PVP intercalated metallic WSe2 as NIR photothermal agents for efficient tumor ablation.

Transition metal dichalogenides (TMDCs) with unique layered structures hold promising potential as transducers for photothermal therapy. However, the low photothermal conversion efficiency and poor stability in some cases limit their practical applications. Herein, we demonstrate the fabrication of ultrathin homogeneous hybridized TMDC nanosheets and their use for highly efficient photothermal tumor ablation. In particular, the nanosheets were composed of metallic WSe2 intercalated with polyvinylpyrrolidone (PVP), which was facilely prepared through a solvothermal process from the mixture of selenourea crystals, WCl6 powder along with PVP polymeric nanogel. Our characterizations revealed that the obtained nanosheets exhibited excellent photothermal conversion efficiency, therapeutic demonstration with improved biocompatibility and physiological stability attributing to the combined merits of metallic phase of WSe2 and hydrophilic PVP insertion. Both the histological analysis of vital organs and in vitro/in vivo tests confirmed the nanosheets as actively effective and biologically safe in this phototherapeutic technique. Findings from this non-invasive experiment clearly emphasize the explorable therapeutic efficacy of the layered-based hybrid agents in future cancer treatment planning procedures.

Global trends of acupuncture clinical research on analgesia from 2010 to 2023: a bibliometric and visualization analysis.

Objective: Acupuncture, acknowledged as a potent non-pharmacological therapy, is frequently employed to alleviate pain. Despite its widespread use, there has been a lack of overarching bibliometric analysis of clinical research on acupuncture analgesia. We aimed to summarize current patterns, hotspots, and development trends in this field through bibliometric analysis. Methods: This study evaluates academic publications retrieved from the Web of Science database (2010.01-2023.09) concerning acupuncture analgesia in clinical settings. All primary and secondary studies on humans were included. To track global developmental trends, we employed several software for analyzing annual publication volumes, countries/regions, institutions, authors, cited authors, journals, cited journals, references, and keywords and to draw collaborative networks and reference co-citation network maps. Results: The final search encompassed 7,190 relevant studies, including 1,263 randomized controlled trials (RCTs) and 1,293 systematic reviews and meta-analyses. The results indicated a gradual increase in the number of annual publications on acupuncture analgesia in clinical practice. Among countries and institutions, China (2,139) and Chengdu University of Traditional Chinese Medicine (258) ranked first. Liang FR (89 articles) was the most prolific author, while MacPherson H (604) was the most cited author. MEDICINE (455) was the most productive journal, and Pain (2,473/0.20) ranked first in both the frequency and centrality of cited journals. Notably, the most frequently cited reference was a systematic review of individual patient data on acupuncture carried out for chronic pain that was published by Vickers Andrew J in 2012 (156). Burst analysis identified frontier research areas for 2010-2020, encompassing network meta-analysis, case reports, dry needling, lumbar disc herniation, cancer, post-herpetic neuralgia, insomnia, and bibliometric analysis. Conclusion: This study outlines current trends and potential future research hotspots in clinical acupuncture analgesia over the past decade. Findings emphasize the necessity for enhanced international collaboration to improve research output and translation.

Safety and Effectiveness of Roxadustat in Dialysis-Dependent Patients With Renal Anemia: A Hospital-Based Cohort Study.

Background Randomized controlled trials (RCTs) have shown the efficacy and safety of Roxadustat and conclude that it has the potential to change the treatment for anemia associated with chronic kidney disease. However, the experience of its use from clinical perspectives post-approval is lacking. Aim Using a clinical practice context, this study aims to compare Roxadustat's effectiveness and tolerability with Erythropoietin (EPO) in patients with renal anemia undergoing dialysis. Methods We examined the clinical records of patients with a diagnosis of renal anemia on dialysis who were prescribed Roxadustat or Erythropoietin at the department of nephrology of the First Affiliated Hospital of Gannan Medical University from January 2021 to December 2021. Eligible hemodialysis (HD) or peritoneal dialysis (PD) patients with renal anemia, aged >18 or <75 years, without infection, active bleeding, and malignancy were recruited. These patients received Roxadustat or EPO based on the preferential prescription choice made by the nephrologists of the department. We retrospectively attempted to determine the treatment response measured by the change in hemoglobin rate, from baseline up to six months. We also explored the impact of various factors on the treatment response and reported adverse events. Results A total of 106 patients have been included in the final analysis, with 53 patients in each group. The mean age of the study group was 49.9 ± 13.6 years with the main Hb level at the baseline of 8.1 g/dL ± 1.23 g/dl. The gain of hemoglobin from the baseline averaged over six months was 2.2 ± 2.11 g/dl in the Roxadustat group compared with 1.1 ± 1.67 g/dL in the EPO group (p=0.01). As compared to EPO,Roxadustat reduced the total cholesterol level by -0.59 ± 1.08 mmol/l versus -0.01 ± 1.28 mmol/l (p=0012) and the low-density lipoprotein (LDL) cholesterol by -0.48 ± 1.07 mmol/l versus -0.47 ± 1.05 (p=0.017) in the first three months. Associated factors with a non-response to treatment were age greater than 65 years (OR=6, 95% CI: 1.23-32.46, p=0.02), hypertension (OR=3.5, 95%CI: 0.89-13.25, p=0.060), and heart failure (OR=4.18, 95%CI:4.18 1.04-20.39, p=0.040). Although the proportion of hospitalization and infection was higher in the EPO group and the incidences of gastrointestinal symptoms (vomiting, nausea) and blood transfusions were higher in the Roxadustat group, there were no statistically significant differences. Conclusion Roxadustat improved hemoglobin compared to erythropoietin in patients undergoing dialysis with a safe profile but precautions should be taken for old patients with a cardiovascular medical history.

Inhibition of cytosolic chaperonin CCTζ-1 expression depletes proliferation of colorectal carcinoma in vitro.

BACKGROUND: It is important to identify the behavior of colorectal cancer (CRC) individually, so more accurate laboratory index is urgently demanded. Chaperonin are key molecules in tumor cell cycle. Our study aims at revealing the expression and correlation of chaperonin containing TCP1 complex 6A (CCTζ-1) in CRC. METHODS: Fifty-eight patients with CRC admitted from 2005 to 2008 were selected. CCTζ-1 expression in cell, tumor, and non-tumor colorectal tissues was detected by Western blot, and their protein was localized by immunohistochemical stain. After HCT116 cells were transfected with CCTζ-1 siRNA, real-time PCR, and Western blot were used to examine gene expression. Cell multiplication and apoptosis were examined by Cell Counting Kit-8 and Annexin V kit. RESULTS: CCTζ-1 ptotein expression was detected in 51 of 58 (87.9%) CRC specimens, which was much higher than those in normal mucosa (P < 0.01), and it was correlated with tumor invasion (P < 0.01) and tumor size (P < 0.05). The levels of CCTζ-1 mRNA and protein were inhibited by CCTζ-1 siRNA in HCT116 cells transfected with CCTζ-1 siRNA, which resulted in growth arrest but not apoptosis. CONCLUSION: CCTζ-1 could be a new prognostic marker for CRC and involve in tumorigenesis. CCTζ-1 inhibition in vivo might therefore become a new therapy for CRC.

Bis[µ-3-(1H-pyrazol-1-yl)benzonitrile-κN:N']bis-[perchloratosilver(I)].

In the title centrosymmetric complex, [Ag(2)(ClO(4))(2)(C(10)H(7)N(3))(2)], the unique Ag(I) ion is coordinated by an N atom from a carbonitrile group, an N atom from a symmetry-related pyrazole group and an O atom of a perchlorate ligand to form a distorted T-shaped environment. Two 3-(1H-pyrazol-1-yl)benzonitrile ligands each bridge two Ag(I) ions to form a dinuclear complex. In the crystal structure, there are weak Ag⋯O inter-actions within the range 2.70-3.01 Šlinking dimeric units into layers approximately parallel to (100). The O atoms of the perchlorate ligand are disordered over two sites with occupancies of 0.570 (11) and 0.430 (11), respectively.

catena-Poly[[(2,9-dieth-oxy-1,10-phen-anthroline-κN,N')cadmium(II)]-di-µ-dicyan-amido-κN:N].

In the title polymer, [Cd(C(2)N(3))(2)(C(16)H(16)N(2)O(2))](n), the Cd(II) ion is coordinated by two N atoms from one 2,9-dieth-oxy-1,10-phenanthroline mol-ecule and four N atoms from four symmetry-related dicyanamide ions in a distorted octa-hedral geometry. In the 2,9-dieth-oxy-1,10-phenanthroline ligand, the O and C atoms of the eth-oxy groups are located almost in the plane defined by the phenanthroline ring system. Two dicyanamide ions bridge two Cd(II) ions, which are located on a twofold axis, forming a one-dimensional zigzag chain along the [001] direction. The 2,9-dieth-oxy-1,10-phenanthroline mol-ecules act as bidentate terminal ligands. There are π-π inter-actions between polymeric chains, characterized by a centroid-centroid distance of 3.7624 (2) Šbetween the phenanthroline rings of two neighbouring chains.

Basic principles,methods and evaluation of minimally invasive treatment for infected pancreatic necrosis / 中华外科杂志

Infected pancreatic necrosis(IPN) is the main surgical indication of acute pancreatitis. Minimally invasive debridement has become the mainstream surgical strategy of IPN,and it is only preserved for IPN patients who are not response for adequate non-surgical treatment. Transluminal or retroperitoneal drainage is preferred,and appropriate debridement can be performed. At present,it is reported that video assisted transluminal,trans-abdominal and retroperitoneal approaches can effectively control IPN infection. However,in terms of reducing pancreatic leakage and other complications,surgical and endoscopic transgastric debridement may be the future direction in the treatment of IPN.

Expression and significance of microRNA-21 and microRNA-181b in peripheral blood of patients with schizophrenia / 中国基层医药

Objective:To investigate the expression and significance of microRNA-21 (miRNA-21) and microRNA-181b (miRNA-181b) in the peripheral blood of patients with schizophrenia.Methods:A total of 100 patients with schizophrenia who received treatment in Shaoxing 7 th People's Hospital from March 2020 to March 2022 were included in the study group. An additional 30 healthy controls who concurrently underwent physical examination were included in the control group. The expression of miRNA-21 and miRNA-181b in peripheral blood was compared between the two groups. The 100 patients with schizophrenia received standardized clinical treatment. Their mental symptoms were evaluated with the Positive and Negative Symptom Scale (PANSS). miRNA-21 and miRNA-181b expression and PANSS scores before and 1, 4, 8, and 12 weeks after treatment were collected and compared between the two groups. The receiver operating characteristic curve was plotted to analyze the value of miRNA-21 and miRNA-181b expression in the diagnosis of schizophrenia. Results:Serum miRNA-21 and miRNA-181b expression in the study group were (2.41 ± 1.12) and (15.62 ± 2.26), respectively, which were significantly higher than (0.73 ± 0.37) and (8.11 ± 0.98) in the control group ( t = 8.07,17.67, both P < 0.05). With the prolongation of treatment time, serum miRNA-21 and miRNA-181b expression and PANSS score in the study group gradually decreased (all P < 0.001). The area under the receiver operating characteristic curve plotted for evaluating the value of miRNA-21 and miRNA-181b expression in the diagnosis of schizophrenia was 0.616 and 0.683, respectively. The area under the receiver operating characteristic curve plotted for evaluating the value of miRNA-21 combined with miRNA-181b expression in the diagnosis of schizophrenia was 0.788, which was markedly higher than that for the detection of miRNA-21 or miRNA-181b expression alone. Conclusion:miRNA-21 and miRNA-181b are abnormally highly expressed in the peripheral blood of patients with schizophrenia. Both of them can be used as objective and effective indicators for early diagnosis of schizophrenia. Combined detection of miRNA-21 and miRNA-181b provides higher accuracy in the diagnosis of schizophrenia than the detection of miRNA-21 or miRNA-181b alone.

Association between vaccination and the risk of immunoglobulin A vasculitis in children / 中国当代儿科杂志

OBJECTIVES@#To study the effect of vaccination on the short-term risk of immunoglobulin A vasculitis (IgAV) in children.@*METHODS@#A retrospective analysis was conducted on the general data and the vaccination history within one year prior to onset in children with IgAV hospitalized in the Children's Hospital Affiliated to Zhengzhou University from November 2021 to January 2023. Vaccine exposure rates in the risk period (3 months prior to IgAV onset) and the control period were compared by autocontrol-case crossover analysis, and the odds ratio and 95% confidence interval (95%CI) were calculated. A sensitivity analysis for the one-month and two-month risk periods was conducted.@*RESULTS@#A total of 193 children with IgAV were included, with a median age of 7.0 years. Among the 193 children, 36 (18.7%) received at least one dose of the vaccine within 1 year prior to IgAV onset, and 14 (7.3%) received at least one dose of the vaccine during the 3-month risk period. Compared to the unvaccinated IgAV group, the vaccinated IgAV group had a significantly younger age of onset (P<0.05). There were no significant differences in the proportions of children with gastrointestinal involvement, renal involvement, and joint involvement between the two groups (P>0.05). The odds ratio for developing IgAV after receiving any type of vaccine within 3 months prior to IgAV onset was 2.08 (95%CI: 0.82-5.27, P>0.05). Further sensitivity analysis for the 1-month and 2-month risk periods demonstrated that the odds ratios for developing IgAV after receiving any type of vaccine were 2.74 (95%CI: 0.72-10.48, P>0.05) and 2.72 (95%CI: 0.95-7.77, P>0.05), respectively.@*CONCLUSIONS@#Vaccination dose not increase the risk of IgAV, nor does it exacerbate clinical symptoms in children with IgAV.

Clinical characteristics and risk factors of poor prognosis in patients with infected pancreatic necrosis caused by multidrug-resistant bacteria / 中华肝胆外科杂志

Objective:To study the clinical features and risk factors of death in patients with infected pancreatic necrosis (IPN) caused by multidrug-resistant bacteria (MDRB).Methods:The clinical data of 219 IPN patients who were managed at the Department of General Surgery of Xuanwu Hospital, Capital Medical University from January 1, 2016 to December 31, 2021 were retrospectively analyzed. There were 142 males, and 77 females, with a median age [ M( Q1, Q3)] of 51(38, 62) years old. Based on the pre-sence or absence of MDRB infection, these patients were divided into the MDRB-infected group ( n=117) and the non-MDRB-infected group ( n=102). Clinical features and outcomes were compared between the two groups, and the risk factors resulting in death in patients with MDRB infection were analyzed. Logistic regression analysis was used to determine the risk factors for poor outcomes in patients with MDRB. Results:There were significant differences in etiologies, distribution characteristics of necrosis and degrees of pancreatic necrosis between the two groups (all P<0.05). When compared with the non-MDRB-infected group, the CT severity index, the levels of procalcitonin and interleukin-6 were significantly higher in the MDRB group on admission, while the hematocrit was significantly lower (all P<0.05). Furthermore, when compared with the non-MDRB infection group, patients with MDRB infection were significantly more likely to have fungal infections [37.6%(44/117) vs. 21.6%(22/102)] and extrapancial infections [75.2%(88/117) vs. 58.8%(60/102)], more patients underwent surgery [89.7%(105/117) vs. 67.6%(69/102)], and more surgical procedures were performed [3(2, 4) times vs. 2(1, 3) times], with a higher incidence of postoperative complications [36.2%(38/117) vs. 18.8%(13/102)], an increase in a new-onset organ failure after surgery [37.1%(39/117) vs. 21.7%(15/102)], a higher in-hospital mortality rate [25.6%(30/117) vs. 10.8%(11/102)], longer hospitalization [39(28, 67) d vs. 29(18, 35) d] and ICU stays [22(10, 42) d vs. 11(6, 18) d], and a longer need for parenteral nutrition [19(9, 37) d vs. 15(7, 25) d, all P<0.05]. On multivariate regression analysis, the risk factor for death in the MDRB-infected group was co-fungal infection ( OR=1.199, 95% CI: 1.025-1.402). On the other hand, receiving therapy containing tigacycline ( OR=0.831, 95% CI: 0.715-0.965) and minimally invasive surgery ( OR=0.698, 95% CI: 0.562-0.868) reduced the risk of death in the MDRB-infected group (all P<0.05). Conclusions:IPN patients with MDRB infection had higher levels of inflammation, more serious pancreatic necrosis, longer treatment time, and increased need for surgical treatment. Measures involving fungal infection control and the use of tigacyclin and minimally invasive surgery reduced the risks of death in patients with MDRB infection.

Research progress on the relationship between pancreatic exocrine insufficiency and intestinal microbiota in aging individuals / 中华肝胆外科杂志

Pancreatic exocrine insufficiency (PEI) refers to insufficient or non-synchronous secretion of trypsin caused by various reasons, resulting in dyspepsia and other symptoms. Intestinal microbiota is a large number of microbiota on the surface of intestinal mucosa. Its main functions include intestinal immune function, forming intestinal biological barrier and participating in the regulation of nutrition and metabolism. Due to aging, some elderly people often have unexplained chronic pancreatic insufficiency, which is often characterized by unexplained weight loss and malnutrition. Several studies have shown that the composition of intestinal microbiota changes significantly with age. This article focuses on aging and its related PEI and then reviews its possible effects on intestinal microbiota, in order to provide a reference basis for individualized prevention and treatment strategies according to the changes of pancreatic exocrine function and microbiota in the elderly.

Biomimetic nanomedicines for precise atherosclerosis theranostics

Atherosclerosis (AS) is a leading cause of the life-threatening cardiovascular disease (CVD), creating an urgent need for efficient, biocompatible therapeutics for diagnosis and treatment. Biomimetic nanomedicines (bNMs) are moving closer to fulfilling this need, pushing back the frontier of nano-based drug delivery systems design. This review seeks to outline how these nanomedicines (NMs) might work to diagnose and treat atherosclerosis, to trace the trajectory of their development to date and in the coming years, and to provide a foundation for further discussion about atherosclerotic theranostics.

Characteristics of plasma Epstein-Barr virus DNA in children with primary infection / 中华儿科杂志

Objective: To explore the characteristics of plasma Epstein-Barr virus (EBV) DNA in primary infection in pediatric cases. Methods: The laboratory and clinical data of 571 children diagnosed with EBV primary infection in Children's Hospital of Fudan University during September 1st, 2017 to September 30th, 2018 were retrospectively analyzed. According to the results of plasma EBV DNA, they were divided into positive group and negative group. According to the EBV DNA, they were devided into high plasma virol load group and low plasma virol load group. The Chi-square test, Wilcoxon rank sum test were used to compare the differences between groups. Results: Among the 571 children with EBV primary infection, 334 were males and 237 were females. The age of first diagnosis was 3.8 (2.2, 5.7) years. There were 255 cases in positive group and 316 cases in negative group. The percentage of cases with fever,hepatomegaly and (or) splenomegaly, elevated transaminase in the positive group were higher than those in the negative group (235 cases (92.2%) vs. 255 cases (80.7%), χ2=15.22, P<0.001; 169 cases (66.3%) vs. 85 cases (26.9%), χ2=96.80, P<0.001; and 144 cases (56.5%) vs. 120 cases (38.0%), χ2=18.27, P<0.001; respectively).In the positive group, 70 cases were followed up for 46 (27, 106) days, 68 cases (97.1%) turned negative within 28 days, with the exception of 2 cases (2.9%) developed chronic active EBV infection by follow-up revision.There were 218 cases in high plasma viral DNA copies group and 37 cases in low copies group. More cases presented with elevated transaminases in the high plasma viral DNA copies group than those in the low group (75.7% (28/37) vs. 56.0%(116/207), χ2=5.00, P=0.025).Both the positive rate of EBV DNA in peripheral blood leukocytes (84.2% (266/316) vs. 44.7% (255/571), χ2=76.26, P<0.001) and the copies of EBV DNA (7.0×107 (1.3×107, 3.0×108) vs. 3.1×106 (1.6×106, 6.1×106) copies /L, Z=15.23, P<0.001) were higher than that of plasma. Conclusions: In immunocompetent pediatric cases diagnosed as EBV primary infection, cases with positive plasma EBV DNA were prone to have fever, hepatomegaly and (or) splenomegaly, and elevated transaminase than those with negative plasma viral DNA. The plasma EBV DNA usually turns negative within 28 days after initial diagnosis.Most cases with high viral load in plasma showed elevated aminotransferase.

Clinical characteristics of patients with colon complications after necrotizing pancreatitis: a retrospective cohort study / 中华外科杂志

Objective: To investigate the clinical characteristics of colon complications in patients with necrotizing pancreatitis(NP). Methods: The clinical data of 403 patients with NP admitted to the Department of General Surgery,Xuanwu Hospital, Capital Medical University from January 2014 to December 2021 were retrospectively analyzed. There were 273 males and 130 females,aged (49.4±15.4) years(range: 18 to 90 years). Among them,there were 199 cases of biliary pancreatitis,110 cases of hyperlipidemic pancreatitis,and 94 cases of pancreatitis caused by other causes. A multidisciplinary diagnosis and treatment model was used to diagnose and treat patients. Depending on whether the patients had colon complications,they were divided into colon complications group and noncolon complications group. Patients with colon complications were treated with anti-infection therapy,parental nutritional support,keeping the drainage tube unobstructed,and terminal ileostomy. The clinical results of the two groups were compared and analyzed using a 1∶1 propensity score match(PSM) method. The t test,χ2 test, or rank-sum test was used to analyze data between groups,respectively. Results: The incidence of colon complications was 13.2%(53/403),including 15 cases of colon obstruction,23 cases of colon fistula,and 21 cases of colon hemorrhage. After PSM,the baseline and clinical characteristics at admission of the two groups of patients were comparable (all P>0.05). In terms of clinical outcome,compared to patients with NP without colon complications,the number of patients with colon complications who received minimally invasive intervention(88.7%(47/53) vs. 69.8%(37/53),χ2=5.736,P=0.030),the number of minimally invasive interventions (M(IQR))(2(2) vs. 1(1), Z=4.638,P=0.034),the number of patients with multiple organ failure(45.3%(24/53) vs. 32.1%(17/53),χ2=4.826,P=0.041),and the number of extrapancreatic infections(79.2%(42/53) vs. 60.4%(32/53),χ2=4.476,P=0.034) increased significantly. The time required for enteral nutrition support(8(30)days vs. 2(10) days, Z=-3.048, P=0.002), parental nutritional support(32(37)days vs. 17(19)days, Z=-2.592, P=0.009),the length of stay in the ICU(24(51)days vs. 18(31)days, Z=-2.268, P=0.002),and the total length of stay (43(52)days vs. 30(40)days, Z=-2.589, P=0.013) were also significantly prolonged. However,mortality rates in the two groups were similar(37.7%(20/53) vs. 34.0%(18/53),χ2=0.164,P=0.840). Conclusions: Colonic complications in NP patients are not rare,which can lead to prolonged hospitalization and increased surgical intervention. Active surgical intervention can help improve the prognosis of these patients.

Decreased AKAP4/PKA signaling pathway in high DFI sperm affects sperm capacitation / 亚洲男科学杂志(英文版)

The sperm DNA fragmentation index (DFI) is a metric used to assess DNA fragmentation within sperm. During in vitro fertilization-embryo transfer (IVF-ET), high sperm DFI can lead to a low fertilization rate, poor embryo development, early miscarriage, etc. A kinase anchoring protein (AKAP) is a scaffold protein that can bind protein kinase A (PKA) to subcellular sites of specific substrates and protects the biophosphorylation reaction. Sperm protein antigen 17 (SPA17) can also bind to AKAP. This study intends to explore the reason for the decreased fertilization rate observed in high sperm DFI (H-DFI) patients during IVF-ET. In addition, the study investigates the expression of AKAP, protein kinase A regulatory subunit (PKARII), and SPA17 between H-DFI and low sperm DFI (L-DFI) patients. SPA17 at the transcriptional level is abnormal, the translational level increases in H-DFI patients, and the expression of AKAP4/PKARII protein decreases. H2O2 has been used to simulate oxidative stress damage to spermatozoa during the formation of sperm DFI. It indicates that H2O2 increases the expression of sperm SPA17 protein and suppresses AKAP4/PKARII protein expression. These processes inhibit sperm capacitation and reduce acrosomal reactions. Embryo culture data and IVF outcomes have been documented. The H-DFI group has a lower fertilization rate. Therefore, the results indicate that the possible causes for the decreased fertilization rate in the H-DFI patients have included loss of sperm AKAP4/PKARII proteins, blocked sperm capacitation, and reduced occurrence of acrosome reaction.

Exosomes secreted from human umbilical cord mesenchymal stem cells promote pancreatic ductal adenocarcinoma growth by transferring miRNAs / 中华肿瘤杂志

Objective: To observe the effects of exosomes derived from human umbilical cord mesenchymal stem cells on the proliferation and invasion of pancreatic cancer cells, and to analyze the contents of exosomes and explore the mechanisms affecting pancreatic cancer cells. Methods: Exosomes extracted from human umbilical cord mesenchymal stem cells were added to pancreatic cancer cells BxPC3, Panc-1 and mouse models of pancreatic cancer, respectively. The proliferative activity and invasion abilities of BxPC3 and Panc-1 cells were measured by cell counting kit-8 (CCK-8) and Transwell assays. The expressions of miRNAs in exosomes were detected by high-throughput sequencing. GO and KEGG were used to analyze the related functions and the main metabolic pathways of target genes with high expressions of miRNAs. Results: The results of CCK-8 cell proliferation assay showed that the absorbance of BxPC3 and Panc-1 cells in the hucMSCs-exo group was significantly higher than that in the control group [(4.68±0.09) vs. (3.68±0.01), P<0.05; (5.20±0.20) vs. (3.45±0.17), P<0.05]. Transwell test results showed that the number of invasion cells of BxPC3 and Panc-1 in hucMSCs-exo group was significantly higher than that in the control group (129.40±6.02) vs. (89.40±4.39), P<0.05; (134.40±7.02) vs. (97.00±6.08), P<0.05. In vivo experimental results showed that the tumor volume and weight in the exosomes derived from human umbilical cord mesenchymal stem cells (hucMSCs-exo) group were significantly greater than that in the control group [(884.57±59.70) mm(3) vs. (695.09±57.81) mm(3), P<0.05; (0.94±0.21) g vs. (0.60±0.13) g, P<0.05]. High-throughput sequencing results showed that miR-148a-3p, miR-100-5p, miR-143-3p, miR-21-5p and miR-92a-3p were highly expressed. GO and KEGG analysis showed that the target genes of these miRNAs were mainly involved in the regulation of glucosaldehylation, and the main metabolic pathways were ascorbic acid and aldehyde acid metabolism, which were closely related to the development of pancreatic cancer. Conclusion: Exosomes derived from human umbilical cord mesenchymal stem cells can promote the growth of pancreatic cancer cells and the mechanism is related to miRNAs that are highly expressed in exosomes.

Laparoscopic transgastric necrosectomy in treatment of wall-off pancreatic necrosis / 中华外科杂志

Mini-invasive surgical or endoscopic step-up approach is the first choice of pancreatic necrosectomy for infected wall-off necrosis. Surgical debridement has the advantage of high efficiency,low cost and good accessibility,while the complication rate of pancreatic fistula and incision hernia after endoscopic necrosectomy is low.Laparoscopic transgastric necrosectomy(LTGN) can combine the advantages of surgical and endoscopic debridement,and may become one of the important methods for the surgical treatment of necrotizing pancreatitis in the future. This paper focuses on the technical advantages,surgical points,indications and application status of LTGN,so as to provide reference for the technical promotion.

Progress on surgical treatment in gastric cancer / 国际外科学杂志

There are high burden of disease including a high incidence, relatively high proportion of late stage when diagnosed and poor overall prognosis in China regarding to the diagnosis and treatment of gastric cancer. Surgery remains as the major treatment for gastric cancer. Based on the latest guidelines, endoscopic surgery or gastrectomy is performed for early gastric cancer, and the standard surgery for locally advanced gastric cancer is D2 lymphadenectomy. Besides, this article will discuss about other research hotspots, such as expansion of lymph node dissection in selected patients, construction methods of adenocarcinoma of esophagogastric junction, especially Siewert type Ⅱ, minimally invasive techniques (laparoscopic gastrectomy and robotic gastrectomy), the surgical treatment for elderly patients with gastric cancer will be discussed also.

CHINA PH ARMACY Volume 33，Number 13，July 15，2022 Semimonthly Table of Contents Discussion on development difficulties and countermeasures of complex preparations in China / 中国药房

OBJECTIVE To discuss the difficulties in t he development of complex preparations and puts forward solutions ，in order to provide some reference for the development and preparation of complex preparations. METHODS Based on the development status of complex preparations ，the challenges faced by the development of complex preparations were analyzed ，and the countermeasures for the development of complex preparations were proposed. RESULTS & CONCLUSIONS The development of complex preparations required high quality of personnel ，and was limited by pharmaceutical excipients ，delivery devices and pharmaceutical equipment. The preparation process was complex ，there were many quality control parameters and patent barriers. Complex preparation development enterprises need to pay more attention to talents ，pharmaceutical excipients ，delivery devices and pharmaceutical equipment ，and clarify the impact of key technology on preparation production and quality characteristics ；in addition，they need to strengthen independent research and development ，crack the patent layout of original research enterprises and protect their own innovative achievements. Domestic complex preparation development enterprises can combine imitation and innovation to develop complex preparation products with independent brands to better meet the needs of patients.

Influence of infection complications on the prognosis of patients with severe acute pancreatitis / 国际外科学杂志

Objective:To analyze the effects of infectious complications [infected pancreatic necrosis (IPN) and extra-pancreatic infection (EPI)] on the outcomes of patients with severe acute pancreatitis (SAP), and evaluate the differences in infection time, infection site and infecting species between SAP patients with infections complications.Methods:The clinical data of 66 SAP patients with combined infectious complications admitted to Xuanwu Hospital, Capital Medical University from January 2014 to December 2020 were retrospectively analyzed, and SAP patients were divided into IPN group ( n=7), EPI group ( n=14) and co-infection (EPI+ IPN) group ( n=45) according to the type of infection. Whether the study data conformed to a normal distribution was assessed by the Shapiro-Wilk test, normally distributed measures were expressed as mean ± standard deviation ( ± s), and ANOVA was used for comparison between groups; skewed measures were expressed as median (interquartile range) [ M ( Q1, Q3)], and the rank-sum test was used for comparison between groups. Bonferroni correction was used for multiple group comparisons ( P value significance level reduced to 0.017). Quantitative data were compared between groups using the χ2 test or Fisher's exact probability method. Results:There were no statistical differences between the three groups in terms of baseline data at admission (gender, age, etiology, modified CTSI score, degree of pancreatic necrosis, and number of organ failure) ( P>0.05), patients in the EPI group were referred earlier than the other two groups ( P<0.05). In clinical treatment, patients in the IPN group and co-infection group required multiple minimally invasive interventions compared with those in the EPI group ( P<0.05), and the number of patients requiring combined nutritional support, length of intensive care unit stay, and total length of hospital stay were higher in the co-infection group than in the other two groups ( P<0.05). In addition, 360 strains of pathogenic bacteria were cultured in this study, with Gram-negative bacteria being the most common, and patients with SAP were more likely to have EPI in the early stage of disease onset, with bacteremia and respiratory tract infections in the early stage (≤14 d), and bacteremia, urinary tract infections, and catheter-associated infections in the late stage (>14 d). Conclusions:Among patients with SAP, patients in the co-infection group had higher surgical intervention, nutritional support and length of hospital stay than those in the single infection group. It is advisable to prioritize EPI in SAP patients with suspected infections, and the common infectious strains in SAP patients are still predominantly Gram-negative bacteria, and clinicians need to adjust the treatment plan in a timely manner according to the changes in patients′ conditions.