Oral leukoplakia is a potentially malignant mucosal disease with a high incidence rate.Macrophages play a significant regulatory role in the malignant transformation of oral leukoplakia,yet there is a lack of research on the molecular mechanisms underlying this process.Recent studies have found that M2 polarization of macrophages has a significant impact on the malignant transformation of oral leukoplakia,and this process is regulated by a complex network involving immune cells,microorganisms,cytokines,and the extracellular matrix,etc.Therefore,this article reviews the biological functions,subtypes,and regulatory factors of macrophage polarization in oral leukoplakia.Building on the preliminary research foundation of our group on the relationship between oral intracellular colonizing bacteria and mucosal malignant tumors,it is proposed that oral intracellular colonizing bacteria,such as Porphyromonas gingivalis,may promote the malignant transformation of leukoplakia by inducing a macrophage M2 polarization that leads to an immunosuppressive microenvironment.This perspective explores potential intervention strategies from the angle of macrophage polarization,providing new research directions for the prevention and treatment of oral leukoplakia and oral cancer.

[Objective]To evaluate the knowledge,attitude and practice(KAP)of medication use and safety among the patients with acquired immune deficiency syndrome(AIDS)in a 3A-grade hospital of Guangzhou city,and to provide scientific basis for AIDS prevention and treatment.[Methods]A questionnaire survey was conducted among AIDS patients aged 18 years and above in our hospital to investigate their KAP regarding medication use and safety.[Results]A total of 549 questionnaires were collected,of which 503 were valid,with an effective recovery rate of 91.6%.The average scores of KAP were(14.58±8.49),(25.21±6.92)and(47.58±3.33),respectively,with the scoring rates of 36.46%,63.02%,and 95.16%,respectively.There were statistically significant differences(P＜0.05)in knowledge scores among people with different ages,education levels and occupations.Multiple linear regression showed that education level and medical insurance status had most significant impact on knowledge scores(P<0.05).Significant differences were found in attitude scores among people with different education levels(P<0.05),as well as in practice scores among people with different occupations(P<0.05).Multiple linear regression revealed that age,occupation,knowledge score and attitude score had a significant impact on practice scores(P<0.05).Patients expected to receive pharmaceutical care services from the pharmacists via face-to-face communication,network platform and telephone consultation on medication knowledge such as adverse drug reactions and response measures,drug-drug interactions,missed medication and response measures,medication adherence measures,etc.[Conclusions]AIDS patients in this hospital have a good awareness of medication safety,but their knowledge of medication use needs improvement.Some bad habits may affect their compliance,resulting in safety hazards.Therefore,there is an urgent demand for pharmaceutical care services related to rational drug use.

Chinese materia medica and its compound formulas have the characteristics of multi-component,multi-target,and multi pathway effects,and have unique advantages in preventing and treating complex diseases.Network pharmacology explains disease patterns and drug mechanisms from the perspective of complex biological networks,and explores the pharmacological substance basis and target of Chinese medicine.This article summarized the application of network pharmacology from the aspects of biological basis of TCM syndrome,the substance basis and pharmacological mechanism of TCM,compatibility theory of TCM compound formulas,etc.,with the purpose to provide a reference for the research and application of network pharmacology in TCM.

Objective:To assess the feasibility and efficacy of hypofractionated radiotherapy with simultaneous integrated boost (HFRT-SIB) for patients with non-osteogenic spinal metastases who were not suitable for stereotactic body radiotherapy (SBRT).Methods:A totoal of 26 spinal metastatic lesions in 24 patients with non-osteogenic spinal metastases admitted to Beijing Luhe Hospital affiliated to Capital Medical University from March 2020 to April 2023 were retrospectively analyzed. In our institution, a higher-dose fractionated regimen for spinal metastases was introduced, at a dose of 3 Gy/f ×10 times (5 times a week, once a day) to the clinical target volume (CTV), and simultaneous integrated boost (SIB) of 4 Gy/f ×10 times (5 times a week, once a day) to the gross tumor volume (GTV). The primary endpoint was the overall relief (OR) rates of pain at 12 and 24 weeks post-radiotherapy, while secondary endpoints included the pain response time and duration of pain relief, the incidence of adverse events post-radiotherapy, and the 1-year overall survival (OS) rate. The differences before and after treatment were analyzed by Wilcoxon signed-rank test. OS was assessed using Kaplan-Meier method.Results:The median follow-up was 11.7 (8.0, 17.0) months. At 12 weeks post-radiotherapy, 92% (22/24) of patients achieved OR, and 81% (17/21) obtained OR at 24 weeks post-radiotherapy. The median pain response time was 4 (3, 5) d. At the last follow-up, 42% (10/24) of patients maintained pain relief for over 1 year, with a median duration of pain relief up to 11.0 (6.0, 16.9) months. The 1-year OS rate was 66.3%, and no patients experienced grade 3 or higher acute or chronic adverse events.Conclusion:HFRT-SIB can effectively alleviate pain, and achieve sustained pain control, and does not lead to severe adverse effects in patients with non-osteogenic spinal metastases.

Objective:To investigate effects of lentinan(LNT)on atherosclerosis(AS)plaque formation and adenosine 5'-mo-nophosphate-activated protein kinase(AMPK)signaling pathway in ApoE-/-mice.Methods:ApoE-/-mice were divided into model group,Lipitor group(5 mg/kg),LNT low(5 mg/kg),medium(10 mg/kg),high(20 mg/kg)dose groups,C57BL/6 mice of similar genetic background were as control group.After 12 weeks of intragastric administration,automatic biochemical analyzer was used to detect serum triglycerides(TG),total cholesterol(TC),low-density lipoprotein(LDL-C)and high-density lipoprotein(HDL-C)levels;serum levels of IL-6 and IL-1β were detected by ELISA;oil red O staining was used to observe overall aortic plaque formation;HE staining was used to observe formation of plaque in aortic roots;AMPK pathway proteins expressions in aortawas were detected by Western blot.Results:Compared with control group,serum TC,TG,LDL-C,IL-6,IL-1β levels,aortic plaque area,aortic root plaque area,aortic tissue NLRP3,IL-6,IL-1β expressions were significantly increased in model group,p-AMPK/AMPK expression in aortic tissue and serum HDL-C level were reduced significantly(P<0.05);compared with model group,TC,TG,LDL-C,IL-6,IL-1β,aortic plaque area,aortic root plaque area,aortic tissues NLRP3,IL-6 and IL-1β expressions were reduced significantly in Lipitor group and medium,high dose LNT groups,p-AMPK/AMPK expression in aortic tissue and serum HDL-C level were increased significantly,difference between each dose of LNT was statistically significant(P<0.05);there was no significant difference between Lipitor group and LNT high-dose group(P>0.05).Conclusion:LNT may inhibit inflammatory response and formation of AS plaques in AS mouse by activating AMPK pathway.

Objective To investigate the clinicopathological features,immunophenotypes,molecular genetic alterations,and prognosis of succinate dehydrogenase-deficient renal cell carcinoma(SDH-RCC).Methods A total of 11 cases of SDH-RCC diagnosed at West China Hospital,Sichuan University between 2016 and 2023 were selected for clinicopathological,immunohistochemical,and DNA sequencing analyses.Results Among the 11 cases of SDH-RCC,there were 5 male patients and 6 female patients.The patients'ages ranged from 12 to 71 years,with an average age of 39.7 years.Among them,5 patients had tumors located in the right kidney,5 had tumors located in the left kidney,and 1 patient had bilateral tumors.Microscopic observation showed that the tumor cells of the SDH-RCC patients displayed a wide spectrum of structures,forming sheet-like,nested,and glandular structures.In addition,tumor cells in papillary structures were observed in some cases.The tumor cells had abundant cytoplasm,was eosinophilic,and contained flocculent materials.Intracytoplasmic vacuolations were observed in some of the cells.Among all the patients,7(7/11,63.6％)showed typical low-grade features(grade 1-2 according to the International Society of Urological Pathology[ISUPJ/WHO 2016 classification),and 4(4/11,36.4％)showed high-grade features(grade 3 according to the ISUP/WHO 2016 classification).The average ages of patients with low-grade and high-grade features were 32.1 years and 58.0 years,respectively.Immunohistochemical staining of all 11 cases demonstrated negative results for SDHB and cytokeratin 7(CK7),and positive staining results for paired box 8(PAX-8),fumarate hydratase(FH),and epithelial membrane antigen(EMA).Their Ki-67 index was l％-30％.In one case,the loss of SDHB expression was also accompanied by a loss of SDHA expression.Sanger sequencing was performed to examine all the exons of SDHB in 7 cases.One case showed a frameshift mutation,c.236Tdel(p.K80Rfs*),and another case harbored a missense mutation,c.725G＞A(p.Arg242His).In another case,next generation sequencing revealed that large fragments of SDHB(Exon 4-8 del)were missing.Follow-up data were available for 10 patients.The follow-up time ranged from 4 to 138 months,with the average being 32.8 months,and all patients survived.Metastasis and recurrence were reported in 5 cases,with 3 of them showing high-grade features and 2 showing low-grade features.Conclusion SDH-RCC is rare and the patients demonstrate a relatively young age of onsets.Patients may present with bilateral tumors.Tumors with low-grade features usually occur in young patients,with their Ki-67 index usually being lower than 5％.Individual cases may experience tumor recurrence and metastasis over a long period of follow-up.Tumors with high-grade features tend to occur in older patients who have a higher Ki-67 index,and who are prone to recurrence and metastasis.Negative immunohistochemical staining results for SDHB can assist in tumor diagnosis,but the loss of SDHB protein expression does not necessarily lead to the detection of SDHB gene mutation.

Objective:To investigate the clinical, epidemic and laboratory characteristics of brucellosis in Hainan, and to summarize the experience of diagnosis and treatment.Methods:The epidemiological characteristics, clinical manifestations, laboratory results, treatment and prognosis of 27 inpatients with brucellosis admitted to the Second Affiliated Hospital of Hainan Medical University from January 2019 to December 2023 were retrospectively analyzed.Results:In 27 cases, the male to female ratio was 2.38 ∶ 1.00 (19 ∶ 8). Occupational distribution was dominated by farmers and herdsmen, with a total of 21 cases (77.8%). Twenty-one patients (77.8%) had a clear history of contact with cattle, sheep, and related products, and there was a phenomenon of family clustering. Eighteen patients (66.7%) developed symptoms from March to July. The clinical manifestations of the patients were lack of specificity, mainly fever (24 cases, 88.9%), dizziness and headache (13 cases, 48.1%), and low back pain (11 cases, 40.7%). Some patients also had symptoms and signs such as fatigue (8 cases), muscle pain (6 cases), chest tightness (4 cases), and splenomegaly (6 cases). Complications commonly included pulmonary infection (13 cases, 48.1%) and spinal involvement (11 cases, 40.7%). The positive rates of Brucella blood culture, tube agglutination test, Rose Bengal plate agglutination test, and cerebrospinal fluid or joint cavity effusion culture were 76.9% (20/26), 100.0% (21/21), 100.0% (11/11), and 3/4, respectively. The combination therapy of doxycycline and rifampicin showed good therapeutic effects, and 22 patients were cured. Conclusions:Hainan is not an epidemic area of brucellosis, and the clinical manifestations of the disease are not specific. The epidemic and clinical characteristics of the disease should be paid attention to in order to improve the level of diagnosis and treatment and control effectiveness.

Objective:To study the epidemiological and clinical characteristics of patients infected with Streptococcus suis in Hainan Province. Methods:Clinical data of patients diagnosed with human infection with Streptococcus suis at the Second Affiliated Hospital of Hainan Medical University from January 2017 to December 2023 were collected, and their epidemiological characteristics, clinical manifestations, auxiliary examination results, treatment and prognosis were retrospectively analyzed. Results:A total of 29 patients infected with Streptococcus suis were included, with 26 males (89.66%) and 3 females (10.34%). The age of the patients was (54.52 ± 10.89) years old, with the highest number of patients aged 51 to 60 years, accounting for 41.38% (12 cases). Farmers were the main occupation (72.41%, 21/29). Forty-four point eighty-three percent (13/29) of the patients had a history of direct or indirect contact with dead or sick pigs. The number of cases from January to December was 0, 0, 2, 2, 4, 8, 2, 3, 2, 2, 3, and 1, respectively. June was the peak period of incidence (27.59%, 8/29). The main clinical manifestations were fever (100.00%, 29/29), altered state of consciousness (51.72%, 15/29), headache (48.28%, 14/29), and hearing impairment (44.83%, 13/29). In clinical classification, common type, meningitis type, and mixed type accounted for 20.69% (6/29), 75.86% (22/29), and 3.45% (1/29), respectively. In the pathogen examination, all 29 patients underwent blood culture, and 18 patients (62.07%, 18/29) had positive blood culture; 26 patients underwent cerebrospinal fluid culture, and 8 cases (30.77%) tested positive for cerebrospinal fluid culture. Eighty-nine point sixty-six percent (26/29) of the patients were treated with ceftriaxone sodium; 55.17% (16/29) of the patients were treated with combined treatment of ceftriaxone sodium and glucocorticoids, including 11 cases treated with dexamethasone and 5 cases treated with methylprednisolone. After treatment, 7 patients were cured and discharged, and 22 patients showed improvement in their condition and discharged from hospital. At discharge, both blood and/or cerebrospinal fluid cultures turned negative. Telephone follow-up was conducted 6 months after discharge, and 20 patients had no sequelae, 9 patients still had hearing impairment, including one who also developed walking difficulties. Conclusions:The patients infected with Streptococcus suis in Hainan Province are mainly middle-aged, elderly, male and farmers, with June being the peak period of the disease. The main clinical manifestations are fever, altered state of consciousness, headache, and hearing impairment. After follow-up, there are still patients with residual hearing impairment. In clinical practice, patients with fever and hearing impairment should be considered as this disease as early as possible.

Objective:To investigate the clinical, epidemic and laboratory characteristics of brucellosis in Hainan, and to summarize the experience of diagnosis and treatment.Methods:The epidemiological characteristics, clinical manifestations, laboratory results, treatment and prognosis of 27 inpatients with brucellosis admitted to the Second Affiliated Hospital of Hainan Medical University from January 2019 to December 2023 were retrospectively analyzed.Results:In 27 cases, the male to female ratio was 2.38 ∶ 1.00 (19 ∶ 8). Occupational distribution was dominated by farmers and herdsmen, with a total of 21 cases (77.8%). Twenty-one patients (77.8%) had a clear history of contact with cattle, sheep, and related products, and there was a phenomenon of family clustering. Eighteen patients (66.7%) developed symptoms from March to July. The clinical manifestations of the patients were lack of specificity, mainly fever (24 cases, 88.9%), dizziness and headache (13 cases, 48.1%), and low back pain (11 cases, 40.7%). Some patients also had symptoms and signs such as fatigue (8 cases), muscle pain (6 cases), chest tightness (4 cases), and splenomegaly (6 cases). Complications commonly included pulmonary infection (13 cases, 48.1%) and spinal involvement (11 cases, 40.7%). The positive rates of Brucella blood culture, tube agglutination test, Rose Bengal plate agglutination test, and cerebrospinal fluid or joint cavity effusion culture were 76.9% (20/26), 100.0% (21/21), 100.0% (11/11), and 3/4, respectively. The combination therapy of doxycycline and rifampicin showed good therapeutic effects, and 22 patients were cured. Conclusions:Hainan is not an epidemic area of brucellosis, and the clinical manifestations of the disease are not specific. The epidemic and clinical characteristics of the disease should be paid attention to in order to improve the level of diagnosis and treatment and control effectiveness.

Objective:To study the epidemiological and clinical characteristics of patients infected with Streptococcus suis in Hainan Province. Methods:Clinical data of patients diagnosed with human infection with Streptococcus suis at the Second Affiliated Hospital of Hainan Medical University from January 2017 to December 2023 were collected, and their epidemiological characteristics, clinical manifestations, auxiliary examination results, treatment and prognosis were retrospectively analyzed. Results:A total of 29 patients infected with Streptococcus suis were included, with 26 males (89.66%) and 3 females (10.34%). The age of the patients was (54.52 ± 10.89) years old, with the highest number of patients aged 51 to 60 years, accounting for 41.38% (12 cases). Farmers were the main occupation (72.41%, 21/29). Forty-four point eighty-three percent (13/29) of the patients had a history of direct or indirect contact with dead or sick pigs. The number of cases from January to December was 0, 0, 2, 2, 4, 8, 2, 3, 2, 2, 3, and 1, respectively. June was the peak period of incidence (27.59%, 8/29). The main clinical manifestations were fever (100.00%, 29/29), altered state of consciousness (51.72%, 15/29), headache (48.28%, 14/29), and hearing impairment (44.83%, 13/29). In clinical classification, common type, meningitis type, and mixed type accounted for 20.69% (6/29), 75.86% (22/29), and 3.45% (1/29), respectively. In the pathogen examination, all 29 patients underwent blood culture, and 18 patients (62.07%, 18/29) had positive blood culture; 26 patients underwent cerebrospinal fluid culture, and 8 cases (30.77%) tested positive for cerebrospinal fluid culture. Eighty-nine point sixty-six percent (26/29) of the patients were treated with ceftriaxone sodium; 55.17% (16/29) of the patients were treated with combined treatment of ceftriaxone sodium and glucocorticoids, including 11 cases treated with dexamethasone and 5 cases treated with methylprednisolone. After treatment, 7 patients were cured and discharged, and 22 patients showed improvement in their condition and discharged from hospital. At discharge, both blood and/or cerebrospinal fluid cultures turned negative. Telephone follow-up was conducted 6 months after discharge, and 20 patients had no sequelae, 9 patients still had hearing impairment, including one who also developed walking difficulties. Conclusions:The patients infected with Streptococcus suis in Hainan Province are mainly middle-aged, elderly, male and farmers, with June being the peak period of the disease. The main clinical manifestations are fever, altered state of consciousness, headache, and hearing impairment. After follow-up, there are still patients with residual hearing impairment. In clinical practice, patients with fever and hearing impairment should be considered as this disease as early as possible.