Objective:To investigate the role and mechanism of leptin on dendritic cells by NLRP3 inflammasome.Methods: BMDCs were induced in vitro,leptin with scalar doses was cocultured with BMDCs,IL-1β and IL-18 mRNA expression and protein secretion level were measured by q-RT-PCR and ELISA respectively.Caspase-1 activity or ROS synthesis were tested with FLICA kit or ROS detection assay kit on flow cytometry.IL-1β or IL-18 were detected after caspase-1 was inhibited by Ac-YVAD-cmk or NLRP3 was interfered by siRNA or ROS inhibitor DPI or KCL were added.Results: Leptin promoted secretion of IL-1β and IL-18.Leptin up-regulated NLRP3 and activted caspase-1 to secret proinflammtory cytokine,which K+ efflux took part in.Conclusion: Leptin promotes secretion of IL-1β and IL-18 by activating NLRP3 inflammasome,and K+ efflux takes part in this,which hints us that leptin may be an activator of NLRP3 inflammasome.

Objective To investigate the prevalence and pattern of androgenetic alopecia (AGA) in Shanghai through a community-based survey. Methods A cluster sampling survey was done among the residents in Beixinjing Community, Changning District, Shanghai. All the subjects were asked to fill a questionnaire to provide their general information, including sex, age, native place, physical status, life habit, family history, etc. The diagnosis of AGA was made by dermatologists. To determine the pattern of hair loss,Norwood-Hamilton classification system and Ludwig classification system were used for male AGA and female AGA, respectively. All the data were statistically analyzed by EpiData and SPSS11.5 software. Results Totally, 7056 subjects completed the questionnaire, including 3519 males and 3537 females, and the response rate was 72.5%. AGA was diagnosed in 809 patients, consisting of 701 males aging from 19 to 91 years (mean 64.16±11.9 years) and 108 females aging from 35 to 91 years (mean 70.46±18.89 years). The standardized prevalence (SP) was 9.47% in total, 15.73% in males and 2.73% in females; the difference was significant between males and females (χ2=356.00, P<0.001). A family history of AGA was observed in 52.7% of all subjects including 391 (55.78%) males and 35 (32.41%) females. Type Ⅲ vertex involvement was the most common type in men aging from 20 to 70 years old, and type Ⅵ in those over 70 years old. Grade Ⅰ and Ⅱ predominated in female AGA. Conclusions The results of this survey indicate that the prevalence of AGA is remarkably higher in men than that in women. Furthermore, the prevalence is steadily increased with advancing age in Shanghai.

Medical quality and safety are the foundation for the high-quality development of public hospitals.The concept of Multi-disciplinary Treatment(MDT)is of great value for functional departments of hospitals to collaborate in carrying out medi-cal quality management practices.Children's Hospital,Zhejiang University School of Medicine explored a new quality manage-ment model,constructed the MDT practice path for medical quality in administration,and formed a closed-loop management process where clinical departments actively initiate consultations,various administrative functional departments collaborate and in-teract in a two-way manner,accurately identify and solve clinical problems,and continuously track and feedback outcomes.After the inception of this path,the overall level of medical quality and safety in the hospital has been comprehensively improved,mainly manifested in the enhancement of quality control capabilities of clinical departments,optimization of core performance e-valuation indicators,and remarkable improvement in patient satisfaction,thereby holding profound significance for high-quality development of the hospital.

Objective This paper aims to explore patient satisfaction with mobile medical payments in ethnic minority areas and its influencing factors.Methods From May to August 2023,565 ethnic minority patients from 6 villages in 4 ethnic minority autonomous counties in Dehong Prefecture and Pu'er City,Yunnan Province,were selected as research subjects,and 186 Han patients in Kunming were selected as controls.The general information questionnaire,the mobile medical payment will-ingness and attitude survey scale,and the medical cost mobile payment satisfaction survey scale were used to investigate their sat-isfaction with actual situation of medical mobile payment.Additionally,this paper discussed influencing factors affecting satisfac-tion.Results The ethnic minority patients exhibited a significantly lower level of satisfaction compared to the Han patients(39.65±10.43 vs.49.54±7.88,P＜0.05).ethnic minority patients scored significantly lower on the dimensions of satisfac-tion,such as perceived safety,ease of use and usefulness of mobile medical payment compared to the group of Han patients(all P＜0.05).Additionally,they ethnic minority patients showed significantly lower level of willingness and attitude to use mobile medical payment compared to the group of Han patients(P＜0.05).The main factors influencing the significant difference in satisfaction with mobile medical payment were ethnic group,number of hospital visits in previous year,first-time use of mobile medical payment,and educational background(P＜0.05).Conclusion Ethnic minority patients have a low perception of secur-ity,ease of use,and usefulness of mobile medical payments,as well as a low willingness and characteristics for mobile medical payment.Therefore it is necessary to further enhance their experience and satisfaction.In the development of mobile medical pay-ment services hospitals should fully consider the current situation of"illiteracy""semi-illiteracy"and"lack of resources"in re-mote ethnic areas.They should actively develop service platforms and applications suitable for mobile medical payment in ethnic minority areas to continuously enhance service efficiency and quality.

BACKGROUND/OBJECTIVES: Activating brown adipose tissue (BAT) and browning of white adipose tissue (WAT) can protect against obesity and obesity-related metabolic conditions.Cryptotanshinone (CT) regulates lipid metabolism and significantly ameliorates insulin resistance. Adenosine-5'-monophosphate (AMP)-activated protein kinase (AMPK), a receptor for cellular energy metabolism, is believed to regulate brown fat activity in humans.MATERIALS/METHODS: The in vivo study included high-fat-fed obese mice administered orally 200/400 mg/kg/d CT. They were evaluated through weight measurement, the intraperitoneal glucose tolerance test (IPGTT), intraperitoneal insulin tolerance test (IPITT), cold stimulation test, serum lipid (total cholesterol, triglycerides, and low-density lipoprotein) measurement, hematoxylin and eosin staining, and immunohistochemistry.Furthermore, the in vitro study investigated primary adipose mesenchymal stem cells (MSCs) with incubation of CT and AMPK agonists (acadesine)/inhibitor (Compound C).Cells were evaluated using Oil Red O staining, Alizarin red staining, flow cytometry, and immunofluorescence staining to identify and observe the osteogenic versus adipogenic differentiation. Quantitative real-time polymerase chain reaction and the Western blot were used to observe related gene expression. RESULTS: In the diet-induced obesity mouse model mice CT suppressed body weight, food intake, glucose levels in the IPGTT and IPTT, serum lipids, the volume of adipose tissue, and increased thermogenesis, uncoupling protein 1, and the AMPK pathway expression. In the in vitro study, CT prevented the formation of lipid droplets from MSCs while activating brown genes and the AMPK pathway. AMPK activator enhanced CT’s effects, while the AMPK inhibitor reversed the effects of CT. CONCLUSION CT promotes adipose tissue browning to increase body thermogenesis and reduce obesity by activating the AMPK pathway. This study provides an experimental foundation for the use of CT in obesity treatment.

Objective To explore the effects and mechanism of Shentao Ruangan Prescription on hepatocellular carcinoma.Methods MTT assay was used to detect the activity of Shentao Ruangan Prescription against HepG2 cells and the effects of PI3K/Akt/MAPK inhibitors(LY294002,Akti,MEKi,JNKi),apoptosis inhibitor(Z-VAD)and autophagy inhibitor(Wortmanin)in human hepatoma cells.),ferroptosis inhibitor(Ferrostatin-1)and cell necrosis inhibitor(Necrostatin-1)on the inhibition of HepG2 activity of human hepatoma cells by Shentao Ruangan Prescription.LDH method was used to detect the toxicity of Shentao Ruangan Prescription on HepG2 cells;Real-time PCR experiment tested the effect of Shentao Ruangan Prescription on the pyroptosis marker IL-1β in human hepatoma cells HepG2;Western blot experiment explored the effect of Shentao Ruangan Prescription on the Akt/ERK signaling pathway in human hepatoma HepG2 cells and the expression of Akt,ERK,P-ERK,the key proteins of apoptosis signaling pathway Caspase 3,PARP,Bcl2,Bax,and the expression of pyroptosis marker Cleavaged Caspase-1.Results Shentao Ruangan Prescription Can effectively inhibit the activity of human hepatoma HepG2 cells.LY294002,Wortmanin,Akti,MEKi,JNKi,Z-Vad,Ferrostatin-1,Necrostatin-1 had no significant effect on the inhibition of HepG2 activity by total extract(water extract),supernatant and precipitation.Shentao Ruangan Prescription promoted the release of LDH in human hepatoma HepG2 cells,causing cytotoxicity.It inhibited HepG2 pyroptosis markers in human hepatoma cells and the expression of IL-1β and Cleavaged Caspase-1 and decreased the protein expression of Akt in human hepatoma cells HepG2 but inversely increased Caspase3 protein expression.Conclusion Shentao Ruangan Prescription has the effect of inhibiting the activity of hepatocellular carcinoma cells and anti-hepatocellular carcinoma,and its mechanism may be related to inhibiting the expression of Akt and promoting the expression of Caspase3.At the same time,Shentao Ruangan Prescription reduces the expressions of IL-1β and Cleavaged Caspase-1,which may inhibit cell pyroptosis.The inhibitory effect of Shentao Ruangan Prescription on the activity of liver cancer cells is likely to be independent of programmed death modes such as autophagy and necrotizing apoptosis,and PI3K/Akt/MAPK signal transduction.The total extract of Shentao Ruangan Prescription has better anti-hepatoma activity than its water-soluble and alcohol-soluble components,and its water-soluble and alcohol-soluble components may have synergistic effect.

Objective To explore the relationship of quality of life with optimisms and sense of coherence in adult kidney transplant recipients. Method A total of 295 kidney transplant recipients participated in the study by a self-designed general questionnaire, revised life orientation test (LOT-R), sense of coherence (SOC-13) and the MOS 36-item short form health survey (MOS SF-36). Results The mean score of mental health scale (PCS) was 47.02±7.30, which differed with different age, employment status and transplant vintage (P ＜0.01). The mean score of phyical health scale (MCS) was 46.87 ±11.14, which differed with education, economic burden and transplant vintage (P ＜0.05). PCS and MCS were positively correlated with the total score of sense of coherence (52.05％) and optimism (23.45％) (P＜0.001). Optimism played a partially mediating role in the relationship between sense of coherence and quality of life. Conclusions The quality of life of kidney transplant recipients needs to be improved, which was at a low level.Optimism (medium to high level) and sense of coherence (medium to low level) are influencing factors of the quality of life. Improving accessment of mental state of patients with kidney transplant receients, paying more atentent and support to their mental change can improve their optimism and sense of coheherce and then life quiality.

Objective:To analyze the etiological distribution and phylogenetic characteristics of hand, foot and mouth disease (HFMD) in Qujing city of Yunnan Province in 2020.Methods:Stool samples were collected from HFMD cases in Qujing city in 2020 and virus RNA was extracted directly from treated stool suspensions. Virus VP4 gene sequences were firstly amplified using MD91/OL68-1 primer pairs and sequenced, then the virus serotypes were determined by BLAST search on the GenBank. Virus entire VP1 gene sequences were amplified and sequenced. Virus serotypes were identified online using Enterovirus Genotyping Tool Version 0.1. Sequences of reference virus genotypes/sub-genotypes were downloaded according to references. Phylogenetic trees were constructed by MEGA5.2 software and the genetic characteristics were analyzed.Results:A total of 47 strains of enteroviruses (EVs) were detected with a detection rate of 10.22% (47/460). The detected viruses were coxsackievirus A4 (CVA4, 0.65%, 3/460), CVA6 (7.83%, 36/460), CVA10 (0.87%, 4/460) and CVA16 (0.87%, 4/460). All were enterovirus species A (EVA), while other group viruses were not detected. The predominant virus was CVA6, accounting for 7.83% (36/460). EVA71 was not detected. CVA4 strains of C2 and C4 subgenotypes were co-circulating strains in Qujing city. CVA6 subgenotype D3a and CVA16 subgenotype B1a were also circulated in Qujing city. All CVA10 strains were in a separate lineage.Conclusions:Similar to the previous situation in China, the detection rates of EVA71 and CVA16 were very low, even zero. This study showed that CVA6 was the predominant virus, indicating a HFMD outbreak caused by CVA6 in Qujing city in 2020. The phylogenetic analysis showed CVA10 isolates belonged to a separate lineage, which might be unique to Qujing city. Laboratory and molecular epidemiological surveillance of non-EVA71 and non-CVA16 viruses, especially CVA6 and CVA10 should be strengthened in the future.

Objective:Using intrapartum ultrasound monitoring to observe and analyse the impact of upright sit-ting delivery on fetal head descent and maternal and infant outcomes during the second stage of labor.Methods:This study used a prospective randomized controlled study,including 110 pregnant women with full-term and com-plete opening of the cervix who were able to undergo vaginal delivery at Beijing Obstetrics and Gynecology Hospi-tal,Capital Medical University from February to September 2023.They were randomly divided into a control group(n=56)and an upright group(n=54)by simple randomization.The control group was delivered in routine supine or semi-supine positions,and the upright group was delivered in upright positions.The parturients in both groups were examined by color Doppler ultrasound at the beginning of the second stage of labor when the cervix was full-y opened to guide delivery and 30 minutes after guidance of the second stage of labor.Abdominal and perineal two-dimensional ultrasound was used to detect fetal head angle of progression(AOP),fetal head perineal dis-tance(HPD),and fetal orientation.At the same time,the time of the second stage of labor and delivery outcome were recorded.The changes in AOP,angle and position of HPD,delivery duration,and maternal and fetal out-comes between the two groups were analyzed.Results:At the beginning of the second stage of labor,there was no significant difference in AOP,HPD,and the rate of non-occipital anterior position of fetal position between the two groups(P＞0.05).After 30 minutes of guiding delivery,compared with the control group,the AOP angle in-creased,the HPD distance shortened,and the proportion of non-occipital anterior fetal position was reduced in the upright position group,and all the differences were statistically significant(P＜0.05).At the same time,compared with the control group,the spontaneous delivery rate,the duration of the second stage of labor,forceps delivery rate,lateral perineal incision rate,perineal edema rate,and oxytocin use rate were significantly decreased in the upright position group,and all the differences were statistically significant(P＜0.05).All newborns were born a-live,and the 1-minute Apgar score was 10 for all newborns in both groups.There was no significant difference in birth weight between the two groups(P＞0.05).Conclusions:When the parturient delivers in an upright sitting position in the second stage of labor,the AOP increases,the HPD shortens,and the time of the second stage of labor is accelerated to increase the natural delivery rate,reduce medical intervention,and reduce maternal and in-fant complications during delivery.

Objective:Using intrapartum ultrasound monitoring to observe and analyse the impact of upright sit-ting delivery on fetal head descent and maternal and infant outcomes during the second stage of labor.Methods:This study used a prospective randomized controlled study,including 110 pregnant women with full-term and com-plete opening of the cervix who were able to undergo vaginal delivery at Beijing Obstetrics and Gynecology Hospi-tal,Capital Medical University from February to September 2023.They were randomly divided into a control group(n=56)and an upright group(n=54)by simple randomization.The control group was delivered in routine supine or semi-supine positions,and the upright group was delivered in upright positions.The parturients in both groups were examined by color Doppler ultrasound at the beginning of the second stage of labor when the cervix was full-y opened to guide delivery and 30 minutes after guidance of the second stage of labor.Abdominal and perineal two-dimensional ultrasound was used to detect fetal head angle of progression(AOP),fetal head perineal dis-tance(HPD),and fetal orientation.At the same time,the time of the second stage of labor and delivery outcome were recorded.The changes in AOP,angle and position of HPD,delivery duration,and maternal and fetal out-comes between the two groups were analyzed.Results:At the beginning of the second stage of labor,there was no significant difference in AOP,HPD,and the rate of non-occipital anterior position of fetal position between the two groups(P＞0.05).After 30 minutes of guiding delivery,compared with the control group,the AOP angle in-creased,the HPD distance shortened,and the proportion of non-occipital anterior fetal position was reduced in the upright position group,and all the differences were statistically significant(P＜0.05).At the same time,compared with the control group,the spontaneous delivery rate,the duration of the second stage of labor,forceps delivery rate,lateral perineal incision rate,perineal edema rate,and oxytocin use rate were significantly decreased in the upright position group,and all the differences were statistically significant(P＜0.05).All newborns were born a-live,and the 1-minute Apgar score was 10 for all newborns in both groups.There was no significant difference in birth weight between the two groups(P＞0.05).Conclusions:When the parturient delivers in an upright sitting position in the second stage of labor,the AOP increases,the HPD shortens,and the time of the second stage of labor is accelerated to increase the natural delivery rate,reduce medical intervention,and reduce maternal and in-fant complications during delivery.