BACKGROUND:Allogeneic hematopoietic stem cell transplantation is an important treatment for malignant hematological diseases,and delayed postoperative platelet implantation is a common complication that seriously affects the quality of patient survival;however,there are no standard protocols to improve platelet implantation rates and prevent platelet implantation delays. OBJECTIVE:To compare the safety and efficacy of oral Herombopag Olamine versus subcutaneous recombinant human thrombopoietin for promoting platelet implantation in patients with malignant hematological diseases undergoing haploid hematopoietic stem cell transplantation. METHODS:Clinical data of 163 patients with malignant hematological diseases who underwent haploidentical hematopoietic stem cell transplantation from January 2016 to October 2022 were retrospectively analyzed.A total of 72 patients who started to subcutaneously inject recombinant human thrombopoietin at+2 days were categorized into the recombinant human thrombopoietin group;a total of 27 patients who started to orally take Herombopag Olamine at+2 days were categorized into the Herombopag Olamine group;and 64 patients who did not apply Herombopag Olamine or recombinant human thrombopoietin were categorized into the blank control group.The implantation status,incidence of acute graft-versus-host disease of degree II-IV within 100 days,1-year survival rate,1-year recurrence rate,and safety were analyzed in the three groups. RESULTS AND CONCLUSION:(1)The average follow-up time was 52(12-87)months.The implantation time of neutrophils in the blank control group,recombinant human thrombopoietin group,and Herombopag Olamine group was(12.95±3.88)days,(14.04±3.71)days,and(13.89±2.74)days,respectively,with no statistically significant difference(P=0.352);the implantation time of platelets was(15.16±6.27)days,(17.67±6.52)days,and(17.00±4.75)days,with no statistically significant difference(P=0.287).(2)The complete platelet implantation rate on day 60 was 64.06%,90.28%,and 92.59%,respectively,and the difference was statistically significant(P<0.001).The subgroup analysis showed that the difference between the blank control group and the recombinant human thrombopoietin group was statistically significant(P<0.001),and the difference between the blank control group and the Herombopag Olamine group was statistically significant(P=0.004).The difference was not statistically significant between the recombinant human thrombopoietin group and Herombopag Olamine group(P=0.535).(3)100-day II-IV degree acute graft-versus-host disease incidence in the blank control group,recombinant human thrombopoietin group,and Herombopag Olamine group were 25.00%,30.56%,and 25.93%,respectively,and the difference was not statistically significant(P=0.752).(4)The incidence of cytomegalovirus anemia,cytomegalovirus pneumonia,and hepatic function injury had no statistical difference among the three groups(P>0.05).(5)During the follow-up period,there was no thrombotic event in any of the three groups of patients.(6)The results showed that recombinant human thrombopoietin and Herombopag Olamine could improve the platelet implantation rate of malignant hematological disease patients after haploidentical hematopoietic stem cell transplantation,with comparable efficacy and good safety.

To investigate the antimicrobial resistance of Enterococci isolated from 596 anal swabs,feces and environmental samples were collected from pig,cattle,chicken and quail farms in Chang-sha,Hunan Province,Enterococci were isolated and identified by mass spectrometry.The minimum inhibitory concentrations(MICs)of 10 antimicrobial agents were determined by AGAR diffusion method.Whole genome sequencing(WGS)was used to detect the distribution of multilocus se-quence typing(ST),drug resistance genes and virulence genes.A total of 272 strains of Enterococ-cus were isolated(45.6％).The isolates were resistant to cefoxitin(68.9％)and cefotiofur(58.5％),followed by trimethoprim/sulfamethoxazole(52.2％),vancomycin(4.4％),and linezolid(13.6％).In this study,six linezolid highly resistant Enterococci isolates were analyzed by whole genome sequencing to explore the transmission mechanism of linezolid resistance because linezolid is forbidden to be used in aquaculture.ST403(4/6),ST16(1/6)and ST476(1/6)were the most common ST types,which all originated from the same farm.Three oxazolidinone resistance genes(cfr,poxtA and optrA)were found in all 21 strains.One strain(Ecc60)carried all three oxazo-lidinone resistance genes,but none of them were located on the plasmid.tet(M),aph(3')-Ⅲ,and lsa(A)were found in all six Enterococcus isolates.Interestingly,the present study is the first to i-dentify enterococci carrying the optrA gene in quail fecal samples.The analysis of the genetic envi-ronment of oxazolidinone resistance genes showed that the genetic environment of cfr(D),poxtA and optrA of isolates from the same farm was similar.A total of 19 virulence genes were detected in 6 isolates,of which 12 genes(ElrA,SrtA,ace,agg,cCF10,cOB1,cad,camE,ebpA,ebpC,efaAfs,tpx)were carried by all 6 isolates,and the types of virulence genes in strains from the same farm were extremely similar.The results showed that the drug resistance of Enterococci iso-lated from the fish farms in Changsha was serious,and the resistance rate to linezolid,which was prohibited in the fish farms,was high.The oxazolidinone resistance gene loci were accompanied by other resistance genes,especially the florfenicol resistance gene(FexA),which may be related to the abuse of florfenicol in the fish farms.

Purpose To explored the correlation between imaging features and patient's blood markers based on quantitative analysis of urate deposition in acute exacerbations of gouty arthritis of the knee by dual-energy spectrum CT(DECT).Materials and Methods A retrospective analysis was conducted on energy spectrum CT imaging of 72 patients clinically diagnosed with acute gouty knee osteoarthritis and 87 patients with non-gouty knee disease during the acute exacerbation period at the First Hospital of Qiqihar from January 2020 to September 2023.The analysis aimed to evaluate urate deposition in different parts of the knee joints and to analyze the influencing factors of urate deposition combined with the blood test indexes of the patients via receiver operating characteristic curves.Results The neutrophil lymphocyte ratio showed a positive correlation with C-reactive protein,erythrocyte sedimentation rate,and urate concentration at the site of urate deposition in gouty nodules of the knee(r=0.354,0.326,0.260,respectively,all P<0.05).The mean platelet volume was significantly positive correlated with the semi-quantitative data of monosodium urate crystals and urate concentration in the knee(r=0.563,0.257,respectively,P<0.05).In the gout group,C-reactive protein was positively correlated with pararticular soft tissue urate concentration and bone urate concentration(r=0.498,0.166,P<0.05),while erythrocyte sedimentation rate was positively correlated with pararticular soft tissue(tendons,ligaments,etc)urate concentration(r=0.325,P<0.01).Additionally,serum uric acid was positively correlated with gouty nodules in the knee joints and pararticular soft tissue(tendons,ligaments,etc)(r=0.264,0.243,respectively,P<0.05).The cut-off values of neutrophil lymphocyte ratio,platelet lymphocyte ratio and mean platelet volume combined with dual-energy energetic spectroscopic CT imaging data in the diagnosis of gouty knee osteoarthritis points were 2.190,122.96 and 9.049,respectively.Conclusion Energetic spectrum CT can identify and quantify urate crystals at the early stage.And blood test indexes such as mean platelet volume,erythrocyte sedimentation rate and serum uric acid have potential value in evaluating the activity of gout and the degree of migration of the disease in gouty knee osteoarthritis.

Chinese head and neck pathology has been comprehensively improved in the past ten year. This paper focuses on the observation and research of sinonasal epithelial tumors, non-epithelial tumors, inflammatory diseases, NK/T cell lymphoma, nasopharyngeal carcinoma, oropharyngeal HPV-associated squamous cell carcinoma, laryngeal squamous cell carcinoma, ear neuroendocrine tumor, adenoid cystic carcinoma, endolymphatic sac tumor, and hyperplastic disease of Waldeyer′s ring lymphoid tissue, etc. The difficult cases were reviewed. Hope to represent the whole picture of the progress of the subject. In the future, we will further strengthen the construction of discipline echelons, deepen the comprehensive and in-depth discussion and research of diseases, and make breakthroughs in the original understanding of diseases.

Objective:To investigate the correlation of combined detection of p16 and Rb with high-risk human papilloma virus (HR-HPV) infection in non-oropharyngeal squamous cell carcinoma (NOPSCC) of the head and neck.Methods:A total of 68 NOPSCC cases of the head and neck (23 cases of the nasal cavity and paranasal sinuses and 45 cases of larynx) with complete clinical and pathological data, diagnosed at the Beijing Tongren Hospital, Capital Medical University, Beijing, China from November 2013 to December 2023, were collected. The expression of p16 and Rb was detected using immunohistochemistry of the EnVision two-step method, while the HR-HPV mRNA expression was detected using in situ hybridization. The concordance, sensitivity, and specificity of p16 alone and the combined detection of p16 and Rb for detecting HR-HPV infection were analyzed.Results:Among the 68 patients with NOPSCC, 53 were male and 15 were female, with a median age of 63.5 (range, 57.3 to 66.8) years. 41 patients had a smoking history and 27 did not. 33 patients had an early T stage (T1/T2) and 35 had advanced T stage (T3/T4). 14 patients had lymph node metastasis and 2 had distant metastasis. Histological types included 62 cases of keratinized squamous cell carcinoma, 5 cases of non-keratinized squamous cell carcinoma, and 1 case of basal-like squamous cell carcinoma. 25 cases were positive for p16. Among the 25 cases, 16 cases were positive for Rb, and 6 cases were positive for HR-HPV mRNA. 43 cases were negative for p16, including 38 cases positive for Rb and no cases positive for HR-HPV mRNA. The concordance between p16 and HR-HPV mRNA expression was poor ( Kappa=0.285, P=0.001), with a sensitivity of 100.0% and specificity of 69.4%. In contrast, the combined detection of p16+/Rb- showed high concordance with HR-HPV mRNA expression ( Kappa=0.719, P<0.001), with a sensitivity of 100.0% and specificity of 95.2%. Conclusions:In NOPSCC of the head and neck, the combined detection of p16 and Rb may be used as a marker for assessing HR-HPV infection. Recognizing the p16+/Rb- expression pattern in NOPSCC can improve the specificity of HR-HPV detection.

As an important parameter in the field of pathological morphology,tumor budding is the histological ba-sis for tumor invasion and metastasis,which is reflected in various types of cancer,such as oropharyngeal cancer,colo-rectal cancer,esophageal cancer,lung cancer,uterine cancer,etc.The in-depth study of tumor budding by scholars suggests that it can be used as a prognostic indicator for head and neck squamous cell carcinoma(HNSCC).This arti-cle aims to review the research progress on the occurrence,grading,and prediction of cancer prognosis in tumor bud-ding,with the hope of providing assistance in clinical treatment decision-making for HNSCC.

Purpose To explored the correlation between imaging features and patient's blood markers based on quantitative analysis of urate deposition in acute exacerbations of gouty arthritis of the knee by dual-energy spectrum CT(DECT).Materials and Methods A retrospective analysis was conducted on energy spectrum CT imaging of 72 patients clinically diagnosed with acute gouty knee osteoarthritis and 87 patients with non-gouty knee disease during the acute exacerbation period at the First Hospital of Qiqihar from January 2020 to September 2023.The analysis aimed to evaluate urate deposition in different parts of the knee joints and to analyze the influencing factors of urate deposition combined with the blood test indexes of the patients via receiver operating characteristic curves.Results The neutrophil lymphocyte ratio showed a positive correlation with C-reactive protein,erythrocyte sedimentation rate,and urate concentration at the site of urate deposition in gouty nodules of the knee(r=0.354,0.326,0.260,respectively,all P<0.05).The mean platelet volume was significantly positive correlated with the semi-quantitative data of monosodium urate crystals and urate concentration in the knee(r=0.563,0.257,respectively,P<0.05).In the gout group,C-reactive protein was positively correlated with pararticular soft tissue urate concentration and bone urate concentration(r=0.498,0.166,P<0.05),while erythrocyte sedimentation rate was positively correlated with pararticular soft tissue(tendons,ligaments,etc)urate concentration(r=0.325,P<0.01).Additionally,serum uric acid was positively correlated with gouty nodules in the knee joints and pararticular soft tissue(tendons,ligaments,etc)(r=0.264,0.243,respectively,P<0.05).The cut-off values of neutrophil lymphocyte ratio,platelet lymphocyte ratio and mean platelet volume combined with dual-energy energetic spectroscopic CT imaging data in the diagnosis of gouty knee osteoarthritis points were 2.190,122.96 and 9.049,respectively.Conclusion Energetic spectrum CT can identify and quantify urate crystals at the early stage.And blood test indexes such as mean platelet volume,erythrocyte sedimentation rate and serum uric acid have potential value in evaluating the activity of gout and the degree of migration of the disease in gouty knee osteoarthritis.

With the development of thyroid pathology in the past decade, thyroid pathological diagnosis has entered the era of molecular pathology. As the most influential academic journal in the field of pathology in China, Chinese Journal of Pathology has published nearly one hundred articles related to thyroid diseases in the past decade. These results have made a great difference to the scientific research and clinicopathological diagnosis of thyroid diseases in China, and have also provided Chinese data for the pathological communication of thyroid diseases internationally. Pathologists should make full use of thyroid cytology and histopathology, combined with molecular testing and digital intelligence technology, to play a core guiding role in the multidisciplinary precise diagnosis and treatment of thyroid diseases.

Objective To investigate the protective effects of Ligilactobacillus salivarius Li01(L.salivarius Li01)against DNA damage induced by Helicobacter pylori(Hp),Benzo(a)pyrene(BaP),and Hp+BaP,and to evaluate the probiotic properties of L.salivarius Li01.Methods After 1 week of adaptive feeding,specific pathogen-free male Mongolian gerbils were randomly assigned to groups and subjected to intragastric administration of Hp,BaP,and Hp+BaP for model induction.At week 32 post model establishment,therapeutic L.salivarius Li01 was administered intragastrically.At week 36,peripheral blood samples were collected from each group for the comet assay,while liver tissues were collected and tested for Cyp1a1 gene expression levels.Results Compared with those in the control group,the comet tail length,％tail DNA,and hepatic Cyp1a1 expression levels were significantly increased in the Hp,BaP,and Hp+BaP groups(P＜0.0001).Among these,the comet tail length,olive tail moment,％tail DNA,and hepatic Cyp1a1 expression levels were significantly higher in the Hp+BaP group than in the Hp and BaP groups(P＜0.05).Following intervention with L.salivarius Li01,the comet tail length,olive tail moment,％tail DNA,and hepatic Cyp1a1 expression levels were significantly reduced in each group(P＜0.001).Conclusions Hp infection,BaP exposure,and the Hp+BaP combination induced DNA damage in the peripheral lymphocytes of Mongolian gerbils,with the Hp+BaP combination showing synergistic damage.L.salivarius Li01 had a protective effect against DNA damage caused by Hp,BaP,and Hp+BaP.

Objective:To develop an intelligent surveillance system for identifying upper gastrointestinal high-risk patients and assigning surveillance intervals, and to verify its efficacy.Methods:The endoscopic and pathological reports of 23 035 patients undergoing endoscopy at Renmin Hospital of Wuhan University from January to October 2021 were collected retrospectively. A training set of 17 934 patients (January to August) and a test set of 5 101 patients (September to October) were established. Keywords in the endoscopic and pathological reports were extracted by the intelligent surveillance system, and high-risk patients were automatically identified and classified into 7 risk levels. Then the standardized surveillance intervals were assigned based on the guideline. Guideline-based surveillance intervals assigned by expert endoscopists based on endoscopic and pathological reports were used as the golden standard. The accuracy of the intelligent surveillance system was calculated. Of the patients within the test set, 189 were hospitalized and the surveillance intervals given by physicians could be obtained from the electronic health records. The accuracy of the intelligent surveillance system with that of physicians from different departments was compared. Then 67 patients were randomly selected from 189 patients by simple random sampling to evaluate the adjunctive effect of the system in assigning surveillance intervals among 3 endoscopists.Results:The overall accuracy of the intelligent surveillance system in identifying upper gastrointestinal high-risk patients was 99.94% (5 098/5 101), and that of assigning surveillance intervals to correctly included patients was 100.00% (534/534). The intelligent surveillance system achieved significantly higher accuracy compared with all physicians from different departments [98.94% (187/189) VS 35.45% (67/189), χ2=118.01, P<0.001] as well as physicians from department of gastroenterology [100.00% (117/117) VS 24.79% (29/117), χ2=86.01, P<0.001]. With the assistance of the intelligent surveillance system, the endoscopists' accuracy of assigning surveillance intervals to 67 patients was significantly improved [55.22% (111/201) VS 22.39% (45/201), χ2=58.68, P<0.001]. Conclusion:The intelligent surveillance system can accurately identify upper gastrointestinal high-risk patients and assign surveillance intervals according to risk levels, which can alleviate the workload of doctors and improve the follow-up rate of patients.