Due to the non-targeted release and low solubility of anti-gastric cancer agent,apatinib(Apa),a first-line drug with long-term usage in a high dosage often induces multi-drug resistance and causes serious side effects.In order to avoid these drawbacks,lipid-film-coated Prussian blue nanoparticles(PB NPs)with hyaluronan(HA)modification was used for Apa loading to improve its solubility and targeting ability.Furthermore,anti-tumor compound of gamabufotalin(CS-6)was selected as a partner of Apa with reducing dosage for combinational gastric therapy.Thus,HA-Apa-Lip@PB-CS-6 NPs were constructed to synchro-nously transport the two drugs into tumor tissue.In vitro assay indicated that HA-Apa-Lip@PB-CS-6 NPs can synergistically inhibit proliferation and invasion/metastasis of BGC-823 cells via downregulating vascular endothelial growth factor receptor(VEGFR)and matrix metalloproteinase-9(MMP-9).In vivo assay demonstrated strongest anti-tumor growth and liver metastasis of HA-Apa-Lip@PB-CS-6 NPs adminis-tration in BGC-823 cells-bearing mice compared with other groups due to the excellent penetration in tumor tissues and outstanding synergistic effects.In summary,we have successfully developed a new nanocomplexes for synchronous Apa/CS-6 delivery and synergistic gastric cancer(GC)therapy.

Objective:To evaluate the efficacy of three kinds of uterine barriers: cook balloon, Foley balloon and intrauterine devices in preventing re-adhesion after separation of moderate or severe intrauterine adhesions.Methods:Seven databases including PubMed, Embase, Medline, Cochrane Library, China HowNet, Wanfang and CQVIP were used to retrieve, and the randomized controlled trials on the effect of using COOK balloon, Foley balloon and intrauterine devices to prevent re-adhesion after the separation of moderate and severe intrauterine adhesions were collected from the establishment of the database to December 2021. Revman 5.1 software was used for Meta analysis.Results:A total of 16 articles were selected according to the inclusion criteria. Meta analysis results showed that the rates of preventing postoperative re-adhesion, improving menstruation and pregnancy in COOK balloon were significantly better than those in intrauterine devices ( OR = 0.31, 2.75 and 1.58; 95% CI 0.19 to 0.49, 1.74 to 4.35 and 1.07 to 2.34; P<0.01); the rates of preventing postoperative re-adhesion, improving menstruation and pregnancy in Foley balloon were significantly better than those in intrauterine devices ( OR = 0.39, 1.90 and 1.73; 95% CI 0.27 to 0.57, 1.33 to 2.71 and 1.02 to 2.39; P<0.01 or <0.05). Conclusions:The use of COOK balloon and Foley balloon to prevent adhesion is better than the use of intrauterine devices in preventing re-adhesion in patients with moderate or severe intrauterine adhesions.

Objective: To investigate the clinical effect and safety of long-acting pegylated interferon-α-2b (Peg-IFN-α-2b) (Y shape, 40 kD) injection (180 μg/week) in the treatment of HBeAg-positive chronic hepatitis B (CHB) patients, with standard-dose Peg-IFN-α-2a as positive control. Methods: This study was a multicenter, randomized, open-label, and positive-controlled phase III clinical trial. Eligible HBeAg-positive CHB patients were screened out and randomized to Peg-IFN-α-2b (Y shape, 40 kD) trial group and Peg-IFN-α-2a control group at a ratio of 2:1. The course of treatment was 48 weeks and the patients were followed up for 24 weeks after drug withdrawal. Plasma samples were collected at screening, baseline, and 12, 24, 36, 48, 60, and 72 weeks for centralized detection. COBAS® Ampliprep/COBAS® TaqMan® HBV Test was used to measure HBV DNA level by quantitative real-time PCR. Electrochemiluminescence immunoassay with Elecsys kit was used to measure HBV markers (HBsAg, anti-HBs, HBeAg, anti-HBe). Adverse events were recorded in detail. The primary outcome measure was HBeAg seroconversion rate after the 24-week follow-up, and non-inferiority was also tested. The difference in HBeAg seroconversion rate after treatment between the trial group and the control group and two-sided confidence interval (CI) were calculated, and non-inferiority was demonstrated if the lower limit of 95% CI was > -10%. The t-test, chi-square test, or rank sum test was used according to the types and features of data. Results: A total of 855 HBeAg-positive CHB patients were enrolled and 820 of them received treatment (538 in the trial group and 282 in the control group). The data of the full analysis set showed that HBeAg seroconversion rate at week 72 was 27.32% in the trial group and 22.70% in the control group with a rate difference of 4.63% (95% CI -1.54% to 10.80%, P = 0.1493). The data of the per-protocol set showed that HBeAg seroconversion rate at week 72 was 30.75% in the trial group and 27.14% in the control group with a rate difference of 3.61% (95% CI -3.87% to 11.09%, P = 0.3436). 95% CI met the non-inferiority criteria, and the trial group was non-inferior to the control group. The two groups had similar incidence rates of adverse events, serious adverse events, and common adverse events. Conclusion In Peg-IFN-α regimen for HBeAg-positive CHB patients, the new drug Peg-IFN-α-2b (Y shape, 40 kD) has comparable effect and safety to the control drug Peg-IFN-α-2a.

An ever increasing number of drugs directed as epidermal growth factor receptor tyrosine kinase inhibi-tor (EGFR-TKI) bring a new revolution for non-small cell lung cancer (NSCLC) therapy, and many large scales of studies show that only people with EGFR-sensitive mutation can benefit from these drugs. The main method of EGFR mutation detection is to analyze the DNA sequence of EGFR, which can be the lung cancer tissue, pleural fluid tumor cells, circulating tumor cells and peripheral blood free DNA obtained by surgery or puncture, the biggest drawback is that the heterogeneity of EGFR muta-tion cannot be analyzed. However, with the development of molecular imaging, the development of EGFR-targeted molecular probes based on positron emission computed tomography-computed tomography (PET-CT) has made it possible to reveal the EGFR mutations in lung cancer tissues in vivo, and can detect the heterogeneity of EGFR mutations. This article reviews all the results and progress of molecular probes targeting EGFR mutations.

Objective To investigate the correlations of apparent diffusion coefficient (ADC) with fibrosis and fibroblast activation protein (FAP) score in pancreatic cancer .Methods Eighteen patients with pathologically confirmed pancreatic cancer were per‐formed conventional MR imaging ,DWI examinations .ADCs were measured with region of interest method on a “Single slice” .The wax blocks of 18 patients with pancreatic cancer were received Masson staining and FAP immunohistochemical staining .The correla‐tions of ADC with levels of fibrosis and FAP scores of pancreatic cancer were assessed by Pearson correlation analysis .Results The mild negative correlation between ADC value of cancerous foci and fibrosis was not significant (r= -0 .459 ,P=0 .056) .Significant negative correlation was found between ADC values of moderate and high differentiation cancerous foci and fibrosis (r= -0 .564 ,P=0 .044) .Significant negative correlation was found between ADC value and FAP score (r= -0 .497 , P=0 .036) .Conclusion The negative correlations are found between ADC and fibrosis ,FAP score of pancreatic cancer .DWI will be helpful to infer the pathologi‐cal characteristics .

OBJECTIVE: To explore the interaction between arginine functionalized hydroxyapatite (HAP/Arg) nanoparticles and endothelial cells, and to investigate mechanisms for endocytosis kinetics and endocytosis.
 METHODS: Human umbilical vein endothelial cells (HUVECs) were selected as the research model.Cellular uptake of HAP/Arg nanoparticles were observed by laser scanning confocal microscopy.Average fluorescence intensity of cells after ingestion with different concentrations of HAP/Arg nanoparticles were determined by flow cytometer and atomic force microscopy.
 RESULTS: The HAP/Arg nanoparticles with doped terbium existed in cytoplasm, and most of them distributed around the nucleus area after cellular uptake by HUVECs. Cellular uptake process of HAP/Arg nanoparticles in HUVECs was in a time and concentration dependent manner. 4 h and 50 mg/L was the best condition for uptake. HAP/Arg nanoparticles were easier to be up-taken into the cells than HAP nanoparticles without arginine functionalized.
 CONCLUSION HAP/Arg nanoparticles are internalized by HUVECs cells through an active transport and energy-dependent endocytosis process, and it is up-taken by cells mainly through caveolin-mediated endocytosis, but the clathrin-dependent endocytic pathway is also involved..
Arginine ; pharmacology ; Biological Transport, Active ; physiology ; Caveolins ; physiology ; Cells, Cultured ; Clathrin ; physiology ; Durapatite ; pharmacokinetics ; Endocytosis ; physiology ; Human Umbilical Vein Endothelial Cells ; cytology ; Humans ; Nanoparticles ; metabolism

Purpose To assess the diagnostic value of 18F-FLT and 18F-FDG PET/CT scan in patients with lung cancer. Materials and Methods Computer-based retrieval was performed on Medline, PubMed, EMbase, Wanfang data, CNKI and the Cochrane Library to search reports on diagnostic value of lung cancer with 18F-FLT and 18F-FDG PET/CT scan. The quality of included studies was evaluated according to quality assessment of diagnostic accuracy studies (QUADAS), and MetaDisc software was adopted to conduct meta-analysis. The pooled specificity, sensitivity, and diagnostic odds ratio (DOR) were calculated. The heterogeneity was tested. The summary receiving operating characteristic (SROC) curve was drawn, and the areas under the curve (AUC) as well as Q* were measured. Results Ten studies were included. Meta-analysis showed pooled sensitivity was 0.88, pooled specificity was 0.56, DOR was 9.10, AUC was 0.8102, Q*was 0.7448 for FDG group;pooled sensitivity was 0.79, pooled specificity was 0.78, DOR was 12.50, AUC was 0.8440, Q*was 0.7756 for FLT group. Conclusion Both 18F-FDG and 18F-FLT have well diagnostic value for lung cancer, but the specificity of 18F-FLT is higher than that of 18F-FDG in the diagnosis of lung cancer.

OBJECTIVETo evaluate the effect of early enteral nutrition(EEN) on immune response and clinical outcomes after esophageal cancer operation.

METHODSSixty patients with esophageal cancer undergoing radical operation between March 2010 and July 2011 were randomly divided into two groups using envelope method: EEN group(n=30, administration of water and enteral nutrition early after operation) and TPN group(n=30, administration of total parenteral nutrition). Two groups both received 7-day nutrition support. Immune indexes(CD3(+), CD4(+), CD8(+), CD4(+)/CD8(+)) and serum nutritional indexes(albumin, pre-albumin, transferrin) were measured before operation and 1-, 3-, and 7-day after operation. The time to first flatus, length of postoperative hospital stay, total hospitalization cost, and postoperative complication were recorded.

RESULTSAs compared to TPN group, the time to first flatus was significantly shorter in EEN group[(66.5±7.3) h vs. (75.1±6.8) h, P<0.01], as was hospital stay[(7.8±1.1) d vs. (9.3±1.3) d, P<0.01]. Total hospitalization cost[(36 210±3810) yuan vs. (39 731±4013) yuan, P<0.01] was lower in EEN group as compared to TPN group. There was no significant difference in postoperative complication rate between the two groups[13.3%(3/30) vs. 20.0%(6/30), P>0.05]. The levels of CD3(+), CD4(+), CD4(+)/CD8(+), albumin, prealbumin and transferrin were significantly higher in EEN group as compared to TPN group on postoperative day 3 and 7(all P<0.05), while CD8(+) was significantly lower in EEN group(P<0.05).

CONCLUSIONEEN can promote early recovery of gastrointestinal function, improve nutritional and immune function, and therefore lead to fast postoperative recovery in esophageal cancer patients.

Objective To discuss the importance of data coding standards for the application of information technology , and put forward a method to solve the identification of complex medical materials in database structure design .Methods utilization of standardized coding , establishment of coding rules and a series of basic data dictionary , improvement of property fields and association dictionaries were used to regulate the generation , collection and processing of information , and to establish data standards for military medicine warehouse management information system .Results The design and implementation of data standards could be applicable for a variety of databases .Conclusion The establishment of standards and regulations of the data were critical to system design , develop-ment, implementation and even the successful operation , especially in management information systems , which had complex manage-ment form including property management , administration, and packaging assembly management .

Objective To evaluate the effect of early enteral nutrition (EEN) on immune response and clinical outcomes after esophageal cancer operation. Methods Sixty patients with esophageal cancer undergoing radical operation between March 2010 and July 2011 were randomly divided into two groups using envelope method: EEN group (n=30, administration of water and enteral nutrition early after operation) and TPN group (n=30, administration of total parenteral nutrition). Two groups both received 7-day nutrition support. Immune indexes (CD3+, CD4+, CD8+, CD4+/CD8+) and serum nutritional indexes (albumin, pre-albumin, transferrin) were measured before operation and 1-, 3-, and 7-day after operation. The time to first flatus, length of postoperative hospital stay, total hospitalization cost, and postoperative complication were recorded. Results As compared to TPN group, the time to first flatus was significantly shorter in EEN group [(66.5±7.3) h vs. (75.1±6.8) h, P<0.01], as was hospital stay[(7.8±1.1) d vs. (9.3±1.3) d, P<0.01]. Total hospitalization cost[(36 210± 3810) yuan vs. (39 731 ±4013) yuan, P<0.01] was lower in EEN group as compared to TPN group. There was no significant difference in postoperative complication rate between the two groups [13.3%(3/30) vs. 20.0%(6/30),P>0.05]. The levels of CD3+, CD4+, CD4+/CD8+, albumin, prealbumin and transferrin were significantly higher in EEN group as compared to TPN group on postoperative day 3 and 7 (all P<0.05), while CD8+ was significantly lower in EEN group (P<0.05). Conclusion EEN can promote early recovery of gastrointestinal function, improve nutritional and immune function, and therefore lead to fast postoperative recovery in esophageal cancer patients.