177Lu-prostate specific membrane antigen(PSMA)radio-ligand therapy has been approved abroad for advanced prostate cancer and has been in several clinical trials in China.Based on domestic clinical practice and experimental data and referred to international experience and viewpoints,the expert group forms a consensus on the clinical application of 177Lu-PSMA radio-ligand therapy in prostate cancer to guide clinical practice.

Objective:To explore the value of the imaging nomogram model based on preoperative CT features of patients with small intestinal stromal tumor (SIST) in predicting pathological risk classification.Methods:This was a cohort study. The patients who were diagnosed as primary SIST by postoperative pathology in Cancer Hospital, Chinese Academy of Medical Sciences from January 2014 to October 2023 were retrospectively included. According to the modified 2008 National Institutes of Health classification criteria, the patients were divided into a pathological intermediate/high-risk group (86 cases) and a very low/low-risk group (56 cases). The features of preoperative enhanced CT images of SIST were analyzed, including tumor boundary, necrosis, intra-tumoral hemorrhage, intra-tumoral calcification, growth pattern, enhancement pattern, enhancement degree, enlarged vessels feeding or draining the mass (EVFDM), and tumor location. Patients were followed up to determine the recurrence-free survival (RFS). Univariate and multivariate logistic regression were used to screen the independent predictors of SIST with pathological medium/high-risk group. The independent predictors were combined to construct an imaging prediction model, and a nomogram was drawn. The receiver operating characteristic curve was used to evaluate the predictive efficacy of the model. The Kaplan-Meier method was used to draw the survival curve, and the log-rank test was used to compare the differences in RFS.Results:Univariate logistic regression results showed that tumor shape, necrosis, intra-tumoral hemorrhage, EVFDM, and tumor location were potentially related to medium/high-risk SIST. Multivariate logistic regression results showed that tumor shape ( OR=3.92, 95% CI 1.58-9.71, P=0.003), necrosis ( OR=4.60, 95% CI 1.91-11.09, P<0.001), and EVFDM ( OR=6.25,95% CI 1.74-22.47, P=0.005) were independent predictors of pathological intermediate/high-risk SIST. The area under the curve of the imaging predictive model combining the three predictors to predict the intermediate/high-risk SIST was 0.835 (95% CI 0.769-0.901), the sensitivity was 0.810, the specificity was 0.839, and the accuracy was 0.789. Taking the cut-off value (0.810) as the boundary value, the patients were divided into the high-risk group (74 cases) and the low-risk group (68 cases) according to the prediction results. The median RFS of the predicted high-risk group was poorer than that of the predicted low-risk group, and the difference was statistically significant ( χ2=5.20, P=0.023). Conclusions:The imaging nomogram model based on preoperative CT image features shape, necrosis, and EVFDM can effectively predict the pathological intermediate/high-risk SIST before surgery and has important predictive value for postoperative recurrence.

Objective:To investigate correlation between neutrophil lymphocyte ratio(NLR),IL-6 and lymphocyte subsets and prognosis of viral pneumonia complicated with acute respiratory distress syndrome(ARDS).Methods:A total of 98 patients with viral pneumonia complicated with ARDS admitted to Xinxiang Central Hospital/the Fourth Clinical College from May 2017 to June 2019 were selected,NLR,IL-6 and lymphocyte subsets expressions in patients with different severity were analyzed.Correlation between NLR,IL-6 and lymphocyte subsets levels in prognosis of viral pneumonia complicated with ARDS was analyzed by Pearson correlation.Logistc regression was used to analyze prognostic risk factors of viral pneumonia complicated with ARDS.Results:With aggravation of viral pneumonia complicated with ARDS,NLR and IL-6 levels were significantly increased(P<0.05),while CD3+T,CD4+T and CD19+T cells levels were significantly decreased(P<0.05).Pearson correlation analysis results showed that NLR and IL-6 were positively correlated with prognosis of viral pneumonia complicated with ARDS(P<0.05),while CD3+T,CD4+T,CD19+T and CD8+T cells were negatively correlated with prognosis of ARDS with viral pneumonia(P<0.05).Multivariate Logistic analysis showed that NLR,IL-6,CD3+T and CD19+T cells were risk factors for viral pneumonia complicated with ARDS(P<0.05).Conclusion:Serum NLR,IL-6,CD3+T and CD19+T cells are closely related to severity and prognosis of patients with viral pneumonia complicated with ARDS.

Objective:To explore the impact of unpleasant symptoms and their antecedents on the functional performance of patients with chronic obstructive pulmonary disease (COPD) .Methods:From January 2020 to June 2023, convenience sampling was used to select COPD patients admitted to the Respiratory and Intensive Care Unit of Xinxiang Central Hospital as research subjects. The subjects were surveyed using the General Information Questionnaire, Functional Performance Inventory-Short Form (FPI-SF), Memory Symptom Assessment Scale (MSAS), Mishel Uncertainty in Illness Scale (MUIS), Social Support Rating Scale (SSRS), and the General Self-Efficacy Scale (GSES). Global Initiative for Chronic Obstructive Lung Disease (GOLD) grading was used to evaluate subjects' lung function. Pearson correlation was used to explore the correlation between the scores FPI-SF, MSAS, MUIS, SSRS, GSES, and GOLD grading. Structural equation modeling was implemented to explore the impact of unpleasant symptoms and their antecedents on the functional performance of COPD patients.Results:A total of 279 questionnaires were distributed and 276 valid questionnaires were collected, with a valid response rate of 98.92%. Among 276 COPD patients, the scores of FPI-SF, MSAS, MUIS, SSRS, and GSES were (2.08±0.24), (2.08±0.28), (95.41±12.83), (43.94±5.94), and (23.78±4.88), respectively. Functional performance was negatively correlated with unpleasant symptoms, disease uncertainty, and GOLD grading ( r=-0.478, -0.353, -0.574; P<0.05) and positively correlated with social support and self-efficacy ( r=0.451, 0.364; P<0.05). Structural equation modeling showed that GOLD grading, disease uncertainty, and social support indirectly affected functional performance through unpleasant symptoms, while GOLD grading and social support directly affected functional performance, and self-efficacy played a partial mediating role between unpleasant symptoms and functional performance; the above differences were statistically significant ( P<0.05) . Conclusions:The functional performance of COPD patients is poor. Medical and nursing staff can develop comprehensive intervention measures, including physiology, psychology, social environment, and self-efficacy, to improve patients' functional performance.

Objective To predict the core targets and action pathways of Hedysari Radix based on UPLC-MS/MS and network pharmacology methods,and to verify the results of network pharmacology by molecular docking and molecular dynamics techniques.This article aims to investigate immune regulation mechanism of effective components absorbed into blood from Hedysari Radix.Methods Qualitative quantification of effective components absorbed into blood from Hedysari Radix were operated by using UPLC-MS/MS technique.The corresponding targets of effective components absorbed into blood from Hedysari Radix were screened by TCMSP and HERB databases.Targets of immune-related disease were obtained through DisGeNET,OMIM,TTD,and MalaCards databases.The network of"components absorbed into blood from Hedysari Radix-immune-related diseases"was then constructed.GO and KEGG enrichment analysis and mapped the PPI network were performed.Molecular docking and molecular dynamics techniques were applied for validation.Results A total of 8 prototype components absorbed into blood,synergistically acting on 101 targets,were identified by UPLC-MS/MS.They mediated 538 biological processes including immune response,positive regulation of gene expression,receptor binding,and cytokine activity.Meanuhile,116 signaling pathways,such as HIF-1,Toll-like receptor,JAK-STAT,T cell receptor,PI3K-Akt,and FoxO etc.were involved.The core targets were MAPK14,PTGS2,MMP9,PPARG,CCND1,etc..The results of molecular docking showed that formononetin and calycosin had strong docking binding activity with MAPK14.And molecular dynamics simulations further demonstrated that the binding between MAPK14 and formononetin or calycosin had good structural stability and binding affinity.Conclusion The results of serum pharmacochemistry,network pharmacology and molecular dynamics were verified to reveal the material basis and mechanism of Hedysari Radix in regulating immunity.The aim of this study is to provide scientific basis for its immunomodulatory mechanism.

Suffering is prevalent in the palliative care population and is an important factor affecting the quality of life of palliative care patients and their family caregivers. In this paper, we review the assessment content, measurement methods, current application status and advantages and disadvantages of suffering assessment tools for palliative care patients, analyze the problems of current suffering assessment tools for palliative care patients and make suggestions, aiming to provide reference for palliative suffering treatment in China.

BACKGROUND: Previous research demonstrated that a homozygous mutation of g.136372044G>A (S12N) in caspase recruitment domain family member 9 ( CARD9 ) is critical for producing Aspergillus fumigatus -induced ( Af -induced) T helper 2 (T H 2)-mediated responses in allergic bronchopulmonary aspergillosis (ABPA). However, it remains unclear whether the CARD9S12N mutation, especially the heterozygous occurrence, predisposes the host to ABPA. METHODS: A total of 61 ABPA patients and 264 controls (including 156 healthy controls and 108 asthma patients) were recruited for sequencing the CARD9 locus to clarify whether patients with this heterozygous single-nucleotide polymorphisms are predisposed to the development of ABPA. A series of in vivo and in vitro experiments, such as quantitative real-time polymerase chain reaction, flow cytometry, and RNA isolation and quantification, were used to illuminate the involved mechanism of the disease. RESULTS: The presence of the p.S12N mutation was associated with a significant risk of ABPA in ABPA patients when compared with healthy controls and asthma patients, regardless of Aspergillus sensitivity. Relative to healthy controls without relevant allergies, the mutation of p.S12N was associated with a significant risk of ABPA (OR: 2.69 and 4.17 for GA and AA genotypes, P = 0.003 and 0.029, respectively). Compared with patients with asthma, ABPA patients had a significantly higher heterozygous mutation (GA genotype), indicating that p.S12N might be a significant ABPA-susceptibility locus ( aspergillus sensitized asthma: OR: 3.02, P = 0.009; aspergillus unsensitized asthma: OR: 2.94, P = 0.005). The mutant allele was preferentially expressed in ABPA patients with heterozygous CARD9S12N , which contributes to its functional alterations to facilitate Af -induced T H 2-mediated ABPA development. In terms of mechanism, Card9 wild-type ( Card9WT ) expression levels decreased significantly due to Af -induced decay of its messenger RNA compared to the heterozygous Card9S12N . In addition, ABPA patients with heterozygous CARD9S12N had increased Af -induced interleukin-5 production. CONCLUSION Our study provides the genetic evidence showing that the heterozygous mutation of CARD9S12N , followed by allele expression imbalance of CARD9S12N , facilitates the development of ABPA.
Humans ; Aspergillosis, Allergic Bronchopulmonary/complications* ; Aspergillus fumigatus/genetics* ; Asthma/genetics* ; Aspergillus ; Mutation/genetics* ; CARD Signaling Adaptor Proteins/genetics*

Objective To analyze the microflora structure and abundance of ileum and colon of SPF male SD rats by high-throughput sequencing technique. MethodsThe ileal and colonic lumen contents of 30 SPF male SD rats were collected, the total bacterial DNA in the contents was extracted and amplified by PCR. The V3-V4 region of bacterial 16S rRNA in the samples was sequenced using Illumina NovaSeq sequencing platform. Then the species structure and abundance of the intestinal flora were analyzed at the phylum and genus level based on validated data. The diversity and differences between ileal and colonic flora were analyzed using the QIIME software (amplicon) analysis tool. The Tax4Fun program was applied to predict the dominant gene enrichment pathways of ileal and colonic flora. ResultsAt the phylum level, the dominant microflora in the ileum of male SD rats were Firmicutes and Actinobacteria, accounting for more than 98%. The dominant colonic microbial community were mainly Firmicutes and Bacteroidetes, accounting for more than 95%. At the genus level, Lactobacillus and Alistipes were the predominant bacteria in the ileum. The colon was dominated by Lactobacillus and Romboutsia. In terms of flora diversity, the alpha diversity of colonic flora including richness index (Chao1 index) and diversity index (Shannon index) were significantly higher than those of ileum (P < 0.01), and the structural variability of the composition of its flora species was smaller than that of ileum; the ileal flora with significant structural variability were mainly of the phylum Firmicutes, Romboutsia, Peptostreptococcaceae, while the colonic flora had significant structural differences in Bacteroidales. In terms of flora function, the ileal flora dominant genes were significantly enriched in lipid-like metabolism, polyketide metabolism, membrane transport, biodegradation and other pathways, while the colonic flora dominant genes were significantly enriched in glycan biosynthesis metabolism, energy metabolism, biosynthesis of cofactor and vitamins and other products, and other pathways. ConclusionThere are significant differences in structure and abundance between the ileal and colonic flora of SPF male SD rats, and the abundance and diversity of colonic flora are higher than those of ileal flora.

Objective:To investigate the feasibility and efficacy of three mini-incision double eyelid blepharoplasty with concurrent reposition of orbital fat pad to correct sunken upper eyelids.Methods:The data of patients who underwent orbital fat reposition to correct upper eyelid depression during the period from January 2018 to April 2021 in the Medical Plastic and Cosmetic Center of Beijing Tongren Hospital affiliated to Capital Medical University were retrospectively analyzed. During the operation, the central mass of orbital fat and its lateral extension were fully dissociated, and then transferred and fixed inward through three mini-incisions. Postoperative follow-up was performed to observe the improvement of the double eyelid shape and upper eyelid depression, and the patient satisfaction was recorded.Results:A total of 72 patients (140 eyes) were included in this study, including 1 male and 71 females, with an average age of 28 years (19-40 years old), 122 eyes with mild upper eyelid depression and 18 eyes with moderate upper eyelid depression before operation. Postoperative follow-up was 6-24 months, with an average of 11 months. The curvature of the double eyelid after operation was smooth and basically symmetrical. Among the 122 eyes with mild upper eyelid depression before operation, 118 eyes were completely corrected after operation, and 4 eyes were not improved. Of the 18 eyes, 3 eyes were completely corrected after operation, and 15 eyes still had mild upper lid depression. The overall satisfaction rate was 93.1% (67/72), the rate of double eyelid failure was 3.6% (5/140), and no other serious complications were found.Conclusions:Three mini-incision double eyelid blepharoplasty simultaneously with orbital fat reposition can effectively correct mild and moderate sunken upper eyelid deformity. The postoperative double eyelid shape is stable with high satisfaction rate.

Objective:To investigate the feasibility and efficacy of three mini-incision double eyelid blepharoplasty with concurrent reposition of orbital fat pad to correct sunken upper eyelids.Methods:The data of patients who underwent orbital fat reposition to correct upper eyelid depression during the period from January 2018 to April 2021 in the Medical Plastic and Cosmetic Center of Beijing Tongren Hospital affiliated to Capital Medical University were retrospectively analyzed. During the operation, the central mass of orbital fat and its lateral extension were fully dissociated, and then transferred and fixed inward through three mini-incisions. Postoperative follow-up was performed to observe the improvement of the double eyelid shape and upper eyelid depression, and the patient satisfaction was recorded.Results:A total of 72 patients (140 eyes) were included in this study, including 1 male and 71 females, with an average age of 28 years (19-40 years old), 122 eyes with mild upper eyelid depression and 18 eyes with moderate upper eyelid depression before operation. Postoperative follow-up was 6-24 months, with an average of 11 months. The curvature of the double eyelid after operation was smooth and basically symmetrical. Among the 122 eyes with mild upper eyelid depression before operation, 118 eyes were completely corrected after operation, and 4 eyes were not improved. Of the 18 eyes, 3 eyes were completely corrected after operation, and 15 eyes still had mild upper lid depression. The overall satisfaction rate was 93.1% (67/72), the rate of double eyelid failure was 3.6% (5/140), and no other serious complications were found.Conclusions:Three mini-incision double eyelid blepharoplasty simultaneously with orbital fat reposition can effectively correct mild and moderate sunken upper eyelid deformity. The postoperative double eyelid shape is stable with high satisfaction rate.