Objective To investigate the predictive value of serum Actinin-4 and N-myc downscream regu-lated gene 4(NDRG4)for recurrence and metastasis in early stage lung cancer patients.Methods A total of 110 patients who underwent early lung cancer radical surgery in the hospital from January 2020 to January 2022 were collected as the study subjects.They were separated into a recurrence group of 62 patients and a non recurrence group of 48 patients based on whether they experienced recurrence or metastasis during a one-year follow-up.Enzyme-linked immunosorbnent assay(ELISA)method was applied to detect serum Actinin-4 and NDRG4 levels.Pearson and Spearman methods were used for correlation analysis.Logistic regression was applied to analyze the influencing factors of recurrence and metastasis in early stage lung cancer patients after radical surgery.Receiver operating characteristic(ROC)curve was applied to analyze the predictive value of serum Actinin-4 and NDRG4 levels for recurrence and metastasis in early stage lung cancer patients after radi-cal surgery.Results Compared with the non recurrence group,the serum Actinin-4 level in the recurrence group was obviously increased,while the NDRG4 level was obviously reduced,and there was a obvious differ-ence in TNM staging and lymph node metastasis between the two groups(P＜0.05).Pearson analysis showed that there was a negative correlation between serum Actinin-4 and NDRG4 levels in the recurrence group(r=-0.566,P＜0.05).Spearman analysis showed that Actinin-4 was positively correlated with lymph node me-tastasis and clinical staging(r=0.429,0.396,P＜0.05),while NDRG4 was negatively correlated with lymph node metastasis and clinical staging(r=-0.411,-0.431,P＜0.05).Logistic regression analysis showed that lymph node metastasis,clinical staging,Actinin-4,and NDRG4 levels could all be used as influencing fac-tors for postoperative recurrence and metastasis in early stage lung cancer patients after radical surgery(P＜0.05).ROC curve analysis showed that the area under the curve(AUC)of serum Actinin-4 and NDRG4 in predicting postoperative recurrence and metastasis in early stage lung cancer patients after radical surgery was 0.857 and 0.848,respectively,and the AUC of combined prediction was 0.950,which was better than those of the two single predictions(P＜0.05).Conclusion Serum Actinin-4 level increases and NDRG4 level decrea-ses in early stage lung cancer patients with postoperative recurrence and metastasis after radical surgery.The combined detection of the two could serve as an auxiliary indicator for predicting postoperative recurrence and metastasis in early stage lung cancer patients after radical surgery.

The biological clock(also known as the circadian rhythm)is the fundamental reliance for all organisms on Earth to adapt and survive in the Earth's rotation environment.Circadian rhythm is the most basic regulatory mechanism of life activities,and plays a key role in maintaining normal physiological and biochemical homeostasis,disease occurrence and treatment.Recent studies have shown that the biologi-cal clock plays an important role in the development of oral tissues and in the occurrence and treatment of oral diseases.Since there is cur-rently no guiding literature on the research methods of biological clock in stomatology,researchers mainly conduct research based on pub-lished references,which has led to controversy about the research methods of biological clock in stomatology,and there are many confusions about how to rationally apply the research methods of circadia rhythms.In view of this,this expert consensus summarizes the characteristics of the biological clock and analyzes the shortcomings of the current biological clock research in stomatology,and organizes relevant experts to summarize and recommend 10 principles as a reference for the rational implementation of the biological clock in stomatology research.

Objective:To analyze the clinic effects of arthroscopic partial trapeziectomy and suture button suspensionplasty in the treatment of first carpometacarpal joint (CMCJ) Eaton stage II/III arthrosis.Methods:A retrospective study was conducted on a total of 15 cases (16 hands) of patients including 5 males (1 bilateral) and 10 females with CMCJ stage II/III arthrosis who underwent surgical treatment at the first affiliated hospital of Shenzhen university from January 2020 to June 2022, with mean age of 56.7±6.4 years (range, 46-75 years). The duration from pain to treatment was 7.8±3.2 months (range, 4-14 months). X-ray showed narrowing of CMCJ with osteophytes and distal radial subluxation. All the patients were treated with arthroscopic partial trapeziectomy and suture button suspensionplasty. The preoperative and last postoperative follow-up radiographs, visual analogue scale (VAS), thumb's Kapandji scores, disabilies of the arm, shoulder, and hand (DASH) scores, grip and pinch strength and time to return to work were compared.Results:All cases were followed up for 19.6±6.3 months (range, 11-36 months). The postoperative X-ray showed all the CMCJs were reduced with a normal height of first metacarpal. The mean time for patients to return to their daily activities was 18.69±3.70 d and the mean time to return to work was 24.63±4.91 d. The average VAS score decreased from 6.56±1.15 preoperatively to 1.00 (0.75, 1.25). The preoperative Kapandji's score was 8.00±0.82 and the postoperative Kapandji's score was 8.00 (7.25, 9.00). The average DASH values improved from 24.06±3.19 to 4.00 (3.00, 5.00). The were significant differences except for Kapandji score ( Z=-4.905, P<0.001; Z=-0.121, P=0.905; Z=-4.846, P<0.001). The mean grip and pinch strength showed improvement from an average of 16.4 (14.13, 18.68) kg and 1.70±0.35 kg to 26.14±3.27 kg and 3.58±0.91 kg with significant difference ( Z=-4.617, P<0.001; t=-7.669, P<0.001). Conclusion:Arthroscopic partial trapeziectomy and suture button suspensionplasty is a minimally invasive surgery for the treatment of first CMCJ Eaton stage II/III arthrosis. By this technique, the patients' existing instability and pain problems can be solved.

The pollution caused by improper handling of plastics has become a global challenge. In addition to recycling plastics and using biodegradable plastics, an alternative solution is to seek efficient methods for degrading plastics. Among them, the methods of using biodegradable enzymes or microorganisms to treat plastics have attracted increasing attention because of its advantages of mild conditions and no secondary environmental pollution. Developing highly efficient depolymerizing microorganisms/enzymes is the core for plastics biodegradation. However, the current analysis and detection methods cannot meet the requirements for screening efficient plastics biodegraders. It is thus of great significance to develop rapid and accurate analysis methods for screening biodegraders and evaluating biodegradation efficiency. This review summarizes the recent application of various commonly used analytical techniques in plastics biodegradation, including high performance liquid chromatography, infrared spectroscopy, gel permeation chromatography, and determination of zone of clearance, with fluorescence analysis techniques highlighted. This review may facilitate standardizing the characterization and analysis of plastics biodegradation process and developing more efficient methods for screening plastics biodegraders.
Biodegradable Plastics/chemistry* ; Biodegradation, Environmental

Objective: To investigate the effect and the mechanism of Astragalus membranaceus (Huangqi in Chinese, HQ) extract on the intestinal absorption of six alkaloids of Aconitum carmichaelii (Fuzi in Chinese, FZ) in rats with spleen deficiency and provide novel insights into the application of HQ on modulating intestinal barrier. Methods: Four-week-old male Sprague-Dawley rats were fed with Xiaochengqi Decoction to induce the spleen deficiency model for 40 d. Single-pass intestinal perfusion model were used to study the effects of HQ extract on the absorption of alkaloids. Protein expression and mRNA levels of MRP2 and BCRP and tight junction proteins (TJ, including Claudin-1, Occludin and ZO-1) were measured using Western blot and real-time PCR, respectively. The location and expression of TJ protein was also investigated by the immunofluorescence method. Results: Compared with the normal group, the protein expression of MRP2, BCRP and TJ proteins in the model group were significantly down-regulated. After oral administration of HQ, the alkaloid absorption in intestinal villi was inhibited, MRP2, BCRP and TJ proteins were up-regulated, the green fluorescence staining of Claudin-1, Occludin, and ZO-1 was enhanced, and a thick layer of mucus was deposited on the surface of the epithelium of the intestinal cavity. Conclusion: HQ as an intestinal barrier modulator improves the physiological changes of the intestinal environment of spleen deficiency to reduce the absorption of toxic components, leading to a decrease in the absorption of drug-like molecules.

Objective:To compare the effects of circular arch device and dressing device on the secretion of collagen, matrix metalloproteinase (MMP-1), transforming growth factor (TGF-β) of fibroblasts in the treated skin, and to explore the changes and mechanisms.Methods:The animals were purchased from the Southern Medical University Laboratory Animal Center. Using the established animal model, 54 mice were randomly divided into three groups: 18 mice each group, including control group, dressing device group and and circular arch device group. At the first, third and fifth day after negative pressure suction treatment, dermal thickness and density of collagen levels were and eosin staining, collagen level in local skin was determined using spectrophotometry, and MMP-1 and TGF-β levels were determined using enzyme linked immunosorbent assay.Results:Dermal thickness level was increased significantly in negative suction treated groups [after 5 days of treatment, control group: (71±8) μm; circular arch device group: (351±9) μm; dressing device group: (267±12) μm, P< 0.05]. Compared with the control group, collagen level in the dermis was significantly higher in circular arch device groups [after 5 days of treatment, control group: (30.9±4.3) mg/g; circular arch device group: (72.7±3.6) mg/g, P< 0.05]. TGF-β level in circular arch device treated group was increasing gradually, and markedly higher than that in the dressing device group and the control group [after 5 days of treatment, control group: (0.24±0.1) ng/ml; circular arch device group: (0.78±0.08) ng/ml; dressing device group: (0.39±0.18) ng/ml, P< 0.05], while MMP-1 level was decreasing. In addition, TGF-β and MMP-1 levels in the dressing device treated group remained stable during the entire experiment. Conclusions:The interface of the circular arch negative pressure suction device can effectively activate the fibroblasts, promote the secretion of TGF-β and collagen, and thicken the skin tissue.

Objective:To investigate the effect of self fixing mesh with " Y-shaped" placement in laparoscopic transabdominal preperitoneal repair of female inguinal hernia.Methods:From February 2019 to September 2020, a total of 40 female patients who underwent TAPP (Keyhole method) in Shaanxi Provincial People′s Hospital were researched.Random number table method was used.According to different patch placement methods, the patients were divided into the self fixing mesh with " Y-shaped" placement group (21 cases) and with normal placement group (19 cases). The operative time, placement time, length of stay, Visual Analogue Scale (VAS), postoperative complication were compared between two groups.Results:All 40 patients completed TAPP, and all patients were followed up successfully, with a median follow-up time of 12.5 months.The operation time and patch placement time were (54.9±9.0) min and (10.8±2.5) min in the Y-shaped placement method group and (62.8±11.2) min and (20.3±3.5) min in the conventional placement method group, respectively; the differences between the two groups were statistically significant ( t=2.490, P=0.017; t=.925, P<0.001). There was no statistically significant difference between the two groups in length of stay, VAS score 1 day after surgery and postoperative complications(all P>0.05). Conclusion:In laparoscopic female inguinal hernia repair (keyhole method), the " Y" shape placement method can effectively shorten the time of self fixing patch placement, thus shorten the operation time, and does not increase the risk of complications.

Objective:To investigate the clinical efficacy of thoracic endovascular aortic repair (TEVAR) in treating Stanford type B traumatic aortic dissection (TAD).Methods:A retrospective case series study was conducted to analyze the clinical date of 26 patients with Stanford type B TAD admitted to Nantong First People's Hospital from June 2011 to December 2019. There were 21 males and 5 females, aged 35-83 years [(56.2±12.9)years]. All patients mainly suffered from chest and back trauma and were treated with TEVAR. The operation time, intraoperative blood loss, intraoperative heparin dosage, duration of ICU stay and postoperative organ complications were collected. The changes of brain natriuretic peptide, urea nitrogen and creatinine were compared before operation and at one day after operation. The CT angiography (CTA) was performed to mainly detect the location of stent, reverse tearing, paraplegia and internal leakage at 6 months after TEVAR. The aortic CTA was used to measure the maximum diameter of aortic dissecting aneurysm and true lumen diameter of distal aorta before operation and at 6 months after operation, and the diameter changes were compared to determine the aortic remodeling after TEVAR.Results:All patients were followed up for 6-36 months [(25.9±6.3)months]. The operation time was 60-200 minutes [(96.7±30.7)minutes], the intraoperative blood loss was 20-45 ml [(31.1±6.8)ml], the dosage of heparin was 0-0.53 mg/kg [(0.4±0.1)mg/kg], the postoperative ICU stay was 1-7 days [(4.7±1.3)days]. Seven patients developed pulmonary infections after operation and showed significant improvement after closed thoracic drainage, airway management and anti-infection treatment. Two patients had abnormal renal function after operation and received medical therapy for improvement. There was no significant difference in brain natriuretic peptide, urea nitrogen and creatinine between before operation and one day after operation ( P>0.05). At 6 months after operation, the CTA showed that the stent position was satisfactory and there were no serious complications such as reverse tearing and paraplegia. Of one patient with type I endoleak, the tumor did not further expand and his condition was stable. At 6 months after operation, the diameter of dissecting aneurysm [(34.4±5.0)mm] was smaller than that before operation [(38.2±5.6)mm], the true lumen of distal stent [(26.8±4.6)mm] was larger than that before operation [(22.6±6.0)mm] ( P<0.05 or 0.01). Conclusion:For Stanford type B TAD, TEVAR has no significant effect on cardiac function and renal function, with no severe complications and good aortic remodeling.

Model informed precision dosing (MIPD) is a new concept to guide precision dosing for individual patient by modeling and simulation based on the available information about the individual patient, medications and the disease. Compared to the empirical dosing, MIPD could improve the efficacy, safety, economics and adherence of the pharmacotherapy according to the individual's pathophysiology, genotyping and disease progression. This consensus report provides a brief account of the concept, methodology and implementation of MIPD as well as clinical decision supporting systems for MIPD. The status and future advancing of MIPD was also discussed to facilitate the appropriate application and development of MIPD in China.

Objective: Comparing the benefit of Abidor, lopinavir/ritonavir and recombinant interferon α-2b triple combination antiviral therapy and lopinavir/ritonavir and interferon dual combination antiviral therapy to hospitalized novel coronavirus pneumonia 2019 in Zhejiang province. Methods: A multi-center prospective study was carried out to compare the effect of triple combination antiviral therapy with dual combination antiviral therapy in 15 medical institutions of Zhejiang Province. All patients were treated with recombinant interferon α-2b (5 million U, 2 times/d) aerosol inhalation. 196 patients were treated with abidol (200 mg, 3 times/d) + lopinavir / ritonavir (2 tablets, 1 time/12 h) as the triple combination antiviral treatment group. 41 patients were treated with lopinavir / ritonavir (2 tablets, 1 time/12 h) as the dual combination antiviral treatment group. The patients who received triple combination antiviral therapy were divided into three groups: within 48 hours, 3-5 days and > 5 days after the symptom onset. To explore the therapeutic effects of triple combination antiviral drugs and dual combination antiviral drugs, as well as triple combination antiviral drugs with different antiviral initiate time. SPSS17.0 software was used to analyze the data. Results: The time of virus nucleic acid turning negative was (12.2 ± 4.7) days in the triple combination antiviral drug group, which was shorter than that in the dual combination antiviral drug group [(15.0 ± 5.0) days] (t = 6.159, P < 0.01 ). The length of hospital stay [12 (9, 17) d] in the triple combination antiviral drug group was also shorter than that in the dual combination antiviral drug group [15 (10, 18) d] (H = 2.073, P < 0.05). Comparing the antiviral treatment which was started within 48 hours, 3-5 days and > 5 days after the symptom onset of triple combination antiviral drug group, the time from the symptom onset to the negative of viral shedding was 13 (10,16.8), 17 (13,22) and 21 (18-24) days respectively (Z = 32.983, P < 0.01), and the time from antiviral therapy to the negative of viral shedding was (11.8±3.9) , (13.5±5.1) and (11.2±4.3) d. The differences among the three groups were statistically significant (Z=32.983 and 6.722, P<0.01 or<0.05). Conclusions The triple combination antiviral therapy of Abidor, Lopinavir/Litonavir and recombinant interferon α-2b showed shorter viral shedding time and hospitalization time compared with the dual combination antiviral therapy. The earlier the time to initiate triple antiviral treatment, the shorter the time of virus shedding.