Recent innovations in nanomaterials inspire abundant novel tumor-targeting CRISPR-based gene therapies. However, the therapeutic efficiency of traditional targeted nanotherapeutic strategies is limited by that the biomarkers vary in a spatiotemporal-dependent manner with tumor progression. Here, we propose a self-amplifying logic-gated gene editing strategy for gene/H₂O₂-mediated/starvation multimodal cancer therapy. In this approach, a hypoxia-degradable covalent-organic framework (COF) is synthesized to coat a-ZIF-8 in which glucose oxidase (GOx) and CRISPR system are packaged. To intensify intracellular redox dyshomeostasis, DNAzymes which can cleave catalase mRNA are loaded as well. When the nanosystem gets into the tumor, the weakly acidic and hypoxic microenvironment degrades the ZIF-8@COF to activate GOx, which amplifies intracellular H⁺ and hypoxia, accelerating the nanocarrier degradation to guarantee available CRISPR plasmid and GOx release in target cells. These tandem reactions deplete glucose and oxygen, leading to logic-gated-triggered gene editing as well as synergistic gene/H₂O₂-mediated/starvation therapy. Overall, this approach highlights the biocomputing-based CRISPR delivery and underscores the great potential of precise cancer therapy.

The harm of pathogenic bacteria to humans has promoted extensive research on physiological processes of pathogens, such as the mechanism of bacterial infection, antibiotic mode of action, and bacterial antimicrobial resistance. Most of these processes can be better investigated by timely tracking of fluorophore-derived antibiotics in living cells. In this paper, we will review the recent development of fluorescent antibiotics featuring the conjugation with various fluorophores, and focus on their applica-tions in fluorescent imaging and real-time detection for various physiological processes of bacteria in vivo.

Objective: To explore the influence of endoscopic sinus surgery on postoperative cognitive performance, quality of life and psychological status of patients with sinusitis and nasal polyps. Methods: From January 2017 to January 2018, 300 patients with sinusitis and nasal polyps who underwent endoscopic sinus surgery in the Fifth Hospital of Shaoxing were selected.The quality of life, psychological status and cognitive performance of patients before and after surgery were compared. Results: After operation, 190 cases were cured, 90 cases were effective, and 20 cases were ineffective.The total effective rate was 93.33% (280/300 cases). After operation, the patients′ nasal endoscopy score was (3.23±0.34) points, which was significantly lower than before operation [(8.53±1.63)points] (t=43.875, P<0.05). After surgery, the clinical main symptoms such as nasal congestion, nasal secretions, headache, facial pain and olfactory disturbance were significantly improved (t=13.070, 12.252, 6.501, 8.954, 5.503, all P<0.05). After operation, the patients' anxiety scale (HAMA) and depression self-rating scale (SDS) scores were significantly lower (t=115.012, 45.203, all P<0.05). After surgery, the scores of physiological function, social function, physiological role, physical pain, mental health, emotional color and vitality were significantly increased (t=5.231, 5.579, 10.360, 8.580, 9.23, 11.336, 1.993, all P<0.05), and the total score of the Medical Outcome Study Simplified Scale-36 (SF-36) score was also significantly improved (t=8.942, P<0.05). After surgery, the 20 and 5 items of the patient-stomach-sinus test-20 (SNOT-20) entry score gradually decreased from 1 month after surgery (t=16.029, 18.041, all P<0.05). After operation, the cognitive performance of the patients was significantly improved.The awareness of sinusitis and nasal polyps related diseases was (70.94±2.85)points, and the knowledge of nasal endoscopy was (95.23±3.84)points, the differences were statistically significant (t=16.474, 58.484, all P<0.05). Conclusion Endoscopic sinus surgery can improve the cognitive performance of patients with sinusitis and nasal polyps, reduce negative emotions such as anxiety and depression, and improve the quality of life of patients.It is worthy of widespread promotion in clinic.

Objective To investigate the value of third generation dual-source CT in early differential diagnosis of intracranial hemorrhage and iodinated contrast medium after endovascular treatment of acute ischemic stroke (AIS).Methods Totally 78 patients with AIS underwent endovascular treatment were prospectively enrolled.Dual-energy CT (DECT) examination (80 kV/Sn150 kV) of the head was performed after treatment with a third generation dual-source CT scanner.Iodine overlay maps and virtual non-contrast images were post-processed.Taking conventional brain CT images obtained 24 48 h after AIS attack as references,the accuracy,sensitivity,specificity,positive predictive value (PPV) and negative predictive value (NPV) of DECT for identifying hemorrhage were computed respectively.Results Totally 31 patients with 53 foci of intracranial hyper-attenuation were finally enrolled.Among 53 foci,26 were correctly diagnosed as hemorrhage by DECT,23 were correctly diagnosed as iodinated contrast medium,while 1 calcification was misdiagnosed as hemorrhage combined with iodinated contrast medium,3 were misdiagnosed as contrast medium which showed delayed hemorrhagic transformation.The sensitivity,specificity and accuracy of DECT was 89.66％ (26/29),95.83％ (23/24) and 92.45％ (49/53),PPV and NPV was 96.30％ (26/27) and 88.46％ (23/26),respectively.Conclusion The third generation dual-source CT is available in early and accurate diagnosis of hemorrhagic transformation after endovascular treatment of AIS,which can help clinicians to adjust the subsequent treatment strategies in time.

OBJECTIVE:To investigate the characteristics of pediatric drug-induced liver injury (DILI) in China,and to provide reference for reducing ADR.METHODS:Using"liver injury liver damage hepatotoxicity hepatitis liver disease""drug induced children" as keywords,related domestic literatures were retrieved from CNKI and Wanfang database during 2007-2016,clinical information of DILI children in literatures were recorded in detail and analyzed comprehensively.RESULTS:A total of 363 literatures were retrieved,including 13 effective literatures and 665 children in total.There were 424 boys (63.76％)and 241 girls (36.24％),with ratio of 1.76 ∶ 1.The youngest child was 1 month old,the oldest child was 14 years old;the average age was 7.87 years,337 children aged more then 7 years old,accounting for 50.68％.Top 3 primary diseases were respiratory tract infection (40 cases,31.50％),hematologic diseases (29 cases,22.83％) and tumor (14 cases,11.02％).Top 3 pediatric DILI-inducing drug types were antibiotics (245 cases,34.41％),TCM (143 cases,20.08％) and antipyretic analgesics (113 cases,15.87％).DILI usually happened within 4 weeks (332 cases,82.18％).The most common clinical classification was hepatocellular type (382 cases,65.30％).The severity of liver injury was mainly mild and moderate (505 cases,86.32％),and 80 cases were severe (13.68％),including 31 cases of hepatic failure (5.30％).Clinical symptoms mainly manifested as anorexia,jaundice,nausea,vomiting,hypodynamia and abdominal discomfort.After drug withdreawd and treatment,96.54％ of the patients were recovered or cured,and 4 cases died (0.60％).CONCLUSIONS:Under the premise of rational use of drugs,it is necessary to carry out medication education and supervision for antibiotics,TCM and antipyretic analgesics which mainly induce pediatric DILI,pay attention to allergic history and evaluate the progress of extrahepatic symptoms.When ADR occurred,the timely and drug withdrawal intervention are conducted to improve good prognosis.

Acupuncture Points ; Acupuncture Therapy ; history ; China ; History, Ancient ; Humans ; Medicine in Literature ; Sleep Initiation and Maintenance Disorders ; history ; physiopathology ; therapy

Objective] To summarize the clinical key points of acupoint sticking therapy in the application of treating disease before its onset. [Method] From the treatment timing, treatment principle, acupoint selection to expound the academic perspective and clinical experience of our department in the application of acupoint sticking therapy by consulting the ancient literature and summarizing clinical practice. [Result] Through the correct selection of treatment timing for acupoint sticking therapy, which is mainly used in summer, secondly used in winter, and focusing on tonifying Yang-qi, and point selection by pattern identification, paying attention to the accumulation of curative effect, this therapy has good curative effect in the treating disease before its onset.[Conclusion] Nowadays, there are more and more sub-health people. Since acupoint sticking therapy has advantages of“easy, convenient, cheap, uesful”and safe, it is a good therapy to apply for treating disease before its onset.

OBJECTIVE To promote the management of nosocomial infections continuous improvement in the clinical and medical technology department.METHODS According to the regulation of nosocomial infections management,a handbook of nosocomial infections management for clinical and medical technology department was designed,and the monitors of nosocomial infection could perform real time inspection and record according require of the handbook.The department of nosocomial infections management examined the monitoring work of clinical and medical technology department every month and summarized every year,and the results were internalized to the valuation of medical quality management.RESULTS After 3 years of the usage of the handbook,the capability of the monitor groups of nosocomial infection and the quality of the all monitoring items were significantly improved;the qualified rates were all above 96.30%.CONCLUSIONS The handbook of nosocomial infections management is useful to improve the quality of nosocomial infections management in the clinical and medical technology department.

Objective To study the effect of rhein on the process of tubular epithelial-mesenchymat transformation in kidney of diabetic rats. Methods Wistar male rats were randomly assigned to 3 groups: Control group (N group, n=12),diabetic group(D group, n=12), rhein treatment group(R group, n=12).The rats of rhein treatment group were treated with daily intragastric administration of periment. The excretion of urinary protein and serum creatine were measured. Histological changes of renal tissue were observed by HE and MASSON stain. Immunohistochemistry was performed to investigate the expression of E-cadherin, α-SMA,FN and TGF-β1 in kidney. Results Compared with the control group, the tubulointerstitial injury and the accumulation of extraeellular matrix protein in diabetic models were obvious(P＜0.01).Compared with the control group, the expression of E-cadherin was decreased significantly and the expression of α-SMA,FN and TGF-β1 was increased significantly in diabetic group. E-cadherin was negatively correlated with TGF-β1(rs=-0.60,P＜0.05),α-SMA and FN was positively correlated with TGF-β1(rs=0.88,P＜0.05;rs:0.91,P＜0.01).In comparison with diabetic group,rhein could up-regulate the expression of E-cad and down-regulate the expression of α-SMA and FN in renal tubular epithelial cells(P＜0.01).Conclusion Rhein could protect kidney by ameliorating interstitial fibrosis in diabetic rats. The mechanism may be depend on down-regulating the expression of TGF-β1 and suppressing tubular epithelial-mesenchymal transformation.

OBJECTIVE To provide scientific basis for the control of hospital infection,and then the effects of nursing quality control were evaluated. METHODS There was significant difference in many targets of hospital infection. RESULTS The nursing quality control was strengthened by the following measures.The administration of hospital infection net be established,the environmental sanitation and sterilization in the medical matter be supervised,and the rules and regulations be enforced in the normal works of nursing against hospital infection. CONCLUSIONS Nursing quality control is very important in the control of hospital infection.