Objective To investigate medical students' cognitive status and attitude toward urban-rural integration and to find the influencing factors in an aim to provide information for the process of urban and rural integration.Methods Sampling survey was conducted among the junior students who were major in eight-year clinical medicine,five-year clinical medicine and nursing (undergraduate) with self-made questionnaire.The data entry was done by 19.0 SPSS software and descriptive statistical analysis and ONE-WAY ANOVA were used to do statistical analysis.Results Students who didn't know urban-rural integration accounted for 53.2％,while 80.7％ students supported urban-rural integration.Students' major and residence were two influencing factors of working in the countryside.Conclusion Measures should be taken to raise students' awareness of urban-rural integration based.Targeted measures should be adopted based on students' majors and residences.

Objective To investigate the association between plasma Klotho protein level and lacunar cerebral infarction in the elderly.Methods Eighty eight patients with lacunar cerebral infarction aged over 60 years were selected as the observation group,and 90 age-and gender-matched elderly patients without lacunar infarction as the control group.The protein level of Klotho was tested by enzyme linked immunosorbent assay (ELISA).Klotho protein level was compared between the observation and control groups.The correlation between plasma Klotho level and lacunar infarction in elderly patients was analyzed.Results Compared with the control group,lacunar infarction group showed that Klotho protein level was decreased [(689.4±40.8) ng/L vs.(848.5±38.7) ng/L,P=0.009],and the proportion of patients with hypertension was increased (83.0％ vs.66.7％,P=0.04).There was no significant difference in age,gender,body mass index (BMI),dyslipidemia,diabetes mellitus and coronary heart disease between the two groups.The multivariate logistic regression analysis showed that the low plasma level of Klotho protein and hypertension were identified as the independent risk factors for Lacunar infarction (OR=3.325 and 2.413,P=0.003 and 0.021,respectively).Conclusions Klotho protein level may be associated with lacunar cerebral infarction in elderly people.Monitoring plasma Klotho protein level has an important clinical significance in the prevention,diagnosis and prognosis of lacunar cerebral infarction.

Objective:To study the relationship of macrophage migration inhibitory factor(MIF)/activator protein-1(AP-1)/matrix metalloproteinase-9(MMP-9)expression with inflammatory response and coronary artery lesion(CAL)in Kawasaki disease(KD).Methods:Forty-six children with KD were enrolled as the KD group, and divided into CAL group( n=17)and non-coronary artery lesion(NCAL)group( n=29). Fifteen age-and gender-matched children with lower respiratory infections and twenty children for selective operation were chosen as the control groups.Fluorescence quantitative PCR and Western blot were used to detect c-Jun/c-Fos mRNA and protein expression respectively.Serum levels of MIF/phospho-c-Jun/MMP-9 were measured by ELISA. Results:The c-Jun/c-Fos mRNA and protein expression as well as phospho-c-Jun level increased significantly in acute phase of KD as compared with those in control groups(comparison between groups: c-Jun mRNA: F=654.318, P<0.001; c-Fos mRNA: F=580.998, P<0.001; phospho-c-Jun: F=74.756, P<0.001; all P<0.05), and they were even higher in the CAL group(c-Jun mRNA: t=6.820, P<0.001; c-Fos mRNA: t=8.047, P<0.001; phospho-c-Jun: t=2.361, P=0.029; all P<0.05), then decreased in subacute phase.Serum protein levels of MIF and MMP-9 in acute phase of KD were higher than those of control groups(comparison between groups: MIF: F=104.008, P<0.001; MMP-9: F=182.798, P<0.001), and much higher in CAL group than those in NCAL group(MIF: t=2.163, P=0.043; MMP-9: t=2.104, P=0.048). There were positive correlations among serum MIF, phospho-c-Jun and MMP-9 in acute phase of KD(MIF and phospho-c-Jun: r=0.552, P<0.001; phospho-c-Jun and MMP-9: r=0.731, P<0.001; MIF and MMP-9: r=0.421, P=0.004). Conclusion:MIF/AP-1/MMP-9 signaling pathway may participate in the pathological progress of KD vasculitis and CAL.AP-1 expression and activation level in acute phase may be helpful to assess the inflammatory status and to predict CAL.

Acute promyelocytic leukemia (APL) is a special subtype of acute myeloid leukemia characterized by an increase of abnormal promyelocytic cells, failure of bone marrow hematopoietic function accompanied by the chromosome translocation t (15;17). APL has become one of the best paradigms of successful molecule targeted therapy with the development of treatments; however, the overall survival (OS) of elderly APL patients was not optimistic. The discovery of all-trans retinoic acid, arsenic and new drugs has provided new therapeutic choices for elderly patients with APL. This article reviews the treatment progress of elderly patients with APL.

A case with horizontal and vertical bone deficiency at the maxillary esthetic area is reported.A titanium disk was applied to maintain the space for guided bone regeneration,and ridge splitting and bone compressing technique were used to prepare the site.Finally,the restoration of implant tooth with favorable esthetic outcome was obtained.

Objective To study the expression of zinc finger and BTB domain containing 20 (ZBTB20) in peripheral blood B cells of the patients with systemic lupus erythematosus (SLE),and to investigate its clinical significance in SLE.Methods The ZBTB20 mRNA expression level in peripheral blood CD19+B cells of 36 cases of SLE (SLE group) and 30 healthy controls(control group) was detected by RT-PCR.The ZBTB20 protein level was detected by western blot;the proportion of B cell subset was measured by flow cytometry.Then the relationship between the ZBTB20 mRNA expression with B cells subset proportion change and its correlation with clinical indicators[anti-dsDNA antibody,immunoglobulin G (IgG),anti-nucleosome antibody (ANA) and anti-extractable nuclear antigen (ENA) antibody] in SLE patients were analyzed.Results The expression level of ZBTB20 mRNA in peripheral blood CD19+B cells of the SLE group was significantly higher than that of the control group (P＜0.05).The peripheral blood ZBTB20 protein level was higher than that of the control group (P＜0.05);the peripheral blood B cells subsets and CD19+ B cells proportion in the SLE patients were decreased,while the CD19-CD138+ plasmocytes/CD19+ B cells ratio and CD19-CD138+ plasmocytes proportion were significantly increased (P＜0.05).The expression level of ZBTB20 mRNA in B cells of SLE patients was positively correlated with the ratio of CD19-CD138+ plasmocytes/CD19+ B cells (P＜0.05).The expression of ZBTB20 mRNA was positively correlated with anti-ds-DNA antibody,ANA and anti-ENA antibody (P＜0.05).Conclusion ZBTB20 might participate in the pathogenesis of SLE possibly via promoting B cells differentiation.

Objective: The aim of this review was to identify the possible mechanisms behind cupping therapy by employing an evidence-based approach,and to explore its possible regional and systemic effects in the human body.Methods: We searched six electronic databases and four online trial registries for articles published up to January 1,2020.Clinical studies on the mechanisms of retained cupping,flashing cupping,moving cupping,and vacuum cupping were considered for this review.The methodological qualities of controlled studies were assessed using the National Institute for Clinical Excellence methodology checklist,the Newcastle-Ottawa Scale,and the Cochrane risk of bias tool.Characteristic statistical description and qualitative summary of results were used for data analysis.Results: Thirty-eight studies(37 full texts and one abstract)were included in this study.Due to the clinical heterogeneity among the studies,we could not conduct a meta-analysis.The results showed that the key factors that contribute to the efficacy of cupping therapy are negative pressure and temperature.Cupping therapy mainly causes local and systemic changes in hemodynamics,immune regulation,metabolism,and pain relief.Conclusion: We identified negative pressure as the key element behind cupping therapy.Cupping therapy may cause redistribution of oxygen at the cupping site and in neighboring tissues,thereby inducing a therapeutic effect by increasing regional blood flow.It may also induce metabolic change,immunomodulation,and neuromodulation.However,additional rigorous clinical research needs to be conducted to further clarify the mechanism behind cupping therapy.

Objective To analyse the hot topics(CKD)frontiers,and of blood pressure monitoring in research of chronic kidney disease(CKD)at home and abroad,and provide references for future research in this field.Methods Articles on blood pressure monitoring in published in Web of Science,China Knowledge Network Infrastructure(CNKI),Wanfang(Wanfang Data)and China Science and Technology Journal Database(VIP)from 2011 to 2022 were searched,and CiteSpace 5.8.R3 visual analysis software was employed to analyse the number of articles involved,country,institution,keyword co-occurrence.The analysis was performed on the number of published papers,countries,institutions,keyword co-occurrence atlas,high frequency subject terms,keyword emergence and emergence of literatures.Results ① A total of 504 articles in English and 72 articles in Chinese were extracted from the literature search.Annual distribution of the number of articles generally showed a continuous upward trend,in which 2 peaks of articles were formed in 2016 and 2018;the main country of issuance was the United States,and the main institution of issuance was the Aristotle University of Thessaloniki,Greece;② In the analysis of keyword co-occurrence,8 high-frequency keywords with a word frequency greater than or equal to 30 were identified.It indicated that the research hotspots mainly focused on the classification of hypertension,the characteristics of blood pressure circadian rhythm,the management of cardiovascular disease and the prediction of death and prognosis in the blood pressure monitoring of CKD;③ Further testing of the emergent terms and emergent literatures yielded 23 strongest emergent terms and 11 emergent literatures,which went through three stages of development,namely,early,intermediate and latest.It was found that the research gradually shifted from the application of blood pressure monitoring in the assessment and diagnosis of kidney disease to the treatment,management and prognostic assessment of hypertension in CKD Conclusion The importance of blood pressure monitoring in the management of hypertension in CKD has received increasing attention from researchers,and future researches should focus on using different blood pressure monitoring schemes to enhance the assessment of cardiovascular risks and the individualised management of hypertension.

Purpose: Pancreatic cancer (PC) is a common malignant tumor of the digestive system, and its 5-year survival rate is only 4%. N6-methyladenosine (m6A) RNA methylation is the most common post-transcriptional modification and dynamically regulates cancer development, while its role in PC treatment remains unclear. Materials and Methods: We treated PC cells with gemcitabine and quantified the overall m6A level with m6A methylation quantification. Real-time quantitative reverse transcription polymerase chain reaction and Western blot analyses were used to detect expression changes of m6A regulators. We verified the m6A modification on the target genes through m6A-immunoprecipitation (IP), and further in vivo experiments and immunofluorescence (IF) assays were applied to verify regulation of gemcitabine on Wilms’ tumor 1–associated protein (WTAP) and MYC. Results: Gemcitabine inhibited the proliferation and migration of PC cells and reduced the overall level of m6A modification. Additionally, the expression of the “writer” WTAP was significantly downregulated after gemcitabine treatment. We knocked down WTAP in cells and found target gene MYC expression was significantly downregulated, m6A-IP also confirmed the m6A modification on MYC. Our experiments showed that m6A-MYC may be recognized by the “reader” IGF2BP1. In vivo experiments revealed gemcitabine inhibited the tumorigenic ability of PC cells. IF analysis also showed that gemcitabine inhibited the expression of WTAP and MYC, which displayed a significant trend of co-expression. Conclusion Our study confirmed that gemcitabine interferes with WTAP protein expression in PC, reduces m6A modification on MYC and RNA stability, thereby inhibiting the downstream pathway of MYC, and inhibits the progression of PC.

Objective:To explore the clinical features and possible pathogenesis of spontaneous remission of acute myeloid leukemia (AML) .Methods:We retrospectively analyzed the clinical data of a patient with spontaneous remission of AML, MLL-AF9 rearrangement, and abnormal liver function in the First Affiliated Hospital of Zhengzhou University, and the relevant pieces of literature were summarized.Results:The patient experienced lung infection, fever, and liver dysfunction and was treated with anti-infection and blood transfusion. After complete response (CR) , the patient remained in CR with mild, indirect bilirubin elevation at 35 months of follow-up. Additionally, 56 cases of adult AML (non-acute promyelocytic leukemia) were reported in the literature from 1990 to June 2021. The cases were checked by bone marrow aspiration, and our patients were summarized and analyzed. Furthermore, 57 patients, including 37 males and 20 females, with a median age of 51 (20-83) years and a median remission time of five months; 52 patients achieved complete remission. In addition, there were five cases with long-term remission and a chromosomal record, with no recurrence so far, three with normal karyotype and two with t (9;11) (q21;q23) .Conclusion:The spontaneous remission of leukemia is rare and may be related to immunosuppression and genes.