Objective: To investigate the clinicopathological characteristics and diagnostic-therapeutic strategies of oncocytic mucoepidermoid carcinoma (OMEC) of the parotid gland, and to enhance awareness of this rare variant among clinicians and pathologists. Methods: The clinical data, imaging findings, histopathological features, immunophenotype, and molecular characteristics of two patients with parotid OMEC were retrospectively analyzed, and the relevant literature was reviewed. Results: Case 1 was a 50-year-old man who presented with a painless mass behind the right earlobe for more than 2 years. The patient underwent extended parotidectomy with preservation of the facial nerve. Histopathological examination revealed that the tumor was predominantly composed of oncocytic cells with a small proportion of mucous cells. Immunohistochemically, the tumor cells were partially positive for cytokeratin 5/6, cytokeratin 7, and P63. Special staining with alcian blue, periodic acid-Schiff, and phosphotungstic acid hematoxylin yielded positive results. The diagnosis of right parotid OMEC was established. No recurrence or metastasis was observed during a 1 year follow-up. Case 2 was a 61-year-old man with a 3-month history of a mass beneath the left ear. After partial parotidectomy at an outside institution, pathological consultation at the Stomatological Hospital of Jilin University demonstrated that the tumor consisted almost entirely of oncocytic cells, exhibited infiltrative growth, and lacked typical mucous, epidermoid, and intermediate cells. Fluorescence in situ hybridization confirmed positive mastermind-like transcriptional activator 2 (MAML2) gene rearrangement, establishing the diagnosis of left parotid OMEC. The patient subsequently underwent total parotidectomy with preservation of the facial nerve, and no recurrence was detected during a short-term 3 months follow-up. A review of the literature indicated that OMEC most commonly arises in the parotid gland and is generally a low-grade malignancy with favorable prognosis. When tumors are composed exclusively of oncocytic cells, exhibit minimal cytological atypia, and lack the classical cellular components of mucoepidermoid carcinoma, they are highly prone to misdiagnosis as oncocytoma, nodular oncocytic hyperplasia, or other benign oncocytic lesions. Accurate differential diagnosis relies on recognition of infiltrative growth patterns, supportive immunophenotypic markers (e.g., P63 positivity), and detection of characteristic MAML2 gene rearrangement. Complete surgical excision remains the treatment of choice. Conclusion OMEC dominated by oncocytic cells carries a high risk of clinical misdiagnosis. Integrating the assessment Conclusion OMEC dominated by oncocytic cells carries a high risk of clinical misdiagnosis. Integrating the assessment of infiltrative histopathological features with immunohistochemistry and molecular detection of MAML2 rearrangement is crucial for accurate diagnosis, appropriate assessment of tumor behavior, and optimal surgical decision making.

This paper systematically elaborates on the key points of diagnosis and differential diagnosis of salivary gland tumors characterized by a substantial amount of extracellular mucus as a main or prominent feature, and clarifies the core differential features. The term "mucus-rich" specifically denotes that mucus is a major component of the tumor, rather than a focal or minor one. This phenomenon is associated with distinct histogenetic mechanisms: it may result from specific genetic mutations (e.g., AKT1 E17K in mucinous adenocarcinoma) that drive ductal epithelial differentiation into mucus-secreting cells, or from myoepithelial cells secreting glycosaminoglycans that form a myxoid stroma. Salivary gland tumors with abundant extracellular mucus include mucinous cystadenoma, sialadenoma papilliferum-like intraductal papillary tumors, mucinous myoepithelioma, pleomorphic adenoma with mucin-rich stroma, mucinous adenocarcinoma, low-grade mucoepidermoid carcinoma, mucin-rich salivary duct carcinoma and intestinal-type adenocarcinoma. The diagnosis of these tumors is complicated by the dual nature of extracellular mucus: while it is a defining feature of some entities, it can also obscure key diagnostic architectural features in others, leading to histological overlap and inconspicuous diagnostic areas. Given the frequent histological morphological overlap among these tumors, immunohistochemical findings and molecular characteristics have emerged as crucial differential diagnostic criteria. Core differential diagnostic points include the following: histologically, there must be meticulous identification of typical structures obscured by mucin (such as squamoid cells in mucoepidermoid carcinoma and apocrine features in salivary duct carcinoma); in immunohistochemical staining, CK20 is useful for distinguishing intestinal-type adenocarcinoma (positive) from mucinous adenocarcinoma (negative), while androgen receptor aids in differentiating salivary duct carcinoma (positive) from mucoepidermoid carcinoma (negative); and molecular testing plays a critical role in definitive diagnosis (e.g., the AKT1 E17K mutation for mucinous adenocarcinoma, MAML2 rearrangement for mucoepidermoid carcinoma, and MEF2C::SS18 fusion for microsecretory adenocarcinoma). This paper systematically summarizes the core pathological features and differential diagnostic points of mucin-rich salivary gland tumors, aiming to provide a practical reference for clinical pathological diagnosis.

Objective To explore the effect of diversified hand function exercise under the mode of collaborative nursing management on the rehabilitation of cerebral infarction patients with hand dysfunction.Methods A total of 100 patients with cerebral infarction and hand dysfunction diagnosed and treated in the Second Affiliated Hospital of Nanchang University from July 2021 to January 2023 were prospectively selected as study objects,and divided into combined group(n=50)and control group(n=50)according to stratified random sampling method.Patients in control group received routine treatment and rehabilitation training,and patients in combined group were combined with diversified hand function exercise under the mode of collaborative nursing management on the basis of control group.Fugl-Meyer assessment(FMA)scale,stroke-specific quality of life scale(SS-QOL),visual analogue scale(VAS)score before and after intervention,and rehabilitation compliance,rehabilitation training satisfaction were compared between two groups.Results After 3 months of intervention,FMA scale score and SS-QOL score of patients in two groups were significantly higher than before intervention,VAS score and swelling degree were significantly lower than before intervention(P<0.05).FMA scale score and SS-QOL score of combined group were significantly higher than those of control group,and VAS score and swelling degree were significantly lower than those of control group(P<0.05).The muscle strength,rehabilitation compliance and rehabilitation satisfaction of combined group were significantly higher than those of control group(P<0.05).Conclusion Diversified hand function exercise under the mode of collaborative nursing management can improve the limb motor function and quality of life of cerebral infarction patients with hand dysfunction,relieve pain and swelling,and improve the rehabilitation compliance of patients,which is worthy of clinical promotion and use.

OBJECTIVES: This study aimed to analyze the influence of drug factors on the efficacy of bisphosphonate for chronic nonbacterial osteomyelitis to provide a reference for clinical treatment and promote clinical rational drug use by evaluation of effectiveness and safety of bisphosphonate treatment of chronic nonbacterial osteomyelitis. METHODS: Literature on the treatment of chronic nonbacterial osteomyelitis by using bisphosphonate was collected and analyzed from PubMed, Medline, Embase, Cochrane, ISI Web of Knowledge, CNKI, VIP, and Wanfang databases. RESULTS: A total of 489 cases were collected, with an average complete response rate of clinical presentation, laboratory tests and imaging findings of 80.37%, 80.56% and 79.22%, respectively. Except for opadronate, risedronate, ibandronate, pamidronate, alendronate, neidronate and zoledronate showed good efficacy, and the average complete response rates were 100%, 100%, 81.64%, 87.50%, 69.23% and 69.23%, respectively.The study found that in the pamidronate group, the average complete response rate of 0.5-1 mg/kg (maximum single dose≤60 mg) subgroup and the frequency of administration once every 3 months subgroup were better than other subgroups. CONCLUSIONS Bisphosphonate could be used to treat chronic nonbacterial osteomyelitis, which of efficacy were affected by different drug types, dose and frequency of administration. The optimal dose and frequency of administration of pamidronate were 0.5-1 mg/kg (maximum single dose≤60 mg) and once every 3 months, respectively.
Osteomyelitis/drug therapy* ; Humans ; Diphosphonates/administration & dosage* ; Chronic Disease ; Bone Density Conservation Agents/administration & dosage* ; Female ; Pamidronate ; Middle Aged ; Male

Objective:To explore the factors influencing the non-reversal of mild cognitive impairment (MCI) after a first stroke.Methods:A total of 243 first stroke patients with MCI were enrolled at the First Affiliated Hospital of Zhengzhou University from March 2020 to March 2023. The patients were followed up for one year to assess the reversal of MCI. Patients who did not undergo reversal and those who did undergo reversal were included in non-reversal group and reversal group, respectively. General information of non-reversal group and reversal group was compared. Binary Logistic regression was used to analyze the factors influencing the non-reversal of MCI after a first stroke.Results:After one year of follow-up, the non-reversal rate was 25.10% (61/243) among 243 first stroke patients with MCI. Binary Logistic regression analysis showed that older age, history of diabetes, high National Institute of Health Stroke Scale (NIHSS) score at admission, left-sided lesions, and modified Fazekas grade 3 were risk factors for non-reversal of MCI after a first stroke ( P<0.05), while educational level of college degree or above was a protective factor ( P<0.05) . Conclusions:Older age, history of diabetes, high NIHSS score at admission, left-sided lesions, and modified Fazekas grade 3 are risk factors for non-reversal of MCI after a first stroke, while an educational level of college degree or above is a protective factor.

Objective To explore the effect of diversified hand function exercise under the mode of collaborative nursing management on the rehabilitation of cerebral infarction patients with hand dysfunction.Methods A total of 100 patients with cerebral infarction and hand dysfunction diagnosed and treated in the Second Affiliated Hospital of Nanchang University from July 2021 to January 2023 were prospectively selected as study objects,and divided into combined group(n=50)and control group(n=50)according to stratified random sampling method.Patients in control group received routine treatment and rehabilitation training,and patients in combined group were combined with diversified hand function exercise under the mode of collaborative nursing management on the basis of control group.Fugl-Meyer assessment(FMA)scale,stroke-specific quality of life scale(SS-QOL),visual analogue scale(VAS)score before and after intervention,and rehabilitation compliance,rehabilitation training satisfaction were compared between two groups.Results After 3 months of intervention,FMA scale score and SS-QOL score of patients in two groups were significantly higher than before intervention,VAS score and swelling degree were significantly lower than before intervention(P<0.05).FMA scale score and SS-QOL score of combined group were significantly higher than those of control group,and VAS score and swelling degree were significantly lower than those of control group(P<0.05).The muscle strength,rehabilitation compliance and rehabilitation satisfaction of combined group were significantly higher than those of control group(P<0.05).Conclusion Diversified hand function exercise under the mode of collaborative nursing management can improve the limb motor function and quality of life of cerebral infarction patients with hand dysfunction,relieve pain and swelling,and improve the rehabilitation compliance of patients,which is worthy of clinical promotion and use.

Objective:To explore the factors influencing the non-reversal of mild cognitive impairment (MCI) after a first stroke.Methods:A total of 243 first stroke patients with MCI were enrolled at the First Affiliated Hospital of Zhengzhou University from March 2020 to March 2023. The patients were followed up for one year to assess the reversal of MCI. Patients who did not undergo reversal and those who did undergo reversal were included in non-reversal group and reversal group, respectively. General information of non-reversal group and reversal group was compared. Binary Logistic regression was used to analyze the factors influencing the non-reversal of MCI after a first stroke.Results:After one year of follow-up, the non-reversal rate was 25.10% (61/243) among 243 first stroke patients with MCI. Binary Logistic regression analysis showed that older age, history of diabetes, high National Institute of Health Stroke Scale (NIHSS) score at admission, left-sided lesions, and modified Fazekas grade 3 were risk factors for non-reversal of MCI after a first stroke ( P<0.05), while educational level of college degree or above was a protective factor ( P<0.05) . Conclusions:Older age, history of diabetes, high NIHSS score at admission, left-sided lesions, and modified Fazekas grade 3 are risk factors for non-reversal of MCI after a first stroke, while an educational level of college degree or above is a protective factor.

Objective To investigate the effects of circ_UBE2C on the proliferation and glycolysis of lung cancer cells and its mechanism of action.Methods The expression of circ_UBE2C,miR-107,and hexokinase 2(HK2)in lung cancer tissues and normal lung tissues were analyzed based on the The Cancer Genome Atlas(TCGA)database.Kaplan-Meier survival curve was plotted to analyze the correlation between circ_UBE2C/miR-107/HK2 expression and survival of the lung cancer patients.qRT-PCR was used to detect the expression of circ_UBE2C and miR-107,and Western blotting was employed to measure the expression of HK2 and PCNA in human normal lung epithelial cells(BEAS-2B)and human lung cancer cell lines(A549,NCI-H460,and NCI-H1299).Then A549 and NCI-H1299 cells were divided into the blank group(NC),circ_UBE2C knockdown group(si-circ),HK2 knockdown group(si-HK2),simultaneous knockdown of miR-107+HK2 group(miR-inhibitor+si-HK2),and simultaneous knockdown of circ_UBE2C+miR-107 group(si-circ+miR-inhibitor).CCK-8 assay and colony formation assay were employed to measure the proliferation of above cell groups.The glucose uptake,lactate generation,and ATP production in the cells were measured by glucose uptake colorimetric assay kit,lactic acid detection kit,and ATP content determination kit,respectively.Seahorse XF glycolytic stress test and Seahorse XF cellular mitochondrial stress test were respectively performed to detect the extracellular acidification ratio(ECAR)and cellular oxygen consumption ratio(OCR).The targeting relationship between the circ_UBE2C and miR-107,and miR-107 and HK2 was validated by dual-luciferase reporter gene assay.Results Compared with normal lung tissues,the expression of circ_UBE2C and HK2 was up-regulated,while that of miR-107 was down-regulated in lung cancer tissues(P＜0.05).The expression of circ_UBE2C and HK2 was elevated,and that of miR-107 was reduced in A549 and NCI-H1299 cells when compared with BEAS-2B cells(P＜0.05).Survival analysis showed that the patients with high expression of circ_UBE2C and HK2 or low expression of miR-107 had shorter survival(P＜0.05).Compared with the NC group,both si-circ and si-HK2 resulted in significantly reduced proliferation,glucose uptake,lactate generation,ATP production,and ECAR and OCR values in A549 and NCI-H1299 cells(P＜0.05).Dual luciferase reporter gene assay confirmed that circ_UBE2C could directly bind to and negatively regulate miR-107 expression.HK2 was then identified as a downstream target of miR-107.Compared with the si-HK2 group,the proliferative ability and glycolysis level of A549 and NCI-H1299 cells were significantly increased in the miR-inhibitor+si-HK2 group and the si-circ+miR-inhibitor group.Conclusion Knockdown of circ_UBE2C significantly suppresses the proliferation and glycolysis of lung cancer cells via targeting up-regulation of miR-107 and then exerting inhibitory effect on HK2 expression.

[Objective] To compare the clinical efficacy of pulsed radiofrequency (PRF) in patients with acute herpes zoster neuralgia (AHN) and postherpetic neuralgia (PHN). [Methods] A retrospective analysis was made on 287 patients with thoracic herpes zoster related pain. The patients were divided into acute herpes zoster neuralgia group (group AHN, within 3 months) and PHN group (group PHN, over 3 months) according to the onset time of herpes zoster. Pain degree (VAS), sleep quality (AIS), anxiety and depression (GAD-7 and PHQ-9) at 1 week, 1 month, 3 months, 6 months and 12 months after the procedure were analyzed and compared between the two groups. [Results] The scores of VAS, AIS, GAD-7 and PHQ-9 significantly decreased in both groups after surgery (P<0.001). The four scores decreased more in AHN group than in PHN group from 1 to 12 months after surgery (P<0.001). After 12 months of follow-up, there were fewer cases of taking oral pregabalin and opioids in the former group than in the latter group (P=0.001). [Conclusion] PRF has a good therapeutic effect on herpes zoster related pain and is better than PHN in relieving pain, improving sleep and anxiety and depression in AHN, or can prevent PHN.

Objective:To comprehensively evaluate the clinical efficacy and safety of pulse radiofrequency therapy for knee osteoarthritis (KOA) with cardiovascular disease (CVD).Methods:A total of 132 patients with knee osteoarthritis (KOA) and cardiovascular disease (CVD) admitted to the First Affiliated Hospital of Xi′an Jiaotong University from March 2022 to February 2024 were randomly divided into two groups using a random number table method. Group A (65 cases) received ultrasound-guided pulse radiofrequency treatment of the hidden nerve, while group B (67 cases) received oral etoposide tablets and intra-articular injection of sodium hyaluronate. Basic data such as age, gender, height, weight, body mass index (BMI), knee joint function grading (K-L grading), and distribution of cardiovascular disease types were recorded between the two groups. The degree of knee joint pain [Visual Analog Scale (VAS) score] and Knee Joint Function Score (OKS), Athens Insomnia Scale (AIS) scores and incidence of complications. were compared between the two groups at 1 week, 1 month, 3 months, and 6 months after treatment.Results:The VAS score of group A showed a slow decreasing trend from 1 week to 6 months after treatment. The VAS score of group B decreased to the lowest level one week after treatment and gradually increased within 6 months after treatment. The VAS scores of both groups improved after 1 week of treatment and at 1, 3, and 6 months of treatment compared to preoperative levels ( F=703.955, P<0.001), and the degree of postoperative pain improvement in the group A was better than that in the group B ( F=106.575, P<0.001). The OKS of both groups decreased significantly after 1 week of treatment and at 1, 3, and 6 months of treatment, and the time effect was statistically significant ( F=2 233.447, P<0.001). The OKS of the group A was lower than that of group B after 1 week of treatment and at 1, 3, and 6 months of treatment, and the difference was statistically significant ( F=141.214, P<0.001). The AIS scores improved significantly after 6 months of treatment compared to preoperative levels ( F=1 044.424, P<0.001), and the group A had better AIS scores than the group B at 1, 3, and 6 months of treatment, with statistically significant differences ( F=124.864, P<0.001). There was no statistically significant difference in postoperative complications between the two groups ( P>0.05). Conclusions:Ultrasound guided pulsed radiofrequency treatment of KOA with CVD can significantly alleviate postoperative pain, improve joint mobility and sleep quality, and is more effective than traditional conservative treatment of oral etoposide tablets combined with intra-articular injection of sodium hyaluronate.