There were some samples collected from the Antarctic soil and South Ocean water for isolation of microorganisms and screening of their antitumor bioactivity by lethality bioassay using brine shrimp and a flow cytometric bioassay.There were 259 stains were isolated from the samples,11% of the Antarctic microorganisms showed strong antitumor activity.This result showed that the Antarctic microorganisms have a good potential in bioactive metabolites researching.

Objective To investigate the clinical characteristics and treatment strategies of arachnoid cyst combined with chronic subdural hematoma.Methods Seventeen patients with arachnoid cyst combined with chronic subdural hematoma,who received treatment in our hospital from February 2008 to March 2016,were chosen in our study;13 of them were performed burr hole irrigation and drainage,2 received craniotomy for removing hematoma and cystectomy,and 2 received endoscopic cyst excision and hematoma removal surgery.A retrospectively analysis of clinical characteristics and treatment strategies of these patients was performed.Results Follow up for 0.5-2 years was performed in the 13 patients performed burr hole irrigation and drainage,and no hematoma relapse was noted;one was found rebleeding in the cyst associated with a small amount of subdural hematoma on the 5th d of surgery,and the subdural hematoma was absorbed during the follow-up observation;one was found that the cyst and subdural hematoma both disappeared in the postoperative check,while the cyst reappeared 40 days after surgery,and during the follow-up observation,the cyst was not enlarged and the chronic subdural hematoma was not relapsed.Two patients recovered after receiving the craniotomy for removing hematoma and cystectomy;two patients recovered after receiving the endoscopic cyst excision andhematoma removal surgery.Conclusion For patients with arachnoid cyst associated with chronic subdural haematoma,burr-hole irrigation and drainage are generally selected;for patients with reappeared cyst or hematoma,there is no need to burr hole again or perform the surgery aiming at the cyst in a haste,and follow-up observation is suggested;for patients whose symptoms in the cyst have appeared before hemorrhage or whose hemorrhage appeared recurrently in the cyst,surgery of hematoma removal and cyst excision can be chosen at the same time.

Objective To explore the expression of peripheral blood miRNA-134 in the patients with breast cancer and chemotherapy drug resistance mechanism.Methods A total of 98 cases of newly diagnosed breast cancer were divided into the chemotherapy sensitive group(n=68) and chemotherapy drug resistant group(n=30).The expression of miRNA-134 in peripheral blood was measured by adopting RT-PCR.miRNA-mimics and miRNA-inhibitor were transfected into epirubicin and docetaxel resistant cell lines,the cell apoptosis and expression levels of Bax and Caspase-3 protein were detected.Results The level of serum miRNA134 expression in the chemotherapy sensitive group was significantly higher than that in the chemotherapy drug resistant group (P＜0.05);the proliferation capacity of epirubicin and docetaxel resistant cell lines was significantly lower than that in the MCF-7 cells(P＜0.05).Compared with normal MCF-7 cell line,the expression level of miRNA-134 in the epirubicin and docetaxel resistant cell lines was significantly decreased(P＜0.05).The apoptosis rate in the miRNA-mimics group was significantly higher than that in the control group and miRNA-inhibitor group(P＜0.05).The expression of Bax and Caspase-3 protein in the miRNA-mimics group was significantly higher than that in the control group and miRNA-inhibitor group(P＜0.05).Conclusion MiRNA-134 may enhance the sensitivity of breast cancer ceils to chemotherapy by promoting the expression of Bax and Caspase-3.

Objective:To investigate the clinical significance of cytokine levels and routine cytology in bronchoalveolar lavage fluid (BALF) in children with severe Mycoplasma pneumoniae pneumonia (SMPP).Methods:A total of 207 children with Mycoplasma pneumoniae pneumonia who underwent parallel bronchoalveolar lavage in the Department of Respiratory, Shanghai Children′s Hospital, Shanghai Jiaotong University from July 2018 to February 2019 were enrolled in this study.There were 121 patients in the SMPP group and 86 patients in the non-SMPP group.Flow cytometry was used to determine the level of cytokines in BALF.Meanwhile, the cells in BALF were stained and cytokines levels and routine cytology were compared between the 2 groups.Receive operating characteristic(ROC) curves were used to analyze the predictive value of cytokine levels and routine cytology for SMPP.Results:The levels of interleukin(IL)-8, IL-1βand IL-6 and white blood cell count in BALF of SMPP group were significantly higher than those of non-SMPP group [1 717.77 (784.31, 3 304.03) ng/L vs.1 013.03 (469.27, 2 040.52) ng/L, 373.18 (70.08, 941.56) ng/L vs.107.50 (0.10, 489.88) ng/L, 200.74 (41.09, 570.61) ng/L vs.95.47 (0.10, 337.68) ng/L, 1 890.00 (955.00, 3 600.00)×10 6/L vs.1 430.00 (467.50, 2 724.00)×10 6/L]( Z=3.27, 3.45, 2.47, 2.57, all P<0.05). The percentage of macrophages in the non-SMPP group was significantly higher than that in the SMPP group [0.04 (0, 0.12) vs. 0 (0, 0.06)] ( Z=-2.67, P=0.01). The optimal critical value and the area under curve (AUC) of IL-8 were 722.69 ng/L and 0.63 (95% CI: 0.56-0.71, P<0.01), respectively. The optimal critical value and AUC of IL-1β were 166.33 ng/L and 0.64, respectively (95% CI: 0.56-0.72, P<0.01). The optimal critical value and AUC of IL-6 were 142.95 ng/L and 0.60, respectively (95% CI: 0.52-0.68, P<0.05). The optimal critical value and AUC of the total white blood cells were 970×10 6/L and 0.61, respectively (95% CI: 0.53-0.69, P<0.05). The optimal critical value and AUC of the percentage of macrophages were 0.19 and 0.60, respectively (95% CI: 0.32-0.48, P<0.05). Conclusions:Children with SMPP have higher levels of cytokines IL-8, IL-1β and IL-6, a higher white blood cell count, and a lower percentage of macrophages in BALF than children with no SMPP. However, cytokine levels and cytology are inadequate to predict SMPP since they are not effective in the clinical diagnosis of SMPP.

Enteral nutrition plays an irreplaceable role in the nutritional treatment of critically ill patients. In order to help clinical medical staff to manage the common complications during the implementations of enteral nutrition for critically ill patients, the consensus writing team carried out literature retrieval, literature quality evaluation, evidence synthesis. Several topics such as diarrhea, aspiration, high gastric residual volume, abdominal distension, etc. were assessed by evidence-based methodology and Delphi method. After two rounds of expert investigations, Expert consensus on prevention and management of enteral nutrition therapy complications for critically ill patients in China (2021 edition) developed, and provided guidance for clinical medical staff.

Objective: To analyze the trend of lung cancer incidence rate among rural residents in Feicheng city between the years 2000 and 2012,and predict the incidence rate between the years 2013 and 2018,and subsequently provide baseline data for lung can-cer control and prevention.Methods:With the cancer registration data in Feicheng rural areas,the time trend of lung cancer inci-dence rate and the annual percentage change(APC)were calculated by the Joinpoint model,while the incidence of lung cancer from 2013 to 2018 were predicted by the ARIMA(p,d,q)model.Results:A total of 3,908 new cases of lung cancer were diagnosed be-tween 2000 to 2012.The incidence rate was 40.77/105,the age-specific cancer incidence rate in the Chinese population(ASRC)and world population(ASRW)were 32.95/105 and 32.97/105,respectively.The incidence was 2.14 times higher among males than females (P<0.001).The incidence of lung cancer which apparently rose from 25.13/105to 64.92/105 with an APC value of 9.74%(P<0.001),was increasing every year.The change in the trend of lung cancer with respect to age could be divided into three segments,the incidence rate in the 0 to 59 years group showed a rapid upward trend(APC=113.38,P<0.001),which was lower in the 60 to 79 years group (APC=20.39,P<0.05)and began to decline in the 80 years or older group(APC=-21.20,P>0.05).The incidence of lung cancer was also observed to be increasing yearly from 2013 to 2018,and with an average annual growth rate of 4.92%,was predicted to reach 87.92/105 in 2018.Conclusions:The occurrence of lung cancer was closely related to population aging,unhealthy habits,and environmental risk factors.Due to the increasing aging population,the incidence of lung cancer will continue to increase.In order to formulate specif-ic strategies,the control and prevention of lung cancer must be based on its incidence features.

Objective To retrieve,evaluate and summarize the best evidence of early mobilization in awake patients on extracorporeal membrane oxygenation,and to provide a reference for clinical practice.Methods UpToDate,BMJ Best Practice,Registered Nurses'Association of Ontario,National Guideline Clearinghouse,National Institute for Health and Care Excellence,Yimaitong,Joanna Briggs Institute Library,Cochrane Library,CINAHL,PubMed,SinoMed,CNKI,Wanfang Database,Vip Database and Extracorporeal Life Support Organization Website were researched to collect the literature,including clinical guidelines,expert consensuses,evidence summaries,systematic reviews,and well-designed original studies.The time limit for retrieval was until June 2023.The quality of literature and the level of evidence were evaluated by the evaluation criteria and evidence grading system of J BI Evidence-Based Health Care Center.Results 14 pieces of the literature were included,including 2 clinical guidelines,4 expert consensuses,5 systematic reviews,2 cohort studies and 1 case series.Totally 33 pieces of evidence were summarized,covering 7 aspects:adaptation conditions for the implementation of awake ECMO,team composition,comprehensive assessment,pre-mobilization preparation,mobilization content,prevention and control of adverse events,and effect evaluation.Conclusion The study summarizes the best evidence of early mobilization in awake patients on extracorporeal membrane oxygenation.It is suggested that medical institutions establish a professional team for the early mobilization of awake ECMO patients,apply the best evidence to standardize the early mobilization process,and formulate an individualized mobilization program.

Objective:To compare the preliminary clinical effect of mitral valve replacement and mitral valvuloplasty on hypertrophic obstructive cardiomyopathy with mitral regurgitation.Methods:From January 2010 to December 2013, the patients undergoing cardiac surgery at Bakulev Cardiovascular Surgery Research Center in Russia were randomly divided into two groups: Forty-one patients received left ventricular outflow tract hypertrophy myocardial resection (Morrow operation) combined with mitral valve replacement (MVR) as MVR group; Forty-seven patients received Morrow surgery combined with mitral valve repair (MVr) as MVr group.The primary end point: death, secondary end point: thrombosis complications (cerebral infarction, peripheral arterial embolism), recurrence of mitral regurgitation and left ventricular outflow tract pressure difference were compared between the two groups.Results:In the MVr group, 6 cases were converted to MVR and were excluded from the study.The survival rates of MVR group and MVR group were 78.9% and 96.6%, respectively , and the thromboembolic free survival rates of MVR group and MVr group were 83.2% and 100%, respectively. The differences were statistically significant( P=0.034, 0.026, respectively). There was no significant difference in mitral regurgitation and left ventricular outflow tract pressure difference between MVR group and MVR group 24 months after operation( P=1.000, 0.934, respectively). Conclusion:Operation combined with MVR or MVr is an effective method to relieve left ventricular outflow tract obstruction and mitral regurgitation. Morrow operation combined with MVr can improve survival rate and reduce thrombosis complications.

ObjectiveThe effect of modified Shengjiangsan on immunoglobulin A （IgA） nephropathy was observed. The microRNA-148b （miRNA-148b）， interleukin 6 （IL-6）， core 1 beta 1，3-galactosyltransferase （C1GALT1）， molecular chaperone Cosmc （core1β3-Gal-T-specific molecular chaperone C1GALT1C1）， and galactose-deficient IgA1 （Gd-IGA1） in serum and kidney tissues of IgA nephropathy rats were detected to explore the underlying mechanism. The result is expected to lay a scientific basis for clinical application of modified Shengjiangsan in the treatment of IgA nephropathy. MethodA total of 42 SPF male SD rats were randomized into the normal group （8rats） and modeling group （34 rats） with the random number table method. After one week of adaptive feeding， rats for modeling were given bovine serum albumin （BSA， gavage）， lipopolysaccharide （LPS， injection into tail vein）， carbon tetrachloride （CCl₄， subcutaneous injection）， and castor oil to induce IgA nephropathy. After modeling， two rats were randomly selected to test the modeling outcome. Then the model rats were classified into the model group， low-dose Chinese medicine group （modified Shengjiangsan，6.27 g·kg^-1）， high-dose Chinese medicine group （modified Shengjiangsan，12.54 g·kg^-1）， and benazepril group （10 mg·kg^-1） with the random number table method， 8 in each group. The administration （gavage， once a day） lasted 4 weeks. The 24-h urinary total protein （24 h-UTP） was detected at the end of the 1^st， 9^th， and 13^th week of the experiment. At the 14th week， after anesthesia， femoral artery blood was collected and centrifugated. The supernatant was collected to detect albumin （ALB）， aspartate aminotransferase （AST）， alanine aminotransferase （ALT）， serum creatinine （SCr）， and blood urea nitrogen （BUN）. The expression levels of IL-6 and Gd-IGA1 were determined by enzyme-linked immunosorbent assay （ELISA）. Based on hematoxylin-eosin （HE）/Masson/periodic Schiff-methenamine silver （PASM） staining， the pathological changes of renal tissues were observed. Ultrastructural changes of glomeruli were observed by transmission electron microscopy. The expression of miRNA-148b， IL-6， C1GALT1， and C1GALT1C1 was detected by immunohistochemistry. The mesangial area of the glomeruli was observed by immunofluorescence. Real-time polymerase chain reaction （Real-time PCR） was employed to determine the mRNA levels of mirNA-148b， IL-6， C1GALT1， and C1GALT1C1， and Western blot was used to detect the protein levels of IL-6， C1GALT1， and C1GALT1C1. ResultCompared with normal group， the model group showed increase in the content of 24 h-UTP， SCr， ALT， IL-6， and GD-IGA1 （P<0.05）， decrease in ALB content （P<0.05）. Moreover， rats in the model group demonstrated hyperplasia of glomerular mesangial cells， thickening of mesangial area， podocyte foot process effacement， and a large number of granular IgA immune complex in the mesangial area. In addition， the model group showed increase in the expression of IL-6 in mesangial area and podocytes， decrease in the expression of C1GALT1 and C1GALT1C1 in mesangial area and podocytes， enhanced expression of IL-6 mRNA and miRNA-148b （P<0.01）， weakened expression of C1GALT1 mRNA and C1GALT1C1 mRNA （P<0.01）， rise of IL-6 protein expression （P<0.01）， and reduction in the protein expression of C1GALT1 and C1GALT1C1 （P<0.01）. Compared with the model group， modified Shengjiangsan decreased the content of 24 h-UTP， SCr， ALT， IL-6， and Gd-IGA1 （P<0.05） and increased the content of ALB （P<0.05， P<0.01）. Moreover， with the treatment of this Chinese medicine， the pathological damage was significantly alleviated and the deposition of IgA immune complex in basement membrane was reduced. The expression of IL-6 in the mesangial area and podocytes of rats was decreased， and the expression of C1GALT1 and C1GALT1C1 in the mesangial area and podocytes of rats was increased. Moreover， the expression of IL-6 mRNA and miRNA-148b was decreased （P<0.01）， and the expression of C1GALT1 mRNA and C1GALT1C1 mRNA was increased （P<0.01）. The protein expression of IL-6 was decreased （P<0.05， P<0.01）， and the protein expression of C1GALT1 and C1GALT1C1 was enhanced （P<0.05， P<0.01）. The Chinese medicine group showed obvious dose-effect trend. ConclusionModified Shengjiangsan may reduce the expression of miRNA-148b and IL-6 in serum and kidney tissue of IgA nephropathy rats， restore the expression of C1GALT1 and C1GALT1C1， and decrease the generation of Gd-IGA1， so as to reduce renal pathological damage and proteinuria， protect the kidney protection， and finally delay the disease progression. Moreover， the effect is enhanced with the rise of dose.