Purpose To evaluate the value of multi-slice spiral computed tomography (MSCT) scan in the diagnosis of papillary renal cell carcinoma. Materials and Methods A retrospective study was conducted on the findings of plain CT scan and triphasic dynamic contrast enhanced CT scan of 23 patients with papillary renal cell confirmed pathologically, and further contrasted with the findings of 96 patients with clear cell renal cell carcinoma at corresponding phases in such aspects as cystic degeneration, enhancement degree and pattern (homogeneous, peripheral or heterogeneous) and tumor spreading pattern (perinephric invasion, lymphadenopathy or venous invasion). Results The degree of enhancement CT value for both diseases showed statistical significance in corticomedullary phase, parenchymal phase and excretory phase (t=9.70, 8.08, 5.92;P<0.01), but papillary renal cell carcinoma was lower than clear cell renal cell carcinoma. In terms of cystic degeneration, papillary renal cell carcinoma was significantly lower than clear cell renal cell carcinoma (21.7%vs 54.2%,χ2=7.54, P<0.01). Papillary renal cell carcinoma mainly showed homogeneous enhancement (60.9%) whereas clear cell renal cell carcinoma mainly presented heterogeneous enhancement (68.8%) with statistical difference (χ2=30.40, P<0.01). The tumor spreading patterns like perinephric invasion, lymphadenopathy and venous invasion had no significant difference (χ2=0.51, 0.11, 0.03;P>0.05). Conclusion Papillary renal cell carcinoma shows homogeneous enhancement, seldom cystic degeneration or necrosis on MSCT scan, which is helpful for the differential diagnosis from clear cell renal cell carcinoma.

Objective To discuss the surgery methods and clinical curative effect of application of nickel titanium memory alloy embracing device fixed femoral fractures inside wall of bone block.Methods The clinical data of 27 patients on the application of nickel titanium memory alloy embracing device fixed femoral fractures inside wall with bone block were retrospectively analyzed.There were 9 cases of male and 18 cases offemale.They were 69 ~89 years old,average 76.2 years.And there were 19 cases on the left side of inside wall and 8 cases on the right side. Curative effect evaluation was conducted according to the Evans-Jensen norm and the improved Harris standard. Results Postoperative follow-up loss in 2 cases,and 24 cases received follow-up for 6 ~20 months,which had an average of 14.15 months and follow-up rate was 92.3%.Three cases died respectively because of acute heart failure, cerebral hemorrhage and cor pulmonale.Patients at the time of the last follow-up had Harris mean score(80 ~97), including the optimal 19 cases,fine 4 cases and poor in 1 case,and the excellent rate was 95.8%.Conclusion Sur-gery method of nickel titanium memory alloy embracing device fixed femoral fractures inside wall of bone has reliable fixation,and can restore the biomechanical balance and decrease complications,etc.It allows early functional exercise of hip part in load conditions to obtain ideal therapeutic effect.

Objective:To explore the changes of number of CD4+ CD25 + foxp3 + regulatory T cells (Treg)and natural killer cells (NK)in the peripheral immune organs and tumor tissue of the murine models of lung cancer,and to clarify their effects on the development of lung cancer.Methods:The C57BL/6 mice were divided into Lewis lung carcinoma cells (LLC)injection group and normal control group.The mice in LLC injection group were injected with LLC subcutaneously in the armpit to establish the tumor models,while the mice in normal control group were injected with the same amount of saline.The number of CD4+ CD25 + T cells,CD4+ CD25 + foxp3 + Tregs in the spleen,lymph nodes and lung cancer tissues,and the number of NK cells in the spleen tissue were labeled by cell surface or intracellular antibody staining,and detected by flow cytometry.Results:The ratios of CD4+ CD25 + T cells to CD4+ T cells,foxp3+ cells to CD4+ CD25 + T cells,and the number of CD4+ CD25 + foxp3 + Treg in the spleen and lymph nodes of the mice in LLC injection group were increased significantly compared with normal control group (P <0.05 or P <0.01).Moreover,the ratios of CD4+ CD25 + T cells to CD4+ T cells and foxp3 + cells to CD4+ CD25 + T cells in the tumor tissue were significantly higher than those in the spleen and lymph nodes of the mice in LLC injection group.However,the ratio of NK cells in the spleen tissue of the mice in lung cancer group was significantly decreased compared with normal control group (P <0.05).Conclusion:The increase of ratio and the number of Treg cells and the decrease of ratio of NK cells in the main immune organs of lung cancer mice may promote the development of tumor and inhibit the immune response to cancer cells in vivo .

Objective:To investigate the change of nature killer T cell(NKT)and myeloid derived suppressor cells(MDSC) during the development of mouse lung tumor.Methods:Lung tumor mouse models were made by subcutaneous injection of Lewis lung tumor cells( LLC) ,peripheral blood leukocytes were extracted from mouse tail blood at different time points after LLC injection.NKT and MDSC were detected by flow cytometry after relative antibody staining.Results:With the increasing volume of lung tumor,the ratio of NKT cells decreased gradually,while the ratio of MDSC increased gradually in the peripheral blood of LLC-injected mice.Both NKT and MDSC showed significantly changes in LLC-injected mice compared with that of normal control mice.Conclusion:NKT and MDSC in LLC-injected mice show opposite changes during the development of lung tumor,so,they can be used as potential monitoring index for lung tumor development.

Among the supplementary applications for Chinese medicines， additional specifications of pills occupy a certain proportion. It is common situation that addition of water honey pills and water pills on the basis of honey pills. Due to the ingredients of Chinese medicine are complex， and honey may be related to the safety and effectiveness of the preparation as a special excipient. Therefore， the necessity of the change should be considered from multiple perspectives and aspects in combination with the characteristics of the pills， and the scientific and reasonable nature of the change should be proved through research. By thinking deeply of the review of the application for adding water honey pill and water pill specification supplement to honey pill， the author discusses the key contents that need to be paid attention to in pharmaceutical research of such changes， and puts forward the following suggestions：①The necessity of change should be considered in combination with clinical drug demand and benefit-risk ratio. ②Attach importance to the research on the change of process and excipient， and evaluate the impact of changes on drug safety and effectiveness. ③Strengthen quality and stability research， and select appropriate packaging materials to ensure stable and controllable sample quality after change. ④Reasonably expression of specifications and loading specifications.

Objective:To evaluate oncological and reproductive outcomes of women ≤40 years undergoing fertility-sparing surgery (FSS) for stage Ⅱ or Ⅲ borderline ovarian tumor (BOT).Methods:The patients with BOT and ≤40 years old with stage Ⅱ-Ⅲ BOT who underwent FSS enrolled from the First Affiliated Hospital of Zhengzhou University between January 2011 and March 2023 were analyzed retrospectively. The clinical data and follow-up results were obtained and analyzed. The univariate and multivariate Cox proportional hazard regression analysis were used to explore high-risk factors associated with prognosis. Additionally, pregnancy outcomes were also analyzed.Results:(1) A total of 79 patients with stage Ⅱ-Ⅲ BOT who have been treated with FSS were conducted, with an average age of (27.5±6.7) years old. The median tumor maximum diameter were 10.4 cm (range: 4.8-90.0 cm). The International Federation of Gynecology and Obstetrics (FIGO) stage was stage Ⅱ in 45 cases and stage Ⅲ in 34 cases. According to the pathological types, there were 48 cases of serous tumor, 21 cases of mucinous tumor, 1 case of endometrioid tumor, and 9 cases of mixed types. There were 41 cases of unilateral ovarian involvement, 38 cases of bilateral ovarian involvement. There were 5 cases of microinvasion, 17 cases of micropapillary subtype. Extra-ovarian invasive implants were found in 5 cases, and there were 31 cases of merged ascites. (2) Tumor outcomes: the median follow-up time from primary cytoreduction were 58 months (range: 8-146 months). At the end of the observation period, 24 cases (30%, 24/79) recurred, among them 5 cases had two recurrences and 2 cases had three recurrences. There were 2 cases (3%, 2/79) of death and 1 case (1%, 1/79) of survival with tumor. (3) Analysis of prognostic risk factors: the results of univariate analysis showed that mucinous tumor, tumor maximum diameter >13.15 cm, FIGO stage Ⅲ, merged ascites, micropapillary subtype, invasive implantation, and bilateral ovarian involvement were independent risk factors (all P<0.05) for disease-free survival (DFS). FIGO stage Ⅲ ( HR=4.555, 95% CI: 1.525-13.607; P=0.007) and micropapillary subtype ( HR=2.396, 95% CI: 1.003-5.725; P=0.049) were found to be related to DFS through the multivariable Cox proportional hazard regression analysis. (4) Pregnancy outcomes: among the patients with fertility intentions 36 cases (46%,36/79), 29 cases (81%, 29/36) had successful pregnancies, and 27 cases (75%, 27/36) had successful births. Conclusions:Patients with stage Ⅱ-Ⅲ BOT underwent FSS have favorable survival and pregnancy rates. Micropapillary subtypes and FIGO staging (stage Ⅲ) are the significant risk factors of DFS.

Objective To understand the pathogenicity and multilocus sequence typing (MLST) characteristics of the pathogenic strain of Burkholderia pseudomallei (Bp) in Hainan,and provide a reference for studying the structural characteristics and phylogenetic characteristics of pathogenic Bp in Hainan.Methods The data of patients with melioidosis in Hainan,who were treated in Hainan General Hospital from 2011 to 2018,and Bp pathogenic strains isolated from patient infected specimens were collected.The Bp pathogenic strains were genotyped by MLST method,and the distribution characteristics of the sequence type (ST) were analyzed.The ST of all Bp pathogenic strains was analyzed by eBURST v3 software to establish the evolutionary relationship map.Results A total of 91 cases of melioidosis patients were studied,including 76 males and 15 females;the ages were mainly concentrated in 40-70 years old;clinical manifestations included sepsis,pulmonary infection and local abscess;and the most common diseases were diabetes.A total of 91 Bp pathogenic strains were observed,of which 85 Bp pathogenic strains were distributed in coastal areas of Hainan,accounting for 93.41％;identified by MLST method,39 ST were discovered,the most common were ST46 (13 strains),ST55 (12 strains),STS0 (8 strains) and ST58 (7 strains),accounting for 14.29％,13.19％,8.79％ and 7.69％,respectively;except ST46 was widely distributed in the coastal areas of Hainan,the ST55,ST50 and ST58 were concentrated in the southwest,northeast and southeast regions of Hainan.Compared with the MLST database,ST30 (3 strains) was currently found only in Hainan,ST562 (4 strains) had been reported in northern Australia,and the remaining ST models had been reported in southeast Asia.The eBURST v3 software divided the 39 ST into 3 subtypes and 18 individual types.Among them,the subtypes with ST300 as the original type had the most number of ST,including 17 ST,57 Bp pathogenic strains;compared with the MLST database,the ST300 was mainly distributed in southeast Asian regions such as Thailand.Conclusions The ST of Bp pathogenic strains in Hainan has high regional diversity and genetic diversity,and is closely related to Bp in southeast Asian regions such as Thailand.

Objective:To explore the association between polymorphisms of transforming growth factor-β(TGF-β)signaling pathway and non-syndromic cleft lip with or without cleft palate(NSCL/P)among Asian populations,while considering gene-gene interaction and gene-environment interaction.Methods:A total of 1 038 Asian NSCL/P case-parent trios were ascertained from an international consortium,which conducted a genome-wide association study using a case-parent trio design to investigate the genes affec-ting risk to NSCL/P.After stringent quality control measures,343 single nucleotide polymorphism(SNP)spanning across 10 pivotal genes in the TGF-β signaling pathway were selected from the original genome-wide association study(GWAS)dataset for further analysis.The transmission disequilibrium test(TDT)was used to test for SNP effects.The conditional Logistic regression models were used to test for gene-gene interaction and gene-environment interaction.Environmental factors collected for the study in-cluded smoking during pregnancy,passive smoking during pregnancy,alcohol intake during pregnancy,and vitamin use during pregnancy.Due to the low rates of exposure to smoking during pregnancy and al-cohol consumption during pregnancy(＜3％),only the interaction between maternal smoking during pregnancy and multivitamin supplementation during pregnancy was analyzed.The threshold for statistical significance was rigorously set at P=1.46 × 10-4,applying Bonferroni correction to account for multiple testing.Results:A total of 23 SNPs in 4 genes yielded nominal association with NSCL/P(P＜0.05),but none of these associations was statistically significant after Bonferroni's multiple test correction.How-ever,there were 6 pairs of SNPs rs4939874(SMAD2)and rs1864615(TGFBR2),rs2796813(TGFB2)and rs2132298(TGFBR2),rs4147358(SMAD3)and rs1346907(TGFBR2),rs4939874(SMAD2)and rs1019855(TGFBR2),rs4939874(SMAD2)and rs12490466(TGFBR2),rs2009112(TGFB2)and rs4075748(TGFBR2)showed statistically significant SNP-SNP interaction(P＜1.46 × 10-4).In contrast,the analysis of gene-environment interactions did not yield any significant results after being cor-rected by multiple testing.Conclusion:The comprehensive evaluation of SNP associations and interac-tions within the TGF-β signaling pathway did not yield any direct associations with NSCL/P risk in Asian populations.However,the significant gene-gene interactions identified suggest that the genetic architec-ture influencing NSCL/P risk may involve interactions between genes within the TGF-β signaling path-way.These findings underscore the necessity for further investigations to unravel these results and further explore the underlying biological mechanisms.

The complex chemical composition and limited research ideas of traditional Chinese medicine （TCM） have led to the unclear material basis and mechanism of the medicinal effects， which is a common problem hindering the modernization of TCM in China. The introduction of computer virtual technology has provided a new perspective for TCM research. In this study， we established the research method of structure-activity omics to study the relationships between the structures and effects of different compounds in TCM based on the chemical structures of TCM components and to analyze and predict the material basis and multitarget synergistic mechanism of TCM. Furthermore， a structure-activity omics study was carried out with the anti-inflammatory and analgesic effects of Qizhi Weitong granules as an example. This study provides support for screening the pharmacodynamic components and analyzing the active ingredients of TCM and gives insights into the research on the material basis and mechanism of compound efficacy and the development of lead compounds of TCM， thus promoting the modern research and the innovative development of TCM.

ObjectiveTo explain the anti-inflammatory and analgesic effects of Corydalis Rhizoma by the means of structure-activity omics. MethodOn the basis of the previous in vitro screening study， we studied the in vivo efficacy of the alkaloids in Corydalis Rhizoma. With the targets as a bridge， the structures of chemical components in Corydalis Rhizoma were connected with the efficacy. The molecular docking of the alkaloids in Corydalis Rhizoma with the targets of inflammation and pain was carried out. According to the docking scores and the differences in the structural nucleus of Corydalis Rhizoma alkaloids， a study of structure-activity omics was carried out to summarize the rules of their connection. ResultThe alkaloids in Corydalis Rhizoma had good anti-inflammatory and analgesic effects in vivo， involving 53 chemical components and 73 targets. There were 3 074 targets associated with inflammation and pain， and 42 targets of direct action were shared by the chemical components and the disease. The protein-protein interaction （PPI） and molecular docking analysis predicted that the main active components of Corydalis Rhizoma were tetrahydropalmatine and palmatine， and the core targets were prostaglandin endoperoxide synthase 2 （PTGS2）， glutamate receptor metabotropic 5 （GRM5）， estrogen receptor 1 （ESR1）， solute carrier family 6 member 4 （SLC6A4）， and fusion oncoproteins （FOS）. According to the differences of mother nucleus， the 53 alkaloid components of Corydalis Rhizoma were classified into 8 categories， including protoberberine， berberine， and aporphine， which had high binding affinities with PTGS2， GRM5 and other targets. The relationship between the structures of Corydalis Rhizoma alkaloids and docking scores in each group showed the same law. In protoberberine， appropriate substituents with hydroxyl， alkoxy or methyl groups on the A and D rings of the parent ring were conducive to enhancing the binding activities with the two targets. In berberine， the structure containing a methyl group on position 13 had strong binding affinities with the two targets. It is hypothesized that the methyl fragment changes the binding mode between the component structure and amino acid residues， which greatly improves the binding affinity. ConclusionThis study employs the method of structure-activity omics to analyze the material basis for the anti-inflammatory and analgesic effects of alkaloids in Corydalis Rhizoma， and the structure-activity omics provides new ideas for revealing the pharmacodynamic substances of traditional Chinese medicine.