[摘 要] 目的：探究双特异性磷酸酶26（DUSP26）在肺腺癌（LUAD）A549细胞增殖、迁移和侵袭中的作用及其分子机制。方法：检索肿瘤数据库GEPIA2网站DUSP26表达数据，分析DUSP26在LUAD患者和正常人肺组织中的表达差异。收集2022年10月至2023年10月期间萍乡市人民医院手术切除的12例LUAD组织和癌旁组织标本，通过免疫组织化学（IHC）和WB法检测DUSP26在LUAD组织和癌旁组织之间的表达差异；通过WB法检测DUSP26在4种LUAD细胞（A549、SK-LU-1、Calu-3、H1299）和2种正常支气管上皮细胞（BEAS-2B、HBEC）中的表达差异。利用慢病毒转染细胞的方法构建稳定过表达DUSP26（DUSP26-OE）及阴性对照（DUSP26-OENC）的A549细胞，通过克隆形成、划痕愈合实验、Transwell实验分别检测DUSP26过表达对细胞增殖、迁移及侵袭能力的影响，WB法检测各组细胞中TGF-β1/SMAD2/3通路、EMT相关蛋白的表达水平，细胞免疫荧光法检测细胞中Ki-67、cyclin D1表达水平。加入TGF-β1重组蛋白进行回复实验。构建A549细胞裸鼠荷瘤模型，观察DUSP26过表达对移植瘤体内生长的影响，WB法检测移植瘤组织中TGF-β1/SMAD2/3通路、EMT相关蛋白表达水平，免疫荧光染色法检测移植瘤组织中Ki-67、cyclin D1表达水平。结果：DUSP26在LUAD组织和细胞中均呈低表达（P < 0.05或P < 0.01或P < 0.001或P < 0.000 1）。与DUSP26-OENC组相比，DUSP26-OE组A549细胞的增殖、迁移和侵袭能力均显著降低（P < 0.01或P < 0.001），TGF-β1、p-SMAD2/3、vimentin、N-cadherin、snail、Ki-67、cyclin D1表达均降低（P < 0.01或P < 0.001或P < 0.000 1），E-cadherin表达升高（P < 0.000 1）。加入5 ng/mL TGF-β1重组蛋白后，可部分逆转在体外实验中由DUSP26过表达导致的结果。成功构建裸鼠A549细胞荷瘤模型，DUSP26-OE组裸鼠移植瘤生长速度缓慢，体积和质量均减小（均P < 0.001），移植瘤组织中TGF-β1、p-SMAD2/3、vimentin、N-cadherin、snail、Ki-67、cyclin D1表达均降低（P < 0.01或P < 0.001），E-cadherin表达升高（P < 0.000 1）。结论：DUSP26在LUAD组织和细胞中均呈低表达状态，上调DUSP26的表达水平能够通过抑制TGF-β1/SMAD2/3信号通路抑制A549细胞的增殖、迁移和侵袭。

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 observe the clinical efficacy of electroacupuncture combined with ear tip bloodletting for insomnia with phlegm-fire disturbing heart. METHODS: A total of 60 cases with insomnia of phlegm-fire disturbing heart were selected, and the treatment of electroacupuncture combined with ear tip bloodletting was delivered. Acupuncture was applied at Yintang (GV24⁺), Shenting (GV24), Sishencong (EX-HN1) and bilateral Shenmen (HT7), Quchi (LI11), Zhaohai (KI6), Shenmai (BL62), Fenglong (ST40), Neiting (ST4), Yintang (GV24⁺) and Shenting (GV24) were connected to electroacupuncture, continuous wave, 2 Hz in frequency. In addition, bloodletting was applied at ear tip. The treatment was given for 4 weeks. Before treatment, and after 1,4 weeks into treatment, the scores of Pittsburgh sleep quality index (PSQI), Athens insomnia scale (AIS), insomnia severity index (ISI) and TCM syndrome were compared, and the clinical efficacy was evaluated in the patients. RESULTS: After 1,4 weeks into treatment, the scores of PSQI, AIS, ISI and TCM syndrome were decreased compared with those before treatment in the patients (P<0.05). Of 60 cases, 30 cases were cured, 19 cases markedly effective, 9 cases effective and 2 cases failed, and the total effective rate was 96.7% (58/60). CONCLUSION Electroacupuncture combined with ear tip bloodletting can improve the sleep quality and clinical symptoms in patients with insomnia of phlegm-fire disturbing heart.
Humans ; Male ; Female ; Electroacupuncture ; Middle Aged ; Sleep Initiation and Maintenance Disorders/physiopathology* ; Adult ; Bloodletting ; Acupuncture Points ; Aged ; Combined Modality Therapy ; Treatment Outcome ; Young Adult

Objective To investigate the clinicopathological characteristics of colorectal cancer patients with different mismatch repair (MMR) statuses and their correlation with KRAS/NRAF/BRAF (KNB) gene mutations. Methods The clinicopathological data of 477 patients with colorectal cancer were collected, and MMR, microsatellite instability (MSI), and KNB status were detected via immunohistochemistry (IHC), PCR–capillary electrophoresis, and next-generation sequencing (NGS), respectively. The clinicopathological features of patients with different MMR statuses and correlations with KNB mutations were analyzed. Results Compared with the patients in the pMMR group, the patients in the classical dMMR group were younger, included more females, and exhibited more tumors in the right colon, mostly mucinous adenocarcinoma and poorly differentiated tumors (all P<0.05). The tumors in the nonclassical dMMR group were commonly found in the right colon and were prone to special histologic types (all P<0.05). MLH1-PMS2 codeletion, BRAF mutation, and KRAS G13 codon mutation were common in patients in both the classical and the nonclassical dMMR groups (both P<0.05). The results of MMR IHC (100%) were highly consistent with those of MSI PCR (99.1%). Patients in the classical dMMR group with KRAS mutations were younger, included more males, and were prone to specific histologic types, but distant metastasis was rare (all P<0.05). Conversely, lymph node metastasis was rare in patients in the nonclassical dMMR group with KRAS mutations (P=0.005). The mutation rate of the MSH6 gene was relatively high in the nonclassical dMMR group (P=0.002), and all patients presented complete deletion of MLH1-PMS2 combined with nonclassical expression of MSH6 (100%). Five patients with medullary carcinoma components had complete deletions of MLH1-PMS2. Among the five patients, three had combined nonclassical expression of MSH2/MSH6. Two of the three patients carried the MSH6 gene c.3261 locus mutation. Conclusion The clinicopathologic features of patients with classical/nonclassical dMMR colorectal cancer differ from those of patients with pMMR, and MMR IHC could be used to predict effectively the MSI status. The clinicopathologic features differ between classical and nonclassical dMMR colorectal cancer patients with KRAS mutations, but both groups present codeletion of MLH1-PMS2, BRAF mutation, and KRAS G13 codon mutation. In patients with nonclassical dMMR, complete deletion of MLH1-PMS2 combined with nonclassical expression of MSH6 is common. Mutations in the MSH6 gene may play a key role in the development of colorectal cancer with medullary carcinoma components.

Objective To investigate the application of equivalent uniform dose(EUD)in intensity-modulated rotational radiotherapy and to explore optimization methods for improving the quality of modulated treatment plans.Methods The impact of the parameter a in the EUD formula on the characteristics of the EUD curve was analyzed using Python.Thirty cases of head and neck tumors,thoracic tumors,and pelvic tumors were randomly selected for treatment planning.Dose optimization for the target area and organs at risk were performed using a physics-based optimization approach or an optimization approach that combines physical constraints with the EUD function.The dose distribution and compliance with constraints of the two groups of plans were compared,while also observing the effect of different values of a on the planning outcomes.Results The impact of the value of a on the changes in EUD curve characteristics was consistent with its impact on the results of EUD plan optimization.When -15≤a≤-5,the dose distribution in the target area was more uniform;when 1≤a≤7,the effect on the uniform dose and low-dose regions in organs at risk was more noticeable;when 10≤a≤30,the effect of constraining the high-dose regions in organs at risk was more pronounced,with the EUD for the target area and organs at risk exhibiting different expressions under different a values.The study also found that the target dose distribution and the protection of organs at risk in the EUD optimization group were better than those in the physical optimization group only.Conclusion The a-value has a significant impact on the,the dose distribution in the target area and the organ at risk,providing a reference for the setting of a-value while using EUD to optimize the intensity modulation plan.The using of EUD optimization method can not only achieve excellent dose distribution in the target area,but also significantly reduce the normal tissue dose and the probability of complications,which has certain clinical application value.

Objective To explore the prescription law of Chinese materia medica for the treatment of epilepsy based on National Patent Database;To provide references for clinical treatment.Methods Patent data on TCM compounds for treating epilepsy that met the inclusion criteria were collected from the establishment of the Chinese Patent Publication Announcement Network until August 21,2023.Excel 2021 was used to establish the database of prescription medication.Python,SPSS Modeler 18.0,Cytoscape 3.10.1,and R language software were used to model prescription data,analyze medication frequency,conduct complex network analysis,association rule analysis,clustering analysis,to explore the prescription law.Results A total of 376 patents meeting the criteria for epilepsy were included,involving 827 kinds of Chinese materia medica,with a total frequency of 4 911 times.Gastrodiae Rhizoma,Acori Tatarinowii Rhizoma,Bombyx Batryticatus,Scorpio,Uncariae Ramulus cum Uncis were among the top five frequently used Chinese materia medica.The high-frequency drug efficacy categories were primarily liver soothing and wind alleviating drugs,tranquilizers,and phlegm resolving,cough suppressing,and asthma alleviating drugs.The predominant medicinal properties were mild,warm and cold,while the predominant tastes were sweet,pungent and bitter.The herbs were classified under the liver,heart,lung and spleen meridians.The core complex network of Chinese materia medica was identified,and the core combination was Gastrodiae Rhizoma-Acori Tatarinowii Rhizoma-Bombyx Batryticatus.The association rule analysis identified 28 commonly used medicinal combinations,with the highest support being observed for Scorpio-Bombyx Batryticatus.Clustering analysis yields four sets of data.Similarity analysis revealed the unique properties of the patented compound in the treatment of epilepsy.Conclusion The high-frequency drugs and commonly used drug combinations of TCM compounds for treating epilepsy,as disclosed on the Chinese Patent Publication Announcement Network,are primarily aimed at calming wind and stopping convulsions,as well as resolving phlegm and opening the orifices,which can provide reference for clinical practice.

Objective To analyze the basic case data and laboratory test index characteristics of patients with myasthenia gravis(MG),so as to evaluate the application value of common clinical laboratory indicators in the construction of a diagnostic model for MG.Methods A retrospective analysis was performed on the basic data and laboratory indicators of MG patients and gender and age-matched healthy controls diagnosed at Beijing Tiantan Hospital,Capital Medical University from April 2021 to April 2023.A diagnostic model was constructed,and the receiver operating characteristic(ROC)curve was drawn to analyze the area under the curve(AUC).Results The BMI,heart rate,systolic blood pressure,and diastolic blood pressure in the MG group were significantly higher than those in the control group,with statistical significance(P＜0.05).There were significant differences in total protein,albumin,white blood cell count,proportion of large platelets,abso-lute value of monocyte and triiodothyronine between MG group and control group(P＜0.05).Seven indexes of heart rate,diastolic blood pressure,albumin,creatine kinase,cholinesterase,triglyceride and apolipoprotein B were selected to construct the diagnostic model.The area under the curve of the combined application of multiple indexes could reach 0.995,with a sensitivity and specificity of 97.60％and 96.10％,respectively.Conclusion In this study,the laboratory test indexes that can be used for the diagnosis of MG are successfully selected,and the sensitivity and specificity of the combined application of multiple indexes are high,which can be used for the auxiliary diagnosis of MG.

As a classic prescription for invigorating spleen and replenishing qi, Sijunzi Decoction has a good clinical efficacy in the treatment of gastric cancer. It can improve chemotherapy resistance, reduce the toxic and side effects of chemotherapy, promote postoperative recovery, enhance immunity, improve the nutritional status of patients, improve the quality of life of patients and prevent precancerous lesions. Network pharmacology studies have shown that Sijunzi Decoction exerts anti-gastric cancer effects through multiple active ingredients, multiple targets and multiple pathways, and quercetin may be the main active component in Sijunzi Decoction to exert anti-gastric cancer effects. The main mechanisms of Sijunzi Decoction in the treatment of gastric cancer include regulating the expression of cell cycle and apoptosis-related gene proteins, and inhibiting the proliferation, migration, invasion and gastric cancer stem cell characteristics of gastric cancer cells.

Objective:To analyze the effect of different gastric mucosa preparation programs on the quality of painless gastroscopy, so as to provide reference for developing mucosal preparation programs.Methods:This was a prospective, randomized controlled study. A total of 150 patients with painless gastroscopy from March 2021 to December 2022 in Shanxi Yuncheng Central Hospital were selected by convenience sampling in this study, they were assigned to control group, water group, and soda water group by random digits table method, each group contained 50 patients. All patients received oral administration of pronase + dimeticone + sodium bicarbonate solution. In addition, control group: prohibited from drinking 4 hours before examination; water group: drinking 200 ml of pure water 2 hours before examination; and soda water group: drinking 200 ml of soda water 2 hours before examination. The clarity score of gastric mucosa and the detection rate of small lesions were compared among the three groups.Results:There were 28 males and 22 females in the control group, aged (47.62 ± 13.83) years old. There were 30 males and 20 females in the water group, aged (44.68 ± 13.61) years old. There were 24 males and 26 females in the soda water group, aged (46.92 ± 12.79) years old. The difference of esophagus, gastric body, gastric antrum and total mucosal clarity scores among the three groups were statistically significant ( F values were 3.68-25.75, all P<0.05). Multiple comparison showed that the esophagus, gastric antrum and total mucosal clarity scores were (1.87 ± 0.58), (1.37 ± 0.34), (6.72 ± 0.92) points in the control group, which were higher than (1.47 ± 0.41), (1.18 ± 0.31), (5.97 ± 0.86) points in the water group, and (1.42 ± 0.41), (1.02 ± 0.22), (5.50 ± 0.79) points in the soda water group, the differences were statistically significant ( t values were 2.67-5.95, all P<0.05). The gastric antrum and total mucosal clarity scores in the water group were higher than in the soda water group, the differences were statistically significant ( t=7.11, 2.71, both P<0.05). The gastric body mucosal clarity score was (1.98 ± 0.74) points in the control group, which was higher than (1.64 ± 0.54) points in the soda water group, the difference was statistically significant ( t=2.66, P<0.05). The gastroscopy examination time and flushin times were (135.20 ± 21.60) s and (1.37 ± 0.43) times in the control group, while (115.52 ± 14.74) s, (0.90 ± 0.29) times and (107.48 ± 13.02) s, (0.62 ± 0.23) times in the water group and soda water group, the control group was higher than the water group and the soda water group, and the water group was also higher than the soda water group, the differences were statistically significant ( t values were 2.38-11.40, all P<0.05). However, there was no statistically significant difference in the detection rate of small lesions among the three groups (all P>0.05). Conclusions:Drinking soda water 2 hours before painless gastroscopy can significantly improve the clarity of patients′gastric mucosa, shorten the examination time and reduce flushing times, but it does not improve the detection rate of small lesions.

Objectives:Quantitative flow ratio(QFR)is a coronary angiography-derived functional test without the need of guidewire use.Fractional flow reserve(FFR)is used as the reference standard to verify the diagnostic value of QFR in patients with non-ST-segment elevation acute coronary syndrome(NSTE-ACS)with coronary critical lesion(40%-70%stenosis)and functional stenosis. Methods:This retrospective analysis included patients with NSTE-ACS who were admitted to Fuwai Central China Cardiovascular Hospital from June 1,2018 to February 1,2023 and underwent coronary FFR examination.QFR values of target vessels were analyzed offline by AngioPlus(Shanghai Pulsation Medical Imaging Technology Co.,LTD.),the second-generation QFR detector,and anatomical parameters of the diseased vessels were recorded as follows:minimal luminal diameter(MLD),percent diameter stenosis(DS%),minimal luminal area(MLA),percent area stenosis(AS%).Functional coronary artery stenosis is defined as FFR≤0.80. Results:Using FFR as the gold standard,the AUC values of contrast-flow QFR(cQFR)and fixed-flow QFR(fQFR)for identifying functional coronary artery stenosis in NSTE-ACS patients were 0.829(95%CI:0.773-0.885,P<0.001)and 0.821(95%CI:0.766-0.875,P<0.001),respectively.The diagnostic accuracy,sensitivity and specificity of cQFR and fQFR were 81.30%,56.00%,98.63%and 76.83%,59.00%,99.04%,respectively.DeLong test showed that diagnostic performance of cQFR was significantly better than fQFR in diagnosing functional stenosis of coronary critical lesions in patients with NSTE-ACS. Conclusions:With FFR as the gold standard,QFR(especially cQFR)has certain diagnostic value in patients with NSTE-ACS with functional stenosis of coronary critical lesions.