The effects of Bacillus subtilis on the immunity, mucosal tissue morphology, immune-related gene transcriptions, and intestinal microbiota in flounder (Paralichthys olivaceus) with two feeding methods: Continuous versus discontinuous feeding.

Probiotics as dietary additives can improve weight gain, feed efficiency, and disease resistance in cultured fish. In this research, we evaluated and compared the effects of Bacillus subtilis on immunity, mucosal tissue morphology, immune-related gene transcriptions, and intestinal microbiota in flounder (Paralichthys olivaceus) by a 30-day feeding experiment based on a continuous feeding schedule (E1) and a discontinuous feeding schedule (E2). As a result, the use of B. subtilis exerted the best positive effects on survival rate, enzyme activity, mucosal tissue morphology, immune-related gene transcriptions, and intestinal microbiota in flounders. Alkaline phosphatase (AKP), lysozyme (LZM), and superoxide dismutase (SOD) activities in the liver of E2 were higher than those of E1 (P < 0.05). Furthermore, the villi length in the intestinal tract and the fold length in the stomach of E2 were also higher than in E1 (P < 0.05). The il-1 expression levels in the spleen were significantly increased in E2 (P < 0.05) compared to E1. We performed 16 S rRNA sequencing analysis to find that Bacillus in E1 (1.06%) and E2 (1.01%) had higher relative abundances than in E0 (0.053%) at the end of the experiments, indicating that short-term application of B. subtilis with the continuous or discontinuous feeding method can allow both the adaptation of the ecosystem to the presence of probiotics by the establishment of new species in the gut microbiota and the ability these new probiotic species to perform corresponding functions. No significant differences in the ability of probiotic establishment were observed between E1 and E2. Our findings provided a unique perspective to explore the mechanism of immune enhancement with probiotics and to screen the optimal administration strategy in aquaculture application for probiotic use. Together, these results point to some level of enhancement in immune status by continuous and discontinuous feeding after a short-term feeding period, which could be used as a prophylactic strategy for flounder health management.

Analysis of risk factors for recurrence after unilateral biportal endoscopy in patients with lumbar disc herniation / 中国内镜杂志

Objective To explore the risk factors for recurrence after unilateral biportal endoscopy in patients with lumbar disc herniation.Methods Clinical data of 156 patients with lumbar disc herniation were retrospectively analyzed.All the patients underwent unilateral biportal endoscopy treatment.Follow up for 2 years after surgery,and the recurrence rate of all patients was recorded.The clinical characteristics of patients in the recurrent and non recurrent groups were compared,the factors influencing postoperative recurrence were analyzed by multivariate Logistic regression.Results After a 2-year follow-up,a total of 22 patients experienced recurrence,with a recurrence rate of 14.10%(22/156).The results of multivariate Logistic analysis showed that,the age>60 years old,fiber ring break>5 mm,incomplete nucleus pulposus removal,and postoperative intervertebral motion>10 ° were independent risk factors for recurrence after unilateral biportal endoscopy in patients with lumbar disc herniation(P<0.05).Conclusion Age>60 years old,fiber ring break>5 mm,incomplete removal of the nucleus pulposus,and postoperative intervertebral motion>10 ° were independent risk factors for recurrence after unilateral biportal endoscopy in patients with lumbar disc herniation,and prevention should be strengthened.

Manifestations of adult adrenal glands in intraoperative ultrasound / 中国医学影像技术

Objective To observe the manifestations of adult adrenal glands in intraoperative ultrasound(IOUS).Methods A total of 71 patients who underwent surgery for liver,biliary or pancreatic lesions were enrolled.Adrenal glands manifestations in IOUS were observed,and the displaying rate and the measured thickness of adrenal glands of IOUS were compared with those of CT/MRI.Results Adult adrenal gland manifested as bilateral weak echogenic structures with clear boundary and irregularly shape in IOUS.CT/MRI displaying rate of adrenal gland was 97.18％(138/142),of IOUS was 95.07％(135/142).IOUS displaying rate of the left side adrenal gland was 97.18％(69/71),of the right side adrenal gland was 92.96％(66/71),including 4 adrenal glands not shown on CT/MRI.The thickness of adrenal gland measured with IOUS was greater than those with CT/MRI(all P＜0.05).Conclusion IOUS of Adult adrenal glands present as bilateral weak echogenic structures with clear boundary and irregularly shape.IOUS displaying rate of adult adrenal gland was higher of the left side than the right side.

Comparison of effective optical zone and corneal high order aberration following small incision lenticule extraction for different degrees of myopia / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To compare the effective optical zone(EOZ)and corneal high order aberrations(HOAs)after small incision lenticule extraction(SMILE)among low, moderate, and high myopic patients.METHODS:A total of 134 patients who had undergone SMILE at the Second People's Hospital of Foshan from February 2019 to February 2021 were recruited, with all right eyes enrolled. The patients were divided into low myopia group(SE &#x003E;-3.00 D), moderate myopia group(-6.00 D&#x003C; SE ≤-3.00 D), and high myopia group(SE ≤-6.00 D)according to the spherical equivalent(SE). The total HOA(tHOA), spherical aberration, coma, and EOZ were measured by Pentacam preoperatively and 1 mo postoperatively, and differences in tHOA, spherical aberration, coma, and EOZ among the three groups were analyzed.RESULTS: EOZ was smaller than programmed EOZ in all groups at 1 mo after SMILE. With the increase in corrected refractive error, the EOZ decreased further(P&#x003C;0.05); The tHOA, spherical aberration, and coma were significantly higher than their corresponding preoperative values in all groups at 1 mo after surgery, and there were statistical differences in the spherical aberration of all the groups at 1 mo after surgery(P&#x003C;0.05), except for that of the mild myopia group(P&#x003E;0.05). The tHOA, spherical aberration and coma increased with corrected refractive errors; the difference in tHOA and spherical aberration was statistically significant among the three groups(all P&#x003C;0.05). Coma in the high myopia group was significantly greater than that in the moderate myopia group and the mild myopia group(P&#x003C;0.05). In addition, the coma in the moderate myopia group and the mild myopia group was not statistically significant(P&#x003E;0.05).CONCLUSION: With the increase of the refractive power corrected by surgery, the postoperative EOZ reduced more after surgery, and the HOA of the cornea is increased; corneal HOA increases at 1 mo after SMILE.

Correlation of corneal biomechanical changes with corneal volume changes and high-order aberration changes in the early stage after small incision lent-icule extraction / 眼科新进展

Objective To observe the corneal biomechanical changes of patients in the early stage after small inci-sion lenticule extraction(SMILE),and to analyze the correlation between the corneal biomechanical changes and changes in corneal volumes and higher-order aberrations.Methods A total of 72 patients(72 eyes)with myopia or myopic astig-matism who were scheduled for SMILE in the Optometric Center of Second People's Hospital of Foshan from January to August 2021 were included.The right eye was selected for observation.Before and 3 months after the SMILE,novel corne-al biomechanical parameters,such as biomechanical intraocular pressure(bIOP),DA ratiomax(2 mm)(DA2 ratio),inte-grated radius(IR),Ambrósio's relational thickness(for evaluation of the morphology and quality of the cornea,ARTh),stiffness parameter applanation 1(SP-A1),Corvis biomechanical index(CBI)and stress-strain index(SSI),were meas-ured by the new generation of Corvis? ST.The Pentacam anterior segment analysis system was used to measure corneal bi-omechanical parameters,including corneal volume(CV3 mm,CV5 mm,CV7 mm and CV10 mm);total root mean square of whole cornea,anterior and posterior corneal surface[RMS(Cornea,CF,CB)];root mean square of high-order aberrations of total cornea,anterior and posterior corneal surface[RMS HOA(Cornea,CF,CB)].Paired t-test or Wilcoxon singed-rank test was used to compare the changes in parameters before and after SMILE.Spearman correlation analysis and partial least squares regression were used to study the correlation between changes in novel corneal biomechanical parameters with cor-neal volume changes and high-order corneal aberration changes after the SMILE.Results Three months after SMILE,the bIOP,ARTh,SP-A1 and SSI decreased significantly,while the DA2 ratio,IR and CBI increased significantly(all P＜0.05).Three months after SMILE,CV3 mm,CV5 mm,CV7 mm and CV10 mm decreased significantly(all P＜0.05).The corneal volume changes from small to large were CV3 mm,CV5 mm,CV7 mm and CV10 mm,with a maximum decrease in the outmost periphery.The RMS(Cornea,CF,CB)and RMS HOA(Cornea,CF,CB)increased significantly(all P＜0.05);compared with the changes in high-order aberration on the anterior corneal surface,the changes in higher-order aberration on the posterior corneal surface were relatively stable.Correlation analysis shows that △ARTh was positively correlated with △CV3mm and△CV5mm,and negatively correlated with △CV10mm(all P＜0.05);△bIOP was negatively correlated with △CV3mm,△CV5mm,△RMS HOA(CF)and △RMS HOA(Cornea)and positively correlated with △CV10mm(all P＜0.05);△IR was negatively correlated with △CV10 mm(P＜0.05);△SP-A1 was positively correlated with △CV10 mm(P＜0.05);△ CBI was negatively correlated with △CV3 mm and △CV5 mm,and positively correlated with △CV10mmand △RMS(CF)(all P＜0.05).Conclusion The changes in corneal biomechanical parameters occur in the early stage after SMILE,with a certain corre-lation with the corneal volume changes in different regions and high-order corneal aberration changes.

Application of Magnetic Resonance Imaging and Transrectal Ultrasound Image Fusion Targeted Transperineal Biopsy Technique Using Electromagnetic Needle Tracking Under Local Anaesthesia / 肿瘤防治研究

Objective To explore the effect and safety of magnetic resonance imaging and transrectal ultrasound (mpMRI-TRUS) image fusion targeted transperineal biopsy technique using electromagnetic needle tracking under local anesthesia. Methods We retrospectively analyzed the clinical and pathological data of 81 patients with mpMRI-TRUS image fusion targeted transperineal prostate biopsy using electromagnetic needle tracking under local anesthesia. Visual analog scale (VAS) and visual numeric scale (VNS) were used to evaluate the pain level and satisfaction of patients during prostate biopsy (VAS-1 and VNS-1), one hour after puncture (VAS-2 and VNS-2), and one day after surgery (VAS-3 and VNS-3). The perioperative clinical data and tumor positive rate of postoperative biopsy were recorded. Results The average prostate volume of 81 patients was 53.39±29.46 cm3. The PSA values of patients with PI-RADS scores of 2, 3, 4, and 5 were 9.14±2.31, 9.95±4.10, 14.77±6.36, and 32.17±24.39 ng/ml, respectively. The scores of VAS-1, VAS-2, and VAS-3 were 1.70±0.73, 1.16±0.58, and 0.53±0.55, respectively; the scores of VNS-1, VNS-2, and VNS-3 were 2.74±0.44, 3.69±0.46, and 3.84±0.37, respectively. The average surgical time was 17.47±3.44 minutes. Postoperative pathological results showed that the tumor positive rate of targeted prostate biopsy was 64.20%. According to the PI-RADS score for subgroup analysis, the tumor positive rates of patients with PI-RADS scores of 2, 3, 4, and 5 were 21.43%, 44.44%, 61.11%, and 96.77%, respectively. After transperineal prostate biopsy, gross hematuria occurred in 19.75% patients, and urinary retention occurred in 3.70%. The latter were relieved after symptomatic treatment. All patients did not experience complications, such as perineal puncture area hematoma, urinary tract infection, hematospermia, hematoma in perineal puncture area, urinary tract infection, hematospermia, vagus nerve reaction, or septic shock. Conclusion For suspected prostate cancer patients, mpMRI-TRUS image fusion targeted transperineal biopsy technique using electromagnetic needle tracking under local anesthesia is a feasible and easily tolerated surgical procedure. It has good safety and high tumor positive-detection rate, indicating that this technique is worthy of further clinical promotion and application.

Effects of the water-soluble fraction of diesel oil on the sera biochemical indicators, histological changes, and immune responses of black rockfish Sebastes schlegelii.

In order to understand the physiological and immune responses of Sebastes schlegelii to the water-soluble fraction of diesel oil (WSD), S. schlegelii were used as the experimental objects to study the effect of WSD on the sera biochemical indicators, histological changes, and immune responses. Significant differences in sera biochemical indicators were observed in S. schlegelii after WSD exposure. The alkaline phosphatase (ALP), glucose (GLU), and globulin (GLB) were reduced by 3.51-fold, 3.12- fold, and 1.58-fold, respectively; however, K+ was increased by 3.55-fold. The results of HE staining showed that interstitial congestion was observed in the liver; the secondary lamellae deformity and hyperplasia, epithelial lifting, the primary lamellae hyperplasia, and aneurism were observed in the gill. Epidermis thickness increased, and epidermal hyperplasia in the skin was shown. The length of the secondary lamellae shortened significantly after WSD exposure. The results of AB-PAS staining showed that three different types of mucous cells were observed in the gill, and a significant increase in the number of all three types of mucous cells was observed after WSD exposure (P < 0.05). In addition, the results of the relative mRNA expressions in the liver of eleven immune-related genes showed that the relative expression levels of IL-1ß, IL-8, TNF receptor, BAFF, C1s, C1r, and MyD88 in the WSD group were substantially higher than those in the LPS group (P < 0.05), and the relative expression of caspase 10 was significantly lower than that in the LPS group (P < 0.05). At the same time, no significant differences were observed in the relative expression levels of IL-1, TNFα, and C1inh between the two groups (P > 0.05). This study was expected to provide essential data for health assessments of S. schlegelii and establish the foundation for the immune-related researches of S. schlegelii after WSD exposure.

Clinical observation on Yi Jin Jing(Sinew-transforming Qigong Exercises)in improving anxiety for asymptomatic patients with COVID-19 infection during quarantine / 针灸推拿医学（英文版）

Objective:To observe the effect of Yi Jin Jing(Sinew-transforming Qigong Exercises)intervention on anxiety in asymptomatic patients with Corona Virus Disease 2019(COVID-19)infection during quarantine.Methods:A total of 160 asymptomatic patients with COVID-19 infection were stratified by gender and divided into an observation group and a control group by the stratified randomization method,with 80 cases in each group.The control group was given basic nursing in the cabin,and the observation group was given additional Yi Jin Jing exercises once a day,20 min each time,and trained continuously until 1 d before leaving the cabin.The Hamilton anxiety scale(HAMA)score was compared between the two groups.Results:A total of 154 cases were included for data analysis in this study,including 74 cases in the observation group and 80 cases in the control group.After intervention,the HAMA scores in both groups increased(P<0.05),while the score in the observation group was lower than that in the control group(P<0.05).In the control group,the HAMA score of females after intervention was higher than that of males.The scores of mental anxiety and somatic anxiety in both groups were higher than those before intervention,while the score of mental anxiety in the observation group was significantly lower than that in the control(P<0.05).However,there was no statistical difference in the somatic score between the two groups(P>0.05).Conclusion:Patients with COVID-19 infection will get anxious during quarantine.Yi Jin Jing exercise can effectively reduce the aggravation of anxiety in asymptomatic patients with COVID-19 infection during concentrated quarantine.

Interpretation of NCCN guidelines version 1. 2023 thymomas and thymic carcinomas / 中国胸心血管外科临床杂志

@#National Comprehensive Cancer Network (NCCN) has updated and released the latest content of NCCN guidelines version 1. 2023 thymomas and thymic carcinomas (known as "guidelines"). The guideline sets standards for the diagnosis and treatment of thymoma and thymic carcinoma based on high quality clinical evidence and the latest advances in research. There have been some updates and revisions in the latest two versions of the guidelines, mainly focusing on the principles of radiotherapy, the principles of systematic therapy, multidisciplinary participation and the improvement of some footnotes, compared with the first version of the guidelines in 2022. In this paper, the contents of the new guideline will be interpreted in order to provide reference for the work of thymoma and thymic carcinoma in our country at the present stage.

Application of 3D virtual reconstruction and printing technology based on thin-slice CT images in network cloud+dual-track teaching / 中华医学教育探索杂志

Objective:To investigate the application prospect of 3D virtual reconstruction and printing technology based on thin-slice CT images in network cloud+dual-track teaching.Methods:A total of 120 medical students who were on probation in The Second Affiliated Hospital of Air Force Medical University from April 2021 to April 2022 were selected as subjects and were randomly divided into experimental group and control group, with 60 students in each group. The students in the experimental group received 3D virtual reconstruction and printing technology combined with network cloud+dual-track teaching, and those in the control group received network cloud+dual-track teaching alone. After 6 months of learning, the teaching effect was compared by closed-book examination, skill operation, speech defense, and questionnaire survey. SPSS 23.0 was used for the t-test and the chi-square test. Results:Compared with the control group in terms of department examination, the experimental group had significantly better scores of theoretical knowledge [(84.25±5.53) vs. (79.43±6.69), P<0.001] and operational skills [(87.68±5.72) vs. (82.97±5.32), P<0.001]. The experimental group had significantly higher scores than the control group in speech [(44.90±2.56) vs. (41.88±2.71), P<0.001] and defense [(45.83±2.62) vs. (43.85±2.56), P<0.001]. The questionnaire survey showed that compared with the control group, the experimental group had significantly higher scores of practical ability, active learning ability, expression ability, practice enthusiasm, and information acquisition ability ( P<0.001). Conclusion:The network cloud+dual-track teaching model assisted by 3D virtual reconstruction and printing technology can significantly improve the objective learning effect and subjective learning initiative of students and has a relatively high value of teaching application and promotion.

Remodeling of the liver fibrosis microenvironment based on nilotinib-loaded multicatalytic nanozymes with boosted antifibrogenic activity

Liver fibrosis is a reversible pathological process caused by chronic liver damage and a major risk factor for hepatocellular carcinoma (HCC). Hepatic stellate cell (HSC) activation is considered the main target for liver fibrosis therapy. However, the efficiency of this strategy is limited due to the complex microenvironment of liver fibrosis, including excessive extracellular matrix (ECM) deposition and hypoxia-induced imbalanced ECM metabolism. Herein, nilotinib (NIL)-loaded hyaluronic acid (HA)-coated Ag@Pt nanotriangular nanozymes (APNH NTs) were developed to inhibit HSCs activation and remodel the microenvironment of liver fibrosis. APNH NTs efficiently eliminated intrahepatic reactive oxygen species (ROS) due to their inherent superoxide dismutase (SOD) and catalase (CAT) activities, thereby downregulating the expression of NADPH oxidase-4 (NOX-4) and inhibiting HSCs activation. Simultaneously, the oxygen produced by the APNH NTs further alleviated the hypoxic microenvironment. Importantly, the released NIL promoted collagen depletion by suppressing the expression of tissue inhibitor of metalloproteinase-1 (TIMP-1), thus synergistically remodeling the microenvironment of liver fibrosis. Notably, an in vivo study in CCl4-induced mice revealed that APNH NTs exhibited significant antifibrogenic effects without obvious long-term toxicity. Taken together, the data from this work suggest that treatment with the synthesized APNH NTs provides an enlightening strategy for remodeling the microenvironment of liver fibrosis with boosted antifibrogenic activity.

Nanoparticles (NPs)-mediated Siglec15 silencing and macrophage repolarization for enhanced cancer immunotherapy

T cell infiltration and proliferation in tumor tissues are the main factors that significantly affect the therapeutic outcomes of cancer immunotherapy. Emerging evidence has shown that interferon-gamma (IFNγ) could enhance CXCL9 secretion from macrophages to recruit T cells, but Siglec15 expressed on TAMs can attenuate T cell proliferation. Therefore, targeted regulation of macrophage function could be a promising strategy to enhance cancer immunotherapy via concurrently promoting the infiltration and proliferation of T cells in tumor tissues. We herein developed reduction-responsive nanoparticles (NPs) made with poly (disulfide amide) (PDSA) and lipid-poly (ethylene glycol) (lipid-PEG) for systemic delivery of Siglec15 siRNA (siSiglec15) and IFNγ for enhanced cancer immunotherapy. After intravenous administration, these cargo-loaded could highly accumulate in the tumor tissues and be efficiently internalized by tumor-associated macrophages (TAMs). With the highly concentrated glutathione (GSH) in the cytoplasm to destroy the nanostructure, the loaded IFNγ and siSiglec15 could be rapidly released, which could respectively repolarize macrophage phenotype to enhance CXCL9 secretion for T cell infiltration and silence Siglec15 expression to promote T cell proliferation, leading to significant inhibition of hepatocellular carcinoma (HCC) growth when combining with the immune checkpoint inhibitor. The strategy developed herein could be used as an effective tool to enhance cancer immunotherapy.

The Action Effect of Two Kinds of Lumbar Massage Obliquity Manipulation with Different Lumbar Degeneration Degrees: A Comparative Study / 医用生物力学

Objective To compare the action effect of traditional and modified lumbar massage obliquity manipulation with different degrees of lumbar degeneration. Methods The biomechanical model of quality-spring-damping system lumbar spine was established and massage forces from professional massage doctors were collected. The force was used as input of the model, and lumbar degeneration was simulated by increasing elastic coefficient of the spring and damping coefficient of the damping in the model. By using MATLAB/ Simulink simulation technology, the effects of massage obliquity manipulation ( the maximum relative displacement and maximum acceleration) with different degrees of lumbar degeneration were obtained for comparative analysis.Results When the lumbar spine was degenerative, the maximum relative displacement and maximum acceleration of each segment were obtained under two manipulations. With the increase of lumbar degenerationdegree, the maximum relative displacement and maximum acceleration of each segment under two manipulations showed a downward trend, and the attenuation rate of the maximum relative displacement and maximum acceleration of each segment under two manipulations was obtained. Conclusions When degenerative changes in the spine do not occur, the effectiveness of traditional lumbar massage obliquity manipulation is slightly better than that of modified lumbar massage obliquity manipulation, but the safety of modified lumbar massage obliquity manipulation is obviously better than that of the traditional lumbar massage obliquity manipulation, so the modified lumbar massage obliquity manipulation should be used. With the aggravation of lumbar degeneration, the action effects of two manipulations are attenuated in a power function. The attenuation rate of effectiveness of modified lumbar massage obliquity manipulation is significantly faster than that of traditional lumbar massage obliquity manipulation, indicating that the modified lumbar massage obliquity manipulation should not be used in the caseof lumbar degeneration.

Contrast-enhanced ultrasound and contrast-enhanced computed tomography for differentiating mass-forming pancreatitis from pancreatic ductal adenocarcinoma: a meta-analysis / 中华医学杂志(英文版)

BACKGROUND@#Patients with mass-forming pancreatitis (MFP) or pancreatic ductal adenocarcinoma (PDAC) presented similar clinical symptoms, but required different treatment approaches and had different survival outcomes. This meta-analysis aimed to compare the diagnostic performance of contrast-enhanced ultrasound (CEUS) and contrast-enhanced computed tomography (CECT) in differentiating MFP from PDAC.@*METHODS@#A literature search was performed in the PubMed, EMBASE (Ovid), Cochrane Library (CENTRAL), China National Knowledge Infrastructure (CNKI), Weipu (VIP), and WanFang databases to identify original studies published from inception to August 20, 2021. Studies reporting the diagnostic performances of CEUS and CECT for differentiating MFP from PDAC were included. The meta-analysis was performed with Stata 15.0 software. The outcomes included the pooled sensitivity, specificity, positive likelihood ratio (+LR), negative likelihood ratio (-LR), diagnostic odds ratio (DOR), and summary receiver operating characteristic (SROC) curves of CEUS and CECT. Meta-regression was conducted to investigate heterogeneity. Bayesian network meta-analysis was conducted to indirectly compare the overall diagnostic performance.@*RESULTS@#Twenty-six studies with 2115 pancreatic masses were included. The pooled sensitivity and specificity of CEUS for MFP were 82% (95% confidence interval [CI], 73%-88%; I2  = 0.00%) and 95% (95% CI, 90%-97%; I2  = 63.44%), respectively; the overall +LR, -LR, and DOR values were 15.12 (95% CI, 7.61-30.01), 0.19 (95% CI, 0.13-0.29), and 78.91 (95% CI, 30.94-201.27), respectively; and the area under the SROC curve (AUC) was 0.90 (95% CI, 0.87-92). However, the overall sensitivity and specificity of CECT were 81% (95% CI, 75-85%; I2  = 66.37%) and 94% (95% CI, 90-96%; I2  = 74.87%); the overall +LR, -LR, and DOR values were 12.91 (95% CI, 7.86-21.20), 0.21 (95% CI, 0.16-0.27), and 62.53 (95% CI, 34.45-113.51), respectively; and, the SROC AUC was 0.92 (95% CI, 0.90-0.94). The overall diagnostic accuracy of CEUS was comparable to that of CECT for the differential diagnosis of MFP and PDAC (relative DOR 1.26, 95% CI [0.42-3.83], P  > 0.05).@*CONCLUSIONS@#CEUS and CECT have comparable diagnostic performance for differentiating MFP from PDAC, and should be considered as mutually complementary diagnostic tools for suspected focal pancreatic lesions.

Anti-Leucine-Rich Glioma-Inactivated 1 Encephalitis: A Single-Center Cohort Study in China / 罕见病研究

  Objective  To evaluate the clinical and paraclinical features of Chinese patients with anti- LGI1 encephalitis.  Methods  Patients with memory deficits, psychiatric symptoms, seizures or altered level of consciousness, suspicious of encephalitis, at presentation to Peking Union Medical College Hospital were recruited between July 2013 and January 2018, and tested for anti-LGI1 antibodies in their serum and/or cerebrospinal fluid(CSF) samples. Patients with anti-LGI1 antibodies were enrolled. The demographic characteristics, clinical manifestations, laboratory examination results, neuroimaging features, immunotherapy, follow-up practices and outcomes for included patients were registered and analyzed.  Results  The study enrolled 120 patients, of whom 66.7% were male. The median age was 61 years (interquartile range [IQR]: 49-66 years). Seizures(65.0%) were the most common initial symptoms. Most patients developed seizures (95.0%), including faciobrachial dystonic seizures (54.2%), memory deficits (92.5%), and psychiatric symptoms (69.1%). Brain MRI and 18F-FDG PET / CT showed that the lesions were mainly located in unilateral or bilateral medial temporal lobes, and (or) basal ganglia. Of the patients, 95.0% received intravenous immunoglobulin (IVIg) or corticosteroids, 47.5% received mycophenolate mofetil as long-term immunotherapy, and no one received second-line immunotherapy. The median follow-up was 34.2 months(IQR: 22.0-45.6 months). 91.2% had a good outcome (modified Rankin Scale score≤2 points). Residual mild memory deficits were present in 47.8% of the patients. Nine deaths were documented. Relapses occurred in 24.8% of the patients in the first year. In total, 24 (20%)cases were young patients(onset age ≤45 years).There were fewer males among the younger patients(37.5% vs. 74.0%, P < 0.01). Besides, there were fewer younger patients with psychiatric symptoms(50.0% vs. 74.0%, P=0.02), hyponatremia(33.3% vs. 68.8%, P < 0.01), and abnormalities on brain 18F-FDG PET/CT(20.8% vs. 47.9%, P=0.02). The relapse-free survival rate was significantly higher in the young patients.  Conclusions  Elderly males were predominant in patients with anti-LGI1 encephalitis. Most patients developed symptoms of limbic encephalitis and/or FDBS during the disease course. Several patients were young adults and lacked typical symptoms. Neuroimaging features were consistent with the involvement of limbic system or basal ganglia. Patients with anti-LGI1 encephalitis respond well to immunotherapy, irrespective of the age.

Application of single-cell RNA-seq technology in the auxiliary diagnosis and treatment of esophageal squamous cell carcinoma / 国际肿瘤学杂志

Single-cell RNA-seq (scRNA-seq) can describe the changes of gene expression in a single tumor cell. And it can reveal the status and function of tumor cells, and capture the extensive transcriptome heterogeneity in the cell population. The application of scRNA-seq can monitor the specific highly expressed genes in esophageal squamous cell carcinoma (ESCC) , and it can also monitor genes related to radio chemotherapy resistance in tumor cells, which is helpful to provide more accurate auxiliary diagnosis for ESCC. Besides, scRNA-seq can evaluate the recurrence risk and survival time of patients. An in-depth study of the relationship between tumor cells and tumor microenvironment in ESCC will provide a theoretical basis for developing a new immunotherapy scheme for ESCC.

Interpretation of the NCCN esophageal and esophagogastric junction cancers clinical practice guidelines in oncology (version 3. 2022) / 中国胸心血管外科临床杂志

@#The National Comprehensive Cancer Network (NCCN) has updated and released the NCCN esophageal and esophagogastric junction cancers clinical practice guidelines in oncology (version 3. 2022). Compared with the version 4 of the guidelines in 2021, the 3 versions in 2022 have some updates and revisions, mainly focusing on molecular marker detection, perioperative treatment, advanced immunotherapy, radiotherapy and other aspects. This article will interpret the main content of the new edition of the guidelines, in order to enhance the understanding of the guidelines and guide the clinical practice of diagnosis and treatment.

Prognostic value of postoperative adjuvant chemotherapy in patients with cervical and upper thoracic esophageal squamous cell carcinoma / 中国胸心血管外科临床杂志

@#Objective    To explore whether surgery combined with adjuvant chemotherapy can bring survival benefits to patients with cervical and upper thoracic esophageal squamous cell carcinoma (ESCC). Methods    The clinical data of patients with cervical and upper thoracic ESCC who underwent R0 resection and neck anastomosis in our department from 2006 to 2010 were retrospectively analyzed. Patients received neoadjuvant therapy or adjuvant radiotherapy were excluded. The adjuvant chemotherapy group was given a combination of taxanes and platinum based chemotherapy after surgery; the surgery alone group did not receive adjuvant chemotherapy. The Kaplan-Meier method was used to analyze the survival difference between the adjuvant chemotherapy group and the surgery alone group. Results    A total of 181 patients were enrolled, including 141 (77.9%) males and 40 (22.1%) females, with an average age of 61.0±8.2 years (80 patients aged≤61 years, 101 patients aged>61 years). There were 70 (38.7%) patients of cervical ESCC, and 111 (61.3%) patients of upper thoracic ESCC. Eighty-seven (48.1%) patients underwent postoperative adjuvant chemotherapy, and 94 (51.9%) patients underwent surgery alone, and the basic clinical characteristics were well balanced between the two groups (P>0.05). The median survival time of patients in the adjuvant chemotherapy group and the surgery alone group was 31.93 months and 26.07 months, and the 5-year survival rate was 35.0% and 32.0%, respectively (P=0.227). There was no statistical difference in median survival time between the cervical ESCC and upper thoracic ESCC group (31.83 months vs. 29.76 months, P=0.763). For cervical ESCC patients, the median survival time was 45.07 months in the adjuvant chemotherapy group and 14.70 months in the surgery alone group (P=0.074). Further analysis showed that the median survival time of lymph node negative group was 32.53 months, and the lymph node positive group was 24.57 months (P=0.356). The median survival time was 30.43 months in the lymph-node positive group with adjuvant chemotherapy and 17.77 months in the lymph-node positive group with surgery alone. The survival curve showed a trend of difference, but the difference was not statistically significant (P=0.557). Conclusion    There is no statistical difference in the long-term survival of cervical and upper thoracic ESCC patients after R0 resection. Postoperative adjuvant chemotherapy may have survival benefits for patients with cervical ESCC and upper ESCC with postoperative positive lymph nodes, but the differences are not statistically significant in this setting.

Study of end-to-end magnetic anastomosis technique of infrahepatic inferior vena cava in rats / 器官移植

Objective To develop a magnetic anastomosis device for infrahepatic inferior vena cava and verify its feasibility and safety in rat models. Methods According to the anatomical characteristics of rat inferior vena cava, a magnetic device suitable for end-to-end anastomosis of infrahepatic inferior vena cava was designed and manufactured. The device consisted of the inner and outer rings. The inner ring was a coated neodymium-iron-boron magnetic ring, and the outer ring was made of polyetheretherketone by 3D printing. Ten fine holes are evenly distributed on the outer ring, of which 5 fine holes were used to load the fine needles, and the other 5 fine holes were mutually connected with the fine needles of the contralateral anastomosis ring during anastomosis. The outer ring was uniformly loaded with fine needles and then bonded with the inner ring to form a magnetic anastomosis complex. Bilateral ends of vessels passed through the anastomosis ring and were fixed to the fine needles, and then end-to-end vascular anastomosis was performed by mutual attraction of two magnetic anastomosis rings. Twenty SD rats were selected and received end-to-end anastomosis of infrahepatic inferior vena cava with magnetic anastomosis device. The time of vascular occlusion, postoperative survival, postoperative anastomotic patency, gross observation and histological examination of anastomotic stoma were analyzed. Results All rats successfully completed end-to-end magnetic anastomosis of the infrahepatic inferior vena cava, and the time of vascular occlusion was 4~6 min. One rat died at 10 d after operation, and the other rats survived within postoperative 2 months. The patency rates of anastomotic stoma in surviving rats at postoperative 1 d, 3 d, 1 month and 2 months were 100%, 100%, 95% and 95%, respectively. At 2 months after operation, no obvious displacement and angulation of the anastomosis device were seen. No signs of corrosion and cracking of the anastomosis rings were observed. No evident hyperplasia and edema of surrounding tissues were noted. Bilateral ends of vessels were completely healed, and no obvious stenosis or thrombosis was found at the anastomotic stoma. Histological examination showed high continuity of bilateral vascular walls of anastomotic stoma, the inner surface of anastomotic stoma was covered by endothelial cells, and no thrombus or fibrous tissue was attached. Conclusions It is safe and feasible to utilize the self-designed magnetic anastomosis device to perform end-to-end magnetic anastomosis of infrahepatic inferior vena cava in rat models.