BACKGROUND: Distraction osteogenesis is an effective method for large bone defects, bone tumors and osteomyelitis. However, there is a lack of a standard model in the basic research concerning distraction osteogenesis. OBJECTIVE: To establish a rabbit femoral model of distraction osteogenesis and to assess its osteogenic effect. METHODS: Twenty male New Zealand rabbits were enrolled to establish the rabbit femoral model of distraction osteogenesis using a novel distractor. Subsequently, the gross observation and X-ray examination of the specimens were performed to assess the osteogenic effect. RESULTS AND CONCLUSION: Gross observation: on day 14 after fixation, there were light-colored and dense newborn bones distributing evenly in the distraction gap, and appeared with a columnar connection with the broken ends; the boundary with normal bones became vague. On day 35, the surface of newborn bones in the distraction gap showed the same color and texture with the normal ones, the boundary between the newborn and normal bones was difficult to distinguish, and the bone mineral density was increased notably. Radiology results: on day 14 after fixation, the stent was fixed stably, the broken ends got good reduction, and cloudy shallows connecting the two ends of the normal bones in the distraction gap and increased bone mineral density were detectable. Completely calcified new-born bones, intact bone cortex and open medullary canal were further visible on day 35. These results suggest that the rabbit femoral model of distraction osteogenesis is established successfully using the self-designed single-arm distractor based on rational surgical procedures and standard operations.

Objective To investigate the experience of endoscopic mini-invasive therapy for residual lesions of peripancreatic necrotizing infection with choledocoscopy-assisted debridement technique, and to explore its clinical application value. Methods 71 patients with postoperative surgical drainage and accompanied with residual focus were collected. Choledochoscope was inserted via the drainage sinus, and the focus was observed and necrotic tissue was removed under direct choledochoscopic vision. Results Of the 71 patients who underwent this procedure, 64 were cured (success rate, 90.1%); 3 patients withdraw from treatment due to economic reasons; 4 patients received open surgery after 1 ～ 3 times of choledocoscopy-assisted debridement. The 64 cured patients received 2 ～ 9 times of choledocoscopy-assisted debridement with a mean of 5.1 times. 87.5% patients needed 4 ～ 6 times of procedures. The healing time was 18 ～ 125 days (average 71.3 days). Hemorrhage occurred in 3 patients and digestive tract fistula occurred in 2 patients and were resolved with non-operative management. Conclusions With the help of postoperative established surgical drainage channel, choledochoscopy-assisted debridement could be considered as a safe and effective miniinvasive treatment for residual focus of peripancreatic necrotizing infection, and is worth of clinical application.

Objective To identify the infection and the replication of Tick-borne encephalitis virus(TBEV) in human neuroblastoma cells.Methods After being inffected with TBEV,the cell culture supernatant of human neuroblastoma cell line SK-N-SH was collected and assayed at different time points.Byusing real-time RT-PCR and plaque assay to measure the titer of virus in the supernatant,the replication andproliferation of TBEV in human neuroblastoma cell was identified.Meanwhile,the morphological change of SK-N-SH after TBEV infection was also visualized by observation under microscope and immunmquorescenceassay.Results Real-time RT-PCR and plaque assay both demonstrated that TBEV could replicate effectively in SK-N-SH cells,the peak titer could reach 2.92× 107 PFU/ml on 3 days post-inoculation.And significant morphological change occured on infected SK-N-SH cells after 2 days post inoculation.By immunofluorescence assay,the virus particles could be detected and visualized.Conclusion TBEV can replicate andproliferate effcctively and cause significant cell morphological changes in human neuroblastoma cell SK-N-SH,which demonstrated that SK-N-SH could be a suitable cell model for TBEV culture.

Objective To construct a Nomogram prediction model based on body position exer-cise training for patients with chronic constipation.Methods A total of 327 patients with chronic constipation from March 2021 to March 2023 were divided into qualified group(n=279)and unqual-ified group(n=48)according to their performance in body position exercises.General clinical mate-rials of the patients were collected,and univariate and multivariate Logistic regression analyses were performed to identify risk factors for unqualified body position exercises in patients with chronic con-stipation;the R software was used to construct a Nomogram model for predicting unqualified body po-sition exercises in patients with chronic constipation,and the receiver operating characteristic(ROC)curve and calibration curve were applied to verify the discrimination and consistency of the Nomogram model.Results There were no significant differences in gender,education level,history of smok-ing,history of alcohol abuse,history of hypertension,history of abdominal surgery,history of colonoscopy,and correct medication administration ratio between the two groups(P＞0.05);the un-qualified group had higher age,longer duration of chronic constipation,and a higher proportion of di-abetes history compared to the qualified group(P＜0.05);age,duration of chronic constipation,and diabetes history were independent risk factors for unqualified body position exercises in patients with chronic constipation(P＜0.05).The constructed Nomogram prediction model demonstrated excellent discrimination(area under the curve was0.923,95％CI,0.888 to 0.949,with sensitivity and specificity of 87.50％and 81.00％respectively)and consistency(H-L goodness-of-fit test x2=2.246,P=0.973).The clinical value of this Nomogram model in predicting unqualified body posi-tion exercises for patients with chronic constipation was high when the high-risk threshold probability ranged from 0.06 to 0.80.Conclusion Age,duration of chronic constipation,and diabetes history are independent risk factors for unqualified body position exercises in patients with chronic constipa-tion,and the Nomogram model constructed based on these multi-factor results has high discrimination and consistency in predicting unqualified body position exercises for patients with chronic constipation.

Objective To construct a Nomogram prediction model based on body position exer-cise training for patients with chronic constipation.Methods A total of 327 patients with chronic constipation from March 2021 to March 2023 were divided into qualified group(n=279)and unqual-ified group(n=48)according to their performance in body position exercises.General clinical mate-rials of the patients were collected,and univariate and multivariate Logistic regression analyses were performed to identify risk factors for unqualified body position exercises in patients with chronic con-stipation;the R software was used to construct a Nomogram model for predicting unqualified body po-sition exercises in patients with chronic constipation,and the receiver operating characteristic(ROC)curve and calibration curve were applied to verify the discrimination and consistency of the Nomogram model.Results There were no significant differences in gender,education level,history of smok-ing,history of alcohol abuse,history of hypertension,history of abdominal surgery,history of colonoscopy,and correct medication administration ratio between the two groups(P＞0.05);the un-qualified group had higher age,longer duration of chronic constipation,and a higher proportion of di-abetes history compared to the qualified group(P＜0.05);age,duration of chronic constipation,and diabetes history were independent risk factors for unqualified body position exercises in patients with chronic constipation(P＜0.05).The constructed Nomogram prediction model demonstrated excellent discrimination(area under the curve was0.923,95％CI,0.888 to 0.949,with sensitivity and specificity of 87.50％and 81.00％respectively)and consistency(H-L goodness-of-fit test x2=2.246,P=0.973).The clinical value of this Nomogram model in predicting unqualified body posi-tion exercises for patients with chronic constipation was high when the high-risk threshold probability ranged from 0.06 to 0.80.Conclusion Age,duration of chronic constipation,and diabetes history are independent risk factors for unqualified body position exercises in patients with chronic constipa-tion,and the Nomogram model constructed based on these multi-factor results has high discrimination and consistency in predicting unqualified body position exercises for patients with chronic constipation.

Purpose The clinical and dual-layer detector spectral CT(DLCT)features of epidermal growth factor receptor(EGFR)mutation and anaplastic lymphoma kinase(ALK)rearrangement of lung adenocarcinoma were studied by DLCT multi-parameter imaging to explore a non-invasive prediction method for clinical diagnosis of lung adenocarcinoma gene expression.Materials and Methods A total of 98 cases of lung adenocarcinoma diagnosed by pathology in Gansu Provincial Hospital were prospectively collected from August 2020 to March 2022.Clinical parameters(gender,age,lesion morphology,number,mediastinal lymph node metastasis,EGFR and ALK mutations status)and DLCT parameters including slope of the spectrum curve of the arteriovenous phase(λHUA,λHUv),the standard iodine concentration of the arteriovenous phase(NICA,NICv),the 40 keV single-energy CT value of the arteriovenous phase(CTA 40 keV,CTv 40 keV),the active atomic number of the arteriovenous phases were collected,respectively.According to the expression of EGFR and ALK,all patients were divided into three groups:EGFR mutant group[EGFR(+)],ALK rearrangement group[ALK(+)],EGFR/ALK both negative group[EGFR/ALK(-)].Clinical and DLCT parameters of each group were analyzed.Results There were statistical difference in gender between the EGFR(+)group and EGFR/ALK(-)group(x2=11.010,P＜0.05).There were statistical differences in lesion morphology among the three groups(x2=12.858,P＜0.05).The value of CTv 40 keV in the EGFR(+)group was significantly higher than that in EGFR/ALK(-)group(t=1.997,P＜0.05),and the NICv in the ALK(+)group was significantly lower than that in EGFR/ALK(-)group(t=2.155,P＜0.05).The λHUv,NICv,CTv 40 keV of EGFR(+)group were significantly higher than those of ALK(+)group(t=2.613,3.149,3.218,all P＜0.05).The sensitivity and specifiicity to identify EGFR(+)and EGFR/ALK(-)adenocarcinoma were 62.7％and 70.0％,the area under curve(AUC)was 0.634(95％CI 0.516-0.756)when the CTv 40 keV value was 141.070 Hu.The sensitivity and specificity to identify ALK(+)and EGFR/ALK(-)adenocarcinoma were 76.7％and 64.2％,the AUC was 0.706(95％CI 0.536-0.853)when NICv value was 0.287.The sensitivity to identify EGFR(+)and ALK(+)adenocarcinoma were 70.6％,64.7％,72.5％and the specificity was 76.5％,76.5％,82.4％,respectively,the AUC was 0.734(95％CI 0.606-0.829),0.751(95％CI 0.610-0.832),0.773(95％CI 0.649-0.861)when the values of λHUv,NICv and CTv 40 keV were 1.335,0.320 and 132.350,respectively.Delong test showed that the AUC of CTv 40 keV and λHUv was statistically different(Z=2.327,P＜0.05),and the AUC of CTv 40 keV was 0.773.Conclusion The gender,lesion morphology and DLCT parameters(λHUv,CTv 40 keV,NICv)of lung adenocarcinoma have certain predictive value for EGFR and ALK genetic expression,which can help clinical judgment of lung adenocarcinoma gene mutation pattern.

Objective:To compare the efficacy and safety of Changsulin ? with Lantus ? in treating patients with type 2 diabetes mellitus (T2DM). Methods:This was a phase Ⅲ, multicenter, randomized, open-label, parallel-group, active-controlled clinical trial. A total of 578 participants with T2DM inadequately controlled on oral hypoglycemic agents were randomized 3∶1 to Changsulin ? or Lantus ? treatment for 24 weeks. The efficacy measures included changes in glycosylated hemoglobin (HbA1c), fasting plasma glucose (FPG), 2h postprandial plasma glucose (2hPG), 8-point self-monitoring of blood glucose (SMBG) profiles from baseline, and proportions of subjects achieving targets of HbA1c and FPG. The safety outcomes included rates of hypoglycemia, adverse events (AEs) and anti-insulin glargine antibody. Results:After 24 weeks of treatment, mean HbAlc decreased 1.16% and 1.25%, FPG decreased 3.05 mmol/L and 2.90 mmol/L, 2hPG decreased 2.49 mmol/L and 2.38 mmol/L in Changsulin ? and in Lantus ?, respectively. No significant differences could be viewed in above parameters between the two groups (all P>0.05). There were also no significant differences between Changsulin ? and Lantus ? in 8-point SMBG profiles from baseline and proportions of subjects achieving the targets of HbA1c and FPG (all P>0.05). The rates of total hypoglycemia (38.00% and 39.01% for Changsulin ? and Lantus ?, respectively) and nocturnal hypoglycemia (17.25% and 16.31% for Changsulin ? and Lantus ?, respectively) were similar between the two groups (all P>0.05). Most of the hypoglycemia events were asymptomatic, and no severe hypoglycemia were found in both groups. No differences were observed in rates of AEs (61.77% vs.52.48%) and anti-insulin glargine antibody (after 24 weeks of treatment, 6.91% vs.3.65%) between the two groups (all P>0.05). Conclusions:Changsulin ? shows similar efficacy and safety profiles compared with Lantus ? and Changsulin ? treatment was well tolerated in patients with T2DM.

With the progress of targeted therapy and immunotherapy for lung cancer, the clinical demand for lung biopsy is increasing. An ideal biopsy specimen can be used not only for histopathological diagnosis, but also for biomarker detection. The ideal biopsy specimen should meet two requirements, including more than 60 mm2 of tumor tissue and containing more than 20% of tumor cells. In order to obtain ideal lung cancer biopsy specimens, advanced imaging techniques are needed to help. In this article, we reviewed the requirements for biopsy specimens based on biomarker detection, as well as the current status and research progress of using imaging techniques for preoperative planning and intraoperative real time guidance of lung cancer biopsy.
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Humans ; Lung Neoplasms/diagnostic imaging* ; Biopsy ; Biomarkers ; Immunotherapy

Background: Subclinical hypothyroidism (SCH) is the most common thyroid dysfunction, and its relationship with blood pressure (BP) has been controversial. The aim of the study was to analyze the association between SCH and newly-diagnosed hypertension. Methods: Based on data from the Thyroid disease, Iodine nutrition and Diabetes Epidemiology (TIDE) study, 49,433 euthyroid individuals and 7,719 SCH patients aged ≥18 years were enrolled. Patients with a history of hypertension or thyroid disease were excluded. SCH was determined by manufacturer reference range. Overall hypertension and stage 1 and 2 hypertension were diagnosed according to the guidelines issued by the American College of Cardiology/American Heart Association in 2017. Results: The prevalence of overall hypertension (48.7%), including stage 1 (28.9%) and 2 (19.8%) hypertension, increased significantly in SCH patients compared with euthyroid subjects. With elevated serum thyroid stimulating hormone (TSH) level, the hypertension prevalence also increased significantly from the euthyroid to different SCH subgroups, which was more profound in females or subjects aged <65 years. The age- and sex-specific regression analysis further demonstrated the same trends in the general population and in the 1:1 propensity matched population. Similarly, several BP components (i.e., systolic, diastolic, and mean arterial BP) were positively associated with TSH elevation, and regression analysis also confirmed that all BP components were closely related with SCH in female subjects aged <65 years. Conclusion The prevalence of hypertension increases for patients with SCH. SCH tends to be associated with hypertension and BP components in females younger than 65 years.

Background: Subclinical hypothyroidism (SCH) is the most common thyroid dysfunction, and its relationship with blood pressure (BP) has been controversial. The aim of the study was to analyze the association between SCH and newly-diagnosed hypertension. Methods: Based on data from the Thyroid disease, Iodine nutrition and Diabetes Epidemiology (TIDE) study, 49,433 euthyroid individuals and 7,719 SCH patients aged ≥18 years were enrolled. Patients with a history of hypertension or thyroid disease were excluded. SCH was determined by manufacturer reference range. Overall hypertension and stage 1 and 2 hypertension were diagnosed according to the guidelines issued by the American College of Cardiology/American Heart Association in 2017. Results: The prevalence of overall hypertension (48.7%), including stage 1 (28.9%) and 2 (19.8%) hypertension, increased significantly in SCH patients compared with euthyroid subjects. With elevated serum thyroid stimulating hormone (TSH) level, the hypertension prevalence also increased significantly from the euthyroid to different SCH subgroups, which was more profound in females or subjects aged <65 years. The age- and sex-specific regression analysis further demonstrated the same trends in the general population and in the 1:1 propensity matched population. Similarly, several BP components (i.e., systolic, diastolic, and mean arterial BP) were positively associated with TSH elevation, and regression analysis also confirmed that all BP components were closely related with SCH in female subjects aged <65 years. Conclusion The prevalence of hypertension increases for patients with SCH. SCH tends to be associated with hypertension and BP components in females younger than 65 years.