Objective To analyze the effect of releasing the lower pulmonary ligament on right residual lung expansion after right upper lobe resection under different body mass index (BMI) levels. Methods The clinical data of patients who underwent thoracoscopic right upper lobe resection in the First Affiliated Hospital with Nanjing Medical University from 2021 to 2022 were retrospectively analyzed. Patients were divided into a group A (17 kg/m2＜BMI≤23 kg/m2), a group B (23 kg/m2＜BMI≤29 kg/m2) and a group C (BMI＞29 kg/m2) according to BMI. The presence of residual cavity was judged by chest X-ray at 7-10 days after operation, the degree of compensation change of the right main bronchus angle was measured, and the changes in lung volume were determined by CT three-dimensional reconstruction. Results A total of 157 patients who underwent thoracoscopic right upper lobe resection were included, including 71 males and 86 females, with an average age of (59.7±11.2) years. There were 50 patients in the group A, 75 patients in the group B, and 32 patients in the group C. In the group A, compared with those without releasing the lower pulmonary ligament, patients with releasing had a lower incidence of postoperative residual cavity (P=0.016), greater changes in bronchus angle (P<0.001), and smaller changes in lung volume (P<0.001). In the group B and C, there was no significant effect of releasing the lower pulmonary ligament on postoperative residual cavity, bronchus angle, and lung volume changes (P>0.05). Conclusion For patients with thin and long body shape and low BMI, releasing the lower pulmonary ligament is helpful to promote the expansion of the residual lung after right upper lobe resection and reduce the occurrence of postoperative residual cavity in patients.

Objective To predict the lymph node metastasis status of patients with invasive pulmonary adenocarcinoma by constructing machine learning models based on primary tumor radiomics, peritumoral radiomics, and habitat radiomics, and to evaluate the predictive performance and generalization ability of different imaging features. Methods A retrospective analysis was performed on the clinical data of 1 263 patients with invasive pulmonary adenocarcinoma who underwent surgery at the Department of Thoracic Surgery, Jiangsu Province Hospital, from 2016 to 2019. Habitat regions were delineated by applying K-means clustering (average cluster number of 2) to the grayscale values of CT images. The peritumoral region was defined as a uniformly expanded area of 3 mm around the primary tumor. The primary tumor region was automatically segmented using V-net combined with manual correction and annotation. Subsequently, radiomics features were extracted based on these regions, and stacked machine learning models were constructed. Model performance was evaluated on the training, testing, and internal validation sets using the area under the receiver operating characteristic curve (AUC), F1 score, recall, and precision. Results After excluding patients who did not meet the screening criteria, a total of 651 patients were included. The training set consisted of 468 patients (181 males, 287 females) with an average age of (58.39±11.23) years, ranging from 29 to 78 years, the testing set included 140 patients (56 males, 84 females) with an average age of (58.81±10.70) years, ranging from 34 to 82 years, and the internal validation set comprised 43 patients (14 males, 29 females) with an average age of (60.16±10.68) years, ranging from 29 to 78 years. Although the habitat radiomics model did not show the optimal performance in the training set, it exhibited superior performance in the internal validation set, with an AUC of 0.952 [95%CI (0.87, 1.00)], an F1 score of 84.62%, and a precision-recall AUC of 0.892, outperforming the models based on the primary tumor and peritumoral regions. Conclusion The model constructed based on habitat radiomics demonstrated superior performance in the internal validation set, suggesting its potential for better generalization ability and clinical application in predicting lymph node metastasis status in pulmonary adenocarcinoma.

Objective:To explore the differences in the ability of different parts of the human skin to recognize vibration frequencies in order to provide data for physiological optimization of vibration parameters in pilots′ tactile vests.Methods:Ten healthy volunteers were selected and grouped by age as 20-40 years (6 cases) and 41-50 years (4 cases). All the subjects participated in 3 trials: ① identification test of frequency steps using cutaneous tactile perception: the back of the left hand was chosen as the test area, a dual-oscillator synchronous vibration system was adopted, and the frequency step was gradually increased (initially 0.1 Hz) to determine the threshold of frequency identification; ② maximum frequency threshold test of cutaneous tactile perception: the maximum frequency recognition thresholds in 7 parts of the trunk (the left waist, right waist, chest, back, left shoulder, right shoulder, neck) and the back of the hand were tested; ③ frequency discrimination test of cutaneous tactile perception: 5 equally spaced frequencies (covering the frequency recognition thresholds) were set to evaluate the accuracy of tactile frequency memory on the back of the hand after 3, 15 min and 24 h. The relationships between the adjacent step sizes of cutaneous tactile perception and the average value of the sum of adjacent frequencies were analyzed using simple linear regression. The highest identification thresholds of frequencies in different parts of the subjects as well as the accuracy of frequency discrimination during different periods were compared across the age groups.Results:The maximum thresholds of frequency identification of cutaneous tactile perception among the 10 subjects ranged from 16.20 to 33.55 Hz, while the range of adjacent step sizes was between 3.60 and 7.10 Hz. The adjacent step sizes were positively correlated with the average value of the sum of adjacent frequencies ( r=0.882, F=529.18, P<0.001). In the test on the maximum threshold of frequency identification of cutaneous tactile perception, there was a statistically significant difference in the main effect of an age group between the 2 groups ( F=15.87, P<0.001), but not in the main effect of the site ( P>0.05), or in the interactions between the group and age ( P>0.05). The accuracies of skin vibration frequency memory on the dorsal hand of the subjects at 3, 15 min and 24 h were 88%, 72% and 68% respectively. In the frequency discrimination test, there were no statistically significant differences in the main effect of the group, main effect of time or in their interactions between the 2 groups (all P>0.05). Conclusions:The ability of the human skin to identify vibration frequency is impacted by age, but there is no difference in sensitivity between the trunk and the back of the hand. It is recommended that the tactile vest for pilots be designed for general purposes to make it easy to adapt to vibration frequencies of multiple parts.

Objective:To verify the applicability of the flight potential evaluation system in the psychological selection of pilots by testing the reliability and validity of the system.Methods:Between September and October 2021, 82 subjects, including 32 pilots and 50 volunteers, were recruited from the Aviation Force and the Air Force Medical Center to complete the flight potential evaluation system test. The pilots and volunteers were divided into the high score group (the top 27% in terms of scores) and low score group (the 27% from the bottom) according to the total score of the evaluation. In order to ensure the consistency of evaluation conditions, some subjects were selected to complete a second evaluation test one week later for reliability analysis. Six flight experts completed the Content Evaluation Form of the Flight Potential Evaluation System while the officer completed the Flight Performance Evaluation Questionnaire as the performance data of the pilots. The pass rates of the pilots and volunteers and discriminability of the flight potential evaluation system were analyzed to test the stability and effectiveness of the system.Results:①The flight potential evaluation system demonstrated a pass rate of 0.75 and a discriminability of 0.30 in pilots, compared with 0.30 and 0.51 in volunteers. The total scores of pilots and volunteers were (7.00±1.16) points and (3.38±2.15) points, respectively, with a statistically significant difference ( t=9.87, P<0.001). Significant differences were found in test scores between high-score group and low-score group for both pilots ( t=10.01, P<0.001) and volunteers ( Z=-4.65, P<0.001). ②Thirty-seven subjects (including 32 pilots and 5 volunteers, all from the Aviation Force) were tested twice, and the Pearson product-moment correlation coefficient for the paired results of 2 identical tests was r=0.750 ( P<0.001). ③As for the content of the evaluation system test, the experts′ degree of agreement and unanimity rate were 1. The evaluation score by the officer was positively correlated with the test score ( r=0.389, P=0.041). Conclusions:The flight potential evaluation system has a strong ability to distinguish flight-related abilities, suggesting that the system can be applied to the psychological selection of pilots and provide data for subsequent tests during the recruitment of candidates.

Peri-implant keratinized mucosa (PIKM) augmentation refers to surgical procedures aimed at increasing the width of PIKM. Consensus reports emphasize the necessity of maintaining a minimum width of PIKM to ensure long-term peri-implant health. Currently, several surgical techniques have been validated for their effectiveness in increasing PIKM. However, the selection and application of PIKM augmentation methods may present challenges for dental practitioners due to heterogeneity in surgical techniques, variations in clinical scenarios, and anatomical differences. Therefore, clear guidelines and considerations for PIKM augmentation are needed. This expert consensus focuses on the commonly employed surgical techniques for PIKM augmentation and the factors influencing their selection at second-stage surgery. It aims to establish a standardized framework for assessing, planning, and executing PIKM augmentation procedures, with the goal of offering evidence-based guidance to enhance the predictability and success of PIKM augmentation.
Humans ; Consensus ; Dental Implants ; Mouth Mucosa/surgery* ; Keratins

Paclitaxel (PTX), a valuable natural product derived from Taxus species, exhibits remarkable anti-cancer properties. It penetrates nanopores in microtubule walls, interacting with tubulin on the lumen surface and disrupting microtubule dynamics, thereby inducing cytotoxic effects in cancer cells. PTX and its derivatives have gained approval for treating various diseases due to their low toxicity, high efficiency, and broad-spectrum application. The widespread success and expanding applications of PTX have led to increased demand, raising concerns about accessibility. Consequently, researchers globally have focused on developing alternative production methods and applying nanocarriers in PTX delivery systems to enhance bioavailability. This review examines the challenges and advancements in PTX sourcing, production, physicochemical properties, anti-cancer mechanisms, clinical applications, trials, and chemo-immunotherapy. It aims to provide a comprehensive reference for the rational development and effective utilization of PTX.
Humans ; Paclitaxel/pharmacology* ; Antineoplastic Agents, Phytogenic/pharmacology* ; Neoplasms/drug therapy* ; Animals ; Taxus/chemistry*

Objective To investigate mutations in OTU domain-containing protein 3(OTUD3)and their functional mechanisms in the initiation and progression of colorectal cancer(CRC).Methods Gene expression profiling interactive analysis(GEPIA2)and the human protein atlas database(THPA)were used to analyze gene transcription and protein expressions.Samples from 32 patients with CRC were collected to identify OTUD3 mutants.Based on the information about mutation sitesof OTUD3 in an existing database,a plasmid vector containing the OTUD3 gene mutant was constructed.Plasmid vectors containing the phosphatase and tensin homolog deleted on chromosome 10(PTEN)and the OTUD3 gene mutant were co-transfected into HCT116 cells.Western blotting,half-life,immunoprecipitation,ubiquitination,and hybrid algorithm molecular docking(H-DOCK)assays were employed to find out whether and why the OTUD3 mutants affected PTEN protein levels.Functional alterations in CRC cells after OTUD3 mutation were verified by CCK-8 cell proliferation,transwell cell invasion,scratch,and clonal formation assays.Results OTUD3 mutations were highly frequent in CRC.OTUD3 mutants R178W and N321S resulted in the loss of function of the stable PTEN protein,leading to enhanced proliferation,invasion,migration,and survival of CRC.Conclusion In CRC,OTUD3 mutation reduces the ability to stabilize PTEN and promotes the occurrence and development of CRC.

Objective To investigate how deubiquitinase OTU domain-containing protein 3(OTUD3)suppresses the progression of hepatocellular carcinoma via gut-liver axis metabolic remodeling and microbiome dynamics.Methods A total of 24 male 2-week-old littermate C57BL/6J mice(12 wild-type and 12 Otud3-/-)were divided into two differential genotype groups before 6 mice from each group were randomly chosen to receive intraperitoneal injections of N-nitrosodieth-ylamine(DEN)for hepatocellular carcinoma(HCC)induction.The mice were divided into four groups(n=6/group):Otud3+/+control(WT CON),Otud3-/-control(KO CON),Otud3+/+DEN-induced HCC(WT DEN),and Otud3-/-DEN-induced HCC(KO DEN).At 40 weeks of age,liver tissues were collected for metabolomic profiling,and fecal samples were obtained for 16S rRNA sequencing.Results Multivariate analyses,including principal component analysis(PCA),partial least squares-discriminant analysis(PLS-DA),sparse partial least squares-discriminant analysis(sPLS-DA),and orthogonal partial least squares-discriminant analysis(OrthoPLS-DA),demonstrated complete intergroup separability.Fifty-four differential metabolites were identified between the WT DEN and KO DEN groups through metabolomic profiling,with gut-liver axis-associated pathways such as cholesterol metabolism and fatty acid biosynthesis revealed by KEGG pathway analysis.Microbiome analysis indicated an upregulation of Bacteroides at the genus level in the KO DEN group compared to WT DEN.Pearson correlation analysis highlighted amino acids and derivatives as predominant metabolite classes and revealed Bacteroidetes and Firmicutesas the dominant gut microbial phyla.Conclusion OTUD3 suppresses HCC progression by modulating gut-liver axis metabolism,potentially mediated by elevated betaine and increased abundance of Odoribacter,Alistipes,and Lachnoclostridium.

OBJECTIVE To retrospectively analyze the clinical efficacy of Qingchi San in the treatment of mild-to-moderate ul-cerative colitis.METHODS A retrospective analysis was conducted on 221 ulcerative colitis patients treated at the Gastroenterology Department of First Teaching Hospital of Tianjin University of Traditional Chinese Medicine from December 2014 to February 2024.Participants were divided into an observation group(n=121)and a control group(n=100).The control group received oral me-salazine,while the observation group received Qingchi San enema in addition to the control group's treatment.Both groups received a 4-week course of treatment.The two groups were compared in terms of clinical efficacy,clinical remission rate,TCM syndrome score,time to intestinal bleeding remission,and changes in inflammatory markers(C-reactive protein,erythrocyte sedimentation rate,and white blood cells)and coagulation markers(platelets and D-dimer).RESULTS After treatment,the total effective rate and clinical remission rate in the observation group were significantly higher than those in the control group(P<0.05,P<0.01).The TCM syn-drome scores for each item(diarrhea,abdominal pain,bloody stools with mucus,and tenesmus)in the observation group were signifi-cantly improved compared with those in the control group(P<0.01).The time to intestinal bleeding remission in the observation group was significantly shorter than that in the control group(P<0.01).C-reactive protein,erythrocyte sedimentation rate,and white blood cell count in the observation group were significantly decreased compared with those in the control group(P<0.05,P<0.01).There was no statistically significant difference in coagulation markers(platelets and D-dimer)between the two groups(P>0.05).No signif-icant treatment-related adverse reactions,such as liver and kidney damage,were observed during treatment.CONCLUSION Qing-chi San enema can improve the clinical efficacy of patients with mild-to-moderate ulcerative colitis,improve clinical symptoms,short-en bleeding time,and reduce inflammatory markers.

OBJECTIVE To retrospectively analyze the clinical efficacy of Qingchi San in the treatment of mild-to-moderate ul-cerative colitis.METHODS A retrospective analysis was conducted on 221 ulcerative colitis patients treated at the Gastroenterology Department of First Teaching Hospital of Tianjin University of Traditional Chinese Medicine from December 2014 to February 2024.Participants were divided into an observation group(n=121)and a control group(n=100).The control group received oral me-salazine,while the observation group received Qingchi San enema in addition to the control group's treatment.Both groups received a 4-week course of treatment.The two groups were compared in terms of clinical efficacy,clinical remission rate,TCM syndrome score,time to intestinal bleeding remission,and changes in inflammatory markers(C-reactive protein,erythrocyte sedimentation rate,and white blood cells)and coagulation markers(platelets and D-dimer).RESULTS After treatment,the total effective rate and clinical remission rate in the observation group were significantly higher than those in the control group(P<0.05,P<0.01).The TCM syn-drome scores for each item(diarrhea,abdominal pain,bloody stools with mucus,and tenesmus)in the observation group were signifi-cantly improved compared with those in the control group(P<0.01).The time to intestinal bleeding remission in the observation group was significantly shorter than that in the control group(P<0.01).C-reactive protein,erythrocyte sedimentation rate,and white blood cell count in the observation group were significantly decreased compared with those in the control group(P<0.05,P<0.01).There was no statistically significant difference in coagulation markers(platelets and D-dimer)between the two groups(P>0.05).No signif-icant treatment-related adverse reactions,such as liver and kidney damage,were observed during treatment.CONCLUSION Qing-chi San enema can improve the clinical efficacy of patients with mild-to-moderate ulcerative colitis,improve clinical symptoms,short-en bleeding time,and reduce inflammatory markers.