Cryoablation therapy with explicit anti-tumor mechanisms and histopathological manifestations has a long history.A large number of clinical practice has shown that cryoablation therapy is safe and effective,making it an ideal tumor treatment method in theory.Previously,its efficacy and clinical application were constrained by the limitations of refrigerants and refrigeration equipment.With the development of the new generation of cryoablation equipment represented by argon helium knives,significant progress has been made in refrigeration efficien-cy,ablation range,and precise temperature measurement,greatly promoting the progression of tumor cryoablation technology.This consensus systematically summarizes the mechanism of cryoablation technology,indications for oral mucosal melanoma(OMM)cryotherapy,clinical treatment process,adverse reactions and management,cryotherapy combination therapy,etc.,aiming to provide reference for carrying out the standardized cryoablation therapy of OMM.

A 55-year-old male patient was admitted to the hospital due to "recurrent chest pain for 8 months, with worsening symptoms for 2 weeks". After admission, comprehensive relevant examinations led to the consideration of a giant chronic left ventricular pseudoaneurysm caused by myocardial infarction with non-obstructive coronary arteries. Surgical treatment was performed at our hospital. We discuss the diagnosis and treatment of this patient.

Objective:To explore the clinical efficacy of internal fixation with a reduction plate assisted by our self-designed lower extremity fracture traction reduction device for tibial plateau fractures of Schatzker type Ⅵ.Methods:A retrospective study was conducted of the 32 patients with tibial plateau fracture of Schatzker type Ⅵ who had been treated at Orthopaedic Department, Mindong Hospital Affiliated to Fujian Medical University from April 2018 to July 2021. Depending on their treatments, they were divided into 2 groups. In the control group of 16 cases subjected to open reduction and internal fixation with manual traction, there were 9 males and 7 females with an age of 50.0±11.7 years; in the observation group of 16 cases subjected to internal fixation with a reduction plate assisted by our self-designed lower extremity fracture traction reduction device, there were 8 males and 8 females with an age of 54.6±11.1 years. The operation time, fracture reduction time, total incision length, intraoperative blood loss, Rasmussen knee function score and maximum active range of knee motion were compared between the 2 groups.Results:There was no significant difference in the preoperative general data between the 2 groups, showing comparability between the groups ( P>0.05). The operation time [(158.6±26.0) min], fracture reduction time [(61.6±9.6) min], and total incision length [16.0 (13.3, 17.0) cm] in the observation group were significantly shorter than those in the control group [(199.9±60.9) min, (73.8±17.2) min, and 20.0 (17.0, 21.8) cm]; the intraoperative blood loss [175.0 (100.0, 200.0) mL] in the observation group was significantly less than that in the control group [200.0 (162.5, 387.5) mL]; the maximum active ranges of knee motion at one week and one month in the observation group were 94.9°±12.0° and 113.8°±14.1°, significantly larger than those in the control group (78.3°±14.6° and 96.8°±11.4°) (all P<0.05). Fractures achieved bony union at one year after operation in both groups. At 12 months after operation, there was no significant difference in the maximum active range of knee motion or the Rasmussen knee function score between the 2 groups ( P>0.05). Conclusion:In the treatment of Schatzker type Ⅵ tibial plateau fractures, compared with manual traction and open reduction, internal fixation with a reduction plate assisted by our self-designed lower extremity fracture traction reduction device can shorten operation time and total incision length, reduce intraoperative blood loss, and facilitate postoperative functional recovery of the knee for the patients.

Objective:To explore the feasibility of direct renin inhibitor aliskiren for the treatment of severe or critical coronavirus disease 2019 (COVID-19) patients with hypertension.Methods:The antihypertensive effects and safety of aliskiren was retrospectively analyzed in three severe and one critical COVID-19 patients with hypertension.Results:Four patients, two males and two females, with an average age of 78 years (66-87 years), were referred to hospital mainly because of respiratory symptoms. Three were diagnosed by positive novel coronavirus 2019 (2019-nCoV) nucleic acid or antibody, and the critical patient with cardiac insufficiency was clinically determined. Two patients were treated with calcium channel antagonist (CCB), one with angiotensin converting enzyme inhibitor (ACEI), and one with angiotensin Ⅱ receptor antagonist (ARB). After admission, ACEI and ARB were discontinued, one patient with heart failure was treated by aliskiren combined with diuretic.Three patients were treated with aliskiren combined with CCB among whom two withdrew CCB due to low blood pressure after 1 to 2 weeks. Based on comprehensive treatment including antiviral and oxygenation treatment, blood pressure was satisfactorily controlled by aliskiren after three to four weeks without serious adverse events. All patients were finally discharged.Conclusion:Our preliminary clinical data shows that antihypertensive effect of aliskiren is satisfactory and safe for severe COVID-19 patients complicated with hypertension.

Clinical features of and genetic mutations in two cases of pseudohypoparathyroidism type Ⅰ a(PHP Ⅰ a) with early-onset skin nodules were analyzed.Both of the two patients were males,and their ages at onset were 2 and 3 months respectively.They both presented with early-onset skin nodules as the main clinical manifestation,and were clinically characterized by a round face,short neck and early obesity.Histopathological examination of skin lesions showed subcutaneous ectopic osteogenesis in both patients.The first patient had low blood calcium,high blood phosphorus,high parathyroid hormone (PTH),and gene sequencing showed a heterozygous mutation c.399delT causing a T base deletion at position 399 in exon 5 of the GNAS gene.The second patient had normal blood calcium and phosphorus levels as well as normal PTH levels at early stage,and gene sequencing showed a heterozygous mutation c.939delT causing a T base deletion at position 939 in exon 9 of the GNAS gene.The blood PTH level was found to increase in the second patient after 1-year follow-up.Both the patients were confirmedly diagnosed with PHP Ⅰa.After treatment with vitamin D3,no new skin nodules occurred,and the blood calcium and phosphorus levels returned to normal.

BACKGROUND:There is a lack of the research concerning the biocompatibility of nano-hydroxyapatite/polyphenylene sulfide (nHA/PPS) composites.OBJECTIVE:To evaluate the in vivo biocompatibility of nHA/PPS composites based on the completed research in vitro.METHODS:Systemic toxicity test:Sprague-Dawley rats were given the intraperitoneal injection of nHA/PPS extract or normal saline.The general situation,body mass and the histological changes of the liver and kidney were observed at 72 hours after injection.Delayed type hypersensitivity test:nHA/PPS extract or normal saline was injected subcutaneously into the back of the rats.Afterwards,skin irritation symptoms were observed at 72 hours.Local reaction experiment:nHA/PPS composites and polyethylene were respectively implanted into the back of the rats.The pathological changes of the implanted materials and their surrounding tissues were observed at 15 and 30 days after implantation.RESULTS AND CONCLUSION:(1) The rats were in good situation after nHA/PPS injection;the body mass increased steadily,which showed no significant difference from the control group (P ＜ 0.05);the morphology and color of the liver and kidney were normal,and the systemic toxicity of the composite materials was normal according to the degree of toxicity classification.(2) There were no obvious skin irritation symptoms after the subcutaneous injection of nHA/PPS composites,and the primary irritation index was less than 0.4,suggesting a low hypersensitivity.After implantation of nHA/PPS composites,there was no obvious degradation,absorption and rejection,and both the degree of inflammatory reaction (15 days ≤ level Ⅲ,30 days ≤ level Ⅱ) and the thickness of fibrous capsule (15 days ≤ level Ⅲ,30 days ≤ level Ⅱ) revealed the good biocompatibility of the composites.These results suggest that the nHA/PPS composites hold an excellent biocompatibility in vivo.

Objective To compare the bio-medical parameters in SIV infected Chinese rhesus monkeys with diverse disease progression,by which the pathogenesis of simian AIDS were to be investigated.Methods Sixteen Chinese rhesus monkeys were inoculated intravenously with SIVmac239 and followed-up for 18 months.Based on their progression patterns and plasma viral loads,animals were divided into 3 groups,including 1 rapid progressor( RP),13 normal progressors(NP),and 2 elite controllor(EC).Their parameters of haematology,virology,immunology and pathology were examined and compared. Results Compared with other animals,RM449(RP) showed higher viral load,unresponsive humoral immunity,and higher level of auto-antibodies against lymph node,thymus,and spleen.Additionally,its effector memory CD4 count was lower,with the transformation progress being blocked-like from naive/central memory subsets to effector memory subset,as the flow-cytometry assay showed.Notable decrease in its peripheral B cell was also observed,especially to the sub-population of tissue-like memory B cells and activated memory B cells.Pathological examination showed the depletion of lymphoid tissue,atrophy of spleen and loss of thymus.Moreover,most of these parameters of RM450 and RM453 (EC) changed opposite to that of RP.Conclusion The hallmarks of RM449 were higher viraemia and lower SIV specific IgG level,which may due to the disturbance of T cells and B cells development and differentiation.Moreover,destructions of organs of the immune system may contribute to the disturbance.Our study suggest that the change of micro-environments of thymus induced by SIV infection,which is necessary in T cell and B cell development and differentiation,may contribute at least partially to the AIDS pathogenesis.

An interaction between the HSV-1 UL25 capsid protein and cellular microtubule-associated protein was found using a yeast two-hybrid screen and β-D-galactosidase activity assays. Immunofluorescence microscopy of the UL25 protein demonstrated its co-localization with cellular microtubule-associated protein in the plasma membrane. Further investigations with deletion mutants suggest that UL25 is likely to have a function in the nucleus.

OBJECTIVE:To optimize the water extraction process for Shenshu yangwei capsule.METHODS:The decoction conditions were optimized by orthogonal design with table L9(34)taking the yield of Hesperidin as index.RESULTS:The optimal watering extraction conditions of Shenshu yangwei capsule were as follows:adding 8 times amount of water,then extracting for 3 times with 1 h for each time.CONCLUSION:The water extraction technology of Hesperidin is simple,with complete extraction and high yield of Hesperidin,thus applicable for industrialized large-scale production.

Background and Purpose:Kaposi's sarcoma(KS) cases occurring in renal allograph recipients was considered to be due to long-term immunosuppressive therapy.But the exact carcinogenetic process has not been elucidated so far.The lesions could not be distinguished from other KS types by histopathological study.Endemic KS cases seemed to be more common in Xinjiang,especially in the Uygur ethnic group,and their relation to other types of KS was investigated in three cases by histopathology and immunohistochemistry for the present study.Methods:Biopsy specimens from three cases of renal tronsplantation related KS,including two Uygur and one Han patients,were obtained from this hospital(No.474 hospital of PLA).Formalin-fixed and paraffin embedded blocks were cut for routine HE and immunohistochemical staining to study respectively.Monoantibodies of CD34,Ⅷ-factor,Vimentin,actin and FN were detected by S-P techniques for immunohistochemistry.Results:Histopathologically,the typical histology of traditional KS was found in almost all the specimens of the three patients.In the early stage of the disease,there are only a few vessel fissures with irregular dilation and clustering obese(epithelioid)cells.In the middle stage,the changes are wider in scope with proliferation of spindle cells,in the form of beams and weaves.The proliferating vessels are dilated and hyperemic around the lesion.In the late stage,the spindle cells proliferation are markedly atypical,and karyokinesis is increased.Immunohistochemistry showed CD34 to be more strongly positive,Ⅷ-Factor(+),Vimentin(+) showed a weak reation;while actin(-),FN(-) were negative.Conclusions:Renal transplantation related KS is not essentially different from other types of KS both in histopathohogy and immunohistochemical characters which may reflect that they have a similar etiopathogenetic procession.However,the distinctive distribution of morbidity among different ethnic groups or districts strongly suggested that the genetic background plays a critical role on KS carcinogenesis.