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Papillary thyroid microcarcinoma(PTMC),which lacks lymph node metastasis,distant metastasis,extra-thyroid invasion,high-risk subtypes,and invasion of the trachea or recurrent laryngeal nerve,may be classified as low-risk PTMC based on clinical assessment.Surgical intervention such as lobectomy or total thyroidectomy is the primary treatment modality for PTMC.This study comprised 124 patients who underwent conformal thyroidectomy and revealed that this innovative surgical approach yielded long-term oncological outcomes comparable to those who received lobectomy or total thyroidectomy.The surgical intervention may play a significant role in the comprehensive management of PTMC,while the implementation of PTMC precision medicine necessitates the utilization of genetic testing,molecular typing,and other advanced technologies to detect early-stage high-risk factors like lymph node microinvasion and integrate biology-based surgery concept for optimal outcomes.
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Currently,methamphetamine(MA)has become the most commonly abused synthetic stimulant.The long-term use of MA has resulted in serious mental disorders and cognitive impairments,posing significant public health and social issues both domestically and internationally.As a novel adjunctive therapy,exercise intervention can effectively mitigate the neuro-structural and functional injury caused by MA by suppressing neural oxidative stress,reducing inflammatory factors and cellular apoptosis levels,restoring glutamate/gamma-aminobutyric acid homeostasis and blood-brain barrier function,and promoting neuroplasticity.Exercise intervention also contributes to decreasing drug cravings,enhancing physical fitness,alleviating with-drawal symptoms,and reducing negative subjective emotions among addicts.Therefore,scientifically tailored exercise interven-tion programs with abundant types of sports and personalized exercise programs designed based on the physical and mental conditions of individuals with addiction can lead to better intervention outcomes and reduce the risk of relapse.This paper provides a comprehensive review of the research progress on the effects,mechanisms and intervention strategies of exercise on neural injury in MA addicts,aiming to provide evidence for the application of exercise intervention in drug withdrawal programs for MA addicts.
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Radiation-induced damage to vascular endothelium is a major complication of radiotherapy and a primary cause of morbidity and mortality in the population exposed to radiation. Ionizing radiation-induced cellular senescence serves as a critical factor in damage to vascular endothelial cells. Therefore, understanding the mechanisms of cellular senescence caused by senescence-associated secretory phenotype (SASP), as well as its role in ionizing radiation-induced damage to vascular endothelial cells, is significant for preventing and treating ionizing radiation-induced damage to vascular endothelial cells. In this study, the relationship between SASP-related premature senescence and this ionizing radiation-induced damage was explored from the following aspects: the mechanisms behind ionizing radiation-induced damage to vascular endothelial cells, ionizing radiation-induced cellular senescence, and the role of SASP-related premature senescence in the ionizing radiation-induced damage to vascular endothelial cells, as well as potential targets.
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Objective @#To explore the mechanism of Wenyang Shengji Ointment (温阳生肌膏, WYSJO) in the treatment of diabetic wounds from the perspective of network pharmacology, and to verify it by animal experiments.@*Methods@#The Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP) and related literature were used to screen active compounds in WYSJO and their corresponding targets. GeneCards, Online Mendelian Inheritance in Man (OMIM), DrugBank, PharmGkb, and Therapeutic Target Database (TTD) databases were employed to identify the targets associated with diabetic wounds. Cytoscape 3.9.0 was used to map the active ingredients in WYSJO, which was the diabetic wound target network. Search Tool for the Retrieval of Interaction Gene/Proteins (STRING) platform was utilized to construct protein-protein interaction (PPI) network. Kyoto Encyclopedia of Genes and Genomes (KEGG) andGene Ontology (GO) enrichment analyses were performed to identify signaling pathways between WYSJO and diabetic wounds. AutoDock 1.5.6 was used for molecular docking of core components in WYSJO to their targets. Eighteen rats were randomly divided into control, model, and WYSJO groups (n = 6). The model and WYSJO groups were used to prepare the model of refractory wounds in diabetes rats. The wound healing was observed on day 0, 5, 9, and 14 after treatment, and the wound tissue morphology was observed by hematoxylin-eosin(HE) staining. The expression levels of core genes were detected by quantitative real-timepolymerase chain reaction (qPCR).@*Result@#A total of 76 active compounds in WYSJO, 206 WYSJO drug targets, 3 797 diabetic wound targets, and 167 diabetic wound associated WYSJO targets were screened out through network pharmacology. With the use of WYSJO-diabetic wound target network, core targets of seven active compounds encompassing quercetin, daidzein, kaempferol, rhamnetin, rhamnocitrin, strictosamide, and diisobutyl phthalate (DIBP) in WYSJO were found. GO enrichment analysis showed that the treatment of diabetes wounds with WYSJO may involve lipopolysaccharide, bacteria-derived molecules, metal ions, foreign stimuli, chemical stress, nutrient level, hypoxia, and oxidative stress in the biological processes. KEGG enrichment analysis showed that the treatment of diabetes wounds with WYSJO may involve advanced glycation end products (AGE-RAGE), p53, interleukin (IL)-17, tumor necrosis factor (TNF),hypoxia inducible factor-1 (HIF-1), apoptosis, lipid, atherosclerosis, etc. The results of animal experiments showed that WYSJO could significantly accelerate the healing process of diabetic wounds (P < 0.05), alleviate inflammatory response, promote the growth of granulation tissues, and down-regulate the expression levels of eight core genes [histone crotonyltransferase p300 (EP300), protoc gene-oncogene c-Jun (JUN), myelocytomatosis (MYC), hypoxia inducible factor 1A (HIF1A), mitogen-activated protein kinase 14 (MAPK14), specificity protein 1 (SP1), tumor protein p53 (TP53), and estrogen receptor 1 (ESR1)] predicted by the network pharmacology (P < 0.05).@*Conclusion@#The mechanism of WYSJO in treating diabetes wounds may be closely related to AGE-RAGE, p53, HIF-1, and other pathways. This study can provide new ideas for the pharmacological research of WYSJO, and provide a basis for its further transformation and application.
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Objective:To investigate the behavioral, electroencephalographic, and cognitive functional differences in drug-resistant epileptic rat models of cognitive impairment prepared by intraperitoneal injection of lithium chloride-pilocarpine followed by intracranial injection of pilocarpine or carbamylcholine.Methods:One hundred and sixty adult male SD rats were randomly divided into normal control group ( n=10), lithium chloride-pilocarpine group (establishing epileptic rat models by intraperitoneal injection of lithium chloride-pilocarpine, n=50), pilocarpine-pilocarpine group (intracranial injection of pilocarpine after intraperitoneal injection of lithium chloride-pilocarpine, n=50)and pilocarpine-carbamylcholine group (intracranial injection of carbamylcholine after intraperitoneal injection of lithium chloride-pilocarpine, n=50). Frequency and duration of spontaneously recurrent seizures (SRSs) were observed by video monitoring system, and 2 weeks after that, phenobarbital and phenytoin sodium were injected intraperitoneally to screen drug-resistant models. Frequency and amplitude of the epileptic waves in EEG were recorded by BL-420 Bio-signal Acquisition and Processing System. Novel object recognition experiment was used to detect the novel exploration, Y-maze free exploration experiment and new and different arm experiment were used to detect the spatial recognition and memory ability, and Morris water maze experiment was used to detect the spatial memory ability. Results:(1) Twenty-four rats (48.00%) survived in the lithium chloride-pilocarpine group, 25 (78.00%) in the pilocarpine-pilocarpine group, and 21 (65.62%) in the pilocarpine-carbamylcholine group; and ultimately 7, 9, and 8 drug-resistant epileptic rat models were identified, respectively; frequency and duration of SRSs in the pilocarpine-pilocarpine group and pilocarpine-carbamylcholine group were significantly higher/longer than those in the lithium chloride-pilocarpine group ( P<0.05). (2) The pilocarpine-pilocarpine group and pilocarpine-carbamylcholine group had significantly higher amplitude of the epileptic waves in EEG compared with the lithium chloride-pilocarpine group ( P<0.05); the frequency of the epileptic waves in EEG increased gradually in the lithium chloride-pilocarpine group, pilocarpine-pilocarpine group, and pilocarpine-carbamylcholine group ( P<0.05). (3) Discrimination index, accuracy, ratio of distance traveled in novel arm to total distance, and time of novel arm entries gradually decreased in the normal control group, lithium chloride-pilocarpine group, pilocarpine-pilocarpine group, and pilocarpine-carbamylcholine group, with significant differences ( P<0.05). (4) Compared with the normal control group, the pilocarpine-pilocarpine group and pilocarpine-carbamylcholine group had significantly decreased frequency in crossing the original platform ( P<0.05); compared with the normal control group, lithium-pilocarpine chloride group and pilocarpine-pilocarpine group, the pilocarpine-carbamylcholine group had statistically shorter distance of target quadrant activity ( P<0.05); number of entries in the target quadrant gradually decreased in the normal control group, lithium chloride-pilocarpine group, pilocarpine-pilocarpine group, and pilocarpine-carbamylcholine group, with significant differences ( P<0.05). Conclusion:Drug-resistant epileptic rat models established by intracranial injection of carbamylcholine after intraperitoneal injection of lithium chloride-pilocarpine have high survival rate, high SRSs rate, and severe cognitive impairment, which is suitable for studying drug-resistant epilepsy combined with cognitive impairment.
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ABSTRACT CONTEXT: Scrub typhus, caused by Orientia tsutsugamushi, has a wide range of clinical manifestations, including meningoencephalitis, acute renal failure, pneumonitis, myocarditis, and septic shock. However, there are no documented cases of scrub typhus with hypokalemia. In this report, we present a case of scrub typhus with hypokalemia and multiple organ failure syndrome, highlighting the importance of electrolyte imbalance in patients with scrub typhus. CASE REPORT: A 59-year-old woman presented to the emergency department with abdominal pain that had been present for 1 day. On admission, the physical examination and laboratory test results indicated that the patient had renal, liver, and circulatory failure, and hypokalemia. She developed meningitis and disseminated intravascular coagulation during hospitalization. She recovered with appropriate management, and was discharged on day 17. CONCLUSION: This report highlights the potential for atypical presentations of scrub typhus, including a previously undocumented association with hypokalemia. Although the contribution of hypokalemia to the patient's clinical course remains uncertain, this case underscores the importance of considering electrolyte imbalance in the management of patients with scrub typhus. Further research is warranted to better understand the relationship between scrub typhus and electrolyte imbalance.
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In atherosclerosis, chronic inflammatory processes in local diseased areas may lead to the accumulation of reactive oxygen species (ROS). In this study, we devised a highly sensitive H2O2-scavenging nano-bionic system loaded with probucol (RPP-PU), to treat atherosclerosis more effectively. The RPP material had high sensitivity to H2O2, and the response sensitivity could be reduced from 40 to 10 μmol/L which was close to the lowest concentration of H2O2 levels of the pathological environment. RPP-PU delayed the release and prolonged the duration of PU in vivo. In Apolipoprotein E deficient (ApoE‒/‒) mice, RPP-PU effectively eliminated pathological ROS, reduced the level of lipids and related metabolic enzymes, and significantly decreased the area of vascular plaques and fibers. Our study demonstrated that the H2O2-scavenging nano-bionic system could scavenge the abundant ROS in the atherosclerosis lesion, thereby reducing the oxidative stress for treating atherosclerosis and thus achieve the therapeutic goals with atherosclerosis more desirably.
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ObjectiveThe study utilized human transcriptome microarray to explore biomarkers for diagnosing drug-induced liver injury （DILI） caused by anti-tuberculosis drugs. MethodsA 6-month follow-up study was conducted on 152 patients treated with anti-tuberculosis drugs in designated hospitals in Shanghai. The blood samples were collected at the 0， 2， 4， 8， 12 and 24 weeks after treatment. According to the clinical biochemical indicators， the research subjects were divided into DILI cases （34 cases） and Control cases （118 cases）. Single factor analysis was conducted on the influencing factors between the two groups. In a 1∶1 matched DILI-control study， RNA samples of 13 pairs of cases were sequenced by the whole transcript expression mRNA array. Differentially expressed genes （DEGs） were screened by Hotelling's T2 value sequencing and the expression trend analysis of genes by STEM （short-time series expression miner）， and the functional enrichment and pathway analysis of DEGs were carried out. ResultsIn total 152 clinical cases， weight of patients was a risk factor for the occurrence of hepatotoxicity caused by anti-tuberculous drugs. Based on the analysis results of mRNA array， 513 DEGs were screened by Hotelling's T2 value sequencing method， which were enriched in 32 annotations of GO （Gene Ontology） analysis and 10 pathways of KEGG （Kyoto encyclopedia of genes and genomes） analysis. One differential expression pattern was screened by STEM， which was enriched in 2 biological process notes of GO. Among them， the key genes AIM2， CD86， CXCL10 and non-coding RNAs SCARNA10， SNHG10 and SNORD105 are potential biomarkers of DILI caused by anti-tuberculosis drugs. ConclusionIn this research for biomarkers conducted on cases with liver injury caused by anti-tuberculosis drugs， biological pathways associated with hepatotoxicity are identified and a series of key genes related with drug-induced liver injury are found， which provides the basis for mechanism study and searching for earlier and more sensitive biomarkers.
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OBJECTIVE To explore the construction of a new scientific management model for temporary drug purchase，and to provide a reference for hospitals to improve the level of rational drug use. METHODS Guided by clinical diagnosis and treatment needs and patient medication safety， our hospital carried out the whole process management practice of temporarily purchased drugs by optimizing the review process， creating a review team， formulating pre-audit and post follow-up evaluation standards based on comprehensive drug evaluation， and evaluated the practice effect through the number of temporary purchase applications， implementation rate， drug structure optimization and other indicators. RESULTS Since January 2021， our hospital had implemented a new mode of temporary drug purchase management. By December 2022， clinical pharmacists had reviewed 111 temporary drug procurement applications， effectively intercepted 13 irrational drug use applications （11.71%）， reduced the overall implementation rate of temporary drug procurement by 8.36%，and proposed five batches of drug structure optimization suggestions； 24 drugs were successively introduced such as camrelizumab，sorafenib，busulfan. After optimizing the management mode，the number of temporary drug procurement applications decreased by more than half from 133 in 2019 and 138 in 2020 to 66 in 2021 and 45 in 2022. CONCLUSIONS The model is helpful to optimize the hospital drug catalog， strengthen rational drug use，ensure the safety of patients’ drug use， and fully reflects the professional value of clinical pharmacists in hospital pharmacy management and rational drug use.
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@#Abstract: Objective To predict the potential distribution of talaromycosis marneffei (TSM) and analyze its driving factors, so as to provide evidence for the surveillance and prevention of this disease. Methods The data of all laboratory-confirmed, non-duplicating TSM published in the English and Chinese literature from the first case in January 1964 to December 2018 was collected. A Maxent ecology model using environmental variables, Rhizomys distribution and HIV/AIDS epidemic was developed to forecast ecological niche of TSM worldwide, as well as identify the driving factors. Results A total of 705 articles (477 in Chinese and 228 in English) were obtained during the study period. After excluding imported cases, a total of 100 foci information were included in the model. The area under the receiver operating characteristic (ROC) curve (AUC) of the model was 0.997 for the training set and 0.991 for the test set. Maxent model revealed that Rhizomys distribution, mean temperature of warmest quarter, precipitation of wettest month, HIV/AIDS epidemic and mean temperature of driest quarter were the top 5 important variables affecting TSM distribution. In addition to identifying traditional TSM endemic areas (South of the Yangtze River in China, Southeast Asian, North and Northeast India), other potential endemic areas were also identified, including parts of the North of the Yangtze River, Central America, West Coast of Africa, East Coast of South America, the Korean Peninsula and Japan. Conclusion Our finding has discovered hidden high-risk areas and provided insights about driving factors of TSM distribution, which will help inform surveillance strategies and improve the effectiveness of public health interventions against TM infections.
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Objective@#: To investigate the efficacy and safety of the posterior endoscopic cervical foraminotomy (PECF) using ultrasonic osteotome for the treatment of cervical osseous foraminal stenosis，focusing on introduction of the advantages of ultrasonic osteotome in partial pediculectomy and ventral osteophyte resection in PECF. @*Methods@#: Nineteen patients with cervical osseous foraminal stenosis who underwent PECF using ultrasonic osteotome in our institution between April 2018 and April 2021 were enrolled in this study. All the patients were followed up more than 12 months. The patients’ medical data, as well as pre- and postoperative radiologic findings were thoroughly investigated. The visual analogue score (VAS), Japanese Orthopaedic Association (JOA) score, cervical dysfunction index (Neck disability index, NDI), and modified MacNab criteria were used to assess the surgical efficacy. @*Results@#: All the patients were successfully treated with PECF using ultrasonic osteotome. The pre- and postoperative VAS, NDI, and JOA scores were significantly improved (p<0.05). According to the modified MacNab criteria, 17 patients were assessed as “excellent”, two patients were assessed as “good” at the last follow-up. There was no dura tear, nerve root damage, incision infection, neck deformity, or other complications. @*Conclusion@#: Adequate nerve root decompression can be accomplished successfully with the help of ultrasonic osteotome in PECF, which has the advantage of reducing the probability of damage to the nerve root and dura mater, in addition to the original merits of endoscopic surgery.
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With the increasing aging of our population， the incidence of drug-related problems among elderly patients in the community is gradually increasing. Drug-related problems can lead to an increased incidence of adverse health outcomes such as falls and frailty in elderly patients in the community. Medication review is one of the effective means of addressing drug-related problems. The medication review models in Europe and the United States have been developed for decades to address drug-related problems； medication review model in the United Kingdom focuses on the management of drug therapy for elderly patients in aged care facilities， while the medication review models in the United States and Australia have a broader scope（covering all elderly patients in the community）， and the frequency of medication reviews in the United States and Australia are clearer and more standardized. Compared with the above countries， China’s medication review model has a late start. Our country can learn from the advanced experience of the United Kingdom， the United States， Australia and other countries， actively explore and build a drug review model suitable for China’s national conditions， so as to improve the health level of elderly patients in the community and save social public medical resources.
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AIM: To observe the therapeutic effect of the diquafosol sodium combined with intense pulsed light(IPL)on meibomian gland dysfunction(MGD)dry eye after refractive surgery.METHODS:A total of 64 patients(128 eyes)with MGD dry eye diagnosed within 6mo after laser corneal refractive surgery in our hospital from March 2021 to December 2021 were selected. They were randomly divided into control group and experimental group. A total of 33 patients(66 eyes)in the control group were treated with sodium hyaluronate combined with IPL, and 31 patients(62 eyes)in the experimental group were treated with diquafosol sodium combined with IPL. Ocular symptom scores were performed before each IPL treatment in both groups to examine non-invasive tear breakup time(NIBUT), tear meniscus height, lipid layer grade of tear film, meibomian gland deletion rate and uncorrected visual acuity.RESULTS:After IPL treatment, ocular symptom scores and meibomian gland deletion rate score of two groups were decreased continuously. NIBUT, tear meniscus height and lipid layer grade of tear film were increased continuously, and there was no significant change in uncorrected visual acuity. NIBUT of patients in the experimental group was better than that in the control group before the third IPL treatment(6.24±0.27s vs. 5.51±0.24s, P=0.046).CONCLUSIONS:Both diquafosol sodium and sodium hyaluronate combined with IPL showed good therapeutic effect on MGD dry eye, but there was no significant difference in the short-term efficacy between the two groups.
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AIM: To observe the visual improvement and anatomical closure of patients with full-thickness macular hole(FTMH)accompanied by lamellar hole-associated epiretinal proliferation(LHEP)after vitrectomy.METHODS: A retrospective study of clinical cases. A total of 28 cases(28 eyes)of patients diagnosed with FTMH in our hospital between January 2018 and January 2022 were included, and they were divided into 12 cases(12 eyes)in the LHEP group and 16 cases(16 eyes)in the non-LHEP group according to the presence or absence of LHEP. All subjects had undergone vitrectomy. The best corrected visual acuity(BCVA)before and 1a after operation, hole closure, continuity of ellipsoid zone and external limiting membrane(ELM), intraocular pressure(IOP), and postoperative complications were compared between the two groups.RESULTS: Preoperative BCVA(LogMAR)was 0.80±0.17 in the LHEP group and 0.92±0.27 in the non-LHEP group(t=1.406, P=0.172); BCVA at 1a after operation was 0.54±0.14 in the LHEP group and 0.39±0.10 in the non-LHEP group(t=3.399, P=0.002). BCVA at 1a after operation was significantly improved in both groups compared with that before operation(tLHEP group=4.029; PLHEP group=0.001; tnon-LHEP group=7.445, Pnon-LHEP group=0.001); the difference in BCVA(LogMAR)before and after the operation was 0.27±0.16 in the LHEP group and 0.52±0.26 in the non-LHEP group(t=3.153, P=0.002). The hole closed in both groups 1a after the operation, and the closure rate was 100%. The ellipsoid zone closed in 20%(2/12)of patients in the LHEP group and 56%(9/16)in the non-LHEP group(Pellipsoid zone=0.04); the ELM closed in 25%(3/12)of patients in the LHEP group and 69%(11/16)in the non-LHEP group(PELM=0.027). A postoperative transient IOP elevation occurred in 2 eyes of the LHEP group and 3 eyes of the non-LHEP group, respectively. There were no significant cataract or serious complications after the vitrectomy in either group.CONCLUSIONS: Compared with FTMH patients without LHEP, the BCVA improvement after vitrectomy was less in FTMH patients with LHEP. Although their macular hole was closed, the closure rates of ellipsoid zone and ELM were lower, and the duration of continuity interruption was longer, so the prognosis requires further clarification.
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In response to the national strategy of building first-class journals and filling the gaps in English journals on radiation medicine and protection, the Radiation Medicine and Protection (RMP) was founded. Within three years, it has entered domestic and international databases such as DOAJ, Scopus, CSCD, WJCI and Embase with its CiteScore ranking first in the discipline and WJCI index surpassing a variety of international authoritative radiation protection journals. Collaborating with KeAi and Elsevier successively, this open access publisher has gained a significant number of international citations to achieve international visibility. Owing to the influence of disciplinary characteristics, domestic evaluation systems, and international exchange situation, RMP is facing development bottlenecks. We hope to explore breakthrough measures from the aspects of expanding manuscript sources, strengthening academic exchanges, and attracting young experts to joining the editorial board.
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@#Abstract：Objective To evaluate the basic development status of public health emergencies of infectious diseases in Hainan Province from 2013 to 2022, analyze the distribution and characteristics of these emergencies, as to provide important scientific basis for the study and formulation of economic health development planning policies, for the health security policies and infectious disease prevention and control strategies in Hainan Province. Methods The relevant statistical data of public health emergencies involving infectious diseases reported in Hainan Province from 2013 to 2022 were collected, and the status quo of these emergencies was analyzed by using descriptive data statistical analysis method. The ARIMA model was used to predict the number of public health emergencies reported by infectious diseases in Hainan Province from 2023 to 2025. Results From 2013 to 2022, a total of 482 public health emergencies were reported in Hainan Province, of which 426 were infectious disease public health emergencies, accounting for 88.38%, with a total of 8 876 cases, an incidence rate of 0.61%, and eight deaths, a case fatality rate of 0.09%. The major public health emergencies of infectious diseases were unclassified events and general events, accounting for 69.25% and 29.58%, respectively. The main diseases were novel coronavirus infection, chickenpox and hand, foot and mouth disease, accounting for 45.07%, 15.49% and 11.97%, respectively; in terms of time distribution, the number of reported incidents showed an upward trend over time, with a decline in 2021, and mainly had three peak periods, April, August and December, with a total of 220 cases reported; in terms of regional distribution, the major cities and counties reported were Haikou, Wanning and Wenchang, accounting for 27.46%, 19.25% and 9.86%, respectively; in terms of location distribution, the events mainly occurred in schools, accounting for 42.02% of the total number of incidents. The ARIMA(1, 1, 0) model was used to predict infectious disease public health emergencies, and the results showed that the forecast state would be stable from 2023 to 2025, with no obvious upward trend, that is, the fluctuation range of public health emergencies related to infectious diseases in Hainan Province would be stable in the next three years. Conclusion The number of infectious disease public health emergencies reported in Hainan Province from 2013 to 2022 has increased year by year, with a decline in 2021. Although the forecast shows that public health emergencies such as infectious diseases are relatively stable with no obvious upward trend, the prevention and control of the epidemic should not be taken lightly. Hainan Province should continue to increase the investment in monitoring public health emergencies, improve the information system of public disease prevention and control, and carry out real-time monitoring of public health emergencies of infectious diseases.
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Scientific journals are an important platform for academic exchange and dissemination, as well as for promoting technological innovation. This article is based on the publishing practice of the Chinese Journal of Radiological Medicine and Protection in recent years, especially after being successfully selected in the Excellent Action Plan of Chinese Science and Technology Journals. It aims to gather high-quality manuscript sources and strictly control academic quality; Pay attention to academic hotspots and strengthen content construction; Based on the characteristics of publishing, create high-quality works; To fulfill our original mission, shoulder social responsibility, strengthen academic leadership, enhance brand value, and explore how to improve the quality and dissemination of academic journal content and influence, in order to better showcase and promote China's achievements in radiation medicine and protection.
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@#[摘 要] 目的：探讨EB病毒核抗原1（EBNA1） mRNA修饰的DC（EBNA1-DC）诱导的淋巴细胞联合甲基化抑制剂5-Aza-CdR对鼻咽癌C666-1细胞的杀伤作用。方法：以构建的EBNA1-pCDNA3.1质粒为模板，体外转录获得EBNA1 mRNA，通过脂质体转染至健康人外周血来源DC，构建EBNA1-DC疫苗。流式细胞术检测转染后DC表型及5-Aza-CdR处理后的C666-1细胞凋亡情况。实时无标记动态细胞分析技术检测EBNA1-DC疫苗诱导的淋巴细胞联合5-Aza-CdR的特异性抗肿瘤活性。结果：转染EBNA1 mRNA后EBNA1-DC表面EBNA1阳性率为（59.3±5.85）%，HLA-DR的表达与未转染DC相比显著升高[（84.9±5.5）% vs （68.0±5.8）%，P=0.026]，CD80的表达也显著升高[（88.2±3.9）% vs （61.1±4.4）%，P=0.015]。低剂量5-Aza-CdR处理后的C666-1细胞凋亡情况与未处理的细胞相比无显著差异。经低浓度5-Aza-CdR预处理的C666-1细胞中IRF7基因表达与未处理的细胞相比显著升高（P=0.000 1）。与空载的DC相比，EBNA1-DC诱导的淋巴细胞对EBV阳性表达的C666-1细胞具有更强的特异性杀伤活性（P=0.049）；经低浓度5-Aza-CdR预处理的C666-1细胞对EBNA1-DC诱导的特异性免疫杀伤更敏感（P=0.019）。结论：5-Aza-CdR与EBNA1-DC疫苗联合可显著增强对C666-1细胞的特异性免疫杀伤，本研究为开拓以mRNA为基础的DC疫苗及其在临床综合治疗中的应用转化提供前期研究基础。
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OBJECTIVE To explore the pharmaceutical care model for elderly patients with drug-related problems （DRPs） based on the comprehensive medication management review （CMMR）， and to observe the effect of pharmaceutical care under the model. METHODS The pharmaceutical care new model for elderly patients was established by concerning CMMR guidelines in Australia. In other words， clinical pharmacists receive medical care through referral by health practitioners and active consultation by patients or their caregivers. Visits were made by a combination of face-to-face and telephone interviews. Follow-up was carried out in the form of outpatient follow-up， telephone follow-up， appointment， and home guidance to know about the treatment of DRPs by healthcare practitioners or patients.Under this model， the occurrence status and classification of DRPs in elderly patients were studied through cross-sectional investigation. The effect of pharmaceutical care was evaluated from the aspects of hospitalization rate， adverse drug reaction （ADR） incidence，medication compliance， the number of medications， blood lipid level， etc.， through self-before-after comparison. RESULTS In this study， a patient-centered， evaluation-intervention-reevaluation closed-loop pharmaceutical care model was formed. Among 317 study subjects， the average number of DRPs was 1.03 （0-7） cases. Compared before and after the intervention， the number of drug types increased from 2.00（0.00，3.00） to 2.00（1.00，3.00）， but the level of low-density lipoprotein cholesterin in patients decreased from 3.48 （2.58， 4.29） mmol/L to 3.11 （2.29，3.81） mmol/L （P＜0.05）. There was no statistical significance in hospitalization rate， ADR incidence within or medication compliance. CONCLUSIONS CMMR-based pharmaceutical care model can effectively identify and manage the patients’ DRPs and reduce the level of blood lipid.
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Objective @#To investigate and analyze the root and root canal morphology of mandibular first molars (MFMs) in the Tibetan population using cone-beam computed tomography (CBCT) and to provide references for clinical root canal treatment in the Tibetan population. @*Methods@#This study was reviewed and approved by the Ethics Committee, and informed consent was obtained from the patients. CBCT imaging data of 300 mandibular first molars from 300 Tibetan patients were included. Patient age, the number of roots in mandibular first molars were recorded. The morphology and incidence of mesial root and mesial root canals and the morphology and incidence of distal root and distal root canals were statistically analyzed by Vertucci classification. @*Results @#There were 198 double-root teeth and 102 three-root teeth in the 300 mandibular first permanent molars. Among the three-rooted molars, 1 case had mesiolingual roots, and the rest had distolingual roots. The incidence rate of the distolingual root was 33.7%(101/300). The most common root canal configuration was Vertucci Ⅳ 65.7% (197/300), followed by Vertucci Ⅱ 20.3% (61/300) in the mesial roots. The overall incidence of middle mesial canals (MMCs) was 6% (18/300), with the highest incidence of MMCs in the 20-40 year-old group at 9% (9/100). The distal roots canals of single-distal-rooted mandibular first molars were mainly Vertucci Ⅰ 66.8% (133/199), followed by Vertucci Ⅱ 14.6% (29/199) and Vertucci Ⅳ 11.6% (23/199). For the mandibular first permanent molars with two distal roots, 96% (97/101) of the distal buccal roots and 100% (101/101) of the distal lingual roots were Vertucci Ⅰ root canals. @*Conclusion@# The root and root canal morphology of mandibular first permanent molars in a Tibetan population is complex and variable. Approximately one-third of patients have distolingual roots, and clinicians should carefully explore the root canals under the guidance of CBCT.