Double plasma molecular adsorption system for Stevens–Johnson syndrome/toxic epidermal necrolysis:A case report

BACKGROUND Stevens–Johnson syndrome and toxic epidermal necrolysis(SJS/TEN)are very serious skin allergies,with an etiology related to infections and medication.Since the coronavirus disease 2019(COVID-19)pandemic,severe acute respiratory syndrome coronavirus-2 has also been considered to cause SJS/TEN.CASE SUMMARY We report the case of a woman in her thirties who took acetaminophen after contracting COVID-19.After 3 d of fever relief,she experienced high fever and presented with SJS/TEN symptoms,accompanied by intrahepatic cholestasis.Three days of corticosteroid treatment did not alleviate the skin damage;therefore,double plasma molecular adsorption system(DPMAS)therapy was initiated,with treatment intervals of 48 h.Her skin symptoms improved gradually and were resolved after seven DPMAS treatments.CONCLUSION DPMAS therapy is beneficial for abrogating SJS/TEN because plasma adsorption and perfusion techniques reduce the inflammatory mediators(e.g.,tumor necrosis factor-alpha and interleukin-10 and-12)speculated to be involved in the pathology of the skin conditions.

Impact of interstitial cells of Cajal on slow wave and gallbladder contractility in a guinea pig model of acute cholecystitis

BACKGROUND Impaired interstitial cells of Cajal(ICCs)are central to the pathophysiology of acute cholecystitis(AC).Common bile duct ligation is a common model of AC,producing acute inflammatory changes and decrease in gallbladder contractility.AIM To investigate the origin of slow wave(SW)in the gallbladder and the effect of ICCs on gallbladder contractions during the process of AC.METHODS Methylene blue(MB)with light was used to establish selective impaired ICCs gallbladder tissue.Gallbladder motility was assessed using the frequency of SW and gallbladder muscle contractility in vitro in normal control(NC),AC12h,AC24h,and AC48h groups of guinea pigs.Hematoxylin and eosin and Massonstained gallbladder tissues were scored for inflammatory changes.ICCs pathological changes alterations were estimated using immunohistochemistry and transmission electron microscopy.The alterations of c-Kit,α-SMA,cholecystokinin A receptor(CCKAR),and connexin 43(CX43)were assessed using Western blot.RESULTS Impaired ICCs muscle strips resulted in the decrease in gallbladder SW frequency and contractility.The frequency of SW and gallbladder contractility were significantly lower in the AC12h group.Compared with the NC group,the density and ultrastructure of ICCs were remarkably impaired in the AC groups,especially in the AC12h group.The protein expression levels of c-Kit were significantly decreased in the AC12h group,while CCKAR and CX43 protein expression levels were significantly decreased in the AC48h group.CONCLUSION Loss ICCs could lead to a decrease in gallbladder SW frequency and contractility.The density and ultrastructure of ICCs were clearly impaired in the early stage of AC,while CCKAR and CX43 were significantly reduced at end stage.

Heparanase inhibition leads to improvement in patients with acute gastrointestinal injuries induced by sepsis

BACKGROUND Patients with sepsis are at high risk for acute gastrointestinal injury(AGI),but the diagnosis and treatment of AGI due to sepsis are unsatisfactory.Heparanase(HPA)plays an important role in septic AGI(S-AGI),but its specific mechanism is not completely understood,and few clinical reports are available.AIM To explore the effect and mechanism of HPA inhibition in S-AGI patients.METHODS In our prospective clinical trial,48 patients with S-AGI were randomly assigned to a control group to receive conventional treatment,whereas 47 patients were randomly assigned to an intervention group to receive conventional treatment combined with low molecular weight heparin.AGI grade,sequential organ failure assessment score,acute physiology and chronic health evaluation II score,D-dimer,activated partial thromboplastin time(APTT),anti-Xa factor,interleukin-6,tumour necrosis factor-α,HPA,syndecan-1(SDC-1),LC3B(autophagy marker),intestinal fatty acid binding protein,D-lactate,motilin,gastrin,CD4/CD8,length of intensive care unit(ICU)stay,length of hospital stay and 28-d survival on the 1^(st),3^(rd) and 7^(th) d after treatment were compared.Correlations between HPA and AGI grading as well as LC3B were compared.Receiver operator characteristic(ROC)curves were generated to evaluate the diagnostic value of HPA,intestinal fatty acid binding protein and D-lactate in S-AGI.RESULTS Serum HPA and SCD-1 levels were significantly reduced in the intervention group compared with the control group(P<0.05).In addition,intestinal fatty acid-binding protein,D-lactate,AGI grade,motilin,and gastrin levels and sequential organ failure assessment score were significantly decreased(P<0.05)in the intervention group.However,LC3B,APTT,anti-Xa factor,and CD4/CD8 were significantly increased(P<0.05)in the intervention group.No significant differences in interleukin-6,tumour necrosis factor-α,d-dimer,acute physiology and chronic health evaluation II score,length of ICU stay,length of hospital stay,or 28-d survival were noted between the two groups(P>0.05).Correlation analysis revealed a significant negative correlation between HPA and LC3B and a significant positive correlation between HPA and AGI grade.ROC curve analysis showed that HPA had higher specificity and sensitivity in diagnosis of S-AGI.CONCLUSION HPA has great potential as a diagnostic marker for S-AGI.Inhibition of HPA activity reduces SDC-1 shedding and alleviates S-AGI symptoms.The inhibitory effect of HPA in gastrointestinal protection may be achieved by enhanced autophagy.

Treatment of a patient with severe lactic acidosis and multiple organ failure due to mitochondrial myopathy:A case report

BACKGROUND Mitochondrial myopathy is a rare genetic disease with maternal inheritance that may involve multiple organ systems.Due to the lack of typical characteristics,its clinical diagnosis is difficult,and it is often misdiagnosed or even missed.CASE SUMMARY The patient was a young college student.When he presented at the hospital,he had severe lactic acidosis,respiratory failure,and shock with multiple organ dysfunction syndrome(MODS).He was treated by mechanical ventilation,venoarterial extracorporeal membrane oxygenation,and other organ support.However,his condition continued to worsen.After a thorough and detailed medical and family history was taken,a mitochondrial crisis was suspected.A muscle biopsy was taken.Further genetic testing confirmed a mitochondrial gene mutation(TRNL13243A>G).The final diagnosis of mitochondrial myopathy was made.Although there is no known specific treatment,intravenous methylprednisone and intravenous immunoglobulin were started.The patient’s shock eventually improved.The further course was complicated by severe infection in multiple sites,severe muscle weakness,and recurrent MODS.After 2 mo of multidisciplinary management and intensive rehabilitation,the patient could walk with assistance 4 mo after admission and walk independently 6 mo after admission.CONCLUSION More attention should be paid to mitochondrial myopathy to avoid missed diagnosis and misdiagnosis.

生长激素释放肽对糖尿病大鼠视网膜病变的保护作用

目的:探讨生长激素释放肽(ghrelin)对糖尿病大鼠视网膜病变的影响并研究其保护作用。方法:雄性SD大鼠18只分为对照组、模型组、ghrelin组,采用HE染色观察视网膜形态,TUNEL染色观察细胞凋亡,透射电镜观察视网膜色素上皮层超微结构,免疫组化检测氧化应激指标,ELISA检测炎性因子含量。结果:形态学观察结果显示,ghrelin可减轻视网膜组织损伤程度,降低糖尿病大鼠视网膜组织细胞凋亡;免疫组化结果显示,与模型组比较,ghrelin组大鼠视网膜组织中超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-PX)活性升高,丙二醛(MDA)含量下降(P<0.05);ELISA结果显示,模型组细胞间黏附分子-1(ICAM-1)、肿瘤坏死因子-a(TNF-a)及白细胞介素-1β(IL-1β)表达较对照组升高(P<0.05),ghrelin干预后,炎症因子表达均下降,与模型组比较有差异(P<0.05)。结论:Ghrelin治疗糖尿病大鼠后,能有效延缓糖尿病大鼠视网膜病变的进程,其作用机制与降低氧化应激水平、抑制炎症反应相关。

Helicobacter pylori promotes invasion and metastasis of gastric cancer by enhancing heparanase expression

AIM To detect the mechanisms of Helicobacter pylori(H. pylori) infection in the invasion and metastasis of gastric cancer(GC).METHODS Specimens from 99 patients with GC were collected. The correlation among H. pylori infection, heparanase(HPA) and mitogen-activated protein kinase(MAPK) expression, which was determined by immunohistochemistry, and the clinical features of GC was analysed using SPSS 22.0. Overall survival(OS) and relapse-free survival(RFS) of GC patients were estimated by the KaplanMeier method. Independent and multiple factors of HPA and MAPK with prognosis were determined with COX proportional hazards models. HPA and MAPK expression in MKN-45 cells infected with H. pylori was analysed using Western blot. RESULTS H. pylori infection was observed in 70 of 99 patients with GC(70.7%), which was significantly higher than that in healthy controls. H. pylori infection was related to lymph metastasis and expression of HPA and MAPK(P < 0.05); HPA expression was relevant to MAPK expression(P = 0.024). HPA and MAPK expression in MKN-45 cells was significantly upregulated following H. pylori infection and peaked at 24 h and 60 min, before decreasing(P < 0.05). SB203580, an inhibitor of MAPK, significantly decreased HPA expression. HPA was related to lymph metastasis and invasive depth. HPA positive GC cases and H. pylori positive GC cases showed poorer prognosis than HPA negative cases(P < 0.05). COX models showed that the prognosis of GC was connected with HPA expression, lymph metastasis, tissue differentiation, and invasive depth. CONCLUSION H. pylori may promote the invasion and metastasis of GC by increasing HPA expression that may associate with MAPK activation, thus causing a poorer prognosis of GC.

Comparative analysis of robotic vs laparoscopic radical hysterectomy for cervical cancer

BACKGROUND Cervical cancer is the most common gynecological malignancy,ranking first in female reproductive malignancies with more than 500000 new cases and 275000 deaths each year.Traditionally,open radical hysterectomy is considered the standard surgical procedure for the treatment of resectable cervical cancer.The latest guidelines from the National Comprehensive Cancer Network and the European Society of Gynecological Oncology suggest that open surgery and laparoscopic surgery(using traditional laparoscopic or robotic techniques)are the main surgical approaches for radical hysterectomy for patients with stage IA2-IIA cervical cancer.Robotic surgery has been increasingly used in abdominal surgery and has shown more beneficial effects.AIM To analyse the perioperative conditions,complications,and short-term and longterm effects in patients undergoing robotic radical hysterectomy(RRH)and laparoscopic radical hysterectomy(LRH)to compare their clinical efficacy,safety,and feasibility.METHODS The perioperative data of patients undergoing RRH and LRH were extracted and collected from the database of surgical treatments for cervical cancer for statistical analysis.RESULTS Of the patients,342 underwent LRH for cervical cancer,and 216 underwent RRH.The total complication rate was 9.65%(20 patients)in the RRH group and 17.59%(60 patients)in the LRH group.The complication rate was significantly lower in the RRH group than in the LRH group.There was no significant difference in the follow-up period(P=0.658).The total recurrence rates were 15.7%and 12%in the RRH and LRH groups,respectively.The progression-free survival time was 28.91±15.68 mo and 28.34±15.13 mo in the RRH and LRH groups,respectively(P=0.669).The overall survival(OS)rates were 92.13%and 94.45%in the RRH and LRH groups,respectively(P=0.292).The OS time was 29.87±15.92 mo and 29.41±15.14 mo in the RRH and LRH groups,respectively(P=0.732).The survival curves and the progression-free survival curves were not statistically significantly different between the two groups(P=0.407 and 0.28,respectively).CONCLUSION RRH is associated with significantly less operative time and blood loss than LRH.The two procedures have similar complication rates,OS,and progression-free survival time.

Characterization of primary hepatic carcinosarcoma by contrast-enhanced ultrasonography: A case report

Primary hepatic carcinosarcoma is a rare tumor and is comprised of a mixture of carcinomatous and sarcomatous elements. We present a case of primary carcinosarcoma of the liver in a 59-year-old woman, which was confirmed by pathology following surgical resection. Using contrast-enhanced ultrasonography, the tumor showed peripheral nodular hyperenhancement in the arterial phase with two feeding arterial vessels and a large internal non-enhancing portion in the center. The peripheral nodular portion of the tumor showed hypoenhancement in the later phase.

Inducing human induced pluripotent stem cell differentiation through embryoid bodies:A practical and stable approach

Human induced pluripotent stem cells(hiPSCs)are invaluable resources for producing high-quality differentiated cells in unlimited quantities for both basic research and clinical use.They are particularly useful for studying human disease mechanisms in vitro by making it possible to circumvent the ethical issues of human embryonic stem cell research.However,significant limitations exist when using conventional flat culturing methods especially concerning cell expansion,differentiation efficiency,stability maintenance and multicellular 3D structure establishment,differentiation prediction.Embryoid bodies(EBs),the multicellular aggregates spontaneously generated from iPSCs in the suspension system,might help to address these issues.Due to the unique microenvironment and cell communication in EB structure that a 2D culture system cannot achieve,EBs have been widely applied in hiPSC-derived differentiation and show significant advantages especially in scaling up culturing,differentiation efficiency enhancement,ex vivo simulation,and organoid establishment.EBs can potentially also be used in early prediction of iPSC differentiation capability.To improve the stability and feasibility of EB-mediated differentiation and generate high quality EBs,critical factors including iPSC pluripotency maintenance,generation of uniform morphology using micro-pattern 3D culture systems,proper cellular density inoculation,and EB size control are discussed on the basis of both published data and our own laboratory experiences.Collectively,the production of a large quantity of homogeneous EBs with high quality is important for the stability and feasibility of many PSCs related studies.

Helicobacter pylori promotes invasion and metastasis of gastric cancer by enhancing heparanase expression

Correction to"Liu LP,Sheng XP,Shuai TK,Zhao YX,Li B,Li YM.Helicobacter pylori promotes invasion and metastasis of gastric cancer by enhancing heparanase expression.World J Gastroenterol 2018;24:4565-4577[PMID:30386106 DOI:10.3748/wjg.v24.i40.4565]."In this article,we have identified some of the images in Figure 2A,C,E,G,and I are identical to the images in Figures 1B,2A,3B,3E,and 3G of another paper entitled"Liu L,Zhao Y,Fan G,Shuai T,Li B,Li Y.Helicobacter pylori infection enhances heparanase leading to cell proliferation via mitogenactivated protein kinase signalling in human gastric cancer cells.",which was published by us in the Molecular Medicine Reports in December,2018[PMID:30320396 DOI:10.3892/mmr.2018.9558].The reason why we asked to replace the pictures was that when we were simultaneously preparing to submit our two different articles to the World Journal of Gastroenterology(WJG)and Molecular Medicine Reports,we uploaded the wrong pictures to the WJG,which were same as those submitted to the Molecular Medicine Reports.We apologize for this negligence and any inconvenience that this may cause.We would be grateful if you could replace the wrong pictures with the correct ones attached.

Enhanced hepatic differentiation in the subpopulation of human amniotic stem cells under 3D multicellular microenvironment

BACKGROUND To solve the problem of liver transplantation donor insufficiency,an alternative cell transplantation therapy was investigated.We focused on amniotic epithelial cells(AECs)as a cell source because,unlike induced pluripotent stem cells,they are cost-effective and non-tumorigenic.The utilization of AECs in regenerative medicine,however,is in its infancy.A general profile for AECs has not been comprehensively analyzed.Moreover,no hepatic differentiation protocol for AECs has yet been established.To this end,we independently compiled human AEC libraries,purified amniotic stem cells(ASCs),and co-cultured them with mesenchymal stem cells(MSCs)and human umbilical vein endothelial cell(HUVECs)in a 3D system which induces functional hepatic organoids.AIM To characterize AECs and generate functional hepatic organoids from ASCs and other somatic stem cells METHODS AECs,MSCs,and HUVECs were isolated from the placentae and umbilical cords of cesarean section patients.Amnion and primary AEC stemness characteristics and heterogeneity were analyzed by immunocytochemistry,Alkaline phosphatase(AP)staining,and flow cytometry.An adherent AEC subpopulation was selected and evaluated for ASC purification quality by a colony formation assay.AEC transcriptomes were compared with those for other hepatocytes cell sources by bioinformatics.The 2D and 3D culture were compared by relative gene expression using several differentiation protocols.ASCs,MSCs,and HUVECs were combined in a 3D co-culture system to generate hepatic organoids whose structure was compared with a 3D AEC sphere and whose function was elucidated by immunofluorescence imaging,periodic acid Schiff,and an indocyanine green(ICG)test.RESULTS AECs have certain stemness markers such as EPCAM,SSEA4,and E-cadherin.One AEC subpopulation was also either positive for AP staining or expressed the TRA-1-60 and TRA-1-81 stemness markers.Moreover,it could form colonies and its frequency was enhanced ten-fold in the adherent subpopulation after selective primary passage.Bioinformatics analysis of ribose nucleic acid sequencing revealed that the total AEC gene expression was distant from those of pluripotent stem cells and hepatocytes but some gene expression overlapped among these cells.TJP1,associated with epidermal growth factor receptor,and MET,associated with hepatocyte growth factor receptor,were upregulated and may be important for hepatic differentiation.In conventional flat culture,the cells turned unviable and did not readily differentiate into hepatocytes.In 3D culture,however,hepatic gene expression of the AEC sphere was elevated even under a two-step differentiation protocol.Furthermore,the organoids derived from the MSC and HUVEC co-culture showed 3D structure with polarity,hepatic-like glycogen storage,and ICG absorption/elimination.CONCLUSION Human amniotic epithelial cells are heterogeneous and certain subpopulations have high stemness.Under a 3D co-culture system,functional hepatic organoids were generated in a multicellular microenvironment.

Predicting differentiation potential of human pluripotent stem cells:Possibilities and challenges

The capability of human pluripotent stem cell(hPSC)lines to propagate indefinitely and differentiate into derivatives of three embryonic germ layers makes these cells be powerful tools for basic scientific research and promising agents for translational medicine.However,variations in differentiation tendency and efficiency as well as pluripotency maintenance necessitate the selection of hPSC lines for the intended applications to save time and cost.To screen the qualified cell lines and exclude problematic cell lines,their pluripotency must be confirmed initially by traditional methods such as teratoma formation or by highthroughput gene expression profiling assay.Additionally,their differentiation potential,particularly the lineage-specific differentiation propensities of hPSC lines,should be predicted in an early stage.As a complement to the teratoma assay,RNA sequencing data provide a quantitative estimate of the differentiation ability of hPSCs in vivo.Moreover,multiple scorecards have been developed based on selected gene sets for predicting the differentiation potential into three germ layers or the desired cell type many days before terminal differentiation.For clinical application of hPSCs,the malignant potential of the cells must also be evaluated.A combination of histologic examination of teratoma with quantitation of gene expression data derived from teratoma tissue provides safety-related predictive information by detecting immature teratomas,malignancy marker expression,and other parameters.Although various prediction methods are available,distinct limitations remain such as the discordance of results between different assays and requirement of a long time and high labor and cost,restricting their wide applications in routine studies.Therefore,simpler and more rapid detection assays with high specificity and sensitivity that can be used to monitor the status of hPSCs at any time and fewer targeted markers that are more specific for a given desired cell type are urgently needed.

Thermal recovery method of submarine gas hydrate based on a thermoelectric generator

1.Objective Natural gas hydrates are considered as a potential alternative fuel resource to petroleum and gas (Chong ZR et al.,2016),which can be exploited by means of depressurization,thermal method,inhibitor injection,etc.For the thermal method,gas hydrates are decomposed into water and methane when the reservoir is heated to above the equilibrium temperature of gas hydrate (Li X et al.,2016). However,the thermal recovery method needs a great deal of heat,and thus the feasibility of economic exploitation is reduced.

Impelling force and current challenges by chemicals in somatic cell reprogramming and expansion beyond hepatocytes

In the field of regenerative medicine,generating numerous transplantable functional cells in the laboratory setting on a large scale is a major challenge.However,the in vitro maintenance and expansion of terminally differentiated cells are challenging because of the lack of specific environmental and intercellular signal stimulations,markedly hindering their therapeutic application.Remarkably,the generation of stem/progenitor cells or functional cells with effective proliferative potential is markedly in demand for disease modeling,cell-based transplantation,and drug discovery.Despite the potent genetic manipulation of transcription factors,integration-free chemically defined approaches for the conversion of somatic cell fate have garnered considerable attention in recent years.This review aims to summarize the progress thus far and discuss the advantages,limitations,and challenges of the impact of full chemicals on the stepwise reprogramming of pluripotency,direct lineage conversion,and direct lineage expansion on somatic cells.Owing to the current chemical-mediated induction,reprogrammed pluripotent stem cells with reproducibility difficulties,and direct lineage converted cells with marked functional deficiency,it is imperative to generate the desired cell types directly by chemically inducing their potent proliferation ability through a lineagecommitted progenitor state,while upholding the maturation and engraftment capacity posttransplantation in vivo.Together with the comprehensive understanding of the mechanism of chemical drives,as well as the elucidation of specificity and commonalities,the precise manipulation of the expansion for diverse functional cell types could broaden the available cell sources and enhance the cellular function for clinical application in future.

Practical choice for robust and efficient differentiation of human pluripotent stem cells

Human pluripotent stem cells(hPSCs)have the distinct advantage of being able to differentiate into cells of all three germ layers.Target cells or tissues derived from hPSCs have many uses such as drug screening,disease modeling,and transplantation therapy.There are currently a wide variety of differentiation methods available.However,most of the existing differentiation methods are unreliable,with uneven differentiation efficiency and poor reproducibility.At the same time,it is difficult to choose the optimal method when faced with so many differentiation schemes,and it is time-consuming and costly to explore a new differentiation approach.Thus,it is critical to design a robust and efficient method of differentiation.In this review article,we summarize a comprehensive approach in which hPSCs are differentiated into target cells or organoids including brain,liver,blood,melanocytes,and mesenchymal cells.This was accomplished by employing an embryoid body-based three-dimensional(3D)suspension culture system with multiple cells co-cultured.The method has high stable differentiation efficiency compared to the conventional 2D culture and can meet the requirements of clinical application.Additionally,ex vivo co-culture models might be able to constitute organoids that are highly similar or mimic human organs for potential organ transplantation in the future.

New perspectives on angiotensin-converting enzyme 2 and its related diseases

Since the worldwide outbreak of coronavirus disease 2019,angiotensin-converting enzyme 2(ACE2)has received widespread attention as the cell receptor of the severe acute respiratory syndrome coronavirus 2 virus.At the same time,as a key enzyme in the renin-angiotensin-system,ACE2 is considered to be an endogenous negative regulator of vasoconstriction,proliferation,fibrosis,and proinflammation caused by the ACE-angiotensin II-angiotensin type 1 receptor axis.ACE2 is now implicated as being closely connected to diabetes,cardiovascular,kidney,and lung diseases,and so on.This review covers the available information on the host factors regulating ACE2 and discusses its role in a variety of pathophysiological conditions in animal models and humans.

Detection of serum Betatrophin in gestational diabetes mellitus patients and its correlation with glucose and lipid metabolism disorders

Objective: To detect the serum Betatrophin level in patients with gestational diabetes mellitus (GDM), and to explore the relationship between Betatrophin level and disorders of glucose and lipid metabolism. Methods: 119 cases of GDM women in our hospital during August 2015 to March 2018 were selected as GDM group, 100 cases pregnant women with normal blood glucose were chosen as Normal control group. Serum level of Betatrophin, glucose metabolism and lipid metabolism between two groups were compared. Pearson test was used to evaluate the relationship between Betatrophin, glucose and lipid metabolism disorders in GDM pregnant women. Results: Serum content of Betatrophin in GDM group was significantly higher than that in Normal control group, levels of HbA1c, FINS and HOMA-IR in peripheral blood were significantly higher than those in Normal control group;contents of TC, LDL-C and Apo-B in peripheral blood were higher than those in Normal control group, contents of HDL-C, Apo-A1 were lower than those in Normal control group. Correlation analysis showed that serum level of Betatrophin in GDM pregnant women was positively correlated with the disorder of glucose and lipid metabolism. Conclusion: Abnormally high expression of Betatrophin in GDM pregnant women may be an important factor in promoting disorder of glucose and lipid metabolism.

Qualitative study of poor intestinal preparation compliance before colonoscopy in elderly patients

Objective:To explore the influencing factors and psychological experience of poor compliance in intestinal preparation before colonoscopy in elderly patients,so as to provide more comprehensive reference for the implementation of targeted nursing intervention measures in the future and to improve the quality of intestinal preparation before colonoscopy in elderly patients.Method:According to the phenomenological research method in the qualitative research,a purposeful sampling selected 11 nursing staff from a digestive endoscopy center of a comprehensive tertiary Class A hospital in Shanxi Province as a research object for a semi-structured interview.Convenience Sampling selected semi-structured interviews with 13 elderly patients who underwent colonoscopy in a comprehensive tertiary Class A hospital in Shanxi Province from July to September 2018 for colonoscopy but had poor bowel preparation results.Colaizzi Phenomenological research methods conduct inductive analysis of data.Results:Through semi-structured interview,the influencing factors of poor compliance of intestinal preparation before colonoscopy in elderly patients were summarized as follows:①nursing staff ignored the individualized education of patients;②in the process of intestinal preparation,elderly patients have insufficient understanding of intestinal preparation,insufficient attention,forgetting the contents of intestinal preparation,intolerance in the process of intestinal preparation,lack of encouragement and professional guidance,etc.Conclusion:In clinical practice,medical staff should strengthen the individualized education of patients undergoing colonoscopy,guide them to correctly understand the intestinal preparation process and understand the importance of intestinal preparation,actively explore more convenient intestinal preparation methods,and actively play the positive role of family members in intestinal preparation of elderly patients.

Theoretical development and mechanism research of evodiamine's antitumor effect

Evodiamine(EVO),one of the bioactive components of traditional Chinese medicine,has been widely concerned for its anti-tumor properties in recent years.In this review,the anti-tumor mechanism of EVO was reviewed from the aspects of inducing tumor cell apoptosis(internal pathway,external pathway and other pathways),inducing autophagy,inhibiting tumor stem cells,inhibiting cell proliferation and migration,inhibiting peripheral vascular proliferation,and recent research progress of EVO anti-tumor drugs.