Collagen is a major structural protein in the matrix of animal cells and the most widely distributed and abundant functional protein in mammals. Collagen’s good biocompatibility, biodegradability and biological activity make it a very valuable biomaterial. According to the source of collagen, it can be broadly categorized into two types: one is animal collagen; the other is recombinant collagen. Animal collagen is mainly extracted and purified from animal connective tissues by chemical methods, such as acid, alkali and enzyme methods, etc. Recombinant collagen refers to collagen produced by gene splicing technology, where the amino acid sequence is first designed and improved according to one’s own needs, and the gene sequence of improved recombinant collagen is highly consistent with that of human beings, and then the designed gene sequence is cloned into the appropriate vector, and then transferred to the appropriate expression vector. The designed gene sequence is cloned into a suitable vector, and then transferred to a suitable expression system for full expression, and finally the target protein is obtained by extraction and purification technology. Recombinant collagen has excellent histocompatibility and water solubility, can be directly absorbed by the human body and participate in the construction of collagen, remodeling of the extracellular matrix, cell growth, wound healing and site filling, etc., which has demonstrated significant effects, and has become the focus of the development of modern biomedical materials. This paper firstly elaborates the structure, type, and tissue distribution of human collagen, as well as the associated genetic diseases of different types of collagen, then introduces the specific process of producing animal source collagen and recombinant collagen, explains the advantages of recombinant collagen production method, and then introduces the various systems of expressing recombinant collagen, as well as their advantages and disadvantages, and finally briefly introduces the application of animal collagen, focusing on the use of animal collagen in the development of biopharmaceutical materials. In terms of application, it focuses on the use of animal disease models exploring the application effects of recombinant collagen in wound hemostasis, wound repair, corneal therapy, female pelvic floor dysfunction (FPFD), vaginal atrophy (VA) and vaginal dryness, thin endometritis (TE), chronic endometritis (CE), bone tissue regeneration in vivo, cardiovascular diseases, breast cancer (BC) and anti-aging. The mechanism of action of recombinant collagen in the treatment of FPFD and CE was introduced, and the clinical application and curative effect of recombinant collagen in skin burn, skin wound, dermatitis, acne and menopausal urogenital syndrome (GSM) were summarized. From the exploratory studies and clinical applications, it is evident that recombinant collagen has demonstrated surprising effects in the treatment of all types of diseases, such as reducing inflammation, promoting cell proliferation, migration and adhesion, increasing collagen deposition, and remodeling the extracellular matrix. At the end of the review, the challenges faced by recombinant collagen are summarized: to develop new recombinant collagen types and dosage forms, to explore the mechanism of action of recombinant collagen, and to provide an outlook for the future development and application of recombinant collagen.

[摘 要] 目的：探讨iSEND免疫评分联合肺癌免疫治疗预后指数（LIPI）在评估非小细胞肺癌（NSCLC）接受免疫治疗预后中的价值。方法：通过回顾性分析2018年2月至2023年2月期间100例接受免疫治疗的晚期NSCLC患者的临床资料，收集并整理患者的iSEND免疫评分和LIPI数据，根据iSEND免疫评分和LIPI分别将患者分为3组（不良组、中等组和良好组），运用Kaplan-Meier方法绘制生存曲线分析所有患者和不同组别患者的无进展生存期（PFS），运用Cox回归分析评估影响患者预后的风险因素。结果：在接受免疫治疗后，NSCLC患者的ORR为42.00%（42/100），DCR为82.00%（82/100）。iSEND免疫评分和LIPI不良组ORR和DCR均最低，良好组均最高，不同组别ORR和DCR比较均有统计学意义（均P < 0.01）。100例NSCLC患者的中位PFS为7.63个月[95% CI（7.23, 8.05）]，iSEND免疫评分不良组、中等组和良好组的中位PFS分别为4.69、6.58和8.99个月，iSEND免疫评分良好组的PFS最长，其次为中等组，不良组最短（χ2=125.391，P < 0.000 1）。LIPI不良组、中等组和良好组的中位PFS分别为4.54、6.39和8.49个月，以LIPI良好组的PFS最长，其次为中等组（χ2 = 115.707，P < 0.000 1）。Cox多因素分析提示，ECOG PS > 1、远处转移、iSEND免疫评分≥ 2分和LIPI ≥ 2分是影响患者独立预后的风险因素。结论：iSEND免疫评分和LIPI可作为评估NSCLC免疫治疗预后的良好指标，具有一定的临床价值。

Prescription optimization is a crucial aspect in the study of traditional Chinese medicine （TCM） compounds. In recent years， the introduction of mathematical methods， data mining techniques， and artificial neural networks has provided new tools for elucidating the compatibility rules of TCM compounds. The study of TCM compounds involves numerous variables， including the proportions of different herbs， the specific extraction parts of each ingredient， and the interactions among multiple components. These factors together create a complex nonlinear dose-effect relationship. In this context， it is essential to identify methods that suit the characteristics of TCM compounds and can leverage their advantages for effective application in new drug development. This paper provided a comprehensive review of the cutting-edge optimization experimental design methods applied in recent studies of TCM compound compatibilities. The key technical issues， such as the optimization of source material selection， dosage optimization of compatible herbs， and multi-objective optimization indicators， were discussed. Furthermore， the evaluation methods for component effects were summarized during the optimization process， so as to provide scientific and practical foundations for innovative research in TCM and the development of new drugs based on TCM compounds.

Background::Coronavirus disease 2019 (COVID-19) has potential risks for both clinically worsening pulmonary hypertension (PH) and increasing mortality. However, the data regarding the protective role of vaccination in this population are still lacking. This study aimed to assess the safety of approved vaccination for patients with PH.Methods::In this national prospective cohort study, patients diagnosed with PH (World Health Organization [WHO] groups 1 and 4) were enrolled from October 2021 to April 2022. The primary outcome was the composite of PH-related major adverse events. We used an inverse probability weighting (IPW) approach to control for possible confounding factors in the baseline characteristics of patients.Results::In total, 706 patients with PH participated in this study (mean age, 40.3 years; mean duration after diagnosis of PH, 8.2 years). All patients received standardized treatment for PH in accordance with guidelines for the diagnosis and treatment of PH in China. Among them, 278 patients did not receive vaccination, whereas 428 patients completed the vaccination series. None of the participants were infected with COVID-19 during our study period. Overall, 398 patients received inactivated severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine, whereas 30 received recombinant protein subunit vaccine. After adjusting for baseline covariates using the IPW approach, the odds of any adverse events due to PH in the vaccinated group did not statistically significantly increase (27/428 [6.3%] vs. 24/278 [8.6%], odds ratio = 0.72, P = 0.302). Approximately half of the vaccinated patients reported at least one post-vaccination side effects, most of which were mild, including pain at the injection site (159/428, 37.1%), fever (11/428, 2.6%), and fatigue (26/428, 6.1%). Conclusions::COVID-19 vaccination did not significantly augment the PH-related major adverse events for patients with WHO groups 1 and 4 PH, although there were some tolerable side effects. A large-scale randomized controlled trial is warranted to confirm this finding. The final approval of the COVID-19 vaccination for patients with PH as a public health strategy is promising.

Aim To investigate the protective effect of Jujing formula on retina of mice with dry age-related macular degeneration(AMD).Methods The mouse model of dry AMD was induced by intraperitoneal in-jection of sodium iodate,and the prognosis was given to the Jujing formula.Retinal thickness was detected by optical coherence tomography(OCT),the retinal morphological changes were observed by hematoxylin-eosin(HE)staining,and the apoptosis of retinal cells was detected by in situ terminal transferase labeling(TUNEL)staining.Combination of tumor necrosis fac-tor-α(TNF-α),interleukin-6(IL-6)and interleukin-1β(IL-1 β)in eyeballs and serum,superoxide dis-mutase(SOD),glutathione(GSH)and malondialde-hyde(MDA)were evaluated to assess the protective effects of Jujing formula on retinal injury in mice with dry AMD.Results The results of OCT,HE and TUNEL staining showed that Jujing formula significant-ly improved the retinal injury induced by sodium iodate in mice with dry AMD,increased the retinal thickness(P＜0.05),reduced the apoptosis of retinal cells(P＜0.01),and increased the levels of GSH,IL-6 and SOD activity in eyeballs and serum(P＜0.01).The levels of TNF-α,IL-6,IL-1β and MDA were reduced(P＜0.01).Conclusions Jujing formula has certain therapeutic effects on retinal injury in dry AMD,which may be related to inhibiting inflammatory response and enhancing antioxidant capacity.

Objective To investigate the effect of artemisinin(ART)on the malignant biological behavior of colorectal cancer(CRC)cells stimulated by glucose and its mechanism.Methods The concentration gradients of 0,5,10,20,40 and 60 μmol/L of ART were used to treat the human colorectal cancer cell line SW480,and then the cell viability was detected by CCK-8.Cell apoptosis was detected by flow cytometry.Transwell was used to detect the cell migration and invasion.Western blot was used to detect the apoptosis,epithelial-mesenchymal transition(EMT)and Janus kinase 2(JAK2)/signal transducer and activator of transcription 3(STAT3)related proteins expression.Results Compared with the 0 μmol/L of ART,the viability of SW480 cells decreased under 5,10,20,40,60 μmol/L of ART treatment(P<0.05),and IC50 was 36.91 μmol/L.Therefore,the cells treated with 10,20 and 40 μmol/L of ART were as the low-dose,medium-dose and high-dose ART groups,the cells treated with 0 μmol/L of ART were as the control group,and the cells treated with 40 μmol/L of ART and 10 μmol/L of Coumermycin A1 were as the Coumermycin A1 group.Compared with the control group,the cell scratch wound healing rate,invasion ability,and expression levels of Bcl-2,N-cadherin,Vimentin,p-JAK2,and p-STAT3 in the low-dose ART group,the medium-dose ART group,and the high-dose ART group decreased obviously(P<0.05),while the apoptosis rate,and expression levels of Bax,Caspase-3 and E-cadherin increased(P<0.05).Compared with the high-dose ART group,the cell scratch wound healing rate,invasion ability,and expression levels of Bcl-2,N-cadherin,Vimentin,p-JAK2,and p-STAT3 in the Coumermycin A1 group increased obviously(P<0.05),while the apoptosis rate,and expression levels of Bax,Caspase-3 and E-cadherin decreased(P<0.05).Conclusion ART may inhibit the viability,migration,invasion and EMT of glucose-stimulated CRC cells and promote apoptosis by inhibiting the JAK2/STAT3 signaling pathway.

In order to understand the prevalence and genetic variation of H9N2 subtype avian influ-enza virus in Shandong,a total 492 tracheal and lung tissue samples collected from chicken farms with respiratory symptoms in partial areas in Shandong were detected by H9 subtype AIV real-time RT-PCR,and the positive samples were inoculated with chicken embryos for two generations.Whole genome sequences of the positive strains by applying Illumina Miaseq platform,and genetic evolution and mutation at positions associating with viral pathogenicity and transmissibility were analyzed.The results showed that there were 72 samples were positive for H9 subtype AIV among the 492 samples,with a positive rate of 14.63％.Thirty-four strains of H9 subtype AIV were ob-tained from the positive samples after passing through chicken embryo,meanwhile,the 34 isolates were all H9N2 subtype AIV by whole genome sequencing analysis.By analyzing the evolutionary tree of HA and NA genes,HA and NA genes of the 34 H9N2 AIV strains belonged to Y280-like branch and F/98-like branch,respectively.Meanwhile,based on above branches,there were obvious time node subbranch,which one was"isolates before 2013",another one was"isolates after 2013".The HA cleavage sites of thirty-four H9N2 strains were all 325PSRSSR↓GLF333,which met the se-quence characteristics of the lowly pathogenic avian influenza virus,and the HA receptor binding site 226 amino acid was leucine,which had the characteristics of blinding to a-2,6 mammalian sialic acid receptors.Among the internal amino acid sites that are key to mammalian adaptation,all strains had an I368V mutation in the PB1 gene that enhanced viral transmissibility in mammals and the PB2 genes of some strains were mutated to enhance the mammalian adaptation of I292 V and A588 V.The above results illustrated that the H9N2 subtype AIV gene segments in Shandong have different degrees of recombination and gene variation,so it is necessary to strengthen the monito-ring of virus variation.

Objective To systematically evaluate the risk prediction model for central venous catheter-related bloodstream infections and provide references for clinical practice.Methods Databases such as CNKI,Wanfang,CBM,VIP,PubMed,Web of Science,Cochrane Library,etc.were retrieved.The search period is from database establishment to June 2,2023.There are 2 researchers who independently screened and extracted the literature,and evaluated the quality of the literature using bias assessment tools of predictive model risk.Results A total of 9 articles were included,including 9 risk prediction models for catheter-related bloodstream infections.The total sample size was 80～11 901 cases;the number of outcome events was 19～403 cases;the C index of the included model was 0.81～0.93.The area under the curve of the subjects ranged from 0.73～0.90.The predictors that appear more frequently in the model mainly included the history of diabetes,albumin value,the number of days of catheterization,the location of catheterization.The evaluation results of the bias assessment tool of predictive model risk for research show that the overall applicability of the included risk prediction models is good,but the bias risk is high.The reasons are related to the improper source of research sample data,inappropriate processing of continuous variable methods,failure to process missing data,insufficient model performance evaluation,and non-standard evaluation indicators.Conclusion There are still some shortcomings in the risk prediction model for central venous catheter-related bloodstream infections.In the future,the quality of related model research should be further improved,especially in terms of predictive factor analysis,model evaluation indicators,etc.,which should be further standardized.

Objective:To identify the risk factors for delayed gastric emptying in patients scheduled for elective caesarean section.Methods:One hundred and five patients, aged≥18 yr, at≥37 week gestation, of American Society of Anesthesiologists Physical Status classification Ⅱ or Ⅲ, scheduled for elective caesarean section from August 2023 to February 2024, who followed the preoperative fasting guidelines, were collected. Based on the quantitative and qualitative ultrasound assessments of the gastric antrum, patients were divided into 2 groups: delayed gastric emptying group, as defined by Perlas A score of grade 2 or the presence of solid contents or gastric volume/weight >1.5 ml/kg, and non-delayed gastric emptying group, as defined by Perlas A score < grade 2 and gastric volume/weight ≤1.5 ml/kg. The variables of which showed statistically significant differences in the intergroup comparison would enter the logistic regression analysis to stratify the risk factors for delayed gastric emptying before elective caesarean section.Results:There were 41 parturients (39.0%) showed delayed gastric emptying before elective caesarean section. According to the results of multifactorial logistic regression analysis, the gastroesophageal reflux disease( OR=5.313, 95% confidence interval 1.013-27.878, P=0.048) was an independent risk factor for delayed gastric emptying in the patients who underwent elective caesarean section. Conclusions:Gastroesophageal reflux disease is an independent risk factor for delayed gastric emptying in the patients scheduled for elective caesarean section.

The application of the smart bed in some hospital from October 2018 to January 2023 was introduced,and the patients using the smart bed were compared with those with the ordinary bed in terms of inpatient department,length of stay,fall/bed fall prediction score,occurrence of adverse events and patient satisfaction.The application effect of the smart bed was summarized.The problems during the application of the smart bed were analyzed,and some suggestions were put forward accordingly.References were provided for the improvement of the smart bed.[Chinese Medical Equipment Journal,2024,45(7):77-80]