OBJECTIVETo evaluate the efficacy and risksof the treatment of facial acne scar with dermabrasion combined with Recell® technology.

METHODS30 patents with II or III degree facial acne scars were treated with dermabrasion and Recell® (skin active cell transplantation) technique in our department from October 2010 to October 2011. The affected area in the face was dermabraded with micro motor system. Then a small piece of razor-thickness skin graft was obtained and processed with Recell® kit. Several milliliterof autologous uncultured epidermal cell suspension was applied to the facial wound and covered with appropriate dressings.

RESULTSTheeffectiveness and risks of this treatment was evaluated with regard to wound healing time, postoperative complication rate, erythema period, etc. Wound healing time was shortened to 5-7 days. The erythema period was also observed shortened with this technique. Within the follow up period, no hyperpigmentation was reported in this case serial.

CONCLUSIONDermabrasion combined with Recell® (skin active cell transplantation) technology can provide a safety and effective treatment approach for patients with facial acne scars.

Acne Vulgaris ; complications ; Cell Transplantation ; methods ; Cicatrix ; etiology ; surgery ; Combined Modality Therapy ; methods ; Dermabrasion ; methods ; Epithelial Cells ; transplantation ; Face ; Humans ; Skin ; cytology ; Treatment Outcome ; Wound Healing

Objective To investigate the feasibility of using a novel docetaxel-loaded polycaprolactoneTween 80 (PCL-Tween 80) nanoparticles for glioma therapy.Methods Two types of docetaxel-loaded nanoparticles were made from commercial polycaprolactone (PCL) and a self-synthesized PCL-Tween 80 copolymer using a modified solvent extraction/evaporation method.A C6 glioma cell line was used to investigate the uptake of polymeric nanoparticles by brain cancer cells.In vitro cancer cell viability was assessed using MTT toxic assay.Results The nanoparticles were found by FESEM to have a spherical shape and be around 200 nm in diameter.The copolymers could encapsulate 10% of the drug in the nanoparticles and release 34.9% of the encapsulated drug over 28 days.The drug-loaded PCL-Tween 80 nanoparticles showed better in vitro cytotoxicity towards C6 cancer cells than Taxotere at the same drug concentration.Conclusion Nanoparticles using PCL-Tween 80 copolymer as drug delivery vehicles may have a promising outcome for glioma patients.

Objective:To explore the characteristics of self-referential network (SRN) functional connectivity in subjective cognitive decline (SCD) patients with normal and impaired metacognition.Methods:Seventy-one subjects were selected from Alzheimer's Disease Neuroimaging Initiative (ADNI) database, with 25 cognitively normal controls and 46 SCD patients. The metacognitive level of SCD patients was assessed by Everyday Cognition Scale (ECog), and then, they were divided into a metacognitively normal group ( n=25, metacognitive scores>-0.074) and a metacognitively impaired group ( n=21, metacognitive scores≤-0.074). Results of Geriatric Depression Scale (GDS), Montreal Cognitive Scale (MoCA), Mini‐Mental State Examination (MMSE), Rey Auditory Word Learning Test (RAVLT), Logical Memory Scale, expressions of pathological markers (cerebrospinal fluid β-amyloid protein [Aβ], total tau protein [t-tau] and phosphorylated tau protein [p-tau]), brain glucose metabolism, and functional magnetic resonance imaging (fMRI) were collected and compared among the 3 groups. Independent component analysis (ICA) was used to extract SRN and analyze the different brain regions among the 3 groups; Pearson correlation was used to analyze the correlations of SRN functional connectivity changes with cognitive scales and pathological markers. Results:No significant differences in demographic characteristics (age and gender), scores of GDS, MoCA and MMSE, or levels of Aβ, t-tau, p-tau and brain glucose metabolism were noted among the 3 groups ( P>0.05). The metacognitive scores in metacognitively impaired group were significantly lower than those in metacognitively normal group and cognitively normal controls ( P<0.05). Significant difference in the functional connectivity of bilateral anterior cingulate gyrus and bilateral orbitofrontal cortex was noted among the 3 groups (TFCE-FWE correction, P<0.01, voxel>100); compared with the cognitively normal controls, the metacognitively impaired group showed significantly decreased functional connectivity of bilateral orbitofrontal cortex, while the metacognitively normal group showed enhanced functional connectivity of bilateral orbitofrontal cortex (TFCE-FWE correction, P<0.01, voxel>100); compared with the metacognitively normal group, the metacognitively impaired group had statistically decreased functional connectivity of bilateral orbitofrontal cortex (TFCE-FWE correction, P<0.01, voxel>100). Further correlation analysis showed that difference value of functional connectivity of bilateral orbitofrontal cortex between metacognitively impaired group and cognitively normal controls was negatively correlated with RAVLT-immediate scores ( r=-0.445, P=0.043); difference value of functional connectivity of bilateral orbitofrontal cortex between metacognitively impaired group and metacognitively normal group was negatively correlated with RAVLT-immediate scores ( r=-0.463, P=0.034). Conclusion:SCD patients with different metacognitive levels have characteristic SRN functional connectivity changes; impaired metacognition may be an early feature of Alzheimer's disease.

Breast cancer is the most common cancer for Chinese women. Early screening is the best way to improve the rates of early diagnosis and early treatment of breast cancer. The peak ages of breast cancer in Chinese women are obviously different from those in the European and American countries. It is imperative to develop a guideline for breast cancer screening that is suitable for Chinese women. Based on the analysis and summary of breast cancer screening data in China, and the latest guidelines and consensus on breast cancer screening in Europe, the United States and East Asia, China Anti-Cancer Association and National Clinical Research Center for Cancer (Tianjin Medical University Cancer Institute and Hospital) has developed a population-based guideline for breast cancer screening in Chinese women. This guideline has provided detailed recommendations on the screening starting age, screening modalities, and screening interval in Chinese women with average risk and high risk of breast cancer, respectively. This article aims to interpret the above guideline, providing references for professionals in breast cancer screening.

Objective:To establish the urodynamic classification of middle-aged and elderly men with benign prostatic obstruction(BPO), and to analyze the efficacy of transurethral resection of the prostate(TURP) on various types of patients.Methods:A retrospective analysis of middle-aged and elderly male patients with non-neurogenic lower urinary tract symptoms(LUTS) who underwent urodynamic tests from January 2010 to December 2018, including 793 patients with BPO. Urodynamics examination of detrusor without contraction needs to complete cystoscopy to diagnose BPO. During urodynamic examination, the detrusor uninhibited contraction induced by spontaneous or stimulation during the bladder filling period is diagnosed as overactivity of the bladder detrusor(DO), and the LinPURR chart indicates the detrusor underactivity(DU). Based on the persistence of BPO leading to DO, DU, and decreased bladder compliance, 793 male patients with BPO with LUTS were divided into four types, including type Ⅰ(BPO: n=164, 20.7%), type Ⅱ(BPO combined with DO: n=333, 42.00%), type Ⅲ(BPO combined with DU: n=267, 33.7%), type Ⅳ(BPO combined with decreased bladder compliance: n=29, 3.7%). The preoperative comparison between groups showed that the age of type Ⅰ-Ⅳ gradually increased, and the age of type Ⅰ was significantly smaller than other types [(67.3±8.2)years, (69.7±7.7)years, (71.5±7.9)years, (72.4±7.1)years, P<0.05]. Compared with other types, the type Ⅰ’s IPSS-S[(9.1±3.6)points vs.(10.4±3.1) points, (9.2±3.3) points, (10.4±3.1)points, P<0.05], IPSS-V[(13.5±3.4) points vs. (14.2±3.5)points, (14.0±3.5)points, (14.2±2.9)points, P<0.05], IPSS scores[(22.6±5.4)points, (24.7±4.9)points, (23.1±5.3)points, (24.6±4.7)points, P<0.05] were significantly lower than other groups, the maximum bladder capacity [(332.6±83.2)ml vs.(221.4±80.8)ml, (286.7±108.2)ml, (242.3±103.4)ml, P<0.05], the functional bladder capacity was significantly higher than other types[(215.2±90.0)ml, (148.5±76.0)ml, (154.9±87.2)ml, (121.2±72.9)ml, P<0.05]. Type Ⅱ’s IPSS-S[(10.4±3.1)points vs.(9.1±3.6)points, (9.2±3.3)points, P<0.05], nocturia frequency[(3.7±1.8)times vs.(3.2±1.8)times, (3.2±1.6)times, P<0.05], IPSS score[(24.7±4.9)points vs.(22.6±5.4)points, (23.1±5.3)points, P<0.05], quality of life scores [(4.9±0.9) points, (4.6±0.9)points, (4.6±0.9)points, P<0.05] was significantly higher than type Ⅰ and type Ⅲ ( P<0.05). Type Ⅲ and Ⅳ had higher residual urine than type Ⅱ[(121.3±96.4)ml, (121.3±96.4)ml vs.(71.2±73.5)ml, P<0.05]. Type Ⅳ’s IPSS-S[(10.4±3.1)points vs. (9.1±3.6)points, (9.2±3.3)points, P<0.05], IPSS-V[(14.2±2.9) points vs.(13.5±3.4)points, (14.0±3.5)points, P<0.05], the frequency of nocturia[(3.8±1.9)times vs.(3.2±1.8)times, (3.2±1.6)times, P<0.05] was significantly higher than that of type Ⅰ and type Ⅲ, and the quality of life score was higher than type Ⅰ and type Ⅲ[(4.3±0.8)points vs.(4.7±0.9)points, (4.6±0.9)points, P<0.05]. type Ⅱ and type Ⅳ’s bladder compliance[(21.4±24.2)ml/cmH 2O, (11.0±11.4)ml/cmH 2O vs.(33.9±23.7)ml/cmH 2O, (33.1±32.7)ml/cmH 2O, P<0.05], maximum bladder capacity[(221.4±80.8)ml, (242.3±103.4)ml vs.(332.6±83.2)ml, (286.7±108.2)ml, P<0.05], functional bladder capacity[(148.5±76.0)ml, (121.2±72.9)ml vs.(215.2±90.0)ml, (154.9±87.2)ml, P<0.05] were significantly less than type Ⅰ and type Ⅲ( P<0.05). From November 2016 to November 2018, 60 middle-aged and elderly male patients with confirmed BPO and TURP were selected, including type Ⅰ( n=17, 28.3%), type Ⅱ ( n=23, 38.3%), and Ⅲ type ( n=11, 18.3%), Ⅳ type( n=9, 15.1%). Type IV patients are significantly older than other types ( P<0.05), bladder compliance is significantly worse than other types( P<0.05), the maximum bladder capacity is smaller than other types( P<0.05). The follow-up started 3 months after the operation. The content of the follow-up included IPSS, IPSS-S, IPSS-V, nocturia frequency, undisturbed sleep time, nocturia quality of life score, and life quality score. Results:The IPSS scores of type Ⅰ, type Ⅱ, and type Ⅲ after TURP were significantly improved compared with preoperative(19.8±6.2 vs.3.4±1.8; 21.9±5.2 vs.4.6±2.6; 21.5±6.2 vs.5.7±4.6, P<0.05), type Ⅳ urine storage symptom score (9.1±4.1 vs.4.3±3.7), nocturia frequency(3.6±1.5vs.2.3±1.6), nocturia quality of life score (25.3±6.9 vs.31.4±13.7) Compared with preoperatively, there was no significant improvement( P>0.05). The quality of life score improvement of type Ⅳ patients was significantly lower than that of type Ⅰ, type Ⅱ, and type Ⅲ (10.9±9.1 vs.12.2±9.0, 14.4±5.7, 12.7±5.8, P<0.05). The IPSS score of type Ⅳ patients was significantly higher than that of type Ⅰ(7.0±5.8 vs.3.4±1.8), and the nocturia quality of life score was significantly lower than that of each group (31.4±13.7 vs.37.5±4.2, 38.7±3.5, 37.8±3.8, P<0.05). Conclusions:For middle-aged and elderly men with BPO, we divide them into four types based on the results of urodynamic examinations, type Ⅰ(simple BPO), type Ⅱ(BPO combined with DO), type Ⅲ(BPO combined with DU), type Ⅳ(BPO combined with bladder compliance decline). Type Ⅰ patients have the best bladder function, and TURP has the best effect; type Ⅱ has a high symptom score and poor quality of life, and can benefit after TURP; type Ⅲ bladder function is poor, and surgery should be performed as soon as possible to prevent further deterioration of bladder function; type Ⅳ bladder function is the best poor, IPSS score and quality of life score are high, TURP surgery is not effective.

Objective:To evaluate the long-term efficacy of AdVance sling bulbar urethral suspension and artificial urethral sphincter (AUS) implantation in the treatment of moderate to severe male stress urinary incontinence.Methods:The clinical data of 12 male patients with urinary incontinence who underwent surgical treatment in Peking University People's Hospital from June 2011 to June 2017 were retrospectively analyzed. The median age was 75(64-80) years. There were 9 cases after radical prostatectomy and 3 cases after transurethral prostatectomy. Patients had a median history of urinary incontinence of 3(1-9) years, and needed an average of 8(5-10) pads per day. Among them, 5 patients had moderate urinary incontinence and 7 patients had severe urinary incontinence. All patients underwent urinary incontinence surgery for the first time. Among the 12 patients, 6 received AdVance sling ball urethral suspension (AdVance group), and 6 received AUS implantation (AUS group). The median age of the AdVance group was 72 (64-73) years. The median number of pads used daily was 6 (5-8) tablets. Urinary incontinence Quality of Life questionnaire (I-QOL) score was (15.0±5.4). Five patients had moderate urinary incontinence and one patient had severe urinary incontinence. In the AUS group, the median age was 78(76-80) years old, the median daily pad use was 8(6-10) tablets, and the I-QOL score was (16.7±5.1), all of which were severe urinary incontinence. The daily pad usage, I-QOL and postoperative complications were recorded at 1 and 5 years after operation.Results:All patients completed the operation successfully. The postoperative follow-up was 5-7 years (mean 5.5 years). In AdVance group, 1 patient with severe urinary incontinence had no significant improvement in postoperative symptoms at 1 year after operation. The other 5 patients showed significant improvement in urinary incontinence symptoms. In the AdVance group, the median number of pads used per day was 2.5 (1-10), and the I-QOL score was (75.0±28.1), which were all significantly improved compared with that before operation ( P<0.05). The median number of pads used per day in the AdVance group 5 years after operation was 2.5(1-10), and the I-QOL score was (78.3±29.3), which were significantly improved compared with those before operation (all P<0.01). In the AUS group, no pad was needed at 1 year after operation, which was significantly improved compared with that before operation ( P<0.01). Urethral erosion occurred in 2 cases 3 years after operation, and the AUS was removed. Urinary incontinence recurred and returned to the preoperative state without reoperation. The other 4 cases did not need to use the pad 5 years after operation. In AdVance group, 3 patients had perineal pain within 3 months after operation, which was related to activity and relieved spontaneously. No wound infection, urethral erosion and other complications occurred. Urethral erosion occurred in 3 cases in AUS group. Conclusions:AdVance sling ball urethral suspension is effective for patients with moderate stress urinary incontinence and has fewer complications. AUS implantation is effective for patients with severe male stress urinary incontinence. However, the long-term complications of this operation may affect the postoperative efficacy.

Objective:To discuss the inhibitory effect of chelerythrine(CHE)on the migration,invasion,and epithelial-mesenchymal transition(EMT)of the human ovarian cancer SKOV3 cells,and to clarify the associated mechanism.Methods:The SKOV3 cells were cultured in vitro and divided into control group and 2.5,5.0,10.0,20.0,and 40.0 μmol·L-1 CHE groups.Methylthiazolydiphenyl-tetrazolium(MTT)assay was used to detect the inhibitory rates of proliferation of the cells in various groups.The SKOV3 cells were cultured in vitro and divided into control group,transforming growth factor-β1(TGF-β1)group,TGF-β1+5 μmol·L-1 CHE group,and TGF-β1+10 μmol·L-1 CHE group.Cell scratch assay was used to detect the migration rates of the cells in various groups;Transwell chamber assay was used to detect the numbers of migration and invasion cells in various groups;Western blotting method was used to detect the expression levels of E-cadherin,N-cadherin,and Vimentin proteins in the cells in various groups;immunofluorescence staining method was used to detect the fluorescence intensities of E-cadherin and N-cadherin in the cells in various groups.Results:The MTT assay results showed that compared with control group,the inhibitory rates of proliferation of the cells in 5.0,10.0,20.0,and 40.0 μmol·L-1 CHE groups were significantly increased(P<0.05 or P<0.01).The cell scratch assay results showed that compared with control group,the migration rate of the cells in TGF-β1 group was increased(P<0.01);compared with TGF-β1 group,the migration rates of the cells in TGF-β1+5 μmol·L-1 CHE group and TGF-β1+10 μmol·L-1 CHE group were significantly decreased(P<0.01).The Transwell chamber assay results showed that compared with control group,the numbers of migration and invasion cells in TGF-β1 group were significantly increased(P<0.05);compared with TGF-β1 group,the numbers of migration and invasion cells in TGF-β1+5 μmo·l L-1 CHE group and TGF-β1+10 μmo·l L-1 CHE group were significantly decreased(P<0.01).The Western blotting results showed that compared with control group,the expression level of E-cadherin protein in the cells in TGF-β1 group was significantly decreased(P<0.01),while the expression levels of N-cadherin and Vimentin proteins were increased(P<0.05 or P<0.01);compared with TGF-β1 group,the expression levels of E-cadherin protein in the cells in TGF-β1+5 μmol·L-1 CHE group and TGF-β1+10 μmol·L-1 CHE group were significantly increased(P<0.01),and the expression levels of N-cadherin and Vimentin proteins were significantly decreased(P<0.01).The immunofluorescence staining results showed that compared with control group,the fluorescence intensity of E-cadherin in the cells in TGF-β1 group was decreased,and the fluorescence intensity of N-cadherin was increased;compared with TGF-β1 group,the fluorescence intensities of E-cadherin in the cells in TGF-β 1+5 μmol·L-1 CHE group and TGF-β1+10 μmol·L-1 CHE group were significantly increased,and the fluorescence intensities of N-cadherin were decreased.Conclusion:CHE can inhibit the proliferation,migration,invasion,and EMT of the human ovarian cancer SKOV3 cells.

Objective To evaluate the current deployment of general practitioners and residents′utilization of services in China, for reference of their optimal allocation across the country. Methods The methods of HRDI and TOPSIS were used to comprehensively evaluate their deployment and residents′utilization of their services in China. Results General practitioners fall short of demand in general, averaging 0.137 1 GP per 1 000 population in China, with unbalanced regional distribution as well. Utilization of residents of general practitioners service remains at a low level, with unbalanced regional distribution as well. As shown in the comprehensive evaluation results, 87.10% of the regions were found with defective deployment and service utilization, featuring " low resources, low utilization" . Conclusions Sizable gapes are found between the eastern, the central and the western regions, in terms of allocation of resources and service utilization. The government should rationalize deployment of general practitioners and minimize such gaps among different regions, in view of local population, geography and health service needs.

Objective:To evaluate the enrollment rate, mutation rate and causes of variability the clinical pathway of bronchopneumonia.Methods:The enrollment rate, completion rate, variation and reasons of the clinical pathway in Beijing Children′s Hospital, Capital Medical University from January 2012 to December 2016 were retrospectively collected.Data of patients after the clinical pathway of bronchopneumonia in other tertiary class A hospitals were gathered by questionnaires, and the enrollment rate, completion rate, variation rate and reasons were analyzed.Results:(1)At the end of 2016, 11 of the 13 hospitals included in this study had implemented the clinical pathway for 5 years, 1 hospital for 3 years, and 1 hospital for 2 years.(2) Eleven hospitals provided their enrollment rates.The enrollement rate of 2 hospitals was<50%, and that of 9 hospitals was>80%.The annual completion rate of Beijing Children′s Hospital was ≥75%, and the completion rates offered by 8 hospitals were basically >70%.(3) Since the implementation of the clinical pathway for 5 years in Beijing Children′s Hospital, a total of 427 cases were enrolled of which 93 cases were mutated (variability 21.78%). The variability of 5 hospitals was maintained at <15%.The variability of 3 hospitals decreased with the implementation years, and became qualified.The variability of 1 hospital first rebounded and then controlled; 1 hospital increased by 27.65%; 1 hospital was first controlled and rebounded; 1 hospital was always >15%.The main cause of the mutation was coexisting diseases, complications, progression of the disease, or correction of the first diagnosis, etc.Conclusions:The completion rate of tertiary class A hospitals meets the requirements of national policy.However, the enrollment rate needs to be improved, and the variation rate among different hospitals differs a lot.Further implementation of the clinical pathway should be strengthened and monitored.

【Objective】 To explore the clinical features and treatment outcomes of female urethral carcinoma so as to improve the awareness and prognosis of this rare malignant disease. 【Methods】 Clinical data of 8 cases of female urethral carcinoma treated during Jan. 2012 to Dec.2022 at the Department of Urology of Peking University People’s Hospital were retrospectively analyzed. The patients underwent urodynamic tests, cystourethroscopy and pathological biopsy to confirm the diagnosis. Traditional radical surgery was performed in 5 cases, and radical surgery for lower urethral cancer with bladder preservation was performed in 3 cases. 【Results】 The patients aged 36 to 68 years, with a mean of 53.75 years. Urinary obstruction, lower urinary tract symptoms and urethral masses were common manifestations. Urodynamic tests indicated bladder outlet obstruction. After surgical treatment, radical surgery for lower urethral cancer with bladder preservation showed advantages over traditional radical surgery in terms of intraoperative bleeding, operation time and postoperative hospital stay. 【Conclusion】 Female primary urethral carcinoma is rare but invasive. Early diagnosis and radical surgery are crucial for improving the prognosis. Radical surgery for lower urethral cancer with bladder preservation has better treatment outcomes and postoperative quality of life compared to traditional radical surgery. For such patients, symptoms should be closely monitored and timely diagnosis and treatment should be performed.