Objective:To investigate impact of leonurine(Leo)on necrotic apoptosis in rats with myocardial ischemia/reperfu-sion(MIR)injury by regulating receptor interacting protein 1(RIP1)-receptor interacting protein 3(RIP3)-mixed lineage kinase domain-like protein(MLKL)pathway.Methods:Fifteen rats were randomly selected as sham surgery group(Sham),left anterior descending coronary artery of remaining rats were ligated to construct MIR model,and randomly grouped into MIR group,Leo group(15 mg/kg),Compound 6i group(1 mg/kg RIP1-RIP3-MLKL pathway activator Compound 6i)and Leo+Compound 6i group(15 mg/kg Leo+1 mg/kg Compound 6i),with 15 rats in each group.MIR group and Sham group were injected with equal amounts of physiological saline.Cardiac function indicators were observed through ultrasound electrocardiogram;ELISA was applied to detect myocardial injury indicators and inflammatory factor levels;HE staining was applied to observe pathological damage of heart;TTC staining was applied to detect myocardial infarction area;TUNEL staining was applied to detect cell apoptosis;Western blot was applied to detect expres-sions of RIP1-RIP3-MLKL pathway proteins.Results:Myocardial cells in Sham group were intact and arranged in an orderly manner;arrangement of myocardial cells was disordered and swollen,myofibril contracted,and sarcolemma was destroyed in MIR group,ejec-tion fraction(EF)and cardiac output(CO)level were obviously lower than Sham group(P<0.05),Mb,cTnⅠ,CK-Mb contents,IL-6,IL-18 levels,myocardial infarction area,myocardial cell apoptosis rate,RIP1,RIP3 and MLKL protein levels were obviously increased(P<0.05);compared with MIR group,Leo group had improved cell arrangement disorder and edema,and obviously increased EF and CO levels(P<0.05),Mb,cTnⅠ,CK-Mb contents,IL-6,IL-18 levels,myocardial infarction area,myocardial cell apoptosis rate,RIP1,RIP3 and MLKL protein levels were obviously reduced(P<0.05),trend of Compound 6i group was opposite;myocardial tissue structure of Leo+Compound 6i group was similar to MIR group,and Compound 6i eliminated cardioprotective effect of Leo on MIR rats.Conclusion:Leo may alleviate myocardial necrosis apoptosis in MIR rats by down-regulating RIP1-RIP3-MLKL pathway,thus playing a therapeutic role in MIR.

Objective:To investigate impact of leonurine(Leo)on necrotic apoptosis in rats with myocardial ischemia/reperfu-sion(MIR)injury by regulating receptor interacting protein 1(RIP1)-receptor interacting protein 3(RIP3)-mixed lineage kinase domain-like protein(MLKL)pathway.Methods:Fifteen rats were randomly selected as sham surgery group(Sham),left anterior descending coronary artery of remaining rats were ligated to construct MIR model,and randomly grouped into MIR group,Leo group(15 mg/kg),Compound 6i group(1 mg/kg RIP1-RIP3-MLKL pathway activator Compound 6i)and Leo+Compound 6i group(15 mg/kg Leo+1 mg/kg Compound 6i),with 15 rats in each group.MIR group and Sham group were injected with equal amounts of physiological saline.Cardiac function indicators were observed through ultrasound electrocardiogram;ELISA was applied to detect myocardial injury indicators and inflammatory factor levels;HE staining was applied to observe pathological damage of heart;TTC staining was applied to detect myocardial infarction area;TUNEL staining was applied to detect cell apoptosis;Western blot was applied to detect expres-sions of RIP1-RIP3-MLKL pathway proteins.Results:Myocardial cells in Sham group were intact and arranged in an orderly manner;arrangement of myocardial cells was disordered and swollen,myofibril contracted,and sarcolemma was destroyed in MIR group,ejec-tion fraction(EF)and cardiac output(CO)level were obviously lower than Sham group(P<0.05),Mb,cTnⅠ,CK-Mb contents,IL-6,IL-18 levels,myocardial infarction area,myocardial cell apoptosis rate,RIP1,RIP3 and MLKL protein levels were obviously increased(P<0.05);compared with MIR group,Leo group had improved cell arrangement disorder and edema,and obviously increased EF and CO levels(P<0.05),Mb,cTnⅠ,CK-Mb contents,IL-6,IL-18 levels,myocardial infarction area,myocardial cell apoptosis rate,RIP1,RIP3 and MLKL protein levels were obviously reduced(P<0.05),trend of Compound 6i group was opposite;myocardial tissue structure of Leo+Compound 6i group was similar to MIR group,and Compound 6i eliminated cardioprotective effect of Leo on MIR rats.Conclusion:Leo may alleviate myocardial necrosis apoptosis in MIR rats by down-regulating RIP1-RIP3-MLKL pathway,thus playing a therapeutic role in MIR.

Purpose: Despite the rapid growing of cancer survivors, prior cancer history is a commonly adoptedexclusion criterion. Whether prior cancer will impact the survival of patients with advancedbreast cancer (ABC) remains uncertain. Materials and Methods: Patients with ABC diagnosed between 2004 and 2010 were identified using Surveillance,Epidemiology, and End Results (SEER) database. Timing, stage, and type were used to characterizeprior cancer. Multivariable analyses using propensity score–adjusted Cox regressionand competing risk regression were conducted to evaluate the prognostic effect of priorcancer on overall survival (OS) and breast cancer-specific survival (BCSS). Results: A total of 14,176 ABC patients were identified, of whom 10.5% carried a prior cancer history.The most common type of prior cancer was female genital cancer (32.4%); more than half(51.7%) were diagnosed at localized stage; most were diagnosed more than 5 years (42.9%)or less than 1 year (28.3%) prior to the index cancer. In multivariate analyses, patients withprior cancer presented a slightly worse OS (hazard ratio, 1.18; 95% confidence interval [CI],1.07 to 1.30; p=0.001) but a better BCSS (subdistribution hazard ratio, 0.64; 95% CI, 0.56to 0.74; p < 0.001). In subset analyses, no survival detriment was observed in patients withprior malignancy from head and neck or endocrine system, at in situ or localized stage, ordiagnosed more than 4 years. Conclusion Prior cancer provides an inferior OS but a superior BCSS for patients with ABC. It does notaffect the survival adversely in some subgroups and these patients should not be excludedfrom clinical trials.

Purpose: This retrospective study aimed to evaluate the distribution pattern and prognostic value of 21-gene recurrence score (RS) in Chinese patients with mucinous breast cancer (MC) and compared with infiltrating ductal carcinoma (IDC). Materials and Methods: Patients diagnosed with MC or IDC from January 2010 to January 2017 were retrospectively recruited. Reverse transcriptase–polymerase chain reaction assay of 21 genes was conducted to calculate the RS. Univariate and multivariate analyses were performed to assess the association between RS and clinicopathological factors. Survival outcomes including disease-free survival (DFS) and overall survival (OS) were estimated by Kaplan-Meier method and compared by log-rank test. Results: The MC cohort included 128 patients and the IDC cohort included 707 patients. The proportions of patients with a low (RS < 18), intermediate (18-30), or high risk (RS > 30) were 32.0%, 48.4%, and 19.5% in MC cohort, and 26.9%, 46.8% and 26.3% in IDC cohort. The distribution of RS varied significantly according to different Ki-67 index and molecular subtype in both cohorts. Moreover, the receipt of chemotherapy was associated with RS in both cohorts. Among patients with MC, tumor stage was related to the DFS (p=0.040). No significant differences in DFS and OS were found among MC patients in different RS risk groups (OS, p=0.695; DFS, p=0.926). Conclusion RS was significantly related to Ki-67 index and molecular subtypes in MC patients, which is similar in IDC patients. However, RS was not able to predict DFS and OS in patients with MC.

The adhesion in the gallbladder triangle is the most important factor influencing the conversion to laparotomy in laparoscopic cholecystectomy (LC).The degree of adhesion in the cholecystic triangle is closely related to the difficulty of LC operation.With the reduction of cholecystic triangle adhesion,the treatment of gallbladder during LC will be easy and the rate of conversion to laparotomy will decrease accordingly.In order to investigate the causes of cholecystic triangle adhesion and its influence on LC,this paper reviews the current research progress.

Objective To study the influence of different placing time of child peripheral blood on blood routine parameters in order to increase the working efficiency of clinical blood routine test.Methods Each 300 μL of peripheral blood was collected from the right hand ring finger in 50 healthy children in our hospital from January 2015 to January 2016.The blood routine was performed by using the whole blood cells analyzer at instantly after blood collection,at 0,5,10,15,30 min after blood collection under the room temperature (20 to 25 ℃).Results With the measured results at 15 min as the control,the detection results at the other times points had no statistical difference (P>0.05).Compared with the detection results at 5 min,the white blood cell count(WBC) and platelet volume distribution width (PDW),lymphocyte absolute value (LYM),neutrophil percentage absolute value (NEU),platelet count (PLT),red blood cell volume distribution width (RDW),hemotocrit (HCT) and plateletcrit(PCT) were statistically different (P<0.05).Conclusion Reasonably arranging time,eliminating pre-analysis error and reducing the influence of peripheral blood placing time on blood routine parameters have an important significance to accurately judge the clinical dat.It is recommended that the blood routine detection time should be controlled within 10-30 min in order to increase the working efficiency of clinical detections.