This article introduces Professor WU Weiping's experience in treating bronchiectasis based on the thought of "half treating from collaterals and half treating as abscess". Professor WU classified this disease under the category of "lung collaterals abscess" and proposed the general principle of "half treating from collaterals and half treating as the abscess"， based on the core pathogenesis of lung-spleen qi deficiency and phlegm-stasis heat accumulation. Treatment should be based on syndrome differentiation according to the pathological characteristics of the disease at different stages. During the acute exacerbation stage， when the lung qi depletion and phlegm-heat congestion obstruct the lung collaterals and form into lung abscess， the methods should therefore focus partly on resolving stasis and unblocking to treat from the collaterals， and partly on clearing heat， eliminating phlegm and draining pus to treat as the abscess. Modified Qianjin Xiejing Decoction （千金苇茎汤） and Loulu Lianqiao Decoction （漏芦连翘汤）. During the chronic protracted stage， when there is lung-spleen qi deficiency， along with collateral deficiency and latent abscess， the main focus should be half on regulating the middle jiao （焦）， moving qi and consolidating the exterior to treat from collaterals， and half on rectifying lung， dispelling stasis and resolving phlegm to treat as the abscess， with modified Yupingfeng Powder （玉屏风散） and Liujunzi Decoction （六君子汤）. At the same time， attention should be paid to differentiating phlegm， blood， and cough to tailor the prescription.

OBJECTIVE: In order to enhance the efficacy of anti-breast cancer, paclitaxel nanoparticles (PTX NPs) and polypyrrole nanoparticles (PPy NPs) were combined with photothermal therapy and chemotherapy. At the same time, the two dosage forms of PTX NPs and PTX NPs gel were compared. METHODS: PTX NPs were prepared by self-assembly method, and then the cytotoxicity in vitro was investigated by Methyl thiazolyl tetrazolium (MTT) and other methods, and the efficacy and side effects in vivo were further investigated. RESULTS: The average hydrated diameter, PDI and electric potential of PTX NPs were (210.20 ± 1.57) nm, (0.081 ± 0.003) mV and (15.80 ± 0.35) mV, respectively. MTT results showed that the IC₅₀ value of PTX NPs on 4 T1 cells was 0.490 μg/mL, while that of PTX injection was 1.737 μg/mL. The cell inhibitory effect of PTX NPs was about 3.5 times higher than that of PTX injection. The tumor inhibition rates of PTX NPs and gel were 48.64% and 56.79%, respectively. Together with local photothermal stimulation, the tumor inhibition rate of the PTX NPs reached 91.05%, surpassing that of the gel under the same conditions (48.98%), moreover, the organ index and H&E staining results of PTX NPs showed a decrease in toxicity. CONCLUSION This combination therapy can significantly enhance the effect of anti-breast cancer, and the synergistic effect of chemotherapy and light and heat provides a feasible and effective strategy for the treatment of tumor.

AIM:To investigate the protective effect of decylubiquinone(DUb)against medium-wave ultravio-let(UVB)-induced photodamage in HaCaT cells and its molecular mechanism.METHODS:The photodamage model was established by irradiating HaCaT cells with UVB.The experiment was divided into 6 groups:control group,UVB model group(30 mJ/cm2),UVB+low-,medium-and high-concentration(2.5,5 and 10 μmol/L)DUb groups,and DUb(10 μmol/L)group.Cell viability was detected using the CCK-8 assay.The morphological changes of the HaCaT cells were observed under a light microscope.The production of reactive oxygen species(ROS)content in the HaCaT cells was analyzed by fluorescence probe of DCFH-DA,and the superoxide dismutase(SOD)activity,intracellular glutathione(GSH)and malondialdehyde(MDA)levels were detected using biochemical reagents.The apoptosis rate was detected through flow cytometry.The protein expression levels of Bax、Bcl-2、caspase-3 and p53 were detected by Western blot.RESULTS:Compared with the control group,the cell viability of UVB model group was significantly decreased(P＜0.01),and obvious morphological changes,ROS and MDA were significantly increased(P＜0.01),GSH and SOD were significantly decreased(P＜0.01),the apoptosis rate was increased(P＜0.01).DUb pretreatment significantly increased the viability of UVB-induced photodamage HaCaT cells(P＜0.01),decreased intracellular ROS and MDA production(P＜0.05,P＜0.01),increased GSH content and SOD activity(P＜0.05,P＜0.01),and reduced apoptosis(P＜0.01).Addi-tionally,the protein expression levels of Bax,caspase-3 and p53 in medium-and high-dose DUb groups were significantly decreased(P＜0.01),while the anti-apoptotic protein Bcl-2 was significantly increased(P＜0.01).CONCLUSION:Dec-ylubiquinone can alleviate UVB-induced photodamage to HaCaT cells,reduce apoptosis and enhance the antioxidant ca-pacity of cells,and protect HaCaT cells against UVB radiation.

Objective:To investigate the prevalence of adult skeletal fluorosis caused by drinking tea-type endemic fluorosis in Yushu Tibetan Autonomous Prefecture (hereinafter referred to as Yushu Prefecture), Qinghai Province, and provide scientific basis for prevention and control of the disease.Methods:In August 2021, one village was selected as a survey site in six counties (cities) in Yushu Prefecture, including Nangqian, Chindu, Yushu, Zadoi, Qumarlêb, and Zhiduo. Drinking water samples and 10 brick tea samples were collected from each village to determine the fluoride content in water and brick tea; at least 100 permanent residents aged ≥ 25, who had a habit of drinking brick tea and had lived in the local area for more than 5 years, were selected for X-ray imaging to examine the prevalence of adult skeletal fluorosis.Results:A total of 75 samples of residential drinking water were collected, with a fluoride content of (0.21 ± 0.05) mg/L, ranging from 0.11 to 0.34 mg/L; 60 samples of brick tea, with a fluoride content of (626.70 ± 157.27) mg/kg, ranging from 324.00 to 2 102.00 mg/kg. A total of 1 136 adults were examined, and 318 cases of skeletal fluorosis were diagnosed, with a detection rate of 27.99%. Among them, the detection rates of mild, moderate, and severe skeletal fluorosis were 20.95% (238/1 136), 6.07% (69/1 136), and 0.97% (11/1 136), respectively, with mild symptoms being the main. The detection rates of skeletal fluorosis in males and females were 29.09% (121/416) and 27.36% (197/720), respectively, with no statistically significant difference between the gender (χ 2 = 0.39, P = 0.533). Comparison of the skeletal fluorosis in different gender, the differences were statistically significant (χ 2 = 22.31, P < 0.001). The detection rates of skeletal fluorosis in the age groups of 25 - 35, 36 - 45, 46 - 55, 56 - 65, 66 - 75, and ≥76 years old were 6.86% (7/102), 22.37% (51/228), 24.02% (92/383), 37.44% (73/195), 43.48% (70/161), and 37.31% (25/67), respectively. The differences between the groups were statistically significant (χ 2 = 59.84, P < 0.001). Moreover, there was a statistically significant difference in the composition of skeletal fluorosis among different age groups ( H = 37.66, P < 0.001). The Spearman correlation analysis results showed that the severity of adult skeletal fluorosis was positively correlated with age ( r = 0.34, P < 0.001). Conclusions:There is a certain degree of prevalence of adult skeletal fluorosis in Yushu Prefecture. And as age increases, the condition of skeletal fluorosis becomes more severe.

AIM:To investigate the protective effect of decylubiquinone(DUb)against medium-wave ultravio-let(UVB)-induced photodamage in HaCaT cells and its molecular mechanism.METHODS:The photodamage model was established by irradiating HaCaT cells with UVB.The experiment was divided into 6 groups:control group,UVB model group(30 mJ/cm2),UVB+low-,medium-and high-concentration(2.5,5 and 10 μmol/L)DUb groups,and DUb(10 μmol/L)group.Cell viability was detected using the CCK-8 assay.The morphological changes of the HaCaT cells were observed under a light microscope.The production of reactive oxygen species(ROS)content in the HaCaT cells was analyzed by fluorescence probe of DCFH-DA,and the superoxide dismutase(SOD)activity,intracellular glutathione(GSH)and malondialdehyde(MDA)levels were detected using biochemical reagents.The apoptosis rate was detected through flow cytometry.The protein expression levels of Bax、Bcl-2、caspase-3 and p53 were detected by Western blot.RESULTS:Compared with the control group,the cell viability of UVB model group was significantly decreased(P＜0.01),and obvious morphological changes,ROS and MDA were significantly increased(P＜0.01),GSH and SOD were significantly decreased(P＜0.01),the apoptosis rate was increased(P＜0.01).DUb pretreatment significantly increased the viability of UVB-induced photodamage HaCaT cells(P＜0.01),decreased intracellular ROS and MDA production(P＜0.05,P＜0.01),increased GSH content and SOD activity(P＜0.05,P＜0.01),and reduced apoptosis(P＜0.01).Addi-tionally,the protein expression levels of Bax,caspase-3 and p53 in medium-and high-dose DUb groups were significantly decreased(P＜0.01),while the anti-apoptotic protein Bcl-2 was significantly increased(P＜0.01).CONCLUSION:Dec-ylubiquinone can alleviate UVB-induced photodamage to HaCaT cells,reduce apoptosis and enhance the antioxidant ca-pacity of cells,and protect HaCaT cells against UVB radiation.

Objective:To analyze clinical manifestations, histopathological and pathogenic fungus characteristics as well as treatment of 3 cases of disseminated cutaneous alternariosis caused by Alternaria. Methods:Clinical data were collected from 3 cases of disseminated cutaneous alternariosis caused by Alternaria, who were diagnosed in Department of Dermatology, Xijing Hospital from 2019 to 2021, and clinical and histopathological features, fungal culture, strain identification and treatment results were retrospectively analyzed. Results:The 3 patients were aged 55, 41 and 46 years respectively, including 1 male and 2 females. Two patients were previously diagnosed with nephrotic syndrome and 1 with systemic lupus erythematosus. All the patients had a history of taking glucocorticoids and tacrolimus for different durations, and experienced chronic infections. Histopathological examination with hematoxylin and eosin (HE) staining showed double-contour thick-walled spores and knot-shaped thick-walled septal hyphae, but no melanin in skin lesions. Sequencing of the fungal internal transcribed spacer region confirmed that 2 cases were infected with Alternaria alternate, and 1 with Alternaria infectoria. Fungal culture at different temperatures showed that the growth ability of Alternaria markedly decreased at the temperature over 35 ℃. To treat these patients, the dose of tacrolimus was reduced to less than 1/3 of the standard dose, or tacrolimus was switched to other immunosuppressants, and systemic antifungal therapy was also given at the same time. After 7-month treatment, good clinical outcomes were achieved in the 3 patients. Conclusion:Disseminated cutaneous alternariosis is characterized by bilateral hematogenous dissemination and lymphatic distribution in unilateral limbs, and the skin lesions are characterized by verrucous plaques covered with scabs, nodules and/or sinuses.

Objective:To investigate the contents of soil metal elements in the plague high incidence area and resting area in the plague natural foci of Qingnan region in Qinghai Province, and to compare and analyze the differences of the contents of soil metal elements between the two areas.Methods:A total of 69 soil samples were collected from 11 sites in the plague high incidence area (Yushu Prefecture) and resting area (Guoluo Prefecture) in Qingnan region, including 39 samples from high incidence area and 30 samples from resting area. The contents of 12 soil metal elements, such as iron (Fe), magnesium (Mg), calcium (Ca), barium (Ba), cobalt (Co), copper (Cu), manganese (Mn), lead (Pb), rubidium (Rb), titanium (Ti), vanadium (V) and zinc (Zn), were measured by X-ray fluorescence spectrometry and SPSS 20.0 software was used for Spearman correlation and other statistical analysis.Results:The contents of Fe and Ca in the soil of the plague natural foci of Qingnan region were relatively high. The contents of 12 soil metal elements in the high incidence area were significantly higher than those in the resting area ( P < 0.01 or < 0.05). There were statistical significant differences in the contents of Mg, Ca, Ba, Mn, Pb and Zn in the soil among the sample plots of the plague high incidence area ( P < 0.01 or < 0.05). There were statistical significant differences in the contents of Fe, Mg, Ca, Rb and Ti in the soil among the sample plots of the plague resting area ( P < 0.05 or < 0.01). Except for Mg and Ca, Fe was positively correlated with other metal elements in the high incidence area and resting area ( P < 0.01 or < 0.05), and Fe was strongly positively correlated with Rb, Ti and V ( r = 0.780 - 0.838). Mg was only positively correlated with Ca in the high incidence area and resting area ( P < 0.01). Ca was negatively correlated with Mn, Pb, Rb, Ti, V and Zn in the high incidence area, and with Rb and Zn in the resting area ( P < 0.01 or < 0.05). The rest of the metal elements were mostly positively correlated in the high incidence area and resting area. Conclusions:The contents of Fe and Ca are rich in the plague natural foci of Qingnan region in Qinghai Province. There are correlations among most soil metal elements in the high incidence area and resting area. The correlation between the contents of soil metal elements in the plague natural foci and the epidemic of plague is worth further exploring.

Objective:To understand the changes of serum interleukin (IL)-2 and IL-6 in adult patients with Kashin-Beck disease (KBD) in Qinghai Plateau, and to provide scientific basis for scientific prevention and treatment of plateau KBD.Methods:According to the "Diagnosis of Kashin-Beck Disease" (WS/T 207-2010), adult KBD patients and healthy people over 18 years old were selected as KBD group and control group, respectively, in KBD disease areas of Xinghai County and Guide County, Hainan Tibetan Autonomous Prefecture, Qinghai Province. Fasting cubital venous blood was collected from the people of two groups, and the levels of serum IL-2 and IL-6 were determined by enzyme-linked immunosorbent assay (ELISA).Results:A total of 193 people were surveyed, including 114 people in KBD group and 79 people in control group. There was no significant difference in age and sex ratio between the two groups ( t = 0.204, χ 2 = 2.547, P > 0.05). The serum IL-2 and IL-6 levels of the KBD group were (572.21 ± 172.92), (42.35 ± 15.86) pg/ml, respectively; compared with the control group [(511.28 ± 173.22), (51.96 ± 17.18) pg/ml], the differences were statistically significant ( t = 2.404, 3.999, P < 0.05). Conclusion:The serum IL-2 level is increased and IL-6 level is decreased in adult KBD patients in Qinghai Plateau, both of which may be involved in the inflammatory reaction of adult KBD.

Objective:To explore surgical treatment strategies and prognosis of early-stage nail apparatus melanoma.Methods:A total of 115 patients with early-stage nail apparatus melanoma receiving surgical treatment were collected from Department of Dermatology, Xijing Hospital, the Fourth Military Medical University from July 2011 to December 2019, and surgical treatment strategies and outcomes were analyzed retrospectively.Results:According to the modified ABCDEF criteria and clinical manifestations (such as deformation of the nail plate, ulcers, nodules) , 73 patients with early-stage nail apparatus melanoma received extended surgical resection based on the resection principles of melanoma in situ, 22 based on the resection principles of stage I and II melanoma, 20 based on the resection principles of stage I and II melanoma with invasion risks. During the follow-up period of 6 months to 9 years, there was no recurrence of the primary tumors in any patients; no abnormalities were observed by the ultrasound examination of lymph nodes in 101 patients; metastases occurred in 2 patients receiving finger amputation, 1 of whom died; 12 patients were lost to follow-up. Conclusion:To select extended surgical resection strategies for early-stage nail apparatus melanoma based on clinical manifestations, can ensure adequate treatment and preserve the normal function of the extremities to the greatest extent without recurrence of the primary tumors.

Objective:To investigate the status of depressive symptoms of the elderly in Beijing community, and to explore its influencing factors.Methods:From October to December 2020, a cross-sectional survey was conducted among 224 senior citizens (aged 80 years old and over) who met the inclusion and exclusion criteria from 7 streets of Dongcheng District of Beijing by convenience sampling method. General demographic data sheet, the 6-item short form of University of California Los Angeles Loneliness Scale, Patient Health Questionnaire-9 (PHQ-9) , Quality of Life Questionnaire-6, Social Support Questionnaire and Activities of Daily Lives data sheet were used to collect information. Analysis of variance and statistical analysis were used χ 2 test was used to analyze the difference of depression degree among the elderly with different characteristics, and multiple linear regression was used to analyze the influencing factors of PHQ-9 score. Results:A total of 132 people were detected depression symptoms (PHQ-9≥5 points) , the detection rate was 58.9% (132/224) . Among them, 63 (28.1%) , 34 (15.2%) , 18 (8.0%) and 17 (7.6%) had mild, moderate, moderate and severe depression, respectively. Univariate analysis showed that the differences of depression degree of the elderly with different ages, marital status, living conditions, the occurrence of the hit events in recent two years, self-care ability, loneliness, quality of life and social support were statistically significant ( P<0.05) . Multiple linear regression analysis showed that age, loneliness, quality of life and social support were the influencing factors of the scores of PHQ-9 (ajusted R2=0.604, P<0.01) . Conclusions:The prevalence rate of depressive symptoms is high in the elderly aged 80 and above living in Beijing community. Age, loneliness, quality of life and social support are associated with depression of the elderly in the community.