The traditional Chinese medicine （TCM） myocardial infarction （MI） unit is a standardized， regulated， and continuous integrated care unit guided by TCM theory and built upon existing chest pain centers or emergency care units. This unit emphasizes multidisciplinary collaboration and forms a restructured clinical entity without altering current departmental settings， offering comprehensive diagnostic and therapeutic services with full participation of TCM in the treatment of MI. Its core medical model is patient-centered and disease-focused， providing horizontally integrated TCM-based care across multiple specialties and vertically constructing a full-cycle treatment unit for MI， delivering prevention， treatment， and rehabilitation during the acute， stable， and recovery phases. Additionally， the unit establishes a TCM-featured education and prevention mechanism for MI to guide patients in proactive health management， reduce the incidence of myocardial infarction， and improve quality of life.

OBJECTIVE: To review the research progress of strontium (Sr) modified β-tricalcium phosphate composite biomaterials (SrTCP) promoting osteogenesis through immune regulation, and provides reference and theoretical support for the further development and research of SrTCP bone repair materials in bone tissue engineering in the future. METHODS: The literature about SrTCP promoting osteogenesis through immune regulation at home and abroad in recent years was extensively reviewed, and the preparation methods, immune mechanism and application of promoting osteogenesis were summarized and analyzed. RESULTS: The preparation methods of SrTCP include solid-state reaction sintering method, solution combustion quenching method, direct doping method, ion substitution method, etc. SrTCP has immune regulatory effects, which can play an immune regulatory role in inducing macrophage polarization, inducing angiogenesis and anti oxidative stress to promote osteogenesis. CONCLUSION At present, studies have shown that SrTCP can promote bone defect repair through immune regulation. Subsequent studies can start from the control of the optimal repair concentration and release rate of Sr, and further clarify the specific mechanism of SrTCP in promoting angiogenesis and anti oxidative stress, which is helpful to develop new materials for bone defect repair.
Calcium Phosphates/pharmacology* ; Strontium/pharmacology* ; Biocompatible Materials/pharmacology* ; Humans ; Osteogenesis/drug effects* ; Tissue Engineering/methods* ; Bone Substitutes/pharmacology* ; Bone Regeneration/drug effects* ; Animals ; Tissue Scaffolds/chemistry* ; Neovascularization, Physiologic/drug effects* ; Macrophages/immunology*

Non-small cell lung cancer (NSCLC), as the predominant histological subtype of lung cancer, accounts for approximately 85% of all lung cancer cases. In recent years, immune checkpoint inhibitors (ICIs), represented by programmed death 1/programmed death ligand 1 (PD-1/PD-L1) inhibitors, have achieved breakthrough advancements in patients with driver gene-negative NSCLC. They have been established as a key component of first-line treatment regimens and have significantly improved clinical outcomes. However, limited clinical evidence has emerged showing the phenomenon of histological transformation from NSCLC to small cell lung cancer (SCLC) in patients experiencing disease progression after ICIs monotherapy or combination therapy. Systematic research data on the clinical characteristics, molecular biological basis, and subsequent treatment strategies for such transformation events are currently lacking. This article reports a case of SCLC transformation occurring in a patient with KRAS-mutated lung adenocarcinoma after 16 months of ICIs combination therapy and provides a systematic review of 22 similar published cases. The study demonstrates that small cell transformation is a critical mechanism of immunotherapy resistance, and transformed patients exhibit poor prognosis. The research emphasizes the importance of dynamic monitoring of neuron-specific enolase (NSE) and standardized repeat biopsies during treatment, providing a basis for clinical practice. This aids in enhancing the recognition and management capabilities for this rare histological transformation, ultimately improving patient outcomes.
Humans ; Immune Checkpoint Inhibitors/therapeutic use* ; Lung Neoplasms/immunology* ; Carcinoma, Non-Small-Cell Lung/immunology* ; Small Cell Lung Carcinoma/genetics* ; Male ; Middle Aged ; Female

Objective To investigate the application value of apparent diffusion coefficient(ADC)histogram parameters of multi-plexed sensitivity encoding diffusion weighted imaging(MUSE-DWI)in evaluating lymph node metastasis of cervical cancer(CC).Methods A total of 54 patients with CC diagnosed pathologically after extensive hysterectomy and pelvic lymph node dissection were analyzed retrospectively,and 74 lymph nodes were extracted,including 28 metastatic lymph nodes and 46 non-metastatic lymph nodes.All patients underwent routine MRI examination and MUSE-DWI before surgery.Through the T2WI fat suppression images were referenced,the region of interest(ROI)covering the entire lymph nodes were drawn on the b=800 s/mm2 images of MUSE-DWI,and ADC histogram parameters were obtained including minimum,maximum,mean,median,percentiles(10 th,25 th,75 th,90 th),kurtosis,and skewness.The differences of ADC histogram parameters between the metastatic lymph nodes and the non-metastatic lymph nodes were compared.The receiver operating characteristic(ROC)curves were drawn and the area under the curve(AUC)were calculated to evaluate the diagnostic efficacy of different parameters in distinguishing lymph node metastasis.Results The mean,median,25 th and 75 th percentiles of ADC histogram of the metastatic lymph nodes were significantly lower than those of the non-metastatic lymph nodes(P＜0.05).However,there were no statistically significant differences in minimum,maximum,10 th percentile,90 th percentile,kurtosis,and skewness(P＞0.05).In the evaluation of various parameters for distinguishing lymph node metastasis,the mean had the highest diagnostic efficacy(AUC=0.718),and when the threshold was 963.07×10-6 mm2/s,the sensitivity and specificity were 0.643 and 0.717,respectively.Conclusion The ADC histogram parameters based on MUSE-DWI have high diag-nostic value in differentiating CC lymph node metastasis,and the mean has the highest diagnostic efficiency.

Objective To explore the diagnostic value of MRE for differentiating hepatic benign and malignant tumors.Methods 36 patients with liver tumor (a total of 39 lesions,including 20 hepatocellular carcinomas,7 hemangiomas,5 cholangiocellular carcinomas,3 metastases,2 hepatic angiomyolipomas,1 carcinosarcoma,1 castleman’s disease)and 9 healthy volunteers were evaluated with MRE.The elastogram were generated with FUNCTOOL post processing program.The mean value of elasticity of hepatic malignant tumors,hepatic benign tumors,hepatic parenchyma around the malignant tumors,hepatic parenchyma around the benign tumors and the normal liver of healthy volunteers were measured and compared.Results The mean value of elasticity of malignant tumors [(7.39±1.70)kPa]was significantly higher than these of benign tumors [(4.11±0.37)kPa,P < 0.001],peripheral parenchyma around the malignant tumors [(3.50±0.73)kPa,P < 0.001],peripheral parenchyma around the benign tumors [(2.61±0.45)kPa,P < 0.001] and normal liver of healthy volunteers [(2.38±0.24)kPa,P <0.001].The mean value of elasticity of parenchyma around the malignant tumors [(3.50±0.73)kPa]was significantly higher than that of hepatic parenchyma around the benign tumors [(2.61 ± 0.45)kPa,P <0.001].The mean value of elasticity of hepatic parenchyma around the benign tumors [(2.61±0.45)kPa]was slightly higher than normal liver of healthy volunteers [(2.38±0.24)kPa],and there was no significant difference between the two (P >0.05).A cutoff value of 5.08 kPa can accurately differentiate malignant tumors from benign tumors and normal liver parenchyma.Conclusion MRE could be used in diagnosis of hepatic focal tumors,which is helpful for differentiating benign and malignant liver tumors.

Objective:To establish an LC-MS/MS and HPLC assay for the determination of linezolid in human plasma to be used for the therapeutic drug monitoring ( TDM) and pharmacokinetic study. Methods:Acetontrile containing furazolidone ( internal stand-ard) as the protein precipitation agent was added to100 μl human plasma, and then vibrated and centrifuged for the precipitation of plasma protein. ① The supernatant was eluted on an Eclipse XDB-C18 (100mm × 2. 1mm,3. 5μm) column with acetontrile and water (80 :20) as the mobile phase at the flow rate of 0. 3 ml·min-1. The electrospray ionization (ESI) source was applied and operated in the positive ion mode. The multiple reaction monitoring (MRM) modes with the transition of m/z338. 1→296. 2 (linezolid) and m/z226.1→122.0 (furazolidone) were used for the quantification. ② The supernatant was eluted on an Eclipse Eclipse XDB -C18(250 mm × 4. 6 mm, 5μm) column with acetontrile and 0. 1% formic acid (20 :80) as the mobile phase at the flow rate of 1. 0 ml·min-1 and detected at 254 nm. The established assays were used for the determination of linezolid in the plasma samples after the administra-tion. Results:Linezolid was linear within the range of 0. 05-30 μg·ml-1 for LC-MS/MS, and 0. 25-30 μg·ml-1 for HPLC ( r2 >0. 999). The extraction recovery and the matrix effect respectively was 82. 1%-91. 3% and 74. 0%-82. 3%. The relative recovery of LC-MS/MS and HPLC was 91. 2%-106. 4% and 100. 1%-111. 6%, respectively. The intra-and inter-day RSDs were both lower than 20%. There was a good correlation between LC-MS/MS and HPLC. The trough concentration of 12 patients was (1. 77 ± 1. 23) g· ml-1 and the plasma concentration of 5 patients 2h after linezolid adminstration was (13. 36 ± 2. 63) g·ml-1 , respectively. Conclu-sion:The established assays are simple, rapid, specific, sensitive and accurate, which are suitable for the TDM and pharmacokinetic study of linezolid.

Objective:To establish an LC-MS/MS and HPLC assay for the determination of linezolid in human plasma to be used for the therapeutic drug monitoring ( TDM) and pharmacokinetic study. Methods:Acetontrile containing furazolidone ( internal stand-ard) as the protein precipitation agent was added to100 μl human plasma, and then vibrated and centrifuged for the precipitation of plasma protein. ① The supernatant was eluted on an Eclipse XDB-C18 (100mm × 2. 1mm,3. 5μm) column with acetontrile and water (80 :20) as the mobile phase at the flow rate of 0. 3 ml·min-1. The electrospray ionization (ESI) source was applied and operated in the positive ion mode. The multiple reaction monitoring (MRM) modes with the transition of m/z338. 1→296. 2 (linezolid) and m/z226.1→122.0 (furazolidone) were used for the quantification. ② The supernatant was eluted on an Eclipse Eclipse XDB -C18(250 mm × 4. 6 mm, 5μm) column with acetontrile and 0. 1% formic acid (20 :80) as the mobile phase at the flow rate of 1. 0 ml·min-1 and detected at 254 nm. The established assays were used for the determination of linezolid in the plasma samples after the administra-tion. Results:Linezolid was linear within the range of 0. 05-30 μg·ml-1 for LC-MS/MS, and 0. 25-30 μg·ml-1 for HPLC ( r2 >0. 999). The extraction recovery and the matrix effect respectively was 82. 1%-91. 3% and 74. 0%-82. 3%. The relative recovery of LC-MS/MS and HPLC was 91. 2%-106. 4% and 100. 1%-111. 6%, respectively. The intra-and inter-day RSDs were both lower than 20%. There was a good correlation between LC-MS/MS and HPLC. The trough concentration of 12 patients was (1. 77 ± 1. 23) g· ml-1 and the plasma concentration of 5 patients 2h after linezolid adminstration was (13. 36 ± 2. 63) g·ml-1 , respectively. Conclu-sion:The established assays are simple, rapid, specific, sensitive and accurate, which are suitable for the TDM and pharmacokinetic study of linezolid.

OBJECTIVE:To investigate the regularity of Chinese patent medicine prescriptions for Qi deficiency and blood sta-sis syndrome (QDBSS),and to provide reference for studying QDBSS diagnosis standard and new TCM for related symptoms. METHODS:Chinese patent medicine for QDBSS were collected from Chinese Pharmacopoeia (2015 edition) and Chinese Mate-ria Medica Preparation(1993 version). The regularity of Chinese patent medicine prescriptions and symptom association rule were analyzed by using TCM inheritance auxiliary system (V2.5). RESULTS:Among the 171 symptoms,chest tightness,shortness of breath,chest pain,fatigue and palpitation were common symptoms,and three groups of symptoms were included as chest tight-ness-shortness of breath-chest pain-palpitation-irregularly pulse;mouth and eye deviation-numbness of hands and feet-hemiple-gia-stiff tongue-spasm;hypomenorrhea-irregular menstruation-abdominal mass-dysmenorrheal. One hundred and thirty-one Chinese patent medicines included 304 ingredients,top 5 in the list of frequency were Astragalus membranaceus,Salvia militiorrhiza,An-gelica sinensis,Ligusticum chuanxiong,Panax ginseng. A. membranaceus- A. sinensis,L. chuanxiong-A. sinensis,S. militiorrhi-za-A. membranaceus,L. chuanxiong- A. membranaceus and L. chuanxiong-S. militiorrhiza were frequently used herbal combina-tions. A. membranaceus-A. sinensis-L. chuanxiong-S. militiorrhiza-P. ginseng-Carthamus tinctorius-Panax notoginseng was the core combination. A new prescription for QDBSS was formed (P. ginseng-Radix Paeoniae Rubra-borneol-Gastrodia elata-artificial moschus-Myristica fragrans). CONCLUSIONS:QDBSS has common symptoms which exist in many kinds of diseases,such as chest tightness,chest pain and shortness of breath;it also has the unique symptoms among various diseases. Invigorating Qi and promoting blood circulation is the basic treatment for the QDBSS. It is of significance to pay attention to"supplement by passing, combination of pass and supplement"and combine regulating Qi-flowing method with enriching blood method or aromatic warming method for QDBSS therapy according to the differ-ence of Zhengxie shengshuai.

Objective To evaluate the value of MR spectroscopy (MRS) in the differential diagnosis between recurrence and radiation encephalopathy after radiotherapy for nasopharyngeal carcinoma (NPC). Methods Muhi-voxel proton MRS was performed on 50 patients with NPC, who were suspected of intracalvarium tumor recurrence or radiation encephalopathy after radiotherapy by conventional MRI,including 44 males and 6 females. Among the 50 patients, 26 cases were finally diagnosised as basicranial tumor recurrence and 24 cases as radiation encephalopathy by clinical and MRI follow-up. The following metabolites, such as Cho, NAA, Cr, lactate and lipid, were analyzed comparatively between basicranial tumor recurrence and radiation encephalopathy(RE), and between the lesions and the relative normal brain tissue. Wilcoxon's rank sum test was used to analyze the data. Results The median of Cho/Cr, Cho/NAA,LI/Cr in tumor recurrence group were 2. 22, 2. 13, and 1.77, respectively, and 1.40, 1.31, and 0. 57,respectively, in RE group. The difference of Cho/Cr, Cho/NAA, and LL/Cr between the two groups were statistically significant (P < 0. 01). Those in tumor recurrence group were higher than in RE group. The median of Cho, Cr, NAA in tumor recurrence group and in RE group were 3366. 00, 1023.00, 1930. 00 and 2469.50, 1864.50, 1734.00. There were no significant difference of Cho, Cr, and NAA between the two groups (P > 0. 05). In the 14 cases whose normal brain tissue were compared with the recurrent tumor tissue in tumor recurrence group, the median of Cr, NAA, LL, Cho/Cr, Cho/NAA, LL/Cr of recurrent tumor tissue and normal brain tissue were 1023.00, 1930.00, 2090.00, 3.76, 2. 13, 3.39 and 2370.00, 3012.00, 1680.00, 1.64, 1.17, 0.75,The difference of Cr, NAA, LL, Cho/Cr, Cho/NAA, LL/Cr between the normal tissue and recurrent tumor tissue were significant (P <0.05). LL, Cho/Cr, Cho/NAA, LL/Cr of recurrent tumors were higher than those of the normal brain tissue,while NAA and Cr of recurrent tumors were lower than those of the normal brain tissue. In the 12 cases whose normal brain tissue were compared with the RE tissue in RE group, the median of Cho, Cr, NAA, LL, Cho/Cr, IX,/Cr of RE tissue and normal brain tissue were 390.00, 217.50, 427.50, 39.00, 1.30, 0.40 and 680.00, 360.00, 610.00, 30.00, 1.54, 0. 09. The difference of above-mentioned parameters between RE tissue and normal tissue were significant. Cho, Cr, NAA, Cho/Cr of RE were lower than those of normal tissue (P <0. 05) ,while LL and LL/Cr of RE were higher than those of normal tissue (P < 0. 05). Conclusion The changes of the metabolites in recurrent lesions and RE lesions were different on MRS. Parameters such as Cho/Cr, Cho/NAA and LL/Cr, which were higher in recurrent lesions than those of RE, were valuable for the differential diagnosis between basicranial tumor recurrence and radiation encephalopathy after radiotherapy for NPC.

Objective To find the effective quantitative parameters for the differentiation of the breast lesions using the post-processing of time.signal curve of 3D dynamic-enhanced MRI.Methods Thirty patients with 35 lesions underwent 3D dynamic-enhanced MRI and the time-signal cHIve was deduced.The four quantitative parameters including SImax,PH,Slope and SlopeR were analyzed in benign andmalignant lesions of the breast.Independent samples t test and rank sum test were used for the statistics.Results Seyenteen benign lesions and 18 malignant lesions were included in this study.The SImax(M)of benign and malignant lesions were 375.2 and 158.1,the 95% confidence intervals of SImax were 278.2-506.0 and 160.5-374.8.The PH(M)of benign and malignant lesions were 114.4 and 87.8,the 95% confidence intervals of PH were 73.7-196.5 and 71.3-162.9.The Slope(M) of benign and malignant lesions were 22.3×10-3 and 44.0×10-3,the 95% confidence intervals of Slope were 13.7×10-3-41.1×10-3 and 46.1×10-3-81.8×10-3.The Slope"(M) of benign and malignant lesions were 2.6 and11.4,the 95% confidence intervals of SlopeR were 1.9-3.4 and 9.8-14.5.There were no significant differences on SImax and PH between benign and malignant lesions(P>0.05).The significant differences existed on Slope(P<0.01)and SlopeR(P<0.01)between benign and malignant lesions of the breast.Conclusion SlopeR is a very effective parameter in t}le differential diagnosis of breast lesions.