Objective: To enhance the recognition of necrotizing sialometaplasia (NS) by elucidating its clinical, pathological characteristics and key diagnostic points, providing a basis for the diagnosis and treatment of the disease. Methods: This study has been reviewed and approved by the Medical Ethics Committee, and informed consent has been obtained from patients. Review the data of a patient with NS occurring at the junction of the right soft and hard palate, and comprehensively analyze its diagnostic process based on its clinical manifestations, imaging, and histopathological examination results. And review the relevant literature on the disease. Results: This study describes a 24-year-old male patient with a documented betel nut habit (2 pieces/day for >6 months), who presented with a bone-deep, irregular crateriform ulcer (3 mm × 6 mm × 5 mm) localized to the right hard-soft palate junction. Spiral CT showed a local soft tissue defect with no apparent underlying bone destruction. Histopathology demonstrated chronic inflammation of the mucosal and minor salivary gland tissues, with no evidence of malignancy. A final diagnosis of NS was established. The ulcer healed completely three weeks after initiation of local anti-inflammatory therapy. A literature review indicates that NS is a rare, benign salivary gland disorder, typically occurring at the hard-soft palate junction in middle-aged men (40-60 years). Its etiology remains unclear, but it is widely attributed to salivary lobe infarction following mechanical trauma-induced ischemia. Due to its clinical resemblance to malignancy, it is often misdiagnosed. Treatment entails local anti-inflammatory measures and meticulous wound care aimed at promoting mucosal healing. Conclusion NS is a self-limiting, benign condition that poses a significant diagnostic challenge due to its close clinical simulation of malignancy. Thus, accurate diagnosis requires a combined assessment of clinical presentation, radiological features, and pathological findings. Treatment is predicated based on a conservative strategy with an emphasis on symptomatic management.

Objective To propose a framework for risk assessment and stepwise management of pulmonary nodules based on existing guidelines and key studies, and to clarify the boundaries for triage, workup escalation, and referral in different detection scenarios. Methods A problem-oriented evidence synthesis approach was used, prioritizing Chinese expert consensus, Fleischner Society Guidelines, British Thoracic Society (BTS) Guidelines, and Lung-RADS. This was supplemented by studies on risk models, imaging measurements, liquid biopsy, tissue sampling, and surgical treatments. This paper is not presented as a formal consensus or a validated clinical pathway. Results A three-tiered framework consisting of basic non-invasive assessment, advanced assessment, and invasive diagnosis was established. It specified the applicable populations, boundaries for the use of risk models, imaging review, management of conflicting results, evaluation of histopathological consistency, and post-intervention follow-up. Liquid biopsy, genetic testing, and artificial intelligence were defined as investigational or adjunctive tools. Conclusion This framework can serve as a preliminary reference for multidisciplinary teams in developing local protocols. It cannot replace applicable guidelines, pathological diagnosis, shared decision-making with patients, or real-world validation.

Objective:To investigate the current situation and influencing factors of work ability in gynecological cancer patients, so as to provide a reference for occupational rehabilitation management of cancer patients.Methods:A total of 183 gynecological cancer patients who visited the gynecological oncology outpatient department of Women′s Hospital of Nanjing Medical University from November 2022 to March 2023 were selected by the convenience sampling. The General Information Questionnaire, Return-to-Work Self-efficacy Questionnaire, Social Support Rating Scale, the European Organization for Research and Treatment of Cancer Quality of Life Quesionnaire Core 30, Work Ability Index were selected for cross-sectional investigaton. The multiple linear regression analysis was used to explore the influencing factors of work ability in gynecological cancer patients.Results:A total of 189 questionnaires were sent out in this study, and 183 were effectively collected, with an effective recovery rate of 96.83% (183/189). The patients were (44.64 ± 7.06) years old. The scores of the patients were (27.77 ± 7.58) points on Work Ability Index, (4.72 ± 1.14) points on Return-to-Work Self-efficacy Questionnaire, (86.93 ± 23.44) points on Social Support Rating Scale, (79.46 ± 19.53) points on overall health status area and (41.23 ± 27.80) points on the field of fatigue symptoms area of the European Organization for Research and Treatment of Cancer Quality of Life Quesionnaire Core 30. Multiple linear regression analysis showed that fatigue, comorbidities, clinical stage of disease, primary treatment, per capita monthly income of families, return-to-work self efficacy and job nature were independent influencing factors of work ability in gynecological cancer patients ( t values were -10.47-2.86, all P<0.05), which explained 67.9% of the total variance. Conclusions:Clinical medical staff should pay attention to the influencing factors that affect work ability in gynecological cancer patients, in order to take targeted occupational rehabilitation measures to improve their work ability.

Objective To examine the effect and mechanism of Duhuo Jisheng Decoction on lumbar intervertebral disc degeneration.Methods In total,105 Sprague-Dawley(SD)rats were randomly assigned to seven groups:sham operation group,model group,Duhuo Jisheng Decoction 1,rapamycin group,rapamycin+Duhuo Jisheng Decoction group,MHY1485 group,and MHY1485+Duhuo Jisheng Decoction group.Except for the sham operation group,the other groups underwent annulus fibrosus puncture to establish a lumbar intervertebral disc degeneration(IDD)animal model.After successful model establishment,a six-week drug intervention was performed,followed by MRI evaluation of the degree of disc degeneration.Samples of the L5-6 intervertebral disc were collected for HE and Alcian blue-nuclear fast red staining,and the degeneration of the nucleus pulposus and changes in the extracellular matrix were observed using light microscopy.Simultaneously,the expression levels of the downstream proteins of the mTOR pathway,p70S6K and 4E-BP1,along with the autophagy-related genes Beclin-1 and LC3,were assessed at both the protein and mRNA levels.Autolysosomes in nucleus pulposus cells were visualized using transmission electron microscopy(TEM).Results ①MRI showed disc Pfirrmann grade I in the sham group,and disc Pfirrmann grade Ⅲ-Ⅳ in the remaining 6 groups in L5-6 segments.②The degree of lumbar disc degeneration with histomorphological observation:MHY1485 group>model group>MHY1485 group+Duhuo Jisheng Decoction group>rapamycin group>Duhuo Jisheng Decoction group>rapamycin+Duhuo Jisheng Decoction group>sham group.Allan-nuclear red staining extracellular matrix proteoglycan content:sham group>rapamycin+Duhuo Jisheng Decoction group>rapamycin group>MHY1485 group+Duhuo Jisheng Decoction group>model group>MHY1485 group.③Relative expression of p-mTOR,p70S6K and 4E-BP1 downstream of mTOR signaling pathway:MHY1485 group>MHY1485 group+Duhuo Jisheng Decoction group>model group>rapamycin group>Duhuo Jisheng Decoction group>rapamycin+Duhuo Jisheng Decoction group>sham group,each experimental group varied significantly from the model group(P<0.01).④Autophagy-related protein Beclin-1 and LC3 expression levels:rapamycin+Duhuo Jisheng Decoction group>Duhuo Jisheng Decoction group>rapamycin>MHY1485 group+Duhuo Jisheng Decoction group>model group>MHY1485>sham group,and the content of each group was significantly(P<0.01).⑤TEM observation of autophagy levels in the cells of each group showed the formation of autolysosomes in Duhuo Jisheng Decoction group,rapamycin group andrapamycin+Duhuo Jisheng Decoction group.Conclusion Duhuo Jisheng Decoction can slow down the degenerative process of lumbar intervertebral discs in rats,and its effect may be linked to the suppression of the mTOR signaling pathway and the promotion of autophagy in nucleus pulposus cells.

Objective:To explore how the teaching of ideological and political courses in colleges and universities can effectively guide online public opinion under the background of melted media,so as to cope with the challenges posed by diversified information transmission channels and complex and changeable online public opinion,thereby promoting the formation of correct values and ideological cognition among students.Methods:A total of 1 353 students who volunteered to participate in this survey in a university that offers courses related to online public opinion guidance were selected as the survey subjects.Multiple linear regression analysis was used to analyze how universities should teach students to deal with online hot topics through relevant ideological and political courses.Results:Results of multiple linear regression analysis indicated that the teaching of ideological and political courses in colleges and universities under the background of melted media significantly enhanced students'awareness of online public opinion,and the courses played a positive role in the guidance.The improvement of media literacy facilitated the formation of students'correct values and ideological cognition,effectively responding to the challenges of diversified information dissemination.Variables including the infringement of personal privacy by online public opinion,the enhancement of civic consciousness,the impact on learning,and the distortion of reality understanding all had an impact on students'perception of the teaching effect of ideological and political courses.Conclusions:The teaching of ideological and political courses in colleges and universities plays a significant role in guiding online public opinion under the background of melted media.By enhancing students'media literacy,discernment,and emotional management ability,it effectively promotes the formation of students'correct values and ideological ideological,and provides strong support for the healthy growth of students in the complex network environment.The important role of ideological and political teaching in cultivating students'comprehensive abilities and guiding them to correctly deal with online public opinion is emphasized.

Objective To assess the efficacy of endoscopic transethmoidal orbital wall decompression(ETMOWD)in conjunction with fat removal orbital decompression(FROD)on restrictive strabismus in patients with thyroid-associated ophthalmopathy(TAO).Methods A retrospective case series study was conducted involving patients diagnosed with TAO at our hospital from December 2021 to August 2024.Patients were divided into two groups:the orbital decompression group(OD group)and the non-orbital decompression group(NOD group),based on whether they underwent orbital decompression surgery.The study compared perioperative data,types of strabis-mus,degree of ocular motility limitation,extent of posterior migration of ocular muscles,and postoperative outcomes between the two groups.Additionally,the effects of ETMOWD combined with FROD on strabismus were evaluated by analyzing changes in relevant indices before and after surgery in the OD group.Results A total of 65 participants were included in the analysis,with 40 in the OD group group and 25 in the NOD group.There was no statistically significant difference in baseline characteristics between the two groups.Preoperative strabismus types,including horizontal and vertical strabismus,did not differ significantly between the OD and NOD groups(P>0.05).However,the mean preoperative restriction grade of eye movement was significantly higher in the OD group compared to the NOD group.Additionally,the number of surgeries,mean total operated muscles,and number of horizontal muscles were all significantly higher in the OD group than in the NOD group(all P<0.05),with a notably different effect on horizontal muscle migration between the two groups.The degree of restriction of eye movement and diplopia improved significantly in all patients,with cure rates of 70%in the OD group and 72%in the NOD group.Furthermore,the OD group underwent ETMOWD combined with FROD orbital decompression surgery,which resulted in a decrease in intraocular pressure(IOP)from(19.43±3.9)mmHg preoperatively to(15.05±2.2 mmHg postoperatively(P<0.001).Both horizontal and vertical strabismus increased after surgery.Conclusions Our results demonstrated that,compared with the NOD group,the OD group exhibited increased complexity in strabismus surgery,as evidenced by a higher number of operations,total muscle strips,horizontal muscle strips,and greater migratory effect size of the horizontal muscles.The combination of ETMOWD and FROD effectively reduced exophthalmos,with a more pronounced effect on the medial rectus muscle compared to the vertical muscles.However,the long-term outcomes between the two groups were similar.

OBJECTIVE: To identify prognostic genes associated with lysosome-dependent cell death (LDCD) in patients with gastric cancer (GC). METHODS: Differentially expressed genes (DEGs) were identified using The Cancer Genome Atlas - Stomach Adenocarcinoma. Weighted gene co-expression network analysis was performed to identify the key module genes associated with LDCD score. Candidate genes were identified by DEGs and key module genes. Univariate Cox regression analysis, and least absolute shrinkage and selection operator regression and multivariate Cox regression analyses were performed for the selection of prognostic genes, and risk module was established. Subsequently, key cells were identified in the single-cell dataset (GSE183904), and prognostic gene expression was analyzed. Cell proliferation and migration were assessed using the Cell Counting Kit-8 assay and the wound healing assay. RESULTS: A total of 4,465 DEGs, 95 candidate genes, and 4 prognostic genes, including C19orf59, BATF2, TNFAIP2, and TNFSF18, were identified in the analysis. Receiver operating characteristic curves indicated the excellent predictive power of the risk model. Three key cell types (B cells, chief cells, and endothelial/pericyte cells) were identified in the GSE183904 dataset. C19orf59 and TNFAIP2 exhibited predominant expression in macrophage species, whereas TNFAIP2 evolved over time in endothelial/pericyte cells and chief cells. Functional experiments confirmed that interfering with C19orf59 inhibited proliferation and migration in GC cells. CONCLUSION C19orf59, BATF2, TNFAIP2, and TNFSF18 are prognostic genes associated with LDCD in GC. Furthermore, the risk model established in this study showed robust predictive power.
Stomach Neoplasms/pathology* ; Humans ; Prognosis ; Lysosomes/physiology* ; RNA-Seq ; Cell Death ; Single-Cell Analysis ; Gene Expression Regulation, Neoplastic ; Cell Proliferation ; Single-Cell Gene Expression Analysis

Objective To investigate the impact of county-level"Unified ECG Network"construction on the treatment efficiency and clinical outcomes of patients with acute ST-segment elevation myocardial infarction(STEMI).Methods A retrospective analysis was conducted on the clinical data of STEMI patients from Beichuan County and Yanting County in Mianyang City,and Jiange County in Guangyuan City,Sichuan Province,during the 18 months before(128 cases)and 18 months after(187 cases)the establishment of the"Unified ECG Network."Differences in demographic characteristics,treatment efficiency,therapeutic methods,and clinical outcomes between the two groups were compared.Results There was no statistically significant difference in general demographic characteristics between the two groups(all P＞0.05).Compared with the pre-construction group,the post-construction group showed significantly shorter times in initial ECG completion[5(3,7)min vs.6(4,8)min],initial ECG diagnosis[3(2,4)min vs.5(2,6)min],first medical contact to preliminary diagnosis[10(9,12)min vs.13(11,15)min],network hospital door-in-door-out time[21(19,23)min vs.26(23,30)min],and first medical contact to wire-crossing time[(94.82±11.87)min vs.(107.97±18.39)min](allP＜0.001).The proportion of patients bypassing the emergency department and coronary care unit significantly increased(64.17％vs.32.81％,P＜0.001).The proportion of patients undergoing emergency percutaneous coronary intervention significantly increased(72.73％vs.51.56％,P＜0.001),while the proportions of thrombolytic therapy and non-reperfusion therapy significantly decreased(both P＜0.05).Additionally,in-hospital mortality rate,Killip class≥Ⅱ proportion,incidence of major adverse cardiovascular events,and average length of hospital stay were all significantly reduced(all P＜0.05).There were no statistically significant differences among the three county-level chest pain centers in terms of major treatment efficiency,therapeutic strategies,or clinical outcomes(all P＞0.05).Conclusions The construction of the county-level"Unified ECG Network"can significantly improve the treatment efficiency of STEMI patients,optimize reperfusion therapy strategies,improve clinical outcomes,and demonstrate substantial clinical promotion value.

Creutzfeldt-Jakob disease(CJD)is a rapidly progressive and fatal neurodegenerative disorder caused by prions,with certain infectivity and iatrogenic transmission risks.With the rapid progress and application of new dia-gnostic biomarkers and detection methods,as well as the construction and improvement of surveillance and reporting systems,the detection of CJD in patients domestically and internationally has shown an increasing trend year by year.Due to its long incubation period and heterogeneity of early symptoms,early identification and diagnosis of the disease is difficult,increasing the risk of transmission within medical institutions.Currently,there is a lack of con-sensus on the infection prevention and control of CJD.In order to timely identify and diagnose CJD as well as effec-tively block its transmission in medical institutions,this consensus summarizes 15 clinical concerns and formulates 24 specific recommendations based on the latest domestic and international research findings and clinical evidence,as well as combines with clinical practice,aiming to standardize healthcare-associated infection prevention and control measures for CJD and reduce its transmission risk in medical institutions.

Objective:To explore how the teaching of ideological and political courses in colleges and universities can effectively guide online public opinion under the background of melted media,so as to cope with the challenges posed by diversified information transmission channels and complex and changeable online public opinion,thereby promoting the formation of correct values and ideological cognition among students.Methods:A total of 1 353 students who volunteered to participate in this survey in a university that offers courses related to online public opinion guidance were selected as the survey subjects.Multiple linear regression analysis was used to analyze how universities should teach students to deal with online hot topics through relevant ideological and political courses.Results:Results of multiple linear regression analysis indicated that the teaching of ideological and political courses in colleges and universities under the background of melted media significantly enhanced students'awareness of online public opinion,and the courses played a positive role in the guidance.The improvement of media literacy facilitated the formation of students'correct values and ideological cognition,effectively responding to the challenges of diversified information dissemination.Variables including the infringement of personal privacy by online public opinion,the enhancement of civic consciousness,the impact on learning,and the distortion of reality understanding all had an impact on students'perception of the teaching effect of ideological and political courses.Conclusions:The teaching of ideological and political courses in colleges and universities plays a significant role in guiding online public opinion under the background of melted media.By enhancing students'media literacy,discernment,and emotional management ability,it effectively promotes the formation of students'correct values and ideological ideological,and provides strong support for the healthy growth of students in the complex network environment.The important role of ideological and political teaching in cultivating students'comprehensive abilities and guiding them to correctly deal with online public opinion is emphasized.