ObjectiveTo investigate the effect and mechanism of polysaccharide in water extract of Cyclocarya paliurus （CPWP） in inhibiting benign prostatic hyperplasia （BPH）. MethodsCPWP was obtained by heating reflux， aqueous extraction， alcohol precipitation， and freeze drying. The chemical composition and structural properties of CPWP were analyzed by high performance liquid chromatography with 1-pheny-3-methyl-5-pyrazolone pre-column derivatization and infrared spectroscopy. Male SD rats were randomly assigned into control， model， finasteride （ig 5 mg·kg^-1）， and low-， medium-， and high-dose （ig 50， 75， 100 mg·kg^-1） CPWP groups， with 8 rats in each group. The BPH model was established by subcutaneously injecting propionate testosterone in castrated rats. The rats in the drug intervention groups were administrated with corresponding drugs， and those in the control group were administrated with an equal volume of normal saline each day. After 30 consecutive days， the rats were sacrificed， and the prostate tissue was separated and weighed. The effects of drug interventions on the body weight， prostate wet weight， and prostate index of rats were examined. The prostate tissue was stained with hematoxylin-eosin （HE） for observation of pathological changes. Enzyme-linked immunosorbent assay was employed to measure the level of dihydrotestosterone （DHT）， and immunohistochemical staining was used to detect the expression of steroid 5 alpha-reductase 2 （SRD5A2） and Ki67 in the prostate tissue. ResultsCPWP was identified as a saccharide， with characteristic absorption peaks of saccharides. CPWP showed the total sugar content of 44.15% and molecular weight within the range of 5.5-78.8 kDa， being composed of mannose， rhamnose， galacturonic acid， glucose， galactose， xylose， and arabinose. Compared with the control group， the model group had significantly increased prostate wet weight and prostate index （P<0.01）， thick and tall prostate epithelial cells， increased internal wrinkles， papillary expansion into the cavity， an elevation in DHT level in the serum， and up-regulated expression of SRD5A2 and Ki67 in the prostate tissue （P<0.05， P<0.01）. Compared with the model group， both the finasteride and CPWP groups showed decreases in prostate wet weight and prostate index （P<0.05， P<0.01）， thinned prostate epithelial cells， with only a small portion of internal wrinkles and papillary expansion into the cavity， shortened papillary protrusions， lowered DHT level in the serum， and down-regulated expression of SRD5A2 and Ki67 in the prostate tissue （P<0.01）. Moreover， CPWP exerted effects in a dose-dependent manner. ConclusionCPWP inhibits BPH by regulating the expression of SRD5A2.

Objective: To analyze the characteristics of injury surveillance cases among the elderly in Ningbo City, Zhejiang Province from 2014 to 2023, so as to provide the basis for formulating targeted injury intervention measures. Methods: Injury surveillance cases aged ≥60 years were collected from seven injury sentinel hospitals in Ningbo City through the Zhejiang Provincial Chronic Disease Surveillance Information Management System from 2014 to 2023. Population distribution, temporal distribution, injury circumstances, and clinical characteristics were described. Results: A total of 67 259 injury surveillance cases among the elderly were reported in Ningbo City from 2014 to 2023, including 32 159 males (47.81%) and 35 100 females (52.19%). The median age was 68.00 (interquartile range, 14.00) years. The three months with a higher number of cases were December (6 271 cases, 9.32%), August (6 226 cases, 9.26%) and October (6 221 cases, 9.25%). The primary causes of injury were falls (25 276 cases, 37.58%), stabs (12 250 cases, 18.21%), and sprains (11 815 cases, 17.57%). The injury occurred mainly in homes (44 975 cases, 66.87%) and streets/urban areas (16 174 cases, 24.05%). The predominant activities at the time of injury were leisure activities (28 801 cases, 42.82%) and household chores (23 647 cases, 35.16%). The proportions of falls as the cause of injury and injuries occurring at home among females and people aged 80 years and above were relatively high. The predominant sites of injury were upper limbs (23 354 cases, 34.72%) and lower limbs (20 343 cases, 30.25%). The predominant nature of injury were soft tissue injuries (43 345 cases, 64.44%) and bone and joint injuries (22 042 cases, 32.77%). Injuries were primarily mild and moderate in severity, with 46 391 cases (68.97%) and 20 205 cases (30.04%), respectively. The proportion of bone and joint injuries, moderate in injuries among females and people aged 80 years and above was relatively high. Conclusions The main causes of injury surveillance cases among the elderly in Ningbo City from 2014 to 2023 were falls and stabs, and the injuries occurred mainly in homes and streets/urban areas. Female and elderly people have a higher risk of injury.

Objective:To investigate the role and mechanism of human umbilical cord mesenchymal stem cell exosomes (hUCMSC-ex) in wounds with escharectomy and skin grafting in scalded rats.Methods:The study was an experimental study. Twelve male Sprague-Dawley (SD) rats aged 6-8 weeks were divided into combined treatment group, fixed+allogeneic skin group, autologous skin+allogeneic skin group, and allogeneic skin group by random number table method (the same grouping method hereinafter), with 3 rats in each group. The four groups of rats were inflicted with scalded wounds on the back and performed with escharectomy, and then the wounds of rats in combined treatment group were fixed with a metal ring (the same fixing method hereinafter) and transplanted with autologous skin grafts and allogeneic skin grafts, and the other three groups of rats were fixed and/or transplanted with skin grafts corresponding to the group name. At 14, 21, and 28 d after surgery, the wound healing area in the four groups of rats was measured. Another 15 male SD rats aged 6-8 weeks were divided into normal group with no treatment, high exosome group, low exosome group, supernatant group, and phosphate buffer solution (PBS) group, with 3 rats in each group. The last 4 groups of rats were treated as that in the above-mentioned combined treatment group, and then were injected around the wounds with 200 μL of PBS containing 100 μg of hUCMSC-ex, 200 μL of PBS containing 50 μg of hUCMSC-ex, 200 μL of supernatant with no hUCMSC-ex, and 200 μL of PBS at 0 (immediately), 7, 14, and 21 d after surgery, respectively. At 14, 21, and 28 d after surgery, the wound healing area in the four groups of rats was measured. The wound neo-epithelial tissue of rats in high exosome group and PBS group at 28 d after surgery and the normal skin tissue of rats in normal group at the same time point were taken, and the differentially expressed proteins were screened by label-free quantitative proteomics method; the two up-regulated and differentially expressed proteins, the immunoglobulin G1 heavy chain constant region (IGHG1) and cystatin A (CSTA) with the largest and second largest fold changes in comparison between high exosome group and PBS group were selected, and their protein expressions were detected by Western blotting. The number of samples in all experiments was 3.Results:At 14, 21, and 28 d after surgery, the wound healing area in combined treatment group, autologous skin+allogeneic skin group, and allogeneic skin group of rats was significantly larger than that in fixed+allogeneic skin group ( P<0.05), the wound healing area in autologous skin+allogeneic skin group of rats at 21 d after surgery and that in allogeneic skin group of rats at 14 and 21 d after surgery was significantly larger than that in combined treatment group ( P<0.05), and the wound healing area in allogeneic skin group of rats at 14 d after surgery was significantly larger than that in autologous skin+allogeneic skin group ( P<0.05). The wound healing area of rats in high exosome group and low exosome group at 14, 21, and 28 d after surgery and in supernatant group at 14 and 28 d after surgery was significantly larger than that in PBS group ( P<0.05); the wound healing area in high exosome group of rats at 14 and 21 d after surgery was significantly larger than that in supernatant group ( P<0.05), and the wound healing area at 14 d after surgery was significantly larger than that in low exosome group ( P<0.05); the wound healing area in low exosome group of rats at 14 d after surgery was significantly larger than that in supernatant group ( P<0.05). Compared with that in PBS group, 332 proteins were differentially expressed in the neo-epithelial tissue of the wounds in high exosome group of rats at 28 d after surgery ( P<0.05), among which the protein expressions of IGHG1 and CSTA were significantly up-regulated (with fold change of 12.60 and 2.27, respectively, P<0.05). Compared with those of normal skin tissue in normal group, 1 400 and 1 057 proteins were differentially expressed in the neo-epithelial tissue of the wounds in high exosome group and PBS group of rats at 28 d after surgery, respectively. The protein expressions of IGHG1 and CSTA in the wound neo-epithelial tissue in high exosome group of rats at 28 d after surgery were significantly larger than those in normal skin tissue of rats in normal group ( P<0.05) and those in PBS group ( P<0.05). Conclusions:hUCMSC-ex may accelerate the repair process of wounds with escharectomy and skin grafting and improve the quality of wound healing in scalded rats by regulating the protein expressions of IGHG1 and CSTA.

Objective To investigate the application effect of evidence-based practice in preventing silent aspiration in elderly hospitalized patients. Methods A total of 70 nurses and elderly patients aged ≥65 years old in the geriatric department were selected as the subjects of evidence-based practice. A total of 704 patients assessed before the application of evidence (November 2021 to April 2022) were included in baseline review group, and 744 patients assessed after the application of evidence (May 2022 to October 2022) were included in evidence application group. After the application of evidence, the nurses′ performance of relevant audit indicators and the incidence of silent aspiration in both groups were evaluated. Results After the application of evidence, the nurses′ performance rates of 11 audit indicators for reducing incidence of silent aspiration were higher than those before the application; the incidence of silent aspiration among patients decreased significantly from 12.5% before the application of evidence to 7.8% after the application (P < 0.05). Conclusion The quality audit project based on evidence is conducive to standardizing nurses′ nursing behaviors for preventing silent aspiration. The implementation of evidence-based practice to reduce the incidence of silent aspiration in elderly hospitalized patients is beneficial to reduce the occurrence of adverse events.

Objective To investigate the effect of insulin-like growth factor 2 mRNA binding protein 2 (IGF2BP2) on the proliferation, migration and tumor immune microenvironment of colorectal cancer cells and its possible molecular mechanism. Methods The Cancer Genome Atlas (TCGA) database was used to analyze the expression levels of IGF2BP2 and MYC in colorectal cancer and adjacent tissues. The expression of IGF2BP2 in HCT-116 and SW480 human colorectal cancer cells was silenced by RNA interference (RNAi), and the silencing effect was detected by quantitative real-time PCR. After knocking down IGF2BP2, colony formation assay, CCK-8 assay and 5-ethynyl-2'-deoxyuridine (EdU) assay were employed to detect cell colony formation and proliferation ability. Transwell^TM assay was used to detect cell migration ability. Quantitative real-time PCR was used to detect the mRNA expression of IGF2BP2, MYC, tumor necrosis factor-α (TNF-α), transforming growth factor-β (TGF-β) and interleukin-10 (IL-10). The protein expression of IGF2BP2 and MYC was detected by western blot. The binding ability of IGF2BP2 and MYC in HCT-116 cells was detected by quantitative real-time PCR after RNA immunoprecipitation. Results The results of TCGA database showed that the expression of IGF2BP2 and MYC in colorectal cancer tissues was significantly higher than that in adjacent tissues, and the survival time of colorectal cancer patients with high expression of IGF2BP2 was shorter. After silencing IGF2BP2, the viability, proliferation and migration of HCT-116 and SW480 cells were decreased. The mRNA expression of MYC, TGF-β and IL-10 in IGF2BP2 knockdown group was significantly decreased, while the expression of TNF-α mRNA was increased. The expression of MYC protein and the stability of MYC mRNA were significantly decreased. RIP-qPCR results showed that IGF2BP2 could bind to MYC mRNA. Conclusion Knockdown of IGF2BP2 inhibits colorectal cancer cell proliferation, migration and promotes tumor immunity by down-regulating MYC expression.
Humans ; Cell Line, Tumor ; Cell Movement/genetics* ; Cell Proliferation/genetics* ; Colorectal Neoplasms/metabolism* ; Gene Expression Regulation, Neoplastic ; Interleukin-10/metabolism* ; RNA, Messenger ; RNA-Binding Proteins/metabolism* ; Transforming Growth Factor beta/genetics* ; Tumor Microenvironment/immunology* ; Tumor Necrosis Factor-alpha/metabolism* ; Proto-Oncogene Proteins c-myc/metabolism*

Objective To explore the effect of chest circumference index adjusting tube voltage techniquey on image quality and radiation dose at coronary CTA. Methods One hundred and twenty consecutive patients [body mass index(BMI)<25 kg/m2] with suspected coronary heart disease (CHD) undergoing coronary CT angiography were prospectively selected and divided into 2 groups at random:conventional group and low dose group. Low dose group was divided into the following three subgroups according to different chest circumferences:A group(<80 cm, n=16), B group(80 to 90 cm, n=44) and C group (>90 cm, n=20). All patients were examined by coronary CTA. The patients in conventional group were performed using retrospective ECG-gating technology and reconstructed by filtered back projection algorithm. The tube voltage/tube current was 120 kV/1 000 mAs. Prospective ECG?gating technology and iterative algorithm reconstruction were used in low dose group. The tube voltages/currents were 80 kV/150 mAs, 100 kV/150 mAs, 120 kV/150 mAs in A, B, C group, respectively. Image quality was assessed by subjective evaluation (image quality score) and objective evaluation (signal?to?noise ratio).The effective radiation dose was calculated. Analyses of the differences between groups were compared with image quality, radiation dose by single factor variance and Wilcoxon signed ranks test.Results The image quality scores and signal?to?noise ratio of aorta were respectively (3.47 ± 0.38), (3.48 ± 0.27), (3.45 ± 0.32), (3.46±0.29) and (15.5±3.6), (15.8±3.6), (15.8±4.1), (16.2±3.9) in conventional, A, B and C groups, there was no statistical difference between the four groups (P=0.24, 0.43). The effective radiation dose of four groups were respectively (17.15 ± 3.25), (0.88 ± 0.02), (1.38 ± 0.05), (2.32 ± 0.04) mSv, the difference was statistically significant (P=0.02). The effective radiation dose of A, B, C group was significantly lower than that in the conventional group. Conclusion Chest circumference index adjusting tube voltages technology at coronary CT angiography can effectively reduce the effective radiation without compromise of image quality.

[ ABSTRACT] AIM:To investigate the inhibitory effect of ginsenoside Re on intimal hyperplasia induced by bal-loon-injury and to explore the role of NF-κB p65 signaling pathway in the process.METHODS:SD rats (n=40) were di-vided into 5 groups randomly: sham operation group, model group, low-dose ginsenoside Re group, middle-dose ginsen-oside Re group and high-dose ginsenoside Re group.The carotid artery intima injury model was established by 2F balloon catheters in all groups except the sham operation group.The day after modeling, the animals in model group and sham op-eration group were administered intragastrically with distilled water, and the rats in low-dose, middle-dose and high-dose ginsenoside Re groups were given ginsenoside Re at doses of 12.5 mg/kg, 25mg/kg and 50 mg/kg, respectively.After 14 continuous days, the morphological changes of the injured arteries were observed by HE staining and the lumen area, intima area and media area as well as the ratio of intimal area/media area were determined.The expression of tumor necrosis fac-tor-α( TNF-α) and interleukin-1β( IL-1β) were detected by real-time PCR.The proliferating cell nuclear antigen ( PC-NA) and nuclear factor-kappa B ( NF-κB) p65 were examined by immunohistochemistry.RESULTS:Compared with sham operation group, the vessel cavity was narrowed (P<0.01), the mRNA levels of TNF-αand IL-1β, and the protein ex-pression of PCNA and NF-κB p65 were increased in model group (P<0.05).Compared with model group, the vascular intimal hyperplasia was alleviated obviously (P<0.05), and the mRNA levels of TNF-αand IL-1β, and protein expres-
sion of PCNA and NF-κB p65 were decreased in medium and high-dose ginsenoside Re groups (P<0.05).CONCLU-SION:Ginsenoside Re inhibits the vascular neointimal hyperplasia induced by balloon-injury in rats, and the molecular mechanism may be related to the inhibition of NF-κB p65 signaling pathway.

Objective To investigate the value of MSCT and its reconstruction technique for etiological factors of adult non traumatic acute abdomen.Methods The CT findings and clinical data of 1 632 adult patients with non traumatic acute abdomen confirmed by clinical treatment or pathological examination from July 2007 to June 2013 were retrospectively analyzed.Six hundred and sixty-four patients underwent plain scan and 968 patients underwent plain and enhanced scan.We observed MSCT manifestations of acute abdomen , calculated the accurate rate of diagnosis , and analyzed causes of missed diagnosis or misdiagnosis.Results CT diagnosis of 1 580 cases were entirely or partially consistent with the final results in 1 632 cases.Overall accuracy rate was 96.8%.Misdiagnosis or missed diagnosis accounted for 3.2% ( 52/1 632 ).The corresponding accuracy rates using CT with various etiology were: urinary system stones 100.0% ( 293/293 ) , appendicitis 99.3% ( 278/280 ) , abdominal tumors 98.3%(227/231), cholecystitis and cholelithiasis 96.4% (213/221), acute pancreatitis 95.8% (159/166), intestinal adhesion 92.6%(100/108), gastrointestinal perforation 97.9%(92/94), internal and external hernia 95.2% ( 59/62 ) , intussusceptions 95.4% ( 42/44 ) , volvulus 91.7% ( 33/36 ) , foreign bodies 95.6%(22/23), ectopic pregnancy 92.3%(12/13), vascular disease 100.0% (16/16), inflammatory bowel disease 77.8%(7/9), and other diseases 75.0%(27/36).The main cause of missed diagnosis was the absence of obvious morphologic changes at early stage of the diseases.Atypical MSCT features resulted in misdiagnosis.Conclusion MSCT is a valuable tool in diagnosing adult non traumatic acute abdomen and its etiology.

Objective To investigate the difference between Asia-Pacific Colorectal Screening (APCS) scoring system and colorectal cancer sequential screening criteria issued by the Health Ministry of China (China sequential criteria) in the evaluation of high-risk colorectal neoplasm in patients undergoing coronary artery angiography (CAG) examination.Methods The data of 870 patients aged from 40 to 74 who underwent CAG examination were retrospectively analyzed.The measurement data were analyzed by t test and the count data were aralyzed by x2 test.Results There were 72 patients aged from 40 to 49 years old.Among them,eight patients were stratified as high-risk population according to the Chinese sequential criteria; however there was no high-risk population by APCS.There were 798 patients aged from 50 to 74 years old.There were 460 patients stratified as high-risk population by APCS.The percentage of CAG negative group (34.7％) was significantly lower than that of the coronary artery disease (CAD) group (68.0％,x2 =77.74,P＜0.01).According to the Chinese sequential criteria,and there were 134 patients stratified as high-risk population,and there was no significant difference between the CAG negative group (17.7 ％) and the CAD group (16.4％,P＞0.05).Among the patients aged from 50 to 74 years old without family history of colorectal cancer in first-degree relatives,72 cases (29.0％) of the CAG negative group and 316 cases (57.5％) of the CAD group were stratified as high-risk according to APCS,however not stratified as high-risk by the Chinese sequential criteria.About 90.5 ％ (351/388) of them were male smokers.According to APCS,30 cases (12.1％) of the CAG negative group and 32 cases (5.8％) of the CAD group were stratified as middle-risk population,however stratified as high-risk population by the Chinese sequential criteria.About 75.8％ (47/62) of them were female non-smokers.Conclusions The percentage of patients stratified as high-risk population by APCS was higher than that by the Chinese sequential criteria.In patients aged from over 50 to 74 years old and without family history of colorectal cancer in first-degree relative,APCS maybe overestimated the risk degree of colorectal neoplasm in male smokers and underestimated the risk degree in female non-smokers.

Objective To evaluate previous gastroscopy before percutaneous coronary intervention (PCI) for the risks and benefits of concomitant use of proton pump inhibitors (PPIs) after PCI in patients with non-acute coronary syndrome (non-ACS).Methods The data of 673 non-ACS patients who underwent PCI with stenting were retrospectively analyzed.They were divided into concomitant use of PPIs group and non-PPIs group,then subdivided into high-,moderate-and low-risk groups according to risk factors associated with adverse upper gastrointestinal (GI) events.The incidences of adverse cardiovascular events and adverse upper GI events were compared among groups.Findings of previous gastroscopy were also included.Results Only 82 patients (12.2％) underwent gastroscopy within 5 years before PCI,of whom,27 (32.9％) were diagnosed as having peptic ulcer,and 55.6％ (15/27) of whom were in concomitant use of PPIs.Compared with the non-PPIs group,the rate of adverse cardiovascular events in the concomitant use of PPIs group was significantly higher (22.6％ vs.8.9％,P ＜0.01),and the highest rate (41.7％) was in the high-risk group.However,the corresponding rate of adverse upper GI events was the lowest (4.2％).In the moderate-risk group,90.5 ％ (344/380) of patients were older than 65 years with concomitant use of NSAIDs.The rate of gastroscopy within 5 years before PCI in these patients was remarkably lower than that in patients who had the history of upper GI disease with concomitant use of NSAIDs (concomitant use of PPIs group 14.1％ vs.54.5％ ; non-PPIs group 7.5％ vs.28.0％ ; P ＜ 0.01).In the concomitant use of PPIs group,the rate of adverse cardiovascular events in the former was notably higher than that in the latter (20.5％ vs.9.1％,P ＜0.01),but the rate of adverse upper GI events within 1 year after PCI were similar (9.0％ vs.9.1％).Conclusion Previous gastroscopy before PCI could provide the baseline information of upper GI disease,which may be helpful for the evaluation of concomitant use of PPIs after PCI so as to decrease the incidence of adverse cardiovascular events.Special attention should be paid to those patients older than 65 years in the moderate-risk group and concomitant use of NSAIDs.