Despite significant advancements in cancer immunotherapy, many patients continue to respond poorly. Novel therapeutic strategies and drugs are urgently needed. Here, we found that CYP2E1 is upregulated in M2 macrophages. The CYP2E1 inhibitor, Q11, could inhibit M2 macrophage polarization, while CYP2E1 overexpression could promote it. Increased levels of CYP2E1 and M2 macrophages in the tumor microenvironment of HCC patients correlate with poor prognosis. Q11 could inhibit tumor cells by targeting M2 macrophages rather than directly attacking tumor cells. Both Q11 and Cyp2e1 knockout could effectively suppress tumor growth. Q11 reduces the production of CYP2E1 metabolites ( ±)9(10)-DiHOME and ( ±)12(13)-DiHOME, thus attenuating PPARγ activation and M2 macrophage polarization. In summary, our findings suggest that Q11 could suppress M2 macrophage polarization by modulating the CYP2E1/( ±)9(10)-DiHOME or ( ±)12(13)-DiHOME/PPARγ axis, indicating that CYP2E1 may be a potential therapeutic target for HCC, and its inhibitor Q11 may be a potential drug for the treatment of HCC.

Papillary thyroid carcinoma (PTC) is the most common endocrine malignancy with a rapidly increasing incidence. The pathogenesis of PTC is unclear, but metabolic and lipidomic reprogramming may play a role in tumor growth. We applied ultra-performance liquid chromatography-tandem mass spectrometry to perform widely targeted metabolomics and lipidomics on plasma samples from 94 patients with PTC and 100 healthy controls. We identified 113 differential metabolites and 236 differential lipids, mainly involved in branched-chain amino acid metabolism, glutamate and glutamine metabolism, tricarboxylic acid cycle, and lipid metabolism. We also screened three potential metabolite biomarkers: sebacic acid, L-glutamine, and indole-3-carboxaldehyde. These biomarkers showed excellent diagnostic performance for PTC in both discovery and validation cohorts, with areas under the receiver operating characteristic curves of 0.994 and 0.925, respectively. Our findings reveal distinct metabolic and lipidomic features of PTC and provide novel targets for diagnosis and treatment.

目的 调查2型糖尿病高危人群的糖尿病防治素养现状并分析其影响因素.方法 采用便利抽样法,于2021年9—12月选取于郑州市某三级甲等医院体检中心接受健康体检的522例2型糖尿病高危人群为调查对象.采用中国公众糖尿病防治素养调查问卷、社会支持评定量表(SSRS)、健康行为能力自评量表(SRAHP)进行问卷调查.结果 防治素养得分≥43.2分判定为具备糖尿病防治素养,522例研究对象糖尿病防治素养总分平均为(38.35±5.94)分,其中133例(25.48％)具备糖尿病防治素养.多元线性回归分析结果显示受教育程度、健康行为能力自评量表中营养能力维度、健康责任维度、社会支持水平是2型糖尿病高危人群糖尿病防治素养的主要影响因素(P<0.05).结论 2型糖尿病高危人群的糖尿病防治素养水平有待进一步提高.受教育程度低、营养能力及健康责任自评较低、社会支持度低均为2型糖尿病高危人群糖尿病防治素养的影响因素.

目的:探讨八段锦联合复方降脂茶对非酒精性脂肪性肝病(non-alcoholic fatty liver disease,NAFLD)患者肝脏脂肪含量,血三酰甘油、低密度脂蛋白、高密度脂蛋白水平的影响.方法:120例NAFLD患者随机分为对照组和观察组各60例.对照组给予常规饮食和运动指导,观察组在对照组干预基础上给予八段锦运动及复方降脂茶.3个月后,比较两组患者肝脏脂肪含量,血三酰甘油、低密度脂蛋白、高密度脂蛋白水平.结果:干预后,观察组患者脂肪含量为(241.65±14.65)dB·mW-1,对照组患者脂肪含量为(259.60±15.91)dB·mW-1,两组患者肝脏脂肪含量比较,差异有统计学意义(P＜0.05).干预后,观察组患者三酰甘油为(2.45±1.04)mmol·L-1,对照组患者三酰甘油为(2.98±1.06)mmol·L-1,两组比较,差异有统计学意义(P＜0.05);观察组患者低密度脂蛋白为(3.59±0.59)mmol·L-1,对照组为(4.06±0.37)mmol·L-1,两组比较,差异有统计学意义(P＜0.05);观察组高密度脂蛋白为(1.18±0.14)mmol·L-1,对照组为(1.13±0.14)mmol·L-1,两组比较,差异有统计学意义(P＜0.05).结论:八段锦运动联合复方降脂茶可显著降低NAFLD患者肝脏脂肪含量、改善血脂水平.

Objective:To explore the effects of early warning nursing on preventing the incidence of venous thrombosis in patients with breast cancer after chemotherapy.Methods:Totally 103 patients with breast cancer admitted at the First Affiliated Hospital of Zhengzhou University from January to December 2018 who received routine nursing were included into the routine group, and 103 patients with breast cancer admitted at the First Affiliated Hospital of Zhengzhou University from January to December 2019 who underwent early warning nursing were included into the early warning group. The incidence of venous thrombosis 1 month after chemotherapy was compared between the two groups. Color Doppler ultrasonography was used to detect axillary blood flow before and 1 month after chemotherapy.Results:The incidence of venous thrombosis in the early warning group after chemotherapy was lower than that in the routine group, and the difference was statistically significant ( P<0.05) . The maximum blood flow rate and average blood flow rate in the armpit after chemotherapy in the early warning group were higher than those in the routine group, with statistically significant difference ( P<0.05) . Conclusions:Early warning nursing has a positive effect on the incidence of venous thrombosis in patients with breast cancer after chemotherapy, which can improve their hemagglutination.

目的:探讨本地区健康人群宫颈人乳头瘤病毒(HPV)感染现状及宫颈细胞学异常情况.方法:对2016-2021年本院健康体检的24 248例女性HPV感染情况及宫颈液基细胞学检测(TCT)异常情况进行回顾性分析.结果:HPV总感染率为13.4％.2016年感染率最高(18.0％),2019年感染率最低(10.1％),不同年份HPV感染率比较,差异有统计学意义(X2=127.46,P＜0.000).≤25岁人群感染率最高(29.0％),≥66岁人群感染率次之(15.2％),不同年龄组感染率差异有统计学意义(X2=38.14,P＜0.000).HPV高危型和低危型感染率分别为14.5％和3.3％.HPV高危型感染率前5位分别为16型(3.8％)、52型(2.6％)、53型(1.5％)、58型(1.5％)、18型(1.4％).TCT异常检出率为2.4％.ASC和HSIL检出率较高的年龄段为46～55岁,LSIL检出率最高为≤25岁组.结论:本院健康女性中HPV高危型以16、52、53、58、18型为主,46～55岁人群中HSIL检出率最高,提示应重视本地区HPV高发感染型别和HSIL高发人群的宫颈癌筛查.

目的 探讨曼陀罗绘画疗法对接受射频消融术治疗的原发性肝癌患者负面情绪的影响.方法 选取2021年3月至2022年2月在郑州大学第一附属医院消化内一科和消化内二科病区接受射频消融术的原发性肝癌患者作为研究对象.采用抽签法将一病区肝癌患者纳入对照组(60例),将二病区患者纳入干预组(60例).对照组患者接受消化内科常规心理护理,干预组患者接受曼陀罗绘画心理疗法护理.采用焦虑自评量表(SAS)、抑郁自评量表(SDS)、匹兹堡睡眠质量指数量表(PSQI)评估两组患者干预前后焦虑、抑郁水平及睡眠质量.结果 干预组患者焦虑自评、抑郁自评得分及匹兹堡睡眠质量指数得分均低于对照组(P<0.05).结论 曼陀罗绘画疗法可缓解接受射频消融术的原发性肝癌患者的焦虑、抑郁情绪,改善其睡眠质量.

健康体检数据积累着丰富的人群健康信息,但因缺乏数据的标准化质控,限制数据的充分挖掘与利用.如何保障健康体检数据规范化收集、高效存储及深层分析是质量控制的关键.本文首先总体分析了健康体检数据处理流程的五个步骤,指出了不同步骤的关键环节,提出健康体检数据质量控制流程的构建目标及现存的主要问题;其次基于三阶段质量控制原理,构建了健康体检数据处理流程的"检前-检中-检后"质量控制流程,为体检数据有效分析及应用提供参考;最后综述了健康体检全流程数据处理质量控制流程下,健康体检数据在风险预测、慢病管理、就医导诊以及科研创新方面带来巨大的促进作用.

目的:分析健康体检人群的重要异常结果及检后质控管理的效果.方法:对2020年1月—12月在郑州大学第一附属医院体检中心健康体检中发现的1413例重要异常结果进行管理分析.结果:1413例的重要异常结果中男性585例(41.40％),女性828例(58.60％),检出率最高的年龄段为50～59岁,有两种及以上重要异常结果的受检者有57例(4.03％),仅一种的有1356例(95.97％).女性人群中,占比较高的为可疑甲状腺结节、可疑宫颈癌、可疑肺结节或占位、可疑乳腺结节,平均年龄为分别为(49.82±13.32)、(43.29±10.52)、(53.60±13.39)、(48.86±13.40)岁;男性人群中,占比较高的为可疑甲状腺结节、可疑肺结节或占位、尿常规严重异常、严重心血管疾病,平均年龄分别为(51.03±13.33)、(55.08±13.67)、(50.50±14.64)、(60.57±13.84)岁.检后管理发现在乳腺、肾脏、宫颈、肺、甲状腺方面的就诊率最高,分别为83.75％、76.19％、75.57％、74.42％、70.70％.结论:对于50～59岁年龄阶段的人群应特别注意重要异常结果的质控管理,完善健全重要异常结果的管理制度,对健康体检质量控制具有重要意义.

化疗是治疗弥漫大B细胞淋巴瘤(DLBCL)的主要手段,但放化疗可导致患者出现恶心、呕吐等不良反应,加之放化疗周期较长,费用较高,增加患者对疾病的不确定感,导致焦虑、抑郁等负性情绪较重,影响生存质量[1].绘画疗法是通过绘画的方式改善患者认知、感觉运动功能,增强患者自尊、自我意识,从而提高患者心理弹性,缓解患者心理冲突及痛苦[2].认知行为干预是将潜意识行为原理、暗示学习原理等多种理论综合在一起的干预手段,通过改变患者不合理认知管理并建立正确认知,从而改善患者心理及生理问题[3].本研究将二者联合应用于DLBCL患者,观察其临床效果.

目的:探究原发性肝癌病人心理弹性与人格及自我效能的关系.方法:选择收治的原发性肝癌病人共100例,经回顾性分析法获取病人相关资料,采用心理弹性量表、大五人格问卷及自我效能感量表对病人心理弹性水平、人格及自我效能进行评价,通过单因素分析、多元线性回归分析筛选原发性肝癌病人心理弹性的影响因素,经Pearson相关性分析心理弹性与原发性肝癌病人人格及自我效能的相关性.结果:原发性肝癌病人心理弹性评分为(62.34±11.49)分、大五人格评分为(146.38±3.35)分、自我效能评分(27.20±6.42)分;单因素分析得到,原发性肝癌病人心理弹性的影响因素有文化水平、家庭人均月收入、医疗费用支付方式、病程、社会支持、应对方式(P<0.05);Pearson相关性检验显示,原发性肝癌病人心理弹性总分与自我效能呈正相关(r=0.354,P<0.01),心理弹性坚韧性、自强、乐观性3个维度与自我效能呈正相关(r值分别为0.398,0.335,0.412,P<0.01),原发性肝癌病人心理弹性总分与大五人格神经质维度呈负相关性(r=-0.374,P<0.01),与大五人格的外倾性、宜人性、责任感、开放性4个维度呈正相关(r值分别为0.442,0.387,0.427,0.432,P均<0.01);多元线性回归分析显示,原发性肝癌病人心理弹性的独立影响因素有初中及以下文化、医疗费用自费、病程<6个月、社会支持低水平、消极应对方式、大五人格、自我效能(P<0.05).结论:原发性肝癌病人心理弹性处于中等水平,其影响因素复杂,且与自我效能、大五人格的外倾性、宜人性、责任感、开放性4维度呈正相关,与大五人格神经质维度呈负相关,临床应加强健康教育与心理疏导,改善病人心理弹性状况.

Recently, ample evidence indicated that numerous aberrantly expressed long non-coding RNAs (lncRNAs) participated in the development of multiple malignancies. However, the expression and function of lncRNA LOXL1-AS1 in mediating esophageal squamous cell carcinoma (ESCC) carcinogenesis remains largely elusive. Here we validated that LOXL1-AS1 was significantly upregulated in ESCC tissues compared with the corresponding adjacent non-neoplastic tissues, and LOXL1-AS1 expression was positively correlated with ESCC patients' lymph node metastasis. Besides, LOXL1-AS1 knockdown impaired ESCC cells proliferation, migration and invasion capabilities in vitro. Furthermore, inhibiting LOXL1-AS1 in ESCC cells increased the percentage of cells at the G1 phase, accompanied by reducing in S phase in contrast to scramble control, and silencing of LOXL1-AS1 evoked ESCC cell apoptosis. From high throughput RNA sequencing (RNA-seq) analysis, we identified that differentially expressed in squamous cell carcinoma 1 (DESC1) was a critical downstream target of LOXL1-AS1. Taken together, we demonstrated the function and mechanism of LOXL1-AS1 in contributing ESCC progression for the first time, and indicated LOXL1-AS1 may be a novel therapeutic biomarker of ESCC.

非酒精性脂肪性肝病已超越乙型肝炎成为我国第一大肝病,不仅浪费了国家大量卫生资源,还增加了管理慢性病的成本,对其进行有效的健康管理可使其进展速度减慢及转归,节约卫生资源,节省慢性病管理的成本.国家倡导的中医健康管理具有很大的优势,但目前仍没有适合非酒精性脂肪性肝病的中医健康方案.中医"五位一体"的健康管理模式对预防慢性病有很大价值.本文将构建一个基于中医五位一体的非酒精性脂肪性肝病患者健康管理模式,旨在促进非酒精性脂肪性肝病的转归.

信息化建设在健康体检、健康管理质量控制中非常重要.本文介绍信息化建设在健康体检信息系统及健康管理系统中的主要功能,详述信息化建设在健康体检与健康管理质量控制中的作用.基于信息化技术进行体检,能实现客户个性化体检、加快体检工作流程、提高数据输入和体检报告的准确性,基于信息化系统的大数据健康风险评估可以提高干预的有效性.信息化是健康管理(体检)中心持续快速发展的关键,其可改进健康体检及健康管理的流程,对质量控制具有重要的作用和意义.

目的 分析弥漫大B细胞淋巴瘤患者应用延续护理对生存质量、护理满意度的影响.方法 选取2019年8月-2020年8月进行治疗的弥漫大B细胞淋巴瘤患者共60例,通过随机颜色球法划分为观察组同参照组,各30例.参照组实施常规护理,观察组实施延续护理.比较两种干预方法下患者的生存质量同护理满意度.结果 两组生存质量指标比对有差异,观察组评分高于参照组,差异显著(P＜0.05).两组护理满意度指标比对有差异,观察组明显优于参照组,差异显著(P＜0.05).结论 给予弥漫大B细胞淋巴瘤患者延续护理,能够促进生存质量及护理满意度的提高.

Unraveling the molecular mechanisms by which genetic variants of cytochrome P450 2A6 lead to different metabolic phenotypes remains a long-standing but important challenge. CYP2A6 is an enzyme involved in the metabolism of several clinical drugs as well as the metabolic activation of carcinogenic nitrosamines. Herein, CYP2A6 genotypes and phenotypes, as indicated by protein content [by liquid chromatography-mass spectrometry (MS)/MS] and metabolic activities [V-max, clearance (CL)], were determined for 90 human liver samples. We determined the median, range, and interindividual and intraindividual variation of CYP2A6 content and activity at the microsomal, liver tissue, and whole liver level and predicted hepatic in vivo clearance by in vitro-in vivo extrapolation based on CYP2A6-mediated coumarin metabolism by each CYP2A6 genotype. These results reveal how different CYP2A6 genotypes yield different phenotypic traits in protein content and enzyme activity. For relative V-max, CL, and protein content, the intraindividual percentage coefficients of variation (ICVs) were 41.0% (18.8%-125.1%), 28.5% (2.39%-133.5%), and 27.8% (2.68%-88.0%), respectively. The high ICVs implied large intraindividual variation at different levels, sometimes in a genotype-dependent manner. Intergenotype analysis revealed that the CYP2A6*4 allele demonstrated the most obvious effect on phenotypic outcomes, both in protein content and in metabolic activity. Indeed, decreased CYP2A6 protein content with the CYP2A6*4 genotype might explain the decreased metabolic activity from the molecular to the organismal level. These findings may allow useful predictions for CYP2A6-mediated drug metabolism on an individual patient basis in accord with the goal of achieving personalized medicine. SIGNIFICANCE STATEMENT We provide the median, range, and interindividual and intraindividual variation in CYP2A6 content at the microsomal, liver tissue, and whole liver level by liquid chromatography-mass spectrometry (MS)/MS as well as activities at the protein, microsomal, liver tissue, and whole liver level both in vitro and at the organismal level based on CYP2A6-mediated coumarin metabolism with each CYP2A6 genotype, thereby allowing us to elucidate how different CYP2A6 genotypes yield differing phenotypic traits (protein content and enzyme activity), facilitating the development of personalized medicine.

BACKGROUND:Long non-coding RNAs (lncRNAs) are powerful factors influencing the tumorigenesis and metastasis of multiple carcinomas. LncRNA MNX1-AS1 plays critical roles in the progression of tumor formation according to recent research, while its roles in esophageal squamous cell carcinoma (ESCC) remains unknown.METHODS:The expression levels of lncRNA MNX1-AS1 were examined in ESCC tissues by quantitative reverse transcriptase polymerase chain reaction (qRT-PCR). The role of lncRNA MNX1-AS1 was performed by WST-1 proliferation assays, migration and invasion assays. Besides, the molecular mechanism of lncRNA MNX1-AS1 was verified by online bioinformatics, qRT-PCR and rescue assays.RESULTS:MNX1-AS1 was signifcantly upregulated in ESCC tissues. It was conformed that high MNX1-AS1 expression was associated with ESCC lymph node metastasis. Moreover, we found that knockdown of MNX1-AS1 apparently suppressed the cell proliferation, migration, and invasion capacity. Flow cytometry analysis showed MNX1-AS1 regulated ESCC cell cycle and apoptosis progression. Mechanism analysis revealed that miR-34a inhibitor could rescue the influence of inhibiting MNX1-AS1 on ESCC cells migration by serving as competing endogenous RNA (ceRNAs). Furthermore, we found that miR-34a specifically targeted SIRTI.CONCLUSIONS:Taken together, we demonstrated that lncRNA MNX1-AS1/miR-34a/SIRT1 regulatory axis could play an important role in ESCC progression, and MNX1-AS1 may act as a novel potential biomarker for esophageal squamous cell carcinoma.

We systematically studied and explored intraindividual variation and correlation in the activities of cytochrome P450 (CYP) using 105 normal liver samples. The intraindividual percentage coefficients of variation of relative Km, Vmax, and CLint were 45.9% (18.3-140%), 44.0% (16.8-127%), and 52.0% (24.2-134%). Overall values of relative Km, Vmax, and CLint for 10 CYPs were sorted. The order, from highest to lowest, was CYP2D6, 3A4/5, 2C19, 2C9, 2B6, 1A2, 2A6, 2C8, and 2E1 for Km; CYP3A4/5, 2C19, 2D6, 2C8, 2E1, 2B6, 1A2, 2A6, and 2C9 for Vmax; and CYP2D6, 2B6, 3A4/5, 2C19, 2C9, 1A2, 2E1, 2C8, and 2A6 for CLint. CYP2A6*4, 2B6 785A>G, and 2D6 100C>T contributed to intraindividual variation of CYP activities. The correlations and similarities among 10 CYP activities were analyzed, and it was found that the highest correlation and similarity for Vmax, Km, and CLint occurred between CYP2C9 and 2C8, CYP2C9 and 1A2, and CYP2C9 and 2C8, respectively. In conclusion, CYP activities exhibit considerable intraindividual variation, with some notable correlations, which might be helpful to comprehensively understand the internal connection among CYP activities and to guide the rational use of drugs.

目的 验证《直立倾斜试验标准操作流程中国专家推荐意见》方法学的合理性,并发现其存在的不足.方法 因晕厥一次及以上为主诉门诊就诊或住院,并申请做直立倾斜试验(head-up tilt table test,HUTT)的患者600例,按检查顺序随机分成试验组和对照组,每组300例.试验组操作严格按照《直立倾斜试验标准操作流程中国专家推荐意见》执行,对照组采用本倾斜实验室一直沿用的方法.观察两组在基础倾斜试验阶段和药物激发试验阶段诱发晕厥的时间及阳性率,阳性反应发生情况及采取的处理手段等.结果 600例患者中阳性393例,阳性率为65.5％.试验组基础倾斜试验阶段阳性率[12.00％(36/300)]明显高于对照组[6％(18/300)](χ2=6.593,P=0.010);两组基础倾斜试验阶段阳性反应发生时间3～39 min,平均(16.67±9.90)min,95％可信区间12.44～20.89 min.药物激发试验阶段试验组阳性反应发生时间(5.13±4.27)min,对照组(5.28±2.39)min,95％可信区间4.59～5.89 min.393例阳性患者中,血管抑制型90例(22.9％),心脏抑制型12例(3.1％),混合型291例(74.0％).仅1例放平倾斜床后心率、血压不升,给予阿托品1 mg静脉注射后,心率、血压仍不能维持;开放静脉通道,给予生理盐水加多巴胺静脉滴注,心率、血压逐渐恢复.结论 新的操作流程使基础倾斜试验阳性率明显提高,但不改变硝酸甘油激发倾斜试验阳性反应的发生率及发生时间.HUTT试验前是否所有患者均需开放静脉通路,有待进一步研究证实.

Objective To investigate the relationship between spina bifida occulta in lumbasacral portion and functional defe-cation abnormality among middle-aged and elderly people.Methods The cross-sectional and cluster random sampling survey meth-od was adopted to select the residents aged 45-90 years old in 7 communities of Zhengzhou City as the respondents.All respond-ents underwent the physical examination and lumbosacral digital radiography(DR)examination in the physical examination center of the First Affiliated Hospital of Zhengzhou University,and filled the related questionnaire about defecation abnormality.The rela-tionship between SBO and functional defecation abnormality among middle-aged and elderly people was studied by diagnosing and analyzing the functional constipation(FC)and functional incontinence(FC).Results The effective sample amounts were 1 057 ca-ses,including 497 males and 560 females,167 cases of SBO(86 males and 81 females).The morbidity rate of functional defecation abnormality was 26.02%(275/1 057),23.34%(116/497)in males and 28.39%(159/560)in females.Among 275 cases of functional defecation abnormality,there were 72 cases of complicating SBO.The Logistic regression analysis results showed that age,SOB,physical activity status,diet and living habits,education level and psychological factors were the risk factors for functional defecation abnormality (P<0.05),while there was no relationship between between past-history of stroke and functional defecation abnormality(P>0.05).Con-clusion SBO may be one of risk factors for functional defecation abnormality among middle-aged and elderly people.