Objective:To screen the key genes related to the prognosis,diagnosis,and immune infiltration of the hepatocellular carcinoma(HCC)patients by bioinformatics analysis methods,and to analyze their potential therapeutic drugs.Methods:The HCC gene expression profile data and corresponding clinical informations of the HCC patients were downloaded from the Gene Expression Omnibus(GEO)database and The Cancer Genome Atlas(TCGA)database.The R software package limma was used to screen the differentially expressed genes(DEGs)in HCC.Gene Ontology(GO)functional enrichment analysis and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway enrichment analysis were performed on the DEGs.The STRING database was used to construct the protein-protein interaction(PPI)network;the Cytoscape software was used to visualize the PPI network and screen the key genes;Kaplan-Meier survival curve and LASSO regression algorithm were used to identify the key genes related to the HCC prognosis;external data sets were used to validate their expressions and analyze the diagnostic efficacy;CIBERSORT algorithm was used to detect the relationship between the expression of prognosis-related key genes and HCC immune cell infiltration.The MiRNet and Network Analyst databases were used to construct the microRNA(miRNA)-key gene mRNA and transcription factors(TFs)-key gene mRNA molecular regulatory networks;CMap database was used to screen the potential small molecule drugs for HCC treatment.Results:A total of 146 DEGs were screened,including 30 upregulated genes and 116 downregulated genes.The GO functional enrichment analysis and KEGG pathway enrichment analysis results showed that the DEGs were significantly enriched in biological processes(BP)such as steroid,alkene compound,and hormone metabolism,as well as signaling pathways such as retinol metabolism,drug metabolism-cytochrome P450(CYP450),complement and coagulation cascades.The PPI network analysis identified 14 key genes,among which formimidoyltransferase cyclodeaminase(FTCD),secreted phosphoprotein 2(SPP2),thrombin-antithrombin complex(TAT),complement C6(C6),and cytochrome CYP450 family member 2C9(CYP2C9)were significantly associated with the prognosis,clinical pathological stage,and histological grade of the HCC patients and also had high diagnostic efficacy for HCC and were closely related to immune cell infiltration in HCC.Hsa-mir-182-5p,CUT-like homeobox 1(CUX1),early growth response 1(EGR1),SMAD family member 4(SMAD4),and tumor protein P53(TP53)were identified as the important regulators targeting the above-mentioned prognosis-related key genes.DL-thiorphan,promethazine,and apigenin may have the therapeutic effects on HCC.Conclusion:FTCD,SPP2,TAT,C6,and CYP2C9 may be the potential targets for the diagnosis,prognosis,and treatment of HCC.Three predicted small molecule drugs,DL-thiorphan,promethazine,and apigenin,may provide the references for the development of therapeutic drugs for HCC.

Objective::To explore the risk factors and pregnancy outcomes in women with a history of cesarean section complicated by placenta accreta (PA).Methods::This case-control study included clinical data from singleton mothers with a history of cesarean section in 11 public tertiary hospitals in seven provinces of China between January 2017 and December 2017. According to the intraoperative findings after delivery, the study population was divided into PA and non-PA groups. We compared the pregnancy outcomes between the two groups, used multivariate logistic regression to analyze the risk factors for placental accreta.Results::For this study we included 11,074 pregnant women with a history of cesarean section; and of these, 869 cases were in the PA group and 10,205 cases were in the non-PA group. Compared with the non-PA group, the probability of postpartum hemorrhage (236/10,205, 2.31% vs. 283/869, 32.57%), severe postpartum hemorrhage (89/10,205, 0.87% vs. 186/869, 21.75%), diffuse intravascular coagulation (3/10,205, 0.03% vs. 4/869, 0.46%), puerperal infection (33/10,205, 0.32% vs. 12/869, 1.38%), intraoperative bladder injury (1/10,205, 0.01% vs. 16/869, 1.84%), hysterectomy (130/10,205, 1.27% vs. 59/869, 6.79%), and blood transfusion (328/10,205,3.21 % vs. 231/869,26.58%) was significantly increased in the PA group ( P < 0.05). At the same time, the neonatal birth weight (3250.00 (2950.00-3520.00) g vs. 2920.00 (2530.00-3250.00) g), the probability of neonatal comorbidities (245/10,205, 2.40% vs. 61/869, 7.02%), and the rate of neonatal intensive care unit admission (817/10,205, 8.01% vs. 210/869, 24.17%) also increased significantly ( P < 0.05). Weight (odds ratio ( OR)= 1.03, 95% confidence interval ( CI): 1.01-1.05)), parity ( OR= 1.18, 95% CI: 1.03-1.34), number of miscarriages ( OR= 1.31, 95% CI: 1.17-1.47), number of previous cesarean sections ( OR= 2.57, 95% CI: 2.02-3.26), history of premature rupture of membrane ( OR= 1.61, 95% CI: 1.32-1.96), previous cesarean-section transverse incisions ( OR= 1.38, 95% CI: 1.12-1.69), history of placenta previa ( OR= 2.44,95% CI: 1.50-3.96), and the combination of prenatal hemorrhage ( OR= 9.95,95% CI: 8.42-11.75) and placenta previa ( OR= 91.74, 95% CI: 74.11-113.56) were all independent risk factors for PA. Conclusion::There was an increased risk of adverse outcomes in pregnancies complicated by PA in women with a history of cesarean section, and this required close clinical attention. Weight before pregnancy, parity, number of miscarriages, number of previous cesarean sections, history of premature rupture of membranes, past transverse incisions in cesarean sections, a history of placenta previa, prenatal hemorrhage, and placenta previa were independent risk factors for pregnancies complicated with PA in women with a history of cesarean section. These independent risk factors showed a high value in predicting the risk for placentab accreta in pregnancies of women with a history of cesarean section.

Objective::To explore the risk factors and pregnancy outcomes in women with a history of cesarean section complicated by placenta accreta (PA).Methods::This case-control study included clinical data from singleton mothers with a history of cesarean section in 11 public tertiary hospitals in seven provinces of China between January 2017 and December 2017. According to the intraoperative findings after delivery, the study population was divided into PA and non-PA groups. We compared the pregnancy outcomes between the two groups, used multivariate logistic regression to analyze the risk factors for placental accreta.Results::For this study we included 11,074 pregnant women with a history of cesarean section; and of these, 869 cases were in the PA group and 10,205 cases were in the non-PA group. Compared with the non-PA group, the probability of postpartum hemorrhage (236/10,205, 2.31% vs. 283/869, 32.57%), severe postpartum hemorrhage (89/10,205, 0.87% vs. 186/869, 21.75%), diffuse intravascular coagulation (3/10,205, 0.03% vs. 4/869, 0.46%), puerperal infection (33/10,205, 0.32% vs. 12/869, 1.38%), intraoperative bladder injury (1/10,205, 0.01% vs. 16/869, 1.84%), hysterectomy (130/10,205, 1.27% vs. 59/869, 6.79%), and blood transfusion (328/10,205,3.21 % vs. 231/869,26.58%) was significantly increased in the PA group ( P < 0.05). At the same time, the neonatal birth weight (3250.00 (2950.00-3520.00) g vs. 2920.00 (2530.00-3250.00) g), the probability of neonatal comorbidities (245/10,205, 2.40% vs. 61/869, 7.02%), and the rate of neonatal intensive care unit admission (817/10,205, 8.01% vs. 210/869, 24.17%) also increased significantly ( P < 0.05). Weight (odds ratio ( OR)= 1.03, 95% confidence interval ( CI): 1.01-1.05)), parity ( OR= 1.18, 95% CI: 1.03-1.34), number of miscarriages ( OR= 1.31, 95% CI: 1.17-1.47), number of previous cesarean sections ( OR= 2.57, 95% CI: 2.02-3.26), history of premature rupture of membrane ( OR= 1.61, 95% CI: 1.32-1.96), previous cesarean-section transverse incisions ( OR= 1.38, 95% CI: 1.12-1.69), history of placenta previa ( OR= 2.44,95% CI: 1.50-3.96), and the combination of prenatal hemorrhage ( OR= 9.95,95% CI: 8.42-11.75) and placenta previa ( OR= 91.74, 95% CI: 74.11-113.56) were all independent risk factors for PA. Conclusion::There was an increased risk of adverse outcomes in pregnancies complicated by PA in women with a history of cesarean section, and this required close clinical attention. Weight before pregnancy, parity, number of miscarriages, number of previous cesarean sections, history of premature rupture of membranes, past transverse incisions in cesarean sections, a history of placenta previa, prenatal hemorrhage, and placenta previa were independent risk factors for pregnancies complicated with PA in women with a history of cesarean section. These independent risk factors showed a high value in predicting the risk for placentab accreta in pregnancies of women with a history of cesarean section.

OBJECTIVE To systematically review the efficacy and safety of induction chemotherapy before concurrent chemoradiotherapy.METHODS We comprehensively searched the CBM,Pubmed,Embase,and the Cochrane databases to identify published studies.Quality assessment of RCTs was conducted according to the methods of Cochrane collaboration.A meta-analysis was performed by using the Revman 5.3 software and Stata12.0software.Primary outcomes included overall survival (OS),progression-free survival (PFS) and overall response rate (ORR).Serious adverse events include neutropenia,anemia,skin reactions,vomiting,etc.RESULTS A Total 6 randomized controlled trials involving 1141 patients were included.There was no significant difference in 1-year survival rate,2-year survival rate,3-year survival rate,5-year survival rate between the two groups(P＞0.05).The 1-year PFS,2-year PFS,3-year PFS,5-year PFS,ORR also showed no difference between the 2 cohorts(P＞0.05).However,the incidence of grade 3 to 4 febrile neutropenia and oral mucositis was higher in the group of induction chemotherapy followed by concurrent chemoradiotherapy (OR=6.99,95％CI:2.43～20.12;OR=1.92,95％CI:1.43～2.58).CONCLUSION Additional induction chemotherapy before concurrent chemoradiotherapy does not improve OS and PFS in locally advanced HNSCC compared to concurrent chemoradiotherapy alone,and can cause a higher incidence of adverse events.

OBJECTIVE To investigate theradiosensitization of combined inhibition of signal transducer and activator of transcription 3(STAT3) and hypoxia-inducible factor-1α(HIF-1α)on laryngeal squamous carcinoma of xenograft mice and its underlying mechanisms.METHODS Xenograft mice were divided into 5 groups randomly: control group(A), irradiation group(B), irradiation and AG490 group(C), irradiation and PX478 group(D), irradiation combined AG490 and PX478 group(E). The size of xenograft tumor was measured and calculated. The expression of Ki67 and HIF-1α was detected by immunohistochemical method. Western blot was used to detect the expression of PARP1.RESULTS The size of xenograft tumor in group E was smaller compared with that in group C and group D. There were significantly difference between them respectively (t=12.367,11.598,P=0.000). The expression of HIF-1α in group E was lower than that in group C and group D respectively, and there were significantly difference respectively(t=5.422, 3.000,P<0.05). Ki67 index in group E was lower compared with that in group C and group D respectively and there were significantly difference respectively (t=4.479, 4.352,P<0.05). The level of cleaved PARP-1 in group E was higher than that in group C and group D respectively and there were significantly difference respectively (t=5.507, 7.102,P<0.05). CONCLUSION Combined inhibition of STAT3 and HIF-1α can increase the radiosensitivity of human laryngeal squamous carcinoma in the xenograft mice.

Objective To investigate the effects of cystectasia with sodium hyaluronate solution on ketamine related cystitis.Methods From June 2008 to October 2012,29 patients with ketamine related cystitis were analyzed,among which 27 were males and 2 were females.Their age ranged from 18 to 36 years old with a mean age of 25.All of them had frequency,urgency,urodynia and suprapubic pain.Voiding volume ranged from 10 to 160 ml and the interval duration ranged from 10 to 60 min.The test of ketamine in urine was positive.Patients were divided into four groups according to the treatment modality,namely the surgical treatment group (group A,n =11),surgery followed by addiction relapse group (group B,n =7),drug treatment group (group C,n =6) and non-drug treatment group (group D,n =5).Patients in group A and B underwent cystectasia with sodium hyaluronate solution under combined spinal-epidural anesthesia,and patients in group B were reported of addiction relapse within 2 weeks after cystectasia treatment.Patients in group C were free of the addiction to ketamine,while those in group D still rely on the ketamine.The average urine volume,OABSS and PUF scores were recorded 2 weeks and 4 weeks after the treatment.Results Two weeks after cystectasia,the average urine volums in group A and B were (107.7±39.6) ml and (95.0±35.5) ml respectively,which was larger than that in group D (42.0±13.5) ml,plus the volume in group A was larger than that in group C (63.3± 16.3) ml.The aforementioned differences were considered statistically significant (P＜0.05).As for OABSS and PUF scores,scores in group A [(6.0±2.6),(14.8± 4.2)] were lower than those in group C [(9.5±2.4),(22.5±2.2)].Furthermore,scores in group B [(9.0±2.4),(19.57±2.7)] were lower than those in group D [(12.2±1.9),(26.4±3.5)] (P＜0.05).Four weeks later,the average urine volume,OABSS and PUF scores in group A [(106.4±37.5) ml,(5.6± 2.5),(13.5±4.0)] and group C[(113.3±27.3) ml,(6.3±2.2),(14.5±2.7)] were significantly different from those in group B [(52.1±21.6) ml,(11.1±1.3),(26.4±2.8)] and group D [(40.0±13.7)ml,(12.0±1.6),(26.6±3.6)] (P＜0.05).While,no obvious distinction was observed between group A and group C,group B and group D in terms of average urine volume,OABSS and PUF scores at 4 weeks postoperatively (P＞0.05).Conclusions Cystectasia can efficiently alleviate lower urinary tract syndromes in patients with ketamine related cystitis.

OBJECTIVE: To study the expression of Cyclin D1 in nasopharyngeal carcinoma cells processed by epigallocatechin gallate(EGCG) and it's significance, and revealed the anti-tumor mechanism of EGCG against nasopharyngeal carcinoma. METHOD: CNE-2 cells were treated by EGCG at different concentrations, the morphological changes of CNE-2 cells were observed by inverted microscope; the inhibition ratio of cell proliferation was detected by MTT colorimetric method, flow cytometry was used to analyze the changes of cell cycle. The expression of Cyclin D1 mRNA was detected by RT-PCR. RESULT: After treated by EGCG, the CNE2 cells decreased in amount and density, some of which became roll and small; Floating and dead cells can be seen in the inverted microscopy; cell proliferation was significantly inhibited in a time and dose dependent (P < 0.05). CNE-2 cells were arrested at G1/G0 phase. The expression of Cyclin D1 mRNA was down-regulated by EGCG with concentration and action time dependent (P < 0.05). CONCLUSION EGCG resisted nasopharyngeal carcinoma by inhibiting the cell proliferation, The down regulation of Cyclin D1 mRNA expression in a time and dose dependent may be the possible mechanisms.
Carcinoma ; Catechin ; analogs & derivatives ; pharmacology ; Cell Cycle ; drug effects ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Cyclin D1 ; metabolism ; Humans ; Nasopharyngeal Carcinoma ; Nasopharyngeal Neoplasms ; metabolism ; pathology

Objective To learn mental health,life events and stress response of immigrant medical professionals. Methods Symptom checklist ( SCL-90), Life event scale ( LES), and Coping questionnaire (CQ) were used for assessment. Results SCL-90 ( 135.95 ± 32. 56 ), Somatization ( 1.62 ± 0. 38 ),obsessive-compulsion ( 1.75 ± 0. 53), depression (1.66 ± 0. 55) ,anxiety ( 1.52 ± 0. 54), hostility ( 1.53 ±0.45) ,and psychoticism (1.45 ±0.46) were even serious in immigrant medical professionals (all P＜0. 05). SCL-90 factor score was positively correlated with LES total score and LES factor score ( both P ＜0. 05 ). However, SCL-90 factor score was negatively correlated with problem-solving and coping style score of CQ (P ＜ 0. 01 ). Conclusion As mental health and life event responses were concerned, more attention should be paid to the immigrant medical professionals.

BACKGROUND AND OBJECTIVEIt was proven that Vitamin C could inhibit the growth of many types of tumors as an antioxidant. The aim of this study is to explore role of Vitamin C in proliferation and apoptosis of lung carcinoma cell line A549 and the underlying mechanism.

METHODSA549 cells were cultured in vitro and incubated with Vitamin C. The cell viability was measured by growth curve and clonogentic assay. Flow cytometry was used to analyze cell cycle and detect apoptosis. The levels of expression of Caspase-3 mRNA and Survivin mRNA were detected by RT-PCR.

RESULTSVitamin C of 400 microg/mL, 4 mg/mL significantly inhibited the growth of A549 cell lines (P = 0.024, P = 0.015, respectively). Flow cytometry showed that the cells major stagnation stayed in the G0/G1 and S phase and the apoptotic rate increased with time prolonged. Vitamin C signifiantly up-regulated the expression of Caspase-3 mRNA, but had no effect on Survivin mRNA.

CONCLUSIONVitamin C can inhibit the proliferation of A549, block A549 cells in G0/G1 and S phase, and induce apoptosis of A549 cells. Apotosis occurred by up-regulated the expression of Caspase-3.

Apoptosis ; drug effects ; genetics ; Ascorbic Acid ; pharmacology ; Caspase 3 ; genetics ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Flow Cytometry ; Gene Expression Regulation, Neoplastic ; drug effects ; genetics ; Humans ; Inhibitor of Apoptosis Proteins ; Microtubule-Associated Proteins ; genetics ; Reverse Transcriptase Polymerase Chain Reaction

Objective To learn the psychological health state,life events and coping styles of the non-native policemen.Methods Symptom checklist (SCL-90),Life event scale (LES) and Coping questionnaire (CQ) was tested to native policemen(n=238) and non-native policeman(n=136).Results Score of SCL-90 (159.68±50.46) ,depression(1.79±0.62) ,photic anxiety(1.54±0.63) ,addition items(1.82±0.59) factors in non-native policemen were higher than that in the native policemen,and there was significant deference(P＜0.05).The concerned analyses showed non-native policemen score of SCL-90 was significantly positively related to LES total score and sub-scale factor (P＜0.01,P＜0.05).The non-native policemen score of SCL-90 was significantly negatively related to settle problem factor of CQ (P ＜ 0.01),and other factors of CQ was significantly positively(P ＜0.O1).Conclusion The poor psychological health state and live emergency events of the non-native policemen should be pay more attention.