Nucleic acid aptamers are ligands with high specificity and affinity for their targets,which are screened from large oligonucleotide pools by the SELEX (systematic evolution of ligands by exponential enrichment,SELEX) technology. For their specific character,they have shown the great applicative prospects in the environment toxicology and related research fields. The recent related researches were reviewed in the present paper.

Objective To investigate the effect of pemetrexed on the immune function,quality of life and survival time of patients with malignant pleural effusion.Methods Eighty cases patients with non-small cell lung cancer from July 2013 to October 2015 in the People′s Hospital of Hunan Province were complicated with pleural effusion,and randomly divided into observation group and control group,40 cases in each group.The control group were used chemotherapy with GP(gemcitabine plus cisplatin) and the central venous catheter was placed in the thoracic cavity.The observation group was treated with retrograde injection of pemetrexed catheter on the basis of the control group.The changes of immunoglobulin and inflammatory cytokines were compared between the two groups,and the quality of life and the 1 year survival rate of the two groups were statistically analyzed.Results The IgM,IgG and IgA of the observation group after the intervention were higher than those in control group((1.65±0.03) mg/L vs.(1.31±0.02) mg/L,(9.55±0.12) mg/L vs.(8.82±0.10) mg/L,(3.99±0.20) mg/L vs.(1.81±0.13) mg/L,t=59.640,29.557,57.800,P<0.05),the TNFα-,IL-1,hs-CRP levels of the observation group after the intervention were lower than the control group((12.0±0.2) μg/L vs.(18.1±0.5) μg/L,(0.60±0.1) mg/L vs.(0.92±0.2) mg/L,(10.3±1.0) mg/L vs.(31.3±2.0) mg/L,t=71.641,9.051,59.397,P<0.05),and quality of life score after the intervention than before((81.5±2.3) points vs.(81.6±2.3) points,(35.3±1.1) points vs.(56.6±1.7) points,t=114.608,55.823,P<0.05).Quality of life of the observation group was better than the control group(t=66.530,P<0.01),1 year survival rate was higher than the control group(25.0%(10/40) vs.50.0%(20/40),U=5.903,P<0.05).Conclusion Local chemotherapy with pemetrexed could significantly improve the immune function of patients with malignant pleural effusion,reduce the inflammatory response,improve the quality of life and prolong the survival time of patients with malignant pleural effusion.

Object To optimize the preparation procedure for Zhixuan Granula (ZXG). Methods The optimum extracting conditions of ZXG were selected by orthogonal test with the active components: 23-acetate alisol B, atractylenolide I, and dried extract as the index, it mice sedation of ZXG was clarified by pharmacodynamics. Results The optimum preparation procedure was as follows: Rhizoma Alismatis and Rhizoma Atractylodis Macrocephalae were extracted with alcohol first, adding 12-fold 70% alcohol by refluxing, extracting twice, 2 h once, then extracted with water, adding 14-fold water, extracting twice, 2 h once. The extract showed the obvious effect on sedation of mice. Conclusion The optimum preparation procedure is reliable, with higher extracting ratio of the active components.

AIM: To establish a convenient liquid chromatography-internal standard method for determining ligustilide and 6-gingerol in Kuanxuean Soft Capsule (Radix Angelicae Sinensis, Rhizoma Zingiberis Preparatum, etc.) METHODS: Ligustilide, 6-gingerol and the internal standard naphthalene were separated on a Kromasil C_ 18 column. The mobile phase consisted of methanol-trifluroacetic acid (67 ∶ 33, V/V) and was determined at 218 nm. The content of ligustilide and 6-gingerol was calculated by the internal standard method. RESULTS: The recovery of ligustilide was 98.64% (RSD=1.58%); the recovery of 6-gingerol was 97.25% (RSD=1.40%). Result of the standard curve method accords with that of internal standard method. CONCLUSION: The method is sensitive, stable, practical, and suitable for the quality control of Kuanxuean Soft Capsule.

Objective To study the feasibility and safety of trial of labor after cesarean section (TOLAC). Methods Retrospective analysis of five medical center of Guangdong province from January 2011 to December 2015 hospitalized delivery information, compare the same scar TOLAC (research group) with the scar pregnancy (control group) pregnancy outcomes, to study the feasibility and safety of TOLAC. Results (1)During 2011-2015, total delivery 95 600 cases in five medical center, 13 824 cases of thme with uterine scar pregnancy, including 12 027 cases elective repeat cesarean section and 1 797 cases (13.00%, 1 797/13 824) with scar uterus vaginal trial of labor. Among 1 308 cases of vaginal delivery,the success for trial of labor rate was 72.79% (1 308/1 797). From 2011 to 2015, there were increased rate of pregnancy after cesarean section, which were respectively 10.71%, 13.28%, 14.45%, 15.54%and 16.98%. The will of vaginal birth were rising and the rate were respectively 11.85%, 12.25%, 13.49%, 13.82%and 12.93%. (2) There were 489(27.21%,489/1 797) cases of scar uterus maternal emergency cesarean section in the trial of labor, reason for“social factors”require for cesarean delivery have 68 cases, the percentage was 13.91% (68/489), compared with control group (7.18%, 206/2 869), the difference was statistically significant difference (χ2=27.356,P=0.000). Doctors diagnosed as“aura uterine rupture”in the labor was 11.86% (58/489), compared with that in control group (1.43%, 41/2 869), the differences were statistically significant difference (χ2=1 578.223,P=0.000). (3) The incidence of uterine rupture of the research group(0.74%,9/1 211)was significantly higher than that of control group (0.01%,2/31 200;χ2>2 000,P=0.000). The incidence of postpartum hemorrhage in research group was 6.94% (84/1 211), compared with that in the control group (3.05%, 951/31 200), there was statistically significant difference (χ2=16.328,P=0.000). While, there were no statistical significancefor the labor time limit,birth rate of severe asphyxia and neonatal birth weight average differences between two groups (P>0.05). Conclusions The rate of pregnancy after cesarean section is increasing year by year, and the will of vaginal birth is increasing, while it still are generally low. TOLAC is safe and feasible, but also significantly higher risk, strictly labor monitoring and can proceed fast cesarean delivery in delivery room is an important guarantee of safe delivery.

Objective:To explore the surgical method and therapeutic effect of repairing soft tissue defect of digit-tip with single subcutaneous pedicle V-Y advancing flap combined with skin grafting.Methods:From August 2013 to December 2020, 25 soft tissue defects of digit-tip were repaired by a single subcutaneous pedicle V-Y advancing flap combined with pedicle skin grafting. The area of the defects was 0.8 cm× 0.8 cm to 1.6 cm× 1.4 cm. The flaps were harvested from palm or lateral side of the wound and the area of flap was 0.5 cm×1.0 cm to 0.8 cm×2.5 cm. In order to make the flap transfer to a further distance, the subcutaneous fibre connection of the flap was cut-off during the operation. At the same time, cut off 1 side of subcutaneous pedicle. Finally, the advanced distance of the flap reached 0.5-1.2 cm. After the flap harvested, the medium thickness skin was removed for graft to close the donor site from the wrist striations. After the surgery, follow-up visits were conducted regularly by outpatient clinic, or via telephone or WeChat review or by home visit. Throughout the follow-up, the flap appearance, sensation and recovery of the function of digital joint were observed, together with the patient satisfaction. Results:After the surgery, the postoperative follow-up lasted for 4 months to 8 years. All 25 flaps and skin grafts were survived in first stage wound healing. The flaps and skin grafting areas had excellent texture. The fingerprint had been reconstructed with good appearance. The TPD was 4-9 mm, the functions of digital joint recovered well, and there was no complain about a discomfort at the donor site. According to the evaluation standard of Michigan hand function questionnaire, all 25 patients were very satisfied with the overall appearance and function of the hand. According to Total Angle of Motion (TAM) evaluation standard, finger mobility was excellent in all 25 patients.Conclusion:Subcutaneous V-Y advancing flap combined with skin grafting is an ideal method for repairing soft tissue defect of digit-tip. The surgery characterises a simple flap cutting, less traumatic damage, long advancing distance of flap and good repair effect.

Objective:To investigate the possible role of non-invasive fibrosis scoring systems for detecting high-risk plaque among patients with non-alcoholic fatty liver disease (NAFLD).Methods:A total of 477 consecutive asymptomatic subjects underwent a health checkup including coronary computed tomography angiography (CTA) and abdominal ultrasonography. Fatty liver was evaluated using ultrasonography, and the NAFLD fibrosis score (NFS) was calculated. Coronary stenosis and plaque were evaluated using coronary CTA.Results:Of the study population, 223 had NAFLD. Among the NAFLD patients, high-risk coronary plaque was more frequent in patients with high or intermediate NFS than those with low NFS (62.5% versus 24.0%, P<0.001). The adjusted odds ratio with 95% confidence interval of high-risk plaque was 3.24 (1.11-9.40) for the highest versus lowest quartile of NFS ( P=0.016). Among those without NAFLD, NFS was not associated with high-risk coronary plaque (C-statistic with NFS versus without NFS, 0.766 versus 0.764, P=0.715). Adding NFS to the traditional cardiovascular disease (CVD) risk model increased the C-statistics by 0.679 to 0.739 ( P=0.031). Conclusions:There was an independent association of NFS with high-risk coronary plaque in patients with NAFLD, suggesting its potential use to optimize management of patients with NAFLD.

Objective To propose an integrated management scheme for perineal pain after vaginal delivery.Methods Literature review and Delphi inquiry were conducted to propose the perineal pain management scheme after vaginal delivery from November 2022 to April 2023.A total of 21 experts were consulted with 2 rounds of correspondence.Results Questionnaires collected from the two rounds of correspondence consultations were both at 100.0%.The expert authority coefficients for the two rounds were 0.930 and 0.935,respectively,with the expert coordination coefficients of the two rounds at 0.109(P<0.001)and 0.392(P<0.001),full mark rate 100%.A total of 3 primary items,15 secondary items and 40 tertiary items were summarised for the perineal pain management scheme after vaginal delivery in relation to prenatal prophylaxis,intrapartum protection and postnatal treatment.Conclusions The developed perineal pain management scheme after vaginal delivery is scientific and reliable.It provides a scientific reference for the prevention and treatment of perineal pain after vaginal delivery.