Objective: To prepare scutellarin nanosuspension ( SCU-NS) and study the main influencing factors in the prepara-tion. Methods:The technology parameters were determined, and then the influencing factors of SCU-NS were studied. The optimal formula was confirmed by orthogonal design with zeta potential as the evaluation index. Results: The optimal formula process was as follows:drug amount was 0. 5 g, Pluronic? F68 amount was 0. 1 g, phospholipid amount was 0. 2 g, SDS amount was 0. 05 g and HPMC E5 amount was 0. 05 g. The average particle size and the zeta potential of SCU-NS was (122 ± 4) nm and ( -25. 5 ± 0. 6) mV, respectively. The result of transmission electron microscope showed that SCU-NS was spherical and uniform, and the dissolution of SCU-NS in 30 min was more than 90%. Conclusion:Nanosuspension can significantly enhance the dissolution of SCU.

Objective To study biological characteristics of R5 tropic human immunodeficiency virus (HIV)-1 strains in different disease stage. Methods Primary clinical viruses were isolated from fresh peripheral blood mononuclear cells (PBMC) using co-culture methods; meanwhile, viral co receptor usage and infectivity were tested using flow cytometry on GHOST (3) cell lines,which expressed CD4 receptor and CC ehemokine receptor 5 (CCR5) or CXCR4 eoreceptor; to identified CCR5 tropic viruses(R5 tropic strains). Viral replication kinetics was detected in PBMCs. Plasma viral load was measured using an HIV-1 nucleotide fluorescence quantification assay kit. Results There were 22 individuals with HIV-1 subtype B' infection, in which 11 were CD4>0. 2 × 109/L and 11 were CD4≤0. 2 × 109/L. All isolated viruses used CCR5 coreceptor and therefore were HIV-1 R5 tropic strains. The infectivity of R5 tropic strains isolated from patients with CD4≤0.2 × 109/L was (7.392 7 ± 4. 584 2) % ; while the infectivity of R5 tropic strain from patients with CD4>0. 2 × 109/L was (2. 613 6 ± 1. 610 5)%. There were significant statistical difference(t= 3. 262, P<0.05). The possibility of viral replication became strong after the day 7 post-infection. There was a significant difference of viral replication between two groups in the day 7,10, 15 post-infection(t value was 3. 771, 2. 509 and 2. 260 respectively, P<0. 05). The possibility of viral replication was higher in CD4≤0.2 ×109/L group than that of CD4>0.2 × 109/L group. The logarithm of viral load was (5. 606 8 ± 0. 815 1 ) copies/mL in CD4≤0.2 × 109/L group and (4. 729 8 ± 0. 431 6) copies/mL in CD4> 0.2 × 109/L group. There was a significant difference between two groups(t = 3. 771 ; P<0.05). Conclusion Viral infection and replication are enhanced during progression of disease, even if viral coreceptor usage do not switch from CCR5 to CXCR4.

Objective To investigate the efficacy,prognosis and safety of weekly paclitaxel with concurrent radiotherapy in nasopharyngeal carcinoma (NPC) patients with multiple liver metastases.Methods A total of 64 NPC patients with multiple liver metastases in First Affiliated Hospital of Hainan Medical University between January 2016 and January 2018 were recruited and randomly divided into experimental group (n =32) and control group (n =32) by the method of random number table.The patients in the two groups were given palliative radiotherapy with a median dose of 30 Gy.The experimental group used weekly paclitaxel (40 mg/m2) concurrent chemotherapy,cisplatin (40 mg/m2) in the control group.Paclitaxel and cisplatin were used weekly until the end of radiotherapy.The clinical efficacy and adverse effects between the two groups were compared.Results During the follow-up,1 patient was lost to follow-up in the experimental group,complete remission (CR) in 6 cases (19.4％),partial remission (PR) in 9 cases (29.0％),stable disease (SD) in 7 cases (22.6％) and progressive disease (PD) in 9 cases (29.0％);2 patients were lost to follow-up in the control group,CRin4 cases (13.4％),PR in 10 cases (33.3％),SD in9 cases (30.0％) and PD in7 cases (23.3％).There was no significant difference between the two groups (Z =-0.060,P =0.952).The effective rates of the experimental group and the control group were 48.4％ (15/31) and 46.7％ (14/30) respectively,and the difference was not statistically significant (/x2 =0.018,P =0.893);the tumor control rates were 71.0％ (22/31) and 76.7％ (23/30),with no statistically significant difference (x2 =0.256,P =0.613).The median survival time of the experimental group and the control group were 9.4 months and 8.9 months respectively,and the 1-year survival rates were 14.5％ and 10.0％,with no significant difference (x2=1.136,P =0.286).Among the adverse effects,the incidence rates of allergic reaction,neurotoxicity and cardiovascular toxicity in the experimental group were higher than those in the control group [18.8％ (6/32) vs.3.1％ (1/32),28.1％ (9/32) vs.15.6％ (5/32),31.3％ (10/32) vs.15.6％ (5/32)],with no significant differences (x2 =2.566,P=0.109;x2 =1.463,P=0.226;x2 =2.177,P =0.140).The incidence rates of granulocyte decline,platelet decline,red blood cell decline,and impaired liver and kidney function in the experimental group were lower than those in the control group [56.3％ (18/32) vs.68.8％ (22/32),12.5％ (4/32) vs.21.9％ (7/32),15.6％ (5/32) vs.25.0％ (8/32),21.9％ (7/32) vs.28.1％ (9/32)],with no significant differences (x2 =1.067,P=0.302;x2 =0.988,P =0.320;x2 =0.868,P =0.351;x2 =0.333,P =0.564).The incidence rates of nausea and vomiting was lower than that in the control group [(40.6％ (13/32) vs.78.1％ (25/32)],with a significant difference (x2 =9.328,P =0.002).Conclusion Weekly paclitaxel with concurrent radiotherapy has equivalent efficacy to cisplatin and the adverse effects can be tolerated.

Objective:To analyze the trend of disease burden of rheumatoid arthritis in China from 1990 to 2019, and to provide scientific basis for formulating targeted prevention and treatment strategies of rheumatoid arthritis.Methods:Based on data of the global burden of disease study 2019 (GBD 2019), according to the number of people with the disease, the prevalence, incidence, disability adjusted life year (DALY) and DALY rate of RA were used to describe the disease burden of RA in China and the world from 1990 to 2019. Joinpoint model was used to analyze the average annual percentage change (AAPC) of age-standardized prevalence rate, age-standardized incidence rate and age-standardized DALY rate of RA in China and the world from 1990 to 2019. The trend of disease burden of RA was analyzed.Results:In general, the standardized prevalence of RA in China and the world showed an upward trend from 1990 to 2019, and the age-standardized prevalence of RA in China increased by 0.18% per year on average ( t=7.34 , P=0.025). The global average annual increase was 0.27%, with a statistically significant difference ( t=6.64, P=0.013). From 1990 to 2019, the standardized incidence rate in China showed an average annual increase of 0.08%( t=7.54, P=0.032), while the standardized incidence rate in the world showed an average annual decrease of 0.37% ( t= -5.64, P=0.001). In 2019, the number of patients and prevalence of RA in China were 4.309.4 million and 302.98/100 000, respectively. The number of new cases and incidence of RA were 22.25 million and 15.64/100 000, respectively. Compared with 1990, in 2019, the number of patients and prevalence rate increased by 114.17% and 78.23%, the number of new cases and incidence rate increased by 77.90% and 48.05%, and DALY rate increased by 109.05% and 73.97%, respectively. From 1990 to 2019, the prevalence rate, incidence rate and DALY rate of women were higher than those of men. Both the prevalence rate and DALY rate showed an increasing trend with age, with the highest in the age group of 75 years old and above. Conclusion:From 1990 to 2019, the standardized incidence rate of RA in China has more increase than that in the world, and the overall incidence and prevalence of RA in China are on the rise. The prevalence, incidence and DALY of RA varies among different populations in China. Women and middle-aged and elderly people are at high risk.

Objective:To explore the value of laparoscopic and endoscopic cooperative surgery with the patient lying on supine position under general anesthesia in the operation of type I Mirizzi syndrome with choledocholithiasis.Methods:From Jan 2018 to Jan 2020, 53 cases of Mirizzi syndrome with choledocholithiasis undergoing laparoscopic and endoscopic cooperative surgery (preLC+ ERCP+ EST) at the Second Affiliated Hospital of Kunming Medical University were retrospectively analyzed.Results:53 patients successfully underwent LC without conversion to open surgery, and 2 patients failed in ERCP + EST attempt, with a success rate of 96.2%. One patient developed pancreas pseudocyst as a result of post-operative hemorrhagic necrotizing pancreatitis. Two patients suffered from chronic pancreatitis. Three patients complaining postoperative upper abdominal discomfort were finally diagnosed as stump cystic duct inflammation by MRCP, and no abnormalities were found in the follow-up of the remaining cases.Conclusion:Laparoscopic and endoscopic cooperative surgery in the treatment of patients with type I Mirizzi syndrome combined with choledocholithiasis is minimally invasive and effective.