Objective     To explore the correlation between the quantitative and qualitative features of CT images and the invasiveness of pulmonary ground-glass nodules, providing reference value for preoperative planning of patients with ground-glass nodules. Methods    The patients with ground-glass nodules who underwent surgical treatment and were diagnosed with pulmonary adenocarcinoma from September 2020 to July 2022 at the Third Affiliated Hospital of Kunming Medical University were collected. Based on the pathological diagnosis results, they were divided into two groups: a non-invasive adenocarcinoma group with in situ and minimally invasive adenocarcinoma, and an invasive adenocarcinoma group. Imaging features were collected, and a univariate logistic regression analysis was conducted on the clinical and imaging data of the patients. Variables with statistical difference were selected for multivariate logistic regression analysis to establish a predictive model of invasive adenocarcinoma based on independent risk factors. Finally, the sensitivity and specificity were calculated based on the Youden index. Results     A total of 555 patients were collected. The were 310 patients in the non-invasive adenocarcinoma group, including 235 females and 75 males, with a meadian age of 49 (43, 58) years, and 245 patients in the invasive adenocarcinoma group, including 163 females and 82 males, with a meadian age of 53 (46, 61) years. The binary logistic regression analysis showed that the maximum diameter (OR=4.707, 95%CI 2.060 to 10.758), consolidation/tumor ratio (CTR, OR=1.027, 95%CI 1.011 to 1.043), maximum CT value (OR=1.025, 95%CI 1.004 to 1.047), mean CT value (OR=1.035, 95%CI 1.008 to 1.063), spiculation sign (OR=2.055, 95%CI 1.148 to 3.679), and vascular convergence sign (OR=2.508, 95%CI 1.345 to 4.676) were independent risk factors for the occurrence of invasive adenocarcinoma (P<0.05). Based on the independent predictive factors, a predictive model of invasive adenocarcinoma was constructed. The formula for the model prediction was: Logit(P)=–1.293+1.549×maximum diameter of lesion+0.026×CTR+0.025×maximum CT value+0.034×mean CT value+0.72×spiculation sign+0.919×vascular convergence sign. The area under the receiver operating characteristic curve of the model was 0.910 (95%CI 0.885 to 0.934), indicating that the model had good discrimination ability. The calibration curve showed that the predictive model had good calibration, and the decision analysis curve showed that the model had good clinical utility. Conclusion     The predictive model combining quantitative and qualitative features of CT has a good predictive ability for the invasiveness of ground-glass nodules. Its predictive performance is higher than any single indicator.

Objective:To explore the association between the intake and changes in various types of food and the changes in blood pressure in patients with mild to moderate hypertension.Methods:Mild to moderate hypertension participants with complete baseline and outcome data were included from DECIDE-Diet study, a multicenter, randomized controlled trial. Dietary records and blood pressure measurements at both 7-day run-in (baseline) and 28-day intervention phases were collected for enrolled participants. Blood pressure change was defined as the difference between blood pressure at the end of trial and the baseline blood pressure. Baseline intake of food was the average daily intake during the run-in period, and the intake increment was defined as the difference between the average intake during the trial period and the average intake during the run-in period. After adjusting for age, sex, study center, intervention groups, baseline body mass index (kg/m 2), antihypertension medication use, and baseline total calorie intake, a linear regression model was used to analyze the associations of the before-after-intervention change in blood pressure with baseline intake and intake increment of foods. Results:A total of 258 patients with mild to moderate hypertension were included, including 133 males, aged (56.5±9.9) years. (1) After adjusting for confounding factors, there was no significant association between baseline intake of food and baseline blood pressure (all P>0.05). The blood pressure change was negatively associated with baseline intakes of tubers, vegetables, and vegetable oils but positively with baseline intake of meats; and was negatively associated with intake increment of whole grains and fish (all P<0.05). (2) The multiple linear regression analysis showed that baseline intake of vegetables ( β=-0.021, P=0.004), vegetable oils ( β=-0.260, P=0.002), and increment in intake of fish ( β=-0.128, P=0.026) were all significantly associated with changes in systolic blood pressure; baseline intake of vegetables ( β=-0.017, P=0.002), vegetable oils ( β=-0.182, P=0.001), dairy products ( β=0.021, P=0.022), and increment in intake of fish ( β=-0.092, P=0.010) were all significantly associated with changes in diastolic blood pressure. Conclusion:Increasing the intake of whole grains, vegetables, vegetable oils, and fish and decreasing the intake of meat may be beneficial for blood pressure control in patients with mild to moderate hypertension.

Hepatic stellate cells (HSCs) represent a significant component of hepatocellular carcinoma (HCC) microenvironments which play a critical role in tumor progression and drug resistance. Tumor-on-a-chip technology has provided a powerful in vitro platform to investigate the crosstalk between activated HSCs and HCC cells by mimicking physiological architecture with precise spatiotemporal control. Here we developed a tri-cell culture microfluidic chip to evaluate the impact of HSCs on HCC progression. On-chip analysis revealed activated HSCs contributed to endothelial invasion, HCC drug resistance and natural killer (NK) cell exhaustion. Cytokine array and RNA sequencing analysis were combined to indicate the iron-binding protein LIPOCALIN-2 (LCN-2) as a key factor in remodeling tumor microenvironments in the HCC-on-a-chip. LCN-2 targeted therapy demonstrated robust anti-tumor effects both in vitro 3D biomimetic chip and in vivo mouse model, including angiogenesis inhibition, sorafenib sensitivity promotion and NK-cell cytotoxicity enhancement. Taken together, the microfluidic platform exhibited obvious advantages in mimicking functional characteristics of tumor microenvironments and developing targeted therapies.

The diagnosis of food allergy in children is one hotspot attracting people′s attention in recent years.The incidence of it shows an increasing trend which exposes problems in the understanding of children′s food allergy in China, especially in the misdiagnosis and missed diagnosis.To further standardize the diagnosis and treatment of food allergy in children, based on the current domestic, foreign guidelines and relevant research evidence, the guideline recommends 16 clinical hot-button issues in the 4 aspects of diagnosis, treatment, prognosis, and prevention.Finally, a diagnosis flowchart has been formulated.The guideline aims to improve the standard diagnosis and treatment of food allergies in children in China.

Objective To understand the basic information on radiological health technical service institutions in Shaanxi Province, China and analyze the main problems, and to strengthen the capacity building of radiological health technical service institutions in Shaanxi Province. Methods The radiological health technical service institutions registered in Shaanxi Province were investigated and analyzed by means of a questionnaire and literature review. Results There were 20 radiological health technical service institutions in Shaanxi Province, including 7 state-owned ones and 13 privately owned ones; of all the institutions, there were 3 disease control institutions, and 15 institutions obtaining the qualification of radiation protection evaluation, radiation health protection testing, and individual dose monitoring at the same time. The total number of radiation workers in the institution was 237, including 48.5% aged less than 35, 68.8% with bachelor degree or above, 54.4% with intermediate professional title or above, 26.5% with a major related to radiation protection, and 79.3% with national and provincial training. The institutions were equipped with 309 testing instruments, of which the radiation diagnostic performance testing equipment accounted for the largest proportion (52.4%). Conclusion The service scope and capacity of radiological health technical service institutions in Shaanxi Province can meet the current needs of the province, but the institutions need to be improved in terms of personnel, equipment, and service quality. The quality control of institutions needs to be strengthened to standardize the service behavior in the whole province.

Objective:To understand the current situation of nurses in 52 hospitals in China on mastery of knowledge about skin injury in the elderly based on the background of mixed-mode homogenization training.Methods:Using the convenient sampling method, a total of 1 067 nurses from 52 hospitals in China were selected as the research objects in January 2021. A self-designed questionnaire on knowledge of skin injury in the elderly was used to investigate the nurses through the questionnaire star and univariate analysis was used to analyze the influencing factors. A total of 1 067 questionnaires were distributed and 1 067 valid questionnaires were recovered, and the effective recovery rate was 100%.Results:The knowledge scores of pressure injury, incontinence-associated dermatitis, skin tear and xerosis cutis among 1067 nurses were (95.66±7.37) , (95.65±9.15) , (91.37±15.45) and (87.67±15.91) , respectively. The results of univariate analysis showed that hospital grade was the influencing factor of nurses' knowledge score of pressure injury, skin tear and incontinence-associated dermatitis ( P<0.05) , educational background was the influencing factor of nurses' knowledge score of skin tear ( P<0.05) , professional title was the influencing factor of nurses' knowledge scores of pressure injury, incontinence-associated dermatitis and xerosis cutis ( P<0.05) . Conclusions:Hospitals at all levels need to strengthen the theoretical and practical knowledge training for nurses on skin xerosis and skin tear in the elderly, especially for nurses with primary titles and lower education in grassroots hospitals.

Objective:To investigate the value of paraffin-embedded section of cell block in the diagnosis of lung adenocarcinoma in bloody pleural effusion.Methods:The data of 60 patients with lung adenocarcinoma diagnosed by bloody pleural effusion and confirmed by pathological biopsy in the First Affiliated Hospital of Xi'an Jiaotong University from June 2018 to June 2019 were retrospectively analyzed. Cell smears and paraffin-embedded sections of cell blocks using removed red blood cells sedim entation method were used to make cytological examination in bloody pleural effusion. The expressions of carcinoembryonic antigen (CEA), cytokeratin 7 (CK7), NapsinA, thyroid transcription factor 1 (TTF-1), cytokeratin 5/6 (CK5/6), calretinin, P63 and P40 in the specimens were detected by using immunohistochemistry. The results of histopathological examination were used as the gold standard, and the diagnostic values of cell block paraffin-embedded sections and cell smears for lung adenocarcinoma in bloody pleural effusion were evaluated and compared.Results:The cell block sections had a clear background, clear and easy to distinguish cell morphology, and can be made into permanent specimens. The bloody pleural effusion cell smears results of 60 cases of lung adenocarcinoma showed that 21 cases were diagnosed as atypical cells, 39 cases were diagnosed as adenocarcinoma, and the coincidence rate with the diagnosis of adenocarcinoma by histopathological examination results was 65% (39/60); the immunohistochemistry results of cell block paraffin-embedded sections of bloody pleural effusion showed that CK7, NapsinA, TTF-1 and CEA were positive, and P40, P63, CK5/6 and calretinin were negative, all 60 cases were diagnosed as adenocarcinoma according to the results, and the coincidence rate with the diagnosis of adenocarcinoma by histopathological examination results was 100% (60/60), which was significantly higher than that of cytological smears ( χ2 = 23.088, P < 0.01). Conclusions:The technique of paraffin-embedded section of cell block using removed red blood cells sedim entation method has a high diagnostic rate for lung adenocarcinoma in bloody pleural effusion, and it has a high coincidence rate with histopathological diagnosis. It can improve the accuracy of diagnosis of lung adenocarcinoma in bloody pleural effusion, and it also has a good reference value for cytological typing.

OBJECTIVE: To explore the mechanism by which ginsenoside 20(S)-Rg3 upregulates the expression of tumor suppressor von Hippel-Lindau (VHL) gene in ovarian cancer cells. METHODS: Ovarian cancer cell line SKOV3 treated with 20(S)-Rg3 were examined for mRNA and protein levels of VHL, DNMT1, DNMT3A and DNMT3B by real-time PCR and Western blotting, respectively. The changes in VHL mRNA expression in SKOV3 cells in response to treatment with 5-Aza-CdR, a DNA methyltransferase inhibitor, were detected using real-time PCR. VHL gene promoter methylation was examined with methylation-specific PCR and VHL expression levels were determined with real-time PCR and Western blotting in non-treated or 20(S)-Rg3-treated SKOV3 cells and in 20(S)-Rg3-treated DNMT3A-overexpressing SKOV3 cells. VHL and DNMT3A protein levels were detected by immunohistochemistry in subcutaneous SKOV3 cell xenografts in nude mice. RESULTS: Treatment of SKOV3 cells with 20(S)-Rg3 significantly upregulated VHL and downregulated DNMT3A expressions at both the mRNA and protein levels ( CONCLUSIONS Ginsenoside 20(S)-Rg3 upregulates VHL expression in ovarian cancer cells by suppressing DNMT3A-mediated DNA methylation.
Animals ; Cell Line, Tumor ; DNA Methylation ; Female ; Gene Expression ; Ginsenosides/pharmacology* ; Humans ; Mice ; Mice, Nude ; Ovarian Neoplasms/genetics* ; Promoter Regions, Genetic ; Von Hippel-Lindau Tumor Suppressor Protein/genetics*

【Objective】 To investigate the clinicopathological characteristics and prognosis of solitary fibrous tumor (SFT) in the retroperitoneum. 【Methods】 We summarized the clinical and prognostic data of nine patients admitted to The First Affiliated Hospital of Xi’an Jiaotong University between January 2007 and December 2017 who were diagnosed with SFT by surgical resection and pathological examination. Nine cases of retroperitoneal SFT were detected by HE and immunohistochemical SP method. The expressions of Vimintin (Vim), CD34, CD99, Ki-67, Bcl-2 and S-100 in tumor cells were analyzed for their clinicopathological characteristics and prognosis. 【Results】 Among the nine patients, four were male and five were female, aged 37-69 years old. Five of them showed abdominal distension, while the other four had no obvious clinical symptoms. The tumor size was (1.0 cm×1.0 cm×2.0 cm)-(30.0 cm×25.0 cm×10.0 cm). There were seven single cases and two multiple cases. Histology showed bundle-shaped, braided spindle cells and collagen fibers of varying degrees, accompanied by mucinous degeneration and hemangiopericytoma-like morphology. Immunohistochemical results were as follows: The positive rate was 100% (9/9) for Vim, CD34 and CD99, 77% (7/9) for Ki-67, 67% (6/9) for Bcl-2, and 22% (2/9) for S-100. All the patients were followed up effectively. Two of them died (the cause of death was not related to the disease studied, and the survival time from postoperative to death was 6.5 years and 8.3 years, respectively). One surviving case relapsed 3 years after the operation, but did not recur after the second operation. No recurrence or metastasis was found in the remaining cases. 【Conclusion】 Retroperitoneal SFT is rare in the clinic, and there are no typical clinical symptoms in the early stage. Most of them are detected in physical check-ups. Ultrasound and CT examinations are the main preoperative examination methods, but they are not specific to SFT. Pathological examination is the only method for diagnosis. Radical resection is the first-choice of treatment. The preferred method for this disease is effective in early radical surgery and regular postoperative review.

Objective To evaluate the efficacy of ultrasound-guided quadratus lumborum block for analgesia after laparoscopic cholecystectomy. Methods Sixty American Society of Anesthesiologists physi-cal statusⅠorⅡ patients, aged 18-64 yr, with body mass index of 20-27 kg∕m2 , scheduled for elective laparoscopic cholecystectomy, were divided into 2 groups ( n=30 each) using a random number table meth-od: ultrasound-guided transversus abdominis plane block group ( group T) and ultrasound-guided quadratus lumborum block group (group Q). In T and Q groups, bilateral ultrasound-guided transversus abdominis plane block and quadratus lumborum block were performed after general anesthesia induction, respectively, with 0. 25％ ropivacaine 20 ml for each side. All the patients received patient-controlled intravenous analge-sia with morphine after surgery, and visual analoge scale scores were maintained≤3 in the two groups. The cumulative consumption of morphine was recorded at 2, 4, 6, 12, 24 and 48 h after surgery. The occur-rence of adverse reactions such as nausea, vomiting, pruritus, over-sedation and respiratory depression was observed and recorded in the analgesic period. The operation time for nerve blocks and nerve blocks-related complications such as bleeding, accidental puncture into the abdominal cavity or intestinal injuries were re-corded. Results Compared with group T, the cumulative consumption of morphine was significantly de-creased at 6, 12, 24 and 48 h after surgery in group Q ( P<0. 05) . There was no significant difference in the operation time for nerve blocks between the two groups ( P>0. 05 ) . There were no adverse reactions such as nausea, vomiting, pruritus, over-sedation and respiratory depression or nerve blocks-related compli-cations in the two groups. Conclusion Ultrasound-guided quadratus lumborum block provides better effica-cy than transversus abdominis plane block when used for analgesia after laparoscopic cholecystectomy.