Objective:To improve the understanding of patients with diffuse large B-cell lymphoma (DLBCL) with pulmonary cryptococcosis.Methods:The clinical data of 1 DLBCL patient with pulmonary cryptococcosis in the Central Hospital of Fengxian District of Shanghai in May 2023 were retrospectively analyzed, and the relevant literatures were reviewed.Results:This 75-year-old female patient was asymptomatic after 2 cycles of R-CHOP chemotherapy. The high-resolution CT of lung showed that lung nodules were progressively enlarged. Antibacterial treatment was ineffective. Pulmonary cryptococcosis was confirmed by bronchoalveolar lavage fluid (BALF) targeted high-throughput sequencing (tNGS) and cryptococcus capsular antigen (CrAg) detection. The central nervous system was not involved. And the long-term adequate-dose fluconazole was prescribed for 6 months, and the treatment against lymphoma was given synchronously. The lung nodule lesions reduced after antifungal therapy for 1 month. The lung nodules disappeared after the follow-up of 6 months after completion of final chemotherapy. The evaluation of lymphoma indicated complete remission.Conclusions:Pulmonary cryptococcosis occurs insidiously and shows no specific symptoms; its imaging manifestations are variable and routine anti-infection is ineffective. Immunochemotherapy for lymphoma patients is a high-risk factor for cryptococcal infection. tNGS and CrAg testing for BALF are effective methods of the confirmed diagnosis. The early and long-term adequate-dose antifungal treatment is the key to preventing the recurrence or progression.

Objective:To analyze the characteristics of viral isolation and unique recombinant from untreated HIV-1 patients infected through sexual transmission and injection drug use, so as to provide evidence for understanding the biological characteristics and precise prevention and control of HIV-1 infection in different transmission routes.Methods:In view of the different HIV-1 transmission risks, newly diagnosed untreated HIV-1 patients from Beijing, Guangxi and Sichuan were carefully selected. Venous blood was collected to detect the viral load and CD4 + T cell count, and peripheral blood lymphocytes were isolated for virus isolation. Viral RNAs were extracted from the virus supernatant, and the near full-length genome sequences were obtained using in-house method, then the recombination patterns were determined. Results:Among the 65 HIV-1 infection, 32(49.2%), 20(30.8%) and 13(20.0%) were infected via men who have sex with men (MSM), heterosexual and injection drug use (IDU), respectively; genotypes mainly included 26(40.0%) CRF07_ BC, 23(35.4%) CRF01_ AE, and 9(13.8%) unique recombinant types (URFs). A total of 46 HIV-1 clinical strains were isolated. The positive rate of HIV-1 isolation was significantly negatively correlated with CD4 + T cells ( X2=4.22, P=0.04), but positively correlated with viral load ( X2=22.4, P<0.001); the multi-variate generalized estimating equations(GEE) model analysis of HIV-1 P24 antigen content showed similar result. In addition, GEE model showed a positive correlation between viral P24 antigen content and virus-producing culture time (52.14, 95% CI: 9.42~94.87, P=0.017). Viral growth curve analysis showed that the level of viral P24 antigen in MSM Group was significantly higher than that in heterosexual group and IDU group (adjusted P values were p<0.01 and P<0.05, respectively), on the 14th day after culture. The proportion of URFs in MSM Group was higher than that in heterosexual group, and the recombinant breakpoints in MSM Group were more than that in heterosexual group. Conclusions:MSM population was more sensitive to HIV-1 virus isolation; there was unique diversity of recombinant forms of HIV-1 among those with sexually transmitted infections, especially in the MSM population.

Objective To explore the clinical value of nodal metastatic characteristics in predicting the distant metastasis of papillary thyroid carcinoma (PTC).Methods A total of 1 408 PTC patients who met the inclusion criteria and received initial thyroidectomy at our department from January 2006 to December 2011 were enrolled in this study.Results After a median follow-up time of 7.8 years,distant metastases developed in 46 patients.Patients with lateral neck lymph node metastasis ≥7,individual size of lateral neck lymph node metastasis ≥ 1.15 cm and the total number of cervical lymph node metastasis ≥9 were prone to higher risk of distant metastasis;the high risk group had a lower 10-year distant metastasisfree survival (78.7％ vs.98％,x2 =122.941,P ＜0.01) and a shorter distant metastasis-free survival time (99.2 M vs.122.5 M,x2 =122.941,P ＜ 0.01).Conclusions Lateral lymph node metastasis is an independent risk factor for distant metastasis in PTC patients.

OBJECTIVE: To explore the relationship between three-dimensional (3-D) reconstruction of regenerated fibers and functional recovery after mastoid segment of facial nerve was repaired with either end-to-end anastomosis or autogenous great auricular nerve grafting. METHOD: Thirty healthy adult New Zealand white rabbits were randomly divided into two groups: one was end-to-end anastomosis group and another was autogenous great auricular nerve grafting group. Only mastoid segment of right facial nerve of each animal was dissected and the contralateral nerve was as a control. Electromyogram (EMG) were recorded from 5 animals of each group at the 30th d, 90th d and 120th d after operation. After that the nerves were extracted, fixed, decalcified and embedded in paraffin. Samples was sectioned serially at 6 microm and stained with special trichrome stain. All the imagines were imported into Mimics software to reconstruct the 3-D model. RESULT: The significant differences were found in the regenerate fibers on 30 th d,and were found in amplitude of EMG on 30 th d and 90 th d. The image of 3-D reconstruction showed that the myelin sheath were thickening, connected from proximal to the distal gradually after repair. CONCLUSION The 3-D reconstruction of regenerated nerve fibers partly conformed to the functional recovery after facial nerve trunk was repaired. The functional recovery of facial nerve was related with both the quantity and the quality of regenerated nerve fibers.
Anastomosis, Surgical ; Animals ; Facial Nerve ; physiology ; surgery ; Image Processing, Computer-Assisted ; Male ; Mastoid ; innervation ; Nerve Regeneration ; Rabbits ; Reconstructive Surgical Procedures ; rehabilitation ; Recovery of Function