Objective To analyze the value of magnetic resonance imaging(MRI)plain scan and contrast-enhanced scan in the staging of cervical cancer.Methods A cohort of 82 cervical cancer patients were enrolled and stratified into 3 pathological stages(Ⅰ,Ⅱ,and Ⅲ-Ⅳ).Concurrently,30 healthy volunteers served as controls.All participants underwent MRI plain scan and dynamic contrast-enhanced MRI(DCE-MRI).Through the comparative analysis of DCE-MRI parameters between healthy controls and cervical cancer patients,and stratified evaluation across stages Ⅰ,Ⅱ,and Ⅲ-,the relationships of DCE-MRI parameters with tumor type,differentiation grade,and lymph node metastasis in cervical cancer patients were explored,and the diagnostic performances of MRI plain scan and DCE-MRI in cervical cancer staging were compared.Results The volume transfer constant(Ktrans),rate constant(Kep),and extracellular extravascular volume fraction(Ve)demonstrated significant elevations in cervical cancer patients compared to healthy controls(P<0.05).Stage Ⅲ-patients exhibited the highest Ktrans,Kep,and Ve,followed by stage Ⅱ patients and stage Ⅰ patients.All inter-stage comparisons reached statistical significance(P<0.05).The Ktrans and Ve in patients with adenocarcinoma were higher than those in patients with squamous cell carcinoma;the poorly differentiated exhibited the highest Ktrans,Kep,and Ve,followed by the moderately differentiated and the high differentiated;and those with lymph node metastasis demonstrated significantly elevated Ktrans and Kep than those without lymph node metastasis(P<0.05).The areas under the curve(AUC)of MRI plain scan,Ktrans,Kep,and Ve for diagnosing stage Ⅲ-cervical cancer were 0.678,0.775,0.731,and 0.695,respectively.The MRI plain scan combined with DCE-MRI demonstrated superior diagnostic performance(AUC=0.859)over individual parameters,with a sensitivity of 90.91％and a specificity of 67.61％.Conclusion The combination of MRI plain scan and DCE-MRI is of high value in cervical cancer staging.

Objective To analyze the value of magnetic resonance imaging(MRI)plain scan and contrast-enhanced scan in the staging of cervical cancer.Methods A cohort of 82 cervical cancer patients were enrolled and stratified into 3 pathological stages(Ⅰ,Ⅱ,and Ⅲ-Ⅳ).Concurrently,30 healthy volunteers served as controls.All participants underwent MRI plain scan and dynamic contrast-enhanced MRI(DCE-MRI).Through the comparative analysis of DCE-MRI parameters between healthy controls and cervical cancer patients,and stratified evaluation across stages Ⅰ,Ⅱ,and Ⅲ-,the relationships of DCE-MRI parameters with tumor type,differentiation grade,and lymph node metastasis in cervical cancer patients were explored,and the diagnostic performances of MRI plain scan and DCE-MRI in cervical cancer staging were compared.Results The volume transfer constant(Ktrans),rate constant(Kep),and extracellular extravascular volume fraction(Ve)demonstrated significant elevations in cervical cancer patients compared to healthy controls(P<0.05).Stage Ⅲ-patients exhibited the highest Ktrans,Kep,and Ve,followed by stage Ⅱ patients and stage Ⅰ patients.All inter-stage comparisons reached statistical significance(P<0.05).The Ktrans and Ve in patients with adenocarcinoma were higher than those in patients with squamous cell carcinoma;the poorly differentiated exhibited the highest Ktrans,Kep,and Ve,followed by the moderately differentiated and the high differentiated;and those with lymph node metastasis demonstrated significantly elevated Ktrans and Kep than those without lymph node metastasis(P<0.05).The areas under the curve(AUC)of MRI plain scan,Ktrans,Kep,and Ve for diagnosing stage Ⅲ-cervical cancer were 0.678,0.775,0.731,and 0.695,respectively.The MRI plain scan combined with DCE-MRI demonstrated superior diagnostic performance(AUC=0.859)over individual parameters,with a sensitivity of 90.91％and a specificity of 67.61％.Conclusion The combination of MRI plain scan and DCE-MRI is of high value in cervical cancer staging.

Radiotherapy (RT) is one of the most common treatments for cancer. However, intracellular glutathione (GSH) plays a key role in protecting cancer from radiation damage. Herein, we have developed a platelet membrane biomimetic nanomedicine (PMD) that induces double GSH consumption to enhance tumor radioimmunotherapy. This biomimetic nanomedicine consists of an external platelet membrane and internal organic mesoporous silica nanoparticles (MON) loaded with 2-deoxy-D-glucose (2-DG). Thanks to the tumor-targeting ability of the platelet membranes, PMD can target and aggregate to the tumor site, which is internalized by tumor cells. Within tumor cells overexpressing GSH, MON reacts with GSH to degrade and release 2-DG. This step initially depletes the intracellular GSH content. The subsequent release of 2-DG inhibits glycolysis and adenosine triphosphate (ATP) production, ultimately leading to secondary GSH consumption. This nanodrug combines dual GSH depletion, starvation therapy, and RT to promote immunogenic cell death and stimulate the systemic immune response. In the bilateral tumor model in vivo, distal tumor growth was also well suppressed. The proportion of mature dendritic cells (DC) and CD8⁺ T cells in the mice was increased. This indicates that PMD can promote anti-tumor radioimmunotherapy and has good prospects for clinical application.

Radiotherapy(RT)is one of the most common treatments for cancer.However,intracellular glutathione(GSH)plays a key role in protecting cancer from radiation damage.Herein,we have developed a platelet membrane biomimetic nanomedicine(PMD)that induces double GSH consumption to enhance tumor radioimmunotherapy.This biomimetic nanomedicine consists of an external platelet membrane and internal organic mesoporous silica nanoparticles(MON)loaded with 2-deoxy-D-glucose(2-DG).Thanks to the tumor-targeting ability of the platelet membranes,PMD can target and aggregate to the tumor site,which is internalized by tumor cells.Within tumor cells overexpressing GSH,MON reacts with GSH to degrade and release 2-DG.This step initially depletes the intracellular GSH content.The subsequent release of 2-DG inhibits glycolysis and adenosine triphosphate(ATP)production,ultimately leading to secondary GSH consumption.This nanodrug combines dual GSH depletion,starvation therapy,and RT to promote immunogenic cell death and stimulate the systemic immune response.In the bilateral tumor model in vivo,distal tumor growth was also well suppressed.The proportion of mature dendritic cells(DC)and CD8+T cells in the mice was increased.This indicates that PMD can promote anti-tumor radioimmunotherapy and has good prospects for clinical application.

Objective:To systematically review the effect of fracture liaison service (FLS) in elderly patients with fragile hip fractures, so as to provide reference for clinical decision-making.Methods:By combining subject terms and free terms, electronic searches were conducted on China National Knowledge Infrastructure, WanFang Data, VIP, China Biomedical Literature Database, PubMed, Embase, Cochrane Library and Web of Science. The included references were manually retrieved using the snowball method. The retrieval time was from the establishment of the database to March 1, 2023. Two researchers screened articles based on inclusion and exclusion criteria, extracted data, and evaluated the quality of articles, using RevMan5.4 software for statistical analysis.Results:A total of 15 articles were included, totaling 4 333 patients with fragile hip fractures, with a follow-up time of ≥3 months. Meta-analysis showed that FLS could improve patient medication compliance [ RR=2.32, 95% CI (1.74, 3.11) , P<0.01] and hip function [ SMD=1.20, 95% CI (0.93, 1.47) , P<0.01] , reduce mortality [ RR=0.70, 95% CI (0.58, 0.84) , P<0.01] and the occurrence of refractures [ RR=0.44, 95% CI (0.32, 0.61) , P<0.01] , with statistical differences. Conclusions:Compared with routine nursing for fragile hip fractures, FLS can improve medication compliance and hip function, decrease mortality and the occurrence of refractures in patients with fragile hip fractures.

Objective:To observe the curative effect and temperature safety management of ginger mud moxibustion of different thickness on ankylosing spondylitis patients with kidney yang deficiency type, and to explore the best curative effect combination and safety combination of ginger mud thickness in Du Meridian moxibustion.Methods:From March 2020 to March 2021, 90 patients with ankylosing spondylitis of kidney yang deficiency type who were treated with Du moxibustion in the Affiliated Hospital of Nanjing University of Chinese Medicine were selected. According to the thickness of ginger paste, they were randomly divided into 2 cm-thick ginger mud thickness group, 3 cm-thick ginger mud thickness group and 4 cm-thick ginger mud thickness group when the diameter and height of moxa wool were the same as 2 cm, 30 cases in each group. They were treated with Fu Yang Du moxibustion once a week for 60 minutes each time. Visual Analogue Scale (VAS), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), traditional Chinese medicine syndrome score were used to evaluate the curative effect of spinal function before and after the intervention for 6 weeks. The time when moxibustion temperature reached 43 ℃ and moxibustion temperature maintained at 43-45 ℃ were analyzed for safety evaluation.Results:After moxibustion, VAS scores of 2 cm-thick ginger mud thickness group, 3 cm-thick ginger mud thickness group and 4 cm-thick ginger mud thickness group were 2.89 ± 0.96, 2.01 ± 0.69, 2.93 ± 1.23, BASDAI scores were 3.51 ± 0.94, 2.69 ± 0.68, 3.13 ± 0.96 and BASFI scores were 1.71 ± 0.99, 0.99 ± 0.36, 1.61 ± 0.50, the traditional Chinese medicine syndrome scores were 15.97 ± 4.61, 12.08 ± 3.21, 13.79 ± 3.58. The scores of the three groups were statistically significant ( F values were 6.51-19.22, all P<0.05) . After the intervention, there were significant differences in the scores between 2 cm-thick ginger mud thickness group and 3 cm-thick ginger mud thickness group, 2 cm-thick ginger mud thickness group and 4 cm-thick ginger mud thickness group, 3 cm-thick ginger mud thickness group and 4 cm-thick ginger mud thickness group ( t values were -6.61-4.56, all P<0.05). Conclusions:Du moxibustion is an effective method to treat ankylosing spondylitis of kidney yang deficiency type. The best curative effect and safety combination is moxa velvet diameter height 2 cm, ginger mud thickness 3 cm.

Objective:To investigate the emergency surgical effect of ruptured intracranial dural arteriovenous fistula (DAVF).Methods:Patients with ruptured intracranial DAVF underwent microsurgery in the Department of Neurosurgery, Nanping First Hospital Affiliated to Fujian Medical University from May 2013 to July 2022 were retrospectively included. The clinical, imaging and follow-up data were collected, and the clinical characteristics, selection of surgical methods and treatment effects of patients were summarized.Results:A total of 8 patients with DAVF were enrolled. Their age ranged from 11 to 60 years (average, 48 years). There were 7 males and 1 female. All 8 patients suffered from intracranial hemorrhage, manifested as headache and vomiting in 2 cases, simple conscious disturbance in 2 cases, conscious disturbance with cerebral hernia in 3 cases, and conscious disturbance with limb paralysis in 1 case. The fistula was located in the anterior fossa in 4 cases (including 2 cases with aneurysms), the middle fossa in 2 cases (including 1 case with moyamoya disease), the transverse sinus in 1 case, and the anterior 1/3 area of the sagittal sinus in 1 case. Cognard classification: 7 patients were type Ⅲ and 1 was type Ⅳ. After admission, all patients underwent emergency craniotomy and microsurgery to remove hematoma. Among them, 4 patients underwent decompressive craniectomy at the same time, 1 patient with moyamoya disease underwent dural turnover and temporalis muscle application at the same time, and 2 patients with aneurysms at the same location were clipped at the same time. Postoperative re-examination of head CT showed that the hematoma was cleared satisfactorily and the midline was no shift in all 8 patients. CT angiography (CTA) showed that the fistula disappeared within 2 weeks. Seven patients were followed up within 1-12 months after operation. CTA or digital subtraction angiography showed no recurrence of DAVF. Two patients with aneurysms did not have residual or recurrent aneurysms. All patients had no new neurological symptoms, and the Glasgow Outcome Scale score in 2 patients increased by 1 compared with that at discharge.Conclusion:Emergency microsurgery is an effective method for the treatment of ruptured intracranial DAVF, especially for patients with special parts or complicated hematoma, cerebral hernia, and other vascular diseases.

Bacillus spp. are probiotics and can secrete a variety of natural antimicrobiol active substances, of which lipopeptides are an important class. Up to now, about 90 lipopeptides have been identified, and most of them are cyclic lipopeptides. surfactin, iturin, fengycin, bacillomycin and polymyxins are widely studied, and the first three have huge potential for application due to their properties of surfactants and anti-fungal, anti-bacterial, anti-viral, anti-tumor and anti-inflammatory functions. In this paper, the research progress in the structure, function, synthesis regulation, separation, purification and production of surfactin, iturin and fengycin was reviewed. Synthetic biology is a vital means to increase the yield of lipopeptides, and in the future, lipopeptides can be used in crop cultivation, animal farming, food, medicine and petroleum industries as well as environmental protection. Future research should be strengthened on the discovery of new lipopeptides, synthesis of high-activity lipopeptides, economical production of lipopeptides on a large scale and their safety evaluation.
Anti-Bacterial Agents ; Anti-Infective Agents/pharmacology* ; Bacillus ; Bacillus subtilis ; Lipopeptides/pharmacology* ; Peptides, Cyclic/pharmacology*

Objeetive To investigate the clinical efficacy of inverted intmmedullary nail combined with medial minimally invasive plate in treatment of type C2 and C3 distal femoral fractures.Methods A retrospective case control study was conducted on 38 patients with complex distal fractures of the femur treated from January 2015 to January 2017.There were 22 males and 16 females,aged 24-72 years [(45.6 ± 2.5)years].AO fracture classification was type C2 in 24 patients and type C3 in 14.All of them were fresh closed fractures.The time duration from injury to operation was 4-16 days (average,7.5 days).Based on the different surgical methods,the patients were divided into lateral single plate fixation group (single plate group,20 patients) and inverted intramedullary nail combined with medial minimally invasive locked plate fixation group (locked plate group,18 patients).The two groups were compared in terms of operation condition,early weight bearing time,fracture healing time,postoperative complications,postoperative knee function and activity of living.Hospital for Special Surgery (HSS) score was used for evaluating postoperative knee function and Barthel index for activity of living.Results The patients were followed up for 10-24 months [(12.2 ± 1.8) months].The operation duration was (110.5 ± 35.4) min for single plate group and (116.7 ± 42.3) min min for locked plate group(P ＞0.05).Intraoperative blood loss in single plate group was [(450.5 ± 120.7)ml] and [(455.2 ± 130.4) ml] in locked plate group (P ＞ 0.05).The early weight bearing time in single plate group was (28.5 ± 8.6)days and 18.7 ± 4.9 (P ＜ 0.01)days in the locked plate group.The fracture healing time in single plate group was (8.5 ± 2.2) months,and [(6.5 ± 1.6) months] in locked plate group (P ＜ 0.01).After 3 weeks,6 months and 12 months,HSS scores of knee joint function of the locked plate group was significantly better than that of single plate group (P ＜ 0.01).At 6 months and 12 months after operation,Barthel index score of locked plate group was significantly better than that of single plate group (P ＜ 0.01).No infection occurred in two groups after operation.There were no complications such as internal fixation failure,knee valgus,external rotation deformity or fat embolism in locked plate group.There were two cases of internal fixation failure,one knee eversion,and two knee varus in single plate group (P ＜ 0.01).Conclusion Compared with single plate fixation,the therapeutic method of inverted intramedullary nail combined with medial minimally invasive locked plate has the advantages of early weight bearing time,quick recovery,better function restoration and fewer complications,and hence is a preferable choice for treatment of type C2 and C3 complex distal femoral fractures.

Objective To study the clinical and pathologic characteristics of inflammatory fibroid polyp (IFP)in gastrointestinal tract,and discuss the diagnosis,differential diagnosis and treatment. Methods The clini-cal and pathologic findings of 28 IFP patients were retrospectively analyzed. Results IFP occurred in 8 males and 20 females aged from 37 to 71(with a mean age of 52 years).Nineteen cases of IFP occurred in stomach(18 in an-trum and 1 in body),7 in small intestine(6 in ileum and 1 in jejunum)and 2 in rectum.The solitary non-capsulat-ed polyp was composed of spindle cells, mainly located in the submucosa. Spine cells concentrically arranged around blood vessels with"onion skin"pattern, but those of small intestine were devoid of concentric formations. Twenty-seven cases showed the spindle cells were positive for CD34. Two cases harbored activating mutations in PDGFRA exon 12. Endoscope or surgical excision was adopted as operation method, and showed good therapeutic effect.Conclusions IFP is a rare benign interstitial tumor exhibits two morphologies,which can harbor activating mutation in PDGFRA.CD34 positive can help the diagnosis.