Objective:To explore the influence of acupoint catgut embedding combined with Xuezhikang capsule on lipid metabolism and antioxidation effect in patients with statin intolerance and hyperlipidemia of spleen-kidney yang deficiency syndrome.Methods:Randomized controlled trial. A total of 82 patients with statin intolerance and hyperlipidemia who were treated in Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine , Shanghai Puto Area Central Hospital, and Lingyun community health Service center, Xuhui District from July 2020 to June 2022 were selected and randomly divided into two groups with 41 patients in each group by odd-even ball method. The two groups were given diet and exercise guidance, and the control group was given Xuezhikang capsule orally on this basis, and the observation group was given poly(l-lactide-co-glycolide) (PLGA) thread acupoint catgut embedding on the basis of the control group. Both groups were treated continuously for 3 months. The TCM syndromes were scored before and after treatment, and body weight (BW), waist circumference (WC) and body mass index (BMI) were recorded. The levels of TC, TG, HDL-C and LDL-C were detected by fully automatic biochemical analyzer. The levels of serum SOD, GSH-Px and total antioxidant capacity (TAOP) were measured by ELISA. The level of serum endothelin-1 (ET-1) was assessed by radioimmunoassay. Color Doppler ultrasound diagnostic instrument was used to detect the brachial artery flow-mediated dilation (FMD) and nitroglycerin-mediated dilation (NMD).Results:The scores of chilly sensation and cold limbs [(1.27±0.12) vs. (1.46±0.16), t=6.08], loose stool [(1.41±0.16) vs. (1.63±0.18), t=5.85], fatigue [(1.45±0.15) vs. (1.57±0.17), t=3.39], dizziness [(1.15±0.11) vs. (1.26±0.13), t=4.14] and loss of appetite [(1.21±0.13) vs. (1.39±0.15), t=5.81] in observation group after treatment were significantly lower than those in the control group ( P<0.01). BW [(68.03±6.57)kg vs. (71.55±6.76)kg, t=2.39], WC [(85.13±4.63)cm vs. (87.35±4.85)cm, t=2.12] and BMI [(27.35±2.84)kg/m 2vs. (29.18±3.05)kg/m 2, t=2.81]were lower than those in the control group ( P<0.05). The levels of serum TC [(3.15±0.13)mmol/L vs. (3.38±0.17)mmol/L, t=6.88], TG [(1.98±0.11)mmol/L vs. (2.21±0.15)mmol/L, t=7.92]and LDL-C [(2.46±0.26)mmol/L vs. (3.04±0.33)mmol/L, t=8.84]were significantly lower compared with those in control group ( P<0.01) while the level of HDL-C [(1.88±0.24)mmol/L vs. (1.74±0.21)mmol/L, t=2.81]was higher than that of the control group ( P<0.01). The levels of serum SOD [(57.82±5.84)μg/L vs. (55.06±5.61)μg/L, t=2.18], GSH-Px [(96.51±9.52)U/L vs. (92.26±9.25)U/L, t=2.30]and TAOP [(6.21±0.57)U/L vs. (5.94±0.54)U/L, t=2.20]were significantly higher compared to control group ( P<0.05). Serum ET-1 [(60.43±4.36) pg/L vs. (63.71±4.68) pg/L, t=3.28] level was significantly lower than that in control group ( P<0.01), while FMD [(12.48±1.02)% vs. (11.34±0.95)%, t=5.24] and NMD [(15.12±1.24)% vs. (14.44±1.18)%, t=2.54] were significantly higher than those in control group ( P<0.01). Conclusion:The combination of acupoint catgut embedding and Xuezhikang capsule can reduce the scores of TCM syndromes, lower the obesity and blood lipids, enhance the antioxidant function and improve the vascular endothelial function in patients with statin intolerance and hyperlipidemia.

As a representative chemotherapeutic drug, docetaxel (DTX) has been used for breast cancer treatment for decades. However, the poor solubility of DTX limits its efficacy, and the DTX based therapy increases the metastasis risk due to the upregulation of C-X-C chemokine receptor type 4 (CXCR4) expression during the treatment. Herein, we conjugated CXCR4 antagonist peptide (CTCE) with DTX (termed CTCE-DTX) as an anti-metastasis agent to treat breast cancer. CTCE-DTX could self-assemble to nanoparticles, targeting CXCR4-upregulated metastatic tumor cells and enhancing the DTX efficacy. Thus, the CTCE-DTX NPs achieved promising efficacy on inhibiting both bone-specific metastasis and lung metastasis of triple-negative breast cancer. Our work provided a rational strategy on designing peptide-drug conjugates with synergistic anti-tumor efficacy.

To investigate the current status of digestive endoscopy diagnosis and treatment in Shanghai, and to provide decision-making support for the revision of the diagnostic and treatment standards and quality control criteria of digestive endoscopy in Shanghai. A total of 145 hospitals providing digestive endoscopy service were investigated through an online survey. The main survey contents were the situation of digestive endoscopists, the development of diagnosis and treatment technology, and the quality and safety situation. There were 1 212 digestive endoscopists in Shanghai, accounting for 1.59% of China which ranked first in all registered practioners in 2019. The annual diagnostic and treatment procedures of digestive endoscopy was 1 902.6 thousand, and endoscopists' working pressure was relatively high. In terms of quality control indicator of a single disease, detection rates of early gastrointestinal cancers and adenomas remained at a high level. The number of digestive endoscopists, endoscopic procedures and quality control indicators of a single disease in Shanghai was in a leading position in China in 2019.

Objective:To understand the prevalence and genotype characteristics of enterovirus and Coxsackie virus in hand, foot and mouth disease (HFMD) patients in Qinghai province from 2015 to 2018.Methods:The throat swabs of HFMD patients were collected for virus isolation and RT-PCR in Qinghai province. The nucleotide sequence of the amplified products was determined and analyzed, and the gene evolution tree was constructed with reference to the sequence of some strains of NCBI.Results:From 2015 to 2018, 1 738 samples of clinical diagnosis positive cases were collected, including 326 EV-A71 cases, accounting for 18.76%, 237 CV-A16 cases, accounting for 13.64%, 628 CV-A6 cases, accounting for 36.13%. There were statistically significant differences among different genotypes in 4 years (EV-A71, χ2=245.315, P<0.001; CV-A16, χ2=27.680, P<0.001; CV-A6, χ2=702.713, P<0.001). A total of 317 cell culture isolates were obtained after isolation with RD cells. After sequence, DNA sequences of typical genotypes were selected for sequence analysis, from 2017 to 2018. The homology of all genotypes of VP1 was between 59% and 100%, the homology was 93% to 100% in 19 strains of EV-A71, the homology was 92% to 100% in 20 strains of CV-A16, the homology was 97% to 99% in 6 strains of CV-A6. According to the evolutionary tree, the sequences of EV-A71 strains are all on the C4a branch of the evolutionary tree in Qinghai province; 18 strains of CV-A16 were B1b and 2 stains were 1D; 5 strains of CV-A6 were D3 and 1 was B1. Conclusions:From 2015 to 2018, the prevalent genotypes of HFMD shifted from EV-A71 to CV-A16 and CV-A6 in Qinghai province, The EV-A71 genotype in Qinghai province has always been C4a genotype. There are different genotypes of CV-A16 and CV-A6. The nucleotide sequence differences between different genotypes are large, and the sequence variation among the same gene is small.

Natural extracellular vesicles (EVs) play important roles in many life processes such as in the intermolecular transfer of substances and genetic information exchanges. Investigating the origins and working mechanisms of natural EVs may provide an understanding of life activities, especially regarding the occurrence and development of diseases. Additionally, due to their vesicular structure, EVs (in small molecules, nucleic acids, proteins, etc.) could act as efficient drug-delivery carriers. Herein, we describe the sources and biological functions of various EVs, summarize the roles of EVs in disease diagnosis and treatment, and review the application of EVs as drug-delivery carriers. We also assess the challenges and perspectives of EVs in biomedical applications.

Objective:To study the genomic sequence of Coxsackievirus A8 (CV-A8) associated with hand, foot and mouth disease (HFMD) from 2013 to 2018 in China and to analyze the genetic evolution of each coding region of the full-length genome.Methods:The genome sequences of 11 CV-A8 strains isolated from patients with HFMD in different regions of China from 2013 to 2018 were determined. Sequence alignment and genetic evolution analysis were performed by Sequencher 5.0 and MEGA 7.0 software, etc.Results:Sequence alignment showed that the genome length of 11 CV-A8 strains ranged from 7 393 bp to 7 400 bp. There was no base insertion or deletion in the coding region compared with the prototype strain, but there were individual base insertion or deletion in the non-coding region. The nucleotide and amino acid similarities in the VP1 region of 11 CV-A8 strains were 78.3%-98.6% and 92.6%-99.7%, respectively, and the nucleotide and amino acid sequences identities with the CV-A8 prototype strain were 78.3%-98.2% and 92.6%-99.7%, respectively. Based on the phylogenetic analysis of VP1 region sequences, the CV-A8 can be divided into five genotypes: A, B, C, D and E. The 11 CV-A8 strains in this study belonged to genotypes C (1 strain), D (2 strains) and E (8 strains). The nucleotide and amino acid similarities of 11 CV-A8 full-length genomes were 81.3%-98.8% and 95.9%-99.5%, respectively. The phylogenetic tree of the P2 region showed that the eight E genotypes CV-A8 had the closest evolutionary distance with CV-A4, CV-A14, and CV-A16. The phylogenetic tree of the P3 region showed that the eight E genotypes CV-A8 had a close evolutionary distance with CV-A5, CV-A16, CV-A14 and CV-A4.Conclusions:The 11 CV-A8 stains in this study showed significant intra-genotype diversity in capsid region and recombinant diversity in non-capsid region which indicated that CV-A8 quasispecies were still undergoing dynamics variation. CV-A8 may become an important pathogen of HFMD and the monitoring of CV-A8 needs to be further strengthened.

Objective: To evaluate the epidemiologic characteristics of hand, foot and mouth disease in Zhejiang province between 2009 and 2017, so that scientific evidence could be provided for prevention and control of hand, foot and mouth disease. Methods: Spatial, temporal and population distribution of HFMD was analyzed. Real-time reverse transcription polymerase cain reaction was used to test Enterovirus A71 and Coxsackievirus A16 in samples. Results: Between 2009 and 2017, 1 108 093 HFMD cases were reported in Zhejiang with the prevalence of 226.24/100000; 2010, 2012, 2014 and 2016 had a higher prevalence than other years. Prevalence of HFMD peaked in April-July and September-October. Wenzhou, Taizhou and Ningbo had a higher prevalence than other cities. In total, 69.27% cases were children who were not enrolled in nursery school, and 65.67% were 1-3 years old. Pathogen surveillance showed that EV-A71 decreased in mild cases, whereas other enterovirus increased. However EV-A71 was still predominant in severe and fatal cases (56.0%). Conclusions Temporal and spatial distribution of HFMD is characteristic in Zhejiang province. EV-A71 predominated in severe cases and fatal cases, while other enterovirus (non-EV-A71, non CV-A16) were the main pathogen for mild cases.

Objective: To understand the pathogenic composition of hand, foot and mouth disease (HFMD) in Ningxia Hui Autonomous Region (Ningxia) from 2016 to 2017, and analyze the genetic characteristics of the main pathogens enterovirus (EV)-A71 and coxsackievirus (CV)-A16. Methods: Analysis of the result of nucleic acid testing of HFMD in Ningxia from 2016 to 2017 to determine the pathogenic composition of HFMD. The complete VP1 coding region was amplified by RT-PCR and the gene sequence was determined for the enterovirus strains sent to the National HFMD Network Monitoring Laboratory in Ningxia from 2016 to 2017. BLAST analysis confirmed the serotype of the strain, and the phylogenetic tree was constructed respectively by selecting EV-A71 and CV-A16 isolates. Results: The leading pathogens of HFMD in Ningxia of 2016 and 2017 were other EV (397, 43.72%) and EV-A71 (918, 56.18%) respectively, and the dominant pathogens in different months may differ. The pathogenic composition causing HFMD in the past two years has changed from CV-A16 and other EV to EV-A71 and other EV. The isolated EV-A71 strains were C4a evolutionary branch and the isolated CV-A16 strains were B1b evolutionary branch. Conclusions Compared to 2016, in 2017 EV-A71, CV-A16 and other EV changed dynamically. Dynamic monitoring of EV-A71 in Ningxia is of great significance to guide the strategy of using EV-A71 vaccine, concentrating medical resources to strengthen the treatment and reduce the mortality rate of severe HFMD cases.

Objective: To investigate the genetic characteristics of enterovirus A group 71 type (EV-A71) and etiological features of hand, foot and mouth disease (HFMD) in Xining city in 2017. Methods: The pharyngeal swab specimens were collected from HFMD patients, and detected by real-time reverse transcription-polymerase chain reaction (RT-PCR). For EV-A71 positive samples, virus isolation was performed. Then RNA of EV-A71 strains was extracted, and then VP1 coding region was amplified by RT-PCR. The phylogenetic tree was constructed by comparing with other genotypes and sub-genotypes strains of EV-A71. Results: Total 57 strains of EV-A71 were isolated in Xining city in 2017, which all belonged to genotype C4a, and could be divided into two different lineages by phylogenetic analysis. The epidemic strains of EV-A71 in Xining City was closely related to other provinces of China in 2017. Conclusions C4a was the dominant genotype of EV-A71 in Xining city in 2017, and no other genotype was detected. In addition, EV-A71 isolated from Xining city was co-evolved with EV-A71 in other provinces of China.

Objective To observe the therapeutic effects and adverse effect of different lipid-lowering regimens in Atherosclerosis renal artery stenosis (ARAS) rat model and select the optimal treatment.Methods 90 Wister rats were randomly divided into sham operation group (group F) and operation group.The operation group was divided into normal feed group (group N) and high-fat feed group (group T).We established the rat model in operatino group by narrowing the renal artery with acupuncture needle and 8 weeks of high-fat feeding.According to the different lipid-lowing therapeutic schedules,the T group rats were randomly divided into five groups:the blank group (T0 group),the Xuezhikang group (T1 group),the rosuvastatin group (T2 group),the regular dose of rosuvastatin combined with Xuezhikang (T3 group),the low dose of rosuvastatin combined with Xuezhikang (T4 group).Mter 6 weeks of intervention,the serum lipids [total cholesterol (TC),triglyceride (TG),high density lipoprotein-cholesterol (HDL-C),low density lipoproteincholesterol (LDL-C)],liver function [alanine aminotransferase (ALT),aspartate aminotransferase (AST)],kidney function [blood urea nitrogen (BUN),serum creatinine (Scr)] and pathological changes of aorta and kidney were detected before and after treatment.Results (1) The blood pressure,BUN and Scr were significantly increased in N group and T group compared with F group (P ＜ 0.05).TC,TG,LDL-C were significantly increased (P ＜ 0.05) and HDL-C were significantly decreased (P ＜ 0.05) in T group compared with N,T group.According to the pathological section,the aorta in T group had visible atherosclerosis change,the renal tubules were atrophied and decreased.All above,the rat model of ARAS was successfully established.(2) After 6 weeks of drug intervention,compared with prior treatment,TC,TG,LDL-C,BUN and Scr were significant decrease (P ＜ 0.05),while HDL-C was significantly increased (P ＜ 0.05) in all treatment groups,and the most remarkable change was in T3,T4 group,T3 group was better than T4 group but with no significant difference between T3 and T4 group (P ＞ 0.05).We found that ALT and AST were significantly increased in T2 and T3 group (P ＜ 0.05) after treatment.Compared with T0 group,pathological lesions of aorta and kidney were reduced best in T3 and T4 group.Conclusions Low dose of rosuvastatin combined with Xuezhikang can achieve ideal lipid-lowing effects.At the same time,it has a protective effect on kidney,and has little damage to liver function.