Objective: To investigate the effect of phosphocreatine (PCr) on angiotensin II (Ang II) induced proliferation and collagen synthesis of cardiac ifbroblasts in neonatal rats with its mechanism.
Methods: The cardiac ifbroblasts (CF) from neonatal rats were cultured in vitro and were divided into 4 groups.①Control group, the CF was cultured in non-serum DMEM,②Ang II group, the CF was cultured with Ang II at (1×10-6) mol/L,③PCr treated group, the CF was cultured with PCr at 10 mmol/L, and④Ang II+PCr group. The CF cell cycle percentage was detected by lfow cytometric assay, myocardial collagen content was observed by VG staining and protein expression of phosphorylated extracellular signal-regulated kinase (pERK1/2) was detected by immuneohistochemistry.
Results: ① Compared with Control group, the CF in Ang II group showed increased percentage of S phase and decreased percentage of G0/G1 and G2/M phases, increased collagen content and pERK1/2 protein expression, all P<0.01.② The CF cell cycle, collagen content and pERK1/2 protein expression were similar between Control group and PCr treated group, all P>0.05. ③ Compared with Control group, Ang II + PCr group had elevated pERK1/2 protein expression, P<0.01, while the CF cell cycle and collagen content were similar with Control group, P>0.05.④Compared with Ang II group, the CF in Ang II + PCr group had increased percentage of G0/G1 and G2/M phases, decreased percentage of S phase, decreased collagen content and pERK1/2 protein expression, all P<0.01.
Conclusion: PCr may partially inhibit Ang II induced CF proliferation and collagen synthesis which might be related to the inhibition of excessively activated ERK1/2. Therefore, PCr could improve Ang II induced myocardial ifbrosis in neonatal rats.

OBJECTIVETo explore the reasonable therapeutic strategy for different types of epicanthus.

METHODSPatients with epicanthus were classificated according to the shape, extent and inner canthal distance and treated with different methods appropriately. Modified asymmetric Z plasty with two curve method was used in lower eyelid type epicanthus, inner canthus type epicanthus and severe upper eyelid type epicanthus. Moderate upper epicanthus underwent '-' shape method. Mild Upper epicanthus in two conditions which underwent nasal augumentation and double eyelid formation with normal inner canthal distance need no correction surgery. The other mild epicanthus underwent '-' shape method.

RESULTSA total of 66 cases underwent the classification and the appropriate treatment. All wounds healed well. During 3 to 12 months follow-up period, all epicanthus were corrected completely with natural contour and unconspicuous scars. All patients were satisfied with the results.

CONCLUSIONSClassification of epicanthus hosed on the shape, extent and inner canthal distance and correction with appropriate methods is a reasonable therapeutic strategy.

Objectives: To study the changes of blood levels of soluble semaphorin 4D (sSema4D) and matrix metalloproteinases-14 (MMP-14);to explore the correlation between sSema4D and ventricular remodeling in patients of dilated cardiomyopathy with chronic heart failure.
Methods: Our research included in 2 groups:Dilated cardiomyopathy group, n=86 patients and Control group, n=32 healthy subjects. Blood levels of sSema4D, MMP14, Pro-BNP and hs-CRP were examined by ELISA. Left atrial diameter (LAD), right ventricular diameter (RVD), ejection fraction (EF), left ventricular end diastolic diameter (LVEDD), left ventricular fractional shortening (LVFS) were measured by echocardiography. Correlation analysis between blood levels of sSema4D, MMP-14 and the parameters for left ventricular remodeling was conducted.
Results: Blood levels of sSema4D and MMP14 were different between 2 groups, P<0.005. In Dilated cardiomyopathy group, sSema4D level was positively related to MMP-14 and LVEDD (r=0.462, P=0.001 and r=0.643, P<0.001) respectively.
Conclusion: Serum level of sSema4D might be related to ventricular remodeling in patients with dilated cardiomyopathy which could be used as risk factor for predicting the prognosis of heart failure in relevant patients.

Objective To observe the curative effect of botulinum toxin A on masseter hypertrophy using three-dimensional stereophotogrammetry.Methods 46 cases with masseter hypertrophy (92 masseters) who received botulinum toxin A injection were enrolled from May 2013 to August 2014.Data were collected before and 3,6 and 9 months after injection.Results The efficacy of botulinum toxin A in reducing the volume of the lower face has been proven by MAS 3D.3 and 6 months after injection,the volume reduction were measured as 7.23 ％,2.15％ respectively (P ＜ 0.05).The coefficients between middle and lower thirds of the face showed an increase compatible with thinning of the lower face with statistical significance at 3 months follow up.The increase percentage was measured by MAS 3D as 40.21％ between pre-and post-injection (P ＜ 0.05),and the increase percentage was 21.03％ at 6 months follow up (P ＜ 0.05).While 9 months after injection,the value was insignificant comparing to pretreatment at 9 months.Conclusions Three-dimensional stereophotogrammetry provides a safe effective and direct way to observe masseter hypertrophy.

Circular RNA has the advantages of a simple synthesis method,high stability,and continuous and stable expression over linear mRNA,and has great potential for application in microbial infection vaccines,tumor vac-cines,protein replacement therapy,etc.In recent years,circular RNA has become a hotspot in the field of nucleic acid drugs.The cyclization technique of RNA is the key to the synthesis of circular RNA in vitro.The cyclization strategy has an important impact on cyclization efficiency,immunogenicity,protein expression,etc.,which limits the basic research and clinical application of circular RNA.This paper provides a systematic review of several cyclization strategies including the chemical method,enzyme method,and ribozyme method.The reaction conditions,cyclization process,cyclization ef-ficiency,and immunogenicity of each cyclization technology were analyzed.At present,the ideal circular RNA formation strategy still faces many challenges.However,studies have confirmed that circular RNA has better stability and stronger immune effects than linear mRNA in the fields of coronavirus disease 2019(COVID-19)vaccine and anti-tumor vaccine.Consequently,circular RNA has become a novel nucleic acid drug molecule with great potential.This research provides valuable insights for optimizing and expanding the research and clinical application of circular RNA.

Objective To observe the curative effect of botulinum toxin A on masseter hypertrophy using three-dimensional stereophotogrammetry.Methods 46 cases with masseter hypertrophy (92 masseters) who received botulinum toxin A injection were enrolled from May 2013 to August 2014.Data were collected before and 3,6 and 9 months after injection.Results The efficacy of botulinum toxin A in reducing the volume of the lower face has been proven by MAS 3D.3 and 6 months after injection,the volume reduction were measured as 7.23 ％,2.15％ respectively (P ＜ 0.05).The coefficients between middle and lower thirds of the face showed an increase compatible with thinning of the lower face with statistical significance at 3 months follow up.The increase percentage was measured by MAS 3D as 40.21％ between pre-and post-injection (P ＜ 0.05),and the increase percentage was 21.03％ at 6 months follow up (P ＜ 0.05).While 9 months after injection,the value was insignificant comparing to pretreatment at 9 months.Conclusions Three-dimensional stereophotogrammetry provides a safe effective and direct way to observe masseter hypertrophy.

Objective:To analyze the prognostic factors of robot-assisted radical cystectomy (RARC).Methods:The clinical data of 224 patients underwent RARC from December 2014 to December 2018 in Nanjing Drum Hospital were reviewed. There were 193 males and 31 females, aged 36-92 years, with mean of 68 years. There were 7 patients(3.1%)undergoing neoadjuvant chemotherapy, the ASA scores of 125 patients (55.8%) were more than 2, and the mean body mass index was 23.4(15.4-35.5)kg/m 2. All patients were treated with RARC, with 72(32.1%) patients undergoing intraoperative blood transfusion. Kaplan-Meier method was used to analyze recurrence-free survival rate (RFS), cancer-specific survival rate (CSS) and overall survival rate (OS). Cox multivariate risk ratio model was used to evaluate the correlation between survival outcome and perioperative and pathological factors in patients treated with RARC. Results:For pathological status, there were 82 of ≤T 1, 64 of T 2, 57 of T 3 and 21 of T 4. Of all the patients, 49(21.9%) had lymph node metastasis, 12(5.4%) had positive surgical margin, 82(36.6%) had lymphovascular invasion(LVI), and 41(18.3%) underwent adjuvant chemotherapy. Follow-up time was between 11-60 months, and the median follow-up time was 24 months. The 5-year cumulative OS, RFS and CSS were 57.15%, 48.84% and 59.60%, respectively. Univariate Cox regression analysis showed that T stage( HR=5.764, 95% CI 1.926-17.249, P=0.002; HR=4.086, 95% CI 1.611-10.364, P=0.003; HR=9.391, 95% CI 2.118-41.637, P=0.003), N stage( HR=6.446, 95% CI 3.438-12.087, P<0.001; HR=5.661, 95% CI 3.086-10.385, P<0.001; HR=5.980, 95% CI 2.982-11.992, P<0.001), LVI( HR=3.319, 95% CI 2.008-5.486, P<0.001; HR=2.894, 95% CI 1.782-4.701, P<0.001; HR=3.471, 95% CI 2.017-5.974, P<0.001), American Society of Anesthesia (ASA)score( HR=2.888, 95% CI 1.619-5.150, P<0.001; HR=1.765, 95% CI 1.060-2.940, P=0.029; HR=2.612, 95% CI 1.424-4.792, P=0.002), body mass index( HR=0.886, 95% CI 0.819-0.957, P=0.002; HR=0.885, 95% CI 0.819-0.955, P=0.002; HR=0.862, 95% CI 0.792-0.938, P=0.001), age( HR=1.580, 95% CI 1.250-1.997, P<0.001; HR=1.362, 95% CI 1.088-1.705, P=0.007; HR=1.530, 95% CI 1.190-1.968, P=0.001) and intraoperative blood transfusion( HR=1.899, 95% CI 1.160-3.108, P=0.011; HR=2.218, 95% CI 1.371-3.587, P=0.001; HR=2.227, 95% CI 1.312-3.782, P=0.003) were significantly related to survival outcome. Multivariate Cox regression analysis showed that T stage( HR=4.506, 95% CI 1.433-14.175, P=0.01; HR=3.159, 95% CI 1.180-8.454, P=0.022; HR=7.810, 95% CI 1.674-36.444, P=0.009), N stage( HR=6.096, 95% CI 2.981-12.467, P<0.001; HR=5.368, 95% CI 2.683-10.740, P<0.001; HR=5.539, 95% CI 2.497-12.288, P<0.001) and ASA score( HR=6.180, 95% CI 2.371-16.110, P<0.001; HR=2.702, 95% CI 1.175-6.215, P=0.019; HR=6.471, 95% CI 2.290-18.286, P<0.001) were independent predictors of RFS, CSS and OS, and adjuvant chemotherapy( R=0.434, 95% CI 0.202-0.930, P=0.032) could only predict OS. Conclusion:T stage, N stage and ASA were main independent predictors of postoperative survival outcomes, and adjuvant chemotherapy was independent predictor of OS.

Objective To explore the pain beliefs in acute phase in elderly patients with lung cancer undergoing thoracotomy using qualitative analysis. Methods Using the phenomenological research method, a total of 15 elderly patients with non-small cell lung cancer undergoing thoracotomy from February to May 2017 in the First Hospital of Jilin University were recruited by purposive sampling method. On the 5th day after thoracotomy, semi-structured in-depth interviews were conducted to describe the pain beliefs and the data were analyzed by Colaizzi analysis. Results Through the analysis of the data, 4 main themes were summarized:pain cognition, negative emotion, controllability, social and family support. Conclusions There are negative pain beliefs and negative emotion in the acute stage in lung cancer patients after thoracotomy, which provides a theoretical basis for the development of pain care after thoracotomy in elderly patients with lung cancer.

Objective To retrieve,evaluate and summarize the relevant evidence on malnutrition management among maintenance hemodialysis(MHD)patients to provide clinical medical staff with evidence-based guidelines for managing malnutrition in MHD patients.Methods Using the"6S"pyramid model of evidence,We searched UpToDate,BMJ best clinical practice,the Australian JBI evidence-based health care centre database(JBI),Medive,the International Guidelines Collaborative Network(GIN),Agency for Healthcare Research and Quality Network,the UK National Institute of Clinical Medicine Guidance Library(NICE),Scottish Inter-College Guide Collaboration network,the Ontario Registered Nurses Association(RNAO),Guidelines Network of International Society of Nephrology,American Nephrology Foundation Guidenet,British Nephrology Society,Society of Nephrology,Chinese Medical Association,Improving Kidney Disease Outcomes Worldwide,International Society of Renal Nutrition and Metabolism,American Society for Parenteral Enteral Nutrition,European Society for Clinical Nutrition and Metabolism,Chinese Nutrition Society,PubMed,Web of Science,Embase,Cochrane Library,CNKI,Wanfang,VIP and CBM,to collect relevant guidelines,expert consensus,clinical decision,evidence summary,recommended practice,best practice,systematic evaluation and clinical practice,from the establishment to the date of April 10th,2023,for literature on malnutrition management of MHD patients.The literature included guidelines,expert consensuses,clinical decision-making studies,evidence summaries,recommended practices,best practices,and systematic reviews.Two researchers independently evaluated,extracted,and integrated the evidence.The evidence was graded by the evidence pre-grading system of the Evidence-based Healthcare Center of Joanna Briggs Institute(JBI).Results A total of 16 articles were included and summarized,comprising 5 guidelines,3 expert consensuses,1 clinical decision-making study,1 evidence summary,and 6 systematic reviews.Thirty-nine pieces of the best evidence were integrated,covering 5 key aspects(39 evidences):screening and assessment,nutritional requirements,nutritional supplement,other interventions,and monitoring and education.Conclusions The best evidence summary of malnutrition management among MHD patients in this study is scientifically rigorous and systematic.Clinical medical staff can use the best evidence to develop personalized malnutrition management programs for MHD patients.

Background and objective The proportion of patients carrying driver gene mutations is notably high among individuals with non-small cell lung cancer(NSCLC)in China.However,the current neoadjuvant treatment strategies for these patients lack evident benefits.This study aims to investigate the efficacy and adverse reactions of neoadjuvant immu-nochemotherapy in patients with driver gene-positive NSCLC,thereby exploring its potential therapeutic value.Methods A total of 50 patients from two centers were retrospectively collected to compare the efficacy and adverse reactions among driver gene-positive NSCLC patients after different treatments and further explore the response to neoadjuvant immunochemo-therapy among different EGFR-sensitive subtypes.Results A total of 50 patients from two centers were included in this study.Among the 40 patients from Peking University People's Hospital(PKUPH),21 received neoadjuvant immunotherapy,with 57.1％ showing partial response on imaging.The major pathological response(MPR)rate after neoadjuvant immunochemo-therapy was 38.1％ ,and pathological complete response(pCR)was only observed in this group.No significant differences were noted in adverse events or their impact on surgical difficulty among different treatments.Additionally,10 patients from Hunan Cancer Hospital(HNCA)were included to analyze the differences in efficiency among EGFR-sensitive subtypes under various neoadjuvant strategies.No significant radiological response differences were observed between neoadjuvant immunotherapy and targeted therapy.However,patients with the L858R mutation exhibited MPR and pCR only after receiving immuno-therapy,surpassing targeted therapy outcomes,while no significant differences were found among 19del patients.Conclusion Under the premise of not exacerbating adverse effects,neoadjuvant immunochemotherapy achieved superior rates of MPR and pCR,with long-term survival comparable to targeted therapy.