ObjectiveTo investigate the expression of lysophosphatidic acid （LPA） in patients with liver cancer， as well as its influence on malignant biological behavior of liver cancer and related regulatory mechanism. MethodsFrom January 2016 to December 2022， 26 patients with liver cancer， 28 patients with liver cirrhosis， and 28 individuals undergoing physical examination were enrolled. ELISIA was used to measure the content of LPA in plasma and peritoneal effusion of the patients with liver cancer or liver cirrhosis accompanied by peritoneal effusion， and the content of LPA was measured in plasma of the normal population at the same time， so as to clarify the difference in the expression of LPA in different populations， such as the patients with liver cancer and those with liver cirrhosis. MTT cell proliferation assay and cell migration assay were used to observe the influence of LPA and its inhibitor pertussis toxin （PTX） on the proliferation， migration， and invasion of SMMC7721 cells. In order to investigate the effect of LPA on the expression of RhoA and its upstream and downstream molecules FAK and P53 after binding to its receptor， qPCR and Western blot were used to observe the effect of LPA on the mRNA and protein expression levels of P53， FAK， and RhoA in SMMC7721 cells. A one-way analysis of variance was used for comparison of the means of continuous data between multiple groups， and the SNK-q test was used for comparison between two groups. ResultsCompared with the patients with liver cirrhosis， the patients with liver cancer had a significantly higher concentration of LPA in plasma （4.99±0.55 μmol/L vs 2.63±0.43 μmol/L， P<0.05） and peritoneal effusion （5.19±0.63 μmol/L vs 2.91±0.46 μmol/L， P<0.05）， and the patients with liver cancer also had a significantly higher level of plasma LPA than the normal population （4.99±0.55 μmol/L vs 1.61±0.39 μmol/L， P<0.05）. The cell proliferation assay showed that LPA significantly promoted the proliferation of SMMC7721 cells， and cell proliferation rate increased with the increase in dose and time； in particular， the middle-and high-dose groups had a significantly higher proliferation rate than the control group （P<0.05）. PTX inhibited the proliferative capacity of SMMC7721 cells in a time-dependent manner， and there was a significant difference between the groups （P<0.05）. The proliferation rate of the 72-hour high-dose LPA group was 3.6 times that of the control group， while the proliferation rate of the PTX group was 0.6 times that of the control group； the proliferation rate of the 72-hour high-dose LPA+PTX group was 1.2 times that of the control group. In addition， LPA increased the migration ability of hepatoma cells， while PTX inhibited their migration， in a time-dependent manner， and there was a significant difference between the groups （P<0.05）. The migration rate of the 72-hour high-dose LPA group was 3.09 times that of the control group， while the migration rate of the PTX group was 0.4 times that of the control group； the migration rate of the 72-hour high-dose LPA+PTX group was 0.99 times that of the control group. qPCR and Western blot showed that there were significant reductions in the mRNA and protein expression levels of P53 in SMMC7721 cells after LPA treatment， while there were significant increases in the mRNA and protein expression levels of FAK and RhoA； there was a significant difference between the LPA group and the control group （P<0.05）. ConclusionThere is an abnormal increase in the expression of LPA in patients with liver cancer， and LPA can promote the proliferation of liver cancer cells and increase their migration ability. At the same time， LPA changes the expression levels of P53， FAK， and RhoA， which may be associated with the promotion of tumor development and progression by LPA.

Objective:To explore the effect of teaching based on task-driven joint feedback mechanism on improving the quality and satisfaction of teaching practical nursing students in department of gynaecology and obstetrics.Methods:A total of 203 practical nursing students who had internship in the Department of Gynaecology and Obstetrics, The First Affiliated Hospital of Hainan Medical University from June 2019 to June 2020 were selected as the research objects. They were divided into a control group ( n=96) and a study group ( n=107) according to the order of admission. The control group used traditional teaching, and the study group used task-driven joint feedback mechanism-based teaching. After the teaching, the teaching effect of the two groups of practical nursing students was evaluated through theoretical assessment, skill operation assessment and teaching satisfaction. SPSS 22.0 was used for t test and non-parametric rank sum test. Results:The theoretical assessment scores [(93.51±4.22) vs. (89.62±4.08)] and the total scores of the skill operation assessment [(93.20±4.14) vs. (82.06±3.82)] of the practical nursing students in the study group were better than those of the control group, and the difference was statistically significant ( P<0.05). The results of teaching satisfaction evaluation (teacher's ability and execution ability, teaching content and task design, teaching task completion, feedback mechanism execution and improvement after feedback) of the study group were better those of the control group, and the difference was statistically significant ( P<0.05). Conclusion:The teaching based on the task-driven joint feedback mechanism can effectively improve the teaching quality and teaching satisfaction of the practical nursing students in the department of obstetrics and gynecology.

Objective:The aim of this study was to investigate the efficacy and safety of rtansabdominal wall press to adjust ovarian position in patients with difficulty in oocyte retrieval.Methods:A retrospective case-control study was conducted to collect 177 patients with difficulty in oocyte retrieval from January 2020 to December 2021 in the Reproductive Medical Center of Peking University Shenzhen Hospital. Among the 177 patients with difficulty in oocyte retrieval, 76 patients used transabdominal wall press to adjust the position of the ovary (pushing group), and the other 101 patients were treated with routine oocyte retrieval (control group). The oocyte retrieval rate, the number of oocyte and mature oocyte, the number of transferable embryos and high-quality embryos were compared between the two groups, and the incidence of complications was recorded.Results:There was no significant difference between the two groups in the ovarian stimulation program, the dosage of ovulation promoting drugs and the number of follicles ≥14 mm on human chorionic gonadotropin (HCG) day (all P>0.05). The days of promoting ovulation in the pushing group were longer than those in the control group, and the level of estradiol on HCG day was significantly higher than that in the control group (all P<0.05). The rate of oocyte retrieval, the number of oocytes retrieved, the number of transferable embryos and high-quality embryos in the pushing group were significantly higher than those in the control group (all P<0.05). The incidence of complications during oocyte retrieval in the pushing group was significantly lower than that in the control group ( P=0.003). Conclusions:Transabdominal wall press to adjust ovarian position can improve oocyte retrieval rate and reduce the incidence of complications in patients with difficulty in oocyte retrieval.

Objective: To investigate the prevalence of postoperative delirium(PD)and its risk factors in patients aged 80 and over with hip fracture treated with total hip arthroplasty(THA). Methods: Clinical history and perioperative data of patients aged 80 years and over with hip fractures who underwent THA in our hospital from Sep.2017 to Mar.2019 were analyzed.Patients were divided into delirium group and non-delirium group.The prevalence of postoperative delirium of THA and its risk factors were analyzed by multiple Logistic regression. Results: A total of 90 patients were eligible for inclusion for this study.Of them, 27 patients(30.0%)were diagnosed as PD and 63(70.0%)did not experience PD.Multivariate stepwise Logistic regression analysis showed that a history of stroke(OR=17.702, 95%CI: 1.514-207.034, P=0.022), preoperative lower serum albumin(OR=1.524, 95%CI: 1.132-2.051, P=0.005), Mini-Nutritional Assessment short-form score(MNA-SF)(OR=1.481, 95%CI: 1.045-2.099, P=0.027)were independent risk factors for PD. Conclusions The prevalence of postoperative delirium of THA is higher in patients aged 80 years and over with hip fractures.Prevention and correction of risk factors, such as malnutrition, may help prevent the postoperative delirium.

Objective To investigate the protein expression of the canonical transient receptor potential(TRPC)channel in the hippocampus of amyloidβprotein(Aβ)?induced Alzheimer’s disease(AD)mice. Methods A total of 36 ICR mice were randomly divided into AD group and control group,with 18 rats in each group. AD mice models were established by Aβ1?42 microinjection into the lateral intracerebroventricular. Learning and memory abilities of the mice were determined using Morris water maze. All TRPC1?TRPC7 mRNA levels in the hippocampus of the mice were detected using reverse transcriptase polymerase chain reaction(RT?PCR). Hippocampal TRPC4 protein expression was examined using immunofluorescence and Western blotting methods. Results Water maze test results showed that the escape latency of AD group were significant?ly longer than that of the control group(P<0.01),and that the target quadrant occupancy of AD group was significantly shortened(P<0.01)and the frequency of platform crossing of AD group was significantly reduced(P<0.01). RT?PCR results showed that all TRPC(TRPC1?TRPC7) mRNA were expressed in the hippocampal of both AD group and control group. Among these channels ,only TRPC4 mRNA levels of AD group was higher than that of the control group(P<0.01). Immunofluorescence images showed that TRPC4 expressed on the membrane of neurons and the intensities of the immunofluorescence of TRPC4 in AD group were stronger than that of control group. Western blotting results showed that the TRPC4 protein expression of AD group was higher than that of control group(P<0.05). Conclusion The increase of TRPC4 protein expression in the hippocampus of mice after intracerebroventricular injection of Aβ1?42 oligomers suggests that TRPC4 may be involved in the pathogenesis of AD induced by calcium homeostasis.

Objective To establish a scientific and comprehensive quality of life ( QOL ) evaluation index system for the elderly living alone. Methods Based on the literature review, we organized theoretical analysis, in-depth interview with the old people living alone, experts group discussion;according to the principle of constructing index system, the QOL evaluation index system framework of the elderly living alone was initially constructed. Then 15 experts were consulted by two-round Delphi method. Each of the index was weighed by matrix dual comparison method. Results The QOL evaluation index system of the elderly living alone was established including 4 primary indexes, 9 secondary indexes and 32 tertiary indexes. Conclusions The index system can provide reference for the research of the QOL scale of the elderly living alone and the guidance for evaluation and enhancement of the QOL of the elderly living alone.

Objective To evaluate the efficiency of BIOMED-2 system in detecting IGH gene clonal rearrangement and application in diagnosis of extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT) lymphoma. Methods Forty-five cases were collected, including 36 MALT lymphomas from different organs, 3 extranodal lymphoid tissue proliferative lesions and 6 severe gastritis associated with H pylori. DNA was extracted from the formalin fixed paraffin embedded blocks of these cases and the quality of DNA was assessed using the BIOMED-2 specimen mixed control primers. IGH gene clonal rearrangement was detected using IGH VH-JH primers. The sensitivity and specificity of BIOMED-2 PCR were analyzed.Results Adequate DNA (≥ 300 bp) was obtained in 31 of 45 samples (including 22 MALT lymphomas, 3 lymphoid tissue proliferative lesions and 6 severe gastritis), and the DNA from the other 14 samples was degraded seriously. 16 of 22 MALT lymphomas were positive of IGH clonal rearrangement with the sensitivity of 72.7 ％.In contrast,none of 6 severe gastritis was positive with the specificity of 100 ％ IGH and clonal rearrangement were detected in one of 3 lymphoid tissue proliferative lesions. Conclusion BIOMED-2 assay is an effient and reliable method for diagnosis and differential diagnosis of MALT lymphoma which is important for clinical practical value.

Objective To identify the expression of DLK1 protein in different types of renal cell carcinomas and its correlations with pathological characteristics and metastasis. Methods Immunohistochemistry analysis was performed to evaluate the expression of DLK1 protein in 94 cases of primary clear cell renal cell carcinoma, 76 cases of papillary renal cell carcinoma, 45 cases of chromophobe renal cell carcinoma, 71 cases of distal metastatic and 24 cases of lymph node metastatic clear cell renal cell carcinoma, as well as 18 cases of normal renal tissue. The correlations of DLK1 protein expression with pathological characteristics were analyzed. Results DLK1 protein was expressed in proximal and distal renal tubular epithelial cells in all the normal renal cases. In contrast, DLK1 protein expression was lower in different types of renal cell carcinoma. The low or negative expression of DLK1 protein in clear cell renal cell carcinoma, papillary renal cell carcinoma and chromophobe renal cell carcinoma was 33.0% (31/94), 27.6% (21/76) and 33.3% (15/45), respectively. Compared to normal renal tissue, DLK1 protein expression was significantly down-regulated in renal cell carcinomas (P＞0.05), whereas there was no significant difference on DLK1 protein expressions among the different types (P＞0.05) of renal cell carcinomas. DLK1 protein expression was not correlated with sex (60 male and 34 female cases), age (≥55, 50 cases and 55, 44 cases), grade (41 cases in grade I, 9 cases in grade II, 21 cases in grade III and 23 cases in grade Ⅳ respectively) and lymph node metastasis (76 cases with and 18 cases without lymph node metastasis) in clear cell renal cell carcinoma (P＞0.05). There was also no significant difference among primary, lymph node and distal metastatic lesions of clear cell carcinoma (P＞0.05). Conclusions DLK1 protein expression is commonly down-regulated in different types of renal cell carcinomas. Down-regulation of DLK1 protein expression is not associated with pathological characteristics and metastasis in clear cell renal cell carcinoma.

Objective To clarify the MUM1/IRF4 expression in follicular lymphoma (FL) and its clinical and pathological significance. Methods Ninety-six cases FL were immunostained with MUM1,CD10,bcl-2,bcl-6 and Ki-67 antibodies. The results were compared with their clinical and pathological features. Results The overall MUM1 expression rate in FL was 59.2 % (58/96),including 36.2 % (19/51) grade 1 or 2 and 86.4 %(39/45) grade 3 cases (x2 =24.406,P <0.001). 68.9 % cases with diffuse area were MUM1 positive (x2 =8.161,P =0.004). MUM 1 and CD10 expression had inverse correlation,83.3 % CD10 negative cases were MUM1 positive (x2= 12.649,P<0.001). The mitosis rate and Ki-67 label index were statistically higher in MUM1 positive cases than in negative cases (t = -3.852 & -4.610,respectively,P <0.001). Conclusion MUM1 can be used as a biomarker to divide FL into different malignancies. The MUM1 positive FL may be the feature of high grade non germinal center B cell malignant lymphoma.

OBJECTIVE: To determine the value of treadmill exercise test in predicting patients with moderate OSAHS treated by uvulopalatopharyngoplasty (UPPP) and tone base reduction or oral appliance. METHOD: Sixty-six patients were treated by UPPP and tone base reduction or oral appliance. The data including PSG (AHI, SaO2) and treadmill exercise test (METs) was analysed. RESULT: The success rate (percentage of patients with at least 50% reduction in AHI) of UPPP and tone base reduction was 86.7%, and 84.8% in oral appliance. The difference (AHI, SaO2, METs or the success rate) between the groups of postoperation or oral appliance was nonsignificant (P > 0.05). CONCLUSION As to moderate OSAHS, the UPPP and tone base reduction or oral appliance may be one of the effective therapy. The data including PSG (AHI, SaO2) and METs may be very useful in predicting effectiveness of treatment to OSAHS.
Adult ; Aged ; Exercise Test ; Female ; Humans ; Male ; Middle Aged ; Palate ; surgery ; Pharynx ; surgery ; Polysomnography ; Predictive Value of Tests ; Sleep Apnea, Obstructive ; metabolism ; physiopathology ; surgery ; Treatment Outcome ; Uvula ; surgery ; Young Adult