OBJECTIVE To evaluate the effect and safety of ciprofol combined with local anesthesia on elderly patients undergoing hemorrhoidectomy. METHODS A total of 108 elderly patients who underwent hemorrhoidectomy at the Department of Proctology， Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine from February 2023 to June 2024， were included. The patients were randomly divided into the etomidate group （54 cases） and the ciprofol group （54 cases） based on a computer-generated random sequence. One patient with intraoperative bleeding and one who refused postoperative examination were excluded， resulting in a final total of 106 patients completing this trial （52 in the etomidate group and 54 in the ciprofol group）. The two groups of patients underwent hemorrhoidectomy under local anesthesia with sedative assistance， receiving either etomidate at 0.2 mg/kg or ciprofol at 0.3 mg/kg combined with sufentanil at 0.1 μg/kg. The sedation success rate， induction time， recovery time， operation time and hemodynamic parameters [heart rate （HR）， mean arterial pressure （MAP）， pulse oxygen saturation （SpO2） and respiratory rate （RR）] were observed at baseline （T0）， after successful induction of anesthesia （T1）， 10 minutes after the start of surgery （T2）， and awakening （T3）. Additionally， the levels of oxidative stress markers [malondialdehyde （MDA） and superoxide dismutase （SOD）] were measured at T0， T2 and T3. The occurrence of adverse reactions was also recorded. RESULTS The induction time of the ciprofol group was significantly shorter than that of the etomidate group （P＜0.05）， while the recovery time was significantly longer in the ciprofol group compared to the etomidate group （P＜0.05）. AtT1 and T2， HR， MAP and RR of two groups were significantly lower compared to the same group at T0 （P＜0.05）. However， no significant differences were observed in the hemodynamic parameters at each time point between the two groups （P＞0.05）. At T2 and T3， the MDA levels in both groups were significantly higher than at T0， while the SOD levels were significantly lower than the same group at T0； the ciprofol group showed significantly better outcomes than the etomidate group at the same time points （P＜0.05）. The proportion of patients with intraoperative somatic movements was significantly lower in the ciprofol group compared to the etomidate group （P＜0.05）. CONCLUSIONS When ciprofol is used in elderly patients undergoing hemorrhoidectomy， it demonstrates certain advantages over etomidate in maintaining hemodynamic stability and reducing oxidative stress. Additionally， ciprofol has higher safety.

Objective To explore the expression and prognostic significance of histone demethylase JMJD2B and HIF-1α in rhabdomyosarcoma(RMS) tissues. Methods A total of 78 RMS patients were followed up to obtain survival time, and immunohistochemical staining was used to detect the expression of JMJD2B and HIF-1α in RMS tissues and analyze their relation with clinicopathological characteristics and prognosis. Results Among the 78 samples, there were 46 (59.0%) and 44 (56.4%) cases of positive expression of JMJD2B and HIF-1α, respectively. The expression of JMJD2B and HIF-1α were positively correlated (P < 0.001, r=0.518) and related to tumor risk, metastasis, IRS staging and neoadjuvant chemotherapy (all P < 0.05). The Kaplan-Meier survival curve and univariate Cox regression analysis showed that the risk level, neoadjuvant chemotherapy, the expression of HIF-1α and JMJD2B were related to the prognosis of patients (all P < 0.05). Multivariate Cox regression analysis showed that JMJD2B (HR=3.161, P=0.039) and risk degree (HR=2.925, P=0.001) could be used as independent prognostic factors for RMS patients. Conclusion JMJD2B and HIF-1α expression are both significantly related to the overall survival of rhabdomyosarcoma patients, and JMJD2B is an independent prognostic indicator.

Osteosarcoma (OS) is the most common primary bone tumor in children and adolescents. It is an aggressive tumor with a tendency to spread to the lung, which is the most common site of metastasis. Patients with advanced OS with metastases have poor prognoses despite the application of chemotherapy, thus highlighting the need for novel therapeutic targets. The tumor microenvironment (TME) of OS is confirmed to be essential for and supportive of tumor growth and dissemination. The immune component of the OS microenvironment is mainly composed of tumor-associated macrophages (TAMs). In OS, TAMs promote tumor growth and angiogenesis and upregulate the cancer stem cell-like phenotype. However, TAMs inhibit the metastasis of OS. Therefore, much attention has been paid to investigating the mechanism of TAMs in OS development and the progression of immunotherapy for OS. In this article, we aim to summarize the roles of TAMs in OS and the major findings on the application of TAMs in OS treatment.

The paper described the hemodynamics of blood flow based on fluid mechanics and its corresponding formulas, and revealed the limitation of blood flow velocity measurement for non-laminar flow when using the conventional pulse wave Doppler. The paper demonstrated the calculation of turbulence for blood flow based on velocity directions and quantified the turbulence according to the presented formulas. Two methods were introduced and the simulated results were analyzed. An example using real data based on ultrasound vector flow imaging for calculating the turbulence of blood flow was presented in the end.
Blood Flow Velocity ; Ultrasonography

Soft tissue sarcomas (STSs) are malignant tumors originating from mesenchymal tissues. They have lower morbidity rates than other cancers, which is only about 1% among adult malignancies. STSs consist of several subtypes and many of them are highly malignant. The 5-year survival rate is approximately 50%-60%. Investigation of STS pathogenesis demonstrated that epigenetic chang-es were closely related to the occurrence and development of STSs. Different from genetics changes, epigenetic changes are heritable and occur mainly through DNA methylation, histone modification, non-coding RNA regulation, and chromatin remodeling, all of which occur without changing the DNA sequence. Elucidation of the epigenetic mechanisms involved in STSs can help develop new clinical di-agnosis and treatment methods, and this article aims to review the recent advances in epigenetic research on STS.

Objective To explore if bacillus bifidus relieve CPFX-induced testosterone reduction in mouse testes.Methods Twenty-four male mices were divided into 4 groups, then administered saline for 6 days (Sal6 group), CPFX for 6 days (A6 group), CPFX for 6 days followed by bifidobacteria treatment for the next 6 days (A6+P6 group), CPFX for 6 days and then saline for the next 6 days (A6+Sal6 group).We detected serum levels of testosterone by RIA, as well as levels of steroidogenic enzymes mRNA [cholesterol side-chain cleavage enzyme (P450scc) and steroidogenic acute regulatory protein (StAR)] and NF-E2-related factor2 (Nrf2) mRNA in testes by real-time PCR, Nrf2, heme oxygenase-1 (HO-1), and 4-hydroxy-2-nonenal (4-HNE) by Western blot and4-HNE by Immunohistochemistry.Results The A6 group had significantly lower serum testosterone levels compared with the Sal6 group (P<0.001), the A6+P6 group had significantly higher compared with the A6 (P<0.001) and A6+Sal6 groups (P<0.01).The A6 group had significantly lower StAR mRNA compared with the Sal6 group (P<0.001), the A6+P6 group had significantly higher level compared with the A6 (P<0.01) and A6+Sal6 groups (P<0.01).The A6 group had significantly lower P450scc mRNA as compared with the Sal6 group (P<0.001), the A6+P6 group had significantly higher compared with the A6 (P<0.001) and A6+Sal6 groups (P<0.05).The A6 group had significantly lower Nrf2 compared with the Sal6 group (P<0.001), the A6+P6 group had significantly higher compared with the A6(P<0.01) and A6+Sal6 groups (P<0.05).The A6 group higher 4-HNE expression compared with the Sal6 group, the A6+P6 group had significantly lower compared with the A6 (P<0.01) and A6+Sal6 groups (P<0.05).Conclusions Bifidobacteria the reduction of CPFX-induced testosterone reduction, and these effects may potentially explained by Nrf2 inflammatory signaling pathway.

Objective To analyze the possibility of using TCR Vβsubfamily as the diagnostic in-dicators for major histocompatibility complex( MHC) deficiency-induced graft-versus-host disease( GVHD) . Methods The BALB/c mice were given 9.5 Gy (950 rad) of irradiation and transplanted with 106 of T-cell depleted (TCD) bone marrow cells from C57BL/6 and DBA/2 mice with MHC Ⅱ deficiency.Two control groups were set up accordingly by injection of TCD bone marrow cells from wild type ( WT) C57BL/6 and DBA/2 mice.Several parameters including the body weight, the GVHD clinical score and the survival time of the recipients were monitored.Flow cytometry analysis and mixed lymphocyte culture test were performed for the evaluation of autoimmune responses.Histological examination was used to analyze the severity of GVHD.Results The MHC deficiency-induced GVHD was successfully induced in the irradiated BALB/c mice receiving MHC mismatched allogeneic hematopoietic cell transplantation ( allo-HCT ) . The MHC matched DBA/2 mice with MHC deficiency could be used as the mice model of subclinical GVHD.Changes of the TCR Vβ6 were consistent with the results of histopathological examination.Conclusion Highly ex-pressed TCR Vβ6 could be used as indicators for the diagnosis of MHC deficiency-induced subclinical GVHD.

BACKGROUND:Vertebral metastatic tumor often occurs in the thoracolumbar segment, and it is difficult for internal fixation due to the complex anatomical position. OBJECTIVE:To evaluate the stability of lumbar vertebra in the patients with single thoracolumbar vertebral metastases after treated with artificial vertebral placement and internal fixation. METHODS:Sixteen patients (9 male and 7 female) with single thoracolumbar vertebral metastases treated in the Department of Orthopedics, the Fourth Hospital of Hebei Medical University from January 2006 to January 2009 were selected, and the age ranged 40-74 years, averaged 52 years. Before treatment, al the patients were evaluated according to Frankel classification:A grade in two cases, B grade in three cases, C grade in three cases, D grade in five cases, and E grade in three cases. And the vertebral state of patients was detected with X-ray plain film examination, systemic radionuclide bone scanning, CT and MRI. The T11 vertebral metastases were treated with chest approach artificial vertebral placement and internal fixation, and T12-L2 vertebral metastases were treated with artificial vertebral placement and internal fixation via extrapleural and extraperitoneal space approach. RESULTS AND CONCLUSION:Al the 16 patients were fol owed up for 4-32 months, and the average survival time after treatment was 12 months. After treatment, Frankel classification was C grade in three cases, D grade in five cases and E grade in eight cases. The visual analog scale score was decreased from (6.22±1.31) before treatment to (3.25±0.94) after treatment, and there was significant difference between two groups (P<0.05). The artificial vertebral placement and internal fixation can restore the stability of lumbar vertebra in the patients with spinal metastases, and thus improving the symptoms and quality of life.

Versican comes from fibroblasts and belongs to chondroitin sulfate proteoglycan.It distributes in various tissues.The versican have functions including regulate cell growth and differentiation,promote cell proliferation,invasion and metastasis,and stimulate angiogenesis.Experiments have confirmed that the expression of versican is involved in various cancers.Here,the author do an overview of versican in the occurrence and development of breast cancer,liver cancer and chondrosarcoma aimed to further explore the pathogenesis of tumors.

Objective To study the risk factors,methods of etiologic diagnosis and treatment of disunion of fracture due to delayed infection after the internal fixation. Methods The clinical data including bacterial tests, clinical manifestation and the administration of antibiotics , of 24 cases of disunion of fracture due to delayed infec-tion after the internal fixation were retrospectively analyzed. Results 22 strains of pathogenic bacteria were distin-guished with a detection rate of 91.67% in the 24 cases. 16 strains of these bacteria were gram-positive,and 6 gram-negative. The gram-positive ones were all sensitive to vancomycin and teicoplanin. The gram-negative ones were all sensitive to imipenem and meropenem. It was common for patients to take antibiotic after operation. Conclusion More infection is caused by gram-positive bacteria than by gram-negative ones. Antibiotic therapy based on the bacte-rial test is reasonable and necessary besides surgeries.