Objective:To prepare a phase-change lipid nanoparticle modified by tumor homing membrane-penetrating peptide (tLyP-1) and carrying paclitaxel (PTX) engineered by metal polyphenol network (TA-Fe 3+ ), and evaluate the therapeutic effects of tumor targeting, ultrasound/photoacoustic imaging and photothermal combined chemotherapy in vitro. Methods:Phase-change lipid nanoparticles (t-P@TFP) with TA-Fe 3+ engineered PTX mediated by tLyP-1 were prepared by solvent replacement method, thin film hydration method and double emulsification method. Its detection and characterization, in vitro targeting ability, photothermal conversion ability, in vitro photoacoustic and ultrasonic imaging ability, CCK-8 method, cell live and death double staining method and flow cytometry method were used to detect the safety of nanoparticles and the killing effects of different nanoparticles on 4T1 cells. Results:t-P@TFP nanoparticles were successfully prepared. Transmission electron microscopy showed that the nanoparticles were spherical with uniform shape and size, with a particle size of (209.8±1.56)nm and a potential of (-25.9±1.36)mV. Laser confocal scanning microscopy showed that t-P@TFP nanoparticles could gather around 4T1 cells in a targeted manner. It had an efficient photothermal conversion effect, and nanoparticles could quickly become microbubbles after being irradiated by near-infrared laser, which enhanced the in vitro ultrasonic imaging effect; The photoacoustic signal of nanoparticles increased with the increase of concentration. CCK-8 method, double staining of living and dead cells and flow cytometry showed that t-P@TFP combined photothermal chemotherapy had the best anti-tumor effect. Conclusions:t-P@TFP nanoparticles are successfully prepared. The nanoparticles have good targeting ability for photoacoustic and ultrasonic imaging and have good photothermal effect, killing breast cancer cells, which is expected to realize the integration of diagnosis and treatment.

Objective:To explore the methods of fertility preservation in prepubertal patients with thalassemia major (TM), and to provide further data support for the fertility preservation in prepubertal patients with hematologic diseases.Methods:A case of a prepubertal patient with TM who required urgent hematopoietic stem cell transplantation (HSCT) receiving ovarian tissue cryopreservation (OTC) and in vitro maturation (IVM) to preserve fertility was reported, and the timing, the indications and strategies of fertility preservation in prepubertal girls with thalassemia were discussed in combination with related literature. Results:After ovarian tissue extraction, a total of 24 cumulus-oocyte complexes (COCs) and 11 ovarian cortex pieces were obtained through puncture and aspiration. After IVM for 48 h, a total of 9 M Ⅱ oocytes were frozen by vitrification. Conclusion:For the prepubertal girls facing HSCT urgently, cryopreserving ovarian tissue in combination with retrieving immature oocytes followed by IVM can preserve the fertility of patients to the greatest extent in a short period of time, as well as improve the therapeutic effect of fertility preservation in patients.

Objective:To explore the methods of fertility preservation in prepubertal patients with thalassemia major (TM), and to provide further data support for the fertility preservation in prepubertal patients with hematologic diseases.Methods:A case of a prepubertal patient with TM who required urgent hematopoietic stem cell transplantation (HSCT) receiving ovarian tissue cryopreservation (OTC) and in vitro maturation (IVM) to preserve fertility was reported, and the timing, the indications and strategies of fertility preservation in prepubertal girls with thalassemia were discussed in combination with related literature. Results:After ovarian tissue extraction, a total of 24 cumulus-oocyte complexes (COCs) and 11 ovarian cortex pieces were obtained through puncture and aspiration. After IVM for 48 h, a total of 9 M Ⅱ oocytes were frozen by vitrification. Conclusion:For the prepubertal girls facing HSCT urgently, cryopreserving ovarian tissue in combination with retrieving immature oocytes followed by IVM can preserve the fertility of patients to the greatest extent in a short period of time, as well as improve the therapeutic effect of fertility preservation in patients.

Objective: To investigate the effect of hypertensive disorder complicating pregnancy (HDCP) on the mortality and early complications of premature infants. Methods: The general clinical data of preterm infants with gestational age 24-36^{+ 6} weeks were collected from the cooperative units in the task group from January 1, 2013 to December 31, 2014.According to the severity of HDCP, the infants were divided into 4 groups: HDCP group, preeclampsia group, eclampsia group and non HDCP group, the mortality and major complications of preterm infants were compared, and the influencing factors were analyzed. Results: The mortality rate of preterm in the HDCP group was significantly higher than that of non HDCP group, and there was statistical significance (χ²=9.970, P=0.019). Eclampsia had a highest fatality rate (4.8%) in the early stage, compared with non HDCP group (2.2%), and the difference was statistically significant.Comparison of HDCP group (1.8%) and eclampsia group (3.2%) suggested that there was no statistically significant difference.The incidence of respiratory distress syndrome (RDS) in preterm in HDCP group was significantly higher than that of non HDCP group, and there was statistical significance (χ²=13.241, P=0.004). Eclampsia group showed the highest incidence (35.4%), compared with non HDCP group (16.2%), the difference was statistically significant, but compared with HDCP group (19.9%), preeclampsia group (17.1%), there was no significant diffe-rence.The incidence of bronchopulmonary dysplasia (BPD) in preterm in HDCP group was significantly higher than that of non HDCP group (χ²=9.592, P=0.022), the highest incidence showed up in eclampsia group (9.7%), compared with non HDCP group (2.0%) and HDCP group (1.7%), the difference was statistically significant.But there was no statistically significant difference, compared with preeclampsia group.As the degree of HDCP aggravated, the incidence of BPD gradually rose.There was no significant impact on necrotizing enterocolitis (NEC), retinopathy of prematurity (ROP), intraventricular hemorrhage (IVH) and sepsis of HDCP (χ²=7.054, 7.214, 0.358, 3.852; P=0.070, 0.065, 0.949, 0.278). Considering the overall outcome of the child, that was, whether the child died or survived, he had at least one complication, and HDCP had an effect on it (χ²=15.697, P=0.001), so the incidence increased while the degree of HDCP rose gradually.After adjusting gestational age, birth weight, sex, way of delivery, placental abruption and front placenta, prenatal hormonal, gestational diabetes, neonatal asphyxia and other factors, the results displayed that HDCP was the factor leading to the death of premature baby (OR=2.159, 95%CI: 1.093-4.266), and comparison between preeclampsia and eclampsia showed no statistical difference (P=0.714, 0.389); HDCP had no significant influence on RDS, BDP, ICH, NEC, ROP and sepsis. Conclusions HDCP leads to increased risk of premature death, but also leads to the increased incidence of RDS and BPD, but it had no obvious effect on NEC, ROP, IVH, sepsis and other complications.

Objective:To investigate Th17,Treg and related factors before and after myocardial infarction ,and explore the cor-relations among them.Methods:Extracted mononuclear cell in peripheral blood ,and used fluorescence-activated cell sorting analysis to detect the contect of Th17 and Treg.Enzyme-linked immunosorbent assay was used to detect cytokine production of IL-17 and TGF-β;real-time PCR was used to detect the contect of RORγT and Foxp3.Results: Compared with the control group , experimental group (both before and after thrombolysis) had increased expressions of Th17,IL-17 and RORγT(P<0.05);the expressions of Treg,TGF-βand Foxp3 had decreased(P<0.05).Compared with the group of before thrombolysis ,the group of after thrombolysis 7 d had decreased expressions of Th17,IL-17 and RORγT(P<0.05);increased expressions of Treg,TGF-βand Foxp3(P<0.05).Conclusion:Compared with the control group,patients with myocardial infarction have the high levels of Th 17 and the related factors,the decreased levels of Treg and the related factors.Thrombolytic therapy can decrease the levels of Th 17 and the related factors,and increase levels of Treg and the related factors.

Clinical data of 62 cases of tracheobronchial foreign bodies with pulmonary atelectasis admitted in Second Affiliated Hospital and Yuying Children′s Hospital during January 2007 to December 2016 were retrospectively analyzed .There were 40 boys and 22 girls aged 9 months to 10 years, and the symptom onset ranged from 6 hours to 4 months prior to medical intervention .The foreign bodies were vegetables in 55 (88.71%), pieces of meat in 3 (4.84%) and chemical product in 4 cases (6.45%). Sixty patients recovered after medical intervention , 1 died preoperatively and 1 died of severe reexpansion pulmonary edema ( RPE) .The foreign bodies were successfully removed with rigid bronchoscopy in a single attempt in 47 children (77.05%), 1 child (1.64%) required two attempts to completely remove the foreign bodies;10 children ( 16.39%) were treated with fiberoptic bronchoscopy;3 children ( 4.92%) received thoracotomy , in which 1 child ( 1.64%) received a lobectomy due to pulmonary atelectasis and lung consolidation during operation .Conclusion Foreign bodies combined with pulmonary atelectasis in children are likely to be misdiagnosed , which led to severe adverse events . RPE is a serious postoperative complication of children receiving rigid bronchoscopy as a treatment , especially those diagnosed with tracheobronchial foreign bodies combined with pulmonary atelectasis .

AIM: To investigate the effect of hypercapnia on hypoxia-induced pulmonary hypertension and the changes of lysyl oxidase (LOX) and extracellular matrix collagen cross-links in the rat.METHODS: Sprague-Dawley rats were randomly divided into 4 groups: normoxia group, hypoxia group, hypercapnia group and hypoxia+hypercapnia group.LOX activity was detected by fluorescence spectrophotometry.LOX protein expression was detected by immunohistochemistry and Western blot.The mRNA expression of LOX in the pulmonary artery was detected by real-time PCR.RESULTS: The levels of mean pulmonary artery pressure (mPAP), RV/(LV+S) and WA/TA in hypoxia group were significantly higher than those in normoxia group (P<0.01).Moreover, the levels of mPAP and RV/(LV+S) in hypoxia+hypercapnia group were significantly lower than those in hypoxia group (P<0.01).However, no significant difference of mPAP and RV/(LV+S) between hypercapnia group and normoxia group was observed.In hypoxia group, the collagen cross-links in the lung tissue was significantly higher than that in normoxia group and hypercapnia group (P<0.01).Importantly, collagen cross-links in the lung tissue of hypoxia+hypercapnia group was significantly lower than that in hypoxia group (P<0.01).There was no significant difference in collagen cross-links between hypercapnia group and normoxia group.The expression of LOX at mRNA and protein levels and its activity in the pulmonary arteries of hypoxia group were significantly increased as compared with normoxia group (P<0.01).Furthermore, the expression of LOX at mRNA and protein levels and its activity in the pulmonary arteries in hypoxia+hypercapnia group were lower than those in hypoxia group (P<0.01).CONCLUSION: Hypoxia not only up-regulates LOX but also promotes collagen cross-linking in the rat lung, which contributes to the development of pulmonary hypertension.Hypercapnia inhibits hypoxia-induced LOX expression and collagen cross-linking, therefore impairing the progress in hypoxia-induced pulmonary hypertension.

OBJECTIVETo investigate the efficacy and adverse effect of DCF regimen with subsequent S-1 maintenance chemotherapy in patients with advanced gastric cancer (AGC).

METHODSSixty AGC patients without disease progression after 4 to 6 cycles of DCF regimen as the first-line chemotherapy were randomized into maintenance group and control group (30 patients each). The patients in the maintenance group received maintenance chemotherapy with S-1 (40 mg/m(2), twice daily for 14 days; 21 days for a treatment cycle) until disease progression or with intolerant toxicity, and those in the control group received optimal supportive care.

RESULTSThe response rate (CR+PR) was 33.3% in the maintenance group, significantly higher than that in the control group (3.33%, P<0.05), and the disease control rate (CR+PR+SD) also differed significantly between the two groups (73.3% vs 46.7%, P<0.05). The median time to progression was 7.9 months in the maintenance group and 6.8 months in the control group, with median overall survival time of 13.8 and 11.7 months, respectively (P>0.05). The most common adverse effect in the maintenance group included nausea, vomiting, leucocytopenia, and hand-foot syndrome; no death occurred in relation to the therapy.

CONCLUSIONS-1 maintenance chemotherapy, with a tolerable toxicity profile, can improve the RR, DCR and median time to progression in AGC patients who respond to DCF regimen, but its efficacy still awaits further evaluation.

Antineoplastic Combined Chemotherapy Protocols ; Humans ; Maintenance Chemotherapy ; Stomach Neoplasms ; drug therapy

BACKGROUNDHemifacial spasm (HFS) is a facial nerve disorder characterized by episodic involuntary ipsilateral facial muscle contraction. Information on Chinese patients with HFS has not been well-characterized. This study aimed to evaluate the clinical feature and the treatment status of HFS across China.

METHODSA cross-sectional study including 1003 primary HFS patients had been carried out in 15 movement disorder clinics in China in 2012. The investigated information was acquired from questionnaires and medical records including demographic data, site of onset, aggravating and relieving factors, treatments prior to the investigation, etc.

RESULTSIn this study, the ratio of male to female was 1.0:1.8, the mean age at onset was (46.6 ± 11.5) years. About 1.0% patients were bilaterally affected. The most often site of initial onset was the orbicularis oculi muscle. The most often affected sites were orbicularis oculi, zygomatic, and orbicularis oris muscles. Stress/anxiety and relaxation were most often aggravating and relieving factors, respectively; 2.3% patients had family history, 28.4% cases were combined with hypertension, and 1.4% patients were with trigeminal neuralgia. Botulinum toxin type A (BTX-A) injection was the most commonly used treatment, followed by acupuncture and oral medication. BTX-A maintained the highest repeat treatment ratio (68.7%), while 98.4% patients gave up acupuncture. The mean latency of BTX-A effect was (5.0 ± 4.7) days, the mean total duration of the effect was (19.5 ± 11.7) weeks, and 95.9% patients developed improvements no worse than moderate in both severity and function. The most common side effect was droopy mouth.

CONCLUSIONSThe onset age of HFS in China is earlier than that in western countries. The most often used two treatments are BTX-A injection and acupuncture, while the latter kept the poor repeat treatment ratio because of dissatisfactory therapeutic effect.

Adult ; Botulinum Toxins, Type A ; therapeutic use ; China ; Cross-Sectional Studies ; Female ; Hemifacial Spasm ; diagnosis ; drug therapy ; Humans ; Male ; Middle Aged ; Neuromuscular Agents ; therapeutic use

Objective To investigate the efficacy and adverse effect of DCF regimen with subsequent S-1 maintenance chemotherapy in patients with advanced gastric cancer (AGC). Methods Sixty AGC patients without disease progression after 4 to 6 cycles of DCF regimen as the first-line chemotherapy were randomized into maintenance group and control group (30 patients each). The patients in the maintenance group received maintenance chemotherapy with S-1 (40 mg/m2, twice daily for 14 days; 21 days for a treatment cycle) until disease progression or with intolerant toxicity, and those in the control group received optimal supportive care. Results The response rate (CR+PR) was 33.3%in the maintenance group, significantly higher than that in the control group (3.33%, P<0.05), and the disease control rate (CR+PR+SD) also differed significantly between the two groups (73.3% vs 46.7%, P<0.05). The median time to progression was 7.9 months in the maintenance group and 6.8 months in the control group, with median overall survival time of 13.8 and 11.7 months, respectively (P>0.05). The most common adverse effect in the maintenance group included nausea, vomiting, leucocytopenia, and hand-foot syndrome; no death occurred in relation to the therapy. Conclusions S-1 maintenance chemotherapy, with a tolerable toxicity profile, can improve the RR, DCR and median time to progression in AGC patients who respond to DCF regimen, but its efficacy still awaits further evaluation.