This article reports a patient with long-term ulcerative colitis (UC) who was initially diagnosed as eosinophilic gastroenteritis due to a increase in peripheral blood eosinophils. During the diagnosis and treatment process, acute myocardial infarction was repeatedly induced. The patient was eventually diagnosed as UC complicated by amoebic infection and improved after anti-infective therapy. Through case analysis and literature review, this article discusses the diagnosis and treatment strategies for UC complicated by rare opportunistic infections.

Objective:To explore the correlation between clinical and CT imaging features and epidermal growth factor receptor (EGFR) gene mutation in patients with non-small cell lung cancer (NSCLC) and screening of mutation prediction indicators.Methods:A retrospective case-control study was conducted. The clinical data of 178 NSCLC patients who were confirmed by pathology and underwent pre-treatment chest-enhanced CT scan and EGFR gene mutation testing in General Hospital of Ningxia Medical University from January 2015 to December 2019 were retrospectively analyzed. Patients were classified into EGFR mutation-positive and mutation-negative groups based on genetic testing results, and the clinical and CT imaging features were compared between the two groups; the multivariate logistic regression model was used to identify the independent influencing factors for EGFR gene mutation in NSCLC patients.Results:Among 178 NSCLC patients, 115 cases (64.6%) were EGFR gene mutation-positive and 63 cases (35.4%) were mutation-negative. Among the 115 EGFR gene mutation-positive patients, there were 61 cases (53.0%) of exon 19 deletion (19del) mutation, 45 cases (39.1%) of exon 21 L858R mutation, 8 cases (7.0%) of exon 20 mutation, and 1 case (0.9%) of exon 18 mutation. The proportions of female patients [60.0% (69/115) vs. 30.2% (19/63)] and patients with out smoking history [74.8% (86/115) vs. 36.5% (23/63)] in EGFR gene mutation-positive group were higher than those in the mutation-negative group, and the differences were statistically significant (both P < 0.001), while the proportions of patients with different pathological types and clinical stages in the two groups showed no statistically significant differences (both P > 0.05). The median maximum diameter of tumor [ M ( Q1, Q3)] detected by CT in the EGFR gene mutation-positive group was 3.70 (2.90, 4.70) cm, while in the mutation-negative group it was 5.30 (3.40, 6.80) cm, and the difference was statistically significant ( Z = -3.66, P < 0.001). The proportions of patients with air bronchogram [27.8% (32/115) vs. 7.9% (5/63)] and without emphysema [83.5% (96/115) vs. 55.6% (35/63)] in the EGFR gene mutation-positive group were higher than those in the mutation-negative group, and the differences were statistically significant (both P < 0.01). The results of multivariate logistic regression analysis showed that no smoking history (yes vs. no, OR = 0.218, 95% CI: 0.073-0.647), short maximum diameter of tumor detected by CT ( OR = 0.814, 95% CI: 0.676-0.981), air bronchogram (yes vs. no, OR = 5.354, 95% CI: 1.782-16.090), and no emphysema (yes vs. no, OR = 0.289, 95% CI: 0.128-0.653) were independent risk factors for EGFR gene mutation in NSCLC patients (all P < 0.05). Conclusions:Clinical and CT imaging features may relate to EGFR gene mutation status in NSCLC patients, and no smoking history, short maximum diameter of tumor detected by CT, air bronchogram and no emphysema may predict EGFR gene mutation.

This article reports a patient with long-term ulcerative colitis (UC) who was initially diagnosed as eosinophilic gastroenteritis due to a increase in peripheral blood eosinophils. During the diagnosis and treatment process, acute myocardial infarction was repeatedly induced. The patient was eventually diagnosed as UC complicated by amoebic infection and improved after anti-infective therapy. Through case analysis and literature review, this article discusses the diagnosis and treatment strategies for UC complicated by rare opportunistic infections.

Objective:To explore the correlation between clinical and CT imaging features and epidermal growth factor receptor (EGFR) gene mutation in patients with non-small cell lung cancer (NSCLC) and screening of mutation prediction indicators.Methods:A retrospective case-control study was conducted. The clinical data of 178 NSCLC patients who were confirmed by pathology and underwent pre-treatment chest-enhanced CT scan and EGFR gene mutation testing in General Hospital of Ningxia Medical University from January 2015 to December 2019 were retrospectively analyzed. Patients were classified into EGFR mutation-positive and mutation-negative groups based on genetic testing results, and the clinical and CT imaging features were compared between the two groups; the multivariate logistic regression model was used to identify the independent influencing factors for EGFR gene mutation in NSCLC patients.Results:Among 178 NSCLC patients, 115 cases (64.6%) were EGFR gene mutation-positive and 63 cases (35.4%) were mutation-negative. Among the 115 EGFR gene mutation-positive patients, there were 61 cases (53.0%) of exon 19 deletion (19del) mutation, 45 cases (39.1%) of exon 21 L858R mutation, 8 cases (7.0%) of exon 20 mutation, and 1 case (0.9%) of exon 18 mutation. The proportions of female patients [60.0% (69/115) vs. 30.2% (19/63)] and patients with out smoking history [74.8% (86/115) vs. 36.5% (23/63)] in EGFR gene mutation-positive group were higher than those in the mutation-negative group, and the differences were statistically significant (both P < 0.001), while the proportions of patients with different pathological types and clinical stages in the two groups showed no statistically significant differences (both P > 0.05). The median maximum diameter of tumor [ M ( Q1, Q3)] detected by CT in the EGFR gene mutation-positive group was 3.70 (2.90, 4.70) cm, while in the mutation-negative group it was 5.30 (3.40, 6.80) cm, and the difference was statistically significant ( Z = -3.66, P < 0.001). The proportions of patients with air bronchogram [27.8% (32/115) vs. 7.9% (5/63)] and without emphysema [83.5% (96/115) vs. 55.6% (35/63)] in the EGFR gene mutation-positive group were higher than those in the mutation-negative group, and the differences were statistically significant (both P < 0.01). The results of multivariate logistic regression analysis showed that no smoking history (yes vs. no, OR = 0.218, 95% CI: 0.073-0.647), short maximum diameter of tumor detected by CT ( OR = 0.814, 95% CI: 0.676-0.981), air bronchogram (yes vs. no, OR = 5.354, 95% CI: 1.782-16.090), and no emphysema (yes vs. no, OR = 0.289, 95% CI: 0.128-0.653) were independent risk factors for EGFR gene mutation in NSCLC patients (all P < 0.05). Conclusions:Clinical and CT imaging features may relate to EGFR gene mutation status in NSCLC patients, and no smoking history, short maximum diameter of tumor detected by CT, air bronchogram and no emphysema may predict EGFR gene mutation.

Concurrent chemoradiotherapy (CCRT) refers to the simultaneous treatment of chemotherapy and radiotherapy, and the effect of radiotherapy is enhanced with low-dose chemotherapy, which can reduce tumor recurrence and metastasis and improve clinical prognosis of patients. At present, the main factors for the increase of radiosensitivity of concurrent chemotherapy is that concurrent chemotherapy prevents the repair of tumor cells, and chemotherapy and radiotherapy act on different cell cycles and have synergistic effects. However, even for patients with locally advanced cervical cancer (LACC) who have undergone CCRT, the 5-year survival rate is only 60%, which is still not ideal. In order to improve the efficacy, researchers have conducted a series of exploratory studies, which consist of the combination of targeted drugs and immunodrugs, and neoadjuvant regimens before CCRT, etc. Although targeted or immunologic drugs are effective treatment of LACC, in view of the lack of large-scale evidence-based medical evidence, multi-center prospective and randomized phase III clinical trials and high-level articles are needed to improve the level of evidence-based medicine. This consensus summarizes several key evidence-based medical studies published recently, especially the clinical research progress in targeted and immunological therapies, providing reference for domestic peers.

Pure-tone audiometry can be performed to evaluate the type and degree of hearing loss， whose results can be divided into four types including low-frequency descending， high-frequency descending， flat descending and total deafness. The low-frequency descending type of sudden hearing loss （SHL） is more likely to be spleen deficiency and dampness exuberance， the high-frequency descending type is often due to yin deficiency of liver and kidney， the flat descending type is commonly associated with qi and blood depletion， and the type of total deafness is often linked to blood stasis. Our team has further developed a comprehensive diagnostic and therapeutic approach for SHL， emphasizing "the integration of disease and syndrome， the combination of acupuncture and herbal medicine， and dynamically administering treatment". Firstly， it advocates integrating disease diagnosis with syndrome differentiation. Secondly， it recommends combining acupuncture and herbal medicine， with local acupoints such as Ermen （TE 21）， Tinggong （SI 19）， Tinghui （GB 2）， and Yifeng （TE 17） used to unblock the auditory orifice， and herbal prescriptions tailored to the hearing curve patterns. For the low-frequency descending type， it is recommended to fortify the spleen and percolate dampness by taking distal points of spleen channel and stomach channel and using Shenling Baizhu Powder （参苓白术散）. For the high-frequency descending type， the method of nourishing kidney and calming liver is recommended， using distal points of kidney and liver channels and taking Erlong Zuoci Pills （耳聋左慈丸）. Regarding the flat descending type， tonifying qi and nourishing blood is advised， for which acupoints of Conception Vessel， spleen， stomach and large intestine channels can be needled， and Yiqi Congming Decoction （益气聪明汤） can be administered. For the total deafness type， it is recommended to activate blood and dissipate stasis， often with Xuehai （SP 10） and Geshu （BL 17） needled and Tongqiao Huoxue Decoction （通窍活血汤） administered. All these are conducted to treat the root and branch simultaneously. At the same time， it emphasizes the need to consider complex syndrome presentations and disease progression， dynamically analyze the disease causes and mechanisms， and adjust treatment according to the changing syndromes. In conclusion， this article is expected to inspire clinical diagnosis and treatment of SHL.

ObjectiveTo evaluate the effectiveness and safety of neck seven-line method combined with periauricular acupuncture as salvage treatment for sudden hearing loss in non-acute stage. MethodsSixty-six patients with non-acute stage of sudden hearing loss with a disease duration of 15-90 days were randomly divided into 33 cases each in treatment group and control group. The treatment group was given neck seven-line method combined with acupuncture at periauricular points； the control group used sham acupuncture and sham electroacupuncture at the same points. Both groups were treated 3 times a week for 6 weeks. The pure tone average hearing threshold of impaired frequencies were examined before treatment， after treatment finish and at follow-up （week 10）， and the difference between pure tone average hearing threshold of impaired frequencies before and after treatment was calculated； calculate the proportion of patients with ≥10 dB improvement in pure tone average hearing threshold of impaired frequency after treatment and at follow-up； compare the patients' Tinnitus Evaluation Scale （TEQ） scores， Chinese Medicine Quality of Life Assessment Scale （CQ-11D） health utility values and the difference between before and after treatment， and record the occurrence of adverse events. ResultsThe pure tone average of impaired frequency in the treatment group were （50.57±18.07） dB and （47.70±17.42） dB at post-treatment and follow-up respectively， and （54.38±21.77） dB and （53.36±20.99） dB in the control group at post-treatment and follow-up. Compared with the pre-treatment period， the pure tone average hearing threshold of impaired frequency in the two groups significantly decreased （P＜0.05） at post-treatment and follow-up. The difference of pure tone average hearing threshold of impaired frequency in the treatment group after treatment and at the follow-up visit compared to that before treatment was lower than those in the control group （P＜0.05）. After treatment， 13 patients （39.39%） in the treatment group and 10 patients （30.30%） in the control group showed improvement of ≥10 dB in pure tone average hearing threshold of impaired frequency； at the follow-up visit， 18 patients （54.55%） in the treatment group and 10 patients （30.30%） in the control group showed improvement of ≥10 dB in the pure tone average hearing threshold of impaired frequency， and there was no statistical significance for comparison between groups at the time of post-treatment and follow-up （P＞0.05）. The TEQ score of the treatment group significantly lower than that before treatment （P＜0.05）； the TEQ score of the treatment group and the difference between before and after treatment significantly lower than that of the control group （P＜0.05）. The difference in CQ-11D health utility values and the difference between before and after treatment were not statistically significant between the two groups （P＞0.05）. Eight cases of acupuncture-related adverse events occurred among 66 patients， including subcutaneous haematomas after needling， severe pain during needling and needle fainting， which disappeared after symptomatic treatment and did not affect the following treatment. ConclusionNeck seven-line method combined with periauricular acupuncture could be used as salvage treatment for sudden hearing loss in non-acute stage to improve the pure tone average hearing threshold of impaired frequency， alleviate tinnitus， with safety.

Natural products are essential sources of antitumor drugs. One such molecule, β-elemene, is a potent antitumor compound extracted from Curcuma wenyujin. In the present investigation, a series of novel 13,14-disubstituted nitric oxide (NO)-donor β-elemene derivatives were designed, with β-elemene as the foundational compound, and subsequently synthesized to evaluate their therapeutic potential against leukemia. Notably, the derivative labeled as compound 13d demonstrated a potent anti-proliferative activity against the K562 cell line, with a high NO release. In vivo studies indicated that compound 13d could effectively inhibit tumor growth, exhibiting no discernible toxic manifestations. Specifically, a significant tumor growth inhibition rate of 62.9% was observed in the K562 xenograft tumor mouse model. The accumulated data propound the potential therapeutic application of compound 13d in the management of leukemia.
Humans ; Mice ; Animals ; Cell Line, Tumor ; Nitric Oxide Donors/pharmacology* ; Sesquiterpenes/pharmacology* ; Leukemia/drug therapy* ; Biological Assay ; Cell Proliferation

‍ ObjectiveTo investigate the protective effect of safranal against sepsis-related liver injury （SRLI） induced by lipopolysaccharide （LPS） in mice and its mechanism. MethodsA total of 32 experimental male C57BL/6 mice were divided into control group， single drug group， model group， and treatment group using the simple random method， with 8 mice in each group. The mice in the single drug group and the treatment group were intraperitoneally injected with safranal （60 mg/kg） for 7 days of pretreatment， and the mice in the model group and the treatment group were intraperitoneally injected with LPS （10 mg/kg） to induce acute liver injury. The activities of serum alanine aminotransferase （ALT） and aspartate aminotransferase （AST） were measured； HE staining was used to observe liver tissue sections； immunohistochemistry was used to analyze the expression of the downstream protein heme oxygenase-1 （HO-1） in the signal pathway； TUNEL was used to analyze the apoptosis of hepatocytes； Western blot was used to measure the expression of total proteins （nuclear factor erythroid 2-related factor 2 ［Nrf-2］ and HO-1） in liver tissue. The human liver cell line L02 was pretreated with safranal （100 μmol/L）， followed by induction of acute hepatocellular injury with LPS （100 ng/mL）， and DCFH-DA fluorescent labeling was used to detect reactive oxygen species （ROS）. ResultsAfter safranal pretreatment， the treatment group had significantly lower levels of ALT and AST than the model group （both P<0.001）， with a relatively intact pseudolobular structure and a smaller necrotic area in the liver. Compared with the model group， the treatment group had significant increases in the expression levels of Nrf2 and HO-1 in liver tissue after safranal+LPS treatment （both P<0.001）， and immunohistochemistry showed that safranal pretreatment increased the number of HO-1-positive cells. In the cell model of LPS-induced acute liver injury， the treatment group had a significant reduction in the production of ROS compared with the model group. ConclusionSafranal can exert a protective effect against SRLI induced by LPS in mice through the Nrf2/HO-1 pathway.

Vascular injury resulting from lower limb amputation leads to the redistribution of blood flow and changes in vascular terminal resistance, which can affect the cardiovascular system. However, there was no clear understanding of how different amputation levels affect the cardiovascular system in animal experiments. Therefore, this study established two animal models of above-knee amputation (AKA) and below-knee amputation (BKA) to explore the effects of different amputation levels on the cardiovascular system through blood and histopathological examinations. The results showed that amputation caused pathological changes in the cardiovascular system of animals, including endothelial injury, inflammation, and angiosclerosis. The degree of cardiovascular injury was higher in the AKA group than in the BKA group. This study sheds light on the internal mechanisms of amputation's impact on the cardiovascular system. Based on the amputation level of patients, the findings recommend more comprehensive and targeted monitoring after surgery and necessary interventions to prevent cardiovascular diseases.
Animals ; Animal Experimentation ; Cardiovascular System ; Cardiovascular Diseases ; Hypertension ; Amputation, Surgical