Purpose To explore the application and clini-cal significance of molecular detection in cell block specimens of lung adenocarcinoma.Methods A total of 200 cell block spec-imens of lung adenocarcinoma were collected.Among them 49 specimens underwent multi-gene panel detection(including EG-FR,EML4-ALK,ROS1,KRAS,HER2,BRAF,RET,MET,NRAS,and PIK3CA),while 151 specimens underwent EGFR single-gene detection.In addition,97 specimens were tested for EML4-ALK fusion gene alterations using the Ventana method,and the results were compared with that by PCR detection.The mutation characteristics were summarized,and the cytological features of the mutations and fusions were observed.Results The positive rate of driver gene mutations in 49 cases of multi-gene panel detection was 65.31％,which indicated no statisti-cally significant difference from that of 99 lung adenocarcinoma tissue specimens(P＞0.05).The positive rates of ALK,ROS1,and RET fusion mutations were 4.08％,4.08％,and 2.04％,respectively,and the positive rates of EGFR,KRAS,HER2,MET,and BRAF mutations were 38.78％,6.12％,4.08％,4.08％,and 2.04％,respectively.The mutation rate of EGFR in 151 cases of single-gene detection was 54.97％,with a mutation rate of 42.86％in males and 67.57％in fe-males,showing a statistically significant difference between gen-ders(P＜0.05).Exon 19 deletion mutation(19-Del)and exon 21 point mutation(21-L858R)in the EGFR gene took the high-est proportions,accounting for 54.22％and 37.35％,respec-tively,significantly higher than other mutation types(P＜0.001).The positive rate of EML4-ALK fusion gene immuno-histochemistry(IHC)in 97 cytological paraffin-embedded speci-mens was 15.46％,among which 6 cases with weak positivity(+)showed negative results in molecular detection,and 9 ca-ses with diffuse positivity(+++)showed positive results in molec-ular detection.The results of immunohistochemistry were highly consistent with molecular detection in cases with diffuse strong positivity(Kappa=1).It was found from the cytological mor-phology of cases with gene alterations that KARS mutation carri-ers were born with unique characteristics,with tumor cells scat-tered or arranged in small clusters and more cytoplasmic vacu-oles were commonly seen.Conclusion Molecular detection in cytological specimens of lung adenocarcinoma is feasible with higher sensitivity.Multi-gene panel detection is superior to sin-gle-gene detection.Immunohistochemistry can be used for screening EML4-ALK fusion gene,and lung adenocarcinoma with KRAS mutation that exhibits distinct cytological morpholo-gy.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Type B insulin resistance syndrome(TBIR)is a rare autoimmune disease caused by the presence of autoantibodies against insulin receptors in the human body,leading to severe refractory hyperglycemia or refractory hypoglycemia.This article reports a case of TBIR patient,summarizes and analyzes its epidemiological characteristics and diagnosis and treatment methods,providing a basis for clinical treatment.

Implantable drug delivery systems,as an emerging therapeutic approach,markedly amplify drug efficacy while mitigating drug toxicity and adverse effects,presenting an innovative avenue for postoperative tumor management.This review delineates pivotal triggers for postoperative tumor recurrence and their respective treatment modalities.Moreover,it comprehensively delves into recent strides in research and development of implantable drug delivery systems following anti-tumor surgery,encompassing implantable such drug delivery platforms as casting implants,electrospinning implants and hydrogel implants.The evolution of anti-tumor postoperative implantable drug delivery systems signifies a promising realm of research,poised to furnish more effective,tailored treatment modalities for cancer patients,heralding a beacon of fresh prospects in their rehabilitation.

【Objective】 To evaluate the quality of suspended red blood cells (SRBC) under low-pressure and hypoxic conditions, in order to lay a theoretical foundation for airline delivery, air drop and storage of SRBC on plateau. 【Methods】 The low-pressure and hypoxic conditions (0.026 MPa and 0.047 MPa) were simulated by a pressure control device. SRBC were divided into 3 groups (5 bags/group, 1.5 U/bag). Each group was stored in 0.026 MPa environment at 2℃-6℃ for 24 hours (named 0.026 MPa), in 0.047MPa environment at 2℃-6℃ for 7 days (named 0.047 MPa), and in a blood storage refrigerator at 4℃ (named the control), respectively. The storage cell characteristics were examined on day 2, 9, 14, 28 and 35. 【Results】 We found that HCT, MCV, K⁺, Na⁺, FHb, hemolytic ratio, 2, 3-DPG and rheological properties in group 0.026 MPa and 0.047 MPa were not significant different compared with that in control (P>0.05). The consumptions of Glu in group 0.026 MPa and 0.047 MPa were significantly higher (P<0.05), and a transient increase in LAC concentration of group 0.026 MPa and 0.047MPa were observed, compared to the control. 【Conclusion】 The conditions of low-pressure and hypoxia have no significant effect on the quality of suspended red blood cells.

Objective:To study the effects of rolling blood pump parameters and blood concentration on hemolysis during extracorporeal circulation.Methods:According to the extracorporeal hemolysis experiment standard, an extracorporeal circulation experimental device was built to analyze the influences of circulation time (0 ~ 90 min), blood flow rate (1~4 L/min), and blood volume fraction (60%, 70%) on the hemolysis of blood samples in the circulatory system. The results of hemolysis were analyzed using first-order linear regression.Results:The longer the blood pump circulation time, the greater the hemolysis rate; the higher the blood flow rate, the greater the hemolysis rate. When the flow rate is 1 and 2 L/min, the hemolysis rate curve has an inflection point that changes with time, i.e. when the circulation time exceeds 30 min, the slope of the hemolysis rate curve suddenly increases. However, when the flow rate is 3 and 4 L/min, the hemolysis mutation phenomenon is not obvious. Compared to the blood sample with blood volume fraction of 70%, a blood sample with a blood volume fraction of 60% is less prone to hemolysis.Conclusions:The longer the blood pump circulation time and the higher the blood flow rate, the more easily the red blood cells are destroyed, i.e. the hemolysis rate is directly proportional to the circulation time and blood flow rate. When the circulation time increases to a certain degree, an inflection point appears in the hemolysis rate curve, and the hemolysis trend will be significantly enhanced.

Objective:To study whether curcumin inhibits the proliferation and promotes the apoptosis of nephroblastoma through activating the miR-192-5p/PI3K/Akt signaling pathway.Methods:CCK-8 assay was used to investigate the effects of curcumin on the proliferation of nephroblastoma SK-NEP-1 cells and the appropriate concentration. The apoptosis rate of SK-NEP-1 cells was detected by V-FITC/PI. Luciferase reporter assay was used to verify the binding activity between miR-192-5p and PI3K. RT-PCR was performed to detect the expression of miR-192-5p at mRNA level. Western blot was used to detect the expression of PI3K and Akt at protein level.Results:Curcumin could significantly inhibit the proliferation of SK-NEP-1 cells and induce cell apoptosis in a dose-dependent manner. RT-PCR results showed that curcumin could significantly increase the expression of miR-192-5p. In addition, miR-192-5p significantly inhibited cell proliferation, induced cell apoptosis, and enhanced the effects of curcumin on the proliferation and apoptosis of SK-NEP-1 cells. Luciferase reporter assay suggested that miR-192-5p could bind to PI3K. Western blot results showed that curcumin down-regulated the expression of PI3K and Akt at protein level by mediating the expression of miR-192-5p.Conclusions:Curcumin could inhibit the proliferation and induce the apoptosis of nephroblastoma cells through mediating the expression of miR-192-5p and further inhibiting the downstream PI3K/Akt signaling pathway.

Objective: To explore the effect of ambient fine particulate matters (PM_2.5) and temperature interaction on schizophrenia admission. Methods: All admission data were retrieved from the Psychiatric Hospital and Municipal Hospital of TongLing from January 1, 2014 to December 31, 2017. Daily air pollution and meteorological data were collected from the Tongling Environmental Protection Agency and Meteorological Bureau, respectively. A distributed lag non-linear model combined with the generalized additive model were applied to explore the effects of PM_2.5, multi-pollutants, and the interaction between temperature and PM_2.5 on schizophrenia admission. The stratification of temperature was divided by three criteria. The low temperature layer was defined as <P₅ or <P₁₀ or <P₂₀; P₅-P₉₅ or P₁₀-P₉₀ or P₂₀-P₈₀ was defined as the middle temperature layer; >P₉₅ or >P₉₀ or >P₈₀ was defined as the high temperature layer. Results: From 2014 to 2017, 6 642 patients were admitted for schizophrenia in Tongling, and the median of PM_2.5 and temperature were 47.0 μg/m³ and 17.5 ℃, respectively. The median concentration of PM_2.5 (P₅₀) was taken as a reference. When the exposure concentration of PM_2.5 was P₉₀, the lagged effect appeared in the first day with RR=1.03 (95%CI: 1.00-1.07) and reached the maximum in the fifth day with RR=1.16 (95%CI: 1.13-1.19). In the multi-pollutant models, it was found that the simultaneous inclusion of PM_2.5 and NO₂ had higher risk of schizophrenia admission, with the RR=1.18 (95%CI: 1.15-1.22), P<0.001. The risk of schizophrenia admission caused by PM_2.5 exposure at high temperature was greatest under the three temperature stratification standards, which were 12.1% (8.5%-15.7%), 9.7% (6.9%-12.6%) and 17.1% (11.6%-22.8%), all P values <0.001. Conclusion With the increase of PM_2.5 concentration, the risk of schizophrenia admission is increased, and the risk effect of PM_2.5 is stronger at high temperature.

Objective To obsOrvO thO diffOrOnt manifOstations and diffOrOncOs of pOlvic laparoscopy in primary and sOcondary infOrtility patiOnts, and to clarify thO application of hystOroscopy combinOd with laparoscopy in thO diag-nosis and trOatmOnt of infOrtility.Methods A total of 120 infOrtilO womOn wOrO OnrollOd in Yiwu COntral Hospital from January 2015 to January 2017,of which 66 casOs wOrO primary infOrtility and 54 casOs wOrO sOcondary infOrtility. ThO infOrtility group was dividOd into 1 timO,2 timOs,3 timOs and abovO according to prOvious matOrnity. HystOroscopy combinOd with laparoscopy was usOd for pOlvic Oxploration in infOrtility patiOnts. ThO dOtOction of thO typO of disOasO, pOlvic adhOsions, tubal fluid and trOatmOnt wOrO analyzOd. Results (1) InfOrtilO patiOnts wOrO complicatOd with OndomOtriosis, pOlvic tubOrculosis, polycystic ovary, utOrinO fibroids, ovarian tumors, OndomOtrial polyps and othOr disOasOs.(2)ThOrO wOrO 94 casOs of pOlvic adhOsions(78.3% ),50 casOs of primary infOrtility(75.8% ),and 44 casOs in SOcondary infOrtility group(81.5% ).(3) Primary infOrtility adhOsion ratio of 75.8% ,sOcondary infOrtility adhO-sion ratio of 81.5% , thO proportion of adhOsions in matOrnal 1 timO patiOnts was 80.6% ,thO proportion of adhOsions in prOgnant womOn with 2 timOs was 83.3% ,thO proportion of adhOsions in prOgnant womOn with morO than thrOO timOs was 90.0% , and thO mOdian adhOsion ratO was 36.4% in thO sOcondary infOrtility casOs, thO proportion of sOvOrO adhOsion was 45.5%.(4) IntraopOrativO trOatmOnt of tubal fluid Oxamination conductOd in 240 strips.ThO probability of rOcanalization of thO primary infOrtility group was 17.78% ,and thO probability of rOcanalization was 18.75%.Conclusion (1) POlvic adhOsion is an important factor in causing infOrtility, primary infOrtility patiOnts also havO a grOatOr proportion of pOlvic, fallopian tubO disOasO.(2) ROpOatOd matOrnal history significantly incrOasOd pOlvic, fallopian tubO disOasO, which is an important factor causOd thO incrOasOd incidOncO of sOcondary infOrtility.

Tooth development is a complex process that involves precise and time-dependent orchestration of multiple genetic, molecular, and cellular interactions. Ameloblastin (AMBN, also named "amelin" or "sheathlin") is the second most abundant enamel matrix protein known to have a key role in amelogenesis. Amelogenesis imperfecta (AI [MIM: 104500]) refers to a genetically and phenotypically heterogeneous group of conditions characterized by inherited developmental enamel defects. The hereditary dentin disorders comprise a variety of autosomal-dominant genetic symptoms characterized by abnormal dentin structure affecting either the primary or both the primary and secondary teeth. The vital role of Ambn in amelogenesis has been confirmed experimentally using mouse models. Only two cases have been reported of mutations of AMBN associated with non-syndromic human AI. However, no AMBN missense mutations have been reported to be associated with both human AI and dentin disorders. We recruited one kindred with autosomal-dominant amelogenesis imperfecta (ADAI) and dentinogenesis imperfecta/dysplasia characterized by generalized severe enamel and dentin defects. Whole exome sequencing of the proband identified a novel heterozygous C-T point mutation at nucleotide position 1069 of the AMBN gene, causing a Pro to Ser mutation at the conserved amino acid position 357 of the protein. Exfoliated third molar teeth from the affected family members were found to have enamel and dentin of lower mineral density than control teeth, with thinner and easily fractured enamel, short and thick roots, and pulp obliteration. This study demonstrates, for the first time, that an AMBN missense mutation causes non-syndromic human AI and dentin disorders.
Adult ; Amelogenesis Imperfecta ; genetics ; Cells, Cultured ; China ; Codon ; Dentin ; abnormalities ; ultrastructure ; Female ; Humans ; Male ; Microsatellite Repeats ; Microscopy, Electron, Scanning ; Middle Aged ; Mutation, Missense ; Pedigree ; RNA ; analysis ; Transfection ; Whole Exome Sequencing