Sweet syndrome (acute febrile neutrophilic dermatosis) is a relatively rare inflammatory di-sease, which is characterized by the sudden appearance of tender erythematous skin lesions, often accompanied by pyrexia and elevated neutrophil count. The pathogenesis is not clear yet. Recently, multiple studies have found the association between Sweet syndrome and infections, autoimmune diseases, malignant tumors and the application of multiple drugs. According to different causes, Sweet syndrome can be divided into three types: classical (or idiopathic) Sweet syndrome, malignancy-associated Sweet syndrome and drug-induced Sweet syndrome. Classical Sweet syndrome usually presents in women between the age of 30 to 50 years and may be related to infection, inflammatory bowel disease, or pregnancy. The clinical symptoms typically respond promptly after corticosteroid therapy. The major diagnostic criteria of classical Sweet syndrome include sudden painful erythematous skin lesions, histopathologic evidence of a dense neutrophilic infiltrate without evidence of leukocytoclastic vasculitis; minor criteria include pyrexia over 38 ℃, association with hematologic or visceral malignancies, inflammatory diseases, pregnancy or preceded by infection, prompt response to systemic glucocorticoid or potassium iodide treatment, abnormal laboratory values (three of four: erythrocyte sedimentation rate >20 mm/h, positive C-reactive protein, >8.0×10⁹/L leukocytes, >70% neutrophils). The presence of both major criteria and two of the four minor criteria are required to diagnose classical Sweet syndrome. As for the malignancy-associated Sweet syndrome, skin lesions can be found precede, follow, or at the same time with the diagnosis of hematologic malignancy or a solid tumor. At present, ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG) is commonly used as a positron emission tomography computed tomography (PET/CT) imaging agent for diagnosing and screening malignant tumors. Therefore, most of the case reports on the ¹⁸F-FDG PET/CT manifestations of Sweet syndrome are malignancy-associated. Even classical Sweet syndrome is often accompanied by inflammatory bowel disease, autoimmune diseases, etc. Therefore, for patients with suspected or confirmed Sweet syndrome, it is necessary to take ¹⁸F-FDG PET/CT examination to clarify the general condition, whether it is for patients with malignant signs such as elevated tumor markers values and weight loss, or for patients with classical Sweet syndrome to exclude underlying inflammatory diseases. ¹⁸F-FDG PET/CT is often able to detect the solid tumor early, and assess the degree of hematologic malignancy and inflammatory disease. This study reported a classical Sweet syndrome case associated with inflammatory bowel disease, which was confirmed with skin and intestinal histological examination. The clinical manifestations, laboratory values, ¹⁸F-FDG PET/CT manifestations of the patient related diseases were reported, which was to improve nuclear medicine physicians' understanding of Sweet syndrome. Early diagnosis and treatment can often achieve excellent clinical effect.
Humans ; Sweet Syndrome/diagnostic imaging* ; Fluorodeoxyglucose F18 ; Positron Emission Tomography Computed Tomography ; Female

Alzheimer's disease (AD) is the major form of dementia in the elderly and is closely related to the toxic effects of microglia sustained activation. In AD, sustained microglial activation triggers impaired synaptic pruning, neuroinflammation, neurotoxicity, and cognitive deficits. Accumulating evidence has demonstrated that aberrant expression of deubiquitinating enzymes is associated with regulating microglia function. Here, we use RNA sequencing to identify a deubiquitinase YOD1 as a regulator of microglial function and AD pathology. Further study showed that YOD1 knockout significantly improved the migration, phagocytosis, and inflammatory response of microglia, thereby improving the cognitive impairment of AD model mice. Through LC-MS/MS analysis combined with Co-IP, we found that Myosin heavy chain 9 (MYH9), a key regulator maintaining microglia homeostasis, is an interacting protein of YOD1. Mechanistically, YOD1 binds to MYH9 and maintains its stability by removing the K48 ubiquitin chain from MYH9, thereby mediating the microglia polarization signaling pathway to mediate microglia homeostasis. Taken together, our study reveals a specific role of microglial YOD1 in mediating microglia homeostasis and AD pathology, which provides a potential strategy for targeting microglia to treat AD.

ObjectiveThis paper aims to analyze the clinical characteristics and medication rationality of liver injury related to Epimedii Folium preparation （EP） and explore the possible risk factors of liver injury， so as to provide a reference for the safe clinical application of Epimedii Folium （EF）. MethodA retrospective analysis was conducted on liver injury cases related to EP from 2012 to 2016. ResultThe number of reported liver injury cases and the proportion of severe cases related to the use of EP show an increasing trend， indicating the objective existence of liver injury caused by EP. There are more cases of liver injury related to EP in women than in men， with an onset age range of 15-91 years old and a median onset age of 60 years old （median onset ages for men and women are 59 and 60 years old， respectively）. The time span from taking EP alone to the occurrence of liver injury is 1-386 days， with a median of 38 days. The time span from taking both EP and Western medicine to the occurrence of liver injury is 1-794 days， with a median of 34 days. EF-related liver injury preparations are mostly composed of traditional Chinese medicines that promote immunity and tonify the liver and kidney， indicating that immune stress in the body may be the mechanism of liver injury caused by the use of EP alone or in combination. There is no increasing trend of toxicity with time or dose in the liver injury caused by EP. By further exploring its risk factors， it is found that patients have unreasonable medication methods such as excessive dosage， repeated use， and multi-drug combination， which may also be one of the important risk factors for EF-related liver injury. ConclusionEP has a certain risk of liver injury and should be emphasized in clinical diagnosis and treatment. Immune stress may be the mechanism of liver injury caused by EP， and in clinical use， it is necessary to be vigilant about the risk of liver injury caused by unreasonable use and combined use with Western medicine.

Objective:To investigate the effect of visceral obesity on the short-term curative effect of Da Vinci robotic-assisted radical resec-tion for rectal cancers.Methods:Clinical and pathological data of patients with rectal cancer undergoing Da Vinci robotic-assisted surgery,admitted to People's Hospital of Zhengzhou University and Cancer Hospital of Zhengzhou University from November 2019 to June 2022 were retrospectively analyzed.Visceral fat area(VFA)≥100 cm2 was used as the standard to define visceral obesity.Patients were categorized in-to visceral and non-visceral obesity groups.The short-term efficacy of the two groups was evaluated,and the influencing factors of post-operative complications were analyzed using univariate and multivariate Logistic regression.Results:Among a total of 169 patients,93 were included in the visceral obesity group and 76 in the non-visceral obesity group.There was no significant difference in the baseline data between the two groups(P>0.05).There was no conversion to laparotomy in the non-visceral obesity group,and the conversion rate was 1.1%(1/93)in the visceral obesity group.The second operation rate was 2.2%(2/93)in the visceral obesity group and 1.3%(1/76)in the non-visceral obesity group with no statistical difference between the two groups.There were no significant differences in the operation dur-ation,intraoperative blood loss,number of lymph node dissections,and total postoperative complication rate between the two groups(P>0.05).Multivariate Logistic regression analysis revealed that an NRS≥3 independently contributed as a risk factor for postoperative com-plications(OR=3.190,95%CI:1.240-8.210,P=0.016).Conclusions:An NRS≥3 is an independent risk factor for complications post-robotic rad-ical rectal cancer surgery.The robotic surgical platform can overcome obesity-related limitations and is equally safe and effective for pa-tients with visceral obesity presenting with rectal cancer.

Despite growing prevalence and incidence, the management of gout remains suboptimal. The intermittent nature of the gout makes the long-term urate-lowering therapy (ULT) particularly important for gout management. However, patients are reluctant to take medication day after day to manage incurable occasional gout flares, and suffer from possible long-term toxicity. Therefore, a safe and easy-to-operate drug delivery system with simple preparation for the long-term management of gout is very necessary. Here, a chitosan-containing sustained-release microneedle system co-loaded with colchicine and uricase liposomes were fabricated to achieve this goal. This microneedle system was confirmed to successfully deliver the drug to the skin and maintain a one-week drug retention. Furthermore, its powerful therapeutic potency to manage gout was investigated in both acute gouty and chronic gouty models. Besides, the drug co-delivery system could help avoid long-term daily oral colchicine, a drug with a narrow therapeutic index. This system also avoids mass injection of uricase by improving its stability, enhancing the clinical application value of uricase. In general, this two-drug system reduces the dosage of uricase and colchicine and improves the patient's compliance, which has a strong clinical translation.

Hepatocellular carcinoma (HCC) has the features of high incidence rate, low survival rate, poor treatment outcome, and complex pathogenesis. In recent years, many studies have shown that long non-coding RNA (lncRNA) MALAT1 is upregulated in HCC and can promote the proliferation, invasion, and metastasis of HCC cells, and it can also guide the diagnosis, prognostic evaluation, and treatment of HCC in clinical practice. This article reviews the current status of research on lncRNA MALAT1 in HCC and discusses its expression pattern, mechanism of action, and clinical significance in predicting and monitoring the progression of HCC, so as to gain a deep understanding of the role of lncRNA MALAT1 in the progression of HCC. It is pointed out that lncRNA MALAT1 is expected to become a potential biomarker for the diagnosis and prognostic evaluation of HCC and may be used as a therapeutic target in clinical practice.

Objective To evaluate the clinical effect of chronic subdual hematoma between surgical procedure twist drill craniostomy with injecting urokinase into hematoma space and only with twist drill craniostomy.Methods Two hundred and twenty-five patients with chronic subdual hematoma patients who were admitted in the Affiliated Hospital of Yangzhou University from January 2011 to April 2017 were retrospectively analyzed.They were divided into two groups according to the different surgical methods,group A for twist drill craniostomy with injecting urokinase into hematoma space (n =116),group B only for twist drill craniostomy (n =109).Then the postoperative drainage volume and residual hematoma was analyzed by repeated measures,while radiographic grading system and recurrence rates after operation were compared between groups with statistical analysis which was done by ANOVA analysis or non-parametric rank sum test.Results The drainage volume 48 hours after surgery was(52.41 ± 7.86) ml in group A,(28.42 ± 4.46) ml in group B as well.The residual volumes which were calculated at 1 month,3 months after surgery was (23.35 ±4.18) ml and (15.31 ±6.15) ml in group A,comparing the volumes of (46.07 ± 5.96) ml and (25.60 ± 5.03) ml in group B.The radiographic grading system was evaluated by grade 1-4.There were 75(64.7％) cases in grade 1,32(27.6％) cases in grade 2,8(6.9％) cases in grade 3,1 (0.9％) cases in grade 4 of group A,as well as 42(38.5％) cases in grade 1,55(50.5％) cases in grade 2,11 (10.1％) cases in grade 3,1 (0.9％) cases in grade 4 of group B.The rate of recurrence for chronic subdural hematoma was 6.0％ in group A,while it was 15.6％ in group B.These data all had significant statistical difference between the two groups (P ＜ 0.05).Conclusion Twist drill craniostomy might be a safe,effective and mini-massive method for treating chronic subdual hematoma,while injecting urokinase into the hematoma space could significantly reduce the rate of recurrence and decrease the volume of hematoma.

Purpose To explore multi-slice spiral CT (MSCT) in differential diagnosis of esophageal leiomyoma and esophageal carcinoma.Material and Methods Plain chest CT scan and enhanced inspection image of 26 patients with esophageal leiomyoma and 68 patients with esophageal carcinoma at the same term which had been confirmed by surgery and pathology were retrospectively analyzed.Characteristics such as focus size,morphology,density and tumor-air surface,etc were recorded and compared.Results MSCT of esophageal leiomyoma showed uniform density,possible calcification,polylimited influence of esophageal wall,scarcity of depression in focus niche,smooth tumor-air surface,low degree of enhanced amplification,and cerioid expansion of related lumen of larger focus.However,MSCT in esophageal carcinoma was represented by thickened annulus of esophageal wall,no calcification of focus,familiarity of depression in focus niche,rough tumor-air surface and intermediate degree strengthening.Differences of contrast of calcification,polylimited influence of esophageal wall,scarcity of depression in focus niche,smooth tumor-air surface in sophageal leiomyoma with that of esophageal carcinoma were statistically significant (P＜0.05).Conclusion MSCT can accurately identify sophageal leiomyoma and esophageal carcinoma,offering evidence for clinical diagnosis and treatment.

Purpose To explore multi-slice spiral CT (MSCT) features of lesions with cross interlobar fissure symptom in the lung,and through pathological results,to study the differential diagnosis significance of cross interlobar fissure symptom.Materials and Methods Forty-nine patients who were confirmed with lesions in the lung with cross interlobar fissure symptom through surgery,pathological certification or clinical diagnosis from October,2015 to October,2016 were collected.Retrospective analysis was conducted on cross interlobar fissure symptom lesions and other representation in the lung on CT image.Results Sixteen cases were multiple lesions and 33 cases of single cross interlobar fissure lesions.9 cases in the multiple lesions (56.3％) were contagious lesions,including tubercle bacillus,fungus,staphylococcus aureus and klebsiella pneumoniae infection,in which 3 cases (18.7％) were adenocarcinoma,2 cases (12.5％) metastasis,1 case (6.3％) Wegener's granulomatosis and 1 case (6.3％) antineutrophil cytoplasmic anti-body (ANCA) related vasculitis.21 cases in single lesions (63.6％) had malignant tumor,including adenocarcinoma of lung,squamous carcinoma,lymphoma and metastasis,in which 6 cases (18.2％) were sclerosing pneumocytoma or hamartoma with smooth verge and without malignant symptom,and another 6 cases (18.2％) were inflammatory lesions.Conclusion Symptoms of lesions in the lung with cross interlobar fissure growth can be seen in malignant tumor,benign tumor and inflammatory lesions.Multiple lesions are accompanied with cross interlobar symptom which can be seen more often in benign lesions,but also can be seen in malignant tumor (metastasis and intrapulmonary metastasis of lung cancer).Single lesions are also accompanied with cross interlobar symptom which can be seen more often in malignant tumor,but also can be seen in cryptogenic organizing pneumonia and benign tumor.Sometimes,it's very difficult to identify malignant tumor with single cross interlobar distributed cryptogenic organizing pneumonia.When features of benign tumor are very clear,possibility of sclerosing pneumocytoma or hamartoma shall be taken into consideration.

PurposeTo investigate the multi-slice spiral CT features of lung primary invasive mucinous adenocarcinoma, a rare malignancy with few relevant literature. Materials and Methods Forty-one patients with pathology proven primary invasive mucinous adenocarcinoma of the lungs underwent MSCT examination, of which 27 patients received intravenous contrast. Imaging features were analyzed, and the patients were divided into groups according to morphology, density and enhancement.Results For 41 patients, 40 cases had one lesion, and one case had more than one lesion; the lesions were in the right upper lobe in 5 cases, right middle lobe in one case, right lower lobe in 17 cases, left upper lobe in 5 cases, and left lower lobe in 12 cases. There was solitary lesion in 40 cases. The other patient had multiple lesions. 29 cases showed nodules/masses, while non-mass lesions in 12 cases. Ground glass opacity was seen in 4 cases, single consolidation in 11 cases, and mixed consolidation in 26 cases. There was significant contrast enhancement in nodules/masses compared to non-mass lesions (t=5.00, 6.51 and 14.06,P<0.05).Conclusion MSCT shows a diversity of imaging features of primary invasive mucinous adenocarcinom, including single round lesion, lower lobe in both side; the density is lower than muscle on CT scan, and presents mild to moderate enhancement on enhancement scan round lesions has high density and enhancement range than irregular-shaped lesions.