In order to investigate the role of Twist gene in the metastasis of hepatocellular carcinoma (HCC), total RNA was respectively extracted from three HCC cell strains with different metastatic potentials, HepG2, MHCC-97L and MHCC-97H. The first strand cDNA was synthesized by reverse transcription, which was then used as template to perform fluorescent quantitative polymerase chain reaction (FQ-PCR). The quantity of Twist gene expression was normalized by that of the housekeeping gene, GAPDH for each sample. ANOVA was used to estimate the relationship between Twist gene and metastasis potential of HCC. The results showed that the normalized initial cDNA concentrations of Twist gene in HepG2, MHCC-97L and MHCC-97H were (9.45+/-0.25)x10(-4), (1.82+/-0.41)x10(-3), (3.06+/-0.62)x10(-3), respectively. FQ-PCR revealed significant differences in the expression level of Twist among HCC cell strains with different metastatic potentials. It was concluded that high expression level of Twist was closely associated with more aggressive behaviors of HCC. Twist provides a novel indicator for HCC metastasis.
Carcinoma, Hepatocellular/*metabolism ; Cell Line, Tumor ; DNA, Complementary/metabolism ; Dose-Response Relationship, Drug ; Gene Expression Regulation, Neoplastic ; Liver Neoplasms/*metabolism ; Neoplasm Metastasis ; Nuclear Proteins/*biosynthesis ; Polymerase Chain Reaction ; RNA/metabolism ; Twist Transcription Factor/*biosynthesis

Evidence-Based Medicine ; Humans ; Medicine, Chinese Traditional

OBJECTIVETo provide quantitative foundation for the diagnosis of atlanto-axial rotatory subluxation by analyzing the various imaging features of normal atlanto-axial joints in neutral position and rotary functional position on the MSCT images.

METHODSForty-one normal volunteers were examined by CT on the atlanto-axial joint in neutral position and rotary functional position. By the observation and measurement of atlanto-dental interval (ADI), lateral atlanta-dental space (LADS), VBLADS and rotating angle of atlas on dentate (RAAD), the imaging manifestations and anatomical characteristics were analyzed and compared. In order to compare VBLADS and RAAD and make a correlation analysis between different age groups, 51 normal volunteers were divided into two groups: age younger than 45 years old group and age older than or equal to 45 years old group.

RESULTSThe dens in neutral position deviated in an angle range of (3.22±0.89)°. The articular facets of lateral atlantoaxial joint in rotary functional position had rotatory displacement and the range of the relative rotation angle was (33.85± 2.79)°. Through the correlation analysis of matching data, it could be concluded that there was no correlation between atlantoaxial relative rotation angle and VBLADS within a certain range. There were statistically differences of atlantoaxial relative rotation angle in rotary functional position between two groups.

CONCLUSIONMSCT imaging in rotary functional position can clearly show the anatomical structure and rotation function of a normal atlanto-axial joint, so as to provide a theoretical basis for the diagnosis of atlanto axial rotatory subluxation.

Adult ; Aged ; Atlanto-Axial Joint ; diagnostic imaging ; Female ; Humans ; Male ; Middle Aged ; Multidetector Computed Tomography ; methods ; Rotation

Objective To investigate the effect of Site-Rite 5 vascular ultrasound on puncturing of grade Ⅱ and Ⅲ veins.Methods Purposive sampling was used and 59 patients with grade Ⅱ and iⅢ veins to receive peripheral intravenous catheteration (PIV) were divided into observation group and control group according to the different wards:30 patients in the observation group and 29 in the control group.The control group received indwelling PIV by routine method and in the observation group,the patients' veins were assessed by Site-Rite 5 ultrasound-guided instrument and marked,followed by puncturing with PIV.The two groups were compared in terms of one-time success rate and incidence of complications.Results The one-time success rate of the observation group was significantly higher than that of the control group.There was no significant difference in the incidence of complications between the two groups (P ＞0.05).Conclusions By the Site-Rite 5 ultrasound-guided instrument,the invisible veins become visible.It is beneficial to improve the success rate of puncturing.

Objective: To learn the health literacy status, trend and associated factors of Ningbo residents from 2015 to 2019, so as to provide basis for developing health policies and interventions. Methods: The monitoring data of health literacy of Ningbo residents from 2015 to 2019 was collected. The health literacy level was calculated and standardized by the population data of the sixth national census of Ningbo in 2010; five-year absolute growth and growth rate were used to reflect the changing trend. Multivariate logistic regression model was employed to analyze the influencing factors for the health literacy level. Results: The health literacy levels from 2015 to 2019 were 15.44%, 21.73%, 22.41%, 27.60% and 30.03%, with an annual increase trend ( P<0.05 ). The five-year absolute growth and growth rate were 14.59% and 94.49%. The Results of multivariate logistic regression analysis indicated that the year ( OR=1.158, 95%CI: 1.132-1.184 ), age ( 25-<35岁 years, OR=1.235, 95%CI: 1.039-1.468; 35-<45岁 years, OR=1.416, 95%CI: 1.193-1.681; 45-<55岁 years, OR=1.221, 95%CI: 1.024-1.455 ) , education level ( primary school, OR=1.790, 95%CI: 1.461-2.195; junior high school, OR=2.574, 95%CI: 2.102-3.154; high school/vocational high school/technical secondary school, OR=4.863, 95%CI: 3.943-5.998; college or above, OR=8.829, 95%CI: 7.109-10.965 ) , urban areas ( OR=0.934, 95%CI: 0.874-0.998 ) and occupation ( farmers, OR=0.692, 95%CI: 0.608-0.787; workers, OR=0.746, 95%CI: 0.664-0.837; enterprise staff, OR=0.822, 95%CI: 0.745-0.906; others, OR=1.106, 95%CI: 1.009-1.211 ) were the influencing factors for health literacy level. Conclusion The health literacy level of Ningbo residents shows an upward trend from 2015 to 2019, which are associated with age, education level, area and occupation.

Objective To investigate the effects of hyperbaric oxygen (HBO) on the expression of hypoxia inducible factor-1α (HIF-1α) mRNA and vascular endothelial growth factor (VEGF) mRNA in colon adenocarcinoma cells. Methods SW480 colon cancer cells were divided into a control group and an HBO group, which was in turn divided into various subgroups according to the various HBO pressures (0.15 MPa, O. 20 MPa, 0.25 MPa) and exposure times (12, 24 and 36 h) tested. The expression of HIF-1α and VEGF mRNA was evaluated with RT-PCR after the various treatments. Results The expression of HIF-1α mRNA was lower in the SW480 cells than in the controls after exposure to 0.25 MPa HBO for 12 h. No expression of HIF-1α mRNA was detected after exposure to 0.25 MPa HBO for 24 h. The expression of VEGF mRNA was lower after exposure to 0.25 MPa HBO for 36 h than in the controls. Conclusion Absence of HIF-1α mRNA expression and decreased expression of VEGF mRNA in SW480 can be observed after exposure to 0.25 MPa HBO for 24 h, suggesting that HBO may inhibit the formation of tumor blood vessels through down-regulating the expression of these mRNAs.

Objective To analysis the immunological characteristics of patients with severe H1N1 influenza A, and to provide theoretical basis for predicting the prognosis of the disease. Methods A retrospective analysis was conducted. The clinical data of 15 patients diagnosed with severe H1N1 influenza A and admitted to Shanghai General Hospital of Nanjing Medical University from October 2015 to December 2016 were collected. All the patients were divided into survival and death groups according to 28-day survival. Clinical characteristics, treatment algorithm, organ function, inflammatory reaction and immune cell status were compared, and Cox regression was used to decide the risk factors of 28-day death in patients with severe H1N1 infection A. Results All 15 patients with severe H1N1 infection A were enrolled, most of who presented with cough (93.3%), fever (86.7%), sputum production (80.0%), shortness of breath (73.3%), myalgia (40.0%) and fatigue (40.0%). All had been received anti-virus, antibiotics, mechanical ventilation and anti-coagulation therapy; some were treated with prone position, neuromuscular blocker and extracorporeal membrane oxygenation (ECMO). The incidences of acute myocardial and kidney injury were high, and the acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score (14.1±6.1) and sequential organ failure assessment (SOFA) score (9.6±4.1) implicated the critical condition. Of 15 patients, 4 patients died in 28 days, while 11 were cured and discharged. Compared with survival group, the patients in death group had higher levels of APACHE Ⅱscore (22.7±3.8 vs. 11.8±3.8), troponin [cTn (μg/L): 0.52 (0.07, 2.02) vs. 0.15 (0.10, 0.45)] and blood urea nitrogen [BUN (mmol/L): 11.9 (6.7, 29.1) vs. 3.9 (2.7, 6.8)] and a lower level of blood platelets count [PLT (×109/L): 76±33 vs. 146±49, all P < 0.05]. The levels of C-reactive protein (CRP) and interleukin-6 (IL-6) within 24 hours of admission in death group were significantly higher than those of survival group [CRP (mg/L): 172.2±88.5 vs. 74.8±33.1, IL-6 (ng/L):283.3 (140.1, 711.0) vs. 18.5 (12.7, 71.4), both P < 0.01]. Compared with survival group, the expressions of CD3+, CD4+, CD8+ T cells and natural killer cell (NK cell) in death group were significantly decreased (CD3+ T cell: 0.348±0.119 vs. 0.573±0.106, CD4+ T cell: 0.135±0.046 vs. 0.344±0.098, CD8+ T cell: 0.089±0.057 vs. 0.208±0.054, NK cell: 0.124±0.057 vs. 0.252±0.182, all P < 0.05), but there were no significant differences in CD4+/CD8+ ratio and human leucocyte antigen-DR positive (HLA-DR+) T cell between death group and survival group (CD4+/CD8+ ratio:1.57±0.26 vs. 1.83±0.54, HLA-DR+ T cell: 0.035±0.022 vs. 0.062±0.036, both P > 0.05). B lymphocyte in death group was significantly higher than that of survival group (0.477±0.136 vs. 0.229±0.121, P < 0.01). Cox regression analysis revealed that APACHE Ⅱ score [risk ratio (RR) = 20.4, 95% confidence interval (95%CI) = 5.3-31.2, P = 0.017], CD4+ T cell (RR = 11.1, 95%CI = 5.1-20.0, P = 0.048) and CD8+ T cell (RR = 9.1, 95%CI = 4.3-16.7, P = 0.049) were independently risk factors of 28-day survival of patients with severe H1N1 influenza A. Conclusion Immunological paralysis and severe inflammatory response were early complicated with severe H1N1 influenza A, and these were significantly associated with prognosis.

Objective To evaluate the prognostic effect of different ratios of fresh frozen plasma (FFP) to packed red blood cells (PRBC) in massively transfused trauma patients.Methods A retrospective cohort study was conducted for 210 trauma patients who received more than 10 units of PRBC during the initial 24 hours from January 2007 to June 2015.The patients were divided into four groups:Group A(PRBC:FFP ≤1,n=41),GroupB (1 ＜PRBC:FFP≤1.5,n=63),GroupC(1.5＜PRBC:FFP≤2,n=30) and Group D (PRBC:FFP ＞2,n =76).At 24 hours after admission,blood transfusion amount,blood transfusion ratios,post-transfusion adverse reactions (allergy,non-hemolytic febrile transfusion reaction,hemolysis,congestive heart failure,pulmonary edema,etc) and coagulation changes [hemoglobin (Hb),platelet count (PC),prothrombin time(PT),activated partial thromboplastin time(APTT),international normalized ratio (INR),etc] were compared among groups.Prognostic markers including sequential organ failure assessment(SOFA),hospital stay,ICU stay,30-day mortality and causes of death were also evaluated.Results Use of PRBC was decreased significantly in Group A than in other groups (P ＜ 0.01),and there were no differences in blood transfusion adverse reactions among all groups (P ＞ 0.05).The coagulation indices (PT,APTT and INR) in Groups A and B were significantly decreased compared to Group D after transfusion (P ＜ 0.05).There were no differences in length of hospital stay and ICU stay among all groups (P ＞ 0.05).Group D was associated with higher SOFA and higher 30-day mortality than other groups(P ＜0.01),but no differences were found in Group A,B and C (P ＞0.05).Meanwhile,ratio of patients died of massive hemorrhage in Group D was also higher than other groups (P ＜0.01).Kaplan-Meier survival analysis showed the survival interval was the shortest in Group D,while the longest in Group B and C.Conclusions Modest transfusion ratios (1.5 ＜ PRBC:FFP ≤2)within 24 hours can substantially improve outcomes in trauma patients.Aggressive ratios may improve coagulation indices and reduce use of PRBC,with no more benefit to the outcomes.

Objective To explore the value of brain CT scanning for distinguishing tumor-like inflammatory demyelinating diseases (TIDD) from glioma or primary central nervous system lymphoma.Methods The brain CT features in 20 patients with TIDD(10 female,10 male;mean age (35.6±14.0)years;range,6-51 years)and 32 gliomas(16 female,16 male;mean age(42.0±19.8)years;range,12-75 years)and 6 lymphomas(3 female,3 male;mean age(53.8±11.8)years;range,32-68 years)were retrospectively reviewed and compared between brain tumors and TIDD.Results (1)Among the 38 primary brain tumors,there were 19 cases(50%,14 gliomas,5 lymphomas)with hyperdense lesions,10 cases(26.3%,9 gliomas,1 lymphomas)with isodense lesions,and 9 glionms (23.7%)with hypodense lesions.In contrast,the brain unenhanced CT manifestation of 20 TIDD all showed with hypodense lesions.(2)On unenhanced CT the lesions of 6 lymphomas all were hyperdense or isodense,like 90% of 20 high grade gliomas(WHO grade Ⅲ and Ⅳ),but this rate for grade Ⅱ was only 41.7%.(3)According to the shape of hyperdense lesions of the 19 primary brain tumors with,7 cages(6 gliomas,1 lymphomas)manifested with asymmetric hyperdense small-patches,4 cases(1 gliomas,3 lymphomas)with symmetric hyperdense large-patches,4 cases(3 gliomas,1 lymphomas)with diffused hyperdensed lesions,and 4 cases(4 gliomas)with ring-shaped hyperdensed lesions.Furthermore,4 primary brain tumors(4 lymphomas)underwent CT enhanced scanning and all the cases showed strong enhancement(3 cases with hyperdense lesions and 1 with isodense lesions on unenhanced CT),but only 3 cases of 7 TIDD showed mild enhancement in contrast.(4)By Spearman's relevant analysis,hyperdense and isodense on unenhanced CT was proved to have significant positive correlation between the grade of gliomas(r=0.435,P=0.013).Therefore,the frequency of hyperdense and isodense lesions in lymphomas and WHO grade Ⅲ and Ⅳ astrocytoma was higher in contrast with low grade astrocytoma.Conclusions Brain CT as a simple,economical and practical examination method has significant meaning for differentiating TIDD from glioma or PCNSL and could be used as an adjuvant method for MRI and magnetic resonance spectroscopy.Patients with hyperdense or isodense on unenhanced CT or strong enhancement could be excluded from TIDD.

Anti-Bacterial Agents ; pharmacology ; Child ; Humans ; Macrolides ; pharmacology ; Microbial Sensitivity Tests ; Mycoplasma pneumoniae ; drug effects