ObjectiveTo investigate the levels of sperm DNA fragmentation index (DFI), reactive oxygen species (ROS), and mitochondrial membrane potential (MMP) in asthenozoospermic patients and assess their predictive value for in vitro fertilization (IVF) pregnancy outcomes.MethodsThis retrospective cohort study included 320 men with asthenozoospermic patients and 100 with normal semen parameters, assessed between January 2023 and June 2024. Of these, 143 couples undergoing IVF-embryo transfer were analyzed for outcomes. Semen samples were evaluated for conventional parameters, DFI, ROS, and MMP. Patients were stratified by DFI and MMP thresholds, and a combined DFI/MMP group was analyzed. Fertilization rate, cleavage rate, high-quality embryo rate, blastocyst formation rate, clinical pregnancy rate, miscarriage rate, and live birth rates were recorded. Multivariate logistic regression and receiver operating characteristic (ROC) curve analyses were performed.ResultsAsthenozoospermic patients showed significantly higher DFI and ROS, and lower MMP compared to controls, with these parameters correlating to asthenozoospermia severity. DFI and MMP were identified as independent predictors of clinical pregnancy rate via multivariate logistic regression. The high DFI group had significantly lower fertilization, pregnancy, and live birth rates than the low DFI group, while the high MMP group demonstrated superior outcomes across all metrics compared to the low MMP group. The low DFI/high MMP group achieved the best results, exhibiting significantly higher fertilization, pregnancy, and live birth rates than the high DFI/low MMP group. ROC curve analysis indicated that the combination of DFI and MMP provided greater predictive power for clinical pregnancy (AUC = 0.771) than DFI (AUC = 0.643) or MMP (AUC = 0.651) alone.ConclusionSperm DFI and MMP are confirmed as independent and clinically significant predictors of clinical pregnancy in asthenozoospermic patients undergoing IVF treatment. The combined assessment of DFI and MMP offers superior predictive utility for IVF pregnancy outcomes compared to the assessment of either marker alone. These findings underscore the critical role of these sperm quality parameters in assessing reproductive potential and suggest significant clinical utility for guiding patient management and optimizing treatment strategies in assisted reproductive technologies.

Alcohol use disorder is closely related to genetic and environmental factors. However, the contribution of coding variation to alcohol use disorder susceptibility remains poorly understood. We aimed to identify genetic mutations in alcohol use disorder by whole exon sequencing. We performed whole-exome sequencing in 83 patients with alcohol use disorder and compared it with exome sequences of healthy controls that were collected from the 1000 Genomes Project. GO and KEGG enrichment analysis and protein interaction analysis were performed for the mutated genes in each group. Three online protein function prediction sites were used to predict whether SNPs/InDels cause protein coding changes. Further, we conducted a rare variant exploration. We identified 106 525 SNV and 19 826 InDel gene mutations in alcohol use disorder. In the healthy and alcohol use disorder groups, mutations in CNTNAP3, ZNF683, ALDPH2, CCHCR1, ZNF45 and ESRRA loci were found to be deleterious mutations in all three sites; CNTNAP3, ZNF683, ALDPH2, CCHCR1, ZNF45 and ESRRA may be potential targets for future precision treatment of alcohol use disorders, and further provide new ideas for drug development.

为了提高学生未来的竞争力,并更好的融入社会,教育部将"核心素养"置于深化课程改革、落实立德树人目标的基础地位."核心素养"指学生应具备的适应终身发展和社会发展需要的必备品格和关键能力,突出强调个人修养、社会关爱、家国情怀,更加注重自主发展、合作参与、创新实践.医学院校是培养未来医生的场所,所以我们有责任对他们进行专业技能培养和医德教育以促进未来医疗事业的发展.本研究基于《中国学生发展核心素养》的五级指标对研究结果进行评价.

Objective To explore the mechanisms of Rg3 in restraining the metastasis and reversing muhidrug resistance of Lovo/5-Fu colorectal carcinoma cells.Methods MTT was applied to determine the chemosensitivity of Lovo/5-Fu to cisplatin;cell invasion assay was used to measure the invasion change of Rg3 to cells;cell membrane lipid fluidity was determined to observe the effects of Rg3 on cells,and the protein expression of nm23,caspase-8 and LRP was tested by Western blot.Results After the treatment of Rg3,Lovo/5-Fu cells had increased sensibility to 5-Fu (P ＜ 0.05),cell membrane lipid fluidity (P ＜ 0.05) as well as invasion ability (P ＜0.05) was reduced.Expressions of caspase-8 and nm23 were markedly increased,but the resistance related protein LRP had no significant change.Conclusion Rg3 can inhibit the invasion and metastasis of Lovo/5-Fu cells by uprngulating the expression of nm23,and decrease the cell membrane lipid fluidity to reverse the drug resistance which is closely associated with the enhanced caspase-8.

Objective To explore the effect of EZH2 overexpression on acquired drug resistance in MCF-7 cells.Methods The relative expressions of EZH2 mRNA and protein of MCF-7 and MCF-7/ADR were detected respectively by real time fluorescence quantitative PCR ( RTFQPCR)and Western -blot.After EZH2 shRNA and EZH2 shRNA-scramble plasmid vectors with reporter gene EGFP were transfected into MCF -7/ADR cells,the stable cell line was screened by G4l8.RTFQPCR was used to validate whether the EZH 2 mRNA in EZH2 shRNA group was supressed.The differences of the effect of adriamycin on cell proliferation were evaluated among EZH2 shRNA goup,EZH2 shRNA-scramble group and negative control groups using WST-1 assays. Results The EZH2 mRNA and protein expression levels in MCF-7/ADR cells were 2.52 ±1.523 and 1.58 ± 0.58 folds of those in MCF-7cells.The differences were significant(P<0.05).After the EZH2 shRNA plasmid was stably expressed in MCF-7/ADR cells,the expressions of EZH2 mRNA were decreased by 84%(P<0.05) and the cell proliferation was decreased by 25%after adriamycin(P<0.05),However there were no significant changes of cell proliferation in EZH2 shRNA-scramble group and negative control groups after adriamycin .Con-clusion EZH2 was overexpressed in MCF-7 /ADR cells compared with MCF-7 cells.Silencing EZH2 may ef-fectively reverse the resistance of MCF-7/ADR cells to adriamycin.

目的探讨肺耐药蛋白(LRP)、P-糖蛋白(P-gp)和谷胱甘肽S-转移酶-π(GST-π)在肺腺癌组织中的表达及其与患者各项临床特征之间的关系。方法回顾分析128例原发性肺腺癌患者资料,采用免疫组织化学S-P技术检测不同腺癌细胞中LRP、P-gp、GST-π的表达,将检测结果进行分类统计分析。整理患者生存资料,生存患者定期电话随访,统计分析各蛋白表达与生存时间的关系。结果相比癌旁组织,肺腺癌组织中LRP、P-gp、GST-π蛋白的表达率明显高于癌旁组织中相应蛋白的表达率(GST-π:71.09%vs 14.06%;P-gp:57.81%vs 19.53%;LRP:50.78%vs17.19%)(均P<0.000 1)。随着肺腺癌分化程度由高到低,P-gp、LRP蛋白表达的阳性率相应增高,而GST-π阳性率降低。128例患者中可获取生存资料121例,结果显示LRP表达阳性患者的术后1、2、3年生存率(81.7%、60.6%、43.7%)明显低于阴性组患者(84.3%、72.5%、62.7%)(χ2=4.14,P<0.05)。P-gp、GST-π表达阳性患者的术后1、2、3年生存率低于阴性组患者,但差别无统计学意义(P>0.05)。结论 P-gp、LRP和GST-π在肺腺癌组织中的表达明显高于癌旁组织,与肺癌的分化程度密切相关。LRP表达阳性患者3年生存率较阴性患者低。联合检测P-gp、LRP和GST-π有助于对预后的判断。

目的:探讨不同肺癌细胞株中谷胱甘肽转移酶（GST-π）、P-糖蛋白（P-gp）、肺耐药蛋白（lung re-sistance protein,LRP）的mRNA表达差异及对多西他赛化疗敏感性的预测价值。方法:采用RT-PCR技术检测ANIP973细胞株、A549细胞株,A2细胞株中GST-π、P-gp、LRP蛋白mRNA的表达,结合多西他赛体外药物敏感实验,分析GST-π、P-gp、LRP的mRNA表达水平与多西他赛化疗敏感的相关性。结果:在肺癌细胞株中,P-gp、LRP、GST-π在腺癌细胞株中表达高于鳞癌细胞株,从高到低依次为ANIP973、A549、A2细胞株,差异有统计学意义。多西他赛药敏试验显示细胞株生存曲线受药物抑制由大到小为A2、A549、ANIP973细胞株。多西他赛IC50均值从高至低依次为ANIP973、A549、A2细胞株。经单向方差分析不同细胞株之间IC50差异显著（F=29.636,P=0.000）。3种肺癌细胞株中多西他赛IC50与GST-π（rs=0.626,P=0.001）、P-gp（rs=0.453,P=0.027）、LRP（rs=0.398,P=0.045）表达水平呈正相关,且与GST-π关系最密切（rs＞0.5）。结论:检测肺癌细胞中GST-π、P-gp、LRP各蛋白mRNA表达水平对多西他赛化疗敏感性具有一定预测价值,联合检测三者可能对临床判断化疗效果以及合理选择化疗药物具有指导作用。

The morbidity and mortality of lung cancer is currently the highest in all the malignant tumors.Because of its higher specificity and milder side-effects,molecule target therapy in non-small cell lung cancer(NSCLC) is drawing concern at present.Recently clinical studies have found that EML4-ALK fusion gene is another important molecular target of tyrosine kinase inhibitors in addition to EGFR mutations and KRAS mutations.The fusion gene has higher morbidity in NSCLC patients who are young,never or light smoking history,adenocarcinomas,without EGFR and KRAS mutation.Although patients who harbor this mutation do not benefit from EGFR TKIs,they have shown good response to ALK inhibitor(for example: Crizotinib).Clinical trials about the drug have shown: the overall response rate was 57%(with 46 confirmed partial responses and 1 confirmed complete response),and the estimated probability of 6-month progression-free survival was 72%,grade 1 or 2 mild gastrointestinal effects are the common side effects.Discovery of the gene and the drug may bring new hope for the patients with NSCLC.

Objective: To investigate the expression of PTEN and MDM2 in transitional non-small cell lung cancer(NSCLC).Methods: The expressions of PTEN and MDM2 were determined by immunohistochemical method in 56 cases of primary lung cancer and 20 case of normal lung tissue.Results: The expression of PTEN in 56 cases of lung carcinoma was 48.21% while which was 95% in 20 cases of normal lung tissues(p0.05).The expression of PTEN was related to the degree of cell differentiation,clinical stage and lymph node metastasis.The expression of MDM2 in 56 cases of pulmonary carcinoma was 53.57%,while which was10% in 20 cases of normal lung tissues(p0.05).The expression of MDM2 was related to the degree of tumor cell differentiationclinical stage and lymph node metastasis(p0.05).There was negative correlation between expression of the PTEN and MDM2 in NSCLC(p0.05).Conclusion:Abnormal expression of PTEN,MDM2 may play an important role in the malignant progression of NSCLC.

Objective: To detect the expressions of kiss-1 and distribution of MVD in non small cell lung cancer,to investigate their clinical significance and associativity.Methods: The expressions of kiss-1 and distribution of MVD were detected in 56 non small cell lung cancer by immunohistochemical SP method.Results: In non small cell lung cancer,express of kiss-1 is lower than control group(P0.05).Distribution of MVD is super than control group(P0.05).Kiss-1 is concerned with clinical stageand,metastasis of lymph nodes in NSCLC P0.05),and MVD is concerned with differentiated level and clinical stageand and metastasis of lymph nodes in NSCLC(P0.05).Distribution of MVD in the expression positive rate of kiss-1 is higher than that in the expression negative rate of kiss-1 in the tissue of NSCLC,they have negative correlation(P0.05,r=-0.363).Conclusions: Kiss-1 and MVD have important role in occurrence and progress of NCSCL.We can predict invasion,metastasis and prognosis of NSCLC by uniting detection kiss-1 and MVD.

肺癌病人出现血小板减少多考虑为化疗所致毒副作用;而免疫性血小板减少症为自身免疫性疾病,二者同时发生在一例患者身上相对少见,本文将哈尔滨医科大学附属第三医院曾诊治的肺癌合并免疫性血小板减少症一例报道如下.

目的 检测VEGF、Ki-67和P53在非小细胞肺癌(NSCLC)组织中的表达情况及临床意义.方法 采用免疫组化方法检测78例NSCLC组织中VEGF、Ki-67和P53的表达情况,并结合肺癌的临床病理特征进行分析.结果 VEGF在NSCLC中的阳性表达率为67%(52/78),Ki-67在NSCLC中的阳性表达率为71%(55/78),P53在NSCLC中的阳性表达率为50%(39/78),它们的表达情况均与肿瘤组织的分化程度及临床分期有关(P＜0.05),与肺癌的组织学分型、有无淋巴结转移及年龄无关(P＞0.05),肿瘤组织分化越差、临床分期越晚者三者表达的阳性率越高.VEGF、Ki-67和P53表达阳性者总生存时间明显差于阴性表达者(P＜0.05).结论 VEGF、Ki-67和P53与肺癌的发生、发展有关,对于判断非小细胞肺癌的预后及指导治疗有重要的参考意义.

目的 探讨氩氦靶向冷冻消融系统(氩氦刀)联合全身化疗治疗中晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)的可行性及疗效.方法 2005年11月-2009年3月,将我科收治的90例中晚期非小细胞肺癌患者随机分入三个治疗组,A组:氩氦刀手术联合全身化疗(31例);B组:单纯氩氦刀(29例);C组:单纯化疗(30例).观察患者治疗有效率、1年生存率及不良反应.结果 三组患者治疗后CEA值较治疗前均有所下降,但以氩氦刀手术联合化疗组(A组)下降最明显;治疗有效率为氩氦刀联合化疗组(A组)70.4%(19/27),单纯氩氦刀组(B组)55.2%(16/29),单纯化疗组(C组)42.9%(12/28),A、C两组比较有统计学意义(P＜0.05),1年生存率在氩氦刀联合化疗组(A组)为63.0%(17/27),单纯氩氦刀组(B组)为41.4%(12/29),单纯化疗组(C组)为46.4%(13/28),三组比较均无统计学意义(P＞0.05).三组患者治疗后不良反应均可耐受.结论 氩氦刀联合全身化疗在疗效方面明显优于单纯氩氦刀治疗和单纯全身化疗,且具有较好的耐受性,是治疗中晚期非小细胞肺癌值得推广的方法.

Objective:To investigate the expression of vascular endothelial growth factor(VEGF),P53,PCNA and microvascular density(MVD) in non-small cell lung cancer and normal lung tissue and their correlation on biological behaviors.Methods: Expression of VEGF,P53,PCNA and MVD were detected by immunohisto chemistry method in 62 cases of NSCLC,the relationship between such expression and clinicopathological features of NSCLC was also studied.Results: The positive immunostaining rate for VEGF was 58.1%(36/62),whose expression was associated with tumor differentiation(P0.05).The positive immunostaining rate for P53 was 46.8%(29/62),the expression of P53 was associated with tumor differentiation(P0.05).The positive immunostaining rate for PCNA was 61.0%(36/59),the expression of PCNA was associated with tumor differentiation(P0.05).The value of MVD was associated with tumor differentiation(P0.05).There were no relation to lymph node metastasis,TNM stage and pathological types of cancers.Conclusion: VEGF,PCNA,P53 and MVD play important roles in the development,progression,metastasis and prognosis of NSCLC.They may be new markers for prognosis of NSCLC.

The genetic impact of UGT2B17 gene copy number variation (CNV) on tobacco-smoking related cancers is of interest since this enzyme plays an important role in glucuronidation of 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL), a major metabolite from the nicotine-derived tobacco-specific nitrosamine, 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK). This is an important mechanism for NNK detoxification. The UGT2B17 gene varies in copy number from zero to two per individual in humans and this CNV was genotyped in 148 lung cancer and 92 control Chinese Han samples by a PCR-based method. The frequency of the UGT2B17 undeleted allele was higher in lung cancer patients than in controls but not significantly so ( p = 0.042, OR 1.6; 95% CI: 0.97–2.57); however, in smokers with lung cancer its frequency is significantly higher than in controls, ( p = 0.016, OR 1.8; 95% CI: 1.08–3.18). The undeleted allele was also significantly higher in the male lung cancer group ( p = 0.015, OR 1.86; 95% CI: 1.09–3.16), and even higher in the male smoker lung cancer group ( p = 0.004, OR 2.23; 95% CI: 1.27–3.89). In subsets of the male smoker lung cancer group defined by their histopathology, the undeleted allele was significantly higher in squamous cell carcinoma ( p = 0.026, OR 2.09; 95% CI: 1.06–4.10). These results show that UGT2B17 copy number is associated with male smoker lung cancer in China, especially squamous cell carcinoma.

Objective:To study the expression of DPC4(deleted in pancreatic carcinoma locus 4,DPC4) gene in non small cell lung carcinoma(NSCLC) as well as its relation with VEGF.Methods:The expression of DPC4 and VEGF was detected in 60 cases of pri-mary NSCLC and 10 adjacent normal lung tissues by using immunohistochemical SP methods.Results:Positive expression rate of DPC4 in primary lung cancer tissues was 63.3%(38/60),compared with the positive rate 90.0%(9/10) in adjacent normal lung tissues.And the DPC4 expression level apparently degraded compared with the normal tissues(P0.05).The positive expression of DPC4 had no correla-tion with age,sex,pathological type,TNM stage and cellular differentiation(P0.05),but it was closely associated with lymph node metastasis(P0.05).The positive expression rate(81.7%,49/60) of VEGF with NSCLC was significantly higher than that(20%,2/10) of normal lung tissue.The positive expression of VEGF had no correlation with age,sex,pathological type,but it was closely associated with TNM stage,cellular differentiation and lymph node metastasis.In 60 patients with NSCLC,the relationship between DPC4 and VEGF showed apparently negative correlation(r=-0.303,P0.05).Conclusion:The low expression of DPC4 could promote lymph node metastasis in NSCLC,while the high expression of VEGF could promote the course of the NSCLC's development and metastasis.

Objective:To compare the therapeutic effect and security of NF and TP plans.Methods:A total of 117 patients with advanced breast cancer proved pathologically were divided into NF and TP groups.TP group (66 cases)was received paclitaxel 135 mg/m iv drip d1,cisplatin 20 mg/m~2,iv drip d2-6,the treatment were repeated every 3 weeks.NF group (51 cases)received navelbine 25 mg/m~2,iv drip d1,8,capecitabine 2500 mg/m~2,twice a day,d2-14,the treatment were repeated every 3 weeks,All parents received two cycles of the treatment at least.Results:The total effective rate was 42.4% (28/66)in TP group,but 60.8% (31/51)in NF group,p<0.05. The median time of progression (TTP)was 7.7 months and the median survival time was 16.6 months in the TP group;in the NF group, the TTP was 10.3 months and the median survival time 22.1 months,p<0.05.Nausea was more serious in TP group than in NF group, p<0.05.There was no significant difference in the other side effects between the two groups.All side effects were tolerable.Conclusion: NF plan is still a firstly selected one for patients with advanced breast cancer.

Objective:To study the clinical effect of ibandronate combined with chemotherapy on the treatment of malignant bone metastases.Methods:60 patients were randomized into two groups:30 patients in chemotherapy group receiving normal chemotherapy, 30 patients in combination group treated with both chemotherapy and ibandronate.The effects were evaluated when two cycles were fin- ished.Results:The overall response rate of bone metastases in chemotherapy group and combination group was 23.3% and 50% respec- tively.The overall response rate of pain relief in chemotherapy group and combination group was 53.3% and 83.3% respectively.Conclu- sion:Ibandronate combined chemotherapy significantly increased therapeutic effect,and improved physical state of patients,accompa- nied with mild side-effect.

目的 观察恶件肿瘤骨转移患者应用伊班膦酸钠治疗后的病灶及临床症状缓解情况.方法 采用开放、无对照的研究方法,48例患者第一周期连续静脉滴注3 d伊班膦酸钠6 mg,以后6mg/4周一次.结果 骨转移病灶总有效率为47.92%;骨痛在第3、14天及2周期后的总有效率分别为68.75%、79.17%、72.92%,表现为波峰趋势,但无统计学意义(P>0.05),治疗后高钙血症恢复正常,活动能力明显改善.结论 负荷剂量伊班膦酸钠可以快速缓解疼痛,效果稳定,患者不良反应轻,可显著改善患者的生存质量.

Objective:To study the expression of VEGF and p53 proteins in non small cell lung cancer(NSCLC)and the relation- ship with biological behavior of NSCLC.Methods:Expression of the VEGF and p53 proteins was evaluated by immunohistochemical polymer detection systemmethod in 62 cases of non small cell lung cancer.Results:The positive expression rate of VEGF was 58.1% (36/62)in 62 cases of non small cell lung cancer,which is related to histological differentiation and surviving time (P0.05).There was no significant correlation between VEGF and pathological type,lymph node metastases status and clinical stage(P0.05).The positive expression rate of p53 was 46.8%(29/62) in this study,which has no correlation between p53 and pathological type clinical stage and lymph node metastases status(P0.05).Conclusions:Determining VEGF and p53 protein expressions simultaneously may play an im- portant role in judgment of prognosis of non small cell lung cancer,p53 mutation can be reflected indirectly by immunohistochemical polymer detection system method.Our study shows that the positive expression rate of p53 is 46.8%.That is to say,1/2 cases of lung can- cer have lost the function of restraining cancer,which shows that the mutation of p53 may be related to the development of NSCLC.Both p53 and VEGF new markers of tumor phenotype.Simultaneous detecting p53 and VEGF become the main reference of pathological di- agnosis.Further study will likely clarify the molecular mechanism of tumor angiogenesis.It is also helpful to the development of anti-tu- mor medicines.