Objective: To investigate the effect of apigenin on the proliferation, migration, invasion, apoptosis and autophagy of human lung squamous carcinoma NCI-H520 cells. Methods: Human lung squamous carcinoma NCI-H520 cells were culturedin vitro, and the CCK-8 method was used to detect the effects of different concentrations of apigenin(2.5, 5, 10, 20 μmol/L) or cisplatin(2.5, 5, 10, 20 μmol/L) on cell viability. Carboxyfluorescein diacetate, succinimidyl ester(CFDA SE) was used to detect the effect of apigenin or cisplatin on cell division. Scratch test and Transwell test were used to detect the effect of apigenin on cell migration and invasion. Annexin V/PI double staining method and Hoechst 33258 nuclear staining method were used to detect the effect of apigenin on cell apoptosis. Transmission electron microscopy was used to observe the generation of autophagic vesicles in cells. Acridine orange(AO) staining was used to observe the changes of acidic organelles in cells. Western blot was used to detect microtubule-associated protein 1 light chain 3 B-Ⅱ(LC3 B-Ⅱ) and p62 protein expression. Results: Compared with the control group, CCK-8 assay and CFDA SE showed that apigenin or cisplatin reduced proliferation of NCI-H520 cells(P<0.05). Scratch test and Transwell test showed that apigenin reduced the migration and invasion levels of cells(P<0.01). Annexin V/PI double staining showed that apigenin increased apoptosis rate(P<0.05). Hoechst 33258 nuclear staining showed that apigenin promoted nuclear condensation and hyperchromatism of cells. AO staining fluorescence value enhanced, the autophagy bimolecular structure appeared under transmission electron microscopy, and the results of LC3 B-Ⅱ and p62 protein expression levels in Western blot showed that apigenin increased the autophagy level of cell NCI-H520(P<0.05). Chloroquine(CQ) failed to increase the protein levels of LC3 B-Ⅱ and p62 in apigenin treated cells. Conclusion Apigenin at different concentrations can inhibit the proliferation, migration and invasion of human lung squamous cell carcinoma NCI-H520, and its inhibition of cell growth and metastasis may be related to the induction of apoptosis and autophagy, and the increase of autophagy may be caused by blocking autophagosome degradation.

Objective:To retrospectively analyze the data of patients undergoing extracorporeal membrane oxygenation (ECMO) during perioperative period of cardiac transplantation and provide objective and reliable evidence for further clinical promotion.Methods:Collect the clinical data of patients undergoing heart transplantation and ECMO support in Fuwai Hospital, analyze the duration of ECMO support, combined use of aortic balloon counterpulsation (IABP), and complications during the supporting period. All statistical analyses were processed by SPSS 23.0 software. Independent sample Student's test was employed for normal distribution and Mann-Whitney U test for abormal distribution. χ2 or Fisher exact test was utilized for comparinge the classification data between groups. Results:All ECMO support models were intravenous-arterial ECMO (V-A ECMO). Eight patients successfully bridging heart transplantation through VA-ECMO. Sixty-one patients (89.7%) who had undergone cardiac transplantation were successfully weaned from ECMO while 48 patients (70.5%) survived and discharged. The most common complications during circulation support are bleeding, acute renal insufficiency, and pulmonary infection. Patients with ECMO support in the operating room had a better rate of survival and weaning off(95.6%, 84.4%) than those with ECMO at the bedside of ICU(72.2%, 27.8%).Conclusions:ECMO can provide adequate circulation and respiratory function support for heart transplant patients, and it is an indispensable treatment for patients to go through the perioperative period of heart transplant surgery smoothly. It is advocated to use IABP combined with ECMO in the early stage and at the same time to increase the perfusion of vital organs, improve the prognosis of patients and obtain good outcomes.

At present, there is still a lack of comprehensive diagnosis and treatment criteria for pancreatic exocrine insufficiency around the world. Pancreatic surgeons often ignore or misjudge pancreatic exocrine insufficiency secondary to pancreatic cancer, and as a result, pancreatic exocrine insufficiency is not adequately treated, which greatly affects the quality of life of patients with pancreatic cancer. This article summarizes the latest research advances in the pathogenesis, typical symptoms, and diagnostic methods of pancreatic exocrine insufficiency, as well as pancreatic enzyme replacement therapy in different stages of pancreatic cancer. It is pointed out that pancreatic enzyme replacement therapy can significantly improve the quality of life of patients with different stages of pancreatic cancer.

Pancreatic ductal adenocarcinoma is a highly invasive malignant tumor of the digestive system with an extremely poor prognosis. Leukemia inhibitory factor is an important member of the interleukin-6 family and can regulate multiple physiological processes such as cell differentiation, growth, and renewing. This article reviews the mechanism of action of leukemia inhibitory factor in pancreatic ductal adenocarcinoma and the research advances in leukocyte inhibitory factor-targeted therapy based on literature evidence, and the analysis shows that leukemia inhibitory factor plays an important role in the progression, immune escape, and chemotherapy resistance of pancreatic ductal adenocarcinoma and may gradually become a potential biomarker and therapeutic target for pancreatic ductal adenocarcinoma.

Objective: To understand the influence of post-abortion care (PAC) on the reproductive health of unmarried female college students,and to provide scientific basis for reproductive health education. Methods: A total of 486 unmarried female college students who received artificial abortion voluntarily due to unwanted pregnancy and had complete follow-up data were investigated by questionnaires before and six months after the operation from July 2017 to June 2018 in the Tongde hospital of Zhejiang Province. Results: There were 248 patients with abortion history, including 15 patients with abortion frequency ≥3 times.72 cases of high-risk abortion, the high-risk factors were re-abortion within half a year and the number of abortion ≥3 times; After PAC intervention, the awareness rate on menstruation and ovulation knowledge, scientific contraceptive knowledge, prevention of sexually transmitted diseases knowledge(types of diseases,raltes of transmission and preventive measures), and the harm of abortion knowledge(short-term and longterm complications), was higher than before(χ2=21.42, 69.65, 71.09, 52.80, 63.25, 187.59, 356.02, P<0.05). Before intervention, only 53.7% (261/486) of female college students used medium and low efficiency contraceptive measures, only 0.4% (2/486) were high-efficiency contraceptive measures. After intervention, all of them used contraceptive measures, The rate of effective contraceptive measures in the immediate and six months after operation was 85.4% (415/486) and 68.3% (332/486) respectively, which was significantly higher than before(χ2=786.10, P<0.05). Conclusion PAC service for female college students can improve awareness rate of sexual and reproductive health, enhance effective contraceptive measures, reduce the risk of repeated abortion.

Objective: To explore the effect of plan-do-check-act (PDCA) cycle on contraceptive methods after induced abortion in female college students. Methods: A total of 456 unmarried female college students who underwent artificial abortion in Tongde Hospital of Zhejiang Province from January 2018 to May 2019 were selected. These students were randomly divided into control group (n=228) and intervention group(n=228). Students from the control group accepted Post Abortion Care (PAC) service, while the intervention group accepted the management of PDCA cycle on basis of PAC services. Results: In the intervention group, the rate of highly effective contraception immediately after abortion and six months after abortion were 91.23% and 71.17% respectively, while in the control group were 82.89% and 60.00%, the intervention group was higher than the control group(χ2=7.03, 5.98, P<0.05). The rate of unsafe contraceptive in the intervention group six months after abortion was 3.60%, while in the control group was 20.00%, the intervention group was lower than the control group(χ2=28.35, P<0.05). Conclusion The PDCA cycle can effectively improve the utilization rate of high efficiency contraceptive methods after induced abortion in college students, reduce the rate of unsafe contraceptive six months after abortion, and it is helpful to reduce the incidence of short-term unplanned pregnancy after abortion.

Objective:To explore the characteristics of cognitive function in patients with early onset and adult onset schizophrenia.Methods:In this cross-sectional study, 546 patients with schizophrenia who met the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-Ⅳ) were selected.Among them, 62 cases were defined as early onset schizophrenia (EOS, age of onset＜18 years) and 175 patients were defined as adult onset schizophrenia (AOS, age of onset≥25 years).Patients underwent clinical assessments with the Positive and Negative Symptom Scale (PANSS) and the Personal and Social Performance Scale (PSP), and comprehensive neuropsychological assessments.Results:The EOS patients got lower scores in motor function-PEGDOM T score [ (26±12) vs. (30±11), P＜0.01], working memory-average T score of PASAT and WMSSP[ (34±12) vs. (38±10), P＜0.05]and executive function (inhibition) -Stroop T score [ (35±12) vs. (39±10), P＜0.05]than AOS patients.No differences were fund in processing speed, verbal memory and learning, visual memory and learning (Ps＞0.05) between the two groups.Conclusion:It suggests that the EOS patients have worse motor function, working memory and inhibition.

Objective? To understand the situation of urinary incontinence and quality of life among patients with post-laparoscopic radical prostatectomy and to analyze the correlation between them. Methods? From September 2015 to October 2016, we selected 115 patients with post-laparoscopic radical prostatectomy at a ClassⅢ Grade A hospital in Beijing for survey by questionnaire with the method of convenience sampling. We collected patients' general information as well as disease information, and evaluated the situation of urinary incontinence (incidence and severity of urinary incontinence) with the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF) and influence of urinary incontinence on quality of life with the Incontinence Impact Questionnaire (IIQ-7) to analyze the correlation between severity of urinary incontinence and quality of life. Results? Among 115 patients with post-laparoscopic radical prostatectomy, there were 95 (82.6%) urinary incontinence patients including 41 cases (43.1%) with mild urinary incontinence, 47 cases (49.5%) with medium urinary incontinence and 7 cases (7.4%) with severe urinary incontinence. The score of severity of urinary incontinence ranged from 0 to 19.0 with 8.0 for the median and 5.0 for the interquartile range. Spearman correlation analysis showed that the score of IIQ-7 had a positive correlation with the severity of urinary incontinence (r=0.674, P＜0.01), and had a negative correlation with the postoperative time (r=-0.215, P＜0.05). Multiple linear regression analysis showed that the main influencing factor of quality of life was severity of urinary incontinence (P＜0.01). Conclusions? Urinary incontinence is common among patients with post-laparoscopic radical prostatectomy mainly in mild and medium urinary incontinence. The more serious the urinary incontinence is,the greater the influence on quality of life is which points out that the scientific and effective management by medical staff for urinary incontinence can improve patients' quality of life.

Objective To investigate the impact of the initial fluid resuscitation with different ratio of crystalloid and colloid on the prognosis of patients with moderate severe acute pancreatitis (MSAP).Methods A retrospective analysis was made by reviewing the clinical data of 72 patients with the diagnosis of MSAP from January 2015 to July 2017 in Shanghai Changhai Hospital.According to crystalloid-colloid ratio,which was the total volume of crystalloid fluid versus colloid fluid in the first 7d at admission,patients were randomly divided into low crystalloid-colloid ratio group (＜ 4.5),middle crystalloid-colloid ratio group (4.5-7.5),and high crystalloid-colloid ratio group (＞ 7.5).The parameters of the fluid resuscitation,the cases progressing into severe acute pancreatitis (SAP),the incidence of multiple organs dysfunction syndrome (MODS) and mechanical ventilation,pancreatic necrosis and infection rate,30-day mortality,the duration of systemic inflammatory response syndrome(SIRS) and the time reaching full amount of enteral nutrition were analyzed.Results There was no statistically significant difference in gender,age,etiology and APACHE Ⅱ score within 24 h at admission in each group,which were comparable.Within the first 7 d,there were no statistic difference in the total volume of fluid infusion and the speed of resuscitation in the three groups.While the total fluid volume in the first 24 h and 72 h [(3 095 ± 1 253) ml vs (2 524 ± 751) ml,(8 005 ± 7 269) ml vs (6 667 ± 1 498)ml],the total volume of crystalloid fluid in the first 7 d [(14 485 ± 3 917) ml vs (11 544 ±2 639) ml],crystalloid-colloid ratio (12.7 ± 4.9 vs 6.0 ± 1.0),the cases of SAP (12 vs 4),MODS (41.7 ％vs 16.0％) in high ratio group were significantly higher than those in middle ratio group,but the total volume of colloid fluid was significantly lower [(996 ± 528) ml vs (1 968 ± 574) ml].In addition,the duration of SIRS [(16.5 ± 15.2) d vs (8.2 ± 6.4) d],and the time reaching full amount of enteral nutrition [(7.2 ±3.6) d vs (4.8 ± 2.4) d] in high crystalloid-colloid ratio group were higher than those in middle crystalloid-colloid ratio group (all P ＜ 0.05).Comparing with middle crystalloid-colloid ratio group,there were no significant difference in the mechanical ventilation rate,pancreatic necrosis and infection rate and 30-day mortality in high ratio group.The total volume of colloid fluid was significantly higher [(3 680 ± 1 310) vs (1 968 ±574)] and the crystalloid-colloid ratio was significantly lower [(3.2 ±0.9) vs (6.0 ± 1.0)] in low ratio group than that in middle ratio group,and there were no statistical differences on other parameters.Conclusions For the patients with MSAP,early fluid resuscitation with the crystatloid-colloid ratio of (4.5-7.5) can decrease the incidence of SAP and MODS,shorten the duration of SIRS,and promote the recovery of intestinal mucosal barrier function.

Objective     To evaluate the safety and efficacy of skeletonized and pedicled harvesting of bilateral internal mammary artery (BIMA) in coronary artery bypass graft (CABG) surgery. Methods     From December 2015 to May 2017, 152 patients (128 males, 24 females, age of 56.5±6.8 years) underwent CABG using either skeletonized BIMA (s-BIMA group, n=73) or pedicled BIMA(p-BIMA group, n=79). The operative data and post-operative outcomes were analyzed in the s-BIMA group (61 males, 12 females, age of 56.6±7.0 years) and the p-BIMA group (67 males, 12 females, age of 56.3±6.7 years). Results     There was no peri-operative mortality. There was no statistical difference in operative time, cardiopulmonary bypass time, aortic cross-clamp time or internal mammary artery graft flow between the two groups. One patient(1.4%) in the s-BIMA group suffered from severe sternal wound complication, which was major sternal wound complication. Five patients (6.3%) in the p-BIMA group suffered from sternal wound complications, including 1(1.3%) with severe complication and 4(5.1%) with minor complication. One(1.4%) patient in the s-BIMA group and 7 (8.9%) patients in the p-BIMA group suffered from chylothorax. The chest tube drainage significantly reduced in the s-BIMA group, both in postoperative day 1(P=0.000) and postoperative day 1-3 (P=0.001). CT angiography showed no stenosis of BIMA in both groups. Conclusion     The use of skeletonized BIMA for CABG is safe and efficacious, with less sternal wound complications, chylothorax and chest tube drainage. Skeletonization should be   suggested if BIMA is harvested in CABG.