Thoracic SMARCA4-deficient undifferentiated tumor (SMARCA4-UT) is an extremely rare and poor-prognosis malignancy, which has recently been noted as a subtype of lung tumors. We presented a case of SMARCA4-UT in a 50-year-old man with progressively worsening respiratory failure. The tumor was the first reported to involve pulmonary artery, and 90% of tumor cells expressed programmed cell death ligand 1 (PD-L1). High tumor mutational burden (TMB, 23.93/Mb) and mutations in SMARCA4 were detected. It is the first reported case to receive Tislelizumab monotherapy with considerable improvement in clinical condition and no adverse events. As a result of our case, we highlight the importance of recognizing SMARCA4-UT as an individual entity, as well as the efficacy of immune checkpoint inhibitor therapy, particularly in patients with high levels of TMB and PD-L1 expression.

主体泛化带来新媒体健康传播的去中心化乱局,传播导向功利化也正在侵蚀健康传播的公益本性.而道德自律不足和监管审查乏力,极易使公众逆向选择并损害其基本健康权益.这些问题会威胁新媒体健康传播价值与效能的发挥,影响公众健康素养的提升,甚至对社会产生其他不容忽视的危害.

目的 分析超声引导下经皮肺穿刺活检术并发症及其影响因素.方法 2017年6月至2020年1月于超声引导下经皮肺穿刺活检的病例193例,统计并分析并发症的发生与患者的性别、年龄、病灶部位、大小、病理结果、穿刺方式及切割次数的关系.结果 193例中出现并发症的患者共42例(21.8％).其中气胸14例(7.3％),咯血14例(7.3％),胸膜反应12例(6.2％),穿刺部位疼痛5例(2.6％).并发症相关因素分析可知:并发症的发生与患者的年龄、病灶部位及病灶大小相关(P<0.05).结论 患者的年龄、病灶部位、大小会影响超声引导下经皮肺穿刺活检并发症的发生率.

Background: The rapid outbreak of coronavirus disease 2019 (COVID-19) posed a serious threat to China, followed by compulsive measures taken against the national emergency to control its further spread. This study was designed to describe residents' knowledge, attitudes, and practice behaviors (KAP) during the outbreak of COVID-19. Methods: An anonymous online questionnaire was randomly administrated to residents in mainland China between Mar 7 and Mar 16, 2020. Residents' responses to KAP were quantified by descriptive and stratified analyses. A Multiple Logistic Regression model was employed to identify risk factors associated with KAP scores. Results: A total of 10,195 participants were enrolled from 32 provinces of China. Participants of the ≥61 years group had higher KAP scores [adjusted Odds Ratio (ORadj) = 4.8, 95% Confidence Interval (CI): 3.0–7.7, P < 0.0001], and the married participants and those in low-income families had higher scores of KAP (ORadj = 1.2, 95% CI: 1.1–1.3; ORadj = 1.8, 95% CI: 1.6–2.2, respectively, both P < 0.0001). The participants living with more than two family members had higher scores in an increasing ORs when the family members increased (ORadj = 1.3, 95% CI: 1.1–1.6, P = 0.013; ORadj = 1.3, 95% CI: 1.1–1.6, P = 0.003; ORadj = 1.3, 95% CI: 1.0–1.6, P = 0.02; for groups of 2, 3–4 and ≥5, respectively). Conclusions: Out of the enrolled participants who completed the survey, 85.5% responded positively toward the mandatory public health interventions implemented nationwide by the Chinese authorities. These effective practices seem to be related to a proper attitude generated by the increased knowledge and better awareness of the risks related to the COVID-19 pandemic and the consequent need for safe and responsible behavior.

Stress is associated with an increased risk of lung metastasis in melanoma. However, the underlying mechanism is elusive. Oxytocin (OXT), a neurohormone produced by the hypothalamus, plays a vital role in laboring induction and lactation. Emerging evidence suggests that OXT also regulates human emotions, social cognition, social behaviors and stress-related disorders. Here, we reported that a significant up-regulation of oxytocin receptors (OXTRs) was observed in malignant melanoma. The activation of OXTRs dramatically promoted migration, invasion and angiogenesis but not the proliferation of melanoma cells in vitro and in vivo via β-arrestin 2-dependent ERK-VEGF/MMP-2 pathway. Next, chronic restraint stress significantly elevated the plasma level of OXT. Notably, 21 days chronic restraint stress facilitated lung metastasis of melanoma and reduced overall survival in mice, which were largely abrogated by knocking down either OXTR or β-arrestin 2. These findings provide evidence that chronic stress hormone-OXT promotes lung metastasis of melanoma via a β-arrestin 2-dependent mechanism and suggest that OXT, a novel pro-metastasis factor, is a potential therapeutic target for melanoma.

Breastfeeding is associated with a decreased risk of ovarian cancer. However, the mechanism underlying this apparent clinical benefit is unknown. Oxytocin (OXT), a hypothalamic nonapetide, plays a crucial role in many reproductive and behavioural functions. In recent year, OXT acts as a growth regulator in many kind of tumor tissues, through the activation of a specific G-coupled transmembrane receptor, the oxytocin receptor (OXTR). OXT has been proved to inhibit the proliferation, migration and invasion of ovarian cancer SKOV3 cells in vitro. But, the underlying mechanisms remain unknown. Here, we found OXT inhibited proliferation, and critically migration and invasion of human ovarian cancer cells SKOV3 and A2780. Strikingly, OXT inhibited ovarian cancer metastasis by repressing the expressions of MMP-2 and VEGF. Moreover, OXT inhibited vascular endothelial cell tube formation by reducing the VEGF production from ovarian cancer cells. Our findings may provide a possible explanation for breastfeeding-associated protective effects and suggest new therapeutic opportunities for ovarian cancer.

Objective To explore the pathogenesis of respiratory inflammation in allergic asthma and investigate the most effective evaluation of therapeutic efficiency by observing the serum level of specific immunoglobulin G4 ( sIgG4) .Methods 65 patients with allergic asthma from September 2015 to September 2016 in the Second Affiliated Hospital of Fujian Medical University were selected with acute attacks from mild to moderate degree ( Asthma Control Test score<20 points) ,and all go into remission after treatment ( Asthma Control Test score > 20 points) .Another 30 healthy subjects were chosen as control group .Measure and compare the serum sIgG4 ,total immunoglobulin E ( TIgE) ,and also forced expiratory volume in the first second ( FEV 1 ) ,peak expiratory flow ( PEF) ,skin prick test ,eosinophils ( EOS) ,fractional of exhaled nitric oxide ( FeNO) in acute attack stage of asthma group ,remission stage of asthma group and control group .Results Serum sIgG4 ,TIgE ,sIgG4/TIgE were higher in remission stage of asthma group and acute attack stage of asthma group than control group ( F =112 .93 ,42 .826 ,4 .092 , all P <0 .05) .The levels of sIgG4 and sIgG4/TIgE in remission stage of asthma group were higher than those in acute attack stage of asthma group ,TIgE was lower in acute attack stage of asthma group ( t =-11 .446 ,7 .750 ,-2 .444 ,all P <0 .05) .The levels of FEV1 ,PEF ,FeNO and EOS in remission stage of asthma group were significantly better than those in acute attack stage of asthma group , and the differences were statistically significant ( t =15 .044 ,11 .744 ,22 .202 ,11 .645 ,all P <0 .001) .Conclusions sIgG4 can indirectly reflect the respiratory inflammation in dust mite allergic asthma and have monitoring and treatment guiding value on them .

BACKGROUND:High-fat diets have been considered a risk factor for sporadic colorectal cancer (CRC) in Western countries. However, data for this phenomenon are lacking in China. The purpose of this study was to comprehensively evaluate the association between diet and the risk for sporadic CRC in Shandong Province, China.METHODS:In this case-control study, 317 patients with sporadic CRC and 317 controls were collected in Shandong Province, China. All the samples were collected on the basis of rigorous screening criteria. The data were analyzed using a χ2 test, univariate or multivariate conditional logistic regression, and stratified analysis.RESULTS:Multivariate logistic regression showed that the following are risk factors for sporadic CRC (all P<0.05): consumption of pork, fried food or barbecued meat; high Body Mass Index (BMI); alcohol abuse; psychosis; and the presence of a factory causing pollution near the home. Moreover, univariate analysis revealed the following qualities were also positively associated with CRC (all P<0.05): intake of animal oil, consuming brawn and kipper, smoking, exhibiting frequent anger, and poor sleep quality. Eating fresh fruit was inversely correlated with the incidence of CRC (P=0.012). Further stratified analysis demonstrated that BMI and the consumption of fried food, barbecued meat, or garlic were correlated with colon cancer. However, alcohol abuse and psychosis were related to an increased risk for rectal cancer.CONCLUSION:Dietary factors are related to sporadic CRC in Shandong Province. Future interventions should focus on reducing the related risk factors while advocating for practice of the protective factors.

中国首例人体冷冻试验引发大众对生死观的思考,人类是应该顺应死亡的不可抗拒,还是可以试图打破生老病死的自然规律,古往今来,这个关于生与死的思考一直未曾停休.在如今死亡还无法避免的现实下,人类对"生"的持久依然有着强烈的期盼,肉体、精神或灵性的延续是人类希望获得生命长久的体现.尊重个体对生命的选择意愿,协助个体在生命终期对生活的掌控,提升个体面对事实死亡时强大的内心力量,使死亡是"必然"前提下优死观的展现.

Chronic stress occurs in everyday life, and often results in memory impairments and depressive symptoms. Resveratrol is a natural polyphenol that possesses numerous biological properties, including potent antidepressant‑like effects. The present study aimed to examine the effects of resveratrol treatment on chronic restraint stress (CRS)‑induced cognitive impairment and to explore the underlying molecular mechanisms. Male Wistar rats were exposed to CRS for 21 days in order to induce depressive‑like behavior. The results demonstrated that CRS (6 h/day, 21 days) was able to induce cognitive deficits in rats, as evidenced by Morris water maze and novel object recognition tests. In addition, CRS exposure significantly decreased the mRNA and protein expression levels of hippocampal brain‑derived neurotrophic factor (BDNF) in the rats. Conversely, chronic treatment with resveratrol (80 mg/kg, i.p.; 21 days) significantly prevented the behavioral and biochemical alterations induced by CRS. The effects of resveratrol were nearly identical to those observed with fluoxetine treatment. In conclusion, the present study demonstrated that resveratrol may be a potential therapeutic agent for the treatment of chronic stress‑induced cognitive impairments, and its underlying molecular mechanism may be associated with the increased levels of hippocampal BDNF.

Objective To discuss the relationship between meibomian gland abnormalities and tear film stability in patients with obstructive sleep apnea-hypopnea syndrome.Methods In a descriptive study from November 2013 to June 2014,63 patients (126 eyes) who were diagnosed with obstructive sleep apnea-hypopnea syndrome (OSAHS) were recruited.Healthy individuals (n=44;88 eyes) who were seeking physical examinations served as the control group.Personal information,clinical history,and the ocular surface disease index (OSDI) were recorded.All eyes were assessed by slit lamp examination,tear break-up time (BUT),noncontact infrared meibography,and meibomian gland inspection.The prevalence of meibomian gland dropout and distortion in OSAHS patients was compared with controls.Results The prevalence of meibomian gland dropout in the control and different OSAHS groups (mild,moderate,and severe) was 12/88(14％),7/18(39％),14/30(47％),and 53/78(68％),respectively.The difference was statistically significant (x2=50.62,P＜0.01).The meibography scores of the mild,moderate,and severe OSAHS group and the control group were 2.29±1.25,2.29±0.91,2.64±1.18,and 1.50±0.67,respectively.The difference was statistically significant.The prevalence of meibomian gland distortion in the control and different OSAHS groups (mild,moderate,and severe) was 8/88(9％),6/18(33％),12/30(40％),49/78(63％),respectively.The difference was statistically significant (x2=51.96,P＜0.01).Meibomian gland orifices were plugged in 32 eyes in the control group (32/88,36％) and in 87 eyes in the OSAHS group (87/126,69％).The difference was significant (x~22.42,P＜0.01).Meibomian abnormalities were present in 34 eyes in the control group (34/88,39％) and in 91 eyes in the OSAHS group (91/126,72％).The difference between the two groups were statistically significant (x2=27.26,P＜0.01).Conclusion Compared to the general population,OSAHS patients have a less stable tear film,and they are more likely to develop meibomian gland atrophy or morphological abnormality.Morphological abnormality of the meibomian gland is correlated with the severity of OSAHS.

Circulating microRNAs (miRNAs) are emerging as novel noninvasive biomarkers for prediction of lymph node metastasis (LNM) in cancer. The aim of this study was to identify serum miRNA signatures for prediction and prognosis of LNM in gastric cancer (GC). MiSeq sequencing was performed for an initial screening of serum miRNAs in 10 GC patients with LNM, 10 patients without LNM and 10 healthy controls. Reverse transcription quantitative real-time PCR was applied to confirm concentration of candidate miRNAs using a training cohort (n = 279) and a validation cohort (n = 180). We identified a four-miRNA panel (miR-501-3p, miR-143-3p, miR-451a, miR-146a) by multivariate logistic regression model that provided high predictive accuracy for LNM with an area under the receiver operating characteristic curve (AUC) of 0.891 (95% CI, 0.840 to 0.930) in training set. Prospective evaluation of this panel revealed an AUC of 0.822 (95% CI, 0.758 to 0.875, specificity = 87.78%, sensitivity = 63.33%) in validation set. Moreover, Kaplan-Meier analysis showed that LNM patients with low miR-451a and miR-146a levels had worse overall survival (OS) (p < 0.05). In Cox regression analysis, miR-451a was independently associated with OS of LNM (p = 0.028). Our results suggested that use of serum miRNAs seems promising in estimating the probability GC patients harbor LNM and providing prognostic information for LNM.

Education of postgraduate students of humanistic medicine is the basis and premise of the implemen-tation of medical humanities education. The cultivation of medical students' humanistic quality is often emphasized in medical education, while the education of postgraduate student education of humanistic medicine is rarely men-tioned. It is mainly manifested in the following aspects: the attention on the education of postgraduate students of humanistic medicine is not enough; the graduate students are lack; the training goal needs to be clear; and the teaching links need to be improved. Project management is a dynamic process and its achievement orientation is prominent. The application of project management in the process of education of postgraduate students of humanistic medicine can expand the application scope of the project management theory. Moreover, it can facilitate education of postgraduate students of humanistic medicine to be completed in a more scientific, reasonable and orderly process.

Objective To analyze the distribution and the drug resistance of the pathogens from blood culture,and to provide basici for the clinicians to rationaly use antibiotic.Methods The retrospective analysis was conducted on distribution and drug-resistance profile of the pathogens from blood culture colected from both inpatients and outpatients in our hospital from 2013 to 2015. The identification of strains and the drug susceptibility testing wereperformed by the VITEK-2 Compacts system.ResultsThe positive incidence of these 8736 samples is 9.89%. There were 407 strains of gram-negative bacili (47.11%),386 strains of gram-positive bacili(44.67%)and 59 strains of fungi(6.83%). The top three species of the gram-negative bacili were escherichia coli,klebsiela pneumonia and pseudomonas aeruginosa. The top three species of the gram-positive bacili were the coagulase-negative staphylococcui, staphylococcus aureusande,faecalis,the pathogens were mainly from ICU,department of hematology and immunology,respiratory medicine and pediatrics, the detection rates of ESBLs and E.coli were 45.3% and 24.1%,pneumonia and enterobacteriaceae were 100.00% sensitive to carbapenems,resistance rates of pseudomonas aeruginosa to amikacin,piperacilin/tazobactam and tobramycin were 9.09%、9.09% and 11.36%,MRSA were16.0%. No strains of ancomycin-resistantdetection or linezolid-resistantdetection strains were found in gram-positive bacili.ConclusionTo promote and standardize the rational use of antibiotics,and to strengthen the control of hospital infection is an important strategy to reduce the drug resistance of the bacteria.

Oxytocin (OT), a hypothalamic neuropeptide, has been implicated in the regulation of social behaviors in rodents and humans. This study assessed the effects of intranasal administration of OT on depressive-like behaviors and hippocampal neurogenesis in adult rats following neonatal maternal deprivation (NMD). Here, we show that NMD resulted in significant depression-like behaviors, as indicated by decreases in physical activity and emotional reactivity in a novel environment, in 2-month-old animals. Notably, the OT levels in the plasma, hypothalamus, and hippocampus were decreased in these animals. Intranasal administration of OT reduced the depressive-like behaviors in NMD rats and rescued hippocampal long-term plasticity impaired by NMD stress in rats by promoting hippocampal neurogenesis. These results indicate that OT alleviates the depressive-like behaviors in NMD adult rats, probably mediated by improving adult hippocampal neurogenesis.

Objective To explore the clinical value of distilled water provocative test in diagnosis of cough variant asthma.Methods 97 chronic cough patients who coughed for more than 8 weeks and whose thoracic iconography examinations were negative were received pulmonary function test and distilled water provocative test in our hospital. Pulmonary ventilation functions of patients were received basic test. Patients were inhaled ultrasonically nebulized distilled water 30ml/20min by oronasal mask and then they were received pulmonary ventilation function reexamination. Wheezing and dyspnea of patients were closely detected during the test. If the patients developed wheezing, nebulization reexamination of pulmonary ventilation function would be stopped immediately. A decrease of more than 20% of FEV1 of the two pulmonary ventilation function test was accepted that distilled water provocative test was positive.Results 15 male and 22 female patients, whose average age was (32.3±2.5), were diagnosed cough variant asthma. 25 patients were diagnosed positive by distilled water provocative test and 10 patients were diagnosed negative by distilled water provocative test. But bronchial asthma was diagnosed by air peak expiratory flow variability or it was diagnosed by bronchodilation test of acute asthma attack in clinical follow-ups showing positive. The positive rate of bronchial asthma by distilled water provocative test was 71.43%. During distilled water provocative tests, one patient was occurred acute asthma attack and cyanotic oral lip. After those symptoms were released by oxygen inhalation, iv bolus methylprednisolone and nebulizing salbutamol.Conclusion Distilled water provocative test is a safe and reliable pulmonary function test and it has higher clinical value in diagnosis of cough variant asthma.

Establishing and perfecting the family doctor system should adhere to the following ethical princi-ples:the principle of public welfare, fairness and efficiency principle, the combination of comprehensive care prin-ciple, attaches great importance to the precautionary principle, the principle of family support, social participation principle. In the horizon, life ethics, puts forward suggestions for the development of family doctor system:impro-ving humanism quality of family physicians,calling the humanistic concern in the process of family doctor service increasing the government's policy support,increase the health resources into, adjust the health insurance policies, guide the community residents in the family doctor first.

The purpose of this paper was to inquire how policy-strength and social sharing of emotion moderate the relationship between emotional labor strategies and customer-directed sabotage behaviors. Survey was administered twice. Data was collected from 788 employees who work in service industry. Hierarchical regression analyses showed that surface acting is a more significant predictor of customer-directed sabotage behaviors than deep acting Moreover, policy strength has a significant moderating effect between surface acting and customer-directed sabotage, and social sharing of emotion has an important mediated effect between deep acting and customer-directed sabotage. Results suggested that surface acting and deep acting strategy take effects in different ways, and each effect varies depending on emotion-based moderator and resource-based moderator respectively.

运用现代生物技术干预大脑功能,调节人的社会行为已成为可能.爱情婚姻关系增强是运用药物、基因技术等生物医学手段干预大脑的神经生理功能,增强夫妻间的情感强度、吸引力和“厮守”,减少婚外情,降低离婚率,实现爱情忠贞、婚姻美满.但是爱情婚姻关系增强会破坏人的理性和自主,贬低人的尊严,是对神圣爱情的亵渎.其安全问题比其他人类增强形式更为严峻.它还会造成情感欺骗等一系列严重的伦理和社会问题.夫妻双方应用心和智慧经营婚姻,创造幸福的婚姻生活.