Objective:To analyze and summarize the characteristics and rules of upper airway computerized tomography (CT) in obstructive sleep apnea (OSA) patients with epiglottic collapse.Methods:As a cross-sectional study, OSA patients (all were male, aged 18 to 60) who received Han-uvulopalatopharyngoplasty (H-UPPP) surgery at Second Affiliated Hospital of Zhejiang University School of Medicine from April 2023 to February 2024 were continuously selected. All patients underwent physical examination, polysomnography (PSG) and three-dimensional CT plain scan of upper airway before surgery. Preoperative drug-induced sleep endoscopy (DISE) was performed on the day of surgery. According to the findings of DISE, all patients were divided into two groups: epiglottic collapse group and non-epiglottic collapse group. The relevant data were collected, and the measured data included epiglottic length, epiglottic width, epiglottic curvature, epiglottic angle, distance between epiglottis and posterior pharyngeal wall, distance between epiglottis and tongue base, angle between epiglottis and tongue base, the lymph tissue classification of the tongue base, airway length, mandibular - hyoid bone distance, soft palate length and soft palate - hard palate Angle. Statistical analysis was performed using SPSS 25.0.Results:There were a total of 104 patients with OSA, consisting of 27 patients with epiglottic collapse and 77 patients with non-epiglottic collapse. In this study, the incidence of epiglottic collapse was 25.96%. There were no significant differences in apnea hyponea index (AHI), minimum blood oxygen saturation and the time ratio of blood oxygen saturation below 90% (TS90) between the two groups (all P>0.05). Compared with the non-epiglottic collapse group, the epiglottic length [(19.77±2.42)mm vs. (18.54±2.62)mm, t=2.162, P=0.033] and the lymph tissue classification of the tongue base [4(1,4) vs.2(1,3), Z=-2.968, P=0.003] in the epiglottic collapse group increased. Distance between epiglottis and tongue base reduced [2.70(0,5.88) mm vs. 5.45(2.15,6.98)mm, Z=-2.385, P=0.017]. According to Logistic regression analysis, epiglottic collapse and epiglottic width ( OR: 1.201; 95% CI: 1.009-1.430, P=0.039) were positively correlated, epiglottic curvature ( OR: 0.979; 95% CI: 0.961-0.998, P=0.030) was negatively correlated, and with the grade of lymph tissue of tongue root ( OR: 1.936; 95% CI: 1.294-2.896, P=0.001) was positively correlated. Conclusion:CT examination in awake OSA patients with epiglottic collapse can reveal its characteristic indicators. The wider the epiglottic width, the smaller the epiglottic curvature, and the larger the lymph tissue grade of the base of tongue were effective predictors of epiglottic collapse.

Objective:To investigate the effect of nuclear receptor subfamily 2 group F member 2(NR2F2)on the biological behaviors of human ovarian cancer SKOV3 cells,and to clarify its molecular mechauism and provide the new idea for treatment of ovarian cancer.Methods:Gene Expression Profiling Interactive Analysis(GEPIA)Database analyse the expression level of NR2F2 gene in ovarian tissue,and analyse its correlation with clinical prognosis of ovarian cancer patients.The human ovarian cancer SKOV3 cells were divided into control group and NR2F2 over-expression(NR2F2 OE)group,which were transfected with mCherry control virus and NR2F2 OE over-expression virus,respectively,when the cell deusity reached 70％,and the stable transfection SKOV3 cell lines were screened with puromycin(puro)48h lafter.Real-time fluorescence quantitative PCR(RT-qPCR)and Western blotting methods were used to detect the transfection efficiencies of the cells;RT-qPCR method was used to detect the expression levels of NR2F2 and sex-determining region Y-box 2(SOX2)mRNA in the cells in two groups;Western blotting method was used to detect the expression levels of NR2F2,ATP-binding cassette superfamily G member 2(ABCG2),and programmed cell death 1-ligand 1(PD-L1)protcins in the cells in two groups.CCK-8 assay was used to detect the proliferation activities of the cells in two groups;Wound assay was used to detect the migration rates of the cells in two groups;Transwell chamber assay was used to detect the number of transmembrane cells;Spheroidization assay was used to detect the numbers of spheroids in the cells;peripheral blood mononuclear cells(PBMCs)-mediated tumor cell killing assay was used to detect the relative densities of surviving tumor cells;CCK-8 assay was used to detect the half maximal inhibitory concentration(IC50)of paclitaxel(PTX)and carboplatin(CBP).Results:Compared with normal ovarian tissue,the expression level of NR2F2 gene in ovarian tumor tissue was decreased(P＜0.05),and decreased with the improvement of clinical pathological grading of ovarian tumor.The patients with higher expression level of NR2F2 gene had better clincal prognosis.The SKOV3 cells with NR2F2 over-expresson were successfully constructed,and the expression levels of NR2F2 mRNA and protein in the cells in NR2F2 OE group were increased compared with control group(P＜0.001).The CCK-8 assay results showed that compared with control group,the proliferation activities of the cells in NR2F2 OE group were decreased at different time points(1,2,3,and 4 d)(P＜0.05 or P＜0.01).The cell wound assay results showed that compared with control group,the migration rate of the cells in NR2F2 OE group was decreased(P＜0.001).The Transwell assay results showed that compared with control group,the number of transmembrane cells in NR2F2 OE group was decreased(P＜0.01).Compared with control group,the number of the spheroids in NR2F2 OE group was decreased(P＜0.05),and the expression levels of SOX2 mRNA(P＜0.01)and protein(P＜0.001)were increased.Compared with control group,the relative density of surviving tumor cells in NR2F2 OE group was decreased,but the difference was not significant(P＜0.05),and the expression level of PD-L1 protein was decreased(P＜0.05).Compared with control group,the proliferation activities of cells in NR2F2 OE group were decreased(P＜0.05),and the drug sensitivities of the cells to PTX and CBP were enhanced(P＜0.05);the IC50 of PTX was significantly reduced,while the IC50of CBP could not be calculated due to excessively high drug concentration;the expression level of ABCG2 protein was decreased(P＜0.05).Conclusion:The over-expression of NR2F2 may inhibit the proliferation,migration,and invasion of the human ovarian cancer SKOV3 cells,decrease the expression levels of SOX2,PD-L1 and ABCG2 proteins,suppress the stemness and immune evasion ability of the SKOV3 cells,and enhance the sensitivities of the SKOV3 cells to PTX and CBP.

Objective:To discuss the effect of long non-coding RNA(lncRNA)LINC00973 on the migration,invasion,and distant metastasis of epithelial ovarian cancer,and to clarify its molecular mechanism.Methods:The human ovarian cancer SKOV3 and OVCAR3 cells were divided into EF1a-FH empty vector control group(control group),LINC00973 overexpression group(LINC00973 OE group),U6-shRNA empty vector control group(SHV group),and LINC00973 knockdown group(LINC00973 KD group),and were transfected with lentivirus containing nonsense sequence(pLent-EF1a-FH-CMV-copGFP-P2A-Puro),LINC00973 overexpression,nonsense sequence(pLent-U6-shRNA-CMV-copGFP-P2A-Puro)and LINC00973 shRNA,respectively,followed by puromycin screening to obtain stably transfected SKOV3 and OVCAR3 cells.Real-time fluorescence quantitative PCR(RT-qPCR)method was used to detect the mRNA expression levels of target genes in the cells in various groups;wound healing assay was used to detect the migration rate of the cells in various groups;Transwell chamber assay was used to detect the number of transmembrane cells in various groups;The mice were divided into control group(WT group),LINC00973 OE group,and LINC00973 KD group,with 4 mice in each group.SKOV3 wild-type cells,LINC00973 OE cells,and LINC00973 KD cells were intraperitoneally injected into the mice in various groups,respectively,to establish the epithelial ovarian cancer intraperitoneal implantation and metastasis model;HE staining was used to observe the morphology of the colon and liver tissues of the mice in various groups;RNA-secquencing(RNA-seq)was used to analyze the differentially expressed genes between SHV and LINC00973 KD groups in the SKOV3 cell line;RT-qPCR method was used to detect the mRNA expression levels of LINC00973 in the normal ovarian epithelial cells IOSE-80 and epithelial ovarian cancer cells SKOV3,A2780 and OVCAR3,the mRNA expression levels of LINC00973,Vimentin,Snail family transcriptional repressor 1(Snail),Twist family basic helix-loop-helix transcription factor 1(Twist),zinc finger E-box binding homeobox 1(ZEB1),zinc finger E-box binding homeobox 2(ZEB2),CXCL8 and matrix metalloproteinase(MMP)16 in the cells in various groups,and the mRNA expression levels of LINC00973,Vimentin and Twist in liver and colon tissues of the mice in various groups.Results:Compared with normal ovarian epithelial cells IOSE-80,the expression level of LINC00973 mRNA in the epithelial ovarian cancer cells SKOV3,OVCAR3 and A2780 was significantly increased(P<0.01),with the highest expression level of LINC00973 in SKOV3 and OVCAR3 cells,which were therefore selected for subsequent experiments.In SKOV3 and OVCAR3 cells,compared with control group,the expression level of LINC00973 mRNA in the cells in LINC00973 OE group was increased(P<0.01);compared with SHV group,the expression level of LINC00973 mRNA in the cells in LINC00973 KD group was decreased(P<0.05 or P<0.01),indicating successful construction of LINC00973 overexpression and knockdown cell lines.In SKOV3 cells,compared with control group,the mRNA expression levels of Vimentin and Twist in LINC00973 OE group were increased(P<0.05 or P<0.01),while no significant difference was observed in Snail mRNA expression level(P>0.05);compared with SHV group,the mRNA expression levels of Vimentin,Snail and Twist in LINC00973 KD group were decreased(P<0.01).In OVCAR3 cells,compared with control group,the mRNA expression levels of Vimentin,Snail and Twist in LINC00973 OE group were increased(P<0.01);compared with SHV group,the expression levels of Vimentin,Snail,and mRNA Twist in LINC00973 KD group were decreased(P<0.01).The wound healing assay results showed that compared with control group,the wound healing rates of the SKOV3 and OVCAR3 cells in LINC00973 OE group were significantly increased(P<0.01);compared with SHV group,the wound healing rates of the cells in LINC00973 KD group were significantly decreased(P<0.01).The Transwell chamber assay results showed that compared with control group,the numbers of transmembrane cells of the SKOV3 and OVCAR3 cells in LINC00973 OE group were significantly increased(P<0.01);compared with SHV group,the numbers of transmembrane cells in LINC00973 KD group were significantly decreased(P<0.01).Compared with WT group,the number of peritoneal nodules in LINC00973 OE group was increased,with rough liver surface and multiple nodules formed on mesentery and colon surface,and the expression levels of LINC00973,Vimentin,and Twist mRNA in colon tissue were increased(P<0.01);compared with WT group,no nodules were formed in the peritoneal cavity of LINC00973 KD group,with smooth liver surface,no nodules in liver tissue,and decreased expression levels of LINC00973,Vimentin,and Twist mRNA,and no nodules were observed on mesentery and colon surface.The HE staining results showed that compared with WT group,the multiple lesions were observed in liver and colon tissues in LINC00973 OE group,manifested as uneven cell size,irregular shape,unclear cell boundaries,increased nuclear division,and uneven red staining in cytoplasm,while in LINC00973 KD group,the cells in liver and colon tissues were arranged neatly with regular shape,and uniform distribution of nuclei and cytoplasm.The RNA-seq results showed that compared with SHV group,no key signaling pathways related to tumor metastasis were enriched in LINC00973 KD group,and the transcription levels of metastasis-related genes CXCL8,MMP16,ZEB1,and ZEB2 were decreased.The RT-qPCR results showed that compared with control group,the expression levels of ZEB1,ZEB2,CXCL8,and MMP16 mRNA in the cells in LINC00973 OE group were significantly increased(P<0.01);compared with SHV group,the expression levels of ZEB1,ZEB2,CXCL8,and MMP16 mRNA in the cells in LINC00973 KD group were significantly decreased(P<0.01).Conclusion:LINC00973 can up-regulate the expression of metastasis-related factors Vimentin,Snail,Twist,ZEB1,ZEB2,CXCL8,and MMP16,and promote the migration,invasion,and distant metastasis of epithelial ovarian cancer.

Objective:To analyze and summarize the characteristics and rules of upper airway computerized tomography (CT) in obstructive sleep apnea (OSA) patients with epiglottic collapse.Methods:As a cross-sectional study, OSA patients (all were male, aged 18 to 60) who received Han-uvulopalatopharyngoplasty (H-UPPP) surgery at Second Affiliated Hospital of Zhejiang University School of Medicine from April 2023 to February 2024 were continuously selected. All patients underwent physical examination, polysomnography (PSG) and three-dimensional CT plain scan of upper airway before surgery. Preoperative drug-induced sleep endoscopy (DISE) was performed on the day of surgery. According to the findings of DISE, all patients were divided into two groups: epiglottic collapse group and non-epiglottic collapse group. The relevant data were collected, and the measured data included epiglottic length, epiglottic width, epiglottic curvature, epiglottic angle, distance between epiglottis and posterior pharyngeal wall, distance between epiglottis and tongue base, angle between epiglottis and tongue base, the lymph tissue classification of the tongue base, airway length, mandibular - hyoid bone distance, soft palate length and soft palate - hard palate Angle. Statistical analysis was performed using SPSS 25.0.Results:There were a total of 104 patients with OSA, consisting of 27 patients with epiglottic collapse and 77 patients with non-epiglottic collapse. In this study, the incidence of epiglottic collapse was 25.96%. There were no significant differences in apnea hyponea index (AHI), minimum blood oxygen saturation and the time ratio of blood oxygen saturation below 90% (TS90) between the two groups (all P>0.05). Compared with the non-epiglottic collapse group, the epiglottic length [(19.77±2.42)mm vs. (18.54±2.62)mm, t=2.162, P=0.033] and the lymph tissue classification of the tongue base [4(1,4) vs.2(1,3), Z=-2.968, P=0.003] in the epiglottic collapse group increased. Distance between epiglottis and tongue base reduced [2.70(0,5.88) mm vs. 5.45(2.15,6.98)mm, Z=-2.385, P=0.017]. According to Logistic regression analysis, epiglottic collapse and epiglottic width ( OR: 1.201; 95% CI: 1.009-1.430, P=0.039) were positively correlated, epiglottic curvature ( OR: 0.979; 95% CI: 0.961-0.998, P=0.030) was negatively correlated, and with the grade of lymph tissue of tongue root ( OR: 1.936; 95% CI: 1.294-2.896, P=0.001) was positively correlated. Conclusion:CT examination in awake OSA patients with epiglottic collapse can reveal its characteristic indicators. The wider the epiglottic width, the smaller the epiglottic curvature, and the larger the lymph tissue grade of the base of tongue were effective predictors of epiglottic collapse.

OBJECTIVE:To promote the realization of information management for hospital pharmacy. METHODS:The practice of pharmacy information management pathway in our hospital was introduced in respects of drug supply,rational drug use monitoring,pharmacy information dissemination,etc. The effects of information management were evaluated in respects of work efficiency,the rate of drug dispensing error and rational drug use index,etc. RESULTS:The information management pathway of our hospital included drug purchase,warehousing and keeping system,drug distribution management system,reasonable drug use monitoring information module,etc. It realized automatic generation and issue of purchase plan,acceptance bar code of drug warehousing,real-time drug stocking and location changing,drug guarantee delivery in advance,window drug delivery and check barcode scanning,drug distribution quality information management,whole process temperature and humidity monitoring, unreasonable prescription after the event,in the event,in advance,early warning of drug use,real-time monitoring of drug use and administration of drugs for chronic diseases,etc. After the implementation of information management,the time of drug warehousing invoice input and drug stocking were shortened.Among drug dispensing error,the percentage of type error decreased from 0.005 2% during Jun.-Dec. 2015 to 0.001 6% during Jan.-Jun. 2016;that of number error decreased from 0.006 9% to 0.001 6%;that of other error dropped to zero. During 2014-2016,the ratio of drug cost to treatment cost decreased gradually;those of inpatient were 26.62%,24.91%,24.36%,respectively;those of outpatient were 44.06%,42.10%,41.32%, respectively. Utilization rates of antibiotics in the inpatients decreased gradually,and were 44.82%,44.14%,43.91%, respectively. CONCLUSIONS:Information construction plays an important role on hospital pharmacy,can effectively improve work efficiency,reduces medication error and promotes rational drug use.

Objective To investigate whether the population pharmacokinetics (PPK)models can optimize the initial dosage of individualized Valproic acid (VPA)in children with epilepsy. Methods The epileptic children without taking VPA previously were recruited from October 2015 to May 2017 at the Department of Pediatrics,Peking University First Hospital,and they were divided into the PPK model group and the traditional empirical method group by randomized method. The initial VPA dosages for the PPK model group were calculated by PPK model,whereas those of the traditional empirical method group were dosed at 20-25 mg/(kg·d)regularly. The steady-state serum trough concentrations of VPA were extracted,and then the number and percentage of the patients whose serum trough concen-trations of VPA were 50-100 mg/L in the 2 groups were analyzed and compared with prospectively randomized me-thod. Results Totally 65 epileptic children were recruited and they were randomly divided into the traditional empirical method group (32 cases)and the PPK model group (33 cases). Twenty-seven children in the traditional empirical method group were observed,and 12 children had local epilepsy attack and 15 had generalized seizures;whereas among 29 cases in the PPK model group,there were 12 local attack of epilepsy and 17 had generalized seizures. VPA add-on therapy was administrated in 9 cases and 15 cases in the traditional empirical method group and the PPK model group, respectively. There were 5 cases,21 cases and 1 case with VPA serum concentrations of ＜50 mg/L,50-100 mg/L and＞100 mg/L in the traditional empirical group;while there were 9 cases,20 cases and 0 case in the PPK model group. The VPA serum concentrations of 21 cases (77. 8%,21/27 cases)in the traditional empirical method group and 20 ca-ses (69. 0%,20/29 cases)in the PPK model group were 50-100 mg/L,respectively,and the difference was not sta-tistically significant(P＞0. 05). Conclusion Although the study doesn't suggest that the established PPK model of VPA in Chinese epileptic children is superior to the traditional empirical method,the PPK model might be potentially valuable for optimized individualized dosage adjustment for those with serum trough concentrations not in the reasonable range by the traditional empirical method and with clinical seizure or brain firing activities.

Objectives: To investigate the effect of β-catenin interacting protein 1 (ICAT) silence in Wnt signaling pathway and sterol drug NSC67657 induced cell differentiation of HL60 cell. Methods: HL-60 cells were treated with NSC67657, the cell surface antigen CD14 expression was detected by flow cytometry. Lentivirus LV-ICAT-RNAi vector was constructed and infected HL-60 cells. Then the ICAT gene and protein expression were analyzed using real-time qPCR and Western blot technique. Furthermore, Co-immunoprecipitation assay was used to confirm the interaction of β-catenin/ICAT proteins, and Western blot was employed to compare the expressions of Wnt signaling pathway downstream targets Cyclin D1, TCF-1 and c-Jun between Lentivirus LV-ICAT-RNAi vector infected HL-60 (HL-60i) cells and un-infected HL-60 (HL-60v) cells. The cellular differentiation of HL-60i and HL-60v cells treated with NSC67657 for 24 h was evaluated by Wright’s staining, transmission electron microscopy and flow cytometry analysis. Results: HL-60 cells could be induced to differentiate into monocytes by 10 μmol/L NSC67657. The CD14 positive cells could reach to (92.30±5.14) % after NSC67657 treatment for 5d. The co- immunoprecipitation assay demonstrated that ICAT protein did interact with β-catenin protein, and the absorbance of protein electrophoresis bands increased in differentiated cells. The expressions of Wnt signaling pathway downstream target proteins in HL-60i cells were higher than that in HL-60v cells when they were treated by 10 μmol/L NSC67657, but lower than NSC67657 untreated cells. CD14 positive HL-60i cells were significantly lower than that of HL-60v cells[ (8.33±3.14) % vs (19.08±4.73) %]when treated with NSC67657, but still higher than that of uninfected and untreated HL60 cells[ (0.60±0.03) %] (F=119.24, P=0.010) . The results of cellular morphology and ultrastructure observation were also in accord with that of cell surface antigen analysis. Conclusions ICAT does participate in HL-60 cells monocytic differentiation induced by NSC67657, and Wnt/β-catenin signaling pathway might play a bridge role.

Objective In order to investigate the impact of interactive online teaching in Laboratory Diagnosis, a randomized experimental study was conducted among the medical students in Grade 2009.Methods A total of 65 subjects were randomized into the experimental group (N=31) and the control group (N=34).In addition to the standard in-class presentation/discussion and school-wide refined online courses offered in the control group, interactive online teaching was added to experimental group.After completion of the course, the impact of interactive online teaching in the experimental group was compared to that in the control group through a final exam and a question-naire concentrating on motivation of study, problem solving and team working skills.Statistical signifi-cance of the comparison was evaluated using t-test.Results The results from the final exam showed that the average score in the experimental group was higher than the control group (87.20 ± 5.25 vs.82.69 ± 5.76), It is statistically significant (P=0.002).The average scores of short answer and case study questions in the experimental group was higher than the control group (26.16 ± 1.57 vs.25.31 ± 1.73, 18.94 ± 1.05 vs.15.53 ± 1.15), It is statistically significant (P=0.043,P=0.000).The satisfaction evaluation of interest in learning, timely answers to questions, learning, analytical skills, teamwork culture reflected by the questionnaire indicated statistically higher (P=0.041,0.000,0.000,0.000,0.000) average scores in the experimental group as compared to its counterparts in the control group (4.30 ± 0.65 vs.3.97 ± 0.62, 4.63 ± 0.49 vs.3.25 ± 0.88, 4.43 ± 0.57 vs.3.49 ± 0.65, 4.46 ± 0.57 vs.3.37 ± 0.73, 4.33 ± 0.66 vs.3.68 ± 0.58).Conclusion Interactive online teaching helps to improve the study performance of medical students in Laboratory Diagnosis.Incorporating interactive online teaching into the current course regarding Laboratory Diagnosis merits recommendation.

In-depth application of the combination of theory and practice is one of the keys to improve the clinical undergraduate teaching quality of clinical laboratory diagnosis.Xuanwu Hospital used ISO15189 standards as a guide to make students fully participate in establishing performance verification and recording registration form,partly participate in the gage calibration,external quality assessment and inter-laboratory comparison etc.It also used the combined form of practice with teaching to make students learn the file writing and the equipment calibration.An orderly teaching model composed of knowledge reserve,file learning,calibration and verification was established,which was a closed-loop system that enabled students to become more deeply and extensively involved in the system and more deeply understand the connotation of clinical laboratory quality.

Objective To evaluate the limit of blank (LoB),limit of detection (LoD),limit of quantitation(LoQ)and functional sensitivity (FS)of prealbumin (PA)detected by the Roche Modular P automatic biochemical analyzer.Methods According to the EP17A file of the American Clinical and Laboratory Standards Institute (CLSI),saline as the blank sample and a series of low con-centration samples were detected by the Roche Modular P automatic biochemical analyzer for determining LoB,LoD and LoQ.And FS was determined based on the domestic universal method .Results LoB of PA was 16.35 mg/L,LoD was 18.23 mg/L,LoQ was temporarily unable to evaluate and FS was 25.00 mg/L.The report scope and the report mode in clinic were affirmed by combi-ning with the low value of the reportable scope.Conclusion LoD of PA detected by the Roche Modular P automatic biochemical an-alyzer is established,which provides more valuable information for clinical diagnosis and treatment.Conducting the comparison of different evaluation methods determines the advantages and limitation of the practical application of different methods.