Objective To investigate the effect of CKLF-like MARVEL transmembrane domain contai-ning member 5(CMTM 5)on EG-VEGF expression in prostate cancer cells , and to detect the potential mechanism of CMTM5 inhibiting prostate cancer .Methods The relative expression of CMTM 5 and EG-VEGF in prostate cells and prostate cancer cells was detected .Prostate cancer cells were given Plasmid transfection to overexpress CMTM5 and EG-VEGF expression was again detected .Then CMTM5 and EG-VEGF were compared between be-fore and after CMTM5 plasmid transfecting prostate cancer cells .Results Compared with the relative expresion of EG-VEGF and CMTM5 in prostate cells , prostate cancer cells showed high expression of EG-VEGF and low ex-pression of CMTM5, which were statistically significant , P<0.05.Compared with prostate cancer cells , the rela-tive expression of CMTM5 were obviously upregulated and EG-VEGF obviously decreased in prostate cancer cell after transfected by CMTM5 plasmid, which were statistically significant , P<0.05.Conclusions Prostate canc-er cells shows higher EG-VEGF expression and lower CMTM 5 campared with normal prostate cells .EG-VEGF is suppressed significantly when the prostate cancer cell is transfected by CMTM 5 plasmid and shows highlevel of CMTM5 expression , suggesting high expression of CMTM 5 may inhibit the development of prostate cancer by downregulating EG-VEGF expression .

Objective: To determine anti oxygen free radical (anti OFR) function in each herb of Kangqianling Granules and its compound prescription. Method:The anti OFR function in herbs was tested in vitro by means of chemical luminescence .Results: The anti OFR functions of Radix et Rhizoma Rhei and Radix Salviae Miltiorrhizae are the best, other herbs also have a bit of effects.Conclusion: Kangqianling Granules retarding CRF's course can be related to it’s anti OFR function.

Objective:To analyze the risk factors and clinical characteristics of liver injury in patients with sepsis and to provide a reference for early recognition, early diagnosis, early intervention, and improve the survival rate of patients.Methods:The clinical data of sepsis patients admitted to the department of general intensive care unit (ICU) of the Second Affiliated Hospital of Zhejiang University School of Medicine from July 2014 to October 2020 were retrospectively analyzed. According to the occurrence of acute liver injury, patients with sepsis were divided into the liver injury group and the non-liver injury group, and the differences of demographic data, history, history of primary diseases, laboratory indicators on the first time of admission, treatments, the severity of the disease and other indicators were compared and analyzed. Logistic regression was used to analyze the risk factors for sepsis-related liver injury.Results:A total of 527 patients with sepsis were enrolled, and 129 patients with acute liver injury, accounting for 24.48%. Compared with the non-liver injury group, acute physiology and chronic health evaluation Ⅱ (APACHEⅡ), sequential organ failure assessment (SOFA), pro-brain natriuretic peptide (pro-BNP), serum MB isoenzyme of creatine kinase (CK-MB), total bile acid (TBA), serum creatinine (SCr), blood urea nitrogen (BUN), lactic acid (Lac), lactate dehydrogenase (LDH), C-reactive protein (CRP), procalcitonin (PCT) in liver injury group were significantly increased [APACHEⅡ score: 23.00±10.40 vs. 16.10±8.10, SOFA score: 9.17±4.29 vs. 5.90±3.12, pro-BNP (ng/L): 5 500.0 (1 166.0, 16 865.0) vs. 1 377.2 (448.8, 6 136.5), CK-MB (U/L): 23.0 (13.0, 55.0) vs. 18.0 (13.0, 31.0), TBA (μmol/L): 5.0 (2.4, 12.9) vs. 2.6 (1.4, 4.9), SCr (μmol/L): 146.0 (75.0, 222.0) vs. 71.0 (52.0, 125.8), BUN (mmol/L): 13.4 (8.8, 20.2) vs. 7.9 (4.9, 11.6), Lac (mmol/L): 2.0 (1.4, 4.4) vs. 1.4 (1.0, 2.2), LDH (μmol·s -1·L -1): 6.43 (3.76, 11.99) vs. 4.55 (3.38, 6.63), CRP (mg/L): 113.0 (61.8, 201.0) vs. 95.0 (37.3, 170.1), PCT (μg/L): 3.8 (1.0, 23.3) vs. 0.8 (0.2, 6.4)], prothrombin time (PT), international standard ratio (INR) and activated partial thrombin time (APTT) were significantly longer [PT (s): 19.4±7.6 vs. 16.0±4.0, INR: 1.7±1.0 vs. 1.3±0.5, APTT (s): 54.0±25.8 vs. 44.1±15.1], plasma fibrinogen (FIB), platelet count (PLT), albumin (ALB), and cholesterol (CHOL) were decreased [FIB (g/L): 4.2±2.3 vs. 4.9±1.8, PLT (×10 9/L): 116.3±74.3 vs. 182.7±108.6, ALB (g/L): 25.4±5.5 vs. 27.6±5.5, CHOL (mmol/L): 2.5±1.2 vs. 3.2±1.3], the probability of shock was significantly increased (91.47% vs. 59.19%), and the duration of shock was prolonged [days: 5.0 (2.0, 9.0) vs. 1.0 (0.0, 3.0)], positive rate of microbial culture (81.40% vs. 71.11%), probability of occurrence of drug-resistant bacteria (67.44% vs. 47.99%) were significantly higher, mechanical ventilation time [days: 6.0 (2.0, 12.7) vs. 2.4 (0.0, 6.9)], continuous renal replacement therapy (CRRT) time [days: 1.2 (0.0, 5.0) vs. 0.0 (0.0, 0.0)], the length of intensive care unit (ICU) stay [days: 9.0 (5.0, 18.0) vs. 7.0 (3.0, 13.0)] were significantly longer, 28-day mortality was significantly higher (80.62% vs. 28.89%), and the differences were statistically significant (all P < 0.05). Further Logistic regression analysis showed that PLT decline, PT prolongation, CRRT duration, shock duration and 28-day mortality were correlated with sepsis-related liver injury [odds ratios ( OR) and 95% confidence interval (95% CI) were 0.992 (0.987-0.998), 3.103 (1.507-6.387), 1.198 (1.074-1.336), 1.196 (1.049-1.362), and 0.213 (0.072-0.633), respectively, all P < 0.05]. Conclusions:Prolonged PT and decreased PLT are independent risk factors for sepsis complicated with liver injury. The long duration of CRRT, long duration of shock, and high mortality are independent clinical characteristics of patients with sepsis-related liver injury.

Objective To evaluate antimicrobial effect and mechanism of meropenem in the model of PA infection by C.elegans.Methods To evaluate drug effects of PA infection with caenorhabditis elegans by different concentrations of culture medium, determinate the lethal rate of C.elegans.Western blot detected mitogen activated protein kinase ( Mitogen-activated protein kinase MAPK ) activity change, and PCR detected antimicrobial peptide genes expression in C.elegans after PA infection,the effect of meropenem on MAPK activity change and antimicrobial peptide genes expression.Results Compared with the control group (OP-50), the death rate of C.elegans in PA infection group changed significantly (P<0.01). Meropenem showed protective effect after C.elegans infection ( P <0.01 ) .Detection of MAPK kinase activity showed that PA infection caused PMK-1 kinase activation, further study showed that antibiotics meropenem did not affect the activation of PMK-1 kinase (no significant difference).C.elegans antimicrobial peptide gene Lys-1, clec-85, F55G11.7, K08D8.5 activity increased in PA infection (P<0.01).Meropenem promoted the expression of the antimicrobial peptide gene increased (P<0.01),with synergistic effects.Conclusion Our results show that a C.elegans pathogenicity model can be applied screening drug susceptible to pathogens infection quickly and easily.

Objective To investigate the learning outcome of clinical scenarios discussion im-plemented in teaching medical students before clinical probation. Methods Using standardized pa-tients (SP) to simulate the clinical common difficult situation, all eight year program clinical medicine students (84) of Grade 2008 who were about to enter the clinical probation were given clinical commu-nication education guidance. Through five classification variables questionnaire and return visit, the teaching effect was evaluate. Epidata 3.0 was used to input data, and the SPSS 15.0 was used to make descriptive analysis of the questionnaire and proportion comparison. Results We found 35.4%(29) and 63.4%(52) of subjects liked and approval this training, respectively;90.2%(74) of the subjects thought the diffi-culty of this train was moderate; 77.3% (65) of subjects believed that it was necessary to set the clinical scenarios discussion before clinical probation. Conclusions The implementation of clinical scenarios discussion before clinical probation was effective on inducing the medical students to pay attention to the doctor-patient communication, and deep thinking about the communication notice mat-ters and cop-ing styles in clinical environment.

BACKGROUND:Posterior stabilized femoral knee prosthesis needs additional condyle osteotomy to accommodate the tibial post and femur fossa structures. Intercondylar fossa on both sides connected at the femoral body with concentrated stress is a place easily affecting fractures. Differences in bone mass between different models of different brands did not have specific data, which was not convenient to select prosthesis for clinicians.
OBJECTIVE: To compare the difference of intercondylar osteotomy data among clinical commonly used posterior stabilized knee prostheses (six imported and domestic brands), and to provide basis for the selection and application of the prostheses.
METHODS:The current commonly used posterior stabilized knee prostheses (six imported and domestic brands) were used, including Zimmer NexGen LPS, Stryker Scrorpio NRG Knee-Flexed, Depuy PFC Sigma, Smith & nephew Genesis-2 PS, United-U1 and Wego GKPS. According to the osteotomy template, the osteotomy-surfaces consisting of femoral condyle starting section and cross section, distal section of femoral condyle, and back-oblique section were identified. The corresponding femoral prosthesis diameter lines included condylar ambilateral and anteroposterior diameters, width and depth of femoral intercondylar fossa. The above data were compared and measured.
RESULTS AND CONCLUSION:The six kinds of knee femoral prostheses were different in ratio of ambilateral diameter and anteroposterior diameter, bone resection of intercondylar fossa, and geometry. Imported prostheses carry shorter diameters in femoral starting and cross sections, so it can catch more posterior condylar osteotomy. With increasing prosthesis sizes, the ratio of bone loss causing by width of intercondylar osteotomy is decreased among six brands. In al sizes, Stryker Scrorpio NRG Knee-Flexed catches shorter width of intercondylar osteotomy. Knee prosthesis osteotomy among six brands is different. The result of this study is not sufficient to evaluate the pros and cons between different prostheses, but as reserving bone is concerned, the design of less intercondylar osteoomy catches more advantages.

Objective To assess the clinical therapeutic effects and safety of Jiangtang Shuxin decoction (JTSXD) on diabetic patients complicated with chronic heart failure (CHF),and to search for its possible function mechanisms.Methods A prospective randomized controlled study was conducted,80 diabetic patients complicated with CHF [New York Heart Association (NYHA) functional class Ⅱ-Ⅲ] admitted into the Department of Traditional Chinese Medicine (TCM) or of Cardiology in Affiliated Hospital of Guangxi Youjiang National Medical College from October 2015 to September 2016 were enrolled,they were assigned to an observation group and a control group by randomized method with a computer,and finally 77 patients (39 cases in observation group and 38 cases in control group) completed this trial.The patients in control group received standardized routine western medical treatment,while the observation group was additionally administered JTSXD (including ingredients:astragalus 15 g,ginseng 10 g,radix ophiopogonis 15 g,radix rehmanniae 15 g,comus 10 g,rhizome coptidis 8 g,peach kernel 10 g,salvia mitiorrhiza 10 g,magnoliaceae 10 g,yam 15 g) on the basis of conventional therapy.The therapeutic course for all the patients in both groups was 2 months.Before and after treatment,the 6-minute walking distance (6MWD) was assessed;the TCM syndrome accumulated scores of the two groups were calculated;the left ventricular end-diastolic volume (LVEDV),the left ventricle ejection fraction (LVEF),the stroke volume (SV),the cardiac output (CO),and the maximum blood flow velocity of early diastolic/atrium late diastolic (E/A) were detected by echocardiography.The serum levels of glycosylated hemoglobin (HbA1c),angiotensin Ⅱ (Ang Ⅱ) and plasma B type brain natriuretic peptide (BNP) were tested with enzyme linked immunosorbent assay (ELISA);the level changes of total cholesterol (TC),triglyeride (TG),high density lipoprotein cholesteral (HDL-C) and low density lipoprotein cholesteral (LDL-C) were observed.Results Compared with the control group,after treatment in the observed group,the TCM syndrome score of palpitation,fatigue and thetotal accumulated score were all obviously decreased (palpitation score:0.9 ± 0.4 vs.1.2 ± 0.8,fatigue score:1.1 ± 0.7 vs.1.7 ± 0.8,total accumulated score:4.8 ± 1.2 vs.8.1 ± 1.8,all P ＜ 0.05);the LVEDV,the serum levels of HbA1c,Ang Ⅱ and BNP were also obviously decreased in the observed group [LVEDV (mL):136.28 ± 17.52 vs.158.82 ± 19.03,HbA1c (％):6.11±0.36 vs.6.89 ±0.32,Ang Ⅱ (ng/L):66.48 ± 17.64 vs.84.55 ± 20.39,BNP (μg/L):138.45 ± 87.55 vs.219.14±88.83,all P ＜ 0.05];The 6MWD,LVEF,SV,CO and E/A were all increased plainly in the observed group [6MWD (m):470.47 ± 79.66 vs.428.46 ± 88.56,LVEF:0.51 ±0.05 vs.0.46 ± 0.04,SV (mL):55.36 ± 2.88 vs.50.32±2.76,CO (L/min):5.74±0.91 vs.4.92±0.74,E/A:1.18±0.27 vs.0.83±0.28,all P ＜ 0.05].The degrees of decreased levels in TC,TG,LDL-C and the degrees of increased levels of HDL-C in observed group were superior to those of the control group,but there were no statistical significant differences (all P ＞ 0.05).Conclusion JTSXD shows good therapeutic effect and safety for treatment of diabetic patients accompanied by CHF (NYHA functional class Ⅱ-Ⅲ),and its mechanisms may be related to its regulation of glucose (reduction of HbA1c level),correction of lipid metabolism disorders,improvement of myocardial energy supply,inhibition of the activation of renin-angiotensin-aldosterone system (RAAS) and the secretion of BNP.

Objective:To evaluate the therapeutic effect of electroacupuncture on acute gastrointestinal injury (AGI) in patients with severe traumatic brain injury (sTBI).Methods:A prospective randomized controlled trial was conducted. 126 consecutively hospitalized patients with AGI after sTBI admitted to intensive care unit (ICU) of the First Affiliated Hospital of Zhejiang University of Traditional Chinese Medicine from January 2018 to December 2019 were enrolled. The patients were divided into observation group and control group by random number table. All the patients of two groups were given conventional treatment of western medicine for consecutive 7 days, including the treatments of primary diseases, indwelling nasogastric tube to extract gastric contents every 6 hours to determine gastric residual volume (GRV). When vital signs were basically stable, enteral nutrition (EN) was implemented and EN feeding amount and speed were adjusted according to GRV. On the basis of conventional western medicine treatment, the observation group was treated with electroacupuncture at Zusanli, Tianshu, Shangjuxu, Xiajuxu and Zhongwan, once in the morning and once in the evening, 30 minutes each time. The gastrointestinal function parameters including intra-abdominal pressure (IAP), serum diamine oxidase (DAO) and gastrointestinal failure (GIF) scores were observed before treatment and at day 3 and day 7 of treatment. The incidence of ICU hospital-acquired pneumonia (HAP-ICU), duration of mechanical ventilation (MV), length of ICU stay, 28-day mortality and adverse reactions of electroacupuncture were also observed in the two groups. Kaplan-Meier method was used for 28-day survival analysis.Results:During the 7-day treatment and observation, 26 cases of 126 patients withdrew from the study, and 100 cases were actually enrolled, 50 cases in the observation group and 50 cases in the control group. IAP and DAO at day 3 of treatment in both groups were significantly lower than those before treatment [control group: IAP (cmH 2O, 1 cmH 2O = 0.098 kPa) was 13.75±2.76 vs. 18.11±3.97, DAO (U/L) was 129.88±24.81 vs. 158.01±22.64; observation group: IAP (cmH 2O) was 13.56±2.19 vs. 18.50±3.54, DAO (U/L) was 129.11±29.32 vs. 159.36±28.65; all P < 0.01]. The gastrointestinal function parameters of the two groups improved gradually with the extension of treatment time, and the IAP, DAO and GIF scores at day 7 of treatment in the observation group were significantly lower than those in the control group [IAP (cmH 2O): 11.28±3.61 vs. 12.68±3.23, DAO (U/L): 49.69±17.56 vs. 57.27±20.15, GIF score: 2.02±0.74 vs. 2.40±0.70, all P < 0.05). The duration of MV and the length of ICU stay in the observation group were significantly shorter than those in the control group [duration of MV (days): 15.72±4.60 vs. 18.08±4.54, length of ICU stay (days): 16.76±4.68 vs. 19.26±5.42, both P < 0.05], and the incidence of ICU-HAP and 28-day mortality were significantly lowered (12.0% vs. 30.0%, 22.0% vs. 32.0%, both P < 0.05). Survival analysis showed that the 28-day cumulative survival rate in the observation group was significantly higher than that in the control group (86.4% vs. 76.1%; Log-Rank test: χ 2 = 37.954, P < 0.001). The patients in the observation group had no significant adverse reaction of electroacupuncture treatment. Conclusion:Electroacupuncture at corresponding acupoints can effectively improve gastrointestinal function in patients with AGI after sTBI, which is beneficial to shortening the length of ICU stay, promoting the recovery of the patients, and reducing the 28-day mortality.

Objective:To establish an early prediction model with multiple indicators to predict the risk of severe acute pancreatitis (SAP) in hyperlipidemic acute pancreatitis (HLAP).Methods:The clinical data of 92 patients with HLAP admitted to the Emergency Department of our hospital from March 2018 to February 2020 were analyzed retrospectively. Among them, 29 cases deteriorated to SAP and 63 cases did not. Univariate analysis was used to screen predictive indicators related to hyperlipidemic severe acute pancreatitis (HL-SAP), and logistic regression analysis was used to screen independent predictive indicators related to HL-SAP. Then a prediction model was established. The area under (AUC) the receiver operating curve (ROC) was used to evaluate the predictive ability of each predictive indicator and the model for HL-SAP. Bootstrap resampling technology was used to validate the predictive ability of the model.Results:Univariate analysis showed that procalcitonin, D-dimer, C-reactive protein, albumin, cholesterol and CT grade had influence on the progression of HLAP to SAP ( P<0.05). Logistic regression analysis showed that D-dimer ( OR=2.112, 95% CI: 1.022-4.366; P<0.05), CT grade ( OR=5.818, 95% CI: 2.481-13.643; P<0.01) and cholesterol ( OR=1.146, 95% CI: 1.004-1.308; P<0.05) were independent risk factor of HL-SAP. The AUC of D-dimer, CT grade, cholesterol and the model were 0.802, 0.875, 0.665 and 0.927, respectively. Internal validation of the predictive ability of the model showed that the C-index was 0.927. Conclusions:In the early phase, application of the prediction model that composes D-dimer, CT grade and cholesterol has a good predictive effect on HL-SAP.

Abnormal iron metabolism mediated by ferritinophagy is one of the most important mechanisms in the occurrence of ferroptosis.The regulatory mechanism of ferritinophagy mainly involves the transcription of NCOA4 and its corresponding protein modifications.Ferroptosis plays an important role in the development of colitis and colitis-associated cancer,and target-oriented regulation of ferroptosis can alleviate colonic inflammatory response and induce the tumor cell death.This article mainly reviewed the regulatory mechanism of NCOA4-mediated ferritinophagy and its progress in colitis and colitis-related cancer,which may provide a new point for the investigation on mechanism of colitis and inflammation-cancer transformation.