Objective To investigate the relationship between primary pulmonary mucinous adenocarcinoma (PPMA) mass type and pneumonia type and their difference in malignant degree, and to analyze the role of clinical manifestations and CT features in the diagnosis of this disease. Methods The clinical data of PPMA patients admitted in the First Affiliated Hospital of Xiamen University from May 2011 to March 2022 were retrospectively analyzed. According to CT features, they were divided into a mass type group and a pneumonia type group. The clinical manifestations, CT features and the degree of malignancy between the two groups were analyzed and compared. Results A total of 57 PPMA patients were enrolled. There were 17 males and 40 females, with an average age of (53.82±10.65) years, and 28 (49%) patients had reversed hato-like sign. There were 42 patients in the mass type group and 15 patients in the pneumonia type group. PPMA often occurs in both lower lungs, with clinical manifestations mainly of coughing and expectorating white mucoid sputum. There were statistical differences between the two groups in the maximum diameter of tumor (P<0.001), boundary condition (P<0.001) and pleural indentation sign (P=0.019). There was no statistical difference between the two groups in Ki-67 index (P>0.05). Conclusion There is no statistical difference in the degree of malignancy between the two types of PPMA. Considering their clinical manifestations and differences in imaging features, it is supported that the pneumonia type is just a progression of the mass type. CT can present various manifestations, among which the reversed hato-like sign is expected to become an important imaging feature. Combined with a high proportion of solid components, pleural indentation sign, and vacuole sign, reversed hato-like sign can play a significant role in the diagnosis of PPMA.

Objective:To investigate the drug resistance of newly diagnosed HIV-1 infected patients in Shanghai and to provide reference value for clinical antiretroviral therapy (ART).Methods:The peripheral venous blood plasma of 196 newly diagnosed HIV-1 infected patients screened according to the inclusion and exclusion criteria at the Shanghai Public Health Clinical Center from April to June 2023 was collected, HIV-1 RNA was extracted, the pol region was amplified by reverse transcription-polymerase chain reaction (RT-PCR) for sequencing, the mutation sites and ART drug resistance were analyzed.Results:The plasma of 196 newly diagnosed HIV-1 infected patients was amplified successfully in 162 cases (amplification success rate was 82.65%). The subtypes consisted of CRF07_BC(51.23%), CRF01_AE (27.78%), and others (6.79%), CRF55_01B (5.56%), B (3.70%), CRF01_AE/B (3.70%) and CRF08_BC (1.23%). The overall transmitted drug resistance rate was 7.41%, the protease inhibitors (PIs), non-nucleoside/nucleotide reverse transcriptase inhibitors (NNRTIs), nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs), integrase inhibitors (INSTIs) resistance rates were 3.09%, 3.70%, 0.00% and 0.62%, respectively. The proportion of NNRTIs-related mutation sites in B (66.67%) and CRF55_01B (88.89%) was higher than that in CRF07_BC (13.25%); the proportion of NNRTIs-related mutation sites in CRF55_01B (88.89%) was higher than that in CRF01_AE (22.22%) and other subtypes (18.18%), the difference was statistically significant (all P<0.05). Multivariate logistic regression analysis showed that the probability of PIs-related mutation sites in CRF01_AE/B was 21.71 times that of CRF07_BC[odds ratio ( OR)=21.71, 95% confidence interval ( CI): 3.36-140.27, P=0.001]. Conclusions:The transmitted drug resistance among newly diagnosed HIV-1 infected patients in Shanghai is at the moderate epidemic level, mainly NNRTIs and PIs-related drug resistance, and the INSTIs resistance rate is low, the use of INSTIs in ART regimens should be considered.

Purpose To investigate the clinicopathological features and prognostic factors of follicular dendritic cell carcinoma(FDCS).Methods Hospital records of 23 patients diagnosed with FDCS were retrospectively re-viewed.The morphological,immunohistochemical features,including the detection of CD21,CD23,and CD35 using the EnVision method,and in-situ hybridization for Epstein-Barr virus encoded nuclear RNA(EBER)were evaluated.Clinicopathological characteristics were analyzed for the evaluation of prognosis.Results The median age of all 23 pa-tients was 50 years(range:27 to 72)and the female to male ratio was 1.3.The median maximum diameter of tumor was 7.0 cm(range:0.5 to 20.0 cm).One case was located in cervical lymph node,while another 22 were discovered in extranodal sites.20 cases were single organ and 3 cases were multiple organs involvement.Microscopically,tumor cells exhibited spindle,oval,or markedly pleomorphic morphology,accompanied by variable lymphoplasmacytic infil-tration in the stroma.CD21,CD35 and CD23 were positive in 22 of 23(95.6％),23 of 23(100.0％)and 4 of 15(26.7％)patients,respectively.EBER in-situ hybridization was positive in 9 of 23 patients(39.1％).The median follow-up time was 84.0(95％CI:50.7-117.3)months,and the 5-year survival rate was 80.2％(95％CI:62.8-97.6).Twelve(52.2％)patients were alive,5(21.7％)were dead,and 6(26.1％)were lost of follow-up.We es-tablished a pathological scoring system containing 5 indexes,i.e.,tumor maximum diameter,mitotic figures,tumor necrosis,cellular pleomorphism and histologic types.Patients with greater than 4 points had a significant poor progno-sis.Conclusion FDCS features a broad spectrum of histologic appearances and behavior.Combined morphological observations(HE staining),applications of a panel of follicular dendritic cell markers and EBER in-situ hybridization are helpful for accurate diagnosis.FDCS poses risks for recurrence,metastasis and death,and those with greater than 4 points in the scoring system have a significant poor prognosis.Long-term follow up is needed.

SPF chickens were immunized with HN-mRNA vaccine by intramuscular injection.He-magglutination inhibition(HI)test,lymphocyte proliferation test,RT-qPCR and pathological sec-tions were used to evaluate the humoral and cellular immunity and protection against challenge in-duced by the candidate HN-mRNA vaccine.The results showed that 2.5,5.0,and 7.5 μg HN-mR-NA induced HI antibody antibodies in a dose-dependent manner.Among them,the Hi antibody in-duced by 7.5 μg HN-mRNA was slightly higher than that of the weak toxic vaccine(La Sota strain).In addition,in response to the stimulation of inactivated NDV virus,the proliferation and activation of lymphocytes in 2.5,5.0 and 7.5 μg HN-mRNA immunization groups and commercial vaccine group were observed.To further evaluate the antiviral protection provided by HN mRNA immunization,the 105 ELD50 NDV strong strain NA-1 was used to attack the 7.5 μg HN-mRNA immunised group and the commercial weakened vaccine(La Sota strain)and PBS groups using na-sal and ocular drops.The results showed that the survival rate of 7.5 μg HN-mRNA immunization group and commercial vaccine group was 100％,and these vaccines could protect tissues and or-gans from the damage caused by virus infection.At the same time,7.5 μg HN-mRNA and commer-cial vaccine could shorten the time of virus shedding in vitro and the viral load in vivo.This study provides a foundational framework for the clinical application of NDV HN mRNA candidate vac-cines and offers insights for the development of novel mRNA vaccines for poultry.

Objective:To determine the weight coefficient of home care service quality indicators for the disabled elderly in Beijing.Methods:In the early stage, our research group has preliminarily constructed quality indicators of home care service for the disabled elderly in Beijing. The importance scores of all indicators were obtained through expert consultation from September to October 2021. Based on the game theory, the subjective and objective weighting methods were integrated to quantify the combinatorial optimization weight assignment of those indicators, in which the subjective weighting was calculated by proportional distribution method, and the objective weighting was obtained by entropy weight method.Results:The subjective weight assignments of the first-level indicators “service conditions”“service process” and “service outcome”were 0.332 2, 0.338 9, and 0.328 9, respectively; the objective weight assignments of the above indicators were 0.332 2, 0.338 9 and 0.328 9, respectively; the combinatorial optimization weight assignment of those indicators were 0.332 2, 0.338 9, and 0.328 9, respectively. Among the second-level indicators, the combination optimization weight coefficients of the top 3 important indicators “patient family evaluation”(1.3),“emergency configuration”(1.4), and“operation process”(2.2) were 0.198 4, 0.198 4 and 0.170 8, respectively. And among the third-level indicators, the combination optimization weight coefficients of the top 5 important indicators“emergency plan”(1.4.1), “humanistic care”(2.2.6), “first aid supplies”(1.4.2), “evaluation of potential resources”(1.3.4), and “means of home visit transportation”(1.2.1) were 0.124 7, 0.075 0, 0.073 8, 0.066 5 and 0.052 7, respectively.Conclusion:The study has successfully conducted the optimization weight assignment of home care service quality indicators for the disabled elderly in Beijing, which indicates that the service conditions and service process are crucial to the quality of service.

In recent years, the incidence of liver metastasis from colorectal cancer has continued to rise, posing a significant threat to human health and life.Although traditional treat-ments such as surgery and chemotherapy have shown some efficacy in certain patients, options remain limited for those who are not surgical candidates or are resistant to chemotherapy.Yttrium-90 microsphere selective internal radiation therapy, as an innovative local treatment, has fully demons-trated its effectiveness and safety in treating colorectal cancer liver metastasis patients. The authors review the research background, mechanisms, and principles of yttrium-90 microsphere selective internal radiation therapy in the field of colorectal cancer liver metastasis, and to explore its applica-tion progress in clinical practice, aiming to provide clinical doctors with more comprehensive and detailed reference information, with the goal of improving treatment outcomes and quality of life for colorectal cancer liver metastasis patients.

Objective To investigate the clinical efficacy of Jiawei Tai Yuan Yin combined with allylestradiol tablets for the treatment of early threatened abortion complicated by subchorionic hematoma(SCH).Methods A total of 120 patients with early threatened miscarriage combined with SCH were selected and divided into the observation group(Jiawei Tai Yuan Yin+allylestradiol tablets,60 cases)and the control group(allylestradiol tablets,60 cases)according to the treatment regimen.Seven days was one course of treatment,and both groups of patients were treated for two courses.Changes of traditional Chinese medicine(TCM)syndrome score before treatment and 14 days after treatment,clinical efficacy,SCH area,the ratio of SCH area to gestational sac area,vaginal bleeding(duration and volume),the miscarriage rate in the early stage of pregnancy,the ratio of auxiliary T cells to inhibitory T cells(Th/Ts)and the level of carbohydrate antigen 125(CA125)were observed.Results After 14 days of treatment,TCM syndrome scores,SCH area,the ratio of SCH area to gestational sac area,the Th/Ts ratio and the CA125 level were decreased in the two groups,and those of the observation group were lower than those of the control group(P＜0.05).After 14 days of treatment,the total effective rate was higher in the observation group than that of the control group(P＜0.05).During the treatment period,the duration of vaginal bleeding,the amount of vaginal bleeding and the miscarriage rate in the early stage of pregnancy were lower in the observation group than those in the control group(P＜0.05).Conclusion The combination of Jiawei Tai Yuan Yin and allylestradiol tablets can effectively treat early threatened miscarriage with SCH,thereby reducing the miscarriage rate in early pregnancy.

Objective To investigate the clinical efficacy of Jiawei Tai Yuan Yin combined with allylestradiol tablets for the treatment of early threatened abortion complicated by subchorionic hematoma(SCH).Methods A total of 120 patients with early threatened miscarriage combined with SCH were selected and divided into the observation group(Jiawei Tai Yuan Yin+allylestradiol tablets,60 cases)and the control group(allylestradiol tablets,60 cases)according to the treatment regimen.Seven days was one course of treatment,and both groups of patients were treated for two courses.Changes of traditional Chinese medicine(TCM)syndrome score before treatment and 14 days after treatment,clinical efficacy,SCH area,the ratio of SCH area to gestational sac area,vaginal bleeding(duration and volume),the miscarriage rate in the early stage of pregnancy,the ratio of auxiliary T cells to inhibitory T cells(Th/Ts)and the level of carbohydrate antigen 125(CA125)were observed.Results After 14 days of treatment,TCM syndrome scores,SCH area,the ratio of SCH area to gestational sac area,the Th/Ts ratio and the CA125 level were decreased in the two groups,and those of the observation group were lower than those of the control group(P＜0.05).After 14 days of treatment,the total effective rate was higher in the observation group than that of the control group(P＜0.05).During the treatment period,the duration of vaginal bleeding,the amount of vaginal bleeding and the miscarriage rate in the early stage of pregnancy were lower in the observation group than those in the control group(P＜0.05).Conclusion The combination of Jiawei Tai Yuan Yin and allylestradiol tablets can effectively treat early threatened miscarriage with SCH,thereby reducing the miscarriage rate in early pregnancy.

Objective:To investigate the risk factors for patients with hypertriglyceridemia-related acute pancreatitis (HTG-AP) developing into severe acute pancreatitis or experiencing organ failure.Methods:This retrospective cohort study collected clinical data from 2 429 patients diagnosed with acute pancreatitis from five hospitals in China between January 2019 and December 2023 using a pre-designed data collection form. The cohort included 1 516 males and 913 females,with an age of (50.2±16.5)years(range: 11 to 99 years). Among them,353 patients (16.1%) had HTG-AP,while 1 846 (83.9%) had non-HTG-AP. HTG-AP was defined as serum triglyceride levels>500 mg/dl with other etiologies excluded. Intergroup comparisons were performed using t-tests,Mann-Whitney U test or χ2 tests,respectively. Univariate and multivariate logistic regression analyses were conducted to assess risk factors for severe acute pancreatitis after adjusting for potential confounders,and a predictive model was developed and validated. Results:Compared with other etiologies,HTG-AP patients had a higher risk of progressing to SAP ( OR=1.415,95% CI: 0.866 to 2.312, P=0.017) and organ failure ( OR=1.256,95% CI: 1.015 to 1.554, P=0.036). Among HTG-AP patients,risk factors for SAP included body mass index ( OR=1.856,95% CI: 1.742 to 1.987, P=0.033),fasting blood glucose ( OR=1.128,95% CI: 1.036 to 1.229, P=0.006),white blood cell count( OR=1.162,95% CI: 1.055 to 1.281, P=0.002),and the presence of pleural effusion ( OR=13.151,95% CI: 4.330 to 19.946, P<0.01). A nomogram prediction model for SAP in HTG-AP was constructed based on these risk factors,demonstrating good discriminative ability with area under the curve values of 0.877 in the training set and 0.894 in the validation set,along with satisfactory calibration. Conclusions:HTG-AP patients are at higher risk of developing SAP and organ failure. The risk prediction model incorporating body mass index,fasting blood glucose,white blood cell count,and pleural effusion shows good predictive value for SAP.

Respiratory syncytial virus (RSV) is one of the most important pathogens causing respiratory infections in children, and a major cause of hospitalization and death.However, current therapeutic measures are based on supportive care and there is a lack of specific antiviral drugs, so prevention of RSV infection is extremely important.Active and passive immunization is the main way to prevent infection, but monoclonal antibodies are not widely applied in clinical practice because they are high-priced and some of them need multiple doses.Therefore, it is important to develop a usable RSV vaccine.Progress of vaccine research was slow previously due to the vaccine-enhanced disease caused by Formalin-inactivated vaccines and the difficult pre-preparation and poor stability of attenuated vaccines.With the gradual clarification of the structural characteristics of RSV fusion proteins, the maturation of biotechnology, and the emergence of component vaccines recently, vaccine research and development has made great progress, and the maternal vaccine Abrysvo has now been approved for the prevention of RSV infections in infants and young children.This review provides an overview of the biological structure of RSV and the current status of research on pediatric RSV vaccine.