Objective To assess the value of multimodal ultrasonography for diagnosing thyroid nodules—atypia of undetermined significance (AUS) of thyroid imaging reporting and data system (TI-RADS) categories 3 to 5. Methods A total of 90 AUS thyroid nodules in TI-RADS 3-5 categories from 88 patients underwent conventional ultrasonography, ultrasound elastography, superb microvascular imaging, and multimodal ultrasonography at the same time. With fine needle aspiration biopsy results as the gold standard, the methods were compared in terms of the sensitivity, specificity, accuracy, false positive rate (FPR), false negative rate (FNR), and area under the receiver operating characteristic curve (AUC) for diagnosing thyroid nodules. Results There were no significant differences between patients with benign and those with malignant thyroid nodules in terms of sex, age, and nodule locations (all P > 0.05), but the proportion of thyroid nodules ≤ 1 cm in diameter was significantly higher for malignant thyroid nodules than for benign thyroid nodules (χ²=9.610, P=0.002). Compared with benign nodules, malignant nodules were significantly more frequent to have low-level echoes or very low-level echoes, a blurred margin, a vertical diameter/horizontal diameter ratio of > 1, and microcalcifications or no calcifications (all P < 0.05). An ultrasound elastography score of ≥ 3 and type III vascularity on superb microvascular imaging indicated a higher possibility of malignant thyroid nodules (both P < 0.001). The multivariable logistic regression analysis showed that the size, echogenicity, margin, and vertical diameter/horizontal diameter ratio, and superb microvascular imaging type of thyroid nodules were not significant markers for benign or malignant thyroid nodules (all P > 0.05), while microcalcifications/no calcifications and an ultrasound elastography score of ≥ 3 were independent risk factors for malignant AUS nodules (both P < 0.05). The diagnostic sensitivity, specificity, accuracy, FPR, and FNR of conventional ultrasonography for AUS nodules were 91.30%, 71.40%, 62.70%, 28.60%, and 8.70%, respectively; the values for ultrasound elastography were 85.50%, 66.70%, 52.20%, 33.30%, and 14.50%, respectively; the values for superb microvascular imaging were 66.70%, 76.20%, 42.90%, 23.80%, and 33.30%, respectively; and the values for multimodal ultrasonography were 75.20%, 92.50%, 67.70%, 24.80%, and 7.50%, respectively. For distinguishing between benign and malignant AUS nodules, the AUC values of conventional ultrasonography, ultrasound elastography, superb microvascular imaging, and multimodal ultrasonography were 0.866, 0.745, 0.774, and 0.918, respectively. Conclusion Multimodal ultrasonography shows better diagnostic efficacy for AUS nodules of TI-RADS 3-5 compared with conventional ultrasonography, ultrasound elastography, and superb microvascular imaging, which can facilitate the malignancy risk stratification and management of AUS thyroid nodules.

Objective:We aimed to develop a novel visualized model based on nomogram to predict postoperative overall survival.Methods:This was a multicenter, retrospective, observational cohort study, including participants with histologically confirmed gastric and colorectal cancer who underwent radical surgery from 11 medical centers in China from August 1, 2015 to June 30, 2018. Baseline characteristics, histopathological data and nutritional status, as assessed using Nutrition Risk Screening 2002 (NRS 2002) score and the scored Patient-Generated Subjective Global Assessment, were collected. The least absolute shrinkage and selection operator regression and Cox regression were used to identify variables to be included in the predictive model. Internal and external validations were performed.Results:There were 681 and 127 patients in the training and validation cohorts, respectively. A total of 188 deaths were observed over a median follow-up period of 59 (range: 58 to 60) months. Two independent predictors of NRS 2002 and Tumor-Node-Metastasis (TNM) stage were identified and incorporated into the prediction nomogram model together with the factor of age. The model's concordance index for 1-, 3- and 5-year overall survival was 0.696, 0.724, and 0.738 in the training cohort and 0.801, 0.812, and 0.793 in the validation cohort, respectively.Conclusions:In this study, a new nomogram prediction model based on NRS 2002 score was developed and validated for predicting the overall postoperative survival of patients with gastric colorectal cancer. This model has good differentiation, calibration and clinical practicability in predicting the long-term survival rate of patients with gastrointestinal cancer after radical surgery.

Objective:To explore the possible mechanism of Bupiwei Xieyinhuo Shengyang Prescription on gastroesophageal reflux disease (GERD) based on network pharmacology and molecular docking technology.Methods:The main active components and target information of Bupiwei Xieyinhuo Shengyang Prescription were screened by TCMSP database, and targets were identified by GeneCards, OMIM, TTD and PharmGKB databases. The intersection of active ingredient components and disease targets was selected to construct PPI network by STRING. Cytoscape CytoNCA plug-in was used to extract core targets for analysis. GO function enrichment and KEGG pathway enrichment analysis were performed using Metascape. Cytoscape 3.7.2 was used to construct the "component-target-signal pathway" network, and Autodock was used to complete molecular docking verification. Animal experiments were further used for verification. SPF SD male rats were selected and GERD model was established by esophageal stent implantation. After 14 days of intervention, serum TNF-α and COX-2 levels of rats in each group were detected for verification.Results:A total of 215 effective compounds were screened from Bupiwei Xieyinhuo Shengyang Prescription. The main targets of GERD were TNF, IL6, CASP3, TP53 and PTGS2, which mainly focused on cancer pathway, AGE-RAGE signaling pathway, calcium signaling pathway and NF-κB signaling pathway. The results of molecular docking showed that the binding potential and activity of the key active components of Bupiwei Xieyinhuo Shengyang Prescription and the core target were better. Compared with the model group, Bupiwei Xieyinhuo Shengyang Prescription could reduce the serum expression levels of TNF-α and COX-2 ( P<0.01). Conclusions:By regulating TNF, IL6, CASP3, TP53, PTGS2 and other core targets, Bupiwei Xieyinhuo Shengyang Prescription can regulate NF-κB signaling pathway, calcium signaling pathway and other signaling pathways to play a role in the treatment of GERD.

Objective:To explore the features the gait of elderly persons with type 2 diabetes and peri-pheral neuropathy.Methods:Twenty patients no less than 60 years old with type 2 diabetes and peripheral neuropathy (DPN) formed a DPN group, while 20 counterparts with type 2 diabetes but without peripheral neuropathy composed the DM group, and another 20 healthy counterparts served as a control group. The three groups were tested using the Swedish Qualisys motion capture system and their walking speed, step length, step width, stride frequency and stride length, bipedal foot support phase time, single foot support phase time, peak plantar pressure, and regional-holding time were collected and compared.Results:The average walking speed, stride length and stepping frequency of the DPN group were all significantly lower than the other 2 groups′ averages. Their bipedal support phase was significantly longer, but their single foot support phase time was significantly shorter. And in the DPN group the average first and second peak plantar pressures and the second peak pressure time were significantly greater than the other groups′ averages.Conclusions:Elderly patients with type 2 diabetes and peripheral neuropathy have significant gait abnormalities, decreased walking stability, as well as increased plantar pressure and plantar compression time.

Objective:To study the effect of long noncoding RNA growth arrest-specifific transcript 5 (lncRNA GAS5) on the occurrence and development of triple-negative breast cancer (TNBC) by analyzing the differential expression of lncrna GAS5 in The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) databases.Methods:The expression of GAS5 in each subtype and pathological stage of breast cancer was studied by the TCGA data. The correlation of GAS5 was analyzed by using TNBC data GSE76124 and GSE83937 from the GEO database of the United States. The elated genes were collected and take the intersection. The positive correlation genes were used to analyze the GO function and the enrichment of KEGG pathway. GSEA of GAS5 was analyzed with TCGA database and GEO76124 data. GSE40525 and GSE76250 were selected from GEO data set to screen different miRNA and mRNA of TNBC, and construct the ceRNA network of GAS5-mirna-mrna through prediction.Results:The expression of GAS5 in breast cancer was lower than that in the adjacent tissues. GAS5 was mainly involved in various metabolic processes, including organic metabolism, macromolecular metabolism, nitrogen metabolism, etc. In terms of pathway, GAS5 mainly affected the ribosome biogenesis in eukaryotes, Wnt signaling pathway. By constructing the regulatory network of GAS5 in TNBC, we found that GAS5 was most likely to regulate the expression of 25 genes including SLC7A2 and lLONRF2 by adsorbing hsa-mir-650 and has-mir-532-5p.Conclusion:lncrna GAS5 may play a role of tumor suppressor gene in breast cancer and provide a new therapeutic target for gene therapy of breast cancer.

Objective:To compare the effects and characteristic difference of negative pressure materials of polyvinyl alcohol and polyurethane in the treatment of full-thickness burn wounds after escharotomy.Methods:From January 2018 to December 2019, 60 patients with full-thickness burns who met the inclusion criteria and hospitalized in Xuzhou Renci Hospital were recruited in this prospective randomized controlled trial. According to the random number table, 60 cases were divided into polyvinyl alcohol group ( n =30, 13 males and 17 females) and polyurethane group ( n =30, 14 males and 16 females), aged (34±7) and (35±6) years respectively, with burn area of 4.20% (2.23%, 4.90%) total body surface area (TBSA) and 3.89% (2.18%, 4.76%)TBSA and escharectomy area of 2.70% (1.97%, 3.42%) TBSA and 2.87% (2.12%, 3.34%)TBSA, respectively. After patient′s admission, debridement was immediately performed on the full-thickness burn wound, and the dressing was changed with iodophor once a day. Escharectomy was performed on post injury day 3. After thorough hemostasis and washing the wounds with normal saline, patients of the two groups chose corresponding foam materials and supporting facilities for continuous negative-pressure treatment for 1 week, with the negative pressure value setting at -19.9 kPa. Installation time of negative-pressure material was recorded. After a week of negative-pressure treatment, the maximum pulling force of removing foam material was recorded to evaluate the adhesional degree between foam materials and wounds. The amount of bleeding in the process of removing foam materials was recorded, hyperplasiaof granulation tissue was observed with hematoxylin eosin (HE) staining, and the expression of CD31 was detected by immunohistochemical staining and Western blotting to denote vascularization. The ratio of R1 to R0 of coefficient of restitution of foam material before and one week after negative-pressure treatment and drainage volume of wound exudate within a week of negative-pressure treatment were recorded to denote the drainage ability of foam material to wound exudate. One week after negative-pressure treatment, the bacterial colonization, residual foreign body, and eczema rate of skin edge were recorded. Data were statistically analyzed with chi-square test, independent-sample t test, and Mann-Whitney U test. Results:(1) Installation time of negative-pressure material of patients in polyurethane group was (14±3) min, which was significantly shorter than (18±3) min in polyvinyl alcohol group ( t=2.788, P<0.01). (2) One week after negative-pressure treatment, the maximum pulling force of removing foam material of patients in polyvinyl alcohol group was (6.4±0.4) N, which was significantly lower than (16.7±0.8) N in polyurethane group ( t=12.010, P<0.01). (3) One week after negative-pressure treatment, the volume of wound bleeding of patients in polyvinyl alcohol group was (20±3) mL in the process of removing foam material, which was significantly less than (59±3) mL in polyurethane group ( t=50.200, P<0.01). (4) One week after negative-pressure treatment, HE staining showed that hyperplastic thickness of wound granulation tissue of patients in polyurethane group was (2.3±0.6) mm which was significantly higher than (1.6±0.4) mm in polyvinyl alcohol group ( t=6.667, P<0.01); immunohistochemical staining showed that the number of microvascular lumen in wound granulation tissue of patients in polyurethane group was significantly more than that in polyvinyl alcohol group; Western blotting showed that protein expression of CD31 in wound granulation tissue of patients in polyurethane group (1.00±0.05) was significantly higher than 0.42±0.03 of polyvinyl alcohol group ( t=10.490, P<0.01). (5)The ratio of R1 to R0 of coefficient of restitution of foam material of patients in polyvinyl alcohol group was 0.39±0.19, which was significantly lower than 0.52±0.16 in polyurethane group ( t=2.975, P<0.01). In patients of polyvinyl alcohol group, the drainage volume of wound exudate of foam material during one week after negative-pressure treatment was (1 258±444) mL, significantly less than (1 658±580) mL of polyurethane group ( t=3.003, P<0.01). (6) One week after negative-pressure treatment, the number of residual foreign body in wounds of patients of polyurethane group was (14.14±0.37) particles, which was significantly more than (3.36±0.15) particles in polyvinyl alcohol group ( t=26.200, P<0.01). The level of bacterial colonization of wounds and eczema rate of skin edge of patients between the two groups were close. Conclusions:Polyurethane foam material is easy to install and operate, relatively difficult to dry and shrink, and has strong ability to discharge wound exudation. Polyurethane foam material is better than polyvinyl alcohol foam material in promoting wound angiogenesis and tissue proliferation. Polyurethane foam material can be chosen firstly for the wounds with need of protecting deep tissues and important organs, as well as the wounds with obvious inflammatory edema and serious contamination. Polyvinyl alcohol foam material is less adherent to wounds, which is better than polyurethane foam material in the aspects of reducing wound bleeding and residual foreign body. Polyvinyl alcohol foam material can be firstly selected to fix and promote skin graft survival after skin grafting, wound bed preparation before skin grafting of burn with large area and deep wound cavity or sinus, etc. Both types of foam materials need to be improved in the aspects of bacterial colonization and prevention and treatment of skin eczema.

Objective: To investigate the effects of remifentanil combined with propofol on hemodynamics, inflammatory stress response and immune function in patients with acute abdomen complicated with septic shock. Methods: From June 2017 to August 2018, 112 patients with acute abdomen complicated with septic shock who admitted to the First Affiliated Hospital of Xiamen University were enrolled in the study.They were randomly divided into observation group and control group according to the digital table, with 56 cases in each group.The control group was anesthetized with sevoflurane combined with propofol.The observation group was anesthetized with remifentanil combined with propofol.The hemodynamic parameters of the patients entering the operating room(T0₎, 0.5h(T₁), 1h(T₂) and awake(T₃) after anesthesia were recorded.The intraoperative norepinephrine dosage was recorded.The inflammatory response, stress response and immune function indicators at T₀, T₂ and T₃ were recorded. Results: Compared with T₀, T₁ and T₂, the MAP of the two groups was higher at T₃, and the differences were statistically significant(t_{control group}=4.834, 4.484, 5.378, t_{observation group}=6.420, 7.006, 6.152, all P<0.05). Compared with T₀, the HR of the two groups was higher at T₃, and the differences were statistically significant(t_{control group}=5.943, t_{observation group}=7.722, all P<0.05). Compared with T₁ and T₂, CO of the two groups was higher at T₃, and the differences were statistically significant(t_{control group}=4.276, 2.262, t_{observation group}=6.318, 5.132, all P<0.05). There were no statistically significant differences in MAP, HR and CO between the two groups at T₀, T₁, T₂ and T₃(all P>0.05). The doses of norepinephrine in the observation group and the control group were (1 587.7±287.5)μg and (1 937.9±397.6)μg, respectively, and the difference was statistically significant(t=5.341, P<0.05). The serum levels of C reactive protein(CRP), tumor necrosis factor alpha(TNF-α) and interleukin 6(IL-6) increased with time in the two groups, and the differences were statistically significant(t_{control group}=17.06, 36.13, 19.07, 3.822, 9.466, 2.874, 14.18, 26.87, 16.21, t_{observation group}=11.72, 20.79, 11.01, 2.810, 6.559, 3.716, 10.52, 24.56, 17.64, all P<0.05). At T₂ and T₃, the serum levels of CRP, TNF-α and IL-6 in the observation group[T₂: CRP (89.63±17.65)mg/L, TNF-α (51.16±10.16)ng/L, IL-6 (34.26±6.25)ng/L, T₃: CRP (136.15±26.25)mg/L, TNF-α (58.64±11.12)ng/L, IL-6 (67.56±12.67)ng/L]were lower than those in the control group[T₂: CRP (112.15±22.34)mg/L, TNF-α (59.56±11.58)ng/L, IL-6 (42.65±8.37)ng/L, T₃: CRP (175.16±34.75)mg/L, TNF-α (65.79±11.35)ng/L, IL-6 (79.02±14.56)ng/L], the differences were statistically significant(t=5.919, 6.703, 4.080, 3.367, 6.010, 4.443, all P<0.05). Compared with T0, serum levels of epinephrine(E), cortisol(Cor) increased in two groups at T₂ and T₃, and the differences were statistically significant(t_{control group}=10.03, 8.096, 8.679, 7.029, t_{observation group}=6.473, 4.728, 6.330, 4.727, all P<0.05). Compared with T₂, serum levels of E and Cor in two groups at T₃ were decreased, and the differences were statistically significant(t_{control group}=2.400, 2.638, t_{observation group}=2.260, 2.162, all P<0.05). At T₂ and T₃, the serum levels of E, Cor in the observation group[T₂: E (286.36±41.02)ng/L, Cor (262.52±29.89)μg/L, T₃: E (270.35±33.59)ng/L, Cor (253.23±30.28)μg/L]were lower than those in the control group[T₂: E (312.56±38.75)ng/L, Cor (287.56±38.76)μg/L, T₃: E (295.79±35.12)ng/L, Cor (270.25±30.15)μg/L], the differences were statistically significant (t=3.457, 3.917, 3.828, 2.981, all P<0.05). At T₀, T₂ and T₃, there were no statistically significant differences in CD₃⁺, CD₄⁺, CD₈⁺ and CD₄⁺/CD₈⁺ between the two groups(all P>0.05). Conclusion Remifentanil combined with propofol anesthesia can make hemodynamics more stable in patients with acute abdomen complicated with septic shock, and can alleviate inflammation and stress response.

Aim To study the effects of propofol on apoptosis of cortical astrocytes isolated from neonatal rats.Methods Pure astrocytes(AST)were obtained from the cultured cerebral cortical cells and identified by the GFAP stain technology in neonatal rats.AST cells were treated with different concentrations of propofol(0,10,30,90 μmol·L-1)for 8 hours.Cell viability was measured by MTT method,and the apoptosis was detected by Annexin V/PI double staining.Cytochrome C(cyt-C)leakage was detected by Western blot.Caspase-3 and caspase-9 activities were measured by spectrophotometry.Results AST cells were administered with different concentrations of propofol(0,10,30,90 μmol·L-1)for 8 hours.It decreased the survival rate in a concentration-dependent manner,induced the leakage of cyt-C in mitochondria,up-regulated the expression of pro-apoptotic protein caspase-3 and caspase-9,and induced AST apoptosis.Conclusion Propofol induces the apoptosis of astrocytes in neonatal rat cortex in vitro,which may be related to the activation of mitochondria apoptosis pathway induced by mitochondrial cyt-C release.

Objective To investigate the expression of interferon-induced protein 44 (IFI44) gene in the leukocytes of the peripheral blood samples from patients with systemic lupus erythematosus (SLE), and to evaluate the relationship between the expression level and disease activity. Methods Mononuclear cells in the peripheral blood samples from 100 SLE patients were compared with those of 40 disease controls and 40 healthy donors (HD) and the expression of the IFI44 was evaluated by quantitative real-time PCR.Comparisons between groups were performed with ANOVA, and the correlation analysis between the level of expression was higher in SLE patients than disease controls and healthy donors (26.8±5.3, 7.4±2.7, 5.2±2.0,respectively) (P=0.0012, P=0.005), but no difference was found between disease controls and healthy donors. Mild disease activity and the SLE patients with stable disease (63.1±22.4, 28.0±7.2, 9.2±1.8, respectively)and 24 hours urine protein level (r=0.42, P=0.000). Conclusion IFI44 is demonstrated to be highly expressed in SLE patients. The level of IFI44 may be a promising candidate biomarker for identifying SLE activity.

p53, as a transcription factor, is an important tumor suppressor gene and plays the key role in the p53-dependent gene regulatory network. Therefore, it is important to understand its biological function at the level of the whole system. In this paper, based on KEGG database and related literatures in English and Chinese, the interaction mode and quantitative relationship of the related molecules involved in p53 signaling pathway were extracted. By using S-system equations and 'Simulink' toolbox of Matlab7.0, a dynamic model of p53 signaling pathway was developed, and the dynamic regulatory characteristics of p53 signaling pathway were analyzed on model simulation. The results were in accord with the literatures and could reflect quantitatively the complex regulatory relationship between the interacting molecules involved in p53 signaling pathway. In addition, model simulation helped us find and identify the key molecules in this signaling pathway. Thus, this model can be used as a basis for the follow-up study of the relationship by precise and quantitative assessment.
Algorithms ; Computer Simulation ; Gene Expression Regulation ; Humans ; Models, Biological ; Signal Transduction ; physiology ; Transcription Factors ; genetics ; metabolism ; Tumor Suppressor Protein p53 ; genetics ; physiology