Objective To retrospectively evaluate the value of SPECT/CT imaging for follow-up of bone metastases.Methods A total of 178 patients with bone metastases (387 lesions) underwent 2 or more events of whole-body bone scintigraphy (WBS) and SPECT/CT imaging.Sequential images were analyzed by 2 experienced,nuclear medicine physicians.Each lesion was interpreted as progressive,remissive or stable in WBS or SPECT/CT independently.Reasons for the discordance between WBS and SPECT/CT results were analyzed.The results of clinical follow-up,including clinical symptoms,tumor markers,serum ALP,radiograph,CT and MRI,were likewise classified as progressive,remissive or stable.The x2 test was used to compare the differences between the two imaging methods.Results The follow-up results of the two imaging methods were consistent in 313 (80.88％,313/387) lesions,including 208 in progression and 105 in remission or stable condition.Among the 74(19.12％,74/387) lesions showing discordance,48 showed remission or stable conditions on WBS but progression on SPECT/CT (64.86％,48/74) ; while 26 showed progression on WBS but remission or stable condition on SPECT/CT (35.14％,26/74).There was a statistically significant difference of the follow-up results between WBS and SPECT/CT (x2 =6.54,P ＜0.05).Conclusion SPECT/CT is more valuable than WBS for follow-up of bone metastases.

Objective To develop a new strategy for preparing large-area full-thickness skin grafts with donor incisions small enough to allow direct suture under low pressure.Methods A geometrical analysis was carried out to design the best strategy to obtain skin grafts with minimal donor defect.In this strategy,two semicircular donor skin grafts are subjected to a malpositioned joining to form a circle which is equal in size to the large-area skin defect.Seven patients with cutaneous malignancy were managed by this operation regimen,including three cases of basal cell carcinoma,three cases of squamous cell carcinoma,and one case of malignant melanoma.Tumors were located in the face or head in five patients,and in feet in two patients.Results The width of donor incisions was significantly reduced by this strategy,and donor defects were sutured directly with the minimal loss of donor graft.Of the five patients with malignancies of the head or face,three achieved complete survival of skin grafts,two experienced mild erosion at the margin of skin grafts.A 10％-20％ necrosis of skin graft was observed in the sole of feet in 2 patients,which healed 1-2 months after dressing changes.Conclusion Joined grafts of equal size may be an effective approach to the repair of large skin defect.

Objective:To analyze clinical features of 78 infants with scabies and their causes of misdiagnosis.Methods:A retrospective analysis was performed on infants aged < 6 months with confirmed scabies at Department of Dermatology in Zhengzhou Children′s Hospital, Jingjiang People′s Hospital, Tangdu Hospital of the Fourth Military Medical University, Second Affiliated Hospital of Soochow University and Henan Provincial People′s Hospital from January 1, 2016 to December 31, 2018. Then, epidemiological features, skin lesion characteristics, treatment and causes of misdiagnosis of infantile scabies were analyzed.Results:A total of 78 infants with scabies were collected. Their age of onset and duration from onset to diagnosis [ M ( P25, P75) ] were 8.5 (7, 12) and 4 (3.5, 5) weeks respectively. At the time of diagnosis, 45 (57.7%) patients showed lower body weight than the first quartile [ P25] of body weight of age- and gender-matched healthy peers, 40 (47.4%) had fussiness and irritation, and 68 (87.2%) had sleep disorders like night crying and increased frequency of night waking. Infantile scabies more frequently occurred in autumn (30 cases [38.5%]) and winter (22 cases [28.2%]) , and least frequently occurred in summer (8 cases [10.3%]) . In the case of 58 patients, there was at least 1 member with scabies at the same time, who had resided with the patients in their families for a long time; in the case of 12 patients, scabies was transmitted through previous contact with temporary residents with scabies in their families. Scabies lesions most commonly occurred on the chest and abdominal regions (80.8%) , followed by the limbs (76.9%) ; skin lesions were polymorphic, and lesions at different stages could coexist; the rashes mainly manifested as edematous red or non-edematous brown papules, blisters, papulovesicles and nodules, and some burrows could be characterized by an oval, linear, serpiginous, comma- or J-shaped appearance. All the patients had visited the clinic for 1 - 4 times with an average of 2.38 visits. Forty-eight (61.5%) patients initially visited non-dermatology departments, and 30 (38.5%) initially visited dermatological outpatient clinics. Incorrect diagnoses included infantile eczema, papular urticaria, impetigo, miliaria, prurigo, urticaria pigmentosa, infantile acropustulosis, herpes simplex and varicella. All the patients received topical sulfur 5% ointment. Nine (11.5%) patients experienced a sudden exacerbation of skin lesions after the topical treatment, and 20 (25.6%) needed 2 - 3 sessions of treatment. No recurrence was observed in all the patients at 2, 4 and 8 weeks after the end of treatment. Conclusions:Infantile scabies lesions are polymorphic, widely distributed, and easily misdiagnosed. To prevent misdiagnosis and improve the early diagnosis rate, a detailed clinical interrogation with clinical-epidemiological examination should be performed.

Background::Triple-negative breast cancer (TNBC) is an aggressive type of breast cancer associated with poor prognosis and limited treatment options. The androgen receptor (AR) has emerged as a potential therapeutic target for luminal androgen receptor (LAR) TNBC. However, multiple studies have claimed that anti-androgen therapy for AR-positive TNBC only has limited clinical benefits. This study aimed to investigate the role of AR in TNBC and its detailed mechanism.Methods::Immunohistochemistry and TNBC tissue sections were applied to investigate AR and nectin cell adhesion molecule 4 (NECTIN4) expression in TNBC tissues. Then, in vitro and in vivo assays were used to explore the function of AR and estrogen receptor beta (ERβ) in TNBC. Chromatin immunoprecipitation sequencing (ChIP-seq), co-immunoprecipitation (co-IP), molecular docking method, and luciferase reporter assay were performed to identify key molecules that affect the function of AR. Results::Based on the TNBC tissue array analysis, we revealed that ERβ and AR were positive in 21.92% (32/146) and 24.66% (36/146) of 146 TNBC samples, respectively, and about 13.70% (20/146) of TNBC patients were ERβ positive and AR positive. We further demonstrated the pro-tumoral effects of AR on TNBC cells, however, the oncogenic biology was significantly suppressed when ERβ transfection in LAR TNBC cell lines but not in AR-negative TNBC. Mechanistically, we identified that NECTIN4 promoter –42 bp to –28 bp was an AR response element, and that ERβ interacted with AR thus impeding the AR-mediated NECTIN4 transcription which promoted epithelial–mesenchymal transition in tumor progression. Conclusions::This study suggests that ERβ functions as a suppressor mediating the effect of AR in TNBC prognosis and cell proliferation. Therefore, our current research facilitates a better understanding of the role and mechanisms of AR in TNBC carcinogenesis.

Objective:To investigate the relationship between family functioning and self-injurious behavior among primary school children, as well as the effects of teacher-student relationship and friendship quality.Methods:A questionnaire survey was conducted with 1 033 primary school children from grade four to six in Hunan province from March to April 2024, using the family APGAR index scale, the deliberate self-injury inventory, the teacher-student relationship subscale of the my class questionnaire, and the friendship quality questionnaire. Data were analyzed using SPSS 26.0 software for normality tests, descriptive statistics, chi-square tests, and Pearson correlation analyses. Confirmatory factor analysis was performed with AMOS 24.0, and moderated mediating effects were examined using the PROCESS 3.5 macro program.Results:(1) The prevalence of self-injurious behavior among the sampled children was 37.4% (359/958), with no significant gender difference ( χ2=0.01, P>0.05). However, the detection rate among grades was significantly different ( χ2=8.25, P<0.05, Cramer's V=0.09). (2) Self-injurious behavior was negatively correlated with family functioning, teacher-student relationship, and friendship quality ( r=-0.29, -0.25, -0.18, P<0.01). Among family functioning, teacher-student relationship and friendship quality, there was positive correlations between each other ( r=0.33-0.40, all P<0.01). (3) Teacher-student relationship partially mediated the relationship between family functioning and self-injurious behavior, with the mediating effect value accounting for 20%(-0.06/-0.30) of the total effect. (4) Friendship quality moderated the first stage of the mediating effect of teacher-student relationship on the relationship between family functioning and self-injurious behavior ( β=0.08, P<0.01). When children's friendship quality was higher, the predictive effect of family functioning on teacher-student relationship was significantly strengthened ( βsimple=0.30, P<0.001, 95% CI=0.21~0.38). Conclusion:Effective family functioning promotes positive teacher-student relationship in children, thereby reducing the risk of self-injurious behavior. This effect is notably stronger among children with higher-quality friendships.

Objective:To explore the effect of situational simulation interactive training on rehabilitation compliance and motor function of stroke patients with hemiplegia.Methods:A total of 140 hemiplegic patients with stroke from July 2017 to October 2019 in Beijing Rehabilitation Hospital Affiliated to Capital Medical University were selected and divided into control group and observation group, 70 cases in each group. Routine treatment and rehabilitation nursing were used in the control group, and situational simulation interactive training were used in the observation group on the basis of the control group. Both groups were followed up for 6 months. Fugl-Meyer Assessment (FMA), World Health Organization Quality of Life Scale Brief (WHOQOL-BREF), Fugl-Meyer Assessment (FMA), self-made rehabilitation training compliance questionnaire and self-made nursing satisfaction questionnaire were used to evaluate the quality of life, motor ability, cognitive ability before intervention and after follow-up, rehabilitation compliance and nursing satisfaction after follow-up of the two groups.Results:There was no significant difference in FMA, WHOQOL-BREF and MMSE scores between the two groups before intervention ( P>0.05). After follow-up, the scores of FMA, WHOQOL-BREF and MMSE in the observation group were 62.57±6.52, 80.65±9.25, 25.30±3.24, significantly higher than 52.68±7.23, 66.68±8.34, 20.36±3.12 in the control group, the difference was statistically significant ( t value was 8.499, 9.385,9.189, P<0.05). After follow-up, the total compliance rate and satisfaction rate of the observation group were 92.86% (65/70) and 94.29% (66/70), respectively, while those of the control group were 78.57% (55/70) and 80.00% (56/70), respectively, the difference between the two groups was statistically significant (Fisher's exact test, P<0.05). Conclusions:The situation simulation rehabilitation training can effectively improve the motor function, rehabilitation compliance and nursing satisfaction of stroke patients with hemiplegia.

Objective:To explore any effect of intermittent theta burst stimulation (iTBS) and of different sequencing of rehabilitation training on upper limb dysfunction after a stroke.Methods:Thirty-six patients with upper limb motor dysfunction after subacute subcortical cerebral infarction were divided at random into a control group, an experimental group 1, and an experimental group 2, each of 12. The control group was given prosthetic stimulation and upper limb function rehabilitation training. Experimental group l received focal iTBS stimulation on M1 immediately followed by upper limb rehabilitation training. Experimental group 2 received the same treatment but in reverse order. The experiment lasted four weeks. Upper limb functioning and ability in the activities of daily living (ADL) were quantified before and after the interventions using the Fugl-Meyer upper extremity assessment (FMA-UE) and the modified Barthel index (MBI). Cortical latency (CL) was also recorded.Results:Before the treatment there were no significant differences among the three groups, but afterward a significant increase was observed in the average FMA-UE and MBI scores of both experimental groups accompanied by a significant decrease in CL. There was no significant difference between the two experimental groups′ results, on average.Conclusion:Supplementing upper limb rehabilitation training with iTBS can significantly improve the upper limb functioning of ischemic stroke survivors, and the sequencing of the training has no effect on the therapeutic results.

{L-End}Objective To analyze the effects of night shift work and overweight/obesity on blood pressure of workers in chemical fiber industry. {L-End}Methods A total of 1 004 workers of a chemical fiber factory were selected as the study subjects using convenient sampling method, and their blood pressure and body mass index were measured. Multiple linear regression model was used to analyze the relationship between night shift work and blood pressure, and multiple logistic regression was used to assess the independent impact and combined impact of night shifts and overweight/obesity on the risk of hypertension. {L-End}Results Compared with the non-night shift workers, the prevalence of hypertension in night shift workers was increased (5.3% vs 13.0%, P<0.05), with elevated systolic and diastolic blood pressure (both P<0.05). The results of multiple linear regression analysis showed that the systolic blood pressure and diastolic blood pressure of the night shift workers were higher than those of the non-night shift workers (both P<0.05), and the systolic blood pressure and diastolic blood pressure of overweight/obesity workers were higher than those of non-overweight/obesity workers (both P<0.01). The results of multiple logistic regression analysis showed that the risk of hypertension in night shift workers and overweight/obesity workers was higher than that in non-night shift workers and non-overweight/obesity workers [odds ratio (OR) and 95% confidence interval (CI) were 2.49 (1.04-5.99) and 2.65 (1.77-3.95), both P<0.05]. Night shift work and overweight/obesity showed a synergistic effect on blood pressure of workers. Compared to non-overweight/obesity non-night shift workers, overweight/obesity night shift workers had a higher risk of hypertension (OR=4.93, 95%CI: 1.70-14.29, P<0.01). {L-End}Conclusion Night shift work could lead to elevated blood pressure in workers in the chemical fiber industry, which is a potential risk factor for hypertension. The synergistic effect of night shift work and overweight/obesity may contribute to the increased risk of hypertension.

Background and objective The pathological types of lung ground glass nodules(GGNs)show great significance to the clinical treatment.This study was aimed to predict pathological types of GGNs based on computed tomog-raphy(CT)quantitative parameters.Methods 389 GGNs confirmed by postoperative pathology were selected,including 138 cases of precursor glandular lesions[atypical adenomatous hyperplasia(AAH)and adenocarcinoma in situ(AIS)],109 cases of microinvasive adenocarcinoma(MIA)and 142 cases of invasive adenocarcinoma(IAC).The morphological characteristics of nodules were evaluated subjectively by radiologist,as well as artificial intelligence(AI).Results In the subjective CT signs,the maximum diameter of nodule and the frequency of spiculation,lobulation and pleural traction increased from AAH+AIS,MIA to IAC.In the AI quantitative parameters,parameters related to size and CT value,proportion of solid component,energy and entropy increased from AAH+AIS,MIA to IAC.There was no significant difference between AI quantitative parameters and the subjective CT signs for distinguishing the pathological types of GGNs.Conclusion AI quantitative parameters were valu-able in distinguishing the pathological types of GGNs.

Background::Cancer immunotherapy has emerged as a promising strategy against triple-negative breast cancer (TNBC). One of the immunosuppressive pathways involves programmed cell death-1 (PD-1) and programmed cell death ligand-1 (PD-L1), but many patients derived little benefit from PD-1/PD-L1 checkpoint blockades treatment. Prior research has shown that MYC, a master transcription amplifier highly expressed in TNBC cells, can regulate the tumor immune microenvironment and constrain the efficacy of immunotherapy. This study aims to investigate the regulatory relationship between MYC and PD-L1, and whether a cyclin-dependent kinase (CDK) inhibitor that inhibits MYC expression in combination with anti-PD-L1 antibodies can enhance the response to immunotherapy. Methods::Public databases and TNBC tissue microarrays were used to study the correlation between MYC and PD-L1. The expression of MYC and PD-L1 in TNBCs was examined by quantitative real-time polymerase chain reaction and Western blotting. A patient-derived tumor xenograft (PDTX) model was used to evaluate the influence of a CDK7 inhibitor THZ1 on PD-L1 expression. Cell proliferation and migration were detected by 5-ethynyl-2′-deoxyuridine (EdU) cell proliferation and cell migration assays. Tumor xenograft models were established for in vivo verification. Results::A high MYC expression level was associated with a poor prognosis and could alter the proportion of tumor-infiltrating immune cells (TIICs). The positive correlation between MYC and PD-L1 was confirmed by immunostaining samples from 165 TNBC patients. Suppression of MYC in TNBC caused a reduction in the levels of both PD-L1 messenger RNA and protein. In addition, antitumor immune response was enhanced in the TNBC cancer xenograft mouse model with suppression of MYC by CDK7 inhibitor THZ1. Conclusions::The combined therapy of CDK7 inhibitor THZ1 and anti-PD-L1 antibody appeared to have a synergistic effect, which might offer new insight for enhancing immunotherapy in TNBC.