Needle-free jet injectors refer to a kind of medical device that uses a specific device to form a small,high-speed jet of medication to pierce the human skin,thereby achieving the delivery of medication into the human body without the use of needles.In the past few decades,needle-free jet injectors have undergone many changes with the development of healthcare systems and advancements in related technologies.In this article,the history,research status,and clinical application of needle-free jet injectors are introduced.The principles of different driving modes for needle-free jet injectors are briefly summarized,and their respective advantages and the existing problems are summarized.Combining the current research status and market application,the technical problems faced by the development of needle-free jet injectors are analyzed.Under the background of intelligent and automatic development of medical equipment,the future development and opportunities for needle-free jet injectors are prospected.

Objective To evaluate the outcomes of sleeve resection following neoadjuvant chemoimmunotherapy for lung cancer. Methods The clinical data of patients diagnosed with lung cancer and underwent sleeve lobectomy surgery at Tianjin Chest Hospital were retrospectively analyzed. Patients were divided into two groups: a neoadjuvant treatment group and a surgery alone group. The clinical data of two groups were compared. Results Finally 22 patients were collected, including 19 males and 3 females with a median age of 63 years. There were 7 patients in the neoadjuvant treatment group, and 15 patients in the surgery alone group. There was no statistical difference in surgical time, intraoperative bleeding, lymph node dissection, postoperative catheterization time, or postoperative drainage volume between the two groups (P>0.05). In the neoadjuvant treatment group, 1 patient had a second thoracotomy exploration for hemostasis due to bronchial artery bleeding, 2 patients had wound infection, 1 patient had immune-associated pneumonia before surgery, and 1 patient had immune-associated pneumonia before postoperative adjuvant therapy. Postoperative pathological results of patients in the neoadjuvant treatment group showed that 1 (1/7, 14.3%) patient had pathological complete response, and 3 (3/7, 42.9%) patients achieved major pathological response. Conclusion Neoadjuvant chemoimmunotherapy can lead to complications, including operation-related complications and immunotherapy-related complications. However, the degree of postoperative pathological remission is also significantly improved. Overall, sleeve resection following neoadjuvant chemoimmunotherapy can be considered as a treatment option for patients with lung cancer.

This report described one human leukocyte antigen pre-sensitized recipient undergoing preoperative plasmapheresis (PP), intravenous immunoglobulins (IVIG) desensitization and immune induction therapy before kidney transplantation with a donor kidney. Early postoperative clinical diagnosis was acute antibody-mediated rejection (AMR). A marked elevation of donor-specific antibodies (DSA) was accompanied by a decline of renal function. PP/IVIG dosing failed to lower the level of DSA. After low-dose splenic irradiation, DSA level dropped steadily and transplanted kidney function normalized. Thus adjuvant low-dose splenic irradiation may eliminate DSA immediately without a rebound.

Objective:To investigate the efficacy of different conversion therapies for colorectal cancer with unresectable simultaneous liver metastasis.Methods:A total of 170 patients of colorectal cancer complicated with liver metastasis who were admitted to the First Affiliated Hospital of Nanchang University from Jan 2015 to Dec 2020 were included in the study. Patients were divided into an initial resectable group (42 cases) and an initial non-resectable group (128 cases).Results:There were no significant differences in OS and PFS between patients with CRLM (colorectal cancer with liver metastasis) who were resected initially and those successfully underwent transformation therapy ( P>0.05). The median OS was 36 months in the group with successful transformation, while it was 21 months in the group with simple primary tumor resection and no liver metastasis resection ( P=0.014), HR=0.48 (0.27-0.86). The median PFS was 28 months in the successful conversion group, while it was 10 months in the primary tumor resection only and no liver metastasis resection ( P=0.005), HR=0.43 (0.24-0.77). The OS difference between the group with simple primary tumor resection and no resected liver metastasis and the group with neither primary tumor nor liver metastasis resection was statistically significant: (21 months vs.13 months), HR=0.52 (0.32-0.86) ( P=0.01), while the PFS between the two groups was not statistically significant, ( P>0.05). Conclusions:Chemotherapy combined with targeted therapy has the best effect among the conversion therapies, and can improve the resection rate and survival rate of patients undergoing R 0 surgery. Resection of the primary lesion alone can also prolong the patient's survival.

Objective:To evaluate the effectiveness of the artificial intelligence-assisted diagnosis and treatment system in distinguishing benign and malignant lung nodules.Methods:Clinical data of 1 650 patients with pulmonary nodules admitted to the Tianjin Chest Hospital Affiliated to Tianjin University from January 2015 to October 2022 were retrospectively analyzed, which included a total of 1 650 nodules. The malignant probability was compared to and analyzedpredict the benign and malignant nodules.Results:A total of 1 650 nodules were included, which were divided into a malignant tumor group(n=1 391, 84.3%) and a benign lesion group(n=259, 15.7%). Between the malignant tumor group and the benign lesion group, the malignant probability was significantly different, and the malignant probability could better distinguish malignant nodules and benign lesions[(78.85±22.91)% vs.(54.91±28.68)%, P<0.001]. The area under the curve( AUC) was 0.768. The critical value of malignant probability for diagnosis of lung cancer was 81.3% with a sensitivity of 0.620 and specificity of 0.815. Stratified analysis results showed that the accuracy of the AI intelligent system for diagnosing pulmonary nodules with the sizes of 0-1 cm, 1-2 cm and 2-3 cm was also increased, and the areas under ROC curve were 0.717, 0.769 and 0.804, respectively. Conclusion:The malignant probability of lung nodules calculated by the artificial intelligence-assisted diagnosis and treatment system can be used in the assessment of the preoperative benign and malignant lung nodules.

Abivertinib, a third-generation tyrosine kinase inhibitor, is originally designed to target epidermal growth factor receptor (EGFR)-activating mutations. Previous studies have shown that abivertinib has promising antitumor activity and a well-tolerated safety profile in patients with non-small-cell lung cancer. However, abivertinib also exhibited high inhibitory activity against Bruton's tyrosine kinase and Janus kinase 3. Given that these kinases play some roles in the progression of megakaryopoiesis, we speculate that abivertinib can affect megakaryocyte (MK) differentiation and platelet biogenesis. We treated cord blood CD34⁺ hematopoietic stem cells, Meg-01 cells, and C57BL/6 mice with abivertinib and observed megakaryopoiesis to determine the biological effect of abivertinib on MK differentiation and platelet biogenesis. Our in vitro results showed that abivertinib impaired the CFU-MK formation, proliferation of CD34⁺ HSC-derived MK progenitor cells, and differentiation and functions of MKs and inhibited Meg-01-derived MK differentiation. These results suggested that megakaryopoiesis was inhibited by abivertinib. We also demonstrated in vivo that abivertinib decreased the number of MKs in bone marrow and platelet counts in mice, which suggested that thrombopoiesis was also inhibited. Thus, these preclinical data collectively suggested that abivertinib could inhibit MK differentiation and platelet biogenesis and might be an agent for thrombocythemia.
Acrylamides/pharmacology* ; Animals ; Blood Platelets/drug effects* ; Cell Differentiation ; Megakaryocytes/drug effects* ; Mice ; Mice, Inbred C57BL ; Piperazines/pharmacology* ; Pyrimidines/pharmacology*

Objective:To summarize the clinical characteristics and therapeutic drug selection of post-transplantation diabetes mellitus(PTDM)after kidney transplantation in children.Methods:From May 2014 to March 2021, a total of 5 cases(5.38%)of 93 paediatric kidney transplant recipients with a median follow-up period of 34 months were diagnosed with PTDM in our centre.Retrospective data analysis was performed for these 5 paediatric recipients.The characteristics of the disease, treatment data and outcomes were summarized.Among the five paediatric recipients, one was male and four patients were female, ranging the age from 12 to 17 years.All recipients received a tacrolimus-based immunosuppressive regimen with prednisone discontinued no later than 3 months after kidney transplant.Results:The onset of PTDM ranged from 1 month to 46 months(median: 17 months)after transplantation.The blood glucose of two children returned to normal gradually after tacrolimus conversion to cyclosporine, with one of them was given insulin temporarily.Three children received oral hypoglycaemic agents, including one received acarbose, one received metformin, and one received metformin combined with acarbose.After a median follow-up of 6 months, the levels of blood glucose in five children were stable, and there was no significant change in serum creatinine and urine protein.Conclusions:The treatment of PTDM in children should be individualized with considering of age, gender and immunosuppressive regimen. Switch from tacrolimus to cyclosporine is effective. Metformin or other hypoglycemic agentsis helpful when tacrolimus is maintained.

To investigate the diversity and composition of gut microbiota in patients with lung adenocarcinoma and lung squamous cell carcinoma. A single-center and case-control study was conducted to consecutively enroll a total of 27 lung cancer patients, including 15 males and 12 females, who were seen at the Affiliated Hangzhou First People′s Hospital, Zhejiang University School of Medicine between September 2018 to October 2020. A total of 20 cases of healthy healthy physical examiners, including 9 males and 11 females were recruited as healthy control group (HC) during the same period. Clinical data and stool samples were collected from each participants, and lung cancer patients were divided into lung adenocarcinoma group (AC, 19 patients, 8 males and 11 females) and lung squamous cell carcinoma group (SCC, 8 patients, 7 males and 1 females) according to the pathology type. Genomic DNA were extracted to amplify 16S rDNA V3-V4 region, then the Illumina MiSeq high-throughput sequencing platform and QIIME software were used for sequencing and analyzing the structure of the gut microbiota, respectively. Analysis of variance, χ 2 test, K-W test were used to analyze the differences in age, gender,α diversity, and relative abundance of microbiota among the three groups. AC, SCC, and HC were aged (58.74±9.27), (63.38±6.12), and (55.65±7.79) years old, respectively. There were no difference in gender and age among the three groups (gender and age are respectively:χ 2=5.155, P=0.076; F=2.598, P=0.086). And no significant difference in alpha diversity were found among the three groups (Chao and Shannon index were respectively: F=0.616, P=0.545; F=2.484, P=0.095), while β-diversity analysis indicated significant differences in the structure of intestinal flora among AC, SCC and HC ( P=0.001). LEfSe analysis showed that AC and SCC both have dominant bacterials. Megasphaera ( H=7.855, P=0.020) and Erysipelatoclostridium ( H=7.426, P=0.024) were enriched in patients with AC, while Enterococcus ( H=8.400, P=0.015), Veillonella ( H=9.957, P=0.007), and Eubacterium_eligens_group ( H=10.514, P=0.005) were enriched in patients with SCC. Lung cancer patients have gut microbiota imbalance, while lung adenocarcinoma and lung squamous cell carcinoma patients have no significant difference in gut microbiota diversity, but lung adenocarcinoma and lung squamous cell carcinoma have their own unique microbiota. This imbalance of the intestinal microenvironment is of great significance for studying the occurrence and development of different pathological types of lung cancer.

To investigate the diversity and composition of gut microbiota in patients with lung adenocarcinoma and lung squamous cell carcinoma. A single-center and case-control study was conducted to consecutively enroll a total of 27 lung cancer patients, including 15 males and 12 females, who were seen at the Affiliated Hangzhou First People′s Hospital, Zhejiang University School of Medicine between September 2018 to October 2020. A total of 20 cases of healthy healthy physical examiners, including 9 males and 11 females were recruited as healthy control group (HC) during the same period. Clinical data and stool samples were collected from each participants, and lung cancer patients were divided into lung adenocarcinoma group (AC, 19 patients, 8 males and 11 females) and lung squamous cell carcinoma group (SCC, 8 patients, 7 males and 1 females) according to the pathology type. Genomic DNA were extracted to amplify 16S rDNA V3-V4 region, then the Illumina MiSeq high-throughput sequencing platform and QIIME software were used for sequencing and analyzing the structure of the gut microbiota, respectively. Analysis of variance, χ 2 test, K-W test were used to analyze the differences in age, gender,α diversity, and relative abundance of microbiota among the three groups. AC, SCC, and HC were aged (58.74±9.27), (63.38±6.12), and (55.65±7.79) years old, respectively. There were no difference in gender and age among the three groups (gender and age are respectively:χ 2=5.155, P=0.076; F=2.598, P=0.086). And no significant difference in alpha diversity were found among the three groups (Chao and Shannon index were respectively: F=0.616, P=0.545; F=2.484, P=0.095), while β-diversity analysis indicated significant differences in the structure of intestinal flora among AC, SCC and HC ( P=0.001). LEfSe analysis showed that AC and SCC both have dominant bacterials. Megasphaera ( H=7.855, P=0.020) and Erysipelatoclostridium ( H=7.426, P=0.024) were enriched in patients with AC, while Enterococcus ( H=8.400, P=0.015), Veillonella ( H=9.957, P=0.007), and Eubacterium_eligens_group ( H=10.514, P=0.005) were enriched in patients with SCC. Lung cancer patients have gut microbiota imbalance, while lung adenocarcinoma and lung squamous cell carcinoma patients have no significant difference in gut microbiota diversity, but lung adenocarcinoma and lung squamous cell carcinoma have their own unique microbiota. This imbalance of the intestinal microenvironment is of great significance for studying the occurrence and development of different pathological types of lung cancer.

Objective:To observe the changes in acromiaohumeral distance(AHD) in patients undergoing the modified arthroscopic double-button Latarjet procedure for recurrent anterior shoulder dislocation complicated with glenoid bone defect.Methods:A retrospective study was performed of the 52 patients who had undergone the modified arthroscopic double-button Latarjet procedure from October 2014 to October 2016 at Department of Sports Medicine, The First Affiliated Hospital to Shenzhen University for recurrent anterior shoulder dislocation complicated with glenoid bone defect. They were 33 males and 19 females, having 30 left and 22 right shoulders affected. Their ages ranged from 19 to 45 years(mean, 29.6 years). Their glenoid bone defects ranged from 17% to 30%(mean, 23.4%). CT scans were performed on the surgery side to observe the healing and reshaping of the bone grafts and to measure the AHDs of healthy shoulder, immediately, 6, 18 and 36 months after operation. Their American Shoulder and Elbow Surgeons(ASES), Rowe and Walch-Duplay scores were recorded before operation and at the final follow-up for comparison.Results:The follow-up time for this series ranged from 37 to 44 months (mean, 40.6 months). The AHDs at immediate postoperation(9.6 mm ± 0.7 mm), 6 months postoperation(8.6 mm ± 0.9 mm), 18 months postoperation (8.0 cm ± 0.8 cm) and 36 months postoperation(7.9 cm ± 0.8 cm) were significantly wider than the healthy side value (7.8 mm ± 0.8 mm)( P<0.05). The ASES, Rowe and Walch-Duplay scores at the final follow-up (93.9±3.2, 94.5±2.7 and 95.7±3.6) were significantly improved than the preoperative values (67.3±9.1, 40.1±4.2 and 63.5±9.0) ( P<0.05). The final follow-ups observed no symptoms or signs of chronic shoulder pain, rotator cuff injury or acromion impingement. Conclusion:As the AHD becomes wider rather than narrower after arthroscopic double-button Latarjet procedure for recurrent anterior shoulder dislocation complicated with glenoid bone defect, no subsequent rotator cuff injury may happen due to the uplift of the humeral head after the modified arthroscopic double-button Latarjet procedure.