Perspectives of Health Care Personnel on the Benefits of Bronchiolitis Interventions.

OBJECTIVES: Many interventions in bronchiolitis are low-value or poorly studied. Inpatient bronchiolitis management is multidisciplinary, with varying degrees of registered nurse (RN) and respiratory therapist (RT) autonomy. Understanding the perceived benefit of interventions for frontline health care personnel may facilitate deimplementation efforts. Our objective was to examine perceptions surrounding the benefit of common inpatient bronchiolitis interventions. METHODS: We conducted a cross-sectional survey of inpatient pediatric RNs, RTs, and physicians/licensed practitioners (P/LPs) (eg, advanced-practice practitioners) from May to December of 2021 at 9 university-affiliated and 2 community hospitals. A clinical vignette preceded a series of inpatient bronchiolitis management questions. RESULTS: A total of 331 surveys were analyzed with a completion rate of 71.9%: 76.5% for RNs, 57.4% for RTs, and 71.2% for P/LPs. Approximately 54% of RNs and 45% of RTs compared with 2% of P/LPs believe albuterol would be "extremely or somewhat likely" to improve work of breathing (P < .001). Similarly, 52% of RNs, 32% of RTs, and 23% of P/LPs thought initiating or escalating oxygen in the absence of hypoxemia was likely to improve work of breathing (P < .001). Similar differences in perceived benefit were observed for steroids, nebulized hypertonic saline, and deep suctioning, but not superficial nasal suctioning. Hospital type (community versus university-affiliated) did not impact the magnitude of these differences. CONCLUSIONS: Variation exists in the perceived benefit of several low-value or poorly studied bronchiolitis interventions among health care personnel, with RNs/RTs generally perceiving higher benefit. Deimplementation, educational, and quality improvement efforts should be designed with an interprofessional framework.

Effects of microvascular invasion and anatomical hepatectomy on early recurrence and survival of patients with hepatocellular carcinoma / 中华肝胆外科杂志

Objective:To analyze the effects of microvascular invasion (MVI) and anatomical hepatectomy on early recurrence and survival of patients with hepatocellular carcinoma (HCC).Methods:The data of 246 patients with HCC admitted to 215 Hospital of Shaanxi Nuclear Industry, Chinese PLA General Hospital and Beijing Tsinghua Chang Gung Hospital from July 2008 to June 2019 were retrospectively analyzed, including 208 males and 38 females, aged (53.8±9.6) years. According to the occurrence of MVI, 246 patients were divided into the MVI group ( n=83) and control group ( n=163, without MVI). Hepatitis B virus (HBV) infection, preoperative alpha-fetoprotein (AFP), maximum tumor diameter, intraoperative blood loss were compared between the two groups. The recurrence-free survival and cumulative survival were compared between the two groups before and after the inverse probability weighted correction for propensity score. Results:The propensity score was calculated by logistic regression model. After inverse probability weighted correction, the virtual sample size was 247 cases (82 cases in MVI group and 165 cases in control group). The proportion of HBV infection, with a serum level of AFP > 200 μg/L, the maximum diameter of tumor and the intraoperative blood loss were higher in MVI group (all P<0.05). The risk of early recurrence in patients undergoing anatomical hepatectomy ( n=107) was lower than that in patients undergoing non-anatomical hepatectomy ( n=139) (univariate Cox regression analysis of HR=1.60, 95% CI: 1.06 to 2.42, P=0.020), but the overall survival was comparable (univariate Cox regression analysis of HR=1.66, 95% CI: 0.80 to 3.42, P=0.200). The recurrence-free survival (RFS) of MVI group was lower than that of the control group, and the postoperative cumulative survival rate was also lower before the inverse probability weighted correction of the tendency score. The RFS in MVI group was lower than that in control group after the tendency score was adjusted by inverse probability weighting ( HR=2.62, 95% CI: 1.61 to 4.27, P<0.001). There was no significant difference in the cumulative survival between the MVI and control group ( HR=2.09, 95% CI: 0.89 to 4.93, P=0.050). Conclusion:MVI is associated with early postoperative recurrence in patients with HCC, and the early recurrence rate after anatomical hepatectomy is lower than that after non-anatomical hepatectomy.

JAK-STAT signaling pathway and rosacea / 中华皮肤科杂志

Studies have shown that rosacea is related to inflammatory factors, neurovascular function, micro-ecological environment and other factors. The Janus kinase (JAK) -signal transducer and activator of transcription (STAT) signaling pathway involves a variety of inflammatory cytokines, and plays an important role in cell proliferation, differentiation, apoptosis, angiogenesis and immune regulation. This review summarizes the JAK-STAT signaling pathway and explores its potential role in rosacea.

A preliminary report of laparoscopic extraperitoneal colostomy anterior to posterior sheath of rectus abdominis-transversus abdominis to prevent parastomal hernia / 中华外科杂志

Objective: To examine the preliminary effect of laparoscopic extraperitoneal colostomy anterior to posterior sheath of rectus abdominis-transversus abdominis for the prevention of parastomal hernia after abdominoperineal resection for rectal cancer. Methods: This study is a prospective case series study. From June 2021 to June 2022, patients with low rectal cancer underwent laparoscopic abdominoperineal resection combined with extraperitoneal colostomy anterior to posterior sheath of rectus abdominis-transversus abdominis at the First Department of General Surgery, Shaanxi Provincial People's Hospital were enrolled. The clinical data and postoperative CT images of patients were collected to analyze the incidence of surgical complication and parastomal hernia. Results: Totally 6 cases of patient were enrolled, including 3 males and 3 females, aging 72.5 (19.5) years (M(IQR)) (range: 55 to 79 years). The operation time was 250 (48) minutes (range: 190 to 275 minutes), the stoma operation time was 27.5 (10.7) minutes (range: 21 to 37 minutes), the bleeding volume was 30 (35) ml (range: 15 to 80 ml). All patients were cured and discharged without surgery-related complications. The follow-up time was 136 (105) days (range: 98 to 279 days). After physical examination and abdominal CT follow-up, no parastomal hernia occurred in the 6 patients up to this article. Conclusions: A method of laparoscopic extraperitoneal colostomy anterior to posterior sheath of rectus abdominis-transversus abdominis is established. Permanent stoma can be completed with this method safely. It may have a preventive effect on the occurrence of parastomal hernia, which is worthy of further study.

Multifaceted Immunomodulatory Effects of the BTK Inhibitors Ibrutinib and Acalabrutinib on Different Immune Cell Subsets - Beyond B Lymphocytes.

The clinical success of the two BTK inhibitors, ibrutinib and acalabrutinib, represents a major breakthrough in the treatment of chronic lymphocytic leukemia (CLL) and has also revolutionized the treatment options for other B cell malignancies. Increasing evidence indicates that in addition to their direct effects on B lymphocytes, both BTK inhibitors also directly impact the homeostasis, phenotype and function of many other cell subsets of the immune system, which contribute to their high efficacy as well as adverse effects observed in CLL patients. In this review, we attempt to provide an overview on the overlapping and differential effects of ibrutinib and acalabrutinib on specific receptor signaling pathways in different immune cell subsets other than B cells, including T cells, NK cells, monocytes, macrophages, granulocytes, myeloid-derived suppressor cells, dendritic cells, osteoclasts, mast cells and platelets. The shared and distinct effects of ibrutinib versus acalabrutinib are mediated through BTK-dependent and BTK-independent mechanisms, respectively. Such immunomodulatory effects of the two drugs have fueled myriad explorations of their repurposing opportunities for the treatment of a wide variety of other human diseases involving immune dysregulation.

New Design of Revivent TC System / 中国医疗器械杂志

Left ventricular aneurysm (LVA) is a common complication of myocardial infarction. Traditional medical and surgical treatments are not effective or require high doctors' operational skills and patients' physical fitness. With the development of minimally invasive medical devices, it becomes possible for revivent TC system to treat LVA and reconstruct the left ventricle. This study introduces an existing product and its defect when used. From the perspective of clinical needs, we propose a new design of revivent TC system which realizes accurate force measurement and simplifies surgery.

Influence of negative pressure drainage on patients after proximal femoral nail antirotation fixation / 国际生物医学工程杂志

Objective:After using proximal femoral nail antirotation (PFNA) fixation to treat femoral intertro-chanteric fractures (ITFs), closed negative pressure drainage systems are often used for drainage, but the clinical effect of this method is uncertain. A prospective randomized controlled trial study was conducted to analyze the negative effects of negative pressure drainage systems after PFNA fixation.Methods:Sixty patients with ITFs and underwent PFNA fixation were randomly divided into two groups. Patients in the drainage group were equipped with negative pressure drainage systems after PFNA fixation. At 4, 10, and 90 days after the surgery, the visual analog scale (VAS) score, analgesic dosage, thigh swelling width, wound and infection status, hemoglobin, hematocrit level, total blood loss and transfusion blood volume of the patients were recorded to evaluate the prognosis.Results:The total blood loss of the drainage group [(579.1±236.7) ml] was greater than that of the non-drainage group [(427.8±239.8) ml; P=0.01]. The transfusion blood volume of the drainage group [(443.3±176.3) ml] was greater than that of the non-drainage group [(307.8±155.4) ml; P=0.01]. Compared with the non-drainage group, the drainage group had a higher VAS score at 4 days after the surgery (2.3±0.6, P=0.02). There was no difference between the two groups in analgesic dosage, thigh swelling width, wound infection and hematoma, hospital stay and the total number of complications (all P>0.05). Conclusions:In the patients with ITFs treated with PFNA fixation, the transfusion blood volume and total blood loss of the patients in the drainage group are higher than those in the non-drainage group. In addition, drainage systems may not have short-term benefits for postoperative wound conditions.

Effect of noninvasive positive pressure ventilation and high-flow nasal cannula oxygen therapy on the clinical efficacy of coronavirus disease 2019 patients with acute respiratory distress syndrome / 中华危重病急救医学

Objective:To observe the effect of noninvasive positive pressure ventilation (NIPPV) and high-flow nasal cannula oxygen therapy (HFNC) on the prognosis of patients with coronavirus disease 2019 (COVID-19) accompanied with acute respiratory distress syndrome (ARDS).Methods:A retrospective study was conducted in Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology when authors worked as medical team members for treating COVID-19. COVID-19 patients with pulse oxygen saturation/fraction of inspiration oxygen (SpO 2/FiO 2, S/F) ratio < 235, managed by medical teams [using S/F ratio instead of oxygenation index (PaO 2/FiO 2) to diagnose ARDS] from February to April 2020 were included. The patients were divided into NIPPV group and HFNC group according to their oxygen therapy modes. Clinical data of patients were collected, including general characteristics, respiratory rate (RR), fraction of FiO 2, SpO 2, heart rate (HR), mean arterial pressure (MAP), S/F ratio in the first 72 hours, lymphocyte count (LYM), percentage of lymphocyte (LYM%) and white blood cell count (WBC) at admission and discharge or death, the duration of dyspnea before NIPPV and HFNC, and the length from onset to admission. The differences of intubation rate, all-cause mortality, S/F ratio and RR were analyzed, and single factor analysis and generalized estimation equation (GEE) were used to analyze the risk factors affecting S/F ratio. Results:Among the 41 patients, the proportion of males was high (68.3%, 28 cases), the median age was 68 (58-74) years old, 28 cases had complications (68.3%), and 34 cases had multiple organ dysfunction syndrome (MODS, 82.9%). Compared with HFNC group, the proportion of complications in NIPPV group was higher [87.5% (21/24) vs. 41.2% (7/17), P < 0.05], and the value of LYM% was lower [5.3% (3.4%-7.8%) vs. 10.0% (3.9%-19.7%), P < 0.05], the need of blood purification was also significantly lower [0% (0/24) vs. 29.4% (5/17), P < 0.05]. The S/F ratio of NIPPV group gradually increased after 2 hours treatment and RR gradually decreased with over time, S/F ratio decreased and RR increased in HFNC group compared with baseline, but there was no significant difference in S/F ratio between the two groups at each time point. RR in NIPPV group was significantly higher than that in HFNC group after 2 hours treatment [time/min: 30 (27-33) vs. 24 (21-27), P < 0.05]. There was no significant difference in rate need intubation and hospital mortality between NIPPV group and HFNC group [66.7% (16/24) vs. 70.6% (12/17), 58.3% (14/24) vs. 52.9% (9/17), both P > 0.05]. Analysis of the factors affecting the S/Fratio in the course of oxygen therapy showed that the oxygen therapy mode and the course of illness at admission were the factors affecting the S/F ratio of patients [ β values were -15.827, 1.202, 95% confidence interval (95% CI) were -29.102 to -2.552 and 0.247-2.156, P values were 0.019 and 0.014, respectively]. Conclusion:Compared with HFNC, NIPPV doesn't significantly reduce the intubation rate and mortality of patients with COVID-19 accompanied with ARDS, but it significantly increases the S/F ratio of those patients.

Early evaluation of the Wuhan City travel restrictions in response to the 2019 novel coronavirus outbreak

Respiratory illness caused by a novel coronavirus (COVID-19) appeared in China during December 2019. Attempting to contain infection, China banned travel to and from Wuhan city on 23 January and implemented a national emergency response. Here we evaluate the spread and control of the epidemic based on a unique synthesis of data including case reports, human movement and public health interventions. The Wuhan shutdown slowed the dispersal of infection to other cities by an estimated 2.91 days (95%CI: 2.54-3.29), delaying epidemic growth elsewhere in China. Other cities that implemented control measures pre-emptively reported 33.3% (11.1-44.4%) fewer cases in the first week of their outbreaks (13.0; 7.1-18.8) compared with cities that started control later (20.6; 14.5-26.8). Among interventions investigated here, the most effective were suspending intra-city public transport, closing entertainment venues and banning public gatherings. The national emergency response delayed the growth and limited the size of the COVID-19 epidemic and, by 19 February (day 50), had averted hundreds of thousands of cases across China. One sentence summaryTravel restrictions and the national emergency response delayed the growth and limited the size of the COVID-19 epidemic in China.

Pathogenic characteristics of enterovirus infection in Yueqing city from 2010 to 2018 / 中华微生物学和免疫学杂志

Objective To analyze the epidemic characteristics of enterovirus infection in Yueqing city from 2010 to 2018, and to provide reference for the prevention and control of hand, foot and mouth dis-ease (HFMD) caused by enterovirus. Methods Clinical data of HFMD cases caused by enterovirus infec-tion during 2010 to 2018 were derived from the disease monitoring information report management system of Yueqing city. Descriptive epidemiological study was performed to analyze the characteristics of enterovirus infection by season, age, gender and region and the features of pathogens. Results There were53178 pa-tients with HFMD in total, including 75 severe cases and six deaths. Enterovirus infection occurred in every month of the years and peaked from April to July. Most of the cases were scattered children and nursery chil-dren under five years old and the incidence was higher in males than in females. From 2010 to 2018, the characteristics of enterovirus in Yueqing city had changed significantly. Enterovirus 71 (EV71) was the pre-dominant pathogen during 2010 to 2014, but its detection rate had gradually decreased since 2013. In recent years, the incidence of HFMD caused by non-EV71 and non-coxsackievirus A16 (non-CVA16) enterovirus-es significantly increased. Conclusions Enterovirus infection in Yueqing city was featured by significant seasonality and population-specific variation. Etiological detection should be strengthened. Comprehensive prevention and control measures should be taken to prevent the outbreak of HFMD during April to July.

SOCS1 Regulates the Immunomodulatory Roles of MSCs on B Cells

Background and Objectives@#The effective use of MSCs for the treatment of some B cell-mediated immune diseases is quite limited. The main reason is that the immunomodulatory effects of mesenchymal stem cells (MSCs) on B cells are unclear, and their underlying mechanisms have not been fully explored. @*Methods@#and Results: By co-culturing B cells with MSCs without (MSC/CTLsh) or with suppressor of cytokine signaling 1 (SOCS1) knockdown (MSC/SOCS1sh), we found that MSCs inhibited B cell proliferation, activation and terminal differentiation. Remarkably, the highest inhibition of B cell proliferation was observed in MSC/SOCS1sh co-culture. Besides, MSC/SOCS1sh reversed the inhibitory effect of MSCs in the last stage of B cell differentiation. However, MSC/SOCS1sh had no effect on inhibiting B cell activation by MSCs. We also showed that IgA+ B cell production was significantly higher in MSC/SOCS1sh than in MSC/CTLsh, although no difference was observed when both MSCs co-cultures were compared to isolated B cells. In addition, MSCs increased PGE2 production after TNF-α/IFN-γ stimulation, with the highest increase observed in MSC/SOCS1sh co-culture. @*Conclusions@#Our results highlighted the role of SOCS1 as an important new mediator in the regulation of B cell function by MSCs. Therefore, these data may help to develop new treatments for B cell-mediated immune diseases.

Pathogenic characteristics of enterovirus infection in Yueqing city from 2010 to 2018 / 中华微生物学和免疫学杂志

Objective@#To analyze the epidemic characteristics of enterovirus infection in Yueqing city from 2010 to 2018, and to provide reference for the prevention and control of hand, foot and mouth disease (HFMD) caused by enterovirus.@*Methods@#Clinical data of HFMD cases caused by enterovirus infection during 2010 to 2018 were derived from the disease monitoring information report management system of Yueqing city. Descriptive epidemiological study was performed to analyze the characteristics of enterovirus infection by season, age, gender and region and the features of pathogens.@*Results@#There were 53 178 patients with HFMD in total, including 75 severe cases and six deaths. Enterovirus infection occurred in every month of the years and peaked from April to July. Most of the cases were scattered children and nursery children under five years old and the incidence was higher in males than in females. From 2010 to 2018, the characteristics of enterovirus in Yueqing city had changed significantly. Enterovirus 71 (EV71) was the predominant pathogen during 2010 to 2014, but its detection rate had gradually decreased since 2013. In recent years, the incidence of HFMD caused by non-EV71 and non-coxsackievirus A16 (non-CVA16) enteroviruses significantly increased.@*Conclusions@#Enterovirus infection in Yueqing city was featured by significant seasonality and population-specific variation. Etiological detection should be strengthened. Comprehensive prevention and control measures should be taken to prevent the outbreak of HFMD during April to July.

Pathogenic characteristics of enterovirus infection in Yueqing city from 2010 to 2018 / 中华微生物学和免疫学杂志

Objective@#To analyze the epidemic characteristics of enterovirus infection in Yueqing city from 2010 to 2018, and to provide reference for the prevention and control of hand, foot and mouth disease (HFMD) caused by enterovirus.@*Methods@#Clinical data of HFMD cases caused by enterovirus infection during 2010 to 2018 were derived from the disease monitoring information report management system of Yueqing city. Descriptive epidemiological study was performed to analyze the characteristics of enterovirus infection by season, age, gender and region and the features of pathogens.@*Results@#There were 53 178 patients with HFMD in total, including 75 severe cases and six deaths. Enterovirus infection occurred in every month of the years and peaked from April to July. Most of the cases were scattered children and nursery children under five years old and the incidence was higher in males than in females. From 2010 to 2018, the characteristics of enterovirus in Yueqing city had changed significantly. Enterovirus 71 (EV71) was the predominant pathogen during 2010 to 2014, but its detection rate had gradually decreased since 2013. In recent years, the incidence of HFMD caused by non-EV71 and non-coxsackievirus A16 (non-CVA16) enteroviruses significantly increased.@*Conclusions@#Enterovirus infection in Yueqing city was featured by significant seasonality and population-specific variation. Etiological detection should be strengthened. Comprehensive prevention and control measures should be taken to prevent the outbreak of HFMD during April to July.

Analysis of clinical features of intermittent flushing in patients with rosacea and its impact on quality of life / 中华皮肤科杂志

Objective:To investigate clinical features of intermittent flushing in patients with rosacea, and to evaluate its impact on the quality of life of patients.Methods:A prospective study was conducted, a total of 728 patients with rosacea were enrolled from Department of Dermatology, Xiangya Hospital from August 2017 to August 2019. Data were collected by using flushing symptom questionnaire (FSQ) , clinician erythema assessment scale (CEA) , patient′s self-assessment (PSA) and visual analogue scale (VAS) . Clinical features and severity of intermittent flushing episodes, degree of bother and impact on life, and correlation of flushing scores with persistent erythema scores were analyzed. Statistical analysis was carried out by using chi-square test and Spearman correlation analysis.Results:Among the 728 patients with rosacea, intermittent flushing most frequently occurred on the cheek (682 cases, 93.7%) and zygomatic region (617 cases, 84.8%) ; the proportion of patients with a flushing duration of 5 minutes to 2 hours was the highest (484 cases, 66.5%) ; 317 (43.6%) had flushing episodes after stimulation, and 233 (32.0%) had multiple flushing episodes every day. Moreover, 503 patients (69.1%) had an overall flushing score above the moderate level; 412 (56.6%) considered that flushing could affect sleep to varying degrees, of which 59 (8.1%) considered that the impact was severe or very severe; 662 (90.9%) considered that flushing had impact on life to different degrees, of which 304 (41.8%) thought that the impact was severe. Both the overall flushing score and life bother score were positively but lowly correlated with the CEA scores ( rs = 0.166, 0.151 respectively, both P < 0.05) , and were positively correlated with the PSA scores ( rs = 0.518, 0.500 respectively, both P < 0.05) . Conclusion:Intermittent flushing occurs at typical sites of patients with rosacea, with long duration of episodes and high frequency, and affects quality of life of patients, so attention needs to be paid by clinicians.

Analysis of clinical features of rosacea and rediscussion of a Chinese diagnostic criterion for rosacea / 中华皮肤科杂志

Objective:To propose a Chinese diagnostic criterion for rosacea on the basis of clinical feature analysis of rosacea, and to assess its sensitivity and specificity.Methods:A total of 3 350 Chinese patients with newly diagnosed rosacea were collected from Department of Dermatology, Xiangya Hospital, Central South University between December 2017 and July 2018, their phenotypes and clinical features were retrospectively analyzed, and a Chinese modified diagnostic criterion for rosacea was put forward. A national multi-center clinical observational trial, which included 2 269 patients with rosacea and 2 408 patients with other facial skin diseases from 28 centers, was conducted to verify this diagnostic criterion. Then, the sensitivity and specificity of the modified diagnostic criterion were evaluated by comparing with the 2017 standard classification of rosacea developed by the National Rosacea Society Expert Committee (NRSEC) .Results:Fixed centrofacial erythema occurred in 3 350 (100%) patients with rosacea. Flushing occurred before or simultaneously with fixed erythema in 1 850 (99.4%) of the 1 861 patients with erythema on the cheeks; among the 1 489 patients with erythema on the nose or perioral area, only 52 (3.5%) had flushing; all the 342 patients presenting with phymatous changes had fixed erythema before phymatous changes. Based on the above clinical findings, it was proposed that patients with periodically aggravated fixed erythema on the cheeks accompanied with flushing could be diagnosed with rosacea; patients with fixed erythema on the nose and perioral area accompanied with at least one of selective phenotypes (flushing, telangiectasia, papules and pustules, phymatous changes, or ocular manifestations) could be diagnosed with rosacea. The national multi-center clinical observational trial revealed that the sensitivity of the Chinese modified diagnostic criterion for rosacea was 99.6%, which was close to the sensitivity (100%) of the NRSEC standard, and its specificity was 91.9%, higher than the specificity (73.3%) of the NRSEC standard.Conclusion:The Chinese modified diagnostic criterion for rosacea has good sensitivity and specificity, and can facilitate the early diagnosis of phymatous rosacea.

Role of DNA methyltransferase 1 in mouse skin aging / 中南大学学报(医学版)

Objective:To explore the role ofDNA methyltransferase 1 (DNMT1) in mouse skin aging.Methods:Epidermal conditional K14 Cre-mediated DNA methyltransferase 1 (DNMT1) knockout mice (Mut group,n=4) and the littermate normal mice with the same age (WT group) n=4) were used in this study.HE staining was used to detect the pathological changes of skin;the changes of number in the dermal elastic fibers were detected by Gomori aldehyde fuchsin staining,the number of 5-bromo-2-deoxyuridine (BrdU)-labeled transit amplifying cells (TAC) in epidermis were detected by immunohistochemical staining;the number of chlorodeoxyuridine (CldU)-labelretaining cells (LRC) in epidermis were detected by immunofluorescent staining.Results:Compared with the WT group,the skin showed premature aging symptoms in the Mut group concomitant with the decreased epidermal thickness as well as the number of dermal collagen fibers,while the increased dermal elastic fiber fracture.Compared with the WT group,the number of TAC in the epidermis was significantly increased (P＜0.05),and the number of LRC was significantly decreased (P＜0.05) in the Mut group.Conclusion:The phenotype of skin premature aging in epidermal stem cell conditional DNMT1-knockout mice suggests an important role of DNMT 1 in skin aging.

A comparative split-face study of invasive microneedle radiofrequency versus plasma fractional radiofrequency in the treatment of atrophic acne scars / 中华皮肤科杂志

Objective To compare the clinical efficacy and safety of invasive microneedle radiofrequency versus plasma fractional radiofrequency in the treatment of atrophic facial acne scars.Methods A total of 30 patients with atrophic acne scars were enrolled from the Department of Dermatology of Xiangya Hospital affiliated to Central South University between January 2017 and March 2017.By a random number table,every patient randomly received the treatment with invasive microneedle radiofrequency on one half of the face and plasma fractional radiofrequency on the other facial side once every 8-12 weeks for 3 sessions.Before and after each treatment,facial photos were taken,acne scars were scored by the ECCA grading scale (échelle d'évaluation clinique des cicatrices d'acné),and improvement rates of these lesions were evaluated subjectively by doctors.Adverse reactions were recorded after treatment,and the degree of pain and satisfaction was evaluated by the patients themselves.The Germany CK physiological index detector was used to detect the skin moisture content,transepidermal water loss (TEWL) and sebum content.Results All of the 30 patients completed 3 sessions of treatment and follow-up.After the 3 sessions of treatment,the average score on invasive microneedle radiofrequency-treated sides was 3.00 ± 0.91,and 22 patients achieved more than 50％ improvement.However,the average score on plasma fractional radiofrequency-treated sides was 3.57 ± 0.57,and 29 patients achieved more than 50％ improvement.The overall therapeutic effect of plasma fractional radiofrequency was significantly superior tothat of invasive microneedle radiofrequency (t =2.894,P =0.005).For V-shaped and U-shaped scars,there was no significant difference in the overall improvement rate between the invasive microneedle radiofrequency-treated side and plasma fractional radiofrequency-treated side (both P ＞ 0.05).For Mshaped rolling scars,the overall improvement rate was significantly lower on the invasive microneedle radiofrequency-treated side (36.5％ ± 2.1％) than on the plasma fractional radiofrequency-treated side (48.7％ ± 3.4％,P ＜ 0.01).However,the pain score was significantly lower on the invasive microneedle radiofrequency-treated side (5.54 ± 0.57) than on the plasma fractional radiofrequency-treated side (8.07 ± 0.79,P ＜ 0.01).After 3 sessions of treatment,there were no significant differences in the degree of patient satisfaction (x2 =0.10,P ＞ 0.05),skin moisture content (P ＞ 0.05),TEWL (P ＞ 0.05) or sebum content (P ＞ 0.05) between the 2 sides.Adverse reactions such as erythema,exudation and hemorrhage occurred on both of the 2 sides.Conclusions For small V-shaped and U-shaped scars,the plasma fractional radiofrequency and invasive microneedle radiofrequency both can be applied in clinic.For large M-shaped rolling scars,the plasma fractional radiofrequency can be preferentially selected.

The clinical significance and underlying correlation of pStat-3 and integrin αvß6 expression in gallbladder cancer.

BACKGROUND: Both phosphorylated signal transducer and activator of transcription 3(pStat-3) and integrin αvß6 can play vital role in the development and progression of cancer. However, little is known about their expression correlation and clinical significance in gallbladder cancer(GBC). OBJECTIVE: The aim of our present study was to investigate the expression of pStat-3 and integrin αvß6, two proteins' correlation and their clinical significance in GBC tissues. RESULTS: The expression of pStat-3 and integrin αvß6 were both significantly associated with T stage, lymph node metastasis status, TNM stage (P=0.008, P=0.000, P=0.000 and P=0.036, P=0.001,P=0.000,respectively). IHC and Western blot showed their expressions in GBC tissues were higher than that in paraneoplastic tissues. Moderate positive correlation existed between the two proteins (r =0.349, P <0.001). The survival analysis by Kaplan-Meier and Cox regression model showed that GBC patients with pStat-3 or integrin αvß6 positive expression had a significantly poorer 2-year survival rate (P = 0.002 and 0.000, the log-rank test, respectively), and either marker could act as unfavorable independent prognostic factors(RR=1.907, P=0.021 and RR=2.046, P=0.038). MATERIALS AND METHODS: The expression levels of pStat-3 and integrin αvß6 were analyzed in GBC cancerous and paraneoplastic tissues of 97 cases via immunohistochemistry(IHC) and further validated by western blot method. Besides, SPSS software was used to observe their clinical significance as well as the two proteins' correlation. CONCLUSION: pStat-3 and integrin αvß6 were indicators of tumor's progression and poor prognosis of patients with GBC. And the further study involving them may provide a helpful therapeutic target in prevention and treatment of GBC patients.

Clinical analysis of 1 090 cases of rosacea and exploration of new diagnostic criteria for rosacea / 中华皮肤科杂志

Objective To propose a new diagnostic criterion for rosacea based on the analysis of clinical features of rosacea in a large sample.Methods A total of 1 090 Chinese outpatients with rosacea were enrolled from Department of Dermatology of Xiangya Hospital,and their demographic data,clinical manifestations and subjective symptoms were collected.According to results of descriptive analysis,clinical features of rosacea were summarized,and a new diagnostic criterion for rosacea was set up.Then,the sensitivity and specificity of the new diagnostic criterion were verified among 1 200 outpatients clinically characterized by facial erythema.Results Of 1 090 patients with rosacea,131 (12.0％) were male and 959(88.0％) were female,and the average age was 33.5 ± 11.1 years (range,10-66).Among the 1 090 patients,715 (65.6％) had initial lesions on the cheek,of whom,712 (99.6％) had intermittent flushing as the initial symptom,and 689 (96％) had sensitive skin symptoms such as dryness,burning and itching sensations;208 (19.1％) had initial lesions on the perioral region,of whom,204 (98.1％) had persistent erythema as the initial symptom;167 (15.3％) had initial lesions on the nose,of whom,163 (97.6％) had persistent erythema as the initial symptom;in addition,311 (28.5％) had lesions on the ocular region,and only 24 (2.2％) had lesions outside the face on the neck and retroauricular region.Based on these clinical features,a new diagnostic criterion for rosacea was proposed,including 1 major condition (intermittent flushing or persistent erythema on the cheek,perioral region or nose) and 5 minor conditions (1.sensitive skin symptoms such as burning,tingling,drying or itching sensations;2.telangiectasia;3.papules or pustules;4.hypertrophy;5.ocular symptoms).If with the major condition and at least one minor condition were met,patients could be diagnosed with rosacea.After verification among 1 200 patients with facial dermatitis clinically characterized by facial erythema,the new criterion was proved to have a sensitivity of 99.3％ and a specificity of 95.8％.Conclusion A new diagnostic criterion for rosacea with high sensitivity and specificity is proposed,which is worthy of clinical application.

Confocal laser scanning electron microscopy for assessment of vaginal Lactobacillus crispatus biofilm / 北京大学学报(医学版)

Objective:To investigate the female vaginal Lactobacillus crispatus biofilm by using confocal laser scanning microscopy (CLSM),thus revealing the formation of biofilm. Methods:The cover slide biofilm culture approach in vitro was employed for induction of the vaginal Lactobacillus crispatus biofilm formation. Following the culture for 2, 4, 8, 12, 16, 20, 24, 48, 72, 96 and 120 hours, the cover slide was removed for subsequent staining with the fluoresce in isothiocyanate-conjugated concanavalin A ( FITC-ConA) and propidium ( PI) . This was followed by determination of the formation and characteris-tics of the vaginal Lactobacillus crispatus biofilm by using CLSM. Results:The CLSM images of biofilm formation at different time points were captured, suggesting that the vaginal Lactobacillus crispatus adhe-sion occurred at h 4, which was in reversible attachment, then more and more Lactobacillus crispatus ag-gregated at h 8 to h 20, which was in irreversible attachment. Lactobacillus crispatus clustered at h 20, with early development of biofilm architecture. Then the biofilm with extracellular matrix around the bacte-ria was set up at h 24,with gradual matureation at h 24 to h 48. The biofilm dispersed at h 72. The bio-film density of cultivating for 20 hours was 42 . 7 × 10 -3 ± 6 . 8 × 10 -3 , and for 24 hours increased to 102. 5 × 10 -3 ± 23. 1 × 10 -3 , suggesting a significant difference, P<0. 05. This meant that mature bio-film was formed at h 24 . Conclusion:The vaginal Lactobacillus crispatus is able to form typical biofilm with distinct developmental phases and architecture characteristics. Mature biofilm is formed at h 24 to h 48, then the biofilm begins to disperse.