A 39-year-old male patient with ankylosing spondylitis received adalimumab 40 mg subcutaneously every 2 weeks plus sulfasalazine enteric-coated tablets 0.75 g orally twice daily. Two weeks after the therapy initiation, he received his second adalimumab injection and discontinued sulfasalazine because of skin rashes. Meanwhile, cetirizine 10 mg once daily was given as anti-allergic treatment for 3 days. Six days later, he developed fever and persistent holocranial dull pain. The next day the headache worsened, with one episode of vomiting gastric contents. Cranial magnetic resonance imaging revealed findings consistent with infectious leptomeningeal lesions, and cerebrospinal fluid analysis suggested intracranial infection. Empirical anti-infection therapy with ceftriaxone and ganciclovir, as well as intracranial pressure reduction therapy with 20% mannitol was initiated. Two days later, next-generation sequencing of cerebrospinal fluid identified Neisseria meningitidis as the highly probable pathogen. The therapy regimen was adjusted to ceftriaxone, acyclovir and dexamethasone. After 12 days of treatments, the patient achieved full clinical recovery from meningitis.

A 39-year-old male patient with ankylosing spondylitis received adalimumab 40 mg subcutaneously every 2 weeks plus sulfasalazine enteric-coated tablets 0.75 g orally twice daily. Two weeks after the therapy initiation, he received his second adalimumab injection and discontinued sulfasalazine because of skin rashes. Meanwhile, cetirizine 10 mg once daily was given as anti-allergic treatment for 3 days. Six days later, he developed fever and persistent holocranial dull pain. The next day the headache worsened, with one episode of vomiting gastric contents. Cranial magnetic resonance imaging revealed findings consistent with infectious leptomeningeal lesions, and cerebrospinal fluid analysis suggested intracranial infection. Empirical anti-infection therapy with ceftriaxone and ganciclovir, as well as intracranial pressure reduction therapy with 20% mannitol was initiated. Two days later, next-generation sequencing of cerebrospinal fluid identified Neisseria meningitidis as the highly probable pathogen. The therapy regimen was adjusted to ceftriaxone, acyclovir and dexamethasone. After 12 days of treatments, the patient achieved full clinical recovery from meningitis.

Solitary cervical submental nodule is a relatively rare case in clinical procedure and prone to miss diagnosis.Differential diagnosis with various head and neck diseases is necessary.This article reported a case of solitary cervical submental metastasis of papillary thyroid carcinoma received in the department of surgery,Civil Aviation Shanghai Hospital,Ruijin Gubei Branch,Shanghai Jiao Tong University School of Medicine.The patient came to the outpatient clinic for treatment due to"consciously larger submental tubercle than before".Ultrasound examination revealed suspicious lesions in both the thyroid and submental regions.Ultrasound-guided final needle aspiration biopsy diagnosed as malignant tumor.Surgical resection was performed and the central group lymph nodes dissected Pathological examination confirmed papillary thyroid carcinoma with solitary submental metastasis.This article reported the clinical diagnosis and treatment of this case,in order to improve the disease recognition for clinicians,and make differential diagnosis with other rare neck diseases,and avoid missing diagnoses.

Objective:To explore the expression level and clinical significance of low-density granulocytes (LDGs) in peripheral blood of patients with inflammatory bowel disease (IBD) .Methods:A cross-sectional survey was conducted. Clinical data of IBD patients admitted to the Department of Gastroenterology, the First Affiliated Hospital of Anhui Medical University from August 2022 to January 2023 were collected. A total of 45 healthy people were enrolled as the normal control group. Simple endoscopic score for Crohn′s disease (SES-CD) was used to evaluate the activity of Crohn′s disease (CD) and Mayo endoscopic score (MES) was used to evaluate the activity of ulcerative colitis (UC). Laboratory indicators included LDGs, white blood cell count (WBC), hemoglobin (HB), platelet count (PLT), C-reactive protein (CRP), neutrophil to lymphocyte ratio (NLR), and fecal calprotectin (FC). The difference in LDGs level between IBD patients and the normal control group was statistically analyzed and the relationship between LDGs level and clinical characteristics of IBD patients was analyzed. Receiver operating characteristic (ROC) curve was used to calculate the predictive value of LDGs for the disease activity of IBD.Results:A total of 130 IBD patients were included, including 83 CD patients and 47 UC. Compared with the normal control group, the LDGs levels of patients in the CD group and UC group were respectively higher[CD: 0.53% (0.32%, 1.41%) vs. 0.19% (0.12%, 0.29%), H= 57.71, P<0.001; UC: 0.87% (0.43%, 1.90%) vs. 0.19% (0.12%, 0.29%), H= 73.23, P<0.001]. Compared with the CD patients in remission phase, the level of LDGs in active CD patients was higher ( P<0.001). Compared with the CD patients in mild activity phase, the LDGs levels of CD patients in moderate and severe activity phases were higher (all P<0.05). In terms of different disease behaviours, the level of LDGs in stricturing CD patients was the highest [1.37% (0.91%, 3.06%), all P<0.05]. Compared with the UC patients in remission phase, the level of LDGs in active UC patients was higher ( P<0.001). Compared with the UC patients in mild activity phase, the LDGs levels of UC patients in moderate and severe activity phases were higher (all P<0.05). In the CD group, LDGs level was positively correlated with CRP, FC, NLR, PLT, simple Crohn′s disease activity index (CDAI), and SES-CD ( r= 0.374, 0.548, 0.345, 0.284, 0.764, 0.721, all P<0.05). In the UC group, LDG levels was positively correlated with CRP, FC, NLR, Sutherland disease activity index (DAI), and MES ( r= 0.325, 0.666, 0.474, 0.638, 0.740, all P<0.05). In CD patients, the cut-off value of LDGs was 0.565%, with the area under curve (AUC) of 0.873, sensitivity of 73.50%, and specificity of 99.30%. In UC patients, the cut-off value of LDGs was 0.545%, with the AUC of 0.877, sensitivity of 76.90%, and specificity of 100.00%. Conclusion:The expression of LDGs in IBD patients is significantly high, which correlates with the disease activity and may be used as a biological marker for the clinical evaluation of IBD patients.

Objective:To explore the expression level and clinical significance of low-density granulocytes (LDGs) in peripheral blood of patients with inflammatory bowel disease (IBD) .Methods:A cross-sectional survey was conducted. Clinical data of IBD patients admitted to the Department of Gastroenterology, the First Affiliated Hospital of Anhui Medical University from August 2022 to January 2023 were collected. A total of 45 healthy people were enrolled as the normal control group. Simple endoscopic score for Crohn′s disease (SES-CD) was used to evaluate the activity of Crohn′s disease (CD) and Mayo endoscopic score (MES) was used to evaluate the activity of ulcerative colitis (UC). Laboratory indicators included LDGs, white blood cell count (WBC), hemoglobin (HB), platelet count (PLT), C-reactive protein (CRP), neutrophil to lymphocyte ratio (NLR), and fecal calprotectin (FC). The difference in LDGs level between IBD patients and the normal control group was statistically analyzed and the relationship between LDGs level and clinical characteristics of IBD patients was analyzed. Receiver operating characteristic (ROC) curve was used to calculate the predictive value of LDGs for the disease activity of IBD.Results:A total of 130 IBD patients were included, including 83 CD patients and 47 UC. Compared with the normal control group, the LDGs levels of patients in the CD group and UC group were respectively higher[CD: 0.53% (0.32%, 1.41%) vs. 0.19% (0.12%, 0.29%), H= 57.71, P<0.001; UC: 0.87% (0.43%, 1.90%) vs. 0.19% (0.12%, 0.29%), H= 73.23, P<0.001]. Compared with the CD patients in remission phase, the level of LDGs in active CD patients was higher ( P<0.001). Compared with the CD patients in mild activity phase, the LDGs levels of CD patients in moderate and severe activity phases were higher (all P<0.05). In terms of different disease behaviours, the level of LDGs in stricturing CD patients was the highest [1.37% (0.91%, 3.06%), all P<0.05]. Compared with the UC patients in remission phase, the level of LDGs in active UC patients was higher ( P<0.001). Compared with the UC patients in mild activity phase, the LDGs levels of UC patients in moderate and severe activity phases were higher (all P<0.05). In the CD group, LDGs level was positively correlated with CRP, FC, NLR, PLT, simple Crohn′s disease activity index (CDAI), and SES-CD ( r= 0.374, 0.548, 0.345, 0.284, 0.764, 0.721, all P<0.05). In the UC group, LDG levels was positively correlated with CRP, FC, NLR, Sutherland disease activity index (DAI), and MES ( r= 0.325, 0.666, 0.474, 0.638, 0.740, all P<0.05). In CD patients, the cut-off value of LDGs was 0.565%, with the area under curve (AUC) of 0.873, sensitivity of 73.50%, and specificity of 99.30%. In UC patients, the cut-off value of LDGs was 0.545%, with the AUC of 0.877, sensitivity of 76.90%, and specificity of 100.00%. Conclusion:The expression of LDGs in IBD patients is significantly high, which correlates with the disease activity and may be used as a biological marker for the clinical evaluation of IBD patients.

Objective:To study the clinical characteristics of ureaplasma urealyticum (UU) infection in preterm infants with gestational age <34 weeks.Methods:From January 2017 to December 2021, premature infants with gestational age <34 weeks admitted to neonatal department of our hospital were enrolled in this prospective cohort study. UU-DNA from respiratory tract samples were examined using quantitative fluorescence polymerase chain reaction method. The infants were assigned into UU (+) group and UU (-) group. Perinatal factors and clinical characteristics were compared between the two groups.Results:A total of 182 preterm infants were enrolled, including 59 cases (32.4%) in UU (+) group and 123 (67.6%) in UU (-) group. UU (+) group had significantly lower gestational age and birth weight and significantly higher incidences of vaginal delivery, premature rupture of membranes (PROM) >18 h and maternal chorioamnionitis than UU (-) group ( P<0.05). Compared with UU (-) group, UU (+) group had significantly higher leucocyte count, neutrophil count and interleukin-6 at 1, 24 and 72 h after birth ( P<0.05). No significant differences existed in C-reactive protein and procalcitonin between the two groups at each time point ( P>0.05). In UU (+) group, the incidences of intrauterine pulmonary infection and bronchopulmonary dysplasia (BPD) were higher and the incidence of respiratory distress syndrome was lower than UU (-) group ( P<0.05). No significant differences existed in the incidences of intraventricular hemorrhage, periventricular leukomalacia, feeding intolerance, necrotizing enterocolitis, retinopathy of prematurity between the two groups ( P>0.0 5). UU (+) group had significantly longer duration of oxygen therapy than UU (-) group ( P<0.05). No significant differences existed in the duration of invasive mechanical ventilation and hospital stay between the two groups ( P>0.05). Conclusions:Preterm infants <34 weeks with positive UU in respiratory tract secretions have higher incidences of vaginal delivery, PROM>18 h and maternal chorioamnionitis. Leukocyte and neutrophil count and interleukin -6 are higher in these infants. They need prolonged oxygen therapy and have increased risks of intrauterine pulmonary infection and BPD.

Background and Objectives: Galectin-3 promotes fibroblast-to-myofibroblast differentiation and facilitates injury repair. Previous studies have shown that exosomes derived from human umbilical cord mesenchymal stem cells (hucMSC-ex) promote the differentiation of myocardial fibroblasts into myofibroblasts under inflammatory environment. Whether hucMSC-ex derived Galectin-3 (hucMSC-ex-Galectin-3) plays an important role in fibroblast-to-myofibroblast differentiation is the focus of this study. Methods: and Results: Galectin-3 was knocked-down by siRNA in hucMSCs, and then exosomes were extracted. Fibroblasts were treated with LPS, LPS＋hucMSC-ex, LPS＋negative control-siRNA-ex (NC-ex), or LPS＋ Galectin-3-siRNA-ex (si-ex) in vitro. The coronary artery of the left anterior descending (LAD) branch was permanently ligated, followed by intramyocardial injection with phosphate buffered saline(PBS), hucMSC-ex, hucMSC-NC-ex, or hucMSC-si-ex in vivo. Western blot, RT-PCR, and immunohistochemistry were used to detect the expression of markers related to fibroblast-to-myofibroblast differentiation and inflammatory factors. Migration and contraction functions of fibroblasts were evaluated using Transwell migration and collagen contraction assays, respectively. β-catenin expression was detected by western blot and immunofluorescence. The results showed that hucMSC-ex increased the protein expression of myofibroblast markers, anti-inflammatory factors, and β-catenin. HucMSC-ex also reduced the migration and promoted the contractility of fibroblasts. However, hucMSC-si-ex did not show these activities. Conclusions HucMSC-ex-Galectin-3 promoted the differentiation of cardiac fibroblasts into myofibroblasts in an inflammatory environment, which was associated with increased β-catenin levels.

Background and Objectives: Galectin-3 promotes fibroblast-to-myofibroblast differentiation and facilitates injury repair. Previous studies have shown that exosomes derived from human umbilical cord mesenchymal stem cells (hucMSC-ex) promote the differentiation of myocardial fibroblasts into myofibroblasts under inflammatory environment. Whether hucMSC-ex derived Galectin-3 (hucMSC-ex-Galectin-3) plays an important role in fibroblast-to-myofibroblast differentiation is the focus of this study. Methods: and Results: Galectin-3 was knocked-down by siRNA in hucMSCs, and then exosomes were extracted. Fibroblasts were treated with LPS, LPS＋hucMSC-ex, LPS＋negative control-siRNA-ex (NC-ex), or LPS＋ Galectin-3-siRNA-ex (si-ex) in vitro. The coronary artery of the left anterior descending (LAD) branch was permanently ligated, followed by intramyocardial injection with phosphate buffered saline(PBS), hucMSC-ex, hucMSC-NC-ex, or hucMSC-si-ex in vivo. Western blot, RT-PCR, and immunohistochemistry were used to detect the expression of markers related to fibroblast-to-myofibroblast differentiation and inflammatory factors. Migration and contraction functions of fibroblasts were evaluated using Transwell migration and collagen contraction assays, respectively. β-catenin expression was detected by western blot and immunofluorescence. The results showed that hucMSC-ex increased the protein expression of myofibroblast markers, anti-inflammatory factors, and β-catenin. HucMSC-ex also reduced the migration and promoted the contractility of fibroblasts. However, hucMSC-si-ex did not show these activities. Conclusions HucMSC-ex-Galectin-3 promoted the differentiation of cardiac fibroblasts into myofibroblasts in an inflammatory environment, which was associated with increased β-catenin levels.

Background: In China, secondary cytoreductive surgery (SCR) has been widely used in ovarian cancer (OC) over the past two decades. Although Gynecologic Oncology Group-0213 trial did not show its overall survival benefit in first relapsed patients, the questions on patient selection and effect of subsequent targeting therapy are still open. The preliminary data from our pre-SOC1 phase II study showed that selected patients with second relapse who never received SCR at recurrence may still benefit from surgery. Moreover, poly(ADP-ribose) polymerase inhibitors (PARPi) maintenance now has been a standard care for platinum sensitive relapsed OC. To our knowledge, no published or ongoing trial is trying to answer the question if patient can benefit from a potentially complete resection combined with PARPi maintenance in OC patients with secondary recurrence. Methods SOC-3 is a multi-center, open, randomized, controlled, phase II trial of SCR followed by chemotherapy and niraparib maintenance vs chemotherapy and niraparib maintenance in patients with platinum-sensitive second relapsed OC who never received SCR at recurrence. To guarantee surgical quality, if the sites had no experience of participating in any OC-related surgical trials, the number of recurrent lesions evaluated by central-reviewed positron emission tomography–computed tomography image shouldn't be more than 3. Eligible patients are randomly assigned in a 1:1 ratio to receive either SCR followed by 6 cyclesof platinum-based chemotherapy and niraparib maintenance or 6 cycles of platinum-based chemotherapy and niraparib maintenance alone. Patients who undergo at least 4 cycles of chemotherapy and must be, in the opinion of the investigator, without disease progression, will be assigned niraparib maintenance. Major inclusion criteria are secondary relapsed OC with a platinum-free interval of no less than 6 months and a possibly complete resection. Major exclusion criteria are borderline tumors and non-epithelial ovarian malignancies, received debulking surgery at recurrence and impossible to complete resection. The sample size is 96 patients. Primary endpoint is 12-month non-progression rate.