Objective:To analyze the effects of adenovirus-mediated interleukin-37 (IL-37) on the growth and radiosensitivity of human non-small cell lung cancer (NSCLC) cell line A549, and to explore the possibility of IL-37 as a new radiosensitizer.Methods:Human NSCLC cell line A549 was used as the research object. A549 cells were divided into three groups: normal A549 cells (control group), empty virus transfected A549 group [NC group, the multiple of infection (MOI) was 100], Ad-IL-37 group (A549 cells were transfected by adenovirus with IL-37, MOI was 100). The expression of IL-37 protein in three groups was detected by Western blot. The three groups were irradiated with 4 Gy irradiation dose at the same time. The methyl thiazolyl tetrazolium (MTT) method was used to detect the absorbance (A) values and observe the proliferation of A549 cells; flow cytometry was used to observe the phase changes of A549 cells in each group after irradiation; Western blot was used to detect the expressions of apoptosis-related proteins (bax, bcl-2, Caspase-3, and Survivin) in each group after irradiation.Results:The expression level of IL-37 in the control group was 0.17±0.04, NC group was 0.29±0.14, and Ad-IL-37 group was 1.17±0.23 (F = 24.263, P = 0.001); there was no statistical difference in A values among the three groups at 24 h after irradiation (F = 2.587, P = 0.160), while the differences of A values among the three groups at 48, 72, 96, 108 h after irradiation were statistically significant (F values were 21.662, 33.635, 33.663, and 31.909, P values were 0.005, 0.001, 0.001, and 0.001, respectively). There was no significant difference in the cell proliferation inhibition rate between NC group and Ad-IL-37 group at 24 h after irradiation (t = 1.620, P = 0.247), while the differences were statistically significant at 48, 72, 96, 108 h after irradiation (t values were 5.414, 7.233, 15.306, and 19.035, P values were 0.032, 0.019, 0.004, and 0.003, respectively). The combination of IL-37 and radiation could affect the cell cycle, the proportion of S-phase cells was (36.4±1.0)% in the control group, (31.3±0.6)% in the NC group, and (27.2±2.9)% in the Ad-IL-37 group (F = 12.96, P = 0.007), and the proportion of in G 2/M-phase cells was (20.5±0.8)% in the control group, (24.7±2.9)% in the NC group, and (41.4±4.1)% in the Ad-IL-37 group, (F = 27.92, P = 0.001). IL-37 could up-regulate the expressions of pro-apoptotic factors bax and Caspase-3 proteins in A549 cells after irradiation (F values were 10.31 and 14.51, P values were both 0.01), and down-regulate the expressions of apoptotic factors bcl-2 and Survivin proteins (F values were 8.95 and 5.52, P values were 0.02 and 0.04). Conclusion:IL-37 could inhibit the growth of human NSCLC cell line A549 and has potential radiosensitization effects, which may be caused by affecting the apoptosis of tumor cells.

BACKGROUND:Ischiogluteal bursitis has been recognized for a long time, but its treatment stil limits to local blocking injection and surgery methods that were developed 40 years ago. OBJECTIVE:To observe the efficacy of platelet-rich plasma on ischiogluteal bursitis. METHODS:Data of 15 patients with ischiogluteal bursitis were colected. Al the patients with ischiogluteal bursitis were treated with bilateral platelet-rich plasma (n=10) or local blocking injection (n=5). Patients’ outcomes were assessed by visual analogue scale, the Treatment Satisfaction Questionnaire for Medication (TSQM) Version II and recurrence rate. The folow-up time was from 6 to 14 months. RESULTS AND CONCLUSION: There was no statistical difference in visual analogue scale score between the platelet-rich plasma group and local blocking group (F=0.219,P=0.643), but the score of visual analogue scale in the platelet-rich plasma group was higher during short-term folow-up (within 1 week after treatment), but lower in the long-term folow-up. In the aspects of overal satisfaction score, clinical effectiveness and side effects, the platelet-rich plasma group was inferior to the local blocking group at short-term folow-up, especialy at 1 week after treatment; however, these scores became better in the platelet-rich plasma group than the local blocking group during the long-term folow-up period. In addition, no statistical difference in the convenience score was found between the two groups. At the last folow-up, the recurrence rate in the platelet-rich plasma group was lower than that in the local blocking group. Both the platelet-rich plasma and local blocking injection can significantly reduce the pain of patients with ischiogluteal bursitis. Local blocking injection has better short-term effectiveness. Platelet-rich plasma injection works moderately, but its effectiveness can last for longer time, and the recurrence rate is lower.

BACKGROUND:Cuscuta chinensis is a mature seed of Cuscutachinensis Lam., can warm kidney. Previous studies demonstrated that kidney compound composed of Cuscuta chinensis could apparently inhibit bone loss and improve bone density.
OBJECTIVE:To explore the influence of flavonoids from Cuscuta chinensis on bone mineral density of femur, 1,25(OH)2D3 levels of serum and kidney, the expression of smal intestine CaBp-D9K mRNA in model rats with ovariectomized osteoporosis.
METHODS:A total of 72 Sprague-Dawley female rats were equal y and randomly divided into six groups (n=12):sham surgery group, model group, vitamin D3 group and low-, moderate-and high-dose flavonoids groups. The sham surgery group only received sham operation and the other five groups were ovariectomized respectively. One week after ovariectomy, the rats were given flavonoids from low-, moderate-and high-dose Cuscuta chinensis and vitamin D3 (2 mg/kg) by intragastric administration for 3 consecutive months. Blood was obtained from the abdominal aorta. Serum was isolated. The kidney was obtained. Enzyme linked immunosorbent assay was used to determine 1,25(OH)2D3 contents of renal and serum. Rats were sacrificed at the end of experiment. The thighbone was taken out to determine bone mineral density. The second lumbar vertebra was taken out to measure the expression of lumbar vertebra and renal vitamin D receptor mRNA using real-time fluorescent reverse transcription-polymerase chain reaction. The smal intestine was taken out to measure the expression of smal intestine CaBp-D9K mRNA using real-time fluorescent reverse transcription-polymerase chain reaction.
RESULTS AND CONCLUSION:Compared with the sham operation group, bone mineral density of femur, and 1,25(OH)2D3 levels of serum and kidney and the expression of lumbar vertebra vitamin D receptor mRNA significantly decreased in model group, and the expression of smal intestine CaBp-D9K mRNA significantly decreased in model group. Compared with the model group, bone mineral density of femur, and 1,25(OH)2D3 levels of serum and kidney, and the expression of the second lumbar vertebra vitamin D receptor mRNA, and the expression of smal intestine CaBp-D9K mRNA were increased in moderate-and high-dose flavonoids groups and vitamin D3 group. Results indicated that flavonoids from Cuscuta chinensis could significantly raise bone mineral density of femur, and 1,25(OH)2D3 levels of serum and kidney and the expression of lumbar vertebra vitamin D receptor mRNA and the expression of smal intestine CaBp-D9K mRNA, accelerate intestinal calcium absorption and osteoblast activity, and reinforce quality of the bone.

Objective To summarize the safety and efficacy of Sunitinib in the treatment of metastatic renal clear cell carcinoma. Methods Fifteen patients with clear cell metastatic RCC were treated with Sunitinib,with 11 males and 4 females,aged from 26 to 74 years with median age of 55 years.Thirteen cases of 15 were T3 to T4 stage,and 8 cases underwent radical nephrectomy,while 5 other cases underwent renal biopsy with the pathological diagnosis of renal cancer.The other two cases (one man and one woman)with the solitary kidney renal cell carcinoma ( stage T1a) and renal insufficiency,were diagnosed as metastatic renal cell carcinoma by biopsy.Sunitinib monotherapy was administered by the regimen of 6 weeks per cycle with daily oral Sunitinib 4 weeks,followed by 2 weeks off ( from 1 - 10 cycles).Response was evaluated by RECIST.Renal tumor was 9.52 ± 3.3 cm in diameter at baseline,and the assessment of metastases included retroperitoneal lymph nodes (6 cases),mediastinal lymph nodes (3 cases),brain (2 cases),lung (6 cases),bone (2 cases) and liver (2 cases).Karnofsky score,tumor changes,adverse events and the survival of each patient was assessed and recorded. Results The follow-up duration was from 1.5 - 15months,with median follow-up of 6 months,and tumor response was evaluated by RECIST.Seven of 15 patients (46.7％) treated with Sunitinib achieved partial responses (PR),7 patients (46.7％) demonstrated stable disease (SD),and 1 patient (6.7％) developed progressive disease (PD) during the follow-up.Objective Response Rate (ORR) was 46.7％,PR + SD was 93.3％,6 months PFS was 93.3％,and median PFS was 12 months,respectively.Renal tumor was 8.7 ± 4.0 cm in diameter after therapy.Two PR patients with the obvious effectiveness had experienced progressed hypertension,and one cases with hypertension that could be controlled below 140/90 mm Hg ( 1 mm Hg =0.133 kPa) by a single drug before treatment,showed increased blood pressure ( ＞ 160/105 mm Hg) following the second cycles treatment,who were administered increased dosage and combination therapy.The other case without history of hypertension,showed high blood pressure ( ＞ 150/100 mm Hg) in the third cycle,and could be controlled well by antihypertensive drugs.Fortunately,the tumor of these two cases reduced obviously by more than 50％. 1/2 adverse reactions of 12 cases:yellowing of the skin and yellow sweat ( 12 cases,80％ ),fatigue ( 12 cases,80％ ),4 cases of hypothyroidism (26.7％),bilirubin and triglyceride levels elevated in 7case (46.7％); Four cases showed 3/4 degree adverse events with the emergence of gastrointestinal bleeding in one case secondary to platelets reduction (6.7％).Three cases (20％) showed serious fatigue,nausea,vomiting and severe hand-foot skin reaction. Conclusions Sunitinib is recommended for the treatment of metastatic renal clear cell carcinoma with good efficacy and safety.

Disruption of the structure of regular sleep is a common cause of neurodegenerative diseases such as Alzheimer′s disease and Parkinson′s disease, and its pathogenesis may be related to the deposition of waste products in the central nervous system. The glymphatic pathway, which is essentially a periarterial cerebrospinal fluid inflow pathway and peripheral venous clearance pathway, is functionally dependent on interstitial bulk flow coupling supported by aquaporin-4 on the astrocyte end-foot, also known as the lymphoid glial system. The glymphatic pathway, which removes waste proteins from the brain, is active primarily during sleep, and sleep quality declines with age, while the glymphatic pathway system also deteriorates with age, suggesting a relationship between sleep disturbances and symptom progression in neurodegeneration, and glymphatic system as a link closely links the two. The interaction of sleep, aging, metabolic waste and glymphatic pathway reticulation provides new clues to the pathogenesis of central nervous system degenerative diseases, and the glymphatic pathway may constitute a new target on treatment. The recent research progress on the effects of sleep and sleep disorders on the circulation of the glymphatic system, and proposes the possibility of sleep intervention to slow down the impairment of the lymphoid system function or even restore the function of the lymphoid system and thus improve the disease development process were reviewed in this paper.

Objective To investigate the work carrying out and learning status of diabetes specialist nurse in training program, in order to optimize diabetes specialist nurse training program and provide evidence for its improvement. Methods The study used E-mail to investigate the nurses′ existing work plant-forms and conditions, diabetes specialist nursing practice, continuing education and improvement by diabetes specialist nurses training scale after the diabetes specialist nurse training. Results A total of 124 diabetes specialist nurses were questioned for the survey, and 80. 65% of them were engaged in diabetes health education or diabetes nursing care, and 8. 06% of them left from the diabetes care ward because of promotion or redeployment. The biggest problem of engaged in the work of diabetes specialist nursing was lack of diabetes specialist nurse post occupying 48. 39%, and 77. 42% trained nurses had improved the diabetes nursing care mode and achieved good results. Meanwhile, 20. 97% trained nurses′ hospital opened a diabetes care clinic, and 37. 1% trained nurses attended the diabetes professional academic exchange. Conclusions The diabetes health education and management were carried out better after diabetes specialist nurse training program compared without training. The training and qualifying of diabetes specialist can improve the status and role of diabetes educator, so as to contribute to the development of diabetes care, education and management.

Propriospinal myoclonus(PSM)is a rare painless movement disorder characterized by recurrent axial myoclonus during the wake and sleep transition periods.The recurrent muscle twitches during the hypnotic period severely affect the patient's sleep.In this paper,we reported a case of typical PSM.The patient was treated for involuntary limb shaking before sleep for more than 1 year,and no significant positive signs were found after physical examination in hospital.After perfecting video polysomnography and polymyography,he was diagnosed as having idiopathic PSM,and he responded well to 1/3 of clonazepam tablets,suggesting the necessity of video polysomnography and polymyography in the diagnosis of PSM.

Objective:To systematically summarize and comparatively analyze the development, establishment and usage of oncology drugs speedy review approaches in China and in the United States between 2012 and 2021.Methods:Based on National Medical Products Administration (NMPA) and Food and Drug Administration (FDA) websites, the development and current status of the speedy review approaches were consulted and summarized. Approved oncology drugs in China and in the United States (87 in China, 118 in the United States) over the past decade were analyzed using chi-square test for group comparison.Results:Five speedy approaches have been established in China and in the United States, three of which are the same, priority review, conditional approval or accelerated approval and breakthrough therapy. The rest two are special review and approval, special examination and approval in China, and fast track and real-time oncology review in the United States. Compared to the United States, speedy review approaches in China set up late (1992 vs. 2005). The overall utilization rates of the oncology drugs speedy review approaches were similar between the China and United States (90.8% vs. 92.4%, P=0.800) in the previous 10 years, and priority review have highest utilization rates in both China and the United States without significant group difference (77.0% vs. 82.2%, P=0.381); relatively low utilization rates of conditional approval (31.0% vs. 44.9%, P=0.041) and breakthrough therapy (2.3% vs. 50.0%, P＜0.001) were seen in China. 52.9% of new drugs applied for special examination and approval in China and 40.7% of new drugs applied for fast track in the United States. Overall, the priority review both in China and the United States are stable, with a similar average annual utilization rate (84.8% vs. 83.7%); accelerated approval and breakthrough therapies in the United States fluctuate wildly, but the situation is tending towards stability in the last 3 years. Conclusions:Both China and the United States have established a relatively complete accelerated review system, with an overall utilization rate over 90%; China's accelerated review started late, although the overall utilization rate is close to that of the United States. The utilization rates of conditional approval and breakthrough therapy are still relatively low. Flexible usage of speedy review approaches, gaining regulatory recognition to use alternative endpoints, achieving real-time review and guidance are keys to accelerate new drug development in China.

Objective:To systematically summarize and comparatively analyze the development, establishment and usage of oncology drugs speedy review approaches in China and in the United States between 2012 and 2021.Methods:Based on National Medical Products Administration (NMPA) and Food and Drug Administration (FDA) websites, the development and current status of the speedy review approaches were consulted and summarized. Approved oncology drugs in China and in the United States (87 in China, 118 in the United States) over the past decade were analyzed using chi-square test for group comparison.Results:Five speedy approaches have been established in China and in the United States, three of which are the same, priority review, conditional approval or accelerated approval and breakthrough therapy. The rest two are special review and approval, special examination and approval in China, and fast track and real-time oncology review in the United States. Compared to the United States, speedy review approaches in China set up late (1992 vs. 2005). The overall utilization rates of the oncology drugs speedy review approaches were similar between the China and United States (90.8% vs. 92.4%, P=0.800) in the previous 10 years, and priority review have highest utilization rates in both China and the United States without significant group difference (77.0% vs. 82.2%, P=0.381); relatively low utilization rates of conditional approval (31.0% vs. 44.9%, P=0.041) and breakthrough therapy (2.3% vs. 50.0%, P＜0.001) were seen in China. 52.9% of new drugs applied for special examination and approval in China and 40.7% of new drugs applied for fast track in the United States. Overall, the priority review both in China and the United States are stable, with a similar average annual utilization rate (84.8% vs. 83.7%); accelerated approval and breakthrough therapies in the United States fluctuate wildly, but the situation is tending towards stability in the last 3 years. Conclusions:Both China and the United States have established a relatively complete accelerated review system, with an overall utilization rate over 90%; China's accelerated review started late, although the overall utilization rate is close to that of the United States. The utilization rates of conditional approval and breakthrough therapy are still relatively low. Flexible usage of speedy review approaches, gaining regulatory recognition to use alternative endpoints, achieving real-time review and guidance are keys to accelerate new drug development in China.