Objective:To investigate the effect of cancer nodules on postoperative liver metastasis in patients undergoing radical resection of colorectal cancer.Methods:The clinicopathological data of 196 patients undergoing radical operation for colorectal cancer admitted to the Dongnan Hospital of Xiamen University from January 2019 to June 2020 were retrospectively analyzed. According to the pathological results, they were divided into cancer nodule group and non-cancer nodule group. Time and the number of liver metastasis during the follow-up period were analyzed. The relationship between cancer nodules and clinicopathological features was analyzed, and the influencing factors of postoperative liver metastasis in patients with colorectal cancer were analyzed by univariate and logistic multivaiate analysis. The receiver operator characteristic (ROC) curve was drawn to analyze the predictive effect of cancer nodule diameter on postoperative liver metastasis of colorectal cancer.Results:There were 50 patients accompanied by cancer nodules in 196 patients with colorectal cancer, the incidence rate was 25.5%, the diameter of cancer nodules was 0.4-1.8 cm, the median diameter was 1.0 cm, and there were 46 patients with liver metastasis, the incidence rate was 23.5%. There were statistically significant differences in carbohydrate antigen CA19-9 ( χ2=7.55, P=0.006), maximum tumor diameter ( χ2=12.23, P<0.001), T stage ( χ2=15.79, P<0.001), vascular thrombus ( χ2=12.79, P<0.001), lymph node metastasis ( χ2=16.18, P<0.001) between the cancer nodule group and the non-cancer nodule group. Univariate analysis showed that CA19-9 ( χ2=7.40, P=0.007), maximum tumor diameter ( χ2=8.23, P=0.004), T stage ( χ2=4.58, P=0.032), vascular cancer thrombus ( χ2=12.97, P<0.001), lymph node metastasis ( χ2=3.96, P=0.047), cancer nodules ( χ2=67.60, P<0.001), cancer nodule diameter ( t=4.28, P<0.001), and the number of cancer nodules ( χ2=68.77, P<0.001) were all influential factors for postoperative liver metastasis in colorectal cancer patients. Multivariate analysis showed that stage T 3-4 ( OR=4.62, 95% CI: 1.51-7.35, P=0.003), vascular cancer thrombus ( OR=5.42, 95% CI: 1.75-12.85, P<0.001), accompanied by cancer nodules ( OR=18.54, 95% CI: 7.45-39.73, P<0.001), the diameter of cancer nodules ( OR=13.20, 95% CI: 4.74-29.64, P<0.001), number of nodules [one cancer nodule ( OR=9.11, 95% CI: 2.24-27.34, P<0.001), two cancer nodules ( OR=6.36, 95% CI: 1.38-9.08, P<0.001) and three cancer nodules ( OR=5.00, 95% CI: 1.98-8.84, P<0.001) ] were independent influencing factors for postoperative liver metastasis in patients with colorectal cancer. ROC curve analysis showed that the best threshold of the diameter of cancer nodules for predicting liver metastasis was 1.1 cm [area under the curve (AUC) =0.764, 95% CI: 0.632-0.896, P=0.002). The incidence of liver metastasis in patients with cancer nodules diameter≥1.1 cm was 95.65% (22/23), higher than that in patients with cancer nodules diameter<1.1 cm (40.74%, 11/27), with a statistically significant difference ( χ2=16.69, P<0.001) . Conclusion:Patients with colorectal cancer with cancer nodules≥1.1 cm in diameter should be vigilant against postoperative liver metastasis.

OBJECTIVE To compare the consistency between the semi-quantitative detection of HPV E6/E7 mRNA and the detection of p16 IHC and E6/E7RNA ISH in the tissues,and the feasibility of detecting high-risk HPV in head and neck mucosal lesions by HPV E6/E7 mRNA detection in the swabs was discussed.METHODS A total of 100 cases of head and neck mucosal lesions treated by the Department of Head and Neck Surgery,Beijing Tongren Hospital Affiliated to Capital Medical University from September 2022 to August 2023 were collected.Semi-quantitative detection of HPV E6/E7 mRNA was performed in oropharynx,lesion surface swab and lesion tissue specimen,and p16 immunohistochemical staining(IHC)and E6/E7 mRNA in situ hybridization(ISH)were detected in lesion tissue,and the consistency and difference of different detection results were studied.RESULTS Among the 100 patients,83 met the inclusion criteria and were divided into 21 papilloma cases,10 polyps/chronic inflammation cases,19 laryngeal cancer cases,13 oropharyngeal cancer cases,and 20 hypopharyngeal cancer cases according to pathological diagnosis.The HPV E6/E7 mRNA semi-quantitative results of oropharyngeal swab and lesion surface swab showed moderate or near high consistency with p16 IHC results.The results of HPV E6/E7 mRNA semi-quantitative in diseased tissue were highly consistent with those of p16 IHC(Kappa=0.780).In the diagnostic efficacy analysis,both swabs showed high consistency with HPV E6/E7 mRNA ISH(Kappa=0.690 and 0.708).CONCLUSION In the head and neck mucosal lesions,the HPV semi-quantitative detection results of oropharyngeal and lesion surface swab showed good consistency compared with classical p16 IHC and gold standard HPV E6/E7 mRNA ISH.It is a simple and reliable method for clinical high-risk HPV detection,which is helpful for the screening and individualized precise prevention and control of HPV infection in head and neck mucosal lesions.

Objective: The method of compositional data analysis was used to explore the relationship between 24 hour movement behavior and obesity indicators, and to examine the difference of quantitative effect on obesity indicators when one behavior replaced another behavior, so as to provide specific movement behavior advice for weight control in children and adolescents. Methods: In June 2021, 231 students from eight classes in a primary school and a middle school in Taiyuan City, Shanxi Province were voluntarily recruited by using random cluster sampling. ActiGraph GT3X+ accelerometer was used to measure 24 hour movement behavior and Inbody J20 body composition analyzer was used to measure body composition. The relationship between each component and obesity indicators was analyzed by compositional multivariate linear regression model. In addition, 30 minutes of one behavior was used to replace another behavior to predict the effect difference of the outcomes. Results: After adjusting for covariates such as height, weight, age, and sex, compared with time spent in sedentary behavior(SB), sleep (SLP) and light physical activity (LPA), time spent on moderate to vigorous physical activity (MVPA) was positively correlated with fat free mass index (FFMI) ( β= 0.40, P ＜0.05), negatively correlated with waist circumference (WC) ( β=-2.50, P ＜0.05) and waist hip ratio (WHR) ( β= -0.04 , P ＜0.05). Compared with SB, SLP and MVPA, time spent on LPA was positively correlated with WHR ( β=0.06, P < 0.05 ). If MVPA of 30 min/d replaces SLP, SB, and LPA respectively, WC and WHR decrease 1.10,1.10,1.34 cm and 0.02, 0.02 ,0.02 respectively, and FFMI increases 0.19,0.19,0.15 kg/m 2 respectively. Conclusion In 24 h movement behavior, with consistent level of sedentary behavior, sleep or low intensity movement behavior, maintaining a high level of MVPA and replacing sedentary with active activities are crucial for optimal abdominal fat and fat free mass in children and adolescents.

Urolithiasis is a common and complex disease of the urinary system, which can cause urinary tract blockage, urinary tract infection, and even damage to urinary system-related tissues. Although urolithiasis can be cured, its high recurrence rate and the development of chronic kidney disease in some patients have drawn the attention of nephrologists. Although the application of extracorporeal lithotripsy, percutaneous nephrolithotomy and other minimally invasive techniques have made the treatment of urolithiasis more efficient, pharmacotherapy plays an indispensable role in reducing their morbidity and recurrence rates. Traditional Chinese medicine (TCM) has been used for treatment and prevention of urolithiasis in developing countries for centuries, known for its unquestionable efficacy and safety. This article reviews the progress of clinical trials and pharmacological studies on the treatment of urolithiasis with Chinese herbal medicines (CHMs). The mechanism of CHMs in the treatment of urolithiasis mainly involve preventing further growth and aggregation of urolithiasis, reducing the PH of urine, promoting calculus dissolution. Furthermore, some CHMs can increase urine output, relax smooth muscles, and promote the removal of calculus. These findings provide new treatment strategies and options for urolithiasis and secondary kidney damage.

Exogenous lipoid pneumonia is an inflammatory response to the lungs caused by inhaled lipid substances, which is prone to secondary bacterial infection, resulting in the formation of local abscesses, which can be life-threatening in severe cases. This paper reports a case of a 55-year-old patient with diesel aspiration, secondary to Klebsiella pneumoniae (ESBL positive) and Candida glabrata infection resulting in lung abscess formation. He was treated with a variety of antibacterial drugs for anti-infection, non-invasive ventilator ventilation, bronchoalveolar lavage, glucocorticoids, phlegm and other medical treatments. Finally, he underwent middle lobectomy for improvement and was discharged from the hospital, and he recovered well with regular follow-up.

Exogenous lipoid pneumonia is an inflammatory response to the lungs caused by inhaled lipid substances, which is prone to secondary bacterial infection, resulting in the formation of local abscesses, which can be life-threatening in severe cases. This paper reports a case of a 55-year-old patient with diesel aspiration, secondary to Klebsiella pneumoniae (ESBL positive) and Candida glabrata infection resulting in lung abscess formation. He was treated with a variety of antibacterial drugs for anti-infection, non-invasive ventilator ventilation, bronchoalveolar lavage, glucocorticoids, phlegm and other medical treatments. Finally, he underwent middle lobectomy for improvement and was discharged from the hospital, and he recovered well with regular follow-up.

Background: Cardiopulmonary resuscitation (CPR) strategies in COVID-19 patients differ from those in patients suffering from cardiogenic cardiac arrest. During CPR, both healthcare and non-healthcare workers who provide resuscitation are at risk of infection. The Working Group for Expert Consensus on Prevention and Cardiopulmonary Resuscitation for Cardiac Arrest in COVID-19 has developed this Chinese Expert Consensus to guide clinical practice of CPR in COVID-19 patients. Main recommendations: 1) A medical team should be assigned to evaluate severe and critical COVID-19 for early monitoring of cardiac-arrest warning signs. 2) Psychological counseling and treatment are highly recommended, since sympathetic and vagal abnormalities induced by psychological stress from the COVID-19 pandemic can induce cardiac arrest. 3) Healthcare workers should wear personal protective equipment (PPE). 4) Mouth-to-mouth ventilation should be avoided on patients suspected of having or diagnosed with COVID-19. 5) Hands-only chest compression and mechanical chest compression are recommended. 6) Tracheal-intubation procedures should be optimized and tracheal-intubation strategies should be implemented early. 7) CPR should be provided for 20-30 min. 8) Various factors should be taken into consideration such as the interests of patients and family members, ethics, transmission risks, and laws and regulations governing infectious disease control. Changes in management: The following changes or modifications to CPR strategy in COVID-19 patients are proposed: 1) Healthcare workers should wear PPE. 2) Hands-only chest compression and mechanical chest compression can be implemented to reduce or avoid the spread of viruses by aerosols. 3) Both the benefits to patients and the risk of infection should be considered. 4) Hhealthcare workers should be fully aware of and trained in CPR strategies and procedures specifically for patients with COVID-19.

Objective: To explore the impact of non-ionic dimeric isotonic iodine contrast agent on rabbit kidneys using intravoxel incoherent motion (IVIM)-DWI and blood oxygen level-dependent (BOLD) imaging. Methods: Totally 25 male New Zealand rabbits were randomly equally divided into 5 groups (each n=5). IVIM-DWI and BOLD scanning and blood collection were performed in four experimental groups (1, 24, 48, 72 h group) 1, 24, 48,72 h after injection of iodixanol, respectively, also in base-line group after injection of equal amount of saline. The rabbits were killed immediately after MRI,and the kidneys were taken for histopathological analysis. Results: Compared with base-line group, both cortex and medulla of kidneys showed decreased ADC, D and f values and the lowest D* value, as well as increased R2* in 1 h group. The lowest ADC, D and f values, the highest R2* and increased D* value of both cortex and medulla were observed in 24 h group. In 72 h group, R2* value of both cortex and medulla were still lower than baseline (all P<0.05), and D* value basically returned to baseline, while f and D values of medulla were still statistically different with respect to baseline (all P<0.05). Meanwhile, different degrees of glomerular and tubular damage were observed in the pathological sections. The serum creatinine and blood urea nitrogen in 48 h group and 72 h group were higher than those in base-line group (all P<0.05). The expression of hypoxia inducible factor-1α and heme oxygenase-1 increased in 1 h group and up to peak in 24 h group. Conclusion: Combining IVIM-DWI with BOLD can effectively evaluate rabbit renal pathophysiologic changes associated with contrast-induced acute kidney injury.

As a promising candidate seed cell type in regenerative medicine, mesenchymal stem cells (MSCs) have attracted considerable attention. The unique capacity of MSCs to exert a regulatory effect on immunity in an autologous/allergenic manner makes them an attractive therapeutic cell type for immune disorders. In this review, we discussed the current knowledge of and advances in MSCs, including its basic biological properties, i.e., multilineage differentiation, secretome, and immunomodulation. Specifically, on the basis of our previous work, we proposed three new concepts of MSCs, i.e., "subtotipotent stem cell" hypothesis, MSC system, and "Yin and Yang" balance of MSC regulation, which may bring new insights into our understanding of MSCs. Furthermore, we analyzed data from the Clinical Trials database ( http://clinicaltrials.gov ) on registered clinical trials using MSCs to treat a variety of immune diseases, such as graft-versus-host disease, systemic lupus erythematosus, and multiple sclerosis. In addition, we highlighted MSC clinical trials in China and discussed the challenges and future directions in the field of MSC clinical application.
Cell Differentiation ; Humans ; Immune System Diseases ; immunology ; Mesenchymal Stem Cell Transplantation ; Mesenchymal Stem Cells ; immunology ; physiology ; Randomized Controlled Trials as Topic ; Regenerative Medicine

OBJECTIVE: To examine the potential of intravoxel incoherent motion (IVIM) and blood oxygen level-dependent (BOLD) magnetic resonance imaging for detecting renal changes after iodinated contrast-induced acute kidney injury (CI-AKI) development in a diabetic rabbit model. MATERIALS AND METHODS: Sixty-two rabbits were randomized into 2 groups: diabetic rabbits with the contrast agent (DCA) and healthy rabbits with the contrast agent (NCA). In each group, 6 rabbits underwent IVIM and BOLD imaging at 1 hour, 1 day, 2 days, 3 days, and 4 days after an iohexol injection while 5 rabbits were selected to undergo blood and histological examinations at these specific time points. Iohexol was administrated at a dose of 2.5 g I/kg of body weight. Further, the apparent transverse relaxation rate (R2*), average pure molecular diffusion coefficient (D), pseudo-diffusion coefficient (D*), and perfusion fraction (f) were calculated. RESULTS: The D and f values of the renal cortex (CO) and outer medulla (OM) were significantly decreased compared to baseline values in the 2 groups 1 day after the iohexol injection (p < 0.05). A marked reduction in the D* values for both the CO and OM was also observed after 1 hour in each group (p < 0.05). In the OM, a persistent elevation of the R2* was detected for 4 days in the DCA group (p < 0.05). Histopathological changes were prominent, and the pathological features of CI-AKI aggravated in the DCA group until day 4. The D, f, and R2* values significantly correlated with the histological damage scores, hypoxia-inducible transcription factor-1α expression scores, and serum creatinine levels. CONCLUSION: A combination of IVIM and BOLD imaging may serve as a noninvasive method for detecting and monitoring CI-AKI in the early stages in the diabetic kidney.
Acute Kidney Injury ; Body Weight ; Creatinine ; Diffusion ; Iohexol ; Kidney ; Magnetic Resonance Imaging ; Methods ; Oxygen ; Perfusion ; Rabbits ; Relaxation ; Vascular Endothelial Growth Factor A