Objective To explore the clinicopathological characteristics and prognosis of multiple-molecular classifier endometrioid adenocarcinomas with DNA polymerase epsilon catalytic subunit(POLE)mutations.Methods In this study,we involved 261 patients with endometrioid adenocarcinoma admitted to the Shengjing Hospital of China Medical University.We detected the expression of the POLE gene and that of p53 protein and mismatch repair(MMR)proteins using gene sequencing and immunohistochemistry,respectively.We analyzed the correlation between different molecular classifications and clinicopathological characteristics using x2 or Fisher test,and Kaplan-Meier survival curves to analyze patients' prognosis.Results We identified nine multiple-molecular classifier cases of endome-trioid adenocarcinoma with POLE mutations,including six POLE mutated+p53 abnormal(POLE mut+p53abn)and three POLE mutated+MMR-deficient(POLE mut+dMMR)cases.Patients with POLE mut+p53abn exhibited significant differences from those with p53abn in terms of the pathological characteristics of tumor-infiltrating lymphocytes and the presence of tumors with peritumoral lymphocyte infiltra-tion(P＜0.05),while no statistically significant difference was present compared to patients with POLE mut(P＞0.05).Kaplan-Meier sur-vival curve analysis revealed that the progression-free survival rates of patients with POLE mut+p53abn and POLE mut+dMMR(100.0％)were higher than those of patients with p53abn(50.0％)and dMMR(8.8％,P＜0.05).Conclusion The clinicopathological characteris-tics of patients with POLE mut+p53abn are similar to those with POLE mut.Both patients with POLE mut+p53abn and POLE mut+dMMR display a good prognosis.

Objective:To assess the application effects of an energy-restricted diet combined with high-protein, high-dietary-fiber meal replacement powder and probiotics in overweight/obese adults.Methods:It was a randomized controlled trial. A consecutive sample of 150 overweight/obese adults who underwent physical examinations at the Health Care Center of the First Hospital of Hebei Medical University between November 2021 and March 2022. The participants were randomly assigned into the combined group, the high-protein group, and the common group (50 participants per group) using a random number table method. All three groups of subjects received weight loss health education, energy-restricted diet, and interventions with meal replacement powder and probiotics (or probiotic placebo). The combined group was given high-protein and high-dietary fiber meal replacement powder and probiotics. The high-protein group was given high-protein meal replacement powder and probiotic placebo. The common group was given ordinary meal replacement powder and probiotic placebo. The meal replacement powder was packaged in 35 g per bag, with main components of varying amounts of protein, fat, carbohydrates, vitamins, and trace elements. Both the probiotic powder and the probiotic placebo came in 2 g sachets. The primary components of probiotic powder were various Bifidobacterium, Lactobacillus and excipients, while the main component of probiotic placebo was excipients. The meal replacement powder and the probiotic powder or probiotic placebo were taken twice a day for a total of 12 weeks, one sachet of each time, followed by a 4-week follow-up. The body weight, body mass index, body fat mass, abdominal circumference and hip circumference were measured before the trial (week 0) and at the end of weeks 2, 4, 8, 12, and 16. The change rates of each indicator were calculated. Biochemical indicators, trace elements, and 25-hydroxyvitamin D levels were measured at the end of week 0, 4, 8, and 12. A product evaluation questionnaire was conducted at the end of week 12. A total of 19 cases dropped out due to various reasons. Finally, 46 cases in the combined group, 42 cases in the high-protein group, and 43 cases in the common group were included in the analysis. Paired-samples t test, Kruskal-Wallis H test, one-way analysis of variance, and Mann-Whitney U test were used to compare the differences in weight-loss and maintenance effects, safety and patient acceptance among the three intervention groups, and to analyze the application effect of the energy-restricted diet combined with high-protein and high-dietary fiber meal replacement powder plus probiotics in overweight/obese adults. Results:Among the 131 overweight/obese adults included in the analysis, there were 57 males and 74 females, with a mean age of (37.30±8.33) years. By the end of the week 12, the body mass index [26.87(25.77, 30.38) vs 29.61(27.96, 33.09) kg/m2; 27.10(24.70, 31.37) vs 29.40(27.20, 34.17) kg/m2; 27.98(26.43, 30.12) vs 29.88(28.22, 31.93) kg/m2] and body fat masses [22.15(17.70, 30.15) vs 30.75(25.63, 35.40) kg; 23.35(19.12, 28.70) vs 29.45(26.20, 37.05) kg; 26.80(24.10, 31.60) vs 30.00(26.00, 34.70) kg] in the combined group, the high-protein group and the common group were all lower than those at baseline (week 0) (all P<0.05). At the end of the week 12, the change rates of body fat mass and body mass index in the combined group were both higher than those in the high-protein group and the common group [(25.98%±9.58%) vs (23.88%±11.15%) and (9.35%±11.00%), 9.29%(7.23%, 11.58%) vs 7.96% (5.51%, 10.92%) and 5.77% (2.68%, 10.03%)] (all P<0.05). At the end of the week 12, the body fat mass in the combined group and the high-protein group were both lower than that in the common group [22.15(17.70, 30.15), 23.35(19.12, 28.70) vs 26.80(24.10, 31.60) kg] (both P<0.05). At the end of the week 12, the decreased values of uric acid and high-sensitivity C-reactive protein in the combined group were both higher than those in the high-protein group and the common group [17.15(13.02, 23.45) vs 1.50(0.22, 28.60) and 4.20(0.15, 19.95) μmol/L, 0.43(0.24, 0.60) vs 0.21(0.06, 0.43) and 0.28(-0.04, 0.88) mg/L](both P<0.05). No serious adverse events were observed during the intervention period and at the end of the intervention. In the product evaluation questionnaire, the combined group scored higher than the high-protein group and the common group on items such as usage frequency, taste, satiety, willingness to continue use, willingness to recommend to others, and willingness to purchase [4(3, 4) vs 3(3, 4) and 3(2, 4) points, 4(3, 4) vs 3(3, 4) and 3(2, 4) points, 4(3, 4) vs 3(3, 4) and 3(3, 3) points, 4(3, 4) vs 3(3, 4) and 3(3, 4) points, 4(3, 4) vs 3(3, 4) and 3(3, 3) points, 3(3, 4) vs 3(3, 4) and 3(2, 3) points] (all P<0.05). Conclusion:An energy-restricted diet combined with high-protein, high-dietary-fiber meal replacement powder and probiotics demonstrates superior weight-loss and weight-maintenance effects in overweight/obese adults, with high safety and great user acceptability.

Objective To explore the clinicopathological characteristics and prognosis of multiple-molecular classifier endometrioid adenocarcinomas with DNA polymerase epsilon catalytic subunit(POLE)mutations.Methods In this study,we involved 261 patients with endometrioid adenocarcinoma admitted to the Shengjing Hospital of China Medical University.We detected the expression of the POLE gene and that of p53 protein and mismatch repair(MMR)proteins using gene sequencing and immunohistochemistry,respectively.We analyzed the correlation between different molecular classifications and clinicopathological characteristics using x2 or Fisher test,and Kaplan-Meier survival curves to analyze patients' prognosis.Results We identified nine multiple-molecular classifier cases of endome-trioid adenocarcinoma with POLE mutations,including six POLE mutated+p53 abnormal(POLE mut+p53abn)and three POLE mutated+MMR-deficient(POLE mut+dMMR)cases.Patients with POLE mut+p53abn exhibited significant differences from those with p53abn in terms of the pathological characteristics of tumor-infiltrating lymphocytes and the presence of tumors with peritumoral lymphocyte infiltra-tion(P＜0.05),while no statistically significant difference was present compared to patients with POLE mut(P＞0.05).Kaplan-Meier sur-vival curve analysis revealed that the progression-free survival rates of patients with POLE mut+p53abn and POLE mut+dMMR(100.0％)were higher than those of patients with p53abn(50.0％)and dMMR(8.8％,P＜0.05).Conclusion The clinicopathological characteris-tics of patients with POLE mut+p53abn are similar to those with POLE mut.Both patients with POLE mut+p53abn and POLE mut+dMMR display a good prognosis.

Objective:To assess the application effects of an energy-restricted diet combined with high-protein, high-dietary-fiber meal replacement powder and probiotics in overweight/obese adults.Methods:It was a randomized controlled trial. A consecutive sample of 150 overweight/obese adults who underwent physical examinations at the Health Care Center of the First Hospital of Hebei Medical University between November 2021 and March 2022. The participants were randomly assigned into the combined group, the high-protein group, and the common group (50 participants per group) using a random number table method. All three groups of subjects received weight loss health education, energy-restricted diet, and interventions with meal replacement powder and probiotics (or probiotic placebo). The combined group was given high-protein and high-dietary fiber meal replacement powder and probiotics. The high-protein group was given high-protein meal replacement powder and probiotic placebo. The common group was given ordinary meal replacement powder and probiotic placebo. The meal replacement powder was packaged in 35 g per bag, with main components of varying amounts of protein, fat, carbohydrates, vitamins, and trace elements. Both the probiotic powder and the probiotic placebo came in 2 g sachets. The primary components of probiotic powder were various Bifidobacterium, Lactobacillus and excipients, while the main component of probiotic placebo was excipients. The meal replacement powder and the probiotic powder or probiotic placebo were taken twice a day for a total of 12 weeks, one sachet of each time, followed by a 4-week follow-up. The body weight, body mass index, body fat mass, abdominal circumference and hip circumference were measured before the trial (week 0) and at the end of weeks 2, 4, 8, 12, and 16. The change rates of each indicator were calculated. Biochemical indicators, trace elements, and 25-hydroxyvitamin D levels were measured at the end of week 0, 4, 8, and 12. A product evaluation questionnaire was conducted at the end of week 12. A total of 19 cases dropped out due to various reasons. Finally, 46 cases in the combined group, 42 cases in the high-protein group, and 43 cases in the common group were included in the analysis. Paired-samples t test, Kruskal-Wallis H test, one-way analysis of variance, and Mann-Whitney U test were used to compare the differences in weight-loss and maintenance effects, safety and patient acceptance among the three intervention groups, and to analyze the application effect of the energy-restricted diet combined with high-protein and high-dietary fiber meal replacement powder plus probiotics in overweight/obese adults. Results:Among the 131 overweight/obese adults included in the analysis, there were 57 males and 74 females, with a mean age of (37.30±8.33) years. By the end of the week 12, the body mass index [26.87(25.77, 30.38) vs 29.61(27.96, 33.09) kg/m2; 27.10(24.70, 31.37) vs 29.40(27.20, 34.17) kg/m2; 27.98(26.43, 30.12) vs 29.88(28.22, 31.93) kg/m2] and body fat masses [22.15(17.70, 30.15) vs 30.75(25.63, 35.40) kg; 23.35(19.12, 28.70) vs 29.45(26.20, 37.05) kg; 26.80(24.10, 31.60) vs 30.00(26.00, 34.70) kg] in the combined group, the high-protein group and the common group were all lower than those at baseline (week 0) (all P<0.05). At the end of the week 12, the change rates of body fat mass and body mass index in the combined group were both higher than those in the high-protein group and the common group [(25.98%±9.58%) vs (23.88%±11.15%) and (9.35%±11.00%), 9.29%(7.23%, 11.58%) vs 7.96% (5.51%, 10.92%) and 5.77% (2.68%, 10.03%)] (all P<0.05). At the end of the week 12, the body fat mass in the combined group and the high-protein group were both lower than that in the common group [22.15(17.70, 30.15), 23.35(19.12, 28.70) vs 26.80(24.10, 31.60) kg] (both P<0.05). At the end of the week 12, the decreased values of uric acid and high-sensitivity C-reactive protein in the combined group were both higher than those in the high-protein group and the common group [17.15(13.02, 23.45) vs 1.50(0.22, 28.60) and 4.20(0.15, 19.95) μmol/L, 0.43(0.24, 0.60) vs 0.21(0.06, 0.43) and 0.28(-0.04, 0.88) mg/L](both P<0.05). No serious adverse events were observed during the intervention period and at the end of the intervention. In the product evaluation questionnaire, the combined group scored higher than the high-protein group and the common group on items such as usage frequency, taste, satiety, willingness to continue use, willingness to recommend to others, and willingness to purchase [4(3, 4) vs 3(3, 4) and 3(2, 4) points, 4(3, 4) vs 3(3, 4) and 3(2, 4) points, 4(3, 4) vs 3(3, 4) and 3(3, 3) points, 4(3, 4) vs 3(3, 4) and 3(3, 4) points, 4(3, 4) vs 3(3, 4) and 3(3, 3) points, 3(3, 4) vs 3(3, 4) and 3(2, 3) points] (all P<0.05). Conclusion:An energy-restricted diet combined with high-protein, high-dietary-fiber meal replacement powder and probiotics demonstrates superior weight-loss and weight-maintenance effects in overweight/obese adults, with high safety and great user acceptability.

Objective:To explore clinical value of multi-phase scan of spiral computed tomography(CT)combined with tumor markers in the diagnosis of gastric cancer.Methods:A total of 80 patients with highly suspected gastric cancer admitted to hospital from September 2019 to September 2023 were selected.All patients underwent multi-phase(arterial phase,venous phase,delayed phase)scan of spiral CT,and the tumor markers[carcinoembryonic antigen(CEA),carbohydrate antigen 724(CA724)and carbohydrate antigen 199(CA199)]of them were detected,as well as pathological examination.Based on the results of pathological examination,the CT values of multi-phase scan of spiral CT and tumor marker levels between patients with malignant tumor and patients with benign tumor were compared.The receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic cut-off values of various parameters,and also analyze the diagnostic value of multi-phase scans of spiral CT combined with tumor markers for gastric cancer.Results:In 80 patients with highly suspected gastric cancer,62 cases were confirmed as malignant tumor by pathological examination.The CT values of arterial phase,venous phase and delayed phase,CEA,CA724 and CA199 levels in patients with malignant tumor were higher than those in patients with benign tumor(P＜0.05),respectively,and the differences of them were significant(t=10.322,15.195,19.123,17.115,14.494,14.041,P＜0.05).The results of ROC curve indicated that the area under curve(AUC)values of the CT values of arterial phase,venous phase and delayed phase of spiral CT examination,single CEA,single CA724,single CA199 and combination of them were all greater than 0.70 in diagnosing gastric cancer,and all of them had diagnostic value but the diagnostic value of combined detection was highest.The optimal diagnostic value could be obtained when the cut-off values of above indicators were respectively 82.275 HU,74.975 HU,50.445 HU,5.970ng/ml,8.385μg/l and 41.315U/ml.According to the results of pathological examination,the sensitivity,specificity and accuracy of multi-phase scan of spiral CT combined with tumor markers were respectively 96.77％,94.44％and 96.25％in diagnosing gastric cancer,and the consistency between the combined examination and the pathological examination was favorable(Kappa=0.895).Conclusion:The combination of multi-phase scan of spiral CT and tumor markers has higher diagnostic value for gastric cancer,which can be used as important auxiliary scheme for the diagnosis of gastric cancer.

Objective? To explore the application of cross-theoretical model and family empowerment theory in functional exercise of postoperative patients with breast cancer, and to provide theoretical basis for clinical nursing intervention. Methods? A total of 90 patients who underwent radical mastectomy in the First Affiliated Hospital of Air Force Military Medical University from January to October 2018 were selected for the study. A total of 45 patients admitted to the hospital from January to May 2018 were assigned into the control group, and 45 patients admitted to the hospital from June to October 2018 were put into the observation group. Patients in the control group were treated with conventional breast cancer surgery, and the benefits and methods of functional exercise were informed. Patients in the observation group were treated with a family empowerment program in conjunction with interventions based on the cross-theoretical model. The effect of the intervention was evaluated using the Positive Aspects of Caregiving and the Anxiety Self-Assessment Scale. Results? There was significant statistical difference in the change stage between the two groups after the intervention (P＜0.05), the average daily exercise time of the observation group was longer than that of the control group, and the difference was statistically significant (P＜ 0.05). After intervention, the total score and dimension scores of Positive Aspects of Caregiving in the observation group were higher than those of the control group with statistical significances(P＜0.05). The scores of Self-rating Anxiety Scale in the observation group was lower than those in the control group after the intervention with statistical significance (P＜ 0.05). Conclusions? The cross-theoretical model combined with family empowerment theory can improve the breast cancer patients＇ compliance of functional exercises, reduce their anxiety levels, and improve the positive feelings of caregivers.

Objective To determine the effects of intrauterine growth retardation(IUGR) caused by malnutrition during pregnancy on the lung structure and expression of Clara cell protein (CCSP) and interferon (IFN)-γ in the fetal lungs,and to explore their relation ship with pulmonary disease.Methods Fetal rats from maternal protein-malnutrition dams were studied on day 20(term 21.5 day).The lung pathology was examined by means of Hematoxylin and eosin(HE) stain.Plasma was collected to determine the CCSP and IFN-γ concentration.Lungs were harvested to measure the expression of CCSP and IFN-γ mRNA by using fluorescent quantization reverse transcription (RT)-PCR and the levels of CCSP and IFN-γ protein were assessed by using enzyme-linked immunosorbent assay.Results Malnutrition fetus body weight significantly less compared to control group,so did the lung weight.However,lung weight,expressed as a percentage of body weight between the 2 groups was not different.The IUGR group had significantly decreased alveolar number manifested by lower radial alveolar count,and significantly increased mean linear intercept of alveoli.Both the CCSP mRNA expression and protein level in lung of IUGR rats were decreased compared with control rats (all P ＜ 0.05).A decline in plasma CCSP protein concentration was also noted compared with control group (P ＜0.05).Furthermore,IUGR group fetus showed lower IFN-γ levels both in circulation and in the lung tissue (all P ＜ 0.05).Conclusions Intrauterine malnutrition significantly alters lung structure and cytokine IFN-γ level,and the latter may further inhibit the transcription of CCSP gene.These alterations may contribute to both early and late postnatal respiratory morbidity.

Objective To study the clinicopathological features and biological behavior of inflammatory pseudotumor-like follicular dendritic cell tumor.Methods We studied the clinical data,HE sections,immunohistochemical staining,Epstein-Barr virus encoded nuclear RNA(EBER)in situ hybridization and outcome of one patient with inflammatory pseudotumor-like follicular dendritic cell tumor of liver,and thirteen patients with inflammatory pseudotumor of liver and spleen treated at the Shengjing Hospital of China Medical University from 2001 to 2010.Results Among the thirteen inflammatory pseudotumors,we diagnosed 1 patient with inflammatory pseudotumor-like follicular dendritic cell tumor of spleen and 1 patient with inflammatory pseudotumor-like follicular dendritic cell tumor of liver using immuno-histochemical staining and EBER in situ by hybridization.The liver case had pathological morphology consistent with those described in the literatures,but the splenic case had specific histologic features.They were both female,and were alive 2.5 and 6 years after operation.Conclusions Inflammatory pseudotumor-like follicular dendritic cell tumor should be distinguished from inflammatory pseudotumor.It is a rare tumor seen mainly in liver and spleen.The diagnosis depends on histopathological and immunohistochemical findings.Inflammatory pseudotumor-like follicular dendritic cell tumor is a low-grade malignant tumor.Surgical excision is the treatment of choice.The two cases provided evidence for its indolent behavior.

Objective:To design the mode of supervision, forwarn and communication system in barrier enviroment of laboratory animal. Methods and Results:Distribution inspect system of industrial computer center was used for live monitoring,displaying,reserving, printing temperature humidity,pressure,difference and ammonia density,according to necessity.The upper and low limit of parameter was set up according to national standard of laboratory animal,if parameter surpass the limit,it will warn the people on duty in multiple spots.Working and animal illumination were established respectively on the basis of illuminace light period of standard,the switch of working illumination was controlled by the people,but the later was controlled, automatically and slowly in order to disinterfere with physiology activity of animal.The mode of moniter add video together with multiple pickup camera in cable television were used,which binded wirh the intellectual industral control group.The communication system was designed using miniature program control changer and terminal telephone, which joined the unit inner telephone to communicate with outside. The double and stereophonic was used to install background music in this enviroment,which was timely played with suitable volume. Conclusion:This system provided the method for the administration of laboratory animal standardization?mathematics and informatics.