Objective To investigate the potential mechanism of inhibition of ursolic acid(UA) on growth of human gastric cancer cell lines SGC7901 in vitro.Methods SGC7901 cells were cultured in vitro,MTT assay was used to observe the effect of UA on growth of SGC7901 cells in various concentrations for different times.After SGC7901 cells were treated by 0—40 ?mol/L UA for 24 h,morphological changes were observed by inverted microscope.Apoptotic changes were detected by fluorescence microscopy and flow cytometry (FCM).Protein expressions of Bcl-2 and Bax were determined by Western blotting.Results UA(20—40 ?mol/L) could significantly inhibit the growth of SGC7901 cells in a(dose-and) time-dependent manner,the IC_(50) value of UA for SGC7901 cells for 12,24,36,and 48 h were((57.50?)1.18),(34.28?2.05),(27.54?1.11),and(24.83?1.02) ?mol/L,respectively.After UA((20—)40 ?mol/L) treatment for 24 h,SGC7901 cells turned round and floated at different levels;SGC7901 cells were arrested at G_0/G_1 phase and apoptosis was induced,and the apoptotic rate was increased along with the increase of UA concentration.Meanwhile Bcl-2 protein expression decreased,whereas Bax protein expression unchanged.Conclusion UA has a stronger antitumor effect on SGC7901 cells.Cytotoxic effect,proliferation inhibition,and apoptosis may be involoved in the mechanism of UA,and the apoptosis caused by UA may be enhanced by decrease of Bcl-2 protein expression.

Objective To measure the displacement of the silver clips guided by kV-plain film at state of moderate deep inspiration hold(mDIBH) assisted by active breathing control(ABC) and to explore the margin of clinical target volume(CTV) to planning target volume(PTV) for breast cancer patients treated with three-dimensional conformal external-beam partial breast irradiation (EB-PBI) assisted by ABC. Methods The patients undertook CT simulation assisted by ABC to get the CT images on the respiratory condition of mDIBH. Four selected silver clips in breast cavity were delineated and the cavity based on all of the clips were delineated as gross tumor volume (GTV). Before each irradiation, two orthogonal kV-plain films were taken for the patients in the respiratory condition of mDIBH assisted by ABC device. 2D-2D auto-matie registration was performed based on pixel between the kV-plain films and the digital reconstructed radi-ographs(DRR). Then manual registration was undertook to get the shifts of the four clips separately at LAT, LNG,and VRT directions. Based on the shift data,the margins of CTV to PTV at LAT,LNG and VRT direc-tions were calculated. Results The margins from CTV to PTV were 5.00 mm,7.78 mm and 9.30 mm at LAT,LNG and VRT directions based on the clip at cephal border of the cavity. The corresponding margins were 4.40 mm,6.43 mm and 6.73 mm based on the clip at bottom of the cavity;5.04 mm,8.63 mm and 10.54 mm based on the clip at lateral border of the cavity;5.40 mm,8.59 ram and 10.81 mm based on the clip at pedal border of the cavity. Conclusions The silver clips in breast cavity can be clearly showed on the kV-plain film. The displacement of the clips can be exactly measured by registration of kV-plain film and planning DRR in condition of mDIBH assisted by ABC. The margins from CTV to PTV for EB-PBI can be calculated based on the displacement of the clips.

Objective To explore the influence of different delineators and different delineating time on target determination of the whole breast and to explore intrafraction and interaction target displacements of the breast on moderate deep inspiration breathing hold (mDIBH) assisted by active breathing control (ABC) after breast conservative surgery. Methods Twenty patients received primary CT-simulation assisted by ABC to get five sets of CT image on the three breathing condition which included one set from free breath ( FB), two sets from mDIBH and two sets from deep expiration breathing control (DEBH). After radiotherapy with ten to fifteen fractions, the repeat CT-simulation was carried out to get the same five sets of CT image as the primary CT-simulation. The whole breast target were delineated at different time by the same delineator and delineated respectively by five delineators on the first set of CT images got with mDIBH from the primary CT-simulation,and to compare the influence of delineator and delineating time on the whole breast target. The total silver clips in the cavity were marked respectively on the two sets of CT images got with mDIBH from the primary CT-simulation, and to compare the intrafraction displacement of geometric body structured by the total of silver clips. The two ribs near the isocentric plane of the breast target were delineated respectively on two sets of the mDIBH CT image from the primary CT-simulation and on one set of the mDIBH CT image from the repeat CT-simulation, and comparing the movement of the point of interest (POI) of the ribs delineated to get the value of intrafraction and interfraction thoracic expansion. Results There was not statistically significant between the four volumes of whole breast targets delineated by the same delineator at different time, but with statistics significant between the volumes of whole breast target delineated by the different delineators(F = 19.681, P = 0.000). There was not statistically significant between the intrafraction displacements of the POI of the geometric body at each direction, and with no statistically significant between intrafraction displacements of the POI of the ribs delineated on the same mDIBH condition. There was not statistically significant between the interfraction displacements of the POI of the ribs delineated. Conclusions The influence of different delineators on the whole breast target is statistically significant. The difference of displacement of the breast target with the same mDIBH eondition assisted by ABC at the different direction is not statistically significant.

Objective To study the suppressive mechanism of the bromo structural domain inhibitor JQ1 on the acute myeloid leukemia cell line U937 and its regulation of the STAT-5 signaling pathway. Methods U937 cells in the logarithmic growth phase were tested. Each experimental group was fed with 0.2, 1.0 and 4.0μmol/L of JQ1, and a blank control group without JQ1 was set up. U937 cells were cultured for 48 h, and the cell proliferation inhibitory rate was measured by MTT assay. Flow cytometry (FCM) was used to detect the apoptotic rate. Real-time fluorescence quantitative polymerase chain reaction (RT-PCR) was used to detect the mRNA expression of focal adhesion kinase (FAK) and P21 activated kinase (PAK1). The expression of STAT-5 protein was analyzed by Western blot. Results Different concentration of JQ1 could inhibit the proliferation of U937 cells in a time and dose-dependent manner, and different concentration of JQ1 could induce the apoptosis of U937 cells in a dose-dependent manner. Treatment of U937 cells with different concentrations of JQ1 (0.2, 1.0 and 4.0 μmol/L) reduced the expression of FKA mRNA and PAK1 mRNA after 48 h, the expression of FAK mRNA was 0.417±0.066, 0.140±0.026, and 0.027±0.006 (F=454.651, P=0.000), and the expression of PAK1 mRNA was 0.533±0.045, 0.080±0.010, and 0.010±0.001 (F=2434.610, P= 0.000), and STAT-5 protein expression was also significantly inhibited. The expression of STAT-5 protein in U937 cells after treated with different concentrations of JQ1 (0.2, 1.0 and 4.0 μmol/L) for 48 h were 0.71± 0.19, 0.62±0.16, 0.53±0.14, and 1.00±0.21 in the control group (F= 263.135, P= 0.000). Conclusion JQ1 can effectively inhibit the proliferation of the acute myeloid leukemia cell line U937 cells and induce their apoptosis, and the possible mechanism of action is regulated via STAT-5 signaling pathway.

Obj ective To explore yhe causes and yhe nursing measures of unexpecyed exyu-bayion of indwelling cayheyer in hepayobiliary surgery.Methods The clinical daye of 10 payienys wiyh unexpecyedly exyubayion among 402 payienys wiyh hepayobiliary surgery and indwelling cayheyers was analyzed.Results In 10 unexpecyedly exyubayion payienys,yhere were 3 payienys pulling ouy yhe syomach yube by yhemselves,2 payienys pulled ouy abdominal drainage yube in yhe nighy when yurning over.2 payienys′abdominal drainage were auyomayically pulled ouy.1 payieny′s cayheyer and 1 payieny’s deep venous inyubayion were pulled ouy by overly power in yheir yranspory. Jejunum nuyriyion yube wiyhouy suyure fixayion of 1 payieny was pulled ouy.Conclusion According yo yhe causes of unexpecyed exyubayion,improvemeny of nursing measures,syandardized and insyiyu-yionalized nursing can reduce yhe incidence raye of unexpecyed exyubayion.

Obj ective To explore yhe causes and yhe nursing measures of unexpecyed exyu-bayion of indwelling cayheyer in hepayobiliary surgery.Methods The clinical daye of 10 payienys wiyh unexpecyedly exyubayion among 402 payienys wiyh hepayobiliary surgery and indwelling cayheyers was analyzed.Results In 10 unexpecyedly exyubayion payienys,yhere were 3 payienys pulling ouy yhe syomach yube by yhemselves,2 payienys pulled ouy abdominal drainage yube in yhe nighy when yurning over.2 payienys′abdominal drainage were auyomayically pulled ouy.1 payieny′s cayheyer and 1 payieny’s deep venous inyubayion were pulled ouy by overly power in yheir yranspory. Jejunum nuyriyion yube wiyhouy suyure fixayion of 1 payieny was pulled ouy.Conclusion According yo yhe causes of unexpecyed exyubayion,improvemeny of nursing measures,syandardized and insyiyu-yionalized nursing can reduce yhe incidence raye of unexpecyed exyubayion.

Objective:To explore the feasibility of early oral nutrition for gastric cancer patients after total gastrectomy based on propensity score matching.Methods:Using convenience sampling method, a retrospective analysis was conducted on the medical records of 755 patients who underwent total gastrectomy for gastric cancer at Jiangsu Subei People's Hospital from 2012 to 2020. A total of 454 patients who received early oral nutrition after surgery were included in the study group, while 301 patients who received conventional nutrition were included in the control group. The study group patients began eating orally on the first day after surgery, while the control group patients began eating orally after anal exhaust. The propensity score matching method was used to balance confounding factors between two groups.Results:A total of 203 pairs (406 cases) of patients were matched. After matching, there was no statistically significant difference in general data between the two groups ( P>0.05). The study group had lower dietary intake time, first anal exhaust time, hospital stay, incidence of abdominal infection, and incidence of anastomotic fistula compared to the control group, with statistically significant differences ( P<0.05) . Conclusions:Early oral nutrition for gastric cancer patients after total gastrectomy can promote intestinal function recovery, shorten hospital stay, and do not increase the risk of complications, including anastomotic fistula. It has the same acceptable tolerance as conventional nutrition, indicating that early oral nutrition after total gastrectomy is safe and feasible.

Objective To summarize the experience of patient positing,port placements setting and robot cart docking in pediatric robot-assisted laparoscopic upper urinary tract operations.Methods From March 2017 to December 2017,140 robot-assisted laparoscopic upper urinary tract procedures were performed in our institution,including 110 cases of pyeloplasty,15 upper pole heminephroureterectomy,12 simple nephrectomy and 3 adrenalectomy.There were 103 males and 37 females with a range age from 1 month to 18 years.The assistant surgeon was adjacent to the instrument nurse,and patients were placed in a supine position with 60°-80° inclination and keep the legs low to the body.Room setup and patient positioning were similar to the traditional laparoscopic surgery.Semi-hidden incision technique was used in 140 patients:the camera port was placed umbilicus,two additional arm ports (one 5 mm and one 8 mm) were placed under direct vision,the 8 mm arm port was placed on the line of a Pfannenstiel incision and the 5 mm arm port was placed below the Xiphoid along the midline.Finally,a 3 or 5 mm assistant port was placed approximately 3 cm lateral to the inferior arm port,the line of a Pfannenstiel incision.Results The average time was (11.5 ± 3.2) min (10.5-16.5 min) from skin incision to robot cart docking completed.All surgeries were successfully completed without open conversion.One patient required an additional assist port for severe adhesion after the previously open surgery,there was no injury to other viscera.Average operative time was (146.9 ± 48.7)min (78-259 min) and average post-operative hospitalization time was (5.7 ± 1.4) d(4-10 d),respectively.There was no visual scar on abdominal 6 weeks postoperatively,and all parents made comments about their satisfaction with the cosmetic appearance.All operations got complete success at a mean follow up of 6 (1-9) months.Conclusions A good room setup,patient positioning and the semi-hidden incision technique port placements are maintaining the safety of the patient,avoiding compression injuries,allowing maximum mobility of the robotic arms,and facilitating a smooth and efficient surgery,and improving post-operative recovery.

Objective:To express virus-like particles of poliovirus type 2 (PV2-VLP) in insect cells using a recombinant baculovirus expressing P1 and 3CD and to preliminarily evaluate its immunogenicity.Methods:Based on the codon preference of High 5 cells, the sequences of P1 gene and 3CD gene of PV2 were optimized and inserted into pUC57-Amp to construct pUC57-PV2-P1 and pUC57-PV2-3CD. UC57-PV2-P1s mutant that carried P1 gene mutation affecting thermostability was then constructed. Recombinant baculovirus strains of rBac-PV2-P1s-3CD and rBac-PV2-P1-3CD (wild type) were constructed using homologous recombination. The expression of target proteins was detected by Western blot. PV2-VLP was purified by ion exchange chromatography. The structure of VLP was observed under transmission electron microscopy to evaluate the assembly efficiency. The immunogenicity of PV2-VLP was assessed in a rat model.Results:The recombinant baculovirus with stable expression of P1s and 3CD proteins was successfully constructed. Western blot results showed that the yield of VLP was higher after thermostability mutation than that of the wild type. A three-dimensional structure with a diameter of about 30 nm was observed under electron microscopy, indicating that the VLP was successfully assembled. Animal experiment showed that the recombinant PV2-VLP had immunogenicity and could effectively induce the production of neutralizing antibodies.Conclusions:Effective VLP vaccines could be successfully prepared using the insect cell-baculovirus expression system, which provided reference for the development of polio VLP vaccine.

Objective:To analyze the differentially expressed genes in PBMCs of patients with systemic lupus erythematosus (SLE) by bioinformatics methods screening and analyzing the key genes related to ferroptosis, and explore the possible mechanism of ferroptosis involved in the pathogenesis of SLE at the transcription level.Methods:The data sets and samples of healthy people (HC) and SLE patients who met the screening criteria were retrieved from the Gene Expression Omnibus (GEO), a sub-database of the National Center for Biotechnology Information (NCBI). The differentially expressed genes, GO enrichment analysis and KEGG pathway enrichment analysis were analyzed by GEO2R, R language and related software packages. The protein interaction network (PPI) of differential genes was analyzed by STRING, Cytoscape and other tools to explore the key genes and pathways. In addition, real-time quantitative reverse transcription PCR (RT-qPCR) was used to verify the expression of key genes. Mann-Whitney U test was used to compare the expression of key genes in PBMCs between the two groups. Spearman rank correlation analysis was used to explore the relationship between SLE disease activity and the level of key genes. Results:Six data sets were included in this study. A total of 166 genes related to ferroptosis were differentially expressed between SLE and HC groups. The differential genes were specifically expressed in alveolar macrophages, neutrophils, CD49 + cells and CD31 + cells. GO enrichment analysis and KEGG pathway enrichment analysis showed that the differentially expressed genes were mainly involved in multiple signaling pathways closely related to SLE, such as oxidative stress response, infection and TNF signaling pathway. Hub genes screened by different algorithms all suggested RELA as a key gene, and RT-qPCR confirmed that compared with the RELA gene expression level in the HC group [0.75(0.37,1.13)], the expression level in SLE group [2.02 (1.19,4.06)] was increased, the difference was statistically significant ( Z=-3.08, P=0.002), and was positively correlated with the corresponding SLEDAI score of SLE samples ( r=0.52, P=0.019). Conclusion:The ferroptosis of many immune cells, including alveolar macrophages and CD49 + NK cells, is involved in the pathogenesis of SLE. RELA may be involved in the ferroptosis of PBMCs in SLE through the NF-κB pathway.