Objective To construct Neuropilins-2 eukaryotic expression vector for RNA interference.Methods Recombinant targeting on gene NRP2 was designed and established with plasmid pGenSil-1 based on NRP2 cDNA equences of Genomes.Two pairs of oligonucleotides were synthesized according to the Tuschl and inserted into plasmid pGenSil-l to generate siRNA eukaryotic expression vector,DH5? strains were transformed,plasmid were extracted,and recombinant vectors were identified by the restriction map and the sequence analysis.The recombinant plasmid(pGenSil-NRP2) was transfected into the cultured LOVO cells.At 48 h after transfection,the whole cell protein was extracted,and the protein level was detected by Western blotting with mouse-anti-human NRP2 monoclonal antibody.Results Recombinant plasmids were completely coincided with the designs by the restriction map and the sequence analysis.pGenSil-NRP2 expression vector into LOVO cells down-regulated the protein level of NRP2 at 48 h after transfection.The recombinant eukaryotic expression vector were constructed successfully.Conclusion siRNA recombinant can be constructed successfully by RNAi technique for inhibiting NRP2 expression.

OBJECTIVE:To observe the effects of Xiaoer Reganning oral liquid(XRN) on clinical symptoms and signs of children with acute upper respiratory tract infections.METHODS:161 children with acute upper respiratory tract infections were randomly divided into three groups.The patients were treated with XRN(XRN group,60 cases),Shuanghuanglian oral liquid(SHL group,41 cases) and Wei C Yingqiao granules(WCG group,60 cases),3～4 times every day for 3 days.The changes of clinical symptoms of coughing rhinorrhea,lassitude,anorexia and dyssomnia,and signs of pharyngeal congestion and tonsillar swelling were studied on the patients before and after treatment for three days,and the results of three groups were compared.RESULTS:The improvement of the clinical symptoms and signs in XRN group was better than that in the control groups(P

Objective: To evaluate the antipyretic action of Xiaoerreganning Oral Solution on acute upper respiratory tract infection of children. Methods: 161 children with acute upper respiratory tract infection were randomly divided into 3 groups. 60 patients at different age ranges in Xiaoerreganning Oral Solution group were treated with Xiaoerreganning Oral Solution at different dosags, 3～4 times every day. The treatment course was 3 days. Patients' body-temperatures before and after treatment were recorded. The temperature differences in various time points before and after treatment were computed, and compared with the results of Shuanghuanglian Oral Solution group and Wei C Yingqiao Tablets group.Results: All three drugs could reduce the patients' body-temperatures gradually, but the antipyretic action of Xiaoerreganning Oral Solution was the strongest. There were significant differences in temperature difference between Xiaoerreganning Oral Solution Group and Wei C Yinqiao Granules (in 2 or 6h after treatment and in 1 day or 3 days after treatment, P

Objective To evaluate mid-term clinical outcomes of autologous osteochondral transplantation (AOT) for the treatment of osteochondral lesions of the talus (OLT) (Hepple types Ⅳ and Ⅴ).Methods From October 2011 to September 2013,AOT procedure was performed in 13 patients with OLT (Hepple types Ⅳ and Ⅴ).They were 9 men 4 women,with a mean age of 31.7 years (range,from 19 to 46 years).There were 5 cases of type Ⅳ and 8 ones of type Ⅴ.The diameters of defective areas ranged from 0.5 to 2.0 cm (average,1.1 cm).Osteochondral plugs were harvested from the non-weight bearing area at the ipsilateral femoral lateral condyle.The arthroscopic single-plug or double-plug AOT procedure was conducted with a supplementary arthrotomy if necessary.Visual analogue scale (VAS),American Orthopedic Foot and Ankle Society (AOFAS) score,Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) score,and the International Knee Documentation Committee Knee Evaluation Form (IKDC) score were measured pre-and post-operatively for assessment of clinical outcomes.Results After successful surgery,all the patients were followed up for 28 to 52 months (average,38.2 months).The VAS (0.7 ±0.8),AOFAS (95.2 ±2.9) and MOCART (6.6 ± 0.9) scores at the final follow-up were significantly improved compared with preoperation (7.9 ± 1.3,63.5 ± 7.4,3.2 ± 1.1,respectively) (P ＜ 0.05).There was no significant difference between pre-and post-operation in the IKDC score for the ipsilateral knee joint (98.5 ± 0.7 versus 98.3 ± 0.9) (P ＞ 0.05).Post-operative MRI showed complete hypertrophic cartilage layer filling in 3 cases,complete filling of the defect at the level of surrounding cartilage in 8 cases,and incomplete atrophic cartilage layer filling in 2 cases.Normal signal intensity of the repair tissue compared with the adjacent native cartilage was seen in 4 cases,and nearly normal activity in 9 cases.All the patients recovered normal walking and daily life.Conclusions In the treatment of Hepple types Ⅳ and Ⅴ OLT,AOT proves to be reliable and can lead to fine mid-term clinical outcomes.

Objective:To investigate the clinical value of peripheral monocyte and neutrophil count in predicting the response of patients with metastatic non-small cell lung cancer (mNSCLC) to immunosuppressive checkpoint inhibitors (ICI).Methods:The clinical data of 34 adult mNSCLC patients who received nafulizumab or pabolizumab in Danzhou People's Hospital of Hainan Province from January 2017 to March 2019 were retrospectively analyzed. The correlation of the demographic characteristics, clinical data, hematological examination results in the first two weeks before the treatment and two weeks after ICI treatment with prognosis was recorded and observed.Results:The baseline mean monocyte count [(0.52±0.09)×10 9/L vs. (0.60±0.12)×10 9/L] and neutrophil count [(4.27±0.87)×10 9/L vs.(5.39±1.02)×10 9/L] of patients with ICI reaction were lower than those of patients without ICI reaction, and the differences were statistically different ( t = -2.572, -2.727, all P < 0.05). However, there was a negative correlation between the monocyte count of the patients who responded to ICI and the reaction time ( r = -0.507, P < 0.05). The median reaction time in patients with monocyte count >0.70×10 9/L was shorter than that in patients with monocyte count ≤0.70×10 9/L (8 weeks vs. 12 weeks, χ2=4.162, P = 0.041). There was no correlation between monocyte count and time of reaction duration, progression of free survival (PFS) and overall survival (OS) ( r = -0.214, 0.182, 0.232, all P > 0.05). The decrease rate of neutrophil count in response group was higher than that in non-response group (22% vs. 2%, P < 0.05). After the first administration, cutoff value of neutrophil count was 4.2×10 9/L; the response rate of patients with neutrophil count ≤ 4.2×10 9/L was higher than that of patients with neutrophil count > 4.2×10 9/L [86.7% (13/15) vs. 36.8% (7/19), χ2=6.657, P < 0.05]. Conclusion:Peripheral blood monocyte and neutrophil count can predict the response to ICI therapy in patients with mNSCLC.

AIM: To compare the difference and consistency of corneal refractive power and astigmatism measured by CASIA2 and IOL Master 700 in patients with age-related cataract.METHODS: Retrospective study. A total of 153 patients(232 eyes)with age-related cataract admitted to Daping hospital from November to December 2021 were selected. The flat keratometry(Kf), steep keratometry(Ks), mean keratometry(Km), degree and axis of astigmatism(vector representation J0 and J45)of the anterior, posterior surfaces together with the total cornea from cataract patients were measured by CASIA2 and IOL Master 700, respectively. The difference, correlation and consistency of the two instruments were analyzed.RESULTS:There was no significant difference in J45 values of posterior corneal surface measured by CASIA2 and IOL Master 700(-0.006±0.038D vs. -0.005±0.044D, P>0.05), but there were significant differences in other parameters(all P<0.05). All parameters measured by the two instruments were significantly positive correlated(all r/rs>0.7, P<0.001); Bland-Altman analysis showed that the refractive power and astigmatism of the anterior cornea surface measured by the two facilities were in good consistency, while the refractive power of the posterior surface and the whole cornea showed poor consistency.CONCLUSION: CASIA2 and IOL Master 700 showed little differences and good consistency in the refractive power and astigmatism of the anterior, posterior and total corneal surface in cataract patients, which seems interchangeable. However, the refractive power of the posterior surface and the whole cornea has significant differences and poor consistency, which should not be interchange casually.

AIM:To compare the differences, correlations and consistency of IOL Master 700 or Lenstar LS900 in preoperative ocular biometry and the accuracy of intraocular lens(IOL)degree calculation of cataract patients with high myopia.METHODS: Retrospective study. A total of 136 cases(136 eyes)of high myopia and cataract patients who underwent phacoemulsification at the ophthalmology department of Army Medical Center of PLA from March 2021 to March 2023 were collected, with a mean age of 57.38±8.08 years. Patients were divided into 3 groups based on axial length(AL): 41 eyes in group A(26 mm≤ AL ≤28 mm), 43 eyes in group B(28 mm< AL ≤30 mm)and 52 eyes in group C(AL >30 mm). AL, mean keratometry(Km), anterior chamber depth(ACD), lens thickness(LT)and white-to-white(WTW)were preoperatively measured by two instruments, respectively. Barrett Universal II formula was used to calculate the IOL degrees of all patients, the appropriate reserved diopter was decided individually, and the prediction error(PE)and absolute error(AE)of the two instruments were compared.RESULTS:The AL and ACD of patients in the three groups measured by Lenstar LS900 were higher than the AL measurd by IOL Master 700(all P<0.05), with a difference of AL measured by the two devices: group C>group B>group A. However, there was no statistical significance in LT, Km, and WTW measured by the two instruments(all P>0.05). All biometric parameters measured by the two devices were positively correlated(all r>0.9, P<0.05), and consistent(95% LoA of all groups were narrow). There was no statistically significant difference in AE calculated by the two devices(P>0.05), but the IOL Master 700 calculated a smaller PE than Lenstar LS900(P<0.05), with lower percentage of hyperopic shift in IOL Master 700.CONCLUSION:In cataract patients with high myopia, AL measured by Lenstar LS900 is longer than that by IOL Master 700, and the differences of AL increase along with the growth of AL. Both devices have a good prediction for IOL calculation, but IOL Master 700 has less refractive error, lower percentage of hyperopic shift, and greater clinical advantages IOL Master 700.

OBJECTIVE To analyze the research status， hotspots and trends in the research of intravenous thrombolytic drugs in the treatment of acute ischemic stroke. METHODS The original studies related to intravenous thrombolytic drugs for acute ischemic stroke were collected by searching the Web of Science core database； the authors， countries/regions， institutions and keywords of the literature were visualized and analyzed using CiteSpace 6.1.R6 software. RESULTS A total of 1 810 articles were included， and the number of articles published showed an increasing trend year by year， with the United States （556 articles） having the largest number of articles， and China ranking the second （339 articles， with centrality of 0）. The most published author was Ahmed of Sweden （32 articles）， and the most published institution was the University of Calgary in Canada （80 articles）. The current research status and hotspots were mainly the application and therapeutic exploration of new thrombolytic drugs， and the frontier and development trend were the adverse prognosis of neurological deterioration and hemorrhagic transformation accompanied by intravenous thrombolytic drug treatment. CONCLUSIONS The research hotspots and frontier about intravenous thrombolytic drugs for acute ischemic stroke are mainly the third generation of intravenous tissue plasminogen activator， and the exploration of new intravenous thrombolytic drugs and their safety and effectiveness will be the future research hotspots. Chinese scholars and research teams should strengthen cooperation and exchanges with other countries， which can be strengthened by carrying out multi-center clinical trials.

Objective    To investigate the short-term effects of Da Vinci robot-assisted Nissen fundoplication in the treatment of refractory gastroesophageal reflux disease (rGERD), and to evaluate the safety and efficacy of its surgical treatment. Methods    A total of 40 patients with rGERD treated by Da Vinci robot-assisted surgery from October 2016 to November 2019 in our hospital were collected. There were 23 males and 17 females at age of 34-76 (61±23) years. The related clinical data were retrospectively analyzed, and the operation skills of Da Vinci robot-assisted Nissen fundoplication with rGERD were summarized. Results    There was no perioperative death or serious complication such as esophagogastric fistula. Postoperative reflux symptoms were significantly improved. DeMeester scores after surgery (39.79±35.01 points vs. 2.61±2.40 points, P=0.029), lower esophageal sphincter pressure (8.74±7.21 mm Hg vs. 24.56±8.76 mm Hg, P=0.020), integrated relaxation pressure (7.29±7.21 mm Hg vs. 16.49±9.99 mm Hg, P=0.023), distal contractile integral (600.49 ± 665.30 mm Hg·s·m vs. 510.99 ± 580.60 mm Hg·s·m, P=0.042), GERD-Q scale score (12.98±2.39 points vs. 7.59±1.11 points, P=0.033) were significantly improved compared with those before surgery. Postoperative dysphagia was found in 2 patients. And dysphagia was alleviated after diet adjustment and other treatments. Conclusion    Da Vinci robot-assisted Nissen fundoplication is a safe and effective treatment for rGERD.

【Objective】 To pilot an informed consent audit system for clinical transfusion in a large tertiary hospital, so as to provide evidence and recommendations to improve the consent system. 【Methods】 A report table containing key items of transfusion informed consent such as transfusion risk, transfusion benefit and alternative treatment was developed in compliance with the national guidelines and regulations, and issued to a total of 206 patients with records on red blood cell transfusion from April 1 to June 30, 2019 in a tertiary hospital. 【Results】 The audit results showed that 98.06% (202/206) of transfusion informed consents were signed by patients, but only 65.05% (134/206) were signed by doctors. 31.07% did not record the reasons for transfusion, and 46.6% did not record the transfusion plan. 99.31% of the doctors participated in the audit claimed that the patients were informed of the risk of blood transfusion, but only 79.8% (158/198) patients recalled that the doctors mentioned the risk. Although 80.5% (116/198) of the patients were informed of alternative treatment, only 28.79% (57/198) recalled being told about alternative treatment. Allogeneic blood transfusion was the most frequently choice for patients recommended by doctors, accounting for 98.61% (142/144). However, only 48.99% (97/198) of patients could recall allogeneic blood transfusion. 80.5% of the patients recalled being informed of alternative treatment plans, and only 28.79% of the patients recalled being offered alternative treatment plans. Only 43.43% of the patients considered themselves as the main participants in decision-making of blood transfusion. In terms of training, 82.64% (119/144) doctors described having attended training programs. 【Conclusion】 The written consents for blood transfusion in our hospital were not well recorded. Patients received less information of blood transfusion informed by the doctors and did not fully participant in the decision-making of blood transfusion. There is a gap between the practice and the current national guidelines and regulations. The audit results indicated that it is necessary to further strengthen the professional knowledge of clinicians and communication skills between the doctors and patients. This audit results in this study will provide recommendations for further transfusion informed consent audit and continuous improvement of clinical transfusion informed consent practice in China in the future.