Objective To evaluate the effects of Yiqi Huayu Jiedu Decoction combined with chemotherapy on disease-free survival rate and disease-free survival(DFS)of patients with stage Ⅱ and Ⅲ postoperative gastric cancer.Methods Totally 102 patients with stage Ⅱ and Ⅲ postoperative gastric cancer treated by Affiliated Hospital of Nanjing University of Chinese Medicine and Nanjing Drum Tower Hospital were selected.The patients were divided into control group(52 cases)and test group(50 cases)with block random method.The control group received conventional postoperative adjuvant chemotherapy for 4-6 cycles.The test group was treated with Chinese materia medica for 6 months on the basis of chemotherapy.Continue follow-up until the patients had recurrence,metastasis or death.DFS was analyzed by Kaplan-Meier method,and the average DFS of the two groups was estimated.Log Rank test was used to test the significance of differences in survival distribution between groups.Univariate and multivariate analyses of variables affecting prognosis were conducted using the Cox regression model.Adverse reactions of both groups were monitored.Results The recurrence and metastasis rate of the test group was 12.0%(6/50),while that of the control group was 34.6%(18/52),which was lower in the test group than in the control group(P<0.05).The 1-year and 2-year DFS rates and DFS of the control group were 86.5%,72.2%and 25.8 months respectively,while those of the test group were 95.6%,84.1%and 33.9 months respectively,with statistical significance(P=0.012).Cox-regression analysis suggested:The independent factors influencing the disease-free survival time of patients with gastric cancer were the test group(P=0.022),surgical methods of subtotal gastrectomy(P=0.038)and clinical stages Ⅱ(P=0.040).No adverse reactions related to Chinese materia medica were reported in the two groups.Conclusion Yiqi Huayu Jiedu Decoction combined with chemotherapy can improve the 1-year and 2-year DFS rate,prolong DFS,reduce the recurrence and metastasis rate,and improve the prognosis.

Objective To evaluate the effects of Yiqi Huayu Jiedu Decoction combined with chemotherapy on disease-free survival rate and disease-free survival(DFS)of patients with stage Ⅱ and Ⅲ postoperative gastric cancer.Methods Totally 102 patients with stage Ⅱ and Ⅲ postoperative gastric cancer treated by Affiliated Hospital of Nanjing University of Chinese Medicine and Nanjing Drum Tower Hospital were selected.The patients were divided into control group(52 cases)and test group(50 cases)with block random method.The control group received conventional postoperative adjuvant chemotherapy for 4-6 cycles.The test group was treated with Chinese materia medica for 6 months on the basis of chemotherapy.Continue follow-up until the patients had recurrence,metastasis or death.DFS was analyzed by Kaplan-Meier method,and the average DFS of the two groups was estimated.Log Rank test was used to test the significance of differences in survival distribution between groups.Univariate and multivariate analyses of variables affecting prognosis were conducted using the Cox regression model.Adverse reactions of both groups were monitored.Results The recurrence and metastasis rate of the test group was 12.0%(6/50),while that of the control group was 34.6%(18/52),which was lower in the test group than in the control group(P<0.05).The 1-year and 2-year DFS rates and DFS of the control group were 86.5%,72.2%and 25.8 months respectively,while those of the test group were 95.6%,84.1%and 33.9 months respectively,with statistical significance(P=0.012).Cox-regression analysis suggested:The independent factors influencing the disease-free survival time of patients with gastric cancer were the test group(P=0.022),surgical methods of subtotal gastrectomy(P=0.038)and clinical stages Ⅱ(P=0.040).No adverse reactions related to Chinese materia medica were reported in the two groups.Conclusion Yiqi Huayu Jiedu Decoction combined with chemotherapy can improve the 1-year and 2-year DFS rate,prolong DFS,reduce the recurrence and metastasis rate,and improve the prognosis.

Objective To investigate the role of miRNAs in maternal amniotic fluid exosomes in development of isolated ventriculomegaly(VM)in fetuses.Methods Amniotic fluid samples were collected from 9 cases of moderate isolated VM and 8 normal control cases to extract exosomal miRNA,and miRNA sequencing technique was used to identify differentially expressed miRNAs between the two groups.Three miRNAs with significant differential expression between the two groups,whose high expression was associated with VM,were selected for verification with RT-qPCR.Dual luciferase reporter assays were used to verify the regulatory effect of miR-122-5p on its predicted target genes AKT3 and CCDC88C.Gene ontology(GO)and KEGG pathway analyses were performed to explore the possible roles of the top 40 significant differential miRNAs in the pathophysiology of VM.Results We identified a total of 272 differentially expressed miRNAs in VM cases,including 43 up-regulated and 229 down-regulated miRNAs.The target genes of these differential miRNAs were associated with DNA and transcription factor binding,transmembrane transporter and nucleic acid binding transcription factor activity,and cell developmental process.These miRNAs were mostly enriched in the MAPK,cGMP-PKG and Wnt signaling pathways.Verification with RT-qPCR showed that miR-122-5p expression level was significantly lower in VM group than in the control group(P<0.05),which was consistent with miRNA sequencing results;let-7b-5p expression level was significantly lower in VM group,which was contrary to miRNA sequencing result.Dual luciferase reporter assays showed that miR-122-5p was not capable of regulating AKT3 or CCDC88C expressions.Conclusions The highly abundant differentially expressed miRNAs in maternal amniotic fluid exosomes play important roles in the occurrence of fetal VM possibly by regulating the MAPK,PI3K-Akt,Wnt and cGMP-PKG signaling pathways.

Background::Genetic variants of dopaminergic transcription factor-encoding genes are suggested to be Parkinson’s disease (PD) risk factors; however, no comprehensive analyses of these genes in patients with PD have been undertaken. Therefore, we aimed to genetically analyze 16 dopaminergic transcription factor genes in Chinese patients with PD.Methods::Whole-exome sequencing (WES) was performed using a Chinese cohort comprising 1917 unrelated patients with familial or sporadic early-onset PD and 1652 controls. Additionally, whole-genome sequencing (WGS) was performed using another Chinese cohort comprising 1962 unrelated patients with sporadic late-onset PD and 1279 controls.Results::We detected 308 rare and 208 rare protein-altering variants in the WES and WGS cohorts, respectively. Gene-based association analyses of rare variants suggested that MSX1 is enriched in sporadic late-onset PD. However, the significance did not pass the Bonferroni correction. Meanwhile, 72 and 1730 common variants were found in the WES and WGS cohorts, respectively. Unfortunately, single-variant logistic association analyses did not identify significant associations between common variants and PD. Conclusions::Variants of 16 typical dopaminergic transcription factors might not be major genetic risk factors for PD in Chinese patients. However, we highlight the complexity of PD and the need for extensive research elucidating its etiology.

Objective To investigate the role of miRNAs in maternal amniotic fluid exosomes in development of isolated ventriculomegaly(VM)in fetuses.Methods Amniotic fluid samples were collected from 9 cases of moderate isolated VM and 8 normal control cases to extract exosomal miRNA,and miRNA sequencing technique was used to identify differentially expressed miRNAs between the two groups.Three miRNAs with significant differential expression between the two groups,whose high expression was associated with VM,were selected for verification with RT-qPCR.Dual luciferase reporter assays were used to verify the regulatory effect of miR-122-5p on its predicted target genes AKT3 and CCDC88C.Gene ontology(GO)and KEGG pathway analyses were performed to explore the possible roles of the top 40 significant differential miRNAs in the pathophysiology of VM.Results We identified a total of 272 differentially expressed miRNAs in VM cases,including 43 up-regulated and 229 down-regulated miRNAs.The target genes of these differential miRNAs were associated with DNA and transcription factor binding,transmembrane transporter and nucleic acid binding transcription factor activity,and cell developmental process.These miRNAs were mostly enriched in the MAPK,cGMP-PKG and Wnt signaling pathways.Verification with RT-qPCR showed that miR-122-5p expression level was significantly lower in VM group than in the control group(P<0.05),which was consistent with miRNA sequencing results;let-7b-5p expression level was significantly lower in VM group,which was contrary to miRNA sequencing result.Dual luciferase reporter assays showed that miR-122-5p was not capable of regulating AKT3 or CCDC88C expressions.Conclusions The highly abundant differentially expressed miRNAs in maternal amniotic fluid exosomes play important roles in the occurrence of fetal VM possibly by regulating the MAPK,PI3K-Akt,Wnt and cGMP-PKG signaling pathways.

Objective:To prevent the possible effects of population aging and find out countermeasures to ensure the sustainable development of basic medical insurance fund balances.Methods:Using system dynamics,by coupling the three subsystems of basic medical insurance fund income,basic medical insurance fund expenditure,and population size,a causal relationship diagram and stock flow diagram are drawn to construct a system dynamics model,and Vensim Software is used for simulation.Results:Under the predicted natural conditions,the balance of the basic medical insurance fund will show a trend of first increasing and then decreasing from 2023 to 2030.Adjusting and combining the three variables of retirement strategy,outpatient visits,and participation rate into four solutions,among which simultaneously implementing the prediction plan of delaying retirement,expanding basic medical insurance coverage,and strengthening elderly health management can significantly reduce the decline of the basic medical insurance fund.Conclusion:The aging population will be detrimental to the sustainable development of the surplus of the basic medical insurance fund.Based on this,the following suggestions are proposed:implement appropriate delayed retirement policies to increase the income of the basic medical insurance fund;further expand the coverage of insured individuals to enhance the risk resistance of the basic medical insurance fund;strengthen the health management of the elderly to control the excessively rapid growth of the basic medical insurance fund expenditures.

Objective:To prevent the possible effects of population aging and find out countermeasures to ensure the sustainable development of basic medical insurance fund balances.Methods:Using system dynamics,by coupling the three subsystems of basic medical insurance fund income,basic medical insurance fund expenditure,and population size,a causal relationship diagram and stock flow diagram are drawn to construct a system dynamics model,and Vensim Software is used for simulation.Results:Under the predicted natural conditions,the balance of the basic medical insurance fund will show a trend of first increasing and then decreasing from 2023 to 2030.Adjusting and combining the three variables of retirement strategy,outpatient visits,and participation rate into four solutions,among which simultaneously implementing the prediction plan of delaying retirement,expanding basic medical insurance coverage,and strengthening elderly health management can significantly reduce the decline of the basic medical insurance fund.Conclusion:The aging population will be detrimental to the sustainable development of the surplus of the basic medical insurance fund.Based on this,the following suggestions are proposed:implement appropriate delayed retirement policies to increase the income of the basic medical insurance fund;further expand the coverage of insured individuals to enhance the risk resistance of the basic medical insurance fund;strengthen the health management of the elderly to control the excessively rapid growth of the basic medical insurance fund expenditures.

Objective:To prevent the possible effects of population aging and find out countermeasures to ensure the sustainable development of basic medical insurance fund balances.Methods:Using system dynamics,by coupling the three subsystems of basic medical insurance fund income,basic medical insurance fund expenditure,and population size,a causal relationship diagram and stock flow diagram are drawn to construct a system dynamics model,and Vensim Software is used for simulation.Results:Under the predicted natural conditions,the balance of the basic medical insurance fund will show a trend of first increasing and then decreasing from 2023 to 2030.Adjusting and combining the three variables of retirement strategy,outpatient visits,and participation rate into four solutions,among which simultaneously implementing the prediction plan of delaying retirement,expanding basic medical insurance coverage,and strengthening elderly health management can significantly reduce the decline of the basic medical insurance fund.Conclusion:The aging population will be detrimental to the sustainable development of the surplus of the basic medical insurance fund.Based on this,the following suggestions are proposed:implement appropriate delayed retirement policies to increase the income of the basic medical insurance fund;further expand the coverage of insured individuals to enhance the risk resistance of the basic medical insurance fund;strengthen the health management of the elderly to control the excessively rapid growth of the basic medical insurance fund expenditures.

Objective:To prevent the possible effects of population aging and find out countermeasures to ensure the sustainable development of basic medical insurance fund balances.Methods:Using system dynamics,by coupling the three subsystems of basic medical insurance fund income,basic medical insurance fund expenditure,and population size,a causal relationship diagram and stock flow diagram are drawn to construct a system dynamics model,and Vensim Software is used for simulation.Results:Under the predicted natural conditions,the balance of the basic medical insurance fund will show a trend of first increasing and then decreasing from 2023 to 2030.Adjusting and combining the three variables of retirement strategy,outpatient visits,and participation rate into four solutions,among which simultaneously implementing the prediction plan of delaying retirement,expanding basic medical insurance coverage,and strengthening elderly health management can significantly reduce the decline of the basic medical insurance fund.Conclusion:The aging population will be detrimental to the sustainable development of the surplus of the basic medical insurance fund.Based on this,the following suggestions are proposed:implement appropriate delayed retirement policies to increase the income of the basic medical insurance fund;further expand the coverage of insured individuals to enhance the risk resistance of the basic medical insurance fund;strengthen the health management of the elderly to control the excessively rapid growth of the basic medical insurance fund expenditures.

Objective:To prevent the possible effects of population aging and find out countermeasures to ensure the sustainable development of basic medical insurance fund balances.Methods:Using system dynamics,by coupling the three subsystems of basic medical insurance fund income,basic medical insurance fund expenditure,and population size,a causal relationship diagram and stock flow diagram are drawn to construct a system dynamics model,and Vensim Software is used for simulation.Results:Under the predicted natural conditions,the balance of the basic medical insurance fund will show a trend of first increasing and then decreasing from 2023 to 2030.Adjusting and combining the three variables of retirement strategy,outpatient visits,and participation rate into four solutions,among which simultaneously implementing the prediction plan of delaying retirement,expanding basic medical insurance coverage,and strengthening elderly health management can significantly reduce the decline of the basic medical insurance fund.Conclusion:The aging population will be detrimental to the sustainable development of the surplus of the basic medical insurance fund.Based on this,the following suggestions are proposed:implement appropriate delayed retirement policies to increase the income of the basic medical insurance fund;further expand the coverage of insured individuals to enhance the risk resistance of the basic medical insurance fund;strengthen the health management of the elderly to control the excessively rapid growth of the basic medical insurance fund expenditures.