Normal tension glaucoma(NTG)is a chronic optic neuropathy characterized by progressive damage to the optic nerve and visual field defects, with its pathophysiology closely linked to genetic, immune-inflammatory and vascular factors. Optical coherence tomography angiography(OCTA)is a noninvasive imaging technique that provides real-time, quantitative assessment of retinal microvascular perfusion. In recent years, OCTA has been increasingly applied in NTG studies, demonstrating significant potential in early diagnosis, disease monitoring and management. This systematic review summarizes the latest advancements in the application of OCTA for NTG, with a focus on vascular parameters in the optic nerve head and macular regions. Its diagnostic value and monitoring management are further summarized. Moreover, the current limitations of OCTA technology and the challenges related to its clinical application are critically evaluated, while exploring its future developments. These insights aim to provide a theoretical foundation for further research on NTG-related microvascular pathology and the broader clinical application of OCTA.

Objective To isolate the Japanese encephalitis virus carried by Culex tritaeniorhynchus in Dongchuan District of Yunnan Province and analyze its molecular characteristics, so as to provide insights into the prevention and control of Japanese encephalitis in Yunnan Province. Methods Mosquito specimens were collected using mosquito-trapping lamps from pig farms in Batang Village and Xiaoxin Village, Dongchuan District, Kunming City, Yunnan Province in July 2016, and the mosquito species was identified according to the mosquito morphology. Then, 60 to 100 mosquitoes of each species served as a group and were ground. Baby hamster kidney-21 (BHK-21) cells and Aedes albopictus clone C6/36 cells were used for virus isolation, and positive isolates were identified using flavivirus primers. The positive isolates were amplified using reverse transcription polymerase chain reaction (RT-PCR) assay with 15 pairs of specific primers covering the full length of the genotype I Japanese encephalitis virus, and DNA sequence assembly was performed using the software SeqMan in the DNASTAR package. The obtained sequences were aligned with the complete sequences of 38 Japanese encephalitis virus downloaded from the GenBank with the software MegAlign, and the nucleotide and amino acid homology analyses of the obtained sequences were performed. The difference in amino acid sites was analyzed with the software GeneDoc, and phylogenetic trees were created based on the sequences of the coding region and E protein of the isolated Japanese encephalitis virus with the software Mega X. In addition, the secondary and tertiary structures of the E protein of the Japanese encephalitis virus were predicted using the online tool SOPMA and the software Swiss-Model. Results A total of 5 820 mosquitoes were collected and 3 843 Cx. tritaeniorhynchus (66.03%) were identified according to the mosquito morphology. A positive virus isolate, termed YNDC55-33, was isolated from Cx. tritaeniorhynchoides following batches of virus isolation from mosquito specimens, and cytopathic effect was observed following inoculation into BHK-21 and C6/36 cells. The YNDC55-33 virus isolate was successfully amplified with the flavivirus primes, and a long sequence containing 300 nucleotides was obtained. Following sequence alignment using the BLAST tool, the sequence of the YNDC55-33 virus isolate had high homology with that of the genotype I Japanese encephalitis virus. A long sequence with 10 845 nucleotides in length, which encoded 3 432 amino acids, was obtained by splicing the full sequence of the YNDC55-33 virus isolate. Phylogenetic analysis based on the whole-genome sequence and E gene sequence of the YNDC55-33 virus isolate showed that the new YNDC55-33 virus isolate was most closely related to the genotype I Guizhou isolate (GenBank accession number: HM366552), with nucleotide homology of 98.5% and amino acid homology of 99.4%, and the YNDC55-33 virus isolate shared 97.96% ± 0.33% nucleotide homology and 99.35% ± 0.08% amino acid homology with other genotype I Japanese encephalitis virus isolates, and < 90% nucleotide homology and < 98% amino acid homology with other genotypes of Japanese encephalitis virus. The YNDC55-33 virus isolate and the live attenuated virus vaccine candidate SA14-14-2 isolate differed at 16 amino acid sites on E gene, and 7 out of 8 key amino acid sites related to neurovirulence. The secondary and tertiary structures of the E protein of the YNDC55-33 virus isolate were predicted to be characterized by random coils. Conclusions A genotype I Japanese encephalitis virus was isolated from Cx. tritaeniorhynchus in Dongchuan District, Kunming City. This virus isolate and the live attenuated virus vaccine candidate SA14-14-2 isolate does not differ at antigenic epitopes-related key amino acid sites, and the major protein structure of the virus isolate is random coils. This study adds new data for the epidemiological distribution of Japanese encephalitis virus in Yunnan Province, which may provide insights into the prevention and control of Japanese encephalitis in the province.

PET (polyethylene terephthalate) is one of the most important petrochemicals that is widely used in mineral water bottles, food and beverage packaging and textile industry. Because of its stability under environmental conditions, the massive amount of PET wastes caused serious environmental pollution. The use of enzymes to depolymerize PET wastes and upcycling is one of the important directions for plastics pollution control, among which the key is the depolymerization efficiency of PET by PET hydrolase. BHET (bis(hydroxyethyl) terephthalate) is the main intermediate of PET hydrolysis, its accumulation can hinder the degradation efficiency of PET hydrolase significantly, and the synergistic use of PET hydrolase and BHET hydrolase can improve the PET hydrolysis efficiency. In this study, a dienolactone hydrolase from Hydrogenobacter thermophilus which can degrade BHET (HtBHETase) was identified. After heterologous expression in Escherichia coli and purification, the enzymatic properties of HtBHETase were studied. HtBHETase shows higher catalytic activity towards esters with short carbon chains such as p-nitrophenol acetate. The optimal pH and temperature of the reaction with BHET were 5.0 and 55 ℃, respectively. HtBHETase exhibited excellent thermostability, and retained over 80% residual activity after treatment at 80 ℃ for 1 hour. These results indicate that HtBHETase has potential in biological PET depolymerization, which may facilitate the enzymatic degradation of PET.
Hydrolases/metabolism* ; Bacteria/metabolism* ; Hydrolysis ; Polyethylene Terephthalates/metabolism*

Gastric cancer is one of the common malignant tumors in China. Among all gastric cancer patients, locally advanced gastric cancer (LAGC) accounts for a high proportion. For this group of patients, the efficacy of surgery alone is limited, and the risk of postoperative recur-rence is high. With the continuous development of therapy mode, various clinical trials and new treatment concepts have emerged, leading to a shift in treatment approaches of LAGC from the previous single chemotherapy to various combination therapies and other novel treatment moda-lities, with the aim to improve efficacy and extend survival of patients. The authors review the current status and progress of neoadjuvant chemotherapy and conversion therapy for LAGC.

Rehabilitation medicine is one of the most important specialties in community health institutions. This article introduces the 12 year′s development of rehabilitation medicine in Fenglin Community Health Service Center, focusing on the talent allocation, service capabilities, resource expansion, basic facilities, personnel recruiting, department operating, service scope, and its achievements and influence, to provide reference for planning and construction of featured specialty in community health service centers.

Community health institutions have entered a new development stage of featured specialty construction. After 12 years of development, rehabilitation medicine now is the featured specialty of Fenglin Community Health Service Center. This article presents the train of thought and key points of specialty construction in primary care institutions based on the Fenglin′s experience. The positioning of featured specialty should be based on the community. The construction process should include 7 elements, namely, the standard operation procedure(SOP)of service system construction, the detailed publicity and implementation of the collaboration of specialists, prevention and control knowledge promotion for general practitioners, prevention and control knowledge education for community residents, service list, clinical efficacy evaluation, and clinical database. In the later iterations, the head of the department should always focus on the service system construction SOP and clinical database construction, and the rest parts can be assigned to the relevant team members.

The construction of featured specialties is the current development strategy of community health service institutions to improve the service scope and to meet the health needs of residents. The rehabilitation medicine has undergone 12 years of development and become a relatively mature featured specialty in Fenglin Community Health Service Center. Based on the Fenglin′s experience, this article discusses the development status and restriction bottlenecks of general practice, and the development status and trend of rehabilitation medicine in the community; and also explores the integrated development model of community-featured specialty with general practice.

Objective: To investigate the clinical pathological feature of primary pulmonary sarcomatold carcinoma and to make a further understandine of the disease. Methods: Data including clinical manifesation, pathological findings, molecular detection and immunophenotyping with pathologically confirmed primary pulmonary sarcomatold carcinoma was retrospectively analyzed. Results: 15 patients with PPSC were identified(13 men and 2 women, age ranged 56-76 years, median age 66 years). The tumor were located in the left lobus superior(8 cases), lobus inferior(6 cases), and the right lobus medius(1 case). The main clinical symptoms was cough, sputum, bloody sputum, chest pain. Among the 13 males, 10 had smoking history of more than 30 years, and 2 females had no smoking history. All cases presented with a spheroid solid lung mass. All tumor showed mild enhancement similar to that of the surrounding musculature after contrast enhancement, and inhomogeneous central low-attenuation areas were seen in 15 patients. Pathological pattern: 6 cases spindle cell carcinoma, 4 cases pleomorphic carcinoma, 2 cases giant cells carcinoma, 2 cases carcinosarcoma, 1 case pulmonary blastoma. The tumors were composed of both carcinomatous and sarcomatous elements. Immunohistochemistry showed that CK was all positive, EMA was positive in 7, VIM was positive in 10 of 15 cases.10 patients were tested for common related genes of lung cancer, 4 patients had MET14 jump mutation, EGFR L858R gene mutation occurred in 3 cases, KARS G13D gene mutation in 2 cases, and BRAF V600E mutation in 1 case. All 15 patients underwent lobectomy, 13 underwent adjuvant chemotherapy, and 6 underwent local radiotherapy. Postoperative follow-up was 8 to 50 months, 3 cases were lost, and 4 cases were survival 3 years after the surgery. Conclusion Pulmonary sarcomatold carcinoma is a rare histologic subtype of non-small cell lung cancer. Compared with other NSCLC, there is no special clinical and imageing characteristics. Its definite diagnosis relies on postoperative pathological analysis and immunohistochemical staining, and PSC needs to be diatinguished from a variely of disease. PPSC is more aggressive and poor prognosis.

Objective: To investigate the clinicopathological characteristics of cardial mixed adenoneuroendocrine carcinoma (MANEC) and analyze its prognostic factors. Methods: The retrospective and descriptive study was conducted. The clinicopathological data of 34 patients with primary cardial MANEC who were admitted to the Changzhou No.2 People′s Hospital of Nangjing Medical University from January 2008 to January 2018 were collected. There were 20 males and 14 females, aged from 39 to 81 years, with an average age of 66 years. All the 34 patients underwent resection of cardia cancer and postoperative pathological examination. Observation indicators: (1) surgery and treatment; (2) clinical manifestations and pathological conditions; (3) pathological examination of surgical resection specimens; (4) follow-up and survival; (5) analysis of prognostic factors. Follow-up using outpatient examination and telephone interview was conducted to detect the survival of patients and tumor recurrence and metastasis up to December 2018. Measurement data with normal distribution were represented as Mean±SD. Measurement data with skewed distribution were expressed as M (range). Count data were expressed as absolute numbers or percentages. Kaplan-Merier method was used to calculate the survival time and rate and draw the survival curve, and log-rank test was used for the survival analysis. Univariate and multivariate analyses were performed using the COX proportional risk model. Results: (1) Surgery and treatment: all the patients underwent surgery successfully and postoperative systemic chemotherapy based on cisplatin + etoposide. (2) Clinical manifestations and pathological conditions: patients had epigastric discomfort, abdominal pain and abdominal distension as the first symptoms. Of 34 patients, number of males, cases with age ≥60 years, cases with esophageal involvement, cases with stable microsatellite, cases with higher CA19-9, cases with elevated cancer embryonic antigen, cases of tumor pathologic TNM stage Ⅲ-Ⅳ, cases with tumor diameter ≥5 cm, cases with vascular tumor emboli, cases with positive lymph node metastasis, cases with nerve invasion were 20, 29, 31, 28, 4, 3, 29, 30, 27, 30, 29, respectively. (3) Pathological examination of surgical excision specimens: the masses of patients were mainly ulcer-type, with the diameter of 3.0-8.4 cm. Of the 34 patients, 1 had tumor infiltrated into submucosa, 5 infiltrated into muscle layer, 18 infiltrated into serosal layer, and 10 infiltrated into extra-serous fibrous adipose tissues. Microscopy examination showed that all tumors were composed of two components including adenocarcinoma and neuroendocrine carcinoma, and the two components accounted for more than 30%. Among adenocarcinoma components of the 34 patients, 14 were poorly differentiated tubular adenocarcinoma, 6 were mucinous adenocarcinoma, 6 were moderately differentiated tubular adenocarcinoma, 5 were low-adhesion carcinoma, 1 was highly differentiated tubular adenocarcinoma, and 2 were papillary adenocarcinoma. Among the neuroendocrine carcinoma components of the 34 patients, 10 were small cell type and 24 were large cell type. Of the 34 patients, 10 had adenocarcinoma and neuroendocrine carcinoma closely adjacent but not confused, and 24 had adenocarcinoma and neuroendocrine carcinoma cross-mixed. Immunohistochemistry examination of 34 patients showed that the components of neuroendocrine carcinoma were positive for synaptophysin, pheochromoin A and nerve cell adhesion molecule. The components of adenocarcinoma were positive for broad-spectrum cytokeratin, cytokeratin 8/18 and cytokeratin 7. (4) Follow-up and survival: 34 patients were followed up for 8.0-68.0 months, with a median time of 53.7 months. The 34 patients had survived for 21-49 months, with a median time of 35 months. The 1-, 3-, 5-year survival rates were 93.31%, 53.60%, and 20.62%. (5) Ananlysis of prognostic factors: results of univariate analysis showed that CA19-9, tumor diameter, intravascular tumor thrombus, tumor pathological TNM stage, lymph node metastasis, microsatellite detection, and histological classification were the related factors affecting the prognosis of patients with cardial MANEC (risk ratio =1.724, 0.327, 1.401, 1.612, 1.542, 1.876, 0.945, 95% confidence interval: 1.226-3.467, 0.218-0.776, 1.171-4.432, 0.694-4.054, 0.987-3.776, 1.217-4.341, 0.614-2.115, P<0.05). Results of multivariate analysis showed that the tumor pathological TNM stage Ⅲ-Ⅳ, positive lymph node metastasis, stable microsatellite, neuroendocrine carcinoma as the main histological classification were independent risk factors affecting the prognosis of patients with cardial MANEC (odds ratio=1.667, 1.441, 1.306, 3.501, 95% confidence interval: 1.013-4.915, 1.035-5.746, 1.006-6.213, 2.076-8.528, P<0.05). Conclusions Cardial MANEC is composed of two components including adenocarcinoma and neuroendocrine carcinoma, and the two components account for more than 30%. The tumors in the neuroendocrine cacinoma area present as solid nest-like pattern, rosettes-shaped or organ-like pattern, with high nuclear-to-plasma ratio and fine chromatin, and it is easy to see mitotic figures. Adenocarcinoma components are tubular adenocarcinoma, mucinous adenocarcinoma, papillary adenocarcinoma with various differentiation. The adenocarcinoma and neuroendocrine carcinoma components can be cross-mixed, and also can be closely adjacent but not confused. Tumor pathological TNM stage Ⅲ-Ⅳ, positive lymph node metastasis, stable microsatellite, neuroendocrine carcinoma as the main histological classification are independent risk factors affecting the prognosis of patients with cardial MANEC.

Objective To discuss the pathological and clinical characteristics,treatments and prognosis of schwannoma of the kidney.Methods Two cases of schwannoma of the kidney in our hospital were reviewed with clinicopathological data and their follow-up.The related literatures were reviewed.The first case was a male patient,28 years old,complained about paroxysmal abdominal pain with nausea over 2 weeks.The physical exam found a 10 cm,qualitative hard,poor activity,tenderness mass in kidney region.MRI preoperative diagnosis was right renal cell carcinoma with renal vein and inferior vena cava tumor thrombus formation.The second patient,female,53 years old,the mass on upper right kidney was found occasionally.It was diagnosed as adrenal pheochromocytoma before operation,laparoscopic resection of right renal hilum mass and right partial adrenectomy plus right nephrectomy were performed.There was no tumor recurrence in the follow-up.Results The abdominal aortography and double renal arteriography were done and right renal artery embolization and inferior vena cava filter were allocated.Then right radical nephrectomy and inferior vena cava tumor thrombus removal were carried out on the first patient.The first malignant and the second benign renal schwannoma patient showed significant difference in pathological presentations.Their immunohistochemistry also showed great diversity.Malignant renal schwannoma was significantly stained by Ki-67 ＞ 40％,S-100 was negative.Ki-67 in benign neurilemmomas was about 2％,and S-100 in benign renal schwannoma was positive.Conclusions Schwannoma of the kidney is rare with a favorable prognosis.The golden standard of diagnosis is pathology.Surgical resection has become the first choice for treatment.Recurrence and malignant transformation would happen after the surgery so that all the patients should be followed up.