Objective:To integrate and analyze large-scale proteomic datasets from clinical hepatocellular carcinoma (HCC) samples to identify key oncogenic proteins and investigate their underlying mechanisms.Methods:Based on two publicly reported large-scale proteomic datasets of hepatocellular carcinoma, we identified lysosomal acid glucosylceramidase (GBA) as a differentially expressed protein between tumor and adjacent non-tumor tissues. The Cancer Genome Atlas (TCGA) database was utilized to analyze survival differences between patients with high ( n=118) and low ( n=118) GBA expression. Tumor and adjacent non-tumor tissue samples were collected from eight HCC patients who underwent surgical treatment at Henan Cancer Hospital between March 2021 and May 2021. Among them, six were male and two were female, ranging from 41 to 66 years old, with a median age of 56 years. The human HCC cell line HCC-LM3 was transfected with siRNAs targeting GBA (siGBA-1 and siGBA-2) or a negative control (siNC). Western blot analysis was performed to assess the expression of relevant proteins in HCC tissues and cells. Quantitative proteomic analysis was conducted to identify differentially expressed proteins in HCC cells, and bioinformatics tools were used to construct an interaction network of downregulated proteins. Cell proliferation and colony formation assays were conducted to evaluate the impact of GBA expression on HCC cell growth. Results:GBA was identified as a significantly upregulated protein in HCC tissues across two clinical proteomic datasets. TCGA analysis further revealed that high GBA expression was associated with poor prognosis in HCC patients. Western blot analysis confirmed that the relative expression level of GBA protein in clinical HCC tissues was (0.60±0.35), which was significantly higher than that in adjacent non-tumor tissues (0.26±0.20) ( t=2.84, P=0.025). Quantitative proteomic analysis interaction analysis of GBA knockdown and control cells identified epidermal growth factor receptor (EGFR) as a potential downstream regulatory target of GBA. Western blot validation demonstrated that EGFR protein expression was significantly reduced following GBA knockdown [siNC: (0.92±0.08), siGBA-1: (0.64±0.07), siGBA-2: (0.51±0.07)]. Cell proliferation and colony formation assays showed that GBA knockdown significantly inhibited cell growth and colony-forming ability. The OD450 values on day 4 in control group and GBA knockdown group (siGBA-1 and siGBA-2) were (1.91±0.17), (1.24±0.11), and (1.21±0.04), respectively. The colony numbers were (674.33±6.51), (388.33±7.51), and (360.00±29.00), respectively. The knockown groups were both lower than negative control group and the differences were statistically significant (both P<0.05). Conclusion:GBA is significantly overexpressed in HCC tissues and may promote HCC cell proliferation by regulating EGFR protein expression.

Objective:To integrate and analyze large-scale proteomic datasets from clinical hepatocellular carcinoma (HCC) samples to identify key oncogenic proteins and investigate their underlying mechanisms.Methods:Based on two publicly reported large-scale proteomic datasets of hepatocellular carcinoma, we identified lysosomal acid glucosylceramidase (GBA) as a differentially expressed protein between tumor and adjacent non-tumor tissues. The Cancer Genome Atlas (TCGA) database was utilized to analyze survival differences between patients with high ( n=118) and low ( n=118) GBA expression. Tumor and adjacent non-tumor tissue samples were collected from eight HCC patients who underwent surgical treatment at Henan Cancer Hospital between March 2021 and May 2021. Among them, six were male and two were female, ranging from 41 to 66 years old, with a median age of 56 years. The human HCC cell line HCC-LM3 was transfected with siRNAs targeting GBA (siGBA-1 and siGBA-2) or a negative control (siNC). Western blot analysis was performed to assess the expression of relevant proteins in HCC tissues and cells. Quantitative proteomic analysis was conducted to identify differentially expressed proteins in HCC cells, and bioinformatics tools were used to construct an interaction network of downregulated proteins. Cell proliferation and colony formation assays were conducted to evaluate the impact of GBA expression on HCC cell growth. Results:GBA was identified as a significantly upregulated protein in HCC tissues across two clinical proteomic datasets. TCGA analysis further revealed that high GBA expression was associated with poor prognosis in HCC patients. Western blot analysis confirmed that the relative expression level of GBA protein in clinical HCC tissues was (0.60±0.35), which was significantly higher than that in adjacent non-tumor tissues (0.26±0.20) ( t=2.84, P=0.025). Quantitative proteomic analysis interaction analysis of GBA knockdown and control cells identified epidermal growth factor receptor (EGFR) as a potential downstream regulatory target of GBA. Western blot validation demonstrated that EGFR protein expression was significantly reduced following GBA knockdown [siNC: (0.92±0.08), siGBA-1: (0.64±0.07), siGBA-2: (0.51±0.07)]. Cell proliferation and colony formation assays showed that GBA knockdown significantly inhibited cell growth and colony-forming ability. The OD450 values on day 4 in control group and GBA knockdown group (siGBA-1 and siGBA-2) were (1.91±0.17), (1.24±0.11), and (1.21±0.04), respectively. The colony numbers were (674.33±6.51), (388.33±7.51), and (360.00±29.00), respectively. The knockown groups were both lower than negative control group and the differences were statistically significant (both P<0.05). Conclusion:GBA is significantly overexpressed in HCC tissues and may promote HCC cell proliferation by regulating EGFR protein expression.

BACKGROUND:At present,open reduction and internal fixation and minimally invasive needle aspiration are commonly used in patients with Sanders types Ⅱ and Ⅲ calcaneal fractures.However,there is little comparison between the clinical efficacy of the two methods and high-level clinical evidence is still available. OBJECTIVE:To compare the curative effect of Sanders types Ⅱ and Ⅲ calcaneal fractures treated by three-dimensional digital model-assisted minimally invasive needle penetration and tarsal sinus incision and manual reduction and internal fixation with steel plate. METHODS:From January 2021 to October 2022,80 patients with Sanders types Ⅱ and Ⅲ calcaneal fractures who were treated in the Department of Orthopedics,Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine in Hebei Province were randomly divided into control group(40 cases)and observation group(40 cases).The control group was treated with manual reduction and internal fixation with steel plate through the traditional tarsal sinus incision,while the observation group was treated with a three-dimensional digital model assisted with minimally invasive needle penetration fixation.The operation time,blood loss,hospitalization time and fracture healing time of the two groups were recorded.The changes in Maryland score,AO-FAS score,pain visual analog scale score,quality of life score(SF-36 score),and imaging parameters(B?hler angle,Gissane angle,calcaneal length,width and height)were observed before and 12 months after operation in the two groups.The complications during the follow-up were recorded. RESULTS AND CONCLUSION:(1)Operation time,blood loss,hospitalization time and fracture healing time in the observation group were lower than those in the control group(all P<0.05).(2)The Maryland score,AO-FAS score,SF-36 score,B?hler angle,Gissane angle,calcaneal length and height of the two groups after treatment were significantly higher than those before treatment(all P<0.05).Visual analog scale score and calcaneal width were significantly lower than those before treatment(all P<0.05).(3)After 12 months of follow-up,the incidence of complications in the observation group was lower than that in the control group(all P<0.05).(4)In conclusion,the treatment of Sanders types Ⅱ and Ⅲ calcaneal fractures with three-dimensional digital model-assisted minimally invasive needle penetration fixation can significantly improve the operation time,bleeding volume and other perioperative indicators,and can reduce the occurrence of multiple complications.The recovery of ankle function,relief of pain symptoms,and improvement of quality of life are equivalent to traditional therapy.

OBJECTIVE: To investigate the value of T2 mapping in the assessment of myocardial changes and prognosis in patients with acute ST segment elevation myocardial infarction (STEMI). METHODS: A retrospective study was conducted. A total of 30 patients with acute STEMI admitted to Tianjin First Central Hospital from January 2021 to March 2022 were enrolled as the experimental group. At the same time, 30 age- and sex-matched healthy volunteers and outpatients with non-specific chest pain with no abnormalities in cardiac magnetic resonance (CMR) examination were selected as the control group. CMR was performed within 2 weeks after the diagnosis of STEMI, as the initial reference. A plain CMR review was performed 6 months later (chronic myocardial infarction, CMI). Plain scanning includes film sequence (CINE), T2 weighted short tau inversion recovery (T2-STIR), native-T1 mapping, and T2 mapping. Enhanced scanning includes first-pass perfusion, late gadolinium enhancement (LGE), and post-contrast T1 mapping. Quantitative myocardial parameters were compared between the two groups, before and after STEMI myocardial infarction. The receiver operator characteristic curve (ROC curve) was used to evaluate the diagnostic efficacy of native-T1 before myocardial contrast enhancement and T2 values in differentiating STEMI and CMI after 6 months. RESULTS: There were no statistically significant differences in age, gender, heart rate and body mass index (BMI) between the two groups, which were comparable. The native-T1 value, T2 value and extracellular volume (ECV) were significantly higher than those in the control group [native-T1 value (ms): 1 434.5±165.3 vs. 1 237.0±102.5, T2 value (ms): 48.3±15.6 vs. 21.8±13.1, ECV: (39.6±13.8)% vs. (22.8±5.0)%, all P < 0.05]. In the experimental group, 12 patients were re-examined by plain CMR scan 6 months later. After 6 months, the high signal intensity on T2-STIR was still visible, but the range was smaller than that in the acute phase, and the native-T1 and T2 values were significantly lower than those in the acute phase [native-T1 value (ms): 1 271.0±26.9 vs. 1 434.5±165.3, T2 value (ms): 34.2±11.2 vs. 48.3±15.6, both P < 0.05]. ROC curve analysis showed that the area under the ROC curve (AUC) of native-T1 and T2 values in differentiating acute STEMI from CMI was 0.71 and 0.80, respectively. When native-T1 cut-off value was 1 316.0 ms, the specificity was 100% and the sensitivity was 53.3%; when T2 cut-off value was 46.7 ms, the specificity was 100% and the sensitivity was 73.8%. CONCLUSIONS The T2 mapping is a non-invasive method for the diagnosis of myocardial changes in patients with acute STEMI myocardial infarction, and can be used to to evaluate the clinical prognosis of patients.
Humans ; ST Elevation Myocardial Infarction/diagnosis* ; Contrast Media ; Prognosis ; Retrospective Studies ; Magnetic Resonance Imaging, Cine/methods* ; Gadolinium ; Myocardium/pathology* ; Myocardial Infarction ; Predictive Value of Tests

Objective:To explore the diagnostic performance of cardiac magnetic resonance imaging (CMR) with T1 mapping and T2 mapping for detection of acute phase of ischemic cardiomyopathy.Methods:Twenty-four patients with acute myocardial infarction (AMI) detected by coronary angiography from May 2020 to April 2021 in Tianjin First Center Hospital were selected. All patients underwent CMR (Philips Ingenia 3.0-T) at (9±4) days after definite diagnosis, which was defined as the first diagnosis. After 3 months and 6 months of chronic myocardial infarction (CMI) phase, one CMR was performed. On the same period with age and sex matching, a total of 26 cases of healthy volunteers and outpatient with non-specific chest pain and CMR examination without abnormality as control group. Plain scan included Cine, T2-weighted (STIR), and native T1/T2 mapping. The enhanced scan included perfusion, late gadolinium enhancement, post-T1 mapping. The changes of myocardial quantitative parameters before and after myocardial infarction were compared. Receiver operator characteristic curves (ROC curve) were developed to evaluate, compare, and distinguish the changes in the AMI group and the CMI group after 6 months.Results:Pre-enhanced T1 value, T2 value and extracellular volume (ECV) of AMI group were significantly higher than those of control group [pre-enhanced T1 value (ms): 1 438.7±173.4 vs. 1 269.2±42.3, pre-enhanced T2 value (ms): 49.8±9.3 vs. 21.7±4.0 , ECV (%): 33.2±10.2 vs. 27.2±2.1, all P < 0.05]. ECV was significantly higher in AMI (%: 33.2±10.2 vs. 27.2±2.1), but stabilized after 3 months (%: 33.2±10.2 vs. 32.4±5.1), and after 6 months later (%: 27.7±4.9 vs. 32.4±5.1), there were no significant difference (all P > 0.05). Pre-enhanced T1 and T2 values were significantly higher in AMI, lower after 3 months, but significantly decreased after 6 months [pre-enhanced T1 values (ms): 1 438.7±173.4 vs. 1 272.1±25.2, pre-enhanced T2 values (ms): 49.8±9.3 vs. 29.0±4.0, all P < 0.05]. The ROC curve showed that the specificity of pre-enhanced T1 and T2 values between AMI and CMI were 100%, and the sensitivity were 72.7%, 100%, respectively, pre-enhanced T1 and T2 value could be better distinguish between AMI and CMI diagnosis method. Conclusion:T1 mapping and T2 mapping with ECV can clearly diagnosis ischemic cardiomyopathy, especially pre-enhanced myocardial T1 and T2 values which is non-invasive diagnosis method of AMI, and can distinguish AMI or CMI, has a great significance to the patient's clinical treatment and follow-up.

Objective:To explore the status and correlates of sleep quality in hospitalized patients with schizophrenia.Methods:A total number of 269 schizophrenia inpatients were recruited from 7 hospitals including Peking University Sixth Hospital, Zhumadian Second People′s Hospital and Liaocheng Fourth People′s Hospital from August 2019 to March 2021. The Brief Psychiatric Rating Scale (BPRS), the Pittsburgh Sleep Quality Index (PSQI), the 9-item Patient Health Questionnaire (PHQ-9), the 7-item Generalized Anxiety Disorder Scale (GAD-7) and the suicide module of Mini-International Neuropsychiatric Interview were evaluated. Poor sleep quality was determined by the score of more than 5 according to PSQI, all patients were divided into groups of poor and normal sleep quality. The general demographic data and clinical characteristics of two groups were compared, and the correlates of sleep quality were obtained by Spearman correlations and multiple logistic regression.Results:The prevalence of poor sleep quality in schizophrenia inpatients was up to 44.6% (120/269). Compared with normal sleep quality group, inpatients with poor sleep quality had higher rates of alcohol consumption history, use of benzodiazepines (BZDs) and current suicide risk, and BPRS total score, factor scores (thinking disorders, anxious-depression, hostile-suspiciousness and activation), PHQ-9 and GAD-7 scores were also higher (all P<0.05). Spearman correlation analyses showed that PSQI total score were significantly positively correlated with BPRS total score ( r=0.323), PHQ-9 score ( r=0.553), GAD-7 score ( r=0.456) and current suicide risk level ( r=0.320) (all P<0.001). Multiple logistic regression showed that history of alcohol consumption ( OR=2.897, 95% CI: 1.002-8.372), use of BZDs ( OR=3.181, 95% CI: 1.548-6.534), thinking disorders ( OR=1.563, 95% CI: 1.015-2.406), comorbidity with depression ( OR=4.968, 95% CI: 1.869-13.202), and current suicide risk ( OR=2.496, 95% CI: 1.360-4.581) were independently correlated with poor sleep quality (all P<0.05). Conclusion:Poor sleep quality is common in hospitalized patients with schizophrenia, and history of alcohol consumption, use of BZDs, thinking disorders, comorbidity with depression and current suicide risk are independent correlates of poor sleep quality.

Objective:To investigate the reoperation and perioperative management of residual cyst wall with perineal intractable sinus after resection of presacral cyst tumors.Methods:The clinical data of 29 patients with residual cyst wall and perineal intractable sinus after resection of presacral cyst tumors in Affiliated Cancer Hospital of Zhengzhou University from January 2014 to August 2019 were reviewed, including the characteristics of the residual cyst wall with perineal intractable sinus after resection of presacral cyst tumors, surgical method, and perioperative management.Results:Twenty-nine patients with residual cyst wall and perineal intractable sinus after resection of presacral cyst tumors, including 9 cases of epidermoid cysts, 7 cases of dermoid cysts, 10 cases of mature teratomas and 3 cases of malignant cysts (including malignant transformation of caudate cyst and teratoma); The 29 patients underwent posterior approaches for cyst resection in other hospital before, of whom 1 patient underwent posterior combined with transabdominal approach. All of thes patients underwent resection of residual presacral cyst wall and perineal intractable sinus in our hospital, of whom 25 patients underwent a transperineal approach through an arc-shaped incision anterior to the apex of the coccyx, and the other 4 patients underwent transperineal arc-shaped incision combined with transabdominal approach. All of the patients were cured without serious complications occurring, postoperative pathological and the magnetic resonance imaging diagnosis showed that the residual cyst wall and perineal intractable sinus were all completely removed.Conclusion:Appropriate surgical approache and perioperative treatment for the patients with residual cyst wall and perineal intractable sinus are very important to promote the resection of residual cyst wall and the healing of perineal intractable sinus.

Objective:To investigate the reoperation and perioperative management of residual cyst wall with perineal intractable sinus after resection of presacral cyst tumors.Methods:The clinical data of 29 patients with residual cyst wall and perineal intractable sinus after resection of presacral cyst tumors in Affiliated Cancer Hospital of Zhengzhou University from January 2014 to August 2019 were reviewed, including the characteristics of the residual cyst wall with perineal intractable sinus after resection of presacral cyst tumors, surgical method, and perioperative management.Results:Twenty-nine patients with residual cyst wall and perineal intractable sinus after resection of presacral cyst tumors, including 9 cases of epidermoid cysts, 7 cases of dermoid cysts, 10 cases of mature teratomas and 3 cases of malignant cysts (including malignant transformation of caudate cyst and teratoma); The 29 patients underwent posterior approaches for cyst resection in other hospital before, of whom 1 patient underwent posterior combined with transabdominal approach. All of thes patients underwent resection of residual presacral cyst wall and perineal intractable sinus in our hospital, of whom 25 patients underwent a transperineal approach through an arc-shaped incision anterior to the apex of the coccyx, and the other 4 patients underwent transperineal arc-shaped incision combined with transabdominal approach. All of the patients were cured without serious complications occurring, postoperative pathological and the magnetic resonance imaging diagnosis showed that the residual cyst wall and perineal intractable sinus were all completely removed.Conclusion:Appropriate surgical approache and perioperative treatment for the patients with residual cyst wall and perineal intractable sinus are very important to promote the resection of residual cyst wall and the healing of perineal intractable sinus.

Objective? To explore the status quo of nursing masters' core competence and to analyze its influencing factors. Methods? Totally 350 full-time schooling nursing masters from 7 universities from Shandong Province, Guangxi Zhuang Automatous Region, Jilin Province, Yunnan Province, Xinjiang Uygur Automatous Region, Tianjin Municipality and Liaoning Province and 140 nursing teachers from 5 teaching hospitals for nursing masters were selected by convenient sampling between March and October 2018. Nursing masters were investigated with the Core Competence Self-rating Scale for Nursing Masters (CCSRS-NM), while nursing teachers were investigated with the Nurse Master-administered Rating Scale (NMARS). A total of 350 questionnaires were distributed to the master of nursing, 332 valid questionnaires were obtained, 140 questionnaires were distributed to the teachers, and 128 valid questionnaires were obtained. SPSS 17.0 was used for statistical analyses. Multivariate linear regression analysis was employed to explore the influencing factors. Results? The CCSRS-NM score of 332 nursing masters totaled (174.67±23.45); the total NMARS score of 128 nursing teachers was (203.10±26.85). Univariate analysis showed that there were statistical differences in CCSRS-NM scores between nursing masters with different sex, grade, frequent presence at seminars, type of training, time of theoretical learning, published papers or not, attitude to nursing and guidance of supervisors (F/t=2.024, 7.306, 2.375, 2.534, -4.780, 3.792, 11.983, 7.454; P＜0.05); there were statistical differences in NMARS scores between nursing teachers with different age, length of service, professional title, educational background and qualified as supervisors or not (F/t=4.305, 4.696, 6.307, 2.330, -2.226;P＜0.05). According to multivariate analysis, nursing masters' attitude to nursing, time of theoretical learning, guidance of supervisors, sex, published papers or not and grade were the factors influencing nursing masters' core competence (P＜ 0.05); Length of service, professional title and qualified as supervisors or not were the influencing factors to nursing teachers' NMARS scores (P＜ 0.01). Conclusions? The core competence of nursing masters stands at an intermediate level, and nursing teachers' evaluation is higher than nursing masters' self-evaluation. Nursing masters' core competence may be enhanced by strengthening professional attitude education, increasing time of theoretical learning, intensifying supervisors' guidance, encouraging male candidates to study as a nursing major and encouraging nursing masters to publish papers, and reinforcing the communication and exchange between students at different grades. Evaluation of nursing masters' core competence should involve teachers and supervisors with different length of service and professional title.

ObjectiveTo explore the effects of applying multidisciplinary team based action study method in quality control of blood samples before test in order to improve the quality of inpatients' blood samples before test. MethodsA multidisciplinary team which was mainly led by the Nursing Department, professionally guided by the department of Clinical Laboratory and assisted by the Service Center as well as the Information Center was established. We analyzed the quality of the blood samples before examination in August 2017 in a Class Ⅲ Grade A hospital, and used the action study method of planning, action, observation and reflection as the axis to intervene. After 3 cycles, the number of unqualified blood samples of inpatients from August 2017 to August 2018 were compared. ResultsThe unqualified rate of blood samples had an overall downward trend during the period from August 2017 to August 2018,and there was statistical difference before and after intervention(P＜0.01). ConclusionsMultidisciplinary team collaboration provides guarantee for the improvement of blood samples quality before examination, and the application of action study method regulate the quality of blood samples in each procedure before examination and effectively reduce the unqualified rate of the blood samples.