Objective To investigate the influencing factors of stroke patients with hypertension and their compliance with antihypertensive drugs, and to provide targeted intervention measures for stroke prevention in hypertensive patients.  Methods Using the method of multi-stage cluster sampling, a total of 59,434 permanent residents aged 40 and above were selected from 48 monitoring sites in 9 cities of Hebei Province from December 2019 to December 2020. Unconditional logistic regression analysis was used to explore the influencing factors of stroke complicated with hypertension and the compliance of patients with antihypertensive drugs.  Results Among the 59 434 subjects, the prevalence rate of stroke was 4.33% and the prevalence rate of stroke complicated with hypertension was 82.47%. The results of univariate analysis showed that the proportion of women, rural areas, dyslipidemia, diabetes, obesity, and people with family history of stroke was higher in stroke patients with hypertension, and the difference was statistically significant (P<0.05). Multivariate logistic regression analysis showed that rural areas, dyslipidemia, diabetes, obesity, and family history of stroke significantly increased the risk of stroke, and the OR (95%CI) values were 1.29 (1.03-1.62), 1.39 (1.12-1.72), 1.58 (1.25-1.99), 1.61 (1.22-2.12) and 1.60 (1.26-2.04), respectively. Among stroke patients with hypertension, 92.71% of patients took antihypertensive drugs. It was found that women's compliance with antihypertensive drugs was good, with an OR (95%CI) value of 1.46 (1.01-2.09).  Conclusion The prevalence rate of stroke complicated with hypertension is high in people aged 40 and above in Hebei Province. Hypertensive people should lower blood lipids, control blood glucose, and lose weight as soon as possible to prevent the occurrence of stroke.

Objective:To summarize the clinical characteristics and key points of diagnosis and treatment in children with TCF3::HLF fusion gene-positive acute lymphoblastic leukemia (ALL).Methods:A case series study was conducted. Clinical data of 8 children diagnosed with TCF3::HLF positive ALL at the Hematology Center of Beijing Children′s Hospital, Capital Medical University and the Hematology Oncology Department of Henan Children′s Hospital between January 2019 and January 2024 were collected. Descriptive analysis was performed on their clinical features, laboratory findings, treatment regimens and prognosis.Results:The cohort included 8 children (3 males and 5 females) with the age of 5.5 (3.5, 7.0) years. Bone pain was the primary clinical manifestation in 4 cases, with multi-site skeletal involvement in 4 cases, hypercalcemia in 5 cases, and coagulation abnormalities in 6 cases. Immunophenotyping revealed common B-cell lineage with myeloid markers in 7 cases and common B-cell phenotype in 1 case. All 8 children were positive for the TCF3::HLF fusion gene. Regarding treatment, 1 case abandoned therapy after diagnosis, while the remaining 7 cases received chemotherapy following the Chinese Children′s Leukemia Group-ALL2018 high-risk protocol. Only 1 case achieved minimal residual disease (MRD) negativity by day 33 of induction therapy. Among the 3 cases with MRD negativity before consolidation therapy, 1 case achieved it via conventional chemotherapy, while 2 cases required additional agents (venetoclax or blinatumomab). One case failed to achieve MRD negativity after consolidation therapy and later discontinued treatment (survival periods: 7months).Of the 4 cases who achieved MRD negativity after consolidation, 2 cases received conventional chemotherapy and 2 cases achieved negativity following chimeric antigen receptor T-cell therapy (CART). All 4 cases underwent hematopoietic stem cell transplantation (HSCT). Two cases in the CART combined with HSCT group survived as of the last follow-up (survival periods: 22 and 13 months). In the conventional chemotherapy combined HSCT group, 1 case relapsed and died (survival: 38 months), and 1 case died from transplant complications (survival: 11 months). The other 2 cases achieved MRD negativity before consolidation therapy but did not receive regular subsequent chemotherapy. After MRD recurrence, they underwent CART therapy without HSCT and remained alive at the last follow-up (survival periods: 49 and 12 months).Conclusions:Children with TCF3::HLF positive ALL often present with bone destruction accompanied by hypercalcemia and coagulopathy at initial diagnosis. This subtype of ALL shows poor response to conventional chemotherapy regimens, characterized by low early remission rates and high relapse risk even after HSCT. Better therapeutic outcomes have been observed with small molecule targeted drugs, immunotherapy and CART therapy.

A 58-year-old female patient presented with red papules, plaques, and scabs on her right foot accompanied by pain and itching for 14 years. Dermatological examination revealed extensive red plaques on her right foot and ankle, with scattered red papules in between; some of the plaques were covered with a moderate amount of yellow-brown crusts, and a small amount of yellow exudate was observed at the junction of the toes and the dorsum of the foot. Histopathological examination of the skin lesions showed hyperkeratosis, parakeratosis, pseudoepitheliomatous hyperplasia, neutrophil aggregation in the epidermis, and mixed inflammatory cell infiltration in the dermis. Three different types of colonies were cultured from the skin lesion tissues: light brown granular colonies, black granular colonies, and white-brown filamentous colonies. Under the microscope, the filamentous colonies appeared as long chains of brown conidia with short cylindrical beaks, while the black and light brown granular colonies appeared as clusters of spores, with single or multiple septa inside, and some budding spores were observed. Electron microscopy further confirmed the above structures. Molecular biological analysis revealed that the three types of colonies were all identified as Alternaria alternata. The patient was diagnosed with cutaneous alternariosis caused by Alternaria alternata with special morphology. After 7 months of treatment with oral itraconazole, the skin lesions healed, and no recurrence was observed during a 3-year follow-up.

Percutaneous coronary intervention(PCI),as one of the primary approaches for revascularization,still faces complications such as restenosis,myocardial ischemia-reperfusion injury and no-reflow/slow-flow phenomena,with no currently effective interventions ensuring long-term efficacy.Based on Li Dongyuan's theory that"fire and original qi cannot coexist",this article inherited Academician Chen Keji's academic perspective on"toxin-stasis pathogenesis"and the hemodynamic characteristics of coronary arteries to propose a"four-stage pathological progression"in post-PCI patients,namely spleen-stomach impairment-original qi deficiency-endogenous yin-fire-toxin-stasis accumulation.It emphasized that the heart vessels rely on qi and blood for nourishment and patency for function,elucidated the therapeutic rationale of Danggui Buxue Decoction,and presented the self-formulated Yixin Hemai Prescription,modified through syndrome differentiation,and performed simultaneous reinforcement and dredging,in order to provide diagnosis and treatment ideas for coronary heart disease after PCI treated with TCM.

Objective:To evaluate the clinical efficacy of endoscopic treatment of superficial non-ampullary duodenal adenoma.Methods:A retrospective analysis was performed on the clinical data and follow-up information of patients diagnosed with superficial duodenal non-ampullary adenomas via preoperative endoscopy and treated endoscopically at Peking University First Hospital between January 2013 and January 2024. The overall en bloc resection rate, complete resection rate of the lesion, perioperative complications, and recurrence rates were evaluated. Patients were categorized into three groups based on their treatment modality: endoscopic mucosal resection (EMR)（ n=46）, endoscopic submucosal dissection (ESD)（ n=16）, and modified ESD (ESD with snare, ESD-S)（ n=24）. Comparative analyses were conducted to evaluate operative time, en bloc resection rate, and complete resection rate among the three groups. Results:Among 86 patients, the overall en bloc and complete resection rates were 87.2% (75/86) and 86.0% (74/86), respectively. No case of delayed bleeding was observed during the perioperative period. Intraoperative perforation occurred in two patients, both of whom improved following conservative management. Delayed perforation was noted in four patients, and three of them were successfully managed with surgical intervention, while one case was resolved after conservative treatment. During the follow-up period, local recurrence was identified in two patients. Following re-treatment with endoscopy and continuous surveillance, no further recurrence was observed. The operative times for the EMR group, ESD-S group, and ESD group were 4 (1-36) minutes, 25 (5-190) minutes, and 46 (5-150) minutes, respectively. Significant differences were observed in operative times among the three groups ( Hc=49.892, P<0.001). The en bloc resection rates for the EMR, ESD-S, and ESD groups were 80.4% (37/46), 91.7% (22/24), and 100.0% (16/16), respectively. The complete resection rates were 80.4% (37/46), 91.7% (22/24), and 93.8% (15/16) for the respective groups. Conclusion:Endoscopic treatment demonstrates favorable efficacy and safety for superficial non-ampullary duodenal adenoma. In addition to traditional EMR and ESD, ESD-S is also an effective procedure for endoscopic treatment of non-ampullary duodenal adenoma.

A 58-year-old female patient presented with red papules, plaques, and scabs on her right foot accompanied by pain and itching for 14 years. Dermatological examination revealed extensive red plaques on her right foot and ankle, with scattered red papules in between; some of the plaques were covered with a moderate amount of yellow-brown crusts, and a small amount of yellow exudate was observed at the junction of the toes and the dorsum of the foot. Histopathological examination of the skin lesions showed hyperkeratosis, parakeratosis, pseudoepitheliomatous hyperplasia, neutrophil aggregation in the epidermis, and mixed inflammatory cell infiltration in the dermis. Three different types of colonies were cultured from the skin lesion tissues: light brown granular colonies, black granular colonies, and white-brown filamentous colonies. Under the microscope, the filamentous colonies appeared as long chains of brown conidia with short cylindrical beaks, while the black and light brown granular colonies appeared as clusters of spores, with single or multiple septa inside, and some budding spores were observed. Electron microscopy further confirmed the above structures. Molecular biological analysis revealed that the three types of colonies were all identified as Alternaria alternata. The patient was diagnosed with cutaneous alternariosis caused by Alternaria alternata with special morphology. After 7 months of treatment with oral itraconazole, the skin lesions healed, and no recurrence was observed during a 3-year follow-up.

Objective:To explore the effect of combining resistance training with stem cell transplantation on vascular remodeling after myocardial infarction, so as to provide a theoretical basis and treatment for clinical use.Methods:Seventy-five Sprague-Dawley rats were randomly divided into a sham operation group, a model group, a stem cell group, and a training and model combination group. All except the sham operation group underwent myocardial infarction modeling by ligation of the left anterior descending coronary artery. The stem cell group then received transplanted bone marrow mesenchymal stem cells (MSCs) and the training group performed weight-bearing ladder training. The combination group was given both interventions. The experiments lasted 8 weeks. At the end of the final exercise session, cardiac structure and functioning and myocardial blood flow were assessed using color Doppler ultrasound. Any pathological changes were observed through HE and Masson staining. Capillary density in the heart was determined via CD31 immunohistochemical staining. The expression levels of vascular endothelial growth factor (VEGF), CD31, α-smooth muscle actin (α-SMA), and endothelial nitric oxide synthase (eNOS) proteins were measured using western blotting.Results:Compared with the model group, cardiac structure and function showed significant improvement in the stem cell, training and combination groups. This was manifested as decreased end-diastolic diameter and end-systolic diameter in the left ventricle, along with increased left ventricular ejection fraction, left ventricular fraction shortening, the ratio of early to late diastolic filling velocity, and myocardial blood flow. Histological examination revealed a significant increase in capillary density, reduced collagen area, and less pathological hypertrophy of cardiomyocytes in the stem cell, training and combination groups. In those groups there was also upregulation of angiogenesis-related cytokines (VEGF, CD31, α-SMA and p-eNOS). Notably, all these improvements were particularly pronounced in the combination group.Conclusion:Resistance training combined with stem cell transplantation effectively improves vascular remodeling and enhances cardiac function after a myocardial infarction, at least in rats. The combination is more effective than either intervention alone.

Objective:To explore the effect of combining resistance training with stem cell transplantation on vascular remodeling after myocardial infarction, so as to provide a theoretical basis and treatment for clinical use.Methods:Seventy-five Sprague-Dawley rats were randomly divided into a sham operation group, a model group, a stem cell group, and a training and model combination group. All except the sham operation group underwent myocardial infarction modeling by ligation of the left anterior descending coronary artery. The stem cell group then received transplanted bone marrow mesenchymal stem cells (MSCs) and the training group performed weight-bearing ladder training. The combination group was given both interventions. The experiments lasted 8 weeks. At the end of the final exercise session, cardiac structure and functioning and myocardial blood flow were assessed using color Doppler ultrasound. Any pathological changes were observed through HE and Masson staining. Capillary density in the heart was determined via CD31 immunohistochemical staining. The expression levels of vascular endothelial growth factor (VEGF), CD31, α-smooth muscle actin (α-SMA), and endothelial nitric oxide synthase (eNOS) proteins were measured using western blotting.Results:Compared with the model group, cardiac structure and function showed significant improvement in the stem cell, training and combination groups. This was manifested as decreased end-diastolic diameter and end-systolic diameter in the left ventricle, along with increased left ventricular ejection fraction, left ventricular fraction shortening, the ratio of early to late diastolic filling velocity, and myocardial blood flow. Histological examination revealed a significant increase in capillary density, reduced collagen area, and less pathological hypertrophy of cardiomyocytes in the stem cell, training and combination groups. In those groups there was also upregulation of angiogenesis-related cytokines (VEGF, CD31, α-SMA and p-eNOS). Notably, all these improvements were particularly pronounced in the combination group.Conclusion:Resistance training combined with stem cell transplantation effectively improves vascular remodeling and enhances cardiac function after a myocardial infarction, at least in rats. The combination is more effective than either intervention alone.

Percutaneous coronary intervention(PCI),as one of the primary approaches for revascularization,still faces complications such as restenosis,myocardial ischemia-reperfusion injury and no-reflow/slow-flow phenomena,with no currently effective interventions ensuring long-term efficacy.Based on Li Dongyuan's theory that"fire and original qi cannot coexist",this article inherited Academician Chen Keji's academic perspective on"toxin-stasis pathogenesis"and the hemodynamic characteristics of coronary arteries to propose a"four-stage pathological progression"in post-PCI patients,namely spleen-stomach impairment-original qi deficiency-endogenous yin-fire-toxin-stasis accumulation.It emphasized that the heart vessels rely on qi and blood for nourishment and patency for function,elucidated the therapeutic rationale of Danggui Buxue Decoction,and presented the self-formulated Yixin Hemai Prescription,modified through syndrome differentiation,and performed simultaneous reinforcement and dredging,in order to provide diagnosis and treatment ideas for coronary heart disease after PCI treated with TCM.

Objective:To summarize the clinical characteristics and key points of diagnosis and treatment in children with TCF3::HLF fusion gene-positive acute lymphoblastic leukemia (ALL).Methods:A case series study was conducted. Clinical data of 8 children diagnosed with TCF3::HLF positive ALL at the Hematology Center of Beijing Children′s Hospital, Capital Medical University and the Hematology Oncology Department of Henan Children′s Hospital between January 2019 and January 2024 were collected. Descriptive analysis was performed on their clinical features, laboratory findings, treatment regimens and prognosis.Results:The cohort included 8 children (3 males and 5 females) with the age of 5.5 (3.5, 7.0) years. Bone pain was the primary clinical manifestation in 4 cases, with multi-site skeletal involvement in 4 cases, hypercalcemia in 5 cases, and coagulation abnormalities in 6 cases. Immunophenotyping revealed common B-cell lineage with myeloid markers in 7 cases and common B-cell phenotype in 1 case. All 8 children were positive for the TCF3::HLF fusion gene. Regarding treatment, 1 case abandoned therapy after diagnosis, while the remaining 7 cases received chemotherapy following the Chinese Children′s Leukemia Group-ALL2018 high-risk protocol. Only 1 case achieved minimal residual disease (MRD) negativity by day 33 of induction therapy. Among the 3 cases with MRD negativity before consolidation therapy, 1 case achieved it via conventional chemotherapy, while 2 cases required additional agents (venetoclax or blinatumomab). One case failed to achieve MRD negativity after consolidation therapy and later discontinued treatment (survival periods: 7months).Of the 4 cases who achieved MRD negativity after consolidation, 2 cases received conventional chemotherapy and 2 cases achieved negativity following chimeric antigen receptor T-cell therapy (CART). All 4 cases underwent hematopoietic stem cell transplantation (HSCT). Two cases in the CART combined with HSCT group survived as of the last follow-up (survival periods: 22 and 13 months). In the conventional chemotherapy combined HSCT group, 1 case relapsed and died (survival: 38 months), and 1 case died from transplant complications (survival: 11 months). The other 2 cases achieved MRD negativity before consolidation therapy but did not receive regular subsequent chemotherapy. After MRD recurrence, they underwent CART therapy without HSCT and remained alive at the last follow-up (survival periods: 49 and 12 months).Conclusions:Children with TCF3::HLF positive ALL often present with bone destruction accompanied by hypercalcemia and coagulopathy at initial diagnosis. This subtype of ALL shows poor response to conventional chemotherapy regimens, characterized by low early remission rates and high relapse risk even after HSCT. Better therapeutic outcomes have been observed with small molecule targeted drugs, immunotherapy and CART therapy.