Objective To study the expression of HIF-1αand and its correlation with gastric cancer recurrence, and to identify its prog-nosis evaluation in gastric cancer recurrence. Methods 80 patients with gastric cancer recurrence after radical surgery were selected as the observation group, and 50 patients without gastric cancer recurrence 5 or more than 5 years after surgery were selected as the control group. The immunohistochemical situation and expression of VEGF of the two groups were compared, and the correlation of HIF-1αand VEGF and gastric cancer recurrence were analyzed. Results The positive expression rate of HIF-1αand VEGF were 77. 50% and 73. 75% respectively in the observation group, which were significantly higher than 12. 00% and 10. 00% in the control group. Univariate analysis showed that the related indices such as degree of differentiation, depth of invasion, lymph node metastasis, vascular invasion, and TNM clinical stage were associated with VEGF expression and positive expression of HIF-1α. The Spearman correlation analysis showed that HIF-1α and VEGF was positively correlated (r=0. 458,P=0. 000). 1-year survival rate of HIF-1α-positive group was 45. 16%, and the average survival time was (8. 62 ± 2. 32) months, which was significantly lower than 77. 77% and (18. 96 ± 3. 14) months respectively in the negative group. Cox risk model analysis showed that HIF-1αand VEGF expression were high risk factors for gastric cancer recurrence. Conclusion HIF-1αand VEGF expression have a very colse correlation with gastric cancer recurrence, and it can be used as evaluation of gastric cancer recurrence and prognosis.

Objective To evaluate the clinical outcomes of lumbopelvic fixation of vertically unstable Tile type C pelvic fractures combined with complex sacral fractures.Methods A prospective study was made on 21 cases of vertically unstable type C pelvic fractures combined with complex sacral fractures admitted between May 2014 and December 2015.There were 10 males and 11 females, with a mean age of 35.9 years (range, 14-59 years).Tile classification of pelvic fractures was type C1 in five cases, type C2 in four and type C3 in 12.Denis classification of sacral fractures was zone I in five cases, zone Ⅱ in seven and zone Ⅲ in nine.Twelve cases had neurological deficits.Operation time, intraoperative blood loss, bone healing time, pelvis vertical displacement and postoperative complications were recorded.Vertical displacement and functional outcome were assessed by Matta method and Majeed score respectively.Results All cases were followed up for (12.5±5.4)months (range, 7-26 months).Operation time was (108.0±49.4) min (range, 64-225 min).Intraoperative blood loss was 150-3 000 ml[400(225-500)ml].All fractures were healed at (19.0±4.6) weeks (range, 15-32 weeks).Vertical displacement of the pelvis was (8.76±5.46)mm (2.54-21.80 mm) before operation and (4.20±3.22)mm (0-12.57 mm) after lumbopelvic fixation (P<0.05), showing the reduction distance of-4.45-17.86 mm [4.09(1.74-5.58)mm].According to the Matta method, the results were excellent in 13 cases, good in six, and fair in two, with the excellent and good rate of 90%.Majeed score evaluation at last follow-up was 51-98 points and the results were excellent in nine cases, good in nine, fair in two and poor in one, with the excellent and good rate of 86%.Deep infection occurred in two cases who were cured by debridement and antibiotics, and the internal instruments of the two cases were removed after fracture healing.Screw loosening occurred in five cases with no evidence of screw breakage.Four cases complained of foreign body sensation and discomfort in sacral area due to the prominence of the iliac hardware.Four cases had limited range of motion of the lumbar spine, especially in anterior flexion range, and lumbar range of motion was recovered in three of them after removal of the internal fixator.Conclusion Lumbopelvic fixation can restore vertical stability of the pelvis, but removal of the internal fixator is suggested after fracture healing due to the high rate of screw loosening.

Objective The present research aimed to explore the relationship of serum CA19-9,CEA,CA125 and sICAM-1 concentration with the diagnosis valuation and tumor metastasis of pancreatic cancer.Methods Ninety pancreatic cancer patients in First Affiliated Hospital of Hebei North University from January 2014 to December 2016 were enrolled in this study.The concentrations of serum CA19-9,CEA,CA125 and sICAM-1 were assayed in different stage of pancreatic cancer patients.The concentrations of these parameters were also detected in metastasis patients and non-metastasis patients.In the same period,90 cases of health examination as contrd group.Measurement data were represented as ~ ± s.Comparison between groups was analyed using t test.single-factor analysis of variance (ANOVA) was used for comparison among groups,and the resuhs were compared by F test.The correlation analysis was performed by spearman method.Results The results showed that CA19-9/ β-actin (control group and Ⅰ / Ⅱ / Ⅲ/Ⅳ stage pancreatic cancer were 0.25 ± 0.03,0.27 ± 0.04,0.31 ± 0.06,0.38 ± 0.09,0.68 ± 0.10,respectively),CEA/β-actin (control group and Ⅰ / Ⅱ / Ⅲ/Ⅳ stage pancreatic cancer were 0.29 ±0.07,0.34 ±0.08,0.47 ±0.09,0.58 ±0.12,0.68 ±0.14,respectively),CA125/β-actin(control group and Ⅰ/Ⅱ/Ⅲ/Ⅳ stage pancreatic cancer were 0.31 ±0.05,0.36 ±0.07,0.55 ±0.13,0.58 ±0.14,0.63 ± 0.14,respectively),sICAM-1/β-actin (control group and Ⅰ/Ⅱ/ Ⅲ /Ⅳ stage pancreatic cancer were 0.34 ± 0.05,0.36 ± 0.08,0.41 ± 0.08,0.49 ± 0.10,0.58 ± 0.12,respectively) were higher in pancreatic cancer than control(P ＜0.05).The tumor metastasis group was higher than tumor un-metastasis group CA19-9/β-actin(un-metastasis group and metastasis group was 0.36 ± 0.09,0.58 ± 0.12),CEA/β-actin (un-metastasis group and metastasis group was 0.42 ± 0.09,0.61 ± 0.14),CA125/β-actin (un-metastasis group and metastasis group was 0.48 ± 0.09,0.60 ± 0.14),sICAM-1/β-actin (un-metastasis group and metastasis group was 0.42 ±0.09,0.52 ± 0.10) (P ＜ 0.05).The results showed that CA19-9,CEA,CA125 and sICAM-1 concentrations are positively (r value were 0.832,0.698,0.748 and 0.845) with the metastasis of pancreatic cancer patients while negatively with the prognosis (r value were-0.867,-0.832,-0.916 and-0.908) and clinical stage (r value were-0.815,-0.896,-0.798,and0.912) of pancreatic cancer patients.Conclusion CA19-9,CEA,CA125 and sICAM-1 concentrations are positively related with the metastasis of pancreatic cancer patients while negatively with the clinical stage and prognosis of pancreatic cancer patients.

Objective To study the value of CA19-9,s-ULBP2 and Dkk1 in the diagnosis of pancreatic cancer and the correlation. Methods From January 2016 to May 2017,56 patients with pancreatic cancer in our hospital were selected,45 healthy subjectsand 33 patients with benign pancreatic diseaseswere enrolled in this study.The differences of serum CA19-9,Dkk1 and s-ULBP2 expression and their relationship with clinicopatholog-ical parameters were compared between the three groups. The diagnostic value of CA19-9,s-ULBP2,Dkk1 and joint detection was analyzed.Results The serum levels of CA19-9,s-ULBP2 and Dkk1 in patients with pancreat-ic cancer were significantly higher than those in the benign pancreatic disease group and the healthy control group (P<0.05).CA19-9 and s-ULBP2 are related to TNM staging and histological differentiation,and CA19-9 is also related to tumor location.Joint test was higher than any of the individual indicators.Conclusion CA19-9,s-ULBP2 and Dkk1 are closely related to pancreatic cancer,and the combined detection of the three can improve the diag-nostic accuracy of pancreatic cancer.

Objective:The effect of bone marrow soluble B cell maturation antigen (sBCMA) expression on the efficacy and side effects of chimeric antigen receptor (CAR) -modified T-cell-targeting B cell maturation antigen (BCMA) in patients with multiple myeloma (MM) .Methods:This study involved 29 patients with relapsed or refractory MM (RRMM) who received humanized anti-BCMA CAR-T cell clinical trials from January 2018 to December 2021. The expression of sBCMA in bone marrow before and after anti-BCMA CAR-T cell treatment was detected by flow cytometry and compared.Results:①Two months after BCMA CAR-T cell treatment, 20 patients (68.97%) achieved an overall response (OR), whereas nine patients had stable disease (SD) or miner emission (MR). ②The expression of sBCMA in the bone marrow of 20 patients with OR was higher before treatment than after [26 926 (18 215, 32 488) ng/L vs 9 968 (6 634, 11 459) ng/L; P<0.001]; no significant difference was observed in patients with MR and SD [41 187 (33 816, 47 046) ng/L vs. 33 954 (31 569, 36 256) ng/L; P=0.145]; sBCMA expression in patients with OR before CAR-T cell treatment was lower than in patients with MR and SD ( P=0.005). ③No significant linear correlation was found between the peak value of CAR-T cells and sBCMA expression in the bone marrow of all 29 patients with RRMM ( R2=0.035, P=0.330). ④No significant difference in sBCMA expression was found between grades 0-1 CRS group (13 patients) and grades 2-4 CRS group [16 patients; 32 045 (18 742, 40 801) ng/L vs 29 102 (24 679, 38 776) ng/L, P=0.879], nor between grade 0 ICANS group (22 patients) and grade 1-3 ICANS group [seven patients; 30 073 (19 375, 40 065) ng/L vs 33 816 (22 933, 43 459) ng/L, P=0.763]. Conclusion:sBCMA expression in the bone marrow is related to the efficacy of BCMA CAR-T cell therapy in patients with RRMM, but is not significantly correlated with the severity of adverse events. It may serve as a predictive biomarker for the efficacy of BCMA CAR-T cell therapy in these patients.

Objective To compare the dose difference between the 12-bit and 16-bit CT images containing metallic implants calculated by different algorithms. Methods The titanium alloy rod was inserted into the phantom and subject to CT scan and then the 12-bit and 16-bit CT images were reconstructed. The CT images were online transmitted to the Monaco planning system and a 0° of single field was designed. The dose distribution was calculated by PB (Pencil Beam), CC (Collapsed Cone) and MC (Monte Carlo) algorithms, respectively. The CT-ED curve was expanded and the dose was recalculated. The depth dose curve through the center of the metallic implants along with the direction of the field was obtained by using the Matlab 8. 3 statistical software. The dose distribution curves between 12-bit and 16-bit CT images calculated by different algorithms and the dose difference of varying distances between the incident and the exit surfaces of metallic implants were statistically compared. The dose was measured by thimble chamber. Results The 16-bit CT images accurately read the CT values of the metallic implants. After the CT-ED curve was expanded, the dose on the incident surface of metallic implant was reduced by 5. 43% and that on the exit surface was increased by 25. 56% calculated by PB algorithm compared with MC algorithm. The dose on the posterior exit surface was higher than that of MC algorithm. The dose on the incident surface of metallic surface was decreased by 4. 5%, whereas that on the exit surface was reduced by 4. 31% using CC algorithm. The dose on the posterior exit surface was more significantly reduced. The calculated values by MC algorithm were the most close to the measured values. Conclusions Application of 16-bit CT image, CT-ED curve expansion of the treatment planning system combined with MC algorithm can enhance the accuracy of dose calculation for the patients containing metallic implants during radiotherapy.

"Toxicity Testing in the 21st Century—A Vision and Strategy"proposed by the National Research Council of US has brought innovative directives and objectives for toxicity evaluation and risk assessment,pushing forward the next generation of toxicity testing and risk assessment.In this initiative,the concept of adverse outcome pathways(AOPs)has emerged as a prominent methodology,capturing the attention of toxicologists and researchers due to its promising applications in recent years.The quantitative AOP(qAOP)is an extension of the adverse outcome pathway,which is built upon the foundational qualitative adverse outcome pathway model and leverages mathematical frame-works to depict dose-response and/or response-response relationships.This article reviews the princi-ples and advancement surrounding qAOP,introduceds two prevalent methodologies for constructing qAOP,Bayesian network models and regression models,and demonstrates diverse applications of qAOP.Actual cases are used to underscore the transformative role of qAOP in contemporary toxicology and risk assessment practices.

Tumor-associated macrophages(TAMs)are the predominant cell group in the tumor microenvironment(TME)and are the most important regulatory cells of immune system suppression and tumor cell proliferation in TIME.Src homology-2 domain-containing protein tyrosine phosphatase 2(SHP-2)is a non-receptor protein tyrosine phosphatase that plays an important role in the transmission of signals from the cell surface to the nucleus.SHP-2 is a key intracellular regulatory factor mediating cell proliferation and differentiation and is involved in a variety of growth factor and cytokine signaling pathways linking the cell surface to the nucleus.Recent studies have shown that SHP-2 is a key enzyme in determining the function of TAMs,but because of its variable function,it plays different or even opposite roles in different solid TMEs.This paper reviews the function of SHP-2 in TAMs and related solid tumors to provide a comprehensive reference for tumor immunity and targeted therapy research.

OBJECTIVETo evaluate the influence of extreme ambient temperature on mortality and years of life lost (YLL) in Chongqing.

METHODSThe daily mortality, meteorology and air pollution index data in Chongqing from the 1(st) January 2010 to the 31(st) December 2013 were collected. Distributed lag non-linear model (DLNM) was used to assess the influence of daily ambient temperature on daily number of deaths and daily YLL respectively. The delayed and cumulative effects of extreme temperature on sex, age, and cause-specific mortality were also assessed.

RESULTSThe relationships between ambient temperature and non-accidental, cardiovascular disease and respiratory disease mortalities and YLL were U-shaped or W-shaped. The effect of heat was obvious on that day, peaked on day 7, and lasted for two weeks, whereas the effect of cold was obvious a week later and lasted for a month. As 1 ℃ increase of ambient temperature, the cumulative relative risks (CRR) of high temperature across lag 0-7 days on non-accidental, respiratory disease and cardiovascular disease mortalities were 1.05 (95%CI: 1.03-1.07), 1.08 (95%CI: 1.05-1.11) and 1.05 (95%CI: 1.01-1.09) respectively. The effects of heat on YLL for each cause were 23.81 (95%CI: 12.31-35.31), 14.34 (95%CI: 8.98-19.70) and 4.43 (95%CI: 1.64-7.21), respectively. On cold days, 1 ℃ decrease of ambient temperature was correlated with an increase in CRR of 1.06 (95%CI: 1.04-1.08), 1.09 (95%CI:1.06-1.12) and 1.06 (95%CI: 1.02-1.11) from lag 0 to 14 for non-accidental, respiratory disease and cardiovascular disease mortalities, respectively. The estimated YLL were 23.34 (95%CI: 10.04-36.64), 16.39 (95%CI: 10.19-22.59) and 2.61 (95%CI: -0.61-5.82). People aged ≥65 years tend to have higher CRR and YLL than those aged <65 years. On high temperature days, the CRR in women was higher than that in men, while the YLL in women was lower than that in men. On low temperature days, both the CRR and YLL in women were higher than those in men.

CONCLUSIONSBoth high and low ambient temperature have adverse health effects. People aged ≥65 years are more sensitive to both high and low ambient temperature. Younger men are more sensitive to high ambient temperature and women and elder men are sensitive to low ambient temperature. It is necessary to take targeted measures to protect the population in Chongqing from the adverse influence of extreme ambient temperature.

Adult ; Aged ; Cardiovascular Diseases ; mortality ; China ; epidemiology ; Cold Temperature ; adverse effects ; Female ; Hot Temperature ; adverse effects ; Humans ; Life Expectancy ; trends ; Male ; Mortality ; trends ; Nonlinear Dynamics ; Respiratory Tract Diseases ; mortality ; Temperature