Objective: To investigate the effect and possible mechanism of Y-box-binding protein 1 (YB-1) on sorafenib resistance in hepatoma cells. Methods: Lentiviral vectors with YB-1 overexpression and knockdown were constructed, respectively, to stimulate human hepatoma cell lines (HepG2 and Huh7) alone or in combination with sorafenib.The overexpression part of the experiment was divided into four groups: overexpression control group (Lv-NC), YB-1 overexpression group (Lv-YB-1), overexpression control combined with sorafenib resistance group (Lv-NC+sorafenib), YB-1 overexpression combined with sorafenib resistance group (Lv-YB-1 + sorafenib). The knockdown part of the experiment was also divided into four groups: knockdown control group (Lv-shNC), YB-1 knockdown group (Lv-shYB-1), knockdown control combined with sorafenib resistance group (Lv-shNC + sorafenib), YB-1 knockdown combined with sorafenib resistance group (Lv-shYB-1 + sorafenib). The occurrence of cell apoptosis was detected by TUNEL. The protein expression levels of phosphorylated (p)-ERK and ERK, key proteins in the extracellular regulatory protein kinase (ERK) signaling pathway, were detected by Western blot and quantified by ImageJ software. Subcutaneous tumorigenesis experiments were performed in nude mice. The effect of YB-1 on the efficacy of sorafenib was verified in vivo. The comparison between the two sets of data was carried out by an independent sample t-test. One-way ANOVA was used for comparisons between the three groups of data above. Results: Sorafenib had accelerated the occurrence of apoptosis in hepatoma cells, while YB-1 overexpression had inhibited cell apoptosis, and at the same time also inhibited the apoptosis-accelerating impact of sorafenib. On the contrary, YB-1 knockdown accelerated cell apoptosis and amplified the induction effect of sorafenib on apoptosis. Furthermore, sorafenib resistance had down-regulated p-ERK levels (HepG2: Lv-NC 0.685 ± 0.143, Lv-NC + sorafenib 0.315 ± 0.168, P < 0.05; Huh7: Lv-NC 0.576 ± 0.078, Lv-NC + sorafenib 0.150 ± 0.131, P < 0.01), whereas YB-1 overexpression had inhibited sorafenib resistance p-ERK reduction (HepG2: Lv-NC + sorafenib 0.315 ± 0.168, Lv-YB-1 + sorafenib 0.688 ± 0.042, P < 0.05; Huh7: Lv-NC + sorafenib 0.150 ± 0.131, Lv-YB-1 + sorafenib 0.553 ± 0.041, P < 0.05). YB-1 knockdown further increased sorafenib-induced p-ERK downregulation (HepG2: Lv-shNC + sorafenib 0.911 ± 0.252, Lv-shYB-1 + sorafenib 0.500 ± 0.201, P < 0.05; Huh7: Lv-shNC + sorafenib 0.577 ± 0.082, Lv-shYB-1 + sorafenib 0.350 ± 0.143, P < 0.05), which was further verified in naked mice (Lv-shNC + sorafenib 0.812 ± 0.279, Lv-shYB-1 + sorafenib 0.352 ± 0.109, P < 0.05). Conclusion: YB-1 mediates the occurrence of sorafenib resistance via the ERK signaling pathway in hepatoma cells.
Humans ; Cell Line, Tumor ; Sorafenib/pharmacology* ; Drug Resistance, Neoplasm ; Y-Box-Binding Protein 1/metabolism* ; Carcinoma, Hepatocellular/metabolism* ; MAP Kinase Signaling System ; Animals ; Mice ; Mice, Nude

Blast injury of the chest injury is the most common wound in modern war trauma and terrorist attacks, and is also the most fatal type of whole body explosion injury. Most patients with severe blast injury of the chest die in the early stage before hospitalization or during transportation, so first aid is critically important. At present, there exist widespread problems such as non-standard treatment and large difference in curative effect, while there lacks clinical treatment standards for blast injury of the chest. According to the principles of scientificity, practicality and advancement, the Trauma Society of Chinese Medical Association has formulated the guidance of classification, pre-hospital first aid, in-hospital treatment and major injury management strategies for blast injury of the chest, aiming to provide reference for clinical diagnosis and treatment.

Objective:To investigate the clinicopathological features, immunohistochemical phenotypes and molecular characteristics of adenosquamous carcinoma of the lung(ASC)in elderly patients.Methods:Clinical data of 72 ASC patients in the Department of Pathology, The Second Affiliated Hospital of Soochow University from January 2009 to December 2020 were retrospectively analyzed, and 48 patients aged ≥60 years were selected.Clinical manifestations, imaging findings, histopathological and immunohistochemical characteristics were collected, and gene mutations were detected by the amplification refractory mutation system(ARMS-PCR).Results:There were 48 patients including 32 males and 16 females with a mean age of 70 years(range: 60-84 years). The maximum diameters of the tumors ranged from 0.3 to 9.0 cm(mean: 2.8 cm). Microscopically, the tumors contained two components, squamous cell carcinoma and adenocarcinoma, with the squamous cell carcinoma tissue showing intercellular bridges and the adenocarcinoma tissue showing papillary, acinar or tubular structures.Immunohistochemistry assays detected varying expression levels of CK7(30/31), CK5/6(20/28), TTF1(12/31), P40(15/17), and P63(12/13). Molecular testing showed that the EGFR mutation rate was 58.8%(10/17)and the ALK fusion mutation rate was 5.9%(1/17), while ROS1 and MET mutations were not detected.All 48 patients underwent surgical resection.Conclusions:ASC cases are relatively rare and prone to misdiagnosis.The diagnosis requires the combination of HE morphology, immunohistochemistry and imaging examination, and surgery is the main treatment option.The mutation rate of the EGFR gene is relatively high in ASC patients.

OBJECTIVE To study the relationship of the expression of PLOD2 protein in laryngeal carcinoma and the clinicopathological features of patients. METHODS The expression of PLOD2 in paraffin-embedded specimens of 114 patients with laryngeal carcinoma was detected by immunohistochemistry. The relationship between the expression of PLOD2 and clinicopathological features was analyzed by χ2 t est, s urvival a nalysis b y K aplan-Meier method, and multivariate analysis of Cox proportional hazard model. The fresh frozen specimens of 8 patients randomly selected from the patients were detected by realtime quantitative polymerase chain reaction and Western blotting for the expression of PLOD2 in tumor tissues and adjacent normal tissues. RESULTS PLOD2 protein was associated w ith c linical s tage a nd T s tage(P <0.05). The expression level of PLOD2 protein in laryngeal squamous cell carcinoma was higher than that in adjacent normal tissue(P <0.05). Kaplan-Meier survival analysis showed that low expression of PLOD2 was associated with patient survival rate(χ2=12.484, P <0.001). Multivariate Cox regression analysis showed that PLOD2 protein expression and M stage were independent risk factors for laryngeal cancer growth (P value, both <0.05). CONCLUSION The level of POLD2 protein expression was positively correlated with clinical stage and T stage. PLOD2 protein is an independent risk factor for the growth of laryngeal cancer. The higher the expression of PLOD2 protein, the lower the prognosis of patients. PLOD2 protein expression may play an important role in the growth and prognosis of laryngeal cancer, and may be a new molecular marker for judging the growth and prognosis of laryngeal cancer.

Objective To investigate the effect of dexmedetomidine combined with fentanil on postoperative sleep quality and cognitive function in elderly patients with patient-controlled intravenous analgesia (PCIA). Methods Forty elderly patients underwent thoracic surgery were randomly divided into control group (fentanil group, n = 20) and experimental group C (fentanil plus dexmedetomidine group, n = 20), The control group was mixed 15 μg/kg fentanil and 5 mg tropisetron into100 mL of normal saline in patient-controlled intravenous analgesia pump, and experimental group contained 15 μg/kg fentanil, 1. 0 μg/kg dexmedetomidine and 5 mg tropisetron in 100 mL of normal saline. The pump was withdrawn after 48 h. The total steep time, sleep quality were recorded at 1 d before surgery and on the day of surgery, and at 3 d after surgery. The Mini-Mental Status Examination (MMSE) were recorded at 1 d before surgery and 1, 3, 7 d after surgery, and the incidence of postoperative cognitive dysfunction was observed. Results Compared with control group, the sleep time of experimental group on the surgery day and at 2 d after surgery was longer (P ＜ 0. 05); the sleep quality were significantly higher (P ＜ 0. 05); the MMSE scores of experimental group on the first and third postoperative day were higher (P ＜ 0. 05), and the incidence of POPD was lower than that in the control group (P ＜ 0. 05). Conclusion Dexmedetomidine combined with fentanil administered for postoperative analgesia in elderly patients shows better efficacy in improvement of sleep status, and improve the postoperative cognitive function.

Objective To investigate the effect of dexmedetomidine combined with fentanil on postoperative sleep quality and cognitive function in elderly patients with patient-controlled intravenous analgesia (PCIA). Methods Forty elderly patients underwent thoracic surgery were randomly divided into control group (fentanil group, n = 20) and experimental group C (fentanil plus dexmedetomidine group, n = 20), The control group was mixed 15 μg/kg fentanil and 5 mg tropisetron into100 mL of normal saline in patient-controlled intravenous analgesia pump, and experimental group contained 15 μg/kg fentanil, 1. 0 μg/kg dexmedetomidine and 5 mg tropisetron in 100 mL of normal saline. The pump was withdrawn after 48 h. The total steep time, sleep quality were recorded at 1 d before surgery and on the day of surgery, and at 3 d after surgery. The Mini-Mental Status Examination (MMSE) were recorded at 1 d before surgery and 1, 3, 7 d after surgery, and the incidence of postoperative cognitive dysfunction was observed. Results Compared with control group, the sleep time of experimental group on the surgery day and at 2 d after surgery was longer (P ＜ 0. 05); the sleep quality were significantly higher (P ＜ 0. 05); the MMSE scores of experimental group on the first and third postoperative day were higher (P ＜ 0. 05), and the incidence of POPD was lower than that in the control group (P ＜ 0. 05). Conclusion Dexmedetomidine combined with fentanil administered for postoperative analgesia in elderly patients shows better efficacy in improvement of sleep status, and improve the postoperative cognitive function.

Objective: To study the clinical efficacy of Sini-Moxibustion in the treatment of cancer-induced fatigue in patients with yang- deficiency gastrointestinal cancer. Methods: A total of 120 patients with gastrointestinal cancer treated in our department from January 2017 to January 2018 were randomly divided into 2 groups: the fire moxibustion group and the conventional group. The conventional group and the fire therapy group were treated with basic treatments such as anti-cancer and nutritional support. The conventional group added Sini-Moxibustion to the basic treatment, and the fire therapy group added"Sini-Moxibustion"therapy for a period of 1 month. Tthe indicators of the 2 groups of patients with Piper fatigue scale and grade, quality of life, symptoms of yang deficiency symptoms, clinical efficacy and blood tests of patients with chemotherapy were evaluated. Results: After the treatment, the degrees of fatigue in the fire moxibustion group was lower than that in the conventional group with statistically significant difference ( χ2 =4.24, P =0.037 ＜ 0.05). The scores of improvement in the quality of life scale and five subscales in the fire moxibustion were higher than those in the conventional group with statistically significant difference (P ＜ 0.01), and the improvement score of the body yang deficiency in the fire moxibustion group was greater than that of the conventional group (P ＜ 0.01). The scores of fatigue, nausea and vomiting, insomnia, anorexia, and diarrhea in the fire moxibustion group were higher than those in the conventional group with statistically significant difference (P ＜ 0.05 or P ＜ 0.01). After treatment, the total effective rate was 76.67％ in the fire moxibustion treatment group, which was higher than the conventional group 91.53％ with statistically significant difference ( χ2 =5.64, P =0.012 ＜ 0.01). Hemoglobin improvement value of 3.92 ± 1.18 in the fire moxibustion group was higher than that of the conventional group 1.02 ± 0.52 with statistically significant difference (t =7.212, P =0.003 ＜ 0.01). Conclusion: Sini-moxibustion can improve the CRF of patients with yangdeficiency gastrointestinal cancer, reduce the symptoms of yang deficiency, improve the quality of life, and increase the hemoglobin content in patients with chemotherapy.

Objective: To investigate the relationship between Work Ⅱ type of congenital first branchial cleft anomaly (CFBCA) and facial nerve and discuss surgical strategies. Methods: Retrospective analysis of 37 patients with CFBCA who were treated from May 2005 to September 2016. Among 37 cases with CFBCA, 12 males and 25 females; 24 in the left and 13 in the right; the age at diagnosis was from 1 to 76 ( years, with a median age of 20, 24 cases with age of 18 years or less and 13 with age more than 18 years; duration of disease ranged from 1 to 10 years (median of 6 years); 4 cases were recurren after fistula resection. According to the classification of Olsen, all 37 cases were non-cyst (sinus or fistula). External fistula located over the mandibular angle in 28 (75.7%) cases and below the angle in 9 (24.3%) cases. Results: Surgeries were performed successfully in all the 37 cases. It was found that lesions located at anterior of the facial nerve in 13 (35.1%) cases, coursed between the branches in 3 cases (8.1%), and lied in the deep of the facial nerve in 21 (56.8%) cases. CFBCA in female with external fistula below mandibular angle and membranous band was more likely to lie deep of the facial nerve than in male with external fistula over the mandibular angle but without myringeal web. Conclusions CFBCA in female patients with a external fistula located below the mandibular angle, non-cyst of Olsen or a myringeal web is more likely to lie deep of the facial nerve. Surgeons should particularly take care of the protection of facial nerve in these patients, if necessary, facial nerve monitoring technology can be used during surgery to complete resection of lesions.

Objective:To interpret the main revision about the test method for bacteriostat effect in Chinese Pharmacopoeia(2015 edition). Methods:The main difference of the bacteriostat effect test method in Chinese Pharmacopoeia(2015 edition) and (2010 edi-tion) was compared. Results:The bacteriostat effect test method in the 2015 edition was revised at a comparatively large scale in the positioning of bacteriostat effect test, product classification, assessment criteria and so on. Conclusion: The bacteriostat effect test method in Chinese Pharmacopoeia (2015 edition) gradually improves the check standards in line with the international standards.

‘Warming-dredging needling technique’ is one of the specific needling techniques created by Prof. Zheng Kui-shan for treating intractable and difficult diseases. Developed from ‘Shao Shan Huo (Mountain-burning Fire)’ and ‘warming- reinforcing method’, this method displays the effects of ‘warming’, ‘dredging’ and ‘reinforcing’. The ‘scapula-penetrating heat’ and ‘eye-transmitting heat’ belong to the representative needling techniques of ‘warming-dredging needling technique’. In order to promote the clinical application of ‘warming-dredging needling technique’, its theoretical foundation and clinical experience are summarized.