Objective To evaluate the promotional effectiveness of different TCM appropriate technology packages; To provide a scientific basis for improving the technology package. Methods 8 assessment indexes, including input costs, the number of experts, the number of people with senior professional post, the number of grassroots people under the guidance of experts, the number of training hours, the number of people receiving training, evaluating rate and the number of users were selected. TOPSIS method was used to evaluate the promotional effectiveness of five kinds of TCM packages in grassroots. Results The Ci values for appropriate technology packages were 0.76 for pains in neck, shoulder, waist and lower extremities, 0.49 for gynecological diseases, 0.44 for infantile diarrhea, 0.66 for chronic gastropathy, and 0.00 for tumors. Conclusion The effectiveness of promotion of TCM appropriate technology packages from high to low is pains in neck, shoulder, waist and lower extremities package, chronic gastropathy package, gynecological diseases package, infantile diarrhea package, tumors package.

Objective: To investigate the clinicopathological features, treatment and prognosis of patients with RET fusion positive non-small cell lung cancer (NSCLC). Methods: A total of 1 089 NSCLCs were retrieved at Affiliated Hospital of Jiangnan University from August 2018 to April 2020. In all cases, multiple gene fusion detection kits (fluorescent PCR method) were used to detect the gene status of RET, EGFR, ALK, ROS1, KRAS, BRAF and HER2; and immunohistochemical method was used to detect the expression of PD-L1 and mismatch repair related proteins. The correlation between RET-fusion and patients' age, gender, smoking history, tumor stage, grade, pathologic type, and PD-L1, mismatch repair related protein expression was analyzed. Results: There were 22 cases (2.02%) detected with RET fusion-positive in 1 089 NSCLC patients, in which 11 males and 11 females; and the median age was 63.5 years. There were 20 adenocarcinomas, including 11 acinar predominant adenocarcinoma (APA), five solid predominant adenocarcinoma (SPA) and four lepidic predominant adenocarcinoma (LPA); There were one case each of squamous cell carcinoma (non-keratinizing type) and sarcomatoid carcinoma (pleomorphic carcinoma). There were 6 and 16 patients with RET fusion-positive who were in stage Ⅰ-Ⅱ and Ⅲ-Ⅳ respectively, and 16 cases with lymph node metastasis, 11 cases with distant metastasis. Among RET fusion-positive cases, one was detected with HER2 co-mutation. The tumor proportion score of PD-L1≥1% in patients with RET fusion positive lung cancer was 54.5% (12/22). Defects in mismatch repair protein expression were not found in patients with RET fusion positive NSCLC. Four patients with RET fusions positive (two cases of APA and two cases of SPA) received pratinib-targeted therapy, and two showed benefits from this targeted therapy. Conclusions: The histological subtypes of RET fusions positive NSCLC are more likely to be APA or SPA. RET fusion-positive NSCLC patients are associated with advanced clinical stage, lymph node metastases, and they may benefit from targeted therapy with RET-specific inhibitors.
Male ; Female ; Humans ; Middle Aged ; Carcinoma, Non-Small-Cell Lung/pathology* ; Lung Neoplasms/pathology* ; B7-H1 Antigen/genetics* ; Protein-Tyrosine Kinases/genetics* ; Proto-Oncogene Proteins c-ret/metabolism* ; Proto-Oncogene Proteins/genetics* ; Adenocarcinoma/pathology* ; Carcinoma, Squamous Cell/genetics* ; Mutation

AIM:To investigate the correlation between severity of diabetic retinopathy(DR)and corneal sub-basal nerve plexus(SNP)changes. METHODS: There were 132 patients with 132 eyes in type 2 diabetes(T2DM)and 80 patients with 80 eyes in age-related cataract selected in our hospital from January 2018 to May 2021, among them, there were 52 non-diabetic retinopathy(NDR)patients with 52 eyes, 40 non proliferative diabetic retinopathy(NPDR)patients with 40 eyes and 40 proliferative diabetic retinopathy(PDR)patients with 40 eyes in T2DM. The general data and corneal laser scanning confocal microscopy were analyzed. Spearman rank correlation analysis was used to evaluate the correlation between DR clinical stage and nerve fiber length. RESULTS: There were no differences in gender and age comparisons among 4 groups(P>0.05). The diabetes duration in PDR group was significantly longer than NPDR group and NDR group(P<0.05). The diabetes duration in NPDR group was significantly longer than NDR group(P<0.05). The levels of fasting blood glucose and glycosylated hemoglobin in age-related cataract group were significantly lower than other three groups(P<0.05). The best corrected visual acuity in PDR group was significantly lower than NPDR group and NDR group(P<0.05). The best corrected visual acuity in NPDR group was significantly lower than NDR group(P<0.05). The length of nerve fibers in age-related cataract group was significantly higher than NDR group, NPDR group and PDR group(P<0.05). The length of nerve fibers in PDR group was significantly shorter than NPDR group(P<0.05). Spearman rank correlation analysis showed that there was a negative correlation between DR stage and nerve fiber length(rs=-0.347, P<0.001).CONCLUSION: There was a correlation between the severity of DR and the changes of corneal SNP. The length of nerve fibers in patients with PDR was significantly shorter than patients with NPDR; Both PDR and NPDR have a loss of neural structure and should pay attention to the evaluation and treatment of ocular surface lesions in the treatment of T2DM fundus lesions.

BACKGROUNDBiliverdin (BV) has a protective role against ischemia-reperfusion injury (IRI). However, the protective role and potential mechanisms of BV on lung IRI (LIRI) remain to be elucidated. Thus, we aimed to investigate the protective role and potential mechanisms of BV on LIRI.

METHODSLungs were isolated from Sprague-Dawley rats to establish an ex vivo LIRI model. After an initial 15 min stabilization period, the isolated lungs were subjected to ischemia for 60 min, followed by 90 min of reperfusion with or without BV treatment.

RESULTSLungs in the I/R group exhibited significant decrease in tidal volume (1.44 ± 0.23 ml/min in I/R group vs. 2.41 ± 0.31 ml/min in sham group; P< 0.001), lung compliance (0.27 ± 0.06 ml/cmH2O in I/R group vs. 0.44 ± 0.09 ml/cmH2O in sham group; P< 0.001; 1 cmH2O=0.098 kPa), and oxygen partial pressure (PaO2) levels (64.12 ± 12 mmHg in I/R group vs. 114 ± 8.0 mmHg in sham group; P< 0.001; 1 mmHg = 0.133 kPa). In contrast, these parameters in the BV group (2.27 ± 0.37 ml/min of tidal volume, 0.41 ± 0.10 ml/cmH2O of compliance, and 98.7 ± 9.7 mmHg of PaO2) were significantly higher compared with the I/R group (P = 0.004, P< 0.001, and P< 0.001, respectively). Compared to the I/R group, the contents of superoxide dismutase were significantly higher (47.07 ± 7.91 U/mg protein vs. 33.84 ± 10.15 U/mg protein; P = 0.005) while the wet/dry weight ratio (P < 0.01), methane dicarboxylic aldehyde (1.92 ± 0.25 nmol/mg protein vs. 2.67 ± 0.46 nmol/mg protein; P< 0.001), and adenosine triphosphate contents (297.05 ± 47.45 nmol/mg protein vs. 208.09 ± 29.11 nmol/mg protein; P = 0.005) were markedly lower in BV-treated lungs. Histological analysis revealed that BV alleviated LIRI. Furthermore, the expression of inflammatory cytokines (interleukin-1β, interleukin-6, and tumor necrosis factor-β) was downregulated and the expression of cyclooxygenase-2, inducible nitric oxide synthase, and Jun N-terminal kinase was significantly reduced in BV group (all P< 0.01 compared to I/R group). Finally, the apoptosis index in the BV group was significantly decreased (P < 0.01 compared to I/R group).

CONCLUSIONBV protects lung IRI through its antioxidative, anti-inflammatory, and anti-apoptotic effects.

Previous studies of midterm fetuses indicated that a cartilaginous fabella appeared to be embedded in the plantaris (PL), and was fused with the gastrocnemius lateral head (GL). We re-examined the topographical anatomy of the fabella or its analogue (a tight fibrous mass) originating in the GL and/or PL by evaluating histological sections of the unilateral knees of 15 late-term fetuses. Regardless of whether the cartilaginous fabella was present (6 fetuses) or absent (9 fetuses), the origins of the PL and GL muscles each had three parts. In each fetus, the fabella or its analogue was embedded in a thick common tendinous origin of the GL and PL. PL1 (whose origin is similar to that of the adult PL) originated from the femoral condyle immediately above the common tendon; PL2 originated from the posteromedial aspect of the fabella or its analogue; and PL3 originated from the inferior aspect of the fabella or its analogue. The muscle fibers of PL1, PL2, and PL3 joined to provide a thick plantaris. GL1 (which is adjacent to PL2) originated from the common tendon in the superior side of the fabella or its analogue and GL2 originated from the inferior side of the fabella or its analogue. GL1 and GL2 joined to provide a thick bundle, whereas GL3 (located far below the fabella or its analogue) originated from the posterior surface aponeurosis.Therefore, drastic reconstruction at these muscle origins was necessary during development. Due to the strong mechanical stress from the GL and the space-occupying effect of the muscle, we hypothesize that PL2 and PL3 are degraded or absorbed into the GL1 and GL2 during the postnatal period, so that the remaining PL1 was likely the remaining PL in adults.

The yolk sac is supplied by the vitelline artery and vein (VA, VV), which run through the yolk stalk in combination with the omphaloenteric duct. Moreover, the VV takes a free posterior course outside the midgut mesentery containing the secondarily-developed superior mesenteric vein (SMV). However, the regression process of these structures has not been demonstrated photographically. The present study evaluated serial histological sections from 20 embryos of stages 15–19 or crown-rump length (CRL) 7.5–20 mm. All specimens carried the SMV as sequential tissue slits. However, an omphaloenteric duct with epithelia continuous with the midgut loop was not observed. In smaller embryos (CRL <13 mm) the VA extended distally or anteriorly from the midgut apex in the extra-embryonic coelom, whereas in larger embryos (CRL 16–20 mm) the artery was absent from the distal side of the apex. The entire course or part of the VV outside the mesentery was always seen, but four larger embryos lacked the venous terminal near the duodenum. A vacuole-like remnant of the yolk sac was present in all smaller embryos (CRL <10 mm), but was absent from 7 of the 11 larger embryos. The size of the remnant was equal to the thickness of the VA or VV, with the remnant being sandwiched between the VA and VV. Moreover, the regressing yolk sac often communicated with or opened to the VV. Consequently, the yolk sac regressed first, followed by the regression of the VA until 6 weeks. The yolk stalk was clearly observed until 5 weeks.

Previous studies of midterm fetuses indicated that a cartilaginous fabella appeared to be embedded in the plantaris (PL), and was fused with the gastrocnemius lateral head (GL). We re-examined the topographical anatomy of the fabella or its analogue (a tight fibrous mass) originating in the GL and/or PL by evaluating histological sections of the unilateral knees of 15 late-term fetuses. Regardless of whether the cartilaginous fabella was present (6 fetuses) or absent (9 fetuses), the origins of the PL and GL muscles each had three parts. In each fetus, the fabella or its analogue was embedded in a thick common tendinous origin of the GL and PL. PL1 (whose origin is similar to that of the adult PL) originated from the femoral condyle immediately above the common tendon; PL2 originated from the posteromedial aspect of the fabella or its analogue; and PL3 originated from the inferior aspect of the fabella or its analogue. The muscle fibers of PL1, PL2, and PL3 joined to provide a thick plantaris. GL1 (which is adjacent to PL2) originated from the common tendon in the superior side of the fabella or its analogue and GL2 originated from the inferior side of the fabella or its analogue. GL1 and GL2 joined to provide a thick bundle, whereas GL3 (located far below the fabella or its analogue) originated from the posterior surface aponeurosis.Therefore, drastic reconstruction at these muscle origins was necessary during development. Due to the strong mechanical stress from the GL and the space-occupying effect of the muscle, we hypothesize that PL2 and PL3 are degraded or absorbed into the GL1 and GL2 during the postnatal period, so that the remaining PL1 was likely the remaining PL in adults.

It is unclear whether forearm and crural muscle fibers extend distally across the wrist and ankle joints, respectively.We hypothesized, in late-term fetuses, an over-production of muscle bellies extending over the joint. Muscle fibers in histological sections from unilateral wrists and ankles of 16 late-term fetuses (30–40 weeks) were examined and compared with 15 adult cadavers. Muscle fibers of the flexor digitorum profundus (FDP) and flexor digitorum superficialis (FDS) in fetuses, especially muscle bellies to the third and fourth fingers, were found to extend far distally beyond the radiocarpal joint.The extensor digitorum and extensor pollicis longus on the extensor side of the wrist were found to carry distally-extending muscle fibers, but these fibers did not extend beyond the distal end of the radius. In the ankle, most muscle bundles in the flexor hallucis longus (FHL), fibularis brevis (FB) and extensor digitorum longus extended distally beyond the talocrural joint, with most FB muscle fibers reaching the level of the talocalcaneal joint. In adult cadavers, muscle fibers of the FDP and FHL did not reach the levels of the radiocarpal and talocrural joints, respectively, whereas the FB muscle belly always reached the talocalcaneal joint. Similarly, some of the FDS reached the level of the radiocarpal joint. Generally, infants’ movements at the wrist and ankle could result in friction injury to over-extended muscle. However, the calcaneal and FDP tendons might protect the FB and FDS tendons, respectively, from friction stress.

Aim To study the effect of different hepa- ry.Methods First, heparin derivatives with different rin sulfation patterns on bleomycin induced lung inju- sulfation patterns,6-desulfated heparin (6-DeH) and N-acetvlated heparin ( N-AcH ) , were synthesized.Secondly, the effect of these compounds on BLM-in¬duced bronchial epithelial cell ( BEARS-2B) injury was evaluated via lactate dehydrogenase activity, MTT experiment, Annexin V/ PI staining and Hoechst 33258 staining.Then , immunofluorescence staining and West¬ern blotting were used to investigate the shedding of Svndecan-1 and the activation of c-Met by 6-DeH/Akt j j signaling pathway.Finally, a BLM-induced lung injury mouse model was used to further verify the protective effect of 6-DeH by HE staining, Svndecan-1 immunos- taining,bodv weight change,and survival rate.Results In the BLM-induced BEARS-2B injury model, 6- DeH was selected as the best candidate, which exerted their effect by competitively binding to BLM, thereby reducing the damage of heparan sulfate barrier (Svnde- can-1 ) on cell surface, and improving cell survival by activating the downstream c-Met/Akt pathway.In the BLM-induced lung injury mouse model, it was further confirmed that 6-DeH reduced the shedding of Svnde- can-1 in the early stage, and delayed the lung injury and fibrosis process.Conclusions 6-DeH protects the bronchial epithelial cells against BLM-induced lung in¬jur)' through inhibiting the shedding of Svndecan-1 and activating the c-Met/Akt signaling pathway.

Objective: To analyze the magnetic resonance imaging (MRI) radiomic performance of hypoxic area in nasopharyngeal carcinoma patients, aiming to provide a reference for identification and analysis of hypoxic area. Methods: The MRI-T₁, MRI-T₂, MRI-T₁+ and PET/CT images of 32 patients initially diagnosed with nasopharyngeal carcinoma were retrospectively analyzed. The gross tumor volume (GTV) of nasopharynx was countoured and the hypoxic areas (GTV-H) were identified by ¹⁸F-FMISO-PET images. The non-hypoxic areas (GTV-NH) were defined as the rest of areas removed GTV-H from GTV. The radiomic features of GTV-H and GTV-NH were extracted and compared. Results: The average volume of GTV-H and GTV-NH was (10.92±11.02) cm³ and (7.21±5.70) cm³, respectively. The maximum rate of change was 46% for intensity direct-global min (ID-GM) on MRI-T₁(P<0.05, AUC>0.7 and Youden index>0.5). The average rate of change was 136% for long run emphasis (LRE), long run high gray level emphasis (LRHGLE) and long run low gray level emphasis (LRLGLE) on MRI-T₂(P<0.05, AUC>0.7 and Youden index>0.5). The high change rates was greater than 90% on MRI-T₁+ (P<0.05, AUC>0.7 and Youden index>0.5) for ID-GM, LRE, LRHGLE and LRLGLE. Conclusions The hypoxic area of tumor target can be reflected by MRI radiomics on T₁/T₂/T₁+ . Quantifying and tracking the variations of these features can bring benefit to recognize the hypoxic area of nasopharyngeal carcinoma tumor target.