This study aimed at exploring the modeling and identification method of autoimmune POF by the ZP3 polypeptide with the provision of scientific basis for the prevention and treatment of POF.B6AF1 female mice,the hybridization of A/J male mice and C57BL/6 female mice,was immunized by zona pellucida polypeptide fragments.Then,the mice estrous cycle was detected by vaginal exfoliated cells Pasteur's staining.After the 14-day modeling,the mice model was identified on the 7th and 14th day,respectively.Ovarian tissue morphology and anti-zona pellucida antibodies immunofluorescence change were detected by H&E staining and ZP3 immunofluorescence staining.Serum hormone levels of E2 and FSH in the mice were tested by ELISA,with the combination of estrous cycle,ovarian tissue morphology and anti-zona pellucida antibodies immunofluorescence change to judge the success of the POF mice model.It was found that ZP3 polypeptide immunized mice appeared the disorder of estrous cycle after 14 days,so did the marked inflammation observed by ovarian biopsy,a clear transparent zone by ZP3 immunofluorescence staining,and the decrease of serum E2 declined and the increase of serum FSH by ELISA.However,no significant change was found on the 7th day in the modeling.In conclusion,ZP3 polypeptide induced autoimmune POF mice model was established successfully,featuring high incidence and simple method and laying a foundation for the further study of autoimmune POF.

Given the rapid progress in recent years,hospital ethics review remains a weak link.This study started from the nature and role of the hospital ethics committee to probe into setbacks found in hospital ethics review practice.Viewpoints in the paper covered the access system,review system,training system,and the conflicts of interest between researchers and subjects,in an effort to further improve the quality of ethic review,and to better protect the rights and interests of subjects.

Objective To discuss clinical efficacy of the modified Stoppa approach in the treatment of acetabular anterior fractures.Methods From January 2011 to December 2014,22 patients with acetabular anterior fracture were treated at our department.They were 14 males and 8 females,with an average age of 36.6 years (range,from 18 to 49 years).By the LetourneI-Judet classification system,there were 9 anterior wall fractures,12 anterior column fractures,and one transverse fracture.The modified Stoppa approach was used for fracture reduction under direct visualization in this cohort.Fixation with reconstruction plate was conducted after satisfactory reduction was confirmed by the X-ray examination.The operative duration,incision length,bleeding volume,fracture reduction quality,function of the affected hip and complications were recorded.Results In this cohort,the incision length ranged from 6 to 15 cm,averaging 9.5 cm;the intraoperative bleeding volume ranged from 100 to 1,000 mL,averaging 550 mL;the operative duration ranged from 40 to 160 minutes,averaging 126.2 min.The 22 patients were followed up for an average of 15.5 months (from 12 to 18 months).According to the Matta imaging evaluation,the fracture reduction was rated as excellent in 18 cases,as good in 3 cases and as poor in one,yielding an excellent to good rate of 95.5％.According to the Harris scoring system,the function of the affected hip was assessed at the final follow-up as excellent in 12 cases,as good in 9 cases,and as poor in one case,giving an excellent to good rate of 95.5％.Traumatic arthritis occurred in one case;there were no such complications as reduction loss or implant failure.Conclusion The modified Stoppa approach is a satisfactory one for the treatment of unstable acetabular anterior fractures,owning to its advantages like minimal invasiveness,simple dissection,excellent visual control of reduction and fixation,and a low rate of complications.

Medical research contract is an important part of business between medical research organizations.It is the official document identifying the right and obligations of respective medical research organizations during research activities.It is the legal basis,and is also on the basis of research expenditure.Therefore,it is very important to improve ability of the contract writing in research management.Composing a sound medical research contract has significant importance in research activities.This paper explored the remarkable issues when composing a medical research contract from the respective of management of funding,including how to make the contract more fair,rational,rigorous and legal.

An introduction to the classified management of such trials and clinical application,documents submission for ethical review,operating procedures and review key points,as well as the problems found in the review.These efforts aim to provide guidance to the review of medical technique clinical trials,and to promote ethical supervision for new medical techniques.

The pain is an emerging subject and need developing. The design of the research is the most important. This article emphatically introduced about the issues on quality monitoring and the logical administrative levels during practice.

Objective:To study the performance of immune reconstitution in patients with chimeric antigen receptor (CAR)-T cell immunotherapy bridging allogeneic hematopoietic stem cell transplantation (allo-HSCT).Methods:A total of 61 patients with acute B lymphocytic leukemia (B-ALL) who received CAR-T cell bridging allo-HSCT in Beijing Lu Daopei Hospital from August 2018 to December 2021 were enrolled, and the clinical medical records of the above patients were retrospectively analyzed. The average age was 14 (7, 30) years old, including 39 males and 22 females. 32 patients were treated with CAR-T cell immunotherapy(CAR-T Group) and 29 didn't with CAR-T cell immunotherapy(non-CAR-T group). The follow-up period was 561 (235,784) days. Multicolor flow cytometry was used to detect the peripheral blood lymphocyte subsets, i.e. total lymphocytes, T lymphocytes, helper T cells, cytotoxic T cells, B lymphocytes, NK cells, and Treg cell counts before transplantation and 1, 2, 3, 6, 8, 10, and 12 months after transplantation, to evaluate the immune reconstitution performance post allo-HSCT.Results:Serum globulin before transplantation: The IgA level in the CAR-T group was 0.18 (0.06, 0.49) g/L, which was lower than that of 1.03 (0.63, 1.56) g/L in the non-CAR-T group ( U=103.5, P<0.001). The IgG level in the CAR-T group was 5.54 (4.04, 7.09) g/L, lower than that of 6.78 (5.27, 9.26) g/L in the non-CAR-T group, ( U=1 298.5, P=0.017), and the IgM level in the CAR-T group was 0.18 (0.05, 0.30) g/L, lower than that of 0.40 (0.26, 0.71) g/L in the non-CAR-T group ( U=166.0, P<0.001). In the CAR-T group before transplantation, the absolute count of total lymphocyte in peripheral blood was 833.00 (335.00, 1 727.50) /μl, lower than that of 1 052.00 (545.75, 1 812.50) /μl in the non-CAR-T group ( U=404.0, P<0.001). The absolute count of T lymphocyte in the CAR-T group before transplantation was 686.00 (233.00, 1 307.00)/μl, lower than that of 860.00 (391.00, 1 419.75) /μl in the non-CAR-T group ( U=406.0, P<0.001). The absolute count of helper T lymphocytes in the CAR-T group was 146.00 (40.50, 327.50) /μl, lower than that of 162.50 (66.00, 384.75) /μl in the non-CAR-T group ( U=494.0, P=0.002). The absolute count of cytotoxic T lymphocytes in the CAR-T group was 343.00 (56.50, 924.00) /μl, lower than that of 478.00 (143.50, 992.25) /μl in the non-CAR-T group ( U=483.5, P=0.001). The absolute count of B lymphocytes in CAR-T group was 22.00 (6.00, 186.00) /μl, lower than that of 33.00 (8.00, 220.00) /μl in the non-CAR-T group ( U=498.0, P=0.002). And when two groups of patients were monitored after transplantation, there was no statistical difference in absolute cell counts of each immune cell subpopulation( P>0.05). Comparing the clinical features of the two groups, the pre-transplant history of the CAR-T group was 981.00 (368.50, 1 514.75) d, longer than that of 323.00 (167.50, 450.50) d in the non-CAR-T group ( U=263.0, P=0.004). The dose of rabbit anti-human thymic immunoglobulin (ATG) in the pretreatment protocol of patients in the CAR-T group was 5.00 (5.00, 7.50) mg/Kg, lower than that of 7.00 (5.00, 7.50) mg/kg in the non-CAR-T group ( U=288.5, P=0.018). The infusion dose of CD34 +cells in the CAR-T group was 5.91 (4.23, 6.02) ×10 6/kg, higher than that of 4.51 (4.00, 5.93)×10 6/kg in the non-CAR-T group ( U=291.0, P=0.012). The duration of the application of cyclosporine after transplantation in the CAR-T group was 167.00 (119.25, 299.50) d, which was shorter than that of 197.00 (102.50, 450.50) d in the non-CAR-T group ( U=421.0, P=0.001). Conclusions:For patients in CAR-T group with low immune function before transplantation, it may be possible to make them comparable to non-CAR-T group in immune reconstitution state by reducing the dose of pretreatment ATG, increasing the counts of CD34 + cells infusion in the graft, and discontinuing cyclosporine as soon as possible after transplantation.

Objective To investigate the effect of NS-398 combined with docosahexaenoic acid (DHA) on apoptosis of cholangiocarcinoma QBC939 cells and its mechanism.Methods In vitro,cultured cholangiocarcinoma QBC939 cells were exposed to 0,25,50,100,150 and 200 μmol/L NS-398 with 0,15,30,45,60 and 75 μg/ml DHA respectively.The absorbance of the QBC939 cells were measured by CCK8 and its growth inhibition ratio were calculated.Flow cytometry was applied to detect cell apoptosis.The level of β-catenin and c-myc mRNA and protein were measured by real-time PCR,Western blot and enzyme-linked immunoabsordent assay respectively.Results Exposure to NS-398 combined with DHA suppressed the growth of QBC939 cells.When NS-398 was at 100 μmol/L and DHA at 45 pμg/ml,the relative growth inhibition rate of QBC939 cells was 90％ (F =5.85,P ＜ 0.05).NS-398 combined with DHA promoted QBC939 cells apoptosis at the early stage (F =8.16,P ＜ 0.01).Real-time PCR could detect low β-catenin and c-myc expression in QBC939 cells disposed by NS-398 combined with DHA (F =7.61,P ＜0.01),(F =7.92,P ＜0.01).NS-398 combined with DHA decreased β-catenin (F =7.75,P ＜ 0.01),(F=8.17,P＜0.01) and c-myc (F=8.76,P＜0.01),(F=8.12,P＜0.01) protein expression in QBC939 cells.Conclusion NS-398 combined with DHA promoted apoptosis and inhibit proliferation of cholangiocarcinoma cells QBC939 in vitro possibly through downregulated mRNA and protein expression of β-catenin and c-myc.

[Objective]Investigating Professor WANG Peijuan's clinical experience in treating PCOS from studying the kidney. [Method] This paper mainly studied by arranging and researching the tutor's theory and experience about treating PCOS that based on the practice in clinic with the teacher as a self perception,the collection about the PCOS cases of tutor's clinical treatment and the analysis of national and international relative literature combined with self-awareness. [Result]Professor WANG thinks that PCOS is the disorder of qi and blood and the transformation failure of kidney-Tiangui-Chongren-uterus, which leads to phlegm and blood stasis, blocking in the uterus and making menstruation lose its inhere periodicity. The disease is of the kidney deficiency and phlegm stagnation syndrome.[Conclusion]Professor WANG holds that to use the method of tonifying kidney properly and attach importance to the three categories of etiologic factors will be effective to the treatment of PCOS. Her experience can provide the basis for diagnosis and treatment about the disease.