Oral squamous cell carcinoma (OSCC) is a common head and neck malignancy. Approximately 50% to 60% of patients with OSCC are diagnosed at a locally advanced stage (clinical staging III-IVa). Even with comprehensive and sequential treatment primarily based on surgery, the 5-year overall survival rate remains below 50%, and patients often suffer from postoperative functional impairments such as difficulties with speaking and swallowing. Programmed death receptor-1 (PD-1) inhibitors are increasingly used in the neoadjuvant treatment of locally advanced OSCC and have shown encouraging efficacy. However, clinical practice still faces key challenges, including the definition of indications, optimization of combination regimens, and standards for efficacy evaluation. Based on the latest research advances worldwide and the clinical experience of the expert group, this expert consensus systematically evaluates the application of PD-1 inhibitors in the neoadjuvant treatment of locally advanced OSCC, covering combination strategies, treatment cycles and surgical timing, efficacy assessment, use of biomarkers, management of special populations and immune related adverse events, principles for immunotherapy rechallenge, and function preservation strategies. After multiple rounds of panel discussion and through anonymous voting using the Delphi method, the following consensus statements have been formulated: 1) Neoadjuvant therapy with PD-1 inhibitors can be used preoperatively in patients with locally advanced OSCC. The preferred regimen is a PD-1 inhibitor combined with platinum based chemotherapy, administered for 2-3 cycles. 2) During the efficacy evaluation of neoadjuvant therapy, radiographic assessment should follow the dual criteria of Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 and immune RECIST (iRECIST). After surgery, systematic pathological evaluation of both the primary lesion and regional lymph nodes is required. For combination chemotherapy regimens, PD-L1 expression and combined positive score need not be used as mandatory inclusion or exclusion criteria. 3) For special populations such as the elderly (≥ 70 years), individuals with stable HIV viral load, and carriers of chronic HBV/HCV, PD-1 inhibitors may be used cautiously under the guidance of a multidisciplinary team (MDT), with close monitoring for adverse events. 4) For patients with a poor response to neoadjuvant therapy, continuation of the original treatment regimen is not recommended; the subsequent treatment plan should be adjusted promptly after MDT assessment. Organ transplant recipients and patients with active autoimmune diseases are not recommended to receive neoadjuvant PD-1 inhibitor therapy due to the high risk of immune related activation. Rechallenge is generally not advised for patients who have experienced high risk immune related adverse events such as immune mediated myocarditis, neurotoxicity, or pneumonitis. 5) For patients with a good pathological response, individualized de escalation surgery and function preservation strategies can be explored. This consensus aims to promote the standardized, safe, and precise application of neoadjuvant PD-1 inhibitor strategies in the management of locally advanced OSCC patients.

Objective:To evaluate the influence of telomerase reverse transcriptase (TERT) promoter mutation on radioiodine uptake status of radioactive iodine refractory papillary thyroid cancer (RAIR-PTC) and radioiodine therapy response by analyzing the mutation frequency of TERT promoter in RAIR-PTC.Methods:A total of 37 patients with RAIR-PTC (15 males, 22 females, age (49.8±16.1) years) and 40 PTC patients with effective radioiodine therapy (13 males, 27 females, age (39.8±10.9) years) between January 2005 and June 2020 in JiangYuan Hospital Affiliated to Jiangsu Institute of Nuclear Medicine were retrospectively analyzed. TERT promoter mutation and B-Raf proto-oncogene, serine/threonine kinase (BRAF) V600E mutation of patients were observed. The differences across genotype patterns on radioiodine uptake status and therapy response were compared. The Fisher′s exact test and independent-sample t test were used for data analysis. Results:The incidence rate of TERT promoter mutation in the RAIR-PTC group was 40.54% (15/37, all C228T), which was significantly higher than that in the effective radioiodine therapy group (0, 0/40; P<0.001). No statistically significant difference was found for the mutation rate of BRAF V600E between the RAIR group (64.86%, 24/37) and the effective radioiodine therapy group (72.50%, 29/40; P=0.858). Patients with TERT promoter mutation were older ( t=3.76, P=0.001) and the non-intake rate of radioiodine in distant metastases of those patients was higher ( P=0.037). Furthermore, 2/3 of patients who received targeted therapies and 3/4 deaths had TERT promoter mutation. Among 35 patients with negative thyroglobulin antibody (TgAb), 11/14 of patients with TERT mutation had a rising stimulated thyroglobulin (sTg), while the percentage of the non-TERT mutation group was 57.1% (12/21; P=0.357). Conclusion:The TERT promoter mutation rate is significantly increased in RAIR-PTC patients and can serve as a prognostic predictor in RAIR.

Objective How to examine the function of transplanted kidney more accurately and sensitively has become a fo?cus of clinical attention.This study was to investigate the value of 99Tcm?DTPA renal dynamic imaging in evaluating the function of trans?planted kidney by glomerular filtration( GFR) after transplantation. Methods Patients were collected from August 2015 to January 2016 in Nanjing General Hospital of Nanjing Military Region. GFR was measured in 74 cases of kidney transplantation patients using the 99Tcm?DTPA renal dynamic imaging.According to the range of serum creatinine,we divided the 74 cases into two groups:the normal group( n=17) and abnormal group( n=57) . We analysed the GFR between two groups and the correlation of GFR and serum creatinine .Transplanted kidney puncture biopsy was operated in 55 patients. We analysed the pathological results and compared the GFR. Results Compared with the abnormal group (GFR=37.7±15.4 mL/min),the average GFR was higher in the normal group(GFR =61.7±15.6 mL/min)(P<0.001). The average GFR(43.2±18.4 mL/min) measured by 99Tcm?DTPA renal dynamic imaging in 74 cases was positive correlated with average serum creatinine(1.84±0.82 mg/dL)(r=-0.673, P<0.001).Compared with patients with abnormal pathological results(GFR=39.6±16.5mL/min), normal people had higher average GFR ( GFR=59. 2 ± 8. 5 mL/min ) ( P=0. 040 ) . Conclusion 99 Tcm?DTPA renal dynamic imaging can reflect the function of transplanted kidney sensitively, it is one of the noninvasive examination to monitor the function in transplanted kidney.

Objective To investigate the feasibility and accuracy of dual energy CT myocardial iodine maps in detecting acute myocardial infarction in canine model. Methods Myocardial ischemia model was made by ligaturing left anterior descending coronary arteries (LAD) after thoracotomy in six dogs, while another 3 dogs undergoing thoracotomy not ligaturing LAD as control group. Before and three hours after operation, dual-source CT (DSCT) was performed, followed by resting 99Tcm-MIBI single photon emission computed tomography myocardial perfusion imaging. Then, dogs were sacrificed, and the hearts were removed, triphenyltetrazolium chloride staining and conventional HE staining were performed. CT number of non-ischemic and ischemic regions were measured and analyzed. The wall of the left ventricle in the short axis was divided into 17 segments, the segments of myocardial perfusion defect in DSCT myocardial iodine maps, SPECT, and pathology were determined. Student t test was used to analyze the difference of CT number between infarcted and non-infarcted myocardium. Kappa test was used for the accuracy of DSCT myocardial iodine maps and SPECT in detecting myocardial ischemia according to the pathological results. Results No abnormal regions were detected using DSCT myocardial iodine maps in preoperative control and infarction group. After thoracotomy, partial sparse or defective perfusion was consistently noted in six dogs' apical anterior and partition wall in both DSCT myocardial iodine maps and SPECT. In the infarcted group, the attenuation of infarction region (34.75 ± 16.66) HU was significantly decreased compared with preoperative measurements ( 123. 18 ± 15.38 ) HU ( t = 10. 526, P ＜ 0. 01 ); decreased perfusion in the infarcted region was also noted in the DSCT myocardial iodine maps and SPECT. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of DSCT myocardial iodine maps and SPECT were 85.0% (34/40) , 84. 1% (95/113) ,65.4% (34/52) ,94. 0%(95/101) ,and 82. 5% (33/40), 90. 3% ( 102/113 ) ,75.0% (33/44) ,93.6% ( 102/109 ), respectively.Kappa values were 0. 63 and 0. 71 for the agreement of DSCT myocardial iodine maps and SPECT.Conclusion DSCT myocardial iodine maps is comparable diagnostic accuracy with rest SPECT myocardial perfusion imaging in detection of acute myocardial infarction in a canine model.

Objective To quantitatively evaluate the metabolic changes in posterior cingulated cortex and left basal ganglia in patients with liver cirrhosis before and after liver Transplantation (LT).Methods A total of 22 controls and 37 cirrhotic patients listed for LT were enrolled in the study. Brain MRS (PRESS sequence) and neuropsychological (NP) tests were performed in all subjects. Eighteen patients were followed up at 1 month and 3 month after LT. The NP parameters including number connection test-A ( NCT-A), digital symbol test (DST) and symbol digital test (SDT) were measured. MRS metabolic contents were measured automatically at posterior cingulate cortex (PCC) and left basal ganglia (LBG).Independent t-test was used to compare the parameters of NP test and MRS metabolites between the 2 groups. The changes of the parameters before and after LT were compared using analysis of variance.Pearson correlation test was also used to analysis the relationship between NP test parameters and MRS metabolites. Results ( 1 ) Before LT, significant difference of metabolites was found in the PCC between the two groups [ NAA/Cr(1.96 ±0.21, 1.73 ±0. 12), Cho/Cr(0. 65 ±0. 12,0. 83 ±0.09), mI/Cr (0.41 ±0.14,0.72±0.11), Glx/Cr(2. 37 ±0. 38,1. 92 ±0. 32) (t= -5.42,5.96,8.62,-4.72,P＜0.01)].And statistical significance also were found in LBG between the 2 groups [ Cho/Cr (0. 63 ± 0. 16,0. 77 ±0. 10), mI/Cr(0.38 ±0. 17,0.53 ±0.21), GIx/Cr(1.70 ±0.36,1.29 ±0.30), (t =3.64,3.07,-4.58 ,P ＜ 0. 01 )]. (2)Compared with controls, the patients before LT had longer NCT-A reaction time [ (58. 17 ±19. 12) s,(37.68 ±8.02) s,t =4. 14,P＜0.01], lower scores of DST (36.67 ±9.91,55.36 ±9.27,t = 4.60,P＜0.01) and SDT (31.67 ±9.49,50.73 ±8.34,t = 4.652,P＜0.01) before LT. All the scores of NP tests changed significantly at 1 and 3 month after LT compared with those before LT[ NCT-A (53.06±12.71) s,(35.72 ±5.20) s,F =33.554,P ＜0.01 ], DST(41.89 ±8. 17,54.39 ±5.69,F =85.772,P＜0.01),SDT(37.44±7.68,49.39±5.65,F=83.061,P＜0.01)]. (3) In the 18 patients who were followed, Cho/Cr [ PCC (0. 90 ± 0. 14,0. 92 ± 0. 08, F = 38. 178, P ＜ 0. 01 ); LBG (0. 81 ± 0. 08,0. 80 ±0.09,F =9.447,P ＜0.01)] and Glx/Cr [ PCC(1.86 ±0.32,1.75 ±0.25,F = 19.420, P ＜0. 01 ); LBG( 1.30 ±0. 20,1.23 ±0. 25 ,F = 17. 952,P ＜0. 01 ) ] recovered at 1 month after LT, while the mI/Cr [PCC (0.39±0.15,0.71 ±0. 10,F =75. 186,P＜0.01) ;LBG (0.47 ±0.25,0.61 ±0.27,F =8. 027, P ＜ 0. 01 ) ] recovered at 3 month after LT. (4)mI/Cr of cingulate cortex correlated significantly with NCT-A, DST and SDT (r= -0.743, 0.597, 0.615, P＜0.01 ) before LT. Conclusion Cerebral metabolic changes in patients with liver cirrhosis is reversible and MRS of the posterior cingulate cortex is a helpful method in following up the changes after LT. mI/Cr is a useful indicator to predict the brain changes of cirrhotic patients before and after LT.

Objective To analyze the radiolngical findings of mediastinal ganglioneuroma and to improve its diagnostic accuracy. Methods Imaging data of 8 cases of pathologically proven mediastinal ganglioueuroma were restrospectively analyzed. Results These tumors could occur in the anterior mediastinum, middle mediastinum or posterior mediastinum, with a preference for the posterior mediastinum (6/8). No specific clinical symptoms and signs were observed. Well-defined enlargrment of mediastinum with homogeneous density was shown on plain X-Ray. CT scanning was performed in 7 cases, including non-contrast scan alone (n = 3 ), both non-coutrast and contrast-enhanced scans ( n = 4). Round or oval shaped, well circumscribed, homogeneous or slightly heterogeneous, hypadense masses were demonstrated on non-contrast scan. Spotty calification could be found in a few cases. Homogeneous or slightly heterogeneous enhancement was seen following the intravenous injection of contrast material. Large tumors showed a tendency of wedging into the space between adjacent organs and structures, and encasing the nearby large vessels. MR without contrast was performed in 1 case. T1 WI showed isointensity to adjacent muscle, T2WI showed homogeneous hyperintensity. Multi-planar reconstruction provided more information concerning the relationship of the mass lesions with neighboring structures. Conclusion Mediastinal ganglioneuromas have some specific characterstics on imaging studies, which could assist in pre-operative diagnosis and surgical planning.

Astaxanthin is a useful pigmentation source in fish aquaculture. It has strong antioxidative activity and therefore has potential application in delaying aging and degenerative diseases in human and animals. In recent years, there is a growing demand for astaxanthin. The red yeast Xanthophyllomyces dendrorhous (called Phaffia rhodozyma before) is one of the most promising microorganisms for the commercial production of astaxanthin. During fermentation, X. dendrorhous shows the Crabtree effect. Higher glucose concentration will cause significant reductions in biomass and astaxanthin production. Therefore, fed-batch processes are particularly useful. In this paper, effects of glucose-feeding strategies on astaxanthin production by X. dendrorhous were studied. Based on the substrate inhibition model, an optimized two-stage feeding strategy for astaxanthin production of high-cell-density fermentation was proposed. Glucose concentration was first controlled at about 25 g/L during the lag phase and the early exponential phase. In such case, biomass could reach its maximum value in relatively short time. Then the glucose concentration was controlled at about 5 g/L in the later exponential phase and stationary phase. The synthesis of astaxanthin could be effectively prolonged. The results showed that the optimized two-stage feeding strategy was the best among all the feeding strategies, and could obtain the highest biomass (23.8 g/L) and astaxanthin production (29.05 mg/L), which was a significant increase (52.8% and 109% respectively) compared with a batch process.
Basidiomycota ; metabolism ; Fermentation ; Kinetics ; Models, Biological ; Xanthophylls ; biosynthesis

OBJECTIVETo investigate the effects of Huchang Qingfei concentrated pellets on the expression of E-cadherin (E-cd) in the lung tissue from mice infected with Mycoplasma pneumoniae (MP).

METHODA mice model of Mycoplasmal pneumonia (MPP) was developed by repeatedly intranasal infectious route. Transmission electronic microscope (TEM) and immunohistochemistry stain were performed to observe the pathological changes and expression of E-cd in lung tissues.

RESULTUnder TEM it was found that the cellular membrane was ruptured, mitochondria was denatured, crista was broken in the pulmonary cells of the model group; the all above parameters in Huchang medicated group were improved obviously. The immunohistochemistry test showed that strong positive brown stain of E-cd expression was found in the pulmonary epithelial cell membrane and bronchial periphery in the model group, however, in the medicated group, the E-cd expression level in the cellular membrane was decreased and the expression ratio was dropped significantly as compared with the model controls.

CONCLUSIONHuchang Qingfei concentrated pellets can inhibit the overexpression of E-cd in the lung tissue of mice with MP-infection, which may be helpful for prevention and treatment of pulmonary injury caused by MPP.

Animals ; Cadherins ; metabolism ; Cell Membrane ; metabolism ; Drug Combinations ; Drugs, Chinese Herbal ; isolation & purification ; pharmacology ; Epithelial Cells ; metabolism ; Female ; Lung ; metabolism ; pathology ; Male ; Mice ; Mycoplasma pneumoniae ; isolation & purification ; Plants, Medicinal ; chemistry ; Pneumonia, Mycoplasma ; metabolism ; microbiology ; pathology ; Random Allocation

Objective To explore resting state network in patients with hepatic cirrhosis using functional magnetic resonance imaging(fMRI).Methods 14 patients with hepatic cirrhosis and 14 healthy volunteers were included in this study.Modified Stroop task in Chinese character was used as target stimulus,block-design fMRI was used to acquire resource data.Group analysis(control epoch minus task epoch) was performed for both tasks in both groups.Results Comparing with controls,the patients with hepatic cirrhosis had abnormal deactivation mode.The absence of posterior cingulate cortex(PCC) and precuneus was present when performing incongruous word-reading task,deactivation of PCC,precuneus,and ventral medial prefrontal cortex were increased when performing incongruous color-naming task.Conclusion Cirrhosis patients have abnormal deactivation mode,the absence of PCC and precuneus is a sensitive not specific biomarker in detecting the brain changes of the patients with hepatic cirrhosis.

Objective:To observe the clinical effect of treatment of burning mouth syndrome in women by hormone replacement therapy (HRT).Methods:21 cases of climacteric women with burning mouth syndrome (BMS) were treated by HRT with nilestriol and medroxyprogesterone acetate.Another 21 cases were treated with vitamin B,C and oryzanol as the controls.The treatment and follow-up were conducted for 3～6 months.Results:The ratio of effectiveness in HRT group and control group was 85.71% and 14.27% (P