Objective To propose a new diagnostic criterion for rosacea based on the analysis of clinical features of rosacea in a large sample.Methods A total of 1 090 Chinese outpatients with rosacea were enrolled from Department of Dermatology of Xiangya Hospital,and their demographic data,clinical manifestations and subjective symptoms were collected.According to results of descriptive analysis,clinical features of rosacea were summarized,and a new diagnostic criterion for rosacea was set up.Then,the sensitivity and specificity of the new diagnostic criterion were verified among 1 200 outpatients clinically characterized by facial erythema.Results Of 1 090 patients with rosacea,131 (12.0％) were male and 959(88.0％) were female,and the average age was 33.5 ± 11.1 years (range,10-66).Among the 1 090 patients,715 (65.6％) had initial lesions on the cheek,of whom,712 (99.6％) had intermittent flushing as the initial symptom,and 689 (96％) had sensitive skin symptoms such as dryness,burning and itching sensations;208 (19.1％) had initial lesions on the perioral region,of whom,204 (98.1％) had persistent erythema as the initial symptom;167 (15.3％) had initial lesions on the nose,of whom,163 (97.6％) had persistent erythema as the initial symptom;in addition,311 (28.5％) had lesions on the ocular region,and only 24 (2.2％) had lesions outside the face on the neck and retroauricular region.Based on these clinical features,a new diagnostic criterion for rosacea was proposed,including 1 major condition (intermittent flushing or persistent erythema on the cheek,perioral region or nose) and 5 minor conditions (1.sensitive skin symptoms such as burning,tingling,drying or itching sensations;2.telangiectasia;3.papules or pustules;4.hypertrophy;5.ocular symptoms).If with the major condition and at least one minor condition were met,patients could be diagnosed with rosacea.After verification among 1 200 patients with facial dermatitis clinically characterized by facial erythema,the new criterion was proved to have a sensitivity of 99.3％ and a specificity of 95.8％.Conclusion A new diagnostic criterion for rosacea with high sensitivity and specificity is proposed,which is worthy of clinical application.

With its excellent biocompatibility,good biomechanics and biodegradability,magnesium zinc alloy has been widely used in biomaterials,and its antineoplastic effect has attracted more and more attention recently.Osteosarcoma is the most common primary malignant bone tumor.With the improvement of the diagnosis and treatment,the rate of 5-year survival has been greatly improved,which is nearly 60％ ～ 70％.However,local recurrence and metastasis after operation are still main risk factors on the survival quality and clinical function of patients.This paper reviews previous researches concerned the antineoplastic effect about magnesium,zinc and its alloys,and summarized the anti-tumor mechanism of magnesium,zinc and its alloys,and its research value in the field of osteosarcoma.

Objective To compare the clinical efficacy and safety of invasive microneedle radiofrequency versus plasma fractional radiofrequency in the treatment of atrophic facial acne scars.Methods A total of 30 patients with atrophic acne scars were enrolled from the Department of Dermatology of Xiangya Hospital affiliated to Central South University between January 2017 and March 2017.By a random number table,every patient randomly received the treatment with invasive microneedle radiofrequency on one half of the face and plasma fractional radiofrequency on the other facial side once every 8-12 weeks for 3 sessions.Before and after each treatment,facial photos were taken,acne scars were scored by the ECCA grading scale (échelle d'évaluation clinique des cicatrices d'acné),and improvement rates of these lesions were evaluated subjectively by doctors.Adverse reactions were recorded after treatment,and the degree of pain and satisfaction was evaluated by the patients themselves.The Germany CK physiological index detector was used to detect the skin moisture content,transepidermal water loss (TEWL) and sebum content.Results All of the 30 patients completed 3 sessions of treatment and follow-up.After the 3 sessions of treatment,the average score on invasive microneedle radiofrequency-treated sides was 3.00 ± 0.91,and 22 patients achieved more than 50％ improvement.However,the average score on plasma fractional radiofrequency-treated sides was 3.57 ± 0.57,and 29 patients achieved more than 50％ improvement.The overall therapeutic effect of plasma fractional radiofrequency was significantly superior tothat of invasive microneedle radiofrequency (t =2.894,P =0.005).For V-shaped and U-shaped scars,there was no significant difference in the overall improvement rate between the invasive microneedle radiofrequency-treated side and plasma fractional radiofrequency-treated side (both P ＞ 0.05).For Mshaped rolling scars,the overall improvement rate was significantly lower on the invasive microneedle radiofrequency-treated side (36.5％ ± 2.1％) than on the plasma fractional radiofrequency-treated side (48.7％ ± 3.4％,P ＜ 0.01).However,the pain score was significantly lower on the invasive microneedle radiofrequency-treated side (5.54 ± 0.57) than on the plasma fractional radiofrequency-treated side (8.07 ± 0.79,P ＜ 0.01).After 3 sessions of treatment,there were no significant differences in the degree of patient satisfaction (x2 =0.10,P ＞ 0.05),skin moisture content (P ＞ 0.05),TEWL (P ＞ 0.05) or sebum content (P ＞ 0.05) between the 2 sides.Adverse reactions such as erythema,exudation and hemorrhage occurred on both of the 2 sides.Conclusions For small V-shaped and U-shaped scars,the plasma fractional radiofrequency and invasive microneedle radiofrequency both can be applied in clinic.For large M-shaped rolling scars,the plasma fractional radiofrequency can be preferentially selected.

Objective:To compare the clinical efficacy and safety of intra-articular platelet rich plasma combined with hyaluronic acid and platelet rich plasma alone in the treatment of knee osteoarthritis.Methods:The relevant literatures published between January 2010 and December 2021 on the randomized control study of intra-articular injection of platelet rich plasma and hyaluronic acid and injection of platelet rich plasma only in the treatment of knee osteoarthritis were searched. The bias risk of all the literatures included in the study was evaluated by Revman 5.3 software, and the data were processed and analyzed by Stata 16.0 software. The standardized mean difference ( SMD) was calculated for the difference of efficacy indexes, and the difference was compared by t- test. The odds ratio ( OR) was calculated for the difference of safety in-dex, and the difference was compared by t- test. Results:①A total of 7 relevant research literatures were in-cluded, all of which were in English. ②A total of 675 patients were included in the study, of which 330 patients were treated with intra-articular injection of platelet rich plasma and hyaluronic acid, and 345 patients were treated with intra-articular injection of platelet rich plasma only. ③The VAS scores of patients with platelet rich plasma and hyaluronic acid injection combined with injection and platelet rich plasma injection alone were compared. After 1 and 3 months of injection, the VAS scores of patients with platelet rich plasma combined with hyaluronic acid injection were compared with those of patients with platelet rich plasma injection only. There was no significant difference[ SMD(95% CI)=-0.02(-0.30, 0.27), t=-0.12, P=0.902; SMD(95% CI)=-0.40(-0.80, 0.00), t=-1.97, P=0.051]. After 6 months of injection, the VAS scores of patients with combined injection of platelet rich plasma and hyaluronic acid were significantly lower than those of patients with injection of platelet rich plasma only, and the difference was statistically significant [ SMD(95% CI)=-0.33 (-0.55, -0.11), t=-2.98, P=0.012]. ④The WOMAC scores of patients with combined injection of platelet rich plasma, hyaluronic acid and platelet rich plasma only were compared. After 12 months of treatment, the WOMAC scores of patients with combined injection of platelet rich plasma and hyaluronic acid were significantly higher than those of patients with PRP only, and the difference was statistically significant [ SMD(95% CI)=-0.30(-0.58, -0.03), t=-2.14, P=0.033]. ⑤The incidence of adverse events of platelet rich plasma combined with hyaluronic acid was lower than that of platelet rich plasma only [ OR(95% CI)=0.55(0.33, 0.93), P=0.021]. Conclusion:Compared with intra-articular injection of platelet rich plasma only, the short-term clinical efficacy of combined injection of platelet rich plasma and hyaluronic acid is equivalent to that of injection of platelet rich plasma only, but the long-term clinical efficacy is significantly better, and the safety of combined injection of platelet rich plasma and hyaluronic acid is significantly better.

Objective:To investigate the prognosis of robotic pancreatoduodenectomy after the learning curve and open pancreatoduodenectomy for pancreatic cancer.Methods:The propensity score matching and retrospective cohort study was conducted. The clinicopathological data of 396 patients who underwent curative pancreatoduodenectomy for pancreatic duct adenocar-cinoma in Ruijin Hospital of Shanghai Jiaotong University School of Medicine from January 2017 to December 2018 were collected. There were 244 males and 152 females, aged 64(range, 36?92)years. Of 396 patients, 86 cases undergoing robotic pancreatoduodenectomy were divided into robotic group, 310 cases undergoing open pancreatoduodenectomy were divided into open group. Observa-tion indicators: (1) propensity score matching and comparison of general data between the two groups after matching; (2) follow-up and survival analysis. Follow-up was conducted by telephone interview or outpatient examinations including tumor markers and abdominal imaging examina-tions to detect survival of patients up to March 2022. Overall survival was defined as the time from the surgery date to death or the last follow-up. Disease-free survival was defined as the time from the surgery date to tumor recurrence or the last follow-up. The propensity score matching was conducted by 1∶1 matching using the nearest neighbor method. Normality of measurement data was examined using the Shapiro-Wilk test. Measurement data with skewed distribution were described as M(range), and comparison between groups was analyzed using the Mann-Whitney rank-sum test. Count data were represented as absolute numbers, and comparison between groups was analyzed using the chi-square test. Kaplan-Meier method was used to calculate survival rates and draw survival curves, and Log-Rank test was used for survival analysis. An intent-to-treat analysis was performed in this study, patients who were converted to laparotomy from robotic surgery were still divided into the robotic group. Results:(1) Propensity score matching and comparison of general data between the two groups after matching: 164 of 396 patients had successful matching, including 82 cases in robotic group and open group, respectively. Before propensity score matching, the body mass index, cases in stage T1, T2, T3, T4, cases in N0, N1, N2 were 23.4(range, 21.4?25.3)kg/m 2,24, 41, 10, 11, 52, 27, 7 for the robotic group, versus 22.4(range,20.3?23.9)kg/m 2,57, 144, 22, 87, 131, 132, 47 for the open group, showing significant differences in the above indicators between the two groups ( Z=3.01, 2.63, 3.03, P<0.05). After propensity score matching, cases of males, age, body mass index, cases with American Society of Anesthesiologists (ASA) score as 1, 2, 3, CA19-9, cases with preoperative biliary drainage, cases with portal vein resection, cases with pancreatic resection margin <1 mm, cases in stage T1, T2, T3, T4, cases in stage N0, N1, N2, cases with nerve invasion, cases with tumor differentiation as high-medium differentiation, medium-low differentiation, low differentiation, cases with adjuvant chemotherapy were 51, 65(range, 59?69)years, 23.0(range, 21.0?25.2)kg/m 2, 32, 41, 9, 160.4(range, 46.7?377.2)U/mL, 21, 9, 8, 21, 40, 10, 11, 48, 27, 7, 76, 26, 47, 9, 53 for the robotic group, versus 58, 65(range, 58?69)years, 23.3(range, 21.4?25.3)kg/m 2, 35, 39, 8, 172.0(range, 69.7?402.9)U/mL, 26, 9, 10, 24, 40, 7, 11, 49, 28, 5, 76, 22, 49, 11, 57 for the open group, showing no significant difference in the above indicators between the two groups ( χ2=1.34, Z=0.18, 0.34, 0.49, 0.51, χ2=0.75, 0.00,0.25, Z=0.59, 0.27, χ2=0.00, Z=0.76, χ2=0.44, P>0.05). (2) Follow-up and survival analysis: after propensity score matching, 164 patients were followed up for 54(range, 1?67)months. The follow-up time of patients was 55(range, 51?59)months for the robotic group, versus 54(range, 50?58)months for the open group, respectively, showing no significant difference between the two groups ( Z=0.48, P>0.05). During the follow-up, the 1-year overall survival rate, 3-year overall survival rate, the median survival time, 1-year disease-free survival rate, 3-year disease-free survival rate, the median disease-free survival time, tumor recurrence rate, cases with recurrence pattern as local recurrence, liver recurrence, other distant recurrence, local and distant recurrence were 81.7%, 39.0%, 27 months(95% confidence interval as 19?33 months), 61.0%, 34.2%, 15 months(95% confidence interval as 12?18 months), 54.9%(45/82), 12, 16, 9, 8 for the robotic group. The above indicators were 79.3%, 36.0%, 24 months(95% confidence interval as 19?31 months), 59.8%, 27.5%, 15 months(95% confidence interval as 10?20 months), 58.5% (48/82), 10, 22, 6, 10 for the open group. There was no significant difference in overall survival or disease-free survival between the two groups ( χ2=0.39, 0.47, P>0.05). There was no significant difference in tumor recurrence rate or tumor recurrence site between the two groups either ( χ2=0.22, 1.86, P>0.05). Conclusion:After the learning curve, robotic pancreato-duodenectomy has non-inferior prognosis compared with open pancreatoduodenectomy.

We developed a portable non-specific low back pain measurement system EasiLBP and evaluated its performance in collecting EMG signals:during the wearer's movement without the assistance of a doctor, the collection of EMG signals by portable devices met problems such as large noise interference, difficulty in accurately calibrating the start and end points of the action interval, and imbalanced samples for feature recognition, et al. To challenge these problems, we proposed a small group-based noise removal method, a dynamic dual-threshold automatic method for identifying the start and end points of the motion interval, and a sampling method to balance group samples, respectively. Portable device and a medical EMG acquisition equipment Thought Technology FlexComp Infiniti 10 were used to perform EMG measurements on 15 patients with non-specific low back pain and 15 normal people. Clinical experiments and statistical analysis show that the portable EMG acquisition system has significant differences in EMG signal characteristics between normal people and non-specific low back pain patients, and it has good measurement consistency and accuracy with the medical EMG acquisition equipment.
Electromyography ; Humans ; Low Back Pain ; Motion ; Movement ; Pain Measurement

Objective:To study the distribution and antibiotics resistance of the main pathogens of neonatal purulent meningitis in different regions of China.Methods:A retrospective descriptive clinical epidemiological study was conducted in children with neonatal purulent meningitis which admitted to 18 tertiary hospitals in different regions of China between January 2015 to December 2019. The test results of blood and cerebrospinal fluid, and drug sensitivity test results of the main pathogens were collected. The distributions of pathogenic bacteria in children with neonatal purulent meningitis in preterm and term infants, early and late onset infants, in Zhejiang Province and other regions outside Zhejiang Province, and in Wenzhou region and other regions of Zhejiang Province were analyzed. The chi-square test was used for statistical analysis.Results:A total of 210 neonatal purulent meningitis cases were collected. The common pathogens were Escherichia coli ( E. coli)(41.4%(87/210)) and Streptococcus agalactiae ( S. agalactiae)(27.1%(57/210)). The proportion of Gram-negative bacteria in preterm infants (77.6%(45/58)) with neonatal purulent meningitis was higher than that in term infants (47.4%(72/152)), and the difference was statistically significant ( χ2=15.54, P=0.001). There were no significant differences in the constituent ratios of E. coli (36.5%(31/85) vs 44.8%(56/125)) and S. agalactiae (24.7%(21/85) vs 28.8%(36/125)) between early onset and late onset cases (both P>0.05). The most common pathogen was E. coli in different regions, with 46.7%(64/137) in Zhejiang Province and 31.5%(23/73) in other regions outside Zhejiang Province. In Zhejiang Province, S. agalactiae was detected in 49 out of 137 cases (35.8%), which was significantly higher than other regions outside Zhejiang Province (11.0%(8/73)). The proportions of Klebsiella pneumoniae, and coagulase-negative Staphylococcus in other regions outside Zhejiang Province (17.8%(13/73) and 16.4%(12/73)) were both higher than those in Zhejiang Province (2.9%(4/137) and 5.1%(7/137)). The differences were all statistically significant ( χ2=14.82, 12.26 and 7.43, respectively, all P<0.05). The proportion of Gram-positive bacteria in Wenzhou City (60.8%(31/51)) was higher than that in other regions in Zhejiang Province (38.4%(33/86)), and the difference was statistically significant ( χ2=6.46, P=0.011). E. coli was sensitive to meropenem (0/45), and 74.4%(32/43) of them were resistant to ampicillin. E. coli had different degrees of resistance to other common cephalosporins, among which, cefotaxime had the highest resistance rate of 41.8%(23/55), followed by ceftriaxone (32.4%(23/71)). S. agalactiae was sensitive to penicillin, vancomycin and linezolid. Conclusions:The composition ratios of pathogenic bacteria of neonatal purulent meningitis are different in different regions of China. The most common pathogen is E. coli, which is sensitive to meropenem, while it has different degrees of resistance to other common cephalosporins, especially to cefotaxime.

Objective:To detect the changes in the biological activity and expression of long-chain non-coding RNA-p21 (lncRNA-p21) in human lens epithelial cells HLE-B3 damage induced by hydrogen peroxide.Methods:HLE-B3 cells were divided into normal control group and hydrogen peroxide group, which were cultured in normal culture medium and culture medium containing 200 μmol/L hydrogen peroxide for 24 hours, respectively.Cell viability was determined by MTS colorimetric method.Cellular reactive oxygen species (ROS) level was detected using ROS assay kits.Cell apoptosis was tested by flow cytometry.Cell Caspase-3 activity was detected using Caspase-3 assay kit.Expressions of Bax and Bcl-2 proteins related to cell apoptosis were determined by Western Blot.Cell cycle distribution was determined by flow cytometry.Cell proliferation ability was detected by EDU proliferation assay kit.The expression of lncRNA-p21 in cells was detected by real time fluorescence quantitative polymerase chain reaction (PCR).The localization of lncRNA-p21 in cells was detected by fluorescence in situ hybridization.Results:The ROS content of cells in hydrogen peroxide group was (4.65±0.38), significantly higher than (1.00±0.01) of normal control group, and the difference was statistically significant ( t=16.66, P<0.05).Compared with the normal control group, the cell apoptosis rate was significantly increased, the activity of Caspase-3 was enhanced, and the relative expression of Bax was significantly increased in the hydrogen peroxide group, with statistically significant differences ( t=20.69, 39.80, 12.73, all at P<0.05).Compared with the normal control group, the proportion of G2 phase cells in the hydrogen peroxide group significantly increased, showing a statistically significant difference ( t=23.10, P<0.05).The EDU-positive cell rate of hydrogen peroxide group was (25.41±6.99)%, significantly lower than (50.58±9.15)% of normal control group ( t=6.559, P<0.05).The relative expression level of lncRNA-p21 in the hydrogen peroxide group was 2.36±0.29, significantly higher than 1.02±0.02 in the normal control group ( t=7.893, P<0.05).The fluorescence in situ hybridization experiments indicate that lncRNA-p21 was localized in the cytoplasm. Conclusions:In the oxidative stress model induced by hydrogen peroxide, the proliferation ability of lens epithelial cells significantly decreases, the apoptosis level significantly increases, and the expression levels of ROS and lncRNA-p21 enhances.lncRNA-p21 may be involved in the oxidative stress injury process of lens epithelial cells.

The proteolysis targeting chimeras (PROTACs) technology has been rapidly developed since its birth in 2001, attracting rapidly growing attention of scientific institutes and pharmaceutical companies. At present, a variety of small molecule PROTACs have entered the clinical trial. However, as small molecule PROTACs flourish, non-small molecule PROTACs (NSM-PROTACs) such as peptide PROTACs, nucleic acid PROTACs and antibody PROTACs have also advanced considerably over recent years, exhibiting the unique characters beyond the small molecule PROTACs. Here, we briefly introduce the types of NSM-PROTACs, describe the advantages of NSM-PROTACs, and summarize the development of NSM-PROTACs so far in detail. We hope this article could not only provide useful insights into NSM-PROTACs, but also expand the research interest of NSM-PROTACs.