Abstract:Objective To investigate the effect of peptidyl-prolyl cis-trans isomerase NIMA-interacting 1(PIN1)on the invasion and metastasis of cervical cancer cells based on the peroxisome proliferator-activated receptor(PPARγ)signaling path-way.Methods A total of 105 patients diagnosed with squamous cell carcinoma of cervical cancer from January 2021 to December 2021 were randomly selected from the pathological database of obstetrics and gynecology of the author's hospital,with the in-formed consent of the patients,80 fresh normal cervical tissue samples and 72 early cervical cancer tissue samples were collected from January 2019 to December 2020.To investi-gate the effect of PIN1 knockdown on the biological function of C33A cells,C33A cells were divided into control group(without any treatment),sh-NC group(transfected with sh-NC lentivirus)and sh-PIN1 group(transfected with sh-PIN1 lenti-virus);in order to investigate the effect of PIN1 up-regulation on the biological function of C33A cells,C33A cells were divided into control group(without any treatment),Vector group(transfected with Vector plasmid)and PIN1 group(transfected with PIN1 plasmid).To investigate the effect of PIN1 on cervical cancer proliferation and invasion by regulating PPARγ,C33A cells were divided into control group(without any treatment),sh-NC+Vector group(transfected with sh-NC and Vector),sh-PIN1 group(transfected with sh-PIN1 lentivirus),PPARγgroup(transfected with PPARγ plasmid)and sh-PIN1+PPARγ group(transfected with sh-PIN1 lentivirus and PPARγ plasmid).PIN1 expressions in cervical cancer tissues and cell lines were analyzed by Western blot and quantitative polymerase chain reaction(qPCR),and the relationship between PIN1 expression and clinico-pathological features was analyzed.The cell viability was evaluated by methyl thiazolyldiphenyl-tetrazolium bromide(MTT)as-say,and the cell invasion ability was detected by Transwell chamber method.Results PIN1 mRNA expression increased in cervical cancer tissues and cell lines(all P＜0.05).Compared with the PIN1 low expression patients,the patients with PIN1 high expression had shorter overall survival(OS)and disease-free survival(DFS)(all P＜0.001).PIN1 expres-sion,stromal invasion and pelvic lymph node metastasis were independent risk factors for OS in patients with squamous cell cervical cancer(P＜0.05),PIN1 expression and stromal invasion were independent prognostic factors for DFS pa-tients with squamous cell cervical cancer(P＜0.05).Compared with the sh-NC group,the optical density(OD)value and the number of invasion in the sh-PIN1 group significantly decreased(all P＜0.001);compared with the Vector group,the OD value and the number of invasion in the PIN1 group significantly increased(all P＜0.01).Co-immunopre-cipitation(co-IP)results showed that PIN1 interacted with PPARγ,and the OD value and the number of cell invasion in the sh-PIN1+PPARγ group significantly increased than those in the sh-PIN1 group(all P＜0.05).Conclusion PIN1 can be used as a novel prognostic indicator in early cervical cancer patients,and it may interact with PPARγ in cervical cancer cells to play a tumor-promoting role.

Abstract:Objective To compare the Wnt pathway-related proteins Wnt2,C-myelocytomatosis viral oncogeneav(C-myc),β-ca ten in and CyclinD1 in gastric adenocarcinoma and precancerous lesions tissues with positive and negative Helicobacter pylori(Hp)infection,and discuss the correlation between Wnt pathway activation and Hp infection and its clinicopathological significance.Methods Paraffin-embedded tissue samples preserved in the department of pathology of the author's hospital from 2015 to 2022 were collected,based on pathological diagnosis,the samples were divided into gastric adenocarcinoma group(n=40),dysplasia group(n=20),chronic atrophic gastritis group(n=20)and normal gastric mucosa group(n=20).Modified Giemsa staining was used to detect Hp infection in each group,and immunohis-tochemistry was performed to detect the expression of Wnt2,β-catenin,C-myc and CyclinD1 in the gastric mucosa speci-mens of each group.Results The levels of β-catenin,Wnt2,C-myc and CyclinD1 in gastric adenocarcinoma group were higher than those in normal gastric mucosa group,chronic atrophic gastritis group and dysplasia group,and the expres-sion of Wnt-related proteins in Hp positive patients was higher than that in Hp negative patients(all P＜0.05);compared with the normal gastric mucosa group and chronic atrophic gastritis group,the expression of β-catenin in the dysplasia group increased,which was related to Hp infection(P＜0.05),and there was no significant difference in the expression of Wnt2,C-myc and CyclinD1,which was not related to Hp infection(P＞0.05);the expressions of Wnt-related proteins in chronic atrophic gastritis group and normal gastric mucosa group were weak positive or negative,and had no relationship with Hp infection(P＞0.05).The analysis of clinical characteristics and Wnt-related protein expression showed that the expression of C-myc and CyclinD1 protein was related to the differentiation degree of gastric adenocarcinoma(all P＜0.05),but the expression of Wnt-related protein was not related to the differentiation degree of gastric adenocarcinoma,age and gender(P＞0.05).Conclusion Hp infection in gastric adenocarcinoma tissues is related to nuclear translocation of β-catenin,abnormal ex-pression of downstream proteins(C-myc,CyclinD1)and activation of Wnt signaling pathway,and β-catenin may be used as an early molecular marker for Hp-related gastric adenocarcinoma;the expressions of C-myc and CyclinD1 in gastric ad-enocarcinoma are related to the degree of tumor differentiation.

Abstract:Objective To study the effect of intrauterine infusion of granulocyte colony-stimulating factor(G-CSF)on preventing recurrence of intrauterine adhesions(IUA)in moderate and severe IUA patients after transcervical resection of adhesion(TCRA),and to explore its mechanism.Methods A total of 90 patients with moderate to severe IUA were selected in the author's hospital from January 2022 to March 2024 and were randomly divided into G-CSF intrauterine ad-ministration group,normal saline intrauterine administration group and control group with 30 patients in each.All the moderate to severe IUA patients underwent TCRA,and Foley balloon was placed in the uterine cavity after,and the pa-tients were given estrogen-progesterone artificial cycle treatment.Patients with the moderate to severe IUA in G-CSF in-trauterine administration group were given intrauterine administration of G-CSF after surgery;the patients with the mod-erate to severe IUA in normal saline intrauterine administration group was given intrauterine administration of normal sa-line after surgery;the patients with the moderate to severe IUA in control group did not receive intrauterine administration after surgery.The recurrence rate of IUA,American fertility society(AFS)score,pictorial blood loss assessment chart(PBAC)score,endometrial thick-ness on the conversion day of artificial cycle estrogen and progesterone of the patients with the moderate to severe IUA at the first postoperative review of hysteroscopy were com-pared among the 3 group.Uterine secretion of the moderate to severe IUA patients of G-CSF intrauterine administration group were collected before and after intrauterine administration,the expression levels of 27 kinds of immune factors were detected.Results There were statistically significant differences in the IUA recurrence rate,AFS score,PBAC score and the endometrial thickness on the conversion day of artificial cycle estrogen and progesterone of the moderate to severe IUA patients among 3 groups at the first postoperative review of hysteroscopy(all P＜0.001).Compared with the control group,the IUA recurrence rates of the moderate to severe IUA patients in the G-CSF intrauterine administration group and normal saline intrauterine administration group both decreased(all P＜0.05),and the G-CSF intrauterine administra-tion group was lower than normal saline intrauterine administration group(P＜0.05).Compared with the control group,the AFS score of the moderate to severe IUA patients in the G-CSF intrauterine administration group decreased(P＜0.05).Compared with the control group and normal saline intrauterine administration group,the PBAC score,the endo-metrial thickness on the conversion day of artificial cycle estrogen and progesterone of the moderate to severe IUA patients in G-CSF intrauterine administration group both increased(all P＜0.05).In 27 immune factors,platelet-derived growth factor BB(PDGF-BB),interleukin 13(IL-13),IL-7,IL-12,IL-1β of the moderate to severe IUA patients were up-regula-ted in G-CSF intrauterine administration group(all P＜0.05).Conclusion Intrauterine administration of G-CSF may re-duce the short-term IUA recurrence rate,reduce the degree of IUA,increase endometrial thickness and improve menstru-al volume after TCRA of moderate to severe IUA by regulating the intrauterine immune microenvironment.

Abstract:Objective To explore the differences in sensitivity,specificity and interference factors of different de-tection methods of human immunodeficiency virus(HIV)by retrospectively analyzing a rare case of multiple false positive results in HIV detection and reviewing relevant literature,and explore the clinical application of combined detection strat-egy.Methods Patient samples were analyzed using colloidal gold immunochromatographic assay(GICA),enzyme-linked immunosorbent assay(ELISA)and magnetic particle chemiluminescence immunoassay(CLIA)for initial screening,com-bined with the confirmation method of HIV antibody Western blot(WB),the patient's samples were systematically detec-ted,and the clinical manifestations were analyzed.Results For this patient,GICA and ELISA results were positive,CLIA and WB results were negative,and the final confirmatory results were negative.Conclusion Different HIV screen-ing methods have their own limitations,combined detection strategy can effectively reduce the risk of false positive and misdiagnosis of HIV.Primary medical institutions and laboratories can use two or more reagents with different principles to test together,and if the results are inconsistent,the WB test results should be used as the basis for diagnosis and sent to the superior for review to improve the accuracy and reduce the risk of misdiagnosis.

Abstract:Objective To investigate the relationship between nocturnal decline rate of systolic blood pressure,ser-um 8-hydroxydeoxyguanosine(8-OHdG)levels and post-stroke cognitive impairment(PSCI)in patients with stroke.Methods A total of 131 stroke patients treated in the author's hospital from October 2022 to October 2023 were selected as the study subjects,they were divided into cognitively normal group(n=78)and cognitive impairment group(n=53)based on the Montreal cognitive assessment(MoCA)scores.The general information,nocturnal decline rate of systolic blood pressure and serum 8-OHdG levels of patients with stroke were compared between the two groups.Spearman corre-lation analysis was applied to assess the correlation between the nocturnal decline rate of systolic blood pressure,serum 8-OHdG levels and MoCA scores in stroke patients,Logistic regression analysis was used to explore the factors affecting PSCI,receiver operating characteristic(ROC)curve analysis was performed to analyze the predictive efficacy of the noc-turnal decline rate of systolic blood pressure and serum 8-OHdG levels on PSCI.Results Compared with the cognitively normal group,the proportion of hypertension increased,the nocturnal decline rate of systolic blood pressure decreased and the nocturnal mean systolic blood pressure and serum 8-OHdG levels increased in stroke patients in the cognitive im-pairment group(all P＜0.05).Spearman correlation analysis showed that serum 8-OHdG levels of stroke patients were negatively correlated with MoCA score(r=-0.343,P=0.012),while the nocturnal decline rate of systolic blood pressure was positively correlated with Mo-CA score(r=0.413,P=0.002).Logistic regression analysis showed that the nocturnal decline rate of systolic blood pressure was a protective factor for PSCI(P＜0.05),and serum 8-OHdG level was a risk factor for PSCI(P＜0.05).ROC curve analysis revealed that the area under the curve(AUC)for diagnosing PSCI using the nocturnal decline rate of systolic blood pressure and serum 8-OHdG levels were 0.745(95％CI:0.662-0.828)and 0.891(95％CI:0.837-0.947),respectively,the AUC for diagnosing PSCI using the combined two detection were 0.923(95％CI:0.880-0.965).Conclusion The serum 8-OHdG level increases and the nocturnal decline rate of systolic blood pressure decreases in stroke patients with cognitive impairment.The combined detection of nocturnal decline rate of systolic blood pressure and serum 8-OHdG level has a good predictive effect on PSCI after stroke.

Abstract:Objective To investigate the protective effects of Rheum officinale decoction on intestinal and liver inju-ry in rats with exertional heat stroke(EHS)under high-temperature and high-humidity exercise and its possible mecha-nisms.Methods A total of 30 male SPF SD rats were subjected to adaptive incremental load running training,after training,6 rats with foot injuries or inability to move correctly were excluded,the remaining 24 rats were ran-domly assigned to control group,normal saline group and Rheum officinale decoction group,with 8 rats in each.The EHS was induced in rats of normal saline group and Rheum officinale decoction group by running under high-temper-ature and high-humidity environment,and the rats were treated with 1 ml/100 g 4℃ normal saline and Rheum officinale decoction by gavage at 0,4 and 8 h respectively;the rats in the control group did not exercise under normal temperature and humidity environment,and were given 1 ml/100 g 4℃ normal saline by gavage at the same time.Blood was collected from the inferior vena cava 12 h after drug administration to measure serum levels of alanine aminotransferase(ALT),as-partate aminotransferase(AST),interleukin 1 beta(IL-1β),IL-6,tumor necrosis factor alpha(TNF-α),lipopolysaccha-ride(LPS),intestinal fatty acid binding protein(IFABP),diamine oxidase(DAO)and D-lactic acid(D-LAC),addition-ally,pathological change of ileum and liver tissues alongside the examination of zonula occludens 1(ZO-1),E-cadherin and Occludin were observed,and the evaluation of Toll-like receptor 4/nuclear factor kappa B(TLR4/NF-κB)signaling path-way related protein expressions in the liver was detected.Results After EHS modeling,2 rats in the normal saline group and 1 rat in the Rheum officinale decoction group succumbed.Hematoxylin-eosin(HE)staining showed that the rats in the normal saline group and the Rheum officinale decoction group showed ileal mucosal injury and hepatocellular lesion;in the normal saline group,the intestinal epithelial exfoliation necrosis and liver cell lysis necrosis of rats were more serious;the ileum tissue of rats in Rheum officinale decoction group showed edema and degeneration of villus,with regular and neat morphology,and occasionally a small amount of villus exfoliation.Compared to the control group,serum IL-1β,IL-6 and TNF-α levels were significantly elevated in both the normal saline and Rheum officinale decoction groups(all P＜0.01);in the normal saline group,the fluorescence staining of ileum mucosa was dim,and the expression of ZO-1,E-Cadherin and Occludin protein in villus terminal cells was weakened;DAO activity and IFABP level significantly increased(all P＜0.01),LPS level increased(P＜0.01);the levels of ALT and AST in the liver function indexes significantly in-creased(all P＜0.01),and the expression of TLR4/NF-κB signaling pathway related proteins in the liver was significant-ly up-regulated(P＜0.05).Compared with the normal saline group,the Rheum officinale decoction group exhibited sig-nificantly lower levels of serum IL-1β,IL-6 levels,DAO activity,IFABP level,ALT and LPS levels(all P＜0.05),tight junction proteins were highly expressed in the ileum mucosa,and the expressions of TLR4/NF-κB signaling pathway-re-lated proteins IKKα and p-NF-κB/NF-κB in the liver significantly decreased(all P＜0.05).Conclusion Rheum officinale decoction can alleviate intestinal and liver injury in rats with EHS,and its mechanism may be achieved by protecting intes-tinal mucosal barrier,reducing endotoxemia and inhibiting TLR4/NF-κB signaling pathway.

Abstract:Objective To analyze the combat rescue experience of the U.S.nurses,and to extract the useful refer-ence for the training of medical service support ability to our military nurses.Methods Through literature research,this paper summarized the combat rescue experiences of the U.S.military nurses.Results The U.S.military faced challen-ges in the construction of professional combat and rescue capabilities and the establishment of multi-dimensional support capabilities.Conclusion It is suggested that our military comprehensively enhance the medical support capabilities of nur-ses by constructing a practical combat training system,formulating an intelligent combat and rescue support system,and establishing a modular curriculum system.

Abstract:Objective To explore the clinical characteristics of acute primary angle closure glaucoma(APACG)concurrent with primary suspensory ligament abnormality.Methods A retrospective analysis was conducted on 76 eyes of 76 patients with monocular APACG admitted to author's hospital from January 2021 to December 2022,the patients were divided into APACG with primary suspensory ligament abnormality group(n=36,36 eyes)and APACG without primary suspensory ligament abnormality group(n=40,40 eyes)according to whether they had primary suspensory ligament ab-normalities or not.Parameters such as intraocular pressure(IOP),axial length(AL),central anterior chamber depth(ACD),angle opening distance(AOD)and angle recess area(ARA)of APACG patients between two groups were recor-ded during attacks and then analyzed.Results In the APACG with primary suspensory ligament abnormality group,the ACD,AOD500 and ARA of the affected eye were significantly smaller than those of the contralateral eye(all P＜0.01),and there was no significant difference in AL between the two eyes(P=0.465).There was no significant difference in AOD500,ARA,AL and ACD between the two eyes of APACG patients without primary suspensory ligament abnormality(P＞0.05).The ACD,AOD500and ARA of APACG patients with primary suspensory ligament abnormality were signifi-cantly smaller than those of APACG patients without primary suspensory ligament abnormality,and the differences were statistically significant(all P＜0.05);there was no significant difference in AL between the two groups(P=0.075).Conclusion A certain proportion of patients with APACG have primary suspensory ligament abnormalities,the ACD,AOD500 and ARA parameters examined by ultrasound biomicroscopy(UBM)are helpful for the preoperative diagnosis of primary suspensory ligament abnormality.

Abstract:Objective To explore the relationship between serum magnesium concentration and fracture in maintenance he-modialysis(MHD)patients.Methods The clinical data of 207 patients who received MHD treatment in author's hospital from January 1,2015 to December 31,2020 were enrolled.Propensity score matching(PSM)was used to balance the baseline data of the two groups,and 57 patients in fracture group(all fractures occurred for the first time)and 57 patients in non-fracture group were included.Logistic regression analysis was used to explore the relationship between serum magnesium and fractures.Receiver operating characteristic(ROC)curve was used to analyze the predictive efficacy of serum magnesium for fracture in MHD pa-tients.Results Among 207 patients,the proportion of fracture was 27.54％(57/207),with hip fractures accounting for 52.63％(30/57),which was the most common type of fracture.After PSM matching,114 patients were finally included,inclu-ding 57 patients in the fracture group and 57 patients in the non-fracture group.The age and body mass index(BMI)levels of MHD patients in fracture group were higher than those in non-fracture group,and the serum magnesium concentration and calci-um concentration were lower than those in non-fracture group(all P＜0.05).Serum magnesium and calcium concentration were negatively correlated with fractures in MHD patients(P＜0.05),while age was positively correlated with fracture in MHD pa-tients(P＜0.05).Logistics regression analysis showed that for every 0.5 mmol/L increase in magnesium concentration,the risk of fracture in MHD patients decreased by 48.30％(OR=0.517,P=0.004);when serum magnesium concentration was used as a categorical variable,the risk of fracture in MHD patients in the high magnesium group decreased by 64.20％compared with the low magnesium group(OR=0.358,P=0.041).ROC curve analysis result showed that serum magnesium combined with age had good predictive effect on fracture in MHD patients[area under the curve(AUC)=0.744,P＜0.010].Conclusion Higher serum magnesium concentration is associated with lower risk of fracture in MHD patients,serum magnesium combined with age may help to predict the risk of fracture in MHD patients.

Abstract:Objective To research on the influence of comfort care intervention to the self-management behavior and life qualities for maintenance hemodialysis patients.Methods Ninety-two patients with maintaining hemodialysis were selected in the center hospital of zhoukou from Tuesday 2014 to June 2016 and posted questionnaire of self-management behavior and health survey before comfort care intervention and three months later,separately.It is compared that the differences of patients' self-management behavior and life qualities before and after comfort care intervention.Results The patients' self-management behavior scores,mental health,life qualities and physical fitness indexs after comfort care intervention in three months were higher than those before comfort care intervention(P＜0.05).Conclusion The comfort care intervention can improve the self-management behavior and life qualities in maintenance hemodialysis patients effectively.It is worthy of clinical expansion.