Objective To explore the predictive value of serum uric acid levels for the occurrence of sarcopenia after hepatectomy in patients with primary liver cancer(PLC).Method A convenience sampling method was used to prospectively include 161 PLC patients who underwent liver resection surgery at Baoding NO.2 Central Hospital of Hebei Province from January 2019 to December 2021.They were divided into occurrence group and non occurrence group based on whether they had muscle deficiency.The clinical data,serum uric acid and other blood biochemical examination results were compared between the two groups,and the predictive value and influence of serum uric acid level on sarcopenia after hepatectomy in PLC patients were analyzed.Results Among the 158 PLC patients who underwent hepatectomy in the final inclusion of this study,34 patients developed postoperative sarcopenia,with an incidence rate of approximately 21.52％.The serum uric acid level(311.79±35.32)μmol/L in the occurrence group was higher than that in the non-occurrence group(280.52±31.15)μmol/L,the ALB level(31.59±5.73)g/L was lower than that in the non-occurrence group(35.63±5.13)g/L,and the proportion of postoperative adjuvant hepatic arterial infusion chemotherapy(HAIC)(38.24％)was higher than that in the non-occurrence group(20.16％),with statistical significant differences(P＜0.05).Multiple Logistic regression analysis showed that serum uric acid、ALB、postoperative adjuvant HAIC were associated with sarcopenia after hepatectomy in PLC patients(OR=0.853,1.035,11.189,95％CI:0.770-0.945,1.018-1.052,3.533-35.433,P＜0.05).The receiver operating characteristic curve(ROC)showed that the area under the curve(AUC)of serum uric acid in predicting sarcopenia after hepatectomy in PLC patients was 0.754(95％CI:0.657-0.850),which had certain predictive value.The nomogram showed that the C-index of the prediction model constructed by serum uric acid assisted other major clinical indicators to predict the occurrence of sarcopenia after hepatectomy in PLC patients was 0.847(95％CI:0.782-0.913),suggesting that the model had certain predictive value.The results of the decision curve showed that when the threshold was in the range of 0.00-1.00,the actual clinical net benefit rate of the model was always greater than 0,and the maximum net benefit rate was 0.215,suggesting that the model had good clinical application value.Conclusion The increase of serum uric acid level in PLC patients is a risk factor for postoperative sarcopenia.The detection of serum uric acid level is helpful to assist in the early prediction of the risk of sarcopenia.

Objective:To evaluate the role of Kv7.2 in the dorsal root ganglion (DRG) in reduction of paclitaxel-induced neuropathic pain (NPP) by morphine in rats.Methods:SPF healthy male Sprague-Dawley rats, aged 5 weeks, weighing 140-160 g, were randomly selected. This experiment was performed in two parts. Experiment Ⅰ Seventy-two rats were divided into control group (group C), control + morphine group (group C+ M), NPP-1 group (group NPP1) and NPP-1 + morphine group (group NPP1+ M), with 18 animals in each group. Experiment Ⅱ Twenty-four rats were divided into NPP2 group, NPP2+ ML252 group, NPP2+ morphine group (NPP2+ M group), and NPP2 + morphine + ML252 group (NPP2+ M+ ML252 group), with 6 animals in each group. The model of NPP was developed by intraperitoneal injection of paclitaxel 2 mg/kg, once every 2 days for 4 times. After preparation of the model, morphine 5 mg/kg was subcutaneously injected in C+ M group, NPP1+ M group, NPP2+ M group and NPP2+ M+ ML252 group, and potassium channel inhibitor ML252 10 mg/kg was intraperitoneally injected for 7 consecutive days in NPP2+ ML252 group and NPP2+ M+ ML252 group. Six rats were randomly selected from each group on the 1st, 3rd and 7th days after the end of continuous administration in experiment Ⅰ and from each group on the 7th day after the end of continuous administration in experiment Ⅱ for measurement of the mechanical paw withdrawal threshold (MWT) and cold paw withdrawal latency (CWL). At the end of the behavioral assessment, the rats were sacrificed and the DRG was removed for determination of Kv7.2 expression by Western blot. On the 1st day after the end of continuous administration in experiment Ⅰ, the expression of Kv7.2 mRNA in DRG was detected using quantitative real-time polymerase chain reaction, and immunofluorescence was used to detect the co-expression of Kv7.2 with neurons and glial cells in group C.Results:Experiment Ⅰ Compared with C group, the MWT was significantly increased, the expression of Kv7.2 protein and mRNA was up-regulated at each time point ( P<0.05), and no significant change was found in the CWL in C+ M group ( P>0.05), and the MWT was significantly decreased, the CWL was shortened, and the expression of Kv7.2 protein and mRNA was down-regulated at each time point in NPP1 group ( P<0.05). Compared with NPP1 group, the MWT was significantly increased, the CWL was prolonged, and the expression of Kv7.2 protein and mRNA was up-regulated at each time point in NPP1+ M group ( P<0.05). Kv7.2 in DRG was expressed in peptideergic small and medium diameter neurons, non-peptideergic small and medium diameter neurons and large diameter neurons, but not in glial cells. Experiment Ⅱ Compared with NPP2 group, no significant change was found in the expression of MWT, CWL and Kv7.2 in NPP2+ ML252 group ( P>0.05), and the MWT was significantly increased, CWL was prolonged, and the expression of Kv7.2 in DRG was up-regulated in NPP2+ M group ( P<0.05). Compared with NPP2+ M group, the MWT was significantly decreased, CWL was shortened, and the expression of Kv7.2 in DRG was down-regulated in NPP2+ M+ ML252 group ( P<0.05). Conclusions:Down-regulation of Kv7.2 expression in DRG is involved in the reduction of paclitaxel-induced NPP by morphine in rats.

To effectively play the guiding role of pathogenic diagnosis in the rational use of antibiotics, hospitals at all levels urgently need to establish an effective control system for clinical microbial specimen submission. In response to the common problems in medical institutions in China, such as the low rate of microbiological specimen submission before antibiotic treatment, unreasonable structure of microbiological specimens, and the majority of morning sputum and urine specimens collected for pathogen testing, the Second Affiliated Hospital of Zhejiang University School of Medicine has constructed a management system for clinical microbiological specimen submission using artificial intelligence technology. It used a built-in intelligent rule engine to implement full process control over the sampling and submission of microbiological specimens by doctors when prescribing antibiotics, urge doctors to implement the requirement of collecting samples before using antibiotics for treatment, and recommend priority the collection of sterile specimens. In addition, the hospital transformed the laboratory and testing process with the goal of receiving microbial samples 24 hours without interruption and inoculating in real-time. The informatization management system began to be applied throughout the hospital in December 2015. The average rate of microbial sample submission before the first therapeutic use of antibiotics from June 2016 to 2023 was 79.2%, an increase of 90.2 percentage points from 41.7% in June 2014 ( χ2=467.781, P<0.01). The structure of microbial specimens continued to be optimized, and the proportion of sterile specimens in all submitted specimens increased from 47.2% in 2014 to 49.9% in 2023 ( χ2=139.119, P<0.01). The proportion of morning sputum and morning urine specimens decreased from 65.2% and 60.6% in 2014 to 11.1% and 16.9% in 2023, respectively ( χ2 values were 19 787.434 and 4 346.664, respectively, P<0.01), providing a more reliable basis for pathogenic diagnosis in clinical practice and providing reference for improving the management of pathogenic specimen submission in medical institutions.

Objective To explore the safety and long-term results of preoperative imatinib mesylate administration (IM) in patients with locally advanced gastrointestinal stromal tumors (GIST).Methods From Sep 2009 to Nov 2016,locally advanced GIST patients treated in Fujian Medical University Cancer Hospital were analysed retrospectively.Result 34 patients were included.Preoperative median IM treatment was 27 weeks(range 12-71 weeks).65％ patients had a partial response to IM,35％ showed stable disease.All patients underwent surgical R0 resection.The complication rate was 9％ and no death occurred within 30 days post operation.The median follow-up time was 62.2 months (range of 13-89 months).20 patients continued to take imatinib orally,14 patients did not.The 3 year survival rate of patients undergoing surgery was 67％.Univariate analysis showed that tumor location,preoperative imatinib effect,pathology,targeted therapy after surgery were factors affecting prognosis.Multivariate analysis show that the independent risk factors affecting prognosis were tumor location,pathology,targeted therapy after surgery.Conclusion In locally advanced GISTs,preoperative IM is useful and safe that can effectively decrease tumor size,facilitating resection.

Objective To analyze the effect of flipped class mode based on grouping in pathology teaching.Method To select four classes of clinical medical undergraduates as the objects of the study,and divide them into control group and experimental group randomly.Flipped class mode was used in control group (60 people),and flipped class mode based on grouping was used in experimental group (60 people).The effect of teaching was evaluated by test results and e-questionnaire results.The data were collated after the entry of SPSS 20.0,and the data comparison between groups was performed by t test.Result Test results and e-questionnaire results of the experimental group (28.1 ± 0.7) were much better than those of the control group (27.5 ± 0.9),and the difference was statistically significant (P=0.008).It improved the learning interest,self-confidence,team spirit and ability to analyze and solve problems of the students in the experimental group.Conclusion Flipped class mode based on grouping can improve the teaching quality and the self-confidence and team spirit of the students at the same time,and can lay a solid foundation for the clinical work in the future.

BACKGROUND:Studies have found that smal intestinal submucosa that is directly implanted into the lesion cannoteffectively promote celgrowth and differentiationin vivoandin vitro, because of its smal pore size and poor permeability.
OBJECTIVE:To establish the smal intestinal submucosa sponge and to explore its morphological characteristics.
METHODS:Porcinesmall intestinal submucosa was prepared by physiochemical method. Thenthe small intestinal submucosa with the mass fraction of 1%, 2%, 3% and 4% was cross-linked by 50, 100 and150 mmol/L 1-ehyl-3-(3-dimethylaminopropyl) carbodimide hydrochloride, respectively, so as to obtain smal intestinal submucosa sponge, whose morphology was detected by lighting and scanning electron microscope. In the meanwhile, smal intestinal submucosa as control group, and smal intestinal submucosa sponge as test groupwere intramuscularly implanted into the back of rats,respectively. At 1, 2 and 3 weeks after implantation, histological changes andimplantdegradation were observed by hematoxylin-eosin staining.
RESULTS AND CONCLUSION:The smal intestinal submucosa sponge, which was prepared by the smal intestinal submucosa with the mass fraction of 1% and 100 mmol/L cross-linking agent, had elastic and close space structure, uniform pore size and regular structure, so it was selected as the implant into themuscle.At 1 week after implantation, in the test group,the mesh sponge had the complete structure withfew neutrophils, lymphocytes and giant cel reaction, andsoft tissue hyperplasia and migration surrounding the implant appeared;in the control group,there were numerous inflammatory cels, and wound adhesion and little migration of surrounding tissues could be found.At 3 weeks, inflammatory cels mostly disappeared, and fibroblast-like cels and vascular components appeared, with thinner and regular colagen fiber bundles, and connective tissue-like structures could be found. In contrast, the control group stil had numerous inflammatory cels and few colagen fibers. In conclusion, smal intestinal submucosa sponge isapotential material used asthe tissue-engineered skinscaffold.

Tumor microenvironment (TME) plays a key role in the development and progression of tumors, such as pro?moting local drug resistance, immune escape, and distal metastasis. According to the TME of different individuals, accurate evaluation and selection of clinical medication can effectively control the malignant transformation of carcinoma in situ and metastatic cancer. At present, the main method to treat cancer is chemotherapy, TME can regulate the reaction of the tumor cells to the standard chemotherapy and target drug therapy, so the combination of the targeted TME therapy and chemothera?py will achieve better clinical efficacy. In this review, we summarized the mechanisms of TME in breast cancer, including ex?tracellular matrix, carcinoma-associated fibroblasts, carcinoma-associated macrophages, regulatory T cells and bone marrow mesenchymal stem cells, which providing a theoretical basis for the development of TME targeted therapy.

Objective To investigate the correlationship between DNMT3a, DNMT3b protein expressions and the state of promoter methylation of ERα gene and ERα protein expression in the development of sporadic breast cancer. Methods A total of 180 patients with sporadic breast cancer and 30 patients with breast fibroadenoma were included in this study. The expressions of DNMT3a and DNMT3b protein were detected by immunohistochemical method. The state of promoter methylation of ERα gene was detected by methylation specific PCR in 97 patients with sporadic breast cancer. Results There were no significant differences in positive expression rates of DNMT3a and DNMT3b protein between breast fibroadenoma and breast cancer. There were higher expression levels of DNMT3a and DNMT3b in breast cancer patient of Ⅲ～Ⅳstages than those of Ⅰ～Ⅱstages. The expression of DNMT3a was significantly higher in patients with lymph node metastasis than that of patients without lymph node metastasis (P＜0.05). Of 97 cases of breast cancer patients, ERα gene promoter methylation occurred in 39 cases (40.2%). The positive expression of DNMT3a protein was positively correlated with the ERα gene methylation (rS=0.250). The DNMT3a protein expression showed a significant influence to the overall survival (OS) in patients of breast cancer (P=0.035), no significant influence to the disease-free survival (DFS) (P=0.064). DNMT3b protein expression showed no significant influence to OS and DFS of patients with breast cancer (P=0.914 and 0.961). Conclusion The positive expressions of DNMT3a and DNMT3b are correlated with the invasion, metastasis and poor prognosis of sporadic breast cancer. DNMT3a was positively correlated with the state of ERα gene promoter methylation. The inhibition of DNMT3a and DNMT3b may have advantages in the prevention and treatment of sporadic breast cancer.

Aiming at the existing problems in the teaching hospital,teachers and practical students during clinical practice teaching,we explored actively in talent training and teaching base construction and promoted the improvement of clinical practice ability for medical students.

Microtubules play important roles in mitotic spindle assembly and chromosome segregation to maintain normal cell cycle progression. A number of microtubule-associated proteins have been identified in epithelial and neural cell cultures; however, their physiological significance is not well characterized due to the lack of appropriate in vivo animal models. Nucleolar spindle-associated protein (NuSAP) is a microtubule-binding protein and is reported to be involved in mitosis by cell culture studies. In this report, we identified the zebrafish homologue of human NuSAP and investigated its expression profile and functions. Using in situ hybridization, we demonstrated that transcripts of zebrafish nusap1 are specifically expressed in the retina, forebrain, hindbrain and neural crest. When the in vivo expression of nusap1 was knocked down through antisense oligonucleotide morpholino technology, the morphants of nusap1 showed impaired morphogenesis in the trunk and yolk extension, implying the involvement of Nusap1 in cell migration. Mechanistic studies revealed that nusap1 morphants have an altered expression pattern of neural crest markers crestin and sox9b, but normal expression of blood vessel and notochord markers gata1 and shh. In addition, nusap1 mRNA injection caused serious apoptosis in retina and hindbrain tissue, and these phenotypes can be rescued by co-injection of morpholino against nusap1. These observations not only suggest a role for Nusap1 in connecting apoptosis with cell migration, but also provide strong evidences that Nusap1 is potentially involved in morphogenesis in vertebrates.
Amino Acid Sequence ; Animals ; Animals, Genetically Modified ; Apoptosis ; genetics ; physiology ; Base Sequence ; Cell Movement ; genetics ; physiology ; Cloning, Molecular ; DNA Primers ; genetics ; Gene Expression Profiling ; Gene Expression Regulation, Developmental ; Gene Knockdown Techniques ; Humans ; In Situ Hybridization ; Microtubule-Associated Proteins ; genetics ; physiology ; Molecular Sequence Data ; Neural Crest ; cytology ; embryology ; physiology ; Phylogeny ; Sequence Homology, Amino Acid ; Zebrafish ; embryology ; genetics ; Zebrafish Proteins ; genetics ; physiology