Objective:To establish tumor specific protein (SP70) targeted tumor cell enrichment technology and to assess applicational value of next-generation sequencing (NGS) analysis for enriched circulating tumor cell (CTC) in precision medicines of non-small cell lung cancer (NSCLC).Methods:The monoclonal antibody NJ001 was covalently coupled to the surface of magnetic beads to build targeted magnetic bead enrichment technology based on SP70. The limit of detection, coincidence rate, interference experiment, recovery test and clinical performance were evaluated. From March 2016 to August 2017, NGS analysis with or without pre-treatment of targeted enrichment for serous fluids of 43 NSCLC in the First Affiliated Hospital with Nanjing Medical University were compared (Kappa or Fisher exact test).Results:The CTC enrichment technology based on SP70 targeted immunomagnetic beads can specifically enrich tumor cells. The limit of detection was 10 4 SPC-A1 cells/L, and the coincidence rate, sensitivity and specificity were 100% (3/3). The endogenous interfering substances such as red blood cells, hemoglobin, white blood cells, epithelial cells and triglycerides had no interfering effects, as well as the exogenous interfering substances such as EDTA-K2, cefoxitin, carboplatin and paclitaxel. The recovery rate was 56.0% (56 000/100 000). A total of 30 gene mutations including 65 loci were found in 43 NSCLC under SP70 targeted enrichment, with a higher detection rate compared with unenrichment method [95.0% (19/20) vs 65.0% (13/20), χ 2=5.625, P=0.044]. Conclusion:In this study, SP70-targeted enriched CTC liquid biopsy method was established, with higher sensitivity and specificity of NGS detection than unenrichment method.

Objective:To establish tumor specific protein (SP70) targeted tumor cell enrichment technology and to assess applicational value of next-generation sequencing (NGS) analysis for enriched circulating tumor cell (CTC) in precision medicines of non-small cell lung cancer (NSCLC).Methods:The monoclonal antibody NJ001 was covalently coupled to the surface of magnetic beads to build targeted magnetic bead enrichment technology based on SP70. The limit of detection, coincidence rate, interference experiment, recovery test and clinical performance were evaluated. From March 2016 to August 2017, NGS analysis with or without pre-treatment of targeted enrichment for serous fluids of 43 NSCLC in the First Affiliated Hospital with Nanjing Medical University were compared (Kappa or Fisher exact test).Results:The CTC enrichment technology based on SP70 targeted immunomagnetic beads can specifically enrich tumor cells. The limit of detection was 10 4 SPC-A1 cells/L, and the coincidence rate, sensitivity and specificity were 100% (3/3). The endogenous interfering substances such as red blood cells, hemoglobin, white blood cells, epithelial cells and triglycerides had no interfering effects, as well as the exogenous interfering substances such as EDTA-K2, cefoxitin, carboplatin and paclitaxel. The recovery rate was 56.0% (56 000/100 000). A total of 30 gene mutations including 65 loci were found in 43 NSCLC under SP70 targeted enrichment, with a higher detection rate compared with unenrichment method [95.0% (19/20) vs 65.0% (13/20), χ 2=5.625, P=0.044]. Conclusion:In this study, SP70-targeted enriched CTC liquid biopsy method was established, with higher sensitivity and specificity of NGS detection than unenrichment method.

Objective By population survey,to explore the epidemiological characteristics of gastric precancerous lesions in Lishui District of Nanjing and provide objective basis for the prevention and treatment of early gastric cancer.Methods From July 2021 to December 2022,21 977 patients who received endoscopy and/or 13C-UBT in Lishui District People's Hospital and 6 medical community units in Nanjing City were retrospectively analyzed for demography characteristics,detection rate of gastric precancerous lesions,and H.Pylori infection rate.Results(1)590 cases of gastric precancerous lesions were detected(detection rate 2.68%);(2)The total detection rate of precancerous lesions and three pathological types in males were all higher than those in females(all P<0.001);(3)The minimum age for the total detection rate of precancerous lesions in males and the mini-mum age for each pathological type were lower than in females(P<0.001,0.009,0.005,0.002);(4)The popu-lation total H.pylori infection rate was 23.10%,the H.pylori infection rate in patients with precancerous lesions was higher than that in non-precancerous lesions(P<0.001),both H.pylori infection rate of male and female in precancerous lesions were all higher than those of non-precancerous lesions of the same sex(all P<0.001),in addition,the H.pylori infection rate of male whether in precancerous or non-precancerous lesions was higher than that of female(all P<0.001);(5)The precancerous lesions detection rate in male,female,and the overall age range of 20～29 to 70～79 years is positively correlated with age growth(P<0.001),and rapidly decreases after the age of 79,the of H.pylori infection rate was also positively correlated with age growth(P<0.001),and the trend of age change(P<0.001)was parallel to the precancerous lesions detection rate.Conclusions The detec-tion rate of gastric precancerous lesions in this region is above the average level in China;the total H.pylori infec-tion rate is at a relatively low level in China;the H.pylori infection rate is parallel to the age trend of the detection rate of gastric precancerous lesions,and increases with age.

Objective To detect the expression of human telomerase reverse transcriptase(hTERT)and silent information regulatory factor 6(Sirt6)in serum of pregnant women with preeclampsia,and explore the value of hTERT and Sirt6 levels in the evaluation of disease severity and pregnancy outcome.Methods A total of 300 patients with preeclampsia who were treated in Shaanxi Provincial People's Hospital from January 2018 to December 2022 were selected as the preeclampsia group,and all pregnant women met the diagnostic criteria for preeclampsia in the Guidelines for the Diagnosis and Treatment of Hypertensive Disorders in Pregnancy(2015).Meanwhile,300 healthy pregnant women who underwent pregnancy examinations in Shaanxi Provincial People's Hospital during the same period were selected as the control group.Preeclampsia group was divided into mild preeclampsia group(n=180)and severe preeclampsia group(n=120)according to the severity of the disease.The preeclampsia group was divided into normal pregnancy group(n=165)and adverse pregnancy group(n=135)according to the occurrence of adverse pregnancy outcomes.Serum hTERT and Sirt6 levels were detected by enzyme-linked immunosorbent assay(ELISA).Spearman correlation analysis was applied to analyze the correlation between serum hTERT and Sirt6 levels and the severity of preeclampsia in patients.Receiver operating characteristic(ROC)curve was applied to evaluate the value of serum hTERT and Sirt6 levels in the diagnosis of preeclampsia and prediction of pregnancy outcomes.Results Compared with the control group serum levels of hTERT(22.15±5.82 ng/ml vs 30.12±9.56 ng/ml)and Sirt6(5.26±1.62 ng/ml vs 7.06±2.29 ng/ml)in preeclampsia group were decreased,and the differences were significant(t=12.334,11.114,all P＜0.001).Compared with the mild preeclampsia group,the serum levels of hTERT(18.28±4.11 ng/ml vs 24.73±6.96 ng/ml)and Sirt6(4.03±1.17 ng/ml vs 6.08±1.92 ng/ml)in the severe preeclampsia group were decreased,and the differences were significant(t=9.142,10.469,all P＜0.001).Compared with the normal pregnancy group,the serum levels of hTERT(17.75±4.61 ng/ml vs 25.75±6.81 ng/ml)and Sirt6(4.06±0.96 ng/ml vs 6.24±2.16 ng/ml)of preeclampsia pregnant women in the adverse pregnancy group were decreased,and the differences were significant(t=11.639,10.878,all P＜0.001).Spearman correlation analysis showed that the levels of hTERT and Sirt6 in serum were negatively correlated with the severity of preeclampsia in patients(r=-0.562,-0.604,all P＜0.001).ROC curve analysis results showed that the area under the curve(95％confidence interval)[AUC(95％CI)]of serum hTERT and Sirt6 in the diagnosis of preeclampsia were 0.711(0.673～0.747)and 0.727(0.689～0.762),respectively.The AUC(95％CI)of the combined diagnosis of preeclampsia was 0.788(0.753～0.820),which was higher than that of the combined diagnosis of preeclampsia(Z=2.719,2.154,P=0.007,0.031).The AUC of serum hTERT and Sirt6 for predicting adverse pregnancy outcomes of preeclampsia were 0.786(0.735～0.831)and 0.783(0.732～0.829),respectively.The AUC(95％CI)of serum HTERT and Sirt6 for predicting adverse pregnancy outcomes of preeclampsia was 0.849(0.804～0.888).It was higher than predicted by the two alone(Z=1.855,1.861,P=0.032,0.031).Conclusion The serum levels of hTERT and Sirt6 in pregnant women with preeclampsia were low,and they were negatively correlated with the disease severity of preeclampsia patients.They may have certain evaluation values for pregnancy outcomes.

Background: and Purpose To examine the clinical and safety outcomes after endovascular treatment (EVT) for acute basilar artery occlusion (BAO) with different anesthetic modalities. Methods: This was a retrospective analysis using data from the Endovascular Treatment for Acute Basilar Artery Occlusion (ATTENTION) registry. Patients were divided into two groups defined by anesthetic modality performed during EVT: general anesthesia (GA) or non-general anesthesia (non-GA). The association between anesthetic management and clinical outcomes was evaluated in a propensity score matched (PSM) cohort and an inverse probability of treatment weighting (IPTW) cohort to adjust for imbalances between the two groups. Results: Our analytic sample included 1,672 patients from 48 centers. The anesthetic modality was GA in 769 (46.0%) and non-GA in 903 (54.0%) patients. In our primary analysis with the PSM-based cohort, non-GA was comparable to GA concerning the primary outcome (adjusted common odds ratio [acOR], 1.01; 95% confidence interval [CI], 0.82 to 1.25; P=0.91). Mortality at 90 days was 38.4% in the GA group and 35.8% in the non-GA group (adjusted risk ratio, 0.95; 95% CI, 0.83 to 1.08; P=0.44). In our secondary analysis with the IPTW-based cohort, the anesthetic modality was significantly associated with the distribution of modified Rankin Scale at 90 days (acOR: 1.45 [95% CI: 1.20 to 1.75]). Conclusion In this nationally-representative observational study, acute ischemic stroke patients due to BAO undergoing EVT without GA had similar clinical and safety outcomes compared with patients treated with GA. These findings provide the basis for large-scale randomized controlled trials to test whether anesthetic management provides meaningful clinical effects for patients undergoing EVT.

Objective: To explore the effects of X-ray repair cross complementing gene 1 (XRCC1) polymorphism and low dose ionizing radiation exposure on radiology professionals’ peripheral blood lymphocyte micronucleus. Methods: A matched case-control study was designed. From 2013 to 2015, 1 102 radiology professionals with micronucleus test rusults, and 45 cases with present micronucleus were enroled into case group. 180 diagnostic radiology technicians detecting no micronucleus were chosen as control group, cases and controls were 1∶4 mached on gender, age ≤40 or >40 years old. According to the detection of micronucleus levels (0‰, 1‰, 2‰) , the objects of our study were divided into the reference group, the low detection group and the medium detection group. The form of radiation workers’ occupational health examination was used to collect the general baseline of the research objects, history of smoking, drinking, poisonous and harmful material exposure, past medical history, accumulated illuminated dose and lymphocyte micronucleus rates (‰) , etc. Using restriction fragment length polymorphism polymerase chain reaction (RFLP-PCR) technology for genotyping; Compared the baseline data and radiation exposure level between the differentmicrokernel detection groups; Adopted multivariate logistic regression to analysis the combination effect of XRCC1 Arg399Gln gene polymorphism and accumulated illuminated dosefor micronucleus rate. Results: The accumulated illuminated dose in the reference group, the low detection group and the medium detection group were (23.44±15.23) , (21.76±2.56) , (24.22±18.61) mSv, respectively. There was no statistically significant difference among the groups (P>0.05) . Under the dominant inheritance mode, after adjusted age, smoking and drinking factors, the results suggested that XRCC1 Arg399Gln micronucleus medium detection group compared with the reference group, Arg399Gln-GG as reference, Arg399Gln-GA+AA decreased the occurrence of micronucleus (OR=0.175, 95%CI: 0.036-0.848) . Arg194Trp and Arg280His did not affect the incidence of micronucleus (P>0.05) . Did not find the combination effect of XRCC1 Arg399Gln gene polymorphism and accumulated illuminated dose for micronucleus rate (P>0.05) . Conclusion XRCC1 Arg399Gln gene polymorphism can affect the incidence of micronucleus, and carrying the XRCC1 Arg399Gln-GA+AA genotype is a protective factor of micronucleus’s occurrence, but low dose ionizing radiation may not affect the occurrence of micronucleus independently.

Objectives: To explore the association between the polymorphism of persistent obesity and genetic variations in the LEP (human leptin gene, LEP) and LEPR (leptin receptor gene, LEPR) genes and different molecular subtypes of breast cancer. Methods: All 703 female patients of breast cancer diagnosed by histopathology in the Sichuan Cancer Hospital or the West China Hospital, excluding patients with metastatic breast cancer or mental disease, were selected as cases from April 2014 to May 2015. At the same time, 805 healthy women received physical examination in medical examination center of Sichuan People Hospital or Shuangliu maternal and child health care hospital, excluding those with therioma, breast disease, and mental disease, were enrolled in control group. A uniform questionnaire was used to collect general information including demographic characteristic, reproductive history height, weight, and so on. And the obesity status in recent 10 years was judged. Time of Flight Mass Spectrometer was used to determine the genotypes of LEP rs7799039, LEPR rs1137100 and LEPR rs1137101, while the multinomial logistic regression analysis was conducted to estimate the effect of risk factors related to breast cancer in different molecular subtypes; and then, the association between polymorphism of persistent obesity, the LEP, LEPR genes and breast cancer of different molecular subtypes was analyzed by binary logistic regression models. Results: The average age of controls was (48.98±8.83) years old, while the age of cases of TNBC, Luminal A, Luminal B, and HER-2+ were (51.43±11.33), (49.94±10.10), (49.73±9.38), (50.50±9.04) years old, respectively. The frequency of genotype LEP rs7799039, LEPR rs1137100 and LEPR rs1137101 in control group was separately 74.8%(1 157/1 546), 83.6%(1 339/1 602) and 88.4%(1 416/1 602); while 77.6% (1 074/1 384), 82.4% (1 155/1 402) and 87.9% (1 232/1 402) respectively in case group. Compared with non-persistent obesity subjects, the persistent obesity ones showed an increased risk in TNBC (OR=3.58, 95%CI: 1.90-6.72), Luminal A (OR=2.65, 95%CI: 1.35-5.21) and Luminal B (OR=1.90, 95%CI: 1.26-2.89) breast cancer. LEP rs7799039-AA was relevant with the upward risk of Luminal B independently (OR=1.30, 95%CI: 1.00-1.69). Besides, persistent obesity was found to have a combined effect on Luminal B (β=3.34, 95% CI: 1.00-11.12) with LEPR rs1137101-GG. Conclusion Persistent obesity could increase the potential risk of TNBC, Luminal A and Luminal B breast cancer. Women who were suffered from persistent obesity with a genotype of LEPR rs1137101-GG were more susceptible to Luminal B breast cancer.

Objective To assess the influence of length of the alanine tract of forkhead box E1 (FOXE1) gene on genetic susceptibility to idiopathic premature ovarian failure (POF). Methods Totally 110 patients with idiopathic POF were recruited between February 2009 and December 2012 at the Affiliated Shenzhen City Maternity and Child Healthcare Hospital of Southern Medical University. Controls (n=110) were individuals with normal menstrual cycles, normal FSH concentrations. The polyalanine tract and flanking sequence of FOXE1 were screened using the multiplex ligation-dependent probe amplification (MLPA) technique and direct sequence technique. Results The most frequent of FOXE1 polyalanine stretch length was 14 residues in both groups. The length of FOXE1 polyalanine reported in this study varied from 12 to 16 alanines, and three variants of FOXE1-polyalanine length, containing 12, 14, or 16 alanine residues, and 5 different genotypes were identified. The most common genotypes were 14/14 homozygote, occurring with the frequency of 81.8% (90/110) in the POF group, while 96.4% (106/110) in control subjects, respectively. The incidence of 14/14 genotypes of FOXE1-polyalanine was significantly lower in patients with POF (χ2=119.730, P=0.001) in comparison to the controls. There were significantly higher frequencies of the 16/16 genotypes in cases with POF [10.0% (11/110) versus 0; χ2=3.403, P=0.001], as compared with the controls. The FOXE1 14 alanine allele was significantly less common in the POF patient group than the controls [84.5% (186/220) versus 98.2% (216/220); χ2=25.923, P=0.001]. The FOXE1 16 alanine allele was significantly more common in the POF patient group than the controls [12.7% (28/220) versus 1.8% (4/220); χ2=19.412, P=0.001]. Conclusions The polymorphism of the polyalanine tract of FOXE1 gene have a certain relevance for the genetic aetiology of idiopathic POF.

Objective To evaluate the effect of keeping atrial septal fenestration in correction of total anomalous pulmonary venous connection (TAPVC) with left ventricular hypoplasia.Methods We reviewed 44 TAPVC patients between June,2006 and June,2013 in Shanghai Xinhua Hospital.According to whether keeping atrial septal fenestration during operation,patients were divided into group A(keeping fenestration,25 cases) and group B(no fenestration,19 cases).Retrospective statistical analysis was carried on the in-patient data and follow-up outcomes.Results No statistically significant differences between the two group on age,weight,left ventricular volume and crossclamp time (P ＞ 0.05).While cardiopulmonary bypass time,ventilation time,dosage of positive inotropic drugs,and ICU stay time of group A were shorter compares with group B (P ＜ 0.05).4 patients in group A (16.00％) suffered from low cardiac output syndrome (LCOS) postoperatively,and 6 in group B(31.58％).Pulmonary edema occurred in 3 patients,1 in group A(4.00％),and 2 in group B(10.53％).Total post-operative mortality was 6.82％ (3/44).2 cases died of serious LCOS(1 from group A,and the other from group B),1 cases died of infection and multiple organ dysfunction syndrome(group B).No significant difference of mortality was observed between two groups.Follow-up data showed some fenestrations can close naturally.Conclusion Keeping atrial septal fenestration can be done as a feasibility tactic in correction of TAPVC with left ventricular hypoplasia.

Objective To understand the current situation of occupational exposure and occupational safety attitudes among nursing students in Kunming Medical University, and to find effective interventions to improve nurses' occupational safety,and to reduce occupational exposure.Methods 854 students in Kunming Medical University were investigated by a questionnaire survey, including Demographic characteristics, Occupational exposure conditions, Occupational safety attitude and Gathers, quit intention . The correlations between occupational safety attitudes and occupational exposure were analyzed with Simple Linear Correlation.Results There were 94.30%female respondents,and only 5.70%male respondents.The average age of respondents was 22.52±2.90 years. The Simple Linear Correlation analysis showed that correlation between Negative attitude and occupational exposure was positive correlated, the occupational exposure and Support from managers, and Optimistic were negative correlation ( <0.05) .Conclusions Occupational safety and attitude are related to occupational exposure. Nursing students should apply standardized operation to improve the professional quality and ability. Schools should strengthen the education of occupational protection for nursing students. Hospital management should regularly organize nurses to study occupational exposure protection knowledge,give full affirmation of the nurse's achievements in the work, and offer certain reward appropriately.