Tumor metastasis is closely related to high mortality rate of cancer.It is well known that glutamine plays an important role in the malignant progression of cancer.Notably,as an important carbon and nitrogen donor,glutamine has been found to be closely related to tumor metastasis in recent years.Glutamine is not only involved in regulating the proliferation of tumor cells,but is also closely related to the migration and invasion of tumor cells.Furthermore,various enzymes along with transporters in the metabolism of glutamine are involved in the process of tumor metastasis through different signaling pathways.This review provided a summary of the role of glutamine in tumor metastasis in recent years and proposed therapeutic targets to provide new strategies for the clinical treatment of tumor metastases.

Objective:To investigate the therapeutic effects of photodynamic therapy (PDT) on a rat model of ulcerative colitis (UC) induced by Escherichia coli. Methods:Each rat was administered 1 ml of 1×10 9 enteric invasive E. coli to establish an UC model. Thirty-six Sprague Dawley rats were randomly divided into control, model, low-dose LD 4-PDT, medium-dose LD 4-PDT, high-dose LD 4-PDT (60, 120, 240 μg/kg), and levofloxacin (LEV) (100 mg/kg) groups, with six rats in each group. The UC model was established in all groups except the control group, which received 0.9% sodium chloride injection once. The first day of E. coli administration was recorded as day 0, and treatment was initiated on day 7 with LD 4 enema, levofloxacin gavage, and alternating enema/gavage for a total of four times. After a 30-minute exposure to each dose, the colon was irradiated using a 650 nm laser PDT system with an energy density of 25 J/cm 2, while the LEV group was not irradiated. The levels of body mass, colon length, intestinal pathological tissue, inflammatory factors interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), malondialdehyde (MDA), oxidative stress factors myeloperoxidase (MPO), glutathione (GSH), and superoxide dismutase (SOD) were compared among all groups. Results:The body mass and colon length of the model group were lower than those of the control group. The body mass and colon length of the low, medium, and high -dose LD 4-PDT groups and LEV group were higher than those of the model group. Compared to the control group, the model group exhibited more epithelial cell loss, multiple ulcers, infiltration of inflammatory cells into the mucosa and submucosa, and decreased goblet cells. In contrast, the surface mucosa of colon tissue recovered, goblet cells increased, and ulcer healing was good in the low, medium, and high-dose LD 4-PDT groups and LEV group compared to the model group. Compared to the control group, the levels of TNF-α, IL-6, and MPO inflammatory factors were significantly increased in the model group ( all P < 0.001). Compared to the model group, the levels of TNF-α, IL-6, and MPO inflammatory factors in colon tissue from the low, medium, and high -dose LD 4-PDT groups and LEV group were significantly decreased ( P < 0.05, P < 0.001). Compared to the control group, MDA levels were increased, while GSH and SOD levels were decreased in the model group. In contrast, MDA levels in the low, medium, and high-dose LD 4-PDT groups were decreased ( P < 0.05, P < 0.001), while GSH and SOD levels were increased compared to the model group. Conclusions:Low-dose LD 4-PDT promotes the healing of colon mucosa, alleviates inflammation, regulates oxidative stress, and improves symptoms of UC.

Objective:To analyze the risk factors of bronchopulmonary dysplasia(BPD)in very preterm infants(VPI), and to provide scientific basis for the prevention and treatment of BPD in VPI.Methods:A prospective multicenter study was designed to collect the clinical data of VPI in department of neonatology of 28 hospitals in 7 regions from September 2019 to December 2020.According to the continuous oxygen dependence at 28 days after birth, VPI were divided into non BPD group and BPD group, and the risk factors of BPD in VPI were analyzed.Results:A total of 2 514 cases of VPI including 1 364 cases without BPD and 1 150 cases with BPD were enrolled.The incidence of BPD was 45.7%.The smaller the gestational age and weight, the higher the incidence of BPD( P<0.001). Compared with non BPD group, the average birth age, weight and cesarean section rate in BPD group were lower, and the incidence of male infants, small for gestational age and 5-minute apgar score≤7 were higher( P<0.01). In BPD group, the incidences of neonatal respiratory distress syndrome(NRDS), hemodynamically significant patent ductus arteriosus, retinopathy of prematurity, feeding intolerance, extrauterine growth restriction, grade Ⅲ~Ⅳ intracranial hemorrhage, anemia, early-onset and late-onset sepsis, nosocomial infection, parenteral nutrition-associated cholestasis were higher( P<0.05), the use of pulmonary surfactant(PS), postnatal hormone exposure, anemia and blood transfusion were also higher, and the time of invasive and non-invasive mechanical ventilation, oxygen use and total hospital stay were longer( P<0.001). The time of starting enteral nutrition, cumulative fasting days, days of reaching total enteral nutrition, days of continuous parenteral nutrition, days of reaching 110 kcal/(kg·d) total calorie, days of reaching 110 kcal/(kg·d) oral calorie were longer and the breastfeeding rate was lower in BPD group than those in non BPD group( P<0.001). The cumulative doses of amino acid and fat emulsion during the first week of hospitalization were higher in BPD group( P<0.001). Multivariate Logistic regression analysis showed that NRDS, invasive mechanical ventilation, age of reaching total enteral nutrition, anemia and blood transfusion were the independent risk factors for BPD in VPI, and older gestational age was the protective factor for BPD. Conclusion:Strengthening perinatal management, avoiding premature delivery and severe NRDS, shortening the time of invasive mechanical ventilation, paying attention to enteral nutrition management, reaching whole intestinal feeding as soon as possible, and strictly mastering the indications of blood transfusion are very important to reduce the incidence of BPD in VPI.

Objective    To evaluate the efficacy of hybrid ablation through compared with thoracoscopic epicardial ablation. Methods    In this study, 108 patients with all long-standing persistent atrial fibrillation (LSPAF) received thoracoscopic epicardial ablation (TEA) after enrollment. There were 82 males and 26 females at age of 56.5±9.4 years. After blanking-period, patients off antiarrhythmic therapy with sinus rhythm were divided into a hybrid ablation (HA) group (50 patients) and a TEA group (58 patients). Only patients in the HA group received catheter ablation after randomization subsequently. In at least two-year observation period, cardiovascular risk factors were observed in all groups’ patients. Results    The mean follow-up duration was 17.3-41.8 (26.9±6.1) months and there was no significant difference between two groups [8.2-40.6 (27.5±5.7) months in the HA group and 17.3-41.8 (26.4±6.7) months in the TEA group]. The off antiarrhythmic agents (AADs) sinus rhythm rate was significantly higher in the HA group than that in the TEA group at the time of postoperative 6, 12, 24 and 36 months ［96.0%, 90.0%, 83.7%, 83.7% versus 79.3%, 75.9%, 67.3%, 63.1%, HR=0.415 (95%CI 0.206-0.923)]. Conclusion    We can conclude that the efficacy of two-staged hybrid ablation for LSPAF is superior to thoracoscopic epicardial ablation alone. Patients can obtain benefit from a supplemental radiofrequency catheter ablation after blanking-period of surgical ablation, instead of those without a supplemental ablation.

Objective: To investigate the status of knowledge about acquired immune deficiency syndrome(AIDS) among college freshmen in Jiangsu Province, and to analyze the influences of AIDS-related knowledge on their sexual attitudes and behaviors. Methods: A total of 8 633 freshmen from 20 colleges and universities in Jiangsu Province were enrolled by multi-stage stratified sampling. The questionnaire for young students about the eight items of AIDS basic knowledge were used to investigate the AIDS-related knowledge, sexual attitudes and behaviors. Multivariate Logistic regression model was used to analyze the influencing factors of the AIDS-related knowledge and to adjust the influences of AIDS-related knowledge on sexual attitudes and behaviors. Results: The overall qualified rate of AIDS-related knowledge among college freshmen in Jiangsu Province was 87.6% and the qualified rate of 8 items were between 59.8% and 98.3%. The types of schools, nationality, mother s education level and whether only child or not were identified as independent factors for qualified rate of AIDS-related knowledge(P<0.05). The awareness of AIDS-related knowledge had significant impacts on the sexual attitudes and behaviors of college freshmen. Students with insufficient knowledge were more likely to approve premarital sexual behaviors(OR=1.31, 95%CI=1.11-1.63), willing to use condoms consistently(OR=1.67, 95%CI=1.43-1.92) and to accept the HIV tests(OR=4.54, 95%CI=3.13-6.52). Students with unqualified knowledge were more likely to have sexual behavior(OR=1.89, 95%CI=1.42-2.49), while those with sexual experiences and insufficient AIDS knowledge were more likely to use condoms consistently(OR=2.13, 95%CI=1.22-3.78). Conclusion The education on AIDS-related knowledge for teenagers was helpful to construct correct sexual concepts and develop healthy sexual behaviors. However, the AIDS-related knowledge of college freshmen in Jiangsu Province is not sufficient and needed to improve.

Objective:To explore the imaging rate and diagnostic rate of positioning the fetal conus medullaris by three-dimensional ultrasound method to detect atlantoaxial intervertebral space, comparing it with the traditional two-dimensional and three-dimensional ultrasound methods.Methods:Consecutively 318 singleton fetuses received routine ultrasound screening during the second trimester were enrolled from November 2017 to December 2018 in Shenzhen Luohu People′s Hospital and Shenzhen People′s Hospital. These fetuses included 276 normal cases and 42 abnormal cases. The abnormal group contained 11 cases tethered cords fetuses(tethered cords group) and 31 cases non-tethered fetuses(non-tethered group). A new ultrasound method named detecting atlanto-axial intervertebral space with three-dimensional ultrasound and traditional two-dimensional and three-dimensional ultrasound methods were used to acquire and store the images. The positions of the fetal conus medullaris were analyzed blindly and recorded by three experienced physicians using three different methods with off-line software.Results:①The χ 2 test comparing multiple sample rates was used to compare the imaging acquisition success rate of fetal conus medullaris by three ultrasound methods. The test level was adjusted to be α′=0.05/4=0.0125, the results showed that there were no statistically significant differences between the three methods in the normal group (χ 2=7.39, P=0.025) and the abnormal group (χ 2=5.32, P=0.070). ②The χ 2 test comparing multiple sample rates was used to compare the diagnostic accuracy of fetal conus medullaris position in normal group by three methods, it showed there was no significant difference in the correct rate of conus medullaris position in the normal group (χ 2=2.52, P=0.284). ③The χ 2 test comparing multiple sample rates was used to compare the diagnostic accuracy of the fetal conus medullaris in tethered cord group and non-tethered group using 3 methods, the difference was not statistically significant in tethered cord group (χ 2=1.22, P=0.543), while the difference was statistically significant in non-tethered group(χ 2=9.69, P=0.008). Conclusions:The method of detecting atlanto-axial intervertebral space with three-dimensional ultrasound has a high imaging rate and diagnostic accuracy in positioning the fetal conus medullaris. Positioning of fetal conus medullaris by detecting atlanto-axial intervertebral space with three-dimensional ultrasound is better than traditional two-dimensional and three-dimensional ultrasound in the abnormal non-tethered fetuses, which can provide more valuable information for prenatal diagnosis consultation and prenatal and postnatal care.

Objective:To explore the effect of specialized games combined with bi-cardiac nursing on postoperative complications and caregivers′ emotions in children with hypospadias.Methods:A total of 100 children with hypospadias treated in our hospital from January 2018 to December 2018 were randomly divided into control group and experimental group, 50 cases in each group. The control group was given routine treatment and nursing. The experimental group was given specialized games combined with bi-cardiac nursing intervention. The incidence of complications after operation was compared between the two groups. Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) were used to test the main caregivers of the two groups before and after the intervention for 3 months respectively. At the same time, their satisfaction was compared after the intervention.Results:The incidence of complications was 10.00% (5/50) in the study group and 28.00% (14/50) in the control group, the difference between the two groups was statistically significant ( χ2 value was 5.263, P=0.022); after intervention, the scores of SAS and SDS of the caregivers in the study group were 23.35 ± 7.33, 37.06 ± 8.22 respectively, and those in the control group were 32.22 ± 6.70, 40.94 ± 8.95, the difference between the two groups was statistically significant ( t values were 6.316, 2.258, all P<0.05); after the intervention, the satisfaction of the study group was 96.00%(48/50), and that of the control group was 84.00%(42/50). The difference between the two groups was statistically significant ( χ2 value was 4.000, P=0.046). Conclusions:Specialized games combined with bi-centric nursing can reduce the incidence of complications after urethroplasty in children with hypospadias, alleviate the bad mood of the main caregivers and improve nursing satisfaction.

Objective To explore the therapeutic efficacy of the water soluable photosensitizer D-galactopyranosyl zinc phthalocyanines (T1)-mediated photodynamic therapy (PDT) applied to HepG2 human hepatocellular carcinoma cells in vitro and in vivo,as well as its mechanism.Methods HepG2 cells in their logarithmic growth phase were cultured and divided into different concentrations ofT1 (0 μM,0.06 μM,0.125 μM,0.25 μM,0.5 μM and 1 μM).Methyl thiazolyl tetrazolium (MTT) assays were employed to determine the effect of the T1-PDT on the proliferation of the HepG2 cells.Cell apoptosis and necrosis were measured using a cell analyzer with Annexin VFITC/PI/Hochest33342 triple-staining.The reactive oxygen species (ROS) and the mitochondrial membrane potentials of the HepG2 cells were detected using fluorescence microscopy.Confocal microscopic assays were used to observe T1's subcellular localization on the HepG2 cells.Real-time quantitative polymerase chain reactions (RT-PCRs)were used to detect any apoptosis of Bcl-2-and Bax-related genes.H-22-bearing mice were used to calculate the antitumor rate of T1-PDT,and the expression levels of Bcl-2 and Bax mRNA were detected using RT-PCRs.Twenty-four healthy mice were randomly divided into a control group,a low-dose group,a middle-dose group and a high-dose group,each of 6.Each group was given different doses of T1-PDT and the tumor inhibition rate was calculated.Results The MTT assays showed that T1-PDT could significantly inhibit HepG2 cell growth,but T1 or PDT alone had little effect.The confocal microscope assay showed that T1 was mainly localized in the mitochondria in HepG2 cells with little in the lysosome.Cell analyzer results showed that T1-PDT could induce HepG2 apoptosis.The ROS levels of HepG2 cells increased after T1-PDT.The RT-PCR results showed that T1-PDT could increase the expression of Bax and decrease the expression of Bcl-2.The in vivo experiments demonstrated that T1-PDT significantly inhibited the growth of H-22-xenografied tumors.Conclusions T1-mediated PDT has a significant lethal effect on HepG2 cells in vitro and in vitro.The lethal effect of PDT on cancer cells is shown in the apoptosis and can be attributed to T1's subcellular localization in the mitochondria,increasing ROS levels,and regulating apoptosis-related genes.

Objective To evaluate the risk of urinary tract infection after total cystectomy and to propose nursing intervention measures.Methods A total of 86 patients with total cystectomy treated were selected as study subjects.The single factor and multi factor Logistic regression analysis were performed on the clinical data of the patients with infection.Results There were 19 patients with urinary tract infection.The age, sex, prostatic hyperplasia, diabetes mellitus, antibiotic use, hepatic and renal insufficiency, and hospital stay time were risk factors for urinary tract infection (P<0.05).Logistic regression analysis showed that age, diabetes, not using antibacterial drugs, length of stay in hospital were independent risk factors for postoperative urinary tract infection.Conclusion The incidence rate of urinary tract infection after total cystectomy is high, and the risk factors are various.Targeted intervention should be implemented to reduce the incidence of postoperative urinary tract infection.

Objective To evaluate the risk of urinary tract infection after total cystectomy and to propose nursing intervention measures.Methods A total of 86 patients with total cystectomy treated were selected as study subjects.The single factor and multi factor Logistic regression analysis were performed on the clinical data of the patients with infection.Results There were 19 patients with urinary tract infection.The age, sex, prostatic hyperplasia, diabetes mellitus, antibiotic use, hepatic and renal insufficiency, and hospital stay time were risk factors for urinary tract infection (P<0.05).Logistic regression analysis showed that age, diabetes, not using antibacterial drugs, length of stay in hospital were independent risk factors for postoperative urinary tract infection.Conclusion The incidence rate of urinary tract infection after total cystectomy is high, and the risk factors are various.Targeted intervention should be implemented to reduce the incidence of postoperative urinary tract infection.