Objective To investigate the relationship between the intraluminal characteristics of the occlusion segment and the degree of the primary collateral circulation(Circle of Willis)opening in patients with acute internal carotid artery occlusion(ICAO)and the occurrence of different subtypes of ipsilateral intracranial watershed infarction(WSI).Methods A total of 63 patients with unilateral acute ICAO accompanied by ipsilateral intracranial WSI were retrospectively included and divided into the internal watershed infarction(IWSI)group and the cortical watershed infarction(CWSI)group.The intraluminal characteristics of the occlusion segment and the degree of the Circle of Willis opening were analyzed using vessel wall magnetic resonance imaging(VW-MRI).Multivariate binary logistic regression analysis was employed to identify independent predictive indicators for the occurrence of CWSI.Results There was no significantly statistical difference in the occlusion range between the two groups.The range of intraluminal high signal involvement,the ratio of intraluminal relative highest signal,the incidence of high signal at the end of occlusion,and the degree of the Circle of Willis opening in the CWSI group were higher than those in the IWSI group(P<0.001).The range of intraluminal high signal involvement,high signal at the end of occlusion,and the degree of the Circle of Willis opening were identified as independent predictive factors for CWSI.Conclusion VW-MRI analysis of the intraluminal characteristics of the occlusion segment and the degree of the Circle of Willis opening can help to elucidate the mechanisms underlying the occurrence of IWSI/CWSI and can provide assistance in formulating etiology-based treatment strategies for clinical practice.

Objective To investigate the relationship between the intraluminal characteristics of the occlusion segment and the degree of the primary collateral circulation(Circle of Willis)opening in patients with acute internal carotid artery occlusion(ICAO)and the occurrence of different subtypes of ipsilateral intracranial watershed infarction(WSI).Methods A total of 63 patients with unilateral acute ICAO accompanied by ipsilateral intracranial WSI were retrospectively included and divided into the internal watershed infarction(IWSI)group and the cortical watershed infarction(CWSI)group.The intraluminal characteristics of the occlusion segment and the degree of the Circle of Willis opening were analyzed using vessel wall magnetic resonance imaging(VW-MRI).Multivariate binary logistic regression analysis was employed to identify independent predictive indicators for the occurrence of CWSI.Results There was no significantly statistical difference in the occlusion range between the two groups.The range of intraluminal high signal involvement,the ratio of intraluminal relative highest signal,the incidence of high signal at the end of occlusion,and the degree of the Circle of Willis opening in the CWSI group were higher than those in the IWSI group(P<0.001).The range of intraluminal high signal involvement,high signal at the end of occlusion,and the degree of the Circle of Willis opening were identified as independent predictive factors for CWSI.Conclusion VW-MRI analysis of the intraluminal characteristics of the occlusion segment and the degree of the Circle of Willis opening can help to elucidate the mechanisms underlying the occurrence of IWSI/CWSI and can provide assistance in formulating etiology-based treatment strategies for clinical practice.

Chronic refractory wound (CRW) is one of the most challengeable issues in clinic due to complex pathogenesis, long course of disease and poor prognosis. Experts need to conduct systematic summary for the diagnosis and treatment of CRW due to complex pathogenesis and poor prognosis, and standard guidelines for the diagnosis and treatment of CRW should be created. The Guideline forthe diagnosis and treatment of chronic refractory wounds in orthopedic trauma patients ( version 2023) was created by the expert group organized by the Chinese Association of Orthopedic Surgeons, Chinese Orthopedic Association, Chinese Society of Traumatology, and Trauma Orthopedics and Multiple Traumatology Group of Emergency Resuscitation Committee of Chinese Medical Doctor Association after the clinical problems were chosen based on demand-driven principles and principles of evidence-based medicine. The guideline systematically elaborated CRW from aspects of the epidemiology, diagnosis, treatment, postoperative management, complication prevention and comorbidity management, and rehabilitation and health education, and 9 recommendations were finally proposed to provide a reliable clinical reference for the diagnosis and treatment of CRW.

Objective To analyze the epidemiological problems concerning cruiser-related infectiousdiseases reported since 1973,so as to provide evidences for the diagnosis,prevention and control of diseases.Methods Information retrieval was made by using Pubmed,Medline and China Knowledge Resource Integrated Database (CNKI) to find out papers concerning cruiser-related infectious diseases reported from 1973 to the present,and at the same time,data concerning cruiser-related gastrointestinal infectious diseases published by the Center for Disease Control (CDC) were also sorted out,and finally statistical analyses were made on such related factors as the category of diseases,types of pathogens and the areas of navigation.Results Research results indicated that gastrointestinal infectious diseases and respiratory infectious diseases,the gastrointestinal infectious diseases in particular,were the two main types of cruiser-related infectious diseases.Norovirus,shigella and Escherichia coli were the most commonly detected pathogens in the gastrointestinal infectious disease pathogens,whereas the most pathogenic factor for respiratory diseases were influenza virus,followed by varicella and legionella.In all the cruisers that were affected by infectious diseases,those sailing in tropical waters had the higher incidence rate,which was significantly higher than those sailing in temperate and frigid zones,which accounted for 72.72％,13.64％ and 13.64％ respectively.Conclusions Gastrointestinal infectious diseases and respiratory infectious diseases were the main types of cruiser-related infectious diseases,and the distribution of pathogens had their special patterns,which were closely related with the geographic regions of sailing.Knowledge about cruiser-related infectious diseases was of important significance for rapid diagnosis,prevention and control of related diseases.

Objective To analyze the epidemiological problems concerning cruiser-related infectiousdiseases reported since 1973,so as to provide evidences for the diagnosis,prevention and control of diseases.Methods Information retrieval was made by using Pubmed,Medline and China Knowledge Resource Integrated Database (CNKI) to find out papers concerning cruiser-related infectious diseases reported from 1973 to the present,and at the same time,data concerning cruiser-related gastrointestinal infectious diseases published by the Center for Disease Control (CDC) were also sorted out,and finally statistical analyses were made on such related factors as the category of diseases,types of pathogens and the areas of navigation.Results Research results indicated that gastrointestinal infectious diseases and respiratory infectious diseases,the gastrointestinal infectious diseases in particular,were the two main types of cruiser-related infectious diseases.Norovirus,shigella and Escherichia coli were the most commonly detected pathogens in the gastrointestinal infectious disease pathogens,whereas the most pathogenic factor for respiratory diseases were influenza virus,followed by varicella and legionella.In all the cruisers that were affected by infectious diseases,those sailing in tropical waters had the higher incidence rate,which was significantly higher than those sailing in temperate and frigid zones,which accounted for 72.72％,13.64％ and 13.64％ respectively.Conclusions Gastrointestinal infectious diseases and respiratory infectious diseases were the main types of cruiser-related infectious diseases,and the distribution of pathogens had their special patterns,which were closely related with the geographic regions of sailing.Knowledge about cruiser-related infectious diseases was of important significance for rapid diagnosis,prevention and control of related diseases.

Objective To evaluate Mycobacterium tuberculosis (M. tuberculosis)-specific cellular immunity in individuals with latent or active tuberculosis and human immunodeficiency virus (HIV) coinfection. Methods One hundred HIV-infected individuals in Yunnan Province were enrolled. The enzyme-linked immunospot (ELISPOT) assay using early secreted antigenic target (ESAT)-6 and culture filtrate protein (CFP)-10 was employed to detect M. tuberculosis-specific T cells in the peripheral blood. The absolute number of CD3+ CD4+and CD3+ CD8+ T cells in the peripheral blood from the enrolled subjects were determined by flow cytometry. Data were analyzed using nonparametric Mann-Whitney test. Results The prevalence of latent tuberculosis co-infection in HIV-infected individuals without any clinical evidence of active tuberculosis was 67.6%. The absolute numbers of CD3+ CD4+ (532 × 106/L) and CD3+ CD8+ (473 × 106×/L) T cell in HIV-infected individuals with latent tuberculosis co-infection were similar to those of only HIV-infeeted individuals (406 ×106×/L and 504 × 106/L). While those in HIV-infected individuals with active tuberculosis co-infection were 189 × 106/L and 293 × 106/L, respectively, which were both significantly lower than those in other two groups (U=168. 0,U=163. 0,U= 374. 0,U=147. 0, all P<0. 01). Furthermore, ESAT-6 (31/106 cells) and CFP-10 (82/106 cells) specific spot-forming cells in HIV-infected individuals with active tuberculosis co-infection were significantly less than those in HIV-infected individuals with latent tuberculosis co-infection (92 × 106 cells and 109 × 106 cells, U= 507. 0,U= 529. 5, both P<0. 01). Conclusions The prevalence of latent tuberculosis in HIV-positive individuals without any clinical evidence of active tuberculosis is high in China. Both overall cellular immunity and M. tuberculosis-specific immune response in HIV-positive individuals with active tuberculosis co-infection are severely impaired.

Objective To investigate the genotypic characteristics of hepatitis B virus(HBV) in Tibet.Methods Serum samples from 60 cases of hepatitis B in Tibet Autonomous Region were collected from January 2000 to March 2004.HBV genotypes were analyzed by sequencing S region and precore/core region.Results HBV isolated from 60 cases were all found to be D genotype by S region sequencing.Dc mixture was found in 59 cases,showing the recombination between their precore/core gene and genotype B virus at 1804-2299 nucleotide.The other one case showed Dbc mixture genotype,showing recombination between its precore/core gene and genotype B and C genes.Conclusions All Tibet cases in this study show mixture genotype D with recombination with genotvpe C or both genotype B and C at precore/core region.No case of pure genotype D is found.