Objective:To explore the clinicopathological characteristics and prognosis of fumarate hydratase-deficient uterine leiomyoma (FH-dUL).Methods:Clinical data and follow-up information for 117 patients with FH-dUL diagnosed through surgical pathology and immunohistochemistry in the First Affiliated Hospital of Nanjing Medical University from January 2020 to December 2024, were collected. A control group of 130 patients with common uterine leiomyomas was also included. The differences between the two groups in clinical, imaging, and pathological characteristics were compared. Additionally, recurrence rates, fertility outcomes for FH-dUL patients, and the incidence of renal cancer in FH germline mutation carriers were monitored.Results:(1) Comparison of clinicopathological characteristics: the median age of 117 FH-dUL patients was 35 years, and the median age at first diagnosis of uterine leiomyomas was 29 years, both significantly younger than the control group (41 and 36 years; both P<0.01). The FH-dUL group showed significantly higher incidences of uterine myomectomy, multiple leiomyomas, diffusion restriction on pelvic magnetic resonance imaging diffusion weighted imaging, and typical pathological features (candelabra-like vessels, bizarre nuclei, cytoplasmic eosinophilic globules, perinuclear halo, cellular atypia) and higher ultrasound blood flow score (all P<0.05). Of the 30 FH-dUL patients who underwent genetic testing, 9 had germline mutations, 3 had somatic mutations, and 6 had mutations of unclear origin. Among the 9 FH gene germline mutation patients, 2 had already developed renal cell carcinoma. (2) Recurrence analysis: among the 56 patients who underwent uterine myomectomy, 22 (39.3%, 22/56) experienced recurrence during follow-up, compared to 12 (21.8%, 12/55) of the 55 patients in the control group, the difference between the two groups was statistically significant ( P=0.046). Multivariate binary logistic regression analysis showed that cellular leiomyomas ( OR=9.489, 95% CI: 1.740-51.755; P=0.009) and multiple uterine leiomyomas ( OR=10.709, 95% CI: 1.354-84.683; P=0.025) were significant risk factors for recurrence in FH-dUL. (3) Fertility analysis: among the 66 FH-dUL patients who underwent fertility-preserving surgery, 16 had the intention to have fertility desire, only 2 (2/16) completed their fertility plans during follow-up. Conclusions:Clinicopathological features and imaging features help to differentiate FH-dUL from common type uterine fibroids, but lack specificity, and the diagnosis of FH-dUL is based on immunohistochemistry. The recurrence rate after resection of FH-dUL is high, and cellular and multiple leiomyomas are important predictors of recurrence. It is crucial to perform genetic testing, genetic counseling, drug treatment to prevent recurrence, fertility guidance, and long-term comprehensive management after surgery for FH-dUL management.

Clinically,neuroendocrine liver metastasis(NELM)is not uncommonly seen,which seriously affects the quality of life and prognosis of patients.For unresectable NELM,hepatic intra-arterial therapy is an effective option for controlling tumor progression and relieving symptoms.This therapy mainly includes transcatheter arterial embolization(TAE),transcatheter arterial chemoembolization(TACE),and selective internal radiotherapy(SIRT),and there was no significant difference in the long-term efficacy among the three therapies.Usually,TAE is recommended for patients with low-grade NELM.Conventional TACE may be considered for NELM patients who have poorly differentiated tumor or high hepatic tumor burden(HTB),and drug-eluting beads TACE is not recommended for NELM patients because it has significant hepatobiliary toxicity.SIRT can be adopted for NELM patients having portal vein thrombosis or having a history of biliary bowel surgery.In comprehensive treatment strategies for unresectable NELM,the combination use of hepatic intra-arterial interventional therapy and systemic therapy has already shown its promising prospects.Through reviewing the relevant literature,this paper summarizes the current situation and research progress of NELM.

Objective:To characterize COVID-19-associated skin diseases and explore their influencing factors.Methods:A cross-sectional survey was conducted via the online platform Wenjuanxing in Changsha area from February 16, 2023, to March 16, 2023. The convenience sampling method was employed to conduct a survey of outpatients with a history of COVID-19 infection from the Second Affiliated Hospital of Hunan University of Chinese Medicine, as well as individuals in certain areas of Changsha who met the inclusion criteria for past COVID-19 infections. Demographic characteristics, COVID-19 infection details, and the occurrence of skin conditions after COVID-19 infection were collected. The chi-square test was used for inter-group comparisons of categorical data, and multivariate logistic regression analysis was performed to investigate factors associated with skin diseases following COVID-19 infection.Results:A total of 357 valid questionnaires were collected, and 357 patients with a history of COVID-19 infection were involved, including 246 females (68.9%) and 111 males (31.1%). Among these patients, 260 (72.8%) were aged ≤ 35 years. After COVID-19 infection, skin diseases occurred in 96 patients (26.9%), with urticaria (27 cases, 31.0%), rosacea (27 cases, 31.0%), hair loss (18 cases, 20.7%), and Henoch-Sch?nlein purpura (15 cases, 17.2%) being the most common diseases. Additionally, 96 patients (26.9%) had a history of pre-existing skin diseases, among whom 36 experienced exacerbation of their pre-existing skin diseases due to COVID-19 infection. Univariate analysis showed that gender, history of chronic diseases, history of allergic diseases, COVID-19 vaccination, duration of COVID-19 infection, and exacerbation of pre-existing skin diseases were significantly associated with the development of new skin diseases following COVID-19 infection (all P < 0.05). Multivariate logistic regression analysis revealed that gender (compared with females, males: OR = 0.235, 95% CI: 0.113, 0.490), history of allergic diseases (compared with patients without a history of allergic diseases, those with the history: OR = 2.159, 95% CI: 1.239, 3.761), and duration of COVID-19 infection (compared with the duration of < 5 days, duration of 6 - 7 days: OR = 3.043, 95% CI: 1.495, 6.193; duration of 8 - 14 days: OR = 2.364, 95% CI: 1.105, 5.506; duration of ≥ 15 days: OR = 4.406, 95% CI: 1.972, 9.849) were influencing factors for skin diseases after COVID-19 infection (all P < 0.05) . Conclusions:COVID-19 infection may lead to skin diseases such as urticaria, rosacea, hair loss, and Henoch-Sch?nlein purpura. Females, individuals with a history of allergic diseases, and those with a relatively long duration of COVID-19 infection were more prone to develop skin diseases after COVID-19 infection.

Objective:To explore the clinicopathological characteristics and prognosis of fumarate hydratase-deficient uterine leiomyoma (FH-dUL).Methods:Clinical data and follow-up information for 117 patients with FH-dUL diagnosed through surgical pathology and immunohistochemistry in the First Affiliated Hospital of Nanjing Medical University from January 2020 to December 2024, were collected. A control group of 130 patients with common uterine leiomyomas was also included. The differences between the two groups in clinical, imaging, and pathological characteristics were compared. Additionally, recurrence rates, fertility outcomes for FH-dUL patients, and the incidence of renal cancer in FH germline mutation carriers were monitored.Results:(1) Comparison of clinicopathological characteristics: the median age of 117 FH-dUL patients was 35 years, and the median age at first diagnosis of uterine leiomyomas was 29 years, both significantly younger than the control group (41 and 36 years; both P<0.01). The FH-dUL group showed significantly higher incidences of uterine myomectomy, multiple leiomyomas, diffusion restriction on pelvic magnetic resonance imaging diffusion weighted imaging, and typical pathological features (candelabra-like vessels, bizarre nuclei, cytoplasmic eosinophilic globules, perinuclear halo, cellular atypia) and higher ultrasound blood flow score (all P<0.05). Of the 30 FH-dUL patients who underwent genetic testing, 9 had germline mutations, 3 had somatic mutations, and 6 had mutations of unclear origin. Among the 9 FH gene germline mutation patients, 2 had already developed renal cell carcinoma. (2) Recurrence analysis: among the 56 patients who underwent uterine myomectomy, 22 (39.3%, 22/56) experienced recurrence during follow-up, compared to 12 (21.8%, 12/55) of the 55 patients in the control group, the difference between the two groups was statistically significant ( P=0.046). Multivariate binary logistic regression analysis showed that cellular leiomyomas ( OR=9.489, 95% CI: 1.740-51.755; P=0.009) and multiple uterine leiomyomas ( OR=10.709, 95% CI: 1.354-84.683; P=0.025) were significant risk factors for recurrence in FH-dUL. (3) Fertility analysis: among the 66 FH-dUL patients who underwent fertility-preserving surgery, 16 had the intention to have fertility desire, only 2 (2/16) completed their fertility plans during follow-up. Conclusions:Clinicopathological features and imaging features help to differentiate FH-dUL from common type uterine fibroids, but lack specificity, and the diagnosis of FH-dUL is based on immunohistochemistry. The recurrence rate after resection of FH-dUL is high, and cellular and multiple leiomyomas are important predictors of recurrence. It is crucial to perform genetic testing, genetic counseling, drug treatment to prevent recurrence, fertility guidance, and long-term comprehensive management after surgery for FH-dUL management.

Objective:To characterize COVID-19-associated skin diseases and explore their influencing factors.Methods:A cross-sectional survey was conducted via the online platform Wenjuanxing in Changsha area from February 16, 2023, to March 16, 2023. The convenience sampling method was employed to conduct a survey of outpatients with a history of COVID-19 infection from the Second Affiliated Hospital of Hunan University of Chinese Medicine, as well as individuals in certain areas of Changsha who met the inclusion criteria for past COVID-19 infections. Demographic characteristics, COVID-19 infection details, and the occurrence of skin conditions after COVID-19 infection were collected. The chi-square test was used for inter-group comparisons of categorical data, and multivariate logistic regression analysis was performed to investigate factors associated with skin diseases following COVID-19 infection.Results:A total of 357 valid questionnaires were collected, and 357 patients with a history of COVID-19 infection were involved, including 246 females (68.9%) and 111 males (31.1%). Among these patients, 260 (72.8%) were aged ≤ 35 years. After COVID-19 infection, skin diseases occurred in 96 patients (26.9%), with urticaria (27 cases, 31.0%), rosacea (27 cases, 31.0%), hair loss (18 cases, 20.7%), and Henoch-Sch?nlein purpura (15 cases, 17.2%) being the most common diseases. Additionally, 96 patients (26.9%) had a history of pre-existing skin diseases, among whom 36 experienced exacerbation of their pre-existing skin diseases due to COVID-19 infection. Univariate analysis showed that gender, history of chronic diseases, history of allergic diseases, COVID-19 vaccination, duration of COVID-19 infection, and exacerbation of pre-existing skin diseases were significantly associated with the development of new skin diseases following COVID-19 infection (all P < 0.05). Multivariate logistic regression analysis revealed that gender (compared with females, males: OR = 0.235, 95% CI: 0.113, 0.490), history of allergic diseases (compared with patients without a history of allergic diseases, those with the history: OR = 2.159, 95% CI: 1.239, 3.761), and duration of COVID-19 infection (compared with the duration of < 5 days, duration of 6 - 7 days: OR = 3.043, 95% CI: 1.495, 6.193; duration of 8 - 14 days: OR = 2.364, 95% CI: 1.105, 5.506; duration of ≥ 15 days: OR = 4.406, 95% CI: 1.972, 9.849) were influencing factors for skin diseases after COVID-19 infection (all P < 0.05) . Conclusions:COVID-19 infection may lead to skin diseases such as urticaria, rosacea, hair loss, and Henoch-Sch?nlein purpura. Females, individuals with a history of allergic diseases, and those with a relatively long duration of COVID-19 infection were more prone to develop skin diseases after COVID-19 infection.

Objective: This study examined the gut bacterial communities of dogs from different breeds, all kept under identical domestication conditions. Methods: Noninvasive sampling and 16S rRNA high-throughput sequencing were used to compare the composition and function of the gut microbiota of three dog breeds: the Chinese Kunming dog (CKD), German Shepherd dog (GSD), and Belgian Malinois dog (BMD). Results: The gut microbiota of the three dog breeds consisted of 257 species across 146 genera, 60 families, 35 orders, 15 classes, and 10 phyla. The dominant bacterial phyla across the three breeds were Firmicutes (57.44%), Fusobacteriota (28.86%), and Bacteroidota (7.63%), while the dominant bacterial genera across the three breeds were Peptostreptococcus (21.08%), Fusobacterium (18.50%), Lactobacillus (12.37%), and Cetobacter (10.29%). Further analysis revealed significant differences in the intestinal flora of the three breeds at the phylum and genus levels. The intestinal flora of BMD was significantly richer than that of CKD and GSD. The functional prediction and Kyoto Encyclopedia of Genes and Genomes analysis showed that the primary functions of the gut microbiota in these breeds were similar, with significant enrichment in various metabolic pathways, including carbohydrate and amino acid metabolism, secondary metabolite biosynthesis, and microbial metabolism in different environments. The intestinal flora of these breeds also played a crucial role in genetic information processing, including transcription, translation, replication, and material transport. Conclusions and Relevance: These results provide novel insights into the intestinal flora of intervention dogs and suggest novel methods to improve their health status, which help increase microbial diversity and normalize metabolite production in diseased dogs.

Objective:The Self-Compassion Scale(SCS)is used to evaluate self-compassion in general popu-lation.The study was designed to evaluate the validity and reliability of the Chinese version of SCS in patients with eating disorders.Methods:Ten experts in the related disciplines completed the content validity evaluation.A total of 136 patients who met the Diagnostic and Statistical Manual of Mental Disorders,Fifth Edition(DSM-5)eating dis-order diagnostic criteria were surveyed with SCS to evaluate structural validity.Using the Rosenberg Self-Esteem Scale(SES),Satisfaction with Life Scale(SWLS),and Eating Disorder Examination Questionnaire 6.0(EDE-Q 6.0)as gold criterion,the criterion validity of SCS was measured.Twenty patients were selected for retesting to e-valuate test-retest reliability.Results:The item-level content validity index(I-CVI)of each item was between 0.70 and 1.00,and the average scale-level content validity index(S-CVI/Ave)was 0.96,indicating good content validi-ty.Factor analysis indicated a good fit for the six-factor model with reasonable factor loadings:x2/df=1.70,RM-SEA=0.07,CFI=0.92,TLI=0.91.The Chinese version of the SCS had an ICC of 0.31 with both SES and SWLS,and a negative correlation with EDE-Q 6.0 scores(r=-0.32).The test-retest reliability of the scale was 0.80.Conclusion:The Chinese version of the SCS has moderate validity and high reliability in patients with eating disorders,and can provide a clinical measure tool for psychological assessment in the Chinese population with eating disorders.

Objective: This study examined the gut bacterial communities of dogs from different breeds, all kept under identical domestication conditions. Methods: Noninvasive sampling and 16S rRNA high-throughput sequencing were used to compare the composition and function of the gut microbiota of three dog breeds: the Chinese Kunming dog (CKD), German Shepherd dog (GSD), and Belgian Malinois dog (BMD). Results: The gut microbiota of the three dog breeds consisted of 257 species across 146 genera, 60 families, 35 orders, 15 classes, and 10 phyla. The dominant bacterial phyla across the three breeds were Firmicutes (57.44%), Fusobacteriota (28.86%), and Bacteroidota (7.63%), while the dominant bacterial genera across the three breeds were Peptostreptococcus (21.08%), Fusobacterium (18.50%), Lactobacillus (12.37%), and Cetobacter (10.29%). Further analysis revealed significant differences in the intestinal flora of the three breeds at the phylum and genus levels. The intestinal flora of BMD was significantly richer than that of CKD and GSD. The functional prediction and Kyoto Encyclopedia of Genes and Genomes analysis showed that the primary functions of the gut microbiota in these breeds were similar, with significant enrichment in various metabolic pathways, including carbohydrate and amino acid metabolism, secondary metabolite biosynthesis, and microbial metabolism in different environments. The intestinal flora of these breeds also played a crucial role in genetic information processing, including transcription, translation, replication, and material transport. Conclusions and Relevance: These results provide novel insights into the intestinal flora of intervention dogs and suggest novel methods to improve their health status, which help increase microbial diversity and normalize metabolite production in diseased dogs.

Objective:To assess the feasibility of using the posterosuperior tetralogy (PS-Tetra) score for predicting the prognosis of repair of posterosuperior massive rotator cuff tears.Methods:Data were retrospectively reviewed for patients who underwent repair of posterosuperior massive rotator cuff tears from February 2016 to June 2020. A total of 95 (male 48, female 47) shoulders with an average age of 58.52±8.33 years (range, 27-76 years) were included. The American Shoulder and Elbow Surgeons (ASES) scores and shoulder range of motions (ROM) were used to evaluate shoulder function. MRI was used to assess preoperative fatty infiltration (FI), atrophy, modified Patte's classification, PS-Tetra score and postoperative tendon integrity. The shoulder function was compared between groups of different PS-Tetra scores. The binary logistic regression was used to determine the risk factors of irreparability and retear.Results:83 cases of repair of posterosuperior massive rotator cuff tears were finally included. Complete repairs were performed in 83 cases, and partial repairs were performed in 12 cases. Retear was observed in 17 (20%) cases. The ASES scores (postoperative 58.52±8.33 vs. preoperative 47.30±17.40, t=-19.642, P<0.001), ROM of forward flexion (postoperative 157.60°±13.85° vs. preoperative 116.88°±50.89°, t=-7.272, P<0.001), external rotation (postoperative 45.26°±14.69° vs. preoperative 37.34°±18.65°, t=-4.043, P<0.001) and internal rotation [postoperative L 1 (T 7-buttock) vs. preoperative L 2 (T 7-buttock), Z=-2.737, P=0.006] were significantly improved postoperatively in the group with PS-Tetra score between 0 and 2. In the group with PS-Tetra score of 3 and 4, the ASES scores (postoperative 69.17±15.91 vs. preoperative 46.85±20.73, t=-11.167, P=0.001) were significantly improved postoperatively, while the ROMs were not. Modified Patte stageⅢ[ OR=26.827, 95% CI (2.089, 344.500), P=0.012] was the risk factor of irreparability. Dominant side involvement [ OR=9.407, 95% CI (1.044, 84.784), P=0.046) and PS-Tetra score of 3 and 4 [ OR=5.037, 95% CI (1.028, 26.623), P=0.046] were risk factors of retear. Conclusions:For repair of posterosuperior massive rotator cuff tears, preoperative PS-Tetra score of 3 and 4 was the risk factors of poor postoperative shoulder functions and retear.

Objective: This study examined the gut bacterial communities of dogs from different breeds, all kept under identical domestication conditions. Methods: Noninvasive sampling and 16S rRNA high-throughput sequencing were used to compare the composition and function of the gut microbiota of three dog breeds: the Chinese Kunming dog (CKD), German Shepherd dog (GSD), and Belgian Malinois dog (BMD). Results: The gut microbiota of the three dog breeds consisted of 257 species across 146 genera, 60 families, 35 orders, 15 classes, and 10 phyla. The dominant bacterial phyla across the three breeds were Firmicutes (57.44%), Fusobacteriota (28.86%), and Bacteroidota (7.63%), while the dominant bacterial genera across the three breeds were Peptostreptococcus (21.08%), Fusobacterium (18.50%), Lactobacillus (12.37%), and Cetobacter (10.29%). Further analysis revealed significant differences in the intestinal flora of the three breeds at the phylum and genus levels. The intestinal flora of BMD was significantly richer than that of CKD and GSD. The functional prediction and Kyoto Encyclopedia of Genes and Genomes analysis showed that the primary functions of the gut microbiota in these breeds were similar, with significant enrichment in various metabolic pathways, including carbohydrate and amino acid metabolism, secondary metabolite biosynthesis, and microbial metabolism in different environments. The intestinal flora of these breeds also played a crucial role in genetic information processing, including transcription, translation, replication, and material transport. Conclusions and Relevance: These results provide novel insights into the intestinal flora of intervention dogs and suggest novel methods to improve their health status, which help increase microbial diversity and normalize metabolite production in diseased dogs.