BACKGROUND:Dysfunction of macrophage efferocytosis can induce local and systemic inflammatory damage and is associated with a variety of obesity-related metabolic diseases.Moreover,compounds targeting efferocytosis have shown good therapeutic effects. OBJECTIVE:By reviewing the effects of obesity on macrophage efferocytosis,to analyze the key mechanism by which obesity inhibits efferocytosis,to summarize the research progress in compounds targeting efferocytosis to treat obesity-related metabolic diseases,so as to provide new ideas for fully understanding efferocytosis and its relationship with metabolic diseases,aiming to provide new strategies for disease prevention and treatment. METHODS:The English search terms were"efferocytosis,metabolism,obesity,obese,atherosclerosis,non-alcoholic steatohepatitis,neurodegeneration,tumor,osteoarthritis,diabetes,compound,medicine,treatment,"which were used for literature retrieval in PubMed and Web of Science.The Chinese search term was"efferocytosis,"which was used for literature retrieval in CNKI,VIP and WanFang datebases.Ninety-nine papers were finally included in the review analysis after a rigorous screening process. RESULTS AND CONCLUSION:In the process of efferocytosis,the"Find me"and"Eat me"processes involving a large number of apoptotic cell derived factors are mainly regulated by apoptotic cells.The efferocytosis factor involved in cytoskeletal remodeling and digestion are mainly derived from macrophages,which are crucial for efferocytosis activity.These results suggest that the"Find me"and"Eat me"factors mainly reflect the condition of apoptosis,and it is more scientific to select the expression of factors involved in cytoskeletal remodeling and digestion when evaluating the efferocytosis activity of macrophages.Obesity inhibits efferocytosis,and shows an inhibitory effect on most digestive factors,but has a stress-induced activation effect on most"Find me,""Eat me"and cytoskeletal recombination factors,which further indicates the decisive effect of digestive stage on efferocytosis and suggests that it is not reliable for some studies to evaluate the efferocytosis based on the increased expression of"Find me"and"Eat me"factors.Targeting cytokines in the digestive phase may be more effective when discussing future intervention strategies targeting macrophages efferocytosis.The efferocytosis activators of macrophages are effective in the treatment of various metabolic diseases,but the efferocytosis inhibitors in tumor tissue show good anticancer effects,suggesting that the role of efferocytosis should be rationally evaluated according to the characteristics of tissue inflammation.Efferocytosis is a relatively new concept proposed in 2003,with a short research history and complex efferocytosis factors.Current studies on obesity and efferocytosis only involve a tip of the iceberg and most of them are at a superficial level and a large number of scientific experiments are needed to further validate the mechanisms.

A middle-aged man was presented with poor appetite, polyuria, polydrpsia, and headache. A sellar mass was found, along with total pituitary hypofunction and visual field defect. A biopsy of the lesion via the trans-sphenoidal approach showed inflammatory changes and granuloma formation. However, repeated cerebrospinal fluid and pathogenic examination of the pathological tissue showed no positive indications. The initial diagnosis considered autoimmune hypophysitis, and treatment of glucocorticoids combined with immunosuppressants was administered, which led to a temporary shrinkage of the lesion, but it gradually enlarged subsequently. After multidisciplinary discussion, a high possibility of pituitary tuberculosis infection was decided upon. After standardized anti-tuberculosis treatment was initiated, the lesion reduced noticeably and the patient′s condition improved. Pituitary tuberculosis infection is incredibly rare and extremely easy to misdiagnose. This case was diagnosed and treated in a timely and effective manner through a multidisciplinary approach, highlighting the importance of such an approach in dealing with rare diseases.

Objective:To investigate the value of texture analysis based on T 2WI and apparent diffusion coefficient (ADC) maps in discriminating low grade from high grade prostate cancer (PCa). Methods:Retrospective analysis was performed on patients who were confirmed to be PCa by pathology after surgery and underwent MRI examination in the department of radiology,Tongji Hospital,Tongji Medical College, Huazhong University of Science and Technology before radical surgery, including routine T 1WI, T 2WI and diffusion weighted imaging (DWI) sequences. 3D data analysis module of the MaZda software was used to manually draw region of interest (ROIs) slice by slice on T 2WI and ADC images, and generate volume of interest (VOI) of the entire tumor. MaZda software was also used to extract texture features. The independent sample t test or Mann-Whitney U test were used to identify the texture features with statistically significant differences between low and high grade PCa groups. Lasso regression model was used to select the best combination of texture features for identifying low and high grade PCa, and then the model was built. The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic performance of the model in both training cohort and test cohort. Results:The best texture feature combination selected by Lasso regression model were the S (1, 0, 0) correlation of T 2WI and the S (1, 0, 0) correlation, S (1, -1, 0) sum entropy and vertical-run length nonuniformity of ADC maps. The area under the ROC curve (AUC) of the model in training cohort was 0.823, and the sensitivity and specificity were 70.4% and 80.8%, respectively, which were better than the single texture feature. The AUC of the model in test cohort was 0.714, which was worse than training cohort. Conclusion:The texture analysis of T 2WI and ADC maps is valuable for the identification of low and high grade PCa.

[Abstract] Objective: To screen candidate epitopes of breast cancer HLA-A2 restrictive neoantigen and to identify high frequency mutation sites in breast cancer neoantigen by using bioinformatics method. Methods: NCBI and GDC databases were used to search missense mutation sites formed by single nucleotide mutation in breast cancer among reported literatures and sequencing data. The new antigen epitopes were predicted by HLA-A2 antigen epitope prediction website BIMAS, SYFPEITHI and artificial neural networkbased NetMHC4.0, and the epitopes with TAP binding power less than Intermediate were eliminated. The candidate epitopes were prioritized by mutation frequency and prediction results. Results: A total of 17 high-frequency mutation genes, including BTLA, ERBB2 and NBPF12 etc, were screened by the above-mentioned methods, and a total of 26 neoantigen epitopes were identified. The binding power of epitopes predicted using BIMAS and SYFPEITHI showed great difference (P<0.05), epitopes in high priority as GSTP1 (A114V , mutation frequency of 5.94%) and BRCA2 (N991H, mutation frequency of 5.40%) etc, were expected to be candidate neo-antigen epitopes; however, their mutation frequency was relatively too low to achieve“universal use” . The possibility of these epitopes used as general breast cancer neo-antigen epitopes is less likely. Conclusion: The common mutation frequency of breast cancer is lower than that of other tumors; it ’s difficult to find“universal”new antigen epitopes of breast cancer; the individualized neoantigen vaccine may be of more promise, which needs further research.

Objective To investigate the value of texture analysis based on MR ADC map of prostate in differentiating between low?grade and high?grade prostate cancer (PCa). Methods PCa confirmed by pathology after radical prostatectomy were analyzed retrospectively, all patients underwent multiparametric MRI before radical prostatectomy, including T1WI,T2WI and DWI. On the ADC map, ROI was drawn manually to encompass the whole tumor by ITK?SNAP software. The python?based pyradiomics package was used to extract 105 texture features. The intraclass correlation coefficient was used to evaluate the repeatability of the texture features. The independent sample t test or Mann?Whitney U test was used to exclude features that had no significant difference between low grade and high grade PCa. Lasso regression model and 5 fold cross validation method were used to obtain texture feature combination of the highest performance and develop a classification modelfor discriminating low from high grade PCa. ROC curve was used to evaluate the diagnostic efficiency of the model. Result Ninety patients with PCa confirmed by pathology after radical prostatectomywere analyzed retrospectively,including 36 patients with low?level PCa (GS≤3+4) and 54 patients with high?level PCa (GS≥4+3). The area under curve of the model was 0.841, with sensitivity 69.6% and specificity 91.2%, which was significantly higher than single texture feature or traditional mean ADC value. Conclusion Texture analysis based on MRI?ADC map of prostate could be used to discriminate low grade PCa from high grade PCa.

Objective: To investigate the value of texture analysis based on MR ADC map of prostate in differentiating between low-grade and high-grade prostate cancer (PCa). Methods: PCa confirmed by pathology after radical prostatectomy were analyzed retrospectively, all patients underwent multiparametric MRI before radical prostatectomy, including T₁WI,T₂WI and DWI. On the ADC map, ROI was drawn manually to encompass the whole tumor by ITK-SNAP software. The python-based pyradiomics package was used to extract 105 texture features. The intraclass correlation coefficient was used to evaluate the repeatability of the texture features. The independent sample t test or Mann-Whitney U test was used to exclude features that had no significant difference between low grade and high grade PCa. Lasso regression model and 5 fold cross validation method were used to obtain texture feature combination of the highest performance and develop a classification modelfor discriminating low from high grade PCa. ROC curve was used to evaluate the diagnostic efficiency of the model. Result: Ninety patients with PCa confirmed by pathology after radical prostatectomywere analyzed retrospectively,including 36 patients with low-level PCa (GS≤3+4) and 54 patients with high-level PCa (GS≥4+3). The area under curve of the model was 0.841, with sensitivity 69.6% and specificity 91.2%, which was significantly higher than single texture feature or traditional mean ADC value. Conclusion Texture analysis based on MRI-ADC map of prostate could be used to discriminate low grade PCa from high grade PCa.

OBJECTIVE:To provide reference for pharmacists to participate in the management of chronic disease. METHODS:A total of 259 patients with chronic airway disease [included asthma and chronic obstructive pulmonary disease (COPD)] met the inclusion criteria were selected from our hospital and 5 community health care centers of medical consortium. These patients received medication safety assessment management,which was led by clinical pharmacists of our hospital with the participation of community pharmacists,including medication safety comprehensive evaluation and risk classification management, follow-up and medication guidance, integrated prescriptions checking, establishment of shared database. 1 years after the implementation,the effectiveness were evaluated by score the relatived indicators in related groups. RESULTS:After a year of the management mode practice,compared with before intervention,the patients'safety medication cognitive ability score in high-risk and low-risk group increased from(4.49±1.26)and(7.31±1.01)to(5.40±1.56)and(7.44±0.91);medication adherence score increased from(4.96±1.21)and(7.08±1.24)to(6.66±1.08)and(7.38±0.98);ACT score from asthma patients increased from (16.15±2.58)and(21.15±1.03)to(16.80±2.57)and(21.64±1.55);CAT score from COPD patients decreased from(25.51± 4.07) and (14.90 ± 3.95) to (24.20 ± 3.96) and (13.80 ± 4.08);the rate of irrational prescription effective identification and intervention by pharmacists increased from 3.6％ and 1.4％ to 9.4％ and 7.6％,respectively. All the differences above were statistically significant (P<0.05). CONCLUSIONS:The participation of pharmacists in long-term medication safety assessment management for chronic airway disease patients can improve patients'safety medication cognitive ability,medication adherence, disease control and the pharmacists'ability of irrational drug use identification and intervention.

Objective:To explore the new management mode of long-term medication safety assessment for chronic obstructive pul-monary disease (COPD) with the participation of pharmacist team in medical treatment alliance to provide reference for pharmacists participating in the management of chronic diseases under the new situation of new medical reform. Methods:Totally 126 patients with COPD meeting the inclusion criteria in our hospital and medical treatment alliance were selected. The patients received medication management including drug safety comprehensive evaluation,classification management,follow-up with medication guidance,integrat-ed prescriptions checking and shared database building etc with the participation of our clinical pharmacists to guide the community pharmacists in coordination with physicians. Results:After one-year management mode practice,the cognitive ability of safe medica-tion and compliance of the patients significantly increased(P<0.01) with significant improvement of control situation of COPD(CAT score) (P<0.05 or P<0.01), and the capacity of effective identification and irrational prescription intervention significantly in-creased (P<0.01). Conclusion:The management mode of long-term medication safety assessment for COPD patients with the partic-ipation of pharmacist team in medical treatment alliance has significant effects on COPD patients' safe medication and drug efficacy, which can improve the professional service of pharmacist team.

Objective To explore the effects of solution-focused approach on improving negative emotions among chronic subdural hematoma patients with trepanation and drainage.Methods From January to December 2017,a total of 100 chronic subdural hematoma inpatients in Beijing Tiantan Hospital of Capital Medical University were divided into control group and observation group by the random number table,50 cases in each group.Control group carried out routine nursing.On the basis of that in control group,observation group provided health education by five-step of solution focused approach.Patients of two groups were evaluated with the Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) on admission and at discharge.Results The scores of SAS and SDS of patients in observation group were (35.00±5.222) and (37.28±5.091) respectively at discharge lower than those [(38.40±6.550) and (41.26±7.001)]in control group with significant differences (P＜0.05).Conclusions Solution-focused approach can improve negative emotions among chronic subdural hematoma patients with trepanation and drainage.It is worth to be popularized and applied in clinic.

Objective To observe the clinical effect of Sangpa Zhike decoction in the treatment of acute exacerbations of chronic bronchitis. Methods 180 patients with acute exacerbation of chronic bronchitis admitted to Autonomous Prefecture Hospital of traditional Chinese medicine(TCM)in Changji,Xinjiang,from August 2012 to August 2013 were enrolled. They were divided into Sangpa Zhike decoction treatment group and western medicine treatment control group by random number table,90 cases in each group. General treatments were given to the two groups. In the Sangpa Zhike decoction treatment group,additionally only oral Sangpa Zhike decoction was given(composition:Morus alba 10 g,loquat leaf 10 g,Houttuynia 10 g,honey aster 15 g,honey coltsfoot flower 6 g,Zhejiang Fritillaria 12 g,perilla 10 g,white mustard seed 6 g,Platycodon grandiflorum 10 g,Rhizoma Cynanchi Stauntonii 12 g,tangerine peel 6 g,Stemona 6 g). The ingredients were mixed in water and boiled to form a decoction,one dose daily,divided into two parts to be taken twice a day. In the western medicine treatment group,the infection was controlled by western medicine and the drugs to eliminate cough and phlegm,etc were used. The therapeutic course in both groups was 7 days. The therapeutic effect for treatment of TCM syndromes and the cough quantized integration score in the two groups were observed after treatment. Results The cure rate of Sangpa Zhike decoction treatment group was significantly higher than that of western medicine treatment control group〔70.00%(63/90)vs. 33.33%(30/90),P<0.01〕. Before treatment,the cough symptom quantization integral scores in the two groups had no statistically significance, but after treatment,the scores in the two groups were significantly lower than those before treatment. And the score in Sangpa Zhike decoction treatment group was decreased more significantly (1.66±1.12 vs. 4.36±2.32, P<0.01). Conclusion Sangpa Zhike Decoction has obvious curative effect in the treatment of acute attack of chronic bronchitis.