Objective To investigate the expression of centromere protein U(CENPU)in the intestinal tissues of patients with colon cancer,and to analyze the effect of CENPU expression level on the prognosis of patients with colon cancer combined with bioinformatics.Methods Firstly,the expression of CENPU in cancer tissues and normal tissues of colon cancer patients was analyzed by the expression of CENPU in tissues was further verified by real-time quantitative real time polymerase chain reaction(qRT-PCR),Western blot(WB)and immunohistochemistry(IHC).Combined with clinical data,univariate and multivariate Cox regression are used to analyze the correlation between CENPU expression and clinical case parameters of colon cancer patients.Then,the predictive effect of CENPU expression on the prognosis of colon cancer patients are explored by drawing receiver operating characteristic(ROC)curve and Kaplan-Meier survival curve.Finally,the possible molecular mechanism of the effect of CENPU expression on the progression of colon cancer are analyzed by bioinformatics.Results By qRT-PCR,WB and IHC experiments,we find that compared with normal tissues,the expression of CENPU in cancer tissues of colon cancer patients is significantly increased.Cox regression analysis show that the expression of CENPU is significantly correlated with the age and TNM stage of patients,and is a risk factor affecting the prognosis of patients.Kaplan-Meier survival curve analysis show that colon cancer patients with high CENPU expression has significantly lower survival rates.ROC curve show that the model based on CENPU expression has a high predictive power for the prognosis of colon cancer patients area under the curve(AUC=0.832).Bioinformatics analysis show that CENPI,CENPN,CENPD,CENPK,CENPP,CENPM,CENPQ,CENPH,NDC80 and ITGB3BP have significant interaction with CENPU gene.CENPU is involved in DNA repair,MYC/TARGETS/V1 and PI3K/AKT/MTOR signaling pathways.Conclusion High expression of CENPU in cancer tissues of patients with colon cancer is significantly associated with poor prognosis of patients,suggesting that CENPU is expected to be a potential target for early diagnosis and prognosis prediction of patients with colon cancer.

Objective To analyze the current status,hot spots and trends of Chinese and English researches in the field of aspiration after dysphasia in the past twenty years. Methods The articles about aspiration after dysphasia were retrieved from CNKI and Web of Science(WOS)core collec-tion database,from January,2003 to June,2023,and were analyzed with CiteSpace 6.1.R6. Results A total of 3 231 articles were included.The annual articles were published more and more year by year.The most English literatures came from the United States.Hot spots mainly focused on the assessment of dysphasia,prevention of complication,nutrition and rehabilitation therapy.It would concentrate on the application of the volume-viscosity swallow test and assessment scales,rehabilitation,penetration aspiration,outcome and effect validation,quality of life,feeding and nutrition condition,and evidence-based nursing,etc.,in the future. Conclusion The researches in the field of aspiration after dysphasia have been increasing in recent years,and the themes and contents of researches have been deepening.

Objective:To investigate the correlation of serum tartrate-resistant acid phosphatase 5b (TRAP-5b), β-collagen degradation products (β-CTX), vitamin D levels and rheumatoid arthritis (RA) complicated with osteoporosis (OP) fractures.Methods:A total of 200 RA patients diagnosed and treated in our hospital from Oct. 2022 to Oct. 2023 were selected. Clinical data of patients were collected, and serum TRAP-5b, β-CTX, vitamin D levels, bone mineral density and bone metabolism markers were detected. They were divided into RA group and RA-OP group according to whether OP fracture occurred. The above indexes were compared and their correlation with osteoporotic fractures in rheumatoid arthritis was analyzed.Results:The levels of serum TRAP-5b and β-CTX in RA patients were higher than those in healthy control group, and the levels of vitamin D were lower ( t=12.27, 20.01, 7.35, P<0.05). There was no statistically significant difference in gender, body mass index, diabetes, hypertension, smoking and drinking incidence between the two groups ( t=1.18, 0.96, 0.55, 1.84, 0.13, 0.30, P>0.05), but there was statistically significant difference in gender composition, serum TRAP-5b, β-CTX, vitamin D and bone metabolism markers between the two groups ( t=2.33, 3.72, 4.94, 5.10, 7.72, 4.77, 2.42, 9.30, 4.01, 6.38, 4.79, P<0.05). Logistic regression analysis showed that the levels of serum TRAP-5b, β-CTX, vitamin D and bone metabolism markers were independent risk factors for OP in RA patients ( P<0.05). Serum TRAP-5b and β-CTX were positively correlated with serum PINP, NTx, PTH, BALP and BGP, respectively ( r=0.811, 0.778, 0.747, 0.675, 0.614; 0.685, 0.513, 0.405, 0.612, 0.518), and negatively correlated with lumbar BMD and proximal femoral BMD ( r = -0.488, -0.512; -0.526, -0.502) ; Serum vitamin D was negatively correlated with serum PINP, NTx, PTH, BALP, BGP ( r=-0.728, -0.640, -0.604, -0.622, -0.545), and positively correlated with lumbar BMD and proximal femur BMD ( r=0.519, 0.492) ( P<0.05) . Conclusions:Serum levels of TRAP-5b, β-CTX and vitamin D are closely related to the occurrence of OP in RA patients. Abnormal increase of serum levels of TRAP-5b and β-CTX and abnormal decrease of vitamin D suggest an increasing risk of OP in RA patients.

Intestinal pathogenic bacteria utilize their own virulence factors to interfere with the nor-mal function of intestinal epithelial cells and evade clearance by the host immune system through precise gene regulation and expression strategies,thereby causing a variety of diseases.It has been found that the mechanisms affecting the gene expression strategies of pathogens include the toxin-antitoxin system,secretory system,and quorum sensing system.Novel antimicrobial strategies are being developed to interfere with the inherent gene regulatory system of bacteria and inhibit the expression of virulence genes,thus enabling a modest approach to the treatment of intestinal disea-ses.This paper initially discusses the components of innate immunity in the gut,followed by a dis-cussion of the common gene regulatory system of intestinal pathogenic bacteria.This article aims to clarify the mechanisms by which intestinal pathogenic bacteria evade clearance by the innate im-mune system through gene regulation and expression strategies,and to provide new ideas for the treatment of intestinal bacterial diseases.

【Objective】 To evaluate the clinical effect of 3D printing technology in autogenous tooth transplantation for tooth loss. 【Methods】 From September 2017 to August 2021, 169 patients (176 teeth) were selected and analyzed regarding age, gender, recipient site, positioning of the donor tooth, transplantation time, and long-term follow-up. 【Results】 A total of 176 autogenous tooth transplants were completed, consisting of 133 cases of traditional autogenous tooth transplantation and 43 cases of autogenous tooth transplantation with 3D printing technology. The donor tooth separation time for autogenous tooth transplantation with 3D printing technology was significantly less than that for traditional autogenous tooth transplantation (P<0.000 1). A total of nine teeth were removed 3 months after the operation due to loosening(autogenous tooth transplantation failure), among which seven failed in traditional tooth transplantation and two failed in autologous tooth transplantation with 3D printing technology. The success rate of traditional tooth transplantation was 77% and the retention rate was 94.7%. The success rate of tooth transplantation with 3D printing technology was 88%, and the retention rate was 95.3%. 【Conclusion】 3D printed tooth donor model can greatly shorten the time of tooth donor, reduce the damage to the periodontal membrane cells of the transplanted teeth, and improve the success rate of tooth transplantation. It is worthy of broad promotion.

ObjectiveTo explore the correlation between gross motor function and spinal range of motion (ROM) in children with bilateral spastic cerebral palsy. MethodsA total of 33 children with bilateral spastic cerebral palsy in Beijing Bo'ai Hospital from December, 2019 to March, 2022 were selected and divided into group 1 (grade Ⅰ, n = 12), group 2 (grade Ⅱ, n = 11) and group 3 (grade Ⅲ, n = 10) according to Gross Motor Function Classification System (GMFCS). SpinalMouse (spine morphometric machine) was used to measure the ROM of forward and backward flexion, and left and right lateral flexion of trunk, respectively, in sitting. Their gross motor ability was then further tested using the Gross Motor Function Measure (GMFM) 88 item. ResultsThe ROM of backward flexion, the left and right lateral flexion, and the total ROM of sagittal and coronal plane were positively correlated with the scores of GMFM88 (r > 0.424, P < 0.05), and were negatively correlated with the grade of GMFCS (|r| > 0.424, P < 0.05). ConclusionSpinal ROM correlates with gross motor function in children with bilateral spastic cerebral palsy.

Objective:To investigate the effect of different blood glucose and BMI levels on the outcome of closed biliary surgery in diabetic patients.Methods:Clinical data of 424 diabetes admitted to Shanxi Provincial People’s Hospital for closed biliary tract surgery from Jan. 2018 to Jun. 2019 were retrospectively analyzed. According to the fasting blood glucose and BMI levels, the subjects were divided into hyperglycemia and non-hyperglycemia groups and obesity and non-obesity subgroups. The differences of clinical data among different groups were compared and analyzed. Multiple regression analysis was used to analyze the factors of postoperative infection, length and cost of hospitalization.Results:①Compared with the non-hyperglycemia group, the hyperglycemia group had higher BMI, serum creatinine, blood urea nitrogen, blood glucose monitoring rate, glycated hemoglobin detection rate, postoperative infection rate, ICU occupancy rate, length and cost of hospitalization, and lower albumin level, all P<0.05.②The age, fasting blood glucose, serum creatinine, low density lipoprotein, length and cost of hospitalization in the hyperglycemic obese subgroup were all lower than those in the non-obese subgroup, all P<0.05; and the serum creatinine in the obese subgroup was higher than those in the non-obese subgroup ( P<0.05) . ③Logistic analysis revealed that hyperglycemia was an independent risk factor for postoperative infection. For every 1mmol/L increase in fasting blood glucose, the risk of postoperative infection increased by 1.158 times, and albumin was a protective factor for postoperative infection. ④Multiple linear regression analysis showed that hyperglycemia and hypoalbumin were the important factors affecting the length of hospital stay and the increase of hospital cost, all P<0.05. Conclusions:Hyperglycemia is an independent risk factor for postoperative infection and a risk factor for longer hospital stay and higher costs. Obesity is not associated with postoperative infection or longer hospital stay, except for increased serum. Patients with diabetes undergoing closed biliary system surgery need to improve the detection rate of glycated hemoglobin and blood glucose monitoring rate, manage blood glucose reasonably, and control body weight appropriately.

Objective:To analyze clinicopathological features of thyroid nodules and to assess preoperative diagnostic methods for the nature of nodules.Methods:The clinical and pathological data of 2 132 patients [456 males and 1 676 females with a mean age of (48.7±11.4) year] with thyroid nodules who underwent surgical treatment in our hospital from January 2017 to December 2019 were retrospectively analyzed. Among all patients, 433 nodules had complete fine needle aspiration biopsy cytology (FNAC) and ultrasound results were selected for further assessment. According to preoperative high-resolution ultrasound images, the nodules were classified by Kwak thyroid imaging and reporting data systems (Kwak TI-RADS) and American College of Radiology TI-RADS (ACR TI-RADS). ROC curve was used to assess the diagnostic efficacy of the two ultrasound modes and FNAC.Results:In 2 132 patients with thyroid nodules, 743 were benign and 1 389 were malignant. In all malignant cases 1 119 were females, accounting for 80.56%. In newly diagnosed benign nodules, 67.97% (505/743) were found by examination, and 32.03% (238/743) were self-found. In malignant nodules, 48.67% (676/1 389) were detected by examination, 51.33% (713/1 389) were self-found. The malignant rate of nodule diameter≤1 cm was the lowest in 1 118 patients with complete thyroid ultrasound data. In 628, 722 and 782 patients who underwent surgical treatment in 2017, 2018 and 2019, the proportion of malignant nodules was 56.37% (354/628), 66.48% (480/722) and 70.97% (555/782); the proportion of benign nodules was 43.63% (274/628), 33.52% (242/722) and 29.03% (227/782), respectively. Among all malignant nodules, papillary carcinoma accounted for 95.18% (1 322/1 389), followed by follicular carcinoma 4.32% (60/1 389), myeloid carcinoma 0.43% (60/1 389) and undifferentiated carcinoma 0.07%(1/1 389). Among all benign nodules, the proportion of nodular goiter was the highest (95.56%, 710/743). The proportion of patients undergoing preoperative FNAC in 2017, 2018 and 2019 was 57.96% (364/628), 63.43% (458/722) and 69.44% (543/782), respectively;the coincidence rate of preoperative FNAC and postoperative pathological diagnosis was 46.15% (168/364), 52.18% (239/458) and 62.06% (337/543), respectively. Among 433 nodules with both FNAC and ultrasound data, the areas under the ROC curve(AUC)of FNA, ACR TI-RADS and Kawk TI-RADS were 0.91, 0.74 and 0.59, respectively ( P<0.05). The sensitivity of ACR TI-RADS and Kawk TI-RADS was 84.34%, 37.35% ( P<0.05) and specificity was 56.29% and 79.14% ( P=0.075). Conclusions:The study reveals that from 2017 to 2019, both the number of cases and malignant rate of thyroid nodules shows a rising trend, meanwhile the application rate of preoperative FNAC and its coincidence rate with postoperative pathology shows an increasing trend. FNAC, ACR Ti-RADS and Kawk TI-RADS have certain diagnostic efficacy in differentiating benign and malignant thyroid nodules, and the diagnostic value of FNAC is the highest followed by ACR TI-RADS and Kawk TI-RADS.

Objective To analyze the hemodynamic changes of cerebral arteries in patients with chronic extracranial internal carotid artery occlusion (EICAO).Methods Ninety-six patients with chronic unilateral EICAO who were admitted to Kailuan General Hospital from September 2012 to December 2015 were selected as the case group (EICAO group),and 30 volunteers were selected as the control group.Color transcranial Doppler ultrasonography was used to detect the anterior communicating artery (ACOA) of the grade Ⅰ collateral circulation,the posterior communicating artery (PCOA),the ocular artery of the grade Ⅱ collateral circulation,and the pial collateral branch.Circulation rate and cerebral hemodynamic parameters:(Mean blood flow velocity (Vm) and pulsatility index).Results In the left and right EICAO groups,the opening rates of collateral circulation at grade Ⅰ were 86.96％ (40/46),96.00％ (48/50) and 78.26％ (36/46) and 88.00％ (44/50) respectively.There were significant differences in the opening rates of collateral circulation at grade Ⅰ between the two groups (x2 =4.114,P =0.043).There was no significant difference in the opening rates of collateral circulation at grade Ⅱ between the two groups (x2 =3.544,P =0.060).The left and right sides of EICAO group were compared with the same side of control group.The Vm of the common carotid artery (left side of the EICAO group (24.08 ± 9.25) cm/s),left side of the control group (32.52±3.28) cm/s,P＜0.01);right side of the EICAO group (22.20±5.51) cm/s),right side of the control group(31.58±3.35) cm/s,P＜0.01)) and the end-carotid artery end stage (TICA) The pulsation index (left side of left EICAO group (0.78 ±0.17),left side of control group (0.92±0.08),P ＜0.01);right side of right EICAO group (0.75 ± 0.19),right side of control group (0.91 ± 0.10),P ＜0.01),Vm of middle cerebral artery (MCA) (left side of left EICAO group(40.29 ±20.61) cm/s,left side of control group(55.72 ±5.60) cm/s,right side of EICAO;The right side of group (37.10±19.70) cm/s),the right side of control group (53.70±6.28) cm/s,P＜0.01),the pulsation index of MCA (left side of left EICAO group(0.74±0.19),left side of control group(0.87±0.10),P＜0.01;right side of right EICAO group (0.69±0.23),right side of control group:(0.90 ± 0.08),P ＜ 0.01).There were significant differences.NIHSS score of neurological impairment:normal 17.39％ (8/46),mild 39.13％ (18/46),moderate 30.44％ (14/46),moderate severe 13.04％ (6/46) in left EICAO group,and normal 18.00％ (9/50),mild 54.00％ (27/50),moderate 24.00％ (12/50),moderate severe 4.00％ (2/50) in right EICAO group.There was no significant difference between the two groups (P =0.178).Conclusion The ipsilateral common carotid artery and its distal middle cerebral artery in patients with chronic unilateral internal carotid artery occlusionshow hypoperfusion of hemodynamics,accompanied by neurological impairment.

Off-label drug use to some extent meets the clinical medication,achieves the most needed treat-ment of patients and promotes the development of medicine,but there exists certain risks at the same time.Through the analysis of the phenomenon of off-label drug use,from the perspective of medical ethics,this paper proposed that it should adhere to the principles of beneficence and respect,specifically,correcting the motives of off-label drug use,strict review of supporting evidence,ensuring patient's informed consent,strengthening ethical review andintroducing the insurance sharing mechanism,so as to achieve both the guarantee of patient's medication safety and the aversion of medical personnel's practice risks.