The study aimed to investigate the expression of ITGB1 in gastric cancer tissues and its impact on the efficacy of immunotherapy,and to find a new biomarker for prognosis assessment and prediction of immunotherapy response in gastric cancer.By utilizing bioinformatics methods to analyze the transcriptomic data,clinical pathological characteristics,and survival information of gastric cancer patients in the Cancer Genome Atlas(TCGA)database,this study evaluates the expression of ITGB1 in gastric cancer and its correlation with clinical features.Furthermore,an in-depth analysis was conducted for evaluating the relationship of ITGB1 expression with immune infiltration,immune checkpoint-related genes,immune subtypes and immunotherapy response.Data showed that high ITGB1 expression in gastric cancer tissues is associated with later T stage,lower survival rates,and lower overall survival.Analysis of immune infiltration scores showed the score for CD4+T cells,CD8+T cells,neutrophils,macrophages and dendritic cells were higher in the high ITGB1 expression group.Additionally,the levels of immune checkpoint-related genes such as SIGLEC15,TIGIT,CD274,HAVCR2,CTLA4 and PDCD1LG2 were elevated in the high ITGB1 expression group,and the expression of ITGB1 was positively correlated with the expression of immune checkpoint-related genes including SIGLEC15,TIGIT,CD274,HAVCR2,CTLA4,LAG3 and PDCD1LG2.Analysis based on the data from the TISIDB database revealed differential expression of ITGB1 in various immune subtypes of gastric cancer,with significantly higher expression levels in the C6 subtype(TGF-β dominant type).The TIDE algorithm indicated a high score for the group with high ITGB1 expression,suggesting poor efficacy of immune checkpoint blockade therapy.To sum up,we find that high expression of ITGB1 in gastric cancer tissues is a poor prognostic indicator for gastric cancer patients,thus ITGB1 may serve as a potential biomarker for assessing prognosis and predicting the efficacy of immunotherapy in gastric cancer.

In this study,a functionalized covalent-organic framework(COF)was first synthesized using porphyrin as the fabrication unit and showed an edge-curled,petal-like and well-ordered structure.The synthesized COF was then introduced to prepare porous organic polymer monolithic materials(POPMs).Two com-posite POPM/COF monolithic materials with rod shapes,referred to as sorbent A and sorbent B,were prepared in stainless steel tubes using different monomers.Sorbents A and B exhibited relatively uniform porous structures and enhanced specific surface areas of 153.14 m2/g and 80.01 m2/g,respectively.The prepared composite monoliths were used as in-tube solid-phase extraction(SPE)sorbents combined with HPLC for the on-line extraction and quantitative analytical systems.Indole alkaloids(from Catharanthus roseus G.Don and Uncaria rhynchophylla(Miq.)Miq.Ex Havil.)contained in mouse plasma were extracted and quantitatively analyzed using the online system.The two composite multifunctional monoliths showed excellent clean-up ability for complex biological matrices,as well as superior selec-tivity for target indole alkaloids.Method validation showed that the RSD values of the repeatability(n=6)were≤3.46％,and the accuracy expressed by the spiked recoveries was in the ranges of 99.38％-100.91％and 96.39％-103.50％for vinca alkaloids and Uncaria alkaloids,respectively.Furthermore,sorbents A and B exhibited strong reusability,with RSD values≤5.32％,which were based on the peak area of the corresponding alkaloids with more than 100 injections.These results indicate that the composite POPM/COF rod-shaped monoliths are promising media as SPE sorbents for extracting trace compounds in complex biological samples.

Indole-3-carbinol(I3C),an important anticancer compound found in broccoli,has attracted considerable attention.The rapid extraction and accurate analysis of I3C in the pharmaceutical industry in broccoli is challenging as I3C is unstable at low pH and high temperature.In this study,a rapid,accurate,and low-cost ultrasound-assisted dispersive-filter extraction(UADFE)technique based on poly(deep eutectic solvent)-graphene oxide(PDES-GO)adsorbent was developed for the isolation and analysis of I3C in broccoli for the first time.PDES-GO with multiple adsorption interactions and a fast mass transfer rate was synthesized to accelerate adsorption and desorption.UADFE was developed by combining dispersive solid-phase extraction(DSPE)and filter solid-phase extraction(FSPE)to realize rapid extraction and separation.Based on the above two strategies,the proposed PDES-GO-UADFE method coupled with high-performance liquid chromatography(HPLC)allowed the rapid(15-16 min),accurate(84.3％-96.4％),and low-cost(adsorbent:3.00 mg)analysis of I3C in broccoli and was superior to solid-phase extraction,DSPE,and FSPE methods.The proposed method showed remarkable linearity(r=0.9998;range:0.0840-48.0 μg/g),low limit of quantification(0.0840 μg/g),and high precision(relative standard deviation≤5.6％).Therefore,the PDES-GO-UADFE-HPLC method shows significant potential in the field of pharmaceutical analysis for the separation and analysis of anti-cancer compounds in complex plant samples.

Objective:To investigate the current status of satisfaction with training program and loyalty to the university among professional postgraduate students majoring in clinical medicine, as well as the association between satisfaction with training program and loyalty to the university.Methods:The 2017 National Medical Student Satisfaction Survey Database was used. A total of 1 944 professional postgraduate students in the second or third year, as well as those with delayed graduation, from 59 postgraduate training colleges and universities who participated in clinical internship were selected. SPSS 20.0 software was used for analysis; descriptive analysis was used to describe satisfaction with training program and loyalty to the university; factor analysis was adopted to calculate comprehensive satisfaction score to reduce the number of variables; logistic regression analysis was applied to investigate the association of general information and satisfaction with training program with loyalty to the university.Results:The professional postgraduate students majoring in clinical medicine had a degree of 60.44% of loyalty to the university. Satisfaction with training program reflected low satisfaction at each link of the training program. For every 1-point increase in the comprehensive satisfaction scores of the four links of courses, research training, college support, and practice, the loyalty to the university was increased to 2.11, 1.83, 1.77, and 1.75 times as the original, respectively, of the baseline scores.Conclusion:There is still room for further improvement in the satisfaction with training program and the loyalty to the university among professional postgraduate students majoring in clinical medicine, and the satisfaction with training program is closely associated with the loyalty to the university. Colleges and universities need to take measures for courses, practice, research training, and college support, so as to improve satisfaction and thus enhance loyalty to the university.

Objective: To examine the effect of standardized lymphectomy and sampling of resected lymph nodes (LN) on TNM staging of resectable pancreatic head cancer. Methods: Consecutive patients with resectable pancreatic head cancer who received standard pancreatoduodenctomy at Department of General Surgery in Beijing Hospital from December 2017 to November 2018 were recruited as study group. After operation, the surgeon sampled lymph nodes from the fresh specimen following the Japanese Gastric Cancer Guidelines.Thirty-three cases were recruited in the study group and the mean age was (59.8±15.2) years.Pathologic reports from December 2015 to November 2016 were taken as control group, containing 29 cases with age of (57.0±13.0) years. Number of lymph nodes, standard-reaching ratio and positive nodes ratio were compared between two groups. According to the seventh edition and eighth edition of TNM staging, the changes of N staging and TNM staging were analysed. The quantitative data conforming to normal distribution were tested by independent sample t test, the quantitative data not conforming to normal distribution were tested by rank sum test, and the enumeration data were analysed by χ² test. Results: The basal data of the two groups were comparable (all P>0.05) . The number of lymph nodes sampled in the study group was 23.27±8.87, significantly more than in control group (12.86±5.90, t=0.653, P=0.000) .Ratio of cases with more than 15 nodes was 81.8% (27/33) in the study group and 34.5% (10/29) in the control group with statistical significance (χ²=14.373, P=0.000) . In the study group, the positive lymph node ratios of No. 17a+17b, 14a+14b, 8a+8p LN were 36.4% (12/33) , 30.3% (10/33) and 9.1% (3/33) respectively. The positive lymph node ratio in No.14a+14b LN was higher than in No.8 LN (χ²=4.694, P=0.030) . According to the change in N staging system in the AJCC eighth edition, 2 cases (6.1%, 2/33) changed from ⅠB to ⅡA, 7 cases (21.2%, 7/33) from ⅡA to ⅠB and 5 cases (15.2%, 5/33) changed from ⅡB to Ⅲ (25.0%, 5/20) . Conclusions No.14 LN should be treated as the first station rather than second station because of the anatomic character and higher metastatic ratio. Standardised lymphectomy and sampling may increase the number of LN resected and improve the TNM staging of resectable pancreatic head cancer.

Objectives? To describe the human resource allocation of ophthalmic nurses in China, and to compare the differences based on the ophthalmic nurse availability among different regions so as to put forward policy recommendations. Methods? We used the latest data of China Ophthalmic Competency Resource Survey in 2015 and China Population and Employment Statistics Yearbook to describe the quantity, education backgrounds and professional titles of ophthalmology nurses in different regions of China. Population-weighted quartiles of the county-level number were defined and used to analyze the differences in education backgrounds and professional titles among different regions and different levels of availability. Results? By the end of 2014, the number of ophthalmic nurses was 3.19 per 100 000. The eastern part had 30% more nurses than the western and the urban area had 285% more than the rural area. The ratio of ophthalmology doctors to ophthalmic nurses is 1∶1.13 while the eastern area had the lowest ratio. Most of the ophthalmic nurses held post-secondary diploma and only entry-level titles. The availability of ophthalmic nurses in the east China was better than any other parts. It was easier to get an ophthalmic nurse in the cities than in rural areas. And the condition got worst in western rural districts. The proportion of nurses with a bachelor's degree went higher with the increase in availability, while this trend reverted with regard to the proportion of senior titled nurses. With the same availability, the quality of human resources in western and rural areas is the worst. Conclusions? The resource allocation of ophthalmic nurses in China has gradually improved, but there are still problems such as regional inequality and large urban-rural gap. The availability analysis can show the inter-regional difference in terms of the quantity of ophthalmic nurses in a more detailed manner, such that the situations in the urban and rural areas are in extremely differentiated states; The quality of ophthalmic nurses in China needs to be further improved, and the quality difference will further aggravate the imbalance of resource allocation.

Objective To investigate the rates of undernutrition and nutritional risks of surgical pa-tients with pancreatic tumors .Methods Totally 121 surgical patients with pancreatic tumors from Depart-ment of Surgery Beijing Hospital were enrolled in a prospective study during January 2014 to December 2015 . Patients were divided into two groups:the pancreatic cancer group ( n=90 ) and other pancreatic tumor group ( n=31 ) .Nutritional Risk Screening 2002 was used to assess the nutritional status .Other data including an-thropometric measure, body composition, blood biochemistry and clinical outcome were collected and ana-lyzed.Results Among 121 patients, the mean age was ( 61.9 ±13.6 ) years, the mean body mass index was ( 23.20 ±2.95) kg/m2 , the mean mid-upper circumference was ( 28.8 ±3.5 ) cm, the mean muscle weight was (44.6 ±7.4) kg, and the mean fat mass was (16.8 ±7.6) kg .There was no significantly differ-ence in anthropometric measurement results and body compositions between two groups ( all P>0.05 ) .In the pancreatic cancer group, albumin [ (39.0 ±4.7) g/L vs. (42.3 ±2.9) g/L, P<0.001], total protein [ (62.8 ±6.2) g/L vs.(66.3 ±2.9) g/L, P<0.001], and prealbumin [ (136.1 ±85.4) mg/L vs. (197.8 ±112.6 ) mg/L, P=0.011 ] were significantly lower than those in the other pancreatic tumor group and a higher fasting blood-glucose [ (6.45 ±2.47) mmol/L vs.(4.95 ±0.79) mmol/L, P<0.011] was found.Among all patients , the rates of undernutrition and nutritional risk were 4.1% and 78.5%, and the pancreatic cancer group had a higher rate of nutritional risk (91.1% vs.38.7%,χ2 =36.525, P<0.001). Conclusion In this prospective study , surgical patients with pancreatic cancer have a high incidence of nutri -tional risk, with low protein level and abnormal glucose metabolism .

Objective To investigate the nutritional status,body composition,and energy metabolism of hepatocarcinoma patients undergoing surgical treatment and explore the relationships of the nutritional status with body composition and energy metabolism.Methods Totally 112 hospitalized hepatocarcinoma patients undergoing surgical treatment met the inclusion and exclusion criteria were enrolled as the intervention group,and another 100 patients with cholelithiasis during the the same period were enrolled as the control group.Their general clinical data including body mass index(BMI),arm circumference,grip,albumin,prealbumin,energy expenditure,and body composition were collected.The nutritional status was assessed by the scored patient-generated subjective global assessment(PG-SGA).The relationships of the nutritional status with body composition and between energy metabolism were analyzed.All the data were analysed by SPSS 16.0 software package.Results The arm circumference [(23.9±3.6)cm vs.(25.3±4.5)cm,t=2.57,P=0.014],hand grip[(31.7±6.0)kg vs.(39.2±7.6)kg,t=8.19,P<0.001],serum albumin[(32.5±4.7)g/L vs.(36.5±7.2)g/L,t=4.92,P=0.007] and prealbumin[(0.172±0.052)g/L vs.(0.263±0.077)g/L,t=10.3,P=0.004] of the intervention group were significantly lower than the control group.The total malnutrition rate of the intervention group was 37.5％(42 cases at levels B and C),and that of the control group was 14.4％(14 cases at levels B and C)(X2=19.73,P<0.001).The extracellular water significantly increased in the intervention group compared with that of the control group[(15.35±2.21)L vs.(13.51±2.73)L,t=5.54,P<0.001];however,the somatic cell mass [(27.54±4.42)kg vs.(29.03±4.38)kg,t=2.53,P=0.012],fat mass[(13.44±4.23)kg vs.(17.36±5.21)kg,t=6.18,P<0.001],and muscle mass[(43.11±6.27)kg vs.(48.17±7.13)kg,t=5.63,P<0.001] had significantly decreased compared with the control group.The measured value of rest energy expenditure(mREE)[(6 581.62±1 201.70)kJ/d vs.(6 290.73±1 071.68)kJ/d,t=1.98,P=0.042] of the intervention group was significantly higher than the control group(P=0.042),and the respiratory quotient(RQ)was also significantly higher(0.87±0.10 vs.0.85±0.06,t=2.72,P=0.027).The extracellular fluid(PG-SGA A vs.B P=0.035;A vs.C P<0.001;B vs.C P=0.042)were significantly increased,and the number of somatic cells(A vs.B P=0.015;A vs.C P=0.001;B vs.C P=0.022),fat(A vs.B P=0.026;A vs.C P=0.003;B vs.C P=0.022)and muscle mass(A vs.B P=0.029;A vs.C P=0.011;B vs.C P=0.036)were decreased with the deterioration of nutritional status,resting energy expenditure(A vs.B P=0.023;A vs.C P=0.002;B vs.C P=0.032),and RQ(A vs.C P=0.004;B vs.C P=0.012)were also increased with the deterioration of nutritional status,and there was significant difference among three groups.Conclusions The incidence of malnutrition is high in hepatocarcinoma patients undergoing surgical treatment.The patients can have lower lean body mass,more water retention,and higher energy metabolism,which may worsen along with the deterioration of nutritional status.

Objective To analyze the characteristics of early cognitive impairment in leukoaraiosis (LA) patients and fractional anisotropy (FA) changes by diffusion tensor imaging (DTI) in various regions of interest (ROIs), and explore the relationship between FA values and cognitive impairment. Methods A total of 38 chronic ischemic LA patients, admitted to our hospital from August 2015 to August 2016, and 20 healthy elderly controls were chosen in our study. Comprehensive assessment of cognitive functions, and MRI and DTI examinations were performed in subjects from these two groups. The cognitive functions, and FA values in ROIs were compared between the two groups;the FA values in ROIs of mild, moderate, and severe ischemic LA patients were compared. The correlations between FA values in ROIs and cognitive functions in LA patients were analyzed. Results As compared with the healthy control group, the patient group had significantly lower Mimi Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) scores, statistically longer time of Stroop test C, lower scores of verbal fluency test (VFT), digit span (DS)-inverted sequence, word similarity test in Chinese Revision of Wechsler Intelligence Scale for Children (WISC-CR), auditory verbal learning test (AVLT), clock drawing test and block testing, and significantly longer time of Trail Marking Test A (TMTA) and Stroop test B (P<0.05), suggesting that the overall cognitive function, executive function, memory, visual-spatial ability, information processing capability of LA patients decreased greatly. Significantly decreased FA values in bilateral anterior horn of lateral ventricle, left superior frontal gyrus, left inferior frontal gyrus, bilateral frontal orbital gyrus, right deep temporal lobe, right cingulate gyrus, and genu of corpus callosum in the LA patient group were noted as compared with those in the control group (P<0.05). In mild, moderate and severe LA patients, the FA values of these ROIs decreased in turn, with statistically significant differences (P<0.05). In the LA patient group, correlation analysis showed that the scores of auditory verbal learning test were positively correlated with FA values in the brain regions of left anterior horn of lateral ventricle, bilateral frontal orbital gyrus, deep white of right temporal lobe, right cingulate gyrus, and genu of corpus callosum (P<0.05), and negatively correlated with FA values in left inferior frontal gyrus (P<0.05); the scores of trail making test A were negatively related with FA values in right anterior horn of lateral ventricle (P<0.05); the Stroop test B scores were negatively correlated with FA values in deep white matter of the right temporal lobe (P<0.05); the Stroop test C scores were negatively related with FA values in left orbital frontal cortex, deep white of right temporal lobe, right cingulate gyrus, and genu of corpus callosu (P<0.05); and the block testing scores were positively related with FA values in left frontal orbital gyrus, right temporal lobe deep, and genu of corpus callosu (P<0.05). Conclusions The early cognitive impairment and decreased FA values are noted in LA patients. FA values are related to cognitive impairment. DTI contributes to diagnose early cognitive impairment in LA patients.

Objective To investigate the changes of pathogens and antimicrobial susceptibility in patients with biliary tract infection during the past 30 years.Methods During the periods of 1981-1984,1988-1998 and 2003-2013,each 100 patients treated with common bile duct exploratoration were selected from every period.Biopsied bile specimens were performed with bacteria culture and antimicrobial susceptibility tests.This study reviewed the changes in bilary pathogens and antimicrobial susceptibility test.Results From 1981 to 1984,the most common pathogens were Escherichia coli (59.2％) and Klebsiella pneumonia (28.9％).Mixed infection of these pathogens accounted for 16.9％.From 1988 to 1998,the types of pathogens significandy increased.Escherichia coli (33.1％) and Klebsiella pneumonia (16.5％) accounted for less than 50％.Mixed infection with Escherichia coli and Pseudomonas aeruginosa was the most common type.From 2003 to 2013,gram-negative bacteria were still the main pathogens,accounting for 61.8％.Escherichia coli and Pseudomonas aeruginosa accounted for 20.1％ and 10.4％,respectively.Gram-positive bacteria increased sigrnificantly.Enterococcusfaecium (22.2％) ranked the first.Mixed infection increased (36％),of which more than 50％ was mixed pathogens of Escherichia coli and Enterococcusfaecium.The incidence of fungi infection also increased (5.6％).Conclusions There was a remarkable change of pathogen category in the biliary infections over the past years.With an increase of gram-positive bacteria and fungi infection in clinical practice,antimicrobial susceptability results could be considered in choosing appropriate drug to avoid bacterial resistance.