Objective To investigate the role of RNA-binding motif protein X-linked(RBMX)in regulating the proliferation,migration,invasion and glycolysis in human bladder cancer cells.Methods A lentivirus vectors system and RNA interference technique were used to construct bladder cancer 1376 and UC-3 cell models with RBMX overexpression and knockdown,respectively,and successful cell modeling was verified using RT-qPCR and Western blotting.Proliferation and colony forming ability of the cells were evaluated using EdU assay and colony-forming assay,and cell migration and invasion abilities were determined using Transwell experiment.The expressions of glycolysis-related proteins M1 pyruvate kinase(PKM1)and M2 pyruvate kinase(PKM2)were detected using Western blotting.The effects of RBMX overexpression and knockdown on glycolysis in the bladder cancer cells were assessed using glucose and lactic acid detection kits.Results RT-qPCR and Western blotting confirmed successful construction of 1376 and UC-3 cell models with RBMX overexpression and knockdown.RBMX overexpression significantly inhibited the proliferation,clone formation,migration and invasion of bladder cancer cells,while RBMX knockdown produced the opposite effects.Western blotting results showed that RBMX overexpression increased the expression of PKM1 and decreased the expression of PKM2,while RBMX knockdown produced the opposite effects.Glucose consumption and lactate production levels were significantly lowered in the cells with RBMX overexpression(P<0.05)but increased significantly following RBMX knockdown(P<0.05).Conclusion RBMX overexpression inhibits bladder cancer progression and lowers glycolysis level in bladder cancer cells by downregulating PKM2 expression,suggesting the potential of RBMX as a molecular target for diagnosis and treatment of bladder cancer.

Objective To investigate the role of RNA-binding motif protein X-linked(RBMX)in regulating the proliferation,migration,invasion and glycolysis in human bladder cancer cells.Methods A lentivirus vectors system and RNA interference technique were used to construct bladder cancer 1376 and UC-3 cell models with RBMX overexpression and knockdown,respectively,and successful cell modeling was verified using RT-qPCR and Western blotting.Proliferation and colony forming ability of the cells were evaluated using EdU assay and colony-forming assay,and cell migration and invasion abilities were determined using Transwell experiment.The expressions of glycolysis-related proteins M1 pyruvate kinase(PKM1)and M2 pyruvate kinase(PKM2)were detected using Western blotting.The effects of RBMX overexpression and knockdown on glycolysis in the bladder cancer cells were assessed using glucose and lactic acid detection kits.Results RT-qPCR and Western blotting confirmed successful construction of 1376 and UC-3 cell models with RBMX overexpression and knockdown.RBMX overexpression significantly inhibited the proliferation,clone formation,migration and invasion of bladder cancer cells,while RBMX knockdown produced the opposite effects.Western blotting results showed that RBMX overexpression increased the expression of PKM1 and decreased the expression of PKM2,while RBMX knockdown produced the opposite effects.Glucose consumption and lactate production levels were significantly lowered in the cells with RBMX overexpression(P<0.05)but increased significantly following RBMX knockdown(P<0.05).Conclusion RBMX overexpression inhibits bladder cancer progression and lowers glycolysis level in bladder cancer cells by downregulating PKM2 expression,suggesting the potential of RBMX as a molecular target for diagnosis and treatment of bladder cancer.

We aimed to evaluate the effectiveness and safety of single-course initial regimens in patients with low-risk gestational trophoblastic neoplasia (GTN). In this trial (NCT01823315), 276 patients were analyzed. Patients were allocated to three initiated regimens: single-course methotrexate (MTX), single-course MTX + dactinomycin (ACTD), and multi-course MTX (control arm). The primary endpoint was the complete remission (CR) rate by initial drug(s). The primary CR rate was 64.4% with multi-course MTX in the control arm. For the single-course MTX arm, the CR rate was 35.8% by one course; it increased to 59.3% after subsequent multi-course MTX, with non-inferiority to the control (difference -5.1%,95% confidence interval (CI) -19.4% to 9.2%, P = 0.014). After further treatment with multi-course ACTD, the CR rate (93.3%) was similar to that of the control (95.2%, P = 0.577). For the single-course MTX + ACTD arm, the CR rate was 46.7% by one course, which increased to 89.1% after subsequent multi-course, with non-inferiority (difference 24.7%, 95% CI 12.8%-36.6%, P < 0.001) to the control. It was similar to the CR rate by MTX and further ACTD in the control arm (89.1% vs. 95.2%, P =0.135). Four patients experienced recurrence, with no death, during the 2-year follow-up. We demonstrated that chemotherapy initiation with single-course MTX may be an alternative regimen for patients with low-risk GTN.
Antineoplastic Combined Chemotherapy Protocols/adverse effects* ; Dactinomycin/adverse effects* ; Female ; Gestational Trophoblastic Disease/drug therapy* ; Humans ; Methotrexate/therapeutic use* ; Pregnancy ; Retrospective Studies

Objective:To retrieve and summarize the evidence on early enteral nutrition in critically ill patients with prone position ventilation.Methods:The relevant evidence on early enteral nutrition in critically ill patients with prone position ventilation was systematically searched through computer in domestic and foreign guideline websites, institutional websites and databases. The quality was assessed using the literature evaluation criteria and systematic review evaluation tools of the Joanna Briggs Institute (JBI) Evidence-Based Health Care Center in Australia. The retrieval time limit was from January 1, 2015 to November 11, 2020.Results:A total of 10 articles were included, involving one clinical decision, four guidelines, three systematic reviews, and two original literature. A total of 18 pieces of evidence from 7 aspects were summarized on early enteral nutrition assessment, restart timing, body position, feeding program (intake, transgastric/postpyloric feeding, nasogastric feeding rate, nutritional preparations) , monitoring (gastric residual volume, gastric antral motility index) , drug prevention, staffing and training.Conclusions:This study summarizes the evidence of early enteral nutrition in critically ill patients with prone position ventilation, and provides evidence-based evidence for nursing managers to formulate enteral nutrition plans scientifically.

OBJECTIVE：To systematically evaluate the effects of phenytoin on 3 kinds of cardiovascular disease-related factors （Folic acid ，vitamin B 12 and homocysteine）in epilepsy patients ，and to provide evidence-based reference for clinical treatment of epilepsy. METHODS ：Retrieved from PubMed ，Google scholar ，CJFD，VIP and Wanfang database ，observational studies about using phenytoin （trial group ） versus using no antiepileptics （control group ） on the levels of folic acid ，vitamin B 12 and homocysteine in serum were collected during Jan. 1991-Jan. 2019. After data extraction of included literatures ，quality evaluation with evaluation criteria for cross-sectional study （AHRQ）scale，Rev Man 5.3 and Stata 11 softwares were used for statistical analysis. RESULTS ：A total of 10 studies were included ，involving 745 patients. Meta-analysis showed that the folic acid level of trial group was significantly lower than control group [SMD ＝－0.90，95％CI（－1.18，－0.62），P＜0.001]；the level of homocysteine in trial group was significantly higher than control group [SMD ＝1.22，95％CI（0.73，1.71），P＜0.001]. There was no significant difference in the levels of vitamin B 12 between 2 groups [SMD ＝－ 0.19，95％ CI（－ 0.39，0.02），P＞0.05]. CONCLUSIONS：Phenytoin can reduce the level of folic acid and increase the level of homocysteine in epilepsy patients.

Objective By investigating the obesity of the adult population in Hunan,we explored the relationship between body mass index (BMI) [including waist circumference (WC),waist-to-hip ratio (WHR),waist-to-body ratio (WHtR) and H-type hypertension] in predicting H-type hypertension.Methods A multi-stage random sampling method was used to conduct a questionnaire survey,physical examination and laboratory testing on 4 012 adults ＞ 30 years old in 6 districts of Hunan Province.The receiver operator characteristic (ROC) curve was used to evaluate the predictive effects of BMI,WC,WHR and WHtR on H-type hypertension.Results ROC curve analysis indicated that the area under curve (AUC) of the evaluation of H-type hypertension of WC,WHtR,WHR and BMI in men were:0.637,0.640,0.601,0.639,of which the largest were combination of WC + BMI and WHtR + BMI,both being 0.647.In women,the AUC of individual indexes WC,WHtR,WHR and BMI for evaluating H-type hypertension were 0.660,0.670,0.660 and 0.604 respectively.The combination of WHtR and WHR had the largest AUC,which was 0.675.The WC for evaluating H-type hypertension in youth people had the largest AUC (0.732);the WC + BMI,WHR + BMI for evaluating H-type hypertension in middle-aged people had the largest AUC,all being 0.687;the WC predicted the largest AUC of H-type hypertension in elderly people (0.590).Conclusions WC,WHtR,WHR and BMI are important predictors of H-type hypertension.The optimal indicators for different genders and ages are different,and the combined indicators are better than the individual indicators.

Objective? To explore the clinical effects of traditional Chinese medicine at the acupoint on gastrointestinal function recovery after abdominal surgery. Methods? Totally 84 patients receiving laparoscopy were divided into the observation group (n=42) and the control group (n=42) using randomized, double-blinded and placebo controls. Patients in the observation group received traditional Chinese medicine at the acupoint, while patients in the control group received placebo. Both groups were observed continuously for 3 days. Time of postoperative borborygmus recovery, time of first exhaust, and time of first defecation were compared between the two groups postoperatively, and safety evaluation was performed. Results? The time of borborygmus recovery of the observation group was 15.5 (13-22) h, and the time of first defecation was 45.5 (29-62) h, both lower than those of the control group (Z=2.40, 2.05; P＜ 0.05). The time of first exhaust of the control group was 18 (15-27) h, and there was no statistically significant difference as compared with the observation group (Z=1.96,P=0.05). Neither group showed adverse effects on local skin after the use of traditional Chinese medicine. Conclusions? Traditional Chinese medicine at the acupoint can promote gastrointestinal function recovery after abdominal surgery, which is simple, easy, cheap and effective and is worth promoting in clinical practice.

Objective To evaluate the effects of different depths of sedation on postoperative cognitive function in elderly patients with mild cognitive impairment.Methods A total of 100 patients with mild cognitive impairment before surgery,aged 65-75 yr,weighing 55-75 kg,of American Society of Anesthesiologists physical status Ⅱ or Ⅲ,scheduled for elective gynecological surgery under general anesthesia,were divided into Ⅰ and Ⅱ groups (n =50 each) using a random number table method.Propofol was given by closed-loop target-controlled infusion,and the target plasma concentration was automatically regulated.The bispectral index value was maintained at 40-50 in group Ⅰ and at＞50-60 in group Ⅱ.Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) were used to evaluate the cognitive function at 1 day before operation (T0) and 7 days after operation (T1),and the development of postoperative cognitive dysfunction (POCD) was recorded.Venous blood samples were collected at T0 and T1 for determination of the concentrations of serum interleukin-10 (IL-10) and tumor necrosis factor-alpha (TNF-α) by enzyme-linked immunosorbent assay.Results Compared with the baseline value at T0,MoCA and MMSE scores were significantly decreased at T1,and the serum concentrations of IL-10 and TNF-α were increased in both groups (P＜0.05).Compared with group Ⅰ,MoCA and MMSE scores were significantly decreased at T1,and the incidence of POCD was increased,the serum concentration of TNF-α was increased,and the serum concentration of IL-t0 was decreased in group Ⅱ (P ＜ 0.05).Conclusion Maintaining BIS value at 40-50 during operation can decrease the development of POCD in elderly patients with mild cognitive impairment,which may be related to reduced systemic inflammatory responses.

Objective To explore the effect of TCM external treatment on the patients with hyperplasia of mammary glands by meta-analysis.Methods Literatures about TCM external treatment on the patients with hyperplasia of mammary glands that were published on domestic or international magazines were extensively solicited and assessed with uniform effect criteria. The total number and valid number of patients in these literatures were counted, and the literatures were also assessed and chosen by meta-analysis with Review Manager 5.3.OR values and a 95% confidence interval (CI) were calculated and consolidated.Results Finally, totally 11 literatures and 945 patients were included in our study, of which 464 received TCM external treatment, an effective rate of 89.22%, while the control group included a total of 481 patients, an effective rate of 82.33%. TCM external treatment showed the same effect on hyperplasia of mammary glands as the oral liquid of Chinese medicines, massage and acupuncture did [OR=1.91,95%CI (0.74-4.97)]. When comparing the effect of TCM external treatment and Rupixiao oral liquid on hyperplasia of mammary glands, totally 6 literatures and 509 patients were included in the study, of which 258 received TCM external treatment, an effective rate of 97.29%, while 251 patients took Rupixiao oral liquid, an effective rate of 88.45%. TCM external treatment had a significantly better effect than Rupixiao oral liquid [OR=4.52,95%CI (1.98-10.33)].Conclusions TCM external treatment has the same effect with oral liquid of Chinese medicines, massage and acupuncture, while TCM external treatment on hyperplasia of mammary glands which promotes the circulation of qi and blood and eliminates phlegm and frees channels has a significantly better effect than Rupixiao oral liquid. It suggests that in our clinical work we should treat patients based on whatever methods they can withstand so as to improve their satisfaction.