To explore the role of the "Clinical Practice Guidelines" column and others in the Medical Joumnal of Peking Union Medical College Hospital (Med J PUMCH) in promoting diseiplinary development.

OBJECTIVE To analyze the clinicopathological features of laryngeal squamous carcinoma tumors and their correlation with prognosis in order to improve the understanding and diagnosis of laryngeal squamous cell carcinoma.METHODS The clinical and pathological data(including gender,age,stage,differentiation,immunohistochemistry,etc.)of 179 patients with laryngeal squamous cell carcinoma[171 males,8 females,aged 30-84(61.53±8.02)years]who were treated in Department of Otolaryngology Head and Neck Surgery,The First and Second Clinical Medical Schools of Ningxia Medical University from January 2015 to December 2022 were retrospectively studied,and the effects of various factors on prognosis were analyzed.RESULTS Among the 179 patients with laryngeal squamous cell carcinoma,the male-to-female ratio was 21.4:1,and the incidence was high in the age group of 60-79 years old(58.7%),and the youngest age of onset was 30 years old.The main clinical manifestations were hoarseness 138 cases(77.1%),sore throat 16 cases(8.9%)and pharyngeal foreign body sensation 13 cases(7.3%).Glottic type was more common in the primary site 135 cases(75.4%),and 31 cases were accompanied by cervical lymph node metastasis(17.3%).The degree of differentiation was more common in the moderately differentiated type 80 cases(44.7%).The positive rates of immunohistochemistry markers p16,EGFR(epidermal growth factor receptor),PD-1/PD-L1 and VEGF(vascular endothelial growth factor)were 20.3%,96.4%,36.4%and 77.3%,respectively.Univariate Kaplan-Meier survival analysis showed that the site of disease,lymph node metastasis,and tumor stage were significantly correlated with disease recurrence.Multivariate Cox regression analysis showed that the clinical stage of the tumor was an independent risk factor for the prognosis of the disease(HR=3.715,95%CI:1.519-9.088,P=0.04).CONCLUSION The stage of laryngeal squamous cell carcinoma,the site of the disease,and the metastasis of the lymph nodes are the main factors affecting the prognosis.The high positive expression rate of immunohistochemistry markers EGFR and VEGF is worth paying attention to Targeted therapy for patients with positive PD-1/PD-L1 testing is a promising research direction.

【Objective】 To study the annual financial expenditure in blood stations with different scales, and to establish the regression equation between blood collection units and total expenditure. 【Methods】 The annual total expenditure, the per capita cost of serving population, as well as the collection units of whole blood and apheresis platelet of 24 blood stations were collected. The financial expenditure required for collecting 10 000U blood was calculated.The statistical analysis was carried out with SPSS statistical software. 【Results】 From 2017 to 2020, the total annual financial expenditure of 24 blood stations showed an upward trend. The total expenditure among blood stations was different. The per capita cost of servicing population in the areas where the 24 blood stations were located had been increasing year by year. The 24 blood stations were divided into two grades according to the blood collection volume as 50 000 U, and the relationship equation between the blood collection volume and the annual total expenditure had been established. After testing, each equation was effective(P<0.05); There was no difference in the financial expenditure required for collecting 10 000U blood among blood stations with different scales. 【Conclusion】 From 2017 to 2020, the blood stations with an annual collection volume more than 50 000 U demonstrated a higher financial expenditure and the per capita cost of serving population than those <50 000 U. The blood collection volume of blood stations is significantly correlated with the annual total expenditure and the per capita cost of serving population.

Background Macrophages are essential components of the natural immune system. They play a significant role in resisting foreign bodies in the respiratory tract and maintaining the homeostasis of the internal environment of lung tissue. Objective To investigate the mechanism of macrophage pyroptosis induced by silica dust with different particle sizes. Methods The modified murine macrophage cell line, RAW-ASC cells, was cultured and divided into a blank control group, a lipopolysaccharide (LPS) group (1 μg·mL⁻¹ LPS), a nano-SiO₂ group (1 μg·mL⁻¹ LPS+100 μg·mL⁻¹ nano-SiO₂), a micro-SiO₂ group (1 μg·mL⁻¹ LPS+750 μg·mL⁻¹ micro-SiO₂), and a positive control group [1 μg·mL⁻¹ LPS+3 mmol·L⁻¹ adenosine triphosphate (ATP)]. Apart from the blank control group, cells in other groups were pretreated with LPS for 6 h, and then exposed to SiO₂ or ATP for 4 h. According to the molecular target NOD-like receptor pyrin domain-containing protein 3 (NLRP3) and reactive oxygen species (ROS), we applied MCC950 (NLRP3 inhibitor) and N-acetyl cysteine (NAC, ROS scavenger) to macrophages. CCK-8 assay was used to detect cell viability; 5-ethynyl-2'-deoxyuridine (EdU) staining was used to detect cell proliferation; lactate dehydrogenase (LDH) assay kit was used to detect LDH in supernatant; calcein AM/PI fluorescent double-staining was applied to evaluate cell rupture; 2',7'-dichlorofluorescin diacetate (DCFH-DA) fluorescent probe was used to measure the content of ROS; Western blotting was used to measure the expressions of NLRP3, apoptosis-associated speck-like protein containing CARD (ASC), Caspase-1, gasdermin D (GSDMD), and interleukin-1β (IL-1β). Results Compared with the blank group, 100 μg·mL^-1nano-SiO₂ and 750 μg·mL^-1micro-SiO₂ dust exposure reduced the cell viability to 40% and 68% (P<0.05), and the cell proliferation rate to 30% and 33% (P<0.01), respectively; they also induced cell lysis and ROS release, upregulated NLRP3, ASC, Caspase-1, GSDMD, and IL-1β at protein level (P<0.05), and induced macrophage pyroptosis. After intervening with MCC950 (10 μmol·L^-1) and NAC (10 mmol·L^-1), the expressions of NLRP3, ASC, Caspase-1, and IL-1β decreased (P<0.05), and, specifically, NAC effectively reduced ROS levels (P<0.05). Conclusion Both nano- and micro-SiO₂ dust have cytotoxicity, can upregulate ROS level, activate NLRP3 inflammasome, and promote the release of cytokines, leading to pyroptosis. These results are helpful to reveal the molecular mechanism of macrophage pyroptosis induced by SiO₂ dust.

Objective:To explore the effects of interpregnancy interval (IPI) on pregnancy outcomes of subsequent pregnancy.Methods:A multicenter retrospective study was conducted in 21 hospitals in China. Information of age, height, pre-pregnancy weight, IPI, history of diseases, complications of pregnancy, gestational age of delivery, delivery mode, and pregnancy outcomes of the participants were collected by consulting medical records of pregnant women who had two consecutive deliveries in the same hospital during 2011 to 2018. The participants were divided into 4 groups according to IPI:<18 months, 18-23 months, 24-59 months and ≥60 months. According to the WHO′s recommendation, with the IPI of 24-59 months group as a reference, to the effects of IPI on pregnancy outcomes of subsequent pregnancy were analyzed. Stratified analysis was further carried out based on age, history of gestational diabetes mellitus (GDM), macrosomia, and premature delivery, to explore the differences in the effects of IPI on pregnancy outcomes among women with different characteristics.Results:A total of 8 026 women were included in this study. There were 423, 623, 5 512 and 1 468 participants in <18 months group, 18-23 months group, 24-59 months group and ≥60 months group, respectively. (1) The age, pre-pregnancy body mass index (BMI), history of cesarean section, GDM, gestational hypertension and cesarean section delivery rate of <18 months group, 18-23 months group, 24-59 months group and ≥60 months group were gradually increased, and the differences were statistically significant ( P<0.05). (2) After adjusting for potential confounding factors, compared with women in the IPI of 24-59 months group, the risk of premature delivery, premature rupture of membranes, and oligohydramnios were increased by 42% ( OR=1.42, 95% CI: 1.07-1.88, P=0.015), 46% ( OR=1.46, 95% CI: 1.13-1.88, P=0.004), and 64% ( OR=1.64, 95% CI: 1.13-2.38, P=0.009) respectively for women in the IPI≥60 months group. No effects of IPI on other pregnancy outcomes were found in this study ( P>0.05). (3) After stratified by age and adjusted for confounding factors, compared with women in the IPI of 24-59 months group, IPI≥60 months would significantly increase the risk of oligohydramnios for women with advanced age ( OR=2.87, 95% CI: 1.41-5.83, P=0.004); and <18 months could increase the risk of premature rupture of membranes for women under the age of 35 ( OR=1.59, 95% CI: 1.04-2.43, P=0.032). Both the risk of premature rupture of membranes ( OR=1.58, 95% CI: 1.18-2.13, P=0.002) and premature delivery ( OR=1.52, 95% CI: 1.07-2.17, P=0.020) were significantly increased in the IPI≥60 months group. After stratified by history of GDM and adjusted for confounding factors, compared with women in the IPI of 24-59 months group, IPI≥60 months would lead to an increased risk of postpartum hemorrhage for women with a history of GDM ( OR=5.34, 95% CI: 1.45-19.70, P=0.012) and an increased risk of premature rupture of membranes for women without a history of GDM ( OR=1.44, 95% CI: 1.10-1.90, P=0.009). After stratified by history of macrosomia and adjusted for confounding factors, compared with women in the IPI of 24-59 months group, IPI≥60 months could increase the proportion of cesarean section for women with a history of macrosomia ( OR=4.11, 95% CI: 1.18-14.27, P=0.026) and the risk of premature rupture of membranes for women without a history of macrosomia ( OR=1.46, 95% CI: 1.12-1.89, P=0.005). After stratified by history of premature delivery and adjusted for confounding factors, compared with women in the IPI of 24-59 months group, IPI≥60 months would significantly increase the risk of premature rupture of membranes for women without a history of premature delivery ( OR=1.47, 95% CI: 1.13-1.92, P=0.004). Conclusions:Both IPI≥60 months and <18 months would increase the risk of adverse pregnancy outcomes in the subsequent pregnancy. Healthcare education and consultation should be conducted for women of reproductive age to maintain an appropriate IPI when they plan to pregnant again, to reduce the risk of adverse pregnancy outcomes in the subsequent pregnancy.

Objective To explore the role of pregabalin on the expression of c-fos in spinal dorsal horn of the rat with neuropathic pain.Methods Thirty Wister rats (male) were divided into shamoperated group,model group and pregabalin group,with 10 cases in each group.The effect of the pregabalin on the heat pain threshold and expression of c-fos in spinal dorsal horn of the rat with neuropathic pain were observed.Results The heat pain threshold in model group at 3rd,4th,5th,6th,7th,10th and 14th day after operation was significantly lower than that in sham-operated group and pregabalin group at same time (P ＜ 0.05).The heat pain threshold in pregabalin group was lower than that in sham-operated group from 2nd day after operation,but there was no significant difference (P ＞0.05).At the 14th day after operation,the number of Fos-like-immunoreactivity (FLI) positive cells in sham-operated group,model group and pregabalin group was (16.4 ± 0.6),(66.7 ± 3.3) and (22.8 ± 1.5)cases,and the number of FLI positive cells in model group was significantly higher than that in shamoperated group and pregabalin group (P ＜ 0.05).Conclusions Pregabalin has analgesic activity on rat with neuropathic pain.Pregabalin activates spinal cord glial cells raisedby the injured peripheral nerve and infection,and also reduces the noxious stimulation of afferent pain to spinal dorsal horn neurons.

Objective:To establish T lineage leukemia Jurkat cell mice model of over expression of C-terminal Src kinase binding protein( Cbp ) and Cbp palmitoylation and to research the effect of Cbp and Cbp palmitoylation to proliferation of Jurkat cell.Methods:Virus transfected cell of neg-EGFP,Cbp-EGFP and Cbp-m-EGFP were used in mice model.24 female BALB/c-nu mice were randomly divided into blank control group,empty virus control group,over expression of CBP group and Cbp palmitoylation group, 6 mice in each group.The nude mice were weighed in 0,1,2,3,4,5 weeks.The amount of white blood cell in peripheral blood were counted in 0, 1, 2, 3, 4, 5 weeks.The proliferation of Jurkat cell in peripheral blood of mice were observed by laser confocal microscope.The pathological changes of liver were observed using HE staining.The proliferation of Jurkat cell in the bone marrow and peripheral blood of mice were detected with flow cytometry.Results:The weight of mice in over expression of Cbp group was less than that in blank control group,but higher than that in empty virus control group and Cbp palmitoylation group.The weight of mice in Cbp palmitoylation group was less than that in blank control group,empty virus control group and over expression of Cbp group.The amount of white blood cell in peripheral blood and proliferation of Jurkat cell in liver, bone marrow and peripheral blood of mice in over expression of Cbp group was higher than that in blank control group, but less than that in empty virus control group and Cbp palmitoylation group.The amount of white blood cell in peripheral blood and proliferation of Jurkat cell in liver, bone marrow and peripheral blood of mice in Cbp palmitoylation group was higher than that in blank control group,empty virus control group and over ex-pression of Cbp group.Conclusion:Over expression of Cbp and Cbp palmitoylation in T lineage leukemia Jurkat cell mice model was established.Over expression of Cbp has inhibitory effect on the proliferation of Jurkat cell.Cbp palmitoylation has promotable effect on the proliferation of Jurkat cell.

OBJECTIVE To examine the reversal effect of desipramine (DMI) on resistance to temozolomide(TMZ) in U251/TR cells and explore its mechanism. METHODS U251/TR cells were exposed to DMI (20-80μmol · L-1) or TMZ (0.5-10 mmol · L-1) for 24 h, cell viability was determined by cell counting kit-8 assay with IC50 calculated. The cytotoxicity of U251/TR cells treated with TMZ (1 or 2 mmol·L-1) in combination with DMI (20, 30 or 40 μmol · L-1) for 24 h was detected using CCK-8 assay. Synergism between DMI and TMZ was analyzed by the JIN Zheng-jun method. Apoptosis of U251/TR cells induced by TMZ 1 mmol · L-1, DMI 30 μmol · L-1,or their combination was examined by Hoechst33258 stains and caspase 3 activity was detected by luminescence analysis. Expression of C/EBP homologous protein (CHOP) was measured using quantitative real-time PCR and Western blotting. The survival rate of U251/TR cells treated with TMZ 1 mmol·L-1 and/or DMI 30μmol·L-1 was also assessed after silencing CHOP expression by small interference RNA (siRNA). RESULTS DMI or TMZ alone inhibited the growth of U251/TR cells significantly in a concentration-dependent manner (r 2=0.983,0.982,P<0.05), with the IC50 (33.6 ± 0.5)μmol · L-1 and (2.5 ± 0.6)mmol · L-1, respectively. The cell viability inhibitory rate of U251/TR cells by TMZ (1 or 2 mmol · L-1) combined with DMI (20, 30, or 40μmol · L-1) was greater than that by TMZ or DMI alone (P<0.05). The JIN Zheng-jun analysis revealed that combination of DMI and TMZ produced synergistic cytotoxicity (Q>1.15), ie, compared with TMZ alone, TMZ (1 mmol·L-1) com?bined with DMI (30 μmol · L-1) produced significant nuclear fragmentation and condensation (P< 0.05). In addition, DMI and TMZ in combination activated caspase 3 activity in U251/TR cells (P<0.05). Knock?down of CHOP by specific siRNA attenuated the synergistic effect of DMI in the presence of TMZ, the survival rate of the combined drug group raised from 51.8%to 62.2%(P<0.05). CONCLUSION The results suggest that DMI reverse resistance of U251/TR cells to TMZ through activation of the CHOP-depend?ently apoptosis pathway.

Objective Cystatin C (CysC) is a cysteine protease inhibitor,is widely expressed in human eukaryotic cells,CysC involved in diabetic nephropathy,retinopathy,peripheral vascular disease and type 2 diabetes,insulin resistance occurs Development,as a predictor of type 2 diabetes and complications

Background:The efficacy of standard triple therapy for eradication of Helicobacter pylori(Hp)is decreasing in recent years,and bismuth-containing quadruple regimen becomes the first-line therapy for Hp infection. However,the application of bismuth has some limitations. Aims:To investigate the efficacy of proton pump inhibitor(PPI)-based standard triple therapy combined with teprenone for Hp eradication. Methods:A total of 155 Hp-infected chronic gastritis patients were enrolled from Jan. 2013 to Dec. 2014 at Aerospace Center Hospital,and were randomly assigned into standard triple therapy group,bismuth-containing quadruple therapy group and teprenone-containing quadruple therapy group. Patients in standard triple therapy group were given rabeprazole sodium 20 mg + amoxicillin and clavulanate potassium 914 mg +clarithromycin 500 mg bid for 10 days. Patients in bismuth-containing quadruple therapy group were given standard triple therapy combined with bismuth potassium citrate 0. 6 g bid for 10 days. Patients in teprenone-containing quadruple therapy group were given standard triple therapy combined with teprenone 50 mg bid for 10 days. Symptoms of patients were evaluated before and after eradication therapy. Four weeks after the end of therapy,13 C-urea breath test( UBT)was reexamined to assess the status of Hp infection. Results:One hundred and fifty-two patients completed the treatment course. By ITT analysis,the eradication rates of standard triple therapy group,bismuth-containing quadruple therapy group and teprenone-containing quadruple therapy group were 69. 8%(37 / 53),86. 5% (45 / 52)and 88. 0% (44 / 50), respectively;by PP analysis,the eradication rates of the three groups were 71. 2%(37 / 52),88. 2% (45 / 51)and 89. 8%(44 / 49),respectively. Eradication rates analyzed by ITT and PP in bismuth-containing quadruple therapy group and teprenone-containing quadruple therapy group were significantly higher than those in standard triple therapy group(P <0. 05),but no statistically significant difference was found between these two groups( P > 0. 05). Relieving rates of abdominal pain,abdominal distention and belching in bismuth-containing quadruple therapy group and teprenone-containing quadruple therapy group were higher than those in standard triple therapy group,but statistically significant difference was only found in relieving of abdominal pain between teprenone-containing quadruple therapy group and standard triple therapy group(88. 9% vs. 70. 3% ,P < 0. 05). Adverse effects included transient and mild nausea,diarrhea and black stool, etc. Conclusions:Teprenone-containing quadruple regimen are effective for Hp eradication and symptoms relieving with no severe adverse effects,the efficacy is comparable with bismuth-containing quadruple regimen.