Transnasal Endoscopic and Transoral Approaches in the Biopsies of Ventral Atlas and Axis Vertebrae: A Comprehensive Retrospective Study for Preprocedural Scheme,Biopsy Procedure,Core Technique Analysis,Diagnostic Yield and Clinical Outcome

ObjectiveThis study aims to describe and analyze the transoral and transnasal approaches for pathologies of the ventral atlas and axis vertebrae, which are considered technically challenging regions for diagnostic biopsy.MethodsA series of transnasal endoscopic approach (TNA) and transoral approach (TOA) biopsies for the pathologies of the first and second cervical vertebrae were conducted and retrospectively analyzed from July 2014 to May 2021. The depth of the biopsy trajectory was measured on computed tomography images for all nine patients (eight males and one female with an average age of 58.11 ± 11.60 years), as were the coronal, sagittal, and vertical biopsy safe ranges. The characteristics of each lesion, including radiographic features, blood supply, and destruction of anterior or posterior vertebral body edges, were evaluated to guide the biopsy. Four biopsy core techniques (BCTs), including “lesion perforating”, “aspiration”, “cutting‐and‐scraping” and “biopsy forceps utilization” were elaborated in this study. The biopsy procedures and periprocedural precautions were demonstrated. Patient demographics, clinical data, lesion characteristics, diagnostic yield, and complications were recorded for each case.ResultsEight TOA biopsies for the axis vertebral body and one TNA biopsy for the atlas anterior arch were successfully performed and yielded adequate pathologies. All biopsies were organized based on the preprocedural radiographic measurements, which showed that the average length of biopsy trajectory and coronal, sagittal, and vertical safe biopsy ranges were 85.00 ± 5.88, 20.63 ± 4.75, 16.25 ± 1.49, and 24.63 ± 2.26 mm, respectively, and these corresponding data were 95, 36, 9, and 26 mm in the TNA patient. Six osteolytic lesions (66.7%), one osteoblastic lesion (11.1%), and two mixed lesions (22.2%) were observed, among which seven lesions had a rich blood supply. Biopsy forceps and core needles were utilized to obtain samples in six and three patients, respectively. All the TNA and TOA biopsies were performed with cooperative application of multiple BCTs under compound anatomic and stereotactic navigations. Intraprocedural or postprocedural complications occurred in no patients who underwent the biopsy in the follow‐up period (1–39 months). No significant differences were found between the preprocedural and postprocedural blood indexes and visual analogue scale scores.ConclusionWith a sophisticated preprocedural arrangement, cooperative application of BCTs, and careful periprocedural precautions, transnasal endoscopic and transoral biopsies are two feasible, efficient, and well‐tolerated procedures that achieve satisfactory diagnostic yield, complication rate, and clinical outcome.     

高效液相色谱法测定通络活血丸人参皂苷Rg1含量

[目的]建立通络活血丸中人参皂苷Rg1含量的测定方法。[方法]采用高效液相色谱法,色谱柱为Kromasil C184.6mm×250mL,4.6μm;流动相为乙腈-0.05%磷酸溶液(21∶80),检测波长为203nm,流速为0.8mL/min。[结果]人参皂苷Rg1含量在0.83与0.89之间,平均回收率99.26%,RSD为1.2%,结果表现回收率良好。[结论]方法简便、准确、专属性强、重现性好,可作为通络活血丸的治疗控制方法。     

乳腺癌患者心理状况及相关因素分析

目的探讨乳腺癌患者的心理健康及相关因素。方法使用症状自评量表SCL-90,EPQ,生活事件量表(LES),并以45名健康患者作对照。结果乳腺癌患者的心理健康状况较差。EQP的P,N,E分值分别为5.49±3.76,7.48±3.07,12.19±5.28、LES总分均与对照组有明显差异。结论应普及有关预防性知识教育,积极改善乳腺癌患者的心理健康状况。     

增损柴胡加龙骨牡蛎汤临证思辨录

结合验案,分析柴胡加龙骨牡蛎汤用于治疗痫病、抑郁型精神分裂症（癫病）、绝经期前后诸症、善恐、颈椎病、眩晕、冠心病（胸痹）等杂病的辨治思路。     

儿童伪膜性肠炎的临床分析

<正>随着抗生素种类的不断增多以及在临床的广泛使用[1],伪膜性肠炎(pseudomembranous colitis,PMC)的发生率逐年增加[2-4]。PMC主要发生于结肠和小肠的急性纤维素渗出性炎症,多系在应用抗生素后导致正常肠道菌群失调,难辨梭状芽胞杆菌(clostridiumdifficile,CD)大量繁殖,产生毒素而致病。临床主要表现为腹泻、腹痛、发热、黏液血便、水电解质及血生化指标异常,与肠道     

Analysis of Carbonation Behavior of Cracked Concrete

The crack and carbonation of concrete pose a great challenge to its durability. Therefore, this paper studies the effect of cracks on the carbonation depth of cement paste under different factors. The relationship between carbonation and cracks was determined, and the carbonation mechanism of cement paste with cracks was clarified. The results show that a small water–binder ratio can effectively inhibit the carbonation process. The bidirectional carbonation enlarged the carbonation area around the crack. Within 21 days of the carbonation, the carbonation depth increased with carbonation time, and the Ca(OH)₂ on the surface of the specimen was sufficient, allowing for a convenient chemical reaction with CO₂. The influence of crack width on the carbonation process at the crack was greater than the influence of the crack depth. Carbonation influenced the hydration of cement-based materials, altering the types and quantities of hydration products. In conclusion, accurately predicting the regularity of carbonation in cracked structures is critical for improving the durability of concrete.     

IL‐27 improves adoptive CD8+ T cells’ antitumor activity via enhancing cell survival and memory T cell differentiation

IL‐27 is an anti‐inflammatory cytokine that triggers enhanced antitumor immunity, particularly cytotoxic T lymphocyte responses. In the present study, we sought to develop IL‐27 into a therapeutic adjutant for adoptive T cell therapy using our well‐established models. We have found that IL‐27 directly improved the survival status and cytotoxicity of adoptive OT‐1 CD8⁺ T cells in vitro and in vivo. Meanwhile, IL‐27 treatment programs memory T cell differentiation in CD8⁺ T cells, characterized by upregulation of genes associated with T cell memory differentiation (T‐bet, Eomes, Blimp1, and Ly6C). Additionally, we engineered the adoptive OT‐1 CD8⁺ T cells to deliver IL‐27. In mice, the established tumors treated with OT‐1 CD8⁺ T‐IL‐27 were completely rejected, which demonstrated that IL‐27 delivered via tumor antigen–specific T cells enhances adoptive T cells’ cancer immunity. To our knowledge, this is the first application of CD8⁺ T cells as a vehicle to deliver IL‐27 to treat tumors. Thus, this study demonstrates IL‐27 is a feasible approach for enhancing CD8⁺ T cells’ antitumor immunity and can be used as a therapeutic adjutant for T cell adoptive transfer to treat cancer.     

Development and evaluation of time‐resolved fluorescent immunochromatographic assay for quantitative detection of SARS‐CoV‐2 spike antigen

BackgroundThe spread of COVID‐19 worldwide caused by the severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) has necessitated efficient, sensitive diagnostic methods to identify infected people. We report on the development of a rapid 15‐minute time‐resolved fluorescent (TRF) lateral flow immunochromatographic assay for the quantitative detection of the SARS‐CoV‐2 spike protein receptor‐binding domain (S1‐RBD).ObjectivesOur objective was to develop an efficient method of detecting SARS‐CoV‐2 within 15 min of sample collection.MethodsWe constructed and evaluated a portable, disposable lateral flow device, which detected the S1‐RBD protein directly in nasopharyngeal swab samples. The device emits a fluorescent signal in the presence of S1‐RBD, which can be captured by an automated TRF instrument.ResultsThe TRF lateral flow assay signal was linear from 0 to 20 ng/ml and demonstrated high accuracy and reproducibility. When evaluated with clinical nasopharyngeal swabs, the assay was performed at >80% sensitivity, >84% specificity, and > 82% accuracy for detection of the S1‐RBD antigen.ConclusionThe new S1‐RBD antigen test is a rapid (15 min), sensitive, and specific assay that requires minimal sample preparation. Critically, the assay correlated closely with PCR‐based methodology in nasopharyngeal swab samples, showing that the detected S1‐RBD antigen levels correlate with SARS‐CoV‐2 virus load. Therefore, the new TRF lateral flow test for S1‐RBD has potential application in point‐of‐care settings.