Objective:To explore the impact of home enteral nutrition (HEN) on the treatment strategy of patients with high position intestinal fistula.Methods:The clinical and follow-up data of 36 patients with high position intestinal fistula requiring HEN treated in Beijing Tsinghua Changgung Hospital from Jan 2021 to Sep 2023 was retrospectively analyzed.Results:Among the 36 cases, 2 had indwelling nasogastric tubes, 12 had indwelling nasojejunal nutritional tubes, and 22 had percutaneous jejunostomy. The incidence of HEN-related complications in patients was 13.9%, and there were no serious catheter complications.During HEN, high position intestinal fistula healed in 19 cases (52.8%), returned to the hospital for the next stage of intestinal fistula treatment in 11 cases (30.6%), needed to return to the hospital for nutritional support in 1 case (2.8%), and intestinal fistula aggravated to terminate HEN in 2 cases (5.6%).Conclusion:Under the management of professional team, HEN via nasogastric/jejunal nutritional tube or percutaneous jejunostomy is safe and feasible in patients with high intestinal fistula.

Objective To explore the effect of CD8+T cell subsets on the formation of atheroscle-rosis(AS)in mice.Methods Lasso regression and random forest were employed to identify key infiltrating immune cells in AS blood vessels.Apolipoprotein E gene(ApoE)/recombination acti-vation gene 1(Rag1)double knockout(ApoE/Rag1-DKO)mice were constructed,and then fed with high-fat chow to establish an AS model.The ApoE knockout mice were divided into control group(Con group)and high-fat diet group(HFD group),with 3 mice in each group.And the ApoE/Rag1-DKO mice were divided into DKO+S group[(high-fat diet+phosphate buffer saline(PBS)],DKO+Tem group(high-fat diet with CD8+Tem cell infusion),and DKO+Temra group(high-fat diet with CD8+Temra cell infusion),with 3 mice in each group.Oil red O staining and HE staining were conducted to observe the formation of AS plaques in the vascular walls in the Con,HFD,DKO+S,DKO+Tem,and DKO+Temra groups respectively.Results The results of Lasso regression and random forest showed that CD8+Tem was the most important CD8+T cell subset in the formation of AS.Oil red O staining and HE staining displayed that compared with the Con group,the AS plaque area were significantly larger in the HFD group(P＜0.05);com-pared with the HFD group,there was no significant increase in the AS plaque area in the DKO+S group(P＞0.05);compared with the DKO+S group,the AS plaque area were notably increased in the DKO+Tem group and the DKO+Temra group(P＜0.05).Conclusion CD8+T cell sub-sets are closely associated with the formation of AS in mice,and CD84 Tem and CD84 Temra cells significantly induce the formation.

Background: and Purpose Patients presenting with clinical characteristics that are strongly suggestive of neuromyelitis optica spectrum disorders (NMOSD) have a high risk of developing definite NMOSD in the future. Little is known about the clinical course, treatment, and prognosis of these patients with likely NMOSD at disease onset. Methods: This study prospectively recruited and visited 24 patients with the limited form of NMOSD (LF-NMOSD) at disease onset from November 2012 to June 2021. Their demographics, clinical course, longitudinal aquaporin-4 immunoglobulin G (AQP4-IgG) serology, MRI, therapeutic management, and outcome data were collected and analyzed. Results: The onset age of the cohort was 38.1±12.0 years (mean±standard deviation). The median disease duration was 73.5 months (interquartile range=44.3–117.0 months), and the follow-up period was 54.2±23.8 months. At the end of the last visit, the final diagnosis was categorized into AQP4-IgG-seronegative NMOSD (n=16, 66.7%), AQP4-IgG-seropositive NMOSD (n=7, 29.2%), or multiple sclerosis (n=1, 4.2%). Seven of the 24 patients (29.2%) experienced conversion to AQP4-IgG seropositivity, and the interval from onset to this serological conversion was 37.9±21.9 months. Isolated/mixed area postrema syndrome (APS) was the predominant onset phenotype (37.5%). The patients with isolated/mixed APS onset showed a predilection for conversion to AQP4-IgG seropositivity. All patients experienced a multiphasic disease course, with immunosuppressive therapy reducing the incidence rates of clinical relapse and residual functional disability. Conclusions Definite NMOSD may be preceded by LF-NMOSD, particularly isolated/ mixed APS. Intensive long-term follow-up and attack-prevention immunotherapeutic management is recommended in patients with LF-NMOSD.

Pure drug-assembled nanomedicines (PDANs) are currently under intensive investigation as promising nanoplatforms for cancer therapy. However, poor colloidal stability and less tumor-homing ability remain critical unresolved problems that impede their clinical translation. Herein, we report a core-matched nanoassembly of pyropheophorbide a (PPa) for photodynamic therapy (PDT). Pure PPa molecules are found to self-assemble into nanoparticles (NPs), and an amphiphilic PEG polymer (PPa-PEG

Tumor metastasis is responsible for chemotherapeutic failure and cancer-related death. Moreover, circulating tumor cell (CTC) clusters play a pivotal role in tumor metastasis. Herein, we develop cancer-specific calcium nanoregulators to suppress the generation and circulation of CTC clusters by cancer membrane-coated digoxin (DIG) and doxorubicin (DOX) co-encapsulated PLGA nanoparticles (CPDDs). CPDDs could precisely target the homologous primary tumor cells and CTC clusters in blood and lymphatic circulation. Intriguingly, CPDDs induce the accumulation of intracellular Ca

Objective: To detect the enterovirus VP4 and VP1 genes in 510 stool samples collected from hand, foot and mouth disease (HFMD) cases and analyze the phylogenetic characteristics of the entire VP1 genes of coxsackievirus A6 (CV-A6) strains in six prefectures/cities of Yunnan Province in 2018. Methods: Viral RNA was abstracted from the stool samples. VP4 gene sequences were amplified by RT-PCR and sequenced using the MD91/OL68-1 primer pair to identify viral genotypes. Whole VP1 gene sequences were amplified and sequenced using appropriate primer pairs. The whole VP1 gene sequences of CV-A6 reference strains were downloaded from GenBank. MEGA5.2 software was used to analyze the similarity in nucleotide and amino acid sequences between different strains and phylogenetic tree was constructed for analysis of genetic characteristics and molecular epidemiology. Results: VP4 and VP1 gene sequences were obtained from 57 out of 510 stool samples with a positive rate of 11.17% (57/510). There were 43 CV-A6 (8.43%, 43/510), six CV-A10 (1.17%, 6/510), two enterovirus A71 (EV-A71, 0.39%, 2/510) and two CV-A9 (0.39%, 2/510) strains. The other four strains were CV-A4 (0.19%, 1/510), CV-A5 (0.19%, 1/510), CV-B1 (0.19%, 1/510) and E11 (0.19%, 1/510). The phylogenetic analysis showed that all 43 CV-A6 strains belonged to sub-genotype D3. Conclusions In the 510 HFMD samples, CV-A6 strains were mostly detected with a detection rate of 8.43% and accounted for 75.44% (43/57) of all isolates, followed by CV-A10 (1.17%, 6/510) and EV-A71 (0.39%, 2/510). There was a large HFMD outbreak mainly caused by CV-A6 in Yunnan Province in 2018. The outbreak was caused by CV-A6 of sub-genotype D3, as was the case with pervious outbreaks in China.

Objective To isolate and analyze the genetic characteristics of a new strain of entero-virus EV-C99 from a healthy child in Yunnan Province in 2016. Methods Virus isolation was performed ac-cording to the World Health Organization ( WHO) recommended procedures. Viral RNA was extracted from the supernatant of cell culture. RT-PCR and sequencing analysis of VP1 gene were used for virus identifica-tion. VP1 sequence was edited and stitched by Sequencher 5. 0 software. The edited sequence was BLAST searched in GenBank and the preliminary result indicated that it was an EV-C99 virus. Nucleotide (nt) and amino acid (aa) identities were calculated by MEGA5. 2 software. Serotype of the virus was identified ac-cording to the standard for enterovirus sequence typing. Results The virus could be amplified by 494/496 and 495/497 primer pairs and the edited sequence was about 1 200 bp. Result of the " BLAST" search showed that it was a new strain of enterovirus EV-C99. Comparative analysis with the prototype strain BAN00-10461 (GenBank ID:EF015008) by MEGA5. 2 software showed that the VP1 gene of that virus was 909 bp and the identities between them were 77. 05% in nt sequence and 90. 04% in aa sequence. According to the standard for enterovirus sequence typing,the virus was a new strain of enterovirus EV-C99 belonging to hu-man enterovirus species C (EV-C). Conclusion A new strain of enterovirus EV-C99 was isolated during an investigation of enteroviruses among healthy children in Yunnan Province in 2016. To our knowledge,this is the third report of EV-C99 in China. Phylogenetic analysis reveals that the EV-C99 Yunnan strain,Xinjiang strains and Shandong strains all belong to genotype B,but group into different clusters,indicating that Chinese strains have diverse genetic characteristics.

Objectives To study the clinical effects of percutaneous kyphoplasty on senile osteoporotic vertebral body compression fractures.Methods The 87 elderly patients with osteoporotic vertebral body compression fractures were randomly grouped into control group (n=42) treated with percutaneous vertebroplasty and observation group (n=45) treated with percutaneous kyphoplasty in our hospital from June 2013-March 2016.And the clinical curative effect before and after treatment was compared and analyzed.Results The visual analog scale (VAS) pain score in observation group versus control group was (8.49±2.86) vs.(8.56±2.98),(t=0.11,P>0.05) before treatment,and[(2.58±1.34) vs.(3.34±2.01),t=2.09,P< 0.05],[(2.06±0.97) vs (3.87±1.96),t=5.51,P<0.05]and[(1.09±0.89) vs (2.37±1.29)],t=5.42,P<0.05]at 1 week,4 weeks,and 12 weeks after treatment respectively,showing statistically significant improvement after treatment.The data of kyphosis angle by using Cobb angle,Oswestry lumbar dysfunction index (ODI),mean time of postoperative ambulation,and mean postoperative hospital stay were similar to that of the visual analog scale (VAS) pain score,showing statistically significant improvement after treatment (all P<0.05).The incidence[cases (%)]of bone cement leakage was lower in observation group[3(6.7)]than in control[9(21.4)](χ2=3.98,P<0.05).Conclusions Clinical treatment effects of percutaneous kyphoplasty on the elderly patients with osteoporotic vertebral body compression fractures are superior to that of percutaneous vertebroplasty.Percutaneous kyphoplasty can effectively relieve pain,and improve body function disorders and the quality of life.

Objective To investigate the enterovirus ( EV)-carrying status and the circulating se-rotypes in healthy children from inner and border areas of Yunnan Province in 2014 and 2015 and to analyze the genetic characteristics of echovirus 6 (ECHO6), ECHO25 and ECHO11 strains. Methods Stool sam-ples were collected from children less than 15 years old living in 6 to 7 counties of 3 inner prefectures/cities and 8 to 9 counties of border prefectures/cities. Altogether 921 samples were collected including 453 sam-ples in 2014 (213 samples in inner counties and 240 samples in border counties) and 468 samples in 2015 (195 samples in inner counties and 273 samples in border counties). Viruses were isolated from the stool samples and their serotypes were identified by gene sequencing. Results The numbers of EV strains isola-ted from the samples collected in inner counties and border counties in 2014 were 20 ( isolating rate:9.39%, 20/213) and 16 (isolating rate: 6. 67%, 16/240), respectively. The overall isolating rate for 2014 was 7. 95% (36/453). The predominant species was enterovirus B, accounting for 88. 89% of all iso-lated strains (32/36), followed by enterovirus A species (11. 11%, 4/36). No strains of enterovirus spe-cies C (including poliovirus) and D was detected in 2014. In total, 46 EV strains were isolated in 2015 with an overall isolating rate of 9. 83% (46/468), including 13 strains in inner counties (isolating rate:6. 67%, 13/195) and 33 strains in border counties (isolating rate:12. 09%, 33/273). Most of the strains were enterovirus B species, accounting for 78. 26% (36/46), followed by enterovirus C species (19. 57%, 9/46) and enterovirus A species (2. 17%, 1/46). Altogether 82 EV strains were isolated in 2014 and 2015 with an isolating rate of 8. 90% (82/921), of which 33 strains were isolated in inner counties (8. 09%, 33/408) and 49 strains were isolated in border counties (9. 55%, 49/513). Among the 82 EV strains, 9 strains were polioviruses (0. 98%, 9/921) and all of them were Sabin-like polioviruses. The rest of the strains were non-polio enterovirus (7. 93%, 73/921). Conclusion In 2014, the EV isolating rate in inner counties (9. 39%) was higher than that in border counties (6. 67%). However, the EV isolating rate in border counties (12. 09%) was higher than that in inner counties (6. 67%) in 2015. Enterovirus B was the predominant species in both 2014 and 2015. No wild type polioviruses and enterovirus D species were detec-ted. Polio-free status was maintained well in Yunnan Province.

Objective To investigate the virus-carrying rate of non-polio enteroviruses ( NPEV) in patients with acute flaccid paralysis ( AFP) in Yunnan province of China in 2015 and to analyze the genetic characteristics of enterovirus 71 (EV71) strains. Methods A total of 213 cases under 15 years old with AFP were reported by Center for Disease Control and Prevention ( CDC) of Yunnan Province of China. Virus isolation was conducted for all samples and the serotypes of isolated NPEV strains were identified by VP1 se-quencing. The isolation rates of NPEV in the past consecutive 5 years were analyzed by SPSS22. 0 software. Phylogenetic trees of NPEV and EV71 strains were constructed by MEGA6. 06 software based on neighbor-joining algorithm and Kimura 2-parameter substitution model and the reliability of the phylogenetic trees was determined by bootstrap analysis with 100 pseudo replicate datasets. Results Altogether, 23 NPEV strains were isolated from 213 AFP cases. Among the 23 strains, 7 strains belonged to EV-A group (2 serotypes, 6 strains of which were EV71 ) , 14 strains belonged to EV-B group ( 8 serotypes ) and the other 2 strains belonged to EV-C group. No NPEV strains of EV-D group were identified. Statistical analysis showed that no significant differences in the isolation rates were observed in the past 5 years ( P=0. 101 ) . Conclusion The isolation rate of NPEV in patients with AFP in Yunnan province in 2015 was similar to that of the previ-ous years. The EV71 strains of C4 subgenotype were the predominant strains circulating in Yunnan province.