Efectividad de Plasma Rico en Fibrina en Lesiones de Osteonecrosis de los Maxilares Asociada a Medicamentos: Resumen Estructurado de Evidencia (FRISBEE)

Introducción: Este trabajo de investigación tiene como objetivo evaluar y determinar la efectividad del uso de plasma rico en fibrina (PRF) como tratamiento para las lesiones de osteonecrosis de los maxilares asociadas a medicamentos (MRONJ). Métodos: Se realizó una búsqueda en Epistemonikos, la mayor base de datos de revisiones sistemáticas en salud, la cual es mantenida mediante el cribado de múltiples fuentes de información, incluyendo MEDLINE, EMBASE, Cochrane, entre otras. Extrajimos los datos desde las revisiones identificadas, analizamos los datos de los estudios primarios y preparamos una tabla de resumen de los resultados utilizando el método GRADE. Resultados y conclusiones: Se identificaron siete revisiones sistemáticas que en conjunto incluyeron 14 estudios primarios, de los cuales, solamente uno corresponde a un ensayo clínico aleatorizado, y el resto a estudios observacionales. No es seguro establecer con claridad si el uso de PRF mejora o contribuye a la resolución de lesiones de osteonecrosis de los maxilares asociados a medicamentos, debido a que el nivel de certeza de la evidencia es muy bajo.

Introduction: This research aims to evaluate and determine the effectiveness of using platelet-rich fibrin (PRF) as a treatment for medication-related osteonecrosis of the jaws (MRONJ). Methods: A search was conducted in Epistemonikos, the largest database of systematic reviews in health, maintained through the screening of multiple information sources, including MEDLINE, EMBASE, Cochrane, among others. Data were extracted from the identified reviews, analyzed from the primary studies, and a summary of findings table was prepared using the GRADE method Results and conclusions: Seven systematic reviews were identified, which together included 14 primary studies, of which only one was a randomized clinical trial, and the rest were observational studies. It is unclear whether the use of PRF improves or contributes to the resolution of medication-related osteonecrosis of the jaws due to the very low certainty of the evidence.

¿Qué condiciones deben reunir las guías de diagnóstico y tratamiento para ser verdaderas guías de práctica clinica basadas en la evidencia? / What conditions should the diagnosis and treatment guidelines meet, to be true clinical practice guidelines based on evidence?

Resumen Las guías de diagnóstico y tratamiento elaboradas por las sociedades científicas médicas, constituyen una herramienta muy útil para el ejercicio profesional de la especialidad. Sustentadas en bibliografía actualizada, representan un material de enorme valor con reco mendaciones de los expertos en los diversos temas de la especialidad. En el presente artículo se intenta determinar si las mismas podrían ser diseñadas acercándolas lo más estrechamente posible al formato de las Guías de Práctica Clínica Basadas en la Evidencia (GPC-BE), para lo cual se revisan las etapas en su elaboración y los requisitos que deberían cumplir para ser conside radas como tales. Las GPC-BE son un "conjunto de recomendaciones elaboradas de forma sistemática para ayudar a los profe sionales y a los pacientes en la toma de decisiones sobre la atención sanitaria más apropiada, seleccionando las opciones diagnósticas y/o terapéuticas más adecuadas en el abordaje de un problema de salud o una condición clínica específica". Su objetivo es mejorar la efectividad, la eficiencia y la seguridad de las decisiones clínicas, y pueden servir de base para la elaboración de políticas de salud. La elaboración de las GPC representa un proceso complejo, que requiere conocimientos, experiencia y re cursos tanto en tiempo como en dinero. Su robustez no depende de quienes la realizan, sino de cómo es realiza da. Ello implica la participación de técnicos que aporten la evaluación de la evidencia por el método GRADE, y la consideración de aspectos de costo-efectividad.

Abstract The guides for diagnosis and treatment prepared by scientific medical societies constitute a very useful tool for the professional practice of the specialty. Supported by an updated bibliography, they represent material of enormous value with recommendations from experts on the various topics of the specialty. This article attempts to determine if they could be designed as "Evidence - Based Clinical Practice Guide lines" (CPG BE), for which the stages in their develop ment and the requirements that they reviewed. The CPG BE are a "set of recommendations prepared systematically to help professionals and patients in making decisions about the most appropriate health care, selecting the most appropriate diagnostic and/or therapeutic options to address a problem of health or a specific clinical condition". Their objective is to improve the effectiveness, efficiency and safety of clinical deci sions, and they can serve a basis for the development of health policies. The preparation of CPGs represents a complex pro cess, which requires knowledge, experience and re sources, both in time and money. Its robustness does not depend on who does it, but on how it is done. This implies the participation of technicians who provide the evaluation of the evidence using the GRADE method and the consideration of cost-effectiveness aspects.

Tumor maligno de la vaina nerviosa periférica: reporte de un caso / Malignant peripheral nerve sheath tumor, a case report

Resumen El tumor maligno de la vaina nerviosa periférica (TMVNP) es un sarcoma de alto grado de malignidad. Es poco frecuente, agresivo y generalmente se localiza en tronco y miembros inferiores. Se presenta mayormente en pacientes con neurofibormatosis tipo 1, aunque no siempre se encuentra esta asociación. Este tumorcomparte características histológicas e inmunohistoquímicas con el melanoma, lo que puede dificultar el diagnóstico. Presentamos el caso de un paciente con TMVNP, en el cual los hallazgos histológicos iniciales condujeron a un diagnósticoerróneode melanoma.

Abstract Malignant peripheral nerve sheath tumor (MPNST) is a high-grade sarcoma. It is rare, aggressive and generally located on the trunk and lower limbs. It occurs in a high percentage of patients with neurofibormatosis type 1, although this association is not always found. This tumor shares histological and immunohistochemical characteristics with melanoma, which can make diagnosis difficult. We present the case of a patient with MPNST, in whom the initial histological findings led to an erroneous diagnosis of melanoma.

Relationship between short-chain fatty acids in the gingival crevicular fluid and peri-odontitis of stage Ⅲ or Ⅳ / 北京大学学报(医学版)

Objective:To analyze the concentration of formic acid,propionic acid and butyric acid in gingival crevicular fluid(GCF)of patients with stages Ⅲ and Ⅳ periodontitis,and their relationship with periodontitis.Methods:The study enrolled 37 systemically healthy patients with periodontitis and 19 healthy controls who visited Department of Periodontology,Peking University School and Hospital of Sto-matology from February 2008 to May 2011.Their GCFs were collected from the mesial-buccal site of one molar or incisor in each quadrant.Periodontal clinical parameters,including plaque index(PLI),probing depth(PD),bleeding index(BI),and attachment loss(AL).Concentrations of formic acid,propionic acid and butyric acid in the supernatant of the GCFs were analyzed by high-performance capil-lary electrophoresis(HPCE).The prediction ability of formic acid,propionic acid and butyric acid with the risk of periodontitis and the differences between grade B and grade C periodontitis were analyzed.Results:In this study,32 patients with stage Ⅲ and 5 patients with stage Ⅳ were enrolled,including 9 patients with grade B and 28 patients with grade C.Clinical periodontal variables in the patients with pe-riodontitis were significantly higher than those in the control group(P＜0.001).Formic acid was signifi-cantly lower in periodontitis than that in the control group[5.37(3.39,8.49)mmol/L vs.12.29(8.35,16.57)mmol/L,P＜0.001].Propionic acid and butyric acid in periodontitis were significantly higher than those in the control group:Propionic acid,10.23(4.28,14.90)mmol/L vs.2.71(0.00,4.25)mmol/L,P＜0.001;butyric acid,2.63(0.47,3.81)mmol/L vs.0.00(0.00,0.24)mmol/L,P＜0.001.There was no significant difference in formic acid,propionic acid and butyric acid concentrations between grade B and grade C periodontitis(P＞0.05).Propionic acid and butyric acid in the deep pocket were significantly higher than in the shallow pocket,while the concentration of formic acid decreased with the increase of PD.Propionic acid(OR=1.51,95％CI:1.29-1.75)and butyric acid(OR=3.72,95％CI:1.93-7.17)were risk factors for periodontitis,while formic acid(OR=0.87,95％CI:0.81-0.93)might be a protective factor for periodontitis.Propionic acid(AUC=0.852,95％CI:0.805-0.900),butyric acid(AUC=0.889,95％CI:0.841-0.937),f(formic acid,AUC=0.844,95％CI:0.793-0.895)demonstrated a good predictive capacity for the risk of periodontitis.Conclusion:The concentration of formic acid decrease in the GCF of periodontitis patients,which is a protective factor for periodontitis,its reciprocal have good predictive capacity.However,propionic acid and butyric acid increase,which are risk factors for periodontitis and have good predictive capacity.The concentration of formic acid,propionic acid,and butyric acid vary with probing depth,but there is no significant difference between grade B and grade C periodontitis.

Exploration of correlation between multiple subjective and objective evaluation indicators in early stage with recovery time in combination of acupuncture and medication for treating facial neuritis / 重庆医学

Objective To analyze the correlation between the multiple evaluation indicators in the early stage and the cure time(needed time from treatment to cure)of the patients with facial neuritis treated by ac-upuncture combined with medication,and to optimize the subjective and objective indicators enable predicting the cure time of facial neuritis in early stage.Methods All patients were treated by acupuncture and medica-tion combination.The research subjects were 64 patients with facial neuritis from the outpatient of cupuncture and moxibustion department of this hospital.The correlation between the grade of facial nerve paralysis,sur-face electromyography related data,scores of self-made symptom scoring scale,Sunnybrook Facial Grading System(SFGS)score,Facial Disability Index-Physical(FDIP)score,Facial Disability Index-Social(FDIS)score on 7 d of onset with the cure time was analyzed.Results The cure time was positively correlated with the grade of facial nerve paralysis and FDIS score on 7 d of onset(P＜0.01),amd negatively correlated with the scores of self-made symptom scoring scale,FDIP score,SFGS score and the affected side to healthy ratio of CMAP amplitude of buccal temporal branch of facial nerve(P＜0.01 or P＜0.05);the cure time had no sig-nificant correlation with the ratio of affected side and healthy side of CMAP amplitude in zygomatic branch of facial nerve,the ratio of affected side and healthy side of CMAP latent period of temporal branch,buccal branch and zygomatic branch of facial nerve and F wave output rate(P＞0.05).Conclusion In the early stage subjective indicators of the acupuncture combined with medication for treating facial neuritis,grade of facial nerve paralysis,self-made symptom scoring scale,scores of self-made symptom scoring scale,FDIP and FDIS scores and the ratio of affected side to healthy side of CMAP amplitude of the buccal branch,temporal branch of the facial nerve in sEMG in the objective indicators could be used to predict the cure time,better guide the treatment and have more effective and accurate comunication with the patients.

The effect of simple topical and intravenous general anesthesia on the occurrence of pancreatitis after ERCP surgery:a retrospective analysis / 临床外科杂志

Objective To investigate the effects of simple topical anesthesia and intravenous general anesthesia on the occurrence of pancreatitis after ERCP.Methods 400 Patients who underwent ERCP due to pancreaticobiliary duct disease in our hospital from January 2021 to March 2023 were selected and divided into two groups:Simple topical anesthesia group and intravenous general anesthesia group,200 cases in each group.The levels of venous pancreatic amylase and abdominal symptoms and signs were recorded in the two groups before operation and 3 h and 24 h after operation.The observation results were hyperamylaseemia and postoperative pancreatitis at 3 h and 24 h after operation.Results The incidence of postoperative pancreatitis after ERCP was higher in the superficial anesthesia group than in the intravenous general anesthesia group(7.5％and 2.0％,respectively;P＜0.05),there was statistical significance;The level of serum pancreatic amylase(198±216)U/L in intravenous general anesthesia group was significantly lower than that in superficial anesthesia group(379±327)U/L at 3h after surgery(P＜0.05).The level of serum pancreatic amylase(129±98)U/L in intravenous general anesthesia group was lower than that in superficial anesthesia group(187±156)at 24h after surgery(P＜0.05).The incidence of hyperamylasemia was 15.5％(31/200 cases)in the 3h postoperative intravenous general anesthesia group,lower than that in the simple surface anesthesia group(34.5％)(69/200 cases),and 5.5％(11/200 cases)in the 24h postoperative intravenous general anesthesia group,lower than that in the simple surface anesthesia group(19.0％)(38/200 cases)(P＜0.05).Conclusion Compared with simple surface anesthesia,intravenous general anesthesia can reduce the level of serum amylase after ERCP,and can reduce the occurrence of pancreatitis after ERCP.

High grade B cell lymphoma with concurrent MYC rearrangement and 11q aberrations:a clinicopathological analysis / 临床与实验病理学杂志

Purpose To investigate the clinicopathological features,molecular genetics and prognosis of high grade B cell lymphoma with concurrent MYC rearrangement and 11q aberra-tions(HGBCL-MYC-11q).MethodsThree cases of HGBCL-MYC-11q were reviewed and analyzed using hematoxylin-eosin staining,immunohistochemistry,EBER in situ hybridization and fluorescence in situ hybridization.Clinical data were collected with follow-up.Results All three patients were male,age was 10,61,and 74 years,respectively.All patients had Ann Arbor stage Ⅳ disease.All three cases were biopsies occurring in the nasopharynx,upper pharynx and ileocecus,respectively.Three cases were morphologically similar to diffuse infiltrative growth of tumor cells,moderate or moderately large cells,round to slightly irregular nuclei and easily visible mitotic figures.Focal necrosis was noted in one case.One case exhibited the distinct"starry sky"pattern.All cases expressed CD20,BCL6 and MUM1 and high Ki67 index,two cases expressed CD10 and two cases ex-pressed BCL2.CD3,CD30 and TDT were all negative.EBER in situ hybridization was all negative.FISH analyses using C-MYC break-apart probes were all positive and all cases had 11q aberrations.One case only had the 11q23.3 amplification;and one case only had the 11q24.3 loss.After a follow-up for 1-18 months,one patient died and two patients survived with disease.ConclusionHGBCL-MYC-11q is rare,morphologically similar to BL/HGBCL,with MYC rearrangement and 11q abnormali-ties.We should enhance awareness of the disease and improve more accurate diagnosis and differential diagnosis of the disease.

The role and mechanism of MCM5 in the occurrence and development of ovarian cancer / 临床与实验病理学杂志

Purpose To explore the expression,mechanism and clinical significance of MCM5 in ovarian cancer.Methods The expression of MCM5 mRNA in ovarian cancer and its correlation with patients'survival were analyzed using GEO and TCGA databases.The expression of MCM5 protein in ovarian cancer was detected by immunohistochemistry of SP two-step method,and its relationship with clinicopathological characteris-tics was analyzed.With inhibition of MCM5 by siRNA in ovarian cancer cells.The effects of MCM5 on cell proliferation,migra-tion,invasion,and apoptosis were detected by CCK-8 assay,EDU,plate cloning,Transwell chamber and flow cytometry.Re-sults Immunophenotype:MCM5 does not stain in the fallopian tube epithelium(0/6),with a positivity rate of 48.3％(57/118)in ovarian cancer.The expression of MCM5 in ovarian cancer is significantly higher than in fallopian tube epithelium,showing diffuse strong expression in high-grade serous carcino-ma.MCM5 expression is strongly correlated with ER-negative status and high Ki67 proliferation index.Knocking down MCM5 expression inhibits proliferation(P＜0.05),clonogenicity(P＜0.05),invasion and migration(P＜0.05)of ovarian cancer cells,and promotes apoptosis.Conclusion MCM5 is highly expressed in human ovarian cancer cells and tissues and is asso-ciated with poor prognosis.It is expected to become a new target for the treatment of ovarian cancer.

Analysis of fertility preservation and HPV negative conversion rate of LEEP by separating the vesicorectal space / 复旦学报（医学版）

Objective To explore the eradication rate of human papillomavirus(HPV)and gestational outcome of patients with high-grade squamous intraepithelial disease of the cervix(HSIL)after loop electrosurgical excision procedure(LEEP)by transvaginal dissection of the vesicorectal form the cervix.Methods A total of 53 patients treated with LEEP by transvaginal dissection of the vesicorectal form the cervix in Obstetrics and Gynecology Hospital,Fudan University from Jan to Dec,2019 were investigated.Clinical information of cervical cytological examination,HPV test and cervical biopsy under colposcopy were followed up for 6,12 and 24 months post-LEEP were collected.HPV infection in these 53 patients were compared before and after LEEP surgery.The rate of successful fertility of the cohort,the HPV conversion rate of patients with hysterectomy and LEEP done were compared.The association between the pathological type and positive surgical margin and the association between HPV infection type and positive surgical margin were analyzed.Results HPV infection rate of was 94.3%(50/53)and the proportion of HPV16 and/or 18 infection was 75.5%(40/53).Mono-HPV infection rate(69.8%,37/53)was significantly higher than mixed HPV infection rate(22.7%,13/53).Thirty-eight patients(71.7%)were found with positive surgical margin in previous LEEP operation.Fifteen patients had recurrence(28.3%)and 40 patients(75.5%)successfully delivered baby after surgery.Postoperative pathology was mainly HSIL,accounting for 66%(30/53),and 28.3%patients(15/53)had no pathological change.Forty cases had satisfying fertility-conservative operation outcome with negative surgical margin,and 38 patients eradicated HPV infection after LEEP,which took up 95%of patients with satisfying fertility-conservative operation.There was no significant difference of positive resection margin rate in between groups of HPV16/18 infection and other types.Five cases had successful delivery(12.5%,5/40)with 1 case of vaginal delivery and 4 cases of cesarean section.Among these 5 cases,3 cases undertook preventive cervical cerclage,with 1 case of vaginal delivery and 2 cases of cesarean sections.Conclusion HPV eradication rate and surgical outcome could be significantly improved by LEEP with transvaginal dissection of the vesicorectal from the cervix,which satisfied the fertility preservation of females at reproductive age.

Application of multimodal MRI in diagnosis of lumbar intervertebral disc degeneration / 实用放射学杂志

Objective To explore the application effect of multimodal MRI in the diagnosis of lumbar intervertebral disc degeneration.Methods A total of 78 patients with lumbar intervertebral disc degeneration treated conservatively were retrospectively selected.The patients underwent sagittal T2WI,axial T2WI sequence and sagittal synthetic MRI scanning and post-processing to generate T1,T2 and proton density(PD)mapping quantitative sequences by GE Signa Pioneer 3.0T MR machine.The T1,T2 and PD values of the anterior and posterior annulus fibrosus and nucleus pulposus of L1-L2 to L5-S1 lumbar intervertebral disc were measured.The Pfirrmann grade,visual analogue scale(VAS)and Oswestry disability index(ODI)scale of each intervertebral disc were evaluated.The T1,T2,PD,VAS and ODI of patients with different Pfirrmann grades were compared.Pearson linear analysis was used to analyze the relationship between T1,T2,PD and VAS,ODI.Spearman rank correlation method was used to analyze the relationship between T1,T2,PD and Pfirrmann.Logistic regression analysis was used to analyze the evaluation value of T1,T2 and PD in Pfirrmann.Results With the increase of Pfirrmann grade,the T1,T2 and PD values of patients decreased,while the VAS score and ODI increased(P<0.05).The T1,T2 and PD values were negatively correlated with VAS score,ODI and Pfirrmann grade(P<0.05).Logistic regression analysis showed that T1,T2 and PD values had good evaluation values for Pfirrmann grade(P<0.05).Conclusion Multimodal MRI can effectively evaluate the Pfirrmann grade,pain and lumbar function of lumbar intervertebral disc degeneration,which can be used to help determine the diagnosis.

Value of MR 3D-ASL,DWI combined with MGMT in the differential diagnosis of postoperative recurrence and pseudoprogression of high-grade glioma / 实用放射学杂志

Objective To explore the value of brain MR three-dimensional arterial spin labeling(3D-ASL),diffusion weighted imaging(DWI)combined with MGMT gene detection in the differential diagnosis of postoperative recurrence and pseudoprogression of high-grade glioma.Methods A total of 30 patients with high-grade glioma were selected,and all patients were divided into pseudoprogression group and recurrence group according to pathological results.The differences in average relative cerebral blood flow(rCBF)and average relative apparent diffusion coefficient(rADC)were compared between recurrence groups and pseudoprogression groups.Results The rCBF in the enhanced center and edge areas in the recurrence group was significantly higher than those in the pseudoprogression group,and the rADC was significantly lower than that in the pseudoprogression group,and the difference was statistically significant(P<0.05).There were correlations between the postoperative recurrence and pseudoprogression of high-grade glioma and the promoter situation of methylation of MGMT gene.Conclusion Brain MR 3D-ASL,DWI combined with MGMT gene detection has important clinical value in the differential diagnosis of postoperative recurrence and pseudoprogression of high-grade glioma.

Correlation of ncRNA-mediated Up-regulation of EphB4 with Poor Prognosis and Tumor Immunoinfiltration in Low-grade Glioma / 医学研究杂志

Objective To investigate the expression of erythropoietin-producing human hepatocellular receptors B4(EphB4)and its upstream targets as well as correlation with prognosis in low-grade glioma(LGG),for analyzing its potential role as a therapeutic tar-get.Methods Firstly analyzed the expression of EphB4 in glioma and normal brain tissue by The Cancer Genome Atlas(TCGA)data-base.Then,Gene Expression Profiling Interactive Analysis(GEPIA)database was used to analyze the effects of EphB4 on various cancer survival.The possible upstream regulatory non-coding RNA(ncRNA)of EphB4 were analyzed by R and starBase database.The correla-tion of EphB4 with tumor immune cell infiltration,biomarkers of immune cells and immune checkpoint expression were analyzed using the Tumor Immune Estimation Resource(TIMER)database.Results UBA6-AS1/hsa-miR-346 axis was the most potential upstream non-coding RNA(ncRNA)related pathway to influence expression of EphB4 in LGG.At the same time,the level of EphB4 was posi-tively correlated with the tumor immune cell infiltration,immune cell biomarkers and immune checkpoint in LGG.Conclusion NcRNA-mediated up-regulation of EphB4 is associated with poor prognosis and tumor immunoinfiltration in LGG.

Transumbilical Single-port Total Laparoscopic Hysterectomy by Conventional Instruments Without Uterine-lifting / 中国微创外科杂志

Objective To investigate the application value of transumbilical single-port total laparoscopic hysterectomy by conventional instrument without uterine-lifting in the treatment of cervical lesions.Methods We selected 60 cases of total laparoscopic hysterectomy due to cervical high-grade squamous intraepithelial lesion(HSIL)or cervical cancer stage ⅠA1 from December 2021 to June 2023.According to the patients'preference,30 cases of single-port laparoscopy through the umbilicus and 30 cases of multi-port laparoscopy were performed,both using conventional instruments without uterine-lifting.The surgical indicators of the two groups were compared.Results No conversion to open surgery occurred in both groups,and no intraoperative injuries to the urinary system,bowel,or major blood vessels occurred.As compared with the multi-port group,the single-port group had significantly reduced amount of bleeding during surgery[(54.6±20.5)ml vs.(67.5±27.0)ml,P = 0.041],earlier anal exhaust time[(27.6±8.0)h vs.(32.2±9.0)h,P =0.040],and shorter total hospitalization time[(4.4±1.5)d vs.(5.1±1.2)d,P = 0.044].There were no significant differences in uterine weight,surgical time,and postoperative complications between the two group(P>0.05).The healing of the abdominal wall puncture wounds in both groups of patients were satisfied.There were no short-term complications related to the puncture device(such as puncture wound infection and bleeding)or long-term complications(such as umbilical hernia and incisional hernia).Conclusion Transumbilical single-port total laparoscopic hysterectomy without uterine-lifting presents advantages of less intraoperative bleeding,faster postoperative recovery,and almost no scarring,with complications similar to traditional laparoscopic surgery.

Molecular markers of postoperative recurrence and malignant transformation in low-grade gliomas and their predictive value / 西安交通大学学报(医学版)

【Objective】 To identify the risk factors for recurrence and malignant transformation (MT) in patients with low-grade glioma (LGG) after surgery. 【Methods】 The data of 163 patients who underwent LGG resection and subsequent follow-up from March 2009 to April 2019 were retrospectively collected. Patients who did not experience recurrence or MT after surgery were included in the control group (85 cases), those who experienced recurrence after surgery were included in the observation 1 group (44 cases), and those who experienced MT after surgery were included in the observation 2 group (34 cases). Based on the clinical data of the three groups of patients, their clinical characteristics were analyzed, and the risk factors and predictive value for recurrence and MT were explored using Logistic regression model and receiver operating characteristic (ROC) curve. 【Results】 There were significant differences between the control group and the observation 1 group in preoperative seizure, preoperative Karnofsky performance status (KPS) score, and surgical approach (P<0.05). There were significant differences between the control group and the observation 2 group in gender, preoperative KPS score, tumor size, and surgical approach (P<0.05). There were significant differences between the control group and the observation 1 group in isocitrate dehydrogenase (IDH) mutation, proliferating cell nuclear antigen (PCNA), matrix metalloproteinase-9 (MMP-9), cancer-testis antigen OY-TES-1, OY-TES-1 mRNA protein, tumor suppressor protein p53, mouse double minute 2 (MDM2), vascular endothelial growth factor (VEGF), or epidermal growth factor receptor (EGFR) (P<0.05). There were significant differences between the control group and the observation 2 group in PCNA, MMP-9, cancer-testis antigen OY-TES-1, OY-TES-1 mRNA protein, or VEGF (P<0.05). Logistic regression analysis showed that IDH mutation, MMP-9, and PCNA were independent risk factors for LGG recurrence (P<0.05), while VEGF, MMP-9, and PCNA were independent risk factors for LGG MT (P<0.05). The area under curve (AUC) of PCNA, MMP-9 and IDH mutation for predicting LGG MT after surgery was 0.744, 0.790, and 0.799, respectively. The AUC of PCNA, MMP-9, and VEGF for predicting LGG recurrence after surgery was 0.729, 0.750, and 0.900, respectively. 【Conclusion】 This study found that IDH mutation, MMP-9 and PCNA were independent risk factors for LGG recurrence, while VEGF, MMP-9 and PCNA were independent risk factors for LGG MT by retrospectively analyzing the clinical data and protein expression of 163 patients with LGG after surgery. These proteins have high accuracy in predicting LGG recurrence and MT after surgery. Therefore, the proteins may play an important role in the biological behavior and treatment effect of LGG, and can be used as reference indicators for prognosis evaluation and individualized treatment of LGG patients after surgery.

New Advances in the Use of 18F-FET PET in the Diagnosis and Management of Adult High-Grade Gliomas / 罕见病研究

Gliomas are the most common primary intracranial tumors in adults, among which high-grade glioma patients are characterized by short survival and poor prognosis. The diagnosis, treatment, evaluation of effective treatments, and prognosis prediction of high-grade gliomas are of great significance for improving patient survival. Conventional enhanced magnetic resonance imaging has deficiencies in delineating tumor extent, identifying tumor progression and treatment-related changes. Therefore, there is a broad consensus to incorporate amino acid PET, and 18F-FET PET inparticular, into the diagnostic and therapeutic process of high-grade gliomas. In this article, we review the new research progress of 18F-FET PET in the diagnosis and treatment of adult high-grade glioma in recent years.

Incidental finding of an atypical cartilaginous tumor in an adult female with recurrent patellar dislocation: Single-stage extended curettage using freezing nitrogen ethanol composite followed by Medial Patello-Femoral Ligament Reconstruction

@#Atypical cartilaginous tumor (ACT) refers to a low-grade cartilaginous neoplasm microscopically identical to grade 1 chondrosarcoma, affecting the appendicular skeleton. Treatment with intralesional curettage has been found to provide sufficient local control with less morbidity compared to wide resection. This is the first reported case of a simultaneous medial patello-femoral ligament (MPFL) reconstruction with extended curettage for ACT on the ipsilateral femur. A 45-year-old female presented with chronic recurrent patellar dislocation of the right knee. Magnetic resonance imaging revealed a tear of the MPFL, with an incidental epi-metaphyseal chondroid lesion. After biopsy confirmed an ACT, single-stage extended curettage using freezing nitrogen ethanol composite (FNEC) and MPFL reconstruction was performed, followed by augmentation with bone cement and a distal femoral plate. Currently, the patient is independently ambulatory, with full range of motion about the knee. Following histologic confirmation of an ACT in the setting of a concurrent MCL tear, a single-stage procedure to address both conditions is a viable option that can reduce complications associated with multiple surgeries. Extended curettage using FNEC has been shown to produce good short-term oncologic outcomes while maximizing function.

Differential expression of FAM83A and β-catenin in cervical lesions / 安徽医科大学学报

Objective @# To investigate the expression difference and potential clinical significance of 83 sequence similar member A (FAM83A) and β-catenin in cervical lesions．@*Methods @#ALCAN and GEPIA2. 0 online data- bases were used to analyze the difference of FAM83A expression in normal cervix and cervical squamous cell carci- noma ( CSCC) and the relationship between FAM83A expression and the prognosis of CSCC patients，LinkedOmics database was used to analyze FAM83A mRNA co-expression genes，and R language was used for KEGG enrichment analysis．Immunohistochemistry was used to detect FAM83A and β-catenin expression in 60 cases of normal cervix， 80 cases of low-grade squamous intraepithelial lesion ( LSIL) ，90 cases of high-grade squamous intraepithelial le- sion (HSIL) and 70 cases of cervical squamous cell carcinoma ( CSCC) ．The relationship between FAM83A ，β - catenin expression and clinicopathological features and the correlation between FAM83A and β-catenin expression were analyzed. @*Results @# UALCAN database analysis showed that FAM83A was highly expressed in CSCC tissues， and GEPIA 2. 0 database analysis suggested that those with high FAM83A expression had a poor prognosis．Linke- dOmics database performing KEGG enrichment analysis suggested that expression of FAM83A was positively correla- ted with aberrant activation of Wnt / β-catenin signaling pathway． The expression rate of FAM83A in CSCC was higher than that in LSIL and normal cervical tissues (P＜0. 001) ，but there was no significant difference compared with HSIL (P = 0. 401) ; the expression of FAM83A was not correlated with age (P = 0. 231) ，but was significant- ly different from the correlation with differentiation (P = 0. 001) and clinical stage (P = 0. 038) ．The abnormal ex- pression rate of β-catenin in CSCC was higher than that in LSIL and normal cervical tissues (P＜0. 001) ，but there was no significant difference compared with HSIL (P = 0. 734) ; the expression of β-catenin was not related to age (P = 0. 088) ，related to differentiation (P = 0. 001) and clinical stage (P＜0. 001) ，and FAM83A was positively correlated with β-catenin expression (P ＜0. 05 ) ．@*Conclusion @#FAM83A and β-catenin are highly expressed in both HSIL and CSCC tissues，and there is a positive correlation between the expression of FAM83A and β-catenin. The high expression of FAM83A has some correlation with the prognosis of CSCC patients and can be used as a po- tential marker to determine the prognosis of CSCC.

A Randomized，Double-blind，Multi-center Clinical Trial of Tengfu Jiangya Tablets Combined with Valsartan/Amlodipine in Treatment of Grade 2 Hypertension with Hyperactivity of Liver Yang / 中国实验方剂学杂志

ObjectiveTo observe the clinical efficacy and safety of Tengfu Jiangya tablets combined with valsartan/amlodipine in the treatment of grade 2 hypertension with liver Yang hyperactivity syndrome. MethodAccording to a randomized，double-blind，and placebo parallel control method，288 patients with grade 2 hypertension with liver Yang hyperactivity from 7 subcenters were included. They were randomly divided into an observation group （144 cases） and a control group （144 cases），and then treated with Tengfu Jiangya tablets combined with valsartan/amlodipine and placebo combined with valsartan/amlodipine，respectively. The efficacy was evaluated after four weeks of intervention. During the experiment，the safety indicators and adverse reaction events of the subjects were recorded for safety evaluation，and the efficacy indicators and TCM syndrome scores were recorded for effectiveness evaluation. Sensitivity analysis was also conducted on the statistical results of the main efficacy indicators such as blood pressure （BP） compliance rate to ensure the accuracy of the analysis results. 88 groups of blood samples from each of the treatment and control groups were included as test subjects. Fasting blood samples were collected from the patients in the clinical trial on the day before and after medication，and enzyme linked immunosorbent assay （ELISA） was performed on the treated serum. The levels of arachidonic acid （AA），thromboxane B2 （TXB2），and prostaglandin E2 （PGE2） in the serum of the patients before and after treatment were measured to explore the regulation of inflammatory factors in the body by Tengfu Jiangya tablets. ResultA total of 271 patients （133 in the observation group and 138 in the control group） completed the trial. There was no statistically significant difference before and after treatment in such safety indicators as the blood routine （white blood cells，red blood cells，and platelets），urine routine （urinary protein and urinary red blood cells），alanine aminotransferase，aspartate aminotransferase，creatinine，urea，and abnormal electrocardiogram，and no serious adverse reactions were observed. After four weeks，the systolic blood pressure （SBP） difference and diastolic blood pressure （DBP） difference of patients in the observation group were greater than those in the control group（P<0.01）. According to the criteria for determining the antihypertensive effect，the overall response rate in the observation group［89.47%（119/133）］ was higher than that in the control group［57.97%（80/138）］ （Z=2.593，P<0.01）. The SBP compliance rate was 61.65%（82/133） and 37.68%（52/138） in the observation group and control group， respectively. The DBP compliance rate in the observation group was 78.20%（104/133），while in the control group it was 55.07%（76/138）. The overall BP compliance rate in the observation group was 48.12%（64/133），while in the control group it was 23.19%（32/138）. The BP compliance rates in the observation group were all significantly higher than those in the control group（χ2=15.571，16.236，18.404，P<0.01）. According to the criteria for evaluating the therapeutic effect of TCM syndrome integration，the overall response rate of the observation group［57.89%（77/133）］ was higher than that of the control group［38.41%（53/133）］ （Z=-3.172，P<0.01）.Compared with those before treatment， the levels of serum AA and TXB2 in the two groups were significantly decreased after treatment （P<0.01）， and the level of PGE2 in the observation group was significantly increased （P<0.01）. Compared with those of the control group after treatment， the levels of AA and TXB2 in the observation group were significantly decreased， while the level of PGE2 was significantly increased （P<0.01）. The results suggest that Tengfu Jiangya tablets can effectively reduce inflammatory factors，reduce the production of inflammatory mediators，and thus prevent the occurrence of inflammatory reactions in the treatment of patients with grade 2 hypertension. ConclusionTengfu Jiangya tablets can more effectively reduce patients' SBP and DBP，improve their BP compliance rates，and improve their TCM syndromes in the treatment of grade 2 hypertension with liver Yang hyperactivity. Its clinical application is safe. Tengfu Jiangya tablets has outstanding clinical efficacy and can be used as an effective intervention method for the treatment of grade 2 hypertension with liver Yang hyperactivity syndrome.

Role of Macrophage Polarization in Chronic Low-grade Inflammation of PCOS Based on Theory of Spleen Being in Charge of Defensive Function / 中国实验方剂学杂志

Polycystic ovary syndrome （PCOS） is a reproductive endocrine disorder characterized by coexisting reproductive dysfunction and glucolipid metabolic disturbance， affecting 8%-13% of women of reproductive age and 3%-11% of adolescent females. Due to the highly heterogeneous clinical features， symptom-oriented individualized strategies are commonly adopted for the treatment of PCOS. Chronic low-grade inflammation is one of the core mechanisms for the occurrence of PCOS. Macrophages， as foundational cells of innate immunity， play an indispensable role in modulating systemic inflammatory responses. The imbalance of macrophage M1/M2 polarization is involved in chronic low-grade inflammation in PCOS via pathways such as activating pro-inflammatory responses， disrupting ovarian tissue repair， stimulating excessive synthesis of androgens， and promoting the occurrence of insulin resistance. Reshaping the phenotype of macrophages might serve as a potential therapeutic strategy for PCOS. Traditional Chinese medicine （TCM） holds that spleen deficiency and phlegm dampness is a crucial pathogenesis of PCOS. The spleen， being in charge of defensive function， plays a key role in ensuring normal physiological functions such as transportation and defense against external pathogen during the occurrence and development of PCOS. The imbalance of macrophage polarization resembles the transition from spleen being in charge of defensive function to spleen losing its defensive role in TCM. Therefore， this paper， for the first time， explores the deep connection between macrophage polarization and the pathogenesis of chronic low-grade inflammation in PCOS from the TCM theory of spleen being in charge of defensive function， providing theoretical support and new research directions for the treatment and drug research of PCOS.

Evaluation of GRADE Clinical Research Evidence of Chinese Patent Medicine Combined with Western Medicine in Treatment of Hypertension with Dyslipidemia / 中国实验方剂学杂志

ObjectiveTo evaluate the effect of antihypertensive and lipid-regulating Chinese patent medicine combined with conventional Western medicine in the treatment of hypertension with dyslipidemia. To carry out the evidence synthesis of clinical research and provide evidence-based evidence support for clinical decision-making. MethodThe databases including China National Knowledge Infrastructure （CNKI），Wanfang Data Knowledge Service Platform （WF），VIP，SinoMed，Embase，PubMed，Web of Science （WOS），and the Cochrane Library were searched for randomized controlled trials （RCT） of all listed Chinese patent medicines in the treatment of hypertension with dyslipidemia from the establishment of the databases to April 15，2023. The literature was screened and extracted，and the risk of bias tool 2.0 （RoB2） was used to assess the quality and risk of bias of the methodology. Revman 5.4.1 software was used to analyze the outcome indicators. Grading of Recommendations Assessment，Development and Evaluation （GRADE） was applied to assess the quality of evidence formed by clinical research data. The inclusion and recommendation of Chinese patent medicines in the National Drug Catalogue for Basic Medical Insurance，Work-related Injury Insurance and Maternity Insurance （2022） and domestic guidelines and consensus were searched to form a bubble chart. ResultA total of 15 studies were included. The evaluation of the methodological quality of each study showed that the risk of bias stemmed from the lack of blinding and allocation concealment，and low sample size. The comprehensive analysis of clinical studies showed that Dengzhan Shengmai capsules combined with rosuvastatin and amlodipine besylate，Yindan Xinnaotong capsules combined with simvastatin and levamlodipine tablets，Xiaoshuan Tongluo capsules combined with nifedipine controlled release tablets and pravastatin sodium tablets，Xinshubao capsules combined with atorvastatin calcium tablets and irbesartan，Wenyading capsules combined with enalapril，and Jiangzhining tablets combined with conventional Western medicines were all superior to conventional Western medicines used in the control group in improving systolic blood pressure （SBP），diastolic blood pressure （DBP），cholesterol （TC），triglyceride （TG），low density lipoprotein cholesterol （LDL-C），and high density lipoprotein cholesterol （HDL-C）. There was no significant difference in the incidence of adverse reactions between the two groups. The GRADE evaluation of the main outcome indicators showed that the evidence quality of SBP and incidence of adverse reactions was graded as B，that of DBP as C，and that of total TC，TG，LDL-C，and HDL-C as D. The evaluation of Chinese patent medicines covered by medical insurance and recommended by guidelines and consensus showed that Yindan Xinnaotong soft capsules，Dengzhan Shengmai capsules and Xiaoshuan Tongluo capsules belonged to class B drugs of medical insurance，and were recommended for 7，6 and 3 times in the guidelines and consensus，respectively. ConclusionCompared with simple medicine treatment，Chinese patent medicine combined with conventional Western medicine has more advantages in improving blood pressure and blood lipid，and shows higher safety. Among them，Yindan Xinnaotong soft capsules，Dengzhan Shengmai capsules and Xiaoshuan Tongluo capsules have stronger clinical applicability and economy. All the trials included in this article adhered to the principle of randomization and reported the outcome measures. However，the quality of evidence in related clinical studies was low. In terms of trial design，large-sample，multi-center，blinded randomized controlled trials based on the consolidated standards of reporting trials （CONSORT） statement are still needed for comprehensive trial designs and reporting，to further improve the GRADE quality evaluation and guideline formulation under the guidance of evidence-based medicine，so as to provide higher quality evidence-based research evidence for clinical decision-making.