Objective To observe the effect of a new cell delivery tool(MSC exo)on the proliferation of pancreatic cancer by transferring targeted genes.Methods Transmission Electron Microscope(TEM)and Nanoparticle Tracking Analysis(NTA)were used to identify human mesenchymal stem cell exosomes(MSC-exo)and transport miR-450a-5p into CFPAC-1,to explore the effect of miR-450a-5p targeting BZW2 on inhibiting the proliferation of pancreatic cancer cells.Results The expression of miR-450a-5p was low in pancreatic cancer tissue(P<0.05),and the expression of CD63 and TSG101 of MSC-exo-miR-450a-5p in CFPAC-1 cells was higher than that of MSC-exo by Western blot(P<0.05).CCK-8 and EdU results showed that MSC-exo-miR-450a-5p significantly inhibited the proliferation of CFPAC-1 cells(P<0.05).Cell scratch and Transwell experiments showed that MSC-exo-miR-450a-5p can inhibit the migration and invasion of CFPAC-1 cells(P<0.05).Through dual luciferase assay,it was confirmed that miR-450a-5p targets BZW2,and RT-qPCR and Western blotting showed a negative correlation(P<0.05)between miR-450a-5p and BZW2 expression.Overexpression of BZW2,CCK-8,EdU,cell scratch,and Transwell experiments confirmed that pc-BZW2 reversed the anti-cancer function of MSC-exo-miR-450a-5p on CFPAC-1.Western blot detected PCNA,Ki-67,MMP2,MMP9,and the results were consistent with the above experiments(P<0.05).Conclusion hMSC exo is a new delivery system,targeting BZW2 to transport miR-450a-5p to inhibit the biological malignancy of pancreatic cancer cells,which provides an important clue for the research of targeted treatment of pancreatic cancer.

Objective:To summarize the electrophysiological characteristics of neuronal intranuclear inclusion disease (NIID) and explore the value of electrophysiological examination in NIID auxiliary diagnosis.Methods:Twenty NIID patients diagnosed by pathological biopsy and genetic confirmation (15 were symptomatic, 5 were asymptomatic), admitted to Department of Neurology, Affiliated Hospital of Xuzhou Medical University from February 2020 to June 2022 were chosen. Peripheral motor/sensory nerve conduction, needle electromyography, F wave, repetitive electrical stimulation, skin sympathetic reflex (SSR), and tremor were analyzed. Peripheral nerve conduction and SSR parameters were compared between 15 patients with symptomatic NIID (symptomatic NIID group) and 11 age- and gender-matched normal control subjects (control group).Results:(1) All 15 patients with symptomatic NIID were with abnormal electrophysiological findings: 14 patients had abnormal peripheral nerve conduction, including 14 with slowed motor nerve conduction velocity (MCV), 4 with reduced composite muscle action potential (cMAP) wave amplitude, 12 with slowed sensory nerve conduction velocity (SCV), and 3 with reduced sensory nerve action potential (sNAP) wave amplitude, and overall slowed nerve conduction velocity and relatively preserved wave amplitude were noted; 4 patients had neurogenic lesions by needle electromyography; 13 patients had prolonged F-wave latency at varied degrees; 12 showed abnormal SSR; 4 exhibited synchronous tremor from 4.0 to 7.5 Hz. (2) In 5 patients with asymptomatic NIID, 3 had abnormal peripheral nerve conduction, including 3 with slowed MCV, 2 with slowed SCV, and 1 with reduced sNAP wave amplitude; 3 showed abnormal SSR. (3) Significant differences in MCV and SCV, some cMAP and sNAP amplitudes, and SSR latency and amplitude were noted in nerves of the upper and lower extremities between the symptomatic NIID group and control group ( P<0.05). Conclusion:Peripheral nerve damages are common in patients with NIID, especially myelin damage and autonomic nerve injury, and some patients may have electrophysiological abnormalities before clinical symptoms; therefore, peripheral nerve conduction and SSR can be recommended as auxiliary screening tools for NIID.

Objective:To assess the imaging characteristics of muscle FDG metabolism, tumor incidence, and pulmonary interstitial changes in patients with anti-melanoma differentiation-associated gene 5 (MDA5) antibody positivity in 18F-FDG PET/CT imaging, and the value of 18F-FDG PET/CT in differentiating anti-MDA5 antibody positive dermatomyositis. Methods:From June 2016 to July 2019, the PET/CT images of 75 patients with dermatomyositis (21 males, 54 females, age (52.3±14.3) years; 34 anti-MDA5 antibody positive and 41 anti-MDA5 antibody negative) and 30 healthy controls (10 males, 20 females; age (53.5±11.8) years) were retrospectively analyzed in Renji Hospital, School of Medicine, Shanghai Jiao Tong University. The SUV max of muscle was measured and the mean of SUV max (mSUV max) was calculated. Statistics of patients with dermatomyositis complicated with neoplastic lesions and the SUV max of pneumonia lesions in patients with dermatomyositis complicated with interstitial pneumonia was determined. Independent sample t test, one-way analysis of variance, Student-Newman-Keuls (SNK) test and χ2 test were used to analyze data. The ROC curve analysis was used to analyze the diagnostic efficacy of mSUV max for the differential diagnosis of anti-MDA5 antibody positive dermatomyositis. Results:The muscle mSUV max of the control group, anti-MDA5 antibody positive and negative groups were 0.39±0.05, 0.66±0.21 and 0.87±0.29 ( F=39.93, P<0.001), respectively. The muscle mSUV max of dermatomyositis patients was increased compared with healthy controls ( q values: 6.76, 12.63, both P<0.001), and the muscle mSUV max of anti-MDA5 antibody negative was higher than positive ( q=5.79, P<0.001). The AUC was 0.74, and the cut-off value of muscle mSUV max was 0.75 with the accuracy of 74.7%(56/75). Of 41 patients with negative anti-MDA5 antibody, there were 6 (14.6%) had malignant tumor, while there was no malignant tumor in patients with positive anti-MDA5 antibody (0/34; χ2=5.41, P=0.020). There were 11 patients (26.8%, 11/41) with anti-MDA5 antibody negative dermatomyositis complicated with interstitial pneumonia and 33 patients (97.1%, 33/34) with anti-MDA5 antibody positive dermatomyositis complicated with interstitial pneumonia ( χ2=37.81, P<0.001). FDG metabolism in anti-MDA5 antibody positive patients was higher than that in anti-MDA5 antibody negative patients (lesion SUV max: 3.65±1.83 and 2.38±1.27; t=2.13, P=0.039). Conclusions:The muscle FDG metabolism of anti-MDA5 antibody positive dermatomyositis patients is higher than that of healthy controls, but lower than that of anti-MDA5 antibody negative patients. The incidence of neoplastic lesions in patients with positive anti-MDA5 antibody is lower than that in patients with negative anti-MDA5 antibody. The proportion and severity of interstitial pneumonia are higher in patients with positive anti-MDA5 antibody than in those with negative anti-MDA5 antibody. 18F-FDG PET/CT has certain value on identifying anti-MDA5 antibody positive dermatomyositis.

Objective To use the fluorescence PCR‐melting curve method to detect CYP2C9 and VKORC1 gene polymorphism in Xinjiang Hui population ,to analyze their gene distribution and gene mutation frequency ,and to evaluate the clinical applicability of the fluorescence PCR‐melting curve method .Methods The fluorescence PCR‐melting curve method and sequencing method were adopted to contrastively detect CYP2C9*2 ,CYP2C9*3 and VKORC1(‐1639G/A)gene polymorphism .Results Among detected 228 Xinjiang Hui individuals ,199 cases of CYP2C9*1/*1 ,2 cases of CYP2C9*1/*2 ,26 cases of CYP2C9*1/*3 and only 1 case of CYP2C9*3/*3 were detected ,no case of CYP2C9*2/*2 and CYP2C9*2/*3 was detected .Two kinds of allele G and A were detected for VKORC1(‐1639G/A) ,in which VKORC1‐1639G/G type was detected in 2 cases ,VKORC1‐1639G/A type was detected in 39 cases and VKORC1‐1639A/A type was detected in187 cases ,compared with the sequencing method ,the results of the fluorescence PCR‐melting curve method were completely consistent .Conclusion Xinjiang Hui population also has CYP2C9 gene *2 ,*3 loci and VKORC1 gene(‐1639G/A) locus polymorphism ,their occurrence frequency has a certain difference with Xingjiang Uygur and other regional populations ,the adopted fluorescence PCR‐melting curve method used in the gene polymorphism detection can meet clinical detection requirements .

Objective To investigate any effects of rubbing acupoints on the right leg on activation and deactivation responses in the human cerebellum. Methods Ten male, healthy, right-handed subjects were examined using functional magnetic resonance imaging (fMRI) while their Zusanli (ST36) , Yanglingquan (GB34),Fenglong (ST40) and Sanyinjiao (SP6) acupoints on the right lower extremity were stimulated. A block-designed method was applied. A piece of sponge was used to rub all the above-mentioned acupoints for stimulation. The mean values of the activation and deactivation signals in different cerebellar zones induced by stimulating each acupoint were calculated.Results Each acupoint could modulate cerebellum function in its specific way, but all acupoints induced the largest mean values in the Vermis Crus I area. The largest deactivation effects for all acupoints except Sanyinjiao were located in the Vermis VI area. For each acupoint, left and right side activation effects of the 20 zones of the cerebellum were basically consistent, though the mean values of most zones were higher on the right side. Conclusions The four acupoints studied not only shared common modulating effects, but also showed point-specific influence on cerebellum function. The effects exerted by each acupoint on the Vermis were greater than that on the cerebellar hemispheres. The phenomena observed in this study could contribute to acupoint selection during rehabilitation.

Objective To investigate insula cortex activation evoked by stimulating different acupoints of lower extremity.Methods Twenty healthy male right-handed subjects were recruited to receive functional magnetic resonance imaging(fMRI)examination with a whole-body 3T Siemens Trio system for whole-brain imaging.Participants were at rest during scanning and were instructed to relax with their eyes closed,without falling asleep.A blockdesigned method was applied for acupoint stimulation.The examined acupoints on the right lower extremity were stimulated,respectively,resulting in 4 experimental conditions.Stimulation was performed by brushing the subject's skin over each acupoint with a sponge at a frequency of approximately 2 Hz.Images were analyzed using SPM5 software package.Group analysis was performed with the mixed-effects model.Small volume correction was used to investigate insula cortex activation under each condition at a threshold of P ＜ O.01,with a 6-mm radius centered on the local maxima of activation in insula cortex.The scope of insula cortex was determined with SPM anatomy toolbox.Results All the examined acupoints induced activation in contralateral insula cortex.Activation clusters evoked by different acupoints presented various types of locations and shapes,and all of them located in the posterior part of insula cortex.Activation in the ipsilateral insula cortex was not found for all examined acupoints.Conclusions Stimulating lower extremity acupoints can activate posterior insula cortex.This effect may promote the recovery of dysphagia via several mechanisms including facilitating the initiation of swallowing,improving oral and pharyngeal sensation,and reducing taste disturbance.

ObjectiveTo explore the difference on clinical features of massive cerebral infarction with different concious states.MethodsPatients diagnosed as massive cerebral infarction of middle cerebral vascular or internal carotid artery were divided into group without conscious disorder and group with conscious disorder according to concious state. Their gender, age, past disease history, conscious state, location of ischemic area, blood pressure, heart rate, temperature, complications, white blood cell, blood glucose, lipemia, and electrolyte were recorded.ResultsThere are more hyperlipemia and diabetes, more complications and fast heart rate in the group with conscious disorder.ConclusionAbnormity of blood glucose and lipemia for a long time may affect the concious state of massive cerebral infarction patients.

Objective To study the changes of ambulatory blood pressure parameters after endovascular treatment.Methods The ambulatory blood pressure of 7 patients with artery stenosis was tested before and after endovascular treatment,and the coefficient of variation(CV)was calculated.Results All patients' blood pressures decreased after endovascular treatment.The CV of blood pressure of patients with internal carotid stent decreased,but the CV of blood pressure in patients with vertebro-basilar artery stent increased.Conclusion The effects of stent on blood pressure is far from clear.

OBJECTIVE:To study the international experiences on essential medicine policy and to provide useful reference for the establishing and improving of essential medicine policy in China.METHODS:The practice and experiences on essential medicine policy of countries at different level of national income were analyzed.RESULTS & CONCLUSION:Experiences from Austria,India,South Africa and Zimbabwe etc suggest that a good strategy to improve the availability of essential medici-nes should give priority consideration to the pharmaceutical system and develop essential medicine policy on the basis of a holistic framework including essential formulary as well as rational pricing and reimbursement systems.

ObjectiveTo investigate the characteristics of the ambulatory blood pressure of acute cerebral infarction patients in the first 24 hours from onset and to study the relationship between their neurological deficit and characteristics of blood pressure.MethodsBlood pressure in 31 acute cerebral infarction patients (within 24 h) was measured serially during the first 24 hours in hospital with ambulatory blood pressure monitoring. Their neurological deficit was assessed with the National Institutes of Health stroke scale (NIHSS) on the first and the fifth day. Results83.87% nocturnal blood pressures decreased less than 10%. In multiple linear regression analysis, 24 h diastolic blood pressure (DBP) becomes the only and the most important factor to NIHSS on the first day. The patients with improved NIHSS on the fifth day showed lower nocturnal DBP and mean arterial pressure (MAP) than those of patients with unimproved NIHSS.ConclusionNot only the level but also the circadian of ambulatory blood pressure in acute cerebral infarction patients is significantly abnormal, especially for the reduction of nocturnal blood pressure decrease. On the first day, the neuroulogical deficit and blood pressure influence each other. The patients with higher nDBP and nMAP on the first day may be associated with poor early neurological function outcomes.