To investigate the correlation between vitamin D nutritional status and insulin resistance in pubertal adolescents.

Immunotherapy represents the third revolution in the pharmacological treatment of tumors and has demonstrated considerable efficacy in the management of malignant solid tumors, including melanoma and lung cancer. By contrast, breast cancer is frequently categorized as a “cold tumor” because of its limited immunogenicity and immunoreactivity, which hinder research progress and clinical outcomes in immunotherapy. Only a small proportion of patients derive benefits from immunotherapeutic interventions, and the development of drug resistance remains a concern. In this regard, novel strategies should be explored for converting immunologically inert “cold tumors” into immunologically active “hot tumors”, thereby expanding the population that will benefit from breast cancer immunotherapy. This study reviews new strategies to transform breast cancer from “cold tumor” to “hot tumor”. Strategies include enhancing the expression of tumor antigens, promoting immune infiltration, and reversing the immunosuppressive microenvironment. Results also emphasize the importance of comprehensive treatment to enhance systemic immunity.

Aim To establish a quantitative immunofluorescent bioactivity assay(ICW)for insulin glargine based on CHO-IN-SRB 1284 transgenic cells,and to study its equivalence with in-sulin bioassay of Ch.P.Methods The cells were diluted 25 times with 1.5 × 108 L-1 cell density plates and 1 500 μmol·L-1 insulin glargine,and then diluted with a 3-fold gradient se-ries.The cells were stimulated in microporous plates for 20 min.After fixation,permeation and antibody incubation.Quantitative immunofluorescence biological activity was detected by odyssey two-color infrared fluorescence imaging system.Results There was a good dose-effect relationship between the concentration of insulin glargine in ICW and its relative potency.The method had good specificity,and the relative accuracy,intermediate preci-sion and linearity met the requirements.The relative deviation of biological activity results of 7 batches of insulin glargine samples measured by the two methods was less than 10％.The results were analyzed by SPSS and SAS software,which showed that the methods were correlated and equivalent.Conclusions The quantitative immunofluorescence assay for the biological activity of insulin glargine can be established.The method has good spe-cificity,high accuracy and precision,and has correlation and e-quivalent with biotiter assay,which can be applied to in vitro ef-ficacy evaluation and quality control of insulin glargine.

Objective:To explore the role of NK cells in allogeneic hematopoietic stem cell micro-transplantation(MST)in the treatment of patients with acute myeloid leukemia(AML).Methods:Data from 93 AML patients treated with MST at our center from 2013-2018 were retrospectively analyzed.The induction regimen was anthracycline and cytarabine combined with peripheral blood stem cells transplantation mobilization by granulocyte colony stimulating factor(GPBSC),followed by 2-4 courses of intensive treatment with medium to high doses of cytarabine combined with GPBSC after achieving complete remission(CR).The therapeutic effects of one and two courses of MST induction therapy on 42 patients who did not reach CR before transplantation were evaluated.Cox proportional hazards regression analysis was used to analyze the impact of donor NK cell dose and KIR genotype,including KIR ligand mismatch,2DS1,haplotype,and HLA-Cw ligands on survival prognosis of patients.Results:Forty-two patients received MST induction therapy,and the CR rate was 57.1％after 1 course and 73.7％after 2 courses.Multivariate analysis showed that,medium and high doses of NK cells was significantly associated with improved disease-free survival(DFS)of patients(HR=0.27,P=0.005;HR=0.21,P=0.001),and high doses of NK cells was significantly associated with improved overall survival(OS)of patients(HR=0.15,P=0.000).Donor 2DS1 positive significantly increases OS of patients(HR=0.25,P=0.011).For high-risk patients under 60 years old,patients of the donor-recipient KIR ligand mismatch group had longer DFS compared to the nonmismatch group(P=0.036);donor 2DS1 positive significantly prolonged OS of patients(P=0.009).Conclusion:NK cell dose,KIR ligand mismatch and 2DS1 influence the therapeutic effect of MST,improve the survival of AML patients.

Objective:The purpose of this study is to explore in depth the mechanism of the impact of brain drain on organizational cohesion,with a view to cracking the vicious circle problem caused by brain drain in the northeast region and eliminating the unfavorable factors affecting the core cohesion of public health institutions.Methods:A combination of convenience sampling and snowball sampling was used to survey11 912 valid questionnaires,and the data were systematically analyzed using descriptive statistics,regression analysis,and moderated mediated effects analysis.Results:Brain drain has a significant negative effect on organizational cohesion(β=-1.29,P<0.001);and role overload partially mediates between the two,with a significant mediating effect(effect value=-0.56,95%CI=-0.67～-0.46),and the indirect effect accounts for 43.4%of the total effect;and monthly income significantly moderates the effect of brain drain on organizational cohesion through role overload(β=1.00,P<0.001).Conclusion:It is recommended to alleviate the sense of role overload among public health personnel by adjusting the level of salary and benefits,and to reduce the negative impact of brain drain by adopting long-term incentive mechanisms and other strategies,thus enhancing organizational cohesion and providing theoretical and practical guidance for relevant institutions.

Objective:To explore the application effect of nano-carbon in single port laparo-scopic transanal total mesorectal resection in the treatment of low rectal cancer.Methods:A total of 96 patients underwent single-port laparoscopic transanal mesorectal resection were selected and randomly divided into observation group(preoperative nano-carbon suspension injection)and control group,48 cases in each group based on the random number table method.After the operation,the number of lymph nodes dissected was recorded,and the number of dark-stained lymph nodes was detected,and pathological examination was performed to confirm the metastasis of each lymph node.Results:The average number of lymph nodes detected in the observation group(18.46±3.52 vs 10.63±1.95)was significantly higher than that in the control group,and the difference was statis-tically significant(P＜0.05).The rate of lymph node metastasis detected in the observation group(12.19％)was higher than that in the control group(9.41％),but the difference between the two groups was not statistically significant(P＞0.05).The metastasis rate of black-stained lymph nodes(88/611,14.40％)was significantly higher than that of non-stained lymph nodes(20/275,6.18％)and the control group(48/510,9.41％),and the difference was statistically significant(x2=9.007,6.495,P=0.003,0.011).Conclusion:Preoperative application of nano-activated carbon suspension injec-tion can increase the number of lymph nodes and the detection rate of lymph node metastasis in pa-tients undergoing single-port laparoscopic transanal mesorectal resection,which can ensure the ac-curacy of pathological staging.It can be used in clinical rectal cancer.The treatment is of guiding sig-nificance.

Objective:To investigate the relationship between non-alcoholic fatty liver disease(NAFLD) and hepatic fibrosis and skeletal muscle mass in patients with type 2 diabetes mellitus(T2DM).Methods:A total of 685 T2DM patients diagnosed at the Endocrinology department of Lanzhou University First Hospital, from April 2022 to May 2023, were divided into NAFLD and Non-NAFLD groups, and the NAFLD group was further categorized into fibrosis and non-fibrosis based on aspartate aminotransferase(AST) /alanine aminotransferase(ALT) level. The differences in appendicular skeletal muscle mass(ASM), appendicular skeletal muscle mass index(ASMI), and the prevalence of muscle mass loss were compared across groups. The correlations between ASMI and NAFLD, as well as liver fibrosis were analyzed by binary logistic regression.Results:Among male T2DM patients, those with NAFLD had lower ASMI levels and a higher prevalence of muscle mass reduction compared to non-NAFLD group. Among female T2DM patients, those with NAFLD had lower levels of ASM and ASMI, and a higher prevalence of muscle mass reduction compared to non-NAFLD group. ASMI levels in both male and female T2DM patients were independently negatively correlated with NAFLD risk( OR=-0.696, 95% CI 0.579-0.837; OR=-0.757, 95% CI 0.629-0.911). In NAFLD patients, ASM and ASMI levels were lower in those with liver fibrosis compared to those without fibrosis; however, the prevalence of muscle mass reduction did not differ significantly. Among male NAFLD patients, ASMI levels were independently negatively correlated with the risk of liver fibrosis( OR=-0.726, 95% CI 0.537-0.983), while no correlation was found in female patients. Conclusion:Reduced muscle mass is independently associated with the risk of NAFLD in both male and female T2DM patients. In males, reduced muscle mass is also independently related to the risk of liver fibrosis.

Objective:To evaluate the application of digital visualization in preoperative planning for surgical clearance of vertebral infection lesions following percutaneous vertebroplasty (PVP).Methods:A retrospective study was conducted to analyze the 13 patients with infectious spondylitis following PVP who had undergone one-stage posterior debridement and interbody bone grafting combined with instrumentation at Department of Spinal Surgery, Zhengzhou Orthopaedics Hospital from January 2016 to December 2022. They were 4 males and 9 females with an age of (71.4±6.5) years. Before surgery, the CT raw data of the patients were imported into software Mimics to reconstruct a three-dimensional model of the spine. After the distribution of bone cement in the model and its relationships with the vertebral plate, pedicle, articular process, and spinal cord were observed, a safe area for spinal canal surgery was designed. Intraoperative operations were carried out according to the preoperative planning. Surgical time, intraoperative blood loss, improvements in American Spinal Injury Association (ASIA) grading, and postoperative complications were recorded. The therapeutic efficacy was evaluated by comparisons of erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), visual analogue scale (VAS), and Oswestry disability index (ODI) between preoperation, 2 weeks and 3 months postoperation, and the last follow-up.Results:Surgery went on successfully in all the 13 patients according to the preoperative planning. The surgical time was (275.9±28.3) min and the intraoperative blood loss (865.4±183.0) mL. All patients were followed up for (24.7±9.4) months. The levels of ESR, CRP, VAS, and ODI at 2 weeks, 3 months and the last follow-up were significantly lower than those before surgery ( P<0.05). At the last follow-up, X-ray and CT examinations showed good positions of internal fixation and sufficient bone graft fusion. The ASIA grading recovered from preoperative D to E in 5 patients. No incision infection, sinus formation, worsening of neurological symptoms, loosening or rupture of internal fixation, or worsening of neurological dysfunction were found. Conclusion:With the assistance of 3D visualization, the spinal cord, bone cement, and debridement area can be visualized directly to reduce nerve injury complications so that a safe and effective preoperative planning can be made for surgical clearance of vertebral infection lesions following PVP.

Objective:To investigate the value of quantitative ultrashort-echo-time (UTE) adiabatic T 1ρ (AdiabT 1ρ) in the diagnosis of articular cartilage degeneration of knee. Methods:A prospective case-control study was used. From March 2023 to September 2024, 30 healthy volunteers and 50 patients with osteoarthritis (OA) were recruited in the Second Affiliated Hospital, South China University of Technology and the Fifth Affiliated Hospital of Sun Yat-sen University. The unilateral knee joints were scanned by using three-dimensional (3D) UTE-Cones-AdiabT 1ρ sequence. The articular cartilages of knee were divided into 13 subregions slice by slice, with a total of 3 837 subregions. The whole-organ magnetic resonance-imaging score (WORMS) was evaluated in each subregion. According to the extent of lesions, the subregions cartilages were divided into normal group (WORMS 0, 2 589 subregions), localized lesion group (WORMS 1, 2, 2.5, 911 subregions) and diffuse lesion group (WORMS 3, 4, 5, 337 subregions). According to the depth of lesions, they were divided into normal group (WORMS 0, 2 589 subregions), partial cartilage layer lesions group (WORMS 1, 2, 3, 4, 1 108 subregions) and full-thickness lesion group (WORMS 2.5, 5, 140 subregions). WORMS 1 was early cartilage degeneration. The Kellgren-Lawrence (KL) grade of the knee joints was assessed and divided into normal group (KL grade 0, 1 323 subregions), suspicious or mild OA group (KL grades 1 and 2, 1 738 subregions), and moderate or severe OA group (KL grades 3 and 4, 776 subregions). The UTE-Cones-AdiabT 1ρ values and curves for each subregion were obtained by Matlab 2017b software. The ANOVA was used to compare the differences in UTE-Cones-AdiabT 1ρ between different WORMS groups and KL groups. Spearman correlation analysis was used to evaluate the correlation between UTE-Cones-AdiabT 1ρ and WORMS and KL groups. The receiver operating characteristic curve and area under the curve (AUC) were used to determine the efficacy of UTE-Cones-AdiabT 1ρ in diagnosing early cartilage degeneration and suspicious or mild OA. Results:Both normal volunteers and OA patients were able to obtain good cartilage images and well-fitting UTE-Cones-AdiabT 1ρ curves. There were 2 589, 569, 277, 65, 199, 63 and 75 cartilage subregions with WORMS scores of 0, 1, 2, 2.5, 3, 4 and 5, respectively, and the UTE-Cones-AdiabT 1ρ values were (36.1±5.1), (41.5±5.2), (42.3±5.3), (45.2±6.3), (43.0±5.2), (44.1±5.4) and (47.5±5.7) ms, respectively. The difference was statistically significant ( F=161.63, P<0.001). There was a statistically significant difference in UTE-Cones-AdiabT 1ρ among normal group, localized lesion group and diffuse lesion group ( F=450.92, P<0.001), and there was a significant difference in UTE-Cones-AdiabT 1ρ value among normal group, partial cartilage lesion group and full-thickness lesion group ( F=479.13, P<0.001). There was a statistically significant difference in UTE-Cones-AdiabT 1ρ among the normal group, the suspected or mild OA group, and the moderate or severe OA group ( F=36.91, P<0.001). The UTE-Cones-AdiabT 1ρ values in all subregions were positively correlated with WORMS and KL grades ( r=0.55, P<0.001; r=0.26, P<0.001). The AUC of UTE-Cones-AdiabT 1ρ in the diagnosis of early cartilage degeneration was 0.773 (95% CI 0.750-0.796), and the AUC in the diagnosis of suspicious or mild OA was 0.580 (95% CI 0.560-0.601). Conclusion:3D UTE-Cones-AdiabT 1ρ is positively correlated with the degree of cartilage degeneration, which can quantitatively evaluate cartilage degeneration and has the value of early diagnosis of articular cartilage degeneration.

A derivatizaton method combined with gas chromatography-mass spectrometry(GC-MS)was established for detection of isobutyl chloroformate(IBCF)residue in active pharmaceutical ingredient of agatroban.The extraction and derivatization reagents,derivatization time,qualitative and quantitative ions were selected and optimized,respectively.The possible mechanism of derivatization and characteristic fragment ions fragmentation were speculated.The agatroban samples were dissolved and extracted by methanol,and the residual IBCF was derived with methanol to generate methyl isobutyl carbonate(MIBCB).After 24 h static derivatization at room temperature,IBCF was completely transformed into MIBCB,which could be used to indirectly detect IBCF accurately.The results showed that the linearity of this method was good in the range of 25-500 ng/mL(R2=0.9999).The limit of detection(LOD,S/N=3)was 0.75 μg/g,and the limit of quantification(LOQ,S/N=10)was 2.50 μg/g.Good recoveries(95.2%-97.8%)and relative standard deviations(RSDs)less than 3.1%(n=6)were obtained from agatroban samples at three spiked levels of IBCF(2.50,25.00,50.00 μg/g),which showed good accuracy of this method.Good precision of detection results was obtained by different laboratory technicians at different times,the mean value of spiked sample solution(25.00 μg/g)was 24.28 μg/g,and the RSD was 2.1%(n=12).The durability was good,minor changes of detection conditions had little effect on the results.Under the original condition and conditions with initial column temperature±5℃,heating rate±2℃/min,column flow rate±0.1 mL/min,the IBCF content of spiked sample solution(25.00 μg/g)was detected,the mean value of detection results was 24.16 μg/g,and the RSD was 2.2%(n=7).Eight batches of agatroban samples from two manufacturers were detected using the established method,and the results showed that no IBCF residue was detected in any of these samples.The agatroban samples could be dissolved by methanol,and then the IBCF residue could be simultaneously extracted and derived with methanol as well.This detection method had the advantages of simple operation,high sensitivity,low matrix effect and accurate quantification,which provided a new effective method for detection of IBCF residue in agatroban.