Objective To evaluate the prognostic impact of a wide spectrum of pathologic parameters in a consecutive series of homogenously treated and well-characterized patients with stage Ⅰ and Ⅱ colorectal cancer, and to investigate the prognostic value of lymph node occult disease (micrometastasis) in disease-free survival rate detected by immunohistochemistry with epithelial membrane antigen and carcinoembryonic antigen. Methods The study included 126 patients operated on by a single surgeon for stage Ⅰ and Ⅱ colorectal tumors. The postoperative follow-up was performed for 64 to 106 months. At least 10 lymph nodes were harvested and examined in all the specimens. The prognostic value of 10 pathologic parameters, including lymph node occult disease (micrometastasis) detected by immunohistochemistry was investigated. Results Multivariate analysis identified lymphatic vessel invasion (absent or present;P=0.009) in lymph node positive and negative by immunohistochemistry. The five-year disease-free survival rates were 78.7%, 65.5% and 43.8% for the lymph node negative, isolated tumor cells and micrometastasis groups, respectively. There was significant difference between the lymph node negative and micrometastasis groups (P=0.005). However, the difference between the lymph node negative and isolated tumor cells groups was not statistically significant (P=0.144). Conclusions We propose that for patients found micrometastasis in lymph node with high-risk stage Ⅰ and Ⅱ colorectal cancer, adjuvant therapies are justified and effective.

Objective To investigate the relationship between gastrin expression and the development of coloreetal neoplasm and cell proliferation.Methods 15 samples of normal coloreetal mucosal tissue,21 samples of coloreetal adenomas and 70 samples of colorectal cancer were selected for evaluation of the expression of gastrin and Ki67 with immunohistochemieal method.Results In normal colorectal mucosal tissues.colorectal adenomas and coloreetal cancer,the positive rates of gastrin expression were 0.28.6%and 25.7%,respectively-which were signff-ieantly hisher in coloreetal cancer and adenomas groups than in the normal colorectal mucosal tissues(P<0.05).But there was no significance between colorectal cancer and adenomas(P>0.05).The positive expression rate of Ki67 with the obove samples were 40.0%,76.2%and 82.8%-respectively,with statistical results identical with results of gastrin(P<0.05).There was significant correlation between gastrin and Ki67[P<0.05).Conclusion Gastrin and Ki67 are highly expressed in eolorectal neoplasm.Gastrin miight play an important role in the carcinogen-esis and development of colorectal neoplasm,and might promote tumor cell proliferation.

Objective We aimed to compare the critical thinking ability between clinical nurses and college nursing students at different grades so as to provide scientific references for reform in nursing education and nursing practice. Methods A total of 287 clinical nurses and 656 nurses in grade one and grade three underwent the investigation by adopting Chinese version of critical thinking disposition inventory (CTDI-CV). Results The total scores of CTDI-CV of nursing students in grade one, nursing students in grade three and clinical nurses were (292.82±26.41), (284.71±26.20) and (290.58±24.87). Statistical difference existed between these groups. The scores of open-mindedness, inquisitiveness and maturity of judgement of nursing students in grade one and grade three were higher than that of the clinical nurses, while the scores of systematicity and self-confidence of critical thinking were less than that of the clinical nurses. Conclusions The current nursing education system needs further reform. At the same time we should also promote the transform of modern clinical nursing model.

Objective To investigate the expression of Vacuolar-H +-ATPase (V-ATPase) and P-glyeoprotein (P-gp) protein in colon carcinoma tissues,the correlation between the expression of V-ATPase and P-gp and their clinicopathological significance.Methods In samples from 80 cases of colon cancer,20 cases of colon adenoma and 10 cases of normal colonic mucosa tissues,the expression of V-ATPase and P-gp protein were detected by immunohistochemical method,their relationship was analyzed,the clinicopathological features and prognosis were evaluated.Results In colon cancer,V-ATPase and P-gp protein expression was 72％ and 80％,higher than that in colon adenomas (40％,35％),and in normal colon mucosa (20％,20％),the difference was statistically significant (P ＜ 0.05).There was a positive correlation between the expression of V-ATPase and that of P-gp (r =0.567,P ＜0.01).V-ATPase and P-gp protein expression in colon cancer was associated with TNM stage,lymph node metastasis and tumor differentiation (P ＜ 0.05).Patients with high V-ATPase expression had lower 5-year survival rate than those with low V-ATPase expression (P =0.023),and 5-year recurrence rate was higher than those with low expression (P =0.024).Conclusions The expression of V-ATPase is up-regulated in colon cancer,there is a positive correlation with colon cancer progress and metastasis,and high V-ATPase protein expression predicts poor prognosis.

Objective To investigate the effect of omeprazole combined with FOLFOX scheme as an adjuvant therapy for stage Ⅱ or Ⅲ colon cancer patients after a radical resection.Methods 98 stage Ⅱ or Ⅲ colon cancer patients in our hospital from January 2008 to December 2009 were randomly divided into study group (48 cases) receiving regimen of omeprazole combined with FOLFOX and control group (50 cases) treated with FOLFOX chemotherapy after radical colectomy.Surgical specimens were examined for expression of V-ATPase protein.Chemotherapy period was 6 months,8-12 courses.We observed results of follow-up curative effect,comparing the side effects and postoperative 2 year,3 year and 5 year disease-free survival rate (DFS) difference using statistical analysis.Results Study was completed in all 93 cases,5 cases were lost to follow-up.The baseline data distribution in the two groups were balanced basically.In study group the gastrointestinal side effects of chemotherapy was lower than the control group (x2 =4.924 6,P =0.026).In the two groups,the 2-year,3-year and 5-year DFS were 73％ vs 60％ (x2 =1.743 7,P =0.187),62％ vs50％ (x2 =1.4075,P=0.235),49％ vs40％ (x2 =0.8159,P=0.366) (P＞0.05).V-ATPase protein expression was 71％ (70/98) in all samples.The 2-year and 3-year DFS of patients for V-ATPase protein positive expression in the two groups were 75％ vs 51％ (x2 =3.970 8,P =0.046),66％ vs 40％ (x2 =4.399 5,P =0.036).Compared with the control group,the 2-year,3-year DFS increased in the study group (P ＜ 0.05).In stage Ⅲ colon cancer patients,the 2-year DFS was 73％ vs 47％ (x2 =4.504 5,P =0.034).Conclusions PPI combined with FOLFOX in V-ATPase protein positive expression or Ⅲ stage colon cancer patients after radical colectemy improves long-term survival,as well as reduces the gastrointestinal side effects of chemotherapy.

Objective To investigate the effect of impulse noise expose on the expression of growth associated protein 43(Gap-43) in inferior colliculus in rat.Methods SPF grade Male SD rats were randomly divided into 5 groups.The normal control group received noise exposure.The model groups received an averange impulse noise exposure of 156 dB SPL with a pulse duration of 0.23 ms, once for 6 s, for 50 times.Auditory brainstem responses (ABRs) were measured before and 3,7,14, and 28 d after noise exposure with tone pips of 2,4,8,16, and 32 kHz, from 20 to 110 dB SPL.Bilateral inferior colliculus of rats in the model groups was collected and treated by immunohistochemical staining.Gap-43 expression of rats in different groups was measured by determining the gray value of inferior immunohistochemical images.Results After noise exposure, ABRs threshold in the model groups were significantly higher than those of in the normal group (P<0.05 or P<0.01).ABRs threshold at 14 and 28 days after noise exposure were significantly lower than 3 days after impulse exposure (P<0.05).Expression of Gap-43 in inferior colliculus was significantly up-regulated in the noise exposed groups compared with the normal group (P<0.05 or P<0.01).Expression of Gap-43 was significantly down-regulated 28 days after noise expose compared with 3 days after noise expose(P<0.05).Conclusion Impulse noise exposure leads to significant elevation of ABR thresholds and up-regulation of Gap-43 expression in inferior colliculus.Impulse noise exposure may induce auditory cortex prominent remodeling.

Clinical studies have confirmed that cryoablation is a safe and effective treatment for lung cancer. Cryoablation has been clinically used in the treatment of various types of lung cancer,and has achieved good therapeutic effects. Some of the complications of cryoablation can be alleviated after symptomatic treat-ment. However,cryoablation still needs further research and exploration in clinical applications.

Objective:To understand the epidemic characteristics of epidemic Japanese encephalitis and the antibody level of healthy people in Longnan City, Gansu Province, analyze and evaluate its epidemic risk, and provide scientific basis for future prevention and control of Japanese encephalitis.Methods:By retrospective analysis, the data of Japanese encephalitis cases in Longnan City from 2015 to 2020 were collected from the "Japanese Encephalitis Monitoring Information Report Management System" of the "China Disease Prevention and Control Information System", and the distributions of the cases(time, region and population distribution) were statistically described and analyzed. In 2018, the cluster stratified sampling method was adopted to select Li County and Xihe County with higher incidence rate of Japanese encephalitis in Longnan City, and Wudu District and Hui County with lower incidence rate as monitoring sites, and 3 administrative villages (communities) were selected from each monitoring site to collect blood samples from healthy people to detect the level of Japanese encephalitis IgG antibodies.Results:From 2015 to 2020, a total of 261 cases of Japanese encephalitis were reported in Longnan City, with an average annual incidence of 1.66 per 100 000; among them, the number of reported cases in 2017 and 2018 accounted for 82.38% (215/261) of the total number of cases. The incidence of Japanese encephalitis was mainly concentrated in August, accounting for 72.03% (188/261); 9 counties (districts) in Longnan City had reported cases of Japanese encephalitis, and the top 5 counties (districts) with the number of cases were Li County (68 cases), Xihe County (64 cases), Wudu District (40 cases), Kang County (33 cases) and Cheng County (18 cases), accounting for 85.44% (223/261) of the total number of cases. The age of onset of Japanese encephalitis cases was mainly concentrated in the 40 - < 60 years old, accounting for 40.23% (105/261); male to female ratio was 1.00 ∶ 1.14 (122 ∶ 139); the occupation was mainly farmers, accounting for 75.86% (198/261). A total of 887 sera samples from healthy people were tested, and the antibody positive rate was 91.09% (808/887); the difference in antibody positive rate of different age groups was statistically significant (χ 2 = 5.77, P < 0.05); the differences of positive rate of antibodies between different genders and regions were not statistically significant (χ 2 = 0.45, 2.06, P > 0.05). Conclusions:The incidence of Japanese encephalitis in Longnan City is mainly middle-aged farmers, with a high incidence in August each year. After the outbreak of Japanese encephalitis in Longnan City in 2017 and 2018, it has showed a low epidemic trend, and the positive rate of Japanese encephalitis antibody in healthy people is high. It is recommended to carry out regular monitoring of Japanese encephalitis immunization level of healthy people and strengthen the immunization of key populations in time.

Objective:To investigate the orthopedists' cognition on Chinese Osteoarthritis Guideline (2018 Edition).Methods:Questionnaire about Chinese Osteoarthritis Guideline (2018 Edition) was developed and sent to orthopedists via an invitation link to fill out after authorization from Chinese Osteoarthritis Association. The content of the questionnaire included the basic personal information of the physician, the awareness rate of the guidelines, the evaluation of the guidelines, and its application effects. The survey duration was from September 2019 to December 2019. Multivariate logistic regression and linear regression analysis were performed for the guideline awareness rate and comprehensive score, respectively.Results:A total of 628 physicians completed the questionnaire, of which 623 of 628 (99.2%) were available. About 72.4% of the orthopedists knew the guideline. The awareness rate was statistically related to the education of the physicians ( P<0.05). Respondents' overall score for the guideline was 8.39 with methodological score 8.28. A total of 41.2% of orthopedists thought that the guideline was very good compared with the European and American guidelines, and the clinical problem coverage rate was 78.6%. There is a statistically significant difference in the appraisal of the recommendations ( χ2=138.9, P<0.05) . More than 40% of orthopedists believed that the guidelines were of great help to orthopedists and patients, and that the guide could be promoted to the primary hospitals. Conclusion:After one year publication of Chinese Osteoarthritis Guideline (2018 Edition), most orthopedists have understood the present guideline and applied recommendations in clinical practice. However, the guideline need to be further promoted and disseminated in the future.

【Objective】 To study the effect of macrophage mediator 1 (MED1) deficiency on atherosclerosis in female mice. 【Methods】 ApoE knockout (ApoE^-/-), LDLR knockout (LDLR^-/-), MED1^fl/fl, and macrophage MED1 knockout (MED1^△Mac) mice were recruited in the study. Two types of mouse model were constructed:ApoE and macrophage MED1 double knockout (MED1^△Mac/ApoE^-/-) mice and their littermate controls (MED1^fl/fl/ApoE^-/-). ② LDLR knockout (LDLR^-/-) mice receiving bone marrow from MED1^△Mac (MED1^△Mac→LDLR^-/-) or MED1^fl/fl (MED1^fl/fl→LDLR^-/-) mice. Female mice from these two models were fed a Western diet (21% fat and 0.15% cholesterol) for 12 weeks to promote the development of atherosclerosis. Body weight, total cholesterol (TC), and total triglyceride (TG) content in plasma were measured dynamically. After Western diet feeding for 12 weeks, aortic tree and aortic root were collected and hematoxylin-eosin (H&E) and oil red O staining were performed. 【Results】 Plasma TC and TG did not significantly differ between MED1^fl/fl/ApoE^-/- control group and MED1^△Mac/ApoE^-/-experimental group. However, the plaque area in aortic tree and aortic root was significantly increased in MED1^△Mac/ApoE^-/-mice. Moreover, compared with that in MED1^fl/fl→LDLR^-/- control group, the plaque area of aortic tree and aortic root had an increasing trend in MED1^△Mac→LDLR^-/- mice group. 【Conclusion】 MED1 deficiency in macrophages promotes the development of atherosclerosis in female ApoE or LDLR knockout mice.