[摘 要] 目的：探究骨髓间充质干细胞（BMSC）衍生的外泌体lncRNA PTENP1在膀胱癌进展中的功能机制。方法：采用透射电子显微镜、纳米颗粒追踪分析及WB法检测外泌体标志蛋白的方式鉴定BMSC来源的外泌体（BMSC-Exo）。通过共聚焦显微镜检测 BMSC-Exo被膀胱癌5637细胞内化的过程。按转染物不同，将膀胱癌5637和T24细胞随机分为以下组别：对照组、BMSC-Exo组、BMSC OE-NC-Exo组、BMSC OE-PTENP1-Exo组、BMSC sh-NC-Exo组和BMSC sh-PTENP1-Exo组。采用CCK-8、集落形成实验评估细胞增殖水平，流式细胞术评估细胞凋亡水平，划痕愈合和Transwell实验评估细胞迁移和侵袭能力。通过RNA下拉（Pull down）、RNA免疫沉淀（RIP）技术验证miR-17和PTENP1、A类清道夫受体5型（SCARA5）mRNA之间的靶向结合关系。结果：qRT-PCR显示过表达PTENP1的BMSC外泌体（BMSC OE-PTENP1-Exo）显著提升膀胱癌细胞中PTENP1水平（P < 0.01）。BMSC OE-PTENP1-Exo抑制细胞增殖（P < 0.01）、迁移（P < 0.01）和侵袭（P < 0.01），促进细胞凋亡（P < 0.01）。此外，体内实验显示BMSC OE-PTENP1-Exo显著抑制裸鼠移植瘤生长（P < 0.01）。结论：BMS-Exo可通过递送PTENP1作为miR-17的“分子海绵”，解除miR-17对SCARA5的抑制作用，进而上调SCARA5的表达，抑制膀胱癌细胞的恶性生物学行为。

Endothelial dysfunction is a key factor linking obstructive sleep apnea hypopnea syndrome (OSAHS) with cardiovascular diseases. In this study, we used advanced proteomics and metabolomics approaches to investigate the impact of extracellular vesicles (EVs) derived from the serum of OSAHS patients on endothelial function. Our multi-omics analysis identified dysregulated pathways related to fatty acid metabolism, apoptosis regulation, and inflammatory responses, highlighting fatty acid synthase (FASN) as a crucial player in OSAHS-induced endothelial dysfunction. Both in vitro and in vivo experiments demonstrated that FASN-enriched EVs impair endothelial cell viability and disrupt metabolic homeostasis, offering new insights for the development of targeted therapies for cardiovascular complications associated with OSAHS.

Objective To investigate the effects of volumetric modulated arc therapy (VMAT) with 6 MV and 10 MV X-ray photon energies in patients with cervical cancer. Methods From March 2019 to May 2020, 24 patients with cervical cancer who underwent radiation therapy in the Oncology Radiotherapy Department of our hospital were selected. VMAT plans with 6 MV and 10 MV photon energies were re-designed for each patient. The target parameters (D_98%, D_2%, D_mean), conformal index, and homogeneity index of the two groups were compared. The radiation doses received by the bladder, rectum, small intestine, left femoral head, right femoral head, and normal tissue other than planning target volume (Body-PTV), as well as monitor units and estimated total delivery time, were also compared. Results D_2%, D_mean, homogeneity index, and monitor units were significantly lower in the 10 MV group than in the 6 MV group (50.78 ± 0.33 Gy vs. 50.35 ± 0.29 Gy; 49.05 ± 0.2 Gy vs. 48.93 ± 0.17 Gy; 0.08 ± 0.01 vs. 0.07 ± 0.01; 1179.26 ± 110.55 vs. 1099.3 ± 80.9). Comparison of organs at risk showed that compared with the 10 MV group, the 6 MV group demonstrated significantly lower V_40Gy of the bladder, D_5% of the right femoral head, and D_2% and V_5Gy of Body-PTV (60.37 ± 13.66 vs. 60.84 ± 13.88; 37.09 ± 5.43 Gy vs. 38.03 ± 5.68 Gy; 41.71 ± 1.39 Gy vs. 42.16 ± 1.31 Gy; 47.88 ± 9.75 vs. 48.23 ± 9.74). There were no significant differences in other parameters between the two groups. Conclusion The VMAT plans with 6 MV and 10 MV X-ray photon energies both meet the clinical needs of cervical cancer radiotherapy. The cervical cancer VMAT plan with 6 MV photon energy is recommended due to better protection of the organs at risk.

Objective To investigate the effects of volumetric modulated arc therapy (VMAT) with 6 MV and 10 MV X-ray photon energies in patients with cervical cancer. Methods From March 2019 to May 2020, 24 patients with cervical cancer who underwent radiation therapy in the Oncology Radiotherapy Department of our hospital were selected. VMAT plans with 6 MV and 10 MV photon energies were re-designed for each patient. The target parameters (D_98%, D_2%, D_mean), conformal index, and homogeneity index of the two groups were compared. The radiation doses received by the bladder, rectum, small intestine, left femoral head, right femoral head, and normal tissue other than planning target volume (Body-PTV), as well as monitor units and estimated total delivery time, were also compared. Results D_2%, D_mean, homogeneity index, and monitor units were significantly lower in the 10 MV group than in the 6 MV group (50.78 ± 0.33 Gy vs. 50.35 ± 0.29 Gy; 49.05 ± 0.2 Gy vs. 48.93 ± 0.17 Gy; 0.08 ± 0.01 vs. 0.07 ± 0.01; 1179.26 ± 110.55 vs. 1099.3 ± 80.9). Comparison of organs at risk showed that compared with the 10 MV group, the 6 MV group demonstrated significantly lower V_40Gy of the bladder, D_5% of the right femoral head, and D_2% and V_5Gy of Body-PTV (60.37 ± 13.66 vs. 60.84 ± 13.88; 37.09 ± 5.43 Gy vs. 38.03 ± 5.68 Gy; 41.71 ± 1.39 Gy vs. 42.16 ± 1.31 Gy; 47.88 ± 9.75 vs. 48.23 ± 9.74). There were no significant differences in other parameters between the two groups. Conclusion The VMAT plans with 6 MV and 10 MV X-ray photon energies both meet the clinical needs of cervical cancer radiotherapy. The cervical cancer VMAT plan with 6 MV photon energy is recommended due to better protection of the organs at risk.

Objective To explore the effects of intervention model based on empowerment theory on health belief, self-care behavior and prognosis of patients with myocardial infarction after percutaneous coronary intervention (PCI). Methods A total of 500 patients with PCI for myocardial infarction in the hospital from November 2021 to October 2023 were randomly divided into control group (n=250) and observation group (n=250). The control group was given routine intervention mode, the observation group was given intervention mode based on empowerment theory, and both groups were intervened until one month after discharge. Before and after intervention, the health belief[the Coronary Heart Disease Health Belief Scale (CADHBS)], self-care ability[the Evaluation for Self-care Ability (ESCA)], cardiac function indexes[left ventricular ejection fraction (LVEF) and 6 minutes walking test (6MWT)] and quality of life[the Chinese Questionnaire of Quality of Life in Chinese Patients with Cardiovascular Diseases (CQQC)] were compared between the two groups; the incidence rate of adverse cardiac events during intervention was compared between the two groups. Results Compared with the control group, the total score of CADHBS and the score of each dimension as well as the total score of ESCA and the score of each dimension in the observation group were significantly higher (P < 0.05). After intervention, the LVEF and 6MWT in the observation group were significantly higher than those in the control group (P < 0.05). The total incidence rate of adverse cardiac events was 19.60 % in the observation group, which was significantly lower than 28.00 % in the control group (P < 0.05). After intervention, the CQQC score in the observation group was significantly higher than that in the control group (P < 0.05). Conclusion For the patients with PCI for myocardial infarction, implementation of intervention model based on empowerment theory can enhance health belief and self-care ability, improve the cardiac function and quality of life, and reduce the incidence rate of adverse cardiac events.

【Objective】 To evaluate and analyze the impact of COVID-19 epidemic on inventory of red blood cells (RBCs)in local and municipal blood stations in China, and to provide reference for the management of public health emergencies. 【Methods】 Relevant data from 2018 to 2021 were collected, and the differences in the volume of qualified RBCs, the usage efficiency of inventory RBCs, the average daily distribution of RBCs,the blood distribution rate of RBCs prepared by 400 mL whole blood, the difference in the average storage days of RBCs at the time of distribution, the average daily inventory of RBCs and the time of the average daily inventory of RBCs to maintain the distribution in 24 local and municipal blood stations in China during the COVID-19 epidemic and non-epidemic periods were retrospectively analyzed. 【Results】 Compared with non-epidemic periods, the volume of qualified RBCs [(117 525.979 ±52 203.175)U] and the average daily distribution of RBCs [( 156. 468 ± 70. 186) U ] increased significantly, but the usage efficiency of inventory RBCs decreased(97.24%±0.51%) significantly (P<0.05).There was no significant difference in the blood distribution rate of RBCs prepared by 400 mL whole blood(73.88%±20.30%), the average storage days of RBCs distribution(13.040 ±3.486), the average daily stock quantity of RBCs[(2 280.542 ±1 446.538) U ] and the time of the average daily inventory of RBCs to maintain the distribution[(15.062 ±7.453) d] (P>0.5). 【Conclusion】 During the COVID-19 epidemic, the inventory management of RBCs operated well, the overall inventory remained relatively stable, the stock composition and storage period showed no significant change.

【Objective】 To study the annual financial expenditure in blood stations with different scales, and to establish the regression equation between blood collection units and total expenditure. 【Methods】 The annual total expenditure, the per capita cost of serving population, as well as the collection units of whole blood and apheresis platelet of 24 blood stations were collected. The financial expenditure required for collecting 10 000U blood was calculated.The statistical analysis was carried out with SPSS statistical software. 【Results】 From 2017 to 2020, the total annual financial expenditure of 24 blood stations showed an upward trend. The total expenditure among blood stations was different. The per capita cost of servicing population in the areas where the 24 blood stations were located had been increasing year by year. The 24 blood stations were divided into two grades according to the blood collection volume as 50 000 U, and the relationship equation between the blood collection volume and the annual total expenditure had been established. After testing, each equation was effective(P<0.05); There was no difference in the financial expenditure required for collecting 10 000U blood among blood stations with different scales. 【Conclusion】 From 2017 to 2020, the blood stations with an annual collection volume more than 50 000 U demonstrated a higher financial expenditure and the per capita cost of serving population than those <50 000 U. The blood collection volume of blood stations is significantly correlated with the annual total expenditure and the per capita cost of serving population.

Objective To investigate and analyze the current situation of nuclear technology utilization and radiation workers' occupational health management in non-medical institutions in Huai'an City, and to strengthen the prevention and control of occupational radiation diseases. Methods 37 non-medical institutions of nuclear technology utilization in Huai'an City were surveyed by questionnaire, including radioisotope and radiation apparatus, personal dose monitoring of radiation workers, implementation of occupational health examination, protective equipment, etc. Results The industry covers manufacturing industry, transportation, warehousing and postal industry, scientific research and technical service industry, residential service, repair and other service industries, 0 class I radiation device, 15 class II radiation devices, 67 class III radiation devices; 0 class I and II radiation sources, 1 class III radiation device, 16 class IV radiation sources, 51 class V radiation sources, 1 unsealed radioactive material Class B workplace; 493 radiation workers, 90.5% with certificates, 85.4% with personal dose monitoring rate, rate of 37.8% with radiation protection monitoring equipment, and 68.0% with occupational health examination rate. It has 13 institutions equipped with personal protective equipment, 23 with dose alarming devices and 14 with radiation protection monitors. 30 radiation workplace tests have been carried out in the past two years. Conclusion The occupational health management of radiation workers in non-medical institutions is weak. At present, the responsibility of occupational health supervision has been assigned to the health department. Therefore, the health administrative department should strengthen the supervision of non-medical nuclear technology utilization institutions and improve the emergency mechanism of radiation emergencies in Huai'an city.

Blocking the biological functions of scaffold proteins and aggregated proteins is a challenging goal. PROTAC proteolysis-targeting chimaera (PROTAC) technology may be the solution, considering its ability to selectively degrade target proteins. Recent progress in the PROTAC strategy include identification of the structure of the first ternary eutectic complex, extra-terminal domain-4-PROTAC-Von-Hippel-Lindau (BRD4-PROTAC-VHL), and PROTAC ARV-110 has entered clinical trials for the treatment of prostate cancer in 2019. These discoveries strongly proved the value of the PROTAC strategy. In this perspective, we summarized recent meaningful research of PROTAC, including the types of degradation proteins, preliminary biological data in vitro and in vivo, and new E3 ubiquitin ligases. Importantly, the molecular design, optimization strategy and clinical application of candidate molecules are highlighted in detail. Future perspectives for development of advanced PROTAC in medical fields have also been discussed systematically.

Objective: To investigate the clinical features and pathogenic genes of a family with osteosclerosis. Methods: Six patients and six family members from a family in Jiangsu were tested for biochemical parameters, bone metabolic markers, bone mineral density, thoracolumbar anterior lateral slices, skull positive lateral radiographs, and pelvic plain films. Meanwhile, Sanger sequencing was performed to detect gene mutations of the proband and five other family members with high bone mass. The conformation of the mutational low-density lipoprotein receptor-related protein 5 (LRP5) protein was predicted by SWISS-MODEL. Results: Four adult patients (one male and three females) were tall, with mandibular enlargement and kyphosis in the center of the lower jaw, and none of the four had fractures. Their X ray examination revealed that the skull and long bone cortex was thickened, while the sella and mandible was enlarged. In addition, the absolute values of bone mineral density at each site of all patients were significantly higher as compared with the standard age- and sex-matched adults or adolescent mean reference values, with Z scores of L2-4, femoral neck and total hip being (6.31±4.03) SD, (6.56±2.36) SD, and (7.19±2.03) SD, respectively. The results of genetic sequencing revealed that all six patients carried a heterozygous mutation (c.331G>T; D111Y) in exon 2 of LRP5 gene, while other family members showed wild type (c.331G>G; D111D). Functional prediction indicated that this mutation was located at the amino acid terminal of exon 2 of LRP5 gene, which encodes the first β-helix-generating region of LRP5 protein. Conclusion The D111Y mutation in LRP5 gene leads to a clinical phenotype characterized by benign increased bone mineral density without increasing the risk of fracture. This mutation may further affect the downstream Wnt signaling pathway by altering the spatial structure of LRP5 protein, thereby promoting maturation and differentiation of osteoblasts and resulting in osteosclerosis.