Objective:To investigate the expression and clinical significance of PD-L1 in colorectal cancer (CRC). Methods:A total of 210 CRC patients who accepted radical surgery in our hospital from January 2015 to January 2016 were divided into three groups, namely, high-frequency microsatellite instability (MSI-H), low-frequency microsatellite instability (MSI-L), and microsatellite stable (MSS). The expression of PD-L1 was detected by immunohistochemistry, and the expression characteristics of PD-L1 in different types of CRC were analyzed. Results:CRC cases with low differentiation had a higher expression of PD-L1 than CRC patients with high differ-entiation (P<0.05). PD-L1 had a positive rate of 75.8%in the MSI-H group and a rate of 9.3%in the MSI-L and MSS groups, wherein the difference between the two groups was statistically significant (P<0.05). Conclusion:PD-L1 was positively expressed in some CRC tu-mor tissues, and its positive rate was significantly higher in MSI-H than in MSI-L and MSS. The therapeutic effect of a PD-L1 blocker for patients with MSI-H CRC might be preferable.

Objective To explore the influence of core competence evaluation on continuing education of training nurses in operation room.Methods Questionnaires were administered to 42 training nurses by using the registered nurse core competence scale (CIRN) in operation room.Results The level of core competence of training nurses in operation room was medium (3.25 ± 0.45).Legal and ethical practice dimension of scores was the highest (3.55 ± 0.63).The single average of clinical nursing dimension was the advanced lowest (3.11 ± 0.54).The nurses self identity was the core influencing factors by multiple stepwise regression analysis in regression.Conclusions The core competence of training nurses in operation room is on the middle level,The focus is to improve the ability of clinical nursing in continuing education.To give more attention and support in self identity of the operation room training nurses,and to provide the scientific basis for the training plan and specialist training for them,in order to promote the continuing education projects of training nurses.

Objective:To investigate the effect of 12(S)-HETE on the p27~(kip1) expression in mesangial cells and glomeruli.Methods:Mesangial cells were exposed to 12(S)-HETE.12(S)-HETE was infused to rats by osmotic mini-pump.Total protein content measurement for cell hypertrophy,RT-PCR for mRNA expression and Western blot for protein expression were performed respectively.Results:12(S)-HETE stimulation induced mesangial cell hypertrophy and p27~(kip1) protein expression,but not p27~(kip1) mRNA expression.Furthermore,p27~(kip1) mRNA and protein expression in the glomeruli were significantly increased by 12(S)-HETE stimulation using osmotic mini-pump.Conclusion:12(S)-HETE plays an important role in the pathogenesis of glomerular cell hypertrophy and senescence through upregulation of p27~(kip1) expression.

Objective: To investigate the differences of genotyping and virulence of hospital-acquired methicillin-resistant staphylococcus aureus (HA-MRSA) and community-acquired methicillin-resistant staphylococcus aureus (CA-MRSA). Methods: A total of 83 non-repetitive clinical specimens were collected in this study. All samples were classified into HA-MRSA and CA-MRSA according to the definition of the USA Centers for Disease Control and Prevention (CDC). Multiple polyemeras chain reaction (PCR) was used for SCCmec typing, and spa typing was conducted by means of PCR plus DNA sequencing. Panton-valentine leucocidin (PVL), phenol-soluble modulins α (PSMa), phenol-soluble modulins mec (PSM-mec), exfoliative toxin A (ETA), exfoliative toxin B (ETB), toxic shock syndrome toxin (TSST), α-toxin (hla), δ-toxin (hld) were also detected by conventional PCR. Results: The SCCmec type Ⅰ, Ⅱ, Ⅲ, Ⅳa and unclassified type accounted for 1.2%, 3.6%, 65.1%, 28.9% and 1.2%, respectively. 82.1% of the 39 strains of HA-MRSA were identified as SCCmec Ⅲ. While for the 44 strains of CA-MRSA, SCCmec Ⅲ and Ⅳa each accounted for 50%. The proportions of SCCmec Ⅲ and Ⅳa in HA-MRSA and CA-MRSA showed significant differences (χ²=9.343, 20.253, both P<0.05); There were 15 types of spa, t437, t062, t015 accounted for 39.8%, 21.7% and 10.8% respectively. Among the strains of HA-MRSA, the spa type t437 and t062 accounted for 28.2% and 23.1%, respectively, while for the spa type of CA-MRSA, t437 and t062 accounted for 50% and 20.5%, respectively. There was significant difference of t437 type between HA-MRSA and CA-MRSA (χ²=4.100, P=0.043). The positive rates of PSM-a, hla and hld were all 100%, and the positive rates of PVL, ETA, ETB, TSST and PSM-mec were 24.3%, 4.8%, 1.2%, 10.8% and 4.8%, respectively. The proportions of PVL positive HA-MRSA and CA-MRSA were 10.3% and 36.4%, respectively, which was significantly different (χ²=7.705, P=0.006), while PSM-mec positive HA-MRSA and CA-MRSA were 10.3% and 0%, respectively. Conclusions The strains of SCCmec Ⅳa and spa t437 are detected in HA-MRSA, suggesting that the more virulent CA-MRSA genotypes coexist with the traditional HA-MRSA genotypes in the hospital-acquired infections, which brings new challenges for the prevention and control of hospital infection.

Objective To investigate the feasibility of using anti-sense RNA against classⅡmajor histocompatibility complex(MHCⅡ)transactivator(CⅡTA),which might regulate MHCⅡexpression,to suppress the relative immune response.Methods Stable transfectants of dermal fibroblasts with pDarⅡ(pDarⅡ-D)were tested for the expression of classic MHCⅡ(HLA-DR,-DP,-DQ)antigens induced with recombinant human interferon-gamma(IFN-?).mRNA abundance of CⅡTA,and classic MHCⅡwas mea-sured by RT-PCR.IL-2mRNA expressed in T cells,stimulated by transfected dermal fibroblasts,was de-termined by mixed lymphocyte reaction.Results When induced with IFN-?,the expression of HLA-DR and-DP antigens on pDarⅡ-D was reduced by95.63%and87.89%,respectively.Meanwhile,the mRNA contents of CⅡTA and classic MHCⅡwere decreased significantly(P

Extracellular matrix (ECM) keeps cell's shape, protects and nourishes cells; it plays a great role in cell proliferation and differentiation. Therefore, ECM is very important in cell and tissue engineering. In this study, after primary mouse osteoblasts and fibroblasts maintained at confluence in vitro were removed, their ECM coated on cell culture plate was prepared, and bone morphogenetic proteins 2 (BMP-2) was detected in the osteoblasts ECM. MC3T3-E1 preosteoblasts cells were seeded on cell culture plates covered with fibroblasts ECM and osteoblasts ECM respectively. The proliferative activity of the cells cultured on fibroblasts ECM was higher than that on osteoblasts ECM and the control group. The alkaline phosphatase activity, relative protein levels of BMP-2 and osteopontin, secreted calcium of the cells cultured on osteoblasts ECM were all the highest. The results indicate that the two different ECMs produced in vitro had different bioactivities, the fibroblasts ECM coated on cell culture plates could accelerate MC3T3-E1 cells proliferation, and the osteoblasts ECM could promote cells osteogenic differentiation.
3T3 Cells ; Alkaline Phosphatase ; metabolism ; Animals ; Animals, Newborn ; Bone Morphogenetic Protein 2 ; metabolism ; Calcium ; metabolism ; Cell Differentiation ; physiology ; Cell Proliferation ; drug effects ; Cells, Cultured ; Extracellular Matrix ; metabolism ; physiology ; Mice ; Osteoblasts ; cytology ; Osteopontin ; metabolism

Objective:To explore the clinical efficacy of morcellator assisted by transurethral bipolar plasmakinetic enucleation and resction of the prostate in the treatment of benign prostatic hyperplasia.Methods:A total of 90 patients with benign prostatic hyperplasia treated in the Department of Urology, Shenyang Fifth People′s Hospital from Apirl 2020 to Apirl 2021 were retrospectively analyzed. They were divided into the experimental group ( n=50) and the control group ( n=40) according to different sugical methods. Among them, patients underwent transurethral plasma anatomical prostatectomy with the aid of morcellator in the experimental group, patients of the control group underwent plasma prostatectomy. The operation time, intraoperative blood loss, the decrease in hemoglobin, postoperative catheter retention, hospitalization time, international prostate symptom score (IPSS) of 3 months after surgery, quality of life score (QOL), maximum urine flow rate(Qmax), residual urine volume (PVR), surgical complications and other related indicators in the two groups were compared. Measurement data were expressed as mean±standard deviation ( Mean± SD), comparison between groups was by t-test; comparison of count data between groups was by Chi-square test. Results:Both groups were successfully treated by transurethral surgery. There were significant difference in the amount of blood loss [(62.11±5.32) mL vs (95.12±10.32) mL], the total operation time[(40.25±12.75) min vs (72.1±13.41) min], postoperative catheter retention[(3.02±0.41) d vs (4.73±1.32) d], hospitalization time[(4.03±0.41) d vs (6.52±0.85) d], the decrease in hemoglobin[(2.65±0.52) g/L vs (4.21±0.85) g/L]( P<0.05); there was no significant difference in the IPSS score(7.36±3.26 vs 8.12±3.56), QOL(2.12±0.32 vs 2.32±0.21), Qmax[(15.47±4.53) mL/s vs (16.23±3.21) mL/s], PVR [(15.25±5.14) mL vs (16.21±5.26) mL], the incidence of complications(6.00% vs 5.00%)( P>0.05). Conclusion:It is safe and feasible to treat benign prostatic hyperplasia by transurethral plasma anatomical prostatectomy assisted by tissue planer, which can significantly improve its clinical efficacy.

Objective To investigate the clinical features of of patients with Staphylococcus aureus blood-stream infection and risk factors for septic shock.Methods A total of 51 patients diagnosed with Staphylococ-cus aureus bloodstream infection in the hospital from January 2018 to March 2023 were enrolled in the study.According to whether the patients developed septic shock,they were divided into septic shock group and non-septic shock group.The clinical data of the patients were collected,and the clinical laboratory indicators were detected on the day of blood culture samples were collected.Bacteria isolated from blood culture specimens of patients were identified and tested for drug sensitivity.The clinical data and clinical laboratory test indicators of the two groups were compared.Multivariate Logistic regression was used to analyze the independent risk factors of septic shock in patients with Staphylococcus aureus bloodstream infection.The receiver operating characteristic(ROC)curve was used to analyze the predictive value of clinical laboratory test indicators for septic shock in patients with Staphylococcus aureus bloodstream infection.Results Septic shock occurred in 12 of 51 patients,with an incidence of 23.5％.The proportion of patients with diabetes,gouty arthritis,the proportion of patients with long-term glucocorticoid use,the proportion of patients with respiratory tract in-fection,the proportion of patients who died,and the hospitalization cost in the septic shock group were higher than those in the non-septic shock group,and the differences were statistically significant(P＜0.05).Long-term glucocorticoid use was an independent risk factor for septic shock in Staphylococcus aureus bloodstream infection(P＜0.05).The combination of C-reactive protein(CRP),albumin(Alb),neutrophil/lymphocyte ratio(NLR)and procalcitonin(PCT)had high value in predicting septic shock in patients with Staphylococ-cus aureus bloodstream infection,and the area under the ROC curve was 0.983.Conclusion Long-term use of glucocorticoids can lead to an increased risk of septic shock in patients with Staphylococcus aureus blood-stream infection.The combined detection of CRP,Alb,NLR and PCT has a higher predictive value than single detection for septic shock in patients with Staphylococcus aureus bloodstream infection.

Objective:To examine the short-term outcomes of modified load-sharing rip-stop repair (mLSRS) and suture-bridge repair (SB) for large rotator cuff tear.Methods:The clinical data of patients who underwent shoulder arthroscopy for large rotator cuff repair at Department of Orthopedic, China Academy of Chinese Medical Sciences Wang Jing Hospital from January 2017 to December 2018 were collected. Totally 111 patients (39 in mLSRS group and 72 in SB group) were included in the study. There were 45 males and 66 females, aged (58.0±6.9)years (range: 40 to 72 years).A total of 39 pairs of patients were successfully matched by propensity score matching. The pain of shoulder joint was assessed by visual analogy score (VAS) , the shoulder function was assessed by Constant-Murley score, the abduction strength of bilateral shoulder joint was assessed by 90? force assessment method of upper limb on the plane of scapula, and the healing of rotator cuff on the operative side was assessed by sugaya ultrasonic classification standard. The difference of short-term outcome between the two groups were compared using t test, χ 2 test, Mann-Whitney U test, repeated measures design anova and multivariate analysis of variance. Results:At the 4th week after surgery, the VAS of mLSRS group was significantly lower than SB group(1 (2) vs. 2 (2) , F=5.32, P=0.02). One year after surgery, Constant-Murley score of two groups were significantly higher than those before surgery, but there was no significant difference between two groups(89.1±5.7 vs. 87.6±7.3, t=1.00, P=0.32). Abductor strength of affected limbs were lower than that of the opposite side, but there were no statistically significant differences between two groups(4.28±1.61 vs. 4.54±1.64, t=-0.70, P=0.49). According to the Sugaya classification, 32 cases in mLSRS group were healed while 7 cases were not healed,30 cases in SB group were healed while 9 cases were not healed(χ 2=0.32, P=0.58). Conclusion:The use of mLSRS fixation construct on large rotator cuff tear can reduce pain and the short-term outcome is reliable.

Objective:To examine the short-term outcomes of modified load-sharing rip-stop repair (mLSRS) and suture-bridge repair (SB) for large rotator cuff tear.Methods:The clinical data of patients who underwent shoulder arthroscopy for large rotator cuff repair at Department of Orthopedic, China Academy of Chinese Medical Sciences Wang Jing Hospital from January 2017 to December 2018 were collected. Totally 111 patients (39 in mLSRS group and 72 in SB group) were included in the study. There were 45 males and 66 females, aged (58.0±6.9)years (range: 40 to 72 years).A total of 39 pairs of patients were successfully matched by propensity score matching. The pain of shoulder joint was assessed by visual analogy score (VAS) , the shoulder function was assessed by Constant-Murley score, the abduction strength of bilateral shoulder joint was assessed by 90? force assessment method of upper limb on the plane of scapula, and the healing of rotator cuff on the operative side was assessed by sugaya ultrasonic classification standard. The difference of short-term outcome between the two groups were compared using t test, χ 2 test, Mann-Whitney U test, repeated measures design anova and multivariate analysis of variance. Results:At the 4th week after surgery, the VAS of mLSRS group was significantly lower than SB group(1 (2) vs. 2 (2) , F=5.32, P=0.02). One year after surgery, Constant-Murley score of two groups were significantly higher than those before surgery, but there was no significant difference between two groups(89.1±5.7 vs. 87.6±7.3, t=1.00, P=0.32). Abductor strength of affected limbs were lower than that of the opposite side, but there were no statistically significant differences between two groups(4.28±1.61 vs. 4.54±1.64, t=-0.70, P=0.49). According to the Sugaya classification, 32 cases in mLSRS group were healed while 7 cases were not healed,30 cases in SB group were healed while 9 cases were not healed(χ 2=0.32, P=0.58). Conclusion:The use of mLSRS fixation construct on large rotator cuff tear can reduce pain and the short-term outcome is reliable.