Objective: To explore the value of an oral squamous cell carcinoma (OSCC) diagnostic model constructed by using principal component analysis (PCA) to analyze a database of differentially expressed genes in OSCC and to provide a reference for clinical diagnosis and treatment. Methods: RNA-seq expression data of OSCC and normal control samples were obtained from The Cancer Genome Atlas (TCGA) database, and then, normalized and differentially expressed genes (DEGs) were identified by R software. DEGs were enriched by Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis to identify their main biological characteristics. 70% of DEGs expression data in RNA-seq were randomly selected as the training set and 30% were selected as the test set. Then, the PCA method was applied to analyze the training set data and extract the principal components (PCs) related to the diagnosis of OSCC in order to construct a PCA model. Then, the receiver operating characteristic (ROC) curves of PCA models in the training set and the test set were respectively drawn, and the area under curve (AUC) was calculated to evaluate the accuracy of the PCA model in the diagnosis of OSCC. Results: RNA-seq expression data of OSCC and normal control samples obtained from TCGA database included 330 samples and 32 samples, respectively. Using false discovery rate (FDR) <0.001 and |log2 fold change| (|log2FC|) >4 as the thresholds, a total of 159 downregulated and 248 upregulated DEGs were identified, which were mainly enriched in cellular components such as intermediate fiber and melanosomal membrane, pigment and salivation-related biological processes and mainly involved in salivary secretion and tyrosine metabolism pathways (P.adjust<0.05 and Q<0.05). The DEGs were proposed as tumor markers for OSCC, and PCA analysis of the training set showed that the cumulative ratio of variance of PC1, PC2 and PC3: [including submaxillary gland androgen regulated protein 3B (SMR3B), proline rich 27 (PRR27), histatin 3 (HTN3), statherin (STATH), cystatin D (CST5), BPI fold containing family A member 2 (BPIFA2), proline rich protein Hae Ⅲ subfamily 2 (PRH2), keratin 35(KRT35), histatin 1 (HTN1), amylase alpha 1B (AMY1B)] were 0.873, 0.100 and 0.023, respectively, and the total weight of the three was 0.996. The PCA diagnostic model of OSCC was further constructed by combining the eigenvectors of the above three components. The ROC curves of the training set and test set showed that the AUC values of the PCA model were 0.852 and 0.844, respectively, which were higher than those of other single genes. Conclusion The OSCC diagnostic model based on the expression levels of SMR3B, PRR27, HTN3, STATH, CST5, BPIFA2, PRH2, KRT35, HTN1 and AMY1B constructed with the PCA method and DEGs has a high diagnostic advantage. This study provides a theoretical basis for the early genetic diagnosis of OSCC and the application of the PCA model in clinical diagnosis.

Objective:To compare the early and late predictive values of critical illness score (CIS) and procalcitonin (PCT) in septic patients with blood stream infection (BSI) induced by intra-abdominal infection (IAI), and to identify the value of PCT in etiological diagnosis.Methods:The clinical data of patients with at least one positive blood culture within 24 hours admission to the emergency department of China-Japan Friendship Hospital from January 2014 to December 2019 and with final diagnosis of IAI induced sepsis were enrolled. Sequential organ failure assessment (SOFA), mortality in emergency department sepsis (MEDS), Logistic organ dysfunction system (LODS), and acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) scores were calculated based on the parameters on the day of admission. Differences in various indicators among different Gram-stained bacterial infections and among patients with different prognosis at 28 days or 60 days were compared. Receiver operator characteristic curve (ROC curve) was used to analyze the value of PCT in differential etiological diagnosis of IAI induced sepsis caused by single bacterial infection, and the predictive value of CIS and PCT on 28-day and 60-day death of septic patients with BSI induced by IAI.Results:A total of 221 septic patients with IAI caused by single bacterial infection were enrolled. The 28-day mortality was 19.9% (44/221), and the 60-day mortality was 25.8% (57/221). Mortality caused by Gram-positive (G +) bacterial infection of patients was significantly higher than that caused by Gram-negative (G -) bacterial infection (28 days: 34.6% vs. 11.4%, 60 days: 42.0% vs. 16.4%, both P < 0.01). Compared with patients with G + bacterial infection, the PCT value of patients with G - bacterial infection was higher [μg/L: 4.31 (0.71, 25.71) vs. 1.29 (0.32, 10.83), P < 0.05]. Compared with survival group, the values of CIS and PCT in death group were higher, either in 28 days or in 60 days [death group vs. survival group in 28 days: SOFA score was 6.0 (4.0, 10.0) vs. 3.0 (2.0, 5.0), MEDS score: 11 (9, 14) vs. 6 (6, 9), LODS score: 4.0 (2.0, 6.0) vs. 1.0 (0, 2.0), APACHEⅡ score: 17.0 (15.0, 24.0) vs. 12.0 (8.0, 15.0), PCT (μg/L): 3.48 (1.01, 26.70) vs. 2.45 (0.32, 15.65); death group vs. survival group in 60 days: SOFA score: 6.0 (4.0, 10.0) vs. 3.0 (2.0, 5.0), MEDS score: 9 (6, 14) vs. 6 (6, 9), LODS score: 4.0 (1.0, 5.0) vs. 1.0 (0, 2.0), APACHEⅡ score: 16.5 (12.0, 20.0) vs. 12.0 (8.0, 15.0), PCT (μg/L): 2.67 (0.98, 17.73) vs. 2.22 (0.31, 16.75); all P < 0.05]. ROC curve showed that: ① the area under ROC curve (AUC) of PCT in the diagnosis of IAI induced sepsis with single bacterial infection was 0.740 [95% confidence interval (95% CI) was 0.648-0.833]. When the optimal cut-off value of PCT was 1.82 μg/L, the sensitivity of diagnosis of G - bacterial infection was 74.0%, and the specificity was 68.2%. When PCT value was higher than 10.92 μg/L, the specificity of diagnosis of G - bacterial infection could reach 81.8%. ② In the prediction of 28-day and 60-day mortality for septic patients with BSI induced by IAI, the APACHEⅡ score achieved the highest AUC [28 days: 0.791 (95% CI was 0.680-0.902), 60 days: 0.748 (95% CI was 0.645-0.851)]. APACHEⅡ score higher than 14.5 could help to predict 28-day and 60-day mortality for IAI patients with negative predictive values of 94.9% and 88.5%. However, the predictive value of PCT for septic patients with BSI induced by IAI was relatively lower [28-day AUC: 0.610 (95% CI was 0.495-0.725), 60-day AUC: 0.558 (95% CI was 0.450-0.667)]. Conclusion:PCT is more reliable in the identification of pathogen type among IAI induced sepsis with BSI, while APACHEⅡ score may perform better in predicting early and late mortality.

OBJECTIVE：To investigate the inhibitory effects of total alkaloids of Gelsemium elegans （TAG） on the proliferation and angiogenesis of human colon cancer cells. METHODS ：Human colon cancer cell line HT- 29 and HUVEC were cultured in vitro . After the intervention of low- ，medium-，high-dose TAG （40，80，120 μg/mL），the morphology of the two cells was observed by fluorescence inversion microscope. The survival rate of HT- 29 cells and HUVEC was detected by CCK- 8 assay. Flow cytometry was used to detect HT- 29 cell cycle. The migration rate ，invasion rate and tube number of HUVEC were observed by scratching test ，Transwell invasion experiment and tube formation experiment. RESULTS ：Compared with blank group ，HT-29 cells and HUVEC were decreased to different extents in TAG groups ；dead cells were observed ，and the survival rate of both decreased significantly （P＜0.05 or P＜0.01）. The proportion of HT- 29 cells at G 2/M phase in TAG groups as well as those at G 0/G1 phase in medium-dose group were increased significantly ；the proportion of HT- 29 cells at S phase in TAG groups as well as those at G 0/G1 phase in high-dose group were decreased significantly （P＜0.05 or P＜0.01）. Survival rate ，migration rate and invasion rate of HUVEC were decreased significantly in TAG groups ，and tube number was also decreased significantly at each time point during 4-24 h（P＜0.01）. CONCLUSIONS ：TAG have inhibitory effect on the proliferation of human colon cancer HT- 29 cells and HUVEC，can change HT- 29 cell cycle ，inhibit the migration ，invasion and tube formation of HUVEC.

Objective:To analyze and compare the radiation dose and image quality of kilo-voltage cone beam CT systems on different Varian accelerator platforms, providing data to support clinical decisions on selecting optimal protocols for image-guided radiotherapy based on cost-effective ratio (image quality / radiation dose).Methods:The radiation dose and image quality of various CBCT systems and scanning protocols on Varian Edge, Truebeam and ix (new and old) LINACs were obtained using a CT dose index (CTDI) phantom combined with a CT ionization chamber and a Catphan604 phantom, respectively. Figure of merit (FOM) was used to evaluate the cost-effective ratio of the image guidance schemes.Results:Considerable inter-system varieties of FOMs were observed, varying from 0.65 (Image Gently-full trajectory) to 48.46 (Image Gently-half trajectory). The inter-protocol varieties were also large, where the mean±SD was 22.14±13.47.Conclusions:Considering the explicit inter-system and inter-protocol varieties, it is clinically favorable to evaluate the image guidance schemes based on machine-specific measurement. For instance, parameters and equipment with low CTDI w can be beneficial for dose-sensitive patients. High CNR regimen favors patients with high image quality requirements. For ordinary patients, cost-effective ratio in terms of FOM can be very helpful to guide the decision-making of clinical image-guided radiotherapy.

Objective:To investigate the acute and long-term toxicity of GJ-4 extracted from Gardenia jasminoides J.Ellis, and to provide safety basis for its development as a new drug for the treatment of dementia. Methods:In the acute toxicity experiment, 30 ICR mice were randomly divided into control group, gardenia extract 2.5 g/kg group and gardenia extract 5.0 g/kg group, 10 mice in each group. The mice in the 2.5 g/kg and 5.0 g/kg gardenia extract groups were administrated with GJ-4 suspension. The control group was given 0.5% sodium carboxymethyl cellulose (CMC-Na) by gavage. The mice were given continuous gavage for 7 days. The mortality, body weight and general condition of mice were recorded. The levels of ALT, ALP, BUN and creatinine (CRE) in serum were measured by automatic biochemical detector. In the long-term toxicity experiment, 75 ICR mice were divided into control group and gardenia extract 100, 250, 500, 1 000 mg/kg group according to the random number table method, 15 mice in each group. The GJ-4 suspension of Gardenia extract 100, 250, 500 and 1 000 mg/kg were administrated to the stomach respectively in the gardenia extract 100, 250, 500 and 1 000 mg/kg groups, and 0.5% CMC-Na of the same volume was administrated to the stomach in the control group once a day for 30 days. The mortality, weight and mental state of mice were recorded. The organ index and the levels of ALT, ALP and BUN in serum were observed.Results:In the acute toxicity experiment, the mental state and diet of mice in each group were good, and there was no death within 7 days. Compared with the control group, there was no significant differences in body weight, heart index, liver index and kidney index between the two groups ( P>0.05). Compared with the control group, the level of BUN (10.17 ± 0.82 mmol/L vs. 11.25 ± 0.47 mmol/L) in the gardenia extract 2.5 g/kg group significantly decreased ( P<0.05), and the level of ALP (116.0 ± 10.75 U/L vs. 148.0 ± 25.73 U/L) in the gardenia extract 5.0 g/kg group significantly decreased ( P<0.05). In the long-term toxicity experiment, the mice were in good mental state and had good diet, and no death occurred. Compared with the control group, there was no significant differences in body weight, heart index, kidney index, spleen index and serum ALT, ALP and BUN levels between the two groups ( P>0.05). The liver index (4.9 ± 0.56 vs. 4.38 ± 0.49) in the 250 mg/kg gardenia extract group significantly increased ( P<0.01), and the thymus index (0.09 ± 0.02 vs. 0.14 ± 0.04) significantly decreased ( P<0.05). Conclusions:The Gardenia jasminoides extract GJ-4 has no obvious toxicity in acute and long-term toxicity experiment, indicating that GJ-4 is safe.

Objective To investigate the correlation between serum carcinoembryonic antigen (CEA) levels and vascular endothelial growth factor (VEGF) levels in diabetics.Methods 92 cases of hospitalized diabetics (they were divided into the pre-treatment group and after-treatment group by intensive hypoglycemic treatment) were collected,and 94 cases of healthy controls were chosen as control group.Serum levels of CEA,hemoglobin Alc (HbAlc),VEGF and another indicators were detected and compared among the three groups.The correlations between VEGF,CEA,and HbA1c were analyzed respectively.Results The serum levels of CEA and VEGF in pre-treatment group were significantly higher than that in after-treatment group and healthy control group.In diabetics,the CEA level was positively correlated with HbA1 c (r =0.91,P ＜ 0.05) and VEGF (r =0.90,P ＜ 0.05),while there was no correlation between HbA1 c and VEGF after intensive treatment (r =0.17,P ＞ 0.05).Conclusions The level of VEGF was positively correlated with CEA,and VEGF maybe one of the pathogenesis of high CEA in diabetes mellitus.

Objective: To observe the hemodynamic change characteristics of left ventricle and evaluate left ventricular systolic function in patients with chronic heart failure (CHF) via vector flow mapping(VFM). Methods: Sixty-two patients with CHF(CHF group) were selected as case group and were divided into three groups (B, C, D) according to the American College of Cardiology Foundation and the American Heart Association (ACC/AHA ) recommended stages.Sixty healthy volunteers were selected as control group. The left ventricular circulation parameters (vortex quantity, vortex area, circulation) and energy loss (EL) of the apex, mid, and basal segments in different groups were compared in all the systolic phases. Left ventricular ejection fraction (LVEF) was calculated by biplane Simpson method, and the correlation was analyzed with the parameters of circulation and EL. Results: ①In the phase of isovolumetric contraction (IVC) and slow ejection (SE), compared with the control group, the levels of EL were increased in mid and basal segments (P<0.01 or P<0.05) in CHF group. The vortex area and circulation during IVC and rapid ejection (RE) were higher in CHF group than those in the control group (P<0.01 or P<0.05). As for SE, only vortex quantity was higher in CHF group than that in the control group (P<0.05). ②In CHF group, EL were increased at stage B and stage C than those in the control group (P<0.05), and EL were decreased at stage D than those in the control group ( P<0.05). Meanwhile, there was decreased tendency of EL in CHF group with the increase of ACC/AHA stages. ③The circulation during IVC of phase D was higher in CHF group than that in the control group (P<0.05), the vortex area during RE was greater in CHF group than that of the control group and stage B (P<0.05). ④EL was positively correlated with LVEF at basal segment of IVC(r=0.615, P<0.001). The vortex area during RE, circulation during IVC and RE were negtively correlated with LVEF (r=-0.598, -0.594, -0.623; all P<0.001). Conclusions VFM technology can quantify the left ventricular hemodynamic changes of patients with CHF in the systolic phase, and shows its relationship with left ventricular systolic function, to provide objective basis for grading of CHF and also provide objective quantitative indicators for clinical treatment and curative effect evaluation.

Objective To explore the effect of Four Flavor Elimination Decoction on treatment of brain metastases.Methods Sixty patients with brain metastases,admitted to our hospital from January 2015 to January 2017,were selected.According to the willing of the patients,they were divided into observation group and control group (n=30).The patients from control group were given conventional medicines,and the patients from observation group were supplemented with Four Flavor Elimination Decoction on the basis of control group.The clinical efficacy of the two groups after treatment,and scores of Kamofsky performance status scale (KPS) and changes of T lymphocyte subsets and tumor markers before treatment and on 7th,14th,21th and 28th d of treatment were observed.Results The total effective rate of the observation group after treatment was 100％,which was significantly higher than that of the control group (50％,P＜0.05).KPS scores of the observation group were significantly higher than those of the control group on 21st and 28th d of treatment (P＜0.05).The levels of CD3+,CD4+ and CD8+ in the observation group were significantly higher than those of the control group after treatment (P＜0.05).The levels of carcino-embryonic antigen,carbohydrate antigen (CA)50 and CA125 in the observation group were significantly lower than those of the control group (P＜0.05).Conclusion Four Flavor Elimination Decoction is efficient in treatment of brain metastases,which can improve quality of life and immune indexes,and is worth of clinical application.

To construct recombinant eukaryotic expression plasmid vector of human IL-34 gene, and to study the effects of IL-34 expressed by human bone marrow-derived mesenchymal stem cells (hBM-MSCs) on THP-1 cells. Full-length IL-34 encoding sequence was amplified by PCR. And this fragment was cloned into the plasmid pIRES2-EGFP. Western blotting and ELISA were used to analyze the expression of IL-34 in hBM-MSCs. THP-1 cells were cultured with hBM-MSCs medium containing IL-34 protein. Real-time PCR detected the effects of IL-34 on the expression of IL-10 and TNFα in THP-1 cells. Restrictive enzyme analysis and sequencing demonstrated that IL-34 eukaryotic expression vector was successfully constructed. IL-34 protein expressed by hBM-MSCs could promote IL-10 and TNFα expression in THP-1 cells. Those results show that IL-34 expressed by hBM-MSCs has regulating effect on THP-1 cells.

Objective To study the inhibitory effects ofberberine on human organic cation transporter (OCTs) including OCT1,OCT2,OCT3,OCTN1 and OCTN2.Methods Using animal cell transgenic method mediated by transporter Lipo 3000,the drug transporters over expression cell lines S2-OCT1,S2-OCT2,S2-OCT3,S2-OCTN1 and S2-OCTN2 were obtained by selective medium culture.The OCTs evaluation model was established by detecting the trans-membrane transport of radioactive substrate in vitro.Wild type (WT) cells were used as control group,activity of OCTs was verified by adding its inhibitor.The inhibition of berberine on the transporters was investigated in vitro.The IC50 of inhibitory effect of berberine on various drug transporters was also calculated.Result The transport activity of transporter cell lines was increased by more than 5 times compared to the WT cell line respectively,what's more,their transport activity decreased significantly by their corresponding inhibitor.The ICs0 of berberine to OCT1,OCT2,OCT3,OCTN1 and OCTN2 were respectively 7.63,6.80,2.25,4.66 and 210.34 μmol/L.Conclusion Berberine significant inhibition to OCT1,OCT2,OCT3,OCTN1 and OCTN2.The inhibition on OCT1,OCT2,OCT3,OCTN1 is stronger compared to OCTN2.