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With severe soil and water erosion, the crucial ion-adsorption rare earth elements (REEs) have attracted much global attention. REEs play a vital role in tracing material sources and exploring sedimentary characteristics due to their unique and stable geochemistry properties. In the present work, three representational possible redeposition areas in western Fujian were selected as the study areas. The geochemical characteristics of REEs in the sediments of the study areas were evaluated to elucidate that REEs are the products of soil and water erosion and to assess their redeposition characteristics. In the research results, the properties of the parent rocks shown in the samples, together with the negative correlation between the content of REEs in the samples and altitude as well as the relief degree on the land surface (RDLS), fully indicate that the sediments in the study areas are the products of migration caused by soil erosion and redeposition in the downstream areas. At the same time, according to the widely applicable standard of rare earth resources exploitation, that is the boundary grade of ion-adsorption rare earth ore in southern China (∑REE = 500 mg·kg-1), we found that the content of REEs in the study areas was close to or exceeded this standard, and the maximum ∑REE of Guozhai Reservoir (869.11 mg·kg-1) was much larger than this standard. Therefore, the redeposited rare earth in Changting Country has high reuse potential under the current scarce resources.

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【Objective】 To statistically analyze the relationship between homologous recombination repair deficiency (HRD) score and clinicopathological characteristics, genomic mutations in patients with high-risk and metastatic hormone-sensitive prostate cancer (mHSPC) and the prognostic predictive value in mHSPC. 【Methods】 A total of 127 patients diagnosed with high-risk prostate cancer and mHSPC, treated at the Department of Urology of Chinese PLA General Hospital during Dec.2021 and Nov.2023 were enrolled.Homologous recombination repair (HRR) gene sequencing was performed, and the genomic scar score (GSS) algorithm were conducted to calculate the HRD score.The relationship between HRD scores and clinicopathological features, genomic alterations, and prognosis were analyzed. 【Results】 The median HRD score was 1.6(0.8, 5.2), 30(23.6%) patients’ HRD scores ≥10, and 11(8.7%) patients’ HRD scores ≥20.Clinicopathological features, including ISUP classification ≥4 (P=0.044) and metastatic status (P=0.008) were associated with high HRD score.Patients with mutations in the BRCA, TP53 and MYC systems had significantly higher HRD score than those with wild-type genes (P<0.05).In mHSPC, the risk of biochemical recurrence was 12.836 times higher in patients with HRD score ≥20 than in those with <20 [OR:12.836 (1.332-124.623), P=0.028]. 【Conclusion】 Baseline HRD score was lower in patients with high-risk prostate cancer and mHSPC.Patients with high HRD score may have higher histological grading (ISUP≥4) and later clinical stage.Further investigation is needed to determine the threshold of HRD scores as biochemical markers suggestive of a poor prognosis.

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Objective:To explore the predictive value of neutrophil to albumin ratio (NAR) in patients with severe acute pancreatitis (SAP) complicated with abdominal infection.Methods:The clinical data of 93 SAP patients admitted to Shunyi Teaching Hospital, Capital Medical University from January 2020 to December 2022 were retrospectively analyzed. According to the incidence of abdominal infection during hospitalization, the patients were divided into infection group (21 cases) and non-infection group (72 cases). The general data, first laboratory examination indexes and NAR values within 24 h after admission were collected and compared between the two groups. Logistic regression was used to analyze the influencing factors of abdominal infection in SAP patients. The predictive value of NAR for abdominal infection in SAP patients was analyzed by receiver operating characteristic (ROC) curve.Results:The number of organ failure in the infection group was higher than that in the non-infection group: 2.00 (1.00, 2.00) vs.1.00 (1.00, 2.00), with a statistical significant difference ( P<0.05). The levels of neutrophil (NEU), C-reactive protein and NAR in the infection group were higher than those in the non-infection group: (10.18 ± 1.26) × 10 8/L vs. (9.43 ± 1.13) × 10 8/L, (16.75 ± 2.27) mg/L vs. (15.16 ± 2.41) mg/L, (3.62 ± 0.63) × 10 8/g vs. (3.11 ± 0.47) × 10 8/g, and the level of albumin was lower than that in the non-infection group: (28.45 ± 3.16) g/L vs. (30.57 ± 2.94) g/L, with a statistical significant difference ( P<0.05). Logistic regression analysis showed that a large number of organ failure, high levels of NEU, C-reactive protein and NAR were risk factors for abdominal infection in SAP patients ( OR>1, P<0.05). The low level of Alb was the protective factor of abdominal infection in SAP patients ( OR<1, P<0.05). The ROC curve analysis showed that NAR predicted the area under curve of SAP patients complicated with abdominal infection to be 0.74, which has certain predictive value. Conclusions:NAR is associated with abdominal infection in SAP patients, and can assist clinical early prediction of the risk of abdominal infection.

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Objective@#To analyze the prevalence of elevated blood pressure among primary and middle school students in Anhui Province in 2022, as well as its influencing factors, so as to provide scientific evidence for the development of effective measures to prevent and control elevated blood pressure among children and adolescents.@*Methods@#Using data from the 2022 "Monitoring of Common Diseases and health Influencing Factors of Students" in Anhui Province, a total of 210 360 primary and middle school students aged 7 to 17 with complete information. Statistical analysis, including independent sample t tests, analysis of variance, and Chi square tests, were conducted to compare blood pressure differences and prevalence rates among students with different characteristics. Generalized linear mixed models were established to analyze the influencing factors of elevated blood pressure in children and adolescents.@*Results@#The overall prevalence of elevated blood pressure among primary and middle school students in Anhui Province was 22.3%, higher among high school students (25.6%) and junior high school students ( 23.7%) than elementary school students (20.4%) ( χ 2=528.49, P < 0.01 ); higher among obese(33.3%) and overweight students (24.9%) than that of normal students (18.6%) ( χ 2=3 704.52, P <0.01), higher among rural students (23.1%) than urban students (21.4%) ( χ 2=83.39, P <0.01), and higher in the northern part of Anhui Province (26.9%) than in the central part (21.9%) and southern part (17.6%) ( χ 2=1 777.51, P <0.01). The generalized linear mixed models revealed that girls, high school stage, overweight, obese, living in the northern part of Anhui Province, and living in rural were all positively correlated with elevated blood pressure( OR =1.11，1.25，1.47，1.45，2.24，1.21，1.67， P <0.01).@*Conclusions@#The prevalence of elevated blood pressure among children and adolescents in Anhui Province is the highest in the country. It is recommended that relevant departments promptly formulate corresponding measures to curb the increasing trend of elevated blood pressure and protect the physical and mental health of children and adolescents.

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ObjectiveThrough the review of the literature about Asari Radix et Rhizoma， we extracted the key information affecting the toxicity of Asari Radix et Rhizoma， aiming to provide a basis for the rational application of Asari Radix et Rhizoma in the classical prescriptions. MethodThe bibliometric method was employed to analyze the ancient and modern literature and thus reveal the relationship of Asari Radix et Rhizoma toxicity with the medicinal plants， medicinal part， processing method， dosage form， prescription compatibility， medication method， and patients' physical factors. ResultThe dosage of Asari Radix et Rhizoma in Danggui Sinitang and Houpo Mahuangtang was 9 g and 6 g， respectively， and the decocting time should be longer than 120 min. The single dosage of Asari Radix et Rhizoma in Xinyisan， Sanbitang， Daqinjiao Tang， and Qingshang Juantongtang were 0.8， 1.2， 0.9， and 1.1 g， respectively. The rhizome of Asarum heterotropoides var. mandshuricum or A. sieboldii var. seou1ense should be selected for Danggui Sinitang， Houpo Mahuangtang， and Qingshang Juantongtang， while that of A. siebodii var. seou1ense should be selected for Xinyisan. In terms of processing， Asari Radix et Rhizoma can be processed with wine when being used in Danggui Sinitang， Houpo Mahuangtang， Sanbitang， and Daqinjiaotang， and it can be stir-fried when being used in Xinyisan and Qingshang Juantongtang. In addition， the toxicity of Asari Radix et Rhizoma is associated with the compatibility of drugs and the physical conditions of patients. ConclusionBy reviewing the literature on Asari Radix et Rhizoma toxicity， we obtained the key information affecting the toxicity of Asari Radix et Rhizoma and explored the effective ways to avoid the toxicity. This study provides a sufficient basis for the rational development and safe application of the classical prescriptions containing Asari Radix et Rhizoma.

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Objective:To investigate the influence of bacterial outer membrane vesicles (OMVs) tumor vaccine on tumor cell proliferation and CD8 + T cell infiltration of mouse with pancreatic cancer. Methods:The experimental study was conducted. The ovalbumin (OVA) lentivirus vector plasmid pLV-EF1a-hluc-P2A-mNeongreen-CMV-OVA-3Xflag-P2A-puro was used to construct the mouse pancreatic cancer Pan02-OVA cells. The ClyA-Catchers-OMVs (CC-OMVs) originated from Escherichia coli and labeled antigenic peptide SpyTag-OVA were used to construct the OMVs tumor vaccine. Mouse CD8 + T cells were stimulated by OMVs tumor vaccine, and the effects of OMVs tumor vaccine on inhibiting pancreatic cancer cells proliferation and stimulating CD8 + T cell infiltration were analy-zed by in vitro cell killing assay, including the OMVs tumor vaccine stimulated T cell group and the control T cell group, subcutaneous pancreatic cancer model, including the OMVs tumor vaccine group and the control group, and immunohistochemical staining. Observation indicators: (1) identification of mouse pancreatic cancer Pan02-OVA cells; (2) morphological observation of CC-OMVs; (3) inhibi-tion of mouse pancreatic cancer Pan02-OVA cells by OMVs tumor vaccine specific T cells; (4) inhibi-tion of mouse pancreatic cancer by OMVs tumor vaccine; (5) CD8 + T cell infiltration in pancreatic cancer tissue of mouse stimulated by OMVs tumor vaccine. Measurement data with normal distribu-tion were represented as Mean± SD, and comparison between groups was analyzed using the t test. Count data were described as absolute numbers or percentages. Results:(1) Identification of mouse pancreatic cancer Pan02-OVA cells. Results of laser scanning confocal microscopy showed that the mNeongreen fluorescence was expressed in Pan02-OVA cells infected with the OVA lentivirus vector plasmid of pLV-EF1a-hluc-P2A-mNeongreen-CMV-OVA-3Xflag-P2A-puro. Results of Flow cytometry showed that using the mouse pancreatic cancer Pan02 cells as references, the protein expression rate of Flag on the Pan02-OVA cells was 90.7%. (2) Morphological observation of CC-OMVs. Results of transmission electron microscopy analysis showed that the CC-OMVs were in spherical shape, with a diameter <50 nm. (3) Inhibition of mouse pancreatic cancer Pan02-OVA cells by OMVs tumor vaccine specific T cells. Results of cell proliferation toxicity test showed that the absorbance at 450 nm of mouse pancreatic cancer Pan02-OVA cells was 0.41±0.12 and 1.05±0.15 in the OMVs tumor vaccine-stimulated T cell group and the control T cell group, respectively, showing a significant difference between the two groups ( t=9.54, P<0.05). (4) Inhibition of mouse pancreatic cancer by OMVs tumor vaccine. The weight of subcutaneous tumor tissue in the back of mouse was (81±10)g and (153±17)g in the OMVs tumor vaccine group and the control group, respectively, showing a significant difference between the two groups ( t=8.26, P<0.05). (5) CD8 + T cell infiltration in pancreatic cancer tissue of mouse stimulated by OMVs tumor vaccine. Results of immuno-histochemical staining showed that the numbers of CD8 + T cells staining in the mouse back subcu-taneous tumor tissues was 28.7±3.5 and 9.3±1.5 in the OMVs tumor vaccine group and the control group, respectively, showing a significant difference between the two groups ( t=8.74, P<0.05). Conclusion:Bacterial OMVs tumor vaccine can inhibit proliferation of pancreatic cancer cells and increase the numbers of CD8 + T cells infiltrated in pancreatic cancer tissue of mouse.

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Objective:To evaluate the efficacy and side effects of PD-1 monoclonal antibody in the treatment of advanced metastatic renal cell carcinoma in China.Methods:The clinical data of 117 patients with advanced metastatic renal cell carcinoma (mRCC) treated with PD-1 monoclonal antibody from October 2016 to February 2022 were retrospectively analyzed. There were 87 males (74.4%) and 30 females (25.6%), with an average age of (57.9±10.9) years old, BMI of (23.6±3.4) kg/m 2and smoking history of 79 (67.5%). There were 44 cases (37.6%) with hypertension, 19 (16.2%) cases of diabetes. The ECOG score of 59.8% (70/117) patients was 0, 33.3% (39/117) was 1, 4.3% (5/117) was 2, and 2.5% (3/117) was 3. The pathological type of 104 cases were renal clear cell carcinoma (ccRCC), 8 cases of papillary renal cell carcinoma, 2 cases of chromophobe cell carcinoma, 2 cases of collecting duct carcinoma and 1 case of eosinophilic cell carcinoma. The general condition of the overall population and the overall survival (OS) of relevant subgroups were analyzed. Secondary goals included progression free survival (PFS), objective response rate (ORR), adverse reactions, overall survival (OS), and progression free survival (PFS). Results:65.8% (77 / 117) of the patients chose targeted combined with PD-1 monoclonal antibody in the first-line treatment. The main targeted drugs were acitinib (81.8%, 63 / 77), tirelizumab (37.6%, 29 / 77) and cindilimab (25.9%, 20 / 77). After first-line treatment, 19.6.1% (23 / 117) patients needed to be converted to second-line treatment, and 15 patients changed the type of PD-1 antibody during treatment. In addition, the targeted drug of combined therapy was replaced by acitinib in 8 patients. The main causes of drug withdrawal were disease progression (70.7%, 29 / 41) and death (29.2%, 12 / 41). The median OS of the overall population was 35.6 (19-60) months and PFS was 12.1 (1-60) months. The ORR of the overall population was 47.8% (56 / 117). 4.2% (5/117) patients had complete remission, another 17.0% (20/117) patients were in stable condition, and 43.5% (51 / 117) patients were in partial remission. In the first-line treatment, the median PFS time of targeted combined with PD-1 monoclonal antibody was 12.6 (1-30) months, the median PFS time of PD-1 single drug immunotherapy was 10.5 (1-60) months. In the second-line treatment, the PFS of patients treated with PD-1 monoclonal antibody was 10.1 (4-19) months, and that of patients treated with PD-1 monoclonal antibody combined with targeted therapy was 11.7 (1-25) months. The most common adverse reactions were elevated blood pressure (18.5%, 23 / 124), followed by hypothyroidism (15.3%%, 19/124), rash (14.5%, 18 / 124), elevated transaminase (10.5%, 13 / 124) and bone marrow suppression (9.7%, 12/124). 9.4% (11 / 117) patients needed to reduce the related adverse reactions by interrupting the treatment control of PD-1 monoclonal antibody.Conclusions:The safety and efficacy of PD-1 monoclonal antibody in domestic patients are better, and the side effects are less. The efficacy and safety of PD-1 monoclonal antibody combined with targeted therapy in the real world population are consistent with many key clinical trials abroad. PD-1 monoclonal antibody combined with targeted drugs can be popularized in the domestic MRCC population.

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Objective:To explore the value of blood routine indexes, C-reactive protein(CRP), and blood culture in predicting the occurrence of neonatal necrotizing enterocolitis (NEC) secondary to late-onset sepsis (LOS) in preterm infants.Methods:This study retrospectively enrolled 80 premature infants with LOS admitted to the First Hospital Affiliated to Army Medical University from January 1, 2015 to January 1, 2020. Based on whether complicated by NEC or not, all the subjects were assigned into the NEC group ( n=11) and non-NEC group ( n=69). Laboratory data for perinatal conditions, complete blood cell count, CRP, and blood culture in the early stage of LOS were recorded, and the decreased value of the hemoglobin concentration before and at early stage of LOS was calculated. Mann-Whitney U test, Chi-square test or Fisher exact probability method was used to compare the differences in perinatal conditions, blood routine, CRP and blood culture results between different groups. Binomial stepwise logistic regression analysis and the receiver operating characteristic (ROC) curve were used to evaluate the risk factors and their predictive value for NEC secondary to LOS, respectively. Results:(1) There was no significant difference in gestational age, birth weight or other perinatal factors between the NEC group and non-NEC group (all P>0.05). (2) Mean platelet volume (MPV), CRP, and the hemoglobin decreased value in NEC group were greater than those in non-NEC group [11.7 fl (10.9-12.6 fl) vs 10.7 fl (10.3-11.6 fl), Z=－2.773; 33.3 mg/L (21.3-92.9 mg/L) vs 13.5 mg/L (4.7-27.3 mg/L), Z=－2.662; 25.0 g/L (18.0 -36.0 g/L) vs 13.0 g/L (1.0-19.0 g/L), Z=－3.803; all P<0.01]. (3) Binomial stepwise logistic regression analysis suggested that higher MPV at early stage of LOS ( OR=3.213, 95% CI: 1.104-9.354, P=0.032) and the decreased hemoglobin ( OR=1.153, 95% CI: 1.057-1.257, P=0.001) were independent risk factors for NEC secondary to LOS in preterm infants. (4) The cut-off values of MPV combined with the decreased value of hemoglobin for predicting NEC in premature infants with LOS were 11.2 fl and 14.0 g/L, respectively, with a sensitivity of 1.00 and specificity of 0.71. Conclusions:MPV combined with the decreased value of hemoglobin may help to predict NEC in the early stage of LOS for preterm infants.

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Bacterial β-glucuronidases (BGUSs) are an important type of hydrolase produced by gut microbiota and play an important role in tumor development and chemotherapy by deconjugating a large number of endogenous and exogenous glucuronides. In recent years, BGUSs inhibition has emerged as a promising approach to reduce cancer risk and alleviate gastrointestinal toxicity of chemotherapy drugs. However, a growing body of evidence underlines great genetic and structural diversity, functional promiscuity, and varied inhibition propensity of BGUSs, which have posed enormous challenges to identifying BGUSs involved in a specific pathophysiological or pharmacological process and developing effective inhibitors. In this review, we summarize the latest advances in structure and function of BGUSs and review the findings of BGUSs-mediated carcinogen reactivation and deconjugation of chemotherapy drugs in recent years, as well as the discovery of BGUSs inhibitors and preclinical investigation of their applications in cancer prevention and drug therapy. Finally, we discuss the prospects of BGUSs inhibition as a new strategy for tumor prevention and drug therapy.

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BackgroundThe coronavirus disease 2019 (COVID-19) pneumonia outbreak began in Wuhan and pandemics tend to occur. Although SARS-CoV-2-specific immunoglobulins have been detected in serum of COVID-19 patients, their dynamics and association with outcomes have not been characterized. MethodsA total of 116 hospitalized patients with confirmed COVID-19 pneumonia and SARS-CoV-2-specific immunoglobulins tested in Tongji hospital were retrospectively investigated. Clinical, laboratory, radiological characteristics and outcomes data were compared between mild-moderate group and died group. Further, a paired case-control study was conducted where each deceased case was matched to three mild-moderate patients of similar age. FindingsAmong 116 subjects included, 101 mild-moderate patients survived and 15 cases died. SARS-CoV-2-specific IgM levels peaked in forth week after onset of COVID-19 pneumonia, while serum IgG levels increased over 8 weeks. Serum IgM levels were higher in deceased patients than mild-moderate patients (P = 0.024), but not IgG. Serum IgM levels were negatively correlated with clinical outcome, eosinophil count and albumin levels (r = -0.269, P = 0.003; r = -0.188, P = 0.043; and r = -0.198, P = 0.033, resp.). The area under the ROC curve (AUC) for IgM antibody was 0.681 (95% CI: 0.517-0.845, P = 0.024). In case-control study paired by age, serum IgM was higher in deceased patients than mild-moderate patients (P = 0.019), positively correlated with leucocyte count (r = 0.260, P = 0.045), while negatively correlated with clinical outcome and albumin levels (r = -0.337, P = 0.008; r = -0.265, P = 0.041). AUC for IgM levels was 0.704 (95% CI: 0.534-0.873, P = 0.019). InterpretationThese results indicate that dynamics of SARS-CoV-2 specific IgM and IgG antibodies was similar with that of SARS-CoV, while elevated serum IgM levels indicate poor outcome in patients with COVID-19 pneumonia.

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Little is known about the clipping strategy to assist phytoremediation by Dicranopteris dichotoma at rare earth mines. We evaluated the phytoremediation ability of D. dichotoma, designed an appropriate clipping strategy, and obtained the phytoextraction time for rare earth elements (REE) by field investigation, laboratory measurement, and statistical analysis etc. at four rare earth mines in south China. D. dichotoma growth and soil nutrients tended to increase across the ecological restoration chronosequence, the total REE content in aboveground biomass was ≥1,000 mg kg-1, the bioabsorption coefficient and translocation factor were ≥1, and the phytoextraction of light REE was greater than heavy REE. Overall, the REE accumulation did not vary significantly among seasons, the total REE accumulation in the underground biomass accounted for 26.55-64% and the vegetation covers were about 90% two years after clipping. It would take 57.88-168.57 years to reduce soil total REE content, and the soil nutrients and REE accumulations of D. dichotoma at Longjing were the highest. D. dichotoma has potential for REE phytoextraction and phytostabilization simultaneously. D. dichotoma should be clipped in winter once every two years with underground biomass retained. The REE phytoextraction time is long with soil nutrients being important influencing factors.

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Breast-conserving surgery (BCS) has become a standard surgical method for early breast cancer. However, with the standardization of BCS, there are still many core issues in clinical practice. First of all, although the indications for BCS generally reach a consensus, the effects of age and tumor size on BCS are still worthy of attention; in addition, how to ensure the negative margin and repair tissue defect that achieve better breast shape are the key to the success of BCS; what′s more, the improvement of margin evaluating methods and the application of oncoplastic technic, neoadjuvant chemotherapy, axillary sentinel lymph node biopsy, mastoscopic technique in the BCS, new artificial materials and 3D printing technology, all for the development of BCS provides a better future. This article will summarize the above-mentioned focus issues on early breast cancer.

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Breast-conserving surgery (BCS) has become a standard surgical method for early breast cancer.However,with the standardization of BCS,there are still many core issues in clinical practice.First of all,although the indications for BCS generally reach a consensus,the effects of age and tumor size on BCS are still worthy of attention;in addition,how to ensure the negative margin and repair tissue defect that achieve better breast shape are the key to the success of BCS;what's more,the improvement of margin evaluating methods and the application of oncoplastic technic,neoadjuvant chemotherapy,axillary sentinel lymph node biopsy,mastoscopic technique in the BCS,new artificial materials and 3D printing technology,all for the development of BCS provides a better future.This article will summarize the above-mentioned focus issues on early breast cancer.

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Objective To propose a model for accurately segmenting blood vessels in medical fundus images. Methods The algorithm of deep learning was used for the task of automatic segmentation of blood vessels in retinal fundus images in this paper. An improved vascular segmentation algorithm was proposed. For the different types of blood vessels in the fundus image, a multi-scale network structure was designed to extract features of both main blood vessels and vessel branches at the same time. Results The segmentation model proposed could achieve good results on all kinds of blood vessels even if they have low contrast and few obvious characteristics. The automatic vessel segmentation of retinal fundus images was implemented, and the performance of the model was evaluated through multiple evaluation indexes which are widely used in the field of medical image segmentation in the test stage. A specificity of 0. 9829,an F1 score of 0. 7944,a G-mean of 0. 8748,an Matthews correlation coefficient(MCC) of 0. 7764 and a specificity of 0. 9782 were obtained on the DRIVE dataset. An F1 score of 0. 7735 and an MCC of 0. 7573 were obtained on the STARE data set. Conclusions The proposed method has a great improvement over the segmentation algorithm of the same task. Furthermore,the results generated by our model can achieve comparable effect with the segmentation of human doctor.

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OBJECTIVE： To systematically evaluate the efficacy and safety of Endostar combined with gemcitabine and cisplatin in the treatment of non-small cell lung cancer （NSCLC）， and to provide evidence-based reference for clinical drug use. METHODS： Retrieved from Cochrane Library， PubMed， Embase， ClinicalTrials， CNKI， Wanfang and VIP database， randomized controlled trials （RCT） about Endostar combined with gemcitabine and cisplatin（trial  group） vs. gemcitabine combined with cisplatin （control group） for NSCLC were collected. After literature screening， data extraction and quality evaluation with Cochrane 5.1.0 bias risk evaluation tool and Jadad scale， Meta-analysis was performed by using Rev Man 5.3 software. RESULTS： A total of 27 RCTs were included， involving 1 646 patients. Results of Meta-analysis showed that response rate [RR＝1.67， 95％CI（1.48，1.89），P＜0.000 01] and clinical benefit rate [RR＝1.26， 95％CI （1.20， 1.33），P＜0.000 01] of trial group were significantly higher than those of control group. There was no statistical significance in the incidence of leucopenia [RR＝0.98，95％CI（0.88， 1.11），P＝0.79]， thrombocytopenia [RR＝1.07， 95％CI（0.91， 1.26），P＝0.39] and gastrointestinal reaction [RR＝1.01， 95％CI（0.90， 1.14），P＝0.85] between 2 groups. CONCLUSIONS： Endostar combined with gemcitabine and cisplatin can improve therapeutic efficacy of NSCLC patients， without increasing the incidence of ADR.

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Immunosuppressive cells in the pancreatic cancer microenvironment play an important role in tumor development. Various immunosuppressive cytokines are secreted by these cells. Immunosuppressive cells may also influence the chemotherapeutic effect as well as promote drug resistance. Gemcitabine, albumin-bound paclitaxel, and other first-line chemotherapy agents not only suppress the proliferation of pancreatic cancer cells directly but also indirectly reinforce the anti-tumor effect of immune cells. However, chemo-therapeutic drugs may also induce immunosuppression, drug resistance, and tumor progression. In this review, we summarize the im-munosuppressive features of the pancreatic cancer microenvironment and its reciprocal relationship with chemotherapy, aiming to op-timize the current chemotherapy strategies from the perspective of the tumor immune microenvironment.

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OBJECTIVE@#To investigate paraffin section thickness in immunohistochemical detection of p16 expression in cervical tissue samples.@*METHODS@#p16 immunohistochemical staining was performed in 150 cases of chronic cervicitis, 126 cases of low-grade squamous intraepithelial lesions(LSIL), 96 cases of high-grade squamous intraepithelial lesions (HSIL) and 78 cases of cervical cancer from January 2014 to March 2018 in Zhongshan Boai Hospital. The results of p16 protein expression in paraffin sections with thickness of 2, 3, 4, 5 and 6 μm were compared using Logistic regression analysis.@*RESULTS@#With the increase of slice thickness, the staining of p16 protein in nucleus gradually increased. The thickness of cervical slices in chronic cervicitis and cervical cancer samples had no significant effect on the positive rate of p16 protein(=7.817 and 1.332, both >0.05), while the thickness of slices in LSIL and HSIL samples had significant effect on the positive rate of p16 protein (=17.688 and 10.182, <0.05 or <0.01). The stable and reliable results were obtained when the slices were between 3 and 5 μm thick.@*CONCLUSIONS@#Paraffin sections with thickness of 3.0-5.0 μm are recommended for immnohistochemical staining of p16 protein in cervical tissue samples.

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Objective To investigate the effect of preoperative anxiety on propofol EC50 for nomovement during Painless gastroscopy.Methods Thirty-one patients (without anxiety) and twenty-seven patients (with anxiety) undergoing gastroscopy under general anesthesia were enrolled on the study.Anesthesia was conducted with a target-controlled infusion (TCI) of propofol.The initial target effect-site propo fol concentration (Ceprop) was 5.0 μg/ml and was adjusted stepwise by 0.5 μg/ml by an up-down sequential method to reach no-movement.Results Propofol EC50 to induce no-movement was higher in patients with anxiety than those without anxiety (5.32 μg/ml,95％ CI:4.75-5.88 μg/ml vs 4.75 μg/ml,95％ CI:4.48-5.01 μg/ml,P ＜ 0.05).Conclusions During painless gastroscopy,patients with anxiety had a higher propofol EC50 for no-movement compared with those without anxiety when intravenous injected of fentanyl 0.1 μg/kg.

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Objective To demonstrate that IDO may be involved in the development of allergic asthma in children by affecting Th1T/Treg differentiation and its related cytokines.Methods Thirty-three children over 5 years old who were diagnosed the first time with allergic asthma were selected from the pediatric outpatient department.Another 33 healthy children were selected as the controls.Pulmonary function test,skin prick test,eosinophil count were taken.Peripheral blood was collected to measure the number and percentage of Th17 and Treg cells and the levels of cytokines,including IL-10,IL-17,IL-6 and TGF-β.Venous blood and induced sputum were used to detect the concentration of tryptophan and kynureninein IDO metabolites.Results Compared with the control group,there was a significant Th17/Treg imbalance in the asthma group,IL-17,IL-6 levels were significantly increased,TGF-β,IL-10 levels were significantly reduced,IDO levels were significantly reduced,and its levels were negativly associated with Th17/Treg ratio.Conclusion In children with allergic asthma,IDO may stimulate the production of IL-10,inhibit the expression of IL-6,upregulate the level of Treg,and lead to the imbalance of Th17/Treg;Therefore,IDO may be a molecular "switch" that leads to the conversion of Th17 cells to Treg cells,which plays a potentially protective role in the pathogenesis of asthma.

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Objective: To investigate the expression and clinical significance of sphingosine-1-phosphate transporter 2 (spinster homolog 2, SPNS2) in colorectal cancer. Methods: Colorectal cancer and adjacent normal tissues were collected from 133 patients undergoing colorectal cancer resection in Anhui Provincial Hospital from January 2010 to June 2013. The expression of SPNS2 protein was detected by immunohistochemistry. RT-qPCR was performed on the cancer tissues and adjacent normal tissues of 29 patients with colorectal cancer from February 2018 to June 2018. The relationship between the expression of SPNS2 in cancer tissues and clinicopathological features of colorectal cancer patients was analyzed using χ2test. The relationship between the expression of SPNS2 and prognosis of patients with colorectal cancer was analyzed based on univariate and multivariate analysis. Results: Immunohistochemistry results indicated that the expression of SPNS2 in colorectal cancer tissues was higher than that in adjacent normal tissues (81.20% vs. 22.60%, χ2=69.136, P<0.001). The results of RT-qPCR indicated that the expression of SPNS2 mRNA in colorectal cancer tissues was significantly higher than that in the corresponding adjacent normal tissues (t=3.974, P<0.001). The overexpression of SPNS2 protein was closely related to tumor differentiation, lymph node metastasis (pN), tumor size, and depth of invasion (Tx); this difference was statistically significant (P<0.001). The survival time of patients with negative SPNS2 expression was significantly longer than that of patients with positive expression (χ2=13.080, P<0.001). Univariate and Cox multivariate analyses showed that abnormal expression of SPNS2 affects the overall survival of colorectal cancer patients and is an independent influencing factor for patient prognosis. Conclusions: The positive expression of SPNS2 in colorectal cancer is related to the occurrence and development of colorectal cancer. SPNS2 can be used as a new colorectal tumor marker to evaluate the prognosis of patients, monitor the invasion and metastasis of postoperative tumors, and serve as a new target for diagnosis and treatment.