Objective:To explore the clinical and imaging features of the concomitant gastric-type endocervical adenocarcinoma(G-EAC)in female patients with Peutz-Jeghers syndrome(PJS),so as to improve the early diagnostic level for PJS.Methods:A retrospective analysis was performed on the clinical and imaging data of 12 patients who were confirmed as PJS with G-EAC at Air Force Medical Center,PLA from June 2021 to December 2024.The 12 patients all received computed tomography(CT)examination before surgery,and 6 cases among of them received magnetic resonance imaging(MRI)examination at the same time.The features of clinical performance,and imaging features of CT and MR in all patients were analyzed.Results:In 12 G-EAC patients,7 cases(58.3%)did not occurred any abnormally relative symptoms of gynaecology and obstetrics,while 5 cases(41.7%)occurred increase of vaginal drainage and/or vaginal bleeding.The results of imaging examination indicated that 12 cases occurred concomitant cyst,including 5 cases(41.7%)with large cysts,6 cases(50.0%)that micro cysts coexisted with large cysts,1 case(8.3%)that solid mass combined with small amount of micro cysts,and 4 cases(33.3%)that combined with small amount of uterine cavity effusion.MR performance was the most of occurrences were quasi-circular object with long T1/T2 signals,and the sequences of diffusion weighted imaging(DWI)appeared there was no diffusion or mild restriction,and apparent diffusion coefficient(ADC)appeared slightly high signal.The tumors that mainly were solid components appeared longer T2 signals,which diffusion was limited,and which ADC values appeared low signals.CT images of them presented enlarged cervixes,and mixed-density cystic and solid nodules and mass shadows at local tissues,and cellular change at local lesions.There was not significant strengthen at the cystic fields of the lesion with enhanced scan,and the solid fields appeared uneven enhancement.The accuracy rates both of preoperative CT and MR diagnosis were 50.0%.Conclusion:The clinical appearance,and imaging futures of CT and MR examinations of PJS female patients with G-EAC are respectively:partial patients occur vaginal drainage and/or vaginal bleeding,the most of tumors often occurs at the entire cervix(includes upper segment),often combines with cystic changes,and often appears infiltrating growth.The clinical PJS appearance,CT and MR examinations contribute to early diagnosis for G-EAC.

Objective:To observe the efficacy and safety of combined lienal polypeptide injection therapy in the treatment of Mycoplasma pneumoniae pneumonia（MPP）in children aged 3 to 14 years old in multiple clinical centers.Methods:A randomized，controlled，multi-center clinical study design was adopted.A total of 240 hospitalized children aged 3 to 14 years old with MPP from 7 hospitals from September 1，2023 to January 31，2024 were included.According to the severity of pneumonia，they were divided into the mild MPP group with 80 cases and the severe MPP/refractory MPP（SMPP/RMPP）group with 160 cases，and then randomly divided into the control group and the experimental group at a ratio of 1 ∶1，using the random number table method.After screening，subjects entered a treatment period of 5 to 7 days.The control group was treated with azithromycin，while the experimental group was treated with azithromycin plus lienal polypeptide injection .The recovery of lung CT，length of hospital stay，duration of fever，cough score，whether mild cases developed into severe or refractory cases，duration of hormone use，use of intravenous immunoglobulin（IVIG），bronchoscopy treatment，and immune function were observed between the two groups to evaluate the efficacy of lienal polypeptide injection.Adverse events after medication，vital signs，blood routine，urine routine，liver function，myocardial enzymes，renal function，and electrocardiogram were observed to evaluate the safety. Results:A total of 231 subjects have completed the trial in the 7 hospitals，including 118 cases in the experimental group and 113 cases in the control group.Main observation index：the rate of lung CT aggravation in the experimental group was lower than that in the control group（2.6% vs 15.3%， P<0.01），and the difference was statistically significant.Secondary indexes：there were no statistically significant differences in the length of hospital stay，duration of fever，cough score，duration of hormone use，whether IVIG treatment was used，the number of bronchoscopy treatment cases，and immunoglobulin between the two groups（all P>0.05）.However，the rate of cases of plastic bronchitis（PB）found under bronchoscopy in the experimental group was lower than that in the control group（0 vs 18.8%， P=0.03），and the difference was statistically significant.Among the mild MPP（72 cases），there were no statistically significant differences in the length of hospital stay，duration of fever，cough score，duration of hormone use，whether IVIG treatment was used，the number of bronchoscopy treatment cases，and the improvement rate of lung CT between the two groups（all P>0.05）.However，compared with the control group，the rate of cases developing into SMPP/RMPP in the experimental group was less（24.3% vs 48.6%， P=0.03），and the difference in IgG before and after treatment was small［0.53（-0.04，1.18）g/L vs 1.33（0.48，2.25）g/L， P=0.01］.Among the SMPP/RMPP cases（159 cases），the rate of cases of PB found under bronchoscopy in the experimental group was less than that in the control group（0 vs 20%， P=0.04），and the rate of cases with aggravated lung CT in the experimental group was less than that in the control group（1.3% vs 19.5%， P<0.01），and the improvement rate of lung CT in the experimental group was higher than that in the control group（88.8% vs 75.3%， P=0.03），with statistically significant differences.There were no statistically significant differences in the length of hospital stay，duration of fever，cough score，duration of hormone use，whether IVIG treatment was used，the number of bronchoscopy treatment cases，and immunoglobulin between the two groups（all P>0.05）.Two cases in the experimental group developed rashes，which improved after the drug was discontinued.There were no serious adverse reactions such as abnormal vital signs like dyspnea and cyanosis due to the use of lienal polypeptide injection.There were no obvious changes in blood routine，liver function，myocardial enzymes，renal function，electrocardiogram，and urine routine values before and after medication compared with the baseline. Conclusion:The combined use of lienal polypeptide injection in the treatment of MPP in children can reduce the probability of the transformation from mild cases to SMPP/RMPP，reduce the rate of aggravation of the image findings，promote the absorption of lung inflammation，reduce the rate of PB found under bronchoscopy，and has good safety.

Objective:To explore the clinical and imaging features of the concomitant gastric-type endocervical adenocarcinoma(G-EAC)in female patients with Peutz-Jeghers syndrome(PJS),so as to improve the early diagnostic level for PJS.Methods:A retrospective analysis was performed on the clinical and imaging data of 12 patients who were confirmed as PJS with G-EAC at Air Force Medical Center,PLA from June 2021 to December 2024.The 12 patients all received computed tomography(CT)examination before surgery,and 6 cases among of them received magnetic resonance imaging(MRI)examination at the same time.The features of clinical performance,and imaging features of CT and MR in all patients were analyzed.Results:In 12 G-EAC patients,7 cases(58.3%)did not occurred any abnormally relative symptoms of gynaecology and obstetrics,while 5 cases(41.7%)occurred increase of vaginal drainage and/or vaginal bleeding.The results of imaging examination indicated that 12 cases occurred concomitant cyst,including 5 cases(41.7%)with large cysts,6 cases(50.0%)that micro cysts coexisted with large cysts,1 case(8.3%)that solid mass combined with small amount of micro cysts,and 4 cases(33.3%)that combined with small amount of uterine cavity effusion.MR performance was the most of occurrences were quasi-circular object with long T1/T2 signals,and the sequences of diffusion weighted imaging(DWI)appeared there was no diffusion or mild restriction,and apparent diffusion coefficient(ADC)appeared slightly high signal.The tumors that mainly were solid components appeared longer T2 signals,which diffusion was limited,and which ADC values appeared low signals.CT images of them presented enlarged cervixes,and mixed-density cystic and solid nodules and mass shadows at local tissues,and cellular change at local lesions.There was not significant strengthen at the cystic fields of the lesion with enhanced scan,and the solid fields appeared uneven enhancement.The accuracy rates both of preoperative CT and MR diagnosis were 50.0%.Conclusion:The clinical appearance,and imaging futures of CT and MR examinations of PJS female patients with G-EAC are respectively:partial patients occur vaginal drainage and/or vaginal bleeding,the most of tumors often occurs at the entire cervix(includes upper segment),often combines with cystic changes,and often appears infiltrating growth.The clinical PJS appearance,CT and MR examinations contribute to early diagnosis for G-EAC.

Background::For patients with severe neck angulation (SNA), hemodynamic and clinical outcomes following endovascular aneurysm repair (EVAR) are still unclear. This study aimed to explore the influence of SNA on hemodynamic and clinical outcomes following EVAR.Methods::This study included a hemodynamic analysis and a retrospective cohort study from West China Hospital of Sichuan University between January 2011 and December 2020. The Cox regression model, inverse probability of treatment weighting (IPTW) analysis, sensitivity analysis, and subgroup analysis were applied. Primary outcome was type IA endoleak (T1AEL).Results::In this hemodynamic analysis, nine non-severe neck angulation (nSNA) and 16 SNA idealized models were constructed. We found a significant difference in drag force between SNA and nSNA models (7.016 ± 2.579 N vs. 4.283 ± 1.460 N, P = 0.008), and proximal neck angles were significantly associated with the magnitude of drag force (F = 0.082 × α-0.006 × β + 2.818, α: 95% confidence interval [CI] 0.070-0.094; P = 0.001; β: 95% CI -0.019 to 0.007; P = 0.319). In our cohort study, 514 nSNA patients (71.5 ± 8.5 years; 459 males) and 208 SNA patients (72.5 ± 7.8 years; 135 males) were included, with a median follow-up duration of 34 months (16-63 months). All baseline characteristics were well balanced after IPTW matching. We found that SNA was associated with a significant risk of adverse limb event (hazard ratio [HR] 2.18, 95% CI 1.09-3.12), yet was not associated with T1AEL, overall survival, or reintervention. In patients without proximal or distal additional procedures (DAP), subgroup analyses suggested a significant risk of T1AEL (Proximal: HR 5.25, 95% CI 1.51-18.23; Distal: HR 5.07, 95% CI 1.60-16.07) and adverse limb event (Proximal: HR 2.27, 95% CI 1.01-5.07; Distal: HR 2.91, 95% CI 1.30-6.54) in SNA patients. However, no noticeable difference was observed in patients with proximal or DAP. Conclusions::SNA has a critical influence on hemodynamic and clinical outcomes following EVAR. Appropriate additional procedures may be of great benefit to SNA patients.

Objective To investigate the expression and clinical significance of S100A14 and LOXL2 in papillary thyroid carcinoma tissues. Methods Paraffin blocks from 90 cases of thyroid lesion were collected to make tissue microarray. The expression of S100A14 and LOXL2 in 30 cases of nodular goiter (NG), 30 cases of classic papillary thyroid carcinoma (CPTC) and 30 cases of high invasion papillary thyroid carcinoma were detected by immunohistochemistry. The correlation of S100A14 and LOXL2 expression with the clinicopathological characteristics of papillary thyroid carcinoma patients was investigated. Results S100A4 and LOXL2 were highly expressed in papillary thyroid carcinoma. There was a gradually increasing trend from the expression in NG group, CPTC group to high invasive group. The positive rate of S100A14 in papillary thyroid carcinoma with lymph node metastasis was higher than that without lymph node metastasis (P < 0.05). There was significant difference of S100A14 and LOXL2 expression between CPTC group and high invasion group (P < 0.05). S100A14 expression was positively correlated with LOXL2 expression (r=0.332). Conclusion The high expression of S100A14 and LOXL2 may be related to the malignant biological behavior and invasiveness of papillary thyroid carcinoma, and S100A14 may promote lymph node metastasis.

Objective:To analyze molecular genetic characteristics of standard strains for functional antibody detection of pneumococcal polysaccharide vaccine, and provide the foundation for clinical research of pneumococcal polysaccharide vaccine. Methods:The 24 strains for functional antibody detection of pneumococcal polysaccharide vaccine were detected by PCR amplification and sequencing using standard strain 16S rRNA gene fragment, and the molecular typing of the related strains was performed by multi locus sequence analysis (MLST) and pulsed field gel electrophoresis (PFGE). Results:The result of 16S rRNA gene sequence alignment showed that the similarity between the gene sequences of the 24 strains and that of NCTC 7465 (LN831051) ranged from 98.35% to 99.86%, and the base difference was 2-23 bp. Multi locus sequence analysis showed that the ST types of 24 standard strains were different. PFGE analysis showed that 24 standard strains had good isolation effect from DNA fragments of 100 kb-1 000 kb, and each serotype had its own characteristic bands (12-15 fragments).Conclusions:This study analyzed the molecular genetic characteristics of the standard strains for the detection of pneumococcal functional antibodies for the first time, and may provide a reference for the quality control method of the standard strains for the subsequent detection of pneumococcal functional antibodies.

Objective:To identify the current situation of contract signing for family physician services in Luohu District, Shenzhen, and to explore the associated factors with contract signing and access to services.Methods:Using the WeChat official account of"People′s Hospital of Luohu", an online survey was conducted to investigate the status of family physician′s contract services for residents in Luohu District from May 19th to 25th, 2019. A total of 14 487 valid responses were received. Chi-square test and Logistic regression models were used to analyze the contract signing of family physician services and the related factors.Results:8 560 (59.09%) of the participants had signed with a family physician, and 12 696 of them had learnt about the service before. The awareness rate of family doctor services was 87.64%. The contract signing rate of those unemployed, who living or working in Luohu less than 5 years, who living alone, having no Shenzhen medical insurance, or having not heard of family physicians signing services were less than 50%. The signing rate was positively correlated with the awareness of family physician contract service, as well as the possibility of accepting signed medical examination, traditional Chinese medicine services and health information. Only 9.70% of the contractors received health services information.Conclusions:The contract Signing rates and awareness rate of family physicians among young and middle-aged residents in Luohu District are relatively high. However, access to contract services varies considerably. The signing rate and accepted services are mainly affected by job, length of residence in Shenzhen, type of medical insurance, and understanding of contract.

Objective: The serotype screening of Shigella flexneri from 1934 to 1965 preserved by the National Center for Medical Culture Collections was carried out, and the molecular characteristics of the serotype conversion strains were studied. Methods: Serotyping of Shigella flexneri in this study was conducted by slide agglutination and multiplex PCR, respectively. The gtrⅡ gene sequence alignment and pulsed field gel electrophoresis typing were performed on the serotype conversion strains. Results: Among the 255 strains of Shigella flexneri preserved in CMCC (B) from 1934 to 1965, 79 were carrying gtrⅡ gene, of which 19 strains and 1 strain were agglutinated with the Y serotype and X serotype, respectively, and furthermore, the multiplex PCR assays results showed serotypes 2a and 2b, respectively, and the strains were considered to have serotype conversion. The 20 strains carrying the gtrⅡ gene showed multiple nucleotide mutations. Besides 3 strains of 3 amino acid mutations, the amino acid sequences of the other 17 strains showed a stop codon in advance, resulting in functional inactivation of gtrⅡ. PFGE analysis revealed that the similarity between the serotype Y strain carrying the gtrⅡ gene and the serotype 2a strain was 75.8%-100%, and the similarity between the serotype X strain carrying the gtrⅡ gene and the serotype 2b strain was 81.6%-100%. Conclusion Mutations in the gtrⅡ gene are more complicated in serotype-transforming Shigella flexneri serotype Y or X strains. Molecular typing suggests that the serotype-transforming Shigella flexneri serotype Y or X strains may be derived from the Shigella flexneri serotype 2a or 2b, and advance the serotype conversion to 1949.

Aim To investigate the protective effects of dihydroquercetin(DDQ) against myocardial ischemis reperfusion injury(MIRI) in rats.Methods Male Sprague-Dawley rats were randomly divided into 4 groups(n=10):normal,control,I/R model, and I/R model+DDQ(5,10 mg·L-1).This study used an isolated Langendorff rat heart model.The left ventricu-lar developed pressure(LVDP),heart rate(HR) and the maximum rise and fall rate of the left ventricular pressure(±dp/dtmax) were monitored and documented using a physiological recorder.The levels of lactate dehydrogenase(LDH) and creatine kinase(CK) were analyzed using enzyme-linked immunosorbent assay(ELISA).Infarct size was measured using 2,3,5-triphenyltetrazolium chloride staining.The levels of superoxide dismutase(SOD) and malondialdehyde(MDA), as well as the ratio of glutathione/glutathione disulfide(GSH/GSSG) were measured via ELISA.HE staining was used to observe the pathological changes of myocardial tissue.Results Compared with the I/R model group, the I/R model+DDQ groups raised hemodynamic parameters, SOD level, and GSH/GSSG ratio;and reduced the amount of CK, LDH, MDA levels.Moreover, the I/R model+DDQ groups had lower infarct size and pathological changes in myocardial tissue than I/R model group.Conclusion DDQ exertes cardioprotective effects against I/R via improving the oxygen free radical scavenging ability, the inhibition of oxygen free radical and reducing lipid peroxidation.

To explore the differentiation of gastrointestinal stromal tumor(GIST) with synchronous carcinoma clinical and pathological features,diagnosis and differential diagnosis.Methods Clinical characteristics,pathological morphology and immunohistochemical staining were observed in 9 cases of GIST with synchronous carcinoma,with review of the relevant literature.Results Microscopically,in 4 cases GIST with esophageal carcinoma,most of tumor cells in central focus were squamous cells and keratin pearls which were well differentiated and the rest of tumor cells are basal like cells on the edge.In the other 5 cases (4 of them with gastric carcinoma and 1 with rectal cancer).Microscopically,the tumors were composed of dysplastic glands which presented as adenoid structures and poorly differentiated.The majority of gastric GIST were spindle cell tumors,which resembled smooth muscle tumors histologically and showed a variety of histological pattern,such as lace like pattern,palisading pattern,antique coins like pattern and eddy pattern.And a perinuclear vacuolization pattern was common.Immunohistochemistry showed that the tumor cells were positive for CK5/6,CK14 and p53,but negative for S-100,CK7 of the 4 cases GIST with esophageal carcinoma.In the other 5 cases (4 of them with gastric carcinoma and 1 with colorectal cancer),showed that CK7,CK20,CEA and HER-2 were positive and negative for S-100.In all the 9 case of GIST,the tumor cells were positive for CD34,CD117 (+),DOG1 and SMA,but negative for S-100,desmin,etc.Conclusion There are no special clinical symptoms in most of GIST with synchronous carcinoma,because these GISTs are generally incidental findings.The proliferative index of GIST with synchronous carcinoma is observably lower than that of GIST without synchronous carcinoma.Most GISTs with synchronous carcinoma can be treated by the standard treatment for the accompanying carcinoma,and do not need specific additional treatments.