Objective To explore the expression of thioredoxin reductase (TrxR) mRNA and protein,as well as the relationship between TrxR and myeloid leukemia.Methods Bone marrow samples from 20 acute myeloid leukemia (AML),20 chronic myeloid leukemia (CML),and 20 healthy persons as normal control group were collected.The human non small cell lung cancer A549 cells were selected as the positive control group.The expression of TrxR mRNA was detected by real-time quantitative polymerase chain reaction.The expression of TrxR protein level was detected by Western blot.Results The relative quantitation expressions of TrxR mRNA were 6.751 (13.459),4.321 (11.389),18.477 (2.089),1.045 (0.467) in AML,CML,positive control and normal control group,were 17.814±3.979 and 4.860±1.550 in the primary diagnosed/relapse group and complete remission (CR) group of AML patients,and were 19.552 (5.758) and 3.459 (2.047) in the primary diagnosed and treatment group of CML patients.The expression levels of TrxR mRNA in AML,CML and positive control group were significantly higher than that in normal control group (H =43.978,P ＜ 0.001).For AML patients,the expression levels of TrxR mRNA in the primary diagnosed/relapse group,CR,positive control group were significantly higher than that in normal control group (F=246.793,P ＜ 0.001),and the difference between the primary diagnosed/relapse group and positive control group was no significant (P ＞ 0.05).The expression of TrxR mRNA were higher in the primary diagnosed/relapse group than that in CR group,and that in CR group than that in normal control group (both P ＜ 0.05).For CML patients,the expression levels of TrxR mRNA in the primary diagnosed,treatment,positive control group were significantly higher than that in normal controls (H =38.222,P ＜ 0.001),the difference between that in the primary diagnosed and that in positive control group was no significant difference (P ＞ 0.05),but the expression of TrxR were significantly higher in the primary diagnosed group than that in treatment group,and that in treatment group than that in normal controls (both P ＜ 0.05).The expression of TrxR mRNA in the primary diagnosed/relapse group of AML and the primary diagnosed group of CML showed no significant difference (P ＞ 0.05).The positive levels of TrxR protein were 0.679,0.606,0.877 and 0.095 in AML,CML,positive control and normal control group.TrxR protein was highly expressed in myeloid leukemia patients.Conclusion The expression levels of TrxR mRNA and protein are increased in myeloid leukemia.The low expression of TrxR in normal hematopoietic stem cells is highly expressed in myeloid leukemia,and is downgraded after treatment,which may be used as one of the parameters to diagnosis,effect and prognosis of myeloid leukemia.

Objective To investigate the expression of nuclear factor erythroid-2 related factor 2 (Nrf2) gene in chronic myeloid leukemia (CML) and explore its relationship with clinical characteristics and thioredoxin reductase (TrxR).Methods The expressions of Nrf2 and TrxR genes in bone marrow cells and K562 cells were analyzed in 30 bone marrow preparations of CML patients in different phases,including 20 in chronic phase,3 in accelerated phase,7 in blastic phase by real-time quantitative polymerase chain reaction.Ten health subjects were served as normal controls.Results The relative quantitation expression of Nrf2 and TrxR mRNA were 5.601±1.069 and 9.017±2.398 in chronic phase,1.698±0.349 and 5.590±1.015 in accelerated phase,1.252±0.807 and 5.050±1.469 in blastic phase,1.377± 0.344 and 1.867±0.977 in normal controls.The expressions of both Nrf2 and TrxR mRNA in CML had significant differences from those of the normal controls (x2 =14.680,P =0.002,x2 =8.271,P =0.041).The expression of Nrf2 mRNA in accelerated phase,blastic phase group showed no significant difference (Z =0.011,P =0.496),but lower than that in chronic phase group (Z =2.155,P =0.016,Z =2.534,P =0.006).The difference between the first visit and post-treated group was significant (Z =2.015,P =0.022).The expression in K562 cells and normal controls had significant difference (Z =1.898,P =0.029).In CML patients,the expression of Nrf2 was positively correlated with that of TrxR (r =0.738,P =0.037).Conclusion The expression of Nrf2 gene is higher in the first visit group of CML than that in the other groups,and is decreased after therapy,which may be the molecular marker predicting the progress of CML.Nrf2 mRNA expression level is correlated with TrxR.

Objective:To analyze and integrate the delivery experience of parturient women undergoing vaginal birth after cesarean (VBAC) .Methods:Databases including PubMed, Embase, Web of Science, CINAHL, EBSCO, OVID, CNKI, VIP, Wanfang and China Biology Medicine disc were searched and qualitative researches on the delivery experience of parturient women undergoing VBAC from the establishment of databases to July 2020 were collected. The quality of literatures was evaluated using qualitative research evaluation standard of Australian JBI Evidence-based Health Care Center, and integrative synthesis method was used to integrate the results.Results:A total of 16 studies were included and 26 results were extracted into 9 categories, which were further integrated into 3 results: decision influencing factors, decision-making development process and reflections after vaginal delivery.Conclusions:The psychological experience of parturient women undergoing VBAC is relatively complex.The medical personnel should provide support and guidance for the psychological needs of parturient women, so as to help them better cope with childbirth.

Objective:To investigate the value of net water uptake (NWU) for predicting early neurological improvement (ENI) after endovascular treatment in patients with acute anterior circulation large vessel occlusion stroke.Methods:A case-control study. A total of 132 patients (80 men, 52 women, median age 68 years) with acute anterior circulation large vessel occlusive stroke receiving endovascular treatment were retrospectively analyzed at Jinling Hospital from October 2014 to September 2019. Patients were divided into two groups based on the occurrence of ENI, which was defined as either an improvement of NIHSS score of ≥4 points, or an NIHSS score of 0 or 1 at 24 hours after endovascular treatment. The rank sum test, Chi square test, and other methods were used to compare differences in baseline characteristics between the two groups. Logistic regression analysis was used to investigate independent predictors of postoperative ENI. Receiver operating characteristic curve analysis used to assess the capacity of NWU to predict ENI.Results:Of the 132 patients in the study, ENI occurred in 47 and did not occur in 85. In multivariate logistic regression analysis age [odds ratio ( OR)=0.940, 95% confidence interval ( CI) 0.903-0.979, P=0.003], time from stroke onset to puncture ( OR=0.995, 95% CI 0.991-0.999, P=0.025), time from puncture to recanalization/end of operation ( OR=0.985, 95% CI 0.974-0.996, P=0.007), NWU ( OR=0.762, 95% CI 0.620-0.937, P=0.010), and mTICI ( OR=1.644, 95% CI 1.043-2.590, P=0.032) were predictive factors for ENI. Receiver operating characteristic curve analysis indicated that NWU could effectively predict ENI (area under the curve=0.642, 95% CI 0.543-0.741, P=0.007), and prediction accuracy was improved when it was combined with other clinical parameters. Conclusion:NWU is an independent predictor of ENI in patients with acute anterior circulation large vessel occlusive stroke undergoing endovascular treatment.