Objective To assess the effect of Lep d2 from Lepidoglyphus destructor as a vaccine for specific immunothera?py on murine model of asthma. Methods Thirty BALB/c mice(SPF)were randomly categorized into a PBS group,an asthma group,and a Lep d2 SIT group. The mice in the asthma group and Lep d2 SIT group were sensitized by intraperitoneal injection with extracts of dust mites on Days 0,7th,and 14th,while those in the PBS group were injected with PBS. From the 21st day, the asthma group and Lep d2 SIT group exposed to the extracts of dust mites were stimulated by aerosol inhalation for 7 succes?sive days. During the period of the 25th-27th Day,the mice in Lep d2 SIT group were injected intraperitoneally with Lep d2 al?lergen for SIT 30 min before nasal inhalation,whereas the PBS group and asthma group were treated with only PBS. Twenty?four hours after the final inhalation,all the mice were sacrificed,the bronchoalveolar lavage fluids(BALFs)were collected. The lev?els of IFN?γ,IL?5 and IL?13 in the BALF and the supernatant of splenocyte culture solution(SSCS)as well as the levels of spe?cific IgE(sIgE)and sIgG2a in the sera were detected by ELISA. The lung tissues of the mice in the above 3 groups were stained by haematoxylin and eosin(H&E)and observed by a microscope. Results The symptoms of acute asthma attack were observed in the mice of the asthma group and Lep d2 group,but not in the PBS group. The allergic inflammation changes in lung in the Lep d2 SIT group were significantly alleviated compared with those in the asthma group. The concentrations of IFN?γin BALFs and SSCS of the mice in the Lep d2 SIT group were significantly higher than those in the asthma group(both P<0.01),while the levels of IL?5 and IL?13 in the former group were significantly lower than those in the latter group(all P<0.01). Mean?while,the level of sIgE of mice in the Lep d2 SIT group was significantly lower than those in the asthma group(P<0.01),while the level of sIgG2a of mice in the former group was higher than those in the latter group(P<0.01). Conclusion Lep d2 allergen as a vaccine can alleviate the allergic symptoms in the lung of mice effectively after allergen specific immunotherapy.

OBJECTIVE:To establish the quality standard of Jingyuan capsule. METHODS:TLC was used for qualitative iden-tification of Epimedium brevicornu,Pseudostellaria heterophylla and Fallopia multiflora in the preparation. HPLC method was used to determine the content of icariin. The determination was performed on Odyssil C18 column with mobile phase consisting of acetoni-trile-water(28:72,V/V)at the flow rate of 1.0 mL/min. The detection wavelength was set at 270 nm,and the column temperature was 30 ℃. The sample size was 10 μL. The contents of polysaccharides was determined by phenol-sulfuric method. RESULTS:TCL spots of E. brevicornu,P. heterophylla and F. multiflora were clear and well separated without interference from negative con-trol. The linear range of icariin ranged 0.027-0.135 mg/mL(r=0.9999);RSDs of precision,stability and repeatability test were all lower than 2.0%. The recoveries were 97.87%-101.94%(RSD=1.47%,n=9). The linear range of glucose ranged 0.056-0.121 mg/mL(r=0.9995),and RSDs of precision,stability and repeatability tests were all lower than 2.0%. The recoveries were 99.37%-100.38%(RSD=0.36%,n=6). CONCLUSIONS:The established standard can be used for the quality control of Jingyuan capsule.

Objective:To compare the effect and safety of continuous veno-venous hemofiltration (CVVH)+double plasma molecular absorption (DPMA)+hemoperfusion (HP), CVVH+HP, and CVVH+plasma exchange (PE) in treatment of patient with severe wasp stings injury.Methods:Multicenter, historical cohort study and superiority test were used. From July 2020 to October 2022, patients with wasp sting injury and multiple organ damage admitted to the intensive care units (ICU) of five hospitals were consecutively screened and recruited into the CVVH+DPMA+HP group (intervention group). Propensity score matching was used to establish historical cohorts. Patients with severe wasp sting injury who hospitalized from January 2016 to June 2020 in each ICU were collected and matched 1∶1 with the intervention group, and divided into CVVH+HP group and CVVH+PE group according to their actual hemopurification protocols (historical control groups). The primary outcome was the acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score on days 3 and 7 after initiation of treatment. Secondary outcomes included complications, length of ICU and hospital stays, and all-cause mortality. Multivariate Cox proportional risk regression was used to analyze the prognosis of patients.Results:After propensity score matching, 56 patients in intervention group and each of the two historical control groups were matched successfully. There were no significant differences in age, gender, comorbidities, biochemical test indices and critical illness scores among the groups. After treatment, APACHE Ⅱ score markedly declined in all groups, and the decrease was faster in the intervention group; treatment with DPMA [hazard ratio ( HR) = 1.04, 95% confidence interval (95% CI) was 1.02-1.08, P = 0.00], the decreased levels of body temperature ( HR = 1.02, 95% CI was 1.00-1.03, P = 0.02), serum creatine kinase (CK; HR = 0.98, 95% CI was 0.96-1.00, P = 0.05) and myoglobin (MYO; HR = 2.88, 95% CI was 1.24-6.69, P = 0.01) were independent risk factors for APACHE Ⅱ score decline to the target value (15 scores). There were no significant differences in the incidence of bleeding complications, filter or perfusion thrombosis, blood pressure reduction, catheter-related infection and anaphylaxis among the groups. Conclusion:CVVH+DPMA+HP regimen can significantly reduce the APACHE Ⅱ score of patients with severe wasp sting injury, and the efficacy is superior to CVVH+HP and CVVH+PE regimens, with safety.

Objective:To investiqate the clinical and CT features of anaplastic thyroid carcinoma.Methods:The clinical and CT data of 23 anaplastic thyroid carcinoma patients were retrospectively analyzed, mainly including gender, age, chief complaint, and CT signs such as tumor size, distribution status, morphology, calcification, necrosis, peripheral invasion, lymph node metastasis and lung metastasis.Results:Among 23 cases of ATC, the ratio of male to female was 7∶16. 21 cases (91.3%) had hoarseness or cervical mass, 8 cases (34.8%) had rapid enlargement of tumor size, 6 cases (26.1%) with lesion in unilateral lobe, 8 cases (34.8%) in unilateral lobe + isthmus, 9 cases (39.1%) in bilateral lobe + isthmus, diameter of tumors was (6.1 ± 1.7) cm, 20 cases (87.0%) had irregular shape of tumors. 16 cases (69.6%) with rough calcification, 17 cases (73.9%) with extensive necrosis, 15 cases (65.2%) with tracheoesophageal groove extension, 18 cases (78.3%) with cervical lymph node metastasis, 8 cases (34.8%) with lung metastasis, 16 cases (69.6%) with trachea invasion, 7 cases (30.4%) with common carotid artery invasion, and 10 cases (43.5%) with internal jugular vein invasion.Conclusions:The clinical features include elderly women patients, big tumors size, rapid enlargement of tumor size, CT signs include irregular shape, coarse calcification, extensive necrosis, tracheoesophageal groove extension, cervical lymph node metastasis, lung metastasis and invasion of trachea, common carotid artery and internal jugular vein. These features have great value in the diagnosis of ATC and evaluation of peripheral structure invasion, cervical lymph node metastasis and distant metastasis.

Tumor-derived exosomes play an important role in the tumor micro-environment. The exosome-derived non-coding RNAs are transmitted in the tumor microenvironment in three ways, communication between tumor cells, normal cells affecting tumor cells, and tumor cells affecting normal cells. Through these three ways, exosomal non-coding RNAs are involved in the regulation of tumor progression, affecting tumor angiogenesis, tumor invasiveness, drug resistance, stemness, tumor metabolic repro-gramming and immune escape, resulting in dual roles in promoting or inhibiting tumor development. Exosomes have a membranous structure and their contents are resistant to degradation by extracellular proteases and remain highly stable in body fluids, thus exosome-derived non-coding RNAs are expected to serve as diagnostic and prognostic indicators for a variety of cancers. In addition, exosomes can be used to deliver non-coding RNAs for targeted therapy, or to knock down or modify tumor-promoting non-coding RNAs for tumor therapy. This article reviews the function and communication mechanism of exosomal non-coding RNAs in the tumor microenvironment, including their pathways of action, effects, potential values for tumor biomarkers and treatment targets. This article also points out the issues that need to be further studied in order to promote the progress of extracellular non-coding RNAs in cancer research and their application in tumor diagnosis and treatment.
Humans ; Exosomes ; Neoplasms/genetics* ; Biomarkers, Tumor ; Body Fluids ; RNA, Untranslated/genetics* ; Tumor Microenvironment

Objective:To investigate the efficacy of CT imaging features in evaluating occult peritoneal metastasis (OPM) of diffuse infiltrating gastric cancer (Borrmann Type Ⅳ).Methods:Totally 101 patients with locally advanced Borrmann type Ⅳ gastric cancer were retrospectively collected who were admitted to Peking University Cancer Hospital from March 2014 to March 2021. The patients were divided into OPM group (53 cases) and the non-OPM group (48 cases) according to the results of preoperative CT and laparoscopic exploration/peritoneal cytology examination. The pathological examination results were recorded, including the degree of histological differentiation and Lauren classification. The evaluation indicators included the tumor center position, the number of tumor-occupied portions, involved orientation, mucosal broadband sign, stratified enhancement, serosa invasion, increased density of peripheral fat tissue, and enlarged lymph nodes. The maximum thickness of the primary tumor, average CT value of the primary tumor (arterial phase, venous phase, and delayed phase), difference between venous phase and arterial phase, difference between delayed phase and venous phase, and pattern of the enhanced curve were recorded. The Mann-Whitney U or Chi-square test was used to compare the differences of pathological and CT features between two groups. The multivariate logistic regression was used to screen independent predictors and establish a nomogram. The receiver operating characteristic curve was used to evaluate the performance of the nomogram in predicting OPM, and the Hosmer-Lemeshow test was used to test the model′s goodness of fit. Results:There was statistical significance in the seven indicators between the OPM and non-OPM groups, including tumor-occupied portions of stomach, mucosal broadband sign, stratified enhancement, serosa invasion, increased density of peripheral fat tissue, the enhanced curve pattern and the degree of histological differentiation ( P<0.05). Among them, the degree of histological differentiation (OR=0.19, P=0.033), stratified enhancement (OR=7.02, P=0.005) and serosa invasion (OR=14.27, P<0.001) were independent predictors of OPM. The nomogram was established based on the three significant features. The area under the curve for predicting OPM was 0.826 (95%CI 0.745-0.908), the sensitivity was 0.566 and the specificity was 0.938. The Hosmer-Lemeshow test showed a good agreement between the OPM risk predicted by the nomogram and the actual risk ( P=0.525). Conclusions:The CT features of Borrmann type Ⅳgastric cancer complicated with OPM have specific characteristics. The diagnosis model based on the degree of histological differentiation, stratified enhancement, and serosa invasion had high efficacy in evaluating OPM.