Experience of National TCM Master Xiong Jibai in Treating Pulmonary Nodules Based on"Body Fluids and Blood Stasis Mixing" / 中国中医药信息杂志

This article summarized the experience of Professor Xiong Jibai,a national TCM master,in treating pulmonary nodules based on the theory of"body fluids and blood stasis mixing"in Huang Di Nei Jing.Professor Xiong Jibai believes that the basic pathogenesis of pulmonary nodules is that"body fluids and blood stasis mixing"accumulate in lung collaterals,and the fundamental pathological factor is phlegm and blood stasis.Xiong's treatment is based on dissipating phlegm and activating qi,activating blood circulation and resolving masses,paying attention to syndrome differentiation and treatment,examining syndromes and seeking causes,flexibly selecting prescriptions and treating both symptoms and root causes;attaching importance to maintaining healthy qi,preventing both illness and change,and preventing recovery after illness.Clinical medical records were attached to prove the clinical thinking and medication characteristics.

Clinical research of first-line chemotherapy and immunotherapy combined with chest radiotherapy for extensive-stage small cell lung cancer / 中华放射肿瘤学杂志

Objective:To evaluate the safety and efficacy of sequential consolidation thoracic radiotherapy after first-line chemotherapy combined with immunotherapy for extensive-stage small cell lung cancer (SCLC).Methods:A retrospective analysis of patients with extensive-stage SCLC admitted to Jiangsu Cancer Hospital from January 2019 to September 2022 was conducted. Patients who achieved effective chemotherapy combined with immunotherapy received sequential consolidation thoracic radiotherapy. The safety was evaluated according to the common terminology criteria for adverse events (CTCAE) 5.0 standard, and the overall survival (OS) and progression-free survival (PFS) were analyzed by Kaplan-Meier method.Results:A total of 33 patients were enrolled, with a median age of 66 years (range, 50-79 years). The median follow-up time was 20 months (range, 3-33 months). Fifteen patients (46%) had disease progression, and 12 patients (36%) died. The toxicities mainly included leukopenia, thrombocytopenia, radiation esophagitis, anorexia, and fatigue, etc. Six patients (18%) had grade 4 hematological toxicity, mainly leukopenia. One patient (3%) had grade 3 radiation pneumonitis, and 3 patients (9%) had grade 1-2 radiation pneumonitis. No grade 5 toxicity was observed in all patient groups. The median PFS was 12 months (95% CI=3.9-20.1). The 6-month, 1-year, and 2-year PFS rates were 78%, 49.6%, and 35.6%, respectively. The median OS was 23 months (95% CI=15.98-30.01). The 6-month, 1-year, and 2-year OS rates were 86.2%, 74.5%, and 47.2%, respectively. Conclusions:Sequential consolidation thoracic radiotherapy after first-line chemotherapy combined with immunotherapy is a safe protocol for extensive-stage SCLC. It brings survival benefits to patients by increasing PFS and OS rates.

M6A-mediated EGLN3 and FOSL2 enhance radioresistance in nasopharyngeal carcinoma / 中华放射肿瘤学杂志

Objective:To screen and verify the key radioresistance genes regulated by m6A methylation in nasopharyngeal carcinoma (NPC) based on the chip data and cell experiments.Methods:The microarray data of NPC radioresistance genes, m6A regulated genes and mRNA expression profiles of NPC genes were downloaded from Gene Expression Omnibus (GEO) database. The differential genes were screened and statistically analyzed by R software. The biological processes, signal pathways and interaction networks of these genes were analyzed by bioinformatics. The m6A regulatory factors were knocked down and the radioresistant strains were constructed. The above m6A differential radioresistant genes of NPC were screened and verified by real-time reverse transcription PCR (qRT-PCR) and Western blot. The m6A modification of screened genes and their direct binding ability with methyltransferase 3 (METTL3) were verified by methylated RNA immunoprecipitation qPCR (MeRIP-qPCR). The siRNA of selected genes was transfected into NPC cells, and after treatment with ionizing radiation, cell proliferation was detected by CCK-8 assay and EdU, apoptosis and cell cycle were detected by flow cytometry, and radiosensitivity was detected by clone formation assay. The trend of differences in the abundance of Fe 2+ and lipid peroxidation between the control and EGLN3 knockdown groups after ionizing radiation treatment was compared by paired t-test. Results:Chip data GSE48501 intersected with GSE200792 and GSE53819 to obtain 6 differential genes, including EGLN3, FOSL2, ADM, JUN, VEGFA and PRDM1. The target genes of EGLN3 and FOSL2 were further screened by TNMplot and KMplot, etc. The mRNA of the target genes directly bound to METTL3 and were subjected to its mediated modification of m6A. The target genes were up-regulated in the parental cells after irradiation in a dose and time gradient manner, which were also significantly up-regulated in radioresistant cells. After EGLN3 and FOSL2 were down regulated, the proliferation activity of NPC cells was more significantly decreased after irradiation, and the radiosensitization ratio was statistically significant compared with that of NPC cells without EGLN3 and FOSL2 down-regulation. After irradiation, EGLN3 down-regulated NPC cells significantly down-regulated glutathione peroxidase 4 (GPX4) expression, increased the abundance of Fe 2+ and lipid peroxidation, which played a role in radiosensitization by inducing ferroptosis. Conclusions:EGLN3 and FOSL2 play a role in radioresistance in NPC through METTL3 mediated m6A methylation. Down-regulation of EGLN3 combined with ionizing radiation can increase the intracellular Fe 2+ abundance and lipid peroxidation and down-reuglate the expression of GPX4 in NPC cells, which can enhance radiosensitization for NPC radiotherapy by the ferroptosis pathway.

Efficacy of concurrent tumor treating fields and chemoradiation in patients with high-grade glioblastoma / 中华放射肿瘤学杂志

Objective:To evaluate the safety and efficacy of tumor-treating fields (TTFields) and chemoradiation in patients with high-grade glioblastoma.Methods:Clinical data of 38 patients admitted to the Jiangsu Cancer Hospital from September 2021 to May 2023 who were diagnosed with high-grade glioblastoma (36 cases of World Health Organization grade Ⅳ and 2 cases of grade Ⅲ) were retrospectively analyzed. All patients received TTFields combined with concurrent chemoradiation after surgery. Response assessment in neuro-oncology (RANO) criteria was used to evaluate the glioma responses as tumor remission, stable or progression. Common terminology criteria for adverse events v5.0 and TTFields related skin adverse reaction (dAE) criteria were used to evaluate the adverse events. Treatment compliance was assessed by data on the NovoTTF-200A therapeutic device, calculated as a percentage of daily TTFields usage time. Survival analysis was estimated by the Kaplan-Meier method and compared by the log-rank test.Results:The median duration of treatment with TTFields in 38 patients was 20 h (rang: 2.4-22.6 h), and the median treatment compliance was 83% (range: 10%-94%). After 42 days of TTFields combined with concurrent chemoradiation, 12 patients who underwent complete tumor resection were assessed as stable according to RANO criteria. Among the 26 patients who underwent partial tumor resection, 23 (88%) were evaluated as disease remission according to RANO criteria. The 7-, 10-, 13-month progression-free survival rate was 81.0%、64.0%、49.5%, repectively. The common adverse events included grade 1 (45%) and grade 2 (8%) dAE, without grade 3-4 dAE. Typical presentations included contact dermatitis, blisters, lesions or ulcers, and abscesses. The median follow-up time was 10.0 months (range: 1.6-21.3 months). At follow-up as of July 2023, 26 of the 38 patients were stable and 12 had disease progression (8 died).Conclusion:The preliminary results show that TTFields combined with chemoradiation is effective, safe and reliable treatment for high-grade glioblastoma.

Network Pharmacological Analysis and Experimental Verification of the Mechanism of Gastrodiae Rhizoma-Salviae Miltiorrhizae Radix et Rhizoma Drug Pair in the Treatment of Hypertension / 中药新药与临床药理

Objective To investigate the mechanism of Gastrodiae Rhizoma-Salviae Miltiorrhizae Radix et Rhizoma drug pair in the treatment of hypertension based on the network pharmacology method and animal experiment verification.Methods(1)TCMSP,BATMAN and TCMIP databases were used to screen the active components and targets of Gastrodiae Rhizoma-Salviae Miltiorrhizae Radix et Rhizoma drug pair.The hypertension-related targets were obtained by searching the Drugbank,Genecard,TTD and Disgenet databases.The intersection(common target)of the active component target and the target related to hypertension disease was taken,and the obtained intersection target was the potential target of Gastrodiae Rhizoma-Salviae Miltiorrhizae Radix et Rhizoma drug pair for the treatment of hypertension.The active ingredients and their targets of Gastrodiae Rhizoma-Salviae Miltiorrhizae Radix et Rhizoma drug pair were imported into Cytoscape 3.9.1 software to construct a'Chinese medicines-active ingredients-targets'network and screen key active ingredients.The protein-protein interaction(PPI)network of potential targets was constructed to screen potential core targets.The Metascape platform was used to analyze the GO function and KEGG pathway enrichment of potential targets.The key active components and potential core targets were selected for molecular docking verification.(2)Thirty male spontaneously hypertensive rats(SHR)were randomly divided into model group,western medicine group(Candesartan Cilexetil,0.72 mg·kg-1)and low-,medium-and high-dose groups of Gastrodiae Rhizoma-Salviae Miltiorrhizae Radix et Rhizoma(2.25,4.50,9.00 g·kg-1).Another male WKY rats were selected as blank group,with 6 rats in each group,once a day for 8 weeks.The systolic blood pressure of rat tail artery was detected before administration and 2,4,6 and 8 weeks after drug intervention.The pathological changes of thoracic aorta were observed by HE staining.The protein expression levels of GRP78,CHOP and Caspase-12 in aorta abdominalis were detected by Western Blot.Results(1)A total of 83 active components of Gastrodiae Rhizoma-Salviae Miltiorrhizae Radix et Rhizoma were obtained,and 158 potential targets(intersection targets)for the treatment of hypertension were screened out.Five key active ingredients:p-hydroxybenzoic acid,4-hydroxybenzylamine,tanshinone I,tanshinone,γ-sitosterol;6 potential core targets:IL6,TNF,CASP3,JUN,PTGS2,IL1B;GO functional enrichment analysis obtained 1 826 biological process items,89 cell component items,and 199 molecular function items.KEGG pathway enrichment analysis obtained 186 pathways,mainly involving neuroactive ligand-receptor interaction,calcium signaling pathway,inflammatory response(such as TNF and MAPK signaling pathway),vascular protection(such as HIF-1 and cAMP signaling pathway),oxidative stress(such as PI3K-Akt signaling pathway)and other signaling pathways.Tanshinone I and tanshinone had strong binding force to 6 potential core targets,and γ-sitosterol had strong binding force to IL6,CASP3,JUN,PTGS2 and IL1B.(2)Compared with the blank group,the systolic blood pressure of the model group was significantly increased(P＜0.01).The thoracic aortic endothelial injury was obvious,the endothelial cell morphology was abnormal,swelling and exfoliated cells could be seen,the intima of the tissue was disordered,the intima structure was incomplete,and the intima was thickened.The protein expressions of GRP78,CHOP and Caspase-12 in abdominal aorta were significantly increased(P＜0.01).Compared with the model group,the systolic blood pressure of the rats in the administration group was significantly decreased(P＜0.01);the injury of thoracic aorta was alleviated,and the morphology,intima structure and thickness of endothelial cells were improved to varying degrees.The protein expressions of GRP78,CHOP and Caspase-12 in abdominal aorta were significantly decreased(P＜0.01).Conclusion Gastrodiae Rhizoma-Salviae Miltiorrhizae Radix et Rhizoma drug pair may act on core targets such as IL6,TNF,CASP3,JUN,PTGS2,and IL1B through key active components such as p-hydroxybenzoic acid,tanshinone,and γ-sitosterol,and regulate key signaling pathways such as TNF signaling pathway,MAPK signaling pathway,PI3K-Akt signaling pathway,and PERK signaling pathway to improve vascular endothelial dysfunction,inhibit endoplasmic reticulum stress,and lower blood pressure.

Prognostic value of the preoperative systemic immune-inflammation index in patients with non-small cell lung cancer: A systematic review and meta-analysis / 中国胸心血管外科临床杂志

@#Objective     To explore the association between the preoperative systemic immune-inflammation index (SII) and prognosis in non-small cell lung cancer (NSCLC) patients. Methods     A comprehensive literature survey was performed on PubMed, Web of Science, EMbase, The Cochrane Library, Wanfang, and CNKI databases to search the related studies from inception to December 2021. The hazard ratio (HR) and 95% confidence interval (CI) were combined to evaluate the correlation of the preoperative SII with overall survival (OS), disease-free survival (DFS), and recurrence-free survival (RFS) in NSCLC patients. Results     A total of 11 studies involving 9 180 patients were eventually included. The combined analysis showed that high SII levels were significantly associated with worse OS (HR=1.61, 95%CI 1.36-1.90, P<0.001), DFS (HR=1.50, 95%CI 1.34-1.68, P<0.001), and RFS (HR=1.17, 95%CI 1.04-1.33, P<0.001). Subgroup analyses also further verified the above results. Conclusion     Preoperative SII is a powerful prognostic biomarker for predicting outcome in patients with operable NSCLC and contribute to prognosis evaluation and treatment strategy formulation. However, more well-designed and prospective studies are warranted to verify our findings.

Serological surveillance of human brucellosis in Ganzhou City， Jiangxi Province from 2018 to 2021 / 上海预防医学

ObjectiveTo describe the serological surveillance results of human brucellosis in Ganzhou City， Jiangxi Province from 2018 to 2021， characterize the epidemic and current situation of brucellosis， and to provide scientific evidence for effective prevention and control of brucellosis. MethodsSurveillance data of human brucellosis serological testing was collected in Ganzhou City from 2018 to 2021. Spatial， temporal， and demographic distribution was further determined. ResultsFrom 2018 to 2021， a total of 42 humans serologically positive for brucellosis were reported from 18 counties （cities and districts） in Ganzhou City， including 26 males and 16 females with a gender ratio of 1.6∶1. The number of serologically positive cases showed a decreasing trend， with the positive rate decreasing from 46.43% in 2018 to 33.33% in 2021. Majority of the cases （54.00%） aged 40‒ years old. Furthermore， the number of serologically positive cases varied by month； majority of the cases （80.95%） was from April to August. Additionally， a total of 10 counties （cities and districts） reported serologically positive cases of brucellosis， among which the top 3 counties （cities and districts） by cumulative number of positive cases were Zhanggong District （18 cases）， Dayu County（5 cases）， and Longnan City（4 cases）. ConclusionSerologically positive cases of human brucellosis decrease in Ganzhou， in which the incidence of male cases is generally higher than female cases. The seasonality of human brucellosis is in spring and summer. At-risk population is 40‒ years old. Additionally， at-risk areas are southwest and central areas of Ganzhou.

Research progress on radio-resistance mechanism of nasopharyngeal carcinoma / 中华放射肿瘤学杂志

Nasopharyngeal carcinoma is one of the most common malignant head and neck tumors, and radiotherapy is the main treatment. However, radio-resistance is a key cause of local recurrence of nasopharyngeal carcinoma. Therefore, overcoming the radio-resistance of nasopharyngeal carcinoma and enhancing the radiosensitivity have become urgent problems in the treatment of nasopharyngeal carcinoma, which also play a key role in improving the overall survival rate of patients. In this article, recent studies on DNA, non-coding RNA (ncRNA), protein and cell behaviors related to radio-resistance of nasopharyngeal carcinoma were reviewed, aiming to provide valuable ideas for clinical treatment of nasopharyngeal carcinoma.

The feasibility of individualized primary CTV for lateralized nasopharyngeal carcinoma / 中华放射肿瘤学杂志

Objective:To investigate the feasibility of individualized primary clinical target volume (CTV) delineation in intensity-modulated radiotherapy for nasopharyngeal carcinoma (NPC).Methods:Clinical data of 87 consecutive patients newly diagnosed with lateralized NPC in Jiangsu Cancer Hospital between October 2016 and February 2018 were retrospectively analyzed. Lateralized NPC is defined as tumor invasion not exceeding the contralateral wall. According to the tumor spread, the primary CTV was optimized as follows: CTV2 only covered the medial part of the contralateral pterygopalatine fossa, whereas the contralateral foramen oval was not included; on the level of parapharyngeal space, the contralateral side of CTV only covered the posterior lateral lymph nodes, whereas the contralateral internal jugular vein was not regularly covered. Failure patterns and 5-year survival [local control rate (LCR), progression-free survival (PFS) and overall survival (OS)] were evaluated by Kaplan-Meier method. Paired t-test and rank-sum test were used to analyze the dose variation in the optimized region and adverse reactions. Results:The median follow-up time was 59.5 months. The 5-year LCR, PFS, and OS were 98.9%, 86.5% and 92.1%, respectively. There was no local recurrence in the optimized area of CTV. Dosimetric comparison results showed that the doses of parotid gland, temporal lobe, cochlea and middle ear on the contralateral side were reduced by 13.45%, 9.14%, 38.83%, and 29.36%, respectively. Four cases (4.6%) developed grade 3 hearing loss, all on the ipsilateral side. The optimized scheme significantly alleviated the hearing loss on the contralateral side compared to that on the ipsilateral side ( P<0.001). Other grade 3 late adverse reactions included cranial nerve injury, subcutaneous fibrosis in the neck and visual impairment, with 1 case each. Conclusion:Individualized primary CTV for lateralized NPC is feasible and safe, with obvious dosimetric advantages and reduced adverse reaction rate, which is worthy of clinical promotion.

Research progress on radiobiological effects of ferroptosis in cancer / 中华放射肿瘤学杂志

Ferroptosis is a new form of regulated cell death discovered in recent years, which is iron-dependent cell death characterized by peroxidation of polyunsaturated fatty acid phospholipids. Recent studies have shown that radiotherapy can induce ferroptosis in cancer cells via ionizing radiation. Targeting ferroptosis plays a synergistic role in tumor suppression with radiation, which not only further deepens the connotation of radiobiology, but also provides a new perspective for tumor radiosensitization. This review systematically summarizes the occurrence and defense of ferroptosis, focusing on the key role of ferroptosis in the radiobiological effects of tumor cells and the potential application of ferroptosis in radiosensitization.

The dosimetric effect of random six-dimensional setup error in intensity-modulated radiotherapy planning for rectal cancer / 中华放射医学与防护杂志

Objective:To design a method to introduce random six-dimensional setup error (6D-SE) into the intensity-modulated radiotherapy (IMRT) planning for rectal cancer and evaluate its dosimetric effect.Methods:A total of 21 IMRT plans for patients with rectal cancer were randomly selected as reference plans [2 Gy per fraction for a total of 50 Gy; a 5 mm uniform margin around the clinical target volume (CTV) was taken as the planning target volume (PTV)]. For each fraction of the reference plan, a randomly generated 6D-SE was introduced by adjusting the geometrical parameters of the radiation field, and the dose was recalculated. The overall dose distribution with 6D-SE was obtained by adding up the dose of each fraction. A treatment simulation program that could complete the above workflow was developed using the Varian Eclipse scripting API (ESAPI). 6D-SEs that obey two preset distributions [distribution 1: translational error obey N(0, 4 2), and rotational error obey N(0, 2 2); distribution 2: translational error obey N(0, 2 2), and rotational error obey N(0, 1 2)] were introduced into the reference plans, and the dosimetric effects were assessed. Results:When the reference plans, error distribution 1, and error distribution 2 were applied, the Dmin values of the CTV were (49.4±0.41), (47.56±0.76), and (49.17±0.64) Gy, respectively; the D98% values of the CTV were (50.23±0.07), (49.98±0.10), and (50.27±0.09) Gy, respectively; the D98% values of the primary target area (the kernel part of the target area, excluding the margins) were (50.25±0.08), (50.42±0.13), and (50.33±0.10) Gy, respectively; the D98% values of the marginal area were (50.22±0.10), (49.88±0.11), and (50.26±0.10) Gy, respectively. In addition, compared with the result of the reference plans, the result of errors 1 and 2 showed no significant changes in the mean dose of the bladder and femoral heads ( P>0.05), despite slight decreases in the conformity index of the dose distribution with limited clinical significance. Conclusion:The proposed method and the treatment simulation program developed thereupon can introduce the 6D-SE obeying different distributions into the IMRT plans for rectal cancer on demand and provide overall dosimetric changes.

Long-term follow-up of salivary gland protection and improvement of late xerostomia by optimizing clinical target volume in IIB region of nasopharyngeal carcinoma / 中华放射肿瘤学杂志

Objective:To explore the effect of clinical target volume (CTV) optimization on long-term survival and late xerostomia of patients with nasopharyngeal carcinoma (NPC).Methods:Clinical data of 763 patients with NPC treated with intensity-modulated radiotherapy (IMRT) in the Jiangsu Cancer Hospital from January 2015 to November 2018 were retrospectively analyzed. All patients were divided into the modified and conventional CTV groups. Propensity score matching (PSM) was applied to balance the distribution of baseline features. The degree of xerostomia was evaluated by Radiation Therapy Oncology Group (RTOG) / European Organisation for Research and Treatment of Cancer (EORTC) standard and Jiangsu Cancer Hospital Multi-dimensional Radiotherapy-Induced Xerostomia scale. Survival analysis was performed by Kaplan-Meier method. The difference of xerostomia between two groups was compared by rank-sum test. The dose parameters of salivary glands were compared by independent sample t-test. Prognostic factors of survival and xerostomia were assessed by univariate / multivariate regression analyses. Results:There were no significant differences in overall survival, local recurrence-free survival, distant metastasis-free survival and progression-free survival between conventional and modified CTV groups before and after PSM. There were no significant differences in the incidence of late xerostomia above grade 2 of RTOG/EORTC standard between two groups. Using multi-dimensional scale criteria, NPC patients in the modified CTV group developed less late xerostomia than those in the conventional CTV group ( P<0.05). D mean and V 26 Gy of bilateral parotid glands, D mean and V 39 Gy of bilateral submandibular glands, and D mean of sublingual glands and mouths were reduced after optimization of CTV (all P<0.001). Univariate analysis showed that clinical staging, T staging and N staging were the independent prognostic factors of overall survival. Multivariate analysis demonstrated that clinical staging was the independent prognostic factor of overall survival. The risk factor for xerostomia during night sleep was the D mean of sublingual glands. Conclusion:The optimization of CTV in IIb region in NPC treated with IMRT can better protect salivary glands and reduce the incidence of late radiation-induced xerostomia on the premise of ensuring long-term survival.

Establishment and identification of radioresistant nasopharyngeal carcinoma cell line / 中华放射肿瘤学杂志

Objective:To establish a radioresistant nasopharyngeal carcinoma cell line in vitro and provide experimental basis for further research of the molecular mechanism of radioresistance. Methods:A radioresistant cell line 5-8F-IR was established by dose gradient irradiation. Cell morphological changes were observed by optical microscope. The formation of colony was detected by colony formation assay. Cell viability was detected by CCK-8 assay. Cell proliferation was assessed by 5-ethynyl-2'-deoxyuridine (EdU) assay. DNA damage repair ability was measured by immunofluorescence staining and comet assay. Cell apoptosis and cycle were detected by flow cytometry. The expression levels of DNA damage related protein γH2AX and apoptosis related protein Caspase-3 were measured by Western blot.Results:The 5-8F-IR cells became longer than that of parental generation 5-8F cells after dose gradient irradiation. The colony formation ability ( P<0.01), cell viability ( P<0.001), cell proliferation ability ( P<0.05) and DNA damage repair ability ( P<0.05) of 5-8F-IR cells were significantly stronger than those of parental generation 5-8F cells. The apoptosis rate of 5-8F-IR cells after irradiation was significantly lower than that of parental generation 5-8F cells ( P<0.01). The 5-8F-IR cells showed higher percentage of cells in S phase without irradiation, and obvious G 2/M phase arrest after irradiation ( P<0.01). Western blot showed that the expression levels of γH2AX ( P<0.001) and Caspase-3 ( P<0.05) in 5-8F-IR cells after irradiation were significantly lower compared with those of parental generation 5-8F cells. Conclusion:5-8F-IR cells induced by dose gradient irradiation of human nasopharyngeal carcinoma cell line 5-8F cells exhibit radioresistance and exhibit different biological characteristics compared to their parental 5-8F cells, providing a research tool for exploring radioresistance mechanism of nasopharyngeal carcinoma.

Diagnosis of a Primary Pleomorphic Liposarcoma in a Tree Shrew（Tupaia belangeri subsp. yaoshanensis） / 实验动物与比较医学

A large spontaneous mass on the dorsal abdomen near the hip joint was found in an aged female Tupaia belangeri subsp. yaoshanensis after 5 years of routine feeding. The tumor in the diseased tree shrew was huge, with an intact surface and no ulceration; however, it caused inconvenience in movement while maintaining a good mental state. After inhalation anesthesia with isoflurane (2%-4%), the tree shrew was euthanized after the tree shrew entered deep anesthesia. Anatomical dissection of the tumor, the tumor boundary was unclear and infiltrated into surrounding tissues. HE staining showed that small focal pleomorphism and large areas of adipocytes were seen in the tumor tissue. The pleomorphic sarcoma area was mainly composed of atypical epithelioid cells with easily visible nuclear divisions. The size of the adipocytes was significantly different, and more pleomorphic adipocytes were seen. The cell volume was large, the nucleus was deeply stained and deformed, the edge was impressed, and the cytoplasm was seen with multiple vesicular lipid droplets. Immunohistochemical results showed that the tumor cells were positive for Vimentin, the small focal polymorphic adipocyte nucleus was positive for S-100, and Ki-67 exhibited a higher proportion of positivity. Combined with HE staining and immunohistochemical results, the spontaneous tumor in this tree shrew was comprehensively diagnosed as pleomorphic liposarcoma.

Pathological significance of plasma cell infiltration in diagnosing lymph node diseases / 中华病理学杂志

Objective: To investigate the value of plasma cells for diagnosing lymph node diseases. Methods: Common lymphadenopathy (except plasma cell neoplasms) diagnosed from September 2012 to August 2022 were selected from the pathological records of Changhai Hospital, Shanghai, China. Morphological and immunohistochemical features were analyzed to examine the infiltration pattern, clonality, and IgG and IgG4 expression of plasma cells in these lymphadenopathies, and to summarize the differential diagnoses of plasma cell infiltration in common lymphadenopathies. Results: A total of 236 cases of lymphadenopathies with various degrees of plasma cell infiltration were included in the study. There were 58 cases of Castleman's disease, 55 cases of IgG4-related lymphadenopathy, 14 cases of syphilitic lymphadenitis, 2 cases of rheumatoid lymphadenitis, 18 cases of Rosai-Dorfman disease, 23 cases of Kimura's disease, 13 cases of dermal lymphadenitis and 53 cases of angioimmunoblastic T-cell lymphoma (AITL). The main features of these lymphadenopathies were lymph node enlargement with various degrees of plasm cell infiltration. A panel of immunohistochemical antibodies were used to examine the distribution of plasma cells and the expression of IgG and IgG4. The presence of lymph node architecture could help determine benign and malignant lesions. The preliminary classification of these lymphadenopathies was based on the infiltration features of plasma cells. The evaluation of IgG and IgG4 as a routine means could exclude the lymph nodes involvement of IgG4-related dieases (IgG4-RD), and whether it was accompanied by autoimmune diseases or multiple-organ diseases, which were of critical evidence for the differential diagnosis. For common lesions of lymphadenopathies, such as Castleman's disease, Kimura's disease, Rosai-Dorfman's disease and dermal lymphadenitis, the expression ratio of IgG4/IgG (>40%) as detected using immunhistochemistry and serum IgG4 levels should be considered as a standard for the possibility of IgG4-RD. The differential diagnosis of multicentric Castleman's diseases and IgG4-RD should be also considered. Conclusions: Infiltration of plasma cells and IgG4-positive plasma cells may be detected in some types of lymphadenopathies and lymphomas in clinicopathological daily practice, but not all of them are related to IgG4-RD. It should be emphasized that the characteristics of plasma cell infiltration and the ratio of IgG4/IgG (>40%) should be considered for further differential diagnosis and avoiding misclassification of lymphadenopathies.

Prognostic Value of Hematological Indicators in Children and Adolescents with Nasopharyngeal Carcinoma / 肿瘤防治研究

Objective To explore the prognostic value of pretreatment hematological indicators in children and adolescents with nasopharyngeal carcinoma. Methods We performed a retrospective analysis on the medical records of 79 children and adolescents (≤20 years old) with nasopharyngeal carcinoma. Before treatment, all patients underwent hematological tests, and patients received intensity-modulated radiotherapy alone or intensity-modulated radiotherapy combined with chemotherapy, targeted, and other comprehensive treatment modes. The follow-up endpoints were overall survival (OS) and progression-free survival (PFS). Results Age≤14 years, no concurrent chemotherapy, pretreatment hematological indicators (high NLR, high PLR, high LDH, and high LAR) were associated with poor OS and PFS in children and adolescents with nasopharyngeal carcinoma (all P < 0.05). No concurrent chemotherapy and high LAR before treatment were independent adverse prognostic factors for OS in children and adolescents with nasopharyngeal carcinoma. Conclusion High NLR, high PLR, high LDH, and high LAR of pretreatment hematological indicators are associated with poor OS and PFS. Meanwhile, high LAR before treatment is an independent adverse prognostic factor for OS in children and adolescents with nasopharyngeal carcinoma.

Extracellular Signal-regulated Kinase 1/2 Signaling Regulates Cell Invasion:a Review / 中国医学科学院学报

Extracellular signal-regulated kinase 1/2 (ERK1/2) is a serine/threoninekinase involved in the signal transduction cascade of Ras-Raf-mitogen-activated protein kinase (MEK)-ERK.It participates in the cell growth,proliferation and even invasion by regulating gene transcription and expression.The occurrence of a variety of diseases such as lung cancer,liver cancer,ovarian cancer,cervical cancer,endometriosis,and preeclampsia,as well the metastasis and disease progression,is closely associated with the regulation of cell invasion by ERK1/2 signaling pathway.Therefore,exploring the regulation of ERK1/2 signaling on cell invasion and its role in pathogenesis of diseases may help to develop more effective treatment schemes.This article introduces recent progress in the regulation of ERK1/2 signaling on cell invasion and the role of such regulation in diseases,with a view to give new insights into the clinical treatment of ERK 1/2-related diseases.

Apheresis granulocyte collection and transfusion efficacy / 中国输血杂志

【Objective】 To analyze the safety of apheresis granulocyte(AG) collection from blood donors mobilized by G-CSF and apheresis granulocyte transfusion efficacy in patients. 【Methods】 The blood routine results, collection process and follow-up of blood donors mobilized by G-CSF before and after AG collection were collected to analyze the safety of AG collection, and the blood routine results, clinical symptom improvement and treatment outcome of patients before and after AG transfusion were collected to analyze the transfusion efficacy. 【Results】 A total of 27 blood donors donated 29 U AG, with collection time at (229±20)min, circulating blood volume at (9 890±1 107)mL, and the dosage of anticoagulant at (1 002±97)mL.Two blood donors had adverse reactions to blood donation, and the AG collection was carried out after treatment.After G-CSF mobilization, WBC increased significantly from (5.61±1.06) ×109/L to (22.85±5.23) ×109/L, while RBC, Hb, Hct and Plt showed no significant change.The blood routine returned to the level before G-CSF mobilization 1-2 days after blood donation.No physical discomfort occurred during the one week after blood donation.Four patients with granulocyte deficiency complicated with multidrug-resistant bacterial infection, who failed to respond to antibiotic treatment, were transfused with 29 U AG, with no adverse reactions and no obvious change in blood routine, but the infection symptoms were improved significantly judged from clinical manifestation, bacterial culture results, temperature monitoring and CT examination, suggesting that the AG infusion was effective.Among the 4 patients, 1 was cured and discharged, 1 gave up treatment, 1 died of sepsis, and 1 died of multiple organ failure. 【Conclusion】 It is safe to collect AG from blood donors mobilized by G-CSF through blood cell separator, and the AG products basically meet the national quality requirements and the treatment needs.Sustained high-dose AG transfusion has a significant effect on infection control in patients with agranulocytosis combined with refractory multidrug-resistant bacterial or fungal infection.

Periostin-a potential molecular marker for early diagnosis of disease / 中国药理学通报

Periostin (POSTN), an evolutionary conserved and secreted extracellular matrix protein, can be easily detected by humoral samples such as blood, urine, interstitial fluid etc., which was firstly found in bone tissues.POSTN is expressed in various tissues and its expression level is closely related to oc¬currence and development of various diseases, which will be a potential molecular marker in early diagnosis of diseases.'Hie paper systematically summarizes the relationship of the expres¬ sion level of POSTN and some diseases including myocardial in¬farction, vascular calcification, diseases related to bone metabo¬lism, chronic nephrosis and various cancers, and explores its function as well as mechanism, which provides scientific basis for the early diagnostic kits or new drug development of diseases based on POSTN.

Application of prospective respiratory gating based on 4D-CT in precise radiotherapy for lung cancer / 中华放射肿瘤学杂志

Objective:The respiratory waveform of lung cancer patients based on 4D-CT respiratory gating was analyzed to evaluate the accuracy of gating during radiotherapy, and to explore the off-target in the 4D-CT respiratory gating radiotherapy.Methods:Clinical data of 18 patients with lung cancer admitted to Radiotherapy Department of Jiangsu Cancer Hospital were collected to obtain the respiratory waveform data during 4D-CT respiratory gating radiotherapy. The waveform in each treatment working cycle was compared with the waveform in 4D-CT scan to study whether there was a possibility of the off-target in the treatment of lung cancer patients.Results:There were 154 treatment sessions and 20,790 treatment breathing cycles in 18 patients, among which the threshold of gated opening beam miss amplitude (Δm-en) was greater than 0 in 95 treatment breathing cycles in 7 patients, accounting for 0.46% of all breathing cycles, and the threshold of gated closing beam miss amplitude (Δm-dis) was greater than 0 in 1419 treatment breathing cycles in 13 patients, accounting for 6.83% of all cycles. Among the 13 patients withΔm-dis greater than 0, actual tumor range of motion (R G) was greater than the sum of the value of target margin (M) and the value of plan tumor range of motion (R T) in 7 patients, R G was more than 1.5 times of M+R T in 7 patients, and there were also 7 patients in the phase of rapid rise and fall of respiratory curve. The correlation efficients between R G-M-R T and the percentage of beam on miss phase (T en%) and the percentage of beam closing off phase (T dis%) were 0.41 and 0.57, respectively. Conclusion:When R G is more than 1.5 times of M+R T value and the gating beam on phase contains the phases in the rapid rise and fall of the respiratory curve, the possibility of the off-target during radiotherapy is significantly increased.