摘要：Background Immunocompromised individuals are susceptible to Cryptococcus and Mycobacterium tuberculo-sis infections.Coinfection can complicate diagnosis,and both may cause cerebral infarction.No previous reports describe cases of cryptococcal meningitis(CM)or tuberculous meningitis(TBM)with cerebrospinal fluid(CSF)testing positive for glial fibrillary acidic protein(GFAP)antibodies. Methods We present the case of a 60-year-old man with chronic lymphocytic leukemia,initially diagnosed with TBM,who developed cerebral infarction and was found to test positive for CSF GFAP antibodies,later confirmed as CM.A focused literature review was performed for cases involving CM/TBM coinfection,cerebral infarction,and GFAP antibody positivity. Results This case highlights overlapping clinical and imaging features of CM and TBM,including basal ganglia and thalamic infarctions.CSF GFAP antibody positivity became negative following antifungal therapy,indicating transient astrocytic injury.A literature search identified no prior reports describing CSF GFAP antibody positivity in leukemia patients with dual central nervous system(CNS)infections. Conclusion CM and TBM present with overlapping features and may coexist with autoimmune encephalitis in immunocompromised patients.Incorporating autoimmune antibody testing,including anti-GFAP,into routine CNS infection evaluation can facilitate early recognition of immune-mediated pathology and guide timely antimi-crobial-immunomodulatory therapy.

摘要：Background Circular RNAs(circRNAs)participate in the development of periodontitis.The present work aims to reveal the role and mechanism of circ_0087199 in human periodontal ligament cell(PDLC)injury during periodontitis. Methods PDLCs were treated with lipopolysaccharides(LPS)to establish a periodontitis cell model.Quanti-tative real-time polymerase chain reaction was used to detect the expression of circ_0087199,miR-527,toll-like receptor 4(TLR4).Western blotting assay was performed to assess protein expression.Cell viability,prolifer-ation,apoptosis and inflammation were investigated by cell counting kit-8,EdU assay,flow cytometry and en-zyme-linked immunosorbent assay,respectively.Oxidative stress was evaluated by malondialdehyde assay kit and superoxide dismutase activity assay kit.The interaction between miR-527 and circ_0087199 or TLR4 was con-firmed by a dual-luciferase reporter assay. Results Circ_0087199 and TLR4 expression levels were significantly increased,while miR-527 was decreased in the periodontal ligament tissues of periodontitis patients and LPS-stimulated PDLCs when compared with con-trols.LPS treatment inhibited cell viability and proliferation but induced cell apoptosis,inflammation and oxida-tive stress,whereas these effects were attenuated after circ_0087199 knockdown.Circ_0087199 bound to miR-527 and regulated LPS-caused PDLC damage by targeting miR-527.Additionally,the overexpression of TLR4,a target gene of miR-527,rescued miR-527 mimic-mediated effects on LPS-treated PDLCs.Further,the regulation of circ_0087199 toward TLR4 involved miR-527. Conclusion Circ_0087199 knockdown attenuated LPS-induced apoptosis,inflammation and oxidative stress of PDLCs by regulating the miR-527/TLR4 pathway.

摘要：Objective To explore the clinical value of ultrasound-guided drainage in the treatment of odontogenic space in-fections of the maxillofacial region. Methods We retrospectively analyzed data for 23 patients with maxillofacial space infections treated between October 2015 and October 2025.All patients underwent ultrasound-guided drainage.Clinical observation indica-tors comprised puncture success rate,time to clinical symptom improvement,pathogenic distribution,and compli-cations. Results One-time puncture was successful in all 23 patients(100%success rate).Postoperative clinical symptoms improved rapidly;the visual analog scale score for local pain decreased by≥50%within 1.6±0.1 days,swelling began to resolve after 2.3±0.2 days,and the times for body temperature and the white blood cell count to return to normal were 3.3±0.2 days and 5.0±0.3 days,respectively.The most common infection site was the neck space.The positive rate of pus culture was 82.6%(19/23),with Gram-positive bacteria predominating,and Streptococcus was cultured most often(21.7%).No major complications,such as vascular or nerve injuries,occurred. Conclusion Ultrasound-guided drainage has the advantages of precision,minimal invasiveness,and safety in treating maxillofacial space infections.This approach effectively promotes rapid relief of clinical symptoms and is worthy of clinical promotion.

摘要：Helicobacter pylori(H.pylori),due to its particular bacterial structures,can colonize in the acidic stomach environment and concomitantly resist to antimicrobial agents.Besides,the virulence factors secreted by the bacterium could induce a series of signaling pathways,leading to the production of inflammation and modulation of gene expression,and ultimate-ly contributing to digestive system and even systemic diseases.With the continuous increase in the incidence and mortal-ity of gastric cancer,researches focusing on H.pylori,one of the key high-risk factors,has gained growing attention in clinical and basic science fields.Once infection is confirmed,timely and standardized treatment,verification of antibiotic susceptibility,and post-therapeutic testing constitute the main prevention and control strategies.Given the diversity and complexity of the pathogenic mechanisms underlying H.pylori infection,this review aims to synthesize the latest advanc-es in understanding its bacterial structure,as well as the pathogenic mechanisms mediated by virulence factors.

摘要：Background Transient perivascular inflammation of the carotid artery(TIPIC)syndrome is relatively rare.Cur-rent research on conventional ultrasound and contrast-enhanced ultrasound(CEUS)for examining this condition is predominantly confined to case reports.Therefore,this study aimed to evaluate the value of conventional ultra-sound and CEUS in the diagnosis and follow-up of TIPIC syndrome. Methods The study conducted a retrospective analysis of 30 patients with TIPIC syndrome who were treated be-tween January 2016 and September 2025.We analyzed their conventional ultrasonographic and CEUS features and compared the evolution of these characteristics during follow-up visits(14 days,1 month,3 months,and 6 months). Results The mean(±standard deviation)maximum thickness of the lesions was 4.4±0.9 mm,and the mean involved length of the lesions was 24.2±8.1 mm.A Pearson correlation analysis showed that the maximum thick-ness of the lesions was positively correlated with lesion length at the initial visit,14-day follow-up,and 1-month follow-up(r=0.442,r=0.465,and r=0.802;P=0.014,P<0.001,and P<0.001,respectively).On conventional ultrasound,TIPIC lesions typically presented as unilateral(100%),eccentric(100%),with perivascular wall thick-ening of the common carotid artery or its bifurcation(100%),and appeared as hypoechoic areas without luminal stenosis(100%).On CEUS,these lesions were mainly diffuse(93.3%)and showed hyperenhancement(90%).During the follow-up,all patients showed a gradual reduction in the lesion thickness and involved area(both P<0.001),accompanied by significantly decreased CEUS enhancement intensity(P<0.001).Most lesions resolved completely within 3 months or earlier(93.3%). Conclusions Conventional ultrasound and CEUS can provide diagnostic imaging evidence for TIPIC syndrome.These techniques play a crucial role in the diagnosis,evaluation of treatment efficacy,and follow-up monitoring of this syndrome,and should be considered the first-line imaging modality.

摘要：Severe Fever with Thrombocytopenia Syndrome(SFTS)commonly presents with clinical manifestations such as fever,muscle pain,headache,and gastrointestinal symptoms.To date,there have been no reports linking SFTS to sleep disturbances.This case involves a patient diagnosed with SFTS who developed sleep disorders during the treatment process,primarily characterized by nocturnal restlessness,mental agitation,talking to oneself,and even verbal aggression.No abnormalities were detected in cerebrospinal fluid examinations,electroencephalography(EEG),EEG topography,video EEG,or cranial magnetic resonance imaging.As the treatment progressed,the patient's sleep condition gradually improved and eventually returned to pre-illness levels.Subsequent follow-ups confirmed no recurrence of sleep disturbances.

摘要：Oral mucosal disease is an important subspecialty of stomatology with rich connotations and broad coverage.Di-agnosis and treatment of oral mucosal disease directly affect a patient's overall oral health assessment and is close-ly related to the associated diagnosis of systemic diseases.Currently,specialists in oral mucosal disease in China face issues such as a large talent shortage,insufficient training standardization,and an unbalanced competence structure.This study aimed to construct a systematic training model for oral mucosal disease specialists,with the core goal of fostering core competencies.The model progresses in three phases:basic standardized training,sub-specialty in-depth training,and research capability enhancement,and relies on four pillars:deepening theoretical education,refining clinical skills,inspiring research reasoning,and cultivating humanistic literacy.This structure forms a closed-loop training system by integrating a"process-oriented+summative+360-degree"multi-dimen-sional assessment system.The present article discusses the training content,implementation methods,and assess-ment criteria of each phase,while presenting potential challenges in implementation(such as balanced faculty allocation and training base construction)and future development directions by combining training with artificial intelligence and precision medicine.The model presented in this article is expected to provide a theoretical basis and practical guidelines to promote the homogeneous,high-level,and sustainable development of the talent team in the field of oral mucosal disease in China.

摘要：This report summarizes the nursing and infection management process for a patient who developed severe late-on-set sinusoidal obstruction syndrome while in a state of deep immunosuppression after allogeneic hematopoietic stem cell transplantation.Key nursing measures included:strict adherence to infection control protocols in the laminar airflow ward during potent immunosuppressive therapy;rigorous aseptic techniques for invasive proce-dures such as abdominal paracentesis and drainage to prevent catheter-related infections;and enhanced monitor-ing and differentiation of symptoms like fever and diarrhea to guard against opportunistic infections.Symptom management for sinusoidal obstruction syndrome,nutritional support,and psychological care were implemented concurrently.Through these comprehensive nursing interventions,the patient recovered without developing any severe infections while immunocompromised.This case offers valuable insights into infection prevention and comprehensive care for similar high-risk patients.

摘要：The journey to recovery for patients with liver cir-rhosis is fraught with numerous risks,among which esophageal and gastric variceal rupture bleeding stands as one of the most perilous.This condition represents an acute medical emergency—sudden in onset,rapid in progression,and potentially fatal within a short period.Timely diagnosis and prompt treatment are therefore crucial.The Hepatobiliary and Gastrointestinal Center at Beijing You'an Hospital has accumulated extensive clinical experience in managing esophageal and gastric variceal rupture bleeding in patients with cirrhosis.The center is dedicated to safeguarding lives with unwaver-ing commitment.

摘要：Purpose:To report an unusual case of central retinal artery occlusion(CRAO)following herpes zoster ophthal-micus,herpes zoster meningitis,and Grade 3(very high risk)hypertension in a patient with acquired immuno-deficiency syndrome(AIDS). Case presentation:A 51-year-old man with AIDS presented with herpes zoster involving the ophthalmic division of the left trigeminal nerve.Clinical findings included severe ptosis,restricted extraocular movements,reduced corneal sensation,anterior uveitis,a dilated pupil with absent light reflex,optic disc hyperemia,and tortuous retinal veins.The patient was febrile and had markedly elevated blood pressure(191/105 mmHg).Cerebrospinal fluid analysis re-vealed elevated protein levels,pleocytosis,and positive detection of varicella-zoster virus.Two weeks after initiating treatment,the patient developed CRAO in the left eye,and 2 months later,he suffered an acute cerebral stroke. Conclusion:This case highlights an uncommon etiology of CRAO and subsequent stroke in an immunocompromised patient.The sequential vascular events likely resulted from the combined effects of herpes zoster-associated vasculop-athy and severe hypertension,suggesting a potential pathogenic link between viral infection and vascular occlusion.

摘要：This article reports the diagnosis and treatment process of a middle-aged woman with systemic disseminated tubercu-losis infection.Her initial symptoms were speech impairment and left limb weakness,and the preliminary diagnosis was cerebral infarction.After admission,she began to complain of headache and developed a fever.Lumbar puncture was then performed,which revealed tuberculous meningitis.During treatment,pulmonary lesions and intestinal ob-struction occurred.Acid-fast staining of alveolar lavage fluid and stool were positive.The final diagnosis was system-ic disseminated tuberculosis.

摘要：Objective To analyze the clinical characteristics of a patient with brucellosis meningitis complicated by Ep-stein-Barr virus(EBV)meningitis in order to enhance awareness of this rare condition. Methods A retrospective analysis was conducted using the clinical data of a patient admitted to Cangzhou Cen-tral Hospital on October 31,2024,with brucellosis meningitis complicated by EBV meningitis.The patient's clini-cal features,treatment course,and prognosis were evaluated. Results The patient presented with headache,nausea,and vomiting.Cerebrospinal fluid(CSF)examination re-vealed markedly elevated intracranial pressure.Metagenomic next-generation sequencing(mNGS)of the CSF detected both Brucella and EBV.Cranial magnetic resonance imaging(MRI)showed no significant abnormalities,and other etiological tests were negative.The diagnosis of brucellosis meningitis complicated by EBV meningitis was established.Initial therapy failed to adequately control the symptoms,but timely adjustment of medications led to improvement in clinical manifestations and laboratory findings,resulting in successful discharge. Conclusions Concurrent meningitis caused by bacterial and viral pathogens is rare in clinical practice and is eas-ily misdiagnosed or subject to delayed treatment.In patients with refractory symptoms,active CSF examination should be performed to achieve early diagnosis and timely intervention.

摘要：Cancer is one of the leading causes of mortality that severely threatens life expectancy.Chemotherapy is the most common regimen for cancer patients.However,low drug availability in tumor site and its off-target effect elicit toxici-ty and attenuate the efficacy of chemotherapy.To overcome that,nanoparticles(NPs)have been delicately designed as carriers for tumor diagnosis and drug delivery.Being formulated and bioengineered such like chemical modification and conjugation of peptide and antibody,NPs hold distinct advantages for better biocompatibility,bioavailability and tumor cell targeting.Hereby,we first overviewed various NP formulations on cancer cell tracing and drug delivery system.Then,we performed PubMed search for NPs involved chemotherapy in clinical trials of advanced non-small-cell lung cancer(NSCLC)and breast cancer.When NPs drug system was applied for monotherapy or drug cocktail,patients were well tolerated and achieved better efficacy in most studies,as evidenced by few months of prolonged overall survival and progression-free-survival in patients among all ages.However,how to achieve long-time survival and better life quality is not covered yet.For perspectives,multimodal regimens are required to enhance targeting effi-ciency.in which NPs delivery system is synergized and integrated with pharmacological and physical treatment.

摘要：Objective To explore the clinicopathological characteristics of pulmonary enteric adenocarcinoma(PEAC)and its treatment and prognosis. Methods Patients with pathologically confirmed PEAC treated at Xuanwu Hospital,Capital Medical University,be-tween 2019 and 2023 were retrospectively identified.Patients with colorectal adenocarcinoma were excluded.Clini-cal manifestations,imaging findings,pathological findings,treatment regimens,and prognostic data were reviewed. Results Eight patients(three male,five female)of median age 67.5 years(range 50-79)were included.The most common symptom was cough(62.5%),with some patients reporting shortness of breath and chest tightness.Chest CT revealed soft tis0sue masses in six cases,a ground-glass nodule in one case,and multiple nodules accompanied by pleural effusion in one case.Histological examination showed tall columnar tumor cells that formed glandular or sieve-like structures.Immunohistochemistry showed that all cases were CK7-positive,seven were CDX2-posi-tive,five were CK20-positive,five were villin-positive,and three were positive for all four markers.Genetic testing showed epidermal growth factor receptor gene mutation positivity in one case and Kirsten rat sarcoma viral oncogene homolog gene mutation positivity in another.Three patients with stage I-II disease underwent surgery,three with stage IV disease received chemotherapy and immunotherapy,and one with stage II disease received targeted therapy.The follow-up data showed that the prognosis of PEAC was related to clinical stage and the treatment regimen,with the longest survival being 58 months. Conclusions PEAC is a rare type of lung adenocarcinoma with clinicopathological features similar to those of colorec-tal adenocarcinoma.Chest CT often shows a large soft tissue shadow,which must be diagnosed by a combination of pa-thology and immunohistochemistry.Early diagnosis,multimodal treatment,and immunotherapy may prolong survival.

摘要：Septic shock is a serious surgical complication with a high mortality rate and presents challenges for anesthetic man-agement.This review examines the pathophysiological mechanisms,perioperative risks,and impact of septic shock on the function of multiple organs,as well as the latest advances and strategies in anesthetic management for surgical pa-tients with septic shock.Remimazolam and ketamine are preferred for anesthetic management of these patients in view of their minimal impact on hemodynamics.Regional anesthesia and nerve block techniques may improve the progno-sis in high-risk patients.Rational use of vasopressors,advanced hemodynamic monitoring,and restrictive transfusion strategies are also key elements in management.Agents such as fentanyl,which may exacerbate circulatory suppres-sion,should be avoided,and the risks of general anesthesia in specific populations should be carefully considered.This review provides a systematic and practical clinical reference for young anesthesiologists,emphasizing individualized and multidisciplinary management to improve perioperative outcomes in patients with septic shock.

摘要：Immune tolerance research The 2025 Nobel Prize in Physiology or Medicine has been awarded to Mary E.Brunkow,Fred Ramsdell,and Shimon Sakaguchi for their groundbreaking con-tributions to the field of peripheral immune tolerance.Their discoveries related to regulatory T cells(Tregs)and the FOXP3 gene have fundamentally transformed our understanding of how the immune system distin-guishes between foreign invaders and the body's own tissues,opening new avenues for the treatment of autoimmune diseases and other immune-related dis-orders.

摘要：Objective To analyze hemodynamic changes in the portal vein and hepatic artery after splenectomy and pericar-dial devascularization. Methods A total of 132 patients with portal hypertension who underwent splenectomy and pericardial devascu-larization in Beijing You'an Hospital from June 2014 to June 2017 were selected.Hemodynamic changes in the portal vein,hepatic artery,and hepatic elasticity were recorded before and at 1,3,6,12,24,and 36 months after the operation,and the characteristics of hepatic blood flow before and after surgery were analyzed. Results Among the 132 patients,there were 89 men and 43 women aged 27-74 years,with a mean±standard deviation)age of 48.6±10.6 years.Liver stiffness at 1,3,6,12,24,and 36 months after surgery was significantly lower than that preoperatively(all P<0.05).Additionally,portal vein flow and velocity at 1,3,6,12,and 24 months after surgery were sig-nificantly lower than those preoperatively(all P<0.05).Liver stiffness was positively correlated with portal vein flow and velocity.Hepatic artery flow at 1 month after surgery was significantly higher than that preoperatively(P<0.05). Conclusions After splenectomy and pericardial devascularization,short-term and long-term liver stiffness,portal vein flow,and mean velocity are lower than those preoperatively.Liver stiffness is positively correlated with portal vein flow and mean velocity.Splenectomy and pericardial devascularization may partially reverse liver cirrhosis and improve liver function.

摘要：Objective To compare the effects of two regimens on immune reconstitution in patients with HIV:bictegravir/em-tricitabine/tenofovir alafenamide(B/F/TAF)and efavirenz+tenofovir disoproxil+lamivudine(EFV+TDF+3TC). Methods Using a retrospective research method,basic data,such as age,gender,occupation,HIV infection route,educational level,height,weight,CD4+T cell count,CD8+T cell count,blood glucose,blood lipids,uric acid,and liver and kidney function,were collected from newly diagnosed individuals with HIV.Patients were divided into the B/F/TAF group and the EFV+TDF+3TC group.SPSS software was used to analyze the differences in vari-ous indicators and their impact on the recovery of CD4+T lymphocyte levels before and after one-year follow-up. Results There were no statistically significant differences between the two groups in terms of gender,age,liver and kidney function,blood lipids,lymphocyte count,viral load,and other baseline indicators.After one year of treatment,there were statistically significant differences in body mass index(t=1.997,P=0.04),CD4+T lymphocyte count(Z=2.750,P<0.01),low-density lipoprotein(t=2.148,P=0.03),high-density lipoprotein(t=5.546,P<0.01),CD4/CD8 ratio(t=2.217,P=0.02),and serum creatinine(Z=2.026,P=0.04)between the two groups.Meanwhile,there were no statistically significant differences in the CD8+T lymphocyte counts,and the levels of alanine aminotransferase,aspartate aminotransferase,total bilirubin,fasting blood glucose,total cholesterol,triglycerides,very low-density lipo-protein,serum uric acid,and viral load>200 copies/mL.The B/F/TAF group had fewer drug resistance cases within one year of treatment compared with the EFV+TDF+3TC group.The binary logistic showed that there were statistically significant differences in high-density lipoproteins(OR=4.104,95%CI(2.035,8.279)),low-density lipoproteins(OR=1.147,95%CI(1.028,1.280)),and CD4+T lymphocyte counts(OR=3.615,95%CI(1.115,8.977)).There was a higher proportion of patients with normal CD4+T lymphocyte levels(greater than 500/µL)using the B/F/TAF regimen compared with the EFV+TDF+3TC treatment between 3 months and 1 year after antiretroviral therapy. Conclusion There is a greater recovery of CD4+T lymphocyte count levels in HIV-infected individuals after an-tiretroviral therapy using the B/F/TAF regimen compared with the EFV+TDF+3TC treatment.At the same time,there is altered lipid metabolism following treatment using the B/F/TAF regimen in patients with HIV.

摘要：Recent advancements in the prevention and management of chronic hepatitis B virus(HBV)infection in children have significantly improved clinical outcomes.This review focuses on recent progress in antiviral treatment reg-imens for children with HBeAg-positive chronic hepatitis B in the immune clearance phase and HBeAg-positive HBV infection in the immune tolerance phase.Additionally,we examine the role of early antiviral intervention in infants with acute or chronic HBV infection,highlighting factors that influence the likelihood of achieving clinical cure in children with chronic HBV.We further discuss the importance of timely decision-making in initiating anti-viral therapy for pediatric patients and identify unresolved challenges and unmet needs in this evolving field.