Objective:This study aims to investigate the influence of microvessel density（MVD） and microlymphatic vessel density（MLVD） on the prognosis of patients with hypopharyngeal squamous cell carcinoma（HPSCC） and to develop a nomogram prediction model for prognosis based on pathological characteristics. Methods:A retrospective analysis was conducted on clinicopathological and follow-up data from HPSCC patients who underwent surgical treatment at our institution between June 2010 and June 2020. Immunohistochemical staining was performed on tumor tissues and adjacent normal margin tissues to evaluate MVD and MLVD. The associations among MVD, MLVD, and clinicopathological features were analyzed. Univariate and multivariate Cox regression analyses were conducted to identify independent risk factors affecting overall survival（OS）. Based on these findings, a nomogram model was constructed and its predictive accuracy was assessed using C-index, receiver operating characteristic（ROC） curve, and calibration curve. Results:Both MVD and MLVD were significantly higher in HPSCC tumor tissues compared to normal tissues. Patients in the high MVD and high MLVD groups exhibited significantly lower OS rates than those in the low MVD and low MLVD groups. Multivariate Cox regression analysis revealed that N stage, recurrence, nerve invasion, lymph node capsule invasion, MVD, and MLVD were independent prognostic factors of OS. Based on these factors, a nomogram prognosis model was successfully constructed. The nomograms demonstrated superior performance in terms of C-index, area under the ROC curve, and calibration, outperforming the AJCC TNM staging system. Conclusion:Elevated MVD and MLVD levels are associated with poorer prognosis in HPSCC patients. The nomogram model based on pathological features provides valuable insights for clinical assessment and decision-making.
Humans ; Hypopharyngeal Neoplasms/blood supply* ; Prognosis ; Retrospective Studies ; Microvascular Density ; Nomograms ; Lymphatic Vessels/pathology* ; Male ; Female ; Middle Aged ; Carcinoma, Squamous Cell/blood supply* ; Microvessels/pathology* ; Lymphatic Metastasis ; Survival Rate

OBJECTIVE To explore the effects of dihydroartemisinin(DHA)on the functions of cancer-associated fibroblasts(CAFs)in the tumor microenvironment in hypopharyngeal squamous cell carcinoma(HPSCC).METHODS The influence of conditioned media from CAFs and normal fibroblasts(NFs)on tube formation was assessed using a tube formation assay.Secreted protein levels of IL-6,VEGFA,and VEGFC were measured by immunofluorescence and ELISA.Western blotting was used to evaluate the expression of α-SMA,p-STAT3,STAT3,VEGF-A,and VEGF-C within the STAT3 signaling pathway.After treatment with DHA,the optimal concentration for DHA's effect was determined using CCK8 assays and morphological observations of cells.The impact of DHA on angiogenesis was analyzed through tube formation assays,changes in IL-6 expression were detected using ELISA and immunofluorescence,and alterations in α-SMA,p-STAT3,and STAT3 expression were examined by Western blot.RESULTS Both CAFs and NFs exhibited pro-angiogenic and pro-lymphangiogenic effects,with CAFs showing a more pronounced impact.Activated CAFs overexpressed and secreted high levels of IL-6,VEGF-A,and VEGF-C.The concentration of IL-6 in the conditioned medium supernatants of CAF1 and CAF2 was significantly higher than that of NF1 and NF2(P1<0.001,P2<0.05).Similarly,the concentration of VEGF-A was significantly increased(P1<0.05,P2<0.01),and the concentration of VEGF-C was also significantly increased(P1<0.05,P2<0.01).Treatment with DHA inhibited the activated state of CAFs,reducing the expression and secretion of IL-6 and p-STAT3,thereby suppressing tube formation.CONCLUSION Our findings indicate that CAFs promote angiogenesis and lymphangiogenesis in HPSCC via activation of the STAT3 pathway.DHA effectively inhibits this process,suggesting a potential new therapeutic strategy for the treatment of HPSCC.

OBJECTIVE To observe the current status and influencing factors for the water contamination of humid-ification tanks of ventilators of the patients undergoing invasive mechanical ventilation.METHODS Totally 139 hu-midified water samples were collected from the patients who received invasive mechanical ventilation in The First Medical Center of Chinese PLA General Hospital from Jul.2024 to Nov.2024.The humidified water samples were collected,cultured and identified on Day 1,3,5 and 7 after humidification tanks replacement.RESULTS Among the 139 samples,25 were tested positive for pathogens,with the positive test rate 17.99％;the positive test rate was highest(33.33％,8/24)in respiratory intensive care unit.The positive test rate was 12.90％on Day 1,18.42％on Day 3,15.00％on Day 5 and 26.67％on Day 7,showing an upward trend.The result of bacterial culture showed that the percentage of isolated Burkholderia cepacia was highest(36.00％).The result of analysis of the related factors for positive test of humidified water samples showed that the sample adding pattern was as-sociated with the isolation rate(P＜0.05).Only 1 case was diagnosed with ventilator-associated pneumonia(VAP)after the humidified water was detected with pathogens and varied in the pathogens.CONCLUSIONS There is an association between the status of water contamination of the ventilator humidification tanks and usage duration of humidification tank.It is necessary to attach great importance to the contamination of humidification tanks,carry out standard management,and implement the prevention and control measures in an all-round way.

Objective To understand the epidemiological characteristics and trends of postoperative pneumonia(POP)in tertiary general hospitals in Jiangsu Province,and provide theoretical basis for carrying out targeted pre-vention and control measures.Methods Surgery patients from 22 tertiary general hospitals in 12 cities in north,central,and south of Jiangsu Province from January 1,2022 to December 31,2023 were chosen as studied subjects,occurrence of POP was analyzed and compared.Results A total of 848 274 surgical procedures were performed in 22 hospitals,and 3 606 cases of POP occurred,with an incidence of 0.43％.The incidence in 2023 was 0.37％,which was lower than that in 2022(0.49％),with statistically significant difference(P＜0.001).The top three de-partments with high incidence of POP were neurosurgery(6.71％),cardiothoracic surgery(2.91％),and general surgery(0.77％).Among hospitals of different grades,the incidence of POP in tertiary first-class hospitals was 0.44％,which was higher than that in other tertiary hospitals(0.37％).There was no statistically significant difference in the incidence of POP between municipal and district/county hospitals(P＞0.05).The incidence of POP in hospitals with a bed:infection control full-time staff ratio＜200∶1 was lower than that in hospitals with the ratio ≥200∶1(0.39％vs 0.47％,P＜0.001),while the incidence of POP in hospitals with a proportion ≥30％of full-time staff being doctors was higher than that in hospitals with a proportion＜30％(0.45％vs 0.36％,P＜0.001).The incidence of POP in male patients was higher than that in female patients(0.62％vs 0.26％,P＜0.001).The incidence of POP in elderly patients aged≥65 was higher than that in patients aged＜65(0.73％vs 0.26％,P＜0.001).A total of 2 667 strains of infectious pathogens were detected,with the top three being Acine-tobacter baumannii,Klebsiella pneumoniae,and Pseudomonas aeruginosa,accounting for 28.95％,22.72％,and 15.45％,respectively.The detection rates of carbapenem-resistant Acinetobacter baumannii(CRAB),carba-penem-resistant Klebsiella pneumoniae(CRKP),and carbapenem-resistant Pseudomonas aeruginosa(CRPA)were 60.75％,21.45％,and 32.28％,respectively.The detection rate of CRKP decreased in 2023 compared with 2022,with statistically significant difference(P＜0.05).Conclusion The overall incidence of POP in tertiary general hos-pitals in Jiangsu Province is relatively low,but there are significant differences among different hospitals.There-fore,perioperative prevention and control measures should be carried out based on the epidemiological characteristics of patients.

OBJECTIVE To observe the current status and influencing factors for the water contamination of humid-ification tanks of ventilators of the patients undergoing invasive mechanical ventilation.METHODS Totally 139 hu-midified water samples were collected from the patients who received invasive mechanical ventilation in The First Medical Center of Chinese PLA General Hospital from Jul.2024 to Nov.2024.The humidified water samples were collected,cultured and identified on Day 1,3,5 and 7 after humidification tanks replacement.RESULTS Among the 139 samples,25 were tested positive for pathogens,with the positive test rate 17.99％;the positive test rate was highest(33.33％,8/24)in respiratory intensive care unit.The positive test rate was 12.90％on Day 1,18.42％on Day 3,15.00％on Day 5 and 26.67％on Day 7,showing an upward trend.The result of bacterial culture showed that the percentage of isolated Burkholderia cepacia was highest(36.00％).The result of analysis of the related factors for positive test of humidified water samples showed that the sample adding pattern was as-sociated with the isolation rate(P＜0.05).Only 1 case was diagnosed with ventilator-associated pneumonia(VAP)after the humidified water was detected with pathogens and varied in the pathogens.CONCLUSIONS There is an association between the status of water contamination of the ventilator humidification tanks and usage duration of humidification tank.It is necessary to attach great importance to the contamination of humidification tanks,carry out standard management,and implement the prevention and control measures in an all-round way.

Objective To understand the epidemiological characteristics and trends of postoperative pneumonia(POP)in tertiary general hospitals in Jiangsu Province,and provide theoretical basis for carrying out targeted pre-vention and control measures.Methods Surgery patients from 22 tertiary general hospitals in 12 cities in north,central,and south of Jiangsu Province from January 1,2022 to December 31,2023 were chosen as studied subjects,occurrence of POP was analyzed and compared.Results A total of 848 274 surgical procedures were performed in 22 hospitals,and 3 606 cases of POP occurred,with an incidence of 0.43％.The incidence in 2023 was 0.37％,which was lower than that in 2022(0.49％),with statistically significant difference(P＜0.001).The top three de-partments with high incidence of POP were neurosurgery(6.71％),cardiothoracic surgery(2.91％),and general surgery(0.77％).Among hospitals of different grades,the incidence of POP in tertiary first-class hospitals was 0.44％,which was higher than that in other tertiary hospitals(0.37％).There was no statistically significant difference in the incidence of POP between municipal and district/county hospitals(P＞0.05).The incidence of POP in hospitals with a bed:infection control full-time staff ratio＜200∶1 was lower than that in hospitals with the ratio ≥200∶1(0.39％vs 0.47％,P＜0.001),while the incidence of POP in hospitals with a proportion ≥30％of full-time staff being doctors was higher than that in hospitals with a proportion＜30％(0.45％vs 0.36％,P＜0.001).The incidence of POP in male patients was higher than that in female patients(0.62％vs 0.26％,P＜0.001).The incidence of POP in elderly patients aged≥65 was higher than that in patients aged＜65(0.73％vs 0.26％,P＜0.001).A total of 2 667 strains of infectious pathogens were detected,with the top three being Acine-tobacter baumannii,Klebsiella pneumoniae,and Pseudomonas aeruginosa,accounting for 28.95％,22.72％,and 15.45％,respectively.The detection rates of carbapenem-resistant Acinetobacter baumannii(CRAB),carba-penem-resistant Klebsiella pneumoniae(CRKP),and carbapenem-resistant Pseudomonas aeruginosa(CRPA)were 60.75％,21.45％,and 32.28％,respectively.The detection rate of CRKP decreased in 2023 compared with 2022,with statistically significant difference(P＜0.05).Conclusion The overall incidence of POP in tertiary general hos-pitals in Jiangsu Province is relatively low,but there are significant differences among different hospitals.There-fore,perioperative prevention and control measures should be carried out based on the epidemiological characteristics of patients.

Non-small cell lung cancer(NSCLC)is a highly lethal malignant tumor that poses a serious threat to human health.Traditional methods for tumor diagnosis and treatment have many limitations.However,circulating tumor DNA(ctDNA)detection,a kind of liquid biopsy technology,has gained widespread attention in the field of NSCLC personalized therapy and monitoring due to its non-invasive,convenient,and comprehensive sensitivity.This article will review the latest research progress of ctDNA detection in the clinical diagnosis and treatment of NSCLC in recent years,including its applications in early screening,disease diagnosis,tumor mutation monitoring,treatment efficacy evaluation,and prognosis assessment.

Objective To investigate the overweight and obesity of primary and middle school students in Sijing area of Shanghai from 2020 to 2022,so as to provide scientific basis for the intervention of childhood obesity.Methods In October 2020 and October 2022,all primary and middle school students in Sijing area underwent physical examination by cluster sampling method.A cross-sectional study was conducted to investigate the obesity and overweight in primary and middle school students of different ages and genders in Sijing area.Results In 2020 and 2022,7 766 and 10 594 students completed physical examination,respectively,and 4 626 of them underwent two consecutive physical examinations.The incidences of overweight and obesity were 15.14%and 21.89%in 2020,respectively.The incidences of overweight and obesity were 15.41%and 21.11%in 2022,respectively.There were no significant differences in the incidences of overweight or obesity between 2020 and 2022(P>0.05).In 2020,the incidences of overweight and obesity of male students were 14.91%and 24.70%;the incidences of overweight and obesity of female students were 15.40%and 18.80%,respectively.In 2022,the incidences of overweight and obesity of male students were 15.04%and 24.14%;the incidences of overweight and obesity of female students were 15.82%and 17.82%,respectively.There was no significant difference in the overweight rate between males and females(P>0.05).The incidence of obesity of male students was significantly higher than that of female students in both 2020 and 2022(P<0.05).In the students aged 12 years old,the incidence of obesity was 27.42%in 2022,which was significantly higher than that in 2020(P<0.05).There was no significant difference in the incidence of obesity between other age groups(P>0.05).Among the 4 626 children who participated in two consecutive physical examinations,the overweight/obesity rates were 14.46%/21.25%in 2020 and 16.04%/21.78%in 2022;there was significant difference in the overweight rates(P<0.05),while no significant difference was found in obesity rates(P>0.05).Among the 4 626 children,there were 2 402 boys and 2 224 girls.In 2020,the overweight/obesity rates were 13.70%/24.48%in these boys and 15.29%/17.76%in these girls.In 2022,the overweight/obesity rates were 16.07%/25.44%in these boys and 16.01%/17.72%in these girls.There was no significant difference in the incidence of overweight between these girls and boys in 2020 and 2022(P>0.05),but the obesity rate of boys was significantly higher than that of girls(P<0.05).Conclusion There are high incidences of overweight and obesity among primary and middle school students in Sijing area of Shanghai,and dietary and exercise guidances should be strengthened.Meanwhile,the incidences of overweight and obesity are higher among boys,and obesity prevention and control measures should be strengthened for boys.

Objective To compare the stability of different Kirschner wire configurations for treating SH-Ⅱ type epiphyseal injury and damage to the epiphyseal plate in children.Methods The CT scanning data of a healthy femur from an eight-year-old child were collected;the image data were imported into Mimics 21.0 to establish a rough femoral and epiphyseal model,which was then imported into Geomagic 2013 to construct a surface model.The surface model was assembled in SolidWorks 2018 with three configurations(dispersed,double-crossed,and single-crossed K-wires)and then imported into ANSYS Workbench 2019.Various motion modes in reality were simulated through different mechanical loadings on the assembly.The maximum displacement of the fracture fragment,von Mises stress distribution,and maximum stress on the K-wire,epiphyseal plate,and fracture fragment were analyzed.Results The maximum displacements of the dispersed,double-crossed,and single-crossed K-wire groups occurred during abduction(2.39 mm),adduction(2.12 mm),and abduction(2.21 mm),and the maximum stress on the epiphyseal plate occurred during abduction(1.22 MPa),anterior flexion(0.20 MPa),and posterior extension(0.29 MPa),respectively.Conclusions The stability of the double-crossed K-wire configuration is superior to that of the dispersed and single-crossed K-wire configurations,with minimal damage to the epiphysis.