Objective:To analyze the safety of reduced clinical target volume (CTV) irradiation of suspicious positive lymph nodes in IIa region in patients with N 0-N 1 nasopharyngeal carcinoma (NPC) and the protective effect of submandibular gland and long-term resting dry mouth, and to explore the diagnostic value of multimodal imaging for suspicious cervical lymph nodes. Methods:Clinical data of T 0-4N 0-1M 0 stage NPC patients admitted to Jiangsu Cancer Hospital from July 2015 to April 2017 were retrospectively analyzed. Clinical, radiation therapy planning, multimodal imaging and other relevant data were collected. All patients were treated with an optimized regimen of IMRT with a prophylactic radiation dose of 50.4 Gy (named as CTV50) for IIa region. Imaging characteristics and treatment response of suspicious lymph nodes were monitored by MRI, MRI-DWI, PET-CT and repeated enhanced positioning CT, etc. The dosimetry of the submandibular gland between optimized and standard dose plans (CTV50 vs. CTV60) was compared by paired t-test. The long-term dry mouth degree of the patients was evaluated using advanced radiation injury from Radiation Therapy Oncology Group (RTOG), Jiangsu Cancer Hospital Multi-dimensional Dry Mouth Evaluation Scale and summated xerostomia inventory (SXI). The difference of dry mouth degree was analyzed by rank-sum test. Results:A total of 106 patients were included in this study, including 149 cervical lymph node negative sides, 73 sides of which had ≤3 recognizable lymph nodes, and 76 of which were>3 in Ⅱa region. Among patients with N 1 stage, 63 patients underwent contralateral single neck area optimization, and 43 patients (N 0 stage and N 1 stage patients with retropharyngeal lymph node metastasis) underwent double-neck area optimization. A total of 109 suspicious lymph nodes with a short diameter of >5 mm were found on the largest cross section, of which 105 had clear portal structure. The ratio of long to short diameter was ≥1.5 in 93 cases, and the maximum standardized uptake value (SUV max) in PET-CT was ≥2.5 in 76 cases. No lymph node recurrence was found in the CTV optimized area. There was no significant difference in the average dose of GTV in tumor target area after optimization ( P>0.05), and the D mean and V 39 Gy in submandibular gland were significantly lower than those in unoptimized plan (both P<0.01). There was no significant difference in long-term dry mouth and resting dry mouth between patients with unilateral and bilateral optimization of submandibular gland (both P>0.05). Conclusions:The optimal program of CTV50 reduction irradiation in Ⅱa area of N 0-N 1 NPC patients is safe and effective. The submandibular gland has obvious dosimetric advantages, and patients have a good subjective response to resting dry mouth. The multimodal imaging tools such as enhanced CT, MRI-DWI and PET-CT should be performed to deliver individual evaluation and treatment for suspicious lymph nodes.

Objective: To find a viable alternative to reduce the number of doses required for the patients with post-traumatic stress disorder (PTSD), and to improve efficacy and patient compliance. Methods: In this study, we used ginger oil, a phytochemical with potential therapeutic properties, to prepare ginger oil patches. High-performance liquid chromatography (HPLC) was used to quantify the main active component of ginger oil, 6-gingerol. Transdermal absorption experiments were conducted to optimize the various pressure-sensitive adhesives and permeation enhancers, including their type and concentration. Subsequently, the ginger oil patches were optimized and subjected to content determination and property evaluations. A PTSD mouse model was established using the foot-shock method. The therapeutic effect of ginger oil patches on PTSD was assessed through pathological sections, behavioral tests, and the evaluation of biomarkers such as tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), brain-derived neurotrophic factor (BDNF), and melatonin (MT). Results: The results demonstrated that ginger oil patches exerted therapeutic effects against PTSD by inhibiting inflammatory responses and modulating MT and BDNF levels. Pharmacokinetic experiments revealed that ginger oil patches maintained a stable blood drug concentration for at least one day, addressing the rapid metabolism drawback of 6-gingerol and enhancing its therapeutic efficacy. Conclusions Ginger oil can be prepared as a transdermal drug patch that meets these requirements, and the bioavailability of the prepared patch is better than that of oral administration. It can improve PTSD with good patient compliance and ease of administration. Therefore, it is a promising therapeutic formulation for the treatment of PTSD.

BACKGROUND: Implantation of bone marrow mesenchymal stem cells (BMSCs) is a potential alternative for promoting bone defects healing or osseointegration in osteoporosis. However, the reactive oxygen species (ROS) accumulated and excessive inflammation in the osteoporotic microenvironment could weaken the self-replication and multi-directional differentiation of transplanted BMSCs. METHODS: In this study, to improve the hostile microenvironment in osteoporosis, Poloxamer 407 and hyaluronic acid (HA) was crosslinked to synthetize a thermos-responsive and injectable hydrogel to load MnO2 nanoparticles as a protective carrier (MnO2 @Pol/HA hydrogel) for delivering BMSCs. RESULTS: The resulting MnO2 @Pol/HA hydrogel processed excellent biocompatibility and durable retention time, and can eliminate accumulated ROS effectively, thereby protecting BMSCs from ROS-mediated inhibition of cell viability, including survival, proliferation, and osteogenic differentiation. In osteoporotic bone defects, implanting of this BMSCs incorporated MnO2 @Pol/HA hydrogel significantly eliminated ROS level in bone marrow and bone tissue, induced macrophages polarization from M1 to M2 phenotype, decreased the expression of pro-inflammatory cytokines (e.g., TNFa, IL-1b, and IL-6) and osteogenic related factors (e.g., TGF-b and PDGF). CONCLUSION This hydrogel-based BMSCs protected delivery strategy indicated better bone repair effect than BMSCs delivering or MnO2 @Pol/HA hydrogel implantation singly, which providing a potential alternative strategy for enhancing osteoporotic bone defects healing.

Objective To explore the effect and mechanism of Chaihu Longgu Muli Decoction (柴胡龙骨牡蛎汤, CHLGMLD) in rats with temporal lobe epilepsy (TLE). Methods A total of 80 Sprague-Dawley (SD) male rats were randomized into control (CON), model (MOD), carbamazepine (CBZ, 0.1 g/kg), CHLGMLD low dose (CHLGMLD-L, 12.5 g/kg), and high dose (CHLGMLD-H, 25 g/kg) groups, with 16 rats in each group. TLE rat models were established in the four groups with the use of lithium-pilocarpine except for the CON group. After the successful establishment of TLE models, all drugs were administered through gavage, and distilled water was given to rats in the CON and MOD groups for four weeks. The frequency and duration of seizures before and after treatment were recorded for the evaluation of the alleviation degree. Quantitative real-time polymerase chain reaction (qRT-PCR) was used to detect the expression levels of miR-146a-3p and miR-146a-5p. The expression levels of toll-like receptor 4 (TLR4), interleukin-1 receptor-associated kinase 1 (IRAK1), tumor necrosis factor (TNF) receptor-associated factor 6 (TRAF6), TAK1-binding protein (TAB), nuclear factor-kappa B (NF-κB), and interleukin-1 beta (IL-1β) in hippocampus were tested by immunofluorescence assay. Correlation analysis between the above factors and expressions of miR-146a-3p and miR-146a-5p were performed separately. Results CHLGMLD decreased the frequency (P < 0.05) and duration (P < 0.01) of seizures in rats. CHLGMLD down-regulated the expression levels of miR-146a-5p and miR-146a-3p (P < 0.05), and inhibited the expression levels of TLR4, IRAK1, TRAF6, TAB, NF-κB, and IL-1β (P < 0.01). The correlation analysis revealed that the expression levels of TLR4, IRAK1, TRAF6, TAB, NF-κB, and IL-1β were positively correlated with the expression levels of miR-146a-3p and miR-146a-5p detected by qRT-PCR, respectively (P < 0.01). Conclusion CHLGMLD can inhibite the TLR4 signaling pathway by lowering the expression levels of miR-146a-3p and miR-146a-5p to alleviate hippocampal dentate gyrus inflammation in TLE rats, thus relieving seizures.

Clustered regularly interspaced short palindromic repeats (CRISPR)/CRISPR-associated (Cas) protein system, as an emerging gene editing system, can be divided into class 1 and class 2 systems according to the number of Cas protein. The CRISPR/Cas9 in class 2 system can cleave target nucleic acid only with the help of Cas9 protein and single-stranded guide RNA, which is currently the most widely used CRISPR/Cas system. In addition to gene editing in the treatment of genetic diseases, a variety of CRISPR/Cas system derived technologies have vast application prospect in the fields of disease-related gene screening, gene expression regulation, and rapid detection, prevention, and control of pathogens. This article summarizes the discovery process of CRISPR/Cas system and applications of several major CRISPR/Cas derived technologies, aiming to provide a reference for researchers in the field of life science.

Objective:To determine initial concentrations of ozonated water under different temperatures,attenuation rules ofozonated water under the room temperature (25 ℃),and to inspect the effects ofozonated water under different concentrations on common microorganisms.Methods:The online test method and the plate cultivation method were employed to check the concentrations and killing rates on common microorganisms of ozonated water produced by HZ-2601 B Ozone Water Generating Instrument.Results:The initial concentrations of ozonated water at 20,25,30,35,and 40 ℃ were 4.38,4.26,3.12,2.76,and 1.31 mg/L,respectively.The ozonated water was rapidly attenuated at first 10 min.The concentration ofozonated water still remained at 1.06 mg/L and 0.37 mg/L at 25 and 30 ℃ after 30 min.The average killing rates for Pseudornonas aeruginosa,Escherichia coli,Staphylococcus aureus,methicillin-resistant Staphylococcus aureus,and Candida albicans in 1.0 mg/L ozonated water for 1 min were 99％,100％,100％,100％,and 100％,respectively.The average killing rates of Escherichia coli,Staphylococcus aureus,methicillin-resistant Staphylococcus aureus,Pseudomonas aeruginosa,and Candida albicans in 0.3 mg/L ozonated water for 1 min were 100％,100％,100％,95％,and 92％,respectively.Conclusion:The initial concentrations of ozonated water produced by HZ-2601 B Ozone Water Generating Instrument decrease with the increase of temperature.Ozonated water under 20-30 ℃ has good sterilization effect on common microorganisms.

Objective:To verify the effect of ozone on Staphylococcus aureus (S.aureus) colonization in patients with atopic dermatitis (AD) and its correlation with the patient's status.Methods:A total of 12 patients with moderate or severe AD,aged from 6 to 65 years,were recruited from outpatient of the Third Xiangya Hospital.The treatment sides were showered with ozonated water and smeared with ozonated oil for 7 days (twice a day),while the control sides were washed with warm running water and smeared with base oil.At different time points,the severity scoring ofatopic dermatitis (SCORAD) scores,sleep and pruritus scores were assessed and compared between the two sides.Meanwhile,plate cultivation was used to quantitatively detect the changes ofS.aureus colonization in skin lesions.Results:After 7 days treatment,erythema and pimples were decreased in the treatment sides.The clear skin texture,smooth skin,improved skin lesions were also observed by dermoscopic examination.The results of reflectance confocal microscopy (RCM) demonstrated that the parakeratosis was improved,the structures were clearer,and the inflammatory cells infiltration was reduced after ozone treatment for 7 days.After ozone treatment for 3 and 7 days,the S.aureus colonization in the treatment sides decreased by (75.55±21.81)％ and (97.24±2.64)％ respectively.Compared to that of control sides,the percentage of S.aureus colony after ozone treatment for 7 days decreased significantly (P＜0.01).After ozone treatment for 7 days,the SCORAD scores,sleep and pruritus scores were significantly decreased (all P＜0.01).There was a linear correlation between the decreasing percentage of S.aureus colony and the declining percentage of SCORAD scores in AD patients.Conclusion:Topical ozone therapy can effectively reduce S.aureus colony in skin lesions and alleviate the severity of AD patients with moderate to severe degree.

Objective:To evaluate the clinical efficacy and safety of the innovative topical ozone therapy for infantile atopic dermatitis.Methods:Sixty children with atopic dermatitis were divided into a treatment group and a control group.The treatment group was showered with ozonated water (3-5 times a week) and smeared with ozonated oil (twice a day),while the control group was washed with warm running water and smeared with base oil,adding moisturizer if necessary.The treatment course was 2 weeks.Efficacy and side effect were evaluated.Results:The skin exudation was reduced and erosion was healing after 3-5 days topical ozone therapy for infantile atopic dermatitis.The effective rates were 80.0％ and 20.0％ in the treatment group and control group for 1 week,and 89.6％ and 30.7％ for 2 weeks,respectively,with significant difference between the 2 groups (P＜0.001).Conclusion:Innovative treatment of infantile atopic dermatitis with topical ozone application is safe and effective,which is worth popularizing in clinic.

Objective:To observe the clinical efficacy and safety of topical ozone therapy for patients with herpes zoster by reflectance confocal microscopy (RCM).Methods:A total of 60 patients with herpes zoster were divided into a control group and an ozone treatment group (n=30).In the control group,patients took oral valacyclovir tablets or granules (0.3 g per day,three times a day) and they were subjected to local weak laser irradiation treatment plustopical 2％ mupirocin ointment twice a day.In the ozone group,the treatment is same as the control group except mupirocin ointment was replaced with topical ozone treatment (hydrotherapy every day plus ozonated oil twice a day).The clinical symptoms,discoid cell and adverse reactions were observed and taken records at day 0,3,7 and 14.Statistical analysis was performed to compare the clinical efficacy between the 2 groups.Results:On the seventh day of treatment,the discoid cells of the ozone group disappeared,and the difference between the control group and the ozone group was statistically significant (P＜0.05).The difference of decreased percentage of pain scores at each time point between the 2 groups was statistically significant (P＜0.05).The clinical efficacy was 100％ in the ozone group and 86.7％ in the control group,with significant difference between the 2 groups (P＜0.05).Conclusion:Topical ozone therapy in patients with herpes zoster is helpful in relieving pain,shortening the course as well as improving the clinical efficacy without obvious adverse reactions.It is worth to be popularized.

Burn medicine of China started in 1958. Great progress has been achieved in discipline construction, scientific research, clinical treatment level, and talent team construction in 60 years. A large number of severely burned patients have been successfully treated, and plans for treatment of burn patients with Chinese characteristics have been established with world-leading treatment level. At the same time, in the continuous improvement of clinical treatment level, extensive experimental researches for the key scientific problems in clinical treatment of burn patients have been conducted, and a large number of innovative research results have been achieved by Chinese burn medicine workers. The theoretical research of burn medicine in China has stepped into advanced ranks of the world. Burn medicine will confront development opportunity and tough challenge in the future. We can take advantage of wound repair of burn discipline to deal with the situation of decreasing incidence of burn and undiminished importance of burn medicine. To establish and improve the chain of burn treatment is an important direction for burn discipline development in the future.