原肌球蛋白4在胃癌细胞迁移、侵袭和转移中的作用

目的:探索原肌球蛋白4（Tropomyosin4,TPM4）在胃癌细胞的迁移、侵袭和转移中的作用。方法:利用Real-time PCR、Western Blot及免疫荧光，检测原肌球蛋白4在不同胃癌细胞系及正常胃上皮细胞中的表达情况；利用免疫组化，检测原肌球蛋白4在胃癌组织及癌旁正常组织中的表达情况；利用慢病毒技术，在GC9811-P细胞中，分别转染LV-TPM4、shRNA-TPM4及对照空载体；通过Transwell和体内实验，检测胃癌细胞迁移、侵袭和转移。结果:Real-time PCR、Western Blot及免疫组化结果显示，原肌球蛋白4在胃癌细胞系及胃癌组织中的表达降低；上调原肌球蛋白4的表达后，抑制胃癌细胞的迁移、侵袭和转移；下调原肌球蛋白4的表达后，促进胃癌细胞的迁移、侵袭和转移（P<0.05）。结论:原肌球蛋白4抑制胃癌细胞的迁移、侵袭和转移。     

Cardiovascular effects and mechanisms of sodium-glucose cotransporter-2 inhibitors

Sodium-glucose cotransporter-2 inhibitors (SGLT2 inhibitors) are a new type of drug for the treatment of diabetes, and they have been proven to have a good hypoglycemic effect. Several lines of clinical evidence have shown that SGLT2 inhibitors can significantly reduce the risks of atherosclerosis, hospitalization for heart failure, cardiovascular death, and all-cause mortality and delay the progression of chronic kidney disease. Because of the protective effects of SGLT2 inhibitors on the heart and kidney, they are being studied for the treatment of heart failure and chronic kidney disease in patients without diabetes. Therefore, it is necessary for cardiologists, patients with diabetes, and nephrologists to fully understand this type of drug. In this review, we summarize the following three aspects of SGLT2 inhibitors: the recent clinical evidence of their cardiovascular benefits, their mechanisms of action, and their safety.     

Helicobacter pylori induces epithelial-mesenchymal transition in gastric carcinogenesis via the AKT/GSK3β signaling pathway

Helicobacter pylori (H. pylori) is a main risk factor for gastric cancer (GC). Epithelial-mesenchymal transition (EMT) is involved in the development and progression of H. pylori-associated GC. However, the exact molecular mechanism of this process remains unclear. The AKT/GSK3β signaling pathway has been demonstrated to promote EMT in several types of cancer. The present study investigated whether H. pylori infection induced EMT, and promoted the development and metastasis of cancer in the normal gastric mucosa, and whether this process was dependent on AKT activation. The expression levels of the EMT-associated proteins, including E-cadherin and N-cadherin, were determined in 165 gastric mucosal samples of different disease stages by immunohistochemical analysis. The expression levels of E-cadherin, N-cadherin, AKT, phosphorylated (p-)AKT (Ser473), GSK3β and p-GSK3β (Ser9) were further determined in H. pylori-infected Mongolian gerbil gastric tissues and cells co-cultured with H. pylori by immunohistochemical analysis and western blotting. The results indicated that the expression levels of the epithelial marker E-cadherin were decreased, whereas the expression levels of the mesenchymal marker N-cadherin were increased during gastric carcinogenesis. Their expression levels were associated with H. pylori infection. Furthermore, H. pylori infection resulted in downregulation of E-cadherin expression and upregulation of N-cadherin expression in Mongolian gerbils and GES-1 cells. In addition, an investigation of the associated mechanism of action revealed that p-AKT (Ser473) and p-GSK3β (Ser9) were activated in GES-1 cells following co-culture with H. pylori. Furthermore, following pretreatment of the cells with the AKT inhibitor VIII, the expression levels of E-cadherin, N-cadherin, p-AKT and p-GSK3β did not show significant differences between GES-1 cells that were co-cultured with or without H. pylori. The levels of p-AKT and p-GSK3β were increased in H. pylori-infected Mongolian gerbils. In conclusion, the present study demonstrated that H. pylori infection activated AKT and resulted in the phosphorylation and inactivation of GSK3β, which in turn promoted early stage EMT. These effects were AKT-dependent. This mechanism may serve as a prerequisite for GC development.     

护理人员科研能力与职业认同的相关性分析

目的了解护理人员的科研能力与职业认同现状及其相关性,为采取针对性措施提高护理人员科研能力,增强其职业认同感提供参考。方法采用护理人员科研能力自评量表与护士职业认同评价量表,对350名护理人员进行调查。结果护理人员科研能力及科研实践能力、专业与发现问题能力、沟通协作能力3个维度得分率分别为37.50%、25.00%、50.00%、50.00%,职业认同评价量表总均分为5.52分。护理科研能力与职业认同呈正相关(P0.01)。结论护理人员具有较高的职业认同,其科研能力尚待加强,科研能力与职业认同呈正相关。管理者应注重护理人员科研能力的培养,从而提高其职业认同。     

PI3K抑制剂ZSTK-474对结直肠癌细胞增殖和侵袭的影响

目的:探讨PI3K抑制剂ZSTK-474对结直肠癌细胞增殖和侵袭的影响。方法:采用不同浓度（0、1、2、4、6、8和10 μmol/L）ZSTK-474处理结直肠癌HT-29和HCT-116细胞24 h和48 h，CCK8法检测细胞增殖活性并计算出ZSTK-474在两株结直肠癌细胞中的半数抑制浓度（IC50）。根据IC50的值选用浓度为4 μmol/L的ZSTK-474作用HT-29和HCT-116细胞24 h，同时设置加入等量的0.1%DMSO为对照。采用平板克隆形成实验检测细胞增殖，流式细胞仪检测细胞凋亡，qRT-PCR检测细胞PI3K、Akt的mRNA水平，Western blot 检测细胞PI3K、Akt的蛋白水平。结果:ZSTK-474可明显抑制HT-29和HCT-116细胞的增殖，且呈时间和剂量依赖性。ZSTK-474可抑制HT-29和HCT-116细胞的侵袭能力，但不影响其凋亡。ZSTK-474处理HT-29和HCT-116细胞24 h后，PI3K和Akt的mRNA和蛋白表达水平均显著下降。结论:ZSTK-474能够抑制结直肠癌细胞增殖，并且能抑制其侵袭。     

植入物乳房重建一步法和二步法临床对比研究

目的:探讨即刻乳房假体重建（一步法）和应用扩张器的假体重建（二步法）两种不同手术方式在术后并发症、美容效果和成本效益的差异。方法:回顾性分析我院乳腺外科2015年5月至2018年5月收治的285例乳腺癌植入物重建患者，依据手术方式不同分为一步法组（145例）和二步法组（140例），比较两组患者临床资料的差异。结果:一步法组术后出血发生率（6.8%）高于二步法组（1.4%），差异有统计学意义（P=0.021）。一步法组术后伤口皮瓣坏死率（6.2%）高于二步法组（1.4%），差异有统计学意义（P=0.036）。二步法组乳房满意度评分（81.5±7.1）分高于1步法组（78.6±6.2）分，差异有统计学意义（P=0.035）。二步法组住院总花费（80 334.8±6 149.8）元高于一步法组（60 966.5±5 544.9）元，差异有统计学意义（P=0.049）。二步法组住院天数（34.3±3.2）天多于一步法组（17.5±3.9）天，差异有统计学意义（P=0.014）。结论:在植入物乳房重建两种手术方式中，二步法相较于一步法，其并发症少，美容效果好，但在成本效益上并不优于一步法。     

加强型鼻咽通气道应用于鼻腔手术后气道管理临床研究

目的研制加强型鼻咽通气道应用于五官科鼻腔手术后的气道管理。方法选取2014年1月至2015年3月行五官科鼻腔手术的患者60例,将其分为A组和B组,各30例。A组作为加强型鼻咽通气道组,术毕在膨胀止血海绵中放置加强型鼻咽通气道保留鼻腔通气;B组作为对照组,术毕采用传统单纯填塞膨胀止血海绵。通过术后24、48 h随访,对两组患者进行疼痛、睡眠质量、口干程度评分,并对其进行对比分析。结果加强型鼻咽通气道具有良好的抗压抗折性;A组患者24、48 h睡眠质量、口干程度评分均明显优于B组,差异均有统计学意义(P<0.05)。结论加强型鼻咽通气道用于五官科鼻腔手术后气道管理可增强气道管理安全性及患者舒适度。