Intra-abdominal Hernia with Bowel Obstruction Triggering Multi-organ Failure: The Role of Preoperative Enteritis This report details the clinical course of a 41-year-old male who developed fulminant multiple organ dysfunction syndrome following emergency surgery for a strangulated intra-abdominal hernia. Preoperative manifestations, including diarrhea and marked leukocytosis, pointed towards an underlying infectious enteritis. We posited that surgical release of the obstructed, ischemic bowel segment precipitated a massive systemic influx of endotoxins and inflammatory mediators, triggering septic shock and rapid sequential organ failure. This case underscored the critical need to suspect concomitant gastrointestinal infection in patients presenting with mechanical bowel obstruction accompanied by infectious signs. Aggressive perioperative sepsis management encompassing early empiric antimicrobial therapy, vigilant hemodynamic monitoring, and preparedness for advanced organ support is essential to mitigate this severe complication.

Objective This study reports on the obligatory parasitism of water mites Arrenurus sp. on Anopheles messeae at the Manzhouli Port, Inner Mongolia, China. Methods Duing July 2024, a survey on the mosquito diversity was conducted at the Manzhouli Port. Captured mosquitoes and their ectoparasites were identified to species level. Results A total of 1840 adult mosquitoes were collected, representing species from three genera: Culex(Cx. modestus, Cx. pipiens pallens), Aedes(Ae. dorsalis, Ae. flavidorsalis, Ae. flavescens), and Anopheles (An. messeae). Among all the mosqutioes specimens,3 out of 150 captured An. messeae were found to carry ectoparasitic mites, with number of 2,4,27 mites separately. Morphological and molecular identification reached the same result as water mites(Hydrachnidiae, Hydracrina). COI gene sequence showed 94% similarity with the closest species Arrenurus truncatellus. Conlusions Literature review suggests water mites are host-specific parasitism of mosquito species and herein with the first record of Arrenurus sp. parasiting on An. Messeae in the most high-latitude region globally.

ObjectiveTo investigate the detection status of scoliosis and its influencing factors among primary and secondary school students in Jiangqiao Town in Jiading District of Shanghai, thereby providing evidence for the prevention and management of scoliosis in children and adolescents. MethodsA stratified cluster random sampling was conducted in March 2025. Three primary schools and two secondary schools in Jiangqiao Town were randomly selected; within each school, 3‒4 entire classes were randomly chosen. Screening was performed in accordance with the criteria specified in GB/T 16133‒2014 Screening for Abnormal Spinal Curvature in Children and Adolescents, and a self-designed structured questionnaire was administered to conduct face-to-face surveys (Cronbach’s α=0.730). ResultsA total of 772 valid questionnaires were collected on-site, representing a 100% response rate. The sample consisted of 413 males (53.50%) and 359 females (46.50%), including 385 primary school students (49.87%) and 387 secondary school students (50.13%). The detection rate of scoliosis in primary and secondary school students was 12.05%. The detection rates were 8.72% for males and 15.88% for females, with the female rate being significantly higher than the male rate (χ²=9.29, P=0.002). For primary and secondary school students, the detection rates were 6.75% and 17.31%, respectively, with the secondary school student rate being significantly higher (χ²=20.31, P<0.001). The results of univariate analysis revealed that students with sufficient sleep and standard sitting postures during reading/writing had a significantly lower scoliosis detection rate compared to those with insufficient sleep and non-standard sitting postures (χ²=5.90, P=0.015 and χ²=5.09, P=0.024). Multivariate logistic regression analyses revealed that the detection rate of scoliosis was significantly higher in females than in males (OR=1.846， 95%CI: 1.156‒2.984), and significantly higher in secondary school students than in primary school students (OR=2.722， 95%CI: 1.656‒4.472). ConclusionThe scoliosis detection rate among primary and secondary school students in Jiangqiao Town in Jiading District is relatively high. Females and secondary school students are key populations requiring targeted prevention and control efforts. It is imperative to strengthen health education on scoliosis, promote early screening and diagnosis, and implement timely targeted interventions.

Objective:To investigate the clinical manifestations, long-term survival, and prognosis of childhood T-cell acute lymphoblastic leukemia (T-ALL).Methods:Case summary.The clinical data of 43 T-ALL children who were diagnosed and treated in Children′s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from January 2010 to December 2021 were retrospectively analyzed.They were stratified for treatment according to the CCCG-ALL regimen, and the correlation of prognosis with the condition at initial diagnosis, early treatment response, and induced remission was analyzed.The Kaplan-Meier survival curve was used to analyze the survival rate, and the survival rates were compared between groups by the Log-rank test.The multivariate Cox regression model was used to analyze the impact of multiple factors on the long-term survival of children.Results:T-ALL patients accounted for 9.5% (43/451) of the total number of acute lymphoblastic leukemia patients admitted to the hospital at the same period.The median onset age of the 43 T-ALL patients was 7 years (1-13 years).Of the 43 patients included, 14 patients (32.6%) had concomitant mediastinal widening, 8 patients (18.6%) had concomitant giant mediastinal masses, and 4 patients (9.3%) had early precursor T-cell acute lymphoblastic leukemia (ETP-ALL) at initial diagnosis.These 43 children were treated according to the CCCG-ALL intermediate- and high-risk group regimen.Among them, 33 children (76.7%) achieved sustained remission, 5 children died, and 5 children had a relapse.As of September 30, 2024, the median follow-up time was 62 months (1-170 months), the 10-year event-free survival rate was (80.2±6.4)%, and the 10-year overall survival rate was (86.6±5.8)%.The median relapse time and 10-year cumulative relapse rate of the 5 relapsed children were 28 months (7-58 months) and (13.7±5.8)%, respectively.The relationship of prognosis with clinical characteristics at initial diagnosis and induced remission in 43 T-ALL children was analyzed.The results showed that patients aged ≥10 years, with a grade-1 non-central nervous system at initial diagnosis, ETP-ALL, abnormal chromosome number and structure, non-M1 status of bone marrow and minimal residual disease (MRD)≥ 1% on day 19 of induction treatment, and MRD ≥ 0.01% on day 46 to 55 of induction treatment had poorer long-term survival(all P<0.05).The multivariate analysis showed that age ≥10 years, ETP-ALL, and abnormal chromosome number and structure were risk factors of poor prognosis ( P=0.045, 0.030, 0.021). Conclusions:The CCCG-ALL regimen has a good overall therapeutic effect in children with T-ALL.Age ≥10 years, abnormal chromosome number and structure, ETP-ALL, grade-1 non-central nervous system at initial diagnosis, and early remission are risk factors of poor prognosis.Treatment after relapse in children with T-ALL is difficult.

Objective:To establish a stable rat model of sequelae of pelvic inflammatory disease(SPID)with clinical characteristics,and to provide a reliable experimental model for the study of the pharmcological effect and mechanism of SPID.Methods:Twenty-four 7-week-old SD rats were divided into sham operation group,model-A(108 cfu/mL mixed bacterial solution,0.2 mL),model-B(109 cfu/mL mixed bacterial solution 0.2 mL),and model-C(108 cfu/mL E.coli 0.2 mL).The weight of the rat's uterine was weighed and the uterine index was calculated.The automatic hematology analyzer was used to detect the blood routine;hematoxylin-eosin staining(HE)and masson staining were used to detect uterine pathlogical changes in rats.Enzyme-linked immunosorbent assay(ELISA)was used to detect interleukin-1β(IL-1β),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)in rat uterine tissue homogenates.Western blot was used to detect the expression of proteins related to NF-κB signaling pathway.Results:Compared with the sham operation group,the uterine index of model-A,model-B,and model-C were significantly increased(P＜0.05,P＜0.01).The levels of WBC and NE in the model-A increased significantly(P＜0.01).The level of LY in model-B decreased significantly(P＜0.01).The levels of IL-1β,TNF-α in model-A,model-B,and model-C were significantly increased(P＜0.01).The levels of IL-6 in model-A and model-B were significantly increased(P＜0.05,P＜0.01).The collagen volume fraction of model-A and model-B were significantly increased(P＜0.01).Mechanism study indicates that the expression levels of p-IKKβ/IKKβ,p-IκBα/IκBα and p-p65/p65 in model-A were significantly increased(P＜0.01),and the expression levels of IκBα/β-actin were significantly decreased(P＜0.01).The expression level of p-IKKβ/IKKβ in model-B was significantly increased(P＜0.01).Conclusions:A stable rat model of SPID that conforms to clinical characteristics can be successfully constructed by combining 0.2 mL of mixed bacterial solution with a concentration of 108 cfu/mL and mechanical injury.This modeling method intervened in the expression of the NF-κB inflammatory signaling pathway.

Objective To evaluate the safety and feasibility of percutaneous mitral balloon valvuloplasty with the assistance of arterio-venous circuit.Methods From January 2015 to October 2022,a total 25 patients[19 females,6 males;age(61.60±9.00)years]were included,who were diagnosed with rheumatic heart disease and severe mitral stenosis.A transseptal puncture was performed to establish a femoral arterio-venous circuit,followed by graded dilation with Inoue balloon(diameters:22.00 mm to 28.00 mm).The target was a mitral valve area≥1.50 cm2 with mild or less regurgitation.Results The arterio-venous circuit was established,and mitral balloon valvuloplasty was successfully completed in all 25 patients.Among them,20 patients experienced difficulty with transvalvular crossing using the balloon catheter with conventional methods,16 patients had valvular severe calcification,and 3 patients presented with a left atrial appendage thrombus despite of more than 6-month anticoagulation therapy with warfarin.The mean balloon diameter was(25.00±1.40)mm.The mitral valve area increased from(0.91±0.15)cm2 preoperatively to(1.70±0.14)cm2 postoperatively(P＜0.001).Mean left atrial pressure decreased from(27.00±7.50)mmHg to(16.36±4.07)mmHg(P＜0.001),and mean pulmonary artery pressure decreased from(40.84±13.81)mmHg to(25.00±7.12)mmHg(P＜0.001).All patients showed significant symptom improvement with no complications.Conclusions Arterio-venous circuit for percutaneous mitral balloon valvuloplasty is safe and feasible.This technique can serve as an alternative to standard technique for patients with complex mitral stenosis.

Objective:To explore the clinical characteristics and identification of the independent risk factors for disease progression in patients with anti-gp210 antibody-positive primary biliary cholangitis (PBC).Methods:A retrospective cohort study was performed. A total of 323 cases with PBC diagnosed in Tianjin Medical University General Hospital from January 2013 to June 2023 (125 patients with anti-gp210 antibody-positive and 198 patients with anti-gp210 antibody-negative) were included. Baseline and follow-up data were collected. The independent sample t-test and Mann-Whitney U rank sum test were used for comparison between groups of continuous data. The χ2 test was used to compare the data between groups for the count data. The Pearson test was used for correlation analysis between continuous variables. The Kaplan-Meier method was used to analyze the disease progression-free survival rate. The Cox regression model was used to analyze the risk factors for disease progression. Results:The male proportion (11.2% vs. 5.1%, P=0.040) and IgM level [3.29(1.88, 4.80) g/L vs. 2.56(1.44, 3.87) g/L, P=0.019] were significantly higher in patients with PBC with positive anti-gp210 antibodies than those of the negative group. Histopathological analysis showed that the Scheuer score [1(0,3) vs. 0(0,2)], bile duct inflammation [(2(1,3) vs. 1(1,2)] and bile duct reaction score [(2(1,3) vs. 1(1,2)] were higher in the positive group than those of the negative group ( P<0.05), and the maturity of the tertiary lymphoid structure was higher ( P=0.011). Kaplan-Meier analysis showed that the 5-year disease-free survival rate was significantly lower in patients with positive anti-gp210 antibodies than that of the negative group (55.8% vs. 79.7%, P=0.006) at a median follow-up of 3(2,6) years. Multivariate Cox regression analysis showed that γ-glutamyl transferase [ HR=1.002 (95% CI: 1.000～1.003)] and platelet count [ HR=0.993 (95% CI: 0.988～0.999)] were the independent influencing factors for disease progression in patients with anti-gp210 antibody-positive PBC ( P=0.002, 0.017). Conclusion:Patients with anti-gp210 antibody-positive PBC have more severe clinical pathological manifestations and a higher risk of disease progression. Higher levels of γ-glutamyl transferase and lower platelet counts during the first visit are independent risk factors for disease progression in patients with anti-gp210 antibody-positive PBC, which can be used as dynamic monitoring indicators for this population, suggesting the need for early intensive intervention.

Objective To evaluate the safety and feasibility of percutaneous mitral balloon valvuloplasty with the assistance of arterio-venous circuit.Methods From January 2015 to October 2022,a total 25 patients[19 females,6 males;age(61.60±9.00)years]were included,who were diagnosed with rheumatic heart disease and severe mitral stenosis.A transseptal puncture was performed to establish a femoral arterio-venous circuit,followed by graded dilation with Inoue balloon(diameters:22.00 mm to 28.00 mm).The target was a mitral valve area≥1.50 cm2 with mild or less regurgitation.Results The arterio-venous circuit was established,and mitral balloon valvuloplasty was successfully completed in all 25 patients.Among them,20 patients experienced difficulty with transvalvular crossing using the balloon catheter with conventional methods,16 patients had valvular severe calcification,and 3 patients presented with a left atrial appendage thrombus despite of more than 6-month anticoagulation therapy with warfarin.The mean balloon diameter was(25.00±1.40)mm.The mitral valve area increased from(0.91±0.15)cm2 preoperatively to(1.70±0.14)cm2 postoperatively(P＜0.001).Mean left atrial pressure decreased from(27.00±7.50)mmHg to(16.36±4.07)mmHg(P＜0.001),and mean pulmonary artery pressure decreased from(40.84±13.81)mmHg to(25.00±7.12)mmHg(P＜0.001).All patients showed significant symptom improvement with no complications.Conclusions Arterio-venous circuit for percutaneous mitral balloon valvuloplasty is safe and feasible.This technique can serve as an alternative to standard technique for patients with complex mitral stenosis.

Suppressor of cytokine signaling 3(SOCS3),a member of SOCS family,plays a major role in cell signaling trans-duction.SOCS3 is important in regulation of immune homeostasis and also involved in the control of energy metabolism,mainly through regulating JAK/STAT pathway.Recent studies have shown that SOCS3 was closely associated with glycolipid metabolic diseases like diabetes and obesity,and can be used as a new target for treatment of these glycolipid metabolic diseases.This review focuses on the latest research progress of the role and mechanism of SOCS3 in glycolipid metabolic diseases,and discusses the possibility of SOCS3 as a therapeutic target for glycolipid metabolic diseases.

Objective:To investigate the clinical efficacy and underlying mechanisms of endoscopic sinus surgery(ESS)combined with budesonide nasal spray in the treatment of chronic rhinosinusitis with nasal polyps(CRSwNP),with a focus on its effects on symptom control,nasal mucosal function repair,immune regulation,and recurrence rate.Methods:A total of 110 patients with CRSwNP were randomly divided into a matched group(60 cases,receiving ESS alone)and an observation group(50 cases,receiving ESS followed by 6 months of postoperative budesonide nasal spray).The Lund-Kennedy score,Visual Analog Scale(VAS)score for symptoms,nasal mucociliary clearance rate(MTR),nasal mucosal T-cell subsets(CD4+/CD8+),inflammatory factors(TGF-β1,VEGF),serum marker(IL-3,IL-4,IL-5,IL-13,TSLP)and complications,recurrence rate(6 months and 12 months)were compared between the two groups before surgery and at 3 and 6 months postoperatively.Results:At 3 months postoperatively,the VAS scores for nasal obstruction,hyposmia,and facial pain in the observation group were lower than those in the matched group(0.76±0.21 vs 1.26±0.34,0.88±0.17 vs 1.48±0.33,0.37±0.07 vs 0.55±0.11,all P＜0.001).At 6 months postoperatively,the Lund-Kennedy score(1.34±0.31 vs 1.65±0.33)and MTR(7.53±1.67 vs 6.54±1.39 mm/min)in the observation group were superior to those in the matched group(both P＜0.05).The CD4+/CD8+ratio(1.03±0.17 vs 0.87±0.14)and TGF-β1 levels(568.33±75.48 vs 506.27±72.87 μg/L)were higher,while VEGF levels(145.95±27.94 vs 178.33±36.37 ng/L)were lower in the observation group(all P＜0.001).At 6 months after surgery,the levels of IL-4,IL-5,IL-13,and TSLP were lower than those in the matched group(P＜0.05).The complication rate(8.00％vs 16.67％)and recurrence rate(4.00％vs 18.33％)in the observation group were lower than those in the matched group(P＜0.05).Conclusion:ESS combined with budesonide can significantly alleviate CRSwNP symptoms and reduce the risk of recurrence by inhibiting Th2-type inflammatory responses,regulating T-cell immune balance,improving ciliary function,and suppressing angiogenesis.The synergistic mechanism involves the dynamic regulation of inflammatory microenvironment remodeling and mucosal repair,demonstrating significant clinical efficacy and safety.This study is the first to propose a postoperative management strategy that integrates mucosal repair,Th2 suppression,and inflammatory remodeling,filling a gap in research on postoperative immune microenvironment regulation.