Krüppel-like factor 5 (KLF5) has been confirmed as a key transcription factor in the occurrence and development of tumors, which is closely related to the malignant biological behaviors such as the proliferation and migration of tumor cells. This article summarizes the latest progress of KLF5 in tumor research, explores the mechanism and role of KLF5 in promoting tumor progression, aiming to further explore the potential of KLF5 as a therapeutic target and bring new thinking to the research in this field.

Objective:To investigate the application value of combined detection of urine genes Twist1,Onecut2,VIM methyl-ation and folate metabolism related genes MTHFR(C677T/A1298C),MTRR(A66G)polymorphisms in the screening and diagnosis of bladder cancer.Methods:A total of 134 patients with primary bladder cancer admitted to the Department of Urology of Qingyang Peo-ple's Hospital and the Second Hospital of Lanzhou University from January 2023 to January 2024 were selected(bladder cancer group),and a total of 130 patients with common benign urinary system diseases and other malignant tumors of urinary system treated with cystoscopy were admitted during the same period(control group).Methylation-specific polymerase chain reaction was used to de-tect the methylation of Twist1,Onecut2 and VIM genes in urine shed cells.PCR fluorescence probe fusion was used to detect the poly-morphism of folate metabolism-related genes in peripheral blood of patients,and collected the clinical data and immunological indica-tors,and to all the data for statistical analysis.Results:The methylation rates of hematuria,bladder irritation,Twist1,Onecut2 and VIM genes were significantly different between two groups(P<0.05).The area under ROC curve(AUC)of Twist1,Onecut2 and VIM genes methylation and their combined detection were 0.721,0.675,0.674 and 0.772,respectively.Sensitivity and specificity were 73.20%and 71.00%,56.10%and 79.00%,48.80%and 86.00%,80.50%and 69.00%,respectively.The AUC of hematuria and blad-der irritation were 0.661 and 0.652.The sensitivity and specificity were 60.20%and 72.00%,41.50%and 89.00%,respectively.The combined AUC of all indicators were the largest(0.858),and the sensitivity and specificity were higher.The frequencies of CC,CT,TT,and T alleles of MTHFR C677T in bladder cancer group were 21.64%,41.79%,36.56%and 57.46%,respectively.Compared with the control group,the difference was statistically significant(P<0.05).The T allele frequency was significantly different between methylated and unmethylated Twist1 groups(P<0.05).Others differences were not statistically significant,and there was no signifi-cant association with gene methylation(P>0.05).Conclusion:The methylation of Twist1,Onecut2 and VIM genes are highly ex-pressed in the urine cells of patients with bladder cancer,and the combination of hematuria and bladder irritation has a high predictive value for the diagnosis of bladder cancer.The MTHFR(C677T)T allele is associated with the methylation of Twist1 gene and may be one of the risk factors for bladder cancer.

Objective:To investigate the application value of combined detection of urine genes Twist1,Onecut2,VIM methyl-ation and folate metabolism related genes MTHFR(C677T/A1298C),MTRR(A66G)polymorphisms in the screening and diagnosis of bladder cancer.Methods:A total of 134 patients with primary bladder cancer admitted to the Department of Urology of Qingyang Peo-ple's Hospital and the Second Hospital of Lanzhou University from January 2023 to January 2024 were selected(bladder cancer group),and a total of 130 patients with common benign urinary system diseases and other malignant tumors of urinary system treated with cystoscopy were admitted during the same period(control group).Methylation-specific polymerase chain reaction was used to de-tect the methylation of Twist1,Onecut2 and VIM genes in urine shed cells.PCR fluorescence probe fusion was used to detect the poly-morphism of folate metabolism-related genes in peripheral blood of patients,and collected the clinical data and immunological indica-tors,and to all the data for statistical analysis.Results:The methylation rates of hematuria,bladder irritation,Twist1,Onecut2 and VIM genes were significantly different between two groups(P<0.05).The area under ROC curve(AUC)of Twist1,Onecut2 and VIM genes methylation and their combined detection were 0.721,0.675,0.674 and 0.772,respectively.Sensitivity and specificity were 73.20%and 71.00%,56.10%and 79.00%,48.80%and 86.00%,80.50%and 69.00%,respectively.The AUC of hematuria and blad-der irritation were 0.661 and 0.652.The sensitivity and specificity were 60.20%and 72.00%,41.50%and 89.00%,respectively.The combined AUC of all indicators were the largest(0.858),and the sensitivity and specificity were higher.The frequencies of CC,CT,TT,and T alleles of MTHFR C677T in bladder cancer group were 21.64%,41.79%,36.56%and 57.46%,respectively.Compared with the control group,the difference was statistically significant(P<0.05).The T allele frequency was significantly different between methylated and unmethylated Twist1 groups(P<0.05).Others differences were not statistically significant,and there was no signifi-cant association with gene methylation(P>0.05).Conclusion:The methylation of Twist1,Onecut2 and VIM genes are highly ex-pressed in the urine cells of patients with bladder cancer,and the combination of hematuria and bladder irritation has a high predictive value for the diagnosis of bladder cancer.The MTHFR(C677T)T allele is associated with the methylation of Twist1 gene and may be one of the risk factors for bladder cancer.

Krüppel-like factor 5 (KLF5) has been confirmed as a key transcription factor in the occurrence and development of tumors, which is closely related to the malignant biological behaviors such as the proliferation and migration of tumor cells. This article summarizes the latest progress of KLF5 in tumor research, explores the mechanism and role of KLF5 in promoting tumor progression, aiming to further explore the potential of KLF5 as a therapeutic target and bring new thinking to the research in this field.

Objective:To determine the predictive role of combined assessment of vasoactive-inotropic score(VIS) and lactate for the prognosis of patients with postcardiotomy cardiogenic shock(PCS) requiring venoarterial extracorporeal membrane oxygenation(VA-ECMO).Methods:222 adults with PCS requiring VA-ECMO were retrospectively analyzed and divided into four groups according to the cut-off values of VIS and lactate(Lac) at 24 h after ECMO initiation: group 1(59 cases): VIS≤14.5, Lac≤2.45 mmol/L; group 2(17 cases): VIS>14.5, Lac≤2.45 mmol/L; group 3(90 cases): VIS≤14.5, Lac>2.45 mmol/L; group 4(56 cases): VIS>14.5, Lac>2.45 mmol/L. The incidence of in-hospital mortality and other clinical outcomes were analyzed. The associations of VIS and lactate and in-hospital mortality were analyzed using Cox proportional hazards analysis.Results:The in-hospital mortality was 18.6%, 58.8%, 63.3% and 71.4% in the four groups( P<0.001), while the rate of successful weaning off ECMO was 88.1%, 88.2%, 58.9% and 33.9% respectively( P<0.001). The group 1 significantly differed from other three groups with regards to in-hospital mortality and ECMO weaning rate( P<0.05). The groups 1 also showed significantly improved cumulative 60-day survival compared with other three groups( log- rank test, P<0.05). Cox proportional hazards analysis showed age( HR=1.03, 95% CI: 1.01-1.05, P=0.001), female( HR=1.87, 95% CI: 1.27-2.76, P=0.002), VIS at 24 h after ECMO initiation( HR=1.02, 95% CI: 1.00-1.05, P=0.020), and lactate at 24h after ECMO initiation( HR=1.12, 95% CI: 1.08-1.16, P<0.001) were independently predictive of in-hospital mortality. Conclusion:Patients with VIS≤14.5 and Lac≤2.45 within 24 h after ECMO initiation had better in-hospital and 60-day outcomes, suggesting that combined assessment of VIS and lactate may be instructive for determining the prognosis of PCS patients requiring VA-ECMO support.

Objective:To examine the long-term survival outcomes and identify mortality risk factors for coronary artery bypass grafting patients who received venoarterial extracorporeal membrane oxygenation(VA-ECMO) for postcardiotomy cardiogenic shock.Methods:Data from 121 consecutive venoarterial extracorporeal membrane oxygenation-treated coronary artery bypass grafting(CABG) patients at Beijing Anzhen Hospital between June 2012 and December 2016 were analyzed. There were 84 males and 24 females. The median age was 62(55, 67) years, and the median body mass index was 25(23, 27)kg/m 2. Thirty-seven patients(34%) had left main artery disease, and 56 patients(52%) underwent off-pump CABG. According to the 3 year survival outcome after ECMO, patients were divided into survival group(35 cases) and non-survival group(73 cases). The differences of clinical indicators between the two groups were compared and analyzed. Multivariable Cox regression modeling was used to identify factors independently associated with 36 month mortality. Results:Sixty-five patients(60%) could be weaned from VA-ECMO, 49 patients(45%) survived to hospital discharge, and 35 patients(32%) survived to 3 years. The median( IQR) time on VA-ECMO support was 4(3, 5) days. The median( IQR) length of ICU stay and hospital stay duration were 8(5, 12) and 20(13, 29) days, respectively. Older age( HR=1.06, 95% CI: 1.03-1.10, P<0.001), left main coronary artery disease( HR=1.62, 95% CI: 1.00-2.60, P=0.048), and vasoactive inotropic score( HR=1.09, 95% CI: 1.03-1.17, P=0.007)were independent risk factors associated with 3-year mortality. The area under the receiver operating characteristic curve for the model, which was constructed with age≥60years, left main coronary artery disease, and vasoactive inotropic score>60, was 0.88(95% CI: 0.80-0.95). Conclusion:Long-term survival of patients who survive to discharge appears favorable. Older age, left main coronary artery disease, and vasoactive inotropic score were associated with 3-year mortality in coronary artery bypass grafting patients who received VA-ECMO.

Background and Objectives: Psoriasis is a chronic inflammatory skin disease, which the mechanisms behind its initiation and development are related to many factors. DMSCs (dermal mesenchymal stem cells) represent an important member of the skin microenvironment and play an important role in the surrounding environment and in neighbouring cells, but they are also affected by the microenvironment. We studied the glucose metabolism of DMSCs in psoriasis patients and a control group to reveal the relationship among glucose metabolism, cell proliferation activity，and VEC (vascular endothelial cell) differentiation in vitro, we demonstrated the biological activity and molecular mechanisms of DMSCs in psoriasis. Methods: and Results: We found that the OCR of DMSCs in psoriatic lesions was higher than that in the control group, and mRNA of GLUT1 and HK2 were up-regulated compared with the control group. The proliferative activity of DMSCs in psoriasis was reduced at an early stage, and mRNA involved in proliferation, JUNB and FOS were expressed at lower levels than those in the control group. The number of blood vessels in psoriatic lesions was significantly higher than that in the control group (p＜0.05), which the mRNA of VEC differentiation, CXCL12, CXCR7, HEYL and RGS5 tended to be increased in psoriatic lesions compared to the control group, in addition to Notch3. Conclusions We speculated that DMSCs affected local psoriatic blood vessels through glucose metabolism, and the differentiation of VECs, which resulted in the pathophysiological process of psoriasis.

Objective To investigate the effect of preoperative serum uric acid level on the incidence of acute kidney in-jury after off-pump coronary artery bypass grafting and to discuss whether serum uric acid level is an independent predictor of postoperative acute kidney injury.Methods A total of 631 patients undergoing off-pump coronary artery bypass grafting in Anzhen Hospital from January 2018 to June 2018 were reviewed.Patients were divided into high uric acid group(higher-than-median)and low uric acid group(lower-than-median) , based on the preoperative serum uric acid level of the patients.The de-mographic variables, comorbidities, the chelsea comorbidity index, preoperative medication, serum creatinine level and glo-merular filtration rate were compared between the two groups.Meanwhile, intraoperative operative time, infusion volume, post-operative acute kidney injury staging and the rate of frozen plasma usage , continuous renal replacement therapy and reoperation rate were observed.Results Among the 631 patients, 83(13.2％, 83/631)cases developed postoperative acute kidney inju-ry, 65(78.3％, 65/83) cases had a higher level of preoperative serum uric acid above the median(OR =3.143, 95％CI:1.850-8.798, P=0.001).After adjustment, multivariate analysis showed that elevated level of serum uric acid and BMI >30 kg/m2, the increase of preoperative serum creatinine level, the decrease of glomerular filtration rate( <60 ml/min) and higher CCI score were associated with postoperative acute kidney injury independently .Intraoperative fluid volume , diabetes and preoperative diuretic administration did not relate to the incidence of acute kidney injury after cardiac surgery .Conclusion Elevated serum uric acid level can be a strong predictor for the incidence of acute kidney injury after off-pump coronary artery bypass grafting.

Objective To analyse the timing of cerebral infarction after cardiac surgery,summarize the intensive care treatment and prognosisof patients with cerebral infarction,and provide the basis for clinical prevention and treatment of postoperative cerebral infarction.Methods A retrospective review of patients undergoing cardiac surgery between January 2014 and December 2016 in our department.Patients had the clinical manifestations of central nervous system injury within 7 days after surgery and confirmed cerebral infarction by CT or MRI examination.The cerebral infarction patients were divided into the onpump and off-pump group,and the clinical data were compared between the two groups.Cerebral infarction was defined as any focal or global neurological deficits lasting for more than 24 hours.Cerebral infarction was classified as early cerebral infarction when it occurred less than 24 hours postoperatively,and delayed cerebral infarction when it occurred more than 24 hours postoperatively.Results In a total of 41 patients with cerebral infarction were included in the study.Early cerebral infarction occurred in 12 patients and delayed cerebral infarction occurred in 29 patients.The off-pump group patients had significantly lower risk of early cerebral infarction(P =0.01).All patients in this study were treated with comprehensive therapy.The time of on-pump and off-pump group staying in ICU was respectively(9.63 ± 6.42)days and(8.19 ± 4.63)days,the total length of hospital stay was (24.25 ± 13.51) days and (19.14 ± 12.81) days,the difference was statistically significant (P ＜ 0.05).When discharged BI was severe disability in 8 cases,deterioration of discharged automatically in 4 cases,death in 1 cases.Conclusion Compared with patients undergoing off-pump CABG,patients undergoing on-pump surgery more frequently had early cerebral infarction.Early and delayed cerebral infarction differed in their mechanisms.Different preventive strategies should be applied in future intervention.Perioperative cerebral infarction seriously affected the patient's prognosis and quality of life.

Objective To investigate the effect of atorvastatin calcium with different doses on inflammatory cytokine and carotid atherosclerotic plaque of patients with cerebral infarction.Methods One hundred and seventy-eight patients with cerebral infarction admitted into our hospital from January 2014 to June 2015 were divided into low dose (LD) group and high dose (HD) group.Ninety patients in LD group were treated with atorvastatin calcium in a dose of 10 mg/d,and eighty-seven patients in HD group were treated with atorvastatin calcium in a dose of 20 mg/d.The serum levels of lipid including TC,TG,LDL-C,HDL-C,inflammatory cytokine including hs-CRP,IL-6,TNF-α,and carotid atherosclerotic plaque of both groups were analyzed and compared before and after treatment.Results After six months of treatment,the serum levels and inflammatory cytokine of patients in both groups showed remarkable improvement (P ＜ 0.05),and those in HD group were significantly better than those of LD group (P ＜ 0.05).Additionally,compared with those before treatment,changes in carotid atherosclerotic plaque of patients in LD group were not obvious,while those in HD group markedly decreased,and which were significantly lower than those of LD group (P ＜ 0.05).Conclusion Atorvastatin calcium with HD of 20 mg/d showed a better capability on improving serum levels of lipid,inflammatory cytokine,and carotid atherosclerotic plaque of patients with cerebral infarction than those with LD of 10 mg/d.