Objective:To assess the diagnostic performance of a panel of autoantibodies against multiple tumor-associated antigens (BRCA2, P53, ANXA11, PARP1, TRIM21, ATAD2, NY-ESO-1 and CAGE) in the detection of breast cancer.Methods:This was a retrospective case-control study. A total of 545 patients diagnosed with breast cancer (BC) by pathological examination, and eligible for enrolment at Jiangsu Cancer Hospital from January 2022 to December 2023 were selected as the patient group. In the same period, 200 patients with benign breast disease (BD) and 200 healthy individuals (HC) were included. Enzyme-linked immunosorbent assay (ELISA) was used to detect the serum levels of tumor-associated autoantibodies in each group. The tumor markers including carcinoembryonic antigen (CEA), glycoconjugate antigen 125 (CA125) and glycoconjugate antigen 153 (CA153) were detected using electrochemiluminescence. Univariate and multivariate logistic regression analyses were used to screen the factors associated with breast cancer. The receiver operating characteristic (ROC) curve was applied to evaluate diagnostic value.Results:The levels of seven autoantibodies against BRCA2, P53, ANXA11, PARP1, ATAD2, NY-ESO-1 and CAGE were significantly higher in the BC group compared to HC group (all P<0.05). Additionally, the levels of six autoantibodies against BRCA2, P53, PARP1, ATAD2, NY-ESO-1 and CAGE were significantly higher in the BC group than those in BD group (all P<0.05). The levels of PARP1 and ATAD2 in the BD group were higher than those in HC group ( P<0.05). Logistic multivariate analysis revealed that BRCA2 ( OR=1.099, 95% CI 0.824-1.107), P53 ( OR=1.534, 95% CI 0.813-2.898), NY-ESO-1( OR=1.159, 95% CI 0.789-1.712) and CA153 ( OR=1.029, 95% CI 0.778-1.495) were potential indicators for breast cancer (all P<0.05). The ROC curves indicated that the AUCs for breast cancer using BRCA2, P53, NY-ESO-1, and CA153 were 0.602 (95% CI 0.549-0.635), 0.688 (95% CI 0.642-0.734), 0.729 (95% CI 0.677-0.781), 0.714 (95% CI 0.663-0.764), respectively. The sensitivities were 0.405, 0.588, 0.683 and 0.653, while the specificities were 0.770, 0.825, 0.851 and 0.790, respectively. The AUC of the combined detection including BRCA2, P53, NY-ESO-1, and CA153 for breast cancer was 0.857 (95% CI 0.832-0.883), with a sensitivity of 0.719 and a specificity of 0.835. Conclusions:The levels of tumor-associated autoantibodies to BRCA2, P53 and NY-ESO-1 were significantly elevated in breast cancer patients, and the combination of the three autoantibodies and CA153 has high diagnostic value for breast cancer.

Objective:To assess the diagnostic performance of a panel of autoantibodies against multiple tumor-associated antigens (BRCA2, P53, ANXA11, PARP1, TRIM21, ATAD2, NY-ESO-1 and CAGE) in the detection of breast cancer.Methods:This was a retrospective case-control study. A total of 545 patients diagnosed with breast cancer (BC) by pathological examination, and eligible for enrolment at Jiangsu Cancer Hospital from January 2022 to December 2023 were selected as the patient group. In the same period, 200 patients with benign breast disease (BD) and 200 healthy individuals (HC) were included. Enzyme-linked immunosorbent assay (ELISA) was used to detect the serum levels of tumor-associated autoantibodies in each group. The tumor markers including carcinoembryonic antigen (CEA), glycoconjugate antigen 125 (CA125) and glycoconjugate antigen 153 (CA153) were detected using electrochemiluminescence. Univariate and multivariate logistic regression analyses were used to screen the factors associated with breast cancer. The receiver operating characteristic (ROC) curve was applied to evaluate diagnostic value.Results:The levels of seven autoantibodies against BRCA2, P53, ANXA11, PARP1, ATAD2, NY-ESO-1 and CAGE were significantly higher in the BC group compared to HC group (all P<0.05). Additionally, the levels of six autoantibodies against BRCA2, P53, PARP1, ATAD2, NY-ESO-1 and CAGE were significantly higher in the BC group than those in BD group (all P<0.05). The levels of PARP1 and ATAD2 in the BD group were higher than those in HC group ( P<0.05). Logistic multivariate analysis revealed that BRCA2 ( OR=1.099, 95% CI 0.824-1.107), P53 ( OR=1.534, 95% CI 0.813-2.898), NY-ESO-1( OR=1.159, 95% CI 0.789-1.712) and CA153 ( OR=1.029, 95% CI 0.778-1.495) were potential indicators for breast cancer (all P<0.05). The ROC curves indicated that the AUCs for breast cancer using BRCA2, P53, NY-ESO-1, and CA153 were 0.602 (95% CI 0.549-0.635), 0.688 (95% CI 0.642-0.734), 0.729 (95% CI 0.677-0.781), 0.714 (95% CI 0.663-0.764), respectively. The sensitivities were 0.405, 0.588, 0.683 and 0.653, while the specificities were 0.770, 0.825, 0.851 and 0.790, respectively. The AUC of the combined detection including BRCA2, P53, NY-ESO-1, and CA153 for breast cancer was 0.857 (95% CI 0.832-0.883), with a sensitivity of 0.719 and a specificity of 0.835. Conclusions:The levels of tumor-associated autoantibodies to BRCA2, P53 and NY-ESO-1 were significantly elevated in breast cancer patients, and the combination of the three autoantibodies and CA153 has high diagnostic value for breast cancer.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Objective To investigate the effect of melanoma associated antigen D1 (Mage-D1)on mouse femoral bone mass and mineralization ability of mouse bone marrow mesenchymal cells (BMSCs)and its potential molecular mechanism.Methods Female Mage-D1 gene knockout heterozygous mice and male wild-type (WT)mice were subjected as parent mice to breed Mage-D1 gene knockout homozygous (Mage-D1 KO)mice.PCR and agarose gel electrophoresis were used to identify male Mage-D1 knockout (Mage-D1 KO)mice and littermate male wild-type (WT)mice.Micro-CT scanning was performed to observe mouse femoral bone mass,and ELISA and chemical assay were employed to detect serum levels of calcium,phosphorus,calcitonin,and parathyroid hormone in mice.After primary cultured BMSCs were identified with flow cytometry,immunofluorescence staining was utilized to detect the expression of Mage-D1 in BMSCs.BMSCs were infected by Mage-D1 silencing lentivirus,and then the cells were divided into negative control group (sh-NC)and silencing group (sh-Mage-D1).Cell scratch assay was conducted to detect the migration ability of BMSCs,and flow cytometry and CCK-8 assay were conducted to detect the cycle change and proliferation ability of BMSCs.After mineralization induction,alkaline phosphatase (ALP) staining and alizarin red staining were performed;RT-qPCR and Western blotting were used to measure the expression levels of ALP,Runx2 and Col1.RT-qPCR was used to detect mineralization-related genes p75NTR and Msx1.Results Compared with the WT mice,the femoral cortical bone thickness,cortical bone mineral content,cancellous bone mineral content,trabecular number,and cancellous bone surface density were decreased,and trabecular separation was increased in the Mage-D1 knockout homozygous mice (P<0.05).There were no significant changes in the serum levels of calcium,phosphorus,calcitonin and parathyroid hormone in mice after Mage-D1 knockout.Mage-D1 was expressed in the whole BMSCs and was highly expressed in the nucleus and perinuclear regions.Compared with the sh-NC BMSCs,the sh-Mage-D1 group had decreased proliferation ability (P<0.01),enhanced migration ability (P<0.01),and decreased expression of ALP,Runx2 and Col1 genes (P<0.05)and protein (P<0.01)after mineralization induction,milder ALP and alizarin red stain,and lower expression levels of p75NTR and Msx1.Conclusion Mage-D1 knockout can significantly reduce femur bone mass in mice.It can promote the proliferation and inhibit migration of BMSCs,and positively regulate their mineralization in vitro,and the p75NTR-Dlx1/Msx1 signaling axis may be involved in the regulation of bone metabolism by Mage-D1.

Objective:To retrieve, evaluate, and integrate the best evidence of low-fiber diet bowel preparation before colonoscopy in children, providing a basis for clinical nursing practice.Methods:Guidelines, systematic reviews, evidence summaries, expert consensus, randomized controlled trials and so on related to bowel preparation for low-fiber diet before colonoscopy in children were searched through computers in domestic and foreign databases, guideline websites and professional association websites. The search period was from database establishment to October 31, 2021. The evidence included was graded using the Joanna Briggs Institute (JBI) evidence pre-grading and evidence recommendation grading system (2014 version) in Australia.Results:A total of 8 articles were included, including four guidelines, one evidence summary, one systematic review, one expert consensus, and one randomized controlled trial. A total of 25 pieces of evidence were summarized from 7 aspects, including assessment before eating, duration of dietary restriction, dietary content, evaluation indicators, eating effectiveness, bowel preparation methods, and health education.Conclusions:This study strictly follows evidence-based methods and summarizes the best evidence of low-fiber diet bowel preparation before colonoscopy in children. This can provide reference for the standardization of low-fiber diet bowel preparation before colonoscopy in children in China, and improve the quality of bowel preparation before colonoscopy in children.

The incidence rate of nonalcoholic fatty liver disease-related hepatocellular carcinoma (NAFLD-HCC) tends to increase worldwide, while its pathogenesis remains unclear. With reference to the literature in recent years, this article summarizes the role of adipose tissue inflammation, oxidative stress, gut microbiota, and insulin resistance in the pathogenesis of NAFLD-HCC and the advances in the prevention and treatment of the above mechanisms, so as to provide new ideas for the treatment of NAFLD-HCC.

Objective:To investigate the efficacy of transumbilical laparoendoscopic single-site supracervical hysterectomy in the treatment of benign uterine diseases.Methods:The clinical data of 39 patients with benign uterine diseases with the volume of uterus less than that at the 14 weeks of pregnancy who underwent supracervical hysterectomy in People's Hospital of Hechuan District of Chongqing, China between January 2018 and December 2019 were retrospectively analyzed. These patients were divided into transumbilical laparoendoscopic single-site supracervical hysterectomy group (single-site group, n = 21) and transumbilical laparoendoscopic multiple-site supracervical hysterectomy group (multiple-site group, n = 18) according to different surgical approaches. Operation time, specimen removal time, intraoperative blood loss, incision suture time, tissue debris shedding rate, postoperative off-bed time, length of hospital stay, pain score on postoperative day 1, time to anal exhaust, and the incidence of complications within 30 days after surgery were compared between the two groups. Results:Tissue debris shedding rate in the single-site group was significantly lower than that in the multiple-site group [0.00% (0/21) vs. 100.00% (18/18), χ2 = 39.00, P < 0.001]. Operation time in the single-site group was significantly longer than that in the multiple-site group [(74.20 ± 9.15) minutes vs. (62.90 ± 6.20) minutes, t = 3.323, P < 0.05). Specimen removal time and incision suture time in the single-site group were (11.10 ± 2.33) minutes and (3.90 ± 0.88) minutes, respectively, which were significantly longer than those in the multiple-site group [(4.90 ± 0.88) minutes, (2.90 ± 0.74) minutes, t = 7.97, 0.386, both P < 0.05]. There were no significant differences in intraoperative blood loss, postoperative off-bed time, pain score on postoperative day 1, length of hospital stay, time to anal exhaust, and the incidence of complications within 30 days after surgery between the two groups (all P > 0.05). Conclusion:Transumbilical laparoendoscopic single-site and multiple-site supracervical hysterectomy can acquire similar short-term surgical outcomes in the treatment of benign uterine diseases at the time of less than 14 weeks of pregnancy and transumbilical laparoendoscopic single-site supracervical hysterectomy can eliminate the long-term complications caused by tissue dissemination.

Objective:To explore the effect of prophylactic use of anti-osteoporosis drugs on hand function in hemiplegic patients after stroke.Methods:From January 2018 to October 2019, 66 patients with hemiplegia after stroke admitted to the Third Hospital of Quzhou were selected and randomly divided into observation group and control group according to the random digital table method, with 33 cases in each group.The control group was given routine rehabilitation treatment, the observation group was given calcium carbonate D3 combined with calcitriol preventive anti-osteoporosis treatment.The two groups were treated for 12 weeks.Before and after treatment, the Brunnstrom stage score, Fugl Meyer(FMA) score, Wolf exercise score, modified Barthel index score, bone mineral density(BMD) and bone markers were compared between the two groups.Results:After treatment for 4, 8, 12 weeks, the Brunnstrom stage scores of the observation group were (2.97±0.90)points, (3.89±1.04)points, (4.68±1.04)points, respectively, which were higher than those of the control group[(2.46±0.89)points, (3.13±0.97)points, (4.09±0.97)points]( t=2.315, 3.070, 2.383, all P<0.05)and the FMA scores of the observation group were (34.28±5.17)points, (49.12±6.24)points, (55.73±6.74)points, respectively, which were higher than those of the control group [(30.07±5.05)points, (44.78±6.03)points, (50.10±6.71)points] ( t=3.346, 2.873, 3.401, all P<0.05), and the Wolf exercise scores of the observation groupwere (1.83±0.45)points, (2.91±0.64)points, (3.96±0.91)points, which were higher than those of the control group [(1.49±0.49)points, (2.28±0.57)points, (3.42±0.83)points] ( t=2.936, 4.223, 2.519, all P<0.05), and the Barthel index scores of the observation group were (59.12±5.73)points, (71.34±6.03)points, (78.98±6.89)points, respectively, which were higher than those of the control group [(55.14±5.62)points, (65.23±6.19)points, (71.54±6.80)points] ( t=2.849, 4.062, 4.415, all P<0.05). After 4, 8 and 12 weeks of treatment, BMD level of lumbar spine and hip in the observation group were higher than those in the control group, and the differences were statistically significant(all P<0.05). After 4, 8 and 12 weeks of treatment, the total amino terminal propeptides of type I collagen in the observation group were (76.02±7.26)μg/L, (58.34±6.45)μg/L, (49.12±5.12)μg/L, respectively, which were lower than those in the control group[(79.98±7.13)μg/L, (64.48±6.71)μg/L, (54.29±5.15)μg/L]( t=2.236, 3.790, 4.090, all P<0.05), and the serum osteocalcin levels in the observation group were (3.41±0.53)ng/L, (4.75±0.49)ng/L, (6.09±0.72)ng/L, respectively, which were higher than those of the control group [(3.02±0.48)ng/L, (4.16±0.47)ng/L, (5.41±0.67)ng/L]( t=3.133, 4.992, 3.972, all P<0.05)and the 25 dihydroxyvitamin D3 levels in the observation group were (34.87±5.41)ng/L, (48.71±5.67)ng/L, (72.67±6.95)ng/L, respectively, which were higher than those of the control group [(30.22±5.30)ng/L, (42.35±5.12)ng/L, (64.62± 6.14)ng/L]( t=3.527, 4.782, 4.987, all P<0.05). Conclusion:The preventive use of anti-osteoporosis drugs in patients with hemiplegia after stroke has significant effect, which can improve the function of hands and upper limbs, improve the quality of life of patients, improve the bone density and improve the bone metabolism index of patients.

Objective To invOstigatO thO clinical OffOct of thO ultrasound monitoring curOttagO and balloon placOmOnt hOmostas in thO trOatmOnt of cOsarOan scar prOgnancy.Methods From May 2014 to May 2016, thO clinical data of 13 casOs with cOsarOan scar prOgnancy in thO POoplO＇s Hospital of HOchuan District wOrO rOtrospOctivOly analyzOd. All 13 casOs rOcOivOd mOthotrOxatO, ultrasonic monitoring curOttagO and balloon placOmOnt hOmostas thOrapy wOrO obsOrvOd.Results Of 13 casOs,11 casOs wOrO curOd, including 9 casOs of gOstational sac OndogOnous typO and mass typO 2 casOs. ThO intraopOrativO blOOding was (167 ± 101)mL, thO opOration timO was (12.3 ± 6.3)min, thO blood HCG droppOd to normal timO was (37.2 ± 13.8)d. ThOrO wOrO 2 casOs of failurO, all of which wOrO OxogOnous gOstational sac .Conclusion Utrasound monitoring curOttagO combinOd with balloon comprOssion is a simplO, safO and Oconomical mOthod for thO trOatmOnt of OndogOnous typO of caOsarOan scar prOgnancy, which is worthy of clinical promotion.

Objective To evaluate the effect of dexmedetomidine on Toll-like receptor 4 ( TLR4)/myeloid differentiation factor 88 ( MyD88)/nuclear factor Kappa B ( NF-κB) signaling pathway in the pe-ripheral blood mononuclear cells of elderly patients with diabetes mellitus undergoing lower extremity surger-y. Methods Forty elderly patients of both sexes with type 2 diabetes mellitus, aged 65-80 yr, with body mass index of 18. 5-27. 9 kg/m2 , of American Society of Anesthesiologists physical status Ⅱ or Ⅲ, with New York Heart Association Ⅰ or Ⅱ, undergoing lower extremity surgery with tourniquets under general anesthesia, were divided into 2 groups ( n=20 each) by using a random number table method: control group ( group C) and dexmedetomidine group ( group D) . Combined intravenous-inhalational anesthesia was applied. Dexmedetomidine was infused over 15 min in a dose of 1μg/kg after induction of anesthesia, fol-lowed by a continuous infusion of 0. 5 μg·kg-1 ·h-1 until the end of surgery in group D, while the equal volume of normal saline was given instead of dexmedetomidine in group C. Before using the the tourniquet and at 15 min, 1 h and 24 h after loosing the tourniquet, arterial blood samples were collected for determi-nation of the expression of TLR4, NF-κB and MyD88 in peripheral blood mononuclear cells and concentra-tions of tumor necrosis factor-alpha ( TNF-α) , interleukin-1β ( IL-1β) , cardiac troponin I ( cTnI ) and creatine kinase-MB ( CK-MB) in plasma. Results Compared with group C, the expression of TLR4, NF-κB and MyD88 in peripheral blood mononuclear cells was significantly down-regulated, and the concentra-tions of TNF-α, IL-1β, cTnI and CK-MB in plasma were decreased at each time point after loosing the tourniquet in group D ( P＜0. 05) . Conclusion The mechanism by which dexmedetomidine reduces myo-cardial damage may be related to inhibiting TLR4/MyD88/NF-κB signaling pathway and reducing systemic inflammatory responses in elderly patients with diabetes mellitus undergoing lower extremity surgery.