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Objective To observe the methylation status of the promoter region of the tumor suppressor gene PDCD4 in gastric cancer tissues and its effect on the expression level of PDCD4, and to explore its clinical significance. Methods The protein expression of PDCD4 in gastric cancer tissues was detected by immunohistochemistry (IHC) and Western blot; the mRNA expression of PDCD4 was detected by RT-PCR; the methylation level of PDCD4 promoter region was detected by MSP. The correlation between PDCD4 expression, promoter methylation level and clinicopathological characteristics of gastric cancer patients was analyzed. Results The expression levels of PDCD4 protein and mRNA in gastric cancer tissues were significantly decreased (P < 0.05), and the methylation of PDCD4 was significantly enhanced (P < 0.05). Deficiency of PDCD4 protein expression is closely correlated with the differentiation, clinical stage and lymph node metastasis of gastric cancer (P < 0.05); hypermethylation of PDCD4 is closely correlated with lymph node metastasis and clinical stage of gastric cancer (P < 0.05). The methylation level of PDCD4 was negatively correlated with the protein and mRNA expression levels of PDCD4 (P < 0.05). Conclusion The expression of PDCD4 in gastric cancer tissues is significantly decreased and correlated with the development of gastric cancer. Hypermethylation of CpG island in promoter region may be the reason for the deficiency of PDCD4 expression.

Background: High expression of programmed death ligand‐1 (PD‐L1) has been related to good response to immunotherapy patients with gastric cancer (GC). However, the influence of Helicobacter pylori (HP) infection on PD‐L1 expression in GC remains unknown. A meta‐analysis was performed to evaluate the association between HP infection and PD‐L1 expression in GC. Methods: Observational studies that investigated the relationship between HP infection and PD‐L1 expression in patients with GC were obtained by search electronic databases, including PubMed, Embase, Cochrane's Library and Web of Science. A random‐effect model incorporating the possible influence of between‐study heterogeneity was used to pool the results. Results: Ten studies with 1870 patients with GC contributed to the meta‐analysis. Pooled results showed that HP infection was significantly associated with the tumour expression of PD‐L1 (odds ratio [OR]: 1.90, 95% confidence interval: 1.33–2.72, p <.001; I2 = 53%). Subgroup analyses showed that the association between HP infection and PD‐L1 expression in GC was not significantly affected by sample size, methods for PD‐L1 evaluation and quality score (p for subgroup analyses all >.05). However, a stronger association was observed in studies with higher prevalence of HP infection (≥35%, OR: 2.58) as compared with those with lower prevalence (<35%, OR: 1.45, p for subgroup difference =.04). Conclusion: Helicobacter pylori infection in GC patients is associated with tumour expression of PD‐L1, suggesting HP infection may be a predictor of good response to immunotherapy in GC. [ABSTRACT FROM AUTHOR]

Introduction and Objective: Hemolytic anemia can be associated with various types of solid tumors; however, in hepatocarcinoma, it is extremely rare. Case Summary: Man 74 years old. Symptoms of two months with dyspnea, asthenia and adynamia. On physical examination, generalized pale skin and sclera, normal heart and lung area, soft, depressible abdomen, with peristalsis present, palpation of the liver edge 5 cm below the costal margin. Laboratories with leukocytes 6.1 103/Al, neutrophils #4.1, lymphocytes #1.3, HB 6.2 g/dL, HTC 16.8%, MCV 103fL, HCM 38pg, platelets 395.00 103/Al; BD 0.5 mg/dL, BI 2.80 mg/dL, BT 3.30 mg/dL, DHL 403 IU/L. Direct Coombs is performed positive dilution 1:128. FSP with anisocytosis, red blood cell agglutination, macrocytosis and macroplatelets, reticulocytes 1.48%, alpha-fetoprotein 12.7 IU/mL. Warm antibodies (IgG) attached to the erythrocyte membrane were documented. Simple and contrast-enhanced abdominopelvic tomography, with images suggestive of multifocal cellular hepatocarcinoma. Liver biopsy, which reports findings of hepatocarcinoma. Management with oral steroid drugs was initiated jointly, reversing the hematological alterations without requiring blood products. Discussion: There are few cases in the medical literature on hematological alterations associated with solid tumor metastases. In this case, the hematological involvement of the patient was not due to metastasis but to a paraneoplastic syndrome since the first manifestation found was anemia with jaundice secondary to hemolysis. Conclusion: The diagnosis must be reached by exclusion, ruling out other causes such as primary hematological alterations, metastases, or vascular processes. Funding: The resources used in this study were from the hospital without any additional financing Declaration of interest: The authors declare no potential conflicts of interest.

Objective. To treat children with acute nonsuppurative otitis media induced by acute upper respiratory tract infection of varying severity and evaluate its therapeutic effects. Materials and Methods. Patients from the emergency department with acute nonsuppurative otitis media were followed up between September 2015 and December 2018. A total of 420 patients were classified into grades I to III according to tympanic membrane intactness and systemic reactions and treated according to grading. Results. Grade I patients showed no significant difference in the recovery of acute symptoms whether antibiotics are used or not. Grade II patients, after 3 months of follow-up, showed no tympanic membrane perforation, and 9 cases of binaural B-type children did not improve but were cured by operation. In grade III patients, after treatment for 4 hours in the experimental group 3, the earache subsided, 1 case had tympanic membrane perforation, and the patients recovered after 2 weeks (64/92) and after 3 months (28/92) of drug treatment. After treatment for 4 h in the control group 3, the earache eased, and 3 patients developed tympanic membrane perforation and were treated for 3 months. 4 binaural B-type children did not improve but recovered after surgical treatment. Conclusion. Grade I patients could be closely followed up by clinical observation. For anti-inflammatory patients with grade II disease, treatment has therapeutic significance. For patients with grade III, some patients still have TMP, but the use of cephalosporin third-generation drugs plus an appropriate amount of hormone therapy is effective in reducing symptoms and tympanic local reactions.

Proliferation and apoptosis are diametrically opposite processes. Expression of certain genes like c-Myc, however, can induce both, pointing to a possible linkage between them. Developing CD4+CD8+ thymocytes are intrinsically sensitive to apoptosis, but the molecular basis is not known. We have found that these noncycling cells surprisingly express many cell cycle proteins. We generated transgenic mice expressing a CDK2 kinase-dead (CDK2-DN) protein in the T cell compartment. Analysis of these mice showed that the CDK2-DN protein acts as a dominant negative mutant in mature T cells as expected, but surprisingly, it acts as a dominant active protein in CD4+CD8+ thymocytes. The levels of CDK2 kinase activity, cyclin E, cyclin A, and other cell cycle proteins in transgenic CD4+CD8+ thymocytes are increased. Concurrently, caspase levels are elevated, and apoptosis is significantly enhanced in vitro and in vivo. E2F-1, the unique E2F member capable of inducing apoptosis when overexpressed, is specifically up-regulated in transgenic CD4+CD8+ thymocytes but not in other T cell populations. These results demonstrate that the cell cycle and apoptotic machineries are normally linked, and expression of cell cycle proteins in developing T cells contributes to their inherent isensitivity to apoptosis. [ABSTRACT FROM AUTHOR]

Purpose/objectives: Care and case management (CCM) aims to provide optimal care for patients and their caregivers on an individual and superordinate level of health care providers and authorities. To facilitate a clear and systematic CCM process as part of a clinical study intervention, a semistructured manual is the prerequisite., Primary Practice Settings: The ongoing COCOS-MS (Communication, Coordination and Security for People with Multiple Sclerosis) study is a randomized controlled Phase II clinical intervention study. The CCM manual is being tested on the intervention group consisting of severely affected individuals with multiple sclerosis (MS; Expanded Disability Status Scale [EDSS] >5) and their caregivers receiving CCM for 12 months in addition to standard care. The intervention comprises monthly personal visits and weekly telephone calls during which the CCM manual is applied., Findings/conclusions: The CCM manual has been developed on the basis of previous literature and well-established questionnaires following theoretical aspects and prior scientific work covering individual domains of life of people with MS. Within the COCOS-MS study, its feasibility is being tested meticulously. It allows for a standardized assessment while being tailored to the individual. At the end of the intervention period, it will be analyzed statistically and qualitatively. Consequently, conclusions can be drawn as to whether the CCM manual is feasible or has to be adapted for use in standard care after analyzation., Implications for Case Management Practice: The CCM manual serves as a tool for the continuous, long-term, cross-sectoral care for patients suffering from severe MS and their caregivers. The manual provides guidance in adequately addressing patients' complex symptoms, problems, and needs, as well as assessing existing resources both at the individual patient level and at a superordinate level., Competing Interests: The authors report no conflicts of interest., (Copyright © 2022 The Authors. Published by Wolters Kluwer Health, Inc.)

Water availability is the key factor limiting plant growth in arid regions. Populus simonii is a typical shelterbelt tree species in Zhangbei County, Hebei Province, with an important role in constructing ecological barrier. With stable isotope technique, graphical method, and multiple linear mixing model, we analyzed water sources and water use strategies of P. simonii in different growth periods with four different degrees of degradation (non-degraded, slightly degraded, modera-tely degraded and severely degraded) in Zhangbei County. Results would help improve our understanding on the cause and mechanism of the large-scale degradation of P. simonii in this area. The results showed that water sources of P. simonii in the early growth stage (May-June) from all four degradation degrees were relatively simple. P. simonii mainly used soil water in 0-40 cm, with the utilization rates being 34.2%, 50.1%, 41.6%, and 55.7% for the four degradation degrees, respectively. At the middle growth stage (July-August), non-degraded P. simonii utilized soil water from layers of 200-280 cm and 280-400 cm, with utilization rates of 20.2% and 30.9%, respectively. Soil water at 200-280 cm and 280-400 cm layers was utilized by slightly degraded poplar, with the contribution rates of each layer being 33.2% and 27.9%, respectively. Moderately degraded P. simonii utilized soil water from the depths of 0-40 cm and 40-120 cm, with the rates of 30% and 26.9%, respectively. Water utilization rate of severely degraded P. simonii to 0-40 cm depth was 55.4%. At the late growth stage (September-October), water sources of non-degraded P. simonii transferred to the upper-middle soil layers, with the utilization rate of 0-40 cm, 40-80 cm, and 80-120 cm being 23.3%, 17.2%, and 16.5%, respectively. The utilization rate of the slightly degraded P. simonii was 35.7% at 0-40 cm and 20.6% at 80-200 cm. The moderately and severely degraded P. simonii mainly utilized soil water at 0-40 cm layer, with the contribution rates of soil water being 43.7% and 51.8%, respectively. With the exacerbation of degradation, the main water source of P. simonii gradually transferred from deep to surface soil water.