The corona virus disease 2019(COVID-19)infection has assumed global pandemic status in a short period of time since its outbreak.This public health crisis has inflicted unprecedented damage and challenges to more than 200 countries and regions around the word.As the peak of the epidemic gradually subsides,an increasing amount of attention has been shifted to the issue of long-term sequelae in COVID-19 patients.These sequelae are manifested as the continuous dysfunction of multiple organ systems and are known as Long COVID.In response to this new issue,clinical pathological research has continuously made new progress,posing new requirements and challenges for the pre-vention and treatment of Long COVID.This article aims to review the progress of clinical pathological research on Long COVID in recent years,with the expectation of providing new ideas and methods for the prevention and treatment of this disease.

The corona virus disease 2019(COVID-19)infection has assumed global pandemic status in a short period of time since its outbreak.This public health crisis has inflicted unprecedented damage and challenges to more than 200 countries and regions around the word.As the peak of the epidemic gradually subsides,an increasing amount of attention has been shifted to the issue of long-term sequelae in COVID-19 patients.These sequelae are manifested as the continuous dysfunction of multiple organ systems and are known as Long COVID.In response to this new issue,clinical pathological research has continuously made new progress,posing new requirements and challenges for the pre-vention and treatment of Long COVID.This article aims to review the progress of clinical pathological research on Long COVID in recent years,with the expectation of providing new ideas and methods for the prevention and treatment of this disease.

Objective:To investigate the effects of metronidazole and vulvar cleaning with 0.1% benzalkonium bromide solution on vaginal environment, etiology, and interleukin-6 and Toll-like receptor 2 levels in lavage fluid of patients with bacterial vaginosis.Methods:A total of 114 patients with bacterial vaginosis who were admitted to Jinan 2 nd People's Hospital from February 2021 to February 2024 were included in this prospective study. These patients were randomly divided into a control group and an observation group, with 57 patients in each group, following a 1:1 ratio. The control group received treatment with metronidazole, while the observation group received metronidazole in combination with vulvar cleaning using a 0.1% benzalkonium bromide solution, for a total of 14 days. The clinical efficacy was evaluated by comparing the vaginal environment (including vaginal pH, cleanliness, and microbial density), microbiological outcomes (lactobacilli detection rate and pathogenic bacteria detection rate), and interleukin-6 and Toll-like receptor 2 levels in the vaginal lavage fluid between the two groups before and after treatment. Adverse drug reactions were recorded. Patients were followed up for 3 months after treatment to record recurrence rates. Results:The total response rate in the observation group was significantly higher than that in the control group [92.98% (53/57) vs. 78.95% (45/57), χ2 = 4.65 P < 0.05]. After treatment, improvements of vaginal pH, vaginal cleanliness, and bacterial density were greater in the observation group than those in the control group ( χ2 = 4.61, Z = 4.92, 4.29, all P < 0.05). After treatment, the detection rate of lactobacilli in the observation group was significantly higher than that in the control group [63.16% (36/57) vs. 42.11% (24/57), χ2 = 5.07, P < 0.05]. The detection rate of pathogenic bacteria in the observation group was significantly lower than that in the control group [5.26% (3/57) vs. 17.54% (10/57), χ2 = 4.25, P < 0.05]. After treatment, lavage fluid levels of interleukin-6 [(8.70 ± 2.13) ng/L vs. (13.52 ± 3.36) ng/L] and Toll-like receptor 2 [(5.06 ± 1.34) ng/L vs. (7.84 ± 1.22) ng/L] in the observation group were significantly lower than those in the control group ( t = 9.15, 11.58, both P < 0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups ( χ2 = 1.37, P > 0.05). After 3 months of treatment, the recurrence rate of bacterial vaginosis in the observation group was significantly lower than that in the control group [4.55% (1/22) vs. 27.78% (5/18), χ2 = 4.19, P < 0.05]. Conclusions:The combination of metronidazole and vulvar cleaning with a 0.1% benzalkonium chloride solution is effective for treating bacterial vaginosis. This approach helps regulate the vaginal environment, increases the levels of lactobacilli, reduces the levels of pathogenic bacteria, and decreases the levels of interleukin-6 and Toll-like receptor 2 in the lavage fluid. Additionally, it decreases the risk of recurrence of bacterial vaginosis and is highly safe.

Objective:Immune checkpoint inhibitors(ICIs)can significantly improve the clinical prognosis of various types of cancer and are increasingly used in surgical combination therapy for lung cancer.However,ICIs can cause serious or fatal immune-related ad-verse events(irAEs),and effective patient assessment and family training are essential for the prevention of irAEs in neoadjuvant im-munotherapy.Therefore,this study aims to determine the educational needs for the prevention of irAEs in patients with lung cancer af-ter neoadjuvant therapy.Methods:A retrospective analysis was performed for the medical records of 178 patients with lung cancer who received neoadjuvant therapy from March 2021 to September 2023,and the frequency and severity of irAEs and unplanned hospitaliza-tion due to irAEs were evaluated.Educational needs were assessed based on initial symptoms,caregivers,telephone counselling,and the interval between the appearance of symptoms and the arrival at the hospital.Results:Among the 178 patients available for assess-ment,86 patients(48.3%)experienced irAEs during the study period.Pneumonia observed in 13 patients was the most common irAE requiring hospitalization,followed by dermatitis in 2 patients and adrenal insufficiency in 2 patients.There was a relatively high inci-dence rate of severe irAEs requiring hospitalization among the patients with lung cancer receiving neoadjuvant therapy.Conclusion:Severe irAEs can be avoided through training of related knowledge for patients and their families,timely assessment and reporting of slight changes in symptoms after neoadjuvant therapy by caregivers,focus on commonly observe severe irAEs,and early detection.

Objective:To investigate the effects of metronidazole and vulvar cleaning with 0.1% benzalkonium bromide solution on vaginal environment, etiology, and interleukin-6 and Toll-like receptor 2 levels in lavage fluid of patients with bacterial vaginosis.Methods:A total of 114 patients with bacterial vaginosis who were admitted to Jinan 2 nd People's Hospital from February 2021 to February 2024 were included in this prospective study. These patients were randomly divided into a control group and an observation group, with 57 patients in each group, following a 1:1 ratio. The control group received treatment with metronidazole, while the observation group received metronidazole in combination with vulvar cleaning using a 0.1% benzalkonium bromide solution, for a total of 14 days. The clinical efficacy was evaluated by comparing the vaginal environment (including vaginal pH, cleanliness, and microbial density), microbiological outcomes (lactobacilli detection rate and pathogenic bacteria detection rate), and interleukin-6 and Toll-like receptor 2 levels in the vaginal lavage fluid between the two groups before and after treatment. Adverse drug reactions were recorded. Patients were followed up for 3 months after treatment to record recurrence rates. Results:The total response rate in the observation group was significantly higher than that in the control group [92.98% (53/57) vs. 78.95% (45/57), χ2 = 4.65 P < 0.05]. After treatment, improvements of vaginal pH, vaginal cleanliness, and bacterial density were greater in the observation group than those in the control group ( χ2 = 4.61, Z = 4.92, 4.29, all P < 0.05). After treatment, the detection rate of lactobacilli in the observation group was significantly higher than that in the control group [63.16% (36/57) vs. 42.11% (24/57), χ2 = 5.07, P < 0.05]. The detection rate of pathogenic bacteria in the observation group was significantly lower than that in the control group [5.26% (3/57) vs. 17.54% (10/57), χ2 = 4.25, P < 0.05]. After treatment, lavage fluid levels of interleukin-6 [(8.70 ± 2.13) ng/L vs. (13.52 ± 3.36) ng/L] and Toll-like receptor 2 [(5.06 ± 1.34) ng/L vs. (7.84 ± 1.22) ng/L] in the observation group were significantly lower than those in the control group ( t = 9.15, 11.58, both P < 0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups ( χ2 = 1.37, P > 0.05). After 3 months of treatment, the recurrence rate of bacterial vaginosis in the observation group was significantly lower than that in the control group [4.55% (1/22) vs. 27.78% (5/18), χ2 = 4.19, P < 0.05]. Conclusions:The combination of metronidazole and vulvar cleaning with a 0.1% benzalkonium chloride solution is effective for treating bacterial vaginosis. This approach helps regulate the vaginal environment, increases the levels of lactobacilli, reduces the levels of pathogenic bacteria, and decreases the levels of interleukin-6 and Toll-like receptor 2 in the lavage fluid. Additionally, it decreases the risk of recurrence of bacterial vaginosis and is highly safe.

AIM: To investigate the characteristics of anterior segment structure in first-degree relatives of patients with primary angle-closure glaucoma(PACG).METHODS: A total of 48 first-degree relatives of PACG patients aged 40-60 who were treated in the Affiliated Eye Hospital of Nanchang University from September 2020 to October 2022 were selected as the observation group. Additionally, 40 cases(40 eyes)of healthy individuals without glaucoma and family history of glaucoma at the same age group were collected as the control group. They were divided into younger group(40-49 years old)and elder group(50-60 years old). All subjects were examined with ultrasound biomicroscopy(UBM)and were measured using camera measure software. The parameters mainly included anterior chamber depth(ACD), anterior chamber area(ACA), anterior chamber width(ACW), anterior segment depth(ASD), angle open distance(AOD500), trabecular iris angle(TIA), trabecular iris area(TISA500), lens vault(LV), iris curve(IC), iris thickness(IT500), scleral ciliary process angle(SCPA), and iris ciliary process distance(ICPD).RESULTS: ACD, ACA, AOD500, TISA500 and TIA in the observation group were lower than those of the control group, and LV and IC were higher than those of the control group(all P<0.05). ACD, ACA, AOD500, TISA500, and TIA of the elder group were lower than those in the age-matched control group, while LV and IC were larger than those of the age-matched control group(all P<0.05). ACD, AOD500, TISA500, and TIA of the younger observation group were smaller than those of the age-matched control group, but LV and IC were significantly larger than those of the age-matched control group(all P<0.05). ACD, ACA, AOD500, TISA500 and TIA of the elder observation group were significantly lower than those of the younger observation group, and LV and IC were significantly larger than those of the younger observation group(all P<0.05). There was a difference in the distribution of ACD between the observation group and the control group(P<0.05), and the proportion of moderate to severe shallow anterior chambers was 10 times that of the control group. Correlation analysis showed that TISA500 was positively correlated with ACD and ACA, and negatively correlated with LV and IC, and TISA500 was mainly influenced by LV. IC had a positive correlation with LV and a negative correlation with ACD and ACA.CONCLUSION: First-degree relatives of PACG with normal axial length have a high risk of angle closure. The anterior segment structures of first-degree relatives of PACG are more crowded than normal individuals, and the lens forward shift may be the initial influencing factor for narrow angle.

Objective:To investigate the effects of subcutaneous immunotherapy (SCIT) on patients′ immune markers and metabolic levels in the early stage of allergen treatment, and to gain insight into the role of SCIT in regulating immune responses and metabolic levels, so as to provide reference data for the further discovery of potential biomarkers.Methods:A longitudinal study was used to include 40 subjects who underwent SCIT with dust mite allergens in the Department of Pediatrics of the First Affiliated Hospital of Guangzhou Medical University between November 2017 and February 2022, including 20 subjects each of single mite subcutaneous immunotherapy (SM-SCIT) and double mite subcutaneous immunotherapy (DM-SCIT). In this study, levels of dust mite allergen-specific antibodies and polyunsaturated fatty acid metabolism were measured before and 12 months after treatment, while pulmonary function tests were performed. The therapeutic effects of the patients were followed up by visual analogue scale (VAS), asthma control test (ACT) and total medication scores (TMS). The results were statistically analyzed using t-test and Mann-Whitney U-test. Results:After 12 months of treatment with SCIT, both groups showed a significant decrease in total VAS score (SM-SCIT: Z=-2.298, P<0.05; DM-SCIT: Z=-3.411, P<0.001); total ACT score (SM-SCIT: Z=-2.054, P<0.05; DM-SCIT: Z=-2.014, P<0.05) and total medication scores (SM-SCIT: Z=-3.799, P<0.000 1; DM-SCIT: Z=-3.474, P<0.001) were significantly higher, in addition to significantly higher MMEF75/25 values in the DM-SCIT group ( t=-2.253, P<0.05). There was no significant change in sIgE in the SM-SCIT group ( P>0.05), and the sIgG4 levels of the Der p, Der f, p 1, p 2, f 2, and p 21 fractions were significantly elevated ( Z=-2.651, -3.771, -2.949, -2.912, -2.725, -2.128, and -3.285, respectively, all P<0.05); The sIgE of Der p 2, f 2, p 7 and p 23 fractions( Z=-2.651, -3.771, -2.949, -2.912, -2.725, -2.128, -3.285, all P<0.05) and the sIgG4 levels of the Der p, Der f, p 1, p 2, f 1, f 2, p 10, p 21 and p 23 fractions ( Z=-3.808, -3.845, -3.061, -2.688, -2.464, -3.211, -2.371, -2.091, -2.427, all P<0.05) of the DM-SCIT group were significantly elevated. Metabolomics analysis showed that arachidonic acid, docosahexaenoic acid, docosapentaenoic acid, eicosapentaenoic acid, 5, 9, 12-octadecatrienoic acid, 5(S)-hydroxylated eicosatetraenoic acid, and dihomo-gamma-linolenic acid were significantly elevated at the beginning of the treatment period after SM-SCIT treatment ( Z of -2.191, -2.497, -1.988, -2.090, -2.19, -2.803, -2.073, all P<0.05); 5(S)-hydroxylated eicosatetraenoic acid showed elevated and alpha-linolenic acid, eicosadienoic acid, and eicosapentaenoic acid were significantly decreased in the DM-SCIT group after treatment ( Z=-1.988, -2.090, -2.497, -1.988, respectively, all P<0.05). Correlation analysis showed that arachidonic acid was significantly negatively correlated with changes in dust mite-specific IgG4 ( r=-0.499, P<0.05), and that alpha-linolenic acid, 5, 9, 12-octadecatrienoic acid, and eicosapentaenoic acid were positively correlated with the ΔsIgG4 of the dust mite der p 2 ( r=0.451, 0.420, 0.474, respectively; all P<0.05). Conclusion:Significant changes in allergen-specific antibody levels and polyunsaturated fatty acid metabolism levels occur during SCIT, and the two may interact and influence each other.

Objective:To investigate the effects of subcutaneous immunotherapy (SCIT) on patients′ immune markers and metabolic levels in the early stage of allergen treatment, and to gain insight into the role of SCIT in regulating immune responses and metabolic levels, so as to provide reference data for the further discovery of potential biomarkers.Methods:A longitudinal study was used to include 40 subjects who underwent SCIT with dust mite allergens in the Department of Pediatrics of the First Affiliated Hospital of Guangzhou Medical University between November 2017 and February 2022, including 20 subjects each of single mite subcutaneous immunotherapy (SM-SCIT) and double mite subcutaneous immunotherapy (DM-SCIT). In this study, levels of dust mite allergen-specific antibodies and polyunsaturated fatty acid metabolism were measured before and 12 months after treatment, while pulmonary function tests were performed. The therapeutic effects of the patients were followed up by visual analogue scale (VAS), asthma control test (ACT) and total medication scores (TMS). The results were statistically analyzed using t-test and Mann-Whitney U-test. Results:After 12 months of treatment with SCIT, both groups showed a significant decrease in total VAS score (SM-SCIT: Z=-2.298, P<0.05; DM-SCIT: Z=-3.411, P<0.001); total ACT score (SM-SCIT: Z=-2.054, P<0.05; DM-SCIT: Z=-2.014, P<0.05) and total medication scores (SM-SCIT: Z=-3.799, P<0.000 1; DM-SCIT: Z=-3.474, P<0.001) were significantly higher, in addition to significantly higher MMEF75/25 values in the DM-SCIT group ( t=-2.253, P<0.05). There was no significant change in sIgE in the SM-SCIT group ( P>0.05), and the sIgG4 levels of the Der p, Der f, p 1, p 2, f 2, and p 21 fractions were significantly elevated ( Z=-2.651, -3.771, -2.949, -2.912, -2.725, -2.128, and -3.285, respectively, all P<0.05); The sIgE of Der p 2, f 2, p 7 and p 23 fractions( Z=-2.651, -3.771, -2.949, -2.912, -2.725, -2.128, -3.285, all P<0.05) and the sIgG4 levels of the Der p, Der f, p 1, p 2, f 1, f 2, p 10, p 21 and p 23 fractions ( Z=-3.808, -3.845, -3.061, -2.688, -2.464, -3.211, -2.371, -2.091, -2.427, all P<0.05) of the DM-SCIT group were significantly elevated. Metabolomics analysis showed that arachidonic acid, docosahexaenoic acid, docosapentaenoic acid, eicosapentaenoic acid, 5, 9, 12-octadecatrienoic acid, 5(S)-hydroxylated eicosatetraenoic acid, and dihomo-gamma-linolenic acid were significantly elevated at the beginning of the treatment period after SM-SCIT treatment ( Z of -2.191, -2.497, -1.988, -2.090, -2.19, -2.803, -2.073, all P<0.05); 5(S)-hydroxylated eicosatetraenoic acid showed elevated and alpha-linolenic acid, eicosadienoic acid, and eicosapentaenoic acid were significantly decreased in the DM-SCIT group after treatment ( Z=-1.988, -2.090, -2.497, -1.988, respectively, all P<0.05). Correlation analysis showed that arachidonic acid was significantly negatively correlated with changes in dust mite-specific IgG4 ( r=-0.499, P<0.05), and that alpha-linolenic acid, 5, 9, 12-octadecatrienoic acid, and eicosapentaenoic acid were positively correlated with the ΔsIgG4 of the dust mite der p 2 ( r=0.451, 0.420, 0.474, respectively; all P<0.05). Conclusion:Significant changes in allergen-specific antibody levels and polyunsaturated fatty acid metabolism levels occur during SCIT, and the two may interact and influence each other.

Objective: To understand the prevalence and trend of diet related behaviors among secondary school students in Shanghai, and to provide a scientific basis for developing appropriate health education strategies. Methods: Anonymous questionnaire surveys were conducted among 71 291 students selected by multi stage stratified cluster sampling method from junior high schools,senior high schools and vocational schools in Shanghai in the year of 2008,2012,2015,2017,2019. The questionnaire adopted was "Shanghai adolescent health related behavior questionnaire". Test for trend test were applied for the analysis of the prevalence of their dietary behaviors. Results: The proportion of middle school students nutritional status within the normal range in each survey year were 73.40 %, 72.60%, 68.06%, 68.73%, 67.53%, respectively, while the rate of overweight and obesity increased from 13.17% in 2008 to 23.73% in 2019. The proportion of "eating fried food" decreased significantly by year, from 12.05 % to 4.23% (male, APC=-7.94%, t =-4.33, female, APC= -9.29%, t=-7.71, P <0.05) respectively. And the proportion of "eating dessert" also decreased significantly by year, from 31.66% to 11.14% (male, APC=-8.41%, t =-6.37, female, APC=-8.67%, t=-6.96, P <0.05). In the five surveys, the percentages of healthy diet related behaviors of secondary school students were 12.81%-21.82%, no significant upward trend was observed in the whole( P >0.05). The proportion of diet-related behaviors of nutrition unbalance and easily leading to obesity decreased significantly from 35.47% to 17.00%(APC=-6.71%, t= -5.00 , P <0.05). The proportion of diet related behavior of nutrition unbalance and not easily leading to obesity increased significantly from 39.15% to 60.16%(APC=3.46%, t=6.18, P <0.05). Conclusion Overweight and obesity among secondary school students in Shanghai are increasing during the past decade, and the proportion of healthy dietary behaviors is low. The knowledge of rational diet should be publicized among these students in order to develop healthy dietary behaviors.

The passing of ethical review is a necessary conditions and prerequisite for the development of life science and medical research involving humans. At present, some medical and health institutions have no or insufficient ethical review capabilities. The lack of ethical review ability has become a bottleneck restricting the development of life science and medical research involving humans. According to documents such as Opinions on Deepening the Reform of the Review and Approval System and Encouraging the Innovation of Pharmaceutical and Medical Devices, Opinions on Strengthening the Ethical Governance of Science and Technology, institutions can entrust competent institutional ethics review committees or regional ethics review committees in writing to conduct ethical review. Entrustment ethical review provides a viable solution for institutions that need to carry out life science and medical research involving humans but do not have an ethics (review) committee or the ethics (review) committee is not competent to review. To conduct the entrustment ethical review, the entrustment between the principal and the trustee is required. According to The Measures for Ethical Review of Life Sciences and Medical Research Involving Humans, if medical and health institutions and their ethical review committees do not accept the formal entrustment to provide the ethical review opinions for other institutions, the local health authorities at or above the county level will impose administrative penalties and sanctions on the relevant institutions and personnel in accordance with the law. Signing the entrustment ethical review contract, implementing legal compliance entrusted ethical review to protect the rights and interests of the trustee and the principal, and protect the research participants.