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    Advances in resilience research
    Shuang-yi CHEN, Jian-yin QIU
    JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY (MEDICAL SCIENCE)    2021, 41 (10): 1397-1400.   DOI: 10.3969/j.issn.1674-8115.2021.10.021
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    Resilience refers to the dynamic process of individual's positive adaptation to adversity, which is closely related to the symptoms of mental disorders and can be improved through intervention. This paper reviews the definition, evaluation method and intervention of resilience, and proposes that resilience can be used as an indicator of mental disorders related to stressor exposure, which has certain reference significance for improving individual resilience and promoting individual mental health development.

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    Practice for multidisciplinary diagnosis and treatment of dermatofibrosarcoma protuberans: expert consensus of Shanghai Ninth People 's Hospital, Shanghai Jiao Tong University School of Medicine (2020 edition)
    JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY (MEDICAL SCIENCE)    2021, 41 (12): 1669-1675.   DOI: 10.3969/j.issn.1674-8115.2021.12.018
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    Dermatofibrosarcoma protuberans (DFSP) is a low- to intermediate-grade malignant soft tissue sarcoma occurring in the skin and subcutaneous tissues. The high misdiagnosis rate often delays the best treatment opportunity, and the wrong treatment method leads to the high recurrence rate of surgery. Traditional extended resection requires 3?5 cm expansion around the tumor, and the huge tissue defect increases the difficulty of surgery, which is also hard to be accepted. In Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, under the support of the multi-disciplinary treatment group, cutaneous spindle cell neoplasms multi-disciplinary team of accurate diagnosis and treatment normatively conducted treatment of DFSP comprehensive diagnosis and treatment. Modified Mohs micrographic surgery was used to remove the tumor while preserving as much normal tissue as possible. Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine expert consensus of diagnosis and treatment of specification of DFSP multidisciplinary specification was formed.

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    Research progress and development trend of lower extremity exoskeleton rehabilitation robot
    Jiyu HAN, Yanhong WANG, Daqian WAN
    JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY (MEDICAL SCIENCE)    2022, 42 (2): 241-246.   DOI: 10.3969/j.issn.1674-8115.2022.02.017
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    Lower limb motor dysfunction caused by various causes is an important public health problem in the world today. Lower extremity exoskeleton rehabilitation robot is a new type of wearable bionic device, which is mainly used to realize the standing and walking of patients with lower extremity motor dysfunction. It is a hot research topic in rehabilitation medicine at present. By reviewing the history of lower extremity exoskeleton rehabilitation robot, some breakthroughs and developments are found to have been made in this field in recent years. In the future, if we can overcome the technical problems such as portability, intelligence and modularization, it will be possible to maximize the recovery of patients with lower limb dysfunction. In this paper, the key technologies and clinical applications of wearable lower extremity exoskeleton rehabilitation robot are reviewed comprehensively, and new prospects for the research and development in this field are proposed.

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    Review of clinical application of peripheral neuropathy scales
    Qun-feng WANG, Li CAO, Xing-hua LUAN
    JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY (MEDICAL SCIENCE)    2021, 41 (11): 1518-1523.   DOI: 10.3969/j.issn.1674-8115.2021.11.018
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    Peripheral neuropathy (PN) refers to a group of diseases caused by the dysfunction and structural changes of peripheral motor, sensory and autonomic nerves. Scales for screening and assessing PN are continuously being used in clinical practice. This article summarizes PN score scales for four kinds of PN, including chronic inflammatory demyelinating polyradiculoneuropathy, Charcot-Marie-Tooth disease, diabetic PN and neuropathic pain, aiming to improve medical staff's understanding and application ability of the PN assessment scale.

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    Protocols for diagnosis and treatment of temporomandibular joint osteoarthritis: experience from the TMJ Center of Shanghai Ninth People 's Hospital, Shanghai Jiao Tong University School of Medicine
    ZHANG Shanyong, YANG Chi
    Journal of Shanghai Jiao Tong University (Medical Science)    2022, 42 (6): 709-716.   DOI: 10.3969/j.issn.1674-8115.2022.06.003
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    Temporomandibular joint osteoarthritis (TMJOA) is the most common degenerative disease in the temporomandibular joint, mainly manifesting with pain in the joints and the muscles, joint locking, popping, crepitus, and limited mouth opening, which may undermine the quality of patients' life. The main pathological features of TMJOA include chronic synovitis, progressive articular cartilage degeneration, and abnormal subchondral bone remodeling. At present, its pathogenesis is still unclear, and abnormal mechanical load, trauma, heredity, metabolism, gender and age can all be regarded as pathogenic factors. Commonly used diagnostic methods for TMJOA include magnetic resonance imaging (MRI) and computed tomography [(CT/cone beam CT (CBCT)]. The staging standards of TMJOA mainly include Wilkes staging system and Yang's staging system. The clinical treatment of TMJOA mainly includes two categories: non-surgical treatment and surgical treatment. Non-surgical treatment includes health education, psychological consultation, medication, occlusion treatment, etc. Surgical treatment includes arthrocentesis, arthroscopic surgery, disc anchoring, autogenous tissue graft, and total joint replacement. This paper summarizes the diagnosis, staging, surgical treatment and postoperative evaluation of TMJOA on the basis of literature review, and proposes diagnosis and treatment protocols based on the experience of the TMJ Center of Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, so as to provide reference for clinicians.

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    Research progress in the role and mechanism of lactylation in diseases
    GE Lingling, HUANG Hongjun, LUO Yan
    Journal of Shanghai Jiao Tong University (Medical Science)    2023, 43 (3): 374-379.   DOI: 10.3969/j.issn.1674-8115.2023.03.014
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    Lactic acid is a product of cell respiration. After entering into cells, glucose is metabolized to pyruvate by glycolysis. When the oxygen supply is sufficient, pyruvate is converted to acetyl coenzyme A through pyruvate dehydrogenase in the mitochondrial matrix to participate in the tricarboxylic acid cycle and provide necessary energy for cells. Pyruvate is catalysed by lactate dehydrogenase in the cytoplasm to produce lactate while cells are grown under hypoxic conditions. Lactate not only provides energy for mitochondrial respiration, but also plays important roles in inflammatory responser, wound repair, memory formation and neuroprotection as well as tumor growth and metastasis and other pathophysiological processes through autocrine, paracrine, and endocrine forms, which affects the development and prognosis of diseases. Epigenetic modification regulates gene replication, transcription and translation by covalently adding or hydrolyzing functional groups on histones and DNA through related enzymes and affects the biological effects of cells. Histones are the major structural proteins of eukaryotic chromosomes. Their post-translational modifications, such as methylation and acetylation, affect their affinity with DNA, change chromatin structures, and are widely involved in regulation of gene expression. Recent studies have found that histones can undergo lactylation, which is a new epigenetic modification by adding lactate to lysine residues on histones. As the research deepens, numerous evidences reveal that lactylation also occurs on non-histone proteins. The discovery of lactylation has expanded our understanding of lactate functions in the pathogenesis of diseases. In this review, we summarize the roles and mechanisms of lactylation in tumor, inflammatory and neural system diseases, in order to provide new ideas for the research, diagnosis and treatment of these diseases.

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    Aptamer-drug conjugates (ApDCs): new trend for cancer precision therapy
    HAN Yongqi, HAN Da, XIA Qian, JI Dingkun, TAN Weihong
    Journal of Shanghai Jiao Tong University (Medical Science)    2022, 42 (9): 1176-1181.   DOI: 10.3969/j.issn.1674-8115.2022.09.003
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    Cancer is a worldwide medical issue that seriously threatens human health. Precision molecular medicine provides a new strategy for cancer theranostics. As excellent targeting recognition molecules and drug delivery platforms, aptamers and aptamer drug-conjugates (ApDCs) have provided a series of useful molecular tools for cancer precision therapy. In this paper, the properties and the selection techniques of aptamers, the construction of ApDCs and their applications to clinical tumor-targeting therapy are reviewed. Additionally, the challenges and perspective of ApDCs in precision molecular medicine for cancers are presented. This review may provide new horizons for molecular-targeted anti-tumor drugs in the therapy of clinical malignant tumors.

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    Review of immunosuppressive tumor microenvironment of pancreatic cancer
    Jing-wei LI, Li-wen WANG, Ling-xi JIANG, Qian ZHAN, Hao CHEN, Bai-yong SHEN
    JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY (MEDICAL SCIENCE)    2021, 41 (8): 1103-1108.   DOI: 10.3969/j.issn.1674-8115.2021.08.018
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    Pancreatic cancer is a highly malignant tumor. The difficulty of early diagnosis and scarcity of effective clinical treatment strategies lead to poor prognosis. Tumor microenvironment (TME) of pancreatic cancer is composed of tumor cells, immune cells, stromal cells, extracellular matrix and soluble factors. TME plays an important role in the development, progression, invasion and metastasis of tumors. The pancreatic cancer microenvironment has significant immune cell infiltration, which is highly immunosuppressive. On the one hand, tumor cells edit the immune system so that cancer cells cannot be recognized by the immune system; on the other hand, they can recruit and activate various immunosuppressive cells such as pancreatic stellate cells, myeloid-derived inhibitory cells, tumor-associated macrophages, regulatory T cells and so on. These immunosuppressive cells can secrete immunosuppressive molecules, affect the function of anti-tumor immune cells, inhibit the host′s anti-tumor immune response, lead to tumor immune escape, and promote tumor development and metastasis. In this review, the mechanisms and effects of these immunosuppressive components are discussed and the updated results of immunotherapy on pancreatic cancer are studied, which may provide novel insights on TME and immunotherapy of pancreatic cancer.

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    Progress in metabolism of the immune cells in tumor microenvironment
    LIN Jiayu, QIN Jiejie, JIANG Lingxi
    Journal of Shanghai Jiao Tong University (Medical Science)    2022, 42 (8): 1122-1130.   DOI: 10.3969/j.issn.1674-8115.2022.08.018
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    Metabolic reprogramming refers to cells' mechanism to change their metabolic patterns in order to meet the increased energy demand caused by growth and proliferation. By way of metabolic reprogramming such as the Warburg effect, tumor cells gain rich energy to support their own survival, growth, and metastasis. The tumor microenvironment (TME) is the internal environment in which tumor cells survive, containing not only tumor cells, but also stromal cells, immune cells, and other components that are closely related to tumor cells. Meanwhile, tumor cells regulate intercellular function and signaling via secreting cytokines, metabolites, and other molecules and shape a commonly hypoxic, acidic, and nutrient-deprived TME which contributes the most to immune resistance. However, rapidly proliferating tumor cells compete for relatively scarce nutrients with immune cells, consequently, producing an immunosuppressive metabolism microenvironment. Under the influence of immunosuppressive TME, immune cells generate tolerance phenotype-related metabolic adaptations through metabolic reprogramming to satisfy their own needs and further perform anti-tumor or immunosuppressive roles. The response of immune cells to tumor cells mainly depends on respective unique metabolic pathways, which are related to the type and function of immune cells. Moreover, the functional properties of immune cells are directly associated with the immunotherapy effects. Regulating metabolic pathways of immune cells provides a great direction for cancer therapy. In this paper, the main metabolic pathways of immune cells in TME is described, the relationship between their metabolic characteristics and immune functions is summarized, and the mechanism of metabolic pathways underlying the functions of immune cells is further discussed, providing new insights for unveiling tumor immunosuppressive microenvironment and improving the efficacy of tumor immunotherapy.

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    Establishment and optimization of co-culture technology for breast cancer organoids
    Tian-hao ZHOU, Zhao-chen XIN, Shao-qian DU, Yuan CAO, Jing-xuan XU, Zeng-hong LAO, Hong-xia WANG
    JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY (MEDICAL SCIENCE)    2021, 41 (8): 1017-1024.   DOI: 10.3969/j.issn.1674-8115.2021.08.004
    Abstract1366)   HTML229)    PDF(pc) (4693KB)(959)       Save
    Objective

    ·To improve the cultivating and passaging method of breast cancer organoids, and establish a co-culture system enriching cancer associated fibroblasts (CAFs).

    Methods

    ·Different types of collagenases (type Ⅰ, type Ⅲ and type Ⅳ) were used to digest fresh tissues from 5 breast cancer patients. The number of cells after tissue digestion was counted by cell counting method, and cell viability was analyzed by cell flow cytometry. Three-dimensional culture of primary breast cancer single cells was carried out by using culture system containing different contents of fibroblast growth factor 7 (FGF7), FGF10 and epidermal growth factor (EGF). The success rate of cell culture and the growing status of organoids were observed and compared. Different centrifugation speeds were used to compare the advantages and disadvantages of passaging methods and simplify the passaging steps. CCK8 assay was used to study the effect of CAFs on the growth of organoids in the co-culture system of primary CAFs and organoids, and the morphological changes of organoids were observed under optical microscope.

    Results

    ·Compared with type Ⅰ and type Ⅲ collagenase, type Ⅳ collagenase got the highest cell yields (P=0.045, P=0.017), and maintained the highest cell viability (P=0.005, P=0.048). By optimizing the composition of organoid medium (omitting FGF7 and FGF10, reducing EGF concentration) and passaging process (improving centrifugal velocity to 900×g), a more economical, effective and rapid method of organoid culture was obtained. Compared with organoids cultured alone, the growth rate (P<0.05) and heterogeneity of organoids increased when organoids were co-cultured with CAFs.

    Conclusion

    ·The optimized culture system can significantly increase the success rate of organoids, simplify the culture steps and reduce the culture cost. The establishment of primary CAFs and organoids co-culture system provides a good in vitro model for the study of breast cancer heterogeneity and tumor microenvironment.

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    Application and research progress of tetrahedral framework nucleic acids in the field of medicine
    XIE Shasha, LÜ Yehui, LIN Jian
    Journal of Shanghai Jiao Tong University (Medical Science)    2023, 43 (3): 380-384.   DOI: 10.3969/j.issn.1674-8115.2023.03.015
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    Since the first proposal by Seeman in 1982, DNA nanostructures have been gradually improved, and have been widely developed and applied to the field of biomedical fields. In recent years, as a representative of 3D DNA nanostructures, tetrahedral framework nucleic acids (tFNA) has made certain research progress and has good application prospects in frontier fields such as biosensors, tumor therapy, antigen detection, regenerative medicine, with the advantages of their good biocompatibility, editability, high stability and easy preparation. This paper briefly describes the concepts of tFNA, and summarizes the applications and research progress of tFNA in the following fields from the perspective of therapeutic applications: ① Building novel self-assembled complexes to improve the efficacy of free drugs, carrying small RNA molecules to slow down tumor progression, and self-assembled complexes for targeted therapy, etc, as biological vectors and tumor drug delivery. ② Regulating inflammation and immune response, such as reducing the level of inflammatory factors, treating inflammatory diseases, preventing diabetes, and acting as immunomodulators, etc. ③ Enhancing tissue regeneration, such as promoting stem cell proliferation and differentiation, stimulating peripheral nerve regeneration, and facilitating wound repair through angiogenesis. This review summarizes the research progress of tFNA, and looks forward to its application prospects based on the analysis of the shortcomings of existing research, in order to provide reference for further research.

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    Application progress of machine learning in the study of facial features of patients with depression
    Xin LI, Qing FAN
    JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY (MEDICAL SCIENCE)    2022, 42 (1): 124-129.   DOI: 10.3969/j.issn.1674-8115.2022.01.019
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    Major depressive disorder (MDD) is a mental illness that severely affects the quality of life, accompanied by changes in facial expressions and other behaviors. The current diagnosis for MDD mainly relies on self-reports and observations from doctors, which has subjective errors. There is a lack of objective and effective automated MDD detection methods. Facial expressions are important nonverbal behaviors, and the researchers have begun to use facial features to assist in identifying and diagnosing depression. As the core of artificial intelligence, machine learning has outstanding advantages in image feature extraction and classification. Taking IEEE Xplore database as the data source, this article sorts out the researches on the facial features of MDD patients based on machine learning from 2016 to 2021, and prospects the future research directions, to provide reference for clinical intelligent diagnosis and tracking of MDD in the future.

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    Application of Quality-of-Life Assessment Scales and psychological assessment tools to people with dry eye disease
    Yu-ying CAI, Yan LIU
    JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY (MEDICAL SCIENCE)    2021, 41 (9): 1252-1255.   DOI: 10.3969/j.issn.1674-8115.2021.09.018
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    Dry eye disease (DED) is a common disease with multiple etiologies. It can affect the daily activities of patients to reduce their quality of life and interfere with their mental state. At present, for DED patients, the clinical application of Quality-of-Life Assessment Scales are more, but the summary research of professional psychological assessment tools is less. On the basis of extensive review at home and abroad, this paper summarizes and explores the application of Quality-of-Life Assessment Scales and psychological assessment tools to DED patients, in order to provide suggestions and guidance for the clinical diagnosis and treatment and nursing work of DED.

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    Diagnosis and treatment protocol of mandibular condylar fracture: experience from the TMJ Center of Shanghai Ninth People 's Hospital, Shanghai Jiao Tong University School of Medicine
    HE Dongmei, YANG Chi
    Journal of Shanghai Jiao Tong University (Medical Science)    2022, 42 (6): 695-701.   DOI: 10.3969/j.issn.1674-8115.2022.06.001
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    Mandibular condylar fracture is common in clinic. Improper treatment will cause sequelae such as malocclusion, ankylosis and limited mandibular development. This paper combines the literature review and the diagnosis and treatment experience of the team to provide reference for clinicians. Imaging diagnosis, especially coronal CT reconstruction, is the basis for classification and treatment of condylar fracture. According to the fracture location, it is divided into condylar (intracapsular) fracture, condylar neck fracture and subcondylar fracture. And intracapsular fracture can be further divided into four types: A, B, C and M. The treatment of condylar fracture includes non-surgical treatment and surgical treatment. For non-surgical treatment, intermaxillary elastic traction is recommended for malocclusion correction. The absolute indication of surgical treatment is the ramus stump dislocated out of the fossa. The relative indications include the stump of the mandibular ramus contacting the articular fossa, severe displacement or dislocation of the condylar neck and subcondylar fracture. The key points of successful operation include adequate exposure, anatomic reduction and stable fixation, protection of lateral pterygoid muscle attachment and articular cartilage, and reposition of the temporomandibular joint disc. For the condylar fracture combined with mandibular fracture, lingual fissure of the mandible should be closed during reduction and fixation for restoring the mandibular width and condylar position in the fossa. When the condylar fracture is combined with midface fracture, the condylar fracture and occlusal relationship should be restored first, and then the maxillary fracture should be fixed according to the lower dentition. The children under 6 years old have the stronge ability of condylar remodeling, so non-surgical treatment is commonly used. The healing and remodeling ability of condyle gradually decreases with age. The condyles of the teenagers over 12 years old are close to those of the adults, so the indications of surgical treatment for condyle fracture refer to the adults.

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    Advances in cell wall structure and Candida albicans-host interaction
    Yi-kun MEI, Jing-cong TAN, An-jun WANG, Hui WANG, Ning-ning LIU
    JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY (MEDICAL SCIENCE)    2021, 41 (9): 1246-1251.   DOI: 10.3969/j.issn.1674-8115.2021.09.017
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    Candida albicans is an opportunistic human fungal pathogen. The mortality rate of blood infection caused by Candida albicans is as high as 40% while that of the cancer patients can even reach to 70%, which greatly increases the burden of human health. The cell wall of Candida albicans is the frontline of defense against external stress and the first contact point between fungi and host. Therefore, the cell wall is very important for fungi-host interaction and immune recognition, and is the most attractive target for antifungal therapy. Once the balance of synthesis and remodeling of cell wall of Candida albicans is broken, the molecular integrity of cell wall will be disturbed, which will finally lead to cell lysis and death. This paper reviews the characteristics of cell wall components of Candida albicans and their functions on fungi-host interaction and immune recognition mechanism, in order to provide novel research clues and theoretical basis for identification of specific antifungal targets and development of more economic and effective antifungal drugs.

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    Analysis of clinical trial research in Shanghai Jiao Tong University School of Medicine
    PENG Shutao, QIU Xiaochun
    Journal of Shanghai Jiao Tong University (Medical Science)    2022, 42 (8): 971-979.   DOI: 10.3969/j.issn.1674-8115.2022.08.001
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    Objective ·To analyze the discipline distribution, research teams, multi-center cooperation and trend of clinical trial registration and published papers of Shanghai Jiao Tong University School of Medicine (SJTUSM) from 2012 to 2021. Methods ·On the Dimensions, and China and US clinical trial registration platforms, the clinical trial information registered by the institutions affiliated to SJTUSM from 2012 to 2021 was retrieved. Each clinical trial was classified and marked according to the classification standards such as Health Research Classification System (HRCS) and International Commission on Radiological Protection (ICRP). Clinical trial papers published by the first author or corresponding author from SJTUSM in the same period were retrieved in PubMed. EXCEL 2016 and VOSviewer 1.6.18 software were used to conduct cluster analysis and visual summary. Results ·From 2012 to 2021, Chinese researchers participated in 54 652 newly registered clinical trials worldwide, accounting for 13.63% of the global in total. Beijing, Shanghai and Guangzhou have been the top three cities with the most clinical trials in China. The number of newly registered and underdeveloped clinical trial projects in SJTUSM has been basically increased year by year in the past 10 years, but it declined slightly in 2021. In total, 3 970 clinical trials were registered by SJTUSM, in which 44.4% were registered on the Chinese clinical trial platform and 55.0% were registered on the US clinical trial platform, and 85.5% were initiated by researchers. Cancer, cardiovascular disease, oral and gastrointestinal disease, mental disease, and metabolic and endocrine disease were the major areas of clinical trial research of SJTUSM. Lung cancer research ranked the first in all 47 kinds of tumor research. The Sixth People 's Hospital, Ruijin Hospital and Renji Hospital ranked top 3 in clinical trial registration among hospitals affiliated to SJTUSM. A total of 1 898 papers (5.4%) were published in clinical trials with SJTUSM as the first author 's or correspondent author 's institution, and the research topics were mainly distributed in the fields of gastroenterology, heart disease, tumor, radiation, orthodontics and diabetes. The affiliated hospitals of Fudan University has been the main institutions of clinical trial cooperation. SJTUSM has formed core research teams in the fields of diabetes, hypertension, orthopedics, radiology and nephrology. Conclusion ·SJTUSM has obvious advantages in clinical trial research discipline and a great potential for emerging disciplines. Innovative clinical research teams have been formed in SJTUSM. Multi-center clinical trials are the norm of clinical trials, and SJTUSM has presided over international multi-center clinical trial cooperation in some fields. However, compared with the clinical trial registration in the world and other domestic regions in 2021, the number of clinical trial registrations of SJTUSM has decreased significantly, and the reasons need to be further analyzed.

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    A novel antithrombotic antibody targeting the binding sites of the coagulation factor FⅨa-FⅧa complex
    Tian-yao SUN, Shi-feng JIANG, Qin XU, Jun-ling LIU, Su-ying DANG, Xue-mei FAN
    JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY (MEDICAL SCIENCE)    2021, 41 (9): 1133-1141.   DOI: 10.3969/j.issn.1674-8115.2021.09.001
    Abstract666)      PDF(pc) (6502KB)(787)       Save
    Objective

    ·To prepare a monoclonal antibody targeting coagulation factor Ⅸa (FⅨa), a key factor in endogenous coagulation pathways, and study its antithrombotic roles and mechanisms.

    Methods

    ·Immunization of mice, hybridoma technology, cell expression and purification were used to prepare the anti-FⅨa monoclonal antibodies of high purity. The monoclonal antibodies with high affinity for FⅨa were screened by enzyme-linked immunosorbent assay. The activated partial thromboplastin time (APTT) and prothrombin time (PT) were used to evaluate the antithrombotic effects of the monoclonal antibody. And then chromogenic substrate method was used to detect the effect of monoclonal antibody on the enzyme activity of FⅨa. The method of computer simulation of protein-protein docking was adopted to predict the possible binding sites between FⅨa and the antibody, and the binding site, was verified by competitive experiments (indirectly through the chromatic substrate method).

    Results

    ·FⅨa-4, an anti-FⅨa monoclonal antibody with high affinity, was generated. Although FⅨa-4 did not affect PT and the enzyme activity of FⅨa, it significantly prolonged APTT to 88.8 s, which was 3.5 times of the control group (25.5 s), in a concentration-gradient dependence. The protein-protein docking prediction results revealed that FⅨa-4 did not directly bind to substrate catalytic sites of FⅨa, but occupied the binding region of FⅨa and FⅧa. Competitive experiments further verified the above results. FⅨa-4 inhibited FⅩa production in a dose-dependent manner, almost completely inhibiting FⅩa production at the concentrations of 400 pmol/L, and FⅧa could correct the inhibition effect of the antibody up to nearly 50%.

    Conclusion

    ·The monoclonal antibody against FⅨa-4 is obtained. FⅨa-4 competes with FⅧa to bind FⅨa, and inhibits the conversion of FⅩ to FⅩa which is catalyzed by FⅧa-FⅨa complex; it plays an antithrombotic role mainly by inhibiting endogenous coagulation pathway.

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    Research of key causative genes and associated pathway in infertility based on big data of biological medicine
    Jia-le WEI, Xin-yi LIU, Shao-yong LU, Xue-feng LU, Jian ZHANG
    JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY (MEDICAL SCIENCE)    2021, 41 (10): 1277-1284.   DOI: 10.3969/j.issn.1674-8115.2021.10.001
    Abstract520)   HTML195)    PDF(pc) (6155KB)(767)       Save
    Objective

    ·To mine regular patterns of mutation and associated causative genes through integrating big data from the perspective of genetic factors in infertility.

    Methods

    ·A classification of causative genes collected in human infertility according to the protein category in the Universal Protein Resource (Uniprot) and statistics of mutation frequency in each kind of genes in clinical cases were made. The function and pathway of oxidoreductase with abnormal function, an important pathogenic factor, were analyzed, and related information was investigated. The mouse ortholog genes and pathogenic information of human steroid hormone biosynthesis were acquired from Mouse Genome Informatics (MGI) in order to evaluate potential genes after finding out regularity and analysis of gene interaction.

    Results

    ·It's commonest for oxidoreductase genes to be mutated in infertility-causative genes. The genes that mutated most easily seemed possibly to focus on the steroid hormone biosynthesis pathway, and, furthermore, potential and related mutation genes were found. Aldo-keto reductase family 1 member C3 (AKR1C3), an oxidoreductase, was considered as a candidate gene bringing about human infertility most probably after analyzing this pathway.

    Conclusion

    ·It's commonest for oxidoreductase-causative genes, which are mainly responsible for generating steroid hormone, to be mutated in infertility, and these genes maybe include AKR1C3.

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    Application of Montreal Cognitive Assessment Scale to the elderly in Chinese community
    An-qi XIA, Jun LI, Ling YUE, Bo HONG, Feng YAN, Ning SU, Shi-fu XIAO, Yuan-yuan LIU, Tao WANG
    JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY (MEDICAL SCIENCE)    2021, 41 (12): 1662-1667.   DOI: 10.3969/j.issn.1674-8115.2021.12.017
    Abstract820)   HTML19)    PDF(pc) (2168KB)(766)       Save
    Objective

    ·To update the cut-off value of the normal elderly (NE) and mild cognitive impairment (MCI) elderly in urban areas of China according to the Montreal Cognitive Assessment (MoCA) scores and analyze the sections of MoCA.

    Methods

    ·A cross-sectional study was conducted to investigate the elderly over 60 years old in ten cities of China. Mini-Mental State Examination (MMSE) and MoCA (Beijing version) were used to assess cognitive function. Data was statistically analyzed by SPSS 19.0.

    Results

    ·There were 2 367 NE, 553 MCI patients, 1 319 males and 1 601 females, with an average age of (70.6±7.5) years and an average length of education of (8.7±5.2) years. There were significant difference in age and length of education between MCI and NE groups (t=12.3, P=0.000; t=-13.5, P=0.000). Female was more likely to have MCI (χ2=13.5, P=0.000). By analyzing the score of MoCA of the NE, it was found that the MoCA score of males, high education level and low age group were higher. Rhinoceros and camel in naming, church and face in delayed memory, alternating connection test and pointer position in clock drawing were more difficult. The sections' scores of MoCA showed that the subjects performed better in the orientation and attention tests, while the scores of visuospatial functions, delayed recalling, sentence repetition and abstract ability were lower. The best cut-off value of MoCA was 20 (sensitivity = 63.7%, specificity = 75.7%). The area under the curve was 0.76.

    Conclusion

    ·MoCA (Beijing version) has a good distinction between NE and MCI, and 20 can be used as a cut-off value in MCI subjects screening in urban areas of China. MoCA score is influenced by age, gender and education level. Based on difficulty analysis, some words that evaluate memory could be replaced (replacing “face” with “hand” and replacing “church” with “factory”).

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    Research progress of clinical application of ASPECT score in acute ischemic stroke
    WEI Xuemin, GAO Chengjin
    Journal of Shanghai Jiao Tong University (Medical Science)    2022, 42 (7): 919-924.   DOI: 10.3969/j.issn.1674-8115.2022.07.011
    Abstract837)   HTML30)    PDF(pc) (1187KB)(749)       Save

    Acute ischemic stroke (AIS) is characterized by a high rate of disability and mortality, and rapid and accurate diagnosis and appropriate treatment are the keys. The severity of AIS patients depends on the location of early ischemic changes (EIC) in the brain tissue and the size of the lesion, so it is necessary to evaluate the patients' conditions by combining with imaging. The Alberta stroke program early CT score (ASPECT score) is a 10-point imaging score system that evaluates the EIC in the middle cerebral artery supplying region of the stroke patients in an accurate and simple way by quantifying the severity in terms of the imaging to help clinicians make medical decisions. ASPECT score is not only widely used to predict the prognosis of stroke patients, but also to identify the population benefiting from the endovascular therapy and evaluate the risk of endovascular therapy for patients. ASPECT score combined with multimodal imaging has also been used to predict ischemic core volumes and the prognosis. In recent years, with the development of artificial intelligence, automatic ASPECT scoring methods based on machine learning have emerged. This paper reviews ASPECT scoring methods, its value in the treatment and the assessment of prognosis in AIS, multimodal ASPECT scoring, and the application of automated ASPECT scoring combined with artificial intelligence.

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