Objective:To explore the effect of stage target intervention on mental state, quality of life and prognosis of spontaneous cerebral hemorrhage, so as to provide reference for improving the quality of life and prognosis of patients with spontaneous cerebral hemorrhage.Methods:A total of 261 patients with spontaneous cerebral hemorrhage from June 2017 to June 2019 in Beijing Union Hospital were selected as the research subjects. Patients were divided into the observation group (131 cases) and the control group (130 cases) by the random number table method. The control group was treated with routine nursing intervention, and the observation group applied stage target intervention based on the control group. The psychological state, quality of life and prognosis of the two groups were evaluated by Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS), modified Rankin Scale (mRS), Stroke Specific Quality of Life scale (SS-QOL).Results:There were no significant differences in SAS, SDS, mRS, SS-QOL before intervention between the two groups ( P >0.05) . After intervention, the scores of energy, family role, language, activity, emotion, personality, self-care ability, social role, upper limb function, work / labor and total scores of SS-QOL in the two groups were all increased ( P < 0.05), and the increase of energy, family role, language, activity, emotion, personality, self-care ability, social role, upper limb function, work / labor and total scores of SS-QOL in the observation group were higher than those in the control group, and the differences were statistically significant ( P < 0.05). After intervention, the scores of SAS, SDS and mRS were (42.07±4.14), (43.09±4.79), (3.06±0.42) points in the observation group and (51.83±4.65), (54.82±4.92), (3.57±0.50) points in the control group, and the differences were statistically significant ( t values were 17.912, 19.516, 8.925, P < 0.05). Conclusions:Stage target intervention can improve the anxiety and depression of patients with spontaneous cerebral hemorrhage, improve the quality of life, and reduce the incidence of poor prognosis.

Objective To observe and compare the different forces between doctors and nurses used visible laryngoscope endotracheal intubation applied to the oropharyngeal organization. Methods 10 nurses (to carry on laryngoscope intubation theory, and had certain study period practice) were chosen in group A and 10 clinical anaesthetize doctors (to be possible correctly used visible laryngoscopes) were chosen in group B, two groups used the visible laryngoscope on the same model person body inserted the tube, computer monitor software recorded results. Results The impulse force was (25.57±3.37) N·s and insert tube time was (25.3±3.3) s in group A which were higher than (16.47±2.99) N·s and (16.2±3.0) s in group B (t=2.550 and 2.207, P<0.05). The average forces in group A and group B were (0.87±0.62) N and (0.64±0.30) N, and peak forces were (3.05±0.95) N and (2.06±0.48) N, there was no remarkable difference between the two groups (P>0.05). Conclusions There is no statistics difference forces applied to the oropharyngeal organization between nurses and anaesthesiologists using visible laryngoscope intubation, and visible laryngoscope intubation technique is easy to learn and it is feasible by the nurse to master the technology and applied to anesthesia intubation care and emergency care.

Objective To evaluate the efficacy and safety of Qingpeng ointment for the treatment of localized dermatitis and eczema in children.Methods Sixty-eight outpatient children with localized dermatitis or eczema were included in this study.All the patients were topically treated by Qingpeng ointment twice daily for a week,which was agreed by their patients.The efficacy was evaluated after the end of the treatment by lesion scores,and adverse reactions during the treatment were recorded.Results Of the 68 patients,61 completed the trial,7 withdrew from the trial because of worsened lesions,unfavorable effects and distrust of this drug.The total response rate was 81.4％ (31/51) in patients treated with Qingpeng ointment alone.Irritant reaction occured in only one case,but did not influence the treatment.Conclusion Qingpeng ointment displays a favorable efficacy and safety in the treatment of localized dermatitis and eczema in children.

Objective To investigate the results and complications of hemispherotomy for drug resistant hemispheric epilepsy.Methods The authors reviewed 5 patients who were diagnosed as drug resistant hemispheric epilepsy and operated in the neurosurgery department of Peking Union Medical College Hospital from 2011 to 2013.All the 5 patients were underwent hemispherotomy after carefully multidisciplinary pre-operation evaluation.Results All patients tolerated the procedure well and the postoperative course was smooth.All the 5 patients didn`t have seizure in the period of following up of 46 to 69 months.Conclusions According to literatures and the authors` experience, hemispherotomy is as safe and efficient for hemispheric epilepsy as hemispherectomy.It is most important advance for hemispherectomy.The procedure of hemispherotomy is complex but not very difficult, illustrating a good prospect of application and extension.

BACKGROUND: Glucocorticoid-induced osteoporosis has relationship with the down-regulation of osteoprotegedn expression. Osteoprotegerin could inhibit bone resorption in the animal experiment and clinical application for treating oestrogenic hormone deficiency osteoporosis. OBJECTIVE: To investigate the effects of exogenous recombinant osteoprotegerin fusion protein on glucocorticoid-induced osteoporosis in rats. DESIGN, TIME AND SETTING: Randomized grouping, controlled animal expenment was performed in the Institute of Orthopedics, Chinese PLA General Hospital between January 2006 and June 2008. MATERIALS: Sixty healthy male Wistar rats of clean grade; Dexamethasone was produced by Tianjin Jinyao Amino Acid Co., Ltd (Licenca No. H12020515). METHODS: Sixty rats were divided into 3 groups randomly with 20 rats in each. Control group: the rats were administrated with 0.9％ sodium chloride. Dexamethasone group: the rats were administrated with dexamethasone intramuscularly. Osteoprotegedn group: the rats were administrated with dexamethasone and recombinant osteoprotegerin intramuscularly. MAIN OUTCOME MEASURES: All rats were sacrificed at 12 weeks after administration. The urine calcium, phosphor, creatinine, bone mineral density, biomechanics tests of femur and vertebral body, were measured. Immunohistochemistry staining were performed to observe osteoprotegerin expression.RESULTS: Sixty rats were all involved in the final analysis. ①Compared with control group, udne calcium increased in the Dexamethasone group (P < 0.05); the bone mineral density of lumbar vertebra and femur decreased significantly (P < 0.05), especially lumbar vertebra (P < 0.01); biomechanics tests of femur and vertebral body (maximum load, maximum stress, elasticity load, elasticity stress, elastic modulus) decreased significantly (P < 0.05); immunohistochemistry staining showed that endogenous osteoprotegerin expressions were reduced significantly in bone marrow of Dexamethasone group (P < 0.01). ②Compared with Dexamethasone group, urine calcium decreased in the osteoprotegerin group (P < 0.01 ); the bone mineral density of lumbar vertebra and femur increased (P < 0.05); the parameters of biomechanics testa of femur and vertebral body increased (P < 0.05); the osteoprotegerin expression was not changed between Dexamethasone group and osteoprotegerin group.CONCLUSION: Glucocorticoid could inhibit osteoprotegerin expression in the bone followed by progressive bone loss and induce osteoporosis. Recombinant osteoprotegerin works effectively in inhibiting bone resorption after administrated with glucocorticoid, reduce bone resorption index, increase bone mineral index and bone strength, thus improving the osteoporosis which is induced by glucocorticoid.

Objective:To screen the predictive factors of gastric tube placement in patients with acute cerebral hemorrhage, and to construct a predictive model of gastric tube placement in patients with acute cerebral hemorrhage and analyze its diagnostic efficacy.Methods:A total of 1 425 patients with acute cerebral ischemia admitted to PMUCH from May 2007 to May 2019 were selected as subjects. The patients were divided into the gastric tube group (observation group, n=135) and the unimplanted group (control group, n=1 290) according to whether the patient was placed in the stomach tube after admission. Logistic regression was used to analyze the predictive factors affecting the placement of gastric tube in patients with acute cerebral hemorrhage, and to construct a predictive model for the placement of gastric tube in patients with acute cerebral hemorrhage. The receiver operating characteristic curve (ROC) was used to analyze the occlusive hydrocephalus + severity of disease + standardized swallowing assessment (SSA) grade + swallowing test (model A) to predict the efficacy of placement of gastric tube in patients with acute cerebral hemorrhage. Results:There were significant differences between the two groups in terms of education, residence, intraventricular hemorrhage, occlusive hydrocephalus, dementia, heart failure, psychological reaction, SSA classification, disease severity, and swallowing test ( χ 2 value was 10.182-99.194, P<0.05). Logistic regression analysis showed that the occlusive hydrocephalus, severity of disease, SSA grade, and swallowing test were closely related to the placement of gastric tube in patients with acute cerebral hemorrhage. The area under the curve (AUC), sensitivity, and specificity of model A in predicts that placement of gastric tube in patients with acute cerebral hemorrhage were 0.874, 77.78%, and 89.30%, respectively. Results:The occlusive hydrocephalus, severity of disease, SSA grade, and swallowing test were closely related to the placement of gastric tube in patients with acute cerebral hemorrhage. The model constructed by the four models can predict the risk of patients with gastric tube and has higher efficacy.

Objective:To investigate the impact of online teaching on dermatology study in the undergraduate stage of the eight-year program medical students of Peking University Third Hospital.Methods:Questionnaires were administered before and after dermatology theoretical lectures and probation among the eight-year program medical students of the Peking University Third Hospital. Online teaching in 2020 was compared with offline teaching from 2016 to 2019. Written examination was taken after studying and the results were analyzed. SPSS 21.0 was used to conduct t-test and Mann-Whitney U test. Results:The total number of students that received online teaching was 53, and the response rate of the questionnaire was 75.5(80/106); the number of students receiving offline teaching was 166 and the response rate of the questionnaire was 99.1% (329/332). After dermatology theoretical lectures and probation, the scores of the written examination of online teaching were better than those of offline teaching ( P<0.001). The self-evaluation of the diagnostic ability of urticaria in students that received online teaching was lower than that in offline teaching students ( P=0.008); whereas the importance rating of dermatology department in hospitals ( P<0.001) and the interest in dermatology ( P=0.002) were significantly higher in online teaching than offline teaching. No significant differences were found in the self-evaluation of the diagnostic ability of eczema and acne, the willingness to be a dermatologist, difficulty rating in dermatology study, etc. Sixty percent (24/40) of students submitted open suggestions, and the most suggestion was to increase offline probation [22.5%(9/40). Conclusion:The online teaching of dermatology theoretical lectures and probation may be better for students' knowledge than offline teaching and they can also stimulate students' interest in learning. However, students' confidence in the diagnosis and treatment of certain common disease might be slightly lower in online teaching than in offline teaching. The combination of online and offline teaching might provide more advantages in the future. The form and content of online teaching also urgently need to be further improved in practice.

Objective:To identify factors influencing the recurrence of psoriasis, and to explore the association between the recurrence of psoriasis and metabolism-related markers.Methods:A retrospective investigation was conducted on the recurrence status of patients with psoriasis vulgaris, who visited the Department of Dermatology, Peking University Third Hospital from January 2016 to April 2023. Patients with recurrence intervals > 3 months were included in the non-rapid recurrence group (non-persistent psoriasis group), while patients with recurrence intervals ≤ 3 months were included in the rapid recurrence group (persistent psoriasis group). General conditions and relapse triggers were analyzed between the two groups. Metabolism-related laboratory data, as well as detection results of serum fatty acid-binding protein 4 (FABP4) and FABP5 in some patients, were collected, and relationships between these indicators and psoriasis recurrence were analyzed. Comparisons between groups were performed using t test, non-parametric test or chi-square test; linear regression analysis was performed to identify possible factors influencing the FABP levels, and multivariate logistic regression analysis to identify relapse triggers. Results:A total of 255 patients were collected, including 194 with non-persistent psoriasis and 61 with persistent psoriasis. There were no significant differences in gender, age (stratified every 30 years), course of psoriasis (stratified every 10 years), family history of psoriasis, and main therapies between the two groups (all P > 0.05). The patients in the non-persistent psoriasis group were more prone to recurrence due to seasonal effects ( χ2 = 18.98, P < 0.001). The proportion of patients with dyslipidemia was significantly higher in the persistent psoriasis group than in the non-persistent psoriasis group ( χ2 = 54.44, P < 0.001). Compared with the non-persistent psoriasis group, the persistent psoriasis group showed significantly increased body mass index and levels of triglycerides, uric acid, and C-reactive protein (all P < 0.05), but significantly decreased high-density lipoprotein cholesterol levels ( U = 3 348.00, P < 0.001). The levels of FABP4 and FABP5 were significantly higher in the persistent psoriasis group than in the non-persistent psoriasis group (both P < 0.05). In the linear regression model adjusted for body mass index and dyslipidemia, FABP4 levels were associated with recurrence status of psoriasis ( P < 0.001). Multivariate logistic regression analysis revealed a significant correlation between dyslipidemia and persistent psoriasis ( P < 0.001) . Conclusion:The psoriasis patients with recurrence intervals ≤ 3 months may be more prone to develop metabolic diseases such as dyslipidemia, and dyslipidemia and elevated FABP4 levels may be associated with the recurrence of psoriasis.

Objective:To investigate the therapeutic effect of human umbilical cord mesenchymal stem cells (MSCs) on psoriasis-like mouse models induced by imiquimod and the underlying mechanisms.Methods:Eighteen C57BL/6 mice were randomly and equally divided into vaseline group, model group and treatment group according to a random number table. The mice in the model group and treatment group received topical treatment with 5% imiquimod cream at a dose of 62.5 mg once a day for 6 consecutive days on the shaved back, and those in the vaseline group received the treatment with the same amount of vaseline ointment; the mice in the treatment group were injected with 1.5×10 6 human umbilical cord MSCs via the caudal vein on days 1 and 4. The severity of skin lesions on the back of the mice was assessed everyday according to the psoriasis area and severity index (PASI) . Twenty-four hours after the last treatment, that is, on day 7, blood samples were taken, and the mice were sacrificed. The dorsal skin tissues were resected and subjected to hematoxylin and eosin (HE) staining. A single cell suspension of the resected spleen was prepared, and flow cytometry was performed to detect the Th1 and Th17 cell subsets in the spleen cells. Enzyme-linked immunosorbent assay was conducted to detect serum levels of cytokines interleukin (IL) -17A and tumor necrosis factor (TNF) -α. One-way analysis of variance was used for comparisons among groups, Tukey test for multiple comparisons, and repeated measures analysis of variance for the analysis of changes in the PASI score over time. Results:On day 7, there was obvious scaly erythema on the back of the mice in the model group, and the skin thickness and number of infiltrating inflammatory cells were significantly higher in the model group (78.73 ± 23.11 μm, 36.16 ± 2.95 cells/mm 2) than in the vaseline group (13.28 ± 4.57 μm, 13.33 ± 1.15 cells/mm 2, q=19.25, 7.21, respectively, both P < 0.001) . The treatment group showed significantly decreased PASI score, epidermal thickness and number of infiltrating inflammatory cells compared with the model group (all P < 0.001) . The percentage of Th17 cell subsets in the spleen cells and serum level of TNF-α were significantly lower in the treatment group than in the model group (both P < 0.05) . There were no significant differences in the spleen weight, spleen index, spleen cell count, Th1 cell percentage or serum IL-17A level between the treatment group and the model group (all P>0.05) . Conclusion:Human umbilical cord MSCs can effectively alleviate skin inflammation induced by imiquimod in the psoriasis-like mouse models, likely by inhibiting Th17 cell formation and TNF-α expression.

Objective:To investigate the etiological diagnostic value of metagenomic sequencing in central nervous system (CNS) infectious diseases.Methods:A total of 170 patients with central nervous system infection admitted to the First Affiliated Hospital of Zhengzhou University from January 2018 to June 2020 were selected as the study subjects according to inclusion and exclusion criteria. General clinical data and pathogen test results were collected. All included patients underwent routine examination and mNGS test, and were divided into the conventional method test group and mNGS test group according to the test results. The measurement data conforming to normal distribution were represented by ± s; The measurement data that did not conform to normal distribution were represented by median and interquartile range. The classification data were expressed by the number of cases and percentage( n,%), and were compared by χ2 test or Fisher's exact test. Consistency test was represented by Kappa value. The detection of pathogenic microorganisms by the two methods and the rule of pathogen spectrum were compared and analyzed. Results:The overall positive rate of mNGS in CNS infectious diseases was higher than that of conventional methods (58.23% vs. 18.82%), and the difference was statistically significant ( P<0.01). Among the 20 samples which were both positive by the two methods, 10 cases were completely pathogenic, 5 cases were partially consistent and 5 cases were completely inconsistent. In the detection of tuberculous nervous system infection, the positive rates were 66.7%, 53.8%, 44.0%, 40.0%, 4.0% in blood T-SPOT, cerebrospinal fluid mNGS, ADA, Mycobacterium tuberculosis DNA and tuberculous specific antibody, respectively. The positive rate of acid-fast staining was 0. The positive rate of mNGS combined with conventional method was 80.8%. Conclusions:The detection rate of mNGS in CNS infection is better than that of conventional methods. However, it does not show obvious superiority in the detection rate of Mycobacterium tuberculosis associated nervous system infection. In general, mNGS detection of pathogenic bacteria is more extensive, which is conducive to a thorough and comprehensive understanding of the bacterial characteristics of central nervous system infection. The combination of the two methods can make up for the deficiency of clinical routine detection to a certain extent, and can maximize the detection rate.