Objective To investigate the role of Taraxasterol(TAR)on ferroptosis in chondrocytes induced by Erastin.Methods The C28/I2 chondrocyte line was treated with Erastin to construct the ferroptosis model of chon-drocytes in vitro and the experiments were divided into Control,Erastin,TAR,and TAR+Erastin groups.Cell via-bility was detected by the CCK-8 assay.Cytotoxicity was detected by the lactate dehydrogenase(LDH)kit and the Calcein/PI cytokinesis kit.Flow cytometry was used to detect lipid reactive oxygen species(ROS).The intracellular glutathione(GSH)content was detected by GSH kit.Mitochondrial membrane potential was detected by JC-1 stai-ning and RH123 staining.ACSL4 and GPX4 protein expression and the key indicators of ferroptosis were detected by Western blot.Results TAR restored the decreased cell viability of C28/I2 chondrocytes induced by Erastin treatment as well as reduced Erastin-induced cytotoxicity(P＜0.01).Compared with the control group,the level of intracellular lipid ROS increased(P＜0.01)and the content of GSH decreased(P＜0.01)after treatment with Erastin,while TAR could reduce the production of lipid ROS(P＜0.01)and increase the content of GSH(P＜0.01).TAR restored mitochondrial membrane potential in C28/I2 chondrocytes ferroptosis,decreased ACSL4 pro-tein expression(P＜0.01)and increased GPX4 protein expression(P＜0.01).In addition,TAR restored the re-duced cell viability caused by IL-1 β treatment.Conclusion TAR can inhibit Erastin induced ferroptosis in C28/I2 chondrocytes,which may be related to the regulation of ACSL4 and GPX4 protein expression.

Objective:To investigate the pathway of self-disclosure to posttraumatic growth in patients after cervical cancer surgery, and to provide reference for improving the level of posttraumatic growth in patients.Methods:A convenient sampling method was used to investigate 300 patients with cervical cancer after surgery in Shandong Provincial Hospital Affiliated to Shandong First Medical University from June to November 2022 by using general data questionnaire, Distress Disclosure Index (DDI), Connor-Davidson Resilience Scale (CD-RISC), the Shortened Chinese Version of the Family Resilience Assessment Scale (FRAS-C) and the Posttraumatic Growth Inventory (PTGI) in a cross-section study.Results:A total of 290 valid questionnaires were collected, with an effective recovery rate of 96.7%. The patients were aged 23-70(48.13 ± 10.39) years. The scores of self-disclosure, resilience, family resilience and posttraumatic growth were (46.41 ± 9.82), (67.06 ± 14.63), (108.18 ± 11.06) and (58.24 ± 17.86) respectively. The results of pathway analysis showed that self-disclosure could not only directly predict posttraumatic growth, but also indirectly predict posttraumatic growth through the mediating role of resilience and family resilience, and the chain mediating role of resilience and family resilience, respectively. The direct effect of self-disclosure on posttraumatic growth was 0.236(95% CI 0.138-0.335), and the chain mediating effect of family resilience and resilience between self-disclosure and posttraumatic growth was 0.036(95% CI 0.018-0.060). Conclusions:Medical staff should not only consider the direct influence of self-disclosure on posttraumatic growth, but also pay attention to improve the resilience and family flexibility of patients after cervical cancer surgery, so as to promote their posttraumatic growth.

Objective:To investigate the expression and clinical significance of Golgi phosphoprotein 3 (GOLPH3) and NOD-like receptor protein 3 (NLRP3) in gallbladder carcinoma (GBC).Methods:Surgical specimens and clinical data were collected from 63 patients with GBC who underwent radical cholecystectomy in the 904th Hospital of Joint Logistic Support Force of PLA from January 2014 to January 2019. In the GBC group, there were 21 males and 42 females, with an average age of 62.5 years. For 30 patients with mild to moderate atypical hyperplasia of gallbladder during the same period were included in the precancerous lesion group, including 9 males and 21 females, with an average age of 62.4 years. Normal gallbladder specimens from 20 patients who underwent surgical resection due to liver trauma or giant hepatic hemangioma were collected and included in the normal group, including 7 males and 13 females, with an average age of 61.9 years. The expressions of GOLPH3, NLRP3, Ki-67 were detected by immunohistochemistry. Log-rank test and Cox regression were adopted to analyze the GOLPH3 and NLRP3 expression and survival prognosis of gallbladder cancer patients.Results:Expression of GOLPH3 and NLRP3 in the tumor group, precancerous lesion group and normal group was decreased separately. In GBC tissues, the level of GOLPH3 and NLRP3 was positively correlated with the Ki-67 expression ( r=0.972 and r=0.969, both P<0.05). Multivariate analysis showed that high level of GOLPH3 ( HR=4.891, 95% CI: 1.776-13.470) and NLRP3 ( HR=3.006, 95% CI: 1.273-7.099) was an independent risk factor for predicting the postoperative survival of patients with GBC (both P<0.05). Conclusion:GOLPH3 and NLRP3 are highly expressed in GBC tissues, and high expression of GOLPH3 and NLRP3 is an independent risk factor for postoperative survival in patients with GBC.

Objective Breast cancer is one of the deadliest malignancies in the world. ebracteolatain A (EA) is a kind of acetylphloroglucinol extracted from ebracteolatain. To explore the specific mechanism of EA inhibiting the proliferation of breast cancer cell MCF-7, so as to provide a new approach for the clinical treatment of breast cancer. Methods EA with different concentrations were added to breast cancer cell MCF-7 to detect changes in PKD1 protein expression. The plasmid with overexpressed PKD1 was constructed and transfected into cells, and the mRNA and protein expression levels of PKD1 were detected by real-time fluorescence quantitative PCR and Western Blot assay. CCK-8 assay was used to detect changes in cell proliferation capacity. Western Blot assay was used to detect the expression level of PKD1 and its related signaling pathways. Results EA inhibited the expression of PKD1 protein in breast cancer cells with a dose-dependent manner (P< 0.05). When transfected with the overexpressed plasmid, PKD1 was significantly increased in mRNA and protein levels (P<0.001). At the same time, PKD1 overexpression significantly reversed inhibition of EA on MCF-7 proliferation (P<0.001). It was confirmed by signaling pathway analysis that EA might affect the proliferation ability of breast cancer cells by inhibiting PKD1-mediated MEK/ERK and PI3K/AKT signaling activity (P<0.05). Conclusion EA could inhibit the proliferation of breast cancer cells by regulating PKD1-mediated MEK/ERK and PI3K/AKT signaling pathways.

Objective To understand the clinical features of hepatic tuberculosis. Methods The clinical manifestations, laboratory findings, treatment, and prognosis of a case of hepatic tuberculosis were analyzed. Similar cases were identified from PubMed database during the period from 2013 to 2017 using search terms "Liver/Hepatology/Hepatic Tuberculosis". The clinical data of the identified patients with hepatic tuberculosis were reviewed and analyzed. Results The 16-year-old male patient presented with cough and abdominal distension. His sputum was positive for acid-fast bacillus. CT showed low-density spaceoccupying lesions. After anti-tuberculosis treatment, the lesion disappeared. Hepatic tuberculosis was finally considered, which was caused by disseminated tuberculosis. Literature search identified 63 similar cases. In summary, the 64 cases(containing this one)included 38 males and 26 females with age from 11 months to 77 years. Tuberculosis in other site or underlying disease was found in 39 cases. The main clinical manifestations were fever(51.6％), abdominal pain(50.0％), weight loss(31.2％), loss of appetite(25.0％), tiredness/weakness(21.9％), and nausea/vomiting(20.3％). Low-density space-occupying lesions were the main features on CT image. The diagnosis was confirmed by histopathological and/or bacteriological testing in 59 patients. Five patients were diagnosed after diagnostic anti-tuberculosis treatment was effective. Overall, 36 patients were cured, 19 improved, and 3 died.Conclusions The clinical symptoms of hepatic tuberculosis are atypical. Imaging combined with histopathological examination of the liver is the preferred method for diagnosis of hepatic tuberculosis. Anti-tuberculosis treatment and timely surgical treatment is usually effective with good outcomes.

Objective To understand the clinical features of splenic tuberculosis. Methods The clinical manifestations, laboratory tests, treatment outcomes of a case of splenic tuberculosis caused by hematogenous pulmonary tuberculosis were analyzed. Related literatures about splenic tuberculosis were also reviewed. Results The patient was a 19-year-old male. Cough, fever, night sweats, and weight loss were the main manifestations. Thoracoscopy revealed tuberculosis and imaging suggested splenic tuberculosis and tuberculosis in multiple body sites. Anti-tuberculosis treatment was effective in improving patient conditions. According to literature review, there are two types of splenic tuberculosis: primary splenic tuberculosis or as part of hematogenous pulmonary tuberculosis.The clinical manifestations of primary splenic tuberculosis are usually atypical. Immune deficiency is a significant risk factor of splenic tuberculosis. The main clinical manifestations of splenic tuberculosis are splenomegaly, fever, digestive system symptoms, and occasionally spontaneous splenic rupture (3/32). Most of the patients with splenic tuberculosis (28/32) were cured or improved by anti-tuberculosis treatment and/or splenectomy. Conclusions The onset of splenic tuberculosis is mostly insidious and clinical symptoms usually atypical. The diagnosis relies on radiographic findings, biopsy and pathological examination. Anti-tuberculosis and selective splenectomy are the effective treatment. The outcome of splenic tuberculosis is good in most patients.

Objective To evaluate the predictive value and to verify the clinical effect of JPKD-vancomycin for the trough concentration of vancomycin in patients with augmented renal clearance (ARC), and to provide a reference for clinical individualized drug therapy. Methods A retrospective analysis was conducted. The clinical data of 48 adult patients with ARC using vancomycin and monitoring steady-state trough concentration of vancomycin admitted to Suzhou Hospital Affiliated to Nanjing Medical University from July 2013 to July 2017 were collected. A combination of classical Vancomycin Calculator software and JPKD-vancomycin software was used. Based on the individual conditions of patients [gender, age, height, weight, serum creatinine (SCr), disease status], Vancomycin Calculator software was used to obtain the recommended regimen and its steady-state trough concentration, and then JPKD-vancomycin software was used to predict the steady-state trough concentration of initial regimen. If the regimen was adjusted during the treatment, JPKD-vancomycin software was used to predict the steady-state trough concentration of the adjusted regimen. The measured values of steady-state trough concentration were recorded. The weight deviation between predicted concentration and measured concentration (WRES) was calculated. WRES < 30% was considered as good prediction, and the predictive value of JPKD-vancomycin software was evaluated for vancomycin trough concentration. Results Forty-eight patients with ARC were enrolled, of whom 24 patients had adjusted the dosing regimen during the treatment. The initial concentration of blood samples was 48, after adjusting the dosage regimen, 24 blood samples were collected. The initial and adjusted daily dose of vancomycin was (2 000±500) mg/d and (2 500±600) mg/d, respectively, and the initial trough concentrations and adjusted trough concentrations was (8.4±7.3) mg/L and (9.1±4.3) mg/L, respectively. Only 14.6% and 25.0% of initial and adjusted trough concentrations reached the target range (10-20 mg/L) without significant difference (P > 0.05). The WRES value of adjusted trough concentrations predicted by JPKD-vancomycin software was significantly lower than that of initial regimen [10.6% (3.0%, 16.4%) vs. 14.3% (10.5%, 38.2%), P < 0.05], and the percentage of WRES < 30% also tended to increase [95.8% (23/24) vs. 70.8% (34/48), P < 0.05]. The well predictive rate of JPKD-vancomycin software for vancomycin trough concentration was 79.2% (57/72), but there were 15 patients with WRES > 30%. Conclusions JPKD-vancomycin software has good predictive value for the vancomycin trough concentration of ARC patients, especially for the trough concentration after adjusting the treatment regimen. JPKD-vancomycin can provide a reference for the design of clinical individualized application of vancomycin.

To address the controversial issue of the toxicity of dental alloys and silver nanoparticles in medical applications, an in vivo-like LO2 3-D model was constructed within polyvinylidene fluoride hollow fiber materials to mimic the microenvironment of liver tissue. The use of microscopy methods and the measurement of liver-specific functions optimized the model for best cell performances and also proved the superiority of the 3-D LO2 model when compared with the traditional monolayer model. Toxicity tests were conducted using the newly constructed model, finding that four dental castings coated with silver nanoparticles were toxic to human hepatocytes after cell viability assays. In general, the toxicity of both the castings and the coated silver nanoparticles aggravated as time increased, yet the nanoparticles attenuated the general toxicity by preventing metal ion release, especially at high concentrations.
Cells, Cultured ; Dental Casting Technique ; Hepatocytes/drug effects* ; Humans ; Metal Nanoparticles/toxicity* ; Silver/toxicity* ; Toxicity Tests

Objective To investigate whether echocardiography left ventricular ejection fraction (LVEF) and NT-proBNP could be an early detective marker for patients with untypical NSTE-ACS. Methods A total of 248 ACS cases admitted to the emergency department of our hospital from January 1,2015 to June 31,2016 were retrospectively reviewed. The data included age,gender,past medical history,D-dimer,MB isoenzyme of creatine kinase(CK-MB),cardiac troponin I(cTnI),the precursor of the N-terminal pro-brain natriuretic peptide(NT-proBNP),electrocardiogram(ECG)before treatment,and the CK-MB,cTnI and LVEF,the treatment of percuta-neous coronary intervention(PCI)or thrombolytic by drugs. Survival condition and time from onset to death were recorded. According to the results of multivariate logistic regression analysis ,receiver operating characteristic curve(ROC curve)and fitting curve were drawn. The association between the LVEF and NT-proBNP before the treatment and prognosis of ACS was analyzed. Results NSTE-ACS patients with chief complaint of chest pain were less than those of STE-ACS(33.6% vs. 70.1%,P=0.003). Pre-hospital time was longer than that of STE-ACS group(67.92 ± 116.89 vs. 30.65 ± 55.59,P = 0.006). CTNI(4.37 ± 12.53 vs. 9.62 ± 18.00,P=0.011)and LVEF(53.51 ± 14.51 vs. 56.26 ± 12.30,P=0.019)were less than that of the STE-ACS group. NT-proBNP was higher than that of the STE-ACS group(2288.37 ± 4612.10 vs. 1506.84 ± 1722.51,P=0.038). mortality rates was higher than the STE-ACS group((15.3%vs. 6.8%,P=0.036). Multivariate logistic regression analysis showed that LVEF values was correlated to 28-day death(B =-0.097 ,P=0.022). The ROC curves showed that LVEF values was negative correlated with the 28-day death. However,combination of LVEF and NT-proBNP was better than single LVEF values. LVEF values was negative correlated with the NT-proBNP(r =-0.263,P=0.001), LVEF values had greater and longer survival time(B=0.401,P=0.045)but NT-proBNP was not related to surviv-al time.(B=0.00,P=0.931). Conclusion LVEF and NT-proBNP are correlated with the early risk assessment of patients with ACS,but was not correlated with the time from onset to death. The decrease in LVEF values at the early stage of NSTE-ACS may be helpful to indicate the critical condition of the ACS patients.

Objective To investigate the role of clinical pharmacist in anti-infection therapy for patients with augmented renal clearance (ARC).Methods A case with multi-site severe infection after traffic accident was treated with anti-infection therapy.According to the characteristics of infection and pharmacokinetics,clinical pharmacist discussed the intervention by clinical pharmacist in terms of formulating anti-infection program and adjustment of individual dose.Results After consultation and evaluation by clinical pharmacist,the patient was diagnosed as ARC.According to pharmacokinetics characteristics reported by literature,vancomycin was adjusted to 1 g (once per 8 h).Based on detection result of pathogenic bacteria,meropenem was replaced by cefoperazone/sulbactam,and the dose was increased to 3 g (once per 6 h).And then,vancomycin concentration was detected again,and it reached ＞ 10 μg· mL-1;pathogenic bacteria culture result was negative.This patient obtained good therapeutic effect.Conclusion Clinical pharmacist could assist physician on anti-infection treatment and dose adjustment of ARC patient,and improve ARC patient's therapeutic effect.