BACKGROUND: Generalized pustular psoriasis (GPP), a rare and recurrent autoinflammatory disease, imposes a substantial burden on patients and society. Awareness of GPP in China remains limited. METHODS: This cross-sectional survey, conducted between September 2021 and May 2023 across 14 hospitals in China, included GPP patients of all ages and disease phases. Data collected encompassed demographics, clinical characteristics, economic impact, disease severity, quality of life, and treatment-related complications. Risk factors for GPP recurrence were analyzed. RESULTS: Among 127 patients (female/male ratio = 1.35:1), the mean age of disease onset was 25 years (1st quartile [Q1]-3rd quartile [Q3]: 11-44 years); 29.2% had experienced GPP for more than 10 years. Recurrence occurred in 75.6% of patients, and nearly half reported no identifiable triggers. Younger age at disease onset ( P  = 0.021) and transitioning to plaque psoriasis ( P  = 0.022) were associated with higher recurrence rates. The median diagnostic delay was 8 months (Q1-Q3: 2-41 months), and 32.3% of patients reported misdiagnoses. Comorbidities were present in 53.5% of patients, whereas 51.1% experienced systemic complications during treatment. Depression and anxiety affected 84.5% and 95.6% of patients, respectively. During GPP flares, the median Dermatology Life Quality Index score was 19.0 (Q1-Q3: 13.0-23.5). This score showed significant differences between patients with and without systemic symptoms; it demonstrated correlations with both depression and anxiety scores. Treatment costs caused financial hardship in 55.9% of patients, underscoring the burden associated with GPP. CONCLUSIONS The substantial disease and economic burdens among Chinese GPP patients warrant increased attention. Patients with early onset disease and those transitioning to plaque psoriasis require targeted interventions to mitigate the high recurrence risk.
Humans ; Male ; Female ; Psoriasis/pathology* ; Adult ; Cross-Sectional Studies ; Adolescent ; Child ; Young Adult ; Quality of Life ; Middle Aged ; China/epidemiology* ; Recurrence ; Risk Factors ; Surveys and Questionnaires ; East Asian People

Cancer represents a major worldwide disease burden marked by escalating incidence and mortality. While therapeutic advances persist, developing safer and precisely targeted modalities remains imperative. Nanomedicines emerges as a transformative paradigm leveraging distinctive physicochemical properties to achieve tumor-specific drug delivery, controlled release, and tumor microenvironment modulation. By synergizing passive enhanced permeation and retention effect-driven accumulation and active ligand-mediated targeting, nanoplatforms enhance pharmacokinetics, promote tumor microenvironment enrichment, and improve cellular internalization while mitigating systemic toxicity. Despite revolutionizing cancer therapy through enhanced treatment efficacy and reduced adverse effects, translational challenges persist in manufacturing scalability, longterm biosafety, and cost-efficiency. This review systematically analyzes cutting-edge nanoplatforms, including polymeric, lipidic, biomimetic, albumin-based, peptide engineered, DNA origami, and inorganic nanocarriers, while evaluating their strategic advantages and technical limitations across three therapeutic domains: immunotherapy, chemotherapy, and radiotherapy. By assessing structure-function correlations and clinical translation barriers, this work establishes mechanistic and translational references to advance oncological nanomedicine development.
Humans ; Neoplasms/radiotherapy* ; Immunotherapy/methods* ; Nanoparticles/chemistry* ; Animals ; Nanomedicine/methods* ; Drug Delivery Systems/methods* ; Drug Carriers/chemistry* ; Radiotherapy/methods*

The purpose of the present study was to investigate the effects of resistance combined with aerobic chrono-exercise on the common carotid artery elasticity and hemodynamics. 24 healthy young men (21.96±0.43 years old) underwent a single acute resistance combined with aerobic exercise intervention at eight time periods (6, 8, 10, 12, 14, 16, 18, and 20 o'clock). The axial flow velocity and diameter waveforms of the common carotid artery were measured, and the hemodynamics were calculated using the classical hemodynamic theory before exercise, immediately after exercise, 10 min and 20 min after exercise. The results showed that during exercise recovery, systolic and mean pressures decreased more markedly after exercise at 8 o'clock (P < 0.05); At 20 min post-exercise, arterial stiffness index and pressure-strain elastic modulus after exercise at 6 o'clock were reduced compared with the resting state, but were significantly elevated after exercise at 20 o'clock (P < 0.05). Immediately after exercise, the pressure rise was higher after exercise at 6 o'clock and the mean wall shear stress was higher after exercise at 20 o'clock (P < 0.05). These results suggest that resistance combined with aerobic chrono-exercise produces different effects on common carotid artery hemodynamics in young men. A single acute session of resistance combined with aerobic exercise at 8 o'clock is more effective in lowering blood pressure. Exercise at 6 o'clock is beneficial to improve arterial elasticity but is not recommended for young male individuals with cardiovascular disease risks because of the excessive increase in blood pressure immediately after exercise. Exercise at 20 o'clock is more effective in improving wall shear stress but is accompanied by elevated arterial stiffness indices and pressure-strain elastic modulus. These results provide a scientific basis for healthy young men in choosing the time of exercise by exploring the common carotid artery elasticity and hemodynamic-related indices.
Humans ; Male ; Young Adult ; Exercise/physiology* ; Carotid Artery, Common/physiology* ; Hemodynamics/physiology* ; Vascular Stiffness/physiology* ; Elasticity ; Resistance Training ; Adult

OBJECTIVE: To determine the role of Tripterygium wilfordii multiglycoside (TGW) in the treatment of psoriatic dermatitis from a cellular immunological perspective. METHODS: Mouse models of psoriatic dermatitis were established by imiquimod (IMQ). Twelve male BALB/c mice were assigned to IMQ or IMQ₊TGW groups according to a random number table. Histopathological changes in vivo were assessed by hematoxylin and eosin staining. Ratios of immune cells and cytokines in mice, as well as PAM212 cell proliferation in vitro were assessed by flow cytometry. Pro-inflammatory cytokine expression was determined using reverse transcription quantitative polymerase chain reaction. RESULTS: TGW significantly ameliorated the severity of IMQ-induced psoriasis-like mouse skin lesions and restrained the activation of CD45⁺ cells, neutrophils and T lymphocytes (all P<0.01). Moreover, TGW significantly attenuated keratinocytes (KCs) proliferation and downregulated the mRNA levels of inflammatory cytokines including interleukin (IL)-17A, IL-23, tumor necrosis factor α, and chemokine (C-X-C motif) ligand 1 (P<0.01 or P<0.05). Furthermore, it reduced the number of γ δ T17 cells in skin lesion of mice and draining lymph nodes (P<0.01). CONCLUSIONS TGW improved psoriasis-like inflammation by inhibiting KCs proliferation, as well as the associated immune cells and cytokine expression. It inhibited IL-17 secretion from γ δ T cells, which improved the immune-inflammatory microenvironment of psoriasis.
Male ; Animals ; Mice ; Tripterygium ; Psoriasis/drug therapy* ; Keratinocytes ; Skin Diseases/metabolism* ; Cytokines/metabolism* ; Imiquimod/metabolism* ; Dermatitis/pathology* ; Disease Models, Animal ; Mice, Inbred BALB C ; Skin/metabolism*

Objective To analyze the correlation between serum levels of long non-coding RNA cyclin-de-pendent kinase inhibitor 2B antisense RNA 1(lncRNA CDKN2B-AS1),and microRNA-184(miR-184)in pa-tients with acute coronary syndrome(ACS)and the occurrence of coronary artery restenosis(RS)after percu-taneous coronary intervention(PCI)treatment.Methods A total of 288 ACS patients who underwent PCI treatment in the hospital from February 2020 to March 2023 were selected.According to the results of follow-up angiography at 6 months after surgery,they were separated into a RS group of 96 cases and a non RS group of 192 cases.The quantitative real-time PCR(qRT-PCR)method was applied to detect the relative expression levels of serum lncRNA CDKN2B-AS1 and miR-184.Pearson correlation was applied to analyze the correlation between serum lncRNA CDKN2B-AS1 and miR-184.The factors affecting the occurrence of RS in ACS pa-tients after PCI were analyzed using multivariate Logistic regression analysis.Receiver operating characteristic(ROC)curve was applied to analyze the evaluation value of serum lncRNA CDKN2B-AS1 and miR-184 for the occurrence of RS in ACS patients after PCI.Results Compared with the non RS group,the serum lncRNA CDKN2B-AS1 level in the RS group was obviously increased,while the miR-184 level was obviously reduced(P＜0.05).There were statistically significant differences in the levels of high-sensitivity C-reactive protein(hs-CRP),interleukin-18(IL-18),total bilirubin(TBIL),and cardiac troponin Ⅰ(cTnⅠ)between the two groups(P＜0.05).Pearson correlation analysis showed that there was a obvious negative correlation(r=-0.427,P＜0.05)between the expression levels of serum lncRNA CDKN2B-AS1 and miR-184 in ACS pa-tients.Multivariate Logistic regression analysis results showed that lncRNA CDKN2B-AS1,hs-CRP,IL-18,and cTnⅠ were risk factors affecting the occurrence of RS in ACS patients after PCI,while miR-184 and TBIL were protective factors affecting the occurrence of RS in ACS patients after PCI(P＜0.05).ROC curve re-sults showed that the area under the curve(AUC)of serum lncRNA CDKN2B-AS1,miR-184,and their com-bination in evaluating the occurrence of RS in ACS patients after PCI was 0.787,0.844,and 0.929,respective-ly,and the AUC of the combined evaluation the occurrence of RS in ACS patients after PCI was obviously higher than those of serum lncRNA CDKN2B-AS1 and miR-184 alone(Zcombination-lncRNACDKN2B-AS1=4.490,Zcombination-miR-184=3.429,all P＜0.05).Conclusion The serum lncRNA CDKN2B-AS1 level in ACS patients is obviously elevated,while miR-184 level is obviously reduced,which is correlated with the occurrence of RS in ACS patients after PCI.Both are factors that affect the occurrence of RS in ACS patients after PCI,and the combination of the two has better evaluation effect on the occurrence of RS in ACS patients after PCI.

Objective Exploring the effect of Percutaneous angular vertebroplasty(PCVP)on functional recovery in elderly patients with osteoporotic vertebral compression fractures(OVCF).Methods Retrospective selection of clinical data from 108 OVCF patients admitted to our hospital from August 2020 to December 2022.According to the different surgical methods,52 cases were divided into a control group(percutaneous vertebroplasty)and an observation group(percutaneous vertebroplasty)with 56 cases;Compare the recovery of vertebral body function,imaging related parameters,functional impairment and lumbar function,surgical related conditions,gait,and complications between the two groups.Results The intraoperative blood loss in the observation group was less than that in the control group[(10.65±3.52)ml vs.(13.11±3.66)ml,P＜0.05],the number of intraoperative fluoroscopy was less than that of control group[(14.21±4.27)vs.(17.04±4.25),P＜0.05],there was no statistically significant difference in the total clinical effective rate between the observation group of 89.28％and the control group of 86.53％(P＞0.05).After 2 months of surgery,the imaging related parameters,functional impairment,lumbar function,surgical and gait related conditions in the control group were better than those in the control group(P＜0.05).There was no statistically significant difference in the incidence of incision infection,nerve root injury,and recurrent fractures between the two groups(P＞0.05),but the leakage rate of bone cement in the observation group was lower than that in the control group(P＜0.05).Conclusion Both surgeries can effectively improve the level of lumbar vertebral function in OVCF patients.PVCP has advantages in increasing the height of the anterior and posterior edges of the vertebral body,reducing the Cobb angle,and relatively fewer intraoperative fluoroscopy times and bleeding.The incidence of bone cement leakage is lower,making it more safe.

Sepsis is a potentially fatal condition characterized by the failure of one or more organs due to a disordered host response to infection. The development of sepsis is closely linked to immune dysfunction. As a result, immunotherapy has gained traction as a promising approach to sepsis treatment, as it holds the potential to reverse immunosuppression and restore immune balance, thereby improving the prognosis of septic patients. However, due to the highly heterogeneous nature of sepsis, it is crucial to carefully select the appropriate patient population for immunotherapy. This review summarizes the current and evolved treatments for sepsis-induced immunosuppression to enhance clinicians' understanding and practical application of immunotherapy in the management of sepsis.

The health insurance fund acts as the resource for the survival of medical institutions.However,it has shown a development trend of structural friction in the county.By analyzing the relationship between strategic purchasing and the function of health insurance system,this study clarifies the central position of payment and the roles of fund allocation and service compensation.By analyzing the reasons of the imbalance between the health insurance fund and primary services in the county,this study proposes that the strategic purchasing of health care services in the county needs to take into account both the front-end of payment-allocation,and the front-end of service--primary.On this basis,this study put forwards the strategic purchasing of primary health services,which aims to cut off the fund"competition"channel between hospitals and primary health care institutions by changing the fund distribution method;to guide the primary health care to proactively identify and satisfy the changes of the county's residents'service needs by adjusting the service compensation method;and supplemented with joint advocacy and collaborative supervision.The strategic purchasing of primary health services will gradually promote the development of primary health services in the county from sustainable to high-quality.

Objective:To investigate the current status of endoscopic treatment for gastroesophageal varices in portal hypertension in China, and to provide supporting data and reference for the development of endoscopic treatment.Methods:In this study, initiated by the Liver Health Consortium in China (CHESS), a questionnaire was designed and distributed online to investigate the basic condition of endoscopic treatment for gastroesophageal varices in portal hypertension in 2022 in China. Questions included annual number and indication of endoscopic procedures, adherence to guideline for preventing esophagogastric variceal bleeding (EGVB), management and timing of emergent EGVB, management of gastric and isolated varices, and improvement of endoscopic treatment. Proportions of hospitals concerning therapeutic choices to all participant hospitals were calculated. Guideline adherence between secondary and tertiary hospitals were compared by using Chi-square test.Results:A total of 836 hospitals from 31 provinces (anotomous regions and municipalities) participated in the survey. According to the survey, the control of acute EGVB (49.3%, 412/836) and the prevention of recurrent bleeding (38.3%, 320/836) were major indications of endoscopic treatment. For primary [non-selective β-blocker (NSBB) or endoscopic therapies] and secondary prophylaxis (NSBB and endoscopic therapies) of EGVB, adherence to domestic guideline was 72.5% (606/836) and 39.2% (328/836), respectively. There were significant differences in the adherence between secondary and tertiary hospitals in primary prophylaxis of EGVB [71.0% (495/697) VS 79.9% (111/139), χ2=4.11, P=0.033] and secondary prophylaxis of EGVB [41.6% (290/697) VS 27.3% (38/139), χ2=9.31, P=0.002]. A total of 78.2% (654/836) hospitals preferred endoscopic therapies treating acute EGVB, and endoscopic therapy was more likely to be the first choice for treating acute EGVB in tertiary hospitals (82.6%, 576/697) than secondary hospitals [56.1% (78/139), χ2=46.33, P<0.001]. The optimal timing was usually within 12 hours (48.5%, 317/654) and 12-24 hours (36.9%, 241/654) after the bleeding. Regarding the management of gastroesophageal varices type 2 and isolated gastric varices type 1, most hospitals used cyanoacrylate injection in combination with sclerotherapy [48.2% (403/836) and 29.9% (250/836), respectively], but substantial proportions of hospitals preferred clip-assisted therapies [12.4% (104/836) and 26.4% (221/836), respectively]. Improving the skills of endoscopic doctors (84.2%, 704/836), and enhancing the precision of pre-procedure evaluation and quality of multidisciplinary team (78.9%, 660/836) were considered urgent needs in the development of endoscopic treatment. Conclusion:A variety of endoscopic treatments for gastroesophageal varices in portal hypertension are implemented nationwide. Participant hospitals are active to perform emergent endoscopy for acute EGVB, but are inadequate in following recommendations regarding primary and secondary prophylaxis of EGVB. Moreover, the selection of endoscopic procedures for gastric varices differs greatly among hospitals.