Objective The objective of this study was to analyze the mortality and changing trend of head and neck cancer(nasopharyngeal cancer,laryngeal cancer,thyroid cancer,and oral cancer)in cancer registry areas of Inner Mongolia Autonomous Re-gion from 2010 to 2020,and to provide a scientific basis for the prevention and control of head and neck cancer in Inner Mongolia Au-tonomous Region.Methods The mortality data for head and neck cancers(nasopharyngeal cancer,laryngeal cancer,thyroid cancer,and oral cancers)in the tumor registration database of Inner Mongolia Autonomous Region from 2010 to 2020 were sorted out,and the China standard mortality of head and neck were calculated by gender,urban and rural areas,and cancer types.The average annual per-centage change(AAPC)was analyzed using Joinpoint 4.9.1.0 software to assess the trend of China standard mortality of head and neck cancers and cancer types.Results The China standard mortality of head and neck cancers in cancer registry areas of Inner Mongolia was 2.85/100,000.The China standard mortality of males(4.24/100,000)was higher than that of females(1.53/100,000),and the China standard mortality in rural areas(2.93/100,000)was higher than that in urban areas(2.79/100,000).The China standard mortality of oral cancer was the highest at 1.16/100,000,and the China standard mortality of nasopharyngeal cancer was the lowest at 0.42/100,000.From 2010 to 2020,the mortality of head and neck cancers increased by an average annual rate of 3.79%(95%CI:1.45%-6.17%),and the trend was statistically significant(P=0.005).The mortality of male head and neck canc-er increased by an annual rate of 7.27%(95%CI:3.05%-11.65%),and the trend was statistically significant(P=0.003).The mortality of females decreased by an average annual rate of 1.08%(95%CI:-4.51%-2.47%),and the trend was not statistically significant(P=0.500).The mortality of oral cancer showed an upward trend with an AAPC of 7.35%(P=0.040),and the mortality of laryngeal cancer,thyroid cancer and nasopharyngeal cancer showed no statistically significant trend(AAPC was3.36%,1.38%and-0.36%,respectively,P>0.05).Conclusion The mortality of head and neck cancer in cancer registry areas of Inner Mongolia Au-tonomous Region showed an upward trend from 2010 to 2020.The prevention and treatment of head and neck cancer should be paid to attention,with rural areas and male groups as the key prevention and control targets.The control measures should be strengthened for high-risk behaviors such as occupational exposure and alcohol consumption,oral cancer prevention and control should be focused on,and HPV vaccination and tobacco control policies should be strengthened.

Objective The objective of this study was to analyze the mortality and changing trend of head and neck cancer(nasopharyngeal cancer,laryngeal cancer,thyroid cancer,and oral cancer)in cancer registry areas of Inner Mongolia Autonomous Re-gion from 2010 to 2020,and to provide a scientific basis for the prevention and control of head and neck cancer in Inner Mongolia Au-tonomous Region.Methods The mortality data for head and neck cancers(nasopharyngeal cancer,laryngeal cancer,thyroid cancer,and oral cancers)in the tumor registration database of Inner Mongolia Autonomous Region from 2010 to 2020 were sorted out,and the China standard mortality of head and neck were calculated by gender,urban and rural areas,and cancer types.The average annual per-centage change(AAPC)was analyzed using Joinpoint 4.9.1.0 software to assess the trend of China standard mortality of head and neck cancers and cancer types.Results The China standard mortality of head and neck cancers in cancer registry areas of Inner Mongolia was 2.85/100,000.The China standard mortality of males(4.24/100,000)was higher than that of females(1.53/100,000),and the China standard mortality in rural areas(2.93/100,000)was higher than that in urban areas(2.79/100,000).The China standard mortality of oral cancer was the highest at 1.16/100,000,and the China standard mortality of nasopharyngeal cancer was the lowest at 0.42/100,000.From 2010 to 2020,the mortality of head and neck cancers increased by an average annual rate of 3.79%(95%CI:1.45%-6.17%),and the trend was statistically significant(P=0.005).The mortality of male head and neck canc-er increased by an annual rate of 7.27%(95%CI:3.05%-11.65%),and the trend was statistically significant(P=0.003).The mortality of females decreased by an average annual rate of 1.08%(95%CI:-4.51%-2.47%),and the trend was not statistically significant(P=0.500).The mortality of oral cancer showed an upward trend with an AAPC of 7.35%(P=0.040),and the mortality of laryngeal cancer,thyroid cancer and nasopharyngeal cancer showed no statistically significant trend(AAPC was3.36%,1.38%and-0.36%,respectively,P>0.05).Conclusion The mortality of head and neck cancer in cancer registry areas of Inner Mongolia Au-tonomous Region showed an upward trend from 2010 to 2020.The prevention and treatment of head and neck cancer should be paid to attention,with rural areas and male groups as the key prevention and control targets.The control measures should be strengthened for high-risk behaviors such as occupational exposure and alcohol consumption,oral cancer prevention and control should be focused on,and HPV vaccination and tobacco control policies should be strengthened.

OBJECTIVE：To evaluate guidelines f or health technology assessment （HTA）at home and abroad ，and to provide reference for scientific formulation of HTA guidelines in China. METHODS ：Databases including PubMed ，Embase，Guidenlines International Network and 83 official websites from 26 countries governments and academic organizations were searched to collect HTA guidelines from inception to April 2020. Two reviewers independently screened literature and extracted data ，including basic characteristics， content of guideline and assessment content. Then a descriptive analysis was conducted. RESULTS & CONCLUSIONS：A total of 19 guidelines published during 2001 to 2018 were included ，7 guidelines（36.8％）were published in 2015-2020；in addition to 1 guideline from WHO ，14 guidelines （73.7％）were published in Europeand ，2 guidelines（10.5％） in North America and 1 guideline each from South America and Asia （5.3％）. There were 11 guidelines（57.9％）developed by academic organizations and 8 guidelines（42.1％）by health administration ；11 guidelines（57.9％）were evidence-based ，while the others weren ’t evidence- based （42.1％）. The purpose ，content and object of assessment are demonstrated in 19 guidelines；18 guidelines specified the assessment method （94.7％），and 16 guidelines（84.2％）defined the subject of assessment ；14 guidelines （73.7％）specified the HTA assessment process ；12 guidelines（63.3％）mentioned the conflict of interest in HTA assessment process；7 guidelines（36.8％）mentioned the application of assessment results. There are some differences in the formulation methods and contents of HTA guidelines in foreign countries ，but the core contents ar e basically the same. At present ，there is a lack of HTA guidelines in China. We can refer to foreign guidelines，and establish applicable HTA guidelines which aresuitable for national conditions ，so as to provide scientific guidance for HTA research.

Objective:To understand the clinical characteristics of bosentan-related liver injury.Methods:PubMed, Ovid, Web of Science, Embase, Springer-link, Wiley Oline Library, CNKI, Wanfang and VIP databases were searched as of April 2020 and case reports on bosentan-related liver injury were collected. General information, primary diseases, comorbidities, bosentan use, combined medication, and occurrence, treatment and outcome of liver injury in patients were extracted and analyzed by descriptive statistical method.Results:A total of 10 case reports on bosentan-related liver injury were included, involving 12 patients (3 from China, 3 from Japan, 2 from Italy, and 4 from Australia, Brazil, Canada, and Sweden respectively). The 12 patients were all female, aged from 29 to 79 years with an average age of 55 years. The primary diseases were systemic sclerosis-associated pulmonary hypertension (PAH) in 5 patients, connective tissue disease-associated PAH in 2 patients, idiopathic, secondary, chronic thromboembolic, biliary cirrhosis-associated, and non-hepatic portal hypertension-associated PAH in 5 patients, respectively. Four patients had comorbidities. All the 12 patients had combined medications,which included 1-9 kinds of drug. Liver injury occurred in patients 20 days to 57 months after bosentan administration (<1 month in 3 patients, 1-3 months in 4 patients, and >12 months in 5 patients) and was manifested as elevated transaminases, accompanied by elevated bilirubin in 5 patients; the clinical manifestations in 6 patients were described, including yellow staining of skin and sclera in 4 cases, anorexia in 4 patients, nausea in 3 patients, fatigue in 3 patients, and vomiting, weight loss, and drowsiness in 3 patients, respectively; liver biopsy was performed in 1 patient, showing autoimmune hepatitis. After liver injury, bosentan was discontinued or continued with a halved dose; symptomatic treatments were given depending on the specific situation of liver injury; among the 12 patients, 9 had normal liver function, 2 had improved liver function, and 1 died of multiple organ failure.Conclusions:Bosentan-related liver injury may occur within 20 days to 57 months of medication and often within 3 months, with similar clinical manifestations to those induced by other drugs. Some patients may have no clinical symptoms but only abnormal liver function while severe liver injury may occur in a small number of patients. Liver function can usually return to normal or be improved after discontinuation of bosentan.

Objective:To understand the clinical characteristics of bosentan-related liver injury.Methods:PubMed, Ovid, Web of Science, Embase, Springer-link, Wiley Oline Library, CNKI, Wanfang and VIP databases were searched as of April 2020 and case reports on bosentan-related liver injury were collected. General information, primary diseases, comorbidities, bosentan use, combined medication, and occurrence, treatment and outcome of liver injury in patients were extracted and analyzed by descriptive statistical method.Results:A total of 10 case reports on bosentan-related liver injury were included, involving 12 patients (3 from China, 3 from Japan, 2 from Italy, and 4 from Australia, Brazil, Canada, and Sweden respectively). The 12 patients were all female, aged from 29 to 79 years with an average age of 55 years. The primary diseases were systemic sclerosis-associated pulmonary hypertension (PAH) in 5 patients, connective tissue disease-associated PAH in 2 patients, idiopathic, secondary, chronic thromboembolic, biliary cirrhosis-associated, and non-hepatic portal hypertension-associated PAH in 5 patients, respectively. Four patients had comorbidities. All the 12 patients had combined medications,which included 1-9 kinds of drug. Liver injury occurred in patients 20 days to 57 months after bosentan administration (<1 month in 3 patients, 1-3 months in 4 patients, and >12 months in 5 patients) and was manifested as elevated transaminases, accompanied by elevated bilirubin in 5 patients; the clinical manifestations in 6 patients were described, including yellow staining of skin and sclera in 4 cases, anorexia in 4 patients, nausea in 3 patients, fatigue in 3 patients, and vomiting, weight loss, and drowsiness in 3 patients, respectively; liver biopsy was performed in 1 patient, showing autoimmune hepatitis. After liver injury, bosentan was discontinued or continued with a halved dose; symptomatic treatments were given depending on the specific situation of liver injury; among the 12 patients, 9 had normal liver function, 2 had improved liver function, and 1 died of multiple organ failure.Conclusions:Bosentan-related liver injury may occur within 20 days to 57 months of medication and often within 3 months, with similar clinical manifestations to those induced by other drugs. Some patients may have no clinical symptoms but only abnormal liver function while severe liver injury may occur in a small number of patients. Liver function can usually return to normal or be improved after discontinuation of bosentan.

Objective To summarize the outcomes and clinical experiences of renal transplantation in human immunodeficiency virus (HIV)-positive patients .Methods The clinical data were retrospectively analyzed for one HIV-positive case of renal transplantation .Diagnosed as chronic renal insufficiency 1 year ago ,he received hemodialysis .After a positive screen for HIV ,he received highly active antiretroviral therapy (HAART) and HIV RNA turned negative 3 months later .CD4 + T cell count was 331 cell/μl at pre-operation and there was no HIV-rated opportunistic infection or cancer . Her mother donated her kidney . Basiliximab and steroid pulse therapy were used preoperatively and immunosuppressants were used after transplantation , including tacrolimus , corticosteroids and mycophenolate mofetil .Results The kidney was transplanted successfully and serum creatinine declined to a normal level at day 4 after transplantation .Because of an interaction between efaverenz and tacrolimus ,the blood concentration of tacrolimus was extremely low and the dose of tacrolimus had to be raised to 0 .2 mg/(kg·d) .Antiroviral therapy remained unchanged .No rejection and other complications were observed .And HIV RNA remained negative .Conclusions Renal transplantation is optimal for HIV-positive patients whose HIV status is completely under control .However ,drug interactions needs to be considered during perioperative and postoperative periods .

Objective To assess the incidence,clinic feature,pathological characteristics and prognosis of incidental prostate cancer from specimens via radical cystoprostatectomy (RCP) for muscleinvasive bladder cancer.The postoperative erectile function in patients with NVB operation are also to be evaluated.Methods Between Jan 2002 and Jan 2015,150 male patients with bladder cancer who underwent radical cystoprostatectomy in our center were included in this study.133 patients underwent open surgery and 17 cases underwent laparoscopic operation (13 patients underwent NVB operation).The average age of 150 patients was 63 years (ranging 41 to 83 years).The average tPSA was 3 ng/ml(ranging 0.2 to 7.8 ng/ml).The digital rectal examination was negative,CT results didnt exhibit the evident of abnormality in prostate.Results Overall,incidental prostate cancer was diagnosed in 11 male patients (7.3％).The pathological diagnosis are all prostatic adenocarcinoma.In those patients,the mean age was 65.5 years (ranging 42 to 82 years).The mean tPSA at the time of surgery was 2.6 ng/ml (0.3-4.0 ng/ml).There was no statistical significance of tPSA values in the incidental prostate cancer group and non risk group (2.6vs.3.2ng/ml)(P ＞ 0.05).The preoperative enhanced CT imaging showed normal prostate in 7 cases,prostate hyperplasia in 2 cases,prostate calcification in 1 cases and bladder cancer invasion into the prostate in 1 cases.9 cases of incidental prostate cancer are low risk grade (Gleason score ≤ 6,the clinical stage ≤T2).Among 11 cases,bladder cancer histologic type in 10 cases was transitional cell carcinoma and small cell carcinoma in 1 case.According to the TNM classification,4 cases were less than pT2 stage and 7 cases were more than pT3 stage.11 patients were followed up between 6 to 24 months (mean 10 months).All patient survived at the end of study without the treatment of castration.Among 13 cases accepted NVB operation,8 cases achieve the preoperative level of erectile function to achieve.Conclusions The rate of incidental prostate cancer from RCP specimens is low,Most patients have low risk level,and there was no statistical significance of tPSA values between the incidental prostate cancer group and non risk group.

The chalcone synthase (CHS) superfamily of the type III polyketide synthases (PKSs) generates backbones of a variety of plant secondary metabolites. Benzalacetone synthase (BAS) catalyzes a condensation reaction of decarboxylation between the substrates of 4-coumaric coenzyme A and malonyl coenzyme A to generate benzylidene acetone, whose derivatives are series of compounds with various biological activities. A BAS gene Pcpks2 and a bifunctional CHS/BAS PcPKSI were isolated from medicinal plant P. cuspidatum. Crystallographic and structure-based mutagenesis studies indicate that the functional diversity of the CHS-superfamily enzymes is principally derived from small modifications of the active site architecture. In order to obtain an understanding of the biosynthesis of polyketides in P. cuspidatum, which has been poorly described, as well as of its activation mechanism, PcPKS2 was overexpressed in Escherichia coli as a C-terminally poly-His-tagged fusion protein, purified to homogeneity and crystallized, which is helpful for the clarification of the catalytic mechanism of the enzyme and lays the foundation for its genetic engineering manipulation.
Butanones ; Catalytic Domain ; Crystallization ; Fallopia japonica ; enzymology ; Polyketide Synthases ; genetics ; metabolism

Methods The clinical data of 4445 cases (5 530 hernias) who underwent LIHR at Ruijin Hospital from Jan 2001 to Dec 2015 were analyzed retrospectively.2 125 cases underwent 2 402 trans-abdominal preperitoneal procedure(TAPP),2 306 cases did 2 907 totally extraperitoneal (TEP),and 21 IPOMs in 20 cases.There were 3 216 indirect hernias (60.3％),1 164 direct hernias (21.8％),399 recurrent hernias (7.5％),479 complex hernias (9.0％),and 72 femoral hernias (1.4％).The median time of follow-up is 51 months with a range between 7 and 187 months.Results The average operation time was 27.1 ± 8.7 min for unilateral hernia repair,and 43.0 ± 11.0 min for bilateral hernia repair.The average hospital stay was 1.4 ± 1.1 d.There were 250 seroma (4.7％),68 urinary retention (1.3％),23 transient neuropraxia (0.4％) and 3 paralytic obstruction of intestines (0.1％).Severe complications included 1 port site hernia,1 intestinal injury,and 1 mechanical intestinal obstruction.After a medium follow-up of 51 months,there were 13 recurrent cases (0.24％),including 5 cases after TAPP,7 after TEP,1 after IPOM.Conclusion LIHR is a safe and efficient technique for hernia repair.

BACKGROUNDOrgan preservation keeps the quality of the organs under prolonged ischemia. Continuous machine perfusions are gaining an important position in clinical research and practice. The aim of this study was to evaluate the protective effect of continuous hypothermic machine perfusion transport system (AirdriveTM) on cold ischemic injury of canine kidney.

METHODSTen kidneys of five healthy preserving canines were taken out after general anesthesia. Five kidneys were stored using common cold preservation (CCP group) by immersing it in the organ preservation solution, mixed with water and ice, and kept in a cold room at 4°C. The other five kidneys were stored using continuous machine perfusion preservation (CMP group) and were placed into the Airdrive(TM) continuous machine perfusion device at room temperature. The renal tissues were examined by histopathology, electron microscopy, and mitochondrial activity check at different time points.

RESULTSHistologic sections showed that the structures of the ten renal tissues were similar during the first 24 hours. After 48 hours, the CCP group showed more pronounced changes, as the renal tubular epithelial cells were more obvious than those in the glomeruli. Oxygen consumption rate of state III and IV respiration in the CCP group decreased after 12-48 hours and increased at 48 hours, respectively, when compared to the CMP group (P < 0.05). Cortex respiratory control ratio and phosphorus oxygen ratio were significantly higher in the CMP group at 48 hours.

CONCLUSIONWith prolonged storage time, the effect of continuous hypothermic machine perfusion transport system is better than that of common cold preservation on canine kidney.