Objective To identify the histopathological characteristics of multiple organ dysfunction syndrome (MODS) with V. vulnificus in mice. Methods Sixteen healthy KM mice (6～8 week old ) divided randomly into two groups, study group ( n =12) and control group ( n =4) The animal model of MODS was established by received either an intraperitioneal, intramuscular subcuneous inoculum of 4.34?10 6 cfu/0.2 ml of V.vulnificus or intraperitioneal injection of a sterile physiological salt solution (control group). Pathological changes of the man organs were individually obsenved in under election microscope (EM). Results Mortality rates exced 100%, 12/12) in study group after inoculums of mice within 4～8 h, while in 0% (0/0) in the control . The detection rate of V. vulnificus were in 100%(12/12) from blood, hearts, lungs, livers, intramuscularly, subcutaneous in the study group, while in 0% (0/4) after sterile saline intraperitioneal injection. The man histopathological changes were :degeneration and necrosis of the parenchyma cells in the different organs;interstitial swelling, mitochondriondrial injure of multiple organs.These changes were especially obvious in the lungs and myocardeum. Conclusions Above pathological changes suggested that results of MODS caused by V. vulnificus septicemia,the multiple organs failure as an important feature of the fatality of V. vulnificus infections,and my be helpful for researchers investigating of V.vulnificus.

Objective To compare the long term effectiveness of tonsillotomy(TT)vs. tonsillectomy (TE)by hypercator in treatment of obstructive sleep apnea hypopnea syndrome(OSAHS)in children. Methods 119 children with tonsil hypertrophy were diagnosed with OSAHS and included in the study. Among them,57 children underwent TT by hypercator and 62 TE only after preoperative laboratory polysomnography(PSG). All participants were interviewed 5 years after operation to assess the satisfaction of their caregivers,investigate the frequency of respiratory infections,the rate of tonsil regrowth and evaluate their quality of life by Obstructive Sleep Apnea-18(OSA-18). Results Some of them received postoperative PSG. All parents reported alleviation of breathing obstruction,but the postoperative satisfaction in TT group was higher than TE group mainly because of the shorter time return to normal diet. The rate of the respiratory tract infections was not increased in all cases after surgery. Four cases of children were observed with tonsillar regrowth,but no surgery was needed for further treatment. The rate of the dry throat symptoms in TT group was lower than TE group. Conclusions Tonsillotomy by hypercator can effectively eliminate the obstruction symptoms in children with OSAHS,superior to TE for its shorter recovery period and smaller oral mucosal injury and lower rate of tonsils regrowth and it is worth to clinical promotion.

Objective To evaluate the safety and effectiveness of endovascular balloon dilatation in removing incarcerated tunnel cuffed catheter (TCC) . Methods The clinical data and the imaging materials of 4 hemodialysis patients with incarcerated TCC, who received endovascular balloon dilatation at Taizhou Hospital of Zhejiang Province, China, during the period from January 2017 to March 2018, were retrospectively analyzed. After the treatment, the patient's vital signs were monitored, and the procedure-related complications such as hemopneumothorax, subcutaneous hematoma, arrhythmia, etc. were documented. Results The mean age of the 4 patients was (73.3±6.4) years. The average indwelling time of TCC was 5.5 years (4-8 years) . Successful treatment of incarcerated TCC was achieved in all 4 patients. In one patient, both 5-mm and 6-mm balloons were used to simultaneously dilate the dual cavities of TCC.Temporary arrhythmia occurred in one patient during operation. No serious postoperative complications occurred. Conclusion For the remove of long-term indwelling incarcerated TCC, endovascular balloon dilatation is minimally-invasive, safe and effective, although more researches are needed to further confirm its safety and reliability.

As the overweight and obese population is growing， the incidence of obstructive sleep apnea is rising， and most of the cases are complicated with coronary heart disease and other cardiovascular diseases. The two diseases affect each other and seriously endanger the patients' health， becoming a major public health problem of global concern. It is of great clinical importance to explore the combination of Chinese and Western medicine in the prevention and treatment of coronary heart disease complicated with obstructive sleep apnea syndrome. Researchers have explored the relationship between the two based on traditional Chinese medicine（TCM） theory and found that the two diseases belong to the TCM disease categories of chest impediment and snoring， respectively， and their co-morbidity is associated with the abnormal physiological functions of the heart and lungs. The failure of the heart to govern blood leads to the generation of blood stasis， and that of the lung to govern Qi movement leads to the generation of phlegm. The accumulation of phlegm and blood stasis in the chest causes chest impediment and snoring due to obstruction of the airway. This paper discusses the internal linkage between the pathogenesis of coronary heart disease and obstructive sleep apnea syndrome in Chinese and Western medicine from the TCM theory of heart-lung correlation. Furthermore， this paper proposes the treatment principles of simultaneously treating the heart and lung and activating blood and resolving phlegm， aiming to provide a theoretical basis for the clinical prevention and treatment of coronary heart disease complicated with obstructive sleep apnea.

Metastatic triple-negative breast cancer (TNBC) is the most aggressive type of breast cancer. Combination of systemic chemotherapy and immune checkpoint blockade is effective but of limited benefit due to insufficient intratumoral infiltration of cytotoxic T lymphocytes (CTLs) and the accumulation of immunosuppressive cells. Herein, we designed a lenvatinib- and vadimezan-loaded synthetic high-density lipoprotein (LV-sHDL) for combinational immunochemotherapy of metastatic TNBC. The LV-sHDL targeted scavenger receptor class B type 1-overexpressing 4T1 cells in the tumor after intravenous injection. The multitargeted tyrosine kinase inhibitor (TKI) lenvatinib induced immunogenic cell death of the cancer cells, and the stimulator of interferon genes (STING) agonist vadimezan triggered local inflammation to facilitate dendritic cell maturation and antitumor macrophage differentiation, which synergistically improved the intratumoral infiltration of total and active CTLs by 33- and 13-fold, respectively. LV-sHDL inhibited the growth of orthotopic 4T1 tumors, reduced pulmonary metastasis, and prolonged the survival of animals. The efficacy could be further improved when LV-sHDL was used in combination with antibody against programmed cell death ligand 1. This study highlights the combination use of multitargeted TKI and STING agonist a promising treatment for metastatic TNBC.