Primary liver cancer is a common malignant tumor in China. The current main treatment methods include surgical resection, liver transplantation, interventional therapy, radiofrequency ablation, chemotherapy, targeted therapy, and immunotherapy. Yttrium-90 microsphere selective internal radiation therapy (⁹⁰Y-SIRT) represents a critical treatment option for converting unresectable intermediate to advanced hepatocellular carcinoma. This report details a case of a patient with a giant hepatocellular carcinoma in the right lobe treated with ⁹⁰Y resin microsphere at the Third Affiliated Hospital of Sun Yat-sen University. Post-treatment, the tumor showed significant necrosis and reduction in size, with a marked decrease in alpha fetoprotein (AFP) levels and notable improvement in clinical symptoms. The case highlights the substantial efficacy of ⁹⁰Y-SIRT in controlling tumor progression and enhancing patient quality of life.

Objective:To investigate the analgesic effect of ultrasound-guided transversus abdominis plane block versus ultrasound-guided quadratus lumborum block in older adult patients undergoing inguinal hernia repair surgery. Methods:A total of 150 older adult patients who underwent inguinal hernia repair surgery at the Marine Police Corps Hospital of Chinese People's Armed Police Force from April 2019 to May 2022 were included in this study. They were randomly divided into a control group ( n = 75) and a study group ( n = 75) using a random number table method. All patients underwent elective laparoscopic tension-free inguinal hernia repair surgery. Patients in the control group received ultrasound-guided transversus abdominis plane block after inguinal hernia repair surgery, while those in the study group received ultrasound-guided quadratus lumborum block. The changes in Visual Analog Scale (VAS) score and Ramsay score within 48 hours after surgery were compared between the two groups. Inflammatory factors and stress factors including serum tumor necrosis factor alpha, interleukin-6, norepinephrine, and cortisol, were measured at 24 and 48 hours after surgery. The use of analgesics, drug-related adverse reactions, and incidence of nerve block-related complications within 48 hours after surgery were also compared between the two groups. Results:There was no significant difference in Ramsay score between the two groups at 4, 8, 12, 24, and 48 hours after surgery (all P > 0.05). There was no significant difference in VAS score between the two groups at 4 and 8 hours after surgery (both P > 0.05). At 12, 24, and 48 hours after surgery, the VAS score in the study group was (1.36 ± 0.57) points, (2.05 ± 0.56) points, and (1.79 ± 0.55) points, respectively, which were significantly lower than (1.92 ± 0.59) points, (2.68 ± 0.62) points, and (2.36 ± 0.59) points in the control group ( t = 6.65, 7.31, 5.86, all P < 0.001). At 24 and 48 hours after surgery, serum tumor necrosis factor alpha, interleukin-6, norepinephrine, and cortisol levels in the study group [24 hours: (63.89 ± 4.65) ng/L, (156.59 ± 8.62) ng/L, (97.02 ± 6.95) g/L, (36.95 ± 3.26) g/L; 48 hours: (49.66 ± 3.74) ng/L, (131.45 ± 7.73) ng/L, (74.63 ± 5.91) g/L, (30.41 ± 2.96) g/L] were significantly lower than those in the control group [24 hours: (76.42 ± 5.17) ng/L, (189.32 ± 10.41) ng/L, (105.53 ± 7.83) g/L, (45.16 ± 3.74) g/L; 48 hours: (58.15 ± 3.94) ng/L, (162.74 ± 8.49) ng/L, (89.51 ± 6.37) g/L, (36.92 ± 3.31) g/L, t = 10.49-26.38, all P < 0.001]. The proportion of patients who received analgesics within 48 hours after surgery in the study group was 8.00% (6/75), which was significantly lower than 25.33% (19/75) in the control group ( χ2 = 8.11, P = 0.004). The overall incidence of drug-related adverse reactions within 48 hours after surgery in the study group [6.67% (3/75)] was significantly lower than that in the control group [11% (11/75), χ2 = 4.61, P = 0.032]. Conclusion:Compared with ultrasound-guided transversus abdominis plane block, ultrasound-guided quadratus lumborum block better helps alleviate postoperative pain in older adult patients undergoing inguinal hernia repair surgery, inhibits inflammation and stress reactions, reduces the dosage of analgesic drugs, and decreases the incidence of adverse drug reactions.

Kidney deficiency syndrome is a common clinical syndrome in traditional Chinese medicine （TCM）. With the progress of science and technology， clinical and animal experiments on kidney deficiency syndrome have made remarkable progress. Research on kidney deficiency and the nature of "kidney" involves a large number of physiological and pathological bases， which are closely related to physiological and pathological links in the human body， among which the neuroendocrine-immune network shares the closest relationship. However， there are still many challenges in modern research on kidney deficiency syndrome， such as expert consensus on clinical diagnostic criteria and evaluation indexes and optimization of animal experimental models. In the past decade， a large number of clinical and animal experiments have been reported in the literature on kidney deficiency syndrome， among which the literature focusing on the combination of disease and syndrome is predominant， and most of them focus on kidney Yang deficiency and kidney Yin deficiency， involving the exploration of many pathological mechanisms. Research on the mechanisms related to kidney deficiency syndrome encompasses multiple signaling pathways and various biochemical indicators， including the phosphatidylinositol 3-kinase/protein kinase B/nuclear factor-erythroid 2-relatedfactor-2（PI3K/Akt/Nrf2） signaling pathway， the Toll-like receptor 4/myeloid differentiation factor88/nuclear factor-κB（TLR4/MyD88/NF-κB） signaling pathway， the Janus kinase 2/signal transducer and activator of transcription 3（JAK2/STAT3） signaling pathway， Osteoprotectin/nuclear factor-κB receptor activator ligand/receptor activator of nuclear factor-κB （OPG/RANKL/RANK） signaling pathway. The biochemical indicators cover the cyclic adenosine monophosphate/cyclic guanosine monophosphate （cAMP/cGMP） ratio， Na⁺-K⁺-ATPase activity， Ca²⁺-Mg²⁺-ATPase activity， adrenocorticotropic hormone （ACTH）， polycorticosterone （CORT）， 17-OHCS， and other sex hormone indicators， providing crucial reference values for diagnosing kidney Yang deficiency or kidney Yin deficiency. The literature related to kidney deficiency syndrome over the past decade was collated and excavated， with a view to providing a reference for research on kidney deficiency syndrome.

Objective:To investigate the effects of carnosine on lipopolysaccharide(LPS)-induced inflammasome activation and pyroptosis in microglia,and to clarify its mechanism.Methods:Activation model of microglia was established by LPS(10 ng/ml).CCK-8 assay was used to detect cell activity of microglia treated with different concentrations of carnosine(0.2,1,5,20,50 mmol/L)for 6 h,and the cell activity of microglia pretreated with different concentrations of carnosine for 0.5 h and then stimulated with LPS for 6 h,to screen a suitable concentration.Then microglia were divided into control group,carnosine group(5 mmol/L),LPS group,and LPS+carnosine group:cell morphological changes in each group were observed under an inverted phase contrast microscope;levels of IL-1β,TNF-α and IL-6 in microglial culture medium were measured by ELISA;propidium iodide(PI)staining was used to detect py-roptotic cells;immunofluorescence was used to observe protein expression of Nod-like receptor protein 3(NLRP3).Results:Com-pared with control group,cell viability of microglia in LPS group was significantly decreased(P<0.01),the shape of microglia was mostly"amoeboid",levels of IL-1β,TNF-α and IL-6 in microglial culture medium were significantly increased(P<0.01),the posi-tive rate of PI and the number of NLRP3 positive cells were significantly increased(P<0.01).Compared with LPS group,cell viability of microglia in LPS+carnosine group was significantly increased(P<0.01),the number of"amoeboid"microglia was decreased,levels of IL-1β,TNF-α in microglial culture medium were significantly decreased(P<0.01),and the level of IL-6 was decreased(P<0.05),the positive rate of PI and the number of NLRP3 positive cells were both significantly decreased(P<0.01).Conclusion:Carnosine can inhibit LPS-induced microglia activation and inflammasome activation,thereby inhibiting cell pyroptosis and the release of inflammato-ry factors.

ObjectiveTo clarify the therapeutic effect of Huashi Baidu prescription on pneumonia in mice caused by influenza A （H1N1） virus and explore its mechanism based on the transcriptome. MethodA mouse influenza viral pneumonia model was built by intranasal infection with influenza A virus， and mice were continuously administered the drug for five days， so as to investigate the general condition， lung index， viral load， pathological morphology of lung tissue， survival time， and prolongation rate of survival time of mice and clarify the therapeutic effect of Huashi Baidu prescription on influenza viral pneumonia. Transcriptome technology was used to detect the differentially expressed genes in the lung tissue of mice in the model group and the normal group， as well as the Huashi Baidu prescription group and the model group， and the potential core target of the Huashi Baidu prescription for the treatment of influenza viral pneumonia was screened. Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） was used to verify the effect of Huashi Baidu prescription on the mRNA expression level of core target genes. ResultCompared with the normal group， the lung index and viral load in the lung tissue of the model group were significantly increased （P<0.05， P<0.01）. Compared with the model group， the high-dose group of Huashi Baidu prescription significantly prolonged the survival time of mice infected with influenza A virus （P<0.05） and significantly reduced the lung index value of mice （P<0.05） and the viral load of lung tissue. The high-dose， medium-dose， and low-dose groups of Huashi Baidu prescription could significantly reduce lung tissue inflammation， blood stasis， swelling， and other pathological changes in mice （P<0.05， P<0.01）. Transcriptome analysis of lung tissue showed that core genes were mainly enriched in the nuclear transcription factor-κB （NF-κB） signaling pathway， interleukin-17 （IL-17） signaling pathway， cytokine-cytokine receptor interaction， and other pathways after the intervention of Huashi Baidu prescription. TRAF6， NFKBIA， CCL2， CCL7， and CXCL2 were the top five node genes with combined score values. Real-time PCR validation showed that Huashi Baidu prescription significantly downregulated the mRNA expression of key genes TRAF6 and NFKBIA in the NF-κB signaling pathway， as well as chemokines CCL2， CCL7， and CXCL2 （P<0.05， P<0.01）. ConclusionHuashi Baidu prescription has a therapeutic effect on influenza viral pneumonia， possibly by inhibiting the expression of key nodes TRAF6 and NFKBIA in the NF-κB signaling pathway and that of chemokines CCL2， CCL7， and CXCL2， reducing the recruitment of inflammatory cells and viral load， and exerting anti-influenza viral pneumonia effects.

Objective:To assess the β-amyloid (Aβ) deposition of voxel-based PET imaging in Alzheimer′s disease (AD) and its relationships with blood biomarkers (Aβ).Methods:From January 2015 to December 2018, a total of 23 AD patients (9 males, 14 females, age (68.5±9.0) years; duration: (40.9±23.3) months; 8 mild patients, 15 moderate or severe patients) who underwent Aβ PET and with positive imaging results in Daping Hospital, Army Medical University were retrospectively enrolled. The information of Mini-Mental State Examination (MMSE) and Clinical Dementia Rating (CDR) were collected. Blood level of Aβ42, Aβ40 were measured. Differences of those metrics including Aβ42/Aβ40 between mild and moderate or severe patients were compared. For all 11C-Pittsburgh compound B (PIB) PET images, voxel-based one-sample independent t test analyses were performed. Voxel-based two-sample independent t test analyses were also performed between mild and moderate or severe patients. The voxel-based Pearson correlation analyses were run to assess the associations between blood metrics and Aβ deposition of 11C-PIB PET. Results:Comparing with mild patients, moderate or severe patients had lower MMSE (9.67±4.37 vs 17.13±2.80; t=4.349, P<0.001) and longer duration ((48.8±23.8) vs (26.0±13.5) months; t=-2.489, P<0.05). On voxel-wise analysis, amyloid PET illustrated brain Aβ deposition in bilateral frontal, right temporal, right occipital and posterior cingulate regions ( t values: 0.44-0.67, all P<0.001). Within AD, Aβ42/Aβ40 ( r values: from -0.62 to -0.41, 0.41-0.66, all P<0.05) were associated with amyloid PET, but not associated with Aβ42 ( r values: from -0.33 to 0, all P>0.05) or Aβ40 ( r values: from -0.41 to 0, all P>0.05). Conclusions:Based on voxel-wise analysis, 11C-PIB PET has comparable value for brain Aβ deposition. Aβ42/Aβ40 has the potential to predict brain Aβ deposition.

Objective:To investigate the diagnostic value of 11C-Pittsburgh compound B (PIB) in patients with mild cognitive impairment (MCI) and Alzheimer′s disease (AD) and explore the factors that may affect the binding of 11C-PIB. Methods:From January 2017 to December 2019, the 11C-PIB uptake of 6 patients with normal cognitive (NC; 3 males, 3 females, age: (64.5±12.3) years), 11 patients with MCI (4 males, 7 females, age: (64.5±9.8) years) and 21 patients with AD (7 males, 14 females, age: (68.1±9.1) years) from Daping Hospital, Army Medical University were retrospectively analyzed. Regional 11C-PIB binding was assessed by using standardized uptake value ratio (SUVR) and visual reading of 11C-PIB scan. Clinical data, including age, gender, education level, cognitive impairment, neuropsychological scale score, vascular risk factors (VRF), apolipoprotein E (ApoE) gene, were collected and differences among groups were analyzed by using one-way analysis of variance, least significant difference t test or Fisher exact test. Factors that affected the 11C-PIB binding were analyzed by multiple linear regression. Results:SUVR of cerebral lobe among NC, MCI and AD groups were significantly different (range of mean SUVR: 1.16-1.26, 1.19-1.35 and 1.40-1.61; F values: 5.331-9.279, all P<0.05). For positive PIB patients, SUVR of posterior cingulate and precuneus were increased in MCI group compared with NC group (1.20±0.15 vs 1.50±0.12, 1.18±0.15 vs 1.59±0.13; F values: 6.389 and 10.668, t values: -2.33 and -3.10, both P<0.05), and there were no significant differences in all lobes between MCI and AD group ( t values: from -1.29 to -0.51, all P>0.05). Visual analysis showed that the positive rates of PIB in frontal lobe (85.7%(18/21)), posterior cingulate (85.7%(18/21)), precuneus (81.0%(17/21)), temporal lobe (81.0%(17/21)) and occipital lobe (47.6%(10/21)) in AD were higher than those in MCI (4/11, 4/11, 4/11, 3/11 and 1/11, respectively; all P<0.05). Multiple linear regression showed that the degree of cognitive impairment were independent risk factors for SUVR of all lobes ( b values: 0.377-0.536, all P<0.05). The ApoE ε4 gene was independent risk factor for SUVR of precuneus ( b=0.290, P<0.05). Conclusion:11C-PIB is helpful for clinical diagnosis of MCI and AD patients and the degree of cognitive impairment and ApoE ε4 gene may be independent risk factors for increasing 11C-PIB binding.

Objective:To investigate the analgesic effects of Dexmedetomidine combined with Ropivacaine for abdominal fascia block(AFB, with transverse abdominis plane block and rectus abdominis sheath block)in elderly patients undergone open surgery for colon cancer.Methods:This was a prospective study.Fifty elderly patients following ASA Ⅰ-Ⅲ open surgery for colon cancer were randomly divided into Group R and Group RD.Patients in Group R were treated with Ropivacaine for AFB, and those in Group RD were given Dexmedetomidine 0.5 μg/kg and Ropivacaine.All patients received Morphine-based patient-controlled intravenous analgesia(PCIA)after surgery.The total dose of postoperative Morphine, the time to first required use of Morphine, and the visual analog score(VAS)at 4, 8, 16, and 24 h after surgery were compared between the two groups.Results:Compared with Group R, patients in Group RD were associated with a significantly decreased total amount of Morphine at 24 h after surgery [25(20-32)mg vs.30(22-38)mg, Z=5.00, P<0.001], a lower VAS at 4 h [17(15-19) vs.36(23-39), Z=23.04, P<0.001]and 8 h after surgery [20(18-22) vs.41(38-55), Z=25.47, P<0.001], a longer time to first required use of Morphine [233(204-256)min vs.183(167-195)min, Z=4.367, P<0.001], and less postoperative nausea and vomiting(20.0% vs.48.0%, P=0.037). Conclusions:For elderly patients after colon cancer surgery, transverse abdominis plane and rectus sheath block with Dexmedetomidine plus Ropivacaine can enhance the analgesic effect, prolong the time of effective analgesia, reduce the amount of Morphine used postoperatively, and is beneficial for early recovery.

Objective:To investigate the expression level of bone marrow stromal antigen 2 (BST2) in patients with glioblastoma (GBM) gene and its correlation with DNA methylation level and prognosis.Methods:The datasets of GBM samples from the Cancer Genome Atlas (TCGA) database (35 cases), GSE22891 cohort (50 cases) within Gene Expression Omnibus (GEO) database, and China Glioma Genome Atlas (CGGA) database (105 cases), and non-tumor brains (NTB) (10 cases in TCGA database, 6 cases in GSE22891 cohort, 5 cases in CGGA database were used to make comparisons of gene expression level; 25 cases in GSE63347 cohort, 4 cases in GSE22891 cohort, 8 cases in CGGA database were used to make comparisons of methylation data). Based on gene expression chip and DNA methylation microarray data from public GBM databases, the expression level of BST2 gene in GBM and the association with non-CpG island DNA methylation, GBM molecular subtypes [CpG island methylation phenotype (G-CIMP) and non-G-CIMP proneural, neural, classical, mesenchymal], overall survival (OS) time and functional gene expression profiles were obtained by using intra-group comparison of BST2 gene expression level between GBM and NTB, survival analysis, and bioinformatic analysis.Results:Compared with NTB samples, BST2 mRNA was highly expressed in GBM (mRNA expression data were based on Z-score standardization) (TCGA database vs. GSE63347 cohort: -0.97±1.14 vs. -2.32±0.21, t = 3.74, P < 0.05; GSE22891 cohort: 9.03±1.28 vs. 7.18±0.22, t = 3.42, P < 0.05; CGGA database: -0.43±1.11 vs. -0.62±0.35, t = 2.09, P < 0.05). In TCGA database, BST2 mRNA was highly expressed in different tumor molecular subgroups (G-CIMP: -1.96±0.94; non-G-CIMP proneural: -1.74±0.88; neural: -0.83±0.98; classical: 0.71±1.18; mesenchymal: -0.55±1.01), which were compared with NTB samples (-2.32±0.21), and the differences were statistically significant (all P < 0.05). There were no statistically significant differences in the expressions of BST2 mRNA in the neural, classical, mesenchymal tumors (all P > 0.05), but the expression of BST2 mRNA in above three groups was higher than that in G-CIMP group and non-G-CIMP proneural group (all P < 0.05). Correlation analysis showed that non-CpG island DNA methylation level of BST2 was negatively correlated with the expression of its mRNA (TCGA database: r = -0.30, P < 0.05; GSE22891 cohort: r = -0.54, P < 0.05; CGGA database: r = -0.29, P > 0.05). Survival analysis showed that BST2 mRNA expression level of non-G-CIMP and non-proneural patients was negatively associated with OS ( HR = 1.18, 95% CI 1.00-1.39, P < 0.05); among those tumors with G-CIMP or proneural subtypes, BST2 mRNA expression was not associated with OS ( HR = 1.08, 95% CI 0.84-1.40, P > 0.05). Bioinformatic analysis showed that among non-G-CIMP and non-proneural samples of TCGA database, GBM samples with higher BST2 expression were enriched with functional gene sets related to negative regulation of immune responses and activation of nuclear factor κB (NF-κB) pathway. Conclusions:The upregulated expression of BST2 gene in GBM may be associated with non-CpG island DNA hypomethylation alteration. BST2 gene may become a potential prognostic biomarker for non-G-CIMP and non-proneural GBM.

Objective: To investigate the correlations among striatal dopamine transporter (DAT) distribution, glucose metabolism and Parkinson′s disease (PD) clinical symptoms. Methods: Twenty-five clinically confirmed idiopathic PD patients (17 males, 8 females, age: (59.8±9.2) years) who underwent ¹¹C-2-beta-carbomethoxy-3-beta-(4-fluorophenyl)tropane (CFT) and ¹⁸F-fluorodeoxyglucose (FDG) PET imaging from January 2015 to December 2016 were reviewed. The detailed clinical scores were systematically collected from all patients. Correlations between DAT distribution, glucose metabolism and clinical symptoms were evaluated at global and voxel levels using Pearson correlation analysis. Results: There were significantly positive correlations between the PD-related pattern (PDRP) value and unified PD rating scale (UPDRS) motor scores, non-motor symptoms scale (NMSS) scores, activity of daily living scale (ADL) scores (r values: 0.580, 0.522, 0.557, all P<0.05). The CFT uptake of ipsilateral caudate nucleus, anterior putamen, and posterior putamen were negatively correlated with UPDRS motor scores (r values: -0.496, -0.492, -0.457, all P<0.05), while those had no significant correlations with NMSS scores (r values: -0.420, -0.402, -0.355, all P>0.05). The CFT uptake of ipsilateral caudate nucleus and anterior putamen were negatively correlated with ADL scores (r values: -0.502, -0.522, both P<0.05). There were no significant correlations between CFT uptake in contralateral striatal, anterior putamen, posterior putamen and PDRP values, UPDRS motor scores, NMSS scores and ADL scores(r values: from -0.466 to -0.129, all P>0.05). The presence of the significant correlations between UPDRS motor scores, ADL scores and the CFT radioactive count were confirmed in left caudate nucleus and left putamen (r values: from -0.90 to -0.47, all P<0.05). The metabolic PET imaging disclosed a set of brain regions correlating with the clinical symptoms. The presence of significant correlations between the metabolic PET imaging and CFT uptake were confirmed in bilateral caudate nucleus (r values: 0.47-0.90, both P<0.01), precentral gyrus and insula (r values: -0.90 to -0.47, all P<0.01). Conclusion The correlations between DAT distribution, glucose metabolism and PD clinical symptoms are complicated, which promote the understanding in the proper application of dopaminergic and metabolic PET imaging in PD and offer more evidences in PD pathophysiological mechanisms.