Glioblastoma (GBM) is a highly aggressive primary brain tumor characterized by poor prognosis. Conventional chemo-radiotherapy demonstrates limited therapeutic efficacy and is often accompanied by significant side effects, largely due to factors such as drug resistance, radiation resistance, the presence of the blood-brain barrier (BBB), and the activation of DNA damage repair mechanisms. There is a pressing need to enhance treatment efficacy, with BRD4 identified as a promising target for increasing GBM sensitivity to therapy. Lacking small molecule inhibitors, BRD4 can be degraded using PROteolysis Targeting Chimera (PROTAC), thereby inhibiting DNA damage repair. To deliver PROTAC, SIAIS171142 (SIS) effectively, we designed a responsive nanocapsule, MPL_(SS)P@SIS, featuring GBM-targeting and GSH-responsive drug release. Modified with 1-methyl-l-tryptophan (MLT), nanocapsules facilitate targeted delivery of SIS, downregulating BRD4 and sensitizing GBM cells to radiotherapy and chemotherapy. After intravenous administration, MPL_(SS)P@SIS selectively accumulates in tumor tissue, enhancing the effects of radiotherapy and temozolomide (TMZ) by increasing DNA damage and oxidative stress. GSH activates the nanocapsules, triggering BRD4 degradation and hindering DNA repair. In mouse models, the nanosensitizer, combined with TMZ and X-ray irradiation, efficiently inhibited the growth of GBM. These findings demonstrate a novel PROTAC-based sensitization strategy targeting BRD4, offering a promising approach for effective GBM therapy.

Objective To analyze the factors influencing the occurrence of post-embolization syndrome(PES)after transhepatic arterial chemoembolization(TACE).Methods A total of 107 patients with hepatocellular carcinoma(HCC),who received TACE treatment at authors'hospital between February 2021 and March 2023,were included in the study.Among them,56 patients developed PES(PES group)and 51 patients did not develop PES(non-PES group).The demographic data,medical history,pathological findings,laboratory indicators and operation-related materials were compared between the two groups,and the risk factors for PES were analyzed.Results There were statistically significant differences in tumor diameter,albumin(ALB)level,preoperative physical condition(ECOG)score,type of embolization agent,drug-loaded microspheres,number of microspheres,and dosage of loaded drug between the two groups(all P＜0.05).Multivariate Logistic analysis revealed that drug-loaded microspheres,number of microspheres,and dosage of loaded drug were the independent risk factors for PES occurring after TACE(all P＜0.05).Conclusion HCC patients treated with TACE using drug-loaded microspheres,large amount of microspheres and high dosage of loaded drug have a higher risk of PES occurring after TACE.For patients having the above risk factors,the formulation of corresponding perioperative intervention strategies is necessary so as to avoid the occurrence of PES and to improve the safety of TACE.

Osteochondral lesion of talus (OLT) is a foot and ankle disease characterized by ankle pain, which may impact the joint function and life quality. If managed improperly, it may lead to a further ankle arthritis, severely compromising the prognosis. The therapeutic effect of conservative treatment for OLT is still uncertain. Surgery is still the main treatment modality for OLT with various techniques. However, the optimized surgical technique is still inconclusive, furthermore, regeneration and repair of cartilage after debridement is also a great challenge for the treatment of OLT. Platelet-rich plasma (PRP) with good repair effect on cartilage injury is gradually applied in the treatment of OLT. However, there still lacks the unified understanding of the technique and specification of PRP for the treatment of OLT. Therefore, National Orthopedics Center of Shanghai Sixth People′s Hospital allied Foot Ankle Basic Research & Orthopedics Group, Chinese Association of Orthopedic Surgeons; Foot and Ankle Committee of Chinese Association of Sports Medicine Physicians; and Foot and Ankle Group of Orthopedic Specialized Branch of Shanghai Medical Association to organize related experts to formulate the Expert consensus on platelet- rich plasma treatment for osteochondral lesion of talus ( version2023). Fifteen recommendations were put forward upon PRP preparation, indications, contraindications and treatment methods of PRP for OLT, so as to standardize the PRP treatment for OLT.

Acute lung injury (ALI) is a prevalent and severe clinical condition characterized by inflammatory damage to the lung endothelial and epithelial barriers, resulting in high incidence and mortality rates. Currently, there is a lack of safe and effective drugs for the treatment of ALI. In a previous clinical study, we observed that Jinyinqingre oral liquid (JYQR), a Traditional Chinese Medicine formulation prepared by the Taihe Hospital, Affiliated Hospital of Hubei University of Medicine, exhibited notable efficacy in treating inflammation-related hepatitis and cholecystitis in clinical settings. However, the potential role of JYQR in ALI/acute respiratory distress syndrome (ARDS) and its anti-inflammatory mechanism remains unexplored. Thus, the present study aimed to investigate the therapeutic effects and underlying molecular mechanisms of JYQR in ALI using a mouse model of lipopolysaccharide (LPS)-induced ALI and an in vitro RAW264.7 cell model. JYQR yielded substantial improvements in LPS-induced histological alterations in lung tissues. Additionally, JYQR administration led to a noteworthy reduction in total protein levels within the BALF, a decrease in MPAP, and attenuation of pleural thickness. These findings collectively highlight the remarkable efficacy of JYQR in mitigating the deleterious effects of LPS-induced ALI. Mechanistic investigations revealed that JYQR pretreatment significantly inhibited NF-κB activation and downregulated the expressions of the downstream proteins, namely NLRP3 and GSDMD, as well as proinflammatory cytokine levels in mice and RAW2647 cells. Consequently, JYQR alleviated LPS-induced ALI by inhibiting the NF-κB/NLRP3/GSDMD pathway. JYQR exerts a protective effect against LPS-induced ALI in mice, and its mechanism of action involves the downregulation of the NF-κB/NLRP3/GSDMD inflammatory pathway.
Humans ; NF-kappa B/metabolism* ; Lipopolysaccharides/metabolism* ; NLR Family, Pyrin Domain-Containing 3 Protein/metabolism* ; Acute Lung Injury/metabolism* ; Lung ; Phosphate-Binding Proteins/therapeutic use* ; Pore Forming Cytotoxic Proteins/therapeutic use*

Objective:To investigate the method and clinical effect of horn-shaped perforator flaps with multiple blood supply for reconstructing massive facial defects caused by various reasons.Methods:A retrospective review was performed on patients with massive facial defects in the Department of Plastic Surgery of First Affiliated Hospital of Anhui Medical University from June 2015 to July 2020. The Doppler ultrasound was used to localize the facial source artery and perforators preoperatively. During the operation, the flap was designed according to the defect size, the elasticity of around skin, the length from the distal end of the defect to the location of the selected perforator, and the Langer’s line of the face. The length of the proximal part of the flap was approximately equal to the defect width, and the length of the flap was about 3 to 3.5 times longer than the defect width. An incision was made along the distal part of the flap. The flap dissection proceeded in a proximal to distal fashion superficial to the superficial musculoaponeurotic system, until forming a large perforator flap. A small number of fibrous around the perforator were retained, and the flap was rotated and advanced to reconstruct the defect without any tension. The donor site was closed directly. Wound healing, scar formation, tumor recurrence, and tumor metastasis were followed postoperatively.Results:A total of nine cases were enrolled, with four male patients and five female patients. The mean age of the patients was 58 years, ranging from 35 to 81 years. The size of the flap ranged from 10.0 cm × 6.0 cm to 14.0 cm × 7.0 cm. All flaps survived, and the wound healed primarily. After 3 to 24 months of follow-up, no recurrence of tumor, obvious scar, flap bloated, facial deformity, or other complications were observed. The patients was satisfied with the aesthetic subunit structure and function.Conclusions:The horn-shaped perforator flap with multiple blood supply is simple in design, easy in decision, reliable in blood supply, and consistent in color and texture with the original tissue. The incision scar can be hidden in the Langer’s line with a satisfying appearance, which is suitable for aged patients with sagging facial skin.

Objective:To investigate the method and clinical effect of horn-shaped perforator flaps with multiple blood supply for reconstructing massive facial defects caused by various reasons.Methods:A retrospective review was performed on patients with massive facial defects in the Department of Plastic Surgery of First Affiliated Hospital of Anhui Medical University from June 2015 to July 2020. The Doppler ultrasound was used to localize the facial source artery and perforators preoperatively. During the operation, the flap was designed according to the defect size, the elasticity of around skin, the length from the distal end of the defect to the location of the selected perforator, and the Langer’s line of the face. The length of the proximal part of the flap was approximately equal to the defect width, and the length of the flap was about 3 to 3.5 times longer than the defect width. An incision was made along the distal part of the flap. The flap dissection proceeded in a proximal to distal fashion superficial to the superficial musculoaponeurotic system, until forming a large perforator flap. A small number of fibrous around the perforator were retained, and the flap was rotated and advanced to reconstruct the defect without any tension. The donor site was closed directly. Wound healing, scar formation, tumor recurrence, and tumor metastasis were followed postoperatively.Results:A total of nine cases were enrolled, with four male patients and five female patients. The mean age of the patients was 58 years, ranging from 35 to 81 years. The size of the flap ranged from 10.0 cm × 6.0 cm to 14.0 cm × 7.0 cm. All flaps survived, and the wound healed primarily. After 3 to 24 months of follow-up, no recurrence of tumor, obvious scar, flap bloated, facial deformity, or other complications were observed. The patients was satisfied with the aesthetic subunit structure and function.Conclusions:The horn-shaped perforator flap with multiple blood supply is simple in design, easy in decision, reliable in blood supply, and consistent in color and texture with the original tissue. The incision scar can be hidden in the Langer’s line with a satisfying appearance, which is suitable for aged patients with sagging facial skin.

Objective:To develop a three-dimensional body image stimuli suitable for middle-aged people in China, and verify the validity and reliability of the body image stimuli.Method:According to China and World Health Organization body mass index classification standards of adults, a set of three-dimensional body image stimuli of Chinese middle-aged males and females with different body size was developed by using 3D Studio Max and Adobe Photoshop CC based on the literature and expert consultation method. Forty-two 45- and 59-year-old middle-aged people in Zhengzhou City, Henan Province were recruited to verify the three-dimensional body image stimuli. Through questionnaire survey and physical examination, the coincidence between the selected body type and the actual body type was tested; the body composition was measured by dual-energy absorptiometry (DXA), and the structure validity of the image was tested; the body size satisfaction was investigated by the body image stimuli and the standard questionnaire, and the empirical validity of the image was tested. The repeated survey was conducted 14 days after the initial survey, and three experts were invited to score the current somatotype of the subjects to test the test-retest reliability and inter-rater reliability of the body image stimuli. Pearson, Spearman, Kendall correlation and Kappa consistency analysis were used to evaluate the validity and reliability of the body image stimuli.Results:The average age of 42 subjects was 52.7 years old, including 13 males and 29 females. A group of three-dimensional body image stimuli of middle-aged men and women were developed, and each group included 8 images. 73.8% of the subjects chose the body size consistent with the actual body type, and the weighted Kappa coefficient was 0.755 ( P<0.01). The selected somatotype was positively correlated with body weight and body composition indexes such as fat content, and the Pearson correlation coefficient of construct validity was 0.623-0.717 ( P<0.05). The results of the two surveys were positively correlated, and the Spearman correlation coefficient of test-retest reliability was 0.784-0.821 ( P<0.05). The scores of the three experts on the current somatotype of the subjects were positively correlated, and the Kendall correlation coefficient of inter-rater reliability was 0.818-0.878 ( P<0.05). Conclusion:The development of principle and reference basis of three-dimensional body image stimuli of middle-aged people is reliable, and the validity and reliability of the body image stimuli are good.

Objective:To evaluate the characteristics of adult abdominal fat distribution and analyze its influencing factors by energy spectrum CT scan.Methods:The body height, weight, waist circumference, and hip circumference of 105 adults were measured, and the characteristics of abdominal fat distribution were evaluated by energy spectrum CT scan.Results:Compared with non-obese individuals, the contents of abdominal subcutaneous fat, abdominal cavity and liver ectopic fat were higher in obese patients ( P<0.05), and the intramuscular fat (IMAT) content did not increase with the increase of BMI. In middle-aged group, the waist circumference, waist-to-hip ratio (WHR) abdominal cavity area and IMAT content were higher than those in the youth group, and the muscle content of the middle-aged group was lower than that of the youth group, the difference between the two groups was significant ( P<0.05); the male group had higher abdominal cavity area and muscle content than the female group, while the female group had higher the subcutaneous fat area, abdominal subcutaneous fat thickness and erector spinae fat content than the male group, the differences were significant ( P<0.05). Conclusions:The characteristics of abdominal fat distribution of subjects with different BMI, age and gender were different. Therefore, we should pay attention to the individual assessment of ectopic fat distribution in obese patients. Energy spectrum CT can be used as an important approach for the assessment of ectopic fat to provide evidence for developing individualized weight loss programs.

Objective:To develop a three-dimensional body image stimuli suitable for middle-aged people in China, and verify the validity and reliability of the body image stimuli.Method:According to China and World Health Organization body mass index classification standards of adults, a set of three-dimensional body image stimuli of Chinese middle-aged males and females with different body size was developed by using 3D Studio Max and Adobe Photoshop CC based on the literature and expert consultation method. Forty-two 45- and 59-year-old middle-aged people in Zhengzhou City, Henan Province were recruited to verify the three-dimensional body image stimuli. Through questionnaire survey and physical examination, the coincidence between the selected body type and the actual body type was tested; the body composition was measured by dual-energy absorptiometry (DXA), and the structure validity of the image was tested; the body size satisfaction was investigated by the body image stimuli and the standard questionnaire, and the empirical validity of the image was tested. The repeated survey was conducted 14 days after the initial survey, and three experts were invited to score the current somatotype of the subjects to test the test-retest reliability and inter-rater reliability of the body image stimuli. Pearson, Spearman, Kendall correlation and Kappa consistency analysis were used to evaluate the validity and reliability of the body image stimuli.Results:The average age of 42 subjects was 52.7 years old, including 13 males and 29 females. A group of three-dimensional body image stimuli of middle-aged men and women were developed, and each group included 8 images. 73.8% of the subjects chose the body size consistent with the actual body type, and the weighted Kappa coefficient was 0.755 ( P<0.01). The selected somatotype was positively correlated with body weight and body composition indexes such as fat content, and the Pearson correlation coefficient of construct validity was 0.623-0.717 ( P<0.05). The results of the two surveys were positively correlated, and the Spearman correlation coefficient of test-retest reliability was 0.784-0.821 ( P<0.05). The scores of the three experts on the current somatotype of the subjects were positively correlated, and the Kendall correlation coefficient of inter-rater reliability was 0.818-0.878 ( P<0.05). Conclusion:The development of principle and reference basis of three-dimensional body image stimuli of middle-aged people is reliable, and the validity and reliability of the body image stimuli are good.

Objective:To understand the clinical manifestations, diagnosis, treatment, and prognosis of children with hereditary thrombocytopenia (HT).Methods:The clinical data of 5 patients with HT in the Hematology and Oncology Department of Children′s Hospital of Chongqing Medical University from August 2015 to October 2017 were retrospectively analyzed. The clinical and laboratory characteristics, treatment, and prognosis of HT were discussed by reviewing relevant literatures.Results:Five patients included 3 boys and 2 girls.The median age at onset of 4 years and 2 months old and the median age at diagnose was 4 years and 4 months old.All patients presented with the thrombocytopenia, among which 4 cases were macrothrombocytopenia and 1 case was normothrombocytopenia.The main clinical presentations of 5 patients were skin petechiae and ecchymoses.Four cases were initially misdiagnosed as immune thrombocytopenia (ITP) and received the glucocorticoid and immunoglobulin, while the therapeutic effect was not satisfactory.The gene sequencing confirmed MYH9 gene mutation(c.3493C>T), MYH9 gene mutation(c.5878G>A), NBEAL2 gene compound heterozygous mutation(c.295C>T; c.4169C>T), GP1BA gene mutation(c.1761A>C), and ANKRD26 gene mutation(c.5123A>G), in 5 patients respectively. Conclusions:HT should be suspected among those with recurrent isolated thrombocytopenia and no response to the ITP regimen, and the early gene screening is of great significance to the patients′ treatment and prognosis.