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.

Objective:To investigate the clinical efficacy of dopamine hydrazine combined with carlobidopa controlled-release tablets in the treatment of Parkinson's disease and its effect on inflammatory reaction, serum homocysteine and YKL-40 levels in patients with Parkinson's disease.Methods:A case-control study was conducted to retrospectively analyze the clinical data of 230 patients with Parkinson's disease who received treatment at Xianyang Hospital of Yan 'an University from January 2020 to December 2022. According to the different treatment methods, these patients were divided into a dopamine hydrazine (treatment with dopamine hydrazine, n = 113) and a combination group (treatment with dopamine hydrazine and carlobidopa controlled-release tablets, n = 117). All patients were treated for 6 weeks. Inflammatory reactions, serum homocysteine levels, and serum YKL-40 levels post-treatment were compared with pre-treatment levels. Clinical efficacy and the incidence of adverse reactions were evaluated between the two groups. Results:After 6 weeks of treatment, the levels of tumor necrosis factor α, interleukin-1β, interleukin-6, and high-sensitivity C-reactive protein in the combination group were (9.76 ± 1.57) ng/L, (27.02 ± 3.41) ng/L, (10.29 ± 1.89) ng/L, and (6.62 ± 0.99) mg/L, respectively, which were significantly lower than those in the dopamine hydrazine group [(12.34 ± 1.97) ng/L, (30.84 ± 4.73) ng/L, (13.83 ± 2.18) ng/L, (8.77 ± 1.55) mg/L, t = -10.98, -7.04, -13.16, -12.58, all P < 0.05]. The serum levels of homocysteine and YKL-40 in the combination group were (19.08 ± 5.70) μmol/L and (3.33 ± 0.97) g/L, respectively, which were significantly lower than those in the dopamine hydrazine group [(22.54 ± 5.62) μmol/L, (4.03 ± 1.23) g/L, t = -4.63, -4.81, both P < 0.05]. The total response rate in the combination group was 94.02% (110/117), which was significantly higher than 78.76% (89/113) in the dopamine hydrazine group (χ2 = 11.47, P < 0.05). There was no significant difference in the incidence of adverse reactions between the two groups ( P > 0.05). Conclusion:The use of dopamine hydrazine combined with carbidopa controlled-release tablets for the treatment of Parkinson's disease reduces inflammatory reactions, decreases serum homocysteine and YKL-40 levels, enhances clinical efficacy, and does not increase the incidence of adverse reactions.

To report a case of neonatal succinate-CoA ligase deficiency with mild methylmalonic aciduria caused by SUCLG1 compound heterozygous mutation. Our proband developed the disease at the 2nd day of life, manifested by vomiting and milk rejection. Blood gas analysis indicated metabolic acidosis and hyperlactacidemia. Laboratory tests showed mild hyperammonemia, mild elevation of serum aminotransferase and normal homocysteine. Imageology examination showed brain dysplasia and multiple cardiac malformations. Mild methylmalonic aciduria was suggested by blood acylcarnitines and urine organic acids analysis. Two novel mutations, c.40A>G (p.M14V) and a heterozygous deletion of exon 6 to 9, were identified by whole-exome sequencing in SUCLG1, which came from the mother and father, respectively. Metabolic acidosis turned better by volume expansion and acidosis correction, but lactic acidosis was persistent. Edema and respiratory failure occurred, after which the parent gave up treatment and the patient died after discharged from hospital. The mutations of SUCLG1 gene lead to succinate-CoA ligase deficiency and mitochondrial DNA depletion syndrome. There is no specific treatment for this disease. For infants with feeding difficulties, lactic acidosis and multiple organ damage, metabolic abnormality screening should be performed. Genetic analysis is the diagnostic method.

Objective To construct a cardiovascular surgery nursing service action plan system based on patient's demand so as to provide a reference for nurse specialisms of cardiovascular surgery to provide good service for patients.Methods From January 2017 to June 2017, patients of cardiovascular surgery of a ClassⅢ Grade A hospital were investigated with the self-designed patients' demand for nursing service questionnaire according to literature analysis and interview results of patients. Weights of the primary index and secondary index were calculated by analytic hierarchy process so as to construct a cardiovascular surgery nursing service action plan system based on patient's demand.Results The cardiovascular surgery nursing service action plan system based on patient's demand included 5 primary indexes and 78 secondary indexes. The Cronbach's α of patients' demand for nursing service questionnaire was 0.974 with a good internal consistency. Kaiser-Meyer-Olkin (KMO) was 0.843, andP value of Bartlett sphericity test was less than 0.001 with a good construct validity. The normalized weight coefficients of 5 primary indexes (physiological needs, safety needs, belongingness and love needs, self-esteem needs and self-actualization needs) were 0.2205, 0.4798, 0.0771, 0.1339 and 0.0887 respectively with 0.0488 for the consistency ratio (CR). TheCR of 21 secondary indexes of physiological needs, 19 secondary indexes of safety needs, 11 secondary indexes of belongingness and love needs, 20 secondary indexes of self-esteem needs and 7 secondary indexes of self-actualization needs was 0.0488, 0.0508, 0.0823, 0.0877 and 0.0746 respectively. TheCR was all less than 0.1 showed a satisfactory consistency in the results of hierarchy sequencing.Conclusions The construction of cardiovascular surgerynursing service action plan system based on patient's demand with the strict scientific method improves patient satisfaction. It is worth to be a reference for nursing peers and managers of cardiovascular surgery.

The paper introduced the present full-time practice of medical social workers in China, with in-depth analysis of the roadblocks encountered.The problems include but are not limited to multiple stakeholders without a healthy resources relationship network, lack of powerful government support in policy and resource orientation, absence of drivers for hospitals to deliver social service, immature social organizations, and poor capacity to link resources.Based on such, the authors explored the establishment of a development model for full-time medical social workers on a multiple cooperation platform, in such perspectives as the government, social worker organizations, hospitals, and third-party performance appraisal.

Anti-N-methyl-D-aspartate receptor encephalitis (Anti-NMDAR-encephalitis) in children is a type of autoimmune encephalitis associated with NMDA receptor.Its etiology and clinical manifestations are specific in children.This disease is associated with teratoma more in adult than in children.However,its etiology is more associated with infection and heredity in children.The pathogenesis is that the anti-NMDAR-antibody can combine with NMDAR of neurons selectively and reversibly.The clinical manifestations include psychiatric syndrome,language,motor,sleep and autonomic nervous disorders.Tumor resection and immtmotherapy are chief treatments.This disorder is often misdiagnosed as it is rarely reported in children.It is valuable to make early diagnosis and treatment.This paper reviews the mechanism,clinical features,diagnosis and treatment of antiNMDAR-encephalitis of children.