Circular RNAs (circRNAs) are a kind of non-coding RNA (ncRNA) with covalent closed-loop structure. They have attracted more and more attention because of their high stability, evolutionary conservatism, and tissue expression specificity. It has shown that circRNAs are involved in the development of a variety of diseases including malignant tumors recently. Nasopharyngeal carcinoma (NPC) is a malignant tumor that occurs in the nasopharynx and has a unique ethnic and geographical distribution in South China and Southeast Asia. Epstein-Barr virus (EBV) infection is closely related to the development of NPC. Radiotherapy and chemotherapy are the mainstays of treatment for NPC. But tumor recurrence or distant metastasis is the leading cause of death in patients with NPC. Several studies have shown that circRNAs, as gene expression regulators, play an important role in NPC and affect the progression of NPC. This review mainly summarized the research status of abnormally expressed circRNAs in NPC and EBV-encoded circRNAs. We also discussed the possibility of circRNAs as a therapeutic target, diagnostic and prognostic marker for NPC.

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.

Objective:To study the reversal effect of NVP-BEZ235 on doxorubicin resistance in Burkitt lymphoma RAJI cell line.Methods:The doxorubicin-resistant cell line was induced by treating RAJI cells with a concentration gradient of doxorubicin.The levels of Pgp,p-AKT,and p-mTOR in cells were detected by Western blot.Cell viability was detected by MTT assay.IC50 was computed by SPSS.Results:The doxorubicin-resistant Burkitt lymphoma cell line,RAJI/DOX,was established successfully.The expression of Pgp and the phosphorylation levels of AKT and mTOR in RAJI/DOX cell line were both higher than those in RAJI cell line.NVP-BEZ235 downregulated the phosphorylation levels of AKT and mTOR in RAJI/DOX cell line.NVP-BEZ235 inhibited the proliferation of RAJI/DOX cell line,and the effect was obvious when it was cooperated with doxorubicin.Conclusion:The constitutive activation of PI3K/AKT/mTOR pathway of RAJI/DOX cell line was more serious than RAJI cell line.NVP-BEZ235 reversed doxorubicin resistance of RAJI/DOX cell line by inhibiting the PI3K/AKT/mTOR signal pathway.

Objective: To investigate the efficacy and safety of a new cervical artificial disc prosthesis in the treatment of cervical degenerative diseases. Methods: The clinical data of 18 patients with single-level cervical degenerative diseases who underwent three dimensional printed anatomical bionic cervical disc replacement at Department of Spinal Surgery,Honghui Hospital,Xi'an Jiaotong University from May 2019 to July 2020 were analyzed retrospectively. There were 7 males and 11 females,aged (45±8) years old(range:28 to 58 years).The surgical segment was located at C_3－4 level in 2 cases, C_4－5 level in 5 cases, C_5－6 level in 9 cases, and C_6－7 level in 2 cases.The clinical and radiographic outcomes were recorded and compared at preoperative,postoperative times of one month and twelve months.The clinical assessments contained Japanese orthopedic association (JOA) score,neck disability index (NDI) and visual analogue scale (VAS).Imaging assessments included range of motion (ROM) of cervical spine, prosthesis subsidence and prosthesis anteroposterior migration.Repeated measurement variance analysis was used for comparison between groups,and paired t test was used for pairwise comparison. Results: All patients underwent the operation successfully and were followed up for more than 12 months.Compared with preoperative score,the JOA score,NDI and VAS were significantly improved after surgery (all P<0.01).There was no significant difference in postoperative ROM compared with 1-and 12-month preoperative ROM (t=1.570,P=0.135;t=1.744,P=0.099). The prosthesis subsidence was (0.29±0.13) mm (range: 0.18 to 0.50 mm) at 12-month postoperatively.The migration of prosthesis at 12-months postoperatively were (0.71±0.20) mm (range: 0.44 to 1.08 mm).There was no prosthesis subsidence or migration>2 mm at 12-month postoperatively. Conclusion: Three dimensional printed anatomical biomimetic cervical artificial disc replacement has a good early clinical effect in the treatment of cervical degenerative diseases, good mobility can be obtained while maintaining stability.
Adult ; Biomimetics ; Cervical Vertebrae/surgery* ; Female ; Follow-Up Studies ; Humans ; Intervertebral Disc/surgery* ; Intervertebral Disc Degeneration/surgery* ; Male ; Middle Aged ; Range of Motion, Articular ; Retrospective Studies ; Total Disc Replacement/methods* ; Treatment Outcome

AIM:To investigate the efficacy and safety of pars plana vitrectomy(PPV)combined with inverted internal limiting membrane(ILM)flap and PPV combined with ILM tamping in the treatment of large basal diameter idiopathic macular hole(IMH), and to analyze the correlation between postoperative visual acuity and preoperative parameters.

METHODS:This study is a retrospective clinical study. Totally 56 patients(57 eyes)with macular hole bottom diameter greater than 1 000μm, who treated in Joint Shantou International Eye Center from January 2018 to December 2020, were enrolled in this study. Thirty eyes were involved in PPV combined with inverted ILM flap(Group 1)and 27 eyes were involved in PPV combined with ILM tamping(Group 2). The best corrected visual acuity(BCVA), the closure of the macular hole, thickness of foveal neurosensory layer and complications were compared between the two groups at 1wk and 1mo after the surgery. Person correlation analysis was used to explore the correlation between preoperative parameters and BCVA at 1mo after operation.

RESULTS: There was no significant difference in gender, age, eye type, course of disease, preoperative BCVA, postoperative macular hole healing classification, preoperative hole bottom diameter and eye axis between the two groups(P>0.05). The closure rate of macular hole in Group 1 was 97%, of which type 1 closure was 80%. The closure rate of macular hole in Group 2 was 100%, of which type 1 closure was 78%, and there was no significant difference in the closure rate(P=0.99). The postoperative follow-up BCVA of patients in both groups was better than that before operation(all P<0.01). The BCVA of Group 1 was better than Group 2 at 1mo after operation, and the difference was statistically significant(t= -2.20, P=0.03). There was no significant difference in the thickness of foveal neurosensory layer between two groups at 1mo after operation(t=0.407, P=0.69). The BCVA at 1mo after operation was positively correlated with the hole diameter and preoperative BCVA(r=0.435, P=0.004; r=0.440, P=0.001). There was no complication in both groups during and after operation.

CONCLUSION:PPV combined with inverted ILM flap and PPV combined with ILM tamping can improve the closure rate of the hole. The long-term visual acuity of PPV combined with inverted ILM flap is better than that of PPV combined with ILM tamping. There is a significant positive correlation between postoperative BCVA and the bottom diameter of the hole and preoperative BCVA. Preoperative bottom diameter can be used as one of the basis for clinical prognosis.

Objective:To explore the correlation between the efficacy of Usnea diffracta in treating atherosclerosis （AS） and the altered microbial flora in rat ileum based on the interior-exterior relationship between heart and small intestine in traditional Chinese medicine （TCM）. Method:Forty-eight SD rats were randomized into a normal group （n=8） and a modeling group （n=40）. The AS model was established with high-fat diet combined with intraperitoneal injection of vitamin D₃. The successfully modeled rats were further randomly divided into the model group， positive control （simvastatin， 4 mg·kg^-1） group， and low- （0.7 g·kg^-1）， medium- （1.4 g·kg^-1）， and high-dose （2.8 g·kg^-1） U. diffracta ethanol extract groups， with eight rats in each group. After four weeks of intervention， the blood， aorta， ileum， and ileum content of rats in each group were collected. The levels of serum lipopolysaccharide （LPS）， tumor necrosis factor-α （TNF-α） and interleukin 6 （IL-6） were measured by enzyme-linked immunosorbent assay （ELISA）， and the pathological changes in rat thoracic aorta was detected by hematoxylin-eosin （HE） staining. Western blot was conducted to determine the protein expression levels of tight junction protein zonula occluden （ZO-1） and Occludin in rat ileum， and the high-throughput 16S rRNA sequencing technology was employed to detect changes in microbial diversity and abundance in rat ileum of each group. Result:Compared with the normal group， the model group exhibited obvious aortic plaque deposition， increased LPS， TNF-α， and IL-6 levels （P<0.01）， but decreased ZO-1 and Occludin protein expression （P<0.01）. The comparison with the model group revealed that U. diffracta significantly ameliorated the aortic plaque deposition of model rats， lowered serum LPS， TNF-α， and IL-6 levels （P<0.05， P<0.01）， and up-regulated ZO-1 and Occludin protein expression （P<0.05， P<0.01）. The abundance of Proteobacteria and Bacteroidetes in the model group changed significantly in contrast to that in the normal group， and the Bacteroidetes/Firmicutes（B/F） value declined （P<0.05）. Alpha and Beta diversity analysis indicated higher total number of intestinal flora species in the model group， but lower richness and uneven distribution （P<0.05， P<0.01）， with a large number of pathogenic bacteria enriched. The ethanol extract of U. diffracta significantly increased the B/F value， corrected the structural disorder of microbial flora in ileum， reduced pathogenic bacteria， and increased the relative abundance of probiotics. Conclusion:U. diffracta exerts the therapeutic effect against AS possibly by improving the intestinal microbial communities， strengthening the intestinal mucosal barrier function， and reducing the serum LPS and inflammatory factors.

OBJECTIVE: To summarize the experiences and outcomes of 108 robot-assisted laparoscopic upper urinary tract reconstruction surgeries conducted by a single surgeon. METHODS: We consecutively and retrospectively reviewed 108 patients who underwent robot-assisted laparoscopic upper urinary tract reconstruction surgeries by a single surgeon from November 2018 to January 2020. The patient demographics, perioperative variables, postoperative complications and follow-up data were recorded. Fifty-three modified dismembered pyeloplasties (MDP), 11 spiral flap pyeloplasties (SFP), 11 ure-teroureterostomies (UUT), 4 lingual mucosal onlay graft ureteroplasties (LMU), 5 appendiceal onlay flap ureteroplasties (AU), 11 ureteral reimplantations (UR), 6 Boari flap-Psoas hitch surgeries (BPS) and 7 ileal ureter replacements (IUR) were enrolled finally. The success was defined as the improvement in subjective pain levels, and the improvement in the degree of hydronephrosis at ultrasound. RESULTS: All the surgeries were successfully completed without open or laparoscopic conversion. The median operative time was 141 min (range: 74-368 min), median blood loss was 20 mL (range: 10-350 mL) and median hospital stay was 4 d (range: 3-19 d) in MDP group, with the success rate of 94.3%. The median operative time was 159 min (range: 110-222 min), median blood loss was 50 mL (range: 20-150 mL) and median hospital stay was 5 d (range: 3-8 d) in SFP group, with the success rate of 100%. The median operative time was 126 min (range: 76-160 d), median blood loss was 20 mL (range: 10-50 mL) and median hospital stay was 5 d (range: 4-9 d) in UUT group, with the success rate of 100%. The median operative time was 204 min (range: 154-250 min), median blood loss was 30 mL (range: 10-100 mL) and median hospital stay was 6 d (range: 4-7 d) in LMU group, with the success rate of 100%. The median operative time was 164 min (range: 135-211 min), median blood loss was 75 mL (range: 50-200 mL) and median hospital stay was 8.5 d (range: 6-12 d) in AU group, with the success rate of 100%. The median operative time was 149 min (range: 100-218 min), median blood loss was 20 mL (range: 10-50 mL) and median hospital stay was 7 d (range: 5-10 d) in UR group, with the success rate of 90.9%. The median operative time was 166 min (range: 137-205 min), median blood loss was 45 mL (range: 20-100 mL) and median hospital stay was 5 d (range: 4-41 d) in BPS group, with the success rate of 83.3%. The median operative time was 270 min (range: 227-335 min), median blood loss was 100 mL (range: 10-100 mL) and median hospital stay was 7 d (range: 5-26 d) in IUR group, with the success rate of 85.7%. CONCLUSIONS The surgeon performed and modified numerous complicated upper urinary tract reconstruction surgeries by the robotic platform, which facilitated the development of the standardized upper urinary tract reconstruction surgical technique.
Humans ; Laparoscopy ; Retrospective Studies ; Robotic Surgical Procedures ; Surgeons ; Treatment Outcome ; Ureter

The clinical predictive factors for malignant testicular histology remain unclear because of the low prevalence. Therefore, the aim of this study was to investigate predictors of malignant histology for testicular masses and decide more testis-sparing surgeries before surgery. This retrospective study enrolled 325 consecutive testicular mass patients who underwent radical orchiectomy (310/325) or testicular preserving surgery (15/325) from January 2001 to June 2016. The clinicopathological factors, including tumor diameter, cryptorchidism history, ultrasound findings, serum alpha-fetoprotein, and human chorionic gonadotropin (HCG) levels, were collected retrospectively for statistical analysis. A predictive nomogram was also generated to evaluate the quantitative probability. Among all patients, 247 (76.0%) were diagnosed with a malignant testicular tumor and 78 (24.0%) with benign histology. Larger tumor diameter (per cm increased, hazard ratio [HR] = 1.284, P = 0.036), lower ultrasound echo (HR = 3.191, P = 0.001), higher ultrasound blood flow (HR = 3.320, P < 0.001), and abnormal blood HCG (HR = 10.550, P < 0.001) were significant predictive factors for malignant disease in all testicular mass patients. The nomogram generated was well calibrated for all predictions of malignant probability, and the accuracy of the model nomogram measured by Harrell's C statistic (C-index) was 0.92. According to our data, the proportion of patients who underwent radical orchiectomy for benign tumors (24.0%) was much larger than generally believed (10.0%). Our results indicated that the diameter, ultrasonic echo, ultrasonic blood flow, and serum HCG levels could predict the malignancy in testicular mass patients.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Biomarkers, Tumor/blood* ; Child ; Chorionic Gonadotropin/blood* ; Humans ; Male ; Middle Aged ; Orchiectomy ; Prognosis ; Retrospective Studies ; Testicular Neoplasms/surgery* ; Testis/pathology* ; Tumor Burden ; Ultrasonography ; Young Adult ; alpha-Fetoproteins/metabolism*

Objective To detect the SNR and geometric accuracy of MRI based on American College of Radiology (ACR)standards.Methods The SNR and geometric accuracy of Siemens Skyra 3.0T,Siemens Trio 3.0T and GE Excite HD 1.5T MRI were measured with ACR phantom,and the detection results were calculated according to the standards.Results The SNR values of Siemens Skyra 3.0T,Siemens Trio 3.0T and GE Excite HD 1.5T MRI were 589.98,438.50 and 277.12 respectively.Siemens Skyra 3.0T MRI had the values of geometric accuracy being-1.93％ at X direction,-3.20％ at Y direction and 0.68％ at Z direction,Siemens Trio 3.0T MRI had the value of geometric accuracy being-0.87％ at X direction,-2.33％ at Y direction and 1.49％ at Z direction,GE Excite HD 1.5T MRI had the values of geometric accuracy being 0.20％ at X direction,-1.53％ at Y direction and 1.69％ at Z direction.Conclusion The detection of the SNR and geometric accuracy of MRI can effectively guarantee the image quality.

OBJECTIVETo analyze the value of dynamic contrast-enhanced magnetic resonance imaging (CEMRI) for evaluating diffuse tumor infiltration of bone marrow in patients with acute leukemia (AL).

METHODSFrom January 2010 to February 2016, 80 AL patients admitted in our hospital were chosen as AL patient group, 100 healthy people were chosen as control group, and all subjects were diagnosed with MRI and CEMRI. The Emax and Slope of ilium and vertebra lumbalis were compared between AI patient and control groups. The relation of Emax and Slope with protocells % was analyzed.

RESULTSThe Emax and Slope of AL patients were significantly higher than those of control group (P<0.05). After treatment, the Emax and Slope of CR/PR patients decreased significantly (P<0.05). Multiple regression analysis showed that the protocells %=-0.5632+0.0540 Emax+0.0056 Slope. The Emax and Slope of AL patients had significant correlation with Protocells %(P<0.05).

CONCLUSIONThe results of CEMRI relate with pathological examination and treatment effect.