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Objective To investigate the clinical effect of free posterior interosseous artery perforator flap combined with muscle fascia for repairing soft tissue and extensor tendon defect of hand.Methods Fifteen cases of hand skin soft tissue and extensor tendon defect admitted to Ningbo No.6 Hospital from December 2017 to December 2020 were repaired with free posterior interosseous artery perforator flap combined with extensor carpi ulnaris muscle fascia transplantation,and curative effect was observed.Results All flaps survived and patients were followed up for 6-24 months.The texture and thickness of the flap were satisfactory,and the recovery of the finger extension and flexion function were good.The excellent and good rate of hand tendon repair was 66.7%.In three cases with nerve anastomosis,the skin flap sensation recovered to S3.Conclusion The free posterior interosseous artery perforator flap combined with muscle fascia has a good clinical effect in repairing hand skin soft tissue and tendon defect.
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L-theanine has been shown to have a therapeutic effect on depression.However,whether L-theanine has an excellent preventive effect on depression in children and adolescents and what its mechanism is have not been well explained.Given the complexity of the pathogenesis of depression,this study investigated the preventive effect and mechanism of L-theanine on depression in juvenile rats by combining serum and hippocampal metabolomic strategies.Behavioral tests,hippocampal tissue sections,and serum and hippocampal biochemical indexes were studied,and the results confirmed the preventive effect of L-theanine.Untargeted reversed-phase liquid chromatography-quadrupole-time-of-flight mass spec-trometry and targeted hydrophilic interaction liquid chromatography-triple quadrupole mass spec-trometry were developed to analyze the metabolism changes in the serum and hippocampus to screen for potential biomarkers related to L-theanine treatment.The results suggested that 28 abnormal me-tabolites in the serum and hippocampus that were considered as potential biomarkers returned to near-normal levels after L-theanine administration.These biomarkers were involved in various metabolic pathways,mainly including amino acid metabolism and lipid metabolism.The levels of amino acids and neurotransmitters in the phenylalanine,tryptophan,and glutamic acid pathways were significantly reduced after L-theanine administration compared with chronic unpredictable mild stress-induced rats.In summary,L-theanine had a significant preventive effect on depression and achieved its preventive results on depression by regulating various aspects of the body,such as amino acids,lipids,and inflammation.This research systematically analyzed the mechanism of L-theanine in preventing depression and laid the foundation for applying L-theanine to prevent depression in children and adolescents.
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Autologous serum skin test (ASST) is commonly used as a screening test to assess immune subtypes of chronic spontaneous urticaria (CSU) in clinical practice, but its immunological mechanisms and associations with clinical features and prognosis of CSU are not yet clear. Studies have shown that positive ASST is associated with increased immunoglobulin G autoantibodies, decreased eosinophil and basophil counts, increased CD63 expression on basophils, and changes in circulating inflammatory cytokine levels in CSU patients, but not associated with age, disease duration, and personal or family history of CSU patients, and may be a predictor of severity of chronic urticaria. ASST-positive patients may respond poorly to second-generation H1 antihistamines, slowly to omalizumab, but respond well to cyclosporine and autologous whole blood/serum injections. This review summarizes the immunological and clinical characteristics of ASST-positive patients, and discusses the predictive value of positive ASST for the efficacy of different treatment regimens.
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Objective:To investigate Helicobactor pylori (H. pylori) infection status and interfamilial transmission pattern in Zhengzhou area. Methods:A cross-sectional study was conducted from September 2020 to march 2021, among 731 individual from 266 families randomly selected from 9 communities of Zhengzhou area. H. pylori infection status was determined by serum antibody tests, and 13C-urea breath test was performed in the previously eradicated population to clarify the current infection status. The individual and familial infection rate, infection status for couples and children and adolescent were analyzed. Results:Among 731 individuals from 266 families, 397 of them were H. pylori positive. The individual infection rate was 54.31% (397/731); among infected individuals 77.83% (307/397) were infected with type Ⅰ strain, 22.67% (90/397) were infected by type Ⅱ strain. Annual household income ( χ2=0.419, 0.410, 0.213, all P>0.05), smoking history (χ 2=0.071, P>0.05), drinking history ( χ2=0.071, P>0.05), dining place ( χ2=0.009, P>0.05), gastrointestinal symptoms ( χ2=0.047, P>0.05), family history of gastric disease ( χ2=0.069, P>0.05), and history of gastric cancer ( χ2=0.004, P>0.05) had no significant differences between H. pylori-positive and -negative groups, but the infection rate in individuals with higher education level was lower ( χ2=4.449, P<0.05). The infection rate was significantly higher in≥18 age groups compared with<18 age groups ( χ2=6.531, 23.362, 20.671, 24.244, 37.948, 14.597 and 5.170, all P<0.05). The familial H. pylori infection rate was 87.59% (233/266), and in 61 families all member were infected (26.18%, 61/233). The positive rate was 23.08% (6/26) in 50 families with children under 18 years when both parents were infected. Among 231 coupled families, both couples were infected in 78 families (33.76%), one couple was infected in 113 families (48.92%), and both couples were not infected in 40 (17.32%). With the increase of marriage time, the infection rate of both spouses increased significantly ( χ2=7.775, 12.662, 15.487, all P<0.05). Conclusions:The distribution of H. pylori infection presents a family cluster pattern, and intrafamilial infection is an important transmission rout of H. pylori. The type I strain of H. pylori is the dominate strain in this area.
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X-linked adrenoleukodystrophy (X-ALD) is the most common peroxisomal disorder. Adult-onset X-ALD characterized by brainstem symptoms is a rare phenotype of the disease. A male youth of adult-onset X-ALD characterized by brainstem symptoms in Tianjin Huanhu Hospital at April 12, 2021 is reported. The patient mainly presented with progressively gait disturbance, dysarthria and ataxia, which were consistent with the clinical diagnosis of X-ALD in combination with other ancillary tests. Genetic testing suggested the presence of a hemizygous mutation site in the ABCD1 gene. The clinical, imaging and genetic characteristics of X-ALD patients in the literature with brain stem lesion are also summarized, thereby improving the understanding of the rare clinical phenotype of X-ALD.
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ObjectiveTo analyze the dynamic changes of the main chemical components and color characteristics of Polygoni Multiflori Radix(PMR) during the process of ancient classical nine-time repeating steaming and sun-drying, and to explore the correlation between the changes. MethodHigh performance liquid chromatography(HPLC) was used to determine the contents of gallic acid, stilbene glycoside, emodin-8-O-β-D-glucoside, physcion-8-O-β-D-glucoside, emodin and physcion in PMR during the process of nine-time repeating steaming and sun-drying, and electronic eye technology was used to objectively characterize the color of PMR during the process. Partial least squares(PLS) was used to analyze the correlation between the content of main components and the color characteristics. ResultDuring the nine-time repeating steaming and sun-drying process of PMR, the content of gallic acid gradually increased with the increase of steaming and sun-drying times, and the contents of other components showed fluctuating changes, with an overall decreasing trend in the contents of stilbene glycoside, emodin-8-O-β-D-glucoside and physcion-8-O-β-D-glucoside, and an overall increasing trend in the contents of emodin and physcion. The results of electronic eye analysis showed that the color of PMR became dark, red and blue in the process of nine-time repeating steaming and sun-drying. The results of hierarchical cluster analysis(HCA) and principal component analysis(PCA) of the contents of six main components and the colors showed that the samples steamed and sun-dried for one to four times could be grouped into one category, the other five categories of samples could be grouped into another category. Gallic acid and stilbene glycoside were significantly correlated with the color indexes of PMR during the process of nine-time repeating steaming and sun-drying. ConclusionThe general changes of material basis and color characteristics of PMR during the process of ancient classical nine-time repeating steaming and sun-drying have certain rules, and the establishment of the correlation model between color and index components can realize the judgment and quality evaluation of processing degree of PMR decoction pieces.
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Objective To understand the current status and analyze the factors affecting the work engagement of wound therapists,and to provide references for promoting their work engagement.Methods From September 2022 to March 2023,wound therapists who were certificated by European Wound Management Association for more than 3 months were selected as subjects by convenient sampling method.The data was collected by the General Information Questionnaire,Hospitals and Wound Clinics Questionnaire,Areas of Worklife Scale and Specialty Nurse Work Engagement Scale,and the factors influencing the work engagement of wound therapists were analyzed by univariate and multiple liner regression.Results A total of 219 wound therapists were included.The total mean score of areas of worklife was(99.37±13.70);the average score of items was(3.55±0.49);the total mean score of the specialty nurse work engagement was(140.01±16.00);the average score of items was(4.38±0.50).The results of multiple linear regression analysis showed that reward,community,fairness,and values were factors influencing the work engagement of wound therapists(P<0.05).Conclusion The higher average score of each dimension of areas of worklife could predict the higher level of work engagement for wound therapists.Nursing managers should pay more attention to the job-matching degree of specialty nurses and adopt scientific and effective management methods to improve the job-matching,which will help improve the specialty nurses'work engagement and satisfaction and reduce job burnout.
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Background@#and Purpose The electrophysiologic characteristics of peripheral neuropathy secondary to nitrous oxide (N2O) abuse remain unclear. The paper therefore aimed to summarize the electrophysiologic characteristics of N2O-associated peripheral neuropathy and identify the risk factors of severe nerve injury. @*Methods@#The electrophysiologic results and clinical data of patients with peripheral neuropathy secondary to N2O abuse at our hospital between 2018 and 2020 were analyzed retrospectively, and their electrophysiologic changes were summarized. @*Results@#Most patients exhibited decreased sensory and motor nerve conduction velocities (75% and 76%), decreased sensory nerve and compound motor action potentials (57% and 59%), and prolonged distal motor latency (59%), while a response was absent in 36%. These findings indicate that N2O abuse can result in generalized injury to sensory and motor nerves. Electrophysiologic results indicated axonal neuropathy in 37 cases (49%), demyelinating peripheral neuropathy in 4 (5%), and mixed neuropathy in 12 (16%). Peripheral nerve injury was more common in the lower limbs (72%) than in the upper limbs (42%, p<0.0001). The upper and lower limbs were primarily affected by sensory nerve demyelination (35%) and motor axonal injury (67%), respectively. Subgroup analysis indicated that longer N2O exposure and longer disease course were associated with more-severe motor axonal injury in the lower limbs. @*Conclusions@#N2O-associated peripheral neuropathy can lead to sensory and motor nerve injury, with axonal injury being the most common. Injuries were more severe in the lower limbs. Prolonged N2O exposure and disease course increased the severity of motor axonal injury in the lower limbs.
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OBJECTIVE@#To characterize the paraspinal muscles of adolescent idiopathic scoliosis (AIS) patients, and to further explore its etiology.@*METHODS@#Clinical records and paraspinal muscle biopsies at the apex vertebra region during posterior scoliosis correction surgery of 18 AIS were collected from November 2018 to August 2019. Following standardized processing of fresh muscle tissue biopsy, serial sections with conventional hematoxylin-eosin (HE) and histochemical and immunohistochemical (IHC) with antibody Dystrophin-1 (R-domain), Dystrophin-2 (C-terminal), Dystrophin-3 (N-terminal), Dystrophin-total, Myosin (fast), major histocompatibility complex 1 (MHC-1), CD4, CD8, CD20, and CD68 staining were obtained. Biopsy samples were grouped according to the subjects' median Cobb angle (Cobb angle ≥ 55° as severe AIS group and Cobb angle < 55° as mild AIS group) and Nash-Moe's classification respectively, and the corresponding pathological changes were compared between the groups statistically.@*RESULTS@#Among the 18 AIS patients, 8 were in the severe AIS group (Cobb angle ≥55°) and 10 in the mild AIS group (Cobb angle < 55°). Both severe and mild AIS groups presented various of atrophy and degeneration of paraspinal muscles, varying degrees and staining patterns of immune-expression of Dystrophin-3 loss, especially Dystrophin-2 loss in severe AIS group with significant differences, as well as among the Nash-Moe classification subgroups. Besides, infiltration of CD4+ and CD8+ cells in the paraspinal muscles and tendons was observed in all the patients while CD20+ cells were null. The expression of MHC-1 on myolemma was present in some muscle fibers.@*CONCLUSION@#The histologic of paraspinal muscle biopsy in AIS had similar characteristic changes, the expression of Dystrophin protein was significantly reduced and correlated with the severity of scoliosis, suggesting that Dystrophin protein dysfunctions might contribute to the development of scoliosis. Meanwhile, the inflammatory changes of AIS were mainly manifested by T cell infiltration, and there seemed to be a certain correlation between inflammatory cell infiltration, MHC-1 expression and abnormal expression of Dystrophin. Further research along the lines of this result may open up new ideas for the diagnosis of scoliosis and the treatment of paraspinal myopathy.
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Humains , Adolescent , Scoliose/chirurgie , Muscles paravertébraux/anatomopathologie , Dystrophine , Stéatose hépatique non alcoolique/anatomopathologie , Cyphose/anatomopathologie , BiopsieRésumé
ObjectiveTo identify potential distribution areas for wild Panax ginseng cultivated under forest in Liaoning province, China, and analyze the ecological factors of spatial stratified heterogeneity affecting its ecological suitability and quality suitability. MethodWild Panax ginseng samples cultivated under forest were collected from 33 cultivation bases in Liaoning province. The Maxent maximum entropy model and ArcGIS were used to delineate the ecological suitability zones. Correlation analysis was performed on seven indicators and 110 ecological factors. Variables with significant correlation (P<0.05) were used to build partial least squares regression analysis models. A comprehensive quality zoning was conducted using the analytic hierarchy process (AHP). The geographic detector was employed to analyze the interactions among dominant ecological factors of spatial stratified heterogeneity affecting habitat suitability, quality suitability, and the ecological driving factors. ResultVegetation type was the most influential ecological factor for delineating the ecological suitability zones for wild Panax ginseng in Liaoning province. The main ecological suitability areas for wild Panax ginseng cultivated under forest were located in the northeast, east, and southeast regions along the line from Xifeng County to Gaizhou City. The comprehensive quality suitability of wild Panax ginseng cultivated under forest was highest in Kuandian County and Huanren County and gradually decreased to the northwest and southwest. Within the delineated regions, the suitability conditions and comprehensive quality of wild Panax ginseng cultivated under forest were primarily influenced by the interactions between radiation and precipitation factors. The content of the measured samples was significantly higher than the standards in the 2020 edition of the Chinese Pharmacopoeia, indicating the high overall quality of wild Panax ginseng in Liaoning Province. ConclusionAccording to the zoning and prediction results, areas in Fengcheng City, Xiuyan County, Zhuanghe City, Liaoyang County, Tieling County, Xifeng County, Gaizhou City, Haicheng City, and Dashiqiao City showed large potential distribution areas with high quality, making them highly promising for wild Panax ginseng cultivation. However, further experimental verification is required. The zoning results can provide insights for research on habitat suitability and comprehensive quality accumulation of wild Panax ginseng cultivated under forest, as well as guidance for the search for potential cultivation areas and industrial development of wild Panax ginseng in Liaoning Province.
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FRMD6, a member of the 4.1 ezrin-radixin-moesin domain-containing protein family, has been reported to inhibit tumor progression in multiple cancers. Here, we demonstrate the involvement of FRMD6 in lung cancer progression. We find that FRMD6 is overexpressed in lung cancer tissues relative to in normal lung tissues. In addition, the enhanced expression of FRMD6 is associated with poor outcomes in patients with lung squamous cell carcinoma (n = 75, P = 0.0054) and lung adenocarcinoma (n = 94, P = 0.0330). Cell migration and proliferation in vitro and tumor formation in vivo are promoted by FRMD6 but are suppressed by the depletion of FRMD6. Mechanistically, FRMD6 interacts and colocalizes with mTOR and S6K, which are the key molecules of the mTOR signaling pathway. FRMD6 markedly enhances the interaction between mTOR and S6K, subsequently increasing the levels of endogenous pS6K and downstream pS6 in lung cancer cells. Furthermore, knocking out FRMD6 inhibits the activation of the mTOR signaling pathway in Frmd6-/- gene KO MEFs and mice. Altogether, our results show that FRMD6 contributes to lung cancer progression by activating the mTOR signaling pathway.
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ATP-binding cassette (ABC) transporters are the largest transporter families in human bodies; they are widely distributed and have complex functions. ABC transporters can mediate the translocation of various substrates on the cell membrane. This paper summarizes the structure, classification, function and action mechanism of ABC transporters and the research progress of ABC transporters in AD in recent years, and discusses the future research direction for preventing and treating AD in this field to provide new ideas and references for the prevention and treatment of AD.
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Background: Colorectal cancer is one of the most commonly diagnosed cancer and leading causes of cancer death worldwide. Fibrinogen-like protein 2 (FGL2), a member of the fibrinogen family, has been demonstrated as a regulator of immune cell functions in tumor microenvironment and might facilitate tumor progression. Aims: To study the expression and clinical significance of FGL2 in colon cancer. Methods: One hundred and fifty colon cancer patients diagnosed from January 2018 to January 2022 at the Second Hospital of Tianjin Medical University were enrolled in this study. The paraffin-embedded tissues were collected for detection of FGL2 protein and the surface markers of tumor infiltrating immune cells (TIICs), including CD4, CD8, CD20, CD68, and CD56 by using immunohistochemistry. The correlations of FGL2 expression level with the clinicopathological parameters and TIICs counting were analyzed. Results: Expression of FGL2 was upregulated in 68.7% of the colon cancer cases. Its expression level was correlated positively with the tumor size and TNM staging (all P0.05). Meanwhile, the expression level of FGL2 was associated with the cell counting of CD4
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A patient who suffered with degloving and destructive servered distal segment of the left thumb was referred to the Department of Hand Surgery, Ningbo No.6 Hospital in May 2021. The thumb was reconstructed by transfer and splicing of a free bilateral fibular hallux nail flap. Metatarsal artery of the metatarsal fibular side of the flap was anastomosed to the proper palmar digital artery at the recipient site. The nerve meridian were anastomosed to the proper palmar digital nerve of thumb, and the distal arterial arch of the metatarsal base between the flaps was anastomosed at the same time. A V-Y advancement flap was employed to repair the donor site. After 3 months, the transferred flaps survived well, the left thumb nail grew well, and the dynamic TPD was at 7 mm. According to the Evaluation Standard of Thumb and Finger Reconstruction Function of the Society of Hand Surgery of the Chinese Medical Association, it was evaluated as excellent (14 points). The advancement flap in the donor site survived well, and the walking, running and jumping of both feet were not affected. According to Maryland's foot function scoring standard, it was evaluated as excellent (98 points).
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BACKGROUND@#Coronavirus disease 2019 (COVID-19) has become a worldwide life-threatening pandemic. Lianhua Qingwen is believed to possess the ability to treat or significantly improve the symptoms of COVID-19. These claims make it important to systematically evaluate the effects of using Lianhua Qingwen with Western medicine to treat COVID-19.@*OBJECTIVE@#To evaluate the safety and efficacy of combination therapy, employing Lianhua Qingwen with Western medicine, to treat COVID-19, using a meta-analysis approach.@*SEARCH STRATEGY@#China National Knowledge Infrastructure, Wanfang Database, VIP Database, PubMed, Embase, and Cochrane Library databases were searched for studies evaluating the effect of Lianhua Qingwen-Western medicine combination therapy in the treatment of COVID-19.@*INCLUSION CRITERIA@#(1) Research object: hospitalized patients meeting the diagnostic criteria of COVID-19 were included. (2) Intervention measures: patients in the treatment group received Lianhua Qingwen treatment combined with Western medicine, while the control group received either Western medicine or Chinese medicine treatment. (3) Research type: randomized controlled trials and retrospective study were included.@*DATA EXTRACTION AND ANALYSIS@#Two researchers extracted the first author, the proportion of males and females, age, body temperature, course of treatment, rate of disappearance of main symptoms, duration of fever, adverse reactions, and total effectiveness from the literature. Odds ratio (OR) and 95% confidence interval (CI) were used as the effect value for count data, and mean difference (MD) and 95% CI were used as the effect value for measurement data.@*RESULTS@#Six articles met the inclusion criteria, including a total of 856 COVID-19 patients. The meta-analysis showed that Lianhua Qingwen combination therapy achieved higher rates of fever reduction (OR = 3.43, 95% CI [1.78, 6.59], P = 0.0002), cough reduction (OR = 3.39, 95% CI [1.85, 6.23], P < 0.0001), recovery from shortness of breath (OR = 10.62, 95% CI [3.71, 30.40], P < 0.0001) and recovery from fatigue (OR = 2.82, 95% CI [1.44, 5.53], P = 0.003), higher total effectiveness rate (OR = 2.51, 95% CI [1.73, 3.64], P < 0.00001), and shorter time to recovery from fever (MD = -1.00, 95% CI [-1.04, 0.96], P < 0.00001), and did not increase the adverse reaction rate (OR = 0.65, 95% CI [0.42, 1.01], P = 0.06), compared to the single medication control.@*CONCLUSION@#The Lianhua Qingwen and Western medicine combination therapy is highly effective for COVID-19 patients and has good clinical safety. As only a small number of studies and patients were included in this review, more high-quality, multicenter, large-sample-size, randomized, double-blind, controlled trials are still needed for verification.
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Femelle , Humains , Mâle , COVID-19 , Médicaments issus de plantes chinoises , Études multicentriques comme sujet , Pandémies , Essais contrôlés randomisés comme sujet , Études rétrospectives , SARS-CoV-2Résumé
ObjectiveTo analyze the flavor substances and change rules of Rhei Radix et Rhizoma during the process of nine-time repeating steaming and sun-drying. MethodThe flavor response values of Rhei Radix et Rhizoma samples were obtained by using PEN3 electronic nose system. The data were processed and analyzed by principal component analysis (PCA), linear discriminant analysis (LDA) and Loadings analysis. ResultRhei Radix et Rhizoma processed with nine-time repeating steaming and sun-drying could be effectively distinguished into two categories as the sixth sample was the turning point. The samples steamed and dried for one to five times could be grouped into one category, the other four samples were obviously distinguished from them. The main flavor components reached the maximum response in the sample processed with six-time repeating steaming and sun-drying, and its response value of inorganic sulfur compounds was about 2.7 times that of the sample processed with one-time repeating steaming and sun-drying. In addition, compared with the raw products, the flavors of Rhei Radix et Rhizoma processed with nine-time repeating steaming and sun-drying and wine stewing changed significantly, and the response value of inorganic sulfur compounds in sample processed with nine-time repeating steaming and sun-drying was about 2.2 times that of raw products. From the perspective of flavor analysis, the response values of inorganic sulfur compounds and nitrogen-oxygen compounds in sample processed with nine-time repeating steaming and sun-drying were higher than those of wine-stewed products, and the two were not completely equivalent. ConclusionElectronic nose technology preliminarily clarifies the dynamic change rules of the flavor of Rhei Radix et Rhizoma during the process of nine-time repeating steaming and sun-drying from the flavor characteristics, and clarifies the difference between products processed with nine-time repeating steaming and sun-drying and wine-stewed products from the odor characteristics, which lays a foundation for revealing the processing principle of Rhei Radix et Rhizoma processed with nine-time repeating steaming and sun-drying.
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A 22-year-old female has complained of hirsutism, acanthosis nigricans, enlarged clitoris, and menstrual disorders since puberty. Laboratory examinations revealed hyperandrogenemia. Severe insulin resistance and diabetes were found during hospitalization in our hospital. She was diagnosed with type A insulin resistance syndrome finally. After treatment with metformin, the acanthosis nigricans was significantly relieved, blood glucose was controlled satisfactorily, and the menstrual cycle was restored.
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Objective:To evaluate the efficacy and safety of baricitinib in the treatment of moderate-to-severe atopic dermatitis (AD) .Methods:From June 2020 to June 2021, patients with moderate-to-severe AD who were insensitive or intolerant to topical agents were enrolled from Department of Dermatology, Peking University First Hospital. Before treatment, the patients were evaluated by 4 scales, including the Investigator′s Global Assessment (IGA), Eczema Area and Severity Index (EASI), Itch Numeric Rating Scale (NRS), and Dermatology Life Quality Index (DLQI) ; meanwhile, photos of skin lesions were taken, routine blood test was performed, blood biochemical indices and total IgE levels were measured. After exclusion of contraindications, the patients were treated with oral baricitinib at a dose of 2 mg/d for 16 weeks. Regular follow-up was conducted at weeks 1, 2, 4, 8, 12, 16 and 20 after the start of treatment, clinical evaluation was carried out with the above 4 scales, and adverse events were recorded during the treatment.Results:A total of 24 patients were enrolled in the study, and all completed 16-week oral treatment and 20-week follow-up. All the 4 scale scores showed a continuous downward trend within 20 weeks after the start of treatment. At week 20, the patients′ IGA, EASI, NRS, and DLQI scores significantly decreased from 4.13 ± 0.61, 37.59 ± 14.86, 6.83 ± 2.26 and 18.67 ± 8.64 points respectively at baseline to 1.12 ± 0.49, 4.53 ± 3.78, 0.72 ± 0.58 and 1.39 ± 0.85 points respectively ( t = 22.70, 10.55, 10.69, 8.40, respectively, all P < 0.001). During the follow-up period, no serious adverse reactions were observed; 3 patients experienced gastric discomfort at the start of oral treatment, but the symptoms disappeared after the treatment continued; 3 developed acute allergic manifestations (1 case of allergic conjunctivitis, 2 cases of acute urticaria), which resolved rapidly after the use of antihistamines without recurrence. Conclusion:Baricitinib can provide a safer and more effective treatment option for patients with moderate-to-severe AD, especially those who are insensitive or intolerant to topical agents and need systemic treatments.
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Objective:To systematically evaluate the effect of melatonin on postoperative sleep quality.Methods:Databases such as PubMed, Embase, Cochrane library, Web of Science, ClinicalTrials.gov, China National Knowledge Infrastructure, Wanfang Database, China Biomedical Literature Database and China Science and Technology Journal Database were searched from inception to January 30, 2022 for randomized controlled trials (RCTs) comparing the effects of melatonin versus placebo on postoperative sleep quality.The outcomes analyzed were visual analog scale (VAS) score, sleep quality scale score, subjective sleep scale score, St.Mary′s Hospital sleep questionnaires score, sleep latency, total sleep time, number and duration of awakenings, and incidence of postoperative sleep disturbance.Statistical analysis was performed using the RevMan 5.4 software and Stata 16 software, and the trial sequential analysis (TSA) was conducted using the TSA 0.9.5.10 Beta software. Results:Eleven RCTs involving 822 patients were finally enrolled, with 431 patients in melatonin group and 391 patients in placebo group.The results of meta-analysis showed that melatonin significantly decreased postoperative VAS and sleep quality scale scores, and increased the postoperative subjective sleep scale and St.Mary′s Hospital sleep questionnaires scores, a daily dose of melatonin 6 mg produced a better efficacy, and it also prolonged the postoperative total sleep time and decreased the incidence of postoperative sleep disorders ( P<0.05), However, it had no effect on postoperative sleep latency and the number and duration of awakenings ( P>0.05). The results of TSA showed that although the actual sample size did not reach the expected sample size, the accumulated Z value crossed the traditional boundary value and the TSA boundary value, which indicated that the results of this meta-analysis had stability and further confirmed the efficacy of melatonin in improving postoperative sleep quality. Conclusions:Melatonin can improve postoperative sleep quality and a daily dose of melatonin 6 mg exerts a better efficacy.
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Objective:To explore the relations of changes in the cognitive function with brain structure network in patients with cerebellar infarction.Methods:Thirty-six patients with cerebellar infarction at the posterior lobe, admitted to our hospital from July 2016 to October 2019, were chosen as cerebellar infarction group; and 30 healthy subjects matched with age, gender, and education level at the same time period were used as control group. Neurocognitive and behavioral tests were performed on both groups to assess the cognitive functions, and MR imaging was performed to obtain diffusion tensor imaging (DTI) data. Deterministic tractography and graph theory were used to obtain the structural brain network and network parameters of all subjects. The differences of clinical data and brain network topological characteristic parameters between the two groups were compared, and the correlation between the subjects' brain structural network characteristic parameters and cognitive function was analyzed.Results:As compared with the control group, patients in the cerebellar infarction group had significantly lower Mini-mental State Examination (MMSE), Montreal Cognitive Scale (MoCA), Rey Auditory Verbal Learning Test (RAVLT), Digit Span Test (DST), Clock Drawing Test (CDT) and Berg Balance Scale (BBS) scores, and significantly longer Trail Making Test (TMT) time-consuming ( P<0.05). As compared with the control group, the cerebellar infarction group showed significantly decreased global efficiency (Eglob) and local efficiency (Eloc) in the brain network, and significantly increased clustering coefficient (Cp) and length of path (Lp, P<0.05). As compared with the control group, the cerebellar infarction group had significantly reduced nodal efficiency in 14 brain regions ( P<0.05), including bilateral median cingulate and paracingulate gyri (DCG), left inferior frontal gyrus-opercular part (IFGoperc), bilateral supplementary motor area (SMA), bilateral precuneus (PCUN), left inferior frontal gyrus-orbital part (ORBinf), left temporal pole-superior temporal gyrus (TPOsup), left temporal pole-middle temporal gyrus(TPOmid), left inferior parietal-supramarginal and angular gyri (IPL), bilateral posterior cingulate gyrus (PCG), left inferior frontal gyrus-triangular part (IFGtriang). MoCA scores were significantly negatively correlated with Lp ( r=-0.388, P=0.019), and were significantly positively correlated with Eglob ( r=0.350, P=0.036), and efficiencies in the right DCG ( r=0.428, P=0.009), left DCG ( r=0.359, P=0.031) and right PCG ( r=0.350, P=0.037) in the cerebellar infarction patients. The RAVLT scores showed a significantly positive correlation with Eglob ( r=0.338, P=0.044). The TMT-A time-consuming and left DCG had significant negative correlation ( r=0.357, P=0.032). TMT-B time-consuming was significantly negatively correlated with right DCG ( r=-0.432, P=0.008), right PCUN ( r=-0.350, P=0.036) and left DCG ( r=-0.398, P=0.016), and positively correlated with Lp ( r=0.406, P=0.014). Conclusions:There is cognitive dysfunction in multiple domains after acute cerebellar infarction, including memory, executive function, visuospatial ability and attention. At the same time, there are reduced efficiency of information transmission in bilateral PCUN, PCG and DCG, and the frontal temporal lobe; among them, the abnormal changes of the right PCG, bilateral DCG, and right PCUN may play key roles in cognitive dysfunction.