Objective To investigate the expression and clinical significance of multiple endocrine neoplasia type 1(MEN1)gene in breast cancer.Methods The Cancer Genome Atlas(TCGA)database was used to analyze the relationship between MEN1 gene and clinicopathological characteristics of breast cancer.Kaplan-Meier method was used to observe the effect of MEN1 on survival of breast cancer patients.Gene Ontology(GO),Kyoto Encyclopedia of Genes and Genomes(KEGG),and gene set enrichment analysis(GSEA)were used to predict the function and signaling pathways of MEN1 related and interacting genes.Tumor Immune Estimation Resource(TIMER)and single sample gene set enrichment analysis(ssGSEA)were used to investigate the correlation between the level of immune infiltration and MEN1 expression in breast cancer.Results MEN1 was highly expressed in breast cancer patients,and its expression level was related to PAM50 subtype and menopause status(both P＜0.05).Kaplan-Meier survival analysis showed that high MEN1 expression was associated with poor clinical outcome(P=0.019).GO and KEGG enrichment analysis showed that MEN1 related and interacting genes were involved in biological processes(histone modification,histone-lysine methylation),cell components(methyltransferase complex and histone methyltransferase complex),molecular functions(histone-methyltransferase activity),and functional pathways(transcriptional disorders in tumors).GSEA identified that the highly expressed MEN1 phenotype was involved in vesicle-mediated transport,complement cascade,B-cell receptor signaling,lymphocyte-non-lymphocyte interaction,interleukin signaling,and cytokine signaling pathways in the immune system.CancerSEA single cell sequencing results indicated that the expression of MEN1 was positively correlated with angiogenesis in MDA-MB-231 cells(P＜0.05).TIMER analysis found that MEN1 in breast cancer was negatively correlated with the infiltration levels of macrophages and CD8+T cells,and positively correlated with the infiltration level of CD4+T cells(all P＜0.05).ssGSEA showed that the infiltration levels of 18 types of immune cells were negatively correlated with MEN1 expression(all P＜0.05).Conclusion High MEN1 level is associated with poor survival and immune infiltration in breast cancer patients.

Objective To evaluate the value of a nomogram model based on ultrasonographic features and inflammatory indicators in the preoperative noninvasive prediction of pathological grading of urothelial carcinoma of bladder(UCB).Methods A retrospective analysis was conducted on 471 patients with pathologically confirmed UCB,and the patients were assigned to high-grade group(401 cases)or low-grade group(70 cases).Basic clinical data(gender,age,macroscopic hematuria),ultrasonographic features(lesion location,blood flow signal,etc.),and blood inflammatory indicators(e.g.neutrophil-to-lymphocyte ratio[NLR])were collected.Independent predictors were screened using univariate and multivariate logistic regression,and a nomogram model was constructed.Model performance was evaluated using the receiver operating characteristic(ROC)curve,calibration curve,and decision curve analysis(DCA).Results Multivariate logistic analysis identified gender(odds ratio[OR]=2.68),age(OR=1.08),macroscopic hematuria(OR=3.19),lesion located in the trigone(OR=4.59),positive blood flow signal(OR=2.87),and NLR(OR=1.03)were independent predictors of high-grade UCB(all P＜0.05).The combined model(clinical features+ultrasonographic characteristics+inflammatory indicators)achieved an area under curve(AUC)of 0.892,which was significantly higher than the clinical feature-only model(AUC=0.799)and the clinical+ultrasonographic model(AUC=0.856).The calibration curve demonstrated good consistency between predicted and actual outcomes,and DCA confirmed its optimal clinical net benefit.Conclusion The nomogram model integrating clinical features,ultrasonographic characteristics,and inflammatory indicators can effectively discriminate UCB pathological grading,providing a reliable preoperative noninvasive assessment tool for personalized treatment decisions.

Objective To investigate the types of diseases examined by ultrasonography in a certain island clinic,and to summarize the experience of ultrasound medical support in island area.Methods The ultrasound examination results of patients who were admitted to a certain island clinic from January 2017 to August 2022 were reviewed,and the types and characteristics of diseases examined by ultrasound were analyzed.Results A total of 2 043 patients underwent ultrasound examination.There were 76 disease categories and 1 579 diseases.The top five diseases were fatty liver(13.24%),kidney crystals(12.10%),kidney stones(10.70%),gallbladder polyps(6.33%)and ureteral stones with hydronephrosis(6.02%).Ultrasound could predict the pathological types of appendicitis and guide the clinical decision by observing the width of the appendiceal lumen and the layers of the appendiceal wall.Doppler-assessed ureteric jet could be used to determine the renal function of the affected side of ureteral calculi.Conclusion There are wide and varied disease categories in islands.Sonographers should have comprehensive abilities and qualities.This study can provide reference for the follow-up medical support on island area.

[Objective]To explore the therapeutic characteristics,technical points and disease spectrum distribution of clinical studies on five-tone therapy,and to provide a reference for the scientific design and implementation of clinical trials on five-tone therapy.[Methods]Retrieve randomized controlled trial(RCT)literature on five-tone therapy from 9 major databases including China National Knowledge Infrastructure(CNKI),VIP,Wanfang Data,China Biology Medicine disc(CBMdisc),PubMed,Embase,Web of Science,Cochrane Library,and Clinical Trails.Extract information such as literature titles,first authors,symptoms,and intervention measures.Use bibliometric methods to analyze the sample size,intervention methods,treatment frequency,treatment environment,control methods,and symptom spectrum of the included studies.[Results]The sample size of the inclusion of 491 articles was mostly focused on 60～100 patients(60.08%),and five-tone therapy was often used in combination with auricular acupressure,traditional Chinese medicine and acupuncture.Treatment frequency<1 session per day,treatment duration<30 min/session and treatment duration>28 days were the main treatment characteristics.Control measures can be categorized into four types:Chinese medical treatment,western medical treatment,music therapy and blank control,with western medical treatment being used most frequently(446 times).Totally 314 articles(63.95%)reported specific varicosities,of which the Jue tone was the highest,for a total of 108 times.Music therapy involved a total of 66 conditions,which were distributed among 17 disease systems,and the top three most frequent appropriate disease systems were mental and behavioral disorders(112 articles),neurological disorders(76 articles),and oncological disorders(71 articles).[Conclusion]The five-tone therapy has a wide range of indications and great potential for clinical application,but there is still a need to establish standardized standards in terms of treatment time,course of treatment,and other technical aspects.In the future,it is still necessary to design and implement more scientific experimental plans to promote the rational application and promotion of five-tone therapy.

Objective To study the splenic injuries caused by high-altitude falling and underwater explosion and the 2-dimensional ultrasound and contrast-enhanced ultrasound(CEUS)characteristics.Methods Twenty-three healthy Beagle dogs were divided into high-altitude falling group(n=13)and underwater explosion group(n=10).Free-fall high-platform device and gram-grade trinitrotoluene were used to simulate high-altitude falling injury and underwater explosion injury in Beagle dogs,respectively.Ultrasound examination of the spleen was performed immediately after injury,with follow-up examinations every hour.CEUS examination was performed in surviving dogs.Spleen specimens were taken from deceased dogs after injury to observe gross injuries.Pathological changes in tissue morphology and cell apoptosis were observed by hematoxylin-eosin(H-E)staining.Results In the high-altitude falling model,6,2,1,and 1 dogs died in the 6 m,7 m,8 m,and 9 m groups,respectively;in the underwater explosion model,1 and 4 dogs died in the buoyancy and frogman groups,respectively.Two-dimensional ultrasound examination of the high-altitude falling model showed spleen rupture(disruption of splenic parenchymal structure),perisplenic fluid accumulation,subcapsular hematoma,intrasplenic hematoma,increased splenic vein echo,and uneven splenic parenchymal echo.Two-dimensional ultrasound examination of the underwater explosion model showed increased splenic vein echo and uneven splenic parenchymal echo,which were less serious compared with the high-altitude falling model.CEUS results indicated 4 major contrast patterns in both models.The Beagle dogs with type Ⅰ(large focal contrast defect),type Ⅱ(diffuse contrast defect),or type Ⅲ(no contrast agent entry into the splenic vein)contrast patterns all had splenic rupture after injury.H-E staining results showed true splenic rupture,diffuse intrasplenic hemorrhage,splenic hematoma/ecchymosis,subcapsular hematoma/ecchymosis,and venous congestion after spleen injury,which were consistent with the 2-dimensional ultrasound findings.Conclusion High-altitude falling causes more serious spleen injuries in Beagle dogs compared with underwater explosions.Routine ultrasound performs well in diagnosing typical splenic injuries,while CEUS has advantages in evaluating atypical splenic injuries and has good predictive ability for delayed splenic rupture.

As excellent demonstration courses with distinctive teaching characteristics and the first-class teaching level, quality courses can improve the quality and effects of standardized training. Based on years of experience in teaching and training and focusing on the problems in standardized training, we have established a series of quality courses, including targeted short video lessons for systematic and comprehensive learning and module-based training, flipped classroom teaching based on case analysis, and real-time remote teaching and online teaching under the background of "Internet Plus". These courses aim at strengthening students' theoretical basis and practical ability and building their clinical thinking, so as to improve teaching effects and training quality.

[Abstract] Objective: To investigate the effect of metformin on the senescence-associated secretory phenotype (SASP) of doxorubicin-induced gastric cancer BGC823 cells. Methods: Human gastric cancer BGC823 cells were cultured in vitro and treated with doxorubicin at gradient concentrations (50, 100, 150 and 200 nmol/L). Cell senescence was detected by SA-β-gal staining, and SASP factor expression was detected by ELISA. The effects of metformin on cell senescence and SASP factor secretion induced by doxorubicin (100 nmol/L) were observed by adding gradient concentrations of metformin (0, 5, 10 and 20 mmol/L). Results: With the increase of doxorubicin concentration and treatment time, the senescence rate of gastric cancer BGC823 cells increased first and then decreased. At 96 h after 100 nmol/L doxorubicin treatment, the peak aging rate reached 68.7%, accompanied with significantly increased expressions of SASP factors IL-1a, IL-6, IL-8 and CXCL1. The proportion of senescent cells was (55.2±1.9)%, (48.7±2.2)% and (40.8±2.3)% respectively under the effects of 5, 10 and 20 mmol/L metformin, which was significantly lower than that in the non-metformin treatment group (P< 0.01). At the same time, with the increase of metformin concentration, the production of SASP factors IL-1α, IL-6, IL-8 and CXCL1 showed a gradient decline. Compared with the non-metformin treatment group, IL-6 and IL-8 decreased significantly under the effect of metformin above 10 mmol/L (P<0.05 or P<0.01), while IL-1α and CXCL1 decreased significantly under the effect of 20 mmol/L metformin (all P<0.05). Conclusion: Metformin can inhibit the senescence and SASP production of gastric cancer cells induced by doxorubicin.

Objective:To investigate the incidence rate of insulin injection-related needlestick injuries, links causing such injuries, and reporting of occupational exposure among nurses in the wards of general hospitals in Hunan, China.Methods:From January 2017 to March 2019, stratified cluster sampling was performed to select 4368 nurses as respondents from 54 hospitals at different levels in 14 prefectures and cities of Hunan. The current status of insulin injection-related needlestick injuries was investigated, including the high-risk links causing insulin injection-related needlestick injuries during the use of insulin syringe (pen) , time and number of needlestick injuries, infection after needlestick injuries, and reporting of needlestick injuries, and a statistical analysis was performed. Continuous data were described as mean±standard deviation, and categorical data were described by percentage (%) .Results:Among the 3697 nurses who were investigated, 1419 (38.4%) once had needlestick injuries related to insulin injection, among whom 413 (29.1%) had needlestick injuries in the past 1 year. The mean number of insulin injection-related needle stick injuries was 1.92±1.80, with a mean number of 0.57±1.18 caused by insulin syringe, 1.30±1.15 caused by the anterior segment of insulin pen, and 0.32±0.81 caused by the posterior end of insulin pen. Among the 1419 nurses with a history of needlestick injuries, 90 (6.3%) had related infection, mainly HBV infection, and after the occurrence of needlestick injuries, 26.0% (369/1419) of these nurses reported it every time and 15.2% (215/1419) never reported it. "Fear of trouble" was the main reason for no reporting (69.1%, 980/1419) , followed by "the thought of no risk" (43.2%, 613/1419) and "no related policy in hospital" (10.9%, 154/1419) ". Among these 1419 nurses, 49.8% (706/1419) were treated according to the standard process for needlestick injuries in hospital every time, and 3.6% (51/1419) did not know such process or there was no such standard process.Conclusion:The current situation of insulin injection-related needlestick injuries is not optimistic among clinical nurses in Hunan, and the incidence rate of needlestick injuries cannot be ignored.

Objective:To investigate the incidence rate of insulin injection-related needlestick injuries, links causing such injuries, and reporting of occupational exposure among nurses in the wards of general hospitals in Hunan, China.Methods:From January 2017 to March 2019, stratified cluster sampling was performed to select 4368 nurses as respondents from 54 hospitals at different levels in 14 prefectures and cities of Hunan. The current status of insulin injection-related needlestick injuries was investigated, including the high-risk links causing insulin injection-related needlestick injuries during the use of insulin syringe (pen) , time and number of needlestick injuries, infection after needlestick injuries, and reporting of needlestick injuries, and a statistical analysis was performed. Continuous data were described as mean±standard deviation, and categorical data were described by percentage (%) .Results:Among the 3697 nurses who were investigated, 1419 (38.4%) once had needlestick injuries related to insulin injection, among whom 413 (29.1%) had needlestick injuries in the past 1 year. The mean number of insulin injection-related needle stick injuries was 1.92±1.80, with a mean number of 0.57±1.18 caused by insulin syringe, 1.30±1.15 caused by the anterior segment of insulin pen, and 0.32±0.81 caused by the posterior end of insulin pen. Among the 1419 nurses with a history of needlestick injuries, 90 (6.3%) had related infection, mainly HBV infection, and after the occurrence of needlestick injuries, 26.0% (369/1419) of these nurses reported it every time and 15.2% (215/1419) never reported it. "Fear of trouble" was the main reason for no reporting (69.1%, 980/1419) , followed by "the thought of no risk" (43.2%, 613/1419) and "no related policy in hospital" (10.9%, 154/1419) ". Among these 1419 nurses, 49.8% (706/1419) were treated according to the standard process for needlestick injuries in hospital every time, and 3.6% (51/1419) did not know such process or there was no such standard process.Conclusion:The current situation of insulin injection-related needlestick injuries is not optimistic among clinical nurses in Hunan, and the incidence rate of needlestick injuries cannot be ignored.