External use of mirabilite to prevent post-endoscopic retrograde cholangiopancreatography pancreatitis in children:A multicenter randomized controlled trial

BACKGROUND Acute pancreatitis is the most common complication of endoscopic retrograde cholangiopancreatography(ERCP).Currently,there is no suitable treatment for post-ERCP pancreatitis(PEP)prophylaxis.Few studies have prospectively evaluated interventions to prevent PEP in children.AIM To assess the efficacy and safety of the external use of mirabilite to prevent PEP in children.METHODS This multicenter,randomized controlled clinical trial enrolled patients with chronic pancreatitis scheduled for ERCP according to eligibility criteria.Patients were randomly divided into the external use of mirabilite group(external use of mirabilite in a bag on the projected abdominal area within 30 min before ERCP)and blank group.The primary outcome was the incidence of PEP.The secondary outcomes included the severity of PEP,abdominal pain scores,levels of serum inflammatory markers[tumor necrosis factor-alpha(TNF-α)and serum interleukin-10(IL-10)],and intestinal barrier function markers[diamine oxidase(DAO),D-lactic acid,and endotoxin].Additionally,the side effects of topical mirabilite were investigated.RESULTSA total of 234 patients were enrolled,including 117 in the external use of mirabilite group and theother 117 in the blank group.The pre-procedure and procedure-related factors were notsignificantly different between the two groups.The incidence of PEP in the external use ofmirabilite group was significantly lower than that in the blank group(7.7%vs 26.5%,P<0.001).The severity of PEP decreased in the mirabilite group(P=0.023).At 24 h after the procedure,thevisual analog scale score in the external use of mirabilite group was lower than that in the blankgroup(P=0.001).Compared with those in the blank group,the TNF-αexpressions weresignificantly lower and the IL-10 expressions were significantly higher at 24 h after the procedurein the external use of mirabilite group(P=0.032 and P=0.011,respectively).There were nosignificant differences in serum DAO,D-lactic acid,and endotoxin levels before and after ERCPbetween the two groups.No adverse effects of mirabilite were observed.CONCLUSIONExternal use of mirabilite reduced the PEP occurrence.It significantly alleviated post-proceduralpain and reduced inflammatory response.Our results favor the external use of mirabilite toprevent PEP in children.

Incidence of rhegmatogenous retinal detachments is increasing in Wenzhou,China

AIM:To estimate and compare the incidence and characteristics of rhegmatogenous retinal detachments(RRDs)in the Wenzhou area in 2015 to 2019.METHODS:All newly developed RRD cases among residents of the Wenzhou area,from January 2015 to December 2019,were retrospectively retrieved from hospital records.Annual population data were extracted from the Wenzhou Statistical Yearbook.RESULTS:There were 3629 eligible cases.The average incidence of RRD was 7.79 cases per 100000 population(95%confidence interval,7.24-8.34),and the incidences were 7.99 and 7.56 for males and females,respectively.The annual incidence increased gradually from 7.26 cases per 100000 in 2015 to 10.00 cases per 100000 in 2019,with an overall increase of 37.74%.The highest rate of increase occurred in the age group from 60 to 69 years.Of 2750 eyes with axial length(AL)data,1675(60.91%)had an AL greater than 24 mm.CONCLUSION:A trend to increasing RRD incidence is observed in the Wenzhou area over the past 5-year period.

Efficacy and safety of endoscopic retrograde cholangiopancreatography in recurrent pancreatitis of pediatric asparaginase-associated pancreatitis

BACKGROUND Asparaginase(ASP)is an important drug in combined chemotherapy regimens for pediatric acute lymphoblastic leukemia(ALL);ASP-associated pancreatitis(AAP)is the main adverse reaction of ASP.Recurrent pancreatitis is a complication of AAP,for which medication is ineffective.AIM To evaluate the efficacy and safety of endoscopic retrograde cholangiopancreatography(ERCP)in treating recurrent pancreatitis due to AAP.METHODS From May 2018 to August 2021,ten children(five males and five females;age range:4–13 years)with AAP were treated using ERCP due to recurrent pancreatitis.Clinical data of the ten children were collected,including their sex,age,weight,ALL risk grading,clinical symptoms at the onset of pancreatitis,time from the first pancreatitis onset to ERCP,ERCP operation status,and postoperative complications.The symptomatic relief,weight change,and number of pancreatitis onsets before and after ERCP were compared.RESULTS The preoperative symptoms were abdominal pain,vomiting,inability to eat,weight loss of 2-7 kg,and 2-9 pancreatitis onsets.After the operation,nine of ten patients did not develop pancreatitis,had no abdominal pain,could eat normally;the remaining patient developed three pancreatitis onsets due to the continuous administration of ASP,but eating was not affected.The postoperative weight gain was 1.5-8 kg.There was one case of post ERCP pancreatitis and two cases of postoperative infections;all recovered after medication.CONCLUSION ERCP improved clinical symptoms and reduced the incidence of pancreatitis,and was shown to be a safe and effective method for improving the management of recurrent pancreatitis due to AAP.

超乳联合房角分离或小梁切除对PACG合并白内障患者血流动力学的影响

目的:探究超声乳化白内障吸除联合房角分离术或小梁切除术对原发性闭角型青光眼(PACG)合并白内障患者血流动力学的影响。方法:随机数字表格法将巴中市中心医院2015-01/2017-06收治的94例94眼PACG合并白内障患者分为超声乳化白内障吸除联合房角分离术(观察组)与超声乳化白内障吸除联合小梁切除术(对照组),每组47例,比较两组疗效指标。结果:观察组术后1、3mo收缩期峰值流速(PSV)、舒张末期流速(EDV)均显著大于对照组,术后3mo阻力指数(RI)明显小于对照组以及前房深度、房角开放程度显著大于对照组(P<0.05)。结论:房角分离或小梁切除联合超声乳化均能有效降低眼压,促进患者视力恢复,但房角分离术相对能更好地促进房角开放,改善血流动力学。

Clinical observation of Shengxuebao Mixture in treating anemia after concurrent chemoradiotherapy for cervical cancer

Objective:To investigate the efficacy of the Shengxuebao Mixture in treating anemia after concurrent chemoradiotherapy for cervical cancer.Methods:The patients who met the criteria were randomly divided into the study group(n=30)and the control group(n=30).The study group was treated with Shengxuebao Mixture(15 ml once,three times a day)for 30 days,and the control group was treated with ferrous succinate tablets(0.1 g,twice a day),folic acid tablets(5 mg,three times a day),and vitamin B12 tablets(25μg,once a day)for 30 days.Observed the hemoglobin level,erythropoietin level,TCM syndrome score,karnofsky performance status score before and after treatment in the two groups,compared the relevant data and clinical efficacy between the two groups and observed the adverse drug reactions at the same time.Results:The age,pathological type,stage,baseline hemoglobin level,erythropoietin level,TCM syndrome score,and karnofsky performance status score were comparable between the two groups(P>0.05).The hemoglobin level of the two groups after treatment was higher than before treatment(P<0.05).After treatment,the hemoglobin level in the study group was significantly higher than that in the control group(P<0.05),and the number of effective cases in the study group was more than that in the control group,and the effective rate in the study group was higher than that in the control group(P<0.05).The erythropoietin level of the two groups after treatment was lower than before treatment(P<0.05).After treatment,the erythropoietin level in the study group was significantly lower than that in the control group(P<0.05).The TCM syndrome score of the study group decreased significantly after treatment(P<0.05),but there was no significant change in the control group(P>0.05).After treatment,the TCM syndrome score of the study group was significantly lower than that of the control group(P<0.05),and the number of effective cases in the study group was more than that in the control group,and the effective rate in the study group was higher than that in the control group(P<0.05).There was no significant change in the karnofsky performance status score of the study group after treatment(P>0.05),but the karnofsky performance status score of the control group decreased significantly(P<0.05).After treatment,the karnofsky performance status score of the study group was higher than that of the control group(P<0.05),and the number of effective cases in the study group was more than that of the control group,and the effective rate was higher than that of the control group(P<0.05).And there were no obvious adverse reactions in this study.Conclusion:To some extent,this study showed that the Shengxuebao Mixture has a definite effect in treating anemia after concurrent chemoradiotherapy for cervical cancer,can promote the use of erythropoietin,improve TCM syndromes and stabilize the quality of life of patients.

To explore the potential vitiligo treatment mechanism of Piperine in Piperis Longi Fructus via network pharmacology and bioinformatics strategies

Objective:To explore the mechanism of Piperine of Piperis Longi Fructus in the treatment of vitiligo based on network pharmacology and transcriptome.Methods:Piperine,the active component of Piperis Longi Fructus,was screened from Traditional Chinese Medicine Systems Pharmacology,and the target network and protein interaction network of piperine-vitiligo were constructed.PPI analyzed the cross targets,GO function,and KEGG pathway analysis.In the GEO database,vitiligo gene expression profile chips GSE65127 and GSE75819 were selected for differential gene screening and gene set enrichment analysis.The potential key signal pathways of piperine in the treatment of vitiligo were identified by transcriptome microarray data verification.Results:31 potential targets of piperine in the treatment of vitiligo were found,of which 9 targets such as ESR1,AKT1,and IGF1 were closely related to the treatment of vitiligo.Enrichment analysis showed that signal pathways such as PI3K-Akt,MAPK,and Melanogenesis were related to piperine's mechanism in treating vitiligo.The cross-validation of chip analysis results confirmed that Melanogenesis is a potential key signal pathway for piperine in vitiligo treatment.Conclusion:This study discusses the potential targets and signal pathways of piperine in the treatment of vitiligo,which helps clarify the mechanism of piperine in the treatment of vitiligo and provides a theoretical basis for the clinical treatment of vitiligo.It also provides direction for the research and development of new drugs for vitiligo.

Progress research on non-drug therapy in cancer-related fatigue

Cancer-related fatigue is the most prevalent and persistently symptom in cancer survivors than any other symptom,which is caused by both the disease and its treatment.Patients with cancer show a severe symptom of fatigue,which cannot be relieved by general rest or sleep.Cancer-related fatigue negatively impacts a patient's physical and emotional function,social ability and even patients’prognosis.At present,the mechanism of cancer-related fatigue remain unclear despite much research,and a variety of mechanisms may contribute to its occurrence and development,including inflammatory reaction,metabolism dysregulation,immune activation,hormonal changes,central nervous system dysfunction,etc.Now a broad variety of drugs and non-drugs interventions are used against cancer-related fatigue.The intervention of conventional western medicine mainly contains hematopoietic stimulants,hormones,mental stimulants,and antidepressants,but their widely clinical application is limited by their effectiveness and possible side effects to a certain degree.There are also many forms of non-drug interventions for managing cancer-related fatigue,such as exercise intervention,psychological intervention,sleep intervention,nutrition intervention,bright white light therapy,etc.The aim of this review is to provide recommendations of non-drug interventions for patients with CRF during and after cancer treatment,in order to provide an evidence-based guideline for clinicians.

Research progress of microbiome and pathogenesis of vitiligo

Vitiligo is a common skin depigmentation disease and affects the mental health of myriad populations around the world.The pathogenesis is multifactorial and the exact driving factor remains unclear.There is much evidence that the changes in microbiome play an important role in the pathogenesis of vitiligo,they affect immune homeostasis,oxidative stress,skin barrier,and gene expression in vitiligo.The restoration of microbiome is a promising preventive and therapeutic strategy for vitiligo.Herein,we have reviewed recent studies on the vitiligo-related microbiome in an attempt to confidently identify the“core”microbiome of vitiligo patients,understand the role of microbiome in the pathogenesis of vitiligo,and explore new therapeutic strategies for vitiligo through microbial intervention.

Identification of signal pathways and biomarkers of plaque psoriasis and prediction of potential microRNA targets via comprehensive strategies

Psoriasis is a complex skin disease and the pathogenesis of psoriasis is not clear.The purpose of this study is to identify the key driving genes and signal pathways involved in psoriasis and to predict the potential miRNA,for further understanding the pathogenesis of psoriasis.Methods:Three gene expression profiling chips,including GSE67853,GSE78097,and GSE136757 with a total of 120 samples were collected and analyzed with R software.The protein-protein interaction network of differentially expressed genes was constructed with STRING database and Cytoscape.CIBERSORT was used to evaluate the infiltration of immune cells in psoriasis tissues,and the correlation between diagnostic markers and infiltrating immune cells was analyzed.Further,the key biomarkers were identified and the targeting miRNA of crucial genes was predicted.Results:A total of 201 differentially expressed genes(163 upregulated genes and 38 downregulated genes)were determined.CXCL1,CXCL2,and CXCL8,the critical biomarkers of psoriasis,were identified by different calculation methods.The potential critical signal pathway NOD-like receptor signaling pathway of psoriasis was explored by gene expression profiling chip gene enrichment analysis and differentially expressed gene enrichment analysis.Immune cell infiltration analysis found that CXCL1,CXCL2,CXCL8 was positively correlated with macrophages M1 and T cells CD4 memory activated and negatively correlated with macrophages M2 and mast cells resting.At the same time,through miRNA prediction,we found that hsa-miR-216a-3p and hsa-miR-6750-5p can be used as potential psoriasis targets.Conclusions:This research proposes a new comprehensive strategy to identify psoriasis’s potential biomarkers through cross-validation and significant scores of different calculation methods.In this research,we identified CXCL1,CXCL2,and CXCL8 as potential key biomarkers of psoriasis,and the NOD-like receptor signaling pathway is the critical signal pathway of psoriasis.Hsa-miR-216a-3p and hsa-miR-6750-5p can be used as potential psoriasis targets.

Progress of studies on cancer-related anemia in Chinese and Western medicine

Cancer-related anemia is a common complication in patients with a malignant tumor caused by the tumor itself or the tumor's treatment.It can seriously affect the quality of life of patients and even accelerate the progression of the tumor.Western medicine is often given a blood transfusion,erythropoietin,and iron agent in cancer-related anemia treatment,but there are also some problems such as increasing tumor-related mortality.Traditional Chinese medicine believes that cancer-related anemia's occurrence is related to the“Deficiency of Spleen and Kidney and Deficiency of Qi and Blood”,so clinical treatment is mainly to“Tonify Spleen and Kidney and Qi and Blood”.The combination of traditional Chinese and Western medicine is useful in cancer-related anemia's treatment,which provides a new idea and method for cancer-related anemia's clinical treatment.

Integrated bioinformatics analysis of key candidate genes and therapeutic drugs for idiopathic pulmonary fibrosis

Background: Idiopathic pulmonary fibrosis is a form of fibrotic and fatal lung disease worldwide with unknownetiology and mechanisms. This manuscript focused on clarifying the core protein-protein interaction network, genesand related pathways correlated with idiopathic pulmonary fibrosis in detail. Methods: Gene chip (GSE24206) wasacquired from the Gene Expression Omnibus database. GEO2R was a R-based online tool to screen differentialexpressed genes. Gene Ontology and the Kyoto Encyclopedia of Genes and Genomes analysis were utilized toascertain gene function and key signaling pathways. The Search Tool for the Retrieval of Interacting Genes was usedto construct the protein-protein interaction network. Key genes and module analysis were screened out usingCytohubba and MCODE plugin. The candidate therapeutic molecular drugs were searched for IPF using DGIdbdatabase. Results: A cohort of 240 differential expression of genes (113 up-regulated and 127 down-regulated) wereknocked out. Gene Ontology enrichment analysis indicated that some differential expression of genes were involvedin extracellular matrix and neutrophil chemotaxis. The Kyoto Encyclopedia of Genes and Genomes pathways werepredominantly involved in chemokine signaling pathway and ECM-receptor interactions. Two significant modulesand 5 hub genes were strongly implicated in idiopathic pulmonary fibrosis from protein-protein interaction network.The 2 module genes were primarily enriched in the cytokine-cytokine receptor, TNF signaling pathway, toll-likesignaling pathway, and Wnt signaling pathway. Finally, 41 small molecules were identified by DGIdb database as thepotential drugs of idiopathic pulmonary fibrosis. Conclusion: To conclude, in this study, the hub genes, signalingpathways, and small molecules will conduce to better understanding the mechanisms and may provide new methodsto the therapy of idiopathic pulmonary fibrosis.

Research progress on the application of microneedle transdermal drug delivery system in dermatology

Transdermal drug delivery systems(TDDs)have the advantages on good local targeting,controlled and sustainable drug delivery.Hoewever,the stratum corneum,as the main skin barrier,severely limits the transdermal penetration of drugs and reduces bioavailability,which also limits their application.Microneedles(MNS)penetrate the stratum corneum and create several reversible microchannels in a minimally invasive manner to significantly improve the penetration of therapeutic agents,and are considered a milestone for effective transdermal drug delivery.As an emerging drug delivery modality,microneedle transdermal drug delivery systems have the advantages of being minimally invasive,safe,efficient,economical and convenient.In addition to the extensive research on microneedles for improving transdermal drug delivery,there is a growing interest in using them to manage and treat dermatological conditions.Being the largest organ in the human body,the skin acts as a barrier between the body and the external environment,while having an immense influence on appearance and self-confidence.Indeed,there is now a considerable body of evidence on how dermatological conditions can lead to psychological problems and a reduced quality of life.The utilisation of microneedle transdermal drug delivery systems for the management and treatment of dermatological conditions is of great therapeutic and commercial value.The principleof microneedle transdermal drug delivery systems and the progress of its clinical application in dermatology are reviewed here.

Neonatal Staphylococcal Scalded Skin Syndrome:A Case Report

Objective:To summarize the clinical features,diagnosis,and treatment of neonatal staphylococcal scalded skin syndrome(SSSS).Methods:The clinical data with SSSS was analyzed,and the related literature was reviewed.Results:The acute onset of the disease was characterized by generalized erythema,epidermis exfoliation,skin non-touch,radial chapping around the mouth,and positive Nissl sign.The culture of binocular secretions and neck exudates showed Staphylococcus aureus and was diagnosed as SSSS.According to the results of drug sensitivity of secretions and exudates,vancomycin was selected for anti-infective treatment,and skincare and symptomatic support were given simultaneously.The child was cured and discharged after ten days of treatment.Conclusion:SSSS belongs to neonatal acute and critical illness.Improving etiological examination and timely targeted anti-infective treatment is the key to correct diagnosis and recovery.

双原位合成超低填充硼酸钙/聚对苯二甲酸乙二醇酯纳米复合材料及其介电储能研究

引入超低含量纳米粒子至聚合物基体能够同时改善介电常数和击穿强度,从而显著提升聚合物薄膜电容储能密度,有助于器件小型化.目前溶液共混策略中的有机溶剂回收及环境安全等诸多因素限制了超低填充聚合物纳米复合材料规模化制备及应用.本文工作提出双原位合成策略:聚对苯二甲酸乙二醇酯(PET)聚合与硼酸钙纳米粒子生长同步,无需任何溶剂实现0.2 wt%硼酸钙纳米粒子均匀分散于PET基体,且界面良好相容.聚酯纳米复合材料介电常数为4.91,最大储能密度为10.69 J/cm^(3),是纯PET 1.94倍.这种双原位合成策略能潜在扩展其他聚酯纳米复合体系,且能批量化制备,为探索聚酯纳米复合材料电能存储和其他应用提供理论依据.

Tumor-Penetrating and Mitochondria-Targeted Drug Delivery Overcomes Doxorubicin Resistance in Lung Cancer

As one of the major challenges in tumor chemotherapy,multidrug resistance typically correlates with the poor drug penetration within tumor tissues and drug efflux by the ATP-driven efflux pumps in tumor cells.Herein,we design a kind of near-infrared(NIR)light-and acidity-activated micellar i PUTDN nanoparticle for mitochondria-targeting doxorubicin(DOX)delivery to combat DOX resistance in small-cell lung cancer.While the PEGylated i PUTDN nanoparticles can keep stealth in blood circulation,NIR irradiation at the tumor region can peel off the PEG shell from the nanoparticles,and the exposed i RGD can facilitate deep tumor penetration of the nanoparticles.After being internalized by DOX-resistant H69AR cells,the poly(β-aminoester)s(PAE)-based nanoparticles can release the triphenylphosphonium(TPP)-conjugated DOX(TDOX)into the cytosol,which can further accumulate in mitochondria with the aid of TPP.Consequently,the mitochondrial membrane potential and ATP content are both reduced in DOX-resistant H69AR cells.The in vivo therapeutic results show that TDOX-loaded nanoparticles with the aid of NIR light irradiation can effectively suppress the DOX-resistant small-cell lung cancer without noticeable adverse effects.

Using echocardiography in newborn screening for congenital heart disease may reduce missed diagnoses

Congenital heart disease(CHD)is the most common type of birth defect in China.According to a national study,the overall prevalences of CHD and critical CHD were 8.98 per 1000 live births and 1.46 per 1000 live births,respectively,in China[1].CHD,particularly critical CHD,not only seri-ously affects the quality of life of patients and their family,but creates huge economic and mental burdens on the fam-ily and on society as a whole[2].Early diagnosis of CHD is imperative for early intervention and treatment.For early diagnosis of CHD,CHD screening in all newborns was first initiated in Shanghai,China on June 1,2016[3].Since July 30,2018,the China National Health Commission initiated newborn screening program for CHD;"double index meth-ods"(cardiac auscultation plus pulse oximetry)were used to screen CHD for newborns 6 hours and 72 hours after birth.

Dense skyrmion crystal stabilized through interfacial exchange coupling:Role fo in-plane anisotropy

A Monte Carlo simulated-annealing algorithm was used to study the magnetic state in an in-plane helimagnet layer on triangular lattice that exchange couples to an underlayer with strong out-of-plane anisotropy.In the single helimagnet layer with in-plane anisotropy(K),the formation of labyrinth-like domains with local spin spirals,instead of parallel stripes,is favored,and these domains rapidly transform into dense skyrmion crystals with increasing interfacial exchange coupling(J'),equivalent to a virtual magnetic field,and finally evolve to an out-of-plane uniform state at large enough J'.Moreover,with increasing K,the skyrmion crystal state can vary from regular 6-nearest-neighboring circular skyrmion arrangement to irregular squeezed skyrmions with less than 6 nearest neighbors when the in-plane anisotropy energy is higher than the interfacial exchange energy as the skyrmion number is maximized.Finally,we demonstrated that the antiferromagnetic underlayer cannot induce skyrmions while the chirality inversion can be achieved on top of an out-of-plane magnetization underlayer with 180°domain walls,supporting the experimental findings in FeGe thin film.This compelling advantage offers a fertile playground for exploring emergent phenomena that arise from interfacing magnetic skyrmions with additional functionalities.

Room temperature multicomponent synthesis of diverse propargylamines using magnetic CuFe_2O_4 nanoparticle as an efficient and reusable catalyst

Copper ferrite （CuFe204） nanoparticles catalyzed room temperature multicomponent reaction of aliphatic amines, formaldehyde, arylboronic acids and alkynyl carboxylic acids was reported for the synthesis of diverse propargylamines with good to excellent yields. The catalyst can be magnetically recovered and reused at least five times without significant loss of activity.