Humans ; Carcinoma, Hepatocellular/drug therapy* ; Liver Neoplasms/drug therapy* ; Biological Products/therapeutic use* ; B7-H1 Antigen

Hemangioma of the penile head is rare. This paper reported a patient, 16 years old, who was admitted to hospital due to the discovery of multiple masses on the head of the penis for more than two years. Physical examination showed that three vascular mass-like masses were distributed along the coronal sulcus at the 3, 9, and 12 points of the penile head, and the larger one was about 10 mm×5 mm size, blue-purple, soft, and painless. Ultrasound examination suggested that the patient had a penile head hemangioma. Surgical resection was performed, and the postoperative pathological diagnosis was penile head hemangioma.The follow-up of 3 months showed that the wound healed well without recurrence, and the penile head appearance was not obviously deform.

Objective To investigate the efficacy of transcranial direct current stimulation(tDCS)on sleep disorder in patients with Parkinson's disease(PD).Methods From July 2021 to July 2023,patients with PD and sleep disorders in the Department of Neurosurgery of the Second People's Hospital of Guangdong Province were selected.The enrolled patients were divided into sham stimulation group(n=28)and true stimulation group(tDCS)(n=29)according to the inclusion and exclusion criteria.MDS-UPDRS,PDSS and other rating scales were used to evaluate the patients.Before and after tDCS treatment,MS-11 was used for intelligent sleep monitor-ing.The baseline and improvement of sleep disorders in the two groups before and after treatment were analyzed.Results Before tDCS treatment,there was no significant difference in general conditions and scale scores between the two groups(P＞0.05).There was no significant difference in polysomnographic monitoring results between the two groups before treatment(P＞0.05).Compared with pre-treatment,there was no significant difference in sleep monitoring results in the sham stimulation group(P＞0.05),while the sleep duration and sleep efficiency signifi-cantly increased,the nighttime awakening duration,nighttime awakening frequency,MDS-UPDRS-Ⅲ score,and LEDD dose significantly decreased in the true stimulation group,with statistical significance(P＜0.05).Conclusion Pharmacological treatment combined with tDCS treatment is effective for sleep disorders and motor function in patients with PD,which could increase the sleep duration and sleep efficiency of PD patients with sleep disorders to a certain extent,reduce the nighttime awakening duration and frequency,thereby improving the fatigue symp-toms during the daytime,and improving the efficacy of conventional pharmacological treatment for PD.

Objective To explore the clinical effect of Shenfu injection combined with ulinastatin in the adjuvant treatment of septic shock.Methods Ninety-one patients with septic shock treated in Handan Central Hospital from January 2022 to June 2023 were selected as the study objects,and were divided into treatment group(47 cases)and control group(44 cases)according to random number table method.Both groups were given conventional treatment,the control group was given ulinastatin injection,and the treatment group was given Shenfu injection combined with ulinastatin injection.The levels of superoxide dismutase(SOD),malondialdehyde(MDA),nitric oxide(NO),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)before treatment and 1,3 and 7 days after treatment,as well as the time of admission to emergency intensive care unit(EICU)and 28 days mortality were compared between two groups.Results The duration of EICU stay in treatment group was significantly shorter than that in control group,and the 28 days mortality was significantly lower than that in control group(P＜0.05).After 1,3 and 7 days of treatment,the serum levels of TNF-α,IL-6,MDA and NO in two groups were significantly lower than before treatment,the SOD level in treatment group was significantly higher than before treatment,and the SOD level in control group first decreased and then increased(P＜0.05).The serum levels of TNF-α,IL-6,MDA and NO in treatment group were significantly lower than those in control group,and the level of SOD was significantly higher than that in control group(P＜0.05).Conclusion On the basis of conventional treatment,Shenfu injection combined with ulinastatin can further inhibit the release of inflammatory factors,reduce the level of oxidative stress,shorten the time of patients staying in EICU,reduce the 28d mortality,and provide a new idea for the treatment of septic shock.

Cancer stands as one of the predominant causes of mortality globally, necessitating ongoing efforts to develop innovative therapeutics. Historically, natural products have been foundational in the quest for anticancer agents. Bulbocodin D (BD) and Bulbocodin C (BC), two bibenzyls derived from Pleione bulbocodioides (Franch.) Rolfe, have demonstrated notable in vitro anticancer activity. In human lung cancer A549 cells, the IC_50s for BD and BC were 11.63 and 11.71 μmol·L^-1, respectively. BD triggered apoptosis, as evidenced by an upsurge in Annexin V-positive cells and elevated protein expression of cleaved-PARP in cancer cells. Furthermore, BD and BC markedly inhibited the migratory and invasive potentials of A549 cells. The altered genes identified through RNA-sequencing analysis were integrated into the CMap dataset, suggesting BD's role as a potential signal transducer and activator of transcription 3 (STAT3) inhibitor. SwissDock and MOE analyses further revealed that both BD and BC exhibited a commendable binding affinity with STAT3. Additionally, a surface plasmon resonance assay confirmed the direct binding affinity between these compounds and STAT3. Notably, treatment with either BD or BC led to a significant reduction in p-STAT3 (Tyr 705) protein levels, regardless of interleukin-6 stimulation in A549 cells. In addition, the extracellular signal-regulated kinase (ERK) was activated after BD or BC treatment. An enhancement in cancer cell mortality was observed upon combined treatment of BD and U0126, the MEK1/2 inhibitor. In conclusion, BD and BC emerge as promising novel STAT3 inhibitors with potential implications in cancer therapy.
Humans ; Lung Neoplasms/metabolism* ; STAT3 Transcription Factor/metabolism* ; Antineoplastic Agents/chemistry* ; A549 Cells ; Apoptosis ; Cell Line, Tumor ; Cell Proliferation

Objective:To compare the efficacy and safety of programmed death-1(PD-1)inhibitors in combination with chemotherapy versus chemotherapy alone in patients with metastatic bladder cancer.Methods:A retrospective analysis was performed on the clinical data of 77 cases of metastatic bladder cancer who were admitted to the First Affiliated Hospital of Zhengzhou University from January 2014 to October 2022. According to the different clinical treatment regimens, they were divided into two groups. Patients treated with PD-1 inhibitors combined with gemcitabine and cisplatin (GC) regimen were referred to as IGC group, and patients who received GC chemotherapy alone were referred to as GC group. There were 24 cases in IGC group, including 18 males and 6 females, with a median age of 60 (56, 67) years old. Seventeen cases had a history of smoking. Fifteen cases had an Eastern Cooperative Oncology Group (ECOG) score of 0 and 9 cases had a score of 1. Twenty-three cases suffered distant metastasis (stage M 1). Two cases suffered lymph node metastasis only, 6 cases with liver metastasis, 8 cases with lung metastasis, and 8 cases with bone metastasis. There were 53 cases in GC group, including 45 males and 8 females, with a median age of 63 (55, 69) years old. Thirty-one cases had a history of smoking. Thirty cases had an ECOG score of 0 and 23 cases had a score of 1, 48 cases suffered stage M 1, 2 cases suffered lymph node metastasis only. Nineteen cases suffered liver metastasis. Twenty-seven cases suffered lung metastasis. And 23 cases suffered bone metastasis. There was no statistically significant difference in the above general information between the two groups ( P>0.05). Kaplan-Meier method was used to plot the survival curves, and the difference of median progression-free survival (mPFS) and median overall survival (mOS) between the two groups was compared by log-rank test. Finally, the difference in adverse reactions between the two groups was compared. Results:The objective response rate (ORR) was 41.7% and the disease control rate (DCR) was 87.5% in the IGC group.As a comparison, the ORR was 43.4% and the DCR was 83.0% in the GC group. The differences in ORR ( P=0.887) and DCR ( P=0.871) between the two groups were not statistically significant. All patients were followed up for 3 to 45 months, with a median follow-up time of 24 (14, 43) months. The mPFS was 7.0 (95% CI 5.7-8.3) months in the GC group and 8.0 (95% CI 3.0-13.1) months in the IGC group, and the difference was statistically significant between the two groups ( P=0.026). The mOS of patients in the GC group was 16.0 (95% CI 14.4-17.6) months, the mOS was not yet reached in the IGC group, and patients in the IGC group had longer mOS with a statistically significant difference ( P=0.022). All patients experienced treatment-related adverse reactions. Grade 3-4 adverse reactions occurred in 8 cases (33.3%) in the IGC group and in 16 cases (30.2%) in the GC group, and no adverse reaction-related deaths were observed( P=0.992). The most common adverse reactions in both groups were anemia, including 18 cases (75.0%) in IGC group and 38 cases (71.7%) in GC group. There were 4 cases (16.7%) of grade 1-2 hypothyroidism in the IGC group but no patients with hypothyroidism were found in the GC group, and the difference was statistically significant ( P=0.012). There were 8 cases (33.3%) and 4 cases (7.5%) of grade 1-2 skin adverse reactions in the IGC and GC groups, respectively, and the difference was statistically significant ( P=0.011). The immune-related adverse reactions of PD-1 inhibitors in IGC group were 1 case of hyperthyroidism (4.2%), 4 cases of hypothyroidism (16.7%), 1 case of adrenal insufficiency (4.2%), and 1 case of immune colitis (4.2%). Conclusions:Compared with chemotherapy alone, PD-1 inhibitors combined with chemotherapy for metastatic bladder cancer can effectively prolong the mPFS and median mOS. The adverse reactions of the two groups were tolerable, and there was no significant difference in the incidence of grade 3-4 adverse reactions. In general, PD-1 inhibitors combined with chemotherapy in the treatment of metastatic bladder cancer is safe and feasible, but attention should be paid to the immune-related adverse reactions of PD-1 inhibitors.

Objective: To examine the longitudinal relationship between academic pressure and Internet addiction of college students and to provide reference for the development of college students mental health. Methods: In October 2016, a longitudinal 4 waves (T1 to T4) of follow up study was conducted among 5 372 college students from a university in Jiangsu, with an interval of 1 year each time. Academic pressure and Internet addiction were derived from the College Students Mental Health Screening Scale. A cross lag analysis was used to explore the relationship between college students academic pressure and Internet addiction. Results: Repeated measures analysis of variance showed that the main effect of time for academic pressure was significant[ F(3,16 113)= 767.28 , P<0.01,η 2=0.13]. The academic pressure of college students showed a downward trend over time, with the highest at T1 stage and the lowest at T4 stage. The main effect of time for college students Internet addiction was significant[ F(3,16 113)= 165.22 , P<0.01, η 2=0.03]. The Internet addiction of college students showed a trend of decreasing after increasing over time, with the highest stage T2 and the lowest stage T4. The cross lag analysis showed that academic pressure of T1 could significantly predict the Internet addiction of T2, and academic pressure of T3 could significantly predict the Internet addiction of T4, and the path coefficients are 0.07 and 0.07( P <0.01). In addition, the pre test (T n ) Internet addiction can significantly predict the post test [T( n +1)] academic pressure, and the path coefficients were 0.06, 0.06, 0.08( P <0.01). Conclusion Academic pressure can partially predict Internet addiction among college students, while Internet addiction can also significantly predict academic pressure. Colleges and universities should strengthen the construction of learning style, reduce the academic pressure of students,and reduce the Internet addiction of college students through various ways, so as to promote the healthy development of college students.

Objective:To investigate the clinicopathological characteristics, treatment methods and prognosis of renal primary neuroendocrine neoplasms.Methods:The clinical data of 42 patients with renal neuroendocrine neoplasms admitted to the First Affiliated Hospital of Zhengzhou University from October 2011 to June 2021 were retrospectively analyzed.There were 17 males and 25 females. The median age was 60.0 (50.0, 67.0) years old.The CT enhancement scan lesion was slightly intensified with less intensification than normal renal parenchyma.The clinic manifestation included lumbar abdominal pain in 7 cases, hematuria in 3 cases, abdominal distension in 1 cases, and asymptomatic in 8 cases. The average diameter of tumor was 8.0 (4.0, 10.0) cm. The tumor of 13 cases was in the left, and 6 cases was in the right. 6 cases were in T 1 stage, 11 cases were in T 2, 11 cases were in T 3, and 14 cases were in T 4.17 cases had lymph node metastasis, 11 cases had distant metastasis.The surgical method was radical nephrectomy in 27 cases, nephrectomy in 5 cases and interventional embolization in 4 case, and no operation in 6 cases, including 5 with chemotherapy alone and 1 with supportive care.Patients were classified by WHO Classification of renal tumors of the urinary system and the male reproductive organs (2016) into high-differentiated renal neuroendocrine tumors (NET, including carcinoid and atypical carcinoids) and high-grade renal neuroendocrine carcinoma (NEC, including small cell neuroendocrine carcinoma and large cell neuroendocrine carcinoma). The clinicopathological characteristics and prognosis of the 2 groups were compared, and the Cox proportional regression risk model was used to analyze the clinical factors affecting the prognosis. Results:In the NET group, 12 cases were carcinoids and 7 cases were atypical carcinoids. In the NEC group, 23 cases were small cell carcinomas.The mean Ki-67 index of 42 cases was 35% (4.5%, 62.5%). The proportion of positive expression of the neuroendocrine markers CD56, chromogranin A (CgA), and synapsin (Syn) were (37/42), (15/42), and (38/42), respectively. A total of 42 patients were followed up, and the median follow-up time was 60 (35, 99) months, and the median survival time was 25 (15, 60) months. The 3-year and 5-year overall survival rates were 40.0% and 21.2%. The 3-year and 5-year overall survival rates in the NET group were 72.6% and 42.3%.The 3-year and 5-year overall survival rates in the NEC groups were 6.3% and 0, respectively. The mean Ki-67 index was 3% (2%, 10%) in the NET group, 2 patients received postoperative chemotherapy and 3 patients had early progression after initial treatment.The mean Ki-67 index in the NEC group was 60% (40%, 80%), 15 patients received postoperative chemotherapy, and 13 patients had early progression of initial treatment.There were statistically differences in treatment method, postoperative chemotherapy, Ki-67 index, and early disease progression (all P <0.05) between the two groups.The results of univariate analysis showed that sex, age, early progression, treatment method, tumor differentiation, and Ki-67 index were all factors influencing patient prognosis (all P <0.05). Cox multivariate analysis showed that poorly differentiated NEC ( HR=13.964, P=0.003) and early progression ( HR=3.626, P=0.018) were independent risk factors for patient survival, and renal radical surgery ( HR=0.197, P=0.033) was independent protective factors for patient survival. Further subgroup analysis showed that the median survival time of the NEC patients with adjuvant chemotherapy after surgery was significantly longer compared with the patients without adjuvant chemotherapy (21 and 9 months, P=0.012). Conclusions:Primary renal neuroendocrine tumors are clinically rare, often manifested as lumbar and abdominal pain, and radical renal surgical treatment is preferred.The NET has a better prognosis and NEC prognosis is extremely poor, but NEC patients can have survival benefit from chemotherapy. NEC and early progression of the disease are independent prognostic risk factors, and radical renal surgical treatment is an independent protective factor for prognosis.

Objective: To understand the overall mental health status of freshmen in colleges and universities in Jiangsu Province, to investigate the effectiveness of mental health courses in improving the mental health of freshmen, so as to provide a reference for improving the mental health of freshmen. Methods: A total of 3 358 freshmen from a university in Jiangsu were selected from March to April 2019, mental health courses were held once(2 class hours each time) a week for 8 consecutive weeks,16 class hours in total(8 class hours of classroom teaching, and 8 class hours of experiential teaching). All the participants were used the Chinese College Students Mental Health Scale to conduct a questionnaire survey followed up before, during and after the implementation of mental health courses. Results: A total of 186 students with serious psychological problems were screened before the course, accounting for 5.54% of the total number, 310 students with general psychological problems, accounting for 9.23% of the total number, and 579 students with potential psychological distress, accounting for the total number 17.23% of the total number of people, 2 283 students without psychological distress, accounting for 67.99% of the total number. In the early, middle and late periods of the course, psychological problems showed a downward trend, and the main effect of time was significant(all P <0.01). After the implementation of the mental health course, the detection rate of serious psychological problems (3.84%, 129/3 358) was significantly lower than before the course(5.54%, 186/3 358)( χ 2= 10.82 , P <0.01). In the early, middle and late periods of the course, the development trajectory of freshmen s psychological problems was divided into two types, namely "first ascending and then descending" (26%) and "slowly descending"(74%). Conclusion The mental health curriculum shows a positive effect on improving the mental health of freshmen. Colleges and universities should pay attention to the construction of mental health curriculum to fully guarantee the quality of the curriculum.

Objective: To explore the dynamic developmental trajectory of problem eating behavior among college students, and to provide evidence for the early prevention and intervention of eating problems. Methods: A cluster sample of 5 372 freshmen from a university in Jiangsu Province were included and followed up for 4 years by using the eating behavior problems scale. Results: The problem eating behavior of college students in Jiangsu Province showed a decreasing after increasing trend(5.17±1.36, 5.39± 1.53 , 5.14±1.42, 4.96±1.37)( F =112.12, P <0.01), and prevalence of problem eating behavior was highest among sophomores. The developmental trajectory of eating behavior problems in college students could be divided into slow decreasing (86.7%) and slow increasing (13.3%) groups. In addition, sex specific developmental trajectory of problem eating behavior was observed, with initial mean level and change speed of female students were signicantly higher than that of male students. Conclusion There are group heterogeneity and sex specific effect in problem eating behavior of college students, which needs specific intervention strategies provided from colleges.