Objective:To investigate the risk factors for liver cancer after splenectomy in patients with cirrhosis.Methods:The clinical data of 150 patients diagnosed with hepatitis B associated cirrhosis, portal hypertension, and hypersplenism who underwent splenectomy at Shaanxi Provincial People's Hospital and the First Affiliated Hospital of Xi'an Jiaotong University from March 2000 to November 2012 were retrospectively analyzed. There were a total of 150 patients included, 114 males and 36 females, aged (44±10) years old. General information, intraoperative conditions, and postoperative complications of the patients were documented. The postoperative progress of patients was monitored by telephone or outpatient follow-up. Based on the follow-up results regarding liver cancer presence, all patients were categorized into two groups: liver cancer group ( n=42) and non-liver cancer group ( n=108). Multivariate analysis was employed to identify factors influencing the liver cancer occurrence after splenectomy. Kaplan-Meier survival analysis along with log-rank test was utilized to assess overall survival and survival rate comparison. Results:Compared to the non-liver cancer group, the liver cancer group exhibited an increased prevalence of hypertension, direct bilirubin levels, prothrombin time, maximum spleen diameter, and postoperative thrombosis (all P<0.05). However, there was a significant reduction in the number of patients receiving long-term regular antiviral therapy and postoperative bleeding (all P<0.05). The multivariate analysis revealed that preoperative hypertension ( OR=6.310, 95% CI: 1.729-23.024, P=0.005), spleen diameter exceeding 12 cm ( OR=5.338, 95% CI: 1.234-23.094, P=0.025), and occurrence of postoperative thrombosis ( OR=8.652, 95% CI: 2.700-27.729, P<0.001) in patients with hepatitis B-related liver cirrhosis and portal hypertension were associated with an increased risk of developing liver cancer following splenectomy. Patients who receive long-term regular antiviral treatment after surgery ( OR=0.143, 95% CI: 0.038-0.545, P=0.004) have a lower risk of developing liver cancer. There was no statistically significant difference observed in the cumulative survival rate between the liver cancer group and the non-liver cancer group ( χ2=1.74, P=0.187). Conclusion:Preoperative hypertension, spleen diameter exceeding 12 cm, and postoperative thrombosis are independent risk factors for liver cancer in patients with hepatitis B-related cirrhosis and portal hypertension after splenectomy. Additionally, postoperative long-term antiviral therapy serves as an independent protective factor.

Objective:To develop a questionnaire on knowledge, attitude and practice of Helicobacter pylori (Hp) infection among physical examination population, and to verify its reliability and validity.Methods:This study was a cross-sectional survey. Based on the theory of knowledge, attitude and practice, the first draft of the questionnaire on knowledge, attitude and practice of Hp infection in physical examination population was designed by means of retrospective literature research, qualitative interview, discussion in the research group. The structure and items of the questionnaire were consulted and revised by the expert consultation method (Delphi method). Through pre investigation of 186 physical examination personnel from May to June in 2021, the final version of the "knowledge, attitude and practice questionnaire on Helicobacter pylori infection among physical examination population" was formed after adjustment and verification of the reliability and validity of the questionnaire.Results:The questionnaire of knowledge, attitude and practice of Hp infection in physical examination population included 3 dimensions and 28 items, and the cumulative variance contribution rate was 56.271%. The content validity index of each item level of the questionnaire was 0.75-1.00, and the content validity index of the total questionnaire was 0.94. The Cronbach alpha of knowledge, attitude and practice dimensions in this questionnaire were 0.862, 0.901 and 0.798 respectively. The overall Cronbach alpha of the questionnaire was 0.890, and the half reliability was 0.698. The test-retest reliability of the questionnaire was 0.919, and the test-retest reliability of each dimension was 0.924, 0.917 and 0.845.Conclusions:The questionnaire has good reliability and validity, and can be used to measure the level of knowledge, attitude and practice of Hp infection in physical examination population.

Tumor metastasis depends on the dynamic balance of the actomyosin cytoskeleton. As a key component of actomyosin filaments, non-muscle myosin-IIA disassembly contributes to tumor cell spreading and migration. However, its regulatory mechanism in tumor migration and invasion is poorly understood. Here, we found that oncoprotein hepatitis B X-interacting protein (HBXIP) blocked the myosin-IIA assemble state promoting breast cancer cell migration. Mechanistically, mass spectrometry analysis, co-immunoprecipitation assay and GST-pull down assay proved that HBXIP directly interacted with the assembly-competent domain (ACD) of non-muscle heavy chain myosin-IIA (NMHC-IIA). The interaction was enhanced by NMHC-IIA S1916 phosphorylation via HBXIP-recruited protein kinase PKCβII. Moreover, HBXIP induced the transcription of PRKCB, encoding PKCβII, by coactivating Sp1, and triggered PKCβII kinase activity. Interestingly, RNA sequencing and mouse metastasis model indicated that the anti-hyperlipidemic drug bezafibrate (BZF) suppressed breast cancer metastasis via inhibiting PKCβII-mediated NMHC-IIA phosphorylation in vitro and in vivo. We reveal a novel mechanism by which HBXIP promotes myosin-IIA disassembly via interacting and phosphorylating NMHC-IIA, and BZF can serve as an effective anti-metastatic drug in breast cancer.

【Objective】 To investigate and summarize the clinical and imaging features of a few patients with coronavirus disease 2019 (COVID-19) in Lanzhou City. 【Methods】 We carried out a retrospective analysis of the epidemiological data, laboratory results and clinical imaging features of eight hospitalized patients with confirmed COVID-19 in The First Hospital of Lanzhou University from January 23 to February 23, 2020. 【Results】 The sex ratio (men to women) of the 8 patients was 5∶3 while their age ranged from 24 to 57 years old. The incubation period was 1-10 days. Of the 8 patients, 7(87.5%) had COVID-19 brought in from other places in China and 1(12.5%) was a secondary infection case. The main clinical manifestations included cough in 6 cases (75%), fever in 4 cases (50%), expectoration in 3 cases (37.5%), and fatigue in 2 cases (25%). All the 8 cases indicated abnormal manifestations in blood routine examinations, 4 cases (50%) decreased in WBC, 7 cases (87.5%) decreased in Lym count, 5 cases (62.5%) increased in LDH, 1 case (12.5%) increased in CK, 1 case(12.5%) increased in CK-MB, 4 cases (50%) increased in CRP, 2 cases (25%) increased in PCT, and 1 case (12.5%) increased in D-dimer. Of the 2 patients examined by chest digital radiography (DR), one DR finding was not typical and the other one suggested increased bilateral lung markings. Six patients were examined by HRCT, of whom four (50%) showed multiple ground glass opacities on both lobes and two (25%) showed multiple ground glass opacities only on the right lobe; none of the 6 imaging findings suggested pleural effusion. Six patients were discharged from hospital after being cured and 1 patient still underwent treatment. 【Conclusion】 Most of these 8 patients had COVID-19 imported from outside the city, and the patients were relatively young with few underlying diseases. Their major symptoms were fever, cough, and expectoration. All of them exhibited abnormal findings in blood routine examinations; half of them suggested increased CRP while a few ones showed abnormal CK and Ddimer values. The imaging manifestations of most patients were multiple ground glass opacities near the peripheral pleura.

Objective:To understand the real experience and feeling of Intensive Care Unit (ICU) nurses after delirium assessment using Cornell Assessment of Pediatric Delirium (CAPD) , so as to provide reference and evidence for improving pediatric ICU delirium assessment.Methods:Using the purposive sampling method, a total of 11 ICU nurses who used CAPD for pediatric delirium assessment in a ClassⅢ Grade A children's specialized hospital in Shanghai from February to April 2020 were selected as the research objects. Phenomenological research method in qualitative research was used to conduct face-to-face and semi-structured in-depth interviews with the research subjects. Colaizzi 7-step analysis method was used to collect and sort the data and analyze and refine the topics.Results:ICU nurses' cognition in pediatric delirium assessment could be classified into four themes, including changes of ICU nurses' cognition of pediatric delirium assessment, obstacles to pediatric delirium assessment, promoting factors for pediatric delirium assessment, and ICU nurses' concern about the collaborative intervention of medical team after the positive delirium assessment.Conclusions:The main manifestations of ICU nurses in this study are the lack of understanding of the evaluation of delirium, the obstacles encountered in the evaluation process, and the lack of collaboration between the medical and nursing team. In order to improve the convenience and accuracy of ICU nurses' assessment of delirium, it is recommended to strengthen the training of medical staff for delirium, gradually optimize the obstacles to the implementation of the assessment, encourage the cooperation of medical teams and develop a delirium assessment process in line with children's ICU according to the working situation and mode of ICU.

Objective To investigate the influence of total progressively motile sperm count(TPMSC) after treatment on clinical outcomes of intrauterine insemination(IUI) with the husband′s sperm in ovulation-promoting cycles.Methods The clinical data in 4179 cases undergoing IUI with the husband′s sperm in ovulation-promoting cycles were retrospectively analyzed.The correlation between clinical pregnancy rate and TPMSC was analyzed.Results Among all the clinical data,TPMSC was to 100×106 in occasional live sperm.TPMSC<0.15×106 was in 15 cases,1 case had pregnancy (live sperm was occasionally seen on IUI day after sperm processing).Ten cases of TPMSC >60×106 had no pregnancy.A total of 4 154 cases of TPMSC (0.15-60.00)×106 were analyzed.The female age,duration of infertility,number of follicles and endometrial thickness(EDM) had no statistical differences among various groups.The clinical pregnancy rate was 13.5%(576/4 154),the group with the highest clinical pregnancy rate was (5.00-<10.00)×106.But there was no statistically significant difference in clinical pregnancy rate among groups(P=0.133).Conclusion Performing IUI in PMSC (0.15-60.00)×106 after processing can get preferable pregnancy rates.

Objective: To evaluate the usefulness of retroauricular hairline incision (RAHI) in partial superficial parotidectomy (PSP) by comparison with modified Blair incision (MBI). Methods: A retrospective analysis of 64 medical records for patients with benign parotid tumors who underwent partial superficial parotidectomy was undertaken (28 were in MBI group, 36 in RAHI group). Size and location of tumors, operative time, occurrence of facial nerve paralysis and Frey′s syndrome, and cosmetic outcomes were compared between RAHI and MBI groups. Results: Compared with MBI group, RAHI group showed better cosmetic results for benign parotid tumors in mean satisfaction score(P<0.001). There were no significant differences in size and location of tumors, operative time, incidence of transient or permanent facial nerve paralysis and Frey′s syndrome between two groups (P>0.05). Conclusions Partial superficial parotidectomy can be performed safely via RAHI in most cases of benign parotid tumors. Compared with MBI, RAHI for benign parotid tumorscan improve the cosmetic outcome, without increasing the operative time or operative morbidity.

Objective To investigate whether TG2 promotes drug resistance to epirubicin through AKT signal pathway in breast cancer. Methods MCF-7 cells with constant expression of TGM2 gene(TGM2-LV)were established via the lentiviral vector. The breast cancer cells were divided into five groups,including the NC group, TG2 group and MK2206 group. The MCF-7/adr cells were divided into ADR group and MKadr group. The expres-sion of TG2 ,AKT ,Bcl-2 and P53 was detected by Western blot assay. Cells were treated with epirubicin. MTT assay was performed to assess cell proliferation. The inhibition ratio of cancer cell proliferation was evaluated. TUNEL analysis was performed to identify the apoptosis of the breast cancer cells. Results Lvels of TG2,p-AKT and Bcl-2 in NC group were significantly lower than those in TG2 group,while the expression of P53 in NC group was much higher. In MK2206(or MK/adr )group,p-AKT and Bcl-2 were down-regulated,while P53 was markedly up-regulated compared with TG2(or ADR)group(P<0.05). The results of the MTT assay showed a strong inhibi-tion in cell proliferation rate in MK2206(or MKadr )group. Compared with the NC group,TG2 promoted prolifera-tion of MCF-7 cells in TG2 group. The cell apoptosis rate in MK2206(or MKadr )group was significantly higher than that in TG2(or ADR)group(P<0.05). TG2 significantly inhibit the apoptosis of breast cancer cells ,com-pared to the control group. Conclusion TG2 might promote drug resistance to epirubicin through AKT signal path-way in breast cancer

Hoxa3-Pax1/Pax9-Eya1-Six1/4 regulatory pathway seems to be operating during forming the bilateral parathyroid/thymus common primordial in early embryonic development.The specification of the parathyroid domain in the parathyroid/thymus primordial is regulated through a Shh-Tbx1-Gcm2 pathway.Gcm2 also may play roles in later steps of parathyroid development,including CaSR and PTH gene expression.MafB and Gcm2 interact with each other and synergistically activate PTH transcription.Genetic basis and the etiology of some hypoparathyroid disorders in man are involved defects in transcription factors that include GCMB,GATA3,Tbxl,SOX3 and GNA11.This marker expression in thymus and parathyroid primordium includes HoxA3,Pax1,Eya1,and Six1;and expression of parathyroid cell-like cells includes Gcm2,CaSR,and PTH.These expressions may serve as markers of stem cell differentiation into parathyroid cell-like cells.

To explore the clinical characteristics ,as well as diagnosis and treatment , of antineutrophil cytoplasmic autoantibody‐associated vasculitides (ANCA‐AAV )with pulmonary infection as the initial manifestation , by analyzing the clinical data of 8 elderly patients with ANCA‐AAV with pulmonary infection as the initial manifestation .Six patients ,who had received treatment of methylprednisolone 1 mg/(kg · d) for 4 to 6 weeks ,switched over to tapering prednisone .Three of the six cases received immunosuppressive cyclophosphamide 2 mg/(kg · d) orally for 1 year simultaneously ,of which one case received tripterygium wilfordii 1 mg/(kg · d) in addition for 3 months .The other two cases did not receive glucocorticoid therapy due to death caused by renal fallure .Among the 8 patients ,apart from 2 patients died in renal fallure and one case of death due to respiratory fallure ,5 patients got significant improvement on symptoms as cough ,sputum ,anemia ,fatigue , muscle aches ,and their body temperature returned to normal .Thus ,ANCA assay should be performed as early as possible for patients who had no specific clinical manifestation and showed no significant improvement to anti‐infection treatment . Administration of glucocorticoid may improve the prognosis of patients with ANCA‐AAV .