BACKGROUND:In recent years,some scholars in the field of tendon bone injury have attached stromal cell-derived factor 1 to tissue engineering scaffolds to promote tendon bone healing,and achieved good results.However,whether stromal cell-derived factor 1 promotes tendon bone healing mechanisms and participates in the repair of natural healing has not yet been defined. OBJECTIVE:To study the expression of stroma-cell derived factor 1 during tendon bone healing after rupture of the whole supraspinatus muscle of the rabbit rotator cuff and its migration effect and optimal in vitro migration promoting concentration on stem cells during tendon bone injury. METHODS:Totally 18 adult New Zealand rabbits were randomly selected to establish rotator cuff injury models,and an additional 3 rabbits were selected as blank controls.At 3,5,7,14,21,and 28 days after modeling,three rabbits were executed separately and the rabbits in the blank group were sacrificed.The tissues of tendon bone junction were taken and stored in a-80℃refrigerator.The expression of stromal cell-derived factor 1 was detected by ELISA at each time point after injury.Mesenchymal stem cells were isolated from the bone marrow of young rabbit femur,cultured,and identified.Transwell assay was performed to verify the migration-promoting effect of stromal cell-derived factor 1 on stem cells and the optimal migration-promoting concentration in vitro.The stem cells cultured to P3 were co-cultured with BrdU and injected into the rabbit ear marginal vein,and immunohistochemical staining was used to verify whether the stem cells migrated to the injury site. RESULTS AND CONCLUSION:(1)Stromal cell-derived factor 1 gene expression was bimodal during rotator cuff tendon bone healing.Stromal cell-derived factor 1 gene expression increased significantly at 3 days post-injury(P<0.01)and then decreased,reaching a minimum at 5 days post-injury.It increased again and reached a peak 14 days after injury(P<0.01)and then decreased.(2)Cell immunohistochemical staining displayed that stem cells labeled with BrdU did migrate to the injury site.(3)The results of the transwell experiment exhibited that 60-80 ng/mL stromal cell-derived factor 1 had the best effect on promoting migration of stem cells,while a concentration of 200 ng/mL inhibited migration.(4)Stromal cell-derived factor 1 is involved in the healing of rotator cuff tendon bone during the inflammatory response phase and the proliferation phase.The mechanism of action may be to promote the migration of stem cells to the injury and their differentiation into various types of cells to promote repair.In addition,the pro-migration effect of stromal cell-derived factor 1 exists at a range of concentrations,beyond which it may act as an inhibitor.

Although the development of COVID-19 vaccines has been a remarkable success, the heterogeneous individual antibody generation and decline over time are unknown and still hard to predict. In this study, blood samples were collected from 163 participants who next received two doses of an inactivated COVID-19 vaccine (CoronaVac®) at a 28-day interval. Using TMT-based proteomics, we identified 1,715 serum and 7,342 peripheral blood mononuclear cells (PBMCs) proteins. We proposed two sets of potential biomarkers (seven from serum, five from PBMCs) at baseline using machine learning, and predicted the individual seropositivity 57 days after vaccination (AUC = 0.87). Based on the four PBMC's potential biomarkers, we predicted the antibody persistence until 180 days after vaccination (AUC = 0.79). Our data highlighted characteristic hematological host responses, including altered lymphocyte migration regulation, neutrophil degranulation, and humoral immune response. This study proposed potential blood-derived protein biomarkers before vaccination for predicting heterogeneous antibody generation and decline after COVID-19 vaccination, shedding light on immunization mechanisms and individual booster shot planning.
Humans ; COVID-19 Vaccines ; Leukocytes, Mononuclear ; Proteomics ; COVID-19/prevention & control* ; Vaccination ; Antibodies ; Antibodies, Viral ; Antibodies, Neutralizing

Based on the teaching concept of constructivism, this study aims to promote independent inquiry-based learning and clinical thinking among students and establish the guiding ideology of "full participation, process control, in-depth discussion, and expansion of thinking". A blending learning model was adopted with offline inquiry-based group learning and in-class defense and comment, as well as online teacher-student interaction and supervision to promote learning. Case-problem-based learning (CPBL) of pathophysiology was carried out among the medical students in the class of 2017, and process management was strengthened to effectively manage the two key links of data retrieval and group discussion. The analysis of 176 teaching evaluations collected at the end of the semester show that in terms of the overall evaluation of CPBL teaching, 162 students (92.05%) had high evaluation on teaching objectives, organization, cases, and personal gains and held a very or relatively favorable attitude. There were more negative feedbacks on "appropriate time allocation"; 21 students (11.93%) held a relatively or very disapproving attitude, and 149 students (84.66%) "felt very tired". In terms of teaching effect evaluation, 150 students (85.23%) strongly or relatively agreed that CPBL teaching may help to understand professional knowledge, stimulate learning enthusiasm and initiative, improve problem solving ability, emphasize clinical practice to cultivate clinical thinking, supervise and promote learning, and enhance team cooperation and teacher-student communication. In terms of the evaluation of teachers, 167 students (94.89%) thought that teachers were rigorous, responsible, and enthusiastic in teaching, attached importance to process management, and did well in effective guidance and thinking inspiration (strongly or relatively agree). The above results suggest that the CPBL teaching reform of pathophysiology based on process management can effectively promote in-depth inquiry-based independent learning and the cultivation of clinical thinking and improve teaching effectiveness, but further improvement is needed for teaching arrangement and time allocation.

OBJECTIVE To prepare Angelica•Cinnamomum（Angelica sinensis-Cinnamomum cassia ）self•microemulsion drug delivery system （AC•SMEDDS），and to optimize its formulation and characterize its preparation . METHODS Using Angelica• Cinnamomum mixed volatile oil as oil phase and model drug ，on the basis of selecting emulsifier and co -emulsifier and the optimization of their mass ratio range ，the formulation was optimized with central composite design •response surface methodology using the ratio of oil phase （Angelica•Cinnamomum mixed volatile oil ），mass ratio of emulsifier and co -emulsifier as factors ，the comprehensive score of volatile oil content ，particle size and emulsifying time as index . Morphology，particle size ，drug loading ， entrapped efficiency and stability of optimized AC•SMEDDS were characterized . RESULTS The optimum formulation of AC•SMEDDS contained the ratio of oil phase was 30%，and the mass ratio of emulsifier （EL•40）and co -emulsifier（ethanol）was 9∶1. Results of validation tests showed that the average particle size of AC•SMEDDS was （148.33±1.53）nm，and emulsifying time was （18.44±0.11）s. The comprehensive score was 0.68，relative deviation of which from the predicted value （0.70）was 2.86%. AC•SMEDDS prepared by optimal formulation was faint yellow ，uniform and transparent liquid ，and spherical particals with translucent edge were observed under transmission electron microscope . Calculated by ligustilide and cinnamaldehyde ，the drug loading was （7.58±0.03） and （4.17±0.01） mg/g，and entrapped efficiency was （93.25±0.01）% and （88.89±0.02）% ， respectively. No stratification or precipitation occurred after centrifugation at the speed of 10 000 r/min or placing within 7 （No.2019-0520） days at 4 and 25 ℃ . The contents of ligustilide and cinnamaldehyde were stable . Its particle size had no significant change after 50，100 and 200 times dilution by purified water . CONCLUTIONS AC•SMEDDS is prepared successfully and its formulation is optimized . The stability of the preparation is good .

Objective: To investigate the association between blood pressure and all-cause mortality in Shanxi, China. Methods: The '2002 China Nutrition and Health Survey' baseline data in Shanxi province was used. A retrospective investigation was performed in 2015. The effects of SBP and DBP on the all-cause mortality were analyzed using the Cox regression model. The hazard ratio ( Results: The follow-up rate was 76.52% over 13 years, while the cumulative mortality rate for all participants was 917.12/100,000 person-years. The mortality rose with an increasing SBP ( Conclusion Adults with SBP > 160 mmHg and DBP > 100 mmHg had a higher mortality risk. Sex and age difference was noted in both DBP and mortality risk.
Adolescent ; Adult ; Aged ; Blood Pressure ; China ; Cohort Studies ; Female ; Health Surveys ; Humans ; Hypertension/mortality* ; Male ; Middle Aged ; Mortality/trends* ; Proportional Hazards Models ; Young Adult

4K laparoscopy brings opportunities and challenges to the development of rectal surgery. 4K laparoscopy can truly provide the structure of abdominal and pelvic fascia, so that surgeons can see more subtle anatomical structure. The clear and real picture under 4K laparoscopic system can reduce visual fatigue of surgeons, which make the operation easier and safer. Radical resection of right colon cancer includes complete mesocolic excision and D 3 lymphadenectomy. Through 4K laparoscopic system, surgeons can easily observe the fascia structure of right mesocolon and its mesenteric bed, distinguish the vascular anatomical relationship at the mesenteric root, which make D 3 lymphadenectomy safer with dissection of lymph nodes completely. The authors comprehensively analyze the related research progress at home and abroad, and systematically elaborate the region of dissection and significance of 4K laparoscopic right hemicolectomy for right colon cancer.

Laparoscopic radical surgery for rectal can-cer involves total mesorectal excision (TME), D 3 lymphadenectomy, and pelvic autonomic nerve preservation, the goal of which is trying to achieve completely radical cure for cancer and urogenital function preservation. In the actual operation procedure, the understanding of fascial anatomy in abdominal and pelvic cavity will help us to improve the quality of TME surgery for rectal cancer and to preserve the pelvic autonomic nerves. When entering the pelvic cavity, the identification of fascia propria of mesorectum, visceral fascia, pre-hypogastric nerve fascia, presacral fascia, ligament structures around the rectum and the Denonvilliers′ fascia in front of the rectum will help us to protect the pelvic autonomic nerves and avoid surgical injury. So the authors focus on how to identify the pelvic fascia structure clearly in laparoscopic radical resection for rectal cancer, furthermore, to master the concepts of fascia anatomy to realize TME for rectal cancer and to achieve pelvic autonomic nerve preservation.

OBJECTIVE：To explore the potential active ingredients and mechanism of Alpinia officinarum in the treatment of gastric ulcer. METHODS ：By network pharmacology method ，the active ingredients and action targets of A. officinarum were screened through TCMSP and TCMID database retrieval [oral bioavailability （OB）≥30％ and drug like （DL）≥0.18] and literature mining. Targets of gastric ulcer were obtained in the TTD ，CTD，OMIM，PubMed，DrugBank and DisGeNet databases. Venny 2.1 software was used to screen common targets for the active ingredients of A. officinarum and gastric ulcer. Then ，the protein-protein interaction（PPI）of the common targets was obtained by STRING database ，and the PPI network was constructed and analysed by using Cytoscape 3.7.1 software. GO function and KEGG pathway enrichment analysis of the common targets were performed by using ClusterProfiler R package. Finally ，Cytoscape 3.7.1 software was used to construct and analyze the network diagram of “active ingredients-targets-pathways ”. RESULTS ：Totally 19 active ingredients of A. officinarum ，209 active ingredients targets and 195 gastric ulcer related targets ，involving 35 common targets ，were screened out. The average node degree of PPI network of common targets was 18，and the average intermediate number was 16.9. There were 11 key targets ，i.e. PTGS2，VEGFA，IL6， IL1B，CCL2，MYC，MMP9，EGFR，HIF1A，ESR1，BCL2L1. The common targets were mainly concentrated in the cell constituents such as the platelet α granule lumen and mitochondria outer membrane ，involved in the biological processes as oxidative stress ，inflammatory response regulation ，and molecular functions as protein phosphatase binding ，growth factor receptor binding. They were also enriched in the signal pathways such as PI3K/Akt，HIF-1. The network of“active ingredients- targets-pathways”showed the active ingredients such as quer- cetin，apigenin，kaempferol and galangin in A. officinarum played an anti-gastric ulcer effect by acting on PTGS2，NOS2， BCL2， IL6， VEGFA， IL1B， MMP9， BCL2L1 and other targets to jointly regulate PI 3K-Akt，HIF-1，TNF，IL-17， NF-κB and other cell proliferation，angiogenesis，and infla- 163.com mmation related pathways. CONCLUSIONS ：A. officinarum shows anti-gastric ulcer effect with the characteristics of multi-ingredient ，multi-target and multi-path.

Digestive tract reconstruction with side-to-side esophagojejunostomy is one of the most commonly used digestive tract reconstruction methods after laparoscopic total gastrectomy. It does not need an auxiliary incision. The linear stapler is used to directly enter the abdominal cavity through the Trocar to perform side-to-side anastomosis of esophagojejunostomy. The common hole can be closed by hand suture or linear stapler. 4K laparoscopy can present a clearer and more realistic view to the operators, so as to realize side-to-side esophagojejunostomy more accurately, to reduce the postoperative anastomo-tic related complications and improve the safety of the operation. This article will elaborate the technical key points and difficulties of esophagojejunostomy in 4K laparoscopic total gastrectomy, as well as the prevention and treatment of anastomotic related complications.

Objective To explore the clinical features of anti-Caspr2 antibody-associated encephalitis. Method The clinical data of anti-Caspr2 antibody-associated encephalitis in a child were retrospectively reviewed. Results A 5-year-old girl manifested as recent memory loss, irritability, cognitive impairment, hallucination, sleep disorders, and so on. The child had positive serum Caspr2 antibody, and was diagnosed with Caspr2 antibody encephalitis after exclusion of other diseases. The literature search retrieved 50 cases of Caspr2 antibody encephalitis with complete data, including 43 male cases and 7 female cases. The minimum onset age of the disease was 5 years in this case. In addition, 1 patient developed the disease at the age of 8, while the rest developed in adulthood. There were 32 cases (62.75％) of marginal encephalitis and 19 cases (37.25％) of morvan's syndrome. The most common clinical symptoms were impaired memory, epileptic seizures, and psychiatric symptoms such as anxiety, apathy, irritability, hallucinations or delusions, peripheral nerve hyperexcitability (PNH) , cerebellar ataxia and autonomic nervous disorders. Forty-four cases (86.27％) recovered or improved, 8 cases (15.69％) were complicated with tumors and 8 cases (15.69％) relapsed. Conclusion Caspr2 antibody encephalitis is relatively rare, especially in children. If the patient has marginal encephalitis symptoms, combining with PNH, ataxia and autonomic nerve symptoms, the possibility of Caspr2 antibody encephalitis should be considered.