Objective To investigate the expression level of RECK-mRNA and MMP-9-mRNA in breast cancer(BC) and fibroadenoma tissues and its significance.Methods The mRNA level of tissues of 39 cases of breast cancer and 14 cases of fibroadenoma was measured by RT-PCR technique and its correlation was analyzed.Results The mRNA level of RECK gene in breast cancer tissues was markedly lower than that in fibroadenoma tissues,while the MMP-9 level was higher in BC tissues.Conclusions RECK is a tumor suppressor gene, the expression in benign and malignant breast tissues is a negative relationship.BECK can inhibit the expression of MMP-9 and thus,inhibit the growth and metastasis of breast cancer.

BACKGROUND:The conditions of teenager and adult skeletons have great differences. Thus, it is dangerous to place screw on teenagers using the methods for adults.
OBJECTIVE:To observe the anatomical features of teenagers’ upper-middle thoracic vertebra images, and to provide experimental basis for pedicle nailing and pedicle-rib head unit nailing in teenagers’ upper-middle thoracic vertebrae.
METHODS:We chose 30 teenagers (13 to 18 years old) without spine lesions, and then they were scanned (0.625-1.25 mm) from T 1 to T 12 segments using CT. The original data were loaded into a three dimensional software in DICOM format for measuring related indicators. At last, we analyzed the data according to different segments.
RESULTS AND CONCLUSION:The trend between the width of pedicle and pedicle-head unit was similar, showing a“V”shape. The minimum of width was located in the T 4 , and there were significant differences between the corresponding vertebral bodies (P<0.05). The trend between pedicle nail road length and pedicle-rib head unit nail road length was similar, and the trend between them was gradual y increasing. The minimum of length was located in T 1 , and the maximum of length was located at T 10 , and there were significant differences between the corresponding vertebral bodies (P<0.05). The trend between the pedicle transverse angle and pedicle rib-head unit transverse angle was similar. The trend from T1 to T10 was on a decline, and there were significant differences in corresponding vertebrae (P<0.05). The trend of curves between pedicle sagittal angle and pedicle rib-head unit sagittal angle was similar, showing a wavy shape, and there were significant differences in corresponding vertebrae (P<0.05). These results confirmed that the same segmental pedicle rib-head unit can provide a safer nailing place than the pedicle relatively.

Gene engineering has attracted worldwide attention because of its ability of precise location of disease mutations in genome. As a new gene editing technology, clustered regularly interspaced short palindromic repeats (CRISPR)/CRISPR-associated 9 (Cas9) system is simple, fast, and accurate to operate at a specific gene site. It overcomes the long-standing problem of conventional operation. At the same time, stem cells are a good foundation for establishing disease model in vitro. Therefore, it has great significance to combine stem cells with the rapidly developing gene manipulation techniques. In this review, we mainly focus on the mechanism of CRISPR/Cas9 technology and its application in stem cell genomic editing, so as to pave the way for promoting rapid application and development of CRISPR/Cas9 technology.

ObjectiveTo demonstrate the efficacy and safety of Hangzhou tacrolimus capsule (Saishi Tac capsule,Hangzhou Zbongmei Huadong Pharmaceutical Co.Ltd,China) in Chinese liver transplant recipients.MethodsMulticenter,randomized open-labeled,prospective controlled clinical trial was performed in de novo Chinese liver transplant recipients.According to inclusive and exclusive criterion,83 liver recipients from 11transplant centers were enrolled.The recipients accepted Saishi Tac capsule,mycopheolate and steroid 48 h post-operation.The initial dose of Tac was 0.1-0.15 mg kg-1day-1and C0 was 8-12 ng/ml in the first 60 days,followed by 5-10 ng/ml until the terminal observation time poiut (12 weeks after transplantation).The efficacy and safety were estimated during the period.The primary efficacy endpoint of the study was the incidence of biopsy-confirmed acute rejection.Graft survival was the secondary endpoint.Safety was assessed by monitoring laboratory parameters and adverse events reported over the course of the study,such as infection,renal damage,hypertension,hyperlipema and diabetes mellitus and other adverse affairs.ResultsThe dose of Tac at 1st,2nd,4th and 8th week post-operation was (4.1±1.9),(4.5±2.1),(4.5±2.1),(4.4±1.8) and (4.1±2.1) mg,and correspondjng values to the C0 were (8.1±4.5),(8.9±4.5),(8.8±4.3),(8.8±4.1) and (8.0±2.8) ng/ml.During 12 weeks of follow-up,the incidence of biopsy-confirmed acute rejection was 4.8％ (4/83),and all of cases were reversed by implosive therapy.The survival rate of graft hver was 100％.The incidence of lung infection and diabetes mellitus was both 6.02％.ConclusionSaishi Tac capsule was safe and effective to Chinese liver transplant recipients.

Objective:To clarify the long-term trend of nursing human resource allocation in China, and provide basis for relevant departments to optimize nursing human resource allocation.Methods:Data were extracted from China′s health statistical yearbook from 1990 to 2019. Six indicators of the number of registered nurses, the number of registered nurses per 1 000 population, the ratio of registered nurses to health technicians, doctor-nurse ratio, hospital bed-nurse ratio and nurse-patient ratio were used to make a descriptive statistical analysis on the changing trend of nursing human resources in China.Results:From 1990 to 2019, the number of registered nurses increased from 0.970 million to 4.445 million in China, with an average annual growth rate of 5.37%, the average annual growth rate was 2.23% from 1990 to 2005, 9.96% from 2006 to 2013, and 8.21% from 2014 to 2019. The number of registered nurses per 1 000 population increased from 0.85 to 3.18, with a 4.65% annual growth rate, the doctor-nurse ratio increased from 1∶0.55 to 1∶1.15, with a 2.58% annual growth rate, the hospital bed-nurse ratio increased from 1∶0.33 to 1∶0.50, and the average annual growth rate was 1.44%. The proportion of registered nurses to health technicians increased from 24.87% in 1990 to 43.84% in 2019, however, the number of registered nurses in hospitals accounted for about 73.00% of registered nurses in health institutions.Conclusions:From 1990 to 2019, the overall allocation efficiency of nursing human resources in China has been significantly optimized, and indicators such as doctor-nurse ratio and hospital bed-nurse ratio have improved, but the growth rate is slowing down. The relevant departments need to take necessary measures to further increase the absolute and relative number of nurses to cope with the increasing service demand.

Objective To investigate the effect of combined administration of autophagy inhibitor 3?methyladenine/bafilomycin A1 and EGFR inhibitor gefitinib on triple?negative breast cancer MDA?MB?468, MDA?MB?231 cells and estrogen receptor?positive MCF?7 cells. Methods All the cells were treated with 3?methyladenine/bafilomycin A1 and/or gefitinib. The effect of autophagy inhibitor and gefitinib on the cell growth was evaluated by MTT assay. Cell apoptosis was detected by flow cytometry. Western blot analysis was used to determine the alteration of autophagy?related protein ( such as LC3) and apoptosis?related proteins ( such as caspase?3 and caspase?9) . Results MTT assay showed that the IC50 in the GE+3?MA and GE+BAF groups were (4.1±0.2) μmol/L and (3.8±0.3) μmol/L, significantly lower than that of the gefitinib alone group [(7.0±0.2) μmol/L] in MDA?MB?468 cells (P<0.05). Similarly, the IC50 in the GE+3?MA and GE+BAF groups were (9.7±0.1) μmol/L and (7.7±0.2) μmol/L, significantly lower than that of the gefitinib alone group [(14.7±0.1) μmol/L]in MDA?MB231 cells (P<0.05). The flow cytometry assay revealed that the apoptosis rates of MDA?MB?468 cells in GE, GE+3?MA and GE+BAF groups were (12.43± 3.18)%, (23.37±2.71)% and (18.71±2.81)%, respectively. The apoptosis rates of MDA?MB?231 cells of the GE, GE+3?MA and GE+BAF groups were (12.15±1.82)%, (16.94±2.19)% and (33.83±5.92) %, significantly higher than that of the gefitinib alone group (All P<0.05). The apoptosis rates of the MCF?7 cells were not changed significantly among the three groups (P>0.05). Western blot data showed that the expression levels of LC3 and p?Akt were decreased in the combined groups than that of the gefitinib alone group, while the p?PTEN, caspase?3 and caspase?9 were increased. Conclusions Autophagy inhibitor may enhance the sensitivity to gefitinib in MDA?MB?468 and MDA?MB?231 cells by activation of the PTEN/P13K/Akt pathway. Apoptosis in MDA?MB?468 and MDA?MB?231 cells might be enhanced by the combination treatment through caspase cascade.

Objective To investigate the effect of combined administration of autophagy inhibitor 3?methyladenine/bafilomycin A1 and EGFR inhibitor gefitinib on triple?negative breast cancer MDA?MB?468, MDA?MB?231 cells and estrogen receptor?positive MCF?7 cells. Methods All the cells were treated with 3?methyladenine/bafilomycin A1 and/or gefitinib. The effect of autophagy inhibitor and gefitinib on the cell growth was evaluated by MTT assay. Cell apoptosis was detected by flow cytometry. Western blot analysis was used to determine the alteration of autophagy?related protein ( such as LC3) and apoptosis?related proteins ( such as caspase?3 and caspase?9) . Results MTT assay showed that the IC50 in the GE+3?MA and GE+BAF groups were (4.1±0.2) μmol/L and (3.8±0.3) μmol/L, significantly lower than that of the gefitinib alone group [(7.0±0.2) μmol/L] in MDA?MB?468 cells (P<0.05). Similarly, the IC50 in the GE+3?MA and GE+BAF groups were (9.7±0.1) μmol/L and (7.7±0.2) μmol/L, significantly lower than that of the gefitinib alone group [(14.7±0.1) μmol/L]in MDA?MB231 cells (P<0.05). The flow cytometry assay revealed that the apoptosis rates of MDA?MB?468 cells in GE, GE+3?MA and GE+BAF groups were (12.43± 3.18)%, (23.37±2.71)% and (18.71±2.81)%, respectively. The apoptosis rates of MDA?MB?231 cells of the GE, GE+3?MA and GE+BAF groups were (12.15±1.82)%, (16.94±2.19)% and (33.83±5.92) %, significantly higher than that of the gefitinib alone group (All P<0.05). The apoptosis rates of the MCF?7 cells were not changed significantly among the three groups (P>0.05). Western blot data showed that the expression levels of LC3 and p?Akt were decreased in the combined groups than that of the gefitinib alone group, while the p?PTEN, caspase?3 and caspase?9 were increased. Conclusions Autophagy inhibitor may enhance the sensitivity to gefitinib in MDA?MB?468 and MDA?MB?231 cells by activation of the PTEN/P13K/Akt pathway. Apoptosis in MDA?MB?468 and MDA?MB?231 cells might be enhanced by the combination treatment through caspase cascade.

Objective To investigate the levels of serum CC chemokine ligand-11(CCL11)and lipocalin-2(LCN-2)in patients with non-small cell lung cancer(NSCLC)and their diagnostic value for NSCLC.Methods NSCLC pa-tients admitted to the hospital from October 2019 to December 2022 were collected as the NSCLC group(80 cases),and 80 patients with benign lung lesions and 80 healthy volunteers treated in the hospital during the same period were collected as benign control group and health control group.Enzyme linked immunosorbent assay(ELISA)was applied to measure serum levels of CCL11 and LCN-2.The general data and serum levels of CCL11 and LCN-2 were compared among the three groups.Receiver operating characteristic(ROC)curve was applied to analyze the diagnostic value of serum CCL11 and LCN-2 for NSCLC.Logistic regression was applied to analyze the influencing factors of the occurrence of NSCLC.Results The serum levels of CCL11 and LCN-2 in NSCLC group were obviously higher than those in benign control group and health control group(P＜0.05),but there was no statistically significant difference between begin control group and health control group(P＞0.05).There was no statistically significant difference in serum CCL11 and LCN-2 levels among NSCLC patients of different genders,ages,and pathological types(P＞0.05),the serum levels of CCL11 and LCN-2 in NSCLC patients with a history of smoking,engaged in work related oil smoke at dust,medium to low differentiation,tumor diameter＞3 cm,lymph node metastasis,and TNM staging Ⅲ-Ⅳ were obviously higher than those in NSCLC patients without a history of smoking,not engaged in work related oil smoke at dust,high differentiation,tumor diameter ≤3 cm,non lymph node metastasis,and TNM stagingⅠ-Ⅱ(P＜0.05).The results of ROC curve showed that the area under the curve(AUC)of CCL11,LCN-2 alone and their combination in the diagnosis of NSCLC was 0.849,0.841 and 0.926 respectively,the sensitivi-ty was 73.8％,75.0％and 85.0％respectively,and the specificity was 70.1％,70.0％and 75.0％respective-ly.The efficacy of combined detection of the two in diagnosing NSCLC was better than those of single detec-tion(P＜0.05).The results of Logistic regression analysis showed that smoking,engaging in high oil fume,dust related works,and serum levels of CCL11 and LCN-2 were all influencing factors for the occurrence of NSCLC(P＜0.05).Conclusion In NSCLC patients,the levels of serum CCL11 and LCN-2 obviously in-crease,and they are closely related to the clinical pathological characteristics of NSCLC patients.Both have certain clinical value in the diagnosis of NSCLC.

Osteoporotic thoracolumbar fracture in the elderly will seriously reduce their quality of life and life expectancy. For osteoporotic thoracolumbar fracture in the elderly, spinal reconstruction is necessary, which should comprehensively consider factors such as the physical condition, fracture type, clinical characteristics and osteoporosis degree. While there lacks relevant clinical norms or guidelines on selection of spinal reconstruction strategies. In order to standardize the concept of spinal reconstruction for osteoporotic thoracolumbar fracture in the elderly, based on the principles of scientificity, practicality and progressiveness, the authors formulated the Clinical guideline for spinal reconstruction of osteoporotic thoracolumbar fracture in elderly patients ( version 2022), in which suggestions based on evidence of evidence-based medicine were put forward upon 10 important issues related to the fracture classification, non-operative treatment strategies and surgical treatment strategies in spinal reconstruction after osteoporosis thoracolumbar fracture in the elderly, hoping to provide a reference for clinical treatment.

Objective    To explore the efficacy of a novel detection technique of circulating tumor cells (CTCs) to identify benign and malignant lung nodules. Methods     Nanomagnetic CTC detection based on polypeptide with epithelial cell adhesion molecule (EpCAM)-specific recognition was performed on enrolled patients with pulmonary nodules. There were 73 patients including 48 patients with malignant lesions as a malignant group and 25 patients with benign lesion as a benign group. There were 13 males and 35 females at age of 57.0±11.9 years in the malignant group and 11 males and 14 females at age of 53.1±13.2 years in the benign group. e calculated the differential diagnostic efficacy of CTC count, and conducted subgroup analysis according to the consolidation-tumor ratio, while compared with PET/CT on the efficacy. Results     CTC count of the malignant group was significantly higher than that of the benign group  (0.50/ml vs. 0.00/ml, P<0.05). Subgroup analysis according to consolidation tumor ratio (CTR) revealed that the difference was statistically significant in pure ground glass (pGGO) nodules 1.00/ml vs. 0.00/ml, P<0.05), but not in part-solid or pure solid nodules. For pGGO nodules, the area under the receiver operating characteristic (ROC) curve of CTC count was 0.833, which was significantly higher than that of maximum of standardized uptake value (SUVmax) (P<0.001). Its sensitivity and specificity was 80.0% and 83.3%, respectively. Conclusion     The peptide-based nanomagnetic CTC detection system can differentiate malignant tumor and benign lesions in pulmonary nodules presented as pGGO. It is of great clinical potential as a noninvasive, nonradiating method to identify malignancies in pulmonary nodules.