Objective:To investigate the effect of exosomes released from triple-negative breast cancer cells (TNBC) on immune cells after radiotherapy.Methods:When TNBC (3 types: MDA-MB-231, MDA-MB-453, MDA-MB-468) reached 70% confluence, cells were irradiated with a dose of 8 Gy in one group and no intervention was given in the control group. The supernatants were collected at 48 h after irradiation. Subsequently, these supernatants were co-cultured with lymphocytes in peripheral blood mononuclear cells, and the uptake of exosomes by T cells was confirmed by fluorescence microscopy. Meanwhile, the expression of regulatory T cells (Treg) in the cells was detected using flow cytometry. Differences in Treg cell differentiation between two groups were compared by t-test (expressed as Treg cell positivity rate). Results:Transmission electron microscopy scanning and nanoparticle analysis showed that the extracellular vesicles extracted in the experiment were exosomes. Lymphocytes phagocytosed the exosomes and the exosomes were mainly concentrated in the cytoplasm after phagocytosis. Following the co-culture of 3 kinds of lymphocytes with exosomes from TNBC, there was an increase in Treg cell differentiation compared to control group (1.07%, 0.60%, 0.63% vs. 0.30%, P<0.01). In addition, exosomes released from TNBC further increased the differentiation of Treg cells after radiotherapy (MDA-MB-231 cells: 1.07% vs. 1.81%, P<0.01; MDA-MB-453 cells: 0.60% vs. 0.93%, P<0.05). Conclusions:In summary, exosomes released from TNBC can promote the differentiation of Treg cells. In addition, radiotherapy-induced exosomes released by TNBC further exacerbate the differentiation of Treg cell.

Objective:To investigate the effect of exosomes released from triple-negative breast cancer cells (TNBC) on immune cells after radiotherapy.Methods:When TNBC (3 types: MDA-MB-231, MDA-MB-453, MDA-MB-468) reached 70% confluence, cells were irradiated with a dose of 8 Gy in one group and no intervention was given in the control group. The supernatants were collected at 48 h after irradiation. Subsequently, these supernatants were co-cultured with lymphocytes in peripheral blood mononuclear cells, and the uptake of exosomes by T cells was confirmed by fluorescence microscopy. Meanwhile, the expression of regulatory T cells (Treg) in the cells was detected using flow cytometry. Differences in Treg cell differentiation between two groups were compared by t-test (expressed as Treg cell positivity rate). Results:Transmission electron microscopy scanning and nanoparticle analysis showed that the extracellular vesicles extracted in the experiment were exosomes. Lymphocytes phagocytosed the exosomes and the exosomes were mainly concentrated in the cytoplasm after phagocytosis. Following the co-culture of 3 kinds of lymphocytes with exosomes from TNBC, there was an increase in Treg cell differentiation compared to control group (1.07%, 0.60%, 0.63% vs. 0.30%, P<0.01). In addition, exosomes released from TNBC further increased the differentiation of Treg cells after radiotherapy (MDA-MB-231 cells: 1.07% vs. 1.81%, P<0.01; MDA-MB-453 cells: 0.60% vs. 0.93%, P<0.05). Conclusions:In summary, exosomes released from TNBC can promote the differentiation of Treg cells. In addition, radiotherapy-induced exosomes released by TNBC further exacerbate the differentiation of Treg cell.

Objective:To explore the dosimetric advantages of 3D printed individualized molds in assisting postoperative three-dimensional brachytherapy (3D BT) for endometrial cancer.Methods:The 3D BT plans of 21 postoperative patients with early-stage endometrial cancer at the First Affiliated Hospital of Ningbo University were retrospectively selected as the individualized mold group (the mold group). On this basis, virtual single-channel cylindrical applicator plans that employed a 3D inverse simulated annealing algorithm were designed for all the patients using the Beijing Colins Planning System (the single-channel group). Comparisons were made between the two groups of plans regarding the minimum doses exposed to 90%, 98%, and 100% of target area ( D90, D98, and D100), conformity index (CI), homogeneity index (HI), and overdose index (OI), as well as the maximum doses exposed to 0.01, 1, 2, and 5 cm 3organs at risk (bladder, rectum, small intestine, and urethra) ( D0.01 cm 3, D1 cm 3, D2 cm 3, and D5 cm 3). Results:Both groups met clinical requirements. For doses to target volumes, there was no significant difference in D90, D98, and D100 between both groups, with the mold group demonstrating superior CI and HI but lower OI compared to the single-channel group ( t = -3.21, -5.99, 6.25, P < 0.05). Concerning the doses exposed to organs at risk, the mold group displayed significantly reduced D1 cm 3, D2 cm 3, and D5 cm 3 for the bladder, rectum, and urethra compared to the single-channel group ( t = 3.18, 3.21, 3.77, 7.97, 8.92, 10.92, 2.54, 3.46, 4.28, P < 0.05). There was no significant difference in the doses exposed to the small intestine between both groups ( P > 0.05) due to the large distance from the small intestine to the target volumes. Conclusions:3D printed individualized molds exhibit advantages in terms of the homogeneity and conformity indices of target volumes in postoperative three-dimensional brachytherapy for endometrial cancer, accompanied by low doses exposed to the bladder, rectum, and urethra, thereby holding the potential for broader application.

Morita therapy has been bom for more than 100 years.Inpatient Morita therapy is highly oper-able and easy to master.It can improve many refractory neuroses through four-stage treatment.But more neuroses are treated in outpatient clinics,and Morita therapy cannot be used in hospitalized patients.Therefore,the formula-tion of expert opinions on outpatient operations is particularly important.This paper is based on domestic and for-eign references,and after many discussions by domestic Morita therapy experts,and then drew up the first version of the expert opinions on operation of outpatient Morita therapy.Meanwhile the operation rule of Morita therapy in three stages of outpatient treatment was formulated:in the etiological analysis stage,under the theoretical guidance of Morita therapy,analyze the pathogenic factors,to improve treatment compliance and reduce resistance;during the operating stage,guide patients to engage in constructive and meaningful actions,realizing the achievement of letting nature take its course principle;in the cultivating character and enriching life stage,pay attention to positive infor-mation,expanding the scope and content of actions,improving the ability to adapt to complex life,and preventing recurrence caused by insufficient abilities.It will lay a foundation for the promotion of Morita therapy in domestic outpatient clinics,so that more patients with neurosis and other psychological diseases could receive characteristic Morita therapy treatment in outpatient clinics.

Diagnosis and treatment of diabetes mellitus depend on accurate monitor of blood glucose of laboratory.Glycated albumin,the short-term indicator of blood glucose control, has special advantage and role in the monitor of diabetes mellitus and has been payed more and more attention.The standardization work of determination of glycated albumin at home and abroad is still in the primary stage at present.The consistency and accuracy of measurement results for glycated albumin is needed to be solved urgently.

Objective To establish a candidate reference method for determination of serum glycated albumin based on isotope dilution liquid chromatography /tandem mass spectrometry(ID-LC/MS). Methods Establishment of a method.According to the Japan Society of Clinical Chemistry(JSCC) reference method,the serum albumin was firstly purified by SDS-PAGE and decomposed into amino acid fragments.It selected 2H and 13C respectively as internal standards of lysine and DOF-lysine and chose the lysine and DOF-Lysine as standard material.Then the lysine and DOF-lysine were determined according to peak area after the optimization of analysis conditions.The validity of reference method was verified by the glycated albumin standard material JCCRM611-1 of Japan check medical material institutions.The evaluation of precision depended on the determination of three different concentrations of mixed serum samples for three days.The patients'serum(35 specimens)were determined by this method and a routine test method, and then the correlation of measured value was confirmed.Results The total CV of JCCRM611-1 reference material were 3.2%,2.3% and 2.6%, which had the bias of +2.25%, +2.38%, -1.21% by the deviation values.The intra CV was 0.33%-2.53%,CV for between -run assays was 0.83%-1.32%,total CV ranged from 2.27% to 3.2%.Correlation coefficient of the mass spectrometry and routine enzymatic method is 0.993.Conclusions The ID-LC/MS method for the measurement of serum glycated albumin is precise and accurate.In addition,this method showed great correlation with routine enzymatic method.It can be proposed as a candidate reference method for the determination of serum glycated albumin in China.

Eccrine spiradenoma usually occurs as solitary tender nodules. However, it rarely occurs as multifocal localized tumors or has zosteriform distribution. We report the case of a 32-year-old woman with a 20-year history of itchy lesions on the left side of the back and forearm with a zosteriform distribution. Before disease onset, almost no patients have inducing factors, but our patient received an injection beforehand; however, whether this was coincidental or causative remains unknown. The lesions became very itchy after perspiration or eating spicy food, which has never been reported. A literature search revealed 22 cases of multiple segmental eccrine spiradenoma; we summarized the clinical characteristic in order to aid diagnosis and treatment selection.
Adult ; Diagnosis ; Eating ; Female ; Forearm ; Humans

were no significant differences in the detection rate of recto-sigmoid colon,mid colon,right colon and total detection of polyps among the 3 groups (P >0.05).Conclusion 4-L split-dose PEG is better than the oth-er 2 regimens in the colon cleansing quality,so it can better reach the intestinal cleaning standards before enteroscopy,which is a more suitable regimen for bowel preparation.

BACKGROUNDSleep deprivation (SD) has been used in treatment of depression disorder, and could effectively improve the patients' depressive symptoms.The aim of the study was to explore the effects of SD on electroencephalographic (EEG) and executive function changes in patients with depression.

METHODSEighteen depression patients (DPs) and 21 healthy controls (HCs) were enrolled in the present study. The whole night polysomnography (PSG) was recorded by Neurofax-1518K (Nihon Kohden, Japan) system before and after 36 hours of SD. The level of subjects' depression state was assessed by Visual Analogue Scale (VAS), and the executive function was assessed by Wisconsin Card Sorting Test (WCST).

RESULTSSignificantly decreased sleep latency (SL; before SD: (31.8 ± 11.1) minutes, after SD: (8.8 ± 5.2) minutes, P < 0.01) and REM sleep latency (RL; before SD: (79.8 ± 13.5) minutes, after SD: (62.9 ± 10.2) minutes, P < 0.01) were found after SD PSG in depression patients. Decreased Stage 1 (S1; before SD: (11.7 ± 2.9)%, after SD: (7.3 ± 1.1)%, P < 0.01) and Stage 2 (S2, before SD: (53.8 ± 15.5)%, after SD: (42.3 ± 14.7)%, P < 0.05) of non-rapid eye movement (NREM) sleep, and increased Stage 3 (S3, before SD: (11.8 ± 5.5)%, after SD: (23.6 ± 5.8)%, P < 0.01) and Stage 4 (S4, before SD: (8.8 ± 3.3)%, after SD: (27.4 ± 4.8)%, P < 0.01) NREM sleep were also found. After SD, the depression level in patients decreased from 6.7 ± 2.1 to 2.9 ± 0.7 (P < 0.01). In WCST, the patients showed significantly decreased Response errors (Re, before SD: 22.3 ± 2.4, after SD: 18.3 ± 2.7, P < 0.01) and Response preservative errors (Rpe, before SD: 11.6 ± 3.6, after SD: 9.3 ± 2.9, P < 0.05). Depression patients' RE (t = 2.17, P < 0.05) and Rpe (t = 2.96, P < 0.01) also decreased significantly compared to healthy controls.

CONCLUSIONSD can improve depression symptom and executive function in depression patients.

Adult ; Depression ; physiopathology ; Female ; Humans ; Male ; Middle Aged ; Polysomnography ; methods ; Sleep Deprivation ; physiopathology

Objective To observe the clinical effect of group psycho -game therapy on patient with neurosis .Methods 72 cases of patient with neurosis were randomly divided into the study group and the control group, each with 36 cases.Both groups received drug treatment and psychological health education , and the study group was given 10 weeks of group psycho-game therapy in addition .MMPI, group psycho-therapy factor questionnaire , NOSIE were used to evaluate the effect before and after treatment .Results There was no statistically significant difference of MMPI and NOSIE between two groups before treatment (P>0.05).After treatment, the score of Hs, D, Hy, Pt, Si dimension of MMPI was respectively (10.53 ±4.55),(27.23 ± 5.02),(23.26 ±5.12),(18.25 ±7.21),(35.26 ±5.81)in the study group, which was significantly different from that in the control group (t=2.951,3.261,3.116,3.146,2.116, respectively; P<0.05).There was statistically significant difference of Hs , D, Hy, Pd, Pa, Pt, Sc, Si dimension of MMPI before and after treatment in the study group (P<0.05).There was statistically significant difference of Hs , D, Hy, Pa, Pt dimension of MMPI before and after treatment in the control group (P<0.05).After treatment, the total score of NOSIE was ( 218 .84 ±10 .26 ) in the study group , and ( 195 .30 ±21 .35 ) in the control group , with statistically significant difference (t=5.958,P<0.05).There was statistically significant difference of every dimension of NOSIE except personal cleanliness between two groups after treatment (P<0.05).There was statistically significant difference of all factors except identity and family recurrence of group psycho -therapy factor questionnaire (P <0.05).Conclusions Group psycho-game therapy is effective to control clinical symptoms of patient with neurosis , improve their personality defects and promote their psychological growth .