The incomplete degradation of tumour cells by macrophages (Mϕ) is a contributing factor to tumour progression and metastasis, and the degradation function of Mϕ is mediated through phagosomes and lysosomes. In our preliminary experiments, we found that overactivation of NADPH oxidase 2 (NOX2) reduced the ability of Mϕ to degrade engulfed tumour cells. Above this, we screened out liquiritin from Glycyrrhiza uralensis Fisch, which can significantly inhibit NOX2 activity and inhibit tumours, to elucidate that suppressing NOX2 can enhance the ability of Mϕ to degrade tumour cells. We found that the tumour environment could activate the NOX2 activity in Mϕ phagosomes, causing Mϕ to produce excessive reactive oxygen species (ROS), thus prohibiting the formation of phagolysosomes before degradation. Conversely, inhibiting NOX2 in Mϕ by liquiritin can reduce ROS and promote phagosome-lysosome fusion, therefore improving the enzymatic degradation of tumour cells after phagocytosis, and subsequently promote T cell activity by presenting antigens. We further confirmed that liquiritin down-regulated the expression of the NOX2 specific membrane component protein gp91 phox, blocking its binding to the NOX2 cytoplasmic component proteins p67 phox and p47 phox, thereby inhibiting the activity of NOX2. This study elucidates the specific mechanism by which Mϕ cannot degrade tumour cells after phagocytosis, and indicates that liquiritin can promote the ability of Mϕ to degrade tumour cells by suppressing NOX2.

Objective:To evaluate the diagnostic value of intestinal tissue metagenomic next-generation sequencing (mNGS) in severe diarrhea following haploidentical allogeneic hematopoietic stem cell transplantation (allo-HSCT) .Methods:Sixteen patients who developed severe diarrhea or hematochezia after haploidentical allo-HSCT at the First Affiliated Hospital of Fujian Medical University (June 2023–August 2024) were enrolled. All underwent gastrointestinal endoscopy and mNGS for microbial detection. Clinical, endoscopic, pathological, and microbiological data were analyzed to evaluate the diagnostic value of mNGS and treatment outcomes following targeted therapy.Results:The study included 16 patients (12 males, 4 females; median age 32.5 years, range 3–60 years). Diarrhea occurred a median of 3.93 months post-transplant (range 1.63–10.40 months). Stool cultures were negative except for one case with Candida. One patient tested positive for Clostridium difficile antigen. Endoscopy revealed mucosal congestion, edema, erosion, and bleeding, with focal inflammation on pathology. mNGS detected pathogens in 87.5% (14/16) of cases, including mixed infections in 78.5% (11/14). Common pathogens were Klebsiella pneumoniae, Enterococcus faecium, Escherichia coli, Rhizopus microsporus, EBV, and CMV. Targeted treatment adjustments led to symptom improvement in 87.5% of patients.Conclusion:Allo-HSCT patients are prone to infectious diarrhea due to immunosuppression. Molecular analysis of endoscopic biopsy tissues using mNGS can accurately identify pathogens, guide targeted therapy, and improve clinical outcomes.

The incomplete degradation of tumour cells by macrophages(Mφ)is a contributing factor to tumour progression and metastasis,and the degradation function of Mφ is mediated through phagosomes and lysosomes.In our preliminary experiments,we found that overactivation of NADPH oxidase 2(NOX2)reduced the ability of Mφ to degrade engulfed tumour cells.Above this,we screened out liquiritin from Glycyrrhiza uralensis Fisch,which can significantly inhibit NOX2 activity and inhibit tumours,to elucidate that suppressing NOX2 can enhance the ability of Mφ to degrade tumour cells.We found that the tumour environment could activate the NOX2 activity in Mφ phagosomes,causing Mφ to produce excessive reactive oxygen species(ROS),thus prohibiting the formation of phagolysosomes before degradation.Conversely,inhibiting NOX2 in Mφ by liquiritin can reduce ROS and promote phagosome-lysosome fusion,therefore improving the enzymatic degradation of tumour cells after phagocytosis,and subse-quently promote T cell activity by presenting antigens.We further confirmed that liquiritin down-regulated the expression of the NOX2 specific membrane component protein gp91 phox,blocking its binding to the NOX2 cytoplasmic component proteins p67 phox and p47 phox,thereby inhibiting the activity of NOX2.This study elucidates the specific mechanism by which Mφ cannot degrade tumour cells after phagocytosis,and indicates that liquiritin can promote the ability of Mφ to degrade tumour cells by suppressing NOX2.

Objective:To evaluate the diagnostic value of intestinal tissue metagenomic next-generation sequencing (mNGS) in severe diarrhea following haploidentical allogeneic hematopoietic stem cell transplantation (allo-HSCT) .Methods:Sixteen patients who developed severe diarrhea or hematochezia after haploidentical allo-HSCT at the First Affiliated Hospital of Fujian Medical University (June 2023–August 2024) were enrolled. All underwent gastrointestinal endoscopy and mNGS for microbial detection. Clinical, endoscopic, pathological, and microbiological data were analyzed to evaluate the diagnostic value of mNGS and treatment outcomes following targeted therapy.Results:The study included 16 patients (12 males, 4 females; median age 32.5 years, range 3–60 years). Diarrhea occurred a median of 3.93 months post-transplant (range 1.63–10.40 months). Stool cultures were negative except for one case with Candida. One patient tested positive for Clostridium difficile antigen. Endoscopy revealed mucosal congestion, edema, erosion, and bleeding, with focal inflammation on pathology. mNGS detected pathogens in 87.5% (14/16) of cases, including mixed infections in 78.5% (11/14). Common pathogens were Klebsiella pneumoniae, Enterococcus faecium, Escherichia coli, Rhizopus microsporus, EBV, and CMV. Targeted treatment adjustments led to symptom improvement in 87.5% of patients.Conclusion:Allo-HSCT patients are prone to infectious diarrhea due to immunosuppression. Molecular analysis of endoscopic biopsy tissues using mNGS can accurately identify pathogens, guide targeted therapy, and improve clinical outcomes.

Objective To analyze the retrieval rate of inferior vena cava filter(IVCF)and its safety,and to make a histological analysis of the filter attachment substances.Methods The clinical data of 234 patients with IVCF,who were admitted to Affiliated Tenth People's Hospital,Tongji University,to retrieve IVCF between June 2020 and May 2023,were retrospectively analyzed.The retrieval success rate,complications and filter attachment substances were statistically analyzed,and the nature of the attachment substances was examined by using histological staining.Results The retrieval success rate in the 234 patients was 91.03％(213/234).In 17 patients the retrieval of IVCF was abandoned due to the filter capturing the thrombus,and in 4 patients the retrieval of IVCF failed due to tilting of the filter.No complications such as vena cava perforation,symptomatic pulmonary embolism and hemorrhage occurred in all patients during perioperative period.Of the 213 patients whose filter was successfully removed,the filter attachment substances was found in 156 patients.Histological staining of the filter attachment substances demonstrated that the main component of these substances was a mixed thrombus with a small amount of cellulose degeneration.Further analysis revealed that the incidence of filter attachment substances in ≤14-day group was lower than than that in＞14-day group,and the difference between the two groups was statistically significant(x2=6.791,P=0.009);and the incidence of filter attachment substances in the non-anticoagulant group was lower than that in the anticoagulant group,and the difference between the two groups was statistically significant(x2=7.774,P=0.005).Conclusion The retrieval rate of retrievable IVCFs is quite high and the retrieval procedure carries less complications,therefore,it is safe to use retrievable IVCFs in clinical practice.However,the formation of tiny thrombosis within the filter after the placement of filter cannot be ignored,which should be seriously considered in the clinical work.

Driven by multiple factors such as policy incentives,enhanced economic capacity of residents,aging popula-tion,and medical system reform,China's rehabilitation industry has been in a rapid development stage where opportunities and challenges coexist.Various rehabilitation hospitals urgently need new development thinking on how to seize the new opportunities for the development of rehabilitation medicine,give full play to the benefits of high-quality rehabilitation medical resources,and deal with the development of rehabilitation institutions under the new situation.Taking the tertiary rehabilitation hospital where the authors work as an example,this paper deeply analyzes the practical difficulties and challenges faced by the development of reha-bilitation hospital under the new circumstance,further explores the construction of a new working mode based on people-oriented and medical-rehabilitation integration.It also briefly summarizes the beneficial experiences and practices in the reform of rehabili-tation service models,and elaborates on the periodic achievement,so as to provide a meaningful reference for the majority of re-habilitation hospitals to plan and practice high-quality development and reform.

Objective To investigate the clinical diagnostic value of anti-cyclic citrullinated peptide(CCP)antibody,anti-mutated citrullinated vimentin(MCV)antibody and 25-hydroxyvitamin D[25-(OH)D]in rheumatoid arthritis(RA)patients.Methods A total of 466 patients with RA who were admitted the Affiliated Huai'an No.1 People's Hospital of Nanjing Medical University from August 2016 to November 2021 were included in RA group,100 patients with other autoimmune diseases and metabolic diseases without RA were included in non-RA group,100 healthy subjects were included in control group.Serum anti-CCP antibody,anti-MCV antibody and 25(OH)D were detected in three groups.Receiver operating characteristic curve was drawn to analyze the diagnostic efficacy of anti-CCP antibody,anti-MCV antibody and 25(OH)D in RA.The correlation between anti-MCV antibody and clinical indexes in RA patients was analyzed.Results Serum anti-MCV antibody and anti-CCP antibody in RA group were significantly higher than those in non-RA group and control group(P<0.05).The serum 25(OH)D level in RA group was significantly lower than that in control group(P<0.05).The area under the curve(AUC)of anti-CCP antibody,anti-MCV antibody and 25(OH)D for the diagnosis of RA were 0.74,0.81 and 0.75,respectively.The AUC for the combined diagnosis of RA was 0.90,the sensitivity was 83.70%,and the specificity was 82.40%.Anti-MCV antibody was positively correlated with erythrocyte sedimentation rate and C-reactive proten(r=0.66,0.64,P<0.05),and negatively correlated with complement C3 and C4(r=-0.69,-0.62,P<0.05).Conclusion Anti-CCP antibody,anti-MCV antibody and 25(OH)D have good sensitivity and specificity for the diagnosis of RA,and anti-MCV antibody was helpful for the diagnosis of the disease activity.

OBJECTIVE：To provide reference for the c onstruction of subject diagnosis and treatment scheme in drug clinical trials. METHODS ：The subject diagnosis and treatment module was developed and implemented in our hospital on the basis of CTMS，and its effects were evaluated. RESULTS ：A subject diagnosis and treatment module was established in CTMS of our hospital. Within one year from the launch of the module in the middle of October ，2019，the overall number of subjects in the group showed an increasing trend ，and the overall mean dropout rate of subjects was 0.16％. The data interface of CTMS system ， hospital information system （HIS），laboratory information management system ，medical imaging information system had been established，so as to realize the synchronization of subject information （displaying subject identification in HIS system ）and the interaction of diagnosis and treatment information and billing data （patients and subjects were charged separately ）. Since the launch of the module ，the amount of data generated by the interface had been increasing ，and the number of departments producing the subject diagnosis and treatment business had been increasing month by month. Compared with subject diagnosis and treatment project based on HIS system ，the number of subject diagnosis and treatment business based on CTMS system was increased significantly（P＜0.05）. CONCLUSIONS ：The subject diagnosis and treatment module based on CTMS improves the efficiency of subject diagnosis and treatment project implementation and financial settlement ，and realizes the efficient implementation of drug clinical trial projects in large general hospitals.

Objective To establish the Polock indexes (PI) of singleton neonates in different gestational age (GA),so as to provide a reference data for evaluating physical fullness and symmetry in neonates at birth.Methods A total of 16 887 live singleton neonates at 27-42 weeks of GA from two hospitals were measured at birth by site survey method using cluster samples by a cross sectional time in Shenzhen City,from 2013 to 2015 in this study,to establish PI of singleton neonates in different GA.Results The PI mean and the percentile curves(3rd,10th,25th,50th,75th,90th,97th)of singleton neonates at 27-42 weeks of GA (male,female,and unisex three groups) were established in 2015 in Shenzhen,China.The fullness and nutrition status of neonates at birth can be evaluated by these PI curves.According to the 3rd,10th,25th-75th,90th,97th curves,the down,mid down,middle,mid upper,upper levels were divided in turn.When the PI values ＞97th curve it was overweighted or fatty.When the PI values ＜ 3rd curve it was malnutrition.The lowest values of PI were at 27 weeks of GA,and the highest values appeared at 42 weeks of GA.The PI values were increasing with GA growth,which indicated that the GA increased the body density and fullness.The 50th percentile curve of male PI was higher than that of the female,and the male ratio increased by 61.2-89.5 at the gestational age of 27-34 weeks;between 35 and 42 weeks of fetal age,males increased by 104.8-149.1,which had a statistical difference (P ＜ 0.001).Conclusions The PI of singleton neonates rises with GA increase,which shows the GA increases the body density and fullness.PI is higher in male than in female singleton neonates.

Objective To investigate the clinical curative effect of laparoscopic cholecystectomy in the treatment of elderly patieuts with acute gaugrenous cholecystitis,and summarized the advantages and disadvantages compared with open cholecystectomy.Methods Using retrospective study,68 elderly patients with acute gangrenous cholecystitis patients in Xiaogan First People's Hospital from January 2010 to January 2015 were selected,and divided into minimally invasive group (36 cases) and laparotomy group (32 cases) according to the different surgical treatment methods,the minimally invasive group patients were treated with laparoscopic cholecystectomy,the laparotomy group patients were treated with open cholecystectomy.Recorded and statistical analysised the incision length,operative time,intraoperative blood loss,laparotomy,postoperative first exhaust time,drainage tube pulled out of time,the degree of pain after operation (visual analogue scale),length of hospital stay,postoperative complications of the two groups.All the patients were followed up by outpatient or telephone,inquiried and recorded the patient's health status up to July 2015.The measurement data were expressed by (x ± s),and the t test was used comparison between groups.The enumeration data was expressed by percentage (％),and the x2 test was used comparison between groups.Results The incision length,intraoperative blood loss,postoperative first exhaust time,length of hospital stay,extubation time were respectively (4.67 ±2.13) cm,(65.67 ±23.61) ml,(31.18 ±4.35) hours,(7.53 ±2.33) days,(2.44±1.31) days in the minimallyinvasive group and (8.48 ±3.49) cm,(103.96 ±35.65) ml,(40.41 ±5.87) hours,(12.34 ±2.94) days,(3.73 ± 1.52) days in the laparotomy group,with statistically significant differences between the 2 groups (all P ＜ 0.05).There was no significant difference in the operation time between the two groups (t =3.574,P ＞ 0.05);The pain scores in the minimally invasive group after 1,3,5 and 7 days were respectively (4.96 ± 1.38) scores,(3.48 ± 1.04) scores,(2.01 ± 0.89) scores,(1.11 ± 0.85) scores and (6.55±1.84) scores,(5.69±1.54) scores,(2.97± 16) scores,(1.81 ±0.94) scores in the laparotomy group,with statistically significant differences between the 2 groups (all P ＜ 0.05).The incidence of complications in minimally invasive group was 17.14％ 6/35),which was significantly lower than that of laparotomy group 41.94％ (13/31) (x2 =15.234,P ＜ 0.05),all the complications were relieved after symptomatic treatment such as anti infection,drainage and so on.All patients were followed up.Among 68 patients enrolled in the study group,1 patient in the minimally invasive group was converted to laparotomy because of excessive adhesion and uncontrollable intraoperative bleeding.The laparotomy group died of septic shock in 1 case,and the remaining patients were treated by surgical treatment.Conclusion Cholecystectomy is effective in treatment of elderly patients with acute gangrenous cholecystitis,and laparoscopic cholecystectomy has the advantages of small incision,less bleeding,less pain,fewer complications and faster recovery after operation thus deserving popularization.