Myeloid derived suppressor cells(MDSCs) are a subpopulation of immunosuppressive innate immune cells derived from bone marrow stem cells,which negatively regulate immune response in tumor progression.MDSCs have a powerful suppressive function and significant heterogeneity.They can modulate innate and adaptive immune responses through a variety of mechanisms to promote the development of tumor,and also facilitate angiogenesis and metastasis of tumor via non immunologic mechanisms.In recent years,as increasingly mature research for the differentiation,proliferation and suppressive function of MDSCs,the derived researches of MDSC-targeted tumor immunotherapy will finally contribute to increasing the efficiency of vaccine and tumor therapy in the future.

Objective To study the morphology, physiology, biochemistry and molecular biologic characteristics of Ochroconis gallopava which was firstly isolated from a pulmonary phaeohyphomycosis in China and compare it with a standard strain to assist in the clinical diagnosis and treatment. Methods The clinical isolate and standard strain were inoculated on SDA, PDA, CMA, CDA, BHIA and OA, respectively to observe the colony morphology and growth rate, and slide cultures were prepared and were examined under light microscope and electron microscope. Thermo-tolerance study, cycloheximide resistance test, API 20C, antifungal susceptibility test and PCR for the internal transcribed spacer of rDNA were also performed. Results Ochroconis gallopava grew rapidly on most media. The colonies appeared to be brown in color with smooth surface. There were aerial mycelia on SDA and PDA. Microscopic observations revealed pale brown and septate hyphae with club-shaped conidia. The growth of O. gallopava was optimal at 35 ℃ and was inhibited by cycloheximide. The two strains assimilated the same 14 glycogens, but 1 different, in API 20C AUX. MICs of fluconazole, itraconazole, amphotericin B and terbinafine were 32 ~ 64 ?g/mL, 1 ?g/mL, 2 ?g/mL and 0.25 ~ 0.5 ?g/mL, respectively. PCR results showed that the ITS segment was 743 bp with 3 bp difference in both strains. The length of 18S region was 506 bp, their sequences were the same entirely. Conclusions The clinical isolate is proved as a domestic strain of Ochroconis gallopava at the level of morphology, physiology, biochemistry and molecular biologic characteristics.

Objective To investigate the effect and long-term prognosis of patients who underwent hepatectomy for hepatolithiasis. Methods We retrospectively analyzed the medical records of 98 patients with hepatolithiasis who were treated by hepatectomy in Peking Union Medical College Hospital.Results Male/femah:1/1.7;median age:55 years old.58 cases(59.2%)had been treated before;among them.50 by surgery.In 88 cages(89.8%)hepatolithiasis involved the left lobe only,in 2(2.0%) only the right lobe involved.and in 8(8.2%)both left and right lobe were involved.51(52.0%)had extrahepatic biliary stones,30(30.6%)had biliary duct strictures,28(28.6%)had a history of biliary ascariasis.and 5(5.1%)had a concurrent biliary tract malignancy.All received partial hepatectomy according to the stone location;for the 8 bilaterally involved patients,left hepatectomy and right lithotomy were performed.Postoperative complications occurredin 14 cases(14.3%),and there were2perioperative deaths(2.0%).Seventy-eight patients(79.6%)have beenfollowedupfor over1 yearwith no tumors;the results were excellent or good in 91.0%;the stone residue and recurrence rate were both 2.0%.Conclusions Hepatectomy not only eliminates calcuci,but also removes diseased biliary tracts,with advantages of low residue stone and recurrence rate.

Objective To compare the clinical efficacy of pedicle subtraction osteotomy(PSO)and posterior unilateral vertebral column resection(PUVCR)for old thoracolumbar compressive fracture accompanied with kyphotic deformity.Methods A retrospective case control study was conducted to analyze the clinical data of 51 patients with old thoracolumbar fracture accompanied with kyphotic deformity admitted to the Third Hospital of Hebei Medical University from January 2010 to January 2016.There were 29 males and 22 females,aged 46-69 years,with an average age of 54.9 years.In terms of the injured segments,there were 11 patients with T11,10 with T12,17 with L1,and 13 with L2.A total of 22 patients were treated with traditional PSO(PSO group),and 29 patients PUVCR(PUVCR group).The operation time,intraoperative blood loss,hospital stay,Cobb angle improvement 2 weeks after operation and postoperative 1 year,visual analogue scale(VAS) 1 year after operation and Japanese Orthopedic Association(JOA)scores were compared between the two groups.Intraoperative and postoperative complications were recorded.Results All patients were followed up for 3-18 months,with an average of 13.5 months.There were no significant differences between PSO group and PUVCR group in hospital stay[(13.8±1.1)days vs.(14.1±1.2)days],thoracolumbar Cobb angle 2 weeks after operation[(8.3±1.5)°vs.(9.1±2.0).]and JOA scores[(26.2±1.2)points vs(25.5±1.5)points](P＞0.05).Significant differences were found between PUVCR group and PSO group in operation time[(184.9±22.9)minutes vs.(219.9±17.1)minutes],intraoperative blood loss[(911.5±70.2)ml vs.(1136.1±92.0)ml],Cobb angle 1 year after operation[(10.0±1.6)°vs.(12.7±1.9)°],and VAS 1 year after operation[(2.3±0.5)points vs.(2.9±0_ 7)points](P＜0.05).No serious complications occurred during operation and follow-up.Conclusions For old thoracolumbar compressive fracture accompanied with kyphotic deformity,PSO and PUVCR can both effectively improve kyphosis and relieve dysfunction.But PUVCR has the advantages of shorter operation time,less intraoperative blood loss,better-improved kyphosis,and lower incidence of spinal nerve injury.

Superparamagnetic iron oxide (SPIO) is a novel biomedical nanomaterial with surface effect,small size effect and macroscopic quantum tunneling effect.It has good biocompatibility and superparamagnetism which makes it widely used in targeted therapies.Compared to other nanodrug carriers,superparamagnetic iron oxide nanoparticles (SPIONs) have great potentials in nanodrug filed due to their properties such as intrinsic magnetic,good safety and the availability of surface modifications,etc.These properties provide the basis for their diverse applications in biomedical field.However,researchers are still concerned about the unpredictable toxicity and the changes in cell signal transduction and gene expression of SPIONs.In this paper,the research progress of SPIONs for drug targeting delivery was summarized.

Objective:The study retrospectively identified the correlative factors of low back pain after single-level oblique lateral interbody fusion (OLIF).Methods:Records of 93 patients (55 males and 38 females) who underwent OLIF (oblique lateral interbody fusion) surgery for lumbar degenerative diseases from May 2016 to September 2019 were analyzed retrospectively and patients' age was 55.73±9.48 years (range 32-78 years). There were 18 patients underwent L 3, 4 segment (19.35%), 73 patients underwent L 4, 5 segment (78.50%), and 2 patients underwent L 5S 1 segment (2.15%). There were 43 patients underwent OLIF stand alone and 50 patients underwent OLIF combined with lateral or posterior internal fixation. The follow-up time was 22.86±5.90 months (range 12-32 months). According to whether the visual analog scale (VAS)≥3 at the last follow-up visit, the patients were divided into low back pain group and no low back pain group. The demographic characteristics (age, gender, body mass index and comorbidities), basic surgical data (surgical segments, surgical methods, surgical time, intraoperative bleeding, endplate injury or not during operation), imaging data (lumbar lordosis, segmental lordosis, intervertebral height and cage subside) and lumbar function were recorded. The potential related factors were analyzed by univariate analysis, and the factors with P<0.05 were selected in the multivariate logistic regression model. Then the risk factors of low back pain after OLIF were determined by multivariate logistic regression analysis. Results:Nineteen patients with VAS score equal or greater than 3 were included in low back pain group, and the remaining 74 patients were included in no low back pain group. There was no significant difference in baseline data such as age, gender, BMI, follow-up time and comorbidities between two groups. There was no significant difference in VAS score between the two groups before operation ( t=0.818, P=0.414), but there was significant difference in VAS score at last follow-up visit ( t=6.958, P<0.001). The incidence rate of osteoporosis in low back pain group (63.16%) was significantly higher than that in no low back pain group (25.68%) ( t=9.558, P=0.002). There was no significant difference in vertebral height between the two groups ( t=1.008, P=0.316), however, the vertebral height was higher in no low back pain group ( t=2.537, P=0.316) at the last follow-up. The incidence of cage subsidencewas 8.11% in no low back pain group and 36.84% in low back pain group and there was significant difference between the two groups ( t=10.381, P=0.001). Multivariate logistic regression analysis showed that osteoporosis ( P=0.009), intraoperative bone endplate injury ( P=0.031), decreased intervertebral space height ( P=0.029) and cage subsidence ( P=0.016) were associated with low back pain after single-level OLIF. Conclusion:Low back pain is one of the common complications after OLIF. Osteoporosis, intraoperative bony endplate injury, decreased intervertebral space height and cage subsidence were closely related to postoperative low back pain. In order to reduce the incidence of postoperative low back pain and improve the clinical outcomes, attention should be paid to the protection of the bony endplate, rational use of internal fixation and active anti-osteoporosis treatment after operation.

Objective:To evaluate the value of ultrasonographic features and classification defined by the Chinese-Thyroid Imaging Reporting and Data System (C-TIRADS) in differentiating follicular thyroid carcinoma (FTC) from follicular thyroid adenoma (FTA) .Methods:Data of 87 patients who underwent thyroid nodule-related surgery at Tianjin Medical University General Hospital from Jan. 2019 to Feb. 2023 and whose postoperative pathology confirmed FTC or FTA was divided into FTC group (26 cases) and FTA group (61 cases) were retrospectively analyzed. The differences of general data, pathological diagnosis, surgical methods, ultrasonographic features of thyroid nodules and C-TIRADS classification between the two groups were compared. Multivariate Logistic regression analysis was used to screen the independent predictors related to the occurrence of FTC, a regression model was established based on the independent predictors and a nomogram was drawn. Bootstrap method was used to verify the nomogram internally, and ROC curve and calibration curve were drawn to evaluate the diagnostic efficiency and predictive ability of the nomogram.Results:There were statistically significant differences between orientation, echo, composition, calcification, margin, halo and C-TIRADS classification between groups (all P<0.05) ; maximum diameter, echotexture, blood flow, general data, pathological diagnosis and surgical methods had no statistically significant differences between groups (all P>0.05) .Single-factor logistic regression analysis showed taller-than-wide, peripheral calcification, blurred/irregular edges or external invasion, C-TIRADS 4B/4C class were candidate variables for predicting the occurrence of FTC ( OR=10.909, 19.059, 19.259, 49.333, all P<0.05). Multivariate logistic regression analysis showed that peripheral calcification, blurry/irregular edges or extra-thyroid invasion, C-TIRADS 4B/4C class were independent predictors for the occurrence of FTC ( OR=33.731, 11.620, 22.794, all P<0.05) .The nomogram of FTC occurrence was constructed based on the above three independent predictors, and the AUC was 0.920 (95% CI=0.854-0.986), which showed that the nomogram had high diagnostic efficacy, and the optimal diagnostic threshold determined by the Youden index was 0.23 (corresponding to the total score of the nomogram is about 52 points), the sensitivity was 88.5%, and the specificity was 82.0%. The calibration curve drawn by internal verification was close to the reference line, suggesting that the nomogram had a high predictive ability. Conclusions:The nomogram prediction model for FTC occurrence based on the ultrasonographic features and classification defined by C-TIRADS has high diagnostic efficiency and predictive ability, and can help in the preoperative identification of FTC and FTA.

By introducing the historical development and current situation of American anesthesia specialist nurses, including qualification certification, curriculum setting and assessment, professional scope and use, work content and effectiveness, this paper analyzes the experience and lessons of American anesthesia specialist nurses, combined with the current situation of anesthesia specialist nurses in China, analyzes the reference aspects of our country, and puts forward suggestions to the standardized development of anesthesia specialist nurses in China at the present stage.

This study was designed to investigate the potential protective effect of isopimpinelline against para-chlorophenylalanine(PCPA)-induced pineal gland damage in rats.Forty male Sprague-Dawley(SD)rats were divided into four groups(n=10 each):a normal group,a model group,a melatonin-treated group(10 mg/kg),and an isopimpinelline-treated group(1.5 mg/kg).All groups,except for the normal,received intraperitoneal injection of PCPA(450 mg/kg)to induce pineal gland damage.Subsequent treatments were administered orally for 7 days.Sleep latency and duration were evaluated on the sixth day using the pentobarbital sodium sleep synergy test.After the treatment period,serum melatonin levels and pineal gland inflammation markers were assessed alongside oxidative and antioxidative parameters.Histological examinations of the pineal gland were conducted,and the expression of proteins related to the Nrf2 and NF-κB signaling pathways were quantified.Data showed that isopimpinelline alleviates the structural damage in the pineal gland of model rats,significantly elevated serum melatonin levels,and markedly improved sleep latency and duration(P＜0.05).Isopimpinelline activated the Nrf2 signaling pathway by inhibiting Keap1 expression,which facilitated the nuclear translocation of Nrf2 and upregulated the antioxidant proteins NQO1 and HO-1,thereby mitigating oxidative stress in the pineal gland(P＜0.05).Furthermore,isopimpinelline significantly reduced the levels of pro-inflammatory cytokines IL-2,TNF-α and IL-6.Isopimpinelline also suppressed the NF-κB signaling pathway,reducing the expression of NF-κB p65,IKKβ,and p-IKKβ proteins,as well as the nuclear translocation of NF-κB p65(P＜0.05),thereby providing anti-inflammatory benefits.In conclusion,isopimpinelline could protect pineal gland from damage by activating the Nrf2 signaling pathway and inhibiting the NF-κB pathway.