BACKGROUND:Photothermal therapy is a novel tumor treatment strategy that uses photothermal agents to transform light energy into heat energy to accomplish non-invasive tumor ablation.The rise of photothermal therapy and nanotechnology has provided a new perspective on breast cancer treatment.OBJECTIVE:To prepare a new type of near-infrared biomimetic nanoprobe that has been modified by breast cancer cell membrane,to investigate the effect of near-infrared fluorescence/ultrasound imaging in vitro,and to observe its targeting ability and photothermal therapy effect on homologous tumor cells in vitro.METHODS:Organic small molecule ITIC-4CI with A-D-A structure was used as photothermal agents;polylactic acid/glycolic acid copolymer as nanocarrier;4T1 cell membrane of mouse breast cancer cells as a surface modifier of nanoparticles;perfluorohexane(PFH)was loaded.A novel near-infrared biomimetic nanoprobe(4T1m/ITIC-4CI/PFH)was prepared by the double emulsion evaporation method and sonication method.The basic characterization of the nanoprobe and the homologous targeting ability were detected.The photothermal properties and photothermal stability of the probe were investigated,and the near-infrared fluorescence/ultrasound imaging effect of the probe under laser irradiation was observed.The CCK-8 assay and calcein/propidium iodide staining were used to assess the efficacy of photothermal therapy.RESULTS AND CONCLUSION:(1)The prepared 4T1m/ITIC-4CI/PFH nanoprobes had uniform size,high stability,and an average particle size of(92.7±2.3)nm.The probe's protein composition was identical to that of the 4T1 cell membrane.The nanoprobe's ability to target homologous 4T1 cells was validated by an in vitro cell uptake assay.(2)The nanoprobe had a red-shift absorption spectrum and tail emission extending to the near-infrared-Ⅱ,which emitted a bright near-infrared-Ⅱ fluorescence signal under laser irradiation.(3)After laser irradiation,the nanoprobe 4T1m/ITIC-4CI/PFH could be turned into microbubbles and enhanced ultrasound imaging.The results of CCK-8 assay and calcein/propidium iodide staining showed that the nanoprobe 4T1m/ITIC-4CI/PFH had an obvious photothermal killing effect on 4T1 cells.(4)The results show that the nanoprobe 4T1m/ITIC-4CI/PFH has the ability to target homologous tumors and enhance near-infrared-Ⅱ fluorescence imaging/ultrasound imaging and photothermal therapy effects.

OBJECTIVE: Pseudostellaria heterophylla has been paid more attention in recent years, mainly as a medicine food homology plant. The content determination of P. heterophylla is not specified in the Chinese Pharmacopoeia (version 2020). The environmental conditions in different production areas could exert an influence on the quality of P. heterophylla. The purpose of this study is to discriminate P. heterophylla collected from different geographical origins of China. METHODS: In this study, the content of polysaccharide in 28 batches of P. heterophylla was determined using phenol-sulfuric acid. HPLC fingerprints were established under optimised HPLC-PDA methods. Subsequently, the similarity analysis (SA) and the quantification of heterophyllin B were analyzed. The metabolites of P. heterophylla were identified and evaluated using UHPLC-Q Exactive HF orbitrap MS system. Principal component analysis (PCA), partial least squares discriminant analysis (PLS-DA), hierarchical cluster analysis (HCA) and orthogonal PLS-DA (OPLS-DA) were performed based on all peak areas. RESULTS: The polysaccharide content in Guizhou and Jiangsu was higher than that of other production areas, which varied significant from different origins. While the content of heterophyllin B in Anhui and Jiangsu was high. The correlation coefficients of HPLC fingerprints for 28 batches samples ranged from 0.877 to 0.990, and the characteristic map can be used to identify and evaluate the quality of P. heterophylla. The samples from Fujian, Guizhou, Jiangsu provinces can be relatively separated using multivariate statistical analysis including PCA, PLS-DA, HCA, OPLS-DA, indicating that their metabolic compositions were significantly different. Ultimately, a total of 15 metabolites which were filtrated by a VIP-value > 1 and a P-value < 0.05 associated with the separation of different origins were identified. CONCLUSION HPLC fingerprint was established to evaluate the quality and authenticity of P. heterophylla. The present work showed that the difference of geographic distributions had an influence on the internal chemical compositions. A sensitive and rapid untargeted metabolomics approach by UHPLC-Q Exactive HF orbitrap MS was utilized to evaluate P. heterophylla from different origins in China for the first time. Overall, this study provides insights to metabolomics of P. heterophylla and supplies important reference values for the development of functional foods.

Objective To provide guidance for pre-hospital emergency treatment by studying the disease spectrum and distribution characteristics of pre-hospital emergency treatment patients in Wuxi area from 2015 to 2020. Methods The medical records of 120 pre-hospital emergency patients in Wuxi area from January 2015 to December 2020 were retrospectively analyzed, and the disease types, gender, age, and seasonal distribution of the pre-hospital emergency patients were statistically analyzed. Results The top five emergency diseases of 16 437 pre-hospital patients were trauma (24.51%), cerebrovascular disease (19.16%), cardiovascular disease (18.33%), digestive system disease (9.70%) and respiratory disease (7.20%). In the distribution of disease types, the proportions of injuries, cerebrovascular diseases, cardiovascular diseases, digestive system diseases, respiratory system diseases, poisoning diseases and urinary system diseases in males were significantly higher than those in females (χ²=4.975, P<0.05). The proportion of male species (9 812/16 437) was higher than that of female species (6 625/16 437). From 2015 to 2020, the age group with high incidence of pre-hospital emergency patients in Wuxi area was distributed in the 50-60 years old (19.30%) and 40-50 years old (16.28%), and the least age group was 0-10 years old (2.60%). The number of pre-hospital emergency patients was 46.60% from 6 to 12 hours per day, and 10.26% from 18 to 24 hours per day. The number of pre-hospital emergency patients was the highest in summer (38.69%), and the lowest in spring (11.87%). Conclusion The pre-hospital emergency diseases in Wuxi area are mainly cardiovascular and cerebrovascular diseases, and the acute and severe diseases show an increasing trend. It is necessary to rationally allocate the pre-hospital emergency resources according to the disease spectrum and the peak months and time periods of different diseases, so as to improve the medical service level in Wuxi.

Objective:To evaluate the effectiveness of staged modular theory and practice lectures in laparoscopic training.Methods:In this study, a large group of medical students and a large group of residents were selected, and each of the two groups was divided into an experimental group and a control group respectively. The experimental group received staged modular theory and practice lectures based on the conventional trainings, and the control group only underwent conventional laparoscopic skills training and instruction. Before and after the training, the completion time of 6 basic laparoscopic operations, laparoscopic suture time, suture quality and the number of accidental injuries were recorded and scored in each group according to the assessment criteria. SPSS 26.0 was used for statistical analysis of the assessment data. Independent samples t-test or Mann-Whitney U test was used for inter-group comparison between the two large groups, and paired samples t-test or Wilcoxon sign rank sum test was used for intra-group comparison before and after the training. Results:Compared with the control group, the experimental group of medical students that had undergone staged modular theory and practice lectures had a shorter time to complete basic laparoscopic operations, faster speed of suturing ( t=6.18, P<0.001) and higher quality of suturing ( t=4.17, P<0.001) and fewer accidental injuries ( Z=-2.03, P=0.043); the experimental group of residents that had undergone staged modular theoretical and practical lectures had a shorter time to complete basic laparoscopic operations, faster speed of suturing ( t=3.31, P=0.002) and higher quality of suturing ( t=3.68, P=0.001) and fewer accidental injuries ( Z=-2.44, P=0.015). Conclusion:The staged modular theory and practice lectures are able to further improve the quality of basic laparoscopic skills training.

Objective:To evaluate the effect of TBK1 overexpression on hypoxia-reoxygenation (H/R) injury in isolated mouse cardiomyocytes subjected to high glucose and the relationship with mitochondrial autophagy.Methods:Normally cultured log-phase HL-1 mouse cardiomyocytes were inoculated in a 6-well plate at a density of 1×10 6 cells/ml and were divided into 4 groups ( n=10 each) using a random number table method: control group (group C), high glucose group (group HG), high glucose and H/R group (group HG+ H/R), and TBK1 overexpression group (group TBK1). The cells were incubated in culture medium with 1% fetal bovine serum and 1% double antibody for 24 h when the cell density reached 50%.When the cell density reached 80%, pcDNA3.1 (+ ) was used as a vector to achieve TBK1 overexpression.The cells were cultured with high glucose medium (33 mmol/L) for 24 h, exposed to 94% N 2+ 5% CO 2+ 1% O 2 for 24 h in an incubator at 37℃ followed by 12 h reoxygenation in an incubator containing 5% CO 2 at 37°C to establish the model of H/R injury to cardiomyocytes subjected to high glucose.After reoxygenation, CCK-8 assay was used to detect cell viability, the activity of lactic dehydrogenase (LDH) in supernatant was detected using LDH kit, mitochondrial contents were determined using Mito-Tracter green fluorescent probe, and the expression of TBK1 and mitophagy-related proteins PINK1, Parkin, LC3B and P62 was detected by Western blot. Results:Compared with group C, the cell viability was significantly decreased, the activity of LDH in supernatant was increased, mitochondrial contents were decreased, the expression of TBK1, PINK1, Parkin and LC3B was down-regulated, and the expression of P62 was up-regulated in HG group and HG+ H/R group ( P<0.05). Compared with group HG, the cell viability was significantly decreased, the activity of LDH in supernatant was increased, mitochondrial contents were decreased, the expression of TBK1, PINK1, Parkin and LC3B was down-regulated, and the expression of P62 was up-regulated in group HG+ H/R ( P<0.05). Compared with group HG+ H/R, the the cell viability was significantly increased, the activity of LDH in supernatant was decreased, mitochondrial contents were increased, the expression of TBK1, PINK1, Parkin and LC3B was up-regulated, and the expression of P62 was down-regulated in group TBK1 ( P<0.05). Conclusion:The mechanism by which TBK1 overexpression reduces the H/R injury is related to restoring mitophagy in isolated mouse cardiomyocytes subjected to high glucose.

Objective To evaluate the role of autophagy in Parkin over-expression-induced reduction of cardiac hypertrophy in diabetic rats.Methods Thirty-two healthy SPF male Sprague-Dawley rats,aged 2 months,weighing 200-230 g,were divided into 4 groups (n =8 each) using a random number table method:non-diabetes mellitus (DM) group (group Non-DM),DM group,DM plus AAV9-CMV-Parkin group (group DM+P) and DM puls AAV9-CMV-Parkin puls autophagy inhibitor 3-methyladenine (3-MA) group (group DM+P+MA).DM was induced by intraperitoneal streptozotocin (STZ) 60 mg/kg and confirmed by blood glucose level ＞16.7 mmol/L,and Parkin overexpression was achieved with adeno-associated virus serotype 9 as a vector.AAV9-CMV-Parkin 1 × 1012 mg/kg was injected into the tail vein at 3 weeks after STZ injection in group DM+P.In group DM+P+MA,AAV9-CMV-Parkin 1× 1012 mg/kg was injected into the tail vein at 3 weeks after STZ injection,and 3 weeks later 3-MA 15 mg/kg was injected into the tail vein,once a week for 6 weeks in total.Cardiac diastolic and systolic function was detected using Bmode ultrasonography.Cardiomyocytes were obtained for microscopic examination of the cross-sectional area (with a light microscope) and for determination of the expression of microtubule-associated protein 1 light chain 3,P62 and Parkin.Results Compared with group Non-DM,the cross-sectional area of cardiomyocytes was significantly increased,and the diastolic and systolic function was decreased in DM group (P＜0.05).Compared with group DM,the cross-sectional area of cardiomyocytes was significantly decreased,the diastolic and systolic function was improved,the expression of microtubule-associated protein 1 light chain 3 and Parkin in myocardial tissues was up-regulated,and the expression of P62 was down-regulated in group DM+P (P＜0.05).Compared with group MD+P,the cross-sectional area of cardiomyocytes was significantly increased,the diastolic and systolic function was decreased,the expression of microtubule-associated protein 1 light chain 3 was down-regulated,and the expression of P62 was up-regulated in group DM+P+MA (P＜0.05) Conclusion Autophagy is involved in Parkin over-expression-induced reduction of cardiac hypertrophy in diabetic rats.

Objective To understand the current postoperative application situation of severity degree evaluation for children patients with congenital heart diseases (CHD) in China and the confronting problems,in order to offer reference to improve clinical severity prediction and nursing ability.Methods Cochrane Library, PubMed,EMbase,CINAHL,CBMdisc,CNKI,Wanfang database and VIP database were searched. Languages were not limited. The literature which was published from 2000 to 2016 was included. The literature which was related to postoperative severity degree evaluation for the children patients with CHD was included. The quality of included literature was critically evaluated and the data were extracted with QUADAS evaluation system by three reviewers. They also completed the literature analysis.Results Twelve articles were included. There were only 2 articles published in nursing journals. Pervasive evaluation methods were mainly applied in the people with diseases of respiratory system. There was only 1 article which studied CHD. The application effects of evaluation methods were different. The application effect of pervasive evaluation methods in CHD was limited. Two studies showed that the application effect of the specific score was good,but there was no multicenter or large sample verification.Conclusions The application of postoperative severity degree evaluation methods for children patients with CHD in China is limited. The recognition degree of nurses is not high. Relative verification research is not enough. Further studies of the specific score are necessary. We suggest that the reasonable application of evaluation methods should be promoted based on verifying the application effects of evaluation methods and in combination with the training of nurses,which guarantees the safety of children patients.

[ABSTRACT]OBJECTIVETo evaluate the clinical value of ultrasound guided fine-needle aspiration (US-FNA) in the diagnosis of thyroid nodules with different size.METHODSThe clinical data of 122 thyroid nodules of 109 cases referred to FNAC for diagnosis were retrospectively reviewed. The final operating histological results of 122 nodules were considered gold standard. RESULTSNon-diagnostic FNAC results occurred in 17 nodules (13.9%). FNAC achieved a sensitivity of 78.6%, a specificity of 93.9%, a positive predictive value of 93.6%, a negative predictive value of 78.3%, and a total accuracy of 85.7%. There was no significant difference between the diameter of the nodule≤1 cm group and>1 cm group, except negative predictive value. The non-diagnostic results rate was no significant difference between groups of different nodule size, benign or malignant nodules, and different operators. CONCLUSIONFNAC is a sensitive, specific and accurate method for differential diagnosis of thyroid nodules.

Objective To evaluate the value of electrospun polymethyl methacrylate (PMMA) nanofibers with different topological structures as scaffolds for growth of Schwann cells (SCs).Methods Electrospun PMMA nanofibers with random or aligned topological structures were fabricated and measured with biocompatibility.Lentivirus-transfected green fluorescent protein was used as the reporting gene to monitor form and growth manner of SCs on different substrates and dependency of cell body and process with fiber structure,with PMMA thin films served as the control.Results Electrospun PMMA nanofibers revealed good biocompatibility and could exert contact guidance to the growth of SCs.Topological structures of the electrospun nanofibers influenced cell morphology.SCs were aligned with the orientation of substrate fibers and form longer cell process when growing on aligned nanofibers (P ＜0.01).Primary SCs preferred to follow the cue of aligned nanofibers compared to random fibers.Conclusion Aligned electrospun PMMA nanofibers have the potentiality as transplantable scaffolds for loading SCs after neural injury.

Objective To investigate the distribution situation of human papillomavirus (HPV) genotypes profile in cervical cells among women in Xuzhou area and its clinical significance .Methods 23 kinds of HPV DNA were extracted in cervical cell samples from 8 010 women in Xiuzhou area .The gene‐chips technique of PCR combined with reverse dot blot was adopted to detect the HPV genotypes .Results Among 8010 cervical cell samples ,there were 1 852 HPV infected cases ,the total HPV infection rate was 23 .12% ,the HPV infection rates of single type accounted for 17 .17% and its predominant types were 16 type (4 .35% ) ,followed by 58 type (2 .12% ) and 52 type (1 .82% ) ,The detection rate of multiple HPV infection was 5 .96% ,in which the predominant types were HPV16+58(4 .40% ) ,16+52(2 .94% ) ,11+16(2 .52% ) .Conclusion The single HPV infection of HPV16 ,58 ,52 and the multiple HPV infection of HPV16+58 ,16+52 ,11+16 are the main genotypes of cervical cells among women in Xuzhou area , this gene chip technique is suitable for the cervical cell sample ,its once detection can detect 23 kinds of HPV genotypes with high specificity and high sensitivity ,which has an important significance for the molecular epidemiologic survey study of HPV genotypes distribution among women in our country .