The different fate of liposomes among species has been discovered and mentioned in many studies, but the underlying mechanisms have not been explored. In the present work, we concentrated on the in vivo fate of PEGylated liposomes (sLip) in three commonly used species (mice, rats, and dogs). It was exhibited that the accelerated blood clearance (ABC) phenomenon and hypersensitivity in large animals (beagle dogs) were much more significant than that in rodents. We demonstrated that anti-PEG IgM (partially) and complement (mostly) determined the elimination of sLip and linked the distinct interspecies performances with the diverse complement capacity among species. Based on the data from animals and clinical patients, it was revealed that the fate of sLip in large animals was closer to that in humans, for the sufficient complement capacity could expose the potential adverse reactions caused by anti-PEG antibodies. Our results suggested that the distinctive interspecies performances of sLip were highly related to the physiological variabilities among species, which should not be overlooked in the innovation and translation of nanomedicines.

Informed consent is an important ethical symbol in clinical research,and researchers have the responsibility to fully inform participants of the research information before conducting clinical research.However,it is difficult to obtain complete informed consent form participants or their guardians within a narrow treatment time period in clinical research conducted in emergency situations.Currently,in addition to traditional general informed consent,there are also reality-accepted informed consent,including exemption of informed consent,broad informed consent,and deferred informed consent.By introducing the origin and development process of deferred informed consent in clinical research,this paper sorted out the current application status of deferred informed consent,proposed the prerequisites for applying deferred informed consent in emergency situations,and explored the issues that need to be noted during the application process of deferred informed consent.It is hoped to provide an ethical defense and ethical procedure for the application of deferred informed consent in clinical research in emergency situations.

Objective:To observe any effect of 12 weeks of moderate-intensity continuous training (MICT) and of high-intensity interval training (HIIT) on intestinal inflammation and the expression of α7 nicotinic acetylcholine receptor (α7nAChR) and nuclear factor kappa B p65 (NF-κΒp65) in rats fed a high-fat diet.Methods:Thirty-two healthy 5-week-old male Sprague-Dawley rats were divided at random into a normal diet and quiet group, a high-fat diet and quiet group, a high-fat diet MICT group, and a high-fat diet HIIT group, each of 8. The high-fat diet MICT group underwent continuous treadmill exercise at 70% of their maximum oxygen uptake (VO 2max), while the high-fat diet HIIT group did treadmill exercise at 40% to 45% of their VO 2max alternating with intervals at 95% to 99% of their VO 2max. The two quiet groups did no exercise. After 12 weeks, hematoxylin-eosin staining was used to observe the morphology of the rats′ intestinal tissue. Serum levels of low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglycerides (TG) and free fatty acids (FFA) were determined, and immunofluorescence double labeling and western blotting were applied to detect the expression levels of α7nAChR, NF-κB p65 and tumor necrosis factor α (TNF-α) in the rats′ intestines. Results:Compared with the normal diet quiet group, the quiet group on a high fat diet had, on average, significantly heavier final body weights, lower total food intake, higher serum LDL, TG and FFA, lower HDL levels, and less protein expression of intestinal α 7nAChR. They showed higher average fluorescence intensity and expression of NF-κB p65 and TNF-α protein. Compared with the high-fat diet quiet group, the high-fat diet MICT and HIIT groups had significantly lighter final body weight, on average, lower total food intake, lower LDL and FFA levels and higher average fluorescence intensity. They showed significantly greater expression of α 7nAChR and NF-κB p65 protein, and lower expression of TNF-α protein. Compared with the high-fat diet MICT group, there was a significantly higher HDL content and lower average fluorescence intensity of NF-κ -Bp65 observed in the high-fat diet HIIT group. Moreover, reduced inflammatory infiltration, epithelial damage and mucosal crypt destruction were found in the colon tissue sections of both the high-fat diet MICT and HIIT groups.Conclusions:Twelve weeks of either MICT or HIIT can relieve intestinal inflammation resulting from a high-fat diet, at least in rats. The training increases the intestinal expression of α 7nAChR protein, and reduces the expression of NF-κBp65 and TNF-α. HIIT is superior to MICT in its effects.

Objective:To observe any effect of 12 weeks of moderate-intensity continuous training (MICT) and of high-intensity interval training (HIIT) on intestinal inflammation and the expression of α7 nicotinic acetylcholine receptor (α7nAChR) and nuclear factor kappa B p65 (NF-κΒp65) in rats fed a high-fat diet.Methods:Thirty-two healthy 5-week-old male Sprague-Dawley rats were divided at random into a normal diet and quiet group, a high-fat diet and quiet group, a high-fat diet MICT group, and a high-fat diet HIIT group, each of 8. The high-fat diet MICT group underwent continuous treadmill exercise at 70% of their maximum oxygen uptake (VO 2max), while the high-fat diet HIIT group did treadmill exercise at 40% to 45% of their VO 2max alternating with intervals at 95% to 99% of their VO 2max. The two quiet groups did no exercise. After 12 weeks, hematoxylin-eosin staining was used to observe the morphology of the rats′ intestinal tissue. Serum levels of low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglycerides (TG) and free fatty acids (FFA) were determined, and immunofluorescence double labeling and western blotting were applied to detect the expression levels of α7nAChR, NF-κB p65 and tumor necrosis factor α (TNF-α) in the rats′ intestines. Results:Compared with the normal diet quiet group, the quiet group on a high fat diet had, on average, significantly heavier final body weights, lower total food intake, higher serum LDL, TG and FFA, lower HDL levels, and less protein expression of intestinal α 7nAChR. They showed higher average fluorescence intensity and expression of NF-κB p65 and TNF-α protein. Compared with the high-fat diet quiet group, the high-fat diet MICT and HIIT groups had significantly lighter final body weight, on average, lower total food intake, lower LDL and FFA levels and higher average fluorescence intensity. They showed significantly greater expression of α 7nAChR and NF-κB p65 protein, and lower expression of TNF-α protein. Compared with the high-fat diet MICT group, there was a significantly higher HDL content and lower average fluorescence intensity of NF-κ -Bp65 observed in the high-fat diet HIIT group. Moreover, reduced inflammatory infiltration, epithelial damage and mucosal crypt destruction were found in the colon tissue sections of both the high-fat diet MICT and HIIT groups.Conclusions:Twelve weeks of either MICT or HIIT can relieve intestinal inflammation resulting from a high-fat diet, at least in rats. The training increases the intestinal expression of α 7nAChR protein, and reduces the expression of NF-κBp65 and TNF-α. HIIT is superior to MICT in its effects.

Objective:To retrospectively analyze the relationship between patterns of local recurrence and radiotherapy target dose after adjuvant radiotherapy for the pancreatic ductal adenocarcinoma(PDAC), aiming to provide reference for exploring reasonable target and dosage.Methods:Clinical data of 138 patients with T 1-4N 0-2M 0 PDAC who underwent adjuvant radiotherapy after radical resection from April 2012 to December 2020 were analyzed retrospectively. The influencing factors of local recurrence and the correlation between local recurrence site and radiotherapy target dose were analyzed. Results:The median follow-up time was 37.2 months. The median overall survival (mOS) was 29.9 months. The 5-year OS rate was 27.4%. And the median progression-free survival (mPFS) was 13.9 months. There were 24 cases of local recurrence (17.4%), and 10 cases of local recurrence complicated with distant metastasis (7.2%). The correlation between local recurrence site and radiotherapy target dose could be evaluated in 19 patients with complete clinical data. The first local recurrence occurred near the para-aortic (Ao), the celiac axis (CA) and the superior mesenteric artery (SMA) were 8, 5 and 4 cases, respectively. The radiotherapy doses of 8 patients with local recurrence only in the PTV field were above 45 Gy. There were 8 cases of local recurrence both in and out of the PTV field, including 3 cases with dose line between 40 and 52 Gy, 2 cases with dose line between 20 and 47.5 Gy, and 3 cases with dose line between 0.5 and 52.5 Gy. There were 3 cases of local recurrence out of the PTV field, and the dose line ranged from 0 to 20 Gy.Conclusions:The local recurrence rate of PDAC after radical surgery combined with postoperative radiotherapy is low, but a small number of patients have recurrence in the high-dose range of radiation field and regional recurrence out of the field. For these patients, it may be necessary to explore a more appropriate target dose and range for adjuvant radiotherapy.

Objective:To explore the research hotspots in home care for the aged at home and abroad, so as to provide a reference for the research on the home care for the aged in China.Methods:Literature on home care for the aged at home and abroad was retrieved in China National Knowledge Infrastructure (CNKI) and Web of Science Core Collection from January 1, 2010 to July 8, 2020. SPSS, COOC and other softwares were used to visually analyze the retrieval results.Results:In the past ten years, the common research hotspots in home care for the aged at home and abroad focused on health education, family caregivers, quality of life, senile dementia, community care, and long-term care. Domestic and foreign scholars had different emphases on dementia and long-term care research. In the past ten years, the differences in the research hotspots of home care for the aged at home and abroad were reflected in the nursing model, family function, and physical and mental health management of the aged. Domestic scholars paid more attention to the management of elderly physical diseases, while foreign scholars paid more attention to the high-dimensional needs of elderly health management and dignity in the management of elderly diseases at home.Conclusions:In the past ten years, the differences in the research hotspots of home care for the aged at home and abroad are mainly concentrated on the nursing level. Domestic scholars paid more attention to disease care, while foreign scholars pay more attention to high-dimensional psychological needs and health level management. It prompts Chinese scholars to carry out research on the status of the high-dimensional needs of the aged, as well as related research on satisfaction strategies.

Objective: To investigate the effect of overexpression of Notch intracellular domain (NICD) on proliferation and osteogenic differentiation of human periodontal ligament stem cells (hPDLSC). Methods: The third generation hPDLSC with stable overexpressing of NICD were assigned as experimental group, normal hPDLSC were as negative control group and hPDLSC transfected with empty vector were as blank control group. The effect of overexpressing NICD on proliferation ability of hPDLSC was detected by using cell counting kit-8 (CCK-8). Alizarin Red staining and real-time quantitative PCR (qPCR) were used to detect the effects of NICD on cementum attachment proteins (CAP), osteocalcin (OCN), Runt-related transcription factor 2 (RUNX2) and Notch signal pathway receptor Notch1. The effect of overexpressing NICD on hPDLSC osteogenic protein RUNX2 and flag marker protein (used to label NICD) were detected by using Western blotting. Results: CCK-8 results showed that there were no significant differences in A values amongst the three groups for 1-2 days (P>0.05). The number of cells in the experimental group was significantly increase than that of the two control groups from the third to seventh days (A values were 0.203±0.016, 0.364±0.014, 0.449±0.020, 0.549±0.020 and 0.570±0.020, respectively) (P<0.05). Alizarin red staining showed that compared with the blank control group and negative control group, the mineralized nodules in the experimental group had smaller formation range and lighter color, and the differences were statistically significant (P<0.05). The expressions of CAP gene (0.751±0.058, 0.887±0.025), osteocalcin gene (0.592±0.051, 0.670±0.045) and RUNX2 gene (0.319±0.038, 0.684±0.055) at 14 and 21 days in the experimental group were significantly lower than those in the negative control group respectively (P<0.05). However, the expression levels of Notch1 gene at 14 and 21 days (2.507±0.047, 4.041±0.219) were significantly higher than those of negative and blank control groups (P<0.05). The results of Western blotting showed that the expressions of flag marker protein (0.167±0.007, 0.204±0.010) at 14 and 21 days in the experimental group were significantly higher than those in the negative and blank control groups (P<0.05). However, the expressions of RUNX2 protein (0.075±0.006, 0.074±0.013) at 14 and 21 days were significantly lower than that in the negative control group (0.092±0.003, 0.118±0.008) and blank control group (0.174±0.006, 0.212±0.008) (P<0.05). Conclusions Overexpression of NICD can promote the proliferation capacity of hPDLSC and inhibit its osteogenic differentiation.

With the development of economy and society, the change of heath concept and increased demands for health care , the cultivation of postgraduates majoring in clinical medicine is facing a lot of problems which seriously affects the quality of culti-vation.The article analyzed the problems and reasons in the clinical medicine postgraduate cultivation.We stated the competency of clinical medicine postgraduates according to the transition of health demands, global medical development and practical requirements for clinical personnel in China.We elaborated the required post competence for clinical medicine postgraduates on the basis of its con-tent and characteristics.We proposed to strengthen the cultivation of clinical medicine postgraduates by the reform and support of the government, enhanced construction of teachers, improved course plan and cultivation process, perfected assessment system in order to make the students competent to their posts.

Objective To assess the diagnostic value of capsule endoscopy (CE) and CT virtual endoscopy (CTVE) for small intestinal diseases.Methods The data of 31 patients with suspected small bowel diseases who were examined by both CTVE and CE were collected.The diagnostic rates of CE and CTVE was compared by paired data McNemar test,using the diagnosis confirmed by surgery or follow-up as the golden standard.Results The confirmed diagnosis of 31 patients were small intestinal tumor in 16,nontumorous lesion in 10 and no abnormal lesion in 5.CE identified positive findings in 24 patients,including 14 cases of tumorous lesion (with mis-location in 2 and failure in definite diagnosis in 7) and 10 cases of non-tumorous lesion.CTVE identified positive findings in 17 patients,including 14 cases of tumorous lesion (with mis-location in 1 and failure in definite diagnosis in 4) and 3 cases of non-tumorous lesion.The combination of CE and CTVE could identified positive findings in 26 patients,including 16 tumorous and 10 nontumorous lesions.The diagnostic rates of CE and CTVE for tumorous lesions were both 87.5％ (14/16).The overall diagnostic rate of combined CE and CTVE was 83.9％ (26/31),which was significantly higher than that of CTVE alone (54.8％,17/31) but similar to that of CE alone (77.4％,24/31).Conclusion Both CE and CTVE are effective in diagnosis of small intestinal lesions and the combined use of 2 methods can increase diagnosis yield.

Objective To describe the structure and the level of the stress of nursing students in clinic practice,and supply reference for reform of clinical teaching method.Methods Totally 100 undergraduate nursing students in clinic practice,who would graduate from nursing school and begin to work in 2013,were interviewed and investigated.Results The main stress sources were divided into five aspects:recognition,clinical nursing ability,career development,field response and exhaustion of body and mind.Conclusions The structure and level of the stress of nursing students changed a lot.Some new appropriate reform should be introduced into clinic education,in order to help nursing students to complete psychological change and role adaptation.