Exosomes are extracellular nanoparticles secreted by multiple types of cells,which are enriched for some bioactive molecules,such as proteins,messcge RNA(mRNA),micro RNA(miRNA), DNA and lipid. These molecules are documented to be involved in the process of intercellular material exchange and signal communication,thus affecting the function of cells. Also,exosomes are considered to participate in tumor angiogenesis,cancer progression and metastasis,but the mechanism remains obscure. Exosomes are of great value for the diagnosis and treatment of tumor. The correlations between exosomes and tumorigenesis and tumor metastasis as well as their clinical applications are summarized in this review.

Objective To investigate the clinical treatment strategy of concomitant diseases and perioperation complications in elderly patients with hip fracture aged ≥ 80 years and the clinical prognosis.Methods A retrospective analysis was conducted in 95 hip fracture patients aged 80 and over years(80～90 years old) undergoing operation.There were 42 cases with femoral neck fractures and 53 cases with intertrochanteric fracture.71 cases (74.7％) had preoperative concomitant medical diseases.Screw fixation was performed in 3 cases (3.2％),hemiarthroplasty in 75 cases (78.9％),total hip replacement in 4 cases (4.2％),proximal femoral nail antirotation (PFNA) in 9 cases (9.5 ％) and reconstruction interlocking nail fixation in 4 cases (4.2 ％).Results No mortality was found during hospitalization.Postoperative anemia was the most common (74.7％),followed by hypoproteinemia (68.4％),digestive disorders (30.5％),electrolyte disturbance (28.4％) and psychiatric symptoms (15.8 ％).At least one-year follow-up was made in 73 cases.39 cases (53.4 ％) acquired independent activities after surgery,48 (65.8％) patients recovered to the preoperative level of activity.The concomitant diseases before surgery (OR =0.23,P =0.011),preoperative ability of activity (OR=0.23,P=0.025),the American Society of Anesthesiology (ASA) classification (OR=0.19,P=0.025) were the related factors influencing the one-year mortality.Conclusions The treatment of concomitant diseases should be emphasized in treating fracture.The active prevention during preoperative,intraoperative,postoperative period could reduce or avoid fatal complications and acquire good functions.

Objective To investigate the risk factors for hemorrhagic transformation (HT) and poor outcomes in patients with acute ischemic stroke after mechanical thrombectomy.Methods The patients with acute ischemic stroke received mechanical thrombectomy were enrolled retrospectively.The demography,vascular risk factors and other clinical data of the patents were collected.The modified Rankin scale (mRS) was used to evaluate the clinical outcomes at day 90.Good outcome was defined as mRS score 0-2.The patients were divided into either a HT group or a non-HT group according to their HT conditions.Multivariate logistic regression analysis was used to identify the independent risk factors for HT and poor outcomes.Results A total of 48 patients with acute ischemic stroke received mechanical thrombectomy were enrolled,including 25 males (52.1％).Their mean age was 64.77± 9.14 years.The mean National Institutes of Health Stroke Scale (NIHSS) score was 17.70 ± 3.77.Twenty-two patients (45.8％) occured HT,of which 9 were symptomatic HT;24 (50.0％) had good outcomes.The proportion of males in the HT group was significantly lower than that in the non-HT goup (30.4％vs.72.0％;x2 =8.293,P =0.004),while the proportions in patients with diabetes (65.2％ vs.36.0％;x2 =4.090,P =0.043) and atrial fibrillation (78.3％ vs.44.0％;x2 =5.880,P =0.015),as well as the baseline fasting blood glucose level (8.514 ± 4.400 mmol/L vs.6.354 ± 1.472 mmol/L;t =2.319,P =0.025) were significantly higher than those in the non-HT group.Multivariate logistic regression analysis showed that the atrial fibrillation (odds ratio [OR] 6.136,95％ confidence interval [CI] 1.617-23.291;P =0.042) was a risk factor for the occurrence of HT after mechanical thrombectomy.The proportion of diabetic patients (29.2％ vs.70.8％;x2 =8.333,P=0.04) and baseline NIHSS score (16.050±4.865 vs.19.210±4.423);t=2.310,P=0.026) of the good outcome group were significantly lower than those of the poor outcome group,while the proportions of patients in atrial fibrillation (75.0％ vs.45.8％;x2 =4.269,P =0.039),anterior circulation stroke (87.5％ vs.62.5％;x2 =4.000,P =0.046) middle cerebral artery (75.0％ vs.29.2％;x2 =10.113,P =0.006),vertebral basilar artery (37.5％ vs.12.5％;x2 =10.113,P =0.006) occlusion and parenchymal hematoma (33.3％ vs.4.1％;P=0.011) were significantly higher than the poor outcome group.Multivariate logistic regression analysis showed that diabetes (OR 5.898,95％ CI 1.699-20.479;P=0.005),baseline NIHSS score (OR 1.167,95％ CI 1.011-1.347;P =0.035),and parenchymal hematoma (OR 1.295,95％ CI 1.099-1.875;P=0.028) were the independent risk factors for poor outcomes.Conclusions Atrial fibrillation is an independent predictor of HT risk in patients with acute ischemic stroke after mechanical thrombectomy.Diabetes mellitus,higher baseline NIHSS score,and concurrent brain parenchymal hematoma are the independent predictors of poor outcomes.Therefore,the risk of HT and adverse outcomes should be fully assessed before mechanical thrombectomy in patients with acute ischemic stroke.

Objective To explore the relationship between the expression of transcription factor ⅡB-related factor 1 (Brf1) and the prognosis of non-small cell lung cancer (NSCLC).Methods Collected 96 cases of NSCLC Surgical specimens and clinical data of patients from January 2013 to August 2015 in our hospital.First of all,we compared the expression of Brf1 in NSCLC tissues and adjacent lung tissues by Western blot and RT-qPCR.Then,Immunohistochemistry was used to detect the expression of Brf1 in NSCLC tissues,and analysis of the relationship between Brf1 expression level and clinical case characteristics.Survival curves were plotted using the Kaplan-Meier method and Log-rank test and multivariate Coxv regression analysis were performed.Results Western blot and RT-qPCR results showed that the expression of Brf1 in NSCLC tissues was significantly higher than that in adjacent lung tissues (P ＜0.01).The positive expression rate of Brf1 in 96 cases of NSCLC was 72.9％.The Brf1 expression level was higher in the poorly differentiated group than in the moderately-highly differentiated group(Mean Rank 62.33 ＞ 43.89,Z =-2.914,P =0.004),and the lymph node metastasis group was higher than the non-metastasis group(Mean Rank 60.34 ＞ 42.58,Z =-3.055,P =0.002),which was independent of patient gender,age,smoking status,tumor size,TNM stage,and pathological type (P ＞0.05).Single-factor survival analysis by Log-rank test showed that the survival rate of Brf1 positive expression group was lower than that of the negative group (x2 =7.560,P ＜0.01).Multivariate analysis of Cox regression model found that Brf1 positive expression (HR =2.043,95％ CI:1.082-3.860) was an independent observational index that affects the prognosis of patients with NSCLC.Conclusion Brf1 is overexpressed in NSCLC tissues,and Brf1 negative expression has a good clinical prognosis,suggesting that Brf1 may be one of the indicators of malignant degree and prognosis of NSCLC.

Objective: To investigate the contamination levels and dietary intakes of seven mycotoxins in Chinese diets. Methods: In Chinese Total Diet Study, food aggregation was based on the food consumption of local residents, thus generating the sampling scheme. According to the sampling scheme, the food items were sampled at three survey points in each province and then mixed in the same proportion. The mixed dietary samples were prepared after being cooked and processed. The samples comprised of 13 categories of food: cereals, beans, potatoes, meat, eggs, aquatic products, milk, vegetables, fruits, saccharides, beverages and drinking water, alcohol, and condiments. Condiments were used in cooking, so there were in total 12 varieties of samples for determination. Altogether, the study included 240 mixed dietary samples from 20 provinces with 12 varieties. The contamination levels of the seven mycotoxins, including sterigmatocystin (SMC), citrinin (CIT), cyclopiazonic acid (CPA), moniliformin (MON), gliotoxin (GLIO), mycophenolateacid (MPA) and verruculogen (Verru), were analyzed by UPLC-MS/MS method, and dietary intakes of residents were estimated as well. Results: Among the detected seven mycotoxins, MPA,GLIO and Verru were not detected. The content range of CPA in beans was 0.47-1.57 μg/kg and in alcohol was 0.19-2.26 μg/kg, and the detection rate of CPA was 7.1% (17/240). The content of SMC in aquatic products of Guangxi, in saccharides of Beijing, and in beverages of Liaoning was 2.88 μg/kg, 0.01 μg/kg, and 0.53 μg/kg, respectively. The content range of SMC in aquatic products was 0.70-1.76 μg/kg, and the detection rate was 2.9% (7/240). In addition, the content of CIT in fruit of Sichuan was 5.31 μg/kg, and the content of MON in milk of Jilin was 3.60 μg/kg. According to the dietary exposure analysis, the exposure levels of the seven mycotoxins in China's general population were low. MPA, GLIO and Verru were not detected, and the exposure range of the other four mycotoxins were 0.000-8.132 (CIT), 0.000-27.448 (SMC), 0.000-3.026 (CPA), and 0.000-62.847 ng·kg^-1·d^-1 (MON), respectively. Conclusion In the detected seven mycotoxins, CPA, SMC, CIT and MON were detected only in the individual diet in some areas with a low dietary exposure level. However, the contamination level of CPA in alcohol merits attention.

Objective To explore the clinical value of micro ribonucleic acid(miR)-27a and miR-1299 in predicting the long-term prognosis of patients with esophageal cancer.Methods A total of 89 patients with esophageal cancer in the hospital were enrolled between June 2020 and June 2022,and all underwent Minimally invasive thoracic and laparoscopic resection of esophageal cancer.The expression levels of miR-27a and miR-1299 were detected by real-time fluorescence quantitative polymerase chain reaction(PCR)before surgery,and level of serum ferritin(SF)was detected by enzyme linked immunosorbent assay.The relationship between miR-27a,miR-1299,SF and clinicopathology in patients with esophageal cancer was analyzed.All were followed up till February 2023 after surgery,and survival of patients was record.The relationship between miR-27a,miR-1299,SF and prognosis was analyzed.The risk factors of long-term prognosis in patients with esophageal cancer were analyzed by multivariate Cox regression model.The relationship between miR-27a,miR-1299 and serum SF was analyzed by Pearson.Results There were significant differences in miR-27a,miR-1299 and serum SF among patients with different tumor staging,lymph node metastasis and differentiation degree(P＜0.05).The results of survival analysis showed that overall survival rates in high-expression miR-27a and SF groups were lower than those in low-expression miR-27a and SF groups(P＜0.05),while which was higher in high-expression miR-1299 group than low-expression miR-1299 group(P＜0.05).Cox regression analysis showed that miR-27a ≥2.54,miR-1299＜4.18 and serum SF ≥223.78 μg/L(P＜0.05)were independent risk factors of postoperative long-term prognosis of patients with esophageal cancer.Pearson correlation analysis showed that level of serum SF was positively correlated with relative expression level of miR-27a(P＜0.05,r=0.612),while negatively correlated with relative expression level of miR-1299(P＜0.05,r=-0.517).Conclusion The miR-27a,miR-1299 and serum SF are related to tumor staging,lymph node metastasis and differentiation degree in patients with esophageal cancer,which can be applied to evaluate postoperative long-term prognosis.

Objective: To compare the residual distribution of fipronil and its metabolites in white and yellow egg, and to analyze the residual changes of fipronil and its metabolites in raw and cooked samples, regarding the risk assessment of fipronil and its metabolites via consuming egg for different age groups. Methods: The white egg and yellow egg were isolated from 10 egg samples containing fipronil residues. Samples were extracted with acetonitrile and purified, and determined by liquid chromatography-high resolution mass spectrometry. The chromatographic analysis was performed on a BEH C₁₈ column with 0.1% acetic acid and acetonitrile as mobile phase with gradient elution, and external standard calibration was used for quantification. The negative ion acquisition mode was applied and quantitative analysis was carried out by using Full Scan/ddms2 model. Results: The results showed that fipronil sulfone was the main residue detected in eggs; The content of fipronil sulfone in white egg was between 2.5 and 59.9 μg/kg, the median was 16.1 μg/kg; and the content of fipronil sulfone in yellow egg ranged from 81.5 and 1 526.0 μg/kg, with a median of 390.0 μg/kg. The ratio of fipronil sulfone in yellow egg to white egg ranged from 8.0 and 14.6. Compared with that observed in fresh egg, after heating or cooking, the content ratio of fipronil sulfone residue between cooked samples and raw samples from yellow egg was between 0.80 and 0.96, the median was 0.90; and the ratio from white egg ranged from 0.65 to 1.06, the median was 0.83. The conversion coefficient of fipronil sulfone (f) between white egg and yellow egg was 3.1. Conclusion Yellow egg is a major intake source of fipronil and metabolites residues, and there is no obvious change for fipronil sulfone residue in eggs after heating or cooking. The conversion coefficient of fipronil sulfone (f) between white egg and yellow egg lays the foundation for assessing the health risks of fipronil and metabolites residues through yellow egg intake in special population.

【Objective】 To determine molecular basis of a rare HLA-A typing results carrying triple A alleles in potential allo-HSCT donor and her family. 【Methods】 HLA-A, -B, -C, -DRB1, -DQB1, -E, -F, -G of 5 members in the family were genotyped at a high-resolution level using next-generation sequencing (NGS). HLA-A of probosita was re-checked using polymerase chain reaction-sequence-based typing (PCR-SBT), and SNP oligonucleotide probes (SNP-array)were scanned with genomic DNA of probosita. 【Results】 There was 162.9Kb duplication in 6p22.1(29, 803, 377-29, 966, 301)of probosita who carried triple A alleles A^*02∶01∶01, A^*11∶01∶01, A^*24∶02∶01. Other two family members were found to carry this haplotype: A^*02∶01∶01, A^*24∶02∶01, B^*54∶01∶01, C^*01∶02∶01, DRB1^*04∶05∶01, DQB1^*04∶01∶01, E^*01∶01∶01∶03, F^*01∶01∶01, G^*01∶01∶01∶01, which as a Mendelian gene was segregated and stably transmitted through two generations. 【Conclusion】 Tiny gene duplication induces one haplotype carries two HLA-A alleles in a potential healthy donor for allo-transplantaion and stably transmits through two generations.Routine HLA typing laboratories should pay more attention to this situation and accurately report.

Objective To establish the main points of clinical trials of HIV detection reagents,including the study methods,clinical trial scheme setup,sample selection and statistical analysis of results.Methods Human Immunodeficiency Virus detection reagents including both quantitive and quanlitive detecting of HIV related biomarkers in human serum,plasma and other body fluid based on the immunological or molecular biological technique.Considering both the active regulations of IVD and the HIV detection reagent's own characteristics,the characteristics of clinical trials of the HIV detection reagents were described in detail.Results Significant problems have been settled in clinical trials of HIV detection reagents.Statistical analysis method should be used in the interpretation of clinical trial results.Conclusion Clinical trials of HIV detection reagents should be carried out scientifically and focus on the accuracy and specificity based on the clinical use.

Objective: To understand the status and health risk assessment of dietary fipronil contamination among 20 provinces of China. Methods: A total of 13 kinds of dietary samples in Chinese total diet study include cereals, legumes, potatoes, meats, eggs, aquatics, dairies, vegetables, fruits, sugars, beverages and water, alcohols, condiments and their corresponding products. Among them, condiments were used in the preparation of 12 other sample categories; thus, the actual mixed dietary samples of each province covered 12 groups. A total of 240 mixed dietary samples were collected from 20 provinces in China from 2009 to 2013. After the sample extraction and cleanup, dietary samples were analyzed for the residues of fipronil and its metabolites to obtain the contamination levels of fipronil residues using liquid chromatography-high resolution mass spectrometry. The dietary intake of adult residents was estimated based on food consumption of general population of China. Results: Among the 240 dietary samples, the detection rate of fipronil was 10.4% (25 samples), and the detection rates of fipronil metabolites, i.e. fipronil desulfinyl, fipronil sulfone and fipronil sulfide were 20.4% (49 samples), 40.0% (96 samples) and 8.8% (21 samples), respectively. According to the dietary exposure analysis, the average lower and upper dietary exposure levels of fipronil residues in adult residents of China were 11.34 and 12.35 ng·kg^-1·d^-1, accounting for 5.7% and 6.2% of acceptable daily intake (ADI), respectively. The highest adult dietary intake of fipronil residues was found in Hunan province, with a value of 72.98 ng·kg^-1·d^-1, accounting for 36.5% of ADI. Vegetables were the main dietary source of fipronil residues, which contributed to 71.0% of the total intake dose. Conclusion Fipronil residues were detected in varying degrees in dietary samples, yet the health risk caused by the dietary intake of adult residents among 20 provinces of China is low.