Advances of immunotherapy-related biomarker in esophageal carcinoma / 中华胃肠外科杂志

Esophageal carcinoma is one of the most common malignant tumors in the world, with incidence and mortality rankings of 7th and 6th, respectively. In recent years, immunotherapy represented by immune checkpoint inhibitors of programmed death-1 and programmed death ligand 1 (PD-L1) has been introduced into clinical practice and has changed the treatment status of esophageal cancer. Although immunotherapy has provided long-term survival benefits for patients with advanced esophageal cancer and high pathological response rates in the neoadjuvant therapy, only a few of the patients have satisfactory therapeutic outcomes. Therefore, effective biomarkers for predicting immunotherapeutic effects are urgently needed to identify those patients who could benefit from immunotherapy. In this paper, we mainly discuss recent research advances of biomarkers related to the immunotherapy of esophageal cancer and the clinical application prospects of these biomarkers.

A Spacetime Odyssey of Neural Progenitors to Generate Neuronal Diversity / 神经科学通报·英文版

To understand how the nervous system develops from a small pool of progenitors during early embryonic development, it is fundamentally important to identify the diversity of neuronal subtypes, decode the origin of neuronal diversity, and uncover the principles governing neuronal specification across different regions. Recent single-cell analyses have systematically identified neuronal diversity at unprecedented scale and speed, leaving the deconstruction of spatiotemporal mechanisms for generating neuronal diversity an imperative and paramount challenge. In this review, we highlight three distinct strategies deployed by neural progenitors to produce diverse neuronal subtypes, including predetermined, stochastic, and cascade diversifying models, and elaborate how these strategies are implemented in distinct regions such as the neocortex, spinal cord, retina, and hypothalamus. Importantly, the identity of neural progenitors is defined by their spatial position and temporal patterning factors, and each type of progenitor cell gives rise to distinguishable cohorts of neuronal subtypes. Microenvironmental cues, spontaneous activity, and connectional pattern further reshape and diversify the fate of unspecialized neurons in particular regions. The illumination of how neuronal diversity is generated will pave the way for producing specific brain organoids to model human disease and desired neuronal subtypes for cell therapy, as well as understanding the organization of functional neural circuits and the evolution of the nervous system.

Risk Factors for in-Hospital Mortality in Patients with Takotsubo Syndrome / 中山大学学报(医学科学版)

ObjectiveTo analyze the risk factors for in-hospital mortality in patients with Takotsubo Syndrome （TTS）. MethodsHospitalization data of consecutive patients with TTS from February 2009 to January 2022 were retrospectively collected and analyzed. Patients were divided into survival group and death group according to outcomes. The basic clinical information， triggering factors， laboratory examinations， electrocardiogram， echocardiography， complications and treatments of the two groups were compared. Univariable logistic regression analysis was used to screen the possible risk factors for in-hospital mortality in TTS patients， and multivariable logistic regression analysis was used to determine the independent risk factors for in-hospital mortality in TTS patients. ResultsA total of 62 TTS patients were included in our study， including 21 males （33.9%）， 41 females （66.1%） and 26 postmenopausal women （41.9%）， with the mean age of （55.6±16.2） years， and physical triggers were found in 50 patients （80.6%）. 17 patients （27.4%） died while 45 patients （72.6%） survived during hospitalization. The death group had lower systolic blood pressure and left ventricular ejection fraction （LVEF）， higher incidence rate of syncope， higher level of N-terminal pro-B natriuretic peptide （NT-proBNP） and hypersensitive troponin T （hs TnT） when compared with survival group （all P value <0.05）. As for the triggering factors， the proportion of TTS induced by neurologic disorders in the death group was higher than that in the survival group （P<0.05）. The death group had higher rates of cardiogenic shock， malignant ventricular arrhythmia， atrial fibrillation， and respiratory failure （all P value <0.05）. Compared with the survival group， therapeutic dopamine， therapeutic norepinephrine， hemodialysis and mechanical ventilation were higher in the death group （all P value <0.05）. Univariable logistic regression analysis suggested that syncope， NT-proBNP， LVEF， neurologic disorders， cardiogenic shock， malignant ventricular arrhythmia， atrial fibrillation， respiratory failure， therapeutic dopamine， therapeutic norepinephrine， hemodialysis and mechanical ventilation were potential risk factors for in-hospital mortality in TTS patients （all P value <0.05）. Multivariable logistic regression analysis indicated that neurologic disorders ［OR（95%CI）=5.651（1.195，26.715），P=0.029］， atrial fibrillation ［OR（95%CI）=6.217（1.276，30.298）， P=0.024）］ and therapeutic norepinephrin ［OR（95%CI）=8.847（1.912，40.949）， P=0.005］ were independent risk factors for in-hospital mortality in TTS patients. ConclusionsNeurologic disorders， atrial fibrillation and therapeutic norepinephrin are independent risk factors for in-hospital mortality in patients with Takotsubo Syndrome. Clinically， attention should be paid to the prevention and treatment of neurologic disorders and atrial fibrillation； norepinephrine should be carefully used in patients with diagnosed TTS complicated with hemodynamic instability.

Left Ventricle Longitudinal Strain Parameters Are Effective for Differentiating Cardiac Amyloidosis from Primary Hypertensive Left Ventricular Hypertrophy / 中山大学学报(医学科学版)

ObjectiveTo clarify the value of the left ventricular longitudinal strain（LVLS）parameters in patients with cardiac amyloidosis （CA） and primary hypertension with left ventricular hypertrophy （HLVH）. MethodsForty-one patients confirmed with CA were selected and assigned to CA with hypertension group （n =14） and pure CA group （n=27） based on the initial diagnosis with or without hypertension. Twenty patients with primary hypertension-induced left ventricular hypertrophy （HLVH group） and twenty healthy controls were also selected， matching for gender， age， and body surface area. Clinical data， conventional echocardiography parameters were collected and LVLS parameters were measured. Within-group variations were compared among the four groups， and pairwise comparisons were conducted between groups. The sensitivity and specificity of each parameter in predicting CA were judged by the receiver operator characteristic （ROC） curvy in CA and HLVH patients with left ventricular ejection fraction （LVEF） preserved. ResultsAmong the conventional echocardiography parameters， LVEF and left ventricular end-diastolic diameter （LVEDD） were lower in the CA with hypertension group and pure CA group compared with the higher values in the HLVH group and control group. Whereas， left ventricular posterior wall thickness （LVPWT）， relative wall thickness （RWT）， and average E/e' were higher in the two CA groups compared with the HLVH group （all P＜0.05）.Among the LVLS parameters， Global longitudinal strain （GLS） was the worst in the CA with hypertension group so as pure CA group， modest in the HLVH group， and highest in the control group. On the contrary， relative longitudinal strain and ejection fraction strain ratio （EFSR） were the highest in the CA with hypertension group so as to pure CA group， modest in the HLVH group， and lowest in the control group （all P＜0.05）. ROC analysis showed that when LVEF was preserved， the absolute value of GLS less than 14.35% and EFSR higher than 4.28 could effectively distinguish CA from HLVH （all AUCs＞0.9，all P＜0.05）； meanwhile GLS showed high sensitivity（100%） and EFSR showed great specificity（95%）. There were not statistically significance in any parameter between CA with hypertension group and pure CA group（all P＞0.05）. ConclusionWhether CA was complicated with hypertension or not， there were statistically significance among routine echocardiography and LVLS parameters compared with HLVH. In particular， GLS and EFSR are accurate in predicting CA in patients with myocardial hypertrophy and preserved LVEF.

Application of acellular bovine pericardium patch in implant based immediate breast reconstruction / 中华外科杂志

Objective: To examine the clinical effect of acellular bovine pericardium patch in implant based immediate breast reconstruction. Methods: The clinicopathological information of 141 breast cancer patients, who admitted to Department of Breast Reconstruction and Oncoplastic Surgery, Tianjin Medical University Cancer Hospital, underwent immediate mammoplasty with implants combined with acellular bovine pericardium patches were analyzed from June 2016 to October 2019. All patients were female, with the age of (38.8±8.5) years (range: 13 to 60 years). The body mass index was (21.9±2.5) kg/m2 (range: 16.0 to 32.3 kg/m2). There were 39 cases of duct carcinoma in situ, 46 cases of stage Ⅰ, 40 cases of stage Ⅱ and 16 cases of stage Ⅲ. All patients received nipple-areola-sparing mastectomy or skin-sparing mastectomy with sentinel lymph node biopsy or axillary lymph node dissection, and prosthesis implantation with sub-pectoralis combined with breast patch. The correlation of clinicopathological characters and complications was assessed by t test, χ2 test, Fisher's exact probability method and Logistic regression. Pre-and post-operative aesthetic, quality of life scores were recorded. Results: The operation time (M(IQR)) was 3.6(1.5) hours (range: 3.0 to 6.5 hours). The early postoperative complication rate was 22.0% (31/141), prosthesis removal was the main postoperative complication, accounting for 64.5% (20/31) of the total complications, of which 15 cases occurred in the first 30 patients. The follow-up time was 28(8) months (range: 20 to 53 months), The most frequent long-term complications were capsular contracture and implant displacement, with the incidence of 11.2% (14/125) and 10.4% (13/125), respectively. Multivariate analysis showed that prosthesis volume ≥300 ml (OR=8.173, 95%CI: 1.302 to 51.315, P=0.021) and peri-areolar incision (OR=7.809, 95%CI: 2.162 to 28.211, P<0.01) were independent relative factors for the occurrence of short-term postoperative local complications. After 2 years of operation, the score of breast appearance satisfaction was 71.7±15.5, postoperative effect satisfaction was 90.4±9.5, psychological satisfaction was 90.7±17.1, sexual satisfaction was 70.1±25.1. The immediate postoperative satisfaction rate at discharge was 95.4% (134/141), and 17.6% (22/125) of patients had the intention to received revision surgery. Conclusions: Prosthesis volume ≥300 ml and peri-areolar incision were independent realtive factors for short-term local complications after bovine pericardium patch combined with prosthesis implantation in the immediate breast reconstruction. After completing the learning curve, the postoperative complications of the procedure could be decreased.

Oligometastatic and oligoprogressive esophageal squamous cell carcinoma:clarifying conceptions and surgery perspectives / 中华外科杂志

The oligometastatic and oligoprogressive state has been a hot issue in cancer research. Its indolent tumor behavior, representing a novel therapeutic opportunity, has been identified as a clinical subtype in several malignancies. However, the clinical implications of the oligometastatic and oligoprogressive state in esophageal squamous cell carcinoma (ESCC) have not been thoroughly elucidated. There are still controversies regarding the existence of the oligometastatic state in ESCC, if the solitary regional lymph node metastasis should be viewed as oligoprogressive disease after esophagectomy, and the role of surgery and radiotherapy in ESCC oligometastatic disease. Despite many exciting contributions to the literature on these, further exploration is warranted. Thus, fostering the advance of research and scientific knowledge on the biological and prognostic characteristics scrupulously would facilitate personalizing treatment strategy for better outcomes.

Treatment and prognosis analysis of perineural invasion on sinonasal adenoid cystic carcinoma / 中华肿瘤杂志

Objective: To analyze the efficacy of sinonasal adenoid cystic carcinoma (ACC) with perineural invasion (PNI), and explore the prognostic value of PNI on sinonasal adenoid cystic carcinoma. Methods: The clinical data of 105 patients with sinonasal ACC admitted to Cancer Hospital, Chinese Academy of Medical Sciences from January 2000 to December 2016 were retrospectively reviewed. All patients were restaged according to American Joint Committee on Cancer 8th edition. Follow-up visits were conducted to obtain information of treatment failure and survival outcome. The Log rank test was used for univariate analysis of prognostic factors, and Cox regression model was used for multivariate prognostic analysis. Results: The maxillary sinus (n=59) was the most common primary site, followed by the nasal cavity (n=38). There were 93 patients with stage Ⅲ-Ⅳ. The treatment modalities included surgery alone (n=14), radiotherapy alone (n=13), preoperative radiotherapy plus surgery (n=10), and surgery plus postoperative radiotherapy (n=68). The median follow-up time was 91.8 months, the 5-year local control (LC), distant metastasis-free survival (DMFS), progression-free survival (PFS), and overall survival (OS) rates were 72.6%, 73.0%, 52.9% and 78.0%, respectively. There were 33 patients (31.4%) with PNI-positive. The 5-year DMFS, PFS, and OS rates of PNI-positive group were 53.7%, 29.4% and 56.5%, respectively, which were significantly inferior to those of PNI-negative group (80.8%, 63.0% and 86.8%, respectively, P<0.05), while there was no significant difference in the 5-year LC rate between both groups (64.5% vs 76.5%, P=0.273). The multivariate Cox regression analysis showed PNI was one of the poor prognostic factors of DMFS (HR=3.514, 95%CI: 1.557-7.932), PFS (HR=2.562, 95%CI: 1.349-4.866) and OS (HR=2.605, 95%CI: 1.169-5.806). Among patients with PNI-positive, the 5-year LC, PFS and OS rates of patients received surgery combined with radiotherapy were 84.9%, 41.3% and 72.7%, respectively, which were significantly higher than 23.3%, 10.0% and 26.7% of patients receiving surgery or radiotherapy alone (P<0.05). Conclusion: The presence of PNI increases the risk of distant metastasis in patients with sinonasal ACC. Compared with patients with PNI-negative, the prognosis of patients with PNI-positive is relatively poor, and surgery combined with radiotherapy for PNI-positive sinonasal ACC results in good clinical outcomes.

Phylogenetic and Mutation Points Analysis of Sophora japonica cv. jinhuai Based on DNA Barcoding Sequences / 中国实验方剂学杂志

ObjectiveTo conduct phylogenetic analysis of internal transcribed spacer 2 （ITS2） and chloroplast gene segments including psbA-trnH， rbcL， and matK of Sophora japonica cv. jinhuai resource samples from different geographical sources， and to explore the genetic diversity of S. japonica cv. jinhuai. MethodPolymerase chain reaction （PCR） method was used to amplify the nucleic acid sequences of ITS2， psbA-trnH， rbcL， and matK of S. japonica cv. jinhuai. Neighbor joining （NJ） method was used to construct phylogenetic trees， and Kimura 2-Parameter （K2P） model was used to calculate the genetic distance of different samples. MEGA and BIOEDIT softwares were applied for mutiple alignment and analysis of ITS2， psbA-trnH， rbcL， and matK sequences of S. japonica cv. jinhuai. ResultThe lengths of ITS2 sequence were 278-279 bp. The lengths of psbA-trnH were 289 bp. The lengths of rbcL sequence were 673 bp. The lengths of matK sequences were 786-792 bp. There were 3 mutation points in ITS2 and psbA-trnH， no mutation point in rbcL， and 13 mutation points in matK. The samples of S. japonica cv. jinhuai were clustered into two groups based on the phylogenetic tree constructed by ITS2 sequences. The sample of seedling tree in Baibao was clustered into one group， while the other 25 samples were clustered into another group. For the psbA-trnH sequence， the success rate of PCR amplification of 28 samples of S. japonica cv. jinhuai was 100%. The 28 samples of S. japonica cv. jinhuai were clustered into three groups based on the clustering results of psbA-trnH sequence. The sample of seedling tree in Shaoshui was clustered into one group. The five samples of grafting tree and seedling tree in Miaotou， grafting trees in Jiantang， Wenqiao， and Daxu， and seeding tree in Xianshui were clustered into one group. The other 21 samples were clustered into another group. The 26 samples of S. japonica cv. jinhuai were clustered into two groups based on the phylogenetic tree constructed by matK sequences. The sample of seedling tree in Xianshui was clustered into one group， while the other 25 samples were clustered into another group. The clustering results of the rbcL sequence of S. japonica cv. jinhuai could not distinguish 28 resource samples. The phylogenetic tree constructed by the combined sequence of ITS2+psbA-trnH+rbcL+matK divided S. japonica cv. jinhuai resource samples into 4 groups. The 13 samples of seedling trees in Qiyang， Daoxian， Miaotou， Shaoshui， Shitang， Xianshui， Jiantang， and Xiangli， and grafting trees in Qiyang， Miaotou， Yongsui， Wenqiao， and Yangtang were clustered into one group. The sample of seedling tree in Wenqiao was clustered into one group. The sample of seedling tree in Daxu was clustered into one group. The remaining samples were clustered into another group. ConclusionPhylogenetic and mutation analysis provide the theoretic foundation to investigate the evolution of the resources of S. japonica cv. jinhuai， and evaluate their genuineness. The results of mutation points can be used to identify the related S. japonica cv. jinhuai resources. The findings of this study show that the combination of different gene sequences has an optimal effect on plant identification.

Characteristics of lapsed apheresis donors from 2016 to 2020, Zhejiang Blood Center / 中国输血杂志

【Objective】 To understand the structural characteristics of lapsed apheresis donors in our blood center and provide guidance for further improving recruitment and retention strategies by retrospectively analyzing the characteristics of lapsed apheresis donors in our center in recent years. 【Methods】 The apheresis donation and lapsed apheresis donors in Zhejiang Blood Center from 2016 to 2020 were statistically analyzed, and the general information of lapsed donors, including gender, blood type, age, education level and occupation composition, were compared and analyzed. The lapse of novel and long-term donors with different frequency were retrospectively analyzed. The SPSS 19.0 statistical software package was used for data analysis. 【Results】 In 2020, the total lapse of apheresis donors decreased by 16.6% as compared with 2016(P<0.05). The lapse rate of donors with blood groups A, B, O and AB was 1∶1∶1∶1, higher in female donors(59.0%) than males(50.0%), and dominated by age group of 18-35(66.3%). With the increase of age, the lapse rate decreased. Donors lapsed were mainly with college or above educational background(60.8%), with high proportion in students and the staff. In 2020, the lapse of novel apheresis donors decreased by 34.1% as compared with 2016, but the average lapse rate of novel apheresis donors was still as high as 70.5%. The average lapse rate of blood donors with different frequency was 52.5%, and the lapse rate decreased significantly with the increase of apheresis donation frequency. The average lapse rate of novel blood donors with whole blood donation experience was lower than those without (56.1% vs 82.9%). 【Conclusion】 Multiple measures for recruitment and retention have effectively reduced the lapse of apheresis donors. However, apheresis donors who are 18-35 years old, with college degree or above, students and staff were the main groups from lapsing. In addition, low-frequency and novel apheresis donors without whole blood donation experience were more likely to be lapsing. Targeted and personalized blood donation services should be further provided, and the management of " full cycle of blood donation" should be strengthened to reduce the lapsing, so as to retain more blood donors.

Analysis of risk factors for bone contusion in the posterior of tibial plateau / 中华骨科杂志

Objective:To investigate the correlation between anterior cruciate ligament injury and the bone contusion in the posterior of tibial plateau and the risk factors of it.Methods:Data of patients with knee trauma who came to our hospital from Oct. 2017 to Nov. 2019 were retrospectively analyzed. There are 100 males and 55 females with an average age of 40.0±10.6 years (range, 18-60). Bone contusion in the posterior tibial plateauand anterior cruciate ligament, posterior cruciate ligament, medial collateral ligament, lateral collateral ligament and fibula injury were evaluated through imaging data, and injury mechanism, age, sex and the side of injury were collected from medical records. The effect of events on bone contusion in the posterior of tibial plateau was analyzed.Results:Bone contusion occurred in 92 of the 155 patients (56 males and 36 females), with an average age of 39.6±10.5 years (range, 19-55 years). There were 45 cases on right knee and 47 cases on the left side. ACL injury: ACL was completely ruptured in 42 cases, partially ruptured in 34 cases, and had no injury in 16 cases. There were 18 cases with PCL injury, and 74 cases without any injury. There were 57 cases of non-contact injury, and 35 cases of contact injury. There were 57 cases with fibular head injury, and 35 cases without. There were 44 cases with MCL injury, and 48 cases without. There were 13 cases with LCL injury, and 79 cases without. ACL injury degree ( χ2=18.345, P<0.05) and the head of fibula ( χ2=5.495, P<0.05) injury were significantly different between the two groups. There was no significant difference in male ratio ( χ2=1.315, P>0.05), knee side ( χ2=0.880, P>0.05), injury mechanism ( χ2=3.467, P>0.05), age ( t=0.664, P>0.05), LCL ( χ2=0.010, P>0.05)、MCL ( χ2=0.029, P>0.05) and PCL ( χ2=0.161, P>0.05). ACL injury was an independent risk factor for bone contusion in the posterior of tibial plateau ( P<0.05) and the injury of fibula head was an independent risk factor for the formation of bone contusion in the posterior of tibial plateau ( P<0.05) according to logistic analysis. The possibility of bone contusion on the posterior tibial plateau in ACL complete injury was significantly greater than that of ACL partial injury ( OR=2.695, P=0.021). Conclusion:The injury of ACL and fibula head are independent risk factors for the bone contusion in posterior of tibial plateau; ACL complete injury is more likely to be associated with posterior tibial plateau bone contusion than ACL partial injury.

Prevention and control of HIV/AIDS in China: lessons from the past three decades / 中华医学杂志(英文版)

In the past 37 years, human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) has undergone various major transmission routes in China, with the world most complex co-circulating HIV-1 subtypes, even the prevalence is still low. In response to the first epidemic outbreak of HIV in injecting drug users and the second one by illegal commercial blood collection, China issued the Anti-Drug Law and launched the Blood Donation Act and nationwide nucleic acid testing, which has avoided 98,232 to 211,200 estimated infections and almost ended the blood product-related infection. China has been providing free antiretroviral therapy (ART) since 2003, which covered >80% of the identified patients and achieved a viral suppression rate of 91%. To bend the curve of increasing the disease burden of HIV and finally end the epidemic, China should consider constraining HIV spread through sexual transmission, narrowing the gaps in identifying HIV cases, and the long-term effectiveness and safety of ART in the future.

Short-term efficacy of laparoscopic gastrectomy versus open gastrectomy for advanced gastric cancer after neoadjuvant chemotherapy: a Meta-analysis / 中华消化外科杂志

Laparoscopic gastrectomy (LG) has been proven to be safe and feasible and widely used in surgical treatment of early and advanced gastric cancer (AGC), which has advantages over open gastrectomy in intraoperative bleeding and postoperative recovery. Neoadjuvant chemo-therapy (NACT) could achieve the effect of tumor downstaging and provide more surgical treatment chances for patients with AGC, thus improving their prognosis. Feasibility of LG for patients with AGC after NACT is a crucial problem for surgeons. The authors review the relevant studies and conducte a Meta-analysis to evaluate the short-term efficacy of laparoscopic versus open gastrec-tomy in the treatment of AGC after NACT.

Advances in Research on Pharmacological Effect of Astragaloside Ⅳ on Cardiovascular and Cerebrovascular Diseases / 中国实验方剂学杂志

Astragalus membranaceus has the effect of tonifying Qi and solid surface， diuretic support poison， discharging pus and astringent sores to produce muscle. It is not only used for syndromes such as deficiency of lung and temper， deficiency of spleen and diarrhea， but also for stroke， chest obstruction and other diseases. Due to the complex chemical composition and diverse pharmacological effect of Astragalus membranaceus， and the main role in invigorating qi and activating blood circulation has not been clarified. Astragaloside Ⅳ is one of its main active ingredients. In recent years， more and more studies on Astragaloside Ⅳ have been conducted at home and abroad. It has been reported that it has the medicinal value of enhancing immune function， strengthening heart and lowerin blood glucose， diuresis， anti-aging and anti-fatigue， et al， and has extensive pharmacological activity. Among them， the role of cardiovascular and cerebrovascular diseases in particular has attracted increasing attention. Cardiovascular and cerebrovascular diseases are ischemic or hemorrhagic diseases occurring in the heart， brain and systemic tissues due to blood viscosity， atherosclerosis， hypertension， hyperlipidemia， etc.， including cardiovascular and cerebrovascular diseases. Such diseases are a serious threat to mankind and are the leading cause of death worldwide. At present， western medicine is the main treatment， with many adverse reactions and poor long-term prognosis. TCM believes that the imbalance of qi and blood is the basic pathogenesis of this kind of disease. Qi deficiency and blood stasis are more common.At present， Astragaloside Ⅳ in the treatment of cardiovascular and cerebrovascular diseases in a number of studies， and achieved some results， but this review in recent years， Astragaloside Ⅳ in the treatment of cardiovascular and cerebrovascular diseases play the pharmacological activity， in order to explore whether Astragaloside Ⅳ is the main role of astragalus qi to find a theoretical basis for material basis， but also for the innovation of traditional Chinese medicine drug research and development of theoretical basis and practical guidance.

Expression and correlation of PD-L1 and MMP-3 in elderly esophageal squamous cell carcinoma / 中国医师杂志

Objective:To analyze the expression and correlation of programmed death receptor ligand 1 (PD-L1) and matrix metalloproteinase-3 (MMP-3) in elderly esophageal squamous cell carcinoma, in order to provide an effective basis for early disease diagnosis, treatment plan formulation and prognosis evaluation of elderly patients with esophageal cancer.Methods:The clinical data of 83 elderly patients with esophageal squamous carcinoma who admitted in Qinghai Provincial Traffic Hospital from October 2018 to October 2019 were retrospectively analyzed and included in the esophageal squamous carcinoma group. Another 46 patients with para-carcinoma tissue were included in the para-carcinoma group. The immunohistochemistry was used to compare the positive rate of PD-L1 and MMP-3 expression in the two groups of tissues, and the relationship between PD-L1 and MMP-3 expression in esophageal squamous carcinoma tissues and clinical pathology was explored. Bivariate Pearson correlation test was used to analyze the correlation between the two and the clinical pathological features of elderly patients with esophageal squamous carcinoma.Results:The positive expression rates of PD-L1 and MMP-3 in the esophageal squamous carcinoma group (55.42%, 67.47%) were higher than those in the para-carcinoma group (23.91%, 30.43%) ( P<0.05); Pearson correlation analysis found that PD-L1 expression was positively correlated with the differentiated degree of esophageal squamous carcinoma ( r=0.449, P<0.001), and MMP-3 expression was positively correlated with the infiltration degree of esophageal squamous carcinoma, tumor node metastasis (TNM) stage, and lymph node metastasis ( r=0.255, 0.367, 0.361, P=0.020, 0.001, 0.001). Conclusions:PD-L1 and MMP-3 are highly expressed in elderly esophageal squamous carcinoma. PD-L1 expression can indicate the degree of differentiation of esophageal squamous carcinoma, and MMP-3 expression can indicate different infiltration degrees of esophageal squamous carcinoma, TNM stage, and lymph node metastasis. PD-L1 and MMP-3 can be used as clinical markers for the development of esophageal squamous carcinoma treatment plans and prognostic evaluation.

Physiologically-based pharmacokinetic modeling for predicting drug-drug interactions induced by acid-reducing agents / 药学学报

Gastric pH is an important factor that affects drug absorption, as gastric pH may lead to lower bioavailability, especially for weak-base drugs. Acid-reducing agents (ARAs) such as antacids, histamine-2 receptor antagonists, and proton pump inhibitors, are susceptible to drug-drug interactions (DDIs), potentially resulting in the loss of efficacy. Physiologically based pharmacokinetic (PBPK) modeling is an important tool for the evaluation of oral drug-drug interactions and the most commonly used models include the advanced comparative absorption and transport (ACAT) model and the advanced dissolution, absorption and metabolism (ADAM) model. These models can be used for adjustment of the dosage regimen and the screening of candidate drugs in drug development by simulating the change of gastric pH to predict the change in drug absorption. This review summarizes the theoretical basis, the most common PBPK models used to predict drug absorption, and the effects of different kinds of ARAs drugs on gastric pH. Some successful applications of PBPK modeling in predicting the effects of gastric pH on drug absorption are also presented.

A new quinoline alkaloid from Scolopendra subspinipes mutilans / 中国中药杂志

Three compounds, including scolosprine C(1), uracil(2) and hypoxanthine(3), were isolated and purified from the ethyl acetate fraction of centipede by silica gel normal-phase column chromatography, reversed-phase medium pressure preparation chromatography, and high-pressure semi-preparative HPLC. The structure was elucidated through a combination of spectroscopic analyses [such as nuclear magnetic resonance(NMR) and mass spectrometry(MS)] and literature review. Among them, compound 1 was a new quinoline alkaloid. In previous reports, we have described the isolation and structure elucidation of one new and two known quinoline alkaloids. In this paper, we would report the isolation and structure elucidation of scolosprine C in detail.

Prevalence trends and related factors of hypertension patients complicating with dyslipidemia in community of Guandong province between 2013 and 2018 / 中华心血管病杂志

Objective: To analyze the prevalence trends and related factors of hypertension patients complicating with dyslipidemia in community. Methods: This was a cross-sectional survey, patients with hypertension were selected from the different communities of Guangdong province in 2013 and 2018 respectively. General clinical characteristics, including demographic information, past history, family history, and medication history, were collected. Dyslipidemia was defined as follows: at least 1 item elevation of total cholesterol (TC)≥5.2 mmol/L, triglyceride (TG) ≥1.7 mmol/L, low-density lipoprotein cholesterol (LDL-C)≥3.4 mmol/L, or reduced high-density lipoprotein cholesterol (HDL-C)<1.0 mmol/L. The incidence of dyslipidemia was standardized based on the 2010 China Census data, and further subgroup analysis was performed according to age (<50, 50-60, ≥60 years old) and sex (male, female). Multivariate logistic regression was used to analyze the related factors of dyslipidemia. Results: In 2013 and 2018, 7 866 (4 148 (52.7%) females, with the age of (62.4±13.6) years) and 11 611 (6 692 (57.6%) females, with the age of (58.2±9.3)years) patients with hypertension were enrolled for data analysis, respectively. In 2013, the total prevalence rate of dyslipidemia in patients with hypertension in the community of Guangdong province was 56.3%, among which the prevalence rates of hypercholesterolemia, hypertriglyceridemia, high LDL-Cemia, and low HDL-Cemia were 17.1. %, 21.3%, 2.3% and 24.4%, respectively. The total prevalence of dyslipidemia in patients with hypertension in the community of Guangdong in 2018 was 47.3%, prevalence of hypercholesterolemia, hypertriglyceridemia, high LDL-Cemia and low HDL-Cemia was 14.1%, 20.3%, 12.0% and 19.4%, respectively. Subgroup analysis showed that the total prevalence of dyslipidemia in male patients with hypertension in the community of Guangdong in 2013 and 2018 was 59.0% and 50.7%, respectively, among which hypercholesterolemia was 13.8% and 8.0%, and hypertriglyceridemia was 22.3%, 20.9%, high LDL-Cemia was 1.7%, 8.1%, low HDL-Cemia was 32.9%, 30.3%, respectively. In 2013 and 2018, the total prevalence of dyslipidemia in female patients with hypertension in the community of Guangdong province was 53.9% and 44.8%, among which prevalence of hypercholesterolemia was 20.5% and 18.5%, hypertriglyceridemia was 20.4% and 19.8%, and high LDL-Cemia was 2.7% and 14.9%, and hypo-HDL-Cemia was 16.8% and 11.3%, respectively. Age subgroup analysis showed that the prevalence of dyslipidemia among hypertensive patients aged<50, 50-60, and ≥60 years in Guangdong community in 2013 were 60.1%, 60.6%, and 53.7%, respectively; and 46.2%, 49.3% and 46.5% in 2018, respectively. Multivariate logistic regression analysis showed that women (OR=0.860,95%CI 0.761-0.973,P=0.017), obese (OR=2.295,95%CI 2.007-2.624,P<0.001), diabetes (OR=1.314,95%CI 1.090-1.583,P=0.004), stroke (OR=1.894,95%CI 1.227-2.924,P=0.004) and the level of fasting blood glucose (OR=1.105,95%CI 1.066-1.146,P<0.001) were independently related with the occurrence of dyslipidemia. Conclusions: The prevalence of dyslipidemia in patients with hypertension in the communities of Guangdong province is relatively high, and the prevalence differs in sex and age. Between 2013 and 2018, the total prevalence of dyslipidemia, hyper-TCemia, and hypo-HDL-Cemia in hypertensive patients shows a downward trend. The prevalence of hyper-TGemia remains unchanged, but the prevalence of high LDL-C shows an upward trend. Several factors are related to the prevalence of dislipidemia in hypertension patients in Guandong community.

Effect of warm needling therapy on nerve conduction in patients with occupational hand-arm vibration disease / 中国职业医学

OBJECTIVE: To investigate the effect of warm needling therapy on the conduction of hand-arm motor nerve and sensory nerve in patients with occupational hand-arm vibration disease(HAVD). METHODS: Male occupational HAVD patients were divided into control group(39 cases) and experimental group(36 cases) by random number table method. The control group received routine therapy, while the experimental group was treated with routine therapy plus warm needling therapy five times a week for four consecutive weeks. The changes on the conduction of motor nerve and sensory nerve in these two groups before and after treatment were compared. RESULTS: Before treatment, the motor nerve conduction velocity(MCV), distal motor latency(DML), compound muscle action potential amplitude(CMAP), sensory nerve conduction velocity(SCV) and sensory nerve action potential amplitude(SNAP) of the median nerve and ulnar nerve in the two groups were compared, and there was no statistically significant difference(all P>0.05). After treatment, the MCV and SCV of median nerve and ulnar nerve in the experimental group were accelerated(all P<0.05), the DML of median nerve and ulnar nerve were shortened(all P<0.01), and the CMAP of median nerve increased compared with the control group(P<0.01). However, there was no significant difference in the CMAP of ulnar nerve and SNAP of median nerve and ulnar nerve(all P>0.05). CONCLUSION: Warm needling therapy can improve the conduction of motor nerve and sensory nerve. Warm needling therapy might be able to promote the repair of injury in axons and myelin sheaths.

Prevention and control strategies of physical examination and health consultation for apheresis donation during the COVID-19 outbreak / 中国输血杂志

【Objective】 To discuss the prevention and control strategies of physical examination and health consultation for apheresis donation during the COVID-19 outbreak, and to verify its necessity and efficiency. 【Methods】 A three-stage (Hubei import period, Jan 23 to 31; local(Zhejiang) epidemic period( Feb 1 to Mar 1); overseas import period, Mar 2 to 22) prevention and control strategy for physical examination and health consultation during the COVID-19 outbreak from January 23 to March 22, 2020 was adopted by our center, and the consultation of residence history, contact history, and the investigation of related symptoms were added to health consultation.The deferral rates of health consultation and physical examination during the COVID-19 outbreak were compared with the same period in 2019. The deferral rates in each stage were compared, containing those contributed by first-time and regular apheresis donors. 【Results】 The deferral rates of health consultation during the epidemic period and the same period in 2019 were 2.31%(100/4 371) vs 1.62%(78/4 740) (P0.05) The deferral rate of travel contact history was the highest at 2.05%(40/1947)during local epidemic period, and respiratory symptoms at 1.29%(5/388)during Hubei import period. The deferral rates of blood pressure during the three stages were1.85%(7/378)vs 3.57%(67/1877)vs 4.08(82/2009)(P>0.05). The deferral rate of health consultation and physical examination in first-time and regular apheresis donors were 5.86%(38/649)vs 1.65%(61/3 696)and 5.79%(35/604)vs 3.41%(124/3 635)(P<0.01). 【Conclusion】 The deferral rates of health consultation and physical examination increased significantly during the COVID-19 epidemic. Therefore, it is necessary to formulate and adopt a targeted consultation strategy during the epidemic period to block COVID-19 transmission to the greatest extent.

Implementation and application of telephone recruitment for apheresis platelet donors: based on the whole process information management of blood collection and supply / 中国输血杂志

【Objective】 To develop and implement a precise and efficient telephone recruitment strategy for apheresis platelet donors based on the information management of blood collection and supply process. 【Methods】 A telephone recruitment strategy based on the whole process information management of apheresis platelet donors (hereinafter referred to as telephone recruitment) was formulated From January 1, 2019, apheresis platelet donors in Hangzhou, registered in the intelligent blood donor recruitment system(hereinafter referred to as the recruitment system), were recruited by telephone calls or (and) SMS reminders to inform re-donation interval, key points of recruitment consultation, blood donation appointment time and other precautions. Response rate, pass rate and blood donation rate of donors before(in 2018) and after( in 2019) the implementation of telephone recruitment, as well as the above three rates during the COVID-19 epidemic in 2020 in Hangzhou were collected and analyzed by χ2 test. 【Results】 The response rate, pass rate, and blood donation rate of apheresis platelet donors in Hangzhou before /after the implementation of telephone recruitment and during the COVID-19 epidemic were 28.52%(3 901/13 678)vs 30.52%(4 429/14 511)vs 39.36%(4 064/10 326), 73.80%(2 879/3 901)vs 77.83%(3 447/4 429)vs 78.20%(3 178/4 064)and 6.77%(2 879/42 553)vs 7.77%(3 447/44 366)vs 8.13%(3 178/39 077, respectively(P<0.05). In 2020, 85.94%(3 178/3 698) of apheresis donors were recruited by telephone(P<0.05). The proportion of apheresis donations successfully recruited by telephone in 2018 and 2019 accounted for 11.74% (2 879/24 519) and 12.48% (3 447/27 628), respectively(P<0.05), contributing 10.59% (4 030 U/38 040 U) and 11.38% (4 875 U/42 853 U) of units(P<0.05) that issued to the clinical. Due to the COVID-19 epidemic, the number of blood donors recruited by telephone and its proportion in 2020 decreased significantly as compared with those before the implementation of telephone recruitment (2019). 【Conclusion】 The telephone recruitment strategy based on the whole-process information management (system) of blood collection and supply can effectively improve the targeted recruitment of apheresis platelet donors and enhance its proportion of apheresis collection that issued to the clinical.