ObjectiveTo investigate the influence of different diagnostic criteria on the short-term prognosis of patients with acute-on-chronic liver failure （ACLF）. MethodsA total of 115 ACLF patients who were hospitalized in Department of Gastroenterology， The Second Affiliated Hospital of Kunming Medical University， from January 2018 to January 2022 were enrolled， and all patients received internal medical treatment combined with artificial liver therapy. According to the guidelines， the patients were divided into CMA guideline group （Diagnostic and treatment guidelines for liver failure by Chinese Medical Association）（n=100）， APASL guideline group （Consensus statements of Asian Pacific Association for the Study of the Liver）（n=94）， and EASL guideline group （Criteria proposed by European Association for the Study of the Liver）（n=36）. The above three guidelines were compared in terms of 90-day mortality rate. A one-way analysis of variance was used for comprision of continuous date between groups； the chi-square test was used for comprision of categorical date between groups. The receiver operating characteristic （ROC） curve of related variables. ResultsThe 90-day mortality rate was 50.0% in the CMA guideline group， 51.1% in the APASL guideline group， and 77.8% in the EASL guideline group， and the EASL guideline group had a significantly higher 90-day mortality rate than the CMA guideline group （χ²=8.351， P=0.004） and the APASL guideline group （χ²=7.650， P=0.006）. EASL guideline had a sensitivity of 22.2% and a specificity of 92.3% in predicting the risk of short-term mortality， with an area under the ROC curve was 0.576. ConclusionACLF patients who meet EASL guideline tend to have a worse short-term prognosis， and this guideline may help to identify patients at a relatively high risk of short-term death.

Pancreatic adenocarcinoma (PAAD) is one of the most lethal malignancies. Although gemcitabine (GEM) is a standard treatment for PAAD, resistance limits its application and therapy. Secoemestrin C (Sec C) is a natural compound from the endophytic fungus Emericella, and its anticancer activity has not been investigated since it was isolated. Our research is the first to indicate that Sec C is a broad-spectrum anticancer agent and could exhibit potently similar anticancer activity both in GEM-resistant and GEM-sensitive PAAD cells. Interestingly, Sec C exerted a rapid growth-inhibiting effect (80% death at 6 h), which might be beneficial for patients who need rapid tumor shrinkage before surgery. Liquid chromatography/mass spectrometry and N-acetyl-l-cysteine (NAC) reverse assays show that Sec C sulfates cysteines to disrupt disulfide-bonds formation in endoplasmic reticulum (ER) proteins to cause protein misfolding, leading to ER stress and disorder of lipid biosynthesis. Microarray data and subsequent assays show that ER stress-mediated ER-associated degradation (ERAD) ubiquitinates and downregulates YAP to enhance ER stress via destruction complex (YAP-Axin-GSK-βTrCP), which also elucidates a unique degrading style for YAP. Potent anticancer activity in GEM-resistant cells and low toxicity make Sec C a promising anti-PAAD candidate.

The coexistence of multiple symptoms of acquired immunodeficiency syndrome (AIDS) has caused serious distress to patients. Symptom management based on the premise of grasping the general situation of symptoms becomes the responsibility of the nursing staff. However, the development and use of symptom assessment tools for AIDS populations at China and abroad have not been effectively sorted out and clarified. This article summarizes and analyzes this situation in related fields, aiming to provide reference and basis for future research.

Objective:To study the specific mechanism of LINC01018 involved in the pathogenesis of colon cancer.Methods:The expression of LINC01018 in colon cancer tissues and cells and normal colon tissues and cells were detected by real time fluorescence quantitative polymerase chain reaction (qRT-PCR). HT-29 cell line which overexpresses LINC01018 stably was established. RNA binding protein immunoprecipitation (RIP) assay was used to detect the interaction between LINC01018 and E2F1 protein. Dual luciferase assay was used to detect the regulatory effect of E2F1 on CDK6 promoter. The expression of E2F1 or CDK6 was up-regulated in HT-29 cell line which overexpresses LINC01018, then the proliferation, invasion and migration of HT-29 cells and the expression of CDK6 and matrix metalloproteinase-2 (MMP-2) in HT-29 cells were detected by cell counting method (CCK-8) assay, Transwell assay and Western blot.Results:The expression of LINC01018 was abnormally low in colon cancer tissues and cells. The result of RIP assay showed that LINC01018 interacted with E2F1 protein. The result of dual luciferase assay showed that E2F1 protein could enhance the efficiency of CDK6 promoter, and E2F1 had a positive regulatory effect on CDK6. Overexpression of LINC01018 could attenuate the positive regulatory effect of E2F1 on CDK6. Up-regulation of E2F1 or CDK6 expression could attenuate the effects of LINC01018 overexpression on the proliferation, invasion, migration and expression of CDK6 and MMP-2 in HT-29 cells.Conclusions:The expression of LINC01018 was abnormally low in colon cancer tissues and cells. LINC01018 may regulate the proliferation, invasion and migration of HT-29 cells through E2F1/CDK6/MMP-2 axis, and participate in the pathogenesis of colon cancer.

Objective:To investigate the effect of decreasing DKC1 gene expression on radiosensitivity of HeLa cells.Methods:A cell model with low expression of DKC1 gene was established by shRNA technology with lentivirus as vector, and the interference efficiency was verified by RT-PCR and Western blot assay. Cells were divided into two groups of interference (Lv-shDKC1) and its negative control. Telomerase activity was detected by TRAP-ELISA, and telomere length was measured by Real-time PCR. Cell survival was obtained through clone formation assay and fitted by multi-target single-hit model, and radiobiological parameters ( D0, Dq, N, SF2) and radiosensitization ratio (SER) were calculated. Results:After DKC1 interfering, the expression levels of mRNA and protein of DKC1 in HeLa cells were significantly decreased by (71.330±4.112)% ( t=25.53, P<0.05) and (35.520±3.804)% ( t=4.833, P<0.05), respectively. Compared with the blank control group and negative control group, the telomerase activity of Lv-shDKC1 group decreased significantly from 0.900±0.044 and 0.897±0.031 to 0.713±0.021 ( F=31.44, P<0.05), the relative telomere length was significantly decreased from 4.233±0.306 and 4.633±0.379 to 2.667±0.404 ( F=39.15, P<0.05). The telomerase activity and relative telomere length of blank control group and Lv-shDKC1 negative control group had no significant difference( P>0.05). SF2 in the interference group (0.571±0.006) was significantly lower than that of the blank control group (0.861±0.009) and the Lv-shDKC1 negative control group (0.807±0.002) ( F=1812, P<0.05), and the radiosensitization ratio (SER) of shDKC1 interference was 1.508. Conclusions:Downregulation of DKC1 in human cervical cancer HeLa cells enhances the radiosensitivity through inhibiting the activity of telomerase and shortening the length of telomere. DKC1 gene may become a new target of radiosensitization.

Objective To analyze the current status and clinical characteristics of urinary incontinence in 138 elderly female inpatients so as to provide thoughts and directions for management and intervention implemented by medical institutions for urinary incontinence people. Methods Cross-sectional investigation was used in this study. From August 2018 to November 2018, this study selected elderly female inpatients at a Class Ⅲ Grade A hospital in Beijing by cluster sampling. The primary screening was carried out with the International Consultation on Incontinence Questionnaire Urinary Incontinence Short Form (ICI-Q-SF) and urinary incontinence knowledge scale. This study analyzed the clinical characteristics and urinary incontinence knowledge in elderly female inpatients with urinary incontinence. Results Among 1105 elderly female inpatients ≥ 60 years old, there were 138 of them with urinary incontinence accounting for 12.5％. Among 138 elderly female inpatients with urinary incontinence, the ages were (74.37±8.49) ranged from 60 to 99; the score of urinary incontinence assessment was (7.09±4.59) from 1 to 21; patients with the mild or moderate level of urinary incontinence occupied 90.6％ (125/138);87.0％ (120/138) of patients were with basic diseases interacted with urinary incontinence. There was a statistical difference in the self-perception influence of the urinary incontinence on life among patients with different conditions (P < 0.05). There were statistical differences in the urinary incontinence knowledge among patients with different education levels (P< 0.01). Conclusions In China, it still faces severe problem of urinary incontinence in elderly female inpatients. Basis diseases of some patients interact with urinary incontinence. Urinary incontinence medical problems should be explored with the scientific, standardized and effective methods because of the bottleneck that public lack knowledge.

Objective:To explore the effects of family-centered continuous follow-up nursing in neonate delivery among acquired immune deficiency syndrome (AIDS) families.Methods:This study adopted the historical control clinical trial design, and randomly selected 60 neonate with preventing human immunodeficiency virus (HIV) mother-to-child transmission and met the inclusion and exclusion criteria in Department of Pediatrics of Beijing Ditan Hospital affiliated to Capital Medical University as subjects from January 2015 to December 2017. A total of 30 neonate from January 2015 to June 2016 were in control group, and 30 neonate from July 2016 to December 2017 were in observation group. Control group carried out the routine outpatient follow-up nursing, while observation group implemented the family-centered follow-up nursing. This study compared the success rate and compliance of preventing mother-to-child transmission, nutritional indicators as well as incidence of malnutrition between two groups.Results:The head circumference, height and arm circumference of infants aged 18 months in observation group were better than those in control group with statistical differences ( P<0.05) ; but there was no statistical difference in the weight ( P>0.05) . The success rates of preventing mother-to-child transmission between two groups were all 100%. The compliance with preventing mother-to-child transmission of observation group was higher than that of control group with a statistical difference ( P<0.05) ; rates of missed further consultation and readmission of observation group was lower than those of control group with statistical differences ( P<0.05) . The block therapy knowledge of guardians of observation group was better than those of control group with statistical difference ( P<0.05) . Conclusions:Family-centered continuous follow-up nursing can effectively improve the compliance with preventing mother-to-child transmission of infants, reduce rates of missed further consultation and readmission, promote the growth of infants and healthy development of nutritional status.

In recent years, with the improvement of living standards, lifestyle changes, and the advancement of medical examination methods, the detection rate of non-alcoholic fatty liver disease (NAFLD) has increased year by year, and it has become one of the important chronic liver diseases that seriously threaten human health worldwide. By far, there has been no ideal and effective treatment for NAFLD. Successful lifestyle intervention is unanimously recognized by experts at home and abroad as the most effective way to change the outcome of the disease. Although many scholars at home and abroad have explored different aspects of diet and exercise for patients with NAFLD in the past two decades, there are still no effective strategies or programs that can be used for reference. Therefore, this study organizes and summarizes relevant articles in recent years, and aims to provide a reference and basis for the future prevention and control of fatty liver and health management in China.

Objective To investigate the value of color Doppler ultrasonography in mammary ductal ectasia( MDE). Methods Preoperative sonograms of 54 MDE,135 invasive ductal carcinoma( IDC) and 68 ductal carcinoma in situ ( DCIS ) patients were retrospectively analyzed and further confirmed by histopathology. Results MDE showed 88.9% (48/54) mass type and 11.1% (6/54) ductal type.The average age of patients in MDE was younger than that in IDC( P ＜0.05). The number of MDE located around the areola was more than that of IDC( P ＜0.05). Mean maximum diameter of MDE was smaller than that of DCIS ( P ＜0.05). Compared to DCIS and IDC,MDE in mass type showed higher detection rate of liquidity area and mammary ductal ectasia( all P ＜0.05),while lower detection rate of hyperecho, peripheral hyperechoic zone,posterior echo attenuation or blood flow richness( all P ＜0.001). Compared to IDC,MDE in mass type showed higher detection rate of inside ductal echolocation,while showed lower detection rate of irregular shape,spiculate margin or axillary lymph node enlargement. Compared to DCIS, MDE showed higher detection rate of large aspect ratios( ≥0.7). Less MDE in ductal type with hyperecho were found than DCIS in ductal type ( P ＜ 0.001 ). The coincidence rate of ultrasonic diagnosis and postoperative histopathhology results in 54 MDE patientis was 13.0% ( 7/54 ). Conclusions The sonographic findings of MDE has diverse manifestations. It shows important value of ultrasonography for MDE in its diagnosis and differential diagnosis with breast cancer.

Objective To investigate the correlation between the features of conventional ultrasound& shear wave elasticity and axillary lymph node involvement in breast cancer . Methods A total of 169 breast cancers patients were divided into lymph node metastasis group( n = 115) and non metastasis group ( n = 54 ) according to the postoperative pathological results . Preoperative conventional ultrasonographic features and preoperative shear wave elastography quantitative parameters ( E values ) of the two groups breast lessons were analyzed by single factor analysis to screen out statistically significant factors ,then Logistic regression analysis was performed to analyze the relationship between above factors and lymph node involvement . Results Single factor analysis showed the microcalcification and hyperechoic halo detection rates of lymph node metastasis group [ 81 .7％ ( 94/115) and 71 .3％ ( 82/115 ) ,respectively] were higher than those in non metastasis group [ 61 .1％ (33/54) and 50 .0％ ( 27/54) ,respectively] . The elastography maximum value( Emax) of lymph node involvement group was ( 182 .2 ± 74 .0) kPa ,which was larger than that in non metastasis group′s ( 153 .3 ± 76 .9) kPa ( P < 0 .05) . Multivariate Logistic regression analysis showed the microcalcification( OR = 2 .498 , P = 0 .022) ,the hyperechoic halo( OR = 2 .482 , P = 0 .013) and the Emax value( OR = 1 .007 , P = 0 .007) were risk factors of axillary lymph node metastasis in breast cancer . Conclusions Breast cancer with microcalcification ,hyperechoic signs and high Emax value is more likely to develop axillary lymph node metastasis .