Objective To investigate the impact of desmoglein 3 (Dsg3) on the proliferation of peripheral T lymphocytes from patients with pemphigus vulgaris (PV).Methods Peripheral blood mononuclear cells (PBMCs) were obtained from 12 patients with PV and 22 normal human controls,cultured with or without the presence of Dsg3 or phytohemagglutinin for 3 days.Flow cytometry was performed to detect the changes of T-lymphocyte subsets in PBMCs stimulated with Dsg3 and proliferation of T-lymphocytes.Results In patients with PV,the percentage of Th2 and Th1 cells was 12.17%±5.32% and 4.08%±1.50%,respectively in Dsg3stimulated PBMCs,9.84%±5.41% and 3.91%±1.38%,respectively in non-stimulated PBMCs.Increased percentage of Th2 cells was observed in Dsg3-stimulated and non-stimulated PBMCs from patients with PV compared with those from normal human controls (both P<0.05).After stimulation with Dsg3,there was a significant proliferation of T cells from patients,and the proliferation rate of CD4+T cells was 4.65%±3.28%,which was significantly higher than that from normal controls(P<0.05).Conclusion Dsg3 can induce the specific proliferation of CD4+T cells,especially Th2 type CD+4 T cells,from patients with PV.

Objective To investigate The Th1/Th2 and Tc1/Tc2 polarization in the peripheral blood of first degree relatives of pemphigus vulgaris(PV) and healthy control individuals, and to approach the mechanism of the Dsg3-specific autoimmunity in PV. Methods The peripheral blood mononuclear cells (PBMC) from first degree relatives and healthy control was stimulated for72 h with Dsg3 and without Dsg3. Th1/Th2, Tc1/Tc2 was assessed by four-color flow cytometry. Results The mean frequency of Dsg3-spe-cific Th2 cells for PV antibody positive first degree relatives was 10.13%±3.72%, compared with stimula-tion without antigen 7.28%±3.58%, the difference was significant (P<0.05). The percentage Dsg3-spe-cific Th2 was markedly higher in the PV antibody positive first degree relatives group than that in the control group(10.13%±3.72% vs 6.10%±2.82%, P<0.05) , Tc2 was markedly higher also (20.01%± 10.43% v514.91%±8.06%, 20.01%±10.43% vs 9.58%±5.49%, P<0.05). Conclusion When Dsg3 stimulated PBMC were used to stimulate autologous T cells an increased amount of Th2 and Tc2 was observed, it is implied that the imbalance of Th1/Th2, Tc1/Tc2 might play an important role in the initia-tion of PV.

OBJECTIVETo investigate the clinical outcome of modified Blair ankle fusion for ankle arthritis.

METHODSBetween November 2009 and June 2012, 28 patients with ankle arthritis were treated, among whom 11 had obvious foot varus deformity, and 17 were almost normal in appearance. There were 13 males and 15 females with an average age of 49.4 years (range, 23-67 years). The main symptoms included swelling, pain, and a limited range of motion of the ankles. The ankle joints functions were assessed by American Orthopedic Foot and Ankle Society (AOFAS) ankle and hindfoot score and visual analog scale (VAS) preoperatively and at 1 year follow-up.

RESULTSTwenty-eight patients were followed up for 19.8 months on average (range, 1-2 years). Superficial wound infection occurred in 3 cases, and was cured after debridement; the other incisions healed by first intention without complications. All ankles were fused at 1 year follow-up after operation. The symptom was relieved completely in all patients at last follow-up without complication of implant failure, or nonunion. The postoperative AOFAS ankle and hindfoot score was 83.13±3.76, showing significant difference when compared with the preoperative score (45.38±3.21, P<0.01). VAS was significantly decreased from 8.01±0.63 to 2.31±1.05 at 1 year follow-up (P<0.05).

CONCLUSIONModified Blair ankle fusion has the advantages of high feasiblity, less cost and rigid fixation. It shows high reliability in pain relief and may obtain a good clinical effectiveness.

Adult ; Aged ; Ankle Joint ; surgery ; Arthrodesis ; methods ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Rheumatic Fever ; surgery

Objective To analyze the risk factors of in-hospital mortality in patients with intracerebral hemorrhage (ICH) in the intensive care unit.Methods Patients with intracerebral hemorrhage were retrospectively collected from January 2013 to January 2018 in the Department of Intensive Care Unit,Zhongnan Hospital of Wuhan University.Patients were excluded aged less than 18 years,pregnant women,the onset time of more than 7 days,the length of hospital stay of less than 48 hours,lack of renal function outcomes within 24 hours after admission,the glomerular filtration rate (eGFR) of lower than 15 mL/(min.1.73 m2),the history of chronic kidney disease,regular dialysis and renal transplantation,and incomplete data.Clinical data were collected from baseline characteristics,past history,and laboratory examination.The included patients were divided into the in-hospital non-survival group and the survival group.SPSS 20.0 software as used for statistical analysis,the binary Logistic regression analysis was performed to evaluate risk factors of in-hospital mortality with intracerebral hemorrhage,the prognosis was assessed by receiver operating characteristic (ROC) curve and survival curve (Kaplan-Meier).A P＜0.05 was considered statistically significant.Results In this single-center retrospective study,a total of 300 patients were enrolled,including 96 patients in the hospital nonsurvival group and 204 patients in the survival group.The incidence of in-hospital death in patients with intracerebral hemorrhage in ICU was 32％.Multivariate analysis demonstrated that the risk factors of inhospital mortality were lower GCS score (OR=0.629,95％CI:0.523-0.757,P＜0.01),higher APACHE Ⅱ score (OR=1.590,95％CI:1.369-1.847,P＜0.01),elevated leukocytes (OR=1.082,95％CI:1.028-1.139,P=0.002) and the incidence of acute kidney injury (AKI) (OR=6.978,95％CI:3.381-14.405,P＜0.01).The ROC curve demonstrated that the area under curve (AUC) of APACHE Ⅱ score was the largest with a sensitivity and specificity of 73.96％ and 75.98％,respectively,which can better predict the mortality of patients with cerebral hemorrhage.Kaplan-Meier survival curve showed that in-hospital survival rate of non-AKI patients were higher than that of AKI patients (P＜0.01).Conclusions Lower GCS score,higher APACHE Ⅱ score,elevated white blood cells and AKI are risk factors for predicting in-hospital mortality in patients with intracerebral hemorrhage in the ICU.Therefore,early identification and treatment should be adopted in these high-risk populations.

Objective? To explore the effects of solution-focused approach combined with tinnitus therapeutic instrument on negative emotions and quality of life among sudden hearing loss patients with tinnitus. Methods? From February 2016 to December 2018, we selected 160 sudden hearing loss patients with tinnitus in Liuzhou Worker's Hospital by purposive sampling as subjects. All of the patients were randomly divided into observation group and control group, with 80 cases in each group. The control group received routine treatment and nursing intervention. Apart from that, observation group received the intervention of solution-focused approach combined with tinnitus therapeutic instrument. The intervention effects were assessed with the Tinnitus Handicap Inventory (THI), the Medical Outcomes Study Short Form-36 (SF-36), Self-Rating Anxiety Scale (SAS) and self-Rating Depression Scale (SDS). Results? After intervention, the total score and dimension scores of THI, scores of SAS and SDS of observation group were lower than those of control group with statistical differences (P＜ 0.01). Besides, the total score and dimensional scores of SF-36 of observation group were higher than those of control group after intervention with statistical differences(P＜0.01). Conclusions? Solution-focused approach combined with tinnitus therapeutic instrument helps to relieve negative emotions of patients and improve tinnitus as well as quality of life of patients.

Objective:To investigate whether coxsackievirus A 16 (CVA16) infection would affect the expression of N6-methyladenosine (m 6A) methylation-related proteins in human bronchial epithelial cells (16HBE), ICR suckling mice and SCRBA2 humanized mice and influence their subcellular localization. Methods:CVA16 was used to infect 16HBE cells at a multiplicity of infection (MOI) of 0.1 and mice at 10 7 CCID 50/ml. Changes in the expression of methyltransferases, demethylases and methylated reading proteins were analyzed by Western blot. Cellular localization of these proteins was observed using immunofluorescence. Results:The expression of m 6A methylation-related proteins was gradually reduced in CVA16-infected cells with time, but showed no obvious change in ICR suckling mice or SCRBA2 humanized mice. After infection, m 6A methylation-related proteins were redistributed in both the nucleus and cytoplasm and even degraded. Conclusions:CVA16 replication in host cells altered the expression and cellular localization of m 6A methylation-related proteins, which indicated that m 6A modification might be a new potential target for enterovirus therapy.

Objective To form the expert consensus on the limb management of patients with transvenous temporary cardiac pacing,standardize the limb management of patients with transvenous temporary cardiac pacing,and reduce complications related to the limb.Methods Using evidence-based methods,the evidence in this field was searched,evaluated and summarized,and relevant recommendations and research conclusions were extracted and classified by the level of evidence quality,and then the first draft of the consensus was formed.From December 2023 to January 2024,through 2 rounds of expert consultation and 4 rounds of expert meetings,the content was adjusted and the consensus was reached.Results Totally 16 experts participated in the consultation.The positive coefficient is 100%;the authoritative coefficient is 0.847 and 0.836;the average value of each index is more than＞3.8;the coefficient of variation is less than 0.21.The Kendall's harmony coefficient of the 2 rounds of expert consultation is 0.372 and 0.314,respectively,which were statistically significant.The consensus covers the preoperative,intraoperative and postoperative on limb management of patients with transvenous temporary cardiac pacing.Totally 11 themes were involved,including the preoperative preparation,position and catheter fixation in operation,position and catheter fixation in postoperative,activity,turn and transfer,duty shift on limb,nursing care after withdrawal of the catheter,prevention of deep vein thrombosis of the operative limb and prevent infection.Conclusion The consensus is highly scientific,and it is helpful to standardize the limb management of patients with transvenous temporary cardiac pacing.

To scientifically evaluate the intervention effect of Chinese medicine preventive administration(combined use of Huo-xiang Zhengqi Oral Liquid and Jinhao Jiere Granules) on community population in the case of coronavirus disease 2019(COVID-19), a large cohort, prospective, randomized, and parallel-controlled clinical study was conducted. Total 22 065 subjects were included and randomly divided into 2 groups. The non-intervention group was given health guidance only, while the traditional Chinese medicine(TCM) intervention group was given two coordinated TCM in addition to health guidance. The medical instructions were as follows. Huoxiang Zhengqi Oral Liquid: oral before meals, 10 mL/time, 2 times/day, a course of 5 days. Jinhao Jiere Granules: dissolve in boiling water and take after meals, 8 g/time, 2 times/day, a course of 5 days, followed up for 14 days, respectively. The study found that with the intake of medication, the incidence rate of TCM intervention group was basically maintained at a low and continuous stable level(0.01%-0.02%), while the non-intervention group showed an overall trend of continuous growth(0.02%-0.18%) from 3 to 14 days. No suspected or confirmed COVID-19 case occurred in either group. There were 2 cases of colds in the TCM intervention group and 26 cases in the non-intervention group. The incidence of colds in the TCM intervention group was significantly lower(P<0.05) than that in the non-intervention group. In the population of 16-60 years old, the incidence rate of non-intervention and intervention groups were 0.01% and 0.25%, respectively. The difference of colds incidence between the two groups was statistically significant(P<0.05). In the population older than 60 years old, they were 0.04% and 0.21%, respectively. The incidence of colds in the non-intervention group was higher than that in the intervention group, but not reaching statistical difference. The protection rate of TCM for the whole population was 91.8%, especially for the population of age 16-60(95.0%). It was suggested that TCM intervention(combined use of Huoxiang Zhengqi Oral Liquid and Jinhao Jiere Granules) could effectively protect community residents against respiratory diseases, such as colds, which was worthy of promotion in the community. In addition, in terms of safety, the incidence of adverse events and adverse reactions in the TCM intervention group was relatively low, which was basically consistent with the drug instructions.
Adolescent ; Adult ; Betacoronavirus ; Coronavirus Infections ; drug therapy ; Drugs, Chinese Herbal ; Humans ; Medicine, Chinese Traditional ; Middle Aged ; Pandemics ; Pneumonia, Viral ; drug therapy ; Prospective Studies ; Young Adult