The key factor of chemotherapy for brain disorders is to penetrate brain blood barrier(BBB). Receptor mediated en-docytosis is one of the mechanisms for drug carriers to cross the BBB. Angiopep-2(ANG)can specifically bind to low density lipopro-tein receptor-related proteins 1(LRP-1)overexpressed on BBB and glioma cells,thus exhibits a higher LRP-mediated BBB penetra-tion capability. Its targeting efficiency is higher than that of other targeting molecules such as transferrin and(TF)lactoferrin(LF). This paper introduces the structure and function of ANG,and its application in brain targeting delivery systems,in order to provide references for research and development of brain targeting preparations and guidance for therapy of brain diseases.

Objective To develop the knee osteoarthritis (KOA) TCM syndrome evaluation scale. Methods Resrarch team collected subjective symptoms from all kinds of syndrome types of KOA and classified the subjective symptoms, which formed the first version of item pool containing 24 subjective symptoms. Expert questionnaires were conducted to calculate the weight coefficient of items, and formed the item pool of the Knee Osteoarthritis TCM Syndrome Evaluation Scale. According to the patient's attention to the 11 items, the items were weighted.Results The Knee Osteoarthritis TCM Syndrome Evaluation Scale contained 11 items, including pain, swelling and stiffness with different weighted scores.Conclusions The Knee Osteoarthritis TCM Syndrome Evaluation Scale were introduced to assess the KOA outcomes on the basis of TCM syndromes. It showed the characteristic of TCM and TCM syndrome.It could provide an objective and standardized measurement for TCM treating KOA.

Objective To study the expression level and clinical significance of Galectin-3 and miRNA-21 in non-small-cell lung carcinoma(NSCLC).Methods One hundred and fifty patients with NSCLC were chosen as cancer group,and 1 50 patients with benign pulmonary diseases were chosen as control group.The expression level of Galectin-3 and that of miRNA-21 between two groups were compared,and the relevance between expression level of Galectin-3 and that of miRNA-21 and clinical feature were analysed.Results In cancer group,the expression level of Galectin-3 was 6.75±2.38,and that of control group was 1.12 ±0.29;the expression level of miRNA-21 was 5.91 ± 1.59,and that of control group was 0.97 ± 0.1 7,and the difference between two groups had statistical significance(P <0.05 ).The relevance between expression level of Galectin-3 and stage,differentiation,lym-phatic metastasis,diameter of carcinoma and PFS,OS of patients had statistical significance(P <0.05).The relevance between ex-pression level of miRNA-21 and stage,differentiation,diameter of carcinoma and PFS,OS of patients had statistical significance(P <0.05).In the diagnosis of NSCLC,the sensitivity of the expression level of Galectin-3 was 90.20%,and its specificity was 70.69%, while the sensitivity of expression level of miRNA-21 was 88.24% and its specificity was 69.97%.The difference between the di-agnostic value of Galectin-3 and that of miRNA-21 had no statistical significance(P >0.05 ).Conclusion The expression level of Galectin-3 and that of miRNA-21 can be applied in the diagnosis and prognosis of non-small-cell lung carcinoma.

Objective To develop a sensitive and simple LC/MS method for determination of methomyl in blood samples.Methods Methomyl was extracted from blood by liquid-liquid extraction with ethyl acetate, and then analyzed on a Zorbax SB-C18 (2.1mm×50mm, 5μm) column. The mobile phase consisted of acetonitrile-0.1% formic acid with gradient elution, at a lfow rate of 0.5 mL/min, at 40℃. LC-MS was performed in ESI source with MRM mode for quantiifcation.ResultsThe linear range of the concentration were 0.05~2.0μg/mL for methomyl (r>0.995). The relative recoveries of methomyl were in the range of 90%~108%. The RSDs of intra-days and inter-day were both less than 15%.Conclusion The method is a simple, quick, sensitive and could be used for determination of methomyl in blood samples.

Objective To study the effects of living environment conditions and animal-animal interaction on the blood hormone levels and psychological behavior in Chinese tree shrews .Methods Chinese tree shrews were raised in ca-ges of different space sizes or were administered reserpine for 15, 30, 60, 120, 180 days, respectively.Then the animals were anesthetized by ether inhalation , and blood samples were taken from the heart to detect the levels of blood testosterone (T), estradiol (E2), endothelin (ET), adrenaline (A) and noradrenaline (NA) by radioimmunoassay (RIA).Results 1.Chinese tree shrews were bred in large cage (D1group) or small cage (X1 group) for 15, 30, 60, 120, 180 days, re-spectively.Compared with the animals bred in the large cage (D1 group), the level of blood testosterone (T) was signifi-cantly reduced (P<0.01), and the levels of adrenaline , noradrenaline and endothelin were significantly increased in the small cage group (P<0.01 for all).2.The animals raised in small cages in close neighborhood with large cages for 15, 30, 60, 120, 180 days, respectively.The levels of testosterone, adrenaline and noradrenaline in the large cage group (X2 group) were significantly higher than those of the small cage group (X1 group) (P<0.01 for all).3.The adrenaline and noradrenaline levels were significantly lower in all the reserpine groups (P<0.01 for all).4.The animals bred in small cages (X1 group) and in small cages in close neighborhood with large cages showed sudden loss , reduced appetite, testicu-lar atrophy , penile prolapse and stress symptoms .The animals of the reserpine groups appeared gentle temperament , signif-icantly reduced activity and reduced appetite .However , after stopping the reserpine administration and feeding them in large cages , the animals gradually returned to normal behavior .Conclusion Both animals living environment conditions and animal-animal interaction may cause changes of blood hormone levels and psychological behavior in Chinese tree shrews.

Objective To investigate the effects of the head peripheral nerve block on remifentanil consumption and postoperative pain in patients undergoing craniocerebral surgery. Methods 80 patients under general anesthesia undergoing supratentorial craniocerebral surgery were randomly divided into two groups:the head peripheral nerve block combined intravenous anesthesia group (group S, 40 cases) and the simple intravenous anesthesia group (group C, 40 cases). After anesthesia induction intubation, the patients in group S received the head peripheral nerve block with 0.596% ropivacaine mesylate injection,including supraorbital nerve, supratrochlear nerve , auriculotemporal nerve , great occipital nerve and lesser occipital nerve , as well as regional nerve on the corresponding position of the bilateral head nails. Haemodynamic index of the operations was measured;drug consumption during operation and VAS pain score at 0. 5, 2, 6, 12, 24 and 48 h after surgery were recorded. Results Compared with group C, the values of SBP, DBP, HR had a significant decrease at head-nail insertion and the latter stage in group S(P<0.05). The remifentanil consumption and VAS scores had a significant decrease in group S (P < 0.05). Conclution Head peripheral nerve block before operation could enhance anesthesic analgesia, reduce the remifentanil consumption and postoperative pain in patients undergoing craniocerebral surgery.

Objective To investigate the clinical risk factors of delayed cerebral ischemia (DCI) in patients with aneurysmal subarachnoid hemorrhage (aSAH).Methods From January 2015 to April 2016,106 consecutive patients with aSAH treated with endovascular embolization at the Department of Neurosurgery,Nanjing General Hospital of Nanjing Military Command were enrolled retrospectively.The patients were divided into either a DCI group (n =34) or a non-DCI group (n =72) according to whether the occurrence of DCI.The general information of patients were collected,including sex,age,Hunt-Hess grade,modified Fisher grade,world federation of neurosurgical societies (WFNS) grade,acute cerebral edema,early (bleeding 1-3 d) hypoalbuminemia,and hypohemoglobinemia.Univariate and multivariate Logistic regression analyses were used to analyze the risk factors for occurrence of DCI.Results The incidence of DCI was 32.1％ (34/106).The Hunt-Hess grade ≥ Ⅲ,modified Fisher grade ≥ Ⅲ,WFNS grade ≥ Ⅳ,acute cerebral edema,the incidences of hypoalbuminemia and hypohemoglobinemia in the DCI group were higher than those in the non-DCI group.There were significant differences between the 2 groups (all P ＜ 0.05).There were no significant differences in the ratios of sex,age ≥ 55 years,hypertension,diabetes and hyponatremia between the 2 groups (all P ＞ 0.05).In univariate analysis,the Hunt-Hess grade ≥ Ⅲ grade,modified Fisher grade ≥ Ⅲ,WFNS grade ≥ Ⅳ on admission,and hypoalbuminemia were used as the independent variables for multivariate analysis,the results showed that WFNS grade ≥ Ⅳ (OR,8.02;95 ％ CI 2.41-26.70),modified Fisher grades ≥ Ⅲ (OR,4.44;95％ CI 1.38-14.32),and hypoalbuminemia at day 1-3 (OR,5.42;95％ CI 1.40-20.76) were the independent risk factors for occurring DCI in patients with aSAH (all P ＜ 0.05),and the Hunt-Hess grade ≥ Ⅲ was not the risk factor for occurring DCI in patients with aSAH (OR,1.86;95％ CI 0.39-8.88,P ＞ 0.05).Conclusion The patients with hypoalbuminemia,WFNS grade≥Ⅳ on adrnission,and modified Fisher grade ≥ Ⅲ may were the independent risk factors DCI after aSAH,and the clinical diagnosis and treatment should attach great importance to.

Objective: To understand the current situation of early childhood sexuality education among parents of leftbehind children in rural areas and associated factors, to provide the evidence to launch the sexuality education for left behind children in rural areas in the future. Methods: An anonymous questionnaire survey was conducted among 1 348 parents of left behind children in rural areas who were selected by multistage stratified sampling during Mar. to May. 2018. Results: The rate of early childhood sexuality education of rural areas in Sichuan was 48.4%(652). Multivariate analysis showed that parents whose child was in higher grade ( OR=1.32, 95% CI =1.12-1.55); total annual income <10 000 yuan( OR=1.48, 95%CI =1.02-2.14), children had asked sexrelated questions ( OR=1.44, 95%CI =1.11-1.87), reckoning it necessary( OR=3.78, 95%CI =2.57-5.58), considering children’s sexuality education should be held by parents ( OR=2.69, 95%CI =1.78-4.07), other family members had launched the early childhood sexuality education( OR=7.86, 95%CI =5.16-11.95), school had launched it ( OR=3.13, 95%CI =2.25-4.34) had a highter rate of early childhood sexuality education. Conclusion Early childhood sexuality education of parents of left behind children of rural areas in Sichuan is in low level. Sexual health education should be based in school, together with parental training towards positive attitude and increases in early childhood sexuality education.

Objective:To develop an online continuing education course of pediatrics for primary physicians using the ADDIE model and to evaluate its application effect.Methods:Experts in fields of general practice and pediatrics were invited to develop an online continuing education course of pediatrics for general practitioners using ADDIE model from June to July 2020. From August 2020 to September 2020 the course was conducted with 12 live sessions on the open platform. In September 2020, 16 primary pediatricians and 15 general practitioners who completed whole courses were invited to attend focus group interviews. The interview contents were recorded, transcribed, and coded using Nvivo software; the subject frame analysis method was used to sort the data and refine the theme.Results:Information was saturated by focus group interviews with 14 general practitioners and 14 pediatricians. Finally, three themes were extracted from the interview results:(1)The advantages of this course were practicality, comprehensiveness and online teaching; (2) The course improved the diagnosis and treatment ability of participants, increased self-confidence of doctors and satisfaction of patients, and also promoted academic exchanges among colleagues; (3) For future improvement of the course, the clinical knowledge points, practical procedures, new thinking of diagnosis and treatment, progress in guidelines, and knowledge depth should be added; and the use of case teaching and combination of online with offline, and extending teaching time should be considered.Conclusion:An online continuing education course of pediatrics for primary physicians has been developed based on the ADDIE model, which received favorable feedback from the primary pediatricians and general practitioners who attended the course.

Objective:To search, evaluate and summarize the evidence of the safety and application of closed tracheal suction systems and to provide reference for clinical nursing work.Methods:BMJ Best Practice, UpToDate, Joanna Briggs Institute Evidence-based Health Care Center, Guidelines International Network, National Institute for Health and Care Excellence, Scottish Intercollegiate Guidelines Network, Registered Nurses' Association of Ontario, American Assocition for Respiratory Care, Society of Critical Care Medicine, Medlive, Cochrane Library, PubMed, Embase, CINAHL, CNKI, Wanfang Database, China Biology Medicine disc were searched for related guidelines, system reviews, expert consensus, best practices, etc. The retrieval time was from the database construction to February 28, 2021. Two researchers independently evaluated the quality of the included literature and extracted and summarized the evidence of the literature that met the quality standards.Results:A total of 20 literatures were included, including 3 clinical decisions, 2 guidelines, 11 systematic reviews and 4 expert consensuses. A total of 27 pieces of best evidence were compiled from five aspects, including indications for use, clinical effects, safety, methods of use and replacement.Conclusions:This study summarizes the best evidence on the clinical application of closed sputum suction devices in adults. When applying the evidence, clinical nurses need to select the best evidence in combination with the clinical environment to standardize the clinical application of closed tracheal suction systems.