Radiotherapy can cause functional and morphological changes in the brain tissues of patients with primary or metastatic malignant brain tumors, leading to radiation-induced brain injury. However, the pathogenesis of radiation-induced brain injury has not yet been unanimously determined, and its research advances and treatment protocols are yet to be elucidated and improved. In this study, we explore the pathogenesis of radiation-induced brain injury from the perspective of vascular injury, inflammatory reactions, neuronal dysfunction, glial cell injury, and gut microbiota and reviewed the advances in research on its treatment and prevention. The purpose is to provide a reference and theoretical basis for the research and clinical diagnosis and treatment of radiation-induced brain injury.

Research integrity is the foundation for ensuring the sound and orderly development of scientific and technological innovation. As the main battlefield of clinical medical research, hospitals should effectively fulfill their main responsibilities and do a good job in research integrity management. The China Hospital Research Integrity Alliance, consisting of the first batch of 43 hospitals, was established in November 2021. With the aim of " complementary advantages, resource sharing, and collaborative development", the alliance has carried out construction practices from seven aspects: construction mode, cultural system construction, organizational management, institutional construction, publicity and education, early warning and supervision, and technological empowerment. It has achieved the overall improvement of the research integrity construction ability of member units of the alliance, organic linkage between government and medical institutions, and efficient combination of internal and external resources, which can provide reference for the research integrity construction of medical institutions in China.

Objective To explore the clinicopathological and immunohistochemical features of nephrogenic adenoma(NA).Methods Clinical data of NA patients diagnosed in the Department of Pathology,Zhongshan Hospital,Fudan University from July 2016 to October 2022 were collected and analyzed to explore their clinicopathological features.Results A total of 13 NA cases were enrolled.There were 11 males and 2 females.Organs involved:ureter(n=7),bladder(n=5),bladder and ureter(n=1),renal pelvis(n=2).NA patients performed as ureteral stenosis(6/7),rough bladder wall(3/5),and renal pelvis polyp(2/2).The typical microscopical features of NA were tubular(13/13)and papillary(4/13)structures,covered with cuboidal or columnar epithelium(13/13),or a mixed hobnail-spike eosinophilic epithelium(12/13);the interstitium was loose,containing varied amounts of vasculature and inflammatory cells(13/13).Immunohistochemistry revealed specific expressions of CK7,PAX-8,CK19 and CK8.Conclusions NA is a rare neoplasm of the urinary system with unique histological features.NA has the risk of misdiagnosis and over-treatment,and the potential of recurrence and malignant conversion.The diagnosis of NA depends on pathology,and the immunohistochemistry can be helpful for its pathological diagnosis.

Humans ; China/epidemiology* ; SARS-CoV-2 ; COVID-19

Objective:To analyze the correlation between related indexes of serum lipid and insulin resistance and cognitive impairment in middle-aged and elderly people with mild cognitive impairment (MCI).Methods:In this cross-sectional study, 262 middle-aged and elderly patients with a Montreal Cognitive Function Scale (MoCA) cognitive score greater than or equal to 18 points who underwent physical examination in the Health Management Center of Beijing Tiantan Hospital Affiliated to Capital Medical University from January 1 to July 31, 2021 were selected as subjects. According to the cognitive function and MoCA score, the patients were divided into MCI group (143 cases) and normal cognition group (119 cases). Basic data, fasting blood glucose, triglyceride (TG), total cholesterol, apolipoprotein E(ApoE) genotype and other clinical indicators were collected. Hypothesis test was used to compare the differences in basic data, related indicators of blood lipid and insulin resistance between the two groups. Spearman correlation analysis was used to analyze the correlation between related indicators of blood lipid and insulin resistance and MoCA score in the two groups.Results:The age and the proportion of patients with hypertension, coronary heart disease and diabetes in the MCI group were all significantly higher than those in normal cognition group [(54.83±8.29) vs (50.76±6.34) years, 37.76% vs 31.93%, 4.20% vs 0.84%, 16.08% vs 8.40%] (all P<0.05). The elevation of serum TG ( r=-0.50, 95% CI:-0.88--0.12), TG glucose product index (TyG) ( r=-0.75, 95% CI:-1.29--0.20) and TG to high-density lipoprotein cholesterol ratio (TG/HDL-C) ( r=-0.52, 95% CI:-0.91--0.13) were all negatively correlated with MoCA score (all P<0.05). After adjusting for age and gender, the elevation of TG ( r=-0.39, 95% CI:-0.75--0.31) and TG/HDL-C ( r=-0.43, 95% CI:-0.80--0.05) were both still negatively correlated with MoCA score (both P<0.05). There was no significant correlation between all indexes and MoCA scores in the normal cognition group (all P>0.05). The elevated TG was negatively correlated with MoCA score in the MCI group ( r=-0.70, 95% CI:-1.23-0.16, P=0.017). There was no significant correlation between elevated TG and MoCA score in patients carrying ApoE ε2 and ApoE ε3 genotypes in MCI group (all P>0.05). Conclusion:Elevated related indexes of blood lipids and insulin resistance are negatively correlated with cognitive scores in middle-aged and elderly people with MCI, and it′s more obvious in patients with ApoE ε4 genotype.

Objective: To understand the epidemiological and clinical characteristics of human brucellosis in Huai'an of Jiangsu Province, and to provide evidence for the formulation of prevention and control measures. Methods: Relevant data was collect through "Infectious Disease Report Information Management System". Descriptive epidemiology (population distribution, time distribution, regional distribution) and clinical characteristics analysis of brucellosis were conducted in Huai'an City from 2013 to 2018. Results: Totally 704 cases of brucellosis had been reported in Jiangsu Province, with an average annual incidence of 0.146 7/100 000, among which 32 cases (4.55%) had been reported in Huai'an, with an average annual incidence of 0.110 0/100 000 from 2013 to 2018. The annual outcomes (incidence rates) were 2 (0.041 6/100 000), 4 (0.083 4/100 000), 6 (0.124 7/100 000), 6 (0.123 2/100 000), 8 (0.163 6/100 000) and 6 (0.122 1/100 000), respectively. Most of the cases were males (20 cases, 62.5%), and aged mainly focused from 40-< 60 years old (20 cases, 62.5%). The occupation was mainly farmers (21 cases, 65.6%). The contact with animals was mainly sheep, and the contact mode was feeding and slaughtering. The cases mainly occurred from March to September (26 cases), and all districts had cases except Hongze. The main clinical manifestations were fever, fatigue, hyperhidrosis and arthromyalgia, with 30 cases (93.8%), 28 cases (87.5%), 25 cases (78.1%) and 22 cases (68.8%), respectively. Some cases showed enlargement of liver, spleen, lymph nodes and testis. Conclusions The incidence of brucellosis in Huai'an City is on the rise, and the characteristics of population distribution, time distribution and regional distribution are obvious. The clinical features are mainly fever, fatigue, and hyperhidrosis. We should strengthen the monitoring of brucellosis, carry out health education for high-risk groups, and reduce the occurrence of brucellosis.

Objective To investigate the therapeutic benefits of tonsillectomy combined with suspension sutures on Friedman stageⅠ obstructive sleep apnea-hypopnea syndrome(OSAHS). Methods Forty-four pa-tients with Friedman stageⅠOSAHS diagnosed and treated from January 2014 to December 2016 were divided into experimental group with 23 patients receiving tonsillectomy combined with suspension sutures and the control group with 21 receiving modified uvulopalatopharyngoplasty. Apnea-hypopnea index(AHI),lowest oxygen saturation (LSaO2)and Epworth Sleepiness Scale(ESS)score were compared between the groups pre- or post-operatively. Results Surgical success rate did not differ significantly between 2 groups(82.6% in the experimental group and 80.9% in the control group). Inner-group comparison indicated that AHI and ESS were significantly lower(P <0.001)while LSaO2was significantly higher after the operation(P < 0.001). There were,however,no significant differences in pre-or post-operative BMI,AHI,ESS or LSaO2between the experimental and control group(all P≥0.05).Conclusion Tonsillectomy combined with suspension sutures is effective for Friedman stageⅠOSAHS.

Objective To investigate the clinical effect of mefformin tablets in the treatment of type 2 diabetes mellitus(T2DM) with atherosclerosis.Methods A total of 84 T2DM patients with atherosclerosis were divided into control group and treatment group according to the random number table method,42 cases in each group.All patients were given diet control,health education and exercise,etc..The control group was treated with gliclazide sustained-release tablets.The treatment group was treated with mefformin and treated for 6 months.The levels of fasting blood glucose(FBG) and 2 h postprandial blood glucose(2hPBG) were measured before and 6 months after treatment.The levels of intima-media thickness (cIMT),leptin (LP),adiponectin (TC),chitinase-3-like protein-1 (YKL-40),triglyceride (TG),low density lipoprotein cholesterol (HDL-C) and high-density lipoprotein cholesterol (HDL-C) were measured.The adverse reactions were observed in the two groups.Results After treatment for 6 months,the levels of FBG and 2hPBG in the treatment group were (6.71 ±0.41) mmol/L and (8.82 ±0.61) mmol/L,respectively,which were significantly lower than those in the control group [(6.96 ± 0.48) mmol/L,(9.58 ± 0.57) mmol/L,t =2.56,5.89,P =0.01,0.00].The levels of cIMT,TC,TG and LDL-C in the treatment group were significantly lower than those in the control group at 6 months after treatment (t =5.36,6.46,9.10,2.31,P =0.00,0.00,0.00,0.02).After 6 months of treatment,the HDL-C level of the treatment group was significantly higher than that of the control group (t =2.84,P =0.00).After treatment for 6 months,HDL-C level in the two groups was significantly higher than before treatment,the other indicators in the two groups were significantly lower than before treatment (all P ＜ 0.05).There were no adverse reactions in the two groups during treatment.Conclusion Metformin in the treatment of T2DM patients with atherosclerosis has significant effect,it can improve blood glucose levels and the clinical and biochemical indicators,and it is safe.

OBJECTIVE: Uur aim was to investigate the association between OSAHS and mean platelet volume (MPV) value. METHOD: This study included 70 cases with OSAHS in our ward between Jan. 2012 and Jan. 2014, and the OSAHS patients were divided two groups: mild- to moderate group and severe group; 30 age-and sex-matched healthy subjects was in control group. The correlation among the levels of the number of platelets (PLT), MPV, platelet distribution width (PDW) were evaluated in the two groups. RESULT: PLT count was significantly lower in the severe group than the control group [(202. 8 ± 68. 9] × 10(9)/L, (235. 9 ± 65. 2) × 10(9)/L]; MPV and PDW were significantly higher in the severe group [(10. 9 ± 0. 9), (10. 4±0. 8) fL; (12. 9 ± 1. 9) %, (12. 0 ± 1. 4) %]. There was not significantly difference of MPV between the mild to moderate group and the control group [(10. 7 ± 0. 7), (10. 4 ± 0. 8)fL]. CONCLUSION MPV levels are elevated in patients with the severe OSAHS.
Blood Platelets ; Case-Control Studies ; Humans ; Mean Platelet Volume ; Sleep Apnea Syndromes ; blood ; Sleep Apnea, Obstructive ; blood

Objective To study the expression of ZNF217 and EF1α gene in the pathological scars and to investigate role and probable mechanism in the pathogenesis of abnormal scar.Methods Quantitative real-time PCR and Western blot were performed to detect the expression and distribution of mRNA and protein of ZNF217 and EF1α in hypertrophic scar (10 cases),keloid (10 cases),normal scar (10 cases),and normal skin (10 cases),and statistics was used to analyze the data.Results The expression of ZNF217 mRNA and protein in the normal skin,normal scar,hypertrophic scar and keloid were 1.46±0.397,1.45±0.265,4.49±0.999,5.47±0.808; 0.276±0.0211,0.299±0.0150,0.743t0.0509 and 0.747±0.0377,respectively.The expression of EF1α mRNA and prorein in the normal skin,normal scar,hypertrophic scar,and keloid were 1.47±0.469,1.47±0.218,5.10±1.68,5.74±1.92; 0.505±0.0371,0.518±0.0153,0.780±0.0369 and 0.792±0.0290,respectively.The positive rate of mRNA and protein of ZNF217 and EF1α was not statistically different between the hypertrophic scar and keloid (P＞0.05),while they were all remarkably significant in comparison between normal scar and abnormal scar (P＜0.01).In pathological scar mRNA and protein of ZNF217 and EF1α showed a strong positive correlation.Conclusions The expression of ZNF217 and EF1α is increased in pathological scar.Therefore,ZNF217 and EF1α overexpression may play an important role in the proliferation of fibroblasts and in the pathogenesis of pathological scar.