Purpose To investigate the diagnostic value of immunohistochemical(IHC)and molecular markers in diffuse pleural mesothelioma(DPM).Methods A total of 114 cases of DPM were retrospectively analyzed for clinical and imaging manifestations,histologic subtype and tumor grade.The positivity rates of Calretinin,WT-1,CK5/6,MC,D2-40,UPK3B,and GATA3 were assessed by IHC,and the loss rates of BAP-1 and MTAP were determined.The concordance between MTAP IHC and p16 gene fluorescence in situ hybridization(FISH)status was calculated,a-long with the sensitivity and specificity of MTAP IHC relative to p16 FISH.Results Among the 114 DPM patients,66(57.9％)were male and 48(42.1％)were female,with a mean age of 58.1 years(range 16-85 years).Imaging predominantly demonstrated pleural effusion and multiple pleural nodules(55.3％,63/114).Histologically,epitheli-oid,sarcomatoid and biphasic subtypes accounted for 88(77.2％),17(14.9％)and 9(7.9％)cases,respectively.Within the epithelioid group,low and high-grade tumors numbered 69(78.4％)and 19(21.6％),respectively.In epithelioid DPM,the highest IHC positivity rates were observed for Calretinin(92.4％,81/88),D2-40(90.0％,79/88)and WT-1(90.0％,79/88).In sarcomatoid DPM,D2-40(76.5％,13/17),WT-1(64.7％,11/17),and Cal-retinin(29.4％,5/17)showed the greatest positivity.UPK3B was positive in epithelioid(59.1％,39/66)and bi-phasic cases(66.7％,4/6),but was absent in sarcomatoid tumors(0/12).Among all DPM cases,loss rates were 47.3％(53/112)for BAP-1 and 19.2％(20/104)for MTAP by IHC,p16 gene deletion by FISH was 31.5％(34/108);Concordance between MTAP IHC and p16 FISH was 81.0％(81/100);MTAP IHC had a specificity of 95.5％(64/67)and sensitivity of 51.5％(17/33)relative to p16 FISH.Additionally,GATA3 was highly expressed in sarco-matoid DPM(76.5％,13/17).UPK3B positivity differed significantly between thoracoscopic DPM(59.2％,32/54)and percutaneous biopsy samples(36.7％,11/30)in epithelioid DPM(P＜0.05).WT-1 positivity was higher in thoracoscopic than percutaneous samples of sarcomatoid DPM(90.0％ vs 28.6％,P=0.009).Conclusion Calreti-nin,D2-40,and WT-1 are highly sensitive mesothelial markers and should serve as first-line IHC stains in DPM diag-nosis.UPK3B is diagnostically valuable in epithelioid DPM,GATA3 may complement the diagnosis of sarcomatoid DPM,and MTAP IHC can be used as a surrogate or adjunct to p16 FISH.

Objective:To explore the level of mental health literacy and its relationship with symptoms of de-pression,anxiety,and insomnia in young adults.Methods:A total of 10 273 young adults aged 18-23 in Guang-zhou were selected and assessed with the National Mental Health Literacy Questionnaire,Patient Health Question-naire-9(PHQ-9),General Anxiety Disorder 7-Item Scale(GAD-7)and Insomnia Severity Index(ISI).Results:Totally 1 137(11.1％)participants met the criteria for adequate mental health literacy,2 758(26.8％)participants were with symptoms of depression,1 355(13.2％)with symptoms of anxiety and 4 936(48.0％)experiencing symptoms of insomnia.Logistic regression analyses showed that after adjusting for other factors,substandard mental health literacy was an independent risk factor for symptoms of depression,anxiety and insomnia(OR=2.08,1.93,1.49;95％CI:1.74-2.48,1.52-2.46,1.31-1.70).Conclusion:The level of mental health literacy in young a-dults is insufficient,and the lack of mental health literacy is significantly associated with the symptoms of depres-sion,anxiety and insomnia.

Objective:To investigate the effects of sampling methods on pathological assessment of resected non-small cell lung cancer (NSCLC) specimen with tumor maximum diameter >3 cm after neoadjuvant therapy.Methods:NSCLC patients with a large tumor (diameter >3 cm) that were resected after neoadjuvant therapy from June 2020 to July 2023 were retrospectively collected in the Department of Pathology, Shanghai Pulmonary Hospital, Shanghai, China. Sampling methods of the tumor bed were performed in accordance with the international and Chinese experts recommendations for resection specimens following neoadjuvant therapy (recommended sampling method, RSM), and all remaining tumor bed lesions were completely sampled after recommended sampling (complete sampling method, CSM). The difference of pathological response assessment of residual viable tumor (RVT) between RSM and CSM was examined.Results:A total of 90 cases were identified and analyzed, including 39 cases of squamous cell carcinoma and 51 cases of adenocarcinoma, treated with neoadjuvant therapy including chemotherapy in 22 cases (24.4%), targeted therapy in 14 cases (15.6%), and chemoimmunotherapy in 54 cases (60.0%). There were 62 males and 28 females with an average age of (62.7±17.9) years. The average tumor maximum diameter was 4.3 cm (range, 3.1-8.0 cm). The average number of sampled blocks was 8 blocks (range, 5 to 16) and 15 blocks (range, 8 to 36) per case by RSM and CSM, respectively. According to the definition of major pathological response (MPR) in which RVT is ≤10%, the numbers of patients with MPR were 34 cases by RSM and 30 cases by CSM, respectively. Four cases showed inconsistent RVT between the two methods, including one case of squamous cell carcinoma and three cases of adenocarcinoma. The RVT of the four inconsistent cases was 7%, 7%, 5% and 9% (MPR by RSM), and 15%, 15%, 15% and 20% (non-MPR by CSM), respectively. The kappa values of MPR consistency evaluated by the two sampling methods were 0.893 for all cases, 0.906 for squamous cell carcinoma cases and 0.751 for adenocarcinoma cases. According to MPR cut-off of 65% for invasive primary adenocarcinoma, 24 cases and 20 cases achieved MPR by RSM and CSM, respectively. Of the four inconsistent cases, the RVT by RSM was 60% in three cases and 65% in one case (MPR), whereas the RVT by CSM was 70% in three cases and 75% in one case (non-MPR). The kappa value of the two sampling methods was 0.741.Conclusions:There is high consistency between RSM and CSM in the pathological assessment of post-treatment responses in resected NSCLC specimens with tumor maximum diameter larger than 3 cm. When the percentage of RVT cells is close to MPR, re-evaluation of the specimen is required and CSM may be necessary to accurately evaluate the degree of pathological remission, assist in clinical postoperative treatment, and predict patient prognosis.

Objective:To explore the level of mental health literacy and its relationship with symptoms of de-pression,anxiety,and insomnia in young adults.Methods:A total of 10 273 young adults aged 18-23 in Guang-zhou were selected and assessed with the National Mental Health Literacy Questionnaire,Patient Health Question-naire-9(PHQ-9),General Anxiety Disorder 7-Item Scale(GAD-7)and Insomnia Severity Index(ISI).Results:Totally 1 137(11.1％)participants met the criteria for adequate mental health literacy,2 758(26.8％)participants were with symptoms of depression,1 355(13.2％)with symptoms of anxiety and 4 936(48.0％)experiencing symptoms of insomnia.Logistic regression analyses showed that after adjusting for other factors,substandard mental health literacy was an independent risk factor for symptoms of depression,anxiety and insomnia(OR=2.08,1.93,1.49;95％CI:1.74-2.48,1.52-2.46,1.31-1.70).Conclusion:The level of mental health literacy in young a-dults is insufficient,and the lack of mental health literacy is significantly associated with the symptoms of depres-sion,anxiety and insomnia.

Objective:To investigate the effects of sampling methods on pathological assessment of resected non-small cell lung cancer (NSCLC) specimen with tumor maximum diameter >3 cm after neoadjuvant therapy.Methods:NSCLC patients with a large tumor (diameter >3 cm) that were resected after neoadjuvant therapy from June 2020 to July 2023 were retrospectively collected in the Department of Pathology, Shanghai Pulmonary Hospital, Shanghai, China. Sampling methods of the tumor bed were performed in accordance with the international and Chinese experts recommendations for resection specimens following neoadjuvant therapy (recommended sampling method, RSM), and all remaining tumor bed lesions were completely sampled after recommended sampling (complete sampling method, CSM). The difference of pathological response assessment of residual viable tumor (RVT) between RSM and CSM was examined.Results:A total of 90 cases were identified and analyzed, including 39 cases of squamous cell carcinoma and 51 cases of adenocarcinoma, treated with neoadjuvant therapy including chemotherapy in 22 cases (24.4%), targeted therapy in 14 cases (15.6%), and chemoimmunotherapy in 54 cases (60.0%). There were 62 males and 28 females with an average age of (62.7±17.9) years. The average tumor maximum diameter was 4.3 cm (range, 3.1-8.0 cm). The average number of sampled blocks was 8 blocks (range, 5 to 16) and 15 blocks (range, 8 to 36) per case by RSM and CSM, respectively. According to the definition of major pathological response (MPR) in which RVT is ≤10%, the numbers of patients with MPR were 34 cases by RSM and 30 cases by CSM, respectively. Four cases showed inconsistent RVT between the two methods, including one case of squamous cell carcinoma and three cases of adenocarcinoma. The RVT of the four inconsistent cases was 7%, 7%, 5% and 9% (MPR by RSM), and 15%, 15%, 15% and 20% (non-MPR by CSM), respectively. The kappa values of MPR consistency evaluated by the two sampling methods were 0.893 for all cases, 0.906 for squamous cell carcinoma cases and 0.751 for adenocarcinoma cases. According to MPR cut-off of 65% for invasive primary adenocarcinoma, 24 cases and 20 cases achieved MPR by RSM and CSM, respectively. Of the four inconsistent cases, the RVT by RSM was 60% in three cases and 65% in one case (MPR), whereas the RVT by CSM was 70% in three cases and 75% in one case (non-MPR). The kappa value of the two sampling methods was 0.741.Conclusions:There is high consistency between RSM and CSM in the pathological assessment of post-treatment responses in resected NSCLC specimens with tumor maximum diameter larger than 3 cm. When the percentage of RVT cells is close to MPR, re-evaluation of the specimen is required and CSM may be necessary to accurately evaluate the degree of pathological remission, assist in clinical postoperative treatment, and predict patient prognosis.

Purpose To investigate the diagnostic value of immunohistochemical(IHC)and molecular markers in diffuse pleural mesothelioma(DPM).Methods A total of 114 cases of DPM were retrospectively analyzed for clinical and imaging manifestations,histologic subtype and tumor grade.The positivity rates of Calretinin,WT-1,CK5/6,MC,D2-40,UPK3B,and GATA3 were assessed by IHC,and the loss rates of BAP-1 and MTAP were determined.The concordance between MTAP IHC and p16 gene fluorescence in situ hybridization(FISH)status was calculated,a-long with the sensitivity and specificity of MTAP IHC relative to p16 FISH.Results Among the 114 DPM patients,66(57.9％)were male and 48(42.1％)were female,with a mean age of 58.1 years(range 16-85 years).Imaging predominantly demonstrated pleural effusion and multiple pleural nodules(55.3％,63/114).Histologically,epitheli-oid,sarcomatoid and biphasic subtypes accounted for 88(77.2％),17(14.9％)and 9(7.9％)cases,respectively.Within the epithelioid group,low and high-grade tumors numbered 69(78.4％)and 19(21.6％),respectively.In epithelioid DPM,the highest IHC positivity rates were observed for Calretinin(92.4％,81/88),D2-40(90.0％,79/88)and WT-1(90.0％,79/88).In sarcomatoid DPM,D2-40(76.5％,13/17),WT-1(64.7％,11/17),and Cal-retinin(29.4％,5/17)showed the greatest positivity.UPK3B was positive in epithelioid(59.1％,39/66)and bi-phasic cases(66.7％,4/6),but was absent in sarcomatoid tumors(0/12).Among all DPM cases,loss rates were 47.3％(53/112)for BAP-1 and 19.2％(20/104)for MTAP by IHC,p16 gene deletion by FISH was 31.5％(34/108);Concordance between MTAP IHC and p16 FISH was 81.0％(81/100);MTAP IHC had a specificity of 95.5％(64/67)and sensitivity of 51.5％(17/33)relative to p16 FISH.Additionally,GATA3 was highly expressed in sarco-matoid DPM(76.5％,13/17).UPK3B positivity differed significantly between thoracoscopic DPM(59.2％,32/54)and percutaneous biopsy samples(36.7％,11/30)in epithelioid DPM(P＜0.05).WT-1 positivity was higher in thoracoscopic than percutaneous samples of sarcomatoid DPM(90.0％ vs 28.6％,P=0.009).Conclusion Calreti-nin,D2-40,and WT-1 are highly sensitive mesothelial markers and should serve as first-line IHC stains in DPM diag-nosis.UPK3B is diagnostically valuable in epithelioid DPM,GATA3 may complement the diagnosis of sarcomatoid DPM,and MTAP IHC can be used as a surrogate or adjunct to p16 FISH.

Objective　To understand the epidemiology, molecular characteristics, and antibiotic susceptibility analysis of Neisseria meningitidis serogroup Y (NmY) in Hainan Province, and to provide a scientific basis for the prevention, control, and therapy of meningococcal disease caused by NmY. Methods Blood samples from two patients with meningitis discovered in Haikou City in May 2022, as well as swab samples from close contacts, were subjected to Nm isolation and culture. Species identification of the suspected Nm isolates was performed using biochemical tests and conventional polymerase chain reaction. The serogroups and genogroups of Nm isolates were determined by slide agglutination and real-time PCR, respectively. Whole genome sequencing and analysis were performed on seven Nm isolates. The susceptibility to thirteen antibiotics was tested using E-test. Results Both patients were teenagers. A total of seven Nm strains were obtained from the patients and their close contacts, with two strains from the patients and five from the close contacts. The serogrouping results were consistent with the gene grouping results, all identifying the isolates as serogroup Y Nm. The GC content of all NmY isolates ranged from 51.84% to 51.86%, and all isolates belonged to sequence type ST-1655, which is part of the ST-23 clonal complex. The types of outer membrane proteins of all isolates were identical porA (P1.5-1,10-1), porB (3-117), and fetA (F4-1). The sequences of antibiotic-related genes of all isolates were identical. The isolates were all susceptible to penicillin, ampicillin, cefotaxime, ceftriaxone, meropenem, chloramphenicol, azithromycin, minocycline, rifampicin, ciprofloxacin, nalidixic acid, and levofloxacin, but resistant to trimethoprim-sulfamethoxazole. Conclusions Cases of infection with ST-1 655 serogroup Y N.meningitides have been identified in Hainan Province. It is necessary to strengthen the surveillance of meningococcal disease and promote the meningococcal ACWY quadrivalent meningococcal vaccine to prevent meningococcal disease caused by NmY.

The utilization of optimal orthodontic force is crucial to prevent undesirable side effects and ensure efficient tooth movement during orthodontic treatment.However,the sensitivity of existing detection techniques is not sufficient,and the criteria for evaluating optimal force have not been yet established.Here,by employing 3D finite element analysis methodology,we found that the apical distal region(A-D region)of mesial roots is particularly sensitive to orthodontic force in rats.Tartrate-resistant acidic phosphatase(TRAP)-positive osteoclasts began accumulating in the A-D region under the force of 40 grams(g),leading to alveolar bone resorption and tooth movement.When the force reached 80 g,TRAP-positive osteoclasts started appearing on the root surface in the A-D region.Additionally,micro-computed tomography revealed a significant root resorption at 80 g.Notably,the A-D region was identified as a major contributor to whole root resorption.It was determined that 40 g is the minimum effective force for tooth movement with minimal side effects according to the analysis of tooth movement,inclination,and hyalinization.These findings suggest that the A-D region with its changes on the root surface is an important consideration and sensitive indicator when evaluating orthodontic forces for a rat model.Collectively,our investigations into this region would aid in offering valuable implications for preventing and minimizing root resorption during patients'orthodontic treatment.

Objective:In order to understand the current situation of air toxic substances without occupational exposure limits (OELs) in the workplace in the Germany GESTIS Substance Database, and to provide an effective reference for formulating OELs of corresponding toxic substances and improving health standards.Methods:From March 2022 to May 2023, based on the standard of GBZ 2.1-2019 Occupational Exposure Limits for Hazardous Agents in the Workplace-Part 1: Chemical Hazardous Agents, air toxic substances without OELs in the standard of GBZ/T 300.1-2017 Determination of Toxic Substances in Workplace Air-Part 1: General Principles were screened out, then corresponding OELs in other countrie/regions were queried through the Germany GESTIS Substance Database.Results:Among the 333 kinds (classes) of air toxic substances in 160 parts of GBZ/T 300.1-2017 standard, 48 kinds (classes) of air toxic substances were screened out and had not yet been formulated OELs in GBZ 2.1-2019 standard. By querying the Germany GESTIS Substance Database, it was found that among the 48 kinds (classes) of air toxic substances, 35 kinds (classes) of air toxic substances had both 8-hour occupational exposure limit and short-term occupational exposure limit, 4 kinds (classes) of air toxic substances had 8-hour occupational exposure limit but no short-term occupational exposure limit, 9 kinds (classes) of air toxic substances hadn't been retrieved any OELs. In addition, standard test methods of 7 kinds of air toxic substances hadn't been published in the present, including trimethylchlorosilane, trimethylbenzenes, cumene, chloroethane, chloropropane, dibromoethane and acetophenone.Conclusion:In the process of formulating or revising the standards of GBZ 2.1-2019 and GBZ/T 300, the latest published OELs in the Germany GESTIS Substance Database could be used as a reference basis.

Objective:To analyze the characteristics of patients with chronic rhinosinusitis (CRS) in the South China region based on pathological tissue biomarkers for regional comparison.Methods:The study population consisted of CRS in-patients in the First Affiliated Hospital of Sun Yat-sen University from October 2019 to June 2022. Among all the 181 cases, 123 of them were male and 58 were female, with an average age of 40. Retrospectively collected clinical data included demographic information, preoperative symptom scores, preoperative endoscopic images, preoperative paranasal sinus computed tomography scanning images, and inflammatory serological features. In addition, 52 variables of pathological tissue biomarkers including cytokines, chemokines and remodeling factors were collected for analysis. Cluster analysis was performed on the integrated data of training set through centroid-based clustering algorithm, and the inflammatory characteristics, post-operation control status, and airway diseases comorbidity of each endotype were analyzed. R project (version 4.2.2) was used in statistical analysis.Results:Cluster analysis divided 181 patients with CRS into 4 endotypes. Cluster 1 ( n=101, 55.80%) showed a locally low inflammatory status. Cluster 2 ( n=23, 12.71%) showed a mixed type of inflammation with predominantly neutrophilic inflammation and tissue remodeling. Cluster 3 ( n=11, 6.08%) was characterized by type Ⅱ inflammation without tissue remodeling. Cluster 4 ( n=46, 25.41%) was mainly characterized by type Ⅱ inflammation with tissue remodeling, showing higher comorbidity rate of asthma and allergic rhinitis. This cluster presented more severe symptoms, significant olfactory dysfunction, extensive overall inflammation based on objective examination results, a notable increase in total eosinophil count and proportion in peripheral blood, and the highest uncontrolled rate observed one year post-surgery. In comparison to other regions, the endotype classification of CRS in Southern China was characterized by a predominant pattern of locally low inflammatory status, a moderate level of type Ⅱ inflammation with tissue remodeling, and a lesser presence of neutrophilic inflammation. Conclusion:CRS distribution in Southern China is mainly characterized by low inflammatory endotype and type Ⅱ inflammation with tissue remodeling. The latter shows more severe clinical manifestations and higher uncontrol rate after surgery.