Messenger RNA (mRNA) has drawn much attention in the medical field. Through various treatment approaches including protein replacement therapies, gene editing, and cell engineering, mRNA is becoming a potential therapeutic strategy for cancers. However, delivery of mRNA into targeted organs and cells can be challenging due to the unstable nature of its naked form and the low cellular uptake. Therefore, in addition to mRNA modification, efforts have been devoted to developing nanoparticles for mRNA delivery. In this review, we introduce four categories of nanoparticle platform systems: lipid, polymer, lipid-polymer hybrid, and protein/peptide-mediated nanoparticles, together with their roles in facilitating mRNA-based cancer immunotherapies. We also highlight promising treatment regimens and their clinical translation.

Objective:To investigate the application value of barbed suture in reinforcing anastomosis during laparoscopic radical resection of rectal cancer.Methods:The retrospective cohort study was conducted. The clinicopathological data of 215 patients with rectal cancer who underwent laparoscopic radical resection in the Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine from March 2016 to December 2018 were collected. There were 122 males and 93 females, aged (62.3±0.7)years, with a range from 20 to 75 years. Of 215 patients, 86 patients undergoing laparoscopic radical resection of rectal cancer with barbed suture for anastomosis were allocated into barbed suture group, and 129 patients undergoing laparoscopic radical resection of rectal cancer without reinforced anastomosis were allocated into traditional group, respectively. Observation indicators: (1) intraoperative situations; (2) postoperative situations; (3) follow-up. Follow-up using outpatient examination and telephone interview was performed to detect postoperative complications, anastomotic healing and patency of patients up to May 2019. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was analyzed using the t test. Measurement data with skewed distribution were described as M (range). Count data were described as absolute numbers or percentages, and comparison between groups was analyzed using the chi-square test. Ordinal data were analyzed using the Friedman non-parametric test. Results:(1) Intraoperative situations: patients in the two groups underwent laparoscopic radical resection of rectal cancer successfully, without conversion to open laparotomy. The volume of intraoperative blood loss, operation time, distance between the anastomosis and dentate line, length of auxiliary incision of the barbed suture group were (127±9)mL, (160.2±3.8)minutes, (3.56±0.15)cm, (4.12±0.11)cm, respectively, versus (114±6)mL, (128.9±2.4)minutes, (3.67±0.12)cm, (4.25±0.09)cm of the traditional group. There was a significant difference in the operation time between the two groups ( t=7.33, P<0.05), but no significant difference in the other indicators between the two groups ( t=1.32, 0.61, 0.94, P>0.05). (2) Postoperative situations: the time to first flatus after surgery and duration of postoperative hospital stay of the barbed suture group were (72.5±2.2)hours and (8.1±0.5)days, respectively, versus (76.2±1.7)hours and (8.0±0.5)days of the traditional group, showing no significant difference between the two groups ( t=1.33, 0.87, P>0.05). (3) Follow-up: 215 patients were followed up for 6-12 months, with a median follow-up time of 8 months. In the barbed suture group, 2 patients had postoperative anastomotic leakage, 5 had urinary retention, 6 had incision infection, 4 had intestinal obstruction, 3 had bowel dysfunction in 6 months after operation. In the traditional group, 13 patients had postoperative anastomotic leakage, 15 had urinary retention, 11 had incision infection, 8 had intestinal obstruction, 9 had bowel dysfunction in 6 months after operation. There was a significant difference in the anastomotic leakage between the two groups ( t=4.77, P<0.05), but no significant difference in the urinary retention, incision infection, intestinal obstruction, bowel dysfunction in 6 months after operation between the two groups ( t=2.07, 0.17, 0.22, 1.26, P>0.05). Patients in the two groups showed unobstructed intestinal tract on enteroscopy. Conclusion:The barbed suture for reinforcing anastomosis in radical resection of rectal cancer is safe and feasible, which can reduce the incidence of anastomotic leakage.

OBJECTIVE: To study the effect of aquaporin 4(AQP4) in regulating the permeability of blood-brain barrier(BBB) induced by subacute 1,2-dichloroethane(1,2-DCE) inhalation. METHODS: Specific pathogen free healthy CD-1 male Aqp4 genetically engineered mice(Aqp4~(+/+)and Aqp4~(-/-)) were randomly divided into control and low-, medium-and high-dose groups. The mice were exposed to 1,2-DCE at the dosages of 0.00, 100.00, 350.00 and 700.00 mg/m~3 for 6 hours per day for consecutive 28 days by systemic dynamic inhalation. After the end of 1,2-DCE exposure, the BBB permeability was evaluated by Evans blue staining. Real-time fluorescence quantitative polymerase chain reaction method was used to detect the mRNA expression of genes related to BBB tight junction protein(Tjp)1, Tjp2, Tjp3, claudin(Cldn)3, Cldn5, Cldn11, occludin(Ocln), matrix metalloproteinase(Mmp)2, Mmp9 and Na-K-Cl cotransporter-1(Nkcc1). RESULTS: The BBB permeability in mice showed significant change with 1,2-DCE dose and Aqp4 genotype(P<0.01). The BBB permeability of Aqp4~(+/+) genotype mice was higher in low-, medium-and high-dose groups than that of control group(all P values were <0.05). The permeability of BBB was lower in Aqp4~(+/+) genotype mice in the control group than that of Aqp4~(-/-) genotype mice in the same group(P<0.05), but BBB permeability was higher in Aqp4~(+/+) genotype mice in the three dose groups than that of Aqp4~(-/-) genotype mice in the same group(all P values were <0.05). The Cldn3 and Olcn mRNA relative expression in the brain cortex had statistical difference in mice with different genotype(all P values were <0.01). The mRNA relative expressions of Cldn3 and Olcn in the brain cortex were higher in Aqp4~(-/-) genotype mice than that of Aqp4~(+/+) genotype mice(all P values were <0.01). The relative mRNA expression levels of Tjp1, Tjp2, Tjp3, Cldn5, Cldn11, Mmp2, Mmp9 and Nkcc1 in the cerebral cortex of mice were not statistically significant in aspect of 1,2-DCE exposure dose and genotype(all P values were >0.05). CONCLUSION: Exposure to 1,2-DCE can increase BBB permeability in mice, and the mechanism may be associated with 1,2-DCE-induced down-regulation of Aqp4 and up-regulation of mRNA expression of the cerebral cortex TJP-related molecules Cldn3 and Ocln.

Objective:To compared the short-term surgical outcomes of the vertical supraumbilical incision with the left lower oblique incision for specimen retrieval in laparoscopic resection for rectal cancer.Methods:A retrospective cohort study was performed. Inclusion criteria: (1) rectal cancer confirmed by colonoscopy and pathological examination; (2) undergoing the operation for the first time; (3) laparoscopic rectal surgery performed by the same surgeon team; (4) age of > 18 years and < 76 years old. According to above criteria, clinical data of 178 consecutive patients scheduled for laparoscopic surgery for rectal cancer at Department of Gastrointestinal Surgery of Renji Hospital between March 2015 and December 2017 were collected. Based on incision site of the mini-laparotomy, patients were classified to the vertical supraumbilical incision group (n=75) and the left lower oblique incision group ( n=103). There were no significant differences in baseline data, such as age, gender, body mass index (BMI), tumor diameter, preoperative carcinoembryonic antigen (CEA) level, score of American Society of Anesthesiologists, TNM stage, between the two groups (all P>0.05). Perioperative variables and follow-up data were compared between two groups. Results:Between the vertical supraumbilical incision group and the left lower oblique incision group, the operation time [(131.7±3.7) minutes vs. (138.5±3.5) minutes], operative bleeding volume [(138.9±11.5) ml vs. (154.3±10.3) ml], length of auxiliary incision [(4.0±0.1) cm vs. (4.0±0.1) cm], and distance from anastomosis to dentate line [(3.8±0.1) cm vs. (4.2±0.1) cm] were not significantly different (all P>0.05). As compared to the left lower oblique incision group, patients in vertical supraumbilical incision group had earlier flatus [(62.7±2.3) hours vs. (69.2±1.7) hours, t=2.282, P=0.023], earlier ambulation [(41.9±1.8) hours vs. (46.78±1.42) hours, t=2.131, P=0.032], lower pain VAS scores at postoperative 24 hours (2.0±0.1 vs. 2.4±0.1, t=2.172, P=0.032) and 48 hours (2.7±0.1 vs. 3.0±0.1, P<0.05), and lower incidence of postoperative incisional hernia [6.7% (5/75) vs. 9.7% (10/103), χ 2=3.942, P=0.042]. However, the postoperative fluids intake time, hospitalization days, pain VAS scores at postoperative 12 hours and postoperative complications (wound infection, anastomotic leakage, urinary retention, intestinal obstruction) were not significantly different between the two groups (all P>0.05). Conclusion:The vertical supraumbilical incision in laparoscopic resection for rectal cancer can reduce the degree of postoperative pain, facilitate early recovery of intestinal function and decrease the incidence of incisional hernia.

Objective:To compared the short-term surgical outcomes of the vertical supraumbilical incision with the left lower oblique incision for specimen retrieval in laparoscopic resection for rectal cancer.Methods:A retrospective cohort study was performed. Inclusion criteria: (1) rectal cancer confirmed by colonoscopy and pathological examination; (2) undergoing the operation for the first time; (3) laparoscopic rectal surgery performed by the same surgeon team; (4) age of > 18 years and < 76 years old. According to above criteria, clinical data of 178 consecutive patients scheduled for laparoscopic surgery for rectal cancer at Department of Gastrointestinal Surgery of Renji Hospital between March 2015 and December 2017 were collected. Based on incision site of the mini-laparotomy, patients were classified to the vertical supraumbilical incision group (n=75) and the left lower oblique incision group ( n=103). There were no significant differences in baseline data, such as age, gender, body mass index (BMI), tumor diameter, preoperative carcinoembryonic antigen (CEA) level, score of American Society of Anesthesiologists, TNM stage, between the two groups (all P>0.05). Perioperative variables and follow-up data were compared between two groups. Results:Between the vertical supraumbilical incision group and the left lower oblique incision group, the operation time [(131.7±3.7) minutes vs. (138.5±3.5) minutes], operative bleeding volume [(138.9±11.5) ml vs. (154.3±10.3) ml], length of auxiliary incision [(4.0±0.1) cm vs. (4.0±0.1) cm], and distance from anastomosis to dentate line [(3.8±0.1) cm vs. (4.2±0.1) cm] were not significantly different (all P>0.05). As compared to the left lower oblique incision group, patients in vertical supraumbilical incision group had earlier flatus [(62.7±2.3) hours vs. (69.2±1.7) hours, t=2.282, P=0.023], earlier ambulation [(41.9±1.8) hours vs. (46.78±1.42) hours, t=2.131, P=0.032], lower pain VAS scores at postoperative 24 hours (2.0±0.1 vs. 2.4±0.1, t=2.172, P=0.032) and 48 hours (2.7±0.1 vs. 3.0±0.1, P<0.05), and lower incidence of postoperative incisional hernia [6.7% (5/75) vs. 9.7% (10/103), χ 2=3.942, P=0.042]. However, the postoperative fluids intake time, hospitalization days, pain VAS scores at postoperative 12 hours and postoperative complications (wound infection, anastomotic leakage, urinary retention, intestinal obstruction) were not significantly different between the two groups (all P>0.05). Conclusion:The vertical supraumbilical incision in laparoscopic resection for rectal cancer can reduce the degree of postoperative pain, facilitate early recovery of intestinal function and decrease the incidence of incisional hernia.

OBJECTIVE: To investigate the effect of 1,2-dichloroethane(1,2-DCE) acute inhalation exposure on the differential gene expression of phase Ⅰ metabolic enzymes. METHODS: The specific pathogen free SD rats were randomly divided into control group(16 rats), low-and high-dose groups(24 rats in each group, half males and half females). Low-and high-dose group were given daily 600, 1 800 mg/m~(3 ) of 1,2-DCE, and the control group given the fresh air by dynamic inhalation for 8 hours per day for consecutive 7 days. After the end of exposure, the relative mRNA expression of cytochrome P450 2 E1(CYP2 E1), alcohol dehydrogenase(ADH1) and acetaldehyde dehydrogenase 3 alpha 1(ALDH3α1) in the liver tissue was detected by real-time fluorescence quantitative polymerase chain reaction. RESULTS: The relative expression of CYP2 E1 in male high-dose group was higher than that in male low-dose group and female high-dose group(P<0.05). The relative expression of ADH1 in male low-and high-dose groups was higher than that in male control group(P<0.05). The relative expression of ADH1 in male high-dose group was higher than that in male low-dose group and female high-dose group(P<0.05). The relative expression of ALDH3α1 in high-dose group was higher than that in control group and low-dose group(P<0.05). CONCLUSION: High dose 1,2-DCE could increase the gene expression of phase Ⅰ metabolic enzymes in rat liver. The 1,2-DCE has more obvious effect in male rats than in female rats.

OBJECTIVE: To evaluate the effect of different types of microplate and loading volumes on the detection results of multi-function microplate reader, and to optimize the analysis method. METHODS: A multi-function microplate reader was used to perform spectrum scanning on each of 5 detection holes of common and ultraviolet(UV) microplates, and the applicable detection wavelength range was those with light transmittance greater than 80.00%. The optical density measurement was carried out on each 12 detection holes of common and UV microplates at different wavelengths, then the matching of the detection holes was compared. Potassium permanganate was quantitatively analyzed by common microplate and UV microplate, while acetone was analyzed by UV microplate, and then detection limit, lower limit of quantitation(LLQ), accuracy and precision at different loading volumes and concentrations were calculated and compared. RESULTS: The shortest applicable analyzing wavelengths for common and UV microplates were(362±2) and(230±3) nm respectively, while the longest applicable analyzing wavelengths were both 1 000 nm. The light transmittance of UV microplate was higher than that of common microplate when the analyzing wavelengths were lower than 400 nm(P<0.01). The deviation and range of light transmittance of detection holes analyzed by UV microplates were smaller than that of common microplates when the analyzing wavelengths were 350-1 000 nm(P<0.05). The detection limit and LLQ of potassium permanganate by multi-function microplate reader was not associated with the types of microplate. The adding standard recoveries of potassium permanganate by UV microplate was higher than that by common microplate(P<0.05). The adding standard recoveries of potassium permanganate by loading volumes of 200 and 250 μL was lower than that by loading volumes of 150 μL(P<0.01), while adding standard recovery of acetone by loading volumes of 200 μL was lower than that by loading volumes of 150 μL(P<0.05). CONCLUSION: When using a multi-function microplate reader to detect chemicals, it is recommended to use UV microplate with wavelengths at the range of 230-1 000 nm, and loading volumes of 200-250 μL.

Objective To investigate the efficacy and safety of Irbesartan Hydrochlorothiazide combined with Metoprolol as initial therapy in the treatment of heart failure in the elderly.Methods A total of 128 elderly patients with heart failure admitted into our hospital from September 2017 to August 2018 were randomly divided into Group A(n=64)and Group B(n=64).Group A was treated with oral Irbesartan Hydrochlorothiazide tablets.Group B was treated with sustained-release oral Metoprolol tablets in addition to what was given in Group A.Therapeutic effects were compared between the groups.Results Compared with Group A,the effectiveness rate of group B was significantly improved(93.8％ vs.81.3％,x2 =4.571,P=0.033).There was no significant difference in brain natriuretic peptide (BNP),interleukin (IL)-12,left ventricular ejection fraction (LVEF),left ventricular end-systolic diameter(LVESD),or left ventricular end-diastolic diameter(LVEDD)between the two groups before treatment (P＞0.05).Compared with Group B,BNP,IL-12,LVEF,LVESD and LVEDD had significantly better profiles in Group A after treatment (P ＜ 0.05).The time-domain measurements of heart rate variability such as sequential five-minute R-R interval means(SDANN),standard deviation of the N-N interval(SDNN),percent of differences between adjacent RR intervals ＞50ms(PNN50)and root mean square of the successive differences(RMSSD)were higher in Group B than in Group A after treatment.No serious adverse reactions were observed in either group,and there was no significant difference in the incidence of adverse reactions between the two groups(4.7％ vs.7.8 ％,x2 =0.533,P =0.465).Conclusions Irbesartan Hydrochlorothiazide combined with Metoprolol as initial therapy has good clinical effects in treating elderly heart failure.It can not only improve the clinical symptoms of patients,but also ensure clinical medication safety.

Crohn's disease(CD)is a chronic non-specific intestinal inflammatory disease,and the incidence of perianal fistulizing CD(PFCD)is 17%-43%. Non-cutting setons is the first choice for surgical treatment of PFCD. Some new surgical methods are effective for specific types of PFCD,however,the efficacy of most new methods remains to be confirmed by further studies. The multidisciplinary team(MDT)mode has become a new direction of PFCD surgery. This article reviewed the advances in surgical treatment of PFCD.

OBJECTIVE: To investigate the effects of subacute systemic inhalation exposure of 1,2-dichloroethane(1,2-DCE) on learning and memory in NIH mice. METHODS: Forty-five specific pathogen free healthy 7-week-old NIH mice were randomly divided into control,low-dose and high-dose groups with 5 female mice and 10 male mice in each group. The mice were exposed to 1,2-DCE at dosages of 0. 00,100. 00 and 350. 00 mg/m3 for 6 hours per day for consecutive 28 days by dynamic systemic inhalation. The neurobehavioral tests of mice were performed before and after the first to fourth weeks of exposure using the Morris water maze test. RESULTS: There was no significant difference in body weight and swimming speed among the three groups of mice( P > 0. 05). The navigation experiment results showed that the escape latency of mice in both low-and high-dose groups were longer than that of the control group at the same time point(P < 0. 05) during 1-4 weeks after exposure. In the control group,the escape latency was shorter than that of the same group before exposure( P < 0. 05). The escape latency of high-dose group prolonged with the increase of exposure time,and in the 4 th week the escape latency was significantly higher than that of the same group before exposure( P < 0. 05).The experiment results of space exploration indicated that the first time of crossing platform in low-and high-dose groups were longer than that of the control group at the second to the fourth week( P < 0. 05). The target quadrant retention time and the number of crossing the platform in the low-and high-dose groups were lower than those in the control group( P <0. 05). CONCLUSION: Subacute inhalation exposure of 1,2-DCE can impair the learning and memory ability of NIH mice.The high-dose exposure may reduce learning ability in mice in a time-effect manner.