Objective:To discuss the expression of Rh family C glycoprotein(RHCG)in the esophageal squamous cell carcinoma(ESCC)tissue and its effect on the malignant biological behavior of ESCC cells,and to clarify the value of RHCG as a diagnostic and prognostic marker for the ESCC patients.Methods:A total of 143 ESCC tissue samples and 105 adjacent normal tissue samples were collected.Using immunohistochemical staining method,141 ESCC samples were divided into two groups:RHCG low expression group(immunohistochemistry score≤6)and RHCG high expression group(immunohistochemistry score>6).Immunohistochemical method was used to detect the RHCG protein expression in 143 ESCC tissues and 105 normal tissues,and the relationship between the clinicopathological characteristics of the ESCC patients was analyzed.Receiver operating characteristic(ROC)curve and Kaplan-Meier survival analysis were used to evaluate the value of RHCG in diagnosis and prognosis of the ESCC patients;univariate and multivariate COX regression analysis were used to determine the independent risk factors affecting the prognosis of the ESCC patients.Gene Expression Profiling Interactive Analysis(GEPIA2)database was used to analyze the expression of RHCG mRNA in various tumor tissues.The ESCC TE-1 cells were cultured and transfected in to 6-well cell culture plates with different Lipofectamine2000∶RHCG ratios;the cells in RHCG transfection group were transfected with weights of 2.0,2.5,and 3.0 μg for 24 and 48 h,respectively,and the cells in NC group transfected with empty vector as control.Western blotting method was used to detect the RHCG protein expression level in the TE-1 cells in various groups after transfection at different concentrations and verify the optimal transfection conditions;cell counting kit-8(CCK-8)assay was used to detect the proliferation activities of the TE-1 cells;plate clone formation assay was used to detect the colony formation numbers of the TE-1 cells;Transwell chamber assay was used to detect the numbers of migrating TE-1 cells.Results:Compared with adjacent normal tissue,the RHCG gene expression level in various cancer tissues including ESCC,glioblastoma multiforme,and head and neck squamous cell carcinoma was significantly decreased(P<0.05).RHCG protein was mainly located on the cell membrane of normal esophageal squamous epithelial cells;the RHCG protein expression intensity in ESCC tissues was lower than that in adjacent normal esophageal tissue(χ2=109.373,P<0.001),and the patients in RHCG low expression group had poorer differentiation than those in RHCG high expression group(P=0.041).The area under the curve(AUC)value of RHCG for diagnosing ESCC was 0.86,with sensitivity and specificity of 95.1%and 75.0%,respectively;the Kaplan-Meier survival analysis results showed that compared with high RHCG expression group,the patients in low RHCG expression group had shorter survival time and poorer prognosis[harard ratio(HR)=0.269,95%confidence interval(CI):0.113-0.639,P=0.020];the COX regression analysis results showed that low RHCG expression could serve as an independent risk factor affecting the prognosis of ESCC[HR=4.569,95%CI=1.315-15.877,P=0.017)].The Western blotting results verified that the optimal transfection condition was 3.0 μg RHCG plasmid for 48 h,at which time RHCG overexpression was optimal and RHCG protein expression level was highest.The CCK-8 assay results showed that compared with control group,the proliferation activity in RHCG overexpression group was decreased on the 4th day after cell seeding(P<0.001).In the TE-1 cells,the colony formation number of the TE-1 cells in RHCG over-expression group was lower than that in control group(t=17.70,P<0.001).The Transwell chamber assay results showed that compared with control group,the number of migrating cells in RHCG over-expression group was decreased(t=23.74,P<0.001).Conclusion:RHCG expression is decreased in ESCC tissues and associated with poor prognosis in ESCC patients;overexpression of RHCG can inhibit the proliferation and migration of the TE-1 cells,providing a theoretical basis for RHCG as a novel diagnostic and prognostic marker and therapeutic target for ESCC.

Objective To investigate the relationship between morphometric parameters of the cerebral cortex and the efficacy of repetitive transcranial magnetic stimulation(rTMS)in the treatment of tardive dyskinesia(TD).Methods A total of 105 schizophrenic patients with TD undergoing basic treatment were enrolled,and randomly divided into group A(n=35),group B(n=35)and group C(n=35).Group A received rTMS at 1 Hz,group B received rTMS at 10 Hz,and group C received sham stimulation.All groups were treated for 12 weeks.The severity of TD was assessed using the Ab-normal Involuntary Movement Scale(AIMS)before and after treatment.The Repeatable Battery for the Assessment of Neuropsychological Status(RBANS)and the Positive and Negative Syndrome Scale(PANSS)in Chinese were used to evaluate patients'neuropsychological status and symptom severity.magnetic resonance imaging(MRI)was employed to scan the left prefrontal cortex of patients to obtain parameters of cortical thickness,surface area and volume.Pearson correlation analysis was used to an-alyze the relationship between cortical morphological parameters and the efficacy of rTMS for TD in pa-tients.Results After treatment,AIMS scores in the three groups were significantly lower than before treatment,and the group A was significantly lower than the group B and group C(P＜0.05).After treatment,RBANS scores were significantly higher and PANSS scores were significantly lower in three groups than before treatment(P＜0.05).After treatment,the RBANS score of the group A was significantly higher than that of the group B and group C,and the group B was significantly higher than the group C(P＜0.05);the PANSS score of the group A was significantly lower than that of the group B and group C,and the group B was significantly lower than the group C(P＜0.05).Af-ter treatment,cortical morphological parameters(cortical thickness,surface area and volume)in the group A and group B were significantly higher than before treatment,and the group A was signif-icantly higher than the group B(P＜0.05).The therapeutic effect of the group A was positively correlated with cortical thickness,surface area and volume(P＜0.05).Conclusion The morpho-metric parameters of the left prefrontal cortex are associated with the efficacy of rTMS in treating TD.The rTMS at 1 Hz can facilitate structural remodeling of the motor cortex,thereby improving treat-ment outcomes for TD patients.

Objective:To investigate the role and mechanisms of cellular FLICE-like inhibitory protein (cFLIP) in mediating oxidative stress induced by myocardial ischemia-reperfusion injury (MI/RI) in rats.Methods:Forty-eight male Sprague-Dawley rats with body weight of 180-200 g, were randomly divided into 4 groups ( n=12 per group) using a random number table: sham operation group (sham group), ischemia-reperfusion group (I/R group), virus control group (I/R+Ad-NC group), and cFLIPL-overexpressing group (I/R+Ad-cFLIPL group). A myocardial ischemia-reperfusion injury (MI/RI) model was established by ligating the left anterior descending coronary artery for 30 min followed by 3 h of reperfusion. The left ventricular ejection fraction (LVEF) and left ventricular fractional shortening (LVFS) in rats were evaluated via echocardiography, and a biochemical analyzer was used to measure the serum lactate dehydrogenase (LDH) and creatine kinase isoenzyme (CK-MB) levels to evaluate the extent of myocardial injury. The 2,3,5- triphenyl tetrazolium chloride (TTC) staining method was used to detect the infarct area of the rat myocardium, and hematoxylin and eosin (HE) staining was performed to observe the morphology of the rat myocardial tissue. Commercial kits were used to measure the levels of superoxide dismutase (SOD), glutathione peroxidase (GSH-px), and malondialdehyde (MDA). Dihydroethidium (DHE) staining was used to assess the number of reactive oxygen species (ROS)-positive cells in the myocardial tissue. Western blot analysis was performed to evaluate the protein expression of cFLIPL, Nrf2, and HO-1. Results:During MI/RI, compared with the sham group, the protein expression of cFLIPL was significantly decreased in the I/R group, and compared with the I/R+Ad-NC group, the protein expression of cFLIPL was significantly increased in the I/R+Ad-cFLIPL group (both P<0.05). Compared with sham group, the level of LDH, CK-MB, MDA, ROS-positive cell count, and myocardial infarct size were significantly increased, whereas the LVEF, LVFS, SOD, and GSH-px were significantly decreased in I/R group (all P<0.05). Compared to the I/R+Ad-NC group, the level of LDH, CK-MB, MDA, ROS-positive cell count, and myocardial infarct area were significantly decreased, whereas the LVEF, LVFS, SOD, and GSH-px were significantly increased in I/R+Ad-cFLIPL group (all P<0.05). Western blot revealed that compared with the sham group, the protein expression of Nrf2 and HO-1 in I/R group were significantly increased, and compared with the I/R+Ad-NC group, the protein expression of Nrf2 and HO-1 in the I/R + Ad-cFLIPL group were significantly increased (all P<0.05). Conclusion:Overexpression of cFLIPL can alleviate myocardial ischemia-reperfusion injury (MI/RI) in rats by activating the Nrf2/HO-1 signaling pathway to inhibit oxidative stress.

Objective To observe the value of preoperative CT radiomics models for predicting composition of in vivo urinary calculi.Methods Totally 543 urolithiasis patients were retrospectively enrolled and divided into calcium oxalate monohydrate stone group(group A,n=373),anhydrous uric acid stone group(group B,n=86),carbonate apatite group(group C,n=30),ammonium urate stone group(group D,n=28)and ammonium magnesium phosphate hexahydrate stone group(group E,n=26)according to the composition of calculi,also divided into training set and test set at the ratio of 7:3.Radiomics features were extracted and screened based on plain CT images of urinary system.Five binary task models(model A-E corresponding to group A-E)and a quinary task model were constructed using least absolute shrinkage and selection operator algorithm for predicting the composition of calculi in vivo.Then receiver operating characteristic curves were drawn,and the area under the curves(AUC)were calculated to evaluate the predictive efficacy of binary task models,while the accuracy,precision,recall and F1 score were used to evaluate the predictive efficacy of the quinary task model.Results All binary task models had good efficacy for predicting the composition of urinary calculi in vivo,with AUC of 0.860-0.948 in training set and of 0.856-0.933 in test set.The accuracy,precision,recall and F1 score of the quinary task model for predicting the composition of in vivo urinary calculi was 82.25％,83.79％,46.23％and 0.596 in training set,respectively,while was 80.63％,75.26％,43.48％and 0.551 in test set,respectively.Conclusion Binary task radiomics models based on preoperative plain CT had good efficacy for predicting the composition of in vivo urinary calculi,while the quinary task radiomics model had high accuracy but relatively poor stability.

Objective:To explore the safety key points of total pancreaticoduodenectomy in the era of vascular resection technology and the important factors affecting rapid postoperative recovery.Methods:The clinical data of 52 patients with pancreatic cancer who underwent total pancreaticoduodenectomy in Beijing Chaoyang Hospital Affiliated to Capital Medical University from November 2014 to September 2022 were retrospectively analyzed, including 34 males and 18 females, aged (62±9). The intraoperative situation, incidence of postoperative complication, postoperative blood glucose control and postoperative survival rate were analyzed.Results:All operations of the 52 patients were successfully completed, including 48 patients underwent total pancreaticoduodenectomy combined with portal vein resection and allograft vascular grafts via artery approach. The portal vein occlusion time was (20±5) min. The incidence of postoperative complications was 28.8% (15/52), including 2 cases of abnormal gastric empty, 2 cases of diarrhea, 2 cases of chylous fistula, 4 cases of abdominal infection, 1 case of gastrointestinal fistula, 3 cases of gastrointestinal bleeding, and 1 case of pulmonary infection. Subcutaneous short-acting insulin injection was used to control blood glucose in the early stage after surgery, short-acting insulin combined with long-acting insulin was used for subcutaneous injection before sleep for diet recovery. All patients did not experience uncontrolled hyperglycemia. The median survival time of 52 patients was 13 months, and the longest follow-up time was 38 months. There were 37 patients died of tumor recurrence, 4 patients died of cardiovascular and cerebrovascular accidents, and 1 patient died of pulmonary infection in the 42 died patients.Conclusions:Total pancreaticoduodenectomy via artery approach can improve the R 0 resection rate in pancreatic cancer patients with vascular invasion, the rate of postoperative complication and mortality has no significant increase. The postoperative blood sugar control is satisfactory and the quality of life is guaranteed.

Inducing the degradation of KRAS represents a novel strategy to combat cancers with KRAS mutation. In this study, we identify ubiquitin-specific protease 2 (USP2) as a novel deubiquitinating enzyme of KRAS in multiple myeloma (MM). Specifically, we demonstrate that gambogic acid (GA) forms a covalent bond with the cysteine 284 residue of USP2 through an allosteric pocket, inhibiting its deubiquitinating activity. Inactivation or knockdown of USP2 leads to the degradation of KRAS, resulting in the suppression of MM cell proliferation in vitro and in vivo. Conversely, overexpressing USP2 stabilizes KRAS and partially abrogates GA-induced apoptosis in MM cells. Furthermore, elevated USP2 levels may be associated with poorer prognoses in MM patients. These findings highlight the potential of the USP2/KRAS axis as a therapeutic target in MM, suggesting that strategically inducing KRAS degradation via USP2 inhibition could be a promising approach for treating cancers with KRAS mutations.

Objective To explore the interventional effect of repetitive transcranial magnetic stimulation (rTMS) on tardive dyskinesia (TD) in schizophrenic patients. Methods A total of 105 schizophrenic patients were selected as subjects and randomly divided into 1 Hz treatment group, 10 Hz treatment group and control group, with 35 patients in each group. All three groups received rTMS treatment for 12 weeks. The Abnormal Involuntary Movement Scale (AIMS), Scale for the Assessment of Negative Symptoms (SANS), Positive and Negative Syndrome Scale (PANSS) and Treatment Emergent Symptom Scale (TESS) scores were compared among the three groups. Physiological indicators such as electrocardiogram, blood routine, blood biochemistry and hormone levels were monitored. Results After treatment, the total AIMS scores in the 1 Hz and 10 Hz treatment groups were significantly lower than before treatment, and those in the 1 Hz and 10 Hz treatment groups were significantly lower than those in the control group (P < 0.05). The reduction rates of AIMS scores in the 1 Hz and 10 Hz treatment groups were 68.6% and 65.7%, respectively, which were significantly higher than the 22.9% in the control group (P < 0.05). After treatment, the total SANS and PANSS scores in the 1 Hz and 10 Hz treatment groups were significantly lower than before treatment, and those in the 1 Hz and 10 Hz treatment groups were significantly lower than those in the control group (P < 0.05). There was no statistically significant difference in the total AIMS score, efficacy and total PANSS score between the 1 Hz and 10 Hz treatment groups (P>0.05). There were no significant differences in the total TESS scores and physiological indicators among the three groups before and after treatment (P>0.05). Conclusion Both 1 Hz and 10 Hz rTMS can effectively improve TD in schizophrenic patients with good safety and have no significant side effects or physiological damage.

Objective : To analyze the expression and immune infiltration levels of the BMP7 gene ( BMP7) in e- sophageal squamous cell carcinoma(ESCC) ． Methods : Initially，in 274 cases of ESCC and 242 cases of normal tissues，the level of BMP7 was verified by immunohistochemistry ，and the relationship between the expression difference and the survival cycle and clinical pathological characteristics of patients with ESCC was explored，and BMP7 overexpression plasmid transfection of ESCC cells was established，and the effect of BMP7 on the biological behavior of ESCC cells was examined by CCK-8，Clone，and Transwell. Results : BMP7 expression in normal e- sophageal tissues was higher than that of ESCC(P＜0. 001) ，the expression level of BMP7 was correlated with the degree of differentiation of patients(P = 0. 006) and TNM staging(P ＜0. 001) ，and the survival of patients with high expression of BMP7 exceeded that of patients with low BMP7 (P = 0. 041) ，and the experiments of CCK-8 and Clone showed that the proliferation effect of cells in the overexpressed BMP7 group was lower than that of the control group．Transwell experiments confirmed that the cell invasion migration capacity of the overexpressed BMP7 group was less than that of the control one．The immune infiltration results showed that BMP7 was positively correlated with macrophages(P = 0. 008) and negatively correlated with γ-δT cells(P = 0. 028) ． Conclusion BMP7 is low in ESCC and associated with poor prognosis and immune infiltration levels in patients.

Objective:To explore the regulatory effect of cellular FLICE-like inhibitory protein (cFLIP) on myocardial ischemia-reperfusion injury based on the RIPK1/RIPK3/MLKL-mediated necroptosis pathway.Methods:The cardiomyocyte hypoxia/reoxygenation (H/R) model was constructed by hypoxia for 4 h/reoxygenation for 12 h, and the rat ischemia reperfusion (I/R) model was constructed by ligating the left anterior descending artery for 30 min and reperfusion for 3 h. CCK-8 method was used to detect the viability of cardiomyocytes in each group. DAPI/PI double staining was used to observe changes in necrosis rate of myocardial cell. STRING database was used to predict the protein interaction network of cFLIP. TTC staining was used to detect the area of myocardial infarction in each group of rats, and the protein expression of cFLIPL, cFLIPS, p-RIPK1, p-RIPK3 and p-MLKL were detected by Western blot.Results:In cardiomyocyte H/R injury and myocardial tissue I/R injury, the protein expressions of cFLIPL and cFLIPS were significantly down-regulated, while the levels of p-RIPK1, p-RIPK3 and p-MLKL were increased significantly. Up-regulating the protein expression of cFLIPL and cFLIPS could significantly reduce the damage of cardiomyocytes and the rate of cell necrosis induced by H/R, and decrease the area of myocardial infarction caused by I/R. STRING database results showed that cFLIP had direct protein interactions with RIPK1 and RIPK3. Overexpression of cFLIP in cardiomyocyte and myocardial tissue significantly inhibited H/R or I/R induced the phosphorylation levels of RIPK1, RIPK3 and MLKL.Conclusions:Overexpression of cFLIP can significantly inhibit the RIPK1/RIPK3/MLKL-mediated necroptosis, thereby reducing myocardial cell damage and decreasing the area of myocardial infarction.

Objective:To explore the influences of different lying positions on vital signs and comforts in patients with tracheal intubation removed after intestinal fistula surgery.Methods:From October 2018 to June 2019, convenience sampling was used to select 150 patients with intestinal fistula surgery after general anesthesia in Intensive Care Unit of the General Hospital of Eastern Theater Command were selected as the research object. After waiting for the patient to wake up from anesthesia, the tracheal intubation was removed, and the lying position was changed after normal spontaneous breathing through the nose. Patients were randomly divided into 5 groups, 30 cases in each group. Group A was in the supine position; group B was in the lying position with the head of the bed raised by 15°; group C was in the lying position with the head of the bed raised by 30°; group D was in the lying position with the head of the bed raised by 45°; group E was in the lying position with the head of the bed raised by 15° to 45 °. At the beginning, the head of the bed was shaken to 15 °; and after two hours, the head of the bed was shaken to 30 °, and after another two hours, the head of the bed was shaken to 45 °. After 5 groups of patients fixed the angle of the lying position, when the patient complained of discomfort or the body position changed spontaneously, the patient changed the lying position. The duration of the lying position, uncomfortable symptoms and pain degree of abdominal incision were compared among 5 groups.Results:Patients with tracheal intubation removed after intestinal fistula surgery had a longer persistence in the 15° and 30° lying positions within 6 hours, respectively (72.27±12.41) min and (69.37±9.10) min. There were statistically significant differences in the persistence time of 5 different lying positions ( P<0.01) . The number of patients in group B and C with waist pain was less, and there were more patients with painless incisions, and there were statistically significant differences among 5 groups ( P<0.05) . Conclusions:Among patients with tracheal intubation removed and normal spontaneous breathing through the nose after intestinal fistula surgery, the 15° to 30° lying position within 6 hours after the operation can prolong the patient's adherence to the lying position, reduce the incidence of abdominal incision pain and waist pain, and reduce the probability of dizziness, nausea and vomiting.