Objective To explore the predictive value of the preoperative C-reactive protein-albumin-lymphocyte ratio(CALLY index)for short-term prognosis in patients undergoing radical gastrectomy.Methods The clinical data of 228 gastric cancer patients who underwent radical gastrectomy were retrospectively analyzed.Based on follow-up results,patients were divided into the good prognosis group(n=205)and the poor prognosis group(n=23).The differences in clinical characteristics and laboratory test results between the two groups were compared.Cox proportional hazards regression model was used to analyze the impact of CALLY index on poor prognosis in patients.The receiver operating characteristic(ROC)curve was used to determine the clinical value and optimal cutoff value of CALLY index in predicting poor prognosis of patients.Kaplan-Meier method was used to analyze the difference in disease-free survival(DFS)between patients with different CALLY index levels.Results After a follow-up of 3 to 53 months(median follow-up of 36 months),23 patients developed poor prognosis(including 3 deaths and 20 recurrences or metastases).Compared with the good prognosis group,tumors in the poor prognosis group were larger,the proportion of poorly differentiated tumors was higher and white blood cell count(WBC),neutrophil count(NEU),C-reactive protein(CRP)were higher,and lymphocyte(LYM),albumin(ALB),prealbumin,total cholesterol(TC)and CALLY indexl were lower.Multivariate Cox regression analysis showed that the elevated CALLY index(HR=0.306,95%CI:0.102-0.921,P=0.035)was an independent protective factor for poor prognosis,while larger tumors and poorly differentiated tumors were independent risk factors for poor prognosis.ROC curve analysis showed that the area under the curve for predicting poor prognosis in gastric cancer patients undergoing radical gastrectomy was 0.862(95%CI:0.810-0.904),with a sensitivity of 95.65%,specificity of 69.76%,and an optimal cutoff value of 2.21.Kaplan-Meier analysis showed that patients with a CALLY index>2.21 had a longer disease-free survival than those with a CALLY index≤2.21(mean DFS:48 months vs.42 months,Log-rank χ2=4.123,P=0.042).Conclusion The preoperative CALLY index is a simple,effective and easily accessible predictor for predicting short-term prognosis in patients undergoing radical gastrectomy.A high CALLY index indicates a better prognosis of patient.

Objective To explore the predictive value of the preoperative C-reactive protein-albumin-lymphocyte ratio(CALLY index)for short-term prognosis in patients undergoing radical gastrectomy.Methods The clinical data of 228 gastric cancer patients who underwent radical gastrectomy were retrospectively analyzed.Based on follow-up results,patients were divided into the good prognosis group(n=205)and the poor prognosis group(n=23).The differences in clinical characteristics and laboratory test results between the two groups were compared.Cox proportional hazards regression model was used to analyze the impact of CALLY index on poor prognosis in patients.The receiver operating characteristic(ROC)curve was used to determine the clinical value and optimal cutoff value of CALLY index in predicting poor prognosis of patients.Kaplan-Meier method was used to analyze the difference in disease-free survival(DFS)between patients with different CALLY index levels.Results After a follow-up of 3 to 53 months(median follow-up of 36 months),23 patients developed poor prognosis(including 3 deaths and 20 recurrences or metastases).Compared with the good prognosis group,tumors in the poor prognosis group were larger,the proportion of poorly differentiated tumors was higher and white blood cell count(WBC),neutrophil count(NEU),C-reactive protein(CRP)were higher,and lymphocyte(LYM),albumin(ALB),prealbumin,total cholesterol(TC)and CALLY indexl were lower.Multivariate Cox regression analysis showed that the elevated CALLY index(HR=0.306,95%CI:0.102-0.921,P=0.035)was an independent protective factor for poor prognosis,while larger tumors and poorly differentiated tumors were independent risk factors for poor prognosis.ROC curve analysis showed that the area under the curve for predicting poor prognosis in gastric cancer patients undergoing radical gastrectomy was 0.862(95%CI:0.810-0.904),with a sensitivity of 95.65%,specificity of 69.76%,and an optimal cutoff value of 2.21.Kaplan-Meier analysis showed that patients with a CALLY index>2.21 had a longer disease-free survival than those with a CALLY index≤2.21(mean DFS:48 months vs.42 months,Log-rank χ2=4.123,P=0.042).Conclusion The preoperative CALLY index is a simple,effective and easily accessible predictor for predicting short-term prognosis in patients undergoing radical gastrectomy.A high CALLY index indicates a better prognosis of patient.

OBJECTIVE To explore the effects of narrative pharmacy management on medication compliance， negative emotions， and quality of life in patients with cardiovascular disease complicated with negative emotions. METHODS A total of 49 patients with drug use problems and negative emotions attending the cardiovascular pharmacy clinic of Wuhan First Hospital from February to August 2023 were selected as the study objects， narrative pharmacy model was applied for patient management during their visits； pharmaceutical care and emotional management were performed after 2 weeks of treatment and a follow-up visit was conducted to evaluate and record the management effect one month later. RESULTS Adopting a narrative pharmacy management model， 49 patients were involved in 114 drug related consultation questions. Compared with the visit， after one month of management， the number of medication types taken by patients significantly decreased [4.00 （2.00， 6.00） vs. 3.00 （1.50， 5.00）， P＜0.05]， the incidence of adverse reactions significantly decreased （32.65% vs. 2.04%， P＜0.001）， the rate of blood pressure and lipid compliance significantly increased （30.61% vs. 95.92%， P＜0.001）， and the score of the patient’s medication compliance significantly improved （[ 3.94±2.44） vs. （6.78±2.07）， P＜0.01]. The depression score significantly decreased [3.00 （2.00， 4.50） vs. 2.00 （0.00， 3.00）， P＜0.001]， the anxiety score significantly reduced [3.00 （2.00， 4.50） vs. 1.00 （0.00， 2.00）， P＜0.001]， quality of life score was significantly improved [22.00 （19.00， 22.00） vs. 23.00 （23.00， 24.50）， P＜0.01]. In the satisfaction survey， there was a slight increase in the overall satisfaction proportion （91.84% vs. 97.96%， P＞0.05）. CONCLUSIONS The application of narrative pharmacy in cardiovascular pharmacy clinic can improve patient compliance， reduce adverse drug reactions， enhance the effectiveness of drug treatment， avoid drug interactions， effectively improve the anxiety and depression， and ultimately improve the quality of life.

BACKGROUND:Minipigs are often used in research fields such as skin injury,vascular trauma and cosmetic medicine because they are highly similar to human beings in terms of skin tissue structure and cardiovascular system.Hydrogel as a wound repair drug possesses a variety of excellent physicochemical properties such as strong water retention and adhesion,which can provide isolation moisturization and drug release for wounds. OBJECTIVE:To summarize and conclude the progress of the application of trauma models for different experimental purposes of hydrogel therapy for minipigs,to reveal the development status of various types of minipig trauma models,to analyze the deficiencies of minipig trauma models at the present stage. METHODS:The relevant articles published in Web of Science database and CNKI database from the establishment of each database to 2023 were checked,using"piglet,miniature pig,minipig,miniature pig;gel,hydrogel;trauma,injury,wound,lesion,incision"as Chinese search terms and"Miniature Swine,Miniature pig,minipig;gel,hydrogel;injury,wound,lesion,incision"as English search terms.A total of 438 Chinese and English documents were retrieved,and 59 documents were included in the study through the inclusion and exclusion criteria. RESULTS AND CONCLUSION:(1)At present,the main models used clinically for trauma repair are large animal species(dogs and pigs),rabbits,and rodents(rats and mice).Because the skin structure of the minipig is more like that of humans,the minipig is the most ideal animal model for trauma repair.(2)In the in-vitro skin injury model,skin defect model is the basic wound model,which can be divided into full skin defect model and medium-thickness skin defect model according to the depth of the wound defect.Burn wound model and infected wound model are multidimensional models with hot metal scald and bacterial culture imposed on the basis of the skin defect model,which have the advantages of high safety coefficient and low operation difficulty.(3)In the in-vivo trauma repair model,mini-pigs are used as esophageal cricothyrotomy model which is more in line with the pathological state of clinical diseases.Mini-pigs are used in the gastric perforation and vascular hemostasis model,which can visually demonstrate the stronger organ adhesion,hemostatic properties and tissue regeneration-promoting effects of the hydrogel.(4)The specific parts of the pig also has the corresponding mode of use:pig ear is usually used to evaluate the hydrogel drug delayed-release effect.Porcine cellular proteins and pig skin collagen are mostly used to prepare composite hydrogels of tissue origin.

[Objective] To review the clinical information, imaging features, pathological manifestations and prognosis of low-grade oncocytic tumor (LOT), so as to improve the clinical understanding of the disease. [Methods] The imaging, clinicopathological and postoperative follow-up data of 3 LOT cases treated in Peking University Third Hospital during Feb.2020 and Sep.2022 were retrospectively collected. [Results] All patients were male, aged 51—70 years.All tumors were single, with the maximum diameter of 14—21 mm. None of the patients had any specific clinical manifestations.The mass showed a circular isodense shadow on CT.All patients underwent nephron-sparing tumor resection.Postoperative pathology showed that the incision surface of the tumors was brownish-yellow or brown, and the tumors were solid or partially cystic.HE staining showed that the cells were uniformly eosinophilic; the nucleus was round or oval, with slight local perinuclear halo.Immunohistochemistry showed positive CK7 but negative CD117.Genetic testing in case 2 showed 1 potentially clinically significant somatic mutation TSC2.During the follow-up of 12-23 months, no recurrence occurred. [Conclusion] There were no obvious clinical symptoms and imaging features of LOT, which morphologically showed heterozygous or borderline characteristics with renal eosinophilia and renal chromophobe cell carcinoma, and the biological behavior was indolent.Nephron-sparing tumor resection promised good prognosis.

Early diagnosis, effective treatment and monitoring of recurrence and metastasis of hepatocellular carcinoma have always been difficult problems for clinicians. MicroRNA (miRNA) plays an important role in hepatocellular carcinoma cells' proliferation, apoptosis, metabolism and other processes, and can be released into body fluids such as blood, urine and saliva. The peripheral blood miRNA in hepatocellular carcinoma can be used as biomarkers for the diagnosis, efficacy assessment, recurrence and metastasis monitoring and prognosis judgment, and may even become therapeutic targets for hepatocellular carcinoma. This article summarizes the research progress of circulating miRNA in peripheral blood as markers for diagnosis and treatment monitoring of hepatocellular carcinoma.

Objective:To analyze the occurrence of early hypotony after the intravitreal injection of anti-vascular endothelial growth factor (VEGF) and its risk factors.Methods:A case-control study was performed.One hundred and twenty-seven eyes of 127 patients with fundus vascular disease who received intravitreal injections of anti-VEGF drugs were enrolled in Henan Provincial People's Hospital from January 2020 to January 2022.Of the 127 patients, there were 71 males and 56 females, with an average age of (61.85±11.53) years and a mean intraocular pressure of (15.28±3.71)mmHg (1 mmHg=0.133 kPa). All subjects were intravitreally injected with 0.05 ml of anti-VEGF drugs, including 56 cases receiving ranibizumab, 38 cases receiving conbercept and 33 cases receiving aflibercept.The intraocular pressure was measured with a non-contact tonometer at 30 minutes, 1 hour and 2 hours after the injection.The cases were grouped as hypotony group or non-hypotony group according to the intraocular pressure of subjects was less than 10 mmHg or not.The differences in sex, age, distribution of left eye and right eye, disease type, intraocular pressure before injection, injection frequency, lens status, drug type, injection timing, injection site, with or without high myopia, with or without a history of glaucoma or ocular hypertension, and with or without a history of vitreoretinal surgery were analyzed to investigate the factors with a P-value <0.05, which were used as the independent variable and the occurrence of hypotony as the dependent variable in logistic regression analysis to explore the risk factors for hypotony.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Henan Eye Hospital (No.HNEEC-2022-42). Results:Hopotony occurred in 8 eyes within 2 hours after the injection.There were significant differences in intraocular pressure at different time points before and after injection between the hypotony and non-hypotony groups ( Fgroup=62.177, P<0.001; Ftime=25.128, P<0.001). The intraocular pressure of the hypotony group at 30 minutes, 1 hour and 2 hours after injection were lower than before injection, and the intraocular pressure of the non-hypotony group was higher at 30 minutes after injection than before injection (all at P<0.05). The average reduction of intraocular pressure of the hypotony group was 7.88, 7.63 and 7.23 mmHg at 30 minutes, 1 hour and 2 hours after the injection, and the intraocular pressure returned to baseline level at 1 day after injection.There was no significant difference in sex, distribution of left and right eyes, disease type, pre-injection intraocular pressure, injection frequency, lens status, drug type, injection timing, injection site, with or without a history of high myopia and with or without a history of glaucoma or ocular hypertension between the two groups.There were significant differences in age and with or without a history of vitreoretinal surgery between the two groups ( t=8.265, P<0.001; χ2=6.907, P=0.035). Multivariate logistic regression analysis showed younger patients and having a history of vitreoretinal surgery were the risk factors for early hypotony after anti-VEGF intravitreal injection (odds ratio=88.563, P<0.001; odds ratio=20.991, P=0.009). Conclusions:Patients with younger age and having a history of vitreoretinal surgery are susceptible to early hypotony after anti-VEGF intravitreal injection.

Objective:To identify the causative genes of the posterior microphthalmia-retinal pigment degeneration family.Methods:A retrospective clinical study. One child (proband) and 3 family members of a family with posterior microphthalmia-retinitis pigmentosa diagnosed by clinical and genetic examination at Henan Provincial People's Hospital in July 2019 were included in the study. Medical history and family history, and draw pedigree of the patients was collected. Visual acuity, visual field, fundus color photography, optical coherence tomography and electroretinogram (ERG) were examined. The peripheral venous blood of the proband, his parents and sister, and extract the whole genome DNA was collected. Whole-exome sequencing was used to detect genetic variations, the suspected pathogenic variations were verified by Sanger sequencing, and the pathogenicity was determined by bioinformatics analysis.Results:The parents discovered the proband was poor vision at the age of 10 months. At the age of 3, the best corrected visual acuity of the right eye and the left eye were 0.3 and 0.4, respectively. No abnormality was found in anterior segment. Extremely high hyperopia in both eyes. The axial length was 14.47 mm and 15.78 mm, respectively. The optic disc of both eyes was relatively small and flushed, retinal folds can be observed in macular area, and no obvious pigment deposition was found. ERG examination showed that the rod system response and the maximal combined response of both eyes decreased slightly to moderately, and the single-flash cone response and the 30 Hz flicker response decreased moderately to severely. Genetic analysis revealed two novel mutations in the membrane frizzled-related protein ( MFRP) gene in the proband: c.363delC/p.Thr121Thrfs*16, c.1627C>T/p.Gln543Stop,37 in exon 4 and 13, the former was a frameshift mutation, encoding 16 amino acids and then terminated, and the latter was an nonsense mutation, truncated 37 amino acids, both which were predicted to be pathogenic and segregate with disease. The mother and sister carried c.363delC, and the father carried c.1627C>T. Conclusion:MFRP gene c.363delC/p.Thr121Thrfs*16, c.1627C >T/p.Gln543Stop, 37 compound heterozygous mutation may be the pathogenic gene of this family.

Objective To explore the correlation between serum lipoprotein-related phospholipase A2 (Lp-PLA2), cystatin C (Cys-C) levels and disease severity in patients with hepatitis B cirrhosis (HBC). Methods Clinical data of 110 HBC patients in the hospital from October 2017 to May 2019 were retrospectively analyzed. According to Child-Pugh classification criteria of liver cirrhosis, they were divided into grade A (n=42), grade B (n=37) and grade C groups (n=31). Another 30 healthy controls during the same period were enrolled as control group. The levels of serum Lp-PLA2 and Cys-C were detected. And their correlation with disease severity was analyzed. Results Levels of serum Lp-PLA2 and Cys-C in HBC group were higher than those in control group (P<0.05). The levels of serum Lp-PLA2 and Cys-C were the highest in grade C group, followed by grade B group and grade A group (P<0.05). The areas under the ROC curve (AUC) of serum Lp-PLA2 combined with Cys-C for evaluating grade A and B, grade B and C HBC were 0.875 and 0.837, which were higher than those of Lp-PLA2 (0.772, 0.750) and Cys-C (0.750, 0.691) alone (P<0.05). Spearmann rank correlation analysis showed that levels of serum Lp-PLA2 and Cys-C were positively correlated with disease severity (r=0.659, 0.561, P<0.05). Conclusion The levels of serum Lp-PLA2 and Cys-C are significantly increased in HBC patients, which are gradually increased with the aggravation of HBC. The two indexes are positively correlated with disease severity, which are of diagnostic efficiency for the classification of liver cirrhosis.

Objective:To explore the role and mechanism of lysine methyltransferase SET8 in calcification induced by high phosphorus in vascular smooth muscle cells (VSMCs).Methods:(1) Male SD rats were selected for in vivo experiments and randomly divided into sham operation group and chronic renal failure vascular calcification group. The thoracic aorta was taken and calcification was detected by von Kossa staining. The expression of SET8 and Caspase-3 was detected by immunohistochemistry. (2) VSMCs were randomly divided into normal group and high phosphorus group (10 mmol/L β-glycerophosphate). Cellular calcification was detected by O-cresol hydrazide complex colorimetric assay and alizarin red staining. Apoptosis was detected by flow cytometry. The expressions of SET8, AKT and Caspase-3 were detected by RT-PCR and Western blotting. (3) In order to further verify the role of SET8 in the apoptosis of VSMCs, liposome transfection was used, and cells were divided into three groups: SET8-shRNA group, empty plasmid group and normal control group. Cellular calcification was detected by O-cresol hydrazide complex colorimetric assay and alizarin red staining. Apoptosis was detected by flow cytometry. The expressions of SET8, AKT and Caspase-3 were detected by RT-PCR and Western blotting. Results:(1) In vivo experiments, compared with the sham operation group, vascular calcium deposition in the chronic renal failure vascular calcification group was significantly increased ( P<0.05). Immunohistochemistry results showed that SET8 expression was significantly decreased and Caspase-3 was significantly increased in the vascular calcification group (both P<0.05). Correlation analysis showed that SET8 was negatively correlated with vascular calcification and Caspase-3 ( r=-0.948, P<0.01; r=-0.961, P<0.01). (2) In vitro, the calcium deposition in the high-phosphorus group was significantly higher than that in the normal group ( P<0.05). The results of flow cytometry showed that the number of apoptosis in the high-phosphorus group was significantly higher than that in the normal group ( P<0.05). RT-PCR and Western blotting showed that, compared with the normal group, the mRNA and protein expression of SET8 and AKT in the high-phosphorus group decreased, and the mRNA and protein expression of Caspase-3 increased (all P<0.05). (3) After interference of SET8 gene expression, calcification and apoptosis of VSMCs significantly increased, AKT mRNA and protein expression decreased, and Caspase-3 mRNA and protein expression increased (all P<0.05). Conclusions:SET8 can inhibit vascular calcification. One of the possible mechanisms is to inhibit the expression of Caspase-3 via promoting AKT activation, thereby inhibiting the apoptosis of VSMCs, and then participating in the regulation of VSMCs calcification induced by high phosphorus.