Research Progress on Mechanisms and Optimization Methods for Toxicity Induced by Antibody–Drug Conjugates / 肿瘤防治研究

Since the approval of gemtuzumab ozogamicin, an antibody–drug conjugate (ADC) targeting CD33 in 2000, 13 ADC drugs have been approved by the FDA. Although these drugs have clearly improved the survival of patients with various types of advanced cancers, their significant toxicity has compromised their therapeutic benefits. The adverse reactions of ADC drugs are complex and include on-target and off-target toxicities, where the payload drug is a determining factor. Antibody and linker may also affect the degree of toxicity. Combination therapy becomes an important strategy in anticancer treatment because of its increased efficiency, but treatment-related adverse reactions also increase accordingly. This review comprehensively analyzes the toxicity mechanisms of current ADC drugs and proposes various optimization strategies, including but not limited to optimizing linker molecules, upgrading antibody design, and changing drug administration strategies, to improve the overall safety profile of ADC drugs.

Construction and Verification of A Nomogram Model for Predicting Invasive Risk of Ground Glass Nodules / 肿瘤防治研究

Objective To investigate the importance of a nomogram model based on biomarkers and CT signs in the prediction of the invasive risk of ground glass nodules. Methods A total of 322 patients with ground glass nodule, including 240 and 82 patients in the model and verification groups, respectively, were retrospectively analyzed. Independent risk factors for the invasive risk of ground glass nodules were screened out after using single and multiple Logistic analysis. R software was used to construct the nomogram model, and clinical decision curve analysis (DCA), receiver operating curve (ROC), and calibration curve were used for internal and external verification of the model. Results In this study, the independent risk factors for the invasive risk of ground glass nodules included systemic immune-inflammation index (SII), CYFRA21-1, edge, vascular cluster sign, and nodular consolidation tumor ratio (CTR). The area under the ROC curve of the constructed nomogram model had a value of 0.946, and that of the external validation group reached 0.932, which suggests the good capability of the model in predicting the invasive risk of ground glass nodules. The model was internally verified through drawing of calibration curves of Bootstrap 1000 automatic sampling. The results showed that the consistency index between the model and actual curves reached 0.955, with a small absolute error and good fit. The DCA curve revealed a good clinical practicability. In addition, nodule margin, vascular cluster sign, and CTR were correlated with the grade of pathological subtype of invasive adenocarcinoma. Conclusion A nomogram model based on biomarkers and CT signs has good value and clinical practicability in the prediction of the invasive risk of ground glass nodules.

Prospective clinical study of concurrent chemoradiotherapy combined with nituzumab for targeted treatment of locally advanced nasopharyngeal carci noma in Guangxi,Yunnan and Guizhou regions / 中国耳鼻咽喉头颈外科

OBJECTIVE To explore the clinical effect of concurrent chemoradiotherapy combined with nituzumab in the treatment of locally advanced nasopharyngeal carcinoma in Guangxi,Yunnan and Guizhou.METHODS A total of 80 patients with locally advanced nasopharyngeal carcinoma who were pathologically confirmed and admitted to Affiliated Hospital of Youjiang Ethnomedicine from July 2021 to July 2022 from ethnic minority areas near the border of Guangxi,Yunnan and Guizhou were selected as the subjects of this study.They were randomly divided into control group(standard concurrent chemoradiotherapy)and observation group(combined treatment with nituzumab on the basis of control group),with 40 cases in each group.The levels of tumor markers,oxidative stress indicators,adverse reactions,complications,and recent clinical efficacy of the two groups were compared.RESULTS After treatment,the levels of superoxide dismutase(SOD),cytokeratin 19 fragment antigen21-1(CYFRA21-1),squamous cell carcinoma associated antigen(SCCAg)and serum ferritin(SF)were significantly decreased in both groups,while nitric oxide(NO)and malondialdehyde(MDA)were significantly increased.The levels of SCCAg,SF,CYFRA21-1,NO and MDA in observation group were lower than those in control group,and the level of SOD was higher than those in control group(P<0.05).Compared with the control group,the objective response rate(ORR)in the observation group was increased(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).CONCLUSION Concurrent chemoradiotherapy combined with nituzumab can effectively improve the short-term survival rate and clinical efficacy of patients with locally advanced nasopharyngeal carcinoma,regulate tumor markers and oxidative stress levels,and alleviate the disease.

Analysis of trends in neonatal mortality and causes of death in NICU,2005-2020: a single-center study / 国际儿科学杂志

Objective:To investigate the changes of mortality，causes of death，and cause-specific mortality rate（CMR）of hospitalized neonates in NICU of the First Affiliated Hospital of Sun Yat-sen University.Method:A retrospective study was performed to compare the mortality，cause of death，and CMR of hospitalized neonates in period Ⅰ（2005-2009），period Ⅱ（2010-2014）and period Ⅲ（2015-2020）.Result:The overall mortality of hospitalized neonates in NICU of our hospital was 0.51%（104/20 493）through 2005 to 2020. The mortality in period Ⅰ，Ⅱ and Ⅲ were 0.61%（48/7 855），0.43%（27/6 209），and 0.45%（29/6 429），respectively. Compared with period Ⅰ，the mortality of preterm infants decreased significantly in period Ⅱ（3.14% vs 1.24%， χ2=14.076， P<0.01）and in period Ⅲ（3.14% vs 0.90%， χ2=25.157， P<0.01）. Eighty-five（81.7%）neonates were premature，and ninety-one（89.2%）neonates had definite abnormal perinatal factors. The CMR of hospitalized neonates related to pulmonary hemorrhage，congenital anomalies，and NRDS were 1.22‰（25/20 493），0.93‰（19/20 493），and 0.59‰（12/20 493），respectively. The CMR of other causes were sepsis 0.44‰（9/20 493），extremely premature 0.34‰（7/20 493），and perinatal asphyxia 0.24‰（5/20 493），respectively. Compared with period Ⅰ，specific mortality of NRDS in period Ⅱ（1.27‰ vs 0.16‰， χ2=5.487， P=0.016）and period Ⅲ（1.27‰ vs 0.16‰， χ2=5.738， P=0.014）significantly decreased. The leading causes of neonatal death in period Ⅰ，period Ⅱ，and period Ⅲ were NRDS，pulmonary hemorrhage，and congenital anomalies，respectively.And 71.2%（74/104）of neonatal deaths occurred within 7 days after birth. Conclusion:The mortality of preterm infants and specific mortality of NRDS in NICU have significantly decreased over the past 16 years.Congenital anomalies and infections remain important causes of death，and further efforts are needed to improve perinatal care.

Design and simulation of a UAV with portable folding wings for search and rescue / 军事医学

Objective To design a search and rescue UAV that is portable and user-friendly in order to meet the needs of rescue personnel on the battlefield.Methods Three-dimensional design software CATIA was used to complete the structural design of the UAV body.In order to make full use of the internal space of the UAV body,folding wings were adopted to reduce the volume of the UAV.By using ABAQUS,the finite elements of the key parts of the UAV were analyzed before the modal analysis of the whole vehicle was conducted to verify the reliability of the structure.The robot simulation software Webots was used for motion simulation of the UAV.Results Simulation analysis and test verification suggested that the structural design of the UAV was well-grounded.It could be quickly and properly deployed by means of hand launch or barrels,which made it easier for rescuers to use the UAV.Conclusion The design and simulation research of UAVs with portable folding wings for search and rescue is of great significance for the research and development of physical prototypes.This study is expected to stimulate new ideas for the development of rescue equipment in the PLA,and contribute to miniaturization of UAVs.

The Global Cancer Statistics Report in 2022: A Narrow Spectrum Summary and Outlook / 肿瘤防治研究

According to the global cancer statistics in 2022 updated by the International Agency for Research on Cancer (IARC), there were nearly 20 million new cases of cancer and 9.7 million deaths. Lung cancer was the most commonly diagnosed cancer, accounting for nearly 2.5 million new cases (12.4% of all global cancers), followed by female breast cancer (11.6%), colorectal cancer (9.6%), prostate cancer (7.3%), and stomach cancer (4.9%). Lung cancer was also the leading cause of cancer deaths, with an estimated 1.8 million deaths (18.7%), followed by colorectal cancer (9.3%), liver cancer (7.8%), female breast cancer (6.9%), and stomach cancer (6.8%). Population-based projections suggest that the number of new cancer cases will reach 35 million by 2050. Increasing the investment in prevention and control measures targeting key cancer risk factors, including smoking, obesity, and infections, could save many lives globally and bring significant economic and social returns to countries in the coming decades.

3D-printed scaffolds repair infected bone defects / 中国组织工程研究

BACKGROUND:At present,the treatment of infected bone defects has the problems of long course of disease,poor treatment effect and high cost.The osteogenic effect of personalized bone replacement materials in clinical treatment is limited.Therefore,a 3D-printed bone graft material with both good osteogenic effect and antibacterial effect is urgently needed for clinical treatment. OBJECTIVE:To summarize the research status of 3D-printed scaffolds loaded with antimicrobial agents for the treatment of infected bone defects. METHODS:PubMed,Web of Science,Elsevier,and CNKI databases from January 2010 to June 2022 were searched for related articles.The Chinese search terms were"bone defect,3D printing,scaffold material,antibacterial,animal experiments,in vitro experiments".English search terms were"bone defect,3D printing,scaffold,antibiosis,animal experiment,in vitro".Finally,60 articles were included for review and analysis. RESULTS AND CONCLUSION:The 3D scaffolds made of titanium,magnesium,tantalum and other metals and their alloys have certain osteogenic properties,but do not have antibacterial function.Hydroxyapatite and other bioceramic materials have good biocompatibility and are prone to be degraded,whereas due to the lack of strength,they are usually combined with artificial polymer materials to form composite materials,which respectively mimic the inorganic and organic components in natural bone,and play their respective excellent functions.Antibiotics,silver/copper nanoparticles,antimicrobial peptides,gallium and other antibacterial agents play an antibacterial role by destroying bacterial cell membrane,producing reactive oxygen species to interfere with bacterial DNA replication,inhibiting iron absorption and other mechanisms.As a result,the 3D-printed scaffold has both antibacterial and osteogenic effects.However,there are still some problems such as drug resistance and difficult to control effective concentrations.3D-printed scaffolds are often loaded with antibacterial agents by loading drug-loaded microspheres on scaffolds,preparing antibacterial coating on the scaffold surface,and participating in joint 3D printing with drugs.The loading mode of antibacterial coating prepared on the scaffold surface is the most widely used,and its antibacterial effect is more stable.Nonetheless,the selection of the most suitable loading mode for antibacterial agents needs to be further discussed and summarized.It is a future research prospect to optimize the mechanical properties of composite scaffolds and prepare biomimetic bone scaffolds so that the degradation rate is consistent with the bone reconstruction rate in infected bone defects.The ideal antibacterial agents may play a role through a variety of antibacterial mechanisms,thus being expected to play a good antibacterial effect through low antibacterial concentration,which should be a hot spot of anti-bone infection research.After loading antibacterial agents on the surface of the scaffold,antibacterial agents can"intelligently"react to the local microenvironment,achieving controlled release,and regulating the osteogenesis,vascularization and immune response of the microenvironment,which is the focus of current research.

Therapeutic Drug Monitoring of 1 106 Cases of Vancomycin Therapy and Analysis of Risk Factors / 医药导报

Objective To analyze the achievement of target vancomycin concentration and the risk factors affecting the concentration to reach the target,providing a reference for the rational use of vancomycin and the implementation of therapeutic drug monitoring(TDM).Methods Patients who were hospitalized and received vancomycin TDM from January 2016 to June 2019 at Zhongshan Hospital,Fudan University were selected.Clinical data,vancomycin blood concentrations,and occurrences of acute kidney injury(AKI)during the hospitalization were collected.Factors affecting the attainment of target vancomycin concentrations were analyzed using logistic regression and grouped according to whether the target concentrations were attained.The correlation between drug concentration and the occurrence of AKI was analyzed.Results A total of 1 106 patients were included,with 70.7％being males and a median age of 60.0(IQR=20)years.Surgical departments accounted for 76.4％of the distribution.The median duration of vancomycin therapy was 10.8 d(IQR=9.0).A total of 21.6％of patients had their first concentration monitored before administration of doses 4 and 5.The drug concentration monitoring results of 46.8％(518/1 106)of patients were in the range between 10-20 μg·mL-1,reaching the target concentration range.The incidence of vancomycin-associated AKI was 25.9％.The incidence of AKI varied among patients with different vancomycin concentrations:when the concentrations are＜10,10-＜15,15-20,and＞20 μg·mL-1,the AKI rates are 15.8％,20.5％,25.8％,and 39.4％,respectively.Multivariate logistic regression analysis showed that target concentrations were more likely to be reached with a dosing course of＞7-14 d(OR=1.688,P=0.001)and＞14 d(OR=1.744,P=0.002)than with a dosing course of ≤7 d.Patients receiving conventional daily doses were more likely to achieve target concentrations than those receiving the non-conventional daily dose(OR=1.540,P=0.003).Conclusion The current status of vancomycin TDM in China still suffers from deficiencies,such as delayed timing of monitoring and low rate of target concentration attainment.Higher vancomycin concentrations are significantly associated with AKI,and the factors affecting the vancomycin concentration to reach the target mainly include treatment duration and the complexity of the dosing regimen.

Quality evaluation of animal studies into acupuncture for glaucoma / 中国比较医学杂志

Objective To evaluate the quality of animal studies into acupuncture for glaucoma using SYRCLE's risk of bias tool,ARRIVE 2.0 guidelines,and the GSPC checklist.Methods Databases from CNKI,VIP,Wanfang,Sinomed,PubMed,Web of Science,Embase and Cochrane Library were searched to find animal research articles on acupuncture for glaucoma.Risk of bias was assessed for the included studies using the SYRCLE's tool,and reporting quality was evaluated using the ARRIVE 2.0 guidelines and GSPC checklist.Statistical analysis was performed by Excel and SPSS software.Results Thirty articles met the inclusion/exclusion criteria and were included in the final analysis.Six of the 10 items of the SYRCLE's tool had a low-risk rate of＜50％,and the non-low-risk items focused on selectivity bias,implementation bias and measurement bias.Twelve of the 22 essential sub-items of the ARRIVE 2.0 guidelines had a low-risk rate of＜50％;9 of the 16 recommended sub-items had a low-risk rate of＜50％;and 12 of the 19 subentries of the GSPC list had a low-risk rate of＜50％.Randomization,blinding,ethical statements,housing and husbandry,animal care and monitoring,and protocol registration were the non-low-risk items in the ARRIVE 2.0 guidelines and GSPC list.Conclusions The quality of the methodology and experimental reporting of animal studies into acupuncture for glaucoma are generally low,and the description of several items is not yet complete,which affects the readers'judgment on whether the result of animal studies can be translated to clinical studies.It is advisable to further promote the use of SYRCLE's tool and reporting guidelines for animal experiments to enhance the design,performance,and reporting of animal experiments;ensure the reproducibility of experiments and result;and provide reliable evidence for the translation of result to the clinic.

Mechanism Study on Chaihuang Qingyi Huoxue Granules Reduce Inflammatory Damage in Severe Acute Pancreatitis Rats by Suppressing NLRP3 Inflammasome Activation / 中药新药与临床药理

Objective To investigate the protective effect and mechanism of Chaihuang Qingyi Huoxue Granules on pancreatic tissue of rats with severe acute pancreatitis,and to observe its regulation on NLRP3 inflammasome activation.Methods Sixty-four SD rats were randomly divided into sham-surgery(SO)group,severe acute pancreatitis model(SAP)group,Chaihuang Qingyi Huoxue Granules(CH)group,and MCC950(NLRP3 inhibitor)group.Each group was further divided into 12-hour and 24-hour subgroups,with rats in each group.The SAP group,CH group,and MCC950 group were retrogradely injected with 3.5%sodium taurocholate(2 mL·kg-1)into the pancreatic ducts to establish SAP model.The MCC950 group was immediately intraperitoneally injected with MCC950(1 mg·mL-1)after model preparation.After awakening from anesthesia,the CH group was administrated by gavage with Chaihuang Qingyi Huoxue Granules solution(0.35 g·mL-1)once every 6 hours.Ascites,abdominal aortic blood,and pancreatic tissue were collected at 12 hours and 24 hours after SAP model construction.The serum amylase and lipase activities were detected using an automated biochemical analyzer.HE staining was used to observe pancreatic injury.Serum levels of IL-18 and IL-1β were detected by ELISA.The expressions of gene and proteins related to the activation of NLRP3 inflammasome were analyzed by IHC,qRT-PCR and Western Blot.Results Compared with the SAP group,the pathological damage of pancreatic tissues in the CH and MCC950 groups was significantly reduced,and the pathological score was significantly reduced(P＜0.05).The levels of serum lipase,amylase,IL-18,and IL-1β were also significantly decreased(P＜0.05).After treatment with Chaihuang Qingyi Huoxue Granules or intraperitoneal injection of NLRP3 inhibitor,the positive expressions of NLRP3,ASC and Caspase-1 in pancreatic tissues,as well as the mRNA levels of NLRP3,ASC and Caspase-1,the protein levels of NLRP3,ASC,Pro-Caspase-1 and Caspase-1 were significantly reduced compared to the SAP group(P＜0.05).Conclusion Chaihuang Qingyi Huoxue Granules can inhibit the activation of NLRP3 inflammasome,reduce the mRNA and protein expressions of NLRP3,ASC and Caspase-1 in pancreatic tissues,and suppress the release of the downstream inflammatory factors IL-18 and IL-1β and alleviate pancreatitis damage in SAP model rats.

Clinical comprehensive evaluation of recombinant Mycobacterium tuberculosis fusion protein / 中国药房

OBJECTIVE To evaluate the effectiveness， safety， economy， innovation， suitability and accessibility of recombinant Mycobacterium tuberculosis fusion protein （EC）， and to provide evidence for selecting skin detection methods for tuberculosis infection diagnosis and auxiliary diagnosis of tuberculosis. METHODS The effectiveness and safety of EC compared with purified protein derivative of tuberculin （TB-PPD） were analyzed by the method of systematic review. Cost minimization analysis， cost-effectiveness analysis and cost-utility analysis were used to evaluate the short-term economy of EC compared with TB-PPD， and cost-utility analysis was used to evaluate the long-term economy. The evaluation dimensions of innovation， suitability and accessibility were determined by systematic review and improved Delphi expert consultation， and the comprehensive score of EC and TB-PPD in each dimension were calculated by the weight of each indicator. RESULTS The scores of effectiveness， safety， economy， innovation and suitability of EC were all higher than those of TB-PPD. The affordability scores of the two drugs were consistent， while the availability score of EC was lower than those of TB-PPD. After considering dimensions and index weight， the scores of effectiveness， safety， economy， innovation， suitability， accessibility and the comprehensive score of EC were all higher than those of TB-PPD. CONCLUSIONS Compared with TB-PPD， EC performs better in all dimensions of effectiveness， safety， economy， innovation， suitability and accessibility. However， it is worth noting that EC should further improve its availability in the dimension of accessibility.

Fluctuation analysis and prediction of intravenous medication dispensing workload based on time series analysis method / 药学实践与服务

Objective To explore the fluctuation characteristics of long-term doctor's order workload in pharmacy intravenous admixture services (PIVAS) and build a daily workload fluctuation prediction model and provide reference for the adjustment of PIVAS work mode. Methods Daily workload data of long-term doctor’s orders from PIVAS in the East Campus of Zhongshan Hospital affiliated to Fudan University from July 2020 to June 2021 were selected , and the time series analysis method was used to analyze the workload fluctuation characteristics and a prediction model was established. The accuracy of the model was verified by fitting parameters and prediction results. Results The fluctuation of PIVAS long-term doctor's daily workload data had the characteristics of periodicity, short-term slow rise and irregular variation. The Winters multiplier model was used to fit the series with R2 = 0.777, the significance value of Ljung-Box statistic value (P value) was 0.060, and the mean absolute error percentage between the fitted and actual values was 4.45%, indicating that the model fitting accuracy was high. The average relative deviation between the predicted and actual results was 3.81%, indicating that the model prediction was effective. Conclusion The model constructed in this study could be used for the analysis and prediction of long-term doctor's orders workload of PIVAS. However, because the workload of doctor's orders has fluctuations such as periodicity and irregular changes, it is necessary to adjust the working model according to the fluctuation characteristics of the workload and the prediction results to ensure the efficient operation of PIVAS.

Efficacy of whole course hyperthermia on cervical metastatic lymph nodes of nasopharyngeal carcinoma and its effects on immune function / 重庆医学

Objective To study the short-term efficacy of combined cervical metastatic lymph nodes hy-perthermia during locally advanced nasopharyngeal carcinoma induction chemotherapy and concurrent chemo-radiotherapy and its effect on peripheral blood lymphocyte subsets.Methods Sixty patients with pathological-ly diagnosed nasopharyngeal carcinoma in this hospital from July 2021 to July 2022 were collected as the study subjects and divided into the observation group(induction chemotherapy+concurrent chemoradiotherapy combined with hyperthermia)and control group(induction chemotherapy+concurrent chemoradiotherapy),30 cases in each group.The general information,short term efficacy,EB virus(EBV)DNA level,adverse reac-tions occurrence,peripheral blood lymph cell subsets and hot shock protein 90α(HSP90α)were recorded and compared between the two groups.Results Compared with the control group,the objective remission rate in the observation group was higher(100.0％vs.90.0％),the EBV positive rate after induction chemotherapy was lower(20.0％vs.46.7％),the occurrence rate of ≥3 grade radiation dermatitis was higher(30.0％vs.6.7％),the level of natural killer(NK)cells after radiotherapy was increased[(25.89±5.53)％vs.(19.18±6.41)％],the HSP90α level after treatment was increased[(91.19±9.18)ng/mL vs.(67.22± 11.02)ng/mL],and the differences were statistically significant(P＜0.05).Compared with before treatment,the levels of CD3+,CD4+,CD4+/CD8+after radiotherapy in the observation group were decreased,the levels of CD3+,CD4+,CD4+/CD8+in the control group were decreased,but the differences between the two groups were not statistically significant(P＜0.05),while the proportion of peripheral blood NK cells in the experi-mental group was significantly increased compared with the control group(P＜0.05).Conclusion Hyper-thermia canimprove the local control of nasopharyngeal carcinoma cervical lymph node metastasis and improve the immune function.

Molecular mechanisms of cellular metabolic homeostasis in stem cells / 国际口腔科学杂志·英文版

Many tissues and organ systems have intrinsic regeneration capabilities that are largely driven and maintained by tissue-resident stem cell populations. In recent years, growing evidence has demonstrated that cellular metabolic homeostasis plays a central role in mediating stem cell fate, tissue regeneration, and homeostasis. Thus, a thorough understanding of the mechanisms that regulate metabolic homeostasis in stem cells may contribute to our knowledge on how tissue homeostasis is maintained and provide novel insights for disease management. In this review, we summarize the known relationship between the regulation of metabolic homeostasis and molecular pathways in stem cells. We also discuss potential targets of metabolic homeostasis in disease therapy and describe the current limitations and future directions in the development of these novel therapeutic targets.

Accuracy of different intraocular lens power calculation formulas in cataract patients with shallow anterior chamber: a meta-analysis / 中华实验眼科杂志

Objective:To systematically compare the accuracy of intraocular lens (IOL) power calculation formulas in cataract patients with shallow anterior chamber.Methods:A comprehensive literature search was conducted in MEDLINE, EMBASE, Cochrane Library, and the Chinese databases including CNKI, Wanfang, and VIP databases.The peer-reviewed literature on the accuracy of IOL power calculation formulas in cataract patients with shallow anterior chamber was searched from the establishment of the database until August 2020.Literature screening, data extraction and quality assessment were performed according to inclusion and exclusion criteria.The mean difference ( MD) of mean absolute error (MAE) among different formulas was analyzed.Meta-analysis was performed using Revman 5.3 software. Results:Seven studies involving 499 eyes were included.The accuracy of six formulas, Barrett Universal Ⅱ, Haigis, SRK/T, Hoffer Q, Holladay 1 and Holladay 2, was evaluated.The MAE of Barrett Universal Ⅱ was significantly lower than that of Hoffer Q ( MD=0.11 D; 95% CI: 0.05-0.17 D; P<0.001), Haigis ( MD=0.08 D; 95% CI: 0.03-0.13 D; P=0.002), and Holladay 2 ( MD=-0.06 D; 95% CI: -0.11--0.01 D; P=0.020). No significant difference was found in the remaining pairwise comparisons (all at P>0.05). Conclusions:The Barrett Universal Ⅱ formula is more accurate than Hoffer Q, Haigis, and Holladay 2 formulas in predicting IOL power in cataract patients with shallow anterior chamber.

Efficacy of capsular tension ring implantation on high myopia patients with cataract: a meta-analysis / 中华实验眼科杂志

Objective:To systematically evaluate the efficacy of phacoemulsification and intraocular lens (IOL) with and without capsular tension ring (CTR) in patients with high myopia and cataract.Methods:MEDLINE, EMBASE, Cochrane Library, and Chinese databases including CNKI, Wanfang Data, and VIP databases were searched from their establishment to October 2020 to obtain peer-reviewed clinical studies comparing the efficacy of cataract phacoemulsification and IOL implantation combined with CTR implantation (experimental group) and cataract phacoemulsification and IOL implantation (control group) in patients with high myopia and cataract.Literature screening, data extraction and methodological quality assessment were implemented based on inclusion and exclusion criteria.A meta-analysis of postoperative best corrected visual acuity (BCVA) in logarithm of the minimum angle of resolution unit, posterior capsular opacification (PCO), capsular contraction syndrome (CCS), retinal detachment (RD) was performed using Revman 5.3 software with mean difference ( MD) and odds ratio ( OR) describing the effect sizes of measurement data and count data, respectively. Results:Eight studies with 2 085 eyes were included in this study, including 1 054 eyes in the experimental group and 1 031 eyes in the control group.Meta-analysis showed that there was no significant difference in BCVA between the two groups at 1 week, 1 month, and 3 months after surgery, but the improvement in BCVA at 6 months after surgery was significantly better in the experimental group than in the control group ( MD: -0.11; 95% CI: -0.15--0.07; P<0.01). The incidence rates of postoperative PCO ( OR: 0.24; 95% CI: 0.15-0.36; P<0.01) and CCS ( OR: 0.08; 95 % CI: 0.01-0.65; P=0.02) and RD ( OR: 0.21; 95% CI: 0.05-0.82; P=0.02) were lower in the experimental group than in the control group, and the differences were statistically significant. Conclusions:The combination of CTR in the treatment of patients with high myopia and cataract can improve the postoperative visual quality and reduce the incidence of postoperative PCO, CCS and RD.

Meta analysis of the efficacy of three kinds of uterine barriers in preventing re-adhesion after separation of moderate or severe intrauterine adhesion / 中国医师进修杂志

Objective:To evaluate the efficacy of three kinds of uterine barriers: cook balloon, Foley balloon and intrauterine devices in preventing re-adhesion after separation of moderate or severe intrauterine adhesions.Methods:Seven databases including PubMed, Embase, Medline, Cochrane Library, China HowNet, Wanfang and CQVIP were used to retrieve, and the randomized controlled trials on the effect of using COOK balloon, Foley balloon and intrauterine devices to prevent re-adhesion after the separation of moderate and severe intrauterine adhesions were collected from the establishment of the database to December 2021. Revman 5.1 software was used for Meta analysis.Results:A total of 16 articles were selected according to the inclusion criteria. Meta analysis results showed that the rates of preventing postoperative re-adhesion, improving menstruation and pregnancy in COOK balloon were significantly better than those in intrauterine devices ( OR = 0.31, 2.75 and 1.58; 95% CI 0.19 to 0.49, 1.74 to 4.35 and 1.07 to 2.34; P<0.01); the rates of preventing postoperative re-adhesion, improving menstruation and pregnancy in Foley balloon were significantly better than those in intrauterine devices ( OR = 0.39, 1.90 and 1.73; 95% CI 0.27 to 0.57, 1.33 to 2.71 and 1.02 to 2.39; P<0.01 or <0.05). Conclusions:The use of COOK balloon and Foley balloon to prevent adhesion is better than the use of intrauterine devices in preventing re-adhesion in patients with moderate or severe intrauterine adhesions.

Meta-analysis of the prevalence and risk factors of new diabetes after chronic pancreatitis / 中华胰腺病杂志

Objective:To evaluate the prevalence and related risk factors of new onset diabetes after chronic pancreatitis by meta-analysis.Methods:Chronic pancreatitis, diabetes, post pancreatitis diabetes, type 2 diabetes, type 3c diabetes, endocrine dysfunction, chronic pancreatitis, diabetes mellitus, post pancreatitis diabetes mellitus, endocrine efficiency, risk factors were used as keywords, and the network database such as the CNKI database, Wanfang, Weipu, Chinese Medical Journal Full Text, PubMed, Embase, Cochrane Library, Web of Science, and so on from the database establishment to January 2023 were searched. The prospective and retrospective cohort studies on new diabetes after chronic pancreatitis published were searched and retrieved, and the papers were screened and the quality were evaluated according to preset inclusion and exclusion criteria; and the important data were extracted. Review Manager 5.4 was used for meta-analysis.Results:22 papers were finally included, including 13 785 patients with chronic pancreatitis, of which 4 233 were patients with new onset diabetes. Meta-analysis showed that the incidence of new diabetes after chronic pancreatitis was 29% ( RD=0.29, 95% CI 26%-32%, P<0.0001), which increased and tended to be stable along with the disease course. Alcohol drinking, smoking, alcoholic chronic pancreatitis, pancreatic calcification, biliary stricture, male, conservative treatment, pancreatic cyst and older onset age were considered as risk factors for new diabetes after chronic pancreatitis, and endoscopic treatment was considered as protective factors. Conclusions:The incidence of new diabetes after the diagnosis of chronic pancreatitis is relatively high. Clinically, we can identify high-risk groups exposed to risk factors, and early intervention can reduce the incidence rate of new diabetes after chronic pancreatitis and improve the prognosis of patients.

Effect of Mingjing Granules on Fibrovascular Membrane of Wet Age-related Macular Degeneration Based on Macrophages and Glial Cells / 中国实验方剂学杂志

ObjectiveTo investigate the effects of Mingjing granules （MJKL） on the fibrovascular membrane of experimental wet age-related macular degeneration （nAMD） based on macrophages and glial cells and further explain the mechanism of MJKL in the treatment of nAMD. MethodThe experimental nAMD fibrovascular membrane model was established by two-stage laser photocoagulation. BN rats were randomly divided into three groups： model group， anti-vascular endothelial growth factor （VEGF） group， and MJKL + anti-VEGF group. The model group was given distilled water for intragastric administration. Anti-VEGF group was injected with leizumab injection in the vitreous cavity. MJKL + anti-VEGF group was injected with leizumab injection in the vitreous cavity， and MJKL was intragastrically administered. Ten normal BN rats were not modeled and fed as controls. After 40 days of model making， fundus lesion morphology， lesion exudation area， and MD value were observed by fundus photography （FP）， fundus angiography （FFA）， optical coherence tomography （OCT）， and retinal pigment epithelium （RPE）-choroid-sclera film. The changes in retinal structure were observed by histopathology， and the expression and distribution of F4/80， Iba-1， and GFAP were detected by immunofluorescence. The relative expression levels of F4/80， Iba-1， and GFAP mRNA were detected by real-time fluorescence quantitative polymerase chain reaction （Real-time PCR）. ResultThe fibrovascular membrane model was established 40d after two-stage laser modeling. The lesion exudation area， MD value， lesion height， and lesion area in the anti-VEGF group were significantly lower than those in the model group （P<0.05）， and the retinal structural damage degree was significantly improved. Compared with the anti-VEGF group， the MJKL + anti-VEGF group significantly decreased the MD value， lesion height， and lesion area （P<0.05）， and lesion area and retinal structural damage degree were significantly improved. The fluorescence intensity of F4/80 and Iba-1 in the model group was significantly higher than that in the normal group （P<0.05）， and that in the anti-VEGF group was significantly lower than that in the model group （P<0.05）. The fluorescence intensity in the MJKL + anti-VEGF group was significantly lower than that in the anti-VEGF group （P<0.05）. The fluorescence intensity of GFAP in the model group was significantly higher than that in the normal group （P<0.05）， and that in the anti-VEGF group was significantly lower than that in the model group （P<0.05）. The relative expression levels of F4/80， Iba-1， and GFAP mRNA in the model group were significantly increased compared with the normal group （P<0.05）， and the anti-VEGF group was significantly decreased compared with the model group （P<0.05）. The relative expression levels of F4/80， Iba-1， and GFAP mRNA in the MJKL + anti-VEGF group were significantly decreased compared with those in the anti-VEGF group （P<0.05）. ConclusionMJKL combined with anti-VEGF drugs can inhibit the growth of experimental nAMD fibrovascular membrane better than anti-VEGF drugs alone， and the mechanism may be related to inhibiting the participation of macrophages and glial cells in the formation of fibrovascular membrane.

Analysis of Animal Models of Cervical Spondylotic Radiculopathy Based on Characteristics of Clinical Symptoms of Chinese and Western Medicine / 中国实验方剂学杂志

With the acceleration of social rhythm， the progress of science and technology， and the increase of the number of phubbers， the incidence of cervical degenerative diseases is also increasing year by year. Cervical spondylotic radiculopathy（CSR）， as one of the diseases induced by cervical degeneration， has seriously affected people's quality of life and physical and mental health. Traditional Chinese medicine（TCM） is effective in the treatment of CSR， but the theoretical and basic experimental evidence is not sufficient， and the current formulation standard of animal model is not unified. Therefore， based on the clinical guidelines of Chinese and Western medicine for CSR and the characteristics of the disease and syndrome， the author systematically summarized and analyzed the existing animal models， and found that the existing models of microvascular clamp nerve root compression method had a poor agreement with the the Chinese and Western medical guidelines， while the modeling methods of spinal canal insertion， autologous bone insertion compression， stainless steel column compression， and fixed frame cervical degeneration reflected a high degree of agreement in the Western medical guidelines. However， the Chinese medical diagnostic criteria were poorly matched. This indicates that the existing animal models of this disease show few TCM syndrome elements， and lack information collection and evaluation in animal behavioral evaluation similar to the four diagnoses of TCM. In conclusion， this paper aims to systematically evaluate the current status of animal model establishment of CSR based on the concept of combination of disease and syndrome， so as to provide a theoretical basis for the model establishment of CSR that is more consistent with clinical characteristics and symptoms of Chinese and Western medicine.