Microwave thermochemotherapy (MTC) has been applied to treat lip squamous cell carcinoma (LSCC), but a deeper understanding of its therapeutic mechanisms and molecular biology is needed. To address this, we used single-cell transcriptomics (scRNA-seq) and spatial transcriptomics (ST) to highlight the pivotal role of tumor-associated neutrophils (TANs) among tumor-infiltrating immune cells and their therapeutic response to MTC. MNDA⁺ TANs with anti-tumor activity (N1-phenotype) are found to be abundantly infiltrated by MTC with benefit of increased blood perfusion, and these TANs are characterized by enhanced cytotoxicity, ameliorated hypoxia, and upregulated IL1B, activating T&NK cells and fibroblasts via IL1B-IL1R. In this highly anti-tumor immunogenic and hypoxia-reversed microenvironment under MTC, fibroblasts accumulated in the tumor front (TF) can recruit N1-TANs via CXCL2-CXCR2 and clear N2-TANs (pro-tumor phenotype) via CXCL12-CXCR4, which results in the aggregation of N1-TANs and extracellular matrix (ECM) deposition. In addition, we construct an N1-TANs marker, MX2, which positively correlates with better prognosis in LSCC patients, and employ deep learning techniques to predict expression of MX2 from hematoxylin-eosin (H&E)-stained images so as to conveniently guide decision making in clinical practice. Collectively, our findings demonstrate that the N1-TANs/fibroblasts defense wall formed in response to MTC effectively combat LSCC.
Humans ; Neutrophils/metabolism* ; Single-Cell Analysis ; Lip Neoplasms/genetics* ; Hyperthermia, Induced/methods* ; Microwaves/therapeutic use* ; Transcriptome ; Carcinoma, Squamous Cell/immunology* ; Tumor Microenvironment

Background and aims:Early and accurate diagnosis of the coexistence of Wilson's disease(WD)and chronic hepatitis B(CHB)presents a significant challenge for clinicians.The objective of this study was to retrospectively analyse the characteristics of such patients to improve clinical practice and provide a reference for clinical management.Methods:From January 2011 to December 2022,35 patients with concurrent CHB and WD(CHB+WD group)were identified.A total of 127 patients with CHB(CHB group)and 168 patients with WD(WD group)were included in the control group between January 2016 and December 2021.Propensity score matching(PSM)was performed to balance the baseline values between groups.The Kaplan-Meier(K-M)survival analysis and log-rank test were performed to compare the prognoses.Results:In the cohort of 35 patients with concurrent CHB and WD,74.3％of patients(26 patients)faced a substantial delay of up to 10 years(range:0-40 years)in WD diagnosis following their CHB diagnosis.Twenty-three(65.7％)patients had cirrhosis at the time of WD diagnosis,and 26(74.3％)patients experienced liver failure.The levels of serum copper and uric acid were lower in patients in the CHB+WD group than in those in the CHB group.Patients in the CHB+WD group presented higher alanine transaminase and total bile acid levels compared to those in the WD group.K-M survival analysis indicated that patients with CHB and WD had poorer outcomes than those with CHB alone;however,the outcomes were similar to those of individuals with WD alone.The optimal cut-point of serum ceruloplasmin(CP)in identifying WD in CHB patients was 0.10 g/L before PSM and after PSM.Conclusions:The present study emphasizes the importance of clinicians being vigilant for concurrent CHB and WD diagnoses,as delays in WD diagnosis may adversely affect patient outcomes.CHB patients with serum CP below 0.10 g/L are highly recommended to screen for WD.

Objective To investigate the sleep disorders and its effects on the changes in quality of life in patients with liver cancer from the hospital admission to 6 months after surgery and to analyse the correlation between the sleep disorder and quality of life.Methods A total of 214 patients who underwent surgery for liver cancer for the first time were included in the study.Demographic questionnaire,Pittsburgh sleep quality index(PSQI),and functional assessment of cancer therapy-hepatobiliary(FACT-Hep)were used for the investigation at admission and at 1,3 and 6 months after surgery.Multiple linear regression was employed to analyse the correlation between the sleep disorders at the admission and its effect on quality of life up to 6 months after surgery.Results Toally 214 patients finished the study at admission and 209 finished the study 1 month after surgery,and 208 finished the stuoly 3 months after surgery,and 205 patients finished the study 6 months after surgery.The scores of both of PSQI at admission and the quality of life at 6 months after surgery varied across the tested time points with a statistically significant difference(both P<0.001).The overall level of sleep disorder in the patients showed a characteristic pattern with initially increasing and then decreasing,and the quality of life presented a characteristic tendency of starting from high to low and then gradually increasing.It showed that the sleep disorder at admission was attributive to the poorer quality of life at 6 months after surgery.The hierarchical regression analysis showed that among the patients at BCLC Stage A,sleep disorder at admission was the influencing factor of the quality of life at 6 months after surgery.Conclusions The sleep disorder and quality of life in the patients who had surgical operations for hepatocellular carcinoma both changed dynamically from admission to the 6 months after surgery.The quality of life was poor in the patients with sleep disorder at admission.Therefore,medical staff should enhance the sleep management at admission,conduct dynamic assessment of the sleep disorder and quality of life of the patients,and then develop continuity nursing measures to improve the quality of life after surgery.

Objective:To analyze and explore the possible mechanism of anti-tumor metastasis of Notoginseng Radix et Rhizoma using Internet pharmacology. Methods:The active components and targets of Notoginseng Radix et Rhizoma were screened by retrieving Chinese Medicine System Pharmacology Database and Analysis Platform (TCMSP). GeneCards database was used to screen the anti-tumor metastasis-related targets, and compounds and disease targets were under mapping analysis. Key targets of Notoginseng Radix et Rhizoma for anti-tumor metastasis were screened through Venn map. With the help of Cytoscape 3.7.2 software, a compound-disease network diagram was constructed. String platform was used to build a PPI network. Bioconductor was used to enrich the target genes for KEGG signaling pathway and GO biological process analysis. Results:Totally 119 active components were selected from Notoginseng Radix et Rhizoma. There were 8 eligible active components, corresponding to 162 related targets, 121 targets related to anti-tumor metastasis, and 30 key targets screened by PPI network, including AKT1, MAPK1, JUN, RELA, IL6, etc. GO enrichment analysis mainly involved biological processes such as cytokine receptor binding, heme binding, RNA polymerase Ⅱ transcription factor binding, ubiquitin protein ligase binding, and steroid hormone receptor activity. 149 signal pathways related to Notoginseng Radix et Rhizoma anti-tumor metastasis were obtained by KEGG enrichment analysis, mainly involving multiple signal pathways, such as AGE-RAGE and PI3K-Akt, and hepatitis B, Kaposi's sarcoma-associated herpes virus infection, human cytomegalovirus infection and other viral infections and various tumors. Conclusion:Notoginseng Radix et Rhizoma can pass multiple active components, such as ginsenoside f2, ginsenoside rh2 β-, sitosterol, stigmasterol and quercetin, and multiple targets, such as AKT1, MAPK1, JUN, RELA and IL6, acting on multiple pathways such as PI3K-Akt, thereby playing the role of anti-tumor metastasis.

Objective: To analyze the clinical epidemiological characteristics including composition of pathogens , clinical characteristics, and disease prognosis acute bacterial meningitis (ABM) in Chinese children. Methods: A retrospective analysis was performed on the clinical and laboratory data of 1 610 children <15 years of age with ABM in 33 tertiary hospitals in China from January 2019 to December 2020. Patients were divided into different groups according to age,<28 days group, 28 days to <3 months group, 3 months to <1 year group, 1-<5 years of age group, 5-<15 years of age group; etiology confirmed group and clinically diagnosed group according to etiology diagnosis. Non-numeric variables were analyzed with the Chi-square test or Fisher's exact test, while non-normal distrituction numeric variables were compared with nonparametric test. Results: Among 1 610 children with ABM, 955 were male and 650 were female (5 cases were not provided with gender information), and the age of onset was 1.5 (0.5, 5.5) months. There were 588 cases age from <28 days, 462 cases age from 28 days to <3 months, 302 cases age from 3 months to <1 year of age group, 156 cases in the 1-<5 years of age and 101 cases in the 5-<15 years of age. The detection rates were 38.8% (95/245) and 31.5% (70/222) of Escherichia coli and 27.8% (68/245) and 35.1% (78/222) of Streptococcus agalactiae in infants younger than 28 days of age and 28 days to 3 months of age; the detection rates of Streptococcus pneumonia, Escherichia coli, and Streptococcus agalactiae were 34.3% (61/178), 14.0% (25/178) and 13.5% (24/178) in the 3 months of age to <1 year of age group; the dominant pathogens were Streptococcus pneumoniae and the detection rate were 67.9% (74/109) and 44.4% (16/36) in the 1-<5 years of age and 5-<15 years of age . There were 9.7% (19/195) strains of Escherichia coli producing ultra-broad-spectrum β-lactamases. The positive rates of cerebrospinal fluid (CSF) culture and blood culture were 32.2% (515/1 598) and 25.0% (400/1 598), while 38.2% (126/330)and 25.3% (21/83) in CSF metagenomics next generation sequencing and Streptococcus pneumoniae antigen detection. There were 4.3% (32/790) cases of which CSF white blood cell counts were normal in etiology confirmed group. Among 1 610 children with ABM, main intracranial imaging complications were subdural effusion and (or) empyema in 349 cases (21.7%), hydrocephalus in 233 cases (14.5%), brain abscess in 178 cases (11.1%), and other cerebrovascular diseases, including encephalomalacia, cerebral infarction, and encephalatrophy, in 174 cases (10.8%). Among the 166 cases (10.3%) with unfavorable outcome, 32 cases (2.0%) died among whom 24 cases died before 1 year of age, and 37 cases (2.3%) had recurrence among whom 25 cases had recurrence within 3 weeks. The incidences of subdural effusion and (or) empyema, brain abscess and ependymitis in the etiology confirmed group were significantly higher than those in the clinically diagnosed group (26.2% (207/790) vs. 17.3% (142/820), 13.0% (103/790) vs. 9.1% (75/820), 4.6% (36/790) vs. 2.7% (22/820), χ²=18.71, 6.20, 4.07, all P<0.05), but there was no significant difference in the unfavorable outcomes, mortility, and recurrence between these 2 groups (all P>0.05). Conclusions: The onset age of ABM in children is usually within 1 year of age, especially <3 months. The common pathogens in infants <3 months of age are Escherichia coli and Streptococcus agalactiae, and the dominant pathogen in infant ≥3 months is Streptococcus pneumoniae. Subdural effusion and (or) empyema and hydrocephalus are common complications. ABM should not be excluded even if CSF white blood cell counts is within normal range. Standardized bacteriological examination should be paid more attention to increase the pathogenic detection rate. Non-culture CSF detection methods may facilitate the pathogenic diagnosis.
Adolescent ; Brain Abscess ; Child ; Child, Preschool ; Escherichia coli ; Female ; Humans ; Hydrocephalus ; Infant ; Infant, Newborn ; Male ; Meningitis, Bacterial/epidemiology* ; Retrospective Studies ; Streptococcus agalactiae ; Streptococcus pneumoniae ; Subdural Effusion ; beta-Lactamases

Objective To compare the initial stability between anterior transpedicular screw (ATPS) fixation,anterior plate (AP) fixation and combining anterior and posterior (CAP) fixation for subaxial cervical three-column injury.Methods Six specimens of cervical spine were prepared.After measurement of the range of motion (ROM) of the intact cervical spine,the specimens were made into models of three-column injury.After the models were simulatively reconstructed using an anterior cervical cage,they were stabilized by ATPS,AP and CAP.After the ROMs of the models in the 3 fixation states were measured,the data were normalized by standardizing them to the intact state ROM which was set at 100％.The normalized ROMs of the models in the 3 fixation states were compared.Results The normalized ROMs of AP fixation state in flexion,extension,lefi lateral bending,right lateral bending,left axial rotation and right axial rotation were 119.68±8.34％,119.63±6.74％,115.20±7.91％,117.47±7.81％,120.67±5.99％ and 112.35 ± 8.42％,respectively,significantly larger than those of the intact state (P ＜ 0.05).The normalized ROMs of the other 2 states in all directions were significantly smaller than those of the intact state (P ＜0.05).The normalized ROM of ATPS state in flexion was 87.48 ± 5.31％,significantly larger than that of CAP state (69.60 ± 2.06％) (P ＜ 0.05).There were no significant differences between the normalized ROMs of ATPS state and those of CAP state in extension (65.53 ± 4.36％ versus 67.17 ± 3.10％),in left lateral bending (82.13 ± 2.85％ versus 82.30 ±4.69％),in right lateral bending (81.78 ± 3.42％ versus 81.27 ± 2.79％),in left axial rotation (83.20 ± 2.30％ versus 82.95 ± 2.40％),or in right axial rotation (83.03 ± 1.30％ versus 83.60 ± 6.56％) (P ＞ 0.05).Conclusions In subaxial cervical three-column injury,the initial stability of ATPS fixation may be superior to that of AP fixation and similar to that of CAP fixation.We believe that ATPS can provide enough initial stability for subaxial cervical three-column injury.

Objective To evaluate the effect of endoscopic management of foreign bodies in the upper digestive tract. Methods Clinical data and endoscopic treatment methods of 41 patients were retrospectively analyzed from October 2014 to May 2016. Patients with incomplete medical records were excluded. Results Foreign bodies in the upper digestive tract occurred high frequency in elderly. 53.6% of the foreign bodies were located in the esophagus. Date stones was the main type of foreign bodies (56.1%). 41 cases with foreign bodies in digestive tract were successfully extracted, while 1 case occurred perforation. Conclusion Endoscopic management of gastrointestinal foreign bodies is safe and effective.

Objective To understand the correlation between psychological counseling behaviors of accompanying family members and anxiety and depression of inpatients with hepatocellular carcinoma. Methods Used self-designed questionnaires to investigate the behaviors of 45 accompanying family members psychological counseling for their relative hospitalized patients with hepatocellular carcinoma, at the same time, evaluated the anxiety and depression among those 45 hospitalized patients with hepatocellular carcinoma, then analyzed the correlation between the accompanying family members' psychological counseling behaviors and hepatocellular carcinoma in patients' anxiety and depression. Results Among the accompanying family members,53.3%(24/45) were the spouses of the patients. During the accompanying nursing time, there were 20.0%(9/45) accompanying families told to their relative patients less than 2 hours per day, and 80.0%(36/45) told to the patients over 2 hours per day. The proportion of anxiety and depression in the hospitalized patients with hepatocellular carcinoma was 28.9%(13/45) and 77.8% (34/45) respectively. Whether the relationship between the accompanying family members and the patients with hepatocellular carcinoma were spouse relationship was related to the incidence of depression in the patients (χ2=10.470, P=0.005), and whether the time accompanying family members spent in talking with the patients over 2 hours every day was correlative with the incidence of anxiety and depression in the patients (χ2=7.012, P =0.030 andχ2=6.438, P=0.040). The patients who accompanying families told to them less than 2 hours per day suffered a higher depression rate (8/9), and among the patients who accompanying families told to them over 2 hours per day, the lowest rate of anxiety (1/12) was found in the patients who accompanying families told to them around 4.1-6.0 hours per day. Conclusions The patients who are accompanied and cared by their spouses have lower depression rate and lesser depression extent. The accompanying families talk to the patients total 4.1-6.0 hours per day could most favorably reduce the incidence of anxiety and depression in the hospitalized patients with hepatocellular carcinoma.

Objective: To investigate the detection rates and inlfuencing factors of atrial septal defect (ASD) and ventricular septal defect (VSD) among neonates in two cities of East China and to provide scientiifc basis for the prevention, diagnosis, treatment and monitor of ASD and VSD. Methods: 2100 newborns with gestational age of at least 28 weeks were recruited consecutively from each city between 2013-09 and 2014-11. Data related to ASD and VSD were collected by questionnaires and echocardiographic screening was conducted within 7 days after birth. Results: A total of 4152 neonateswere examined with gestational age of (39.03 ± 1.29) weeks, among whom 2189 were male infants (52.72%), and age of mother was (26.32 ± 4.10) years old. Detection rates of ASD and VSD were 60.5‰ and 12.8‰ respectively, showing no significant difference between genders (P>0.05). Multivariate logistic regression analysis showed that maternal pre-pregnancy BMI and home decoration were the inlfuencing factors of ASD and maternal drug use in early pregnancy was the inlfuencing factor of VSD among newborns. Conclusions: Detection rates of ASD and VSD among neonates were relatively high in two cities of East China. Early screening is importtant to reduce the incidence of ASD and VSD and improve the prognosis.

Objective To compared and analyze the therapeutic effect of conservative treatment on distal radius fracture as compared with surgical treatment,so as to provide evidence for the diagnosis and treatment of distal radius fracture.Methods A retro-spective analysis was made on the clinical data of 162 patients with distal radius fracture treated in our hospital from January 2005 to De-cember 2011.In accordance with the different treatment methods,the patients were divided into 2 groups:the conservative treatment group and the surgical treatment group.The patients in the conservative treatment group consisted of 95 patients,including 58 males and 37 females,with an age range between 21 and 64,averaging 52.8 years old.There were 47 cases of extra-articular fracture (type A fracture),28 cases of partial intra-articular fracture (type B fracture)and 20 cases of complicated intra-articular fracture (type C fracture).They were fresh closed fractures and were sent to hospital within 8 hours after fracture.After manual reposition,they had plaster splint for 4 to 7 weeks.The surgical treatment group contained 40 male and 27 female patients,with an age range between 22 and 65,averaging 53.1 years old.The control group included 31 type A fractures,22 type B fractures and 14 type C fractures.T-form steel plates were used for fixation of fractures after surgical reposition.Medical follow-ups were performed 12 to 41 months after surgery (averaging 14.5 months),and therapeutic effects were observed by using reposition scores and function test scores.Results Of the
162 patients,139 patients fulfilled the 12 to 41-month (averaging 14.5 months)medical follow-ups,including 80 cases in the conser-vative treatment group and 59 cases in the surgery group.With regard to function test scores,35 cases were of excellent rate,20 cases were of good rate and 4 cases were of moderate rate for the surgical treatment group.As for the conservative treatment group,45 cases were of excellent rate,25 cases were of good rate,8 cases were of moderate rate and 2 cases were of poor rate.Excellent rates for type A,B and C fractures accounted for 89.47% (17 /19),94.12% (16 /17)and 92.31% (12 /13)respectively,all with satisfactory therapeutic results.As for conservative treatment group,excellent rates for type A,B and C fractures accounted for 94.59% (35 /37), 91.67% (22 /24)and 68.42% (13 /19)respectively.There was no statistical significance in the reposition scores of type A and B fractures and function test scores,when comparisons were made between the surgical and conservative treatment groups(P >0.05). However,the reposition scores of type C fracture and function test scores for the surgical treatment group were obviously superior to those of the conservative treatment group,with statistical significance (P <0.01).Conclusion As for type A and B fractures,manual reposition plus external splint fixation and surgical reposition plus internal fixation could all achieve relatively good therapeutic results, whereas surgical reposition plus internal fixation for type C fracture could achieve better results.