Objective:To investigate the factors influencing the delayed onset of intrapartum fever following epidural labor analgesia and their impact on maternal and neonatal outcomes.Methods:Select parturients who experienced intrapartum fever following labor analgesia(T≥38.0℃,age≥18 years,singleton pregnancy,ASA classification Ⅱ)between January 1,2021,and December 31,2023.Group them based on the median time of intra-partum fever onset after labor analgesia:those with onset times less than the median were classified as the ear-ly-onset fever group,and those with onset times greater than the median were classified as the late-onset fever group.Using univariate and multivariate Logistic regression analysis to explore factors influencing the delay in in-trapartum fever onset and the pregnancy outcomes of the mothers and newborns in both groups.Results:A total of 253 parturients were included,and the time range of onset of intrapartum fever following epidural labor analgesi-a was 1.83-28.42 hours,with a median fever onset time of 8.00 hours.There were 126 cases in the early-onset group and 127 in the late-onset group.Multivariate Logistic regression analysis indicated that primiparous women,artificial membrane rupture,and neonatal birth weight were independent risk factors for delayed fever onset(OR＞1,P＜0.05),whereas the administration of oxytocin prior to labor analgesia was found to be a protective factor(OR＜1,P＜0.05).The late-onset group exhibited higher levels of white blood cells(WBC),C-reactive pro-tein,longer hospital stays,higher hospitalization costs,greater diagnosis rates of chorioamnionitis,higher NICU ad-mission rates,as well as a higher incidence of neonatal pneumonia,for newborns compared to the early-onset group(P＜0.05).Conclusions:Primiparous women,artificial membrane rupture,and higher neonatal birth weight may be associated with delayed onset of intrapartum fever,while oxytocin administration prior to labor analgesia may offer some protective benefit.The later the onset of intrapartum fever,the worse the clinical outcomes for both mother and infants.

Objective To observe CT manifestations of Fitz-Hugh-Curtis syndrome(FHCS).Methods Data of 23 patients with FHCS were retrospectively analyzed,and non-enhanced and enhanced abdominal and pelvic CT manifestations were observed.Results All 23 cases were found with pelvic inflammation,peritonitis,perihepatic inflammation,as well as abdominal and pelvic adhesion.The main manifestations of pelvic inflammation included pelvic effusion(23/23,100％),inflammatory changes of uterus and accessories(17/23,73.91％),and the latter presented as tubal thickening(8/17,47.06％)or tubal cystic dilatation and effusion(9/17,52.94％),with ovarian enlargement(8/9,88.89％)or nodules on uterine surface(1/9,11.11％).The main CT manifestations of peritonitis were peritoneal thickening(23/23,100％)and peritoneal nodules(15/23,65.22％),of perihepatic inflammation were mainly liver capsule enhancement(23/23,100％),subcapsular transient perfusion abnormality(16/23,69.57％),perihepatic effusion(20/23,86.96％)and perihepatic"violin-string sign"(16/23,69.57％).No inflammation in the bare area of liver was noticed.Among 23 cases,3 cases(3/23,13.04％)complicated with mechanical ileus,19 cases(19/23,82.61％)were accompanied by mesenteric or retroperitoneal lymph nodes enlargement with uniform or circular enhancement.Conclusion The main CT manifestations of FHCS included pelvic inflammation,peritonitis,perihepatic inflammation,as well as abdominal and pelvic adhesion,having certain characteristics.

BACKGROUND:Acute lung injury is a common severe complication in sepsis patients,with a complex pathogenesis,for which there is currently no effective pharmacological treatment.The therapeutic mechanism by which human umbilical cord-derived mesenchymal stem cells improve sepsis-induced acute lung injury through the inhibition of excessive cellular pyroptosis is increasingly receiving attention.OBJECTIVE:To investigate the effects and mechanisms of human umbilical cord-derived mesenchymal stem cells on cellular pyroptosis in lung tissues of mice with sepsis-induced acute lung injury.METHODS:Totally 48 male Balb/c mice were randomly divided into sham,model,and treatment groups(n=16 per group).The model and treatment groups underwent cecum ligation and puncture to establish a sepsis-induced acute lung injury model,while the sham group underwent laparotomy without further procedures.The treatment group received a tail vein injection of 200 μL of human umbilical cord-derived mesenchymal stem cell suspension(5x105 cells)6 hours after the procedure,while the model and sham groups received 200 μL of saline 6 hours after the surgery.Twenty-eight hours post-procedure,five mice from each group were randomly selected for tail vein injection of Evans blue dye to assess pulmonary vascular permeability.The remaining mice from each group had their bronchoalveolar lavage fluid and lung tissues collected for ELISA to measure levels of interleukin-1β and interleukin-18,cell counts,and macrophage numbers in the bronchoalveolar lavage fluid.Hematoxylin and eosin staining was used to observe the pathological morphology of lung tissue.TUNEL staining was used to assess cellular pyroptosis.RT-PCR and western blot analyses were conducted to measure mRNA and protein expression levels of Toll-like receptor 4,GSDMD,and Caspase-11 in lung tissues.RESULTS AND CONCLUSION:Compared to the model group,the treatment group showed a significant decrease in pulmonary vascular permeability at 28 hours post-procedure(P＜0.05),reduced levels of interleukin-1β and interleukin-18 in bronchoalveolar lavage fluid(P＜0.05),and lower cell and macrophage counts(P＜0.05).Lung injury severity was reduced,with a decreased pyroptosis index(P＜0.05)and significantly lower levels of Toll-like receptor 4,GSDMD,GSDMD-N,and Caspase-11 mRNA and protein expression in lung tissues(P＜0.05).These results suggest that human umbilical cord-derived mesenchymal stem cells may improve the severity of sepsis-induced lung injury to some extent by inhibiting the activation of the Toll-like receptor 4/Caspase-11/GSDMD signaling pathway and reducing cellular pyroptosis in lung tissues.

At present,the laboratory medicine industry in China has developed rapidly,with various new technologies and methods emerge one after another. However,the current training process of laboratory medicine technology professionals still follows a training model that emphasizes theyory over practice,and the quality of training personnel is far from the requirments of the current development of the laboratory medicine industry in China. In order to effectively alleviate the current situation of the shortage of practical high-quality laboratory medicine talents,it is urgent to reform the teaching of laboratory medicine. The author of this paper puts forward the "Four-in-one" personnel training mode which is suitable for the development of laboratory medicine in China. It is proposed to explore a new teaching mode on the basis of the existing one,giving full play to the students' initiative and innovation,and providing new ideas for training high-quality laboratory medicine professionals.

Objective To observe the early changes of vault after implantation of posterior chamber phakic intraocular lens implantable collamer lens(ICL),and investigate the effect of different implantation axes on the early vault changes.Methods A prospective,parallel cohort study was performed,enrolling a total of 124 eyes of who underwent ICL(V4c)implantation in the refractive clinic.The changes of vault were observed by scheimpflug tomography(Pentacam)and anterior segment optical coherence tomography(CASIA2)at 1 day,1 week and 1 month after surgery.Results The ICL vault declined significantly by approximately(108.2±82.4)μm 1 week after surgery with the proportion of 16.6%±12.1%compared with the values 1 day after surgery(P<0.001),and then remained stable.Within 1 month after surgery,excluding the difference in vault baseline at 1 day after surgery,the proportion of vault decline in the middle vault group(250-749 μm)and the high vault group(≥750 μm)was similar,and there was no statistically significant difference.We analyzed the relationship between ICL axial directions and vault and found that the vault decline of the horizontal ICL group stabilized quickly at 1 week after surgery,and the vault decline of the vertical ICL group was more significant within 1 month after surgery(P<0.05).Conclusion The vault of the ICL shows a downward trend in the early stage after implantation.The middle vault group and ICL in the horizontal position stabilizes faster,and the downward trend of the high vault group or ICL in the vertical position is more obvious.

A 3-month-old female infant was admitted for incessant crying for 3 days.Examination revealed a rapidly growing massive retroperitoneal mass that was difficult to resect.Needle biopsy confirmed infantile fibrosarcoma.Initial chemotherapy with the VAC regimen(vincristine,actinomycin D,and cyclophosphamide)was administered,but the response was poor.The common fusion in infantile fibrosarcoma is ETV6-NTRK3,and next-generation sequencing detected an RBPMS-NTRK3 gene fusion in this patient.To our knowledge,this is the first reported case of infantile fibrosarcoma with RBPMS-NTRK3 fusion in China.Treatment with larotrectinib resulted in marked tumor shrinkage.

Objective Bibliometric analysis software VOSviewer and CiteSpace were applied to analyze literatures related to acupuncture for myocardial Ischemia/Reperfusion(I/R)injury published in Chinese and English,to explore the status quo,dynamic trend and hot spots in the field,in order to provide reference for future research.Methods Based on the literature on acupuncture and moxibustion for myocardial I/R injury published in CNKI and Web of Science Core Collection database,VOSviewer and CiteSpace software were used to analyze literature publication trends,authors,institutions,countries,journals,keywords and citations,and draw graphs and tables to show the development status of the field and analyze the future development direction.Results Both Chinese and English literatures on the treatment of myocardial I/R injury by acupuncture and moxibustion show an increasing trend,which is one of the academic hotspots with great potential at present.In terms of Chinese literature,Yan Jie is the scholar who has published the most papers,and Hunan University of Traditional Chinese Medicine is the representative of the high production institution.The journal of Acupuncture Research has published the most papers.In terms of English literature,lu sheng-feng is the representative scholar with a high number of publications,Nanjing University of Chinese Medicine is the institution with the largest number of publications,and Evidence-Based Complementary and Alternative Medicine is the journal with the largest number of publications.The authors in the field have weak interinstitutional cooperation and exchange,and their research is mainly from China,with little international collaboration and exchange.At present,acupuncture treatment of myocardial I/R injury covers three aspects:specific acupoints,molecular biological mechanisms and clinical studies,which mainly focus on seven hot spots.Conclusion The bibliometric visual analysis visually demonstrated the current status,hot spots and frontier trends of acupuncture in the treatment of myocardial I/R injury.In the future,it is necessary to strengthen international collaboration,promote exchanges and cooperation between scholars and institutions,and promote the publication of multi-center,large-sample and high-level clinical randomized controlled studies;At the same time,the effect mechanism was further discussed from the perspectives of new molecular biological mechanisms,new intervention measures and point selection,and clinical translational research was carried out.

A 3-month-old female infant was admitted for incessant crying for 3 days.Examination revealed a rapidly growing massive retroperitoneal mass that was difficult to resect.Needle biopsy confirmed infantile fibrosarcoma.Initial chemotherapy with the VAC regimen(vincristine,actinomycin D,and cyclophosphamide)was administered,but the response was poor.The common fusion in infantile fibrosarcoma is ETV6-NTRK3,and next-generation sequencing detected an RBPMS-NTRK3 gene fusion in this patient.To our knowledge,this is the first reported case of infantile fibrosarcoma with RBPMS-NTRK3 fusion in China.Treatment with larotrectinib resulted in marked tumor shrinkage.

Excessive fat accumulation,viral infections and sustained inflammatory responses caused by non-alcoholic and alcoholic factors can contribute to liver inflammation,fibrosis and carcinogenesis,promoting the development of chronic liver disease.Gaining an in-depth understanding of the etiologic factors and underlying mechanisms that lead to chronic liver disease can help identify potential therapeutic targets for targeted therapy.Lactate,as an important substance in hepatic metabolism,has been found to be involved in the process of chronic liver disease through various pathways,and this review will provide a useful reference for the prevention and treatment of chronic liver disease.

BACKGROUND:Acute lung injury is a common severe complication in sepsis patients,with a complex pathogenesis,for which there is currently no effective pharmacological treatment.The therapeutic mechanism by which human umbilical cord-derived mesenchymal stem cells improve sepsis-induced acute lung injury through the inhibition of excessive cellular pyroptosis is increasingly receiving attention.OBJECTIVE:To investigate the effects and mechanisms of human umbilical cord-derived mesenchymal stem cells on cellular pyroptosis in lung tissues of mice with sepsis-induced acute lung injury.METHODS:Totally 48 male Balb/c mice were randomly divided into sham,model,and treatment groups(n=16 per group).The model and treatment groups underwent cecum ligation and puncture to establish a sepsis-induced acute lung injury model,while the sham group underwent laparotomy without further procedures.The treatment group received a tail vein injection of 200 μL of human umbilical cord-derived mesenchymal stem cell suspension(5x105 cells)6 hours after the procedure,while the model and sham groups received 200 μL of saline 6 hours after the surgery.Twenty-eight hours post-procedure,five mice from each group were randomly selected for tail vein injection of Evans blue dye to assess pulmonary vascular permeability.The remaining mice from each group had their bronchoalveolar lavage fluid and lung tissues collected for ELISA to measure levels of interleukin-1β and interleukin-18,cell counts,and macrophage numbers in the bronchoalveolar lavage fluid.Hematoxylin and eosin staining was used to observe the pathological morphology of lung tissue.TUNEL staining was used to assess cellular pyroptosis.RT-PCR and western blot analyses were conducted to measure mRNA and protein expression levels of Toll-like receptor 4,GSDMD,and Caspase-11 in lung tissues.RESULTS AND CONCLUSION:Compared to the model group,the treatment group showed a significant decrease in pulmonary vascular permeability at 28 hours post-procedure(P＜0.05),reduced levels of interleukin-1β and interleukin-18 in bronchoalveolar lavage fluid(P＜0.05),and lower cell and macrophage counts(P＜0.05).Lung injury severity was reduced,with a decreased pyroptosis index(P＜0.05)and significantly lower levels of Toll-like receptor 4,GSDMD,GSDMD-N,and Caspase-11 mRNA and protein expression in lung tissues(P＜0.05).These results suggest that human umbilical cord-derived mesenchymal stem cells may improve the severity of sepsis-induced lung injury to some extent by inhibiting the activation of the Toll-like receptor 4/Caspase-11/GSDMD signaling pathway and reducing cellular pyroptosis in lung tissues.