Integrin α _v β ₃ is overexpressed in various tumor cells and angiogenesis. To date, no drug has been proven to target it for therapy. A first-in-human study was designed to investigate the safety, pharmacokinetics, and dosimetry of ¹⁷⁷Lu-AB-3PRGD2, a novel integrin α _v β ₃-targeting radionuclide drug with an albumin-binding motif to optimize the pharmacokinetics. Ten patients (3 men, 7 women; aged 45 ± 16 years) with integrin α _v β ₃-avid tumors were recruited to accept ¹⁷⁷Lu-AB-3PRGD2 injection in a dosage of 1.57 ± 0.08 GBq (42.32 ± 2.11 mCi), followed by serial scans to obtain its dynamic distribution in the body. Safety tests were performed before and every 2 weeks after the treatment for 6-8 weeks. No adverse event over grade 3 was observed. ¹⁷⁷Lu-AB-3PRGD2 was excreted mainly through the urinary system, with intense radioactivity in the kidneys and bladder. Moderate distribution was found in the liver, spleen, and intestines. The estimated blood half-life was 2.85 ± 2.17 h. The whole-body effective dose was 0.251 ± 0.047 mSv/MBq. The absorbed doses were 0.157 ± 0.032 mGy/MBq in red bone marrow and 0.684 ± 0.132 mGy/MBq in kidneys. This first-in-human study of ¹⁷⁷Lu-AB-3PRGD2 treatment indicates its promising potential for targeted radionuclide therapy of integrin α _v β ₃-avid tumors. It merits further studies in more patients with escalating doses and multiple treatment courses.

Objective To observe the effect of preoperative enteral nutritional support combined with modified Ivor-Lewis surgery for esophageal cancer on lung function and mRNA expression of GATA-binding protein 3(GATA3)and forkhead protein P3(Foxp3)in peripheral blood.Methods Sixty esophageal cancer patients who underwent modified Ivor-Lewis surgery in our hospital from January 2022 to October 2023 were selected and divided into two groups by simple random method.The control group was given conventional diet before operation,and the observation group was given enteral nutrition support before operation.The two groups were compared in terms of nutritional support.Results Both groups showed significantly decreases in one-second exertion expiratory volume/exertion lung volume(FEV1/FVC)(P<0.05),FVC(P<0.05),FEV1(P<0.05)and the levels of peripheral blood GATA3(P<0.05),Foxp3 mRNA(P<0.05)expression compared with those at admission(P<0.05),but no significant differences in pulmonary function(P>0.05),peripheral blood GATA3(P>0.05),and Foxp3 mRNA(P>0.05)expression between them at 1 week postoperatively.Both groups exhibited significantly lower levels of albumin,prealbumin,haemoglobin,transferrin,PNI and body mass and body mass index at admis-sion as compared to those at one week after surgery(P<0.05).The observation group showed significantly higher levels of albumin,prealbumin,haemoglobin,transferrin,and PNI at 1 week postoperatively(P<0.05),but no significant differences in ventilation time,defecation time,drain retention time,hospitalisation time,and compli-cation rate as compared to the control group(P>0.05).Conclusion Preoperative enteral nutritional support combined with modified Ivor-Lewis surgery for esophageal cancer improves postoperative nutritional status,and ren-ders less effect on postoperative lung function and peripheral blood GATA3 and Foxp3 mRNA expression.

Objective:To investigate the effect of nano silver dressing as adjuvant therapy on wound healing, vascular endothelial growth factor (VEGF), and epidermal growth factor (EGF) levels in patients with deep and extensive burns.Methods:A total of 100 patients with deep and extensive burns admitted to the Zhangjiakou First Hospital from May 2022 to May 2023 were retrospectively selected and divided into a control group and an observation group according to different treatment methods, with 50 patients in each group. The control group was treated with recombinant human epidermal growth factor, while the observation group was treated with nano silver dressing in addition to the control group. A comparative analysis was conducted on the levels of serum EGF, VEGF, tumor necrosis factor alpha (TNF-α), interleukin-10 (IL-10), and intercellular adhesion molecule-1 (ICAM-1) between two groups, as well as their recovery status, pain rating scale (NRS) score, wound healing rate, scar color, thickness, vascular distribution, and softness score.Results:Before treatment, there was no statistically significant difference in the levels of VEGF, EGF, TNF-α, IL-10, and ICAM-1 between the two groups (all P>0.05); After treatment, the levels of VEGF, EGF, IL-10, and ICAM-1 increased in both groups, while the level of TNF-α decreased. The observation group had higher levels of VEGF, EGF, IL-10, and ICAM-1 than the control group, and lower levels of TNF-α than the control group, with statistically significant differences (all P<0.001). Compared with the control group, the observation group had a shorter disappearance time of burn secretions, wound healing time, and inflammation symptoms (all P<0.001). After dressing change, the NRS score level of the observation group was lower than that of the control group ( P<0.001). The wound healing rate in the observation group was higher than that in the control group at 1, 3, and 6 months (all P<0.001). After 6 months of treatment, the color, thickness, vascular distribution, and softness scores of both groups were lower than before treatment, and the observation group was lower than the control group (all P<0.001). Conclusions:The use of nano silver dressings as adjuvant therapy for patients with deep and extensive burns can shorten wound healing time, improve EGF, VEGF, and ICAM-1 levels, alleviate inflammatory reactions, and improve the condition.

Objective:To investigate the clinical efficacy of robot-assisted screw fixation for unstable pelvic ring multifocal fractures.Methods:A retrospective analysis was performed on 76 patients with unstable pelvic fractures treated with orthopaedic robot-assisted screw fixation in the Trauma Center of the Affiliated Central Hospital of Shandong First Medical University from January 2015 to June 2022, including 43 males and 33 females, aged 52.53±13.68 years (range, 16-87 years). There were 43 cases of falling injuries from high places, 22 cases of traffic accidents, 11 cases of crushing injuries and heavy objects. Fifty-five patients were employed before the injury, while 21 were not. Fractures were classified according to the Tile classification, with 72 cases classified as type B and 4 cases as type C. Robot-assisted fixation techniques included internal fixator (INFIX), anterior ring screws, sacroiliac screws, and LC-II screws. Intraoperative blood loss, fluoroscopy frequency, surgical time, and the success rate of initial guidewire placement were recorded. Fracture reduction quality was evaluated using the Matta criteria, and postoperative pelvic function recovery was assessed using the Majeed criteria.Results:A total of 150 surgical procedures were performed on 76 patients, including 34 cases of INFIX fixation, 48 cases of anterior ring screws, 61 cases of sacroiliac joint screws, and 7 cases of LC-II screws. The mean intraoperative fluoroscopy frequency was 46.63±17.50 times (range, 15-93 times). Intraoperative fluoroscopy frequency varied among different fixation techniques, with INFIX group at 16.44±4.32 times, LC-II group at 21.59±5.80 times, anterior ring screws group at 29.44±11.65 times, and sacroiliac screws group at 23.10±11.87 times. The intraoperative blood loss was 20 (10, 47.5) ml (range, 5-300 ml), and the surgical time was 105 (86, 150) min (range, 30-290 min). The mean surgical time varied among different fixation techniques. All patients were followed up for an average of 6.46±2.26 months (range, 3-16 months). Clinical healing was achieved in all patients within 6 months, with an average time of 3.14±0.50 months. At the last follow-up, fracture reduction quality assessed by the Matta score was excellent in 21 cases and good in 43 cases, with an excellent/good rate of 84% (64/76). The Majeed score was 81.82±9.14 points (range, 50-92 points). For patients who were employed before the injury, the Majeed score was 86.55±4.85 points (range, 60-92 points), with 49 cases rated as excellent, 5 cases as good, and 1 case as fair. For patients who were not employed before the injury, the Majeed score was 69.43±5.34 points (range, 50-73 points), with 18 cases rated as excellent, 2 cases as good, and 1 case as fair. The overall excellent and good rate was 97% (74/76). Among patients who underwent INFIX internal fixation, 8 cases experienced lateral femoral cutaneous nerve injury postoperatively, all of which recovered sensation after 3 months; 1 case using LC-II screws experienced screw loosening postoperatively and was advised to reduce activity, then the screw was removed after fracture healing at 6 months postoperatively; 1 case using anterior ring channel screws experienced surgical site infection postoperatively, which was controlled after debridement.Conclusion:In the treatment of unstable pelvic ring multiple fractures, robot-assisted screw fixation has less blood loss, less fluoroscopy times, high success rate of planning guide needle, satisfactory reduction quality and postoperative function.

Objective To investigate the prevalence of musculoskeletal disorders (MSD) in dentists and to analyze the risk factors of MSD to provide suggestions for preventing and reducing MSD in dentists. Methods Through stratified cluster random sampling, 373 dentists were selected from one Hospital of Stomatolagy and five general hospitals among Three-A hospitals in Wuhan as the research objects. The prevalence of MSD was surveyed using the Nordic musculoskeletal disorders standard questionnaire (NMQ) and Numerical Rating Scale (NRS) of pain measurement, and the risk factors of MSD was analyzed with binary Logistic regression. Results The total MSD annual prevalence rate of dentists was 93.3%, with a prevalence rate in neck, shoulder and back, waist and wrist at 78.3%, 70.0%, 56.0% and 36.2% respectively. Through Binary Logistic regression analysis, it was found that the risk factors associated with neck MSD were work fatigue（χ²=24.00，P=0.000）, neck hunching（χ²=23.55，P=0.000）, and shoulder side lift（χ²=24.52，P=0.000）. The risk factors associated with MSD in shoulder and back were work fatigue（χ²=34.64，P=0.000）, neck twisting（χ²=21.68，P=0.000） and wrist bending（χ²=45.87，P=0.000）. The risk factors associated with waist MSD were age（χ²=29.83，P=0.000）, majors（χ²=16.68，P=0.028）, work fatigue（χ²=21.08，P=0.000）, waist bending（χ²=22.88，P=0.000）. The risk factors associated with wrist MSD were gender（χ²=4.17，P=0.041）, majors（χ²=23.47，P=0.001）, working years（χ²=11.63，P=0.009）, physical activities（χ²=9.14，P=0.028）, number of patient visits per day（χ²=18.41，P=0.000）, bending and twisting（χ²=24.12，P=0.000）, wrist twisting（χ²=34.41，P=0.000）, and prevalence of microscope using（χ²=12.09，P=0.020）, while physical exercise was a protective factor for wrist MSD.The differences of the above-mentioned risk factors were statistically significant (P<0.05). Conclusion The prevalence of MSD in dentists is relatively high, and hospital management should strengthen organizational training to help dentists to realize the importance of adopting correct operating posture, a 5-minute breaks during work, prevent MSD at an early stage.

Objective:To investigate the value of ultrasound elastography combined with serum urokinase plasminogen activator (uPA) in differential diagnosis of benign and malignant thyroid nodules.Methods:From May 2018 to May 2019, 150 patients with thyroid nodules (160 nodules) were selected, 69 patients with benign nodules (76 benign nodules) and 81 patients with malignant nodules (84 malignant nodules) were diagnosed by postoperative pathology. In the same period, 40 healthy people underwent health examination were selected as the control group. All preoperative patients were subjected to ultrasound elastography. The results of pathological examination were diagnosed as "gold standard"; the characteristics of ultrasound elastography were observed and scored, and compared with the results of pathological examination. The level of serum uPA was measured by enzyme-linked immunosorbent assay (ELISA), the sensitivity, specificity, and the area under the receiver operating characteristic (ROC) curve (AUC) were compared among single real-time ultrasound elastography, serum uPA and combined diagnosis.Results:Among the 150 patients (160 nodules), for ultrasound elastography, the sensitivity was 97.37% (74/76), the specificity was 85.71% (72/84), the accuracy was 91.25% (146/160), and the Kappa value was 0.726. The ratio of 0 to 2 points in malignant group was significantly lower than that in the benign group, the ratio of 3 to 4 points was significantly higher than that in the benign group ( P < 0.05). Compared with the control group, the levels of serum uPA in the benign group and the malignant group increased significantly ( P < 0.05). Compared with the benign group, serum uPA level in the malignant group increased significantly ( P < 0.05). The AUC of combined diagnosis was 0.869, 95% confidence interval ( CI): 0.789 - 0.949, and the best cut-off point for the combined diagnosis was uPA = 982.16 mU/L, at this time, the diagnostic sensitivity was 0.646, and the diagnostic specificity was 0.575. The AUC of ultrasound elastography was 0.814, 95% CI: 0.721 - 0.907, and the AUC of combined diagnosis was higher than that of ultrasound elastography. Conclusion:The clinical value of ultrasound elastography combined with serum uPA in differentiating benign and malignant thyroid nodules is higher than that of ultrasound elastography.

Objective:To analyze the diagnosis of renal injury caused by chronic arsenism by color Doppler ultrasound and the observation of renal hemodynamics.Methods:From January 2018 to April 2019, 74 patients with occupational chronic arsenism admitted to Binzhou People's Hospital were selected and divided into two groups according to whether the patients were complicated with renal injury or not, 26 patients in renal injury group and 48 patients in non-renal injury group. The renal function indexes [serum creatinine (SCr), blood urea nitrogen (BUN), urine and blood β2-microglobulin (β2-MG)] were measured and the renal hemodynamics [peak blood flow velocity during systole (Vmax), minimum blood flow velocity during diastole (Vmin), resistance index (RI)] of the two groups were analyzed by color Doppler ultrasound, and the correlation between renal function indexes and renal hemodynamics was analyzed.Results:The levels of SCr, BUN, urine β2-MG and blood β2-MG in renal injury group were significantly higher than those in non-renal injury group [(136.28 ± 21.05) vs (108.42 ± 26.49) μmol/L, (8.03 ± 1.04) vs (5.36 ± 0.97) mmol/L, (157.48 ± 25.63) vs (127.42 ± 18.95) μg/L, (3.97 ± 1.12) vs (2.35 ± 0.84) mg/L, t = 4.625, 11.022, 5.740, 7.028, P < 0.05]. The Vmax and Vmin of the main renal artery and interlobular artery in renal injury group were significantly lower than those in non-renal injury group [cm/s: (50.34 ± 13.42) vs (75.32 ± 16.52), (18.13 ± 5.21) vs (29.83 ± 7.05), (12.31 ± 3.82) vs (17.22 ± 5.07), (4.08 ± 1.15) vs (6.03 ± 1.93), t = 6.833, 7.084, 4.657, 4.775, P < 0.05], and the RI of the main renal artery and interlobular artery in renal injury group was significantly higher than that in non-renal injury group [(0.71 ± 0.06) vs (0.62 ± 0.08), (0.68 ± 0.10) vs (0.56 ± 0.08), t = 5.017, 5.634, P <0.05]. Vmax and Vmin of the main renal artery and interlobular artery were negatively correlated with SCr, BUN, urine β2-MG and blood β2-MG ( P < 0.05). RI of the main renal artery and interlobular artery were positively correlated with SCr, BUN, urine β2-MG and blood β2-MG ( P < 0.05). Conclusions:Color Doppler ultrasound can effectively reflect the status of renal injury in chronic arsenism patients. The renal blood flow perfusion in renal injury patients is decreased, and the blood flow resistance is increased, which is closely related to the degree of renal injury and deserves clinical attention.

Two strains of porcine reproductive and respiratory syndrome virus (PRRSV) were isolated in 2006 and 2016 and designated as FZ06A and FZ16A, respectively. Inoculation experiments showed that FZ06A caused 100% morbidity and 60% mortality, while FZ16A caused 100% morbidity without death. By using genomic sequence and phylogenetic analyses, close relationships between a Chinese highly pathogenic PRRSV strain and the FZ06A and FZ16A strains were observed. Based on the achieved results, multiple genomic variations in Nsp2, a unique N-glycosylation site (N³³→K³³), and a K151 amino acid (AA) substitution for virulence in the GP5 of FZ16A were detected; except the 30 AA deletion in the Nsp2-coding region. Inoculation experiments were conducted and weaker virulence of FZ16A than FZ06A was observed. Based on our results, a 30 AA deletion in the Nsp2-coding region is an unreliable genomic indicator of a high virulence PRRSV strain. The Nsp2 and GP5 differences, in addition to the virulence difference between these two highly pathogenic PRRSV strains, have the potential to be used to establish a basis for further study of PRRSV virulence determinants and to provide data useful in the development of vaccines against this economically devastating disease.
Asian Continental Ancestry Group ; China ; Genomics ; Humans ; Mortality ; Phylogeny ; Porcine Reproductive and Respiratory Syndrome ; Porcine respiratory and reproductive syndrome virus ; Vaccines ; Virulence

In order to analyze the immunogenicity of the recombinant EG95s protein ,the recombinant plasmids of pET-1EG95s ,pET-2EG95s and pET-3EG95s which containing respectively 1 ,2 ,and 3 copies EG95s were induced to express HIS-1EG95s ,HIS-2EG95s and HIS-3EG95s ,and then the proteins were purified and identified by western-blotting .The same im-mune process was used ,and 8 weeks-old BALB/c mice were immunized ,then its immunogenicity was analyzed by detecting an-tibody levels in mice by indirect ELISA method .Results showed that for recombinant EG95s proteins after transformation , HIS-1EG95s ,HIS-2EG95s ,and HIS-3EG95s also retained immunogenicity and could induce specific antibodies in mice .One week's late after the first immunization with HIS-1EG95s ,the antibody level of was significantly higher than HIS-2EG95s and HIS-3EG95s .But began from 2 weeks after immunization ,the antibody level of HIS-3EG95s was always higher than that of HIS-1EG95s group during the period of the immune .Both the final antibody titers after immunization of HIS-1EG95s and HIS-2EG95s groups was 1∶819 200 ,while HIS-3EG95s group was 1∶163 840 0 .HIS-1EG95s ,HIS-2EG95s and HIS-3EG95s all induced IFN-γin immune mice ,but the difference was not significant .The HIS-1EG95s showed lower response to Echinococ-cus granulosus positive serum than HIS-2EG95s and HIS-3EG95s .It’s indicated that the HIS-1EG95s and HIS-3EG95s also had good immunogenicity .HIS-3EG95s make recombinant protein immunic effects more lasting ,and benefit to generate more long-lasting protective immunity .This study provides the scientific basis for the immunization of echinococcosis (hydatidosis) .