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@#Tumor immunotherapy is a therapeutic modality that uses immunological principles and methods to activate and enhance the body''s immune system to generate immune response for the removal of tumour cells. Many new immunotherapeutic agents have demonstrated effective anti-tumour capabilities, yet their clinical use is challenging due to the complex mechanisms of tumour immune escape. Meanwhile, these drugs would accumulate in different tissues and organs in the human body and be unable to achieve precise and specific targeting therapeutic effects, resulting in serious immune-related adverse effects, which greatly hinders the clinical potential of immunotherapy.Nanodrug delivery systems can deliver immunotherapeutic drugs to target tissues or specific immune cells precisely, thereby enhancing immune effects and reducing side effects.This paper reviews the research progress of nanodrug delivery systems in tumour immunotherapy in recent years based on the regulatory mechanism of the anti-tumour immune response, with a prospect of the challenges and development in this field.
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Objective:To investigate the clinical characteristics and perinatal outcomes of pregnancy with placental cystic lesions.Methods:A retrospective study was carried out on 48 pregnant women diagnosed as pregnancy complicated with placental cystic lesions from January 2000 to January 2020 at the Women′s Hospital, Zhejiang University School of Medicine. The clinical features, pathological diagnosis and perinatal outcome were analyzed.Results:The age of 48 cases was (30±5) years, and the diagnostic gestational week of ultrasound was (24±8) weeks. Twenty-five cases in which showed a cystic mass at the fetal surface were diagnosed as placental cyst. The live birth rate was 100% (25/25) and the premature birth rate was 20% (5/25). Twenty-three cases showed “honeycomb like” cystic echo. Cystic lesions of 10 cases were located in the uterine cavity connected with the margin of the normal placenta, and finally diagnosed as hydatidiform mole and coexisting fetus (HMCF). Six cases of HMCF terminated pregnancy, and the live birth rate was 4/10, the premature delivery rate was 2/4. Cystic lesions of 13 cases were located in the placenta substance, and finally diagnosed as 4 cases of placental mesenchymal dysplasia (PMD) and 9 cases of focal chorionic edema; the live birth rate was 6/13 and the premature delivery rate was 4/6. The median hCG was lower in focal chorionic edema group [80 kU/L (60-110 kU/L)] than in the groups of HMCF [240 kU/L (180-430 kU/L)] and PMD [360 kU/L (210-700 kU/L)], and the differences were statistically significant (all P<0.01). Conclusions:For pregnancy complicated with placental cystic lesions, prenatal ultrasound should be performed to evaluate the shape, location and blood flow of the lesions. Maternal serological examination and invasive prenatal diagnosis are helpful for prenatal diagnosis and treatment. Due to the difference of perinatal outcomes, maternal and fetal complications, individualized pregnancy management should be carried out.
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In last few years, therapeutic peptides/proteins are rapidly growing in drug market considering their higher efficiency and lower toxicity than chemical drugs. However, the administration of therapeutic peptides/proteins is mainly limited in parenteral approach. Oral therapy which was hampered by harsh gastrointestinal environment and poorly penetrating epithelial barriers often results in low bioavailability (less than 1%-2%). Therefore, delivery systems that are rationally designed to overcome these challenges in gastrointestinal tract and ameliorate the oral bioavailability of therapeutic peptides/proteins are seriously promising. In this review, we summarized various multifunctional delivery systems, including lipid-based particles, polysaccharide-based particles, inorganic particles, and synthetic multifunctional particles that achieved effective oral delivery of therapeutic peptides/proteins.
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Objective To investigate the clinical features, diagnosis and treatments of heterotopic pregnancy(HP)and demonstrate the outcomes of HP after the surgical treatment of ectopic pregnancies. Methods A retrospective analysis was performed on 144 cases of HP in Women′s Hospital, School of Medicine, Zhejiang University from January 2003 to December 2016. Results (1)Clinical features of HP:the average age of patients was(30.8±3.8)years old, body mass index(BMI)was(21.9±2.9)kg/m2, and was diagnosed at(6.5±1.3)weeks gestational age. Four patients(2.8%)were naturally pregnant, 10 patients (6.9%)received ovulation induction, and 130 patients(90.3%)had received infertility treatments. Fifty-one patients(35.4%)had no clinical symptoms, and 93 patients(64.6%)had clinical symptoms included vaginal hemorrhage, abdominal pain and hemorrhagic shock caused by intraperitoneal hemorrhage. The location of ectopic pregnancy was most common in the fallopian tubes(59.0%, 85/144)and the interstitial part (33.3%, 48/144). (2)Ectopic pregnancy treatment of HP: thirteen patients underwent expectation treatment, and the remaining 131 cases underwent surgical treatment, including laparoscopy(n=56), laprotomy(n=52), and fetal reduction (n=23). Among the 131 patients underwent surgery, intrauterine pregnancy were found inevitable abortion in 6 cases preoperatively. The total early abortion rate after surgery was 14.4%(18/125); the second operation rate was 3.1%(4/131).(3)Intrauterine pregnancy outcome of HP:120 intrauterine fetal were survival, the total live birth rate was 83.3%(120/144).One hundred and seven intrauterine fetal were survival after operation and the live birth rate after operation was 85.6%(107/125). Twenty-nine cases were premature delivery and the premature delivery rate was 24.2%(29/120). There was no significant differences between tubal HP and interstitial HP group in the preterm birth rate [25.8%(16/62) vs 26.3% (10/38); χ2=0.003, P>0.05]. Cesarean section rate of delivery in interstitial HP group was significantly higher than that in tubal HP group [97.4%(37/38)vs 59.7%(37/62)], and the difference was statistically significant(χ2=17.400, P<0.05). Conclusions The clinical manifestations of HP are diversified, combining of high risk factors, clinical symptoms and ultrasonography could improve the accuracy of diagnosis. Different method has been used to treat HP, such as laparoscopic or laparotomy and fetal reduction, and there are varying degrees of failure rate and postoperative abortion rate. We should consider carefully to adopt expectant management. Through individualized treatment, most HP could get good perinatal outcomes.
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Objective To investigate the traits of anxiety characteristics and its influencing factors in children with tic disorders ( TD) . Methods 31 children with tic disorders and 32 normal children were assessed by the screen for child anxiety related emotional disorders(SCARED), eysenck personality ques-tionnaire(EPQ) for child,attachment security scale and egma minnen av bardndosnauppforstran(EMBU).In-dependent sample t-test was used to compare the differences in anxiety disorders between the children of the two groups,and Pearson correlation and multivariate linear step-by-step regression analysis were used to ana-lyze the effects of personality traits,parent-child attachment and parental education on anxiety. Results So-matization/panic and separation anxiety in TD((6.20±5.33),(4.87±3.18)) were higher than those in con-trol group((3.75±3.34),(3.06±2.61);both P<0.05).There was positive correlation between somatization/panic and children's personality of introversion-extroversion(E),psychoticism(P),excessive interference mother,the mother refusal and denial,mother severely punishment(r=0.580,0.427,0.399,0.674,0.575,P<0.05 or P<0.01),and negative correlation between somatization/panic and mother closeness(r=-0.365,P<0.05).Generalized anxiety was positively correlated with E,P,lie,excessive interference mother,the mother refusal and denial,mother severely punishment(r=0.604,0.543,0.526,0.365,0.613,0.395,P<0.05 or P<0.01) . Separation anxiety was positively correlated with E, lie, the mother refusal and denial ( r=0. 440, 0.401,0.365,P<0.05).Social phobia was positively correlated with excessive interference mother,the mother refusal and denial (r=0.367,0.482,P<0.05 or P<0.01).School phobia was not only positively associated with E, N, P, excessive interference mother, the mother refusal and denial, mother severely punished ( r=0.635,0.449,0.526,0.463,0.541,0.589,P<0.05 or P<0.01),but also negatively correlated with mother closeness(r=-0.394,P<0.05).The mother refusal and denial affected on somatization/panic and social pho-bia(accounted for 45.4％,23.2％) ,the mother refusal and denial and lie affected on generalized anxiety( ac-counted for 51.0％) ,E affected on separation anxiety( accounted for 19.3％) ,E and mother severely punish-ment affected on school phobia( accounted for 50.0％) ,the mother refusal and denial and E affected on total anxiety( accounted for 49.4％) . Conclusions Somatization/panic and separation anxiety in children with tic disorder is higher than that in normal children.Anxiety disorder is mainly affected by fewer mother's encour-agement and tolerance,and children's extroversion.
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Objective To study and observe the application effect of debridement adhesive combined with comfeel silver ion dressing in the treatment of wound after the total cystectomy.Methods 90 patients with total cystectomy in Cixi People's Hospital from July 2014 to June 2016 were selected as the research object, and all the patients were randomly divided into control group 45 cases and observation group 45 cases, the control group were treated with conventional treatment of postoperative wound, the observation group were treated with debridement adhesive combined with comfeel silver ion dressing on the treatment of control group, then the infection rates, degree of edema and local comfort, life quality and local microcirculation state before and after the intervention of two groups were respectively analyzed and compared .Results The infection rates of observation group were higher than those of control group, the degree of edema and local comfort, life quality and local microcirculation state after the intervention were all significantly better than those of control group, the difference was all statistically significant ( P <0.05 ).Conclusion The application effect of debridement adhesive combined with comfeel silver ion dressing in the treatment of wound after the total cystectomy is better , and it has active role for the improvement of discomfortableness and microcirculation state.
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Objective To compare the difference between C-WISC and WISC-Ⅳ in the diagnosis of IQ in the children diagnosed with mental retardation(MR) or borderline intellectual funcition(BIF).Methods 80 children aged 6-16 years were enrolled in this study.All of them were diagnosed with MR or BIF based on the criteria of DSM-Ⅳ-R.Then,C-WISC and WISC-Ⅳ were used to measure the IQ.Results There was no significant difference in the scores of full IQ between C-WISC and WISC-Ⅳ in these children ((65.49±12.83) vs (64.86±10.10),t=-0.591,P＞0.05).The score of verbal intelligence quotient in the C-WISC was significantly lower than the corresponding score in the WISC-Ⅳ ((64.96± 13.14) vs (68.26 ± 10.99),t=3.029,P＜0.05).The score of performance intelligence quotient in the C-WISC was significantly higher than the corresponding score in the WISC-Ⅳ ((72.48±14.04) vs (69.35±11.75),t=-2.488,P＜0.05).The scores of similarities,coding,and block design in the C-WISC were significantly higher than the corresponding score in the WISC-Ⅳ (P＜0.05)).There was no significant difference in the scores of comprehension and digit span between the two methods (P＞0.05).There was also no significant difference in MR hierarchical diagnosis between the two methods (x2=0.427,P9＞0.05).Conclusion There is no significant difference between C-WISC and WISC-Ⅳ in the diagnosis of IQ in the children aged 6-16 years who were diagnosed with MR or BIF.Both C-WISC and WISC-Ⅳ can be used to diagnose the MR and marginal intelligence for the children aged 6-16 years.
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Central nervous system(CNS)diseases are serious threats to human health. Blood-brain barrier(BBB)plays an im?portant role in protecting the CNS. However,it also impedes the delivery of drugs to CNS and affects the treatment of CNS diseases. Brain targeted nano-drug delivery systems provide the possibility to brain-targeting drug delivery. In this article,we introduce the phys?iological structure and functions of BBB,and the brain targeting mechanism and the applications of brain-targeting nano-vectors to give a brief overview of the research status of brain targeting nano-drug delivery system.
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Objective To analyze the correlation of traditional Chinese medical constitution types withcardiovascular risk factors in community hypertension patients. Methods We defined the constitution types of 1108 community hypertension patients, created personal health archives and provided routine examination for the subjects. After that, we input and analyzed the relevant data and results by computer. Results In 1108 cases of hypertension patients, 229 (20.67%) were defined as harmony physique, 879 (79.33%) as biased physique. In patients with biased physique, phlegm-dampness physique accounted for 25.54% (283 cases) , and then came yin deficiency physique and Qi deficiency physique, which accounted for 15.16% (168 cases) and 13.18% (146 cases) , respectively. The biased physique was dominated by single biased physique with a total of 590 cases ( 67.12%) , but the complex physique was also in large quantity, with a total of 289 cases ( 32.88%) . The complex physique consisting of two kinds of single physique was commonly seen in the patients with complex physique, accounting for 15.70%. The complex physique consisting of more kinds of single physique had less percentage. Phlegm-dampness physique was a kind of physique involving the most cardiovascular risk factors. Patients with phlegm-dampness physique had higher incidence of overweight, abnormal lipid level, family history of cardiovascular disease, lack of physical exercise and electrocardiographic abnormality, and the difference was statistically significant compared with other physique types ( P<0.05 or P<0.01) . Conclusion Phlegm-dampness, yin deficiency and Qi deficiency physique are the three commonly-seen constitution types in hypertension patients. Phlegm-dampness physique is the most commonly-seen biased physique and is also a kind of physique involving the most cardiovascular risk factors. Prevention and management in consideration with the constitution characteristics and cardiovascular risk factors will be a new prospective method for the treatment of hypertension patients in community.
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Objective To study effects of palm pressing peripherally inserted untral catheter(PICC) and mandible-pressing-on-shoulder on PICC′s misplacement in jugular veins during intubation. Methods Seventy-six patients undergoing intubation with PICC were randomized into observation group and control group equally by random digital table. The palm pressing PICC method was used in the observation group and the mandible-pressing-on-shoulder method was used in the control group. The two groups were compared in terms of the incidence of PICC misplacement. Result The misplacement rate of PICC in the experiment group was significantly lower than that in control group (P<0.01). Conclusion Palm pressing method is much effective in prevention of PICC misplacement in jugular veins and worth promoting especially in hospitals of basic level.
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Objective To investigate the numbers of corpus luteum and ovarian follicles and compare the levels of serum prolactin (PRL), luteinizing hormone (LH), follicle-stimulating hormone (FSH) and estradiol (E2 ) in different phases of estrus cycle in female gerbils .Methods Consecutively taking vaginal smears of the gerbils and directly examined under light microscope to distinguish the four phases of the estrus cycle .Hematoxylin and eosin staining was used to histological examination of the gerbil ovaries , and to detect the levels of serum PRL , LH, FSH and E2 by ELISA assay during estrus cycle .Results The proportion of cornified vaginal exfolliated cells could be the basis to distinguish four phases respectively:proestrus, oestrus, metoestrus, and dioestrus.Moreover, there were no significant differences between the numbers of ovarian follicles in different phases of estrus cycle .The numbers of corpus luteum in preoestrus were significantly lower than that in the other phases of estrus cycle ( P <0.05 ) .The levels of serum PRL and LH were increasing constantly from preoestrus to dioestrus , and both reached a peak at dioestrus ( P<0.05 ) .The levels of serum FSH and E2 both peaked at preoestrus , and were significantly higher than those at oestrus , metoestrus and dioestrus ( P<0.05).Conclusions There are no significant differences between the numbers of ovarian follicles in different phases of estrus cycle .Gonadotropin , prolactin and estradiol paly important roles in the regulation of estrous cycle .The phases during which surges of FSH and E 2 occur in Mongolian gerbils are similar to those of rats and mice , while the PRL and LH are different .Our findings provide further reference to the study of reproductive physiology of Mongolian gerbils .
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Objective To summarize the nursing experience in prehospital first-aid of patients with cardiac traumas in order to improve the cooperation capability of prehospital first-aid. Methods The nursing cooperation of prehospital first-aid of 33 patients with cardiac trauma was analyzed retrospec-tively. Results 24 cases of them were rescued successfully, and were completely recovered without se-quelas. 4 cases complicated with severe multiple trauma, died after arriving at hospital, and 3 cases com-plicated with multiple trauma died of complications, while 2 cases with injury of thoracic aorta died during the surgery. Conclusions Early emergency treatment and judgment of traumatic condition could pro-vide valuable chance for inhospital first-aid.
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ObjectiveTo study the mastery, acquiring ways and need of studying the knowl-edge and skill of emergency treatment in non- medical junior college and technical secondary school students. MethodsThe survey was carried out in 600 non-medical junior college and technical sec-ondary school students to investigate their mastery and need of emergency knowledge, the results underwent analysis. ResultsThe mastery of the emergency knowledge was uneven in non- medical junior college and technical secondary school students. 100.0% of them can call 120 correcdy, 58.5% of them mastered the e-mergency treatment of carbon monoxide poisoning, and 25.0% mastered cardiac pulmonary resuscitation. All the students desired to hold the knowledge and skill of emergency treatment. Television, broadcast and internet were the main ways for them to master emergency knowledge. ConclusionsThe mastery of the knowledge and skill of emergency treatment is not good. It is urgent to educate and train them with the knowledge and skill of emergency treatment, and to improve knowledge and skill of emergency treatment.
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Objective To investigate the infection rate of Legionella pneumophila(LP)in children younger than 5 years with lower respiratory infections by ELISA and PCR.Method Serum LP-IgM and IgG were measured by ELISA,and LP DNA in sputum or throat swab were detected by PCR in 300 children less than 5 years with lower respiratory infections.The data were analyzed by chi-square test and the consistency of the two methods was analyzea by NcNemar test.Results Serum antibody detected by ELISA was positive in 17 cases(5.67%),including 10 positive of IgM and 7 positiile of lgG.In these 17 eases,11 were males and 6 were females with similar positive rates(5.76%vs 5.5%).Four cases(2.53%)were positive in children aged from 27 days to 1 year,while 7(7.37%)and 6 cases(12.77%)were positive in children aged 1-3 years and 3-5 years,respectively.Seven cases(5.19%)found in the winter and spring seasons and 10 cases(6.06%)in summer and autumn seasons.Eleven children(11.83%)were from urban area and only 6(2.9%)from countryside.DNA in sputum or throat swab detected by PCR was positive in 16 cases(5.33%),included 10 males and 6 females with similar positive rates(5.24%vs 5.5%).Five cases(3.16%)were positive in children aged from 27 days to 1 year,while 6(6.32%)and 5 cases(10.64%)were positive in children aged 1-3 years and 3-5 years,respectively.Three cases(2.22%)found in the winter and spring seasons and 13 cases(7.88%)in sunmmr and alltumll seasons.Nine children(9.68%)were from urban area and only 7(3.38%)from countryside.McNemar test was used to compare the data of ELISA and PCR results with a Qm of 0.037 and a Pr of 0.8474.Conclusions LP might contribute partly to the lower respiratory infections in children less than 5 years.The infection rate of LP increases with age increasing.Urban children have a higher infection rate than those living in countryside.Both methods have a good consistency.