Microwave thermochemotherapy (MTC) has been applied to treat lip squamous cell carcinoma (LSCC), but a deeper understanding of its therapeutic mechanisms and molecular biology is needed. To address this, we used single-cell transcriptomics (scRNA-seq) and spatial transcriptomics (ST) to highlight the pivotal role of tumor-associated neutrophils (TANs) among tumor-infiltrating immune cells and their therapeutic response to MTC. MNDA⁺ TANs with anti-tumor activity (N1-phenotype) are found to be abundantly infiltrated by MTC with benefit of increased blood perfusion, and these TANs are characterized by enhanced cytotoxicity, ameliorated hypoxia, and upregulated IL1B, activating T&NK cells and fibroblasts via IL1B-IL1R. In this highly anti-tumor immunogenic and hypoxia-reversed microenvironment under MTC, fibroblasts accumulated in the tumor front (TF) can recruit N1-TANs via CXCL2-CXCR2 and clear N2-TANs (pro-tumor phenotype) via CXCL12-CXCR4, which results in the aggregation of N1-TANs and extracellular matrix (ECM) deposition. In addition, we construct an N1-TANs marker, MX2, which positively correlates with better prognosis in LSCC patients, and employ deep learning techniques to predict expression of MX2 from hematoxylin-eosin (H&E)-stained images so as to conveniently guide decision making in clinical practice. Collectively, our findings demonstrate that the N1-TANs/fibroblasts defense wall formed in response to MTC effectively combat LSCC.
Humans ; Neutrophils/metabolism* ; Single-Cell Analysis ; Lip Neoplasms/genetics* ; Hyperthermia, Induced/methods* ; Microwaves/therapeutic use* ; Transcriptome ; Carcinoma, Squamous Cell/immunology* ; Tumor Microenvironment

Pulmonary arterial hypertension (PAH) is an abnormal remodeling of the pulmonary vascular wall due to various causes, resulting in severe cardiovascular disease characterized by increased pulmonary vascular resistance and pressure. The mortality and morbidity of pregnant women with PAH are extremely high. This article reports a woman with severe PAH associated with connective tissue disease who developed cardiac arrest, PAH crisis, and right heart failure during her two consecutive pregnancies without regular prenatal examination. After multidisciplinary consultation and extracorporeal membrane oxygenation, effective cardiopulmonary support was timely, and the patient was finally discharged from the hospital in stable condition. After ten months of follow-up, the mother and child both had good outcomes. Although the mother and her child were survived, severe PAH is a contraindication for pregnancy due to its severely harmful effect on endangering maternal and fetal health.

Objective:To analyze the current situation and influencing factors of rectus abdominis muscle separation in postpartum women.Methods:The clinical data of 3 368 postpartum women who underwent postpartum physical examination in Shenzhen Longgang maternal and child health hospital from June to October 2020 were retrospectively analyzed. The general data, rectus abdominis separation and pelvic organ prolapse were collected for cross-sectional investigation.Results:The incidence of rectus abdominis separation in postpartum women was 60.7% (2 045/3 368). <30 years old, ≥30 years old (56.8% (856/1 507) and 63.9% (1 189/1 861), χ2=17.54)). The increase of body mass during pregnancy was <16 kg, ≥16 kg (59.1% (1 351/2 285) and 64.1% (694/1 083), χ2=7.57)). Spontaneous labor and cesarean section (55.7% (1 262/2 266) and 71.7% (790/1 102), χ2=77.87)). Pregnancy 1, 2, ≥3 times (53.9% (645/1 196), 62.1% (702/1 131) and 67.1% (698/1 041), χ2=41.48). Production for 1, 2, ≥3 times (53.9% (877/1 628), 67.0% (1 016/1 517) and 68.2% (151/223), χ2=62.09)). History of macrosomia (68.7% (160/233) and 60.1% (1 885/3 135), χ2=6.64)). Prolapse of anterior vaginal wall (75.2% (1 559/2 072) and 37.5% (486/1 296), χ2=476.15), there were significant differences in the incidence of rectus abdominis separation (all P<0.05). Logistic regression analysis showed that ≥ 3 times pregnancies ( OR=1.572,95% CI=1.270-1.945),cesarean section ( OR=2.440,95% CI=2.050-2.905),macrosomia ( OR=1.660,95% CI=1.213-2.273), anterior vaginal prolapse( OR=7.324,95% CI=6.083-8.819) were risk factors of diastasis recti abdominis (all P<0.05). Conclusions:The incidence of rectus abdominis separation in postpartum women is high. Three or more pregnancies, cesarean section, history of macrosomia and prolapse of anterior vaginal wall play an important role in the occurrence of rectus abdominis separation.

Background: and Purpose Patients presenting with clinical characteristics that are strongly suggestive of neuromyelitis optica spectrum disorders (NMOSD) have a high risk of developing definite NMOSD in the future. Little is known about the clinical course, treatment, and prognosis of these patients with likely NMOSD at disease onset. Methods: This study prospectively recruited and visited 24 patients with the limited form of NMOSD (LF-NMOSD) at disease onset from November 2012 to June 2021. Their demographics, clinical course, longitudinal aquaporin-4 immunoglobulin G (AQP4-IgG) serology, MRI, therapeutic management, and outcome data were collected and analyzed. Results: The onset age of the cohort was 38.1±12.0 years (mean±standard deviation). The median disease duration was 73.5 months (interquartile range=44.3–117.0 months), and the follow-up period was 54.2±23.8 months. At the end of the last visit, the final diagnosis was categorized into AQP4-IgG-seronegative NMOSD (n=16, 66.7%), AQP4-IgG-seropositive NMOSD (n=7, 29.2%), or multiple sclerosis (n=1, 4.2%). Seven of the 24 patients (29.2%) experienced conversion to AQP4-IgG seropositivity, and the interval from onset to this serological conversion was 37.9±21.9 months. Isolated/mixed area postrema syndrome (APS) was the predominant onset phenotype (37.5%). The patients with isolated/mixed APS onset showed a predilection for conversion to AQP4-IgG seropositivity. All patients experienced a multiphasic disease course, with immunosuppressive therapy reducing the incidence rates of clinical relapse and residual functional disability. Conclusions Definite NMOSD may be preceded by LF-NMOSD, particularly isolated/ mixed APS. Intensive long-term follow-up and attack-prevention immunotherapeutic management is recommended in patients with LF-NMOSD.

Objective:To analyze the body composition and determinants of gestational diabetes mellitus(GDM), so that to provide basic data for prevent and control GDM further.Methods:All 1 553 pregnant women with GDM (GDM group) at 24-28 weeks of gestation were selected, and 1 298 pregnant women with normal glucose tolerance (NGT) at the same pregnancy were taken as the control group. The general data, body composition test data and 75 g oral glucose tolerance test results of the two groups were collected for statistical analysis. T-test was used for comparison between normal distribution measurement data groups, and counting data were compared χ 2 inspection. Results:The age of GDM group (31.30±4.63) years, the body mass index before pregnancy (21.78±3.11) kg/m 2, and the proportion of body fat content (30.77±5.26)% were all higher than that of NGT Group ((28.42±4.01) years, (20.74±3.04) kg/m 2, (27.76±5.56)%). The proportion of water content (50.46±4.11)%, protein content (13.91±1.27)%, and inorganic salt content (4.90±1.99)%, were lower than that of NGT Group ((52.11±3.97)%, (14.47±1.18)%, (5.71±2.26)%), and there were significant differences between the two groups (t values were 17.84, 9.03, 6.41, 8.67, 7.14 and 5.94, respectively; all P<0.001). The detection rates of advanced age 25.4%(394/1 553), family history of diabetes 23.1%(359/1 553), history of GDM 4.3%(67/1 553), history of polycystic ovary syndrome 0.6%(9/1 553) in GDM group were higher than those in NGT group (7.4%(96/1 298), 11.4%(148/1 298), 0.3%(4/1 298), 0.1%(1/1 298)). There were statistically significant differences between the two groups(χ 2 values were 160.49, 66.36, 46.73 and 5.11, respectively; all P<0.05). The proportion of lean, normal, overweight and obese people in GDM group was 11.5%(179/1 553), 65.8%(1 022/1 553), 18.5%(287/1 553), 4.2%(65/1 553), and 22.6%(293/1 298), 63.0%(818/1 298), 11.4%(148/1 298), 3.0%(39/1 298), respectively. The body fat content in GDM group was 1.9%(30/1 553), 45.5%(707/1 553), 52.6%(817/1 553), and 8.1%(105/1 298), 54.0%(701/1 298), and 37.9%(492/1 298), respectively. The protein content in GDM group was 95.9%(1 489/1 553), 4.1%(64/1 553), 0(0/1 553), and 89.5%(1 162/1 298), 10.5%(136/1 298), 0(0/1 298), respectively. The low, normal and high water content in GDM group were 36.3%(564/1 553), 54.3%(843/1 553), 9.4%(146/1 553), and 22.5%(292/1 298), 58.8%(763/1 298), 18.7%(243/1 298), respectively. There were statistically significant differences in the overall distribution of body mass index before pregnancy and the contents of body water, body fat and protein between the two groups (statistical values were 78.89, 100.21, 43.80 and 92.54, all P<0.001). Logistic analysis showed that old age ( OR=3.462, 95% CI=2.737-4.380), overweight before pregnancy ( OR=1.296, 95% CI=1.031-1.628), family history of diabetes ( OR=2.061, 95% CI=1.676-2.535), history of GDM ( OR=12.688, 95% CI=4.577-35.169), high body fat content ( OR=1.607, 95% CI=1.234-2.092), low water content ( OR=1.493, 95% CI=1.025-2.175) were the risk factors of GDM (all P<0.05). Low body fat content ( OR=0.341, 95% CI=0.151-0.768) was the protective factor of GDM ( P<0.05). Conclusions:In addition to the traditional risk factors such as body mass index before pregnancy, old age, family history of diabetes, and history of GDM, the contents of body water and body fat also played an important role in the occurrence of GDM.

Objective:To explore the clinical application value of group A Streptococcus (GAS) antigen rapid detection method in children suffering from GAS infection.Methods:A total of 44 733 children with suspected GAS infection who were admitted to the Outpatient and Inpatient Departments of Shenzhen Children′s Hospital from January 2015 to December 2019.Throat swab specimens from all children were collected, and BinaxNOW Strep A Test reagent was used for GAS antigen rapid detection.Among them, the throat swabs of 346 children were inoculated with blood culture medium for traditional bacterial culture, and then the GAS antigen rapid detection was tested.The sensitivity and specificity of the two methods were compared, and according to the result of the GAS antigen rapid detection, its age, gender and seasonal trends were analyzed.SPSS 19.0 software was applied for statistical analysis of the data.Results:Among the 346 children tested by both methods, the results of bacterial culture were adopted as the reference method, the sensitivity of the rapid detection method for GAS antigen was 89.41%(152/170 cases), and the specificity was 94.32%(166/176 cases) compared with culture methods.A total of 44 733 cases GAS antigen were tested in children in Shenzhen, of which 10 024 cases were positive, with the positive detection rate of 22.41%.The trend of GAS antigen rapid detection was consistent with the five-year trend, with the high positive rate of 3-8 years, of which 4-6 years of positive rate was the highest.The two seasonal peaks were evident each year, with peaks occurring in April-June, and November and January of next year.The detection rate ratio of male and female was 1.74∶1, and the gender difference was significant ( χ2=27.93, P<0.000 1). GAS antigen rapid detection rate in different clinical departments from high to low in order are as follows: dermatology outpatient (52.34%), emergency clinic (47.74%), internal medicine outpatient (37.36%), infectious disease area (19.71%), five-level disease area (10.27%), internal medicine area (8.63%), surgical areas (7.34%) and neonatal areas (0). Conclusions:GAS antigen rapid detection method and bacterial culture method have high coincidence rate, and high sensitivity and specificity, and can be popularized and applied in the diagnosis of GAS infectious diseases in children.GAS detection rate is higher in outpatient emergency department and dermatology clinics.There are obvious differences from seasonal and population (age and gender) in the positive detection of GAS antigen.No neonates were found.

Objective:To investigate the diagnosis and management of partial or complete hydatidiform mole with coexistent intrauterine pregnancy.Methods:Clinical data of 10 cases of hydatidiform mole with coexistent intrauterine pregnancy admitted to the Third Affiliated Hospital of Guangzhou Medical University, from September 2009 to May 2019 were retrospectively described.Results:(1) During the same period, 65 960 women were delivered at our hospital, and hydatidiform mole with coexistent intrauterine pregnancy was accounted for 1/6 596, among which complete hydatidiform mole and coexisting fetus (CHMCF) and partial hydatidiform mole and coexistent fetus (PHMCF) were found in four and six cases, respectively. The mean age of the ten patients were (30.9±4.1) years old, ranging from 26 to 35 years old, with 2.5 (1-4) times of pregnancies. Nine cases were identified at 22 +3 (12 +3-32 +3) gestational weeks and one at 9 + weeks. (2) Recurrent vaginal bleeding during pregnancy occurred in six cases, nausea and vomiting in three cases, and hyperthyroidism in mid- and late pregnancy in two cases. One patient developed preeclampsia and one case of severe mitral regurgitation with mild pulmonary hypertension. (3) In the 10 patients, the summit serum β -hCG level was 139 935 (16 990-546 033) U/L, and CHMCF and PHMCF patients were 212 500 (200 000-546 033) U/L and 60 768 (16 990-225 000) U/L, respectively. (4) The ultrasound results revealed a dark honeycomb area of the placenta in five cases, placental thickening in two cases, and vesicular placenta in one case. One case was found with bilateral giant luteinized ovarian cyst by ultrasound, multiple metastases in the left lower lobe of the lung by chest CT, multiple nodules in the pleural wall of the left lung by lung MRI, and CHMCF by pelvic MRI. In one case, ultrasound at 14 weeks of gestation showed interrupted fetal abdominal wall, visible mass, gastric bubble, liver, part of the intestinal echoes, and omphalocele. One case was found with embryo arrest. (5) The karyotype analysis of one case through amniocentesis was 46,XX with no anomalies, and chromosome microarray analysis was arr[hg19](1-22)×2. Prenatal diagnosis was refused in the remaining cases. (6) Among the ten patients, three were terminated by rivanol intra-amniotic injection, two received drug abortion, and uterine evacuation, and two with spontaneous abortion followed by curettage with a visible fetus and hydatidiform tissue. Total hysterectomy was performed in one patient due to partial invasion of the uterus by hydatidiform mole. One patient underwent a cesarean section on account of the left lower lung metastasis. One case developed preeclampsia at 33 +4 weeks of gestation and delivered two premature infants by cesarean section. Pathology examination found a complete and partial vesicular fetal mass in four and six cases, with P57 (－) and P57 (+), respectively. (7) During the follow-up, two women developed the persistent trophoblastic disease and received chemotherapy, while the remaining eight cases did not. Conclusions:When hydatidiform mole with coexistent intrauterine pregnancy is found, a timely differential diagnosis between CHMCF and PHMCF is needed. CHMCF is at a higher risk of abortion, intrauterine death, premature delivery, preeclampsia, and other maternal complications. Therefore, termination of CHMCF should be individualized. Most PHMCF patients have fetal malformation or fetal loss; thereby, timely termination is recommended.

Pure drug-assembled nanomedicines (PDANs) are currently under intensive investigation as promising nanoplatforms for cancer therapy. However, poor colloidal stability and less tumor-homing ability remain critical unresolved problems that impede their clinical translation. Herein, we report a core-matched nanoassembly of pyropheophorbide a (PPa) for photodynamic therapy (PDT). Pure PPa molecules are found to self-assemble into nanoparticles (NPs), and an amphiphilic PEG polymer (PPa-PEG

Objective:To investigate the appropriate method of labor induction in the second trimester for complete placenta previa patients.Methods:The labor induction outcomes of 85 cases with complete placenta previa in the second trimester were retrospectively analyzed. Twenty patients in group A were treated with cesarean section, 30 patients in group B were treated with ethacridine and mifepristone combined with uterine artery embolization (UAE), and 35 patients in group C were induced by using ethacridine and mifepristone. The clinical features and induction outcomes of three groups were compared.Results:The total duration of labor in group B [(28.7±30.1) hours] was significantly longer than that of group C [(24.3±21.9) hours; P<0.05]. The total amount of blood loss during induction and labor in group B [(302±271) ml] was significantly lower than those of group C [(393±523) ml] and group A [(626±487) ml; P<0.05]. The incidence of fever in group B (13%, 4/30) was significantly higher than those of group C (11%, 4/35) and group A (10%, 2/20; P<0.05). In group C, 13 patients (37%, 13/35) underwent emergency UAE, and 2 patients (6%, 2/35) underwent emergency cesarean section. As to average hemoglobin level and blood transfusion rate, there were no difference among the three groups (all P>0.05). Conclusion:Prophylactic UAE combined with drug induction in patients with complete placenta previa in the second trimester could significantly reduce the amount of bleeding during induction and reduce the risk of emergency procedures.

Objective To detect the expression of Survivin and Caspase-9 gene in Uygur breast cancer pa-tients with different HER-2 phenotypes,to find out the difference and association of the two genes and to find out the potential roles of the two genes breast cancer pathogenesis. Methods We selected 72 Uygur patients diag-nosed as breast cancer initially and they were divided into group A with HER-2 positive(n = 39)and group B with HER-2 negative(n = 33). Another 40 Uygur patients with benign breast were involved as the controls. Immunohis-tochemistry and real-time RT-PCR were used to detect the two genes,and analyze the differences and association of each gene between the groups. Results (1)The expression of Survivin gene in group A and B were higher than that in the control group. Further analysis showed that the expression of Survivin gene was enhanced in group A when compared with that in group B(P < 0.05);while even the expression of Survivin gene in group B was higher than that in the control group but no statistical difference was found(P > 0.05).(2)The expression of Caspase-9 gene in group A and B were lower than that in the control group. Real-time RT-PCR showed that the expression of Caspase-9 gene of group A was decreased when compared with that in group B(P < 0.05);While the expression of Caspase-9 gene of group B was slightly lower that of the control group but it showed no statistical significance (P > 0.05). Immunohistochemical results showed there were no statistical differences of expression of Caspase- 9 gene in group A and B and control group(all P > 0.05). The expression of Survivin and Caspase-9 gene was nega-tively associated in group A and B(P < 0.01;P < 0.05). Conclusions In Uygur patients with HER-2 positive breast cancer,the expression of Survivin gene is enhanced but that of caspase-9 gene is decreased,and they are negatively associated. Through inhabiting caspase-9 gene,Survivin gene may potentially lead to the occurrence of HER-2 positive breast cancer.