Objective To explore the changes in intrarenal pelvic pressure and intrarenal temperature during F6.3 disposable electronic ureteroscopic lithotripsy through in vitro experiments. Methods Microchannels were established in the upper, middle, and lower calyces of ex vivo porcine kidneys. Spherical calcium oxalate stones(size:0.5 cm×0.5 cm×0.5 cm, 1-2 per target calyx)were placed via the microchannels. Temperature and pressure sensors were connected through sheaths and placed in each calyx. F6.3 disposable electronic ureteroscope combined with super-pulsed thulium fiber laser(pulse energy:0.1 J, frequency:300 Hz, power:30 W)was used for laser lithotripsy. During the procedure, normal saline(25±1)℃ was used for irrigation at a gradient of 10-150 mL/min(increasing by 10 mL/min). The temperature and pressure in the upper, middle, and lower calyces were observed and recorded at different irrigation flow rates, with each experiment repeated five times, and the average value was calculated. The intrarenal temperature and pressure changes within and between the three groups were compared. Results In the ex vivo porcine kidney model, intrarenal pelvic pressure increased linearly with the increase in irrigation flow rate. When the flow rate reached 90 mL/min, the average intrarenal pelvic pressure was(28.8±1.16)mmHg. When the flow rate was increased to 100 mL/min, the pressure exceeded the safety threshold, reaching(31.23±1.12)mmHg. With the increase in irrigation flow rate, intrarenal temperature gradually decreased. When the flow rate reached 20 mL/min, the maximum intrarenal temperature was 45.1 ℃. When the flow rate was increased to 30 mL/min, the maximum intrarenal temperature was 40.9 ℃, which did not exceed the safety threshold(43 ℃). Conclusion The in vitro experiments demonstrated that during F6.3 disposable electronic ureteroscopic lithotripsy, maintaining an irrigation flow rate of 30-90 mL/min kept the intrarenal pelvic pressure and intrarenal temperature within the safety thresholds, indicating that the procedure is safe and reliable.

Objective To construct an in vitro co-culture model of gastric cancer organoids and cancer-associated fibroblasts(CAFs),and investigate the role of cancer-associated fibroblasts in the proliferation and chemotherapy resistance of gastric cancer organoids.Methods Tumor tissues from 12 gastric cancer patients undergoing surgical treatment in Department of General Surgery of Second Affiliated Hospital of Army Medical University from February 2023 to March 2024 were collected to construct gastric cancer organoids using 3D culture.HE staining was used to observe the morphology,and immunohistochemical assay was employed to determine the expression of cytokeratin CK7,carcinoembryonic antigen(CEA),and proliferation marker Ki-67.After CAFs derived from the same patient were cultured,observed for their morphology under a light microscope,and detected for the phenotype by flow cytometry,the cells were co-cultured with gastric cancer organoids in a 1:1 ratio.Phase-contrast microscopy was applied to observe the growth of the organoids and analyze the number,average diameter,and total area.Then,organoids cultured alone served as the control group.After the control and co-culture groups were treated with chemotherapy drugs,5-fluorouracil and oxaliplatin,for 48 h,the viability and apoptosis of organoids were assessed with CellTiter-Glo??3D assay and CellEvent? Caspase 3/7 activity,respectively.Results Gastric cancer organoids and CAFs were successfully established from 10 gastric cancer patient-derived samples.The gastric cancer organoids exhibited morphological characteristics consistent with the corresponding primary tumors,and showed positive expression of CK7,CEA,and Ki-67.CAFs displayed typical spindle-shaped morphology and exhibited the phenotypic markers CD326-,CD45-,CD31-,α-SMA+,CD73+,CD90+,and CD105+.Compared to the organoids cultured alone,the organoids co-cultured with CAFs showed more formation of organoids,in larger average diameter,and taking larger total area(P<0.05).After the treatment of 5-fluorouracil and oxaliplatin,the half-maximal inhibitory concentration(IC50)was 10.66 and 3.26 μmol/L,respectively in the control group,while was 46.23 and 91.11 μmol/L in the co-culture group.Additionally,the number of CellEvent? Caspase 3/7 positive apoptotic cells was significantly less in the co-culture group than the control group.Conclusion Compared with individually cultured gastric cancer organoids,the co-culture model of gastric cancer organoids and CAFs better simulates the pro-tumor proliferation and drug resistance effects of in vivo tumor microenvironment.

Objective To establish a mouse model of infection with the minimum lethal dose of Vibrio vulnificus(V.vulnificus)and to evaluate the protective efficacy of inactivated whole-cell(IWC)vaccine using this model.Methods A mouse model of lethal-dose infection was established by intraperitoneal injection of different doses of V.vulnificus.Bacterial colonization in the organs was detected with tissue homogenate plating,and pathological changes in the organs were observed after tissue section staining.Flow cytometry was used to detect immune cell responses after liver tissues were digested into single-cell suspension.IWC vaccine of V.vulnificus was prepared,and the mice were immunized through different routes to observe the protective efficacy of the vaccine.Results A mouse model of infection with the minimum lethal dose at 1×106 CFU of V.vulnificus was successfully established.After infection,the bacteria were mainly colonized in the liver of mice and caused severe pathological damages.Compared with the uninfected mice,the proportion of neutrophils in the liver was significantly increased in the infected mice,whereas the proportions of B cells and T cells were correspondingly decreased(P<0.05).A single intramuscular or intraperitoneal injection of the IWC vaccine could protect the mice effectively against lethal infection of V.vulnificus in 7 d later(P<0.01),although the level of serum IgG having no significant increase.Conclusion A mouse model of lethal-dose infection with V.vulnificus is successfully established,with histopathological characteristics.The IWC vaccine of V.vulnificus rapidly mediates immune protection in this model probably independent of IgG.

Hematoma expansion (HE) in patients with spontaneous intracerebral hemorrhage (sICH) is often associated with neurological deterioration and poor prognosis. Early and accurate identification of patients at high risk for HE is crucial for guiding clinical practice. This article summarizes the imaging predictors for HE in patients with sICH, primarily focusing on non-enhanced CT and CT angiography, and briefly introduces various prediction models based on imaging features, in order to provide references for the clinical diagnosis and treatment of sICH.

Radiopharmaceuticals play an important role in the medical field,but they also carry certion risks and potential safety concerns.Medical institutions implement pharmacovigilance to ensure the safety of patients'drug use,including the safety of Radiopharmaceuticals.The operation and management of the pharmacovigilance system in the United States and the European Union are relatively mature.China can learn from their advanced concepts and establish our own radiopharmaciligence system.

AIM: To analyze the research status and future development trends of intermittent exotropia(IXT)by bibliometric study.METHODS: Bibliometrics methods were used and the related literatures in the Web of Science Core Collection(WoSCC)database from 2003 to 2022 were retrieved. CiteSpace6.2.R2 software was used to conduct visualized analysis of publications of one year, countries, institutions, journals, authors, references and keywords.RESULTS: A total of 620 literatures on IXT were retrieved from 2003 to 2022, and there has been a progressive increase in the number of publications. South Korea and the United States, Mayo Clinc and Holmes JM were the most productive and impactful country, institution and author, respectively. The Journal of American Association for Pediatric Ophthalmology and Strabismus(J AAPOS)published the most manuscripts(78 publications). The keywords with the strongest citation burst were surgery, epidemiology, alignment and recurrence.CONCLUSION: Visualized analysis conducted by CiteSpace software could objectively show the quantity changes and distribution of literatures on IXT from 2003 to 2022. Furthermore, the research hotspot of IXT has gradually shifted from surgery and epidemiology to fusion and recurrence.

Objective To explore the mechanism underlying the protective effect of α2-macroglobulin (A2M) against glucocorticoid-induced femoral head necrosis. Methods In a human umbilical vein endothelial cell (HUVEC) model with injuries induced by gradient concentrations of dexamethasone (DEX;10-8-10-5 mol/L), the protective effects of A2M at 0.05 and 0.1 mg/mL were assessed by examining the changes in cell viability, migration, and capacity of angiogenesis using CCK-8 assay, Transwell and scratch healing assays and angiogenesis assay. The expressions of CD31 and VEGF-A proteins in the treated cells were detected using Western blotting. In BALB/c mouse models of avascular necrosis of the femoral head induced by intramuscular injections of methylprednisolone, the effects of intervention with A2M on femoral trabecular structure, histopathological characteristics, and CD31 expression were examined with Micro-CT, HE staining and immunohistochemical staining. Results In cultured HUVECs, DEX treatment significantly reduced cell viability, migration and angiogenic ability in a concentration- and time-dependent manner (P<0.05), and these changes were obviously reversed by treatment with A2M in positive correlation with A2M concentration (P<0.05). DEX significantly reduced the expression of CD31 and VEGF-A proteins in HUVECs, while treatment with A2M restored CD31 and VEGF-A expressions in the cells (P<0.05). The mouse models of femoral head necrosis showed obvious trabecular damages in the femoral head, where a large number of empty lacunae and hypertrophic fat cells could be seen and CD31 expression was significantly decreased (P<0.05). A2M treatment of the mouse models significantly improved trabecular damages, maintained normal bone tissue structures, and increased CD31 expression in the femoral head (P<0.05). Conclusion A2M promotes proliferation, migration, and angiogenesis of DEX-treated HUVECs and alleviates methylprednisolone-induced femoral head necrosis by improving microcirculation damages and maintaining microcirculation stability in the femoral head.

Objective To investigate the distribution of B cells in both tumor and non-tumor tissues of gastric cancer patients,analyze their phenotypic characteristics and explore the impact on T cell proliferation.Methods Immunohistochemical staining was utilized to detect the expression of B cell surface marker CD 19 in tumor and non-tumor tissues from 33 gastric cancer patients.The expression levels of chemokine receptors and immunoglobulin molecules on B cells in both tumor and non-tumor tissues were measured using flow cytometry.Chemotaxis experiments were conducted to examine the role of the CXCL12-CXCR4 axis in B cell chemotaxis.B cells isolated and purified from both tissue types were co-cultured with autologous peripheral T cells to assess their effect on T cell proliferation.Results There were significantly more B cells infiltrated in tumor tissues than those infitrated in the non-tumor tissues of gastric cancer patients(P＜0.01),and CXCR4 was highly expressed on tumor-infiltrating B cells compared with B cells derived from non-tumor tissues(P＜0.05).The Cancer Genome Atlas(TCGA)analysis indicated that the expression level of CXCL12 in tumor tissues was positively correlated with the expression level of CD19 in gastric cancer patients(r=0.15,P＜0.01).And the expression level of CXCL12 in tumor tissues of the gastric cancer patients was also positively correlated with the number of B cells infiltrated in tumor tissues.Chemotaxis experiments confirmed that the CXCL12-CXCR4 axis was involved in promoting B cell chemotaxis(P＜0.05).Although B cells in tumor and non-tumor tissues had similar levels of IgM,IgG,and IgA expression,tumor-infiltrating B cells significantly inhibited the proliferation of T cells when compared with B cells derived from non-tumor tissues(P＜0.01).Conclusion There are more B cells infiltrated in gastric cancer tissues,which may be recruited to tumor tissues through the CXCL12-CXCR4 axis,and then inhibit T cell proliferation to promote the progression of gastric cancer.

Objective To explore the mechanism underlying the protective effect of α2-macroglobulin (A2M) against glucocorticoid-induced femoral head necrosis. Methods In a human umbilical vein endothelial cell (HUVEC) model with injuries induced by gradient concentrations of dexamethasone (DEX;10-8-10-5 mol/L), the protective effects of A2M at 0.05 and 0.1 mg/mL were assessed by examining the changes in cell viability, migration, and capacity of angiogenesis using CCK-8 assay, Transwell and scratch healing assays and angiogenesis assay. The expressions of CD31 and VEGF-A proteins in the treated cells were detected using Western blotting. In BALB/c mouse models of avascular necrosis of the femoral head induced by intramuscular injections of methylprednisolone, the effects of intervention with A2M on femoral trabecular structure, histopathological characteristics, and CD31 expression were examined with Micro-CT, HE staining and immunohistochemical staining. Results In cultured HUVECs, DEX treatment significantly reduced cell viability, migration and angiogenic ability in a concentration- and time-dependent manner (P<0.05), and these changes were obviously reversed by treatment with A2M in positive correlation with A2M concentration (P<0.05). DEX significantly reduced the expression of CD31 and VEGF-A proteins in HUVECs, while treatment with A2M restored CD31 and VEGF-A expressions in the cells (P<0.05). The mouse models of femoral head necrosis showed obvious trabecular damages in the femoral head, where a large number of empty lacunae and hypertrophic fat cells could be seen and CD31 expression was significantly decreased (P<0.05). A2M treatment of the mouse models significantly improved trabecular damages, maintained normal bone tissue structures, and increased CD31 expression in the femoral head (P<0.05). Conclusion A2M promotes proliferation, migration, and angiogenesis of DEX-treated HUVECs and alleviates methylprednisolone-induced femoral head necrosis by improving microcirculation damages and maintaining microcirculation stability in the femoral head.

Objective To evaluate the accuracy of bioelectrical impedance analysis(BIA)in measurement of appendicular skeletal muscle mass(ASM)of adults.Methods A total of 836 adults aged 18-42 years were recruited in Guangzhou using a convenient sampling method from April 2021 to September 2022.ASM was measured using BIA and Dual-energy X-ray absorptiometry(DXA).Using DXA as the standard method,the consistency between the BIA and DXA measurements was evaluated by intra-class correlation coefficients(ICCs)and Bland-Altman analysis in logarithmically transformed data,in order to evaluate the accuracy of BIA in ASM measurement.Receiver operating characteristic curve was plotted to evaluate the diagnostic value of BIA for screening low muscle mass.Results A total of 774 individuals were included for analysis finally.ICCs for ASM measured by BIA and DXA were 0.774 and 0.667 in males and females,respectively.Mean ratios(limits of Agreement)of ASM were 0.94(0.80-1.10)and 0.91(0.78-1.05)in males and females,respectively.Area under curve of BIA for screening low muscle mass were 0.91 and 0.94 in males and females,respectively.The optimal cut-off values of Z-score by BIA for males and females were-0.57 and-0.66,respectively.Sensitivity and specificity for males were 82.5%and 86.0%,while being 86.8%and 93.8%,for females.Conclusion BIA shows a moderate consistency with DXA for measuring ASM in adults.Furthermore,BIA yields a good diagnostic value in identifying low muscle mass in adults aged 18-42 years.