Objective To investigate the expression of KLF4 in cervical carcinoma and its significance. Methods Immunohistochemistry and tissue microarray were used to examine the expression of KLF4 in 39 cases of carcinoma, 30 cases of normal cervical epithelial tissues and 28 cases of cervical cancer in situ. Results Moderate to strong nuclear staining for KLF4 was found in normal tissues and cervical cancer in situ. Interestingly, KLF4 expression was lost in 16 (P<0.05) of 39 carcinoma cases. However, KLF4 expression was not associated with clinicopathologic parameters, including tumor stage and differentiation. Conclusion Our observations indicate that KLF4 may function as a tumor suppressor in the pathogenesis of cervical cancer.

Objective:To explore the characteristic of parenting style and its relationship with self congruence in Tibet middle school students.Methods:Totally 1149 Tibet students in 2 middle schools were investigated by the Scale of EMBU (Egma Minnen av Bardndosnauppforstran)and SCCS (Self Consistency and Congruence Scale) from counties resided mainly by Tibet people.Results:The total average scores of Tibet students'self-congruence were lower than the median[(2.8 ± 0.3) < median 3].There was no significant difference between genders [(2.6 ±0.3)vs.(2.7 ±0.4),P >0.05],and the scores of self flexibility had statistical significant difference in gender [(2.9 ±0.5)vs.(2.8 ±0.5),P <0.05].The scores of parenting style in positive elements were negatively correlated with self congruence in Tibet middle school students (r =-0.20,P <0.01 ).Multi-linear regression showed that the element of maternal emotion and understanding had negative relevance with SCCS(β=-0.16,P <0.01),while the element of maternal rejection and denial had positive relevance with SCCS(β=0.16,P <0.01) .Conclusion:It indicates that the level of self-congruence is higher than median,and that parenting style might have a certain relationship with self congruence in Tibet middle school students.

Objective:To explore the effect of hydrotherapy combined with breathing training on lung function and mobility of patients with thoracolumbar spinal cord injury.Methods:A total of 80 patients with thoracolumbar spinal cord injury admitted to Beijing Rehabilitation Hospital Affiliated to Capital Medical University from April 2018 to March 2020 were selected as observation objects.A prospective cohort study was conducted and randomly divided into observation group and control group with 40 cases in each group.The control group was given routine rehabilitation therapy combined with respiratory training.On the basis of the control group, the observation group was treated with water therapy.The indexes of lung function, motor function, lower limb muscle tension, function evaluation and activities of daily living were compared between the two groups.Results:After intervention, the observation group′s forced vital capacity (FVC) was (3.86±0.82) L, the forced expiratory volume in the first second (FEV1) was (3.76±0.68) L, the maximum ventilation (MVV) was (102.34±10.38) L/min, the maximum suction pressure (MIP) is (50.36±4.62) cmH 2O; the control group FVC was (3.41±0.76) L, and FEV1 was ( 3.35±0.63) L, MVV was (90.67±11.68) L/min, MIP was (44.38±4.85) cmH 2O, the difference between the two groups is statistically significant ( t=2.546, 2.797, 4.723, 5.646, respectively, all P<0.05). After the intervention, the motor function score of the american spinal injury association (ASIA) of the observation group was (58.62±7.56) points, and the modified ashworth scale (MAS) score was (2.74±0.89) points; The ASIA motor function score of the control group was (42.24±6.40) points, and the MAS score was (3.36±0.94) points.The difference between the two groups was statistically significant ( t=10.459 and -3.029, respectively, all P<0.05). After intervention, the observation group′s spinal cord independence measure (SCIM III) score was (75.33±10.72) points, and the modified barthel index (MBI) was (66.64±6.34) points; the SCIM III score of the control group was (68.34±9.55) points, and the MBI score was (57.52±6.77) points, the difference between the two groups was statistically significant ( t=3.079 and 6.219, respectively, all P<0.05). Conclusion:Hydrotherapy combined with breathing training can significantly improve lung function and respiratory muscle strength in patients with thoracolumbar spinal cord injury, and improve motor function and ability of daily living.

Objective: To analyze the prevalence and influencing factors of suicidal behaviors among middle school students in minority areas of Guizhou Province, and to provide the reference for targetedly preventing suicidal behavior among middle school students. Methods: Questionnaire survey including adolescent health information, Depression Self-rating Scale for Children(DSR-SC), Childhood Trauma Questionnaire-Short Form (CTQ-SF) and the Pittsburgh Sleep Quality Index survey were conducted among 6 139 middle school students in minority areas of Guizhou Province, Logistic regression was used to analyze the influencing factors of suicidal behavior of middle school students. Results: A total of 1 241(20.2%) had suicidal ideation in the past 12 months, and 250 (4.1%) of middle school students had committed suicide in the past 12 months. Suicidal ideation among middle school students was positively associated with: female, non-residence, being only child, smoking, having poor relationship with teachers, poor relationship with classmates, school violence victimization, physical abused, sexual abuse, emotionally neglected, having depression, having sleeping disorders(OR=1.67, 1.64, 0.84, 0.72, 0.67, 0.58, 2.06, 2.45, 2.12, 1.68, 2.82, 1.62). While being women(OR=1.52), non-residence(OR=2.25), smoking(OR=0.52), poor relationship with teachers(OR=0.49), poor relationship with classmates(OR=0.47), school violence victimization (OR=1.79) and physically abused(OR=2.17), sexual abused(OR=1.97), physically neglected(OR=1.94), depressive symptoms(OR=3.14), sleep disorders (OR=1.66) were associated positively with the risk of suicide attempt. Conclusion Suicide-related behaviors are more common in minority areas of Guizhou Province. Teachers and parents should attach great importance to it, and their suicidal risk should be early recognized to reduce suicide-related behaviors.

Objective: To investigate whether Schisandrin B (Sch B) could improve cardiac structure and function in myocardial infarction (MI) mice and related mechanisms. Methods: Male C57BL/6J mice were randomized into sham (n=8), MI+ Sch B (n=24, 80 mg·kg^-1·d^-1 per gavage) or MI+ vehicle (n=24, equal volume). After treatment for 3 weeks, cardiac function was detected by echocardiography measurement.Infarction size was measured by Evans blue and TTC staining.HE and Masson trichrome staining were used to observe the myocardial inflammation, structure and fibrosis.TNF-α, TGF-β, IL-1β were detected by ELISA. The apoptosis index of ischemic myocardial cells was detected by immunofluorescence. NF-κB, Bcl-2, Bax, Akt phosphorylated Akt(p-Akt), eNOS, phosphorylated eNOS (p-eNOS) were detected by Western blot. Results: Three weeks after operation, survival rate (83.33% vs. 54.17%, P<0.05), LVEF((51.77±8.50)% vs.(40.23±8.30)%, P<0.05), LVFS((26.44±5.15)% vs. (19.53±4.56)%, P<0.05)were significantly higher; LVEDD ((4.13±0.40) mm vs.(4.44±0.46)mm, P<0.05), LVESD((3.07±0.39) mm vs. (3.46±0.52)mm, P<0.05), the heart weight/body weight ratio((0.59±0.06)% vs. (0.68±0.10)%, P<0.05)was significantly lower and infarct size ((23.4±2.36)% vs. (39.4±2.06)%, P<0.05) was significantly reduced in MI+ Sch B group than those in MI+ vehicle group. In MI+ vehicle group, HE staining showed a large number of inflammatory cells in the peri-infarctl region, and the permutation structure was very disorganized, while above changes were significantly reduced in the MI+ Sch B group. Masson staining results showed that the degree of myocardial fibrosis in MI+ Sch B group was significantly less than that of MI+ vehicle group.Moreover, Sch B could down-regulate some inflammatory cytokines, like NF-κB、TGF-β、TNF-α and IL-1β, activate Akt-eNOS pathway, upgrade Bcl-2 and downgrade Bax and reduce cell apoptosis as compared with MI+ vehicle group (all P<0.05). Conclusions Our results demonstrate that Sch B can reduce inflammation, inhibit apoptosis, and attenuate cardiac remodeling and improve cardiac function in this mice MI model.Sch B might serve as a potential novel therapeutic agent for ischemic heart disease.

BACKGROUND:Hemiarthroplasty is a proven method for reconstruction of the hip joint function, especialy for the elderly patients who cannot tolerate the total hip arthroplasty. However, for the patients with osteoporosis, there are stil more controversial in clinical practice about using cemented or cementless femoral prosthesis for hemiarthroplasty. OBJECTIVE: To observe the repair effect of cemented or cementless femoral prosthesis when were used for hemiarthroplasty in patients with osteoporosis. METHODS:The clinical data from 105 patients treated with hemiarthroplasty were retrospectively analyzed. Osteoporosis was diagnosed in these patients using the dual energy X-ray absorptiometry before surgery.Patients were divided into bone cement group (n=56) and cementless group (n=49) depending on different types of femoral stem prosthesis. The difference of efficacy between cemented or cementless femoral prosthesis when were used for hemiarthroplasty in patients with osteoporosis was analyzed by comparing the operative time, volume of drainage, post-operative Harris scores of hip joint function and radiographic assessment (prosthesis subsidence, osteolysis, severe stress shielding, heterotopic ossification) during the folow-up after the replacement. RESULTS AND CONCLUSION:In the process of hemiarthroplasty in patients with osteoporosis, the operative time in the cement group was significantly longer than that in the cementless group (P < 0.05). However, there was no significant difference in the postoperative volume of drainage between these two groups (P > 0.05). At the 1, 3, 6 and 12 of folow-up after replacement, there were no significant differences in the Harris score of hip joint function, total effective rate and radiographic assessment between these two groups (P> 0.05). These results suggest that in the process of hemiarthroplasty in patients with osteoporosis, the clinical efficacy of cementless femoral prosthesis is similar to the cement femoral prosthesis, therefore two prostheses can al be selected; however, the operative time of the cement femoral prosthesis is longer than the cementless femoral prosthesis, so we can give priority to the cementless femoral prosthesis for patients with osteoporosis who can’t tolerate a long operative time because of the poor basic condition.

Objective:To study the optimal surgical timing of laparoscopic cholecystectomy (LC) after percutaneous transhepatic gallbladder drainage (PTGBD) for acute cholecystitis.Methods:A retrospective analysis of the clinical data of patients with acute cholecystitis who were treated at Zhengzhou Central Hospital Affiliated to Zhengzhou University from April 2016 to October 2020 with initial PTGBD followed by LC. These patients were divided into three groups according to the time intervals between LC with PTGBD. Patients who underwent LC 3~4 weeks after PTGBD were in the short interval group ( n=67); patients who underwent LC 5~8 weeks after PTGBD were in the intermediate interval group ( n=78); and patients who underwent LC>8 weeks after PTGBD were in the long interval group ( n=73). The baseline and perioperative data of the three groups were compared. Results:In 218 patients, 97 were males and 121 were females, aged (72.1±8.4) years. Before LC, the gallbladder wall in the short interval group (4.77±0.62) mm was significantly thicker than that in the intermediate interval group (3.85±0.34) mm and the long interval group (3.81±0.25) mm (all P<0.05). Intraoperative blood loss in the intermediate interval group was significantly less than that in the short interval group ( P<0.05). The operation time, conversion to laparotomy, placement of drainage tube, postoperative hospital stay and total hospitalization expenses in the intermediate interval group were significantly better than those in the other two groups (all P<0.05). The incidence of complications in the intermediate interval group was significantly lower than that in the short interval group [2.56% (2/78) vs. 14.93% (10/67)], and the long interval group [2.56% (2/78) vs. 12.33% (9/73), all P<0.05]. Conclusion:The best timing for sequential LC after PTGBD in acute cholecystitis was shown in this study to be 5 to 8 weeks after PTGBD.

Objective To investigate the clinical value of indocyanine green (ICG) fluorescence navigation in laparoscopic cholecystectomy (LC) after percutaneous transhepatic gallbladder drainage (PTGBD) in elderly patients with acute cholecystitis. Methods A retrospective analysis was performed for the perioperative clinical data of the elderly patients with acute cholecystitis who underwent LC after PTGBD in Zhengzhou Central Hospital Affiliated to Zhengzhou University from June 2021 to February 2022. The 36 patients who underwent ICG fluorescence navigation were enrolled as experimental group, and the 26 patients who did not undergo ICG fluorescence navigation during the same period of time were enrolled as control group. Preoperative general information was analyzed for both groups, as well as time to identify the biliary system during surgery, time of operation, intraoperative blood loss, bile tract injury, conversion to laparotomy, time to first flatus after surgery, time to ambulation, time to removing abdominal drainage tube, time to return to normal diet, and length of postoperative hospital stay. The group t -test or the Mann-Whitney U test was used for comparison of continuous data between two groups, and the chi-square test was used for comparison of categorical data between groups. Results Compared with the control group, the experimental group had a significantly shorter time to identify the biliary system during surgery (19.9±3.7 min vs 36.5±5.9 min, t =13.56, P < 0.05), a significantly shorter time of operation (50.6±8.5 min vs 80.9±10.6 min, t =12.48, P < 0.05), and a significantly lower amount of intraoperative blood loss ( χ 2 =6.91, P < 0.05). No patient was converted to laparotomy in the experimental group, while 2 patients in the control group were converted to laparotomy, and no bile duct injury was observed in either group. Compared with the control group, the experimental group had significantly shorter time to ambulation (10.2±2.4 hours vs 16.6±3.2 hours, t =8.92, P < 0.05), time to removing abdominal drainage tube (20.1±3.4 hours vs 30.7±4.7 hours, t =10.2, P < 0.05), time to return to normal diet (20.3±3.8 hours vs 31.2±6.0 hours, t =8.68, P < 0.05), and length of postoperative hospital stay [3.3 (3.0-4.3) days vs 5.3 (5.0-6.2) days, Z =5.91, P < 0.05]. Conclusion ICG fluorescence navigation can visualize the extrahepatic biliary system during LC after PTGBD in elderly patients with acute cholecystitis, which may help to achieve accurate operation, reduce the risk of surgery, shorten the time of operation, and accelerate postoperative recovery.