Primary pulmonary nuclear protein of the testis (NUT) midline carcinoma (NMC) is a rare and highly aggressive thoracic malignancy that poses significant diagnostic and therapeutic challenges in clinical practice. This tumor is characterized by its heterogeneous clinical presentations and poor prognosis, often evading accurate initial diagnosis. In this study, we present two cases of primary pulmonary NMC treated with an integrated therapeutic approach combining anti-angiogenic agents, platinum-based chemotherapy, and radiotherapy. This multimodal strategy achieved survival durations of 32 and 13 months, respectively, surpassing the currently reported median survival of advanced NMC. Through a systematic literature review of reported cases, we have summarized the currently used diagnostic methods and treatment modalities for NMC. Our findings suggest that multimodal therapy incorporating anti-angiogenic treatment may offer superior clinical outcomes compared to conventional monotherapy regimens, particularly for patients who are not eligible for surgery. This comprehensive investigation enhances our understanding of NMC management by elucidating diagnostic pitfalls through histopathological correlation and proposing an effective therapeutic combination that demonstrates improved survival outcomes. By providing valuable insights into the diagnosis and treatment of primary pulmonary NMC, we hope to contribute to the development of more effective strategies for managing this rare and aggressive malignancy.
Humans ; Angiogenesis Inhibitors/therapeutic use* ; Carcinoma/therapy* ; Combined Modality Therapy ; Lung Neoplasms/diagnosis* ; Nuclear Proteins ; Oncogene Proteins ; Neoplasm Proteins

Objective:To investigate the application status of emergency radiology in China, and to provide data support for the standardized development, scientific management and big data research of emergency radiology.Methods:From August 12th to October 19th, 2022, a questionnaire survey was conducted through WeChat"Questionnaire Star"to send targeted questionnaires to investigate the relevant data of the current status of emergency radiology in China, mainly including digital radiography (DR) and computed tomography (CT). This study was initiated by the Chinese Emergency Radiology Database Collaboration Group, and comprehensively investigated emergency imaging personnel, equipment, workload, critical value reporting process, and artificial intelligence (AI) application status.Results:There were 123 hospitals in the study. The survey showed that emergency DR/CT reports were mainly completed by residents and above (69.1%). There were 21 DR brands, 10 CT brands and 8 MR brands used for emergency imaging examinations. The median number of DR examinations in tertiary hospitals and secondary hospitals investigated from January to June 2022 was 4 642 and 2 015 cases respectively, and the median number of CT examinations was 16 512 and 3 762 cases respectively. The average single-shift workload of DR in the emergency radiology department during the day and night shift in tertiary hospitals was mainly ≤20 copies and 21-50 copies, and the average single-shift workload of CT in the emergency radiology department during the day and night shift was mainly 21-50 copies and 51-100 copies, while the average single-shift workload of DR/CT in the emergency radiology department during the day/night shift in secondary hospitals was mainly ≤20 copies. In terms of critical value reporting process, 74.8% of emergency imaging doctors and 84.6% of emergency imaging technicians took the way of phone/text message to notify the clinical doctor or the patients′ family. The overall deployment rate of AI in emergency imaging was about 60.2%. 75% of the respondents believed that in the future, AI can improve emergency radiology work from aspects such as emergency screening, aided diagnosis and process optimization.Conclusions:The emergency medical imaging mainly based on DR and CT has the current situations such as generally low seniority of doctors, diverse brands of imaging equipments, large volume of examinations and intense workload per doctor, especially in tertiary hospitals, and dependence on traditional means for critical value reporting. At present, AI is emerging in the field of emergency imaging, and there is still a long way to go to play the huge potential of AI in the intelligent whole process of emergency imaging in the future.

Objective:To study the hemostasis effect of the ingredients in compound hemostasis patches .Methods:The effect of the ingredients in compound hemostasis patches on the clotting time was studied by the coagulation of rabbit whole blood in vitro.The models of femoral arterial injury in rats and perforation of femoral artery in pigs were established , and the effect of the ingredients in compound hemostasis patches on the bleeding time and the bleeding loss was studied .Results:The results of the whole blood coagula-tion in vitro showed that the clotting time of the three compound hemostasis patches at different concentrations and thrombin group was significantly shorter than that of the blank control group and the saline control group (P<0.01).Compared with to the blank control group, the results of rat femoral artery trauma model test showed that the three patch groups and thrombin group could significantly re -duce the bleeding loss and bleeding time (P<0.05 or P<0.01).The results of pig femoral artery perforation hemorrhage model test showed that the compound hemostasis patches could significantly reduce the bleeding time (P<0.05).Conclusion:Compound hemo-stasis patches can significantly shorten clotting time and decrease bleeding loss .

Objective To study the effects of electroacupuncture(EA)on gastrointestinal motility and nitric oxide synthase(NOS)positive nerves in myenteric plexus in acute exhaustive exercise rats. Methods A total of 54 male Sprague-Dawley rats were randomly divided into an acute exhaustive exercise(AEE)group,an AEE plus EA group and a control(C)group.The gastric empty rate and intestinal motility rate were measured,and histological changes of NOS-positive nerves in ileum myenteric plexus were observed with enzymatic histochemical method and image analysis technique. Results In the rats of AEE group,the gastric empty rate and intestinal motility rate were delayed but the numbers of NOS-positive neurons and expression levels of NOS in the ileum myenteric plexus significantly increased comparing with those of the C group(P＜0.01).Compared with AEE group,the gastric empty rate and intestinal motility rate were significantly increased but the number of NOS-positive neurons and expression level of NOS in the ileum myenteric plexus significantly decreased in AEE plus EA group(P＜0.01). Conclusion The findings of this study suggest that increase of NOS-positive neurons and expression levels of NOS in the myenteric plexus is one of the mechanisms of slowing down of gastrointestinal movement after acute exhaustive exercise.Electroacupuncture at Zusanli acupoint may decrease the number of NOS-positive neurons and expression levels of NOS in the myenteric plexus,and improve gastrointestinal movement in acute exhaustive exercise rats.

Objective To observe the effects of CO2 pneumoperitoneum on the enteric motor function and acetylcholine esterase(AchE) neuron and nitric oxide synthase(NOS) neuron in the enteric nervous system,and explore the neuromechanism of the CO2 pneumoperitoneum on renteric motor function.Methods Thirty-six Sprague Dawley rats were randomly divided into experiment group(n=24) and control group(n=12).The experiment group was divided into two subgroups namely pneumoperitoneum 30min group and pneumoperitoneum 60min group(12 each) based on the maintenance time of pneumoperitoneum.Rats in each group were gavaged with medicinal carbon powder,and then the transmission of carbon powder in small intestine was determined.The spreading specimens of intestinal myenteric plexus of small intestine were prepared and the stained AchE and NOS neurons were observed and compared.Results The propellant velocity of carbon powder was slower in pneumoperitoneum 60min group than that in pneumoperitoneum 30min group and control group(28.55%?3.45% vs 45.90%?6.30%,48.25%?5.28%,P0.05).The number of positive expression of AchE neurons in intestinal myenteric plexus decreased in pneumoperitoneum 60min group compared with that in pneumoperitoneum 30min group and control group(48.00?3.16 vs 58.82?4.62,61.83?4.17,P0.05).The number of positive expression of NOS neurons in intestinal myenteric plexus increased in pneumoperitoneum 60min group compared with that in pneumoperitoneum 30min group and control group(42.17?4.45 vs 32.50?4.34,30.83?3.6,P0.05).Conclusions Prolonged CO2 pneumoperitoneum can affect or damage cholinergic neurons and nitroxidergic neurons in the enteric nervous system to some extent,and it may be the underlying mechanism of the intestinal motor dysfunction after operation.