Characterization of potential bitterness critical quality attributes in Xiaoer Ganmao Oral Liquid based on UHPLC-LTQ-Orbitrap MSn / 药学学报

To identify the bitter compounds of real-world Xiaoer Ganmao Oral Liquid sugar-free intermediates, an integrated strategy has been developed by using ultra-high performance liquid chromatography with linear ion trap-Orbitrap mass spectrometry (UHPLC-LTQ-Orbitrap MSn) method and BitterX database prediction. The chromatographic operating conditions were as follows, chromatographic column: Acquity UPLC BEH C18 (100 mm × 2.1 mm, 1.7 μm), mobile phase: 0.1% formic acid-water solution (A)-acetonitrile (B) with gradient elution. The data were collected in positive and negative ion modes, respectively. The accurate molecular mass and structural information of the target compounds were obtained based on quasi-molecular ions and fragmentation ions provided by high-resolution mass spectrometry. The compounds were identified by combining retention time, reference substances, reports, and other relevant data, and a total of 57 constituents including flavonoids, alkaloids, and phenylpropanoids were finally identified. Further, the BitterX database was used to predict binding probability of compounds to bitter receptors and identify potential bitter critical quality attributes, finally 33 potential bitter compounds, including kukoamine A and linarin, were predicted. This study comprehensively characterized the material basis of Xiaoer Ganmao Oral Liquid sugar-free intermediates, it provides an effective method for bitter compound screening and a reference for further improving the undesirable taste of Xiaoer Ganmao Oral Liquid.

Identification of taste critical quality attribute and formulation optimization of Xiaoer Qingrening Granules based on electronic tongue and human senses / 药学学报

This study primarily concentrated on scientific problems of poor taste caused by unclear critical quality attributes of oral preparations manufactured by Chinese materia medica, successfully established an identification method for taste critical quality attribute and a taste improvement method combining electronic tongue with human senses, and determined the optimal taste formula, to improve patients' oral medication compliance. The study received ethical approval from the Review Committee of the Beijing University of Chinese Medicine. The results showed that the proportion of bitterness of Xiaoer Qingrening Granule was 61.8%, and its bitterness grade was 3.70, it was determined that bitterness is the critical quality attribute that caused the poor taste of Xiaoer Qingrening Granule. Additionally, the optimal taste formula per milliliter of Xiaoer Qingrening sugar-free intermediate was determined with allowable daily intake, solubility, and sweetness as the limiting conditions, which was 40 mg hydroxypropyl β-cyclodextrin, 180 mg trehalose, and 1.5 mg acesulfame potassium. Compared with the Xiaoer Qingrening Granule, the sensory evaluation score of the optimal taste formula was increased by 37.5 points. In conclusion, this study achieved the taste improvement of Xiaoer Qingrening Granule and formed a set of taste improvement strategies including the identification of taste critical quality attribute, the selection of the type and dosage of corrigent, and the optimization of taste formula, which provided a thought reference for the taste improvement of other oral preparations and a new perspective for quality control of intelligent manufacturing of traditional Chinese medicines.

A hnRNPA2B1 agonist effectively inhibits HBV and SARS-CoV-2 omicron in vivo

The twenty-first century has already recorded more than ten major epidemics or pandemics of viral disease, including the devastating COVID-19. Novel effective antivirals with broad-spectrum coverage are urgently needed. Herein, we reported a novel broad-spectrum antiviral compound PAC5. Oral administration of PAC5 eliminated HBV cccDNA and reduced the large antigen load in distinct mouse models of HBV infection. Strikingly, oral administration of PAC5 in a hamster model of SARS-CoV-2 omicron (BA.1) infection significantly decreases viral loads and attenuates lung inflammation. Mechanistically, PAC5 binds to a pocket near Asp49 in the RNA recognition motif of hnRNPA2B1. PAC5-bound hnRNPA2B1 is extensively activated and translocated to the cytoplasm where it initiates the TBK1-IRF3 pathway, leading to the production of type I IFNs with antiviral activity. Our results indicate that PAC5 is a novel small-molecule agonist of hnRNPA2B1, which may have a role in dealing with emerging infectious diseases now and in the future.

Analysis of GNAS gene variant in a Chinese pedigree affected with pseudohypoparathyroidism / 中华医学遗传学杂志

OBJECTIVE@#To explore the genetic etiology of a Chinese pedigree affected with pseudohypoparathyroidism.@*METHODS@#Peripheral blood samples of the proband and his parents were collected and subjected to trio-whole exome sequencing (trio-WES). Candidate variants were verified among the pedigree and 50 randomly selected healthy individuals through analysis of restriction fragment length polymorphism. Short tandem repeat (STR) linkage analysis was used to verify the parental origin of the pathogenic variants.@*RESULTS@#Trio-WES and Sanger sequencing showed that the proband and his mother had both harbored a c.121C>G (p.His41Asp) variant of the GNAS gene, which was not found in other family members and the 50 healthy controls. The variant was not found in international databases. Based on guidelines from the American College of Medical Genetics and Genomics, the variant was predicted to be likely pathogenic.@*CONCLUSION@#The novel c.121C>G variant of the GNAS gene probably underlay the disease in this pedigree. Above finding has enriched the spectrum of GNAS gene variants.

Multi-omics integrated analysis reveals a specific phenotype of CD8+ T cell may contribute to immunothromosis via Th17 response in severe and critical COVID-19

T lymphocyte reduction and immunosenescence frequently occur in severe and critical coronavirus disease 2019 (COVID-19) patients, which may cause immunothrombosis and numerous sequelae. This study integrated analyzed multi-omics data from healthy donors, pneumonia, COVID-19 patients (mild & moderate, severe, and critical), and convalescences, including clinical, laboratory test, PBMC bulk RNA-seq, PBMC scRNA-seq and TCR-seq, BAL scRNA-seq, and lung proteome. We revealed that there are certain associations among T lymphocyte reduction, CD8+ T cell senescence, Th17 immune activation, and immunothrombosis. A specific phenotype (S. P.) CD8+ T cells were identified in severe and critical COVID-19 patients in both PBMC and BAL scRNA-seq, which showed highly TCR homology with terminal effector CD8+ T cells and senescent CD8+ T cells. Pseudotime analysis showed that the S. P. CD8+ T cells were located in the transition trajectory from mild to severe disease. Which may be activated by terminal effector CD8+ T cells or senescent CD8+ T cells, thereby promoting Th17 cell differentiation. This phenomenon was absent in healthy donors, mild and moderate COVID-19 patients, or convalescences. Our findings are an important reference for avoiding the conversion of patients with mild to severe diseases and provide insight into the future prevention and control of COVID-19 and its variants.

Research on the construction of a performance appraisal index system for medical specialty alliances / 中华医院管理杂志

Objective:To build a performance appraisal index system for medical specialty alliances, as a reference for promoting the development of the alliances in a connotation-based, high quality and sustainable manner.Methods:An index system was initialized by means of policy literature review and brainstorming, which was followed by two rounds of expert consultations to finalize the index system. Each index in the system was weighted through the analytic hierarchy process.Results:A performance appraisal index system of specialist alliances so developed comprised the six level-1 indexes of organization and implementation, hierarchical healthcare, influence capacity, talent cultivation, clinical research and academic research, as well as 31 level-2 indexes. The average scoring of importance and operability of all the indexes was>3.50, while the weights of organization and implementation(0.205 3), talent cultivation(0.178 8)and clinical research indexes(0.165 1)were higher than the rest.Conclusions:The performance appraisal index system of specialty alliances proves highly reliable and scientific, serving a desirable vehicle for the leaders of the alliance to develop cross-regional development of medical specialties.

Establishment and validation of a risk prediction model for early-stage complications after liver transplantation / 临床肝胆病杂志

Objective To investigate the risk factors for early-stage complications among liver transplant recipients, and to establish and validate a risk prediction model for early-stage complications after transplantation. Methods A retrospective analysis was performed for the clinical data of 234 patients who underwent orthotopic liver transplantation in Department of Liver Transplantation, Tianjin First Central Hospital, from January 2016 to December 2018. According to the presence or absence of Clavien-Dindo grade ≥Ⅲ complications after liver transplantation, the patients were divided into complication group with 97 patients and non-complication group with 137 patients. The two groups were compared in terms of the indices including age, sex, body mass index (BMI), blood type, psoas muscle thickness/height (PMTH), Controlling Nutritional Status (CONUT) score, Model for End-Stage Liver Disease (MELD) score, total serum bilirubin, serum creatinine, international normalized ratio of prothrombin time, blood urea nitrogen, hemoglobin, white blood cell count, platelet count, amount of intraoperative red blood cell transfusion, amount of frozen plasma transfusion, blood loss, anhepatic phase, time of operation, donor age, donor BMI, cold ischemia time of donor liver, and warm ischemia time of donor liver. The independent samples t -test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups; the chi-square test was used for comparison of categorical data between two groups. Univariate analysis and the binary logistic regression analysis were used to investigate the risk factors for early-stage complications after liver transplantation, and a risk prediction model for complications after liver transplantation was established based on the method for establishing a scoring system using the logistic model provided by Framingham Research Center. Internal validation of the model was performed by C-index, receiver operating characteristic (ROC) curve, calibration curve, and the Hosmer-Lemeshow test, and the decision curve was used to evaluate the clinical applicability of the model. The Kaplan-Meier method was used to compare the incidence rate of early-stage complications after liver transplantation between the patients with different risk scores. Results Compared with the non-complication group, the complication group had significantly higher MELD score, proportion of patients with low PMTH, total serum bilirubin, serum creatinine, blood urea nitrogen, CONUT score, amount of intraoperative red blood cell transfusion, and amount of frozen plasma transfusion, as well as a significantly lower level of hemoglobin (all P < 0.1). The multivariate binary logistic regression analysis showed that MELD score (odds ratio [ OR ]=1.104, 95% confidence interval [ CI ]: 1.057-1.154, P < 0.05), PMTH ( OR =2.858, 95% CI : 1.451-5.626, P < 0.05), and CONUT score ( OR =1.481, 95% CI : 1.287-1.703, P < 0.05) were independent risk factors for grade ≥Ⅲ complications in the early stage after liver transplantation. MELD score, PMTH, and CONUT score were included in a predictive model, and this model had the highest score of 24 points, a C-index of 0.828, an area under the ROC curve of 0.812( P < 0.001), a sensitivity of 0.792, and a specificity of 0.751, suggesting that this predictive model had good discriminatory ability. The calibration curve of this model was close to the reference curve, and the Hosmer-Lemeshow test obtained a chi-square value of 8.528( P =0.382), suggesting that this predictive model had a high degree of fitting. The decision curve showed that most patients were able to benefit from the predictive model and achieved a high net benefit rate, suggesting that this predictive model had good clinical applicability. The score of 11 was selected as the cut-off value according to the optimal Youden index of 0.507, and the patients were divided into low-risk (< 8 points) group with 55 patients, moderate-risk (8-10 points) group with 63 patients, high-risk (11-14 points) group with 67 patients, and extremely high-risk (≥15 points) group with 49 patients. These four groups had a 90-day cumulative incidence rate of early-stage postoperative complications of 3.6%, 28.6%, 59.7%, and 75.5%, respectively, and the incidence rate of complications increased with the increase in risk score ( P < 0.001). Conclusion MELD score, PMTH, and CONUT score are independent risk factors for early-stage complications among liver transplant recipients, and the risk prediction model established based on these factors has a high predictive value in high-risk patients.

Advances in the clinical research on liver transplantation in treatment of acute-on-chronic liver failure / 临床肝胆病杂志

Acute-on-chronic liver failure (ACLF) is a disease of rapid deterioration of liver function caused by the acute exacerbation of chronic liver diseases, and it is often associated with multiple organ failure and has a poorer prognosis than common liver cirrhosis. Many studies suggest that timely liver transplantation can significantly improve the survival rate of patients with ACLF; however, there are currently no reliable guidelines that point out the indications for liver transplantation in patients with ACLF. This article summarizes recent studies and discusses the indication, timing, and prognosis of liver transplantation in ALCF patients.

Research advances in improving the prognosis of recipients of fatty liver transplantation / 临床肝胆病杂志

With the increasing demand for liver donors, more and more marginal donors have been used. How to use fatty liver grafts has become a new issue that physicians in the department of liver transplantation must face. Compared with the normal donor liver, fatty liver grafts have high incidence of postoperative complications and increase the difficulty of clinical cure. This review describes the measures to improve the prognosis of recipients of fatty liver transplantation, and points out that these measures can reduce the risk of fatty liver transplantation and thus increase the utilization of fatty liver grafts.

Practice on establishing simple evaluation standards for access preparation of molar / 中华医学教育探索杂志

Objective:To establish simple and accurate evaluation standards for access preparation of molar and verify its reliability.Methods:9 undergraduate students who had entered the intership for one month prepared access of molars in vitro. 10 dentists specialized in endodontics for over 5 to 15 years evaluated the molars according to the evaluation standards. Intraclass correlation coefficient of the results was analyzed by SPSS statistics. Results:The intraclass correlation co-efficient of the evaluation given by 10 endodontists was 0.739 ( P=0.000), which had statistical significance. The result was between 0.61 and 0.80, meaning the evaluation standards were moderately reliable and applicable among different observers. Conclusions:The evaluation standards proposed in this study are reliable and has not been influenced by the clinical experience of observers. And it is worth further exploration and promotion.

Function and molecular mechanism of mitogen-activated protein kinase (MAPK) in regulating oocyte meiotic maturation and ovulation / 生理学报

The mitogen-activated protein kinase (MAPK) signaling pathway is a highly conserved signal transduction pathway from yeast to human species, and is widely distributed in various eukaryotic cells. In almost all of the species studied over the past three decades, this signaling pathway plays a crucial role in the development of female germ cells and meiotic maturation. Especially in a variety of mammalian species including primates, rodents, and domestic animals, the MAPK signaling pathway is activated during the resumption of first oocyte meiosis and plays an indispensable role in meiotic spindle assembly and cell cycle progression. In granulosa cells of fully grown ovarian follicles, the MAPK pathway also mediates the physiological action of gonadotropins, including cumulus expansion, ovulation, and corpus luteum formation. Although the MAPK signaling pathway plays a wide range of physiological functions during the female reproduction process, and these functions are highly conserved in evolution, their underlying mechanisms, especially their direct and physiological target molecules, have not been sufficiently studied for a long time. In recent years, based on some new gene-editing mouse models and theoretical findings, as well as the wide application of various omics techniques, it has been further revealed that MAPK directly phosphorylates and activates the RNA binding protein cytoplasmic polyadenylation element-binding protein-1 (CPEB1), promoting poly(A) tail extension of maternal mRNA to regulate protein translation during meiotic recovery. These findings not only constitute the current basic mechanism of mammalian oocyte maturation and ovulation, but also provide useful research ideas for other related research in this field. In this review, we summarize the research findings in our laboratory and from other groups regarding the role of MAPK cascade in regulating oocyte maturation and ovulation. We also discuss the latest research progress on MAPK regulation of mRNA translation and degradation by directly activating the translation initiation complex and mRNA poly(A) polymerase by phosphorylation in the granulosa cells.

Comparative Toxicity of Nanomaterials to Air-blood Barrier Permeability Using an In Vitro Model / 生物医学与环境科学（英文）

OBJECTIVE@#To comparatively study the toxicity of four metal-containing nanoparticles (MNPs) and their chemical counterparts to the air-blood barrier (ABB) permeability using an in vitro model.@*METHODS@#ABB model, which was developed via the co-culturing of A549 and pulmonary capillary endothelium, was exposed to spherical CuO-NPs (divided into CuO-40, CuO-80, and CuO-100 based on particle size), nano-Al2O3 (sheet and short-rod-shaped), nano-ZnO, nano-PbS, CuSO4, Al2(SO4)3, Zn(CH3COO)2, and Pb(NO3)2 for 60 min. Every 10 min following exposure, the cumulative cleared volume (ΔTCL) of Lucifer yellow by the model was calculated. A clearance curve was established using linear regression analysis of ΔTCL versus time. Permeability coefficient (P) was calculated based on the slope of the curve to represent the degree of change in the ABB permeability.@*RESULTS@#The results found the increased P values of CuO-40, CuO-80, sheet, and short-rod-shaped nano-Al2O3, Al2(SO4)3, and Pb(NO3)2. Among them, small CuO-40 and CuO-80 were stronger than CuO-100 and CuSO4; no difference was observed between Al2(SO4)3 and sheet and short-rod-shaped nano-Al2O3; and nano-PbS was slightly weaker than Pb(NO3)2. So clearly the MNPs possess diverse toxicity.@*CONCLUSION@#ABB permeability abnormality means pulmonary toxicity potential. More studies are warranted to understand MNPs toxicity and ultimately control the health hazards.

Efficacy of microbotulinum toxin A combined with intense pulsed light on facial rejuvenation / 中华医学美学美容杂志

Objective To investigate the efficacy of micro botulinum toxin A (BTX) combined with intense pulsed light (IPL ) treatment in facial rejuvenation patients .Methods A total of thirty patients (1 male ,29 females ,aged 35 to 55 years with average age of 45 .56 years) with facial pho-toaging in the Department of Medical Cosmetology ,Renmin Hospital of Wuhan University from Jan . to Sept .2018 were enrolled as out-patients .Thirty patients were recruited in the study and randomly assigned averagely to the combination group and control group .All received standard IPL treatment every month for a total of 3 sessions .Patients in combined group received microinjections of diluted BTX on cheeks after the first IPL .VISIA CR images were analyzed before ,1 month and 3 months af-ter treatment .Dermatologists assessed the improvement of color spots ,wrinkles ,texture ,pore ,and erythema improvement .The patient satisfaction survey was analyzed .Results The effective rate of the combined group was better than that of the intense pulsed light group one month after treatment (χ2 = 6 .208 ,P = 0 .045) ,but there was no significant difference between the two groups three months after treatmen (χ2 = 1 .077 ,P = 0 .584t) .The patient satisfaction survey showed that there was no sta-tistical difference between the two groups .Slight erythema and bruising were observed but disappeared at the end of the treatment (P > 0 .05) .Conclusions The adjunctive use of MicroBTX can enhance treatment efficacy of IPL alone .It is a highly effective and safe treatment method for facial antiaging .

Exploration of the Function of Medical Social Work Service in Tertiary Hospitals under the Grading Diagnosis and Treatment / 中国医学伦理学

As an important part of the medical supply-side reform, grading diagnosis and treatment is the core objective of various medical services carried out by medical institutions at all levels. This paper proposed that tertia-ry hospitals should promote the construction of grading diagnosis and treatment from three aspects of multi-sited practice of physicians, construction of medical alliance and functional orientation planning. On this basis, this pa-per mainly discussed the service function of medical social work involved in grading diagnosis and treatment mode in tertiary hospitals.

Chiral Probe for Recognition of Landiolol Hydrochloride and Its Stereoisomer by Mass Spectrometry / 分析化学

In this work,two chiral chloride probes were used to differentiate landiolol hydrochloride by mass spectrometry. Two chiral chloride probe reagents, N-(p-Tosyl)-L-phenylalaninyl chloride (TSPC) and (-)-Camphanic acid chloride, were chosen to react with landiolol hydrochloride and its stereoisomers to form covalent bonding derivatives, which enlarged the difference of stereo structure between landiolol and its stereoisomers. Result of tandem mass spectrometry showed that fragment from derivative products prefers to losing water to form fragment ions m/z 793 and m/z 672. The relative abundance of ions m/z 793 and m/z 672 was quite different in each isomer. The fragment ions m/z 603 from (-)-Camphanic acid chloride derivative products showed distinction relative abundance because of the different stability of each stereoisomers, which gave rise to the enlarged difference of stereo structure between landiolol and its stereoisomers. By comparing the different relative abundance ratio of analyte and each stereoisomer in MS/MS spectra, we could realize recognization landiolol hydrochloride and its stereoisomers. Accurate masses of precursor and fragment ions were confirmed on an IT-TOF mass spectrometer. This method by using ion-trap mass spectrometry could rapidly and simply differentiate landiolol hydrochloride and its stereoisomers. This work could also contribute to differentiation and discrimination of landiolol hydrochloride and its stereoisomers.

Effects of inositol hexaphosphate on proliferation of human osteosarcoma cell line MG-63 and primary cultured osteoblasts / 西安交通大学学报(医学版)

Objective To investigate the effects of inositol hexaphosphate (IP6) on proliferation of human osteosarcoma cell line MG-63 and primary cultured osteoblasts so as to explore the optimal concentration for achieving anti-cancer effects.Methods We primary cultured and identified human osteoblasts.Then we made recovery and normal culture of human osteosarcoma cell line MG-63.We tested the proliferation of two kinds of cell lines under different concentrations of IP6 by MTT to determine the optimal concentration and then detected MG-63 cell cycle and apoptosis by flow cytometry.Results When IP6 concentration was more than 1 mmol/L,IP6 began to inhibit the proliferation of MG-63 cell line in the time-dose dependent manner.When the concentration reached 4 mmol/L,this inhibitory effect was the maximum.When IP6 concentration was 0.5 mmol/L or 1 mmol/L,the proliferation of osteoblasts was not obviously inhibited.When it was 2 mmol/L,the proliferation was slightly inhibited.A concentration of 4 mmol/L caused the apoptosis of osteoblasts.Conclusion IP6 can inhibit the proliferation of osteosarcoma cell line MG-63 and lead to its apoptosis.The optimal concentration is 2 mmol/L for achieving anti-cancer effects.

Preparation and evaluation of compressive strength and biocompatibilitywith biological calcium citrate cement / 西安交通大学学报(医学版)

Objective To produce the biological calcium citrate cement with fresh oyster shells, and investigate its compressive strength and biocompatibility so as to provide the experimental basis for clinical application of the material.Methods The compressive strength of biological calcium citrate cement was measured and its surface morphology was observed by SEM.The calcium release curve and pH value were measured in the simulated body fluid.Last, its biocompatibility was detected by cytotoxicity test.Results Biological calcium citrate cement produced by 0.33mL/g liquid solid ratio had the maximum compressive strength, and the crystal structure of the material was uniform and orderly.The determination of pH value showed that the degradation and absorption of biological calcium citrate cement did not significantly change the pH value of the body fluid.With gradual degradation of the material, the concentration of Ca2+ in the solution increased gradually.Cytotoxicity test showed that this material had good biocompatibility and no cytotoxicity.Conclusion Biological calcium citrate cement possesses strong compressive strength and good biocompatibility, and it can form a microenvironment with low in alkaline and high in calcium.

In vitro anticoagulant activity of different processed products of Whitmania pigra by water extraction and bionic extraction / 中国中药杂志

In order to determine the scientificalness of traditionally processed Whitmania pigra, water extraction method and bionic extraction method were used respectively to extract the anticoagulating active components in W. pigra hanging dry products, talcum powder fried products and wine immersing-baked products. Activated partial thromboplastin time (APTT), prothrombin time (PT), thrombin time (TT), and antithrombin activity were selected as the activity indexes to evaluate the anticoagulant activities of different processed W. pigra. Then the contents of protein in different processed W. pigra were measured by Coomassie brilliant blue method to preliminarily explain the reason of anticoagulant activity changes. When water extraction method was used, the results of APTT, PT, TT and antithrombin activity showed that the anticoagulant activities of W. pigra were decreased both in talcum powder fried products and wine immersing-baked products, and the activity order was as follows: hanging dried products> wine immersing-baked products>talcum powder fried products. This order was same as the protein content order. While when bionic extraction was used, APTT was shortened in talcum powder fried products, but all the other results indicated the anticoagulant activities of W. pigra processed products were increased, and the activity order was as follows: wine immersing-baked products>talcum powder fried products>hanging dry products. As compared with water extraction, the bionic extraction was more similar to the absorption process of W. pigra in human digestive system after oral administration and was more scientific. Therefore, the traditional processing method can not only modify the taste and smell, but also enhance the anticoagulant activity of W. pigra.

Study on the difference of sunitinib and sorafenib as first-line treatment in advanced renal carcinoma / 国际肿瘤学杂志

Objective To evaluate the efficacy and safety of sunitinib versus sorafenib in the first-line treatment of advanced renal cell carcinoma.Methods Forty-two patients with advanced renal cell carcinoma were divided into two groups according to the therapeutic method.Twenty patients were treated with sunitinib (50 mg, oral administration, once a day, for 4 weeks, drug withdrawal of 2 weeks, 6 weeks was a cycle) and 22 patients were treated with sorafenib (400 mg, oral administration, twice a day, until the disease progression, 6 weeks was a cycle).The efficacy and toxicity were evaluated every 2-cycle treatment.Results All 42 patients could be evaluated.The disease remission rate (RR), disease control rate (DCR) of sunitinib group and sorafenib group were 30.0％ (6/20), 22.7％ (5/22), 90.0％ (18/20), 77.3％ (17/22) respectively,the median progression free survival (PFS) were 10.8, 6.2 months, the median overall survival (OS) were 25.6, 18.6 months respectively.There were no statistical differences in the RR (x2 =0.287, P =0.592) and DCR (x2 =1.222, P =0.269) between the two groups.There were statistical difference in the PFS (x2 =6.041, P =0.014) and OS (x2 =11.245, P =0.001) between the two groups.The most common toxicities of the sunitinib group were diarrhea, fatigue, oral mucositis, nausea, vomiting, all these toxicities were mainly Ⅰ-Ⅱ degree, and could be well tolerated.The hand-foot syndrome rate of the sorafenib group obviously exceeded the sunitinib group (59.1％ vs.25.0％ , x2 =4.972, P =0.026).Conclusion Sunitinib has good efficacy in the first-line treatment of advanced renal cell carcinoma with less toxicity than sorafenib, so it is worthy of popularization.

Research progress of medication strategy in the moduIation of wound heaIing after gIaucoma fiItration surgeries / 国际眼科杂志(Guoji Yanke Zazhi)

·To improve the effect of glaucoma filtration operation in reducing intraocular pressure ( lOP ) , it’s important to prevent and inhibit fibrotic scar formation during and after operation.This paper focuses on the current and future possible means for modulation of wound healing after glaucoma filtration surgery, mainly including series of medications ( antimetabolites, anti-inflammation drugs, antigrowth factor drugs, drugs acting on cell signal pathways, etc.) , new drug delivery system and other technologies. This article also discusses the future orientation in this field.