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Tumor vaccine is a promising strategy for cancer immunotherapy by introducing tumor antigens into the body to activate specific anti-tumor immune responses. Along with the technological breakthroughs in genetic engineering and delivery systems, messenger ribonucleic acid (mRNA) technology has achieved unprecedented development and application over the last few years, especially the emergency use authorizations of two mRNA vaccines during the COVID-19 pandemic, which has saved countless lives and makes the world witness the powerful efficacy of mRNA technology in vaccines. However, unlike infectious disease vaccines, which mainly induce humoral immunity, tumor vaccines also need to activate potent cellular immunity to control tumor growth, which creates a higher demand for mRNA delivery to the lymphatic organs and antigen-presenting cells (APCs). Here we review the existing bottlenecks of mRNA tumor vaccines and advanced nano-based strategies to overcome those challenges, as well as future considerations of mRNA tumor vaccines and their delivery systems.

Five-year outcomes of biodegradable versus second-generation durable polymer drug-eluting stents used in complex percutaneous coronary intervention / 中华医学杂志(英文版)

BACKGROUND@#There are few data comparing clinical outcomes of complex percutaneous coronary intervention (CPCI) when using biodegradable polymer drug-eluting stents (BP-DES) or second-generation durable polymer drug-eluting stents (DP-DES). The purpose of this study was to investigate the safety and efficacy of BP-DES and compare that with DP-DES in patients with and without CPCI during a 5-year follow-up.@*METHODS@#Patients who exclusively underwent BP-DES or DP-DES implantation in 2013 at Fuwai Hospital were consecutively enrolled and stratified into two categories based on CPCI presence or absence. CPCI included at least one of the following features: unprotected left main lesion, ≥2 lesions treated, ≥2 stents implanted, total stent length >40 mm, moderate-to-severe calcified lesion, chronic total occlusion, or bifurcated target lesion. The primary endpoint was major adverse cardiac events (MACE) including all-cause death, recurrent myocardial infarction, and total coronary revascularization (target lesion revascularization, target vessel revascularization [TVR], and non-TVR) during the 5-year follow-up. The secondary endpoint was total coronary revascularization.@*RESULTS@#Among the 7712 patients included, 4882 (63.3%) underwent CPCI. Compared with non-CPCI patients, CPCI patients had higher 2- and 5-year incidences of MACE and total coronary revascularization. Following multivariable adjustment including stent type, CPCI was an independent predictor of MACE (adjusted hazard ratio [aHR]: 1.151; 95% confidence interval [CI]: 1.017-1.303, P  = 0.026) and total coronary revascularization (aHR: 1.199; 95% CI: 1.037-1.388, P  = 0.014) at 5 years. The results were consistent at the 2-year endpoints. In patients with CPCI, BP-DES use was associated with significantly higher MACE rates at 5 years (aHR: 1.256; 95% CI: 1.078-1.462, P  = 0.003) and total coronary revascularization (aHR: 1.257; 95% CI: 1.052-1.502, P  = 0.012) compared with that of DP-DES, but there was a similar risk at 2 years. However, BP-DES had comparable safety and efficacy profiles including MACE and total coronary revascularization compared with DP-DES in patients with non-CPCI at 2 and 5 years.@*CONCLUSIONS@#Patients underwent CPCI remained at a higher risk of mid- to long-term adverse events regardless of the stent type. The effect of BP-DES compared with DP-DES on outcomes was similar in CPCI and non-CPCI patients at 2 years but had inconsistent effects at the 5-year clinical endpoints.

Bone turnover markers, hip bone geometry parameters and metabolic syndrome in community overweight postmenopausal women / 中华内分泌代谢杂志

Objective:To explore the changes of bone turnover markers and geometric parameters of hip bone in overweight postmenopausal women with metabolic syndrome(MS), as well as the influence of MS components. To analyze the association of these factors with the risk of fracture.Methods:A total of 505 overweight postmenopausal female patients who underwent health check-up in Lianhu Community Service Center, Danyang City, Jiangsu Province from January to December 2017 were selected. According to the MS diagnostic criteria of the International Diabetes Federation(2009), the patients were divided into MS group( n=331)and non-MS group( n=174). Blood samples were collected to determine the level of procollagen type 1 N-terminal propeptide(P1NP)and carboxy-terminal cross-linked telopeptide of type 1 collagen(CTX). Bone mineral density and hip bone geometry parameters were tested with dual-energy X-ray absorptiometry and hip structural analysis software. Results:The incidence of osteoporotic fracture and hip fracture in MS group was significantly higher than that in non-MS group(21.1% vs 13.8%, 4.8% vs 1. 1%, P<0.05). However, the bone mineral density of lumbar vertebra 1-4, femoral neck, and total hip in MS group was significantly higher than that in non-MS group, which remained after adjusting for age( P<0.05), but the difference disappeared after further adjustment for body mass index( P>0.05). The P1NP, CTX, femur strength index(FSI), section modulus(SM), and cross-sectional area(CSA)of MS group were significantly lower than those of non-MS group, the buckling ration(BR)was significantly higher than that in non-MS group, and the differences were still statistically significant after adjusting for age and body mass index( P<0.05). There was no significant difference in bone mineral density of lumbar vertebra 1-4, femoral neck, total hip, P1NP, and CTX between fracture group and non-fracture group in patients with MS. But FSI, SM, cross-sectional moment of inertia(CSMI), and CSA were significantly lower, BR was significantly higher( P<0.05) and femur strength decreased in patients with fracture. Regression analysis showed that high BR was an independent risk factor for fracture risk, while high FSI, SM, CSMI, and CSA were protective factors. Multivariate linear regression analysis showed that wasit circumference, diastolic blood pressure, and fasting plasma glucose were the main MS components affecting bone mineral density, bone turnover indexes, and hip bone geometry parameters. Conclusions:Overweight postmenopausal MS patients had decreased bone turnover rate, femoral strength, and relatively poor bone quality. Hip bone geometry parameters can be used as one of the methods to assess fracture risk in MS patients. Waist circumference, diastolic blood pressure, and fasting blood glucose are the important MS components affecting bone mass and bone quality.

Impact of insulin injection induced lipohypertrophy on multidimensional glucose variability in patients with type 1 diabetes mellitus / 中华内分泌代谢杂志

Objective:This study aimed to investigate the effect of lipohypertrophy induced by insulin injection on blood glucose fluctuation in patients with type 1 diabetes mellitus.Methods:A total of 80 patients with type 1 diabetes mellitus were recruited between June 2021 and December 2021 from the First Affiliated Hospital of Nanjing Medical University. And these patients all received insulin injection more than six months. Lipohypertrophy was assessed by ultrasound scanning, and blood glucose fluctuation was evaluated using the flash glucose monitoring system(FGM). Univariate analysis and multivariate linear regression were used to analyze the relationship of lipohypertrophy and and core indicators of blood glucose fluctuation.Results:Compared with patients without lipohypertrophy, patients with lipohypertrophy had higher mean amplitude of glycemic excursions(MAGE), coefficient of variation(CV), mean of daily differences(MODD), standard deviation(SD) of blood glucose, time above range(TAR), and high blood glucose index(HBGI; all P<0.05), while time in range(TIR) of glucose markedly become lower( P<0.01). Moreover, multivariate linear regression analysis showed that lipohypertrophy detected by ultrasound was an independent influencing factor of TIR( β=-9.423, P=0.032), MAGE( β=1.114, P=0.039), CV( β=4.304, P=0.041), MODD( β=0.717, P=0.046) after adjusting for age at diagnosis, duration of insulin injection, fasting C-peptide, and daily dose of insulin per unit weight. Conclusion:Lipohypertrophy increases glycemic variability and imposes negative impact on glycemic control rate in patients type 1 diabetes mellitus.

Association of Ego-depletion level with glycemic control and quality of life among adolescents with type 1 diabetes / 中国实用护理杂志

Objective:To investigate the ego-depletion level of adolescents with type 1 diabetes mellitus (T1DM) and to explore its association with glycemic control and quality of life.Methods:This was a cross-sectional survey study. A total of 195 adolescents with T1DM were recruited from the First Affiliated Hospital of Nanjing Medical University from March to September 2022 by convenient sampling method. The Self-Regulatory Fatigue Scale (SRF-S) and Short Form of the Chinese version Diabetes Quality of Life for Youth Scale (C-DQOLY-SF) and the general information questionnaire were collected and the glycated hemoglobin (HbA 1c) value was detected. Results:The total score of self-regulatory fatigue for 195 adolescents with T1DM was (42.23 ± 9.94) points, with a scoring rate of 52.79%, which was at a medium level. Pearson correlation analysis showed that the total score of self-regulatory fatigue was positively correlated with HbA1c ( r = 0.25, P<0.01), and negatively correlated with quality of life ( r = -0.61, P<0.01). The hierarchical linear regression results showed that after controlling for demographic sociolagy and disease variables, ego-depletion had a positive predictive effect on HbA1c ( t = 3.69, P<0.01), while ego-depletion had a negative predictive effect on Quality of life ( t = -8.48, P<0.01). Conclusions:Ego-depletion of adolescents with T1DM may affect their blood glucose control and quality of life, which should be noticed by medical workers.

Effects of the S1PR3 specific agonist peptide GPS-725.017 on acute lung injury in mice / 中华急诊医学杂志

Objective:To design a modified S1PR3 specific agonist, GPS-725.017, and investigate its protective effect on acute lung injury by promoting macrophage clearance of bacteria.Methods:A short peptide derived from the intracellular region of S1PR3 receptor was named GPS725.017, which was modified with norleucine (Nle) and myristicacid (myr) at its N terminus. Mice were divided into the sham operation group, solvent group and GPS-725.017 treatment group. The acute lung injury model was induced by endotracheal injection of E. coli (5×10 6 CFU), and the experimental group was treated with GPS-725.017 (10 mg/kg). The 48-h survival rate of mice was recorded. After 5 h of modeling, the bacterial load and inflammatory cytokines in peripheral blood and lung were detected, and Vps34 protein content in alveolar macrophages was determined by Western blot. After 12-h of modeling, lung tissues were collected for H&E staining and pathological scores. Results:Compared with the solvent group, the survival rate of mice in the GPS-725.017 treatment group was significantly improved ( P<0.01), the bacterial CFU in blood and alveolar lavage fluid was significantly lower than that in the solvent group ( P<0.001), and the levels of TNF-α and IL-1β in blood and alveolar lavage fluid were significantly lower than those in the solvent group ( P<0.001). Western blot showed that the expression level of Vps34 protein in alveolar macrophages was significantly higher than that in the solvent group ( P<0.01). Histopathology result showed that the pathological damage of lung in the treatment group was significantly less than that in the solvent group ( P<0.001). Conclusions:The modified synthetic S1PR3 specific agonist GPS-725.017 could specifically activate the S1PR3 receptor on the membrane of alveolar macrophages and up-regulate the expression level of intracellular Vps34 protein, which can promote the removal of bacteria in alveolar macrophages, significantly reduce the degree of lung injury and improve the survival rate in ALI mice.

A study on the composite indices of femoral neck strength in non-low-weight postmenopausal women with type 2 diabetes mellitus in community / 中华内分泌代谢杂志

Objective:To explore the risk of hip fracture, changes of composite indices of femoral neck strength and its influential factors in non-low-weight postmenopausal women with type 2 diabetes mellitus(T2DM).Methods:A total of 626 non-low-weight postmenopausal women were selected and divided into type 2 diabetes group, pre-diabetic group, and non-diabetic group according to the diagnostic criteria of the American Diabetes Association in 2010. Each participant completed the questionnaire, physical examination, laboratory examination, and Dual-energy X-ray absorptiometry(DXA) examination.Results:Hip fracture rate in T2DM group was significantly higher than that in non-diabetic group(3.4% vs 0.7%, P<0.05), while no significant difference was observed between pre-diabetic group and non-diabetic group(1.1% vs 0.7%, P>0.05). Bone mineral density(BMD) of lumbar spine 1-4, femoral neck, and total hip was comparable between T2DM group and non-diabetic group or pre-diabetic group and non-diabetic group, respectively( P>0.05). The composite indices of femoral neck strength in T2DM group was significantly lower than that in non-diabetic group( P<0.05), but there was no significant difference between pre-diabetic group and non-diabetic group( P>0.05). Regression analysis showed that age and body mass index were the main influential factors of the femoral neck bone mineral density and the composite indices of femoral neck strength( P<0.05). Conclusion:The composite indices of femoral neck strength could be used as one of the markers to evaluate the risk of hip fracture in type 2 diabetic patients.

Influence factors of the peak time in computed tomography portal venography / 中国医师杂志

Objective:To evaluate the influence factors of the peak time in computed tomography (CT) portal venography.Methods:Twenty-eight patients who underwent CT perfusion (CTP) examination in Minhang Hospital Affiliated to Fudan University from October 2020 to December 2021 were retrospectively collected. The CT enhancement time-density curves of the main portal vein trunk and abdominal aorta were obtained at the cross section of the left and right branches of portal vein. The peak time of portal vein and abdominal aorta, the enhanced CT attenuation of the liver and spleen parenchyma enhancement at the peak value of portal vein were measured. Pearson correlation and regression analysis were performed.Results:The peak time of abdominal aorta was (16.39±2.68)s, and portal vein was (27.12±4.65)s. The enhanced CT attenuation of liver and spleen parenchyma were (84.64±20.21)HU and (142.28±25.15)HU, respectively. The peak time of portal vein was positively correlated with the peak time of abdominal aorta ( r=0.825, P<0.001), and there was no statistical correlation with the enhanced CT values of liver and spleen. Multiple linear regression analysis showed that the peak time of abdominal aorta was an independent factor affecting the peak time of portal vein ( b=1.326, t=5.874, P<0.001). The regression equation was the peak time of portal vein=4.185+ 1.451× the peak time of abdominal aorta. The peak time of portal vein in cirrhosis group was (27.78±4.48)s, and that in noncirrhosis group was (26.8±4.81)s, with no significant difference between the two groups ( P=0.614). Conclusions:There was a linear correlation between the peak time of portal vein and the abdominal aorta, and the results could be helpful to optimize the setting of delay time before CT portal venography.

Long-term prognosis effects of single and staged percutaneous coronary intervention in patients with multi-vessel coronary artery disease / 中国医师进修杂志

Objective:To compare the influence of single and staged percutaneous coronary intervention (PCI) on long-term prognosis in patients with multi-vessel coronary artery disease.Methods:Using prospective research methods, 1 832 patients with multi-vessel coronary artery disease from January to December 2013 in Fuwai Hospital, Chinese Academy of Medical Sciences were selected. According to the time of PCI, the patients were divided into single PCI group (1 218 cases) and staged PCI group (614 cases). The patients were followed up for 2 years, the primary endpoint was major cardiovascular and cerebrovascular event (MACCE), including target vessel-related myocardial infarction (TV-MI), target vessel-related revascularization (TVR), cardiogenic death and stroke, and the secondary endpoint was stent thrombosis. The propensity score matching (PSM) was applied to balance the discrepancies between 2 groups, and the baseline and follow-up data were compared. The Kaplan-Meier survival curves were drawn to evaluate the survival rates events; multifactor Cox proportional risk regression was used to analyze whether staged PCI was an independent risk factor for the endpoint events.Results:The in-hospital stay, duration of procedure and synergy between percutaneous coronary intervention with taxus and cardiac surgery (SYNTAX) score in single PCI group were significantly lower than those in staged PCI group: (5.54±3.09) d vs. (9.50±4.06) d, (43.12±28.55) min vs. (79.54±44.35) min, (14.04±7.63) scores vs. (18.51±7.79) scores, and there were statistical differences ( P<0.01); there were no statistical difference in complete revascularization rate and SYNTAX score after PCI between 2 groups ( P>0.05). Based on 2-year follow-up, the incidences of TV-MI and stent thrombosis in staged PCI group were significantly higher than those in single PCI group: 2.1% (13/614) vs. 0.5% (6/1 218) and 2.0% (12/614) vs. 0.4% (5/1 218), and there were statistical differences ( P<0.01). Kaplan-Meier survival curves analysis results showed that the event-free survival rates of TV-MI and stent thrombosis in single PCI group were better than those in staged PCI group (99.5% vs. 97.9% and 99.6% vs. 98.0%, P<0.01). Multifactor Cox proportional risk regression analysis results showed that staged PCI was an independent risk factor for stent thrombosis ( HR = 3.91, 95% CI 1.25 to 12.18, P = 0.019). After PSM, the incidences of TV-MI and stent thrombosis in staged PCI group were significantly higher than those in single PCI group: 2.1% (13/614) vs. 0.7% (4/614) and 2.0% (12/614) vs. 0.5% (3/614), and there were statistical differences ( P<0.05); Kaplan-Meier survival curve analysis results showed that the event-free survival rates of TV-MI and stent thrombosis in single PCI group were significantly higher than those in staged PCI group: (99.3% vs. 97.9% and 99.5% vs. 98.0%, P<0.05); multifactor Cox proportional risk regression analysis results showed that staged PCI was not an independent risk factor of stent thrombosis ( HR = 2.29, 95% CI 0.58 to 9.00, P = 0.234). Both before and after PSM, there were no evidences for interaction between the type of angina pectoris and staged PCI ( P>0.05). Conclusions:Although a seemingly increase exists in the incidence of TV-MI and stent thrombosis in the staged PCI group, staged PCI is an independent risk factor neither for MACCE and its components, nor for stent thrombosis. In addition single PCI reduces the in-hospital days and duration of PCI procedure, which may be a relatively reasonable approach to clinical practice.

Impact of the depth of lipohypertrophy assessed by ultrasound on glycemic control in diabetic patients / 中华内分泌代谢杂志

To evaluate the impact of the depth of lipohypertrophy on glycemic control in diabetic patients, 498 diabetic patients were recruited from July 2017 to July 2020 in the First Affiliated Hospital of Nanjing Medical University. Their demographic and clinical data were collected. Lipohypertrophy was assessed with ultrasound. 85.1%(424/498) of patients had lipohypertrophy. The average depth of lipohypertrophy was(5.62±2.49) mm. Compared with HbA 1C≤7%, patients with HbA 1C>7% had significantly higher proportion of lipohypertrophy with depth >5 mm(69.7% vs 81.3%, P<0.05). After adjusting potential confounders, the level of HbA 1C in patients with the depth of lipohypertrophy>5 mm was still significantly higher than those with the depth of lipohypertrophy≤5 mm( OR=1.716, 95% CI 1.104-2.668, P<0.05). The depth of lipohypertrophy may be an independent risk factor for suboptimal HbA 1C. However, prospective studies are still needed to confirm.

A preliminary study of radiomics in predicting WHO/ISUP grading of clear cell renal cell carcinoma based on unenhanced CT texture analysis / 中华放射学杂志

Objective:To investigate the value of radiomics based on unenhanced CT texture analysis in predicting the WHO/International Society of Urological Pathology (ISUP) grading of clear cell renal cell carcinoma (ccRCC).Methods:Postoperative pathology-confirmed ccRCC subjects ( n=90) who received CT scanning and had a definite pathological grading in Cancer Hospital of the University of Chinese Academy of Sciences were collected retrospectively from December 2016 to May 2019. The cases were randomly divided into training group ( n=63) and test group ( n=27) as a ratio of 7∶3. All cases were classified into low grade (grades Ⅰ and Ⅱ, n=57) and high grade (grades Ⅲ and Ⅳ, n=37) according to the new pathological grading (WHO/ISUP grading, version 2016) of renal carcinoma. 3D-ROI segmentation was performed on unenhanced CT images and 93 texture features were extracted. The least absolute shrinkage and selection operator (LASSO) regression was used to reduct dimension of texture parameters and then the radiomics score (Rad-score) was established. The logistic regression was used to develop the prediction model with the pathological grading as the gold standard. The ROC curve and calibration curve were used to evaluate the predictive performance of the model, and the area under the curve (AUC), accuracy, sensitivity and specificity were calculated. The Hosmer-Lemeshow test was used to evaluate calibration degree of the model. Results:The 10 non-zero coefficient texture features were screened out through dimension reduction steps. The Rad-score was formed according to the linear combination of these ten features and corresponding coefficients, and then the prediction model was developed. The AUC of the model in training group was 0.933 (95%CI 0.862-1.000), the sensitivity was 92.3%, the specificity was 89.2%, and the model accuracy was 90.5%. The calibration curve showed the good calibration ( P=0.257). The AUC value in test group was 0.875 (95%CI 0.734-1.000), the sensitivity, specificity and accuracy were 72.7%, 87.5% and 81.5%. The calibration curve showed the good calibration ( P=0.125). Conclusion:The radiomics prediction model based on unenhanced CT texture analysis have application potential for the evaluation of WHO/ISUP grading of ccRCC.

Advances of genetics of age-related macular degeneration / 中华实验眼科杂志

Age-related macular degeneration (AMD) is one of the leading causes of blindness for the elderly over 50, characterized by loss of central vision irreversibly.The mechanism of AMD is not clear.In recent years, researchers have screened a variety of AMD-related genes ( CFH, ARMS2, HTRA1, etc.) and single nucleotide polymorphisms (SNPs) through genome-wide association study (GWAS). By testing these specific loci in high-risk populations, we can predict the risk of AMD, the subtypes, how AMD would develop, and how patients would react to treatment.There are few breakthroughs in the pathogenesis of the disease.Gene therapy focuses on anti-vascular endothelial growth factor (VEGF), complement pathway inhibition and RNA interference, by expressing functional proteins through transfection of adeno-associated virus vectors, but the safety and efficacy remains to be further evaluated.

Changes of diagnosis and treatment strategies of retinal vein occlusion according to EURETINA updated guidelines / 中华实验眼科杂志

Retinal vein occlusion (RVO) is one of the most common diseases severely threatening visual acuity.There is not a complete consensus on the clinical treatment strategies and schemes,and no guideline or consensus has been published in China.The publication of the latest international guidelines has provided more comprehensive and clear suggestions and advices for treatment and management strategies for RVO.Reading and understanding those guidelines could provide references for clinical practice,and offer help for standard diagnosis and treatment.

Combination of a single-chain variable fragment JZC00 with 2-deoxyglucose inhibited tumor growth in murine models / 中国药科大学学报

@#This study aimed to investigate the antitumor efficacy of a single-chain variable fragment JZC00 combined with 2-deoxyglucose(2-DG)on murine non-small lung cancer cell and breast cancer cell models. JZC00 was expressed by E. coli and identified using SDS-PAGE and Western blot. The combination inhibited the proliferation of LLC and 4T1 cells. The concentration of glucose and lactic acid in the medium were determined by glucose and lactate kit, respectively, then calculated the tumor cell glucose uptake inhibition rate and lactate release inhibition rate. In vivo, the tumor volume and tumor weight were analyzed after 15-day treatment. The results showed that the molecular weight of JZC00 expressed was correct, and it could inhibit the proliferation of tumor cells in vitro. JZC00 and 2-DG could inhibit the glycolysis of tumor cells, respectively, and JZC00 combined with 2-DG could inhibit glycolysis synergistically. When hypoxic microenvironment was induced in vitro, the inhibition of glycolysis by JZC00 treatment decreased. However, it was reversed with the addition of 2-DG. The in vivo models the combination showed a significantly improved tumor suppressive effect compared with JZC00 treated group, suggesting that 2-DG could improve the anti-tumor effect of anti-angiogenic antibodies and its combination has the potentialial value in the treatment of solid tumors.

Study on the Effects of Self-assembly Micelles of Euphorbiae Semen Fatty Oil on Intestinal Absorption of 4 Kinds of Euphorbia in Rats / 中国药房

OBJECTIVE：To study the effects of different amounts of Euphorbiae Semen fatty oil in self-assembly micelles on intestinal absorption of 4 kinds of euphorbia （euphorbia L 1，L2，L3，L8）in rats. METHODS ：The self-assembled micelle solution containing 4 kinds of euphorbia was prepared by adding 4 kinds of euphorbia （40 mg/L）in excess ，using the fatty oil of Euphorbia Semen（0.2，0.4，1，4 g/L）and sodium deoxycholate as carriers. Totally 60 rats were collected to establish in-situ one-way intestinal perfusion model. Different intestinal segments （duodenum，jejunum，ileum，colon）were perfused with drug-containing intestinal perfusion fluid according to different dosage of Euphorbiae Semen fatty oil. HPLC method was adopted to determine the contents of 4 kinds of euphorbia in the intestinal perfusate before and after perfusion. The absorption rate constant （Ka）and apparent absorption coefficient （Peff）of 4 kinds of euphorbia in different intestinal segments were calculated. The ileum segment with better absorption was selected as the object to investigate and calculate the ac cumulative absorption of 4 kinds of euphorbia. RESULTS：The self-assembled micelles formed by different concentrations of fatty oil of Euphorbiae Semen could significantly increase the absorption of 4 kinds of euphorbia in different intestinal segments to different extents. When the dosage of Euphorbiae Semen fatty oil was 0.4 g/L，the intestinal absorption effect of 4 kinds of euphorbia were all the best ；the Peff was significantly increased，compared with no fat oil group （P＜0.05 or P＜ . According to the order of Ka and Peff of each intestinal ： segment in different fatty oil dosage groups ，the absorption 0531-89628590。E-mail：1310394709@qq.com effect of 4 kinds of euphorbia in each intestinal segment was the best in jejunum and the worst in colon. Compared with no fatty oil group ，when the amount of Euphorbiae Semen fatty oil w as 0.2-4 g/L，accumulative amount of 4 kinds of euphorbia in the ileum of rats increased significantly （P＜0.05 or P＜0.01）， and the highest in 0.4 g/L Euphorbiae Semen fatty oil group. CONCLUSIONS ：The self-assembly micelle s composed of Euphorbiae Semen fatty oil and deoxycholate can increase the absorption of euphorbia L 1，L2，L3，L8 in each intestinal segment to different extent，and the jejunum is the main absorption segment.

Changes of diagnosis and treatment strategies of retinal vein occlusion according to EURETINA updated guidelines / 中华实验眼科杂志

Retinal vein occlusion (RVO) is one of the most common diseases severely threatening visual acuity.There is not a complete consensus on the clinical treatment strategies and schemes, and no guideline or consensus has been published in China.The publication of the latest international guidelines has provided more comprehensive and clear suggestions and advices for treatment and management strategies for RVO.Reading and understanding those guidelines could provide references for clinical practice, and offer help for standard diagnosis and treatment.

Impact of flash glucose monitoring on glycemic control in type 1 diabetic patients / 中华内分泌代谢杂志

Objective The application of flash glucose monitoring ( FGM) in type 1 diabetes could diminish the frequency of hypoglycaemia, however, how FGM improving the glycaemic control target (e.g. HbA1C) is waited to be investigated. Methods Seventy type 1 diabetic patients were recruited from December 2017 to July 2018 in the First Affiliated Hospital of Nanjing Medical University. Their demographic data, use of FGM and HbA1C level were collected. Results We observed that type 1 diabetic patients wearing the FGM showed lower insulin dose [(0.562± 0.059)U/kg vs (0.772±0.049)U/kg, P=0.008)], shorter diabetic duration[2.0(0.8-6.0) vs 6.0(2.5-10), P=0.013], lower HbA1C value [6.8％(6.2％-7.7％) vs 8.0％(6.9％-9.4％), P=0.001]. Nevertheless, after adjusting the potential confounders, the level of HbA1C in patients wearing FGM was significantly lower than those without FGM. Moreover, it was independent of other factors, such as the dose of insulin and the insulin delivery method. Conclusion Type 1 diabetic patients wearing FGM had lower HbA1C value but it needs further follow-up to confirm the improvement of glycaemic control in type 1 diabetes with the use of FGM.

Effect of transversus abdominis plane block on postoperative cognitive function in elderly patients undergoing laparoscopic surgery under general anesthesia / 中华麻醉学杂志

Objective To evaluate the effect of transversus abdominis plane (TAP) block on postoperative cognitive function in elderly patients undergoing laparoscopic surgery under general anesthesia.Methods Forty-eight male patients undergoing laparoscopic tension-free repair of inguinal hernia under general anesthesia,aged 65-75 yr,of American Society of Anesthesiologists physical status Ⅱ or Ⅲ,with body mass index of 20-28 kg/m2,were divided into 2 groups (n =24 each) using a random number table method:TAP block combined with general anesthesia group (group TG) and general anesthesia group (group G).Anesthesia was induced with midazolam,cisatracurium besylate,sufentanil and etomidate,and the patients were mechanically ventilated after laryngeal mask airway insertion.TAP block was performed through the anterior superior iliac spine approach,and 0.25％ ropivacaine 30 ml was injected in group TG.Anesthesia was maintained by target-controlled infusion of propofol and remifentanil and muscle relaxation by intravenously injecting cisatracurium.The occurrence of cerebral regional oxygen saturation (rSO2) and low rSO2 events (rSO2 ＜60％) was recorded at 1 min before anesthesia induction (T0),5 min after inserting the laryngeal mask airway (T1),at skin incision (T2),30 min after skin incision (T3),and at the end of surgery (T4).The consumption of propofol and remifentanil was recorded during surgery.Montreal Cognitive Assessment (MoCA) was used to evaluate the cognitive function of patients at 1 day before surgery and 7 days after surgery,and the development of postoperative cognitive dysfunction (POCD,MoCA scores＜ 26) was recorded.Results Compared with group G,the intraoperative consumption of propofol and remifentanil was significantly reduced,rSO2 was increased at T2~,and the incidence of low rSO2 events was decreased,MoCA scores were increased at 7 days after surgery,and the incidence of POCD was decreased in group TG (P＜0.05).Conclusion TAP block can reduce the incidence of POCD in elderly patients undergoing laparoscopic surgery under general anesthesia.

In Vitro and In Vivo Study on the Effect of Lysosome-associated Protein Transmembrane 4 Beta on the Progression of Breast Cancer / 한국유방암학회지

PURPOSE: Although the effect of lysosome-associated protein transmembrane 4 beta (LAPTM4B) on the proliferation, migration, and invasion of breast cancer (BC) cells has already been studied, its specific role in BC progression is still elusive. Here, we evaluated the effect of different levels of LAPTM4B expression on the proliferation, invasion, adhesion, and tumor formation abilities of BC cells in vitro, as well as on breast tumor progression in vivo. METHODS: We investigated the influence of LAPTM4B expression on MCF-7 cell proliferation, invasion, adhesion, and tube formation abilities in vitro through its overexpression or knockdown and on breast tumor progression in vivo. RESULTS: Cell growth curves and colony formation assays showed that LAPTM4B promoted the proliferation of breast tumor cells. Cell cycle analysis results revealed that LAPTM4B promoted the entry of cells from the G1 into the S phase. Transwell invasion and cell extracellular matrix adhesion assays showed that LAPTM4B overexpression increased the invasion and adhesion capabilities of MCF-7 cells. More branches were observed in MCF-7 cells overexpressing LAPTM4B under an electron microscope. In comparison with LAPTM4B overexpression, LAPTM4B knockdown decreased the expression of vascular endothelial growth factor-A and significantly inhibited the vasculogenic tube formation ability of tumors. These results were also verified with western blot analysis. CONCLUSION: LAPTM4B promoted the proliferation of MCF-7 cells through the downregulation of p21 (WAF1/CIP1) and caspase-3, and induced cell invasion, adhesion, and angiogenesis through the upregulation of hypoxia-inducible factor 1 alpha, matrix metalloproteinase 2 (MMP2), and MMP9 expression. This specific role deems LAPTM4B as a potential therapeutic target for BC treatment.

Drug resistance analysis of Myroides odoratimimus producing MUS-1 carbapenemase / 临床检验杂志

Objective@#To investigate the clinical and microbiological characteristics of Myroides odoratimimus producing MUS-1 carbapenemase. @*Methods@#A strain of gram-negative bacterium isolated from the urine sample of one patient hospitalized in the oncology department of Affiliated Hospital of Xuzhou Medical University was identified by the Vitek 2 automatic microbial analyzer and 16S RNA sequencing, and its bla MUS-1 gene was detected with PCR. The minimum inhibitory concentrations (MICs) of antimicrobial drugs were determined by the broth dilution method. @*Results@#One strain of MUS-1 carbapenemase producing Myroides odoratimimus was found. The drug susceptibility test showed that it was resistant to most of antibiotics conventionally used, but sensitive to minocycline and meropenem, the MIC of imipenem was 8 μg/mL, which was judged as intermediate. @*Conclusion@#The bla MUS-1 gene may be the cause leading Myroides odoratimimus to resistant carbapenems drugs.