[Evaluation of brain age changes in patients with liver cirrhosis and hepatic encephalopathy with deep learning models based on structural magnetic resonance imaging].

Objective: To investigate the brain aging in patients with cirrhosis and hepatic encephalopathy(HE), constructed a prediction model of brain age based on deep learning and T1 high-resolution MRI, and try to reveal the specific regions where cirrhosis and HE accelerating brain aging. Methods: A cross-sectional study. A brain age prediction model based on the 3D full convolutional neural network was constructed through T1 high-resolution MRI data from 3 609 healthy individuals across eight global public datasets. The mean absolute error (MAE) between actual age and predicted brain age, Pearson correlation coefficient (r) and determination coefficient (R2) were calculated to evaluate the accuracy of the model's predictions. A test set (n=555) from the Human Connectome Project was used to assess the accuracy of the model. A total of 136 patients with cirrhosis were recruited from Tianjin First Central Hospital as the case group (79 patients with cirrhosis without HE and 57 patients with cirrhosis with HE), and 70 healthy individuals were recruited from the society as the healthy control group during the same period. Brain-predicted age difference (Brain-PAD), digital connection-A (NCT-A) and digital-symbol test (DST) scores of all subjects were calculated for all subjects to assess brain aging and cognitive function in the healthy control group, the cirrhosis without HE group, and the cirrhosis with HE group. The network occlusion sensitivity analysis method was employed to assess the importance of each brain region in predicting brain age. Results: As for the prediction model, in the training set, MAE=2.85, r=0.98, R2=0.96. In the test set, MAE=4.45, r=0.96, R2=0.92. In the local data set of the healthy control group, MAE=3.77, r=0.85, R2=0.73. The time of NCT-A in both cirrhosis groups was longer than healthy control group, while the DST scores were lower than healthy control group, and the differences were statistically significant (both P<0.001); the Brain-PAD of healthy control group was (0.8±4.5) years, the Brain-PAD of no-HE group was (6.9±8.1) years, and the HE group was (10.2±7.7) years. The differences between the three groups were statistically significant (P<0.001), and the differences between any two groups were statistically significant (all P<0.05). The importance ratio of visual network in predicting brain age increased in cirrhosis patients, and the HE group was higher than no-HE group. Conclusions: In patients with cirrhosis, the cognitive function is reduced, brain aging is accelerated, and these changes are more obvious in patients with HE. The importance differences of each brain network in predicting brain aging provide a new direction for identifying the specific regions where cirrhosis and HE accelerate brain aging.

[Second allogeneic hematopoietic stem cell transplantation with reduced-intensity conditioning and donor changes in relapsed hematological malignancies after the first allogeneic transplant].

Objective: The purpose of this study was to assess the safety and efficacy of a second allogeneic hematopoietic stem cell transplantation (allo-HSCT) with reduced-intensity conditioning (RIC) in patients with hematological malignancies who had relapsed after the first allo-HSCT. Methods: Between April 2018 and June 2021, 44 patients with hematological malignancies (B-ALL 23, T-ALL/T-LBL 4, AML15, and MDS 2) were enrolled and retrospectively examined. Unrelated donors (n=12) or haploidentical donors (n=32) were used. Donors were replaced in all patients for the second allo-HSCT. Hematological and immunological germline predisposition genes and hematopoietic and immune function tests were used to select the best-related donor. Total body irradiation (TBI) /fludarabine (FLU) -based (n=38), busulfan (BU) /FLU-based (n=4), total marrow irradiation (TMI) /FLU-based (n=1), and BU/cladribine-based (n=1) were the RIC regimens used. For graft versus host disease (GVHD) prevention, cyclosporine, mycophenolate mofetil, short-term methotrexate, and ATG were used. Eighteen (40.9%) of 44 patients with gene variations for which targeted medications are available underwent post-transplant maintenance therapy. Results: The median age was 25 years old (range: 7-55). The median interval between the first and second HSCT was 19.5 months (range: 6-77). Before the second allo-HSCT, 33 (75%) of the patients were in complete remission (CR), whereas 11 (25%) were not. All patients had long-term engraftment. The grade Ⅱ-Ⅳ GVHD and severe acute GVHD rates were 20.5% and 9.1%, respectively. Chronic GVHD was found in 20.5% of limited patterns and 22.7% of severe patterns. CMV and EBV reactivation rates were 29.5% and 6.8%, respectively. Hemorrhage cystitis occurred in 15.9% of cases, grade Ⅰ or Ⅱ. The 1-yr disease-free survival (DFS), overall survival (OS), and cumulative recurrence incidence (RI) rates of all patients were 72.5% (95% CI, 54.5%-84.3%), 80.6% (95% CI, 63.4%-90.3%), and 25.1% (95% CI, 13.7%-43.2%), respectively, with a median follow-up of 14 (2-39) months. There were eight deaths (seven relapses and one infection). The rate of non-relapse mortality (NRM) was only 2.3%. The CR patients' 1-yr RI rate was significantly lower than the NR patients (16.8% vs 48.1%, P=0.026). The DFS rate in CR patients was greater than in NR patients, although there was no statistical difference (79.9% vs 51.9%, P=0.072). Univariate analysis revealed that CR before the second allo-HSCT was an important prognostic factor. Conclusion: With our RIC regimens, donor change, and post-transplant maintenance therapy, the second allo-HSCT in relapsed hematological malignancies after the first allo-HSCT is a safe and effective treatment with high OS and DFS and low NRM and relapse rate. The most important factor influencing the prognosis of the second allo-HSCT is the patient's illness condition before the transplant.

[Current application and prospect of accurate navigation technology in orthopaedic trauma].

In the past decades,a dramatic development of navigation technology in orthopaedic surgery has been witnessed. By assisting the localization of surgical region,verification of target bony structure,preoperative planning of fixation,intraoperative identification of planned entry point and direction of instruments or even automated insertion of implants,its ability and potential to reduce operation time,intraoperative radiation,surgical trauma,and improve accuracy has been proved. However,in contrast to the widespread use of navigation technology in arthroplasty,orthopaedic tumor,and spine surgery,its application in orthopaedic trauma is relatively less. In this manuscript,the main purpose is to introduce the technical principles of navigation devices,outline the current clinical application of navigation systems in orthopaedic trauma,analyze the current challenges confronting its further application in clinical practice and its prospect in the future.

[Association between body mass index and coronary heart disease in Qingdao: a prospective study].

Objective: To analyze the association between body mass index (BMI) and coronary heart disease. Methods: The data for the present study were from the prospective cohort study of China Kadoorie Biobank (CKB) in Qingdao, a total of 33 355 participants aged 30-79 years were included in the study. Cox regression analyses were performed to evaluate the association between BMI and coronary heart disease. Results: During the follow-up for an average 9.2 years, a total of 2 712 cases of ischemic heart disease (IHD) and 420 cases of major coronary events (MCE) were found. Multivariate Cox regression analysis showed that, compared with participants with normal BMI, the participants who were overweight had a 41% and 87% higher risk of IHD and MCE, the adjusted HR were 1.41 (95%CI: 1.27-1.56) and 1.87 (95%CI: 1.43-2.44), respectively. The participants who were obesity had 91% and 143% higher risk of IHD and MCE, the adjusted HR were 1.91 (95%CI: 1.72-2.13) and 2.43 (95%CI: 1.82-3.24), respectively. Conclusion: Overweight and obesity might increase the risk for IHD and MCE.

[T lymphocyte subsets combined with inflammatory indicators for auxiliary diagnosis and prognosis evaluation of sepsis].

Objective: To explore the application value of T lymphocyte subsets combined with procalcitonin (PCT), C-reactive protein (CRP), neutrophil to lymphocyte ratio (NLR) and white blood cell count (WBC) in the auxiliary diagnosis and prognosis evaluation of sepsis. Methods: In a retrospective study, seventy-two patients with sepsis diagnosed and treated in Tianjin First Central Hospital from June 2018 to April 2021 were selected as the research objects, and included in the sepsis group were 46 males and 26 females, aged 68 (57.3, 80.3) years. In addition, 111 patients with local infection admitted to hospital during the same period were included in the local infection group, including 62 males and 49 females, aged 68 (51, 77) years. Sepsis patients were divided into survival group (43 cases) and death group (29 cases) according to the 28-day outcome. CD3+, CD4+, CD8+, CD4+/CD8+ ratio were detected by flow cytometry within 24 h after admission, PCT was detected by ELISA, CRP was detected by immunoturbidimetry, blood routine examination, blood lactic acid (Lac) and oxygen partial pressure (PO2) were detected by instrumental method. Multivariate Logistic regression analysis was used to evaluate the correlation between each indicator and sepsis, and receiver operating characteristic curve (ROC) was drawn to evaluate the diagnostic value of each indicator for sepsis. Multivariate Logistic regression analysis and Kaplan Meier survival analysis were used to evaluate the prognostic value of each index for patients with sepsis. Results: Peripheral blood CD3+, CD4+, CD8+, CD4+/CD8+ ratio and PLT in sepsis group were significantly lower than those in local infection group(Z=-8.184,P<0.001;Z=-7.210,P<0.001;Z=-5.936,P<0.001;Z=-2.700,P=0.007;Z=-6.381,P<0.001); PCT, CRP, NLR and Lac levels were significantly higher than those in local infection group(Z=-8.262,P<0.001;Z=-3.094,P=0.002;Z=-9.004,P<0.001;Z=-4.770,P<0.001). Multivariate Logistic regression model showed that PCT, NLR, CD3+, CD8+, CD4+/CD8+ were independent risk factors for sepsis. According to ROC curve analysis, AUC of sepsis patients diagnosed by each indicator were 0.862, 0.894, 0.858, 0.760 and 0.618, respectively. The cut-off values were 3.075 ng/ml, 10.715, 44.935×109/L, 27.463×109/L and 0.750, respectively. The NLR sensitivity was 80.6%, and the CD3+ specificity was 94.6%. The AUC of combined detection of PCT and NLR was 0.947, sensitivity was 87.5% and specificity was 91.9%. The combined detection AUC of PCT, NLR, CD3+, CD4+/CD8+ was 0.958, the sensitivity and specificity were 90.3% and 91.0% respectively(P<0.001). PCT and Lac in death group were significantly higher than those in survival group(Z=-2.302,P=0.021;Z=-3.095,P=0.002);Peripheral blood CD4+/CD8+ levels were significantly lower than those in survival group(Z=-3.691,P<0.001),Multivariate Logistic regression model showed that CD4+/CD8+ ratio was an independent risk factor for 28 d mortality in patients with sepsis (P<0.001). The ROC curve showed that the AUC was 0.758, and the Youden index reached the maximum when the cut-off value was 1.27, the sensitivity and specificity were 79.3% and 60.5%, respectively. Compared with patients with CD4+/CD8+ ≥1.27, 28-day mortality was significantly increased in patients with CD4+/CD8+<1.27 (P=0.032). Conclusion: The combined detection of PCT, NLR, CD3+ and CD4+/CD8+ can improve the auxiliary diagnostic efficiency of sepsis, and the ratio of CD4+/CD8+ in peripheral blood may have certain predictive value for the prognosis of sepsis.

[A prospective randomized controlled study of the effects of balance training combined with routine training on patients with lower limb motor and balance dysfunction after severe burns].

Objective: To observe the effects of balance training combined with routine training on patients with lower limb motor and balance dysfunctions after severe burns. Methods: A prospective randomized controlled study was conducted. From January 2016 to January 2020, sixty-four patients with lower limb motor and balance dysfunction after severe burns who met the inclusion criteria were admitted to Tongren Hospital of Wuhan University＆Wuhan Third Hospital. According to the random number table, the patients were divided into routine training (RT) group and combined training (CT) group. There were 32 cases in each group, 22 males and 10 females in RT group, aged 40.5 (35.5, 52.8) years, and 24 males and 8 females in CT group, aged 37.0 (30.0, 44.0) years. Patients in RT group performed conventional treatment including knee joint stretch, continuous passive motion, lower limb muscle strength training, and pressure therapy etc., while patients in CT group received balance training in addition to RT treatment including sitting balance, center of gravity transfer, pelvic stability, standing alternately on one leg, and standing on balance pad. Patients in both groups were treated for 4 months. Before treatment and after 4 months of treatment, the Berg Balance Scale, Lower Extremity Function Scale, and Activities-specific Balance Confidence Scale were used to evaluate the balance function, lower limb function, and balance activity self-confidence of patients respectively. Data were statistically analyzed with independent sample t test, paired sample t test, Mann-Whitney U test, Wilcoxon signed rank test or chi-square test. Results: Before treatment, the Berg balance score of patients in RT group was (25±9) points, which was similar to (25±7) points in CT group (t=-0.154, P>0.05). After 4 months of treatment, the Berg balance score of patients in CT group was (43±6) points, which was significantly higher than (40±6) points in RT group (t=2.028, P<0.05). The Berg balance scores of patients in RT and CT groups after 4 months of treatment were obviously higher than those before treatment (t=-15.189, -26.200, P<0.01). Before treatment, the lower limb function score of patients in RT group was 25.0 (16.5, 30.0) points, which was similar to 23.0 (10.3, 28.8) points in CT group (Z=-1.575, P>0.05). After 4 months of treatment, the lower limb function score of patients in CT group was 55.0 (35.0, 60.0) points, which was significantly higher than 43.0 (36.0, 53.0) points in RT group (Z=-2.744, P<0.01). The lower limb function scores of patients in RT and CT groups after 4 months of treatment were obviously higher than those before treatment (Z=-4.943, -4.955, P<0.01). Before treatment, the balance activity self-confidence scores of patients in the two groups were similar (t=-0.966, P>0.05). After 4 months of treatment, the balance activity self-confidence scores of patients in CT group was significantly higher than that in RT group (t=3.343, P<0.01). The balance activity self-confidence scores of patients in RT and CT groups after 4 months of treatment were obviously higher than those before treatment (t=-19.611, -34.300, P<0.01). Conclusions: Conventional treatment combined with balance training for patients with lower limb motor and balance dysfunctions after severe burns can effectively promote the recovery of their lower limb motor and balance function.

[A prospective randomized controlled study on the effect of balance training on lower limb movement and balance dysfunction in severe burn patients].

Objective: To observe the rehabilitation effect of balance training on motor and balance function of lower extremities of deep burn patients. Methods: A prospective randomized controlled study was conducted. From January 2016 to January 2020, sixty-four patients with lower limb motor and balance dysfunction after deep burn were admitted to Tongren Hospital of Wuhan University＆Wuhan Third Hospital, the burn area was 30% to 70% Total Body Surface Area, and the burn depth of more than one hip, knee and ankle joint of both lower limbs and their periphery were deep second or third degree. According to the method of random number table, the patients were divided into routine training(RT) group and balance training(BT) group. There were 32 cases in each group, 22 males and 10 females in the RT group, aged 40.5 (35.5, 52.8) years old, and 24 males and 8 females in the BT group, aged 37.0 (30.0, 44.0) years old. Patients in group RT were conventionally conducted with knee joint stretch treatment, continuous passive motion treatment, lower limb muscle strength training and pressure therapy; while patients in group BT were conducted with balance training besides RT such as sitting balance, center of gravity transfer, pelvic stability, standing alternately on one leg and standing on balance pad. Patients in the 2 groups were treated for 4 months. Before treatment and after 4 months of treatment,Berg balance score, lower limb function score and balance activity self-confidence score were evaluated . The data were statistically analyzed with t test, Mann-Whitney U test, Wilcoxon signed rank test or χ² test. Results: (1) Before treatment, the difference value of Berg balance score of patients in group RT was (25±9), which was similar to (25±7) in group BT(t=-0.154,P>0.05). After 4 months of treatment, the difference value of Berg balance score of patients in group BT was (43±6), which was higher than (40±6) in group RT (t=2.028,P<0.05). The difference values of Berg balance scores of the patients in group RT and BT after 4 months of treatment were obviously higher than those before treatment(t=-15.189,-26.2,P<0.001). (2) Before treatment, the lower limb function score of patients in group RT was 25.0 (16.5,30.0), which was similar to 23.0(10.3,28.8) in group BT(Z=-1.575,P>0.05). After 4 months of treatment, the lower limb function score of patients in group BT was 55.0(35.0, 60.0) , which was significantly higher than 43.0 (36.0, 53.0) in group RT(Z=-2.744,P<0.01). The lower limb function scale of patients in group RT and BT after 4 months of treatment were obviously higher than those before treatment(Z=-4.943,-4.955,P<0.01). (3) Before treatment, the balance activity self-confidence scores of the two groups were similar(t=-0.966,P>0.05) . After 4 months of treatment , the balance activity self-confidence scores of patients in group ST was significantly higher than that in group RT (t=3.343,P<0.01). The balance activity self-confidence scores of patients in groups RT and BT after 4 months of treatment were obviously higher than those before treatment(t=-19.611,-34.300,P<0.001). Conclusions: The balance training can effectively promote the recovery of lower limb motor and balance function on the basis of conventional rehabilitation treatment for patients with lower limb motor and balance dysfunction after deep burns.

[Influence of maggot excretions/secretions on the anti-Pseudomonas aeruginosa effect of neutrophils in patients with diabetic foot ulcer].

Objective: To investigate the effects of medical maggot excretions/secretions (ES) on neutrophils phagocytosis and bactericidal effect in patients with diabetic foot ulcer (DFU). Methods: The experimental research method was used. Thirty DFU patients (16 males and 14 females, aged (64±7) years)who were admitted to the Diabetes Foot Center, the Department of Endocrinology of Air Force Hospital of Eastern Theater Command from June to December 2020 and met the inclusion criteria were recruited. Discontinuous percoll gradient centrifugation method was used to separate the neutrophils. Cells from each patient were enrolled into normal saline group and maggot ES group (30 wells in each group), respectively; sterile normal saline and ES with a final mass concentration of 357 µg/mL (the same as below) were added, respectively. After 1 and 2 hour(s) of culture, the phagocytosis rate and phagocytic index of cells were observed and counted under Wright's staining. Ten patients were selected, then the cells of each patient were enrolled into Pseudomonas aeruginosa+neutrophils group and Pseudomonas aeruginosa+neutrophils+maggot ES group (10 wells in each group) and were treated corresponding, respectively. Pseudomonas aeruginosa alone group and Pseudomonas aeruginosa+maggot ES group (10 wells in each group) were set up respectively; Pseudomonas aeruginosa+RPMI 1640 culture medium+sterile normal saline and Pseudomonas aeruginosa+RPMI 1640 culture medium+maggot ES were added, respectively. After 2 hours of culture, the number of viable bacteria colony was counted by plate colony number method. Six, six, and three patients were selected respectively, and the cells of each patient were respectively enrolled into maggot ES group and normal saline group (6, 6, and 3 wells in each group, respectively) and treated accordingly. After 6 hours of culture, real-time fluorescent quantitative reverse transcription polymerase chain reaction was used to detect the mRNA expressions of interleukin 1ß (IL-1ß), IL-6, and lysozyme in cells, the content of IL-1ß and IL-6 in cell culture supernatant were determined by enzyme-linked immunosorbent assay, and the positive cells expressing lysozyme were observed with immunofluorescence method. Data were statistically analyzed with one-way analysis of variance, paired sample t test, least significant difference test, and Wilcoxon rank sum test. Results: After 1 hour of culture, the phagocytosis rate and phagocytic index of cells in maggot ES group (53.5% (49.7%, 58.0%) and 3.18 (2.96, 3.32)) were similar to 52.0% (47.5%, 55.2%) and 3.15 (2.96, 3.25) of normal saline group (Z=-1.701, -1.092, P>0.05). After 2 hours of culture, the phagocytosis rate and phagocytic index of cells in maggot ES group (70.0% (66.7%, 72.0%) and 4.47 (4.22, 4.96)) were significantly higher than 58.0% (55.0%, 60.0%) and 4.11 (3.52, 4.24) in normal saline group (Z=-4.786, -4.279, P<0.01). After 2 hours of culture, the number of viable bacteria colony in Pseudomonas aeruginosa+neutrophils group was significantly lower than that in Pseudomonas aeruginosa alone group (P<0.01), and the number of viable bacteria colony in Pseudomonas aeruginosa+neutrophils+maggot ES group was significantly lower than that in Pseudomonas aeruginosa+maggot ES group and Pseudomonas aeruginosa+neutrophils group (P<0.01). After 6 hours of culture, the mRNA expressions of IL-1ß, IL-6, and lysozyme of cells in maggot ES group were significantly higher those in normal saline group (t=-3.279, -4.273, -4.763, P<0.05 or P<0.01); the concent of IL-1ß and IL-6 in cell culture supernatant of maggot ES group were significantly higher than those of normal saline group (t=-9.526, -6.447, P<0.01); there were significantly more positive cells expressing lysozyme in maggot ES group than in normal saline group. Conclusions: Maggot ES can enhance the phagocytosis and bactericidal effect of neutrophils on Pseudomonas aeruginosa by promoting the production of neutrophils immune defense related cytokines and lysozyme in DFU patients.

Integrative analysis of the characteristics of lipid metabolism-related genes as prognostic prediction markers for hepatocellular carcinoma.

OBJECTIVE: Dysregulated lipid metabolism has been reported in the progression of hepatocellular carcinoma (HCC). In the present study, we investigated the molecular characteristics of lipid-metabolism-related genes (IMRGs) as prognostic markers for HCC. MATERIALS AND METHODS: Multi-dimensional bioinformatics analyses were performed to comprehensively analyze IMRGs, and to construct prognostic prediction signatures. RESULTS: Data of 770 HCC patients and their corresponding 776 IMRGs were downloaded from three databases. Patients were classified into 2 molecular clusters that were associated with overall survival, clinical characteristics, and immune cells. The biological functions of the IMRGs differentially expressed between the 2 clusters were associated with tumor-related metabolic pathways. A 6 IMRG signature (6-IS), consisting of FMO3, SLC11A1, RNF10, KCNH2, ME1, and ZIC2, was established as an independent prognostic factor for HCC. The performance of the signature of 6-IS prognostic was verified in a validation set and compared to an external data set. It was revealed that the 6-IS could effectively predict the prognosis of patients with HCC. CONCLUSIONS: This study provides new insights into the role of IMRGs in the pathogenesis of HCC, and presents a novel signature (6-IS) to predict the prognosis of HCC.

OTX1 is a novel regulator of proliferation, migration, invasion and apoptosis in lung adenocarcinoma.

OBJECTIVE: Orthodenticle Homeobox 1 (OTX1) has been found to be closely related to the development of several human tumours. However, the function and underlying molecular mechanisms of OTX1 in non-small cell lung cancer (NSCLC) are unclear. This research was performed to investigate the effects of downregulating OTX1 gene expression on the proliferation, migration, invasion, cell cycle and apoptosis of human NSCLC cell lines. PATIENTS AND METHODS: Cultured NCI-H292 and XWLC cells were transfected with control small interfering RNA (siNC) or experimental siRNA (siOTX1). The mRNA levels were detected using a quantitative real-time PCR (RT-qPCR) assay. A Cell Counting Kit-8 (CCK-8) and a Real Time Cell Analyzer (RTCA) were used to determine cell activity. The RTCA and transwell chambers were used to assess cell migration and invasion. In addition, cell cycle progression and apoptosis were measured using flow cytometry, and the expression levels of key signalling pathway proteins were examined by Western blotting. RESULTS: The results revealed that compared with the control group, the experimental group exhibited significantly decreased cell activity (***p<0.001), significantly decreased migration and invasion abilities (***p<0.001), and cell cycle arrest in G2/M phase (*p<0.05). However, the number of apoptotic cells was higher in the experimental group than in the control group (*p<0.05). The Western blotting results were consistent with the functional experiment results. CONCLUSIONS: Silencing the OTX1 gene suppressed the proliferation, migration and invasion of NCI-H292 and XWLC cells, impeded the cell cycle transition from G2 to M phase, and accelerated apoptosis, revealing OTX1, a regulator of NSCLC, as a potential new therapeutic target.

[Effect of high expression of type â collagen α1 chain protein on the prognosis of triple negative breast cancer].

Objective: To investigate the expression of type Ⅰ collagen α1 chain protein (COL1A1) in triple negative breast cancer (TNBC), and its relationship with clinicopathological features and prognosis of TNBC. Methods: A total of 148 TNBC specimens were collected from the Affiliated Cancer Hospital of Xinjiang Medical University from 2013 to 2015. The mRNA expression of COL1A1 was detected by fluorescence quantitative RT-PCR and the protein expression of COL1A1 was detected by Western blot. The expression of COL1A1 and α-smooth muscle actin (α-SMA) in TNBC were detected by immunohistochemistry. The relationship between the expression of COL1A1 and clinicopathological parameters and prognosis of TNBC patients was analyzed. Results: The mRNA and protein expression of COL1A1 in MDA-MB-231 cells were 1.696±0.486 and 0.550±0.088, respectively, which were higher than those in MCF-10A cells (1.020±0.231 and 0.350±0.083, P=0.032, P=0.046). The mRNA and protein expression of COL1A1 in TNBC tissues were 1.632 ±0.598 and 0.733 ±0.068, respectively, which were higher than those in paracancerous tissues (1.041±0.316 and 0.612±0.016, P=0.003, P=0.039). The high expression rates of COL1A1 and α-SMA in TNBC tissues were 35.8% and 56.7% respectively, which were higher than those in paracancerous tissues (16.7% and 30.0%, P=0.041, P=0.037). The expression of COL1A1 was correlated with tumor size, TNM stage, lymph node metastasis, vascular invasion and α-SMA expression (all P<0.05). The median survival time in COL1A1 high expression group was 64 months, which was lower than that in low expression group (73 months, P<0.05). Multivariate analysis of Cox proportional hazard regression model showed that COL1A1 expression was an independent influencing factor for the survival of TNBC patients (HR=3.952, P=0.004). Conclusion: The high expression of COL1A1 in TNBC is an independent prognostic factor of TNBC patients.

[The relationship between occupational wood dust exposure and nasal cancer].

Nasal cancer has not been included in the current list of legal occupational diseases in China. There is also a lack of systematic and in-depth study on the relationship between nasal cancer and occupational exposure factors in China. In September 2018, the department for work and pensions of UK released the latest edition of the "List of diseases covered by industrial injuries disablement benefit", which lists nasal cancer and nasopharyngeal carcinoma associated with wood dust exposure on the UK's occupational disease list. In order to better protect the health of workers, the relationship between occupational wood dust exposure and nasal cancer is reviewed, which provides a reference for further revision and improvement of occupational disease catalogue.

A new diphosphate Ba2LiGa(P2O7)2: synthesis, crystal structure and Eu3+-activated fluorescence performance.

Finding new luminescent materials is always a meaningful goal in the field of photoelectricity studies. Herein, a new diphosphate compound Ba2LiGa(P2O7)2 (BLGP) was prepared using a high-temperature flux method. It displays an anionic chain structure of [LiGa(P2O7)2]∞, constructed from P2O7, LiO5 and GaO6 polyhedra. The Ba2+ ions are distributed in the voids between the [LiGa(P2O7)2]∞ chains, bonding them and maintaining charge balance. To test its potential as a luminescent host, Eu3+ doped phosphors BLGP:xEu3+ (x = 0.05, 0.10, 0.15, 0.20, 0.25 and 0.30) were synthesized and studied in detail. Upon 394 nm light irradiation, BLGP:xEu3+ showed bright orange emission with a dominant peak at 595 nm due to the 5D0 → 7F1 transition of Eu3+. The optimal doping amount of Eu3+ is 0.20, and the internal quantum efficiency of the phosphor B1.8LGP:0.2Eu3+ was determined to be 67%. The temperature quenching behavior of B1.8LGP:0.2Eu3+ was studied, suggesting that the photoluminescence (PL) intensity decreased to about 50% at 450 K due to thermal quenching. All these features show that this compound is a good luminescent host material for Eu3+ activators.

Research on cardioprotective effect of irbesartan in rats with myocardial ischemia-reperfusion injury through MAPK-ERK signaling pathway.

OBJECTIVE: The aim of this study was to explore whether the mechanism of Irbesartan (IRB) in the treatment of rats with myocardial ischemia-reperfusion injury (MIRI) was related to the mitogen-activated protein kinase (MAPK)-extracellular signal-regulated kinase (ERK) signaling pathway. MATERIALS AND METHODS: The rat model of MIRI was first successfully established. All rats were randomly divided into 5 groups, including the Sham group (sham operation control group, ligation only), Model group (MIRI rat model group), IRB12.5 group [low-dose IRB (12.5 mg/kg/d) group], IRB50.0 group [medium-dose IRB (50.0 mg/kg/d) group] and IRB200.0 group [high-dose IRB (200.0 mg/kg/d) group]. After treatment of IRB in MIRI rats, the activities of four myocardial enzyme indexes, including creatine kinase-MB (CK-MB), aspartate aminotransferase (AST), lactate dehydrogenase (LDH) and cardiac troponin T (cTnT), were detected via enzyme-linked immunosorbent assay (ELISA). The effect of IRB on myocardial apoptosis in MIRI rats was detected via Annexin V-fluorescein isothiocyanate/Propidium Iodide (FITC/PI) double staining. Meanwhile, the messenger ribonucleic acid (mRNA) levels of ERK, B-cell lymphoma-2 (Bcl-2) and Bcl-2 associated X protein (Bax) in myocardial cells after treatment of IRB were detected via Reverse Transcription-Polymerase Chain Reaction (RT-PCR). Furthermore, the protein levels of ERK and p-ERK were detected via Western blotting. RESULTS: Different concentrations of IRB could protect myocardium from MIRI. IRB at doses of 50.0 mg/kg/d and 200.0 mg/kg/d could significantly downregulate myocardial enzyme indexes in MIRI (p<0.01). Meanwhile, both the doses could markedly inhibit myocardial apoptosis in MIRI rat model by regulating the expressions of apoptosis-related genes (Bcl-2 and Bax) (p<0.01), eventually improving myocardial pathological damage. At the same time, it could also significantly decrease the mRNA and protein levels of ERK in the MAPK-ERK signaling pathway (p<0.05). CONCLUSIONS: The cardioprotective mechanism of IRB in MIRI rats may be related to the inhibition of the activation of the MAPK-ERK signaling pathway.

[Clinical effects of Archimedes sling system in the rehabilitation of knee joint flexion dysfunction after deep burn].

Objective: To observe the therapeutic effects of Archimedes sling system in the rehabilitation of knee joint flexion dysfunction of patients after deep burns. Methods: Thirty-seven patients with knee joint flexion dysfunction after deep burn, conforming to the study criteria and hospitalized in Burn Rehabilitation Center of Tongren Hospital of Wuhan University & Wuhan Third Hospital from March 2015 to December 2017, were recruited in this prospective controlled study. According to the order of admission, 18 odd-numbered patients and 19 even-numbered patients were enrolled in conventional treatment (CT) group [13 males and 5 females, aged (42±10) years] and sling treatment (ST) group [13 males and 6 females, aged (37±10) years] respectively. Patients in group CT were conventionally conducted with knee joint mobilization treatment, continuous passive motion treatment, and pressure therapy, while patients in group ST were conducted with supine knee joint flexion and extension training and micro-squat short arc resistance training with Archimedes sling system besides CT. Patients in the 2 groups were treated for 6 months, and 1 course of treatment was 1 month. Before treatment and after 6 months of treatment, the knee joint active motion range was measured and the difference value was calculated, the American Hospital for Special Surgery (HSS) knee joint score was used to assess the functional disorder of patients, and the self-function satisfaction of patients were evaluated with modified Likert Scale. Data were processed with independent sample t test, paired sample t test, and chi-square test. Results: (1) Before treatment, the difference value of knee joint active motion range of patients in group CT was (45±11)°, which was similar to (44±12)° in group ST (t=-0.206, P>0.05). After 6 months of treatment, the difference value of knee joint active motion range of patients in group ST was (89±14)°, which was obviously higher than (75±12)° in group CT (t=0.897, P<0.01). The difference values of knee joint active motion range of patients in groups CT and ST after 6 months of treatment were obviously higher than those before treatment (t=-13.394, -29.459, P<0.01). (2) Before treatment, the HSS knee joint score of patients in group CT was (40±10) points, which was similar to (36±11) points in group ST (t=0.816, P>0.05). After 6 months of treatment, the HSS knee joint score of patients in group ST was (68±13) points, which was obviously higher than (57±10) points in group CT (t=0.162, P<0.01). The HSS knee joint score of patients in groups CT and ST after 6 months of treatment were obviously higher than those before treatment (t=-12.410, -30.559, P<0.01). (3) Before treatment, the self-function satisfaction scores of patients in the two groups were similar (t=0.140, P>0.05). After 6 months of treatment, the self-function satisfaction score of patients in group ST was obviously higher than that in group CT (t=3.103, P<0.01). The self-function satisfaction scores of patients in groups CT and ST after 6 months of treatment were obviously higher than those before treatment (t=-11.697, -29.029, P<0.01). Conclusions: The Archimedes sling system can effectively increase the difference value of knee joint active motion range, alleviate the degree of knee joint dysfunction, and enhance the self-function satisfaction of patients on the basis of conventional rehabilitation treatment for patients with knee joint flexion dysfunction after deep burns.