BACKGROUND:In anoxic environment, invasive ability of tumor cels significantly increased. The increase in above invasive ability is possibly associated with the changes in urokinase or matrix metaloproteinases. Studies on hypoxia and tumor therapy especialy the effect on chemotherapy have made great progress, and found that hypoxia-inducible factor 1 is a key nuclear factor mediating celular hypoxia response, and also an important factor for regulating cel apoptosis during hypoxia. OBJECTIVE:To observe the effects of cyclooxygenase-2 inhibitor NS-398 on invasive ability of MG-63 cels under hypoxic condition in cel models of hypoxia osteosarcoma. METHODS: Chemical hypoxia inducer cobalt chloride was used to establish chemical hypoxia environment of concentration gradient of 0, 100, 200, 400 μmol/L. Under 200 μmol/L cobalt chloride, concentration gradient of 30, 60, 90 μmol/L of NS-398 were set. Osteosarcoma cels were determined after 48 hours of culture. Quantitative PCR was used to detect the expression of matrix metaloproteinases 9 mRNA and hypoxia-inducible factor 1α mRNA. Western blot assay was applied to measure hypoxia-inducible factor 1α expression. Flow cytometry was utilized to examine cel apoptosis in each group. RESULTS AND CONCLUSION:PCR and western blot assay results demonstrated that with increased concentration of cobalt chloride, matrix metaloproteinases 9 mRNA and hypoxia-inducible factor 1α mRNA and protein expression increased (P < 0.05), showing a concentration-dependent manner. Under cobalt chloride concentration of 200 μmol/L and hypoxia, with increased concentration of NS-398, matrix metaloproteinases 9 mRNA and hypoxia-inducible factor 1α mRNA and protein expression gradualy reduced, showing a concentration-dependent manner (P < 0.05). Flow cytometry results showed that under 400 μmol/L cobalt chloride concentration, cel apoptosis noticeably reduced. Under cobalt chloride concentration of 200 μmol/L and hypoxia, with increased concentration of NS-398, cel apoptosis increased (P < 0.05). Results confirm that anaerobic environment is an important factor for increased invasive ability of osteosarcoma. Under the anaerobic environment, NS-398 could effectively suppress the invasive ability of osteosarcoma and promote cel apoptosis.

Objective To investigate the relationship of polymorphisms at codons 333 and 637 of TAP-1 allele gene to recurrent condyloma acuminatum (CA) in a Chinese population. Methods Amplificatory refraction mutation system-PCR (ARMS-PCR) was performed to detect TAP1 polymorphic residues at codon 333 in 88 patients with recurrent CA and 81 age- and sampling date-matched controls and at codon 637 in 60 patients with recurrent CA and 60 age- and sampling date-matched controls. Results The frequencies of AA,GG and AG genotypes at codon 333 of TAP-1 gene were 86.36%, 0, 13.64%, respectively, in patients with recurrent CA, 79.01%, 0 and 20.99%, respectively, in the controls, and no significant difference was observed between the two groups (χ2 = 1.604, P ＞ 0.05). However, a significant difference was observed in the frequencies of AA, GG and AG genotypes at codon 637 of TAP-1 gene between the patients and controls (3.33% vs 10.0%, 95.00% vs 60.00%, 1.67% vs 30.00%, χ2 = 21.551, P ＜ 0.01 ). Conclusions The recurrence of CA may be associated with the polymorphism at codon 637, but not with that at codon 333, of TAP-1 gene.

Mean platelet volume (MPV) in patients with type 2 diabetes mellitus (DM) and coronary artery disease was increased significantly.In those with acute coronary syndrome,multi-vascular disease,obesity,and highvalue of HbA1C(＞7％),the MPV was much higher.Gisini coronary score,fasting blood glucose,high density lipoprotein cholesterol and HbA1C were the independent predictors of MPV in patients with DM and coronary artery disease.

AIM　To assess the pharmacokinetic profile of single doses of meloxicam in healthy Chinese volunteers. METHODS　The plasma concentrations of meloxicam after an oral dose of 15 mg to twenty healthy male volunteers were analized by means of a validated HPLC method. The pharmacokinetic parameters were subjected to Shapiro-Wilk test to determine whether these data were fitted to a normal distribution. RESULTS The twenty volunteers can be classified into extensive metabolizers and poor metabolizers according to pharmacokinetic parameters. The main parameters in the two groups obtained were as follows: T1/2 were 21±4 and 38±9 h, AUC0-∞ were 49±10 and 110±8 μg*h*mL-1, respectively. Even the AUC data in extensive metabolizers were 1.7 times as that reported in White volunteers following the same doses of meloxicam. CONCLUSION　There were significant individual differences in the pharmacokinetics of meloxicam in Chinese volunteers, which may be due to the genetic polymorphism of CYP2C9.

Objective:To survey the practice of hospice care and influencing factors among health providers in Shanghai.Methods:From November to December in 2019, a sampling survey on the practice of hospice care was conducted among 2 982 health providers from 217 institutions in 16 districts of Shanghai by using the self-designed scale.Results:The overall behavior frequency of hospice care in health providers was between "occasionally" (3 points) and "often" (4 points). The item score was (3.7±0.9), and the total score was (52.1±10.0). In the aspect of building a good relationship with patients and family(77.7%, 2 317/2 982), the participants had the highest work-practice(46.4%, 1 383/2 982). However, they practiced less in recommending the hospice care institutions to terminal patients. In terms of work-practice, the average score in male providers, those with education of undergraduate and above, those being married (including divorced or widowed), medical staff, those with associated senior titles, with witness of dying, or those currently working in the hospice care service department was higher.Conclusions:The hospice care work-practice of health providers in Shanghai is generally satisfactory, however, there is still some discrepancy among health providers with various characteristics. To further improve quality of hospice care, it is necessary to strengthen policy implementation, to encourage multidisciplinary team cooperation and carry out various forms of professional training for health providers.

Objective:To compare the choriocapillaris flow density and choroidal vessel volume (CVV) of acute and chronic central serous chorioretinopathy (CSC).Methods:A cross-sectional observational clinical study. A total of 64 eyes of 64 patients (CSC group) diagnosed with CSC at Department of Ophthalmology of West China Hospital of Sichuan University from May 2019 to October 2020, and a total of 64 eyes of 64 age and gender matched healthy volunteers (control group) during the same period were included in this study. In the CSC group, there were 34 patients with acute CSC (acute CSC group) and 30 patients with chronic CSC (chronic CSC group). There was no significant difference in age ( t=-0.041) and sex composition ratio ( χ2=0.191) between CSC group and control group ( P>0.05). There were statistically significant differences in age ( t=-1.872) and sex composition ratio ( χ2=8.778) between acute CSC group and chronic CSC group( P<0.05). Swept source optical coherence tomography angiography (SS-OCTA) was performed using VG200D. The scanning mode was 512×512 and scannig range was 12 mm × 12 mm. The choriocapillaris flow density of the 3 mm, 6 mm, 12 mm circular area and 1-3 mm ring, 3-6 mm ring, and 6-12 mm ring, and the CVV of the of the 3 mm, 6 mm, 12 mm circular area was automatically generated by the built-in software (v1.28.6). The age, choriocapillaris flow density and CVV were compared between two groups using independent sample t test. Results:Compared with the control group, the choriocapillaris flow density decreased in the CSC group, and there were statistically significant differences in the 3 mm, 6 mm circular area ( t=-7.210, -4.040; P<0.001). There were statistically significant differences between CSC group and control group in the 3 mm, 6 mm, 12 mm circular area ( t=1.460, 12.270, 11.250; P<0.05). Compared with the acute CSC group, the choriocapillaris flow density decreased in the chronic CSC group, and there were statistically significant differences ( P<0.05) in the 3 mm, 6 mm circular area ( t=3.230, 2.330), the total and four quadrants of 1-3 mm ring ( t=2.780, 2.060, 2.140, 2.620, 3.770), the superior quadrants of the 3-6 mm ring ( t=2.550), and the superior and temporal of 6-12 mm ring ( t=3.070, 2.610). There was no significant difference of CVV in the 3 mm, 6 mm and 12 mm circular area between the acute CSC group and the chronic CSC group ( t=0.250, 0.070, -0.110; P>0.05). Conclusion:Compared with acute CSC, chronic CSC exhibits significant decreased choriocapillaris flow density and no change in CVV.

Objective To prospectively compare the clinical effect of 131I therapy for Graves disease (GD) using the 131I-iodide dose determined by radioactive iodine uptake formula and by individualized experience method respectively.Methods (1) A total of 527 GD patients referred for 131I therapy were enrolled and divided into two groups using interval sampling method.Group 1 consisted of 241 patients with their 131I activity calculated by iodine uptake formula.Group 2 consisted of 286 patients with their 131I activity calculated by individualized method based on clinical experience.(2) The patients who were not cured for the first time were retreated after 3 months in the same way until remission.(3) All patients were followed for more than 1 year after GD was cured.The clinical outcome was compared between the 2 groups.x2 test and two-sample t test were used for data analysis.Results There were no significant differences in age,gender,disease course,ATD pretreatment,the time of ATD discontinuation,level of thyroid hormone and autoantibody before 131I therapy,131I uptake rate,size of thyroid and duration of follow-up between the two groups (t=0.156-1.430,x2 =0.159,all P＞0.05).Group 1 had less 131I dose than group 2 ((247.9± 107.3) MBq vs (329.3±177.6) MBq,t=6.102,P＜0.05),fewer patients whose disease was controlled at early stage (x2 =25.279,P＜0.05) and lower remission rate for the first time of treatment (x2 =13.074,P＜ 0.05),but higher repeated treatment rate (t =2.735,P＜0.05) and ratio of hypothyroidism to normalized patients at the first treatment (x2=10.190,P＜0.05).The number of patients with permanent hypothyroidism between the two groups had no statistically significant difference (x2=1.138,P＞0.05).Conclusions The first treatment dose of 131I by individualized experience method is slightly higher than that by radioactive iodine uptake formula.Individualized treatment method for GD based on experience might help to control the GD earlier and improve the one-off remission rate without increasing the rate of hypothyroidism.

Background:Matrix metalloproteinase-9(MMP-9)is known to play a key role in tumor invasion and metastasis by mediating the degradation of extracellular matrix. It has been revealed that neutrophil gelatinase-associated lipocalin ( NGAL)is capable of protecting MMP-9 from degradation and thereby preserving its enzymatic activity. Aims:To explore the MMP-9 and NGAL levels in peripheral blood of gastric cancer patients and their clinical significance. Methods:Serum levels of MMP-9 and NGAL were determined by ELISA in 76 gastric cancer patients and 50 healthy controls. Correlations of serum MMP-9 and NGAL levels with clinicopathological features of gastric cancer were analyzed,and their diagnostic performance for screening gastric cancer was evaluated by ROC curve. Results:Serum levels of MMP-9 and NGAL in patients with gastric cancer were significantly higher than those in healthy controls(P<0. 01),and either of them was positively correlated with the TNM stage of gastric cancer. Furthermore,MMP-9 was correlated with lymph node metastasis and serosal invasion,while NGAL was correlated with distant metastasis. However,tumor differentiation was not correlated with either MMP-9 or NGAL. By ROC curve,608. 19 ng/mL and 14. 71 ng/mL were identified as the cutoff value of serum MMP-9 and NGAL,respectively,for screening gastric cancer. Sensitivity and specificity of MMP-9 were 64. 5% and 90. 0%,and those of NGAL were 85. 5% and 90. 0%,respectively. When parallel test was taken,the sensitivity would be increased to 94. 7% and specificity being 82. 0%. Conclusions:Serum levels of MMP-9 and NGAL are elevated and associated with tumor progression in patients with gastric cancer. Both of them might be used as potential markers for screening,disease assessment and prognosis prediction of gastric cancer.

Objective To discuss the effects of capsular tension ring after phacoemulsification combined with IOL implantation on tilt and decentration of IOL in high myopia patients with cataract by ultrasonic biomicroscope (UBM).Methods A total of 36 cases (40 eyes) with high myopia and cataract underwent phacoemulsification combined with IOL implantation were chosen.The average axial length was 26.88 mm.The patients were divided into implant group (19 eyes,the capsular tension ring was implanted) and control group (21 eyes,the routine surgery was performed).The patients were examined by conventional slit lamp,and the best corrected visual acuity (BCVA)was measured at pre-operation and postoperative 6 months.Tilt and decentration were measured horizontally and vertically,and total tilt and decentration were calculated by geometry method.Results The postoperative BCVA in the two groups were all better than the pre-operation,there was no statistical difference in the preoperative and postoperative BCVA between two groups (all P ＞ 0.05).The horizontal,vertical and total decentration the implant group were (0.15 ± 0.07) mm,(0.30 ± 0.40) mm,(0.11 ±0.02)mm,respectively,which in the control group were (0.26 ± 0.19)mm,(0.32 ±0.60) mm,(0.24 ± 0.97) mm,respectively.The horizontal,vertical and total tilt in the implant group were 0.02° ±0.11°,0.70° ±0.25°,0.21° ±0.74°,respectively,which in the control group were 0.11 ° ± 0.31 °,1.09° ± 0.20°,1.24° ± 0.97°,respectively.There were statistical differences in the horizontal,total tilt and decentration between two groups (all P ＜ O.05),but no statistical difference in the vertical tilt and decentration (P ＞ 0.05).Conclusion The capsular tension ring can stable the IOL position after surgery in high myopia and cataract patients.

Objective:To observe the effect of warm needling plus oral administration of rosuvastatin calcium tablets on blood lipids in cerebral infarction patients. Methods:A total of 125 eligible cases were randomly allocated into group A (n=42), group B (n=40) and group C (n=43). Cases in group A received warm needling plus oral administration of rosuvastatin calcium tablets, cases in group B received warm needling, whereas cases in group C received oral administration of rosuvastatin calcium tablets. Results:After treatment, the total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C) all dropped obviously in the three groups, with significant differences (allP<0.05), modified Barthel index (BI) scores all significantly rise (allP<0.05), and high-density lipoprotein cholesterol (HDL-C) remained unchanged (allP>0.05). After treatment, the changes of TC, TG and LDL-C in group A were significantly different from those in group B and group C (allP<0.05), while the changes showed no statistical significance between group B and group C (P>0.05). There were no between-group differences in HDL-C among the three groups (allP>0.05); the modified BI scores in groupA and groupB were significantly higher than that in group C (bothP<0.05), while there was no significant difference between group A and group B (P>0.05).After treatment, the total effective rate was significantly higher in group A than that in group B and group C (bothP<0.05), there was no significant difference between group B and group C (P>0.05). Conclusion:Warm needling and oral administration of rosuvastatin calcium tablets both can adjust blood lipids effectively in cerebral infarction patients with a similar therapeutic efficacy, while the effect gets better based upon combining both methods; acupuncture-moxibustion plays an important role in the recovery of nerve functions in cerebral infarction patients.