Objective To explore the correlation of MET status in patients with advanced prostatic acinar adenocarcinoma with the clinical pathological parameters and prognosis. Methods The specimen from 135 patients with advanced prostatic acinar adenocarcinoma was included. The expression of c-MET protein was detected via immunohistochemistry, and MET gene amplification was assessed by fluorescence in situ hybridization. The relationships of c-MET expression and gene amplification with clinicopathological features and prognosis were analyzed. Results The positive expression rate of c-MET was 52.60% (71/135). Compared with the c-MET expression in adjacent tissues, that in tumor tissues showed lower heterogeneous expression. Among the cases, 1.71% (2/117) exhibited MET gene polyploidy, but no gene amplification was detected. Positive c-MET expression was significantly correlated with high Gleason scores and grade groups (P=0.0073). However, no significant relationship was found between c-MET expression and progression-free survival or post-treatment t-PSA levels. Conclusion c-MET protein is expressed at a relatively low level in advanced prostatic acinar adenocarcinoma, suggesting that c-MET may not be a viable target for ADC drug development in prostatic acinar adenocarcinoma.

Objective:To compare the results of invasive prenatal diagnosis and preimplantation genetic testing (PGT) and explore the underlying mechanism.Methods:Clinical data of pregnant women undergoing PGT and invasive prenatal diagnosis at the Sixth Affiliated Hospital of Sun Yat-sen University from January 2019 to December 2022 were collected. The results of PGT and invasive prenatal diagnosis were compared, and the outcomes of pregnancies were followed up. This study has been approved by the Medical Ethics Committee of the the Sixth Affiliated Hospital of Sun Yat-sen University (No. 2022SLYEC-491).Results:A total of 172 couples were included in this study, and 26 non-targeted variants were discovered upon prenatal diagnosis, including 10 cases (38.5%) by chromosomal karyotyping, 15 (57.7%) by chromosomal microarray analysis (CMA), and 1 (3.8%) by whole exome sequencing. The 10 karyotypic anomalies had included 6 chromosomal polymorphisms, 2 chromosomal mosaicisms, 1 paternally derived translocation, and 1 missed maternal chromosomal inversion. CMA has identified 15 copy number variations (CNVs), which included 11 microdeletions and microduplications, 3 loss of heterozygosity, and 1 low-level mosaicism of paternal uniparental disomy. One CNV was classified as pathogenic, and another one was likely pathogenic, whilst the remaining 13 were classified as variants of uncertain significance. Therefore, 8.7% of CNVs was detected by invasive prenatal diagnosis after PGT. 92.3% (24/26) of the non-targeted variants have been due to technological limitations of next-generation sequencing (NGS).Conclusion:Invasive prenatal diagnosis after PGT can detect non-targeted variants, which may further reduce the incidence of birth defects.

Obstructive sleep apnea(OSA)is an independent risk factor for several cardiovascular diseases,and its characteristic intermittent hypoxic environment induces dysregulation of miRNA in cells and circulation,which promotes cellular dysfunction and metabolic disorders,and participates in the formation of atherosclerosis(As).This article re-views the potential role of miRNA in the occurrence and progression of OSA-related As,which helps to understand the mo-lecular pathways underlying the pathogenesis of OSA-related As and provides new insights for the development of miRNA based therapies for OSA-related cardiovascular diseases.

Objective:To evaluate the effectiveness of oral-nasal oxygen supply mouth guard in painless gastroscopy for snoring patients.Methods:The snoring patients who underwent painless gastroscopy at two Endoscopy Centers of Shanghai East Hospital, Tongji University in July 2022 were randomly divided into the observation group (using oral-nasal oxygen supply mouth guard) and the control group (using ordinary nasal oxygen tube and mouth guard). Parameters such as the wearing time and the removal time of the mouth guard, lowest pulse oxygen saturation (SpO 2), incidence of hypoxemia, and the satisfaction of medical staff were compared between the two groups. Results:The wearing time of mouth guard was 11.63±0.84 seconds and the removal time was 5.33±0.76 seconds in the observation group ( n=40), which were lower than those in the control group ( n=47) (14.91±1.21 seconds, t=-14.463, P<0.001; 10.38±0.80 seconds, t=-30.095, P<0.001). The wearing satisfaction score was 9.80±0.61, the lowest SpO 2 was (96.70±3.42)%, the removal satisfaction score was 9.75±0.67, and the anesthesiologists' satisfaction score was 9.20±1.42 in the observation group, which were higher than those in the control group [7.70±0.93, t=12.209, P<0.001; (94.06±3.72)%, t=3.417, P=0.001; 7.96±0.98, t=9.803, P<0.001; 8.13±1.35, t=3.615, P=0.001] with significant difference. There was no significant difference in the incidence of hypoxemia [10.00% (4/40) VS 14.89% (7/47), χ2=0.130, P=0.718] and endoscopic physician satisfaction score (9.30±0.97 VS 9.02±1.31, t=1.112, P=0.269) between the two groups. Conclusion:The oral-nasal oxygen supply mouth guard is easy to wear and remove, effectively reducing SpO 2 fluctuations during painless gastroscopy for snoring patients. It can enhance medical staff satisfaction with high clinical value.

OBJECTIVE To investigate whether aldo-keto reductases(AKRs)can act as a nitrore-ductase(NR)and bioactivate aristolochic acid Ⅰ(AA-Ⅰ)to produce AA-Ⅰ-DNA adducts.METHODS① Human-induced hepatocytes(hiHeps)and human bladder RT4 cells were used as tool cells and treated with AA-Ⅰ0,0.5,1.0 and 2 μmol·L-1 for 24 h.Cell viability was detected using the CCK-8 method,and the half maximal inhibition concentration(IC50)was calculated using the CCK-8 method and the level of DNA adduct production was calculated.②hiHeps and RT4 cells were treated with AKR inhibitor luteotin(0,5,10 and 25 μmol·L-1)+AA-Ⅰ 0.2 and 1.0 μmol·L-1 for 24 h,respectively,and the levels of DNA adducts were detected by a liquid chromatography-tandem mass spectrometer(LC-MS/MS).③hiHeps cells were incubated with 80 nmol·L-1 small interfering RNAs(si-AKRs)for 48 h and treated with AA-Ⅰ1.0 μmol·L-1 for 24 h.Real-time qualitative PCR(RT-qPCR)method was used to detect the mRNA expression of AKRs gene and LC-MS/MS technology was used to investigate the effect of specific AKR gene knockdown on DNA adduct levels.④500 nmol·L-1 human AKR recombinant proteins AKR1A1 and AA-Ⅰwere incubated in vitro under anaerobic conditions and the formation of AA-Ⅰ-DNA adducts was detected.RESULTS ①The IC50 of AA-Ⅰto hiHeps and RT4 cells was 1.9 and 0.42 μmol·L-1,respec-tively.The level of DNA adduct production of the two cell lines was significantly different(P<0.01).② Luteolin≥5 μmol·L-1 significantly inhibited the production of AA-Ⅰ-DNA adducts in both cells(P<0.05),and there was a concentration-dependent effect in hiHeps cells(P<0.01,R=0.84).③In the AKR family,the knockdown of AKR1A1 gene up to 80%inhibited the generation of AA-Ⅰ-DNA adducts by 30%-40%.④The AA-Ⅰ-DNA adducts were detected in the incubation of recombinant protein AKR1A1 and AA-Ⅰ under anaerobic conditions in vitro,approximately 1 adduct per 107 nucleotides.CONCLU-SION AKR1A1 is involved in AA-Ⅰ bioactivation,providing a reference for elucidation of the carcino-genic mechanism of AA-Ⅰ.

Objective:To investigate the risk factors for liver cancer after splenectomy in patients with cirrhosis.Methods:The clinical data of 150 patients diagnosed with hepatitis B associated cirrhosis, portal hypertension, and hypersplenism who underwent splenectomy at Shaanxi Provincial People's Hospital and the First Affiliated Hospital of Xi'an Jiaotong University from March 2000 to November 2012 were retrospectively analyzed. There were a total of 150 patients included, 114 males and 36 females, aged (44±10) years old. General information, intraoperative conditions, and postoperative complications of the patients were documented. The postoperative progress of patients was monitored by telephone or outpatient follow-up. Based on the follow-up results regarding liver cancer presence, all patients were categorized into two groups: liver cancer group ( n=42) and non-liver cancer group ( n=108). Multivariate analysis was employed to identify factors influencing the liver cancer occurrence after splenectomy. Kaplan-Meier survival analysis along with log-rank test was utilized to assess overall survival and survival rate comparison. Results:Compared to the non-liver cancer group, the liver cancer group exhibited an increased prevalence of hypertension, direct bilirubin levels, prothrombin time, maximum spleen diameter, and postoperative thrombosis (all P<0.05). However, there was a significant reduction in the number of patients receiving long-term regular antiviral therapy and postoperative bleeding (all P<0.05). The multivariate analysis revealed that preoperative hypertension ( OR=6.310, 95% CI: 1.729-23.024, P=0.005), spleen diameter exceeding 12 cm ( OR=5.338, 95% CI: 1.234-23.094, P=0.025), and occurrence of postoperative thrombosis ( OR=8.652, 95% CI: 2.700-27.729, P<0.001) in patients with hepatitis B-related liver cirrhosis and portal hypertension were associated with an increased risk of developing liver cancer following splenectomy. Patients who receive long-term regular antiviral treatment after surgery ( OR=0.143, 95% CI: 0.038-0.545, P=0.004) have a lower risk of developing liver cancer. There was no statistically significant difference observed in the cumulative survival rate between the liver cancer group and the non-liver cancer group ( χ2=1.74, P=0.187). Conclusion:Preoperative hypertension, spleen diameter exceeding 12 cm, and postoperative thrombosis are independent risk factors for liver cancer in patients with hepatitis B-related cirrhosis and portal hypertension after splenectomy. Additionally, postoperative long-term antiviral therapy serves as an independent protective factor.

Establishing a full-cycle contract management model for comprehensive public hospitals has practical signifi-cance for the development of smart hospitals.The aim is to create a hierarchical and classified contract management system fo-cused on information sharing.The method involves outlining the systematic processes of contract management within the hospital,analyzing common issues from multiple dimensions-such as management processes,level of information technology,and process supervision-and proposing solutions to meet the requirements of modern public smart hospital contract management.Based on in-formation sharing and hierarchical management,this approach offers ideas for refined management in hospitals and promotes the high-quality development of comprehensive medical services in smart hospitals..

Objective:To construct a thirst management scheme for adult surgical patients and provide practical guidance for nurses to carry out perioperative thirst management.Methods:From April to May 2023, literature search was conducted to extract domestic and foreign evidence related to thirst, and after group discussion, a preliminary management plan for thirst in adult surgical patients was constructed. From May to June 2023, 18 experts were selected for two rounds of Delphi expert letter consultation, and a formal plan for thirst management of adult surgical patients was discussed and revised according to expert opinions.Results:A total of 18 experts completed two rounds of expert letter consultation. The effective recovery rate of the questionnaire was 100.00% and the expert authority coefficient was 0.915. The coefficients of variation for the importance and operability scores of the first round of expert inquiry were 0.05-0.25 and 0.06-0.42, respectively, and the Kendall's harmony coefficients were 0.224 and 0.184 ( P<0.01). The coefficients of variation for the importance and operability scores of the second round of inquiry were 0.05-0.23 and 0.06-0.24, respectively, and the Kendall's harmony coefficients were 0.166 and 0.154 ( P<0.01). The final thirst management scheme included five primary items (preliminary preparation, identification and evaluation, preoperative relief strategies, postoperative intervention measures and effectiveness evaluation) and 23 secondary items. Conclusions:The thirst management scheme for adult surgical patients constructed in this study is scientific and comprehensive, which can provide a reference basis for clinical practice.

Objective:To conduct a scoping review on the application of family resilience intervention in adults with chronic disease.Methods:Related studies published from database establishment to October 30, 2023 were systematically searched on PubMed, Web of Science, Cochrane Library, PsycINFO, CINAHL, Scopus, China National Knowledge Infrastructure, Wanfang Data, VIP, and China Biomedical Database. The included literature was summarized and analyzed.Results:A total of 9 articles were included. The intervention elements for family resilience included increasing awareness of diseases and family characteristics, solving and responding to family problems, engaging in family interaction and communication, integrating internal and external resources, and providing psychological and technical support. The outcome indicators were the level of family resilience and effectiveness.Conclusions:The intervention of family resilience in adults with chronic disease has certain effectiveness and clinical significance, but research is still in the exploratory stage. Further high-quality research is needed to verify the long-term intervention effect and feasibility, and to construct a diversified family resilience intervention program suitable for China.

Objective:To explore the influencing factors of postoperative abdominal infection in critically ill patients with trauma.Methods:A retrospective case-control analysis was conducted on the clinical data of 82 patients who underwent critical surgery in Beijing Shijingshan Hospital from July 2020 to September 2023. There were 52 males and 30 females. Age ranged from 19 to 63 years old, with an average age of (44.50±14.55) years. According to whether the patient has developed infection after surgery, they were divided into an infected group ( n=20) and an uninfected group ( n=62). To compare the differences between the two groups intraoperative data (bleeding volume, cholangioenterostomy, crystal infusion volume, colloid infusion volume, laparoscopic use, operation time and surgical incision length) and postoperative data (ascites, anastomotic leakage, preventive stoma, pulmonary infection). Normally distributed measurement data were expressed as mean±standard deviation ( ± s), and independent samples t-test was used for comparison between groups; Chi-square test was used for comparison between groups for count data. Single factor analysis and multivariate Logistic regression were used to analyze the risk factors for postoperative abdominal infection in critically ill patients with trauma. Results:The number of cases of biliary intestinal anastomosis, bleeding volume, crystal infusion volume, and colloid infusion volume in the infected group were 12 cases, (573.26±206.21) mL, (4 531.0±258.0) mL, and (1 612.0±96.0) mL, respectively. The uninfected group was 14 cases, (468.25±174.21) mL, (2 753.0±226.0) mL, and (1 105.0±85.0) mL, respectively. The difference between the two groups was statistically significant ( P<0.05). The incidence rates of postoperative ascites, anastomotic fistula, prophylactic stoma, and postoperative pulmonary infection in the infected group were 25.00%, 65.00%, 25.00%, and 55.00%, respectively, while those in the non infected group were 9.68%, 27.42%, 51.61%, and 24.19%, respectively. The difference between the two groups was statistically significant ( P<0.05). Multivariate logistic regression analysis showed that postoperative ascites, biliary intestinal anastomosis, postoperative anastomotic fistula, and postoperative pulmonary infection ( OR=5.504, 4.432, 18.172, 7.687, 95% CI: 1.456-20.754, 1.175-16.669, 4.752-69.418, 2.141-27.595, P<0.05) were risk factors for the risk of postoperative abdominal infection. Conclusion:The risk factors for postoperative abdominal infection in critically ill patients with trauma include postoperative ascites, biliary intestinal anastomosis, postoperative anastomotic fistula, and postoperative pulmonary infection. Special attention needs to be paid to postoperative monitoring and treatment.