Glioblastoma(GBM)is the most aggressive primary malignant tumor in the central nervous system.GBM frequently recurs after surgery and has limited therapeutic options.Hydrogels,characterized by their injectability,biocompatibility,and controlled drug release,of-fer innovative solutions for postoperative GBM management.Advances in hydrogel technology provide new avenues for personalized GBM treatments with significant clinical potential.This article focuses on the current progress in the research on hydrogels as carriers for chemo-therapeutic drugs,immunomodulatory platforms,and multimodal therapeutic systems.Key strategies,including thermo-and pH-responsive gels,co-delivery systems,and the regulation of macrophage function,are analyzed for their therapeutic efficacy.Additionally,the advant-ages of hydrogels in surgical cavity filling,targeted therapy,and recurrence prevention are highlighted.We also discuss the challenges in clin-ical translation and future directions of hydrogel application in postoperative GBM management.

Objective:To analyze the epidemiological and clinical features of infectious diseases of the central nervous system (CNS).Methods:A cross-sectional study and analysis were conducted to summarize the epidemiological and clinical characteristics of 9 918 patients with CNS infectious diseases, who were diagnosed and treated at 29 hospitals across China from January 1, 2001 to December 31, 2020. Data collected included demographic data, clinical manifestations, health economic indicators, and prognostic outcomes.Results:Among the 9 918 collected cases of CNS infectious diseases, 5 559 were male (56.0%) and 4 359 were female (44.0%), with an onset age of 38 (25, 53) years. Education level: slightly more junior high school education (2 651 cases, 26.7%), and less elementary school education and below (2 181 cases, 22.0%) were found. Occupational distribution: farmers were found predominant (3 215 cases, 32.4%), followed by workers (1 826 cases, 18.4%) and students (1 633 cases, 16.5%). Clinical manifestations: headache (6 074 cases, 61.2%), fever (5 869 cases, 59.2%) and positive meningeal irritation signs (2 273 cases, 22.9%) were the 3 most common clinical manifestations, followed by nausea and (or) vomiting (2 095 cases, 21.1%), impaired consciousness (2 077 cases, 20.9%), psychiatric symptom (1 866 cases, 18.8%) and epilepsy (1 627 cases, 16.4%), etc., and cranial nerve involvement was found in 669 cases (6.7%). Major pathogens included viruses in 6 814 cases (68.7%), Mycobacterium tuberculosis in 1 677 cases (16.9%), common bacteria in 864 cases (8.7%), fungi in 254 cases (2.6%), spirochetes of syphilis in 183 cases (1.8%), parasites in 121 cases (1.2%), and rickettsiae in 5 cases (0.1%). Urban-rural distribution: slightly more cases were found in the countryside (5 418 cases, 54.6%) than in the towns (4 500 cases, 45.4%). Distribution of onset by season: 2 412 cases (24.3%) fell ill in spring, 2 835 cases (28.6%) in summer, 2 187 cases (22.1%) in fall, and 2 484 cases (25.0%) in winter. Health economics: the duration of hospitalization was 15 (8, 27) days, and the cost of hospitalization was 1.53 (0.91, 3.02)×10 000 yuan. Prognosis: 9 531 cases (96.1%) were cured or improved, and 92 cases (0.9%) died. Conclusions:The pathogens responsible for CNS infectious diseases are predominantly viruses. Although the incidence is slightly higher during the summer months, the overall seasonal pattern is not particularly pronounced. These infections are more commonly observed in young and middle-aged males and present with a diverse range of clinical manifestations, contributing to a significant disease burden.

Glioblastoma(GBM)is the most aggressive primary malignant tumor in the central nervous system.GBM frequently recurs after surgery and has limited therapeutic options.Hydrogels,characterized by their injectability,biocompatibility,and controlled drug release,of-fer innovative solutions for postoperative GBM management.Advances in hydrogel technology provide new avenues for personalized GBM treatments with significant clinical potential.This article focuses on the current progress in the research on hydrogels as carriers for chemo-therapeutic drugs,immunomodulatory platforms,and multimodal therapeutic systems.Key strategies,including thermo-and pH-responsive gels,co-delivery systems,and the regulation of macrophage function,are analyzed for their therapeutic efficacy.Additionally,the advant-ages of hydrogels in surgical cavity filling,targeted therapy,and recurrence prevention are highlighted.We also discuss the challenges in clin-ical translation and future directions of hydrogel application in postoperative GBM management.

Objective:To analyze the epidemiological and clinical features of infectious diseases of the central nervous system (CNS).Methods:A cross-sectional study and analysis were conducted to summarize the epidemiological and clinical characteristics of 9 918 patients with CNS infectious diseases, who were diagnosed and treated at 29 hospitals across China from January 1, 2001 to December 31, 2020. Data collected included demographic data, clinical manifestations, health economic indicators, and prognostic outcomes.Results:Among the 9 918 collected cases of CNS infectious diseases, 5 559 were male (56.0%) and 4 359 were female (44.0%), with an onset age of 38 (25, 53) years. Education level: slightly more junior high school education (2 651 cases, 26.7%), and less elementary school education and below (2 181 cases, 22.0%) were found. Occupational distribution: farmers were found predominant (3 215 cases, 32.4%), followed by workers (1 826 cases, 18.4%) and students (1 633 cases, 16.5%). Clinical manifestations: headache (6 074 cases, 61.2%), fever (5 869 cases, 59.2%) and positive meningeal irritation signs (2 273 cases, 22.9%) were the 3 most common clinical manifestations, followed by nausea and (or) vomiting (2 095 cases, 21.1%), impaired consciousness (2 077 cases, 20.9%), psychiatric symptom (1 866 cases, 18.8%) and epilepsy (1 627 cases, 16.4%), etc., and cranial nerve involvement was found in 669 cases (6.7%). Major pathogens included viruses in 6 814 cases (68.7%), Mycobacterium tuberculosis in 1 677 cases (16.9%), common bacteria in 864 cases (8.7%), fungi in 254 cases (2.6%), spirochetes of syphilis in 183 cases (1.8%), parasites in 121 cases (1.2%), and rickettsiae in 5 cases (0.1%). Urban-rural distribution: slightly more cases were found in the countryside (5 418 cases, 54.6%) than in the towns (4 500 cases, 45.4%). Distribution of onset by season: 2 412 cases (24.3%) fell ill in spring, 2 835 cases (28.6%) in summer, 2 187 cases (22.1%) in fall, and 2 484 cases (25.0%) in winter. Health economics: the duration of hospitalization was 15 (8, 27) days, and the cost of hospitalization was 1.53 (0.91, 3.02)×10 000 yuan. Prognosis: 9 531 cases (96.1%) were cured or improved, and 92 cases (0.9%) died. Conclusions:The pathogens responsible for CNS infectious diseases are predominantly viruses. Although the incidence is slightly higher during the summer months, the overall seasonal pattern is not particularly pronounced. These infections are more commonly observed in young and middle-aged males and present with a diverse range of clinical manifestations, contributing to a significant disease burden.

Objective To observe and compare of the effects of esketamine and sufentanil induction for general anesthesia on postoperative analgesia in obese patients undergoing laparoscopic sleeve gastrectomy.Methods Patients scheduled for elective laparoscopic sleeve gastrectomy between March 2023 and March 2024,irrespective of gender,aged between 20 and 50 years,with a BMI ranging from 30.0 to 50.0 kg/m2 and ASA Ⅰ or Ⅱ classification,were randomly allocated into two groups:the esketamine group(Group E)and the sufentanil group(Group S),each consisting of 32 cases.During anesthesia induction,Group E received a dose of esketamine at 0.5 mg/kg while Group S received sufentanil at a dosage of 0.5 μg/kg;the remaining protocol remained unchanged.Heart rate(HR),mean arterial pressure(MAP),and SpO2 were recorded at various time points:upon arrival(T0),prior to anesthesia induction(T1),immediately after induction(T2),during intubation(T3),at the conclusion of anesthesia adminis-tration(T4),and during extubation(T5).Postoperative pain scores using the Numeric Rating Scale(NRS)were assessed at specific intervals following surgery:one hour post-surgery(P0),six hours post-surgery(P1),twelve hours post-surgery(P2),twenty-four hours post-surgery(P3)and forty-eight hours post-surgery(P4).Additionally,intraoperative remifentanil consumption as well as the number of presses on the analgesic pump within forty-eight hours after surgery in both patient groups were documented along with any occurrences of adverse reactions.Results During the surgery,there was no statistically significant difference in mean arterial pressure(MAP)and heart rate(HR)between the two patient groups at T0～T5(P>0.05).At T2,both groups exhibited lower MAP and HR compared to T0;specifically,group S had a MAP of(91.81±8.94)mmHg and HR of(81.75±13.37)beats/min,while group E had a MAP of(93.69±9.96)mmHg and HR of(80.38±13.2)beats/min,with group E showing values closer to baseline levels.At T3,both groups experienced a transient increase in MAP and HR(P<0.05);specifi-cally,group S had a MAP of(97.56±8.96)mmHg and HR of(86.47±13.84)beats/min,while group E had a MAP of(101.03±8.29)mmHg and(89.41±15.32)times/min,with S group closer to baseline values.There was no statistically significant difference in the amount of remifentanil used during surgery between group S and group E(P>0.05),which were(2071.88±717.63)μg and(2093.75±718.39)μg,respectively.Compared with the postoperative conditions of the two groups,the NRS scores of group E(0.41±0.61±1.870.75,2.47±0.62)at P0,P1 and P2 were lower than those in group S(0.88±0.71,2.47±0.72,2.97±0.54),and the difference was statisti-cally significant(P<0.05).The number of intravenous analgesia pump presses was significantly reduced in group E after surgery(P<0.05),with the postoperative analgesic pump compressions occurring 11.25±2.70 times in group S and 8.56±2.23 times in group E.The incidence of postoperative nausea and vomiting(PONV)and hypotension in Group E(21.88%,15.63%)was lower than that observed in group S(46.88%,37.50%),demonstrating statistical significance(P<0.05).Conclusion In comparison to sufentanil induction,the utilization of esketamine anesthesia induction is deemed safe for laparoscopic sleeve gastrectomy in obese patients,effectively mitigating postoperative acute pain and reducing the incidence of PONV.

Lung cancer remains the most frequently diagnosed cancer and the leading cause of cancer-related death worldwide, with anaplastic lymphoma kinase (ALK) fusion mutations accounting for approximately 4%-9% of cases. In recent years, there are increasing clinical evidences suggesting that the combination of ALK inhibitors with surgical treatment holds significant potential for clinical application in resectable early and locally advanced non-small cell lung cancer (NSCLC) patients. This review aims to summarize the advances in neoadjuvant targeted therapy for ALK fusion positive NSCLC and discuss its advantages and challenges in clinical practice.
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Humans ; Carcinoma, Non-Small-Cell Lung/enzymology* ; Anaplastic Lymphoma Kinase/antagonists & inhibitors* ; Lung Neoplasms/enzymology* ; Neoadjuvant Therapy/methods* ; Molecular Targeted Therapy ; Protein Kinase Inhibitors/therapeutic use*

Objective To investigate the effect of fluid shear(FS)on apoptosis of glomerular epithelial cells(GECs)and the role of Piezo 1 protein in it.Methods GECs(glomerular epithelial cells)of SD rat were cul-tured.Fluid shear stimulation was simulated by a Flexcell-T5000 tensiometer.Apoptosis level was detected by flow cytometry.The expression of Piezo 1 proteins in GECs was detected by immunofluorescence staining.The activating of Piezo 1 channels by fluid shear was observed using Ca2+indicator(Cal-590 AM).The effect of Piezo 1 on apop-tosis in GECs was analyzed after modulating the function or expression of Piezo 1 protein using the chemical activa-tor Yoda1,the inhibitor GsMtx 4 was regulated by lentivirus Lv-shPiezo 1.Results Compared with the blank controlgroup,apoptosis increased in the fluid shear group(P＜0.05).The rate of apoptosis increased with the enhancing of fluid shear strength;Piezo 1 was commonly expressed in GECs.Fluid shear activated Piezo 1 chan-nel and enhanced expression of Piezo 1.The agonist Yoda1 promoted the apoptosis of GECs GsMtx 4 inhibited the apoptosis induced by fluid shear.Lv-shPiezo 1 knocked down the expression of Piezo 1 in GECs and the apoptosis rate of GECs in the knockdown group was reduced as compared to that in the control group and Lv-Ctrl group(P＜0.05).Conclusions Fluid shear may promote apoptosis of GECs by activation of Piezo 1 and by enhancing expression of Piezo 1.

ObjectiveTo analyze the monitoring data of schistosomiasis from 2004 to 2021 in Suzhou New District， Jiangsu Province， and to provide evidence for improving schistosomiasis elimination strategies. MethodsFollowing the Opinions on Prevention and Control of Schistosomiasis， Parasitic Diseases and Endemic Diseases in Suzhou and the Technical Plan for Prevention and Control of Schistosomiasis， Parasitic Diseases and Endemic Diseases in Suzhou， the monitoring of schistosomiasis in the population and snail habitats from 2004 to 2021 was conducted. The Mann-Kendall method and Joinpoint regression method were employed to analyze the trend of epidemic indicators （such as seropositive rate， prevalence of snail frames， etc.）. Time series analysis （exponential smoothing model） was conducted to predict snail occurrence. ResultsFrom 2004 to 2021， a total of 73 680 people were serologically tested for schistosomiasis， with a positive rate of 0.084%. The seropositivity rate showed statistically significant differences between different years （χ²=70.73， P<0.05）， but there was no significant trend over time. In addition， 3 053 fecal tests were conducted and no positive result was found. The snail habitats covered an area of 70.11 hm² and showed a decreasing trend （Z=-1.97， P<0.05）. A total of 30 093 frames were surveyed， of which 19.038% contained snails. The difference in the prevalence of snail frames between different years was statistically significant （χ²=7 203.09， P<0.05）， with a decreasing trend in the prevalence of snail frames （Z=-2.05， P<0.05）. A total of 26 296 live snails were seized and density of live snails was 0.874 snails per frame， showing a decreasing trend in the density of live snails （Z=-2.35， P<0.05）. A total of 12 391 snails were dissected and no infected snail was found. The areas treated with molluscicides remained stable at 264.60 hm². An area of 27.77 hm² achieved the goal of snail eradication through environmental modification， with a decreasing trend （Z=-2.44， P<0.05）. It is estimated that the prevalence of snail frames and snail density will remain relatively stable from 2022 to 2026， but the snail habitat area will fluctuate significantly， showing an increasing trend. ConclusionNo indigenous cases of schistosomiasis and no infected snails are reported， indicating the successful consolidation of schistosomiasis prevention and control measures. However， the snail habitat area fluctuates greatly with an increasing trend， suggesting the need for long-term Oncomelania snail monitoring in local areas.

Objective:To evaluate the effect of clinic standardized blood pressure measurement model (SBPM) applying to first blood pressure measurement among community population aged 35 years old and above.Methods:SBPM was implemented in the community health service center of Dapuqiao street, Huangpu district of Shanghai from June 1, 2018, and the data between June 1 and December 31, 2018 was used as the SBPM data. The first-diagnosis blood pressure measurement data in this center between June 1 and December 31, 2017 was used as the conventional measurement (CM) model data. The detection rate of elevated blood pressure under SBPM was standardized according to the gender and age distribution of subjects in CM. The equilibrium of the value distribution of the end digit of blood pressure value in different pressure-measuring models and difference of elevated blood pressure rate of subjects with different characteristics and seasons were analyzed by using the χ 2 test, and the difference of standardized elevated blood pressure rate in different pressure-measuring models was analyzed by using the U test. Results:The SBPM included 1 548 subjects and 639 (41.28%) of them were males. The CM included 2 952 inpatients and 1 196 (40.51%) of them were males. The frequency of the end digit of blood pressure in SBPM ranged from 9.04% to 10.72%, and both systolic and diastolic blood pressure showed a balanced distribution of end digit ( P values were 0.996 and 0.981 respectively). The frequency of blood pressure end digital in the CM ranged from 0.37% to 67.92%, and both systolic and diastolic blood pressure showed an unbalanced distribution (both P values <0.001). The crude rate and standardized elevated blood pressure rate in SBPM were 23.19% (359/1 548) and 23.05%, which were higher than that in CM, about 7.22% (213/2 952) (both P values <0.001). The elevated blood pressure rate in SBPM in summer, autumn and winter was 18.85% (141/748), 26.72% (152/591) and 31.58% (66/209), respectively, which was higher than that in CM, about 6.28% (91/1 450), 7.20% (82/1 139) and 11.02% (40/363), respectively (all P values <0.001). Conclusion:The quality of blood pressure data and the efficiency of hypertension screening of SBPM are better than those of CM when applying to first blood pressure measurement among community population aged 35 years old and above.

Objective:To investigate the association between metabolic syndrome (MS) components and renal cell cancer in Chinese males.Methods:All male employees and retirees of the Kailuan Group were recruited in the Chinese Kailuan Male Cohort Study. They had been experienced routine physical examinations ever two years since May 2006. A total of 104 274 males were prospectively observed by 31 December 2015. Information on demographics, height, weight, blood glucose, blood lipid, blood pressure, as well as the information of incident renal cell cancer cases were collected at the baseline investigation by questionnaire, physical measurement and laboratory test. Cox proportional hazards regression models were used to evaluate the association between baseline MS and MS components (body mass index, blood glucose, blood lipid, blood pressure) and the risk of renal cell cancer in males.Results:A total of 104 274 males were recruited in our study with a age of (51.21±13.46) years, with 823 892.96 person-years follow-up and the median follow-up time was 8.88 years. A total of 131 new renal cell cancer cases were identified in the Kailuan male cohort study, and the crude incidence density was 15.90 per 100,000 person-years. Compared with no MS, the hazard ratios ( HR) (95% CI) of MS was 1.97 (1.32-2.94).When compared with normal level, the HR (95% CI) of obesity or overweight, hypertension, and dyslipidemia was 1.49 (1.04-2.14), 1.56 (1.06-2.29), and 1.77(1.23-2.54), after adjusting for potential confounding factors (i.e., age, education, income, smoke, and alcohol drink), respectively. In addition, a statistically significant trend ( P for trend<0.001) of increased renal cell cancer risk with an increasing number of abnormal MS components was observed. Conclusion:Obesity or overweight, hypertension, dyslipidemia and MS may increase the risk of renal cell cancer for Chinese males.