Objective: To evaluate the feasibility of dynamic contrast-enhanced MRI (DCE-MRI) in differentiating tumor deposits (TDs) from metastatic lymph nodes (MLNs) in rectal cancer. Materials and Methods: A retrospective analysis was conducted on 70 patients with rectal cancer, including 168 lesions (70 TDs and 98 MLNs confirmed by histopathology), who underwent pretreatment MRI and subsequent surgery between March 2019 and December 2022. The morphological characteristics of TDs and MLNs, along with quantitative parameters derived from DCE-MRI (K trans , kep, and v e) and DWI (ADCmin, ADCmax, and ADCmean), were analyzed and compared between the two groups.Multivariable binary logistic regression and receiver operating characteristic (ROC) curve analyses were performed to assess the diagnostic performance of significant individual quantitative parameters and combined parameters in distinguishing TDs from MLNs. Results: All morphological features, including size, shape, border, and signal intensity, as well as all DCE-MRI parameters showed significant differences between TDs and MLNs (all P < 0.05). However, ADC values did not demonstrate significant differences (all P > 0.05). Among the single quantitative parameters, v e had the highest diagnostic accuracy, with an area under the ROC curve (AUC) of 0.772 for distinguishing TDs from MLNs. A multivariable logistic regression model incorporating short axis, border, v e, and ADC mean improved diagnostic performance, achieving an AUC of 0.833 (P = 0.027). Conclusion The combination of morphological features, DCE-MRI parameters, and ADC values can effectively aid in the preoperative differentiation of TDs from MLNs in rectal cancer.

Objective: To evaluate the feasibility of dynamic contrast-enhanced MRI (DCE-MRI) in differentiating tumor deposits (TDs) from metastatic lymph nodes (MLNs) in rectal cancer. Materials and Methods: A retrospective analysis was conducted on 70 patients with rectal cancer, including 168 lesions (70 TDs and 98 MLNs confirmed by histopathology), who underwent pretreatment MRI and subsequent surgery between March 2019 and December 2022. The morphological characteristics of TDs and MLNs, along with quantitative parameters derived from DCE-MRI (K trans , kep, and v e) and DWI (ADCmin, ADCmax, and ADCmean), were analyzed and compared between the two groups.Multivariable binary logistic regression and receiver operating characteristic (ROC) curve analyses were performed to assess the diagnostic performance of significant individual quantitative parameters and combined parameters in distinguishing TDs from MLNs. Results: All morphological features, including size, shape, border, and signal intensity, as well as all DCE-MRI parameters showed significant differences between TDs and MLNs (all P < 0.05). However, ADC values did not demonstrate significant differences (all P > 0.05). Among the single quantitative parameters, v e had the highest diagnostic accuracy, with an area under the ROC curve (AUC) of 0.772 for distinguishing TDs from MLNs. A multivariable logistic regression model incorporating short axis, border, v e, and ADC mean improved diagnostic performance, achieving an AUC of 0.833 (P = 0.027). Conclusion The combination of morphological features, DCE-MRI parameters, and ADC values can effectively aid in the preoperative differentiation of TDs from MLNs in rectal cancer.

Objective: To evaluate the feasibility of dynamic contrast-enhanced MRI (DCE-MRI) in differentiating tumor deposits (TDs) from metastatic lymph nodes (MLNs) in rectal cancer. Materials and Methods: A retrospective analysis was conducted on 70 patients with rectal cancer, including 168 lesions (70 TDs and 98 MLNs confirmed by histopathology), who underwent pretreatment MRI and subsequent surgery between March 2019 and December 2022. The morphological characteristics of TDs and MLNs, along with quantitative parameters derived from DCE-MRI (K trans , kep, and v e) and DWI (ADCmin, ADCmax, and ADCmean), were analyzed and compared between the two groups.Multivariable binary logistic regression and receiver operating characteristic (ROC) curve analyses were performed to assess the diagnostic performance of significant individual quantitative parameters and combined parameters in distinguishing TDs from MLNs. Results: All morphological features, including size, shape, border, and signal intensity, as well as all DCE-MRI parameters showed significant differences between TDs and MLNs (all P < 0.05). However, ADC values did not demonstrate significant differences (all P > 0.05). Among the single quantitative parameters, v e had the highest diagnostic accuracy, with an area under the ROC curve (AUC) of 0.772 for distinguishing TDs from MLNs. A multivariable logistic regression model incorporating short axis, border, v e, and ADC mean improved diagnostic performance, achieving an AUC of 0.833 (P = 0.027). Conclusion The combination of morphological features, DCE-MRI parameters, and ADC values can effectively aid in the preoperative differentiation of TDs from MLNs in rectal cancer.

Objective: To evaluate the feasibility of dynamic contrast-enhanced MRI (DCE-MRI) in differentiating tumor deposits (TDs) from metastatic lymph nodes (MLNs) in rectal cancer. Materials and Methods: A retrospective analysis was conducted on 70 patients with rectal cancer, including 168 lesions (70 TDs and 98 MLNs confirmed by histopathology), who underwent pretreatment MRI and subsequent surgery between March 2019 and December 2022. The morphological characteristics of TDs and MLNs, along with quantitative parameters derived from DCE-MRI (K trans , kep, and v e) and DWI (ADCmin, ADCmax, and ADCmean), were analyzed and compared between the two groups.Multivariable binary logistic regression and receiver operating characteristic (ROC) curve analyses were performed to assess the diagnostic performance of significant individual quantitative parameters and combined parameters in distinguishing TDs from MLNs. Results: All morphological features, including size, shape, border, and signal intensity, as well as all DCE-MRI parameters showed significant differences between TDs and MLNs (all P < 0.05). However, ADC values did not demonstrate significant differences (all P > 0.05). Among the single quantitative parameters, v e had the highest diagnostic accuracy, with an area under the ROC curve (AUC) of 0.772 for distinguishing TDs from MLNs. A multivariable logistic regression model incorporating short axis, border, v e, and ADC mean improved diagnostic performance, achieving an AUC of 0.833 (P = 0.027). Conclusion The combination of morphological features, DCE-MRI parameters, and ADC values can effectively aid in the preoperative differentiation of TDs from MLNs in rectal cancer.

Objective: To evaluate the feasibility of dynamic contrast-enhanced MRI (DCE-MRI) in differentiating tumor deposits (TDs) from metastatic lymph nodes (MLNs) in rectal cancer. Materials and Methods: A retrospective analysis was conducted on 70 patients with rectal cancer, including 168 lesions (70 TDs and 98 MLNs confirmed by histopathology), who underwent pretreatment MRI and subsequent surgery between March 2019 and December 2022. The morphological characteristics of TDs and MLNs, along with quantitative parameters derived from DCE-MRI (K trans , kep, and v e) and DWI (ADCmin, ADCmax, and ADCmean), were analyzed and compared between the two groups.Multivariable binary logistic regression and receiver operating characteristic (ROC) curve analyses were performed to assess the diagnostic performance of significant individual quantitative parameters and combined parameters in distinguishing TDs from MLNs. Results: All morphological features, including size, shape, border, and signal intensity, as well as all DCE-MRI parameters showed significant differences between TDs and MLNs (all P < 0.05). However, ADC values did not demonstrate significant differences (all P > 0.05). Among the single quantitative parameters, v e had the highest diagnostic accuracy, with an area under the ROC curve (AUC) of 0.772 for distinguishing TDs from MLNs. A multivariable logistic regression model incorporating short axis, border, v e, and ADC mean improved diagnostic performance, achieving an AUC of 0.833 (P = 0.027). Conclusion The combination of morphological features, DCE-MRI parameters, and ADC values can effectively aid in the preoperative differentiation of TDs from MLNs in rectal cancer.

The transcriptome sequencing based on Illumina Novaseq 6000 Platform was performed with the untreated seed embryo(DS), stratified seed embryo(SS), and germinated seed embryo(GS) of Zanthoxylum nitidum, aiming to explore the molecular mechanism regulating the seed dormancy and germination of Z. nitidum and uncover key differentially expressed genes(DEGs). A total of 61.41 Gb clean data was obtained, and 86 386 unigenes with an average length of 773.49 bp were assembled. A total of 29 290 DEGs were screened from three comparison groups(SS vs DS, GS vs SS, and GS vs DS), and these genes were annotated on 134 Kyoto Encyclopedia of Genes and Genomes(KEGG) pathways. KEGG enrichment analysis revealed that the plant hormone signal transduction pathway is the richest pathway, containing 226 DEGs. Among all DEGs, 894 transcription factors were identified, which were distributed across 34 transcription factor families. These transcription factors were also mainly concentrated in plant hormone signal transduction and mitogen-activated protein kinase(MAPK) signaling pathways. Further real-time quantitative polymerase chain reaction(RT-qPCR) validation of 12 DEGs showed that the transcriptome data is reliable. During the process of seed dormancy release and germination, a large number of DEGs involved in polysaccharide degradation, protein synthesis, lipid metabolism, and hormone signal transduction were expressed. These genes were involved in multiple metabolic pathways, forming a complex regulatory network for dormancy and germination. This study lays a solid foundation for analyzing the molecular mechanisms of seed dormancy and germination of Z. nitidum.
Zanthoxylum/metabolism* ; Plant Dormancy/genetics* ; Seeds/metabolism* ; Gene Expression Regulation, Plant ; Plant Proteins/metabolism* ; Transcriptome ; Gene Expression Profiling ; Germination ; Transcription Factors/metabolism* ; Plant Growth Regulators/genetics* ; Signal Transduction

Objective To observe the therapeutic effect and compatibility mechanism of Wumei Wan on diabetic gastroparesis(DGP)mice.Methods Sixty-nine C57BL/6J mice were randomly divided into normal group(12 mice)and model group(57 mice).The DGP model was constructed by 60％high-fat diet combined with intraperitoneal injection of streptozotocin(STZ).After successful modeling,the mice in the model group were randomly divided into model group,Wumei Wan whole prescription group,Wumei Wan sour medicine group,Wumei Wan bitter medicine group,Wumei Wan sweet medicine group and Wumei Wan pungent medicine group,with nine mice in each group.After 28 days of treatment,the gastric emptying rate and small intestinal propulsion rate of mice were measured.The pathological changes of gastric antrum were observed by hematoxylin-eosin(HE)staining.The fasting blood glucose(FBS)of mice was detected by blood glucose meter.The levels of triglyceride(TG),total cholesterol(TC)and low density lipoprotein cholesterol(LDL-C)were detected by colorimetry.The contents of gastrin(GAS),motilin(MTL)and vasoactive intestinal peptide(VIP)in gastric antrum were detected by enzyme-linked immunosorbent assay(ELISA).Western Blot was used to detect the expression of Kelch-like ECH-associated protein 1(Keap-1),nuclear factor erythroid 2-related factor 2(Nrf-2),NAD(P)H:quinone oxidoreductase 1(Nqo-1)and superoxide dismutase 1(Sod-1)in gastric antrum tissue.Results(1)Compared with the normal group,the levels of serum FBS,TG,TC and LDL-C in the model group were significantly increased(P＜0.05 or P＜0.01 or P＜0.001);compared with the model group,the blood glucose level of the whole prescription group,the sour medicine group and the bitter medicine group was decreased significantly at the end of the third and fourth week(P＜0.05 or P＜0.01 or P＜0.001),the serum TG,TC and LDL-C levels of the whole prescription group were significantly decreased(P＜0.05 or P＜0.01),the serum TC level of the sour medicine group,the bitter medicine group,the sweet medicine group and the pungent medicine group was significantly decreased(P＜0.05),and only the LDL-C level of the sour medicine group was significantly decreased(P＜0.05).(2)Compared with the normal group,the glandular cells in the gastric antrum mucosa and submucosa of the model group were disordered;compared with the model group,the pathological damage of gastric antrum tissue in Wumei Wan whole prescription group was significantly improved,the recovery effect of gastric antrum tissue damage in DGP mice in the sour medicine group and the bitter medicine group was superior to that in the sweet medicine group and the pungent medicine group.(3)Compared with the normal group,the gastric emptying rate and small intestinal propulsion rate of the model group were decreased(P＜0.01 or P＜0.001);compared with the model group,the gastric emptying rate of the whole prescription group,the sour medicine group and the bitter medicine group was significantly increased(P＜0.05 or P＜0.001),and the intestinal propulsion rate of the whole prescription group,the sour medicine group,the bitter medicine group,the sweet medicine group and the pungent medicine group was significantly increased(P＜0.05 or P＜0.01 or P＜0.001).(4)Compared with the normal group,the content of VIP in the gastric antrum tissue of the model group was significantly increased(P＜0.01),and the contents of GAS and MTL were significantly decreased(P＜0.01 or P＜0.001).Compared with the model group,the content of GAS in Wumei Wan whole prescription group,the sour medicine group,the bitter medicine group and the sweet medicine group was significantly increased(P＜0.01 or P＜0.001),the content of MTL in the whole prescription group and the bitter medicine group was significantly increased(P＜0.05 or P＜0.01),and the content of VIP in gastric antrum tissue of mice in Wumei Wan whole prescription group,sour medicine group,bitter medicine group and sweet medicine group was significantly decreased(P＜0.05 or P＜0.01 or P＜0.001).(5)Compared with the normal group,the expression level of Keap-1 in the gastric antrum tissue of the model group was increased(P＜0.05),and the expressions of Nrf-2,Nqo-1 and Sod-1 were decreased(P＜0.05 or P＜0.001).Compared with the model group,the expression level of Keap-1 protein in the whole prescription group and the bitter medicine group was significantly decreased(P＜0.05 or P＜0.001),and the expression levels of Nrf-2,Nqo-1 and Sod-1 in the whole prescription group,the sour medicine group and the bitter medicine group were significantly increased(P＜0.05 or P＜0.001).Conclusion Wumei Wan can effectively regulate glucose and lipid metabolism,improve gastric antrum injury and promote gastrointestinal motility in DGP mice.The efficacy of the whole prescription is superior to that of each disassembled prescription.The mechanism may be related to the synergistic compatibility of sour medicine,bitter medicine,sweet medicine and pungent medicine,and mainly through sour medicine and bitter medicine regulating Nrf-2/Keap-1 pathway further to improve oxidative stress injury.

Hemophagocytic syndrome(HPS),also known as hemophagocytic lymphohistiocytosis(HLH),is a rare and highly malignant hematologic disease with a poor prognosis.It can be divided into two categories:primary HLH and secondary HLH.HLH is characterized by a large number of abnormal immune cells that continuously activate and regulate out of control,leading to systemic inflammatory factor storm and multiple organ failure.Clinical manifestations mainly include persistent malignant hyperthermia,pancytopenia,hepatosplenomegaly,and hemophagocytosis in tissues and organs.The pathogenesis of adult HLH is complex,with rapid onset and rapid disease progression,and the fatality rate remains high.The main causes of death in HLH patients are multiple organ failure,abnormal coagulation and septic shock.Due to the specificity of HLH and the lack of effective understanding of the severity and prognosis in clinical practice,some HLH patients are misdiagnosed or overlooked,missing the best opportunity for diagnosis and treatment.Therefore,this review systematically explores and discusses the latest diagnostic and treatment progress of adult HLH,aiming to provide reference for clinical diagnosis,treatment and prognosis assessment of HLH.

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.