Objective:To investigate the expression of homeobox protein C4(HOXC4)in gastric cancer tissues and cells,as well as its effects on the proliferation,migration and invasion of gastric cancer cells and the underlying mechanisms.Methods:The cancer and adjacent tissue specimens surgically removed from 16 patients with advanced gastric cancer at the Department of Oncology,Nanyang First People's Hospital,between May 2020 and April 2021 were collected.Additionally,human normal gastric epithelial cells(GES-1)and gastric cancer cell lines(AGS,SGC-790,and MGC-803)were included.Western blot(WB)was performed to detect HOXC4 expression in gastric cancer tissues and cells.RNA interference technology was used to knockdown or overexpress HOXC4 in SGC-790 and AGS cells,with experimental groups divided as follows:the sh-HOXC4#1 group,sh-HOXC4#2 group,sh-Con group,sh-HOXC4+pc-integrin β1 group,pc-HOXC4 group,pc-Con group,and pc-HOXC4+pc-integrin β1 group.EdU assay,CCK-8 assay,and Transwell assay were employed to evaluate the effects of HOXC4 knockdown or overexpression on cell viability,proliferation,migration,invasion,and integrin β1 expression in each group.A tumor-bearing mouse model was established using HOXC4-knockdown AGS cells to observe the impact of HOXC4 knockdown on tumor volume and the expressions of Ki67 and integrin β1 proteins in xenograft tissues.Results:The expression of HOXC4 in gastric cancer tissues and cells was significantly up-regulated(all P<0.01).Compared with those in the sh-Con group,the expression levels of HOXC4 and integrin β1 in SGC-790 and AGS cells,and the cell viability,proliferation,migration and invasion ability decreased significantly in sh-HOXC4#1 and sh-HOXC4#2 groups(all P<0.01).Compared with those in the sh-HOXC4 group,the cell viability,invasion and migration abilities of cells in the sh-HOXC4+pc-integrin β1 group increased significantly(all P<0.01).Compared with those in the pc-Con group,the cell viability,invasion and migration abilities of cells in the pc-HOXC4 group increased significantly(all P<0.01).Compared with those in the pc-HOXC4 group,the cell viability,invasion and migration abilities of cells in the pc-HOXC4+integrin β1-shRNA group decreased significantly(all P<0.01).Compared with those in the sh-Con group,the tumor grew slowly,and the volume decreased,and the expressions of Ki67 and integrin β1 decreased significantly in the sh-HOXC4#1 and sh-HOXC4#2 groups(all P<0.01).Conclusion:The expression of HOXC4 is up-regulated in gastric cancer tissues and cells,and it promotes the proliferation,migration and invasion of gastric cancer cells by activating the integrin β1 signaling pathway.

Objective To assess the early prognosis of 117 patients after carduopulmonary resuscitation (CPR) in ICU by using the markers of inflammation,Glasgow Coma Scale (GCS) and Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) scores.Methods A total of 117 CPR patients admitted between 2010 January to 2012 December were enrolled for study.Within 24 h after admission,inflammatory markers,blood routine items,hepatorenal function,electrolytes of blood were measured.The GCS and APACHE Ⅱ scores were recorded.Arterial blood gas analyses were performed at 0,12,and 24 h after hospitalization,and the 12-h and 24-h lactate clearance rates were calculated.Seven days after treatment,according to the outcomes,the patients were divided into survival group and death group,and the clinical data of two groups were analyzed.Results (1) Of them,73 patients died and 44 survived.Factor analysis showed that age,time elapsed from resuscitation to ICU admission,D-dimer,arterial oxygenation index (FiO2),arterial blood pH,arterial blood lactate concentration upon ICU admission,GCS score and APACHE Ⅱ score were significantly different between the two groups (P ＜ 0.05or P ＜ 0.01); (2) Two classification logistic regression analysis showed that D-Dimer,GCS score and APACHE Ⅱ score significantly correlated with the mortality risk of the patients in the wake of CPR with relative odds ratios of 1.000,2.091,and 0.531,respectively (P ＜ 0.05 or P ＜ 0.01) ; (3) Receiver operating characteristic curve analysis indicated that the area under the curve of GCS (0.821) and APACHE Ⅱ (0.869) had higher predictive value than D-dimer (0.655).The highest accuracy (84.6％) in predicting patient survival was achieved when the GCS score was 6.5.Meanwhile,the highest accuracy (82.1％) in predicting patient death was achieved when the APACHE Ⅱ score was 17.5.Conclusions Both GCS score and APACHE Ⅱ score has obvious correlation with the prognosis of the critically ill patients after CPR and could be used to predict prognosis at early stage.

Objective To characterize the disease ofneurogenic pulmonary edema (NPE),and to investigate the optimal fluid therapeutic strategy as well as to assess the role of extravascular lung water index (EVLWI) in management of fluid resuscitation.Methods Data of seven patients with NPE,admitted to our intensive care unit (ICU) from September 2012 to January 2014,were collected and analyzed retrospectively.The continuous cardiac output pulse indication (PICCO) monitoring was implemented as soon as the patients were admitted.Conservative fluid therapeutic strategy was adopted,targeting at decreasing EVLWI as the primary goal and maintaining normal blood volume or mean aortic pressure more than or equal to 65 mmHg as the secondary goal.The hemodynamic parameters and input and output volume of fluid,pulmonary vascular permeability index (PVPI),global end-diastolic volume index (GEDVI),extravascular lung water index (EVLW1),oxygenation index (PaO2/FiO2) and lactic acid (Lac) level,and the chest Ⅹ ray and cranial CT images were recorded and analyzed.The starting point of the record was defined as the time of NPE occurring,and the ending point as time of discharging from ICU or rectification of hypotension or pulmonary edema.Results In a lot of cases,NPE was secondary to severe traumatic brain injury or acute cerebrovascular diseases,concomitant with severe hypotensive shock and pulmonary capillary leakage with a mean PVPI value of 3.3±1.7.The mean fluid input in 7 patients was (2099±1146) mL/d,and the net fluid balance was achieved in a median of-250 mL/d.The mean value of GEDVI was maintained at a level of (727±149) mL/m2.The mean value of EVLWI declined gradually firom (18.0±7.0) mL/kg at the startting point to (10±4.3) mL/kg at the ending point of record,and 5 patients showed significant improvement in lung effusion and brain edema as being illustrated in the chest Ⅹ ray or CT images,1 died and the other abandoned therapy; the mean length of ICU stay was 9 days.Pearson correlation analysis showed that EVLWI was correlated with PaO2/FiO2 and PVPI (r=-0.570 and 0.760,respectively,P＜0.05).Conclusion Successful management of NPE relies on an elaborate balance of both improvement of cranial perfusion and prevention of pulmonary edema exacerbation; PICCO monitoring is a useful tool in assessment of the blood volume status,and targeting at the decreasing EVLWI as a goal of fluid resuscitation is of benefit to patients with NPE.

Objective To compare the rates of clearance of different solutes during continuous veno-venous haemodiafiltration (CVVHDF) between pre-dilution and post-dilution.Methods A study in vitro was carried out using model CRRT system with AN69 filter used,which was applied to perform CVVHDF for solutes clearance.The removed amounts of different solutes including potassium ion (K +),creatinine (Cr),vancomycin,insulin,and interleukin-6 (IL-6) were determined in the groups of control (without dilution),pre-dilution and post-dilution during CVVHDF at the same substitution fluid amount.Each group was repeated 4 times (n =4).Results Post-dilution mode increased K +,Cr,vancomycin and insulin clearances significantly.There was no difference in clearance of IL-6 between the pre-and post-dilution groups.In the control group,insulin and IL-6 levels were decreased extremely.Conclusions In general,the rate of clearance using post-dilution of CVVHDF is higher than that using pre-dilution.Among high molecular weight solutes,the difference in clearance is not significant.The control group demonstrates insulin and IL-6 adsorbed by the filter.

OBJECTIVETo explore the role of central venous pressure (CVP), global end diastolic volume index (GEDI) and extravascular lung water index (ELWI) monitoring in patients with septic shock during fluid resuscitation by pulse induced continuous cardiac output (PiCCO) test.

METHODSForty-six patients with severe sepsis and septic shock were enrolled in this study. Hemodynamic monitoring was performed during fluid resuscitation and the data including CVP, GEDI and ELWI were collected to analyze their relationship and the clinical values.

RESULTSIn patients with septic shock, CVP showed a weak linear correlation with GEDI during fluid resuscitation (r=0.137, P=0.009). In the subgroups stratified with CVP cut-off values of 8 mmHg and 12 mmHg, the correlation coefficient between CVP and GEDI was 0.149 (P=0.029) in CVP<8 mmHg group, 0.075 (P=0.462) in 8 mmHg ≤ CVP ≤ 12 mmHg group, and 0.049 (P=0.726) in CVP>12 mmHg group. In the total of 367 data groups obtained, CVP showed no linear correlation with ELWI (r=0.040, P=0.445). In the CVP subgroups, CVP and ELWI were weakly correlated in CVP<8 mmHg group (r=0.221, P=0.001), but they showed no correlations in 8 mmH g≤ CVP ≤ 12 mmHg and CVP>12 mmHg groups (r=-0.047, P=0.646; r=0.042, P=0.765).

CONCLUSIONThere is no significant linear correlation between CVP and GEDI or between CVP and ELWI in patients with septic shock. CVP can not reflect the circulatory blood volume or the degree of pulmonary edema.

Blood Volume ; Cardiac Output ; Central Venous Pressure ; Extravascular Lung Water ; Fluid Therapy ; Humans ; Pulmonary Edema ; Resuscitation ; Shock, Septic ; therapy

A male patient undergoing extracorporeal ultrasound lithotripsy developed the symptoms of dyspnea, low blood pressure, palpitations, chest tightness, and sweating, and a clinical diagnosis of pulmonary capillary leak and hypovolemic shock was made. Pulse indicator continuous cardiac output (PiCCO) technique was used for resuscitation according to the measurements of extravascular lung water index (EVLWI) and global end-diastolic volume index (GEDI). The patient showed low levels of cardiac output (CO) and GEDI with a peak EVLWI of 32 ml/kg and profuse pink and thin sputum overflow from the trachea. The high ventilator support parameters failed to correct low oxygen saturation. Restricted fluid infusion was used to reduce pulmonary edema. Colloidal solution was given when GEDI was below 500 ml/m(2), and the volume and fluid infusion rate were reduced for a GEDI higher than 500 ml/m(2). Pulmonary edema was gradually reduced after the treatments with improvement of lactic acid level and liver and kidney functions. Vasopressors were withdrawn 6 days later, mechanical ventilation was discontinued 10 days later, and tracheal intubation was removed 25 days later, after which the patient was discharged. In the treatment of the patient, PiCCO monitoring played an important role.
Adult ; Capillary Leak Syndrome ; complications ; therapy ; Fluid Therapy ; Humans ; Lithotripsy ; adverse effects ; Male ; Pulmonary Edema ; complications ; therapy ; Shock ; complications ; therapy

A male patient undergoing extracorporeal ultrasound lithotripsy developed the symptoms of dyspnea, low blood pressure, palpitations, chest tightness, and sweating, and a clinical diagnosis of pulmonary capillary leak and hypovolemic shock was made. Pulse indicator continuous cardiac output (PiCCO) technique was used for resuscitation according to the measurements of extravascular lung water index (EVLWI) and global end-diastolic volume index (GEDI). The patient showed low levels of cardiac output (CO) and GEDI with a peak EVLWI of 32 ml/kg and profuse pink and thin sputum overflow from the trachea. The high ventilator support parameters failed to correct low oxygen saturation. Restricted fluid infusion was used to reduce pulmonary edema. Colloidal solution was given when GEDI was below 500 ml/m2, and the volume and fluid infusion rate were reduced for a GEDI higher than 500 ml/m2. Pulmonary edema was gradually reduced after the treatments with improvement of lactic acid level and liver and kidney functions. Vasopressors were withdrawn 6 days later, mechanical ventilation was discontinued 10 days later, and tracheal intubation was removed 25 days later, after which the patient was discharged. In the treatment of the patient, PiCCO monitoring played an important role.

A male patient undergoing extracorporeal ultrasound lithotripsy developed the symptoms of dyspnea, low blood pressure, palpitations, chest tightness, and sweating, and a clinical diagnosis of pulmonary capillary leak and hypovolemic shock was made. Pulse indicator continuous cardiac output (PiCCO) technique was used for resuscitation according to the measurements of extravascular lung water index (EVLWI) and global end-diastolic volume index (GEDI). The patient showed low levels of cardiac output (CO) and GEDI with a peak EVLWI of 32 ml/kg and profuse pink and thin sputum overflow from the trachea. The high ventilator support parameters failed to correct low oxygen saturation. Restricted fluid infusion was used to reduce pulmonary edema. Colloidal solution was given when GEDI was below 500 ml/m2, and the volume and fluid infusion rate were reduced for a GEDI higher than 500 ml/m2. Pulmonary edema was gradually reduced after the treatments with improvement of lactic acid level and liver and kidney functions. Vasopressors were withdrawn 6 days later, mechanical ventilation was discontinued 10 days later, and tracheal intubation was removed 25 days later, after which the patient was discharged. In the treatment of the patient, PiCCO monitoring played an important role.

Objective The present study investigated the expression of the citrullinated proteins in the synovium and serum of rheumatoid arthritis(RA)patients.Methods The expression of the citrullinated proteins in the synovium and serum of RA patients was analyzed by two-dimensional western blotting analysis (2-D WB),mass spectrometry MALDI-TOF/TOF MS,western blotting,immunohistochemistry and ELISA.Then we analyzed the data with one-way ANOVA,LSD test,Kruskal-Walls test and Spearman correlation analysis.Results Alpha-1-antitrypsin(A1AT),fibrinogen beta chain(FIBB),keratin type Ⅱ cuticular Hb4(KRT84),tubulin beta chain(TBB)and vimentin(VIME)were detected in RA serum and anti-citrulline antibody could be detected using 2-D WB.A1AT,KRT84 and TBB were expressed significantly in the synovial membranes and synovial fluids of RA patients.Furthermore,high levels of autoantibodies against KRT84 were detected in the blood of RA patients when compared with samples from the healthy controls.Conclusion Current study has identified novel autoantigens in RA,including A1AT,FIBB,KRT84,TBB and VIME using 2-D WB with purified RA sera and anti-citrulline antibody.FIBB and VIME have been confirmed to be autoantigens in the literature,this demonstrates the feasibility of our protocol and the reliability of our study results.

OBJECTIVETo explore the relationship between interleukin-6 (IL-6) production and central nervous injury in septic patients.

METHODSTwenty-two septic patients without central nervous system diseases were examined for serum IL-6 and neuron-specific enolase (NSE) levels, and the serum NSE levels and APACHEII scores were compared between patients with low, moderate, and high serum IL-6 levels. The correlations between NSE, APACHEII and serum IL-6 were analyzed.

RESULTSIn patients with low, moderate, and high serum IL-6 levels, the serum levels of NSE were 10.29∓4.05, 16.06∓5.84 and 23.97∓3.28 µg/L, respectively, showing a significant difference between the 3 groups (P<0.001). The APACHEII scores also differed significantly between the 3 groups (14.17∓4.67, 16.40∓4.84, and 24.00∓6.26, respectively, P=0.009). Correlation analysis showed significant positive correlations of IL-6 with NSE (r=0.788, P<0.001) and with APACHEII scores (r=0.733, P<0.001).

CONCLUSIONIn septic patients, serum IL-6 level is significantly correlated with the severity of sepsis and brain injury, and can be used as a marker to monitor brain injury in septic patients.

APACHE ; Adult ; Aged ; Brain Injuries ; blood ; pathology ; Female ; Humans ; Interleukin-6 ; blood ; Male ; Middle Aged ; Phosphopyruvate Hydratase ; blood ; Sepsis ; blood