OBJECTIVE To explore the clinical characteristics of cardiotoxicity caused by lidocaine， and provide a reference for the safe use of drug in clinical practice. METHODS Chinese and English search terms， such as “lidocaine”“ cardiotoxicity”， were used to search for literature related to lidocaine-induced cardiac toxicity from CNKI， Wanfang Data， VIP， PubMed and Embase， and conduct descriptive analysis. RESULTS A total of 31 papers were included， with 40 patients. Of the 40 patients， 23 were male and 17 were female； ages ranged from 5 months to 73 years， with 4 patients≤18 years old， 17 patients 19-59 years old， and 19 patients≥60 years old. The main indications for medication were surgical anesthesia （26 cases）， and the main routes of administration were intravenous administration， nerve block anesthesia and local infiltration anesthesia （15， 6， 6 cases）； the dosage of medication for 34 patients complied with the instructions； the most of cardiotoxicity occurred 1 min-1 h after medication （19 cases）， and the main symptoms were bradycardia， atrial conduction slowing， atrioventricular block， sinus arrest， etc. Thirty- four patients improved after resuscitation and symptomatic treatment， and six patients died. CONCLUSIONS Lidocaine-induced cardiotoxicity can occur in all ages， mainly within 1 h after administration， and is manifested as arrhythmia， tachycardia or tachycardia， atrioventricular block， etc.， which is severe. When using it clinically， it is necessary to strengthen pharmaceutical monitoring of medication dosage， administration route， toxic reactions， etc.； when relevant symptoms appear， medication should be stopped promptly and symptomatic treatment should be carried out， to protect the safety of drug use.

OBJECTIVE To explore the clinical characteristics of cardiotoxicity caused by lidocaine， and provide a reference for the safe use of drug in clinical practice. METHODS Chinese and English search terms， such as “lidocaine”“ cardiotoxicity”， were used to search for literature related to lidocaine-induced cardiac toxicity from CNKI， Wanfang Data， VIP， PubMed and Embase， and conduct descriptive analysis. RESULTS A total of 31 papers were included， with 40 patients. Of the 40 patients， 23 were male and 17 were female； ages ranged from 5 months to 73 years， with 4 patients≤18 years old， 17 patients 19-59 years old， and 19 patients≥60 years old. The main indications for medication were surgical anesthesia （26 cases）， and the main routes of administration were intravenous administration， nerve block anesthesia and local infiltration anesthesia （15， 6， 6 cases）； the dosage of medication for 34 patients complied with the instructions； the most of cardiotoxicity occurred 1 min-1 h after medication （19 cases）， and the main symptoms were bradycardia， atrial conduction slowing， atrioventricular block， sinus arrest， etc. Thirty- four patients improved after resuscitation and symptomatic treatment， and six patients died. CONCLUSIONS Lidocaine-induced cardiotoxicity can occur in all ages， mainly within 1 h after administration， and is manifested as arrhythmia， tachycardia or tachycardia， atrioventricular block， etc.， which is severe. When using it clinically， it is necessary to strengthen pharmaceutical monitoring of medication dosage， administration route， toxic reactions， etc.； when relevant symptoms appear， medication should be stopped promptly and symptomatic treatment should be carried out， to protect the safety of drug use.

Objective To investigate the effects of Echinococcus multilocularis infection on levels of memory T (Tm) cells and their subsets in lymph nodes of mice at different stages of infection, so as to provide new insights into immunotherapy for alveolarechinococcosis. MethodsTwenty-four C57BL/6J mice aged 6 to 9 weeks were randomly divided into the infection group and the control group, of 12 mice in each group. Mice in the infection group were administered with 3 000 E. multilocularis protoscoleces via portal venous injection, while animals in the control group were administered with an equal volume of physiological saline. Three mice from each group were sacrificed 4, 12 weeks and 24 weeks post-infection, and lymph nodes were sampled and stained with hematoxylin and eosin (HE) to investigate the histopathological changes of mouse lymph nodes in the infection group. The expression and localization of T lymphocyte surface markers CD3, CD4, and CD8 were observed in mouse lymph nodes using immunohistochemical staining. In addition, lymphocyte suspensions were prepared from mouse lymph nodes in both groups at different time points post-infection, and the levels of Tm cell subsets and their secreted cytokines were detected using flow cytometry. Results HE staining showed diffuse structural alterations in the subcapsular cortical and paracortical regions of mouse lymph nodes in the infection group 4 weeks post-infection with E. multilocularis. Immunohistochemical staining detected CD3, CD4 and CD8 expression in mouse lymph nodes in both groups. Flow cytometry revealed higher proportions of CD4⁺ Tm cells [(55.3 ± 4.8)% vs. (38.8 ± 6.1)%; t = -4.259, P < 0.05] and CD4⁺ tissue-resident Tm (Trm) cells [(57.7 ± 3.7)% vs. (34.1 ± 11.2)%; t = -3.990, P < 0.05] in mouse lymph nodes in the infection group than in the control group 4 weeks post-infection, and higher proportions of CD4⁺ Tm cells [(34.6 ± 3.2)% vs. (23.3 ± 7.5)%; t = -2.764, P < 0.05] and CD4⁺ Trm cells [(44.0 ± 1.9)% vs. (31.2 ± 1.5)%; t = -4.039, P < 0.05] in mouse lymph nodes in the infection group than in the control group 24 weeks post-infection. The proportions of CD8⁺ Tm cells were higher in the infection group than in the control group 4 weeks [(56.8 ± 2.7)% vs. (43.9 ± 5.2)%; t = -4.416, P < 0.01] and 12 weeks post-infection [(25.4 ± 2.7)% vs. (12.0 ± 2.6)%; t = -2.552, P < 0.05], while the proportions of tumor necrosis factor (TNF)-α⁺ CD4⁺ T cells [(15.7 ± 5.0)% vs. (49.4 ± 6.4)%; t = 7.150, P < 0.01], TNF-α⁺CD8⁺ T cells [(20.7 ± 5.5)% vs. (57.5 ± 8.4)%; t = -6.694, P < 0.01], and TNF-α⁺ CD8⁺ Tm cells [7.0% (1.0%) vs. 31.0% (11.0%); Z = -2.236, P < 0.05] were lower in the infection group than in the control group 24 weeks post-infection. Conclusions Tm cells levels are consistently increased in lymph nodes of mice at different stages of E. multilocularis infection, with Trm cells as the predominantly elevated subset. The impaired capacity of CD8⁺ Tm cells to secrete the effector molecule TNF-α in mouse lymph nodes at the late-stage infection may facilitate chronic parasitism of E. multilocularis.

Objective: To compare the clinical efficacy of mini percutaneous nephrolithotomy (mPCNL) and super mini percutaneous nephrolithotomy (SMP) in the treatment of single pediatric renal pelvis stones with CT value ≤ 800 HU，to provide reference for the diagnosis and treatment of children with such low-density stones. Methods: The clinical data of 74 children with single renal pelvis stones (1.0—2.5 cm in size，CT value ≤ 800 HU) treated in our hospital during Jan.2015 and Dec.2021 were retrospectively，with the subjects divided into mPCNL group (n=39) and SMP group (n=35) based on the surgical methods.The operation time，decrease in hemoglobin 2 hours after surgery，hospital stay，stone clearance rate，tubeless rate，and the incidence of complications (fever，mild renal pelvis injury) were compared between the two groups. Results: The operation time [(45.5±20.1) min vs. (59.8±13.6) min，P<0.001] and average hospital stay [(7.1±1.4) d vs.(11.1±2.6) d， P<0.001] were shorter in the SMP group than in the mPCNL group，while the tubeless rate (68.6% vs. 10.3%，P<0.001) was higher.There were no significant differences in the hemoglobin 2 hours after surgery and stone clearance rate at 1 month after surgery between the two groups (P>0.05).No blood transfusion was required in either group.Fever (≥38.5 ℃) occurred in 1 case and mild renal pelvis perforation occurred in 2 cases in the SMP group，while fever occurred in 2 cases and mild renal pelvis perforation occurred in 3 cases in the mPCNL group，with no significant difference between the two groups (8.6% vs.12.8%，P=0.556). Conclusion: The mPCNL and SMP have comparable efficacy in the treatment of single pediatric renal pelvis stones with CT value ≤800 HU，but SMP has advantages of shorter operation time，shorter average hospital stay，and higher tubeless rate.

Objective To investigate the effect of LAG-3 deficiency (LAG3^-/-) on natural killer (NK) cell function and hepatic fibrosis in mice infected with Echinococcus multilocularis. Methods C57BL/6 mice, each weighing (20 ± 2) g, were divided into the LAG3^-/- and wild type (WT) groups, and each mouse in both groups was inoculated with 3 000 E. multilocularis protoscoleces via the hepatic portal vein. Mouse liver and spleen specimens were collected 12 weeks post-infection, sectioned and stained with sirius red, and the hepatic lesions and fibrosis were observed. Mouse hepatic and splenic lymphocytes were isolated, and flow cytometry was performed to detect the proportions of hepatic and splenic NK cells, the expression of CD44, CD25 and CD69 molecules on NK cell surface, and the secretion of interferon γ (IFN-γ), tumor necrosis factor α (TNF-α), interleukin (IL)-4, IL-10 and IL-17A. Results Sirius red staining showed widening of inflammatory cell bands and hyperplasia of fibrotic connective tissues around mouse hepatic lesions, as well as increased deposition of collagen fibers in the LAG3-/-group relative to the WT group. Flow cytometry revealed lower proportions of mouse hepatic (6.29% ± 1.06% vs. 11.91% ± 1.85%, P < 0.000 1) and splenic NK cells (4.44% ± 1.22% vs. 5.85% ± 1.10%, P > 0.05) in the LAG3^-/- group than in the WT group, and the mean fluorescence intensity of CD44 was higher on the surface of mouse hepatic NK cells in the LAG3^-/- group than in the WT group (t = −3.234, P < 0.01), while no significant differences were found in the mean fluorescence intensity of CD25 or CD69 on the surface of mouse hepaticNK cells between the LAG3^-/- and WT groups (both P values > 0.05). There were significant differences between the LAG3^-/- and WT groups in terms of the percentages of IFN-γ (t = −0.723, P > 0.05), TNF-α (t = −0.659, P > 0.05), IL-4 (t = −0.263, P > 0.05), IL-10 (t = −0.455, P > 0.05) or IL-17A secreted by mouse hepatic NK cells (t = 0.091, P > 0.05), and the percentage of IFN-γ secreted by mouse splenic NK cells was higher in the LAG3^-/- group than in the WT group (58.40% ± 1.64% vs. 50.40% ± 4.13%; t = −4.042, P < 0.01); however, there were no significant differences between the two groups in terms of the proportions of TNF-α (t = −1.902, P > 0.05), IL-4 (t = −1.333, P > 0.05), IL-10 (t = −1.356, P > 0.05) or IL-17A secreted by mouse splenic NK cells (t = 0.529, P > 0.05). Conclusions During the course of E. multilocularis infections, LAG3^-/- promotes high-level secretion of IFN-γ by splenic NK cells, which may participate in the reversal the immune function of NK cells, resulting in aggravation of hepatic fibrosis.

Objective To analyze the clinicopathological features of bladder urothelial carcinoma BUC in children and to share the experience of diagnosis and treatment.Methods The clinicopathological data,diagnosis and treatment process of a rare 9-year-old boy with BUC treated in the Second People's Hospital of Kashgar were reported and the literature was reviewed.Results The main clinical symptom is hematuria.Both preoperative urinary ultrasound and CT urography(CTU)identified the tumor,which was then removed with transurethral holmium laser resection under general anesthesia.Postoperative pathology confirmed papillary urothelial neoplasm of low malignant potential(PUNLMP).Epirubicin hydrochloride instillation was administered,and no evidence of recurrence or progress was detected during the 3-month follow-up.Conclusion Bladder urothelial carcinoma in children is extremely rare.The most common symptom is hematuria,and there are no characteristic signs.Urinary ultrasound is the first choice for preoperative imaging,and transurethral resection of the carcinoma results in good recovery.There is no recommendable instillation,and patients need long-term postoperative follow-up.

Hepatocellular carcinoma(HCC),commonly known as primary liver cancer,is a major cause of malignant tumors and cancer-related deaths in China,accounting for approximately 85％of all cancer cases in the country.Several guidelines have been used to diagnose and treat liver cancer.However,these guidelines provide a broad definition for classifying advanced liver cancer,with an emphasis on a singular approach,without considering treatment options for individual patients.Therefore,it is necessary to establish a comprehensive and practical expert consensus,specifically for China,to enhance the diagnosis and treatment of HCC using the Delphi method.The classification criteria were refined for Chinese patients with HCC,and the corresponding optimal treatment regimen recommendations were developed.These recommendations took into account various factors,including tumor characteristics,vascular tumor thrombus grade,distant metastasis,liver function status,portal hypertension,and the hepatitis B virus replication status of patients with primary HCC,along with treatment prognosis.The findings and rec-ommendations provide detailed,scientific,and reasonable individualized diagnosis and treatment strategies for clinicians.

Objective To study the serum expression of interleukin-36α(IL-36α),C1q/tumor necrosis factor-related protein 6(CTRP6)levels in patients with polycystic ovary syndrome(PCOS)and their diagnostic value.Methods A total of 98 PCOS patients diagnosed and treated in the Fifth Affiliated Hospital of Xinjiang Medical University from April 2019 to April 2022 were taken as the PCOS group,and 70 healthy women were taken as the control group.Enzyme-linked immunosorbent assay was applied to detect serum IL-36 α and CTRP6 level expression.The correlation between the expression of serum IL-36 α,CTRP6 levels and clinical indicators was analyzed by Pearson correlation analysis.Multivariate logistic regression analysis was used to analyze factors affecting the occurrence of PCOS.Receiver operating characteristic curve was used to evaluate the diagnostic efficacy of serum IL-36α,CTRP6 and combination in PCOS.Results Serum CTRP6(18.25±3.67μg/L),FPG(5.71±0.49nmol/L),FINS(18.96±2.68mIU/L),HOMA-IR(4.72±0.46),LH(6.17±1.44IU/L),T(1.32±0.42nmol/L),ovarian number(17.86±5.20)and ovarian volume(9.29±2.14cm3)in the PCOS group were higher,while serum IL-36 α(0.67±0.13ng/L)and FSH((4.27±1.33IU/L)were lower compared with those in the control group(5.14±1.28μg/L,4.76±0.54mmol/L,8.63±1.65mIU/L,1.83±0.33,4.92±1.39IU/L,0.86±0.28nmol/L,6.76±1.94 个,5.26±1.31cm3,2.11±0.38ng/L,5.42±1.67IU/L),with significant differences(t/x2=4.962～44.934,all P<0.05).Serum IL-36α(0.87±0.15ng/L,0.70±0.12ng/L,0.51±0.11ng/L,0.42±0.10ng/L)levels in patients with type 1,type 2,type 3,and type 4 PCOS were decreased sequentially,while CTRP6(14.07±3.35 μg/L,17.66±3.97 μg/L,21.16±3.67 μg/L,24.08±3.53 μg/L)were increased sequentially,with significant differences(F=61.281,33.854,all P<0.05).There was a negative correlation between serum IL-36 α and ovarian number,ovarian volume,FINS and HOMA-IR(r=-0.661,-0.621,-0.554,-0.671,all P<0.05).Serum CTRP6 was positively correlated with ovarian number,ovarian volume,FINS and HOMA-IR(r=0.625,0.631,0.537,0.738,all P<0.05).CTRP6(OR=1.327,95%CI:1.104～1.596)was an independent risk factor affecting the occurrence of PCOS,while IL-36 α(OR=0.707,95%CI:0.547～0.914)was a protective factor.The area under the curve(95%CI)of combination of IL-36 α and CTRP6 for the diagnosis of PCOS was 0.933(0.872～0.969),which was greater than that of IL-36 α,CTRP6 alone[0.870(0.821～0.926),0.898(0.854～0.940)],with significant differences(Z=4.258,4.119,all P<0.05).Conclusion The decrease of serum IL-36α and the increase of CTRP6 in PCOS patients are related to the severity of PCOS,and the combined detection of the two may have high diagnostic value for PCOS.

This study was aimed at investigating the effect of lymphocyte activation gene-3(LAG3)on liver B lymphocyte subsets and their functions in WT and LAG3-KO mice infected with Echinococcus multilocularis(E.multilocularis).In a mouse model of E.multilocularis infection,the expression and localization of CD19 and α-SMA in liver were detected by immu nohistochemistry.CD80,CD86 and MHC-Ⅱ molecules expressed on B cells and their subsets in mice liver were detected by flow cytometry.After 12 weeks of infection,the area and percentage of CD19 in LAG3-KO group was slightly higher than that in WT group,but the difference was not statistically(t=-1.241、-1.237,P＞0.05).The area and percentage of a-SMA in LAG3-KO group was higher than that in WT group(t=-3.224、-3.227,P＜0.05).The proportion of CD80 and MHC-Ⅱ molecules expressed on liver B cells in LAG3-KO group was up-regulated(t=-2.379,-3.321,P＜0.05).The percentage of liver B2 cells in LAG3-KO group was higher than that in WT group(t=-2.695,P＜0.05).The expression of CD80 on Blb cells in LAG3-KO group was significantly up-regulated(t=-5.315,P＜0.001).The proportion of CD80 of B2 cells in LAG3-KO group was lower than that in WT group(t=2.806,P＜0.05).The expression of MHC-Ⅱ molecule in B2 cells in LAG3-KO group was up-regulated(t=-4.227,P＜0.01).It is suggested that LAG3 molecules affected the B cell subsets and func-tion of mouse liver in the middle stage of E.multilocularis infection,especially B2 lymphocytes.LAG3 molecule exerted an in-hibitory effect on the activation of B cells and the expression of MHC-class Ⅱ molecules,suggesting that it may be involved in B cell exhaustion caused by E.multilocularis.

Objective:To investigate the correlation between neutrophil to lymphocyte ratio (NLR), D-dimer, residual lipoprotein cholesterol (RLP-C) levels and the occurrence and severity of acute myocardial infarction in young adults.Methods:A total of 96 young patients with acute myocardial infarction who visited the First People′s Hospital of Kashgar from June 2020 to June 2022 were retrospectively selected as the observation group, and 100 healthy volunteers who underwent physical examinations at our hospital during the same period were selected as the control group. The serum NLR, D-dimer, and RLP-C levels of the two groups of patients were compared. Coronary angiography was performed on the patients, and the observation group patients were divided into mild stenosis, moderate stenosis, and severe stenosis subgroups based on their Gensini scores. The serum NLR, D-dimer, and RLP-C levels of patients in different subgroups were recorded and compared. Pearson correlation analysis was used to determine the correlation between serum NLR, D-dimer, and RLP-C levels and patients′ Gensini scores. The diagnostic value of NLR, D-dimer, and RLP-C levels in young patients with acute myocardial infarction and severe coronary artery stenosis was explored using receiver operating characteristic (ROC) curves.Results:The levels of NLR, D-dimer, and RLP-C in the observation group were significantly higher than those in the control group (all P<0.05). The ROC curve analysis results showed that the area under the curve (AUC) for diagnosing acute myocardial infarction in young patients with NLR, D-dimer, and RLP-C were 0.942, 0.865, and 0.970, respectively (all P<0.05). The levels of NLR, D-dimer, and RLP-C in patients with severe stenosis were higher than those in patients with mild to moderate stenosis (all P<0.05). Pearson correlation analysis showed that the levels of NLR, D-dimer, RLP-C in young patients with acute myocardial infarction were positively correlated with Gensini score ( r=0.806, 0.843, 0.851, all P<0.001). The ROC curve analysis results showed that the AUC values of NLR, D-dimer, and RLP-C levels for diagnosing severe coronary artery stenosis in young patients with acute myocardial infarction were 0.915, 0.874, and 0.922, respectively (all P<0.05). Conclusions:The levels of NLR, D-dimer, and RLP-C are elevated in young patients with acute myocardial infarction, and are positively correlated with the severity of the disease. Clinical attention should be closely monitored.