[摘 要] 目的：探讨透明质酸介导运动受体（HMMR）在食管鳞状细胞癌（ESCC）细胞恶性进展中的作用及其潜在的分子机制。方法：收集2018年1月至2020年12月期间在河北医科大学第四医院手术切除的8例ESCC组织及癌旁组织标本，以及ESCC细胞KYSE-30和KYSE-150。利用WB法和免疫组化（IHC）法检测HMMR在ESCC组织中的表达情况。采用RNA干扰技术，在KYSE-30和KYSE-150细胞中敲低HMMR表达，qPCR法和WB法检测敲低效果，通过CCK-8实验和Transwell实验分别检测敲低HMMR对ESCC细胞增殖和侵袭能力的影响。4-硝基喹啉1-氧化物（4NQO）诱导小鼠致癌建立ESCC模型，H-E染色观察食管的形态变化，IHC法分析HMMR、序列相似性家族83成员D（FAM83D）、上皮钙黏素（E-cadherin）和神经钙黏素（N-cadherin）在小鼠不同癌变程度组织中的表达情况。结果：人ESCC组织中HMMR表达水平显著高于癌旁组织（均P < 0.05）。敲低HMMR后，KYSE-30和KYSE-150细胞的增殖和侵袭能力均显著降低（P < 0.05或P < 0.01），同时降低了FAM83D的表达水平（均P < 0.01）。裸鼠成瘤实验中，4NQO组小鼠体质量均低于对照组（均P < 0.05）；IHC法染色结果显示，肿瘤组织中HMMR呈高表达（P < 0.05），其中在高级别上皮内瘤变（HGIN）组织中的表达显著高于低级别上皮内瘤变（LGIN）组织（P < 0.001）。HMMR与FAM83D、N-cadherin表达呈显著正相关（r = 0.724、0.870，均P < 0.001），与E-cadherin表达呈显著负相关（r = -0.714，P < 0.001）。结论：HMMR在ESCC组织中呈高表达，其可能通过上调FAM83D表达水平促进ESCC的进展。

AIM:To investigate the molecular mechanisms of KG-1 cell proliferation by profiling its responses to various protein kinase inhibitors.METHODS:CCK-8 assay,real time quantitative PCR(qRT-PCR)and Western-blot were used to detect the effect of various protein kinase inhibitors on KG-1 cell proliferation,the expression levels of mRNA and phosphorylation level of signaling pro-teins in the FGFR1 downstream pathways.RE-SULTS:NVP-BGJ398 and PD173074 effectively in-hibited the proliferation of KG-1 cells,indicative of a crucial role of FGFR downstream signaling.After treatment with FGFR inhibitors,the levels of p-FG-FR1OP2-FGFR1 and p-STAT5 decreased significantly(P<0.001),p-AKT decreased slightly(P<0.05),with-out affecting the p-ERK level(P>0.05).CONCLU-SION:FGFR1OP2-FGFR1 mainly acts on the down-stream STAT5 signaling pathway to promote cell proliferation.Comprehensive protein kinase inhibi-tion analysis is a reliable and direct approach to identify functional drivers of cancer cell prolifera-tion.

Hyperlipidaemic rats were randomly divided into a model group,a total flavonoids from echinops latifolius tausch(TFET)high,medium and low dose group,and a positive control group;meanwhile,healthy rats were selected as a blank control group.The rats in each group were dosed with the corresponding concentrations of TFET,simvastatin and distilled water for 45 consecutive days,and were tested for relevant lipid biochemical indexes,antioxidant indexes and PPARα path-way-related gene expression.The results showed that high-dose TFET could reduce the concentra-tions of TC,TG and LDL-C and increase the concentration of HDL-C very significantly;medium-dose TFET could reduce the concentrations of TC and TG very significantly and reduce the con-centration of LDL-C significantly;and low-dose TFET could reduce the concentrations of TC and LDL-C significantly.High,medium and low doses of TFET can extremely significantly reduce in-crease SOD activity;high and medium doses of TFET can extremely significantly reduce MDA content;high dose of TFET can extremely significantly increase T-AOC activity.The high dose of TFET could extremely significantly increase the expression of PPARα,CYP7A1 and CPT-1 genes in rat liver;the medium dose of TFET could extremely significantly increase the expression of CYP7A1 and CPT-1 genes,and could significantly increase the expression of PPARα gene;the low dose of TFET could extremely significantly increase the expression of CYP7A1 gene,and signifi-cantly increase the CPT-1 gene expression.The results suggest that TFET has antioxidant and lip-id-lowering effects on hyperlipidaemic rats,and its mechanism may be related to the activation of PPARα and its downstream related genes to promote fatty acid β-oxidation.

Abstract： Objective　To analyze the epidemic situation and risk factors of schistosomiasis in Hubei Province from 2015 to 2022, and to provide a scientific basis for the goal of all schistosomiasis-endemic counties in the province reaching the elimination standard by 2030. Methods　According to the requirements of the National Schistosomiasis Surveillance Plan (2014 edition) and National Schistosomiasis Surveillance Plan (2020 edition), the snail situation and the risk of wild fecal transmission, along with regional distribution in schistosomiasis endemic areas in Hubei Province from 2015 to 2022 were analyzed and the risk was rated. Results　From 2015 to 2022, a total of 60 203 risk monitoring environments per time was carried out, with 10 223 460 frames of snails inspected, capturing 2 344 094 snails, among which 1 357 479 live snails, and an average density ranging from 0.07-0.29 snails/0.11 m2. In 2015 and 2017, 11 and 3 schistosomiasis-infected snails were detected respectively, corresponding to 3 and 2 positive snail environments. The proportion of wild feces distribution environment in the total monitoring environment showed a downward trend, with cow dung accounting for the highest proportion (69.27%). A total of 19 549 wild feces were collected, of which 78 were positive for schistosomiasis. Since 2018, only one positive cow dung was found in 2019, and none in other years. From 2015 to 2020, the density of live snails and the proportion of wild feces in the monitoring environment in each risk monitoring county (city, district) had significantly reduced, with areas of higher snail density such as Gongan County, Yangxin County with higher density of live snails decreasing to below 1 per 0.11 m2 from 2017. Among the 60 203 risk monitoring environments, 53 were identified as GradeⅠrisk (not detected since 2020), 1 999 as GradeⅡrisk, and 58 030 as GradeⅢrisk. Conclusions　From 2015 to 2022, the overall schistosomiasis epidemic in Hubei Province showed a downward trend. However, the risk of schistosomiasis transmission still exists in some areas. In the future, we should continue to strengthen the epidemic monitoring in key areas, improve the sensitivity and level of monitoring, and prevent the rebound of the epidemic.

Objective:To explore the application value of real-time shear wave elastography(SWE)and ultrafast pulse wave velocity(UFPWV)techniques in assessing carotid artery stiffness of patients with gouty arthritis(GA).Methods:A total of 80 GA patients admitted to the First People's Hospital of Yibin from August 2022 to July 2023 were selected as GA group.Among of them,24 cases combined with bone erosion who were confirmed by imaging examination,and 56 cases did not combine with bone erosion.In addition,a total of 40 healthy individuals,who underwent physical examinations in our hospital during the same period,were selected as the healthy control group.SWE and UFPWV were used to detect the maximum,minimum and mean values of Young's modulus values of the vessel wall of common carotid artery,and the pulse wave velocity at the beginning of systole(PWVBS)and pulse wave velocity at the end of systole(PWVES)of the vessel wall of common carotid artery of all subjects,and to assess the hardness of circumferential and longitudinal vessel wall of common carotid artery of them.The differences in Young's modulus values,PWVBS and PWVES between two groups were compared.And then,the correlations between bone erosion and Young's modulus values,PWVBS,PWVES of GA patients were further analyzed.Results:The maximum,minimum,mean values,PWVBS and PWVES in the GA group were respectively(78.80±12.38)kPa,(57.83±7.42)kPa,(67.67±8.38)kPa,(7.06±0.59)m/s and(9.50±0.63)m/s,which were significantly higher than those in the healthy control group(t=11.066,8.216,11.751,14.159,19.118,P＜0.05).The maximum,minimum,mean values,PWVBS and PWVES of GA patients with bone erosion were respectively(82.95±6.37)kPa,(59.59±5.29)kPa,(72.18±7.62)kPa,(7.37±0.43)m/s,(10.43±0.47)m/s,which were significantly higher than those[(77.01±5.32)kPa,(57.08±4.73)kPa,(65.73±4.54)kPa,(6.92±0.39)m/s and(9.10±0.41)m/s]of GA patients without bone erosion,the differences were significant(t=4.309,2.099,4.699,4.586,12.720,P＜0.05).Spearman correlation analysis showed that there was significant correlations between maximum,minimum,mean values,PWVBS,PWVES and the combined bone erosion in GA patients(r=0.602,0.421,0.682,0.647,0.732,P＜0.05).Conclusion:SWE and UFPEV techniques can evaluate the hardness of vascular wall of GA patients,and the hardness of circumferential and longitudinal vessel wall of common carotid artery of GA patient is higher than that of healthy person,and the hardness of circumferential and longitudinal vessel wall of common carotid artery of GA patient with bone erosion is higher.

The goal of achieving elimination of schistosomiasis across all endemic counties in China by 2030 was proposed in the Outline of the Healthy China 2030 Plan. On June 16, 2023, the Action Plan to Accelerate the Elimination of Schistosomiasis in China (2023—2030) was jointly issued by National Disease Control and Prevention Administration and other 10 ministries, which deployed the targets and key tasks of the national schistosomiasis elimination programme in China. This article describes the progress of the national schistosomiasis control programme, analyzes the opportunities to eliminate schistosomiasis, and proposes targeted recommendations to tackle the challenges of schistosomiasis elimination, so as to accelerate the process towards schistosomiasis elimination and facilitate the building of a healthy China.

Objective To analyze the type and incidence of abnormal chromosome karyotype in peripheral blood of infertile patients with different semen quality.Methods Selectet 292 infertility patients who came to our hospital from January 2018 to December 2021 for G-banding karyotyping and semen analysis.According to the semen analysis results,the patients were divided into abnormal semen quality group and normal control group.We made statistics and analysis on the abnormal karyotypes.Results In the group with abnormal semen quality,20 cases(18.87%)of abnormal karyotypes were found.In the normal control group,9 cases(4.84%)had abnormal karyotypes were found.The comparison of the abnormal rates of peripheral blood chromosome karyotypes between the two groups showed statistical significance(P<0.05).The detection rate of chromosomal abnormalities in patients with Azoospermia was 50%,and sex chromosome abnormalities were the main types of abnormalities in this group.Conclusion Karyotype analysis of infertile patients can effectively analyze the causes of infertility,and has important clinical significance for assisted reproduction and primary prevention of birth defects.

Objective:To investigate the relationship between spread through air spaces(STAS) of peripheral stage ⅠA small adenocarcinoma of the lung(≤2 cm) and related factors such as clinical and CT morphological features, and to construct a nomogram model.Methods:Relevant clinical, pathological and imaging data of patients who underwent lung surgery and were diagnosed as peripheral stage ⅠA small lung adenocarcinoma by postoperative pathology in the Affiliated Hospital of Nantong University from 2017 to 2022 were collected, of which cases that met the inclusion criteria from 2017 to 2021 served as the training group, and those that met the inclusion criteria in 2022 served as the validation group. The independent risk factors for the occurrence of STAS in peripheral stage ⅠA lung small adenocarcinoma were investigated by using univariate analysis and multifactorial logistic regression analysis, based on which a nomogram prediction model was constructed, and the subjects were analyzed by using the receiver operating characteristic curve( ROC), correction model, etc. were used to evaluate the model. Results:A total of 430 patients who met the criteria were included, including 351 patients in the training group(109 STAS-positive and 242 STAS-negative) and 79 patients in the validation group(23 STAS-positive and 56 STAS-negative). Univariate analysis showed that the patients in the two groups showed a significant difference in age(>58 years old), gender, smoking history, tumor location(subpleural, non-subpleural), pleural pull, nodule type, nodule maximal diameter, solid component maximal diameter, consolidation tumor ratio(CTR), lobulation sign, burr sign, bronchial truncation sign, vascular sign(includes thickening and distortion of blood vessels in/around the nodes), satellite lesions, and ground-glass band sign were statistically significant( P<0.05). The results of multifactorial logistic regression analysis showed that CTR( OR=4.98, P<0.001), lobulation sign( OR=4.07, P=0.013), burr sign( OR=3.66, P<0.001), and satellite lesions( OR=3.56, P=0.009) were the independent risk factors for the occurrence of STAS. Applying the above factors to construct the nomogram model and validate the model, the results showed that the ROC curve was plotted by the nomogram prediction model, and the area under the ROC curve( AUC) of the training set was 0.840(sensitivity 0.835, specificity 0.734), and the validation set had an AUC value of 0.852(sensitivity 0.786, specificity 0.783), and the training set and validation set calibration curves have good overlap with the ideal curve. Conclusion:CTR, lobular sign, burr sign, and satellite lesions are independent risk factors for STAS, and the nomogram model constructed in this study has good predictive value.

Objective To investigate the differences in human epidermal factor receptor 2(HER-2)expression between urothelial bladder carcinoma(UBC)and upper tract urothelial carcinoma(UTUC)and the relationship between HER-2 expression and disease recurrence and progression.Methods Clinical data of 184 patients with urothelial carcinoma admitted in our hospital during Nov.2015 and Jun.2022 were retrospectively analyzed.The patients were divided into UBC group and UTUC group.The positive expression rate of HER-2,recurrence-free survival(RFS)and progression-free survival(PFS)of the two groups were compared,and the survival curve was drawn.The effects of HER-2 expression on the recurrence and progression of disease were analyzed with Cox proportional hazards model.Results The positive expression of HER-2 was significantly higher in UBC patients than in UTUC patients(49.6％vs.32.2％,P=0.027).Among UTUC patients,there was no statistically significant difference in the positive expression of HER-2 in those with renal pelvis cancer and ureteral cancer(30.6％vs.34.8％,P＞0.05).Cox analysis showed that HER-2 positive expression affected UBC recurrence(P＜0.001),but had no effects on the recurrence and progression of UTUC;HER-2 positive expression(P＜0.001),tumor diameter ≥3 cm(P＜0.001),stage ≥T2(P=0.003)and multiple tumor foci(P=0.033)affected the progression of UBC.Conclusion The positive expression of HER-2 is significantly higher in UBC than in UTUC,which can increase the risk of recurrence and progression of UBC,but has no significant effects on the recurrence and progression of UTUC.HER-2 expression is not recommended to independently predict the risk of recurrence and progression of UTUC.

Objective: To explore the association of health literacy with smoking attempt behavior among middle school students in China，and to provide ideas for health education for middle school students. Methods: Using stratified cluster sampling method, 1 066 students were selected from Zhejiang, Guangdong, Jiangxi, Sichuan and Guizhou provinces in China during June to November 2017, a questionnaire survey was conducted to collect health literacy and smoking attempt behavior. Results: The score of health literacy among middle school students was (13.49±1.87). Students who lived in eastern and rural areas, girls, guardians who were jointly supervised by their parents and grandparents, the only child, non smokers, and small amount of weekly pocket money had higher scores in health literacy（ t/F =9.81,3.10,11.12,2.65,3.50,4.47,2.64， P ＜0.05）. The prevalence of smoking attempt behavior was 5.5%. Multiple Logistic regression analyses showed that central and western China, drinking and low healthy literacy were positively correlated with smoking attempt behavior ( OR =2.75, 3.54, 21.62, 2.50, P <0.05). Conclusion Low healthy literacy can be used as a predictor of smoking attempt among middle school students, the health education should be conducted to control the smoking attempt behavior.