Objective To explore the clinical,pathological,imaging characteristics,treatment,and prognosis of primary pericardial mesothelioma(PPM).Methods The clinical,pathological and imaging data of 11 PPM patients diagnosed in Peking Union Medical College Hospital from 2014 to 2024 were retrospectively collected,the Kaplan-Meier curve was calculated by Log-Rank test to determine the prognostic factors of the patients.Results The median age of the 11 patients was 48 years,including one well-differentiated papillary mesothelioma,and ten malignant mesothelioma.CA125 was elevated in all patients.PET/CT all indicated increased pericardial metabolism.Male patients and patients with ECOG score>2 points had worse prognosis(P=0.018,P=0.01,re?spectively).Compared with the untreated group(4 cases),both immunotherapy(3 cases)and chemotherapy(3 ca?ses)can prolong patient survival(P=0.025,P=0.025,respectively),and the benefit of immunotherapy was greater than chemotherapy(P=0.049 9).Conclusions This study is the largest single center pericardial mesothe?lioma cohort in China.CA125 and PET/CT contributes to the diagnosis of PPM,and immunotherapy might be the future direction of PPM treatment.

Objective To explore the diagnosis and treatment experience of malignant peritoneal mesothelioma by analyzing the clinical characteristics of patients with single center peritoneal mesothelioma.Methods Retrospec-tively analyze the clinical data,including age and treatment regimens,of 99 patients with malignant peritoneal mes-othelioma admitted to Peking Union Medical College Hospital from June 2012 to July 2023.Kaplan-Meier for surviv-al analysis and Logistic and Cox regression were applied to assess the impact of factors like age and treatment regi-mens on survival time.Results The median age of diagnosis for 99 patients with peritoneal mesothelioma was 56 years,of which 82 were pathologically diagnosed.Among them,38 cases(51.4%)underwent tumor cell reduction surgery,and 57 cases(77.0%)underwent systemic or local treatment.The median survival time for all patients was 43 years.The age of diagnosis may affect the prognosis of patients with malignant mesothelioma,and those aged≥65 at the time of diagnosis have a worse prognosis.Conclusions Malignant peritoneal mesothelioma is a rare but invasive malignant tumor with a poor prognosis.There is still a need to develop novo drugs and comprehensive treat-ment strategies.

Objective:To summarize the clinical symptoms of cyclic vomiting syndrome（CVS）in children and investigate its association with small intestinal bacterial overgrowth（SIBO）.Methods:A total of 89 children who were diagnosed as CVS and improved lactulose hydrogen breath test (LHBT) in the Pediatric Department of Beijing Tsinghua Changgung Hospital from June 2020 to June 2023 were selected as CVS group.Simultaneously，50 healthy children with physical examination in our hospital were selected as the control group. According to the results of LHBT,the children with CVS were divided into SIBO group (LHBT positive) and non-SIBO group (LHBT negative). The clinical data of children in each group were compared.Results:Among the 89 CVS patients，there were 42 males and 47 females，with a mean age of（7.50±3.54）years.Common accompanying symptoms included excessive sleepiness（76 cases，85.39%），anorexia(62 cases，69.66%），constipation（55 cases，61.80%），abdominal pain（34 cases,38.20%）and so on. There were no significant differences in age and gender between children in CVS group and control group ( P>0.05). The body mass index of CVS group was lower than that of control group.The positive rate of LHBT was higher than that of the control group (56.18% vs. 8.00%),the difference was statistically significant ( P<0.05),and the concentrations of hydrogen and methane in CVS group were higher than those of the control group at different time points( P<0.05).Among 89 children with CVS,there were 50 cases in SIBO group and 39 cases in non-SIBO group. There were no significant differences in gender,age and body mass index between the two groups ( P>0.05). The constipation rate and moderate/severe disease rate in SIBO group were higher than those in non-SIBO group (88.00% vs. 28.21%,94.00% vs. 43.59%),and the differences were statistically significant ( P<0.05). Conclusion:The incidence of SIBO in children with CVS is higher,and SIBO may play a key role in CVS. CVS children with SIBO have higher disease severity.

Objective:To assess the nutritional status and risk of children with cyclic vomiting syndrome（CVS）and to provide a clinical evidence for nutritional support.Methods:A total of 160 children diagnosed with CVS and 160 healthy controls were prospectively enrolled in the study，who were admitted to Beijing Tsinghua Changgung Hospital from April 2021 to February 2024.Nutritional status was assessed by anthropometric indices（height，weight，and body mass index），and it was expressed in standard deviation score（Z score）.Nutritional risk screening tool STRONGkids was applied to nutritional risk screening，and the laboratory assessment（albumin，pre-albumin，hemoglobin，urea nitrogen and creatinine）were measured.Results:Among the 160 cases，there were 73 males and 87 females，including 18 cases of mild seizures and 142 cases of moderate and severe seizures，with the average onset age of（47.54±2.96）months and an average diagnosis age of（74.89±3.68）months.The average duration from the first attack to diagnosis was（27.35±2.36）months，and the average course of the disease was（41.35±2.63）months.The malnutrition rate of children in CVS was 36.9%（59/160），of which 18.1%（29/160）was severely malnourished.There was a statistically significant difference in the weight-for-age Z-score（WAZ），height-for-age Z-score（HAZ），and body mass index-for-age Z-score（BAZ）between the CVS group and the control group（ P<0.001）.We found a statistically significant difference in laboratory indicators（albumin，pre-albumin，hemoglobin，urea nitrogen and creatinine）between the two groups（all P<0.001）and hemoglobin was positively correlated with WAZ，HAZ and BAZ（ r=0.346,0.250,0.277，all P<0.01）.Using the STRONGkids nutritional risk screening tool，there were 43 cases with moderate nutritional risk and 117 cases with high nutritional risk，and children with high nutritional risk were likely to have lower WAZ，HAZ and BAZ than the children with moderate nutritional risk，and there was a significant difference in WAZ，HAZ，BAZ，hemoglobin，and creatinine between the two groups（ P<0.05）.And there was a correlation between the degree of CVS attack and nutritional risk grouping（ r=0.543， P<0.001）. Conclusion:Children with CVS have a high incidence of malnutrition，and the serum albumin，prealbumin，hemoglobin，urea nitrogen and creatinine levels are of great value for nutritional assessment.The STRONGkids score method helps to evaluate nutritional risk in children with CVS.

Objective:To investigate the characteristics of gut microbiota distribution in children with cyclic vomiting syndrome（CVS）complicated by constipation.Methods:The children with CVS, aged from 1 to 16 years, who were admitted to Beijing Tsinghua Changgung Hospital from June 2022 to January 2024, were divided into constipation group and normal group(non-constipation group) according to whether they were complicated with constipation or not.The clinical data and stool samples of children were collect. The abundance, diversity and composition of intestinal flora in fecal samples of two groups were detected by metagenomics sequencing.Results:A total of 20 children with CVS were collected, including 10 patients in constipation group and 10 patients in normal group.There were no significant differences in general demographic data between the two groups, including age at admission, age at first onset, body mass index, gender distribution, disease severity, endoscopic findings, and abdominal pain patterns.Microbiome analysis yielded 470 operational taxonomic units (OTUs), with 414 OTUs identified in normal group and 56 OTUs in constipation group. The abundance and diversity of intestinal flora in constipation group were significantly lower than those in normal group. Principal coordinate analysis and principal component analysis indicated significant structural differences in gut microbiota composition between the two groups. LEfSe analysis revealed distinct taxonomic patterns between the two groups, with the normal group demonstrating predominant representation of Firmicutes at the phylum level, while the constipation group showed higher relative abundance of Bacteroidetes and Actinobacteria. KEGG pathway analysis revealed that the carbon metabolism pathways was significantly enriched in the constipation group.Conclusion:There are significant differences in intestinal flora between CVS children with and without comorbid constipation.Bacteroides and Actinomycetes play an important role in constipation of children with CVS. The diversity and metabolic function of intestinal flora may be one of the pathological mechanisms of CVS complicated with constipation.

Objective:To summarize the clinical symptoms of cyclic vomiting syndrome（CVS）in children and investigate its association with small intestinal bacterial overgrowth（SIBO）.Methods:A total of 89 children who were diagnosed as CVS and improved lactulose hydrogen breath test (LHBT) in the Pediatric Department of Beijing Tsinghua Changgung Hospital from June 2020 to June 2023 were selected as CVS group.Simultaneously，50 healthy children with physical examination in our hospital were selected as the control group. According to the results of LHBT,the children with CVS were divided into SIBO group (LHBT positive) and non-SIBO group (LHBT negative). The clinical data of children in each group were compared.Results:Among the 89 CVS patients，there were 42 males and 47 females，with a mean age of（7.50±3.54）years.Common accompanying symptoms included excessive sleepiness（76 cases，85.39%），anorexia(62 cases，69.66%），constipation（55 cases，61.80%），abdominal pain（34 cases,38.20%）and so on. There were no significant differences in age and gender between children in CVS group and control group ( P>0.05). The body mass index of CVS group was lower than that of control group.The positive rate of LHBT was higher than that of the control group (56.18% vs. 8.00%),the difference was statistically significant ( P<0.05),and the concentrations of hydrogen and methane in CVS group were higher than those of the control group at different time points( P<0.05).Among 89 children with CVS,there were 50 cases in SIBO group and 39 cases in non-SIBO group. There were no significant differences in gender,age and body mass index between the two groups ( P>0.05). The constipation rate and moderate/severe disease rate in SIBO group were higher than those in non-SIBO group (88.00% vs. 28.21%,94.00% vs. 43.59%),and the differences were statistically significant ( P<0.05). Conclusion:The incidence of SIBO in children with CVS is higher,and SIBO may play a key role in CVS. CVS children with SIBO have higher disease severity.

Objective:To assess the nutritional status and risk of children with cyclic vomiting syndrome（CVS）and to provide a clinical evidence for nutritional support.Methods:A total of 160 children diagnosed with CVS and 160 healthy controls were prospectively enrolled in the study，who were admitted to Beijing Tsinghua Changgung Hospital from April 2021 to February 2024.Nutritional status was assessed by anthropometric indices（height，weight，and body mass index），and it was expressed in standard deviation score（Z score）.Nutritional risk screening tool STRONGkids was applied to nutritional risk screening，and the laboratory assessment（albumin，pre-albumin，hemoglobin，urea nitrogen and creatinine）were measured.Results:Among the 160 cases，there were 73 males and 87 females，including 18 cases of mild seizures and 142 cases of moderate and severe seizures，with the average onset age of（47.54±2.96）months and an average diagnosis age of（74.89±3.68）months.The average duration from the first attack to diagnosis was（27.35±2.36）months，and the average course of the disease was（41.35±2.63）months.The malnutrition rate of children in CVS was 36.9%（59/160），of which 18.1%（29/160）was severely malnourished.There was a statistically significant difference in the weight-for-age Z-score（WAZ），height-for-age Z-score（HAZ），and body mass index-for-age Z-score（BAZ）between the CVS group and the control group（ P<0.001）.We found a statistically significant difference in laboratory indicators（albumin，pre-albumin，hemoglobin，urea nitrogen and creatinine）between the two groups（all P<0.001）and hemoglobin was positively correlated with WAZ，HAZ and BAZ（ r=0.346,0.250,0.277，all P<0.01）.Using the STRONGkids nutritional risk screening tool，there were 43 cases with moderate nutritional risk and 117 cases with high nutritional risk，and children with high nutritional risk were likely to have lower WAZ，HAZ and BAZ than the children with moderate nutritional risk，and there was a significant difference in WAZ，HAZ，BAZ，hemoglobin，and creatinine between the two groups（ P<0.05）.And there was a correlation between the degree of CVS attack and nutritional risk grouping（ r=0.543， P<0.001）. Conclusion:Children with CVS have a high incidence of malnutrition，and the serum albumin，prealbumin，hemoglobin，urea nitrogen and creatinine levels are of great value for nutritional assessment.The STRONGkids score method helps to evaluate nutritional risk in children with CVS.

Objective:To investigate the characteristics of gut microbiota distribution in children with cyclic vomiting syndrome（CVS）complicated by constipation.Methods:The children with CVS, aged from 1 to 16 years, who were admitted to Beijing Tsinghua Changgung Hospital from June 2022 to January 2024, were divided into constipation group and normal group(non-constipation group) according to whether they were complicated with constipation or not.The clinical data and stool samples of children were collect. The abundance, diversity and composition of intestinal flora in fecal samples of two groups were detected by metagenomics sequencing.Results:A total of 20 children with CVS were collected, including 10 patients in constipation group and 10 patients in normal group.There were no significant differences in general demographic data between the two groups, including age at admission, age at first onset, body mass index, gender distribution, disease severity, endoscopic findings, and abdominal pain patterns.Microbiome analysis yielded 470 operational taxonomic units (OTUs), with 414 OTUs identified in normal group and 56 OTUs in constipation group. The abundance and diversity of intestinal flora in constipation group were significantly lower than those in normal group. Principal coordinate analysis and principal component analysis indicated significant structural differences in gut microbiota composition between the two groups. LEfSe analysis revealed distinct taxonomic patterns between the two groups, with the normal group demonstrating predominant representation of Firmicutes at the phylum level, while the constipation group showed higher relative abundance of Bacteroidetes and Actinobacteria. KEGG pathway analysis revealed that the carbon metabolism pathways was significantly enriched in the constipation group.Conclusion:There are significant differences in intestinal flora between CVS children with and without comorbid constipation.Bacteroides and Actinomycetes play an important role in constipation of children with CVS. The diversity and metabolic function of intestinal flora may be one of the pathological mechanisms of CVS complicated with constipation.

Objective To study the effect of high mobility group box B1(HMGB1)gene knockout on alleviating a-cute lung injury and inhibiting toll-like receptor 4(TLR4)/nuclear factor-KB(NF-κB)pathway of sepsis mice.Methods Wild-type(WT)mice were divided into WT-Sham group and WT-model group,and HMGB1 knockout(KO)mice were divided into KO-sham group and KO-model group.Sepsis ALI model was established by cecal ligation and perforation in WT-model group and KO-model group.Sham operation was performed in WT-Sham group and KO-Sham group.24 h after modeling,the partial pressure of arterial oxygen(PaO2)was detected,oxy-genation index(OI)was calculated,pathological changes of lung tissue were detected and lung injury score was calculated,the concentrations of tumor necrosis factor-α(TNF-α),interleukin-1 β(IL-1 β),interleukin-6(IL-6),reactive oxygen species(ROS),malondialdehyde(MDA),superoxide dismutase(SOD),in serum and lung tissues and the expression of HMGB1,TLR4 and nuclear NF-κB in lung tissues were detected.Results The PaO2,OI and the concentration of SOD in serum and lung tissue of WT-model group were lower than those of WT-Sham group,the lung injury scores,the concentrations of TNF-α,IL-1 β,IL-6,ROS and MDA in serum and lung tissue,and the expression levels of HMGB1,TLR4 and nuclear NF-κB in lung tissue were higher than those in WT-Sham group(P＜0.05).HMGB1 was not expressed in lung tissue of KO-model group,and the concentrations of PaO2,OI and the concentration of SOD in serum and lung tissue of KO-model group were higher than those of WT-model group,the lung injury scores,the concentrations of TNF-α,IL-1β,IL-6,ROS and MDA in serum and lung tissue,and the expression levels of TLR4 and nuclear NF-κB in lung tissue were lower than those of the WT-model group(P＜0.05).Conclusion HMGB1 gene knockout alleviates acute lung injury of sepsis mice,the re-lated molecular mechanism may be the inhibition of TLR4/NF-κB pathway mediated inflammation and oxidative stress.

  Objective  To investigate the needs of eight-year program clinical medical students for the organization and contents of clinical oncology courses.  Methods  From September to November 2020, a questionnaire survey was conducted among eight-year program clinical medicine students in Peking Union Medical College to find out their knowledge base in oncology, teaching mode preference and course contents of interest.  Results  A total of 122 students participated in the survey, in which 89.3%(109/122) of the students showed interest in basic and clinical research projects related to oncology, 84.4%(103/122) thought it was better to use Simulation-based medical education (SBME), and 91.0%(111/122) hoped to learn throughoff-line discussion. In terms of course contents, eight-year program medical students were more interested in knowledge directly related to clinical context, such as diagnosis, treatment, multidisciplinary comprehensive treatment and evidence-based medicine. In terms of sub-analysis, traditional eight-year students (86%, 92/107) showed a higher acceptance of palliative care than students in the 4+4 reform program(60%, 9/15) and were more willing to act as scriptwriters in SBME(26% vs. 7%, P=0.013). The students in clinical phase gained a better understanding of oncology knowledge through research training and were more inclined to take on the role of scriptwriters in SBME than those in basic phase (27% vs. 11%, P=0.048).  Conclusions  The eight-year program clinical medical students are interested in the clinical oncology course and prefer study in the form of Simulation-based medical education (SBME).