In this article we analyzed the current development of moxibustion treating rheumatoid arthritis from the usefulness, advancement, synergistic effect as well as the variance between different kind of moxibustion. We concluded that moxibustion was an effective intervention for treating RA, and the methods used in moxibustion were searched in clinic. But the clinical tralls has a long way to go, we should pay more attention to the critical issues while in the use of moxibustion.

BACKGROUND:The structure of tissue engineering carrier affects the bio-action of cells greatly.OBJECTIVE: To investigate the biological characteristics of bone marrow stem cells (MSCs) in different concentrations of alginate combined with de-antigen bone xenograft (DBX).DESIGN: Observational trial.SETTING: PLA Institute of Trauma and Orthopedics, the Fourth Military Medical University of Chinese PLA.MATERIALS: Alginate, calcium chloride, MSCs, bone xenograft.METHODS: Bovine cancellous bone was out into cubes, which were degreased, deproteinized and then lyophilized.Cubes in pore size within 300-500 μm were selected for use after ethylene oxide sterilization. The purified sodium alginate was dissolved in DMEM cell culture medium of concentrations as different as 0.5%, 2%, 8% and 16%; 1×1012 L-1 induced MSCs were blended with isopyknic alginate-DMEM and compounded with DBX at a status of 0.5 Mpa negative pressure for 5 minutes in order to make a cell suspension fully fill into the pores of the cancellous bone. Then alginate was crosslinked with 50 g/L calcium gluconic acid for 30 seconds. The complex was put into a CO2 incubator and cultured for 4 days. The gel compound and cell growth in the pores of the complex were grossly observed with an inverted microscope. Status of cell growth in the complex with different concentrations of alginate was observed with scanning electron microscopeMAIN OUTCOME MEASURES: Compound status of alginate and bone xenograft, cell growth status and matrix secretion in compound carries.RESULTS: When the concentration of alginate was 0.25% or 1%, alginate was equally combined in DBX, while that of 4% and 8% only combined on the surface of cancellous bone. After in vitro cultured for 4 days, alginate of 0.25% were broken off from DBX surface. But alginate of 1% was equally combined with DBX pores with cells secreting well in alginate. Development of cells in alginate of 4% was restricted and no cells were seen in alginate of 8%.CONCLUSION: Alginate of 1% is suitable for constructing the carrier of bone tissue engineering with bone xenograft.

Objective To investigate the correlations between miRNA and mRNA ( the regulatory effects of miRNA) in a rat model of trinitro-benzene-sulfonic acid (TNBS)/ethanol induced ulcerative colitis ( UC) .Methods TNBS and ethanol were used to induce the development of UC in rats .After the modeling procedure and oral administration of normal saline ( NS) for 14 days, rats from the control and model groups were dissected to collect the samples of colonic mucosa .General and histological evaluations were performed to validate the modeling of UC .The expression of miRNA was profiled using miRNA microarray .The target miRNAs that were closely related to the pathogenesis of UC were selected out according to the results of mi -croarray and related literatures .RT-PCR was performed to verify the differentially expressed miRNAs .The mirWalk database was used to predict the target genes of miRNAs .In order to verify whether the predicted results were in accordance with the actual results , the microarray technology was used for mRNA expression profiling .The genes that showed interactions with those miRNAs were screened out .The David database was used for gene annotation .An interaction net between miRNA and mRNA was formed .Results General and histological manifestation of colon tissue samples from the model group were in accordance with the features of UC.Sixty-eight miRNAs were identified to be differentially expressed in rats from the model group and the control group (fold change>2, P<0.05, expression mean>7).Six candidate miRNAs were selected as hav-ing close relations to the pathogenesis of UC referring to reported literatures , the expression of which was checked and verified by real-time polymerase chain reaction (PCR).Compared with the control group, 4 miRNAs (miR-146a-5p, miR-146b-5p, miR-126a-3p and miR-21-5p) were up-regulated (P<0.01, P<0.05) and 2 miRNAs (miR-200b-3p and miR-145-5p) were down-regulated (P<0.01) in rats with TNBS/ethanol induced UC.Four mRNAs (IL-6, Ccl5, Mapk3 and Smad7) that interacted with the 6 miRNAs were identified based on the results of target gene prediction of the above 6 miRNAs and gene expression pro-filing.The David database was used to annotate the interactions for elucidating their significance in the path -ogenesis of UC .Conclusion A miRNA can regulate many signaling pathways and a signaling pathway can also be regulated by many miRNAs .Therefore , simply inhibiting certain pathways may not radically stop the process of inflammation .Studying the functions of miRNAs and elucidating the correlations between miRNA and mRNA might fundamentally inhibit the development of UC .

Objective:To investigate the diagnostic value of the promoter methylation of plasma RNF180 gene and its protein ex-pression for the detection of gastric cancer. Methods:Methylation-specific polymerase-chain reaction (MSP) and enzyme-linked immu-no-sorbent assay (ELISA) were performed to detect DNA methylation and protein expression of the RNF180 gene, respectively. The correlations of DNA methylation and protein expression of the RNF180 gene with the clinico-pathological parameters of gastric carcino-ma were then separately analyzed. Results:MSP showed that the methylation rates of the RNF180 gene were 62.75%and 21.88%in the plasma of patients with gastric carcinoma and healthy volunteers, respectively;this result indicated that the two groups significantly differed (P<0.01). The methylation of the RNF180 gene was associated with tumor size, clinical stage, tumor differentiation, lymph node metastasis, and distant metastasis (P<0.05). ELISA results showed that the protein expression of the RNF180 gene [(23.22 ± 1.36)μg/mL] was significantly lower (P<0.01) in the plasma of patients with gastric carcinoma than in the plasma of healthy volunteers [(34.25 ± 2.44)μg/mL]. However, the protein expression of the RNF180 gene was not associated with clinicopathological parameters (P>0.05). Conclusion:The RNF180 gene is expressed at a hypermethylation rate, and the corresponding protein expression level is de-creased in the plasma of individuals with gastric carcinoma. Therefore, RNF180 gene methylation in plasma could be applied to detect microinvasion for the clinical diagnosis of gastric cancer.

BACKGROUND: Alginic acid has a relatively mild gel condition and good biocompatibility, and it has been widely used in bio-tissue engineering.OBJECTIVE: To construct bone tissue engineering scaffolds using alginate gel composite bone xenograft approach, and to observe the cell biological properties and in vivo osteogenic potential in scaffolds.METHODS: The bone marrow was harvested from two 2-week-old New Zealand rabbits, 1 ×10~(-8)mol/L recombinant human bone morphogenetic protein-2 was used to induce bone marrow mesenchymal stem cells. The induced bone marrow mesenchymal stem cells at the second generation were incubated into 1% sodium alginate gel, after cultured for 4 days, the cell morphology in gel was observed by hematoxylin-eosin staining. Bone marrow mesenchymal stem cells at the second generation were divided into simple DMEM gel group and DMEM containing 1% sodium alginate gel group, followed by a culture of 7 days. Then bone morphogenic protein-2 immunohistochemical staining was performed. A total of 24 nude mice were randomly divided into two groups, both sides of the thigh muscle pockets were implanted with bone marrow-derived mesenchymal stem cells/alginate gel/bovine cancellous bone complex as an experimental group, with bone marrow-derived mesenchymal stem cells/bovine cancellous bone as a control group. At 2 and 4 weeks post-operation, the osteogenesis in the composite was observed by histological examination, the percentage area of new bone or cartilage was determined using image analysis system.RESULTS AND CONCLUSION: The bone marrow-derived mesenchymal stern cells in the sodium alginate gel exhibited a well-stacked morphology, they suspended in a gel, showing cell division and mitosis phase. In the simple DMEM gel group and DMEM gel containing 1% sodium alginate group, the immunohistochemical results showed that, cell division and proliferation were normal, with prominence at a variety of forms, large nucleus, and clear nucleolus. The bone morphogenetic protein-2 expression had no significant difference between the simple DMEM gel group and DMEM gel containing 1% sodium alginate group (P>0.05).Scanning electron microscopy revealed that, the alginate gel evenly composited in bovine cancellous bone micropores, cell grew at different planes. Animal experiments showed that there were significant differences regarding the percentage of new bone or cartilage area between the experimental group and control group at 2 and 4 weeks postoperation (P< 0.05). It is indicated that constructing bone tissue engineering scaffolds by using alginate gel/bovine cancellous bone, complies with the ultra-structural principle of tissue engineering scaffolds, can maximize the cell loads, achieve good bio-performance, without adverse affects on the proliferation, osteogenic phenotype and related biological properties of bone marrow-derived mesenchymal stem calls, the in vivo osteogenic efficiency was high.

Objective? To explore the effects of enhanced recovery nursing on early postoperative vein thromboembolism (VTE) risk after pancreaticoduodenectomy (PD). Methods? Using convenience sampling method, the 45 cases of PD patients with traditional nursing methods from September 2016 to March 2017 were assigned as the control group, and the 66 cases of PD patients with enhanced recovery nursing from March 2017 to June 2018 were assigned as intervention group. The plasma D-dimer level before operation, immediately after operation, and in different postoperative days (POD): POD1, POD2, POD3 and POD7 were collected. The D-dimer level and the incidence rates of symptomatic VTE were compared between two groups. Results? The D-dimer values of the intervention group immediately after surgery, POD1, POD2, POD3 and POD7 were (2.74±2.31), (3.31±2.03), (3.98±3.10), (4.30±2.89) and (7.46±3.90) mg/L·FEU. The D-dimer of the control group at each postoperative time point were (2.88±1.92), (3.77±2.72), (4.37±2.70), (4.08±1.81) and (6.85±4.07) mg/L·FEU. The overall D-dimer value of the two groups showed an upward trend after operation,but there was no significant difference between two groups (P＞0.05). Repeated measures analysis of variance showed that there were no differences in between-group effect (F=0.03, P=0.87) or interaction effect (F=1.01,P=0.38) of D-Dimer, while the difference in intra-group effect was statistically significant (F=108.28, P＜ 0.05). There was no statistical significance in the difference of the incidence rates of symptomatic VTE between two groups (χ2=0.87, P＞ 0.05). Conclusions? The early postoperative VTE risk after PD gradually increased, and the enhanced recovery nursing show no significantly advantage in VTE risk reduction after PD compared to traditional methods.

Objective:To explore the effect of different surgical procedures on early postoperative symptomatic thrombosis in patients undergoing pancreaticoduodenectomy.Methods:From September 2016 to June 2018, 111 patients undergoing pancreaticoduodenectomy in Peking Union Medical College Hospital, Chinese Academy of Medical Sciences were selected as the research objects by convenience sampling method, and were divided into the laparoscopic group ( n=47) and the laparotomic group ( n=64). The levels of D-dimer immediately after surgery and on the first, second, third, and seventh day after surgery and the occurrence of early postoperative symptomatic thrombus were compared between the two groups. Results:Repeated measures analysis of variance showed that there were between-group and time effects in the comparison of D-dimer immediately after surgery and on the first, second, third, and seventh day after surgery between the two groups, and the differences were statistically significant ( P<0.05). There was no significant difference in the occurrence of symptomatic thrombosis between the two groups ( P=0.62) . Conclusions:The risk of early symptomatic thrombosis after pancreaticoduodenectomy gradually increases, and laparoscopy had no significant advantage in reducing the risk of early symptomatic thrombosis after pancreaticoduodenectomy.

Objective This study aims to systematically evaluate the experiences of patients with hematologic neoplasm undergoing chimeric antigen receptor T-cell(CAR-T)therapy and nursing care,and to provide a reference basis for healthcare providers to develop personalized intervention strategies.Methods PubMed,Web of Science,Embase,CINAHL,Cochrane Library,PsycINFO,Scopus,Australia Joanna Briggs Institute(JBI)EBP Database,China National Knowledge Infrastructure(CNKI),Wanfang Data,VIP Database,and China Biology Medicine(CBM)Database were systematically searched for qualitative studies on the experiences of patients with hematologic neoplasm undergoing CAR-T therapy and nursing care.The search period extended up to September 2023.The quality of the literature was reviewed according to the JBI Qualitative Assessment and Review Instrument,and a pooled analysis was applied to integrate the results.Results A total of 15 studies were included,generating 76 findings,which were then organized into 8 categories,resulting in 3 integrated findings.(1)Patients experienced conflicting emotions,with expectations often at odds with reality,leading to emotional fluctuations:expectations about treatment were entangled with concerns about risks;emotions fluctuated with expectations and actual experiences.(2)Patients experienced physical and social functional impairments,but as the disease eased,normal functioning recovered:rapid decline and improvement in physical functions;loss and recovery of social functions.(3)Patients desired access to professional guidance and psychosocial support.Conclusion Patients undergoing CAR-T therapy often contend with emotional conflicts.Changes in physical and social functions after the completion of treatment result in needs for seeking comprehensive medical and nursing support.It is recommended that healthcare providers conduct dynamic assessments and interventions regarding patients'emotional states before treatment,focus on early identification and management of adverse reactions after treatment,and offer continuous nursing services after discharge to enhance patients'confidence in participating in CAR-T therapy and improve their overall quality of life.

Hepatosplenic candidiasis (HSC) is a rare type of candidiasis that can occur in patients with hematologic malignancies, hematopoietic stem cell transplantation. At present, there is still a lack of studies on HSC in patients with hematologic disorders. Based on The Chinese Guidelines for the Diagnosis and Treatment of Invasive Fungal Disease in Patients with Hematological Disorders and Cancers (the 6th revision), We retrospectively analyzed the clinical characteristics and prognosis of patients with HSC treated in Peking University Institute of Hematology from 2008 to 2022. Finally, eighteen patients were included, with 1 (5.6%) proven, 2 (11.1%) probable, and 15 (83.3%) possible HSC. Among them, 3 (16.7%) patients occurred after haploid hematopoietic stem cell transplantation and 15 (83.3%) patients occurred after chemotherapy. 6 (33.3%) patients had positive blood cultures, including 4 cases of Candida tropicalis and 2 cases of Candida albicans. At 4 weeks of antifungal therapy, 10 (58.8%) patients achieved partial response (PR), At 8 weeks, 1 (6.3%) patients achieved complete response and 10 (62.5%) patients achieved PR. At 6 months after diagnosis, 3 (16.7%) patients died of hematopoietic recurrence, and none of them died of HSC. As a rare fungal infection disease, HSC has a low positive rate of microbiological and histological examinations, a persistent treat cycle, and has difficulty in remission, reminding us of the need for vigilance in patients with hematopoietic disorders and persistent fever.

OBJECTIVETo establish rabbit VX2 colorectal cancer(CRC) model and to compare CT images with gross pathology in order to offer help for TNM staging in patients with CRC.

METHODSVX2 tumor pieces were implanted into colonic wall in 9 New Zealand white rabbits and rectal wall in 2 New Zealand white rabbits. Four weeks after inoculation, Ultravist(370 mg/ml) was injected through ear marginal vein with high pressure injector for stage 3 scanning of chest, abdomen and pelvis, and enhanced CT (collimation 0.5 mm mm × 320, pitch factor 0.828, bulb rotation speed 0.5 s/cycle, 120 kV, automatic ma, range 80 to 100 mAs) was performed to determine the presence of CRC or metastasis once a week for 4-6 weeks. Once inoculated CRC or metastases occurred or 6 weeks after implantation, the rabbits were sacrificed regardless of the presence or absence of CRC or metastasis on the CT images. One rabbit was used for gross anatomy observation. Others were placed in wood boxes with -80centi-degree for 24 hours, then samples of 3 mm thickness were cut using a motorized saw to make macropathology. Each cutting surface of the specimens was photographed in serial number. If certain or suspected lesions were found on the slices, such part was labeled and then placed in 10% phosphate-buffered formaldehyde numbered box for subsequent pathological examination. CT image postprocessing was performed referring to the gross slice specimens and all findings were compared with the pathological reports.

RESULTSAmong 11 rabbits, tumor was successfully established in 8 rabbits. Pathology showed that single lung metastasis (7 to 10 mm) was found in 2 rabbits and liver metastasis (9 mm) in 1 rabbit. Number of lymph node located around the inoculated tumor was 22 and that around mesenteric vessels was 13 with diameter of 2 to 16 mm. Among these 35 lymph nodes from 8 successful rabbits, 9 nodes were positive, including 7 around inoculated tumor and 2 around mesenteric vessels. CT identified above 8 primary inoculated tumors, 2 lung metastatic lesions and 1 liver metastatic lesion, with detection rate of 100%. For the detection of lymph node in CT, 27 nodes were identified in the pericolorectal region (17 nodes) and perimesenteric vessels (10 nodes), in which 6 were positive metastasis (ring-shaped enrichment and central low density necrosis), resulting in a detection rate of 77.1%(27/35 nodes), and positive detection rate of 66.7% (6/9 nodes), respectively.

CONCLUSIONLiving rabbit CT-gross pathological slice(3 mm-cut) of VX2 CRC model can be applied in image evaluation of small metastatic lesion.