Objective: To explore the clinical and pathological characteristics, diagnosis, and differential diagnosis of oral verruciform xanthoma, and to provide a reference for accurate clinical identification and treatment. Methods: Two cases of verruciform xanthoma occurring on the gingiva and vestibular mucosa are reported. The clinical features and pathological characteristics of both cases are described in detail, and information from a literature review on verruciform xanthoma is provided. Results: Case 1: a 37-year-old female patient presented with a pink, rough lesion on the gingiva of the right mandibular posterior teeth for one month. The lesion measured approximately 14 mm × 7 mm, and it was firm and painless. After periodontal therapy, the lesion was excised under local anesthesia. Postoperative pathological examination showed that the epithelial nail protruded and was elongated, and a large number of foam cells filled the connective tissue papilla, leading to the diagnosis of verrucous xanthoma. Case 2: a 36-year-old male patient presented with a pale pink lesion on the right lower vestibular mucosa for three months. The lesion measured approximately 18 mm × 10 mm with irregular margins, and it was firm and painless. The lesion was excised under local anesthesia, and postoperative pathological examination showed parateratosis of epithelium, hypertrophy and elongation of the nail process, and more foam cells in the lamina propria papilla area. The diagnosis was xanthoma verrucosa. The results of a literature review show that the incidence of verruciform xanthoma is 0.025%-0.094%, it primarily occurs in patients aged 50-70 years, the incidence in males is slightly higher than that in females, and it primarily occurs in areas of the oral cavity that include the hard palate and gums. It is generally non-invasive. The etiology and pathogenesis remain unclear. Clinically, verruciform xanthoma lacks specific characteristics, so these lesions are frequently misdiagnosed as other conditions, such as papilloma, common warts, condyloma acuminatum, squamous cell carcinoma, or verrucous carcinoma. The key to diagnosis lies in histopathology, with the hallmark feature being the accumulation of foam cells in the connective tissue papilla beneath the epithelium. Conclusion Verruciform xanthoma is a rare oral mucosal lesion with non-specific clinical manifestations and a high rate of misdiagnosis. It must be differentiated from conditions that include squamous papilloma, common warts, condyloma acuminatum, squamous cell carcinoma, and verrucous carcinoma. Definitive diagnosis depends on histopathological examination, and the primary treatment is surgical excision, with a low recurrence rate and minimal risk of malignant transformation.

Objective: To analyze the epidemiological characteristics of leptospirosis in Jinhua City, Zhejiang Province, from 2007 to 2024, so as to provide a basis for improving the prevention and control strategies of leptospirosis. Methods: Data pertaining to leptospirosis cases in Jinhua City from 2007 to 2024 were collected through the Monitoring and Reporting Management System of the Chinese Disease Prevention and Control Information System. Descriptive epidemiological methods were used to analyze the distribution characteristics of leptospirosis in terms of time, region, population, interval from the onset of the disease to diagnosis and the outbreak of the epidemic. Results: A total of 81 cases of leptospirosis were reported in Jinhua City from 2007 to 2024, with an average annual reported incidence of 0.08/100 000. The peak incidence occurred from August to September, with 57 cases accounting for 70.37%. Leptospirosis cases were reported in 9 counties (cities, districts) in Jinhua City. Pan'an County reported the most cases, with 52 cases accounting for 64.20%. There were 54 male cases and 27 female cases, with a male-to-female ratio of 2∶1. The majority of cases were aged over 40 years, with 73 cases accounting for 90.12%. The average reported incidence of leptospirosis showed an upward trend with the increase of age (P<0.05), and the highest incidence of leptospirosis was at the 60-<80 age group (0.21/100 000). The majority of patients were farmers, with 77 cases accounting for 95.06%. The median interval from onset to diagnosis was 4.00 (interquartile range, 6.00) days. There were significant differences in the interval from onset to diagnosis among cases in Dongyang City compared with Pan'an County, Wuyi County, and Wucheng District, between Pan'an County and Jindong District, Wucheng District, and between Wuyi County and Wucheng District (all P<0.05). In 2007, one outbreak of leptospirosis was reported, which occurred in Jiuhe Township, Pan'an County, with 36 reported cases. Conclusions The reported incidence of leptospirosis in Jinhua City from 2007 to 2024 is generally low. The high-incidence period is from August to September, and Pan'an County is the high-incidence area. Males over 40 years and farmers are the key populations for prevention and control. It is recommended to strengthen epidemic surveillance and health education for high-risk populations.

Objective To evaluate the diagnostic value of myocardial work related parameters in coronary ischemia patients with coronary artery disease(CAD)coronary ischemia using non-invasive left ventricular pressure strain loop(PSL),taking fraction flow reservation(FFR)as the gold standard.Methods From December 2020 to December 2021,53 clinically suspected CAD patients were prospectively enrolled.All patients underwent echocardiography,invasive coronary angiography and FFR measurement.According to the results of coronary angiography,patients were divided into myocardial ischemia group(n=24,FFR≤0.80)and non-myocardial ischemia group(n=29,FFR＞0.80).PSL was used for off-line analysis to obtain the global work index(GWI),global constructive work(GCW),global wasted work(GWW),global work efficiency(GWE),global positive work(GPW),and global systolic constructive work(GSCW)and other myocardial work parameters.The differences of parameter values between the two groups were compared.The diagnostic efficacy of work parameters in myocardial ischemia was analyzed by ROC curve.Results Compared with the non-myocardial ischemia group,GWI,GCW,GPW and GSCW were significantly decreased in the myocardial ischemia group at the 18-,16-,and 12-segment levels(P＜0.001).The ROC curve showed that the AUC results of GWI,GCW,GPW,GSCW at the 18-segment level were 0.803(95％CI 0.679-0.927),0.807(95％CI 0.687-0.928),0.822(95％CI 0.708-0.936),0.819(95％CI 0.703-0.935).The optimal cut-off value of GWI was 1 676.3 mmHg％,and the sensitivity,specificity and accuracy of predicting myocardial ischemia were 70.8％,86.2％and 79.2％,respectively.The optimal cut-off value of GCW was 1 999.4 mmHg％,and the sensitivity,specificity and accuracy of predicting myocardial ischemia were 75.0％,82.8％and 79.2％,respectively.Conclusions Analyzing myocardial work using PSL has good significance for screening suspected myocardial ischemia in CAD patients.

Objective:To offset the shortage of traditional large-scale population surveillance and provide early-warning signals in the early stage of the outbreak of COVID-19, people in Chongqing had carried out severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) monitoring since 2023.Methods:After COVID-19 was managed with measures against Class B infectious diseases, we selected five sewage treatment plants with automatic sample collection facilities in four districts of the main city. Two samples of sewage from each sewage treatment plant were collected every week. Then SARS-CoV-2 from these samples was concentrated by aluminum hydroxide adsorption-precipitation, detected and analyzed by multiple real-time fluorescent RT-PCR.Results:From January 16 to December 31 of 2023, a total of 496 sewage samples were monitored, of which 285 samples were positive by SARS-CoV-2 nucleic acid assay, with a total detection rate of 57.46%. The detection rate of SARS-CoV-2 in weeks 3-5, 18-21 and 40-47 was 100.00%. The daily mean nucleic acid concentration of SARS-CoV-2 in sewage peaked in the 18th week, and then began to decline, entering a low level and fluctuated in epidemic period. The variable trend of daily mean concentration of SARS-CoV-2 nucleic acid was basically consistent with daily number of SARS-CoV-2 infected patients or SARS-CoV-2 positive rate in fever clinic counted by infectious disease monitoring system.Conclusions:The detection rate of SARS-CoV-2 in sewage of Chongqing is relatively high, especially in April to May, and sewage monitoring can indirectly reflect the status of COVID-19 infection.

A purified polysaccharide with a galactose backbone(SPR-1,Mw 3,622 Da)was isolated from processed Polygonati Rhizoma with black beans(PRWB)and characterized its chemical properties.The backbone of SPR-1 consisted of[(4)-β-D-Galp-(1]9→ 4,6)-β-D-Galp-(1 → 4)-α-D-GalpA-(1 → 4)-α-D-GalpA-(1 →4)-α-D-Glcp-(1 → 4,6)-α-D-Glcp-(1 → 4)-α/β-D-Glcp,with a branch chain of R1:β-D-Galp-(1 → 3)-β-D-Galp-(1 → connected to the →4,6)-β-D-Galp-(1 → via O-6,and a branch chain of R2:α-D-Glcp-(1 →6)-α-D-Glcp-(1 → connected to the →4,6)-α-D-Glcp-(1 → via O-6.Immunomodulatory assays showed that the SPR-1 significantly activated macrophages,and increased secretion of NO and cytokines(i.e.,IL-1β and TNF-α),as well as promoted the phagocytic activities of cells.Furthermore,isothermal titration calorimetry(ITC)analysis and molecular docking results indicated high-affinity binding between SPR-1 and MD2 with the equilibrium dissociation constant(KD)of 18.8 μM.It was suggested that SPR-1 activated the immune response through Toll-like receptor 4(TLR4)signaling and downstream responses.Our research demon-strated that the SPR-1 has a promising candidate from PRWB for the TLR4 agonist to induce immune response,and also provided an easily accessible way that can be used for PR deep processing.

Objective To analyze the current situation of depressive symptoms among medical staff in Beijing City and its correlation with symptoms of anxiety, occupational stress and insomnia. Methods A total of 2 687 medical staff from 28 medical institutions in eight municipal districts of Beijing City were selected as study subjects using multi-stage sampling method. The basic situation, depression symptoms, anxiety symptoms, occupational stress and insomnia symptoms were investigated using the National Occupational Health Literacy Monitoring Questionnaire for Key Groups, Patient Health Questionaire-9, 7-item Generalized Anxiety Disorder Scale, Core Occupational Stress Scale, and Self-Sleep Management Questionnaire. Results The detection rate of depressive symptoms was 28.3%, and the detection rates of moderate, moderate-severe and severe depressive symptoms were 18.9%, 6.9% and 2.5%, respectively. The detection rate of anxiety symptoms was 41.3%, and the detection rates of mild, moderate and severe anxiety symptoms were 29.7%, 7.7% and 3.9%, respectively. The detection rate of occupational stress was 26.7%. The detection rate of insomnia symptoms was 36.6%. The results of multivariate logistic regression analysis showed that the risk of depressive symptoms in male medical staff was higher than that in female (P<0.05). The risk of depressive symptoms in night shift staff was higher than that in staff without night shift (P<0.05). The more severe the anxiety symptoms, the higher the risk of depressive symptoms (all P<0.01). The risk of depressive symptoms in medical staff with occupational stress was higher than those without occupational stress (P<0.01). The risk of depressive symptoms in medical staff with insomnia symptoms was higher than those without insomnia symptoms (P<0.01). Conclusion The detection rate of depressive symptoms among medical staff in Beijing City is relatively high. Gender, night shift, anxiety symptoms, occupational stress, and insomnia symptoms were independent risk factors of depressive symptoms.

Objective To investigate the difference of matrix stiffness in different regions of tibial plateau in osteoarthritis (OA) and its effects on morphology of the cartilage and mitochondria. Methods The tibial plateau cartilage specimens of OA were obtained for nanoindentation test, transmission electron microscopy and histological analysis. The stiffness of cartilage matrix in different regions of OA tibial plateau was detected by nano-indentation. The morphology of cartilage mitochondria in different regions was observed by transmission electron microscopy, and the changes of mitochondrial plane area, shape and ridge volume density were quantitatively analyzed. Cartilage injury in different regions of OA tibial plateau was observed by histological staining. Results The cartilage of OA tibial plateau showed regional heterogeneity, and the cartilage and mitochondria on medial side of varus knee OA were more severe, and the matrix stiffness was higher. The OA scores were positively correlated with matrix stiffness. There was also a significant correlation between OA scores and mitochondrial morphology: the higher OA scores, the larger and rounder mitochondrial plane area, and the lower cristae volume density. Conclusions The differences of tibial plateau revealed the correlation between cartilage matrix stiffness, OA scores and mitochondrial morphological parameters. The increased cartilage matrix stiffness may be the main cause of chondrocyte mitochondrial injury, and further aggravate the progression of OA.

With the multi-directional differentiation potential such as osteogenic differentiation, chondrogenic differentiation and adipogenic differentiation, mesenchymal stem cells (MSCs) have been widely used in basic research and clinical applications. The differentiation potential of MSCs is altered during senescence. Osteogenic differentiation potential decreases, while the lipogenic differentiation potential increases in aging MSCs. Changes in differentiation potential of MSCs during senescence are accompanied with cell physical heterogeneity variation (cell size, cell stiffness and nucleoplasmic ratio). Studies have shown that changes in physical heterogeneity of stem cells may be a key factor leading to the differences in differentiation potential of MSCs. Therefore, studies on physical heterogeneity variation of MSCs during senescence will provide a new research direction in fate prediction of stem cell. In this review, the effects of physical heterogeneity variation on differentiation potential of MSCs were summarized, and the corresponding mechanism was also discussed.

Objective:To evaluate the intelligent performance measurement system for colonoscopy.Methods:Nine endoscopists from Renmin Hospital of Wuhan University were randomly assigned to the quality control group and the control group based on inclusion and exclusion criteria by the random number table. In the pre-quality-control stage (from April 20, 2019 to May 30, 2019), colonoscopic data acquired by the enrolled endoscopists were collected. In the training stage (June 1-30, 2019), the quality control group was trained on the quality control knowledge and the use of intelligent gastrointestinal endoscopy performance measurement system; but the control group was only trained on the quality control knowledge.In the post-quality-control stage (from July 1, 2019 to August 20, 2019), a weekly quality feedback was given to endoscopists of the quality control group, while the endoscopists of the control group had no quality control report.Then, the colonoscopic data acquired by enrolled endoscopists were prospectively collected during the period. The primary endpoint was adenoma detection rate. The secondary endpoints were withdrawal time, polyp detection rate and cecal intubation rate.Results:Four endoscopists were assigned to the quality control group and five to the control group. A total of 1 471 colonoscopic procedures were analyzed. The detection rates of adenoma and polyp in the quality control group increased with feedbacks[13.7% (45/329) VS 7.1% (24/338), χ2=55.796, P<0.001; 48.9% (161/329) VS 40.2% (136/338), χ2=4.071, P=0.044], while there were no significant differences in the control group [9.3% (37/398) VS 9.1% (37/406), χ2=0.329, P=0.566; 33.9% (135/398) VS 33.0% (134/496), χ2=3.616, P=0.057]. The withdrawal time in the quality control group increased with feedbacks[5.9 (3.9, 7.3) min VS 4.1 (2.8, 6.1) min, Z=6.965, P<0.001], while there was no significant difference in this variable in the control group [3.9 (2.7, 6.1) min VS 3.6 (2.6, 5.8) min, Z=1.355, P=0.175]. Conclusion:The intelligent performance measurement system for gastrointestinal endoscopy with feedbacks can monitor and improve the colonoscopic quality.

Objective:To study the risk factors of hypotension after ligation of patent ductus arteriosus (PDA) in very/extremely low birth weight infants (VLBWI/ELBWI).Method:From March 2016 to January 2021, preterm infants with birth weight <1 500 g receiving bedside PDA ligation in the neonatal intensive care unit (NICU) of our hospital were enrolled in the study. According to the occurrence of hypotension within 72 hours after ligation, the infants were assigned into non-hypotension group and hypotension group. The general status and perioperative conditions of the two groups were analyzed. Multivariate Logistic regression was used to analyze the risk factors of hypotension.Result:A total of 44 cases were enrolled, including 33 in non-hypotension group and 11 in hypotension group. Univariate analysis showed that hypotension group had significantly more cases with body weight <1 100 g during surgery and receiving preoperative high frequency oscillatory ventilation (HFOV) than non-hypotension group ( P<0.05). Multivariate Logistic regression analysis showed that weight <1 100 g during surgery ( OR=12.045, 95% CI 1.351~107.394, P=0.026) and receiving preoperative HFOV ( OR=27.832, 95% CI 1.363~568.292, P=0.031)were independent risk factors of hypotension. Conclusion:Hypotension is one of the common complications of PDA ligation in VLBWI/ELBWI. The infant's body weight during ligation and receiving preoperative HFOV are independent risk factors of hypotension.