Objective To explore the effect of management model of clinical pharmacists participating in multidisciplinary collaborative diagnosis and treatment(MDT)for new anti-tumor drugs in the national medical insurance drug negotiation(hereinafter referred to as"national negotiation"),including efficacy,safe-ty,economy and rationality.Methods The medical records of 326 cases using novel anti-tumor drugs by na-tional negotiation and conforming to the including and excluding standards in this hospital from July 2018 to June 2023 were retrospectively analyzed.The patients were divided into the MDT group(n=122)and non-MDT group(n=204).The patients diagnosed as non-small cell lung cancer(NSCLC)in the two groups were extracted and defined as the MDT-NSCLC subgroup(n=41)and non-MDT-NSCLC subgroup(n=77).The progression-free survival(PFS),overall survival(OS),disease control rate(DCR)and the indexes such as survival quality and medical quality control were compared between the groups.Results The median PFS in the two groups was 12.7 months and 8.0 months,the median OS was 75.2 months and 56.3 months,DCR was 96.72％and 81.86％respectively,and the differences were statistically significant(P＜0.05).The COX multivariate regression analysis indicated that the HR value of clinical pharmacists participating in MDT was higher than the other influencing factors.The median PFS time in the MDT-NSCLC subgroup and non-MDT-NSCLC subgroup was 10.5 months and 6.7 months,DCR was 97.30％and 75.64％respectively,and the differences were statistically significant(P＜0.05),the median OS time was 55.1 months and 40.3 months respectively,and the difference was statistically significant(P＞0.05).The COX multivariate regression anal-ysis indicated that the HR value with clinical pharmacists participating in MDT was higher than the other in-fluencing factors;The adverse reaction occurrence rate in the MDT group and non-MDT group was 45.9％and 58.3％respectively,and the difference was statistically significant(P＜0.05).The KPS score after treatment in the MDT group was higher than that in the non-MDT group,and the difference was statistically significant;in the aspect of medical quality control,the average drug proportion in the MDT group and non-MDT group was 63.93％and 64.54％respectively,the rational drug rate of comments on prescription was 98.36％and 88.73％respectively,the patient satisfaction average value was 90.69 points and 87.36 points respectively and the differences were statistically significant(P＜0.05).Conclusion Clinical pharmacists participating in MDT related to novel anti-tumor drugs by national negotiation is beneficial to improve the therapeutic effects,living quality and patient satisfaction,also benefit to management and control of off-label drug use and medical quality control indexes.

Objective To explore the roles of transfer RNA-derived small RNAs(tsRNAs)in the oncogenesis and progression of lung adenocarcinoma by analyzing the differential expression of tsRNAs in lung adenocarcinoma and the relationship between the expression levels of tsRNAs in lung adenocarcinoma and the prognosis of patients in order to further screen and validate the tsRNAs associated with lung adenocarcinoma.Methods The differential expression of tsRNAs between lung adenocarcinoma tissues and normal tissues was analyzed based on the database of the Computational Medicine Center.The effects of tsRNAs expression levels on the prognosis of lung adenocarcinoma patients were analyzed based on the Cancer Genome Atlas(TCGA)database(TCGA-LUAD).The target genes were predicted based on TRFtarget2.0 and tRFTar databases.Gene ontology(GO)enrichment analysis and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway analysis were performed based on DAVID and KOBA KEGG online websites.The expression levels of target genes in lung adenocarcinoma tissues and normal tissues were analyzed based on the University of ALabama at Birmingham CANcer data analysis Portal(UALCAN)database.In vitro cell proliferation,migration,and invasion assays were performed to investigate the biological functions of tRF-19-69M8LOJX in lung adenocarcinoma cells.Results Compared with the normal tissues,tRF-19-69M8LOJX was up-regulated in lung adenocarcinoma tissues(log2FC=4.28,FDR＜0.05).High expression level of tRF-19-69M8LOJX was associated with shorter progression-free survival(HR=1.565,95％CI=1.142-2.145,P=0.005).And its overexpression promoted cell proliferation and migration(P＜0.001),and invasion(P=0.009)of A549 cells,and up-regulated COL1A1(P=0.002)and VCAN(P=0.022)significantly in the tRF-19-69M8LOJX overexpression cell model.Conclusion tRF-19-69M8LOJX is up-regulated in lung adenocarcinoma tissues.And its high expression is closely associated with poor prognosis.The tsRNA may play an important role in the pathogenesis and development of lung adenocarcinoma.

Objective To investigate the expression of long non-coding RNA(lncRNA),surfactant associated 1 pseudogene(SFTA1P)in lung squamous carcinoma and its effect on the biological functions of SFTA1P in lung squamous carcinoma cell lines.Methods Based on the cancer genome atlas(TCGA)database,the differential expression of SFTA1P in tumor and normal tissues were compared in patients diagnosed with lung squamous cell carcinoma.Then,the expression of SFTA1P was detected in human normal lung epithelial cell line BEAS-2B and lung squamous cell lines SK-MES-1 and H520 with real-time quantitative polymerase chain reaction(RT-qPCR).SK-MES-1 and H520 cells with overexpression and/or knockdown of SFTA1P were constructed by transfecting the overexpression plasmids(pcDNA3.1-SFTA1P)and small interfering RNAs(si-SFTA1P-1 and si-SFTA1P-2).CCK-8 assay and Transwell assay were used to investigate the effect of SFTA1P on biological functions in lung squamous carcinoma cells.Differential gene expression analysis,correlation analysis and functional enrichment analysis were employed to explore the potential mechanism that SFTA1P may affect biological functions of lung squamous cells.Results Analysis of TCGA showed that the expression of SFTA1P was significantly lower in lung squamous cell carcinoma tissue than adjacent normal tissue(P＜0.05).RT-PCR results showed that the expression of SFTA1P was obviously lower in lung squamous carcinoma cells than the human normal lung epithelial cells(P＜0.05).And the expression level of SFTA1P was relatively lower in the SK-MES-1 cells than the H520 cells(P＜0.05).Overexpression of SFTA1P suppressed the proliferation,migration and invasion of lung squamous carcinoma cells(P＜0.05),while its knockdown promoted these abilities(P＜0.05).Differential gene expression analysis,correlation analysis and functional enrichment analysis indicated that SFTA1P may inhibit MYC,G2m checkpoints and E2f signaling pathways in lung squamous cell carcinoma.Conclusion SFTA1P shows anti-cancer function in lung squamous cell carcinoma,and it may affect the biological functions of lung squamous cell carcinoma cells through down-regulating MYC,G2m checkpoints and E2f signaling pathways.

Objective:To investigate the efficacy of iRoot BP Plus pulpotomy versus root canal therapy for the management of cariously exposed pulp in deciduous molars. Methods:A total of 62 teeth from eligible patients who received treatment at Hefei Stomatological Clinical College (Hefei Stomatological Hospital), Anhui Medical University between September 2021 and March 2022 were selected for the study. These teeth were randomly treated either with iRoot BP Plus pulpotomy (pulpotomy group, n = 31) or root canal therapy (root canal therapy group, n = 31). Follow-up examinations were conducted at 6, 12, and 18 months post-treatment to compare the success rates of treatment between the two groups. Results:The success rates of treatment at 6, 12, and 18 months post-treatment in the pulpotomy group were 100.0% (31/31), 100.0% (31/31), and 96.8% (30/31), respectively, while in the root canal therapy group, they were 100.0% (31/31), 93.5% (29/31), and 80.6% (25/31). The success rates in the pulpotomy group were significantly higher than those in the root canal therapy group at both 12 and 18 months post-treatment, with a statistically significant difference observed at 18 months (χ2 = 4.02, P < 0.05). Conclusion:The iRoot BP Plus pulpotomy procedure yields a more favorable and stable outcome compared with root canal therapy for managing cariously exposed pulp in deciduous molars.

Objective:To explore the diagnosis, staging, and treatment of fibro-adipose vascular anomaly(FAVA).Methods:The data of the patients with FAVA admitted to Xi’an International Medical Center Hospital between October 2019 and February 2023 were retrospectively reviewed. Ultrasound and magnetic resonance imaging (MRI) were routinely performed. X-ray and CT were performed for patients with unequal length of lower limbs, lesions involving joints, and obvious joint deformities. The treatment plan was made according to the stage: stage Ⅰ (pain stage), open or laparoscopi radical resection of the lesion was performed; stage Ⅱ (contracture stage), radical surgery was performed to remove the lesion, sometimes combined with Achilles tendon lengthening or tenolysis, and rehabilitation training was performed 2 weeks after surgery; stage Ⅲ(deformity stage), comprehensive treatment based on surgical resection was adopted, combined with joint capsule release, Achilles tendon lengthening or dissection, tendon transfer and oral sirolimus (each time 0.08 mg/m 2, twice daily ) before and after the operation. For patients with lesions involving multiple anatomical regions, staged surgery was performed, and in principle, only one anatomical region was operated per time. Patients were followed up for pain, joint activity and recurrence. Results:A total of 42 patients were admitted, including 18 males and 24 females. The onset age was (7.3±5.0) years, but the average age of diagnosis was (12.5±6.0) years. The lower limbs were involved in 38 cases, the upper limbs in 4 cases. There were 17 cases of stage Ⅰ, 17 cases of stage Ⅱ and 8 cases of stage Ⅲ. Only 4 cases had no misdiagnosis experience, and the misdiagnosis rate was 90.5%(38/42). Persistent pain, muscle contractures and joint deformities were the main clinical symptoms of the disease. MRI showed heterogeneous high and low signal intensity on T1-weighted images, and the high signal intensity was the same as that of subcutaneous adipose tissue. T2 fat-suppressed sequences showed stronger heterogeneous hyperintensity. The follow-up time was (14.6±10.8) months. Patients who took sirolimus orally before or after surgery experienced significant relief of pain symptoms. Of the 42 patients, the symptoms of 31 patients were completely relieved after the operation, and 11 patients still had residual pain or joint movement disorder or even deformity after the operation. Sixteen of 17 stage Ⅰ patients were cured, the lesion was further expanded and the pain recurred in 1 case after the operation. Of the 17 stage Ⅱ patients, 15 were cured, and 2 had mild limitation of ankle movement after the operation. Eight stage Ⅲ patients had varying degrees of pain or joint movement disorder after surgery, postoperative oral sirolimus significantly relieved symptoms. All 10 patients with stage Ⅰ and Ⅱ who underwent endoscopic resection were cured.Conclusion:FAVA usually occurred in school-age and adolescent children. Pain, muscle contracture and joint deformity were the characteristic clinical features. Combined with MRI features, the diagnosis can be confirmed. FAVA staging system could guide treatment and predict prognosis. For stage Ⅰ and Ⅱ patients, surgery should be performed as soon as possible and the prognosis was good. For stage Ⅲ patients, surgery-based comprehensive treatment could improve symptoms, but it was difficult to cure them radically. Oral sirolimus was also required after surgery.

Objective:To explore the diagnosis, staging, and treatment of fibro-adipose vascular anomaly(FAVA).Methods:The data of the patients with FAVA admitted to Xi’an International Medical Center Hospital between October 2019 and February 2023 were retrospectively reviewed. Ultrasound and magnetic resonance imaging (MRI) were routinely performed. X-ray and CT were performed for patients with unequal length of lower limbs, lesions involving joints, and obvious joint deformities. The treatment plan was made according to the stage: stage Ⅰ (pain stage), open or laparoscopi radical resection of the lesion was performed; stage Ⅱ (contracture stage), radical surgery was performed to remove the lesion, sometimes combined with Achilles tendon lengthening or tenolysis, and rehabilitation training was performed 2 weeks after surgery; stage Ⅲ(deformity stage), comprehensive treatment based on surgical resection was adopted, combined with joint capsule release, Achilles tendon lengthening or dissection, tendon transfer and oral sirolimus (each time 0.08 mg/m 2, twice daily ) before and after the operation. For patients with lesions involving multiple anatomical regions, staged surgery was performed, and in principle, only one anatomical region was operated per time. Patients were followed up for pain, joint activity and recurrence. Results:A total of 42 patients were admitted, including 18 males and 24 females. The onset age was (7.3±5.0) years, but the average age of diagnosis was (12.5±6.0) years. The lower limbs were involved in 38 cases, the upper limbs in 4 cases. There were 17 cases of stage Ⅰ, 17 cases of stage Ⅱ and 8 cases of stage Ⅲ. Only 4 cases had no misdiagnosis experience, and the misdiagnosis rate was 90.5%(38/42). Persistent pain, muscle contractures and joint deformities were the main clinical symptoms of the disease. MRI showed heterogeneous high and low signal intensity on T1-weighted images, and the high signal intensity was the same as that of subcutaneous adipose tissue. T2 fat-suppressed sequences showed stronger heterogeneous hyperintensity. The follow-up time was (14.6±10.8) months. Patients who took sirolimus orally before or after surgery experienced significant relief of pain symptoms. Of the 42 patients, the symptoms of 31 patients were completely relieved after the operation, and 11 patients still had residual pain or joint movement disorder or even deformity after the operation. Sixteen of 17 stage Ⅰ patients were cured, the lesion was further expanded and the pain recurred in 1 case after the operation. Of the 17 stage Ⅱ patients, 15 were cured, and 2 had mild limitation of ankle movement after the operation. Eight stage Ⅲ patients had varying degrees of pain or joint movement disorder after surgery, postoperative oral sirolimus significantly relieved symptoms. All 10 patients with stage Ⅰ and Ⅱ who underwent endoscopic resection were cured.Conclusion:FAVA usually occurred in school-age and adolescent children. Pain, muscle contracture and joint deformity were the characteristic clinical features. Combined with MRI features, the diagnosis can be confirmed. FAVA staging system could guide treatment and predict prognosis. For stage Ⅰ and Ⅱ patients, surgery should be performed as soon as possible and the prognosis was good. For stage Ⅲ patients, surgery-based comprehensive treatment could improve symptoms, but it was difficult to cure them radically. Oral sirolimus was also required after surgery.

Objective To study the effect of levosimendan on cardiac function and hemodynamics in patients with acute myocardial infarction and cardiogenic shock.Methods Totally 118 patients with acute myocardial infarction complicated with cardiogenic shock admitted to 363 Hospital were randomly assigned to control group or observation group,with 59 cases in each group.All the patients in both groups received routine treatment,and the observation group was given levosimendan additionally.The cardiac function indexes such as stroke volume(SV),cardiac index(CI),left ventricular ejection fraction(LVEF),and longitudinal peak systolic strain rate(SRs),the myocardial funtion indexes such as troponin I(cTnI),creatine kinase isoenzyme(CK-MB),vasopressin(AVP)and angiotensin(AngⅡ),hemodynamic parameters such as central venous pressure(CVP),pulmonary capillary wedge pressure(PCWP),mean arterial pressure(MAP),and left ventricular end-diastolic volume(LVEDV)were compared between the two groups before treatment and on day 3 after treatment.Shock duration,drug dose,time staying in intensive care unit(ICU),use of intra-aortic balloon counterpulsation(IABP),and incidence of malignant arrhythmia were also compared.Results There were no significant differences in all indexes between the two groups before treatment(P>0.05).On day 3 after treatment,SV,LEVF,CI,SRs,and MAP in the observation group were significantly higher than those in the control group(P<0.05),while AVP,AngⅡ,cTnI,CK-MB,CVP,PCWP,and LVEDV in the observation group were significantly lower than those in the control group(P<0.05).The duration of shock,the dosage of drugs,ICU time,and IABP time in the observation group were significantly lower than those in the control group(P<0.05).The incidence of malignant arrhythmia in the observation group was significantly lower than that in the control group(13.56%vs 28.81%,P<0.05).Conclusion Levosimendan can improve the hemodynamics of patients with acute myocardial infarction and cardiogenic shock.It has clinical application value.

Objective:To investigate the clinical application value of triamcinolone acetonide combined with hyaluronidase injection and shallow X-ray in the treatment of multiple keloids.Methods:From March 2018 to October 2019, 144 cases of multiple keloids in outpatient department were analyzed retrospectively. There were 89 males and 55 females, aged from 16 to 68, with an average age of 28 years. The average duration was 6 years(ranged from 1 to 20 years). Among them, 65 cases were treated with superficial X-ray radiotherapy combined with local injection (group A) and 79 cases were treated only with local injection (group B). The Vancouver Scar Scale (VSS), t-test and chi-square test were used to evaluate the validity of the two groups. The patients were followed up for 6-18 months. Results:In group A, the VSS was changed from 11.9±0.9 to 6.5±1.1. 51 cases were improved and 14 cases showed obviously effective. The significant effect rate was 21.54%(14/65). The main side effect of group A was transient pigmentation. In group B, the VSS was changed varied from 12.1±1.0 to 8.3±1.0. 74 cases were improved, 2 cases were markedly effective, but 3 cases were ineffective. The significant effective rate was 2.63%(2/76). The side effects include telangiectasia, skin atrophy, even arousing abnormal menstrual cycles and hair growth in several females. The comparability between the two groups was confirmed by the VSS scores before treatment( t=-1.114, P=0.267). Then, the difference of VSS scores became significant after treatment( t=-10.208, P<0.001), the same to apparent efficiency( χ2=12.450, P<0.001). Conclusions:Triamcinolone acetonide combined with hyaluronidase injection and shallow X-ray radiation therapy for multiple keloids has ideal curative effect and low incidence of adverse reactions, which is a prospected clinical method.

Objective:To investigate the clinical application value of triamcinolone acetonide combined with hyaluronidase injection and shallow X-ray in the treatment of multiple keloids.Methods:From March 2018 to October 2019, 144 cases of multiple keloids in outpatient department were analyzed retrospectively. There were 89 males and 55 females, aged from 16 to 68, with an average age of 28 years. The average duration was 6 years(ranged from 1 to 20 years). Among them, 65 cases were treated with superficial X-ray radiotherapy combined with local injection (group A) and 79 cases were treated only with local injection (group B). The Vancouver Scar Scale (VSS), t-test and chi-square test were used to evaluate the validity of the two groups. The patients were followed up for 6-18 months. Results:In group A, the VSS was changed from 11.9±0.9 to 6.5±1.1. 51 cases were improved and 14 cases showed obviously effective. The significant effect rate was 21.54%(14/65). The main side effect of group A was transient pigmentation. In group B, the VSS was changed varied from 12.1±1.0 to 8.3±1.0. 74 cases were improved, 2 cases were markedly effective, but 3 cases were ineffective. The significant effective rate was 2.63%(2/76). The side effects include telangiectasia, skin atrophy, even arousing abnormal menstrual cycles and hair growth in several females. The comparability between the two groups was confirmed by the VSS scores before treatment( t=-1.114, P=0.267). Then, the difference of VSS scores became significant after treatment( t=-10.208, P<0.001), the same to apparent efficiency( χ2=12.450, P<0.001). Conclusions:Triamcinolone acetonide combined with hyaluronidase injection and shallow X-ray radiation therapy for multiple keloids has ideal curative effect and low incidence of adverse reactions, which is a prospected clinical method.

In recent years, tumor immunotherapy has become a new hot spot in the field of cancer treatment. Besides the great success of immunological checkpoint inhibitors and cellular immunotherapy, small molecule immunotherapy has also attracted more and more attention. As a key signal transduction molecule involved in the innate immune response, stimulator of interferon genes plays an important role in defending against viral and intracellular bacterial infections, mediating type I IFN production and regulating the production of spontaneous anti-tumor immune responses in vivo. This paper briefly introduces the biological mechanism of STING signaling pathway and reviews the research progress of STING agonists based on the structural classification, so as to provide some reference for the design and discovery of STING agonist drugs.