Objective To explore the clinical features and prognostic factors of adult hemophagocytic syndrome(HPS).Methods The clinical data of 68 newly diagnosed patients with HPS who were hospitalized from December 2018 to December 2023 were retrospectively analyzed,and clinical features,treatment and prognostic factors of patients were analyzed.Results The median age of 68 patients was 49(17-75)years old,the most common cause was infection,40 cases(58.82％),and the most common clinical manifestation was fever,63 cases(92.6％).Of the 68 patients,12(17.65％)patients died and the median survival time was 32 months.Cox univariate analysis showed that the prognosis of adult HPS was affected by SF,epstein-barr virus(EBV)infection,platelet count(＜20× 109/L),age over 60 years old,activated partial thromboplastin over 60s and other factors(P＜0.05).Multivariate Cox analysis showed that EBV infection and platelet count(＜20×109/L)were independent prognostic factors of adult HPS(P＜0.05).Conclusion The clinical manifestations of adult HPS are not typical,and the prognosis of adult HPS is affected by many factors.EBV infection and platelet count(＜20× 109/L)are independent risk factors for death.

In graduate course of"Advanced Pharmacology",problem-based learning(PBL)was used to stimulate students'initiative.To further study the advanced pharmacology knowledge,the new use of old drugs,literature re-viewing,clinical case and flipped classroom were applied in the courses to comprehensively strengthen capacity building of students'scientific thinking and reasoning.The outcomes of this course remodeling are well appreciated.

Objective:To investigate the current application of blood purification in the treatment of acute poisoning within Jiangsu Province and to evaluate the impact of extracorporeal blood purification on the clinical outcomes of critically poisoned patients.Methods:This multicenter, cross-sectional real-world observational study followed patients presenting with poisoning to the emergency departments of nine hospitals in Jiangsu Province between June 2015 and May 2019. Data were collected on demographic characteristics, vital signs within the first hour of emergency presentation, treatment modalities, length of hospital stay, and survival outcomes. Clinical data from patients who underwent extracorporeal blood purification were compared with those who did not, using the Wilcoxon rank-sum test and Chi-square test.Results:A total of 4 178 poisoning cases were included between June 2015 and May 2019. Among them, 21.7% (908/4 178) received blood purification therapy, while 78.3% (3 270/4 178) did not. Hemoperfusion (90.4%) was the most frequently employed method, followed by continuous renal replacement therapy (CRRT) (4.4%). In combined blood purification modalities, 4.8% underwent hemoperfusion combined with CRRT, 0.1% received hemoperfusion with plasma exchange, and another 0.1% underwent hemoperfusion combined with both CRRT and plasma exchange. Among patients who underwent blood purification, pesticide poisoning was the most prevalent (76.3%), with the most common toxic agents being paraquat (23.7%), dichlorvos (8.7%), methamidophos (5.2%), omethoate (4.0%), and glyphosate (3.7%). Compared to the non-blood purification group, patients in the blood purification group were more likely to present within the first hour with a low Glasgow Coma Scale (GCS) score (3-8) (22.6% vs. 9.7%, P <0.05), low mean arterial pressure (8.0% vs. 3.2%, P <0.05), longer hospital stays [5(3,9) days vs. 2(1,4) days, P <0.05] and a higher in-hospital mortality rate (21.1% vs. 5.3%, P <0.05). Follow-up via telephone 28 days after discharge revealed a survival rate of 78.9%, with a mortality rate of 21.1% in the blood purification group. Conclusions:Hemoperfusion is the most commonly utilized blood purification technique for treating poisoning in Jiangsu Province, with pesticides being the primary toxic agents treated. Although the mortality rate is higher in the blood purification group, the intervention may still contribute to improved patient outcomes.

This paper introduces chief physician of traditional Chinese medicine WANG Yigang's clinical experience in treating peripheral facial palsy in the acute stage with acupuncture-medication-combined therapy.Professor WANG believes that the pathogenesis of facial paralysis in the early stage is mostly the external invasion of wind and pathogenic toxins and the internal disturbance of dampness and toxins,resulting in the obstruction of collaterals and muscle regions of meridians.The treatment should be guided by the"unity of form(body)and spirit(Shen)",paying attention to the movement of the spirit,dispelling evils,and regulating the spirit.Professor WANG believes that when the spirit initiates,the healthy Qi is strong,and the pathogen subsides.In the treatment,he is good at combining acupuncture and medication for a synergistic effect,stresses the use of scalp points,and coins the empirical point Miandong(Extra).At the same time,he does not restrict himself to the traditional needling method and treats facial paralysis with"dynamic retention acupuncture".

Ultra micro angiography (UMA) can effectively improve the sensitivity and spatial resolution of blood flow imaging. To further meet the clinical requirements of quantitative measurements for microvascular imaging, this article demonstrated technical features and performance verification results of the microflow quantitative analysis function, which was developed based on the UMA function. This article provided preliminary validation of the measurement of Synchronous Arbitrary Gate-PW (SAG-PW) using a Doppler flow phantom and a moving string phantom. The Doppler flow phantom results demonstrated that the SAG-PW measurement values were close to the traditional PW results, and the average error of multiple sets of measurement results under different conditions was 3.9%. The results of SAG-PW and PW were strongly linearly correlated, with the slope and correlation coefficient approaching 1. The results of the moving string phantom demonstrated that the relative errors of TAMean and SAG-PW with different phantom set values were within 10%.
Phantoms, Imaging ; Ultrasonography, Doppler/instrumentation* ; Microvessels/diagnostic imaging*

Objective To explore the clinical features and prognostic factors of adult hemophagocytic syndrome(HPS).Methods The clinical data of 68 newly diagnosed patients with HPS who were hospitalized from December 2018 to December 2023 were retrospectively analyzed,and clinical features,treatment and prognostic factors of patients were analyzed.Results The median age of 68 patients was 49(17-75)years old,the most common cause was infection,40 cases(58.82％),and the most common clinical manifestation was fever,63 cases(92.6％).Of the 68 patients,12(17.65％)patients died and the median survival time was 32 months.Cox univariate analysis showed that the prognosis of adult HPS was affected by SF,epstein-barr virus(EBV)infection,platelet count(＜20× 109/L),age over 60 years old,activated partial thromboplastin over 60s and other factors(P＜0.05).Multivariate Cox analysis showed that EBV infection and platelet count(＜20×109/L)were independent prognostic factors of adult HPS(P＜0.05).Conclusion The clinical manifestations of adult HPS are not typical,and the prognosis of adult HPS is affected by many factors.EBV infection and platelet count(＜20× 109/L)are independent risk factors for death.

This paper introduces chief physician of traditional Chinese medicine WANG Yigang's clinical experience in treating peripheral facial palsy in the acute stage with acupuncture-medication-combined therapy.Professor WANG believes that the pathogenesis of facial paralysis in the early stage is mostly the external invasion of wind and pathogenic toxins and the internal disturbance of dampness and toxins,resulting in the obstruction of collaterals and muscle regions of meridians.The treatment should be guided by the"unity of form(body)and spirit(Shen)",paying attention to the movement of the spirit,dispelling evils,and regulating the spirit.Professor WANG believes that when the spirit initiates,the healthy Qi is strong,and the pathogen subsides.In the treatment,he is good at combining acupuncture and medication for a synergistic effect,stresses the use of scalp points,and coins the empirical point Miandong(Extra).At the same time,he does not restrict himself to the traditional needling method and treats facial paralysis with"dynamic retention acupuncture".

Objective To investigate the clinical characteristics,treatment and prognosis of tuberculosis in patients with autoimmune diseases after tumor necrosis factor-αinhibitors.Methods Clinical data of 33 patients with TB after biologics(tumor necrosis factor-α inhibitors)treated in Guangzhou Chest Hospital from January 2019 to March 2023 were collected,including 25 males and 8 females,with a median age of 32 years.The clinical symptoms,laboratory results,imaging and tracheoscopic features,pathological features,treatment and outcome were analyzed retrospectively.Results The common clinical manifestations were cough(26/33),sputum(23/33)and fever(17/33).The most common cases were pulmonary tuberculosis(32/33),bronchial tuberculosis(15/33),mediastinum and hilar lymph node tuberculosis(11/33).Bilateral lung spread of tuberculosis(21/33),intrapulmonary spread of tuberculosis(bronchus,mediastinal hilar lymph nodes,pleura)(19/33),extrapulmonary tuberculosis(18/33),pulmonary tuberculosis with intrapulmonary or extrapulmonary tuberculosis(26/33).Blood CD4+T lymphocyte test was normal(23/33),and blood IGRA test was positive(27/33).Pulmonary imaging miliary nodules(8/33).The histopathology of the lymph nodes showed atypical granulomatous nodules.The duration of anti-tuberculosis treatment is 8-32 months.1 case of death.Conclusion Patients with autoimmune diseases complicated with tuberculosis after the application of tumor necrosis fact-α inhibitor are more likely to have double lung lesions,which are easy to spread to lung tissues and multiple organs of the body,and have decreased immune function.Most of them need to extend the treatment course,and the prognosis is generally good after comprehensive treatment.

The World Health Organization (WHO) classification serves as the internationally recognized standard for diagnosing and classifying hematopoietic and lymphoid tissue tumors(WHO-HEAM). Since 2001, it has undergone multiple upgrades and revisions, updating, clarifying, and refining previous tumor diagnostic and classification standards while incorporating numerous new genetic and molecular biological subtypes. In 2022, two classification proposals emerged due to a wealth of clinical and scientific research results: the fifth edition of the WHO hematopoietic and lymphoid tissue classification (WHO-HAEM5), published in Leukemia journal; and the International Consensus Classification (ICC), published in Blood journal. These two schemes differ in their approach to classifying hematopoietic and lymphoid tissue tumors, posing challenges for clinical laboratory diagnosis and treatment.

Objective To compare the value of stack-of-stars-volumetric interpolated breath-hold examination(Star-VIBE)and T1-volumetric interpolated breath-hold examination(T1-VIBE)MRI for displaying peripheral lung cancer.Methods Fifty-two patients with 56 peripheral lung cancer were prospectively enrolled,and chest Star-VIBE and T1-VIBE MRI were acquired.The morphological features were observed,and the subjective scores were recorded.The maximum diameter,signal-to-noise ratio(SNR)and contrast-to-noise ratio(CNR)of lesions were measured based on Star-VIBE and T1-VIBE MRI,respectively.Taken CT as the references,the value of Star-VIBE and T1-VIBE MRI for displaying peripheral lung cancer were compared.Results Star-VIBE MRI had higher scores for displaying spiculation sign,lobulation sign,pleural depression sign and halo sign than T1-VIBE(both P＜0.05).CNR and SNR of Star-VIBE MRI were significantly higher than those of T1-VIBE(both P＜0.001).No significant difference of the maximum diameter of lesions measured based on Star-VIBE and T1-VIBE MRI compared with CT was found,nor between Star-VIBE and T1-VIBE MRI(all P＞0.05).Conclusion Star-VIBE MRI had better value for displaying peripheral lung cancer than T1-VIBE.