Objective To investigate the relationship between cytochrome P450 3A5*3(CYP3A5*3)gene polymorphism and adverse reactions of apatinib monotherapy in advanced gastric cancer patients.Methods A total of 86 patients with advanced gastric cancer who received apatinib monotherapy at Nanjing First Hospital from January 2020 to June 2022 were selected,and 2 ml of peripheral venous blood from patients was collected.The genotype of CYP3A5*3 was identified using PCR-RFLP combined sequencing method,and its correlation with adverse reactions was analyzed by apatinib.Results Among the 86 patients,there were 29 cases of mutant heterozygous genotype(AG genotype)and 51 cases of mutant homozygous genotype(GG genotype),with a mutation type accounting for 93.02％.The incidence of hypertension and leukopenia in patients with the CYP3A5*3 GG genotype was significantly higher than in patients with the AA+AG genotype(χ2=6.154,6.947,P=0.043,0.027).Other adverse reactions related to apatinib treatment were not found to be associated with the CYP3A5*3 genotype(P＞0.05).In addition,no correlation was found between severe adverse reactions and the CYP3A5*3 genotype(P＞0.05).Conclusion The CYP3A5*3 GG genotype significantly increased the risk of hypertension and leukopenia caused by apatinib monotherapy,and no correlation was found with the risk of serious adverse reactions.

Objective:To explore the rehabilitation effect of multi-factor intervention based on the Finnish model of prevention of cognitive impairment in the elderly on patients with cognitive impairment after first-episode stroke, and to provide reference for rehabilitation nursing of cognitive impairment after stroke.Methods:The quasi-experiment research scheme was adopted and convenience sampling method was used to select participants with first-episode stroke cognitive impairment hospitalized in the General Hospital of Tianjin Medical University Airport Site. The 50 patients admitted from January to June 2022 were selected as the control group, and 50 patients admitted from July to December 2022 were selected as the intervention group. The control group received routine rehabilitation nursing and health education, and the intervention group received the Finnish model of prevention of cognitive impairment in the elderly on patients before discharge on the basis of the control group. The Mini-Mental State Examination (MMSE) and Health Education Compliance Assessment Scale for Stroke Patients were used to evaluate the changes of overall cognitive function and rehabilitation compliance before intervention, 3 and 6 months after intervention.Results:The final control group included 49 cases, including 35 males and 14 females, aged (64.67 ± 7.47) years old; the intervention group included 50 cases, 32 males and 18 females, aged (66.68 ± 8.75) years old. Before intervention, there were no significant differences in overall cognitive function and compliance of rehabilitation score ( P>0.05). At 3 and 6 months after intervention, the overall cognitive function score, the total score on compliance of rehabilitation, dimension scores of diet compliance, exercise rehabilitation compliance and health behavior compliance of the intervention group were (26.36±2.36) , (125.96 ± 13.80) , (23.30 ± 5.26) , (27.72 ± 4.46) , (43.66 ± 6.80) and (27.26 ± 3.71) , (152.44 ± 9.06) , (30.12 ± 6.42) , (33.32 ± 3.02) , (52.36 ± 4.70) , respectively. They were higher than the control group (24.04 ± 4.50) , (116.67 ± 10.26) , (19.31 ± 3.95) , (25.29 ± 3.45) , (40.59 ± 4.33) and (24.27 ± 4.33) , (138.92 ± 16.71) , (24.20 ± 4.48) , (30.00 ± 5.53) , (47.65 ± 8.03) , and the differences had statistical significance ( t values were -5.31- -2.67, all P<0.05). According to the variance analysis of repeated measurement, intergroup and time factor, the interaction between groups and time had significant impact on general cognitive function score, the total score of rehabilitation compliance, the dimension scores of diet, exercise rehabilitation and health behavior compliance ( Fgroup values were 8.33-18.08, Ftime values were 135.71-944.69, Finteraction values were 5.46-27.30, all P<0.05) . Time factor had significant impact on patient medication adherence score ( Ftime=206.23, P<0.05) . Conclusions:Multi-factor intervention based on the Finnish model of prevention of cognitive impairment in the elderly can improve the overall cognitive function and rehabilitation compliance of patients with cognitive impairment after first-episode stroke.

Objective To evaluate the efficacy,safety and economy of cyclin-dependent kinase 4/6(CDK4/6)inhibitors for the first-line treatment of hormone receptors positive(HR+),human epidermal growth factor receptor 2 negative(HER2-)advanced breast cancer(ABC)by rapid health technology assessment,and to provide evidence for clinicians and policymakers.Methods PubMed,Cochrane Library,Embase,CNKI,WanFang Data,VIP databases and the official website of health technology assessment(HTA)agency were electronically searched to collect clinical evidence and literature of CDK4/6 inhibitors in the treatment of HR+/HER2-ABC from the inception to December 31,2023.Two reviewers independently identified studies,extracted data,assessed the quality of included studies,and descriptively analyzed and summarised the results.Results A total of 33 articles were included,including 9 systematic reviews/Meta-analyses,15 pharmacoeconomic studies and 9 HTA reports.In terms of efficacy,compared with endocrine therapy alone,the addition of CDK4/6 inhibitors significantly improved progression-free survival(PFS)and overall survival(OS)in patients with HR+/HER2-ABC(P＜0.05),but there was no significant difference in efficacy among palbociclib,abemaciclib and ribociclib(P＞0.05).In terms of safety,more adverse events were observed in patients treated with CDK4/6 inhibitors when compared with endocrine therapy(P＜0.05).There was a difference in the incidence of adverse effects between the different CDK4/6 inhibitors,with palbociclib having higher incidence of haematological adverse effects(P＜0.05),and abemaciclib being more likely to cause gastrointestinal adverse reactions such as diarrhoea(P＜0.05).The economic evaluation results were variable due to differences in healthcare costs,analysis perspectives,willingness-to-pay thresholds,and study duration in different countries.Conclusion CDK4/6 inhibitors have similar efficacy in the first-line treatment of HR+/HER2-ABC patients,but there are some differences in aspects such as safety and economy.

Objective:To analyze and monitor the genetic stability of Omicron strain inactivated vaccine.Methods:The virus seeds of Omicron strain for inactivated vaccine through different routes, that was with plaque purification or not, were continuously passaged on cells, and then the supernatant of cell culture was harvested to extract virus nucleic acid. The next generation sequencing was used to analyze virus transcriptome, and the differences of mutation sites, mutation frequencies and insertions/deletions in the whole genome of Omicron virus under different conditions were compared.Results:After continuous passage, more than 5% mutation sites in ORF1ab and S gene sequences were significantly less in the plaque-purified seed than those of the virus without plaque purification, and no insertion/deletion mutations were detected in the whole genome of the purified virus.Conclusions:The nucleic acid sequences of virus with different routes were analyzed by next generation sequencing. The result showed that the genetic stability of virus after plaque purification was better than that of unpurified virus strains, which provides a scientific basis for virus seed selection in the development of inactivated vaccine.

To address the increasing need for detecting and validating protein biomarkers in clinical specimens, mass spectrometry (MS)-based targeted proteomic techniques, including the selected reaction monitoring (SRM), parallel reaction monitoring (PRM), and massively parallel data-independent acquisition (DIA), have been developed. For optimal performance, they require the fragment ion spectra of targeted peptides as prior knowledge. In this report, we describe a MS pipe-line and spectral resource to support targeted proteomics studies for human tissue samples. To build the spectral resource, we integrated common open-source MS computational tools to assemble a freely accessible computational workflow based on Docker. We then applied the workflow to gen-erate DPHL, a comprehensive DIA pan-human library, from 1096 data-dependent acquisition (DDA) MS raw files for 16 types of cancer samples. This extensive spectral resource was then applied to a proteomic study of 17 prostate cancer (PCa) patients. Thereafter, PRM validation was applied to a larger study of 57 PCa patients and the differential expression of three proteins in prostate tumor was validated. As a second application, the DPHL spectral resource was applied to a study consisting of plasma samples from 19 diffuse large B cell lymphoma (DLBCL) patients and 18 healthy control subjects. Differentially expressed proteins between DLBCL patients and healthy control subjects were detected by DIA-MS and confirmed by PRM. These data demonstrate that the DPHL supports DIA and PRM MS pipelines for robust protein biomarker discovery. DPHL is freely accessible at https://www.iprox.org/page/project.html?id=IPX0001400000.

OBJECTIVE To discuss the clinical traits,pathogenesis and TCM stepwise treatments of urinary tract infection(UTI) based on symptom differentiation among elderly patients.METHODS Because of the whole and the partial immune defense function descending,the elderly patients easily suffered from UTI,which was characterized by non-typical symptom,complex and serious condition.In the aspects of the pathogenesis of UTI among elderly patients,the principal aspect of which was the deficiency of the kidney and spleen(weakened body resistance)and the secondary incidental was accumulated damp-heat in the lower warmer(affected pathogenic factor),viz weaken healthy qi and excessive pathogenic factor.Hence during the clinical treatment we should attach importance to regulate entire faculty condition.Considering the acute attack stage and non-acute phase,we will differently inflict therapies of clearing away the heat-evil,dissolving dampness,treating stranguria,hemostasis,and invigorating spleen and kidney assisted by treating stranguria and so on,according to differentiation of symptoms and treatments,in which way we could give attention to both the principal and the secondary aspects of a disease.RESULTS The TCM stepwise therapy of UTI among elderly patients had the characteristics of high efficacy,few side reactions and stable long-term curative effects.CONCLUSIONS The TCM therapy of UTI among elderly patients has more potentiality and predominance,which deserves further study.

OBJECTIVE To investigate the clinical characteristics and prevention of urinary tract infections in chronic renal failure(CRF) patients.METHODS An analysis of pathogens and clinical characteristics of 96 hospitalized patients with CRF complicating urinary tract infections was performed.RESULTS Among CRF patients complicating urinary system infections,the most common pathogens were Escherichia coli(51.03%),Klebsiella pneumoniae(12.50%),Staphylococcus epidermidis(11.46),etc.There were no significant difference between symptom group and non-symptom group.But they were obviously more among senile patients over 60 years old in the asymptomatic group,accounted for 67.50% and significantly higher than that in symptomatic group(39.29%,P

Keshan disease was an endemic cardiomyopathy in China. The very low selenium intake of local people was considered to be an important causal factor. The main pathological characteristics of this disease was multifo-cal necrosis and fibrous replacement of myocardium that was scattered throughout the wall of all chambers.Two patterns of myocardial necrosis, myofibrillar pattern and mitochondrial pattern were distinguished in electron microscopy. The myofibrillar pattern was characterized by myofibril segmentation. It agreed well with the contraction band necrosis described in light microscopy. It was mainly seen in acute Keshan heart and might be related to circulatory disorders. Mitochondrial pattern was identical with myocytolysis of conventional pathology. It represented the typical lesion of Keshan disease.Mitochondria showed early and conspicuous changes in involved myo-cytes. Myofibrillar damage seemed to be secondary to the mitochondrial injury in the development of myocytolysis.Histochemical studies revealed that the acid phosphatase activity was obviously increased in muscle fibers surrounding the necrotic foci, and the succinic dehydrogenase activity was greatly reduced in damaged myocardio-cytes.