A 59-year-old man was admitted to the Department of Ear, Nose and Throat with a complaint of six-month history of left facial numbness and toothache. There was no special previous medical history in addition to smoking. No obvious abnormality in routine electrocardiogram, chest X-ray, abdominal B ultrasound were found. (1) CT scans showed heterogeneous shadows in maxillary sinus with the lesions on the left max- illary bone and evidently destruction of alveolar bone. The histopathological examination revealed bone tissue which was partly covered by an intact adenocarcinoma cell. (2) Immunohistochemical staining foe CK7, CD117, thyroid transcription factor-1, and novel aspartic proteinase A were positive and thus compatible with metastatic lung adenocarcinoma. (3) Chest CT scans showed a 1 cm x 2 cm mass on the superior lobe of the left lung, with destruction of sternum and rib, confirming that the lesions in the paranasal sinuses were lung cancer metastases. Therefore, this patient conclusively diagnosed as lung adenocarcinoma with multiple bone metastases.
Adenocarcinoma ; diagnosis ; pathology ; Adenocarcinoma of Lung ; Bone Neoplasms ; secondary ; Humans ; Lung Neoplasms ; diagnosis ; pathology ; Male ; Maxillary Sinus ; pathology ; Middle Aged ; Nose Neoplasms ; secondary

ObjectivesTo study the effect of community interventions and management on asthma in children and its impact on knowledge, attitude, and practice (KAP)of parents and the home environment.MethodsAn asthma health management profile of 0 to 14-year-old asthmatic children (n =93 ) in Sanlitun and Liulitun communities in Chaoyang District in Beijing was established.The children were randomly divided into a management group ( n =49) and control group ( n =44 ) based on community.Community-integrated management,such as regular follow-up,condition monitoring and health education,was implemented in the asthmatic children in the management group but not in the control group.The parents' KAP and the household environment in the two groups were compared after 1 year based on the changes shown in the health management profile.ResultsThe asthma relapse rate decreased to 27.9％ (12/43) in the management group.Compared with the control group,the rates of hospitalization (x2 =8.174,P =0.004) and school absences ( x2 =4.962,P =0.026) significantly decreased.The KAP level of parents increased to 67.4％ ( 29/43 ) in the management group and 20.4％ (9/44) in the control group,and the difference was statistically significant (x2 =19.517,P ＜0.01 ).Knowledge improved the most and showed a significant difference from the control group ( x2 =19.517,P ＜0.01 ).Home environment in the management group improved to 76.7％ (33/43).The number of indoor pets ( x2 =3.906,P =0.048) and indoor cockroaches ( x2 =4.962,P =0.026 ) reduced and showed significant differences between the two groups.In addition,children's allergy-related symptoms decreased to 30.2％ ( 13/43 ) in the management group compared with 9.1％ (4/44) in the control group,which was a significant difference ( x2 =6.183,P =0.013).ConclusionsParents' knowledge of asthma,compliance behaviors,and home environmentwere effectively improved through community-integrated management.This management technique can reduce the allergy-related symptoms of asthmatic children,improve asthma severity,and reduce the influence of asthma on children's daily lives.

Objective The aim is to observe the role and mechanism of estradiol ( E2 ) on the proliferation of rat hippocampal neural stem cells ( NSCs ) .Methods Twenty hippocampi from embryonic 17-day ( E17 ) SD rats were dissociated and plated into culture flasks with NSCs specific medium containing different concentrations of estradiol .The proliferation and the vitality of NSCs were detected by immunofluorescence against BrdU and MTT assay .The expression of estrogen receptors ( ERαand ERβ) was measured by immunofluorescence staining combined with Nestin double labeling . Results BrdU and MTT assay results showed that the cell number increased when the concentration of estradiol increased from 10 -10 to 10 -8 mol/L.The number of cell proliferation and the viability of cells were best at the concentration of 10 -8 mol/L compared to the other groups .However, when the estradiol concentration was increased from 10-8 to 10 -6 mol/L, the cell proliferative capacity declined gradually .Double immunofluorescence labeling showed that the two types of estrogen receptors ( ERαand ERβ) were expressed in the cultured hippocampal NSCs .Conclusion Estradiol promotes the proliferation of hippocampal NSCs in a certain concentration range , and ERαand ERβmay be involved in the estradiol-induced proliferation .

Objective To investigate the level and influencing factors of stigma among patients with lung cancer, in order to provide evidence for staff nurses to take pertinent interventions for assisting patients to deal with stigma. Methods Totally 234 hospitalized patients with lung cancer were cross-sectional survey with General Demographic Questionnaire, Disease Information Questionnaire, Chinese version of Cataldo Lung Cancer Stigma Scale (CLCSS-CV). Results The total score of stigma was (72.35±10.85) points. The total scale score and each subscale score was divided by the item number. The mean score of CLCSS-CV was (2.68±0.40) points, the rate of the patients with lung cancer with moderate above stigma was 51.20% (120/234). The patients rated higher scores on the subscales of smoking (2.90±0.58) points, while lower scores on the subscales of discrimination (2.47 ±0.55) points. Multiple stepwise regression analysis showed that the number of children and the clinical stages were influencing factors of lung cancer stigma, where regression coefficients were -0.065, 0.136 respectively, coefficients of determination was 0.178. Conclusions Patients with lung cancer have a moderate or higher level of stigma. The medical staff should communicate with patients, evaluate the psychological status, impose public health education, mobilize the social support for assisting them to deal with stigma.

Objective: To investigate the hepatitis C prevention and control knowledge among clinicians in Jiaxing City, Zhejiang Province, so as to provide the evidence for intensified training and improved diagnosis and treatment of hepatitis C among clinicians. Methods: In November, 2021, clinicians were sampled using a stratified random sampling method from a city-level and a county (district)-level hepatitis C designated hospital in Jiaxing City. A questionnaire survey was performed using the Questionnaire for Hepatitis C Prevention and Control Knowledge among Clinicians, and the awareness of basic knowledge, professional knowledge and related knowledge about hepatitis C prevention and control among clinicians were descriptively analyzed. Results: A total of 186 questionnaires were allocated and 179 valid questionnaires were recovered, with an effective recovery rate was 96.24%. The respondents included 107 men (59.78%) and 72 women (40.22%) and had a mean age of (37.06±9.46) years. There were 107 respondents with a bachelor degree (59.78%), 56 with junior professional titles (31.28%), and 170 from non-infectious disease departments (94.97%). The awareness of basic hepatitis C prevention and control knowledge was 96.09%, and the awareness of “Transfusion of blood containing hepatitis C virus may acquire hepatitis C” was high (98.88%), and the awareness of “Hepatitis C can be cured” was low (77.09%). The awareness of professional hepatitis C prevention and control knowledge was 3.91% to 100.00%, and the awareness of “Pathogens of hepatitis C” (100.00%) and “Recommended screening populations for hepatitis C” (86.59%) was high, while the awareness of “There are two categories of hepatitis C cases: clinically diagnosed cases and confirmed cases” (3.91%) and “Clinical diagnosis of hepatitis C: positive anti-HCV antibody + any one of abnormal liver function or epidemiological history or clinical symptoms” (3.91%) was low. The awareness rates of “The state has included antiviral agents against hepatitis C into medical insurance” was and “Antiviral agents against hepatitis C are reimbursed in outpatient and inpatient departments of our hospital” were 81.56% and 59.78%, respectively. There were 69 clinicians participating hepatitis C-related training within one year (38.55%), and the awareness of clinicians that had participated in hepatitis C-related training had a higher awareness rate of basic hepatitis C prevention and control knowledge than those without participation (100.00% vs. 93.64%, P<0.05). Conclusion The awareness of basic hepatitis C prevention and control knowledge is high among clinicians in Jiaxing City; however, the training on diagnosis and classification criteria of hepatitis C and related medical insurance policy require to be improved.

Objective:To explore the anti-inflammatory therapeutic effect and possible immunoregulatory mechanism of Buyang Huanwu Decoction (BYHWD) on the development of experimental autoimmune encephalomyelitis (EAE). Methods:Female C57BL/6 mice were immunized subcutaneously with myelin oligodendrocyte glycoprotein peptides ( MOG35-55 ) ,and randomly divided into saline group,BYHWD group,with 13 mice in each group. At the 3th day,25 ml/kg of saline was orally given to each mouse of saline group,50 g/kg ig of crude BYHWD was orally given to each mouse in BYHWD group for 25 days. Clinical score and body mass were recorded every day. Inflammatory cell infiltrations of spinal cord were observed by HE staining Myelin staining observes the demyelination situa-tion. And the expression of ROCKⅡ in spleen was detected by immunofluorescence staining. The subtypes of CD4+ T cells were analyzed by flow cytometry. Western blot was used to detect the expression of TLR4,Myd88,NF-κB,COX-2,ROCKⅡ in spinal cord and ROCKⅡ in brain. Results: The neurologicalscore significantly decreased in EAE mouse of BYHWD group compared with the saline group (P<0. 001) . BYHWD inhibited the inflammatory cell infiltration and demyelination in the nervous centralis(P<0. 05). The treatment of BYHWD effectively reduced the increased the proportion of CD25+(P<0. 05),IL-10+(P<0. 05),TGF-β+(P<0. 01), IFN-γ+( P<0. 05 ) CD4+T cells , and inhibited the expression of peripheral and central ROCKⅡ( P<0. 05 ) ;BYHWD reduced the expression of TLR4,MyD88,NF-κB,COX-2 in spinal cord (P<0. 05). Conclusion:BYHWD can exert anti-inflammatory and immune regulation effect by the inhibition of ROCKⅡ/TLR4/ NF-κB signaling pathway and regulation of the proportion of peripheral T cell sub-sets.

Monkeypox is a zoonotic disease caused by monkeypox virus. It is similar to human smallpox, although typically much less serious and limited to human-to-human transmission. Smallpox no longer occurs following its worldwide eradication in 1980, whereas monkeypox still occurs sporadically in parts of Africa. To respond to the outbreak of monkeypox correctly, we need to rely on effective method of virus detection. This review presents the development in monkeypox virus detection method in recent years to provide reference for the situation of potential virus spreading into our country and for preventing and acting correctly against bioterrorism.

OBJECTIVETo analyze the clinical phenotype of a Chinese pedigree affected with Papillon-Lefevre syndrome(PLS) and detect mutation of CTSC gene.

METHODSClinical phenotypes were noted, and oral examination for the proband was carried out for the clinical diagnosis of PLS. PCR and Sanger sequencing were used to identify potential mutation of the CTSC gene. Functional effect of the mutation was predicted with SIFT and PolyPhen-2. Swiss-Port was used to predict the tertiary structure of wild type and mutant proteins. The mRNA and protein expression were analyzed by real-time PCR and Western blotting.

RESULTSA homozygous mutation c.901G>A (p.G301S) in exon 7 of CTSC gene was identified in the patient. Both parents of the patient had carried a heterozygous c.901G>A mutation. The mutation was located in the conserved region of CTSC enzyme and was predicted to be damaging by changing the structure of the protein, which could affect the activity of Cathepsin C. However, no significant difference was found in the expression of p.G301S variant at the mRNA and protein levels compared with that of the wild type CTSC gene.

CONCLUSIONThe c.901G>A mutation of the CTSC gene was first reported in China, which has expanded its mutation spectrum.

Adult ; Asian Continental Ancestry Group ; genetics ; Base Sequence ; Cathepsin C ; genetics ; Child, Preschool ; China ; Exons ; Female ; Humans ; Male ; Molecular Sequence Data ; Mutation ; Papillon-Lefevre Disease ; enzymology ; genetics ; Pedigree

AIM:To explore the therapeutic effect of Buyang-Huanwu decoction (BYHWD) on experimental au-toimmune encephalomyelitis ( EAE) and its immunoregulatory effect on monocyte-macrophages .METHODS: Chronic EAE was induced by myelin oligodendrocyte glycoprotein peptide fragment 35-55 ( MOG35-55 ) in the female C57BL/6 mice, which were randomly divided into saline group and BYHWD group .On day 3 after immunization , the mice in BYHWD group were orally administrated with BYHWD , while normal saline was given to the control mice .The clinical score and body mass were recorded every other day .At day 17 after immunization , the mice were sacrificed and spinal cords were obtained for HE staining and myelin staining .The M1 and M2 macrophage phenotypes of splenic cells were detected by flow cytometry and immunofluorescence staining .The protein expression of iNOS , TNF-α, arginase and IL-10 in the spinal cord macro-phages was determined by Western blotting .RESULTS:BYHWD delayed the onset of EAE , reduced the clinical scores of EAE, inhibited the inflammatory cell infiltration and demyelination in the spinal cord , and promoted the conversion of M 1 macrophages into M2 phenotype in the spinal cord and spleen .CONCLUSION:BYHWD intervention attenuates the be-havioral and pathological changes in the EAE mice , and its mechanism may be related to the macrophage conversion .

Objective:To investigate risk factors for infection of biofilm-forming Klebsiella pneumonia and prognosis of patients. Methods:The clinical data of 125 patients with Klebsiella pneumoniae bloodstream infection admitted in Tianjin Medical University General Hospital from January to December 2019 were analyzed retrospectively. According to the presence of Klebsiella pneumoniae biofilm, patients were divided into biofilm positive group ( n=81) and biofim negative group ( n=44). In biofilm positive group 17 patients died (fatal group) and 64 survived (survival group) during 3-month follow-up. The antimicrobial resistance of the strains was analyzed, and multivariate logistic regression analysis was used to investigate the risk factors of biofilm-forming Klebsiella pneumoniae infection and the risk factors of death in biofilm positive group. Results:A total of 125 strains of Klebsiella pneumoniae were isolated from 125 patients, of which 81(64.80%) strains were biofilm positive. Antimicrobial resistance analysis showed that the resistance rate of biofilm positive group to aztreonam, amikacin, ciprofloxacin and levofloxacin was significantly higher than that in the biofilm negative group ( χ2=5.94, 4.03, 5.05 and 4.15, P<0.05). Multivariate logistic regression analysis showed that endotracheal intubation ( OR=3.460, 95% CI 2.890-14.445, P<0.05) and administration of immunosuppressants ( OR=6.945, 95% CI 1.160-21.567, P<0.05) within 3 months before infection were independent risk factors for biofilm-forming Klebsiella pneumoniae bloodstream infection. The use of tegacycline ( OR=4.886, 95% CI 1.123-21.263, P<0.05) within 3 months before death was independent risk factors for the death of biofilm-positive Klebsiella pneumoniae bloodstream infection. Conclusions:In order to reduce the incidence and fatality of biofilm-forming Klebsiella pneumoniae bloodstream infection, antibiotics should be used rationally and invasive procedures should be minimized.