Objective : To investigate the effect of solasonine regulation of the STAT3 signaling pathway on the bio- logical behavior of lung adenocarcinoma cells． Methods : H1299 cells were treated with 0. 125，0. 25，0. 5 and 0. 75 mmol /L solasonine，respectively．The proliferative activity of H1299 cells was detected by CCK-8．The mi- gration and invasion ability of H1299 cells were detected by scratch，Transwell migration and invasion assay．The apoptosis level of H1299 cells was detected by flow cytometry and Hoechest 33258 /PI double staining．The protein expression levels of STAT3，p-STAT3 ，Bcl-2 ，Bax ，Caspase-3 ，Cl-Caspase-3 ，Snail ，Slug ，N-cadherin and E- cadherin in H1299 cells were detected by Western blot assay． Results: Solasonine at different concentrations sig- nificantly reduced the proliferation of H1299 cells (P＜0. 05) ．0. 125 and 0. 25 mmol /L solasonine promoted the apoptosis of H1299 cells (P＜0. 05) and inhibited the migration and invasion of H1299 cells (P＜0. 05) ．Solaso- nine inhibited the expression of STAT3，p-STAT3 and Bcl-2 proteins，enhanced the expression of Bax，Caspase-3 and Cl-Caspase-3 proteins．Solasonine inhibited the activation of STAT3 in cells，reduced Snail and Slug protein expression levels，enhanced E-cadherin，reduced N-cadherin(P＜0. 05) ． Conclusion Solasonine can inhibit the activation of STAT3 ，activate the Bcl-2 /Bax / Caspase3 apoptosis pathway ，inhibit the continuous proliferation of lung adenocarcinoma H1299 cells，and promote the apoptosis of lung adenocarcinoma H1299 cells．Meanwhile，it can inhibit the activation of STAT3，reduce the expression of Snail / Slug protein，affect the EMT transformation of lung adenocarcinoma H1299 cells，and inhibit the migration and invasion of lung adenocarcinoma H1299 cells．

Objective : To investigate the effects of immunoglobulin gene superfamily 10 (IGSF10) on prolifera- tion，migration and invasion of lung adenocarcinoma cells． Methods : ioinformatics was applied to study the ex- pression levels of IGSF10 in tumor tissues and normal tissues． Western blot and quantitative real-time PCR ( qPCR) were used to detect the expression level of IGSF10 in lung adenocarcinoma cell lines and normal lung epi- thelial cells．Knockdown of IGSF10，the effect of knockdown of IGSF10 on proliferation，migration and invasion of lung adenocarcinoma A549 cells was examined using cell counting kit-8 ( CCK-8) ，Transwell migration and inva- sion assay，scratch assay and plate cloning assay．The effects of knockdown of IGSF10 on the expression of invasion and migration-related genes in A549 cells were examined by Western blot and qPCR assays. Results : IGSF10 ex- pression in lung adenocarcinoma tissues was lower than that in normal tissues (P ＜0. 05) ．IGSF10 expression in lung adenocarcinoma cell lines was lower than that in lung epithelial cells (P＜0. 05) ．Knockdown of IGSF10 pro- moted the ability of lung adenocarcinoma A549 cells to proliferate ，proliferation ，migration and invasion ( P < 0. 05) ．Knockdown of IGSF10 promoted the expression of regulatory epithelial-mesenchymal transition marker Neu- ral-cadherin (N-cadherin) and key transcription factors Snail family transcriptional repressor 1 (Snail) and Snail family transcriptional repressor 2 (Slug) (P＜0. 05) and inhibited the expression of Epithelial-cadherin (E-cad- herin) (P＜0. 05) ． Conclusion Knockdown of IGSF10 may promote proliferation，migration and invasion of lung adenocarcinoma cells through activation of Snail，Slug / E-cadherin signaling axis，and this result may provide a po- tential new target for clinical diagnosis and treatment of lung adenocarcinoma.

Epithelial splicing regulatory protein 1(ESRP1)is an epithelial cell-specific splicing factor that in-volved in selective splicing and translation of multiple genes.ESRP1 regulates signaling pathways that affect cell proliferation and tumor growth via mediating target genes and regulating cyclic RNA cyclization and biogenesis in a variety of cancers,including head and neck squamous cell carcinoma,carcinoma of colon,and prostate cancer.Through integrating and analyzing the link between ESRP1 and related cancers,provide new ideas for the treatment of tumor cells in which ESRP1 as a key factor.

Objective To investigate the value of the volume percentage of solid component in differential diagnosis of stage Ⅰ lung adenocarcinoma subtypes,and to predict the optimal critical CT value of solid component.Methods A total of 962 nodules with sur-gical pathological findings confirmed as adenocarcinoma in situ(AIS)or pulmonary adenocarcinoma and manifested as subsolid nod-ules on thin-section CT were analyzed retrospectively,and divided the lesions into:(1)AIS(n=350)or pulmonary adenocarcinoma(n=612)groups;and(2)minimally invasive adenocarcinoma(MIA)(n=213)or invasive adenocarcinoma(IAC)(n=399)groups based on pathological findings.The volume percentage of solid components within pulmonary nodules was measured via CT density histogram analysis at different thresholds,the diagnostic efficacy of different thresholds was analyzed and the optimal critical CT val-ues of solid component was found.Results In the AIS versus pulmonary adenocarcinoma groups,age,mass,and volume percentage of solid component were statistically significant(P＜0.001);the CT threshold of-350 HU had the highest diagnostic efficacy[area under the curve(AUC)0.859,accuracy 81.69％,sensitivity 85.60％,and specificity 74.86％,respetively],and the critical value of volume percentage of solid component determined under this threshold was 8.3％.In the MIA versus IAC groups,age(P=0.017),mass(P＜0.001),and volume percentage of solid component(P＜0.001)were statistically significant;the CT threshold of-350 HU had the highest diagnostic efficacy(AUC 0.857,accuracy 78.27％,sensitivity 82.91％,and specificity 69.48％,respectively),and the critical value of volume percentage of solid component determined under this threshold was 16.9％.Conclusion The volume percentage of solid component measured based on CT density histogram analysis may be helpful in the differential diagnosis of early stage lung ade-nocarcinoma subtypes.

Purpose To explore the clinical and imaging characteristics of rupture death cases of pseudoaneurysm,and to enhance the awareness of prevention strategies,early diagnosis and treatment.Materials and Methods Clinical imaging data of six patients with pseudoaneurysm rupture and death in the Second Affiliated Hospital of Air Force Military Medical University from January 2016 to December 2021 were retrospectively analyzed.Results CT and MRI findings of false aneurysms were circular or irregular tumor bodies that protrusion the tumor bearing artery,and could be seen to communicate with the tumor bearing artery.There might be thrombosis in the tumor body,compression displacement of the adjacent tumor bearing artery,thinning or thickening of the lumen.Imaging features of six cases with pseudoaneurysm showed that the location,shape,size,size of rupture,relationship with parent artery and surrounding tissue structure,with clear and definite diagnosis.Two cases of pseudoaneurysm of aortic arch was formed after swallowing date kernel by mistake and removing under endoscope.Pseudoaneurysm formation was caused by trauma in one case,after intervention in one case,and with no clear reason in one case.In one case,pseudoaneurysm of cavernous segment of left internal carotid artery was caused by erosion of adjacent vessel wall by intracranial nonspecific infection.Before death,all 6 cases had sudden symptoms of hematemesis or nosebleed,suggesting pseudoaneurysm rupture.Conclusion The rupture of pseudoaneurysm has a high mortality rate.CT and MR can objectively show the imaging manifestations of pseudoaneurysm,with certain clinical value.

Hemodynamically unstable pelvic fracture is an important cause of trauma-related deaths and its treatment presents a major challenge for trauma surgery. Internal iliac artery devascularization including ligation and embolization of the internal iliac artery with occlusion of the internal iliac artery as their hemostatic mechanism, has been proved to be effective in controlling massive hemorrhage after pelvic fracture. Nevertheless, there still remain substantial differences in the understanding of internal iliac artery devascularization in clinical practice. Some and issues that should be paid attention to its emergency application in the management of hemodynamically unstable pelvic fracture have not been fully elucidated. To this end, the authors emphasized the efficacy and safety of internal iliac artery devascularization, its indications, and key points in implementation, aiming to promote its standardized application in the treatment of hemodynamically unstable pelvic fracture, thus improving treatment outcomes.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Objective:To analyze clinical features, short-term efficacy and side effects of salvage re-irradiation therapy for patients with locally recurrent esophageal cancer after definitive chemoradiotherapy, to investigate the prognostic factors of re-irradiation with precise radiotherapy techniques.Methods:A retrospective analysis was performed on patients with locally recurrent esophageal squamous cell carcinoma after definitive chemoradiotherapy treated in the Fourth Hospital of Hebei Medical University from January 2008 to December 2016. The patients underwent re-irradiation therapy (re-RT) or re-irradiation therapy concurrent chemotherapy (re-CCRT). The main observation index was after-recurrence survival (ARS), which was calculated by Kaplan-Meier method for survival analysis. Univariate analysis was conducted by log-rank test, and multivariate analysis was performed by Cox regression model.Results:A total of 109 patients were included, with a median age of 66 years (43-89 years), and a median follow-up time of 120.8 months (79.0-176.5 months). The objective response rates (ORR) and dysphagia improvement rates (DIR) in all patients were 64.2% and 63.0%, respectively. The median ARS and 1-, 3-, 5-, 8-year survival rates in all patients were 7.8 months and 32.1%, 9.2%, 7.3% and 2.3%, respectively. The median ARS and 1-, 3-, 5-years survival rates were 10.8 months and 45.9%, 13.5%, 10.8% for patients with time to recurrence (TTR) ≥24 months, significantly longer than those of 5.7 months and 25.0%, 6.9%, 5.6% for patients with TTR<24 months ( χ2=7.99, P=0.005). The median ARS in groups with re-irradiation dose of ≤50 Gy,>50-54 Gy, and>54 Gy groups were 5.7, 10.0 and 8.1 months, respectively ( χ2=6.94, P=0.031). The 1-, 3- and 5-year survival rates were 30.4%, 5.1%, and 3.8% for re-RT versus 36.7%, 20.0%, and 16.7% for re-CCRT ( χ2=2.12, P=0.145). Multivariate analysis showed that TTR ( HR=0.607, 95% CI=0.372-0.991, P=0.046) and lesion length ( HR=0.603, 95% CI=0.371-0.982, P=0.042) were the independent factors for ARS. There was no significant difference in ≥2 grade pneumonitis and 2-3 grade radiation esophagitis between the re-RT and re-CCRT groups ( χ2=0.25, P=0.619; χ2=0.51, P=0.808). The morbidity of ≥2 grade myelosuppression in the re-RT group was significantly lower than that in the re-CCRT group (3.7% vs. 36.7%, χ2=18.15, P<0.001). Conclusions:Precise re-irradiation therapy for patients with locally recurrent esophageal cancer after definitive chemoradiotherapy can alleviate dysphagia, but ARS remains poor. Re-irradiation dose range from>50-54 Gy may be suitable for locally relapse patients as salvage treatment. Patients with TTR≥24 months and lesion length ≤5 cm obtain favorable prognosis.

Objective:To investigate the clinical characteristics and surgical treatment outcomes of children with cervical bronchogenic cysts. Methods:A retrospective study of 6 pediatric patients with bronchogenic cysts in the neck region treated in our hospital during 2014 to 2020 was performed. All children underwent complete resection of cervical mass under general anesthesia. Results:There were 6 children, aged from 1 to 5 years, with a median of 2.25 years. There were 3 males and 3 females. The lesions were located on the left neck in 3 cases, the midline neck in 2 cases and the right neck in 1 case. The clinical manifestations were painless mass in 5 cases and recurrent neck infection in 1 case. The size of the mass ranged from 2.1 to 7.5 cm. There was no characteristic clinical or imaging features of bronchogenic cysts. Misdiagnosed as lymphangioma in 3 cases, thyroglossal cyst in 2 cases and piriform fistula in 1 case. The follow-up ranged from 1.50 to 7.75 years, with a median of 4.13 years. All 6 children had no recurrence or complications. Conclusion:Although rare, bronchogenic cysts should be considered in the differential diagnosis of cervical cystic masses in children. Surgery is the most effective way to treat cervical bronchogenic cyst, and histopathological examination is the gold standard for diagnosis.
Male ; Female ; Humans ; Child ; Bronchogenic Cyst/pathology* ; Retrospective Studies ; Neck/surgery* ; Diagnosis, Differential ; Treatment Outcome

Objective To explore the common CT signs of acquired immune deficiency syndrome(AIDS)-associated pneumocystis jirovecii pneumonia(PJP).Methods The chest CT data of 123 patients with AIDS-associated PJP were analyzed retrospectively.Results Multifocal lesions in both lungs were found in all cases.Distribution characteristics were as follows:diffuse and symmetrical distribution in both lungs in 100 cases(81.3％),diffuse and asymmetrical distribution in both lungs in 15 cases(12.2％),and scattered distribution in both lungs in 8 cases(6.5％).The density and morphological features were as follows:ground glass opacity in 120 cases(97.6％);"lunate arch sign"in 25 cases(20.3％);pulmonary interstitial proliferation in 103 cases(83.7％);crazy paving pattern in 14 cases(11.4％);patchy or consolidation shadow in 55 cases(44.7％);pulmonary cysts in 26 cases(21.1％);and nodular in 26 cases(21.1％).Other rare signs included pleural effusion in 11 cases,pericardial effusion in 6 cases,mediastinal and hilar lymphadenopathy in 9 cases,and mediastinal emphysema in 1 case.Conclusion The chest CT manifestations of AIDS-associated PJP have certain characteristics,including diffuse and symmetrical distribution of lesions in both lungs,as well as ground glass opacity and interstitial hyperplasia as common signs,especially,"lunate arch sign"and pulmonary cysts are more specific signs.