Objective To investigate the expression of Delta-like 4 (DLL4) in pancreatic cancer and its clinical significance.Methods The expression of DLL4 in pancreatic cancer was examined by immunohistochemistry method.The microvessel density (MVD) was calculated after CD34 staining specifically for microvessel endothelium; and their correlations and relationship between them and clinicopathological parameters as well as prognosis of pancreatic carcinoma was investigated.Results The expression of DLL4 in pancreatic cancer was significantly higher than that in normal pancreatic tissue (68.3％ vs 20％,P ＜ 0.01).The over-expression of DLL4 in pancreatic cancer was related to degree of differentiation,TNM staging,lymph node metastasis and invasion depth,while not related to the size,location and histological types.The MVD in pancreatic cancer tissues was notably higher than that in normal tissues (34.9 ± 13.2 vs 18.9 ± 2.2,P ＜0.01).MVD was correlated to degree of differentiation,lymph node metastasis,but not related to the size,location and histological types.DLL4 expression was closely associated with prognosis.COX model analysis showed that TNM staging and DLL4 expression were independent prognostic factors for pancreatic cancer.Conclusions The over-expressions of DLL4 may play an important role in metastasis and invasion of pancreatic cancer.Expression of DLL4 and TNM staging is useful for predicting the prognosis of patients with pancreatic cancer.

Objective To investigate the serum levels of procalcitomn (PCT) and high mobility group box chromosomal protein-1 ( HMGB1 ) in patients with acute pancreatitis (AP) ; and study the relationship between the serum levels of PCT,HMGB1 and the severity and prognosis of AP.Methods The blood samples were collected from 80 AP patients,including 38 severe acute pancreatitis (SAP) patients and 42 mild acute pancreatitis (MAP) patients.The serum levels of HMGB1 were measured by ELISA kit,and the levels of PCT were measured by immunoassay chemiluminescent technique,then their relationship with other biochemical parameters,the severity and prognosis of AP was analyzed.30 healthy adults were treated as the control group.Results The serum PCT and HMGB1 levels were ( 8.18 ± 3.24) μg/L and ( 11.79 ± 3.98 ) μg/L in SAP group,and the corresponding values were (5.67 ± 2.43) μg/L and ( 5.38 ± 2.06) μg/L in MAP group,and both were significantly higher than those in control group [ ( 1.85 ± 0.86) μg/L and ( 1.87 ± 1.47) μg/L,P ＜0.01 ].The serum level of PCT was positively correlated with serum 1evel of HMGB1 ( r =0.276,P =0.014),and both were positively correlated with Ranson score,APACHE Ⅱ score,Balthazar CT score (P＜0.05 or ＜0.01 ).The HMGB1 levels were significantly higher in patients with organ dysfunction than those in patients without organ dysfunction (P ＜0.05).Conclusions In AP patients,serum PCT and HMGB1 levels were significantly increased,and they were positively correlated with disease severity.These results suggest that PCT and HMGB1 may act as potential serum markers for AP severity evaluation.

Objective To use clustering analysis to help physicians detect abnormal parameters in radiotherapy treatment plans and improve the efficiency of plan verification. Methods From 2010 to 2015, 835 breast cancer treatment plans for using 4?field hybrid intensity?modulated radiotherapy from MOSAIQ were collectted. Fractional dose, beam angle, and monitor unit were used as featured parameters of a treatment plan to generate a dataset. The K?means clustering algorithm based on principal component analysis was used to perform a clustering analysis of the dataset and divide the dataset into different clusters. The outliers of clusters were automatically detected based on the distance threshold. The outlier?contained treatment plans were manually verified by physicians to determine the accuracy of clustering analysis in detection of abnormal plans. Results In the clustering analysis, the sample space composed by parameters of treatment plans for breast cancer was divided into 4 clusters, 3 of which had outliers detected. In the targeted treatment plans, 3 plans became outliers because of special target volume and the other 4 plans needed improvement. Conclusions Clustering analysis is effective to help physicians to independently verify treatment plans.

Objective To evaluate the efficiency and safety of exercise interventions on cancer related fatigue. Methods Cochrane Library, JBI Database of Systematic Reviews, MEDLINE, EMbase, CINAHL, Chinese Journal Full- text Database, Chinese Biomedical Literature Database, and Wanfang Databse were searched from the inception to November 2014 to screen the systematic review and Meta-analysis conforming to the inclusion criteria. Two authors independently appraised their methodological qualities with Overview Quality Assessment Questionnaire (OQAQ), and analyzed the data using descriptive analysis. The primary outcome included the scaling of cancer related fatigue, the secondary outcome included adherence to exercise intervention and the incidence of adverse events. Results Fourteen systematic review/Meta-analysis were identified, twelve of them had a high methodological quality (Scoring 5-7). Six systematic review/Meta-analysis found that aerobic exercise could effectively alleviate cancer related fatigue, especially for breast cancer patients;seven articles showed that exercise could modulate cancer related fatigue of patients under active treatments;seven articles reported the compliance to the exercise intervention, four articles reported adverse events occurring during the intervention, very few of them resulted directly from the exercise intervention. Conclusions Exercise intervention can modulate cancer related fatigue with good safety.

Objective To explore the structure of violent attitude and the predictive character of the passionate criminal and recidivist. Methods This study used FMMU-Abnormal Personality Risk Factors Inventory (FMMU-APRI) for measuring explicit violent attitude of the passionate criminal and recidivist in prison; while used the picture Attitude Activation paradigm (AAP) for assessing implicit violent attitude. Results The AAP results showed that parts of passionate criminal and recidivist had reversed priming effect, according to whether reversed, there were divided into four types: no-reversal passionate criminals, reversal passionate criminals, no-reversal recidivists and reversal recidivists, VIO scores of no-reversal passionate criminals and recidivists recidivist were significantly higher than the norm, as reversal passionate criminals and recidivists had no significance; in noreversal passionate criminals, compatible response rate was 1.104, incompatible response rate was 1.053; in reversal passionate criminals, compatible response rate was 1.042, incompatible response rate was 0.997; in no-reversal recidivists, compatible response rate was 1.059, incompatible response rate was 1.097; in reversal recidivists , compatible response rate was 1.039, incompatible response rate was 0.998, as each group had strong priming effect, and each group had a dissociation of implicit and explicit violent attitude. Conclusion The results suggest that offenders who have committed a crime in the same category also had a different violent attitude; and integrating indirect methods with direct methods would predict a crime more accurately.

Objective To study the relationship between the expression of Mycobacterium tuberculosis small heat shock protein Hsp16.3 and the apoptosis of infected mouse alveolar macrophages.Methods The laboratory mice were infected with bacterial suspension of the international standard virulent strain of Mycobacterium tuberculosis H37Rv strains (H37Rv),Hsp16.3 gene deletion mutants of the international standard virulent of Mycobacterium tuberculosis H37Rv strains(△H37Rv),or sterile saline solution (normal control)by the tail vein. After successful replication of mouse infection model in each group,we cleaved the alveolus of each group of mice and collected lavage fluid to obtain alveolar macrophages of the infected mice at days 1 ,3 ,5 ,7 ,9 ,1 1 ,1 3 and 1 5 .Then the infection status of macrophages was observed with confocal laser scanning microscopy;flow cytometry was used to detect the apoptosis rate of alveolar macrophages of the infected mice;Caspase-3 and Bcl-2 expressions were examined by Western blot.Results The apoptosis rate of Hsp16.3 gene was higher in deletion strain (△H37Rv)group and H37Rv strains (H37Rv)group than in control group.The apoptosis rate of alveolar macrophages in △ H37Rv group gradually increased,peaked at day 7 ,and then gradually decreased.It was significantly higher in H3 7 Rv group than in H3 7 Rv strain group from day 1 to 7 and from day 1 3 to 1 5 (P<0 .0 5 ).Caspase-3 and Bcl-2 protein expressions in the macrophages of△H37Rv group and H37Rv group were higher than those of control group.Caspase-3 expression in the microphages of △H3 7 Rv group and H3 7 Rv group gradually increased from day 1 to 7 and peaked at day 7;it peaked again at day 13 in H37Rv group.However,Caspase-3 expression remained significantly higher in△H37Rv group than in H3 7 Rv group (P<0 .0 5 ).Bcl-2 expression in △H3 7 Rv group did not change much at the early stage of infection (P<0 .0 5 ),but gradually increased after day 9 .Bcl-2 expression in H3 7 Rv group did did not change much from day 1 to 7 (P<0.05),but gradually increased after day 7.However,it remained lower in△H37Rv group than in H37Rv group,especially after 7 days(P<0.05).Conclusion Mycobacterium tuberculosis small heat shock protein Hsp16.3 can inhibit the apoptosis of macrophages during the early and late stages of infection,and this inhibition may be achieved by inhibiting the expression of apoptotic protease Caspase-3 and promoting the expression of Bcl-2 protein.

Objective:To explore the distribution of pelvic lymph node (PLN) metastasis and the correlative dangerous factors in early cervical cancer patients.Methods:The medical records of 508 patients who underwent extensive hysterectomy and lymphadenectomy for International Federation of Gynecology and Obstetrics (FIGO) stage Ⅰb-Ⅱb cervical cancer in Guizhou Provincial People`s Hospital were reviewed retrospectively.Results:There were 278 patients with stage Ⅰb cervical cancer, 204 patients with stage Ⅱa cervical cancer and 26 patients with stage Ⅱb cervical cancer; the positive rate of lymph node metastasis was 16.7%(85/508), and obturator lymph node metastasis was the most common (56.6%); there were 19 patients with bilateral lymph node metastasis, accounting for 22.35%(19/85); lymph node metastasis occurred 104 times (two times for bilateral simultaneous transfer), and jumping lymph node metastasis accounted for 37.5%(39/104); common iliac lymph node metastasis accounted for 18.3%(19/104). The metastasis rate of patients with stage Ⅱa and Ⅱb (including parametrial, lymph node, ovarian and oviduct metastasis) was higher than that of patients with stage Ⅰb, and the odd ratio ( OR) was 2.30 and 2.48 respectively ( P<0.05); the metastasis rate of patients with moderately differentiated tumors was significantly higher than that of patients with well differentiated and poorly differentiated tumors ( P<0.05). There was no significant difference in the positive rate of pelvic lymph node metastasis among patients with different ages and histological types ( P>0.05); the positive rate of pelvic lymph node metastasis in patients with stage Ⅱa and Ⅱb was higher than that in patients with stage Ⅰb with statistically significant difference ( P<0.05); the positive rate of pelvic lymph node metastasis in patients with moderately differentiated tumors was higher than that in patients with well differentiated and poorly differentiated tumors, with statistically significant difference ( P<0.05). Conclusions:Obturator lymph node metastasis is the most common in cervical cancer. The risk of lymph node metastasis is increased in patients with stage Ⅱa or moderately differentiated tumors. Jumping metastasis is also a common way of metastasis, which suggests that standard and complete lymph node resection is an important measure to ensure the curative effect.

Application of new technical means and methods and in-depth exploration in medical service scenarios, for improving the efficiency and quality of diagnosis and treatment, improving the operation and management level and patient′s medical experience are the goals aimed by smart hospitals. Guangdong Second Provincial General Hospital, based on the technical framework of hospital intelligent twins, was exploring to build an all-scenario smart hospital. The hospital built an intelligent operations center, all-scenario smart wards and a smart security and fire protection integrated management center. These practices promoted the service synergy, provided efficient internet of everything experience, and promoted the integrated linkage management of security and fire protection. The hospital effective resolved such deficiencies as insufficient data connectivity, fragmented application scenarios, limited coverage and poor mobility, hence providing reference for the construction and application of whole-scenario smart hospitals.

BACKGROUNDAltered immunoresponse is associated with tumorigenesis and cancer progression. This study assessed the levels of tumor-infiltrating CD3 + or CD8 + T lymphocytes and interleukin-2 (IL-2) protein in radically resected non-small cell lung cancer (NSCLC) tissues to predict overall survival (OS) of the patients.

METHODSParaffin-embedded tissue specimens from 129 NSCLC patients were retrospectively collected for immunostaining of CD8 + , CD3 + , and IL-2 expression. Clinicopathological and survival data were collected and analyzed using the Chi-squared test, Kaplan-Meier curves, and the log-rank test or the Cox regression model.

RESULTSThe data showed a significant inverse association between CD8 + T lymphocyte levels and IL-2 expression (r = -0.927; P = 0.000) and between the levels of CD8 + and CD3 + T lymphocytes (r = -0.722; P = 0.000), but a positive association between CD3 + T lymphocyte levels and IL-2 expression (r = 0.781; P = 0.000) in NSCLC tissues. Furthermore, the levels of CD3 + and CD8 + T lymphocytes and IL-2 expression were associated with tumor stage (P = 0.023, 0.006, and 0.031, respectively) and the level of CD8 + T lymphocytes was associated with the patient gender (P = 0.024). In addition, the levels of CD8 + T lymphocytes were associated with an unfavorable 5-year OS, whereas patients with high levels of CD3 + T lymphocytes in tumor lesions and IL-2-expressing tumors had significantly better 5-year OS rates than patients with low levels.

CONCLUSIONSThe levels of CD8 + T cells in tumor lesions and IL-2 expression were both independent predictors of OS for these NSCLC patients. Thus, the detection of tumor-infiltrating CD3 + or CD8 + T lymphocytes and IL-2 expression could be useful to predict the prognosis of radically resected NSCLC patients.

CD3 Complex ; metabolism ; CD8-Positive T-Lymphocytes ; metabolism ; Female ; Humans ; Immunohistochemistry ; Interleukin-2 ; metabolism ; Lung Neoplasms ; immunology ; metabolism ; Lymphocytes, Tumor-Infiltrating ; metabolism ; Male ; Prognosis

Objective To design a storage device for lymph node specimens of gynecological malignant tumors and to evaluate its application effect.Methods The specimen depository is composed of 3 parts,including storage frame,partition plate and marking plate.391 patients with gynecological malignant tumor surgeries requiring collection of retroperitoneal lymph nodes were selected in the operating room of a tertiary A hospital in Zhejiang Province from January to December 2022 in accordance with the operation schedule.They were randomly divided into an experimental group(n=196)and a control group(n=195).Patients in the experimental group used a newly developed storage device,while the control group was with traditional device.The incidence of additional verification specimens by doctors,the average time for disposing of lymph node specimens,and the job satisfaction survey of doctors and nurses were compared.Results Within a period of 12 months after utilizing this easily recognizable specimen storage device,the additional verification rate in the experimental group was 10.62％compared with the rate of 72.48％in the control group.The average time of disposing lymph node specimens was reduced from(8.3±0.9)to(5.2±0.3)minutes.Doctors and nurses in the experimental group reported a higher level of satisfaction for the specimen storage device(P＜0.05).Conclusion Utilizing the newly designed specimen storage device can help medical staff to alleviate their workload,enhance their work efficiency,raise their job satisfaction,and ensure the accuracy of pathological results.