Highly Sensitive and Linear Resonator-Based Biosensor for White Blood Cell Counting: Feasible Measurement Method and Intrinsic Mechanism Exploration.

Since different quantities of white blood cells (WBCs) in solution possess an adaptive osmotic pressure of cells, the WBCs themselves and in solution have similar concentrations, resulting in them having similar dielectric properties. Therefore, a microwave sensor could have difficulty in sensing the quantity variation when WBCs are in solution. This paper presents a highly sensitive, linear permittivity-inspired microwave biosensor for WBCs, counting through the evaporation method. Such a measurement method is proposed to record measurements after the cell solution is dripped onto the chip and is completely evaporated naturally. The proposed biosensor consists of an air-bridged asymmetric differential inductor and a centrally located circular fork-finger capacitor fabricated on a GaAs substrate using integrated passive fabrication technology. It is optimized to feature a larger sensitive area and improved Q-factor, which increases the effective area of interaction between cells and the electromagnetic field and facilitates the detection of their changes in number. The sensing relies on the dielectric properties of the cells and the change in the dielectric constant for different concentrations, and the change in resonance properties, which mainly represents the frequency shift, corresponds to the macroscopic change in the concentration of the cells. The microwave biosensors are used to measure biological samples with concentrations ranging from 0.25 × 106 to 8 × 106 cells per mL in a temperature (26.00 ± 0.40 °C) and humidity (54.40 ± 3.90 RH%) environment. The measurement results show a high sensitivity of 25.06 Hz/cells·mL-1 with a highly linear response of r2 = 0.99748. In addition, a mathematical modeling of individual cells in suspension is performed to estimate the dielectric constant of individual cells and further explain the working mechanism of the proposed microwave biosensor.

Investigation of Mold Flux Entrapment in Deep Oscillation Mark of Interstitial-Free Steel Shell Using Mold Simulator.

The slag entrapment defect has become a big issue for the IF steel casting process. In this study, the mechanism of mold flux entrapment in deep oscillation mark of an IF steel shell was studied by a high-temperature mold simulator. Results show that both temperature and heat flux in a copper mold become lower when mold flux B with lower melting and viscosity is used, compared with these when mold flux A with higher melting and viscosity is used. The average thickness of the slag film for mold fluxes A and B is 1.31 mm and 1.63 mm, and the consumption of them is 0.33 kg/m2 and 0.35 kg/m2, respectively. The shell for mold flux A exhibits sharper oscillation marks, while the shell for mold flux B has shallower oscillation marks. These deeper oscillation marks capture the mold flux by overflow of molten steel at the meniscus, which finally produces the slag entrapment defect in the shell.

Health risk assessment and potential sources of metals in riparian soils of the Wujiang River, China.

In order to understand the pollution status of metals in the riparian soils along the Wujiang River, 26 sampling sites in the mainstream and tributary streams were selected for investigation. The geo-accumulation index (Igeo), Nemerow integrated pollution index, and potential ecological risk index were applied to evaluate the contamination status and ecological risks of metals. Results revealed that the average concentrations of As, Cd, Cr, Cu, Mn, Ni, Pb, and Zn were 12.20, 0.51, 84.01, 57.42, 922.57, 38.37, 38.06, and 127.82 mg/kg, respectively. The metal contamination degree and ecological risks in the upper reaches were significantly higher than those in the middle and lower reaches of the Wujiang River. Cd was the dominant contamination metal. Significant non-carcinogenic and carcinogenic risks of metals were found in children based on the hazard index and carcinogenic risk. As was the main non-carcinogenic and carcinogenic pollutant metal in both adults and children. According to principal component analysis, hierarchical clustering analysis, and absolute principal component scores-multiple linear regression, anthropogenic sources (mining and agricultural activities) contributed most to Zn, Pb, Cr, Cd, Cu, and Ni, with contribution rates of 89.14, 82.32, 74.46, 72.12, 68.52, and 61.02%, respectively. Natural sources contributed most to Mn, with a contribution rate of 83.07%. Unidentified sources contributed most to As, with a contribution rate of 47.27%.

Lysine acetyltransferase 6A maintains CD4+ T cell response via epigenetic reprogramming of glucose metabolism in autoimmunity.

Augmented CD4+ T cell response in autoimmunity is characterized by extensive metabolic reprogramming. However, the epigenetic molecule that drives the metabolic adaptation of CD4+ T cells remains largely unknown. Here, we show that lysine acetyltransferase 6A (KAT6A), an epigenetic modulator that is clinically associated with autoimmunity, orchestrates the metabolic reprogramming of glucose in CD4+ T cells. KAT6A is required for the proliferation and differentiation of proinflammatory CD4+ T cell subsets in vitro, and mice with KAT6A-deficient CD4+ T cells are less susceptible to experimental autoimmune encephalomyelitis and colitis. Mechanistically, KAT6A orchestrates the abundance of histone acetylation at the chromatin where several glycolytic genes are located, thus affecting glucose metabolic reprogramming and subsequent CD4+ T cell responses. Treatment with KAT6A small-molecule inhibitors in mouse models shows high therapeutic value for targeting KAT6A in autoimmunity. Our study provides novel insights into the epigenetic programming of immunometabolism and suggests potential therapeutic targets for patients with autoimmunity.

Integrated Passive Sensing Chip for Highly Sensitive and Reusable Detection of Differential-Charged Nanoplastics Concentration.

In this work, a new type, highly sensitive, and reusable nanoplastics (NPs) microwave detection method is proposed, which can be used to rapidly analyze NPs with different surface charges and sizes. The effective dielectric constant of NPs varies according to the different concentrations, particle sizes, and surface charges of NPs in aqueous solution. The feasibility of the microwave method for differential-charged NPs detection is verified using a complementary split ring resonator sensor manufactured on a cost-effective printed circuit board, which shows a high sensitivity only for positively charged NPs (PS-NH2) detection. To achieve microwave detection of both positively and negatively charged NPs (PS-SO3H), a microscale spiral-coupled resonator sensing chip is manufactured through integrated passive technology, which demonstrates extremely low detection limits and high sensitivity for both PS-NH2 and PS-SO3H, with different concentrations, particle sizes, and charges. In addition, for NPs solution doped with methyl orange, the device can still perform stable measurements, overcoming the inability of traditional NPs molecular element determination and optical detection methods to detect NPs aqueous solution with organic matter doping and color presence. The proposed microwave detection method could also be extended to sensing detection for detecting other hazardous environmental substances.

Color restoration based on digital pathology image.

OBJECTIVE: Protective color restoration of faded digital pathology images based on color transfer algorithm. METHODS: Twenty fresh tissue samples of invasive breast cancer from the pathology department of Qingdao Central Hospital in 2021 were screened. After HE staining, HE stained sections were irradiated with sunlight to simulate natural fading, and every 7 days was a fading cycle, and a total of 8 cycles were experienced. At the end of each cycle, the sections were digitally scanned to retain clear images, and the color changes of the sections during the fading process were recorded. The color transfer algorithm was applied to restore the color of the faded images; Adobe Lightroom Classic software presented the histogram of the image color distribution; UNet++ cell recognition segmentation model was used to identify the color restored images; Natural Image Quality Evaluator (NIQE), Information Entropy (Entropy), and Average Gradient (AG) were applied to evaluate the quality of the restored images. RESULTS: The restored image color met the diagnostic needs of pathologists. Compared with the faded images, the NIQE value decreased (P<0.05), Entropy value increased (P<0.01), and AG value increased (P<0.01). The cell recognition rate of the restored image was significantly improved. CONCLUSION: The color transfer algorithm can effectively repair faded pathology images, restore the color contrast between nucleus and cytoplasm, improve the image quality, meet the diagnostic needs and improve the cell recognition rate of the deep learning model.

The Top 100 Cited Articles on Acupuncture in the Last 20 Years: A Bibliometric Analysis.

BACKGROUND: Acupuncture has gained increasing international attention in recent decades. The act of incorporating acupuncture treatment into the routine treatment of COVID-19 in China drove us to review the 100 most influential articles of the last 20 years to learn about the current status and trends of acupuncture. METHOD: Articles related to acupuncture from January 1, 2001, to July 4, 2022, were searched in the Clarivate Analytics Web of Science Core Collection database. The top 100 most cited publications were selected, and information was extracted. Software such as VOSviewer, GraphPad Prism, Scimago Graphica, and CiteSpace were used to visualize and analyze the extracted data. RESULT: The 100 most cited articles were identified, with an average of 218 citations (range: 131-625). The majority of the top 100 articles were from the USA (n = 53). The institution that published the most highly cited papers was Harvard University (n = 16). The most influential team was Klaus Linde's group. Pain was the top-ranked journal in terms of the number of publications. The largest clusters for co-occurrence keyword analysis focused on acupuncture and electroacupuncture analgesia and brain imaging responses to acupuncture stimulation via functional MRI. The two highest strength burst keywords were "randomized controlled trials" and "osteoarthritis," with "randomized controlled trials" being a consistent burst keyword from 2011 to the present. CONCLUSION: This study provides insight into articles of historical significance in the field of acupuncture through bibliometric analysis. These data should provide clinicians and researchers with insight into future directions related to acupuncture.Die Akupunktur hat in den vergangenen Jahrzehnten zunehmend die internationale Aufmerksamkeit auf sich gezogen. Die Einbeziehung der Akupunktur in die Routinebehandlung von COVID-19 in China hat uns dazu veranlasst, die 100 einflussreichsten Artikel der letzten 20 Jahre zu überprüfen, um etwas über den aktuellen Stand und die Trends in der Akupunktur zu erfahren.Artikel mit Bezug zu Akupunktur vom 1. Januar 2001 bis 4. Juli 2022 wurden in der Clarivate Analytics Web of Science Core Collection Datenbank gesucht. Die 100 am häufigsten zitierten Veröffentlichungen wurden ausgewählt und die Informationen wurden extrahiert. Visualisierung und Analyse der extrahierten Daten erfolgten mithilfe der Software VOSviewer, GraphPad Prism, Scimago Graphica und CiteSpace.Es wurden die 100 am häufigsten zitierten Artikel ermittelt mit durchschnittlich 218 Zitierungen (Spanne: 131 bis 625). Der Großteil der 100 meistzitierten Artikel stammte aus den Vereinigten Staaten (n = 53). Die Institution, die die meisten zitierten Artikel veröffentlichte, war die Harvard-Universität (n = 16). Das einflussreichste Team war die Gruppe von Klaus Linde. Was die Zahl der Veröffentlichungen betrifft, war Pain die am häufigsten zitierte Zeitschrift. Bei der Analyse der Koinzidenz von Schlüsselwörtern lag der Fokus der größten Cluster auf Akupunktur-und Elektroakupunktur-Analgesie sowie auf den Reaktionen auf Akupunkturstimulation in den bildgebenden Untersuchungen des Gehirns mittels funktioneller MRT. Die beiden stärksten Burst-Schlüsselwörter waren "randomisierte kontrollierte Studien" und "Osteoarthritis," wobei "randomisierte kontrollierte Studien" von 2011 bis heute durchgängig ein Burst-Schlüsselwort ist.Diese Studie bietet einen Einblick in historisch bedeutsame Artikel auf dem Gebiet der Akupunktur mittels bibliometrischer analyse. Diese Daten sollen Klinikern und Forschern einen Einblick in zukünftige Richtungen im Zusammenhang mit Akupunktur geben.

Research on fatigue optimization simulation of polymeric heart valve based on the iterative sub-regional thickened method.

Prosthetic polymeric heart valves (PHVs) have the potential to overcome the inherent material and design limitations of traditional valves in the treatment of valvular heart disease; however, their durability remains limited. Optimal design of the valve structure is necessary to improve their durability. This study aimed to enhance the fatigue resistance of PHVs by improving the stress distribution. Iterative subregional thickening of the leaflets was used, and the mechanical stress distribution and hemodynamics of these polymeric tri-leaflet valves were characterized using a fluid-structure interaction approach. Subregional thickening led to a reduction in stress concentration on the leaflet, with the effective orifice area still meeting ISO 5840-3 and the regurgitant volume achieving a similar value to those in previous studies. The maximum stress in the final iteration was reduced by 28% compared with that of the prototype. The proposed method shows potential for analyzing the stress distribution and hemodynamic performance of subregional thickened valves and can further improve the durability of PHVs.

Bioaccumulation and Health Risk Assessment of Metals in Small-Sized Fish (Rhodeus sinensis, Ctenogobius giurinus) and Mussel (Cristaria plicata) from a River Reservoir, Southwest China.

In order to assess the bioaccumulation and health risk of metals in a river reservoir, concentrations of copper (Cu), zinc (Zn), lead (Pb), cadmium (Cd), arsenic (As), and mercury (Hg) in the water, sediments, two small-sized fish, and a freshwater mussel from the Zhoubai reservoir were examined. The results indicated that all of these metals conform with class one of environmental quality standards for surface water (State Environmental Protection Administration of China, GB 3838-2002). There were no significant differences for total metal concentrations in sediment between the three sampling sites (p > 0.05), but the bioavailable concentrations in S3 were the lowest. The Cd was dominated with exchangeable fraction and showed considerable risk. All metal concentrations except for Pb in Rhodeus sinensis were significantly higher than those in Ctenogobius giurinus (p < 0.05). The metal concentrations in Cristaria plicata showed a similar pattern of bioavailable metals in sediment, indicating that the metal concentrations in aquatic organisms were determined by the bioavailable forms of metals. Negative correlations were observed between the size of fish and concentrations of Cu, Zn, Pb, Cd, and As. However, significant positive correlations were found between the size of mussel and concentrations of Cd (p < 0.01), As (p < 0.05), and Hg (p < 0.01). Zn had the highest BCF values in fish and mussel. The aquatic organisms showed lower ability of metal bioaccumulation from the sediment. Low values of target hazard quotient (THQ), hazard index (HI), and carcinogenic risk (CR) indicated that these metals do not pose a health risk to public through fish and mussel consumption in this study area.

Super-Branched PdCu Alloy for Efficiently Converting Carbon Dioxide to Carbon Monoxide.

The alloying of noble metals with Cu is one of the most effective strategies for improving catalytic performance and reducing cost in electrocatalytic carbon dioxide reduction reactions (CO2RR). Previous works usually focused on the influence of morphology and composition on the catalytic activity, but lacked the study of the valence state ratio of metals and the electron transfer behavior on alloys. In this work, PdCu-2 alloy (Pd/Cu molar ratio is 1:2) was obtained by a simple one-step solvothermal method, which can effectively convert CO2 to CO with a maximum Faradaic efficiency (FE) of 85% at -0.9 V (vs. RHE). Then, the effect of the chemical state of Pd and Cu on the catalytic performance was investigated. The X-ray photoelectron spectroscopy (XPS) shows that the binding energy of Pd in PdCu alloy has a negative shift, which has affected the adsorption of key intermediates. When the proportion of oxidized state and zero-valent metal in the alloy is about 1:2, the PdCu alloy shows the best catalytic activity. In addition, the transient photovoltage (TPV) measurements further demonstrate that due to the introduction of Cu, the electron transfer rate of PdCu-2 becomes the slowest, which helps the accumulation of electrons on PdCu-2 and leads to the improvement of catalytic performance for electrocatalytic CO2RR. This work can provide more insights into the alloy catalysts of electrocatalytic CO2RR.

Comparative study on metal concentrations in water, sediments, and two fish species (Cyprinus carpio and Pelteobagrus fulvidraco) from the Wujiang River, China.

In order to assess the metal pollution in the Wujiang River, concentrations of Cu, Zn, Fe, Mn, Pb, Cd, As, and Hg in the water, sediments, and two fish species Cyprinus carpio and Pelteobagrus fulvidraco from the middle reaches (Tuomugang, TMG) and lower reaches (Wulong, WL) of the Wujiang River were examined. The results indicated that all metal concentrations were lower than the values for grade one water quality according to the Environment Quality Standard for Surface Water of China (GB 3838-2002). The bioavailable fraction concentrations of Zn, Fe, Mn, Pb, and Hg in WL were significantly higher than those in TMG (p < 0.05), indicating that these metals in sediments of WL have higher bioavailability and mobility. The Cu, Zn, Fe, Pb, As, and Hg were mainly related to the residual fraction, while the Mn and Cd were mainly associated with the non-residual fraction. The risk assessment code (RAC) and the secondary phase to the primary phase (RSP) values indicated that Mn and Cd have a high risk of secondary release. The mean metal concentrations in the liver of the two fish species were higher than those in muscle. The higher metal concentrations of fish in WL suggested that bioaccumulation of metals in fish could be influenced by metal bioavailability. No identical relationships between metal concentrations and fish length were manifested in the present study. The values of target hazard quotient (THQ) and hazard index (HI), and carcinogenic risk (CR) of metals for the consumption of C. carpio and P. fulvidraco indicated that the anglers would likely not experience significant non-carcinogenic risk, but the carcinogenic risk of As cannot be ignored. Thanks to prohibited commercial fishing in the Wujiang River, the metal pollution will probably not pose a health risk to the general public for wild fish consumption.

Pathological diagnosis and molecular alternations of pulmonary mucinous adenocarcinoma / 中国综合临床

Primary pulmonary mucinous adenocarcinoma is a rare subtype of lung adenocarcinoma. It differs from non-mucinous adenocarcinoma in etiology, pathogenesis, clinical, imaging, histological, immunophenotypic and genotypic features, prognosis and treatment. pulmonary mucinous adenocarcinoma mainly originates from bronchial basal cells and mucous cells. Tumor cells show a goblet and/or columnar cell morphology with abundant intracytoplasmic mucin and basally oriented nuclei, with a typical lepidic-predominant growth, the commonest molecular alterations are KRAS mutations.

Research progress of pulmonary rehabilitation in lung cancer / 中国医师杂志

Primary lung cancer is a malignant tumor with the highest incidence and mortality in China, and lung rehabilitation for lung cancer has become a research hotspot. Many literature and studies have confirmed the feasibility and safety of pulmonary rehabilitation for lung cancer, but the mechanism of pulmonary rehabilitation for lung cancer is not completely clear. This article will discuss the mechanism of pulmonary rehabilitation for lung cancer, the specific content of pulmonary rehabilitation and remote home pulmonary rehabilitation.

Solid placental transmogrification of the lung: A case report and literature review / 北京大学学报(医学版)

Placental transmogrification of the lung (PTL) is a very rare benign lung lesion. There are only about 40 cases reported in the literature. The imaging and histological features of PTL cases in the publication are various, most of which are cystic and a few of which are solid. Being extremely rare, the solid PTL is unknown to major pathologists and surgeons. We reported a case of solid PTL in the anterior mediastinum. The patient was a 52-year-old male with no history of smoking and without symptoms. During physical examination, chest CT revealed a circular low-density lesion with a maximum diameter of 2.9 cm beside the spine in the posterior basal segment of the left lower lobe of the lung. The wedge resection was performed by video-assisted thoracoscopy. Grossly, a round nodule was located underneath the visceral pleura. It was about 3.0 cm×3.0 cm×1.6 cm and the cut surface was grey-red, soft and spongy. Microscopically, the nodule was constituted of papillare, which resembled placental villi at low magnification. The axis of papillae was edema, in which some mild round cells with clear cytoplasm and CD10 positive staining aggregated and transitioned to immature adipocytes and amorphous pink materials deposited with a few of inflammatory cells infiltration. The surface of papillae was covered with disconti-nuous alveolar epithelium. Combined with the typical morphology and immunohistochemical characteristics of CD10 positive, the diagnosis was PTL. The patient was followed up for 1 year without recurrence and discomfort. So far, the pathogenesis of PTL is unclear. The major hypotheses include hamartoma, variant of emphysema and clonal hyperplasia of stromal cells. Based on the study of our case and publication, we speculate that the hyperplasia of stromal cells located in the alveolar septa might be the first step to form the solid PTL. With the progression of the disease, a typical unilateral cystic nodule develops as a result of secondary cystic degeneration due to the occlusive valve effect. Surgery is the only option for diagnosis and treatment of PTL. The clinician should make an individualized operation plan according to the clinical manifestations, location and scope of the lesion, and preserve the surrounding normal lung tissue as much as possible while completely removing the lesion. There is a favorable prognosis.

Thoracic SMARCA4-deficient undifferentiated tumor-pathological diagnosis and combined immune checkpoint inhibitor treatment / 北京大学学报(医学版)

We explored clinicopathological features and treatment strategies for thoracic SMARCA4-deficient undifferentiated tumor (SMARCA4-UT). Thoracic SMARCA4-UT is a new entity recently acknowledged in the 2021 edition of World Health Organization Classification of Thoracic Tumors, and doctors are relatively unfamiliar with its diagnosis, treatment, and prognosis. Taking a case of SMARCA4-UT treated in Peking University First Hospital as an example, this multi-disciplinary discussion covered several hot issues on diagnosing and treating thoracic SMARCA4-UT, including histological features, immu- nohistochemical and molecular phenotype, immune checkpoint inhibitor (ICI) therapy, and pathological assessment of neoadjuvant therapy response. The patient was an older man with a long history of smoking and was admitted due to a rapidly progressing solid tumor in the lower lobe of the right lung. Histologically, tumor cells were epithelioid, undifferentiated, diffusely positive for CD34, and partially positive for SALL4.The expression of BRG1 protein encoded by SMARCA4 gene was lost in all of tumor cells, and next-generation sequencing(NGS)confirmed SMARCA4 gene mutation (c.2196T>G, p.Y732Ter). The pathological diagnosis reached as thoracic SMARCA4-UT, and the preoperative TNM stage was T1N2M0 (ⅢA). Tumor proportion score (TPS) detected by immunohistochemistry of programmed cell death 1-ligand 1 (PD-L1, clone SP263) was 2%. Tumor mutation burden (TMB) detected by NGS of 1 021 genes was 16. 3/Mb. Microsatellite detection showed the tumor was microsatellite stable (MSS). Neo-adjuvant therapy was implemented with the combined regimen of chemotherapy and ICI. Right lower lobectomy was performed through thoracoscopy after the two weeks' neoadjuvant. The pathologic assessment of lung tumor specimens after neoadjuvant therapy revealed a complete pathological response (CPR). The post-neoadjuvant tumor TNM stage was ypT0N0M0. Then, five cycles of adjuvant therapy were completed. Until October 2022, neither tumor recurrence nor metastasis was detected, and minimal residual disease (MRD) detection was negative. At present, it is believed that if BRG1 immunohistochemical staining is negative, regardless of whether SMARCA4 gene mutation is detected, it should be classified as SMARCA4-deficient tumors. SMARCA4-deficient tumors include a variety of carcinomas and sarcomas. The essential criteria for diagnosing SMARCA4-UT includes loss of BRG1 expression, speci-fic histological morphology, and exclude other common thoracic malignant tumors with SMARCA4-deficiency, such as squamous cell carcinoma, adenocarcinoma and large cell carcinoma. SMARCA4-UT is a very aggressive malignant tumor with a poor prognosis. It has almost no targeted therapy mutations, and little response to chemotherapy, but ICI is currently the only effective drug. The successful diagnosis and treatment for this case of SMARCA4-UT should enlighten significance for various kinds of SMARCA4-deficient tumors.

Consistency comparison of programmed cell death 1-ligand 1 in different immuno-histochemical staining methods / 北京大学学报(医学版)

OBJECTIVE@#To compare the consistency of programmed cell death 1-ligand 1 (PD-L1, clone E1L3N, 22C3, SP263) in different immunohistochemical staining methods.@*METHODS@#The first step was to select the optimal process: The PD-L1(clone E1L3N) antibody recommended process, self-built process ①, self-built process ② and self-built process ③ were used to perform immunohistochemical staining in 5 cases of tonsil tissue. The quality of all slides was scored by expert pathologists (0-6 points). The process with the highest score was selected. The second step was to compare the consistency between the optimal procedure and the two standard procedures. Thirty-two cases of lung non-small cell carcinoma diagnosed by pathology in Peking University First Hospital in the past two years were randomly selected. The 32 cases were stained in parallel with the SP263 and 22C3 standard procedures, and all stained slides were scored by specialized pathologists for tumor proportion score (TPS). The scoring results were grouped according to < 1%, ≥1% to < 10%, ≥10% to < 50%, and ≥50%. The consistency of PD-L1 detection antibody clone E1L3N and 22C3, E1L3N and SP263 staining results was analyzed.@*RESULTS@#Tonsil stained slides scores (0-6 points) were as follows: The recommended protocol was 5, 5, 5, 5 and 5. The self-built process ① was 5, 6, 6, 5 and 6. The self-built process ② was 4, 4, 4, 4 and 4.The self-built process ③ was 3, 3, 3, 3 and 3. The self-built process ① was the best with the highest score. The TPSs of 32 non small cell lung carcinoma (NSCLC) cases were as follows: Of self-built process ①, 6 cases were lower than 1%, 5 cases were from 1% to 10%, 10 cases were from 10% to 50%, and 11 cases were higher than 50%; of 22C3 standard procedure, 5 cases were lower than 1%, 3 cases were from 1% to 10%, 13 cases were from 10% to 50%, 11 cases were higher than 50%; of SP263 standard procedure, 7 cases were lower than 1%, 4 cases were from 1% to 10%, 11 cases were from 10% to 50%, 10 cases were higher than 50%. The results of the consistency test were as follows: The κ value for self-built process ① and 22C3 standard procedure was 0.736 (P < 0.001), the agreement was good; the κ value for self-built process ① and SP263 standard procedure was 0.914 (P < 0.001), the agreement was very good.@*CONCLUSION@#The immunostaining using PD-L1(E1L3N) with validated self-built staining protocol ① by Ventana Benchmark GX platform can obtain high quality of slides, and the TPSs based on these slides are in good agreement with 22C3 and SP263 standard procedures.

Evaluation of accuracy of pathological diagnosis based on thyroid core needle biopsy / 北京大学学报(医学版)

OBJECTIVE@#To explore the protocol for diagnosing thyroid nodules based on core needle biopsy (CNB) and study the biomarkers' application in distinguishing indeterminate samples.@*METHODS@#Patients with thyroid nodules treated at Peking University First Hospital from 2015 to 2020 were reviewed. In the study, 598 cases with CNB and matched resected specimens were retrieved. According to "diagnostic categories of thyroid CNB" proposed by the Korean Endocrine Pathology Thyroid Core Needle Biopsy Study Group, the CNB samples were diagnosed as follows: Ⅰ, unsatisfactory; Ⅱ, benign; Ⅲ, indeterminate; Ⅳ, follicular neoplasm; Ⅴ, suspicious for malignancy; and Ⅵ, malignant. The samples of CNB Ⅲ were stained by immunohistochemistry (IHC) using antibodies against CK19, Galectin-3, HBME-1, and CD56, and detected by next-generation sequencing (NGS) using an OncoAim® thyroid cancer multigene assay kit (Singlera Genomics) that detected 26 genes. Taking the resected specimens' classification as the gold standard, the predictive value of CNB for determining the malignancy of thyroid nodules and the biomarkers for distinguishing the samples of CNB Ⅲ was calculated.@*RESULTS@#The study included 598 patients, of which none were CNB Ⅰ, 40 cases were CNB Ⅱ, 40 cases were CNB Ⅲ, 32 cases were CNB Ⅳ, 35 cases were CNB Ⅴ, and 451 cases were CNB Ⅵ. The predictive value of CNB Ⅳ for determining follicular neoplasm was sensitivity (Sen) 100.00% and specificity (Sep) 100.00%, CNB Ⅴ-Ⅵ for determining malignancy was Sen 94.55% and Sep 100.00%, CNB Ⅱ for determining benign lesions was Sen 75.00% and Sep 99.80%. The predictive value of biomarkers for determining malignancy in cases of CNB Ⅲ was Sen 96.30% and Sep 92.31% by NGS, and Sen 81.48% and Sep 92.30% by IHC.@*CONCLUSION@#The Korean "diagnostic categories of thyroid CNB", which considers the histological specificity of CNB samples and the habits of clinicians, have strong operability, high diagnosis rate, and high clinical value. Under this framework, the cases of CNB Ⅵ should be treated with surgical operation, the cases of CNB Ⅴ-Ⅵ are recommended to be treated as malignant neoplasms, and the major cases of CNB Ⅱ could be followed up without worrisome except the one considered malignant by ultrasound. The value of biomarkers in distinguishing the cases of CNB Ⅲ is significant.

Research progress in the etiology of hepatitis type E virus / 中华肝脏病杂志

Hepatitis type E virus (HEV) is a significant infectious zoonotic disease that causes hepatitis E. The disease is primarily transmitted via the fecal-oral route through contaminated water or food and is transmissible between species and genera. The causative agent for the disease is the hepatitis type E virus, which is a member of the Hepadnaviridae family and a single-stranded RNA virus. Its 7.2 kb genome mainly contains three open reading frames (ORFs): ORF1 encodes a non-structural polyprotein that mediates viral replication and transcription; ORF2 encodes a capsid protein and free antigen that induce neutralizing antibodies; ORF3 partially overlaps with ORF2 and encodes a small multifunctional protein involved in virion formation and release. HEV has a unique dual life cycle: it is excreted into feces in the form of naked virions but circulates in the blood in the form of "quasi-enveloped" particles. The two kinds of virus particles adsorb and penetrate the host cell in distinct ways, then internalize and decapsulate to replicate the genome, thereby producing more virion and releasing it outside the cell to mediate the virus's spread. This paper reviews the morphological characteristics, genome structure, encoded proteins, and function of HEV virus-like particles in order to provide a theoretical basis for basic research and comprehensive disease prevention and control.

Establishment of a risk model for severe adenovirus pneumonia and prospective study of the timing of intravenous immunoglobulin therapy in children / 中国当代儿科杂志

OBJECTIVES@#To develop a risk prediction model for severe adenovirus pneumonia (AVP) in children, and to explore the appropriate timing for intravenous immunoglobulin (IVIG) therapy for severe AVP.@*METHODS@#Medical data of 1 046 children with AVP were retrospectively analyzed, and a risk prediction model for severe AVP was established using multivariate logistic regression. The model was validated with 102 children with AVP. Then, 75 children aged ≤14 years who were considered at risk of developing severe AVP by the model were prospectively enrolled and divided into three groups (A, B and C) in order of visit, with 25 children in each group. Group A received symptomatic supportive therapy only. With the exception of symptomatic supportive therapy, group B received IVIG treatment at a dose of 1g/(kg·d) for 2 consecutive days, before progressing to severe AVP. With the exception of symptomatic supportive therapy, group C received IVIG treatment at a dose of 1 g/(kg·d) for 2 consecutive days after progressing to severe AVP. Efficacy and related laboratory indicators were compared among the three groups after treatment.@*RESULTS@#Age<18.5 months, underlying diseases, fever duration >6.5 days, hemoglobin level <84.5 g/L, alanine transaminase level >113.5 U/L, and co-infection with bacteria were the six variables that entered into the risk prediction model for severe AVP. The model had an area under the receiver operating characteristic curve of 0.862, sensitivity of 0.878, and specificity of 0.848. The Hosmer-Lemeshow test showed good consistency between the predicted values and the actual observations (P>0.05). After treatment, group B had the shortest fever duration and hospital stay, the lowest hospitalization costs, the highest effective rate of treatment, the lowest incidence of complications, the lowest white blood cell count and interleukin (IL)-1, IL-2, IL-6, IL-8, IL-10 levels, and the highest level of tumor necrosis factor alpha (P<0.05).@*CONCLUSIONS@#The risk model for severe AVP established in this study has good value in predicting the development of severe AVP. IVIG therapy before progression to severe AVP is more effective in treating AVP in children.

Mid-term effectiveness of arthroscopic Bankart repair in treatment of recurrent anterior shoulder dislocation / 中国修复重建外科杂志

OBJECTIVE@#To investigate the mid-term effectiveness of arthroscopic Bankart repair for recurrent anterior shoulder dislocation.@*METHODS@#The clinical data of 107 patients with recurrent anterior shoulder dislocation who met the inclusion criteria between January 2017 and June 2021 was retrospectively analyzed, and all patients underwent arthroscopic Bankart repair. There were 88 males and 19 females. The age of the primary dislocation ranged from 13 to 48 years (mean, 23.3 years). The number of preoperative dislocations was 2-160 times (median, 7 times). The duration of preoperative instability was 0.2-240.0 months (median, 36.0 months). The mean age at operation was 28.2 years (range, 16-61 years). There were 43 cases of left shoulder and 64 cases of right shoulder. The proportion of glenoid defects in 63 patients was 1.7%-16.1% (mean, 8.1%). MRI showed that none of the patients had rotator cuff tears or shoulder stiffness. The CT three-dimensional reconstruction was performed at 1 day after operation to evaluate the distribution of implanted anchors and the occurrence of glenoid split fracture and whether there were nails pullout at the implant site. The postoperative complications were observed, and the pain and function of the shoulder were evaluated by visual analogue scale (VAS) score, Rowe score, Constant-Murley score, and American Shoulder and Elbow Surgeons (ASES) score. The recurrence of instability, the results of apprehension test, the number of patients who returned to preoperative sports level, and the satisfaction rate of patients were recorded.@*RESULTS@#All patients were successfully operated and were followed up 20-73 months (mean, 41.5 months). All incisions healed by first intention. The CT three-dimensional reconstruction at 1 day after operation showed that the anchors were located at the 2 : 00-5 : 30 positions of the glenoid, and there was no glenoid split fracture or nails pullout at the implant site. At last follow-up, VAS score was significantly lower than that before operation, and Rowe score, Constant-Murley score, and ASES score were significantly higher than those before operation ( P<0.05). Seven patients (6.5%) had recurrence of anterior shoulder dislocation at 23-55 months (mean, 39.9 months) after operation, including 6 cases of dislocation and 1 case of subluxation. At last follow-up, 51 patients (47.7%) returned to preoperative sports level, and 11 patients (10.3%) had a positive apprehension test. The patients' satisfaction rate was 90.7% (97/107). Among the 10 patients who were not satisfied with the surgical effectiveness, 7 patients had postoperative recurrence of instability, and 3 patients felt that they did not return to preoperative sports level.@*CONCLUSION@#Arthroscopic Bankart repair has good mid-term effectiveness in patients with recurrent anterior shoulder dislocations, minimal or no glenohumeral bone defects and low sports need.