Objective To discuss the influence of different concentration sulindac on pancreatic cancer cell line PANC-1 cell proliferation and apoptosis,and investigate the possible mechanism that sulindac can inhibit the Wnt/beta-catenin pathway to kill pancreatic cancer cells. Methods PANC-1 cell were divided into negative control group (added containing no sulindac DMSO)and experimental group (added sulindac with concentrations of 0.25 ,0.5 ,1 ,1.5 ,2 mM medium,respectively,name as 0.25 mM group,0.5 mM group,1.0 mM group,1.5 mM group,2.0 mM group),and treated with different time,cell proliferation inhibition ratio in each group was detected by MTT assay,cell apoptosis ratio was detected by flow cytometry,the expression ofβ-catenin mRNA and protein were detected by RT-PCR and immunocytochemistry.Results MTT results showed that sulindac can inhibit the cell proliferation of PANC-1 by a dose-and time-dependent manner.Cell apoptosis increased after sulindac treatment in different degrees,and there were statistical differences between 1.5,2.0 mMgroup and control groups (P<0.05).RT-PCR results showed that the expression ofβ-catenin mRNA decreased after the treatment of sulindac,there were statistical differences between 1.5,2.0 mMgroup and control group (P<0.05). In the 2.0mM group,the expression ofβ-catenin decreased along with the time extending (P<0.05 ).ICC results showed that sulindac inhibited the expression ofβ-catenin protein and nuclear accumulation,there were no statistical differences in 0.25 ,0.5 mM group and control group,but there were statistical differences in 1.0,1.5,2.0 mMgroup.Conclusion Sulindac could inhibit cell proliferation and facilitate apoptosis of PANC-1,this effect is dose-and time-dependent.The inhibition of Wnt/beta-catenin signal pathway may be a possible mechanism of its cytotoxicity.

Objective: To find a viable alternative to reduce the number of doses required for the patients with post-traumatic stress disorder (PTSD), and to improve efficacy and patient compliance. Methods: In this study, we used ginger oil, a phytochemical with potential therapeutic properties, to prepare ginger oil patches. High-performance liquid chromatography (HPLC) was used to quantify the main active component of ginger oil, 6-gingerol. Transdermal absorption experiments were conducted to optimize the various pressure-sensitive adhesives and permeation enhancers, including their type and concentration. Subsequently, the ginger oil patches were optimized and subjected to content determination and property evaluations. A PTSD mouse model was established using the foot-shock method. The therapeutic effect of ginger oil patches on PTSD was assessed through pathological sections, behavioral tests, and the evaluation of biomarkers such as tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), brain-derived neurotrophic factor (BDNF), and melatonin (MT). Results: The results demonstrated that ginger oil patches exerted therapeutic effects against PTSD by inhibiting inflammatory responses and modulating MT and BDNF levels. Pharmacokinetic experiments revealed that ginger oil patches maintained a stable blood drug concentration for at least one day, addressing the rapid metabolism drawback of 6-gingerol and enhancing its therapeutic efficacy. Conclusions Ginger oil can be prepared as a transdermal drug patch that meets these requirements, and the bioavailability of the prepared patch is better than that of oral administration. It can improve PTSD with good patient compliance and ease of administration. Therefore, it is a promising therapeutic formulation for the treatment of PTSD.

Objective:To investigate the technical points and clinical effect of thulium fiber laser lobes-enucleation of the prostate (ThuLLEP).Methods:A total of 90 patients underwent ThuLLEP and plasmakinetic enucleation of prostate (PKEP) in our hospital from November 2018 to December 2020 were collected. The age of patients in the two groups was (67.7±6.8) years and (65.7±7.1) years, the prostate volume was 56.0 (46.0-83.5) ml and 61.0 (53.5-79.5) ml, the serum PSA was 3.6 (2.2-6.0) ng/ml and 4.4 (1.8-7.3) ng/ml, the international prostate symptom score (IPSS) was 27 (22-31) and 28 (23-30), the quality of life score (QOL) was 5 (5-6) and 5 (5-6), the maximum urinary flow rate (Q max) was (8.5±5.7) ml/s and (7.8±3.8) ml/s, the post-void residual volume (PVR) was 127 (47-250) ml and 100 (27-209) ml. The differences had no statistical significance ( P>0.05). The glands were bluntly dissected to establish the surgical capsule plane on both sides of the verumontanum after the verumontanum being located. And then the middle lobe was removed. The glands formed grooves at 12 o'clock after vaporization, which served as anatomical marker. The left and right lobes were removed step by step. Finally, tissue crushing was performed. The PKEP group was enucleated by three lobes enucleation. Perioperative indicators were compared between the two groups. Results:All the operations were completed successfully. The median operative time in ThuLLEP and PKEP groups was 60 (50-73) minutes and 75 (60-100) minutes, the postoperative bladder irrigation time was 2.8 (2.3-3.6) d and 3.8 (2.6-4.7) d, the catheter indwelling time was 4.1 (3.7-4.9) d and 4.9 (4.7-6.0) d, the postoperative hospital stay was 5 (4-6) d and 6 (5-7) d. The decreased hemoglobin was 8.0 (1.5-14.5) g/L and 15.0 (6.5-21.0) g/L. The differences had statistical significance ( P<0.05). Follow-up was performed for 6 months after surgery. The median IPSS score of the two groups was 5 (2-11) and 6 (3-9), the QOL score was 1 (1-2) and 1 (1-2) respectively, which had statistical significance compared with the preoperative parameters ( P<0.05), but no statistical significance between the two groups ( P>0.05). The ThuLLEP group had 1 case of postoperative blood transfusion, 1 case of transient urinary incontinence and 2 cases of urethral stricture. The PKEP group had 1 case of fever and blood transfusion, 3 cases of transient urinary incontinence and 3 cases of urethral stricture. Conclusions:ThuLLEP has definite clinical effect because of less bleeding, quicker recovery and fewer complications. The relatively simple operation steps are beneficial for beginners to master.

Objective:To investigate the effect of total anatomical reconstruction (TAR) during robot-assisted radical prostatectomy (RARP) .Methods:The clinical data of 99 patients with RARP performed by a single doctor in our hospital from January 2018 to January 2021 were analyzed retrospectively.There were 38 patients in the TAR+ vesicourethral anastomosis (VUA) group and 61 patients in the VUA group. There were no significant differences between the two groups in the age of patients [ 65.5 (60.8, 71.0) years vs. 66.0 (61.5, 69.0) years], body mass index[ (24.92±2.65) kg/m 2 vs. (25.51±2.80) kg/m 2], prostate volume [28.13 (25.21, 36.53) ml vs. 26.33 (19.75, 47.84) ml], PSA [15.67 (9.02, 31.49) ng/ml vs. 14.58 (9.23, 30.06) ng/ml], neoadjuvant therapy [50.0% (19/38) vs. 63.9% (39/61)], Gleason score (6/7/8/9-10 scores: 8/16/5/9 cases vs. 16/25/9/11 cases) and clinical T stage (T 1/T 2/T 3 stage: 4/29/5 cases vs. 3/53/5 cases)(all P>0.05). The TAR technique was performed as follows. ①The two layers of posterior reconstruction involved the residual Denonvilliers fascia, the striated sphincter and medial dorsal raphe (MDR), and the vesicoprostatic muscle (VPM), the fascia which was 1-2 cm from the cranial side of the bladder neck and MDR. ②The one layer of anterior reconstruction involved detrusor apron, tissues around the urethra and the visceral and parietal layers of the endoplevic fascia. The VUA technique was suturing the bladder neck and urethra consecutively. Perioperative indexes were compared between the two groups. Results:All 99 operations were successfully completed. There were no statistically significant differences between the TAR+ VUA and VUA groups in operation time [ (174.16±47.21) min vs. (188.70±45.39) min], blood loss [ 50 (50, 100) ml vs. 100 (50, 100) ml], incidence of postoperative complications [10.5% (4/38) vs. 14.8% (9/61)], phathological T stage [pT 2/pT 3~4 stage: 25/12 cases vs. 42/19 cases, P=0.895], and the time of indwelling catheter [ 21.0 (19.0, 21.0) d vs. 21.0 (21.0, 21.0) d] (all P>0.05). The difference in postoperative length of stay between the two groups was statistically significant[6.0 (5.0, 6.0) d vs. 7.0 (6.0, 7.5)d, P<0.001]. Follow-up was performed for 1 year after surgery. The recovery rate of urinary continence 3 months after surgery in TAR+ VUA and VUA groups were 86.8% (33/38) vs. 65.6% (40/61), which were statistically significant( P=0.019). There were no significant differences between TAR+ VUA and VUA groups in recovery rate of urinary continence 1 months after surgery [47.4% (18/38) vs. 45.9% (28/61)], 6 months after surgery [94.7% (36/38) vs. 85.2% (52/61)], and 12 months after surgery [94.7% (36/38) vs. 93.4% (57/61)] (all P>0.05). Conclusions:TAR technique has good surgical safety, and can promote recovery of early urinary continence after RARP.

Objective To observe the value of chocolate balloon(controlled dilatation technique)for vascular preparation of endovascular treatments for lower extremity arteriosclerosis obliterans(ASO).Methods Data of 110 patients with lower extremity ASO who underwent vascular preparation with chocolate balloon were retrospectively analyzed.The type of ASO,with calcification or not and so on were recorded,and the success rate of vascular preparation with chocolate balloon and the therapeutic effect of endovascular treatments for ASO were evaluated.Results Among 110 patients,unilateral lower extremity ASO were found in 100 cases,while bilateral lower extremities ASO were noticed in 10 cases,including 100(100/120,83.33%)chronic occlusive lesions,8(8/120,6.67%)stenotic lesions and 12(12/120,10.00%)thrombotic lesions.Calcification with grade 3-4 were observed in 50 lesions(50/120,41.67%).The technical success rate of vascular preparation with chocolate balloon was 92.50%(111/120),while 7(7/120,5.83%)lesions developed flow-limiting dissection after chocolate balloon dilatation and 2(2/120,1.67%)lesions had significant residual stenosis that did not meet the technical success criteria,which underwent stent implantation without drug-coated balloon(DCB).Besides,flow-limiting dissection were noticed in 15 lesions after DCB,hence salvage stents were implanted.The success rate of endovascular treatments of ASO was 100%.Conclusion Chocolate balloon(controlled dilation technique)was valuable for vascular preparation of endovascular treatments for lower extremity ASO.

Establishing a comprehensive mechanism for the initiation and review of investigator-initiated trial(IIT) plays an important role in ensuring the scientific validity of clinical research and improving research quality.Since 2021, Zhongshan Hospital affiliated to Fudan University had actively explored improvements in the project management of IIT. The hospital had established a standardized grading review management process, developed an integrated clinical research management system, established a three-level clinical research training system, built a methodological support platform, and formulated research plan templates, gradually formed a standardized grading project approval review management mode. As of February 2024, the hospital had completed 400 quick reviews and more than 400 expert letter reviews based on the integrated clinical research management system. The efficiency and quality of IIT project approval had been improved. At the same time, over 40 academic salons and forums had been held, cultivating a group of young clinical research talents, providing data management training for more than 30 clinical departments, and promoting the improvement of the quality of research protocol. In the future, hospitals should further optimize their information systems, expand the influence of their training systems, enhance the capabilities of their methodological support platforms, and improve the efficiency of the application of clinical research protocol templates, so as to escort the establishment and implementation of high-quality clinical research projects and provide references for other hospitals′ IIT project management.

Objective To investigate the epidemiologic characteristics of diabetes mellitus (DM) in Uygur residents in Kashgar of Xinjiang.Methods The survey was conducted among the Uygur residents aged ≥ 18 years selected through stratified cluster sampling in Kashgar by means of questionnaire survey,physical examination and basic laboratory test.The prevalence of different groups were calculated and risk factors of DM was analyzed by logistic vegression model.Results A total of 4 608 adults were surveyed.The prevalence of DM was 11.31％ (standardized prevalence:10.59％) and the prevalence was 13.65％ (standardized prevalence:12.34％) in males and 10.04％ (standardized prevalence:9.83％) in females.The prevalence increased with age.The prevalence of DM was higher than the prevalence of impaired fasting glucose (IFG) in people aged ＞60 years,especially in females.The rates of awareness,treatment and control of DM were 28.02％,21.31％ and 5.57％,respectively.Multivariate logistic regression analysis indicated that people aged 45-55,55-65 and ＞65 years had higher risk of DM and the odds ratio were 2.08 (95％CI:1.24-3.48),2.73 (95％CI:1.63-4.56) and 3.90 (95％ CI:2.24-6.78) for men and 2.63 (95％ CI:1.71-4.02),3.14 (95％ CI:2.00-4.94) and 5.56 (95％CI:3.47-8.92) for woman,respectively.Family history of DM (OR=2.88 for men,95％Cl:1.45-5.72;OR=2.52 for women,95％CI:1.49-4.26) and BMI≥28.0 kg/m2 (OR=1.77 for men,95％CI:1.19-2.64,OR.=1.80 for women,95％CI:1.30-2.50) were also risk factors for DM.Conclusion The prevalence of DM was high in Uygur residents in Kashgar,but the rate of awareness,treatment and control of DM were low.It is necessary to improve the detection rate of DM and conduct targeted prevention and control of DM.

Objective To understand the prevalence of dyslipidemia and normal blood lipids level in Uygur diabetes patients in Kashgar prefecture in southern area of Xinjiang.Methods A total of 5 078 local residents aged ≥ 18 years (42.56％ were men) selected through cluster random sampling in Kashgar were surveyed by means of questionnaire survey,physical examination and laboratory test,and 521 diabetes patients were screened.Results The overall prevalence of dyslipidemia in diabetes patients was 59.50％ (310/521) with adjusted rate as 49.39％.Age ≥65 years,overweight,obesity and abdominal obesity increased the risk for dyslipidemia by 0.771 times (95％ CI:1.015-3.088),1.132 times (95％CI:1.290-3.523),1.688 times (95％CI:1.573-4.592) and 0.801 times (95％CI:1.028-3.155) respectively.Compared with males,female was a protective factor for dyslipidemia (OR=0.507,95％CI:0.334-0.769).The overall normal rate of blood lipids level including total cholesterol (TC),triglycerides (TG),high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) for type 2 diabetes patients was 11.13％.Female,higher BMI and abdominal obesity were the factors influencing the overall normal blood lipids level.The normal rate of LDL-C level decreased with increase of age,BMI and waist circumferences (trend test x2=18.049,P＜ 0.001;trend testx2=10.582,P=0.001;x2=19.081,P＜0.001),but increased with educational level (trend testx2=9.764,P=0.002).Conclusion The prevalence of dyslipidemia in Uygur diabetes patients in Kashgar was high,however,the overall normal rate of blood lipid level was relatively low.Obesity was the most important risk factor for dyslipidemia in this area.More attention should be paid to dyslipidemia prevention in women.

Objective To investigate the knowledge,attitude and practice (KAP) to chronic diseases and associated influencing factors in Uygur adults in Kashgar of southern Xinjiang,and provide basic information for developing ethnic specific prevention and control strategies for chronic diseases.Methods With stratified cluster random sampling,investigations,including questionnaire survey,physical examination and laboratory tests were performed among local residents who were aged ≥ 18 years and selected in Shufu county in southern Xinjiang.KAP scores were calculated and unconditional logistic regression models were used to analyze influencing factors.Results A total of 4 772 Uygur adults were surveyed.The awareness rate of chronic disease related knowledge ranged from 4.32％ to 56.04％,while the awareness rate of preventive measures were from 1.76％ to 85.18％ and the participation rate of prevention program varied from 4.00％ to 97.99％.The average KAP score was 15.90 ± 4.20 and the rate of total KAP was 47.86％.Multi-factor analysis suggested the pass rate of total KAP score increased with educational level.Other factors positively associated with ‘KAP score pass rate’ were commercial insurance investment,hypertension,family history of common chronic diseases,female and abdominal obesity,while overweight was negatively associated with the KAP score pass rate.Conclusions The KAP level on chronic diseases was low in Uygur adults in Kashgar.It is necessary to continuously implement ethnic targeted health education and health promotion campaigns,especially in low education level,low income level,overweight and male groups.

Objective This study aimed to assess the diagnostic value of anti-mutated citrullinated vimentin (MCV) antibodies in rheumatoid arthritis (RA) and its correlation with disease progression, extra-articular manifestations and overlap syndrome. Methods Retrospective Studies. Clinical data of 837 patients in PekingUnionMedicalCollegeHospitalfrom June to August 2017 were collected, including the result of anti-MCV, anti-cyclic citrullinated peptide (anti-CCP) antibodies, rheumatoid factor (RF), erythrocyte sedimentation rate (ESR) and High-sensitivity-C-reactive protein (CRP). According to the 1987 American College of Rheumatology classification criteria for rheumatoid arthritis, there were 323 patients diagnosed with RA, including 59 males and 264 females with the average age of 51 years. According to whether the RA patients have overlap syndrome with other autoimmune disease (AID) or have extra-articular manifestations, 258 cases were categorized into RA group, including 47 males and 211 females with the average age of 50 years; 14 cases were categorized into the group of overlap syndrome, including 1 male and 13 females with the average age of 36 years;51 cases were categorized into the group of extra-articular manifestations, including 11 males and 40 females with the average age of 59 years.According to 2010 rheumatoid arthritis classification criteria for destruction in joints, the radiographic changes were divided into 4 stages. There were 203 casesenrolled in our study, 88 caseswere fitted into early stage group (stage I)including 21 males and 67 females with the average age of 48 years; 115 caseswere fitted into progressive stage group, which compromisedstageⅡ (interim stage), stage Ⅲ (severe stage) and stage Ⅳ(final stage) cases, including 19 males and 96 females with the average age of 53 years. Mann-Whitney U test, x2 test, Receiver operating characteristic (ROC) curves and Spearmancorrelation coefficientwere used in Statistical analysis. Results Ⅰ Amongdiagnosed RA patients, 199 (61.6％) cases were positive for anti-MCV, anti-CCP and RFsimultaneously, 42 (13％) cases were positive for anti-MCV, which was higher than anti-CCP positive (1 cases, 0.3％) or RF positive (7cases, 2.2％). The difference was statistically significant(P<0.001, P<0.001). ⅡROC was calculated and MCV=35.95 U/ml was used as best-fit cut-off value. The AUC for anti-MCV was 0.867, while the sensitivity was 80.5％and specificity was 80.9％.ⅢThe detection levels of anti-MCV (682.8 (106.4-1000.0)), anti-CCP (407 (4.0-1536.0)) and RF (82.8 (21.1-244.9)) in the group of progressive stage were higher than those in the group of early stage (114.5 (28.5-1000.0), 62.5 (5.0-1020.7), 50.1 (6.7-127.1)), which showed a significant difference(P<0.05, P<0.05, P<0.05). The anti-MCV, anti-CCP and RF were positively related to the degree of joint destruction (r=0.229, P<0.05;r=0.187, P<0.05;r=0.167, P<0.05);anti-MCV and anti-CCP were positively related to extra-articular manifestation (r=0.152, P<0.05;r=0.136, P<0.05). Conclusion Anti-MCV antibodies are more sensitive in patients with RA, and have complementary diagnostic value for anti-CCP and RF-negative patients; high levels of anti-MCV and anti-CCP in RA patients are associated with RA progression and extra-articular involvement.