[Objective] To explore the clinical features of IgG4-related urinary diseases so as to provide reference for the diagnosis and treatment of such diseases. [Methods] The clinical data of 4 cases of IgG4-related urinary system diseases diagnosed and treated in Xijing Hospital of Air Force Medical University during Aug.2019 and Dec.2023 were retrospectively collected.Here, we report on the diagnosis and treatment of these patients, analysing their symptoms, serology, imaging and pathology as well as their treatment and outcomes. [Results] The patients included 2 male and 2 female.The lesions were involved with the retroperitoneum and urinary system.Three patients had symptoms of lumbar pain.The imaging manifestations were complex, including retroperitoneal mass involving urinary system organs in 2 cases, tabdense shadow of the right kidney in 1 case, and simple cystic mass of kidney in 1 case.Serum IgG4 value was not detected before surgery.All patients underwent radical surgical treatment.Postoperative pathology showed fibrous tissue hyperplasia with a large number of plasma cells, lymphocytes, a few neutrophil infiltrates, and lymphoid follicles and obliterated vasculitis in some specimens.The number of IgG4⁺ plasma cells was more than 10 in all tissues under high power microscope.After surgery, 3 patients had symptoms improved, and serum IgG4 value was within the normal range; 1 patient (patem 3) had elevated IgG4 value during follow-up, received subsequent hormone therapy, and the serum IgG 4 level remained stable. [Conclusion] The symptoms of IgG4-related diseases involving the urinary system are non-specific, and the imaging findings are various, easily confused with other diseases.Early detection of serum IgG4 and biopsy pathology can help clinicians make correct diagnosis in the early stage.

Mucinous adenocarcinoma of the renal pelvis is rare in clinical practice. This article reported a case of primary renal pelvis mucinous adenocarcinoma mixed with signet ring cell carcinoma. The patient was admitted to hospital due to right low back pain, and was diagnosed with right kidney stones accompanied by hydrops and infection, right kidney abscess, and nonfunctional right kidney after complete examination. Right renal puncture drainage was performed twice, followed by laparoscopic robot assisted right neprectomy. The postoperative pathological diagnosis was right renal pelvis primary mucinous adenocarcinoma (mixed with signet-ring cell carcinoma). Eleven months after the operation, regular "sodium folinate + oxaliplatin + 5-fluorouracil" chemotherapy was performed for 12 courses, and imaging showed no signs of recurrence or metastasis.

Objective To analyze the risk factors for prolonged sedation recovery time in epileptic children.Methods A cross-sectional trial was conducted on the epileptic children who underwent electroencephalography(EEG)with oral administration of chloral hydrate and nasal dexmedetomidine for sedation in our hospital from November 2019 to December 2022.Their general information and sedation and medication data were collected.Prolonged sedation recovery time was defined as beyond the 75th percentile of awaking time,and then the children were divided into recovery time ≤1 h group and＞1 h group.Univariate and multivariable logistic regression analyses were used to identify the risk factors for recovery time in these children.Results A total of 1 346 children were enrolled,including 805 males and 541 females,with a median age of 6.03(4.42,8.56)years.There were 986 children assigned into recovery time ≤1 h group and 360 ones into recovery time＞1 h group.Univariate analysis showed that significant differences were observed in the proportions of age＜1 year(0.8％vs 2.2％,P=0.046),sedation more than 3 times(35.8％vs 42.2％,P=0.031),and treated with multiple antiepileptic drugs(AEDs)(25.5％vs 36.9％,P＜0.001)between the 2 groups.Multivariable logistic regression analysis indicated that age＜1 year(OR=2.943,95％CI:1.063～8.142,P=0.034),sedation times ≥3(OR=1.287,95％CI:1.003～1.649,P=0.047)and multiple use of AEDs(OR=1.718,95％CI:1.325～2.223,P＜O.001)were risk factors for prolonged recovery time.Conclusion Age＜1 year,sedation times ≥3 and multiple use of AEDs are risk factors for prolonged sedation recovery time in epileptic children undergoing EEG after oral chloral hydrate and nasal dexmedetomidine.

Objective To investigate the correlation between plasma inflammatory factors [IL-1β, IL-6, IL-10, IL-12, IL-17, IL-23, TNF-α, TGF-β, IFN-γ, C-reactive protein (CPR) CCL-5] and hand-foot syndrome in colorectal cancer patients after taking capecitabine. Methods 35 colorectal cancer patients treated with capecitabine were collected and the degree of severity was divided according to the hand-foot syndrome grading diagnostic criteria. The concentrations of inflammatory factors in plasma were determined by ELISA kits. Results The standard curve of all inflammatory cytokines were linear (r>0.9900), and plasma concentrations of inflammatory cytokines in patients with colorectal cancer were determined. The concentration of TNF-α changed obviously, which had reference value. Conclusion The concentrations of different inflammatory factors were different and the concentration of TNF-α was closely correlated with the severity of hand-foot syndrome.

Objective:To investigate the clinicopathological features,immunophenotype,and prognosis of head and neck spindle cell squamous cell carcinoma(SCSCC)to improve the understanding and diagnosis of this tumor.Methods:Clinicopathological data collected from January 2012 to December 2022 at the First Affiliated Hospital,Air Force Military Medical University from 20 patients with head and neck SCSCC were retrospectively reviewed for histological morphology and immunophenotype.In situ and fluorescence in situ hybridization were performed to detect EBV-encoded ribonucleic acid(EBER)status and MDM2 gene amplification,respectively.Results:The median age among the 20 SCSCC cases was 67 years with a male-to-female ratio of 4∶1.Tumor locations were laryngeal(35.0%)and sinonasal(30.0%).SCSCC presented as polypoid or exogenous growths(61.5%),often with surface ulceration(90.0%).Histologically,sarcomatoid growth pat-terns were exhibited in 75.0%of the patients(n=15),while the remainder showed granular tissue-like or angiosarcomatoid patterns.Most tumors(65.0%)displayed components of conventional squamous cell carcinomas,with a predominant occurrence of high to moderate dif-ferentiation(91.7%).In terms of immunohistochemistry,AE1/AE3 was expressed in 83.3%(15/18)of cases,while p63 and p40 expression rates were 62.5%and 66.7%,respectively.All cases were negative for EBER.The Ki-67 proliferation index ranged 10%-70%.Overall,33.3%(1/3)of the cases showed MDM2 gene amplification.Among these,the median follow-up time for 18 patients was 18.3 months(range:1-92 months),with 6 survivors and 12 deaths.Conclusions:Head and neck SCSCC is more prevalent among elderly male smokers,predominantly exhibits a polypoid growth pattern,and does not display human papillomavirus or Epstein-Barr virus infection.Diagnosis requires a compre-hensive evaluation of clinical and pathological features and immunophenotype.Surgical resection is the primary treatment method.

Objective:To investigate the status of preoperative frailty in elderly patients undergoing neurosurgery and explore its influencing factors.Methods:A total of 135 elderly patients undergoing neurosurgery in Xuanwu Hospital Capital Medical University from April 2020 to March 2021 were selected as the research objects by the convenient sampling method. The survey was conducted using the general information questionnaire, Clinical Frailty Scale, Short-Form Mini Nutritional Assessment, Barthel Index Evaluation Scale and Geriatric Depression Scale-15. Logistic regression analysis was used to screen the influencing factors of preoperative frailty in elderly patients undergoing neurosurgery.Results:A total of 135 questionnaires were sent out, and 123 were effectively collected, with an effective recovery rate of 91.1%. Among 123 elderly neurosurgical patients, the incidence of preoperative frailty was 32.5% (40/123) . The results of logistic regression analysis showed that female, malnutrition and self-care ability were the influencing factors for preoperative frailty in elderly neurosurgical patients ( P<0.05) . Conclusions:The incidence of preoperative frailty in elderly neurosurgical patients is relatively high, which should be actively evaluated clinically, considering the gender difference of patients, improving the nutritional status of patients, effectively helping the self-care dependent population and improving the prognosis of patients.

Integrins are transmembrane receptors that have been implicated in the biology of various human physiological and pathological processes. These molecules facilitate cell-extracellular matrix and cell-cell interactions, and they have been implicated in fibrosis, inflammation, thrombosis, and tumor metastasis. The role of integrins in tumor progression makes them promising targets for cancer treatment, and certain integrin antagonists, such as antibodies and synthetic peptides, have been effectively utilized in the clinic for cancer therapy. Here, we discuss the evidence and knowledge on the contribution of integrins to cancer biology. Furthermore, we summarize the clinical attempts targeting this family in anti-cancer therapy development.

The vagus nerve plays an important role in regulating the homeostasis of inflammation. Inflammation signals in the body are passed to the vagus nerve efferent fibers via nerve reflexes, and the signals generated by efferent fibers will play an anti-inflammatory role in various inflammatory diseases through immune cells such as T cells that express choline acetyltransferase and macrophages. However, the resolution of inflammation is not only the interaction between pro-inflammatory and anti-inflammatory cytokines, but also an active process of biosynthesis, including the synthesis of various pro-resolving mediators and their physiological utility process. Moreover, the cholinergic inflammation reflex also plays a crucial role in inflammation resolution. This review reviews and summarizes the cholinergic inflammatory reflex and its key role in the process of inflammation resolution.

2019 Novel coronavirus (2019-nCoV) infection has caused a global pandemic. Although researchers have carried out a lot of research on 2019-nCoV, analyzed the molecular structure and conducted evolutionary tree analysis, there is still insufficient understanding of its specific pathogenic mechanism, resulting in the lack of specific and effective therapeutic drugs and method. 2019-nCoV infection can cause inflammation and may deteriorate to acute respiratory distress syndrome (ARDS) and sepsis, which have become the main complication of its death. Therefore, using antiviral and symptomatic treatment with inflammation reduction can have a better therapeutic effect. Mesenchymal stem cells (MSCs) not only have a significant immune-regulation function, but also play a role in regeneration and repair, repairing damaged lungs, so they can be considered as a new effective method for the treatment of coronavirus disease 2019 (COVID-19). This article analyzes the main pathogenic mechanism of 2019-nCoV, and the process of developing into ARDS, combined with the research status of MSCs, to explore its significance and feasibility for the treatment of COVID-19. Finally, it will provide a substantial theoretical basis for clinical treatment now and in the future.

Objective:To discuss the key technique and strategy in the treatment of humeral shortening complicated with proximal deformity using a monorail external fixator.Methods:We retro-spectively reviewed 10 patients (8 males and 2 females) with humeral shortening and proximal deformity who had been treated by a monorail external fixator between March 2015 and April 2018.Their mean age was 19.6 years (range, from 15 to 27 years).The humeral shortening was complicated with proximal varus in 8 cases, and with proximal varus plus kyphosis in 2.The affected humeri were 6 to 11 cm (mean, 8.5 cm) shorter than the normal ones.Half-pins were placed onto the lateral upper arm for installation of a unilateral external fixator to correct the proximal humeral deformity immediately after proximal osteotomy.Gradual lengthening was performed after osteotomy in the middle humeral shaft.The limb function was evaluated by the Cattaneo cri-teria.Results:All patients were followed up for 15 to 41 months (mean, 20 months).The length of lengthening ranged from 5 to 12 cm (mean, 7.5 cm).The range of shoulder abduction averaged 160° (from 130° to 180°), much improved than the preoperative average value (90°).Fine ossification was observed in the lengthening part in 9 patients but dysostosis in the lengthening part occurred in one patient who was healed after iliac autografting.No such complications as pin tract infection and radial nerve injury occurred.Ac-cording to the Cattaneo criteria, 9 limbs in 8 cases were excellent and 2 cases good.Conclusions:A monorail external fixator is a reliable choice for treatment of humeral shortening complicated with proximal deformity.To obtain satisfactory clinical effects, it is essential to master the installation technique of external fixator and prevent and control complications as well.