Famine exposure in early life and type 2 diabetes in adulthood: findings from prospective studies in China

BACKGROUND/OBJECTIVES@#This study examined the relationship between famine exposure in early life and the risk of type 2 diabetes in adulthood during the 1959–1961 Chinese Famine. @*SUBJECTS/METHODS@#A total of 3,418 individuals aged 35–74 years free of diabetes from two studies in 2006 and 2009 were followed up prospectively in 2009 and 2012, respectively. Famine exposure was classified as unexposed (individuals born in 1962–1978), fetal exposed (individuals born in 1959–1961), child exposed (individuals born in 1949–1958), and adolescent/adult exposed (born in 1931–1948). A logistic regression model was used to assess the relationship between famine exposure and diabetes after adjustment for potential covariates. @*RESULTS@#During a three-year follow-up, the age-adjusted incidence rates of type 2 diabetes were 5.7%, 14.5%, 12.7%, and 17.8% in unexposed, fetal-exposed, child-exposed, and adolescent/adult-exposed groups, respectively (P < 0.01). Relative to the unexposed group, the relative risks (95% confidence interval) for diabetes were 2.15 (1.29–3.60), 1.53 (0.93– 2.51), and 1.65 (0.75–3.63) in the fetal-exposed, child-exposed, and adolescent/adult-exposed groups, after controlling for potential covariates. The interactions between famine exposure and obesity, education level, and family history of diabetes were not observed, except for the urbanization type. Individuals living in rural areas with fetal and childhood famine exposure were at a higher risk of type 2 diabetes, with relative risks of 8.79 (1.82–42.54) and 2.33 (1.17–4.65), respectively. @*CONCLUSIONS@#These findings indicate that famine exposure in early life is an independent predictor of type 2 diabetes, particularly in women. Early identification and intervention may help prevent diabetes in later life.

Exosome-mediated regulatory mechanisms in skeletal muscle: a narrative review / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

Skeletal muscle plays a paramount role in physical activity, metabolism, and energy balance, while its homeostasis is being challenged by multiple unfavorable factors such as injury, aging, or obesity. Exosomes, a subset of extracellular vesicles, are now recognized as essential mediators of intercellular communication, holding great clinical potential in the treatment of skeletal muscle diseases. Herein, we outline the recent research progress in exosomal isolation, characterization, and mechanism of action, and emphatically discuss current advances in exosomes derived from multiple organs and tissues, and engineered exosomes regarding the regulation of physiological and pathological development of skeletal muscle. These remarkable advances expand our understanding of myogenesis and muscle diseases. Meanwhile, the engineered exosome, as an endogenous nanocarrier combined with advanced design methodologies of biomolecules, will help to open up innovative therapeutic perspectives for the treatment of muscle diseases.

Clinical value of ultrasound shear wave dispersion imaging for assessing the hepatic inflammation activity of chronic hepatitis B / 中华超声影像学杂志

Objective:To investigate the clinical value of ultrasound shear wave dispersion (SWD) imaging in assessing the hepatic inflammation activity in patients with chronic hepatitis B.Methods:Fifty-two patients with chronic hepatitis B who underwent liver biopsy in Peking University Third Hospital and Beijing Ditan Hospital Affiliated to Capital Medical University from December 2020 to December 2021 were prospectively enrolled.Liver stiffness (LS) and shear wave dispersion slope (SWDS) were measured by SWD imaging in all participants. Baseline data and laboratory indexes of liver function were collected.Liver inflammation grading(G0-G4) and fibrosis staging (S0-S4) were determined by pathological examination. The relationship between SWDS and various indicators was analyzed by univariate and multivariate linear regression analysis. The participants were grouped according to the pathological grading of hepatic inflammatory activity. The differences of various indexes among three groups were compared, and the correlations between SWDS, LS and laboratory indicators and hepatic inflammatory activity were analyzed. The ROC curve was used to evaluate the diagnostic performances of ultrasound and laboratory indicators for hepatic inflammation activity, and the diagnostic accuracy of different indicators was compared by Delong test.Results:Inflammation and fibrosis were both independent affecting factors of SWDS (all P<0.05); there were significant differences in alanine transaminase(ALT), aspartate aminotransferase(AST), LS and SWDS among groups with different inflammatory activities (all P<0.05). The SWDS and LS of the G3 and G2 groups were statistically higher than those of the G1 group (all P<0.001). ALT was only significantly different between G1 group and G2 group ( P<0.05), and AST was only significantly different between G1 group and G3 group ( P<0.05); The SWDS and LS showed strongly positive correlation ( rs=0.728, P<0.001) and moderately positive correlation ( rs=0.679, P<0.001) with hepatic inflammatory activity, respectively; while the correlations between ALT, AST and hepatic inflammatory activity were weaker( rs=0.376, P<0.05; rs=0.485, P<0.001). The area under the ROC curve, sensitivity and specificity of SWDS for diagnosing hepatic inflammation ≥G2 grade were 0.965, 0.933 and 0.865, respectively. Conclusions:SWDS has certain value in evaluating the hepatic inflammatory activity of ≥G2 grade in patients with chronic hepatitis B.

Differential impact of Covid-19 on incidence of diabetes mellitus and cardiovascular diseases in acute, post-acute and long Covid-19: population-based cohort study in the United Kingdom

ObjectiveThis study aimed to estimate the incidence of new diabetes mellitus (DM) and cardiovascular diseases (CVD) up to one year after Covid-19 compared with matched controls. MethodsA cohort study was conducted using electronic records for 1,473 family practices with a population of 14.9 million. Covid-19 patients without DM or CVD were individually matched with controls and followed up to October 2021. A difference-in-difference analysis estimated the net effect of Covid-19 allowing for baseline differences and covariates. ResultsThere were 372,816 Covid-19 patients, with 2,935 CVD and 3,139 DM events, and 372,816 matched controls with 1,193 CVD and 1,861 DM events following the index date. Net incidence of DM increased in acute Covid-19 up to four weeks from index date (adjusted rate ratio, RR 1.71, 1.40 to 2.10) and remained elevated in post-acute (five to 12 weeks from index date; RR 1.17, 1.01 to 1.36) and long-Covid-19 (13 to 52 weeks, 1.20, 1.09 to 1.31). Acute Covid-19 was associated with net increased CVD incidence (RR 6.02, 95% confidence interval 4.84 to 7.47) including pulmonary embolism (RR 14.5, 7.72 to 27.4), atrial arrythmias (6.58, 3.78 to 11.4) and venous thromboses (5.44, 3.22 to 9.17). CVD incidence declined in post-acute Covid-19 (1.68, 1.41 to 2.01) and showed no net increase in long Covid-19 (0.95, 0.85 to 1.06). ConclusionsDM incidence remains elevated up to one year following Covid-19. CVD is increased early after Covid-19 mainly from pulmonary embolism, atrial arrhythmias and venous thromboses.

Impact of patient access to their electronic health record: systematic review.

Patient access to their own electronic health records (EHRs) is likely to become an integral part of healthcare systems worldwide. It has the potential to decrease the healthcare provision costs, improve access to healthcare data, self-care, quality of care, and health and patient-centered outcomes. This systematic literature review is aimed at identifying the impact in terms of benefits and issues that have so far been demonstrated by providing patients access to their own EHRs, via providers' secure patient portals from primary healthcare centers and hospitals. Searches were conducted in PubMed, MEDLINE, CINHAL, and Google scholar. Over 2000 papers were screened and were filtered based on duplicates, then by reading the titles and finally based on their abstracts or full text. In total, 74 papers were retained, analyzed, and summarized. Papers were included if providing patient access to their own EHRs was the primary intervention used in the study and its impact or outcome was evaluated. The search technique used to identify relevant literature for this paper involved input from five experts. While findings from 54 of the 74 papers showed positive outcome or benefits of patient access to their EHRs via patient portals, 10 papers have highlighted concerns, 8 papers have highlighted both and 2 have highlighted absence of negative outcomes. The benefits range from re-assurance, reduced anxiety, positive impact on consultations, better doctor-patient relationship, increased awareness and adherence to medication, and improved patient outcomes (e.g., improving blood pressure and glycemic control in a range of study populations). In addition, patient access to their health information was found to improve self-reported levels of engagement or activation related to self-management, enhanced knowledge, and improve recovery scores, and organizational efficiencies in a tertiary level mental health care facility. However, three studies did not find any statistically significant effect of patient portals on health outcomes. The main concerns have been around security, privacy and confidentiality of the health records, and the anxiety it may cause amongst patients. This literature review identified some benefits, concerns, and attitudes demonstrated by providing patients' access to their own EHRs. This access is often part of government strategies when developing patient-centric self-management elements of a sustainable healthcare system. The findings of this review will give healthcare providers a framework to analyze the benefits offered by promoting patient access to EHRs and decide on the best approach for their own specialties and clinical setup. A robust cost-benefit evaluation of such initiatives along with its impact on major stakeholders within the healthcare system would be essential in understanding the overall impact of such initiatives. Implementation of patient access to their EHRs could help governments to appropriately prioritize the development or adoption of national standards, whilst taking care of local variations and fulfilling the healthcare needs of the population, e.g., UK Government is aiming to make full primary care records available online to every patient. Ultimately, increasing transparency and promoting personal responsibility are key elements of a sustainable healthcare system for future generations.

Effect of micro RNA-296-3p regulated cell on proliferation, migration and invasion of tongue squamous cell carcinoma by targeting nucleoprotein 1 / 中国医师进修杂志

Objective:To investigate the effects of micro RNA(miR)-296-3p on cell proliferation, migration and invasion of tongue squamous cell carcinoma and its underlying mechanism.Methods:Normal oral epithelial mucosal keratinocytes HOK was used as the control. Real-time quantitative polymerase chain reaction (PCR) was used to detect the expression of miR-296-3p and nucleoprotein 1(NUPR1) mRNA in tongue squamous cell carcinoma cell lines CAL27, SCC15 and SCC9, and Western blot was used to detect the expression of NUPR1 protein. CAL27 cells were divided into NC group, miR-con group, miR-296-3p group, si-con group, si-NUPR1 group, miR-296-3p+pcDNA group and miR-296-3p+pcDNA-NUPR1 group, then CCK8 method was used to detect the cell activity. Transwell was used to detect the cell migration and invasion. Western blot was used to detect the protein expression levels of proliferating cell nuclear antigen (PCNA), matrixmetallo proteinase-2(MMP-2) and matrixmetallo proteinase-9(MMP-9). Dual-luciferase reporter assay system was implemented to verify the relationship between miR-296-3pand NUPR1.Results:Compared with the HOK cells, the content of miR-296-3p in the tongue squamous cell line CAL27, SCC15 and SCC9 groups was significantly reduced (0.54 ± 0.08, 0.38 ± 0.05, 0.59 ± 0.07 vs. 1.04 ± 0.12, t = 10.401, 15.231 , 9.718, P<0.05), while the expression levels of NUPR1mRNA (5.94 ± 0.40, 4.48 ± 0.45, 5.19 ± 0.48 vs.0.94 ± 0.12, t = 35.918, 22.803, 25.769) and protein (0.79 ± 0.09, 0.54 ± 0.05, 0.62 ± 0.08 vs. 0.28 ± 0.04, t = 15.535, 12.182, 11.404) were significantly increased (all P<0.05). Compared with those in the NC group or miR-con group, CAL27 cell activity, migration number, invasion number and the protein expression of PCNA, MMP-2 and MMP-9 in the miR-296-3p group were decreased (all P<0.05). Compared with those of the NC group or the si-con group, the CAL27 cell activity, migration number, number of invasions and the protein expression of PCNA, MMP-2 and MMP-9 in the si-NUPR1 group were decreased (all P<0.05). miR-296-3p negatively regulatedthe expression of NUPR1 in CAL27 cells. Compared with the miR-296-3p+pcDNA group, CAL27 cell viability (138.34 ± 5.73 vs. 98.54 ± 5.89, t = 14.530), migration number (95.28 ± 7.56 vs. 67.92 ± 5.23, t = 8.929), invasion number (184.53 ± 17.57 to 101.26 ± 10.64, t = 12.162) and the protein expression of PCNA (0.68 ± 0.07 to 0.35 ± 0.06, t = 10.738), MMP-2 (0.43 ± 0.05 to 0.29 ± 0.04, t = 6.559) and MMP-9 (0.58 ± 0.06 vs. 0.33 ± 0.08, t = 7.500) in the miR-296-3p+pcDNA-NUPR1 group were increased (all P<0.05). Conclusions:miR-296-3p may inhibitthe proliferation, migration and invasion of tongue squamous cell carcinoma cells by negatively regulating NUPR1.

DNA damage repair and cell cycle arrest / 国际生物医学工程杂志

In the face of DNA damage caused by various factors, cells have a set of response and repair mechanisms. Cell cycle arrest plays an important role in the DNA damage repair, which provides enough time for repairing damaged DNA. Research on cell cycle regulation focuses on cyclin-dependent protein kinases (CDKs) and cell cycle checkpoints. In the process of DNA damage repair, phosphatidylinositol-3-kinase like kinases (PIKKs) which are recruited to the DNA damage sites can activate cell cycle checkpoint-related proteins to halt cell cycle. In the common DNA damage repair pathways, such as base excision repair (BER), nucleotide excision repair (NER) , mismatch repair (MMR) , and DNA double-strand break repair, the recruitment of repair-related proteins also plays a role in the cell cycle regulation. In this paper, the relationship between the main forms of DNA damage repair and cell cycle arrest and relevant research progress were reviewed.

Taeniid cestodes in Tibetan foxes (Vulpes Ferrilata) detected by copro-PCR: Applications and challenges.

Tibetan foxes (Vulpes ferrilata) have been confirmed as the main wild definitive hosts in echinococcosis transmission in the eastern Tibetan Plateau. However, little information is available about the epidemiology in wildlife from the perspective of the Taeniidae family, which is essential knowledge in understanding the epidemiology and phylogeography of cestode species in the Tibetan plateau. Therefore, in this study, we used copro-PCR techniques, by amplifying nad1 and cox1 gene fragments, to detect the taeniid species from Tibetan fox feces collected in Shiqu County, (Sichuan Province, China), eastern Tibetan Plateau. Phylogenetic relationships between amplified sequences and existed Taenia species genotypes were evaluated. Then, the maximum prevalence (positive PCR results from at least one primer pair) and the conservative prevalence (positive PCR results from at least two primer pairs) were calculated. Thirty-six Tibetan fox feces were analyzed. Echinococcus multilocularis (conservative prevalence ± 95% CI: 22.2% ± 13.6%; maximum prevalence ± 95% CI: 33.3% ± 15.4%) and E. shiquicus (2.8 ± 5.4%; 8.3 ± 9.0%) was detected. Meanwhile, DNA fragments of T. polyacantha were detected with high similarity to NCBI sequences (cox1, 94.0%) and to the larva sample DNA sequenced in this study (93.4%), and were supported by phylogenetic analysis. Thus, T. polyacantha might infect Tibetan foxes (5.6% ± 7.5%, 11.1% ± 10.3%). Our limited findings in the epidemiology of parasitic Taenia species suggest that sylvatic transmission cycles for a more species-rich Taeniid community must be established between wild canids and small mammals than just for the two Echinococcus species. Besides, discrepancies in different primer pairs in detecting the taeniid species were evaluated. The sensitivity of some widely used universal primer pairs was poor in detecting Taenia species from canid copro-DNA samples. It is still challenging to the development of effective taeniid species-specific molecular markers especially for non-zoonotic species.

Acceptance and preference for COVID-19 vaccination in health-care workers (HCWs)

BackgroundA major obstacle to successful coronavirus disease (COVID-19) vaccine rollout is vaccine hesitancy. Acceptance of and preferences for COVID-19 vaccination among healthcare workers (HCWs) is critical, because they are a key target group for vaccination programs, and they are also highly influential to vaccine uptake in the wider population. This study sought to comparatively determine the acceptance of and preference for COVID-19 vaccination among HCWs and the general population. MethodsAn Internet-based, region-stratified discrete-choice experiment was conducted among 352 HCWs and 189 general population respondents recruited in March 2020 from 26 Chinese provinces. We accessed knowledge of disease, attitude towards and acceptance of COVID-19 vaccination. Several attributes (related to COVID-19 disease, COVID-19 vaccination and one social acceptance) were identified as key determinants of vaccine acceptance. ResultsHCWs had a more in-depth understanding of COVID-19 and showed a higher willingness to accept COVID-19 vaccines with lower effectiveness and/or more severe adverse effects compared to the general population. 76.4% of HCWs (vs 72.5% of the general population) expressed willingness to receive vaccination ({chi}2=2.904, p=0.234). High levels of willingness to accept influenza (65.3%) and pneumococcal (55.7%) vaccination were also seen in HCWs. Future COVID-19 disease incidence (OR: 4.367, 95% CI 3.721-5.126), decisions about vaccination among social contacts of respondents (OR 0.398, 95% CI 0.339-0.467), and infection risk >30% (OR 2.706, 95% CI 1.776-2.425) significantly increased the probability of vaccination acceptance in HCWs. ConclusionMulti-component interventions to address the key determinants of hesitancy in both HCWs and in the general population should be considered for COVID-19 vaccination programs.

Relationship between sleep problems and non-suicidal self-injury behavior among college students / 中国学校卫生

Objective@#To explore the relationship between sleep problems and non-suicidal self-injury behavior in Chinese college students, and to provide scientific basis for the prevention and intervention of non-suicidal self-injury behavior.@*Methods@#A cross-sectional survey of 11 689 college students from three universities in Guangzhou were selected as the research subjects. A questionnaire survey of college students’ mental health was conducted to investigate non-suicidal self-injury behavior, sleep problems, demographic information, lifestyle, and depressive symptoms.@*Results@#In the past year, the prevalence rates of non-suicidal self-injury in college students was 7.8%. Univariate Logistic analysis showed that all sleep problems were associated with non-suicidal self-injury behavior(P<0.05). After controlling for potential confounders,including grade,gender,parents’ education level,health conditon,family income,smoking,drinking and depression,multivariate Logistic regression showed that shorter sleep time at weekend (<7 h/d), insomnia symptoms and frequent nightmares significantly increased the risk of nonsuicidal selfinjury behavior in college students (OR=1.32-3.25, P<0.05), while longer sleep time at weekdays (≥9 h/d) was an important protective factor (OR=0.60, P<0.05).@*Conclusion@#These findings indicate that short sleep time, insomnia and nightmares are important risk factors for college students’ non-suicidal self-injury behavior. Intervention and management on sleep problems can effectively reduce the occurrence of self-injury behaviors.

Relationship of BMI and wrist joint index with carpal tunnel syndrome in manual laborers / 中华劳动卫生职业病杂志

Objective@#To evaluate the severity of median nerve damage in patients with carpal tunnel syndrome (CTS) , and to analyze its relationship with body mass index (BMI) and wrist joint index.@*Methods@#From May 2016 to January 2017, 23 patients with mild CTS (mild group) and 35 patients with moderate to severe CTS (moderate to severe group) were enrolled in this study. And 22 healthy volunteers matched for sex and age were selected as control group. The neuroelectrophysiological monitor was used to measure the median nerve movement and sensory nerve conduction in the subjects. The BMI and wrist joint index were calculated. The relationship of neuroelectrophysiological parameters with BMI and wrist joint index was analyzed in the CTS patients.@*Results@#Compared with the control group, the mild group and the moderate to severe group had significantly higher wrist joint index, significantly longer distal motor latency (DML) of the median nerve, and significantly lower sensory nerve conduction velocity (SNCV) and sensory nerve action potential (SNAP) amplitude of the finger 1-wrist and finger 3-wrist (P<0.01) ; the moderate to severe group had significantly higher BMI and significantly lower composite muscle action potential (CMAP) amplitude (P<0.01) . The wrist joint index and BMI were positively correlated with DML of the median nerve and negatively correlated with SCV and SNAP amplitude of the finger 1-wrist and finger 3-wrist (all P<0.05) . The patients with a wrist joint index of >0.73 had a significantly higher risk of CTS than those with a wrist joint index of <0.73 (odd ratio=30.67, 95% confidence interval: 3.79-248.36) .@*Conclusion@#A wrist joint index of >0.73 is an independent risk factor for CTS in manual laborers. CTS should be prevented in the manual laborers with high wrist joint index and BMI.

Study on effect of different extraction methods on anti-inflammatory and analgesic activity of Anemone hupehensis / 重庆医学

Objective To investigate the effect of different extraction methods on anti-inflammatory and analgesic activity of Anemone hupehensis.Methods The different abstracts were prepared from the whole herb of Anemone hupehensis.The analgesic effect was observed by adopting the mouse torsion and electric heating plate method,and the anti-inflammatory activity was comprehensively evaluated by using the mouse ear tumefaction,toe tumefaction and tampon granulation tumefaction exprements.Results Compared with the blank model group,the anti-inflammatory action difference of low dose in the water layer parts of mouse ear tumefaction,toe tumefaction and tampon granulation tumefaction had no statistical significance(P＞0.05),and the extracting parts of rest doses all had significant anti-inflammatory and analgesic effect (P＜0.05).Ethyl acetate part had strongest activity in the electric heating plate experiment.N-butanol part had strongest activity in the ear tumefaction,toe tumefaction,tampon granulation tumefaction experiments and torsion method.Conclusion The whole herb of Anemone hupehensis has prominent anti-inflammatory and analgesic effect,and the ethyl acetate part E and N-butanol part are main effective parts.

Short-term Outcome of Uniportal and Three Portal Video-assisted Thoracic Surgery for Patients with Non-small Cell Lung Cancer / 中国肺癌杂志

BACKGROUND@#Currently, there are many reports on the advantages of three portal video-assisted thoracic surgery (VATS) in the treatment of lung cancer, but there are few reports on the comparison between uniportal and three portal video-assisted thoracic surgery. In this study, we aimed to evaluate the recent curative effect of the postoperative short-term quality of life between uniportal and three portal video-assisted thoracic surgery for non-small cell lung cancer.@*METHODS@#We retrospectively evaluated 266 patients with NSCLC who underwent intended VATS lobectomy by a single surgical team in our ward between January 2016 and August 2017. The general clinical date, perioperative data and short-term life quality were individually compared and analyzed between the two groups.@*RESULTS@#The two groups were similar in terms of clinicopathological features, total number of dissected lymph nodes and nodal stations, postoperative complications and pulmonary complications (P>0.05). Compared with three portal VATS, the intraoperative blood loss, chest tube duration, postoperative thoracic drainage, length of stay and NRS score were significantly decreased in uniportal VATS, with significant differences (P<0.05).@*CONCLUSIONS@#As a more minimally invasive surgery, uniportal VATS can be safely and effectively performed for resectable lung cancer, which would achieve even better operation curative effect than three portal VATS.

The influence of the prognostic nutritional index on postoperative complications and prognosis in patients with resectable non-small cell lung cancer / 中华胸心血管外科杂志

Objective To investigate the correlation between the prognostic nutritional index(PNI) and the clinicopathologic features of patients with non-small cell lung cancer(NSCLC),and to compare postoperative complications and survival between patients with High-PNI(H-PNI) and Low-PNI(L-PNI) after operation.Methods This study retrospectively reviewed and analyzed the medical records of 216 patients underwent surgery between July 2010 and December 2011 who were pathologically dignosed with NSCLC.Among these,127 patients with H-PNI,and 89 patients with L-PNI.The clinicopathologic features,median survival time and 5-year survival rates between two groups were analyzed.Results Patients in the L-PNI group had greater pathologic TNM stage,larger tumors,lower Serum albumin levels,and greater percentage of chemotherapy than those in the H-PNI group(P ＜ 0.05).The H-PNI group was associated with significantly fewer postoperative complications than the L-PNI group (P ＜ 0.05).For the patients with H-PNI,the MST was 61.6 months an the 1-,3-,and 5-year OS were 91.3 ％,80.1％,and 74.1％,respectively.For the patients with L-PNI,the MST was 49.9 months and the 1-,3-,and 5-year OS were 82.0％,63.5％,and 53.5％,respectively.There was significant difference in survival between the two groups(P ＜ 0.05).TNM staging and PNI were showed to be independent prognostic factors.Conclusion Different PNI of NSCLC has certain heterogeneity.Patients with H-PNI show better survival and lower postoperative complications rate than those with L-PNI.

A prospective study of quality of life after minimally invasive Sweet esophagectomy for siewert type Ⅱ esophagogastric junction adenocarcinoma / 中华胸心血管外科杂志

Objective To observe the impact of minimally invasive Sweet esophagectomy on short term quality of life for patients with Siewert typeⅡesophagogastric junction adenocarcinoma.Methods From January 2015 to September 2017, 60 patients underwent minimally invasive Sweet esophagectomy(MISE group) and 60 patients underwent open sweet esophagecto-my(OSE group).The questionnaires(EORTC QLQ-C30 and QLQ-OES18) were applied to assess the quality of life of the pa-tients before and 1,2,4,8 weeks after operation.The clinicopathologic factors, operational factors and postoperative complica-tions of the two groups were compared by t test and χ2test.The Mann-Whitney test was used to test for statistical significance because the responses were not normally distributed.Results The two groups were similar in terms of clinical characteristics and preoperative QOL scores(P ＞0.05).The MISE group was associated with a significant decrease in surgical blood loss [(88.1 ±32.2)ml vs.(119.5 ±34.1)ml, t＝5.052, P＝0.001], chest tube duration[(8.1 ±4.4)d vs.(10.5 ±4.0)d, t＝3.110, P＝0.002] and postoperative stay[(9.1 ±4.6)d vs.(11.6 ±3.8)d, t＝3.167, P＝0.002] relative to the OSE group.The postoperative in-hospital mortality and total morbidity did not differ between the two groups (P＞0.05).The MISE group was associated with significantly fewer respiratory complications than the OSE group (8.5%vs.22.7%, t＝4.063, P＝ 0.044).The MISE group was associated with a significant increase in hospitalization costs [(54 106 ±4 352) yuan vs. (51 143 ±5 315)yuan, P＝0.001] relative to the OSE group.MISE group gained higher scores in physical function, role func-tion, emotional function, Global QOL and lower scores in pain, fatigue, acid reflux than OSE group after surgery.Conclusion Our minimally invasive technique for Siewert typeⅡesophagogastric junction adenocarcinoma can be safely and effectively performed with favorable early outcomes.Compared to conventional open Sweet approach, MISE impoved the short term quality of life after surgery.

Effect of Olaparib on proliferation activity and radiosensitization of human non-small cell lung cancer cells / 国际生物医学工程杂志

Objective To investigate the effects of Olaparib on cell proliferation and radiosensitization of human non-small cell lung cancer cells.Methods Non-small cell lung H460 and H1299 cell lines were cultured in vitro and the cells in logarithmic growth phase were selected for experiments.MTT and colony formation assays were used to determine cell proliferation and radiosensitization,respectively.Single cell gel electrophoresis assay (comet assay) was used to detect irradiation-induced DNA damage.Results The results of MTT assay showed that Olaparib inhibited the proliferation of H460 and H1299 cells in a dose-dependent pattern (all P＜0.05).H1299 cell line was more sensitive to Olaparib than H460 cells.The results of colony formation assay showed that Olaparib enhanced the radiosensitizition of H460 and H1299 cells (all P＜0.05).The results of comet assay showed that Olaparib increased γ ray-induced DNA damage.Conclusions Olapani can enhance the radiosensitization of human non-small cell lung cancer cells,and the radiosensitization effect of Olaparib may be associated with the inhibition of cell proliferation and induction of irradiation-induced DNA damage.

Prognostic Value of Neutrophil-to-lymphocyte Ratio in Patients with Lung Adenocarcinoma Treated with Radical Dissection / 中国肺癌杂志

BACKGROUND@#Previous studies have shown that the neutrophil-to-lymphocyte ratio (NLR) has a significant impact on the prognosis of many malignant tumors such as gastric cancer, colorectal cancer and pancreatic cancer, but the study on the prognosis of patients with resectable lung adenocarcinoma is less. The aim of this study is to investigate the correlation between the NLR and the clinicopathologic features of adenocarcinoma of lung patients who underwent radical pneumonectomy. Furthermore, this study aimed to clarify the predictive and prognostic significance of NLR in patients who underwent pneumonectomy for lung adenocarcinoma.@*METHODS@#This study reviewed the medical records of 163 patients with lung adenocarcinoma who underwent pneumonectomy. The receiver operating characteristic (ROC) curve and Youden index were used to determine the cut-off value of the NLR. Survival curves were described by Kaplan-Meier method and compared by Log-rank test. The univariate and multivariate analyses were performed with the Cox proportional hazard model to identify the prognostic factors.@*RESULTS@#When the NLR value was 2.96, the Youden index was maximal, with a sensitivity of 77.5% and a specificity of 75.9%. The 5-year survival rate in the low NLR group was higher than that in the high NLR group (P<0.05). The univariate and multivariate analyses showed that TNM staging and NLR were independent factors in predicting survival rate.@*CONCLUSIONS@#The NLR value was a simple and useful tool to predict the prognosis of lung adenocarcinoma after radical pneumonectomy.

Research progress on the functional regulation of Nrf2 gene and its mechanisms in lung cancer / 国际生物医学工程杂志

As a nuclear transcription factor , nuclear factor E2-related factor 2 (Nrf2) protein plays an important role in regulating intracellular redox balance and cellular resistance to various stresses. Oxidative stress and ionization stress can cause Nrf2 to translocate from cytoplasm to nucleus. Then the Nrf2 binds to antioxidant response elements to regulate the transcription of antioxidant genes such as NQO1 and HO-1 and play the anti-oxidant protective effect. In recent years, the results show that many cancer cells, including lung cancer, involve Nrf2 overexpression, and there is a connection between Nrf2 protein levels and the occurrence, development, chemoradiotherapy resistance as well as the patient prognosis of lung cancer. The excessive Nrf2 protein levels in lung cancer cells, caused by the mutation of Nrf2 or its inhibitory protein Keap1, can promote the proliferation and migration of lung cancer cells, leading to chemoradiotherapy resistance and poor prognosis. The structure, function and regulation of Nrf2 were summarized, and the research progress on the mechanism of Nrf2 in the occurrence, development and treatment of lung cancer were reviewed.

Efficacy of sequential endoscopic variceal ligation plus endoscopic variceal sclerotheropy and the factors associated with the prognosis / 中国内镜杂志

Objective To explore the efficacy of sequential endoscopic variceal ligation plus endoscopic variceal sclerotheropy and the factors associated with the prognosis.Methods 106 cases with esophageal varices in control group was treated with drugs alone;study group had 113 cases, was given endoscopic therapy add drugs, The study group randomly divided into two groups, one was treated with endoscopic variceal ligation all the time (EVL group), another was treated with sequential endoscopic variceal ligation plus endoscopic variceal sclerotheropy (sequential group). After the treatment, the rate of removal of varicose veins, the rate of rebleeding, the number of total treatment,mortality and intra-operative complications and postoperative complications were compared. And compared rebleeding rate and mortality with the control group and study groups with different CTP and MELD, analyze the factors of prognosis, and evaluate their prognostic value.Results Rebleeding, rate in control group, EVL group and sequential group were 41.51%,10.53% and 10.64%,sequential group was significantly better than control group (P = 0.000); mortality in control group, EVL group and sequential group were 15.09%, 5.26% and 2.13%, sequential group was also significantly better than control group (P = 0.001); rate of recurrence in EVL group and sequential group within half a year were 73.68% and 44.68%, sequential group was significantly better than EVL group (P = 0.021). In all control group and EVL group and the sequential group, rebleeding rate and mortality of the liver function Child-Turcotte-Pugh (CTP) class C was significantly higher than that of calss A; In MELD model, AUC area under the ROC curve of rebleeding rate in control group and sequential group were 0.944 and 0.851, mortality of the two groups were 0.881 and 0.984, while the rate of recurrence in the EVL group and sequential group were respectively 0.914 and 0.765, the MELD score has the important value to the prediction of rebleeding and death.Conclusion The rebleeding rate and mortality in cirrhotic patients with esophageal varices treated with sequential endoscopic variceal ligation plus endoscopic variceal sclerotheropy were significantly decreased and the recurrence rate was lower than that of the patients with endoscopic variceal ligation all the time. Liver function Child-Turcotte-Pugh (CTP) score and the MELD score have important value in prediction of rebleeding and death, ligation and sclerosing sequential therapy can significantly reduced rebleeding and mortality in CTP class B and C, and improve the MELD threshold of rebleeding and death.

Application of informatized blood glucose management system to diabetes patient outside hospital / 医疗卫生装备

Objectivde To explore the efficacy of i-GMS applied to the diabetes patient outside the hospital.Methods Totally 80 type 2 diabetes mellitus patients were divided into an experiment group (Group A) and a control group (Group B).Group A executed blood glucose monitoring by Glucose Management App and intelligent blood glucose meter (personal version),and Group B completed monitoring by some portable blood glucose meter.Telephone follow-up was performed once a week,and the two groups were compared on glycated albumin (GA) value 3 weeks after discharging,values of HbA1c,FPG and PG2h 3 months after,the times of blood glucose monitoring and hypoglycaemia as well as the patient satisfaction over the glucose management.Results Group A had the values of GA,HbA1c,FPG and PG2h significantly lower than those of Group B (P＜ 0.05).The times of glucose monitoring and patient satisfaction in Group A were statistically higher than those of Group B,while the incidence rate of hypoglycaemia of the former was lower than that of the latter (P＜0.05).Conclusion I-GMS proves efficient when used for glucose self monitoring and management of the type 2 diabetes mellitus patient.