Dysregulation of cell metabolism, especially glucose metabolism, is implicated in tumorigenesis and tumor progression.Cancer cells uptake a large amount of glucose and prefer to perform glycolysis in the cytosol even under normal oxygen condition, which fuels fast cell growth and proliferation.Dysregulation of glucose metabolism leads to tumorigenesis and promotes cancer development.Conversely, the initiation and development of cancer reprograms glucose metabolism to confer cancer cells the ability to survive and proliferate.Oncogenes, tumor suppressors or non-coding RNAs could regulate glucose metabolism.Meanwhile, the enzymes and metabolites involved in glucose metabolism could regulate the expression of factors related to cancer.Enzymes, the direct executor of cell metabolism, play a key role in dysregulation of glucose metabolism, tumorigenesis and tumor development.

Objective:To optimize the preparation technology of compound sodium lactate injections for the improvement of clari-ty. Methods:The orthogonal test was adopted to screen the best preparation conditions using four influencing factors including the de-carburization temperature of the concentrated solution (A), pH value of the concentrated solution (B), decarburization time of the concentrated solution ( C) and the filling temperature of the injections ( D) with 3 levels for each, and the clarity of the injections as the index. Results:The best preparation conditions were as follows:the decarburization temperature was 60℃, pH value of the con-centrated solution was 6. 5, the decarburization time was 20minute and the filling temperature was 50℃. Conclusion: The optimal process can improve the clarity of compound sodium lactate injections.

In the process of promoting the implementation and transformation of the Q3D guideline of the International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH) in China, the risk assessment of elemental impurities in naturally sourced excipients often faces challenges such as multiple types of elemental impurities and insufficient detection methods. In this paper, an inductively coupled plasma mass spectrometry (ICP-MS) method for screening 12 elemental impurities in titanium dioxide was established using the optimized acid extraction pre-treatment method. The accuracy and repeatability of the method were good. The recoveries of cadmium, lead, mercury, cobalt, nickel, lithium, barium, molybdenum, copper, chromium and iron were 83.6%−101.6%, the recovery of antimony was 54.1%, and the RSD was 1.1%−10.2% (n=6). The evaluation results of elemental impurities showed that the risk of cadmium, mercury, cobalt, nickel, lithium, barium, molybdenum, copper, chromium and antimony was low, while the risk of lead was high, and it is recommended that a lead salt test be added to the pharmacopoeia standard for this product. Based on the statistical data, the differences in the control levels of elemental impurities and whiteness of 29 batches of titanium dioxide samples from 10 domestic and foreign manufacturers were compared and analyzed. The Pearson correlation coefficient method was used to analyze the correlation between residual elemental impurities and whiteness, and a heat map was used to visualize the results. The results showed that whiteness was significantly negatively correlated with the amount of residual barium and the sum of residual elemental impurities. It is suggested that the manufactures should include whiteness as an internally controlled indicator to further improve the quality of titanium dioxide used as a pharmaceutical excipient.

ObjectiveTo evaluate the inhibitive effect of Photodynamic therapy (PDT) with different parameters on dental caries formation in rats.MethodsWistar rats were infected with S.mutans to establish the rat caries mode 1.The rat's teeth were treated with 0.9% NS and 0.2% NaF as controls;laser,photosensitizer and laser plus photosensitizer,respectively as treated groups.Hematoporyrin monomethyl ether(HM ME) was used as photosensitizer and laser as the light source.The rats were sacrificed after five weeks.Keyes count was used to measure the inhibitory effect of PDT on dental caries.The surface morphology of the teeth was evaluated by scan electronic microscopy(SEM).Results The PDT-treated group and NaF-treated group showed significantly reduced Keyes scores compared with the negative controls (P＜0.05).The laser-treated group,photosensitizer-treated group and NS-treated group showed no significantly reduced Keyes scores compared with the negative controls (P＜0.05).The differences of Keyes scores between various parameter PDT treated groups were significant (P＜0.05).Additionally,Keyes scores reduced gradually with the increasing of laser power.The outcome of SEM showed that the teeth treated with different laser powers exhibited different changes in morphology.Conclusion HMMEPDT had significant inhibitive efficacy on caries development in rats and its inhibitory effect presented close correlation with the power of laser,which indicates that it is important to apply appropriate power in clinical treatment.

Aim To explore the effects of Yupingfeng polysaccharide(YPF-P)on T cells of adjuvant arthritis(AA)in rats.Methods Freund's complete adjuvant was used to induce AA in rat.Secondary paw swelling of AA rats was measured with volumeter.Peripneral blood lymphocyte proliferation response induced by concanavalin A(ConA)was examined with MTT assay.The CD4+ and CD8+ T cell in peripheral blood were detected by flow cytometer.ELISA method was applied to determine the content of factor IFN-? and radio-immunity assay of factor IL-4.RT-PCR procedures were utilized to determine the expression of IFN-? mRNA.Results 80,160 mg?kg-1 YPF-P could singnificantly inhibit the secondary paw swelling of AA rats.The suppressesion of lymphocyte proliferation of peripheral blood T cell in AA rats was reversed.After treatment by YPF-P,the number of CD4+ cell and the ratio of CD4+/CD8+ markedly decreased.The level of IFN-? in YPF-P treating group was obviously decreased in comparison with that of model control group,while the level of IL-4 was increased.The mRNA expression of IFN-? was inhibited as well.Conclusion Yupingfeng polysaccharide can regulate the turbulence of periphery abnormal T cell subgroups of adjuvant arthritis rats and can recover Th1/Th2 balance to move towards Th1,which may be one of its mechanisms of inhibiting the secondary paw swelling.

Postoperative surgical site infection (SSI) can lead to adverse clinical outcomes in patients, such as prolonged hospital stay, increased medical costs, and severe economic burden on patients and on society.In addition, it may also cause nosocomial cross-infection.Therefore, it has aroused the high attention of medical workers.The development of SSI is closely related to a variety of factors, including patient factors, such as blood glucose levels, smoking, systemic use of steroids, obesity and malnutrition, and perioperative related factors, such as long preoperative hospital stay, preoperative skin preparation and prophylactic use of antibiotics of patients, hand hygiene and asepsis principles of medical staff, operation-related factors, anesthetic management and operation related factors, operating room environment factors and postoperative factors.Through reading a large number of relevant literatures published in recent years and according to the work characteristics of anesthesiologists, the author summarized the influential factors and preventive measures for postoperative SSI for the reference of fellow doctors.

Objective To investigate the value of Q-analysis real-time elasticity in differentiating between benign and malignant thyroid nodules. Methods Eighty-six thyroid nodules in 62 patients with pathologic diagnosis were included in this study and were examined using Q-analysis real-time elasticity. The real-time elasticity features were observed and the quantitative index including the whole elasticity rate and the local elasticity rate were compared between benign and malignant nodules. Results There were 51 benign and 35 malignant nodules according to histopathological examination. The Q-analysis curve of real-time elasticity of benign nodules was smoother and with lower peak, compared with that of malignant nodules. The whole elasticity rate of malignant nodules were significantly higher than that of benign nodules (3.59±0.84 vs 2.32±0.56, P=0.000). And the local elasticity rate of malignant nodules were significantly higher than that of benign nodules (3.96±1.32 vs 2.39±0.58, P=0.000). The cutoff point of whole elasticity rate for the differential diagnosis was 3.25 with sensitivity, specificity and diagnostic accuracy as 71.4%, 96.1% and 86.0% respectively. The cutoff point of local elasticity rate for the differential diagnosis was 3.45 with sensitivity, specificity and diagnostic accuracy as 68.6%, 96.1% and 84.9% respectively. The diagnostic efficiency of whole elasticity rate and local elasticity rate had no significant difference (P=0.591).Conclusions Q-analysis real-time elasticity could provide the real-time elasticity features of thyroid nodules. The whole and local elasticity rate as the quantitative index contributed to the differential diagnosis of benign and malignant thyroid nodules.

Objective To investigate the effect of different doses of ioversol on renal function,and to explore early renal injury biomarkers on contrast induced kidney injury and safe ioversol dosage.Methods A total of 158 cases (98 males and 60 females) undergoing cerebral vascular intervention (CVI) in our department was selected with age ranging from 23 to 81 years old (average age 59.70 ± 12.02).Based on ioversol dosage in surgery,patients were divided into three groups:low dose group (≤ 150 ml,n =49),middle dose group (151-200 ml,n =74),and high dose group (＞200 ml,n =35).U-κ,U-λ,urinary transferrin (UTRF),urine microalbumin (UMA),urinary immunoglobulin IgG (UIgG),urine beta2-microglobulin (Uβ2-MG),Uα1-MG,urinary N-acetyl-beta-D-glucosaminidase (UNAG),plasma cystatin C (CysC) and Scr were detected by scattering turbidimetry,immune turbidimetry and fully automatic biochemical analysis pre-surgery 24 h and post-surgery 72 h.Contrast-induced acute kidney injury (CI-AKI) was defined as laboratory increase of Scr value≥44.2 μmol/L or ≥25％ from baseline measurement at 48 hours after surgery.The relationship in ioversol dosage and various factors was assessed by Single and multiple factors binary logistic regression analysis.Results According to the criterion that Scr increase value were ≥44.2 μmol/L,of 158 cases,3 cases occurred CI-AKI,the AKI incidence was 1.90％.Based on the criterion that Scr increase value was ≥25％,33 cases occurred CI-AKI,the incidence was 20.89％.The concentration of U-κ,UTRF,Uα1-MG,UNAG and plasma CysC were significantly different in high dose group compared to low ioversol dose group (P ＜ 0.05),while the other biomarkers had no significant difference (P ＞ 0.05).Conclusions The contrast media-ioversol could lead to CI-AKI;when the dosage of ioversol was more than 200 ml one-time,the concentration of U-κ,UTRF,Uα1-MG,UNAG and plasma CysC increased significantly.U-κ,UTRF,Uα1-MG,UNAG and plasma CysC could predict the early renal injury in patients who undergoing CVI.The rise of U-κ,UTRF,Uα1-MG,UNAG and plasma CysC are related to the dosage of ioversol.Furthermore,possibility of kidney injury is significantly high when ioversol dosage is more than 200 ml one-time.

Objective To investigate the therapeutic effect of uteroplasty aided with temporary balloon occlusion of abdominal aorta in treating pernicious placenta previa combined with placenta percreta.Methods Sixty-two third-trimester gravidas who were diagnosed as pernicious placenta previa combined with placenta percreta by prenatal ultrasound and magnetic resonance imaging (MRI) in the First Affiliated Hospital of Zhengzhou University from January 1,2013 to May 31,2016 were enrolled in this study.All of them received cesarean section and then underwent uteroplasty following temporary balloon occlusion of abdominal aorta.Efficacy of that treatment was evaluated from the perspectives of blood loss,operation time,complications and postoperative recovery.All data were analyzed by descriptive analysis.Results All of the 62 cases were diagnosed with placenta percreta during operation including 10 cases (16.1％) with perimetrium invasion,46 cases (74.2％) with invasion to the muscular layer of bladder and six cases (9.7％) with bladder invasion.The average blood loss of all cases during and within 24 hours after operation was (1 377.3±605.2) ml and (140.6±66.3) ml,respectively.The average operation time was (72.3 ±24.5) min and the average length of postoperative hospital stay was (5.8± 1.6) d.The six cases of placenta percreta with bladder invasion received bladder repair.Sixty-one cases had their uterus preserved and the other one case had a sub-total hysterectomy due to amniotic fluid embolism.One woman developed phlebothrombosis in her lower limbs after operation.No intestinal or ureteral injury,puerperal infection,uterine ischemia necrosis or death was reported.In addition to three cases lost to follow-up,the other 59 patients were followed up to May 31,2017.Results of physical examination indicated that the 59 cases had normal uterine involution after operation.Menses returned in 58 of the 59 cases without any difference from before,and did not return in one case due to breastfeeding.Conclusion Uteroplasty aided with temporary balloon occlusion of abdominal aorta is a safe and effective uterus-preserving surgery for patients with pernicious placenta previa combined with placenta percreta.

Objective To invest the prevalence and the missed diagnosis rate of COPD in presurgical patients and their relationship with high risk factors.Methods Epidemic study was carried out in presurgical patients who received pulmonary function test in PFT laboratory of Zhongshan Hospital.Totally 339 patients were selected and their general conditions,exposure history and PFT results were analyzed.Results The prevalence of COPD was 21.8%,and the missed diagnosis rate was 83.8%.About 53.1% subjects had positive exposure history,among which 43.1% had smoking history and 18.6% had occupational exposure history,with the prevalence of 34.2% and 36.5%,between which no statistical significance was revealed.The prevalence of COPD in subjects with negative exposure history was 8.8%,and the missed diagnosis rate was 71.4%.The prevalence of COPD with and without exposure history above the age of 50 years was 38.0% and 10.0%,the former being significantly higher.The prevalence of COPD of men was 25.1%,which was significantly higher than that of women(15.2%)(P=0.04).Logistic regression analysis showed that the prevalence had little relation with gender(OR=0.80,95% CI:0.42～1.51),but had relation with exposure history(OR=4.22,95% CI:2.35～8.34).The severity classification of 62 COPD patients who were newly diagnosed after this PFT:stage Ⅰ 30.6%,stage Ⅱ 56.5%,stage Ⅲ 11.3%,stage Ⅳ 1.9%.Conclusion Most presurgical patients have the risk factors of COPD,like smoking and occupational exposure,and the latter is especially higher in our country.The prevalence and the rate of missed diagnosis of COPD is very high and the classification of severity of most missed diagnosed patients is stage Ⅱ or even more severe.