Aim To investigate the effect of rapamycin on proliferation, migration, and invasion of squamous cell carcinoma A431 cells in vitro. Methods Human squamous cell carcinoma A431 cells were cultured in vitro. MTT assay was used to investigate proliferation of A431 cells treated by rapamycin at different concentra-tions of (5,10,20 nmol·L-1). Wound healing and transwell assay were performed to detect migration and invasion of A431 cells treated by rapamycin, respec-tively. Reverse transcription PCR ( RT-PCR ) and Western blot were used to determine the expression of the osteopontin ( OPN ) in A431 cells at mRNA level and protein level, respectively. Results Rapamycin significantly increased the inhibitory rates of prolifera-tion and inhibited the migration and invasion of A431 cells in vitro. Furthermore, rapamycin treatment re-duced the expression of OPN in A431 cells. Conclu-sions Rapamycin can inhibit the migration and inva-sion of A431 . The intrinsic mechanism of rapamycin might be related to the down-regulation of the OPN ex-pression.

The epidemic of COVID-19 has lasted for nearly a year, the number of confirmed cases worldwide is still rising, and the trend of the epidemic is unclear. How will be the further development of COVID-19 epidemic? What is the current status of research on new drugs for coronary virus disease? Will the vaccine currently used change the epidemic pattern? In the context of the normalization of the epidemic, whether the epidemiology of other respiratory viruses will change? This article will discuss and analyze these hot and difficult issues.

Objective To assess the value of functional magnetic resonance urography (fMRU)for the unilateral renal function in children with hydronephrosis.Methods Fourteen children with congenital hydronephrosis (unilateral hydronephrosis in 1 2 cases,bilateral hydronephrosis in 2 cases)examined by fMRU in Beijing Children′s Hospital,Capital Medical University,were enrolled.In 7 patients of them,diuretic renal scintigraphy (DRS)was per-formed within 1 0 days before fMRU examination.The following parameters in fMRU,as renal parenchymal volume,volu-metric differential renal function (vDRF),Patlak,Patlak differential renal function (pDRF),index of glomerular filtra-tion rate (GFR)and differential renal function based on index of GFR (gDRF),were calculated and analyzed.Statisti-cal analysis was performed by using SPSS 1 3.0.Results In 7 cases whose fMRU and DRS were examined,the indexes of GFR obtained from fMRU and GFR from DRS were well correlated (r =0.892,P <0.001 )in 1 4 kidneys.The gDRF determined by 2 methods on the left kidneys[the average was(46.80 ±1 9.20)% and(45.1 8 ±20.29)%,respective-ly]had no significant difference (t =0.051 6,P =0.624),which was also highly correlated (r =0.91 2,P =0.004). In 1 2 cases with unilateral hydronephrosis,vDRF,pDRF,index of GFR and gDRF in hydronephrotic side[(43.54 ± 9.61 )%,(42.80 ±1 0.83)%,(38.56 ±29.23)mL/min,(38.37 ±1 3.61 )%]were all less than those in the con-tralateral side[(56.46 ±9.61 )%,(57.1 9 ±1 0.83)%,(57.02 ±26.22)mL/min,(61 .63 ±1 3.61 )%](t =2.326, 2.300,2.422,2.960;P =0.040,0.042,0.034,0.01 3).However,there was no statistical difference in both renal pa-renchymal volume and Patlak between the hydronephrotic and the contralateral side kidneys(t =1 .765,1 .450;P =0.1 05,0.1 75).Conclusions fMRU is a very valuable examination method in evaluating single kidney function in children with congenital hydronephrosis,and able to demonstrate that gDRF,indexes of GFR,vDRF and pDRF decrease in the hydronephrotic kidney.

Objective To analyze the clinicopathologic data and operative parameters of 209 elderly co-lon cancer patients treated by radical resection between January 2002 and December 2011 ,and to investigate the factors related to recurrence and metastasis after colon cancer radical resection in elderly patients .Methods We used univariate and multivariate analysis of Cox regression ,including 14 variables:age,gender,disease duration, hospitalization duration,surgeon experience,operation duration,laparoscopicsurgery,tumor location,tumor size, gross morphology ,differentiate degree ,depth of bowel wall invasion ,lymph node involvement and obstruction .The survival curve was obtained by Kaplan -Meier method.Results Univariate analysis showed that tumor size (RR=2.658,P<0.0001),gross morphology(Infiltrating type,RR=3.407,P=0.0054),degree of differentiation (RR=0.32,P<0.0001) were associated with tumor relapse and metastasis .Multivariate analysis showed that gender(RR=0.585,P=0.0359),tumor size(RR=2.364,P<0.0001),degree of differentiation (Infiltrating type,RR=0.246,P=0.0437),gross morphology(RR=0.31,P<0.0001)were the significant factors.Conclu-sion Gender,tumor size,degree of differentiation,gross morphology were the independent factors of recurrence and metastasis of colon cancer after radical resection in elderly patients .Targeted follow -up for high -risk groups will improve patients′life quality and prolong their survival time .

Objective:To explore the influence of rosuvastatin in the lipid levels, atherosclerosis plaque and apoptosis in the plaque of atherosclerotic apolipoprotein E (ApoE)-knockout mouse models, and to clarify the mechanism of rosuvastatin in inhibiting atheromatous plaque and apoptosis in the plaque.Methods:Thirty healthy six-week old male mice were randomly divided into high fat diet group (n=10),rosuvastatin group (n=10)and general diet control group (n=10).The mice in first two groups were fed with high fat diet,and the mice in general diet control group were fed with general diet;4 weeks later the mice in three groups were respectively given 0.9% NaCl solution,rosuvastatin (10 mg·kg·d-1 )and 0.9% NaCl solution by gavage for 8 weeks.And then ELISA was used to detect the serum lipid levels,the area of atherosclerotic plaque was measured by HE staining, and the apoptosis in plaques was detected by TUNEL method;the expression of apoptosis-assoicated gene Bax protein was measured by immunohistochemical staining.Results:Compared with high fat diet group,the levels of total cholesterol (TC)and low density lipoprotein cholesterol (LDL-C)of the mice in rosuvastatin group were significantly decreased (P<0.05 or P<0.01),and the 1evel of high density lipoprotein cholesterol (HDL-C)was significantly increased (P<0.01).The aortic atherosclerotic plaque of the mice in high fat diet group was massive with a great quantity of foam cells, cholesterol crystal, necrotic cells and inflammatory cells in the plaque;the aortic atherosclerotic plaque of the mice in rosuvastatin group was smaller with less foam cells,necrotic cells and inflammatory cells;the aortic atherosclerotic plaque area of the mice in rosuvastatin group was significantly smaller than that in high fat diet group (P<0.01);the apoptotic index in the aortic atherosclerotic plaque of the mice in rosuvastatin group was significantly lower than that in high fat diet group (P<0.01).Compared with high fat diet group,the expression of Bax protein in rosuvastatin group was significantly decreased.Conclusion:Rosuvastatin may inhibit the progression of atherosclerotic plaque and the apoptosis in plaques through mitochondrial pathway.

Objective To analyze the effect of using standardized patient (SP) tutorial in the spe-cialized training of pancreatic surgery with WeChat platform. Methods 48 surgeons participating in resi-dent standardized training in Changhai Hospital (all for postgraduate education) were enrolled as teaching object. 48 surgeons were divided into two groups: SP group (n=24) receiving WeChat combined with SP tutorial which updates learning plan, learning contents, and clinical discussion by Wechat platform and performs practical teaching by SP method, control group (n=24) receiving traditional tutorial by using tradi-tional clinical teaching methods and video teaching followed by practical teaching. The theoretical exami-nation, questionnaires and expert assessment were used to evaluate the effect of the two teaching methods. Statistical analysis was performed using the SPSS 19.0. Continuous data were expressed as median±stan-dard deviation and compared using the Student's t-test. Categorical data were compared using the Pearson's chi-square test. Results The score of theoretical examination of the two groups showed no significant difference [(85.5±7.6) vs. (81.4±14.9), P=0.238]. The results of questionnaires and expert assessment in WeChat&SP group were significantly better than those in the control group (P<0.001) other than theoretical and analytical ability (P>0.05). Conclusion WeChat platform combined with standardized patient tutorial in the specialized training of pancreatic surgery is feasible and more effective than traditional tutorial to improve teaching effectiveness.

Objective To investigate the utility of plasma procalcitonin (PCT) as an early predictor for postoperative complications in patients who underwent elective pancreaticoduodenectomy (PD).Methods Clinical data of 87 patients who underwent elective PD in Changhai Hospital from March.1, 2016 to Dec.31, 2016 were collected.The general data, postoperative recovery, serum PCT level and white blood cell (WBC) count before, 1 d, 3 d and 5 d after PD were recorded.ROC curve was drawn and AUC was calculated to determine the cutoff value, sensitivity and specificity.Patients were divided into complication group (n=42) and noncomplication group (n=45) based on the occurrence of post-operative complications, and the comparisons between the two groups were performed.Results There were no significant differences on the age, gender, diabetes, obstructive jaundice, laboratory tests including PCT, operative time, blood loss volume during surgery and tumor type between the two groups, which were comparable.Complication group had longer hospitalization than noncomplication group (24 d vs 15 d,P<0.001), and the differences were statistically significant.In complication group, 18 patients had pancreatic fistula, 13 had peritoneal infection, 7 had gastric empty dysfunction, 8 had bleeding, 2 had bile fistula and 2 had incision infection after PD.The postoperative plasma PCT level in patients with gastric empty dysfunction, bleeding, bile fistula and incision infection was not statistically different from those in noncomplication group (all P>0.05), but the plasma PCT level in patients with pancreatic fistula and peritoneal infection on 3 d and 5 d after PD was significantly higher than those in noncomplication group, and the difference was statistically significant (all P<0.05).The combination of plasma PCT and WBC on 3 d and 5 d after PD was superior to PCT or WBC alone in predicting pancreatic fistula (sensitivity 88.9%, 72.7%;specificity 68.5%, 78.2%) and abdominal infection (sensitivity 100%, 100%;specificity 45.9%, 44.4%).Conclusions Plasma PCT could predict the occurrence of abdominal infection and pancreatic fistula after PD.The combination of PCT and WBC might be more valuable in predicting abdominal infection and pancreatic fistula.

Objective:To assess the left ventricular (LV) myocardial mechanical dysfunction in patients with cirrhosis using ultrasonic layer-specific strain imaging and to explore its value in clinical application.Methods:A total of 80 consecutive cirrhosis patients without cardiovascular diseases were prospectively enrolled from October 2020 to March 2021 in Sichuan Provincial People′s Hospital, 39 of whom were assigned to the compensated group and 41 were assigned to the decompensated group according to the occurrence of portal hypertension. Forty-three healthy volunteers during the same period were randomly recruited as the control group. Transthoracic echocardiography was performed to assess the LV configuration and functional parameters. LV global longitudinal strain in endocardial, middle and epicardial myocardium (GLSendo, GLSmid, GLSepi), and longitudinal strain (LS) in basal, middle and apical segments, and peak strain dispersion (PSD) were obtained using ultrasonic layer-specific strain imaging. ΔLS was calculated by the formula of GLSendo-GLSepi. Then, the differences of related parameters among three groups were compared.Results:①Conventional echocardiography: compared with the control group, the interventricular septum end-diastolic thickness (IVSTd), left ventricular posterior wall end-diastolic thickness (LVPWd), left ventricular mass (LVM) and LVM index (LVMI) were increased in compensated and decompensated groups (all P<0.05), while no significant differences in conventional echocardiographic parameters were identified between the two cirrhosis groups (all P>0.05). ②Global layer-specific strain: compared with the control group, GLSendo, GLSmid, GLSepi and ΔLS were decreased and PSD was increased in compensated and decompensated groups (all P<0.05); Moreover, the decompensated group showed a more impaired GLSendo, GLSmid and GLSepi than compensated group (all P<0.05), whereas there were no significant differences of ΔLS and PSD between the two groups(all P>0.05). ③Segmental layer-specific strain: compared with the control group, LS values of three layers in compensated and decompensated groups were reduced at basal, middle and apical levels (all P<0.05); Compared with the compensated group, LS values of three layers in decompensated group tended to be reduced at above there levels, but only apical segments had significant differences (all P<0.05). Conclusions:There are different degrees of LV mechanical dysfunction in patients with variable severity of cirrhosis. Ultrasonic layer-specific strain imaging has the potential to quantitatively assess the state of cardiac involvement in patients with cirrhosis and to provide visual evidence for the early and accurate diagnosis of myocardial injuries.

Objective To reveal the early elastic dysfunction of common carotid artery may have occurred in systemic lupus erythematosus( SLE) patients ,the circumferential strain parameters of common carotid artery intima in SLE patients at different serum complement levels were quantitatively evaluated by layer-specific strain imaging . Methods Seventy-two patients suffered from SLE without evidence of atherosclerosis were enrolled ,and the results of laboratory examination of serum complement C 3 in patients with SLE were recorded in detail ,49 cases of SLE patients whose serum C3 was lower than the normal reference range(SLE C3+ group) ,23 cases of SLE patients whose serum C3 was in the range of normal reference value(SLE C3 - group) . And a matched healthy control group ( n =38) were selected . Carotid ultrasound were performed in all three groups ,and the common carotid artery conventional parameters ,such as common carotid artery intima-media thickness ( CCA-IM T ) ,peak systolic velocity ( PSV ) ,end-diastolic velocity(EDV) ,resistance index(RI) and circumferential strain related parameters ,such as circumferential strain of common carotid artery intima(CSendo) and circumferential strain rate(CSr) were measured and derived.Therelatedparametersamongthosegroupswerecomparedfordifference.Results ①Therewas no significant difference in RI among the three groups(all P >0 .05) . The values of CCA-IMT in the SLE C3+ group and SLE C3- group were larger than that in the control group( all P <0 .05) . ②The values of CSendo and CSr in the SLE C3+ group and SLE C3 - group were lower than those in the control group ,the values of SLE C3+ group were significantly lower than those in the control group ( P <0 .001) ,and there was no significant difference between the SLE C3- group and control group( P >0 .05) . ③The CSendo and CSr in the SLE C3+ group were lower than those in the SLE C3- group(all P < 0 .05) . Conclusions CSendo which is provided by new ultrasonic technology of layer-specific strain combined with recent changes in serum complement C3 may provide visual evidence for assessing early elastic disfunction of carotid intima in SLE patients .

Objective To evaluate the transmural myocardial strain in three specific layers of the left ventricle at the papillary muscle level in short-axis view in SD rats before and after doxorubicin administration usmg myocardial layer-specific strain imaging based on two-dimensional ultrasound speckle tracking imaging (2D-STI),and to demonstrate the myocardial mechanical characteristics of doxorubicininduced early-stage acute cardiac toxicity in rats.Methods Thirty-two SD male rats weighing 300-350 g were randomly divided into a doxorubicin group (DOX group,n=16) and a control group (n=16).In the doxorubicin group,doxorubicin hydrochloride (concentration,2 mg/ml) was injected intraperitoneally at a single dose of 12 mg/kg,while the control group was given equal volume of 0.9％ sodium chloride solution.LVEDD,LVESD,IVSd,LVPWd,FS,and LVEF were measured and derived using two-dimensional gray-scale echocardiography at the left ventricular papillary muscle level in short-axis view at three time points (before administration and 24 and 48 hours after administration).The circumferential strain in the subendocardium,medium,and subepicardium at the left ventricular papillary muscle level in short-axis view were obtained using ultrasonic 2D-STI.The values of FS,LVEF,and the global myocardial circumferential strain in different layers of the left ventricular wall at the papillary muscle level in short axis view at three time points were compared between the two groups.After echocardiographic examinations at 48 h and 72 h,the hearts of three rats in each group were randomly selected,sliced,and HE-stained for myocardial pathological observation.Results In both groups,there was a circumferential strain gradient of the left ventricular wall at the papillary muscle level in the short-axis view:subendocardium ＞ medium ＞ epicardial myocardium.In the DOX group,the circumferential strain in the subendocardial myocardium decreased at 48 hours after DOX administration;the difference was statistically significant between the two groups (-25.13± 10.6 vs -17.04± 2.89,t=2.3,P ＜ 0.05).There was no significant difference in myocardial circumference strain in the three layers,as well as LVEDD,LVESD,IVS,LVPW,FS,or LVEF at three time points between the control group and DOX group (P ＞ 0.05).The pathological changes were mainly myocardial cell edema,vascular degeneration,myocardial nucleus atrophy,dissolution,interstitial edema,and capillary dilatation in the doxorubicin group,which were especially obvious in subendocardial cardiomyocytes.Conclusion 2D-STI technology based layer-specific strain imaging could be used to detect and quantitatively evaluate the deformation damage of the transmural left ventricular wall in SD rats.