Objective:To investigate the pathological change mechanism of patients with chronic active Epstein-Barr virus infection (CAEBV).Methods:The clinical manifestations, laboratory examinations, diagnosis and treatment of one CAEBV patient in Suzhou Hongci Hematology Hospital of Jiangsu Province were retrospectively analyzed with review of related literature.Results:Combined with the results of laboratory, lymph node biopsy and bone marrow tests in different periods, the patient initially showed lymphoproliferative disease, and gradually transformed into lymphoma with the diagnosis results of EB virus-related lymphocyte clones in different periods. The patient received the corresponding treatment plan in different periods, but eventually died due to hemophagocytic syndrome and rapid progress of the disease.Conclusion:CAEBV may cause lymphocytes to gradually evolve from polyclonal to monoclonal state.

Objective To study to take the oxidized Mannan?modified 786?0 in renal clear cell carcinom as tumor cells antigen to sensitize Dendrit?ic cells(DC)and to observe the its killing effect on renal clear cell carcinoma of CTLs induced. Methods Getting the peripheral blood mononucle?ar cells from the volunteers,and then to be stimulated to turn to be maturation by GM?CSF and IL?4 in vitro. Taking the clear renal carcinoma cell as the tumor antigen,and then making it to be modified by oxidized Mannan to acquire the tumor cell vaccine.Experimental groups include:blank group:DC?PBS group,control group:control?DC?786?0,experimental group:DC?Ox?Mannose?786?0 group. Taking the flow cytometry to detect the changes of DC phenotype,then taking the ELISA to detect the sencretion levels of supernatant of IL?12 of DC,then taking the CCK to detecte the cytotoxicity of lymphocytes(CTL)induced by DC of these experiment groups. Results Results by flow cytometry:the mature phenotype of DCs sensitized by Ox?Mannose?786?0 group included CD80,CD83,CD86 and HLA?DR expressed significantly higher than the other groups. As well as the secretion levels of IL?12. Meanwhile the cytotoxicity activity of lymphocytes(CTLs)induced by DCs which are sensitized by Ox?Mannose?786?0 increased more significantly than the other groups. Conclusion Glycosylated Antigens can be more effective in sensitizing antigen?presenting cells DC,and stimulating them to be maturation,while the killing effect to tumor cells also have noticeably improved.

Objective To investigate the effect of urinary training on urination control in infants using nappies after birth.Methods Stratified sampling method was used to investigate the daytime urination control and the using of diapers by children in kindergartens of 6 prefecture-level cities in Henan Province,China.The survey was conducted among parents of healthy children.Results In a total of 12 250 questionnaires,11 697 had response,and 10 562 valid questionnaires were collected,and the effective recovery rate was 86.22％.After the birth of infants,the age of toilet training was divided into 6 groups (0-＜ 3 months old group,3-＜ 6 months old group,6-＜ 12 months old group,12-＜ 18 months old group,18-＜ 24 months old group and no toilet training group).Results showed that toilet training within 12 months leads to higher urinary control rate compared with toilet training after 12 months and no toilet training till the age of 2 years old,70.56％ (4 831/6 847 cases) in contrast with 59.02％ (1 545/2 618 cases) and 42.48％ (466/1 097 cases),and the differences were statistically significant (x2 =114.76,335.48,all P ＜ 0.000 1).Within 12 months,there was no statistical difference in the urinary control rate between subgroups at 2 years of age(all P ＞0.05).After 12 months,the urination control rate decreased with the start time delayed till 2 years of age,and the urinary control rate at the age of 2 years old n different groups was 59.97％ (1 314/2 191 cases) and 54.10％ (231/427 cases) respectively.The results of other ages(0.5,1.0,1.5 years old) were similar to those of 2 years old.There was no difference between the groups of different genders (all P ＞ 0.05).Conclusions The use of diapers in infants before the age of 1 year to start urinary training is conducive to the development of urinary control in infants.

Diabetes mellitus is a complex metabolic disease involving multiple organ systems in the body.In recent years,its global incidence rate has increased year by year.In China,the blood glucose control of patients with diabetes mellitus who receive oral hypogly-cemic agents or insulin treatment remains poor.In the early disease stages,exercise is important to control blood glucose levels.Recently,many studies have found that the occurrence of type 2 diabetes mellitus was related to declining levels of irisin,an exercise-related muscle factor.Furthermore,studies have found that irisin improved insulin resistance,promoted the production of pancreatic isletβcells,and affected the body's glucose and lipid metabolism.In addition,its levels were also implicated in the occurrence of various complications,such as diabetic nephropathy and diabetes-related cardiovascular diseases.This article summarizes and analyzes the role of irisin in the occurrence and development of diabetes mellitus and further describes its impact and mechanism on various diabetic complications.

Objective: To evaluate the efficacy and safety of Jiawei Simiao powder (JWSMP) combined with celecoxib for the treatment of acute gouty arthritis by conducting a meta-analysis of randomized controlled trials (RCTs). Methods: The Chinese National Knowledge Infrastructure Databases, Chinese Scientific Journal Database, Wanfang, Cochrane Library, EMBASE, PubMed, and Web of Science databases were searched from inception until December 2023. Continuous variables were analyzed using the mean difference (MD) for analysis, and dichotomous variables were used as risk ratios. Data with similar characteristics were pooled for meta-analysis, and heterogeneity was assessed using I2. The Cochrane Handbook was used to assess the risk of bias and quality. RevMan 5.3 software was used to perform the meta-analysis. Results: Thirteen RCTs involving 1007 patients were included in the study. The quality of the included studies was low (unclear randomization processes and insufficient blinding reporting). The group receiving JWSMP combined with celecoxib showed significantly lower levels of serum uric acid (SUA, MD = −66.32, 95% confidence interval (CI): −80.97 to −51.67, P < .001), erythrocyte sedimentation rate (ESR, MD = −6.05, 95% CI: −8.29 to −3.82, P < .001), C-reactive protein (CRP, MD = −7.39, 95% CI: −11.15, −3.63, P < .001), and joint pain score (VAS score, MD = −2.14, 95% CI: −2.4 to −1.88, P < .001) compared to celecoxib alone. Additionally, the JWSMP combined group had a higher total effective rate (risk ratio = 1.22, 95% CI: 1.14 to 1.29, P < .001) and fewer adverse compared to celecoxib alone. Conclusions JWSMP combined with celecoxib is more effective than celecoxib alone in improving the total efficacy rate, alleviating joint pain, and improving SUA, ESR, and CRP levels. JWSMP also reduced the occurrence of adverse events caused by celecoxib. However, the quality of the included studies was low, highlighting the need for further high-quality research with larger sample sizes and robust methodologies, such as double-blind randomization, to confirm these findings.

To effectively introduce and utilize global advanced educational resources, the implementation of Chinese-foreign joint education program in medical universities and the establishment of an internal quality assurance system with Chinese characteristics and substantially equivalent to international standards of medical education is crucial for improving the quality of Chinese medical talent cultivation and achieving high-quality development of education opening up to the outside world in the new era. Using the Chinese-Foreign Joint Education Program jointly run by Chongqing Medical University and University of Leicester as an example, this paper proposes a plan for the development of an internal quality assurance system with three core indicators of management mechanism, team building, and student services. This plan provides experience and a reference for domestic universities to carry out cross-border medical education and improve the quality and efficiency of Chinese-foreign joint education programs.

Objective:To summarize the best evidence for the management of lower urinary tract dysfunction (LUTD) in total hysterectomy patients, so as to provide evidence-based basis for clinical practice.Methods:According to the "6S" pyramid model, literature related to the management of LUTD in total hysterectomy patients was successively searched from guide websites, evidence-based websites, professional websites and comprehensive databases. The search deadline was from the establishment of the databases to March 31, 2023. Two researchers evaluated the quality of the included literature, extracted evidence and recommended the level of evidence.Results:A total of 14 articles were included, including one clinical decision, two evidence summaries, three guidelines, one expert consensus and seven systematic evaluations. A total of 25 pieces of evidence were summarized from four aspects, such as symptom assessment, urinary tract management, symptom intervention and health education.Conclusions:Medical staff should manage lower urinary tract dysfunction in patients undergoing total hysterectomy based on evidence-based evidence to prevent or reduce the occurrence of lower urinary tract dysfunction in patients.

As a metabolic disease,obesity increases the risk of many chronic metabolic diseases;in fact,it is an epidemic in the 21st cen-tury.Exercise is an important means of controlling and treating obesity.Irisin,a myocyte cytokine,was discovered and reported in 2012;it is regulated by exercise and involved in the browning of adipose tissue.A recent discovery is irisin's ability to improve obesity,which is embodied in its effect on glucose and lipid metabolism.Irisin can induce the browning of white fat;promote glucose homeostasis;resist the damage of fat cells caused by inflammation,oxidative stress,and other factors;inhibit insulin resistance;and improve glucose,lipid metabolism,and obesity.This review addresses the role of irisin in improving glucose levels,lipid metabolism,and obesity,as well its role in regulating exercise.Further,the prospect of future research is discussed.

Objective This study aims to analyze the factors influencing benefit finding among cervical cancer patients and their spouses,as well as the interconnections between these factors.The goal is to provide a foundation for developing targeted clinical interventions.Methods Using the convenience sampling method,cervical cancer patients and spouses of 245 pairs who attended or were hospitalized in a tertiary-level hospital in Taiyuan City from October 2022 to July 2023 were selected as study subjects.Data were collected using a general information questionnaire,the Distress Disclosure Index,the Connor-Davidson Resilience Scale,and the Benefit Finding Scale.Univariate analysis,Pearson correlation analysis,and multiple linear regression were employed to scrutinize the data,leading to the establishment of Actor-Partner Interdependence Model.Results Benefit finding scores for cervical cancer patients and their spouses were(65.31±7.94)and(69.87±9.63),respectively.Multiple linear regression revealed that the educational level of patients and their spouses,whether or not they received chemotherapy or radiotherapy,self-disclosure and psychological resilience were the factors that affected patients'benefit finding.Spouse's education level,occupation,self-disclosure,psychological resilience and patients'self-disclosure and psychological resilience were the influencing factors of spouse's benefit finding.The Actor-Partner Interdependence Model analysis indicated that the self-disclosure and psychological resilience of cervical cancer patients positively predicted their own benefit finding and that of their spouses(path coefficients were 0.415,0.501,0.216,and 0.168,respectively,all P＜0.05).However,spouses'self-disclosure and psychological resilience could only positively predict their own benefit finding(path coefficients were 0.188 and 0.254,respectively,all P＜0.05).Conclusion Benefit finding among cervical cancer patients and their spouses is moderate and influenced by various factors.Both self-disclosure and psychological resilience of cervical cancer patients and their spouses have positive subjective effects on their own benefit finding.Healthcare professionals should encourage both parties to engage in healthy interactions about the disease,take steps to increase the level of psychological resilience of both,and ultimately tap into a higher level of benefit finding.

To explore how to create and optimize a promotion index system of medical quality evaluation, this article focuses on the hospital visiting process from patients, using analyzing collected those index system from couples of Grade Ⅲ hospitals in Beijing, and combining the results of literal study, field study and specialist consult, according to the different situation of general hospitals and specially hospitals, with the spirit of "maintaining the patients benefits, safeguarding the patients safety,and enhancing the medical quality", introduces the framework of the promotion index system, the rules to select the indicator, and so on, and discusses several problerns related to creating the index system.