AIM: To explore the effect of Snail1 siRNA on high-glucose induced tubular epithelial-to-mesenchymal transition (TEMT). METHODS: Subconfluent renal tubular epithelial cells were incubated in serum-free DMEM for 24 h to arrest and synchronize the cell growth. Then cells were treated with normal glucose (5.5 mmol/L D-glucose) or high glucose (25 mmol/L D-glucose) for 72 h. Meanwhile 19.5 mmol/L D-manntiol was used as high osmotic control. Snail1 siRNA was transfected into tubular epithelial cells. In parallel, cells were transfected with non-specific siRNA which served as the control data sets. Cells were then treated with 25 mmol/L D-glucose for 72 h. RNA and cell lysates were collected to determine the protein and mRNA levels of Snail1, TGF-β_1, α-SMA, vimentin and E-cadherin. RESULTS: Transfection caused the decreases in Snail1 at mRNA and protein levels by 62% and 68% respectively as compared to those in untransfected cells cultured in high glucose medium. Western blotting exhibited that Snail1 siRNA transfection restored E-cadherin protein expression by 61% compared to that in high-glucose-treatment cells, whereas it inhibited high-glucose-induced induction of α-SMA protein by 58%. Similarly, RT-PCR revealed that Snail1 siRNA transfection dramatically suppressed the high-glucose-induced mRNA expressions of α-SMA and vimentin by 72% and 61%, respectively, while E-cadherin mRNA increased by 53%. CONCLUSION: Our study provides direct evidence that Snail1 is able to control TEMT.

Objective To investigate the impact of PET-CT on the target volume delineation and precise radiothera?py planning for patients with advanced non-small cell lung cancer (NSCLC). Methods PET-CT scanning was performed in 30 histologically proved NSCLC patients. The gross tumor volume (GTV) was delineated, and radiotherapy planning was es?tablished with identical parameters based on the CT image and PET-CT fused image, respectively. The differences of doses between GTV, planning target volume (PTV) and organsat rise (OAR) were compared. Results PET-CT image results changed the target volume delineation in 30 patients with 8 increased and 22 decreased. There were no differences in GTV and PTV between the VGTV and VPTV statistically, although PET-CT image changed conventional CT image size sketch of GTV and PTV. The V20 of total lung decreased in the PlanPET-CT compared with that of PlanCT (P<0.05), but no differences were found in the V30 of total lung, mean lung dose (MLD), the data of spinal cord, esophagus and heart. Conclusion PET-CT may reduce the radiation injuries in the lung and improve the target dose.

Objective:To analyze the injury characteristics of peritalar dislocations using ankle models reconstructed with software Mimics.Methods:A retrospective study was conducted to analyze the medical records of 36 patients with peritalar dislocation who had been treated at Department of Orthopaedics, The Fourth Hospital of Wuhan from January 2008 to April 2022. There were 28 males and 8 females with an age of (46.0±14.6) years, and 16 left and 20 right limbs. Their CT data were imported into software Mimics to reconstruct ankle models to observe the fractures of the postero-medial process of the talus, the affiliated injuries to the surrounding bone structures outside the talus, and the complete or incomplete dislocations of the talonavicular articulation.Results:32 patients (88.9%, 32/36) had fracture of the postero-medial process of the talus, and 24 patients (66.7%, 24/36) a total of 33 affiliated injuries to the surrounding bone structures outside the talus, including 12 lateral malleolus ones, 4 medial malleolus ones, 7 scaphoid ones, 6 calcaneus ones, 3 fractures of the cuboid and 1 fracture of the fifth metatarsal. Sixteen patients were complicated with 1 affiliated injury, 7 patients with 2 affiliated injuries, and 1 patient with 3 affiliated injuries. The 8 patients with 2 or more affiliated injuries all had complete dislocation of the talonavicular articulation. Of the 36 patients, 26 had complete dislocation of the talonavicular articulation and 10 incomplete dislocation of the talonavicular articulation. The incidence of affiliated injuries [84.6% (22/26)] in the patients with complete dislocation of the talonavicular articulation was significantly higher than that [20.0% (2/10)] in those with incomplete dislocation of the talonavicular articulation ( P=0.001). Conclusions:Most of the peritalar dislocations are combined with the fracture of the postero-medial process of the talus. The incidence of complete dislocation of the talonavicular articulation is high. Patients with complete dislocation of the talonavicular articulation are more likely to have an affiliated injury, or even more than two injuries.

OBJECTIVE: To reveal the characteristics of gene expression in adrenal gland of H22 tumor mice with typical syndromes and in different liver cancer stages. METHODS: By the quantitative four diagnosis and syndrome differentiation methods and GeneChip Mouse Exon 1.0 ST Array, we observed adrenal gland gene expression in H22 tumor mice with pathogenic factor-toxin predominance syndrome and qi deficiency syndrome in the earlier stage, yang-qi deficiency syndrome in the intermediate stage, and qi-yin-yang deficiency syndrome in the advanced stage. Genes highly expressed and remarkably different were analyzed in this study. RESULTS: A total of seventy-three up-regulated coincident genes and twenty-six down-regulated coincident genes in different stages were investigated in the study. Up-regulated coincident genes included Hp, C3, Anxa1, Procr, C2, Il4ra, Cd14, Ptprc, Cd52, C4b, Eno3, Xdh, Gpx3, and so on. Down-regulated coincident genes included nervous system function-related genes such as Plp1, Mbp, Aldh1a1, Cck, Atn1, genes associated with electrolyte metabolism such as Aldh1a1 and Slc22a17, genes related to signal transduction such as Cxcr4, Spag5 and Stmn3, etc, and genes related to transcriptional control and protein biosynthesis such as Hspa1a, Dnajb1, Thra, Hhex and so on. CONCLUSION: With the development of the tumorigenesis, the symptoms and signs and differentially expressed genes in adrenal gland of H22 tumor mice can be measured. Up-regulated and down-regulated coincident genes may be the features of H22 tumor mice different from those of normal mice.

Objective To explore optimal suctioning negative pressure in endoscopic nasobiliary drainage (ENBD) after endoscopic retrograde cholangiopan-creatography (ERCP). Methods A total of 131 patients with extrahepatic bile duct stones complicated with infection, who were treated by ENBD after ERCP, were randomly divided into two groups according to intubation dates from September 2013 to December 2014. The patients of two groups were treated with the same medical and nursing care. The pressure of low suctioning negative pressure group (61 cases) was -1--5 kPa and the pressure of high suctioning negative pressure group (70 cases) was -5--8 kPa. The conditions of biliary bleeding, drainage volume, drainage tube obstruction and patient comfort in two groups were compared. Results There were 4 cases of bile occult blood in low suctioning negative pressure group and 9 cases in high suctioning negative pressure group (P>0. 05). The daily biliary drainage volume in low suctioning negative pressure group was (349. 79 ± 108. 26) ml, which was more than that in high suctioning negative pressure group (t=6. 76,P<0. 01). There were 8 cases of drainage tube obstruction in low suctioning negative pressure group, which was less than that of 25 cases in high suctioning negative pressure group (χ2 =8. 83,P<0. 01). There were 2 cases of postoperative vomiting and 4 cases of xiphoid under pain in low suctioning negative pressure group, which were less than those in high suctioning negative pressure group (χ2 =17. 27,3. 89;P<0. 05). Conclusions The optimal suctioning negative pressure in ENBD after ERCP is -1--5 kPa. It can be used in clinical nursing care in order to improve patient comfort and keep the drainage tube unobstructed.

Objective To analyze the characteristics of blood lipid metabolism in patients with Wilson's disease(WD)and understand the influencing factors of abnormal blood lipid.Methods The clinical data of 170 patients with WD and 59 healthy people were collected from June 2021 to March 2023,the blood lipids of the two groups were compared.To compare the characteristics of blood lipid metabolism in WD patients with different gender,age,body mass index(BMI)and disease types.According to whether the blood lipid was abnormal or not,WD patients were divided into normal blood lipid group and abnormal blood lipid group,and the biochemical indexes of the two groups were compared.The general situation and biochemical indicators were included in the single factor regression analysis,and the related factors that might affect blood lipid metabolism were screened out.The related factors of single factor screening were included in multivariate Logistic regression analysis to determine the abnormal factors affecting blood lipid.Results The triglyceride(TG)level of WD patients was lower than that of healthy controls,the difference was statistically significant(P<0.05).The rate of dyslipidemia in WD patients was 40.59%.Low density liporotein cholestrol in female WD patients was significantly lower than that in male WD patients(P<0.05).The values of BMI,alanine aminotransferase(ALT)and uric acid(UA)in dyslipidemia group of WD patients were significantly higher than those in normal group(all P<0.05).Multivariate Logistic regression analysis showed that BMI 24～28(OR=4.526,P<0.05),BMI>28(OR=6.360,P<0.05),UA(OR=1.006,P<0.01)and hyaluronic acid(HA)(OR=1.003,P<0.01)were associated with the high risk of dyslipidemia,with statistical significance.Conclusions WD patients have a high incidence of abnormal lipid metabolism,mainly with low high density liporotein cholestrol and high TG.The dyslipidemia in WD patients is affected by many factors.BMI,UA and HA are independent risk factors for dyslipidemia in WD patients.

Aceruloplasminemia(ACP)is a rare,adult-onset autosomal recessive disorder characterized by ceruloplasmin(CP)deficiency and iron metabolism disorders,with typical clinical manifestations of the triad of"neurological symptoms,diabetes,and retinopathy".Cranial MRI shows widely symmetrical T2-weighted imaging(T2WI)hypointensity in the basal ganglia,thalamus,dentate nucleus,and cortex.The diagnosis of ACP depends on genetic testing.Iron chelators were the main treatment,and some patients had unsatisfactory improvement in neurological symptoms.Clinicians should improve the recognition of ACP.Early diagnosis and treatment are helpful for the recovery of the disease.

Objective:To explore the association between sleep duration, sleep quality and the prevalence of hypertension in the elderly aged 65 years and above.Methods:This study was conducted among the elderly in communities in Yiwu, China from April to July, 2019, and participants were recruited through physical examination in the hospital. Face-to-face interview was performed to obtain basic information. Sleep duration and sleep quality were evaluated by Pittsburgh Sleep Quality Index (PSQI). Associations between sleep duration, sleep quality and hypertension were evaluated by multivariate logistic regression analysis.Results:A total of 3 169 elderly persons, aged ≥65 years old, were included in the study. The overall prevalence of hypertension was 50.8%. The elderly with very poor sleep quality and short sleep duration accounted for 22.4% and 28.5%, respectively. After adjusting for demographic characteristics, socioeconomic status, lifestyle and health status, the OR of hypertension for the elderly with very poor sleep quality was 1.42 (95% CI: 1.12-1.80) compared with those with very good sleep quality. Compared with the elderly with sleep duration of 6-7 h a night, the OR of hypertension for those with sleep duration <6 h was 1.37 (95% CI: 1.15-1.65). As the sleep quality decreased, the risk for hypertension increased. An U-shaped association was found between sleep duration and risk of hypertension. Subgroup analyses showed that this association existed in both men and women, but only significant in the elderly aged <75 years. Conclusion:Poor sleep quality and short sleep duration were associated with risk for hypertension in the elderly.