Cholesterol,as an important component of cell membranes,plays a multifaceted role in mediating tumor immunomodulation and drug intervention.In case of cholesterol metabolic imbalance,the accumulation of cholesterol metabolic intermediates,the changes in concentrations,and the regulation of related signaling pathways can affect tumor immunity by promoting inflammation and inhibiting immune cell function.Preclinical and clinical studies have shown that controlling cholesterol metabolism can inhibit tumor growth,re-shape body immune regulation,and enhance antitumor immunity.A deep understanding of the association between immune cells and cholesterol metabolic pathways in the tumor microenvironment can help to develop novel drugs targeting cholesterol metabolism.This article reviews the multifaceted role of cholesterol and its derived metabolites in the tumor microenvironment by regulating various types of immune cells such as myeloid-derived suppressor cells,tumor-associated macrophages,dendritic cells,and T-lymphocytes,as well as the characteristics of tumor immunomodulation mediated by cholesterol metabolism and the advances in pharmaceutical re-search on improving the immune function of the body by intervening against cholesterol,in order to further provide new ideas and a thera-peutic basis for cholesterol modulation and intervention in tumor im-munotherapy.

Objective To evaluate the causal relationship between serum uric acid(SUA)level and cerebrovascular disease(CVD)by a two-sample bidirectional Mendelian randomization(MR)study.Methods Single nucleotide polymorphisms(SNPs)from Genome-Wide Association Studies(GWAS)were obtained as instrumental variables for both samples.Inverse-variance weighted(IVW)method was primarily adopted,with weighted median method,weighted mode method,and MR-Egger regression serving as supplementary approaches for sensitivity analyses to verify the robust-ness of the results.Results The forward IVW analysis results showed that increased SUA was a risk factor for stroke(OR=1.183,95％CI,1.081 to 1.295,P=2.51× 10-4),ischemic stroke(OR=1.196,95％CI,1.084 to 1.320,P=3.81 ×10-4),and large artery atherosclerotic stroke(OR=1.466,95％CI,1.134 to 1.897,P=0.004),and also a protective factor for vascular dementia(OR=0.451,95％CI,0.273 to 0.745,P=0.002)and multi-infarct dementia(OR=0.372,95％CI,0.144 to 0.959,P=0.041).The reverse IVW analysis results did not support a causal effect of genetically predicted CVD risk on SUA level.All significant results were corrected by Bonfer-roni with P value less than 0.005.Sensitivity analyses further confirmed the reliability of the study find-ings.Conclusion The MR analysis reveals positive correlations between increased SUA level and the risk of stroke,ischemic stroke and large artery atherosclerotic stroke,and negative correlations of SUA level with the risk of vascular dementia and multi-infarct dementia.

An increasing number of studies have shown that neuroimaging techniques, including CT- and MRI-related imaging biomarkers, are associated with the clinical outcome after intravenous thrombolysis in patients with acute ischemic stroke. Therefore, as a necessary diagnostic item for acute ischemic stroke, imaging examinations and related biomarkers have important value in predicting the outcome after intravenous thrombolysis in patients with acute ischemic stroke.

Objective:To investigate the safety, feasibility and accuracy of esophageal sponge cytology in esophageal carcinoma screening in high-incidence districts.Methods:Opportunistic screening for esophageal carcinoma was conducted on individuals aged 40-75 years with high-risk factors for esophageal carcinoma and visited out-patient clinic in Lianshui People's Hospital from May 2021 to June 2022. A new esophageal cell collector independently developed in China was used for esophageal sponge cytology sampling followed by cytopathological analysis. Atypical squamous cells or more severe lesions were defined as positive esophageal sponge cytology. Then gastroscopy was performed, and all suspicious areas under the endoscopy were biopsied for histopathological examination. Gastroscopy, biopsy histopathology and esophageal sponge cytology were conducted blindly in pairs. Outcome measures included adverse reactions during sampling, subject tolerability (using a visual simulation score), sampling quality, and diagnostic efficacy of esophageal sponge cytology using gastroscopy plus biopsy histopathology as the gold standard.Results:A total of 1 590 patients completed the screening program. During esophageal sponge cytology sampling, no serious adverse events were observed, and the adverse reactions were mainly manifested as vomiting during sampling [0.31% (5/1 590)] and sore throat after sampling [2.45% (39/1 590)], all of which resolved spontaneously without further medical intervention. The majority of subjects [98.62% (1 568/1 590)] reported good tolerance during the procedure. After sampling, 1 526 (95.97%) subjects had completely expanded sponge material, meeting the standard of good sampling quality. The scanning analysis of the digital pathology system showed that the number of sampled cells in 1 590 subjects ranged (2.01-4.00)×10 6, with a median of 3.48×10 6 cells, which could meet the requirements for interpreting cytological results. Using the positive esophageal sponge cytology for the diagnosis of esophageal carcinoma including high-grade intraepithelial neoplasia, esophageal squamous cell carcinoma and adenocarcinoma of esophagogastric junction, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 98.57% (69/70), 91.51% (1 391/1 520), 34.85% (69/198), 99.93% (1 391/1 392), and 91.82% (1 460/1 590), respectively. Conclusion:Esophageal sponge cytology presents promising diagnostic efficacy for esophageal carcinoma screening, offering a simple, safe, convenient, and effective approach in high-incidence esophageal carcinoma regions.

Objective:To evaluate the usability of Gafchromic HD-V2 film for dose dosimetry in the ultra-high dose-rate (UD) electron beam from a modified medical linac, and to investigate the response between the energy and dose-rate dependence to the film.Methods:The HD-V2 film was utilized to measure the average dose-rate of the UD electron beam. The measured result was compared with those by advanced Markus chamber and alanine pellets. And characteristics of the UD electron beam were also measured by HD-V2 film. Energy dependence of HD-V2 film at three beam energies (6 MV X-ray, 9 MeV and 16 MeV electron beam) was investigated by obtaining and comparing the calibration curves based on the clinical linear accelerator in the dose range of 10-300 Gy. The dose-rate dependence of HD-V2 film was also studied by varying the dose rate among 0.03 Gy/s, 0.06 Gy/s and 0.1 Gy/s, and range of 100-200 Gy/s.Results:The measured average maximum dose-rate of 9 MeV UD electron beam at source skin distance (SSD) 100 cm was approximately 121 Gy/s using HD-V2 film, consistent with the results by advanced Markus chamber and alanine pellets. The measured percentage depth dose (PDD) curve parameters of the UD electron beam were similar to the conventional 9 MeV beam. The off-axis dose distribution of the UD electron beam showed the highest central axis, and the dose was gradually decreased with the increase of off-axis distance. The energy dependence of HD-V2 film had no dependency of 6 MV and 9, 16 MeV while measuring the dose in the range from 20 to 300 Gy. The HD-V2 film had no significant dose-rate dependency at the dose rate of 0.03 Gy/s, 0.06 Gy/s and 0.1 Gy/s for the clinical linear accelerator. Likewise, there was also no dose-rate dependence in the range 100-200 Gy/s in the modified machine.Conclusion:HD-V2 film is suitable for measuring ultra-high dose rate electron beam, independent of energy and dose rate.

ObjectiveTo explore the relationship between five-state personality and Cattell's 16 personality factors. MethodsA total of 913 students recruited from Beijing University of Chinese Medicine from November 2020 to January 2021 were assessed by using the Five-state Personality Test Form and the 16 Personality Factors Questionnaire （16PF）. The five-state personality scores were compared with national norms and gender differences were examined. Additionally， a structural equation model was established and the model fit was assessed using comparative fit index （CFI）， Tucker-Lewis index （TLI）， and root mean square error of approximation （RMSEA）. The five-state personality （Taiyang， Shaoyang， Yin-yang balance， Shaoyin and Taiyin） was used as individual outcome variables while the 16PF factors was employed as predictor variables. Based on standardized parameter estimation results， we explored the relationships between the five-state personality and 16PF. ResultsA total of 913 students were recruited， and 756 valid samples were obtained after excluding unqualified questionnaires. Among these， the scores of Taiyang， Shaoyang and Taiyin in the 756 school students were significantly lower than the national norms， while the scores of Yin-yang balance was significantly higher （P＜0.05 or P＜0.01）. The scores of Taiyang， Shaoyang， Yin-yang balance and Shaoyin were significantly higher than in males compared to females （P＜0.05 or P＜0.01）. Regarding the relationship between the dimensions of five-state personality and 16PF， the model demonstrated a good fit with CFI and TLI values of 0.993 and 0.980， respectively， and an RMSEA value of 0.027. The 16PF factors， including dominance， social boldness， vigilance， rule-consciousness， tension， and emotional stability， positively predicted the Taiyang personality traits， while privateness and apprehension negatively predicted the Taiyang personality traits （P＜0.05 or P＜0.01）. For Shaoyang personality traits， factors such as liveliness， social boldness， dominance， and tension positively predicted them， while rule-consciousness， apprehension， and privateness negatively predicted Shaoyang perso-nality traits （P＜0.05 or P＜0.01）. In the case of Yin-yang balance personality traits， perfectionism， rule-consciousness， emotional stability， and self-reliance positively predicted them， while apprehension negatively predicted Yin-yang balance personality traits （P＜0.05 or P＜0.01）. Regarding Shaoyin personality traits， perfectionism， emotional stability， self-reliance， rule-consciousness， and vigilance positively predicted them， while dominance， social boldness， and liveliness negatively predicted Shaoyin personality traits （P＜0.01）. Apprehension， tension， vigilance， and self-reliance positively predicted Taiyin personality traits， while social boldness， rule-consciousness， and intelligence negatively predicted Taiyin personality traits （P＜0.05 or P＜0.01）. ConclusionThere is a significant correlation between five-state personality test and 16PF with 16PF factors capable of predicting five-state personality factors. The five-state personality demonstrates scientific validity and effectiveness.

Objective:To understand the epidemiological characteristics of human brucellosis in Yantai City, Shandong Province, and to provide scientific basis for the formulation and adjustment of brucellosis prevention and control strategy.Methods:The epidemic data, demographic data and case data of human brucellosis in Yantai City in 2019 were collected from the National Health Insurance Disease Control Information System and the epidemiological case survey of brucellosis in Shandong Province. Descriptive epidemiological method was used to analyze the three distribution characteristics, clinical characteristics and infection routes of brucellosis.Results:In 2019, 158 cases of brucellosis were reported in Yantai City, with an incidence rate of 2.22/100 000 and no deaths. The incidence peak was from April to June, accounting for 43.67% (69/158). In addition to Changdao County, 12 other cities and districts had reported brucellosis cases, and Laizhou City had the largest number of reported cases, accounting for 39.87% (63/158). The ratio of men to women was 2.1 ∶ 1.0 (107 ∶ 51). The age of onset was mainly 40 - 69 years (75.95%, 120/158). Farmer was the main occupation, accounting for 83.54% (132/158). The main clinical manifestations were fever (114 cases), muscle and joint pain (107 cases), fatigue (95 cases), hyperhidrosis (85 cases). Patients had a clear history of livestock contact accounted for 58.86% (93/158). The main contact ways were breeding (68 cases) and slaughter (26 cases). Protective measures were taken in 18.28% (17/93) of the patients, and wearing gloves was the most common protective measure, accounting for 76.47% (13/17). The rate of hand washing after contact was 91.40% (85/93), of which 37.65% (32/85) were washed only with water and 62.35% (53/85) were washed with soap. The percentage of changing laundry after contact was 82.80% (77/93).Conclusions:The awareness and ability of personal protection of brucellosis key population in Yantai City are low. Improving the effectiveness of health education and behavior intervention is an important measure for prevention and control of the disease in the future.

【Objective】 To explore the role and significance of nucleic acid testing(NAT) in blood transfusion. 【Methods】 The NAT data from March 2015 to December 2019 were collected and analyzed by inquiring the monthly analysis table of NAT-yielding results and the information management system of Qiao Blood Station (shinow9.5). The NAT capability of Kehua and Roche nucleic acid screening systems were compared. 【Results】 A total of 19 8348 samples were screened by Kehua and Roche nucleic acid screening systems, 67 reactive samples were detected, including 65 HBV DNA reactive samples, 2 HIV RNA reactive samples, and no HCV RNA reactive sample. 151 096 samples and 47 252 samples were detected by Kehua system and Roche system, with the resolution ratio at 44.55% vs 56.25% (P>0.05) and the reactive rate at 0.032% vs 0.038 % (P>0.05), respectively. The effective resolution ratio were 42.86%, 45.45%, 50%, 40% and 57.14% each year from 2015 to 2019, and the reactive rates were 0.041%, 0.042%, 0.027%, 0.021% and 0.038%, respectively. There was no statistical significance among each year by the effective resolution ratio and the reactive rate (P>0.05). The reactive yield at resolution was the highest (77.42%, 24/31) in minipool with CT <33 and the lowest(13.64%, 3/22) in minipool with CT≥40, mostly(73.13%, 49/67) remaining in CT<35. 【Conclusion】 Both Kehua and Roche screening system can detect NAT reactive samples in enzymatic non-reactive samples. The lower the CT value of mini pool, the greater the resolution probability of reactive samples. NAT can further guarantee the safety of blood transfusion.

Through checking the ancient books and the articles at the modern times and combining the disciplinary characteristics of techniques of acupuncture and moxibustion, the training of manipulation skills was discussed. It is proposed that during the teaching of the techniques of acupuncture and moxibustion, the most basic ability of needling technique should be trained in the first place. This ability includes the ability of spiritual cultivation, the ability of tactile perception and the specific training for the needling techniques. The ability of spiritual cultivation refers to the consciousness concentration to the patient when providing acupuncture, which may promotes and conducts to the affected area. The ability of tactile perception refers to the different feelings of different tissues under the hands before and after acupuncture, the perception to the different needling sensations corresponding to the chief complains of patients as well as the different body responses after acupuncture. In order to ensure the better learning results, the specific manipulations of needling techniques should be provided accordingly on the base of these basic training skills of acupuncture.
Acupuncture ; education ; Books ; Learning ; Moxibustion ; Teaching

To clarify the molecular mechanism of SAHA in the cell proliferation of ER-positive breast cancer cell line MCF-7 induced by leptin. Methods Human breast cancer cell MCF-7 was incubated with SAHA and/or leptin, and cell viability, apoptosis and cell cy-cle of MCF-7 cells were detected by Muse Cell Analy-zer. The expression of proteins related with apoptosis was determined by apotosis antibody array. Results Real-time cell proliferation assays indicated that the in-duction effect of leptin for MCF-7 cells reached the peak at a concentration of 0. 625 nmol · L-1 . SAHA reduced the viability of MCF-7 cells, induced G0/G1 phase arrest in the cell cycle, and triggered the apopto-sis. Meanwhile, SAHA significantly induced the pro-tein expressions of some apoptotic factors, including Bax, Caspase-3, TRAIL DR5, p21CIP1, and inhibited the expressions of Claspin, Clusterin, x-linked inhibi-tor of apoptosis protein(XIAP) and survivin. Howev-er, leptin had reverse effects on the related expression of the proteins. Conclusion The effects of cell prolif-eration by leptin and SAHA treatment in breast cancer ER positive cell line MCF-7 may involve in the activa-tion of apoptosis pathway, in particular with releasing of Caspase-3 trigged by endogenous mitochondrial ap-optosis pathway.