OBJECTIVE:To prepare the norcantharidin (NCTD) nano-micelle and study its antitumor effect. METHODS:NCTD nano-micelle was self-formed in water using Triblock copolymers distearyl phosphatidylethanolamine-polyethylene glycol-ma-leimide;its shape was observed,the drug-loading rate,entrapment efficiency,particle size,Zeta potential were investigated. MTT was used to investigate the cell survival rate of human lung cancer A549 cells in negative control group (Phosphate buffer solu-tion),carrier group (blank nano-micelle),positive control group (NCTD APIs,5-320 μg/mL) and NCTD nano-micelle group (NCTD,5-320 μg/mL) after acting different time (24,48,72 h). Tumor nude mice were randomly divided into blank control group,NCTD injection group(1 mg/kg),NCTD low-dose,high-dose groups(0.5,1 mg/kg),6 in each group. All mice were in-travenously injected relevant medicines in tail,once a day,for 8 weeks. Tumor size was measured every week,and tumor quality was detected after the second day of finishing administration. RESULTS:NCTD nano-micelle was round,drug-loading rate was (2.82±0.05)%,entrapment efficiency was(83.67±1.78)%,particle size was(138.6±45.8)nm,Zeta potential was -(12.75± 0.34)mV(n=6). Cell survival rate of A549 cells in carrier group had no obvious changes,and was obviously decreased in posi-tive control group and NCTD nano-micelle group,which was positively correlated with concentration and time. And the decrease degree of cell survival rate in NCTD nano-micelle group was stronger than positive control group(P<0.01). Compared with blank control group,the tumor quality of mice in 3 administration groups was reduced (P<0.05),the reduction degree in NCTD na-no-micelle high-dose group was stronger than NCTD nano-micelle injection group (P<0.05). CONCLUSIONS:NCTD nano-mi-celle is successfully prepared,which has good in vitro and in vitro anti-tumor effect on A549 cells.

[Abstract ] Objective Nephroblastoma is one of the solid malignancies with fair prognosis in children .The lungs, liver, and bones are the common organs for distant metastasis of the tumor and important factors influencing the therapeutic effects as well .This study was to investigate the clinical characteristics and prognosis of nephroblastoma with distant metastasis in children . Methods We retrospectively analyzed the clinical characteristics , pathological features , and prognosis of 9 cases of nephroblastoma with distant metastasis treated in Nanjing Children Hospital from September 2011 to May 2015 . Results The patients presented with abdominal masses, distention and pain at preliminary diagnosis and confirmed with nephroblastoma , with pulmonary metastasis in 7 cases, liver metastasis in 1, and lung and liver metastases in the other .All were treated by surgery, radiotherapy, and chemotherapy and followed up for a median time of 34 months.By the end of the follow-up, 1 patient died of recurrence , 1 was undergoing chemotherapy , and the other 7 were being recovered, including complete disappearance of lung metastasis in 4, obvious reduction or calcification of lung metastasis in 2, evident disappearance of liver metastasis in 1, but relapse in none. Conclusion Lung and liver are common sites of nephroblastoma metastasis in children .As for the treatment of the disease , relatively good results can be achieved by radiotherapy , chemotherapy , and reoperation .

Objective:To observe the clinical efficacy and safety of compound hypoglycemic Yuye oral liquor combined with metfo-ma and glimepiride in the treatment of type 2 diabetes mellitus ( deficiency of both Qi and Yin) . Methods:Totally 80 type 2 diabetes mellitus patients were randomly divided into the treatment group and the control group with 40 each, both groups were treated with met-formin hydrochloride tablets and glimepiride tablets, the treatment group was given compound hypoglycemic Yuye oral liquor additional-ly, and the treatment duration was 12 weeks. At the end of the treatment, fasting plasma glucose( FPG) , postprandial 2 hours plasma glucose(2hPG), hemoglobin A1c(HbA1c)and traditional Chinese medicine (TCM ) syndrome in the two groups were compared. Re-sults:In both groups, FPG, 2hPG and HbAlc were decreased after the treatment, and the decrease in the treatment group was more notable than that in the control group with statistically significant difference (P<0. 05 or P<0. 01). As for TCM syndrome, the score in the treatment group was lower than that in the control group with statistically significant difference (P<0. 01). The clinical efficien-cy in the treatment group was 47. 5%, that was 22. 5% in the control group, and the difference between the two groups was statistically significant (P<0. 05). Conclusion:Compound hypoglycemic Yuyeoral liquor can reduce the blood glucose in type 2 diabetes mellitus patients( deficiency of Qi and Yin) , and the improvement of clinical symptom is striking with good safety and clinical application value.

Objective:To analyze the report accuracy and risk factors of congenital syphilis (CS), and to provide references of accurate diagnosis for clinicians.Methods:CS notification data, including suspected cases and confirmed cases, were obtained from national notifiable disease reporting system (NNDRS) reported from 2016 to 2019 in Guangzhou City. Information of syphilis infected pregnant women and their children who were diagnosed or excluded with CS during 2012-2019 were extracted from Guangzhou City'the integrated prevention of mother-to-child transmission of human immunodeficiency virus, syphilis and hepatitis B virus surveillance system’. Their demographic characteristics, serological test results of syphilis, reporting doctors and treatment regimens were analyzed.Chi-square test was used for univariate analysis and multivariate logistic regression analysis was used to identify the influencing factors associated with CS.Results:A total of 95 CS cases were reported in NNDRS, and the reporting accuracy rate was 36.8%(35 cases). The proportion of children younger than 30 days who were reported incorrectly (73.3%(44/60)) was higher than the proportion of those were reported correctly (51.4%(18/35)), and the difference was statistically significant ( χ2=4.679, P=0.031). However, the reporting accuracy was not associated with hospital grade, doctor profession and doctor title of reporting ( χ2=0.283, 0.483 and 3.681, respectively, all P>0.05). Maternal age≤24 years (adjusted odds ratio ( aOR)=4.62), titers of non- Treponema pallidum antigen serologic test before treatment≥1∶8 ( aOR=7.56), initiation of antisyphilitic treatment during delivery ( aOR=25.43), no antisyphilitic treatment during pregnancy ( aOR=14.12), and premature delivery ( aOR=8.97) increased the risks of CS (all P<0.01). Conclusions:The reporting accuracy rate of CS is low. Young mothers, high serological titers of non- Treponema pallidum antigen before treatment, initiation of antisyphilitic treatment during delivery or no antisyphilitic treatment during pregnancy, and premature delivery are risk factors for CS. Doctors may focus on collecting this information to assist clinical diagnosis.

Objective: To investigate the prevalence of osteoporosis (OP) and its influencing factors among people aged 60 years and above, so as to provide insights into OP prevention and treatment among the elderly. Methods: People aged 60 years and above who underwent physical examinations were selected from Hangzhou First People's Hospital from January to October 2023. Demographic information, lifestyle and physical examination data were collected through field surveys and hospital information systems. Bone density was measured by dual-energy X-ray densitometer, and OP was diagnosed with reference to the Guidelines for the Diagnosis and Treatment of Primary Osteoporosis (2022). Factors affecting the OP were identified using a multivariable logistic regression model. Results: A total of 482 participants were included and had a mean age of (69.10±6.52) years. There were 217 men (45.02%) and 265 women (54.98%). The prevalence of OP was 43.36%. Multivariable logistic regression analysis identified gender (women, OR=3.791, 95%CI: 1.726-8.314), age (70 to 79 years, OR=1.260, 95%CI: 1.018-1.559; 80 years and above, OR=3.083, 95%CI: 1.546-6.147), body mass index (≥24 kg/m2, OR=0.358, 95%CI: 0.205-0.626), family history of fracture (OR=1.475, 95%CI: 1.073-2.030), diabetes (OR=1.626, 95%CI: 1.109-2.382), regular exercise (OR=0.457, 95%CI: 0.287-0.726), intake of milk products (OR=0.511, 95%CI: 0.335-0.780), intake of calcium supplements (OR=0.473, 95%CI: 0.287-0.778) and vitamin D deficiency (OR=2.132, 95%CI: 1.309-3.473) as factors affecting OP. Conclusion The prevalence of OP is associated with gender, age, body mass index, family history of fracture, diabetes, diet and vitamin D deficiency.

Objective To observe the effect of extracorporeal shock wave therapy (ESWT) on upper limb spasticity of hemiplegic patients.Methods 30 hemiplegic patients with upper extremity spasticity were divided into ESWT group (n=15) and control group (n=15).Routine rehabilitation therapy was administrated in two groups. Furthermore, ESWT group received 4 sessions (once a week) of ESWT. The modified Ashworth scale (MAS) and Fugl-Meyer assessment (FMA) were used in evaluation at different time points: pre-treatment, each treatment and follow-up 4 weeks after treatment. Results The scores of MAS decreased and the scores of FMA increased in the ESWT group since the 1st session (P<0.05), only in the control group after the 4th session (P<0.05). Compared to the control group, the scores of MAS decreased in the ESWT group (P<0.01) since the 1st ESWT and the scores of FMA increased since the 4th session (P<0.01). There was no side effect associated with ESWT. Conclusion EWST is effective, sustained and safe on upper limb spasticity of hemiplegics

Objective To investigate the effect of continuous quality improvement on venous transfusion exosmosis in elderly patients.Methods Through the investigation into venous transfusion exosmosis in 160 elderly patients,the causes for exosmosis were identified,followed by regulating and enforcing improvement measures and assessing the effect.Results The incidence of venous transfusion exosmosis in elderly patients was reduced from 6.40%to 2.57%and the satisfaction of patients improved from 90.00%to 97.50%.Conclusion The continuous quality improvement may effectively reduce the incidence of venous transfusion exosmosis and improve patients’satisfaction.

Transcuataneous electrical nerve stimulation (TENS) analgesia as a non-drug method has received people's more and more attention recently. Considering problems of existing products, such as unstable performance and unsatisfied effectiveness, we developed a new analgesia therapy system for delivery based on bio-feedback TENS in our laboratory. We proposed a new idea for stimulation signal design, that is, we modulated a middle frequency signal by a traditional low frequency TENS wave in the new system. We designed different prescription waves for pain relief during a uterine contraction or massage between contractions. In the end, a bio-feedback TENS method was proposed, in which the waveforms of stimulation signals were selected and their parameters were modified automatically based on feedback from uterine pressure, etc. It was proved through quality tests and clinical trials that the system had good performance and satisfied analgesia effectiveness.
Analgesia ; methods ; Biofeedback, Psychology ; methods ; Female ; Humans ; Pain Management ; Transcutaneous Electric Nerve Stimulation ; methods ; Uterine Contraction

Objective To investigate the expression of pro-inflammatory cytokines in lumbar dorsal root ganglions (DRG) of rats model of high-dose fentanyl induced hyperalgesia. Methods 64 male SD rats were divided into 2 groups (n = 32), fentanyl group and normal saline (NS) group. The rats were injected with fentanyl (60 μg/kg) or NS 4 times in total subcutaneously with a 15-minute interval. Mechanical and thermal nociception were measured via the tail pressure test (tail flick thresholds, TFT) and paw withdrawal test (paw withdrawal latency, PWL) at 1 day before, at 1, 2, 3 and 4 hour and on 1 ~ 7 day after administration. 4 rats were sacrificed and the lumbar DRG were harvested to analyze the expression of PGE2 , IL-1β, IL-6 and TNF-αvia ELISA. Results There were no significant changes of TFT, PWL and the expression of pro-inflammatory cytokines in DRG compared to baseline of rats in NS group. The value of TFT , PWL in fentanyl group were above the baseline at the 1 ~ 4 hour and below the baseline at 1~3 day after fentanyl injections. PGE2 , IL-1β, TNF-α and IL-6 increased on 1,3,5,7 day after fentanyl injections significantly. Conclusions High-dose fentanyl induced significant hyperalgesia and up-regulation of pro-inflammatory cytokines in DRG. The expression pro-inflammatory cytokines peaked later and were more protracted than the change of behavior test and show no direct relationship between the two.

BACKGROUND:Because of their immunological properties, bone marrow mesenchymal stem cells transfusion is developed as a new treatment for refractory graft-versus-host disease. OBJECTIVE:To analyze the safety and curative effect of bone marrow mesenchymal stem cells transfusion on treating different organ damages in graft-versus-host disease after al ogeneic hematopoietic stem celltransplantation. METHODS:Eight patients with malignant hematologic disease were included in this study. The patients developed severe steroid-resistant graft-versus-host disease after al ogeneic hematopoietic stem celltransplantation and received transfusion of mesenchymal stme cell(1×106 of immunosuppressive agent. RESULTS AND CONCLUSION:For the total y eight patients, six got response (two cases of complete remission, and four cases of partial remission) and two showed no remission. Four of five cutaneous damages were ameliorated and one showed no effect. For three cases of oral graft-versus-host disease, two acquired complete remission and one showed partial remission. Two cases of liver graft-versus-host disease and two cases of astro-intestinal graft-versus-host disease obtained complete remission. No response was displayed to three cases of ocular graft-versus-host disease, one case of bronchiolitis obliterans, and one case of urinary graft-versus-host disease. In the median fol ow-up of 28 months (7-62 months), three patients developed posttransplant lymphoproliferative disorders within 3 months after mesenchymal stem cells transfusion. Administration of mesenchymal stem cells is safe for treatment of severe graft-versus-host disease after al ogeneic hematopoietic stem celltransplantation. Mesenchymal stem cells transfusion may be a promising/kg) together with the primary therapy therapy for refractory cutaneous , astro-intestinal, liver and oral graft-versus-host disease but not for pulmonary, ocular and urinary graft-versus-host disease. Whether mesenchymal stem cells transfusion is associated with posttransplant lymphoproliferative disorders needs more case data.