Age-related macular degeneration(AMD)is a serious threat to the visual health of the elderly,and the dysfunction of retinal pigment epithelial cells(RPE)is a significant etiology risk.Aging process leads to RPE repli-cation senescence,and some environment factors like light exposure and cigarette exposure may lead to RPE stress premature aging,and the decreased lysosomal digestion ability of senescent RPE cells may lead to the accumulation of lipofuscin,triggering the occurrence of early AMD.A series of homeostatic imbalances in aging retina,such as cell senescence-renewal imbalance,oxidative stress-antioxidant imbalance,chronic inflammatory-anti-inflammatory imbalance,intestinal barrier and intestinal microbiota imbalance and pro-angiogenesis-antiangiogenic imbalance all contribute to the development of AMD.

The immune checkpoint blockade therapy has profoundly revolutionized the field of cancer immunotherapy. However, despite great promise for a variety of cancers, the efficacy of immune checkpoint inhibitors is still low in colorectal cancer (CRC). This is mainly due to the immunosuppressive feature of the tumor microenvironment (TME). Emerging evidence reveals that certain chemotherapeutic drugs induce immunogenic cell death (ICD), demonstrating great potential for remodeling the immunosuppressive TME. In this study, the potential of ginsenoside Rg3 (Rg3) as an ICD inducer against CRC cells was confirmed using in vitro and in vivo experimental approaches. The ICD efficacy of Rg3 could be significantly enhanced by quercetin (QTN) that elicited reactive oxygen species (ROS). To ameliorate in vivo delivery barriers associated with chemotherapeutic drugs, a folate (FA)-targeted polyethylene glycol (PEG)-modified amphiphilic cyclodextrin nanoparticle (NP) was developed for co-encapsulation of Rg3 and QTN. The resultant nanoformulation (CD-PEG-FA.Rg3.QTN) significantly prolonged blood circulation and enhanced tumor targeting in an orthotopic CRC mouse model, resulting in the conversion of immunosuppressive TME. Furthermore, the CD-PEG-FA.Rg3.QTN achieved significantly longer survival of animals in combination with Anti-PD-L1. The study provides a promising strategy for the treatment of CRC.

Objective:To construct a standard index system for the outpatient job competency of midwife, and to clarify the midwives' abilities when providing outpatient services, so as to improve the midwives' core competencies and service satisfaction.Methods:A research group was established in December 2018. On the basis of literature review and survey of midwives' outpatient needs in the early stage, referring to expert opinions, and taking job competency theory as the theoretical framework, the standard index system for the outpatient job competency of midwife were initially constructed. From December 2018 to March 2019, convenience sampling was used to select 24 experts from different ClassⅢ Grade A hospitals of Beijing, and the Delphi method was used to conduct 2 rounds of expert consultations.Results:Among 2 rounds of expert consultations, the effective recovery rates of the questionnaires were all 100.0% (24/24) , the positive coefficient of experts was 100.0%, and the coefficient of authority of experts was 0.786. The Kendall coordination coefficients of the 2 rounds of correspondence were 0.030 and 0.400, respectively ( P<0.05) . The final construction of standard index system for the outpatient job competency of midwife included 4 first-level indicators, 9 second-level indicators and 24 third-level indicators of knowledge and skills, professional quality, health education ability, and ability to improve the quality of professional services. Conclusions:The standard index system for the outpatient job competency of midwife is scientific and reasonable, comprehensive in content, and strong in specialty, which can provide a reference for the training and assessment of midwife.

Objective:To explore the innovative measures of scientific and technological achievements transformation in hospital by taking the practical experience of scientific and technological achievements transformation of West China Hospital of Sichuan University (WCH).Methods:The data of patents and technological achievements transformation of WCH was analyzed.Results:WCH applied for 1 800 patents and granted 1 145 during January 2015 and December 2019. By 2019, the conversion rate of scientific and technological achievements of WCH reached 14%.Conclusions:WCH has achieved remarkable results in promoting the scientific and technological achievements transformation through a series of innovative explorations and practices, including building professional technology transfer organizations and teams, establishing achievement transformation incentive policies, developing technology transformation standard process and regulations, creating a positive atmosphere of achievement transformation , as well as actively cultivating high-value patents.

OBJECTIVE: To compare the results of occupational health risk of 2-butoxyethanol(2-BE) by two risk assessment methods. METHODS: Occupational health investigation and detecting 2-BE level in workplace were carried out in a bicycle manufacturing factory in Tianjin City, a printing factory in Shenzhen City and an automobile manufacturing factory in Beijing City. The occupational health risk of 2-BE was assessed by Singapore's semi-quantitative risk assessment model and occupational hazards risk assessment index method. The risk classification results of the 2 risk assessment methods were compared and analyzed. RESULTS: The results of Singapore's semi-quantitative risk assessment method showed that all the 2-BE risk ratios of the decals workshop in the bicycle manufacturing factory, the binding and printing workshops of the printing factory, the spray finishing and the intermediate painting and the electrophoresis workshops of the automobile manufacturing factory were 0.4. The classification of 2-BE risk ratios belongs to low risk level. The results of occupational hazards risk assessment index method showed that the risk ratios of decals workshop in the bicycle manufacturing factory, the binding and printing of the printing factory, the spray finishing and the intermediate painting and the electrophoresis of the automobile manufacturing factory were 0.4, 0.4 and 0.2, respectively, which correspondence to low, low and negligible risk classification, respectively. The two methods were consistent with the appraisal positions of decals post in the bicycle manufacturing factory and the evaluation of binding and printing positions of a printing factory, although the risk assessment results of key positions in the paint shop of an automobile manufacturing industry were inconsistent. CONCLUSION: The occupational hazard risk assessment index method takes into account of the health effects, exposure conditions and operating conditions, and can comprehensively and accurately assess the occupational health risks caused by 2-BE.

Objective This study aimed to assess the diagnostic value of anti-mutated citrullinated vimentin (MCV) antibodies in rheumatoid arthritis (RA) and its correlation with disease progression, extra-articular manifestations and overlap syndrome. Methods Retrospective Studies. Clinical data of 837 patients in PekingUnionMedicalCollegeHospitalfrom June to August 2017 were collected, including the result of anti-MCV, anti-cyclic citrullinated peptide (anti-CCP) antibodies, rheumatoid factor (RF), erythrocyte sedimentation rate (ESR) and High-sensitivity-C-reactive protein (CRP). According to the 1987 American College of Rheumatology classification criteria for rheumatoid arthritis, there were 323 patients diagnosed with RA, including 59 males and 264 females with the average age of 51 years. According to whether the RA patients have overlap syndrome with other autoimmune disease (AID) or have extra-articular manifestations, 258 cases were categorized into RA group, including 47 males and 211 females with the average age of 50 years; 14 cases were categorized into the group of overlap syndrome, including 1 male and 13 females with the average age of 36 years;51 cases were categorized into the group of extra-articular manifestations, including 11 males and 40 females with the average age of 59 years.According to 2010 rheumatoid arthritis classification criteria for destruction in joints, the radiographic changes were divided into 4 stages. There were 203 casesenrolled in our study, 88 caseswere fitted into early stage group (stage I)including 21 males and 67 females with the average age of 48 years; 115 caseswere fitted into progressive stage group, which compromisedstageⅡ (interim stage), stage Ⅲ (severe stage) and stage Ⅳ(final stage) cases, including 19 males and 96 females with the average age of 53 years. Mann-Whitney U test, x2 test, Receiver operating characteristic (ROC) curves and Spearmancorrelation coefficientwere used in Statistical analysis. Results Ⅰ Amongdiagnosed RA patients, 199 (61.6％) cases were positive for anti-MCV, anti-CCP and RFsimultaneously, 42 (13％) cases were positive for anti-MCV, which was higher than anti-CCP positive (1 cases, 0.3％) or RF positive (7cases, 2.2％). The difference was statistically significant(P<0.001, P<0.001). ⅡROC was calculated and MCV=35.95 U/ml was used as best-fit cut-off value. The AUC for anti-MCV was 0.867, while the sensitivity was 80.5％and specificity was 80.9％.ⅢThe detection levels of anti-MCV (682.8 (106.4-1000.0)), anti-CCP (407 (4.0-1536.0)) and RF (82.8 (21.1-244.9)) in the group of progressive stage were higher than those in the group of early stage (114.5 (28.5-1000.0), 62.5 (5.0-1020.7), 50.1 (6.7-127.1)), which showed a significant difference(P<0.05, P<0.05, P<0.05). The anti-MCV, anti-CCP and RF were positively related to the degree of joint destruction (r=0.229, P<0.05;r=0.187, P<0.05;r=0.167, P<0.05);anti-MCV and anti-CCP were positively related to extra-articular manifestation (r=0.152, P<0.05;r=0.136, P<0.05). Conclusion Anti-MCV antibodies are more sensitive in patients with RA, and have complementary diagnostic value for anti-CCP and RF-negative patients; high levels of anti-MCV and anti-CCP in RA patients are associated with RA progression and extra-articular involvement.

Objectives To explore the clinical significance of autoantibodiesin individuals who accept a routine physical examination.Methods From April to June 2012, the serum of 932 individualsincluding 649 males and 283 females, from department of routine physical examination center of Peking Union Medical College Hospitalwerecollected , it uesd IIF for ANA, line immunoassay ( LIA) for specific ANAs antibodies and ELISA for the other antibodies , includinganti-CCP antibodies , AMA-M2, ACL antibodies and anti-anti-β2GPⅠantibodies.Chi-square test was used for data measurement of positive rate of autoantibodies in men and women;Fisher′s exact test was used when the data not meet the conditions of Chi-square test.Individualswith high-risk of autoimmune disease according to the results ofautoantibodies ( Titersof autoantibodies≥2-fold cut-off and accompanied with other autoimmune diseases related laboratory abnormalities) were recalled to visit doctor.Results Of the 932 cases, the overall positive rate of ANA was 11.27%.The positive rate of ANA was19.79%inwomen, which was significantly higher than thatin men (7.09%)(χ2 =32.6, P<0.01); the overall positive rate of ANAswas 8.69%, and the positive rate of ANA was13.43%inwomen, whichwas significantly higher than that in men ( 6.63%) (χ2 =11.49, P <0.01);the overall positive rates of AMA-M2, anti-CCP antibodies , anti ACL antibodies and anti β2GPⅠantibodies were 3.22%, 0.54%, 2.90%and 0.21% respectively , which were 2.83%, 0.71%, 3.18%and 0.71 % in women , and 3.39%, 0.46%, 2.77% and 0.00% in men respectively , there was no statistically significant of positive rate between female and male 58 patients accounting for 6.22% in high-risk of autoimmune disease were recalled , of which 15 cases, accounting for 1.61% were diagnosed or highly suspected of autoimmune diseases (AID) of the 15 patients, 11 patients accounting for 1.18% were diagnosed AID, including 6 CTD, 3 pSS, 1 RA and 1 pSS/PBC;4 patients were highly suspected as AID , including 3 suspected CTD and 1 suspected pSS.The titers concentration of the positive antibodies in patients with confirmed or suspected AID ≥ 3 times cut-off.Conclusions The positive rate of autoantibodies in individuals of physical examination is high , but there is clinical significance when the titers concentration of positive autoantibodies ≥ 3 times of the cut-off.Positive-autoantibodies patients with high-risk of autoimmune disease need professional clinician to provide follow-up, consulting and health education for early discovery, timely diagnosis, and proper treatment of AID.

Objective To define the patterns of local extension and nodal involvement in patients with early stage nasal NK/T-cell lymphoma, and to improve the delineation of clinical target volume.Methods Two hundred and twenty-two patients consecutively diagnosed with nasal NK/T-cell lymphoma were reviewed.All patients had stage Ⅰ E/Ⅱ E diseases.CT/MRI images were reviewed to determine the local invasion of adjacent organs or structures and involvement of lymph node.Results 143 of 222(64%) patients had primary tumor extended into adjacent organs or structures from nasal cavity.According to the incidence rates of tumor extension, the involved organs or structures were subclassified into three subgroups:high risk (≥40%):ethmoid sinus (60%) and maxillary sinus (55%);intermediate risk (5%-40%):nasopharynx (39%), skin (22%), oropharynx (12%), orbit (10%), and hard palate (10%);and low risk (≤5%):sphenoid sinus (3%), soft plate (3%),frontal sinus (3%) and skull base (1%).Cervical lymph node metastasis occurred in 16%(36/222) of the patients and these patients were staged as Ⅱ E.Thirty-three patients with stage Ⅱ E disease had available images and were analyzed for the pattern of nodal involvement.Submandibular or submental (57%) and the upper cervical lymph nodes (57%) were the most commonly involved sites of nodal region.For the 24 patients with primary tumor located in the unilateral nasal cavity, 54% presented with contralateral cervical lymph node metastasis.Whereas for the 9 patients with primary tumor located in the bilateral nasal cavity, 57% had bilateral cervical lymph node metastasis.For the 88 patients with extensive stage Ⅰ E disease who did not receive irradiation to the cervical lymph node, only one patient (1%) had disease relapse in cervical lymph node.Furthermore, all patients with disease extended to nasopharynx (n= 23) or oropharynx (n= 8) did not receive prophylactic cervical lymph node irradiation, and none of them developed cervical lymph node relapse.Conclusions The delineation of clinical target volume for early stage nasal NK/T-cell lymphoma should be determined by the risk of involvement of paranasal structures and cervical lymph node.Prophylactic neck irradiation is not recommended for patients with stage Ⅰ disease.

Objective From the angle of electrophysiology, go further into the mechanism of action of acupuncture treatment to the insufficient blood-supply of vertebral basilar artery and at the same time, make a comparison of the effects between the acupuncture on cephalic meridian points and zonation cephalic acupuncture. Methods Through the contrast before and after adopting the self-acupuncture on the testees of 28 cases (including healthy persons of seven cases and TIA patients of 21 cases), observe the change of immediate effect of all waves latent period values of BAEP. Results The BAEP wave latent period of healthy persons (exclusive of I wave of auditory fainting region) assumes a relative delay within the physiological range and by comparison between points and region, the delay of V-wave Baihui point is evidently higher than that of auditory fainting region. However, the latent period of all waves of TIA patients is relatively moved up, especially there are evident differences before and after the I-wave acupuncture is carried out. Viewing from the comparison between points and region, there is no significant difference. Conclusion The function of acupuncture lies in the adjustment of antagonistic body state and it is most effective under the pathological state. Acupuncture will play the main role of excitation to the auditory nerve conduction of BAEP of TIA patients (from cochlea to midbrain) and the influence over the peripheral nerves is more sensitive than over the center ones. Although points and region have their own relative specificities, there is no significant difference between them.