The Leucine-rich repeats and immunoglobulin-like domains-2 (LRIG2) gene expression in pituitary adenoma and its correlation with tumor invasiveness were studied. The expression of LRIG2 mRNA and protein in human pituitary adenoma obtained surgically was detected by RT-PCR (39 cases) and immunohistochemical staining (30 cases). It was found that LRIG2 was mostly localized at the nucleus of the pituitary adenoma cells. Its expression was significantly higher in the invasive cases than in the non-invasive cases. LRIG2 protein was positive in 14 cases out of 21 cases of invasive adenoma, but only 2 cases were positive in 9 cases of non-invasive adenoma. The positive expression rate of LRIG2 mRNA was 91.3% in invasive cases (total 23 cases) and 62.5% in non-invasive cases (total 16 cases), respectively. LRIG2 gene is overexpressed in invasive pituitary adenoma. It may play an important role in pituitary adenoma invasiveness and further studies are necessary to elucidate the mechanism under this phenomenon.

Objective To investigate the effect of histone deacetylase inhibitor trichostatin A (TSA) on the chemotherapy sensibility of 5-fluorouracil (5-Fu) in colorectal cancer cell line Lovo, and to explore the possible mechanisms.Methods According to the treatment methods, the cells were divided into control group, 5-Fu group, TSA group, TSA preconditioning group and combination group (TSA+5-Fu).MTT assay was used to detect cell proliferation at 24 h, 48 h and 72 h after drugs treatment.Transwell assay was used to test cell invasion after 24 h drugs treatment.Flow cytometer was applied to observe the apoptosis after 24 h drugs treatment.The expressions of thymidylate synthase (TS) were detected by Western blot after 24 h drugs treatment.Results Compared with control group, the 5-Fu group, TSA preconditioning group and combination group had a growth inhibition to Lovo cell at 24 h, 48 h and 72 h (P ＜ 0.05), and compared with 5-Fu group, the growth inhibition of TSA preconditioning group and combination group were distinctive at 48 h and 72 h (P ＜ 0.05).However, the inhibition between TSA preconditioning group and combination group were no significant (P ＞ 0.05).Interfered after 24 h, the number of cells penetrating the matrigel in control group, 5-Fu group, TSA group,TSA preconditioning group and combination group were (25.0±4.2), (16.8±2.8), (19.6± 2.5), (8.2±3.2) and (6.5±2.6), respectively (P ＜ 0.05), and the apoptosis rates were (4.26±1.36) ％, (11.66± 3.18) ％, (8.57±2.69) ％, (39.79±8.53) ％ and (45.18±10.07) ％, respectively (P ＜ 0.05).Compared with control group, the number of cells penetrating the matrigel in the experimental groups was significantly decreased, and the apoptosis rate was significantly increased (P ＜ 0.05).Compared with 5-Fu group, the numbers of cells penetrating the matrigel in TSA preconditioning group and combination group were markedly decreased, and the apoptosis rates were markedly increased (P ＜ 0.05), but the number of cells penetrating the matrigel and the apoptosis rate between TSA preconditioning group and combination group were not different (P ＞ 0.05).The difference of TS expression between control group and 5-Fu group was not significant (P ＞ 0.05).Compared with that in control group and 5-Fu group, TS expressions in TSA group, TSA preconditioning group and combination group were markedly decreased (P ＜ 0.05), but TS expressions among the last three groups were not different (P ＞ 0.05).Conclusion TSA can increase the chemotherapy sensibility of 5-Fu in Lovo cells, which may be dependent on reducing the TS expression.

Objective:To investigate the clinical significance of the primary tumor size in patients with endometrial carcinoma (EC).Methods:A total of 385 patients with EC admitted to Peking University People's Hospital from January 2006 to December 2016 with complete follow up data were selected, whose tumor size data before biopsy were retrospectively studied.Results:(1) The mean diameter of the primary tumor was (3.6±1.8) cm (range: 1-15 cm). And 48 cases were 0-<2 cm, 78 cases were 2-<3 cm, 92 cases were 3-<4 cm, 73 cases were 4-<5 cm, 94 cases were ≥5 cm. The diameter of the tumor was associated with age <60 years old, premenopause, CA 125≥35 kU/L, non-parturition, poor differentiation, stage Ⅲ-Ⅳ, depth of myometrial infiltration ≥1/2, cervical interstitial involvement, adnexal metastasis and lymph node metastasis (all P<0.05), but not associated with body mass index, hypertension, diabetes mellitus, pathology, lymph-vascular space invasion (all P>0.05). (2) Among the 334 patients underwent lymphadenectomy, 45 (13.5%, 45/334) cases with lymph node metastasis were observed. Stratified analysis showed that lymph node metastasis and recurrence rate of patients with EC gradually increased with the increase of tumor size ( P<0.05). Adopting 2, 3, 4 and 5 cm as cut-off values of tumor size, there were significant differences in the rate of lymph node metastasis and recurrence among them observed ( P<0.05), except for lymph node metastasis rate and recurrence rate when the cut-off value was 2 cm ( P>0.05). (3) An receiver operating characteristic (ROC) curve analysis showed that a tumor diameter of 4.25 cm was the cut-off prognostic value to predict lymph node metastasis and recurrence of EC. Conclusions:Tumor diameter is significantly correlated with lymph node metastasis and recurrence in patients with EC. Tumor size should be considered in determining the scope of surgery and adjuvant therapy.

Objective:To evaluate the effectiveness of exogenous melatonin in preventing delirium in critically ill patients.Methods:The computer searched Pubmed, Medline, Embase, Web of Science, the Cochrane Library and other English databases for randomized controlled trials on the efficacy of exogenous melatonin in the prevention of delirium in critically ill patients. The retrieval time was from the establishment of the database to March 2021. Two researchers independently screened the literature, extracted data and evaluated the quality according to the inclusion and exclusion criteria. Revman 5.3 software was used for meta-analysis.Results:A total of 10 randomized controlled trials and 1 224 critically ill patients were included. The results of meta-analysis showed that there were no significant differences in the incidence of delirium during hospitalization (relative risk [ RR] 0.72, 95% confidence interval [ CI] 0.47-1.09; Z=1.57, P=0.12), ICU hospitalization time (mean difference [ MD] -0.36, 95% CI -1.01-0.28; Z=1.11, P=0.27), mechanical ventilation time ( MD -49.42, 95% CI -126.63-27.80; Z=1.25, P=0.21) and mortality ( RR 0.74, 95% CI 0.42-1.30; Z=1.05, P=0.29) between the experimental group and the control group. Conclusion:Exogenous melatonin can not prevent the occurrence of delirium in critically ill patients, nor can it shorten the hospitalization time and mechanical ventilation time in intensive care unit and reduce the mortality.

Objective To study the value of virtual touch tissue imaging quantification (VTIQ) and real-time elastography technology in the differential diagnosis of benign and malignant Thyroid Imaging Reporting and Data System (TI-RADS) 4 thyroid nodules. Methods The real-time elastography imaging and touch tissue imaging quantitative (VTIQ) image features of 110 patients (117 nodules) with TI-RADS 4 thyroid nodules were retrospectively analyzed. The real-time elastic technology was used to measure strain ratio (SR) of nodules. VTIQ technique was used to measure the shear wave velocity (SWV) of nodules. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of the two methods alone and in combination were calculated using postoperative pathology as the gold standard. Then, the ROC curve was drawn, and the area under the curve (AUC) and the optimal cut-off value were obtained. Results There were 43 benign nodules and 74 malignant nodules in 117 thyroid nodules. The specificity, accuracy, positive predictive value, negative predictive value, the area under the ROC curve of the two technologies alone and in combination were 80.3% vs 86.7% vs 83.7%,72.5% vs 82.3% vs 84.2%,76.1% vs 84.6% vs 87.5%,73.3% vs 83.4% vs 84.5%,79.7% vs 85.5% vs 88.7%,0.786 vs 0.869 vs 0.881.According to the ROC curve, the optimal cut-off value of SR was 3.3 and the optimal cut-off value of VTIQ was 3.03 m/s. The Z values and P values of the two methods alone and in combination were (Z=1.95, 1.83, 1.03, all P>0.05), respectively. There was no difference statistically among the three methods. Conclusion The two techniques alone or in combination are valuable in the differential diagnosis of TI-RADS 4 thyroid nodules with similar diagnostic value in the three methods.

Objective To make bibliometrics analysis on case management literature in China so as to understand the research hotspots of case management and provide a basis for development of case management. Methods Journal articles related to case management were retrieved based on the theme "Case Management"in Chinese National Knowledge Infrastructure (CNKI) from 1st January 2009 to 31st December 2018 and the bibliography was collected. Excel and self-design computer program were used to frequency statistics and to construct co-word analysis and co-occurrence matrix of high-frequency keywords. SPSS 22.0 was used to hierarchical cluster analysis. Results A total of 1 102 articles were included and 53 high-frequency keywords were extracted. From 2009 to 2018, case management applied research showed growth trend in China. A total of 988 authors published 1 102 articles in 531 journals. Hierarchical cluster analysis showed that research hotspots of case management in China focused on 8 aspects including community-based rehabilitation, Aids, chronic heart failure, diabetes, peritoneal dialysis, chronic obstructive pulmonary disease, human resources and social work. Conclusions Nearly 10 years, case management is widely used in nursing field and social work, but research depth and width is insufficient. Achievable case management scheme should be built and informative case management system should be constructed to improve prognosis and quality of life of patients. There is still large room for development in the future.

Objective:To analyze the research status and hotspots of post-stroke cognitive impairment management, so as to provide basis for post-stroke cognitive impairment management.Methods:The articles on the post-stroke cognitive impairment management in the Web of Science from November 1, 2011 to November 1, 2021 were retrieved systematically. The bibliometric analysis was carried out from the aspects of year, journal and country. The Latent Dirichlet Allocation (LDA) topic model was used to mine potential topics and determine topic keywords.Results:A total of 1 815 articles were included. The overall number of the article showed a steady growth trend, with a total of 394 source publications, and the journal with the largest number of articles was Stroke (61 articles) . The United States was the main country for research in this field, with 34.93% (634/1 815) of the articles issued. Six topics were identified through the LDA topic model, including functional impairment and mental health in various fields of patients with post-stroke cognitive impairment, neuropsychological screening and evaluation tools, rehabilitation training and effect evaluation, support and health promotion of family caregivers, epidemiological characteristics and risk factors of post-stroke cognitive impairment. Conclusions:The research on the post-stroke cognitive impairment management is generally on the rise. The topic mining and analysis of the research is conducive to further providing the development direction and information support for the post-stroke cognitive impairment management.

Objective:To establish a dental fluorosis model of SD rats with various degrees, to observe the microstructures of enamel samples under scanning electron microscope and to clarify the changes of enamel microstructures with various degrees of dental fluorosis, so as to provide clinical reference for the treatment of patients with moderate and severe dental fluorosis.Methods:Thirty male SD rats (6 weeks of age) were randomly divided into 3 groups with 10 rats in each group. The control group was fed with deionized water without fluoride, the low fluoride group was fed with 50 mg/L NaF deionized water and the high fluoride group was fed with 100 mg/L NaF deionized water in order to establish the dental fluorosis model of rats. After feeding for 6 weeks, the rats were sacrificed and the mandibular incisor teeth were collected and recorded. The surface and sagittal plane of each tooth were observed by scanning electron microscopy and the enamel thickness was measured.Results:In the control group, the enamel color was brown yellow. Enamel color discoloration occurred both in low-fluoride group and high-fluoride group. The enamel color in low-fluoride group was mostly yellow and white striped while in high-fluoride group was mostly chalky white. Under electronic microscope, the enamel rods were alternately arranged and their structure was clear and plump in the control group. The enamel rods of moderate fluorosis were arranged in a straight orientation like tips of bamboo shoots. The enamel rods of severe fluorosis, however, became thinner and the tips of rods were broken. In the control group, sagittal images of enamel turned out to be a dense outer structure with clear boundaries among the inner. The structure of the middle layer was reticulated showing a clear boundary with middle and outer layers. The structure of enamel rods in the inner layers was arranged vertically and horizontally. In the moderate fluorosis group, the outer layer of the enamel became thinner and the middle layer disappeared although the boundary between the outer and middle layers was still clear. In the inner layer, the vertically arranged enamel rods seemed still clear, however the horizontal enamel rods disappeared. In the severe fluorosis group, the outer layer could not be traced. The middle layer was exposed to the air and the inner enamel rods contracted. The inner layers of the enamel had gradually become thinner with the development of the dental fluorosis. The thicknesses of inner layers in control, moderate and the severe groups were (180.71 ±7.01), (157.10 ±11.04) and (121.10 ±12.56) μm respectively. As for the thicknesses of the full layers in the above mentioned three groups, the same trend was observed. The thicknesses, in order of the severity of dental fluorosis, were (241.54 ±7.76), (207.42 ±14.36) and (143.79 ±14.60) μm. Conclusions:With the development of dental fluorosis, the outer enamel layers became thinner or disappeared and the inner enamel layers became thinner or lost its normal structure as well. It is highly recommended that the resin penetration could be used for the proper treatment of moderate and severe dental fluorosis and the strong bleaching and the micro-grinding should be used cautiously.

Objective To explore the expression of aquaporin-2 (AQP-2) in human fetus kidney and amniotic fluid at different stages of pregnancy.Methods Twenty-two cases of aborted fetuses' kidneys were collected.They were divided into 3 groups according to the pregnancy age:8 cases in 17-23 + 6 weeks,8 cases in 24-31 +6 weeks,and 6 cases in 32-38 +6 weeks.Western blot was used to examine the expression of AQP-2 in the kidney.Twenty-four cases of the amniotic fluid were collected,and they were divided into 3 groups according to the pregnancy age:10 cases in 17-23 +6 weeks,6 cases in 24-31 +6 weeks,and 8 cases in 32-38 +6 weeks.Eight cases of healthy adult morning urine were collected as positive controls.The AQP-2 protein in the amniotic fluid was detected with the method of enzyme-linked immunosorbent assay (ELISA) and the osmotic pressure of amniotic fluid at different stages of the pregnancy was measured with the freezing point osmometer.Results The expression of AQP-2 was increased with the extending of pregnancy age,and the AQP-2 expressions in fetus kidney of 17-23 +6 weeks,24-31 + 6 weeks and 32-38 +6 weeks were 0.986 ± 0.335,1.566 ± 0.272,and 2.080 ± 0.246,respectively,and the difference was significant (P ＜ 0.05).The AQP-2 detected from amniotic fluid was positively correlated with the result of AQP-2 in the kidney(r =0.985,P ＜ 0.05),and the AQP-2 expression also increased with the extending of pregnancy age:17-23 +6 weeks,24-31 +6 weeks,32-38 +6 weeks and adult urine was (30.253 ±5.843) mg/L,(35.103 ±7.271) mg/L,and (42.580 ± 1.230) mg/L and (46.493 ± 0.450) mg/L,respectively.The osmolality of the amniotic fluid of 17-23 +6 weeks,24-31 +6 weeks,32-38 +6 weeks was (272.600 ± 4.827) mmol/L,(252.00 ± 15.360) mmol/L,and (261.750 ±5.560) mmol/L,respectively,and the difference was significant(P ＜0.05).Conclusions The AQP-2 expression in human fetus kidneys has good correlation with amniotic fluid,which indicates that the level of AQP-2 of the amniotic fluid may reflect the expression of AQP-2 in the fetus kidney.

Objective To investigate the effect of erythropoietin(EDO)on the expression and function of aqua_porin_1( AQD _1)in the kidney of young male SD rats after release of bilateral ureter obstruction( BUO _ R). Methods Porty_eight young SD rats were randomly divided into bilateral ureteral complete obstruction(BUO)group (n﹦6),BUO_R group(n﹦12),BUO_R﹢EDO group( n﹦12)and Sham group( n﹦18). The BUO model was built through bilateral ureteral ligation. BUO group were killed after 24 h,and BUO_R group and BUO_R﹢EDO group were relieved after obstruction of 24 h. EDO(500 U∕kg)was given to BUO_R﹢EDO rats at 1 h after release of BUO,and then repeated 1 d,3 d and 5 d thereafter and the same volume of 9 g∕L saline was simultaneously given to BUO_R rats. The Sham group was prepared in parallel by laparotomy and free dissection of bilateral ureters but not ligated,both side kidneys and blood samples were collected on 3 d and 7 d(24 h,3 d,7 d for Sham group)after release of BUO. The u_rine samples were collected by using metabolic cage before death. The plasma osmotic pressure,creatinine(Cr)and u_rea nitrogen(BUN)in the plasma of young rats were detected. The expression of AQD_1 protein in all groups of kidney tissues was detected by adopting immunohistochemistry and Western blot. Results On day 3 after release of BUO,24 h water intake and urine volume of BUO_R﹢EDO group were higher than those of Sham group,but lower than those of BUO group(P〈0. 05),the urine osmotic pressure of BUO_R﹢EDO group was higher than that of BUO group,but lower than that of Sham group(P〈0. 05),while plasma osmotic pressure,Cr and BUN of BUO_R﹢EDO group were higher than those of Sham group,but lower than those of BUO group(P〈0. 05),and they were all of lower than BUO group( P 〈0. 05). On day 7 after release of BUO,there was no obvious change in Sham group,and the indexes of BUO_R group and BUO_R﹢EDO group gradually recovered,but they still did not reach the normal level(P〈0. 05). The difference between BUO_R group and BUO_R﹢EDO group was statistically significant(P〈0. 05). The immuno_histochemical results showed that the expression of AQD_1 in collecting duct in BUO group was significantly down_regulated compared with that in Sham group,whereas it was slightly weaker in BUO_R group and BUO_R﹢EDO group than that of Sham group(P〈0. 05). Compared with 3 days after release of BUO,the staining intensity of BUO_R﹢EDO group and BUO_R group was enhanced,but still lower than that of the Sham group. These results were further confirmed by adopting Western blot,and BUO group was also the lowest of the four groups,and BUO_R﹢EDO group was higher than that of BUO group,but lower than that of Sham group( P〈0. 05). Conclusion EDO can promote not only the recovery of AQD_1 protein expression but also the recovery of renal function in young BUO_R rats.