauma and began to decline.(4) Multivariate logistic analysis showed that peak concentration of IL-1 β was still an independent predictor for injury severity (moderate group:odds ratio,1.21;95％ confidence interval:1.05-1.39,P =0.007;severe group:odds ratio,1.20;95％ confidence interval:1.03-1.40,P =0.019) and sepsis (odds ratio,1.28;95％ confidence interval:1.10-1.50,P =0.001),but had no significant association with MODS and trauma mortality even after controlling other risk factors.Conclusions The serum IL-1β at 6 hours after injury could be used as an early effective indicator to evaluate the injury severity and infectionrelated complications in patients with multiple trauma.

OBJECTIVE:To systematically review therapeutic efficacy of Haikun shenxi capsule in the treatment of chronic renal failure (CRF).METHODS:Retrieved from Central,PubMed,EMBase,CJFD,CBM,VIP and Wanfang database,randomized clinical trials (RCTs) about Haikun shenxi capsule combined with routine treatment (trial group)vs.single routine treatment (control group) in the treatment of CRF were collected.Meta-analysis was performed by Rev Man 5.3 software after screening literature,extracting data and evaluating quality by using risk bias evaluation of Cochrane collaboration network.RESULTS:A total of 10 RCTs were included eventually,involving 704 patients.The results of analysis showed that compared to general therapy,Haikun shenxi capsule could improve total effective rate [RR =4.42,95 ％ CI (2.70,7.22),P＜ 0.001],and could reduce SCr[MD =-140.37,95 ％ CI (-191.72,-89.03),P＜ 0.001],BUN[MD =-5.49,95 ％ CI (-8.36,-2.63),P＜ 0.001] and 24 h-Upro [MD =-0.43,95 ％ CI (-0.62,-0.23),P＜ 0.001],with statistical significance.CONCLUSIONS:The clinical efficacy of Haikun shenxi capsule in the treatment of CRF is good and significantly improve related indexes of renal function.

Objective:To explore the effect of nursing version of Mini-Clinical Evaluation Exercise (Mini-CEX) on improving the job competency of junior nurses in Thoracic Surgery Department.Methods:From July 2020 to July 2021, 45 junior nurses in the Thoracic Surgery Department of Zhongnan Hospital of Wuhan University were selected as research object by convenience sampling. In 2020, the nurse job competency assessment team of Thoracic Surgery Department were established to formulate entry and advanced requirements for each post, improve the nursing quality control standards for various diseases, and use the nursing version of Mini-CEX to investigate the junior nurses in Thoracic Surgery Department, evaluate the clinical comprehensive ability of nurses, and adjust the training plan according to the feedback results. Before and after the intervention, the nurses' self-efficacy, job competency, and nursing version of the Mini-CEX were evaluated.Results:Before and after the implementation of the project, the self-efficacy scores of junior nurses in Thoracic Surgery Department were (25.20±2.74) and (32.36±2.99) respectively, and the job competency scores were (64.26±2.57) and (75.27±2.02) respectively, and the nursing version of Mini-CEX scores were (50.04±5.38) and (73.40±3.52) respectively, and the differences were all statistically significant ( P<0.05) . Conclusions:The use of the nursing version of Mini-CEX can effectively improve the job competency of junior nurses in Thoracic Surgery Department, which has a certain significance for improving nursing quality and ensuring patient safety.

PURPOSE: Cell-in-cell structures are created by one living cell entering another homotypic or heterotypic living cell, which usually leads to the death of the internalized cell, specifically through caspase-dependent cell death (emperitosis) or lysosome-dependent cell death (entosis). Although entosis has attracted great attention, its occurrence is controversial, because one cell line used in its study (MCF-7) is deficient in caspase-3. METHODS: We investigated this issue using MCF-7 and A431 cell lines, which often display cell-in-cell invasion, and have different levels of caspase-3 expression. Cell-in-cell death morphology, microstructures, and signaling pathways were compared in the two cell lines. RESULTS: Our results confirmed that MCF-7 cells are caspase-3 deficient with a partial deletion in the CASP-3 gene. These cells underwent cell death that lacked typical apoptotic properties after staurosporine treatment, whereas caspase-3-sufficient A431 cells displayed typical apoptosis. The presence of caspase-3 was related neither to the lysosome-dependent nor to the caspase-dependent cell-in-cell death pathway. However, the existence of caspase-3 was associated with a switch from lysosome-dependent cell-in-cell death to the apoptotic cell-in-cell death pathway during entosis. Moreover, cellular hypoxia, mitochondrial swelling, release of cytochrome C, and autophagy were observed in internalized cells during entosis. CONCLUSION: The occurrence of caspase-independent entosis is not a cell-specific process. In addition, entosis actually represents a cellular self-repair system, functioning through autophagy, to degrade damaged mitochondria resulting from cellular hypoxia in cell-in-cell structures. However, sustained autophagy-associated signal activation, without reduction in cellular hypoxia, eventually leads to lysosome-dependent intracellular cell death.
Apoptosis ; Autophagy ; Caspase 3* ; Cell Death ; Cell Hypoxia ; Cell Line ; Cytochromes c ; Entosis ; MCF-7 Cells* ; Mitochondria ; Mitochondrial Swelling ; Staurosporine

Objective To investigate the outcome of postoperative hypopituitarism and hormone replacement in patients with pituitary adenoma,and to analyze the potential factors related to postoperative hypopituitarism.Methods A total of 215 postoperative patients with pituitary adenoma were analyzed.Pituitary functions( including gonadal,thyroid,and adrenal axes ) were asessed by strict criteria.Data of surgery history and hormone replacement situation were collected for statistical analysis.Results The prevalence of hypopituitarism was 54.0％,including 36.7％ hypogonadism,32.6％ hypothyroidism,and 28.4％ hypoadrenalism.Replacements of gonadal steroid,glucocorticoid,and thyroxine were carried out in 25.6％,84.3％,and 80.6％ of the cases,respectively.Univariate analysis showed that male sex and large tumor were related to hypopituitarism. Conclusion After pituitary adenomectomy,approximately half of the patients present anterior pituitary dysfunction,while quite a number of them have not been treated appropriately.

ObjectiveTo unify the definitions of colonoscopic characteristics of Crohn disease (CD) and intestinal tuberculosis ( ITB),and to evaluate colonoscopic and clinical features in the differential diagnosis of CD and ITB.MethodsA collaborative group composed of 10 experts from 5 hospitals voted to identify and confirm the colonoscopic characteristics.Clinical and colonoscopic characteristics were analyzed,thereafter,characteristics were scored based on different diagnostic specificity.ROC curve was used for determining the cutoff point to differentiate CD from ITB.ResultsFirstly,standard endoscopic images and descriptions were determined.Secondly,colonoscopic parameters which were significantly different between the CD and ITB patients included the follows:involvement of more than four intestinal segments,anorectal involvement,longitudinal ulcers,cobblestone appearance and transverse ulcers.Clinical findings which were significantly different between the CD and ITB patients included active pulmonary tuberculosis,PPD-test strong positive,anal fistula/perianal abscess and extra-intestinal manifestations in CD.4.4％(6/136) patients were confirmed by histological evidence of caseating granulomas.By using our scoring system,39.7％ (54/136) confirmed diagnoses and 18.4％ (25/136) suspected diagnoses were made in patients without histological evidence.ConclusionIdentification of colonoscopic characteristics and unification of the colonscopic diagnostic criteria were helpful in the differential diagnosis between CD and ITB.The differential diagnosis rate could he improved by using the scoring system.Half cases could not be confirmed even with combined pathology and the scoring system,so a more comprhensive scoring system would be warranted.