Objective To investigate the CT and MRI findings of different types of small round cell tumor(SRCT)in the nasal cavity and sinuses.Methods A retrospective analysis was conducted on the imaging data and clinical data of 35 SRCT patients confirmed by pathology.Thirty-one SRCT patients underwent CT examination,and 19 SRCT patients underwent MRI examination.Results There were 20 cases of tumors that invaded the nasal cavity and 19 cases involved the sinuses,including 11 cases of the maxillary sinus,7 cases of the ethmoid sinus,2 cases of the sphenoid sinus,and 1 case of the frontal sinus.CT findings of SRCT were all soft tissue masses.Lymphoma was relatively homogeneous with mild bone destruction,and usually involved nasal vestibular skin.Rhabdomyosarcoma(embryonic type)happened at an early age and easily caused bone destruction and metastasis.Melanoma generally occurred in the nasal septum and nasal cavity,which was prone to bleeding.Small cell neuroendocrine carcinoma was heterogeneous,with moderate to significant enhancement,bone absorption and destruction were often noticed.The MRI manifestations of SRCT were equal or long signal on T1WI,high signal on T2WI,and significant diffusion limitation on diffusion weighted imaging(DWI)and apparent diffusion coefficient(ADC)except for melanoma.On contrast-enhanced images,lymphoma showed mild to moderate enhancement,rhabdomyosarcoma showed typical"grape sign",and small cell neuroendocrine carcinoma showed"sieve"and"map-like"obvious enhancement.Typical melanoma showed a high signal on T1WI and a low signal on T2WI and usually caused bleeding.The MRI findings were related to the presence of melanoma and hemorrhage within the lesion.Conclusion SRCT of the nasal cavity and sinuses have a high degree of malignancy and poor prognosis,CT and MRI have many similar manifestations.Combining clinical data,bone destruction,MRI enhancement,and DWI sequence can effectively distinguish different types of SRCT,as well as squamous cell carcinoma of the nasal cavity and sinuses and adenoid cystic carcinoma.

Objective To investigate the effect of osimertinib combined with aspirin on the survival pe-riod of the advanced lung adenocarcinoma patients with epidermal growth factor receptor(EGFR)mutation.Methods Sixty lung adenocarcinoma patients with EGFR mutation in advanced non-small cell lung cancer(NSCLC)first diagnosed in Banan District Second People's Hospital of from August 2020 to October 2021 were selected as the study subjects and divided into the observation group and control group by the random number table method,30 cases in each group.The observation group adopted osimertinib combined with aspi-rin,and the control used osimertinib merely.The overall response rate(ORR),disease control rate(DCR),progression-free survival(PFS),overall survival(OS)and the adverse reactions occurrence were compared between the two groups.Results ORR and DCR after 3,6,12 months medication in the observation group were higher than those in the control group,but the differences were not statistically significant(P＞0.05).Compared with the control group,PFS and OS in the observation group were longer,and the differences were statistically significant[14.9(11.8,17.2)m vs.10.5(8.9,12.5)m;24.1(19.5,27.4)m vs.18.1(16.1,21.1)m,P＜0.05].In addition,PFS and OS in male and female patients with brain metastasis,EGER19 and 21 ex-on mutation in the observation group were longer than those in the control group,and the differences were statistically significant(P＜0.05).There was no statistically significant difference in overall and≥Ⅲ degree adverse reactions between the two groups(P＞0.05).Conclusion Osimertinib combined with aspirin could prolong PFS and OS of the advanced lung adenocarcinoma patients with EGFR mutation without increasing the risk of adverse reactions.

Background Perfluoroalkyl substances (PFASs) are classified as persistent organic pollutants and have been widely detected in human. Studies investigating the associations between PFASs exposure and estimated glomerular filtration rate (eGFR) yielded inconsistent results, and little is known about the effects of PFASs on eGFR in population without kidney disease. Objective To explore the associations of exposure to PFASs with eGFR and renal dysfunction in population without kidney disease. Methods A total of 609 participants with an eGFR > 60 mL·min⁻¹·1.73 m⁻² and without renal impairment matched for sex and age (1∶1) were recruited from endocrinology department and medical examination center of two hospitals in Tianjin, China, from April 2021 to March 2022. Each subject was interviewed using a structured questionnaire to collect information about sex, age, height, weight, disease history, smoking, alcohol intake, etc. Clinical parameters were obtained from medical record, such as fasting blood glucose (FBG), creatinine (Cre), total cholesterol (TC), and triglyceride (TG). Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured by professionals using standard methods. The serum concentrations of PFASs were determined by liquid chromatography/mass spectrometry. Multivariable linear and logistic regression models were performed to evaluate the associations of PFASs exposure with eGFR and renal dysfunction, respectively. Subgroup analyses stratified by age and sex were also performed to assess the modified effects of covariates on the associations of PFASs exposure with eGFR. Results There were 283 males, accounting for 46.5% of the total population. The mean age of the participants was (56.86±12.47) years, and the average body mass index (BMI) was (25.59±3.84) kg·m⁻². Perfluoro-n-octanoic acid (PFOA), perfluorohexane sulfonic acid (PFHxS), perfluorooctane sulfonic acid (PFOS), perfluoro-n-nonanoic acid (PFNA), perfluoro-n-decanoic acid (PFDA), perfluoro-n-undecanoic acid (PFUnDA), sodium 1H, 1H, 2H, 2H-perfluoro-1-octanesulfonate (6:2 FTS), and perfluoropentane sulfonic acid (PFPeS) were positive in more than 75% of serum samples, and the corresponding median concentrations were 9.50, 1.67, 17.22, 1.86, 1.41, 0.78, 0.42, and 0.43 μg·L⁻¹, respectively. After full adjustments of sex, age, BMI, hypertension, diabetes, TC, TG, smoking, and drinking, the linear regression models showed that log₂-transformed PFHxS concentration was negatively associated with eGFR (b=−1.160, 95%CI: −2.280, −0.410). Compared with the lowest exposure tertile, the estimated change of eGFR in the highest tertile for PFHxS was significantly decreased (b=−2.471, 95%CI: −4.574, −0.368). Furthermore, compared with males, the negative association of PFHxS with eGFR was strengthened among females (female: b=−1.281, 95%CI: −2.388, −0.174; male: b=−0.781, 95%CI: −2.823, 1.261, P_interaction=0.043). Conclusion A significant negative association between serum PFHxS and eGFR is observed in the sampled population without kidney disease, and females are more susceptible to PFASs exposure than the males.

OBJECTIVE: To review the research progress in biotherapy of rotator cuff injury in recent years, in order to provide help for clinical decision-making of rotator cuff injury treatment. METHODS: The literature related to biotherapy of rotator cuff injury at home and abroad in recent years was widely reviewed, and the mechanism and efficacy of biotherapy for rotator cuff injury were summarized from the aspects of platelet-rich plasma (PRP), growth factors, stem cells, and exosomes. RESULTS: In order to relieve patients' pain, improve upper limb function, and improve quality of life, the treatment of rotator cuff injury experienced an important change from conservative treatment to open surgery to arthroscopic rotator cuff repair. Arthroscopic rotator cuff repair plus a variety of biotherapy methods have become the mainstream of clinical treatment. All kinds of biotherapy methods have ideal mid- and long-term effectiveness in the repair of rotator cuff injury. The biotherapy method to promote the healing of rotator cuff injury is controversial and needs to be further studied. CONCLUSION All kinds of biotherapy methods show a good effect on the repair of rotator cuff injury. It will be an important research direction to further develop new biotherapy technology and verify its effectiveness.
Humans ; Rotator Cuff Injuries/therapy* ; Quality of Life ; Arthroplasty ; Exosomes ; Neurosurgical Procedures

Metabolic-associated fatty liver disease (MAFLD), which is previously known as non-alcoholic fatty liver disease (NAFLD), represents a major health concern worldwide with limited therapy. Here, we provide evidence that ferroptosis, a novel form of regulated cell death characterized by iron-driven lipid peroxidation, was comprehensively activated in liver tissues from MAFLD patients. The canonical-GPX4 (cGPX4), which is the most important negative controller of ferroptosis, is downregulated at protein but not mRNA level. Interestingly, a non-canonical GPX4 transcript-variant is induced (inducible-GPX4, iGPX4) in MAFLD condition. The high fat-fructose/sucrose diet (HFFD) and methionine/choline-deficient diet (MCD)-induced MAFLD pathologies, including hepatocellular ballooning, steatohepatitis and fibrosis, were attenuated and aggravated, respectively, in cGPX4-and iGPX4-knockin mice. cGPX4 and iGPX4 isoforms also displayed opposing effects on oxidative stress and ferroptosis in hepatocytes. Knockdown of iGPX4 by siRNA alleviated lipid stress, ferroptosis and cell injury. Mechanistically, the triggered iGPX4 interacts with cGPX4 to facilitate the transformation of cGPX4 from enzymatic-active monomer to enzymatic-inactive oligomers upon lipid stress, and thus promotes ferroptosis. Co-immunoprecipitation and nano LC-MS/MS analyses confirmed the interaction between iGPX4 and cGPX4. Our results reveal a detrimental role of non-canonical GPX4 isoform in ferroptosis, and indicate selectively targeting iGPX4 may be a promising therapeutic strategy for MAFLD.

Regulatory T cells (Treg cells) have a critical role in the maintenance of immune homeostasis. However, tumor infiltrating Treg (TITR) contributes to weaken anti-tumor specific immune response through enhancing immunosuppressive effect in tumor microenvironment (TME), leading to tumor escape from immune surveillance. Recently, Treg cells-based immunotherapy has achieved good anti-tumor effects with the appearance of immune checkpoint inhibitors, chemokines and their receptors antagonists, specific Treg cells selective target genes knockout and novel drugs. This paper reviews the biological characteristics of TITR and discusses the prospect and application of Treg cells-based immunotherapy.

OBJECTIVE:To observe the efficacy and safety of Sanjiao fuzheng mixture combined with concurrent chemoradiotherapy of paclitaxel and nedaplatin in the treatment of local advanced non-small cell lung cancer (NSCLC). METHODS:A total of 68 patients with local advanced NSCLC selected from our hospital during Jan. 2015 to Jan. 2017 were divided into control group and observation group according to random number table,with 34 cases in each group. Control group was given Paclitaxel injection 135 mg/m2 intravenously,d1+Nedaplatin for injection 75 mg/m2 intravenously,d3,21 d as a treatment course,for 2 courses;routine fractionated intensity modulated radiation therapy,2 Gy each time,5 times a week,60-70 Gy in total;given 2 cycles of primary chemotherapy continuously after radiotherapy. Observation group was additionally given Sanjiao fuzheng mixture 250 mL/d,divided into 3 times,till the end of treatment,on the basis of control group. Clinical efficacies were observed in 2 groups. The levels of nutritional indexes (BMI,PAB,ALB,Hb) and tumor markers (SCC-Ag,CEA,TK1, CYFRA21-10) before and after treatment were observed. The occurrence of ADR were recorded. RESULTS:There was no statistical significance in the total effective rate between 2 groups (observation group 82.35％ vs. control group 73.53％)(P>0.05). After treatment,the levels of BMI,PAB,ALB and Hb in 2 groups were significantly lower than before treatment,but the observation group was significantly higher than the control group. The levels of SCC-Ag,CEA,TK1 and CYFRA21-1 in 2 groups were significantly lower than before treatment,and the observation group was significantly lower than the control group,with statistical significance (P<0.05). The incidence of Ⅲ-Ⅳ degree aleucocytosis,Ⅰ-Ⅱ degree hemoglobin reduction and thrombocytopenia in observation group were significantly lower than control group, with statistical significance (P<0.05). CONCLUSIONS:The efficacy of Sanjiao fuzheng mixture combined with concurrent chemoradiotherapy of paclitaxel and nedaplatin is similar to that of concurrent chemoradiotherapy of paclitaxel and nedaplatin for localadvanced NSCLC,which can improve nutritional status significantly,and reduce the incidence of ADR.

Objective To investigate the feasibility, efficacy, safety and economy of secondary splenic pedicle trisection method in removing schistosoma cirrhosis caused the splenic function. Methods Thirty patients receiving spleen secondary structure amputation between July 2014 and September 2016 were analyzed. Results Laparoscopic splenectomy with secondary splenic pedicle transaction was successfully performed in 28 patients, whereas two Endo-GIAs were used in 2 patients. The average of operation time was (80 ± 20) min, and operative blood loss was (320 ± 10) ml. The drainage of the splenic fossa was removed (3- 4) days after operation.Postoperative hospital stay was (10.8 ± 1.2) days after operaions. No massive hemorrhage, pancreatic leakage, secondary infection, serious complications such as abscess under diaphragm and recent complication such as infection of incision occurred postoperatively. Platelet of all patients recovered in 4 days postoperatively, and patients with platelet>400 × 109/L was given oral aspirin enteric-coated metformin hydrochloride. All patients were followed up for 6 months postoperatively, and no intestinal obstruction, portal vein thrombosis and other long-term complications occurred in all patients. Conclusions The amputation of secondary structures of the spleen in laparoscopic splenectomy to remove schistosoma cirrhosis caused the splenic function is safe. It could shorten the length of hospital stay and reduce the medical cost. It is a valuable method for clinical promotion.

OBJECTIVETo establish rabbit VX2 colorectal cancer(CRC) model and to compare CT images with gross pathology in order to offer help for TNM staging in patients with CRC.

METHODSVX2 tumor pieces were implanted into colonic wall in 9 New Zealand white rabbits and rectal wall in 2 New Zealand white rabbits. Four weeks after inoculation, Ultravist(370 mg/ml) was injected through ear marginal vein with high pressure injector for stage 3 scanning of chest, abdomen and pelvis, and enhanced CT (collimation 0.5 mm mm × 320, pitch factor 0.828, bulb rotation speed 0.5 s/cycle, 120 kV, automatic ma, range 80 to 100 mAs) was performed to determine the presence of CRC or metastasis once a week for 4-6 weeks. Once inoculated CRC or metastases occurred or 6 weeks after implantation, the rabbits were sacrificed regardless of the presence or absence of CRC or metastasis on the CT images. One rabbit was used for gross anatomy observation. Others were placed in wood boxes with -80centi-degree for 24 hours, then samples of 3 mm thickness were cut using a motorized saw to make macropathology. Each cutting surface of the specimens was photographed in serial number. If certain or suspected lesions were found on the slices, such part was labeled and then placed in 10% phosphate-buffered formaldehyde numbered box for subsequent pathological examination. CT image postprocessing was performed referring to the gross slice specimens and all findings were compared with the pathological reports.

RESULTSAmong 11 rabbits, tumor was successfully established in 8 rabbits. Pathology showed that single lung metastasis (7 to 10 mm) was found in 2 rabbits and liver metastasis (9 mm) in 1 rabbit. Number of lymph node located around the inoculated tumor was 22 and that around mesenteric vessels was 13 with diameter of 2 to 16 mm. Among these 35 lymph nodes from 8 successful rabbits, 9 nodes were positive, including 7 around inoculated tumor and 2 around mesenteric vessels. CT identified above 8 primary inoculated tumors, 2 lung metastatic lesions and 1 liver metastatic lesion, with detection rate of 100%. For the detection of lymph node in CT, 27 nodes were identified in the pericolorectal region (17 nodes) and perimesenteric vessels (10 nodes), in which 6 were positive metastasis (ring-shaped enrichment and central low density necrosis), resulting in a detection rate of 77.1%(27/35 nodes), and positive detection rate of 66.7% (6/9 nodes), respectively.

CONCLUSIONLiving rabbit CT-gross pathological slice(3 mm-cut) of VX2 CRC model can be applied in image evaluation of small metastatic lesion.

OBJECTIVE To investigate the clinical pathological characteristics of differentiated thyroid carcinoma (DTC) in children and adolescents. METHODS The clinical data of 30 children and adolescents with DTC were retrospectively reviewed. Meanwhile the clinical pathological characteristics of DTC were analyzed according to patients' age and gender. RESULTS Papillary thyroid carcinoma (PTC) was found in 27 cases and follicular thyroid carcinoma (FTC) in 3 cases. The average diameter of tumors was (2.56±1.1) cm. In the group of children, the incidence of lymph node metastasis was 92.3% (12/13), pulmonary metastasis was 46.2% (6/13), and those in the group of adolescents was 88.2% (15/17) and 35.3% (6/17) respectively. Children group tended to present with more vascular invasion, thyroid capsule invasion, and invasion out of thyroid, and a higher rate of cervical lymph node metastasis (P=0.025, 0.007, 0.025, 0.033). CONCLUSION Thyroid carcinoma in childhood and adolescent has a stronger invasive feature. It is easy to local invasion, lymph node and distance metastasis.