AIM:This study aims to investigate the molecular mechanism by which tubeimoside I(TBMS1)inhibits Snail expression in pancreatic cancer cells(PANC-1).METHODS:Human pancreatic cancer PANC-1 cells were cultured in vitro.The inhibitory effect of TBMS1 on PANC-1 cells was assessed using the MTT assay,and the data were analyzed based on the IC50 value of TBMS1.The impact of TBMS1 on the clonal formation ability of PANC-1 cells was evaluated through colony formation assays.The Transwell assay was employed to assess the effect of TBMS1 on the migrato-ry capability of PANC-1 cells.Apoptosis and cell cycle alterations in PANC-1 cells were analyzed using acridine orange staining and flow cytometry.The expression of Snail protein in pancreatic cancer and its relationship with survival of the patients were analyzed using the GEPIA database and Kaplan-Meier Plotter data.Immunofluorescence staining was con-ducted to investigate the effect of TBMS1 on Snail expression,while Western blot was used to evaluate the expression of poly(ADP-ribose)polymerase(PARP),E-cadherin and Snail in the cells.The ubiquitination of Snail protein was mea-sured using immunoprecipitation techniques.RESULTS:As the concentration of TBMS1 increased,the survival rate and number of clones formed by PANC-1 cells progressively decreased,leading to apoptosis,cleavage of PARP,and cell cycle arrest in the G1 phase.There was also a reduction in the proportion of cells in the S phase and a decrease in cell migration ability.The expression of Snail protein,a critical factor in cell migration,was inhibited,while E-cadherin protein levels were increased.Treatment with the proteasome inhibitor MG132 was able to reverse the suppression of Snail protein ex-pression caused by TBMS1.Immunoprecipitation results indicated that TBMS1 enhances the ubiquitination and subse-quent degradation of Snail protein.CONCLUSION:TBMS1 effectively inhibits the malignant progression of pancreatic cancer cells by promoting the ubiquitination and degradation of Snail protein in PANC-1 cells.

AIM:This study aims to investigate the molecular mechanism by which tubeimoside I(TBMS1)inhibits Snail expression in pancreatic cancer cells(PANC-1).METHODS:Human pancreatic cancer PANC-1 cells were cultured in vitro.The inhibitory effect of TBMS1 on PANC-1 cells was assessed using the MTT assay,and the data were analyzed based on the IC50 value of TBMS1.The impact of TBMS1 on the clonal formation ability of PANC-1 cells was evaluated through colony formation assays.The Transwell assay was employed to assess the effect of TBMS1 on the migrato-ry capability of PANC-1 cells.Apoptosis and cell cycle alterations in PANC-1 cells were analyzed using acridine orange staining and flow cytometry.The expression of Snail protein in pancreatic cancer and its relationship with survival of the patients were analyzed using the GEPIA database and Kaplan-Meier Plotter data.Immunofluorescence staining was con-ducted to investigate the effect of TBMS1 on Snail expression,while Western blot was used to evaluate the expression of poly(ADP-ribose)polymerase(PARP),E-cadherin and Snail in the cells.The ubiquitination of Snail protein was mea-sured using immunoprecipitation techniques.RESULTS:As the concentration of TBMS1 increased,the survival rate and number of clones formed by PANC-1 cells progressively decreased,leading to apoptosis,cleavage of PARP,and cell cycle arrest in the G1 phase.There was also a reduction in the proportion of cells in the S phase and a decrease in cell migration ability.The expression of Snail protein,a critical factor in cell migration,was inhibited,while E-cadherin protein levels were increased.Treatment with the proteasome inhibitor MG132 was able to reverse the suppression of Snail protein ex-pression caused by TBMS1.Immunoprecipitation results indicated that TBMS1 enhances the ubiquitination and subse-quent degradation of Snail protein.CONCLUSION:TBMS1 effectively inhibits the malignant progression of pancreatic cancer cells by promoting the ubiquitination and degradation of Snail protein in PANC-1 cells.

Objective:To investigate the efficacy of phenolamine in the treatment of sepsis-induced myocardial dysfunction and its effect on cardiac function, myocardial injury index, and hemodynamics in patients.Methods:The clinical data of 79 patients with sepsis-induced myocardial dysfunction who received treatment in Huangshi Central Hospital, Edong Healthcare Group from February 2017 to February 2020 were retrospectively analyzed. These patients were divided into a control group (without phenolamine treatment, n = 41) and an observation group (with phenolamine treatment, n = 38) according to whether they received phenolamine treatment or not. Clinical efficacy, cardiac function, myocardial injury index, and hemodynamic index pre- and post-treatment were compared between the two groups. Results:There was no significant difference in 28-day mortality rate between the two groups ( P > 0.05). Intensive care unit length of stay and mechanical ventilation duration in the observation group were (9.33 ± 3.52) days and 83.00 (28.50, 138.00) hours, which were significantly shorter than (12.17 ± 4.15) days and 111.00 (47.50, 169.00) hours in the control group ( t = 3.26, Z = -2.27, both P < 0.05). The response rate in the observation group was significantly higher than that in the control group [81.58% (31/38) vs. 60.98% (25/41), χ2 = 4.05, P < 0.05]. After 7 days of treatment, the left ventricular ejection fraction in each group was significantly increased, and the left ventricular end-diastolic diameter and left ventricular end-systolic diameter in each group were significantly decreased compared with before treatment (all P < 0.05). After 7 days of treatment, the left ventricular ejection fraction in the observation group was significantly higher than that in the control group ( t = 3.29, P < 0.05), and left ventricular end-diastolic diameter and left ventricular end-systolic diameter were significantly lower than those in the control group ( t = 5.94, 11.21, both P < 0.05). N-terminal pro-brain natriuretic peptide and cardiac troponin I levels in each group were significantly decreased with time (both P < 0.05). At 24 and 72 hours and 7 days after treatment, N-terminal pro-brain natriuretic peptide and cardiac troponin I levels in the observation group were significantly lower than those in the control group (both P < 0.05). After 7 days of treatment, heart rate in each group decreased significantly compared with that before treatment (both P < 0.05), mean arterial pressure, cardiac index, and stroke output index in each group increased significantly compared with those before treatment (all P < 0.05). After 7 days of treatment, heart rate in the observation group was significantly lower than that in the control group ( t = 4.90, P < 0.05), and mean arterial pressure, cardiac index, and stroke output index in the observation group were significantly higher than those in the control group ( t = 4.37, 3.23, 6.01, all P < 0.05). Conclusion:Phentolamine can improve hemodynamics, reduce myocardial injury and improve cardiac function in patients with sepsis-induced myocardial dysfunction.

Objective:To explore the application effect of three-dimensional quality evaluation model in continuous nursing during puerperium in the first-time cesarean section.Methods:The convenient sampling method was used to select the first cesarean section women who gave birth in Xinxiang Central Hospital from January to December 2018 as the research objects. Parturients were divided into the control group and the observation group, with 93 cases in each group by random number table method. The control group was given conventional puerperal care, while the observation group was given continuous care based on the control group using three-dimensional quality evaluation model. The intervention time was 6 weeks. Maternal health knowledge, maternal and child health status and quality of life were assessed in both groups. In this study, 8 cases were lost to follow-up in the control group and 7 cases in the observation group, and 171 cases of parturients were finally included, including 85 cases in the control group and 86 cases in the observation group.Results:After intervention, maternal health knowledge scores, neonatal health knowledge scores and scores of all dimensions of the WHO Quality of Life Inventory were higher in the two groups than before intervention, and the observation group was higher than the control group, and the differences were statistically significant ( P<0.05) . The cases of poor incision healing, poor uterine recovery, acute mastitis, puerperal infection and postpartum constipation in the observation group were lower than those in the control group, and the differences were statistically significant ( P<0.05) . The incidence of neonatal jaundice, eczema and diarrhea in the observation group were lower than that in the control group, and the differences were statistically significant ( P<0.05) . Conclusions:Based on the three-dimensional quality evaluation model as the theoretical basis, continuous nursing for first-time cesarean delivery mothers helps the mothers grasp the knowledge of puerperium health, has a positive effect on the health status of mothers and infants and improves the quality of life of the women, which is worthy of clinical application.

Objective:To analyze blood transfusion and prognostic factors of extracorporeal membrane pulmonary oxygenation (ECMO) for the treatment of respiratory and circulatory failure.Methods:The clinical data of 80 patients with respiratory and circulatory failure who received treatment in Huangshi Central Hospital from March 2016 to July 2021 were retrospectively analyzed. According to 28-day prognosis, these patients were divided into death group ( n = 44) and survival group ( n = 36). The general data, blood transfusion during the process of ECMO, vital signs, laboratory indicators, ventilation time, and length of hospital stay were compared between the two groups. The factors affecting death during the process of ECMO were analyzed. Results:There were no significant differences in sex, age, body mass index, complications, the cause of respiratory and circulatory failure, and the mode of ECMO between the two groups (all P > 0.05). Preoperative Acute Physiology and Chronic Health Evaluation II score, creatinine, procalcitonin and lactic acid levels in the survival group were (22.36 ± 3.71) points, (79.17 ± 9.29) μmol/L, (2.77 ± 0.79) ng/L, (2.74 ± 0.36) mmol/L, respectively, which were significantly lower than (34.27 ± 4.98) points, (94.16 ± 10.23) μmol/L, (3.69 ± 1.10) ng/L, (5.18 ± 0.42) mmol/L, respectively in the death group ( t = -11.89, -6.79, -5.62, -27.53, all P < 0.001). There were no significant differences in preoperative respiratory frequency, diastolic pressure, systolic pressure, heart rate, oxygenation index (PaO 2/FiO 2) and C-reactive protein between the two groups (all P > 0.05). The volume of blood transfused on the day of undergoing ECMO, the volume of blood transfused on the day of withdrawing ECMO, the volume of blood transfused during the whole process of ECMO, duration of ventilation, and the incidence of complications related to ECMO were(98.74 ± 16.28) mL, (37.23 ± 10.36) mL, (398.79 ± 67.81) mL, (210.39 ± 20.21) hours, 38.89% (14/36), respectively, which were significantly lower than (160.17 ± 23.14) mL, (48.26 ± 12.25) mL, (600.23 ± 70.12) mL, (320.14 ± 18.21) hours, 79.55% (35/44), respectively in the death group ( t = -13.43, -4.29, 4.94, 25.25, χ2 = 13.79, all P < 0.001). The length of hospital stay in the survival group was longer than that in the death group [(20.14 ± 5.36) days vs. (14.17 ± 4.23) days, t = 5.56, P < 0.001). Acute Physiology and Chronic Health Evaluation II score, procalcition level, the volume of blood transfused on the day of ECMO, duration of ventilation, and the volume of blood transfused during the whole process of ECMO are risk factors for death after ECMO, while length of hospital stay is a protective factor for ECMO. Conclusion:Preoperative evaluation of Acute Physiology and Chronic Health Evaluation II score, continuous blood transfusion during the whole process of ECMO, grasping the opportunity of ventilation and preventing against complications of ECMO are the keys to increasing the survival rate of patients with respiratory and circulatory failure.

Objective:To compare between laparoscopic and open pancreaticoduodenectomy in the treatment of distal cholangiocarcinoma.Methods:The clinical data of laparoscopic pancreaticoduodenectomy (LPD group, n=101) and open pancreaticoduodenectomy (OPD group, n=99) in patients with distal cholangiocarcinoma who underwent pancreaticoduodenectomy at Hunan people's Hospital from Jan 2015 to Dec 2019 were analyzed retrospectively. The operation time, intraoperative blood loss, number of lymph node dissection, R 0 resection rate, postoperative hospital stay, postoperative complications and overall survival rate were compared between the two groups. Results:The operation time was (475.0±90.7) min and (444.8±63.3) min, the intraoperative blood loss was (350.9±397.9) ml and (546.7±642.9) ml, the postoperative hospital stay was (11.5±4.7) d and (13.3±5.1) d, the differences were statistically significant ( P<0.05).The number of lymph node dissection was 14.8±3.0 and 15.4±2.4, the R 0 resection rate was 93.1% and 96.0%, respectively, and there was no significant difference ( P>0.05). There was no significant difference in the incidence of residual complications ( P>0.05). During the follow-up of 5-64 months, the OS of 1, 3 and 5 years in the two groups were 90.4%, 41.3%, 20.6% and 94.3%, 50.8% and 24.7%, respectively. ( P>0.05). Conclusions:LPD is safe and feasible in the treatment of distal cholangiocarcinoma, and its short-term curative effect, curative effect and long-term overall survival rate are similar to those of OPD.

Objective To study the clinical efficacy and safety of microwave ablation (MWA) in the treatment of autonomous functional thyroid nodules(AFTN) . Methods Sixty-seven nodules of 53 AFTN patients who refused or were not suitable for surgical resection and 131I therapy were enrolled in the study . All the nodules were evaluated by ultrasound ,color Doppler flow imaging ( CDFI) and contrast enhanced ultrasound(CEUS) ,and all of them were benign and confirmed by pathology . And then ,percutaneous MWA was performed . Fluid isolation and mobile ablation were used to completely inactivate the nodules ,and CEUS was used to evaluate the efficacy of the treatment . The following items included thyroid hormone level ,nodule volume ,nodular blood supply ,thyroid radionuclide imaging ,conscious symptom ,beauty score and complication . Finally ,the factors influencing the curative effect were analyzed . Results The follow-up period was at least 12 months . Compared with before treatment ,the differences of thyroid hormone level , the volume of nodules ,the nodule blood supply were statistically significant ( P ＜ 0 .01) . The 61 hot nodules" changed to cold or warm nodules" . The differences between the improvement ratio of conscious symptoms and beauty scores were statistically significant( P ＜ 0 .05) . The cure ratio in this study was 81 .13% ,and the incidence of complications was 11 .32% ,and the recurrence ratio was 4 .48% . The nodule volume≥14 .04 ml or in a dangerous position were the main factors affecting the curative effect . Conclusions MWA can inactivate the AFTN in situ ,make it lose the secretory function and reduce the volume of nodules . Therefore ,percutaneous MWA guided by ultrasound and CEUS treatment of AFTN can be regarded as another safe and effective treatment besides surgical resection or 131I therapy .

Objective To investigate the effects of miR-335-5p on the proliferation and apoptosis of osteoblasts which were exposed to high glucose condition, and explore its possible molecular mechanisms. Methods MC3T3-E1 osteoblasts were divided into four groups:control group(5. 5 mmol/L glucose), high glucose group(HG group, 22. 0 mmol/L glucose), agomir-335-5p group(transfected with agomir-335-5p and exposed to 22. 0 mmol/L glucose) , and agomir negative control group( agomir NC group, transfected with agomir negative control and exposed to 22. 0 mmol/L glucose), cultured for 7 days. Cell proliferaton, cell apoptosis, expressions of miR-335-5p and dickkopfhomolog1(DKK1)mRNA,proteinlevelsofDKK1andcysteinylaspartate-specificproteinase-3(caspase-3) were detected using MTT, flow cytometry, quantitative realtime PCR and western blot, respectively. Results Compared with control group, the expression of miR-335-5p mRNA and cell proliferation in HG group were significantly decreased(P<0. 05), while cell apoptosis and the protein levels of DKK1 and caspase-3 were increased significantly(P<0. 05), the expression of DKK1 mRNA did not change (P>0. 05). The miR-335-5p mRNA expression and cell proliferation in agomir-335-5p group were higher than those in HG group and agomir NC group(P<0. 05). However, Cell apoptosis and the protein levels of DKK1 and caspase-3 in agomir-335-5p group were lower than those in HG group(P<0. 05). Conclusion High glucose inhibits the proliferation and induce the apoptosis of MC3T3-E1 osteoblast through decreasing the expression of miR-335-5p and subsequently increasing the DKK1 expression.

Objective To investigate the effect of group cognitive behavioral therapy on anxiety and depression in patients with chronic heart failure ( CHF ) .Methods One hundred patients with CHF were recruited from January 2012 to December 2013 in cardiovascular department , and were divided into the intervention group and the control group , with 50 patients each .Comprehensive intervention including routine heart failure care and group cognitive behavioral therapy combined with other therapies was adopted on the patients in the intervention group .The Self-rating Anxiety Scale ( SAS ) and the Self-rating Depression Scale ( SDS) were used to compare the difference of anxiety and depression between groups .Results At the baseline, the incidence of anxiety was 25%, within which 11 patients had mild anxiety , and 10 patients had moderate anxiety, and 4 patients had severe anxiety.The incidence of depression was 39%, within which 19 patients had mild depression , and 14 patients had moderate depression , and 6 patients had severe depression .The score of SAS and SDS in the intervention group after intervention were (36.90 ±8.465) and (27.53 ±7.162), respectively, which were significantly lower than (40.91 ±8.019) and (36.78 ±10.562) in the control group (t=9.244,10.335, respectively;P<0.01).Conclusions Group cognitive behavioral therapy can effectively relieve the anxiety and depression in patients with chronic heart failure .

Objective To review the application status and prospect the medical ultrasound technology applied in space medicine based on literature analysis.Literature resource and selection Research papers and reports in space medicine and relative fields published at home and abroad were retrieved.Literature quotation Forty-eight published papers and reports were cited.Literature synthesis Medical ultrasonography,as a traditional medical imaging technology,has been widely used to diagnose and monitor many different diseases in clinical setting for several decades.It is also widely used to investigate the human physiology in spaceflight or simulated-weightlessness environment,especially on diagnosing cardiovascular functions.The effects of countermeasures against weightlessness could be expediently assessed via medical ultrasonography.During spaceflight,when astronaut has diseases or accident injuries,medical ultrasonography is the only choice of medical imaging diagnose.Conclusions Medical ultrasound has shown its advantages in space medicine.It will become more worthy as Chinese astronauts execute long-term spaceflight missions in future,