Objective To compare the diagnostic performance of three breast MRI measurement methods—RECIST 1.1,the optimal method,and three-dimensional(3D)volumetric assessment—in assessing the efficacy of neoadjuvant chemotherapy(NAC)in breast cancer patients,with the objective of identifying the most clinically practical approach.Methods A total of 110 breast cancer patients who underwent NAC followed by surgical treatment between 2019 and 2023 were included in the study.Breast magnetic resonance imaging(MRI)was conducted within one week before and after the completion of NAC.Tumor response was evaluated using RECIST 1.1 criteria,widely recognized as the optimal method,as well as 3D volume measurement.Pathological response was determined according to the Miller-Payne grading system.Sensitivity,specificity,accuracy,and the area under the receiver operating characteristic curve(AUC)were computed and compared using the DeLong test.Results The AUC values for RECIST 1.1,the optimal method,and 3D volumetric assessment were 0.768,0.795,and 0.883,respectively.The 3D volumetric assessment exhibited significantly better discriminative performance(P＜0.05),with the highest sensitivity(98.9％),specificity(77.8％),and accuracy(95.5％).Additionally,the optimal method demonstrated superior performance over RECIST 1.1 across multiple parameters.Conclusions 3D volumetric mea-surement demonstrates superior performance compared to RECIST 1.1 and the optimal method in evaluating the response to NAC,offering a more accurate and comprehensive assessment tool.Additionally,the optimal method shows advantages over RECIST 1.1 and may serve as a practical alternative in settings where 3D software is not available.

Objective To compare the diagnostic performance of three breast MRI measurement methods—RECIST 1.1,the optimal method,and three-dimensional(3D)volumetric assessment—in assessing the efficacy of neoadjuvant chemotherapy(NAC)in breast cancer patients,with the objective of identifying the most clinically practical approach.Methods A total of 110 breast cancer patients who underwent NAC followed by surgical treatment between 2019 and 2023 were included in the study.Breast magnetic resonance imaging(MRI)was conducted within one week before and after the completion of NAC.Tumor response was evaluated using RECIST 1.1 criteria,widely recognized as the optimal method,as well as 3D volume measurement.Pathological response was determined according to the Miller-Payne grading system.Sensitivity,specificity,accuracy,and the area under the receiver operating characteristic curve(AUC)were computed and compared using the DeLong test.Results The AUC values for RECIST 1.1,the optimal method,and 3D volumetric assessment were 0.768,0.795,and 0.883,respectively.The 3D volumetric assessment exhibited significantly better discriminative performance(P＜0.05),with the highest sensitivity(98.9％),specificity(77.8％),and accuracy(95.5％).Additionally,the optimal method demonstrated superior performance over RECIST 1.1 across multiple parameters.Conclusions 3D volumetric mea-surement demonstrates superior performance compared to RECIST 1.1 and the optimal method in evaluating the response to NAC,offering a more accurate and comprehensive assessment tool.Additionally,the optimal method shows advantages over RECIST 1.1 and may serve as a practical alternative in settings where 3D software is not available.

Objective To explore the clinical efficacy of thermosensitive moxibustion in treating headache and dizziness in patients with sympathetic type of cervical spondylosis(SCS).Methods A total of 80 patients with SCS treated in Affiliated Hospital of Jiangxi University of Chinese Medicine from June 2023 to June 2024 were selected and divided into observation group and control group according to random number table method,with 40 patients in each group.The patients in control group were treated with regular moxibustion,while the patients in observation group were treated with thermosensitive moxibustion.The clinical efficacy,pain,quality of life,cervical spine function,cervical sympathetic symptoms,and adverse reactions between two groups were compared.Results The total effective rate of observation group was significantly higher than that of control group(x2=4.501,P=0.034).After treatment,visual analogue scale(VAS),Northwick Park neck pain questionnaire(NPQ)and cervical sympathetic nerve symptom scores of patients in two groups were significantly lower than before treatment,and clinical assessment scale for cervical spondylosis(CASCS)scores were significantly higher than before treatment(P＜0.05).VAS,NPQ and cervical sympathetic nerve symptom scores of observation group were significantly lower than those of control group,and CASCS score was significantly higher than that of control group(P＜0.05).No adverse reactions such as fainting and scalding occurred in both groups during treatment.Conclusion Thermosensitive moxibustion for SCS can reduce cervical sympathetic nerve symptoms and pain,improve cervical spine function,and improve patients'quality of life,and is relatively safe.

Objective To explore the clinical efficacy of thermosensitive moxibustion in treating headache and dizziness in patients with sympathetic type of cervical spondylosis(SCS).Methods A total of 80 patients with SCS treated in Affiliated Hospital of Jiangxi University of Chinese Medicine from June 2023 to June 2024 were selected and divided into observation group and control group according to random number table method,with 40 patients in each group.The patients in control group were treated with regular moxibustion,while the patients in observation group were treated with thermosensitive moxibustion.The clinical efficacy,pain,quality of life,cervical spine function,cervical sympathetic symptoms,and adverse reactions between two groups were compared.Results The total effective rate of observation group was significantly higher than that of control group(x2=4.501,P=0.034).After treatment,visual analogue scale(VAS),Northwick Park neck pain questionnaire(NPQ)and cervical sympathetic nerve symptom scores of patients in two groups were significantly lower than before treatment,and clinical assessment scale for cervical spondylosis(CASCS)scores were significantly higher than before treatment(P＜0.05).VAS,NPQ and cervical sympathetic nerve symptom scores of observation group were significantly lower than those of control group,and CASCS score was significantly higher than that of control group(P＜0.05).No adverse reactions such as fainting and scalding occurred in both groups during treatment.Conclusion Thermosensitive moxibustion for SCS can reduce cervical sympathetic nerve symptoms and pain,improve cervical spine function,and improve patients'quality of life,and is relatively safe.

OBJECTIVE To explore the effects of trichloroisocyanuric acid(TCCA)on the prolifera-tion of spermatogonia by inducing oxidative stress and ferroptosis.METHODS GC-1 cells were cultured in DMEM-F12 medium,and cell proliferation was plotted according to the growth curve.GC-1 cells were treated with TCCA at concentrations of 0(cell control),97,194,and 387 μmol·L-1 for 24 h.Cell viability was detected using the CCK-8 method,apoptosis cells were stained with Hoechst 33342,cell cycle was examined by PI staining method,RT-qPCR was performed to measure the mRNA expres-sion levels of apoptosis-related genes Bax,Fas,oxidative stress-related genes superoxide dismutase 2(SOD2),glutathione peroxidase 4(GPX4),nuclear factor erythroid 2-related factor 2(Nrf2),solute carrier family 7 member 11(SLC7A11),dihydroorotate dehydrogenase(DHODH),DNA methyltransferase 3A(DNMT3A),and DNA methyltransferase 3L(DNMT3L).The Griess method was used to determine the nitric oxide(NO)content,colorimetric method for the malondialdehyde(MDA)level,DCFH-DA fluores-cence probe method for the reactive oxygen species(ROS)level,DNTB colorimetric method for the reduced glutathione(GSH)content,and WST-8 method for the reduced coenzymeⅡ(NADPH)content.RESULTS Compared with the cell control group,the cell survival rates in the TCCA 194 and 387 μmol·L-1 groups decreased significantly(P<0.01),accompanied by nuclear condensation and fragmentation,a significant increase in apoptosis rate(P<0.01),and cell arrest in the G2/M phase(P<0.05).Additionally,in the TCCA 387 μmol·L-1 group,the levels of NO,MDA and ROS increased(P<0.01),while the levels of GSH and NADPH decreased(P<0.01).Moreover,the mRNA expressions of SOD2,GPX4,Nrf2,SLC7A11,and DHODH decreased(P<0.05,P<0.01),while the expressions of Bax,Fas,DNMT3L,and DNMT3A increased(P<0.05,P<0.01).CONCLUSION TCCA exposure reduces the viability of GC-1 cells,inhibits cell proliferation,induces apoptosis of GC-1 cells.The mechanism may be related to the ability of TCCA to enhance oxidate stress,induce ferroptosis,and interfere with the methylation of GC-1 cells.

Objective:To prepare anti-human IgE nanobody by phage display technology,and to establish a method for hyper-sensitivity detection of cat dander specific IgE antibody.Methods:Allergen bio-information of cat was searched in WHO/IUIS Allergen Database.After synthesizing sequence,recombinant cat dander allergenic protein Fel d 1 was expressed and purified in prokaryotic ex-pression system.Human IgE was used to immunize Bactrian camel and RNA were extracted from lymphocyte to construct phage dis-play library.Library capacity,diversity and insertion rate were analyzed,anti-human IgE nanobody were obtained by screening and identification.A magnetic particle chemical method for cat dander specific IgE antibody detection was established using recombinant allergen-coupled magnetic particles and acridine ester-labeled nanobodies.Results:Capacity of phage display library was 1.88×108 cfu/ml,insertion rate was 93.6%,and purity of nanobody was>95%.Linear range of the method based on nanobody was 0.1～100 U/ml,who was consistent with ImmunoCAP detection system by clinical data.Conclusion:Nanobody-based cat dander specific IgE antibody hypersensitivity assay is successfully prepared,providing a technical basis for auxiliary diagnosis of cat allergic diseases.

BACKGROUND:Mechanical factors can affect the angiogenic ability of vascular endothelial cells.How the vessel number affects the hydrodynamic properties of microvessels remains to be clarified. OBJECTIVE:To investigate the influence of vessel number on the hydrodynamics of vascular networks based on computational fluid dynamics. METHODS:Three three-dimensional models of vascular network with different vessel numbers were constructed using the Geometry module of ANSYS 19.0 software,and then the vascular network was meshed to tetrahedral elements in Mesh module.The vascular network was assumed to rigid wall without slip,and the blood was assumed to laminar,viscous,and incompressible Newtonian fluid.Blood density,velocity,and a series of blood viscosity coefficients were also established.The Navier-Stokes equation was used for calculation.Hydrodynamic properties of different parts of vascular network with different vessel numbers were analyzed and compared. RESULTS AND CONCLUSION:The streamline,velocity,and mass flow all had the same trend in the vascular network,that is,the outlet and inlet were higher and the middle junction of vascular network was lower.The more the number of vessels,the thinner the blood flow lines in each part of the vascular network.Also,the velocity,mass flow,and wall shear decreased with the increase of the number of blood vessels.Therefore,the changes in vessel number could influence the hydrodynamic environment in the vascular network.Computational fluid dynamics indicates that the changes in vessel numbers can influence the hydrodynamic properties of blood,and provides a new idea for treating bone hypoperfusion-induced diseases(fracture nonunion,bone defect,osteoporosis,etc.)through tonifying kidney and activating blood circulation based on the coupling between angiogenesis and osteogenesis.

Objective To investigate the combined effect of CdCl2 and nicotine on the cell cycle and apoptosis of mouse spermatogonium(GC-1).Methods A CCK-8 assay was used to detect the inhibition of GC-1 cell proliferation in the CdCl2 groups,nicotine groups,and combined groups at 24 hours.Flow cytometry was used to detect the effects of CdCl2,nicotine,and the combined treatment on the cell cycle and apoptosis of GC-1 cells at 24 hours.Results The inhibitory effect on the proliferation of GC-1 cells increased with the rise in CdCl2 and nicotine concentrations.The IC50 values of CdCl2 and nicotine alone were 5.409 μmol/L and 2814 μmol/L,respectively.The IC50 values of CdCl2 and nicotine combined for GC-1 cells were 4.422,4.532,3.309,and 2.532 μmol/L at nicotine concentrations of 0.175,0.350,0.700,and 1.400 mmol/L,respectively,thus there was an obvious decrease with nicotine concentration.The IC50 values were lower than those of the group administered CdCl2 alone,and the combined action of CdCl2 and nicotine had synergistic effects.Cell cycle result showed that CdCl2 concentration of 2.5 μmol/L increased the percentage of G2/M phase cells in the combination groups.Cells were arrested in the G2/M phase in the combined groups(P＜0.01).When combined,CdCl2 and nicotine had a synergistic effect on the cell cycle,and the synergistic effect of CdCl2 was stronger.The result of apoptosis showed the proportion of cells in apoptosis increased in the 2.5 μmol/L CdCl2 group.Compared with the CdCl2 and nicotine single-treatment groups,the CdCl2 and nicotine combined group's percentage of cells in apoptosis increased significantly(P＜0.01),and CdCl2 had a stronger synergistic effect.Conclusions Combinations of CdCl2 and nicotine had a synergistic effect on mouse spermatogonium(GC-1)and led to enhanced cytotoxicity,G2/M cell cycle arrest,and cell apoptosis.CdCl2 was the main effect factor in the synergistic effect.

Objective To investigate the combined effect of CdCl2 and nicotine on the cell cycle and apoptosis of mouse spermatogonium(GC-1).Methods A CCK-8 assay was used to detect the inhibition of GC-1 cell proliferation in the CdCl2 groups,nicotine groups,and combined groups at 24 hours.Flow cytometry was used to detect the effects of CdCl2,nicotine,and the combined treatment on the cell cycle and apoptosis of GC-1 cells at 24 hours.Results The inhibitory effect on the proliferation of GC-1 cells increased with the rise in CdCl2 and nicotine concentrations.The IC50 values of CdCl2 and nicotine alone were 5.409 μmol/L and 2814 μmol/L,respectively.The IC50 values of CdCl2 and nicotine combined for GC-1 cells were 4.422,4.532,3.309,and 2.532 μmol/L at nicotine concentrations of 0.175,0.350,0.700,and 1.400 mmol/L,respectively,thus there was an obvious decrease with nicotine concentration.The IC50 values were lower than those of the group administered CdCl2 alone,and the combined action of CdCl2 and nicotine had synergistic effects.Cell cycle result showed that CdCl2 concentration of 2.5 μmol/L increased the percentage of G2/M phase cells in the combination groups.Cells were arrested in the G2/M phase in the combined groups(P＜0.01).When combined,CdCl2 and nicotine had a synergistic effect on the cell cycle,and the synergistic effect of CdCl2 was stronger.The result of apoptosis showed the proportion of cells in apoptosis increased in the 2.5 μmol/L CdCl2 group.Compared with the CdCl2 and nicotine single-treatment groups,the CdCl2 and nicotine combined group's percentage of cells in apoptosis increased significantly(P＜0.01),and CdCl2 had a stronger synergistic effect.Conclusions Combinations of CdCl2 and nicotine had a synergistic effect on mouse spermatogonium(GC-1)and led to enhanced cytotoxicity,G2/M cell cycle arrest,and cell apoptosis.CdCl2 was the main effect factor in the synergistic effect.

Objective:To evaluate the safety of double and a half layered esophagojejunal anastomosis in radical gastrectomy.Methods:This prospective, multi-center, single-arm study was initiated by the Affiliated Cancer Hospital of Zhengzhou University in June 2021 (CRAFT Study, NCT05282563). Participating institutions included Nanyang Central Hospital, Zhumadian Central Hospital, Luoyang Central Hospital, First Affiliated Hospital of Henan Polytechnic University, First Affiliated Hospital of Henan University, Luohe Central Hospital, the People's Hospital of Hebi, First People's Hospital of Shangqiu, Anyang Tumor Hospital, First People's Hospital of Pingdingshan, and Zhengzhou Central Hospital Affiliated to Zhengzhou University. Inclusion criteria were as follows: (1) gastric adenocarcinoma confirmed by preoperative gastroscopy;(2) preoperative imaging assessment indicated that R0 resection was feasible; (3) preoperative assessment showed no contraindications to surgery;(4) esophagojejunostomy planned during the procedure; (5) patients volunteered to participate in this study and gave their written informed consent; (6) ECOG score 0–1; and (7) ASA score I–III. Exclusion criteria were as follows: (1) history of upper abdominal surgery (except laparoscopic cholecystectomy);(2) history of gastric surgery (except endoscopic submucosal dissection and endoscopic mucosal resection); (3) pregnancy or lactation;(4) emergency surgery for gastric cancer-related complications (perforation, hemorrhage, obstruction); (5) other malignant tumors within 5 years or coexisting malignant tumors;(6) arterial embolism within 6 months, such as angina pectoris, myocardial infarction, and cerebrovascular accident; and (7) comorbidities or mental health abnormalities that could affect patients' participation in the study. Patients were eliminated from the study if: (1) radical gastrectomy could not be completed; (2) end-to-side esophagojejunal anastomosis was not performed during the procedure; or (3) esophagojejunal anastomosis reinforcement was not possible. Double and a half layered esophagojejunal anastomosis was performed as follows: (1) Open surgery: the full thickness of the anastomosis is continuously sutured, followed by embedding the seromuscular layer with barbed or 3-0 absorbable sutures. The anastomosis is sutured with an average of six to eight stitches. (2) Laparoscopic surgery: the anastomosis is strengthened by counterclockwise full-layer sutures. Once the anastomosis has been sutured to the right posterior aspect of the anastomosis, the jejunum stump is pulled to the right and the anastomosis turned over to continue to complete reinforcement of the posterior wall. The suture interval is approximately 5 mm. After completing the full-thickness suture, the anastomosis is embedded in the seromuscular layer. Relevant data of patients who had undergone radical gastrectomy in the above 12 centers from June 2021 were collected and analyzed. The primary outcome was safety (e.g., postoperative complications, and treatment). Other studied variables included details of surgery (e.g., surgery time, intraoperative bleeding), postoperative recovery (postoperative time to passing flatus and oral intake, length of hospital stay), and follow-up conditions (quality of life as assessed by Visick scores).Result:[1] From June 2021 to September 2022,457 patients were enrolled, including 355 men and 102 women of median age 60.8±10.1 years and BMI 23.7±3.2 kg/m2. The tumors were located in the upper stomach in 294 patients, mid stomach in 139; and lower stomach in 24. The surgical procedures comprised 48 proximal gastrectomies and 409 total gastrectomies. Neoadjuvant chemotherapy was administered to 85 patients. Other organs were resected in 85 patients. The maximum tumor diameter was 4.3±2.2 cm, number of excised lymph nodes 28.3±15.2, and number of positive lymph nodes five (range one to four. As to pathological stage,83 patients had Stage I disease, 128 Stage II, 237 Stage III, and nine Stage IV. [2] The studied surgery-related variables were as follows: The operation was successfully completed in all patients, 352 via a transabdominal approach, 25 via a transhiatus approach, and 80 via a transthoracoabdominal approach. The whole procedure was performed laparoscopically in 53 patients (11.6%), 189 (41.4%) underwent laparoscopic-assisted surgery, and 215 (47.0%) underwent open surgery. The median intraoperative blood loss was 200 (range, 10–1 350) mL, and the operating time 215.6±66.7 minutes. The anastomotic reinforcement time was 2 (7.3±3.9) minutes for laparoscopic-assisted surgery, 17.6±1.7 minutes for total laparoscopy, and 6.0±1.2 minutes for open surgery. [3] The studied postoperative variables were as follows: The median time to postoperative passage of flatus was 3.1±1.1 days and the postoperative gastrointestinal angiography time 6 (range, 4–13) days. The median time to postoperative oral intake was 7 (range, 2–14) days, and the postoperative hospitalization time 15.8±6.7 days. [4] The safety-related variables were as follows: In total, there were 184 (40.3%) postoperative complications. These comprised esophagojejunal anastomosis complications in 10 patients (2.2%), four (0.9%) being anastomotic leakage (including two cases of subclinical leakage and two of clinical leakage; all resolved with conservative treatment); and six patients (1.3%) with anastomotic stenosis (two who underwent endoscopic balloon dilation 21 and 46 days after surgery, the others improved after a change in diet). There was no anastomotic bleeding. Non-anastomotic complications occurred in 174 patients (38.1%). All patients attended for follow-up at least once, the median follow-up time being 10 (3–18) months. Visick grades were as follows: Class I, 89.1% (407/457); Class II, 7.9% (36/457); Class III, 2.6% (12/457); and Class IV 0.4% (2/457).Conclusion:Double and a half layered esophagojejunal anastomosis in radical gastrectomy is safe and feasible.