ObjectiveTo investigate the role of Ras-GTPase-activating protein SH3 domain-binding protein 2 （G3BP2） in regulating the activation， proliferation， and migration of hepatic stellate cells （HSCs）. MethodsThe mouse HSCs （JS-1 cell line） were treated with 5 μg/L transforming growth factor-beta 1（TGF-β1） for 24 hours to establish an HSC activation and proliferation model. A G3BP2 knockdown system was constructed using siRNA interference technology. The experiment was divided into four groups： Control， TGF-β1 treatment， TGF-β1+si-NC， and TGF-β1+ G3BP2-siRNA. The expression levels of key fibrosis indicators， including type I collagen （Collagen I）， α-smooth muscle actin （α-SMA）， and G3BP2， were detected by Western blot and RT-qPCR. Cell proliferation activity was assessed using the CCK-8 proliferation assay kit and EdU fluorescence labeling technology. Cell migration ability was analyzed by scratch wound healing assay and Transwell migration assay. The formation level of stress granules was quantified by immunofluorescence microscopy to investigate the effects of G3BP2 on stress granule formation in activated HSCs. ResultsStimulation with TGF-β1 upregulated the expression of G3BP2 in JS-1 cells （RT-qPCR： P0.000 1； Western blot： P0.000 1）， while a downward trend in its expression was observed in the G3BP2‑silenced group （RT-qPCR： P0.01； Western blot： P0.000 1）. Compared with the control group， the TGF-β1 group exhibited increased protein expression levels of α-SMA and Collagen I （RT-qPCR： both P0.01； Western blot： P0.01 and P0.05， respectively）， concomitant with an increased number of stress granules and enhanced cell proliferation and migration capacity （all P0.001）. The experimental results demonstrated that G3BP2 knockout effectively reversed the aforementioned phenotypes， with the G3BP2-silenced group showing reduced expression of fibrotic markers （all P0.01）， decreased stress granule formation （P0.01）， and reduced cell proliferation and migration capacity （all P0.05）， compared to the negative control group. ConclusionG3BP2 enhances the activation， proliferation， and migration of HSCs by promoting the formation of stress granules， thereby accelerating the pathological progression of liver fibrosis. This suggests that stress granules may serve as important regulators in controlling the activation， proliferation， and migration of HSCs.

Background: and Purpose Limited evidence exists on the effectiveness of endovascular treatment (EVT) for acute posterior circulation tandem lesion (PCTL). This study aimed to explore the role of extracranial vertebral artery (VA) stenting in patients with PCTL stroke undergoing EVT. Methods: Individual patient data were pooled from the BASILAR (EVT for Acute Basilar Artery Occlusion Study) and PERSIST (Posterior Circulation Ischemic Stroke) registries. Patients with PCTLs who underwent EVT were included in the present cohort and divided into the stenting and nonstenting groups based on the placement of extracranial VA stents. The primary efficacy outcome was the modified Rankin Scale (mRS) scores at 90 days and 1 year. Safety outcomes included 24-hour symptomatic intracranial hemorrhage (sICH) and all-cause mortality at 90 days and 1 year post-surgery. Results: A combined dataset of 1,320 patients with posterior circulation artery occlusion, including 263 (19.9%) with tandem lesions, of whom 217 (median age, 65 years; 82.9% male) met the inclusion criteria for the analysis. The stenting group had 84 (38.7%) patients, while the non-stenting group had 133 (61.3%). After adjustment for the potential confounders, extracranial VA stenting was associated with favorable shifts in mRS scores at both 90 days (adjusted common odds ratio [OR], 2.30; 95% confidence interval [CI], 1.23–4.28; P<0.01) and 1 year (adjusted OR [aOR], 2.04; 95% CI [1.05–3.97]; P=0.04), along with lower rate of mortality at both 90 days (aOR, 0.45; 95% CI [0.21–0.93]; P=0.01) and 1 year (aOR, 0.36; 95% CI [0.16–0.79]; P=0.01), with no significant difference in sICH incidence (aOR, 0.35; 95% CI [0.06–1.98]; P=0.24). Conclusion Extracranial VA stenting during EVT may improve functional outcomes and reduce mortality in patients with PCTL strokes.

Background and purpose:The microphthalmia-associated transcription factor(MITF)plays a complex role in melanoma pathogenesis and progression.It is known to regulate multiple processes both in melanocytes and melanoma cells.While numerous studies have explored MITF in cutaneous melanoma(CM),research in acral melanoma(AM)is still limited.This study retrospectively analyzed the correlation between MITF expression and clinical,pathological characteristics and prognosis in AM patients,providing a basis for prognosis evaluation and personalized treatment plan formulation for patients.Methods:Patients who underwent primary resection of AM at Fudan University Shanghai Cancer Center from March 2008 to February 2022 were included.All surgical samples were diagnosed by clinical histopathology and used to construct the tissue microarray(TMA).This study was approved by the medical ethics committee of Fudan University Shanghai Cancer Center(approval number:2203-ZZK-69-3).Cutting complete tissue microarray and evaluating MITF expression levels by immunohistochemistry(IHC)staining were carried out.The results were independently assessed and scored by three pathologists.Clinical and pathological data were collected from the hospital's electronic medical record system,and each patient's data was matched to their corresponding tissue sample on the chip.Patients were stratified into two groups based on MITF expression levels.Statistical analyses were performed to assess differences in clinical,pathological characteristics and survival outcomes between these two groups.Results:A total of 137 AM patients were included.MITF expression was significantly associated with T stage,N stage,American Joint Committee on Cancer(AJCC)stage,clark level,sentinel lymph node status,and presence of ulceration.Among these,N stage and ulceration were independent risk factors for high expression of MITF after adjusting for confounding factors.Survival analysis showed that AM patients with high MITF expression or higher T stage were associated with shorter disease-free survival(DFS).Patients with high MITF expression showed no significant difference in overall survival(OS)between observation or cytokine therapy and adjuvant immune checkpoint inhibitor(ICI)therapy,whereas those with low MITF expression derived significant survival benefits from ICI treatment.Conclusion:A higher N stage or the presence of ulceration indicates high MITF expression in tumor cells,with high MITF levels serving as a warning signal for early recurrence,metastasis,and even death.Patients with low MITF expression could receive improved OS with early adjuvant ICI therapy.MITF could not only serve as an auxiliary diagnostic marker for melanoma but also provide a basis for clinical prognosis assessment and the formulation of personalized treatment plans.

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 understand the molecular epidemiological characteristics and hypervirulence evolution trend of ST11 carbapenem-resistant Klebsiella pneumoniae(CRKP)isolated from medical institutions in Shanghai,and provide scientific basis for formulating the prevention and control measures of drug-resistant organisms.Methods A total of 201 strains of CRKP isolated from 12 medical institutions in Shanghai from 2021 to 2022 were collected.Antimicrobial susceptibility testing and whole genome sequencing were performed.The concatenated data was used for multilocus sequencing typing(MLST),serum typing(wzi typing),as well as analysis of resistance and viru-lence genes.Results All 201 CRKP strains were multidrug-resistant organisms(MDROs).These strains were al-most completely resistant to carbapenems,cephalosporins,and quinolones.Drug resistance gene analysis showed that 93.03％of CRKP strains carried KPC gene.201 CRKP strains were divided into 6 ST types and 10 capsule wzi types,with ST11-KL64(n=104)being the dominant type,followed by ST15-KL19(n=54).52.24％(n=105)of CRKP carried rpmA/rpmA2+iucA+iutA+iroN genes.Conclusion CRKP isolated from medical institutions in Shanghai is mainly ST11-KL64 type with severe multidrug resistance,and more than half of the strains are hyper-virulent carbapenem-resistant Klebsiella pneumoniae(hv-CRKP).It is necessary to continuously strengthen the monitoring of the molecular characteristics of CRKP,so as to prevent outbreaks of healthcare-associated infection.

Objective To analyze the predictive value of cerebrospinal fluid interleukin-6(IL-6)and interleukin-10(IL-10)in the prognosis of patients with primary intraocular lymphoma(PIOL).Methods A retrospective study was conducted,60 PIOL pa-tients admitted to Peking Union Medical College,Chinese Academy of Medical Sciences,Peking Union Medical College Hospital from Jan-uary 2018 to December 2022 were selected.Follow-up assessments were conducted for 2 years after discharge to evaluate the prognosis and calculate the incidence of adverse outcomes.Patients with adverse outcomes were classified as the poor prognosis group,while those without adverse outcomes were classified as the good prognosis group.Clinical data at admission were compared between the two groups.Multivariate Logistic regression analysis was used to assess the impact of cerebrospinal fluid IL-6 and IL-10 on prognosis.Receiver op-erating characteristic(ROC)curve were plotted to evaluate the predictive value of cerebrospinal fluid IL-6 and IL-10 for prognosis.Results After 2 years follow-up of 60 patients,22 patients developed adverse outcomes,with an incidence rate of 36.67％.The poor prognosis group included 22 patients,while the good prognosis group included 38 patients.There were statistically significant difference in cerebrospinal fluid IL-6 and IL-10 between the two groups(P＜0.05).The results of multivariate Logistic regression analysis indicated that cerebrospinal fluid IL-6 and IL-10 were risk factors for adverse outcomes.The area under the curve(AUC),sensitivity,and spe-cificity of the combined detection of IL-6 and IL-10 in cerebrospinal fluid for predicting prognosis were 0.879,85.53％and 91.46％,respectively,which were higher than those of single detections of IL-6 or IL-10 in cerebrospinal fluid.Conclusion The combined de-tection of IL-6 and IL-10 in cerebrospinal fluid has a certain predictive value for the prognosis of PIOL patients,with high levels of IL-6 and IL-10 indicating a poor prognosis.

The nursing experience was summarised over a patient who developed an impending myasthenic crisis following immune checkpoint inhibitors(ICIs)therapy after the surgery for stage-Ⅳ liver cancer.Key nursing points included:close monitoring for early signs of impending myasthenic crisis;set up a multi-disciplinary team to improve respiratory,oropharyngeal and ocular function,control respiratory infection,provide psychological support in order to prevent the patient from developing a manifest myasthenia-gravis crisis(MC);combine with medications to relieve myasthenic symptoms and prevent adverse drug reactions;individualised rehabilitation training to promote recovery of muscular strength.Eventually,the patient did not develop into a MC during hospitalisation(20d)and was well at 3-month after discharge.

Keratinized mucosa width (KMW) is one of the main components of peri-implant phenotype. The impact of KMW adequacy on peri-implant soft and hard tissues health has been a focus question among periodontology and implantology in recent years. The present article reviewed the research progress on the clinical significance of peri-implant KMW. Recent evidence has indicated that a narrow band of peri-implant KMW was associated with more significant plaque accumulation, peri-implant soft and hard tissues inflammations and patient discomfort. Clinicians should enhance their understanding on the relationship between peri-implant KMW and peri-implant health. Soft tissue considerations should be integrated in implant treatment designing to develop a more comprehensive, biologically oriented treatment plan, and timely interventions for sites with insufficient KMW is essential to maintain the long-term health and stability of peri-implant tissues.

Objective:To compare the clinical effects of using xenogenic bone graft materials with or without collagen components for tooth micro crestal flap-alveolar ridge preservation (MCF-ARP) at molars with severe periodontitis.Methods:This study included patients who visited Department of Periodontology, Peking University School and Hospital of Stomatology from May to November 2023 due to severe periodontitis, requiring tooth extraction and planning for implant-retained prostheses. A total of 24 molars from 24 patients with severe periodontitis were assigned into two groups: the deproteinized bovine bone mineral (DBBM) group and the DBBM with collagen (DBBM-C) group. Twelve affected teeth from 12 patients were included in each group. Both groups underwent minimally invasive tooth extraction and MCF-ARP, with DBBM and DBBM-C implanted in the extraction socket, respectively. Cone beam CT (CBCT) was performed before and 6 months after the surgery for assessing changes of hard tissue. Intraoral scanning was performed before and at 2 weeks, 1 month, 3 months, and 6 months after the surgery for assessing soft tissue contour changes and patterns in both groups.Results:After 6 months of healing, the central bone height increased by (8.35±2.25) mm in the DBBM group and (7.70±2.36) mm in the DBBM-C group. The ridge width at 1 mm apically from the higher bone crest increased by 6.43 (-0.76,7.96) mm in the DBBM group and 6.01 (5.41,7.90) mm in the DBBM-C group. There was no statistically significant difference in the changes of bone height and width between the two groups (all P>0.05). In terms of soft tissue contour changes, although the buccal contour collapses were less in the DBBM-C group, the two groups showed no statistically significant difference (all P>0.05). Conclusions:Within the limitations of this study, it was demonstrated that the clinical effects of MCF-ARP using xenogenic bone graft materials with or without collagen components in molars with severe periodontitis were comparable.

Objective To understand the molecular epidemiological characteristics and hypervirulence evolution trend of ST11 carbapenem-resistant Klebsiella pneumoniae(CRKP)isolated from medical institutions in Shanghai,and provide scientific basis for formulating the prevention and control measures of drug-resistant organisms.Methods A total of 201 strains of CRKP isolated from 12 medical institutions in Shanghai from 2021 to 2022 were collected.Antimicrobial susceptibility testing and whole genome sequencing were performed.The concatenated data was used for multilocus sequencing typing(MLST),serum typing(wzi typing),as well as analysis of resistance and viru-lence genes.Results All 201 CRKP strains were multidrug-resistant organisms(MDROs).These strains were al-most completely resistant to carbapenems,cephalosporins,and quinolones.Drug resistance gene analysis showed that 93.03％of CRKP strains carried KPC gene.201 CRKP strains were divided into 6 ST types and 10 capsule wzi types,with ST11-KL64(n=104)being the dominant type,followed by ST15-KL19(n=54).52.24％(n=105)of CRKP carried rpmA/rpmA2+iucA+iutA+iroN genes.Conclusion CRKP isolated from medical institutions in Shanghai is mainly ST11-KL64 type with severe multidrug resistance,and more than half of the strains are hyper-virulent carbapenem-resistant Klebsiella pneumoniae(hv-CRKP).It is necessary to continuously strengthen the monitoring of the molecular characteristics of CRKP,so as to prevent outbreaks of healthcare-associated infection.