Background Toluene and chlorobenzene have been designated as surrogate contaminants in the challenge test for evaluating the safety of recycling processes for food-contact recycled polyethylene terephthalate (rPET). Establishing a reliable analytical method is essential for ensuring the compliant use of rPET and safeguarding food safety. Objective To develop a rapid quantitative method for determining toluene and chlorobenzene in rPET using headspace gas chromatography-mass spectrometry (HS-GC-MS), as part of the challenge test for process safety evaluation. Methods The effects of different chromatographic columns and headspace conditions on detection of target analytes were investigated. Three columns HP-5 ms UI (30 m×0.25 mm×0.25 μm), DB-624 (30 m×0.32 mm×1.8 μm), and VF-WAXms (30 m×0.25 mm×0.25 μm) were compared for separation efficiency and peak shape. Headspace equilibration temperatures (50-100 ℃) and equilibration times (10-30 min) were evaluated to determine the optimal instrumental parameters. The effect of sample grinding on recovery was assessed to select the best pretreatment conditions. The established method was validated for selectivity, linearity, sensitivity, accuracy, and precision, and was subsequently applied to the analysis of 12 rPET samples. Results The target analytes achieved good separation and response within 15 min, under the optimized conditions using an HP-5 ms UI column, a headspace equilibration temperature of 60 ℃ and a 10 min equilibration time. Direct analysis without grinding yielded satisfactory recovery rates. Toluene and chlorobenzene showed excellent linearity (0.0030-5.0 mg·kg⁻¹, R²≥0.999). The limits of detection (LOD) and quantification (LOQ) were 0.00003 mg·kg⁻¹ and 0.00011 mg·kg⁻¹ for toluene respectively, and 0.00011 mg·kg⁻¹ and 0.00037 mg·kg⁻¹ for chlorobenzene respectively. The recoveries of the matrix spike at low and high spiking levels ranged from 88.6% to 110%, with relative standard deviations of 0.52%-4.9% (n=6). Among the 12 rPET samples from different recycling stages, three samples contained detectable levels of toluene (0.196-0.250 mg·kg⁻¹) and chlorobenzene (0.704-0.867 mg·kg⁻¹). Conclusion The proposed method is simple, rapid, highly sensitive, and accurate, making it suitable for determining toluene and chlorobenzene in food-contact rPET. It provides a robust technical approach for the safety evaluation of rPET recycling processes.

BACKGROUND:Radiotherapy significantly improves survival rates in patients with various malignant tumors.However,with prolonged post-treatment survival,many patients face the risk of radiation-related cardiac toxicity.This is especially true after chest radiotherapy,where the risk of radiation-induced heart disease significantly increases,becoming one of the most severe complications affecting prognosis survival.OBJECTIVE:To identify diagnostic markers of endothelial cellular senescence in radiation-induced heart disease through systematic transcriptomic analysis.METHODS:Firstly,genes associated with cellular senescence were screened from the CellAge database and intersected with the transcriptomic training dataset of a mouse model of radiation-induced heart disease to identify differentially expressed senescence-related genes.Secondly,weighted gene co-expression network analysis and machine learning were used to identify key hub genes that play critical roles in radiation-induced heart disease.The expression of these genes was validated using a dataset of radiation-induced endothelial injury.Additionally,the quanTlseq method was employed to assess the immune infiltration status related to radiation-induced heart disease.The expression levels of key genes and their association with survival in esophageal squamous cell carcinoma patients receiving chest radiotherapy were explored through the analysis of The Cancer Genome Atlas database.RESULTS AND CONCLUSION:(1)Systematic transcriptomic analysis identified CCND1 as the core gene of endothelial cellular senescence in radiation-induced heart disease,and this finding was validated in the mouse model of radiation-induced heart disease.(2)The diagnostic model constructed from these data indicated that CCND1 had high specificity and sensitivity for diagnosing radiation-induced heart disease.(3)Immune infiltration analysis revealed significant immune response dysregulation in the mouse model of radiation-induced heart disease,and CCND1 was closely related to various immune cells.(4)Kaplan-Meier survival analysis showed that CCND1 was associated with poorer disease-specific survival in esophageal squamous cell carcinoma patients receiving chest radiotherapy.This study systematically uncovers,for the first time,the pivotal role of CCND1 in endothelial cell senescence associated with radiation-induced heart disease.CCND1,a gene integral to cell cycle regulation,can induce cellular senescence when abnormally expressed.Furthermore,the findings highlight its potential as an early diagnostic marker.

BACKGROUND:Radiotherapy significantly improves survival rates in patients with various malignant tumors.However,with prolonged post-treatment survival,many patients face the risk of radiation-related cardiac toxicity.This is especially true after chest radiotherapy,where the risk of radiation-induced heart disease significantly increases,becoming one of the most severe complications affecting prognosis survival.OBJECTIVE:To identify diagnostic markers of endothelial cellular senescence in radiation-induced heart disease through systematic transcriptomic analysis.METHODS:Firstly,genes associated with cellular senescence were screened from the CellAge database and intersected with the transcriptomic training dataset of a mouse model of radiation-induced heart disease to identify differentially expressed senescence-related genes.Secondly,weighted gene co-expression network analysis and machine learning were used to identify key hub genes that play critical roles in radiation-induced heart disease.The expression of these genes was validated using a dataset of radiation-induced endothelial injury.Additionally,the quanTlseq method was employed to assess the immune infiltration status related to radiation-induced heart disease.The expression levels of key genes and their association with survival in esophageal squamous cell carcinoma patients receiving chest radiotherapy were explored through the analysis of The Cancer Genome Atlas database.RESULTS AND CONCLUSION:(1)Systematic transcriptomic analysis identified CCND1 as the core gene of endothelial cellular senescence in radiation-induced heart disease,and this finding was validated in the mouse model of radiation-induced heart disease.(2)The diagnostic model constructed from these data indicated that CCND1 had high specificity and sensitivity for diagnosing radiation-induced heart disease.(3)Immune infiltration analysis revealed significant immune response dysregulation in the mouse model of radiation-induced heart disease,and CCND1 was closely related to various immune cells.(4)Kaplan-Meier survival analysis showed that CCND1 was associated with poorer disease-specific survival in esophageal squamous cell carcinoma patients receiving chest radiotherapy.This study systematically uncovers,for the first time,the pivotal role of CCND1 in endothelial cell senescence associated with radiation-induced heart disease.CCND1,a gene integral to cell cycle regulation,can induce cellular senescence when abnormally expressed.Furthermore,the findings highlight its potential as an early diagnostic marker.

Fracture healing is a complex process that necessitates the synergistic action of various cells and molecules. Macrophages play an indispensable and crucial regulatory role in the process of fracture repair, influencing stages such as inflammatory modulation, angiogenesis, and tissue remodeling. This article delves into the functional characteristics of macrophages and their roles at different stages of fracture healing. Additionally, it explores the impact of aging macrophages on the healing process. Furthermore, the potential of emerging therapies, such as hydrogel-based treatments and exosomes, in modulating macrophage responses is analyzed. This study provides a theoretical foundation for the development of innovative therapies aimed at enhancing the efficacy of fracture healing.

Objective:To investigate the predictive value of radiomics features derived from dynamic contrast-enhanced MRI (DCE-MRI) based on habitat imaging technology for pathological complete response after neoadjuvant therapy (NAT) for breast cancer.Methods:All patients were female, aged 25-67 years. Patients were stratified into training ( n=83) and validation ( n=36) sets via stratified random sampling (7∶3 ratio). Pathological complete remission (pCR) and non-pathological complete remission (non-pCR) were defined using the Miller-Payne grading system. All patients underwent DCE-MRI before NAT. ITK-Snap software was used to outline the region of interest (ROI), the imaging histological features of the entire tumor region were extracted and screened, a traditional imaging histological model for predicting post-NAT pCR (ROI overall model) was constructed; the tumor region was divided into three subregions using habitat imaging technology, and the imaging histological features within ROI subregion 1, ROI subregion 2, and ROI subregion 3 were extracted and screened, and the habitat imaging model for predicting post-NAT pCR were constructed (ROI subregion 1 model, ROI subregion 2 model, ROI subregion 3 model). Univariate logistic regression identified clinical predictors of pCR for clinical model construction. Combined models integrating clinical predictors and habitat imaging features were established. The efficacy of each model in predicting pCR after NAT in breast cancer was evaluated using receiver operating characteristic curves and area under the curve (AUC), and the efficacy of clinical application of the models was evaluated using decision curve analysis (DCA). Results:Of the 119 patients, 74 were pCR patients, with 52 in the training set and 22 in the validation set, and 45 were non-pCR patients, with 31 in the training set and 14 in the validation set. Logistic regression analysis showed that human epidermal growth factor receptor 2 status ( OR=0.254, 95% CI 0.093-0.697, P=0.008) was an independent predictor of pCR after NAT, and this was used to construct a clinical prediction model. The predictive efficacy of ROI subregion 1 model and ROI subregion 2 model in the habitat model was higher than that of the traditional imaging histology model (ROI overall model), with AUCs of 0.805, 0.748,0.728 for the training set and 0.776,0.718,0.708 for the validation set, respectively. The combined clinical prediction model for predicting pCR after NAT in breast cancer had AUCs of 0.877 and 0.818 for the training and validation sets, respectively. DCA showed a higher net benefit for the combined model than for the traditional imaging histology model and the habitat imaging histology model. Conclusion:Compared with the traditional method of extracting the entire tumor region, extracting radiomics features from DCE-MRI subregions based on habitat imaging technology can improve the predictive performance of NAT efficacy in breast cancer.

Objective:To investigate the predictive value of radiomics features derived from dynamic contrast-enhanced MRI (DCE-MRI) based on habitat imaging technology for pathological complete response after neoadjuvant therapy (NAT) for breast cancer.Methods:All patients were female, aged 25-67 years. Patients were stratified into training ( n=83) and validation ( n=36) sets via stratified random sampling (7∶3 ratio). Pathological complete remission (pCR) and non-pathological complete remission (non-pCR) were defined using the Miller-Payne grading system. All patients underwent DCE-MRI before NAT. ITK-Snap software was used to outline the region of interest (ROI), the imaging histological features of the entire tumor region were extracted and screened, a traditional imaging histological model for predicting post-NAT pCR (ROI overall model) was constructed; the tumor region was divided into three subregions using habitat imaging technology, and the imaging histological features within ROI subregion 1, ROI subregion 2, and ROI subregion 3 were extracted and screened, and the habitat imaging model for predicting post-NAT pCR were constructed (ROI subregion 1 model, ROI subregion 2 model, ROI subregion 3 model). Univariate logistic regression identified clinical predictors of pCR for clinical model construction. Combined models integrating clinical predictors and habitat imaging features were established. The efficacy of each model in predicting pCR after NAT in breast cancer was evaluated using receiver operating characteristic curves and area under the curve (AUC), and the efficacy of clinical application of the models was evaluated using decision curve analysis (DCA). Results:Of the 119 patients, 74 were pCR patients, with 52 in the training set and 22 in the validation set, and 45 were non-pCR patients, with 31 in the training set and 14 in the validation set. Logistic regression analysis showed that human epidermal growth factor receptor 2 status ( OR=0.254, 95% CI 0.093-0.697, P=0.008) was an independent predictor of pCR after NAT, and this was used to construct a clinical prediction model. The predictive efficacy of ROI subregion 1 model and ROI subregion 2 model in the habitat model was higher than that of the traditional imaging histology model (ROI overall model), with AUCs of 0.805, 0.748,0.728 for the training set and 0.776,0.718,0.708 for the validation set, respectively. The combined clinical prediction model for predicting pCR after NAT in breast cancer had AUCs of 0.877 and 0.818 for the training and validation sets, respectively. DCA showed a higher net benefit for the combined model than for the traditional imaging histology model and the habitat imaging histology model. Conclusion:Compared with the traditional method of extracting the entire tumor region, extracting radiomics features from DCE-MRI subregions based on habitat imaging technology can improve the predictive performance of NAT efficacy in breast cancer.

Objective Taking typical cases of Western medicine as an example,this paper explores the connection between Chinese and Western medicine on the understanding of tongue elephants.Methods After collecting the literature with tongue diagram attached to the clinical imaging column published in NEJM magazine,extracting the symptoms,signs and Western medicine disease information recorded in the literature,the tongue diagram was diagnosed from three aspects:tongue quality,tongue moss and sublingual meridians,and whether the symptoms and signs of tongue correspond to a certain diagnosis result,and the results were analyzed.Results A total of 48 articles were included,including 6 literature on abnormal tongue dynamics,which could correspond to abnormal tongue morphology in traditional Chinese medicine.Thirty-four cases of abnormal tongue shape were found.Among them,12 cases could be diagnosed with corresponding TCM tongue diagnosis,including 7 cases of abnormal tongue shape and 5 cases of abnormal coating.The remaining 22 cases were secondary changes in tongue structure.There were 8 articles on abnormal tongue color,including 1 abnormal tongue color,1 abnormal sublingual chord,and 6 abnormal lichen color.Conclusion Starting from the form and function,explore the connection between Chinese medicine and Western medicine in their understanding of tongue diagnosis,and promote the objectification and standardization of Chinese medicine tongue diagnosis.

Objective:To discuss the feasibility and safety of modified side overlap with fundoplication by Yamashita (mSOFY) in laparoscopic proximal gastrectomy.Methods:Using the method of descriptive case series study, the clinical data of 9 patients with upper gastric cancer who successfully performed mSOFY anastomosis from March 2022 to October 2022 in the Affiliated Huaian No.1 People's Hospital of Nanjing Medical University were retrospectively analyzed.The reconstruction steps of mSOFY anastomosis are as follows: (1) Make a small incision on the right side of the esophageal stump and in front of the anterior wall of the gastric stump; (2) The 45mm linear cutting stapler is placed into the preset anastomosis of the esophagus and the remnant stomach, and the esophagus is rotated 90° counterclockwise along the axis, so that the right wall of the esophagus is anastomosed with the remnant stomach, and the stomach wall is sutured to the left side of the esophagus; (3) The common opening of esophagus and remnant stomach was sutured with inverted suture; (4)Suture the left and lower sides of the esophagus with the remnant stomach to make the esophagus flat against the stomach wall; (5) Open the sutured common opening: due to the pressure of the false dome, the posterior wall of the lower esophageal segment was compressed into a valve-like structure. We mainly observing the postoperative reflux and nutritional improvement of the patients, and recording the intraoperative situation and postoperative complications.Results:Nine patients with upper gastric cancer who completed laparoscopic proximal gastrectomy (mSOFY anastomosis) did not have conversion to laparotomy or intraoperative / postoperative complications. The operation time was (169.4±10.4) minutes, the anastomotic reconstruction time was (51.7±7.1) minutes, the intraoperative bleeding volume was (98.9±43.4) ml, and the number of lymph nodes dissected was (27.2±6.7). The patient recovered well after operation, without any complaints related to reflux esophagitis. Postoperative gastrointestinal radiography showed that the anastomosis was smooth, without stenosis and leakage. The serum albumin [(41.6±3.4) L vs. (39.9±2.6) L], prealbumin [(211.3±38.6) mg/L vs. (205.3±36.0) mg/L], and hemoglobin levels [(126.7±13.2) g/L vs. (121.0±9.7) g/L] of patients before and one month after surgery have no statistically significant differences (all P>0.05). Conclusion:mSOFY anastomosis can be used as one of the safe and feasible reconstruction methods in laparoscopic proximal gastrectomy.

Objective:To discuss the feasibility and safety of modified side overlap with fundoplication by Yamashita (mSOFY) in laparoscopic proximal gastrectomy.Methods:Using the method of descriptive case series study, the clinical data of 9 patients with upper gastric cancer who successfully performed mSOFY anastomosis from March 2022 to October 2022 in the Affiliated Huaian No.1 People's Hospital of Nanjing Medical University were retrospectively analyzed.The reconstruction steps of mSOFY anastomosis are as follows: (1) Make a small incision on the right side of the esophageal stump and in front of the anterior wall of the gastric stump; (2) The 45mm linear cutting stapler is placed into the preset anastomosis of the esophagus and the remnant stomach, and the esophagus is rotated 90° counterclockwise along the axis, so that the right wall of the esophagus is anastomosed with the remnant stomach, and the stomach wall is sutured to the left side of the esophagus; (3) The common opening of esophagus and remnant stomach was sutured with inverted suture; (4)Suture the left and lower sides of the esophagus with the remnant stomach to make the esophagus flat against the stomach wall; (5) Open the sutured common opening: due to the pressure of the false dome, the posterior wall of the lower esophageal segment was compressed into a valve-like structure. We mainly observing the postoperative reflux and nutritional improvement of the patients, and recording the intraoperative situation and postoperative complications.Results:Nine patients with upper gastric cancer who completed laparoscopic proximal gastrectomy (mSOFY anastomosis) did not have conversion to laparotomy or intraoperative / postoperative complications. The operation time was (169.4±10.4) minutes, the anastomotic reconstruction time was (51.7±7.1) minutes, the intraoperative bleeding volume was (98.9±43.4) ml, and the number of lymph nodes dissected was (27.2±6.7). The patient recovered well after operation, without any complaints related to reflux esophagitis. Postoperative gastrointestinal radiography showed that the anastomosis was smooth, without stenosis and leakage. The serum albumin [(41.6±3.4) L vs. (39.9±2.6) L], prealbumin [(211.3±38.6) mg/L vs. (205.3±36.0) mg/L], and hemoglobin levels [(126.7±13.2) g/L vs. (121.0±9.7) g/L] of patients before and one month after surgery have no statistically significant differences (all P>0.05). Conclusion:mSOFY anastomosis can be used as one of the safe and feasible reconstruction methods in laparoscopic proximal gastrectomy.

Objective: To investigate the value of clinical data and qualitative and quantitative computed tomography (CT) in predicting the pathological grade of thymoma． Methods: The clinical data and CT images of 81 patients with confirmed pathological diagnoses of thymoma were retrospectively analyzed．The patients were divided into low-risk and high-risk groups according to the pathological results，and the clinical features and qualitative and quantitative CT findings were compared between the groups．The efficacy of different parameters in predicting the pathological thymoma grade was evaluated by logistic univariate and multivariate regression analyses and receiver operating characteristic (ROC) curves. Results: Sixty-two tumors were classified as low-risk thymoma and 19 as high-risk thymoma. The efficacies of both the maximum CT values on enhancement and maximum degree of enhancement for risk prediction were statistically significant (P＜0. 001)．Logistic regression analysis showed that both the maximum CT values on enhancement (OR = 0. 88，95% CI : 0. 83 － 0．94) and maximum degree of enhancement (OR = 0. 92，95% CI :0. 88－0. 97) were independent predictors of thymoma risk (P＜0. 001)．The area under the ROC curve (AUC) of the maximum CT values on enhancement was 0. 884，with a sensitivity of 68. 4% and a specificity of 96. 8% ; the AUC of the maximum degree of enhancement was 0. 833，with a sensitivity of 89. 5% and a specificity of 72. 6% . Conclusion Quantitative parameters based on enhanced CT are helpful for the preoperative prediction of thymoma risk stratification．The predictive efficacy of the maximum CT values on enhancement is superior to that of the maximum degree of enhancement.