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.

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.

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.

Ulcerative colitis （UC） is a chronic non-specific inflammatory disease characterized by the damage of the epithelial barrier of the colon and the destruction of immune homeostasis. It has a long course， no recovery and high recurrence rate， and is recognized as a difficult digestive disease. MicroRNA （miRNA） has been confirmed to be specifically or differentially expressed in both UC patients and UC animal models， so miRNA can be used as markers for UC diagnosis or reference for treatment evaluation. TCM therapy has a definite therapeutic effect， a wide range of effects， and minimal side effects in the treatment of UC， so this article takes miRNA as the starting point and systematically elaborates on the mechanism of TCM regulating UC related signaling pathways by regulating the expression of miRNA. The results show that chlorogenic acid， Anchang decoction， and Fuyang huoxue jiedu formula can regulate the expressions of miR-155， miR-146a and miR-31-5p， etc.， thereby inhibiting signal transducer and activator of transcription （STAT） signal pathway transduction to improve UC. Limonin， ginsenoside Rh2， artesunate， etc. can inhibit nuclear factor-κB （NF-κB） signaling pathway conduction to improve UC by regulating the expressions of miR-214， miR- 155 and miR-19a， etc. Nitidine chloride， berberine， resveratrol， etc. can regulate the expressions of miR-31， miR-146a， miR- 146b， etc.， thereby inhibiting the Toll-like receptor 4 （TLR4） signaling pathway to improve UC. Mango polyphenolics， Compound qinbai granules， and Astragalus membranaceus polysaccharides can regulate the expressions of miR-126 and miR-193a-3p， thereby inhibiting the phosphoinositide 3-kinase/protein kinase B/mammalian target of rapamycin （PI3K/AKT/mTOR） signaling pathway to improve UC.

ObjectiveTo describe a COVID-19 outbreak due to SARS-CoV-2 Omicron variant in a school and provide suggestions for COVID-19 prevention and control. MethodsData on the COVID-19 outbreak in a school in Putuo District of Shanghai were collected from November 14 to December 20， 2022. Epidemiological characteristics， incidence rate of secondary cases and response measures were described and analyzed. ResultsA total of 27 COVID-19 cases were identified infected with SARS-CoV-2 Omicron BA.5.2 variant， including 14 students （51.9%） and 13 family members / teachers living with those students （48.1%）. The first case occurred on November 14， with peak incidence during November 16-18. The median generation interval of the second generation cases was 2 （2，3） days. The index case （case 1， a student） had a clear contact history outside the school， which was found through routine examination in key populations in the school. Immediate management was conducted after the notification. All the second generation cases were exposed students in the same class with case 1， which were identified during the quarantine， whereas the third generation cases were their family members/teachers living with the second generation cases. The incidence rate within the class and school were 36.8% and 3.0%， respectively. No further social transmission was found outside the school. ConclusionEarly detection， multi-sectoral collaboration， prompt control and quarantine measures are effective in containing SARS-CoV-2 transmission. Health promotion， surveillance， ventilation and prophylactic disinfection should be reinforced in schools， office buildings and other gathering places.

Objective: To study the buccolingual inclination of posterior premolars and molars and the curve of Wilson in patients with different sagittal skeletal patterns, to explore the compensation mechanism of horizontal inclination of posterior teeth in patients with different sagittal skeletal patterns and to provide a reference for the control of posterior tooth inclination in the treatment of bone malocclusion. Methods: This study was reviewed and approved by the Ethics Committee, and informed consent was obtained from the patients. Ninety CBCT scans of adults and ninety scans of adolescents before orthodontic treatment were evaluated in this cross-sectional study. There were 30 skeletal Class I, Class Ⅱ, and Class Ⅲ patients in the adult group and adolescent group. The inclination angles of posterior teeth and the curve of Wilson of first and second molars were measured, and data were analyzed between adolescents and adults with different sagittal skeletal patterns. Results : Compared with skeletal Class Ⅰ adult patients, the upper posterior molar inclination of skeletal Class Ⅱ patients was significantly lower, and the lower posterior molar inclination was significantly higher. Compared with skeletal ClassⅠ adult patients, the upper posterior molar inclination of skeletal Class Ⅲ adult patients was higher, and the lower posterior molar inclination was significantly lower. The Wilson curve of the second molar in skeletal Class Ⅱ adult patients was significantly higher than that in the other groups. Compared with skeletal ClassⅠ adolescent patients, skeletal Class Ⅲ adolescent patients had a significantly higher upper posterior molar inclination; however, no difference was found between the inclination of the posterior teeth between skeletal Class Ⅰ, Class Ⅱ and Class Ⅲ adolescent patients. Comparing adolescent and adult samples, in skeletal Class Ⅱ patients, adults showed more lingual inclination than adolescents in the upper posterior teeth and less lingual inclination in the lower posterior teeth except for the mandibular first molar. Comparing adolescent and adult samples, in skeletal Class Ⅲ patients, adults showed more lingual inclination than adolescents in the lower posterior teeth except for the mandibular second molars and showed no difference in the upper posterior teeth. Conclusions The inclination of the posterior teeth and the curve of Wilson show significant differences between the three sagittal skeletal patterns. Compared with those of skeletal Class Ⅰ patients, the posterior teeth of skeletal Class Ⅱ patients show more lingual inclination in the upper arch and less lingual inclination in the lower arch. Meanwhile, posterior teeth of skeletal Class Ⅲ patients show more lingual inclination in the lower arch and maintain the inclination in the upper arch.

Objective:To study the clinicopathological features, immunophenotype, molecular genetic characteristics and prognosis of renal cell carcinoma associated with TFEB gene rearrangement (TFEBr-RCC).Methods:Eight cases of TFEBr-RCC diagnosed at the West China Hospital of Sichuan University from 2014 to 2022 were collected for clinicopathological, immunohistochemical, fluorescence in situ hybridization and RNA sequencing analyses, with review of literature.Results:Six patients were male and two were female. The patient ages ranged from 25 to 50 years (mean: 34 years, median: 32 years). The tumors were present in the right kidney (3 cases) or the left kidney (5 cases). The maximum diameters of the tumors ranged from 4.0 cm to 18.5 cm, with an average of 8.5 cm. Histologically, majority of the cases (5/8) showed typical biphasic "pseudorosette" structure, while the remaining three cases demonstrated atypical morphology that was similar to epithelioid angiomyolipoma or clear cell renal cell carcinoma. Immunohistochemical study showed positivity of TFEB (8/8), PAX8 (8/8), MART-1 (7/7), and HMB45 (5/6). Interestingly, PD-L1 was variably expressed in all five tested cases. Staining for TFE3 in all cases was negative. TFEB translocation was verified in all 8 cases using TFEB fluorescence in situ hybridization. RNA sequencing showed MALAT1-TFEB gene fusion in 4 of the 5 tested cases (two of which showing novel MALAT1-TFEB fusion sites), and one case with a novel ACTB-TFEB gene fusion. Patient follow-ups ranged from 5 to 96 months (average 47 months). All patients were alive without recurrence or metastasis.Conclusions:TFEBr-RCC tends to occur in young adults and has a good prognosis. Histologically, most of the cases show characteristic biphasic structure, and some cases show epithelioid angiomyolipoma-like or clear cell RCC-like morphology. Immunohistochemical reactivity to TFEB, melanocytic markers and PD-L1 is characteristic. MALAT1-TFEB gene fusion is the most common molecular change, with variable fusion sites.

BACKGROUND: Massive bleeding is the main concern for the management of placenta percreta (PP). Intra-abdominal aortic balloon occlusion (IABO) is one method for pelvic devascularization, but the efficacy of IABO is uncertain. This study aims to investigate the outcomes of IABO in PP patients. METHODS: We retrospectively reviewed the clinical data of PP cases from six tertiary centers in China between January 2011 and December 2015. PP cases with/without the use of IABO were analyzed. Propensity score matching analysis was performed to reduce the effect of selection bias. Postpartum hemorrhage (PPH) and the rate of hysterectomy, as well as neonatal outcomes, were analyzed. RESULTS: One hundred and thirty-two matched pairs of patients were included in the final analysis. Compared with the control group, maternal outcomes, including PPH (68.9% vs. 87.9%, χ2 = 13.984, P < 0.001), hysterectomy (8.3% vs. 65.2%, χ2 = 91.672, P < 0.001), and repeated surgery (1.5% vs. 12.1%, χ2 = 11.686, P = 0.001) were significantly reduced in the IABO group. For neonatal outcomes, Apgar scores at 1 minute (8.67 ± 1.79 vs. 8.53 ± 1.68, t = -0.638, P = 0.947) and 5 minutes (9.43 ± 1.55 vs. 9.53 ± 1.26, t = 0.566, P = 0.293) were not significantly different between the two groups. CONCLUSIONS IABO can significantly reduce blood loss, hysterectomies, and repeated surgeries. This procedure has not shown harmful effects on neonatal outcomes.
Aorta ; Balloon Occlusion/methods* ; Blood Loss, Surgical ; Female ; Humans ; Hysterectomy ; Infant, Newborn ; Placenta Accreta/surgery* ; Placenta Previa/surgery* ; Postpartum Hemorrhage ; Pregnancy ; Retrospective Studies