Ovarian cancer is a heterogeneous malignant tumor,one of the most common causes of cancer death in women worldwide,and there is currently no effective treatment available for its treatment,which seriously affects women's life and health.In order to deeply explore the pathogenesis of ovarian cancer and study the specific therapeutic drugs and methods,this paper summarizes,summarizes,assigns and evaluates the clinical characteristics of traditional Chinese and Western medicine for ovarian cancer,and screens out a more complete animal model.Through CNKI,Wanfang,Pubmed and other databases,the relevant content of ovarian cancer animal models was collected and sorted,and the model diagnostic indicators were assigned and the consistency was evaluated.In the evaluation of the model,it is found that the animal model of spontaneous ovarian cancer can simulate the pathogenesis process of human natural ovarian cancer,and the model has high modulus rate,high similarity,and high consistency with the clinical characteristics of traditional Chinese and Western medicine.The subcutaneous tumor graft type model and the blood stasis type model were in good clinical agreement with traditional Chinese medicine,a high degree of similarity,and a longer survival time.At present,animal models of ovarian cancer are mainly based on Western medicine models,and research on animal models consistent with traditional Chinese medicine syndromes is rare.Therefore,the improvement direction of ovarian cancer animal models and the necessity of improving the evaluation system are proposed,so as to make the animal models of ovarian cancer more clinical,and provide a theoretical basis for the determination of the efficacy of traditional Chinese medicine and the discussion of pharmacological effects of ovarian cancer,and provide a theoretical basis for the subsequent research on the pathogenesis and treatment measures of ovarian cancer,in order to improve the model of combining ovarian cancer symptoms in line with the clinical characteristics of traditional Chinese medicine and Western medicine.

Autophagy is a dynamic process that degrades intracellular proteins and damaged organelles, and maintains environmental stability within the cell and provides good conditions for cell survival. Hyperoxic acute lung injury (HALI) is one of the serious complications of clinical oxygen therapy. The pathogenesis of HALI is still unclear. There are studies having shown that autophagy is involved in the pathogenesis of HALI. There are many pathway mechanisms that regulate autophagy, including phosphatidylinositol-3-kinase/Akt/mammalian target of rapamycin (PI3K/Akt/mTOR) signaling pathway, mitogen-activated protein kinase/extracellular signaling-regulated protein kinase (MAPK/ERK) signaling pathway, adenosine 5'-monophosphate-activated protein kinase/unc-51 like autophagy activating kinase 1 (AMPK/ULK1) signaling pathway, transforming growth factor β (TGF-β) and forkhead box O1 (FoxO1) and Ras guanosine triphosphatease superfamily member Rab11a, each of which is referred to as microRNA-21-5p (miR-21-5p) target gene having a role in regulating autophagy activity in many diseases. In this paper, the above-mentioned signaling pathways of miRNA-21-5p target genes regulating autophagy were reviewed in order to find clues about the mechanism of miRNA-21-5p regulating autophagy in HALI and provide a theoretical basis for subsequent basic research.

Acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) are characterized by the destruction of the barrier function of alveolar epithelial cells and capillary endothelial cells and the recruitment of inflammatory cells, which leads to alveolar and interstitial edema, hyaline membrane formation and inflammatory infiltration of the lungs, etc. The mechanism is not completely defined. The current treatment plan focuses on comprehensive treatments such as ventilator support treatment, fluid management, and nutritional support, but the prognosis is still poor. Studies have shown that extracellular vesicle microRNA (miRNA) from different sources participate in regulating the function of epithelial cells, endothelial cells and phagocytes in different ways, thus aggravating or improving ALI, and have diagnostic, differential diagnosis and the therapeutic value. In this article, the mechanism, diagnostic and differerntial value of extracellular vesicle miRNA from different sources in ALI and the therapy of extracellular vesicle miRNA from stem cell in ALI are reviewed.

Objective Deep brain stimulation (DBS) can greatly improve the clinical symptoms of Parkinson's disease (PD),but it can poorly improve the similar clinical symptoms of multiple system atrophy P-type (MSA-P);therefore,identification is a necessity for the two diseases before DBS is carried out on these patients;surface electromyography (sEMG) was employed to analyze the surface electromyographic characteristics associated with tremor and rigidity of PD and MSA-P to explore the role of sEMG in the differential diagnosis of PD and MSA-P.Methods Twenty patients with PD and 25 patients with MSA-P,admitted to our hospital from June 2013 to January 2015,were enrolled in the study.The sEMG was performed on all patients on the 2nd d of hospitalization.Tremor frequency,tremor sEMG activity intensity and postural tremor latency were analyzed.Synchronous sEMG activity intensity during passive activities was analyzed.Root mean square (RMS) in two states was calculated,and t-test was applied to compare tremor frequency,postural tremor latency and sEMG activity intensity.Results The incidence of rest tremor in MSA-P patients was 36％ and that in PD patients was 60％,with significant difference (P＜0.05).And the incidence ofpostural tremor in MSA-P ones was 44％ and that in PD ones was 35％,with significant difference (P＜0.05).Besides,the postural tremor latency in MSA-P patients was significantly longer than that in PD patients ([9.3±3.2] s vs.[5.3±2.1] s,P＜0.05).Thepostural tremor and rest tremor frequencies of MSA-P patients ([7.3±2.1] and [6.4±3.6]-Hz) were significantly higher than those in PD patients ([5.3±2.4] and [4.9±1.2] Hz,P＜0.05).In rest tremor,RMS of flexor and extensor in MSA-P patients was significantly decreased as compared with that in PD patients (P＜0.05);in postural tremor,RMS of flexor and extensor in MSA-P patients was significantly decreased as compared with that in PD patients (P＜0.05).During passive activities,RMS of extensor in MSA-P patients was statistically higher than that in PD patients ([27.927.9± 11.4] vs.[18.318.3±6.4] μV,P＜0.05),while there was no significant difference between RMS of flexor in MSA-P and PD patients ([31.1±13.6] vs.[29.2±8.9] μV,P＞0.05).Conclusion The sEMG can be applied in the preoperative differential diagnosis for DBS of PD and MSAP.

This article reviews the current status, challenges, and reflections on the full-cycle health management of stroke in China. In response to the three major challenges of insufficient public attention to stroke health management, inadequate management of health care services, and an incomplete quality evaluation system, this article proposes to encourage the participation of multiple stakeholders and promote proactive health management, deepen interdisciplinary cooperation and multi-governance, strengthen human resource construction, establish and improve stroke full-cycle health management norms and quality evaluation systems, so as to provide reference for the development and improvement of stroke full-cycle health management in China.

Objective To evaluate the safety and efficacy of lenalidomide plus rituximab in treatment of the patients with relapsed/refractory B-cell non-Hodgkin lymphoma (B-NHL). Methods The clinical data of the patients with relapsed/refractory B-NHL after the varieties of treatment methods in Peking Union Medical College Hospital between January 2015 and December 2017 were retrospectively analyzed. All the patients were treated with R2 regimen: oral lenalidomide (25 mg/d for day 1-day 21) and rituximab (375 mg/m2 of intravenous infusion on day 1, 28-day of each cycle); the efficacy was evaluated after three cycles. After this induction phase, the patients achieving complete response (CR), partial response (PR), or stable disease (SD) were given R2 regimen until the end of 8 cycles. The major end point was overall response rate (ORR) defined as CR + PR. Secondary end point included 1-year progression free survival (PFS), 1-year overall survival (OS) and grade 3-4 adverse events. T cell and B cell subsets of 7 patients at baseline were measured, and T cell and B cell subsets of 13 patients with good efficacy were dynamically observed. Results A total of 49 patients who received 1-4 chemotherapy regimens were included. The ORR after the R2 treatment for 3 courses was 65% (32/49). Thirty-six patients (9 cases of CR, 22 cases of PR, 5 cases of SD) were enrolled in R2 maintenance treatment. The median follow-up time was 13 months, 1-year PFS rate was 61% and 1-year OS rate was 84% . The most common adverse event was bone marrow suppression, including grade 3-4 neutropenia (27% ), grade 3-4 thrombocytopenia (6% ) and grade 4 anemia (4% ), most of which could be controlled by prolonging interval cycles or reduced lenalidomide dosage. The decreased number of CD19+B cell after treatment could be seen in 13 patients who obtained good efficacy under the dynamic observation. Conclusion Lenalidomide plus rituximab is well tolerated and highly active in the treatment of relapsed/refractory B-NHL.

Objective:To investigate the clinical features and outcomes of patients with light-chain (AL) amyloidosis with an ultra-high level of serum free light-chain (FLC) .Methods:Five hundred and ninety-five patients with AL amyloidosis were retrospectively reviewed between January 2009 and January 2020 at Peking Union Medical College Hospital. We analyzed the clinical features and prognosis of patients with ultra-high FLC levels [difference between involved and uninvolved light chains (dFLC) >500 mg/L; n=124] and those without ultra-high FLC levels (dFLC≤500 mg/L; n=471) . Results:Patients with ultra-high FLC presented with more frequent cardiac involvement (82.3% vs 70.1%, P=0.007) , and a higher percentage of patients with 2004 Mayo Ⅲ stage (41.8% vs 33.8%, P=0.029) , but less frequent renal involvement than patients without an ultra-high FLC (59.7% vs 71.8%, P=0.009) . Patients with an ultra-high FLC achieved a lower proportion of hematologic (72.4% vs 82.3%, P=0.048) and cardiac response (37.3% vs 54.7%, P=0.016) and had shorter overall survival (13.0 months vs not reached, P<0.001) and a higher early death rate within 3 months (28.2% vs 11.3%, P<0.001) than those without an ultra-high FLC. Ultra-high FLC independently predicted worse prognosis in patients with AL amyloidosis ( HR=2.279, 95% CI 1.685-3.083, P<0.001) . Conclusions:Patients with an initially ultra-high FLC represented a subgroup with more common cardiac involvement, more advanced cardiac stages, and extremely poor prognosis.

Objective:To explore the function of MDM2 and its relationship with p53 at the cellular level during H 2O 2 induced oxidative damage. Methods:MLE-12 HALI cell models were established using 0.5 mmol/L H 2O 2, and were divided into three groups: normal control group, H 2O 2 injury group, H 2O 2+MDM2 overexpressed group, and H 2O 2+MDM2 shRNA group. Infection of MLE-12 cells with adenovirus vector overexpressing and silencing MDM2; Using immunoprecipitation (Co-IP) to analyze the interaction between MDM2 and p53; Western blotting was used to detect the protein expression levels of MDM2, p53, Bcl-2, Bax, and cleared caspase-3 after HALI modeling; Measure the apoptosis rate of cells in each group. Results:After transcriptome sequencing,the p53 signaling pathway closely related to HALI. Compared with the normal group, the expression of MDM2 in the H 2O 2 injury group was lower ( P<0.05); Compared with the H 2O 2 injury group, overexpression of MDM2 resulted in a decrease in the apoptosis rate of MLE-12 cells ( P<0.05), a decrease in the expression levels of p53, Bax, and cleared caspase-3 proteins, and an upregulation of MDM2 and Bcl-2 protein expression ( P<0.05). Compared with the H 2O 2 injury group, when MDM2 was silenced, the cell apoptosis rate increased ( P<0.05), and the expression levels of p53, Bax, and cleared caspase-3 proteins were upregulated, while the expression levels of MDM2 and Bcl-2 proteins decreased ( P<0.05). Co-IP experiments showed that MDM2 binds to p53 protein. Conclusions:MDM2 can exert a protective effect on HALI by inhibiting MLE-12 cell apoptosis through the p53/Bcl-2/Bax axis.

BACKGROUND: Islet transplantation is currently considered the most promising method for treating insulin-dependent diabetes. The two most-studied artificial islets are alginate-encapsulated b cells or b cell spheroids. As three-dimensional (3D) models, both artificial islets have better insulin secretory functions and transplantation efficiencies than cells in twodimensional (2D) monolayer culture. However, the effects of these two methods have not been compared yet. Therefore, in this study, cells from the mouse islet b cell line Min6 were constructed as scaffold-free spheroids or alginate-encapsulated dispersed cells. METHODS: MIN6 cell spheroids were prepared by using Agarose-base microwell arrays. The insulin secretion level was determined by mouse insulin ELISA kit, and the gene and protein expression status of the MIN6 were performed by Quantitative polymerase chain reaction and immunoblot, respectively. RESULTS: Both 3D cultures effectively promoted the proliferation and glucose-stimulated insulin release (GSIS) of MIN6 cells compared to 2D adherent cells. Furthermore, 1% alginate-encapsulated MIN6 cells demonstrated more significant effects than the spheroids. In general, three pancreatic genes were expressed at higher levels in response to the 3D culture than to the 2D culture, and pancreatic/duodenal homeobox-1 (PDX1) expression was higher in the cells encapsulated in 1% alginate than that in the spheroids. A western blot analysis showed that 1% alginate-encapsulated MIN6 cells activated the phosphoinositide 3-kinase (PI3K)/serine/threonine protein kinase (AKT)/forkhead transcription factor FKHR (FoxO1) pathway more than the spheroids, 0.5% alginate-, or 2% alginate-encapsulated cells did. The 3D MIN6 culture, therefore, showed improved effects compared to the 2D culture, and the 1% alginate-encapsulated MIN6 cells exhibited better effects than the spheroids. The upregulation of PDX1 expression through the activation of the PI3K/AKT/FoxO1 pathway may mediate the improved cell proliferation and GSIS in 1% alginate-encapsulated MIN6 cells. CONCLUSION This study may contribute to the construction of in vitro culture systems for pancreatic islets to meet clinical requirements.

Objective:To study the expression and significance of neutrophil extracellular traps (NETs) in neonatal sepsis.Methods:Prospective research were used in this study. Term infants with neonatal sepsis hospitalized for the first time in the Department of Neonatology, Children's Hospital of Soochow University from June 2020 to November 2020 were selected as the sepsis group. According to a ratio of about 1∶1, term infants with mild hyperbilirubinemia who were admitted in the same period, with gestational age difference less than 1 week from those in the sepsis group, and whose parents agreed to participate in the study were selected as the control group. On admission, clinical data as well as blood samples of the two groups were collected. Levels of NETs marker citrulline histone H3-DNA (CitH3-DNA) were detected by Enzyme-linked immunosorbent assay, and circulating cell-free DNA (cfDNA) was tested by the fluorescence microplate reader. General data, white blood cell (WBC), neutrophil count (NE), platelet (PLT), C- reactive protein (CRP), blood culture, CitH3-DNA and cfDNA were compared between the two groups. The diagnostic value of CITH3-DNA and cfDNA in neonatal septicemia was analyzed by the receiver operating characteristic (ROC) curve.Results:A total of 74 infants were included in the study, including 39 cases in the sepsis group and 35 cases in the control group. CitH3-DNA and cfDNA in the sepsis group were significantly higher than those in the control group [CitH3-DNA (optical density): 0.85±0.05 vs. 0.48±0.03, cfDNA (mg/L): 0.90±0.05 vs. 0.56±0.03] ( P<0.01). There was no significant correlation between CitH3-DNA and cfDNA. The level of CitH3-DNA had no correlation with gender, gestational age, age, birth weight, WBC, NE, PLT and CRP ( P>0.05). cfDNA was positively correlated with age and NE ( P<0.05), and negatively correlated with PLT ( P<0.05). Combined with CRP, the area under the ROC curve of CitH3-DNA+CRP, cfDNA+CRP, and CitH3-DNA+cfDNA+CRP were 0.947, 0.947 and 0.970 respectively, and the sensitivity to predict neonatal sepsis were 92.3%, 84.6% and 94.9% respectively, the specificity were 94.3%, 97.1% and 100% respectively, all higher than the predictive value of each index alone. Conclusions:The plasma NETs levels increase significantly in neonatal sepsis patients, especially CitH3-DNA with a strong specificity, and can be considered as a biomarker for early diagnosis of neonatal sepsis. NETs together with CRP, could drastically improve the predictive value of neonatal sepsis.