Objective:Analyze the clinical manifestations,diagnosis,treatment,and prognosis of uterine arterio-venous fistula(UAVF).Methods:A retrospective analysis was conducted on the clinical data of 30 patients diag-nosed with UAVF by ultrasonography at The First Affiliated Hospital of Zhengzhou University from January 1,2019,to December 31,2022.Results:Among the 30 patients,the median age was 33 years.All patients had a his-tory of uterine surgery,and 3 cases(10.0%)were complicated by gestational trophoblastic disease.Vaginal bleeding was the presenting symptom in 26 cases(86.7%).All patients were diagnosed using color Doppler ul-trasonography.Additionally,22 patients(73.3%)underwent digital subtraction angiography(DSA)for definitive diagnosis.The treatments administered were as follows:8 patients underwent uterine artery embolization(UAE)to hysteroscopic lesion resection,10 patients received UAE only,4 patients underwent hysteroscopic lesion resec-tion only,4 patients required UAE due to massive bleeding during hysteroscopic lesion resection,1 patient under-went direct hysterectomy,3 patients received conservative management.Among the 22 patients who underwent UAE,19 cases(86.4%)experienced no recurrence of vaginal bleeding.Among the 26 patients who underwent fertility-preserving treatment,18(69.2%)regained normal menstruation.Of the 10 patients within this group who desired pregnancy,4 subsequently had successful deliveries.Conclusions:UAVF primarily manifests as irregular vaginal bleeding.Color Doppler ultrasonography can serve as the initial diagnostic tool,while DSA provides a de-finitive diagnosis.UAE and hysteroscopic lesion resection can be considered preferred treatment options for pa-tients desiring fertility preservation.

Objective:Analyze the clinical manifestations,diagnosis,treatment,and prognosis of uterine arterio-venous fistula(UAVF).Methods:A retrospective analysis was conducted on the clinical data of 30 patients diag-nosed with UAVF by ultrasonography at The First Affiliated Hospital of Zhengzhou University from January 1,2019,to December 31,2022.Results:Among the 30 patients,the median age was 33 years.All patients had a his-tory of uterine surgery,and 3 cases(10.0%)were complicated by gestational trophoblastic disease.Vaginal bleeding was the presenting symptom in 26 cases(86.7%).All patients were diagnosed using color Doppler ul-trasonography.Additionally,22 patients(73.3%)underwent digital subtraction angiography(DSA)for definitive diagnosis.The treatments administered were as follows:8 patients underwent uterine artery embolization(UAE)to hysteroscopic lesion resection,10 patients received UAE only,4 patients underwent hysteroscopic lesion resec-tion only,4 patients required UAE due to massive bleeding during hysteroscopic lesion resection,1 patient under-went direct hysterectomy,3 patients received conservative management.Among the 22 patients who underwent UAE,19 cases(86.4%)experienced no recurrence of vaginal bleeding.Among the 26 patients who underwent fertility-preserving treatment,18(69.2%)regained normal menstruation.Of the 10 patients within this group who desired pregnancy,4 subsequently had successful deliveries.Conclusions:UAVF primarily manifests as irregular vaginal bleeding.Color Doppler ultrasonography can serve as the initial diagnostic tool,while DSA provides a de-finitive diagnosis.UAE and hysteroscopic lesion resection can be considered preferred treatment options for pa-tients desiring fertility preservation.

Objective:To investigate impacts of soy isoflavones(SIF)on alveolar bone resorption and inflammatory response in periodontitis rats based on Slit homologue 2(Slit2)/P38 mitogen-activated protein kinase(MAPK)signaling pathway.Methods:Rats were separated into Control group,Model group,SIF low-dose group(L-SIF,25 mg/kg)and SIF high-dose group(H-SIF,75 mg/kg),with 10 rats per group,and periodontitis model was established by ligating necks of maxillary first molars of rats with silk thread except for control group.Rats in L-SIF group and H-SIF group were given corresponding doses of SIF by gavage,Control group and Model group were given same amount of normal saline by gavage,once a day,for 4 consecutive weeks.After administration,serum Slit2,TNF-α,IL-6 and IL-1β levels were detected by ELISA;Micro-CT scan was performed to detect distance between cemen-tumenamel junction and alveolar ridge crest(CEJ-ABC),bone mineral density(BMD),bone volume fraction(BV/TV),and alveolar bone loss was evaluated;HE staining and tartrate-resistant acid phosphatase(TRAP)staining were performed to evaluate tissue inflam-mation,bone resorption and osteoclast activity;expressions of osteoprotegerin(OPG)and receptor activator of nuclear factor κB ligand(RANKL)in periodontal tissues were detected by immunohistochemistry(IHC);Western blot was performed to detect protein expressions of Slit2,P38 MAPK and p-P38 MAPK in periodontal tissues.Results:Compared with Control group,serum levels of Slit2,TNF-α,IL-1β,IL-6,CEJ-ABC distance,periodontal histopathological damage score,osteoclast number,positive expression of RANKL,protein level of Slit2 and p-P38 MAPK/P38 MAPK were greatly increased in Model group,BMD,BV/TV and positive ex-pression of periodontal tissues OPG were greatly decreased(all P<0.05);compared with Model group,serum levels of Slit2,TNF-α,IL-1β,IL-6,CEJ-ABC distance,periodontal histopathological damage score,osteoclast number,positive expression of RANKL,pro-tein levels of Slit2 and p-P38 MAPK/P38 MAPK were greatly decreased,BMD,BV/TV and OPG positive expression of periodontal tissues were greatly increased in L-SIF group and H-SIF group(P<0.05),the above indicators in H-SIF group changed greatly better than L-SIF group(P<0.05).Conclusion:SIF can inhibit alveolar bone resorption and inflammatory response in periodontitis rats and improve periodontitis,whose mechanism may be related to inhibition of Slit2/P38 MAPK signaling pathway.

As widely-used immunotherapy has brought therapeutic benefits to cancer patients, some problems begin to come, such as pseudoprogression which has posed a major challenge for clinicians to manage patients receiving novel drugs. If pseudoprogression is mistaken for the progression of the disease, the immunotherapy is stopped, which may lead patients to lose the treatment opportunity. Liquid biopsies based on circulating tumor DNA (ctDNA) play a key role in the evaluation of therapeutic efficacy and drug-resistance mechanism of tumor immunotherapy. This article reviews the potential application of ctDNA in the identification of pseudoprogressio for patients after tumor immunotherapy.

OBJECTIVE: To investigate the impact of middle- and long-distance running on mental health of students in a college in Guangzhou during the COVID-19 outbreak. METHODS: We collected data using online questionnaires from the college students selected via snowball sampling. After exclusion of invalid questionnaires and matching the data of running exercise with physical test scores of the participants, 1022 questionnaires were deemed valid for analysis. Of the 1022 students, 869 completed at least a 60-km running distance each semester as required and 153 students did not complete the task. The mental health status of the students was evaluated using PTSD Checklist-Civilian Version (PCL-C), Zung Self-rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS). The scale scores were compared between the students who completed the running task and those who did not, and the factors affecting anxiety and depression were analyzed using univariate analysis and binary logistic regression. RESULTS: The students who completed the running task had significantly higher physical test scores than those who did not complete the task ( CONCLUSION Regular middleand long-distance running exercise may enhance the physical health to indirectly promote the mental health of the college students during COVID-19 outbreak.
Anxiety ; COVID-19 ; China ; Cross-Sectional Studies ; Disease Outbreaks ; Humans ; Mental Health ; SARS-CoV-2 ; Students ; Surveys and Questionnaires

Sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to infection. The pathophysiology core issue is that the body initiates a severe inflammatory reaction in response to the invasion of pathogenic microorganisms at the initial stage of disease. Subsequently, the body begins to fight inflammation in order to balance immunity status and eventually induces the immune paralysis or immunosuppressive state characterized by exhaustion of immune cell. Both in innate immunity and in acquired immunity, some co-suppressor molecules on the surface of immune cells play important roles in immunosuppression, such as, programmed death receptor-1 (PD-1), T cell immunoglobulin and mucin-containing protein-3 (TIM-3), cytotoxic T lymphocyte associated antigen-4 (CTLA-4), natural killer cell receptor 2B4 (CD244), B and T lymphocyte attenuator (BTLA) and NKG2A (CD94), et al. Blocking the interaction between these co-suppressor molecules and their ligands can significantly reverse the immunosuppressive state in septic animal models or patients. In order to provide a reference for the monitoring and treatment of sepsis immune dysfunction, this article mainly summarizes the new findings on the role of those co-suppressor molecules in sepsis immune dysfunction in recent years.

The worldwide COVID-19 outbreak caused by 2019-nCoV infection has been declared as a public health emergency of international concern by the World Health Organization (WHO). COVID-19 patients usually present with respiratory symptoms, while severe cases could also have extrapulmonary organ damages. The immune system is essential in defending against viral infection. However, clinical features as well as pathological findings of COVID-19 suggest that 2019-nCoV infection might cause immune deficiency. It has been revealed that immune imbalance and hyper-inflammatory state in COVID-19 patients are closely associated with disease progression and poor outcomes. This review provided an update on immune responses in 2019-nCoV-infected patients including innate immunity, adaptive immunity and cytokine storm, aiming to elucidate the role of immune system in the pathogenesis of COVID-19 and provide reference for clinical prevention and treatment of COVID-19.