Uncovering the risk factors of pulmonary hypertension and its mechanisms is crucial for the prevention and treatment of the disease.In the current study,we showed that experimental periodontitis,which was established by ligation of molars followed by orally smearing subgingival plaques from patients with periodontitis,exacerbated hypoxia-induced pulmonary hypertension in mice.Mechanistically,periodontitis dysregulated the pulmonary microbiota by promoting ectopic colonization and enrichment of oral bacteria in the lungs,contributing to pulmonary infiltration of interferon gamma positive(IFNγ+)T cells and aggravating the progression of pulmonary hypertension.In addition,we identified Prevotella zoogleoformans as the critical periodontitis-associated bacterium driving the exacerbation of pulmonary hypertension by periodontitis,and the exacerbation was potently ameliorated by both cervical lymph node excision and IFNγ neutralizing antibodies.Our study suggests a proof of concept that the combined prevention and treatment of periodontitis and pulmonary hypertension are necessary.

Objective:To explore the effect of personalized training based on early start Denver model (ESDM) combined with applied behavior analysis (ABA) in children with autism spectrum disorder (ASD) .Methods:From January 2021 to January 2023, convenience sampling was used to select 90 children with ASD who received treatment at the Shaoxing Seventh People's Hospital and their caregivers as research subjects. The children were divided into two groups using a random number table method in a 1∶1 ratio. The control group received routine rehabilitation, while the observation group was treated with personalized training based on ESDM combined with ABA. Both groups were intervened for six months. Children's Autism Rating Scale (CARS), Autism Behavior Checklist (ABC), Gesell Developmental Schedule (GDS), Sign-Significate Relation (S-S) Language Development Delay Assessment, Social Life Ability Scale for Infant-Junior Middle School Students (S-M), and Modified Barthel Index (MBI) were used to evaluated the effects of intervention on two groups of ASD children before and after intervention.Results:After six months of intervention, the CARS and ABC scores of ASD children in the observation group were lower than those in the control group, and the scores of GDS dimensions and total developmental quotient, S-S Language Development Delay Assessment score, S-M score, and MBI score were higher than those in the control group, and the differences were statistically significant (all P<0.05) . Conclusions:Personalized training based on ESDM combined with ABA has a good effect, which can improve loneliness symptoms of children with ASD, alleviate cognitive, language, and behavioral dysfunction, enhance social adaptation ability and activities of daily living.

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.

Objective:The epidemiological and clinical characteristics of 18 cases of Japanese spotted fever (JSF) in Zigui County were analyzed in order to improve the prevention and treatment of JSF.Methods:This is a case series analysis. The epidemiological and clinical data, laboratory tests and imaging characteristics of 18 JSF cases with median age of 60 years (54, 68) identified by The People′s Hospital of Zigui from April 2021 to August 2022 were collected and analyzed retrospectively.Results:Most (17/18) of the patients were farmers and all had a field exposure history. The patient′s onset was from April to October. Spring and autumn were the seasons with the highest incidence of JSF. The first symptoms of patients were high fever, headache, and fatigue. Of the 18 cases, 15 had a rash and 12 presented an eschar and 3 had neither rash nor eschar. In addition, 10 of 18 cases experienced edema of both lower extremities, and 3 got disturbance of consciousness. Laboratory tests found that 15 patients had abnormal white blood cells and 11 patients had decreased platelets. C-reactive protein, procalcitonin, D-dimer, lactate dehydrogenase, and alpha-hydroxybutyrate dehydrogenase were elevated in all patients; 13 patients with elevated alanine aminotransferase, 14 patients with elevated aspartate transamination. Kidney damage caused by Rickettsia japonica infection showed by abnormal proteinuria in 11 of the patients. Conclusions:The most common clinical manifestations of JSF are non-specific indications such as high fever, chills, fatigue, headache. The eschar and rash, which are the main features of Rickettsia infection, are not present in all patients, resulting delay of diagnosis or misdiagnosis. Medical workers should be more alert to rickettsial infections in patients with fever of unknown origin, especially in seasons of high incidence of spotted fever. Early diagnosis and correct antibiotic treatment shall be given according to the patient′s clinical manifestations, laboratory results and imaging test to control disease progression.

ObjectiveTo observe the fine structure of the trunk kidney in zebrafish, and to identify its secreted exosomes. MethodsThe microstructure and ultrastructure of the trunk kidney in zebrafish were observed by light microscopy and electron microscopy, and the particle size of exosomes was detected by nanoparticle tracking analysis (NTA). ResultsThe trunk kidney was close and parallel to the spine in adult zebrafish. The nephron consisted of renal tubules and renal corpuscles. The renal tubules could be further divided into three types: proximal convoluted tubules, distal convoluted tubules, and cervical segments. The renal corpuscles were composed of glomerulus and renal capsules. The periodic acid-Schiff (PAS) staining results revealed that there were abundant glycogen granules in the proximal convoluted tubules, with brush-like outline in the apical surface of epithelial cells. Under transmission electron microscopy (TEM), there were exosomes distributed in the lumen of renal tubules, with numerous late endosomes and few number of multivesicular bodies (MVBs) in the cytoplasm of the epithelial cells concentrating on the apical side. Meanwhile, MVBs were also distributed in the apical regions of the renal tubules and the podocytes of the renal glomeruli. Immunohistochemical staining results showed that CD9, CD63 and TSG101 were strongly expressed in the lumen surface of the renal tubules, but weakly expressed in the corpuscles and lumen. NTA and TEM results showed that the exosomes isolated from zebrafish trunk kidney were saucer-like outline, and the particle size mode was 144.4 nm, which was consistent with the characteristics of morphological futures of exosome. ConclusionThe zebrafish somatic kidney has the typical structure of the mammalian kidney and is the urinary organ in the body. The renal tubules have the ability to secrete exosomes, and their formation is a process of releasing poly-vesicles to the free surface of epithelial cells into the extracellular space. This study laid a morphological foundation for further study of exosomes in urinary function in aquatic experimental animals as well as the development and application of related models.

ObjectiveTo review the clinical characteristics and capacity of cardiopulmonary exercise test in patients with intermediate coronary stenosis. MethodsFrom January, 2015 to January, 2020, the patients underwent coronary angiography and cardiopulmonary exercise test in Beijing Bo'ai Hospital were divided into intermediate coronary stenosis group (n = 184) and non-coronary heart disease group (n = 73). Symptoms, general information, laboratory and echocardiography information, results of cardiopulmonary exercise test were compared between two groups, and the main cardiovascular events during a year were observed. ResultsThe proportion of male (χ² = 15.857, P < 0.001), smoking history (χ² = 9.067, P = 0.003), hypertension history (χ² = 15.087, P < 0.001) and hyperlipidemia history (χ² = 13.507, P < 0.001) were more, and the level of hemoglobin A1c (Z = 2.431, P = 0.015) and high sensitivity C-reactive protein (Z = 2.108, P = 0.035) were higher in the intermediate coronary stenosis group, while less of them could reach anaerobic threshold (χ² = 10.702, P = 0.001). The heard rate and respiratory exchange rate as anaerobic threshold decreased in the intermediate coronary stenosis group (Z > 2.156, P < 0.05). There was no significant difference in main cardiovascular events between the two groups within a year (P = 1.000). ConclusionCardiopulmonary capacity has been impaired in patients with intermediate coronary stenosis, who need to pay attention to the risk factors such as smoking, diabetes mellitus, hypertension and hyperlipidemia.

In the context of the global pandemic of COVID-19, with the epidemic epicenter located in the Wuhan City, China, patients with severe mental illness have also been deeply affected by the epidemic. In this paper, two patients with schizophrenia who recovered from COVID-19 were reported. Because of the long-term positive results of the SARS-CoV-2 serum antibody IgM test, they had to undergo medical isolation and social restrictions for a long time. After the situation was effectively identified by the medical staff and they were eliminated as a potential virus carrier and released from the medical isolation center. Since psychiatrists often lack systematic knowledge of infectious diseases, the authors hope that this paper can provide a reference to avoid unnecessary wastage of medical resources and prevent placing serious mental burden on such patients in the future.

Objective: To investigate the clinical pathological features, pathological diagnosis and differential diagnosis of hybrid schwannoma/perineurioma. Methods: The clinicopathological data of 35 cases were collected at Fudan University Shanghai Cancer Center, from October 2010 to August 2017; morphological observation and immunohistochemical staining were performed, and the literatures were also reviewed. Results: There were 7 males and 28 females (male∶female=1∶4), patients with onset age ranging from 3 to 81 years(mean=36 years). Of 35 tumors, 11 cases occurred in the head and neck, 10 in the extremities, 9 in the trunk, 4 in the intestine, and 1 in the labiamajora, respectively. Clinically, most patients presented as a slowly growing dermal nodule, sometimes associated with pain. The duration of symptoms ranged from 1 month to 20 years before excision. Tumor size ranged from 0.8 cm to 6.0 cm (mean=2.6 cm). Microscopically, the tumors were usually well circumscribed but unencapsulated. At low power, most tumors were located in the dermis or subcutis, and several cases in the submucosal tissues. The tumors were composed of fascicular, storiform or whorled growth of closely intermixed plump spindle cells and slender spindle cells. The plump spindle cells had ill-defined eosinophilic cytoplasm with larger tapered or wavy nuclei, whereas the slender spindle cells had comparatively delicate nuclei with elongated cytoplasmic processes. Tumor cells had no obvious atypia, and mitoses were rare. Scattered large cells with degenerative nuclear atypia were seen in some cases. By immunohistochemistry, most of plump spindle cells showed strong staining of S-100 protein(35/35) and SOX10(8/9), whereas slender spindle cells stained variably for epithelial membrane antigen(31/35), CD34(32/33), Claudin-1 (15/15) and GLUT-1(8/8). Ki-67 proliferation index were all less than 5%. Follow-up data available in 16 patients (range 4 to 72 months; mean=46 months) were all free of disease, and one case developed local recurrence. Conclusions Hybrid schwannoma/perineuriomaisa benign nerve sheath tumor that typically manifests as a dermaland subcutaneous tumor, less frequently may affect uncommon sites such as the nasal cavity, the gastro-intestinal tract, and the external genital areas. The tumors consisted of intimately admixed plump-spindled schwannian cells and slender-spindled perineurial cells showing dual differentiation of strong S-100 protein and SOX10 expression in the former component and variable immunoreactivity of epithelial membrane antigen, Claudin-1 and CD34 in the latter. It should be aware of the possibility of potentially misinterpretation of hybrid schwannoma/perineurioma as dermatofibrosarcoma protuberans and solitary fibrous tumor and so on.

Objective To investigate the clinical pathological features, pathological diagnosis and differential diagnosis of hybrid schwannoma/perineurioma. Methods The clinicopathological data of 35 cases were collected at Fudan University Shanghai Cancer Center, from October 2010 to August 2017;morphological observation and immunohistochemical staining were performed, and the literatures were also reviewed. Results There were 7 males and 28 females (male∶female=1∶4), patients with onset age ranging from 3 to 81 years(mean=36 years). Of 35 tumors, 11 cases occurred in the head and neck, 10 in the extremities, 9 in the trunk, 4 in the intestine, and 1 in the labiamajora, respectively. Clinically, most patients presented as a slowly growing dermal nodule, sometimes associated with pain. The duration of symptoms ranged from 1 month to 20 years before excision. Tumor size ranged from 0.8 cm to 6.0 cm (mean=2.6 cm). Microscopically, the tumors were usually well circumscribed but unencapsulated. At low power, most tumors were located in the dermis or subcutis, and several cases in the submucosal tissues. The tumors were composed of fascicular, storiform or whorled growth of closely intermixed plump spindle cells and slender spindle cells. The plump spindle cells had ill?defined eosinophilic cytoplasm with larger tapered or wavy nuclei, whereas the slender spindle cells had comparatively delicate nuclei with elongated cytoplasmic processes. Tumor cells had no obvious atypia, and mitoses were rare. Scattered large cells with degenerative nuclear atypia were seen in some cases. By immunohistochemistry, most of plump spindle cells showed strong staining of S?100 protein(35/35) and SOX10(8/9), whereas slender spindle cells stained variably for epithelial membrane antigen(31/35), CD34(32/33), Claudin?1 (15/15) and GLUT?1(8/8). Ki?67 proliferation index were all less than 5%. Follow?up data available in 16 patients (range 4 to 72 months; mean=46 months) were all free of disease, and one case developed local recurrence. Conclusions Hybrid schwannoma / perineuriomaisa benign nerve sheath tumor that typically manifests as a dermaland subcutaneous tumor, less frequently may affect uncommon sites such as the nasal cavity, the gastro?intestinal tract, and the external genital areas. The tumors consisted of intimately admixed plump?spindled schwannian cells and slender?spindled perineurial cells showing dual differentiation of strong S?100 protein and SOX10 expression in the former component and variable immunoreactivity of epithelial membrane antigen, Claudin?1 and CD34 in the latter. It should be aware of the possibility of potentially misinterpretation of hybrid schwannoma/perineurioma as dermatofibrosarcoma protuberans and solitary fibrous tumor and so on.

Objective To study the characteristics of colorectal cancer patients in Yunnan Tumor Hospital, and to provide the basis for the prevention and treatment of colorectal cancer. Methods Retrospective analysis was used to review colorectal cancer patients who were diagnosed first and received the main treatment in Yunnan Cancer Hospital from March 2005 to December 2014.According to the sampling principle ,there were 100 cases each year , with a total of 1000 cases. The clinical and pathological data were analyzed, including age, gender, pathogenesis, pathological type, and TNM stage. Results The average age of the 1000 patients enrolled in the survey was (63.4±12.8) years old, the male and female age group (60-69) accounted for the highest proportion.both men and women aged between 60 and 69 had a high occurance rate, and male patients were more than the female with a fraction of 1.42:1. Rectum is the most common primary site, accounting for 57%, followed by ascending colon, sigmoid colon, straight B junction, transverse colon, descending colon, and cecum. Adenocarcinoma was the main pathological type, accounting for 89.4%.Stage Ⅲ was the most common in TNM staging, accounting for 35.9%, followed by stage Ⅱ, Ⅰ, and stage Ⅳ. Most rectal cancers were found at stage Ⅲ, and colon cancer at stage Ⅱ . Conclusion The proportion of colorectal cancer in the age group (60-69 years) was the highest; the proportion of middle-aged and male was significant.The high incidence of colorectal cancer was 60～69 years old, especially males.The main part of colorectal cancer was located in the rectum.Adenocarcinoma was the most common pathological type. Most patients were later stage when diagnosed.