Gastric cancer with peritoneal metastasis (GCPM) is a common and lethal manifestation of advanced gastric cancer, with a median survival of only 5-11 months. This consensus was developed by 30 experts from Asia (China, Japan, Korea, and Singapore) using the Delphi method and the GRADE evidence grading system. A total of 29 statements were formulated, covering the diagnosis and assessment of GCPM, indications for laparoscopic exploration and NIPS (normothermic intraperitoneal and systemic treatment), treatment regimens, prevention and management of complications, criteria for conversion surgery, and postoperative intraperitoneal therapy. The consensus aims to standardize clinical practice and improve the prognosis of patients with GCPM.

The Myh3 (myosin heavy chain 3) gene is a marker gene of muscle cell differentiation and regulates the utilization of energy in muscle cells, but whether it affects the glycolysis process of muscle cells in different states is rarely reported. In this paper, the expression patterns of Myh3 and glycolysis-related genes Pkm (M-type pyruvate kinse), Prkag3 (protein kinase adenosine monophosphate-activated γ3-subunit), and Gsk3β (glycogen synthase kinase-3β) were studied by the qRT-PCR (quantitative-Real-Time-PCR) method using C2C12 cells at different stages of myoblast and adipogenic differentiation as models. It was found that in the process of myoblast differentiation of C2C12 cells, the relative expression trends of Myh3 and glycolysis genes Prkag3 and Pkm were basically the same, and the relative expression levels first increased, reached the peak on the second day of differentiation, and then decreased; glycogen synthase the expression trend of the inhibitory gene Gsk3β was relatively stable. In the process of adipogenic differentiation of C2C12 cells, the relative expression trend of Myh3 and glycolysis genes Prkag3 and Pkm remained basically the same, and the relative expression gradually increased, reaching the highest value on the 8th day of differentiation; glycogen synthase inhibitory gene Gsk3β expression remained stable. In the myogenic differentiation state of C2C12 cells, qRT-PCR and Western blotting were used to detect the effects of interfering Myh3 on the mRNA and protein expressions of glycolysis-related genes Pkm, Prkag3, and Gsk3β. The results showed that after interfering with Myh3, the mRNA expressions of glycolysis genes Pkm and Prkag3 were significantly decreased (P<0.01), while the mRNA expression of glycogen synthase inhibitory gene Gsk3β had no significant change (P > 0.05). The protein levels of Myh3 and Pkm were significantly lower than those in the blank group and NC group. Under the adipogenic differentiation state of C2C12 cells, after interfering with Myh3, the mRNA levels of glycogen synthase inhibitor Gsk3β and glycolysis gene Prkag3 were significantly increased (P<0.01), and the mRNA level of glycolysis gene Pkm was decreased; the protein levels of Myh3 and Pkm in the Myh3 interference group were also lower than those in the blank group and NC group. Based on the above studies, there are significant differences in the levels of glycolysis in C2C12 cells in the myogenic and adipogenic states, and the expression patterns of Myh3 and glycolysis genes are similar. Further results showed that Myh3 suppression could inhibit the glycolysis of C2C12 cells in the myogenic state without affecting the glycogen synthesis. Unlike in the myogenic state, interfering expression of Myh3 in the adipogenic state of C2C12 cells inhibited both glycogen synthesis and glycolysis.

Grid management plays an important role in improving the efficiency of social service management. The authors explored the establishment of a nosocomial infection grid management model and implemented it at a tertiary general hospital in Shanghai. χ2 test results showed that since the hospital fully implemented the grid management model in early 2016, the number of hospital infections, surgical site infections, type I surgical incision infections, and ventilator-related pneumonia had shown a downward trend year by year. The number of inspections before the use of antibacterial drugs, the number of blood cultures submitted for fever patients, and the timing of hand hygiene compliance showed an increasing trend year by year( P<0.05), and the management of nosocomial infection was more effective than the previous period. The application of grid management model required establishment of grid organization structure, control of key links, implementation of the special personnel responsibility, formulation of a performance evaluation system, and implementation of incentive measures. The grid management model can significantly reduce the risk of hospital infection, improve the efficiency of hospital infection management, and was valuable to be applicated and promoted in medical institutions.

Objective To know the medication compliance in elderly patients with hypertension,to analyze the influence factors of medication compliance,and to propose forward intervention countermeasures.Methods The treatment of hypertension in elderly patients was investigated by questionnaire survey.Medication compliance and influence factors were analyzed.Results 166 cases with poor medication compliance,and the rate was 45.0％; 203 cases with good medication compliance,and the rate was 55.0％.It's showed significantly difference on degree of education between the observation group and control group (x2 =12.071,P=0.002).The proportion of peasant and worker was higher in the observation group than control group (78.9％ vs.62.1％,x2 =12.817,P=0.002).The smoker (48.8％) and drinker (59.0％) in observation group more than smoker (27.1％) and drinker (31.0％) in control group(x2=18.481,P＜0.001; x2=29.115,P＜ 0.001).The ratio of payout of-pocket for healthcare was higher in the observation group (21.1％) than control group (9.9％) (x2=9.084,P=0.003).The duration of hypertension was longer in the observation group (8.8±4.6) than control group (6.0±4.1) (t=1.806,P=0.036).The income per month was less in the observation group (1850±150) than control group (2150±200) (t=5.799,P＜ 0.001).There were regression relationship between medication compliance and degree of education,medical security and duration of hypertension.Conclusions According to the influence factors of medication compliance in elderly hypertensive patients,it's useful to improve medication compliance by enhancing health education and designing a personal treatment.

Objective To investigate the apoptosis-inducing effect of L-gossypol on human nasopharyngesl carcinoma cell line CNE2 and its possible mechanism.Methods The effect of L-gossypol on proliferation of CNE2 cells was estimated by MTT assay.Flow cytometry was used to analyz cell apoptosis induced by(-)-gossypol and the expression of Bcl-2 、Bax proteins.Caspase-3 activity was determined by caspase-3 colorimetric assay kit.Results Lgossypol was able to inhibit the proliferation of CNE2 cells in a dose-dependent and time-dependent fashion at concentrations more than 10 μmoL/L.L-gossypol regulated cell cycle and GO/G1 arrest could be observed in CNE2 cells.In the process of apoptosis,the expression of Bcl-2 was down-regulated and Bax was up-regulated,caspase-3 activity was in peak at 24h.Conclusion L-gossypol could induce apoptosis in nasopharyngeal carcinoma cell line CNE2 in vitro,which may be associated with down-regulation of Bcl-2,up-regulation of Bax genes expression and caspase-3 activation.

AIM: To establish a method of in vitro donor heart perfusion in murine cardiac transplantation during preservation and apply it in adenovirus mediated gene transfection for donor heart. METHODS: Donor heart was transfected with recombinant adenovirus and stored for 2 hours after harvest, then it was transplanted heterotopically in abdomen. The grafts were appraisal by palpitation. Marked gene products were determined by X-Gal staining, aod T cell infiltration was determined by immunohistochemistry. The activation markers of recipients' lymphocytes were examed by cytometry. RESULTS: The grafts survival rate is 100% after perfusion and cold storage. The LacZ staining became strong 1 week after transplantation. The grafts remained an intact structure and no apparent T cell infiltration. The activation status of recipients' lymphocytes were not enhanced by transfected cardiac graft. CONCLUSION: In vitro perfusion during graft cold preservation is feasible for adenovirus mediated gene transfection. [