Objective:To prepare Dermatophagoides farinae (Der f) crude protein to establish BALB/c bronchial asthma model , and to observe the morphology and degranulation of mast cells and detect related cytokines .Methods: Dermatophagoides farinae ( Der f) crude protein were prepared by trituration .30 BALB/c mice were randomly divided into 3 groups:PBS control group (A), asthma model group (B) and Der f crude protein treatment group (C).Group A were treated with PBS(100 μl) all the time, group B and group C were treated with 50 μg Der f crude protein mixed with 50μl alum adjuvant on day 0,day 7 and day 14.On day 28 group A and B were subcutaneous injected with PBS (100 μl) and group C were subcutaneous injected with Der f crude protein (350μg) in PBS(100 μl) at 1-day intervals.One week after the last treatment ,group A,B and C were intranasally challenged with 50 μg Der f crude protein daily for seven days .Twenty-four hours after the last challenge , airway hyper-responsiveness ( AHR) was assessed by using whole-body plethysmography .Two days post challenged , mice were sacrificed and bronchoalveolar lavage fluid ( BALF) was collected.Number of the total cells and eosinophil was determined .Level of IL-4,IL-10 and IFN-γcytokines in the BALF and the su-pernatant of splenocyte culture was assayed by ELISA .Level of Der f specific IgE and histamine in the sera was determined by ELISA . Airway inflammation was analyzed by HE staining .Observation of the morphology and degranulation of mast cells was analyzed by tolui -dine blue staining.Results:Compared with group B,AHR and the lung inflammation in group C were greatly reduced (P<0.01). Numbers of total cells and eosinophils in BALF of group C were significantly lower than that of group B ( P<0.01 ) .Compared with group B, the observation of degranulation of mast cells was insignificant in group C .Compared with group B(IgE:1.905), the level of specific IgE was significantly lower in groups C (IgE:1.278)(P<0.01).The level of IL-4 in BALF of group C was significantly lower than that of group B(P<0.01).Compared with group A and B, the level of IL-10 in BALF was significantly higher in group C (P<0.01) and the level of IFN-γin BALF of group C was significantly higher than that of group A and B (P<0.01).Compared with group B, the level of IL-4 in cultured splenocytes was significantly lower in group C (P<0.01), and the level of IL-10 and IFN-γin cultured splenocytes of group C was significantly higher than that of group B (P<0.01).Compared with group B, the level of histamine in BALF was slightly lower in groups C (P<0.05), and the level of histamine in sera was significantly lower in groups C (P<0.05). Conclusion:The degranulation of mast cells of murine bronchial asthma model was suppressed after the desensitization therapy .

Objective To investigate the diagnostic value of MR diffusion tensor imaging (DTI) and diffusion tensor fiber bundle imaging (DTT) in white matter injury of cerebral infarction in different periods, and to observe the damage of white matter fiber bundles. Methods Four adult male rhesus monkeys, aging 8. 0 ± 1. 5 years old and weighted 9. 6 ± 1. 2 kg were experimented. Middle cerebral artery (Ml segment) embolization-reperfusion model was prepared by rhesus monkey autologous thrombosis and recanalization with recombinant tissue plasminogen activator 2. 5 h after embolization. Routine magnetic resonance imaging (MRI), diffusion weighted imaging (DWI) and DTI were performed at 4 h, 7 d and 30 d after surgery, respectively. The anisotropic coefficient (FA) values and changes of the white matter fiber bundles in corresponding parts of cerebral white matter between the infarcted side and the healthy side were compared. Results FA and the number of fiber bundles in the infarct side showed a trend of decrease on day 7 and increase on day 30 after ischemia, and the difference was statistically significant (At 4 h, 7 d and 30 d after cerebral ischemia, FA was 0. 301 ± 0. 045, 0. 200 ± 0. 050 and 0. 305 ± 0. 026, respectively: The number of fiber bundles was 43. 0 ± 1. 6, 22. 8 ±11.0 and 31.3 ± 6. 4, respectively. F values were 8. 223 and 7. 861, respectively; all P <0. 05). At different time points after cerebral ischemia, FA and the number of fiber bundles in the frontal lobe and cerebellum of the infarcted side showed no statistical difference compared with the corresponding parts of the opposite side of the white matter (all P > 0. 05). Conclusion DTI and DTT can better evaluate the degree of white matter fiber bundle injury in cerebral infarction at different stages, which is of great value in guiding clinical diagnosis and predicting prognosis.

Objective:To investigate the effects of dexmedetomidine combined with propofol on cognitive function, hemodynamics and diaphragm movement in elderly patients undergoing painless gastroenteroscopy.Methods:The clinical data of 82 patients who underwent painless gastroenteroscopy in Fuyang Minsheng Hospital from April 2021 to November 2022 were retrospectively collected, and they were divided into the control group and the observation group by anesthesia induction method, each group with 41 cases. The control group was anesthetized with propofol, and the observation group was anesthetized with dexmedetomidine and propofol. The recovery time, orientation recovery time and satisfaction of the two groups were compared; the cognitive function before anesthesia, 1, 12 h after anesthesia and 1, 7 d after anesthesia were compared; the changes of hemodynamics and diaphragm movement before anesthesia induction (T 0), 5 min after anesthesia induction (T 1) and at awakening (T 2) and adverse reactions were compared. Results:The recovery time, orientation recovery time in the observation group were shorter than those in the control group: (9.87 ± 1.52) min vs. (11.92 ± 1.74) min, (15.87 ± 2.31) min vs.(18.79 ± 2.54) min; the dosage of propofol was less than that in the control group: (200.21 ± 50.46) mg vs. (300.23 ± 60.29) mg; the satisfaction scores was higher than that in the control group: (9.54 ± 0.32) scores vs. (8.81 ± 0.47) scores, there were statistical differences ( P<0.05). The scores of Mini-Mental State Examination (MMSE) at 1 h after anesthesia and 12 h after anesthesia in the observation group were higher than those in the control group: (23.12 ± 1.86) scores vs. (20.31 ± 1.65) scores, (26.21 ± 1.43) scores vs. (24.12 ± 1.57) scores, there were statistical differences ( P<0.05). The scores of MMSE at 1, 7 d after anesthesia had no statistical differences between the two groups ( P>0.05). The levels of mean arterial pressure (MAP) and heart rate (HR) at T 1 and T 2 were decreased and the levels of MAP and HR at T 1 and T 2 in the observation group were higher than those in the control group: (76.48 ± 4.01) mmHg (1 mmHg = 0.133 kPa) vs. (72.31 ± 3.26) mmHg, (82.31 ± 3.27) mmHg vs. (77.97 ± 3.64) mmHg; (78.72 ± 2.17) bpm vs. (76.23 ± 2.35) bpm, (82.19 ± 3.08) bpm vs. (79.63 ± 2.56) bpm, there were statistical differences( P<0.05). The diaphragm thickness fraction (DTF) and diaphragmatic motion amplitude (DM) at T 1 and T 2 were decreased and the levels of DTF and DM at T 1 and T 2 in the observation group were higher than those in the control group: 0.21 ± 0.02 vs. 0.17 ± 0.03, 0.26 ± 0.03 vs. (0.22 ± 0.04); (15.67 ± 0.81) mm vs. (14.21 ± 0.77) mm, (16.72 ± 0.68) mm vs. (15.46 ± 0.82) mm, there were statistical differences ( P<0.05). The adverse reactions in the two groups had no significant difference ( P>0.05). Conclusions:The combination of dexmedetomidine and propofol has little effect on cognitive function, hemodynamics and diaphragm movement in elderly patients undergoing painless gastroenteroscopy, which can accelerate the recovery of patients and improve patient satisfaction.

Objective To investigate the efficacy and safety of 308-nm excimer laser compared to high-intensity ultraviolet radiation for the treatment of active localized vitiligo,and to observe changes in skin lesions before and after the treatment by confocal laser scanning microscopy.Methods Sixty patients with 203 skin lesions of active localized vitiligo and were enrolled into this study,and the vitiligo disease activity (VIDA) score of these patients ranged from 2 to 3.We selected more than 3 skin lesions from a same anatomical site of each patient,one of lesions served as a control and the other skin lesions (≥ 2) were randomly treated with 308-nm excimer laser (laser group) or high-intensity ultraviolet radiation (ultraviolet group).The treatment was conducted twice a week for 25 sessions,and a 3-month follow-up was performed.Results A total of 48 patients with 169 skin lesions completed the trial.The marked response rate was significantly higher in the laser group [66.15％ (43/65)] than in the ultraviolet group [44.64％ (25/56),x2 =8.28,P ＜ 0.01].The patients with a VIDA score of 2 showed a significantly higher marked response rate [67.69％(44/65)] compared with those with a VIDA score of 3 [44.64％(25/56),x2 =6.80,P ＜ 0.01].During the 3-month follow-up,no relapse was observed.Confocal laser scanning microscopy showed that the number of inflammatory cells increased at the dermal-epidermal junction of the intra-and extra-marginal lesional skin.After treatment,the number of inflammatory cells markedly decreased and returned to normal level in lesions.Conclusion Both 308-nm excimer laser and high-intensity ultraviolet radiation are effective in the treatment of active localized vitiligo,but the 308-nm excimer laser shows a more rapid onset of action and a better therapeutic effect.

Objective:To analyze the health literacy level and influencing factors of Uyghur residents in Moyu County, Xinjiang between 2018 and 2020.Methods:A total of 5 211 and 5 207 Uyghur residents in Moyu County, Xinjiang were sampled using the multi-stage cluster method in 2018 and 2020, respectively. The health culture questionnaire for ethnic minority in Xinjiang was used. The survey included general demographic characteristics, overall health literacy levels, and the three aspects of health literacy levels (health knowledge and concepts, healthy lifestyles and behaviors, and health skills) and six dimensions (scientific health concept, health information literacy, infectious disease prevention and control literacy, chronic disease prevention literacy, safety and first aid literacy, and basic medical literacy). The influencing factors of residents′ health literacy in 2020 were analyzed using χ2 test and multivariate logistic regression. Results:In 2020, overall health literacy and its three aspects among Uyghur residents in Moyu County, Xinjiang were higher than in 2018 (overall 8.10% vs 5.07%, health knowledge and concepts 9.99% vs 7.60%, healthy lifestyle and behavior 6.88% vs 5.33%, health skills 40.12% vs 30.22%) (all P<0.05). In 2018, results for the six dimensions of health literacy were, from high to low, as follows: safety and first aid literacy (26.42%), basic medical literacy (14.14%), health information literacy (13.38%), scientific health concept (10.17%), infectious disease prevention and control literacy (8.96%), chronic disease prevention and treatment literacy (5.57%); In 2020, the results, from high to low, were: safety and first aid literacy (36.09%), basic medical literacy (24.08%), health information literacy (20.47%), infectious disease prevention and treatment literacy(15.19%), scientific health concept (13.85%), and chronic disease prevention and treatment literacy (10.10%). All values were higher than in 2018 (all P<0.05). Gender, age, education level, marital status, occupation, per capita monthly household income level, and area of residence influenced health literacy levels of local residents. Conclusions:The health literacy of Uyghur residents in Moyu County, Xinjiang improved from 2018 to 2020; however, the overall level remains low. Elderly people, people with low education levels, people with low incomes, business people & staff are the key groups requiring health education. Healthy lifestyle and behavior, chronic disease prevention and treatment literacy, scientific health concept, infectious disease prevention and control literacy are identified as areas necessitating health education and health promotion intervention.

Objective To investigate the clinical effect of radiofrequency ablation (RFA) combined with non-specific sequential immunotherapy (IM) for early hepatocellular carcinoma (HCC),and analyze the factors affecting prognosis of patients after RFA.Methods The prosepctive study was conducted.The clinicopathological data of 72 early HCC patients who were admitted to the People's Hospital of Guangxi Zhuang Autonomous Region from January 2009 to October 2015 were collected.Patients were divided into 3 groups by random number table:patients in group A underwent single RFA therapy;patients in group B underwent RFA + non-specific sequential IM (1-3 times);patients in group C underwent RFA + non-specific sequential IM (≥ 4 times).RFA was performed by the same doctors team,and non-specific sequential IM planning included thymalfasin + interleukin-2 (IL-2).Observation indicators:(1) treatment situations;(2) follow-up and survival;(3) analysis of prognostic factors after RFA.Follow-up using outpatient examination was performed to detect tumor recurrence and overall survival up to December 2015.Measurement data with normal distribution were represented as (x) ± s,and comparison among groups were evaluated with the ANOVA.Comparison of count data were analyzed using the chi-square test.The curve,rate and time of tumor recurrence after treatment,overall survival curve and time were respectively drawn and calculated by the Kaplan-Meier method,and the Log-rank test was used for survival analysis.The univariate analysis and multivariate analysis were respectively done using the COX proportional hazard regression model.Results Seventy-two patients were screened for eligibility,including 31 in group A,22 in group B and 19 in group C.(1) Treatment situations:patients in 3 groups underwent RFA,and contrast enhanced ultrasound showed complete tumors ablation at 5 days postoperatively.Patients in group B and C didn't have significant adverse reactions after RFA during IM therapy.(2) Follow-up and survival:72 patients were followed up for 2-66 months after treatment,with a median time of 34 months.The 1-year tumor recurrence rates after treatment in group A,B and C were respectively 19.4％,13.6％ and 10.5％,with no statistically significant difference (x2=0.714,P＞0.05).The median tumor recurrence times in group A,B and C were respectively 24.0 months,30.0 months and 33.0 months,with no statistically significant difference (x2 =3.283,P＞0.05).The median overall survival times in group A,B and C were respectively 46.0 months,56.0 months and 57.0 months,with a statistically significant difference (x2=7.079,P＜0.05).There were statistically significant differences between group A and group B and C (x2 =4.566,4.243,P＜0.05),and no statistically significant difference between group B and group C (x2 =0.078,P＞0.05).(3) Analysis of prognostic factors after RFA:results of univariate analysis showed that initial tumor,tumor number,Barcelona clinic liver cancer (BCLC)staging and sequential IM after RFA were related factors affecting prognosis of early HCC patients [hazard ratio (HR)=2.636,2.530,0.145,0.582,95％ confidence interval (CI):1.218-5.703,1.110-5.767,0.041-0.517,0.321-0.867,P＜0.05].Results of multivariate analysis showed that tumor number ＞ 1,staging B of BCLC and without sequential IM after RFA were independent risk factors affecting prognosis of early HCC patients (HR=2.376,2.683,0.567,95％CI:1.080-5.229,1.530-21.112,0.335-0.962,P＜0.05).Conclusions The non-specific sequential IM of thymalfasin + IL-2 can prolong survival time of early HCC patients after RFA.Tumor number ＞ 1,staging B of BCLC and without sequential IM after RFA are independent risk factors affecting prognosis of early HCC patients.

Objective:To retrieve, evaluate and integrate the relevant evidence of prevention of lower limb ischemic complications in venous-arterial extracorporeal membrane oxygenation (VA-ECMO) patients, and provide reference for the development of scientific and complete prevention and management of lower limb ischemic complications.Methods:According to the evidence-based methodology, clinical decisions, guidelines, expert consensus, evidence summary, systematic review, randomized controlled trials and experimental studies related to lower limb ischemia complications in VA-ECMO patients were searched from CNKI, Wanfang, PubMed, Cochrane Library and other domestic and foreign databases as well as relevant professional websites. The literature search period was from the establishment of the database to August 2023. Two researchers independently evaluated the literature quality, and then extracted and summarized the evidence according to the theme.Results:A total of 27 004 articles were obtained in the preliminary search, and 11 articles were finally included after screening, including 1 guide, 2 expert consensus, 2 systematic reviews and 6 original studies. Through literature reading, evidence extraction and classification, and expert group meetings, a total of 24 best evidences were concluded in four dimensions, including team training and management, VA-ECMO pre-computer evaluation, VA-ECMO catheter selection, and the monitoring and management of lower limb ischemia.Conclusions:This study summarized the best evidence for the prevention of lower limb ischemia complications associated with VA-ECMO patients, and can provide reference for healthcare providers in clinical practice. In order to ensure the safety of VA-ECMO treatment and reduce the incidence of related complications, healthcare professionals should carefully select and apply evidence according to the clinical context and patients′ wishes.