Objective: To explore the application of photodynamic therapy (PDT) combined with orally administered retinoic acid in the treatment of proliferative verrucous leukoplakia (PVL) and provide a reference for clinical practice. Methods: A case of sequential treatment of PVL with PDT and orally administered retinoic acid was reported. The characteristics, diagnosis, treatment of PVL, and the application of PDT and retinoic acid in oral leukoplakia were retrospectively analyzed based on the literature. Results: After four PDT sessions, a majority of the oral lesions were eliminated in a patient clinically diagnosed with PVL, but the lesions recurred two months later. Subsequently, the patient was treated with retinoic acid at a dose of 10 mg, once a day, orally before bedtime. After continuous treatment for 2 weeks, the oral lesions were significantly reduced. The dose was then adjusted to 10 mg, twice a day, and the treatment was extended for 3 months until the lesions completely disappeared. Following this, a periodic regimen was adopted to continue the administration of retinoic acid at a dose of 10 mg, twice a day (3 weeks of treatment followed by 1 week of drug withdrawal as one cycle), for a total of 6 cycles. No recurrence was observed during the 5-month follow-up after drug withdrawal. A review of the literature indicates that PVL is an oral potentially malignant disorder (OPMD) characterized by multifocality, high recurrence rate, and high malignant transformation rate. Currently, there is no ideal treatment method for PVL. PDT is advantageous because of its low toxicity. Furthermore, it is strongly selective, minimally invasive, and patients experience no scarring. Thus, it has been recommended as the first-line therapy for PVL. However, due to the limitations of local application of photosensitizers in terms of effectiveness, targeting, and penetration depth, the efficacy of PDT in treating PVL remains uncertain. There are a few reports on the treatment of oral leukoplakia with retinoic acid given by oral, but no literature has reported the combination of PDT and retinoic acid given by oral for PVL. Conclusion The sequential combination of PDT and oral retinoic acid therapy is an effective treatment for PVL.

OBJECTIVE To discuss the participation of clinical pharmacists in rational drug use management by informatization clinical pathway under diagnosis related groups(DRGs) background by taking glycyrrhizic acid injection as an example. METHODS Based on the PDCA cycle theory, the evaluation scheme was established to find the problems in the use of glycyrrhizic acid injection in Jinhua Municipal Central Hospital, and the necessity of glycyrrhizic acid injection in the pathway was determined according to the needs of diagnosis and treatment, and the elimination and maintenance were carried out. The rational rate of drug use and the changes of monitoring indexes were compared before and after intervention in the same period(Q2 2021 vs Q2 2022). RESULTS Compared with the same period in 2021, the rational use rate of glycyrrhizic acid injection increased to a certain extent in the second quarter of 2022, and the utilization rate, the number of intravenous administration per capita per day, the intensity of use and the average drug cost per case all decreased. CONCLUSION Under the background of DRGs, the participation of clinical pharmacists in rational drug use by informatization clinical pathway can reduce the irrational use of glycyrrhizic acid injection and reduce the hospital monitoring index.

ObjectiveTo investigate the prevalence of stroke in Songjiang District from 2017 to 2022, to analyze the epidemiological characteristics of stroke incidence, so as to provide a scientific basis for the formulation of stroke prevention and control policies. MethodsData of new stroke incidence from 2017 to 2022 in Songjiang District were obtained from the Shanghai Stroke and Acute Myocardial Infarction Registration and Reporting Information System. In addition, different classifications such as time of onset, gender, age group and types of stroke, were statistically analyzed. Statistical indicators, such as the number of incidence, crude incidence rate, standardized incidence rate and average age of incidence were calculated simultaneously. Joinpoint software were used to calculate the annual change percentage (APC) and the trend of stroke incidence in Songjiang District. ResultsFrom 2017 to 2022, the newly reported cases of stroke were 12 988 in Songjiang District, the crude incidence rate was 325.76/10⁵, and the standardized incidence rate was 127.58/10⁵. The crude incidence rate and standardized incidence rate in males were 363.45/10⁵ and 157.17/10⁵, respectively, but 288.68/10⁵ and 99.02/10⁵ in females. The mean age of onset was (73.12±11.75) years, of which the mean age of onset was (70.86±11.96) years for men and (75.91±10.85) years for women. The incidence of stroke increased with age, rising rapidly after 60 years and reaching a peak in the age group of ≥ 80 years old. The crude incidence rate and standardized incidence rate of stroke in Songjiang District showed a downward trend from 2017 to 2022, with an APC of -6.20% and -8.01%, respectively (P=0.018, 0.007). The newly reported stroke was dominated by ischemic stroke, accounting for 82.81% of the total cases, with a crude incidence rate of 269.77/10⁵ and a standardized rate of 103.84/10⁵. The incidence of stroke presented seasonal characteristics, with the highest incidence in winter, accounting for 26.11% of the whole year. ConclusionThe incidence rate of stroke in Songjiang District shows a declined trend, but the overall incidence is still at a high level. The situation of prevention and control is still serious, with a heavy disease burden. It is necessary to strengthen health education and disease management for the elderly.

Objective To investigate the efficacy of hypofractionated radiotherapy (HFRT) combined with programmed cell death protein-1/programmed cell death ligand-1 (PD-1/PD-L1) inhibitors in sequential with granulocyte-macrophage colony-stimulating factor (GM-CSF) and interleukin-2 (IL-2) for the treatment of advanced metastatic solid tumors. Methods A prospective single-center single-arm study was designed for patients failed standard treatments for advanced refractory solid tumors in the Department of Radiotherapy of Jiangyin Hospital affiliated to Nantong University, and eligible patients were given quadruple therapy: HFRT (5 to 8 Gy × 2 to 3 f) once every 21 days for at least 2 cycles; 200 μg GM-CSF from the 1st to 7th day of radiotherapy, and 2 million IU IL-2 from the 8thto 14th day. Within 1 week after the completion of HFRT, PD-1/PD-L1 inhibitors were used for treatment. The above treatment strategy was repeated. GM-CSF and IL-2 were treated for 6 cycles, followed by maintenance with PD-1/PD-L1 inhibitors until disease progression (PD) or intolerable toxicity occurred. Objective response rate (ORR) and treatment-related adverse events were analyzed. Results From January 9, 2021 to June 15, 2023, totally 40 patients were enrolled, with follow-up of 2.8 to 31.0 months and a median follow-up of 9.9 months, and 39 patients (97.5%) completed at least one time tumorsite evaluation within the non-radiotherapy target area. 97.5% of patients had cancers, 2.5% had soft tissue sarcomas, and 20.0% had received immune checkpoint inhibitors (ICIs) at baseline check. The ORR was 30.8%, and the disease control rate (DCR) was 71.8%; the ORR for non-small cell lung cancer (NSCLC) was 28.6%, and the DCR was 57.1%; the ORR for colorectal cancer was 14.3%, and the DCR was 71.4%; the ORR for gastric cancer was 16.7%, and the DCR was 66.7%; 28 patients (70.0%) had treatment-related adverse events (TRAE), 4 patients (10%) had TRAE≥level 3, and the most common types of TRAE were fatigue, fever and hypothyroidism. Conclusion The treatment of HFRT combined with immune checkpoint inhibitors in sequential with GM-CSF and IL-2 is well tolerated and toxicity accepted in patients with advanced metastatic solid tumors, which may provide a new method for salvage treatment of patients with advanced metastatic solid tumors.

Radiotherapy, as an important means of tumor treatment, plays a significant role in the treatment of cervical cancer. However, the ovaries are highly sensitive to radiation, which is prone to appear radiation-related injuries, leading to ovarian dysfunction and loss of fertility in young female patients, seriously affecting their physical and mental health. The degree of ovarian injury is influenced by various factors such as the dose, volume, and duration of radiation exposure to the ovaries, as well as the patient's age. Ovarian displacement and advancements in radiotherapy techniques can significantly relieve radiation-related ovarian injury. Currently, drug protection techniques are still immature, and new fertility preservation methods are receiving increasing attention but require further improvement. This article reviewed the research progress in the molecular mechanisms, prevention strategies, and new fertility preservation techniques for ovarian injury related to cervical cancer radiotherapy, aiming to provide a reference for ovarian function protection during radiotherapy for young cervical cancer patients.

Humans ; Nerve Tissue Proteins ; Epithelial-Mesenchymal Transition/genetics* ; Constriction, Pathologic ; Receptors, Immunologic ; Epithelial Cells/metabolism* ; Smad3 Protein/metabolism* ; Transforming Growth Factor beta1/metabolism*

Fibrosis is a repair response initiated by tissues and organs after injury, and is a self-protection mechanism of the body. It has been found that endothelium-to-interstitial transdifferentiation (EndMT) is involved in the physiological and pathological processes of various organ fibrosis, which has become a focus of the research on fibrotic diseases. In recent years, the study has found that EndMT plays an important role in many pathological processes in cardiovascular system, lungs, kidneys, liver, pancreas fibrosis, and so on. This article summarizes EndMT regulatory mechanism and its role in each organ fibrosis, as well as the related treatment progress of EndMT targets, so as to provide new targets for prevention and control of organ fibrosis.

ObjectiveTo analyze the HIV infection characteristics and influencing factors among the spouses of HIV/AIDS patients in Shanghai. MethodsA cross-sectional survey was conducted to collect demographic， behavioral， epidemiological and spousal HIV detection information of newly reported and married patients with HIV/AIDS in Shanghai from January 2018 to July 2022 in the comprehensive HIV prevention and control information system of Chinese Center for Disease Prevention and Control. Descriptive analysis was used to analyze the HIV positivity rate of the spouses of HIV patients and the influencing factors were analyzed by univariate and multivariate logistic regression models. ResultsA total of 1 233 subjects were investigated， and the first HIV-testing positivity rate of the spouses of HIV/AIDS patients was 29.3% （361/1 233）. There were statistically significant differences in the HIV-testing positivity rate among spouses of HIV/AIDS patients by different age， gender， education level， occupation， transmission route， quantity of non-marital sexual activities， quantity of homo-sexual activities， and baseline CD4 cell count level （P<0.05）. Spouses of the HIV/AIDS patients aged ≥65 years old， female， heterosexual transmission， less non-marital sex， and no history of homosexual sex had relatively high HIV positive rate. The HIV-positive detection rate of spouses in the ≥65 age group was 1.81 times higher than that in the <45 age group. The HIV-positive detection rate of spouses in the female group was 3.66 times higher than that in the male group， and the HIV-positive detection rate of spouses in the homosexual transmission group was 0.25 times higher than that of the heterosexual transmission group. ConclusionRisk awareness of HIV infection among married people with spouses should be improved. The key populations with the characteristics such as females as the first HIV-positive reporter， and heterosexual transmission should be paid special attention.Their spouses should be mobilized to conduct HIV-testing as early as possible

Objective:To understand the prevalence of arboviruses in mosquito samples in Xichang City, Sichuan Province, and enrich the data of arbovirus activity and genetic characteristics in southwestern Sichuan Province.Methods:In June 2018, the nucleic acid was extracted from Culex tritaeniorhynchus mosquitoes collected from different pigsties in three villages and suburbs of Xichang City. The specific primers of Yunnan orbivirus, Banna virus, Tibet orbivirus (S7, S10), Flavivirus and alphavirus were used for quantitative polymerase chain reaction examination, and the positive product was cloned for sequencing analysis. Results:A total of 9 012 mosquitoes were collected, of which Cx. tritaeniorhynchus was the dominant species. A number of 88 batches of these mosquitoes were amplified, and 2 strains of Japanese encephalitis virus (JEV), 7 strains of Banna virus (BAV), 7 strains of Tibet orbivirus (TIBOV) and 1 strain of Yunnan orbivirus virus (YOUV) were detected, respectively. By the results of cluster analysis and evolutionary tree analysis, the 17 newly found virus strains were close to the Yunnan isolates, and 2 JEV strains were located in the GI-b clade. The other 7 strains of BAV were A2 evolutionary clades. Of the 7 TIBOV plants, 6 were located in the same clade. One TOUV was in the same clade as the Yunnan strain. Conclusions:Culex tritaeniorhynchus mosquitoes in Xichang city might carry JEV, BAV, YOUV and TIBOV, among them JEV was GI-b type and BAV was A2 type. The results provide data supporting the detection and analysis of arboviruses in Xichang city.

Objective: To explore the relative risks of rotavirus diarrhea after exposure to different levels of atmospheric pressure in children in Guangzhou City, so as to provide reference for improving public awareness of high atmospheric pressure exposure. Methods: The study used the China Notifiable Communicable Diseases Network System and China Meteorological Science Data Sharing Service Network to collect meteorological data and data relating to daily cases of rotavirus diarrhea in children at Guangzhou Women and Children s Medical Center from 2012 to 2020. The association between rotavirus diarrhea and atmospheric pressure was analyzed using distributed lag non linear models (DLNM). The relative risks of different sex and age sub groups exposed to different atmospheric pressures were also evaluated. Results: A total of 18 587 cases of rotavirus diarrhea were reported from 2012 to 2020, among which 11 662 cases (62.7%) were boys, and 12 582 cases (67.7%) were children aged 6 to 24 months old, which represented the highest proportion. The results of the DLNM showed that the relative risk of rotavirus diarrhea was the highest on the day of exposure to extreme high atmospheric pressure ( RR =1.50, 95% CI =1.24-1.82, P <0.05) and the effect could last for 28 days. Risk of rotavirus diarrhea was low for exposure to low pressure within 2 weeks ( P <0.05). During extremely high atmospheric pressure weather, RR was higher in girls ( RR =3.31, 95% CI =1.46-7.49， P <0.05) than that in boys ( RR =1.98, 95% CI =0.96-4.07， P >0.05). Among different age sub groups, RR was the highest in children aged 24 to 60 months after exposure to the highest level of atmospheric pressure exposure ( RR =3.36, 95% CI =1.27-8.89, P <0.05). Conclusion In Guangzhou, exposure to high pressure increases the risk of rotavirus diarrhea in children. In the future, public awareness should be raised regarding the risk after exposure to high atmospheric pressure.