Changes in fundus microcirculation of myopic adolescents after wearing orthokeratology observed by optical coherence tomography angiography / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To observe changes in fundus microcirculation of myopic adolescents after wearing orthokeratology by applying optical coherence tomography angiography(OCTA).METHODS: Prospective study. A total of 40 cases(40 eyes)of adolescents with low to moderate myopia who chose orthokeratology to correct visual acuity at our hospital from April 2021 to June 2022 were collected. The uncorrected distant visual acuity and axial length were evaluated at 1, 3 and 6mo before and after wearing orthokeratology, respectively. Furthermore, the changes in superficial vessel density(SVD), deep vessel density(DVD), central retinal thickness(CRT), foveal avascular zone area(FAZ-A), foveal avascular zone perimeter(FAZ-P), retinal nerve fiber layer(RNFL)thickness and radial peripapillary capillaries density(RPCD)were observed by applying OCTA.RESULTS: The uncorrected distant visual acuity was significantly improved at 1, 3 and 6mo after wearing orthokeratology(P<0.001). There was no statistically significant difference in axial length before and after wearing orthokeratology(P>0.05). Moreover, there were significant differences in both SVD of fovea quadrant and DVD of fovea and lower quadrant(P<0.01), but there were no differences in CRT, FAZ-A and FAZ-P, RNFL thickness and RPCD(P>0.05).CONCLUSION: Wearing orthokeratology can significantly improve visual acuity and increase local retinal vessel density in the macula in adolescents with low to moderate myopia.

Parotid duct anastomosis with an epidural catheter as a stent and evaluation of postoperative gland function / 口腔疾病防治

Objective @#To investigate the feasibility of epidural catheters in parotid gland duct anastomosis and the function of the affected side gland after parotid gland duct anastomosis. @* Methods@# Thirteen patients who were treated in the Department of Oral and Maxillofacial Surgery of Xuzhou Central Hospital using an epidural catheter as the scaffold for parotid gland catheter anastomosis were enrolled from Jan. 2019 to June 2021. The swelling, salivary fistula and catheter patency in the parotid gland area were evaluated two weeks after the operation. 99mTcO4- single photon emission computed tomography (SPECT) was used for quantitative detection of salivary gland secretion function@*Results@# Thirteen patients had no swelling or salivary fistula in the parotid gland area of the affected side two weeks after the operation, and the catheter secretion was unobstructed. There was no significant difference in the uptake rate between the parotid gland on the affected side and the parotid gland on the healthy side (t = -0.859, P = 0.399), and there was no significant difference in the excretion rate between the parotid gland on the affected side and the parotid gland on the healthy side (t = 0.693, P = 0.495). The parotid gland excretion function of the affected side was excellent three months after the operation.@*Conclusion @#Parotid duct anastomosis with an epidural catheter as the stent has good feasibility, and parotid gland secretion function recovers well after the operation, which is worthy of clinical application.

Refractory pneumoparotid in children: a case report and literature review / 口腔疾病防治

Objective @#To discuss the treatment of pneumoparotid and to provide a reference for clinical practice. @*Methods@# A case of refractory pneumoparotid was reported, and the diagnosis and treatment of parotid emphysema were reviewed and analyzed in combination with the literature.@*Results @#This child had parotid gland enlargement without any obvious cause for more than 1 month. Conservative treatment, such as anti-inflammatory agents, psychological interventions and physical compression were ineffective. The patient had a history of cerebral palsy with epilepsy and involuntary cheek bulging behavior. Therefore, we considered it a refractory case. It was cured after parotid duct ligation and partial parotidectomy of the superficial lobe. A literature review showed that a pneumoparotid is a rare parotid enlargement. Most of the clinical cases were considered to be caused by the return of air into the parotid gland through the parotid duct due to an increase in oral pressure. The diagnosis of pneumoparotid mainly depends on intermittent parotid gland swelling and other clinical manifestations and imaging examination methods, such as ultrasound, CT, MRI and angiography. Its treatment mainly includes conservative anti-inflammatory treatment, physical therapy and psychological intervention. Surgical treatment is indicated for refractory parotid emphysema.@*Conclusion@# Pneumoparotid cases may further develop into parotid inflammation, which is generally treated conservatively. For some severe, recurrent and poor compliance cases, surgical treatment is sometimes needed.

Effect of comprehensive quality control intervention on the use of antibiotics and standardized medical record writing in the elderly patients with closed fracture / 中国综合临床

Objective:To explore the effect of comprehensive accusation intervention on the use of antibacterial drugs and the writing of medical records in elderly patients with closed fracture.Methods:A total of 120 elderly patients (aged ≥60 years) with fracture were enrolled from January 2017 to June 2019 in the department of orthopaedics and traumatology of the Second Hospital of Tangshan University and the Affiliated Hospital of North China University of Technology. According to random number table method, 120 patients were divided into intervention group (61 cases) and non intervention group (59 cases) by computer random number method. The patients in the intervention group received pharmaceutical care and quality control management intervention during the perioperative period; The patients in the non intervention group were routinely treated with antibiotics and wrote medical records. The use effect of antibiotics, the cost of antibiotics and the effect of standardized writing of medical documents were compared between the two groups. Independent sample t-test was used for comparison between measurement data groups with normal distribution, and χ 2 test was used for comparison between counting data groups. Results:Compared with the non-intervention group, the rate of perioperative use of antibiotics (49.2% (30/61)), the rate of drug use without indication (4.9% (3/61)), the rate of irrational drug selection (6.6% (4/61)), the rate of irrational drug use (6.6% (4/61)), and the proportion of irrational combined use of antibiotics (3.3% (2/61)) were significantly lower than that in the non-intervention group (81.4% (48/59), 16.9%(10/59), 22.0% (13/59), 20.3% (12/59), 18.6% (11/59)), the difference was statistically significant (χ 2 values were 13.65, 4.49, 5.91, 4.93 and 7.33, respectively; P values were <0.001, 0.034, 0.015, 0.026 and 0.007,respectively). The cost of antibiotics in the intervention group ((283.86±59.86) yuan) was lower than that in the non intervention group ((820.45±136.27) yuan), and the difference was statistically significant ( t=27.478, P<0.001). The eligible rate of the pre-operative informed consent document signing was 100% (61/61) in the intervention group, and the eligible rate of the operative record completion time was 100% (61/61) higher than that in the non-intervention group (84.7% (50/59), 79.7% (47/59)), the difference was statistically significant (χ 2 values were 7.98 and 13.79; P values were 0.005 and <0.001). The loss rate of preoperative alternative therapy (0) and postoperative communication (0) were significantly lower than those of non-intervention group (11.9% (7/59), 10.2% (6/59)) (χ 2 values were 5.68 and 4.56; P values were 0.017 and 0.033). Conclusion:The implementation of comprehensive quality control intervention mode reduced the application of unreasonable antibiotics and standardized the writing of inpatient medical records. It is of great significance for the rational use of antibiotics and the standardization of medical record writing in the elderly patients with closed fracture.

Advances in immunotherapy of thymic tumors / 中华胸心血管外科杂志

Thymic epithelial tumor is a rare anterior mediastinal tumor. Surgery is the most important treatment for thymic tumors. However, non-surgical treatment is still an inevitable choice for unresectable advanced thymic tumors. The traditional treatment methods include chemotherapy and radiotherapy, but the effect is limited. With the development of immunotherapy therapy, some studies have attempted the exploration of immunotherapy for thymic tumors. Because of the low incidence rate of thymic tumors, these studies are mostly small retrospective analyses. This article review the clinical and basic research progress of immunotherapy for thymic tumors

Predictive value of mucosal vascular pattern under narrow-band imaging colonoscopy in colonic epithelial proliferation of patients with ulcerative colitis / 中华消化杂志

Objective:To investigate the predictive value of mucosal vascular pattern (MVP) in colonic epithelial proliferation of patients with ulcerative colitis (UC) under narrow-band imaging (NBI) colonoscopy.Methods:From December 1, 2012 to January 31, 2015, 42 patients with UC visiting Peking Union Medical College Hospital and receiving NBI colonoscopy were selected. The images of 119 colorectal lesions of all the patients under the conventional white light and NBI endoscopy were collected and at least one biopsy of each lesion was obtained for histological assessment. All the endoscopic images were randomly allocated to one endoscopist (associated chief physician) for the MVP and the Mayo endoscopic score (MES) assessment. The degree of mucosal inflammation was graded from 0 to 4 according to the histological colitis score. The degree and distribution of Ki-67 expression were evaluated by immunohistochemical staining. Student-Newman-Keuls (SNK)- q test and Spearman rank correlation analysis were used for statistical analysis. Results:Under NBI colonoscopy, the MVP of patients with UC was divided into clear type, obscure type and absent type. According to the morphology of mucosal glandular duct, the absent type was divided into crypt opening subtype and villous subtype. There was a positive correlation between MVP under NBI mode and the MES under white light mode ( r=0.80, P<0.001). The Ki-67 staining indexes of MVP obscure type, absent type, crypt opening subtype and villous subtype of absent type were all higher than that of MVP clear type (30.3±12.8, 45.9±12.5, 45.5±12.1 and 46.3±13.1 vs. 15.6±7.3), and the differences were statistically significant (SNK- q test, all P<0.001); and the Ki-67 staining indexes of MVP absent type, crypt opening subtype and villous subtype of MVP absent type were all higher than that of MVP obscure type, and the differences were statistically significant (SNK- q test, all P<0.001). There was a positive correlation between the MVP type under NBI colonoscopy and the distribution of Ki-67 expression ( r=0.49, P<0.001). The Ki-67 staining indexes of inflammation grade 2, 3 and 4 were higher than that of grade 1 (28.8±10.9, 40.2±11.6 and 49.5±10.3 vs. 17.1±8.4), and the difference was statistically significant (SNK- q test, all P<0.001); the Ki-67 staining indexes of inflammation grade 3 and 4 were higher than that of grade 2, and Ki-67 staining index of inflammation grade 4 was higher than that of grade 3, and the differences were statistically significant (SNK- q test, all P<0.001). The distribution of Ki-67 expression was positively correlated with the degree of histological inflammation ( r=0.56, P<0.001). Conclusions:The MVP under NBI colonoscopy may indirectly predict the colonic epithelial proliferation of patients with UC, which may be closely related to the degree of mucosal inflammation.

Regulatory Effect of Herbal Pair Astragali Radix-Puerariae Lobatae Radix on PI3K/Akt/FoxO1 Signaling Pathway in Rats with T2DM Based on Network Pharmacology / 中国实验方剂学杂志

ObjectiveTo explore the mechanism of herbal pair Astragali Radix-Puerariae Lobatae Radix （AR-PLR） against type 2 diabetes mellitus （T2DM） based on network pharmacology and experimental verification. MethodThe active ingredients and targets of AR and PLR were retrieved from the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform （TCMSP）. The related targets of T2DM were retrieved from disease databases and the common targets of drugs and diseases were extracted. The protein-protein interaction （PPI） network was analyzed and constructed by STRING and the network topology of key targets was analyzed by Cytoscape 3.7.1. Then gene ontology（GO） and Kyoto encyclopedia of genes and genomes（KEGG） enrichment analyses of core targets were carried out by DAVID to explore its possible molecular mechanism. The T2DM model was induced in rats by the high-fat diet combined with tail intravenous injection of streptozocin. The rats were divided into a normal group，a model group，a metformin group，and high-，medium- and low-dose AR-PLR groups. After four weeks of intragastric administration，the serum levels of fasting blood sugar （FBS），fasting insulin（FINS），aspartate aminotransferase（AST），alanine aminotransferase（ALT），triglyceride（TG），total cholesterol（TC），low-density lipoprotein cholesterin（LDL-C），high-density lipoprotein cholesterin （HDL-C），interleukin-6（IL-6）， and tumor necrosis factor-α（TNF-α） of rats in each group were measured. The protein expression of insulin receptor substrate-2（IRS-2），phosphatidylinositol 3-kinase（PI3K），protein kinase B（Akt）， and forkhead box transcription factor O1（FoxO1） in rat liver was detected by Western blot. ResultA total of 131 core targets of AR-PLR in the treatment of T2DM were screened out by network pharmacology， where Akt1，mitogen-activated protein kinase 1 （MAPK1），TNF-α，and IL-6 were critical. As revealed by KEGG enrichment analysis， AR-PLR exerted the hypoglycemic effect mainly through the PI3K/Akt，TNF， and FoxO signaling pathways. Compared with the model group，the high- and medium-dose AR-PLR groups showed reduced FBS and FINS levels and increased glycogen level （P<0.05，P<0.01），all the AR-PLR groups showed decreased levels of AST，ALT，TG， and LDL-C （P<0.05，P<0.01）， the high- and low-dose AR-PLR groups showed decreased TC levels （P<0.05）. Compared with the model group， the high- and medium-dose AR-PLR groups showed reduced levels of IL-6 and TNF-α（P<0.05，P<0.01）， and the high-dose AR-PLR group showed increased expression of IRS-2， Akt， p-Akt， PI3K， and p-PI3K， and decreased expression of FoxO1 protein（P<0.05）. ConclusionAR-PLR has the characteristics of multi-component，Multi-target and multi-pathway in the treatment of T2DM. This herbal pair may regulate the PI3K/Akt/FoxO1 signaling pathway through IL-6， TNF-α， and other targets to affect insulin resistance， glycogen synthesis， gluconeogenesis， glucose transport， inflammation， immune response， and other processes， thereby treating T2DM.

Dahuang Lingxian Prescription Regulates Effect of TAK1 and TRAF6 Interaction and Co-localization on Inflammatory Response of Bile Duct Cells / 中国实验方剂学杂志

ObjectiveTo observe the repair effect of Dahuanglingxian prescription （DHLX） on bile duct epithelial cells of rats. To explore whether its mechanism of action is to adjust the mutual binding of transforming growth factor -β （TGF-β） activated kinase 1（TAK1） and tumor necrosis factor receptor-associated factor 6 （TRAF6）， and regulate the activation of the nuclear transcription factor -κB （NF-κB）/mitogen-activated protein kinase （MAPK） signaling pathway. MethodThe 20 SD rats were randomly divided into normal group and DHLX group， 10 rats in each group， were given saline and DHLX （320 mg·kg-1·d-1） for 8 days， to prepare normal serum and DHLX serum. Biliary epithelial cells were extracted from normal SD rats and divided into 9 groups： Normal group， model group （20 mg·L-1）， LPS+DHLX group （20 mg·L-1+10% DHLX）， LPS+PDTC group （20 mg·L-1+200 μmol·L-1）， LPS+SB203580 group （20 mg·L-1+0.5 μmol·L-1）， LPS+PDTC+SB203580 group （20 mg·L-1+200 μmol·L-1+0.5 μmol·L-1）， LPS+PDTC+DHLX group （20 mg·L-1+200 μmol·L-1+10% DHLX serum）， LPS+SB203580+DHLX group （20 mg·L-1+0.5 μmol·L-1+10% DHLX serum）， LPS+PDTC+SB203580 +DHLX group （20 mg·L-1+200 μmol·L-1+0.5 μmol·L-1+10% DHLX serum）. The microscopic observation of morphological changes in each group of cells after drug intervention. Enzyme-linked immunosorbent assay（ELISA） was used to detect the expression of （IL）-1β and IL-6 in each group of cells. Western blot detected the expression levels of TAK1 and TRAF6 proteins in each group of cells， Co-IP detected the interaction between TAK1 and TRAF6， and further observed the distribution and co-localization of TAK1 and TRAF6 using Laser confocal microscope. ResultAfter the action of LPS， the cell synapses are reduced， the cell body becomes significantly rounded and smaller， but the cell morphology of each group tends to be normal after medication. Compared with normal group， the expression levels of IL-1β and IL-6 in model group were significantly increased （P<0.05）， while the expression level of TAK1 was decreased while the expression level of TRAF6 was increased （P<0.05）. The content of TAK1-TRAF6 protein complex showed a decreasing trend， and the two proteins co-located in the cytoplasm. Compared with model group， the expression levels of IL-1β and IL-6 in LPS+DHLX group were significantly decreased （P<0.05）， the expression level of TAK1 was increased and the expression level of TRAF6 was decreased （P<0.05）， the content of TAK1-TRAF6 protein complex was significantly increased （P<0.01）， and the two proteins were significantly co-located in cytoplasm. Compared with LPS+DHLX group， the expression levels of IL-1β and IL-6 in other groups were significantly decreased （P<0.05，P<0.01）. TAK1-TRAF6 protein complex content in each group was significantly decreased after pathway blocker intervention （P<0.05）， while TAK1-TRAF6 protein complex content in each group was significantly increased after pathway blocker combined with DHLX intervention （P<0.05）. Co-localization of the TAK1-TRAF6 in cytoplasm was not obvious. ConclusionIn the LPS-induced inflammatory response of bile duct cells， the binding of TAK1 and TRAF6 showed a weakening trend， but DHLX could reverse the phenomenon， we think the mechanism of action may be related to promoting the mutual binding of TAK1 and TARF6 to inhibit the activation of the NF-κB/MAPK signaling pathway.

Sudden chest pain, painful swelling left lower limb and malar erythema / 中华风湿病学杂志

Objective:To improve the understanding of the relationship between antiphospholipid syndrome (APS) and systemic lupus erythematosus (SLE).Methods:The clinical characteristics and process of diagnosis and treatment of a case was reported and analyzed. This patient was initially diagnosed as antiphospholipid syndrome and later developed new skin lesion and positive anti-dsDNA antibody, which made the diagnosis of systemic lupus erythematosus.Results:A 15-year-old girl suffered acute pulmonary embolism, lower extremity deep vein thrombosis, and high titer of anti-phospholipid antibody, but negative for other autoantibodies. So primary antiphospholipid syndrome was diagnosed. Symptoms were improved after thrombolysis and anticoa-gulation treatment. During the follow-up period, the patient developed malar erythema, lymphocytopenia, proteinuria, positive ANA, anti-dsDNA antibody, and reduced complement level. So she was diagnosed with systemic lupus erythematosus. After glucocorticoid pulse therapy and immunosuppressants treatment, the symptoms were relieved and lupus disease activity was decreased.Conclusion:A few primary APS patients can progress into SLE. Patients with risk factors such as a younger age of onset, positive ANA and positive Coomb's test results should be closely followed up.

A case of pseudomyogenic hemangioendothelioma misdiagnosed as low-grade malignant fibrous histiocytoma and review of literature / 中南大学学报(医学版)

Pseudomyogenic hemangioendothelioma (PHE) is a rare angiogenic tumor. Histologically, the morphological characteristics of neoplastic vessels and endothelial differentiation are not obvious, and it is easy to be confused with epithelioid sarcoma, epithelioid hemangioendothelioma and myogenic tumor. PHE usually occurs in arms and legs in young people and has a significant male predominance. The tumor has a predilection for the distal extremities and its typical manifestation is multiple center invasion of a single limb, which can involve all layers of skin and subcutaneous tissues,and is often accompanied by abvious pain. Histologically, PHE is characterized by infiltrative growth of tumor. Most tumor lesions are composed of sheets and loose fascicles of plump spindle or epithelioid cells within a background of variably prominent inflammatory infiltration, which was commonly composed of neutrophils. Some cells may resemble rhabdomyoblasts, and nuclear atypia and mitosis were rare. The tumor cells generally expressed positive cytokeratin (CK), ETS-related gene (ERG), Friend leukemia virus integration 1 (FLI1) and integrase interactor 1(INI1). In some cases, the tumor cells expressed CD31. A case of a young woman was reported in this paper, who presented with a subcutaneous mass with severe pain and was chronologically misdiagnosed with herpes zoster, low-grade malignant fibrous histiocytoma and epithelioid hemangioendothelioma. In this study, the clinical and pathological features, differential diagnosis and the latest progress in therapy of PHE were analyzed based on relevant literature.

Effects of plication procedures in special cases of Peyronie's disease: a single-center retrospective study of 72 patients / 亚洲男科学杂志(英文版)

General recommendations regarding surgical techniques are not always appropriate for all Peyronie's disease (PD) patients. Therefore, the purpose of this study was to investigate the effects of plication procedures in PD patients with severe penile curvature and the effects of early surgical correction in patients who no longer have progressive deformities. The clinical data from 72 patients who underwent plication procedures were analyzed in this study. Patients were divided into Groups A and B according to the curvature severity (≤60° or >60°) and Groups 1 and 2 according to the duration of disease stabilization (≥3 months or <3 months). At the 1-year follow-up, 90.0% (36/40) and 90.6% (29/32) patients reported complete penile straightening, and 60.0% (24/40) and 100.0% (32/32) patients reported penile shortening in Groups A and B, respectively. No curvature recurrence occurred in any patient, and no significant differences were observed in postoperative International Index of Erectile Function-Erectile Function domain (IIEF-EF), erectile pain, sensitivity, or suture knots on the penis whether such outcomes were grouped according to the curvature severity or the duration of stabilization. However, the duration from symptom onset to surgical management in Group 1 was significantly longer than that in Group 2 (mean ± standard deviation [s.d.]: 20.9 ± 2.0 months and 14.3 ± 1.2 months, respectively, P < 0.001). The present study showed that the plication procedures seemed to be an effective choice for the surgical treatment of PD patients with severe penile curvature. In addition, the early surgical treatment seemed to benefit those patients who already had no erectile pain and no longer exhibited progressive deformity.

Acupuncture for perimenopausal early-wake insomnia: a randomized controlled trial / 中国针灸

OBJECTIVE@#To observe the clinical effect of acupuncture for perimenopausal early-wake insomnia.@*METHODS@#A total of 60 patients with perimenopausal early-wake insomnia were randomly divided into an observation group (30 cases, 3 cases dropped off) and a control group (30 cases, 2 cases dropped off, 2 cases were removed). In the observation group, acupuncture was applied at Baihui (GV 20), Yintang (GV 24+), Anmian (Extra), Hegu (LI 4), Shenmen (HT 7), Taichong (LR 3), Taixi (KI 3), etc., once every other day, 3 times a week. In the control group, oryzanol tablets were taken orally, 20 mg each time, 3 times a day. Both groups were treated for 4 weeks. Before and after treatment, the sleep actigraphy (ACT) was used to measure the effective sleep time, sleep quality, wake-up time, wake-up frequency, each wake-up time, and the Pittsburgh sleep quality index (PSQI) score and early-wake score were compared in the two groups, and the clinical effect was assessed.@*RESULTS@#After treatment, compared before treatment, the effective sleep time was prolonged and the sleep quality was improved (P<0.05), the wake-up time, each wake-up time were shortened and wake-up frequency was decreased (P<0.05), the PSQI score and early-wake score were decreased (P<0.05) in the observation group. After treatment, the wake-up frequency, PSQI score and early-wake score were decreased in the control group (P<0.05). The effective sleep time, sleep quality, wake-up time, wake-up frequency, each wake-up time, PSQI score and early-wake score after treatment in the observation group were superior to the control group (P<0.05). The total effective rate was 88.9% (24/27) in the observation group, which was higher than 38.5% (10/26) in the control group (P<0.05).@*CONCLUSION@#Acupuncture can increase the effective sleep time and improve sleep quality in patients with perimenopausal early-wake insomnia.

Analysis of clinical characteristics of 35 inflammasomopathies cases / 中华儿科杂志

Objective: To summarize the clinical characteristics of inflammasomopathies, enhance the recognition of those diseases, and help to establish the early diagnosis. Methods: The clinical manifestations including fever, rash, systems involvement as well as laboratory results and genotypic characteristics of 35 children with inflammasomopathies diagnosed by the Department of Pediatrics, Peking Union Medical College Hospital, from January 1, 2008 to December 31, 2020 were analyzed retrospectively. Results: A total of 35 cases of inflammasomopathies were diagnosed, and 20 of them were boys while 15 were girls. Inflammasomopathies patients have early onset, the age of onset as well as diagnostic age were 1 (0,7) and 7 (3,12), respectively. Among those patients, 10 had familial mediterranean fever, 3 had mevalonate kinase deficiency, 15 cases had NLRP3 gene associated autoinflammatory disease, 4 cases had NLRP12-associated autoinflammatory disease, 2 cases had familial cold autoinflammatory syndrome 3, and 1 case had familial cold autoinflammatory syndrome 4. A total of 34 cases (97%) showed recurrent fever, 27 cases (77%) had skin rashes, while 11 cases (31%), 10 cases (29%), and 8 cases (23%) were presented with lymphadenopathy, hepatosplenomegaly and growth retardation, respectively. In terms of systemic involvement, there were 18 cases (51%), 12 cases (34%), 8 cases (23%), and 5 cases (14%) with skeletal, neurological, auditory, and renal involvement, respectively. Central nervous system involvement was seen only in NLRP3 gene associtated autoinflammatory diseases (12 cases), sensorineural deafness was seen in NLRP3 gene associtated autoinflammatory diseases (6 cases) and NLRP12 gene associated autoinflammatory diseases (2 cases), and abdominal pain was observed in familial Mediterranean fever (5 cases), mevalonate kinase deficiency (1 case) and NLRP12 gene related autoinflammatory diseases (1 case). In the acute inflammatory phase, the acute phase reactants (erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP)) of 35 cases (100%) were significantly increased. There were 21 cases received ferritin examination, and only 4 cases (19%) showed an increase of it. In terms of autoantibodies, among all 35 patients, 4 cases (11%) were positive for antinuclear antibodies (ANA). Conclusions: Fever, skin rash, and skeletal manifestations are the most common clinical features, accompanied with increased CRP and ESR, and negative results of autoantibodies such as ANA. The clinical manifestations of those diseases are complex and diverse, and it is prone to delayed diagnosis and treatment.

Willingness to pay for treatment of rosacea and its influencing factors: a survey of patients in Changsha region / 中华皮肤科杂志

Objective:To investigate the willingness to pay (WTP) for treatment and its influencing factors, to evaluate the correlation between the disease burden (quality of life) index and dermatology life quality index (DLQI) in patients with rosacea, and to provide a basis for individualized diagnosis and treatment.Methods:Patients with rosacea were enrolled via a WeChat platform at Department of Dermatology, Xiangya Hospital from August 2019 to February 2020. An online questionnaire survey was performed to investigate the WTP for a single session of treatment by which rosacea is assumed to be cured, and general information as well as data about clinical characteristics and DLQI scores were collected. Factors influencing high WTP were analyzed by using a logistic regression model.Results:Among the 435 respondents, 397 (91.3%) were females and 38 (8.7%) were males, with an age of 28.46 ± 8.33 years (range, 18- 63 years) . The respondents spent 10 474.95 ± 834.19 ( M[ P25, P75], 5 000 [1 000, 10 000]) RMB Yuan on previous medical treatment; the WTP was 12 510.86 ± 990.84 ( M[ P25, P75], 5 000[2 000, 10 000]) RMB Yuan; the DLQI score was 11.2 ± 0.38. Logistic regression analysis showed that lesions on the cheeks ( OR= 1.89, P= 0.041) , annual household income of > 100 000 RMB Yuan ( OR= 1.63, P= 0.029) , disease duration of > 1 year ( OR= 2.82, P < 0.001) , high number of visits in the past 1 year ( OR= 1.62, P < 0.001) , high self-rated rosacea severity score ( OR= 1.16, P= 0.002) and high DLQI score ( OR= 1.52, P < 0.001) were associated high WTP for treatment. Spearman correlation analysis showed that the DLQI score was positively correlated with WTP ( rs= 0.27, P < 0.05) and relative WTP (the proportion of WTP to monthly income, rs= 0.133, P < 0.05) . Conclusions:Among the patients with rosacea in Changsha, the WTP was at a moderate to high level, reflecting a serious impact on the quality of life. The WTP value can indirectly reflect the quality of life and help to rapidly understand the burden of disease in patients with rosacea.

Role and action mechanism of aquaporin 3 in alleviating photoaging of skin fibroblasts by regulating hnRNPQ/p53 / 中华皮肤科杂志

Objective:To investigate the role and action mechanism of aquaporin 3 (AQP3) in skin photoaging.Methods:Normal human skin fibroblasts (NHDF) were divided into several groups: NHDF group receiving normal culture without transfection, AQP3 cDNA group transfected with AQP3 cDNA, AQP3 siRNA group transfected with AQP3 siRNA, heterogeneous nuclear ribonucleoprotein Q (hnRNPQ) cDNA group transfected with hnRNPQ cDNA, hnRNPQ siRNA group transfected with hnRNPQ siRNA, AQP3-hnRNPQ cDNA group transfected with AQP3 and hnRNPQ cDNAs, AQP3-hnRNPQ siRNA group transfected with AQP3 and hRNPQ siRNAs, cDNA empty vector group transfected with a cDNA empty vector, and siRNA empty vector group transfected with a siRNA empty vector. Transfected or untransfected NHDFs were irradiated with ultraviolet A (UVA) at a dose of 10 J·cm -2·d -1 for 3 consecutive days to establish a model of cellular senescence, and NHDF receiving no UVA irradiation served as a control. A cell counting method was used to evaluate the cellular proliferative activity, a senescence-related β-galactosidase staining kit to evaluate the senescence level of NHDFs in each experimental group, and luciferase reporter gene technology to assess the transcriptional regulation activity of p53. Western blot analysis was performed to determine the expression of AQP3, hnRNPQ and senescence-related proteins p53 and p21 in NHDFs. Two-independent-sample t test was used for comparisons between two groups, and one-way analysis of variance for comparisons among multiple groups. Results:After 3-day consecutive irradiation with UVA, the expression of p53 and p21 in NHDFs and the percentage of β-galactosidase-positive cells significantly increased compared with the unirradiated control group (all P < 0.05) , but the expression of AQP3 and cellular proliferative activity on days 5, 6 and 7 significantly decreased in the UVA group compared with the unirradiated control group (all P < 0.05) . After 3-day consecutive irradiation with UVA, aggravated senescence-related phenotypes of UVA-induced NHDFs were observed in the AQP3 siRNA group compared with the siRNA empty vector group, and there were significant differences in the expression of p53, p21 and hnRNPQ, percentage of β-galactosidase-positive cells, p53 transcriptional regulation activity and cellular proliferative activity between the 2 groups (all P < 0.05) . Further silencing of the hnRNPQ gene could reverse the above effects. Compared with the siRNA empty vector group, the senescence-related phenotypes of UVA-induced NHDFs were attenuated in the hnRNPQ siRNA group, and significant differences were observed between the 2 groups in terms of the expression of p53, p21 and hnRNPQ, percentage of β-galactosidase-positive cells, p53 transcriptional regulation activity and cellular proliferative activity (all P < 0.05) . After 3-day consecutive irradiation with UVA, the senescence-related phenotypes of UVA-induced NHDFs were significantly attenuated in the AQP3 cDNA group compared with the cDNA empty vector group (all P < 0.05) , manifesting as significantly decreased expression of p53 (0.25 ± 0.06 vs. 0.56 ± 0.08) , p21 (0.23 ± 0.06 vs. 0.70 ± 0.07) and hnRNPQ (0.82 ± 0.09 vs. 0.92 ± 0.03) , percentage of β-galactosidase-positive cells (31.23% ± 6.54% vs. 81.53% ± 7.62%) and p53 transcriptional regulation activity (2.52 ± 0.36 vs. 7.16 ± 0.25) , but increased cellular proliferative activity ([2.93 ± 0.33]× 10 6/ml vs.[2.15 ± 0.23]× 10 6/ml) , and further overexpression of hnRNPQ could reverse the above effects. After 3-day consecutive irradiation with UVA, the expression of p53, p21, percentage of β-galactosidase-positive cells, p53 transcriptional regulation activity and cellular proliferative activity in the hnRNPQ cDNA group were 1.41 ± 0.09, 1.42 ± 0.06, 91.06% ± 4.24%, 12.35 ± 0.88 and (1.23 ± 0.41) × 10 6/ml respectively, and the senescence-related phenotypes of UVA-induced NHDFs were significantly aggravated in the hnRNPQ cDNA group compared with the cDNA empty vector group (all P < 0.05) . Conclusion:AQP3 may alleviate the UVA-induced senescence of NHDFs by regulating hnRNPQ and downregulating p53 expression.

Analysis of Da Vinci robot-assisted laparoscopy in children’s duplication of kidney / 中华泌尿外科杂志

Objective:To investigate the efficacy of robot-assisted laparoscopic surgery in heminephrectomy in children.Methods:The clinical data of 54 children with heminephrectomy in the First Affiliated Hospital of Zhengzhou University from January 2017 to December 2019 was analyzed retrospectively, of which 42 cases underwent laparoscopic heminephrectomy (LH group) and 12 cases underwent robot-assisted laparoscopic heminephrectomy (RALH group). In LH group, there were 17 males and 25 females, with an average age of (71.74±34.57)months, 29 on the left and 13 on the right. In RALH group, there were 4 males and 8 females, with an average age of (76.83±37.33) months, 9 on the left and 3 on the right. There was no significant difference in age, sex composition and deformity side between the two groups ( P > 0.05). The clinical indexes such as operation time, intraoperative blood loss, postoperative drainage time, hospital stay and postoperative complications were compared between the two groups. Results:There were significant differences in operation time[(196.48±21.92)min vs.(171.50±24.91)min], intraoperative blood loss[(34.14±8.63)ml vs.(18.50±5.92)ml], postoperative drainage time[6.0(5.0, 7.0)d vs. 4.5(3.0, 6.5)d] and postoperative hospital stay[(8.93±1.70)d vs.(7.33±1.37)d] between LH and RALH groups ( P < 0.05). During the follow-up from 3 months to 2 years, the lower kidneys of the two groups developed well and the symptoms before operation such as urinary tract infection, intermittent voiding leakage and dysuria caused by ureterocele were gradually relieved and disappeared after operation. In the LH group, 2 cases were complicated with the symptoms as ureteral stump effusion, cyst formation and recurrent ureteral stump infection after operation, which were cured after reoperation. There was no case of ureteral stump effusion and cyst formation in the RALH group. Conclusions:Robot-assisted laparoscopic heminephrectomy in children has shorter intraoperative blood loss, postoperative drainage time and hospital stay, lower incidence of postoperative complications, and has better efficacy and safety.

Prognosis analysis of T 1 stage nasopharyngeal cancer with different lymph node and metastasis stages in the era of precision radiotherapy / 中华放射肿瘤学杂志

Objective:To evaluate the survival prognosis for T 1 stage nasopharyngeal carcinoma patients complicated with different stages of cervical lymph node metastasis, aiming to provide reference for optimizing the treatment plan. Methods:Clinical data of 413 patients in non-keratinizing carcinoma and undifferentiated locally early nasopharyngeal carcinoma (T 1N 0-3M 0-1) undergoing radiotherapy alone or radiochemotherapy in Department of Radiation Oncology of our hospital from January 2014 to December 2019 were retrospectively analyzed. The survival analyses were performed with Kaplan-Meier method and statistically compared using the log-rank test. Results:Of all patients, 291 were male, and 122 were female (aged from 9 to 78 years old) with a median age of 51 years old. All patients were diagnosed with T 1N 0-3M 0-1 nasopharyngeal carcinoma. In the TNM stage grouping system, 48(11.6%) patients were classified as stage Ⅰ (T 1N 0M 0), 158(38.2%) cases of stage Ⅱ(T 1N 1M 0), 162(39.2%) cases of stage Ⅲ(T 1N 2M 0), and 45(10.9%) cases of stage Ⅳ A to Ⅳ B(T 1N 3M 0/T 1N xM 1). Eight patients (1.9%) with stage Ⅳ B had metastasis at presentation. The lymph node positivity rate of all patients reached up to 88.1%. Seven patients received three-dimensional conformal radiotherapy, 371 cases of intensity-modulated radiotherapy and 35 cases of volumetric-modulated arc therapy. The 5-year overall survival rate was (95.9±1.2)% and with 100% for T 1N 0M 0 patients, (99.2±0.8)% for T 1N 1M 0 patients, (95.1±2.2)% for T 1N 2M 0 patients and (87.9±6.6)% for T 1N 3M 0 patients, respectively. Primary distant metastasis and N 3 stage were significantly correlated with poor prognosis (both P<0.05). The most common long-term side effect of radiotherapy was xerostomia with an incidence rate of 18.6%(17.9% for grade 1 toxicity), followed by hearing damage and tooth discomfort. Only 2 patients developed Grade Ⅲ toxic reactions, manifested as complete hearing loss. Conclusions:Although T 1 nasopharyngeal carcinoma patients have a high propensity of cervical node metastasis, favorable clinical prognosis can be obtained after radiotherapy alone. Moreover, the long-term side effects under precision radiation exert no severe effect upon the quality of life of patients.

Analysis and comparison of metabolic processes of salvianolic acid A and salvianolic acid B in rats based on UHPLC-LTQ-Orbitrap MS technology / 中国中药杂志

The metabolites of salvianolic acid A and salvianolic acid B in rats were analyzed and compared by ultra-high-perfor-mance liquid chromatography with linear ion trap-orbitrap mass spectrometry(UHPLC-LTQ-Orbitrap MS). After the rats were administrated by gavage, plasma at different time points and urine within 24 hours were collected to be treated by solid phase extraction(SPE), then they were gradient eluted by Acquity UPLC BEH C_(18) column(2.1 mm×100 mm, 1.7 μm) and 0.1% formic acid solution(A)-acetonitrile(B) mobile phase system, and finally all biological samples of rats were analyzed under negative ion scanning mode. By obtaining the accurate relative molecular mass and multi-level mass spectrometry information of metabolites, combined with the characteristic cleavage law of the reference standard and literature reports, a total of 30 metabolites, including salvianolic acid A and B, were identified. Among them, there were 24 metabolites derived from salvianolic acid A, with the main metabolic pathways including ester bond cleavage, dehydroxylation, decarboxylation, hydrogenation, methylation, hydroxylation, sulfonation, glucuronidation, and their multiple reactions. There were 15 metabolites of salvianolic acid B, and the main biotransformation pathways were five-membered ring cracking, ester bond cleavage, decarboxylation, dehydroxylation, hydrogenation, methylation, sulfonation, glucuronidation, and their compound reactions. In this study, the cross-metabolic profile of salvianolic acid A and B was elucidated completely, which would provide reference for further studies on the basis of pharmacodynamic substances and the exploration of pharmacological mechanism.

Evaluation on the laparoscopic repair in children with ureterovesical junction malformation through internal or external bladder / 中华实用儿科临床杂志

Objective:To evaluate the therapeutic characteristics of laparoscopic repair in children with ure-terovesical junction malformation through internal or external bladder.Methods:From February 2018 to August 2019, 29 cases of hydronephrosis combined with ureter expansion treated in the First Affiliated Hospital of Zhengzhou University, with 17 boys and 12 girls confirmed through the preoperative examinations.Inspection results revealed 15 cases of ureteropelvic junction obstruction, 12 cases of vesicoureteral reflux, and 2 cases of single ectopic ureter.Totally, 21 cases were treated by pneumovesical laparoscopic Cohen means, including 17 unilateral cases and 4 bilateral cases, 5 cases of ureterocele, and 8 cases of ureteral clipping.A total of 8 cases were treated by laparoscopic Lich -Gregoir surgical treatment, including 7 unilateral cases and 1 bilateral case.Meanwhile, 4 cases of ureteral clipping were performed among them.There was 1 case of duplex kidney with the ectopic upper ureter outside iliac blood vessels, 1 case of bilateral cryptorchidism and 1 case of unilateral cryptorchidism.Ureteral stents were implanted for those with ureteral tailoring.The catheters were removed 7 days after operation, and the indwelling ureteral stents were removed by cystoscope under general anesthesia after about 6 weeks.Results:All the cases with hydronephrosis and ureteral dilatation were completed in laparoscopic surgery, without open surgery or blood transfusion, 21 cases were treated by pneumovesical laparoscopic Cohen means, with the average time being 1.8 hours in unilateral side and 2.8 hours in bilateral sides.At the same time, 8 cases were treated by laparoscopic Lich-Gregoir means, with the unilateral average time being 1.7 hours and bilateral time being 3.0 hours.All cases were followed up at an average month of 9 (4-20 months), and all children underwent voiding cystourethrography 4 months after the operations.The voiding cystourethrogram(VCUG) of all the cases was confirmed successfully, with only 1 case of vesicoureteral reflux in level Ⅲ, and their hydronephrosis were relieved.There was no vesicoureteral reflux in the others.The short-term urinary retention occurred in 1 patient with bilateral ureteral reimplantation in Lich-Gregoir group, and the symptom disappeared after 1 week of indwelling catheterization.Among them, 1 patient in Cohen group had hematuria that disappeared gradually for 4 days after surgery.There were no significant differences in operation time and postoperative recovery between the two groups.The length of hospital stay in laparoscopic Lich -Gregoir group was slightly longer than that in pneumovesical laparoscopic Cohen group.Conclusions:As for children with ureterovesical junction malformation, laparoscopic Lich-Gregoir surgery is suitable for the ectopia of ureter opening, overexpansion of ureter, and other abdominal malformation complicated and expansive ureter without tortuosity.Pneumovesical laparoscopic Cohen surgery is suitable for hydronephrosis and ureteral expansion with ureterocele, especially with the symptom of dysuria, and ureteral tortuosity obviously.The two ways are safe and reliable, and the advantages and disadvantages should be weighed before being chosen.

Genetic Diversity Analysis of Erigeron breviscapus Based on SSR Markers / 中国实验方剂学杂志

Objective:To explore the genetic diversity and population structure of <italic>Erigeron breviscapus</italic>， so as to provide a scientific basis for its resource protection and rational utilization. Method:Twelve pairs of simple sequence repeat（SSR） primers were screened out from 243 individuals in 16 natural populations to calculate the genetic diversity parameters of <italic>E. breviscapus</italic>， which were then subjected to principal coordinate analysis and cluster analysis. Result:Twelve SSR markers generated 209 alleles， with an average of 17.417 alleles per locus. Based on 12 SSR markers and 16 populations of <italic>E. breviscapus</italic>， the observed heterozygosity （<italic>H</italic>₀） values were determined to be 0.603 and 0.613， the expected heterozygosity （<italic>H</italic>_e）to be 0.658 and 0.659， and the Shannon's information index （<italic>I</italic>） to be 1.443 and 1.446， respectively. The Wright's fixation index （<italic>F</italic>_st） was 0.123 and gene flow （<italic>N</italic>_m） was 2.077. Analysis of molecular variance （AMOVA） and genetic differentiation revealed that genetic variation within populations was the main source of total variation. The Nei's genetic distance and genetic identity coefficients were within the ranges of 0.107 （YA and XY）-0.713 （SZ and XZD） and 0.490 （SZ and XZD）-0.899 （YA and XY）， respectively. As demonstrated by the principal coordinate analysis and cluster analysis， the 16 populations of <italic>breviscapus </italic>were divided into two clusters. Conclusion:The genetic diversity of <italic>E. breviscapus</italic> was relatively high and there existed certain genetic differentiation and gene flow within and among populations. The genetic variation was mainly present within populations. All these have provided reference for subsequent study on good germplasm selection of <italic>E. breviscapus.</italic>