Objective To study the inhibitory effect of valdecoxib on Lewis tumor and the potential relationship with cyclooxygenase-2(COX-2).Methods HE staining was used to observe lymphocyte infiltration in tumor tissue and the cell structure of the stomach and colon.Western blotting was used to detect the expression of COX-2 in tumor tissue.PGE_2 ELISA kit was used to detect the content of PGE_2 in tumor tissue.Results ① Valdecoxib inhibited the growth of the tumor,and the survival rate was increased.②There was lymphocyte infiltration in treatment group and the content of PGE_2 was decreased.③Valdecoxib did not affect cell structure of stomach and colon,bleeding and clotting time.Conclusion Valdecoxib inhibits the growth of the Lewis tumor and enhances the survival rate.The effect of valdecoxib is related to the inhibition of COX-2.

Aim To investigate the effects of oleanolic acid on proliferation of SGC-7901/CDDP cells in vitro and its potential mechanisms.Methods Model of SGC-7901 cells resistant to cisplatin(SGC-7901/CDDP)was established in vitro.MTT assay was used to evaluate the viability of SGC-7901/CDDP cells in vitro.Real-time PCR was used to analyse the expression of Bcl-2 and Bax gene.Results MTT assay showed that oleanolic acid dramatically inhibited the proliferation of SGC-7901/CDDP cells in vitro,more than 62% SGC-7901/CDDP cells were inhibited when the cells were treated with 100 ?mol?L-1 oleanolic acid for 72 h;Real-time PCR showed that Bax(pro-apoptotic gene)was upregulated and Bcl-2(anti-apoptotic)was downregulated after being treated with oleanolic acid.Conclusions These results suggest that oleanolic acid inhibits proliferation of SGC-7901/CDDP cells in vitro,and its potential mechanisms may be through the upregulation of Bax and the downregulation of Bcl-2.

Objective To investigate the expression of CDX2 in different subtypes of intestinal metaplasia (IM) and gastric cancer,and its relationship with Helicobacter Pylori (H.pylori) infection.Methods The expressions of CDX2 protein were detected with immunohistochemical method in 42 cases of chronic atrophic gastritis (CAG),46 cases of CAG with IM,34 cases of paracancerous IM and 50 cases ofgastric cancer.The IM was divided into three subtypes by HID-AB staining:27 cases of IM Ⅰ,23 cases of IM Ⅱ,and 30 cases of IM Ⅲ.H.pylori infection was detected with one minute rapid urease test,serum H,pylori IgG of ELISA method and HE staining in 80 caese of IM,which were divided into 46 cases of H.pylori-posi-tive groups and 34 cases of H.pylori-negative groups.Results The positive rates of H.pylori infection in IM Ⅰ,IM Ⅱ andIM Ⅲ were 66.67％,65.22％ and 43.34％,respectively,and there was no significant difference among different subtypes ofIM (x2=3.953,P＞0.05).The positive rates of CDX2 expression in IM Ⅰ,IM Ⅱ and IM Ⅲ were 85.19％,69.57％ and 36.67％,respectively,and IM Ⅲ were significant lower than IM Ⅰ,IM Ⅱ (x2 =13.899,P＜0.001;x2 =5.638,P=0.018),and there was no significant difference between IM Ⅰ and IM Ⅱ.Comparing of different types of IM group and gastric cancer group showed that the positive rates of CDX2 expression in IM Ⅰ,IM] were significant higher than in gastric cancer group (x2 =14.517,P＜0.001;x2 =5.509,P＜0.05),but there was no significant difference between IM Ⅲ and gastric cancer group (x2 =0.088,P＞0.05).The positive rates of CDX2 expression in H.pylori-positive groups was significant higher than in H.pylori-negative groups in all of.IM (76.09％ vs 44.12％,x2 8.525,P=0.004).Comparing between different subtypes of IM showed that the positive rates of CDX2 expression in H.pylori-positive groups was significant higher than in H.pylori-negative groups in IM Ⅲ (P=0.023),but there was no significant difference between IM Ⅰ and IM Ⅱ (P＞0.05).There was also no significant difference of CDX2 expression between H.pylori-positive groups and H.pylori-negative groups in gastric cancer.Conclusion H.pylori infection may affect the progression of IM and gastric carcinogenesis by affecting the expression of CDX2 in different subtypes of IM.

Objective To analyze the causes of death for 89 HIV/AIDS patients,and the association of CD4+ T lymphocyte counts with the mortality.Methods Data were collected from 89 deceasedpatients who were admitted to Shanghai Public Health Clinical Center from Jan 1996 to Sep 2007,and wereretrospectively analyzed with t-test.Results Heterosexual,blood transfusion and blood products were themajor transmission routs for 89 deceased HIV/AIDS patients.The primary causes of death varied with different levels of CD4+ T lymphocyte counts.With higher CD4+T lymphocyte counts,patients were more likelyto die from non-AIDS-related opportunistic infections such as upper digestive tract hemorrhage.Serious pulmonary infection induced by various etiologies was the primary cause of death.Co-infections of multiple etiologics were often seen in these death cases.Conclusion Opportunistic infection is the primary cause of death for HIV/AIDS patients.Appropriate therapies should be based on CD4+ T lymphocyte counts and patients' specific conditions to reduce the mortality.

Objective To investigate the influence of hedysaryum polysaccharide (HPS)in the kidney function and expressions of Glut-1 mRNA and protein in kidney tissue of db/db mice with diabetic nephropathy (DN)and to elucidate its possible action mechanism.Methods 10 db/m mice were taken as normal control group(n=10);50 fueling animal model db/db mice with DN were randomly divided into model group,enalapril group and the low, middle and high doses of HPS groups(n=10).The mice in noral control group and model group were given physioloical saline by gavege;and the mice in the other groups were respectively given 10 mg·kg-1 ·d-1 enalapril, 100,200 and 400 mg·kg-1 ·d-1 HPS by gavage;lasted 8 weeks.Picric acid method was used to determine the serum creatinine(SCr)level of the mice,enzyme coupling rate method was used to determine the blood urea nitrogen (BUN)level,ELISA method was used to determine the urinary microalbumin(UMALB)level,RT-PCR method was performed to detect the expression of Glut-1 mRNA, and Western blotting and immunohistochemical methods were used to detect the expression of Glut-1 protein.Results Compared with model group,the levels of SCr, BUN, UMALB, the mRNA and protein of Glut-1 expressions were decreased, especially in 400 mg·kg-1 ·d-1 HPS and enalapril groups(P<0.01).The HE and Masson staining results showed that less inflammatory cells infiltration in glomerular of the mice were found, capillary lumens were unobstructed, and the collagen deposition was not obvious in 400 mg·kg-1 ·d-1 group.Conclusion HPS could improve the kidney function of the db/db mice and inhibit the Glut-1 mRNA and protein expressions obviously, which indicates that HPS could delay the development of DN by inhibiting the Glut-1 expression in the glomerular mesangial cell membrane.

Objective:To analyze the drug sensitivity of human lung adenocarcinoma stem cells (LASC) to cisplatin (DDP) and carboplatin (CBP). Methods:Human lung adenocarcinomaic cells SPC-A1,AG,and CPA-Y2 were treated with DDP and CBP. The cell viability of cells was detected by CCK-8 assay. The phenotypic characteristics of drug surviving cells(DSCs)were determined by immunofluorescence staining. The LASC population was then separated by magnetic-activated cell sorting method. The LASC in DSCs was traced by using green fluorescence protein (GFP). The drug sensitivity of DSCs to DDP and CBP was analyzed.Results:The LASC exhibited the phenotypes of bronchioalveolar stem cells (BASC, OCT4~+CCSP~+SP-C~+). After mixture of CD221~+LASC with CD221~-lung adenocarcinoma differentiated cells, the DSC population showed OCT4~+BASC phenotypes. These DSCs were significantly resistant to DDP and CBP.Conclusion:LASC has a high resistance to DDP and CBP. This may be the reason for tumor recurrence after chemotherapy.

Objective To evaluate the effects of Traditional Chinese Medicine (TCM) nursing training based on Kirkpatrick's model relying on TCM hospitals.Methods Totally 77 clinical nurses from 50 medical institutions in Hangzhou were enrolled for TCM training.The four levels of Kirkpatrick's model including reaction,learning,behavior and results were applied for the evaluation together with questionnaires,paper-based exams,scene simulation method and semi-structured interviews.Results Nurses' attendance was over 85％,and average score of training satisfaction was 96.32±5.91 which lied between highly satisfied and very satisfied.TCM knowledge and skills were higher after training(P＜0.05).The scores of self-evaluation and peer evaluation were higher after training(P＜0.05).The numbers of projectsand personnel to practice TCM in the department or outpatient clinic were higher after training (P＜0.05).The patient satisfaction was over 82％.The themes of training benefits among nurses were reaching the expected values,growth and harvest,and expectation of continuous learning.Conclusion Using Kirkpatrick's model as the evaluation tool can evaluate the effects of TCM nursing training relying on TCM hospitals in a comprehensive and long-term manner,and improve the quality of training.

Objective:To study the clinical application and complications of umbilical arterial catheterization (UAC) in premature infants.Methods:From January 2021 to December 2022, premature infants with UAC successfully inserted in NICU of our hospital were enrolled. According to birth weight (BW), the infants were assigned into three groups: <1 000 g, 1 000~1 499 g and ≥1 500 g. The perinatal data, UAC usage, UAC-related complications and risk factors of UAC-related complications were retrospectively analyzed.Results:A total of 39 premature infants received UAC, with gestational age 29.3(27.3, 30.4) weeks and BW 1 100 (900, 1 310) g. The insertion length (IL) of UAC was calculated using the average value of two formulas: a, IL (cm) =4×BW (kg) +7; and b, IL(cm) =3×BW (kg)+9. The accuracy of tube end position was determined using chest/abdomen radiography. 30(76.9%) cases had accurate position, 6(15.4%) had higher position and 3(7.7%) had lower position. The proportion of appropriately positioned tube end in <1 000 g, 1 000~1 499 g and ≥1 500 g groups were 80.0%, 76.5% and 71.4%, respectively, without statistically significant differences ( P>0.05) .No significant differences existed among the three groups in UAC duration and UAC routinely removal rate ( P>0.05). 9 cases (23.1%) of UAC were removed for specific reasons, including 4 cases of arterial spasm, 2 cases of withdrawal of treatment, 1 case of tube end displacement, 1 case of abdominal distension and 1 case of death. 21 cases received 1 U/ml heparin (0.9%NaCl solution) 0.5~1 ml/h arterial infusion. 23.8% (5/21) had hypernatremia and the level of sodium became normal after reducing the concentration of NaCl solution. Arterial vasospasm occurred in 4 patients with skin color changes of one side of the lower extremities. After UAC removal, the skin color returned to normal. Conclusions:UAC is helpful and safe for preterm infants, however, its complications should be alerted to.

OBJECTIVE To evaluate th e effects of comprehensive drug cost control in China ，and to provide reference for further improving the effects of cost control. METHODS Entropy method was used to establish a comprehensive evaluation index system of the comprehensive drug cost control effect from the respective of drug price control ability ，drug cost control ability and patient affordability. The comprehensively evaluate the effects of drug cost control in 31 provinces （autonomous regions and municipalities）during 2016-2020. The k-means cluster method was used to analyze the effects of comprehensive drug cost control in various provinces. RESULTS & CONCLUSIONS During the period of 2016-2020，the total score of comprehensive drug cost control effect of 31 provinces were 14.64，16.71，17.58，17.57，17.88，respectively. The results of cluster analysis were similar to the ranking of entropy method. Medical and health system reform policy had entered a stable period after achieving phased results ； the effects of comprehensive drug cost control was characterized by regional steps in 31 provinces；the effects of comprehensive drug cost control were better in developed coastal areas and some provinces and cities of western regions ，followed by provinces and cities in central China ；however，comprehensive drug cost control in 3 provinces of northeast China showed poor effect. The effects of comprehensive drug cost control in pilot cities of comprehensive medical reform were significantly improved. It is suggested that the successful experience of pilot cities of comprehensive medical reform should be promoted nationwide ，and policies such as volume-based drug procurement ，medical insurance drug price negotiation ，and diagnosis-related groups / diagnosis-intervention packet payment method reform should be further deepened.