Objective To analyze the differential value of gastrointestinal stromal tumors and non-gastrointestinal stromal tumor by cytokeratin-19 fragment(CYFRA21-1),protein kinase B(PKB)and carbohydrate antigen 19-9(CA19-9)combined with endoscopic ultrasonography(EUS).Methods 69 patients with gastrointestinal stromal tumors from January 2020 to July 2023 were selected as the study group,and 78 patients with non-gastrointestinal stromal tumor(they were 25 cases of gastrointestinal leiomyoma and 53 cases of gastrointestinal schwannoma)were selected as the control group during the same period prospectively.The EUS indicators and tumor markers in the two groups were compared.Receiver operator characteristic curve(ROC curve)was drawn to analyze the diagnostic value of serum levels of CYFRA21-1,PKB and CA19-9 alone and in combination for gastrointestinal stromal tumors.Results Compared with the control group,the mean gray level,gray standard deviation and serum levels of CYFRA21-1,PKB and CA19-9 in the study group were higher(P<0.05).There was no significant difference in mean gray level,gray standard deviation and serum levels of CYFRA21-1,PKB and CA19-9 in patients with gastrointestinal stromal tumors of different genders and ages(P>0.05).Compared with patients with gastrointestinal stromal tumors with tumor diameter≤5 cm and pathological mitotic figure≤5/50 HPF,the mean gray level,gray standard deviation and serum levels of CYFRA21-1,PKB and CA19-9 were higher in patients with gastrointestinal stromal tumors with tumor diameter>5 cm and pathological mitotic figure>5/50 HPF(P<0.05).Gastrointestinal stromal tumors were included as positive and non-gastrointestinal stromal tumor as negative.ROC curve was drawn to analyze the diagnostic value of gray mean value,gray standard deviation,serum levels of CYFRA21-1,PKB,and CA19-9 alone and in combination for gastrointestinal stromal tumors,and the combined detection was the highest,area under the curve(AUC)was 0.936,the sensitivity was 82.61%,and the specificity was 91.03%.Conclusion With the occurrence and development of gastrointestinal stromal tumors,CYFRA21-1,PKB,CA19-9 levels,gray mean value and gray standard deviation increase,and levels of CYFRA21-1,PKB,CA19-9 combined with EUS are valuable in the diagnosis of gastrointestinal stromal tumors.

Pathological cardiac hypertrophy serves as a significant foundation for cardiac dysfunction and heart failure. Recently, growing evidence has revealed that microRNAs (miRNAs) play multiple roles in biological processes and participate in cardiovascular diseases. In the present research, we investigate the impact of miRNA-34c-5p on cardiac hypertrophy and the mechanism involved. The expression of miR-34c-5p was proved to be elevated in heart tissues from isoprenaline (ISO)-infused mice. ISO also promoted miR-34c-5p level in primary cultures of neonatal rat cardiomyocytes (NRCMs). Transfection with miR-34c-5p mimic enhanced cell surface area and expression levels of foetal-type genes atrial natriuretic factor (Anf) and β-myosin heavy chain (β-Mhc) in NRCMs. In contrast, treatment with miR-34c-5p inhibitor attenuated ISO-induced hypertrophic responses. Enforced expression of miR-34c-5p by tail intravenous injection of its agomir led to cardiac dysfunction and hypertrophy in mice, whereas inhibiting miR-34c-5p by specific antagomir could protect the animals against ISO-triggered hypertrophic abnormalities. Mechanistically, miR-34c-5p suppressed autophagic flux in cardiomyocytes, which contributed to the development of hypertrophy. Furthermore, the autophagy-related gene 4B (ATG4B) was identified as a direct target of miR-34c-5p, and miR-34c-5p was certified to interact with 3' untranslated region of Atg4b mRNA by dual-luciferase reporter assay. miR-34c-5p reduced the expression of ATG4B, thereby resulting in decreased autophagy activity and induction of hypertrophy. Inhibition of miR-34c-5p abolished the detrimental effects of ISO by restoring ATG4B and increasing autophagy. In conclusion, our findings illuminate that miR-34c-5p participates in ISO-induced cardiac hypertrophy, at least partly through suppressing ATG4B and autophagy. It suggests that regulation of miR-34c-5p may offer a new way for handling hypertrophy-related cardiac dysfunction.

Objective To investigate the characteristics of gray matter volume in Obsessive Compulsive Disorder (OCD) patients compared with healthy controls, and to explore the correlation between brain regions with altered gray matter volume and the patients'cognitive function and clinical symptoms. Method Thirty-six patients with first-episode OCD and 35 healthy controls who were matched by age, gender and education level were selected and examined by MATRICS Consensus Cognitive Battery (MCCB) and Yale-Brown Obsessive Compulsive Scale (Y-BOCS). The head MRI and the Voxel-based morphometry was used to test the volume of gray matter. The correlation analysis was conducted to analyze the correlation between brain areas with altered gray matter volume and patients'cognitive function and Y-BOCS results. Results Compared with the control group, the OCD group had increased gray matter volume in frontal parietal lobe (postcentral gyrus-L, precentral gyrus-L) (t=4.299, P<0.0005, voxels>100) and temporal-limbic system (fusiform gyrus-L, superior temporal gyrus-L, medial temporal lobe-L, parahippocampal gyrus-L) (t=4.841, P<0.0005, voxels> 100). Meanwhile, the volume of gray matter decreased in bilateral anterior cingulate gyrus (t=-4.181, P<0.0005, voxels>100). In the case group, there were a positive correlation between the volume of gray matter in the temporal lobo-limbic system and social cognition score (r=0.347,P=0.038) and a positive correlation between the volume of gray matter in the anterior cingulate gyrus and obsessions score (r=0.416,P=0.012). Conclusion Patients with OCD have abnormal gray matter volume in a wide range of brain regions, including the frontal parietal lobe, the temporal-limbic system, and bilateral anterior cingulate gyrus, among which the volume of gray matter in the temporal-limbic system is correlated with social cognition, and gray matter volume in the anterior cingulate gyrus is correlated with obsessions.

Objective To analyze the brain structure changes of the first-episode obsessive compulsive disorder (OCD) patients who were scanned by three-dimensional structure magnetic resonance imaging.Methods According to the diagnostic criteria of OCD in American Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (DSM-Ⅳ),the fist-episode obsessive compulsive disorder patients as case group(OCD,n=26) and the adult healthy volunteers as control group (control group,n=25) were selected.All subjects were assessed with Yale-Brown obsessive-compulsive scale(Y-BOCS),Hamilton Anxiety rating Scale (HAMA) and Hamilton Depression Rating Scale(HAMD),and then,they received 3D-MRI scanning runs.All the data was processed with freesurfer software and analyzed about cerebral cortical volume,cortical thickness,cortical surface area,the local gyrification index and subcortical nuclei volume.Results Compared with control group,the cerebral cortical thickness of OCD group increased at the left postcentral gyrus ((2.223±0.118)mm),left supramarginal gyrus ((2.486 ± 0.027) mm) and left parahippocampal gyrus ((2.399±0.164)mm).The cerebral cortical surface area larged at the right inferior frontal gyrus((1.036±0.079) mm2),right paracentral lobule ((0.827 ± 0.048) mm2) and medial orbitofrontal ((0.990 ± 0.083)mm2),and decreased at right superior parietal lobule ((0.779 ± 0.040) mm2),right inferior parietal lobule ((0.767±0.093) mm2) and right inferior temporal gyrus ((0.888±0.070) mm2).The cerebral cortical volume increased at the right inferior frontal gyrus((2.330±0.223) mm3).The cerebral cortical local gyrification index decreased at right middle temporal gyrus(2.893±0.288)and left inferior temporal gyrus(2.589±0.100).Conclusion The first-episode OCD patients have multiple changes of brain structures,and this changes were priority for the frontal lobes,orbital frontal,parietal lobe,temporal lobe and hippocampus.The changes in these regions maybe have close relationship with symptoms of OCD.

Objective To study the biological effects of dose radiotherapy for primary liver cancer patients with stereotactic body portion.Methods 80 patients with primary liver cancer were selected.According to a random number table method, all patients were divided into observation group and control group,40 patients in each group.All patients were treated with stereotactic body radiotherapy treatment, the observation group was treated with high dose, while the control group received low-dose.The radiotherapy effects of different doses were analyzed and compared.Results After treatment, the effective rate of the observation group was 77.5%,which of the control group was 55.0%, ,the difference between the two groups was statistically significant (x2=4.528,P=0.033).After treatment for 6 months,1 year and 2 years, the survival rates of the observation group were 77.5%,75.0%,72.5%, which were significantly higher than 55.5%,52.5%,50.0% of the control group (P<0.05).The incidence rate of adverse reactions of the observation group was 42.5%, which was significantly lower than 72.5% of the control group (x2=7.365,P=0.006).Conclusion Stereotactic body radiotherapy treatment with different therapeutic dose has different treatment efficacy, high-dose SBRT treatment has significantly higher efficacy, survival rate and lower adverse reactions, which is worthy of clinical application.

Objective To study the biological effect of different dose of satereotactic body radiation therapy (SBRT) on hepatoma Hep G2 Cells.Methods Hep G2 hepatumor cells vitality of 0,2,4,6,8,and 10 Gy doses of SBRT were determined by methyl thiazolyl tetrazolium (MTT) method.The cell colony formation rate and the cell survival fraction were detected.The cell apoptosis was detected by flow cytometry.The expressions of cyclin D1,Bax,Bcl-2,and caspase-3 protein were detected by Western blot.Results Hep G2 cells vitality was obvious inhibitory effect in different doses of SBRT,increasing with the SBRT dose,the cell vitality inhibition [2 Gy group (4.29 ± 0.63) ％,4 Gy group (19.37 ± 4.54) ％,6 Gy group (41.35 ±4.51)％,8 Gy group (86.34 ±5.68)％,10 Gy group (97.24 ±5.41)％] was increased,compared to 0 Gy group [(2.94 ± 0.52) ％],the difference was statistically significant (all P ＜ 0.01 or P ＜0.05).The cell colony formation rate and survival score in different doses of SBRT were statistically lower than the control group,increasing with the SBRT dose,the cell colony formation rate [4 Gy group (83.15 ± 4.71),6 Gy group (65.23 ± 5.47),8 Gy group (41.28 ± 5.36),10 Gy group (8.14 ± 5.22)] and survival score [2 Gy group (95.49 ±3.21),4 Gy group (84.23 ±3.45),6 Gy group (66.08 ± 3.71),8 Gy group (41.82 ± 3.82),10 Gy group (8.25 ± 3.56)] were decreased,compared to 0 Gy group [(98.72 ± 1.23),(100.00 ±0.00)],the differences were statistically significant (all P ＜0.01 or P ＜ 0.05).The cell apoptosis in different doses of SBRT was increased,increasing with the SBRT dose,the Hep G2 cells apoptosis [4 Gy group (13.67 ±4.62),6 Gy group (28.71 ±5.13),8 Gy group (54.16 ±5.24),10 Gy group (76.31 ± 5.17)] were significantly increased,compared to 0 Gy group (1.35 ±0.46),the difference was statistically significant (all P ＜ 0.01).The expressions of cyclinD1,Bax,Bcl-2,and caspase-3 protein in different doses of SBRT were decreased,increasing with the SBRT dose,the cyclin D1 [6 Gy group (1.94 ± 0.57),8 Gy group (1.38 ± 0.41),10 Gy group (0.52 ± 0.34)],Bax[6 Gy group (2.67 ±0.59),8 Gy group (1.73 ±0.45),10 Gy group (0.63 ±0.37)],Bcl-2 [4 Gy group (1.78 ±0.41),6 Gy group (1.03 ±0.35),8 Gy group (0.76 ±0.28),10 Gy group (0.38 ± 0.21)],Caspase-3 [6 Gy group (0.76 ± 0.31),8 Gy group (0.42 ± 0.24),and 10 Gy group (0.24 ± 0.21)] were obviously decreased,compared to 0 Gy group [(3.41 ± 0.75),(4.36 ± 0.87),(2.57 ± 0.46),(1.67 ± 0.55)],the difference was statistically significant (all P ＜ 0.05).Conclusions Different dose of SBRT can reduce Hep G2 cell vitality,enhance radiation sensitivity,have a dose dependent,maybe related to promote cell apoptosis and inhibit the proliferation of protein expression.

BACKGROUND: Studies have demonstrated that platelet-rich plasma can promote osteogenesis and proliferation of bone marrow mesenchymal stem cells, adipose-derived stem cells and skeletal muscle satellite cell, but whether it can promote the proliferation and osteogenesis of human umbilical cord mesenchymal stem cells (hUC-MSCs) is unclear. OBJECTIVE: To investigate the effects of different concentrations of platelet-rich plasma on the proliferation and osteogenic differentiation of hUC-MSCs. METHODS: Passage 5 hUC-MSCs were cultured in medium containing different concentrations of platelet-rich plasma (0, 250, 500, 750, 1000, 2000 ng/L), respectively. Cell proliferation was detected at 1, 3, 5, 7 days after culture, and the best platelet-rich plasma mass concentration was screened. Afterwards, passage 5 hUC-MSCs were divided and cultured in complete medium (blank control group), optimal concentration of platelet-rich plasma (platelet rich plasma group), osteogenesis induction medium (osteogenic induction group), or the osteogenesis induction medium containing the optimal concentration of platelet-rich plasma (combined group). Cell activity of alkaline phosphatase was detected after cultivated for 3, 7, 14 days. Osteopontin, bone specific transcription factor, and osteocalcin mRNA relative expression levels were detected after cultivated for 7, 14, 21 days. Mineralization of the extracellular matrix was detected after cultivated for 21 days. RESULTS AND CONCLUSION: After 5 and 7 days of culture, the cell proliferation was higher in 500, 750, 1000 ng/L platelet-rich plasma groups than 0 ng/L group (P < 0.05), and 750 ng/L platelet-rich plasma showed the best effect on cell proliferation, which was used in the following experiments. Compared with the other groups, the combined group had significantly increased alkaline phosphatase activity (P < 0.05), and up-regulated osteopontin, bone specific transcription factor and osteocalcin mRNA relative expression levels (P < 0.05) at different culture times. In addition, the degree of extracellular matrix mineralization in the combined group was also higher than that in the other three groups (P < 0.05).To conclude, 750 ng/L platelet-rich plasma can promote hUC-MSCs proliferation and osteogenic differentiation.

Objective To explore the effect of applying personal digital assistant(PDA)in documenting medical orders and monitoring vital signs.Method There was significant diffenence the between two groups in dicumenting,inedical orders,monitoring vital signs(P<0.05).Result BPDA needed significantly shorter time for documenting medical orders and monitoring vital signs than the traditional method(P<0.05).Conclusions PDA may shorten the time for documenting medical orders and monitoring vital signs. It reduces the repetition of nursing routines,optimizes the work flow sheet so that nurses have more time for patients and the quality of nursing is improved.

Objective To investigate the correlation between the level of serum cortisol and alexithymia in depressive patients with somatic symptoms.Methods The morning level of serum cortisol was measured with radioimmunoassay in 30 depressive patients with somatic symptoms (somatization group) and 30 depressive patients without somatic symptoms (non-somatization group).The severity of alexithymia was evaluated with Toronto alexithymia Scale(TAS-20).Results (1) The level of serum cortisol in somatization group was significantly higher than that in non-somatization group((533.88±144.10) μmol/L vs (458.27±82.87) μmol/L,P＜0.01).(2) The total TAS score and the factor score of Difficulty in identifying feelings and Difficulty in describing feelings in somatization group were obviously higher than those in non-somatization group,respectively ((67.13 ± 6.96) vs (62.03±7.14),(24.50±3.78) vs (21.63±3.63),(15.30±2.69) vs (13.57±2.03),all P＜0.01).(3) The level of serum cortisol in somatization group was positively correlated with the total score of alexithymia (r=0.596,P＜0.01) and the factor score of Difficulty in identifying feelings, Difficulty in describing feelings, externally oriented thinking,respectively (r=0.391,0.435,0.452,all P＜0.05).(4) The level of serum cortisol in non-somatization group was positively related to the total TAS score (r=0.418,P＜0.05) and the factor score of externally oriented thinking(r=0.489,P＜0.01).Conclusions Compared with depressive patients without somatic symptoms,depressive patients with somatic symptoms had more severe alexithymia,especially in Difficulty in identifying feelings and Difficulty in describing feelings.The severity of alexithymia was positively correlated with the level of serum cortisol.

Objective To explore the influence of ozone therapy on high-sensitivity C-reactive protein (hs-CRP) and matrix metalloproteinases-3 (MMP-3) in synovial fluid of patients with knee osteoarthritis,and to investigate the possible mechanism.Methods Sixty-two patients with knee osteoarthritis were divided into observation group and control group by random digits table method with 31 cases each.The patients of observation group were treated with ozone,while the patients of control group were treated with hyaluronic acid once a week for 5 weeks.The efficacy was evaluated and the level of hs-CRP and MMP-3 in synovial fluid were detected before and after treatment.Results The total effective rate in observation group was 100.00％ (31/31),significantly higher than that in control group [87.10％ (27/31)],and there was significant difference (x2 =4.28,P ＜ 0.05).After treatment,the level of hs-CRP and MMP-3 in observation group was (6.68 ±2.15) mg/L,(69.84 ± 16.97) μ g/L,significantly lower than that in control group [(8.72 ± 2.39) mg/L,(85.43 ± 19.52) tμ g/L],and there was significant difference (t =3.53,3.36,P ＜ 0.01).Conclusion There is significant effect of ozone therapy of patients with knee osteoarthritis,its mechanism may be reducing the level of MMP-3 and inhibiting inflammatory reaction.