Objective: To investigate the effects of sulforaphane (SFN) on oxidative stress and Nrf2(Nuclear factor E2-related factor 2)/HO-1(heme oxygenase-1) signaling pathway in renal tubular epithelial cells (HK-2).Methods: HK-2 cells were cultured in vitro and divided into five groups, including the control group, H2O2 group, H2O2+10 μmol·L-1 SFN group, H2O2+20μmol·L-1 SFN group and H2O2+40 μmol·L-1 SFN group.The levels of MDA, NO, GSH and the activity of SOD were measured.The expression levels of Nrf2, HO-1 mRNAR and proteins were analyzed using RT-PCR and Western Blot methods.Results: The levels of MDA and NO in H2O2 group significantly increased when compared with those in the control group, while the levels of GSH and the activity of SOD significantly decreased(P<0.05).The levels of MDA and NO in the cells after the treatment of sulforaphane at different concentrations significantly reduced when compared with those in H2O2 group, while the levels of GSH and the activity of SOD significantly increased(P<0.05).The results of RT-PCR and Western Blot analysis showed that the expression levels of Nrf2, HO-1 mRNAR and proteins in the cells after the treatment of sulforaphane at different concentrations were significantly up-regulated when compared with those in H2O2 group (P<0.05).Conclusion: Sulforaphane can strengthen the antagonism effects on oxidative stress injury in HK-2 cells and the underlying mechanism might be associated with activating Nrf2/HO-1 signal transduction pathway.

Gastroenteropancreatic neuroendocrine neoplasms are a group of heterogeneous tumors originated from the gastrointestinal peptidergic neurons and neuroendocrine cells.Rectum is one of the major sites of gastroenteropancreatic neuroendocrine neoplasms.Although the progression of rectal neuroendocine neoplasms (rNENs) is relatively slow,metastasis could occurs and liver is the major target organ invaded by distant metastatic rNENs.Surgical operation can be used as the preferred method for the treatment of rNENs and its metastasis at present.If the clinical situations of tumors are not eligible for the operation,interventional treatment can be considered as an alternative treatment.The chemotherapies and molecule-targeted drugs for rNENs are primarily in the light of therapeutic methods for pancreatic neuroendocrine neoplasms,it may help patients achieve partial response or stable disease,and prolong patients survival time.However,there has been few clinical researches directed toward rNENs and no an extensive consensus for treatment of rNENs up to now,and more evidences of evidence-based medicine should be necessitated.This paper has discussed and summarized treatment progression of rNENs and its metastasis.

Objective: To investigate the health-seeking intention for urinary incontinence among adult women in Gansu Province, so as to provide insights into the management of female urinary incontinence. Methods : Women at ages of 20 years and older who lived in 8 communities and 8 villages of Gansu Province for at least one year were recruited using the multi-stage stratified cluster random sampling method. A face-to-face questionnaire survey was conducted from October 2019 to February 2020, and the demographic features, urinary incontinence status and health-seeking intention were collected and descriptively analyzed. Results: A total of 3 580 questionnaires were allocated and 3 485 were recovered, with a recovery rate of 97.35%. The respondents had a mean age of ( 51.18±17.13 ) years, with 1 759 respondents ( 50.47% ) that lived in urban areas, and 1 726 ( 49.53% ) that lived in rural areas. There were 1 150 respondents with self-reported urinary incontinence ( 33.00% prevalence ), including 340 cases with stress urinary incontinence ( 29.57% ), 78 cases with urge urinary incontinence ( 6.78% ) and 732 cases with mixed urinary incontinence ( 63.65% ). The overall proportion of health-seeking intention for urinary incontinence was 41.57%, and the proportions of health-seeking intention were 51.76%, 39.74% and 37.02% for stress, urge and mixed urinary incontinence, respectively. The proportion of health-seeking intention for urinary incontinence appeared a tendency towards a decline with the increase in household monthly income per capita and frequency of urinary leakage, and appeared a tendency towards a rise with the increase in educational levels ( P<0.05 ). In addition, a higher proportion of health-seeking intention for urinary incontinence was seen in women living in urban areas than in rural areas (5 3.63% vs. 31.98%, P<0.05 ), and a higher proportion was found in women with mental labors than in those with physical labors ( 60.81% vs. 40.24%, P<0.05 ), while a higher proportion was found in married women than in divorced or widowed women ( 44.33% vs. 23.53%, P<0.05 ). Conclusions There is a low proportion of health-seeking intention for urinary incontinence among adult women in Gansu Province. Age, occupation, place of residence, educational level, income, marital status, and frequency of urine leakage may affect the intention to seek medical care for urinary incontinence among adult women.

Objective To discuss the value of intrapartum operation in management of birth defects and the prognosis. Methods From August 2008 to November 2009, 11 fetuses were identified with birth defects through 3D color Doppler ultrasound and confirmed by MRI and fetal karyotype in the Maternal Fetal Medicine Center, Affiliated Shengjing Hospital, China Medical University including three lymphangiomas,two congenital diaphragmatic hernias (CDH), one sacrococcygeal teratoma, three omphalocele and two gastroschisi. All the above identified birth defects were indications for surgery. All fetuses were born abdominally and received intrapartum operations, including three intrapartum fetal operations with placental infusion (two repairs of CDH, one sacrococcygeal teratoma resection), six ex-utero intrapartum treatment (EXIT; two repairs of omphalocele, two repairs of gastroschisi, two lymphangioma resection) and two surgeries in house (one omphalocele repair and one lymphangioma resection). Both the mothers and fetuses were regularly followed up. Results ( 1 ) Operations: the average operating time for the three intrapartum fetal operations was 89 minites, 5.5 minites for the six EXIT, during which EXIT was performed first,followed by blocking the umbilical circulation and neonatal surgery, and 37 minites for the two surgeries in house. All neonates survived except for one death from severe CDH at 3.5 hours after the operation. The average blood loss for cesarean section and fetal operation was 275 ml. All mothers recovered soon without fever or infection and were discharged three to five days after the operation. (2) Follow-ups: the ten survived neonates were followed up at 1 - 18 mouths at the pediatric clinics and all were growing and developing normally except for one baby with gastroschisi suffered from enteral torsion and feeding intolerance showed lower weight than babies at the same age, but catched up to normal at four months old after posture therapy. One baby with mild CDH developed pulmonary infection at two months after operation with 1/4 pneumothorax on chest X-ray, and were hospitalized for two weeks. At six months old, patent ductus arteriosus was diagnosed in the same baby and chest X-ray was normal. The baby with omphalocele was complicated with ventricular septal defect before operation and the cardiac function was normal during followups for one year. The baby with sacrococcygeal teratoma was reported to have no automatic micturition, but recovered to normal at one month of age. Conclusion Babies with certain birth defects can be managed through intrapartum operation with better outcomes.

The idea of establishing Shanghai Academy of Medical Sciences was brought forward　in the background of great external changes.It was to meet the demand for resolving all kinds of　conflicts about researches arised from the long time operation of Medical Institutes in Shanghai.This　article mainly discusses about the necessity and plans for establishing Shanghai Academy of Medical　Sciences.

This study surveyed medical research institutions in Shanghai for the structure set, input and output, development orientation, bottleneck and other aspects. Problems were found with their relationship management, discipline arrangement, research efficacy and else.

Medical research institutions in Shanghai have been developing in at a slow pace because of problems such as out of date institution structures, unreasonable resource allocation and distribution,shortage of research resources, insufficient creativity, and unfocused effort and investment. Hence reform is the only way out. This research discussed the possible strategies for development and proposed some suggestions on the institution categorization, structure change, allocation of resource and overall arrangement.

Objective To compare the serological non-invasive liver fibrosis tests and pathological examination in the clinical diagnosis of chronic hepatitis B. Methods Selected 97 patients with chronic hepatitis B in our hospital as the research object and tested non-invasive liver fibrosis tests and liver biopsy pathological examination.Compare the test results of two kinds. Results The serum noninvasive hepatic fibrosis index(PⅢP,Ⅳ-C,HA,LN)showed good positive correlation with pathological stage. The correlation coefficient suggested that with the aggravation of hepatic fibrosis,liv-er fibrosis indexes tended to rise gradually,and the indicators differences were statistically significant (P<0.05). Con-clusion Liver biopsy in patients with chronic hepatitis B diagnosis detection is the "gold standard" with greater injury. Serological non-invasive liver fibrosis tests has high diagnostic value,can reduce the number of puncture biopsy.

Objective To study the antitumor effects of exosomes derived from heat-shocked E.G7-OVA tumor cells in vivo. Methods Exosomes derived from E.G7-OVA tumor cells were isolated and purified by serial centrifugation and sucrose gradients ultracentrifugation. Exosomes from heat-shocked or non-heat-shocked E.G7-OVA tumor cells were named as Exo/HS and Exo correspondingly. Exosomes were viewed by electron microscopy. Protein components of exosomes were detected by Western blot. Exo, Exo/ HS or PBS were injected into mice before injection of E.G7-OVA tumor cells, and antitumor effects were ob-served in each group. Mouse model bearing E.G7-OVA tumor cells were established to examine immunother-apy effects of Exo or Exo/HS. Cytotoxity of spleen CTL were measured by LDH. Results Exosomes con-tained bi-layer membrane and their diameters are between 40 nm and 100 nm under electron microscopy. The Western blot results showed that HSC70, HSP70, HSP60, HSP90, MHC Ⅰ and OVA were present in both Exo and Exo/HS. However, Exo/HS contained more HSP70 and MHC Ⅰ than Exo. Protective antitu-mor immunity suggested that tumor-free survival (90 days) rate in Exo/HS vaccinated mice was significantly higher than those in Exo or PBS vaccinated mice (50%, 20%, 0%, P<0.01). Therapeutic antitumor effects showed that immunization by Exo/HS resulted in dramatically enhanced antitumor effects when com-pared to the Exo- or PBS-treated groups (P<0.01). CTL results showed that immunization with Exo/HS in-duced higher level of OVA-specific CTL responses as compared with those from Exo or PBS (P<0.01). Conclusion Exosomes derived heat-shocked E.G7-OVA tumor cells may be used as potent cancer vaccine.

Neuroendocrine neoplasms, commonly deriving from neuroendocrine cells of gastrointestinal tract and pancreas, are remarkably heterogeneous. As for gastroentero-pancreatic neuroendocrine neoplasms, surgery is the first choice for treatment, whereas molecular targeted therapy provides a new treatment option for patients with local advancement or metastases. Drugs for molecular targeted therapy used clinically include somatostatin analogs, mammalian target of rapamyoin pathway inhibitors, tyrosinekinase inhibitors, immunotherapy and so on. Research findings from experiments and clinic trials will possibly provide new therapeutic methods for molecular targeted therapy in the future.