The therapeutic effect of human umbilical cord mesenchymal stem cells (hUCMSCs) combined with intestinal probiotics on the wound healing of diabetic mice and its potential mechanism were explored. A diabetic wound mouse model was established, and 25 male C57BL/6J mice were randomly divided into five groups: blank control group, model group, hUCMSCs treatment group, probiotics treatment group, and hUCMSCs combined with probiotics treatment group. The wound healing conditions were photographed and recorded on days 0, 3, 6, 9, and 12 after modeling, and the differences in wound healing rates among the groups were analyzed. HE and Masson staining were used to observe the histopathological changes and collagen deposition. CD31 immunofluorescence was used to detect angiogenesis. Collagen I immunohistochemistry was used to evaluate the formation of type I collagen. ELISA was used to detect the expression levels of anti-inflammatory factors (Arg1) and pro-inflammatory factors (IL-6, IL-1β, TNF-α) in wounded skin tissue and serum. The results showed that on day 12 after modeling, compared with the other groups, the combined treatment group had the most significant wound contraction and the fastest healing rate. HE and Masson staining showed that the combined treatment group had the fastest epithelialization and the most collagen deposition. Immunofluorescence and immunohistochemistry showed that the combined treatment group had the highest expression levels of CD31 and Collagen I. ELISA results indicated that the combined treatment group had higher expression levels of Arg1 in wound skin tissue and serum than the other groups, while the expression levels of IL-6, IL-1β, and TNF-α were significantly lower. These results suggest that the combined treatment of hUCMSCs and intestinal probiotics can accelerate wound healing in diabetic mice through mechanisms such as promoting angiogenesis, enhancing collagen deposition, and regulating the inflammatory microenvironment. The therapeutic effect was significantly better than that of single treatment, providing a new potential strategy for the clinical treatment of diabetic foot.

Due to their unique physicochemical properties, nanomaterials can optimize drug delivery and reshape the tumor microenvironment. Manganese-based nanomaterials are primarily used in tumor immunotherapy for the following purpose, including targeted activating of the cyclic GMP-AMP synthase-stimulator of interferon gene pathway to enhance immunogenicity, utilizating of manganese′s redox properties to regulate the tumor microenvironment, and developing of manganese-based magnetic resonance imaging contrast agents to monitor immune responses in real time. In this review, synthesis methods of manganese-based nanomaterials such as thermal decomposition method, hydrothermal/solvothermal synthesis method, and chemical precipitation/mixing method as well as an in-depth analysis of their applications in tumor immunotherapy including immune regulation, regulation of tumor microenvironment and enhanced magnetic resonance imaging were reviewed.

OBJECTIVE To analyze the clinical distribution characteristics and drug resistance of Enterobacter cloa-cae in Gansu Province from 2019 to 2023,providing reference for the prevention and control of E.cloacae infec-tions in this region.METHODS Data on the distribution and drug resistance of E.cloacae from hospitals in mem-ber units of the Gansu Antimicrobial Surveillance Network between 2019 and 2023 were collected.In vitro drug susceptibility testing was performed by the Kirby-Bauer disk diffusion(K-B)method,minimum inhibitory con-centration method,and fully automated instrumentation,followed by analysis of the susceptibility results.RESULTS From 2019 to 2023,a total of 402 490 bacterial strains were isolated and cultured in Gansu Province,including 17 417 strains of E.cloacae,with a detection rate of 4.33％.The bacteria were primarily iso-lated from sputum specimens(62.81％),followed by urine(7.37％)and wound pus specimens(6.07％).The de-partmental distribution was dominated by internal medicine(44.96％)and surgery(28.50％).The highest detec-tion rate was observed in the adult group(15-65 years,45.79％).E.cloacae exhibited varying degrees of resist-ance to over 20 antibacterial drugs,but the overall drug resistance rate showed a declining trend(P＜0.05).The highest drug resistance rate was observed for cefazolin(96.40％-98.38％),while the lowest was for tigecycline(0.44％—2.92％).Carbapenem-resistant E.cloacae demonstrated an increasing trend in drug resistance rates,with imipenem resistance ranging from 2.79％to 3.71％(P=0.044)and meropenem resistance ranging from 1.29％to 3.41％(P＜0.05).CONCLUSIONS The isolation rate of E.cloacae in Gansu Province remains stable,with a declining trend in drug resistance to multiple antibacterial drugs.However,the increasing drug resistance to carbapenems warrants attention.

Objective To investigate the expression levels and clinical significance of Galectin-3,interleukin(IL)-1β and IL-9 in peripheral blood of children with refractory mycoplasma pneumoniae pneumonia(RMPP).Methods A total of 132 hospitalized children diagnosed with RMPP were selected as the RMPP group,and another 128 children with general MPP(GMPP)in the same period were selected as the GMPP group.The clinical data of C-reactive protein(CRP),tumor necrosis factor-α(TNF-α)and procalcitonin(PCT)in pediatric patients were collected.The expression levels of Galectin-3,IL-1β and IL-9 were detected by enzyme-linked immunosorbent assay(ELISA).The correlation between Galectin-3,IL-1β and IL-9 levels in peripheral blood of RMPP children and clinical factors were analyzed by Pearson or Spearman methods.Multivariate Logistic regression analysis was used to analyze risk factors of GMPP progression to RMPP.The predictive value of peripheral blood Galectin-3,IL-1β and IL-9 levels to RMPP was analyzed by receiver operating characteristic(ROC)curve.Results The heat course,CRP,TNF-α,PCT,Galectin-3,IL-1β,IL-9 and the proportion of extrapulmonary complications were higher in the RMPP group than those in the GMPP group(P＜0.01).The correlation analysis results showed that Galectin-3,IL-1β and IL-9 levels were positively correlated with heat course,extrapulmonary complications,CRP,TNF-α and PCT(P＜0.01).Logistic regression analysis showed that the increased levels of Galectin-3,IL-1β and IL-9 were independent risk factors for GMPP progression to RMPP(P＜0.05).The area under the curve(AUC)of peripheral blood Galectin-3,IL-1β,IL-9 and their combined prediction of GMPP progression to RMPP were 0.852,0.813,0.812 and 0.949,respectively,and the combined prediction showed the highest efficacy(P＜0.01).Conclusion The levels of Galectin-3,IL-1β and IL-9 in the peripheral blood of children with RMPP are abnormally elevated,and their combined detection can be used as an important indicator for evaluating the progression of GMPP to RMPP.

Idiopathic pulmonary fibrosis (IPF), a chronic interstitial lung disease, is characterized by aberrant wound healing, excessive scarring and the formation of myofibroblastic foci. Although the role of alternative splicing (AS) in the pathogenesis of organ fibrosis has garnered increasing attention, its specific contribution to pulmonary fibrosis remains incompletely understood. In this study, we identified an up-regulation of serine/arginine-rich splicing factor 7 (SRSF7) in lung fibroblasts derived from IPF patients and a bleomycin (BLM)-induced mouse model, and further characterized its functional role in both human fetal lung fibroblasts and mice. We demonstrated that enhanced expression of Srsf7 in mice spontaneously induced alveolar collagen accumulation. Mechanistically, we investigated alternative splicing events and revealed that SRSF7 modulates the alternative splicing of pyruvate kinase (PKM), leading to metabolic dysregulation and fibroblast activation. In vivo studies showed that fibroblast-specific knockout of Srsf7 in conditional knockout mice conferred resistance to bleomycin-induced pulmonary fibrosis. Importantly, through drug screening, we identified lomitapide as a novel modulator of SRSF7, which effectively mitigated experimental pulmonary fibrosis. Collectively, our findings elucidate a molecular pathway by which SRSF7 drives fibroblast metabolic dysregulation and propose a potential therapeutic strategy for pulmonary fibrosis.

Objective To investigate the expression levels and clinical significance of Galectin-3,interleukin(IL)-1β and IL-9 in peripheral blood of children with refractory mycoplasma pneumoniae pneumonia(RMPP).Methods A total of 132 hospitalized children diagnosed with RMPP were selected as the RMPP group,and another 128 children with general MPP(GMPP)in the same period were selected as the GMPP group.The clinical data of C-reactive protein(CRP),tumor necrosis factor-α(TNF-α)and procalcitonin(PCT)in pediatric patients were collected.The expression levels of Galectin-3,IL-1β and IL-9 were detected by enzyme-linked immunosorbent assay(ELISA).The correlation between Galectin-3,IL-1β and IL-9 levels in peripheral blood of RMPP children and clinical factors were analyzed by Pearson or Spearman methods.Multivariate Logistic regression analysis was used to analyze risk factors of GMPP progression to RMPP.The predictive value of peripheral blood Galectin-3,IL-1β and IL-9 levels to RMPP was analyzed by receiver operating characteristic(ROC)curve.Results The heat course,CRP,TNF-α,PCT,Galectin-3,IL-1β,IL-9 and the proportion of extrapulmonary complications were higher in the RMPP group than those in the GMPP group(P＜0.01).The correlation analysis results showed that Galectin-3,IL-1β and IL-9 levels were positively correlated with heat course,extrapulmonary complications,CRP,TNF-α and PCT(P＜0.01).Logistic regression analysis showed that the increased levels of Galectin-3,IL-1β and IL-9 were independent risk factors for GMPP progression to RMPP(P＜0.05).The area under the curve(AUC)of peripheral blood Galectin-3,IL-1β,IL-9 and their combined prediction of GMPP progression to RMPP were 0.852,0.813,0.812 and 0.949,respectively,and the combined prediction showed the highest efficacy(P＜0.01).Conclusion The levels of Galectin-3,IL-1β and IL-9 in the peripheral blood of children with RMPP are abnormally elevated,and their combined detection can be used as an important indicator for evaluating the progression of GMPP to RMPP.

Objective:To evaluate the intervention effectiveness of scenario simulation teaching based on the Eilks model on the social context integration ability, critical thinking, and humanistic care of resident physicians in the department of stomatology.Methods:A total of 94 resident physicians in the department of stomatology were included in the study, with 53 in the experimental group and 41 in the control group. The control group received traditional teaching, while the experimental group received scenario simulation teaching based on the Eilks model. Through the five-link design of "text analysis, scientific background, social context, viewpoint debate, and meta reflection", the integration of social science issues (such as ethical conflicts and economic costs) and clinical decision-making was strengthened. Trainees were evaluated for clinical decision-making ability, clinical reflection ability, and doctor-patient communication ability. The data were subjected to t-test and chi-square test using SPSS 24.0. Results:In terms of clinical decision-making ability, the experimental group outperformed the control group in ethical cost balance [(7.85±1.08) vs. (6.12±1.73), t=5.68, P<0.001], multidisciplinary collaboration [(8.25±0.73) vs. (5.83±0.82), t=6.01, P<0.001)], and complication planning [(7.98±1.02) vs. (5.34±1.42), t=6.79, P<0.001]. In terms of clinical reflection ability, the experimental group scored higher in depth of cost-benefit analysis, intensity of evidence-based reflection, and cognitive upgrading (all P<0.001). In terms of doctor-patient communication skills, the experimental group demonstrated superior performance compared to the control group in information collection [(10.25±1.28) vs. (7.53±1.33)] and emotional support [(10.97±1.18) vs. (6.53±1.23)]. Conclusions:Based on the Eilks model, scenario simulation teaching effectively enhances the ability of residents in the department of stomatology to integrate social factors, optimize ethical decision-making, and perform empathetic communication through social conflict simulation (such as three-way role debate) and dual path critical thinking training. In the future, further optimization is needed in terms of personalized expression and the timeliness of basic training.

Congenital heart disease (CHD) is a congenital malformation resulting from abnormal embryonic development of the heart and great vessels, accounting for approximately 25% of all congenital malformations. Children with CHD are often complicated by short stature. Although surgical treatment can improve their growth and development to a certain extent, some children still experience growth retardation after surgery. Recombinant human growth hormone (rhGH) is the main drug for treating short stature, but its efficacy and safety in the treatment of patients with concomitant CHD warrant further investigation. This article reports six cases of children with CHD and short stature who were treated with rhGH. Through a literature review, we summarize and discuss the therapeutic efficacy, follow-up experiences, and adverse reactions of rhGH treatment, aiming to provide references for clinicians in applying rhGH to treat patients with CHD and short stature.

Neurofibromas are benign peripheral nerve sheath tumors. It is more common in neurofibromatosis type Ⅰ. However, isolated vagal nerve neurofibroma（VNN） of the neck is extremely rare, and only a few case reports have been reported. Its etiology and pathogenesis are not clear. The diagnosis is mainly based on pathological examination and immunohistochemistry, and surgical resection is the main treatment. This study reports a rare case of giant solitary vagus neurofibroma in the neck. The patient was a 29-year-old female who was found to have a mass on the right side of the neck by physical examination, which was considered to be a vagus nerve tumor by neck ultrasound and imaging examination. The tumor was completely removed during the operation, with the size of about 10.0 cm×2.5 cm, and the patient had no special discomfort. Postoperative pathology and immunohistochemistry confirmed neurofibroma. After surgery, the patient had right vocal cord paralysis, hoarseness, choking and paroxysmal cough. After swallowing function training and voice rehabilitation treatment in the department, the patient recovered satisfactorily. There was no complication and recurrence during the follow-up of 1 year. This article reviews the literature to improve the diagnosis and treatment of solitary vagus neurofibroma in the neck by combining its medical history, imaging features, pathology and immunohistochemistry, and surgical treatment.
Humans ; Female ; Adult ; Neurofibroma ; Vagus Nerve/pathology* ; Neck ; Cranial Nerve Neoplasms

Objective　To analyse the crude detection rate and trends of newly detected HIV/AIDS cases in medical institutions in China from 2017 to 2023, and to provide a reference for optimizing HIV testing strategies in medical institutions. Methods　Data on HIV testing and newly reported HIV/AIDS cases were analysed using data from the Comprehensive AIDS Prevention and Control Information System of the China Information System for Disease Control and Prevention for the period from 2017 to 2023. HIV testing in medical institutions includes patients tested preoperatively, those tested before transfusion, those tested in sexually transmitted disease (STD) clinics, prenatal care clinics, and other types of patients. Descriptive statistical analysis and χ2 test were performed using SAS 9.4 software. Joinpoint regression was performed using Joinpoint 4.9.0 software to analyse trends of the crude detection rates over time. Results　From 2017 to 2023, the person-times of HIV tests in medical institutions increased from 143 million to 255 million, with an increase of 78.07%. The number of newly detected HIV/AIDS cases increased from 74 000 to 88 000 and then declined to 69 000. The crude detection rate of new HIV/AIDS cases declined from 5.18/10 000 to 2.71/10 000, showed a declining trend, the mean annual percentage change was -9.99%(P<0.001). The crude detection rate of new HIV/AIDS cases in STD clinics was the highest among all types of clinic visits (12.79/10 000-24.47/10 000), and the crude detection rate of new cases among all types of clinic visits showed a decreasing trend(P<0.05). Among different medical institutions, general hospitals were the most important source of the number of tests and the number of newly detected HIV/AIDS cases, accounting for more than 62.93% and 62.68%, respectively. Specialised medical institutions had the highest crude detection rate of new cases, which was maintained at more than 5.13/10 000. The crude detection rate of new cases for all four types of medical institutions, except for primary medical institutions, showed a decreasing trend (P<0.05). Conclusions　The detection rate of new cases in medical institutions showed a decreasing trend in 2017-2023, and the efficiency of STD clinics testing and detection was higher among all types of attendees. General hospitals are the main source of new cases detection, and testing in specialised medical institutions is more efficient. Testing should be strengthened in key groups of patients and in key medical institutions.