Objective To study the inhibitory effect of Huidu Yinhua powder from the Orthodox Manual of External Medicine on methicillin-resistant Staphylococcus aureus(MRSA),virulence factor α-hemolysin(Hla)activity,and biofilm formation,and to explore the optimal ratios of Huidu Yinhua powder and provide experimental support for its use.Methods The inhibitory effects of Huidu Yinhua powder and the herbs in the formula on USA300 were analyzed by the minimum inhibitory concentration(MIC),minimum bactericidal concentration(MBC),and disk diffusion assay(K-B method).Hemolysis,neutralization,oligomerization,and Western blot assays were used to verify in which form the drug inhibits the activity of virulence factor α-hemolysin(Hla).A biofilm assay was performed to evaluate the inhibitory effect of Huidu Yinhua powder on biofilm.Orthogonal experiments were performed to explore the optimal ratio of Huidu Yinhua powder.Results Huidu Yinhua powder inhibited the MRSA strain with a MIC90 of 64 mg/mL and an MBC of 256 mg/mL with antibacterial circle diameter of(7.50±0.50)mm.Huidu Yinhua powder inhibited Hla activity by inhibiting Hla secretion.The minimum effective concentration(MEC)was 16 mg/mL,and the MEC of biofilm was 8 mg/mL.In Huidu Yinhua powder,honeysuckle and astragalus only affected the hemolytic activity of MRSA and biofilm formation without inhibiting bacterial growth.The hemolytic activity and biofilm of MEC were both 32 mg/mL.Glycyrrhiza had a strong bacterial inhibitory capacity with a MIC90 of 8 mg/mL and biofilm MEC of 1 mg/mL without showing inhibitory hemolytic activity at subinhibitory concentrations.The orthogonal experiment showed that,at a ratio of honeysuckle,astragalus,and glycyrrhiza in Huidu Yinhua powder of 1∶2∶4,the MIC90 was 16 mg/mL,MEC of hemolytic activity was 8 mg/mL and that of biofilm was 4 mg/mL,both of which were the lowest among the nine groups.Conclusions Huidu Yinhua powder affects the hemolytic activity and biofilm formation of MRSA at subinhibitory concentrations with the optimal ratio of honeysuckle,astragalus,and glycyrrhiza being 1∶2∶4.

Objective To explore the mechanisms associated with symptom burden and depression in hepatocellular carcinoma patients after hepatectomy. Methods A total of 230 hospitalized patients with hepatocellular carcinoma who were underwent hepatectomy for the first time were selected as study subjects. A self-administered General Information Questionnaire, MD Anderson Symptom Inventory, Patient Health Questionnaire, Connor-Davidson Resilience Scale, and Pittsburgh Sleep Quality Index were used to investigate sociodemographic, sociodemographic data, symptom burden, depression, psychological resilience, and sleep quality of postoperative hepatocellular carcinoma patients. Pearson correlation analysis was used to identify specific associations among variables. The mediating and moderating effects of psychological resilience and sleep quality between symptom burden and depression were analyzed using the Process. Results Psychological resilience partially mediated the association between symptom burden and depression (β=-0.137, SE=0.084, 95%CI, -0.243 to -0.082), with the mediating effect accounting for 44.08% of the total effect, and the interaction term between symptom burden and sleep quality had predictive value for psychological resilience (β=-0.014, t=-6.209, P < 0.001). Conclusion Postoperative symptom burden in hepatocellular carcinoma patients can play a role in depression through psychological resilience, where the effect of symptom burden on psychological resilience is moderated by sleep quality. Clinical staff should take reducing patients'postoperative symptom burden and improving psychological elasticity with sleep quality as important goals and develop appropriate nursing interventions to reduce the risk of depression in patients.

Epidermal growth factor receptor 2 (HER2) is an oncogene involved in tumour genesis and progression. It is expressed in 7% of patients with colorectal cancer (CRC) and is associated with drug resistance of epidermal growth factor receptor monoclonal antibodies. With the emergence of the therapeutic dilemma of CRC and the survival benefits of targeting HER2 for patients with breast cancer and gastric cancer, the significance of HER2 in CRC and the prognostic value of anti-HER2 therapy have been widely concerned, clinical researches on HER2-positive CRC have been continuously carried out. Currently, the diagnostic criteria for HER2 positive CRC have gradually been unified. HER2-targeting therapies such as monoclonal antibodies, tyrosine kinase inhibitors, antibody-drug coupling and HER2-related immunotherapy alone or in combination have shown good efficacy and brought significant survival benefits for HER2 positive CRC. This paper reviews the research progress of HER2 in CRC.

Objective:To analyze the clinical features, treatment, and outcomes of fetal/neonatal atrial flutter (AFL) at the onset of the perinatal period to improve the management of this condition.Methods:This retrospective study analyzed the clinical data, treatment, and follow-up results of fetal/neonatal AFL cases transferred to Shanghai Children's Medical Center from November 2013 to August 2021. Clinical characteristics, cardioversion procedures, and outcomes were summarized. Descriptive method was used for statistical analysis.Results:A total of 21 fetuses/neonates presenting with AFL in the perinatal period were involved in this study, including 17 males and four females. Ten of them were born at full term, and 11 were preterms. All of the patients were delivered by cesarean section at 32 to 41 gestational weeks [ (36.6±1.9) weeks] with a birth weight of 2 130 to 4 450g [ (3 059±528) g]. Increased fetal heart rate was all detected after 32 weeks of gestation, and three of them were diagnosed with AFL by fetal echocardiography before being born. The heart rate remained elevated in all cases after birth. All were diagnosed as AFL based on an electrocardiogram on the day of birth, which showed a 2 to 6 over one ratio of atrioventricular conduction. Among the six cases of cardiac insufficiency and low blood pressure complicated by dyspnea and cyanosis, the symptoms were relieved in four cases after mask oxygenation and two cases after ventilation. Among the 21 cases, one was converted spontaneously to normal sinus rhythm and the other 20 recovered after medication or electrical cardioversion. Seven cases were initially treated by drug conversion with a success rate of 5/7 and hospitalized for 23 d (13-25 d). There was one with cardiac insufficiency before treatment and three newly developed cardiac insufficiency during treatment among the seven cases. Thirteen cases were offered electrical cardioversion initially, and the success rate of cardioversion was 12/13. There were five cases of cardiac insufficiency before treatment, while no new cases of cardiac insufficiency was reported during treatment. The duration of hospitalization was 11 d (9-14 d). Apart from one case, the rest 20 infants were followed up from one month to eight years old, and no recurrence was reported.Conclusions:For fetal/neonatal AFL with the onset during the perinatal period, the symptoms mainly manifest in late pregnancy. Its diagnosis depends on fetal echocardiography before birth or electrocardiogram after birth, and electrical cardioversion is a fast and effective measure. While the prognosis of perinatal-onset AFL is generally good.

Background::Many studies have emphasized that selective resection of epileptic lesions in temoral lobe is associated with better preservation of cognition function; whether this applies to patients with refractory mesial temporal lobe epilepsy (MTLE) remains unknown. The objective of this study was to evaluate changes in cognitive functions, mood status, and quality of life after anterior temporal lobectomy in patients with refractory MTLE.Methods::This single-arm cohort study assessed cognitive function, mood status, and quality of life, as well as electroencephalography findings, in patients with refractory MTLE who underwent anterior temporal lobectomy at Xuanwu Hospital from January 2018 to March 2019. Pre- and post-operative characteristics were compared to evaluate the effects of surgery.Results::Anterior temporal lobectomy significantly reduced the frequencies of epileptiform discharges. The overall success rate of surgery was acceptable. Anterior temporal lobectomy did not result in significant changes in overall cognitive functions (P > 0.05), although changes in certain domains, including visuospatial ability, executive ability, and abstract thinking, were detected. Anterior temporal lobectomy resulted in improvements in anxiety and depression symptoms and quality of life. Conclusions::Anterior temporal lobectomy reduced epileptiform discharges and incidence of post-operative seizures as well as resulted in improved mood status and quality of life without causing significant changes in cognitive function.

OBJECTIVE：To provide evidence for promoting the scientific resea rch ability and talent team construction of hospital pharmacists. METHODS ：From Dec. 2019 to Apr. 2020，“Survey Form for Scientific Research Ability of Hospital Pharmacists”were issued to pharmacists in 62 medical institutions from 20 provinces across the country. The questionnaire was mainly based on five aspects ，i.e. general information of surveyed pharmacists ，the number of internal/external funds and patents approved in recent five years （2015-2019），the number of papers published in domestic/abroad/SCI journals ，the familiarity with scientific research projects ，the difficulties in carrying out scientific research. The collected data were summarized and analyzed with R 4.0.3 software. RESULTS ：A total of 300 questionnaires were sent out ，and 288 valid questionnaires were collected with effective recovery rate of 96％. Among surveyed pharmacists ，94 were male and 194 were female. The majority of them were 31-39 years old （52.78％）；56.25％，28.12％ and 15.63％ of them had bachelor ’s degree ，master’s degree and doctor ’s degree respectively，and 156（54.17％）had intermediate title. Totally 74.66％ of hospital pharmacists thought it was very necessary or necessary to carry out research projects （involving all doctors ，26 masters and 4 bachelors）. There were significant differences among pharmacists with different educational background in respects of the number of applications for internal and external funds and patents ，as well as the number of papers published in domestic/foreign/SCI journals ，and most of them were doctors （P＜ 0.05）. In recent five years ，most of hospital pharmacists had published 1-3 papers in domestic journals ，accounting for 44.80％， while 27.08％ had published papers in SCI journals. Totally 51.39％ of hospital pharmacists were not familiar or not very familiar with scientific research projects funding （most of them had bachelor ’s degree ）；52.43％ expressed that experimental conditions were the biggest difficulty in conducting scientific research. CONCLUSIONS：This survey shows that hospital pharmacists have a relatively positive attitude towards scientific researchprojects. Most of papers are published in domestic journals. 8804919。E-mail：songjc1234@126.com However， there are still many shortcomings in scientific research status. Scientific research capabilities need to be improved. Experimental conditions also limit the scientific research projects to a certain extent. Hospitals need to strengthen funding for pharmacist research projects ，strengthen academic exchanges ， so that pharmacists can understand scientific research projects more comprehensively and systematically.

Objective:To explore the clinical utility of liquid chromatography tandem mass spectrometry forprimary aldosteronism screening.Methods:From January to October 2019, 413 inpatients diagnosed hypertension from Fuwai Hospital of Chinese Academy of Medical Sciences were enrolled, including 60 Primary aldosteronism(PA)patients and 353 primary hypertension patients. The plasma aldosterone concentration (PAC) and renin concentration (DRC) were measured after 2 h of standing. The 24 h urine samples were collected for measurement of aldosterone using LC-MS/MS. The performance of urine aldosterone and urine aldosterone/renin ratio (UADRR) in PA screening was evaluated by ROC, and compared with PAC/DRC ratio (ADRR). Meanwhile, the efficiency of urine aldosterone in elderly patients or patients with low blood potassium or 24 h urine sodium over 200 mmol was investigated.Results:Area under the curve (AUC)of urine aldosterone was 0.725 (95 %CI 0.679-0.767), and the best cut-off was 7.13 μg/24 h, which was lower than AUC of ADRR (0.958, 95 %CI 0.934-0.975). The AUC of UADRR was 0.947 (95 %CI 0.920-0.966), the best cut-off was 1.11 (μg/24 h)/(μIU/ml), the sensitivity and specificity were 91.7% and 89.0%, respectively. There is no significant differences found with ADRR. In patients with 24 h urine sodium over 200 mmol, AUC of aldosterone was 0.834 (95 %CI 0.730-0.910) and the best cut-off was 9.31 μg/24 h. The sensitivity and specificity were 90.9% and 68.7%, respectively. For the elderly patients over 60 years old, the AUC of urinary aldosterone was 0.860 (95 %CI 0.770-0.925), and the best cut-off was 6.91 μg/24 h. The sensitivity and specificity were 84.6% and 81.3%, respectively. When admission blood potassium was less than 3.50 mmol/L, AUC of urinary aldosterone was 0.822 (95 %CI 0.684-0.917), and the best cut-off was 10.63 μg/24 h. The sensitivity and specificity were 85.7% and 66.7%, respectively. Conclusion:The detection of aldosterone in urine by LC-MS/MS can provide clinical information for PA screening, and the screening performance is better in patients with 24-hour urine sodium over 200 mmol, elderly patients or patients with low blood potassium. If combined with renin, screening efficiency was the same as that in ADRR.

Objective: To investigate the role of exosome (EXO) transporting Let-7a to regulate MYC gene in the malignant biological behaviors of triple negative breast cancer (TNBC) cell, and to explore the underlying mechanism. Methods: After the completion of cell culture, the gene and protein expressions of MYC and Let-7a in TNBC MDA-MB-231cells were detected by qPCR and WB, respectively. Recombinant lenti-virus vector carrying Let-7a and Crisper/Cas-9 system with MYC knockdown were transfected into MDA-MB-231 cells; MTT assay, Transwell assay and Scratch healing assay were performed to examine the proliferation, invasion and migration of MDA-MB-231 cells. Luciferase activity assay was performed to validate the binding between MYC and Let-7a. EXO was isolated and identified by transmission electron microscopy and WB assay in wild-type and Let-7a over-expressed MDA-MB-231 cells, respectively. After co-incubation of two types of EXO and MDA-MB-231 cells, the effects of Let-7a on biological behaviors of MDAMB-231 cells via EXO were detected by qPCR, WB, MTT and Transwell etc. Results: Let-7a was negatively correlated with MYC in breast cancer tissues and cell lines (all P<0.05); MYC promoted while Let-7a inhibited the proliferation, migration and invasion of breast cancer cells (all P<0.01); Let-7a silenced MYC by acting on 3'UTR of MYC gene, thereby reducing the expression of MYC protein (P<0.05); Let-7a was enveloped by EXO and transported to cancer cells, there by inhibiting the proliferation, migration and invasion of MDA-MB-231 cells. Conclusion: EXO some mediated Let-7a silences MYC gene by acting on its 3'UTR region, thus inhibiting the proliferation, migration and invasion of MDA-MB-231 cells.

Objective To explore the feasibility and safety of radiofrequency ablation for difficult access liver cancer under percutaneous local anesthesia combined with contrast-enhanced ultrasonography.Methods 45 patients(62 lesions) in the experimental group were treated by percutaneous,local anesthesia combined with contrast-enhanced ultrasound and in some cases with artificial ascites assisted by radiofrequency ablation vs control group of 40 patients (54 lesions) receiving radiofrequency ablation guided by CT or ultrasound through laparoscopy or open surgery.The complications,and postoperative residual and recurrence rates were compared between the two groups.Results Of the all patients,4 cases suffered from severe complications.The pain scores and the blood loss were less significant in the experimental group.There was no significant difference in tumor residual rate between the two groups when evaluated on one month after the procedures,and in the recurrence rate after three and six months.Conclusion Radiofrequency ablation for difficult liver cancer by percutaneous local anesthesia combined with contrastenhanced ultrasonography is less traumatic and less of complications compared to traditional method with a similar tumor residual rate and recurrence rate.

Objective To explore the effect of postoperative rehabilitation nursing for hypertensive intracerebral hemorrhage treated by minimally invasive hematoma evacuation.Methods A total of 100 cases with hypertensive intracerebral hemorrhage treated by minimally invasive hematoma evacuation were randomly divided into two groups.Patients in the control group were given routine nursing,while the experimental group applied rehabilitation care.Hematoma removal,deterioration rate and mortality,related score of disease and rehabilitation before and after intervention,the incidence of related clinical adverse events and family nursing satisfaction were compared.Results The 3 d hematoma clearance rate and overall hematoma clearance rate of the experimental group were significantly higher than that of the control group (P ＜ 0.05).The scores of GSS and AS were significantly higher,and the scores of SSS,FM and ADL were significantly lower than that of the control group(P ＜ 0.05).The incidence of overall adverse events was significantly lower,and nursing satisfaction were significantly higher than that in the control group (P ＜ 0.01).Conclusion Effect of postoperative rehabilitation nursing for patients with hypertensive intracerebral hemorrhage treated by minimally invasive hematoma is significant,and it can improve satisfaction of family members.