OBJECTIVES: To explore the efficacy of DSA-guided intrathecal drug delivery system combined with Zi Wu Liu Zhu Acupoint Therapy for management of cancer pain and provide reference for its standardized clinical application. Methods and. RESULTS: Recommendations were formulated based on literature review and expert group discussion, and consensus was reached following expert consultation. The consensus recommendations are comprehensive, covering the entire treatment procedures from preoperative assessment and preparation, surgical operation process, postoperative management and traditional Chinese medicine treatment to individualized treatment planning. The study results showed that the treatment plans combining traditional Chinese with Western medicine effectively alleviated cancer pain, reduced the use of opioid drugs, and significantly improved the quality of life and enhanced immune function of the patients. Postoperative follow-up suggested good treatment tolerance among the patients without serious complications. CONCLUSIONS The formulated consensus is comprehensive and can provide reference for clinicians to use DSA-guided intrathecal drug delivery system combined with Zi Wu Liu Zhu Acupoint Therapy. The combined treatment has a high clinical value with a good safety profile for management of cancer pain.
Humans ; Medicine, Chinese Traditional ; Cancer Pain/therapy* ; Drugs, Chinese Herbal/therapeutic use* ; Drug Delivery Systems ; Pain Management/methods* ; China

Objective To explore the efficacy of DSA-guided intrathecal drug delivery system combined with Zi Wu Liu Zhu Acupoint Therapy for management of cancer pain and provide reference for its standardized clinical application.Methods and Results Recommendations were formulated based on literature review and expert group discussion,and consensus was reached following expert consultation.The consensus recommendations are comprehensive,covering the entire treatment procedures from preoperative assessment and preparation,surgical operation process,postoperative management and traditional Chinese medicine treatment to individualized treatment planning.The study results showed that the treatment plans combining traditional Chinese with Western medicine effectively alleviated cancer pain,reduced the use of opioid drugs,and significantly improved the quality of life and enhanced immune function of the patients.Postoperative follow-up suggested good treatment tolerance among the patients without serious complications.Conclusion The formulated consensus is comprehensive and can provide reference for clinicians to use DSA-guided intrathecal drug delivery system combined with Zi Wu Liu Zhu Acupoint Therapy.The combined treatment has a high clinical value with a good safety profile for management of cancer pain.

Objective:To investigate the mechanism of Circ_0085315 on Treg mediated immune escape of colon cancer(CC)through miR-149-5p/immunity-related GTPase Q(IRGQ)pathway.Methods:Cancer and normal tissues of 50 CC patients were col-lected,CC cell lines(SW480,HCT116,HT29,SW620,Lovo)and human normal colon epithelial cells HCoEpiC were cultured in vitro,and the expression level of Circ_0085315 in tissues and cells was detected by qRT-PCR.CC cell line SW480 was used as the re-search object,bioinformatics analysis,double luciferase reporter gene experiment and RNA binding protein immunoprecipitation(RIP)experiment were applied to confirm the relationship between Circ_0085315,miR-149-5p and IRGQ,qRT-PCR was used to de-tect the expression levels of Circ_0085315,miR-149-5p and IRGQ mRNA in cells,CCK-8 was used to detect cell proliferation activity,flow cytometry was used to detect the apoptosis rate,Western blot was used to detect the expression of IRGQ,Ki-67,PCNA,Bcl-2,Bax,and Cleared caspase-3 proteins in cells,ELISA was used to detect the level of immune related cytokines in the co-culture system of CC cells and Treg,flow cytometry was used to detect the proportion of FOXP3+CD25+,FOXP3+CD4+,FOXP3+CD8+in the co cul-ture system of CC cells and Treg.The mouse tumorigenesis experiment was used to verify the influences of Circ_0085315 on CC tumor growth,miR-149-5p/IRGQ pathway and immune related cytokines.Results:Circ_0085315 was overexpressed in CC tissues and cell lines.According to bioinformatics analysis,double luciferase reporter gene experiment and RIP experiment,miR-149-5p might be the downstream target of Circ_0085315,and IRGQ might be a target gene of miR-149-5p.Silencing Circ_0085315 decreased the expres-sion levels of IRGQ mRNA and protein,and increased the expression level of miR-149-5p in CC cells(P<0.05);it decreased the survival rate of CC cells and increased the apoptosis rate,decreased the expression levels of Ki-67,PCNA,Bcl-2 proteins,while in-creased the expression levels of Bax and Cleaved caspase-3 proteins(P<0.05);it could also reduce the contents of IL-10 and TGF-β,and the proportions of FOXP3+CD25+and FOXP3+CD4+in the co-culture system of CC cells,and increase the contents of IL-2 and IFN-γ,and the proportion of FOXP3+CD8+(P<0.05).Further research results showed that inhibition of miR-149-5p expression could increase the expression level of IRGQ mRNA and weaken the influences of silencing Circ_0085315 on CC cell proliferation,apoptosis and immune escape.In vivo mouse tumorigenesis experiment showed that after silencing Circ_0085315,the expression level of IRGQ mRNA,tumor volume and weight were decreased,while the expression level of miR-149-5p was increased(P<0.05);in addition,the contents of IL-10 and TGF-β in peripheral blood serum were decreased,while the contents of IL-2 and IFN-γ were increased(P<0.05).Conclusion:Silence Circ_0085315 can not only inhibit CC cell proliferation and induce apoptosis,but also inhibit Treg mediated CC immune escape by regulating miR-149-5p/IRGQ pathway.

Objective To explore the association between walking exercise guided by 6 minute walking test(6MWT)and the incidences of 3-year major adverse cardiovascular event(MACE)in elderly patients with acute coronary syndrome(ACS)after percutaneous coronary intervention(PCI).Methods A total of 628 elderly ACS patients who undergoing PCI and obtaining success-ful coronary revascularization in our department from November 2018 to April 2019 were enrolled,and divided into 6MWT group(n=147)and control group(n=481)based on participa-ting in walking exercise guided by 6MWT or not.All of them were followed up for 3 years.The incidences of MACE[including coronary target vascular restenosis,acute myocardial infarction,heart failure,ischemic or hemorrhagic stroke]and all-cause death were observed.Univariate and multivariate Cox proportional analyses and Kaplan-Meier survival curve analysis were employed for data statistical analyses.Results At the end of follow-up,the incidences of target vascular restenosis(6.9％vs 2.0％,P=0.028),heart failure(3.7％vs 0％,P=0.036),stroke(3.7％vs 0％,P=0.036),and total MACE incidence(15.0％vs 4.1％,P=0.000)were statistically higher in the control group than the 6MWT group.Kaplan-Meier survival curve analysis showed that the cumulative incidence of MACE was significantly lower in the 6MWT group than the control group(Plog rank=0.001).Multivariate Cox regression analysis showed that not participating in walking exercise guided by 6MWT was an independent risk factor for occurrence of 3-year MACE(HR=3.102,95％CI:1.327-7.250,P=0.009).Conclusion Walking exercise guided by 6MWT reduces the incidence of 3-year MACE and improves the long-term prognosis of elderly ACS patients after PCI.

Objective To explore the association between walking exercise guided by 6 minute walking test(6MWT)and the incidences of 3-year major adverse cardiovascular event(MACE)in elderly patients with acute coronary syndrome(ACS)after percutaneous coronary intervention(PCI).Methods A total of 628 elderly ACS patients who undergoing PCI and obtaining success-ful coronary revascularization in our department from November 2018 to April 2019 were enrolled,and divided into 6MWT group(n=147)and control group(n=481)based on participa-ting in walking exercise guided by 6MWT or not.All of them were followed up for 3 years.The incidences of MACE[including coronary target vascular restenosis,acute myocardial infarction,heart failure,ischemic or hemorrhagic stroke]and all-cause death were observed.Univariate and multivariate Cox proportional analyses and Kaplan-Meier survival curve analysis were employed for data statistical analyses.Results At the end of follow-up,the incidences of target vascular restenosis(6.9％vs 2.0％,P=0.028),heart failure(3.7％vs 0％,P=0.036),stroke(3.7％vs 0％,P=0.036),and total MACE incidence(15.0％vs 4.1％,P=0.000)were statistically higher in the control group than the 6MWT group.Kaplan-Meier survival curve analysis showed that the cumulative incidence of MACE was significantly lower in the 6MWT group than the control group(Plog rank=0.001).Multivariate Cox regression analysis showed that not participating in walking exercise guided by 6MWT was an independent risk factor for occurrence of 3-year MACE(HR=3.102,95％CI:1.327-7.250,P=0.009).Conclusion Walking exercise guided by 6MWT reduces the incidence of 3-year MACE and improves the long-term prognosis of elderly ACS patients after PCI.

Objective:To investigate the mechanism of Circ_0085315 on Treg mediated immune escape of colon cancer(CC)through miR-149-5p/immunity-related GTPase Q(IRGQ)pathway.Methods:Cancer and normal tissues of 50 CC patients were col-lected,CC cell lines(SW480,HCT116,HT29,SW620,Lovo)and human normal colon epithelial cells HCoEpiC were cultured in vitro,and the expression level of Circ_0085315 in tissues and cells was detected by qRT-PCR.CC cell line SW480 was used as the re-search object,bioinformatics analysis,double luciferase reporter gene experiment and RNA binding protein immunoprecipitation(RIP)experiment were applied to confirm the relationship between Circ_0085315,miR-149-5p and IRGQ,qRT-PCR was used to de-tect the expression levels of Circ_0085315,miR-149-5p and IRGQ mRNA in cells,CCK-8 was used to detect cell proliferation activity,flow cytometry was used to detect the apoptosis rate,Western blot was used to detect the expression of IRGQ,Ki-67,PCNA,Bcl-2,Bax,and Cleared caspase-3 proteins in cells,ELISA was used to detect the level of immune related cytokines in the co-culture system of CC cells and Treg,flow cytometry was used to detect the proportion of FOXP3+CD25+,FOXP3+CD4+,FOXP3+CD8+in the co cul-ture system of CC cells and Treg.The mouse tumorigenesis experiment was used to verify the influences of Circ_0085315 on CC tumor growth,miR-149-5p/IRGQ pathway and immune related cytokines.Results:Circ_0085315 was overexpressed in CC tissues and cell lines.According to bioinformatics analysis,double luciferase reporter gene experiment and RIP experiment,miR-149-5p might be the downstream target of Circ_0085315,and IRGQ might be a target gene of miR-149-5p.Silencing Circ_0085315 decreased the expres-sion levels of IRGQ mRNA and protein,and increased the expression level of miR-149-5p in CC cells(P<0.05);it decreased the survival rate of CC cells and increased the apoptosis rate,decreased the expression levels of Ki-67,PCNA,Bcl-2 proteins,while in-creased the expression levels of Bax and Cleaved caspase-3 proteins(P<0.05);it could also reduce the contents of IL-10 and TGF-β,and the proportions of FOXP3+CD25+and FOXP3+CD4+in the co-culture system of CC cells,and increase the contents of IL-2 and IFN-γ,and the proportion of FOXP3+CD8+(P<0.05).Further research results showed that inhibition of miR-149-5p expression could increase the expression level of IRGQ mRNA and weaken the influences of silencing Circ_0085315 on CC cell proliferation,apoptosis and immune escape.In vivo mouse tumorigenesis experiment showed that after silencing Circ_0085315,the expression level of IRGQ mRNA,tumor volume and weight were decreased,while the expression level of miR-149-5p was increased(P<0.05);in addition,the contents of IL-10 and TGF-β in peripheral blood serum were decreased,while the contents of IL-2 and IFN-γ were increased(P<0.05).Conclusion:Silence Circ_0085315 can not only inhibit CC cell proliferation and induce apoptosis,but also inhibit Treg mediated CC immune escape by regulating miR-149-5p/IRGQ pathway.

Objective To analyze the therapeutic effect and mechanism of Cangfu Daotan Decoction on obese polycystic ovary syndrome(PCOS)rats.Methods Fifteen female SD rats were randomly divided into normal group,model group and Chinese medicine group,with five rats in each group.In addition to the normal group,the remaining rats were treated with Letrozole Solution by gavage combined with high-fat diet to construct an obese PCOS model.After successful modeling,the rats in the Chinese medicine group were given Cangfu Daotan Decoction by gavage for 30 days.At the end of administration,the ovarian protein expression of rats in each group was detected by non-standard proteomics quantitative technique,and the results of differential protein function,gene ontology(GO)enrichment,Kyoto Encyclopedia of Genes and Genomes(KEGG)enrichment and differential protein KEGG pathway clustering were compared.Results The functions of differential proteins between the model group and the normal group were mainly concentrated in lipid transport,metabolism and post-translational modification,and protein transcription,and the cluster analysis results of KEGG pathway enrichment and pathway enrichment were mainly concentrated in the degradation of valine,leucine and isoleucine,arginine and proline metabolism,tryptophan metabolism pathway enrichment and renin angiotensin system.The functions of differential proteins between the Chinese medicine group and the model group were concentrated in information storage and processing,especially in transformation,ribosomal structure and signal transduction mechanism,and the cluster analysis results of KEGG pathway enrichment and pathway enrichment were mainly concentrated in ribosome metabolism,drug metabolism-cytochrome P450,methyl butyrate metabolism,and vitamin B6 metabolism.The functional classification of differential proteins between Chinese medicine group and normal group was mainly in signal transduction mechanism,lipid transport and metabolism,and the clustering analysis results of KEGG pathway enrichment and pathway enrichment were mainly concentrated in ribosome,protein digestion and absorption,steroid hormone biosynthesis pathway,cell adhesion molecule,glycerol lipid metabolism and gastric acid secretion.Conclusion Cangfu Daotan Decoction may play a role in the treatment of obese PCOS by regulating branched-chain amino acid metabolism,renin-angiotensin-aldosterone system and steroid hormone synthesis pathway.

A a novel composite ZIF-8/MWCNT was synthesized by combining zeolitic imidazolate framework-8(ZIF-8)with multi-walled carbon nanotubes(MWCNT).The composite was modified on glassy carbon electrode(GCE)to obtain ZIF-8/MWCNT/GCE,which was served as an effective electrochemical sensor for detection of Pb2+ and Cd2+.Benefiting from the high electrical conductivity of MWCNT and the synergistic effect between ZIF-8 and MWCNT,ZIF-8/MWCNT showed excellent electrocatalytic activity in individual and simultaneous detection of Cd2+ and Pb2+.Under the optimized conditions,the linear ranges were 0.03?8.00 μmol/L and 0.03?6.00 μmol/L with corresponding limits of detection(S/N=3)of 0.019 and 0.035 μmol/L for individual detection of Cd2+and Pb2+,respectively.Whereas for simultaneous detection of Cd2+and Pb2+in their mixture solutions,the linear ranges were 0.03?5.00 μmol/L and 0.03?5.00 μmol/L with corresponding limits of detection(S/N=3)of 0.022 and 0.048 μmol/L,respectively.In addition,the sensor exhibited good stability,reproducibility and anti-interference ability.Moreover,the sensor showed good feasibility and accuracy for determination of Cd2+ and Pb2+ in actual river water samples with spiking recoveries of 98.1%?104.0%and 98.3%?102.2%,respectively.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Objective:To explore the expressions of zinc homeostasis-related proteins,G protein-coupled receptor 39(GPR39)and ANO1 mRNA in the sperm of patients with asthenozoospermia(AS),and analyze their correlation with sperm motility.Methods:We collected semen samples from 82 male subjects with PR+NP＜40％,PR＜32％and sperm concentration＞15 × 106/ml(the AS group,n=40)or PR+NP≥40％,PR≥32％and sperm concentration＞15 × 106/ml(the normal control group,n=42).We analyzed the routine semen parameters and measured the zinc content in the seminal plasma using the computer-assisted sperm analysis system,detected the expressions of zinc transporters(ZIP13,ZIP8 and ZNT10),metallothioneins(MT1G,MT1 and MTF),GPR39,and calcium-dependent chloride channel protein(ANO1)in the sperm by real-time quantitative PCR(RT qPCR),examined free zinc distribution in the sperm by laser confocal microscopy,and determined the expressions of GPR39 and MT1 proteins in the sperm by immunofluorescence staining,followed by Spearman rank correlation analysis of their correlation with semen parameters.Results:There was no statistically significant difference in the zinc concentration in the seminal plasma between the AS and normal control groups(P＞0.05).Compared with the controls,the AS patients showed a significantly reduced free zinc level(P＜0.05),relative expressions of MT1G,MTF,ZIP13,GPR39 and ANO1 mRNA(P＜0.05),and that of the GPR39 protein in the AS group(P＜0.05).No statistically significant differences were observed in the relative expression levels of ZIP8,ZNT10 and MT1 mRNA between the two groups(P＞0.05).The relative expression levels of GPR39,ANO1,MT1G and MTF mRNA were positively correlated with sperm motility and the percentage of progressively motile sperm(P＜0.05).Conclusion:The expressions of zinc homeostasis proteins(MT1G,MTF and ZIP13),GPR39 and ANO1 mRNA are downregulated in the sperm of asthenozoospermia pa-tients,and positively correlated with sperm motility.