This study was aimed at the transport across blood-brain barrier (BBB) of polysorbate-80 modified neurotoxin loaded polybutylcyanoacrylate nanoparticle (P-80-NT-NP) and its cytotoxicity. An in vitro model of BBB using rat brain microvascular endothelial cells (rBMECs) was established. The cytotoxicity of P-80-NT-NP was measured by the MTT assays, where neurotoxin (NT), nanoparticle (NP), neurotoxin nanoparticle (NT-NP) as control, and the permeability of P-80-NT-NP was determined by using of Millicell insert coculture with rBMECs and fluorescence spectrophotometry. MTT results showed that NT, NP, NT-NP and P-80-NT-NP were avirulent to rBMECs when the concentration of NT was lower than 200 ng x mL(-1). But the cytotoxicity of NP, NT-NP and P-80-NT-NP would be augmented accordingly as concentration increased (P < 0.01), causing obvious reductions of cell survival rate, with no significant difference between them (P > 0.05). When the concentration of NT was 150 ng x mL(-1), the permeability on rBMECs of P-80-NT-NP and NT-NP were both significantly higher than that of NT (P < 0.01), and the permeability of P-80-NT-NP was greater than that of NT-NP (P < 0.05). In conclusion, polysorbate-80 modified neurotoxin nanoparticles can transport across the BBB, while concentration of NT is greater than 200 ng x mL(-1), P-80-NT-NP has a little cytotoxicity against rBMECs.

Objective To explore the responses of antigen-specific T cells stimulated by hepatitis B virus(HBV)-specific proteins in chronic hepatitis B patients accepting antiviral therapy. Methods Seventeen patients with chronic hepatitis B (CHB) accepting antiviral therapy were included in this study. The peripheral blood monocular cell ( PBMC) were separated from the whole blood collected at the three different time of before and one and three months after accepting antiviral therapy. ELISPOT assay was used to detect the frequency and strength of secreting IFN-γ cells of PBMC stimulated by HBsAg, HBcAg and HBeAg. HBV virus loading, HBsAg, HBeAg, ALT and AST in serum were detected at the same time. Results After three months therapy, ALT, TBiL were improved in all patients, and HBV DNA level were dropped and undetectable in 11 cases. The rates of T cell response in patients to HBV specific proteins were 64. 7% , 76. 5% and 82. 4% at the time of before and one and three months after accepting antiviral therapy, respectively. The frequency of responses of antigen-specific T cells stimulated by HBcAg was higher than that stimulated by HBsAg or HBeAg, and the frequency was enhanced after antiviral therapy. The average response magnitude was expressed as spot forming cells (SFC) per million input cells. SFC of T cell responses to HBcAg was also higher than to HBsAg or HBeAg. There was no significant difference in SFC of T cell responses to HBsAg or HBeAg at the time of before and after antiviral therapy, but there were significant difference in SFC of T cell responses to HBcAg at the time of before and after antiviral therapy. SFC of T cell responses to HBcAg was negatively associated with HBV DNA, and no associated with level of ALT in serum. Conclusion The responses of antigen-specific T cells were improved in CHB patients accepting antiviral therapy which associated with the decrease of HBV DNA. It suggested to investigate HBV specific T cell responses was important.

OBJECTIVEInvestigate the best surgical resection of esophageal cancer by comparing the efficacy and safety between Ivor-Lewis esophagectomy and Sweet esophagectomy.

METHODSThe relevant literatures comparing Ivor-Lewis esophagectomy with Sweet esophagectomy were searched through PubMed, Embase, the Cochrane Library, Google scholar, CNKI, CBM, VIP, WanFang Data. RevMan 5.2 software was used for data analysis.

RESULTSA total of 4106 patients in 15 studies were reviewed and the data were pooled for analysis. Meta-analysis showed that, compared with the Sweet group, Ivor-Lewis operative time was significantly longer(pooled mean difference=57.40; 95%CI:42.43 to 72.38; P=0.000), operative bleeding was significantly higher(pooled mean difference=28.39, 95%CI:4.06 to 52.72, P=0.02); the number of lymph node dissection significantly more(pooled mean difference=4.19, 95%CI:3.06 to 5.32, P=0.000); No significant difference was present in hospital stay, vocal cord paralysis, chylous leakage, pulmonary complications, anastomotic leakage(all P>0.05). The 5-year survival between the two groups showed no significant difference(P=0.52).

CONCLUSIONSThe two kinds of operation have the same long term effect. Compared with Ivor-Lewis operation, Sweet operation is easier to perform, less time consuming and more tolerable. Ivor-Lewis operation can dissect more lymph nodes than Sweet operation, without increased complications.

Purpose/Significance To strengthen the management of scientific and technical novelty search of traditional Chinese med-icine(TCM),and to standardize the work of novelty search.Method/Process The process of"Specification for Scientific and Technical Novelty Search of Traditional Chinese Medicine"standard formulation is expounded in detail,and the key points of the standard and its application in science and technology novelty management system are analyzed.Result/Conclusion The standard can better guide the scientific and technical novelty search institutions,standardize the writing of scientific and technical novelty search reports,improve the quality of scientific and technical novelty search reports,and help promote the healthy development of scientific and technical novelty search of TCM.The scientific and technical novelty management system based on the standard improves the efficiency of novelty search.

Objective Investigate the best surgical resection of esophageal cancer by comparing the efficacy and safety between Ivor-Lewis esophagectomy and Sweet esophagectomy. Methods The relevant literatures comparing Ivor-Lewis esophagectomy with Sweet esophagectomy were searched through PubMed, Embase, the Cochrane Library, Google scholar, CNKI, CBM, VIP, WanFang Data. RevMan 5.2 software was used for data analysis. Results A total of 4106 patients in 15 studies were reviewed and the data were pooled for analysis. Meta-analysis showed that, compared with the Sweet group, Ivor-Lewis operative time was significantly longer (pooled mean difference=57.40; 95%CI:42.43 to 72.38;P=0.000), operative bleeding was significantly higher (pooled mean difference=28.39, 95%CI:4.06 to 52.72, P=0.02); the number of lymph node dissection significantly more (pooled mean difference=4.19, 95%CI:3.06 to 5.32, P=0.000); No significant difference was present in hospital stay, vocal cord paralysis, chylous leakage, pulmonary complications, anastomotic leakage (all P>0.05). The 5-year survival between the two groups showed no significant difference (P =0.52). Conclutions The two kinds of operation have the same long term effect. Compared with Ivor-Lewis operation, Sweet operation is easier to perform, less time consuming and more tolerable. Ivor-Lewis operation can dissect more lymph nodes than Sweet operation , without increased complications.

Objective Investigate the best surgical resection of esophageal cancer by comparing the efficacy and safety between Ivor-Lewis esophagectomy and Sweet esophagectomy. Methods The relevant literatures comparing Ivor-Lewis esophagectomy with Sweet esophagectomy were searched through PubMed, Embase, the Cochrane Library, Google scholar, CNKI, CBM, VIP, WanFang Data. RevMan 5.2 software was used for data analysis. Results A total of 4106 patients in 15 studies were reviewed and the data were pooled for analysis. Meta-analysis showed that, compared with the Sweet group, Ivor-Lewis operative time was significantly longer (pooled mean difference=57.40; 95%CI:42.43 to 72.38;P=0.000), operative bleeding was significantly higher (pooled mean difference=28.39, 95%CI:4.06 to 52.72, P=0.02); the number of lymph node dissection significantly more (pooled mean difference=4.19, 95%CI:3.06 to 5.32, P=0.000); No significant difference was present in hospital stay, vocal cord paralysis, chylous leakage, pulmonary complications, anastomotic leakage (all P>0.05). The 5-year survival between the two groups showed no significant difference (P =0.52). Conclutions The two kinds of operation have the same long term effect. Compared with Ivor-Lewis operation, Sweet operation is easier to perform, less time consuming and more tolerable. Ivor-Lewis operation can dissect more lymph nodes than Sweet operation , without increased complications.

Objective    To explore the therapeutic effect and safety of irreversible electroporation (IRE) ablation technique on esophageal cancer. Methods    An ECM830 electroporator was used for IRE treatment on esophageal cancer cells EC109 and KYSE30. According to the different electric field intensity, five groups were assigned: a control group, a 500 V/cm group, a 1 000 V/cm group, a 1 500 V/cm group, and a 2 000 V/cm group. After 24 h, methyl thiazolyltetrazolium (MTT) was used to detect the cell proliferation of each group. Western blotting was performed to evaluate the expression of apoptosis proteins in cells before or after IRE treatment. Eight healthy BALB/c nude mice were equally divided into two groups: a control group (n=4) and an IRE group (n=4). EC109 was used to establish subcutaneous transplantation tumors and subsequently the mice in the IRE group were treated with flat electrode. The weight and volume of tumors were measured after 14 days. Ten healthy New Zealand white rabbits were equally divided into two groups: a control group (n=5) and an IRE group (n=5). After exposing the abdominal cavity, the abdominal esophagus of the IRE group was treated with flat electrode. Seven days later, the esophagus was extracted for HE and Masson staining. Results    When the electric field intensity was low (500 V/cm), there was no change in esophageal cancer cells proliferation after IRE treatment compared to the control group (EC109: P=0.385, KYSE30: P=0.600). With the increase of electric field intensity, the influence of IRE on the proliferation of esophageal cancer cell gradually increased. When it reached 2 000 V/cm, there was basically no cell viability after IRE treatment (P<0.001). The results of Western blotting showed that the expression of cleaved caspase-3 increased after IRE treatment (P<0.01). Animal experiments indicated that the weight and volume of tumors in nude mice reduced (P<0.05) and the growth of tumors was slowed down after IRE treatment. In addition, the parenchymal cells of rabbit esophagus were largely damaged, while interstitial tissues such as fibers were well preserved. Conclusion    IRE ablation has the potential to inhibit the proliferation of esophageal cancer cell and slow down the tumor growth.What’s more, it is safe for the esophagus.

In order to further strengthen the training and management of clinical teachers, broaden the career development channels of clinical teachers, and truly stimulate their teaching enthusiasm and initiative, this study further classifies clinical teachers according to the principle of the Snell model, focuses on the training of educational clinicians, and explores the training mechanism of teaching talents in line with the actual development needs of hospitals affiliated to universities from the aspects of selection, training, incentive, and assessment. The results of practice show that related practices have a good effect, and the mean number of teaching achievements was 1.98 for the 56 educational physicians, which was 3.9 times that for non-educational physicians. The per capita teaching achievements of educational physicians tended to increase every year compared with those of non-educational physicians. The training path for educational physicians provides useful experience for the construction of clinical teaching team and the high-quality development of education and teaching, and at the same time, it is necessary to further strengthen the dynamic adjustment of talent echelon, the improvement of operating mechanism, and the introduction of new technology.

Objective:To evaluate the enrollment rate, mutation rate and causes of variability the clinical pathway of bronchopneumonia.Methods:The enrollment rate, completion rate, variation and reasons of the clinical pathway in Beijing Children′s Hospital, Capital Medical University from January 2012 to December 2016 were retrospectively collected.Data of patients after the clinical pathway of bronchopneumonia in other tertiary class A hospitals were gathered by questionnaires, and the enrollment rate, completion rate, variation rate and reasons were analyzed.Results:(1)At the end of 2016, 11 of the 13 hospitals included in this study had implemented the clinical pathway for 5 years, 1 hospital for 3 years, and 1 hospital for 2 years.(2) Eleven hospitals provided their enrollment rates.The enrollement rate of 2 hospitals was<50%, and that of 9 hospitals was>80%.The annual completion rate of Beijing Children′s Hospital was ≥75%, and the completion rates offered by 8 hospitals were basically >70%.(3) Since the implementation of the clinical pathway for 5 years in Beijing Children′s Hospital, a total of 427 cases were enrolled of which 93 cases were mutated (variability 21.78%). The variability of 5 hospitals was maintained at <15%.The variability of 3 hospitals decreased with the implementation years, and became qualified.The variability of 1 hospital first rebounded and then controlled; 1 hospital increased by 27.65%; 1 hospital was first controlled and rebounded; 1 hospital was always >15%.The main cause of the mutation was coexisting diseases, complications, progression of the disease, or correction of the first diagnosis, etc.Conclusions:The completion rate of tertiary class A hospitals meets the requirements of national policy.However, the enrollment rate needs to be improved, and the variation rate among different hospitals differs a lot.Further implementation of the clinical pathway should be strengthened and monitored.

OBJECTIVE To explore the renal protective mechanism of Shenbining granules on IgA nephropathy （IgAN） rats based on mitochondrial quality control system. METHODS IgAN rat model was established by the method of “bovine serum albumin+carbon tetrachloride+lipopolysaccharide”. The model rats were randomly divided into model group， prednisone acetate group （6.25 mg/kg）， Shenbining equal-dose group （4.1 g/kg） and Shenbining high-dose group （20.5 g/kg）. The normal rats were taken as the normal control group， with 12 rats in each group. Rats were given corresponding drugs or distilled water intragastrically in each group， once a day， for 4 consecutive weeks. After the last medication， the 24 h total urinary protein （24 h- UTP） and erythrocyte count in urine were determined， and the levels of serum creatinine （Scr）， blood urea nitrogen （BUN）， albumin （ALB） and alanine transaminase （ALT） were also detected. The histopathological changes in the kidneys and changes in IgA deposition in the mesangial area of the kidney were observed. mRNA and protein expression levels of PTEN-induced putative kinase 1 （PINK1）， E3 ubiquitin ligase（Parkin）， microtubule-associated protein 1 light chain-3 （LC3）， dynamin-related protein 1 （Drp1） and mitofusin 2 （Mfn2） were detected in the kidney tissues of rats. RESULTS Compared with model group， 24 h-UTP， urinary erythrocyte count， ALT， BUN and Scr levels， LC3-Ⅱ/LC3-Ⅰ mRNA ratio， mRNA and protein expressions of Drp1 were reduced significantly in prednisone acetate group， Shenbining equal-dose group and Shenbining high-dose group （P＜0.05）； ALB level， LC3-Ⅱ/LC3-Ⅰ protein ratio， mRNA and protein expressions of PINK1， Parkin and Mfn2 were increased significantly （P＜0.05）； the pathological morphology of kidney tissue in rats was significantly improved， and IgA deposition was significantly reduced. CONCLUSIONS Shenbining granule may reduce renal pathological injury in IgAN rats and protect renal function by activating the PINK1/Parkin pathway， enhancing mitochondrial autophagy， and correcting mitochondrial kinetic disorders.