In order to promote the innovative application of Sanjiao theory and Yingwei theory， this paper tries to apply the ''Sanjiao-Yingwei'' Qi transformation theory to the treatment of tumor diseases， integrating it with T cell exhaustion mechanism to elaborate on its scientific connotation and using network pharmacology and bioinformatics to elucidate the correlation between the anti-tumor mechanism of ''Sanjiao-Yingwei'' Qi transformation and T cell exhaustion. The ''Sanjiao-Yingwei'' Qi transformation function is closely related to the immunometabolic ability of the human body， and the ''Sanjiao-Yingwei'' Qi transformation system constitutes the immunometabolic exchange system within and outside the cellular environment. Cancer toxicity is generated by the fuzzy Sanjiao Qi， and the long-term fuzzy Sanjiao Qi is the primary factor leading to T cell exhaustion， which is related to the long-term activation of T cell receptors by the high tumor antigen load in the tumor microenvironment. Qi transformation malfunction of the Sanjiao produces phlegm and collects stasis， which contributes to T cell exhaustion and is correlated with nutrient deprivation， lipid accumulation， and high lactate levels in the immunosuppressed tumor microenvironment， as well as with the release of transforming growth factor-β and upregulated expression of programmed death receptor-1 by tumor-associated fibroblasts and platelets in the tumor microenvironment. Ying and Wei damage due to Sanjiao Qi transformation malfunction is similar to the abnormal manifestations such as progressive loss of exhausted T cell effector function and disturbance of cellular energy metabolism. Guizhi decoction， Shengming decoction， and Wendan decoction can correct T cell exhaustion and exert anti-tumor effects through multi-target and multi-pathways by regulating ''Sanjiao-Yingwei'' Qi transformation， and hypoxia inducible factor-1α （HIF-1α） may be one of the main pathways to correct T cell exhaustion. It was found that HIF-1α may be one of the important prognostic indicators in common tumors by bioinformatics. The use of the ''Sanjiao-Yingwei'' Qi transformation method may play an important part in improving the prognosis of tumor patients in clinical practice.

Objective:To study the postoperative complications and its risk factors in patients undergoing breast reconstruction with abdominal flaps.Methods:The clinical data of patients undergoing breast reconstruction with abdominal flaps at Department of Breast Oncoplastic Surgery, Tianjin Medical University Cancer Institute and Hospital from Jan 2011 to Apr 2022 were reviewed.Results:Postoperative complications occurred in 95 of 484 patients (19.6%), 15.5% had flap complications, 5.2% had donor-site complications, and fat necrosis was the most common complication (11.9%). The rate of fat liquefaction decreased significantly through technical improvement (1.7% vs. 7.0%); By univariate analysis, there were statistically significant differences among the groups by reconstructive type, neoadjuvant chemotherapy, BMI, smoking history ( χ2=21.088, P<0.001; χ2=4.385, P=0.036; χ2=14.784, P=0.018; χ2=19.015, P=0.048). Unplanned reoperation statistically related to the timing of reconstruction, and reconstructive type ( χ2=7.316, P=0.007; χ2=17.167, P<0.001). Revision surgery significantly related to the timing of reconstruction and timing of radiation ( χ2=40.785, P<0.001; χ2=18.602, P<0.001);By multivariate analysis, deep inferior epigastric perforator flap, smoking history were independent risk factors for flap necrosis ( OR=0.084, 95% CI:0.022-0.325, P<0.001; OR=41.623, 95% CI:3.241-534.569, P=0.004) . Conclusions:Complications after breast reconstruction with abdominal flaps are related to many factors. The surgical risks should be carefully evaluated and personalized plan should be formulated before surgery.

With the population aging, the prevalence rate of cardiovascular diseases in China continues to rise, among which, the mortality rate of aortic diseases is high, the treatment is difficult, and the risk is high. In recent years, the surgical treatment of aortic diseases in China has developed rapidly, and the overall scale has been increasing. This paper introduces the current status of treatment of aortic diseases in China, analyzes the medical quality of endovascular surgery and open surgery, including the number of operations, patient characteristics, mortality, readmission rate and other indicators, and compares the differences among different regions. In addition, advances in the treatment of aortic disease are discussed, including surgical methods, evaluation of effectiveness, and application of new technologies. Overall, China has made some progress in the treatment of aortic diseases, but it still faces the challenge of uneven distribution of medical resources and improvement of medical quality.

Objective:To compare the effect of self-radiopaque markers guiding physician-modified fenestration, chimney technique and hybrid Ⅳb technique on reconstruction of left subclavian artery (LSA) in endovascular treatment of aortic dissection (TEVAR).Methods:The clinical and follow-up data of 312 TEVAR patients treated with LSA blood supply reconstruction technology from Jan 2016 to Dec 2019 at Fuwai hospital were retrospectively analyzed.Results:There were 35 patients in the hybrid Ⅳb technique group, 93 in the chimney technique group, and 184 in the in vitro fenestration group. The follow-up period ranged from 12 to 24 months. No artificial blood vessel and stent occlusion occurred in all patients during follow-up, and the LSA blood flow was unobstructed. A total of 19 patients had endoleak by the last follow-up, and there was no statistical difference between the three groups. Eleven patients underwent reintervention surgery, all were from chimney technique group and in vitro fenestration group, with no statistical difference ( P>0.05). Severe complications occurred in 28 patients during hospitalization, and the incidence of complications was the highest in the hybrid Ⅳb technique group ( P<0.01). During follow-up, 4 patients died in the bypass group, 6 died in the external window group, and 8 died in the chimney group, with no significant difference ( P>0.05). Conclusions:The safety and efficacy of the left subclavian artery flow reconstruction by in vitro fenestration and chimney technique were similar. The occurrences of early complications were lower than that of the hybrid Ⅳb technique, but the reintervention rate of endoleak was higher.

Objective:To explore the expression and importance of Piezo1, E-cadherin, and Vimentin in nasal polyps patients. Methods:Thirty-five patients undergoing endoscopic sinus surgery under general anesthesia were streamed into 20 cases of nasal polyps（NP group） and 15 cases of simple septoplasty without any sinus disease（Control group）. Immunofluorescence staining and Western Blot were applied to detect the protein level of Piezo1, E-cadherin, and Vimentin in NP tissues and nasal polyp-derived primary human nasal epithelial cells（pHNECs）. Also, BEAS-2B cell lines were treated with human TGF-β1 protein to establish epithelial mesenchymal transition（EMT） model in vitro and quantitative real-time polymerase chain reaction were used to calculate Piezo1 and above biomarkers in the model. Results:Compared with control group, Piezo1 and Vimentin showed higher level while E-cadherin was lower in NP tissues and pHNECs.In EMT model in vitro, Piezo1 and Vimentin were demonstrated higher expression with decreased level of E-cadherin. Conclusion:The tendency of Piezo1 is consistent with the mesenchymal-related biomarker Vimentin, going against with epithelial-related biomarker E-cadherin, implying its involvement with EMT process in nasal polyps.
Humans ; Biomarkers/metabolism* ; Cadherins/metabolism* ; Chronic Disease ; Epithelial-Mesenchymal Transition ; Nasal Polyps/metabolism* ; Rhinosinusitis ; Sinusitis ; Transforming Growth Factor beta1/metabolism* ; Vimentin/metabolism*

Single chain antibody fragment (scFv) is a small molecule composed of a variable region of heavy chain (VH) and a variable region of light chain (VL) of an antibody, and these two chains are connected by a flexible short peptide. scFv is the smallest functional fragment with complete antigen-binding activity, which contains both the antibody-recognizing site and the antigen-binding site. Compared with other antibodies, scFv has the advantages of small molecular weight, strong penetration, low immunogenicity, and easy expression. Currently, the most commonly used display systems for scFv mainly include the phage display system, ribosome display system, mRNA display system, yeast cell surface display system and mammalian cell display system. In recent years, with the development of scFv in the field of medicine, biology, and food safety, they have also attracted much attention in the sectors of biosynthesis and applied research. This review summarizes the advances of scFv display systems in recent years in order to facilitate scFv screening and application.
Animals ; Immunoglobulin Variable Region/genetics* ; Immunoglobulin Fragments/metabolism* ; Single-Chain Antibodies/metabolism* ; Peptide Library ; Mammals/genetics*

Objective:To investigate the clinical effects of Ilizarov external fixation combined pedicle flap transfer in the treatment of infected tibial nonunion plus soft tissue defects.Methods:A retrospective study was performed to analyze the data of 35 patients with infected tibial nonunion plus soft tissue defects who had been admitted to Department of Orthopedic Trauma, Tianjin Hospital Affiliated to Tianjin University from July 2005 to July 2020. There were 25 males and 10 females with an age of (37.5±6.0) years. Their original traumas were 27 open and 8 closed fractures, with a disease course ranging from 8 to 42 months. Three patients had undergone 1 operation, 7 patients 2 operations, and 25 patients 3 or more operations. All patients presented with different degrees of skin and soft tissue defects or bone exposure, wound sinus formation and bone scaring. The size of pedicle flaps transferred ranged from 6 cm×5 cm to 15 cm×10 cm. Surgical transfer of skin flap and external fixation were performed at one stage in 25 patients while staged surgery was performed in 10 patients. The first stage consisted of local debridement, vacuum sealing drainage, and delayed flap operation while the second stage consisted of delayed flap transfer and Ilizarov external fixation. The survival of skin flap, limb shortening, bony union and complications were observed after operation. The limb function was evaluated according to the criteria of The Association for the Study and Application of Methods of Ilizarov (ASAMI) for bone and functional results.Results:All patients were followed up for (23.8±7.4) months. Fracture union was achieved in all. The flaps survived postoperatively, the wounds were repaired by the first intention, infection did not recur, and bony union was achieved in 32 patients. Partial necrosis of the flap edge occurred in 3 cases, but responded to dressing change. In the 10 patients undergoing delayed flap operation, 100% of the flaps survived. In all patients, the limbs were shortened by (0.8±0.1) cm, and the tibial fractures got united after (7.2±1.2) months. By the ASAMI criteria for bone results, 29 cases were excellent and 6 cases good; by the ASAMI criteria for functional results, 25 cases were excellent, 8 cases good, and 2 cases fair.Conclusion:As Ilizarov external fixation combined pedicle flap transfer can repair bone and soft-tissue defects at the same time, this surgical scheme facilitates infection control and leads to reliable outcomes.

Objective:To understand the employment situation of graduates of public health-related majors and explore the associated factors of turnover intention among public health practitioners in China.Methods:In April 2020, the convenient sampling method was used to recruit public health related graduates from 98 universities with public health-related majors from 31 provinces in China (excluding Hong Kong, Macao and Taiwan) and from Chinese Center for Disease Control and Prevention (only including working or unemployed status, no requirement for graduation years). A total of 1 322 questionnaires were collected, of which 1 165 (88.1%) were valid. Through the network questionnaire survey, the information of public health graduates′ work situation, job satisfaction and turnover intention were collected. Multivariate logistic regression model was used to analyze the associated factors of turnover intention, and structural equation model was constructed to explore the correlation between turnover intention and job satisfaction.Results:The age of 1 165 graduates was (28.1 ±4.8) years. Among them, 719 (61.7%) were female and 856 (73.5%) graduates were engaged in public health-related work after graduation. The results of multivariate logistic regression analysis showed that compared with those over 30 years old, graduates under 30 years old had higher turnover intention ( OR=2.531, 95% CI: 1.549-4.155). Compared with those with junior or no title, graduates with senior title had higher turnover intention ( OR=2.310, 95% CI: 1.047-5.162). The results of structural equation model analysis showed that the four factors of job satisfaction, ‘salary and welfare’, ‘promotion development’, ‘work itself’, and ‘internal and external environment’, were negatively correlated with turnover intention. The internal and external environment had the greatest impact on turnover intention (total effect =-0.539). Conclusion:Most graduates of public health-related majors are engaged in public health-related work in China. Age, professional title and job satisfaction are the associated factors of turnover intention.

Objective:To understand the employment situation of graduates of public health-related majors and explore the associated factors of turnover intention among public health practitioners in China.Methods:In April 2020, the convenient sampling method was used to recruit public health related graduates from 98 universities with public health-related majors from 31 provinces in China (excluding Hong Kong, Macao and Taiwan) and from Chinese Center for Disease Control and Prevention (only including working or unemployed status, no requirement for graduation years). A total of 1 322 questionnaires were collected, of which 1 165 (88.1%) were valid. Through the network questionnaire survey, the information of public health graduates′ work situation, job satisfaction and turnover intention were collected. Multivariate logistic regression model was used to analyze the associated factors of turnover intention, and structural equation model was constructed to explore the correlation between turnover intention and job satisfaction.Results:The age of 1 165 graduates was (28.1 ±4.8) years. Among them, 719 (61.7%) were female and 856 (73.5%) graduates were engaged in public health-related work after graduation. The results of multivariate logistic regression analysis showed that compared with those over 30 years old, graduates under 30 years old had higher turnover intention ( OR=2.531, 95% CI: 1.549-4.155). Compared with those with junior or no title, graduates with senior title had higher turnover intention ( OR=2.310, 95% CI: 1.047-5.162). The results of structural equation model analysis showed that the four factors of job satisfaction, ‘salary and welfare’, ‘promotion development’, ‘work itself’, and ‘internal and external environment’, were negatively correlated with turnover intention. The internal and external environment had the greatest impact on turnover intention (total effect =-0.539). Conclusion:Most graduates of public health-related majors are engaged in public health-related work in China. Age, professional title and job satisfaction are the associated factors of turnover intention.

Objective:To investigate public health-related professions' recruit requirements and understand the training scheme for preventive medicine-majored undergraduates in colleges and universities in China.Methods:An online questionnaire was adopted to collect data on the recruit requirements of public health-related professions. Information on the core courses, internship, and practical training for preventive medicine-majored undergraduates was collected through universities' official websites.Results:The employers had a high requirement for education and specific majors. Also, administration professions attached importance to comprehensive quality, while professional positions to professional skills. 47.2% (67/142) employers made Talent Introduction Programs for the next three years. 20.0% (3/15) universities offered all the core courses required by national standards. For internship and practical training, both clinical practice and professional practice's median durations were 16 and 11 weeks, respectively.Conclusion:Employers showed significant demand for public health graduates and having a high requirement for personal ability and comprehensive quality. The universities should improve the setting of core courses and strengthen students' practical ability and overall quality.