Height， as one of the crucial indicators for assessing children’s growth and development， has consistently been a global focus. With economic development and improvements in social living standards， the clinical management needs for children with short stature have been increasingly growing. While growth hormone brings hope to children with short stature， it also triggers ethical challenges such as medical standardization， expansion of indications， equitable accessibility， and informed consent. To avoid the ethical issues related to the use of pediatric growth hormone， multidimensional and comprehensive clinical management should be implemented for children with short stature， including strictly adhering to medical standards and ethical guidelines， enhancing public awareness， and promoting the standardized development of recombinant human growth hormone （rhGH） therapy and ethics.

OBJECTIVE: To investigate the effectiveness of using 3 hollow compression screws combined with 1 screw off-axis fixation under the guidance of three-dimensional (3D) printed guide plate with mortise-tenon joint structure (mortise-tenon joint plate) for the treatment of Pauwels type Ⅲ femoral neck fractures. METHODS: A clinical data of 78 patients with Pauwels type Ⅲ femoral neck fractures, who were admitted between August 2022 and August 2023 and met the selection criteria, was retrospectively analyzed. The operations were assisted with mortise-tenon joint plates in 26 cases (mortise-tenon joint plate group) and traditional guide plates in 28 cases (traditional plate group), and without guide plates in 24 cases (control group). There was no significant difference in the baseline data of gender, age, body mass index, cause of injury, and fracture side between groups ( P>0.05). The operation time, intraoperative blood loss, frequency of intraoperative fluoroscopy, incision length, incidence of postoperative deep vein thrombosis of lower extremity, pain visual analogue scale (VAS) score at 1 week after operation, and Harris score of hip joint at 3 months after operation were recorded and compared. X-ray re-examination was taken to check the quality of fracture reduction, fracture healing, and the shortening length of the femoral neck at 3 months after operation, and the incidences of internal fixation failure and osteonecrosis of the femoral head during operation. RESULTS: Compared with the control group, the operation time, intraoperative blood loss, and frequency of intraoperative fluoroscopy reduced in the two plate groups, and the quality of fracture reduction was better, but the incision was longer, and the differences were significant ( P<0.05). The operation time and intraoperative blood loss were significantly higher in the traditional plate group than in the mortise-tenon joint plate group ( P<0.05), the incision was significantly longer ( P<0.05); and the difference in fracture reduction quality and the frequency of intraoperative fluoroscopy was not significant between two plate groups ( P>0.05). There was 1 case of deep vein thrombosis of lower extremity in the traditional plate group and 1 case in the control group, while there was no thrombosis in the mortise-tenon joint plate group. There was no significant difference in the incidence between groups ( P>0.05). All patients were followed up 12-15 months (mean, 13 months). There was no significant difference in VAS score at 1 week and Harris score at 3 months between groups ( P>0.05). Compared with the control group, the fracture healing time and the length of femoral neck shortening at 3 months after operation were significantly shorter in the two plate groups ( P<0.05). There was no significant difference between the two plate groups ( P>0.05). There was no significant difference in the incidences of non-union fractures, osteonecrosis of the femoral head, or internal fixation failure between groups ( P>0.05). CONCLUSION For Pauwels type Ⅲ femoral neck fractures, the use of 3D printed guide plate assisted reduction and fixation can shorten the fracture healing time, reduce the incidence of postoperative complications, and be more conducive to the early functional exercise of the affected limb. Compared with the traditional guide plate, the mortise-tenon joint plate can reduce the intraoperative bleeding and shorten the operation time.
Humans ; Femoral Neck Fractures/diagnostic imaging* ; Bone Plates ; Fracture Fixation, Internal/instrumentation* ; Male ; Female ; Retrospective Studies ; Middle Aged ; Bone Screws ; Adult ; Aged ; Treatment Outcome ; Printing, Three-Dimensional ; Operative Time

B and T lymphocyte attenuator (BTLA) is an inhibitory immune checkpoint, which typically interacts with herpesvirus entry mediator (HVEM) and plays a crucial role in regulating immune balance. BTLA interacts with its ligand HVEM in a cis manner on the surface of the same immune cell to maintain immune tolerance, while trans interactions on the surface of different immune cells mediate immunosuppressive effects. Dysregulation of the BTLA/HVEM axis can impair the functions of immune cells, particularly T lymphocytes, promoting immune escape of tumor cells and ultimately leading to tumor progression. Researchers have found that BTLA and HVEM are abnormally expressed in various tumors and are associated with prognosis, suggesting that they may be potential targets for tumor immunotherapy. This review summarizes the molecular structures of BTLA and HVEM, immunomodulatory mechanisms, recent advances in hematologic malignancies, potential inhibitors of BTLA/HVEM interaction, and their applications in immunotherapy for hematologic malignancies.
Humans ; Receptors, Tumor Necrosis Factor, Member 14/chemistry* ; Receptors, Immunologic/immunology* ; Hematologic Neoplasms/genetics* ; Immunotherapy/methods* ; Animals

Alzheimer's disease (AD) is the leading cause of dementia, and no effective treatment has been developed for it thus far. Recently, the use of natural compounds in the treatment of neurodegenerative diseases has garnered significant attention owing to their minimal adverse reactions. Accordingly, the potential therapeutic effect of pterostilbene (PTS) on AD has been demonstrated in multiple in vivo and in vitro experiments. In this study, we systematically reviewed and summarized the results of these studies investigating the use of PTS for treating AD. Analysis of the literature revealed that PTS may play a role in AD treatment through various mechanisms, including anti-oxidative damage, anti-neuroinflammation, anti-apoptosis, cholinesterase activity inhibition, attenuation of β-amyloid deposition, and tau protein hyperphosphorylation. Moreover, PTS interferes with the progression of AD by regulating the activities of peroxisome proliferator-activated receptor alpha (PPAR-α), monoamine oxidase B (MAO-B), silent information regulator sirtuin 1 (SIRT1), and phosphodiesterase 4A (PDE4A). Furthermore, to further elucidate the potential therapeutic mechanisms of PTS in AD, we employed network pharmacology and molecular docking technology to perform molecular docking of related proteins, and the obtained binding energies ranged from -2.83 to -5.14 kJ/mol, indicating that these proteins exhibit good binding ability with PTS. Network pharmacology analysis revealed multiple potential mechanisms of action for PTS in AD. In summary, by systematically collating and summarizing the relevant studies on the role of PTS in treatment of AD, it is anticipated that this will serve as a reference for the precise targeted prevention and treatment of AD, either using PTS or other developed drug interventions.

LC-MS/MS methods for the quantitative determination of mecobalamin and ceftriaxone in rat plasma were established, and utilized to assess the pharmacokinetic behaviors of the two drugs in rats and to determine whether there were pharmacokinetics-based drug-drug interactions between them. Methanol was used as a protein precipitant to process rat plasma samples. For mecobalamin, acetonitrile containing 0.1% formic acid was used as the organic phase, while an aqueous solution of 0.1% formic acid and 2 mmol/L ammonium acetate served as the aqueous phase. For ceftriaxone, the organic phase was acetonitrile with 0.1% formic acid, and the aqueous phase was a 1% formic acid aqueous solution. LC-MS/MS quantitative analysis methods for both drugs were developed under the positive ion mode, followed by comprehensive methodological validation. Single-dose administration (either alone or in combination) was carried out via caudal vein injection. The dosing regimens were 0.03, 0.1, and 0.3 mg/kg for mecobalamin and 90 mg/kg for ceftriaxone. The results of methodological validation indicated that mecobalamin exhibited good linearity in the range of 3−3000 ng/mL (r = 0.9991), and ceftriaxone showed excellent linearity in the range of 0.5~500 μg/mL (r = 1). The selectivity, precision, accuracy, extraction recovery, matrix effect, and stability of the analytical methods for both substances met the relevant requirements. The pharmacokinetic study revealed that, compared with single-drug administration, the average plasma concentration-time profiles of the two drugs almost overlapped during single-dose combined administration. Statistical analysis, specifically one-way analysis of variance, demonstrated no significant differences in major pharmacokinetic parameters (t1/2, AUC0−∞, etc.) (P > 0.05). This study confirmed that no pharmacokinetic-based drug-drug interactions occurred when mecobalamin and ceftriaxone were co-administered in rats. The findings of this research offer a reliable pharmacokinetic foundation for the rational clinical co-use of these two drugs, thus providing valuable insights into optimizing therapeutic strategies.

Nosocomial infection poses a significant threat to patient safety and increase their disease burden. Outbreaks of nosocomial infection are the main harmfulness associated with nosocomial infection, which making them socially sensitive issues. Nosocomial infection surveillance and warning are core contents of nosocomial infection management. Accurate early warning technology for nosocomial infection outbreaks can reflect the management capability of infection prevention and control. This study designed an early warning system based on a multi-dimensional and multi-scale comprehensive information surveillance mode for nosocomial infection outbreaks which was launched in March 2023. This system extracted the process-related indicators of nosocomial infection from various hospital information systems into the nosocomial infection database center. Under the multi-dimensional and multi-scale surveillance mode, the process-related data were stratified according to the predefined dimensions and scales, then generating time-series datasets of numerous subgroups. The system conducted weekly for all time-series datasets of subgroups based on warning rules, and subsequently sent out warning signals to managers. These warning signals could be verified by managers through data check, case verification and epidemiological investigation. Once a nosocomial infection outbreak was confirmed, intervention measures could be implemented promptly. In practical application, the system generated warning signals for nosocomial infection clusters in 12 departments on August 7th, 2023. The traditional nosocomial infection case report system ultimately reported 54 nosocomial infection cases, which distributed across 13 departments, with clusters(more than 3 cases) observed in 6 departments. All these 6 departments received warning signals generated from our system. It has been demonstrated that our system could predicted the nosocomial infection clusters 5.3 days earlier than the traditional nosocomial infection case report system on average, with warning sensitivity of 100.0% and positive predictive value of 50.0%. Early warning under the multi-dimensional and multi-scale comprehensive information surveillance mode was able to transform the work pattern of nosocomial infection outbreaks control and management from passive to active. Particularly it has advantages in early detection for occult outbreaks, providing a valuable support for improving nosocomial infection management capability.

Objective To explore the polymorphism and distribution of apolipoprotein E(ApoE)gene in patients with hyperlipidemia.Methods A total of 370 hyperlipidemia patients diagnosed at Hangzhou Ninth People's Hospital from October 2023 to June 2024 were selected.Gene polymorphism was detected in the blood samples of the patients using fluorescence polymerase chain reaction,and the distribution of gene polymorphism among different genders and age groups within this population was compared.Results ①The polymorphism distribution of the two genetic loci(ApoE 388T＞C and ApoE 526C＞T)in the studied sample population conforms to Hardy-Weinberg equilibrium,indicating that it is representative of the population;②Among the 370 patients,the distribution of the ApoE gene was as follows:E3/E3(66.49％),E3/E4(20.27％),E2/E3(8.65％),E2/E4(1.89％),E2/E2(1.35％),and E4/E4(1.35％).The proportion of the patient population carrying the E4 allele was about 1.88 times higher than that of those carrying the E2 allele;③The distribution differences of ApoE gene polymorphism were not related to the patients'gender and age(P＞0.05).Conclusion The distribution of ApoE gene polymorphism among hyperlipidemia patients at a hospital in Hangzhou is uneven and is not related to gender or age groups.Therefore,it is recommended to prioritize the detection of ApoE gene in patients before using statin medications to assess treatment effectiveness.

Objective:To understand the psychological experience of tumor radiotherapy patients after participating in acceptance and commitment therapy (ACT), and to provide reference and supplement for the development of ACT psychological intervention plans for tumor radiotherapy patients.Methods:This study was a qualitative study. Using the purposive sampling method, a total of 17 tumor radiotherapy patients treated at Shanghai Proton and Heavy Ion Center from January to March 2023 were selected as the research objects. Phenomenological research method was used to conduct semi-structured in-depth interviews with patients, and the interview data were analyzed by Colaizzi 7-step analysis method.Results:Three themes were extracted, namely, positive physical and mental experience (including improving physical symptoms, relieving negative emotions and cooperating with particle therapy), gaining personal growth (including learning flexible and varied psychological coping strategies, gaining mutual help and friendship, feeling valuable family affection and drawing a better future life) and recommendations for optimizing the ACT intervention program (including building teams according to the patients' conditions, increasing the frequency of activities, trying to experience relief exercises outdoors and increasing the continuity of the intervention program) .Conclusions:ACT can help cancer radiotherapy patients improve their physical and mental health, cope with psychological problems, so that patients can face the disease, treatment and life more positively.

Objective:To explore the effect of supportive-expressive group psychological intervention on the fear of recurrence in cancer patients receiving radiotherapy.Methods:From September 2022 to February 2023, convenience sampling was used to select 72 tumor inpatients from Shanghai Proton and Heavy Ion Center. According to the random number table method, patients were divided into an intervention group and a control group, with 36 cases in each group. The control group received routine nursing, while the intervention group carried out supportive-expressive group psychological intervention. The fear of recurrence, meaning in life, and perceived social support scores of two groups of patients before and after intervention were compared using the Fear of Progression Questionnaire-Short Form (FoP-Q-SF), Cancer-Meaning in Life Scale (C-MiLS), and Perceived Social Support Scale (PSSS) .Results:A total of 7 cases were lost, with 33 cases in the intervention group and 32 cases in the control group completing the study. Before intervention, there was no statistically significant difference in the general information, fear of recurrence, meaning in life, and perceived social support scores between the two groups of patients ( P>0.05). After supportive-expressive group psychological intervention, the total score of cancer recurrence fear, physical health dimension, and social family dimension scores of the intervention group were (30.42±8.31), (15.58±4.12), and (14.82±4.83), respectively, which were lower than the control group's (36.19±5.64), (18.84±3.48), and (17.09±3.27), and the differences were statistically significant ( t=-3.260, -3.446, and -2.216; P<0.05). After intervention, the total score of the intervention group's meaning in life was (63.42±6.37), which was higher than the control group's (54.91±6.53), and the difference was statistically significant ( t=5.325, P<0.05). After intervention, the perceived social support score of the intervention group was (67.64±7.93), which was higher than the control group's (62.38±10.25), and the difference was statistically significant ( t=2.318, P<0.05). After intervention, the level of fear of recurrence in the intervention group was lower than that before intervention, and the level of meaning in life and perceived social support were higher than those before intervention, with statistical differences ( P<0.05) . Conclusions:Support-expressive group psychological intervention can help cancer patients deal with survival, emotional, and interpersonal issues they face, reduce their fear of recurrence, improve their meaning in life, and perceived social support.