Objective To prepare tubeimoside Ⅲ nanoemulsion(TBMⅢ-NE)and evaluate its adjuvant effect in vaccines.Methods TBMⅢ-NE was prepared using low-energy emulsification.Dynamic light scattering was used to characterize the particle size and polydispersity index of the obtained TBMⅢ-NE,and transmission electron microscopy(TEM)was employed to observe the morphology.CCK-8 assay was utilized to determine the cytotoxicity of TBMⅢ-NE on bone marrow-derived dendritic cells(BMDCs).The in vitro safety of TBMⅢ-NE was evaluated using a hemolysis assay.The ability of TBMⅢ-NE to promote the phagocytosis of antigens by DC2.4 cells was observed using confocal laser microscopy.After co-incubation of TBMⅢ-NE with BMDCs,the expression levels of CD40,CD86,MHC-Ⅰ,and CCR7 on the surface of BMDCs were detected using flow cytometry,and the levels of cytokines in the supernatant of BMDCs were measured using enzyme-linked immunosorbent assay(ELISA).After female BALB/c mice were immunized with the SARS-CoV-2 antigen RBD in combination with TBMⅢ-NE,ELISA was conducted to determine the serum levels of specific IgG,IgG2a,and IgG1 antibodies.The number of specific IFN-γ-secreting cells in mouse splenocytes was detected using enzyme-linked immunospot(ELISpot)assay.Results The prepared blank nanoemulsion(BNE)and TBMⅢ-NE were in a particle size of 25.46 and 25.89 nm,and a polydispersity index of 0.214 and 0.125,respectively.TEM displayed that TBMⅢ-NE was in uniform sphere and well dispersed.When the TBMⅢ-NE adjuvant was diluted by 400-fold,the survival rate of BMDCs was approximately 86%.Compared with free TBMⅢ,the hemolytic toxicity of TBMⅢ-NE was significantly reduced(P<0.01).TBMⅢ-NE promoted the phagocytosis of antigens by DC2.4 cells and significantly increased the expression of CCR7 on the surface of BMDCs(P<0.05),indicating its potential to promote more dendritic cells to effectively migrate to lymph nodes.TBMⅢ-NE also promoted the expression of IL-6 and IL-1β in the supernatant of BMDCs(P<0.05).When combined with RBD,TBMⅢ-NE significantly increased the levels of specific IgG,IgG2a,and IgG1 antibodies in mouse serum(P<0.01)and promoted the secretion of specific IFN-γ in splenocytes(P<0.01),indicating that TBM Ⅲ-NE could enhance specific cellular immune responses.Conclusion A stable and highly effective TBMⅢ-NE that can induce humoral and cellular immune responses is successfully prepared.

Objective To evaluate the effectiveness and safety of acupuncture in patients with Major Depressive Disorders.Methods Search the database for relevant literature published before April 15,2023.Select randomized controlled trial that meeting the enrollment criteria,evaluate the quality of the literature and classify before meta-analysis systematic evaluation.Results 15 RCTs are included in this study,with a total of 1077 patients.The results showed that acupuncture treatment,compared with antidepressants alone,The score of Hamilton Depression Scale(HAMD)in patients with liver-qi depression disorder[MD=-0.73,95%CI(-1.22,-0.24),P<0.05],the score of TCM Syndrome Scale[MD=-1.89,95%CI(-2.35,-1.44),P<0.001],effective rate[RR=1.09,95%CI(1.03,1.153),P=0.001]and TESS score[MD=-2.76,95%CI(-3.68,-1.85),P<0.001]were statistically significant.Compared with fluoxetine hydrochloride,the effective rate of HAMD scale score was statistically significant[RR=1.07,95%CI(1.01,1.14),P<0.05].Conclusion Compared with antidepressants alone,acupuncture therapy has the advantages for the improvement of HAMD score in patients,the improvement of Traditional Chinese medicine symptoms,and significantly less adverse effects than those in the control group.Through this study,it is considered that acupuncture can be a safe and effective treatment modality.However,due to the quantity and quality of the included literature,the above conclusions still need to be verified by more high-quality clinical trials.

Objective To explore the prognostic value of serum neutrophils/lymphocytes(NLR)for first-line treatment of patients with advanced gastric cancer using programmed cell death receptor 1(PD-1)inhibitors.Methods A total of 168 patients with advanced gastric cancer who were treated with immunotherapy combined with chemotherapy in the Fourth Hospital of Qinhuangdao from January 2018 to January 2021 were selected as study subjects,and the follow-up period was terminated at January 2023.The patients'data were collected,hematological and tumor markers before the combined treatment were analyzed,and the optimal cut-off value of NLR was calculated using X-tile software.The effect of NLR expression on the survival rate of patients with advanced gastric cancer was analysed by the Kaplan-Meier survival curve.Receiver operating curve(ROC)was used to analyze the predictive value of NLR in patients with advanced gastric cancer.The related factors affecting the disease progression of patients with advanced gastric cancer were screened combined with Cox proportional risk model.Results Among 168 patients,the optimal cut-off value of serum NLR before treatment was 2.41.Patients were divided into high NLR group(NLR＞2.41,n=93)and low NLR group(NLR＜2.41,n=75).NLR was related to tumor differentiation,distant metastasis,composite positive scores of PD-L1,carcinoembryonic antigen and cancer antigen 125(P＜0.05);the effective rate in the low NLR group was significantly higher than that in the high NLR group(P＜0.05);the median progression free survival(PFS)and the overall survival(OS)of patients in the low NLR group were both longer than those in the high NLR group(PFS:P=0.006;OS:P=0.023);ROC analysis showed that the area under the curve of NLR for the prognosis of advanced gastric cancer patients was 0.740,sensitivity was 81.50％,and specificity was 69.70％;in multivariate analysis,except initial NLR value,tumor differentiation degree and distant metastasis were also independent predictors of poor prognosis in patients with advanced gastric cancer(P＜0.05).Conclusion Among patients with advanced gastric cancer who received first-line immunotherapy combined with chemotherapy,pretreatment NLR is correlated with efficacy and PFS/OS,and has high value in predicting the prognosis of immunotherapy for advanced gastric cancer.

Objective To construct and evaluate the rat model of thyroid nodule liver-qi depression syndrome with the combination of disease and syndrome,so as to lay a foundation for the exploration of the mechanism and clinical research of traditional Chinese medicine in the treatment of thyroid nodule.Methods 36 rats were randomly divided into three groups.The model was induced by chronic unpredictable mild stress(CUMS)stimulation combined with propylthiouracil(PTU).The rats in the blank group were fed with saline at the dose of 1 mL·100 g-1·d-1,and the rats in the PTU group were fed with 0.1%PTU solution at the dose of 1 mL·100 g-1·d-1.The rats in the CUMS+PTU group were fed with CUMS stimulation in a single cage and intragastric administration of 0.1%PTU solution according to the dose of 1 mL·100 g-1·d-1,and the modeling time lasted for 6 weeks.After the establishment of the model,the model of combination of disease and syndrome was evaluated comprehensively by means of animal behavior detection,ultrasonic image,apparent morphology observation,pathological staining and serum hormone index detection.Results Compared with control group and PTU group,the total distance in the open field was significantly shortened,the sucrose preference rate was significantly decreased,and the swimming suspension time was significantly prolonged in the CUMS+PTU group,showing obvious symptoms of liver qi stagnation.In addition,compared with the other two groups,the thyroid gland of CUMS+PTU group showed obvious enlargement and nodule formation,thyroid index significantly increased,and thyroid follicular epithelial cells showed a high phase of proliferation.In terms of hormone levels,compared with control group,the serum levels of free triiodothyronine(FT3)and free thyroxine(FT4)in CUMS+PTU group were significantly lower,while the level of thyroid stimulating hormone(TSH)was significantly higher,which was in line with the current evaluation criteria of thyroid nodule model.Conclusion The method of CUMS stimulation combined with PTU drug induction can successfully prepare the rat model of thyroid nodule liver-qi depression syndrome,and the comprehensive evaluation method is stable and reliable,which is helpful to improve the scientific nature of the disease-syndrome combination model.

Medical imaging is an important auxiliary means of disease diagnosis. In the process of diagnosis, diseases are usually presented in a static way, which is one of the characteristics of imaging diagnosis. However, this static representation of diseases imposes certain limitations, which can, to some extent, lead to the loss of medical humanities. Therefore, it is very important for imaging diagnostic doctors to correctly use philosophical thinking to understand, analyze, and solve problems. The reinforcement of philosophical thinking in imaging diagnosis entails commitment to the "patient-centered" perspective in medicine as well as the integration of comprehensiveness, regularity, and proactivity. This not only effectively trains the diagnostic thinking of imaging diagnostic doctors but also improves their humanistic quality, thereby addressing the problems associated with these limitations. This allows the diagnosis to be both technically accurate and emotionally attuned.

Disclosure ; Genetic Counseling ; Genetic Testing ; United States

Objective To compare the effects of different right ventricular pacing sites on left ventricle systolic function in elderly patients with sick sinus syndrome (SSS).Methods A total of 78 elderly patients with SSS were selected in our hospital from 2014 to 2016,and were divided into the right ventricular apical group (RVA group,40 cases) and right ventricular outflow tract group (RVOT group,38 cases) according to sites of right ventrieular pacing.The QRS duration,accumulative total right ventricular pacing percentage and left ventricle function indicators were compared between the two groups before operation and 3,9 months after operation.Results There was no statistically significant difference in QRS duration and left ventricle function indicators before operation between the two groups (P＞0.05).The QRS durations in the RVA group at 3,9 months after operation were longer than those in the RVOT group,there were statistically significant differences (P＜0.05).No statistically significant difference was found in accumulative total right ventricular pacing percentage at 9 months after operation between the two groups (P＞ 0.05).At 9 months after operation,the left ventricular ejection fraction in the RVOT group was higher than that in the RVA group,and the left ventricular end diastolic diameter was lower than that in the RVA group,there were statistically significant differences (P＜0.05).Conclusion The effects of RVOT pacing on left ventricle systolic function in elderly patients with SSS is superior to the RVA pacing.

Objective To compare the curative effect and safety of non-X-ray fluoroscopic radiofrequency catheter ablation and conventional X-ray fluoroscopic radiofrequency catheter ablation in treating paroxysmal supraventricular tachycardia by Ensite Velocity three-dimensional electroanatomical mapping system.Methods One hundred cases diagnosed as paroxysmal supraventricular tachycardia in this hospital during 2014-2016 were selected and randomly divided into the control group (conventional X-ray exposure) and the experimental group(non-X-ray exposure by three-dimensional electroanatomical mapping system),50 cases in each group.The operation time,X-ray exposure time,complication rate,immediate and follow-up success rate were compared between two groups.Results There was no statistically significant difference in the operation time between the two groups (P＞0.05),but the X-ray exposure time in the experimental group [(0.46±0.14) min] was significantly lower than that of the control group [(13.87 ±4.03) min] and the complication rate (0 ％) was also significantly lower than that of the control group (8.00％);the immediate success rate (98.00 ％) was significantly was significantly decreased compared with the control group[(0.46± 0.14)min vs.(13.87 ±4.03)min],the complication rate was significantly lower than that in the control group(0 ％ vs.8 ％),the immediate success rate was significantly higher than that in the control group(98.00 ％ vs.84.00 ％),the follow up success rate was also significantly higher than that in the control group (94.00 ％ vs.74.00 ％),the differences were statistically significant (P＜0.05).Conclusion Using Ensite Velocity three-dimensional electroanatomical mapping system to conduct radiofrequency catheter ablation has an ideal clinical effect in the treatment of paroxysmal supraventricular tachycardia,which is safe and reliable.

This article was aimed to study the factors associated with sleep quality of anger-out and anger-in population based on the frequent pattern-tree (FP-Tree) growing algorithm with data mining. The algorithm of structuring frequent model FP-tree and mining frequent itemsets were designed. The database information scanned was recorded by using FP-Tree growing algorithm through state-trees. The frequent itemsets met minimum support required was generated through reducing the search space of project sets and scanning database only one. The data mining of all factors associated with emotional diseases was actualized. The results showed that factors associated with sleep quality of anger-out and anger-in population were disturbance in respiration, cough or snoring, feeling cold, hot or nightmares. The total time for program analysis was 2 seconds. It was concluded that data mining algorithm based on FP-Tree frequent itemsets can effectively realize the useful information receiving from factors associated with emotional diseases.

BACKGROUND:Rabbit bone marrow mesenchymal stem cels as a kind of adult stem cels with strong proliferation and multilineage differentiation potential exhibit a tremendous application potential in tissue engineering and biological therapy.
OBJECTIVE:To in vitro culture, proliferate and identify rabbit bone marrow mesenchymal stem cels and to observe cel biological characteristics.
MEHTODS:Bone marrow of rabbits was extracted under sterile conditions to separate bone marrow mesenchymal stem cels using the whole bone marrow adherence method and Percol density gradient centrifugation method. Afterwards, the cels were purified and proliferated using differential adherence method. Morphology and growth pattern of cels were observed under microscope, and expression of cel surface antigen markers was detected by flow cytometry.
RESULTS AND CONCLUSION:Rabbit bone marrow mesenchymal stem cels presented with short adherent time and fast growth. After passage and purification, impurities cel counts were decreased. Primary cels presented with triangular, fusiform and spindly shapes. Passage 5 cels with single shape showed the typical polar swirling growth, and could not express CD34 and CD45, but expressed CD29 and CD44. These findings indicate that the cels cultured using the whole bone marrow adherence method and Percol density gradient centrifugation method possess stem cel characteristics in morphology, surface markers and multilineage differentiation, which have been identified as bone marrow mesenchymal stem cels by flow cytometry.