Objective:To investigate the prognostic value of aldosterone synthase (CYP11B2) immunohistochemical expression in adrenal specimens for surgical outcomes of primary aldosteronism (PA).Methods:The clinical data of 99 patients who underwent total unilateral adrenalectomy from June 2022 to January 2023 at Beijing Anzhen Hospital was retrospectively analysed. The clinical data of 99 patients who underwent unilateral total adrenalectomy at Beijing Anzhen Hospital from June 2022 to January 2023 were retrospectively analyzed.There were 59 patients in the PA group, age (53.02±10.56) years, body mass index (BMI) (26.28±4.33) kg/m 2, preoperative aldosterone 29.0(15.9, 61.5)ng/dl, plasma renin 1.3(0.6, 2.8)μIU/ml, aldosterone renin ratio (ARR) 19.3(9.1, 59.2) μg/μIU, preoperative potassium (3.60±0.69) mmol/L, and systolic blood pressure (156.54±21.39) mmHg (1 mmHg=0.133 kPa).There were 40 cases in the nonfunctioning adenoma (NFA) group, age (57.23±9.39) years, BMI (27.07±3.46) kg/m 2, preoperative aldosterone 9.0(7.2, 14.1) ng/dl, plasma renin 18.0(5.2, 47.6)μIU/ml, ARR 0.6(0.2, 1.4) μg/μIU, preoperative potassium (4.17±0.41) mmol/L, and systolic blood pressure (157.97±26.87) mmHg. The differences between the two groups were statistically significant for potassium ( P<0.01), aldosterone ( P=0.012), renin ( P<0.01), and ARR ( P<0.01).Surgical outcomes were assessed using the Consensus on the Outcome of Surgery for Primary Aldosteronism (PASO) (complete/partial/no success for clinical and biochemical outcomes). CYP11B2 expression was evaluated by immunohistochemistry using the 2022 World Health Organization's histopathology of primary aldosteronism (HISTALDO) criteria. The correlation between the expression of CYP11B2 and surgical outcomes was assessed. Results:The mean follow-up of 99 patients was (11.73±4.92) months. Of these, 36 out of 59 PA patients had positive CYP11B2 expression in their adrenal specimens, while 23 were negative; all 40 NFA patients were negative for CYP11B2. Among the 36 CYP11B2-positive PA patients, there were 19 cases of aldosterone-producing adenomas, 3 aldosterone-producing nodules, 4 aldosterone-producing micronodules, 8 multiple aldosterone-producing micronodules, and 2 aldosterone-producing diffuse hyperplasia. 36 cases of CYP11B2-positive PA patients had complete clinical success in 15 cases, partial success in 20 cases, and no success in 1 case, and complete biochemical success in 24 cases, partial success in 11 cases, and no success in 1 case; 23 CYP11B2-negative PA patients had complete clinical success in 4 cases, partial success in 15 cases, and no success in 4 cases, and complete biochemical success in 6 cases, partial success in 15 cases, and no success in 2 cases. Adrenal specimens from CYP11B2-positive PA patients had significantly better clinical ( P=0.038) and biochemical ( P=0.008) success rates than CYP11B2-negative PA patients. Patients with aldosterone-producing adenomas had complete clinical success in 8 cases, partial success in 11 cases, and no success in 0 cases, and biochemical success was completely achieved in 16 cases, partially achieved in 2 cases, and not successful in 1 case. They also had significantly higher clinical ( P=0.028) and biochemical ( P<0.01) success rates compared to CYP11B2-negative PA patients. Conclusions:Patients with PA who had immunohistochemical staining for CYP11B2 positivity and high expression in adrenal specimens had a better postoperative clinical and biochemical prognosis. Patients with aldosterone-producing adenomas had the greatest postoperative outcome of all pathological subtypes of PA.

Objective:To investigate the prognostic value of aldosterone synthase (CYP11B2) immunohistochemical expression in adrenal specimens for surgical outcomes of primary aldosteronism (PA).Methods:The clinical data of 99 patients who underwent total unilateral adrenalectomy from June 2022 to January 2023 at Beijing Anzhen Hospital was retrospectively analysed. The clinical data of 99 patients who underwent unilateral total adrenalectomy at Beijing Anzhen Hospital from June 2022 to January 2023 were retrospectively analyzed.There were 59 patients in the PA group, age (53.02±10.56) years, body mass index (BMI) (26.28±4.33) kg/m 2, preoperative aldosterone 29.0(15.9, 61.5)ng/dl, plasma renin 1.3(0.6, 2.8)μIU/ml, aldosterone renin ratio (ARR) 19.3(9.1, 59.2) μg/μIU, preoperative potassium (3.60±0.69) mmol/L, and systolic blood pressure (156.54±21.39) mmHg (1 mmHg=0.133 kPa).There were 40 cases in the nonfunctioning adenoma (NFA) group, age (57.23±9.39) years, BMI (27.07±3.46) kg/m 2, preoperative aldosterone 9.0(7.2, 14.1) ng/dl, plasma renin 18.0(5.2, 47.6)μIU/ml, ARR 0.6(0.2, 1.4) μg/μIU, preoperative potassium (4.17±0.41) mmol/L, and systolic blood pressure (157.97±26.87) mmHg. The differences between the two groups were statistically significant for potassium ( P<0.01), aldosterone ( P=0.012), renin ( P<0.01), and ARR ( P<0.01).Surgical outcomes were assessed using the Consensus on the Outcome of Surgery for Primary Aldosteronism (PASO) (complete/partial/no success for clinical and biochemical outcomes). CYP11B2 expression was evaluated by immunohistochemistry using the 2022 World Health Organization's histopathology of primary aldosteronism (HISTALDO) criteria. The correlation between the expression of CYP11B2 and surgical outcomes was assessed. Results:The mean follow-up of 99 patients was (11.73±4.92) months. Of these, 36 out of 59 PA patients had positive CYP11B2 expression in their adrenal specimens, while 23 were negative; all 40 NFA patients were negative for CYP11B2. Among the 36 CYP11B2-positive PA patients, there were 19 cases of aldosterone-producing adenomas, 3 aldosterone-producing nodules, 4 aldosterone-producing micronodules, 8 multiple aldosterone-producing micronodules, and 2 aldosterone-producing diffuse hyperplasia. 36 cases of CYP11B2-positive PA patients had complete clinical success in 15 cases, partial success in 20 cases, and no success in 1 case, and complete biochemical success in 24 cases, partial success in 11 cases, and no success in 1 case; 23 CYP11B2-negative PA patients had complete clinical success in 4 cases, partial success in 15 cases, and no success in 4 cases, and complete biochemical success in 6 cases, partial success in 15 cases, and no success in 2 cases. Adrenal specimens from CYP11B2-positive PA patients had significantly better clinical ( P=0.038) and biochemical ( P=0.008) success rates than CYP11B2-negative PA patients. Patients with aldosterone-producing adenomas had complete clinical success in 8 cases, partial success in 11 cases, and no success in 0 cases, and biochemical success was completely achieved in 16 cases, partially achieved in 2 cases, and not successful in 1 case. They also had significantly higher clinical ( P=0.028) and biochemical ( P<0.01) success rates compared to CYP11B2-negative PA patients. Conclusions:Patients with PA who had immunohistochemical staining for CYP11B2 positivity and high expression in adrenal specimens had a better postoperative clinical and biochemical prognosis. Patients with aldosterone-producing adenomas had the greatest postoperative outcome of all pathological subtypes of PA.

Objective To evaluate the value of digital radiography(DR)imaging of extraoral third molar in evaluating impacted teeth before extraction.Methods DR multi-parameter imaging was performed on the highly simulated standard physiological simulator.The mouth opening and X-ray projection angle of the simulator were changed to obtain DR images of the third molar under different imaging parameters.Optimal imaging parameters were selected by comparing the DR images,and were applied in clinic.According to the definition of DR images,the root display of the third molar on the affected side,and the overlap degree of the upper and lower third molars,the DR images of the third molar were classified and the surgical risk was assessed.The evaluation results of two doctors were tested by Cohen's Kappa test.Results The best X-ray projection angle of extraoral third molars was obtained.The optimal offset distance of limited mouth open was±15 cm,and the optimal offset distance of maximum mouth open was±20 cm.A total of 51 patients completed DR imaging of the third molar,and 69 molars were evaluated.The DR images of the two doctors were consistent(Kappa value=0.809).There were 51(73.91%)first-grade images and 18(26.09%)second-class images.There were 19(27.54%)oblique impacted teeth,24(34.78%)vertical impacted teeth,and 26(37.68%)horizontal impacted teeth.The subcrown position of the third molar was classified,and there were 41 cases(59.42%)of high position,21 cases(30.43%)of middle position,and 7 cases(10.14%)of low position.Clinicians assessed the risk of third molar extraction,including 33 low-risk impacted teeth(47.83%),19 medium-risk impacted teeth(27.54%),and 17 high-risk impacted teeth(24.64%).Conclusion DR imaging of extraoral third molar with different X-ray projection angles at limited mouth open and maximum mouth open positions can obtain high image quality and provide reliable information for clinical evaluation of impacted teeth before extraction.

BACKGROUND: The goal of this study was to create a biomaterial which combines concentrated growth factor (CGF) with an adipose-derived stem cell (ADSC) sheet to promote the repair of skull defects in rats. METHODS: We determined the optimal concentration of CGF extract by investigating the effects of different concentrations (0, 5%, 10%, and 20%) on the proliferation and differentiation of ADSCs. Then we created a complex combining CGF with an ADSC sheet, and tested the effects on bone repair in four experimental rat groups: (A) control; (B) ADSC sheet; (C) CGF particles; (D) combination of CGF ? ADSCs. Eight weeks after the procedure, osteogenesis was assessed by micro-CT and hematoxylin and eosin staining. RESULTS: We found that the concentration of CGF extract that promoted optimal ADSC proliferation and differentiation in vitro was 20%. In turn, bone regeneration was promoted the most by the combination of CGF and ADSCs. CONCLUSION In this study, we determined the optimal ratio of CGF and ADSCs to be used in a biomaterial for bone regeneration. The resulting CGF/ADSCs complex promotes maxillofacial bone defect repair in rats.

BACKGROUND: The goal of this study was to create a biomaterial which combines concentrated growth factor (CGF) with an adipose-derived stem cell (ADSC) sheet to promote the repair of skull defects in rats. METHODS: We determined the optimal concentration of CGF extract by investigating the effects of different concentrations (0, 5%, 10%, and 20%) on the proliferation and differentiation of ADSCs. Then we created a complex combining CGF with an ADSC sheet, and tested the effects on bone repair in four experimental rat groups: (A) control; (B) ADSC sheet; (C) CGF particles; (D) combination of CGF ? ADSCs. Eight weeks after the procedure, osteogenesis was assessed by micro-CT and hematoxylin and eosin staining. RESULTS: We found that the concentration of CGF extract that promoted optimal ADSC proliferation and differentiation in vitro was 20%. In turn, bone regeneration was promoted the most by the combination of CGF and ADSCs. CONCLUSION In this study, we determined the optimal ratio of CGF and ADSCs to be used in a biomaterial for bone regeneration. The resulting CGF/ADSCs complex promotes maxillofacial bone defect repair in rats.

Objective:To verify the predictive value of fully-automated 3D volume segmentation of CT images for the overall survival prognosis of resectable pancreatic ductal adenocarcinoma (PDAC).Methods:From July 2018 to March 2019, the clinical data of 198 cases of resectable PDAC were continuously collected in the First Affiliated Hospital of Naval Medical University. According to the level of carbohydrate antigen(CA)19-9 and carcinoembryonic antigen(CEA), the patient were divided into low CA19-9 group(≤210 U/ml ), high CA19-9 group (>210 U/ml ), normal CEA group (<5 ng/ml ) and high CEA group (≥5 ng/ml). Using our fully-automated segmentation tool developed in the early stage, images at the plain phase and portal phase were matched to those at the late artery phase by taking the artery phase as the matching target to establish UNet model; and the PDAC tumor and pancreatic glands were three-dimensionally segmented to estimate the tumor 3D volume. Univariate and multivariate logistic regression analysis were performed to compare the tumor 3D volume with the common preoperative risk factors (tumor 2D long diameter, CA19-9 level, CEA level, etc.) in predicting the patients′ survival. C-index was used to estimate the accuracy for predicting the survival. Receiver operating characteristics curve (ROC) was drawn and AUC was calculated to evaluate the accuracy for predicting the 1-year and 2-year overall survival and the influence of CA19-9 and CEA level on the patients′ overall survival.Results:Univariate logistic analysis showed that age, tumor 3D volume, tumor location, CA19-9 and CEA level were correlated with the patients′ overall survival. Multivariate logistic analysis showed that tumor 3D volume, CA199 and CEA were correlated with the overall survival. Among them, tumor 3D volume was most strongly correlated with the overall survival ( HR=2.25, 95% CI1.49-3.39, P<0.0001). The prognostic C-index of automatic 3D tumor volume, tumor long diameter, serum CEA and CA19-9 was 0.667(95% CI0.617-0.717), 0.637(0.583-0.691), 0.593(0.527-0.659) and 0.585(0.526-0.644), respectively. The AUCs of 3D tumor volume, tumor location, tumor long diameter, serum CEA and CA19-9 for predicting 1-year and 2-year survival were 0.726 and 0.698, 0.562 and 0.562, 0.703 and 0.660, 0.583 and 0.624, 0.602 and 0.609 respectively. C-index and AUC of tumor 3D volume was significantly better than those of the other common preoperative risk factors, and the difference was statistically significant (all P value <0.05). The survival of patients with large tumor 3D volume was greatly poorer than that of patients with small tumor 3D volume in low CA19-9 group, high CA19-9 group, normal CEA group and high CEA group, and the differences were all statistically significant ( HR=2.27, 95% CI 1.39-3.72; HR=2.42, 95% CI1.23-4.74; HR=2.08, 95% CI1.07-4.06; HR=2.67, 95% CI1.63-4.38, all P value <0.01). And the automatic 3D volume was the strongest predictor for the survival in high CA19-9 group. Conclusions:The tumor 3D volume obtained by automatic CT segmentation was an objective and reliable prognostic biomarker, which can supplement the established preoperativel risk factors and was expected to guide the personalized choice of neoadjuvant therapy.

[Abstract] Objective: To detect the expression of CD39 in head and neck squamous cell carcinoma (HNSCC) tisseus, and to analyze its correlation with patients’clinicopathological features and its prognostic significance. Methods: Tissue specimens and case data of 85 patients with HNSCC underwent surgery at Cancer Hospital of Tianjin from May 2012 to December 2013 were collected for this study. Gene chips were obtained from Oncomine database, and HNSCC cell lines SCC15, UM1, and Cal25 were selected for this study. Online analysis was performed to compare the differential expression of CD39 in buccal mucosa (BM) tissues and HNSCC tissues, Western blotting and Immunohistochemistry (IHC) were used to detect the protein expression of CD39 in HNSCC tissues. Spearman’ s correlation analysis was used to study the correlation between the expressions of CD39 and clinicopathological features of HNSCC patients. Both Kaplan-Meier curve analysis and Log rank test were used to analyze the association between the expression of CD39 in HNSCC tissues and the survival of patients, and Cox risk proportional regression model was used to evaluate the relationship between CD39 expression and the risk of relapse. Results: The transcription level of CD39 was obviously up-regulated in HNSCC tissues than in BM tissues (P<0.01), and CD39 expression was detected in HNSCC cell lines SCC15, UM1 and Cal25. Dexamethasone (DXM) could enhance the expression of CD39 in UM1 cells in dose-dependent manner. CD39 was highly expressed in 53 (62.4%) HNSCC patients, which was positively correlated with preoperative chemotherapy (r=0.234, P<0.05). The recurrence-free survival (RFS) of patients with high CD39 expression was significantly shortened (P<0.05), and high CD39 expression was an independent relapse risk factor (HR=2.328, 95%CI=1.091-4.967; P<0.05) for patients with HNSCC. Conclusion: CD39 is DXM-inducively and constitutively expressed in HNSCC. And over-expression of CD39 is an independent predictor of poor prognosis in HNSCC patients, indicating its important role in the progression of HNSCC.

肿瘤浸润性免疫细胞（TIC）参与构成肿瘤免疫微环境，调控肿瘤的生长，并影响患者的生存及抗肿瘤治疗的疗效。 TIC分布模式的类型主要有冷肿瘤型、混合型和间质型。这3种分布类型在免疫细胞的种类、数量与比例和分布位置上呈现明显 的差别。在不同肿瘤、不同个体，甚至同一肿瘤的不同区域之间，TIC分布模式既有差异性也有规律性，既有模式相似但功能相异 的差异性，也有模式不同但功能相近的规律性。TIC分布模式的分型体现的就是其差异性。近来研究发现，利用TIC分布模式可 以预测患者的预后及抗肿瘤治疗的疗效，这体现的就是TIC分布模式的规律性。本文就该领域的研究进展进行综述。

The Arc Peace hospital ship (No.866) is the first hospital ship with a displacement of over ten thousand tons ever designed and constructed by China .Its mission is to undertake medical support training at sea during peace time, and also to provide medical service to fleet formations and island or reef garrison forces stationed in areas far away from land .At war time, it could assume the tasks of providing preliminary combat casualty care as well as partial tertiary professional medical care to combat forces .The Xisha sea disaster search and rescue mission on September 29 was not only a humanitarian rescue mission , but also a demonstration in the capability of the hospital ship to perform multiple missions .The author has the following gains and experience derived from actual practice of corpse handling onboard the hospital ship during perils of the sea .

The Arc Peace hospital ship (No.866) is the first hospital ship with a displacement of over ten thousand tons ever designed and constructed by China .Its mission is to undertake medical support training at sea during peace time, and also to provide medical service to fleet formations and island or reef garrison forces stationed in areas far away from land .At war time, it could assume the tasks of providing preliminary combat casualty care as well as partial tertiary professional medical care to combat forces .The Xisha sea disaster search and rescue mission on September 29 was not only a humanitarian rescue mission , but also a demonstration in the capability of the hospital ship to perform multiple missions .The author has the following gains and experience derived from actual practice of corpse handling onboard the hospital ship during perils of the sea .