Objective:To analyze the DKK1 expression in breast cancer cell line MDA-MB-231 and examine its effect on the mi-gration and invasion of the cell line. Method:DKK1 expression in the breast cancer tissues was detected immunohistochemically, and DKK1 distribution in the breast cancer cells was observed using immunofluorescence. Western blot was used to investigate DKK1 ex-pression in breast cancer tissues and their matched normal breast tissues. A eukaryotic expression vector of DKK1 was constructed and transfected into MDA231 cell line. The migration and invasion ability of the cells were observed through scratch assay and Boyden chamber, respectively. Results: Immunohistochemical staining showed that DKK1 in the transfected lymph node or non-lymph node was highly expressed in the breast cancer tissues (P<0.05). The positive DKK1 expression in lymph node metastasis was less signifi-cant than those in non-lymph node transfected cells. Immunofluorescence localization results showed a remarkable bright red granular fluorescence in the cytoplasm of the MDA231 cell line. Western blot analysis showed that the DKK1 protein expression in carcinoma tissues were obviously higher than that in matched normal breast tissues. The migration and invasion ability of DKK1-overexpressed MDA231 cell was lower than those of MDA231 cell transfected with pCMV-Tag-2b empty vector. Conclusion:Negative correlation was found between DKK1 expression and the migration and invasion ability in breast cancer cells.

Hyponatremia is the most common electrolyte imbalance.Other than neurological complications,other complications of hyponatremia have not received due attention.Mild,chronic hyponatremia can result in subtle symptoms such as gait disturbance and falls,and increase the risks of osteoporosis and fractures.This paper reviewed the emerging relationship between hyponatremia and bone metabolism,its possible mechanisms and clinical implications.

Objectives To observe the effect of rehabilitation robots with routine rehabilitation training on walking func -tion after stroke .Methods Sixty patients with stroke were randomly divided into treatment group and control group , 30 ca-ses in each group .The control group received routine rehabilitation training while the treatment group received routine reha -bilitation training by rehabilitation robots .The lower extremity functions ,balance and walking ability were assessed with a simplified Fugl-Meyer Assessment(FMA) and using the Berg Balance Scale (BBS) before treatment and after 12 weeks. Results Before treatment , neither the treatment group nor the control group showed any statistically significant difference in terms of FMA and BBS results (P>0.05).After 12 weeks′training, both groups showed significant improvement in terms of FMA and BBS results(P<0.05).The treatment group showed significantly better improvement in lower extremity function, balance and walking function than the control group (P<0.05).Conclusion Rehabilitation robots can signifi-cantly improve walking function in patients after stroke .

Objective To explore the effect classroom teaching quality evaluation on the improve-ment of teaching quality. Methods In-service teachers offering classes to undergraduates majoring in clinical medicine during the period of 2010 to 2011 in Tangshan Clinical Hospital of Hebei Medical University were enrolled as research objectives. Totally 128 teachers(majored in 16 disciplines), screened out from the enrolled teachers, met the criteria and passed through the evaluation in terms of class quality of lessons. They were arranged in descending order and the top 15%were grouped as the preeminent group while the 15%at the bottom were classified as standard group and the rest 70%as good group. Descriptive analysis was made to appraise results from four respects:major and discipline, records of formal school-ing, professional ranks and titles and length of teaching experience. Results Based on the analysis of teaching situation in major disciplines, the top 3 disciplines possessing the largest proportion of preemi-nent teachers were neurology ( 50%) , otolaryngology-head and neck surgery ( 40%) and surgery (20.6%). When it comes to the analysis of formal schooling records of teachers , there is no distinct dis-crepancy in rate of standard reaching between teachers with postgraduate degree and teachers with gradu-ate degree. However, rate of standard reaching was slightly higher in teachers with other degrees than teaching with undergraduate degree or above. In the analysis of professional ranks and titles, the proportion was 94.6%in teachers with senior professional title(associated senior professional title and senior profes-sional title) and the teachers with medium grade professional title only occupied a proportion of 5.4%. In the dimension of teaching years, rate of outstanding and good teachers was relatively high in teachers with 8 teaching years and teacher with less than 3 teaching years, whereas the outstanding rate was low and rate of standard reaching was high in teachers with the 3-4 teaching years. Conclusions Measures to enhance the quality of teaching can be found out according to the analysis of influencing factors of teaching quality evaluation.

Objective To analyze clinical distribution and drug resistance of extended-spectrum β-lactamase(ESBLs)-producing and non ESBLs-producing Escherichia coli(E.coli) isolated from 2014 to 2015.Methods Collected 4 721 clinical specimens from January 2014 to December 2015,separated and identified by using VITEK 2-Compact automatic microorganism identification and sensitivity analysis system of Biomerieux,France.Results A total of 1 181 E.coli were isolated from 4 721 clinical specimens,the isolation rate was 25.02%,and the isolation rates of 2014 and 2015 were 17.38% and 19.24% respectively.Meanwhile,the isolation rates of ESBLs-producing E.coli from 2014 and 2015 were 44.46% and 51.71%,increased 7.25%.For the ESBLs-producing E.coli,the main specimens from urine,sputum,blood,appendix content,pus and secreta,and general surgery department,pneumology department,urology,Neurosurgery departments were the main infection departments.For the non ESBLs-producing E.coli,the main specimens from urine,blood,sputum,appendix content,pus and secreta.The drug resistance of E.coli to antibiotics showed increasingly upward trend from 2014 to 2015.However,it showed high sensitive to amikacin,imipenem and meropenem.Conclusion As the isolation rate of E.coli increased in 2015,so does the drug resistance,and it is need combine with the actual situation of medication to regulate the usage of antibiotics.

Objective To analyze the early risk factors of overweight and obesity in preschool children.Methods Using stratified cluster sampling,the data of 1 335 preschool children's physical examination in High-tech Zone,Urumqi,Xinjiang were collected,and the case group had 153 overweight and obese children,the control group had 1 182 non-overweight and obese children;a case-control study was conducted.The basic data of mothers and the basic data of neonatal birth were analyzed retrospectively.The univariate and unconditional multivariate logistic regression analysis was performed.Results The prevalence of overweight and obesity in preschool children in High-tech Zone in Urumqi was 11.5％.Non-conditional multivariate logistic regression analysis showed that children's age (OR=1.31,95％ CI:1.07-1.61),mother's pre-pregnancy BMI (OR=1.11 95 ％,CI:1.06-1.17) and whether mothers had gestational hypertension (OR=1.99 95％,CI:1.03-3.85) were the risk factors for overweight and obesity in preschool children (P＜0.05).Conclusion In Urumqi high school district preschool children's overweight and obesity rate was high;mothers with high BMI before pregnancy,and those with high blood pressure during pregnancy can increase the risk of overweight and obesity in children,preschool children's increased age may increase the risk of overweight and obesity in children.

BACKGROUND: Intra-articular injection is a classic strategy for the treatment of early osteoarthritis (OA). However, the local delivery of traditional therapeutic agents has limited benefits for alleviating OA. Exosomes, an important type of extracellular nanovesicle, show great potential for suppressing cartilage destruction in OA to replace drugs and stem cellbased administration. METHODS: In this study, we developed a thermosensitive, injectable hydrogel by in situ crosslinking of Pluronic F-127 and hyaluronic acid, which can be used as a slow-release carrier to durably retain primary chondrocyte-derived exosomes at damaged cartilage sites to effectively magnify their reparative effect. RESULTS: It was found that the hydrogel can sustainedly release exosomes, positively regulate chondrocytes on the proliferation, migration and differentiation, as well as efficiently induce polarization of M1 to M2 macrophages. Intraarticular injection of this exosomes-incorporated hydrogel significantly prevented cartilage destruction by promoting cartilage matrix formation. This strategy also displayed a regenerative immune phenotype characterized by a higher infiltration of CD163+ regenerative M2 macrophages over CD86+ M1 macrophages in synovial and chondral tissue, with a concomitant reduction in pro-inflammatory cytokines (TNF-a, IL-1b, and IL-6) and increase in anti-inflammatory cytokine (IL-10) in synovial fluid. CONCLUSION Our results demonstrated that local sustained-release primary chondrocyte-derived exosomes may relieve OA by promoting the phenotypic transformation of macrophages from M1 to M2, which suggesting a great potential for the application in OA.

Objective:To investigate the clinicopathological features, immunophenotype and differential diagnosis of clear cell hidradenoma, and to analyze the origin of clear cell hidradenoma and the underlying mechanism.Methods:The clinical data of 23 cases of clear cell hidradenoma who underwent surgical resection in Suzhou Municipal Hospital between December 2017 and July 2021 were retrospectively analyzed. Clinical manifestation, imaging features, pathological features and prognosis of the 23 cases of clear cell hidradenoma were analyzed. Expression levels of epithelial membrane antigen, cytokeratin 20, cytokeratin 7, cytokeratin 14, carcinoembryonic antigen, and gross cystic disease fluid protein 15 were detected by immunohistochemical staining technique using the EnVision system. Periodic acid-Schiff (PAS) staining was performed to visualize glycogen.Results:Among the 23 cases, 8 were male and 14 were female, aged 14-94 years, with a median age of 55 years. The first symptom of clear cell hidradenoma was epidermal bulgels in 18 cases.Contrast ultrasonography showed a subcutaneous cystic solid echo mass with abundant blood flow in the solid part. The tumor histologically consisted of two types of cells: secretory epithelial cells or glandular epithelial cells and clear cells. Twenty cases had tumors with the features of benign clear cell hidradenoma. Two cases had atypical clear cell hidradenoma with atypia and mitosis. One case had malignant clear cell hidradenoma. Tumor cells were positive for epithelial membrane antigen, cytokeratin 7, cytokeratin 14, carcinoembryonic antigen, and gross cystic disease fluid protein 15 and they were Periodic acid-Schiff-positive. Twenty-three patients were followed up for 2-36 months, of which 4 were lost to follow-up and the rest had no recurrence of clear cell hidradenoma.Conclusion:Clear cell hidradenoma is rare and has a good prognosis. Malignant clear cell hidradenoma is rarer and has a poor prognosis. Diagnosis of clear cell hidradenoma is mainly based on comprehensive analysis of pathological features and immunophenotypes. Clear cell hidradenoma should be differentiated from metastatic clear cell carcinoma, spiral adenoma, cortical adenoma, and malignant melanoma.

Objective To study the estimated value of general pituitary hormone levels and "overall levels of pituitary hormone" in patients with pituitary adenoma.Methods Sixty-six patients presented with non-function pituitary adenomas,admitted to our hospital from January 2009 and April 2013,were chosen in our study.Pre-and post-operative hormonal levels and MR imaging data were collected.Patients were divided into two groups:macroadenoma (1 cm＜diameter＜3 cm) group and huge adenoma (diameter＞3 cm) group,and the patients were divided into subtotal resection group (resection rate＞60％) and partial resection group (resection rate＜60％).Self-made scale of "overall levels of pituitary hormone" was performed to assess the remnant pituitary function.The levels for 6 kinds of pituitary hormones and "overall levels of pituitary hormone" were compared between each two groups.Results (1) The levels of 6 kinds of pituitary hormones between the macroadenoma group (n=38) and huge adenoma group (n=28) showed no significant difference before surgery (P＞0.05);the per-operative "overall levels of pituitary hormone" were statistically different between the macroadenoma group (19.59±2.71) and huge adenoma group (18.07±2.00,P＜0.055);there were 13 patients (34.2％) from macroadenoma group and 17 (60.7％) from huge adenoma group having one or more kinds of pituitary hormones lower than normal levels,with significant difference (P＜0.05).(2) The levels of 6 kinds of pituitary hormones between subtotal resection group (n=57) and partial resection group (n=9) showed no significant difference after surgery (P＞0.05);the post-operative "overall levels of pituitary hormone" in the subtotal resection group were significantly higher than those in the partial resection group (P＜0.05);there were 34 patients (59.6％) from subtotal resection group and 2 (22.2％) from partial resection group having one or more kinds of pituitary hormones lower than normal levels,without significant difference (P＜0.05).Conclusions The "overall levels of pituitary hormone",in which 6 kinds of pituitary hormones are seen as a whole,can assess the remnant pituitary function in pituitary adenoma patients more accurately than evaluation of the 6 kinds of pituitary hormone levels separately.

Tuberculosis(TB) caused by the Mycobacterium tuberculosis(Mtb) is a worldwide public health threat.Microbiota in body affects human health and is involved in human diseases, and its clinical importance is begi-nning to be understood.In this review, studies on the relationship between the establishment of Mtb infection and microbiota as well as the development and antibiotic treatment of Mtb infection were discussed.Studies have shown that: (1) microbiota influences the establishment of Mtb infection; (2) co-infection of Helicobacter pylori alters susceptibility to Mtb infection and progression of active TB; (3) microbiota influences the progression of TB by regulating the nutritio-nal, metabolic and immune status of the host; (4) susceptibility to reinfection increases in TB patients treated with antibiotics, possibly due to T-cell epitope depletion of common intestinal non-Mtb Mycobacterium, the effects of antibio-tics are long-term in patients; (5) the occurrence of childhood TB is age-related and many factors such as co-infection and vaccine inoculation increase risk.An in-depth study of the relationship between the microbiota and TB will provide a new perspective on the prevention of TB.