Objective: To understand the health status of primary school freshmen in Guiyang and the health management service needs of parents after examination, so as to provide a reference for establishment of a collaborative health management framework involving schools, families, and healthcare providers. Methods: From September to October 2024, a stratified random cluster sampling method was used in Guiyang City to select 3 210 students and 3 133 parents who participated in the physical examination for primary school freshmen. Demographic indicators, physical examination indicators and laboratory examination indicators of students were collected, and parents needs for post examination health management service were investigated by self designed questionnaire. Multiple linear regression analysis was adopted to investigate the related factors of parents health management service needs after the examination. Results: The detection rates of common illness among primary school freshmen were 60.22% for dental caries, 17.23 % for screening myopia, 6.11% for obesity, 3.86% for iron deficiency anemia, and 1.15% for scoliosis. The co-occurrence rate of common illness among freshmen during the physical examination was 23.89% ( n =767), among which the comorbidity rate of screening myopia and dental caries (8.22%) and obesity and dental caries (4.27%) were higher. About 63.80% parents indicated that the physical examination items were simple, and 2 366 parents (75.52%) indicated a demand for post examination management services; the average score of parents demands for post examination services was (3.12±0.70). In terms of the scores of each dimension, the mean score of nutrition and health (3.58±0.74) was the highest, while the lowest mean score was for traditional Chinese medicine health care (2.77±0.67). The mean scores for the other dimensions were as follows:exercise intervention (3.29± 0.79 ), psychological monitoring (3.17±0.58), and health education and signing (2.81±0.73). The results of multiple linear regression analysis showed that parents educational level (junior high school, high school/vocational school, college/undergraduate and above), living conditions (floating), and children s illness status (1, 2, >3 types) were the related factors of parents health management service needs after the entrance examination for new students ( B =2.16, 3.07, 3.68; -2.19; 3.14, 3.34, 3.11, P <0.05). Conclusions The prevalence of common illness in primary schools in Guiyang is characterized by a heavy burden from single diseases, with a notable occurrence of multiple comorbidities. After the physical examination, parents have obvious demand for follow up health management services. These health management services should integrate the concept of multi disease prevention according to the needs of parents.

OBJECTIVE: To investigate the clinical characteristics and prognostic of venetoclax (VEN) combined targeted therapy in acute leukemia (AL) patients with PICALM∷MLLT10 fusion gene positivity. METHODS: A retrospective analysis was conducted on 16 PICALM∷MLLT10-positive AL patients treated at the First Affiliated Hospital of Soochow University from January 2021 to August 2024. These patients were diagnosed by targeted RNA sequencing (RNA-seq) or reverse transcription multiplex PCR, including newly diagnosed and relapsed/refractory (R/R) cases. The immunophenotypes, genetic features, gene mutations, and the efficacy of VEN combination targeted therapy of patients were evaluated. RESULTS: Among the 16 cases, 3 were confirmed by reverse transcription multiplex PCR, and 13 were detected through targeted RNA-seq among 528 AL patients, with a detection rate of 2.46%. The averge age of patients was (28.0±8.58) years. Patients exhibited diverse immunophenotypes, including 7 cases of acute myeloid leukemia, 5 of acute T-lymphoblastic leukemia, 1 of acute B-lymphoblastic leukemia, 1 of acute undifferentiated leukemia, and 2 of mixed-phenotype acute leukemia. Among them, 11 had extramedullary disease (EMD), 14 expressed CD7, and 12 expressed CD33. Major co-occurring mutations included PHF6 (6 cases), NOTCH1 (5 cases), and 7 cases with complex karyotypes. Of the 12 patients who received standard induction therapy, 7 did not achieve remission (PR+NR). All 4 patients treated with VEN combination therapy achieved complete remission (CR). Among the 7 induction failure cases, 4 achieved CR upon re-induction with VEN, while the remaining 3 re-induced with standard therapy, did not achieve CR. Thirteen patients received allogeneic hematopoietic stem cell transplantation, including 6 who received maintenance therapy with hypomethylating agents (HMA) alone or in combination with VEN, and seven were followed up. Survival analysis showed that the overall survival was better in the maintenance therapy group (P =0.044). CONCLUSION PICALM∷MLLT10-positive AL involves multiple lineages and demonstrates poor response to conventional chemotherapy. VEN combination therapy shows promising efficacy in both newly diagnosed and R/R patients. Post-transplant maintenance therapy with HMA alone or combined with VEN may extend survival; however, further clinical validation is required.
Humans ; Sulfonamides/therapeutic use* ; Retrospective Studies ; Prognosis ; Bridged Bicyclo Compounds, Heterocyclic/therapeutic use* ; Adult ; Male ; Female ; Leukemia, Myeloid, Acute/genetics* ; Mutation ; Oncogene Proteins, Fusion/genetics* ; Precursor Cell Lymphoblastic Leukemia-Lymphoma/drug therapy*

BACKGROUND: Both medication and non-medication therapies are effective approaches to control blood pressure (BP) in hypertension patients. However, the association of joint changes in antihypertensive medication use and healthy lifestyle index (HLI) with BP control among hypertension patients is seldom reported, which needs to provide more evidence by prospective intervention studies. We examined the association of antihypertensive medication use and HLI with BP control among employees with hypertension in China based on a workplace-based multicomponent intervention program. METHODS: Between January 2013 and December 2014, a cluster randomized clinical trial of a workplace-based multicomponent intervention program was conducted in 60 workplaces across 20 urban areas in China. Workplaces were randomly divided into intervention (n = 40) and control (n = 20) groups. Basic information on employees at each workplace was collected by trained professionals, including sociodemographic characteristics, medical history, family history, lifestyle behaviors, medication status and physical measurements. After baseline, the intervention group received a 2-year intervention to achieve BP control, which included: (1) a workplace wellness program for all employees; (2) a guidelines-oriented hypertension management protocol. HLI including nonsmoking, nondrinking, adequate physical activity, weight within reference range and balanced diet, were coded on a 5-point scale (range: 0-5, with higher score indicating a healthier lifestyle). Antihypertensive medication use was defined as taking drug within the last 2 weeks. Changes in HLI, antihypertensive medication use and BP control from baseline to 24 months were measured after the intervention. RESULTS: Overall, 4655 employees were included (age: 46.3 ± 7.6 years, men: 3547 (82.3%)). After 24 months of the intervention, there was a significant improvement in lifestyle [smoking (OR = 0.65, 95% CI: 0.43-0.99; P = 0.045), drinking (OR = 0.52, 95% CI: 0.40-0.68; P < 0.001), regular exercise (OR = 3.10, 95% CI: 2.53-3.78; P < 0.001), excessive intake of fatty food (OR = 0.17, 95% CI: 0.06-0.52; P = 0.002), restrictive use of salt (OR = 0.26, 95% CI: 0.12-0.56; P = 0.001)]. Compare to employees with a deteriorating lifestyle after the intervention, those with an improved lifestyle had a higher BP control. In the intervention group, compared with employees not using antihypertensive medication, those who consistent used (OR = 2.34; 95% CI: 1.16-4.72; P = 0.017) or changed from not using to using antihypertensive medication (OR = 2.24; 95% CI: 1.08-4.62; P = 0.030) had higher BP control. Compared with those having lower HLI, participants with a same (OR = 1.38; 95% CI: 0.99-1.93; P = 0.056) or high (OR = 1.79; 95% CI: 1.27~2.53; P < 0.001) HLI had higher BP control. Those who used antihypertensive medication and had a high HLI had the highest BP control (OR = 1.88; 95% CI: 1.32-2.67, P < 0.001). Subgroup analysis also showed the consistent effect as the above. CONCLUSION These findings suggest that adherence to antihypertensive medication treatment and healthy lifestyle were associated with a significant improvement in BP control among employees with hypertension.

Objective:To investigate the clinical characteristics, treatment approaches and prognosis of primary hepatic angiosarcoma (PHA).Methods:Clinical data of 15 PHA patients treated at the Department of Hepatobiliary Surgery, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College between January 2005 and April 2024 were retrospectively analyzed, including three females and 12 males, aged (59.4±11.9) years. Clinical manifestations, tumor characteristics, and survival outcomes were summarized. Kaplan Meier method was used to plot survival curves.Results:The clinical manifestations and tumor markers of the patients were non-specific, and the lesion sizes varied. The diagnosis was confirmed by pathology, and immunohistochemical staining showed positive expression of vimentin, endothelial cell markers CD31, and CD34 in most of the tested patients (seen on 9/11, 8/11, and 7/11, respectively). Patients were followed up for 2-234 months. Eight patients died at the last follow-up. The median overall survival of the patients was 42.37 months, and the cumulative survival rates at 1, 3, and 5 years were 66.7%, 59.3%, and 44.4%, respectively.Conclusion:The clinical features of PHA lack specificity, and diagnosis relies on pathology and immunohistochemistry. Surgical resection remains the treatment of choice. For advanced-staged patients, actively exploring effective comprehensive therapeutic strategies holds promise for extending overall survival.

Objective:To evaluate the clinical efficacy of inferior gluteus maximus muscle-pedicled myocutaneous flap for reconstruction of stage Ⅳ ischial pressure sores.Methods:Clinical data of patients with stage Ⅳ ischial pressure sores treated between April 2020 and September 2023 at the First People’s Hospital of Yulin were retrospectively analyzed. Underlying comorbidities were treated preoperatively to assure surgical safety. Stage Ⅰ management involved radical debridement of infected tissue followed by vacuum sealing drainage (VSD). Stage Ⅱ reconstruction was performed after inflammation control. An inferior gluteus maximus-pedicled myocutaneous flap was designed laterally to the defect. The muscle component width exceeded the skin paddle width, with the distal muscle extending about 3 cm beyond the skin island. The flap was advanced medially in a V-Y fashion to cover the defect. The donor site was sutured in layers. Postoperative flap viability, wound healing, aesthetic outcomes, and pressure sores recurrence were assessed.Results:A total of 20 patients were included in this study. Among them, 14 were males and 6 were females. The age ranged from 27 to 72 years, with a mean age of 52.3 years. The body mass index (BMI) ranged from 17.8 to 31.3 kg/m 2, with a mean BMI of 21.0 kg/m 2. All had paraplegia secondary to spinal cord injury. Comorbidities included type 2 diabetes and (or) hypertension (10 cases) and ischial osteomyelitis (3 cases). Pressure sores duration ranged from 1 month to 3 years. Defect sizes were 3 cm×4 cm to 5 cm×10 cm (depth: 3-6 cm). Flap sizes matched defects (3 cm×4 cm to 5 cm×10 cm), with muscle dimensions of 2 cm×5 cm×9 cm to 3 cm×8 cm×15 cm. Postoperatively, all 20 flaps showed good blood supply without flap necrosis. The wound healing time ranged from 12 to 22 days (mean: 15 days). Seventeen cases achieved primary wound healing. The remaining three cases developed fat liquefaction at the donor sites, but their wounds eventually healed after dressing changes on postoperative days 18, 20, and 22, respectively. During follow-up (mean: 13 months, range: 6-34 months), the flaps maintained good texture with no recurrence. Conclusion:The inferior gluteus maximus muscle-pedicled myocutaneous flap provides sufficient bulk, simple design, and reliable transposition for dead-space obliteration and surface coverage in stage Ⅳ ischial pressure sores. This technique yields favorable aesthetics and low recurrence rates.

Objective To explore the mechanism of Scutellaria baicalensis(Huangqin)in ameliorating postoperative cognitive dysfunction in surgical patients through network pharmacology approaches combined with experimental validation.Methods Network pharmacology was used to screen the relevant targets and pathways of Huangqin in relation to postoperative cognitive dysfunction,followed by molecular docking to verify the affinity of core components with key targets.HT22 cell line of mouse hippocampal neurons was cultured,and an inflammation injury model was induced by LPS stimulation.Huangqin was selected for intervention treatment,divided into five groups:control group,model group,low-dose Huangqin group(10 μmol/L),medium-dose Huangqin group(50 μmol/L),and high-dose Huangqin group(100 μmol/L).After co-culturing for 24 h,the expression of key target proteins HIF1A,MAPK1(ERK2/p-ERK2),and SIRT1 were detected by Western blotting,and the mRNA expression of these proteins was measured by qRT-PCR.Results A total of 27 active components of Huangqin were screened by network pharmacology,corresponding to 379 targets,with 220 disease targets related to POCD,resulting in 35 intersecting genes.Molecular docking results showed that components like baicalein and oroxylin A had strong affinity with targets such as HIF1A,MAPK1,and SIRT1.In vitro experimental results indicated that baicalein significantly downregulated the expression and transcription levels of HIF1A and MAPK1(ERK2/p-ERK2),while upregulating the expression and transcription levels of SIRT1,effectively improved the inflammatory response in HT22 cells and reduced neuronal damage.Conclusion The traditional Chinese medicine Huangqin can reduce the occurrence and development of postoperative cognitive dysfunction by improving the expression of key proteins,controlling inflammatory responses,and protecting neuronal function.

Objective To study the expression characteristics of osteoprotegerin(OPG)/receptor activator of nuclear factor-κB ligand(RANKL)/receptor activator of nuclear factor-κB(RANK)system and the relationship with fibrosis in myocardial tissues of rats with chronic heart failure.Methods SD rats were randomly divided into sham-operation group(12 rats)and model group.In sham-operation group,surgical thread was passed through the abdominal aorta without constricting it after laparotomy;in model group,establish the heart failure model by abdominal aorta coarctation.The successful model rats were randomly divided into model 1 week(12 rats),model 2 weeks(11 rats),model 4 weeks(11 rats),model 8 weeks(11 rats)and model 12 weeks groups(11 rats).The end point of the study is at week 12.The contents of hydroxyproline(HYP),total myocardial collagen and collagen volume fraction(CVF)were compaired in all proups.The expression levels of OPG,RANKL and RANK proteins in cardiomyocytes were determined by Western blot.Results The contents of HYP in sham-operation,model 1 week,model 2 weeks,model 4 weeks,model 8 weeks and model 12 weeks group were(0.25±0.04),(0.37±0.05),(0.45±0.04),(0.60±0.05),(0.82±0.10)and(1.03±0.07)μg·mg-1;the total myocardial collagen contents were(1.87±0.31),(2.73±0.38),(3.36±0.31),(4.47±0.37),(6.08±0.74)and(7.67±0.49)μg·mg-1;the CVF were(1.95±0.23)％,(2.40±0.25)％,(3.65±0.25)％,(5.43±0.29)％,(6.97±0.36)％and(9.38±0.49)％;the relative expression levels of OPG protein were 0.64±0.07,0.80±0.07,1.02±0.07,1.32±0.11,2.13±0.12 and 2.84±0.16;the relative expression levels of RANKL protein were 0.71±0.08,1.06±0.07,1.53±0.07,2.62±0.12,4.46±0.14 and 6.11±0.16;the relative expression levels of RANK protein were 0.30±0.05,0.45±0.05,0.63±0.06,0.98±0.07,1.43±0.10 and 1.63±0.10.With the extention of time,the above indexs of all model groups were significantly higher than those in the sham-operation group(all P＜0.05).There were positive linear correlation between the relative expression levels of OPG,RANKL,RANK protein and the levels of CVF and total contents in cardiomyocytes of rats with chronic heart failure(allP＜0.01).Conclusions In the process of chronic heart failure,the expression of OPG/RANKL/RANK axis is obviously enhanced,in which the up-regulation of RANKL level is most obvious.The expression level of OPG/RANKL/RANK is positively correlated with CVF and total myocardial collagen content.

Purpose The results of EBER in situ hybridization on the external quality assessment(EQA)organ-ized by the pathology Equipment Branch of the China Association of Medical Equipment were analyzed,for providing technical support for the standardization and normalization of the technology.Methods Paraffin-embedded sections of confirmed EBV-positive diffuse large B-cell lymphoma were selected as the evaluation specimens.Additionally,EBER in situ hybridization liquid cell controls were applied to the slides as evaluation references.A questionnaire was distrib-uted to collect staining information and methodologies from participating laboratories.Finally,the stained slides were collected and independently evaluated by pathology experts from the association according to predefined scoring criteria.Results A total of 38 pathology laboratories from 7 provinces and municipalities directly under the central government participated in the EQA,including 32 hospital pathology departments and 6 independent clinical laboratories.21 par-ticipants used manual staining,and others(17)used automated staining method by immunohistochemistry(IHC)stainers.The overall qualification rate of EBER in situ hybridization staining was 94.74％(36/38),and the excellent& good rate was 26.32％(10/38).The excellent & good rate of automated staining(41.12％,7/17)was significant-ly higher than that of manual staining(14.29％,3/21)(x2=4.852,P=0.028).The positive cell line control showed good consistency with the tissue control(Kappa=0.909,r=0.944).Conclusion The EBER in situ hybrid-ization technique in most of the pathology laboratories in the external quality assessment is qualified.There is a statisti-cally significant difference in the excellent & good rate between different staining methods.EBER in situ hybridization using automated IHC stainers is recommended as the preferred method.There is no difference in the performance of positive cell line control and tissue control.Some laboratories' staining techniques need to be improved.

The cribriform fascia is formed by the fusion of deep and superficial fascias in the axilla,and it forms the base of the axilla together with the subcutaneous tissue and skin,which is a key part of the system of the membranous anatomy of breast surgery.The loose anatomical structure of the cribriform fascia makes it an important anatomical landmark in the axillary region,which plays an important role in accurate localization of lymph nodes.The sentinel lymph node biopsy through cribriform fascia has less intraoperative blood loss and shorter catheterization time compared with the traditional axillary fold approach.However,the anatomical structure of the cribriform fascia and its significance in the membranous anatomy of breast surgery have not been fully elucidated.This article analyzes the anatomical structure of the cribriform fascia and its adjacent tissues,and emphasizes the anatomical structure that needs to be paid attention to in sentinel lymph node biopsy through the axillary cribriform fascia,so as to provide a reference for clinicians to fully understand the cribriform fascia structure.