[Objective]To summarize Professor CHU Haoran's understanding and treatment experience on diarrhea type irritable bowel syndrome(IBS-D).[Methods]Through clinical study with teachers,consulting ancient books and combining modern literature research,summarize the understanding and treatment ideas of Professor CHU for IBS-D,clarify the basic diagnosis and treatment rules of the disease,and provide a clinical medical case as evidence.[Results]Professor CHU believes that disordered movement of Qi in the middle-Jiao is the core pathomechanism of IBS-D.He advocates for the treatment principle of"ascending Qi mechanism,regulating the middle-Jiao,and nourishing vital energy".The acupoint Tianshu(ST25)is considered the focal point,complemented by Zhongwan(CV12),Zhangmen(LR13),Shangjuxu(ST37),Dachangshu(BL25),and Zusanli(ST36)to regulating the middle-Jiao.This is paired with the needling technique of"Dragon and Tiger battle"to assist in facilitating the flow of Qi in the middle-Jiao.A key selection is"Baihui(DU20)-Neiguan(PC6)"to regulate the clear Qi,comb the mind and spirit located in the head,and elevate the overall movement of Qi.Additionally,"Guanyuan(RN4)-Zusanli(ST36)"are used to firm the foundation and cultivate the primal Qi,supplementing the innate vital energy.In a case study,the patient was diagnosed with syndrome differentiation of spleen and stomach deficiency,with concurrent restlessness of the heart spirit and signs of deficient Yang Qi.Professor CHU treated the patient by using the method of raising the clear Qi,managing the middle-Jiao,and nourishing vital energy,supplementing the postnatal to nourish the prenatal while calming the spirit,resulting in significant effects.[Conclusion]In clinical practice,Professor CHU modifies acupoints according to syndrome differentiation.By integrating groups of acupoints,he facilitates the beneficial ascent and descent of Qi within the middle-Jiao,creating a distinctive"regulating the middle and restoring the vital energy"diagnostic and treatment system for IBS-D,which provides a new approach to the clinical treatment of IBS-D.

Objective:To investigate short-term safety, efficacy and the learning curve of this self-developed novel transcatheter valve repair system (Neonova?) in patients with mitral regurgitation, and explore the role of perioperative echocardiography.Methods:Ten patients who visited the Union Hospital of Tongji Medical College, Huazhong University of Science and Technology from June 2021 to March 2022 and met the inclusive criteria were prospectively enrolled. All the patients were at high risk of surgery with moderate to severe or severe mitral regurgitation (MR). Clamps of Neonova? were implanted under guidance of transesophageal echocardiography and digital subtraction angiography. Clinical outcomes, echocardiography indexes and learning curves of this technique were evaluated immediately after intervention, 7 d, 1 month and 3 months post-intervention.Results:The technical success rate was 100% with MR relieved in all patients immediately after intervention. The device and procedural success rates were both 90.0% with 1 patient received surgical replacement at 37 days post-intervention while the others′ reduced to mild (8/9) and moderate (1/9) MR. New York Heart Association class and the Kansas City Cardiomyopathy Questionnaire improved significantly (all P<0.001). Mean mitral valve pressure gradient didn′t increase significantly after intervention when compared with that before intervention( P=0.324), and no mitral stenosis was observed. Left ventricular end-diastolic diameter decreased significantly ( P=0.008) during follow up.Procedure duration ranged from 60 to 300 (175.8±75.2)minutes. The simple linear regression model between procedure volume and duration showed that procedure duration decreased significantly with the increase of procedure volume ( F=15.857, P=0.004). Conclusions:Neonova? implantation can improve MR severity and clinical symptoms safely and effectively. Transthoracic echocardiography and transesophageal echocardiography are essential for perioperative management of transcatheter mitral valve repair.

Hepatocellular carcinoma （HCC） most often develops in patients with liver disease characterized by chronic non-resolving inflammation. The inflammatory response is mainly derived from innate immune cells， and tumor-associated macrophages （TAMs） play an important role in the development of tumors．It is usually chemotactic from mononuclear progenitor cells in the blood to tumor tissue， then is induced by the tumor microenvironment and further develops into TAMs. They play an important role in promoting tumor growth，angiogenesis and tumor invasion and inducing tumor tissues to form an environment without inhibition mechanisms. As the relationship between TAMs and malignant tumors becomes clearer， TAMs are beginning to be seen as therapeutic targets. The heterogeneity of TAM subtypes and their origin and dynamic phenotype during the initiation and progression of HCC has been partially unraveled. It further forms the base for developing therapeutic agents by decreasing the population of TAMs via blocking recruitment of bone marrow-derived monocytes and functionally reprograms TAMs to anti-tumoral behavior. This review focuses on the preclinical evolution and hitherto clinical trials for TAM-targeted therapy in HCC.

【Objective】 To prepare positron emission computed tomography (PET) molecular probes targeting macrophages using Nb119 and BCⅡ10 labeled with ⁶⁸Ga nuclide. 【Methods】 To explore the labeling conditions of nanobodies with ⁶⁸Ga nuclides, first, the anti-Vsig4 nanobody Nb119 and isotype control antibody BCⅡ10 were incubated with NOTA and then purified to obtain the chelating agent-modified NOTA-Nb119 and NOTA-BCⅡ10. The NOTA-Nb119 and NOTA-BCⅡ10 were further incubated with ⁶⁸Ga. Finally, NOTA-Nb119 was identified by SDS-PAGE and MALDI-TOF methods, and the radiochemical purity was detected by radio-HPLC. 【Results】 The results of SDS-PAGE showed that the lanes of the successfully labeled NOTA-Nb119 had apparent hysteresis than the unlabeled nanobody band, which proved that the molecular weight of the labeled product was increased and NOTA successfully modified the nanobody. Subsequently, ⁶⁸Ga nuclides could successfully label Nb119 and BCⅡ10. According to radio-HPLC detection, the radiochemical purity of NOTA-Nb119 and NOTA-BCⅡ10 labeled with ⁶⁸Ga was greater than 90% and remained stable. 【Conclusion】 ⁶⁸Ga-labeled nanobodies have high radiochemical purity and high stability, indicating that this study can be applied to other nanobodies for modification and labeling and provides a practical and feasible method for the preparation of PET using nanobodies.

Objective:To explore CT and MRI features of the endolymphatic sac tumor (ELST).Methods:The CT and MRI morphology confirmed by surgical pathology for 19 patients with ELST were retrospectively analyzed from June 2011 to May 2019 in Eye & ENT Hospital of Fudan University. The features of CT and MRI included location, size, adjacent structures invasion, CT values, bone destruction, features of T 1WI and T 2WI, enhancement distribution characteristics, dynamic enhancement curve morphology, DWI signal characteristics. The ADC values of the lesions and ipsilateral medial pterygoid muscles were compared using a paired t test. Results:Nineteen ELST patients (one with bilateral diseases) were included. Totally 20 ears (right 9 and left 11) of 13 females and 6 males were studied. The masses with slightly high-density and obscure boundary were located around the vestibular aqueduct at the posterior edge of the petrosal bone. Bone destruction involved mastoid process of the middle ear (16 ears), jugular foramen (11 ears), semicircular canal (10 ears), facial nerve canal (7 ears) and internal auditory canal (9 ears). A large amount of residual bone could be found in the interior of nineteen masses. The CT value was (78.6±21.9) HU. The lesion showed central iso-intensity and peripheral hyperintensity on T 1WI and T 2WI in 16 ears, while no obvious hyperintensity on T 1WI in the other 4 ears. The hyperintensity on T 1WI was around the margin of the lesion in 10 ears, situated at lateral side in 5 ears and all over the lesion in 1 ear. Flow voids signals could be seen in 9 ears as well. Liquid-liquid plane was seen on T 2WI in 2 ears. The solid mass portion which showed iso-intensity on both T 1WI and T 2WI presented marked enhancement on contrast-enhanced T 1WI, while other part of the mass no enhancement. DWI of 14 ears illustrates no evidence of restricted diffusion, and the ADC value [(1.25±0.08)×10 -3 mm 2/s] was slightly higher than that of the medial pterygoid muscles ( t=4.437, P=0.001). The style of time-signal intensity curves of the dynamic contrast-enhanced MRI was rapidly ascending followed by descending curves in 2 ears. Conclusion:Imaging findings of ELST have some characteristics, including located around the vestibular aqueduct at the posterior edge of the petrosal bone, bone destruction, peripheral hyperintensity on T 1WI and no restricted diffusion, which is helpful for its diagnosis.

Objective:To observe the effects of T-2 toxin on expression of hepatocyte growth factor (HGF) and HGF receptor (C-Met) in articular cartilage and epiphyseal cartilage of rats under low selenium condition.Methods:Twenty-four healthy male SD rats weighted 60-80 g were randomly divided into conventional diet group (selenium content of 101.5 μg/kg) and low-selenium diet group (selenium content of 1.1 μg/kg), with 12 rats in each group. After 30 days of feeding, the conventional diet group was further divided into conventional group and T-2 toxin group (100 μg·kg -1·d -1), and the low-selenium diet group was further divided into low-selenium group and low-selenium+T-2 toxin group (100 μg·kg -1·d -1), with 6 rats in each group. After 30 days of feeding, the rats were sacrificed and the cartilage of knee joint was taken, the morphological changes of knee articular cartilage and epiphyseal cartilage were observed by HE staining under light microscope. Immunohistochemical method was used to detect the expression of HGF and C-Met in knee articular cartilage and epiphyseal cartilage, and positive expression rates of HGF and C-Met were calculated. Results:Under light microscope, chondrocytes of articular cartilage and epiphyseal cartilage in low-selenium+T-2 toxin group were sparse, and the necrosis and structural area were found in the deep layer, and the extracellular matrix of chondrocytes in the region was degraded and light stained, and proliferating granulation tissue was visible nearby. The positive expression rates of HGF in articular cartilage [(21.97 ± 6.90)%, (49.41 ± 8.24)%, (76.39 ± 5.88)%] and epiphyseal cartilage [(23.36 ± 12.49)%, (58.43 ± 14.48)%, (66.59 ± 10.83)%] of rats in low-selenium, T-2 toxin and low-selenium+T-2 toxin groups were higher than those in conventional group [(9.13 ± 6.01)%, (11.14 ± 4.67)%, P < 0.05]. The positive expression rates of C-Met in articular cartilage [(25.34 ± 7.53)%, (58.21 ± 12.54)%, (81.46 ± 7.89)%] and epiphyseal cartilage [(35.21 ± 4.71)%, (40.84 ± 2.03)%, (49.41 ± 6.29)%] of rats in low-selenium, T-2 toxin and low-selenium+T-2 toxin groups were higher than those in conventional group [(11.21 ± 5.11)%, (12.12 ± 4.71)%, P < 0.05]. Conclusion:T-2 toxin may affect the expression of HGF and C-Met in articular cartilage and epiphyseal cartilage of rats under low selenium condition.

According to the situation of 34 batches of natural rubber latex condoms tested by our center in 2018, the unqualified items in the product inspection items and the exploratory research results of D4 and D5 content in silicone oil lubricants are analyzed. We make recommendations on product technical requirements or standards to strengthen the quality supervision of products.
Condoms/standards* ; Latex ; Silicone Oils

With the increasing cost of drug development and clinical trials, it is of great value to make full use of all kinds of data to improve the efficiency of drug development and to provide valid information for medication guidelines. Model-based meta-analysis (MBMA) combines mathematical models with meta-analysis to integrate information from multiple sources (preclinical and clinical data, etc.) and multiple dimensions (targets/mechanisms, pharmacokinetics/pharmacodynamics, diseases/indications, populations, regimens, biomarkers/efficacy/safety, etc.), which not only provides decision-making for all key points of drug development, but also provides effective information for rational drug use and cost-effectiveness analysis. The classical meta-analysis requires high homogeneity of the data, while MBMA can combine and analyze the heterogeneous data of different doses, different time courses, and different populations through modeling, so as to quantify the dose-effect relationship, time-effect relationship, and the relevant impact factors, and thus the efficacy or safety features at the level of dose, time and covariable that have not been involved in previous studies. Although the modeling and simulation methods of MBMA are similar to population pharmacokinetics/pharmacodynamics (Pop PK/PD), compared with Pop PK/PD, the advantage of MBMA is that it can make full use of literature data, which not only improves the strength of evidence, but also can answer the questions that have not been proved or can not be answered by a single study. At present, MBMA has become one of the important methods in the strategy of model-informed drug development (MIDD). This paper will focus on the application value, data analysis plan, data acquisition and processing, data analysis and reporting of MBMA, in order to provide reference for the application of MBMA in drug development and clinical practice.

Objective To investigate the efficacy of neuroendoscopy combined with urokinase in the treatment of spontaneous intraventricular hemorrhage.Methods From August 2014 to August 2017,91 spontaneous thalamic hemorrhage ruptured into ventricles patients in Affiliated Hospital of the Yangzhou University were enrolled,who were underwent surgical treatment in this retrospective study.The patients were divided into the study group(n =41) and control group(n =50) based on different methods of treatment.The patients in the study group were given with remove visible intraventricular hematoma by neuroendoscopy,followed by External Ventricular Drainage (EVD) combined with urokinase fibrinolysis.The patients in control group were given with EVD combined with urokinase fibrinolysis.The time of postoperative drainage,ICU stay,duration of onset of fever,the number of intracranial infections,and the proportion of Glasgow outcome scale (GOS) (1 to 5) at 6 months postsurgery were compared between two groups.Measurement data were expressed as (Mean ± SD),and t test was used for measurement data.The count data were analyzed by x2 test or nonparametric rank sum test.Results The time of postoperative drainage,the number of intracranial infections,ICU stay in study group were (6.19 ± 1.1) d,5 cases,(2.8 ± 1.6) d,the indexes in control group were (7.06 ± 1.3) d,15 cases,(5.2 ± 2.0) d.The time of postoperative drainage,ICU stay,the number of intracranial infections were superior to those of the control group,and the difference was statistically significant.The proportion of GOS (1 to 5) at 6 months after surgery was 5 cases (12.2％),5 cases (12.2％),10 cases (24.4％),14 cases (34.1％),7 cases (17.1％) in study group,the indexes in control group were 10 cases(20.0％),13 cases (26.0％),11 cases(22.0％),10 cases(20.0％),6 cases(12.0％).The 6-month postoperative GOS of the study group were superior to those of the control group,and the difference was statistically significant (P ＜ 0.05).Conclusion Neruendoscopy combined with urokinase in the treatment of spontaneous intraventricular hemorrhage can reduce the time of postoperative drainage and the incidence of intracranial infection,shorten the time of ICU stay and improve the functional prognosis of the patients.

BACKGROUND: Mis Seven implant has become more and more popular in oral implant restoration, and the clinical application in dentate-deficient patients remains to be studied. OBJECTIVE: To explore the short-term effects of the Mis Seven implant system on fixed restorations in dentition loss. METHODS: Nineteen patients undergoing fixed dental prostheses with the Mis Seven system due to dentition loss at the Department of Implants of the Stomatological Hospital of Guangzhou Medical University between April 2015 and December 2017 were included. Three patients had missing maxillary and maxillary dentition and unilateral maxillary teeth. Six patients were loss of maxillary dentition, and there were 10 cases of unilateral mandibular dentition missing. The total dental implants were 134. All cases were implanted and fixed for one stage. Clinical examination, alveolar bone and inter-implant image performance and post-load repair effect at 6, 12 and 24 months of follow-up were used as evaluation indicators. RESULTS AND CONCLUSION: (1) In 134 implants, failure was in 2 cases due to surrounding tissue infection. The success rate of before implant restoration was 98.51％, and the success rate after repair was 100％. (2) The stability of dentition of 19 patients was good, showing good occlusion. No mechanical complications or biological complications occurred. The stability of the restoration was 100％. (3) The vertical absorption of bone tissue around all implants was less than 0.2 mm at 6, 12, 24 months after repair, suggesting that the implant has no obvious edge bone resorption. The gingival tissues around all implants were healthy, and no unhealed inflammation or hyperkeratosis appeared. (4) These results imply that the Mis Seven system in the dentition defect fixation exhibits good short-term clinical results.