Deubiquitinating enzyme MINDY1 is an independent risk factor for the maintenance of stemness and poor prognosis in liver cancer cells / 中华肝脏病杂志

Objective: To explore the key deubiquitinating enzymes that maintain the stemness of liver cancer stem cells and provide new ideas for targeted liver cancer therapy. Methods: The high-throughput CRISPR screening technology was used to screen the deubiquitinating enzymes that maintain the stemness of liver cancer stem cells. RT-qPCR and Western blot were used to analyze gene expression levels. Stemness of liver cancer cells was detected by spheroid-formation and soft agar colony formation assays. Tumor growth in nude mice was detected by subcutaneous tumor-bearing experiments. Bioinformatics and clinical samples were examined for the clinical significance of target genes. Results: MINDY1 was highly expressed in liver cancer stem cells. The expression of stem markers, the self-renewal ability of cells, and the growth of transplanted tumors were significantly reduced and inhibited after knocking out MINDY1, and its mechanism of action may be related to the regulation of the Wnt signaling pathway. The expression level of MINDY1 was higher in liver cancer tissues than that in adjacent tumors, which was closely related to tumor progression, and its high expression was an independent risk factor for a poor prognosis of liver cancer. Conclusion: The deubiquitinating enzyme MINDY1 promotes stemness in liver cancer cells and is one of the independent predictors of poor prognosis in liver cancer.

Clinical features of acute macular neuroretinopathy induced by Omicron / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To observe the clinical features of acute macular neuroretinopathy(AMN)induced by Omicron.METHODS: A retrospective study. A total of 9 patients(18 eyes)diagnosed with AMN from December 2022 to January 2023 in the Hospital of Chengdu University of Traditional Chinese Medicine were included. Patients underwent spectral-domain optical coherence tomography(SD-OCT), fundus fluorescein angiography(FFA), fundus photography, autofluorescence(AF), infrared reflectance(IR), optical coherence tomography angiography(OCTA)and multicolor, etc. Furthermore, they were followed up for 1～3mo and observed the prognosis.RESULTS: The initial symptom of the Omicron-induced AMN was the sudden onset of central/paracentral scotoma in the eyes with or without impaired vision and metamorphopsia, and the scotoma could persist for at least 3mo. The image features of AMN are as follows. First, the SD-OCT examination showed the rupture of outer retinal layers, scattered hyperreflective lesions, and atrophy of outer retinal layers. In severe cases, hyperreflective lesions were seen in the inner nuclear layer(INL)or with microcystic cavities under the retinal pigment epithelium(RPE). Second, the OCTA examination demonstrated the decreased blood flow density of the deep capillary plexus(DCP)of the macula. Third, the IR examination showed the weak reflection of lesion areas. Fourth, the fundus photography demonstrated the localized brown wedge-shaped lesion.CONCLUSIONS: The Omicron-induced AMN is mostly found in young females, and the characteristic manifestation of fundus is damage to the outer retinal layers. The extent of fundus lesions is related to the systemic inflammatory response and ocular microcirculatory changes after infection. The multimodal fundus image examination and a history of Omicron infection are helpful to diagnose the Omicron-induced AMN.

Research progress on ferroptosis regulated by glycolysis-fatty acid metabolism in metabolic diseases / 药学学报

In metabolic diseases, the accumulation of reactive oxygen species and oxidative stress are closely associated with ferroptosis. As a key regulatory factor, the imbalance between glycolysis and fatty acid metabolism can participate in ferroptosis directly or indirectly, thereby regulating the occurrence and development of various metabolic diseases. The essence of ferroptosis is a new regulatory cell death mode, which is caused by the excessive accumulation of iron-dependent lipid peroxide. It is closely related to glycolysis and fatty acid metabolism, which plays an important role in metabolic diseases. This regulatory cell death mode is significantly distinguished from other programmed cell death modes and has unique changes in cell morphology, symbolic characteristics and mechanisms. This paper first illustrates the main mechanism of glycolysis and fatty acid metabolism imbalance in the occurrence of ferroptosis, then reviews the research progress of ferroptosis in tumor, diabetes, rheumatoid arthritis and other metabolic diseases, and finally reveals the internal connection between glycolysis-fatty acid metabolism imbalance and ferroptosis, as well as its impacts on metabolic diseases, which provide new strategies for the prevention and treatment of metabolic diseases.

Renewal of embryonic and neonatal-derived cardiac-resident macrophages in response to environmental cues abrogated their potential to promote cardiomyocyte proliferation via Jagged-1-Notch1

Cardiac-resident macrophages (CRMs) play important roles in homeostasis, cardiac function, and remodeling. Although CRMs play critical roles in cardiac regeneration of neonatal mice, their roles are yet to be fully elucidated. Therefore, this study aimed to investigate the dynamic changes of CRMs during cardiac ontogeny and analyze the phenotypic and functional properties of CRMs in the promotion of cardiac regeneration. During mouse cardiac ontogeny, four CRM subsets exist successively: CX3CR1+CCR2-Ly6C-MHCII- (MP1), CX3CR1lowCCR2lowLy6C-MHCII- (MP2), CX3CR1-CCR2+Ly6C+MHCII- (MP3), and CX3CR1+CCR2-Ly6C-MHCII+ (MP4). MP1 cluster has different derivations (yolk sac, fetal liver, and bone marrow) and multiple functions population. Embryonic and neonatal-derived-MP1 directly promoted cardiomyocyte proliferation through Jagged-1-Notch1 axis and significantly ameliorated cardiac injury following myocardial infarction. MP2/3 subsets could survive throughout adulthood. MP4, the main population in adult mouse hearts, contributed to inflammation. During ontogeny, MP1 can convert into MP4 triggered by changes in the cellular redox state. These findings delineate the evolutionary dynamics of CRMs under physiological conditions and found direct evidence that embryonic and neonatal-derived CRMs regulate cardiomyocyte proliferation. Our findings also shed light on cardiac repair following injury.

Rethinking the marketing strategy of anti-tumor drugs by single-arm trials supported / 中华肿瘤杂志

Single-arm trial refers to a clinical trial design that does not set up parallel control group, adopts open design, and does not involve randomization and blind method. These features, on the one hand, speed up the process of clinical trials, significantly shorten the time to market and meet the needs of patients with advanced malignancies, but also lead to the uncertainty of single-arm clinical trials themselves. Recently, the US Food and Drug Administration held a meeting of the oncologic drug advisory committee to discuss six tumor indications that have been accelerated approved, which once again triggered the discussion of single-arm trials. The basis of accelerated approval by single-arm trial is actually a compromise on the level of evidence-based medical evidence requirements after assessing the benefit risk. Therefore, the sponsor should strictly grasp the applicable conditions of single-arm trial in anti-tumor drugs and conduct single-arm trial scientifically. Post-marketing clinical trial should be implement as early as possible to ensure the benefit of patients. Based on the characteristics of single-arm trial, combined with two guidance relevant to single-arm trial issued by National Medical Products Administration recently, this article is supposed to propose and summarize the strategy of single-arm trial supporting the marketing of anti-tumor drugs.

Considerations on Clinical Development and Regulatory of the Oversea License-in Anti-tumor Drugs / 中国肺癌杂志

With the boom of China's innovative pharmaceutical industry, licensing-in model has gradually become an important research and development model for innovative pharmaceutical companies. The in-licensed drugs at different stages need different research and development (R&D) strategy in China. The pharmaceutical companies take the responsibility to comprehensively collate the oversea clinical data and conduct a detailed analysis of clinical pharmacology, safety, efficacy and ethnic sensitivity. Clinical R&D strategy should be made based on the results of the above data and analysis. We encourage high-quality drugs which fill unmet clinical needs licensed in, and as early as possible, so as to conduct multi-regional clinical trials (MRCTs). The clinical R&D strategy in China is particularly important for the drug's approval. Guidelines published by the National Medical Products Administration (NMPA) and clinical associations should be followed. Communications about clinical R&D strategy with Center of Drug Evaluation (CDE) are encouraged.
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Short-term effects and seasonal variation of ozone on daily hospital outpatient visits for childhood asthma in Lanzhou / 北京大学学报(医学版)

OBJECTIVE@#To analyze the effects of ozone (O3) concentrations measured with different approaches across different seasons on the total number of childhood asthma-related clinical visits, as well as the differentiation of such effects across different groups of patients.@*METHODS@#The outpatient data of three grade A tertiary hospitals in Lanzhou City spanning from 1 January 2014 to 31 December 2017, as well as air pollution and meteorological data during the same period were collected. Considering the nonlinear relationship between O3 concentrations and the total number of childhood asthma-related clinical visits and meteorological factors, a generalized additive temporal sequence model was employed to analyze the short-term association between changes in O3 concentrations and the total number of childhood asthma-related clinical visits. Taking into account of the variations in O3 concentrations within 1 day, this study adopted different measurement approaches to address the three types of O3 exposures, namely, the maximum 1 h daily concentration (O3max1h), the maximum 8 h daily concentration (O38h) and the mean 24 h daily concentration (O324h) as the short term exposure indicators to O3, followed by a model-based analysis.@*RESULTS@#The increase in short-term exposure levels to O3 in summer had a significant effect on the increase in the total number of childhood asthma-related clinical visits. With lag0 for the current day, every 10 μg/m3 increase in atmospheric concentration of O3max1h was associated with an increase in the total number of childhood asthma-related clinical visits by 3.351% (95%CI: 1.231%-5.516%); for every 10 μg/m3 increase in O38h concentration, the total number of childhood asthma-related clinical visits increased by 3.320% (95%CI: 0.197%-3.829%); for every 10 μg/m3increase in O324h concentration, the total number of childhood asthma-related clinical visits in summer increased by 6.600% (95%CI: 0.914%-12.607%); moreover, an increase in exposure to O3max1h also led to a significant rise in the total number of childhood asthma-related clinical visits among the males.@*CONCLUSION@#The increase in short-term exposure levels to O3 in summer in Lanzhou City has a significant effect on the increase in the total number of childhood asthma-related clinical visits; O3max1h is more closely correlated with the increase in the total number of childhood asthma-related clinical visits.

CXCL10/CXCR3 Signaling in the DRG Exacerbates Neuropathic Pain in Mice / 神经科学通报·英文版

Chemokines and receptors have been implicated in the pathogenesis of chronic pain. Here, we report that spinal nerve ligation (SNL) increased CXCR3 expression in dorsal root ganglion (DRG) neurons, and intra-DRG injection of Cxcr3 shRNA attenuated the SNL-induced mechanical allodynia and heat hyperalgesia. SNL also increased the mRNA levels of CXCL9, CXCL10, and CXCL11, whereas only CXCL10 increased the number of action potentials (APs) in DRG neurons. Furthermore, in Cxcr3

TLR8 in the Trigeminal Ganglion Contributes to the Maintenance of Trigeminal Neuropathic Pain in Mice / 神经科学通报·英文版

Trigeminal neuropathic pain (TNP) is a significant health problem but the involved mechanism has not been completely elucidated. Toll-like receptors (TLRs) have recently been demonstrated to be expressed in the dorsal root ganglion and involved in chronic pain. Here, we show that TLR8 was persistently increased in the trigeminal ganglion (TG) neurons in model of TNP induced by partial infraorbital nerve ligation (pIONL). In addition, deletion or knockdown of Tlr8 in the TG attenuated pIONL-induced mechanical allodynia, reduced the activation of ERK and p38-MAPK, and decreased the expression of pro-inflammatory cytokines in the TG. Furthermore, intra-TG injection of the TLR8 agonist VTX-2337 induced pain hypersensitivity. VTX-2337 also increased the intracellular Ca

Diagnostic Value of Circular RNAs for Colorectal Cancer: A Meta-analysis / 肿瘤防治研究

Objective To systematically assess the diagnostic efficacy of circRNA in detecting CRC. Methods Eligible studies were obtained by searching the databases, such as PubMed, EMBASE, CNKI, etc. in line with the inclusion and exclusion criteria. Study quality and bias were judged by QUADAS-2 tool. The overall effect size, including pooled diagnostic parameters, was combined based on STATA 12.0 software. The causes of heterogeneity were investigated by conducting the subgroup, sensitivity and meta-regression analyses. Results We included 17 eligible studies which contained 1873 CRC cases and 1573 paired controls. For CRC detection, circRNA expression harbored a pooled sensitivity, specificity and AUC of 0.79 (95%CI: 0.76-0.81), 0.69 (95%CI: 0.64-0.73) and 0.81, respectively. Subgroup analysis showed that serum-derived circRNA testing (AUC=0.89, DOR=16.79) harbored higher diagnostic efficacy than plasma (AUC=0.79, DOR=7.08) and tissue (AUC=0.76, DOR=6.87); oncogenic circRNAs achieved higher diagnostic capacity in detecting CRC than the anti-cancer circRNAs (AUC: 0.81 vs. 0.76; DOR: 8.54 vs. 6.21); however, circRNA testing quantified based on GAPDH showed comparable diagnostic capacity with the overall pooled effect. Conclusion Abnormally-expressed circRNAs have relatively high diagnostic efficacy in diagnosing CRC and may be rated as auxiliary biomarkers for CRC detection.

Effectiveness and Safety of Moxibustion Robots on Primary Dysmenorrhea: A Randomized Controlled Pilot Trial / 中国结合医学杂志

OBJECTIVE@#To conduct a pilot trial to explore the effectiveness and safety of moxibustion robots in treating primary dysmenorrhea (PD) and evaluate its feasibility in clinic.@*METHODS@#A total of 70 participants with PD were allocated to either moxibustion robot (MR) group (35 cases) or manual moxibustion (MM) group (35 cases) using computer-generated randomization. One acupoint Guanyuan (CV 4) was selected to receive moxa heat stimulation. Two groups of participants were given 3 menstrual cycles of MM and MR treatment respectively (once a day, 5 days a session) and received another 3 menstrual cycles follow-up. The degree of pain was evaluated by short-form McGill pain questionnaire (SF-MPQ) and the symptoms of dysmenorrhea were evaluated by Cox Menstrual Symptom Scale (CMSS). The safety was measured by the occurrence rate of adverse events (AEs), including burns (blisters, red and swollen), itching, bowel changes, menstrual cycle disorder, menorrhagia and fatigue, etc. RESULTS: A total of 62 patients completed the trial, 32 in MR group and 30 in MM group. Compared with baseline, scores of SF-MPQ and CMSS significantly decreased in both groups (P0.05). The total occurrence rate of AEs in MR group was 2.1%, which was significantly lower than MM group (7.2%, P<0.05).@*CONCLUSIONS@#MR has the same effect as MM at SF-MPQ and CMSS in patients with PD. However, MR is safer than MM (Trial registration No. ChiCTR1800018236).

IL-10 producing regulatory B cells ameliorated cardiac hypertrophy of viral myocarditis mice / 中华微生物学和免疫学杂志

Objective:To explore the mechanism of B10 cell involved in cardiomyocyte hypertrophy following myocarditis, and to develop potential therapeutic strategies.Methods:BALB/c mice infected with Coxsackie virus B3 induced viral myocarditis model. The expression of angiotensin (ANG)Ⅱ and its receptor in myocarditis mice was detected. The changes of B10 cells in the hearts of control mice and myocarditis mice were analyzed by flow cytometry. After losartan was administered to myocarditis mice, the degree of myocardial inflammation was detected by HE staining, the expression of inflammatory factors was detected by ELISA, the myocardial hypertrophy was detected by wheat germ agglutinin (WGA) staining, and the changes of B10 cells in the heart were analyzed by flow cytometry. The levels of cardiac troponin T (C-TNT) and high mobility group box 1 (HMGB1) protein in neonatal mouse cardiomyocytes treated with ANGⅡ and ANGⅡ+ IL-10 were detected. Cardiomyocytes were treated with ANGⅡ, ANGⅡ+ B10 cells, ANGⅡ+ B10 cells + IL-10 receptor antibody and ANGⅡ+ B cells to detect C-TNT protein levels, and Annexin-V/PI was used to detect the apoptosis of cardiomyocytes. Cardiomyocytes were treated with oxidized HMGB1, reduced HMGB1 and disulfide HMGB1, and C-TNT expression was detected.Results:Coxsackievirus B3 infection caused cardiac hypertrophy, high expression of ANGⅡ and its receptor, and transient increase of B10 cells in mice. Losartan treatment blocked the angiotensin receptor, reduced expansion of B10 cells. B10 cells alleviated apoptosis of cardiomyocytes and inhibited the production of HMGB1 induced by ANGⅡ patch by producing IL-10, thus alleviating viral myocarditis and cardiac hypertrophy.Conclusions:B10 cells may play an important role in myocardial protection in myocarditis.

Dual role of high mobility group box 1 (HMGB1) in tumor progression / 中华微生物学和免疫学杂志

High mobility group box 1 (HMGB1), a ubiquitous non-histone protein in the nuclear chromatin of eukaryotic cells, plays an important role in inflammatory diseases, autoimmune diseases and cancer. The function of HMGB1 in the development and progression of tumor varies with its subcellular localization. On one hand, HMGB1 promotes the growth, proliferation, invasion and metastasis of tumor cells, and mediates immune escape and immune tolerance; on the other hand, HMGB1 possesses anti-tumor activity by maintaining the stability of genome, regulating the expression of tumor suppressor genes, inhibiting cell invasion and metastasis and improving the anti-tumor therapeutic effect. In recent years, increasing evidences have suggested that HMGB1 is closely associated with the development of tumor. Therefore, understanding the function of HMGB1 in cancer will provide enlightenment for preventive and therapeutic strategies. This review summarized the dual role of HMGB1 in tumor progression.

Occupational Health Risk Assessment of Benzene, Toluene, and Xylene in Shanghai / 生物医学与环境科学（英文）

Objective@#This study was designed to conduct a retrospective and systematic occupational health risk assessment (OHRA) of enterprises that used benzene, toluene, and xylene (BTX) in Shanghai, China.@*Methods@#All data for the study were obtained from 1,705 occupational health examination and evaluation reports from 2013 to 2017, and a semiquantitative model following Chinese OHRA guidelines (GBZ/T 298-2017) was applied for the assessment.@*Results@#The selected enterprises using BTX were mainly involved in manufacturing of products. Using the exposure level method, health risk levels associated with exposure to BTX were classified as medium, negligible, or low. However, the risk levels associated with benzene and toluene were significantly different according to job types, with gluers and inkers exhibiting greater health risks. For the same job type, the health risk levels assessed using the comprehensive index method were higher than those using the exposure level method.@*Conclusion@#Our OHRA reveals that workers who are exposed to BTX still face excessive health risk. Additionally, the risk level varied depending on job categories and exposure to specific chemicals. Therefore, additional control measures recommended by OHRA guidelines are essential to reduce worker exposure levels.

Clinical profiles and outcomes of acute type A aortic dissection and intramural hematoma in the current era: lessons from the first registry of aortic dissection in China / 中华医学杂志(英文版)

BACKGROUND@#Acute type A aortic dissection (ATAAD) and acute type A intramural hematoma (ATAIMH) are life-threatening diseases with high mortality. To better understand their clinical features in the Chinese population, we analyzed the data from the first Registry of Aortic Dissection in China (Sino-RAD) to promote the understanding and management of the diseases.@*METHODS@#All patients with ATAAD and ATAIMH enrolled in Sino-RAD from January 1, 2012 to December 31, 2016 were involved. The data of patients' selection, history, symptoms, management, outcomes, and postoperation complications were analyzed in the study. The continuous variables were compared using the Student's t test for normal distributions and the Mann-Whitney U test for non-normal distributions. Categorical variables were compared using the Chi-square test or Fisher exact test.@*RESULTS@#A total of 1582 patients with ATAAD and 130 patients with ATAIMH were included. The mean age of all patients was 48.4 years. Patients with ATAAD were significantly younger than patients with ATAIMH (48.9 years vs. 55.6 years, P < 0.001). For the total cohort, males were dominant, but the male ratio of patients with ATAAD was significantly higher compared to those with ATAIMH (P = 0.01). The time range from the onset of symptom to hospitalization was 2.0 days. More patients of ATAIMH had hypertension than that of ATAAD (82.3% vs. 67.6%, P < 0.05). Chest and back pain were the most common clinical symptoms. Computerized tomography (CT) was the most common initial diagnostic imaging modality. 84.7% received surgical treatment and in-hospital mortality was 5.3%. Patients with ATAAD mainly received surgical treatment (89.6%), while most patients with ATAIMH received medical treatment (39.2%) or endovascular repair (35.4%).@*CONCLUSIONS@#Our study suggests that doctors should comprehensively use clinical examination and genetic background screening for patients with ATAAD and ATAIMH and further shorten the time range from symptoms onset to intervention, achieving early diagnosis and treatment, thereby reducing the mortality rate of patients with aortic dissection in China. We should standardize the procedures of aortic dissection treatment and improve people's understanding. Meanwhile, the curing and transferring efficiency should also be improved.

Development and application of a moxibustion instrument with multi-jointed manipulator / 中国针灸

In view of the limitations of the existing moxibustion instruments, i.e. possible accidental injury when using moxibustion instruments, the negative effects of products from moxibustion instruments on treatment efficacy and health of medical staff and patients, a moxibustion instrument with multi-jointed manipulator is designed. This moxibustion instrument could accurately control the temperature, maintain a safe moxibustion distance, automatically process the burning ashes of moxa and selectively handle moxa smoke. The experimental results shows that this instrument could maintain the constant temperature of target acupoint, reduce the risk of empyrosis, and reasonably deal with the products of moxibustion. The purification rate of moxa smoke is 44.9%, which not only ensures the therapeutic effect of moxa smoke, but also reduces the negative effects of high-concentration moxa smoke on the health of medical staff and patients.

Feasibility Analysis of Wumeiwan in Treatment of Advanced Biliary Tract Cancers / 中国实验方剂学杂志

Biliary tract cancers are group of highly heterogeneous malignant tumors derived from gallbladder and bile duct epithelium， including gallbladder cancer and cholangiocarcinoma， with a high degree of malignancy. When diagnosed， the course of disease often develops to the middle and late stage， with a poor prognosis. It is difficult to treat the advanced biliary tract cancers， with a lack of unified chemotherapy standard and targeted drugs. Traditional Chinese medicine（TCM） compound has multi-target， multi-link and multi-path characteristics， with effects in stabilizing tumor， alleviating clinical symptoms， alleviating side effect of radiotherapy and chemotherapy， and improving the quality of life. Especially in the treatment of advanced cancer patients， it plays an irreplaceable role. Therefore， it is concerned by many researchers. According to TCM， the pathogenesis of patients with advanced biliary tract cancers are mainly due to asthenia of healthy Qi and sthenia of pathogenic factors， Yin-Yang disharmony， and simultaneous occurrence of cold and heat. The location of the disease is related to liver， gallbladder， spleen， stomach and kidney. Because the advanced biliary tract cancers are similar to Jueyin syndrome in disease location， course and disease， Wumeiwan is often used in clinical treatment. Based on "theory， method， prescription and medicine" of TCM， Wumeiwan has the effect in regulating cold and heat， clearing the upper and lower temperature， warming the liver and supporting Yang， attacking and supplementing simultaneously， balancing the liver， spleen and kidney， which conforms to the TCM syndrome characteristics of advanced biliary tract cancers， according to modern Chinese medicine pharmacology， many effective ingredients in Wumeiwan have the effects in inducing tumor cell apoptosis， inhibiting tumor cell proliferation and reducing tumor cell proliferation， reducing inflammatory response in the body， inhibiting angiogenesis， reversing multidrug resistance of tumor cells and regulating immunity. This paper analyzes the feasibility of treatment of advanced biliary tract cancers with Wumeiwan from the perspective of traditional Chinese and Western medicine， so as to provide reference for clinical comprehensive treatment of advanced biliary tract cancers and the experimental study of TCM.

Interventional treatment with covered stent graft for retrograde Stanford type A aortic dissection and intramural hematoma: A systematic review and meta-analysis / 中国胸心血管外科临床杂志

@#Objective    To evaluate the prognosis of interventional treatment with covered stent graft for retrograde Stanford type A aortic dissection and intramural hematoma by single-arm meta-analysis. Methods    Related studies on treating retrograde Stanford type A aortic dissection and intramural hematoma with covered stent graft were retrieved from the databases by computer, including PubMed, EMbase, The Cochrane Library, Wanfang Data, VIP, CNKI and CBM, from inception to January 2020. Literatures were screened by researchers step by step according to the predefined inclusion and exclusion criteria. Quality of the enrolled literatures was evaluated, and data were extracted from the included studies. Afterwards, single-arm meta-analysis was carried out by the R3.6.3 software. Results    A total of 12 English and 5 Chinese studies were included, which were all case series, and the quality of all literatures was moderate evaluated by Newcastle-Ottawa Scale (NOS). After analyzing the clinical prognosis of 260 patients, the 30-day mortality was 6% (95%CI 0.04 to 0.11, P=0.97), the late mortality was 8% (95%CI 0.05 to 0.14, P=0.78), the incidence of endoleak was 21% (95%CI 0.16 to 0.29, P=0.06), the incidence of stroke was 5% (95%CI 0.03 to 0.09, P=0.99), the incidence of new aortic dissection was 7% (95%CI 0.04 to 0.11, P=0.96), the incidence of dissection progression was 10% (95%CI 0.07 to 0.16, P=0.24), and the absorption rate of intramural hematoma was 84% (95%CI 0.37 to 1.00, P<0.01). Conclusion    Interventional treatment with covered stent graft for retrograde Stanford type A aortic dissection and intramural hematoma can obtain good early treatment results for some patients, and can be used as a safe and effective treatment for aged patient with high risk who cannot tolerate surgery. Endoleak, stroke and new aortic dissection are the early serious complications of this method.

Effect of endoscopic tympanic membrane repair on chronic suppurative otitis media with perforation of tympanic membrane / 中国基层医药

Objective@#To investigate the effect of endoscopic tympanic membrane repair in the clinical treatment of patients with chronic suppurative otitis media with tympanic membrane perforation.@*Methods@#From November 2014 to September 2018, 72 patients with chronic suppurative otitis media with tympanic membrane perforation in Taizhou Central Hospital were divided into control group and observation group according to different treatment methods, with 36 cases in each group.The control group underwent microsurgical tympanic membrane repair, the observation group underwent endoscopic tympanic membrane repair.The bleeding volume and operation time of the two groups were compared.The pain degrees of the two groups were evaluated by numerical simulation scale (VAS). The postoperative hospital stay and complications were recorded.The postoperative follow-up of 6 months was used to evaluate the aesthetics of the two groups.The hearing improvement status and treatment effect of the two groups were evaluated.@*Results@#The average surgical bleeding volume of the observation group was (6.14±1.25)mL, which was significantly less than that of the control group [(19.87±2.65)mL], and the operation time was (75.69±2.54)min, which was significantly shorter than that of the control group [(102.34±3.69)min](t=28.116, 35.694, all P<0.05). The VAS score of the observation group was (2.34±0.62)points, which was significantly lower than that of the control group [(3.59±0.85)points](t=7.128, P<0.05). The average length of hospital stay in the observation group was (4.89±1.25)d, which was significantly shorter than that in the control group [(9.18±1.36)d](t=13.935, P<0.05). The incision satisfaction of the observation group was significantly higher than that of the control group(P<0.05). The improvement in hearing of the observation group was (22.058±10.129)dB, which of the control group was (21.695±9.764)dB, the difference was not statistically significant (P=0.487). The effective rate of the observation group was 94.44%(34/36), which of the control group was 91.67%(33/36) (χ2=3.598, P=0.165). The incidence rate of complications in the observation group was 2.78%(1/36), which was significantly lower than 16.67%(6/36) in the control group(χ2=3.956, P=0.046).@*Conclusion@#Chronic suppurative otitis media tympanic membrane perforation patients treatment with endoscopic tympanic membrane repair is more effective, and the surgical method is better after surgery, so it is more acceptable to patients, it is worthy of promoting.

Effect of Active Components of Traditional Chinese Medicine in Resisting Gallbladder Carcinoma / 中国实验方剂学杂志

Allbladder cancer is highly malignant and has few effective therapeutic drugs. Traditional Chinese medicine (TCM) has attracted the attention from researchers because of its multi-target, multi-link, multi-channel and less toxic side effect. In recent years, the basic studies of gallbladder cancer have made certain achievements in active components of TCM. Relevant experimental studies have extended to the lever of cells, molecules and genes. The main mechanism of experimental research include inhibiting tumor cell proliferation, inducing tumor cell apoptosis, inhibiting cell metastasis, inhibiting cell migration, influencing signal transduction pathway, enhancing sensitivity of chemotherapeutic drugs, and inhibiting tumor angiogenesis. The existing experimental studies have showed that active components of TCM have certain curative effect on gallbladder cancer, but with many problems. For example, although the extract of active components of TCM shows an anti-tumor activity, the specific composition and chemical molecular structure are still unclear. Most studies focus on the level of in vitro cell experiments, but only a few in vivo experimental studies have been carried out in animals. Therefore, more in-depth studies need to be carried out in the future. Currently, most of the mechanisms of anti-gallbladder cancer of active components of TCM are classical signaling pathways. The next step is to find new signaling pathways and new targets. In addition, under the guidance of TCM theory, the future studies of TCM compound can bring advantages of TCM against tumor into full play. The experimental study on the mechanism of action of active components of TCM in the treatment of gallbladder cancer is summarized as follows, which is helpful for researchers to understand the current experimental studies on active components of TCM in gallbladder cancer, in order to conduct more in-depth studies. Basic experimental studies on gallbladder cancer can provide theoretical basis for clinical treatment.