Objectives To explore the expression, biological function, and mechanism of MKI67 in pancreatic cancer and its clinical significance. Methods The expression level, diagnosis, and prognostic value of MKI67 in pancreatic cancer were analyzed using public databases. We also investigated the association between the MKI67 with immune cell infiltration and immune checkpoint molecules. We analyzed the functional pathway enrichment to uncover the possible molecular mechanisms. qRT-PCR and Western blot assay were used to verify the expression of MKI67 mRNA and protein. Immunohistochemistry staining was used to detect the expression of MKI67 in tissue protein. Results The high expression of MKI67 was significantly associated with high histological grades and poor outcomes in pancreatic cancer. High MKI67 expression was correlated with poor prognosis of pancreatic cancer patients (P=0.009). MKI67 was an independent risk factor for the patient outcome (95%CI: 1.084-1.743, P<0.05). The MKI67 expression was positively correlated with the helper T cell 2 levels but negatively correlated with plasmacytoid DC, NK cells, mast cells, the T follicular helper, immune DC, and CD8 T cells. Conclusion MKI67 may serve as a biomarker for the diagnosis and prognosis of pancreatic cancer and the mechanism might be associated with immune escape or immunosuppression.

Objective:To analyze the association of CD19+CD24hiCD27+regulatory B cells(Bregs)with ankylosing spondylitis(AS).Methods:Eighty patients with AS in Ganzhou People's Hospital from January 2019 to December 2021 were enrolled as observa-tion group,meantime,another 60 healthy individuals were set as control group.Observation group was further divided into subgroups according to clinical stages and disease activity,advanced stage,ankylosis stage,active stage and non-active stage.Percentage of CD19+CD24hiCD27+Bregs in CD19+cells in peripheral blood of observation group and control group,and observation group patients with different stages were detected and compared,thereafter,relationship between percentage of CD19+CD24hiCD27+Bregs and clini-cal characteristics of AS patients were discussed,such as course of disease,duration of morning stiffness,the Bath Ankylosing Spon-dylitis Disease Activity Index(BASDAI),IL-10,erythrocyte sedimentation rate(ESR),C-reactive protein(CRP)and X-ray classifi-cation of sacroiliitis.Results:Percentage of CD19+CD24hiCD27+Bregs in peripheral blood in observation group was higher than that in control group.Percentage of CD19+CD24hiCD27+Bregs in CD19+cells in AS patients at ankylosis stage was higher than that in patients at advanced stage,and percentage of CD19+CD24hiCD27+Bregs in peripheral blood of patients with bony ankylosis stage was higher than that in patients with fibrous ankylosis stage.Percentage of CD19+CD24hiCD27+Breg in CD19+B cells in active AS patients was sig-nificantly higher than that of patients with stable AS(P<0.05).Serum IL-10 level in observation group was lower than that in control group,while ESR and CRP levels were higher than those in control group,with statistical significance(P<0.05).Percentage of CD19+CD24hiCD27+Breg in CD19+B cells in peripheral blood of AS patients was positively correlated with BASDAI score and serum IL-10 level,while negatively correlated with ESR and CRP levels,and had no correlation with morning stiffness time and X-ray classi-fication of sacroiliitis.Conclusion:Percentage of CD19+CD24hiCD27+Bregs in peripheral blood is reduced in AS patients,moreover,percentage is closely related to disease stage,activity and laboratory indicators IL-10,ESR and CRP,which may be involved in the occurrence and development of AS.

Objective To investigate the kinesiophobia level in patients after spinal fracture surgery and their correlations with rehabilitation self-efficacy and adherence. Methods A total of 150 patients who underwent spinal fracture surgery were enrolled in this study. General information was collected from all patients. The Tampa Scale for Kinesiophobia, Self-Efficacy for Rehabilitation Outcomes Scale, department-developed Rehabilitation Adherence Scale and postoperative activity pain [assessed using the Visual Analogue Scale (VAS)] were analyzed. Pearson correlation analysis was used to examine the relationships of kinesiophobia level with rehabilitation self-efficacy and adherence. Multiple linear regression analysis was conducted to identify factors influencing kinesiophobia level. Results The total score of postoperative kinesiophobia level in patients with spinal fracture was (57.14±3.12), which was at a high level. The total score of rehabilitation self-efficacy was (35.19±3.45), which was at a low level. The total score of rehabilitation compliance was (16.46±2.32), which was at a low level. Pearson correlation analysis showed that the total score of kinesiophobia level was negatively correlated with the total score of rehabilitation self-efficacy and rehabilitation compliance (P < 0.05). Univariate analysis revealed statistically significant differences in scores of kinesiophobia level among patients with different educational levels, postoperative activity pain and the presence or absence of postoperative complications (P < 0.05). Multiple linear regression analysis identified self-efficacy (B=-0.271, 95%CI, -0.439 to -0.103), adherence (B=-0.168, 95%CI, -0.331 to -0.004), educational level (B=0.190, 95%CI, 0.020 to 0.361), postoperative complications (B=0.403, 95%CI, 0.233 to 0.573) and postoperative activity pain (B=0.162, 95%CI, 0.003 to 0.320) were the influencing factors of postoperative kinesiophobia level in patients with spinal fracture. Conclusion The patients with spinal fracture have a higher level of kinesiophobia. The influencing factors of level of kinesiophobia are rehabilitation self-efficacy, rehabilitation compliance, education level, postoperative complications and postoperative activity pain.

The classification and differentiation of renal tumors are related to the choice of therapeutic modalities and prognosis of patients. CT texture analysis is an objective and quantitative assessment of tumor heterogeneity based on the distribution and relationship characteristics of pixel or voxel gray levels in images, which can make up for the subjective limitations of traditional image visual analysis methods for diagnosis. In this article, CT texture analysis and its application in the diagnosis of renal tumors are reviewed and the limitations are also discussed.

Septin 9 (SEPT9) gene, a member of the conserved framework protein genes family, has guanosine triphosphataseg (GTPase) activity and play an important role in a wide range of biological processes such as cell division, cell polarization and membrane remodeling.Accumulated evidence have confirmed that SEPT9is closely related to the generation and development of human diseases.And SEPT9has become the new aroused general interest in tumor related research at this stage.This article mainly reviews the structural features of SEPT9gene, action mechanism of SEPT9protein and the role of SEPT9gene in a variety of common oncogenesis, and explores the potential value of SEPT9as a marker in early tumor screening.

Delirium is an acute cognitive impairment syndrome. The incidence of delirium in intensive care unit (ICU) is higher than that in general wards which is an independent risk factor of clinical outcomes of ICU patients. At present, there is no unified standards in assessment instrument for ICU delirium in China which has influences on early diagnosis and assessment by medical staff and makes the incidence of ICU delirium high. This paper reviewed the research progress of assessment instrument for ICU delirium at home and abroad so as to provide a basis for assessment of ICU patients with delirium in China.

Objective? To evaluate the impacts of early enteral nutrition (EEN) support and delayed enteral nutrition(DEN) support in the nutritional status and infection complications in patients with severe traumatic brain injury. Methods? The articles of randomized controlled trials about EEN support and DEN support on the nutritional status and infection complications in patients with severe traumatic brain injury were searched in CBMdisc, CNKI, Wanfang Data, VIP, Cochrane Library, Web of Science, PubMed, EMbase from 1990 to 2017. The quality evaluation method in Cochrane-Handbook5.0 handbook was adopted to evaluate the quality of articles and test the heterogeneity of the included articles. Fixed-effect model or random-effect model were used to merge the effects. Results? A total of 10 randomized controlled trials were included. Meta-analysis results proved that, compared with DEN support, EEN support can increase the level of serum total protein, albumin and peripheral lymphocyte count (Z=10.20, 4.23, 5.24;P＜0.01) and reduce the incidence of pulmonary infection and craniocerebral infection in patients with craniocerebral injury (Z=4.12, 2.15; P＜0.05), but it has no effect on the incidence of upper gastrointestinal hemorrhage in patients with craniocerebral injury (Z=0.82, P=0.41). Conclusions? Compared with DEN support (within 48 hours of admission), EEN support (48 hours after admission) can effectively improve serum total protein and albumin, improve nutritional status, increase peripheral lymphocyte count, increase patient resistance and reduce the occurrence of cranial infection and pulmonary infection. Therefore, patients with severe craniocerebral injury should receive EEN support if there is no contraindication.

Objective To compare the composition of γδ T cells in the peripheral blood of gestational diabetes mellitus(GDM) patients with those of normal pregnant women,so as to explore the association of γδ T cells with the onset and progression of GDM.Methods The peripheral blood mononuclear cells(PBMC) of GDM patients(case group) and normal pregnant women(con-trol group) were separated by Ficoll-Hypaque density gradient centrifugation.γδ T cells were labeled with FITC conjugated anti TCRγδ monoclonal antibody(McAb) and PE conjugated anti-CD3 McAb and analyzed by flow cytometry.Results γδ T cells in GDM patients' peripheral blood were about(6.89 ± 3.22) ％,which was higher than normal control group(4.26 ± 1.64) ％.The percentage of γδ T cells in non-treated GDM group was significantly increased to(8.79 ± 2.33)％,while in treated GDM group,the percentage of γδ T cells was drop to normal(3.76±1.62)％.Conclusion γδ T cells in GDM patients' peripheral blood and CD3+ T Cells were slightly increased.The alteration may be related to the onset of GDM.

Objective: To investigate the situation of dental fluorosis and residents awareness of dental flourosis in rural area of Tianjin, providing the basis for control of dental fluorosis prevalence level and continuous supervise of dental fluorosis prevalence. Methods: The objectives were selected by stratified cluster sampling method. Health interview survey and oral examination were perfor med. Results : The prevalence of dental fluorosis was 5.2% in 3-5 years children group, 68.6% in 12-14 years youth group, 64.5% in 15 years youth group, and 68.2% in 35-74 years group. The prevalence of dental fluorosis in 12-14 years group was lower than that in 2005 (χ2=21.62, P < 0.001). The community index of dental fluorosis (CFI ) was 0.1 in 3-5 years children group, 1.48 in 12-15 years youth group, 1.85 in 35-74 years old group. 47.7% students knew nothing about dental fluorosis, and 54.2% adult dental fluorosis patients did not know they were suffering from dental fluorosis. 47.4% of the subjects knew the relationship between dental fluorosis and fluoride in drinking water, and 18.8% subjects considered dental fluorosis was related with tooth cleaning. Conclusion The prevalence of dental fluorosis in 12-14 years old students was lower than 12 years old at 2005, but the increase of prevalence of dental fluorosis in 3-5 years children indicates the intake of fluorosis should be more strictly controlled. The awareness of dental fluorosis in rural area residents is poor and oral health education about fluorosis should be enhanced.

Objective To explore the effect of early nasogastric tubing bile reinfusion on gastrointestinal function recovery for patients undergoing laparoscopic bileduct operation.Methods One hundred patients undergoing laparoscopic bileduct operation were divided into observation group and control group with 50 cases each by random digits table method.The control group received routine nursing,and the observation group received early nasogastric tubing bile reinfusion on the basis of routine nursing.The recovery of postoperative gastrointestinal function and the incidence of postoperative abdominal distention between the two groups were observed and compared.Results The length of time needed for intestinal voice restoration and exhausting were (17.12 ± 3.88),(33.92 ± 8.96) h in observation group,and (24.08 ± 7.25),(43.64 ± 11.18) h in control group,and the differences were statistically significant (t =5.99,4.80,P ＜ 0.01).The incidence of postoperative abdominal distension was 22％(11/50) in observation group,and 42％(21/50) in control group,and the difference was statistically significant (x2=4.60,P＜ 0.05).Conclusions The early nasogastric tubing bile reinfusion in patients undergoing laparoscopic bileduct operation can effective promote their gastrointestinal function recovery and reduce the occurrence of postoperative abdominal distension.