Objective To investigate the expressions of a disintegrin and metalloprotease 17 (ADAM17) and epidermal growth factor recepter (EGFR) in human esophageal squamous cell carcinoma (ESC),and to explore their relationship with clinicopathological characteristics.Methods The paraffin specimens in postoperative pathological tissues of 66 ESC patients in the Third People's Hospital of Hefei from January 2013 to December 2017 were selected.Expressions of ADAM17 and EGFR proteins were examined by using immunohistochemistry in 66 cases of ESC tissues and 33 cases of adjacent tissues of the tumors.The relationship of ADAM17 and EGFR with clinicopathological features was analyzed.Kendall method was used to detect the expression correlation of ADAM17 and EGFR.Results The positive rate of ADAM17 protein in ESC tissues was higher than that in the adjacent tissues of the tumors [68.2 ％ (45/66) vs.33.3 ％ (11/33),x2 =10.874,P =0.001].The positive rate of EGFR protein in ESC tissues was higher than that in the adjacent tissues of the tumors [66.7 ％ (44/66) vs.39.4 ％ (13/33),x2 =6.699,P =0.01].The expressions of ADAM17 and EGFR protein were related with ESC pathological TNM staging,infiltration depth,lymph node metastasis (x2 =4.797,4.890,6.089;8.790,8.766,10.154,respectively,all P ＜ 0.05).ADAM17 expression was positively correlated with EGFR protein (r,=0.368,P ＜ 0.05).Conclusions ADAM17 and EGFR are highly expressed in human ESC.Besides,ADAM17 and EGFR have the interaction in the occurrence and development of esophageal cancer.Joint detection may help to determine the degree of metastasis and evaluate prognosis.

Most patients with spinal cord injury suffer from limb motor dysfunction. Given drugs, surgery and other conventional treatments are often not effective, the patients can only rely on a wheelchair to move or even lie in bed for a long time, seriously affecting their quality of life. Brain computer interface (BCI) technology provides a non-muscular pathway for the recovery of motor function in patients with spinal cord injury, which allows the patients to recover partial motor function through the normal function of their own non-diseased spinal cord or external mechanical devices. After decades of development of BCI technology, signal collection devices can identify and collect the motor signals of the brain more accurately, transform the signal by characteristic analysis, and implement the brain command by using the output device. A large number of experimental and clinical studies have also proved that the application of BCI technology in patients with spinal cord injury can partially improve the motor function of upper and lower limbs. Therefore, BCI technology has attracted more and more attention. The authors summarized the BCI technology and its influence on motor function rehabilitation in patients with spinal cord injury, so as to provide a reference for the rehabilitation of motor function in patients with spinal cord injury.

Objective To investigate the features of oral lesions in patients with human immunodeficiency virus infection/acquired immunodeficiency syndrome(HIV/AIDS).Methods A total of 127 HIV-seropositive patients were interviewed for health information and examined for their HIV-related oral lesions according to the EC Clearing House Criteria on Oral Problems related to HIV-Infection (1992).The examinations were conducted by dental specialist and HIV specialist.The CD4 T cell count in peripheral blood of the patients was tested by flow cytometry.The patients were divided into HIV-infected group(42) and AIDS group(85) according to CDC Classification System for HIV-Infected Adults and Adolescents(revised in 1993).Chi-square test was used to test the relationship between systemic disease and oral lesions,and the difference of the prevalence of oral lesions between the two groups.Results Among the 127 patients,oral candidiasis(51/127),oral hairy leukoplakia(24/127) were common oral manifestation.There was no relationship between the oral manifestation and systemic disease(P=0.397).The occurrence of oral lesions and oral candidiasis was significantly different between the two groups(x2=7.684,P=0.006; x2=14.410,P＜0.001).The CD4 count was related to the prevalence of oral lesions (P==0.006) and oral candidasis (P=0.003).Conclusions Most oral lesions appeared before the appearance of systemic disease.Oral candidiasis and oral hairy leukoplakia were the most common lesions.Oral lesions had no relationship with systemic disease but could be still an indicator for disease progress.

Objective:To investigate respiratory virus infection in children with septic shock in pediatric care units (PICU) in China and its influence on clinical outcomes.Methods:The clinical data of children with septic shock in children′s PICU from January 2018 to December 2019 in 10 Chinese hospitals were retrospectively collected. They were divided into the pre-COVID-19 and post-COVID-19 groups according to the onset of disease, and the characteristics and composition of respiratory virus in the 2 groups were compared. Matching age, malignant underlying diseases, bacteria, fungi and other viruses, a new database was generated using 1∶1 propensity score matching method. The children were divided into the respiratory virus group and non-respiratory virus group according to the presence or absence of respiratory virus infection; their clinical characteristics, diagnosis, and treatment were compared by t-test, rank sum test and Chi-square test. The correlation between respiratory virus infection and the clinical outcomes was analyzed by logistic regression. Results:A total of 1 247 children with septic shock were included in the study, of them 748 were male; the age was 37 (11, 105) months. In the pre-and post-COVID-19 groups, there were 530 and 717 cases of septic shock, respectively; the positive rate of respiratory virus was 14.9% (79 cases) and 9.8% (70 cases); the seasonal distribution of septic shock was 28.9% (153/530) and 25.9% (185/717) in autumn, and 30.3% (161/530) and 28.3% (203/717) in winter, respectively, and the corresponding positive rates of respiratory viruses were 19.6% (30/153) and 15.7% (29/185) in autumn, and 21.1% (34/161) and 15.3% (31/203) in winter, respectively. The positive rates of influenza virus and adenovirus in the post-COVID-19 group were lower than those in the pre-COVID-19 group (2.1% (15/717) vs. 7.5% (40/530), and 0.7% (5/717) vs. 3.2% (17/530), χ2=21.51 and 11.08, respectively; all P<0.05). Rhinovirus virus were higher than those in the pre-Covid-19 group (1.7% (12/717) vs. 0.2% (1/530), χ2=6.51, P=0.011). After propensity score matching, there were 147 cases in both the respiratory virus group and the non-respiratory virus group. Rate of respiratory failure, acute respiratory distress, rate of disseminated coagulation dysfunction, and immunoglobulin usage of the respiratory virus group were higher than those of non-respiratory virus group (77.6% (114/147) vs. 59.2% (87/147), 17.7% (26/147) vs. 4.1% (6/147), 15.6% (25/147) vs. 4.1% (7/147), and 35.4% (52/147) vs. 21.4% (32/147); χ2=11.07, 14.02, 11.06 and 6.67, all P<0.05); and PICU hospitalization of the former was longer than that of the later (7 (3, 16) vs. 3 (1, 7)d, Z=5.01, P<0.001). Univariate logistic regression analysis showed that the presence of respiratory viral infection was associated with respiratory failure, disseminated coagulation dysfunction, the use of mechanical ventilation, and the use of immunoglobulin and anti-respiratory viral drugs ( OR=2.42, 0.22, 0.25, 0.56 and 1.12, all P<0.05). Conclusions:The composition of respiratory virus infection in children with septic shock is different between pre and post-COVID-19. Respiratory viral infection is associated with organ dysfunction in children with septic shock. Decreasing respiratory viral infection through respiratory protection may improve the clinical outcome of these children.

Objective:To investigate the clinical features, pathogen composition, and prognosis of septic shock in pediatric intensive care units (PICU) in China.Methods:A multicenter retrospective cohort study. A retrospective analysis was conducted on the clinical data of children with septic shock from 10 hospitals in China between January 2018 and December 2021. The clinical features, pathogen composition, and outcomes were collected. Patients were categorized into malignant tumor and non-malignant tumor groups, as well as survival and mortality groups. T test, Mann Whitney U test or Chi square test were used respectively for comparing clinical characteristics and prognosis between 2 groups. Multiple Logistic regression was used to identify risk factors for mortality. Results:A total of 1 247 children with septic shock were included, with 748 males (59.9%) and the age of 3.1 (0.9, 8.8) years. The in-patient mortality rate was 23.2% (289 cases). The overall pathogen positive rate was 68.2% (851 cases), with 1 229 pathogens identified. Bacterial accounted for 61.4% (754 strains) and virus for 24.8% (305 strains). Among all bacterium, Gram negative bacteria constituted 64.2% (484 strains), with Pseudomonas aeruginosa and Enterobacter being the most common; Gram positive bacteria comprised 35.8% (270 strains), primarily Streptococcus and Staphylococcus species. Influenza virus (86 strains (28.2%)), Epstein-Barr virus (53 strains (17.4%)), and respiratory syncytial virus (46 strains (17.1%)) were the top three viruses. Children with malignant tumors were older and had higher pediatric risk of mortality (PRISM) Ⅲ score, paediatric sequential organ failure assessment (pSOFA) score (7.9 (4.3, 11.8) vs. 2.3 (0.8, 7.5) years old, 22 (16, 26) vs. 16 (10, 24) points, 10 (5, 14) vs. 8 (4, 12) points, Z=11.32, 0.87, 4.00, all P<0.05), and higher pathogen positive rate, and in-hospital mortality (77.7% (240/309) vs. 65.1% (611/938), 29.7% (92/309) vs. 21.0% (197/938), χ2=16.84, 10.04, both P<0.05) compared to the non-tumor group. In the death group, the score of PRISM Ⅲ, pSOFA (16 (22, 29) vs. 14 (10, 20) points, 8 (12, 15) vs. 6 (3, 9) points, Z=4.92, 11.88, both P<0.05) were all higher, and presence of neoplastic disease, positive rate of pathogen and proportion of invasive mechanical ventilation in death group were also all higher than those in survival group (29.7% (87/289) vs. 23.2% (222/958), 77.8% (225/289) vs. 65.4% (626/958), 73.7% (213/289) vs. 50.6% (485/958), χ2=5.72, 16.03, 49.98, all P<0.05). Multiple Logistic regression showed that PRISM Ⅲ, pSOFA, and malignant tumor were the independent risk factors for mortality ( OR=1.04, 1.09, 0.67, 95% CI 1.01-1.05, 1.04-1.12, 0.47-0.94, all P<0.05). Conclusions:Bacterial infection are predominant in pediatric septic shock, but viral infection are also significant. Children with malignancies are more severe and resource consumptive. The overall mortality rate for pediatric septic shock remains high, and mortality are associated with malignant tumor, PRISM Ⅲ and pSOFA scores.

ObjectiveTo explore the current status, hot spots and development of researches on post-stroke dysphagia in recent five years with visualization analysis. MethodsResearches on post-stroke dysphagia were retrieved from Web of Science Core Collection, from January 1st, 2017 to December 31st, 2021, and reviewed with CiteSpace 5.7.R5 software. ResultsA total of 857 articles were included. The annual number of articles increased with time, published from 61 countries/regions, by 211 institutions and 247 authors. The United States, Japan and China were the most prolific countries, and the University of Manchester was the leading institution. The top three authors were Dziewas R, Wakabayashi H and Hamdy S. The keywords bursting in recent three years included prediction, severity, percutaneous endoscopic gastrostomy, accuracy and early management; co-word clustering showed that researches might be mainly about neuromuscular electrical stimulation, swallowing screening, stroke-associated pneumonia, evidence-based practice, etc. ConclusionThe researches in the field of post-stroke dysphagia have been increasing.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.