Abstract:Abnormal ovarian function, including ovarian dysfunction and high ovarian response, is one of the important causes of female infertility. Women with abnormal ovarian function have undesirable pregnancy outcomes, manifested as high miscarriage rate, low live birth rate, increased pregnancy complications, and neonatal risk. The unsatisfactory pregnancy outcomes caused by abnormal ovarian function are attributed to the decline of oocyte quality and the disruption of the maternal environment. This article reviews the impact of abnormal ovarian function on pregnancy outcomes and its mechanism, so as to provide reference for the clinical comprehensive diagnosis and treatment and relative research.

Abstract:Stroke is the leading cause of death in China, and large vessel occlusion (LVO) stroke is the type of ischemic stroke with the highest mortality and disability rate. Clinical guidelines recommend early interventions through intravenous thrombolysis, bridging therapy, or endovascular treatment to salvage ischemic brain tissue. Therefore, early identification of LVO stroke is of vital importance for prehospital emergency and referrals. Currently, numerous assessment tools for predicting LVO stroke have been developed, such as the prehospital acute stroke triage (PAST) scale, emergent large vessel occlusion screen (ELVO) scale, Cincinnati prehospital stroke severity scale (CPSSS), emergency medical stroke assessment (EMSA) scale and large artery intracranial occlusion stroke (LARIO) scale. This article focuses on the content and prediction efficiency of these assessment tools developed in recent years for prehospital prediction of LVO stroke, aiming to facilitate their applications in clinical practice.

Abstract:Large vessel occlusion (LVO) stroke is the most severe subtype of stroke with high disability and mortality. This article reviews the progress in the definition, epidemiology, pathophysiology, etiology classification, influencing factors, clinical evaluation and emergency care of acute LVO stroke, so as to elucidate the risk factors and to provide support for the prevention and treatment of this disease. Incorporating the assessment of LVO stroke into the comprehensive framework of pre-hospital emergency care and nursing, coupled with training of interdisciplinary experts in clinical medicine and nursing, can significantly improve treatment outcomes for these patients and substantially contribute to the advancement of healthcare in China.

Abstract:Asymptomatic carotid atherosclerotic stenosis is a risk factor of ipsilateral ischemic cerebrovascular events. However, the treatments for asymptomatic carotid atherosclerotic stenosis are still controversial, for the medical practice contradicts with the clinical evidence. Hence, it is necessary to access the stroke risk of asymptomatic carotid atherosclerotic stenosis patients and choose vulnerable plaques for surgical intervention to improve the effectiveness of treatment. This review briefly summarizes the epidemiology and research progress on the treatment, stroke risk assessment and underlying intervention indications of asymptomatic carotid atherosclerotic stenosis, aiming to reduce unnecessary interventions and prevent stroke more effectively.

Abstract:Objective To investigate the effect of neuroendoscopic surgery on supratentorial hypertensive intracerebral hemorrhage. Methods Totally 42 patients with supratentorial hypertensive intracerebral hemorrhage treated in our center from Jan. to Dec. 2022 were retrospectively enrolled and divided into neuroendoscopic group (n=22) and craniotomy group (n=20) according to the treatment methods. The volume of residual hematoma, the rate of good prognosis 90 d after operation (modified Rankin scale score was 0-3), mortality, and complication incidence were compared between the 2 groups. Results The proportion of patients with postoperative residual hematoma less than 15 mL in the neuroendoscopic group (77.3 %, 17/22) was significantly higher than that in the craniotomy group (35.0 %, 7/20; P=0.022). In the neuroendoscopic group and craniotomy group, 14 (63.6 %) patients and 4 (20.0 %) patients had good prognoses 90 d after operation, respectively, with significant difference (P<0.001). The incidence of postoperative rebleeding was significantly lower in the neuroendoscopy group (4.5 %, 1/22) than that in the craniotomy group (5.0 %, 1/20; P=0.001). The incidence of postoperative pulmonary infection in both groups was 100 %, without significant difference (P=1.000). The 90 d mortality was significantly lower in the neuroendoscopic group (13.6 %, 3/22) than that in the craniotomy group (30.0. Conclusion, 6/20; P<0.001). Conclusion Neuroendoscopic surgery can improve the hematoma clearance rate, reduce complication incidence and mortality, and improve the prognosis of patients.

Abstract:Objective To investigate the status and influencing factors of quality of life of stroke patients, and to analyze the mediating effect of disease perception between family health and quality of life. Methods From May to Jun. 2023, 191 stroke patients who were admitted to Neurovascular Center of our hospital were enrolled by convenience sampling method. General data questionnaire, EuroQol five-dimensional questionnaire, Chinese version of family health scale and brief illness perception questionnaire were used to investigate the general information, quality of life, family health and disease perception, respectively. Multiple linear regression analysis was used to explore the influencing factors of quality of life of stroke patients. Pearson correlation analysis was used to study the relationships between family health, disease perception and quality of life. SPSS 25.0 software macro program Process Model4 was used to conduct mediation model test. Results The quality of life score of the stroke patients was 0.72±0.31, the family health score was 36.73±6.75, and the disease perception score was 49.99±13.17. Family health was positively correlated with quality of life and was negatively correlated with disease perception, and quality of life was negatively correlated with disease perception. The results of multiple linear regression showed that age, occupation, marital status, number of siblings, family health, and disease perception were the influencing factors of quality of life of stroke patients, and together accounted for 47.9 % of the variation. The results of mediation model test showed that disease perception played a partial mediating role between family health and quality of life. Conclusion The quality of life of stroke patients is at a general level, and disease perception plays a mediating role between family health and quality of life. Reducing the negative disease cognition of stroke patients and giving play to the collaborative support of family might be conducive to improving their quality of life.

Abstract:Objective To investigate the inhibitory effect of arsenic trioxide (ATO) on the expression of peptidylprolyl cis-trans isomerase NIMA-interacting 1 (Pin1) in liver cancer and its molecular mechanism. Methods The expression of Pin1 in human hepatocellular carcinoma cell lines and liver cancer tissue was analyzed using DepMap database and GEPIA database. Human hepatocellular carcinoma cell line Huh7 and mouse hepatocellular carcinoma cell line H22 were used as cell models to detect the effect of ATO on tumor cell viability by adenosine triphosphate method. The effects of ATO on Pin1 expression at protein and transcription levels were detected by Western blotting, immunofluorescence staining and quantitative polymerase chain reaction (qPCR). After pretreatment with chloroquine to inhibit lysosome pathway in Huh7 cells, the regulation effect of ATO on Pin1 expression was detected by Western blotting and immunofluorescence staining. The effects of ATO on hepatoma cell growth and Pin1 expression in vivo were verified by subcutaneous tumor-bearing mouse model and immunohistochemical staining. The possible signaling pathways affected by ATO were analyzed by RNA sequencing and were verified by Western blotting and qPCR. Results The expression of Pin1 in 23 kinds of human hepatocellular carcinoma cell lines in DepMap database and human hepatocellular carcinoma tissue in GEPIA database showed a high level. In vitro, the viability of Huh7 and H22 cells was decreased after ATO treatment, and the protein and transcription levels of Pin1 were decreased. The effect of ATO on Pin1 expression was reversed after inhibiting lysosomal pathway by chloroquine. In the subcutaneous tumor-bearing mouse model, ATO showed certain anti-tumor effects, and immunohistochemical staining showed that Pin1 expression and tumor cell proliferation were inhibited after ATO treatment. The genes related to Wnt/β-catenin pathway were enriched in ATO-treated H22 cells, and the expression of β-catenin was decreased after inhibiting Pin1 expression in H22 cells. Conclusion ATO inhibits proliferation of hepatocellular carcinoma cells by inhibiting Pin1 expression through lysosomal pathway and affecting Wnt/β-catenin signaling pathway.

Abstract:Objective To establish a label-free aptasensor based on the fluorescent dye thiazole orange (TO) and aptamer 45e-1 for rapid and sensitive detection of saxitoxin (STX). Methods The aptamer 45e-1 (50 nmol/L) was dissolved in buffer (20 mmol/L trihydroxymethyl aminomethane-HCl, 100 mmol/L NaCl, 2.5 mmol/L MgCl₂, 5 mmol/L KCl, pH=7.5). It was then heated in a water bath at 95℃ for 10 min, followed by cooling in an ice-water bath for 5 min. The STX standard solution was added, thoroughly mixed, and then incubated at room temperature for 10 min. After that, TO solution was added, and buffer was also added to make the reaction system volume 100 μL. The mixture was thoroughly mixed and incubated for 2 min at room temperature. Finally, the fluorescence intensity of the system was measured at excitation wavelength of 496 nm. Results When the molar concentration ratio of TO to 45e-1 was 5:1, the incubation time of TO and 45e-1 was 2 min, the incubation time of STX and 45e-1 was 10 min, the concentration of Mg²⁺ was 2.5 mmol/L, and the concentration of K⁺ was 5 mmol/L, the changes in fluorescence intensity showed a good linear relationship with STX concentration. The fitting linear equation was Y=3 639.8X+2 341.5 (R²=0.972 5; X was the common logarithm of STX concentration[nmol/L]), and the detection limit was 0.67 nmol/L. The cross-reaction with other common marine toxins was negligible. In seawater, the recovery rate was 90.7 %-108.7 %, and the relative standard deviation was 7.1 %-10.9 %. Conculsion The label-free aptasensor established in this study can achieve the quantitative detection of STX with good specificity and reproducibility.

Abstract:Objective To establish a method for distinguishing microglia and infiltrating macrophages in central nervous system by fluorescence-activated cell sorting. Methods Adult C57BL/6 mice with bilateral common carotid artery stenosis were treated with PLX5622 (a colony stimulating factor 1 receptor inhibitor) or clodronate liposomes. After separating, homogenizing and resuspending brain and spinal cord tissue, the mononuclear cell suspensions were obtained by Percoll density gradient centrifugation. Anti-CD45, anti-CD11b, and anti-lymphocyte antigen 6 family member C (Ly6C) were used to obtain microglia (CD11b⁺CD45^lowLy6C^- cells) and infiltrating macrophages (CD11b⁺CD45^highLy6C⁺ cells) by fluorescence-activated cell sorting. The treatment effects of PLX5622 and clodronate liposomes were verified. Results Microglia and infiltrating macrophages in the central nervous system were effectively distinguished by anti-CD45, anti-CD11b, and anti-Ly6C. Compared with the control group, the number of microglia was significantly decreased after PLX5622 treatment (P=0.001), while the number of infiltrating macrophages was significantly decreased after clodronate liposome treatment (P<0.001). Conclusion The established method can effectively distinguish microglia and infiltrating macrophages in central nervous system by fluorescence-activated cell sorting, and PLX5622 and clodronate liposomes can selectively eliminate microglia and infiltrating macrophages in the central nervous system.

Abstract:Objective To investigate whether ruxolitinib can slow down the progression of primary myelofibrosis (PMF) by inhibiting angiogenesis at exosome level. Methods Exosomes were extracted from bone marrow samples collected from 3 newly diagnosed PMF patients before treatment (newly diagnosed group) and after 3 month of treatment with ruxolitinib (ruxolitinib group) and 3 primary immune thrombocytopenia patients (control group). The expression of angiogenesis-related factors in exosomes was detected by Western blotting. The exosomes were co-cultured with human umbilical vein endothelial cells (HUVECs) for 24 h. The proliferation ability of HUVECs was detected by cell counting kit 8 method. The cell cycle distribution of HUVECs was detected by flow cytometry. The migration and invasion of HUVECs were detected by scratch assay and Transwell invasion assay. The mRNA and protein expression levels of invasion- and proliferation-related factors in HUVECs were detected by quantitative polymerase chain reaction and Western blotting. Results Compared with the control group, the expression levels of vascular endothelial growth factor (VEGF), VEGF receptor 1 (VEGFR1), hypoxia inducible factor-1α (HIF-1α) and cyclooxygenase-2 (COX-2) in the exosomes were significantly higher in the newly diagnosed group (all P<0.01), while they were significantly lower in the ruxolitinib group than those in the newly diagnosed group (all P<0.01). Compared with the control group, the proliferation, migration and invasion of the HUVECs co-cultured with exosomes were significantly enhanced in the newly diagnosed group (all P<0.05), while they were significantly weakened in the ruxolitinib group than those in the newly diagnosed group (all P<0.05). The proportion of HUVECs co-cultured with exosomes at S phase was higher in the newly diagnosed group than that in the control group, while the proportion of HUVECs co-cultured with exosomes at S phase was lower in the ruxolitinib group than that in the newly diagnosed group. Compared with the control group, the mRNA and protein expression levels of matrix metalloproteinase (MMP)-2, MMP-9, focal adhesion kinase (FAK) and proliferating cell nuclear antigen (PCNA) in the HUVECs co-cultured with exosomes were significantly higher in the newly diagnosed group (all P<0.01), while they were significantly lower in the ruxolitinib group than those in the newly diagnosed group (all P<0.01). Conclusion Bone marrow-derived exosomes can promote the progression of PMF through angiogenesis, and ruxolitinib can inhibit angiogenesis at exosome level to exert the therapeutic effect of PMF in vitro.

Abstract:Objective To compare the effects of neurokinin-1 (NK-1) receptor antagonist (RA) plus tropisetron versus dexamethasone plus tropisetron against moderately emetogenic chemotherapy-induced nausea and vomiting (MECCINV). Methods A non-inferiority trial was designed. Patients who received moderately emetogenic chemotherapy in Department of Oncology of General Hospital of Southern Theater Command of PLA from Apr. 2021 to Jan. 2022 were randomly assigned to NK-1 RA (NK-1 RA+tropisetron) group or dexamethasone (tropisetron+dexamethasone) group by random number table method. Primary evaluation indexes were complete response (CR) rates of vomiting at overall phase (0- 120 h), delayed phase (24-120 h) and acute phase (<24 h). Secondary evaluation indexes were complete control (CC) rate of nausea and total response (TR) rate of nausea and vomiting at each phase. Safety indexes were adverse events (symptoms such as fatigue, constipation, hiccup and insomnia; abnormal laboratory indicators such as decline of leukocyte, neutrophil, hemoglobin and platelet and increase of alanine transaminase and/or aspartate transaminase and serum creatinine). The intervention effects of the 2 groups were compared by difference test (test level was 0.05) and non-inferiority test (noninferiority margin was 15 %, and test level was 0.025). Results A total of 101 patients participated in the study, including 51 in the NK-1 RA group and 50 in the dexamethasone group. The CR rates of vomiting at overall phase in the NK-1 RA group and dexamethasone group were 58.8 % (30/51) and 56.0 % (28/50), respectively, and non-inferiority test showed no statistical significance (P_{non-inferiority}=0.035, rate difference[RD]=2.80 %, 95 % confidence interval[CI]-16.5 %-22.1 %); the CR rates of vomiting at acute phase were 80.4 % (41/51) and 78.0 % (39/50), respectively, and non-inferiority test was statistically significant (P_{non-inferiority}=0.016, RD=2.40 %, 95 % CI -13.4 %-18.2 %); and the CR rates of vomiting at delayed phase were 62.7 % (32/51) and 58.0 % (29/50), respectively, and non-inferiority test was statistically significant (P_{non-inferiority}=0.021, RD=4.70 %, 95 % CI -14.4 %-23.8 %). The CC rate of nausea at each phase was slightly higher in the NK-1 RA group than that in the dexamethasone group, and the non-inferiority test was statistically significant (all P_{non-inferiority}<0.025). There was no significant difference in the safety indicators between the 2 groups (all P>0.05). Conclusion In MEC-CINV patients, the control effect of antiemetic regimen of NK-1 RA combined with tropisetron on nausea and vomiting is non-inferior to the standard dual regimen dexamethasone combined with tropisetron, and the safety is good.

Abstract:Objective To explore the relationship between serum ferroptosis-related indexes and cognitive impairment in postmenopausal women. Methods A total of 148 women were selected from Department of Neurology of The First Affiliated Hospital of Naval Medical University (Second Military Medical University) from Aug. 2019 to Dec. 2021, including 22 cases in reproductive group, 11 in perimenopausal group, and 115 in postmenopausal group. The general information and serum ferroptosis-related indexes (glutathione peroxidase 4[GPX4], reduced glutathione[GSH], cystine/glutamate antiporter[system Xc^-], acyl-CoA synthetase long-chain family member 4[ACSL4], reactive oxygen species (ROS), lipid hydroperoxide[LPO], and malondialdehyde[MDA]) of the 3 groups were compared. According to Montreal cognitive assessment (MoCA) score, the postmenopausal women were divided into cognitive impairment group (n=77) and non-cognitive impairment group (n=38). The levels of the serum ferroptosis-related indexes were compared between the 2 groups. Multiple logistic regression model was used to analyze the influencing factors of cognitive impairment in postmenopausal women. Receiver operating characteristic (ROC) curve was used to analyze the diagnostic value of the influencing factors for cognitive impairment in postmenopausal women. Results Compared with the reproductive and perimenopausal groups, the MoCA score of the postmenopausal group was significantly lower (both P<0.05). The serum levels of system Xc^-, GPX4, GSH, ACSL4, ROS, LPO and MDA were gradually increased in the reproductive, perimenopausal and postmenopausal groups, and the differences were significant (all P<0.001). Compared with the noncognitive impairment group, the educational years of the postmenopausal women was significantly shorter in the cognitive impairment group, and serum levels of system Xc^-, GPX4, GSH, ACSL4, ROS, LPO and MDA were significantly higher (all P<0.05). Multiple logistic regression analysis showed that educational years (OR=0.785, 95 % confidence interval[CI]0.662-0.930, P=0.005) and serum GSH (OR=1.291, 95 % CI 1.087-1.534, P=0.004) were the influencing factors of cognitive impairment in postmenopausal women, and ROC curve analysis showed that area under curve of the combination in diagnosing cognitive impairment was 0.764, with a sensitivity of 0.750 and a specificity of 0.676. Conclusion The serum levels of ferroptosis-related indexes system Xc^-, GPX4, GSH, ACSL4, ROS, LPO and MDA are increased in postmenopausal women. Serum GSH is associated with cognitive impairment, and its combination with educational years may be a potential marker for early diagnosis of cognitive impairment in postmenopausal women.

Abstract:Objective To explore the relationships between systemic immune-inflammation response index (SIIRI) and the severity of coronary artery stenosis and long-term major adverse cardiovascular events (MACEs) in patients with coronary heart disease (CHD). Methods A total of 545 patients admitted to No. 904 Hospital of Joint Logistics Support Force of PLA due to chest pain and underwent coronary angiography from Dec. 2020 to Dec. 2021 were retrospectively enrolled. According to the results of coronary angiography, the patients were divided into CHD group (n=435) and non-CHD group (n=110). According to the Gensini score, the CHD patients were divided into severe coronary artery stenosis group (Gensini score ≥ 30, n=272) and mild coronary artery stenosis group (Gensini score 1-<30, n=163). The SIIRI calculation formula was:SIIRI=neutrophil count×monocyte count×platelet count÷lymphocyte count. The CHD patients were followed up for 1 year and 216 patients were successfully followed up. Based on the follow-up results, the 216 patients were divided into MACE group (n=77) and non-MACE group (n=139). Logistic regression model was used to analyze the independent predictors of CHD and severe coronary artery stenosis. Cox proportional hazard regression model was used to analyze the independent risk factors of MACEs in CHD patients after percutaneous coronary intervention (PCI). Receiver operating characteristic curve was used to analyze the predictive value of SIIRI for severe coronary artery stenosis and MACEs. Results The SIIRI of the CHD group was significantly higher than that of the non-CHD group (305.19×10¹⁸[170.98×10¹⁸, 550.76×10¹⁸]/L² vs 121.25×10¹⁸[91.17×10¹⁸, 194.41×10¹⁸]/L², P<0.001). The ability to predict CHD was the strongest when the SIIRI cutoff value was 251.02×10¹⁸/L², with a sensitivity of 58.9 % and a specificity of 90.9 %. The SIIRI of the severe coronary artery stenosis group was significantly higher than that of the mild coronary artery stenosis group (420.75×10¹⁸[238.76×10¹⁸, 810.13×10¹⁸]/L² vs 185.41×10¹⁸[127.39×10¹⁸, 294.07×10¹⁸]/L², P<0.001). When the SIIRI cutoff value was 304.86×10¹⁸/L², the efficacy of predicting severe coronary artery stenosis was the highest, with a sensitivity of 68.0 % and a specificity of 79.1 %. The SIIRI of the MACE group was significantly higher than that of the non-MACE group (942.38×10¹⁸[528.00×10¹⁸, 1 494.43×10¹⁸]/L² vs 319.93×10¹⁸[176.41×10¹⁸, 498.90×10¹⁸]/L², P<0.001). When the SIIRI cutoff value was 650.23×10¹⁸/L², the predictive ability for MACEs after PCI was the strongest, with a sensitivity of 71.4 % and a specificity of 84.9 %. The values of area under curve for SIIRI in predicting CHD, severe coronary artery stenosis, and MACEs were 0.809 (95 % confidence interval[CI]0.770-0.848), 0.775 (95 % CI 0.732-0.819), and 0.798 (95 % CI 0.732-0.864), respectively, and were all higher than those of systemic immune-inflammation index, systemic inflammatory response index, platelet to lymphocyte ratio, neutrophil to lymphocyte ratio, and monocyte to lymphocyte ratio. Conclusion SIIRI is an independent risk factor of CHD and severe coronary artery stenosis. It also has good predictive value for long-term MACEs in CHD patients after PCI.

Abstract:Objective To investigate the effects of atropine eye drops of different concentrations and administration frequencies on pupil diameter, accommodative amplitude, and tear film function in myopic children. Methods The left eye data of 280 myopic children who were treated in our hospital from Jan. 2018 to Jan. 2021 were selected. The randomized envelope method was used to divide the patients into 4 groups (groups A, B, C, and D), with 70 cases (70 eyes) in each group. Patients in the group A were given 0.01 % atropine eye drops every night at bedtime (both eyes); patients in the group B were given 0.01 % atropine eye drops every other night at bedtime (both eyes); patients in the group C were given 0.02 % atropine eye drops every night at bedtime (both eyes); patients in the group D were given 0.02 % atropine eye drops every other night at bedtime (both eyes); and all of them were given 1 drop each time per eye. The pupil diameter, accommodative amplitude, equivalent spherical diopter, axial length, anterior chamber depth, tear film function, and adverse reactions of the 4 groups of patients were compared before and 4, 8, and 12 months after treatment. Results Before treatment, there were no significant differences in pupil diameter, accommodative amplitude, equivalent spherical diopter, axial length, anterior chamber depth, or tear film lipid layer thickness between the 4 groups (all P>0.05). There were no significant differences in pupil diameter, accommodative amplitude, equivalent spherical diopter, axial length, anterior chamber depth, or lipid layer thickness before and after treatment between the 4 groups (all P_group>0.05). The change trends of pupil diameter, accommodative amplitude, equivalent spherical diopter, axial length, anterior chamber depth and tear film lipid layer thickness at different time points before and after treatment were the same in each group (all P_time>0.05). At each time point after administration, the pupil diameter and equivalent spherical diopter were significantly greater than those before administration, and the accommodative amplitude was significantly less than that before administration (all P<0.01). At 4 and 8 months after administration there was no significant difference in the axial length of each group compared with that before administration (all P>0.05), but at 12 months after administration the axial length of each group was significantly greater than that before administration (all P<0.05); and there were no significant differences in anterior chamber depth or tear film lipid layer thickness before and after administration in each group (all P>0.05). There were no significant differences in pupil diameter, accommodative amplitude, equivalent spherical diopter, axial length, anterior chamber depth, or tear film lipid layer thickness at each time point between the groups (all P>0.05), and there was no interaction between different treatments and administration time points (all P_interaction>0.05). Within 1 month after treatment, some children were afraid of strong light; according to intention to treat analysis (ITT), there were 12 (17.14 %) cases in the group A, 11 (15.71 %) in the group B, 16 (22.86 %) in the group C, and 13 (18.57 %) in the group D, with no significant difference (P>0.05); according to per-protocol analysis (PP), there were 12 (18.18 %) cases in the group A, 10 (15.62 %) in the group B, 14 (20.90 %) in the group C, and 11 (16.42 %) in the group D, with no significant difference (P>0.05). There were also some myopic children with blur of close-up reading within 1 month after treatment; according to ITT, there were 7 (10.00 %) cases in the group A, 4 (5.71 %) in the group B, 6 (8.57 %) in the group C, and 8 (11.43 %) in the group D, with no significant difference (P>0.05); according to PP, there were 5 (7.58 %) cases in the group A, 3 (4.69 %) in the group B, 6 (8.96 %) in the group C, and 5 (7.46 %) in the group D, with no significant difference (P>0.05). Conclusion Daily or every other day eye drops of 0.01 % or 0.02 % atropine have the same effects on pupil diameter, accommodative amplitude and equivalent spherical diopter of myopic children, and there was no significant difference in adverse reactions.

Abstract:Hepatocellular carcinoma (HCC) is a highly malignant tumor and the third cause of cancer-related death. Serum α-fetoprotein and imaging examination are the most commonly used tests for early diagnosis, treatment and dynamic efficacy monitoring of HCC. However, the accuracy of these approaches is limited and can not clearly reflect the underlying biological characteristics of the tumor. Therefore, novel HCC tumor markers that are more accurate and can comprehensively reflect the biological characteristics of the tumor have potential clinical application value. Circulating tumor cell (CTC), as a kind of cancer cells derived from primary tumors or metastases, provides important information about tumor progression and metastasis, and is good candidate for early diagnosis and evaluation of metastasis, recurrence, and prognosis, and even potential therapeutic target for HCC. This article discusses the application of CTC in the whole clinical course management of HCC patients, as well as its limitations and future research direction.

Abstract:Optical coherence tomography (OCT) is a tissue imaging based on infrared ray, and it can achieve a resolution up to 10-20 μm. It has been widely used in the diagnosis and treatment of coronary artery diseases, and its applications in the diagnosis and treatment of cerebrovascular diseases have also been increasingly valued. The applications of OCT in interventional diagnosis and treatment of carotid artery stenosis, intracranial artery stenosis and dissection, cerebral aneurysms and cerebral venous diseases have made some progress, but there is still a lack of robust large-sample evidence. Due to the unique anatomical features of cerebral vessels, there is a need for more suitable instrument designs. With the continuous improvement in instrument designs and techniques, OCT is expected to become a crucial imaging tool for the prevention, diagnosis, and treatment of cerebrovascular diseases.

Abstract:Histone modifications, as one of the epigenetic mechanisms, play a crucial role in chromatin structure, nucleosome localization, and regulation of gene expression. Recent studies have revealed that histone modifications such as acetylation, methylation, phosphorylation and ubiquitination regulate the differentiation of osteoclasts and osteoblasts and affect bone homeostasis. This article reviews the research progress of histone modifications in regulating the differentiation and function of osteoclasts and osteoblasts.

Abstract:Objective To investigate the food and nutrient intake, physical development, energy expenditure, and physical fitness of military university students, and to evaluate their dietary and nutritional status. Methods A total of 46 undergraduate students majoring in preventive medicine in a naval college were selected as survey objects. Caloric energy, nutrient intake, and physical condition were investigated by dietary survey, physical measurement, energy expenditure survey, dietary nutrition questionnaire survey, and physical fitness test. Results Among the 46 military university students, the intakes of grains, vegetables, fruits, aquatic products, milk and dairy products, vegetable oil and fungi and algae were insufficient, and the intakes of livestock meat and poultry meat were excessive. The average daily energy intake per student was 3 444 kcal (1 kcal=4.184 kJ), which was higher than the upper limit of daily energy intake per person in military standard (3 000 kcal) and average daily energy consumption per student calculated by 24-h life observation method (2 656 kcal). Among the 3 major productivity nutrients, the energy supply ratio of carbohydrates was insufficient (32.8 %, military standard 55 %- 65 %), the energy supply ratio of fat exceeded the standard (49.8 %, military standard 20 %-30 %), and the protein energy supply ratio was slightly higher (17.4 %, military standard 12 %-15 %). Among the micronutrients, the intakes of phosphorus, sodium and iron exceeded the standard, and the intake of vitamin A was insufficient. The proportions of overweight/obese students (n=13, 28.3 %) and those who failed in physical fitness test (n=16, 34.8 %) were high. The results of the questionnaire survey showed that average score of nutrition knowledge was low (67.4). Conclusion The students' dietary structure is not reasonable, the ratio of the 3 major nutrients is unbalanced, the intake of micronutrients is unbalanced, and the proportion of overweight students is high. It is recommended to reduce the intakes of livestock meat and poultry meat, reduce the use of condiments, increase the intakes of grains, vegetables and fruits, increase the supply of aquatic products and milk and dairy foods, and strengthen the publicity and education of reasonable dietary science.

Abstract:Objective To investigate the safety and efficacy of individualized endovascular treatment in patients with symptomatic intracranial atherosclerotic stenosis (sICAS). Methods The clinical data of sICAS patients who received individualized endovascular treatment in our hospital from Jan. 2019 to Dec. 2022 were retrospectively collected. The success rate of revascularization, the perioperative complications and death, and the incidence of recurrent ischemic stroke (IS), transient ischemic attack, death and restenosis during follow-up were analyzed. Results There were 55 lesions of 52 sICAS patients, and they all received endovascular treatment. The mean age was (62.94±9.04) years old. The preoperative stenosis severity was 90 % (80 %, 99 %) and the stenosis length was 8 (5, 11) mm. The surgical methods were balloon-mounted stenting (25 cases, 27 lesions), self-expanding stenting (19 cases, 20 lesions), and simple balloon dilation angioplasty (8 cases, 8 lesions). The postoperative residual stenosis severity was 10 % (0, 20 %), which was significantly lower than that before surgery (P<0.001). The success rate of revascularization was 94.23 % (49/52). The incidence of perioperative complications was 3.85 % (2/52). The clinical follow-up time was 12 (12, 18) months and the imaging follow-up time was 10 (6, 12) months. During the follow-up period, the incidence of vascular restenosis was 7.69 % (4/52), the incidence of recurrent IS was 1.92 % (1/52), and there was no death. Conclusion Individualized endovascular treatment is safe and effective for sICAS patients. It can improve the success rate of revascularization and reduce perioperative complications, long-term recurrence rate of IS and risk of restenosis.