Objective To observe the aging,apoptosis,cell cycle arrest and oxidative stress in human skin fibroblast(HSF)induced by UVB,and to detect the expression profiles of p66Shc,a determinant of oxidative stress response and life span,in this process.Methods HSF cells were exposed to UVB at a subcytotoxic dosage twice a day for three days.The cells without exposure served as control.After another 24-hour culture,SA-β-Gal staining was performed to evaluate the senescence state of the cells,flow cytometry to observe cell apoptosis;cell cycle arrest was detected by serum starvation and flow cytometry:ELISA was applied to detect intracellular levels of superoxide dismutase(SOD)and malondialdehvde(MDA),and Western blotting to analyze the expression of p66Shc protein.Results The percentage of cells positive for SA-β-Gal staining increased from 0 to 98.3% after UVB radiation,which strongly suggested an aging state of HSF cells.The percentage of apoptotic cells increased from 0.96% to 37%.and 80.07% of the HSF cells were arrested in G0/G1 phase following the irradiation.Intracellular SOD activity decreased from(52.35±4.97)ng/g to(7.81±0.68)ng/g(P＜0.01).while intracellular MDA was found to increase from(3.52±0.34)ng/g to(33.91±3.20)ng/g(P＜0.05).The p66Shc protein was found to be weakly expressed in HSF in 24 hours following the exposure to UVB,and a stronger expression was noted 48 hours later.Conclusions HSF cells are induced into a state of senescence associated with oxidative stress after UVB irradiation,which may be applied as an in vitro model in aging research.The expression of p66Shc is increased in HSF during this process,and further studies are needed to explore the relation between p66Shc and oxidative stress as well as cellular aging.

Objective To study the effect of Aloe polysaccharides (AP) on the thymocytic apoptosis and cell cycle in ? - ray irradiated mice. Methods Single- cell thymocytes suspension was sampled at different time points to observe the thymocytic apoptosis and cell cycle by flow cytometry. DNA ladders were tested by 1.8 % agarose gel electrophoresis. Transmission electron microscopy was used to examine the ultrastructure of thymocytes. Results Pre- treating with AP (50 mg/kg,ip) 30 min before irradiation could significantly decrease the percentages of apoptotic thymocytes in? - ray irradiated mice 4 h, 8 h and 12 h after irradiation, increase the percentage of thymocytes at G0/G1 phase and reduce the percentage of thymocytes at G2/M phase. It could also lessen the DNA ladders and reduce the number of apoptotic bodies. Conclusion The protective effects of AP on the thymocytes in ? - ray irradiated mice is related with the alleviation of the disorder of cell cycle and the inhibition of the apoptosis of thymocytes.

Objective To examine the impact of case management on hospitalizations of the chronically and severely mentally ill patients in Zhongshan. Methods Patients with severe and chronic mental illness,aged ≥ 15 years and living in pilot area were divided into two groups naturally since the program of case management launched, 65 cases in the group of case management and 112 patients in the group of standard management. Hospitalizations of the two groups before and after case management were compared. Results Data were analysised with MIXED procedure. Length of stay in days per admission (LOS) of both groups decreased with time in years (F=11.02, P=0.001), and the decline in LOS of case management group was greater than that of standard management group (F=9.02, P=0.003). The average admissions of case management group was more than that of standard management group (F=4.98,P=0.03). There was no significant differences in average hospitalization incidents before and after case management in both groups(case management group 5.13%vs. 5.38%, standard management group 7.14%vs. 8.92%, P>0.05). Conclusions Case management was effective in reducing hospitalizations for a group of Chinese with chronic and severe mental illness, and may contribute to the balance on mental health resources between community and hospital.

Objective To observe and compare the different orthotopic models of papillary thyroid cancer ( PTC) cell lines of RET/PTC1 rearrangement and BRAFV600E mutation in nude mice. Methods Human PTC cell lines TPC-1, BHP5-16 and BHP2-7 were used. The genotypes of RET/PTC1 rearrangement and BRAFV600E mutation were determined by realtime-PCR and DNA sequencing analysis. The cells(2×105) were injected into the thyroid gland of nude mice. The nude mice were executed at 4th, 12th week, and then their thyroid tumors were removed and weighed. The levels of thyroid hormone were detected using chemiluminescent immunoassay. Results Both TPC-1 and BHP2-7 cells were identified as RET/PTC1 rearrangement by real time-PCR, and the expression of RET/PTC1 rearrangement in BHP2-7 cell was higher than that of TPC-1 cell. BRAFV600E mutation was found in BHP5-16 cell by DNA sequencing analysis, but was not found in TPC-1 and BHP2-7 cells. There were different characteristics in three orthotopic nude model groups. Tumorigenic rates of TPC-1 and BHP5-16 groups were 100%, but the growth of tumor was more rapid in BHP5-16 group than that in TPC-1 group, with more weight tumor. The changes of thyroid hormone levels in BHP5-16 group and TPC-1 group were the same, which were normal at 4th week and sharply decreased at 12 th week(P<0. 05). However, the tumorigenic rate of BHP2-7 group was only 6. 25%. Compared with normal control group, there was no statistical difference in the levels of thyroid hormone in BHP2-7group(P>0. 05). Conclusions It showed difference in the orthotopic models of PTC cell lines of RET/PTC1 rearrangement and BRAFV600E mutation in nude mice. BRAFV600E mutation has obvious impacts on increasing tumorigenic rate and promotion of tumor growth in the orthotopic model. It should not be ignored that advanced thyroid tumor will lead to the destruction of thyroid function.

Objective To investigate the relationship between plasma concentration of B type natri uretic peptide (BNP) and the severity and prognosis of patients with acute spontaneous intracerebral hemorrhage (ICH).Methods Review of 86 cases of patients with spontaneous intracerebral hemorrhage analysis in our hospital Department of Emergency/Surgical Intensive Care Unit (ED/S1CU) were admitted within 6 hours of admission to collect blood samples,head CT,biochemical index,Glasgow Coma Scale (GCS) score and other clinical data,and detected within 6 hours after admission,the admission of third days and 7 days of plasma BNP concentration.The blood volume of cerebral hemorrhage was computed.The GCS was used to evaluate nerve function after admission.The survival of 28 days was observed.Results The concentration of BNP detected at 3 time points increased with the increase of the amount of bleeding in patients with acute cerebral hemorrhage and increased with the decrease of GCS score at admission (P ＜0.01).The BNP concentration was mild higher in the small amount of bleeding group than that of the control group (P =0.094),while that of the other two groups were significantly higher (P ＜ 0.01).Concentration of BNP detected within 6 hours of admission was positively correlated with cerebral hemorrhage (r =0.551).The a mount of BNP in the 6 hours after admission of the GCS ＞ 8 group was significantly higher than those of the control group (P ＜ 0.05),and the GCS ≤ 8 group was significantly higher than that of the control group and GCS ＞ 8 group (P ＜ 0.01).The BNP concentration was negatively correlated with GCS score at admission (r =-0.532).The 28-day mortality was predicted by BNP ＞ 168 pg/ml for 6 hours,AUC was 0.814,the sensitivity was 75.0％ and the specificity was 81.4％.Conclusions The concentration of BNP in patients with acute spontaneous intracerebral hemorrhage increased with the increase amount of bleeding and the decrease of GCS score at admission.The concentration of BNP in the 6 hours after admission was correlated with the severity and the prognosis of the disease,which can be used as the important reference indicators for evaluating severity and prognostic prediction.

Objective To observe the clinical effect of a modified version of constraint-induced movement therapy(MCIMT)on motor recovery in the upper extremities of stroke patients. Methods Twenty-seven stroke patients were randomly divided into a treatment group(n=14)and a routine group(n=13).The Bobath approach and functional arm exercise were administered to the patients in the routine group(2 h/d,5 times a week)for ten weeks.The MCIMT administered to the treatment group involved restriction of the functional arm by a sling during 90%of waking time and during training(by shaping)of the affected extremity(1 hour per day,three times a week)in addition to activities of daily living exercise for at least 2 hours every day.The main outcome measures were the ten items of the simplified test for evaluating hand function(STEF)and Wolf's Motor Function Test(WMFT). Results No significant difference was observed between the 2 groups with regard to WMFT and STEF scores before treatment.After treatment,both groups had improved their WMFT and STEF scores significantly,but there was a significant difference between the treatment and the control groups with regard to WMFT scores and 7 items of the STEF test. Conclusion Modified constraint-induced movement therapy is effective not only for promoting motor recovery of the upper extremity,but also for improving the flexibility and velocity of movement instroke patients.

Objective To evaluate the ability of diffusion-weighted imaging (DWI)in differentiating pancreatic carcinoma from chronic lump type pancreatitis. Methods Totally 38 cases of pancreatic cancer, 9 cases of chronic lump type pancreatitis, 15 cases of normal patients underwent DWI. DWI with b value＝0, 500, 1 000 s/mm2 was performed twice. Apparent diffusion coefficient (ADC) was measured by analysis of imagines of ADC. Results The mean ADC value of 38 subjects with pancreatic carcinoma was (1.411± 0.101)×10-3 mm2/sec, the mean ADC value of 9 subjects with lump type pancreatitis was (1.053±0.113) ×10-3 mm2/sec, and the mean ADC value of normal pancreas subjects was (1.245±0.112)×10-3 mm2/s. The difference between the three groups were statistically significant (P＜0.05). Conclusions DWI may have the clinical potential to differentiate chronic lump type pancreatitis from pancreatic carcinoma.

Severe pneumonia is a common disease in intensive care unit (ICU), which is characterized by acute onset, poor prognosis, and can cause multiple systems dysfunction. For critical ill patients, in a state of stress, catabolism is increased, and nutritional risk is extremely high. Proper nutrition treatment can reduce the decomposition of own tissues in the stress period and supplement the protein and energy needed by the body′s metabolism. Therefore, the nutritional treatment of severe pneumonia patients is particularly important. This paper mainly reviews the nutritional literatures of severe pneumonia and critical ill patients in recent years, in order to provide more appropriate nutritional treatment for severe pneumonia patients.

Objective:To investigate the short term outcomes and postoperative respiratory complications of patients with chronic thromboembolic pulmonary hypertension(CTEPH) treated by pulmonary endarterectomy(PEA).Methods:45 consecutive CTEPH patients underwent PEA between December 2017 and January 2020 in our institution were enrolled, including 25 females and 20 males. The mean age of operation was 51.2(25-70) years old. 24(53.5%) patients were in New York Heart Association(NYHA) functional class Ⅲ-Ⅳ. The mean PVR before operation was 923(461-2 711) dyn·s·cm -5. All patients’ data were entered in a prospective database, divieded into patients with respiratory complications group(WRC)and without respiratory complications group(WORC). To assess risk factors for postoperative respiratory complications and its effect on short term outcomes. Results:There was a significant reduction in mPAP(from 37 mmHg to 20 mmHg) and PVR(from 923 dyn·s·cm -5 to 293 dyn·s·cm -5) in the entire group. The in-hospital mortality rate was 4.4%(2 cases), died due to postoperative cardiogenic circulatory failure, even with VA-ECMO treatment and mediastinal infection, respectively. Postoperative respiratory complications occurred in 32 patients(71.1%). The most common complications were reperfusion pulmonary edema 44.4%(20 cases) and residual pulmonary hypertension 11.1%(5 cases). The WRC group showed a tendency to have longer periods of mechanical ventilation, longer ICU stays and more ICU costs. Independent predictors of postoperative respiratory complications were time from symptom onset to PEA>36 months( OR=12.2, 95% CI: 2.1-70.7, P=0.005)and six-minute walking distance<300 m( OR=12.6, 95% CI: 1.1-138.0, P=0.0038). Conclusion:Pulmonary endarterectomy is an effective and safe treatment for CTEPH. Postoperative respiratory complications were mainly determined by symptom onset time and pre-operative status. Patients with CTEPH should consider PEA surgery early.

Purpose: We aimed to investigate whether obtaining a higher level of education was causally associated with lower breast cancer risk and to identify the causal mechanism linking them. Methods: The main data analysis used publicly available summary-level data from 2 large genome-wide association study consortia. Mendelian randomization (MR) analysis used 65 genetic variants derived from the Social Science Genetic Association Consortium as instrumental variables for years of schooling. The outcomes from the Breast Cancer Association Consortium (BCAC) were the overall breast cancer risk (122,977 cases/105,974 controls in women) and the two subtypes: estrogen receptor (ER)-positive breast cancer and ER-negative breast cancer. Fixed and random effects inverse variance weighted methods were used to estimate the causal effects, along with other additional MR methods for sensitivity analyses. Results: Results showed that each additional standard deviation of 4.2 years of education was causally associated with a 27% lower risk of ER-negative breast cancer (odds ratio, 0.73; 95% confidence interval, 0.64–0.84; p-value < 0.001). This finding was consistent with the results of the sensitivity analyses. Physical activities can help improve the protective effect of education against breast cancer, with relatively large mediation proportions. Education increases the risk of ER-positive breast cancer due to alterations in high-density lipoprotein level, triglyceride level, height, waist-to-hip ratio, body mass index, and smoking status, with relative medium mediation proportions. Other mediators including low-density lipoprotein, hip circumference, number of cigarettes smoked per day, time spent performing light physical activity, and performing vigorous physical activity for > 10 minutes explain a small part of the causal effect of education on the risk of developing breast cancer, and their mediation proportion is approximately 1%. Conclusion A low level of education is a causal risk factor in the development of breast cancer as it is associated with poor lipid profile, obesity, smoking, and types of physical activity.