Half a century has passed since the normalization of diplomatic relations between Japan and China, and there is an urgent need to consider home care for elderly Chinese returnees in Japan. The purpose of this study was to clarify problems and needs in home care support for Chinese returnees as ascertained from caregivers’ experiences. Participants were representatives of 94 long-term care insurance service offices in the Kanto region that were able to provide care services in Chinese, and a questionnaire survey was conducted by mail. Seventeen facilities that provide long-term care services to Chinese returnees now or within the past 2 years were included in the analysis. 8 (47%) of the service offices were “day-care centers” or “communitybased day-care centers”, and 10 (59%) were in Tokyo. The number of offices with “less than 5” Chinese-speaking staff was 13 (76%). The major home care problems were differences in language and culture, and four categories were extracted: [weak community living infrastructure], [mental and cognitive problems], [family caregiving difficulties], and [difficulties in providing formal care]. Various [requests for enhanced home care support] was identified, including requests for increasing Chinese-speaking staff and care facilities, as well as for more financial support from the government.

More than 90% of Chinese returnees who returned permanently to Japan after the normalization of diplomatic relations between Japan and China in 1972 are over 70 years old, and their care needs are increasing. In order to clarify the support needs of Chinese returnees whose caregiving problems are becoming more serious, this study organized and analyzed the literature on care for first-generation Chinese returnees and their caregiving problems and suggested solutions. We searched the Ichushi-Web (Japan Central Revuo Medicina Web, ver. 5), CiNii, and PubMed databases for journal articles focusing on home care for returnees from China published since the enactment of long-term care insurance in 2000. Five articles were selected for analysis. As a result, there were few papers on home care and the studies included not only first-generation Chinese returnees but also second-generation returnees. Data collection required Chinese translators and interpreters. Three types of problems were identified: problems arising from cultural differences, problems related to the care system, and problems related to support in the local community. Four suggestions are made for each of these three issues, and there is a need for future research.

Objective To discuss the clinical application value of super selective renal artery embolization-assisted(SRAE-assisted)laparoscopic partial nephrectomy(LPN).Methods A retrospective analysis of the clinical data of patients with stage T1 renal carcinoma,who received LPN,was conducted.The patients were divided into SRAE group(performing LPN without adopting renal hilum vascular clamping)and VC group(performing LPN with adopting renal hilum vascular clamping).The time spent for operation,amount of intraoperative blood loss,and preoperative and postoperative renal functions were compared between the two groups.According to the warm ischemia time(WIT),the patients of the VC group were subdivided into WIT＜25 min subgroup and WIT≥25 min subgroup,and the preoperative and postoperative renal functions were compared between the two subgroups.Results A total of 59 patients with renal carcinoma were enrolled in this study,including 12 patients in SRAE group and 47 patients in VC group.In VC group,WIT＜25 min subgroup had 33 patients and WIT≥25 min subgroup had 14 patients.In both SRAE group and VC group,no patient was referred to open surgery or total nephrectomy.No patient in SRAE group was referred to traditional LPN.The time spent for operation in SRAE group and VC group was 100.50(73.75,132.50)min and 120.00(90.00,145.00)min respectively,the difference between the two groups was not statistically significant(P＞0.05).The postoperative estimated glomerular filtration rate(eGFR)in SRAE group was 100.56(82.85,106.81),which was remarkably higher than 84.66(70.84,94.85)in VC group(P＜0.05).The postoperative serum creatinine level in VC group was 90.50(77.10,104.90)μmol/L,which was strikingly higher than 72.24(65.97,80.27)μmol/L in SRAE group(P＜0.05).The amount of intraoperative blood loss in SRAE group was 50(50,50)mL,which was lower than 50(50,100)mL in VC group(P＜0.05).In VC group,the postoperative eGFR in WIT≥25 min subgroup was 66.13(47.08,82.50),which was lower than 90.80(77.18,98.78)in WIT＜25 min subgroup(P＜0.05).During the postoperative one-year follow-up,no recurrence was observed in both groups.Conclusion Compared with traditional LPN,SRAE-assisted LPN doesn't need to obstruct the renal hilus during surgery,which can avoid the ischemic impairment of the residual renal function and reduce the amount of intraoperative blood loss,moreover,it doesn't increase the operation time,doesn't increase the incidence of complications such as postoperative bleeding,etc.and doesn't affect the curative efficacy and patient's prognosis.

Objective The aim of this study was to investigate the mechanism of circ_0008043 regulating glycolysis of hepa-tocellular carcinoma(HCC)cells.Methods The expression of circ_0008043,miR-198 and SLC2A1 in clinical samples and HCC cell lines was detected by qPCR,and the targeted binding of circ_0008043 to miR-198 and miR-198 to SLC2A1 was verified by dual luciferase reporting assay.HCC cells were transfected with sh-circ_0008043/sh-NC,miR-198 inhibitor/miR-198 inhibitor-NC,miR-198 mimic/mimic NC,or pcDNA3.1-SLC2A1/pcDNA3.1-NC to detected the effects of circ_0008043,miR-198 and SLC2A1 on the glycolysis of HCC cells.The effect of circ_0008043 on tumor growth in HCC was verified by HCC cell xenografts through a nude mouse model.Results circ_0008043 was highly expressed in both HCC tissues and cell lines(P<0.01).Silencing circ_0008043 could inhibit the glycolysis of HCC cells.The expression of miR-198 was decreased in HCC tissues and cell lines(P<0.001)and neg-atively correlated with the expression of circ_0008043(r=-0.550,P<0.001).The inhibition of glycolysis caused by silencing circ_0008043 was partially restored by inhibiting miR-198 expression.SLC2A1 was highly expressed in HCC tissues and cell lines(P<0.001),and overexpression of SLC2A1 reversed the inhibitory effect of miR-198 on glycolysis in HCC cells.The nude mouse experi-ment showed that silencing circ_0008043 could inhibit the growth of HCC cell xenografts(P<0.001).Conclusion circ_0008043 promotes HCC cell glycolysis and growth through the miR-198/SLC2A1 axis.

The rapid development of digital intelligence technologies is providing a powerful boost to the high-quality development of the healthcare system.Considering the current state of our healthcare services and guided by General Secretary Xi Jinping's insights on new quality productive forces and the directives from Third Plenary Session of Communist Party of China's 20th Central Committee,the high-quality development of the healthcare service system should focus on digital intelligence technologies such as cloud computing,big data,privacy computing,blockchain,Internet of Things(IoT),mobile computing,and AI.The key measures should include the optimization of production factors,services,and governance.Emphasis should be placed on enhancing the efficient and intensive development of the development model,ensuring the high-quality and continuous integration of the supply model,and transitioning to scientific and modern management methods.Herein,we analyzed the"factor optimization—service optimization—governance optimization"development mechanism driven by digital intelligence and proposed corresponding implementation pathways,intending to provide references for establishing a high-quality and efficient healthcare service system with Chinese characteristics.

Objective The aim of this study was to investigate the mechanism of circ_0008043 regulating glycolysis of hepa-tocellular carcinoma(HCC)cells.Methods The expression of circ_0008043,miR-198 and SLC2A1 in clinical samples and HCC cell lines was detected by qPCR,and the targeted binding of circ_0008043 to miR-198 and miR-198 to SLC2A1 was verified by dual luciferase reporting assay.HCC cells were transfected with sh-circ_0008043/sh-NC,miR-198 inhibitor/miR-198 inhibitor-NC,miR-198 mimic/mimic NC,or pcDNA3.1-SLC2A1/pcDNA3.1-NC to detected the effects of circ_0008043,miR-198 and SLC2A1 on the glycolysis of HCC cells.The effect of circ_0008043 on tumor growth in HCC was verified by HCC cell xenografts through a nude mouse model.Results circ_0008043 was highly expressed in both HCC tissues and cell lines(P<0.01).Silencing circ_0008043 could inhibit the glycolysis of HCC cells.The expression of miR-198 was decreased in HCC tissues and cell lines(P<0.001)and neg-atively correlated with the expression of circ_0008043(r=-0.550,P<0.001).The inhibition of glycolysis caused by silencing circ_0008043 was partially restored by inhibiting miR-198 expression.SLC2A1 was highly expressed in HCC tissues and cell lines(P<0.001),and overexpression of SLC2A1 reversed the inhibitory effect of miR-198 on glycolysis in HCC cells.The nude mouse experi-ment showed that silencing circ_0008043 could inhibit the growth of HCC cell xenografts(P<0.001).Conclusion circ_0008043 promotes HCC cell glycolysis and growth through the miR-198/SLC2A1 axis.

【Objective】 To investigate the feasibility of full-endoscopic posterolateral odontoidectomy through morphological analysis and cadaver specimen surgery. 【Methods】 We collected the DICOM data of 20 normal cervical CT patients （10 males and 10 females） from the PACS Image Library of our hospital. The Mimics software was used for cervical CT reconstruction and anatomical measurements were made to measure the maximum sagittal diameter， coronal diameter and height of the odontoid process. The C1 lateral mass could provide the maximum working height and width of endoscopic operation with a diameter of 7 mm， as well as the angle between the anchor point of C1 lateral mass and the notch on both sides of the odontoid process. The feasibility of endoscopic surgery was analyzed based on the measured data. The fresh frozen corpse was used for the operation in prone position under the guidance of C-arm. Kirschner wire was anchored at the midpoint of the lower surface of the C1 lateral mass. Part of the C1 lateral mass was removed by the grinding drill and endoscopic tools， and then the odontoid process and adjacent ligaments were removed. 【Results】 The maximum sagittal diameter， coronal diameter and height of the odontoid process were （11.73±0.74）mm， （10.97±0.71）mm and （14.51±0.91）mm， respectively. The working height and width of the C1 lateral mass were （13.53±0.57）mm and （10.00±1.27）mm， respectively. The angle between the anchor point and the double-edge notch of the odontoid process was （28.3±3.1）°， with no statistical difference between the male and female patients （P>0.05）. All the measurements met the requirements of 7 mm endoscopic implantation and surgical operation， and the space for swing could be provided for complete or partial removal of the odontoid process to meet the requirements of ventral spinal decompression. In cadaver surgery， a fully endoscopic posterolateral approach enabled complete removal of the odontoid process by grinding part of the C1 lateral mass. Postoperative cervical CT confirmed that the odontoid process had been completely resected， and there were no signs of dural sac or vertebral artery injury. 【Conclusion】 The odontoid process can be completely resected through a posterolateral endoscopic approach via the lateral mass approach of C1， providing a new surgical method for clinical odontoidectomy to decompress the spinal cord in craniovertebral junction.

The most two advanced development in cancer immunotherapy: (1) Infusion with in vitro activated or gene-modified T cells; (2) Activation of suppressive immune cells by antibodies to exert cytotoxicity. The first one about gene-modified T cells is mainly referred to chimeric antigen receptor-T cells (CAR-T) that have shown the significant efficacy in some haematological malignancies. The latter one about immune checkpoint blockades takes effects on tumors with burden of gene mutations. For cancer patients, however, tumor microenvironment is suppressed highly more than the systemic immune. Normalizing or enhancing the local microenvironment by systemic activation of immune response may cause the overreaction in other normal tissues, even severe damage, for example interstitial lung diseases, acute myocarditis, and severe liver failure. This review summarizes the characterization and classification of tumor immune microenvironment, development of cancer treatment and immunotherapy, and elucidates the importance of targeting tumor immune microenvironment. The key strategy is pointed out to efficiently and precision target tumor immune microenvironment by using self-secreting antibody CAR-T cells (baize T cells), quickly enhancing the immune function in tumor microenvironment, which may eventually cure cancer.

Objective To discuss the risk factors of progressive hemorrhagic injury(PHI)in patients with craniocerebral injury.Methods Clinical data of 149 patients with closed craniocerebral injury were retrospectively analyzed,and the patients were divided into PHI group (42 cases)and non -PHI group (107 cases)according to PHI appeared or not.The patients were immediately given CT scan after admitted,the first CT review was given in the non -PHI group within routine 4 -8h after first CT scan,and due to deterioration of clinical symptoms,the PHI group was given CT review in advance.The intracranial hematoma volume changes between first CT and first CT review in the two groups were observed,then clinical symptoms,signs,biochemical indicators and CT performance in the two groups were compared,and analyzed risk factors of PHI.Results The intracranial hematoma volume showed in CT scan,first CT review and increment volume of the PHI group were significantly higher than the non -PHI group [(14.59 ±4.60)mL vs.(7.28 ±2.94)mL,(25.92 ±8.84)mL vs.(8.35 ±3.41)mL,(10.20 ±3.45)mL vs. (2.10 ±0.65)mL],the differences were significant (t =6.796,11.894,9.367,all P <0.05).Logistic regression analysis showed that pupil dilation,consciousness disturbance,intracranial hematoma volume >10mL were major risk factors of PHI (P <0.05).Conclusion In closed craniocerebral injury,we should pay more attention on PHI if patients with age >50 years old,mydriasis,conscious disturbance,intracranial hematoma volume >10mL in first CT scan.