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 evaluate the expression of B7-H3 and CD133 in colorectal cancer(CRC),colorectal polyps,and normal colorectal mucosa and investigate their roles in the development and prognosis of CRC.Methods:Immunohistochemistry was used to detect the ex-pression of B7-H3 and CD133 in 195 CRC,76 villous/tubulovillous adenoma,64 tubular adenoma,30 non-adenomatous polyp,and 10 nor-mal colorectal mucosa samples obtained from The Second Affiliated Hospital of Zhengzhou University between October 2012 and April 2017 and Pengan County People's Hospital between January 2017 and May 2019.Patient age,sex,and immunohistochemical staining results of B7-H3,CD133,and carcinoembryonic antigen were incorporated as risk factors to establish a CRC survival prediction model.Results:B7-H3 and CD133 expression showed an increasing trend from normal mucosa to non-adenomatous polyps,tubular adenomas,villous/tubulovil-lous adenomas,and CRC(P<0.05),and correlated with adenoma size.It was also associated with CRC metastasis and shorter survival(P<0.05).Furthermore,the expressions of B7-H3 and CD133 demonstrated a value in the CRC survival prediction model,in the training as well as validation set.Conclusions:The immune regulator B7-H3 and cancer stem cell marker CD133 are associated with poor prognosis in CRC,and their expressions may serve as predictive factors for CRC prognosis.

Objective To investigate the effects and underlying mechanisms of a spray prepared from exosomes derived from M2 macrophages induced by interleukin-4 （IL-4） and tantalum particles （Ta） on the healing of pressure ulcers. Methods Bone marrow-derived macrophages were polarized into M2 macrophages using IL-4 or Ta, and exosomes （Exo-IL-4/Exo-Ta） were extracted. The regulatory effects of Exo-IL-4/Exo-Ta on M1 macrophage phenotypes and fibroblast matrix secretion were evaluated in vitro. Proteomic analysis was conducted to explore the biological processes and regulatory networks associated with Exo-Ta. A rat pressure ulcer model was used to assess the effects of Exo-IL-4/Exo-Ta spray on wound healing rate, inflammatory cell infiltration, and collagen deposition. Results In vitro, Exo-IL-4/Exo-Ta induced the polarization of M1 macrophages to M2 macrophages, reduced the secretion of pro-inflammatory factors, and promoted the expression of anti-inflammatory substances. Additionally, Exo-IL-4/Exo-Ta enhanced the production of collagen and fibronectin in fibroblasts. Proteomic analysis revealed that Exo-Ta primarily participated in biological processes such as energy metabolism and macromolecule biosynthesis. In vivo, Exo-IL-4/Exo-Ta spray accelerated wound healing, reduced inflammatory infiltration, and improved tissue remodeling in the rat pressure ulcer model. Conclusion Exosome sprays derived from M2 macrophages could accelerate pressure ulcer healing by modulating inflammation and promoting tissue regeneration, which demonstrated excellent clinical application potential.

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 explore the effect of community pharmacy outpatient service on patients with type 2 diabetes mellitus. Methods A non-randomized controlled study was conducted, and type 2 diabetes patients managed in the community were divided into an intervention group of 112 cases and a control group of 110 cases. The control group received routine medication guidance during general practice outpatient visits, while the intervention group received comprehensive pharmacy outpatient service intervention based on routine medication guidance in general practice. Follow-up visits were conducted every 3 months. Repeated measurement analysis of variance and multivariate linear regression analysis were used to evaluate the intervention effect of the pharmacy outpatient service. Results Fasting blood glucose and glycosylated hemoglobin levels in the intervention group showed a decreasing trend with the increase of intervention time compared to pre-intervention time （P<0.01）, with increased duration of weekly exercise, decreased staple food intake, increased vegetable intake, and increased medication adherence score （P<0.01）. After adjusting for confounding factors through multivariate linear regression model, pharmacy outpatient intervention was found to be an independent protective factor for fasting blood glucose level （β=−0.891, P<0.01） and glycosylated hemoglobin level （β=−0.760, P<0.01） in the study subjects. Conclusion The community pharmacy outpatient service could enhance the self-management ability of patients with type 2 diabetes mellitus, and effectively improve patients’ fasting blood glucose and glycosylated hemoglobin.

Objective:To investigate the role of ionizing radiation in regulating mitochondrial autophagy and epithelial mesenchymal transaction (EMT) in lung, in order to provide experimental evidence for further elucidating the pathogenesis and clinical treatment of radiation-induced pulmonary fibrosis (RIPF).Methods:Beas-2B cells were irradiated with 6 Gy X-rays, and their morphological changes were observed at 0, 12, 24 and 48 h after irradiation. The changes of mitochondrial autophagy and EMT-related proteins in PINK1/Parkin pathway were detected by Western blot assay. The changes of mitochondrial membrane potential were detected by JC-1 staining. TEM was used to observe the changes of cell ultrastructure 48 h after radiation. Beas-2B cells were then divided into control group, irradiation group (RI), RI + vector plasmid group (RI+ oeNC), RI+ PINK1 overexpression group (RI+ oePINK1), and the protein changes of FN1 and LC3 were detected by immunofluorescence. Flow cytometry was used to detect the change of reactive oxygen species (ROS) in each group. The changes of mitochondrial autophagy and EMT-related protein contents were detected by immunofluorescence, flow cytometry and Western blot, respectively.Results:After X-ray irradiation, the cell morphology of human epithelial cells Beas-2B was changed from irregular polygon to spindle shape along with the time increase after irradiation, showing EMT appearance. JC-1 staining showed that, along with the time after irradiation, the red fluorescence was weakened, and the green fluorescence was enhanced, so that the red/green fluorescence ratio was decreased. TEM observation indicated that the cell morphology changed to spindle shape and the number of autophagic lysosomes decreased significantly at 48 h after irradiation. Western blot assay showed that the protein expression levels of PINK1, Parkin and Beclin1 were significantly decreased, while the expression of p62 protein was significantly increased after irradiation. Moreover, the expressions of E-cad and CK19 were significantly decreased, while the expressions of N-cad and Vim were significantly increased ( t = 6.48, 3.72, 6.06, -18.71, P<0.05). Immunofluorescence assay showed that LC3 expression was increased and FN1 expression was decreased in the oePINK1 group ( t = 6.06, -21.49, -9.58, 3.58, P < 0.05). Flow cytometry assay showed that ROS in the oePINK1 group was significantly decreased ( t = -342.54, 88.01, 25.48, P<0.05). After PINK1 overexpression, the expression levels of PINK1, Parkin and Beclin1 were significantly increased, while the expression of p62 protein was significantly decreased ( t = -25.57, -8.76, -11.24, 34.81, P<0.05); meanwhile, the expressions of E-cad and CK19 were significantly increased, while the expressions of N-cad and Vim were significantly decreased ( t =-7.12, 12.04, 67.92, -7.64, P<0.05). Conclusions:X-ray irradiation promoted EMT and impaired mitochondrial function of Beas-2B cells, and weakened mitochondrial autophagy mediated by PINK1/Parkin pathway. Overexpression of PINK1 promoted mitochondrial autophagy, which improved mitochondrial function and effectively inhibited cell EMT, thus alleviating pulmonary fibrosis.

Objective:To investigate the role of ionizing radiation in regulating mitochondrial autophagy and epithelial mesenchymal transaction (EMT) in lung, in order to provide experimental evidence for further elucidating the pathogenesis and clinical treatment of radiation-induced pulmonary fibrosis (RIPF).Methods:Beas-2B cells were irradiated with 6 Gy X-rays, and their morphological changes were observed at 0, 12, 24 and 48 h after irradiation. The changes of mitochondrial autophagy and EMT-related proteins in PINK1/Parkin pathway were detected by Western blot assay. The changes of mitochondrial membrane potential were detected by JC-1 staining. TEM was used to observe the changes of cell ultrastructure 48 h after radiation. Beas-2B cells were then divided into control group, irradiation group (RI), RI + vector plasmid group (RI+ oeNC), RI+ PINK1 overexpression group (RI+ oePINK1), and the protein changes of FN1 and LC3 were detected by immunofluorescence. Flow cytometry was used to detect the change of reactive oxygen species (ROS) in each group. The changes of mitochondrial autophagy and EMT-related protein contents were detected by immunofluorescence, flow cytometry and Western blot, respectively.Results:After X-ray irradiation, the cell morphology of human epithelial cells Beas-2B was changed from irregular polygon to spindle shape along with the time increase after irradiation, showing EMT appearance. JC-1 staining showed that, along with the time after irradiation, the red fluorescence was weakened, and the green fluorescence was enhanced, so that the red/green fluorescence ratio was decreased. TEM observation indicated that the cell morphology changed to spindle shape and the number of autophagic lysosomes decreased significantly at 48 h after irradiation. Western blot assay showed that the protein expression levels of PINK1, Parkin and Beclin1 were significantly decreased, while the expression of p62 protein was significantly increased after irradiation. Moreover, the expressions of E-cad and CK19 were significantly decreased, while the expressions of N-cad and Vim were significantly increased ( t = 6.48, 3.72, 6.06, -18.71, P<0.05). Immunofluorescence assay showed that LC3 expression was increased and FN1 expression was decreased in the oePINK1 group ( t = 6.06, -21.49, -9.58, 3.58, P < 0.05). Flow cytometry assay showed that ROS in the oePINK1 group was significantly decreased ( t = -342.54, 88.01, 25.48, P<0.05). After PINK1 overexpression, the expression levels of PINK1, Parkin and Beclin1 were significantly increased, while the expression of p62 protein was significantly decreased ( t = -25.57, -8.76, -11.24, 34.81, P<0.05); meanwhile, the expressions of E-cad and CK19 were significantly increased, while the expressions of N-cad and Vim were significantly decreased ( t =-7.12, 12.04, 67.92, -7.64, P<0.05). Conclusions:X-ray irradiation promoted EMT and impaired mitochondrial function of Beas-2B cells, and weakened mitochondrial autophagy mediated by PINK1/Parkin pathway. Overexpression of PINK1 promoted mitochondrial autophagy, which improved mitochondrial function and effectively inhibited cell EMT, thus alleviating pulmonary fibrosis.

Objective:To evaluate the expression of B7-H3 and CD133 in colorectal cancer(CRC),colorectal polyps,and normal colorectal mucosa and investigate their roles in the development and prognosis of CRC.Methods:Immunohistochemistry was used to detect the ex-pression of B7-H3 and CD133 in 195 CRC,76 villous/tubulovillous adenoma,64 tubular adenoma,30 non-adenomatous polyp,and 10 nor-mal colorectal mucosa samples obtained from The Second Affiliated Hospital of Zhengzhou University between October 2012 and April 2017 and Pengan County People's Hospital between January 2017 and May 2019.Patient age,sex,and immunohistochemical staining results of B7-H3,CD133,and carcinoembryonic antigen were incorporated as risk factors to establish a CRC survival prediction model.Results:B7-H3 and CD133 expression showed an increasing trend from normal mucosa to non-adenomatous polyps,tubular adenomas,villous/tubulovil-lous adenomas,and CRC(P<0.05),and correlated with adenoma size.It was also associated with CRC metastasis and shorter survival(P<0.05).Furthermore,the expressions of B7-H3 and CD133 demonstrated a value in the CRC survival prediction model,in the training as well as validation set.Conclusions:The immune regulator B7-H3 and cancer stem cell marker CD133 are associated with poor prognosis in CRC,and their expressions may serve as predictive factors for CRC prognosis.

Objective To investigate the predict value of imaging parameters in computed tomography perfusion(CTP)combined with computed tomography angiography(CTA)examination and serum biomarkers for recurrent stroke events at three-month and one-year follow-ups.Methods A total of 136 patients with cerebral infarction diagnosed for the first time were included in the retrospective study.These patients received CTA+CTP one-stop examination and serum biomarkers testing,followed by three-month and one-year follow-ups for the occurrence of recurrent stroke events.Recurrent stroke events were defined as ischemic stroke,retinal infarction,intracerebral hemorrhage,subarachnoid hemorrhage,and death.Results The recurrent stroke events rate was 23.5%(32 cases)and 36.8%(50 cases)at three-month and one-year follow-ups,respectively.Ischemic penumbra(IP)volume[odds ratio(OR)=1.010,P=0.029]and modified Rankin scale(mRS)score at discharge(OR=1.388,P=0.008)were independent predictors for recurrent stroke events at the three-month follow-up,so were lipoprotein(a)[Lp(a)](OR=1.002,P=0.044),vascular stenosis severity(OR=1.489,P=0.029),and mRS score at discharge(OR=1.282,P=0.038)at the one-year follow-up.Conclusion Among patients with stroke diagnosed for the first time,IP volume,Lp(a),vascular stenosis severity and mRS score at discharge are the most powerful predictors of recurrent stroke events at three-month and one-year follow-ups.

Three children with Skene duct cyst were presented in this article. By reviewing literature, in pediatric population, Skene duct cycts mostly occur in newborns and conservative therapy is the first choice in this group.In contrast, it is extremely rare between the ages of 1 and 12, and surgical excised is the preferred therapy because of having a similar pathogenesis to adults.