METHODS: Rat BMSCs were isolated, cultured and identified. The time-dependent expressions of TSP-2 and Sox9 in BMSCs under a dynamic mechanical pressure of 0–120 kPa at 0.1 Hz for 1 h were tested by qPCR and Western blotting. The role of TSP-2 in chondrogenic differentiation of BMSCs under mechanical pressure was validated by using small interfering RNA. The impact of TSP-2 and mechanical pressure on chondrogenesis were detected and the downstream signaling molecules were explored using Western blotting. RESULTS: Mechanical pressure stimulation of 0–120 kPa for 1 h significantly upregulated the expression of TSP-2 in BMSCs. The expression of the chondrogenesis markers Sox9, Aggrecan, and Col-II were all upregulated under dynamic mechanical pressure or TSP-2 stimulation. Additional exogenous TSP-2 may potentiate the chondrogenic effect of mechanical stimulation. After knock down TSP-2, the upregulation of Sox9, Aggrecan and Col-II under mechanical pressure was inhibited. The NF-jB signaling pathway responded to both dynamic pressure and TSP-2 stimulation, and the cartilage-promoting effect was blocked by an NF-jB signaling inhibitor. CONCLUSION TSP-2 plays an essential role in the chondrogenic differentiation of BMSCs under mechanical pressure. NF-jB signaling is involved in the mechano-chemical coupling of TSP-2 and mechanical pressure for the chondrogenic differentiation of BMSCs.

Objective:To investigate the in vitro anti-cancer effect of Vinorelbine (NVB) combined with adriamycin (PLD) on human breast cancer MCF-7 cells and related mechanisms.Methods:The effects of NVB and PLD alone or in combination on the proliferation of breast cancer cells were detected by CCK-8 experiment. Flow cytometry was used to detect cell apoptosis and changes in reactive oxygen species (ROS) levels. Western blot experiment was carried out to detect protein expression.Results:The results of CCK-8 showed that compared with the blank control group, the inhibition rates of the vinorelbine treatment group, the adriamycin treatment group and the combined treatment group were 27.6%, 31.2% and 65.4%, compared with the NVB group and PLD group, the difference between the combined treatment group was statistically significant ( P=0.005 vs 0.001) . The results of flow cytometry showed that the proportion of apoptotic cells in each group was 3.54%, 16.95%, 15.01% and 32.24%, compared with the NVB group and PLD group, the difference between the combined treatment group was statistically significant ( P=0.006 vs 0.005) . The levels of reactive oxygen species in each group were 1, 1.03, 1.06 and 1.57, compared with the NVB group and PLD group, the difference between the combined treatment group was statistically significant ( P=0.008 vs 0.007) . Western blot results showed that the expression of p-ERK and p-STAT3 decreased after the combination of NVB and PLD, which inhibited the ERK/STAT3 signaling pathway. Conclusions:The combination of NVB and PLD can promote the apoptosis of breast cancer cells and inhibit the proliferation of breast cancer cells with high efficiency and low toxicity. Its mechanism of action may be related to the up-regulation of ROS levels in cells, thereby inhibiting the activation of the ERK/STAT3 pathway.

Objective:To analyze the risk factors for the most common adverse events, i.e. abdominal pain and distension in sedation-free colonoscopy.Methods:This was a multicenter clinical study, in which clinical data of patients including outpatients and inpatients who underwent selective sedation-free colonoscopy at six gastrointestinal endoscopy centers from July 2017 to December 2019 were collected, including patients' general information, complicating diseases, examination time, examination results, and occurrence of adverse events of abdominal pain and distension. Univariate and multivariate logistic regression was performed to analyze the risk factors for adverse events of abdominal pain and distension during sedation-free colonoscopy.Results:A total of 2 394 patients underwent sedation-free colonoscopy, among whom 690 (28.8%) suffered from abdominal pain, and 1 151 (48.1%) experienced abdominal distension. The results of multivariate logistic analysis showed that overweight ( OR=1.33, 95% CI:1.09-1.62, P=0.005), obesity ( OR=1.55, 95% CI:1.14-2.11, P=0.005) and combination of hypertension ( OR=1.58, 95% CI:1.23-2.02, P<0.001) were independent risk factors for abdominal pain during sedation-free colonoscopy, and overweight ( OR=1.40, 95% CI:1.17-1.68, P<0.001) and combination of hypertension ( OR=1.39,95% CI:1.10-1.76, P=0.006) were independent risk factors for abdominal distension during sedation-free colonoscopy. Conclusion:Obesity, overweight and combination of hypertension are independent risk factors for abdominal pain, and overweight and combination of hypertension are independent risk factors for abdominal distension during sedation-free colonoscopy.

Objective To explore the influencing factors of weight gain in women with schizophrenia after treatment.Methods From January 2016 to December 2016,180 patients with schizophrenia who admitted to the Second People′s Hospital of Lishui for the first time and were treated with antipsychotics (APD) were followed up at hospital and 4 months after discharge.The height,weight and body mass index were observed.The joint general situation questionnaire,brief psychiatric scale(BPRS),negative symptoms(SANS),positive symptom scale(SAPS) and the clinical curative effect overall rating scale subscales of overall curative effect (CGI-GI) were comprehensively evaluated.The data were analyzed statistically.Results The weight gain was related to the type of antipsychotics (χ2＝37.3,P＜0.01),and the effect of aripiprazole and ziprasidone on body weight was significantly less than that in the case of weight(χ2＝31.1,P＜0.01).Single factor analysis showed that a medication time correlation (F＝4.92,P＜0.05),and each point GⅠscore had no correlation with weight gain,and weight gain was associated with BPRS,SAPS subtraction score at discharge (r＝0.079,0.092,all P＜0.01),and during follow-up weight gain was correlated with SANS score reduction (r＝-0.063,-0.086,P＜0.05 or P＜0.01).Stepwise regression analysis showed that at the alpha＝0.05 level,entered the regression equation factors in the order : APD types,maximum doses and taking the product of time,the negative symptoms,the best functional level at 1 year before disease.Conclusion It is important to control the weight gain of young women.The mediating role of diet and activity should not be underesti-mated.Appropriate APD was chosen to adjust the maintenance treatment strategy as appropriate,improve the negative symptoms and improve the level of individual social function as the main intervention measure .

Objective To investigate the related factors of central regional lymph node metastasis (CLNM) in patients with papillary thyroid microcarcinoma (PTMC).Methods The clinical and pathological fea tures of 550 cases of PTMC with clinical lymph node negative (cN0) were retrospectively analyzed.x2 test and multivariate logistic regression analysis were used to analyze the related factors of CLNM.ROC curve was used to analyze tumor diameter and CLNM of PTMC.Results The CLNM rate was 35.6％.Univariate analysis showed that patients aging less than 45 y(x2=13.983,P＜0.001),with tumor diameter≥7 mm (x2=14.263,P＜0.001),with capsule invasion (x2=7.316,P=0.006),multifocality (x2=14.321,P＜0.05) and bilateral tumors (x2=9.265,P=0.002) were more likely to have CLNM.Multivariate Logistic regression analysis showed that age ＜45 y,tumor diameter ≥7 mm,invasion of capsule and multifocal are all independent risk factors of CLNM for patients with PTMC.The optimal cutoff value of CLNM by diameter was 8 mm.Conclusion The CLNM of PTMC is related to many factors.When the age of the patient is less than 45 y,the diameter of the tumor is more than 7 mm,the invasion of the capsule and the multifocal lesion,the central lymph node dissection should be performed.

Objective To establish a kind of simple,rapid,accurate and reliable method to analyze the concentration of alcohol in blood by headspace gas chromatography (HS-GC) with dual-column and dual-detector.Methods The samples were pre-treated by headspace sampler,which was the basis on the extraction principle of the gas extracting volatile substances.Next,these samples were analyzed by HS-GC that the tertiary butyl alcohol was acted as the internal standard substance.The HS-GC was equipped with two chromatographic column (the DB-ALC2 chromatographic column of 001 channel;the DB-ALC1 chromatographic column of 002 channel).At the same time,the HS-GC was also equipped with two hydrogen flame ionization detector (FID1 detector;FID2 detector).The retention time of the peak was finally performed as qualitative parameter and the standard curves method of internal standard were acted as quantitative basis.Results The liner range of the method was 0.2-2.0 mg/mL.The linear regression equation of 001 channel was Y=1.057 7X+0.048 2 and the correlation coefficient was R2=0.999 05.Besides,the linear regression equation of 002 channel was Y=1.039 5X+0.046 5 and the correlation coefficient was R2=0.999 25.In short,the average recovery rate of the method was 99.70%.Relative standard deviation(RSD) was less than 4% between the analysis results of 001 channel and 002 channel for the determination of the plan sample.Conclusion The method shown satisfactorily that it could not only be applied to determine the alcohol of blood of forensic toxicological analysis,but also be applied to determine the plan sample of ability test and verify of laboratory ability accreditation.

Objective To observe the effect of strict designed form for chewing gum on the first anus exhaust and defecation after laparoscopic surgery,and the actual compliance of chewing gum was investigate.Methods Totally 106 patients with abdominal operation in gynaecology department of Shaanxi Provincial People's Hospital from August to December 2016 were classified into chewing gum group and control group according to stratified random sampling.Chewing gum group had 53 cases,and the principle and requirement of chewing gum in patients and relatives were explained before operation.The xylitol chewing gum was chosed and chewed 2 to 3 gums in the 2 hours after operation,chewed about 30 times every minute and last for 15 to 20 minutes each time.From 7∶00 to 22∶00 the interval was 2 hours, and the interval at the rest time must not exceed 3 hours until exhaust.Fifty-three cases in control group received routine nursing,and started to drink a small amount of water 6 hours after operation,and gradually started to eat.Other dietary guidance and medical care measures were identical in both groups.Compared the first anus exhaust time,defecation time,abdominal distension and postoperative hospitalization time in two groups,and the actual compliance of chewing gum was investigated.Results The first anus exhaust time and the first defecation time of chewing gum group were (19.60±7.59) hours and (36.77±17.16) hours respectively,while those of the control group were (33.79±10.54)hours and (53.25±16.92) hours,and the differences were statistically significant(P<0.05).No abdominal distension occurred in chewing gum group,8 cases (15.1%) in control group had abdominal distension,the difference was statistically significant(P<0.05).The postoperative hospitalization time of chewing gum group and control group were (3.94±1.87) days and (4.42±1.26)days respectively,and the difference was statistically significant(P>0.05).The actual compliance investigation of chewing gum was selected in 53 cases with the actual completion of 48 cases(90.6%).The averaged actual chewing number was (4.39±1.35) times,the averaged actual chewing time in each duration was (16.16±2.05) minutes,the average actual chewing interval was (2.38±0.26) hours.Conclusion The well designed form of chewing gum postoperative can shorten the postoperative anus exhaust and defecation time, and it can reduce postoperative abdominal distention.

Objective To explore the lateral neck lymph node metastasis (LNM) in patients affected by papillary thyroid carcinoma(PTC) with clinically negative neck (cN0-PTC) and to discuss the necessity of prophylactic lateral neck lymph node dissection.Methods Clinical data of 651 cN0-PTC patients who underwnt surgical procedure in Tumor Hospital of Zhengzhou University from Jan.2012 to May.2015 were retrospectively analyzed.Chi-square test was used for univariate analysis.Results Of the 651 cN0-PTC patients,62.9％ had LNM (51.3％ in central neck,41.0％ in lateral neck,and 11.7％ with "skip" metastasis).The lateral neck metastasis rate was 50.9％ in men and 37.7％ in women (P＜0.05),61.9％ in patients with tumor diameter ＞1.0 cm and 25.9％ in patients with tumor diameter ≤ 1.0 cm (P＜0.001),47.2％ with multifocal cancer and 40.3％ with unifocal tumor(P＜0.05),63.1％ with extrathyroidal extention and 34.3％ without extention (P＜0.001),64.1％ with ≥3 positive nodes in central neck and 48.3％ with ＜3 positive nodes (P＜0.05),52.4％ with upper lobe cancer and 32.9％ with other locations(P＜0.001),41.0％ in patients ≤45 years and 40.9％ in patients ＞45 years(P＞0.05).Conclusion Central neck dissection should be performed in all cN0-PTC patients.Prophylactic lateral neck dissection should beselectively performed in cN0-PTC patients with following high-risk factors:male,tumor diameter ＞1.0 cm,multifocal cancer,extrathyroidal extention,≥ 3 positive nodes in central neck and upper lobe cancer.

BACKGROUND:Currently, there is no effective treatment for keloids that often recur. Its pathogenesis is stil entirely unclear, and fibroblast proliferation and apoptosis have become a research hotspot.
OBJECTIVE:To investigate the expression of Livin, Smac and Caspase-3 in keloids and to analyze their relationship so as to preliminarily explore the significance of Livin, Smac and Caspase-3 in the pathogenesis of keloids.
METHODS:RT-PCR and immunohistochemical methods were used to detect the mRNA and protein expressions of Livin, Smac and Caspase-3 in keloids (n=20) and normal skin tissues (n=20).
RESULTS AND CONCLUSION:Compared with the normal skin tissue, the mRNA and protein positive expressions of Livin were significantly higher in keloids (P < 0.05), while the mRNA and protein positive expressions of Smac and Caspase-3 were lower in keloids (P < 0.05). There was a negative association between Livin and Smac, Caspase-3 protein expression in keloids. These findings indicate that the high mRNA expression of Livin may cause the imbalance between proliferation and apoptosis of fibroblasts by inhibiting the mRNA expression of Smac and Caspase-3, and eventualy lead to the formation of keloid.

According to clinical epidemiological researches, the usage of antibiotics in infant increases the risk of childhood asthma morbidity. The mechanism of this link is not entirely clariifed, and it is assumed of being related to side effects of antibiotics, which changes the colonization of normal intestinal lfora and reduces the diversity. It is clear that normal intestinal lfora of infant help to construct innate immune system and adaptive immune system, and forge immune tolerance. Therefore, normal intestinal lfora might be helpful in reducing allergies. The usage of antibiotics in early life changes the quantity and the composition of intestinal lfora, and breaks the balance of immune homeostasis, which might increase the risk of asthma morbidity. The abuse of antibiotics in children is a general phenomenon in China which needs attention from pediatricians.