Objective To explore the infection status and clinical characteristics of human parvovirus B19 (HPV-B19) in patients with hematological disease. Methods A total of 94 patients with benign hematological disease, 128 patients with hematological malignancy, and 89 healthy individuals at Shanghai Eighth People’s Hospital from February 2019 to February 2020 were selected. The levels of specific IgM and nucleic acid of HPV-B19 in the plasma were detected using ELISA and PCR. The infection rates among the 3 groups and clinical characteristics between HPV-B19 positive and negative patients with hematological disease were compared. Results The positive rate of HPV-B19 IgM was 9.6% (9/94), the positive rate of nucleic acid was 11.7% (11/94), and the overall infection rate of HPV-B19 (IgM and/or nucleic acid positive) was 14.9% (14/94) in benign group of patients. The positive rate of HPV-B19 IgM was 18.0% (23/128), the positive rate of nucleic acid was 19.5% (25/128), and the overall infection rate of HPV-B19 was 26.6% (34/128) in malignant group of patients. The positive rate of HPV-B19 IgM was 1.1% (1/89), the positive rate of nucleic acid was 2.2% (2/89), and the overall infection rate of HPV-B19 was 2.2% (2/89) in healthy controls. The overall HPV-B19 infection rate in benign group of patients was higher than that in healthy controls (P＝0.006). The overall HPV-B19 infection rate was higher in malignant group of patients than that in benign group of patients (P＝0.037) and healthy controls (P＜0.001). In the benign group, the HPV-B19 infection rates in patients with pure red cell aplasia (PRCA), autoimmune hemolytic anemia (AIHA), immune thrombocytopenic purpura (ITP), and aplastic anemia (AA) were higher, with 44.4% (4/9), 27.3% (3/11), 25.0% (4/16), and 21.4% (3/14), respectively. In the malignant group, the HPV-B19 infection rates in patients with non-Hodgkin lymphoma (NHL) and chronic lymphocytic leukemia (CLL) were higher, with 42.9% (9/21) and 37.5% (6/16), respectively. The HPV-B19 positive patients in both hematological disease groups were older (P＜0.05). In patients with NHL, CLL or multiple myeloma (MM), HPV-B19 infection decreased the reticulocyte ratio (P＜0.05); in patients with NHL, acute myeloid leukemia (AML) or acute lymphoblastic leukemia (ALL), HPV-B19 infection prolonged bone marrow suppression time after chemotherapy (P＜0.05). Conclusions HPV-B19 infection rate in patients with hematological disease is elevated and HPV-B19 infection may influence the condition and treatment efficiency of these patients.

This review aimed to provide a comprehensive analysis of the etiology, epidemiology, pathology, and conventional treatment of heterotopic ossification (HO), especially emerging potential therapies. HO is the process of ectopic bone formation at non-skeletal sites. HO can be subdivided into two major forms, acquired and hereditary, with acquired HO predominating. Hereditary HO is a rare and life-threatening genetic disorder, but both acquired and hereditary form can cause severe complications, such as peripheral nerve entrapment, pressure ulcers, and disability if joint ankylosis develops, which heavily contributes to a reduced quality of life. Modalities have been proposed to treat HO, but none have emerged as the gold standard. Surgical excision remains the only effective modality; however, the optimal timing is controversial and may cause HO recurrence. Recently, potential therapeutic strategies have emerged that focus on the signaling pathways involved in HO, and small molecule inhibitors have been shown to be promising. Moreover, additional specific targets, such as small interfering RNAs (siRNAs) and non-coding RNAs, could be used to effectively block HO or develop combinatorial therapies for HO.
Humans ; Ossification, Heterotopic/genetics*

BACKGROUND: Neoadjuvant therapeutic strategies play a pivotal role in the comprehensive treatment of non-small cell lung cancer (NSCLC). However, lung squamous cell carcinoma (SCC) generally exhibits a more favorable response to neoadjuvant therapy compared with lung adenocarcinoma (ADC). The aim of this study is to elucidate how baseline cancer-associated fibroblasts (CAFs) and tumor-associated endothelial cells (TAECs) influence the differential therapeutic outcomes of neoadjuvant treatment in SCC versus ADC. METHODS: We retrospectively collected pretreatment biopsy samples from 104 patients with stage II-III NSCLC who underwent neoadjuvant chemotherapy (NAC) or neoadjuvant chemoimmunotherapy (NAIC) at Shandong Cancer Hospital between January 1, 2018 and December 31, 2023. Tissue microarrays were constructed using an automated arrayer, and multiplex immunofluorescence staining (α-SMA/CD31/CK/DAPI) was performed to identify CAFs (α-SMA+/CK-) and TAECs (CD31+/CK-). Quantitative analyses included CAFs and TAECs densities, the nearest neighbor distance (NND) between CAFs and TAECs, and their spatial proximity (30 μm). Differences in major pathological response (MPR) between groups, defined as residual viable tumor cells ≤10% in resected specimens after neoadjuvant therapy, were assessed using the χ² test. The Mann-Whitney U test was applied to analyze intergroup differences in quantitative indicators, and receiver operating characteristic (ROC) curve analysis was conducted to evaluate the predictive performance of immune-related markers for MPR in the NAIC cohort. RESULTS: Among the 104 NSCLC patients who received neoadjuvant therapy, 35 underwent NAIC and 69 received NAC. Overall, patients with SCC were more likely to achieve MPR compared with those with ADC (50.0% vs 22.4%, P=0.006). This trend persisted in the NAIC subgroup (72.7% vs 30.8%, P=0.038), whereas no significant difference in MPR rates was observed between SCC and ADC in the NAC subgroup. At baseline, prior to NAIC or NAC, programmed cell death ligand 1 (PD-L1)/programmed cell death 1 (PD-1) expression, CAFs and TAECs densities, CAFs-TAECs NND, and CAFs-TAECs proximity (30 μm) showed no significant differences between SCC and ADC. In patients with SCC receiving NAIC, baseline PD-L1/PD-1 expression, CAFs density, and TAECs density showed not significant differences between MPR and NMPR groups. However, the CAFs-TAECs distance was significantly greater in the MPR group (NND: 31.2 vs 24.7 μm, P=0.038), and the number of TAECs within 30 μm of CAFs was significantly lower (proximity: 1.1 vs 3.6, P=0.038). Univariate Cox regression analysis indicated that low TAECs density was associated with MPR following NAIC (OR=36.00, 95%CI: 2.68-1486.88, P=0.019). Furthermore, ROC analysis demonstrated that baseline CAFs-TAECs NND and proximity (30 μm) exhibited strong predictive performance for MPR in SCC patients treated with NAIC, with an area under the curve (AUC) of 0.893, sensitivity of 0.857, and specificity of 1.000. CONCLUSIONS CAFs are more spatially distant from TAECs and more prone to MPR after NAIC in SCC, which may be related to the reduced interaction of CAFs with TAECs and reduced tumor-associated angiogenesis.
Humans ; Lung Neoplasms/therapy* ; Neoadjuvant Therapy ; Male ; Female ; Middle Aged ; Retrospective Studies ; Endothelial Cells/drug effects* ; Aged ; Cancer-Associated Fibroblasts/drug effects* ; Immunotherapy ; Carcinoma, Squamous Cell/drug therapy* ; Carcinoma, Non-Small-Cell Lung/drug therapy* ; Adult

Objective To explore the mechanism by which Sestrin2(SESN2)regulates autophagy activity of chondrocytes by mediating mammalian rapamycin target protein complex 1(mTORC1)signaling pathway.Methods The normal chondrocytes were treated with interleukin-1 β(IL-1β)to establish an osteoarthritis(OA)chondrocyte model,which was divided into the control group and the IL-1 β-treated group.Real-time quantitative PCR(qPCR)and Western blot were used to detect the expression levels of matrix metalloproteinase 13(MMP13),type Ⅱ collagen(COL2A1)and SESN2 in the two groups.The cell models of the chondrocyte overexpression SESN2 group and knockdown SESN2 group were obtained via cell transfection technology,and the expression levels of SESN2 in each group were detected by qPCR while those of SESN2,MMP13,COL2A1,mTORC1 pathway-related proteins and autophagy-related proteins in each group were detected by Western blot.The effects of SESN2 on cell proliferation and migration were detected by CCK-8 and cell scratch assay.Results(1)The expression level of MMP13 in the IL-1 β-treated group was significantly up-regulated,while the expression levels of COL2A1 and SESN2 were significantly decreased.(2)Compared with the control group,the expressions of p-mTORC1,ribosomal protein S6 kinase 1(S6K1),and MMP13 protein in OA chondrocytes in the overexpression group were significantly down-regulated,while the expressions of adenosine 5'-monophosphate(AMP)-activated protein kinase(AMPK)and chondroprotective gene COL2A1 were significantly increased,and the expression level of Beclin-1 and the ratio of microtubule associated protein 1 light chain 3-Ⅱ(LC3-Ⅱ)/(LC3-Ⅰ)were increased.Meanwhile,overexpression of SESN2 could up-regulate the proliferation and migration of chondrocytes,but the results were opposite after knockdown of SESN2.Conclusion SESN2 can enhance autophagy,proliferation and migration of chondrocytes by inhibiting mTORC1 pathway,which has provided data for revealing the pathogenesis of OA and exploring new therapeutic methods.

The use of robots to augment human capabilities and assist in work has long been an aspiration.Robotics has been developing since the 1960s when the first industrial robot was introduced.As technology has advanced,robotic-assisted surgery has shown numerous advantages,including more precision,efficiency,minimal invasiveness,and safety than is possible with conventional techniques,which are research hotspots and cutting-edge trends.This article reviewed the history of medical robot development and seminal research papers about current research progress.Taking the autonomous dental implant robotic system as an example,the advantages and prospects of medical robotic systems would be discussed which would provide a reference for future research.

Accurate segmentation of oral surgery-related tissues from cone beam computed tomography(CBCT)images can significantly accelerate treatment planning and improve surgical accuracy.In this paper,we propose a fully automated tissue segmentation system for dental implant surgery.Specifically,we propose an image preprocessing method based on data distribution histograms,which can adaptively process CBCT images with different parameters.Based on this,we use the bone segmentation network to obtain the segmentation results of alveolar bone,teeth,and maxillary sinus.We use the tooth and mandibular regions as the ROI regions of tooth segmentation and mandibular nerve tube segmentation to achieve the corresponding tasks.The tooth segmentation results can obtain the order information of the dentition.The corresponding experimental results show that our method can achieve higher segmentation accuracy and efficiency compared to existing methods.Its average Dice scores on the tooth,alveolar bone,maxillary sinus,and mandibular canal segmentation tasks were 96.5%,95.4%,93.6%,and 94.8%,respectively.These results demonstrate that it can accelerate the development of digital dentistry.

Objective:To evaluate the accuracy of 3D ultrasound calibration in image guided radiotherapy for prostate cancer by taking cone beam CT calibration as the gold standard, and to analyze the risk factors of accuracy.Methods:From December 2018 to December 2021, 51 patients with prostate cancer from the Department of Radiation Oncology, First Affiliated Hospital of Hebei North University were selected as the study subjects. They received cone beam CT calibration based on bone and 3D ultrasound calibration based on soft tissue before fraction volumetric modulated arc therapy treatment three times a week. Taking cone beam CT calibration data as the gold standard, the Bland-Altman method was used to analyze the consistency of 3D ultrasound calibration data with the former. Taking 3 mm as the allowable threshold of accuracy, the calibration accuracy of 3D ultrasound relative to cone beam CT was evaluated. Logistic regression was used to analyze the risk factors affecting the accuracy of 3D ultrasound calibration.Results:A total of 765 pairs of cone beam CT and 3D ultrasound calibration data were obtained from 51 patients in left-right, superior-inferior and anterior-posterior directions. The calibration data of 3D ultrasound and cone beam CT were (1.39±0.11) and (1.13±0.07) mm in the left-right direction, (1.98±0.20) and (1.61±0.12) mm in the superior-inferior direction, (2.68±0.48) and (1.78±0.27) mm in the anterior-posterior direction, respectively, with statistically significant differences ( t=-6.42, P<0.001; t=-7.07, P<0.001; t=-7.34, P<0.001). The analysis results of Bland-Altman showed that the consistency of calibration data of the two methods were acceptable in three directions. The number of pairs of 3D ultrasound relative to cone beam CT calibration data difference <3 mm in the three directions were 676 (88.37%) on the left-right direction, 604 (78.95%) on the superior-inferior direction, and 577 (75.42%) on the anterior-posterior direction. The factors with statistically significant differences in the left-right direction included age ( χ2=18.27, P<0.001), prostate volume ( χ2=14.55, P<0.001), Charlson comorbidity index (CCI) ( χ2=8.01, P=0.005) and field range ( χ2=11.30, P<0.001). Age ( OR=2.02, 95% CI: 1.90-3.39, P=0.010) and the field range ( OR=1.45, 95% CI: 1.18-2.55, P=0.020) were the independent risk factors affecting the accuracy of 3D ultrasound calibration in the left-right direction. The factors with statistically significant differences in the superior-inferior direction included age ( χ2=80.68, P<0.001), body mass index ( χ2=35.89, P<0.001) and field range ( χ2=40.39, P<0.001). Age ( OR=1.49, 95% CI: 1.15-2.09, P=0.021) and the field range ( OR=1.10, 95% CI: 1.01-1.90, P=0.034) were the independent risk factors affecting the accuracy of 3D ultrasound calibration in the superior-inferior direction. The factors with statistically significant differences in the anterior-posterior direction included age ( χ2=46.07, P<0.001), CCI ( χ2=47.97, P<0.001) and field range ( χ2=11.86, P=0.001). Age ( OR=1.91, 95% CI: 1.22-3.45, P=0.015) and the field range ( OR=2.89, 95% CI: 1.45-3.90, P=0.001) were the independent risk factors affecting the accuracy of 3D ultrasound calibration in the anterior-posterior direction. Conclusion:The consistency and accuracy of the calibration results of 3D ultrasound relative to cone beam CT are acceptable. It is necessary to consider the patient's age and field range to reduce the impact on accuracy before conducting 3D ultrasound calibration.

Objective:To retrospectively evaluate the clinical outcomes of autonomous dental implant robot(ADIR)assisted implant surgery in 1-year follow-up.Methods:20 patients with tooth missing underwent implantation surgery by ADIR were incuded.The plat-form deviation,apex deviation and angular deviation of the implants were analyzed.The marginal bone height and peri-implant soft tis-sue health were measured and observed immediately,6 months and 12 months after the restoration.Results:The platform deviation,apex deviation and angular deviation of 20 implants at the 3 follow-up examinations were(0.34±0.11)mm,(0.34±0.15)mm and(0.82°±0.38°),respectively.There was no significant difference in the accuracy of different implant diameter and length(P＞0.05).During the follow-up period,all implants had successful osseointegration,stable marginal bone height,and acceptable peri-implant soft tissue condition.Conclusion:The 1-year follow-up indicates that ADIR can achieve promising clinical performance.Long-term follow-up studies are still necessary for verification.

Objective:To evaluate clinical efficacy of local treatment for prostate cancer patients with bone metastases at the initial diagnosis.Methods:Clinical data of 211 prostate cancer patients with bone metastases at the initial diagnosis admitted to the First Affiliated Hospital of Soochow University from January 2014 to December 2021 were retrospectively analyzed. All patients were divided into the systemic and combined local treatment groups according to whether they received local treatment or not. Patients in the combined local treatment group were further divided into the prostatectomy and radical radiotherapy groups. According to whether they received radiotherapy, they were divided into the radiotherapy and non-radiotherapy groups. Statistical analysis was performed by SPSS 26.0 statistical software. The differences in the survival of patients among different groups were analyzed and compared by Kaplan-Meier method and log-rank test. The comparison was repeatedly conducted after the propensity score matching. Clinical characteristics and treatment factors of patients were included in Cox's proportional hazard regression model, and their relationship with survival was analyzed.Results:Compared with systemic treatment, local treatment significantly improved the 5-year clinical progression-free survival (CPFS) and 5-year overall survival (OS) ( P=0.049, 0.010). After propensity score matching was performed, patients in the local treatment group outperformed those in the systemic treatment in 5-year biochemical progression-free survival (BPFS) and 5-year OS ( P=0.036, 0.029). There were no statistically significant differences in 5-year BPFS, CPFS and OS between the prostatectomy and radical radiotherapy groups. Radiotherapy improved 5-year BPFS and 5-year OS compared with non-radiotherapy ( P=0.030, 0.020). After propensity score matching was performed, 5-year BPFS and 5-year OS in the radiotherapy group remained significantly higher than those in the non-radiotherapy group ( P=0.046, 0.047). Overall, patients who received radiotherapy were well tolerated and did not experience serious radiation-related adverse events. Radiotherapy improved 5-year OS for patients who were older than 65 years, had bone metastases confined to the pelvis and had a Gleason score of ≤ 8 ( P=0.039, 0.024, 0.036). Conclusions:Local treatment, especially radiotherapy, prolongs BPFS and OS rates in prostate cancer patients with bone metastases at first diagnosis. Radiotherapy appears to be more effective in patients of advanced age, with bone metastases confined to the pelvis and with relatively low Gleason scores.