Phosphatidylinositol 3-kinase,Akt,and the mammalian target of rapamycin (PI3K/Akt/mTOR)signaling pathway is shown to play a key role in the tumorigenesis,proliferation,metastasis,apoptosis,and angiogenesis of hepatocellular carcinoma (HCC)by regulating gene expression.The components and functions of PI3K/Akt/mTOR signaling pathway are briefly described,and the research advances in the action mechanism of PI3K/Akt/mTOR signaling pathway in the progression of HCC and related inhibitors are reviewed.It is disclosed that blocking the PI3K/Akt/mTOR signaling pathway may become a new therapy for HCC.

Objective:To investigate the effect of Luteolin on the degranulation function of RBL-2H3 mast cells and its mechanism of action.Methods:DNP-BSA-IgE was used to establish the sensitized cell model in RBL-2H3 cells.Cell viability was exa mined by MTT assay at different concentrations (5,15,25 μmol/L) of Luteolin pretreated RBL-2H3 cells.The effect of Luteolin on β-hexosa minidase(β-hex) and TNF-αwas evaluated by ELISA.The change of Ca2+influx was detected by Flou-4AM calcium ion fluorescent probe.The expression of AKT and P-AKT were detected by Western blot.Results:The sensitized cell model was established successfully .Cell viability had not significantly changes stimulated by different concentrations of Luteolin ,and a significantly inhibition role showed the release of β-hex and TNF-αfrom RBL-2H3 cells.The concentration of intracellular Ca 2+ was significantly decreased.However,the Western blot results showed that the level of Phosphorylation AKT was decreased .Conclusion: Luteolin suppress RBL-2H3 cell degranulation in dose dependence ,which may via impacting the Ca2+influx and the activity of AKT.

Objective To compare the axial length (AL) measured by Lenstar and contact A-Scan in the patients with idiopathic macular hole and study the correlation between the difference of the two measurements and the foveal thickness measured by optical coherence tomography (OCT).Methods Twenty-seven eyes of 26 idiopathic macular hole patients (IMH group) and 27 eyes of 25 patients with mild cataract (control group) were enrolled in this study.Foveal thickness was measured with 3D OCT.The AL was measured by Lenstar and contact A-Scan,and the consistency of the two measurements was determined by Bland Altman analysis.The correlation between the difference of the two measurements and foveal thickness was analyzed by Pearson correlation analysis.Results Mean foveal thickness of IMH and control eyes were (372.85±60.02) μm and (243.44±22.50) μm,respectively.The difference between the foveal thickness of the two groups was highly significant (t=-10.490,P＜0.001).In the IMH group,the AL measured by Lenstar and contact A-Scan were (23.20± 1.12) mm and (23.18± 1.13) mm,respectively,the difference between the two measurements was not statistically significant (t =-0.549,P =0.588),whereas in the control group,the AL was (23.41 ± 0.72) mm by Lenstar and (23.33 ± 0.74) mm by contact A-Scan,the two measurements were significantly different (t=-4.832,P＜0.001).However,no correlation was found by Pearson correlation analysis between the difference of the two measurements and the foveal thickness in either IMH or control group (r=0.181,-0.141; P＞0.05).Conclusions Although there is no difference of axial length measurements using Lenstar and contact A-Scan in IMH eyes,in clinical measurements the results of two instruments should be taken into comprehensive consideration.

ObjectiveTo explore the effects of nutritional intervention and individualized nursing on nutritional risk, undernutrition and quality of life (QOL) in end-stage renal disease (ESRD) patients with peritoneal dialysis. MethodsA total of 104 ESRD patients with peritoneal dialysis who met the inclusion criteria of the protocol were enrolled and randomized to receive nutritional intervention plus individualized nursing ( study group, n =52 analyzed) or self-diet plus routine nursing ( control group, n =50 analyzed) for 6 months. Nutritional risk, anthropometry, and QOL of the two groups were analyzed pre- and post-nutritional intervention. ResultsBaseline data were comparable in the two groups. Prevalences of nutritional risk and undernutrition in study group were significant lower than those in control group after the intervention ( nutritional risk: 32.6％ vs. 56.0％, P =0.028 ;undernutrition: 15.4％ vs. 34.0％, P =0.038). The decrease of grip strength in study group between pre- and post-study was significantly less than that in control group [( - 1.6 ± 0.9 ) kg vs. ( - 9.9 ± 1.4 ) kg, P =0.001], but there were no significant differences in other parameters related to anthropometry, including triceps skin-fold thickness, upper arm circumference, and arm muscle circumference ( all P ＞ 0.05 ). The QOL score significantly increased in study group after intervention but decreased in control group. The differences of renal disease and dialysis-related scores ( △KDTA: 2.5 ± 4.4 vs.- 7.9 ± 7.4, P =0.001 ) and general condition scores (△SF-36 : 3.4 ±4.1 vs.- 6.8 ± 6.3, P =0.001 ) before and after intervention were significantly different between two groups. ConclusionNutrition intervention and individualized nursing may help to improve the nutritional status and QOL in ESRD patients with peritoneal dialysis.

Objective To decrease the unhappiness of children and make them happy to the utmost in their process of seeking medical help by constructing a clinical nursing model of happiness and natural affection. Methods During the clinical process of setting up a suitable surrounding for children's hospi-tal visit and hospitalization, and finding a pleasant method to meet children's psychological needs, indexes of physiological response pre and post admission, discharge and painful operations including surgeries were recorded. Parameters of psychological reactions such as facial expressions, movement reactions and emo-tions were observed and changes of medical compliance were analyzed. We also evaluated variation of fear, time of disease rehabilitation, the satisfaction degree of parents and doctors. Results Child's fear was lowered obviously, cooperation and compliance of treatment were improved remarkably, time of disease re-habilitation was shortened to different degree, the satisfaction degree of patients and doctors had been im-proved to above 98%. Conclusions The clinical nursing model of happiness and natural affection for children can decrease the unhappiness of children and make them happy to the utmost in their process of seeking medical help.

Objective To analyze the cases of malignant tumors found in health examination in our hospital, and to determine the prevalence and characteristics of malignant tumor, and to provide evidence for the development of effective early screening program. Methods A total of 468673 subjects were included from those who had health checkup from July 2009 to December 2014 at the physical examination center. The subjects were between 4 to 96 years of age, with average age of (56.0±12.5) years. Of them, there were 278484 men, 190189 women. All cases found in the examination were confirmed with pathological testing. Prevalence comparison was done withχ2 test, statistic significance level was set at P<0.05. Results Totally 753 cases of malignant tumors were found in 6 consecutive years, with an overall prevalence rate at 160.7/100000. The prevalence rate increased yearly from 50.0/100000 for the first year, and 100.6/100000, 146.1/100000, 149.1/100000, 188.9/100000, 221.6/100000 thereafter. The difference between each 2 years was statistically significant (P<0.01). The top ten malignant tumors were liver cancer, cervical cancer, lung cancer, renal cell carcinoma, esophageal cancer, gastric cancer, colon cancer, breast cancer, leukemia and thyroid cancer. The prevalence rates of malignant tumors in the top three were liver cancer, lung cancer and kidney cancer for man and cervical cancer, lung cancer and breast cancer for women respectively. With the increase of age, the incidence of malignant tumor showed a rising trend, especially for the group of over 80 years old. But women with cervical cancer in the 50-years age group was the highest. Conclusion The number of cases of malignant tumors found in the health checkup population was rising. It is important to include early screening for malignant tumor in physical examination. We should also pay attention to the relevant departments, in order to improve the early cancer detection rate and decrease the morbidity and mortality of malignant tumors.

Objective.To probe into the influence of Jiannao Anshen Capsule of Miao medicine on the behavioral performance,content of cytokine interleukin-1 (IL-1),neuroendocrine hormone melatonin (MT) and monoamine neurotransmitter 5-hydroxytryptamine (5-HT) of rats with sleep deprival.Methods All of the 60 rats were evenly and randomly divided into 5 groups:the normal control group,model control group,estazolam group,Zaoren Anshen group,and Jiannao Anshen of Miao medicine group,respectively.Every group had 12 rats.Sleep deprivation rat model was established by intraperitoneal injection of para-chlorophenyla lanice (PCPA).After successful modeling,the rats were intragastrically administrated with corresponding medicines.The contents of serum 5-HT,IL-1 and MT and the contents of 5-HT,MT in brain tissue were determined.Results Behavioral score,the contents of 5-HT,MT and IL-1 in serum and the contents of 5-HT,MT in brain tissue in insomnia rats caused by PCPA were significantly decreased as compared with normal control group (P ＜ 0.05).In the Jiannao Anshen group,estazolam group and Zaoren Anshen group,the behavioral score,the content of 5-HT,MT and IL-1 in serum and the content of 5-HT and MT in brain tissue of insomnia rats were significantly increased as compared with model control group (P ＜ 0.05).The behavioral score,the content of 5-HT,MT and IL-1 in serum and the content of 5-HT and MT in brain tissue of insomnia rats were not statistically significant different among Jiannao Anshen group,estazolam group and Zaoren Anshen group (P ＞ 0.05).Conclusion Jiannao Anshen capsule of Miao medicine could obviously improve the sleep quality of rats with sleep deprival.The mechanism may be related to improving the content of IL-1,MT and 5-HT.

Objective To evaluate the application of Addenbrooke′s cognitive examination revised(ACE?R)scale to evaluate cognitive function in patients with chronic kidney disease(CKD). Methods We used ACE?R scale to evaluate the cognitive function on 205 cases of CKD patients received outpatient and inpatient treatment in renal Department of four hospitals in Nanjing. One?way ANOVA analysis ,receiver operating characteristic (ROC)curve and other statistical methods were adopted to compare differences. Results (1)There is significant difference of ACE?R scale scores among group NC?NCDs(89.18 ± 4.80),group Mild?NCDs(77.28 ± 5.80)and group Major?NCDs(55.90 ± 10.90)(F = 292.28,P < 0.01). There is significant difference between any two groups(all P<0.01).(2)(ACE?R)scale(AUC=0.944,P<0.01)showed significantly higher sensitivity than mini?mental state examination(MMSE)scale(AUC = 0.777,P < 0.01)on identifying Mild?NCDs patients with chronic kidney disease(P < 0.01);(3)The optimal cut?off value of total ACE?R score between group NC?NCDs and group Mild?NCDs was 83/84,(sensitivity 88.00%,specificity 85.90%,Youden index 0.739),the optimal cut?off value between group Mild?NCDs and group Major?NCDs was 83/84(sensitivity 89.70%,specificity 96.10%, Youden index 0.858). Conclusion ACE?R possesses a good ability in distinguishing different severity of cognitive impairment in patients with CKD. ACE?R can effectively identify early mild cognitive impairment ,which is suitable for clinical application as a tool to evaluating and studying of cognitive function in patients with CKD.

Objective To analyze the clinical efficacy of psychological nursing on patients with pregnancy-induced hypertension (PIH) combined with obstructive sleep apnea hypopnea syndrome (OSAHS).Methods 96 patients with pregnancy-induced hypertension (PIH) combined with OSAHS from January 2009 to July 2012 were admitted.They were randomly divided into the experimental group and the control group with 48 cases in each group.All patients were given routine drug therapy,based on this,the control group received routine care,and the experimental group was given routine care and psychological nursing.The anxiety and depression score and the treatment effect were compared between the two groups.Results After eight-week treatment,in the experimental group,the scores of SAS,SDS declined obviously and the levels of blood pressure were significantly decreased compared with those in the control group.The difference was statistically significant.Conclusions Psychological nursing for patients with pregnancy-induced hypertension(PIH) combined with OSAHS played a positive role in nursing of these patients,it can remit their anxiety and depression emotion and also can significantly decrease the patients'blood pressure.

Objective To investigate the effects of chronic fluorosis on the expressions of matrix metalloproteinase-9 (MMP-9) mRNA and protein and the differentiation and maturation process of bone cell in the osteoclast of bone tissue of rats.Methods According to body weight,thirty-six healthy SD rats(body mass 100-120 g) were divided into three groups by random number table,twelve in each group,half male and half female.The rats of control group were given tap water(NaF ＜ 1 mg/L),and rats of low-fluorine and high-fluorine groups were fed with tap water containing 5 and 50 mg/L NaF to establish chronic fluorosis model.Rats were sacrificed after eight months; the contents of urinary fluoride in 24 hours and bone fluoride were analyzed by fluoride selective electrode.Serum content of tartrate resistant acid phosphatase 5b(TRACP5b)was detected by enzyme-linked immunosorbent assay (ELISA).The paraffin section of bone tissue was stained by hematoxylin-eosin (HE) and pathological morphometry was observed under optical microscope.The protein and mRNA levels of MMP-9 in the osteoclast of bones were detected by immunohistochemistry (IHC) and in situ hybridization (ISH),respectively.Results The differences of fluoride contents of urine and bone in rats were statistically significant between groups(F =400.612,48.229,all P ＜ 0.05).Fluoride contents of urine and bone were increased in lowfluorine and high-fluorine groups[(6.09 + 0.56),(7.69 + 0.64)mg/L,(12.65 ± 3.07),(26.53 + 5.88)mg/kg] compared to the control groups[(1.36 ± 0.51)mg/L,(0.67 ± 0.16)mg/kg,all P ＜ 0.05],and the fluoride contents of urine and bone were gradually increased with increasing fluoride doses(all P ＜ 0.05).The difference of TRACP5b content in serum was statistically significant between groups (F =9.607,P ＜ 0.05),in low-fluorine and high-fluorine groups,the TRACP5b contents[(1.86 ± 0.13),(1.92 ± 0.22)U/L] were higher than that of control group [(1.57 + 0.20)U/L,all P ＜ 0.05].The pathological examination showed osteosclerosis in fluoride exposed groups.The differences of MMP-9 mRNA and protein expressions were statistically significant between groups (F =365.727,331.382,all P ＜ 0.05).Compared to the control groups(97.22 ± 2.24,78.51 ± 1.16),the expressions of MMP-9 protein(108.18 ± 1.97,119.28 ± 1.76) and mRNA(89.44 ± 2.86,102.14 ± 2.39) were increased(all P ＜ 0.05),and the expressions of MMP-9 mRNA and protein were gradually increased with increasing fluoride doses (all P ＜ 0.05).Conclusions Chronic fluorosis might influence osteoclast differentiation and maturation process through regulating the expression levels of MMP-9 protein and mRNA.