Objective:To investigate the clinical and pathological characteristics of primary thoracic synovial sarcoma (PTSS).Methods:Forty-two PTSS cases diagnosed at the Department of Pathology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China from October 2011 to April 2024 were analyzed. All cases were retrospectively studied using hematoxylin-eosin staining and immunohistochemistry. Their clinicopathological features were also reviewed. SS18 rearrangement was assessed in 28 cases using fluorescence in situ hybridization (FISH). Next generation sequencing (NGS) was performed on 8 cases.Results:Among the 42 cases, there were 23 biopsies and 19 surgically-removed specimens. One case was a specimen resected after neoadjuvant chemotherapy. There were 22 males and 20 females, with an age ranging from 6 to 68 years. Twenty-nine cases occured in the lung, 6 in mediastinum, 4 in pericardium, 1 in visceral pleura, and 1 in right atrium. One case did not show any unequivocal primary site. Computed tomography showed the tumors were manifested as a cystic mass, a solid mass, or thickening of the pleura and pericardium. Thirty-two cases had respiratory symptoms, while 19 had pleural effusion. One case had a history of radiotherapy for papillary thyroid carcinoma. Nineteen patients were treated with surgery, while 19 were treated with chemotherapy without surgery. Four patients were diagnosed and discharged, without specific treatment on the record. Morphologically, 1 case was biphasic type, 39 cases were monophasic type, and 2 cases were poorly differentiated type. In addition to the typical morphology of synovial sarcoma, tumors also showed pulmonary bullous changes, stromal collagen hyalinization, hemangiopericytoma-like vasculature, stromal edematous myxoid changes, and microcystic structure. Immunohistochemically, all cases were diffusely positive for TRPS1 (22/22), TLE1 (21/22), CD99 (26/26), SS18-SSX (25/25) and INI1 (12/12), including 3 cases with decreased expression of INI1. Twenty-one cases were focally positive for EMA (21/30), 4 cases for SMA (4/23), 2 cases for S-100 (2/28), and 2 cases (2/35) for CKpan. Twenty-eight cases (28/28) had SS18 rearrangement displaying a split signal on FISH analysis. Eight cases were found to have mutations in SMC1A, NOTCH2, CDK12, SPRY4, BRCA1, STK11, NF2, and PDGFRα genes using NGS. Eighteen of the 29 patients survived and 16 showed disease progression.Conclusions:PTSS is more commonly found in the lungs than other sites and has non-classical morphological features of various types, which need to be differentiated from other tumors. TRPS1 is highly expressed in PTSS and has certain diagnostic values. The diagnosis of PTSS also requires combination of patient′s medical history with thorough imaging studies.

Objective To explore the changes in cognitive neural networks in AD patients at differ-ent stages of disease progression to provide electrophysiological basis for the pathogenesis and early diagnosis and treatment of AD.Methods A total of 84 patients admitted to Department of Neurology of General Hospital of Tianjin Medical University from September 2018 to June 2022 were prospectively recruited,and divided into AD patients group(42 cases)and MCI group(42 cases)according to their disease severity.Another 42 healthy individuals who taking physical examination during the same period were subjected and served as HC group.Post-resting EEG data were analyzed with Matlab software,and coherence analysis was performed by self-programmed program.Univariate analysis of variance was used to compare the interhemispheric and intra-hemispheric coherence values of six frequency bands in the three groups.Results The cohe-rence values of the related electrode pairs in the anterior head(frontal region+anterior tem-poral region)were significantly lower in the AD group than in the HC group(P＜0.05),with the Alpha and Beta dominant bands and dominant hemispheres dominant,while the values of related electrode pairs in the posterior head(temporal region)were obviously higher in the AD group than the HC group(P＜0.05),with the Gamma band dominant.In all the frequency bands except the Alpha band,the AD group had higher coherence values in most of the electrode pairs than the HC group,and the Gamma band was the most extensive.In the MCI group,only the coherence value of the electrodes in the occipito-posterior temporal region(O2-T6)in the right Alpha band was higher than that in the HC group(P＜O.05).Except Gamma band,the coherence value of the related electrode pairs in the frontal region was notably lower in the AD group than the MCI group(P＜0.05),and the Alpha and Beta bands were dominant.The results of interhemispheric cohe-rence showed that most of the electrode pairs in the AD group had higher coherence values than the MCI group in all the frequency bands and the Gamma band(P＜0.05).Conclusion EEG coherence can provide electrophysiological basis for the pathogenesis and early diagnosis of AD.

Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by persistent inflammation and joint damage, accompanied by the accumulation of plasma cells, which contributes to its pathogenesis. Understanding the genetic alterations occurring during plasma cell differentiation in RA can deepen our comprehension of its pathogenesis and guide the development of targeted therapeutic interventions. Here, our study elucidates the intricate molecular mechanisms underlying plasma cell differentiation by demonstrating that PRDX1 interacts with DOK3 and modulates its degradation by the autophagy-lysosome pathway. This interaction results in the inhibition of plasma cell differentiation, thereby alleviating the progression of collagen-induced arthritis. Additionally, our investigation identifies Salvianolic acid B (SAB) as a potent small molecular glue-like compound that enhances the interaction between PRDX1 and DOK3, consequently impeding the progression of collagen-induced arthritis by inhibiting plasma cell differentiation. Collectively, these findings underscore the therapeutic potential of developing chemical stabilizers for the PRDX1-DOK3 complex in suppressing plasma cell differentiation for RA treatment and establish a theoretical basis for targeting PRDX1-protein interactions as specific therapeutic targets in various diseases.

Objective To investigate the clinical efficacy of Chinese medicine sequential therapy combined with Clomiphene in the treatment of ovulatory disorder infertility(ODI),and to observe the effects of the combined therapy on the endometrial thickness,ovarian diameter,ovulation rate and pregnancy rate of the patients.Methods A total of 120 patients with ODI admitted to the Department of Obstetrics and Gynecology of the 7th People's Hospital of Zhengzhou from July 2021 to August 2023 were randomly divided into the control group and the observation group,with 60 patients in each group.The two groups were treated with Clomiphene,and additionally the observation group was treated with Chinese medicine sequential therapy of"nourishing yin and enriching blood,warming kidney to resolve phlegm and unblock collaterals,and tonifying kidney and strengthening spleen"in accordance with the menstrual cycle.Three menstrual cycles constituted a course of treatment.Before and after treatment,the changes in the traditional Chinese medicine(TCM)syndrome scores of the two groups were observed.After treatment for three menstrual cycles,the clinical efficacy,endometrial thickness,follicle diameter,ovulation rate,pregnancy rate,incidence of biphasic basal body temperature(BBT),and the incidence of adverse reactions after in the two groups were compared.Results(1)After three menstrual cycles of treatment,the total effective rate of the observation group was 96.67％(58/60)and that of the control group was 83.33％(50/60),and the comparison between the two groups showed that the efficacy of the observation group was significantly superior to that of the control group,the difference being statistically significant(x2=5.926,P＜0.05).(2)After three menstrual cycles of treatment,the TCM scores of patients in both groups were decreased significantly compared with those before treatment(P＜0.01),and the decrease of the scores in the observation group was significantly superior to that in the control group,with statistically significant differences(P＜0.01).(3)After three menstrual cycles of treatment,the follicle diameter of the observation group was longer than that of the control group,and the incidence of biphasic BBT[60.00％(36/60)],ovulation rate[63.33％(38/60)],and pregnancy rate[25.00％(15/60)]were higher than those of the control group,which were 31.67％(19/60),41.67％(25/60),and 10.00％(6/60),respectively.The differences of the above four indicators between the two groups were statistically significant(P＜0.05 or P＜0.01).However,the differences of endometrial thickness and the incidence of adverse reactions between the two groups were not statistically significant(P＞0.05).Conclusion Chinese medicine sequential therapy combined with Clomiphene exerts certain efficacy in treating patients with ODI,which can effectively relieve clinical symptoms,improve the BBT conditions,enhance the ovulation rate and pregnancy rate,with high safety.

Objective To develop an erythrocyte-based delivery system for butyrylcholinesterase(BChE)that is capable of prophylaxis against organophosphorus nerve agents.Methods Recombinant BChE was produced and analyzed for oligomerization via polyacrylamide gel electrophoresis(PAGE)and Western blotting.A modified hypotonic preswelling method was employed to prepare BChE-loaded erythrocytes.The drug loading capacity and encapsulation efficiency were quantified using enzyme-linked immunosorbent assay(ELISA).Catalytic activity was assessed in vitro with an activity detection kit.The system was characterized via scanning electron microscopy(SEM),flow cytometry and a hematology analyzer.Results Recombinant BChE predominantly existed as dimers(85％dimer,15％monomer).The optimized volume ratio of erythrocytes to hypotonic solution was determined as 1:7.Compared with native and empty erythrocytes,BChE-loaded erythrocytes exhibited significantly higher catalytic activity(P＜0.001).The mean corpuscular volume of BChE-loaded erythrocytes increased(P＜0.001),while the mean content of corpuscular hemoglobin and hemoglobin in erythrocytes per 100 mL decreased(P＜0.001).SEM revealed no morphological differences(biconcave disc shape).Hypotonic preswelling moderately increased erythrocyte apoptosis(P＜0.001),but no statistical difference was observed between BChE-loaded and hypotonic-treated erythrocytes(P＞0.05).CD47 expression remained unchanged compared to native erythrocytes(P＞0.05).Conclusion The modified hypotonic preswelling method can generate BChE-loaded erythrocytes that retain the characteristics of native erythrocytes while conferring catalytic activity,offering a novel strategy for clinical intervention against organophosphorus poisoning.

Objective:To investigate the clinical and pathological characteristics of primary thoracic synovial sarcoma (PTSS).Methods:Forty-two PTSS cases diagnosed at the Department of Pathology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China from October 2011 to April 2024 were analyzed. All cases were retrospectively studied using hematoxylin-eosin staining and immunohistochemistry. Their clinicopathological features were also reviewed. SS18 rearrangement was assessed in 28 cases using fluorescence in situ hybridization (FISH). Next generation sequencing (NGS) was performed on 8 cases.Results:Among the 42 cases, there were 23 biopsies and 19 surgically-removed specimens. One case was a specimen resected after neoadjuvant chemotherapy. There were 22 males and 20 females, with an age ranging from 6 to 68 years. Twenty-nine cases occured in the lung, 6 in mediastinum, 4 in pericardium, 1 in visceral pleura, and 1 in right atrium. One case did not show any unequivocal primary site. Computed tomography showed the tumors were manifested as a cystic mass, a solid mass, or thickening of the pleura and pericardium. Thirty-two cases had respiratory symptoms, while 19 had pleural effusion. One case had a history of radiotherapy for papillary thyroid carcinoma. Nineteen patients were treated with surgery, while 19 were treated with chemotherapy without surgery. Four patients were diagnosed and discharged, without specific treatment on the record. Morphologically, 1 case was biphasic type, 39 cases were monophasic type, and 2 cases were poorly differentiated type. In addition to the typical morphology of synovial sarcoma, tumors also showed pulmonary bullous changes, stromal collagen hyalinization, hemangiopericytoma-like vasculature, stromal edematous myxoid changes, and microcystic structure. Immunohistochemically, all cases were diffusely positive for TRPS1 (22/22), TLE1 (21/22), CD99 (26/26), SS18-SSX (25/25) and INI1 (12/12), including 3 cases with decreased expression of INI1. Twenty-one cases were focally positive for EMA (21/30), 4 cases for SMA (4/23), 2 cases for S-100 (2/28), and 2 cases (2/35) for CKpan. Twenty-eight cases (28/28) had SS18 rearrangement displaying a split signal on FISH analysis. Eight cases were found to have mutations in SMC1A, NOTCH2, CDK12, SPRY4, BRCA1, STK11, NF2, and PDGFRα genes using NGS. Eighteen of the 29 patients survived and 16 showed disease progression.Conclusions:PTSS is more commonly found in the lungs than other sites and has non-classical morphological features of various types, which need to be differentiated from other tumors. TRPS1 is highly expressed in PTSS and has certain diagnostic values. The diagnosis of PTSS also requires combination of patient′s medical history with thorough imaging studies.

Objective To explore the changes in cognitive neural networks in AD patients at differ-ent stages of disease progression to provide electrophysiological basis for the pathogenesis and early diagnosis and treatment of AD.Methods A total of 84 patients admitted to Department of Neurology of General Hospital of Tianjin Medical University from September 2018 to June 2022 were prospectively recruited,and divided into AD patients group(42 cases)and MCI group(42 cases)according to their disease severity.Another 42 healthy individuals who taking physical examination during the same period were subjected and served as HC group.Post-resting EEG data were analyzed with Matlab software,and coherence analysis was performed by self-programmed program.Univariate analysis of variance was used to compare the interhemispheric and intra-hemispheric coherence values of six frequency bands in the three groups.Results The cohe-rence values of the related electrode pairs in the anterior head(frontal region+anterior tem-poral region)were significantly lower in the AD group than in the HC group(P＜0.05),with the Alpha and Beta dominant bands and dominant hemispheres dominant,while the values of related electrode pairs in the posterior head(temporal region)were obviously higher in the AD group than the HC group(P＜0.05),with the Gamma band dominant.In all the frequency bands except the Alpha band,the AD group had higher coherence values in most of the electrode pairs than the HC group,and the Gamma band was the most extensive.In the MCI group,only the coherence value of the electrodes in the occipito-posterior temporal region(O2-T6)in the right Alpha band was higher than that in the HC group(P＜O.05).Except Gamma band,the coherence value of the related electrode pairs in the frontal region was notably lower in the AD group than the MCI group(P＜0.05),and the Alpha and Beta bands were dominant.The results of interhemispheric cohe-rence showed that most of the electrode pairs in the AD group had higher coherence values than the MCI group in all the frequency bands and the Gamma band(P＜0.05).Conclusion EEG coherence can provide electrophysiological basis for the pathogenesis and early diagnosis of AD.

Objective To explore the safety and feasibility of the application of day surgery management model under enhanced recovery after surgery(ERAS)concept in patients undergoing gynecologic laparoscopic surgery.Methods A non-randomized concurrent control trial was conducted on the patients who underwent laparoscopic surgery in our department from January to August 2021.A total of 92 patients admitted on odd date were assigned into Ward B of our department and served as the control group,and another 96 patients hospitalized on even date were subjected into Ward A and served as the observation group.The control group was given the routine treatment schedule,including the relevant examinations after admission and general operation procedure during hospitalization.The observation group was under a day surgery management model based on the concept of ERAS,with aid of a day surgery team and optimized perioperative management measures,including pre-hospital rehabilitation,shortening water fasting before surgery,multi-mode analgesia,preventive antiemesis,intraoperative warmth,prevention of deep vein thrombosis,immediate postoperative eating and activity,and follow-up after discharge.Postoperative subjective comfort,intestinal function recovery,social and economic benefits,postoperative complications and inflammatory indicators were compared between the 2 groups.Results In 0～6,7～12 and 13～24 h after operation,the scores of thirst,hunger,nausea,pain,abdominal distension and pharyngeal discomfort were significantly lower in the observation group than the control group(P＜0.01).The observation group had obviously shorter length of hospital stay and ealier bowel sound recovery and first anal exhaust than the control group(P＜0.01).No postoperative complication,such as fall,unplanned secondary operation or wound infection was observed in both groups.The postoperative inflammatory indicators,including procalcitonin(PCT),neutrophil percentage(Neu％)and white blood cell count(WBC)were all in the normal ranges in the 2 groups at 24 h and 3 and 7 d after surgery.Statistical differences were found in firstly postoperative mobilization,length of hospital stay,hospitalization cost and patient satisfaction between the 2 groups(P＜0.01).Conclusion ERAS-based day surgery management model has the advantages of shortening hospital stay,reducing medical costs,promoting postoperative rehabilitation,and improving the comfort and satisfaction in patients undergoing gynecologic laparoscopic surgery.

ObjectiveBased on cyclic adenosine monophosphate （cAMP）/cAMP-regulated guanine nucleotide exchange factor 1 （Epac1）/Ras-homologous protein 1 （Rap1） signaling pathway to explore the myocardial protective mechanism of Yiqi Huoxue prescription on coronary heart disease （CHD） rats with Qi deficiency and blood stasis syndrome. MethodEighty-eight specific-pathogen-free （SPF） grade male Sprague-Dawley （SD） rats were divided into a sham operation group （n=12） and an experimental group （n=76） according to the random number table. The experimental group underwent a restricted diet and exhaustive swimming combined with left anterior descending （LAD） coronary artery ligation to construct a model of CHD with Qi deficiency and blood stasis syndrome， and electrocardiograms （ECGs） of rats before and after the LAD operation were collected. After the model was successfully established， the rats were randomly divided into model group， Yiqi Huoxue prescription low-dose group （4.28 g·kg^-1）， medium-dose group （8.55 g·kg^-1）， high-dose group （17.1 g·kg^-1）， and Western medicine group （isosorbide mononitrate tablets， 3.6 mg·kg^-1）. Rats were intragastrically administered assigned drugs for 4 weeks consecutively， while the sham operation group and the model group were administered with equal volumes of double distilled water. Twenty-four hours after the final administration， the rats were anesthetized with isoflurane to detect the left ventricular end-diastolic diameter （LVEDD）， left ventricular end-systolic diameter （LVESD）， left ventricular fractional shortening （FS， %）， and ejection fraction （EF， %） by echocardiography. Blood samples were collected from the abdominal aorta for hemorheological measurements， and plasma cAMP levels were determined using enzyme-linked immunosorbent assay （ELISA）. Myocardial tissue was collected for hematoxylin-eosin （HE） staining and Masson staining to observe myocardial pathological damage， and a transmission electron microscope was used to observe ultrastructural changes of myocardial tissue， fluorescent quantitative real-time polymerase chain reaction （Real-time PCR） was used to detect the expressions of myocardial Epac1， Rap1 GTPase activating protein （Rap1GAP） and Rap1 mRNA， and Western blot was used to detect the expressions of myocardial Epac1， Rap1GAP and Rap1 protein. ResultCompared with those in the sham operation group， LVEDD and LVISD of rats in the model group significantly increased （P<0.01）， and the ratios of EF and FS significantly decreased （P<0.01）， indicating symptoms of heart function decline， referred to as "heart Qi deficiency". The viscosity of whole blood and plasma significantly increased （P<0.01）， and the content of cAMP significant increased （P<0.01）. In addition， there was a significant proliferation of collagen fibers in myocardial tissue （P<0.01）， and the ultrastructure of the myocardial tissue was severely damaged， indicating pathological changes consistent with "blood stasis". Real-time PCR results showed that Epac1 and Rap1 mRNA levels in the model group were significantly reduced （P<0.01）， while Rap1GAP mRNA levels were significantly increased （P<0.01）. Western blot analysis showed a significant decrease in Epac1 protein expression （P<0.01） and a significant increase in Rap1GAP protein expression （P<0.05）. Compared with the model group， Yiqi Huoxue prescription improved cardiac function， reduced blood viscosity， lowered plasma cAMP levels， decreased collagen fiber proliferation， and improved myocardial ultrastructure damage in CHD rats with Qi deficiency and blood stasis syndrome. The high-dose group showed the most significant effects. In the high-dose group， Epac1 mRNA and protein expression levels significantly increased （P<0.01）， Rap1 mRNA expression significantly increased （P<0.01）， and Rap1GAP mRNA and Rap1GAP/Rap1 protein expression levels significantly decreased （P<0.05， P<0.01）. ConclusionYiqi Huoxue prescription can improve cardiac function， reduce blood viscosity and plasma cAMP levels， improve myocardial damage， and reduce collagen fiber proliferation in CHD rats with Qi deficiency and blood stasis syndrome. The myocardial protection mechanism may be related to the regulation of the cAMP/Epac1/Rap1 signaling pathway.