Objective To explore the efficacy and safety of enhanced external counterpulsation(EECP)in elderly patients with acute ischemic stroke(AIS)complicated by coronary heart dis-ease(CHD).Methods A total of 65 AIS patients with CHD admitted in our hospital from Janu-ary to June 2023 were recruited and randomly divided into a control group(drug secondary pre-vention,n=32)and a treatment group(drug combined with EECP therapy,n=33).Their NIHSS score,mRS score and Canadian Cardiovascular Society(CCS)angina grade were evaluated before and after treatment and compared between the two groups.The incidences of recurrent ischemic stroke,new hemorrhagic stroke and major adverse cardiovascular events(MACE)were also recor-ded during treatment.Results The NIHSS score and mRS score were significantly decreased in both groups after treatment(P＜0.01).After treatment,the NIHSS score(2.67±1.63 vs 3.56± 1.83),mRS score[1.0(0.0,1.0)vs 2.0(1.0,2.0)]and CCS grade[1.0(1.0,2.0)vs 2.0(1.0,2.0)]were obviously lower in the treatment group than the control group(P＜0.05,P＜0.01).There were no statistical differences in the incidence rates of recurrent ischemic stroke,new-onset hem-orrhagic stroke,and MACE between the control group and the treatment group(9.4％vs 6.1％,6.3％vs 3.0％,12.5％vs 6.1％,P＞0.0 5).Conclusion EECP is a safe and effective treatment option for elderly AIS patients with CHD.

Background::Bladder cancer, characterized by a high potential of tumor recurrence, has high lifelong monitoring and treatment costs. To date, tumor cells with intrinsic softness have been identified to function as cancer stem cells in several cancer types. Nonetheless, the existence of soft tumor cells in bladder tumors remains elusive. Thus, our study aimed to develop a microbarrier microfluidic chip to efficiently isolate deformable tumor cells from distinct types of bladder cancer cells.Methods::The stiffness of bladder cancer cells was determined by atomic force microscopy (AFM). The modified microfluidic chip was utilized to separate soft cells, and the 3D Matrigel culture system was to maintain the softness of tumor cells. Expression patterns of integrin β8 (ITGB8), protein kinase B (AKT), and mammalian target of rapamycin (mTOR) were determined by Western blotting. Double immunostaining was conducted to examine the interaction between F-actin and tripartite motif containing 59 (TRIM59). The stem-cell-like characteristics of soft cells were explored by colony formation assay and in vivo studies upon xenografted tumor models. Results::Using our newly designed microfluidic approach, we identified a small fraction of soft tumor cells in bladder cancer cells. More importantly, the existence of soft tumor cells was confirmed in clinical human bladder cancer specimens, in which the number of soft tumor cells was associated with tumor relapse. Furthermore, we demonstrated that the biomechanical stimuli arising from 3D Matrigel activated the F-actin/ITGB8/TRIM59/AKT/mTOR/glycolysis pathways to enhance the softness and tumorigenic capacity of tumor cells. Simultaneously, we detected a remarkable up-regulation in ITGB8, TRIM59, and phospho-AKT in clinical bladder recurrent tumors compared with their non-recurrent counterparts.Conclusions::The ITGB8/TRIM59/AKT/mTOR/glycolysis axis plays a crucial role in modulating tumor softness and stemness. Meanwhile, the soft tumor cells become more sensitive to chemotherapy after stiffening, that offers new insights for hampering tumor progression and recurrence.

The close relationship between gastric cancer (GC) and type 2 diabetes mellitus (T2DM) has garnered significant attention. On one hand, T2DM may play a role in the development and progression of GC, correlating with poor patient outcomes. On the other hand, after radical surgery for GC, T2DM can be effectively managed, potentially improving tumor prognosis. In recent years, bariatric and metabolic surgery (BMS) has revolutionized T2DM treatment for obese and overweight patients. Comparative analyses reveal similarities between surgical approaches for gastric cancer and BMS, leading to the emergence of the onco-metabolic surgery (OMS) concept, which suggests that radical tumor resection and T2DM remission in GC patients can be potentially achieved through a single procedure. However, there are notable differences between OMS and BMS, including target populations, surgical details, and perioperative management. Therefore, optimizing the application of the OMS concept in GC patients holds significant clinical importance. This article provides a review to facilitate the better implementation of this concept in practice.

The close relationship between gastric cancer (GC) and type 2 diabetes mellitus (T2DM) has garnered significant attention. On one hand, T2DM may play a role in the development and progression of GC, correlating with poor patient outcomes. On the other hand, after radical surgery for GC, T2DM can be effectively managed, potentially improving tumor prognosis. In recent years, bariatric and metabolic surgery (BMS) has revolutionized T2DM treatment for obese and overweight patients. Comparative analyses reveal similarities between surgical approaches for gastric cancer and BMS, leading to the emergence of the onco-metabolic surgery (OMS) concept, which suggests that radical tumor resection and T2DM remission in GC patients can be potentially achieved through a single procedure. However, there are notable differences between OMS and BMS, including target populations, surgical details, and perioperative management. Therefore, optimizing the application of the OMS concept in GC patients holds significant clinical importance. This article provides a review to facilitate the better implementation of this concept in practice.

Objective To investigate the diagnostic value of high-resolution magnetic resonance im-aging(HRMRI)in elderly patients with non-cardioembolic acute ischemic stroke(NCAIS).Meth-ods A retrospective analysis was conducted on 101 elderly NCAIS patients having HRMRI in our hospital from July 2022 to July 2023.Stroke subtypes were classified according to the Trial of Org 10172 in Acute Stroke Treatment(TOAST)system and the Chinese Ischemic Stroke Sub-classification(CISS)system.The constituent ratio distribution of each subtype classification was compared before and after HRMRI in both classification systems.Results TOAST system identi-fied 8 cases of small-artery occlusion(SAO),1 case of other determined etiology(SOE),5 cases of undetermined etiology(SUE)and then reclassified as large artery atherosclerosis(LAA),1 case of SUE which was reclassified as SAO,and 7 cases of LAA and 4 cases of SUE being reclas-sified as SOE after HRMRI.In total,the diagnosis of 26 cases(25.74％)was modified.In the CISS system,10 cases of penetrating artery disease(PAD),1 case of other etiologies(OE),and 4 cases of undetermined etiology(UE)were reclassified as LAA.Furthermore,9 cases of LAA and 3 cases of UE were reclassified as OE after HRMRI.In total,the diagnosis of 27 cases(26.73％)was modified.There were statistical differences in the constituent ratio before and after HRMRI in both TOAST(x2=15.425,P＜0.01)and CISS(x2=17.300,P＜0.01)systems.Conclusion HRMRI is of diagnostic value and significance in accurately diagnosing the etiology of AIS in eld-erly patients without cardioembolic causes.

OBJECTIVE To study the effects of isoliquiritigenin （ISL） regulating gut microbiota and repairing gut barrier function in model mice with non-alcoholic fatty liver disease （NAFLD）， and to clarify its mechanism for improving NAFLD. METHODS Thirty male C57BL/6J mice were randomly divided into the normal （ultrapure water）， model group （ultrapure water）， ISL group （100 mg/kg）， with 10 mice in each group. Model group and ISL group were fed with high-fat diet for 19 weeks to establish NAFLD model； at the same time， the mice were given relevant medicine/ultrapure water intragastrically. The changes of body weight in mice were recorded， and liver index， white fat index and brown fat index were calculated. The pathological changes of liver tissue and colon tissue as well as lipid accumulation were observed in mice. The levels of total cholesterol （TC）， triglyceride （TG）， aspartate aminotransferase （AST） and alanine aminotransferase （ALT） E-mail：xiangshj3@mail.sysu.edu.cn in serum or liver were measured； the serum levels of interleukin-6 （IL-6）， IL-1β and tumor necrosis factor-α （TNF-α） and the levels of IL-6， IL-1β and TNF-α mRNA expression in liver tissue were detected. Fecal samples underwent 16S rDNA sequencing analysis， and the effects of ISL on gut microbiota structure of mice were investigated. The expressions of gut mucosal barrier-related proteins （Claudin-4， Occludin and ZO-1） were determined in the colon tissue of mice. RESULTS Compared with model group， the body weight， liver index， the levels of TC in liver tissue and serum， the levels of AST and ALT in serum， the levels of IL-6， IL-1β and TNF-α in serum， and the mRNA expression of TNF-α in liver tissue were all decreased significantly in ISL group， while brown fat index was increased significantly. The inflammation and damage of liver tissue were significantly improved， and the NAFLD activity score and the proportion of lipid staining area were significantly reduced （P＜0.05）. ISL could significantly up-regulate the relative abundance of beneficial microbiota （norank_f_Muribaculaceae， Odoribacter， Ruminiclostridium， etc.） and the expressions of intestinal barrier function- related proteins， but could significantly down-regulate the relative abundance of harmful bacteria （Desulfovibrio， norank_f_Lachnospiraceae， unclassified_p_Firmicutes）， and could repair intestinal barrier. CONCLUSIONS ISL could significantly delay the progress of NAFLD， the mechanism of which may be associated with regulating gut microbiota and improving gut barrier function.

Lung cancer is the leading cause of cancer death in the world today, and adenocarcinoma is the most common histopathological type of lung cancer. In May 2021, World Health Organization (WHO) released the 5th edition of the WHO classification of thoracic tumors, which classifies invasive non-mucinous adenocarcinoma (INMA) into lepidic adenocarcinoma, acinar adenocarcinoma, papillary adenocarcinoma, solid adenocarcinoma, and micropapillary adenocarcinoma based on its histological characteristics. These five pathological subtypes differ in clinical features, treatment and prognosis. A complete understanding of the characteristics of these subtypes is essential for the clinical diagnosis, treatment options, and prognosis predictions of patients with lung adenocarcinoma, including recurrence and progression. This article will review the grading system, morphology, imaging prediction, lymph node metastasis, surgery, chemotherapy, targeted therapy and immunotherapy of different pathological subtypes of INMA.
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Humans ; Lung Neoplasms/pathology* ; Adenocarcinoma of Lung/pathology* ; Adenocarcinoma/pathology* ; Prognosis ; Lymphatic Metastasis ; Neoplasm Staging ; Retrospective Studies

COVID-19 is caused by a novel coronavirus-severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2), which has being spreading around the world, posing a serious threat to human health and lives. Neutralizing antibodies and small molecule inhibitors for virus replication cycle are the main antiviral treatment for novel coronavirus recommended in China. To further promote the rational use of antiviral therapy in clinical practice, the National Center for Infectious Diseases (Beijing Ditan Hospital Capital Medical University and the First Affiliated Hospital, Zhejiang University School of Medicine) invited experts in fields of infectious diseases, respiratory and intensive care to develop an Expert Consensus on Antiviral Therapy of COVID-19 based on the Diagnosis and Treatment Guideline for COVID-19 ( trial version 10) and experiences in the diagnosis and treatment of COVID-19 in China. The consensus is concise, practical and highly operable, hopefully it would improve the understanding of antiviral therapy for clinicians and provide suggestions for standardized medication in treatment of COVID-19.

Objective:To observe the efficacy of the serial treatment with autologous hematopoietic stem cell transplantation after bortezomib and dexamethasone-based triple chemotherapy regimen and followed by lenalidomide and intermittent intensive therapy in primary plasma cell leukemia.Methods:A retrospective analysis was made on the clinical data of one patient who was diagnosed as primary plasma cell leukemia with complex karyotype in April 2018 in Henan Cancer Hospital, and the relevant literature was reviewed.Results:The patient received multiple cycles of bortezomib and dexamethasone-based triple chemotherapy regimen, then received autologous hematopoietic stem cell transplantation, lenalidomide and intermittent intensive therapy. The patient eventually achieved complete remission and the progression-free survival time was 18 months until the day before the deadline for this article.Conclusion:The treatment with autologous hematopoietic stem cell transplantation after bortezomib and dexamethasone-based triple chemotherapy regimen and followed by lenalidomide and intermittent intensive therapy may improve the prognosis of patients with primary plasma cell leukemia and prolong the survival time.

Objective: To analyze the serotype distribution and antibiotic resistance characteristics of food-borne Salmonella strains isolated from food and patients with gastroenteritis in Guizhou Province from 2016 to 2018. Methods: Serotypes of the strains were characterised using slid agglutination method with Salmonella antisera. Minimal inhibitory concentrations (MIC) of antibiotics were determined by the broth microdilution method. Microsoft Excel 2007 and SPSS18.0 were used for statistical analysis. Results: A total of 170 strains of food-borne Salmonella were detected in food and patients with gastroenteritis in Guizhou Province from 2016 to 2018. Thirty-five serotypes were identified and 6 were found in both food and patients. The main serotypes in food were Salmonella Typhimurium (16.67%) and Salmonella Stanley (8.33%), and the predominant serotypes in patients were Salmonella Typhimurium (41.79%), Salmonella Enteritidis (16.42%) and Salmonella London (8.96%). The rate of resistance to ampicillin, chloramphenicol, tetracycline, ciprofloxacin, nalidixic and trimeth-sulfame were 27.78%-33.33% among the isolates from food, and 22.22%-25.00% to gentamicin, cefocime and ampicillin/sulbatan. Among the isolates from patients, the highest resistance was to ampicillin (55.97%), followed by that to tetracycline (49.25%), ampicillin/sulbatan (44.03%), nalidixic acid (41.04%) and cefazolin (37.31%), and 20.90%-30.60% strains were resistant to chloramphenicol, ciprofloxacin, gentamicin, cefotaxime and ampicillin/sulbatan. There were 25.00% isolates from food and 25.37% isolates from patients resistant to at least 6 antibiotics, and the main multi-resistant pattern was ampicillin-tetracyline-nalidixic-cephalosporin antibiotics (partial). Conclusions There were many kinds of serotypes of food-borne Salmonella in Guizhou Province from 2016 to 2018 and the predominant types were Salmonella Typhimurium, Salmonella Enteritidis and Salmonella London. Drug resistance was common in the strars and some multidrug resistant strains were detected.