Objective To investigate the relationship between single nucleotide polymorphism (SNP) of susceptibility genes CD-KAL1 ,CDKN2A-CDKN2B ,TCF7L2 and HHEX-IDE of type 2 diabetes mellitus and gestational diabetes mellitus (GDM) in Jiangsu region .Methods 185 healthy pregnant women without GDM tendency (control group) and 176 pregnant women with GDM (GDM group) were enrolled .Case-control method and Multiplex SNaPshot SNP genotyping technology were utilized to detect genotypes at SNP loci of CDKAL1 ,CDKN2A-CDKN2B ,TCF7L2 and HHEX-IDE of pregnant women both in the two groups , and all SNP loci were subject to continuous disequilibrium analysis .Results Compared the allele frequencies of pregnant women in GDM group and the control group ,C allele of CDKAL1(rs7754840) was a risk factor for GDM .The risk of suffering GDM of CC genotype carriers was 1 .73 times the non-CC genotype carriers[P<0 .01 ,OR=1 .73 ,95% CI:1 .28-2 .33] .No statistical difference wasfound in gene distribution of detection loci of CDKN2A-CDKN2B(rs10811661),TCF7L2(rs7903146) and HHEX-IDE (rs1111875) .The genotype frequencies of CDKAL1(rs7754840) ,CDKN2A-CDKN2B(rs10811661) ,TCF7L2(rs7903146) and H HEX-IDE(rs1111875) were all accordance with the law of genetic equilibrium .Conclusion CDKAL1(rs7754840) is closely re-lated to GDM susceptibility in Jiangsu region .

Objective To explore the surgical treatment effect reconstructing calcaneus partial defect with deep iliac circumflex artery illium lamella and sural nerve slap. Methods Sevens of calcaneus fracture with posterior part defect from July 2005 to July 2010 were rehabilitated with deep iliac circumflex artery ilium lamella whose artery were anastomosed to posterior tibial artery and whose skin were repaired with sural nerve slap. Results All patients were obtained follow-up,which ranged from 9 to 30 months with a mean of 19.5 months. Its Bohler angle maintain a range from 35 to 45 degree and foot bridge maintain its figure,as well as perfect skin.According to Maryland grades system,the result were excellent in 3 cases with score 90,good in 2 with score 85 and fair in 2 with score 75. Conclusion It is a perfect method for calcaneus trauma which lose its foot bridge to rehab its figure and function with deep iliac circumflex artery ilium lamella and sural nerve slap.

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 investigate the current staffing of nurses and need of hospital nursing human resources in China.Methods Data were collected from 181 secondary and tertiary hospitals and 9774 nurses in mainland China by questionnaires.Results The average doctor-nurse ratio was 1 ∶ 1.39 in tertiary hospitals and 1 ∶ 1.31 in secondary hospitals.The doctor-nurse ratios in 164 hospitals (97.6％) and the proportion of nurses in health care staff in 105 hospitals (61.8％) had not reached the standard set by the Ministry of Health of China.62.3％ nurses held secondary diploma for their initial nursing education.The constituent ratio of nurses held secondary diploma decreased,while the ratio of nurses held advanced diploma and bachelor degree increased in the last 5 years from 2003 to 2007.Sixty percent of newly employed nurses were contract nurses in 2003.The proportion increased to 78％ in 2007,and in some regions it accounted for more than 90％ of new nurses.The needs and constituent ratio of nurses with.secondary diploma and advanced diploma would decrease while nurses with bachelor degree and master degree would increase in the next 5 years (from 2009 to 2013).Conclusions The nursing shortage is still severe in China,and nursing staff mainly held secondary diploma for their initial nursing education.Most of new nurses were employed as conwact nurses.The need of hospitals for nurses has increased,especially for nurses with higher educational level such as bachelor degree and master degree,while the need for secondary diploma hold ers have decreased.The need for advanced diploma holders has increased in the last 5 years and would decrease in the next 5 years,but they would still be the majority of employed nurses.The authors suggested that the staffing of nursing manpower,the work environments and career development of contract nurses should be improved,and the initial nursing education should be upgraded to meet the needs of hospitals.

PICK1, a PDZ domain-containing protein, is known to increase the reuptake activities of dopamine transporters by increasing their expressions on the cell surface. Here, we report a direct and functional interaction between PICK1 and dopamine D₃ receptors (D₃R), which act as autoreceptors to negatively regulate dopaminergic neurons. PICK1 colocalized with both dopamine D₂ receptor (D₂R) and D₃R in clusters but exerted different functional influences on them. The cell surface expression, agonist affinity, endocytosis, and signaling of D₂R were unaffected by the coexpression of PICK1. On the other hand, the surface expression and tolerance of D₃R were inhibited by the coexpression of PICK1. These findings show that PICK1 exerts multiple effects on D₃R functions.
Autoreceptors ; Dopamine Plasma Membrane Transport Proteins ; Dopamine* ; Dopaminergic Neurons ; Endocytosis ; Hand

OBJECTIVETo investigate the role of matrix metalloproteinase-7 (MMP-7) expression in caricinogenesis and progression of gastric cancer.

METHODSWe studied MMP-7 expression and microvessel density (MVD) in adjacent mucosa and primary foci of 113 cases of gastric cancer by streptavidin-biotin-immunoperoxidase method using anti-MMP-7 and anti-CD34 antibodies. MMP-7 expression and mean MVD were compared with clinicopathological features of gastric cancer, with the relationship between MMP-7 expression and MVD concerned in gastric cancer.

RESULTSMMP-7 showed positive expression in adjacent mucosa of gastric cancer (29.20%, 33/113), less than that in gastric cancer (69.03%, 78/113). MMP-7 expression in primary foci of gastric cancer was positively correlated with tumor size, invasive depth, metastasis and TNM staging (P<0.05), but not with differentiation or growth pattern of gastric cancer (P>0.05). Positive correlation of mean MVD with tumor size, invasive depth, metastasis and TNM staging was found (P<0.05), despite no relationship between mean MVD and differentiation of gastric cancer (P>0.05). Mean MVD was dependent on MMP-7 expression in gastric cancer (P<0.05).

CONCLUSIONUpregulated expression of MMP-7 played an important role in carcinogenesis and progression by participating in growth, invasion, metastasis and angiogenesis of gastric cancer. MMP-7 expression could be regarded as an effective and objective marker to reflect the biological behaviors of gastric cancer.

Biomarkers, Tumor ; metabolism ; Humans ; Lymphatic Metastasis ; Matrix Metalloproteinase 7 ; metabolism ; Neoplasm Invasiveness ; Neoplasm Staging ; Neovascularization, Pathologic ; pathology ; Stomach Neoplasms ; blood supply ; metabolism ; pathology

Desensitization and acute tolerance are terms used to describe the attenuation of receptor responsiveness by prolonged or intermittent exposure to an agonist. Unlike desensitization of G protein-coupled receptors (GPCRs), which is commonly explained by steric hindrance caused by the β-arrestins that are translocated to the activated receptors, molecular mechanisms involved in the acute tolerance of GPCRs remain unclear. Our studies with several GPCRs and related mutants showed that the acute tolerance of GPCRs could occur independently of agonist-induced β-arrestin translocation. A series of co-immunoprecipitation experiments revealed a correlation between receptor tolerance and interactions among receptors, β-arrestin2, and Gβγ. Gβγ displayed a stable interaction with receptors and β-arrestin2 in cells expressing GPCRs that were prone to undergo tolerance compared to the GPCRs that were resistant to acute tolerance. Strengthening the interaction between Gβγ and β-arrestin rendered the GPCRs to acquire the tendency of acute tolerance. Overall, stable interaction between the receptor and Gβγ complex is required for the formation of a complex with β-arrestin, and determines the potential of a particular GPCR to undergo acute tolerance. Rather than turning off the signal, β-arrestins seem to contribute on continuous signaling when they are in the context of complex with receptor and Gβγ.
Immunoprecipitation ; Receptors, Dopamine D3

Objective: To understand and analyze the epidemiological characteristics of dental caries in children and its effects on jaw function, so as to prevent occurrence of abnormality of jaw function. Methods: In October 2020, 860 cases of children from 5 kindergartens and 3 primary schools in Beijing were selected by adopting the convenience sampling method. All of them received oral examination, and the questionnaire according to the fourth national oral health epidemiological survey standard, including demographic information, eating habits, oral hygiene habits, oral health care,etc. The epidemiological characteristics of dental caries in children and its effects on jaw function were analyzed. Results: A total of 190 children had dental caries, with a dental caries incidence rate of 22.09%. Dental caries in children s deciduous teeth or permanent teeth was related to age, residence, parents education level,whethe to eat before going to bed, whether eating sweet food, tooth brushing age, daily brushing frequency, whether parents have assisted tooth brushing, whether regular oral examination, whether parents have received oral health guidance( χ 2= 5.04 ,4.70，75.37，7.91，12.03，9.30，7.64，255.47，253.27，11.38, P <0.05). Compared with the noncaries group[(81.52±3.16， 80.54± 1.52，1.92±0.25，31.52±1.62，33.63±3.41，50.72±1.68)°], the sella nasion A point(SNA), sella nasion B point(SNB),A point nasion B point(ANB),frankfot horizontal mandibular plane angle(FH MP),skull nasion mandibular plane angle(SN MP),anteriors relationship palataplane mandibular(Ptm ANS) decreased in the dental caries group[(78.62±2.11，79.35±1.02，1.68±0.32，30.69±0.45，32.15±3.02，48.62±1.21)°](t=78.62,79.35,10.94, 30.69, 32.15, 48.62, P<0.05). Conclusion The prevalence of caries in children was high and jaw structure abnormalities and dysfunction. It is suggested that caries prevention and control work should be carried out early to strengthen the prevention and control of oral disease education work.

Background and objective Invasive mucinous adenocarcinoma(IMA)was a rare and specific type of lung adenocarcinoma,which was often characterized by fewer lymphatic metastases.Therefore,it was difficult to evaluate the prognosis of these tumors based on the existing tumor-node-metastasis(TNM)staging.So,this study aimed to develop Nomo-grams to predict outcomes of patients with pathologic N0 in resected IMA.Methods According to the inclusion criteria and exclusion criteria,IMA patients with pathologic N0 in The Affiliated Lihuili Hospital of Ningbo University(training cohort,n=78)and Ningbo No.2 Hospital(validation cohort,n=66)were reviewed between July 2012 and May 2017.The prognostic value of the clinicopathological features in the training cohort was analyzed and prognostic prediction models were established,and the performances of models were evaluated.Finally,the validation cohort data was put in for external validation.Results Univariate analysis showed that pneumonic type,larger tumor size,mixed mucinous/non-mucinous component,and higher overall stage were significant influence factors of 5-year progression-free survival(PFS)and overall survival(OS).Multivariate analysis further indicated that type of imaging,tumor size,mucinous component were the independent prognostic factors for poor 5-year PFS and OS.Moreover,the 5-year PFS and OS rates were 62.82％and 75.64％,respectively.In subgroups,the sur-vival analysis also showed that the pneumonic type and mixed mucinous/non-mucinous patients had significantly poorer 5-year PFS and OS compared with solitary type and pure mucinous patients,respectively.The C-index of Nomograms with 5-year PFS and OS were 0.815(95％CI:0.741-0.889)and 0.767(95％CI:0.669-0.865).The calibration curve and decision curve analysis(DCA)of both models showed good predictive performances in both cohorts.Conclusion The Nomograms based on clinicopathological characteristics in a certain extent,can be used as an effective prognostic tool for patients with pathologic N0 after IMA resection.

Objective:To investigate the efficacy of intravoxel incoherent motion (IVIM) imaging parameters for the diagnosis of placenta accreta spectrum disorders (PASDs) and the prediction of massive intraoperative blood loss.Methods:The pregnant women with suspected PASDs were prospectively collected in this case-control study at the Shandong Provincial Hospital Affiliated to Shandong First Medical University from January 2017 to December 2022. The participants were scanned using the IVIM sequence and were divided into two groups, the PASDs group (69 cases) and the control group (37 cases), based on cesarean section and pathological findings. The PASDs group was further stratified into superficial implantation subgroup (29 cases) and deep implantation subgroup (40 cases) according to the depth of placental implantation, and into massive blood loss subgroup (48 cases) and non-massive blood loss subgroup (21 cases) based on intraoperative blood loss. The IVIM parameters, including the diffusion coefficient (D), pseudo-diffusion coefficient (D *), and perfusion fraction (f), were measured. The Mann-Whitney U test was employed to compare IVIM parameters between the two groups, while the Kruskal-Wallis test was assessed among the three groups, with post-hoc Bonferroni corrections for multiple comparisons. The receiver operating characteristic curves were utilized to assess the diagnostic efficacy of IVIM parameters for PASDs and their predictive value for massive intraoperative blood loss. Results:The f value in the PASDs group [0.330 (0.302, 0.361)] was significantly higher than that in the control group [0.287 (0.269, 0.318)] ( Z=-5.25, P<0.001), while the differences in D and D * values were not statistically significant (both P>0.05). The overall differences in D and f values among the control, superficial implantation subgroup, and deep implantation subgroup were statistically significant ( H=7.73, P=0.021; H=46.19, P<0.001), whereas the difference in D * values was not ( H=2.20, P=0.353). The deep implantation subgroup exhibited a higher D value than that in the control group ( P=0.029), and a higher f value than that in both the superficial implantation subgroup and the control group (both P<0.001). The area under the curve (AUC) of 0.910 (95% CI 0.847-0.973) for the f value in diagnosing PASDs, and an AUC of 0.870 (95% CI 0.789-0.951) for distinguishing superficial from deep placental implantation. The AUC for the D value in distinguishing normal from deep placental implantation was 0.670 (95% CI 0.544-0.796). The difference in f value between the massive blood loss subgroup and non-massive blood loss subgroup was statistically significant ( Z=-3.47, P<0.001), with an AUC of 0.851 (95% CI 0.764-0.938) for predicting massive intraoperative blood loss. Conclusions:The placenta in patients with PASDs exhibits hyperperfusion, and f values can be used to diagnose PASDs, evaluate deep placental implantation, and predict massive intraoperative blood loss.