ObjectiveTo detect the expression levels of macrophage migration inhibitory factor (MIF) in peripheral blood mononuclear cells (PBMCs),sera and skin tissue fluid from patients with vitiligo vulgaris,and to investigate their clinical significance.MethodsThirty-nine patients with vitiligo vulgaris and 31 age- and sex-matched normal human controls were recruited in this study.Real-time reverse transcription-PCR was employed to assess the expressions of MIF mRNA in PBMCs,enzyme-linked immunosorbent assay (ELISA) to detect the concentrations of MIF in sera and skin tissue fluid from these subjects.ResultsPatients with vitiligo vulgaris showed a significantly higher level of MIF mRNA in PBMCs (6.70 (2.64 - 8.65) vs.1.67 (1.24 - 2.45),Z=5.895,P＜ 0.05),MIF protein in sera (32.76 (10.67 - 40.98) μg/L vs.7.89 (6.13 - 9.54) μg/L,Z=5.936,P ＜ 0.05 ) and skin tissue fluid ( 167.80 ( 107.40 - 219.60) μg/L vs.42.44 (32.29 - 49.74) μg/L,Z =4.715,P ＜ 0.05) compared with the normal human controls.The expression levels of MIF mRNA in PBMCs,and MIF protein in sera and skin tissue fluid were also higher in patients with progressive vitiligo than in those with stable vitiligo (7.89 (3.89 - 9.12) vs.5.62 (2.23 - 7.29),Z=2.213,P＜ 0.05; 37.80 (29.50 - 45.70) μg/L vs.22.70 (9.36 - 37.78) μg/L,Z=2.141,P＜ 0.05; 211.50 (131.70 - 248.75) μg/L vs.144.65 (89.13 - 167.30) μg/L,Z =2.100,P ＜ 0.05).In addition,the vitiligo area severity index (VASI) score was positively correlated with the expression levels of MIF mRNA in PBMCs (r =0.486,P ＜ 0.05)and MIF protein in sera (r =0.453,P ＜ 0.05).ConclusionMIF might play a certain role in the pathogenesis of vitiligo vulgaris.

Objective To investigate the protective effects of soybean isoflavone(SI) on genetic toxicity induced by di-n-butul phthalate(DBP) in mice.Method(1) Micronucleus test:40 male 7 w old Kunming mice were randomized into 4 groups:High and low dose SI intervention groups,DBP model group,and solvent control group.SI intervention groups were given different doses of SI(50,100mg/kg) for 30 d,meanwhile,the DBP group and solvent group were given 0.5% sodium carboxymethyl cellulose.Then all groups were treated by 0.5g/kg DBP for 5d except solvent group.Mice were sacrificed 6 hour after last treatment,and then counting micronucleated cells in bone marrow.(2) Sperm malformation test:40 male 6w old Kunming mice were grouped and treated the same as micronucleus test.Mice were sacrificed at 35 day after the first treatment,and then sperm quantity,motility,viability and abnormality rate were calculated.Result Micronucleus rate and sperm abnormality rate of SI intervention group were lower than DBP model group,while sperm motility and viability were higher than DBP model group.Conclusion SI can relieve the genetic toxicity induced by DBP in mice.

Objective To analyse the adherence of community-dwelling stroke survivors to functional exercise regimens and explore the influencing factors.Then to establish measures to improve the situation.Methods A total of 208 stroke survivors from 10 communities were randomly recruited.Four questionnaires-a general information questionnaire,an exercise adherence questionnaire,a self-efficacy perceptions scale and a perceived social support scale-were administered.Results The mean adherence score was 34.71 ± 8.45 and the mean adherence rate was 61.98％.The compliance to physical exercise,seeking advice positively and exercise effectiveness monitoring scores ranged from highest to lowest in order.Self-efficacy perceptions and perceived social support were both positively correlated with the adherence rate.Multiple linear regression showed that the influencing factors included self efficacy perceptions,social support perceptions,self-care ability and age.Conclusions The community stroke survivors' exercise adherence was moderate in general,but it could be improved by increasing their self-efficacy and social support perceptions and their self-care ability.

Objective To detect the expressions of miR-155,T helper type 17 (Thl7) cells,and Th17 cellspecific transcription factor RORγt and effector cytokine interleukin (IL)-17 in peripheral blood and skin lesions from,and to evaluate their relationship in,patients with atopic dermatitis (AD).Methods Peripheral blood was obtained from 37 patients with AD and 33 age-and sex-matched healthy controls,and biopsy specimens from the lesional and perilesional skin of five patients with severe AD as well as from the normal skin of five healthy human controls.Real-time fluorescence-based reverse transcription (RT)-PCR was employed to measure the mRNA expression levels of miR-155,RORγt and IL-17 in peripheral blood mononuclear cells (PBMCs) and skin specimens,flow cytometry to detect the percentage of Th17 cells in PBMCs,enzyme-linked immunosorbent assay (ELISA) to determine the plasma concentration of IL-17.Statistical analysis was done using independent sample's t test,one-way analysis of variance followed by the least significant difference test,and linear correlation analysis.Results Compared with the healthy controls,the patients with AD showed a significant increase in Th17 cell percentage (1.78％ ± 0.52％ vs.0.47％ ± 0.15％,P＜ 0.01),mRNA expression levels of miR-155 (5.78 ± 1.78 vs.1.82 ± 0.46,P＜ 0.01),RORγt (6.08 ± 1.04 vs.1.64 ± 0.52,P＜ 0.01) and IL-17 (7.09 ± 1.75 vs.1.71 ± 0.46,P＜ 0.01),as well as in the plasma concentration of IL-17 ((2.51 ± 6.15) pg/ml vs.(11.80 ± 2.24) pg/ml,P＜ 0.01).There was a sequential decrease in the expression levels of miR-155,RORγt and IL-17 mRNA from lesional skin,perilesional skin to normal skin (F =41.803,17.040 and 37.064 respectively,all P ＜ 0.01).The miR-155 mRNA expression level in PBMCs was positively correlated with the SCORing Atopic Dermatitis (SCORAD) index,Th17 cell percentage,RORγt and IL-17 mRNA expression levels as well as IL-17 plasma concentration (r =0.405,0.426,0.402,0.410 and 0.408 respectively,all P ＜ 0.05).Similarly,the miR-155 expression level was positively correlated with RORγt and IL-17 mRNA expression levels in lesional and paralesional specimens (r =0.428 and 0.435 respectively,both P ＜ 0.05).Conclusion The up-regulated expression of miR-155,Th17 cells and their effector cytokine IL-17 may be associated with the development of AD.

Objective To investigate the relation between anormalities of fetal abdominal great vessels and heterotaxy, the clinical significance of screening fetal heterotaxy by the abnormalities of fetal abdominal great vessels. Methods 6532 fetuses from our hospital were scanned and the fetuses with abdominal great vessels abnormalities were included. Parameters of fetal growth, abdominal great vessels and anatomical survey were detected. Results Forty-five cases (0.7%) of fetal abdominal great vessels abnormalities were detected prenatally. Forty-two cases were confirmed postnatally, including 35 cases of heterotaxy syndrome and 7 cases of situs inversus totalis and 3 cases missed. The incidences of the abnormal fetus,heterotaxy syndrome and situs inversus totalis of the fetuses with abnormal abdominal great vessels were higher than that of the fetuses with normal abdominal great vessels, the differences were statistically significant( P＜ 0.001). The incidence of both type Ⅰ and type Ⅱ of the heterotaxy syndrome were significantly higher than that of type Ⅳ (P＜0.001). There was a high incidence of left isomerism in abnormal type Ⅰ and of right isomerism in abnormal type Ⅱ , the differences were statistically significant (P＜ 0.001). Conclusions Abnormal great vessels abnormalities have strong relations to heterotaxy and situs inversus which can be used as effective and simple indicator in screening heterotaxy syndrome.

Objective To study the cultivation status of health inspection and the setting of the related major of this subject in colleges in China.Methods The setting situation of health inspection in undergraduate and junior colleges were searched from the professional information database of higher vocational schools,information query system of Chinese university and official websites of 7 junior colleges and 167 undergraduate colleges.Excel 2007 was used for inputting and sorting out data,and the data were combed and analyzed.Results The setting of college level of health inspection was approved in 2004,and there were 6 record colleges in 2014.The undergraduate level of related major was set in 2012 and only 1 college recruited students.Among 167 undergraduate universities,only 2 universities carried out professional education of health inspection,74 universities carried out professional education of health law and 65 universities carried out professional education of health management.Conclusion The subject of health inspection has been set in undergraduate and junior colleges for a short time and there are a few admissions; Professional education of preventive medicine,health law,health management and health inspection are relatively extensive.

This study reported a 50-year-old female patient who was diagnosed with anti-IgLON family member 5(anti-IgLON5)antibody-related encephalopathy,presented with cognitive and sleep disorders,autonomic dysfunction and seizures,positive serum IgLON5 antibody but negative cerebro-spinal fluid IgLON5 antibody,negative human leukocyte antigen(HLA)by genetic testing,and was diagnosed as anti-IgLON5 antibody-related encephalopathy.After hospital admission,the patient was given intravenous methylprednisolone combined with immunoglobulin immunotherapy,donepezil for improvement of cognition,sodium valproate and oxcarbazepine for prevention and treatment of epilep-tic seizures,and finally her symptoms improved significantly.

This study reported a 50-year-old female patient who was diagnosed with anti-IgLON family member 5(anti-IgLON5)antibody-related encephalopathy,presented with cognitive and sleep disorders,autonomic dysfunction and seizures,positive serum IgLON5 antibody but negative cerebro-spinal fluid IgLON5 antibody,negative human leukocyte antigen(HLA)by genetic testing,and was diagnosed as anti-IgLON5 antibody-related encephalopathy.After hospital admission,the patient was given intravenous methylprednisolone combined with immunoglobulin immunotherapy,donepezil for improvement of cognition,sodium valproate and oxcarbazepine for prevention and treatment of epilep-tic seizures,and finally her symptoms improved significantly.

The two-agent chemotherapy regimen of etoposide + platinum has always been the standard treatment modality for extensive-stage small cell lung cancer (ES-SCLC) during the past 30 years. However, the application of radiotherapy in ES-SCLC has not been clarified. Immunotherapy has made significant breakthroughs in ES-SCLC in recent years. Currently, the regimen of immunotherapy combined with basic chemotherapy has become the standard of care for ES-SCLC. As more and more evidence suggests that there is a non-negligible synergistic anti-tumour effect between radiotherapy and immunotherapy, the application value of radiotherapy in ES-SCLC has been reintroduced in the era of immunotherapy. At present, early clinical studies of thoracic radiotherapy (TRT) and brain radiotherapy (BRT) combined with immunotherapy have been initially explored in this regard, and the introduction of low-dose radiotherapy (LDRT) in ES-SCLC has also proposed a new direction of exploration. In this article, the progress in the application of radiotherapy in ES-SCLC was reviewed.

Background and purpose:Radical surgery after neoadjuvant immunotherapy combined with chemotherapy(nICT)in patients with locally advanced esophageal squamous cell carcinoma(LAESCC)has good efficacy and safety,and it can improve the patients'pathological complete remission(pCR)rate,main pathologic response(MPR)rate and R0 resection rate.The prognosis of patients with pCR/MPR after nICT is significantly better compared with patients without pCR.The prognosis of patients achieving pCR/MPR after neoadjuvant therapy has been demonstrated to be significantly better than that of patients with non-pCR/MPR.Therefore,finding predictive factors of pCR/MPR is beneficial for us to screen out the advantageous populations for combination therapy.The aim of this study was to investigate the value of clinical data of patients with LAESCC before and after nICT in predicting the degree of remission of different pathologies after radical surgery following neoadjuvant treatment and to observe the safety of the treatment.Methods:Data of patients with locally LAESCC who underwent radical surgery after nICT from January 2019 to June 2023 at the Affiliated Hospital of Chuanbei Medical College were collected.The clinical data of all patients as well as some blood,inflammation and nutritional indexes of patients before and after neoadjuvant therapy were collected,and the patients were grouped according to the different degrees of pathological remission after neoadjuvant therapy.Data were analyzed by multi-group comparative analysis of variance(ANOVA)and LSD-t post-hoc test.We explored the factors that had an influence on the different degrees of pathological remission,and collected and recorded the patients'adverse reactions during neoadjuvant therapy as well as their eventual surgeries.Results:Data of 62 patients with LAESCC treated with nICT who underwent radical surgery were collected.Only one patient showed grade 4 myelosuppression during neoadjuvant therapy,and the rest of the patients had adverse reactions≤grade 2.The R0 resection rate of the surgery was 98.39%.The present study was compared with the previous studies of LAESCC treated with neoadjuvant chemotherapy followed by radical surgery performed in Affiliated Hospital of Chuanbei Medical College.Compared with the previous studies conducted in our center,no significant difference was observed in terms of operation time,intraoperative bleeding,postoperative hospitalization time and surgical complications.The postoperative pathologic results showed that the pCR rate was 22.58%(14/62),and the MPR rate was 40.32%(25/62).According to the different tumor regression grade(TRG)after surgery,patients were divided into 3 groups of TRG1,TRG2 and TRG3-4,and differences in the platelet distribution width(PDW)before neoadjuvant therapy and the preoperative neutrophil-to-lymphocyte ratio(NLR)after neoadjuvant therapy were statistically significant among the 3 groups(P＜0.05).Further intra-group two-by-two comparisons of PDW before neoadjuvant therapy and NLR before surgery after neoadjuvant therapy were performed for the three groups of patients,respectively,and it was found that the PDW and NLR in the TRG2 group were lower compared with the TRG3-4 group,and the differences were statistically significant(P＜0.05).Conclusion:Radical surgery after nICT treatment in patients with LAESCC can have high R0 resection rate,pCR rate,MPR rate and reliable safety,and the lower PDW of patients before neoadjuvant therapy and the lower NLR of patients before surgery after neoadjuvant therapy predict better pathological remission efficacy.