Castleman’s disease(CD) is a rare lymphoproliferative disorder that is classified based on the affected sites and pathological features. The pathogenesis of CD remains not fully understood and may be associated with viral infections, genetic abnormalities, and immunological factors. Clinically, CD is categorized into two types based on lymph node involvement: Unicentric Castleman Disease(UCD) and Multicentric Castleman Disease(MCD). Treatment options include surgery, chemotherapy, immunotherapy, and targeted therapy. This article summarizes recent advancements in the understanding of the pathogenesis, clinical characteristics, diagnosis, and treatment of CD, aiming to provide assistance for future clinical work.

BACKGROUND:Vital pulp therapy is one of the main treatments for common oral diseases such as deep caries.The antibacterial properties of pulp-capping materials are crucial to the efficacy of the treatment.Currently,commonly used pulp-capping material has weak antibacterial properties and may induce a certain degree of inflammatory response in the pulp tissue,leading to treatment failure.OBJECTIVE:To investigate the antibacterial effects of nanosilver-reduced graphene oxide/polydopamine/methacrylated gelatin@Gap19(AgNPs-rGO/PDA/GelMA@Gap19)hydrogel material.METHODS:Nanosilver-reduced graphene oxide was prepared.Human dental pulp stem cells were cultured in complete medium containing different mass concentrations of nanosilver-reduced graphene oxide.Cell proliferation was detected by CCK-8 assay.The inhibition zone assay was used to detect the inhibitory effect of different mass concentrations of nanosilver-reduced graphene oxide on Staphylococcus aureus.The nanosilver-reduced graphene oxide mass concentration with the most obvious cell proliferation and antibacterial effects was screened by the results of CCK-8 and inhibition zone assays,and loaded into hydrogels.Human dental pulp stem cells were cultured in complete medium containing different concentrations of Gap19(a specific inhibitor of connexin 43 hemichannels),and cell proliferation was detected by CCK-8 assay.The Gap19 concentration with the most obvious cell proliferation effect was screened and loaded into hydrogels.AgNPs-rGO/PDA/GelMA@Gap19 hydrogel was prepared,and the physicochemical properties of the hydrogel material were characterized.The suspension of Staphylococcus aureus(or Escherichia coli,Streptococcus mutans,Lactobacillus)was co-cultured with mineral trioxide aggregates,polydopamine/methacrylated gelatin hydrogel,nanosilver-reduced graphene oxide/polydopamine/methacrylated gelatin hydrogel and AgNPs-rGO/PDA/GelMA@Gap19 hydrogel.The bacterial suspension cultured alone was used as the blank control group to detect the antibacterial rate of each group of hydrogels.RESULTS AND CONCLUSION:(1)The optimal mass concentration of nanosilver-reduced graphene oxide was determined to be 12.5 μg/mL by CCK-8 assay and inhibition zone test results,and the optimal concentration of Gap19 was determined to be 20 μmol/L by CCK-8 assay.(2)Scanning electron microscopy showed that AgNPs-rGO/PDA/GelMA@Gap19 hydrogel was wrinkled and porous,and nanosilver was loaded on the surface and inside of the hydrogel.Energy spectrum analysis results showed that nanosilver-reduced graphene oxide and Gap19 were successfully loaded on the hydrogel.(3)The four hydrogels had obvious inhibitory effects on Staphylococcus aureus,Escherichia coli,Streptococcus mutans,and Lactobacillus,and the antibacterial effects of nanosilver-reduced graphene oxide/polydopamine/methacryloyl gelatin hydrogel and AgNPs-rGO/PDA/GelMA@Gap19 hydrogel were the most significant,indicating that AgNPs-rGO/PDA/GelMA@Gap19 hydrogel,as a new type of pulp capping material,has an obvious antibacterial effect.

Vasovagal syncope is the common type of unexplained syncope,and non-drug therapy is the primary method for its treatment.Till now,there are obvious limitations of western medicine treatment.Vasovagal syncope can be attributed to the category of"syncope syndrome"in the field of traditional Chinese medicine.Professor Wu Wei believes that the fundamental pathogenesis of vasovagal syncope is due to the failure of spleen yang in ascending,and the therapeutic method is to elevate and flourish spleen yang.Professor Wu established the basic formula for elevating spleen yang,which is maily composed of Astragali Radix,Atractylodis Macrocephalae Rhizoma,Codonopsis Radix,Fici Simplicissimae Radix,Citri Reticulatae Pericarpium,Bupleuri Radix,salt-prepared Eucommiae Cortex,wine-prepared Corni Fructus,Psoraleae Fructus,Aconiti Lateralis Radix Preparata,Paeoniae Radix Alba and Zingiberis Rhizoma Recens.The formula has the primary actions of elevating and flourishing spleen yang,and also has the auxiliary effect on nourishing heart,soothing liver and warming kidney.The treatment of vasovagal syncope using the method of elevating and flourishing spleen yang by Professor Wu Wei has achieved satisfactory efficacy,and his experience can provide a reference for the clinical treatment of vasovagal syncope with Chinese medicine.

Objective:To investigate the clinicopathological characteristics and prognostic factors of patients with giant cell carcinoma of the lung (GCCL).Methods:A retrospective case series study was conducted. The clinical data and the survival related information of patients with GCCL in Surveillance, Epidemiology and End Results (SEER) database from the establishment of the databank to April 2019 were collected, and the clinicopathological characteristics of patients were summarized. Cox proportional hazards model was used for univariate and multivariate analysis of the overall survival (OS) and the independent influencing factors for poor OS were screened. Kaplan-Meier method was used to analyze the OS and cancer-specific survival (CSS) of the entire group and the patients stratified by the independent influencing factors. The log-rank test was used for inter-group comparisons.Results:A total of 248 GCCL cases were included. Among them, 64.9% (161 cases) were aged ≤70 years, 60.1% (149 cases) were male, and 57.7% (143 cases) were married. GCCL was more commonly found in the right lung [58.5% (145 cases)], and 64.1% (159 cases) were classified as TNM stage Ⅲ-Ⅳ. No high differentiation cases were observed, and there was only 1 case (0.4%) of moderate differentiation, while the remaining cases were poorly differentiated [56.0% (139 cases)] or undifferentiated [43.5% (108 cases)]. Lymph node metastasis was observed in 55.6% (138 cases), and distant metastasis occurred in 35.5% (88 cases). Regarding treatment, 50.4% (125 cases) underwent surgery, 18.5% (46 cases) received radiotherapy, and 39.1% (97 cases) underwent chemotherapy. Kaplan-Meier analysis showed that the 1-year and 5-year OS rates for all 248 cases were 38.8% and 21.3%, respectively, while the 1-year and 5-year CSS rates were 47.7% and 32.3%, respectively. Univariate and multivariate Cox regression analyses revealed that age (≥71 years vs. <70 years, HR = 1.526, 95% CI: 1.145-2.033, P = 0.004), marital status (married vs. others, HR = 0.755, 95% CI: 0.569-1.000, P = 0.049), N stage (all compared to N 0 stage; N 1 stage: HR = 1.876, 95% CI: 1.212-2.903, P = 0.005; N 2 stage: HR = 1.560, 95% CI: 1.074-2.265, P = 0.020; N 3 stage: HR = 1.902, 95% CI: 1.089-3.323, P = 0.024), M stage (M 1vs. M 0, HR = 2.122, 95% CI: 1.488-3.026, P < 0.001), and surgical treatment (surgery vs. no surgery, HR = 0.542, 95% CI: 0.361-0.813, P = 0.003) were independent risk factors for poor OS. Kaplan-Meier analysis demonstrated that patients aged >70 years, married, without lymph node metastasis, without distant metastasis, and those who underwent surgery had better OS, and the differences were statistically significant (all P < 0.05). Conclusions:GCCL is more common in elderly men and is more frequently found in the right lung. Most patients have lymph node metastasis and the patients with the distant metastasis are relatively common. The majority of cancer patients have an undifferentiated or poorly differentiated degree. Age, marital status, N stage, M stage, and whether surgery was performed are independent prognostic factors for GCCL.

BACKGROUND:Vital pulp therapy is one of the main treatments for common oral diseases such as deep caries.The antibacterial properties of pulp-capping materials are crucial to the efficacy of the treatment.Currently,commonly used pulp-capping material has weak antibacterial properties and may induce a certain degree of inflammatory response in the pulp tissue,leading to treatment failure.OBJECTIVE:To investigate the antibacterial effects of nanosilver-reduced graphene oxide/polydopamine/methacrylated gelatin@Gap19(AgNPs-rGO/PDA/GelMA@Gap19)hydrogel material.METHODS:Nanosilver-reduced graphene oxide was prepared.Human dental pulp stem cells were cultured in complete medium containing different mass concentrations of nanosilver-reduced graphene oxide.Cell proliferation was detected by CCK-8 assay.The inhibition zone assay was used to detect the inhibitory effect of different mass concentrations of nanosilver-reduced graphene oxide on Staphylococcus aureus.The nanosilver-reduced graphene oxide mass concentration with the most obvious cell proliferation and antibacterial effects was screened by the results of CCK-8 and inhibition zone assays,and loaded into hydrogels.Human dental pulp stem cells were cultured in complete medium containing different concentrations of Gap19(a specific inhibitor of connexin 43 hemichannels),and cell proliferation was detected by CCK-8 assay.The Gap19 concentration with the most obvious cell proliferation effect was screened and loaded into hydrogels.AgNPs-rGO/PDA/GelMA@Gap19 hydrogel was prepared,and the physicochemical properties of the hydrogel material were characterized.The suspension of Staphylococcus aureus(or Escherichia coli,Streptococcus mutans,Lactobacillus)was co-cultured with mineral trioxide aggregates,polydopamine/methacrylated gelatin hydrogel,nanosilver-reduced graphene oxide/polydopamine/methacrylated gelatin hydrogel and AgNPs-rGO/PDA/GelMA@Gap19 hydrogel.The bacterial suspension cultured alone was used as the blank control group to detect the antibacterial rate of each group of hydrogels.RESULTS AND CONCLUSION:(1)The optimal mass concentration of nanosilver-reduced graphene oxide was determined to be 12.5 μg/mL by CCK-8 assay and inhibition zone test results,and the optimal concentration of Gap19 was determined to be 20 μmol/L by CCK-8 assay.(2)Scanning electron microscopy showed that AgNPs-rGO/PDA/GelMA@Gap19 hydrogel was wrinkled and porous,and nanosilver was loaded on the surface and inside of the hydrogel.Energy spectrum analysis results showed that nanosilver-reduced graphene oxide and Gap19 were successfully loaded on the hydrogel.(3)The four hydrogels had obvious inhibitory effects on Staphylococcus aureus,Escherichia coli,Streptococcus mutans,and Lactobacillus,and the antibacterial effects of nanosilver-reduced graphene oxide/polydopamine/methacryloyl gelatin hydrogel and AgNPs-rGO/PDA/GelMA@Gap19 hydrogel were the most significant,indicating that AgNPs-rGO/PDA/GelMA@Gap19 hydrogel,as a new type of pulp capping material,has an obvious antibacterial effect.

Castleman’s disease(CD) is a rare lymphoproliferative disorder that is classified based on the affected sites and pathological features. The pathogenesis of CD remains not fully understood and may be associated with viral infections, genetic abnormalities, and immunological factors. Clinically, CD is categorized into two types based on lymph node involvement: Unicentric Castleman Disease(UCD) and Multicentric Castleman Disease(MCD). Treatment options include surgery, chemotherapy, immunotherapy, and targeted therapy. This article summarizes recent advancements in the understanding of the pathogenesis, clinical characteristics, diagnosis, and treatment of CD, aiming to provide assistance for future clinical work.

Objective:To investigate the clinicopathological characteristics and prognostic factors of patients with giant cell carcinoma of the lung (GCCL).Methods:A retrospective case series study was conducted. The clinical data and the survival related information of patients with GCCL in Surveillance, Epidemiology and End Results (SEER) database from the establishment of the databank to April 2019 were collected, and the clinicopathological characteristics of patients were summarized. Cox proportional hazards model was used for univariate and multivariate analysis of the overall survival (OS) and the independent influencing factors for poor OS were screened. Kaplan-Meier method was used to analyze the OS and cancer-specific survival (CSS) of the entire group and the patients stratified by the independent influencing factors. The log-rank test was used for inter-group comparisons.Results:A total of 248 GCCL cases were included. Among them, 64.9% (161 cases) were aged ≤70 years, 60.1% (149 cases) were male, and 57.7% (143 cases) were married. GCCL was more commonly found in the right lung [58.5% (145 cases)], and 64.1% (159 cases) were classified as TNM stage Ⅲ-Ⅳ. No high differentiation cases were observed, and there was only 1 case (0.4%) of moderate differentiation, while the remaining cases were poorly differentiated [56.0% (139 cases)] or undifferentiated [43.5% (108 cases)]. Lymph node metastasis was observed in 55.6% (138 cases), and distant metastasis occurred in 35.5% (88 cases). Regarding treatment, 50.4% (125 cases) underwent surgery, 18.5% (46 cases) received radiotherapy, and 39.1% (97 cases) underwent chemotherapy. Kaplan-Meier analysis showed that the 1-year and 5-year OS rates for all 248 cases were 38.8% and 21.3%, respectively, while the 1-year and 5-year CSS rates were 47.7% and 32.3%, respectively. Univariate and multivariate Cox regression analyses revealed that age (≥71 years vs. <70 years, HR = 1.526, 95% CI: 1.145-2.033, P = 0.004), marital status (married vs. others, HR = 0.755, 95% CI: 0.569-1.000, P = 0.049), N stage (all compared to N 0 stage; N 1 stage: HR = 1.876, 95% CI: 1.212-2.903, P = 0.005; N 2 stage: HR = 1.560, 95% CI: 1.074-2.265, P = 0.020; N 3 stage: HR = 1.902, 95% CI: 1.089-3.323, P = 0.024), M stage (M 1vs. M 0, HR = 2.122, 95% CI: 1.488-3.026, P < 0.001), and surgical treatment (surgery vs. no surgery, HR = 0.542, 95% CI: 0.361-0.813, P = 0.003) were independent risk factors for poor OS. Kaplan-Meier analysis demonstrated that patients aged >70 years, married, without lymph node metastasis, without distant metastasis, and those who underwent surgery had better OS, and the differences were statistically significant (all P < 0.05). Conclusions:GCCL is more common in elderly men and is more frequently found in the right lung. Most patients have lymph node metastasis and the patients with the distant metastasis are relatively common. The majority of cancer patients have an undifferentiated or poorly differentiated degree. Age, marital status, N stage, M stage, and whether surgery was performed are independent prognostic factors for GCCL.

Objective:To summarize the clinical and genetic features of children with intellectual developmental disorder with seizures and language delay (IDDSELD) due to 12q24.31 deletion and SETD1B locus variants. Methods:The clinical data of a child with 12q24.31 deletion diagnosed in the Department of Pediatric Neurology of the Third Affiliated Hospital of Zhengzhou University in September 2022 were retrospectively analyzed. Trio-whole exome sequencing (trio-WES) and copy number variations sequencing (CNV-seq) were used for genetic analysis. The relevant literatures were reviewed to summarize the clinical features of the disease.Results:The proband was a 7 years and 9 month old girl who had clinical features of global developmental delay, epilepsy, hyperactivity, hypertonia, gait disorder, special facial features (high eyebrow arch, big ears, upper lip protrusion), funnel chest, lumbar lordosis. Karyotypic analysis showed 46XX in the proband. CNV-seq showed 12q24.31 (chr12: 121895654-122449092) position had a deletion of about 553.44 kb which contained the SETD1B gene. Trio-WES showed deletion of all exons 1-16 of the SETD1B gene. CNV-seq results of her parents were normal: the SETD1B gene was wild-type. This type has not been reported in China. Four children with IDDSELD caused by 12q24.31 deletion (including the SETD1B gene) were retrieved (totally 5 cases including this case), with male to female ratio of 1∶4, all with de novo mutations, and all with mental retardation, cephalo-facial and skeletal malformations. Three cases had seizures, 2 cases still had developmental backwardness after treatment, and 1 case was seizure controlled. Forty-seven cases of IDDSELD due to point mutation in the SETD1B gene were retrieved: male to female ratio was 31∶16, missense mutations (38/47) were predominant, most were de novo mutations (36/47), and a few were inherited from their fathers/mothers (6/47) or of unknown origin (5/47), with clinical manifestations of speech delay (43/47), growth retardation (43/47), intellectual disability (37/41), behavioral problems (37/47), facial malformations (34/47), skeletal malformations (23/47), obesity (16/47), skin abnormalities (11/47), etc. Thirty-nine cases were combined with seizures, 23 of whom were under control after treatment, and 8 cases were recorded as still having developmental backwardness after treatment. Conclusions:IDDSELD patients are rare at home and abroad, with diverse clinical phenotypes and difficult diagnosis. Symptomatic treatment is the main approach. And the patients can leave behind seizures and varying degrees of developmental backwardness. Among them, patients with 12q24.31 deletion are relatively rare and have not been reported in China, and this type is more common in females, all of whom have de novo mutations, and genetic testing is helpful for the early diagnosis of IDDSELD.

Objective To explore a method of calculating the paternity index(PI)in parentage testing of both paternal and maternal mutations.Methods In this study,the general formulas of PI in parentage testing were derived based on Mendel's laws of inheritance and mutation basic model first.Subsequently,on the basis of the general formula,parentage testing of both paternal and maternal mutations were classified into 8 types according to child-mother-father genotypes.From,these classifications,detailed formulas of PI in alleged father cases(PIAF)and PI in alleged parent cases(PIAP)were further refined.Finally,a simulation experiment was designed to generate 10,000 parents composed of unrelated individuals on 19 autosomal loci of the EX20 kit,and the percentages of mutations of confirming group(c group),single mutant group(s group),and double mutants group(d group)were calculated.the min,max,and arithmetic mean(x)of PI in alleged father groups and alleged parent groups were all calculated based on simulated data.Meanwhile,the min,max,and geometric mean(Π)of cumulative parentageindex(CPI)were calculated in the same two groups.Results In this study,All PI formulas of both paternal and maternal mutations in parentage testing were derived.The conclusive analysis of the min,max and mean(x)of PI in group c,group s,and group d led out the following rules:minc>mins>mind,maxc>maxs>maxd,xc>xs>xd.The CPI of all simulation cases met the conditions of excluding kinship.Conclusion The PI formulas in this paper could be applied to parentage testing of both paternal and maternal mutations.

Objective To explore the effect of the physician-nurse-social worker linkage rehabilitation model on the psychological status in patients receiving methadone maintenance treatment(MMT).Methods Ninety-four patients who received MMT were enrolled and randomly divided into experimental group(n = 48)and control group(n = 46).The experimental group received physician-nurse-social worker linkage rehabilitation model intervention,while the control group received conventional methadone treatment service.The anxiety,depression and quality of life of the two groups were evaluated before the intervention,3 months and 6 months after the intervention.Results After 6 months of physician-nurse-social worker linkage rehabilitation mode intervention,the depression status and the anxiety status of the experimental group subjects were significantly improved compared with those before intervention,and both BDI and BAI scores were significantly lower than those of the control group subjects(P＜0.05).Moreover,the proportion of"had depression"and"had anxiety"in the experimental group were significantly lower than those in the control group(P＜0.05).After 6 months of intervention,the QOL-DA score of the experimental group subjects(183.77±8.90)was significantly higher than that of the control group sub-jects(174.76±11.14)(P＜0.01).Conclusion The physician-nurse-social worker linkage rehabilitation model had certain advantages in improving the psychological state of MMT patients,which is worthy of promotion.