Under the trend of increasing aging， integrated elderly care and medical services is an important measure to optimize the supply of elderly care services and promote the good death of the elderly. Using the cooperative production theory and the classical grounded theory， a qualitative analysis was conducted on 38 cases of elderly palliative care and 25 cases of hospital-based palliative care under the integrated elderly care and medical services model from a hospital in Nanning City using Nvivo 20.0 software. This paper found that the integrated elderly care and medical services mode emphasized the deep integration of medical and elderly care services by integrating resources and improving service efficiency， to achieve the basic experience of comprehensive health care for the elderly. The promotion of these experiences has a positive significance for building a multi-agent cooperative production system， strengthening personnel training， perfecting the performance distribution mechanism， and further promoting the development of the national palliative care pilot.

ObjectiveThe full name of vertebroplasty is percutaneous vertebroplasty (PVP). It is a clinical technique that injects bone cement into the diseased vertebral body to achieve strengthening of the vertebra. The research on the safety and efficacy of bone cement is the basis for clinical application. In this study, vertebroplasty is used to evaluate and compare the safety and efficacy of Tecres and radiopaque bone cement in experimental pigs, and to determine the puncture method suitable for pigs and the pre-clinical evaluation method for the safety and efficacy of bone cement. MethodsTwenty-four experimental pigs (with a body weight of 60-80 kg) were randomly divided into an experimental group (Group A) and a control group (Group B). Group A was the Tecres bone cement group, and Group B was the radiopaque bone cement group, with 12 pigs in each group. Under the monitoring of a C-arm X-ray machine, the materials were implanted into the 1st lumbar vertebra (L1) and 4th lumbar vertebra (L4) of the pigs via percutaneous puncture using the unilateral pedicle approach. The animals were euthanized at 4 weeks and 26 weeks after the operation, respectively. The L4 vertebrae were taken for compressive strength testing, and the L1 vertebrae were taken for hard tissue pathological examination to observe the inflammatory response, bone necrosis, and degree of osseointegration at the implantation site. ResultsThe test results of compressive strength between groups A and B showed no significant difference at 4 weeks and 26 weeks after bone cement implantation (P > 0.05). Observation under an optical microscope (×100) revealed that at 4 weeks postoperatively, both groups A and B showed that the bone cement was surrounded by proliferative fibrous tissue, with lymphocyte infiltration around it. The bone cement was combined with bone tissue, the trabecular arrangement was disordered, and osteoblasts and a small amount of osteoid were formed. At 26 weeks postoperatively, bone cement was visible in both groups A and B. The new bone tissue was mineralized, the trabeculae were fused, the trabecular structure was regular and dense with good continuity, and no obvious inflammatory reaction was observed. ConclusionIn experimental pig vertebrae, there were no significant differences observed in the compressive strength, inflammation response, bone destruction, and integration with the bone between Tecres and non-radiopaque bone cement. Both exhibited good biocompatibility and osteogenic properties. It indicates that using vertebroplasty to evaluate the safety and efficacy of bone cement in pigs is scientifically sound.

Objective:To explore the effects of hinokiol on the cell cyle and apoptosis of CNE1 nasopharyngeal carcinoma cells and the relevant molecular mechanism.Methods:The CNE1 cells were cultured in vitro and incubated with different concentrations of honokiol, and the cells were divided into blank control group, 10 μmol/L, 20 μmol/L and 40 μmol/L hinokiol treatment groups, and 10 μg/ml cisplatin group. Cell viability was determined by methylthiazolyldiphenyl- tetrazolium bromide (MTT) method, the cell cycle distribution was detected by flow cytometry, mitochondrial membrane potential was detected by mitochondrial membrane potential test kit, apoptosis was detected by terminal deoxynucleotidyl transferase mediated dUTP nick end labeling (TUNEL) method, and the proteins expression of proliferating cell nuclear antigen (PCNA) and G 1/S specific cyclin D1 (cyclin D1) were detected by immunoblotting. RNA-Seq was conducted in the hinokiol-treated cells. The mRNA expression of yes-associated protein delta (YAP) was detected by quantitative reverse transcription polymerase chain reaction (RT-qPCR). The proteins expression of phosphor-YAP (p-YAP) and nuclear YAP were detected by immunoblotting, the nuclear distribution of YAP protein was detected by immunofluorescence in the cells with or without treated with the mammalian STE20-like kinase 1/2 (MST1/2) inhibitor (XMU-MP-1), hinokiol, and XMU-MP-1+hinokiol. Statistical analysis of the data was conducted using GraphPad Prism 8.0 software. Resluts Compared with the control group, the cell viablity of CNE1 cells, the levels of mitochondrial membrane potential, the proteins expression of PCNA and cyclin D1 in hinokiol treatment groups were markedly decreased (all P values<0.05), while the proportion of G 0/G 1 phase cells and the ratio of TUNEL-positive cells were significantly increased (both P values<0.05). Transcriptome analysis showed that differential genes were mainly enriched in Wnt signaling pathway, tumor necrosis factor pathway, and Hippo signaling pathway. The mRNA level of YAP and the protein expression of YAP in the nucleus were decreased and the level of p-YAP protein was increased in cells treated with hinokiol, which were significantly different from control group (all P values<0.05). Compared with the hinokiol group, XMU-MP-1+hinokiol groups showed the decrease of p-YAP protein expression (1.157±0.076 vs 0.479±0.038, t=37.120, P<0.05), the increase of YAP protein expression in the nucleus (0.143±0.012 vs 0.425±0.031, t=29.181, P<0.05), the reduced proportion of cells in G 0/G 1 phase [(72.494±3.309)% vs (58.747±2.865)%, t=17.265, P<0.05], and the decrease of apoptosis ratio [(53.158±3.376)% vs (29.621±2.713)%, t=28.584, P<0.05]. Conclusion:Hinokiol can arrest the cell cycle and induce the cell apoptosis of CNE1 cells via Hippo/YAP signaling pathway.

Objective: To investigate the expression of eukaryotic translation initiation factor 2B1(eIF2B1) in HCC and its correlation with clinical prognosis. Methods: Through the follow⁃up of the clinical data of 743 hepatocellular carcinoma patients in the specimen bank ,91 HBV⁃related liver cancer patients with complete follow⁃up information were screened out , and their postoperative tumor tissues were selected. Meanwhile , the adjacent tumor tissues with a distance of more than 2 cm from the tumor margin were collected to make tissue chips. Western blot and immunohistochemical experiments were performed. Image J was used to analyze the proportion of positive cells stained by tissue chip and the gray value of Western blot results. Clinical data and follow⁃up data of included patients were statistically analyzed by R4. 0. 5 software. Results: Immunohistochemical results suggested that eIF2B1 was more strongly expressed in HCC than in para⁃cancerous tissues. Western blot results showed that eIF2B1 was more strongly expressed in HepG2. 2. 15 cells than in HepG2 cells. The expression of eIF2B1 in HCC tissues was correlated with tumor number (P < 0. 05) . Cox multivariate regression analysis showed that the expression of eIF2B1 was an independent risk factor for the overall clinical prognosis of HBV⁃DNA positive patients (HR = 4. 28 ,P = 0. 018) . Conclusion The expression of eIF2B1 is significantly enhanced in HBV⁃associated HCC tissues and is significantly associated with overall survival in HBV DNA positive patients.

Objective:To investigate the level of serum vascular endothelial growth factor (VEGF) and its correlation with clinical symptoms in patients with first-episode drug-naive schizophrenia patients of different genders.Methods:From January 2016 to October 2019, a total of 81 first-episode drug-naive schizophrenia patients(patient group, 41 male, 40 female) and 64 healthy controls (control group, 40 male, 24 female) were included in this study.The serum level of VEGF was detected with flow cytometric bear array (CBA). Positive and negative symptom scale (PANSS) was used to evaluate the relevant clinical symptoms of patients.SPSS 22.0 software was used for statistical analysis.Independent sample t-test and nonparametric test were used for comparison between groups.The relationship between VEGF and clinical variables was analyzed by Pearson correlation analysis and Spearman correlation analysis. Results:The level of serum VEGF in the patient group was significantly lower than that in the control group(148.08(75.89, 208.61)pg/mL, 179.94(99.14, 318.41)pg/mL, Z=-2.20, P=0.028). The total PANSS score((82.71±17.30), (73.45±16.36), t=2.473, P=0.016)and cognitive score((7.88±3.36), (6.23±2.81), t=2.402, P=0.019) in male patients were higher than those in female patients.There was a negative correlation between VEGF level and PANSS negative symptom score in the patient group( r=-0.228, P=0.041), as well as significant negtive correlation between VEGF level and cognitive score in male patients( r=-0.425, P=0.007). Conclusion:The level of serum VEGF is reduced in first-episode patients with schizophrenia, which influences their negative symptom. Moreover, the decline in serum VEGF level is implicated in cognitive impairments in male patients with first-episode schizophrenia.

Objective:To investigate the effect of miR-375-3p on DNA damage repair and radioresistance of colorectal cancer cells.Methods:After overexpression of miR-375-3p in HCT116 and HT29, cell proliferation ability was detected by CCK-8 assay, clone formation ability was detected by clone formation assay, apoptosis was detected by Annexin V-FITC/PI double staining method and cell cycle distribution was detected by flow cytometry, and the formation of γ-H2AX foci were used to analyze homologous recombination (HR) repair efficiency. Bioinformatics was used to predict the downstream target genes of miR-375-3p in the HR repair pathway. A dual luciferase reporter gene assay was used to validate the regulation effect of miR-375-3p on Rad51 gene. The expression of miR-375-3p in HCT116 cells irradiated with 60Co γ-rays at 2 and 6 Gy was measured by RT-qPCR. The inhibition effect of miR-375-3p on the radiosensitivity of HCT116 cells was analyzed after irradiation with different doses of 0, 1, 2, 4 and 6 Gy. Results:Overexpression of miR-375-3p inhibited the proliferation and colony formation ability, induced G1 phase cycle arrest and cell apoptosis of colorectal cancer cells, enhanced DSBs formation, inhibited Rad51 expression, and significantly decreased HR repair efficiency ( t = 10.055, P < 0.05). Dual luciferase reporter gene assay demonstrated that miR-375-3p bound to Rad51 3′UTR region ( t = 5.013, P< 0.05). In addition, irradiation increased miR-375-3p expression, and inhibition of miR-375-3p expression reduced radiosensitivity of colorectal cancer cells ( t=6.460, 5.619, 10.150, P<0.05). Conclusions:miR-375-3p inhibited the homologous recombination repair efficiency of DSBs and enhanced the radiosensitivity of colorectal cancer cells.

Objective:To investigate the clinical value of transjugular liver biopsy (TJLB) in patients with unexplained liver disease complicated with massive ascites or coagulopathy.Methods:A retrospective analysis was performed from patients underwent TJLB in the First Affiliated Hospital of Zhengzhou University, Zhoukou Central Hospital, Shangqiu First People's Hospital and Jincheng People's Hospital from March 2015 to January 2022 due to unexplained liver disease complicated with massive ascites or coagulopathy. A total of 37 patients were included, including 21 males and 16 females, aged (53.5±11.9) years. According to different puncture points, the patients were divided into two groups: transhepatic right vein TJBL and transhepatic middle vein TJBL. The obtained liver tissue sampling effect, puncture times, complications were analyzed.Results:The success rate of TJLB was 97.3%(36/37). Thirty-six patients were able to obtain more than three segments of liver tissue and obtain histological diagnosis, and the pathological diagnosis rate was 100.0%(36/36). The number of puncture times, the amount of hepatic tissue and the number of portal areas in the right hepatic vein group (21 cases) were (3.7±0.9), (3.7±0.7) and (6.5±0.9) respectively, and those in the middle hepatic vein group (15 cases) were (3.7±0.7), (3.7±0.7) and (6.3±0.8) respectively. There were no significant differences between the two groups (all P>0.05). Conclusion:TJLB is safe and feasible for patients with unexplained liver disease complicated with massive peritoneal effusion and coagulopathy. Good liver tissue specimens can be obtained by TJLB from both right hepatic vein and middle hepatic vein.

Objective:To analyze the safety and clinical efficacy of invasive treatment for portal vein thrombosis after splenectomy or devascularization.Methods:Invasive treatment was retrospectively analyzed from Jan 2016 to Jan 2020. In 319 cases who met the inclusion criteria.Result:There were complications in 41 cases and no death;The average portal vein pressure before and after thrombus clearance treatment was (25.6±4.9) mmHg and (14.7±4.1) mmHg respectively ( t=2.53, P<0.05); Thrombus decreased significantly in most patients. Conclusion:Invasive therapy is a safe and effective method for patients complicated with portal vein thrombosis after splenectomy or devascularization.

Objective:To confirm the protective effect of Xiangsha Yuyang decoction on acetic acid-induced gastric ulcer model rats and explore its mechanism， so as to provide experimental basis for clinical drug use. Method:The 60 SPF Wistar rats were randomly divided into 6 groups： group， model group， high， middle and low dose groups of Xiangsha Yuyang decoction and omeprazole control group. The rat model of gastric ulcer was induced by acetic acid. The rats in the high， middle and low dose groups of Xiangsha Yuyang decoction were intragastrically administered at the dose of 28，14，7 g·kg^-1， and with omeprazole at the dose of 4.17 g·kg^-1in normal saline， respectively. The rats in the blank group and model group were intragastrically infused with the same volume of normal saline once a day. After 14 days of continuous treatment， the rats were killed， the blood was collected， the area and inhibition rate of gastric ulcer were measured and calculated， the histopathological sections of gastric mucosa were made and the state of gastric mucosal injury was observed， and the changes of gastric mucosal repair factor， gastric tissue related protein， oxidative stress factor and inflammatory factor in serum were detected by enzyme-linked immunosorbent assay（ELISA）. Detected the expression of p62 Kelch-like epichlorohydrin-related protein 1 （Keap1）， nuclear transcription factor E2 related factor 2 （Nrf2） and heme oxygenase-1 （HO-1） signal pathway-related proteins in gastric mucosa by Western blot. Result:Compared with control group， the gastric mucosa of the model group showed obvious pathological changes and a large number of leukocytes infiltrated. In model group， the ulcer area was significantly increased（P<0.01）， the contents of mucin mucoprotein 5AC （MUC5AC）， epidermal growth factor （EGF）， superoxide dismutase （SOD） and increased prostaglandin E₂ （PGE₂） were significantly decreased（P<0.01）， the gastrin （GAS）， 8-hydroxydeoxyguanosine （8-OHdG）， malondialdehyde （MDA）， tumor necrosis factor-α （TNF-α）， cyclooxygenase-2 （COX-2） were significantly increased. The expression of HO-1 and Nrf2 protein decreased significantly（P<0.01）， the content of Keap1 increased significantly （P<0.05）， and the expression of p62 protein decreased. Compared with model group， the hierarchical structure of cells in Xiangsha Yuyang decoction high dose group and omeprazole group were clearer and regular， middle and low dose groups could also repair gastric mucosa to a certain extent. The high and middle dose groups of Xiangsha Yuyang decoction could significantly reduce the gastric ulcer area of acetic acid-induced gastric ulcer rat model （P<0.01） and increase the ulcer inhibition rate. It can effectively promote the expression of MUC5AC and EGF in gastric mucosa， decrease the level of GAS（P<0.05，P<0.01）， decrease the level of 8-OHdG and MDA， increase the activity of SOD（P<0.01）， decrease the expression level of TNF-α and COX-2， increase the content of PGE₂， and significantly increase the amount of Nrf2 and HO-1 protein in gastric mucosa（P<0.01）. The high dose group of Xiangsha Yuyang decoction could decrease the protein expression of Keap1（P<0.05） and increase the expression of p62 protein. Conclusion:Xiangsha Yuyang decoction is effective in the treatment of acetic acid-induced gastric ulcer model rats， which can effectively reduce the ulcer area， increase the ulcer inhibition rate and protect the ulcer tissue. Its mechanism may be related to activating p62/Keap1/Nrf2 signal pathway and regulating the expression of related genes so as to improve inflammatory response and regulate oxidative stress response.

Objective:To explore the effects of different surgical treatments on swallowing function in partial laryngectomy patients and to analyze the development trend of swallowing function.Methods:From January 2019 to September 2019, this study selected 54 patients first diagnosed as laryngeal carcinoma with partial laryngectomy at a ClassⅢ Grade A hospital as subjects by convenience sampling. There were 25 patients with vertical partial laryngectomy (vertical group) , 12 patients with horizontal supra-glottic partial laryngectomy (horizontal group) and 17 patients with supra-cricoid partial laryngectomy (SCPL group) . This study observed the time of gastric tube extubation of patients, video-fluoroscopic swallowing study (VFSS) 15 days after surgery, score of Modified Penetration Aspiration Scale (MPAS) and scores of Gugging Swallowing Screen (GUSS) 15, 20 and 30 days after surgery, and compared the swallowing function of patients among three groups.Results:There were statistical differences in the time of gastric tube extubation, scores of GUSS and VFSS+MPAS 15 days after surgery among three groups ( P<0.01) . When taking time as main effect, the Roy maximum root test displayed F=460.693, P<0.001 which showed that time had influence on the score of GUSS; when taking surgery as the main effect, the Roy maximum root test displayed F=218.387, P<0.001 which showed that surgery type had influence on the score of GUSS. There were statistical differences in the development trends of swallowing at different times among three surgery types when time interacted with the surgery type ( F=164.033, P<0.001) . Conclusions:The vertical partial laryngectomy has the small impact on swallowing function and patients recovery quickly. However, horizontal supra-glottic partial laryngectomy and SCPL have great impact on swallowing function; swallowing function can't be well compensated by sphincter function of remnant larynx in a short time; besides, patients with horizontal supra-glottic partial laryngectomy need a long rehabilitation period.