Achalasia is a primary esophageal motility disorder, with the main symptom of dysphagia; and caused by the tonus increase and abnormal relaxation of the lower esophageal sphincter(LES). The etiology remains unclear, the objective of the current treatment approaches for achalasia containing the reduction of the LES tone and obstruction to relieve the patients' symptoms; including pharmacologic treatment, botulinum toxin treatment, surgical myotomy, pneumatic dilatation and cardia stent dilatation. The temporary cardia stent dilatation possesses some better advantages and effects; and ought to be the first choice of minimal invasive interventional management for achalasia.

Objective To study the influence of the small interfering RNA (siRNA) interference TMPRSS4 expression on human pancreatic cancer SW1990 cell's proliferation and invasion. Methods The four eukaryotic expression vector of TMPRSS4 gene were synthesized in vitro and were transfected transiently into human pancreatic cancer SW1990 cells. TMPRSS4 mRNA expression of transfected cells was detected by real-time RT-PCR. The most efficient eukaryotic expression vector was used to be transfected into SW1990 cells. By using G418, cell strain that can silence TMPRSS4 gene stably was screened. The TMPRSS4 mRNA expression of the stable cell strain was detected by real time PCR TMPRSS4 protein expression was detected by western blot. The proliferation ability of transfected SW1990 cells was detected by CCK-8 method. By Transwell, the invasion change of SW1990 cell was detected. Results A stable cell strain, SW1990/psi TMPRSS4, was successfully constructed, in which the expression level of TMPRSS4 could be reduced stably by RNA interference. Cell transfection efficiency was 82.9%. Compared with the control group, the TMPRSS4 mRNA and protein levels were reduced by 80.1% and 60% ,and number of penetrating cells was 118.6 ±13.4 in SW1990/psi TMPRSS4 group, which was significantly lower than those in the negative control group (157.4 ± 12.9) and control group (157.0±9.5, P <0.01). Cells invasion inhibitory rate was 24.5% in SW1990/psi TMPRSS4 group. The cell proliferation was not significantly different among all the groups. Conclusions A stable cell strain is screened successfully in which the expression level of TMPRSS4 can be reduced stably. The down-regulation of TMPRSS4 gene expression level can inhibit the invasion of SW1990 cells, but has no effect on cell proliferation.

Objective To establish ovarian cancer cell line SKVO3 that can stably express human ADP ribosylation factor-4 (ARF4). Methods A eukaryotic expression vector pCDH-CMV-MCS-EF1-Puro/ARF4 was constructed and transfected into SKOV3 cells after verifying by DNA sequencing. The expression of ARF4 mRNA was verified by real-time quantitative PCR (qRT-PCR). Then, the recombinant plasmid with lentiviral packaging plasmids were co-transfected into SKOV3 cells for packaging. The recombinant lentiviral particles LV-ARF4 were collected and transfected into SKOV3 cells, and the stable transfected SKOV3 cell line was screening by culture with puromycin. The expression of ARF4 gene was detected by qRT-PCR and Western Blot. Results A eukaryotic expression vector pCDH-CMV-MCS-EF1-Puro/ARF4 was successfully constructed. The vector could significantly up-regulate the expression of ARF4 mRNA in SKOV3 cells and be successfully packaged into recombinant lentiviral particles in HEK-293T cells. Compared with the control group, the relative expression level of ARF4 mRNA and protein in SKOV3 cells was significantly increased after the infection with LV-ARF4 (all P<0.001). Conclusion The recombinant plasmid pCDH-CMV-MCS-EF1-Puro/ARF4 and lentiviral vector LV-ARF4 were successfully constructed. The establishment of stably infected SKOV3 cell line with LV-ARF4 provides an experimental foundation for further studies on the biological function of ARF4 in ovarian cancer.

Aptamers are DNA or RNA fragments that can specifically bind to target substances.Because of the excellent properties such as strong binding force,high specificity,small physical size,chemical synthesis and modification,good biocompatibility,and low immunogenicity aptamers show wide application propects in biomedical researches.Aptamers can also bind specifically to receptors on the surface of cell membranes,and mediate the endocytosis of nanoparticles into cells,making them ideal drug targeting ligands.Organic nanomaterials have excellent application value in nanodrug delivery system because of their good biocompatibility and degradability.In this paper,the recent research progress of aptamers and organic nanomaterials drug delivery systems was reviewed.

Objective:To analyze the relationship between plasma fibrinogen(FIB) within normal range and microalbuminuria in elderly patients with type 2 diabetes mellitus.Methods:A total of 869 elderly subjects with type 2 diabetes mellitus admitted to the Department of Endocrinology of Shanghai Fifth People′s Hospital from October 2012 to October 2014 were included in the study. The patients were divided into four groups based on the quartile level of FIB: Q1 group(<2.42 g/L), Q2 group(2.42-2.89 g/L), Q3 group(2.90-3.61 g/L), and Q4 group(≥3.62 g/L). The relationship between FIB and urinary albumin/creatinine ratio(UACR) was analyzed.Results:With the increasing of FIB, the level of UACR was significantly elevated( P<0.05). Pearson correlation analysis showed that FIB was positively associated with age, duration of diabetes, creatinine(Cr) and UACR in men and women( P<0.01). Multiple regression analysis showed that FIB was an independent factor of UACR( P<0.01). Logistic regression analysis showed that the risks of microalbuminuria and macroalbuminuria were respectively 4.536 folds(95% CI 2.516-8.175, P<0.01) and 13.314 folds(95% CI 2.925-60.612, P<0.01) in Q4 group, and 2.177 folds(95% CI 1.273-3.724, P<0.01) and 4.098 folds(95% CI 1.101-19.226, P<0.05) in Q3 group as compared with Q1 group after adjused by following factors: gender, age, duration of diabetes, body mass index(BMI), systolic blood pressure(SBP), diastolic blood pressure(DBP), fasting plasma glucose(FPG), HbA 1C, total cholesterol(TC), triglyceride(TG), low density lipoprotein-cholesterol(LDL-C), Cr, alanine aminotransferase(ALT), as well as smoking and drinking behavior. Based on the cut off values to UACR 30 mg/g and 300 mg/g, the receiver operating characteristic curve(ROC) was used to evaluate the value of FIB for UACR. The optimal cut-off value of FIB was 3.18 g/L and 3.22 g/L respectively. Conclusions:Plasma FIB was closely associated with microalbuminuria in elderly patients with type 2 diabetes mellitus, which may be considered as one of the predictors for diabetic nephropathy.

Objective:To explore the association between the frequency of using smoking cessation application (APP) and the effect of smoking cessation in smoking cessation clinic.Methods:A clinical trial with a non-randomized controlled design was conducted in the smoking cessation clinic of China-Japan Friendship Hospital from July 2019 to June 2021. Participants were given a comprehensive smoking cessation intervention of mobile APP combined with bupropion. The primary outcome measures were carbon monoxide validated sustained abstinence at 9-12 weeks.Results:A total of 187 participants were included in the final analysis. After 12-week intervention, the sustained abstinence at 9-12 weeks was 42.2%. For the frequency of APP use, 20.9% (39/187) of the participants used it≥6 days per week, 62.0% (116/187) used it 2-5 days per week, and 17.1% (32/187) used it≤1 day per week. Multivariate analysis showed that smoking cessation rate was associated with smoking duration, cigarettes smoked per day and frequency of APP use. Participants with higher frequency of APP use had a higher likelihood of quitting smoking ( OR=4.95, 95% CI: 1.32-18.63). Conclusion:The increased frequency of mobile smoking cessation APP use is associated with higher probability of quitting smoking in smoking cessation clinic.

Objective To evaluate the long-term safety of sentinel lymph node biopsy mapped by combination of indocyanine green and methylene blue in breast cancer patients.Methods 198 breast cancer patients with clinical negative axillary lymph node received sentinel lymph node biopsy mapped by combination of indocyanine green and methylene blue.Patients were followed up and regional lymph node recurrence,disease free survival(DFS) and overall survival(OS) were analyzed.Results After a median follow-up of 70 months,2 patients had ipsilateral lymph node recurrence with a regional lymph node recurrence rate of 1％ (2/198).14 patient had recurrence or metastasis and 6 patients died of distant metastasis.The estimated 6 years DFS was 94.4％ and OS was 96.5％.The incidence of arm lymphoedema within patients who received axillary lymph node dissection was 4.5％ and it was 2.5％ in patients who received sentinel lymph node biopsy.Conclusions The sentinel lymph node biopsy mapped by combination of indocyanine green and methylene blue was safe and reliable method for further staging axillary lymph node stastus.

Objective To investigate the characteristics of ST segment changes in middle-aged and elderly people in Fuzhou through cardiopulmonary exercise test and to analyze its possible influencing factors, in order to provide theoretical guidance for cardiovascular prevention. Methods A total of 987 individuals undergoing health examination at the physical examination center of 900TH Hospital of Joint Logistics Support Force from 2017 to 2023 were collected as study subjects, and cardiopulmonary exercise tests were performed, and the exercise maximum heart rate (/min), resting systolic blood pressure (mm Hg), resting diastolic blood pressure (mm Hg), peak systolic blood pressure (mm Hg),，carbon dioxide ventilation equivalent (%) ，Borg score (score) and other index data were collected, using Logistic regression to analyze the influencing factors of ST segment anomalies. Results A total of 234 ST-segment abnormalities occurred, and the abnormal rate was 23.72%. Among them, 148 cases (14.99%) were depressed in ST segment, 52 cases (5.27%) were elevated in ST segment, 13 cases (1.32%)was extended in ST segment , and 21 cases (2.14%) was shortened in ST segment . The ST-segment abnormal group had higher exercise maximum heart rate (/min), resting systolic blood pressure (mm Hg), resting diastolic blood pressure (mm Hg), peak systolic blood pressure (mm Hg), peak diastolic blood pressure (mm Hg), carbon dioxide ventilation equivalent (%) and Borg score (score) than the normal group, and the differences were statistically significant. The results of multivariate regression analysis showed that peak systolic blood pressure (mm Hg), carbon dioxide ventilation equivalent (%) and Borg score (score) were the influencing factors in the ST segment depression ; the peak systolic blood pressure (mm Hg) and Borg score (score) were the influencing factors in the ST segment elevation(OR>1). Conclusion Peak systolic blood pressure (mm Hg), carbon dioxide ventilation equivalent (%) and Borg score (score) are the influencing factors of ST segment abnormalities in cardiopulmonary exercise test in middle-aged and elderly people , and their measurement is of great significance for cardiovascular health evaluation and treatment.

D-alanine is a chiral molecule of L-alanine that participates in the formation and regulation of cell wall peptidoglycans, phosphoteichoic acid, spore germination and respiratory metabolism in individual bacteria. D-alanine participates in the formation and regulation of biofilm in bacterial communities. The function and metabolism of D-alanine in bacteria are specific, and the enzymes and genes in its metabolic pathway can be used as drug targeting sites. In this paper, the synthesis, metabolism and function of D-alanine in bacteria were reviewed, and the relationship between D-alanine and pathogenicity of Streptococcus mutans was discussed to provide a theoretical basis for candidate targeting sites of anti-caries drugs. According to existing research results, the enzymes and related genes involved in D-alanine metabolism play important roles in the growth and biofilm formation of Streptococcus mutans, and D-alanine is expected to be a target for the design of anti-caries drugs.

Objective:To describe the study methods and baseline characteristics of participants enrolled in mCessation program.Methods:This is a longitudinal, real-world study with non-randomized controlled design. The mCessation program consisted of a WeChat official account, an applet and a website using the same name ‘mCessation Online’. After users followed the WeChat account, filled in baseline information online and set a quit date, they would receive 162 short text messages in the next six and a half months as scheduled. This study collected the information of participants enrolled from May 26, 2021 to September 30, 2022, and analyzed baseline data including demographic characteristics, smoking characteristics, degree of tobacco dependence, reasons for smoking cessation and other related factors.Results:During the study period, a total of 16 746 participants registered, and 13 887 participants (82.9%) were enrolled in final analysis after screening the inclusion and exclusion criteria and completion of main indicators. Each year the number of enrolled participants in May or June was 1 381 to 2 707 per month, higher than the number of enrolled participants in other months (233 to 569 per month). Participants from North China accounted for the largest proportion (29.3%). There were 13 316 men (95.9%) in enrolled participants and the mean age was (36±10) years. Most participants were 25-34 (38.8%) or 35-44 (30.8%) years old. In terms of smoking characteristics, there were 12 564 (90.5%) daily smokers. The starting age of smoking was 18 (15, 20) years old. 11 866 participants (85.4%) were tobacco dependent, mostly with degree of mild (76.4%) or moderate (20.2%). In terms of reasons for quitting, 9 315 participants′ (67.1%) reasons were to prevent disease, 6 742 participants (48.5%) were concerned about impact of smoking on family members, and 6 731 participants (48.5%) were under requested by families.Conclusion:mCessation program can effectively recruit smokers with intention to quit in short time, especially those who were male, young and tobacco dependent.