Objective:To explore the diagnosis and treatment of lymphoepithelioma-like intrahepatic cholangiocarcinoma(LEL-ICC).Methods:The retrospective and descriptive study was conducted. The data of 7 patients with pathological diagnosis of LEL-ICC after hepatectomy who were treated in Lishui Central Hospital in Zhejiang Province from December 1, 2009 to January 30, 2024 were collected. There were 2 males and 5 females. The age range was from 40 to 64 years old, with a median age of 52 years old. All 7 patients showed no obvious clinical symptoms.We analysed the imaging manifestations, pathological features, treatmentsand prognoses of patients.Postoperative follow-upswere conducted via telephone, with a focus on whether the patient had relapsed. The deadline was February 20, 2024.Results:Five cases underwent ultrasound examination, of which 4 cases showed hypoechogenicity and 1 case showed hyperechogenicity. 7 cases underwent MRI examination, showing low signal on T1WI, high signal on T2WI, and high signal on diffusion-weighted imaging. 2 cases had type A enhancement, 2 cases had type B enhancement, and 3 cases had type C enhancement. All 7 cases received surgical treatment, 2 cases were received prophylactic transarterial chemoembolization (TACE) after surgery, and 3 cases were received systemic chemotherapy after surgery; All 7 cases underwent postoperative follow-up, with a follow-up time of 1-166 months and a median follow-up time of 56 months. One case developed hilar and retroperitoneal lymph node metastasis after surgery for 6 months, and underwent surgical treatment. After surgery, chemotherapy was performed. 25 months later, right adrenal gland metastasis reappeared, and after combined treatment, the metastatic lesion was reduced and the patient received surgical treatment and chemotherapy, and there is currently no recurrence. The remaining 6 cases showed no recurrence.Conclusions:LEL-ICC lacks specific clinical symptoms and imaging manifestations, diagnosis relies on histopathological and immunohistochemical examinations. Comprehensive treatment with surgical intervention as the main approach can lead to better prognosis for patients.

Objective: To compare the effectiveness before and after the adjustment of schistosomiasis control strategies in Nanjing City, so as to provide the evidence for improving schistosomiasis control interventions. Methods: The prevalence of Schistosomasis japonicum infections in humans, livestock, Oncomelania hupensis and sentinel mice was collected in Nanjing City from 1993 to 2018, and the prevalence of S. japonicum infections in humans, livestock, sentinel mice and O. hupensis, and the areas of snail habitats, areas of infected snail habitats and snail control areas were compared before (1993-2004) and after (2005-2018) the adjustment of schistosomiasis control strategies to evaluate the effectiveness. Results: The prevalence of S. japonicum infections in humans, livestock, O. hupensis and sentinel mice was 0.77% and 0.02% (χ2=6 430.634, P<0.001), 0.46% and 0.01% (χ2=344.401, P<0.001), 0.19% and 0.11% (χ2=239.685, P<0.001), and 34.35% and 1.56% (χ2=1 856.286, P<0.001) in Nanjing City before and after the adjustment of schistosomiasis control strategies, respectively. The median areas (interquartile range) of snail habitats, infected snail habitats and snail control were 4 175.37 (1 301.65) and 2 366.44 (885.27) hm2 (Z=-3.755, P<0.001), 870.49 (1 001.75) and 0 (158.89) hm2 (Z=-3.654, P<0.001) and 1 383.23 (793.57) and 5 031.94 (629.11) hm2 (Z=-4.320, P<0.001) in Nanjing City before and after the adjustment of schistosomiasis control strategies, respectively. Conclusions After the adjustment of schistosomiasis control strategies, remarkable effects on schistosomiasis control has achieved in Nanjing City, where the transmission of schistosomiasis was interrupted. Nevertheless, the strategy requires to be continued and improved to move towards elimination of schistosomiasis in Nanjing City.

Objective To observe the effect of vancomycin-loaded calcium sulfate for one-stage treatment of chronic osteomyelitis.Methods A retrospective case series study was made on 26 patients with chronic osteomyelitis treated from January 2014 to April 2016.There were 23 males and 3 females,with a mean age of 35.8 years (range,16-90 years).After focus debridement of osteomyelitis,the cavities were filled with vancomycin-loaded calcium sulfate and systemic antibiotics were used.Meanwhile,gentamicin was added to patients showing unclear pathogens.Three patients underwent flap transfer surgery simultaneously due to the inadequate soft tissue coverage.Wound healing,local redness and swelling,sinus recurrence,recovery of osteomyelitis and repair of bone defect were detected after operation.Results All patients were followed up for 6-30 months (mean,19.5 months).Primary healing was achieved in all patients.One patient experienced wound exudate and was effectively managed by dressing change,one patient experienced inadequate local soft tissue coverage and was effectively managed by a second flap transfer surgery,and one patient remained wound unhealing after two surgeries and was cured by infected bone resection using the Masquelet induced membrane technique.Follow-up showed local bone defect was repaired in all patients without bone infection recurrence.Conclusions For patients with chronic osteomyelitis,one-stage surgery with vancomycin-loaded calcium sulfate can control infection with simultaneous repair of bone defect.Therefore,the procedure is a simple and effective method and worthy of clinical practice.

Objective To master the current status of iodine nutrition of people in Nanjing after the adjustment of iodized salt standard,and to provide scientific basis for reasonable iodine supplementation and strategies for iodine nutrition control.Methods The probability proportional to size (PPS) sampling method was employed in the investigation.We firstly selected 30 streets in the whole city,and then chosen 50 children aged 8-10 years from each of 30 primary schools respectively,which was selected from 30 different streets to examine the size of thyroid gland by palpation and B-type ultrasound.We also collected urine and edible salt samples from 12 children aged 8-10 years from each primary school,to detect their urinary and salt iodine content.Moreover,20 pregnant women and 10 lactating women were picked out from each of 30 schools nearby to detect their urinary and salt iodine content.We also conducted a unique questionnaire survey in 30 fifth-grade students selected from each of 30 schools,and 5 housewives selected from these schools nearby to understand their knowledge of iodine deficiency disorders.Results The thyroid palpate swelling rate was 0.33％(5/1 500) in 1 500 children aged 8-10.The medians of urinary iodine level were 220.5 μg/L in 362 school-age children,196.7 μg/L in 600 pregnant women and 152.0 μg/L in 300 lactating women.A total of 1 260 samples of edible salt were tested.The coverage rate of iodized salt and the consumption rate of eligible iodized salt were 99.7％ (1 256/1 260) and 96.9％ (1 221/1 260),respectively.The mean iodine content of edible salt was (24.5 ± 4.5) mg/kg.A total of 900 fifth-grade students and 150 housewives were surveyed for health knowledge of iodine,and the eligible rate was 83.2％ (2 246/2 700) and 91.6％ (412/450),respectively.Conclusions After the adjustment of iodized salt content,iodine nutrition level of people in Nanjing has maintained appropriately.However,health education should be further strengthened.Improving the awareness rate of iodine deficiency knowledge,and guiding scientific iodine consciousness are our serious task in the future.

Objectives To investigate MRI patterns of functional connectivity(FC)in different brain areas of the subthalamic nucleus (STN)in Parkinson's Disease (PD)and its correlation with cognition.Methods We used functional magnetic resonance imaging to investigate the difference in whole-brain resting-state FC of STN between 32 patients with PD during the medicatiom ON state and 25 healthy control group(HC)matched for age,gender,and cognition,and examine the correlation between functional connectivity strength and montreal cognitive assessment (MoCA)scores.Results Compared with HC,the PD group showed increased FC in the right lingual gyrus of the left STN and the right STN showed decreased FC in the left superior frontal gyrus and the supplementary motor area(t=4.29,-3.61,and-3.83,respectively,each P ＜ 0.05),while the right STN showed only decreased FC in the right bilateral cingulate gyrus and the precuneus(t=-4.44,4.29,and-4.30,respectively,each P＜ 0.05).In addition,PD patients' connectivity strength between RSTN and the bilateral precuneus was positively correlated with MoCA scores(t =0.58 and 0.57,respectively,each P＜0.05).Conclusions Compared with HC,PD patients exhibit decreased FC between RSTN and the precuneus,with FC strength positively correlated with MOCA scores.The cognitive decline caused by deep brain stimulation in STN may be related to injuries of the precuneus.

Objective To observe the development of Schistosoma japonicum after single sexual infection and double sexual infection respectively. Methods A single Oncomelania hupensis snail was infected by a single schistosome miracidium. The lar?va were induced and released from the snail after 60?day incubation at 26℃. The mice were infected by the larva(single sexual infection)and dissected 40 days after the infection. All the worms were collected and the sex of the larvae was determined by the sex of the adult worms. Then,the mice and rabbits were infected by single sex of larvae(single sexual infection)and double sex of larvae(double sexual infection)respectively. The mice and the rabbits were dissected 40 days after the infection. All the worms were collected and measured under a microscope. Results All the male or female worms were collected from the mice and rabbits after single sexual infection. There were three main forms of worms after dissection of double sexual infection of mice and rabbits:folded mature male and female,male or female. Few folded male and immature female were found. Only the double sexual larva infected mice or rabbits had schistosome eggs in the liver and the liver had typical schistosome egg nodules. The sin?gle sexual larva infected mice or rabbits had no schistosome eggs or schistosome egg nodules in the liver tissues. The single male larva could develop to worms with the testis,and with a little smaller size compared to the mature folded male,while the single sexual infection female worm could not develop to the mature stage with much thinner and smaller compared to the mature folded female. Conclusions The male or female worms from single sexual infection are smaller than those from double sexual infection (mature worms?folded male and female). So it is necessary to check single sex worms in vessels of intestinal mucosa thoroughly in the sentinel mice when no schistosome eggs were found in the liver.

Objective To analyze the epidemiological characteristics of malaria in Nanjing City,so as to provide the evi?dence for further formulating and adjusting the malaria prevention and control strategy. Methods The data of malaria situation, malaria cases and epidemiological investigations were collected from the Internet Reporting System in Nanjing City from 2010 to 2015 and analyzed statistically. Results A total of 137 confirmed malaria cases were reported in Nanjing City from 2010 to 2015,including 102 falciparum malaria cases(74.45%),33 vivax malaria cases(24.09%),one ovale malaria case(0.73%) and one quartan malaria case(0.73%). Among the 137 malaria cases,126 cases(91.97%)were imported from foreign coun?tries,2 cases(1.46%)were infected locally,and nine cases(6.57%)were imported from other provinces in China. Among the 126 overseas imported cases,117 cases were imported from African countries and 9 from Asian countries. These malaria cases were majorly young men working as migrant workers,laborers and technical persons. About 19.30%of the cases went to hospital on onset day,and 55.65%were confirmed by medical institutions as malaria in the same day. The majority of diagnosis institu?tions were municipal hospitals(74.45%). Conclusions The number of malaria cases in Nanjing City is declining year by year. The local infections are eliminating gradually. However,the situation of imported malaria from overseas is still serious. There?fore,the surveillance work and health education still should be strengthened,so as to reduce the risk of imported malaria.

Objective To explore and integrate the key techniques used in the surveillance and forecast of schistosomiasis in the water regions along the Yangtze River,so as to provide technical support for identifying rapidly the risk of schistosomiasis transmission and implementing control measures targeting the risk. Methods According to the distribution of water systems and water regions along the Yangtze River in Jiangsu Province,the demonstration sites for surveillance and forecast of schistoso? miasis were set across the province,where the integration and demonstration of the techniques regarding monitoring of Schistoso?ma japonicum infection in sentinel mice,human and animal activities,release of forecast information,and emergency treat?ment of water regions at risk of infection were performed. The pattern of human and animal activities was compared with the S. ja?ponicum infection in sentinel mice in the demonstration sites,and the operability of the release of information and emergency treatment of the risk of S. japonicum infection was evaluated. Results A total of 50 demonstration sites for surveillance and forecast of schistosomiasis were set in fixed anchor points,opening of the navigation lock to the Yangtze River,freight terminal, agritainment places,ferry,large construction places,and places for guaranteeing the Youth Olympic Games in 23 counties(dis?tricts)of 5 cities,Jiangsu Province. During the period between May and September,2014,the infectivity of water body was monitored by using 5 batches of sentinel mice,with a 99.06%(4 954/5 001)gross recovery rate of mice. S. japonicum infection was detected in a demonstration site,and an infected mouse was found,with a 0.02%(1/4 933)gross positive rate of sentinel mice. The field survey showed 2 088 person?times contacting water,including 91.95%(1 920/2 088)contacting water due to the production such as capturing fish,harvesting and cultivating crops,and repairing and building boats,and 8.05%(168/2 088)contacting water due to the life activity,such as fishing,washing vegetables and playing with water. The people contacted water predominantly in August and September(49.57%). A total of 859 boats containing 1 877 boatmen were observed,68.22%(586/859)of which were fishing boats containing 1 306 fishermen(69.58%). There were 32 sheep found in 4 demonstration sites,and 3 sheep were seen in the demonstration site with infected sentinel mouse. Four blue forecasts(emergence of water con?tact)and one orange forecast(S. japonicum?infected sentinel mouse detected)were released across the province,with one fore?cast map released which showed 5 sites with fishing and one site with sheep grazing,one emergency response system initiated, mollusciciding implemented in 10 hm2 high?risk regions,120 sheep grazed in fence,and 35 fishermen given health?education materials,schistosomiasis examination and preventive therapy. In addition,no acute schistosomiasis occurred in the demonstra?tion site with S. japonicum?infected sentinel mice. Conclusions The integration and demonstration of the techniques regarding monitoring of S. japonicum infection in sentinel mice,human and animal activities,release of forecast information,and emer?gency treatment of water regions at risk of infection provides an effective approach for the large?scale surveillance and forecast of schistosomiasis.

Objective To comprehensively evaluate the relationship between murine double minute 2 (MDM2) gene promoter SNP309 T＞G polymorphism and the susceptibility of gastrointestinal cancer.Methods The China National Knowledge Infrastructure (CNKI),WanFang database,SpringerLink database and PubMed were retrieved to get all case-control research literatures (2005-2012) on the relationship of MDM2 gene SNP309 T＞G and gastrointestinal cancer susceptibility.Meta-analysis with RevMan 4.2 was used to combine OR values of the relationship between SNP309 T＞G and gastrointestinal cancer susceptibility.A sensitivity analysis and tested publication bias were made with all selected literatures' data.Results A total of 17 domestic and foreign qualified papers were included in this study.Twenty case-control studies including 5 183 cases and 6 660 controls were identified for the present meta-analysis.A significant association was detected between the MDM2 SNP309 T＞G polymorphism and gastrointestinal cancer risk.The meta-aualysis showed that the combined odds ratio (OR) for GG genotype was 2.23 (95 ％ CI =1.73-2.89,P ＜ 0.01) compared with that for TG + TT genotypes.There was no statistical significance for the evaluation of publication bias.Conclusion The GG genotype of MDM2 SNP309 may increase gastrointestinal cancer risk in Asians.

Objective To investigate the distribution of-6411A/G (rs208679) polymorphism in the 5' region of catalase (CAT) gene among Han population in Chongqing and its correlation with noiseinduced hearing loss (NIHL).Methods A total of 225 healthy volunteers (normal control group) and 237 noise exposure cases (noise exposure group) were collected from the unrelated Han people in Chongqing.The noise exposure group were further divided into non-deaf group (n =170) and deaf group (n =67) according the presence or absence of NIHL.rs208679 polymorphism in the 5' region of CAT gene was identified using the improved multiplex ligation detection reaction (iMLDR) technique.Genotypes,allelic frequencies and clinical deaf incidence were compared among groups.Results Three genotypes (AA,AG,and GG) were detected in the rs208679 locus.Frequencies of A and G alleles in normal control group and noise exposure group were 0.76 and 0.24 respectively.Genotype distribution in normal control group and noise exposure group showed no deviation from the Hardy-Weinberg equilibrium (P ＞0.05).There were no significant differences in gene polymorphism (AA,AG,and GG) and allelic frequencies (A and G) between normal control group and noise exposure group and between deaf group and non-deaf group (P ＞ 0.05).However,significant difference was observed between deaf group and non-deaf group in recessive analysis (GG vs AG + AA,P ＜ 0.05).Conclusion rs208679 is the predisposing gene to NIHL and can be used as the biomarker for NIHL susceptibility.