A rising frequency of thymic epithelial tumors has been noted recent years,however limited drugs can be chosen for recurrent and metastatic thymic epithelial tumors patients.Treatment patterns in mul-tiple tumors have been rapidly developing in parallel with the growing use of immune checkpoint inhibitors(ICIs).Although ICIs have showed certain efficacy in thymic epithelial tumors patients,the relatively high in-cidence of immune-related adverse events(irAEs)limited its application.This review aims to summary the ef-ficacy,side effects and related mechanisms of ICIs for treating thymic epithelial tumors patient,which may shed light on the predicament of immunotherapy for thymic epithelial tumors patients.

Objective·To explore the clinical efficacy and safety of sticky bone[deproteinized porcine bone mineral granules combined with advanced platelet-rich fibrin(A-PRF)and liquid platelet-rich fibrin(L-PRF)]in the repair of unilateral alveolar cleft.Methods·Patients diagnosed with unilateral alveolar cleft who met the inclusion and exclusion criteria were recruited from December 1,2023 to August 31,2024.The patients were randomly divided into 2 groups.The experimental group received sticky bone grafts,and the control group received autologous iliac cancellous bone grafts for alveolar cleft repair.The primary efficacy index was the bone resorption rate at 6 months post-surgery,calculated by measuring the grafted bone volume immediately after surgery and at 6 months using Simplant Pro 17.01 software based on patients'computed tomography data collected before surgery,immediately after surgery,and 6 months post-surgery.Secondary efficacy indices included bone density at 6 months after surgery,the occurrence of postoperative complications in patients,and the scores on the oral health-related quality of life scale.Prism 10 software was used for data analysis,and t-test and Pearson correlation analysis methods were adopted.Results·Seventeen patients with unilateral alveolar cleft were included in the experimental group,and 15 in the control group.The remaining bone volume in the experimental group at 6 months after surgery was more than that in the control group.The bone resorption rate in the experimental group was 33.24%±17.16%,significantly lower than 66.31%±17.98%in the control group(P<0.001).One patient in the experimental group had vestibular mucosal dehiscence accompanied by bone powder discharge 2 weeks after surgery;3 patients in the control group had vestibular mucosal dehiscence accompanied by cancellous bone discharge 1 month after surgery,with one case of grafted bone necrosis 4 months after surgery.The bone density in the experimental group at 6 months after surgery was significantly higher than that in the control group(P<0.001),and the scores on the oral health-related quality of life scale were lower.Conclusion·Compared with iliac cancellous bone,when sticky bone is used in the treatment of patients with unilateral alveolar cleft,it shows a lower bone resorption rate and higher bone density,indicating better osteogenic ability.Fewer number of complications and lower scores on the oral health-related quality of life scale suggest greater safety,thereby supporting its strong potential for clinical promotion and application.

Objective·To explore the clinical efficacy and safety of sticky bone[deproteinized porcine bone mineral granules combined with advanced platelet-rich fibrin(A-PRF)and liquid platelet-rich fibrin(L-PRF)]in the repair of unilateral alveolar cleft.Methods·Patients diagnosed with unilateral alveolar cleft who met the inclusion and exclusion criteria were recruited from December 1,2023 to August 31,2024.The patients were randomly divided into 2 groups.The experimental group received sticky bone grafts,and the control group received autologous iliac cancellous bone grafts for alveolar cleft repair.The primary efficacy index was the bone resorption rate at 6 months post-surgery,calculated by measuring the grafted bone volume immediately after surgery and at 6 months using Simplant Pro 17.01 software based on patients'computed tomography data collected before surgery,immediately after surgery,and 6 months post-surgery.Secondary efficacy indices included bone density at 6 months after surgery,the occurrence of postoperative complications in patients,and the scores on the oral health-related quality of life scale.Prism 10 software was used for data analysis,and t-test and Pearson correlation analysis methods were adopted.Results·Seventeen patients with unilateral alveolar cleft were included in the experimental group,and 15 in the control group.The remaining bone volume in the experimental group at 6 months after surgery was more than that in the control group.The bone resorption rate in the experimental group was 33.24%±17.16%,significantly lower than 66.31%±17.98%in the control group(P<0.001).One patient in the experimental group had vestibular mucosal dehiscence accompanied by bone powder discharge 2 weeks after surgery;3 patients in the control group had vestibular mucosal dehiscence accompanied by cancellous bone discharge 1 month after surgery,with one case of grafted bone necrosis 4 months after surgery.The bone density in the experimental group at 6 months after surgery was significantly higher than that in the control group(P<0.001),and the scores on the oral health-related quality of life scale were lower.Conclusion·Compared with iliac cancellous bone,when sticky bone is used in the treatment of patients with unilateral alveolar cleft,it shows a lower bone resorption rate and higher bone density,indicating better osteogenic ability.Fewer number of complications and lower scores on the oral health-related quality of life scale suggest greater safety,thereby supporting its strong potential for clinical promotion and application.

Background The benchmark dose (BMD) method calculates the dose associated with a specific change in response based on a specific dose-response relationship. Compared with the traditional no observed adverse effect level (NOAEL) method, the BMD method has many advantages, and the 95% lower confidence limit of benchmark dose lower limit (BMDL) is recommended to replace NOAEL in deriving biological exposure limits. No authority has yet published any health-based guideline for rare earth elements. Objective To evaluate genotoxicity threshold induced by acute exposure to neodymium nitrate in mice using BMD modeling through micronucleus test and comet assay. Methods SPF grade mice (n=90) were randomly divided into nine groups, including seven neodymium nitrate exposure groups, one control group (distilled water), and one positive control group (200 mg·kg⁻¹ ethyl methanesulfonate), 10 mice in each group, half male and half female. The seven dose groups were fed by gavage with different concentrations of neodymium nitrate solution (male: 14, 27, 39, 55, 77, 109, and 219 mg·kg⁻¹; female: 24, 49, 69, 97, 138, 195, and 389 mg·kg⁻¹) twice at an interval of 21 h. Three hours after the last exposure, the animals were neutralized by cervical dislocation. The bone marrow of mice femur was taken to calculate the micronucleus rate of bone marrow cells, and the liver and stomach were taken for comet test. Results The best fitting models for the increase of polychromatophil micronucleus rate in bone marrow of female and male mice induced by neodymium nitrate were the exponential 4 model and the hill model, respectively. The BMD and the BMDL of female mice were calculated to be 31.37 mg·kg⁻¹ and 21.90 mg·kg⁻¹, and those of male mice were calculated to be 58.62 mg·kg⁻¹ and 54.31 mg·kg⁻¹, respectively. The best fitting models for DNA damage induced by neodymium nitrate in female and male mouse hepatocytes were the exponential 5 model and the exponential 4 model, respectively, and the calculated BMD and BMDL were 27.15 mg·kg⁻¹ and 11.99 mg·kg⁻¹ for female mice, and 16.28 mg·kg⁻¹ and 10.47 mg·kg⁻¹ for male mice, respectively. The hill model was the best fitting model for DNA damage of gastric adenocytes in both female and male mice, and the calculated BMD and BMDL were 36.73 mg·kg⁻¹ and 19.92 mg·kg⁻¹ for female mice, and 24.74 mg·kg⁻¹ and 14.08 mg·kg⁻¹ for male mice, respectively. Conclusion Taken the micronucleus rate of bone marrow cells, DNA damage of liver cells and gastric gland cells as the end points of genotoxicity, the BMDL of neodymium nitrate is 10.47 mg·kg⁻¹, which can be used as the threshold of genotoxic effects induced by acute exposure to neodymium nitrate in mice.

Objective To carry out a proficiency testing of content determination of geniposide in Gardeniae fructus,evaluate the content determination ability of index components in traditional Chinese medicine in the laboratory of inspection and detection in drug-related fields,and improve the quality control ability of content determination of related laboratories.Methods The laboratory's capability-verification activities were conducted based on the CNAS-RL02 Rules for Proficiency Testing and ISO/IEC 17043 Conformity Assessment-General Requirements for Proficiency Testing.After preparing the sample,the results of homogeneity and stability tests were analyzed according to CNAS-GL003 Guidance on Evaluating the Homogeneity and Stability of Samples Used for Proficiency Testing.After the test results were qualified,they were used as proficiency testing samples and randomly distributed to participants.The results were collected,and the robust statistical method and the Z scores were used to analyze the results of these laboratories'reports.Results 403 laboratories in this proficiency testing program reported the results,of which 367 results were acceptable,accounting for 91.07％,17(4.22％)laboratories obtained suspicious results,and 19 laboratories gave unsatisfactory results,with the dissatisfaction rate of 4.71％.Conclusion The majority of the 403 participant laboratories have the ability to determine the content of geniposide in Gardeniae fructus by HPLC and the laboratory testing ability and quality management level of the drug monitoring system are high.This proficiency testing provides a basis for understanding the technical reserve capacity and management level of China's pharmaceutical inspection and testing laboratories,and provides technical support for future government supervision.

Antibodies, Antinuclear ; Autoantibodies ; China ; Cohort Studies ; Humans ; Scleroderma, Systemic

Objective:To explore the clinical effect of Pingchuan Decoction combined with routine western medicine therapy in the treatment of acute attack of bronchial asthma in children. Methods:From January 2017 to June 2019, 118 children with acute attack of bronchial asthma were selected from the Seventh People’s Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, and they were randomly divided into control group (59 cases) and observation group (59 cases) according to the random number table. The control group was treated with routine western medicine therapy, and the observation group was treated with Pingchuan Decoction on the base of control group, and both groups were treated for 14 days. The main symptom scores before and after treatment were evaluated. The percentage of forced vital capacity expressed as percent predicted (FVC% pred) and the forced expiratory volume in 1 second expressed as percent predicted (FEV1% pred) were measured by pulmonary function meter. The levels of CD3 +, CD4 + and CD4 +/CD8 + in peripheral blood were detected by flow cytometry. The adverse reactions during the treatment were recorded and the clinical efficacy was evaluated. Results:The total clinical effective rate was 93.2% (55/59) in the observation group and 71.2% (42/59) in the control group, where the difference between the two groups was statistically significant ( χ2=9.790, P=0.002). After treatment, the scores of cough, wheezing and wheezing rale in the observation group were significantly lower than those in the control group ( t=27.695, 17.573, 32.827, P<0.001). After treatment, FVC% pred [(80.21 ± 4.06)% vs. (71.71 ± 3.95)%, t=11.526], FEV1% pred [(78.84±3.92)% vs. (72.26 ± 3.59)%, t=9.508] in the observation group were significantly higher than those in the control group ( P<0.01). The levels of CD3 + [(74.05 ± 5.13)% vs. (67.44 ± 4.98)%, t=7.101], CD4 + [(48.43 ± 4.31)% vs. (42.20 ± 4.06)%, t=8.082] and the ratio of CD4 +/CD8 + (1.67 ± 0.29 vs. 1.34 ± 0.25, t=6.620) in the observation group were significantly higher than those in the control group ( P<0.01). During the treatment, the incidence of adverse reactions was 10.2% (6/59) in the observation group and 6.8% (4/59) in the control group, and there was no significant difference between the two groups ( χ2=0.437, P=0.509). Conclusion:The Pingchuan Decoction combined with routine western medicine therapy can reduce the clinical symptoms of children with acute attack of bronchial asthma, improve lung function, improve organism immunity and clinical effect with safety.

The epidemic of coronavirus disease 2019 (COVID-19) puts higher demands on critical care medicine. Lots of studies have been conducted to solve COVID-19-related problems. Therefore, we reviewed the annual progress for COVID-19-related issues including antivirals threapies, respiratory support and immunomodulatory therapies and other critical issues, including the effect of antibiotic on mitochondrial damage and its relationship with sepsis, the goal and direction of antimicrobial de-escalation, drug prophylaxis of constipation, bleeding in gastrointestinal disorders and management of critical illness in the informalization era and so on. We hope to provide reference for clinical and scientific research work of the intensivists.

Objective:To construct a real-time monitoring system based on computer vision for monitoring withdrawal speed of colonoscopy and to validate its feasibility and performance.Methods:A total of 35 938 images and 63 videos of colonoscopy were collected in endoscopic database of Renmin Hospital of Wuhan University from May to October 2018. The images were divided into two datasets, one dataset included in vitro, in vivo and unqualified colonoscopy images, and another dataset included ileocecal and non-cecal area images. And then 3 594 and 2 000 images were selected respectively from the two datasets for testing the deep learning model, and the remaining images were used to train the model. Three colonoscopy videos were selected to evaluate the feasibility of real-time monitoring system, and 60 colonoscopy videos were used to evaluate its performance.Results:The accuracy rate of the deep learning model for classification for in vitro, in vivo, and unqualified colonoscopy images was 90.79% (897/988), 99.92% (1 300/1 301), and 99.08% (1 293/1 305), respectively, and the overall accuracy rate was 97.11% (3 490/3 594). The accuracy rate of identifying ileocecal and non-cecal area was 96.70% (967/1 000) and 94.90% (949/1 000), respectively, and the overall accuracy rate was 95.80% (1 916/2 000). In terms of feasibility evaluation, 3 colonoscopy videos data showed a linear relationship between the retraction speed and the image processing interval, which indicated that the real-time monitoring system automatically monitored the retraction speed during the colonoscopy withdrawal process. In terms of performance evaluation, the real-time monitoring system correctly predicted entry time and withdrawal time of all 60 examinations, and the results showed that the withdrawal speed and withdrawal time was significantly negative-related ( R=-0.661, P<0.001). The 95% confidence interval of withdrawal speed for the colonoscopy with withdrawal time of less than 5 min, 5-6 min, and more than 6 min was 43.90-49.74, 40.19-45.43, and 34.89-39.11 respectively. Therefore, 39.11 was set as the safe withdrawal speed and 45.43 as the alarm withdrawal speed. Conclusion:The real-time monitoring system we constructed can be used to monitor real-time withdrawal speed of colonoscopy and improve the quality of endoscopy.

Objective:To construct an artificial intelligence-assisted diagnosis system to detect gastric ulcer lesions and identify benign and malignant gastric ulcers automatically.Methods:A total of 1 885 endoscopy images were collected from November 2016 to April 2019 in the Digestive Endoscopy Center of Renmin Hospital of Wuhan University. Among them, 636 were normal images, 630 were with benign gastric ulcers, and 619 were with malignant gastric ulcers. A total of 1 735 images belonged to training data set and 150 images were used for validation. These images were input into the Res-net50 model based on the fastai framework, the Res-net50 model based on the Keras framework, and the VGG-16 model based on the Keras framework respectively. Three separate binary classification models of normal gastric mucosa and benign ulcers, normal gastric mucosa and malignant ulcers, and benign and malignant ulcers were constructed.Results:The VGG-16 model showed the best ability of classification. The accuracy of the validation set was 98.0%, 98.0% and 85.0%, respectively, for distinguishing normal gastric mucosa from benign ulcers, normal gastric mucosa from malignant ulcers, and benign ulcers from malignant ulcers.Conclusion:The artificial intelligence-assisted diagnosis system obtained in this study shows noteworthy ability of detection of ulcerous lesions, and is expected to be used in clinical to assist doctors to detect ulcer and identify benign and malignant ulcers.