Kounis syndrome is an acute coronary syndrome triggered by an allergic reaction, which is clinically rare and frequently subject to misdiagnosis or missed diagnosis. This article presents a case report of a 70-year-old male patient who developed a rash, pruritus, and chest pain following colon polyp resection. Coronary angiography revealed occlusion of the left anterior descending artery, and blood flow was restored after stent implantation. However, the patient experienced recurrent symptoms accompanied by loss of consciousness. Drug skin tests confirmed positive reactions to chlorhexidine and fondaparinux sodium, leading to a diagnosis of type Ⅱ Kounis syndrome. By avoiding allergenic drugs and combining antihistamines with symptomatic treatment to correct myocardial ischemia, the patient′s clinical symptoms significantly improved, and he eventually recovered and was discharged from the hospital. This case underscores the importance of maintaining vigilance for this syndrome in patients with allergies accompanied by chest pain and promptly identifying and avoiding allergens.

Objective To explore the effect of dexmedetomidine on the proliferation,invasion and cell cycle of gallbladder cancer cells by regulating the C-C chemokine ligand 2(CCL2)-C-C chemokine receptor 2(CCR2)pathway.Methods GBC-SD cells were devided into the control group,the low concentration dexmedetomidine group(2 μmol/L),the high concentration dexmedetomidine group(4 μmol/L)and the high concentration dexmedetomidine+CCL2 group(4 μmol/L dexmedetomidine and 10 μg/L CCL2 protein).The clone formation experiment and Edu experiment were performed to measure cell proliferation.Transwell experiment was performed to measure cell invasion and migration.Flow cytometry was performed to measure cell cycle and apoptosis.Western blot assay was used to measure the proliferating cell nuclear antigen(PCNA),Cyclin D1,matrix metalloproteinase(MMP)-2,MMP-9,Bcl-2 associated X protein(Bax),cysteine-dependent aspartate-specific protease-3(Caspase-3),CCL2 and CCR2 proteins.The nude mouse transplant tumor experiment was used to determine the growth of gallbladder cancer transplant tumors.Results After treatment with low and high concentrations of dexmedetomidine,the number of cell clone formed,the positive rate of Edu,the numbers of invasions and migrations,the expression levels of PCNA,CyclinD1,MMP-2,MMP-9,CCL2 and CCR2 proteins,the proportions of G2/M and S phase cells decreased,the proportion of G0/G1 phase cells,apoptosis rate and expression levels of Bax and Caspase-3 proteins increased,and the effect of high-concentration dexmedetomidine was more significant(P＜0.05).The inhibitory effects of dexmedetomidine on the proliferation,invasion,migration and cell cycle of gallbladder cancer cells,as well as its promoting effect on cell apoptosis could be reversed by CCL2 protein(P＜0.05).In vivo experiments showed that dexmedetomidine could reduce tumor mass,tumor volume of nude mice and expression levels of CCL2 and CCR2 proteins(P＜0.05).Conclusion Dexmedetomidine inhibits the proliferation and invasion of gallbladder cancer cells,and blocks the cell cycle in the G0/G1 phase by suppressing the CCL2-CCR2 pathway.

Objective To explore the effect of dexmedetomidine on the proliferation,invasion and cell cycle of gallbladder cancer cells by regulating the C-C chemokine ligand 2(CCL2)-C-C chemokine receptor 2(CCR2)pathway.Methods GBC-SD cells were devided into the control group,the low concentration dexmedetomidine group(2 μmol/L),the high concentration dexmedetomidine group(4 μmol/L)and the high concentration dexmedetomidine+CCL2 group(4 μmol/L dexmedetomidine and 10 μg/L CCL2 protein).The clone formation experiment and Edu experiment were performed to measure cell proliferation.Transwell experiment was performed to measure cell invasion and migration.Flow cytometry was performed to measure cell cycle and apoptosis.Western blot assay was used to measure the proliferating cell nuclear antigen(PCNA),Cyclin D1,matrix metalloproteinase(MMP)-2,MMP-9,Bcl-2 associated X protein(Bax),cysteine-dependent aspartate-specific protease-3(Caspase-3),CCL2 and CCR2 proteins.The nude mouse transplant tumor experiment was used to determine the growth of gallbladder cancer transplant tumors.Results After treatment with low and high concentrations of dexmedetomidine,the number of cell clone formed,the positive rate of Edu,the numbers of invasions and migrations,the expression levels of PCNA,CyclinD1,MMP-2,MMP-9,CCL2 and CCR2 proteins,the proportions of G2/M and S phase cells decreased,the proportion of G0/G1 phase cells,apoptosis rate and expression levels of Bax and Caspase-3 proteins increased,and the effect of high-concentration dexmedetomidine was more significant(P＜0.05).The inhibitory effects of dexmedetomidine on the proliferation,invasion,migration and cell cycle of gallbladder cancer cells,as well as its promoting effect on cell apoptosis could be reversed by CCL2 protein(P＜0.05).In vivo experiments showed that dexmedetomidine could reduce tumor mass,tumor volume of nude mice and expression levels of CCL2 and CCR2 proteins(P＜0.05).Conclusion Dexmedetomidine inhibits the proliferation and invasion of gallbladder cancer cells,and blocks the cell cycle in the G0/G1 phase by suppressing the CCL2-CCR2 pathway.

Objective: To treat malignant and non-malignant hematological diseases, allogeneic hematopoietic stem cell transplantation(alloSCT) is widely used. However, its application is limited by the risk of graft-versus-host disease(GVHD), difficulties in donor matching, and the high incidence of transplantation-related mortality due to myeloablative conditioning regimens. Therefore, there is an urgent need to develop new strategies that reduce the intensity of conditioning while enhancing donor engraftment efficiency. Methods: In an alloSCT model, minor histocompatibility antigen-specific donor central memory T cells(miHA-TM) combined with a CD40 agonist were adoptively transferred to evaluate donor bone marrow engraftment under different irradiation doses. Results: Minor histocompatibility antigen(miHA)-specific donor-derived central memory T cells(TM) facilitated recipient immune reconstitution without inducing GVHD. Donor-derived TM cells, however, underwent exhaustion during the process of recipient immune reconstitution, which compromised complete donor engraftment under reduced-intensity conditioning. At a low irradiation dose(4 Gy), the combination of miHA-TM and a CD40 agonist significantly promoted donor bone marrow engraftment. Conclusion miHA-TM facilitates immune reconstitution in recipients without inducing graft-versus-host disease.

Objective:To investigate and analyze basic status of radiotherapy units in Hebei Province in 2024.Methods:Led by the Fourth Hospital of Hebei Medical University, the Radiation Oncology Branch of the Hebei Medical Association, and the Radiation Oncology Expert Committee of the Hebei Society of Clinical Oncology, a province-wide survey was conducted using structured questionnaires. The survey covered key aspects such as basic information of radiotherapy institutions, personnel allocation, equipment configuration, and implementation of radiotherapy techniques. Collected data were summarized and descriptively analyzed comparing with a 2013 survey of radiotherapy in Hebei Province.Results:All 158 radiotherapy institutions across Hebei Province participated in the survey. A total of 2273 radiotherapy professionals were reported, including 1317 radiation oncologists (57.94%), 332 medical physicists (14.61%), 71 radiotherapy engineers (3.12%), and 553 radiotherapy technologists (24.33%). The number of radiotherapy devices significantly increased from 121 in 2013 to 237 in 2024, including 68 domestic radiotherapy equipment. The current inventory includes 195 medical linear accelerators (2.61 units per million population), 2 cobalt-60 units, 27 afterloading machines, 9 tomotherapy (TOMO) systems, 3 CyberKnife units, and 1 proton therapy system. Three-dimensional conformal radiotherapy and stati intensity-modulated radiotherapy have been widely adopted across the province, while advanced techniques such as volumetric-modulated arc therapy, stereotactic body radiotherapy, and respiration-gated technology, and respiratory gating are gradually being implemented.Conclusions:In recent years, the configuration of radiotherapy personnel in Hebei Province has become more balanced, and the availability of precision radiotherapy equipment has significantly improved. There is a growing trend in the adoption of domestically manufactured radiotherapy equipment, marking substantial progress in the development of radiation oncology services in the region.

Objective:To assess the predictive performance of a nomogram model integrating endoscopic ultrasound（EUS）radiomic features with clinical variables for distinguishing early esophageal squamous cell carcinoma（ESCC）from non-cancerous lesions.Methods:Clinical and imaging data from 454 patients who underwent EUS for suspected esophageal malignancies were retrospectively collected in the First Affiliated Hospital of Nanjing Medical University（training cohort， n = 323）and Dongyang People's Hospital（external validation cohort， n = 131）from January 2020 to November 2023. Independent clinical predictors of early ESCC were identified using univariable and multivariable Logistic regression analyses to establish a clinical model. Pearson correlation and Least Absolute Shrinkage and Selection Operator（LASSO）algorithms were used to construct a radiomics model. A combined model integrating radiomics scores and clinical predictors was developed and visualized as a nomogram. The predictive performance of each model was assessed using the area under the ROC curve（AUC），and calibration curves were used to evaluate the model's fitting capability. Results:The training set and validation set indicated that there were statistically significant differences in age，smoking history and lesion location between the early ESCC group and the non-cancerous lesion change group（all P < 0.05）. According to univariate and multivariate Logistic regression analysis，age（ OR = 1.039，95% CI = 1.003–1.077， P = 0.036）and smoking（ OR = 2.358，95% CI = 1.270 - 4.376， P = 0.007）were identified as independent predictors and used to develop the clinical model，with AUCs of 0.608 and 0.694 in the training and validation cohorts，respectively. Fourteen optimal radiomic features were selected to construct the radiomics model，with AUCs of 0.881 and 0.807 in the training and validation cohorts，respectively. The combined nomogram model demonstrated superior predictive performance with AUCs of 0.893 and 0.830，sensitivities of 82.5% and 79.1%，and specificities of 82.2% and 81.3% in the training and validation cohorts，respectively. Conclusions:The EUS-based nomogram model demonstrates optimal predictive performance and can serve as a non-invasive tool to assist endoscopists in distinguishing early ESCC from non-cancerous lesions.

Objective:To explore the factors influencing the success rate of culturing patient-derived gastric and colorectal cancer organoids.Methods:From Feb 2022 to Oct 2023, 398 tumor tissue specimens from patients who underwent gastric cancer and colorectal cancer resection at the Department of Gastrointestinal Surgery, the Affiliated Hospital of Qingdao University, were used for organoid culture. The clinicopathological factors affecting the success rate of organoid culture were analyzed.Results:The overall success rate of organoid culture in this group was 75.1% (299/398), with the success rate of gastric cancer organoid culture being 79.8%(154/193) and that of colorectal cancer being 70.7% (145/205). Different clinicopathological T stage ( χ2=4.765, P<0.05),histological type ( χ2=11.248, P<0.05), and tumor regression grade (TRG) grade after neoadjuvant chemotherapy ( χ2=7.797, P<0.05) were related to the success rate of organoid culture . Multivariate analysis showed that the TRG grade was an independent influencing factor( P=0.040). For colorectal cancer, different pathological T stage ( χ2=5.108, P<0.05), histological type ( χ2=11.270, P<0.05), and TRG grade after neoadjuvant chemotherapy ( χ2=6.797, P<0.05) were related to the success rate of organoidculture . Different from gastric cancer, the results of multivariate analysis of colorectal cancer showed that the histological type was an independent influencing factor ( P=0.018). Conclusions:The pathologic T stage, histological type of tumors, and TRG of cancer patients all have a significant impact on the success rate of establishing tumor organoids. Among them, the TRG grade is an independent influencing factor for the culture of gastric cancer organoids, and the histological type is an independent influencing factor for colorectal cancer organoids.

Objective To investigate the therapeutic efficacy of combination of dapagliflozin and sacubitril valsartan on patients with heart failure(HF)complicated with type 2 diabetes mellitus(T2DM).Methods A retrospective study was conducted on 160 patients with HF and T2DM admitted to our hospital from November 2020 to November 2022.According to drug treatment,they were classified into sacubitril valsartan group(80 cases)and combined group(dapagliflozin combined with sacubitril valsartan,80 cases).After 3 months of treatment,the differences were compared between the two groups in following aspects:blood glucose fluctuations,left ventricular diastolic function,and vascular endothelial function,and the incidence of adverse events after 1 year of follow-up.Results After 3 months of treatment,serum FPG,2 h-PG and HbAlc levels,and MAGE,LAGE,MODD and SDBG values were significantly lower in the combined group than the sacubitril valsartan group(P＜0.05,P＜0.01).The combined group had obviously higher e'and LVEF values while lower LVMI and BNP levels than the other group(P＜0.05,P＜0.01).After 3 months of treatment,NO and FMD were notably higher[96.18±6.70 ng/L vs 92.34±6.85 ng/L,P=0.000;(8.25±1.16)％vs(7.72±1.28)％,P=0.007],while ET-1(59.72±4.95 ng/L vs 63.90±4.63 ng/L,P=0.000)was remarkably lower in the combined group than the sacubitril valsartan group.There was no statistical significance in the total incidence of adverse events between both groups after 1 year of follow-up(P＞0.05).Conclusion The combination of dapagliflozin and sacubitril valsartan has a significant improvement effect on blood glucose,left ventricular diastolic function and vascular endothelial function in T2DM patients with HF,with good drug safety.

Objective:To investigate and analyze basic status of radiotherapy units in Hebei Province in 2024.Methods:Led by the Fourth Hospital of Hebei Medical University, the Radiation Oncology Branch of the Hebei Medical Association, and the Radiation Oncology Expert Committee of the Hebei Society of Clinical Oncology, a province-wide survey was conducted using structured questionnaires. The survey covered key aspects such as basic information of radiotherapy institutions, personnel allocation, equipment configuration, and implementation of radiotherapy techniques. Collected data were summarized and descriptively analyzed comparing with a 2013 survey of radiotherapy in Hebei Province.Results:All 158 radiotherapy institutions across Hebei Province participated in the survey. A total of 2273 radiotherapy professionals were reported, including 1317 radiation oncologists (57.94%), 332 medical physicists (14.61%), 71 radiotherapy engineers (3.12%), and 553 radiotherapy technologists (24.33%). The number of radiotherapy devices significantly increased from 121 in 2013 to 237 in 2024, including 68 domestic radiotherapy equipment. The current inventory includes 195 medical linear accelerators (2.61 units per million population), 2 cobalt-60 units, 27 afterloading machines, 9 tomotherapy (TOMO) systems, 3 CyberKnife units, and 1 proton therapy system. Three-dimensional conformal radiotherapy and stati intensity-modulated radiotherapy have been widely adopted across the province, while advanced techniques such as volumetric-modulated arc therapy, stereotactic body radiotherapy, and respiration-gated technology, and respiratory gating are gradually being implemented.Conclusions:In recent years, the configuration of radiotherapy personnel in Hebei Province has become more balanced, and the availability of precision radiotherapy equipment has significantly improved. There is a growing trend in the adoption of domestically manufactured radiotherapy equipment, marking substantial progress in the development of radiation oncology services in the region.

Objective To investigate the therapeutic efficacy of combination of dapagliflozin and sacubitril valsartan on patients with heart failure(HF)complicated with type 2 diabetes mellitus(T2DM).Methods A retrospective study was conducted on 160 patients with HF and T2DM admitted to our hospital from November 2020 to November 2022.According to drug treatment,they were classified into sacubitril valsartan group(80 cases)and combined group(dapagliflozin combined with sacubitril valsartan,80 cases).After 3 months of treatment,the differences were compared between the two groups in following aspects:blood glucose fluctuations,left ventricular diastolic function,and vascular endothelial function,and the incidence of adverse events after 1 year of follow-up.Results After 3 months of treatment,serum FPG,2 h-PG and HbAlc levels,and MAGE,LAGE,MODD and SDBG values were significantly lower in the combined group than the sacubitril valsartan group(P＜0.05,P＜0.01).The combined group had obviously higher e'and LVEF values while lower LVMI and BNP levels than the other group(P＜0.05,P＜0.01).After 3 months of treatment,NO and FMD were notably higher[96.18±6.70 ng/L vs 92.34±6.85 ng/L,P=0.000;(8.25±1.16)％vs(7.72±1.28)％,P=0.007],while ET-1(59.72±4.95 ng/L vs 63.90±4.63 ng/L,P=0.000)was remarkably lower in the combined group than the sacubitril valsartan group.There was no statistical significance in the total incidence of adverse events between both groups after 1 year of follow-up(P＞0.05).Conclusion The combination of dapagliflozin and sacubitril valsartan has a significant improvement effect on blood glucose,left ventricular diastolic function and vascular endothelial function in T2DM patients with HF,with good drug safety.