Objective To evaluate the regulatory effect of Diwu Yanggan(DWYG)Decoction on lysoglycerophospholipids(Lyso-GPLs)in circulating exosomes in a mouse model of nonalcoholic fatty liver disease(NAFLD).Methods Circulating exosomes isolated from mouse serum by size exclusion chromatography were morphologically characterized using transmission electron microscope and examined for surface markers CD9,CD63 and TSG101 using Western blotting.Twenty-four male Kunming mice were randomized into 3 groups for normal feeding(control,n=8)or high-fat diet feeding for 1 week to induce NAFLD,after which the latter mice were given DWYG decoction(treatment group,n=8)or normal saline(model group,n=8)by gavage for 4 weeks.After the last treatment,blood samples were collected from the mice for testing serum TC,HDL-C,LDL-C,ALT and AST levels and isolating circulating exosomes.Using multivariate statistical analysis based on targeted metabolomics strategy,the potential biomarkers for Lyso-GPLs in the exosomes were screened.Results The isolated exosomes about 100 nm in size had a typical saucer-like structure with distinct double-layer membranes and a mean particle size of 137.5 nm and expressed the specific surface marker proteins CD9,CD63 and TSG101.The mouse models of NAFLD had significantly increased serum levels of TC,HDL-C,LDL-C and AST and lowered serum ALT level.A total of 43 Lyso-GPLs with significant reduction after DWYG Decoction treatment were identified in NAFLD mice.Conclusion DWYG Decoction can regulate Lyso-GPLs in circulating exosomes in NAFLD mice,which provides a new clue for studying the therapeutic mechanism of DWYG Decoction for liver disease.

Objective:To investigate the clinical manifestations, endoscopic characteristics, and prognostic factors of patients with colorectal extranodal NK/T cell lymphoma.Methods:The clinical data of 52 patients with colorectal extranodal NK/T cell lymphoma admitted to the First Affiliated Hospital of Zhengzhou University from January 2013 to January 2023 were retrospectively analyzed. Their clinical manifestations and endoscopic characteristics were summarized, and the prognostic factors were analyzed by Cox regression model.Results:Among the 52 patients with colorectal extranodal NK/T cell lymphoma, there were 35 males and 17 females, with a male-to-female ratio of 2.06∶1. Among the general symptoms, abdominal pain was the most common (39 cases), and B symptoms occurred in 47 patients, among which fever was the most common lymphoma B symptom (42 cases), and gastrointestinal perforation was the most common complication (18 cases). Forty-three patients underwent colonoscopy, and the main manifestations under endoscopy were the ulceration type (24 cases). The ulcers were irregular at the edges and often covered with moss at the bottom. The median survival time was 4.3 months. Multivariate Cox regression analysis showed that hemocytic syndrome ( HR=8.50,95% CI: 1.679-8.328, P=0.001), serum albumin ( HR=3.59,95% CI: 1.017-6.551, P=0.048), and with or without chemotherapy ( HR=0.31, 95% CI: 0.246-1.061, P=0.025) were independent factors influencing the overall survival of patients with colorectal extranodal NK/T cell lymphoma. Conclusions:Colorectal extranodal NK/T cell lymphoma is a rare disease with a very poor prognosis. When patients present with abdominal pain and lymphoma B symptoms, and when ulcers with irregular edges and moss covering the bottom are found under endoscopy, the disease should be considered, and endoscopic biopsy should be taken in time for pathological diagnosis. The prognosis of patients with hemophagocytic syndrome and hypoproteinemia is poor. This disease should be treated with chemotherapy and surgery, and on this basis, hemophagocytic syndrome and hypoproteinemia should be treated to improve the prognosis of patients.

Objective To evaluate the regulatory effect of Diwu Yanggan(DWYG)Decoction on lysoglycerophospholipids(Lyso-GPLs)in circulating exosomes in a mouse model of nonalcoholic fatty liver disease(NAFLD).Methods Circulating exosomes isolated from mouse serum by size exclusion chromatography were morphologically characterized using transmission electron microscope and examined for surface markers CD9,CD63 and TSG101 using Western blotting.Twenty-four male Kunming mice were randomized into 3 groups for normal feeding(control,n=8)or high-fat diet feeding for 1 week to induce NAFLD,after which the latter mice were given DWYG decoction(treatment group,n=8)or normal saline(model group,n=8)by gavage for 4 weeks.After the last treatment,blood samples were collected from the mice for testing serum TC,HDL-C,LDL-C,ALT and AST levels and isolating circulating exosomes.Using multivariate statistical analysis based on targeted metabolomics strategy,the potential biomarkers for Lyso-GPLs in the exosomes were screened.Results The isolated exosomes about 100 nm in size had a typical saucer-like structure with distinct double-layer membranes and a mean particle size of 137.5 nm and expressed the specific surface marker proteins CD9,CD63 and TSG101.The mouse models of NAFLD had significantly increased serum levels of TC,HDL-C,LDL-C and AST and lowered serum ALT level.A total of 43 Lyso-GPLs with significant reduction after DWYG Decoction treatment were identified in NAFLD mice.Conclusion DWYG Decoction can regulate Lyso-GPLs in circulating exosomes in NAFLD mice,which provides a new clue for studying the therapeutic mechanism of DWYG Decoction for liver disease.

Objective:To investigate the clinical manifestations, endoscopic characteristics, and prognostic factors of patients with colorectal extranodal NK/T cell lymphoma.Methods:The clinical data of 52 patients with colorectal extranodal NK/T cell lymphoma admitted to the First Affiliated Hospital of Zhengzhou University from January 2013 to January 2023 were retrospectively analyzed. Their clinical manifestations and endoscopic characteristics were summarized, and the prognostic factors were analyzed by Cox regression model.Results:Among the 52 patients with colorectal extranodal NK/T cell lymphoma, there were 35 males and 17 females, with a male-to-female ratio of 2.06∶1. Among the general symptoms, abdominal pain was the most common (39 cases), and B symptoms occurred in 47 patients, among which fever was the most common lymphoma B symptom (42 cases), and gastrointestinal perforation was the most common complication (18 cases). Forty-three patients underwent colonoscopy, and the main manifestations under endoscopy were the ulceration type (24 cases). The ulcers were irregular at the edges and often covered with moss at the bottom. The median survival time was 4.3 months. Multivariate Cox regression analysis showed that hemocytic syndrome ( HR=8.50,95% CI: 1.679-8.328, P=0.001), serum albumin ( HR=3.59,95% CI: 1.017-6.551, P=0.048), and with or without chemotherapy ( HR=0.31, 95% CI: 0.246-1.061, P=0.025) were independent factors influencing the overall survival of patients with colorectal extranodal NK/T cell lymphoma. Conclusions:Colorectal extranodal NK/T cell lymphoma is a rare disease with a very poor prognosis. When patients present with abdominal pain and lymphoma B symptoms, and when ulcers with irregular edges and moss covering the bottom are found under endoscopy, the disease should be considered, and endoscopic biopsy should be taken in time for pathological diagnosis. The prognosis of patients with hemophagocytic syndrome and hypoproteinemia is poor. This disease should be treated with chemotherapy and surgery, and on this basis, hemophagocytic syndrome and hypoproteinemia should be treated to improve the prognosis of patients.

Objective:To explore the applications of deep inferior epigastric artery perforator (DIEP) flaps in the repair of scrotal avulsions and provide the reference for reconstructions of large soft tissue defects in the scrotum.Methods:The reconstructions of five cases in large scrotal skin and soft tissue avulsion injuries by DIEP flaps in Xijing Hospital, Air Force Medical University from October 2010 to December 2016 were retrospectively analyzed and summarized. The patients were 3 to 24 years old with an average age of 14.6. The defects of the scrotum and adjacent areas were ranged from 11 cm×6 cm to 25 cm×12 cm.Results:Blood supplies of all transferred flaps were good, and there was no serious complication observed, such as abdominal hernia, hematoma, and infection in the donor or recipient sites. Patients were followed up for 12 to 24 months. The scrotum’s appearances and functions in four cases were good, with a high patient satisfaction level. One case with swelling was obtained good results after a subsequent defatting procedure. The sensation of flaps partially recovered six months later.Conclusions:Thinned DIEP flaps provided sufficient tissue volumes for repairing large defects of the scrotal, which provided reliable blood flow and strong anti-infection capacity. The flap tissues could protect the scrotal contents. These advantages improved the patients’ satisfaction postoperatively. The thinned DIEP flap is a feasible choice to repair large defects of the scrotum.

Objective:To explore the applications of deep inferior epigastric artery perforator (DIEP) flaps in the repair of scrotal avulsions and provide the reference for reconstructions of large soft tissue defects in the scrotum.Methods:The reconstructions of five cases in large scrotal skin and soft tissue avulsion injuries by DIEP flaps in Xijing Hospital, Air Force Medical University from October 2010 to December 2016 were retrospectively analyzed and summarized. The patients were 3 to 24 years old with an average age of 14.6. The defects of the scrotum and adjacent areas were ranged from 11 cm×6 cm to 25 cm×12 cm.Results:Blood supplies of all transferred flaps were good, and there was no serious complication observed, such as abdominal hernia, hematoma, and infection in the donor or recipient sites. Patients were followed up for 12 to 24 months. The scrotum’s appearances and functions in four cases were good, with a high patient satisfaction level. One case with swelling was obtained good results after a subsequent defatting procedure. The sensation of flaps partially recovered six months later.Conclusions:Thinned DIEP flaps provided sufficient tissue volumes for repairing large defects of the scrotal, which provided reliable blood flow and strong anti-infection capacity. The flap tissues could protect the scrotal contents. These advantages improved the patients’ satisfaction postoperatively. The thinned DIEP flap is a feasible choice to repair large defects of the scrotum.

Purpose To explore the correlation between multi-slice spiral CT (MSCT) findings of pancreatic neuroendocrine tumor (pNET) and different histological grades,so as to improve the diagnostic accuracy.Materials and Methods MSCT data of 35 pathologically confirmed pNET were retrospectively analyzed.All patients underwent CT plain scan and three-phased contrast-enhanced CT scan.The imaging features and the enhanced parameters in each stage were analyzed.Results Among the 35 pNET,there were 15 G 1,15 G2 and 5 G3.There was no statistically significant difference in age,gender and endocrine function among different grades (P＞0.05).The number of lesions with intact capsule in G1,G2 and G3 was 11,5 and 0,respectively;the number of lesions with cystic change or necrosis was 3,9,and 4,respectively;and the number of lesions with sign of malignancy (locally invasion or metastasis) was 1,1 and 4,respectively.The differences in completeness of capsule,cystic change or necrosis and sign of malignancy among different grades were all statistically significant (P＜0.05).Multivariate analysis suggested that only peripancreatic tissue invasion or metastasis was significantly associated with pathological classification (OR=0.09,95％ CI 0.01-0.86,P＜0.05).The three-stage absolute enhanced degree and the enhanced percentage of pNET in different grades,as well as the relative enhanced degree between lesions in arterial phase and portal venous phase were all statistically significantly different (P＜0.05).Conclusion The MSCT findings of pNET with different pathological grades have certain characteristic.Peripancreatic tissue invasion or metastasis is associated with high-grade tumors,and CT features of different grades can contribute to the preoperative grading of pancreatic neuroendocrine tumors.

Objective:To examine the features of multislice spiral computed tomography (MSCT) in micropapillary-predominant lung adenocarcinomas to improve the understanding of this type of lung cancer. Methods:The MSCT features of 18 cases with micro-papillary-predominant lung adenocarcinoma (micropapillary component>50%) confirmed by histopathology were analyzed retrospec-tively. Results:Among the 18 cases of lung cancer, 1 was diffuse, 3 were central, and 14 were peripheral lung cancer (PLC). The size of the adenocarcinomas in the 14 PLC cases ranged from 1.3 cm to 8.5 cm, with an average of 3.56 cm, including the size of 8 cases greater than or equal to 3 cm. Among the 18 cases, 13 were lobulated, 9 showed spicule signs, 7 showed pleural indentation signs, 5 had pleural adhesions, 1 had bronchial truncation (i.e., cut-off sign), and 4 were surrounded by obstructive inflammation. In addition, calcifi-cation was observed in one case, uneven density in two large lesions, air bronchus sign in four, and solid and ground-glass mixed densi-ty in two. Among the total number of cases, a variety of the measurable enhanced CT values (ΔCT) of lesions were found in 16, ranging from 13 HU to 80 HU, with an average of 47.5 HU, of which 15 were cases ofΔCT≥15 HU and 15 were cases ofΔCT≥20 HU. Pleu-ral thickening was observed in two cases with pleural effusion, and pleural metastasis in one case was confirmed by histopathology. One case with pleural effusion suffering pleural metastasis was confirmed. Ground-glass density nodules in both lungs were observed in one case, with a few bilateral pleural and pericardial effusions. Eight cases had mediastinal or hilar enlarged lymph nodes with uneven density enhancement, and lymph node metastasis was pathologically confirmed in six cases. Lymph node metastasis was found in four cases, but no apparent enlargement of lymph nodes in MSCT was observed. Conclusion:Micropapillary-predominant lung adenocarci-nomas were common in non-smoking elderly female patients, whose lung cancer cases were mostly PLC. The typical features of PLC include lobulation, spicule, and pleural indentation signs. Solid density ranked first in the PLC cases, with evident enhancement and high rate of lymph node metastasis.

Objective To investigate the role of CT in the diagnois of superior vena cava syndrome secondary to pulmonary carcinoma. Method Fifty patients with pulmonary carcinoma resulting in SVCS were confirmed by pathological examinations. Relationship between anatomical distribution and gross type of pulmonary carcinoma and modes of pulmonary carcinoma resulting in SVCS were analyzed retrospectively and statistically. Correlation among obstructive degree of SVC, opening of collateral pathway and swelling of chest wall was analyzed retrospectively and statistically. Results For modes of pulmonary carcinoma resulting in SVCS, direct invasion of pulmonary carcinoma was 7 patients, metastasis of lymph node was 16 patients and both of the two was 27 patients.Modes of pulmonary carcinoma resulting in SVCS were different for different gross types of pulmonary carcinoma in different pulmonary lobes ( x2 = 30.012,P ＜ 0.05). On CT appearances of secondary lesions, cases of simple constitution and opening of collateral pathway, simple swelling of chest wall, both of the two and neither of the two were 14 patients, 12 cases, 15 patients and 9 patients in order on CT. With SVC obstruction at different extent,constitution and opening of collateral pathway and swelling of chest wall were different ( x2= 12.881, P ＜ 0.05).Conclusions SVCS resulted from pulmonary carcinoma can be diagnosed by contrast enhanced CT.

OBJECTIVE: To discuss the quality of reporting in randomized controlled trials (RCTs) of Chinese herbal medicine (CHM), and to provide suggestions for improving the reporting of future clinical studies in this therapeutic area. METHODS: A search of the Cochrane Library was conducted to identify RCTs of CHM. A revised CONSORT checklist designed for CHM clinical studies was implemented. The revised CONSORT checklist contained 63 items, including the following new items added specifically for CHM: (1) "syndrome of disease" based on Chinese medicine theories; (2) rationale of CHM formula; (3) formula composition; (4) preparation form of CHM; (5) quality control of CHM. RESULTS: The overall reporting quality of the RCTs as assessed with the revised CONSORT checklist varied between 19% and 44%, with a median score of 32% (standard deviation 8%). CONCLUSION: The overall quality of reporting of RCTs of CHM evaluated with a revised CONSORT checklist was poor, reflecting the need for improvements in reporting future clinical trials in this area. RECOMMENDATIONS: To improve the quality of reporting of RCTs of CHM, we recommend adopting a revised CONSORT checklist that includes items specific to CHM. We also recommend that editors of CHM journals require authors to use a structured approach to presenting their trials as a condition of publication.