Adipocytic tumors are the most common type of soft tissue tumors,which can be divided into lipomas and liposarcomas.Studies have found that benign lipomas resected from the same site can transform into liposarcomas,especially atypical lipomatous tumors(ALT),suggesting an underlying biological association.In this case,the patient underwent resection of a right neck mass in our hospital in 2017,and the pathology showed fibrolipoma.One year later,the mass recurred at the original site but was not treated.By 2023,the mass had significantly enlarged and extended deeply.MRI showed that the lesion had an unclear boundary with the surrounding fat,suggesting liposarcoma.Puncture and molecular pathology showed MDM2 gene amplification,and the diagnosis of ALT was made,which was confirmed by pathology after complete surgical resection.It can be seen that adipocytic tumors have great differences in biological behavior,and benign lipomas can transform into liposarcomas(especially ALT).Clinically,it is necessary to combine imaging,pathology and molecular detection(such as MDM2/CDK4)for differentiation to formulate treatment plans.

Adipocytic tumors are the most common type of soft tissue tumors,which can be divided into lipomas and liposarcomas.Studies have found that benign lipomas resected from the same site can transform into liposarcomas,especially atypical lipomatous tumors(ALT),suggesting an underlying biological association.In this case,the patient underwent resection of a right neck mass in our hospital in 2017,and the pathology showed fibrolipoma.One year later,the mass recurred at the original site but was not treated.By 2023,the mass had significantly enlarged and extended deeply.MRI showed that the lesion had an unclear boundary with the surrounding fat,suggesting liposarcoma.Puncture and molecular pathology showed MDM2 gene amplification,and the diagnosis of ALT was made,which was confirmed by pathology after complete surgical resection.It can be seen that adipocytic tumors have great differences in biological behavior,and benign lipomas can transform into liposarcomas(especially ALT).Clinically,it is necessary to combine imaging,pathology and molecular detection(such as MDM2/CDK4)for differentiation to formulate treatment plans.

The ultrasonic manifestations of benign and malignant breast imaging-reporting and data system(BI-RADS)4 lesions overlap in some degrees,is able to result in unnecessary biopsy or untimely therapy.Accurate classifying the nature of BI-RADS 4 breast lesions can provide reliable references for clinical decision-making.The progresses of application of new ultrasonic technologies,including automated breast volume scanner,superb micro-vascular imaging,elastography,contrast-enhanced ultrasound and artificial intelligence for assisting diagnosis of BI-RADS 4 lesions were reviewed in this article.

Based on the previous publications， it is believed that damp-heat syndrome is the core syndrome of rheumatoid arthritis （RA）， and Qingre Huoxue Formula （清热活血方） is an effective formula for the treatment of damp-heat syndrome of RA. “Inflammation-bone destruction” is a key pathological link of RA， and it is also the advantage of the effectiveness of Qingre Huoxue Formula. Leucine rich α-2-glycoprotein 1 （LRG1） can mediate the transforming growth factor-β （TGF-β） signalling pathway to participate in the pathogenic process of “inflammation-bone destruction” of RA， and it can be used as a target protein in the treatment of damp-heat syndrome of RA by Qingre Huoxue Formula. Accordingly， a scientific hypothesis was proposed that Qingre Huoxue Formula may regulate TGF-β signalling pathway mediated by LRG1 to improve “inflammation-bone destruction” of RA， and it was envisioned that the clinical effect of Qingre Huoxue Formula on LRG1 could be confirmed through clinical studies， and the mechanism of action of Qingre Huoxue Formula on the LRG1/TGF-β signalling axis as well as the influence of the expression or non-expression of the LRG1/TGF-β signalling axis on the therapeutic effectiveness of Qingre Huoxue Formula could be clarified through animal experiments.

Radiotherapy is widely used in the management of advanced colorectal cancer (CRC). However, the clinical efficacy is limited by the safe irradiated dose. Sensitizing tumor cells to radiotherapy via interrupting DNA repair is a promising approach to conquering the limitation. The BRCA1-BARD1 complex has been demonstrated to play a critical role in homologous recombination (HR) DSB repair, and its functions may be affected by HERC2 or BAP1. Accumulated evidence illustrates that the ubiquitination-deubiquitination balance is involved in these processes; however, the precise mechanism for the cross-talk among these proteins in HR repair following radiation hasn't been defined. Through activity-based profiling, we identified PT33 as an active entity for HR repair suppression. Subsequently, we revealed that BAP1 serves as a novel molecular target of PT33 via a CRISPR-based deubiquitinase screen. Mechanistically, pharmacological covalent inhibition of BAP1 with PT33 recruits HERC2 to compete with BARD1 for BRCA1 interaction, interrupting HR repair. Consequently, PT33 treatment can substantially enhance the sensitivity of CRC cells to radiotherapy in vitro and in vivo. Overall, these findings provide a mechanistic basis for PT33-induced HR suppression and may guide an effective strategy to improve therapeutic gain.

Objective:To analyze the application of thinking visual guidance teaching model in anesthesia clinical practice teaching.Methods:Taking the implementation time (March 2019) of thinking visual guidance teaching model in our hospital as the limit, 56 interns who came to our hospital for anesthesia practice before the implementation were included as control group, and 61 interns enrolled after the implementation (from March 2019 to March 2020) were included in study group. The mastery status of professional skills (duration of anesthesia operation, success rate of one-time anesthesia puncture and success rate of one - time tracheal intubation), professional knowledge assessment results and professional attitude changes were compared between the two groups at 2 months and 6 months of training. Self-evaluation after 6 months of training was compared between the two groups. SPSS 18.0 was used for t test and chi-square test. Results:After 6 months of training, the mastery status of professional skills (duration of anesthesia operation, success rate of one-time anesthesia puncture, and success rate of one-time tracheal intubation) of the two groups of interns were significantly improved compared with those after 2 months of training, and the above indicators of study group were significantly better than those of control group (all P<0.05). After 6 months of training, the scores of assessment results of professional knowledge (basic knowledge, understanding and memory, case analysis, emergency handling) and professional attitude (behavior, language, initiative and adaptability) in the two groups of interns were significantly higher than those after 2 months of training, and the above indicators scores of study group were significantly higher than those of control group (all P<0.05). The scores of self-evaluation (learning efficiency, learning atmosphere, learning ability, self-confidence and satisfaction) of study group at 6 months of training were significantly higher than those of control group at the same period (all P<0.05). Conclusion:Thinking visual guidance teaching model can effectively improve the professional knowledge and operation skills of anesthesia clinical interns, and it has a good application effect.

Objective To evaluate the curative effect and feasibility of catheter-directed thrombolysis with urokinase for acute limb ischemia. Methods The clinical data of a total of 21 patients with acute limb ischemia, who were treated with infusion of urokinase through UniFuse thrombolytic catheter, were retrospectively analyzed. The clinical curative efficacy, prognosis and complications of catheter - directed thrombolysis (CDT) were summarized. Results In all patients, thrombolysis therapy was effective, the clinical symptoms were alleviated, and successful limb salvage was achieved. One patient died of cerebral hemorrhage due to renal decompensation. No other serious complications such as hemorrhage, hematoma or disability occurred. Conclusion Preliminary clinical study shows that CDT with urokinase is effective and safe for the treatment of acute limb ischemia. This therapy can help reduce unnecessary surgical procedures or stent implantation, and the risk of thrombolysis is controllable. (J Intervent Radiol, 2018, 27: 262-265)

OBJECTIVETo evaluate the effect of outbreaks control in school settings after a 2 dose varicella vaccine immunization strategy implemented in Beijing.

METHODSEpidemiological data of varicella outbreaks in school and kindergarten settings, which were reported by all 16 districts (county) during 2007-2013 according to the technical management norms of Beijing, was collected. The first dose and second dose varicella vaccine coverage rate of eligible children after the 2 dose varicella vaccine immunization strategy implementation were estimated through BJIIMS. Based on above we analyzed the changes of outbreak quantity, case quantity and the distribution characteristics between the pre-adjustment era (2007-2011 years) and late adjustment era (2013) of the 2 dose immunization strategy.

RESULTSIn pre-adjustment era (2007-2011 years), an average of 74 (95% CI: 60-89) outbreaks was reported and 964 (95% CI: 812-1 116) cases were involved per year. In late adjustment era (2013): Outbreaks (35) declined 52.7%, involved cases (371) declined 61.5%; Outbreaks epidemic duration shortened from 22 days of pre-adjustment era to 18 days; Outbreaks involved 10-24 cases declined 64.7% (from 34 to 12); Outbreaks involved ≥ 25 cases declined 71.4% (from 7 to 2); Outbreaks of different school type as well as different regions without exception declined dramatically. Cumulative one-dose vaccine coverage in children of 2-6 yr of age was 89.6% (812 859/907 579), and cumulative second-dose vaccine coverage in children of 4-7 yr of age was 44.3% (289 764/647 732).

CONCLUSIONImplementation of a 2 dose varicella vaccine immunization strategy effectively controlled outbreaks in school and kindergarten settings.

Chickenpox ; Chickenpox Vaccine ; Child ; Child, Preschool ; Disease Outbreaks ; Epidemics ; Humans ; Schools ; Students ; Vaccination

Objective To study the inhibitory effect of fluorouracil combined with DDP on the growth of human osteosarcoma cell line MG-63,and to explore its influence on the expressions of transient receptor potential vanilloid 5 (TRPV5 )and transient receptor potential vanilloid 6 (TRPV6 )proteins.Methods The MG-63 cells were cultured by the density of 5 × 104 mL-1 .Fluorouracil group,DDP group,fluorouracil+ DDP group and control group containing 10% FBS were set up.The inhibitory rates of growth of MG-63 cells at different time were detected by CCK-8 assay.The apoptosis of MG-63 cells after treated with different drugs was determined by Hoechst staining Kit.The immunocytochemical staining was used to treatent to detect the expressions of TRPV5 and TRPV6 before and after treatment.Results Fluorouracil and DDP both inhibited the growth of MG-63 cells in a time-and dose- dependent manner.There were a lot of black particles in the MG-63 cells and the cells were smaller,aging or death when they were exposed to fluorouracil or DDP.Compared with 24 h group,the inhibitory rates of proliferation of MG-63 cells after treated with the sigle drug of fluorouracil or DDP for 48 and 72 h were increased significantly (P <0.05).Compared with control group,the apoptotic rates of MG-63 cells in fluorouracil group and DDP group 24,48,and 72 h after treatment were increased (P < 0.01)in a time-dependent manner. The expression levels of TRPV5 and TRPV6 in MG-63 cells 72 h after treatment of fluorouracil and DDP were decreased significantly compared with before treatment (P < 0.05 ). Conclusion Fluorouracil, DDP and fluorouracil combined with DDP could significantly inhibit the proliferation of MG-63 cells,induce the apoptosis, and decrease the expression levels of TRPV5 and TRPV6.

BACKGROUND:For reason of pathological particularity, treatments for young adult patients with lumbar disc herniation require more demanding procedures. Traditional discectomy and rigid fixation and fusion receive a lower clinical satisfaction rate because of their concomitant complications. Waveflex is a semi-rigid fixation system with non-fusion pedicle screws. Once combined with the technology of annulus repair, it can maintain the normal movement of the segments, and can thus raise clinical satisfaction rate. OBJECTIVE:To evaluate the short-term efficacy of the treatment of young adult lumbar disc herniation through the technology of the posterior Waveflex non-fusion pedicle screw elastic fixed smal window nucleus pulposus extirpation associated with annulus repair. METHODS: Thirty-eight patients with lumbar disc herniation were involved in this study, among which, 18 cases in the elastic fixation group were subjected to a posterior lumbar smal window nucleuspulposus extraction along with annulus repair together bound with Waveflex elastic fixation; the rest 20 cases in the nucleus pulposus removal group underwent simple nucleus pulposus extirpation. After these operations, a series of folow-up study was conducted, including: folow-up analysis of clinical efficacy and complications, colection of low-back pain visual analogue scores, colection of Japanese Orthopaedic Association scores (JOA), regular assessment of Oswestry dysfunction index, and reevaluation of the lumbar lateral radiographs related indicators. RESULTS AND CONCLUSION:Folow-up visits to the patients were conducted 12-20 months later since the operations. Both groups showed a better performance than before treatment in the pain visual analogue scale, low back pain JOA score, and Oswestry dysfunction index of low-back pain (P < 0.05) during the last visit. The pain visual analogue scale, low back pain JOA score, and Oswestry dysfunction index of low-back pain in the dynamic fixation group were superior to those in the nucleus pulposus removal group (P <0.05). Stil in the last folow-up, operative segment disc height in the dynamic fixation group was greater than that before treatment, and the operative segment range of motion was smaler than that before treatment (P <0.05). These results suggest that compared to nucleus pulposus removal, Waveflex system associated with nucleus pulposus excision annulus repair has a more satisfactory effect in the early recovery of lumbar spine function and exerts a positive effect on the stability of the operated segments in the treatment of lumbar protrusion of the intervertebral disc in young adults.