Objective To investigate the expression of serum interleukin(IL)-32β and long non-coding RNA-T cell leukemia/lymphoma 6(lncRNA-TCL6)in women with severe preeclampsia(sPE)and its relationship with adverse pregnancy outcomes.Methods A total of 316 women with sPE(sPE group)and 323 healthy pregnant women(control group)admitted to Sichuan Jinxin Women and Children's Hospital from November,2020 to June,2023 were enrolled.Serum IL-32β and lncRNA-TCL6 were detected,and pregnancy outcomes were followed up.Multivariate Logistic regression was used to analyze the influencing factors of adverse pregnancy outcomes in women with sPE.Receiver operating characteristic(ROC)curve was used to analyze the efficacy of IL-32β and lncRNA-TCL6 in predicting the pregnancy outcomes of sPE.Results The serum IL-32β level(4.13±1.46 pg/ml)and lncRNA-TCL6 expression(1.36±0.30)in the sPE group were higher than those in the control group(2.35±0.77 pg/ml,0.89±0.21),and the differences were statistically significant(t=19.335,22.983,all P<0.05).The level of serum IL-32β(4.65±0.39 pg/ml)and the expression of lncRNA-TCL6(1.42±0.19)in the poor outcome group were higher than those in the good outcome group(3.98±0.37pg/ml,1.34±0.11),and the differences were statistically significant(t=13.207,4.480,all P<0.05).Early onset preeclampsia,high levels of IL-32β and high expression of lncRNA-TCL6 were risk factors for adverse pregnancy outcomes in sPE patients(Wald χ2=6.138,1.921,1.702,all P<0.05).The AUC of IL-32 β,lncRNA-TCL6,and their combined prediction of sPE pregnancy outcomes were 0.815,0.825 and 0.958,respectively.The combined prediction of IL-32β and lncRNA-TCL6 was higher than the individual prediction,and the differences were statistically significant(Z=4.502,4.017,all P<0.05).Conclusion The serum levels of IL-32β and lncRNA-TCL6 are increased in patients with sPE,which are related to the adverse pregnancy outcome.Combined IL-32β and lncRNA-TCL6 have a high value in predicting the pregnancy outcome of patients with sPE.

Objective To investigate the expression of serum interleukin(IL)-32β and long non-coding RNA-T cell leukemia/lymphoma 6(lncRNA-TCL6)in women with severe preeclampsia(sPE)and its relationship with adverse pregnancy outcomes.Methods A total of 316 women with sPE(sPE group)and 323 healthy pregnant women(control group)admitted to Sichuan Jinxin Women and Children's Hospital from November,2020 to June,2023 were enrolled.Serum IL-32β and lncRNA-TCL6 were detected,and pregnancy outcomes were followed up.Multivariate Logistic regression was used to analyze the influencing factors of adverse pregnancy outcomes in women with sPE.Receiver operating characteristic(ROC)curve was used to analyze the efficacy of IL-32β and lncRNA-TCL6 in predicting the pregnancy outcomes of sPE.Results The serum IL-32β level(4.13±1.46 pg/ml)and lncRNA-TCL6 expression(1.36±0.30)in the sPE group were higher than those in the control group(2.35±0.77 pg/ml,0.89±0.21),and the differences were statistically significant(t=19.335,22.983,all P<0.05).The level of serum IL-32β(4.65±0.39 pg/ml)and the expression of lncRNA-TCL6(1.42±0.19)in the poor outcome group were higher than those in the good outcome group(3.98±0.37pg/ml,1.34±0.11),and the differences were statistically significant(t=13.207,4.480,all P<0.05).Early onset preeclampsia,high levels of IL-32β and high expression of lncRNA-TCL6 were risk factors for adverse pregnancy outcomes in sPE patients(Wald χ2=6.138,1.921,1.702,all P<0.05).The AUC of IL-32 β,lncRNA-TCL6,and their combined prediction of sPE pregnancy outcomes were 0.815,0.825 and 0.958,respectively.The combined prediction of IL-32β and lncRNA-TCL6 was higher than the individual prediction,and the differences were statistically significant(Z=4.502,4.017,all P<0.05).Conclusion The serum levels of IL-32β and lncRNA-TCL6 are increased in patients with sPE,which are related to the adverse pregnancy outcome.Combined IL-32β and lncRNA-TCL6 have a high value in predicting the pregnancy outcome of patients with sPE.

Objective:This study aimed to investigate the correlation between the use of glucose-lowering drugs and the risk of pancreatic cancer through propensity score matching(PSM),which provides a scientific basis for clinical decision-making.Methods:This study retrospectively analyzed the clinical data of patients diagnosed with type 2 diabetes mellitus(T2DM)and treated with glucose-lowering drugs in Nanjing Drum Tower Hospital between 2000 and 2023.The patients were divided into two groups:those with T2DM alone and those with T2DM combined with pancreatic cancer.PSM was employed to align the baseline characteristics of patients across groups,minimizing the impact of confounding factors.According to the use of glucose-lowering drugs,the correlation between the use of various types of glucose-lowering drugs and the occurrence of pancreatic cancer was explored by logistic regression analysis,and the drug influencing factors that might potentially affect the occurrence of pancreatic cancer were screened out.Additionally,the relationship between the use of glucose-lowering medications,both as monotherapy and in combination,and the occurrence of pancreatic cancer was further analyzed.Results:The logistic regression analyses showed that previous use of sulfonylureas was significantly associated with pancreatic cancer in patients with T2DM,and previous use of dipeptidyl peptidase-4(DPP-4)inhibitors was weakly associated with pancreatic cancer,and sulfonylureas[odds ratio(OR)=0.631,95%CI:0.415-0.961,P=0.032]and dipeptidyl peptidase-4(DPP-4)inhibitors(OR=0.639,95%CI:0.388-1.052,P=0.078)may be associated with a reduced risk of pancreatic cancer in T2DM patients.Other drugs,including insulin,metformin,α-glucosidase inhibitors,and sodium-glucose transporter-2(SGLT-2)inhibitors,were not significantly associated with pancreatic cancer development.In a further analysis of glucose-lowering treatment regimens,it was shown that metformin in combination with other oral glucose-lowering agents was associated with pancreatic cancer[adjustment OR(aOR)=0.463,95%CI:0.224-0.959,P=0.038]and may be a protective factor for pancreatic carcinogenesis.Conclusion:The use of sulfonylureas and DPP-4 inhibitors in T2DM patients is related to the reduction of pancreatic cancer,and compared with the use of drugs alone,the use of drugs combined with oral hypoglycemic drugs can further reduce the incidence of pancreatic cancer.

Objective:This study aimed to investigate the correlation between the use of glucose-lowering drugs and the risk of pancreatic cancer through propensity score matching(PSM),which provides a scientific basis for clinical decision-making.Methods:This study retrospectively analyzed the clinical data of patients diagnosed with type 2 diabetes mellitus(T2DM)and treated with glucose-lowering drugs in Nanjing Drum Tower Hospital between 2000 and 2023.The patients were divided into two groups:those with T2DM alone and those with T2DM combined with pancreatic cancer.PSM was employed to align the baseline characteristics of patients across groups,minimizing the impact of confounding factors.According to the use of glucose-lowering drugs,the correlation between the use of various types of glucose-lowering drugs and the occurrence of pancreatic cancer was explored by logistic regression analysis,and the drug influencing factors that might potentially affect the occurrence of pancreatic cancer were screened out.Additionally,the relationship between the use of glucose-lowering medications,both as monotherapy and in combination,and the occurrence of pancreatic cancer was further analyzed.Results:The logistic regression analyses showed that previous use of sulfonylureas was significantly associated with pancreatic cancer in patients with T2DM,and previous use of dipeptidyl peptidase-4(DPP-4)inhibitors was weakly associated with pancreatic cancer,and sulfonylureas[odds ratio(OR)=0.631,95%CI:0.415-0.961,P=0.032]and dipeptidyl peptidase-4(DPP-4)inhibitors(OR=0.639,95%CI:0.388-1.052,P=0.078)may be associated with a reduced risk of pancreatic cancer in T2DM patients.Other drugs,including insulin,metformin,α-glucosidase inhibitors,and sodium-glucose transporter-2(SGLT-2)inhibitors,were not significantly associated with pancreatic cancer development.In a further analysis of glucose-lowering treatment regimens,it was shown that metformin in combination with other oral glucose-lowering agents was associated with pancreatic cancer[adjustment OR(aOR)=0.463,95%CI:0.224-0.959,P=0.038]and may be a protective factor for pancreatic carcinogenesis.Conclusion:The use of sulfonylureas and DPP-4 inhibitors in T2DM patients is related to the reduction of pancreatic cancer,and compared with the use of drugs alone,the use of drugs combined with oral hypoglycemic drugs can further reduce the incidence of pancreatic cancer.

Objective:To investigate the synergistic antitumor effect of pyrotinib in combination with 5-fluorouracil(5-Fu)on human epidermal growth factor receptor 2(HER2)positive breast cancer cells and its underlying molecular mechanism. Methods:HER2 positive breast cancer cells were screened by Western blotting.HER2 positive SKBR-3 and BT474 cells were treated with pyrotinib and 5-Fu individually or in combination for the following experiments.MTT assay was used to assess the effect of different drugs on the proliferation of the treated cells,and the combination index(CI)values were calculated using Combidrug software.Colony formation assay was used to evaluate the effect of different drugs on the colony-forming ability of the treated cells.FCM assay was used to analyze the effect of different drugs on the apoptosis rate and cell cycle of the treated cells.Western blotting was used to examine the effect of different drugs on the expression levels of proteins in the proliferation-and apoptosis-related signaling pathways.SKBR-3-cell-based tumor xenograft model was established using BALB/c nude mice.After treatment with pyrotinib and 5-Fu individually or in combination,the growth profiles of the xenograft tumors were recorded and the expression levels of proteins in the proliferation-and apoptosis-related signaling pathways were examined in the tumor tissues. Results:HER2 positive breast cancer cell lines SKBR-3 and BT474 were selected for further experiments after screening.The proliferation SKBR-3 and BT474 cells could be inhibited after treatment with pyrotinib and 5-Fu individually or in combination(all P＜0.05).Compared with pyrotinib or 5-Fu single drug treatment,pyrotinib in combination with 5-Fu had higher inhibition rate on the proliferation of SKBR-3 and BT474 cells with a Cl value of＜1,indicating the synergistic effect of pyrotinib and 5-Fu.In addition,in contrast to pyrotinib or 5-Fu single drug treatment,there was a further decrease in the number of colonies formed,increase in apoptosis rate,and increase in the percentage of G0/G,cells in SKBR-3 and BT474 cells after treatment with pyrotinib in combination with 5-Fu(all P＜0.01).Animal experiment results showed that the growth rate of xenograft tumors in mice treated with pyrotinib in combination with 5-Fu was significantly slower than that of the single-drug treated mice(P＜0.05).Western blotting analysis showed that the expression levels of HER2,HER4,AKT and phosphorylated ERK were significantly decreased after treatment with pyrotinib in combination with 5-Fu both in vitro and in vivo(all P＜0.01),indicative of the blockage of proliferation-related signaling pathways.Meanwhile,analysis of the apoptosis-related proteins revealed a decrease in the expression levels of caspase 3,poly ADP-ribose polymerase(PARP),and Bcl-2(all P＜0.01),while an increase in the expression levels of cleaved-caspase 3,cleaved-PARP,and p21(all P＜0.01). Conclusion:Pyrotinib and 5-Fu had synergistical antitumor effect on HER2 positive breast cancer cells,and the underlying mechanism may be related to the blockage of proliferation-associated signaling pathways and the induction of apoptosis and cell cycle arrest.

Helicobacter pylori (Hp) resides in the epithelium of gastric mucosa and can cause chronic inflammation. Under the conventional white light endoscopy, normal gastric mucosa, current Hp-infected gastric mucosa and past Hp-infected gastric mucosa have different endoscopic features. High-resolution white light endoscopy and various new image-enhanced endoscopy are helpful to accurately diagnose the infection of Hp, and thereby improving the detection rate of early gastric cancer by identifying the high-risk endoscopic manifestations related to gastric cancer. This article reviewed the endoscopic diagnosis of Hp infection and its clinical value.

Objective To observe the effect of electroacupuncture at extensors plus acupoints based on syndrome differentiation on the wrist-ankle activity in post-stroke hemiplegia. Method A total of 168 patients with post-stroke hemiplegia were randomly divided into a control group and a treatment group, 84 cases each. Both groups were prescribed with Western medication, based on which, the control group received electroacupuncture at acupoints based on syndrome differentiation, and the treatment group received electroacupuncture at extensors plus acupoints based on syndrome differentiation. The changes of electromyography (EMG) in the two groups after the intervention were observed, and the clinical efficacies were compared between the two groups.Results The total effective rate was 95.1% in the treatment group versus 91.0% in the control group, and the between-group difference was statistically significant (P<0.05). After the intervention, the EMG of extensor carpi radialis in the treatment group was significantly different from that in the control group (P<0.05); the between-group difference was statistically insignificant in comparing the EMG of tibialis anterior muscle (P>0.05), but the intra-group differences were statistically significant in both groups(P<0.05). The value of M-amp/H-amp was changed significantly in both groups after the treatment (P<0.01), but the between-group difference was statistically insignificant after the treatment (P>0.05).Conclusion Electroacupuncture at extensors plus acupoints based on syndrome differentiation can increase the motor unit of carpi radialis and decrease the spasm of gastrocnemius in post-stroke hemiplegia, and consequently produce a remarkable clinical efficacy.

Objective:To observe the effect of CD40 siRNA on the changes in kidney,urinary protein and complement C3 of MRL/Lpr mice and explore its therapy on lupus nephritis.Methods: 16 female MRL/Lpr mice were randomly divided into control group,empty vector group,CD40-siRNA1 group and CD40-siRNA2 group.The vectors expressing siRNA against CD40 were injected by tail veil into MRL/Lpr mice,while MRL/Lpr mice in control group and empty vector group were injected with the same dose of PBS and pGFP-V-RS vector respectively.There were six times injection and every one day.The 24 hours urine output was gathered 24 hours before mice were killed.Fourteen days following administration,these mice were killed,tissue sections of kidney were observed if the signal of siRNA were expressed in kidney.The expression levels of CD40 mRNA and protein in kidney tissue of MRL/Lpr mice were detected by RT-PCR and immunohistochemistry methods respectively.At the same time,the pathological changes of the kidney were observed by haematoxylin-eosin ( HE) staining method.The 24 h urinary protein content was detected using the method of coomassie brilliant blue and the expression levels of complement C3 in serum were detected by Immunoturbidimetric assays.Results:The vector of CD40-siRNA was expressed in kidney of MRL/Lpr.The expression levels of CD40 mRNA and protein in kidney were lower in CD40-siRNA1 group and CD40-siRNA2 group than control group and empty vector group on the 14th day after last injection ( P<0.05).The inflammatory cells infiltration of kidney and some glomerular volume were significantly reduced in CD40-siRNA1 group and CD40-siRNA2 group than control group and empty vector group.The renal tubular swelling was alleviated in CD40-siRNA1 group and CD40-siRNA2 group than control group and empty vector group.The levels of 24 hours urinary protein were lower and the levels of complement C3 were higher in CD40-siRNA1 group and CD40-siRNA2 group than control group and empty vector group ( P<0.05). Conclusion:CD-40 siRNA can suppress the expression levels of CD40 mRNA and protein and decrease inflammatory cells infiltration in kidney of MRL/Lpr.Meanwhile after suppressing expression of CD40 mRNA and protein, it can reduce the content of 24 hours urinary protein and elevate the level of complement C3 in serum,which CD-40 siRNA can delay progress of the disease and protect kidney,so that it has therapy effect on lupus nephritis.

Objective To investigate the clinical,pathologic and endoscopic ultrasound characteristics of pancreatic neuroendocrine tumors (PNETs).Methods Clinical data of 24 consecutive patients of PNETs who were admitted between January 2002 and January 2011 were reviewed.Results Among these 24 patients,19 were diagnosed to have insulinomas,1 was malignant insulinoma,2 were gastrinomas,and 2 were glucagonomas.Eighteen (75％) cases of PNETs were functional PNETs,and 6 (25％) were nonfunctional PNETs.The mean age of the patients was (42 ± 14) years old ranging from 19 ～ 64 years old,and the percentage of male patient was 33.3％.The main symptoms of insulinomas were intermittent abdominal pain or discomfort,and the main manifestations of glucagonomas were weight loss,skin migratory erythema; and the main symptoms of gastrinomas were diarrhea,vomiting with large amounts of water-like liquid.The detection rate of CT was 86.7％ (13/15),and the detection rate of EUS was 100％ (15/15),but PET-CT detected only 40％ of tumors (2/5).The endoscopic ultrasound characteristics of PNETs were circular or oval hypoechoic mass,and the volume was small with clear boundary and homogeneous echo.There was no enlarged lymph node,and liquid was detected in big tumor.Twenty-two patients received operation and 2 patients did not.PNETs expressed CgA and Syn protein.All patients of PNETs were alive with 7 to 80 months follow-up.Conclusions The clinical characteristics of PNETs were unique.EUS has a high accuracy for detecting and localizing PNETs.The surgical method is similar to that of pancreatic cancer,and the prognosis is relatively good.

Objective To investigate the therapeutic effect of tumor necrosis factor (TNF)-αsiRNA on typeⅡcolla-gen induced arthritis (CIA) in rats. Methods The expression vectors of siRNA against TNF-αgene were constructed suc-cessfully and were injected by tail veil into CIA rats. Twenty-four CIA rats were randomly divided into 4 groups including model group, empty vector group, TNF-α-siRNA1 group and TNF-α-siRNA2 group. CIA rats were injected with the same dose of phosphate buffered sodium (PBS) and pGFP-V-RS vector respectively in model group and empty vector group, while TNF-α-siRNA1 group and TNF-α-siRNA2 group were injected with TNF-α-siRNA1 eukaryotic expression vector and TNF-α-siRNA2 eukaryotic expression vector respectively. Another 6 rats, which were not established CIA model, were in-jected with PBS (blank control group). The serum expression levels of IL-1 were detected by ELISA on day 1, 5, 9 and 13 af-ter injection. The expression level of TNF-αmRNA was detected by reverse transcriptase polymerase chain reaction (RT-PCR) on day 13. Results The expression level of IL-1 was significantly higher on day 1, 5, 9 and 13 in model group than that of blank group (P＜0.05). The expression levels of IL-1 were significantly lower on day 1, 5 and 9 in TNF-α-siRNA1 group and TNF-α-siRNA2 group than that of model group and blank group (P ＜ 0.05). The expression level of TNF-αmRNA was significantly higher on day 13 in model group than that of blank group (P＜0.05). The expression levels of TNF-αmRNA were significantly lower in TNF-α-siRNA1 group and TNF-α-siRNA2 group than those of model group and emp-ty vector group (P＜0.05). Conclusion TNF-αspecific siRNA can suppress the levels of TNF-αmRNA and IL-1, which provides experimental basis for gene therapy of rheumatoid arthritis.