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With the change in environmental pollution and lifestyle， the incidence and mortality of cancer are increasing year by year， which is a serious threat to human life and health. Autophagy is a process in which eukaryotic cells use lysosomes to degrade cytoplasmic proteins and damaged organelles under the regulation of autophagy-related genes. It plays a dynamic inhibiting or promoting role in the occurrence and development of cancer and is involved in the regulation of tumor formation， proliferation， metastasis， and response to anticancer therapy. With the deepening of the research on the mechanism of cancer， a variety of cancer treatment methods have been established， such as chemotherapy， radiotherapy， surgery， immunotherapy， and gene therapy. Pharmacological or genetic inhibition of autophagy has been shown to enhance the lethal effect of various anticancer treatments on tumor cells， suggesting that inhibition of autophagy is an effective sensitization strategy in cancer therapy. Meanwhile， over-stimulation of autophagy may also provide a new method for the treatment of drug-resistant cancer cells with high apoptotic thresholds. As a treasure of Chinese culture， traditional Chinese medicine plays an important role in the adjuvant treatment of cancer with its advantages of multi-target， multi-pathway， and small side effects. In recent years， many positive results have been achieved in the study of natural autophagy regulatory factors of traditional Chinese medicine in cancer， and they have been widely verified in different autophagy regulatory models. This article outlines the mechanism of autophagy， summarizes the dual regulatory role of autophagy in tumor biology， and collects relevant studies published in the databases of China National Knowledge Infrastructure (CNKI） and Wanfang Data for nearly 10 years that affect the role of tumorigenesis and development by regulating autophagy. The article also collates autophagy rules of tumor cells induced by traditional Chinese medicine and its active ingredients， so as to provide a certain reference for the research on the development and application of anti-tumor drugs.
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As the pace of society increases and lifestyles change， the incidence and mortality rates of breast cancer continue to rise. Targeted therapies are now promising in the treatment of breast cancer， and a variety of protein targets have been identified to play an important role in the development of breast cancer. Among them， signal transducer and activator of transcription （STAT） proteins constitute a crucial group that serves as important targets for transducing cellular transcriptional information， which can regulate downstream cell proliferation， apoptosis， cell migration， invasion， angiogenic factors， etc. and then affect the progression of breast cancer. The STAT family is closely associated with the inflammatory response to tumors and plays a landmark role in tumor development as well as in diagnosis and prognosis. The "inflammation-cancer" transformation refers to the process in which the inflammatory microenvironment caused by uncontrolled inflammation promotes normal cells to become cancerous. According to the theory of Chinese medicine， "heat toxicity" in "cancer toxicity" corresponds to inflammation， which is closely related to tumor development. As a major link associated with the inflammatory response， the STAT family has a promising role in the development and treatment of a variety of tumors， but its relevance to breast cancer remains inadequately explored. Chinese medicine has been shown to have good efficacy in the prevention and treatment of breast cancer， and some current studies have shown that the active ingredients and compounds of Chinese medicine have certain intervention effects on breast cancer-related STAT proteins， but there has not been a systematic review. In order to better sort out and summarize the studies on the effects of Chinese herbal medicines based on the STAT family interventions in breast cancer， this paper reviewed the studies on Chinese herbal medicines acting on the STAT family in recent years， aiming to provide new ideas for clinical applications in breast cancer and to provide thoughts for the development of STAT protein-based drugs.
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Fibrosis refers to the disorder of repair response after tissue damage， which is mainly characterized by the increase of fibrous connective tissue and the decrease of parenchymal cells in organs. Progressive fibrosis can lead to the destruction of tissue structure and organ failure. Ferroptosis is a new type of programmed cell death， which is caused by the accumulation of iron dependent lipid peroxides and regulated by iron metabolism， iron autophagy， amino acid metabolism and lipid metabolism. Ferroptosis plays an important role in the pathological process of fibrosis， participating in many pathological processes such as organ parenchymal cell injury， macrophage inflammation， oxidative stress and myofibroblast transformation. Studies have shown that ferroptosis occurs in myofibroblasts during extracellular matrix deposition in the fibrous cascade reaction， and the targeted regulation of ferroptosis can effectively reduce chronic organ injury and tissue fibrosis. It has been confirmed that a variety of traditional Chinese medicine and its active components can regulate the ferroptosis parenchyma cells of organs and play an anti-fibrosis effect， showing a good research prospect. This article summarizes the role of ferroptosis in the pathological process of liver， lung， kidney and heart fibrosis and the intervention of related Chinese medicine， in order to provide a new target for Chinese medicine to prevent and treat fibrosis.
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Objective:To explore the research trends, research advances and future orientations in the field of inflammatory bowel disease (IBD), so as to inform future researches.Methods:Web of Science database was searched from 2000 to 2021. CiteSpace software was used for visual and quantitative analysis.Results:A total of 3 582 articles were included. Publications on nutrition science in IBD showed a rising trend. The United States ranked first according to number of publications by country, the University of Toronto ranked first by institution, Inflammatory Bowel Diseases ranked first by journal and Li J from Nanjing University was the very author with the highest number of relevant publications. Research hotspots mainly focused on risk, gut microbiota and pediatric population. Research fronts mainly focused on the gut microbiota. Conclusion:Visual analysis shows the research trend in the field of nutrition in IBD, with gut microbiota as the research hotspots in the future.
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Objective:To analyze the characteristics and hot spots of hospital management projects funded by National Natural Science Foundation of China(NSFC), for the reference for furthering improving the modernization level of hospital management.Methods:The NSFC funded research projects in hospital management during 2010-2020 was searched. Project name, keywords, approval year, affiliation and other informations were obtained. CiteSpace was used for bibliometric analysis of these research projects, while all the data acquired were subject to descriptive analysis and frequency analysis.Results:The number of hospital management projects funded by NSFC increased from 4 in 2010(0.93 million yuan) to 32(9.94 million yuan) in 2020, totaling 192 projects and 72.76 million yuan. These numbers consisted of 90 general projects(46.9%) and 79(41.1%) youth fund projects respectively. All the funded projects were distributed in sub-disciplines under the NSFC first-level discipline of macro management and policy, namely health management and policy(154) and medical/drug management and policy(38). The hotspots of the funded projects covered performance evaluation, payment method, public health system, health economics, hierarchical diagnosis and treatment, utility theory, regional medical alliance, essential medicine system, capitation and incentive strategy, and so on.Conclusions:Recent years are witnessing a rising trend in the number and grants of NSFC projects on hospital management. More and more funds are granted to universities, especially young researchers, and a hospital management research system has been initially taken shape. Hospital management in China should take into full account of the management characteristics and the status quo of the medical and health field, focus on performance appraisal incentive mechanism, hierarchical medical system, construction of medical alliances. and patient medical experience as well. In addition, the cooperation between hospitals and universities should be strengthened in order to promote the translation of research results.
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COVID-19, caused by SARS-COV-2, has the characteristics of world epidemic, highly infectious and large base of death. In China, transmission route of SARS-COV-2 has been contained so effectively that COVID-19 has been well controlled due to the proactive national prevention and control strategy. However, not only does it bring a huge impact on the existing medical structure model, but also an objective impact on the treatment of patients with chronic diseases such as malignant tumors. Based on the progress reported in the domestic and international literatures and the actual management experience of our team, this paper reflects on the treatment strategies for patients with gastrointestinal stromal tumor (GIST) during the epidemic period of COVID-19. We focus on risk stratification for primary GIST and forming treatment strategies accordingly. Major considerations include the impact of delayed operation, the burden of medical resources, the waiting time for elective operation, and the principle of emergency operation. In addition, we focus on the level of evidence for non-surgical approaches with a view to developing a holistic strategy of "priority management principles" to guide clinical treatment in the context of limited resources and different GIST priorities.
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Humans , COVID-19 , China , Gastrointestinal Stromal Tumors , SARS-CoV-2ABSTRACT
Objective To analyze of the efficacy of minimally invasive surgery combined with medication in the treatment of ureteral calculi.Methods From June 2013 to June 2015,124 patients with ureteral calculi which confirmed by X-ray in our hospital were collected as subjects.According to the treatment method,they were divided into control group and observation group,patients in the control group were treated with simple medication,while the observation group were treated with minimally invasive surgery combined with drug therapy.The effects of treatment and the levels of MCP-1,TFF1 and HMGB1 in urine between two groups were compared.Results The stone expulsion rate and the net rate of the observation group was higher than those of the control group,the differences were significant(P<0.05).The stone expulsion time of observation group was shorter than that of the control group,the formation rate of the observation group was lower than that of the control group,the differences were significant(P<0.05).Adverse reactions occurred in 11 cases of the observation group,in 29 cases of the control group,the incidence of adverse reactions in the observation group was lower than that in the control group,the difference was significant(P<0.05).After the treatment,17 cases of adverse drug reactions occurred in the observation group,which was more than 5 cases of adverse drug reactions in the control group,the difference was significant(P<0.05).After treatment,the levels of MCP-1 and HMGB1 in urine of two groups were decreased compared with those before treatment,the level of TFF1 was increased,the differences were significant(P<0.05);while the levels of MCP-1 and HMGB1 of the observation group after treatment were lower than those of the control group,the level of TFF1 was higher than that of the control group,the difference was significant(P<0.05).The effective rate of the observation group was 88.71％,which higher than 69.35％ of the control group,the difference was significant(P<0.05).Conclusion On the basis of medication,combined with extracorporeal shock wave lithotripsy for ureteral calculi can not only improve the therapeutic effect,but also reduce the risk of adverse reactions.
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Objective To identify the threshold of percentage of body fat (BF％) associated with diabetes mellitus,hypertension and dyslipidemia in an elderly Chinese population.Methods An individual was considered as a subject if they exhibited any one of the three cardiovascular disease risk factors:diabetes mellitus,hypertension or dyslipidemia.A total of 1 140 subjects were recruited from the Physical Examination Center of Tianjin Hospital,China (male 511,female 629,aged ≥60 years).Questionnaire interview,physical examination,body composition measurement,blood biochemistry measurement,muscle strength measurement and other measurements were performed for each subject.Receiver operating curves (ROC) were created to determine the optimal percentage of body fat cutoff points,with the presence of diabetes mellitus,hypertension or dyslipidemia as outcome variable.Results The percentage of subjects with at least one of the following conditions (diabetes mellitus,hypertension or dyslipidemia) was 62.8％ for men and 73.9％ for women.Increased percentage of body fat was associated with an increased occurrence of diabetes mellitus,hypertension or dyslipidemia in the elderly,particularly among women.The ROC curve shows that the threshold of fat percentage in men and women was 28.2％ and 36.6％,respectively.Conclusion The risks of diabetes,hypertension and dyslipidemia is closely related to elevated body fat mass in the elderly.The percentage of body fat mass is an important indicator of obesity,threshold of BF ％ can provide reference for clinical obesity intervention in elderly patients.It also can provide reference for the treatment and prevention of cardiovascular disease.
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Objective To measure the tear film lipid layer thickness (LLT) in dry eye patients and investigate the correlations of LLT with ocular surface signs.Methods One hundred and thirty dry eye patients (130 eyes),including 64 meibomian gland dysfunction (MGD) patients and 66 non-MGD patients,were included in this study.LLT,break-up time (BUT),fluorescein staining (FL),Marx's line (ML) score and Schirmer I test were performed and examined.The distribution of LLT in different age groups and the correlations between LLT and other examinations were analyzed.Results There was significant difference in LLT among different age groups (P =0.007),while LLT was not significantly different between male and female in each age group (P ＞ 0.05).LLT was positively correlated with age (r =0.334,P ＜ 0.001) and was not correlated with sex (r =0.107,P =0.226).LLT was positively correlated with upper eyelid ML score (r =0.295,P =0.001) and lower eyelid ML score (r =0.233,P =0.008).There was no significant correlation of LLT with BUT,FL or Schirmer Ⅰ test (all P ＞0.05).In the MGD group,there were positive correlations of LLT with upper eyelid ML score and lower eyelid ML score (all r =0.306,P =0.014),and no correlation of LLT with other examinations (all P ＞ 0.05).In the non-MGD group,there was no correlation of LLT with other examinations (all P ＞ 0.05).In a multivariate linear regression analysis,age and upper eyelid ML score were significantly related to LLT (β =0.254,P =0.005 for age and β =0.207,P =0.022 for upper eyelid ML score) in all dry eye patients.Age was the only factor related to LLT (β =0.382,P =0.002) in the MGD group.Upper eyelid ML score and lower eyelid ML score were higher in the MGD group than the non-MGD subgroup (all P ＜ 0.001).Conclusion LLT is positively correlated with age and ML score in dry eye patients.The measurement of tear film LLT,as an auxiliary examination in the diagnosis of dry eye disease,should be analyzed with the influential factors including age.
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Mental retardation is defined by significant limitations in intellectual function and adaptive behavior that occur before 18 years of age. Many chromosomal diseases come with mental retardation. We reported two Chinese families with partial trisomy 9p and other chromosome partial monosomy, clinical features of mental retardation and mild facial and pinkie anomalies. In the family 1, we showed that the proband carried a trisomy 9p21.3→pter and monosomy 21q22.3→qter by using fluorescence in situ hybridization analysis. Molecular genetic analysis defined the precise breakpoint on chromosome 9p between markers D9S1846 and D9S171, an interval of about 2.9 Mb on 9p21.3, and the breakpoint on chromosome 21q between markers D21S1897 and D21S1446, a region of about 1.5 Mb on 21q22.3. In the family 2, a patient with trisomy 9p21.3→pter and monosomy 5p15.33→pter, and a de novo maternal balanced translocation between chromosomes 5 and 9 was identified in his mother. Cytogenetic and molecular genetic analysis defined the precise breakpoints on chromosome 9p21.3 and chromosome 5p15.33. Further clinical investigation found that any individual had no refractoriness eczema disease except the proband in this family. These results further implicate that trisomy 9p is associated with mental retardation, and that there may be key gene duplication on chromosome 9p21.3→9pter responsible for mental retardation and mild facial anomaly. This result has been applied successfully in prenatal diagnosis of the second family.