Objective To explore the feasibility and reference value of allogeneic lung transplantation and postoperative monitoring in miniature pigs for lung transplantation research. Methods Two miniature pigs (R1 and R2) underwent left lung allogeneic transplantation. Complement-dependent cytotoxicity tests and blood cross-matching were performed before surgery. The main operative times and partial pressure of arterial oxygen (PaO₂) after opening the pulmonary artery were recorded during surgery. Postoperatively, routine blood tests, biochemical blood indicators and inflammatory factors were detected, and pathological examinations of multiple organs were conducted. Results The complement-dependent cytotoxicity test showed that the survival rate of lymphocytes between donors and recipients was 42.5%-47.3%, and no agglutination reaction occurred in the cross-matching. The first warm ischemia times of D1 and D2 were 17 min and 10 min, respectively, and the cold ischemia times were 246 min and 216 min, respectively. Ultimately, R1 and R2 survived for 1.5 h and 104 h, respectively. Postoperatively, in R1, albumin (ALB) and globulin (GLB) decreased, and alanine aminotransferase increased; in R2, ALB, GLB and aspartate aminotransferase all increased. Urea nitrogen and serum creatinine increased in both recipients. Pathological results showed that in R1, the transplanted lung had partial consolidation with inflammatory cell infiltration, and multiple organs were congested and damaged. In R2, the transplanted lung had severe necrosis with fibrosis, and multiple organs had mild to moderate damage. The expression levels of interleukin-1β and interleukin-6 increased in the transplanted lungs. Conclusions The allogeneic lung transplantation model in miniature pigs may systematically evaluate immunological compatibility, intraoperative function and postoperative organ damage. The data obtained may provide technical references for subsequent lung transplantation research.

Bacterial biofilms can make traditional antibiotics impenetrable and even promote the development of antibiotic-resistant strains. Therefore, non-antibiotic strategies to effectively penetrate and eradicate the formed biofilms are urgently needed. Here, we demonstrate the development of self-propelled biohybrid microrobots that can enhance the degradation and penetration effects for Pseudomonas aeruginosa biofilms in minimally invasive strategy. The biohybrid microrobots (CR@Alg) are constructed by surface modification of Chlamydomonas reinhardtii (CR) microalgae with alginate lyase (Alg) via biological orthogonal reaction. By degrading the biofilm components, the number of CR@Alg microrobots with fast-moving capability penetrating the biofilm increases by around 2.4-fold compared to that of microalgae. Massive reactive oxygen species are subsequently generated under laser irradiation due to the presence of chlorophyll, inherent photosensitizers of microalgae, thus triggering photodynamic therapy (PDT) to combat bacteria. Our algae-based microrobots with superior biocompatibility eliminate biofilm-infections efficiently and tend to suppress the inflammatory response in vivo, showing huge promise for the active treatment of biofilm-associated infections.

Objective To assess the effect of ultrasonic thyroid artificial intelligence(AI)-assisted diagnostic system(AI-assisted diagnostic system)for diagnosing medullary thyroid carcinoma(MTC)compared with different physicians and taken papillary thyroid carcinoma(PTC)as the controls.Methods Totally 63 MTC,70 PTC and 62 benign thyroid nodules confirmed by pathology were enrolled.AI-assisted diagnostic system was utilized to analyze thyroid nodules and identify the likelihood of malignancy,and the probability value threshold was set at ≥0.40.All thyroid nodules were retrospectively reviewed and categorized by 3 physicians(1 senior physician,1 attending physician and 1 junior physician)according to Chinese thyroid imaging reporting and data system(C-TIRADS).The efficacy of AI-assisted diagnostic system and physicians for diagnosing MTC and PTC were evaluated.Results AI-assisted diagnostic system showed lower sensitivity,specificity,positive predictive value,negative predictive value,accuracy,and area under the curve(AUC)for diagnosing MTC and PTC compared with physicians.Significant differences of AUC were found between senior physician and AI-assisted diagnostic system,as well as between attending physician and AI-assisted diagnostic system for diagnosing MTC and PTC(all P＜0.01),while no significant difference of AUC was between junior physicians and AI-assisted diagnostic system(both P＞0.05).The sensitivity,specificity,positive predictive value,negative predictive value,accuracy and AUC for AI-assisted diagnostic system for diagnosing MTC were all lower than those for diagnosing PTC,but the AUC was not significantly different(P＞0.05).Conclusion Ultrasonic thyroid AI-assisted diagnostic system had relatively high value for diagnosing MTC.

Objective:To evaluate the mechanism of α7 nicotinic acetylcholine receptor (α7nAChR) agonist-induced protection of the intestine in rats undergoing cardiopulmonary bypass (CPB) and the relationship with the activity of enteric glial cells (EGCs).Methods:Seventy-two clean-grade adult male Sprague-Dawley rats, aged 400-500 g, were divided into 3 groups ( n=24 each) using a random number table method: sham operation group (group S), CPB group (group C) and α7nAChR agonist PHA568487 plus CPB group (group P). In group P, PHA568487 0.8 mg/kg was intraperitoneally injected, and 30 min later CPB model was established.At the beginning of CPB (T 0), at 1 h of CPB (T 1), and at 2 and 6 h after termination of CPB (T 2, 3), the rats were sacrificed, and intestinal tissues were obtained for examination of the pathological changes and for determination of the expression of ZO-1, occludin, glial fibrillary acidic protein (GFAP), and calcium-binding protein (S-100β protein) by Western blot.The immunohistochemical method was used to observe the positive expression of GFAP at T 2. Results:Compared with group S, the expression of GFAP and S-100β protein was significantly up-regulated, and the expression of ZO-1 and occludin was down-regulated at T 1-3( P<0.05), the positive expression of GFAP was increased, and the intestinal tissue injury was accentuated in C and P groups.Compared with group C, the expression of GFAP, ZO-1 and occludin was significantly up-regulated, and the expression of S-100β protein was down-regulated at T 1-3( P<0.05), the positive expression of GFAP was increased, and the intestinal tissue injury was reduced in group P. Conclusion:The mechanism by which α7nAChR agonist attenuates intestinal injury may be related to activating EGCs and improving intestinal barrier function in rats undergoing CPB.

Objective:To describe our experiences in application of the 2019 revision of "CCCG-WT-2016" for the diagnosis of Wilms tumors.Methods:Ninety-one cases of Wilms tumor diagnosed at Shanghai Children′s Medical Center from January 2015 to December 2018 were collected. All cases were reviewed by two senior pathologists, including one from China and the other from Singapore, according to the 2019 revision of "CCCG-WT-2016."Results:The specimens were obtained by core biopsy ( n=21), primary nephrectomy ( n=41), post-chemotherapy nephrectomy/resection ( n=18), or biopsy/resection of metastatic/relapse/post-chemotherapy metastatic lesion(s) ( n=11). The specimens of core biopsy and primary nephrectomy ( n=62) all had favorable histology.Twelve post-chemotherapy nephrectomy cases were subdivided into three risk groups: low risk ( n=0), intermediate risk ( n=10) and high risk ( n=2). Six post-chemotherapy resection cases were subdivided into 3 risk groups:low risk ( n=0), intermediate risk ( n=5) and high risk ( n=1). The remaining 11 cases were comprised of metastatic, relapse, and post-chemotherapy metastatic lesions. The concordance rate of the two senior pathologists was 100%(91/91). Conclusions:The 2019 revision of "CCCG-WT-2016" is clearly written and easy to use. It can serve as the basis of accurate classification for clinical treatment.

Objective:To investigate the clinical and pathological features of pediatric NTRK-rearranged tumors.Methods:Four NTRK-rearranged soft tissue tumors and one renal tumor at Shanghai Children′s Medical Center, Shanghai Jiaotong University and Singapore KK Women′s and Children′s Hospital from January 2017 to September 2019 were identified. Pan-TRK immunohistochemistry, and the ALK and ETV6 gene break-apart fluorescence in situ hybridizations (FISH) were performed. NTRK gene rearrangement was detected using sequencing-based methods.Results:There were 3 males and 2 females in this study. The patients were between 3 months and 13 years of age. Histologically, the tumors were infiltrative spindle cell tumors with variable accompanying inflammatory cells. Immunohistochemistry showed positive reactivity for pan-TRK in all tumors, with nuclear staining for NTRK3 fusion, and cytoplasmic staining for NTRK1 fusion. The molecular testing revealed NTRK gene fusions (one each of TPM3-NTRK1, ETV6-NTRK3 and DCTN1-NTRK1, and two cases of LMNA-NTRK1). Two patients were receiving larotrectinib. The others were are well without disease, with follow-up durations of 9 to 29 months.Conclusions:NTRK-rearranged mesenchymal tumors from soft tissue sites and kidney are identified. A novel DCTN1-NTRK1 fusion is described. Pan-TRK immunohistochemistry is useful for diagnosis. NTRK-targeted therapy may be an option for unresectable, recurrent or metastatic cases.

Objective To evaluate the relationship between endogenous protective mechanism of intestinal barrier injury induced by cardiopulmonary bypass ( CPB) and enteric glia cells in rats. Methods Forty-eight clean-grade adult male Sprague-Dawley rats, weighing 400-500 g, were divided into 2 groups (n=24 each) using a random number table method: sham operation group (group S) and CPB group. Rats were sacrificed at the beginning of CPB, 60 min of CPB, and 2 and 6 h after CPB, and the intestinal tissues were removed for examination of pathological changes ( by HE staining) and for determina-tion of the expression of ZO-1, occludin, glial fibrillary acidic protein ( GFAP ) and calcium-binding pro-tein ( S-100) and the positive expression of GFAP ( by immunohistochemical method) . Results Compared with group S, the expression of GFAP and S-100 was significantly up-regulated at 60 min of CPB and 2 and 6 h after CPB, the expression of ZO-1 and occludin was down-regulated (P<0. 05), the positive expres-sion of GFAP was enhanced, and the intestinal mucosal injury was marked in group CPB. Conclusion The enhanced activation of enteric glia cells may be involved in the endogenous protective mechanism of in-testinal barrier injury induced by CPB in rats.

Objective To examine the impact of loneliness on cognitive impairment among community-dwelling elderly people.Methods A cross-sectional survey was conducted between July and August 2015 with 895 community-dwelling elderly participants in four residential areas of Wuchang District,Wuhan.The Montreal Cognitive Assessment (MoCA) was used to measure cognitive function.Chi square test,t-test,and multivariate linear regression were used to analyze the data.Results Multivariate linear analysis showed that loneliness was independently and negatively associated with cognitive function among the participants (β=-1.2828,95％ CI:-2.27--0.30).Participants who felt loneliness recorded lower scores on visuospatial executive,attention,and language ability than those who did not (P＜0.05).Multivariate logistic analysis demonstrated that loneliness was also associated with cognitive function after adjustment for age and gender,with OR (95 ％CI) at 1.74(1.05 2.91) / 1.78 (1.07 2.94).Loneliness remained an independent risk factor for cognitive dysfunction after adjustment for age,gender,education level,monthly income,living arrangement,physical activity,mental activity,hypertension,diabetes,frequency of social interaction,and type of social interaction,with OR (95％CI) at 1.69(1.002.87) / 1.72(1.022.90).Conclusions Loneliness is a significant and independent impact factor for cognitive dysfunction among community dwelling elders.

BACKGROUND:The clinical study on the mechanical properties of biomaterials for cruciate ligament reconstruction is of great importance, which can provide a theoretical basis for the clinical development of materials with good structure, biomechanics and compatibility. OBJECTIVE:To analyze the mechanical properties of vascularized patelar tendon graft. METHODS:The anterior cruciate ligaments of the left foreleg from 42 New Zealand white rabbits were cut off. Then, these rabbits were randomly and evenly divided into two groups: experimental group and control group. Rabbits in the experimental group were implanted vascularized patelar tendon graft for anterior cruciate ligament repair. Rabbits in the control group were implanted with autologous non-vascularized patelar tendon graft for anterior cruciate ligament repair. At the 8th, 12th and 16th weeks after implantation, biomechanical properties of specimens from these two groups were detected. RESULTS AND CONCLUSION: There was no significant difference on the fracture location at different time points between these two groups; at the 12th and 16th weeks after transplantation, the knee laxity in the experimental group was higher than that in the control group (P < 0.05). At the 8th week after transplantation, there was no significant difference in the knee laxity between these two groups. At the 8th, 12thand 16th weeks after transplantation, the maximum load in the experimental group was higher than that in the control group (P < 0.05). At the 8th, 12th and 16th weeks after transplantation, the stiffness in the experimental group was higher than that in the control group (P < 0.05). There was no significant difference in the maximum tensile elongation between these two groups at different time points after transplantation. These results demonstrate that vascularized patelar tendon graft has good mechanical properties.

Objective To construct recobinant pmRNA IRES-hKDR and lay a primary foundation for further study of gene therapy for tumors.Methods pmRNA IRES-hKDR was obtained from pDC520 hkDR and pmRNA IRES-Luc which was reserved by our laboratory through molecular biology technology and was transfected into Hepall-6 via lipsome after identification of PCR,restriction enzyme digesting and DNA ELISA and Western blot.Results The recombiant plasmid had pmRNA IRES-hKD gene which was expressed in Hepall-6//G418 in vitro and the expressed protein was secreted out of the cells could response with specific hKDR antibody,which was identified by Western blot.Conclusion An eukaryotic expression recombiant plasmid pmRNA IRES-hKDR can be constructed successfully which provides the possibility of further researches on its anti-tumor effect.