China is facing the double burden of high incidence of lung cancer and tuberculosis epidemic. Lung cancer combined with tuberculosis has a high incidence and complexity in clinical practice. High-risk groups include immunocompromised people, long-term smokers and people with a history of tuberculosis. The coexistence of the two diseases not only increases the difficulty of diagnosis and treatment decision-making, but also increases the risk of treatment-related adverse reactions and drug interactions. The guideline was developed by Committee of Integrated Rehabilitation for Lung Cancer, Chinese Anti-Cancer Association; Chinese and Western Integrated Lung Cancer Committee of Chinese Anti-Cancer Association; Society of Tuberculosis, Chinese Medical Association, aiming to standardize the diagnosis and treatment of lung cancer complicated with pulmonary tuberculosis. The guideline emphasizes the core position of combined diagnosis of multimodal imaging, etiology and pathology. It is proposed that anti-tuberculosis and anti-tumor treatment should be coordinated under the framework of multidisciplinary team, and drug interactions and timing optimization should be paid attention to. For surgical treatment, minimally invasive resection combined with systematic lymph node dissection is recommended after infection control. Systemic therapy requires individualized risk stratification and dynamic monitoring of efficacy and adverse reactions. Based on evidence-based medicine and Chinese clinical practice, combined with the accessibility of drugs and technologies, this guideline proposes a whole-process management pathway covering screening, diagnosis, treatment and follow-up, in order to improve the prognosis and quality of life of patients.

OBJECTIVE: To review the research progress of Schöttle's method in medial patellofemoral ligament reconstruction (MPFLR), and provide the latest knowledge and suggestions for surgical treatment. METHODS: The studies on Schöttle's method at home and abroad in recent years were extensively collected, then summarized the problems affecting the accuracy of Schöttle's method and the new ideas to improve the accuracy of localization. RESULTS: It's vital to accurately locate the femoral tunnel during MPFLR. Malposition of the femoral tunnel is the main cause of postoperative complications and surgical failure. Schöttle's method is the most well studied and most reproducible method for femoral tunnel localization, which is widely used as the "gold standard". However, there are still problems that affect the accuracy of Schöttle's method, including the impact of the internal/external rotation and varus/valgus of the knee on localization accuracy, unclear requirements for X-ray imaging and anatomical landmark reference line drawing standards, no suitable for patients with anatomical variations, and lack of further research on pediatric patients. In recent years, some new ideas are proposed to improve the Schöttle's method to improve the localization accuracy. CONCLUSION Future research should combine new technologies such as three-dimensional (3D) printing and intraoperative navigation to develop personalized and intelligent Schöttle's method, further improving their localization accuracy.
Humans ; Femur/surgery* ; Plastic Surgery Procedures/methods* ; Patellofemoral Joint/surgery* ; Patellar Ligament/surgery* ; Postoperative Complications ; Knee Joint/surgery* ; Ligaments, Articular/surgery* ; Tomography, X-Ray Computed/methods*

Osteosarcoma （OS） is the most common primary malignant bone tumor originating from mesenchymal stem cells， which features high degree of malignancy， strong invasiveness， easy early metastasis， and high recurrence rate. The clinical manifestations of OS are pain， local mass， limited movement， and pathological fracture. OS mainly occurs in children， adolescents， and the elderly， seriously threatening physical and mental health of patients， as well as their quality of life. The currently available therapies for OS are surgery， chemoradiotherapy， and the combination of the two. Although the therapeutic effect has been improved， tumor recurrence and metastasis and multidrug resistance still occur. Thus， the therapeutic effect is not satisfactory， especially in improving the overall survival rate of patients with metastatic OS. As a result， clinicians and researchers have been making efforts to find an effective therapy. In recent years， the mechanism of curcumin （CUR） against OS has attracted wide attention. CUR， a pigment extracted from the rhizomes or tubers of many plants， such as Curcuma longa， C. rcenyujin， and C. phaeocaulis， has a variety of pharmacological effects. Scholars have found that CUR has the effects of inhibiting proliferation， inducing apoptosis， and reversing multidrug resistance （MDR） of tumor cells， but also it has poor water solubility and low bioavailability， which limit the clinical application. This paper mainly discusses the mechanism of CUR against OS， the existing problems， new treatment methods， and future research directions， which is expected to provide new ideas for scientific researchers and provide a reference for the development and utilization of CUR in the future.

Non-small cell lung cancer (NSCLC) is the most common pathological type of lung cancer. The systemic antitumor therapy of advanced NSCLC has undergone renovations of chemotherapy, targeted therapy and immunotherapy, which results in greatly improved survival for patients with advanced NSCLC. Immune checkpoint inhibitors (ICIs), especially targeting programmed cell death protein 1 (PD-1)/programmed death-ligand 1 (PD-L1), has changed the treatment paradigm of NSCLC. ICIs have become the standard treatment for advanced NSCLC without epidermal growth factor receptor(EGFR) mutation or anaplastic lymphomakinase(ALK) translocation in the first- or second-line setting, and for locally advanced NSCLC following concurrent radiotherapy and chemotherapy. ICIs are also promising in adjuvant/neoadjuvant therapy. More and more ICIs have been approved domestically for the treatment of NSCLC. Led by the NSCLC expert committee of Chinese Society of Clinical Oncology (CSCO), this consensus was developed and updated based on thoroughly reviewing domestic and foreign literatures, clinical trial data, systematic reviews, experts' discussion and the consensus(2019 version). This consensus will aid domestic clinicians in the treatment of NSCLC with ICIs.
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Objective:To explore the value of quantitative parameters of dynamic contrast-enhanced MRI(DCE-MRI) in evaluating the biological behavior of soft tissue tumors.Methods:The clinical data of 69 patients with soft tissue tumors confirmed by pathology in the Affiliated Hospital of Qingdao University from January 2017 to December 2019 were analyzed retrospectively, including 29 benign tumors and 40 malignant tumors. All patients were examined by routine MRI and DCE-MRI before the operation. The DCE-MRI parameters including volume transfer constant (K trans), rate constant (K ep) and extracellular space volume fraction (V e) were acquired by post-processing software analysis. Microvessel density (MVD) and Ki-67 labeling index (Ki-67 LI) were detected using immunohistoche mical method. Spearman correlation test was used to analyze the correlation between DCE-MRI quantitative parameters and MVD and Ki-67 LI.Independent sample t-test or Mann-Whitney U test was used to compare the difference of parameters between benign and malignant group, and the receiver operating characteristic (ROC) curves were performed to evaluate the diagnostic value. Results:There was positive correlation between K trans, K ep and MVD ( r=0.633, 0.727, P<0.0l), and positive correlation between K trans, K ep and Ki-67 LI ( r=0.557, 0.612, P<0.01). There was no correlation between V e and MVD, Ki-67 LI ( P>0.05). The K trans, K ep, MVD and Ki-67 LI in the malignant group were higher than those in the benign group, and the differences were significant ( P<0.05).There was no significant difference in V e value between malignant group and benign group. When K trans value of 0.169/min was used, the sensitivity, specificity and area under the ROC curve (AUC) for differentiating benign and malignant soft tissue tumors were 84.6%, 85.8% and 0.859, respectively. When K ep value of 0.367/min was used, the sensitivity, specificity and AUC were 92.3%, 83.3% and 0.846, respectively. Conclusion:The DCE-MRI quantitative parameters K trans and K ep can be used to evaluate the biological behavior of soft tissue tumors.

Non-small cell lung cancer (NSCLC) is the most common pathological type of lung cancer, most NSCLC patients are at advanced stage at the time of diagnosis. For patients without sensitive driven-oncogene mutations, chemotherapy is still the main treatment at present, the overall prognosis is poor. Improving outcomes and obtaining long-term survival are the most urgent needs of patients with advanced NSCLC. In recent years, immunotherapy has developed rapidly. Immune checkpoint inhibitors (ICIs), especially targeting programmed death-1 (PD-1)/programmed death-ligand 1 (PD-L1), have made a breakthrough in the treatment of NSCLC, beneficial to patients' survival and changed the treatment pattern for NSCLC. It shows more and more important role in the treatment of NSCLC. Led by NSCLC expert committee of Chinese society of clinical oncology (CSCO), relevant experts in this field were organized. On the basis of referring to domestic and foreign literature, systematically evaluating the results of Chinese and foreign clinical trials, and combining the experiences of the experts, the experts group reached an agreement to develop this consensus. It will guide domestic counterparts for better application of ICIs to treat NSCLC.

To investigate the effects of triptolide on inflammation and apoptosis induced by focal cerebral ischemia/reperfusion in rats.The rat model of focal cerebral ischemia/reperfusion injury was established according to Longa's method. A total of 80 SD rats were randomly divided into 5 groups:normal control, sham group, DMSO group, middle cerebral artery occlusion (MCAO) group, and MCAO with tripolide treatment group. TTC staining was used to examine the site and volume of cerebral infarction, and Longa score was employed for neurological disorders measurement. Number of astrocytes was measured by fluorescence staining, and neuronal apoptosis was determined by TUNEL staining. The expressions of inducible nitric oxide synthase(iNOS), cyclooxygenase 2(COX-2) and NF-κB proteins were detected by immunohistochemistry, and the expression of iNOS, COX-2 mRNA was detected by real-time PCR.Compared with DMSO group and MCAO group, brain edema was improved (80.03±0.46)% (<0.05), infarct volume was reduced (8.3±1.4)% (<0.01), Longa score was decreased (1.38±0.20,<0.05) in triptolide treatment group. Meanwhile triptolide also dramatically reduced the number of GFAP-positive astrocytes (<0.05), alleviated protein expression of COX-2 (91.67±1.31), iNOS (95.24±5.07) and NF-κB (75.03±2.06) triggered by MCAO (all<0.05), and induced a down-regulation of cell apoptosis as showed by TUNEL assay (64.15±3.52,<0.05).Triptolide can reduce the cerebral infarction volume, attenuate brain edema and ameliorate the neurological deficits induced by cerebral ischemia-reperfusion injury rats, indicating that it might be used as a potential anti-inflammatory agent.
Animals ; Apoptosis ; drug effects ; Astrocytes ; Brain Edema ; drug therapy ; Brain Injuries ; chemically induced ; drug therapy ; Brain Ischemia ; chemically induced ; Cyclooxygenase 2 ; drug effects ; Diterpenes ; pharmacology ; Down-Regulation ; drug effects ; Epoxy Compounds ; pharmacology ; Infarction, Middle Cerebral Artery ; chemically induced ; drug therapy ; Inflammation ; drug therapy ; Male ; NF-kappa B ; drug effects ; Nitric Oxide Synthase Type II ; drug effects ; Phenanthrenes ; pharmacology ; Rats ; Rats, Sprague-Dawley ; Reperfusion Injury ; chemically induced ; drug therapy

Objective: To investigate the effects of triptolide on inflammation and apoptosis induced by focal cerebral ischemia/reperfusion in rats .Methods: The rat model of focal cerebral ischemia/reperfusion injury was established according to Longa's method.A total of 80 SD rats were randomly divided into 5 groups: normal control, sham group , DMSO group , middle cerebral artery occlusion ( MCAO ) group , and MCAO with tripolide treatment group .TTC staining was used to examine the site and volume of cerebral infarction , and Longa score was employed for neurological disorders measurement . Number of astrocytes was measured by fluorescence staining , and neuronal apoptosis was determined by TUNEL staining .The expressions of inducible nitric oxide synthase ( iNOS ) , cyclooxygenase 2 ( COX-2 ) and NF-κB proteins were detected by immunohistochemistry , and the expression of iNOS , COX-2 mRNA was detected by real-time PCR.Results: Compared with DMSO group and MCAO group , brain edema was improved ( 80 .03 ±0 .46 ) % ( P <0 .05 ) , infarct volume was reduced (8.3 ±1.4)%(P<0.01), Longa score was decreased (1.38 ±0.20, P<0 .05 ) in triptolide treatment group .Meanwhile triptolide also dramatically reduced the number of GFAP-positive astrocytes ( P <0.05 ), alleviated protein expression of COX-2 (91.67 ±1.31), iNOS (95.24 ±5.07) and NF-κB (75.03 ±2.06) triggered by MCAO ( all P<0 .05 ) , and induced a down-regulation of cell apoptosis as showed by TUNEL assay (64.15 ±3.52, P<0.05).Conclusion: Triptolide can reduce the cerebral infarction volume , attenuate brain edema and ameliorate the neurological deficits induced by cerebral ischemia-reperfusion injury rats , indicating that it might be used as a potential anti-inflammatory agent .

Objective To explore the clinical efficacy and safety of umbilical cord derived mesenchymal stem cells transplantation(UC-MSCT)for patients with refractory systemic lupus erythematosus (SLE).Methods Twelve patients with refractory SLE were enrolled in this study.UC-MSCs(≥106/kg cell number)were infused intravenously for each patient. The clinical manifestations and laboratory parameters were compared before and after MSCT. Results The twelve patients were followed up for one to twenty-six months after MSCT.The systemic lupus erythematosus disease activity index(SLEDAI)score decreased from 18±4 to 10±4 one month after MSCT(n=12,P＜0.01)and then decreased to 7±4 at three month follow-up.Nine patients showed improvement of 24 h proteinuria[(2103±749)mg vs(3359±1248)mg,P＜0.01]one month after MSCT.Further improvement of 24 h proteinuria was observed in eight patients[(1427±616)mg vs(3342±1333)mg,P＜0.01]at three months post MSCT.Serum creatinine of five patients decreased significantly and ten patients showed an increase of serum albumin. Serum complement C3 increased in three patients and four patients showed obvious amelioration of hematological abnormalities. There was no transplantation related complications for all the patients. Conclusion UC-MSCT is effective and safe for refractory SLE,but further observation is required to evaluate its long term efficacy.

Objective:To investigate the effects of 17β-Estradiol (E2) on mesenchymal stem cells (MSC) and to evaluate the effects of MSC treated with E2 on the maturation and function of dendritic cells (DC).Methods: We first isolated and cultured MSC from the human fetal lung.The MSC were treated with E2 for 24 hours at various concentrations ( 10~(-9),10~(-8) and 10~(-7) mol/L).After cell counting,proliferation,adherent ability and immunophenotypes of MSC were detected by flowcytometry.The gene expressions of cytokine (IL-6,TGF-βand VEGF) were measured by RT-PCR.The effects of MSC treated with E2 on the maturation and function of DC were determined.Results:After treated with E2,the proliferation and adherent ability of MSC were increased,while the immunophenotypes of MSC were not affected.When MSCs co-cultured with DC,MSC could inhibit the immuophenotypes and function of DC.However,when DC co-cultured with E2-pretreated MSC,the immunophenotypes (MHC Ⅱ,CD80 and CD86) of DC had been reconstructed.After treated with the high concentration of E2 for 24 hours,MSC secreted lower level of TGF-β than that in the control group,while IL-6 and VEGF expressions were increased compared with those in the control group.Conclusion: Estrogen may alter the immuno-suppressive effects of MSC on DC via modulating the cytokine secretion of MSC.