Active immunotherapy for cancer aims to treat disease by inducing effective cellular immunity and humoral immunity.Research on virus-like particles(VLPs)vaccines has made tremendous progress in recent years,dramatically reducing morbidity and mortality from some infectious diseases.VLPs are nanoparticles self-assembled from one or more structural proteins,with highly ordered repeat sequences and good immunogenicity,which can induce strong cellular immune and humoral immune responses.VLPs can overcome immunosuppressive state of tumor microenvironment,break self-tolerance,and trigger strong cytotoxic T lymphocyte activity,which is critical for both viral clearance and destruction of cancer cells.This article mainly reviews current research progress of VLPs-based cancer vaccines and potential defects of VLPs as vaccine carriers in development of cancer vaccines.

Virus-like particles(VLPs)are nanoparticles that are self-assembled from one or more structural proteins,which can be arranged in several layers or contain a lipid outer membrane.Due to the lack of genetic material,VLPs cannot infect host cells,but are highly immunogenic and can induce immune responses different from conventional inactivated vaccines.VLPs can be produced using a variety of systems including bacterial,yeast,plant,insect and mammalian cells.Compared with traditional vaccines,VLPs have incomparable advantages,so they are becoming more and more popular in the biomedical field.To date,a series of vaccine candi-dates based on VLPs have been developed for immunization and prevention of various infectious diseases.At the same time,the recent successful application of VLPs in targeted drug delivery and gene therapy has attracted attention.This paper mainly reviews the com-monly used expression systems of VLPs and the research progress of their applications.

Objective To utilize a 3D technology in the design of a female bed urinal and to evaluate its clinical efficacy.Methods A total of 102 adult female fracture patients with normal urination function admitted to a tertiary hospital in Hangzhou City from October 2022 to June 2023 were included in the study.They were divided into a control group(n=51)and an experimental group(n=51)according to random number method.Patients in control group used a regular urinal,while patients in the experimental group used the 3D technology-based female bed urinal.The level of physical pain caused by urination,the rate of urine immersion in the sacrococcygeal or gluteal cleft and the rate of bed unit or clothing of contamination were compared between the 2 groups.Results There was no significant difference in the rate of bed unit or clothing contamination between the 2 groups(P＞0.05).However,the experimental group experienced significantly lower pain caused by urination,a lower rate of urine impregnation in the sacrococcygeal or gluteal fissure(P＜0.001),compared to the control group.Conclusion The 3D technology-based female bed urinal has reasonable structure and simple operation,which can significantly reduce the physical pain caused by the change of body position,reduce the incidence of urine immersion events.

Objective:To explore the application effect of theory of inventive problem solving(TRIZ)in the management of loaner instruments in central sterile supply department(CSSD).Methods:TRIZ management team was set up to analyze problems in cleaning,disinfection and sterilization of loaner instruments.The invention principles of TRIZ were compared to determine targeted solutions to the corresponding problems.A total of 1,000 pieces of loaner instruments received by The Third Affiliated Hospital of Air Force Medical University were selected from January and December 2023 were selected,the 500 pieces received from January to June were managed by routine standard management mode,and the 500 pieces received from July to December were managed by the TRIZ management mode.The qualification rates of instruments cleaning,disinfection,packaging and sterilization,the incidence of adverse events,the satisfaction scores of clinical departments and assessment results of newly hired nurses of CSSD were compared between the two management modes.Results:The qualification rates of instruments cleaning,disinfection,packaging and sterilization of TRIZ management mode were 98.00%(490/500),97.20%(486/500),96.40%(482/500)and 96.00%(480/500),respectively,which were higher than those of routine standard management mode,the difference was statistically significant(x2=12.029,11.685,8.859,8.322,P<0.05).The incidence of adverse events of TRIZ management mode was 0%,the routine standard management mode was 1.20%,the difference was statistically significant(x2=6.036,P<0.05).The average scores of CSSD newly hired nurses in of theoretical knowledge,treatment process,cleaning,disinfection and sterilization and packaging of TRIZ management mode were(89.20±6.69)points,(88.47±3.48)points,(92.47±5.37)points and(92.00±5.83)points,respectively,which were higher than those of routine standard management mode,the difference was statistically significant(t=3.993,4.402,3.926,3.332,P<0.05).The satisfaction scores of clinical department personnel with instruments quality,distribution,handover,information traceability,service attitude and overall satisfaction of TRIZ management mode were(18.65±0.81)points,(18.85±1.04)points,(18.95±1.05)points,(18.40±0.75)points,(18.35±0.93)points and(93.20±1.91)points,respectively,which were higher than those of the routine standard management mode,the difference was statistically significant(t=3.599,5.889,4.851,4.865,2.075,8.723,P<0.05).Conclusion:The application of TRIZ in the management of loaner instruments in CSSD can significantly improve theoretical knowledge and practical skills of newly hired nurses in CSSD,thereby improving the qualification rates of instruments cleaning,disinfection,packaging and sterilization of loaner instruments,reducing the occurrence of instrument-related adverse events and improving satisfaction of department personnel with instruments use.

Objective:To explore the impact of multimorbidity on disability in older adults, providing a reference for formulating strategies for the management and nursing of multimorbidity and disability in older adults.Methods:Adopting the method of cross-sectional survey research, the data of 6 469 older adults (≥60 years old) were collected from the 2018 Chinese Longitudinal Healthy Longevity Survey database in July 2023, including basic information, chronic disease prevalence, and disability measured by basic activities of daily living (BADL), and instrumental activities of daily living (IADL). They were divided into multimorbidity and non-multimorbidity groups based on whether they had two or more chronic diseases. The propensity score matching (PSM) method was used to match the basic conditions of the two groups of older adults with the proportion of 1∶1. Binary logistic regression was applied to analyze the effects of multimorbidity on BADL disability and IADL disability.Results:Among 6 469 older adults, there were 2 882 males and 3 582 females, with 3 158 aged 60-84 years old and 3 311 aged over 84 years old. BADL disability accounted for 26.5% (1 712/6 469), while IADL disability accounted for 66.8% (4 324/6 469). There were 2 335 patients in the multimorbidity group and 4 134 patients in the non-multimorbidity group. Binary Logistic regression analysis showed that the risk of BADL disability in older adults in multimorbidity group was 1.511 times higher than that in the non-multimorbidity group (95% CI 1.317-1.734, P<0.01); the risk of IADL disability in older adults in the multimorbidity group was 1.618 times higher than that in the non-multimorbidity group (95% CI 1.426-1.835, P<0.01). Conclusions:Multimorbidity would increase the risk of disability in older adults. Relevant authorities should develop relevant interventions and nursing responses to enhance the prevention and management of multimorbidity and disability in older adults.

Malignant tumors are a major health problem in current society. With the improvement of people's living standards and the changes in diet structure， the development trend of gastrointestinal tumors in China is gradually similar to that in developed countries. The incidence and mortality of colorectal cancer （CRC） remain high in China. Although targeted therapy and immunotherapy have greatly improved the prognosis of patients in recent years， chemotherapy is still the main means in clinical practice. However， the adverse reactions of chemotherapy often seriously affect the quality of life of patients， and even lead to treatment interruption， thereby affecting the efficacy. Oral Chinese medicine shows unique advantages in enhancing efficiency and reducing toxicity in CRC patients during chemotherapy， but its poor drug experience not only makes it difficult for patients to take it consistently but also affects the popularization of Chinese medicine at this stage. Medicinal and edible herbs （MEHs） are an important part of Chinese medicine and they are mild， delicious， convenient， affordable， nutritious， and safe. Therefore， they may be more suitable for patients with CRC chemotherapy to adhere to treatment. However， their efficacy is often criticized by clinical practitioners. They are only used in the food and health products industry， and their role as Chinese medicines has not been fully utilized. This paper summarized the common traditional Chinese medicine （TCM） syndromes and treatment methods during CRC chemotherapy， sorted out the nature， flavor， meridian tropism， and efficacy of MEHs， and reviewed the modern pharmacological research results of MEHs by the method of literature statistics. This study finds that the nature， flavor， meridian tropism， and efficacy of MEHs are in good agreement with the common TCM syndromes and treatment methods during CRC chemotherapy. Moreover， many MEHs have the effects of resisting CRC and alleviating the adverse reactions of chemotherapy. Furthermore， the effectiveness and superior efficacy of MEHs in CRC chemotherapy are initially demonstrated from the theoretical level， but high-quality clinical evidence is still needed to support it. The present study discussed the efficiency-enhancing and toxicity-reducing effects and application advantages of MEHs in CRC patients during chemotherapy to provide references for the clinical promotion of MEHs.

【Objective:】 The co-word analysis method was used to analyze narrative medical literature studied in China in the past 10 years to explore the research status in this field and lay a foundation for further research. 【Methods:】 Using "narrative medicine" as the theme term, with the limited time interval of 2013—2022 to retrieve for relevant literature in CNKI, Wanfang, and VIP databases, and include literature that meets the research standards. Bicomb2 was used to perform keyword statistics and analysis on the downloaded literature. Ucinet6.0 and Netdraw were used to draw co-occurrence analysis graphs to visualize the co-occurrence relationship between high-frequency keywords. 【Results:】 A total of 565 papers were included and 31 high-frequency keywords were extracted. The co-occurrence relationship diagrams showed that the current research hotspots of narrative medicine in China include traditional Chinese medicine, nursing, general practice, evidence-based medicine, medical ethics, hospice care, chronic diseases, cancer and other popular disciplines and diseases. Most of them were about enhancing the empathy and humanistic caring ability of medical personnel and improving doctor-patient communication to improve the doctor-patient relationship, as well as doing well in medical humanities education and cultivating narrative ability through parallel medical records and reflective writing. The research on gerontology, improving the professional identity of medical staff, integrating literature and medicine, and the impact on patients were relatively few. 【Conclusion:】 At present, narrative medicine in China has achieved many achievements in fields such as nursing, traditional Chinese medicine, general practice medicine, chronic diseases, cancer, medical humanities education, and improving doctor-patient relationships. In the future, in-depth exploration can be conducted from the use of narrative medicine in multi-disciplinary and disease fields, trying different training methods, and synchronous cultivation of teachers and students, so as to build a more comprehensive narrative medicine system.

OBJECTIVE To study the chemical composition and analgesia molecular mechanism of Shuanghu Zhongtongning tincture by UPLC-Q-TOF-MS/MS and network pharmacology. METHODS By comparing the chromatogram and blank chromatogram of Shuanghu Zhongtongning tincture, combined with PubChem, HMDB, MassBank database spectrum and the lysis information of reference substance, the chemical composition of Shuanghu Zhongtongning tincture was analyzed and identified. Protein-protein interaction network was constructed by using STRING database, and potential targets of analgesic effect of Shuanghu Zhongtongning tincture were screened. And GO and KEGG enrichment analysis were performed to analyze the core pathways related to analgesia. The network of "chemical composition-disease-target" was constructed by Cytoscape software to analyze the key compounds related to analgesia. RESULTS Seventeen core components of neochlorogenic acid, chlorogenic acid, hesperidin, neohesperidin, ferulic acid, berberine, ursolic acid, deoxyaconitine, mesaconitine, hypaconitine, benzoylmesaconine, benzoylhypacoitine, caffeic acid, quercetin, oleanolic acid, 4-hydroxycinnamic acid and mefenamic acid were identified, 3 core targets of STAT3, MAPK3 and MAPK1 were found, and 4 key signaling pathways of IL-17, TNF, PI3K-Akt and arachidonic metabolism were revealed. CONCLUSION This study preliminarily clarifies the chemical composition of Shuanghu Zhongtongning tincture and potential mechanism of analgesic effect, and provides a scientific theoretical basis for the study on the material basis and mechanism of Shuanghu Zhongtongning tincture.

Objective:To study the impact of excessive iodide intake during pregnancy and lactation on lipid metabolism in offspring male rats.Methods:Forty-eight six-week-old Wistar rats (half male and half female) were fed adaptively for one week. The cage was closed according to the ratio of male and female 1∶1. The pregnant rats were divided into two groups according to their weight (220-240 g) by random number table. (1) 10 times high iodine (10 HI) intake during pregnancy and lactation until the postnatal day 21 (PN21) of their offspring: pregnant rats were divided into normal iodine group (NI group, drinking deionized water), 10 HI group (drinking potassium iodide solution with iodine content of 2 250 μg/L). Breast milk was used to feed the offspring rats to PN21, and the offspring male rats were taken as the research subjects, with 6 rats in each group. (2) 100 times high iodine (100 HI) intake during pregnancy and lactation to the offspring postnatal day 120 (PN120): pregnant rats were divided into NI group (drinking deionized water) and 100 HI group (drinking potassium iodide solution with iodine content of 24 750 μg/L). After feeding the offspring rats with breast milk until PN21, the offspring were continued to drink potassium iodide solution with the same iodine content as the mother's to PN120. The offspring male rats were taken as the research subjects, with 6 rats in each group. The levels of free triiodothyronine (FT 3), free thyroxine (FT 4), thyrotropin (TSH) in serum, low-density lipoprotein cholesterol (LDL-C), triglyceride (TG) and total cholesterol (TC) in serum and liver tissue homogenates were measured by enzyme-linked immunosorbent assay (ELISA). The mRNA expression of cholesterol 7α-hydroxylase (CYP7A), low-density lipoprotein receptors (LDLR), sterol regulatory element-binding protein (SREBP)-1c, malic enzyme (ME) and thyroid hormone receptor β (TRβ) in the liver tissue were measured by real-time quantitative PCR. Results:(1) Effects of 10 HI intake during pregnancy and lactation on PN21 offspring male rats: compared with NI and 10 HI groups, the serum FT 3 [(7.53 ± 0.74), (8.88 ± 0.99) pmol/L], FT 4 [(5.58 ± 0.56), (7.68 ± 0.30) pmol/L], TSH levels [(16.69 ± 1.05), (14.49 ± 0.16) ng/ml] of offspring male rats were statistically significant ( t=- 2.91,-8.76, 3.59, P < 0.05). The levels of LDL-C, TG, TC in serum and liver of offspring male rats of 10 HI group were significantly lower than those of NI group ( t=3.28, 8.71, 3.44, 3.70, 3.49, 2.74, P < 0.05). The differences of mRNA expression levels of LDLR, ME, SREBP-1c in the liver of PN21 offspring male rats of 10 HI and NI groups were statistically significant ( t=- 3.50,-3.92, 5.58, P < 0.05). Among them, the levels of LDLR and ME in 10 HI group were higher than those in NI group, while the level of SREBP-1c in 10 HI group was lower than that in NI group. There no significant difference in CYP7A and TRβ mRNA levels between the two groups ( t=- 2.44, 3.20, P > 0.05). (2) Effects of 100 HI intake during pregnancy and lactation on PN120 offspring male rats: there were significant differences in serum FT 3, FT 4 and TSH levels of offspring male rats between 100 HI and NI groups ( t=- 4.39,-3.19, 4.72, P < 0.05). The levels of serum FT 3 and FT 4 in 100 HI group were lower than those in NI group, and the level of TSH in 100 HI group was higher than that in NI group ( P < 0.05). Compared with NI group, the serum and liver LDL-C, TG and TC levels in the offspring male rats of 100 HI group were significantly higher ( t=4.49, 12.85, 16.62, 4.35, 11.04, 16.01, P < 0.05). The differences of CYP7A, LDLR, ME, TRβ and SREBP-1c mRNA levels in liver of PN120 offspring male rats of 100 HI and NI groups were statistically significant ( t=26.40, 54.85,-10.98, 32.52, 10.50, P < 0.05). Among them, the CYP7A, LDLR, ME and TRβ mRNA levels in 100 HI group were lower than those of NI group, while the SREBP-1c mRNA level was higher than that of NI group ( P < 0.05). Conclusions:10 HI intake during pregnancy and lactation to the offspring male rats PN21 showed the serological changes of hyperthyroidism, the levels of blood lipids and liver lipids decreased, the levels of LDLR and ME mRNA increased, and SREBP-1c mRNA decreased in liver. However, 100 HI intake during pregnancy and lactation to the offspring male rats PN120 showed serological changes of hypothyroidism, the levels of blood lipids and liver lipids increased, the levels of CYP7A, LDLR, ME mRNA decreased, and SREBP-1c mRNA increased in liver.

Objective:To investigate the effect of long non-coding RNA 068 (lncRNA 068) on the migration of a melanoma cell line A375, and to explore its mechanism of action.Methods:From December 2015 to November 2020, 21 patients with pathologically confirmed cutaneous melanoma were collected from Department of Dermatology, Affiliated Hospital of Nantong University, and quantitative PCR (qPCR) was performed to determine the expression of lncRNA 068 in melanoma and paracancerous tissues. LncRNA 068 was overexpressed or knocked down via lentiviral transfection in A375 human melanoma cells in the following experiments. Specifically, A375 cells were divided into lentiviral vector (LV) -green fluorescent protein (GFP) group and LV-lncRNA 068 group to be transfected with a GFP-expressing LV and a LV containing lncRNA 068 respectively in the overexpression experiment, and were divided into LV-LacZ short hairpin RNA (shRNA) group and LV-lncRNA 068 shRNA group to be transfected with a LV containing the reporter gene LacZ-specific shRNA and a LV containing the lncRNA 068-targeting shRNA respectively in the low-expression experiment, with the LV-GFP group and LV-LacZ shRNA group serving as the control groups. Transwell and scratch assays were performed to evaluate cell migration, EdU cell proliferation assay and cell counting kit-8 (CCK8) assay to determine the proportion of proliferative cells and cell viability respectively, and immunofluorescence staining was conducted to evaluate epithelial-mesenchymal transformation in the above groups. Lentivirus-transfected A375 cells from the above groups were inoculated into the axillae of BALB/c nude mice, and tumor volume was measured and calculated every 3 days. After 30 days, all mice were sacrificed, and tumor tissues were resected to measure the tumor volume and weight. Cultured B16F10 cells were subcutaneously inoculated into the back and foot of BALB/c nude mice to construct mouse models of subcutaneously transplanted B16F10 melanoma. After 2 weeks, the mice were sacrificed, and qPCR and Western blot analysis were performed to determine the mRNA expression of inflammatory factors in transplanted B16F10 melanoma and paracancerous tissues, and expression of IκB kinase (IKK) /P65 signaling pathway-related proteins, respectively. Comparisons between 2 groups were done by t test, and comparisons of tumor volume and weight at different time points among groups were done by repeated measures analysis of variance. Results:qPCR showed that the relative expression of lncRNA 068 was significantly lower in human melanoma tissues and transplanted B16F10 murine melanoma tissues (0.414 ± 0.109, 0.717 ± 0.041, respectively) than in the corresponding paracancerous tissues (1.050 ± 0.103, 1.011 ± 0.023, t = 19.48, 10.83, respectively, both P < 0.001). Transwell and scratch assays both showed that the cellular migratory ability was significantly lower in the LV-lncRNA 068 group than in the LV-GFP group (both P < 0.01), and significantly higher in the LV-lncRNA 068 shRNA group than in the LV-LacZ shRNA group (both P < 0.05). Immunofluorescence assay showed significantly increased fluorescence intensity of E-cadherin and decreased fluorescence intensity of N-cadherin in the LV-lncRNA 068 group compared with the LV-GFP group (both P < 0.001), but significantly decreased fluorescence intensity of E-cadherin and increased fluorescence intensity of N-cadherin in the LV-lncRNA 068 shRNA group compared with the LV-LacZ shRNA group (both P < 0.05). In vivo tumor formation experiment in nude mice showed that there were no significant differences in the volume or weight of melanoma between the LV-lncRNA 068 group and LV-GFP group (both P > 0.05), as well as between the LV-lncRNA 068 shRNA group and LV-LacZ shRNA group (both P > 0.05). As qPCR and Western blot analysis showed, the mRNA and protein expression of interleukin-10 (IL-10) and claudin-1 in A375 cells were significantly higher in the LV-lncRNA 068 group than in the LV-GFP group (both P < 0.05), but significantly lower in the LV-lncRNA 068 shRNA group than in the LV-LacZ shRNA group (both P < 0.05). Compared with the paracancerous tissues, B16F10 melanoma tissues showed significantly decreased mRNA expression of IL-10 ( P < 0.01), but significantly increased mRNA expression of IL-6 and tumor necrosis factor-α, as well as protein expression of phosphorylated P65 and phosphorylated IKK ( P < 0.01) . Conclusion:Overexpression of lncRNA 068 can inhibit the migration of A375 melanoma cells, and may affect the development of inflammation and inhibit the epithelial-mesenchymal transformation by inhibiting the IKK/P65 signaling pathway.