OBJECTIVES: To investigate the synergistic inhibitory effects of AKBA and doxorubicin on malignant phenotype of triple-negative breast cancer (TNBC) MDA-MB-231 cells. METHODS: CCK-8 assay was used to determine the 48-h IC₅₀ of AKBA and doxorubicin in MDA-MB-231 cells, and SynergyFinder was employed to calculate the synergistic index and the optimal concentrations of the two agents. MDA-MB-231 cells treated with AKBA (22.5 μmol/L), doxorubicin (0.84 μmol/L) or their combination were examined for changes in cell proliferation, migration, invasion and apoptosis using Transwell migration, scratch assay, clone generation, RT-qPCR and Western blotting. Network pharmacology analysis was conducted to identify the downstream targets of AKBA in TNBC. In nude mouse models bearing subcutaneous MDA-MB-231 cell xenografts, the effects of normal saline, AKBA (50 mg/kg), doxorubicin (2.5 mg/kg), and AKBA combined with doxorubicin on xenograft growth and histopathology were observed. RESULTS: The IC₅₀ of AKBA and doxorubicin in MDA-MB-231 cells at 48 h was 45.15±0.97 μmol/L and 0.42±0.99 μmol/L, respectively. SynergyFinder confirmed the synergistic effect of AKBA and ADR with a ZIP>10. The combined treatment with AKBA and doxorubicin significantly inhibited the proliferation, migration and invasion, promoted apoptosis of MDA-MB-231 cells, and effectively suppressed xenograft growth in nude mice. Network pharmacology analysis predicted that AKBA affects the progression of TNBC through its downstream target AKBA. CONCLUSIONS AKBA combined with doxorubicin inhibits proliferation, migration and invasion, promotes apoptosis of MDA-MB-231 cells and suppresses MDA-MB-231 cell xenograft growth in nude mice. The combined use of AKBA can attenuate the toxic effects of doxorubicin in nude mice.
Animals ; Doxorubicin/pharmacology* ; Triple Negative Breast Neoplasms/pathology* ; Mice, Nude ; Mice ; Cell Proliferation/drug effects* ; Cell Line, Tumor ; Humans ; Female ; Apoptosis/drug effects* ; Cell Movement/drug effects* ; Xenograft Model Antitumor Assays ; Drug Synergism ; MDA-MB-231 Cells

BackgroundSuicidal behavior in adolescence and early adulthood is a major public health concern， and suicide attempts are found to be associated with reasons for living and self-control， whereas there remains a striking lack of empirical research exploring the association among the three in college students. ObjectiveTo explore the relationship among suicide attempts， reasons for living and self-control， and to inform targeted efforts to prevent the development of suicidal behavior. MethodsFrom April to May 2023， a sample of 775 college students from 10 colleges and universities in Shaanxi province， Sichuan province and Chongqing municipality were selected using random sampling method. All students were subjected to complete Self-Control Scale （SCS）， the Reasons for Living Inventory for Adolescents （RFL-A）， and the self-administered Suicide Attempt Questionnaire. Spearman correlation analysis was utilized to examine the correlation among the above scales in students， and mediation analysis was performed using Mplus 8.3. ResultsA total of 738 college students （95.32%） completed the effective questionnaire survey.Suicide attempts were detected in 99 college students （13.41%）. SCS score was positively correlated with RFL-A score （r=0.329， P<0.01）， and SCS score and RFL-A score were both negatively correlated with the risk of suicide attempts （r=-0.194， -0.285， P<0.01）. The indirect mediation effect value of self-control on the relationship between reasons for living and suicide attempts was -0.059 （95% CI： -0.105~-0.018）， accounting for 11.07% of the total effect. There was a gender difference in the mediating effect of self-control， among which the effect was significant in male group， with an indirect effect value of -0.089 （95% CI： -0.163~-0.030） and accounting for 15.72% of the total effect， whereas the mediating effect was not significant in female group （95% CI： -0.407~0.115）. ConclusionReasons for living can negatively predict suicide attempts among college students， and self-control may play a mediating role in the relationship between reasons for living and suicide attempts among college students， and the mediating effect of self-control appears to be statistically significant only in male but not in female students.

As a new strategy for the application of sacubitril/valsartan (LCZ696) in patients with CKD, much evidence showed that it improved the prognosis of patients with CKD. This review summarizes the efficacy and safety of sacubitril/valsartan in physiology, pathology, pharmacology and clinical application by searching Wanfang, CNKI, PubMed and other databases for related articles on the application of sacubitril/valsartan in CKD patients. Although LBQ657, the active product of sacubitril, has a high drug accumulation in patients with moderate, severe renal injury, and ESRD, it is not cleared in hemodialysis, and has very little eliminated in peritoneal dialysis, which does not affect its safety. Compared with angiotensin converting enzyme inhibitor and angiotensin receptor blocker drugs, LCZ696 could increase the blood pressure control rate, improve cardiac function, slow down the decline of glomerular filtration rate, and significantly improve cardiovascular outcomes without more adverse events. Sacubitril/valsartan can be used in all levels of CKD patients complicated with hypertension and/or heart failure, with reliable safety and tolerance.

Objective:To provide references for cardiovascular health management of military pilots by investigating the risk of ischemic cardiovascular diseases (ICVD) in military pilots.Methods:The physical examination data of military pilots in Air Force Healthcare Center for Special Services Hangzhou were retrospectively analyzed. The military pilots were divided into 2 groups by age (22-34 years, 35-56 years), and they were divided into 5 groups by flying hours (≤500 h, 500-≤1 000 h, 1 000-≤2 000 h, 2 000-≤3 000 h, >3 000 h). The 10-year ICVD incidence risk of pilots was evaluated according to the 10-year ICVD incidence risk assessment table of Chinese people. The distribution and influencing factors of absolute risk and relative risk of ICVD incidence in military pilots were analyzed, and the risk factors between different age groups were compared.Results:①A total of 337 military pilots were included, 194 in the 22-34 years group and 143 in the 35-56 years group. ②Absolute risk detection: there were 336 very low-risk military pilots and a low-risk military pilot. Relative risk detection: 87 (25.82%) military pilots were relatively high risk including 41 (21.13%) cases in 22-34 years group, 46 (32.17%) cases in 35-56 years group, the difference between 2 groups was statistically significant ( χ2=5.23, P=0.022); there were 250 (74.18%) relatively low-risk military pilots. ③Among the pilots aged 22-34 years, there was significant difference in relative high-risk ratio between flying hours ( χ2=17.00, P<0.001). The relative high-risk ratio of the pilots with flying hours 500-≤1 000 h was higher than that of pilots with flying hours ≤500 h, and the difference was statistically significant ( P<0.05); the proportion of pilots with elevated triglyceride and low density lipoprotein cholesterol indexes was higher than that of those with normal indicators (all P<0.05). The relative high-risk ratio of pilots with hypertension in 35-56 years group was higher than that of those with normal blood pressure ( χ2=23.70, P<0.001); the proportion of pilots with elevated triglyceride indicators was higher than that of high-risk groups ( P<0.05). ④The smoking rate, BMI and total cholesterol abnormality rate were higher in the 35-56 years group than in the 22-34 years group, and the differences were statistically significant ( χ2=9.71, 29.72, 19.17, P=0.002, <0.001,<0.001). ⑤The aggregation analysis of the risk factors of smoking, BMI, total cholesterol, systolic blood pressure and diabetes showed that the number of risk factor aggregates ≥2 species accounted for 51.04%, and the aggregation of risk factors in different age groups was statistically significant ( Z=6.38, P<0.001). Conclusions:The relative risk of ICVD in pilots is high, and the aggregation of risk factors is serious. Simply improving a single index is hardly to meet the demand of risk reduction. It needs a variety of joint interventions to improve the lifestyle and reduce the abnormal rate of total cholesterol, overweight rate, systolic blood pressure level and smoking rate. It is suggested that ICVD incidence risk prediction score should be routinely used in the risk assessment of chronic diseases in aviation medicine.

Objective:To provide references for cardiovascular health management of military pilots by investigating the risk of ischemic cardiovascular diseases (ICVD) in military pilots.Methods:The physical examination data of military pilots in Air Force Healthcare Center for Special Services Hangzhou were retrospectively analyzed. The military pilots were divided into 2 groups by age (22-34 years, 35-56 years), and they were divided into 5 groups by flying hours (≤500 h, 500-≤1 000 h, 1 000-≤2 000 h, 2 000-≤3 000 h, >3 000 h). The 10-year ICVD incidence risk of pilots was evaluated according to the 10-year ICVD incidence risk assessment table of Chinese people. The distribution and influencing factors of absolute risk and relative risk of ICVD incidence in military pilots were analyzed, and the risk factors between different age groups were compared.Results:①A total of 337 military pilots were included, 194 in the 22-34 years group and 143 in the 35-56 years group. ②Absolute risk detection: there were 336 very low-risk military pilots and a low-risk military pilot. Relative risk detection: 87 (25.82%) military pilots were relatively high risk including 41 (21.13%) cases in 22-34 years group, 46 (32.17%) cases in 35-56 years group, the difference between 2 groups was statistically significant ( χ2=5.23, P=0.022); there were 250 (74.18%) relatively low-risk military pilots. ③Among the pilots aged 22-34 years, there was significant difference in relative high-risk ratio between flying hours ( χ2=17.00, P<0.001). The relative high-risk ratio of the pilots with flying hours 500-≤1 000 h was higher than that of pilots with flying hours ≤500 h, and the difference was statistically significant ( P<0.05); the proportion of pilots with elevated triglyceride and low density lipoprotein cholesterol indexes was higher than that of those with normal indicators (all P<0.05). The relative high-risk ratio of pilots with hypertension in 35-56 years group was higher than that of those with normal blood pressure ( χ2=23.70, P<0.001); the proportion of pilots with elevated triglyceride indicators was higher than that of high-risk groups ( P<0.05). ④The smoking rate, BMI and total cholesterol abnormality rate were higher in the 35-56 years group than in the 22-34 years group, and the differences were statistically significant ( χ2=9.71, 29.72, 19.17, P=0.002, <0.001,<0.001). ⑤The aggregation analysis of the risk factors of smoking, BMI, total cholesterol, systolic blood pressure and diabetes showed that the number of risk factor aggregates ≥2 species accounted for 51.04%, and the aggregation of risk factors in different age groups was statistically significant ( Z=6.38, P<0.001). Conclusions:The relative risk of ICVD in pilots is high, and the aggregation of risk factors is serious. Simply improving a single index is hardly to meet the demand of risk reduction. It needs a variety of joint interventions to improve the lifestyle and reduce the abnormal rate of total cholesterol, overweight rate, systolic blood pressure level and smoking rate. It is suggested that ICVD incidence risk prediction score should be routinely used in the risk assessment of chronic diseases in aviation medicine.

Objective: To investigate the correlation between takeaway food consumption and poor sleep status of college students in Jiangxi Province, to provide a theoretical basis for poor sleep prevention and intervention among college students. Methods: A total of 2 610 college students were selected from a university in Shangrao City, Jiangxi Province by cluster stratified random sampling in May of 2018. The frequency and type of takeaway food consumption, sleep quality and drowsiness were investigated. Results: The detection rate of takeaway food consumption behavior(≥4 times in a week) for college students was 74.8%. The detection rates of poor sleep quality and drowsiness were 17.0% and 18.3%, respectively. The difference of sleep quality was statistically significant with sex, college, different self rated family conditions, study burden, physical activity level, depression and daily smoking ( χ 2=4.33，8.67，23.14，39.03，12.89，313.37，15.23， P <0.05). There were statistically significant differences between drowsiness and college, grade, learning burden, physical activity and depression ( χ 2=12.81，6.57，20.61，8.42，228.06， P <0.05). Logistic regression analysis showed that takeaway consumption (≥4 times in a week) had statistical significance with poor sleep quality and drowsiness ( P <0.05). Conclusion College students takeaway consumption (≥4 times in a week) of rice noodles, malatang, fragrant pot hot pot increase the risk of poor sleep. It is suggested that schools should strengthen nutrition and health education for college students.

A 64-year-old male patient with colon cancer received one cycle chemotherapy of oxaliplatin+capecitabine and 7 cycles of oxaliplatin+raltitrexed chemotherapy. There were no interstitial changes in chest CT before operation. After 8 cycles of chemotherapy, the patient developed chest tightness and shortness of breath. Chest CT showed interstitial changes in bilateral lungs, which were considered to be related to oxaliplatin. After 31 days of treatments with drugs such as broad-spectrum antibiotics, glucocorticoids, acetylcysteine, and reduced glutathione, as well as noninvasive ventilator assisted ventilation, oxygen inhalation, and other symptomatic treatments, his symptoms of chest tightness and shortness of breath were relieved, and chest CT showed that interstitial lesions in the bilateral lungs were obviously relieved.

A 64-year-old male patient with colon cancer received one cycle chemotherapy of oxaliplatin+capecitabine and 7 cycles of oxaliplatin+raltitrexed chemotherapy. There were no interstitial changes in chest CT before operation. After 8 cycles of chemotherapy, the patient developed chest tightness and shortness of breath. Chest CT showed interstitial changes in bilateral lungs, which were considered to be related to oxaliplatin. After 31 days of treatments with drugs such as broad-spectrum antibiotics, glucocorticoids, acetylcysteine, and reduced glutathione, as well as noninvasive ventilator assisted ventilation, oxygen inhalation, and other symptomatic treatments, his symptoms of chest tightness and shortness of breath were relieved, and chest CT showed that interstitial lesions in the bilateral lungs were obviously relieved.

Objective To investigate the role of exhaled nitric oxide (FeNO) detection in patients with bron-chial asthma,and to observe the correlation between FeNO level and pulmonary function .Methods The clinical data of 61 patients with acute exacerbation of bronchial asthma were retrospectively analyzed .The patients were included in the case group .According to the disease condition ,the patients were divided into mild asthma group ( 30 cases ) and moderate asthma group (31 cases).A total of 60 healthy people were selected as the control group .All the patients were given corresponding symptomatic treatment ,before and after treatment ,the FeNO and lung function were deter-mined in two groups.Results After treatment,the level of FeNO in the mild asthma group was (22.22 ±8.39)ppb, which was significantly lower than (35.21 ±10.84)ppb in the moderate asthma group (t=5.22,P=0.00).The levels of FEV1 and PEF in the mild asthma group were (2.49 ±0.38)%,(3.82 ±0.24)L/min,respectively,which in the moderate asthma group were (2.52 ±0.41)%,(3.74 ±0.35)L/min,respectively,the differences between the two groups were not statistically significant (t=0.29,1.03,P=0.76,0.30).The FeNO levels of the two groups after treatment were significantly lower than those before treatment ,and the FEV1 ,PEF levels were significantly higher than those before treatment (all P<0.05).Before treatment,the levels of FeNO,FEV1 and PEF in the case group were(50.41 ±30.09) ppb,(1.98 ±0.37)%,(3.24 ±0.36) L/min,respectively,which in the control group were (12.59 ±6.39)ppb,(2.79 ±0.34)%,(4.02 ±0.18)L/min,respectively,the differences were statistically signifi-cant between the two groups (t=9.52,12.53,15.03,P=0.00,0.00,0.00).After treatment,the levels of FeNO, FEV1 and PEF in the case group were (23.52 ±10.54)ppb,(2.81 ±0.35)%,(3.91 ±0.40)L/min,respectively, which in the control group were (12.59 ±6.39)ppb,(2.79 ±0.34)%,(4.02 ±0.18)L/min,respectively,the difference of FeNO between the two groups was statistically significant (t=6.88,P=0.00),the differences of FEV1 and PEF were not statistically significant between the two groups (t=0.31,1.94,P=0.75,0.05).The difference of FeNO between males and females was not statistically significant (P >0.05).There was a negative correlation between FeNO and FEV1 before treatment(r=-0.172,P=0.02),and FeNO negatively correlated with FEV (r=-0.163,P=0.01).There was no correlation between FeNO and FEV 1 after treatment(r=-0.031,P=0.754), independent of FEV(r=-0.141,P=0.09).Conclusion The level of FeNO is helpful to evaluate the severity of airway inflammation and lung function in bronchial asthma patients , and it is not related to sex .FeNO level is negatively correlated with pulmonary function ,and is helpful to evaluate the clinical efficacy .

Objective: To explore the turnover intention of nurses in Quzhou and its influential factors. Methods: From July to August in 2017 cross-sectional study and self-filled questionnaire are used to investigate 980 nurses from 7 hospitals in Quzhou, including two third-level hospitals and five second-level ones. T-test, F-test, Pearson and linear regression are used in data with the method of statistical analysis. Results: The total score of turnover intention of nurses was (14.95±3.17) points, and the index value was 62.27%, of which the turnover intention was above 78%. The analysis of Single factor showed that age (F=4.895) , Department (F=2.971) , title, nursing age (F=5.863) , self-assessment of physical conditions (F=4.092) were closely related to nurses’ turnover intention(P<0.05). According to Person’s correlation analysis, there are positive correlations between turnover intention and source of stressor, and moral distress (P<0.05) . Multiple linear regression showed that the nurses’ turnover intention was age, Department, health selfevaluation, stressor and moral distress. Conclusion The turnover intention of nurses is high, which is related to age, Department, self-evaluation of health, stressor and moral distress.