Chronic refractory wound (CRW) is one of the most challengeable issues in clinic due to complex pathogenesis, long course of disease and poor prognosis. Experts need to conduct systematic summary for the diagnosis and treatment of CRW due to complex pathogenesis and poor prognosis, and standard guidelines for the diagnosis and treatment of CRW should be created. The Guideline forthe diagnosis and treatment of chronic refractory wounds in orthopedic trauma patients ( version 2023) was created by the expert group organized by the Chinese Association of Orthopedic Surgeons, Chinese Orthopedic Association, Chinese Society of Traumatology, and Trauma Orthopedics and Multiple Traumatology Group of Emergency Resuscitation Committee of Chinese Medical Doctor Association after the clinical problems were chosen based on demand-driven principles and principles of evidence-based medicine. The guideline systematically elaborated CRW from aspects of the epidemiology, diagnosis, treatment, postoperative management, complication prevention and comorbidity management, and rehabilitation and health education, and 9 recommendations were finally proposed to provide a reliable clinical reference for the diagnosis and treatment of CRW.

In order to improve the level of diagnosis and treatment, we report a rare case of hyperthyroidism patient occurred agranulocytosis and hemophagocytic syndrome after taking methimazole. After methimazole treatment, agranulocytosis and infection was developed, but was improved temporarily after treatment. However because of infection, the condition was rapidly developed into hemophagocytic syndrome. Finally, the patient improved rapidly with the treatment of dexamethasone.

OBJECTIVETo investigate the presence of cancer stem cells (CSCs) exist in non-small cell lung cancer (NSCLC) and explore the relationship among the expressions of CD133, Notch1, and vascular endothelial growth factor (VEGF) and their relations with the clinicopathological parameters of the patients.

METHODSA total of 305 specimens of NSCLC and 80 normal lung tissue specimens were analyzed for CD133, Notch1, and VEGF protein expressions by immunohistochemical staining.

RESULTSIn NSCLC specimens, the positivity rates of CD133, Notch1, and VEGF were 48.9%, 43.9%, and 45.6%, respectively, significantly higher than those in normal lung tissues (10.0%, 15.0%, and 0%, respectively, P<0.01). The expression levels of CD133, Notch1, and VEGF proteins were significantly correlated with the tumor grades, lymph node metastasis, TNM stages, and postoperative survival time of the patients (P<0.01). A positive correlation was found among the expression levels of CD133, Notch1, and VEGF proteins. Kaplan-Meier survival analysis showed a significantly lower overall mean survival time of the patients positive for CD133, Notch1, and VEGF than that of the negative patients (P<0.001). Cox regression analysis suggested that positive expressions of CD133 and Notch1 were independent prognostic factors of NSCLC (P<0.05).

CONCLUSIONSCD133, Notch1, and VEGF may play important roles in the occurrence, progression, invasion, and metastasis of NSCLC. CD133 and Notch1 have important values for predicting the prognosis and evaluating disease progression of the patients.

AC133 Antigen ; Antigens, CD ; metabolism ; Carcinoma, Non-Small-Cell Lung ; metabolism ; Glycoproteins ; metabolism ; Humans ; Kaplan-Meier Estimate ; Lung ; metabolism ; Lung Neoplasms ; metabolism ; Lymphatic Metastasis ; Neoplastic Stem Cells ; metabolism ; Peptides ; metabolism ; Prognosis ; Receptor, Notch1 ; metabolism ; Regression Analysis ; Survival Rate ; Vascular Endothelial Growth Factor A ; metabolism

OBJECTIVETo explore the expression of Snail and Slug in primary cervical squamous cell carcinoma (CSCC) and their relationship with KAI1 expression.

METHODSThe expressions of Snail, Slug, and KAI1 proteins were examined by immunohistochemistry in 154 specimens of CSCC tissues, 50 specimens of cervical intraepithelial neoplasm (CIN), and 40 specimens of normal cervical tissues.

RESULTSThe positivity rates of Snail, Slug, and KAI1 expression were 0%, 2.5%, and 95.0% in normal cervical tissues, 32.0%, 34.0% and 64.0% in CIN tissues, and 66.2%, 66.9%, and 43.5% in CSCC tissues, respectively, showing significant differences in the rates among the 3 groups (P<0.05). The expressions of Snail, Slug, and KAI1 were significantly correlated with the histological grades of the tumor, depth of invasion, lymph node metastasis, International Federation of Gynecology and Obstetrics (FIGO) stages, and postoperative survival time (P<0.05). The expressions of Snail and Slug were positively correlated (r=0.752, P<0.001), and both of them were negatively correlated with the expression of KAI1 (P<0.001). Kaplan-Meier analysis showed that patients positive for Snail and Slug had significantly lower survival rates than the negative patients (P<0.001), while a positive expression of KAI1 was associated with a higher survival rate of the patients. Cox regression analysis identified Snail, KAI1, and FIGO stage as independent factors that affected the outcomes of CSCC (P<0.05).

CONCLUSIONThe expressions of Snail, Slug, and KAI1 are related to the tumor grade, FIGO stage, invasive depth, lymph node metastasis, and prognosis of CSCC, and their combined detection can help estimate the outcomes of the patients.

Carcinoma, Squamous Cell ; metabolism ; pathology ; Cervical Intraepithelial Neoplasia ; metabolism ; pathology ; Female ; Humans ; Immunohistochemistry ; Kangai-1 Protein ; metabolism ; Kaplan-Meier Estimate ; Lymphatic Metastasis ; Neoplasm Staging ; Prognosis ; Snail Family Transcription Factors ; Survival Rate ; Transcription Factors ; metabolism ; Uterine Cervical Neoplasms ; metabolism ; pathology

OBJECTIVETo explore expressions of CD133, E-cadherin and Snail in human epithelial ovarian cancer (EOC) and elucidate their relationship with the clinicopathologic features and prognosis of the patients.

METHODSThe expression of CD133, E-cadherin and Snail were detected by immunohistochemical staining in 150 specimens of EOC and 50 specimens of benign ovarian epithelial tumor tissues.

RESULTSThe positivity rates of CD133, E-cadherin and Snail protein in EOC were 58.7%, 60.7% and 32.7%, respectively, significantly different from the rates in benign epithelial tumor tissues (10%, 8.0%, and 70%, respectively; P<0.05). The expressions of CD133, E-cadherin and Snail in EOC were significantly correlated with abdominal organ and lymphnode metastases and FIGO stage (P<0.01). E-cadherin expression was inversely correlated with Snail and CD133 expression (r=-0.545 and -0.570, P<0.01), and the latter two were positively correlated (r=0.599, P<0.01). Overexpressions of CD133 and Snail and a decreased expression of E-cadherin were all related to a poor prognosis of the patients (P<0.05). FIGO stage and expressions of CD133, E-cadherin and Snail were all independent prognostic factors of EOC (P<0.05).

CONCLUSIONThe expressions of CD133, E-cadherin and Snail are related to lymph node metastasis, clinical stage, and prognosis of EOC. Combined detection of these indexes provides important evidence for predicting the progression and prognosis of EOC.

AC133 Antigen ; Antigens, CD ; metabolism ; Cadherins ; metabolism ; Disease Progression ; Female ; Glycoproteins ; metabolism ; Humans ; Lymphatic Metastasis ; Neoplasms, Glandular and Epithelial ; metabolism ; pathology ; Ovarian Neoplasms ; metabolism ; pathology ; Peptides ; metabolism ; Prognosis ; Snail Family Transcription Factors ; Transcription Factors ; metabolism

Objective To investigate the presence of cancer stem cells (CSCs) exist in non-small cell lung cancer (NSCLC) and explore the relationship among the expressions of CD133, Notch1, and vascular endothelial growth factor (VEGF) and their relations with the clinicopathological parameters of the patients. Methods A total of 305 specimens of NSCLC and 80 normal lung tissue specimens were analyzed for CD133, Notch1, and VEGF protein expressions by immunohistochemical staining. Results In NSCLC specimens, the positivity rates of CD133, Notch1, and VEGF were 48.9%, 43.9%, and 45.6%, respectively, significantly higher than those in normal lung tissues (10.0%, 15.0%, and 0%, respectively, P<0.01). The expression levels of CD133, Notch1, and VEGF proteins were significantly correlated with the tumor grades, lymph node metastasis, TNM stages, and postoperative survival time of the patients (P<0.01). A positive correlation was found among the expression levels of CD133, Notch1, and VEGF proteins. Kaplan-Meier survival analysis showed a significantly lower overall mean survival time of the patients positive for CD133, Notch1, and VEGF than that of the negative patients (P<0.001). Cox regression analysis suggested that positive expressions of CD133 and Notch1 were independent prognostic factors of NSCLC (P<0.05). Conclusions CD133, Notch1, and VEGF may play important roles in the occurrence, progression, invasion, and metastasis of NSCLC. CD133 and Notch1 have important values for predicting the prognosis and evaluating disease progression of the patients.

Objective To explore expressions of CD133, E-cadherin and Snail in hu?man epithelial ovarian cancer (EOC) and elucidate their relationship with the clinicopathologic features and prognosis of the patients. Methods The expression of CD133, E-cadherin and Snail were detected by immunohistochemical staining in 150 specimens of EOC and 50 specimens of benign ovarian epithelial tumor tissues. Results The positivity rates of CD133, E-cadherin and Snail protein in EOC were 58.7%, 60.7%and 32.7%, respectively, significantly different from the rates in benign epithelial tumor tissues (10%, 8.0%, and 70%, respectively; P<0.05). The expressions of CD133, E-cadherin and Snail in EOC were significantly correlated with abdominal organ and lymphnode metastases and FIGO stage (P<0.01). E-cadherin expression was inversely correlated with Snail and CD133 expression (r=-0.545 and-0.570, P<0.01), and the latter two were positively correlated (r=0.599, P<0.01). Overexpressions of CD133 and Snail and a decreased expression of E-cadherin were all related to a poor prognosis of the patients (P<0.05). FIGO stage and expressions of CD133, E-cadherin and Snail were all independent prognostic factors of EOC (P<0.05). Conclusion The expressions of CD133, E-cadherin and Snail are related to lymph node metastasis, clinical stage, and prognosis of EOC. Combined detection of these indexes provides important evidence for predicting the progression and prognosis of EOC.

Objective To explore the expression of Snail and Slug in primary cervical squamous cell carcinoma (CSCC) and their relationship with KAI1 expression. Methods The expressions of Snail, Slug, and KAI1 proteins were examined by immunohistochemistry in 154 specimens of CSCC tissues, 50 specimens of cervical intraepithelial neoplasm (CIN), and 40 specimens of normal cervical tissues. Results The positivity rates of Snail, Slug, and KAI1 expression were 0%, 2.5%, and 95.0%in normal cervical tissues, 32.0%, 34.0%and 64.0%in CIN tissues, and 66.2%, 66.9%, and 43.5%in CSCC tissues, respectively, showing significant differences in the rates among the 3 groups (P<0.05). The expressions of Snail, Slug, and KAI1 were significantly correlated with the histological grades of the tumor, depth of invasion, lymph node metastasis, International Federation of Gynecology and Obstetrics (FIGO) stages, and postoperative survival time (P<0.05). The expressions of Snail and Slug were positively correlated (r=0.752, P<0.001), and both of them were negatively correlated with the expression of KAI1 (P<0.001). Kaplan-Meier analysis showed that patients positive for Snail and Slug had significantly lower survival rates than the negative patients (P<0.001), while a positive expression of KAI1 was associated with a higher survival rate of the patients. Cox regression analysis identified Snail, KAI1, and FIGO stage as independent factors that affected the outcomes of CSCC (P<0.05). Conclusion The expressions of Snail, Slug, and KAI1 are related to the tumor grade, FIGO stage, invasive depth, lymph node metastasis, and prognosis of CSCC, and their combined detection can help estimate the outcomes of the patients.

Objective To investigate the presence of cancer stem cells (CSCs) exist in non-small cell lung cancer (NSCLC) and explore the relationship among the expressions of CD133, Notch1, and vascular endothelial growth factor (VEGF) and their relations with the clinicopathological parameters of the patients. Methods A total of 305 specimens of NSCLC and 80 normal lung tissue specimens were analyzed for CD133, Notch1, and VEGF protein expressions by immunohistochemical staining. Results In NSCLC specimens, the positivity rates of CD133, Notch1, and VEGF were 48.9%, 43.9%, and 45.6%, respectively, significantly higher than those in normal lung tissues (10.0%, 15.0%, and 0%, respectively, P<0.01). The expression levels of CD133, Notch1, and VEGF proteins were significantly correlated with the tumor grades, lymph node metastasis, TNM stages, and postoperative survival time of the patients (P<0.01). A positive correlation was found among the expression levels of CD133, Notch1, and VEGF proteins. Kaplan-Meier survival analysis showed a significantly lower overall mean survival time of the patients positive for CD133, Notch1, and VEGF than that of the negative patients (P<0.001). Cox regression analysis suggested that positive expressions of CD133 and Notch1 were independent prognostic factors of NSCLC (P<0.05). Conclusions CD133, Notch1, and VEGF may play important roles in the occurrence, progression, invasion, and metastasis of NSCLC. CD133 and Notch1 have important values for predicting the prognosis and evaluating disease progression of the patients.

Objective To explore expressions of CD133, E-cadherin and Snail in hu?man epithelial ovarian cancer (EOC) and elucidate their relationship with the clinicopathologic features and prognosis of the patients. Methods The expression of CD133, E-cadherin and Snail were detected by immunohistochemical staining in 150 specimens of EOC and 50 specimens of benign ovarian epithelial tumor tissues. Results The positivity rates of CD133, E-cadherin and Snail protein in EOC were 58.7%, 60.7%and 32.7%, respectively, significantly different from the rates in benign epithelial tumor tissues (10%, 8.0%, and 70%, respectively; P<0.05). The expressions of CD133, E-cadherin and Snail in EOC were significantly correlated with abdominal organ and lymphnode metastases and FIGO stage (P<0.01). E-cadherin expression was inversely correlated with Snail and CD133 expression (r=-0.545 and-0.570, P<0.01), and the latter two were positively correlated (r=0.599, P<0.01). Overexpressions of CD133 and Snail and a decreased expression of E-cadherin were all related to a poor prognosis of the patients (P<0.05). FIGO stage and expressions of CD133, E-cadherin and Snail were all independent prognostic factors of EOC (P<0.05). Conclusion The expressions of CD133, E-cadherin and Snail are related to lymph node metastasis, clinical stage, and prognosis of EOC. Combined detection of these indexes provides important evidence for predicting the progression and prognosis of EOC.