Chemotherapy based on cisplatin or its combination therapy is a common cancer treatment method. However， the non-specific side effects of cisplatin， poor pharmacokinetic properties of small molecule drugs， and susceptibility to drug resistance greatly limit the clinical application of cisplatin as first-line anti-tumor drug. With the development of nanocarrier technology， liposomes have become an ideal carrier for delivering cisplatin drugs due to their excellent properties of targeting， reducing toxicity， and enhancing efficacy. This paper reviews the status of cisplatin liposome both domestically and internationally which have entered clinical trials， including L-NDDP，SPI-077®， Lipoplatin®，LiPlaCis，SLIT and ILC， etc. Currently， only Lipoplatin® and ILC are showing good potential in cancer therapy. Although cisplatin liposome has made some progress in reducing systemic toxicity and improving treatment efficiency in clinical research， there is still potential for further improvement in tumor targeting and reducing side effects. In the future， more low-toxicity and efficient cisplatin liposomes can be developed through formulation technologies such as co-delivery liposome， stimuli-responsive liposome and targeting liposome.

Objective:To investigate the short-term efficacy and safety of cardiac contractility modulation (CCM) in patients with heart failure.Methods:This was a cross-sectional study of patients with heart failure who underwent CCM placement at the First Affiliated Hospital of Xinjiang Medical University from February to June 2022. With a follow-up of 3 months, CCM sensation, impedance, percent output, and work time were monitored, and patients were compared with pre-and 3-month postoperative left ventricular ejection fraction (LVEF) values, and 6-minute walk test distance and New York Heart Association (NYHA) cardiac function classification, and the occurrence of complications was recorded.Results:CCM was successfully implanted in all 9 patients. Seven(7/9) of them were male, aged (56±14) years, 3 patients had ischaemic cardiomyopathy and 6 patients had dilated cardiomyopathy. At 3-month postoperative follow-up, threshold was stable, sense was significantly lower at follow-up than before (right ventricle: (16.3±7.0) mV vs. (8.2±1.1) mV, P<0.05; local sense: (15.7±4.9) mV vs. (6.7±2.5) mV, P<0.05), and impedance was significantly lower at follow-up than before (right ventricle (846±179) Ω vs. (470±65) Ω, P<0.05, local sense: (832±246) Ω vs. (464±63) Ω, P<0.05). The CCM output percentage was (86.9±10.7) %, the output amplitude was (6.7±0.4) V, and the daily operating time was (8.6±1.0) h. LVEF was elevated compared to preoperative ((29.4±5.2) % vs. (38.3±4.3) %, P<0.05), the 6-minute walk test was significantly longer than before ((96.8±66.7)m vs. (289.3±121.7)m, P<0.05). No significant increase in the number of NYHA Class Ⅲ-Ⅳ patients was seen (7/9 vs. 2/9, P>0.05). The patient was not re-hospitalised for worsening heart failure symptoms, had no malignant arrhythmic events and experienced significant relief of symptoms such as chest tightness and shortness of breath. No postoperative complications related to pocket hematoma, pocket infection and rupture, electrode detachment, valve function impairment, pericardial effusion, or cardiac perforation were found. Conclusions:CCM has better short-term safety and efficacy in patients with heart failure.

Objective:To investigate the correlation between early recurrence and late recurrence within 48 hours after catheter ablation of atrial fibrillation.Methods:A retrospective analysis was conducted on atrial fibrillation patients who underwent catheter ablation at the Heart Center of the First Affiliated Hospital of Xinjiang Medical University from April 2020 to November 2021. Preoperative examinations and baseline data of patients were collected. After surgery, the patient was given continuous electrocardiogram monitoring for 48 hours to observe whether there was early recurrence of atrial fibrillation. Follow up visits were conducted at 3, 6, 9, and 12 months after surgery to observe whether there were atrial fibrillation events. The impact of extremely early recurrence on late recurrence free atrial fibrillation was analyzed using Kaplan Meier curves, and the predictive value of extremely early recurrence and other indicators for late atrial fibrillation recurrence was evaluated using Cox proportional hazards models and receiver operating characteristic (ROC) curves.Results:A total of 96 patients who underwent catheter ablation for atrial fibrillation for the first time were included in this study, with an age of (60.2±12.6)years. Among them, 46 patients (47.92%) experienced very early recurrence within 48 hours after surgery. During the 1-year follow-up, 16 patients in the very early recurrence group experienced late recurrence, which was statistically significant compared to the very early non recurrence group ( P=0.003). The proportion of persistent atrial fibrillation was higher in patients with very early recurrence (32.6% vs 8.0%, P=0.006), and more patients with late recurrence (34.8% vs 8.0%, P=0.003). The left atrial diameter was larger [(40.28±4.72)mm vs (37.10±4.35)mm, P=0.001]. The Kaplan Meier curve showed that compared with the very early non recurrence group, the late recurrence rate of patients in the very early recurrence group was significantly higher (Long rank P=0.001 6). Cox single factor regression analysis showed that very early recurrence, age increase, increased left atrial diameter, hypertension and diabetes were risk factors for late recurrence (all P<0.2). Multivariate regression analysis suggested that extremely early recurrence was an independent risk factor for late recurrence ( HR=3.99, 95% CI: 1.22-13.06, P=0.021). The area under the ROC curve for predicting late recurrence after catheter ablation of atrial fibrillation with extremely early recurrence was 0.703, and the negative predictive value was 0.920. Conclusions:Early recurrence within 48 hours after catheter ablation of atrial fibrillation is an independent risk factor for late recurrence and has good predictive value.

Objective:To explore the effect of virtual reality (VR) technology in postoperative pain management for surgical patients.Methods:The literature on VR technology for relieving postoperative pain in surgical patients was electronically retrieved from eight databases, including PubMed, Web of Science and so on. The search period was from database establishment to November 19, 2023. Two researchers independently screened literature, extracted data, and conducted literature quality evaluation, using RevMan 5.4 for Meta-analysis.Results:A total of 18 articles were included. Meta-analysis results showed that VR technology could reduce postoperative resting pain scores [ MD=-1.13, 95% CI (-1.29, -0.96), P<0.001], postoperative 12 hour pain scores [ MD=-0.49, 95% CI (-0.73, -0.24), P<0.001], postoperative 24 hour pain scores [ MD=-0.73, 95% CI (-0.92, -0.54), P<0.001], postoperative 48 hour pain scores [ MD=-0.69, 95% CI (-0.84, -0.53), P<0.001], postoperative 72 hour pain scores [ MD=-0.37, 95% CI (-0.59, -0.16), P<0.001], and postoperative pain scores during dressing changes [ MD=-1.11, 95% CI (-2.06, -0.16), P=0.02], and could improve patient postoperative comfort [ MD=8.31, 95% CI (6.57, 10.06), P<0.001] . Conclusions:As a non-pharmacological intervention, VR technology can alleviate postoperative pain and improve patient comfort in surgical patients. In the future, large-scale and high-quality research is still needed to further verify the effectiveness of VR technology.

Objective:To explore the current situation and influencing factors of amputation decision-making dilemma of diabetic foot patients.Methods:From July to December 2023, 200 patients with diabetic foot in the Tianjin Medical University General Hospital and Tianjin Medical University Chu Hsien-I Memorial Hospital were selected as study subjects by convenience sampling. General Information Questionnaire, Decisional Conflict Scale (DCS), Family APGAR Index, and Hospital Anxiety and Depression Scale were used to conduct a cross-sectional survey. Pearson correlation was used to analyze the correlation between diabetic foot patients' amputation decision-making dilemma and family caring, anxiety and depression, and multiple linear regression was used to analyze the influencing factors of diabetic foot patients' amputation decision-making dilemma.Results:A total of 200 questionnaires were distributed, and 180 valid questionnaires were collected, with a valid response rate of 90.0% (180/200). The DCS score of 180 patients with diabetic foot was (30.04±9.77), 76.7% (138/180) patients scored ≥25.0, and they had decision-making dilemma, and 25.0% (45/180) of patients scored ≥37.5, indicating decision-making delay. Multiple linear regression analysis showed that occupational status, diabetes course, family caring, anxiety and depression were the influencing factors of amputation decision-making dilemma of diabetic foot patients ( P<0.05) . Conclusions:Diabetic foot patients face certain dilemmas in the process of amputation decision-making. Clinical medical and nursing staff should reasonably evaluate the patient's occupational status, disease course, family caring, and psychological state, and develop personalized decision support strategies to improve decision quality and prevent changes in the patient's condition caused by delayed decision-making.

Objectives:To explore the effect of mammalian target of rapamycin (mTOR) antagonist rapamycin (RAPA) on the imbalance of regulatory immune T cell (Treg)/regulatory immune T cell (Th17) immune homeostasis in mice with heart failure (HF) by regulating mTOR signaling pathway. Methods:The model of heart failure after myocardial infarction was constructed by ligation of the left anterior descending coronary artery in 34 healthy C57BL/6 mice.The mice were randomly divided into sham operation group,heart failure (HF) group,low-dose (1 mg/[kg·d])RAPAgroup (RAPAL group),medium-dose (2 mg/[kg·d]) RAPA group (RAPAM group) group and high-dose (4 mg/[kg·d]) RAPA group (RAPAH group) according to the random number table method,with 6 mice in each group.RAPA was administered via tail vein for 4 weeks,and the other groups were injected with the same amount of normal saline by tail vein for 4 weeks.The cardiac structure and function of mice were evaluated by echocardiography.The morphological changes of myocardial tissue were observed by hematoxylin-eosin (HE) staining.The degree of myocardial fibrosis were observed by Sirius red staining The levels of Treg and Th17 cells in peripheral blood were detected by flow cytometry.Western blot was used to detect the protein expression of mTOR,phosphorylated-mTOR (p-mTOR) in myocardial tissue. Results:Echocardiography examination revealed that compared with sham operation group,left ventricular ejection fractions (LVEF) and left ventricular short axis shortening rate (LVFS) were significantly lower ( both P<0.01),and Left ventricular end-diastolic Diameter (LVEDD) and Left ventricular end-systolic diameter (LVEDS) were significantly larger (both P<0.05) in HF group.Compared with HF group,LVEF in RAPAL group,RAPAM group and RAPAH group were significantly higher (all P<0.01),LVFS were significantly higher (all P<0.05).LVEDS in RAPAM and RAPAH groups were significantly lower than those in HF group (both P<0.05).HE staining and Sirius red staining showed that compared with the sham operation group,the myocardial tissue of the HF group was disordered,broken,and enriched with myocardial fibrosis.Compared with the HF group,the myocardial tissue disorder,breakage,and myocardial fibrosis of the RAPAL group,RAPAM group,RAPAH group were all improved.Flow cytometry and protein immunoblotting showed that compared with the sham operation group,the percentage of peripheral blood Treg cells in the HF group was decreased (P<0.01),the percentage of Th17 cells was increased (P<0.01),the Treg/Th17 ratio was decreased (P<0.01),and There was no significant difference in the expression of p-mTOR protein in myocardial tissue (P>0.05).Compared with the HF group,the percentage of peripheral blood Treg cells in the RAPAL group,RAPAM group,RAPAH group were increased (all P<0.01),the percentage of Th17 cells were decreased (all P<0.05),the ratio of Treg/Th17 in the RAPAM and RAPAH groups were all increased (P both<0.01),and the expression of p-mTOR protein in myocardial tissue were all downregulated (both P<0.01). Conclusions:Targeted inhibition of mTOR signaling can regulate the imbalance of Treg/Th17 immune homeostasis in HF mice,reduce myocardial fibrosis and improve cardiac function,among which the high-dose RAPA has the most significant effect.

Atopic dermatitis (AD) is a common chronic inflammatory disease that often coexists with atopic diseases such as asthma, allergic rhinitis, and food allergies. In recent years, more and more studies have shown that AD is associated with various diseases such as cardiovascular diseases, autoimmune diseases, and mental disorders, which exacerbate the disease burden on patients with AD and severely affect their quality of life. This review summarizes AD-associated comorbidities reported in previous literature, analyzes their possible common pathogenesis, and explores potential treatments.

Objective:To explore the related risk factors for systemic embolism (SE) in patients aged≥75 years with non-valvular atrial fibrillation (NVAF).Methods:A case-control study. NVAF patients aged≥75 years who were hospitalized at the First Affiliated Hospital of Xinjiang Medical University from October 2018 to October 2020 were divided into no SE ( n=1 127) and SE ( n=433) groups according to the occurrence of SE after NVAF. Multivariate logistic regression was used to analyze SE-related factors in patients with NVAF without anticoagulation treatment. Results:In the multivariate model, the following factors were associated with an increased risk of SE in patients with NVAF: history of AF≥5 years [odds ratio ( OR)=2.75, 95% confidence interval ( CI) 1.98-3.82, P<0.01], lipoprotein(a)>300 g/L ( OR=2.07, 95% CI 1.50-2.84, P<0.01), apolipoprotein (Apo)B>1.2 g/L ( OR=1.91, 95% CI 1.25-2.93, P=0.003), left ventricular ejection fraction (LVEF) of 30%-49% ( OR=2.45, 95% CI 1.63-3.69, P<0.01), left atrial diameter>40 mm ( OR=1.54, 95% CI 1.16-2.07, P=0.003), and CHA 2DS 2-VASc score≥3 ( OR=15.14, 95% CI 2.05-112.13, P=0.01). ApoAI>1.6 g/L was negatively correlated with the occurrence of SE ( OR=0.28, 95% CI 0.15-0.51, P<0.01). Conclusions:History of AF≥5 years, lipoprotein(a)>300 g/L, elevated ApoB, left atrial diameter>40 mm, LVEF of 30%-49%, and CHA 2DS 2-VASC score≥3 are independent risk factors for SE whereas ApoAI>1.6 g/L is a protective factor against SE in patients with NVAF.

ObjectiveTo compare the incidence of respiratory and allergic diseases in children in Xuhui District， Shanghai in 2013 and 2020， and to determine the influencing factors. MethodsAnnual average levels of air pollutants including PM_2.5， PM₁₀， O₃， SO₂， and NO₂ were collected and described in Shanghai from 2013 to 2020. A cross-sectional survey was conducted by using a questionnaire among grade 3 to 5 students in a school in Xuhui District， Shanghai， in September 2013 and 2020， respectively. The questionnaire collected variables including living environment， daily habits， family history of respiratory and allergic diseases， and incidence of these diseases in children. Chi-square test was used to determine the difference across respiratory and allergic diseases. Logistic regression was conducted to determine the influencing factors. ResultsA total of 1 398 valid questionnaires were collected （705 in 2013 and 693 in 2020）. Compared with 2013， annual average concentrations of PM_2.5， PM₁₀， O₃， SO₂， and NO₂ in 2020 significantly decreased. The prevalence of bronchial asthma， bronchitis， persistent cough and persistent expectoration in 2013 were significantly higher than those in 2020 （P<0.05） in Xuhui District. Multivariate analysis showed that severe air pollution， boys， parents with asthma or allergy， parents with higher educational levels， and more allergens in household were the risk factors associated with the incidence of bronchial asthma， bronchitis， allergic rhinitis and atopic eczema （P<0.05）. Parents with allergy history， high smoking frequency of family member， and more allergens in household were the risk factors associated with the incidence of persistent cough and persistent expectoration （P<0.05）. ConclusionTo 2013，2020 air pollution in Shanghai has been mitigated and prevalence of bronchial asthma and bronchitis of children has decreased. Childhood respiratory and allergic diseases are associated with indoor and outdoor environment， family medical history， and family daily habits.

Extracorporeal membrane oxygenation (ECMO) is a technique in which breathing and circulation are supported extracorporeally. Severe trauma may induce cardiopulmonary failure, for which ECMO can play an adjunctive role in the salvage treatment of circulatory and respiratory failure when conventional treatments are ineffective. Bypass with ECMO can rapidly improve the state such as circulatory failure and hypoxemia in critically ill patients in short term and can partially or fully replace their cardiopulmonary function in long term, winning valuable time for normal recovery of cardiopulmonary function. Because of the physical state of severe trauma patients and the ECMO equipment, there are still various complications clinically. Trauma patients show high risk of bleeding, vulnerability to wound infection and probability of combined organ injury and dysfunction, so more comprehensive measures for the prevention and treatment of complications during the use of ECMO therapy are required. The authors review the research progress in complications and corresponding prevention and treatment strategies during ECMO support for severe trauma, aiming to provide a reference to prevent and treat these complications.