Objective:To investigate diagnostic and prognostic value of actin-binding protein ANLN in clear cell renal cell carcinoma(ccRCC)and its relationship with tumor microenvironment.Methods:Gene expression data and clinical data for ccRCC were downloaded from The Cancer Genome Atlas(TCGA).Relationship between ANLN expression and clinicopathological features was assessed by Wilcoxon rank sum test and Logistic regression.Receiver operating characteristic(ROC)curve was used to assess diagnostic value of ANLN expression in ccRCC.Kaplan-Meier and Cox regression analysis were used to investigate effect of ANLN expression on overall survival.Gene set enrichment analysis(GSEA)was used to identify signaling pathways associated with ANLN in ccRCC.Relationship between ANLN expression and immune infiltration was analyzed by ESTIMATE algorithm,tumor immune estima-tion resource(TIMER)and CIBERSORT algorithms.Relationship between ANLN and drug sensitivity was calculated using CellMiner database.Results:ANLN expression was significantly upregulated in ccRCC tissues.ANLN expression in ccRCC was correlated with clinicopathological features.ROC analysis showed that ANLN had a high diagnostic value in ccRCC.High ANLN expression was signifi-cantly associated with poor prognosis.Multivariate Cox regression analysis showed that high ANLN expression was an independent risk factor for overall survival in ccRCC patients.GSEA showed that ANLN was associated with multiple signaling pathways.In terms of immunity,ANLN was closely associated with tumor microenvironment,immune infiltration and immune checkpoint molecules in ccRCC.ANLN expression was negatively correlated with sensitivity of most antitumor drugs.Conclusion:ANLN is a potential diagnos-tic and prognostic biomarker and immunotherapeutic target for ccRCC.

Objective To observe the drainage pathways of interstitial fluid(ISF)and substance clearance pattern in rat brain with fluorescence tracing imaging and treacer-based MRI.Methods Thirty-three male SD rats were randomly divided into fluorescence tracing group(F group,n=18)and treacer-based MRI group(MRI group,n=15),then further divided into thalamic,hippocampal and caudate nucleus subgroups,respectively.Evans blue was injected to rats in F group,and cardiac perfusion was performed after injection,then brain tissue was harvested,and frozen sections were made to observe the drainage pathways of IFS in different subgroups.MRI was performed on rats in MRI group before and after injection of gadolinium-diethylenetriamine pentaacetic acid(Gd-DTPA)to observe signal intensity in ROI of brain regions in different subgroups,the signal unit ratio was calculated,and the changing trend was explored.Results ISF in thalamus,hippocampus and caudate nucleus had different dominant drainage pathways,and the time of tracer reached to adjacent brain regions and whole brain in F group were different.In MRI group,within 4 h after injection of Gd-DTPA,there were differences in direction and clearance rate among tracer in thalamus,hippocampus and caudate nucleus,mainly manifesting as the tracer in thalamus and hippocampus drained to the ipsilateral cortex and lateral ventricle,while the tracer in the caudate nucleus diffused to the cortex and midbrain,and there were differences of the peak time of tracer signal among adjacent drainage brain regions.Conclusion Fluorescence and MR dual-mode imaging showed that there were differences in the dominant drainage pathways of IFS and clearance rates of small molecule substances among hypothalamus,hippocampus and caudate nucleus of rats.

Male ; Humans ; Varicocele/surgery* ; Treatment Outcome ; Abdomen ; Vascular Surgical Procedures ; Microsurgery

Objective To study the quality standard of Gardenia jasminoides and its effective parts. Methods TLC was used to identify Gardenia jasminoides and its effective parts. The heavy metals, harmful elements, and moisture in Gardenia jasminoides and its effective parts were examined. The content of Gardenia jasminoides and its effective parts was determined by high performance liquid chromatography. Results TLC method could be used to identify Gardenia jasminoides and its effective parts. The moisture content of Gardenia jasminoides and its effective parts were 8.4% and 3.2%, respectively. ICP-MS was used to determine the contents of five elements in Gardenia jasminoides and its effective parts simultaneously. There was a good linear relationship between arsenic, cadmium, copper, mercury, and lead in the range of 0~20, 0~10, 0~500, 0~5 and 0~20 ng/ml, respectively; The method detection limit of each metal element was 3.3×10⁻⁵~1.3×10⁻³ mg/kg. The relative standard deviation (RSD) of precision was 0.32%~0.82%. RSD values of each element content showed that the method had good repeatability. And the recoveries of arsenic, cadmium, copper, mercury, and lead were 103%~112%, 98%~99%, 98%~99%, 105%~106% and 100%~103%, respectively (n=3). The stability of each element was good within 8 h. The contents of the five elements were within the limits of the current edition of Chinese Pharmacopoeia. The standard curve equation of gardenia was Y=15860X+22543, r=0.9999, indicating that there was a good linear relationship of gardenia in the range of 20.16~322.6 μg/ml. The RSD of precision was 1.86%. RSD of the two samples were 2.38% and 2.60%, respectively, indicated that the method had good repeatability. The average recovery of Gardenia was 99.1% (n=6). The stability of the two solutions was good within 8 h. The contents of gardenia and its effective parts were 5.71% and 34.2%, respectively. Conclusion The research on the quality of Gardenia jasminoides effective parts was carried out based on the research on the quality of Gardenia jasminoides, and the results met the requirements. Therefore, the method established in this experiment could control the quality of Gardenia jasminoides and its effective parts simultaneously.

To investigate the effect of nucleoside diphosphate kinase (NDK) on the synthesis of hyaluronic acid, nucleoside diphosphate kinase gene (ndk) was overexpressed along with the hyaluronic acid-producing genes in recombinant B.subtilis. Two engineered strains named Hp8tg and Pn8tg were constructed.Uniform hyaluronic acid (HA) could be obtained from both engineered strains.HA produced by both recombinant strains was confirmed by monosaccharide composition analysis, Fourier transform infrared spectometry and nuclear magnetic resonance spectroscopy.Inducing conditions of HA fermentation were optimized by response surface methodology.Overexpression of ndk could increase the production and molecular weight of HA by 1.3-fold and 1.1-fold, respectively. This study revealed for the first time that overexpression of ndk could relieve the inhibition effect of uridine diphosphate (UDP) on Class II HA synthase and increase the production and molecular weight of HA, which proves to be an efficient strategy for the production of HA, and the preparation of other polysaccharides.

In recent years， with the change in life style， social environment， and national childbearing policy， the proportion of high-risk pregnant women has increased significantly， triggering the spectrum of obstetric diseases to constantly change， which has brought new challenges to the diagnosis and treatment of obstetrics. Traditional Chinese medicine （TCM） has been proved effective in dealing with a variety of obstetric diseases， and various treatment methods are available， which can serve as alternative means for solving refractory obstetric diseases. However， most obstetric clinicians are currently less aware of the therapeutic effects of TCM， which has significantly hindered its participation in clinical treatment. Therefore， the China Association of Chinese Medicine （CACM） organized the outstanding young obstetricians of TCM and western medicine to discuss 15 obstetric diseases responding specifically to TCM or integrated TCM and western medicine， including hyperemesis gravidarum， threatened abortion， ectopic gestation， cough during pregnancy， pregnancy-induced hypertension syndrome， maternal-fetal ABO incompatibility， postpartum hypogalactia， residual pregnancy tissue in uterine cavity， puerperal infection， pantalgia after childbirth， hematoma/undesirable healing after caesarean section， postpartum urinary retention， ileus after cesarean section， pelvic floor dysfunction， and postnatal depression. The suggestions for their treatment with TCM or integrated TCM and western medicine were also proposed， aiming to provide patients with effective and personalized treatments in clinical practice and improve the diagnosis and treatment effects of obstetric diseases， thus benefiting the public. At the same time， more obstetrical clinicians are expected to understand the therapeutic effects and advantages of TCM and draw on the strengths of both TCM and western， thereby promoting the establishment of an obstetric diagnosis and treatment system with Chinese characteristics.

Model informed precision dosing (MIPD) is a new concept to guide precision dosing for individual patient by modeling and simulation based on the available information about the individual patient, medications and the disease. Compared to the empirical dosing, MIPD could improve the efficacy, safety, economics and adherence of the pharmacotherapy according to the individual's pathophysiology, genotyping and disease progression. This consensus report provides a brief account of the concept, methodology and implementation of MIPD as well as clinical decision supporting systems for MIPD. The status and future advancing of MIPD was also discussed to facilitate the appropriate application and development of MIPD in China.

Objective:To understand the knowledge situation of sudden cardiac death (SCD) among general practitioners (GPs) and provide the suggestions on the prevention and treatment of SCD basis for GPs.Methods:A self-designed questionnaire on SCD-related knowledge was used for GPs in He′nan province, including GPs in the training program and working in rural areas.The questionnaire included three dimensions of SCD-related knowledge on prevention, early diagnosis and emergency treatment.There were 5 questions for each dimension, with a total score of 15 points for all 15 questions.Statistical analysis was performed using t test, analysis of variance and Chi-square test. Results:A total of 124 GPs were included in the cross-sectional survey, including 63 GP trainers and 61 rural GPs.The GPs had the low level of SCD-related knowledge of prevention, early diagnosis and emergency treatment, with an overall score of 8.03 (SD=2.58). The score of GP trainers was significantly higher than that of rural GPs in all three dimensions [(3.44±0.89)points vs.(2.19±1.06)points, (2.67±0.91)points vs.(1.43±0.80)points, (3.54±0.94)points vs.(2.84±1.30)points, t=7.13, 8.11, 3.45, all P<0.001]. Rural GPs had a significantly higher correct rate of " choice of early screening examinations" and " first-aid measures for cardiac arrest" than GP trainers (50.8% vs.9.8%, 88.9% vs.26.2%, χ 2=24.79, 49.02, all P<0.001). Conclusion:GPs have low levels of SCD-related knowledge.The training for the GPs should be targeted on the weak points of knowledge on the primary prevention and secondary prevention of SCD.

Objective: Comparing the benefit of Abidor, lopinavir/ritonavir and recombinant interferon α-2b triple combination antiviral therapy and lopinavir/ritonavir and interferon dual combination antiviral therapy to hospitalized novel coronavirus pneumonia 2019 in Zhejiang province. Methods: A multi-center prospective study was carried out to compare the effect of triple combination antiviral therapy with dual combination antiviral therapy in 15 medical institutions of Zhejiang Province. All patients were treated with recombinant interferon α-2b (5 million U, 2 times/d) aerosol inhalation. 196 patients were treated with abidol (200 mg, 3 times/d) + lopinavir / ritonavir (2 tablets, 1 time/12 h) as the triple combination antiviral treatment group. 41 patients were treated with lopinavir / ritonavir (2 tablets, 1 time/12 h) as the dual combination antiviral treatment group. The patients who received triple combination antiviral therapy were divided into three groups: within 48 hours, 3-5 days and > 5 days after the symptom onset. To explore the therapeutic effects of triple combination antiviral drugs and dual combination antiviral drugs, as well as triple combination antiviral drugs with different antiviral initiate time. SPSS17.0 software was used to analyze the data. Results: The time of virus nucleic acid turning negative was (12.2 ± 4.7) days in the triple combination antiviral drug group, which was shorter than that in the dual combination antiviral drug group [(15.0 ± 5.0) days] (t = 6.159, P < 0.01 ). The length of hospital stay [12 (9, 17) d] in the triple combination antiviral drug group was also shorter than that in the dual combination antiviral drug group [15 (10, 18) d] (H = 2.073, P < 0.05). Comparing the antiviral treatment which was started within 48 hours, 3-5 days and > 5 days after the symptom onset of triple combination antiviral drug group, the time from the symptom onset to the negative of viral shedding was 13 (10,16.8), 17 (13,22) and 21 (18-24) days respectively (Z = 32.983, P < 0.01), and the time from antiviral therapy to the negative of viral shedding was (11.8±3.9) , (13.5±5.1) and (11.2±4.3) d. The differences among the three groups were statistically significant (Z=32.983 and 6.722, P<0.01 or<0.05). Conclusions The triple combination antiviral therapy of Abidor, Lopinavir/Litonavir and recombinant interferon α-2b showed shorter viral shedding time and hospitalization time compared with the dual combination antiviral therapy. The earlier the time to initiate triple antiviral treatment, the shorter the time of virus shedding.

Purpose: This study aimed to evaluate nursing students’ understanding of the prevention of COVID-19, as well as their anxiety towards the disease and their perception of their professional identity in the wake of the pandemic, in Zhengzhou, China. Methods: A cross-sectional study was designed to investigate 474 nursing students by cluster sampling using a stratified questionnaire from February 15 to March 31, 2020. Multiple linear regression was used to identify the factors affecting professional identity. Binary and multiple logistic regression were used to identify the factors affecting anxiety. Results: Responders with a high level of understanding of COVID-19 and frequent use of behavioral strategies for its prevention comprised 93.2% and 30.0% of the cohort, respectively. Professional identity was significantly associated with gender and anxiety (p < .050). The prevalence of anxiety among nursing students was 12.4%. Male (odds ratio [OR] = 2.39; 95% confidence interval [CI] = 1.26~4.52), sophomores (OR = 5.30; 95% CI = 1.61~7.45), and infrequent use of prevention measures (OR = 3.49; 95% CI = 1.16~5.19) had a significant effect on anxiety. Conclusion Anxiety during the COVID-19 epidemic gives an adverse effect on the professional identity of nursing in students. Nursing education institutions need to provide psychological counseling services for nursing students, in addition to improving their teaching of COVID-19 prevention strategies.