Uncommon presentation of gastric mucosa-associated lymphoid tissue lymphoma in a 13-year-old girl: acute vomiting of blood as the initial symptom.

Introduction and importance: Extranodal marginal zone lymphoma (EMZL lymphoma), also known as mucosa-associated lymphoid tissue (MALT) lymphoma, is a rare B-cell lymphoma that rarely affects children. The involvement of infectious agents, especially H. pylori, has been observed in the formation and progression of MALT lymphoma in the stomach. Hematemesis as the primary clinical manifestation is uncommon, highlighting the need for case studies with this presentation. This article uses SCARE2023 criteria as a framework to sort out a case report in order. Case presentation: A 13-year-old female patient was admitted in August 2022 with an episode of hematemesis. She had a prior diagnosis of anaemia and was found positive for H. pylori. Despite treatment, she developed symptoms of chronic non-atrophic gastritis and had recurring episodes of hematemesis. Physical and diagnostic examinations revealed B-cell lymphoma localized in the gastric antrum. The primary diagnosis was extranodal MALT lymphoma with unique plasma cell differentiation. Clinical discussion: The presentation of gastric MALT lymphoma can be variable, with definitive diagnosis often achieved via endoscopic biopsy. H. pylori plays a significant role in the onset and progression of this lymphoma, emphasizing the importance of its eradication for treatment. Effective outcomes can be achieved through anti-H. pylori treatment, although it is essential for clinicians to ensure its complete eradication post-treatment. Conclusion: Paediatric presentation of gastric MALT lymphoma, especially with hematemesis as the primary symptom, is rare and can be easily misdiagnosed. Compared to adults, children generally exhibit a better prognosis with effective H. pylori treatment. It is vital for medical professionals to recognize the differences in presentation between children and adults to ensure accurate diagnosis and treatment.

Clinical characteristics of re-positive COVID-19 patients in Huangshi, China: A retrospective cohort study.

A cluster of patients with coronavirus disease 2019 (COVID-19) underwent repeated positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA tests after they were discharged from the hospital. We referred to them as re-positive (RP) patients in this study. We aimed to describe the clinical characteristics of these patients in a retrospective cohort study. After being treated for COVID-19, the patients underwent 14 days of quarantine following their discharge from the Huangshi Hospital of Traditional Chinese Medicine and the Huangshi Hospital of Youse. Two additional sequential SARS-CoV-2 RNA tests were performed at the end of quarantine. The median age of the 368 patients was 51 years, and 184 (50%) patients were female. A total of 23 RP patients were observed at follow-up. Using multivariate Cox regression analysis, risk factors associated with RP included a higher ratio of lymphocyte/white blood cell on admission (adjusted HR 7.038; 95% CI, 1.911-25.932; P = 0.0034), lower peak temperature during hospitalization (adjusted HR, 0.203; 95% CI, 0.093-0.443; P<0.0001), and the presence of comorbidities, particularly hypertension or chronic diseases in the respiratory system (adjusted HR, 3.883; 95% CI, 1.468-10.273; P = 0.0063). Antivirus treatment with arbidol was associated with a lower likelihood of re-positive outcomes (adjusted HR, 0.178; 95% CI, 0.045-0.709; P = 0.0144).

Stearic acid-g-chitosan polymeric micelle for oral drug delivery: in vitro transport and in vivo absorption.

Stearic acid-g-chitosan (low molecular weight chitosan CS-SA) with different amino-substituted degrees was synthesized and evaluated as an oral delivery vehicle in this paper. Synthesized CS-SA with 4.47%, 24.36% and 40.36% amino-substituted degree (SD) could form micelles by self-aggregation in aqueous medium. The critical micelle concentration (CMC) ranged from about 0.16 to 0.25 mg/mL, which decreased with the increased SD of CS-SA. The CS-SA micelles had 33.4-130.9 nm size and 22.9- 48.4 mV zeta potential. CS-SA with higher SD had the smaller size and the higher zeta potential. The permeability and possible transport route of CS-SA micelles across the gastrointestinal tract was investigated by in vitro model Caco-2 cells. The results exhibited that the CS-SA micelles had good permeability, and the permeability enhanced with increasing SD of the CS-SA. The transport of the micelles showed energy, pH and concentration dependent transcytosis process, mainly through macropinocytosis and partly via fluid-phase transcytosis and caveolar route. The reversible decrease in transepithelial electrical resistance (TEER) by treatment of micelles suggested that paracellular transport pathway was another route of the micelles crossing the gastrointestinal tract. Using doxorubicin (DOX) as a model drug, the permeation results further demonstrated that the DOX transport mediated by CS-SA micelles could avoid efflux via P-glycoprotein. In vivo study demonstrated that the micelles could significantly improve the bioavailability of encapsulated drug. The results presented that the CS-SA with higher SD was a promising vehicle for oral drugs.