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

OBJECTIVES: To elucidate the underlying mechanisms of macrophage-mediated inflammation and tissue injury in diabetic foot ulcer (DFU). METHODS: Skin tissue samples were collected from patients with DFU and with non-DFU. A total of 79 272 high-quality cell transcriptomes were obtained using single-cell RNA sequencing. An unbiased clustering approach was employed to identify cell subpopulations. Seurat functions were used to identify differentially expressed genes between DFU and non-DFU groups, and gene ontology (GO) enrichment analysis was used to reveal gene function. Furthermore, cell-cell communication network construction and ligand-receptor interaction analysis were performed to reveal the mechanisms underlying cellular interactions and signaling regulation in the DFU microenvironment from multiple perspectives. RESULTS: The results revealed a significant expansion of myeloid cells in DFU tissues, alongside a marked reduction in structural cells such as endothelial cells, epithelial cells, and smooth muscle cells. Major cell types underwent functional reprogramming, characterized by immune activation and impaired tissue remodeling. Specifically, macrophages in DFU skin tissues exhibited a shift toward a pro-inflammatory M1 phenotype, with upregulation of genes associated with inflammation and oxidative stress. Cell communication analysis further demonstrated that M1 macrophages served as both primary signal receivers and influencers in the COMPLEMENT pathway mediated communication network, and as key signal senders and mediators in the secreted phosphoprotein 1 (SPP1) pathway mediated communication network, actively shaping the inflammatory microenvironment. Key ligand-receptor interactions driving macrophage signaling were identified, including C3-(ITGAM+ITGB2) and SPP1-CD44. CONCLUSIONS This study establishes a comprehensive single-cell atlas of DFU, revealing the role of macrophage-driven cellular networks in chronic inflammation and impaired healing. These findings may offer potential novel therapeutic targets for DFU treatment.
Humans ; Macrophages/immunology* ; Diabetic Foot/pathology* ; Single-Cell Analysis ; Transcriptome ; Gene Expression Profiling ; Inflammation ; Skin ; Cell Communication ; Signal Transduction ; Cellular Reprogramming

This research investigates the regulatory role of the transcription factor PU.1 in type 1 conventional dendritic cells (cDC1) and its therapeutic potential of modulating the nuclear factor kappaB (NF-κB) cells signaling pathway in non-small cell lung cancer (NSCLC). Utilizing single-cell transcriptome sequencing and comprehensive bioinformatics tools, including the CIBERSORT algorithm, we analyzed the immune cell landscape within NSCLC tissues. Our analysis revealed distinct NSCLC subtypes and delineated the developmental trajectories and functional distinctions of cDC1 cells. Key differentially expressed genes (DEGs) and pivotal functional modules within these cells were identified, highlighting PU.1 as a critical mediator underexpressed in NSCLC samples. Functionally, PU.1 demonstrated the induction of the NF-κB pathway, which led to inhibited tumor proliferation and enhanced activation of cDC1, thereby suggesting its role in tumor immune surveillance. In vivo models confirmed the suppressive effect of PU.1 on NSCLC progression, mediated through its influence on cDC1 functionality via the NF-κB pathway. These findings propose PU.1 as a promising target for NSCLC therapeutic strategies, emphasizing the importance of transcriptional regulators in the tumor microenvironment.

Objective:To explore the relationship between parental mediation and adolescents'tendency of online game addiction,and the effect of self-control in it.Methods:Totally 553 senior high school students were tested with the Chinese version of Parental Mediation of Online Activities Questionnaire,Internet Gaming Disorder Scale-Short-form(IGDS9-SF)and Dual-mode of Self-control Scale for Adolescents(DMSC-S).Parental active me-diation,restrictive mediation,Internet game addictive tendency,adolescent self-control impulsive system,control system were evaluated respectively.SPSS macro program PROCESS was used to test the mediating role.Results:The scores of restrictive mediation of parents were negatively associated with the scores of adolescents'tendency of online game addiction(β=-0.14,P＜0.001).Self-control scores played an independent mediating role between parental active mediation scores and online game addiction tendency scores(indirect effect=-0.09,95％CI=-0.09--0.01)and a partial mediating role between parental restrictive mediation scores and online game addiction tendency scores(indirect effect=-0.04,95％CI=0.00-0.07).Conclusion:Parental active and restrictive medi-ation are related to adolescents'tendency of online game addiction.Self-control plays a partial mediating role.

Objective:To develop adjustable peel force tester with peel angle from 0° to 180°,so as to realize the test for the performance of interface adhesion of wearable electronic products under multi angles.Methods:The rotating platform of angle adjustment component was used to realize free adjustment of peel angle from 0° to 180°.A method of peel test procedure based on the peel force tester with full-angle was established,and the comparative experiment between that and tensile testing machine was conducted.The peel tests of various kinds of wearable electronic products were conducted under peel angle of 45°,90° and 180°.Results:The test results of the peel force tester with full-angle were consistent with those of the tensile testing machine,which function opposed reliability.The peel test results of more than 10 wearable electronic products indicated that the peel force tester with full-angle could effectively determinate the performance of interface adhesion.Conclusion:The peel force tester with full-angle can effectively appear the performance of the interface adhesion of wearable electronic products,which provides basis for establishing the standard of peel test of wearable electronic products.

Objective:To evaluate the clinical outcomes of arthroscopic debridement combined with in situ ulnar nerve release in patients with osteoarthritic elbow stiffness complicated by tardy ulnar neuritis.Methods:A retrospective chart review was conducted on 36 patients with osteoarthritic elbow stiffness and tardy ulnar neuritis who underwent arthroscopic debridement and in situ ulnar nerve release between January 2018 and October 2022. The mean patient age was 51.3±6.5 years (range: 40-62 years), with 29 males and 7 females. The procedure was performed on 28 right and 8 left elbows, all on the dominant side. Radiographic classification of elbow osteoarthritis (OA) revealed 16 cases of Kellgren-Lawrence grade II, 15 cases of grade III, and 5 cases of grade IV. The duration of OA was 4.2±1.8 years (range: 2-8 years), and the duration of ulnar nerve compression symptoms was 4.6±3.2 months (range: 2 months-1 year). Elbow function and pain were assessed preoperatively and 12 months postoperatively using flexion-extension range of motion, the Mayo Elbow Performance Index (MEPI), and the Visual Analogue Scale (VAS) for pain. Ulnar nerve function was evaluated through grip strength, pinch strength, two-point discrimination of the little finger, and motor and sensory nerve conduction velocities (MNCV and SNCV).Results:The mean operation time was 151.4±16.2 minutes (range: 125-180 minutes), with an average hospital stay of 6.5±1.0 days (range: 5-8 days). One patient (2.8%) experienced skin necrosis at the ulnar nerve release incision, while all other incisions healed at the first stage. At the 12-month follow-up, significant improvements were observed in elbow extension [26.00° (20.00°, 30.00°) vs. 6.00° (5.00°, 10.00°), Z=-5.235, P<0.001], flexion range of motion [98.00° (88.25°, 100.00°) vs. 120.50° (109.00°, 128.00°), Z=-5.234, P<0.001], VAS pain scores (7.5±0.9 vs. 1.8±0.8, t=32.788, P<0.001), and MEPI [32.50 (26.25, 43.75) vs. 85.00 (80.00, 85.00), Z=-5.269, P<0.001]. Improvements in grip strength (24.1±2.4 N vs. 35.0±2.7 N, t=30.745, P<0.001), pinch strength (16.2±1.3 N vs. 23.8±1.7 N, t=40.239, P<0.001), two-point discrimination [16.00 (14.00, 18.00) mm vs. 5.00 (3.00, 7.00) mm, Z=-5.270, P<0.001], and MNCV (27.5±3.0 m/s vs. 41.6±3.0 m/s, t=53.673, P<0.001) / SNCV (25.1±2.7 m/s vs. 35.0±2.9 m/s, t=47.538, P<0.001) were also noted. At the 12-month follow-up, 5 patients (13.9%) had an elbow extension lag greater than 15° (range: 18°-20°), though elbow flexion recovered to at least 100°, sufficient for daily activities. One patient (2.8%) had incomplete relief of ulnar nerve symptoms postoperatively, but was generally satisfied with the outcome. Three patients (8.3%) experienced temporary worsening of ulnar nerve symptoms during rehabilitation, which improved with adjusted exercise routines, and the symptoms resolved by the 1-year follow-up. Conclusion:Arthroscopic debridement combined with in situ ulnar nerve release is a safe and effective treatment for osteoarthritic elbow stiffness complicated by tardy ulnar neuritis. This minimally invasive procedure is associated with a low complication rate and yields significant functional improvements.

Objective:To investigate the clinical efficacy of unicompartmental knee arthroplasty (UKA) in the treatment of medial compartment knee osteoarthritis (OA) with concomitant lateral discoid meniscus.Methods:A retrospective analysis was conducted on 13 patients (16 knees) who underwent UKA for medial compartment OA of the knee associated with lateral discoid meniscus at Central Hospital of Cangzhou between January 2016 and July 2021. The mean age of the patients was 59.1±7.7 years (range, 49-74 years), with a mean body mass index (BMI) of 28.9±1.7 kg/m 2 (range, 25.2-31.3 kg/m 2). Of the 13 patients, 7 were male (9 knees) and 6 were female (7 knees). The procedure was performed on 10 knees of the left leg and 6 knees of the right leg. Preoperative radiographic assessment showed that all patients had Kellgren-Lawrence grade 3-4 knee OA (9 knees with grade 3, 7 knees with grade 4). The average duration of knee pain was 6.0±1.5 years (range, 3-8 years). No surgical intervention was performed on the lateral discoid meniscus during the UKA procedure. The alignment of the lower limbs was assessed by measuring the hip-knee-ankle (HKA) angle using full-length weight-bearing X-rays. Functional outcomes were evaluated using the Hospital for Special Surgery (HSS) score, Oxford knee score (OKS), and American Knee Society (AKS) knee and function scores. The presence of lateral knee pain or tenderness along the lateral joint line was used to assess symptoms related to lateral meniscus injury. Results:The average surgical time for the 16 knees was 55.9±4.5 min (range, 48-62 min), and the mean length of hospital stay was 10.2±3.2 days (range, 7-15 days). The mean follow-up duration was 53.2±11.1 months (range, 36-68 months). At 6 months, 1 year, and the final follow-up, significant improvements were observed in HSS scores [57.00(54.25, 58.00) vs. 91.00 (89.25, 92.00) vs. 95.50(92.00, 97.00) vs. 96.50 (95.00, 97.75)], OKS [37.00(36.00, 39.00) vs. 15.00(15.00, 16.00) vs. 14.00(13.00, 14.00) vs. 13.00(12.25, 13.00)], AKS knee scores [52.00(50.00, 53.75) vs. 91.50(91.00, 92.00) vs. 95.00(95.00, 97.00) vs. 96.50 (95.00, 97.00)], and AKS function scores [53.00(45.00, 55.00) vs. 90.00(90.00, 90.00) vs. 95.00(92.00, 99.25) vs. 95.00(95.00, 100.00)] compared to preoperative values ( P<0.001). Statistically significant differences were found between the 6-month follow-up and the 1-year or final follow-up ( P<0.05), but no significant differences were observed between the 1-year and final follow-up ( P>0.05). Preoperative HKA angle was 8.00°(6.25°, 9.75°) of varus, whereas the postoperative HKA angle was 3.00° (3.00°, 3.75°) of varus. The postoperative alignment showed a significant reduction in varus deformity, with a statistically significant difference compared to preoperative values ( Z=-3.419, P=0.001). One knee developed symptomatic intra-articular loose body at 5 years postoperatively, which was successfully treated with arthroscopic removal. At the final follow-up, all prostheses were well-positioned, with no signs of loosening, subsidence, periprosthetic infection, or the need for revision surgery. No symptoms were indicative of lateral discoid meniscus injury were observed. Conclusion:UKA for the treatment of medial compartment knee OA in patients with lateral discoid meniscus yields favorable clinical outcomes, with significant improvements in knee function and pain relief, as well as stable midterm prosthesis performance.

Objective To systematically evaluate the experiences of drug self-management in elderly patients with multiple chronic illnesses,so as to provide references for the development of personalized drug self-management intervention programs.Methods Qualitative research on drug self-management experiences of elderly patients with multiple chronic diseases was retrieved from PubMed,Cochrane Library,Embase,CINAHL,Web of Science,Scopus,CNKI,Wanfang,VIP and SinoMed.The retrieval time limit is from the establishment of the databases to November 2023.The qualitative research quality evaluation criteria of the Joanna Briggs Institute Evidence-based Health Care Center in Australia was used to evaluate quality of studies.The results were integrated by meta-integration method.Results A total of 9 studies were included,and 33 research results were extracted,and 4 integrated results and 12 categories were synthesized.The integration results included the objective dilemmas and challenges of drug self-management,the low level of drug literacy,willingness to engage in positive behavior attempts,need of multi-party assistance.Conclusion The objective dilemmas of drug self-management and low level of drug literacy in elderly patients with multimorbidity will seriously affect their health outcomes.Medical staffs should pay attention to the different experiences of patients in the process of drug self-management,identify the needs of patients,formulate targeted intervention support strategies,and improve the level of drug self-management in elderly patients.

Objective:Network Meta-analysis was used to compare the predictive value of different detection indicators for bloodstream infection in ICU adult patients, providing evidence-based basis for early clinical diagnosis of bloodstream infection in patients.Methods:Cochrane Library, PubMed, Embase, CINAHL, Web of Science, China National Knowledge Infrastructure (CNKI), VIP, Wanfang database and SinoMed were searched by computer. All the experimental studies on different detection indicators for predicting bloodstream infection in ICU adult patients were collected. The retrieval time limit was from the establishment of the database to July 9, 2023.Two researchers independently searched and screened the literature according to the literature inclusion and exclusion criteria, strictly evaluated the quality of the included literature, extracted data, and used Revman5.4 software for Meta-analysis.Results:A total of 13 studies were included. The ranking results of network Meta-analysis showed that among different detection indicators, procalcitonin (PCT), C-reactive protein (CRP), combined with (IL-6) had the highest area under the cumulative rank probability curve for sensitivity, negative predictive value and accuracy (85.08%, 90.41%, 79.39%). PCT, hypersensitive-C-reactive protein(hs-CRP) combined with IL-6 had the highest area under the cumulative rank probability curve of specificity and positive predictive value (68.47%, 77.92%). The results of cluster analysis showed that PCT+hs-CRP+IL-6 and PCT+CRP+IL-6 were the farthest distance from the origin compared with other detection indicators.Conclusions:PCT+CRP/hs-CRP+IL-6 can be used as a predictor for the diagnosis of bloodstream infection in ICU adult patients. In a single detection, pro-adrenomendullin may be the direction of future research, but due to the small sample size, the above conclusions need to be verified by more large sample and high quality studies.

Objective To investigate the distribution and antimicrobial resistance profiles of the common pathogens isolated from urine from 2015 to 2021 in the CHINET Antimicrobial Resistance Surveillance Program.Methods The bacterial strains were isolated from urine and identified routinely in 51 hospitals across China in the CHINET Antimicrobial Resistance Surveillance Program from 2015 to 2021.Antimicrobial susceptibility was determined by Kirby-Bauer method,automatic microbiological analysis system and E-test according to the unified protocol.Results A total of 261 893 nonduplicate strains were isolated from urine specimen from 2015 to 2021,of which gram-positive bacteria accounted for 23.8％(62 219/261 893),and gram-negative bacteria 76.2％(199 674/261 893).The most common species were E.coli(46.7％),E.faecium(10.4％),K.pneumoniae(9.8％),E.faecalis(8.7％),P.mirabilis(3.5％),P.aeruginosa(3.4％),SS.agalactiae(2.6％),and E.cloacae(2.1％).The strains were more frequently isolated from inpatients versus outpatients and emergency patients,from females versus males,and from adults versus children.The prevalence of ESBLs-producing strains in E.coli,K.pneumoniae and P.mirabilis was 53.2％,52.8％and 37.0％,respectively.The prevalence of carbapenem-resistant strains in E.coli,K.pneumoniae,P.aeruginosa and A.baumannii was 1.7％,18.5％,16.4％,and 40.3％,respectively.Lower than 10％of the E.faecalis isolates were resistant to ampicillin,nitrofurantoin,linezolid,vancomycin,teicoplanin and fosfomycin.More than 90％of the E.faecium isolates were ressitant to ampicillin,levofloxacin and erythromycin.The percentage of strains resistant to vancomycin,linezolid or teicoplanin was＜2％.The E.coli,K.pneumoniae,P.aeruginosa and A.baumannii strains isolated from ICU inpatients showed significantly higher resistance rates than the corresponding strains isolated from outpatients and non-ICU inpatients.Conclusions E.coli,Enterococcus and K.pneumoniae are the most common pathogens in urinary tract infection.The bacterial species and antimicrobial resistance of urinary isolates vary with different populations.More attention should be paid to antimicrobial resistance surveillance and reduce the irrational use of antimicrobial agents.