Objective To analyze the clinical characteristics of pulmonary nocardiosis misdiagnosed as pulmonary tuberculosis and the causes of misdiagnosis, aiming to improve the diagnosis and treatment of the disease. Methods　Clinical data were collected from 18 cases of pulmonary nocardiosis misdiagnosed as pulmonary tuberculosis admitted to Beijing Chest Hospital (1 case), Hebei Chest Hospital (15 cases), the 5th Hospital of Shijiazhuang (1 case), and the 1st Hospital of Xinji (1 case) from October 2018 to June 2024, and the clinical manifestations, laboratory tests, imaging, treatment process, disease outcomes, and the causes of misdiagnosis were retrospectively analyzed. Results Among the 18 patients, there were 10 males and 8 females, with a median age of (59±14) years. All of the cases had the common clinical manifestations of cough and sputum. Seventeen cases had underlying disease, including 1 case with AIDS, 1 case with diabetes, 2 cases with obsolete pulmonary tuberculosis, 2 cases with chronic obstructive pulmonary disease, and 14 cases with bronchiectasis. Sputum or bronchoalveolar lavage fluid samples from 18 patients were cultured positive on Columbia blood plates, Roche medium, or MGIT 960, identifying 11 cases of Nocardia farcinica, 1 case of Nocardia otitidiscaviarum, and 6 cases of Nocardia cyriacigeorgica. All of the 18 patients received treatment with trimethoprim-sulfamethoxazole, 14 in 18 receiving combination therapy, resulting in 8 cures, 8 improvements, and 2 deaths. The reasons for misdiagnosis included: When an infectious disease in patients with long-term expectoration could not be controlled initially, the diagnosis of pulmonary tuberculosis would often be made clinically, and the patients would be given anti-tuberculosis therapy; insufficient understanding of the knowledge of Nocardia by laboratory physicians and doctors; the laboratory physicians neglected the importance of the judgment of Nocardia morphology by Gram staining; the bacterial culture period was usually 48 hours, while Nocardia grew slowly, resulting in missed detections; MGIT 960 culture and Roche culture had long cultivation period, which could increase the positive rate of Nocardia, but fewer units were carrying out such cultivation; insufficient understanding of the morphology differences between cultured Nocardia and Nocardia in the original specimen resulted in misjudgment. Conclusions Pulmonary nocardiosis is easily misdiagnosed as pulmonary tuberculosis. For patients, who have long-term expectoration, with hypoimmunity, or diseases that damage the lung structure such as bronchiectasis, if the response of conventional treatment is poor, Nocardia infection should be considered; Medical staff should enhance their understanding of Nocardia and pay more attention to the microscopic examination of Gram staining, weak acid-fast staining, and culture of sputum; Timely treatment following the diagnosis of nocardiosis can significantly improve the prognosis.

Cancer is a leading cause of death worldwide. Although a variety of cancer therapies, such as surgical resection and local ablation, chemoembolization, radiotherapy, and systemic chemotherapy, have developed rapidly in recent years, the curative effect and 5 year-survival rate of cancer remain to be unsatisfactory. In recent years, with the deepening basic research of hydrogen, its role on the treatment of various diseases including cancer has attracted an increased attention. Hydrogen can promote the apoptosis of colon cancer cells, and which combined with 5-fluorouracil has a synergistic effect and can reduce the renal toxicity induced by cisplatin, without affecting its anti-tumor effect. Hydrogen can alleviate the side effects of radiotherapy, significantly improve the quality of life for patients with liver cancer, and does not affect the effect of radiotherapy. Hydrogen application provides a new therapeutic approach to the treatment of cancer. The specific mechanism of hydrogen in cancer treatment needs further study. This article reviewes the research progress of the role of hydrogen on the treatment of cancer, including antioxidant, anti-inflammatory, adjuvant chemoradiotherapy, and the regulation of signaling pathways.

Objective To explore the clinical significance of detecting hand-foot-and-mouth disease (HFMD) children's cardiac enzymes and neuron-specific enolase (NSE).Methods One hundred and fiftytwo HFMD children were selected as observation group,and 56 cases of healthy children were selected as control group.Cardiac enzymes and NSE levels were compared between two groups.Results The levels of aspartic transaminase(AST),creatine kinase(CK),creatine kinase isozyme-MB(CK-MB),lactate dehydrogenase (LDH),alpha-hydroxybutyric dehydrogenase (α-HBDH),and NSE in observation group were (40.4 ± 14.8)U/L,(109.9 ± 87.5) U/L,(47.0 ± 29.4) U/L,(316.9 ± 119.2) U/L,(256.2 ± 96.1) U/L,(30.9 ± 18.2) μ g/L,and in control group were (24.5 ± 9.2) U/L,(77.4 ± 32.5) U/L,(15.4 ± 7.4) U/L,(134.0 ± 34.4) U/L,(131.1 ± 37.7)U/L,(9.8 ± 4.6) μ g/L.The differences between two groups were statistical significance(P ＜ 0.01).Conclusion The heart and nervous system lesions of HFMD children can be found through detecting cardiac enzymes and NSE early,which provide evidence for early diagnosis and treatment.

Objective To observe the expression of heat shock protein 47 (HSP47) and transforming growth factor-β2 (TGF-β2) in vitreous specimens and epiretinal membranes of patients with proliferative vitreoretinopathy diseases.Methods Vitreous specimens and epiretinal membranes were obtained from 48 patients (48 eyes) with proliferative vitreoretinopathy (PVR) and 50 patients (50 eyes) with proliferative diabetic retinopathy (PDR).Vitreous specimens and internal limiting membranes were collected from 20 patients (20 eyes) with idiopathic macular hole (IMH) as control group.The expression of HSP47 and TGF-β2 in the vitreous specimens was evaluated using enzyme linked immunosorbent assay.The expression of HSP47,TGF-β2,types Ⅰ and Ⅲ collagen in epiretinal membrane and internal limiting membrane specimens were observed for immunohistochemical staining method.The correlation between the positive expression of HSP47 and TGF-β2,types Ⅰ and Ⅲ collagen in epiretinal membrane specimens of patients with PVR and PDR were analyzed.Results The expression of HSP47 in vitreous specimens of patients with PVR,PDR and IMH were (212.35±23.32),(231.30±26.79),(171.06±28.91) pg/ml,respectively.The expression of TGF β2 in vitreous specimens of patients with PVR,PDR and IMH were (1919.96 ± 318.55),(1939.39 ± 177.57),(1194.61 ± 234.20) pg/ml,respectively.The expression of HSP47,TGF-β2 in the vitreous specimens of patients with PVR and PDR were significantly increased compared with patients with IMH and the difference was statistically significant (F=12.952,34.532;P＜0.01).The epiretinal membrane of patients with PVR and PDR showed markedly increased expression of HSP47,TGF β2,types Ⅰ and Ⅲ collagen in the cytoplasm and extracellular matrix.The expression of HSP47 and type Ⅲ collagen was negative and the expression of TGF-β2 was weakly positive and the expression of types Ⅰ collagen was positive in internal limiting membrane of patients with IMH.The expression of HSP47,TGF β2,types Ⅰ and Ⅲ collagen in the epiretinal membrane of patients with PVR and PDR were significantly increased compared with patients with IMH and the difference was statistically significant (F=13.469,18.752,12.875,20.358;P＜0.01).The expression of HSP47 was positively correlated with thepositive expression of TGF-~,types Ⅰ and Ⅲ collagen in epiretinal membrane specimens of patients withPVR (r=0.475,0.556,0.468;P＜0.05) and PDR (r=0.484,0.589,0.512;P＜0.05).Conclusions This study showed increased consistent expression of HSP47 and TGF-β2 in vitreous and epiretinal membrane specimens of patients with PVR and PDR.Both HSP47 and TGF-β2 were expressed in the cytoplasm and extracellular matrix.HSP47 and TGF-β2 may be involved in the pathological process of PDR and PVR by promoting collagen synthesis.

Objective To evaluate the role of endoscopic ultrasonography in the diagnosis and preoperative staging of rectum carcinoma. Methods Fifty-seven patients with rectum carcinoma were performed with preoperative endoscopy and endoscopic ultrasonography. And the staging results of endoscopic ultrasonography were compared to that of postoperative pathological assessment. Result Compared with the pathological staging, the endoscopic ultrasonography staging accuracy rate was 78.9% (45/57),and lymph node metastasis accuracy rate was 73.7% (42/57). Conclusion Endoscopic ultrasonography is effective in diagnosing and preoperative staging of rectum carcinoma.

AIM: To investigate effects of rBMMSC on hematopoiesis and immune reconstitution after allo-hematopoietic stem cells transplantation (HSCT). METHODS: Allogeneic BMT model from Fischer344 rats (RT-1Al) to Wistar rats (RT-1Au) was established. The effects of MSCs on hematopoietic reconstitution and immune reconstitution were studied by observing the survival rate, peripheral blood counts, thymus counts, spleen counts, bone marrow counts and immune function analysis at 30 days after transplantation. RESULTS: 1. Cotransplantation of MSCs and bone marrow (BM) was demonstrated to improve hematopoietic reconstitution. Lymphocyte and platelet counts in peripheral blood in cotransplantation groups were higher than those in control groups. More bone marrow neucleated cells were also observed in cotransplantation groups. 2. Cotransplantation of MSCs and BM improved immune reconstitution. First, overall thymic cellularity and spleen cellularity significantly increased in cotransplantation groups at day 30. Secondly, cotransplantation improved immune functional recovery. Non-specific lymphocytes proliferation reaction induced by ConA and LPS increased in cotransplantation group, and so did for allogeneic mixed-lymphocyte reaction. CONCLUSION: Hematopoietic reconstitution and immune reconstitution were significantly enhanced by MSCs cotransplanted with BM.