Nucleic acids, as a next generation of biotechnology drugs, not only can fundamentally treat diseases, but also own significant platform characteristics in view of technology and production. Therefore, nucleic acid-based drugs have broad clinical applications in biomedical fields. However, nucleic acids are degradable and unstable, and have very low intracellular delivery efficiency in vitro and in vivo, which greatly limits their applications. In recent years, ionizable lipid-based lipid nanoparticles have shown promising application potentials and have been successfully applied to COVID-19 (Coronavirus Disease 2019) vaccines in clinic. Lipid nanoparticles demonstrate high in vivo delivery efficiency and good safety profile due to their unique structural and physicochemical properties, which provides many possibilities for their clinical applications for nucleic acid delivery in the future. This review focused on the characteristics of nucleic acid drugs and their delivery barriers, and discussed the approved nucleic acid drugs to illustrate the key aspects of the success of their delivery carrier system. In addition, problems to be solved in the field were highlighted.

Objective To analyze the etiology,diagnosis and therapy of benign biliary strictures and im-prove curative and preventive effects. Methods 212 patients suffering from benign biliary strictures in Nankai Hos-pital from January 2004 to December 2006 were retrospectively analyzed. Results Inflammatory strictures (65.12%,140/215) and strictures caused by operations (20.46%,44/215) were the most two causes. Strictures parts were mainly located in the latter segment of common bile duct 52.09% (112/215). In our group,the stent of strictures parts took 31.37% (64/204), bilioendodraignage 18.13% (37/204), and the modification of strictures parts 43.63% (89/204) as well as resection of stricture parts 1.96% (4/204). Conclusions Inflammatory stricture is the main cause in benign biliary strictures and the main locus is the hinder segment of common bile duct. The di-agnesis of benign biliary strictures before operation is important because it can help to decide the approach way and prognosis. The strategies of curing benign biliary strictures could include operations and endoscopy. The stent of stric-tures parts, bilioendodraignage and the modification of strictures parts are the main treaments for benign biliary stric-tures.

Integrable Ware is a new kind of teaching software.The construction of integrable ware system has two parts: integrable ware base and development platform.This paper discussed the making methods of Integrable Ware system and its noteworthy items for general practice education according to its practical situation.

Objective To investigate the main predisposing factors of hematoma enlargement in spontaneous intracerebral hemorrhage,reduce the early mortality,and improve clinical outcomes.Methods By a retrospective study of 268 patients,all patients underwent their first computed tomography (CT)scan within 24 hours of arrival and a second CT scan within 72 hours of admission.These predisposing factors were analyzed by means of univariate and multivariate logistic regression analyses.Results The patients occurred early hematoma enlargement were accounted for 27.99％ (75/268).Univariate analyses indicated that hematoma shape,midline shift,breaking into the ventricle,thrombin clotting time (TT),white blood cells,neutrophil percentage,serum creatinine,fasting plasma glucose (FPG),and Glasgow coma scale (GCS) were significantly different between the patients with or without hematoma enlargement (P ＜0.05).Furthermore,multivariate logistic regression analyses revealed that the following four factors were independently associated with hematoma enlargement:the midline shift [OR (95％ CI) =3.356 (1.251-8.999),P =0.000],the GCS score [OR (95 ％ CI) =0.745 (0.671-0.827),P =0.023],the FPG [OR (95％ CI) =3.022 (1.232-7.408),P =0.016],and the breaking into the ventricles [OR (95％ CI) =2.851(1.158-7.019),P =0.005].Conclusions The midline shift of brain CT scan,the GCS score,the FPG,and the breaking into the ventricles maybe the independent predisposing factors of hematoma enlargement.Therefore,timely review of CT scan and dynamic monitoring of peripheral blood biochemical indicators should be very important for further therapy.

Acupuncture Therapy ; Adult ; Aged ; Bloodletting ; Combined Modality Therapy ; Female ; Humans ; Hypesthesia ; therapy ; Male ; Middle Aged ; Moxibustion

[Objective]To probe the efficacy of total hip arthroplasty(THA)in the treatment of patients with ankylosing spondilitis(AS).[Method]Ninety-eight THA were performed in 56 patients who had AS,and 42 patients(76 hips)were analyzed retrospectively with an average follow-up period of 5.6 years(ranged,2.5 to 5.5 years).The clinical results were evaluated by the Harris hip scoring system and radiographic analysis.[Result]For the latest follow-up,the average Harris hip score improved from 26.8 points(ranged,4 to 51 points)preoperatively to 85.2 points(ranged,55 to 94 points)at the final postoperatively evaluation.89.5% of the patients had an excellent or good results evaluated by Harris hip scoring system postoperatively.One patient was revised for infection,fissured fracture of neck of femur or calcar femorale above the lesser trochanter happended in two patients,one patient had footdrop and recovered 3 months later,1 patient had deep vein thrombosis.There was no sign of loosening,dislocation or fracture of the prosthesis.According to the system of Brooker,the incidence of heterotopic ossification was 9.2 %(7 hips).[Conclusion]THA can greatly relieve the pain of the patients who have AS and reconstruct the function of hip joint.Compared with THA operated for other cause of disease,THA in AS leads to no high risk.

Objective To investigate the causes and the clinical significance of the female lower urinary tract symptoms (LUTS). Methods Of the 72 female patients (mean age,48 years;range,8 to 86 years) with LUTS,46 had dysuria,14 with incontinence,10 with frequency and urgency of micturition and 2 with nocturnal enuresis.Urodynamic examinations were conducted in these patients. Results Among the 46 cases with difficulty of urination,whose bladder volumes were 60 to 800 ml,20 had the bladder detrusor contractility of 0,and 26,of 9 to 160 cm H 2O.Linearised passive urethral resistance relation (Linp-URR) figure showed at least grade Ⅲ obstruction in 19 cases.The urethral pressure profiles (UPPs) were 25 to 130 cm H 2O.Dyssynergia of detrusor-external sphincter occurred in 33 cases with voiding dysfunction.Ten cases with frequency of micturition had bladder volume of 97 to 450 ml.Two cases had the bladder detrusor contractility of 0,the other 8 cases were of 9 to 160 cm H 2O.Linp-URR figure showed at least grade Ⅲ obstruction in 2 cases.One case with urgent incontinence had hyper-sensitive bladder.The abdominal leak point pressures were 44 to 76 cm H 2O in 6 cases of stress incontinence.3 cases of overflowing urinary incontinence had no contraction of bladder detrusor and the UPPs were 32 to 42 cm H 2O.The UPPs were 0 to 16 cm H 2O in the 4 cases of total urinary incontinence.Two cases of nocturnal enuresis had detrusor instability with impaired contractility. Conclusions Urodynamic examination is necessary to the diagnosis of female LUTS and it also has significant value in predicting the treatment and prognosis of LUTS.

Objective To reproduce an animal model of psychological simulation training,and to investigate the influence of psychological training on the ability of counter physical stress.Methods Thirty-two Wister rats were assigned to four groups,8 for each,namely control group(group A),psychological training group(group B),stress group(group C)and psychological training prior to stress(group D).Rats in group A received neither psychological training nor stress,group B received psychological training without stress,group C received stimulation including stress of strong noise and strong light,but without psychological training,and group D,after psychologically training for 4 weeks,received the same stress stimulation as group C.Twenty-four hours after stress,open-field experiment was done on group C and D.At last,rats in all the 4 groups were anesthetized by ether and 5ml of blood was drawn from each rat in order to detect the content of beta-endorphin(?-EP),corticosterone and IL-1?.Results In the open-field experiments,the psychologically trained groups(B and D)showed remarkably lower scores than the un-trained groups(A and C).The levels of ?-EP and corticosterone were significantly elevated in rats after receiving stress stimulation,while that of IL-1? lowered dramatically.The level of ?-EP and corticosterone in psychological training group(group D)was remarkably lower,while that of IL-1? was higher,than the stress group(group C)during the stress.Conclusion Psychological training can lessen the inhibitory effects of harmful stress on endocrine and immunologic functions,and enhance the physical ability to confront stress.

Objective To investigate the psychology and personality factors which affect soldiers' psychological health, in order to provide theoretical evidences for the changes in psychology among recruits engaged in tunnelling operation. Methods Using psychological health questionnaire (SCL-90) and Eysenck personality questionnaire (EPQ), 1191 recruits of missile army recruits were tested before and after the mission of tunnelling in 2004~2005 (with the exclusion the dropped outs, those who were transferred or did not complete the whole test period). Results After entering the tunnel, scores of human relationship sensitivity, anxiety, fright and positive items of the recruits were all higher than before the mission or that of servicemen′s norms. In a group of 931 healthy recruits, 157 turned sub-healthy, while 35 of a group of 260 sub-healthy turned healthy. Using EPQ to investigate the personality of these 2 groups, the C value of the former group was found to be on the high side, and this result showed that there had a tendency of concealment and pretension before entering the tunnel. The turnover observed in the latter group maybe due to their extroversion personality. The SCL-90 test of the latter group showed that it was also related to a lowering of score of human relationship sensitivity. Conclusion It shounld be emphasized that it is important to conduct self-education and psychological mediation for the recruits to improve relationship sensitivity and to allay anxiety and fear for the reeruits before and after the tunnelling operation, in order to improve their psychological health status.

Objective To explore whether augmentation index is an independent risk factor for coronary heart disease or not,and the relationship between augmentation index and coronary artery disease severity.Methods In the study,245 subjects who were hospitalized between Dec.2003 and Dec.2004,were classified into 4 groups and their clinical and biological characteristics and the summary of the scores in each of the eight segment and aortic pressure waveform in ascending aorta were recorded respectively.Results The larger the augmentation index was,the more the number of coronary stenosis vessels was.Linear regression analysis indicated that augmentation index was significantly correlated with grade of coronary stenosis.When augmentation index was more than 45%,the sensibility and specificity was 91.5%and 92.6%respectively.In the logistic regression model,augmentation index was the independent risk factor for coronary heart disease,and the odds ratio of coronary heart disease was 1.893.The 95%CI was 1.421~2.521.Conclusion Augmentation index is an independent risk factor for coronary heart disease and a predictor of angiographic coronary artery disease severity.