Objective:To isolate and culture the pulp cells from human young permanent teeth (pDPC),and to observe their biological characteristics and the expression of some specific markers,and to induce these pulp cells to differentiate into osteoblast, adipocyte, neuron and chondrocyte lineages. Methods:Pulp cells were isolated and cultured from orthodontic extracted premolars of children. The attached cells after at least 3 passages were used for the following experiments:1. Morphology and ultrastructure analysis; 2. Cell cycle and phenotype were analyzed by flowcytometry; 3. Growth curve were recorded;4. pDPC were induced to differentiate into osteoblast,adipocyte,neuron in vitro,and were identified by histochemical methods and RT-PCR. Results: 1. Attached pDPCs were fibrablast-like cells,which were distinguished from BMSC. 2. The cell organs in dDPCs were well developed. 3. pDPCs were highly positive for CD90, CD44, CD147,which are mesenchymal stem-cell markers,but were negative for other markers including CD34, CD38, CD45, HLA-DR. 4. pDPCs showed high growth rate. 5. pDPCs could be induced to differentiate into osteoblast, adipocyte, and neuron lineages,but not chondrocyte lineages. Conclusion:pDPCs were characterized by their ability to proliferate with high growth rate in vitro. The expression of some BMSC markers in these cells were observed. They showed the potential to differentiate into multiple mesenchymal lineages such as osteoblst,adipocyte, neuron lineages under specific conditions in vitro.

Objectives In order to evaluate the clinical effect of manipulation combined with traditional Chinese medicine for the lateral epicondylitis.Methods A total of 150 patients with lateral epicondylitis were randomly divided into two groups, 75 patients in each group. The treatment group received manipulation combined with the TCM herbal bathing decoction, and the control group received the shock wave therapy and TCM herbal bathing decoction. Two groups were treated for 3 months. The SF-McGill scale, VAS, PPI, PRI were measured, and the clinical curative effect rate was assessed after treatment.Results The total effective rate of the treatment group was 92.0% (69/75), and the control group was 80.0% (60/75). There was statistical significant difference between two groups (χ2=8.339,P=0.039). The SF-McGill pain questionnaire scores, after treatment (26.3 ± 9.9vs. 29.4 ± 8.8, t=-4.183), one month after treatment (20.5 ± 7.7vs. 25.6 ± 6.9, t=-3.954), and 3 months after treatment (14.4 ± 8.0vs. 18.3 ± 6.7,t=-4.031) in the treatment group were significantly lower than those in the control group (P<0.05). The VAS scores after treatment (4.9 ± 1.4vs. 5.8 ± 1.3,t=-4.631), one month after treatment (3.0 ± 1.0vs. 4.1±1.2,t=-3.752), and three months after treatment (2.3 ± 1.0vs. 3.0 ± 1.3,t=-4.350) in the treatment group were significantly lower than those in the control group  (P<0.05). The PPI score after treatment (2.4 ± 0.6vs. 3.1 ± 0.5,t=-7.528), one month after treatment (1.8 ± 0.6 vs. 2.5 ± 0.7,t=-6.630), and 3 months after treatment (1.1 ± 0.4vs. 1.9 ± 0.7,t=-3.425) in the treatment group were significantly lower than those in the control group (P<0.05). The PRI score after treatment (19.5 ± 8.0vs. 22.3 ± 5.7,t=-3.574), one month after treatment (13.7 ± 4.7vs. 17.3 ± 5.3,t=-3.985), and three months after treatment (9.3 ± 6.6vs. 12.5 ± 4.8,t=-1.270) in the treatment group were significantly lower than those in the control group (P<0.05).Conclusions The Manipulation combined with traditional Chinese medicine bathing therapy can relief the symptoms of lateral epicondylitis, and improve the clinical curative effect.

Objective: To examine and analyze the nm23, p16 gene expression in gastric cancer tissure,and follow up patients 5 years to discuss the relationship between nm23 and p16 gene synergy expression and gastric cancer biological characteristic and prognosis.Methods: nm23 and p16 protein in gastric cancer tissue and control were detected by immunohistochemistry,and the patients had been followed up for 5 years. Results: In 84 samples of gastric cancer, nm23 positive rate was 46.43%, p16 was 44.05%, the positive rate of gastric cancer tissue and metastasitic lymph node was lower than that of normal control, normal tissue near cancer or benign polyp,and these two genes were related to the depth of tumor invasion and clinical stage.The mortality and recurrence-metastasis rate was higher in these low expression group, and had a shorter median survive period. Conclusion: Abnormal expression of nm23 and p16 gene plays a important role in gastric cancer recurrence and devolepment and may be one of markers for evaluating tumor biological behavior and prognosis.

Objective Ti explire the applicatiin if fiam dressing in nursing if medicine changing if clised drainage if thiracic cavity.Methods 126 patients with clised thiracic drainage were randimly divided inti the ibservatiin griup and the cintril griup,the ibservatiin griup was applied fiam dressing nursing,while the cintril griup was cinducted nirmal dry gauze dressing nursing.The patients in the twi griups were all given the riutine nursing if clised thiracic drainage,nutritiin,anti-infectiin and psychiligical nursing.And the pain scire if resting and dressing,time if wiund healing after extubatiin,the average intervals if changing,patients′sat-isfactiin were cimpared in twi griups.Results The difference was nit statistically significant in the resting pain scire.And the difference was statistically significant in the average time interval, scire if dressing pain,time if wiund healing after extubatiin,cimplicatiins and patient satisfac-tiin.Conclusion Applicatiin if fiam dressing if clised thiracic drainage ti nurse the patients can effectively reduce the wiund cimplicatiins,priling the time interval,shirten the wiund heal-ing time.The patients feels cimfirtable during wiund healing pricess and painless in resting time ir dressing changing time,which has imprived patients′satisfactiin.

Objective Ti explire the applicatiin if fiam dressing in nursing if medicine changing if clised drainage if thiracic cavity.Methods 126 patients with clised thiracic drainage were randimly divided inti the ibservatiin griup and the cintril griup,the ibservatiin griup was applied fiam dressing nursing,while the cintril griup was cinducted nirmal dry gauze dressing nursing.The patients in the twi griups were all given the riutine nursing if clised thiracic drainage,nutritiin,anti-infectiin and psychiligical nursing.And the pain scire if resting and dressing,time if wiund healing after extubatiin,the average intervals if changing,patients′sat-isfactiin were cimpared in twi griups.Results The difference was nit statistically significant in the resting pain scire.And the difference was statistically significant in the average time interval, scire if dressing pain,time if wiund healing after extubatiin,cimplicatiins and patient satisfac-tiin.Conclusion Applicatiin if fiam dressing if clised thiracic drainage ti nurse the patients can effectively reduce the wiund cimplicatiins,priling the time interval,shirten the wiund heal-ing time.The patients feels cimfirtable during wiund healing pricess and painless in resting time ir dressing changing time,which has imprived patients′satisfactiin.

Objective To observe the initial mechanism investigation in immune escaping correlated T cell proportion of Lewis lung cancer by Fuzheng-Peiyuan formula. To provide a theoretical basis for the application of the Chinese medicine of strengthening the body resistance in clinics. Methods The healthy C57BL/6J mice were divided into six groups by the random number table: the Chinese medicine group, the Chinese medicine plus chemotherapy group, the chemotherapy group, the model group and the normal control group. There were 6 mice in each group. All the groups expect the normal control group were inoculated subcutaneously with Lewis lung cancer cell suspension 0.2 ml. The medicine given to the Chinese medicine group were orally Fuzheng-Peiyuan formula with 8.17 g/kg. The combination group was given intraperitoneal injection of cyclophosphamide 60 mg/kg and orally Fuzheng-Peiyuan formula 8.17 g/kg. The chemotherapy group received the injection of cyclophosphamide 60 mg/kg and intragastric administration of normal saline. The model group and normal control group were administered with saline. After continuous administration for 13 days, the expressions of CD4, Foxp3, CD8 and CD28 in spleen cells of tumor bearing mice were observed by flow cytometry. Results Compared with the model group, the chemotherapy group and the chemotherapy combined with Chinese traditional medicine group showed that tumor weight (1.76 ± 0.42 g, 1.40 ± 0.43 g vs. 4.37 ± 0.59 g) significantly decreased (P<0.01); and the CD4+ Foxp3+ cells of mouse spleen cells in the Chinese medicine group and Chinese medicine plus chemotherapy group (11.25% ± 1.69%, 9.30% ± 2.68% vs. 14.21% ± 1.50 %) significantly decreased (P<0.05 or P<0.01). Conclusions The result initial proved that the Chinese medicine could strengthen the body resistance, adjust the proportion of Treg and CTL in spleen T cell in tumor-bearing mouse.

Objective:To investigate the clinicopathological features, molecular pathology characteristics, and prognosis of non-small cell lung carcinoma (NSCLC) exhibiting co-expression of p40 and thyroid transcription factor1 (TTF1).Methods:Clinical and pathological data of six NSCLC cases with co-expression of p40 and TTF1 diagnosed at the First People′s Hospital of Xiaoshan District, Hangzhou, China from January 2016 to December 2023 were collected. Relevant literature was also reviewed.Results:NSCLC with co-expression of p40 and TTF1 commonly occurred in male smokers and had been in stage Ⅲ-Ⅳ when diagnosis. Microscopic examination revealed that the tumor cells were arranged in solid nests and sheets with marked atypia and visible mitotic figures. There was no prominent evidence of keratinization or glandular formation. The tumor cells diffusely co-expressed p40 and TTF1, exhibiting a dual immunophenotype characteristic of both squamous cell carcinoma and adenocarcinoma. Molecular testing of four NSCLC co-expressing p40 and TTF1 revealed the presence of common EGFR mutations, as well as mutations of NRAS (mutation rate of 2.09%), EML4-ALK (mutation rate of 24.77%), and PIK3CA (exon 10 c.1658 G>C p.S553T, mutation rate of 4.32%). All six tumors were poorly differentiated, highly invasive, and associated with poor prognosis. Four of the six patients experienced widespread metastasis and died within 7 to 30 months after the diagnosis or initial treatment.Conclusions:NSCLC with co-expression of p40 and TTF1 exhibits distinct clinicopathological features, immunophenotypes, molecular alterations, and clinical outcomes, characterized by rapid progression and poor prognosis. Pathologists should be vigilant in recognizing this entity to avoid misdiagnosis and missed diagnosis.

BACKGROUND:"Tendon off-position"is a disease name included in the International Classification of Diseases 11th Revision,and also a clinical indication of manipulation,acupuncture and other treatments.However,its specific mechanism is still unclear.It is urgent to establish an animal model that can reflect the clinical and pathological characteristics of"tendon off-position,"so as to further study the mechanism of effective clinical treatments. OBJECTIVE:To establish an animal model of"tendon off-position"in rats based on isometric contraction of skeletal muscles,and to explore the changes of skeletal muscle function and morphological phenotype after"tendon off-position." METHODS:Sixty rats were randomly divided into control group,static-loading group and extra loading group,with twenty rats in each group.Rats in the control group were kept normally without treatment.In the latter two groups,the rats were fixed by the self-made static-loading modeling device and a static-loading(the body mass of each rats was applied as the static-loading)was applied to cause sustained isometric contraction of the upper limb muscles.Then,animal models of"tendon off-position"were successfully established.In the extra loading group,50%of the body mass was added to the ankle joint after modeling.The skeletal muscle samples were harvested at 2 and 4 weeks after modeling.The changes of limb grip strength,wet mass of skeletal muscle,and serum levels of creatine kinase-muscle and lactate dehydrogenase A were measured,and the changes of skeletal muscle histomorphology and ultrastructure were observed. RESULTS AND CONCLUSION:At 2 weeks after modeling,the rats in the static-loading group and extra loading group showed significantly decreased grip strength and wet muscle mass,significantly increased serum levels of creatine kinase-muscle and lactate dehydrogenase A,and abnormal muscle fiber morphology and structure accompanied by a large number of deposited collagen fibers.Electron microscopy results showed that the structure of myofibrils was disordered,the Z-line was distorted,and the light and dark boundaries were blurred.At 4 weeks after modeling,the grip strength of the model rats was increased compared with that at 2 weeks,the serum creatine kinase-muscle and lactate dehydrogenase A levels were decreased,and the changes of muscle fiber morphology and ultrastructure were recovered to varying degrees.It is suggested that the rat skeletal muscle injury model based on continuous isometric contraction of skeletal muscle can well reflect the pathological characteristics of"tendon off-position"at 2 weeks,and can be used to study the mechanism of acupuncture and manipulation in the treatment of"tendon off-position."

Objective To systematically review the efficacy and safety of different oral Chinese patent medicines combined with conventional western medicines in the therapy of lumbar disc herniation(LDH).Methods PubMed,Embase,Cochrane Library,Medline,CNKI,WanFang data,VIP and SinoMed databases were electronically searched to collect randomized clinical trials(RCTs)on oral Chinese patent medicines combined with conventional western medicines in the treatment of LDH from the inception to April 10,2023.Two reviewers independently screened the literature,extracted data,and evaluated the risk of bias of included studies.Network Meta-analysis was then performed by Stata 17.0 and RevMan 5.4 softwares.Results A total of 26 RCTs were included,involving 16 Chinese patent medicines with a total sample size of 2 448 cases.The network Meta-analysis results showed that 13 Chinese patent medicines combined with conventional western medicines had better effects than conventional western medicines alone.Among them,in terms of a better VAS score,the top three interventions were Jingyaokang capsules+conventional western medicine＞Yaobitong capsules+conventional western medicine＞Huoxue Zhitong capsules+conventional western medicine;in terms of a better Japanese Orthopaedic Associationl(JOA)score,the top three interventions were Qufeng Zhitong capsules+conventional western medicine＞Yaobitong capsules+conventional western medicine＞Luchuan Huoluo capsules+conventional western medicine;in terms of the clinical effective rate,the top three interventions were Luchuan Huoluo capsules+conventional western medicine＞Xianling Gubao capsules+conventional western medicine＞Tongzhi Surunjiang capsules+conventional western medicine;in terms of safety,no serious adverse drug reactions occurred in all studies,and the overall incidence of adverse drug reactions in the oral Chinese patent medicines combined with conventional western medicines group was lower than that in the conventional western medicines group.Conclusion The combination of oral Chinese patent medicines and conventional western medicines has been shown to improve the clinical efficacy of LDH.Among these,Yaobitong capsules stand out for its ability to reduce VAS score,improve JOA score ranking,and increase the effective rate.Due to limited quality and quantity of the included studies,more high-quality studies are required to verify the above conclusions.

Based on the pathogenesis of “tendon off-position and joint subluxation”， combined with modern ana-tomy and biomechanics， the characteristic manifestations of “tendon off-position” and “joint subluxation” of the knee and the intrinsic connection between them are clarified. Through sorting out the relationship between “tendon off-position and joint subluxation” and knee osteoarthritis （KOA） in modern research， it is believed that “tendon off-position and joint subluxation” is the key mechanism for the occurrence and development of KOA， and accordingly， it is proposed to take the diet as the guide， use bone manipulation for external diagnosis and treatment， use traditional Chinese medicine decoction for internal treatment， and use Daoyin exercise throughout the whole process as the strategy for KOA's comprehensive traditional Chinese medicine treatment to improve the clinical effectiveness.