Objective:To analyze the relationship between tumor-associated immune cells and cytokines with papillary thyroid carcinoma (PTC) and explore the correlation between tumor-associated immune cells and the risk stratification of PTC recurrence.Methods:A total of 58 PTC patients diagnosed by surgical pathology from Aug. 2022 to Aug. 2023 in the General Surgery and Thyroid and Hernia Department of Tianjin Medical University General Hospital were selected. All patients underwent thyroidectomy combined with central or lateral cervical lymph node dissection. According to lymph node metastasis status, patients were divided into lymph node metastasis-negative (22 cases) and lymph node metastasis-positive groups (36 cases) based on post-operative pathological diagnosis. Flow cytometry was used to detect the levels of tumor-associated immune cells (T, B, NK cells) and cytokines (IL-10, IL-17, IL-35, IFN-γ) in T cells.Results:Compared to normal tissue located distant from the cancer, a significant increase in the proportion of NK cells was observed in cancerous tissue ( t=-2.11, P=0.032). Similarly, the proportion of CD8+ T cells was also significantly elevated ( t=-5.12, P=0.005). In lymph node tissue, the proportion of CD4+ T cells in LNM-positive tissue was significantly higher than in LNM-negative tissue ( t=-3.89, P=0.004), while the proportion of CD8+ T cells exhibited a significant decrease ( t=2.41, P=0.004). Additionally, the levels of IL-10 in cancerous tissue were significantly elevated ( t=-3.83, P=0.003), as were the levels of IL-17 ( t=-4.83, P=0.003). In lymph node tissues categorized by LNM status, although not statistically significant, the levels of IL-10 and IL-17 were generally higher in LNM-positive cases compared to LNM-negative cases. Among the 58 cases stratified by recurrence risk, 22 cases (37.9%) were classified as low-risk, while 36 cases (62.1%) were classified as intermediate-risk. The differences in the proportions of CD4+ T and CD8+ T cell subsets in the lymph nodes of PTC patients were statistically significant. Logistic regression analysis indicated that a higher proportion of CD4+ T cell subsets in the lymph nodes of PTC patients was associated with a higher recurrence risk stratification compared to those with a lower proportion ( OR=1.107, 95% CI: 1.001-1.224). Using the predicted probability as the test variable and "low and medium risk" as the state variable, a ROC curve was constructed, yielding an AUC of 0.790 with P=0.003, indicating a good predictive effect of the model on the dependent variable. Conclusions:Compared to normal tissues located distant from cancerous regions, cancer tissues exhibit a significantly elevated proportion of tumor-associated immune cells and cytokine levels, thereby creating an immunosuppressive tumor microenvironment. Additionally, patients with papillary thyroid carcinoma (PTC) who are classified as having a higher risk of recurrence demonstrate a greater proportion of CD4+ T cell subsets in their lymph nodes.

Hyperparathyroidism-jaw tumor syndrome (HPT-JT) is a rare familial autosomal dominant genetic disease with primary hyperparathyroidism, jaw tumors, kidney tumors and uterine tumors caused by cell division cycle 73 (CDC73) germline mutations. A 42-year-old male patient was admitted for pancreatitis and further examination revealed elevated PTH at 54.00pmol/L and a history of jaw tumors. This patient was diagnosed as HPT-JT finally and underwent upper right, lower right, and upper left parathyroid glands resection and genetic testing. Postoperative pathology revealed that atypical adenomatous nodules of parathyroid glands with extensive atypia and nucleus division and parathyroid hyperplasia and whole exome sequencing suggested that the CDC73 mutation.

Objective:To reveal the coupling mechanism of beam temporal profile and tissue oxygen content on radical kinetics, further explain the potential biological basis of the FLASH effect, and provide a reference for beam optimization and treatment planning design of FLASH radiotherapy (FLASH-RT).Methods:TOPAS-nBio v3.0 was used to simulate the physical and chemical processes of electron beams in water, and a full-scale kinetic model was established covering the generation, diffusion, reaction, and quenching of free radicals such as hydroxyl radical (·OH) and hydrated electrons (e aq-). Under different beam temporal profiles (single pulse, multi-pulses, continuous wave irradiation) and different oxygen concentration conditions, the evolution dynamics of free radicals were systematically simulated. At the same time, the data on e aq- content were obtained by experimental measurement of laser absorption spectroscopy to verify the accuracy of the model prediction. Results:The changing trend of e aq- concentration measured in the experiment was highly consistent with the simulation result, verifying the reliability of the constructed model. The beam time structure had a significant impact on the peak value and duration of free radical concentration. The single-pulse structure can cause the free radicals to rapidly increase and then quickly quench in a short time, while the continuous or long-pulse structure can cause the radical concentration to remain at a high level for a long time. The evolution of ·OH was not sensitive to the oxygen environment, while e aq- are greatly affected by the oxygen environment. The scavenging efficiency of free radicals in a hypoxic environment was significantly decreased, leading to an enhanced accumulation of oxidative damage to biological macromolecules. The lifespan of e aq- in an oxygen-rich environment decreased rapidly. Conclusions:Radical kinetics are regulated by both the beam temporal profile and oxygen content. FLASH-RT can utilize single-pulse or multi-pulses intervals to form periodic windows, reducing normal tissue damage by efficiently scavenging free radicals through antioxidants, while free radicals in tumor tissues continuously accumulate and amplify damage, thus generating a selective protective effect.

Objective:To analyze the relationship between tumor-associated immune cells and cytokines with papillary thyroid carcinoma (PTC) and explore the correlation between tumor-associated immune cells and the risk stratification of PTC recurrence.Methods:A total of 58 PTC patients diagnosed by surgical pathology from Aug. 2022 to Aug. 2023 in the General Surgery and Thyroid and Hernia Department of Tianjin Medical University General Hospital were selected. All patients underwent thyroidectomy combined with central or lateral cervical lymph node dissection. According to lymph node metastasis status, patients were divided into lymph node metastasis-negative (22 cases) and lymph node metastasis-positive groups (36 cases) based on post-operative pathological diagnosis. Flow cytometry was used to detect the levels of tumor-associated immune cells (T, B, NK cells) and cytokines (IL-10, IL-17, IL-35, IFN-γ) in T cells.Results:Compared to normal tissue located distant from the cancer, a significant increase in the proportion of NK cells was observed in cancerous tissue ( t=-2.11, P=0.032). Similarly, the proportion of CD8+ T cells was also significantly elevated ( t=-5.12, P=0.005). In lymph node tissue, the proportion of CD4+ T cells in LNM-positive tissue was significantly higher than in LNM-negative tissue ( t=-3.89, P=0.004), while the proportion of CD8+ T cells exhibited a significant decrease ( t=2.41, P=0.004). Additionally, the levels of IL-10 in cancerous tissue were significantly elevated ( t=-3.83, P=0.003), as were the levels of IL-17 ( t=-4.83, P=0.003). In lymph node tissues categorized by LNM status, although not statistically significant, the levels of IL-10 and IL-17 were generally higher in LNM-positive cases compared to LNM-negative cases. Among the 58 cases stratified by recurrence risk, 22 cases (37.9%) were classified as low-risk, while 36 cases (62.1%) were classified as intermediate-risk. The differences in the proportions of CD4+ T and CD8+ T cell subsets in the lymph nodes of PTC patients were statistically significant. Logistic regression analysis indicated that a higher proportion of CD4+ T cell subsets in the lymph nodes of PTC patients was associated with a higher recurrence risk stratification compared to those with a lower proportion ( OR=1.107, 95% CI: 1.001-1.224). Using the predicted probability as the test variable and "low and medium risk" as the state variable, a ROC curve was constructed, yielding an AUC of 0.790 with P=0.003, indicating a good predictive effect of the model on the dependent variable. Conclusions:Compared to normal tissues located distant from cancerous regions, cancer tissues exhibit a significantly elevated proportion of tumor-associated immune cells and cytokine levels, thereby creating an immunosuppressive tumor microenvironment. Additionally, patients with papillary thyroid carcinoma (PTC) who are classified as having a higher risk of recurrence demonstrate a greater proportion of CD4+ T cell subsets in their lymph nodes.

Hyperparathyroidism-jaw tumor syndrome (HPT-JT) is a rare familial autosomal dominant genetic disease with primary hyperparathyroidism, jaw tumors, kidney tumors and uterine tumors caused by cell division cycle 73 (CDC73) germline mutations. A 42-year-old male patient was admitted for pancreatitis and further examination revealed elevated PTH at 54.00pmol/L and a history of jaw tumors. This patient was diagnosed as HPT-JT finally and underwent upper right, lower right, and upper left parathyroid glands resection and genetic testing. Postoperative pathology revealed that atypical adenomatous nodules of parathyroid glands with extensive atypia and nucleus division and parathyroid hyperplasia and whole exome sequencing suggested that the CDC73 mutation.

This article reviews the diagnosis, therapeutic approaches, and subsequent care for a patient with a complex, long-standing history of encapsulating peritoneal sclerosis (EPS). A 40-year-old male, who had been on peritoneal dialysis (PD) for 11 years, encountered refractory peritonitis, leading to the removal of PD catheter and the subsequent diagnosis of EPS. The patient was transitioned to hemodialysis (HD) and prescribed tamoxifen to mitigate peritoneal fibrosis. After 4 months on HD, the patient underwent a kidney transplant, but acute rejection episode caused the transplanted kidney to fail 3 months postoperatively, necessitating a return to HD. Over the past 7 years, the patient has been repeatedly hospitalized due to recurrent bowel obstructions and infected abdominal fluid accumulation. A multidisciplinary approach, including anti-infective therapy, gastrointestinal intervention, nutritional support, and psychological care, has been instrumental in managing symptoms, and sustaining life. This case underscores the importance of recognizing EPS in long-term PD patients with peritonitis. While discontinuing PD, switching to HD, or receiving kidney transplantation do not halt the progression of EPS, optimized comprehensive management can extend the patient's survival.

Dental treatments for children and adolescents have unique clinical characteristics that differ from dental care for adults in terms of children's physiology, psychology, and behavior. These differences impose specific requirements on the application of local anesthesia in pediatric dental procedures. This article presents expert consensus on the principles of local anesthesia techniques in pediatric dental therapies, including the use of common anesthetic drugs and dosage control, safety and efficacy evaluation, and prevention and management of complications. The aim is to improve the safety and quality of pediatric dental treatments and offer guidance for clinical application by dentists.
Humans ; Child ; Anesthesia, Local/methods* ; Consensus ; Anesthesia, Dental/methods* ; Adolescent ; Anesthetics, Local/administration & dosage* ; Dental Care for Children

Objective: To investigate the effect of receptor of activated protein kinase C 1 ( RACK1) on lipopo- lysaccharide ( LPS) -induced barrier function in rat pulmonary microvascular endothelial cells ( RPMVEC) and its interplay with the Sonic hedgehog ( SHH) signaling pathway． Methods: RPMVEC were cultured in vitro and ran- domly divided into si-NC，si-NC + LPS，si-RACK1，si-RACK1 + LPS，si-RACK1 + LPS + Vismodegib and Vis- modegib + SAG groups．The RACK1 of RPMVEC was silenced by small interfering RNA ( siRNA) technology and the cells were treated with LPS ( 10 mg / L) ，SHH signaling pathway inhibitor ( Vismodegib) ( 20 μmol / L) and SHH signaling pathway agonist ( SAG) ( 1 μmol / L) ．Following the intervention，the expressions of RACK1 and caveolin-1 in RPMVEC were detected by immunofluorescence ，while the transendothelial electrical resistance ( TEER) was evaluated using the method of Transwell，and the expression levels of RACK1，glioma-associated on- cogene homolog 1 ( Gli-1) and caveolin-1 were detected by Western blot． Results: Silencing RACK1 increased the TEER value of RPMVEC induced by LPS ( P＜0. 05) ．The expression of caveolin-1 decreased ( P＜0. 05) ，and the expression of Gli-1 increased ( P ＜0. 05) ．Inhibiting the SHH signaling pathway could reverse the increased TEER value of LPS-induced RPMVEC caused by silencing RACK1 ( P ＜0. 05) ，and the expressions of RACK1 and caveolin-1 increased ( P＜0. 05) ．Activation of the SHH signaling pathway increased the TEER value of LPS- induced RPMVEC caused by silencing RACK1 ( P ＜0. 05) ，and the expressions of RACK1 and caveolin-1 de- creased ( P＜0. 05) ． Conclusion RACK1 plays a role in LPS-induced hyperpermeability of RPMVEC，and its effect may be achieved by modulating the SHH signaling pathway and caveolin-1．

This article reviews the diagnosis, therapeutic approaches, and subsequent care for a patient with a complex, long-standing history of encapsulating peritoneal sclerosis (EPS). A 40-year-old male, who had been on peritoneal dialysis (PD) for 11 years, encountered refractory peritonitis, leading to the removal of PD catheter and the subsequent diagnosis of EPS. The patient was transitioned to hemodialysis (HD) and prescribed tamoxifen to mitigate peritoneal fibrosis. After 4 months on HD, the patient underwent a kidney transplant, but acute rejection episode caused the transplanted kidney to fail 3 months postoperatively, necessitating a return to HD. Over the past 7 years, the patient has been repeatedly hospitalized due to recurrent bowel obstructions and infected abdominal fluid accumulation. A multidisciplinary approach, including anti-infective therapy, gastrointestinal intervention, nutritional support, and psychological care, has been instrumental in managing symptoms, and sustaining life. This case underscores the importance of recognizing EPS in long-term PD patients with peritonitis. While discontinuing PD, switching to HD, or receiving kidney transplantation do not halt the progression of EPS, optimized comprehensive management can extend the patient's survival.

Objective:To reveal the coupling mechanism of beam temporal profile and tissue oxygen content on radical kinetics, further explain the potential biological basis of the FLASH effect, and provide a reference for beam optimization and treatment planning design of FLASH radiotherapy (FLASH-RT).Methods:TOPAS-nBio v3.0 was used to simulate the physical and chemical processes of electron beams in water, and a full-scale kinetic model was established covering the generation, diffusion, reaction, and quenching of free radicals such as hydroxyl radical (·OH) and hydrated electrons (e aq-). Under different beam temporal profiles (single pulse, multi-pulses, continuous wave irradiation) and different oxygen concentration conditions, the evolution dynamics of free radicals were systematically simulated. At the same time, the data on e aq- content were obtained by experimental measurement of laser absorption spectroscopy to verify the accuracy of the model prediction. Results:The changing trend of e aq- concentration measured in the experiment was highly consistent with the simulation result, verifying the reliability of the constructed model. The beam time structure had a significant impact on the peak value and duration of free radical concentration. The single-pulse structure can cause the free radicals to rapidly increase and then quickly quench in a short time, while the continuous or long-pulse structure can cause the radical concentration to remain at a high level for a long time. The evolution of ·OH was not sensitive to the oxygen environment, while e aq- are greatly affected by the oxygen environment. The scavenging efficiency of free radicals in a hypoxic environment was significantly decreased, leading to an enhanced accumulation of oxidative damage to biological macromolecules. The lifespan of e aq- in an oxygen-rich environment decreased rapidly. Conclusions:Radical kinetics are regulated by both the beam temporal profile and oxygen content. FLASH-RT can utilize single-pulse or multi-pulses intervals to form periodic windows, reducing normal tissue damage by efficiently scavenging free radicals through antioxidants, while free radicals in tumor tissues continuously accumulate and amplify damage, thus generating a selective protective effect.