Neurodevelopmental disorders(NDDs)are chronic developmental brain disorders that can affect cognition,motor,social adaptation,behavior and so on due to multiple genetic or acquired causes.Natural polysaccharides are synthesized by living organisms,located in the cell wall,inside and between cells,and outside the cells,and are essential components of life activities.Previous studies have found that natural polysaccharides play an important role in neurological diseases,which mainly ameliorate the behavioral abnormalities and clinical symptoms caused by anti-oxidative stress,anti-neuronal apoptosis,anti-neuroinflammation,anti-excitatory amino acid toxicity,and regulation of the brain-gut axis.This review summarizes the intervention role of 17 bioactive polysaccharides from plants and fungi in neurological diseases,aiming to provide new ideas for the research and treatment of NDDs.

Objective:To observe the efficacy and safety of albumin paclitaxel in patients with advanced breast cancer.Methods:A retrospective analysis was performed on 138 patients with advanced breast cancer admitted to Xiangyang Central Hospital from June 2018 to June 2021. The patients were divided into groups according to molecular type, number of treatment lines for albumin paclitaxel, number of metastatic sites, specific metastatic sites, past use of docetaxel and paclitaxel and combination therapy of albumin paclitaxel. Median progression-free survival (mPFS) and treatment-related adverse reactions in different subgroups treated with albumin paclitaxel were investigated. Survival curves were plotted by Kaplan-Meier method and log-rank test was performed, and multivariate analysis was performed by Cox model.Results:The mPFS of the overall population was 8.2 months. The mPFS of triple negative breast cancer, human epidermal growth factor receptor-2 (HER-2) positive breast cancer and Luminal breast cancer were 6.4 months, 11.2 months and 8.1 months respectively, with a statistically significant difference (χ 2=7.42, P=0.025) . The mPFS of patients treated with first- and second-line albumin paclitaxel was 9.5 months, and the mPFS of patients treated with third- to seventh-line was 6.3 months (χ 2=3.86, P=0.049) . The mPFS of patients with ≤3 metastatic sites was 8.1 months, and the mPFS of patients with >3 metastatic sites was 7.0 months (χ 2=0.38, P=0.535) . The mPFS of patients with liver and brain metastases was 6.8 months, and the mPFS of patients with extrahepatic and extracerebral metastases was 9.6 months (χ 2=7.53, P=0.006) . The mPFS of patients who had previously treated with docetaxel and paclitaxel was 8.2 months, and the mPFS of patients who had not previously received docetaxel or paclitaxel was 9.6 months (χ 2=0.03, P=0.862) . The mPFS of patients with albumin paclitaxel combined with targeted therapy, combined with immunotherapy, combined with chemotherapy and monotherapy were 12.1, 7.8, 9.0 and 7.1 months respectively, with a statistically significant difference (χ 2=8.96, P=0.030) . Multivariate analysis showed that molecular type (triple negative breast cancer RR=1.87, 95% CI: 1.24-4.22, P=0.008; HER-2 positive breast cancer RR=0.63, 95% CI: 0.52-0.94, P=0.042) , number of treatment lines ( RR=0.67, 95% CI: 0.32-0.86, P=0.011) , specific metastatic sites ( RR=1.26, 95% CI: 1.12-2.75, P=0.014) and combination therapy (combined with targeted therapy RR=0.74, 95% CI: 0.16-0.86, P=0.021; combined with chemotherapy RR=0.93, 95% CI: 0.48-0.96, P=0.045; combined with immunotherapy RR=0.81, 95% CI: 0.17-0.78, P=0.032) were independent factors for prognosis. The main adverse reactions were alopecia, neutropenia, peripheral neurotoxicity and rash, and there was no death caused by adverse reactions. Conclusion:Albumin paclitaxel is effective in the treatment of advanced breast cancer with controllable adverse reactions.

Objective:To investigate the clinical characteristics as well as short-term and long-term prognostic factors of patients with Stanford type B aortic dissection (TBAD) with hypertension.Methods:Patients with TBAD who received thoracic endovascular aortic repair (TEVAR) admitted to Xiangyang Central Hospital from January 2014 to December 2018 were enrolled. The baseline data of patients admitted to the hospital were collected through the case management system, including gender, age, underlying diseases (hypertension, diabetes, coronary heart disease), smoking history, drinking history, duration of pain, vital signs at admission [heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP)], laboratory results [white blood cell count (WBC), platelet count (PLT), neutrophil/lymphocyte ratio (NLR), serum creatinine (SCr), C-reactive protein (CRP), D-dimer, ascending aorta diameter], etc. The clinical characteristics of TBAD patients with hypertension were analyzed. Logistic regression model and Cox proportional risk model were used to analyze the impact of hypertension on the short-term and long-term all-cause deaths after TEVAR in TBAD patients.Results:Among 227 TBAD patients, 160 cases (70.5%) were complicated with hypertension, while 67 cases (29.5%) were not. The average age, the proportion of diabetes and coronary heart disease, and the level of SBP, DBP and SCr at admission of TBAD patients with hypertension were higher than those of TBAD without hypertension [age (years old): 53.1±11.9 vs. 42.8±14.1, combined with diabetes: 8.8% vs. 1.5%, combined with coronary heart disease: 6.3% vs. 0%, SBP (mmHg, 1 mmHg = 0.133 kPa): 147.9±18.1 vs. 136.9±15.2, DBP (mmHg): 93.9±11.9 vs. 89.1±13.8, SCr (μmol/L): 97.8±25.4 vs. 89.8±23.6, all P < 0.05]. The short-term mortality of TBAD with hypertension group was significantly higher than that of TBAD without hypertension group [6.3% (10/160) vs. 0% (0/67), χ2 = 4.386, P = 0.036]. 227 patients with TBAD were followed up for 3-66 months, with a median follow-up time of 25 months. There was no significant difference in long-term mortality between TBAD patients with and without hypertensive during discharge follow-up [13.1% (21/160) vs. 9.0% (6/67), χ2 = 0.784, P = 0.376]. Further multivariate Logistic regression analysis and Cox regression analysis did not indicate that hypertension was an independent risk factor for short-term and long-term death in TBAD patients [odds ratio ( OR) and 95% confidence interval (95% CI) were 13.477 (0.541-330.215), 1.012 (0.990-1.035), both P > 0.05]. Age and HR were independent risk factors for the short-term mortality of TBAD patients [ OR and 95% CI were 15.287 (1.051-226.415), 0.026 (0.002-0.840), both P < 0.05]. Age, PLT and D-dimer were independent risk factors for the long-term mortality of TBAD patients [ OR and 95% CI were 1.808 (1.205-2.711), 0.555 (0.333-0.924), 1.482 (1.035-2.122), respectively, all P < 0.05]. Conclusions:The TBAD patients with hypertension have older age, high rates of diabetes or coronary heart disease. However, hypertension is not an independent risk factor for short-term and long-term mortality in TBAD patients.

Objective: To investigate the clinical significance of antegrade lower limb venography in varicose veins of lower limbs. Methods: The data of 230 cases of varicose veins of lower limb in Department of Vascular Surgery, Xiangyang Central Hospital from June 2018 to August 2019 were examined by antegrade lower limb venography. All patients were divided into simple varicose veins group (group A, 67 cases) and secondary varicose veins group (group B, 63 cases) according to the patency of deep veins. The data of sex, limb side, swelling and ulcer were analyzed respectively. Results: There was no significant difference in the results of sex between the two groups (57.5% vs 63.5%, P>0.05). The incidence of left side in group A was lower than that in group B (59.3% vs 76.2%, P<0.05). And the incidence of swelling of lower extremities and ulcer in boot area in group A was lower than that in group B (31.1% vs 49.2%, P<0.05; 18.6% vs 31.7%, P<0.05 respectively). Conclusions Combined with swelling of lower extremities, ulcer in boot area or the varicose veins in left side had a higher incidence of secondary varicose veins. Anterograde venography of lower extremities can accurately distinguish the classification of varicose veins of lower extremities and improve the diagnostic coincidence rate, which has significant clinical significance.

The hospital grade assessment is an effective approach to measure the comprehensive strength and the overall level of a hospital, and it is also an effective carrier which can promote the standardized management , improve the quality of connotation and accelerate the development of the hospital .This article aims to expound the effective and concrete methods for preparation in the hospi -tal grade assessment by introducing the practice and experience of Jinling Hospital in grade assessement .It also points out that:defi-ning the purpose of the assessment is the fundation , having a thorough grasp of the assessment criteria is the basis , having a compre-hensive knowledge of the hospital is the premise , establishing and implementing the plan strictly is the crux .All these might be helpful to promote the hospital grade assessment .

Objective:Until recently, no consensus has been reached about the treatment of primary tumor in patients with meta-static breast cancer, and whether or not to excise it has not yet reached agreement. This study aimed to evaluate the value of surgical and nonsurgical treatment of primary tumor by analyzing the clinical data of patients with metastatic breast cancer. Methods:This re-view includes the data of 120 metastatic breast cancer patients. Their clinical data in Xiangyang Central Hospital (Hubei province) from January 2005 to December 2012 were collected. All cases were divided into surgical and nonsurgical groups, and the overall survival and symptomatic local progression rates were analyzed. Results:The 120 patients had a median follow-up of 52 months (range=10-92 months). A total of 55 cases were in the surgical group, 30 of whom had surgery before the metastatic diagnosis, and 65 cases were in the nonsurgical group. No significant differences were observed regarding the tumor classification, lymph-node classification, and meta-static site of the tumor in the two groups. Patients in the surgical group experienced longer overall survival (49 months vs. 33 months, P=0.016) and lower rates of symptomatic local progression (14.5%vs. 46.2%, P<0.001). Conclusion:This study demonstrated that the overall survival and symptomatic local control in the surgical group were better than those in the nonsurgical group. However, this hy-pothesis remains to be proved by multicenter clinical trials.

Objective To quantify the correlation between isometric and isokinetic tests of core muscles during trunk rotation. Methods The strength of the core muscles of 38 healthy males was measured isometrically and isokinetically ( at 60°/s) during trunk rotation.The left and right peak rotation torque ( LPT,RPT) and the ratio of left to right torque (L/R) were analyzed using correlation and regression analysis and paired t-tests. Results The subjects' LPTs and RPTs were positively correlated ( rL =0.644,P ≤ 0.01 ;rR =0.566,P≤0.01 ) There were significant differences in the L/R ratios determined using the two tests (r=0.663,P≤0.01 ).The regression equations predicting LPT and RPT were yL =22.330 + 0.937x and yR =32.752 +0.847x,respectively.Paired t-tests showed that tL =4.562,P≤0.01 and tR =3.855,P≤0.01 during left or right rotation.There was a significant difference,but there was no significant difference in LPT/RPT. Conclusion Isometric and isokinetic tests of core muscles during trunk rotation give results which are strongly correlated.Either can correctly reflect the maximal strength of core muscles during trunk rotation.Clinicinas may reasonably choose either testing method to assess patients and guide treatment according to the patient's clinical symptoms and the severity of the problem.

Objective To isolate specific humanized anti-D-dimer scFv(single chain Fv) antibody from scFv phage libraries. Methods Isolate anti-D-dimer positive clones from Tomlinson I + J phage libraries by three rounds of panuing, then sequence monoclonal genes by bideoxy-mediated chain termination and express soluble scFv antibody; Pick out anti-D-dimer antibodies with high specificity and affinity by ELISA.Results After three rounds of selection from human scFv phage libraries Tomlinson I and J, 38 monclonal specific anti-D-dimer scFv fragments were selected. By polyclonal and monoclonal phage ELISA and gene sequencing, 20 different full-length monoclonal scFv phages were identified, the result of soluble scFv ELISA showed that 20 full-length monoclonal scFv were expressed smoothly. According to the result of soluble scFv ELISA, in 5 scFv antibodies with high value of A450 selected, 3 scFv antibody fragments showed high specific and affinity. Conclusion Antibody phage display was an effective, rapid method to isolate anti-D-dimer antibodies with high specificity and affinity.

BACKGROUND AND OBJECTIVEIt has been proven that cytochrome P450 enzyme 2A13 (CYP2A13) played an important role in the association between single nucleotide polymorphisms (SNP) and human diseases. Cytochrome P450 enzymes are a group of isoenzymes, whose sequence homology may interfere with the study for SNP. The aim of this study is to explore the interference on the SNP study of CYP2A13 caused by homologous sequences.

METHODSTaqman probe was applied to detect distribution of rs8192789 sites in 573 subjects, and BLAST method was used to analyze the amplified sequences. Partial sequences of CYP2A13 were emplified by PCR from 60 cases. The emplified sequences were TA cloned and sequenced.

RESULTSFor rs8192789 loci in 573 cases, only 3 cases were TT, while the rest were CT heterozygotes, which was caused by homologous sequences. There are a large number of overlapping peaks in identical sequences of 60 cases, and the SNP of 101 amino acid site reported in the SNP database is not found. The cloned sequences are 247 bp, 235 bp fragments.

CONCLUSIONThe homologous sequences may interfere the study for SNP of CYP2A13, and some SNP may not exist.

OBJECTIVE: To explore the effects of psoralen (PSO) plus long-wave ultraviolet-A (PUVA) on apoptosis and expression of Fas ligand (FasL) in HL-60 leukemia cells. METHODS: The HL-60 cells were taken as the study objects and their apoptosis rates, ultrastructure changes and the expression of FasL were detected in order to observe the effects of PSO and ultraviolet-A (UVA) of wave length 360 nm. The factorial design and analysis of variance were used to analyze the interaction among the factors. RESULTS: PSO, UVA and PUVA all induced the apoptosis and the effects of PUVA were stronger than those of the other two. After HL-60 cells had been treated with PUVA, they all showed obvious ultrastructure changes due to apoptosis observed under the electron microscope. PSO, UVA and PUVA all decreased the expressions of FasL gene and protein. The effects of PUVA were stronger than those of the other two. CONCLUSIONS: PUVA can induce the apoptosis of HL-60 cells and the effects are stronger than those of PSO or UVA alone. The expression of FasL gene in HL-60 cells is down-regulated during the apoptosis induced by PUVA.