Objective:To investigate the clinicopathological features, immunophenotype, molecular characteristics, and differential diagnosis of primary intracranial DICER1-mutant sarcoma in order to better understand this tumor type.Methods:A retrospective analysis was conducted on 7 cases of primary intracranial DICER1-mutant sarcoma diagnosed in the Department of Pathology, Sun Yat-sen University Cancer Center, Guangzhou, China between 2021 and 2023 using next-generation sequencing. At the same time, 10 gliosarcomas, 4 intracranial FET::CREB fusion-positive mesenchymal tumors, 4 malignant meningiomas, 3 malignant solitary fibrous tumors, 3 malignant peripheral nerve sheath tumors, 3 synovial sarcomas and 3 rhabdomyosarcomas (total 30 cases) were selected as control.Results:Among the 7 patients with primary intracranial DICER1-mutant sarcoma, 6 were male and 1 was female, aged 10-32 years (median, 23 years). The tissue morphology was predominantly spindle or pleomorphic sarcoma-like, with 6 cases exhibiting eosinophilic globules, and 3 cases showing rhabdomyoblastic or rhabdomyosarcoma-like cell differentiation. Immunohistochemistry revealed focal desmin expression in 3 cases (3/7), ATRX loss in 3 cases (3/7), and p53 mutant pattern in 4 cases (4/7). Additionally, 4 cases (4/7) showed focal or diffuse SALL4 expression, whereas the control cases (30 cases) did not exhibit SALL4 protein expression, suggesting that SALL4 may possess certain auxiliary diagnostic value. Next-generation sequencing confirmed that all 7 cases of primary intracranial DICER1-mutant sarcoma harbored mutations in the DICER1 gene, with 5 cases having the mutation site at p.E1813D. Until May 2024, all 7 patients were alive.Conclusions:Primary intracranial DICER1-mutant sarcoma is a rare tumor. Understanding its morphological characteristics, immunohistochemical and molecular markers and differential diagnosis is crucial to avoid misdiagnosis and to improve diagnostic accuracy of this tumor.

Objective: To investigate the relationship between breakfast eating frequency and health-risk behavior of high school students in Chongqing, and provide a reference for conducting students to get a good habit of eating breakfast everyday. Methods: A total of 3 283 high school students in Chongqing were selected to participate in a questionnarie by using convenience sampling method. Logistic regression analysis were condueted to analyze the influences made by the unhealty eating behaviors on eating frequency of breakfast. Results: There were 2 064(69.2%) students eating breakfast everyday, 1 219(37.1%) students having no breakfast or eating breakfast sometimes. There were significant differences between different gender, grade, native place, drinking energy drink, smoking, drinking alcohol, gambling, internet addiction students rate of unhealthy breakfast eating frequency(χ2=6.80, 53.97, 8.10, 23.79, 7.89, 16.31, 3.93, 17.96, P<0.05), the males (36.1%) was beyond the females(33.3%), the energy drink drinkers(41.2%) was beyond the non-drinkers(31.7%), the smokers (40.9%) was beyond the non-smokers(34.4%), the alcohol drinkers(40.3%) was beyond the non-drinkers(33.3%), the gamblers(39.7%) was beyond the non-gamblers(34.3%), those having internet addictions (40.0%) was beyond those having no addictions(33.0%). Drinking energy drink(OR=1.32, 95%CI=1.12-1.55), drinking alcohol(OR=1.24, 95%CI=1.02-1.51), internet addiction(OR=1.42, 95%CI=1.19-1.68) were positively correlated with unhealthy breakfast eating frequency of high school students(P<0.05). Conclusion Social, families and schools should strengthen the guidance of high school students to develop the habit of eating breakfast every day, and advoid the clustering of skipping breakfast and health-risk behaviors.

Since the outbreak of COVID-19, several prevention and control measures have been successively promulgated in Wuhan. To name a few, setup of designated hospitals for severe COVID-19 patients is key to enforcing the policy of pooling patients, experts, resources and standardizing treatment. These efforts contribute decisively to improving the cure rate and reducing the mortality of COVID-19. As one of the designated hospitals composed of multiple medical teams, Wuhan Union Hospital put in place a joint working mode for treating severe COVID-19 patients, and found solutions to the main problems and difficulties in management. Its experiences provide references for the operation of joint medical institutions in emergency.

Objective To investigate the effect of the peroxide proliferator-activated receptorgamma (PPAR-γ) agonist rosiglitazone on the motor function recovery of hind limbs in rats with spinal cord injury.Methods Sixty-eight female SD rats were used to establish spinal cord injury model by modified Allen method.(1) Eight rats were randomly divided into negative control group and rosiglitazone group with four rats in each group.The expression of aspartate proteolytic enzyme-1 (caspase-1) in spinal cord of rats 7 days after injury was detected by immunohistochemical staining.(2) Forty-eight rats were randomly divided into negative control group,rosiglitazone group,rosiglitazone + Clostridium chitosans group [nuclear factor kappa B (NF-kappa B) activator],rosiglitazone + monosodium urate group [oligomerization domain-like receptor protein 3 (NLRP3) antagonist],with 12 rats in each group.BBB scores of hindlimb motor function were assessed at 1,3,14,21 and 28 days after injury in each group.The expression of interleukin-1 β (IL-1 β) and tumor necrosis factor-α (TNF-α) in each group was detected by ELISA at 28 days after injury.Microglia were isolated from the spinal cord of 12 rats and cultured for 7 days.They were randomly divided into the following five groups:(1) negative control group:no drug treatment;(2) rosiglitazone group:1 micromol/L rosiglitazone treatment;(3) rosiglitazone + Clostridium chitin group:1 micromol/L rosiglitazone + 20 micromol/L Clostridium chitosporin treatment;(4) Clostridium chitosan treatment Mycoplasma group:20 μ mol/L shell Clostridium treatment;(5) Clostridium chitosanin + MCC950 group [(NLRP3) antagonist]:20 μmol/L Clostridium chitosanin + 100 nmol/L MCC950;Western blot was used to detect the expressions of caspase-1,NF-kappa B and NLRP3 in microglia cells;ELISA was used to detect the expressions of IL-1β and TNF-α in the supernatant of microglia culture.Results Compared with negative control group,caspase-1 expression was decreased in rosiglitazone group in spinal cord injury area [gray matter area:5.1 ± 0.8∶6.9 ± 1.1;white matter area:5.6 ± 0.9 ∶ 7.5 ± 1.1] (P ＜ 0.05).At 28 days after operation,the rosiglitazone group had the highest BBB score [(14.7 ± 1.6) points],and the BBB score of rosiglitazone + Clostridium chitosans group (10.5 ± 2.1) points was superior to that of rosiglitazone + monosodium urate group [(7.2 ± 1.3)points,P ＜ 0.05].The expressions of IL-1β and TNF-α in rosiglitazone + monosodium uric acid group were lower than those in other groups at 28 days after injury (P ＜ 0.05).In vitro,the expressions of caspase-1,NF-kappa B,IL-1β and TNF-α in rosiglitazone group were lower than those in negative control group (P ＜ O.05).The expressions of caspase-1,NLRP3,IL-1β and TNF-α in rosiglitazone + Clostridium chitosani group were higher than those in rosiglitazone group,(P ＜ 0.05).The expressions of caspase-1 and IL-1β were higher than those in Clostridium chitosani + MCC950 group (P ＜0.05),but there was no significant difference in the expression of TNF-α between the two groups (P ＞0.05).Conclusion Rosiglitazone can promote the recovery of hind limb motor function in rats with spinal cord injury by inhibiting the expression of NF-kappa B,thereby reducing the activation of NLRP3 inflammatory bodies in microglia and ultimately inhibiting the occurrence of inflammation.

Objective : The present study observed the clinical effects on reattachment and pulpotomy of young crown-fractured and pulp-exposed permanent incisors. Methods : In a one-year retrospective clinical observation study, 30 traumatic intact segments of permanent incisors with crown fracture and pulpal exposure were treated using a pulpotomy and reattachment technique with an enamel-dentin luting agent and composite resin. Results : The number of subsequent visit teeth was 30, 29, 25 at 1, 3, 6 months follow-up respectively. The pulpotomy success rates were 100% at 1 month, 93.1% at 3 months, 93.1% at 6 months. The retention rates using the reattachment technique were 100% at 1 month, 100% at 3 months, 100% at 6 months. Conclusion Pulpotomy is the preferred method of preserving live pulp after pulpal exposure of young permanent incisors, and the clinical effect is prominent. The fragment reattachment technique is an effective middle- and short-term method for temporary restoration of young crown-fractured permanent incisors.

Objective To explore the effects of PDCA circulation in improving quality of intravenous infusion. Methods Nurses accepted a standardized training of intravenous infusion with the method of PDCA circulation based on the Policies and Procedures for Infusion Therapy published by Intravenous Nurses Society in 2016. Inpatients with infusion in the Peking University Third Hospital in June 2016 and November 2016 acted as the study subjects. This study compared the problems of intravenous infusion and the problems of intravenous infusion in the intensive monitoring wards before and after training. Results After training, there was a statistically significant difference in comparing problems of intravenous infusion (P< 0.05). The problems of intravenous infusion in the intensive monitoring wards reduced with no significant difference (P>0.05). Conclusions The application of PDCA circulation can improve the quality of intravenous infusion.

Objective:To evaluate the clinical effect of the revaseularization procedure for immature teeth with necrotic pulp and apical periodontitis.Methods:12 immature teeth with necrotic pulp and apical periodontitis in 12 patients(9-13 years old) were treated with revascularization protocol.The patients were followed up for 21-24 months.Results:All teeth were cured.4 types of responses were observed:①Increased thickening of the canal walls and continued root maturation;②Severe calcification of the canal space beneath MTA;③Partial pulp canal obliteration;④Continued root development with an open apex.Conclusion:Revascularization procedure may the formation of the root apex but not in all the cases.Excessive deposition of hard tissue might caused calcification in canal space.

Objective To investigate the influencing factors for post-discharge treatment compliance of patients with multidrug-resistant tuberculosis (MDR-TB).Methods MDR-TB patients who were hospitalized in a tubercu-losis hospital between November 2011 and January 2013 were chosen,post-discharge follow-up was conducted regu-larly through telephone call.Medicine-taking and re-examination of patients was inquired,factors influencing pa-tients’treatment compliance were analyzed.Results 299 patients were included in the study,the total treatment compliance rate was 81 .94% (n=245);249(83.28%)patients regularly took medicine,50(16.72%)didn’t regu-larly take medicine;254 (84.95%)were re-examined on time,45 (15.05%)were not re-examined on time;37 (12.37%)discontinued treatment,260 (86.96%)continuously treated till the survey deadline.Univariate analysis revealed that treatment compliance (including regular medication rate,timely re-examination rate,interrupted treat-ment rate,and total compliance rate)was significantly different among MDR-TB patients of different ages,education levels,treatment time,and with or without adverse reactions(all P <0.05 ).Logistic regression analysis revealed that treatment compliance of MDR-TB patients was negatively correlated with treatment time(β=-1 .47,Wald χ2=24.28,P <0.05)and adverse reactions(β=-2.02,Waldχ2 =24.24,P <0.05 ),while positively correlated with education levels(β=0.79,Wald χ2 =6.50,p <0.05 ).Conclusion Prolonged treatment time and adverse reactions can reduce the treatment compliance of MDR-TB patients,the higher education levels of MDR-TB patients have, the better treatment compliance they implement.

Objective To analyze the precision and accuracy of the Olympus AU5421 automatic biochemical analyzer in order to verify the performance of this detection system declared by the manufacturer.Methods The Precision and Accuracy of User Au-thentication-Guide for Approval Second Edition(CLSI EP15-A2)was used to perform the routine detection on the Olympus AU5421 automatic biochemical analyzer.The systematic precision and accuracy were analyzed.Results Under this experiment condition,the precision and accuracy of the Olympus AU5421 automatic biochemical analyzer was consistent with the performance declared by the manufacturer.Conclusion The Olympus AU5421 automatic biochemical analyzer system has the high precision and good accuracy, and can be better applied in the clinical routine detection.

BACKGROUNDThe Xpert MTB/RIF showed high sensitivity and specificity in previous studies carried out in different epidemiological and geographical settings and patient populations in high-burden tuberculosis (TB) countries. However, there were little data obtained by validation or demonstration study of the assay in China. In this study, the performance of Xpert MTB/RIF was investigated in two county-level laboratories in Hunan Province, China.

METHODSConsecutive patients with suspected pulmonary tuberculosis (PTB) and suspicion for multidrug-resistant tuberculosis (MDR-TB) were enrolled. For each patient suspected to have PTB, three sputum specimens (one spot sputum, one night sputum, and one morning sputum) were collected and each sputum was tested with smear microscopy, Löwenstein-Jensen (LJ) culture, and Xpert MTB/RIF test. For comparison across subgroups and testing methods, 95% confidence intervals were calculated. All analyses were done with SPSS 16.0, and P < 0.05 was regarded as significant.

RESULTSFor case detection, the sensitivity of Xpert MTB/RIF was 100% for smear- and culture-positive TB and 88.6% for smear-negative and culture-positive TB; the overall sensitivity was 94.5% for all culture-positive patients. The specificity was 99.8%. The sensitivity of Xpert MTB/RIF assay was 22.0% in clinical TB patients and the specificity reached 100.0% in the group of patients who are infected with nontuberculous mycobacteria. For the detection of rifampin resistance, the sensitivity of MTB/RIF RIF-resistance detection was 92.9%, and the specificity was 98.7%. Of the 26 Xpert MTB/RIF-positive and RIF-resistant patients confirmed by LJ proportion tests, 20 (76.9%) patients were infected by MDR-TB.

CONCLUSIONSThe Xpert MTB/RIF assay is a highly sensitive and specific method for diagnosis of TB and RIF resistance, which will enable it to have the potential to be used in county-level laboratories and lead to the reduction of the infectious pool and improvements in TB control in China. Further evaluations in county-level laboratories for implementing the assay are still required.

Adult ; Antibiotics, Antitubercular ; therapeutic use ; China ; Female ; Humans ; Male ; Middle Aged ; Rifampin ; therapeutic use ; Tuberculosis ; diagnosis ; drug therapy ; Tuberculosis, Multidrug-Resistant ; Tuberculosis, Pulmonary ; diagnosis ; drug therapy ; Young Adult