Objective:Before the radiotherapy was performed, patients with pelvic tumors were analyzed for the consistency of bladder filling in the three steps of " Immobilization" , " CT Simulation" and " X-ray Simulation" .Methods:In 2014, 105 patients (68 cases of cervical cancer, 32 cases of rectal cancer, 3 cases of vaginal cancer and 2 cases of prostate cancer) with pelvic tumor radiotherapy were randomly assigned to monitor bladder urine volume to a target urine volume of 400 ml. First, patient were exhorted to empty the bladder, and the bladder volume meter BVI 9400 was used to measure the urine volume of the patient after emptying of the bladder. The patient immediately drank about 540 ml of water and suppressed urine, measurements were taken every 0.5 h. At the same time, when the patient complained of " urgency of urine" , bladder urine volume would be measured again and the time would also be recorded. Every other half an hour (emptying, 0.5 h after emptying, 1.0 h after emptying), when complaining of " urgency of urine" , when actually performing urine volume and time were described as: U 0 and t 0, U 0.5 and t 0.5, U 1.0 and t 1.0, U t and t, U T and T. Results:There was a statistically significant difference in gender and age, and women had stronger ability to urinate than men U 1.0( P=0.003), young people had stronger ability to urinate than middle-aged U 1.0( P=0.002). In the three-step comparison, there was no statistically difference between 1 hour after emptying urine volume U 1.0( P=0.177) and the actually performing urine volume U T ( P=0.052). And the final urine volume was concentrated at 298-526 ml. After the patient emptied the urine volume and complained of " urgency of urine" , the time slot was t=(75.2±49.9) min, with the urine volume of U t=(331.2±140.3) ml. And there was no statistically difference between U t and U T ( P=0.198) at X-ray Simulation. Conclusions:The patient emptied the bladder and immediately drank 540 ml of water. After 1 hour of suppressing urine, he complained of " urgency of urine" and achieved the target urine volume (400 ml). At this time, the bladder urine volume U 1.0 was consistency in the immobilization, CT Simulation, and X-ray Simulation.

OBJECTIVE:To explore an effective method to formulate management-related strategies for off-lable use of drugs by the evidence-based medicine. METHODS:The process of guideline formulation included seven procedures,i.g. establishment ofguideliesformulation workgroup;investigation and selection of the status quo on off-label drug use;identification of the clinical problems;retrieval and evaluation and comprehensing of evidence;applification of GRADE in evidence quality grading;formation of the recommendations consensus;peer review and result publication. And eventually guidelines were formed based on the steps. This study took off-label use of rheumatoid immunoprotective subjects as a case to explore. RESULTS & CONCLUSIONS:Based on the evidence evaluation system and above 7 steps,the methods and process of guideline formulation on off-label use of rheuma-toid immunoprotective subjects that integrated administration,law,clinical medicine,pharmacy subjects were made .The process of guideline formulation fully reflects multidisciplinary characteristics of the workgroup,the advanced nature of the process,the comprehensiveness of evidence ,the rigor of evidence quality grading,and the normalization of consensus. It provides reference in methodology for establishing a comprehensive evidence-based evaluation and management system of off-label use of drugs for all clinical specialist disease. Therefore,this scientific research results may promote the standardization and legalization of the off-label use of drugs management in China.

Objective:To investigate the situation of patients with human immunodeficiency virus (HIV) infection who re-engaging treatment after dropping-out during anti-retroviral therapy (ART), and the influencing factors of ART re-engagement in Yunnan Province.Methods:The total dropping-out cases of ART up to December 31, 2018, including cases of lost-of-follow-up and withdrawing medications in Yunnan Province were included. The status of drop-out and demographic data were collected from survey questionnaires and the extracted medical-visiting records from the China National Free Antiretroviral Treatment Program Database of Chinese Center for Disease Control and Prevention. Chi-square test was used in statistical analysis and logistic regression was applied in analyzing factors related with re-engagement.Results:Among the total 6 075 cases with HIV infection which were recorded with the status of drop-out during ART in Yunnan Province, 5 340(87.9%) cases were confirmed drop-out, 540(8.9%) cases were false dropping-out due to belated medical visiting records, 109(1.8%) cases provided invalid answers or had no response to survey questionnaire, and 86(1.4%) cases failed to report results. Among 5 340 confirmed drop-out cases, the findings showed that 923(17.3%) cases were tracked and successfully re-initiated ART, 2 327(43.6%) cases could not be contacted, 1 443(27.0%) cases refused ART, 100(1.9%) cases died, 39(0.7%) cases came back for treatment by self-willing, 91(1.7%) cases were detained, and 417(7.8%) cases were in other situations. Tracking the dropping-out cases were through the workers based on the health facilities including ART clinics, centers for disease control and prevention and the community-based organizations. They tracked the dropping-out cases by phone, through household visiting or face-to-face communication. Statistically significant differences were found in the proportion of patients re-engagement by gender, re-engagement age, route of infection, education level and time from entry to last loss ( χ2=6.14, 21.26, 8.24, 17.69, 12.75, respectively, all P<0.050). The logistic regression suggested that the protective factors related with the re-engagement included female (adjusted odds ratio (a OR)=1.34, 95% confidence interval ( CI) 1.12 to 1.61, P=0.002), re-engagement age≤30 year-old (a OR=1.78, 95% CI 1.25 to 2.55, P<0.001), age of 31 to 60 year-old (a OR=1.33, 95% CI 1.01 to 1.76, P=0.043), education level with primary school to high school or technical secondary school (a OR=1.56, 95% CI 1.21 to 2.01, P<0.001), the period>24 months between first initiating ART and dropping-out (a OR=1.37, 95% CI 1.11 to 1.70, P=0.004). Conclusions:The program of tracking and re-engagement for ART dropping-out patients in Yunnan Province needs multi-department participation and investing large resources, but the success rate of tracking and re-engagement is not high. The protective factors related with re-engagement are female, re-engagement age≤60 year-old, education level with primary school to high school or technical secondary school, the period>24 months between first initiating ART and dropping-out.

OBJECTIVETo investigate the association of mesorectal invasion depth before neoadjuvant radiochemotherapy with pathological outcome and to provide evidence for individualized treatment in T3 rectal cancer.

METHODSRetrospective analysis was performed on the clinical records of 73 consecutive rectal cancer patients treated with neoadjuvant radiochemotherapy and radical surgery in the Shanghai Cancer Center from January 2010 to December 2012. All the patients underwent high-resolution MRI and the depth of mesorectal invasion, lymph node status, tumor length, and mesorectal fascia status were evaluated. The category T3 was subdivided according to the measurement of the maximal tumor invasion beyond the outer border of the muscularis propria: T3a(<5 mm), T3b(5-10 mm) and T3c(>10 mm). The association of mesorectal invasion depth,other MRI and clinical features with short-term efficacy was analyzed,especially with pathological complete response(pCR).

RESULTST3a, T3b and T3c accounted for 19.2%, 64.4% and 16.4% in 73 rectal cancer patients who underwent high resolution MRI, respectively. There were 42.9% of T3a patients achieved pathological complete response,significantly higher than those of T3b(14.9%)and T3c(0%) (P=0.017).

CONCLUSIONST3a rectal cancer patients are more likely to achieve pCR than those of T3b and T3c after neoadjuvant radiochemotherapy. The maximal tumor invasion beyond the outer border of the muscularis propria less than 5 mm may act as a predictive factor and guide the follow-up treatment of T3 rectal cancer.

Adult ; Aged ; Chemoradiotherapy ; Female ; Humans ; Male ; Middle Aged ; Neoadjuvant Therapy ; Neoplasm Invasiveness ; Rectal Neoplasms ; pathology ; therapy ; Retrospective Studies ; Treatment Outcome ; Young Adult

17α hydroxylase is a key enzyme for the conversion of progesterone to prepare various progestational drug intermediates. To improve the specific hydroxylation capability of this enzyme in steroid biocatalysis, the CYP260A1 derived from cellulose-mucilaginous bacteria Sorangium cellulosum Soce56 and the Fpr and bovine adrenal-derived Adx_4-108 derived from Escherichia coli str. K-12 were used to construct a new electron transfer system for the conversion of progesterone. Selective mutation of CYP260A1 resulted in a mutant S276I with significantly enhanced 17α hydroxylase activity, and the yield of 17α-OH progesterone reached 58% after optimization of the catalytic system in vitro. In addition, the effect of phosphorylation of the ferredoxin Adx_4-108 on 17α hydroxyl activity was evaluated using a targeted mutation technique, and the results showed that the mutation Adx_4-108T69E transferred electrons to S276I more efficiently, which further enhanced the catalytic specificity in the C17 position of progesterone, and the yield of 17α-OH progesterone was eventually increased to 74%. This study provides a new option for the production of 17α-OH progesterone by specific transformation of bacterial-derived 17α hydroxylase, and lays a theoretical foundation for the industrial production of progesterone analogs using biotransformation method.
Animals ; Cattle ; Progesterone/metabolism* ; Hydroxylation ; Biocatalysis ; Electron Transport ; Mixed Function Oxygenases/metabolism*

ObjectiveTo investigate the menstrual conditions of women infected with COVID-19 in Shanghai and analyze the influencing factors. MethodsFrom December 2022 to March 2023， menstrual data from 281 women infected with COVID-19 in Shanghai were collected with a questionnaire survey， including usual menstrual characteristics， the most recent menstrual period post-infection， symptoms of infection， and medication usage. According to the crossover period between the menstrual period and the infection period of the respondents， the samples were divided into two groups for comparative analysis： those whose menstrual and infection periods overlapped （positive group） and those whose menstruation started after conversion to virus-negative （negative conversion group）. ResultsAmong the 281 respondents， 196 （65.8%） experienced menstrual changes. Among them， 145 （51.6%） had changes in menstrual volume， color and texture， and 109 （38.8%） had changes in menstrual duration or cycle. Decreased menstrual volume （22.1%）， darker color （23.49%）， thicker texture （21.0%）， increased blood clots （16.7%）， and prolonged duration （21.8%） were observed in both groups. The rate of changes in menstrual volume， color， and texture was higher in the positive group （56.8%， 69/110） than that in negative group （37.3%， 76/171） （P<0.05）. Regarding the menstrual cycle changes， the rate of early onset was higher in the positive group （14.5%） compared to the negative conversion group （3.5%）（P<0.05）， while the rate of delayed menstruation was higher in the negative conversion group （25.1%） than that in the positive group （5.5%） （P<0.05）. Correlation analysis showed a weak association between sore throat and menstrual changes （r=0.154， P<0.05）. ConclusionSome women infected with COVID-19 experience short-term changes in their menstrual conditions， characterized by reduced volume， darker color， thick texture， increased clots， and prolonged menstrual duration， reflecting a pathogenesis of blood stasis. Menstruation during the infection period tends to occur earlier， while delayed menstruation is more prevalent at post-conversion.

Membrane-disruptive peptides/peptidomimetics (MDPs) are antimicrobials or anticarcinogens that present a general killing mechanism through the physical disruption of cell membranes, in contrast to conventional chemotherapeutic drugs, which act on precise targets such as DNA or specific enzymes. Owing to their rapid action, broad-spectrum activity, and mechanisms of action that potentially hinder the development of resistance, MDPs have been increasingly considered as future therapeutics in the drug-resistant era. Recently, growing experimental evidence has demonstrated that MDPs can also be utilized as adjuvants to enhance the therapeutic effects of other agents. In this review, we evaluate the literature around the broad-spectrum antimicrobial properties and anticancer activity of MDPs, and summarize the current development and mechanisms of MDPs alone or in combination with other agents. Notably, this review highlights recent advances in the design of various MDP-based drug delivery systems that can improve the therapeutic effect of MDPs, minimize side effects, and promote the co-delivery of multiple chemotherapeutics, for more efficient antimicrobial and anticancer therapy.

Humans ; Autistic Disorder ; China/epidemiology* ; Cohort Studies ; Autism Spectrum Disorder/genetics* ; Asian People