Extraskeletal Ewing's sarcoma（EES） in the head and neck is extremely rare, with non-specific clinical manifestations, high malignancy, easy recurrence and metastasis, and poor prognosis. This paper reports a case of EES of the parapharyngeal skull base presenting with secretory otitis media as the initial symptom.The treatment consisted of surgery, chemotherapy and radiotherapy. No further metastasis or recurrence was observed during the two years and six months follow-up. Now we reviewed the relevant literatures and summarized the experience of diagnosis and treatment in EES.
Humans ; Otitis Media with Effusion/etiology* ; Sarcoma, Ewing/therapy* ; Skull Base ; Skull Base Neoplasms/therapy*

Ergothioneine is a natural antioxidant known for its potent anti-inflammatory and antioxidative properties. It has been applied in various sectors such as food, cosmetics, and pharmaceuticals. Edible fungi, both wild and cultivated, stand as the primary natural sources capable of synthesizing ergothioneine. This paper reviews the research progress in the content, physiological functions, extraction and detection methods, synthetic genes and pathways, mycelium fermentation, and engineering strain construction for ergothioneine production. The aim is to provide a comprehensive reference for advancing the research and industrial development related to ergothioneine in edible fungi.
Ergothioneine/isolation & purification* ; Fungi/genetics* ; Antioxidants/metabolism* ; Fermentation

Objective To investigate the protective effect of 5-hydroxy-6,7-dimethoxyflavone(5-HDF),a compound extracted from Elsholtzia blanda Benth.,against lung injury induced by H1N1 influenza virus and explore its possible mechanism of action.Methods 5-HDF was extracted from Elsholtzia blanda Benth.using ethanol reflux extraction and silica gel chromatography and characterized using NMR and MS analyses.In an A549 cell model of H1N1 influenza virus infection(MOI=0.1),the cytotoxicity of 5-HDF was assessed using MTT assay,and its effect on TRAIL and IL-8 expressions was examined using flow cytometry;Western blotting was used to detect the expression levels of inflammatory,apoptosis,and ferroptosis-related proteins.In a mouse model of H1N1 influenza virus infection established by nasal instillation of 50 μL H1N1 virus at the median lethal dose,the effects of 30 and 60 mg/kg 5-HDF by gavage on body weight,lung index,gross lung anatomy and lung histopathology were observed.Results 5-HDF exhibited no significant cytotoxicity in A549 cells within the concentration range of 0-200 μg/mL.In H1N1-infected A549 cells,treatment with 5-HDF effectively inhibited the activation of phospho-p38 MAPK and phospho-NF-κB p65,lowered the expressions of IL-8,enhanced the expression of anti-ferroptosis proteins(SLC7A11 and GPX4),and inhibited the expressions of apoptosis markers PARP and caspase-3 and the apoptotic factor TRAIL.In H1N1-infected mice,treatment with 5-HDF for 7 days significantly suppressed body weight loss and increment of lung index and obviously alleviated lung tissue pathologies.Conclusion 5-HDF offers protection against H1N1 influenza virus infection in mice possibly by suppressing H1N1-induced ferroptosis,inflammatory responses,and apoptosis via upregulating SLC7A11 and GPX4,inhibiting the activation of phospho-NF-κB p65 and phospho-p38 MAPK,and decreasing the expression of cleaved caspase3 and cleaved PARP.

Objective To investigate the clinical value of multimodal ultrasonography combined with clinical indicators in predicting the progression of ischemic stroke(IS).Methods A total of 134 patients with IS admitted to Third People's Hospital of Yunnan Province from January 2020 to October 2022 were selected as study objects and were divided into progressive ischemic stroke(PIS)group(n=20)and non-progressive ischemic stroke(NPIS)group(n=114)according to the National Institutes of Health Stroke Scale(NIHSS)score.The clinical indicators,multi-modal ultrasonic image manifestations and related parameters of the two groups were counted,the influencing factors of PIS were screened by Logistics,the nomogram model was drawn,and the predictive efficiency of the nomogram model was evaluated by ROC curve and calibration curve.Results There were significant differences in age,baseline nutritional risk index(GNRI)score,baseline homocysteine(Hcy)and baseline uric acid(UA)between the two groups(P<0.05).The peak time(TTP),peak intensity(PI),the area under the curve(AUC),carotid plaque enhancement mode,the mean value of maximum elastic modulus(MEmax)and mean value of minimum elastic modulus(MEmin)were compared between the two groups,and the differences were statistically significant(P<0.05).Logistic analysis showed that baseline GNRI score,baseline UA,TTP,PI,AUCTC,carotid plaque enhancement pattern,MEmax and MEmin were the influencing factors of PIS(P<0.05).Based on the above factors,the nomogram model was drawn.ROC curve and calibration curve showed that the model had good prediction efficiency,and the prediction efficiency was in good agreement with the reality.Conclusion The influencing factors of PIS include baseline GNRI score,baseline UA,TTP,PI,AUCTC,carotid plaque enhancement pattern,MEmax,MEmin,and the neagram model based on the above factors has good differentiation and accuracy.

Parkinson's disease(PD)challenges us to assess the disease due to the lack of definitive biomarkers.Currently,PD patients have been found to contract several gastrointestinal comorbidities such as con-stipation and intestinal inflammation that precede its symptomatic manifestations.These conditions are intricately linked to proliferative metabolisms of the gut microbiota,which are manifested to be some primary changes in the gut microbiota or other changes involved in medication during treatment.In this paper we review the recent research on gut microbiota biomarkers in PD,arguing for the clinical relevance of gut microbiota as a marker in the progression of PD and prospecting the potential efficacy of fecal microbiota transplantation as an intervention in managing PD.

Objective To investigate the protective effect of 5-hydroxy-6,7-dimethoxyflavone(5-HDF),a compound extracted from Elsholtzia blanda Benth.,against lung injury induced by H1N1 influenza virus and explore its possible mechanism of action.Methods 5-HDF was extracted from Elsholtzia blanda Benth.using ethanol reflux extraction and silica gel chromatography and characterized using NMR and MS analyses.In an A549 cell model of H1N1 influenza virus infection(MOI=0.1),the cytotoxicity of 5-HDF was assessed using MTT assay,and its effect on TRAIL and IL-8 expressions was examined using flow cytometry;Western blotting was used to detect the expression levels of inflammatory,apoptosis,and ferroptosis-related proteins.In a mouse model of H1N1 influenza virus infection established by nasal instillation of 50 μL H1N1 virus at the median lethal dose,the effects of 30 and 60 mg/kg 5-HDF by gavage on body weight,lung index,gross lung anatomy and lung histopathology were observed.Results 5-HDF exhibited no significant cytotoxicity in A549 cells within the concentration range of 0-200 μg/mL.In H1N1-infected A549 cells,treatment with 5-HDF effectively inhibited the activation of phospho-p38 MAPK and phospho-NF-κB p65,lowered the expressions of IL-8,enhanced the expression of anti-ferroptosis proteins(SLC7A11 and GPX4),and inhibited the expressions of apoptosis markers PARP and caspase-3 and the apoptotic factor TRAIL.In H1N1-infected mice,treatment with 5-HDF for 7 days significantly suppressed body weight loss and increment of lung index and obviously alleviated lung tissue pathologies.Conclusion 5-HDF offers protection against H1N1 influenza virus infection in mice possibly by suppressing H1N1-induced ferroptosis,inflammatory responses,and apoptosis via upregulating SLC7A11 and GPX4,inhibiting the activation of phospho-NF-κB p65 and phospho-p38 MAPK,and decreasing the expression of cleaved caspase3 and cleaved PARP.

Objective To compare the efficacy of carvedilol and propranolol combined with octreotide in the treatment of upper gastrointestinal hemorrhage in patients with liver cirrhosis.Methods A total of 72 patients with liver cirrhosis and upper gastrointestinal hemorrhage who were admitted to No.928 Hospital of Joint Logistic Support Forces of PLA from January 2020 to January 2022 were selected as research objects.The patients were divided into control group and observation group by random number table method,with 36 patients in each group.The control group was treated with propranolol and octreotide,and the observation group was treated with carvedilol and octreotide.Portal vein blood flow,splenic vein blood flow,hepatic venous wedge pressure(WHVP),hepatic venous free pressure(FHVP),and hepatic venous pressure gradient(HVPG)were recorded before and after treatment.The treatment efficacy,rebleeding rate within 48 h,length of hospital stay and adverse reactions were compared between the two groups.Results The total effective rate of treatment in the observation group was significantly higher than that in the control group(P＜0.05).There was no significant difference in the rebleeding rate within 48 h,the length of hospital stay,or the incidence of adverse reactions between the two groups(P＞0.05).There was no significant difference in the portal venous blood flow,splenic venous blood flow,WHVP,FHVP,or HVPG between the two groups before treatment(P＞0.05).The portal venous blood flow,splenic venous blood flow,WHVP,and HVPG in the observation group were significantly lower than those in the control group after treatment(P＜0.05),while there was no significant difference in the FHVP between the two groups(P＞0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P＞0.05)Conclusion Carvedilol combined with octreotide is more effective in treating upper gastrointestinal hemorrhage in patients with liver cirrhosis than propranolol combined with octreotide.It can significantly reduce HVPG and improve portal and splenic venous blood flow,with a good safety profile.It is worthy of clinical application.

Objective:To analyze the clinical efficacy of bone transport with unilateral external fixation in the treatment of massive tibial bone defects.Methods:A retrospective study was conducted to review the 21 patients with massive tibial bone defects who had been treated by bone transport with unilateral external fixation from February 2017 to January 2022 at Department of Trauma Orthopedics, Ganzhou People's Hospital. There were 14 males and 7 females with a mean age of (46.3 ± 11.3) years. Causes for bone defects: trauma ( n=5), resection of bone non-union ( n=9), resection of infected bone ( n=6) and resection of bone tumor ( n=1). The mean bone defect length was (8.3 ± 1.7) cm. Bone transport started from 10 to 12 days after operation, with a speed of 1 mm/d, and was completed in 4 times. X-ray films were reviewed every 2 weeks. The bone union time, external fixation time (EFT), external fixation index (EFI), docking site situation and complications were recorded. The clinical efficacy was assessed by Paley score. Results:All patients were followed-up for a mean time of (13.5 ± 5.5) months. The mineralization of regenerated bone was good. The bone union time was (9.6 ± 2.2) months, the EFT (10.3 ± 4.0) months, and the EFI (1.3 ± 0.4) months/cm. All docking sites got united. The docking sites were cleaned in 14 patients, of whom simple compression with external fixation was performed in 5 and bone grafts at the docking sites in 9. Postoperative nail tract infection was observed in 6 cases, tibial alignment deviation in 1 case, foot drop deformity in 5 cases, horseshoe varus foot deformity in 1 case, toe flexion deformity in 3 cases, and refracture after removing the external fixation in 1 case. By the Paley score, the bony outcomes were rated as excellent in 16 and as good in 5 cases. The functional outcomes were excellent in 10, good in 7, and acceptable in 4.Conclusion:Bone transport with unilateral external fixation is an effective treatment for massive tibial bone defects, showing advantages of easy operation and convenient carry.

Objective:To investigate the effects of breast milk to total milk intake ratio during hospitalization on the duration of antibiotic therapy in preterm infants less than 34 weeks of gestation.Methods:Clinical data of preterm infants ( n=1 792) less than 34 gestational weeks were retrospectively collected in 16 hospitals of Jiangsu Province Neonatal-Perinatal Cooperation Network from January 1, 2019, to December 31, 2021. The days of therapy (DOT) were used to evaluate the duration of antibiotic administration. The median DOT was 15.0 d (7.0-27.0 d). The patients were divided into four groups based on the quartiles of DOT: Q 1 (DOT≤7.0 d), Q 2 (7.0 d27.0 d) groups. According to the breast milk intake ratio (breast milk intake to total milk intake during hospitalization×100%), they were also divided into four groups: very-low-ratio breastfeeding group (breast milk intake ratio≤25%), low-ratio breastfeeding group (25%75%). Univariate analysis ( Chi-square test and Kruskal-Wallis rank-sum test) was used to analyze the factors influencing DOT. Spearman correlation analysis and trend Chi-square test were used to explore the relationship between breast milk intake ratio and DOT. After using multiple imputations to address missing data, two models were constructed after adjusting for different factors, and multinomial logistic regression model was applied to evaluate the effects of the breast milk intake ratio on DOT. Finally, sensitivity analysis was conducted to assess the stability of the models. Results:(1) Of the 1 792 preterm infants, there were 507 (28.3%) in the Q 1 group, 422 (23.5%) in the Q 2 group, 438 (24.4%) in the Q 3 group and 425 (23.7%) in the Q 4 group. (2) The median values of DOT in the very-low-ratio, low-ratio, medium-ratio and high-ratio breastfeeding groups were 20.0 d (11.0-31.0 d), 20.0 d (11.0-32.0 d), 13.0 d (6.0-25.8 d) and 10.0 d (4.0-21.0 d), respectively. Compared with the very-low-ratio and low-ratio breastfeeding groups, the medium-ratio and high-ratio breastfeeding groups had shorter DOT (all P<0.05). (3) After adjusting for factors with P<0.1 (prenatal glucocorticoid exposure, antimicrobial use within 24 h before delivery, gestational age at delivery, birth weight, Apgar score≤7 at 1 min, neonatal respiratory distress syndrome, infectious pneumonia and early-onset neonatal sepsis) between the DOT quartile groups, it showed that medium-ratio and high-ratio breastfeeding were protective factors in contrast to very-low-ratio breastfeeding in the Q 2, Q 3 and Q 4 groups as compared with the Q 1 group [Q 2 group: OR=0.50 (95% CI: 0.30-0.85) and OR=0.36 (95% CI: 0.26-0.51); Q 3 group: OR=0.31 (95% CI: 0.18-0.55) and OR=0.20 (95% CI: 0.14-0.29); Q 4 group: OR=0.22 (95% CI: 0.12-0.42) and OR=0.17 (95% CI: 0.12-0.26)]. Conclusion:Breast milk intake accounting for over 50% of total milk intake has a positive impact on reducing DOT in premature infants requiring antibiotics, which suggests that breastfeeding should be actively encouraged.