To eliminate cancer hazards to human health,the development of the therapeutic cancer vaccine has been given more and more attention.By contrast of tradition therapy,cancer immunotherapy take the advantage of being able to achieve target therapy and take modest harm to organism.Here,we first idiscussed the mechanisms of cancer immune escape,and reviewed the design principles of therapeutic cancer vaccine,as well as the latest research progress of therapeutic cancer vaccine and its application.

The main progress in international critical care medicine in 2020 are: the reflections on the mandatory of implementation of the 1-hour cluster treatment strategy for sepsis are still continuing; the "metabolic resuscitation" therapy, represented by large dose of vitamin C, failed to yield positive results; the global epidemic of coronavirus disease 2019 (COVID-19) continues to spread, with evidences indicating Dexamethasone, Remdesivir or interferon β-1b (IFNβ-1b), Lopinavir/Ritonavir and ribavirin as promising therapy; conservative oxygen therapy did not exert positive effects neither for mechanical ventilated patients nor for acute respiratory distress syndrome (ARDS) patient; the concept of lung- and diaphragm-protective mechanical ventilation illuminates a new opportunity to potentially improve clinical outcomes for critically ill patients; there was no positive evidence for stress ulcer prophylaxis and timing of endoscopy for severe acute upper gastrointestinal bleeding; early initiation of renal-replacement therapy (RRT) for critically ill patients with acute kidney injury (AKI) has not shown positive effect. At last, artificial intelligence (AI) has shown good potential in identifying ARDS phenotypes and early predicting sepsis.

Objective Autoimmune inner ear disease is one of the inner ear diseases that can be effectively treated clinically, and researches on it have significant clinical and practical value.This study explored the immunoregulating and therapeutic effects of the mi-croRNA-146a recombinant lentiviral vector (RLV) on immune-medicated inner ear disease (IMIED) in guinea pigs so as to avoid the adverse reactions of the currently used immunodepressants. Methods IMIED models were established in 30 guinea pigs by immuni-zation with keyhole limpet hemocyanin and divided into three groups: microRNA-146a RLV, empty lentiviral vector ( ELV) control, and surgery simulation control, microinjected via the scala tympani with microRNA-146a RLV, ELV, and PBS, respectively.Before and after immunization and at 7 days after microinjection, the auditory function and the level of specific anti-KLH antibodies in the ser-um were measured by auditory brainstem response ( ABR) audiometry and ELISA, respectively.Seven days after microinjection, 3 ani-mals in each group were subjected to HE staining and light microscopy, another 3 to fluoro-autography for realizing the situations of the inner ear transfected by the lentiviral vector, and the other 4 to measurement of the contents of microRNA-146a in the inner ear tissue. Results Compared with the baseline, immunization significantly increased the level of specific anti-KLH antibodies in the serum (0.09 ±0.01 vs 1.90 ±0.74 in the RLV group, 0.11 ±0.02 vs 2.20 ±0.75 in the ELV group, and 0.11 ±0.02 vs 2.10 ±0.64 in the surgery simulation control) as well as the average threshold of the ABRⅢwave (left ear 11.67 ±2.58 vs 61.67 ±5.16 and right ear 12.50 ±2.73 vs 60.00 ±4.47 in the RLV group;left ear 14.16 ±3.76 vs 64.33 ±9.17 and right ear 13.33 ±2.58 vs 60.83 ± 4.92 in the ELV group;left ear 15.83 ±3.76 vs 64.17 ±10.2 and right ear 15.00 ±5.47 vs 62.50 ±9.35 in the surgery simulation control) .The average threshold of the ABRⅢwave was decreased after local injection into the inner ear as compared with that after immunization, with no statistically significant difference between the ELV and surgery simulation control groups.Fluoro-autographic ob-servation showed that the main parts of the inner ear transfected with microRNA-146a recombinant lentiviruses were the spiral limbus, spiral ganglion afferent fibers, basal cells of the spiral ligament, Corti organ, and psalterial cords.The immune inflammatory reaction of the inner ear was significantly reduced in the RLV group as compared with the ELV and surgery simulation control groups, while the content of microRNA-146a in the inner ear tissue was obviously increased in the former group than in the latter two. Conclusion The microRNA-146a recombinant lentiviral vectors are widely distributed and transfected in the inner ear tissue after injected via the scala tympani.Injecting recombinant microRNA-146a lentiviral vectors into the inner ear can significantly reduce pathological damage and auditory dysfunction caused by inner ear immune inflammatory reaction.

OBJECTIVETo investigate the effect of spearmint oil on emphysema-like changes and the expression of tumor necrosis factor-alpha (TNF-alpha), interleukin-1beta(IL-1beta), matrix metalloproteinase-9 (MMP-9) and tissue inhibitor of metalloproteinase-1 (TIMP-9) in lipopolysaccharide (LPS) treated rats.

METHODEmphysematous changes model was induced by intratracheal instillation of LPS once a week for up to 8 weeks in rats. Rats were divided into control, dexamethasone (0.3 mg x kg(-1)), and spearmint oil (10, 30,100 mg x kg(-1)) groups. Each group was treated with saline, dexamethasone, and spearmint of oil respectively for 4 weeks. Then total and different white blood cell counts in bronchoalveolar lavage fluid(BALF) were carried out. The pathologic changes of lung tissue such as alveolar structure, airway inflammation, and goblet cell metaplasia were observed by HE and AB-PAS staining. Expression of TNF-alpha, IL-1beta, TIMP-1 and MMP-9 were measured.

RESULTBoth spearmint and dexamethasone decreased the destruction of pulmonary alveolus. The total and different white blood cell counts in BALF including neutrophile and lymphocyte of spearmint oil 100 mg x kg(-1) and dexamethasone group were significantly reduced, and the goblet cell metaplasia was also inhibited. Dexamethasone had inhibitory effect on the expression of TNF-alpha, IL-1beta, TIMP-1 and MMP-9. Spearmint oil 30, 100 mg x kg(-1) significantly reduced TNF-alpha and IL-1beta respectively. Spearmint oil 10, 30 and 100 mg x kg(-1) had no effect on the expression of TIMP-1, but could decrease the expression of MMP-9 significantly in lung tissues.

CONCLUSIONSpearmint oil has protective effect on rats with emphysematous changes, since it improves alveolar destruction, pulmonary inflammation, and goblet cell metaplasia. The mechanism may include reducing TNF-alpha, IL-1beta content and inhibiting overexpression of matrix metalloproteinase-9 in lung tissues.

Animals ; Azo Compounds ; pharmacology ; Bronchoalveolar Lavage Fluid ; cytology ; Goblet Cells ; drug effects ; Interleukin-1beta ; drug effects ; metabolism ; Leukocytes ; drug effects ; metabolism ; Lipopolysaccharides ; Lymphocytes ; drug effects ; metabolism ; Matrix Metalloproteinase 9 ; drug effects ; metabolism ; Mentha spicata ; chemistry ; Metaplasia ; Monocytes ; drug effects ; metabolism ; Neutrophils ; drug effects ; metabolism ; Phytotherapy ; Plant Oils ; therapeutic use ; Pulmonary Emphysema ; chemically induced ; drug therapy ; enzymology ; pathology ; Rats ; Respiratory System ; drug effects ; pathology ; Tissue Inhibitor of Metalloproteinase-1 ; drug effects ; metabolism ; Tumor Necrosis Factor-alpha ; drug effects ; metabolism

OBJECTIVE:To optimize the hypoglycemic active parts from the leaves of Dimocarpus longan for type 2 diabetes mellitus mice,and to provide reference for material basis study of it. METHODS:Total extract was obtained from the leaves of D. longan with 95% ethanol percolation extraction. After confirming hypoglycemic effect of total extract,extract was suspended with water. Relevant extract was obtained by using petroleum ether,ethyl acetate and n-butanol in turn(respectively marked as ST,YT,ZT and WT). The model of type 2 diabetes mellitus mice was established by high glucose and high fat diet combined with STZ. Model mice were randomly divided into model group(distilled water),positive control group(metformin,0.1 g/kg), ST low-dose,medium-dose and high-dose groups(22.2,29.6,44 g/kg,calculated by crude drug,similarly hereinafter),YT low-dose,medium-dose and high-dose groups(10.7,16,32 g/kg),ZT low-dose,medium-dose and high-dose groups(10.5, 15.8,31.6 g/kg),WT low-dose,medium-dose and high-dose groups(18.5,24.6,37 g/kg),with 10 mice in each group. Other 10 normal mice were included in normal group(distilled water). Those groups were given relevant medicine intragastrically,once a day,for consecutive 28 d.The growth of mice and the change of body weight were observed and recorded. Fasting blood glucose(FBG)of mice was detected,and glucose tolerance test of mice was conducted. The contents of TC,TG,HDL-C and LDL-C in serum of mice were also determined. RESULTS:Compared with normal group,body weight and serum content of HDL-C in model group were decreased;FBG and the blood sugar after giving glucose for 0.5,1,2 h and area under glucose tolerance curve of mice were increased,and serum contents of TC,TG and LDL-C were alse increased,with statistical significance(P<0.01). compared with model group,body weight of mice in YT high-dose group after administration of 25 d was increased,FBG of mice in YT groups and ZT medium-dose,high-dose groups were decreased(P<0.05 or P<0.01);blood sugar of mice in YT medium-dose,high-dose groups and ZT high-dose group after giving glucose for 1 h as well as blood sugar of mice in YT high-dose group after giving glucose for 2 h were all decreased;area under glucose tolerance curve of mice and serum content of TC were decreased in YT groups and ZT high-dose group,while serum content of HDL-C was increased. Serum content of TG and LDL-C in YT high-dose group and ZT high-dose group as well as serum content of TG in YT medium-dose group were all decreased,serum content of HDL-C in ZT medium-dose group was increased,with statistical significance(P<0.05 or P<0.01). CONCLUSIONS:The ethyl acetate part and n-butanol part from the leaves of D. longan show good hypoglycemic effect on type 2 diabetes mellitus mice.

Objective To investigate the laparoscopic feature and its relationship with clinical manifesta-tions in infertile patients with endometriosis. Methods From Jan.2013 to Jan.2017,infertile patients who received hysteroscopy and hysteroscopy combination surgery in Ganzhou People′s Hospital were enrolled in this ret-rospective study.The basic clinical data and the distribution of endometriotic lesions were recorded and analyzed in patients with endometriosis simultaneously. Analysis was performed about the clinical manifestations and the rAFS stage of the patients. Results 204 patients are totally enrolled in the study. Among them,120 patients(58.8%) had endometriosis. The presence of menorrhea,dyspareunia,tenesmus,chronic pelvic pain,hypermenorrhea, adnexal mass,restricted uterine mobility,tenderness of adnexa,and tenderness nodules of posterior vaginal fornix are clinically statistically significant.In addition,the presence of ovarian endometrioma is also a significant clinical factor that is close related with the rAFS stage of infertile patients with endometriosis. Moreover,uterosacral liga-ment,rectovaginal septum,vagina and bowel were more common infiltrated in stage Ⅲ and stage Ⅳ endometrio-sis. Conclusions For infertile patients,detailed case history,overall bimanual examination and trans-vaginal ultrasound examination are very important to help diagnosis endometriosis preoperatively and provide evidence for the selection of individualized treatment strategies.

Objective: To evaluate the safety and efficacy of transurethral enucleation of bladder tumor(TUEBT) in the treatment of non muscle-invasive bladder cancer (NMIBC). Methods: The clinical and pathological data of 82 NMIBC patients treated between No-vember 2015 and January 2018 in the First Affiliated Hospital of the Jinzhou Medical University were retrospectively analyzed. The 82 NMIBC patients were divided into a TUEBT group (38 cases) and a transurethral resection of bladder tumor (TURBT) group (44 cases). The differences in intraoperative indices, postoperative indices, and pathological staging between the two groups were compared. Re-sults: The bladder irrigation, indwelling catheter, and postoperative hospitalization times in the TUEBT group were (21.00 ± 3.55) h, (4.34±0.81) d, and (5.29±0.96) d, respectively, compared with (27.57±3.87) h, (5.32±0.83) d, and (6.32±0.86) d in the TURBT group, and the differences between groups were statistically significant (P<0.05). The operative time in the TUEBT group [(29.55±4.13) min] was longer than in the TURBT group [(25.30±4.01) min]. The hemoglobin decrease in the TUEBT group [(2.00±0.38) g/dL] was less than that in the TURBT group [(2.30±0.32) g/dL]. The incidence of obturator nerve reflex in the TUEBT group was 13.16% (5/38), compared to 34.09% (15/44) in the TURBT group. The recurrence rate in the TUEBT group was 10.53% (4/38), compared to 29.55% (13/44) in the TURBT group. The detrusor deletion rate in the TUEBT group was 0 (0/38), compared to 31.82% (14/44) in the TURBT group. The re-peat transurethral resection (ReTUR) standard was met in 22 cases in the TUEBT group and 33 in the TURBT group. ReTUR due to lack of a detrusor was required in 0 cases in the TUEBT group and 14 in the TURBT group. The differences in the above clinical characteris-tics were statistically significant (P<0.05). Conclusions: TUEBT can remove a tumor completely, while preserving the detrusor, improv-ing the accuracy of pathological staging, and reducing the probability of ReTUR. For NMIBC, TUEBT can obtain satisfactory clinical effi-cacy, with surgical safety and long-term efficacy superior to those of TURBT.

Objective To clarify the incidence and survival of colorectal carcinoma (CRC) patients among permanent residents in Yangpu district of Shanghai,from 2002 to 2012.Methods Data of CRC patients in permanent residents of Yangpu district were collected from the database of the registration and management system in Shanghai city.Temporal trend in the incidence of CRC was analyzed by using Annual Percent Change (APC) model.Kaplan-Meier analysis with Log-rank testing was employed to estimate the survival.Incidence and mortality rates were standardized on age composition of standard population from 2000 nationwide census.Results A total of 5 881 CRC cases were diagnosed from 2002 to 2012 with crude incidence as 50.60/105 and standardized one as 31.21/105.The crude incidence rates of colon cancer and rectal cancer were 31.09/105 and 18.27/105,respectively and the standardized rates were 14.49/105 and 8.83/105,respectively.The incidence rates of colon cancer were not significantly different between different gender.However,the incidence of rectal cancer in males was significantly higher than in females (P＜0.001).The incidence rates of CRC significantly increased in the age group older than 50 years.However,the standardized incidence rate did not change significantly (APC=0.39).A total of 3 735 cases died of CRC in this period.The annual crude mortality of CRC was 31.35/105 with the standardized rate as 13.72/105.The mortality kept increasing significantly in the population older than 60 years.Mortality of rectal cancer was significantly higher in males than in females (P＜0.001).The 5-year survival rates in both colon cancer and rectal cancer patients were 48.88％ and 54.16％,respectively.Survivals were significantly higher in those who had received surgical treatments than in those without surgical treatments (colon cancer:58.10％ vs.37.22％,P＜0.001 ; rectal cancer:66.18％ vs.39.37％,P＜0.001).Conclusion Age seemed to have contributed to an increased morbidity and mortality of CRC in Yangpu district of Shanghai.The mortality of CRC appeared higher than the incidence.Surgical treatment could significantly prolong the survival of CRC patients.

Objective:To investigatethe heterogeneity of career growth recognition amongphysicians at the stage of standardized training and the growth characteristics of clinical physicians in the early stage, and to provide a reference for improving the quality of standardized training.Methods:The trainees who received standardized residency trainingwere randomly selected from three grade A tertiary hospitals in Chongqing, China. Mplus7.4 was used for latent profile analysis to explain the relationship between explicit continuous indicators, and the subtypes of career growth recognition were analyzed.Results:Career growth recognition at the stage of standardized training was classifiedinto three subtypes of all-round growth recognition, high resource and expectation recognition, and unclassified growth recognition, among which the subtype of unclassified growth recognition accounted for the highest percentage of 40.27% (207 trainees).Conclusions:Physicians at the stage of standardized training show obvious uncertainty aboutcareer growth recognition, and it is necessary to strengthen the education on career growth recognition during standardized training and design a development pathway based on the characteristics of career growth recognition.

Objective:To investigate the effect and mechanism of circular RNA (cirRNA) on the radiosensitivity of rectal cancer.Methods:The differential circRNAs in radiosensitive and radioresistant rectal cancer tissues (biopsy tissue before radiotherapy and chemotherapy) were detected by gene sequencing, and the effect of circRNAs on the radiosensitivity of colorectal cancer cells was further confirmed in vitro. Results:Through gene sequencing of rectal cancer tissue samples, 64 circRNAs were found to be highly expressed in radiosensitive rectal cancer tissues, and 36 circRNAs were lowly expressed in radiosensitive tissues. Ten differential circRNAs were selected and verified by qRT-PCR, and it was found that circATL2 was highly expressed in radiosensitive rectal cancer tissues. In vitro cell experiment indicated that up-regulation of circATL2 expression could significantly improve the radiosensitivity of rectal cancer. Subsequently, 8 miRNAs lowly expressed in radiosensitive rectal cancer tissues were analyzed. The direct binding relationship between miR-205 and circATL2 was confirmed by dual luciferase reporter assay. The rescue experiment confirmed that circATL2 in rectal cancer regulated the radiosensitivity of rectal cancer through miR-205. Conclusion:circATL2 regulates the radiosensitivity of rectal cancer by binding to miR-205.