Objective: To investigate the effects and mechanisms of Astragalus Polysacharin(APS) on the proliferation and metastasis of breast cancer cells by regulating miR-107 and miR-346-mediated macrophage polarization in breast cancer-derived exosomes. Methods: Forty 8-week-old female BALB/c mice were selected and breast cancer xenograft models and 4T1 transplanted tumor models were established. The mice were divided into the control group and the APS group. The APS group mice received daily intragastric administration of APS for 25 days, while the control group mice were given the same amount of normal saline. After all treatments were completed, the mice were euthanized, and tumor tissues were isolated. Western blot and flow cytometry were used to detect the expressions of proliferating cell nuclear antigen(PCNA), Ki-67, CD206, CD163, inducible nitric-oxide synthase(iNOS), and CD86. The apoptosis of single-cell suspensions in tumor tissues was analyzed. Human breast cancer cell line MDA-MB-231 was cultured and stimulated with APS, and exosomes from the cell culture medium were collected. The proliferation, migration, and invasion of cells were detected by CCK-8 assay, scratch assay, permeability chamber cell invasion assay, and qRT-PCR. Differentially expressed genes were screened by bioinformatics. Results : By measuring the expressions of molecules related to breast cancer cell proliferation and metastasis, it was shown that APS treatment reduced the expressions of proliferation-related proteins(PCNA and Ki-67) and metastasis-related proteins(Vimentin) in MDA-MB-231 xenograft tumor tissues; and the polarization of tumor-associated macrophages was observed. APS treatment of 4T1 transplanted tumor tissues could reduce the number of M2 macrophages and increase the number of M1 macrophages, resulting in a decrease in the ratio of M2/M1 macrophages and an increase in cell apoptosis in 4T1 transplanted tumor tissues. The expressions of related proteins iNOS and CD86 increased, and CD206 and CD163 decreased. After APS treatment, the exosomes produced by MDA-MB-231 reduced the polarization of M2 macrophages and affected the expressions of miR-107 and miR-346. Conclusion APS inhibits the polarization of M2 macrophages by regulating the expression of miR-107 or miR-346 in breast cancer cell-derived exosomes, ultimately inhibiting the proliferation and metastasis of breast cancer cells.

Spine fracture and dislocation are common traumatic spinal conditions that often require surgical intervention due to compromised spinal stability. Surgical approaches include anterior, posterior, and combined anterior-posterior spinal procedures. According to the specific surgical requirements, patients may be placed in the prone position or repositioned between prone and supine positions during surgery. Intraoperative repositioning has become an essential step in patient positioning. However, during repositioning, patients with spinal fracture and dislocation are at increased risk for complications such as hemodynamic instability, nerve injury, and pressure injuries to the skin and soft tissue. Notably, due to the instability of the spinal cord, even minor manipulations can further exacerbate the damage, potentially leading to severe outcomes like paraplegia. Although the current clinical guidelines provide instructive recommendations for standard position, there remains no specific protocols for intraoperative repositioning in patients with spine fracture and dislocation. With a concern for the lack of clinical studies on positioning techniques, risk prevention, and operational norms for special patients, no applicable guidelines or standards are available. A consensus was required to provide clinical reference, meet the requirements of surgical treatment, and minimize the safety risks of patients caused by improper placement of positions. Professional Committee of Operating Room Nursing of Shaanxi Nursing Association organized experts in nursing management and operating room nursing from major hospitals across China to formulate Expert consensus on intraoperative repositioning for patients with spinal fracture and dislocation ( version 2025). The consensus provides 11 recommendations covering pre-repositioning preparation, intraoperative maneuvers, and post-repositioning observation, aiming to provide references for clinical standardization of the intraoperative repositioning process and protection of patients′ safety.

Spine fracture and dislocation are common traumatic spinal conditions that often require surgical intervention due to compromised spinal stability. Surgical approaches include anterior, posterior, and combined anterior-posterior spinal procedures. According to the specific surgical requirements, patients may be placed in the prone position or repositioned between prone and supine positions during surgery. Intraoperative repositioning has become an essential step in patient positioning. However, during repositioning, patients with spinal fracture and dislocation are at increased risk for complications such as hemodynamic instability, nerve injury, and pressure injuries to the skin and soft tissue. Notably, due to the instability of the spinal cord, even minor manipulations can further exacerbate the damage, potentially leading to severe outcomes like paraplegia. Although the current clinical guidelines provide instructive recommendations for standard position, there remains no specific protocols for intraoperative repositioning in patients with spine fracture and dislocation. With a concern for the lack of clinical studies on positioning techniques, risk prevention, and operational norms for special patients, no applicable guidelines or standards are available. A consensus was required to provide clinical reference, meet the requirements of surgical treatment, and minimize the safety risks of patients caused by improper placement of positions. Professional Committee of Operating Room Nursing of Shaanxi Nursing Association organized experts in nursing management and operating room nursing from major hospitals across China to formulate Expert consensus on intraoperative repositioning for patients with spinal fracture and dislocation ( version 2025). The consensus provides 11 recommendations covering pre-repositioning preparation, intraoperative maneuvers, and post-repositioning observation, aiming to provide references for clinical standardization of the intraoperative repositioning process and protection of patients′ safety.

Since the outbreak of coronavirus disease 2019 (COVID-19), chest computed tomography (CT) has been an important imaging modality in the diagnosis, treatment and follow-up of patients with COVID-19,but meanwhile the risk of cross-infection between the staff and patients in Department of Radiology is increasing. Shelter CT is specifically used for the examination of patients with suspected or confirmed COVID-19 to reduce the infection risk. Based on practical work experience, the management and prevention measures for COVID-19 in shelter CT are discussed from the aspects of the installation, function division and examination procedures of shelter CT, patient examination route, the staff management and infection prevention for radiology technologists, and the disinfection of CT equipments and object surface.

Objective:To study the effect of the psychological counseling on the delivery mode of single birth elderly primiparas with anxiety and depression, and to seek a new and effective intervention way to improve the vaginal delivery rate.Methods:A preliminary screening was carried out for 486 single birth elderly primiparas received in the birth cohort research center of China Medical University from April 2018 to September 2019. Among them, 274 cases had mild, moderate or severe anxiety and depression. They were randomly divided into the observation group and the control group (n=137). The control group was given routine nursing measures and simple psychological education and the intervention group was given extra psychological counseling. Psychological counseling adopted the mode of combination of online and offline. The degree of anxiety and depression and the delivery mode were compared between two groups.Results:Before intervention, the degree of anxiety and depression between the observation group and the control group showed no significant difference. After intervention, the degree of anxiety and depression in the observation group was lighter than that of the control group ( χ2 value was 12.782, 6.647, P<0.05). The proportion of cesarean section, vaginal delivery, forceps delivery accounted for 32.1% (44/137), 67.2%(92/137), 0.7%(1/137) in the observation group, and 45.3% (62/137), 54.7%(75/137), 0 in the control group. The difference between the two groups showed statistical significance ( χ2 value was 5.787, P<0.05). Conclusion:The psychological counseling for the single birth elderly primiparas with anxiety and depression can effectively improve the psychological situation and increase the vaginal delivery rate.

Objective:To evaluate the cryopreservation effect of the home-made Strawtop micro-carrier method and Straw method for cryopreservation of human low volume sperm.Methods:A prospective study was performed to analyze the post-thaw results of cryopreserved human sperm using the home-made Strawtop method and Straw method. Compare the survival rate, sperm DNA fragmentation index (DFI), ultrastructure, fertilization ability and embryo developmental competence of donated semen samples from the patients who underwent intracytoplasmic sperm injection (ICSI) treatment in Center for Reproductive Medicine, Shanghai East Hospital, Tongji University School of Medicine during the period from May 1, 2018 to June 30, 2018.Results:The survival rate of Strawtop group (46.8%±17.1%) was significantly higher than that of Straw group (23.1%±13.7%, P=0.001). Compared with fresh sperm (18.9%±11.6%), Straw method (33.5%±15.0%) significantly increased the sperm DFI ( P=0.019), while Strawtop method didn't (23.4%±11.7%, P=0.375). The sperm ultrastructure of Strawtop group was superior to that of Straw group. There was no difference among Strawtop, Straw and fresh group in normal fertilization rates, cleavage rates and day 2 high-quality embryo rates. Conclusion:For human low volume sperm cryopreservation, the Strawtop method was simple and convenient. The survival rate of Strawtop method was higher than that of straw method and the sperm could be used for ICSI directly after thawing. The strawtop method is worth to be widely used in clinical practice.

Objective:To evaluate the cryopreservation effect of the home-made Strawtop micro-carrier method and Straw method for cryopreservation of human low volume sperm.Methods:A prospective study was performed to analyze the post-thaw results of cryopreserved human sperm using the home-made Strawtop method and Straw method. Compare the survival rate, sperm DNA fragmentation index (DFI), ultrastructure, fertilization ability and embryo developmental competence of donated semen samples from the patients who underwent intracytoplasmic sperm injection (ICSI) treatment in Center for Reproductive Medicine, Shanghai East Hospital, Tongji University School of Medicine during the period from May 1, 2018 to June 30, 2018.Results:The survival rate of Strawtop group (46.8%±17.1%) was significantly higher than that of Straw group (23.1%±13.7%, P=0.001). Compared with fresh sperm (18.9%±11.6%), Straw method (33.5%±15.0%) significantly increased the sperm DFI ( P=0.019), while Strawtop method didn't (23.4%±11.7%, P=0.375). The sperm ultrastructure of Strawtop group was superior to that of Straw group. There was no difference among Strawtop, Straw and fresh group in normal fertilization rates, cleavage rates and day 2 high-quality embryo rates. Conclusion:For human low volume sperm cryopreservation, the Strawtop method was simple and convenient. The survival rate of Strawtop method was higher than that of straw method and the sperm could be used for ICSI directly after thawing. The strawtop method is worth to be widely used in clinical practice.

Objective To investigate the relationship between the initial change of thyroglobulin (Tg) and clinical outcome in differentiated thyroid carcinoma (DTC) patients with pulmonary metastases after 131I treatment. Methods A total of 69 DTC patients with pulmonary metastases from January 2010 to December 2015 were retrospectively analyzed. Patients were divided into 3 groups according to the variation of Tg: groupⅠ(Tg declined≥ 50%), groupⅡ(Tg declined＜50% or Tg increased＜10%), and group Ⅲ (Tg increased ≥10% ). The follow-up time was (49.2 ± 9.3) months. Clinical outcomes were divided into remission, stable disease and progressive disease according to the serum test and imaging results. Results The percentage of group Ⅰ, Ⅱ, Ⅲ patients was 44.9% (31/69), 40.6% (28/69), and 14.5% (10/69) respectively. Results of follow-up showed 19.4% (6/31) patients achieved remission and 80.6% (25/31) had stable disease in groupⅠ. There were 10.7% (3/28) patients with remission, 60.7% (17/28) with stable disease and 28.6% (8/28) with progression disease in groupⅡ. All patients showed progressive disease in groupⅢ. The clinical outcome was related to the variation of Tg after 131I treatment (P＜0.01). Conclusions Initial Tg after 131I treatment could be a predictor to the outcome of patients. The increased Tg level indicates a high possibility of 131I refractory disease.

Objective To analyze the distributions of Chinese medical syndrome types of polycystic ovary syndrome(PCOS),and explore the differences of clinical features between different syndromes. Methods The data of 496 PCOS patients and the data of reproductive endocrine and metabolic indexes were collected and ana-lyzed retrospectively. Results The results of retrospective analysis:of the 469 patients with PCOS,163 cases were phlegm and blood stasis syndrome(34.75%),157 phlegm dampness syndrome(33.48%),90 kidney liver depression syndrome(19.19%),and 59 kidney deficiency and blood stasis syndrome(12.58%). Compared with the patients with PCOS of kidney liver depression syndrome and kidney deficiency and blood stasis syndrome,the score of acanthosis nigricans as well as the levels of BMI,WC,HC,SHBG,FAI,FPG,FINS,HOMA-IR,TG, CHOL,LDL,ApoB,and ApoB/ApoA-I ratio were significantly increased(P < 0.05),but the level of HDL and ApoA-I significantly decreased in the patients of phlegm and blood stasis syndrome and phlegm dampness syndrome (P<0.05).WHR was higher in the patients of phlegm and blood stasis syndrome than in the patients of kidney liver depression syndrome and kidney deficiency and blood stasis syndrome(P<0.05).Compared with the patients with phlegm and blood stasis syndrome,the level of ApoB and the ApoB/ApoA-I ratio were lower in the patients of phlegm dampness syndrome(P<0.05),the level of FSH and LH were higher in the patients of kidney deficiency and blood stasis syndrome(P<0.05).When compared with the patients of phlegm dampness syndrome,the level of LH was higher in the patients of kidney deficiency and blood stasis syndrome(P<0.05),but the level of T was lower in the patients of kidney liver depression syndrome(P < 0.05). Conclusions Compered with the PCOS patients with phlegm dampness syndrome,kidney liver depression syndrome,kidney deficiency and blood stasis syndrome, phlegm and blood stasis syndrome patients show more serious reproductive endocrine and metabolic disorder.

AIM:To probe whether CpG oligodeoxyribonucleotides 7909 (CpG ODN7909) combined with Toll like receptor (TLR)9 affected the chemotherapeutic sensitivity of doctaxel (DOC) in human lung cancer A549 and H520 cell lines.METHODS:Sequences of TLR9 siRNAs were designed.A549 and H520 cells were transfected with TLR9 siR-NA by lipofectamine.The expression of TLR9 was detected by Western blot .The cell activity was measured by CCK-8 as-say.The experiments were divided into blank control group , control siRNA group and TLR9 siRNA interference group.The cell cycle distribution and cell apoptosis were analyzed by flow cytometry .The expression of P38 and Bax was determined by Western blot .The cells in each group were exposed to CpG ODN 7909 and/or DOC.RESULTS: In A549 cells and H520 cells, CpG ODN7909 alone had no obvious effect on the cell activity , G2/M phase arrest and apoptosis , but in-creased the protein expression of P 38 and Bax ( P<0.01) .In addition, there was no significant changes of the above inde-xes in CpG ODN7909 treated-TLR9 siRNA group was observed .DOC alone significantly inhibited the cell activity , higher the G2/M phase fractions, apoptotic rates and Bax expression (P<0.01), but didn’t affect the expression of P38 in all 3 groups.Compared with the cells treated with DOC alone , the cells treated with CpG ODN7909 combined with DOC exhibi-ted lower cell activity, higher G2/M phase fractions, apoptosis rates and more Bax expression (P<0.01), showed no sig-nificant change of P38 expression.In addition, there was no significant change of the above indexes in CpG ODN 7909 com-bined with DOC treated-TLR9 siRNA group was observed .CONCLUSION:CpG ODN7909 may enhance the chemothera-peutic sensitivity of DOC in human lung cancer cells by combining with TLR 9.The mechanism might be related to enhan-cing the inhibitory effect and apoptosis of DOC on the cell activity in vitro, arresting the cells at G 2/M phase of the cells .