Objective To characterize the properties of Hepa1-6-derived microparticles (Hepa1-6-MPs), investigate their stimulatory effects on dendritic cells (DCs) and their cellular uptake pathways, and explore the specific cytotoxic effects of CD8⁺ T cells induced by Hepa1-6-MP-loaded DCs on hepatoma cell lines, with the aim of developing a novel immunotherapeutic model for hepatocellular carcinoma (HCC). Methods The isolated Hepa1-6-MPs were identified using Western blotting, transmission electron microscopy (TEM) and dynamic light scattering (DLS). Flow cytometry was used to assess the uptake pathways of Hepa1-6-MPs by DCs. Subsequently, enzyme-linked immunosorbent assay (ELISA) was used to measure the effects of Hepa1-6-MP-loaded DCs on the release levels of tumor necrosis factor α(TNF-α) and interferon γ(IFN-γ) into the supernatant of CD8⁺ T cells. Lactate dehydrogenase (LDH) tests were conducted to evaluate the cytotoxic effects of CD8⁺ T cells stimulated by Hepa1-6-MP-loaded DCs on hepatoma cells. Results The morphology, size and protein markers of Hepa1-6-MPs met the established criteria. Hepa1-6-MPs enhanced the expression of DC maturation markers CD80 and CD86, and were internalized by DCs via clathrin-mediated endocytosis and phagocytosis pathways. Subsequently, Hepa1-6-MP-loaded DCs stimulated CD8⁺ T cells to release high levels of TNF-α and IFN-γ, which induced their specific cytotoxicity against HCC cells. Conclusion These findings suggest that Hepa1-6-MP-loaded DCs may be a promising HCC immunotherapeutic tool.
Carcinoma, Hepatocellular/therapy* ; Liver Neoplasms/therapy* ; Dendritic Cells/immunology* ; Humans ; Cancer Vaccines/immunology* ; CD8-Positive T-Lymphocytes/immunology* ; Cell Line, Tumor ; Tumor Necrosis Factor-alpha/immunology* ; Interferon-gamma/immunology* ; Cell-Derived Microparticles/immunology* ; Animals

Early correction of childhood malocclusion is timely managing morphological, structural, and functional abnormalities at different dentomaxillofacial developmental stages. The selection of appropriate imaging examination and comprehensive radiological diagnosis and analysis play an important role in early correction of childhood malocclusion. This expert consensus is a collaborative effort by multidisciplinary experts in dentistry across the nation based on the current clinical evidence, aiming to provide general guidance on appropriate imaging examination selection, comprehensive and accurate imaging assessment for early orthodontic treatment patients.
Humans ; Malocclusion/diagnostic imaging* ; Child ; Consensus

Lung transplantation is currently the only recognized effective treatment for end-stage lung disease and has improved the quality of life for patients. However, lung transplantation still faces many challenges, including rejection, infection, post-transplant acute kidney injury, post-transplant diabetes mellitus, ischemia-reperfusion injury and donor shortage, etc. Chinese lung transplantation scholars made a series of important progress in the field of clinical research in 2024, focusing on the study and solution of the above problems, and providing new ideas for lung transplantation surgery. This article systematically reviews the clinical research and technological innovation in the field of lung transplantation in 2024, summarizes the achievements of clinical research in the field of lung transplantation in China in 2024, and aims to providing new directions and strategies for future research.

Objective To investigate the application value of full-length lower extremity CT scans performed at different noise index(NI)in terms of image quality and radiation dose for robot-assisted total knee arthroplasty(RTKA).Methods Eighty patients who underwent RTKA were selected and randomly divided into four groups based on different NI:NI=8,NI=18,NI=28,and NI=38.Subjective scores were assigned to the full-length lower extremity CT images and the three-dimensional skeletal models generated by volume rendering(VR)post-processing.Objective evaluations were performed using three indicators:dose length product(DLP),volume CT dose index(CTDIvol),and hip-knee-ankle angle(HKA).The application value of full-length lower extremity CT scans in RTKA was analyzed.Results(1)As the NI value increased,the subjective scores of thin-slice images decreased.Images with NI between 8 and 18 met the imaging diagnostic standards,while those with NI higher than 18 were unacceptable.(2)As the NI value increased,all VR skeletal models met the acceptance criteria for RTKA.(3)As the NI value increased,DLP and CTDIvol gradually decreased,with statistically significant differences(P<0.05),However,in the comparison between the NI=28 and NI=38 groups,the difference was not statistically significant(P>0.05).Conclusion Performing full-length lower extremity CT scans with an NI of 28 not only meets the preoperative planning requirements for RTKA but also minimizes the radiation dose.

Objective To explore the efficacy of the self-formulated Zhuzhang Formula in trea-ting the spleen deficiency with dysfunction of transportation syndrome of idiopathic short stature(ISS)and its effects on the growth rate,disease-related indicators,and bone metabolism indicators in affect-ed children.Methods A total of 80 children with ISS were enrolled as study subjects.They were randomly assigned to control group and observation group using random number table method,with 40 cases in each group.The control group received conventional western medicine treatment,while the observation group was administered self-formulated Zhuzhang Formula in addition to the treatment of the control group.Comparisons were made between the two groups in terms of clinical efficacy,TCM syndrome scores,growth parameters(monthly average height increment,annual growth rate),levels of disease-related indicators[serum insulin-like growth factor-1(IGF-1),bone morphogenetic pro-tein-2(BMP-2),insulin-like growth factor binding protein-3(IGFBP-3)],levels of bone metabo-lism indicators[bone alkaline phosphatase(BAP),type Ⅰ procollagen N-terminal propeptide(PⅠNP),type Ⅰ collagen cross-linked C-terminal telopeptide(β-CTX)],and the incidence of adverse reac-tions.Results The overall effective rate in the observation group was 97.50％,which was significantly higher than the 80.00％ in the control group(P＜0.05).After 3 and 6 months of intervention,the scores for symptoms such as short stature,sallow complexion,loss of appetite,weak voice and shortness of breath,limb weakness,and loose stools,as well as the total TCM syndrome scores,were lower in the observation group than those in the control group,with statistically significant differences(P＜0.05).After 6 months of intervention,the monthly average height increment and annual growth rate were higher in the observation group than those in the control group,and the differences were statistically significant(P＜0.05).After 3 and 6 months of intervention,the levels of IGF-1,BMP-2,IGFBP-3,BAP,and PⅠNP were higher in the observation group than those in the control group,while the level of β-CTX was lower,and the differences were statistically significant(P＜0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P＞0.05).Conclusion The self-formulated Zhuchang Formula demon-strates remarkable efficacy in treating the spleen deficiency with dysfunction of transportation syndrome of ISS.It can alleviate clinical symptoms by regulating the levels of IGF-1,BMP-2,IGFBP-3,and bone metabolism indicators,thereby promoting the growth and development of affected children,and exhibits high safety.

With the continuous development of China's aging society and the prevalence of unhealthy lifestyles, the incidence of cardiovascular disease in China has been increasing in recent years. Among them, atrial fibrillation (AF) is the most common arrhythmia disease. In recent years, pulsed field ablation (PFA) has been continuously applied to AF treatment as a novel treatment. This paper first introduces the principle of PFA applied to AF treatment, and introduces the research progress of PFA in different directions, such as the comparison of different ablation methods, the study of physical parameters, the study of ablation area, the study of tissue specificity and clinical research. Then, the clinical prior research of PFA is discussed, including the use of simulation software to obtain the simulation effect of different parameters, the evaluation of ablation effect during animal research, and finally the current AF treatment. Various prior studies and clinical studies are summarized, and suggestions are made for the shortcomings found in the study of AF treatment and the future research direction is prospected.

Objective:To assess the efficacy and safety of “one-stop” procedures combining radiofrequency catheter ablation and left atrial appendage closure by guidance of intracardiac echocardiography(ICE) in elderly patients with atrial fibrillation.Methods:A retrospective cohort study was conducted on patients who underwent ICE-guided “one-stop” procedures at the Department of Cardiology, General Hospital of Northern Theater Command between December 2020 and January 2023. Patients were divided into elderly group (age≥60 years old) and non-elderly group (age 18-59 years old). The clinical characteristics, acute success rate, peri-operative complications and follow-up data between two groups were compared. Multivariate logistic regression analysis was used to analyze whether age was the influencing factor for perioperative complications and atrial fibrillation recurrence.Results:A total of 213 atrial fibrillation patients were enrolled, including 158 (74.18%) in the elderly group (age: (68.3±5.0) years; 56.96% male) and 55 (25.82%) in the non-elderly group (age: (53.7±5.2) years; 81.82% male). The elderly group had lower proportions of males, persistent atrial fibrillation, and left atrial spontaneous echocardiographic contrast compared to the non-elderly group ( P<0.05). CHA 2DS 2-VASc and HAS-BLED scores were higher in elderly group ( P<0.05). The acute success rate,“one-stop” procedure time, fluoroscopy time and the rate of peri-operative complications (6 (3.80%) in elderly group vs. 2 (3.64%) in non-elderly group) were similar between two groups (all P>0.05). The average time of clinical and telephone interviews in elderly group and non-elderly group was (16.9±6.1) months and (17.9±5.9) months, respectively. There was no significant difference in the rate of atrial fibrillation recurrence or clinical events between two groups (47 (30.72%) vs. 14 (26.42%), P=0.554; 10 (6.54%) vs. 2(3.77%), P=0.689, respectively). Iatrogenic atrial septal defects in 3-month transesophageal echocardiography follow up were detected in 44 patients (36.97%) in elderly group and 9 patients (19.57%) in non-elderly group ( P=0.032). Multivariate logistic regression analysis results showed that age was not the influencing factor for peri-operative complications and atrial fibrillation recurrence ( P=0.905 and P=0.676, respectively). Conclusion:Intracardiac echocardiography-guided “one-stop” procedures in the treatment of atrial fibrillation in elderly patients are safe and effective.

Objective:To investigate the efficacy and safety of ablation index-guided radiofrequency catheter ablation (RFCA) and second-generation cryoballoon ablation (CBA) in elderly patients with atrial fibrillation (AF).Methods:This retrospective cohort study included 1 986 patients undergoing pulmonary vein isolation for AF at General Hospital of Northern Theater Command from August 2016 to May 2020, comprising 760 RFCA cases and 1 226 CBA cases. Elderly patients were defined as those aged 60 years or older, while non-elderly patients were those under 60 years of age. All patients were followed up for 3 years after the procedure to assess AF recurrence rates. Kaplan-Meier survival curves were plotted and compared by log-rank test. Multivariate logistic regression was used to analyze the influencing factors of AF recurrence.Results:Among 1 986 AF patients (aged (58.7±10.2) years; 1 307 males, 65.81%; 987 elderly patients, 49.70%), the overall AF recurrence rate was 24.37% (484/1 986). Kaplan-Meier analysis demonstrated a higher AF recurrence rate in the elderly group compared to the non-elderly group (log-rank P=0.007). In the RFCA group, AF recurrence rate was 22.50% (171/760), with no significant difference between the elderly (24.44%, 88/360) and non-elderly (20.75%, 83/400) subgroups ( P=0.223). In the CBA group, recurrence rates were 25.53% (313/1 226), with significantly higher recurrence in elderly patients (28.55%, 179/627) than non-elderly (22.37%, 134/599) ( P=0.013). Multivariate logistic regression analysis revealed that advanced age was not an independent predictor of AF recurrence ( P=0.447). Longer AF duration and larger left atrial diameter were independent risk factors for recurrence, while male sex was a protective factor (all P<0.05). Conclusion:Pulmonary vein isolation with second-generation CBA and RFCA guided by ablation index are safe and effective in the treatment of AF in elderly patients.

Objective::This study aimed to investigate the feasibility, efficacy, and safety of using a miniature mobile integrated cabin-theatre equipped with angiography and surgical operating room capabilities, and to explore its therapeutic scope, effectiveness, and operational mode.Methods::A miniature mobile integrated operating cabin-theatre was deployed across 15 hospitals in 15 cities or counties in China from April 2012 to November 2024. The interventions and outcomes of interventional and minimally invasive surgical procedures were prospectively observed and evaluated; perioperative complications were documented, and the stability, adaptability, and mobility of the integrated system were assessed.Results::A total of 133 procedures were successfully performed, 130 of which were interventional and 3 minimally invasive. The angiography machine showed good imaging performance without any equipment failures, loosening, or damage, with normal chamber unfolding. One patient experienced a fever the day after laparoscopy, while none of the other patients exhibited perioperative complications such as infection, surgical site bleeding/hematoma, or reperfusion arrhythmia. The instrument was easily manipulated, aligning with the needs of clinical intervention and surgery, and was perceived by patients as being a comfortable environment, with no psychological or other obvious discomfort.Conclusions::The miniature mobile integrated cabin-theatre, comprising an angiography machine and an operating room, allows interventional or minimally invasive surgical procedures to be performed smoothly and safely. It can also provide rapid and efficient on-site treatment of acute and critical illnesses across multiple body systems, including the cardiovascular, cerebrovascular, and gastrointestinal systems.

Objective To investigate the application value of full-length lower extremity CT scans performed at different noise index(NI)in terms of image quality and radiation dose for robot-assisted total knee arthroplasty(RTKA).Methods Eighty patients who underwent RTKA were selected and randomly divided into four groups based on different NI:NI=8,NI=18,NI=28,and NI=38.Subjective scores were assigned to the full-length lower extremity CT images and the three-dimensional skeletal models generated by volume rendering(VR)post-processing.Objective evaluations were performed using three indicators:dose length product(DLP),volume CT dose index(CTDIvol),and hip-knee-ankle angle(HKA).The application value of full-length lower extremity CT scans in RTKA was analyzed.Results(1)As the NI value increased,the subjective scores of thin-slice images decreased.Images with NI between 8 and 18 met the imaging diagnostic standards,while those with NI higher than 18 were unacceptable.(2)As the NI value increased,all VR skeletal models met the acceptance criteria for RTKA.(3)As the NI value increased,DLP and CTDIvol gradually decreased,with statistically significant differences(P<0.05),However,in the comparison between the NI=28 and NI=38 groups,the difference was not statistically significant(P>0.05).Conclusion Performing full-length lower extremity CT scans with an NI of 28 not only meets the preoperative planning requirements for RTKA but also minimizes the radiation dose.