Objective:To investigate the application value of dermoscopy and reflectance confocal microscopy (RCM) in identifying field cancerization in actinic keratosis (AK) in the elderly.Methods:A retrospective analysis was conducted on clinical, dermoscopic, and RCM features of elderly (> 60 years old) patients, who were confirmedly diagnosed with AK and had complete medical records at Shanghai Skin Disease Hospital from January 2022 to December 2023.Results:A total of 132 elderly patients with AK were included. Dermoscopy showed brownish-gray pseudonetwork pigment patterns, follicular horn plugs, irregular branched vessels, and rosette signs in AK lesions. Histopathological examination in 51 patients revealed that 47 (92.16%) were confirmedly diagnosed with AK. Field cancerization was observed in 106 patients (80.3%), among whom 66 (62.26%) had irregular branched vessels, 88 (83.02%) predominantly exhibited brownish-gray pseudonetwork pigment patterns, and 83 (78.30%) showed scattered brown pigment networks/fingerprint-like patterns. Post-treatment follow-up of 63 patients showed varying degrees of changes in vascular and pigment structures by dermoscopy, with significant reductions in follicular horn plugs and superficial yellow-white scales or keratin masses. RCM examinations in 41 AK patients all showed disordered arrangements of keratinocytes presenting as atypical honeycomb patterns, with atypical cells in the AK lesions; in the field cancerization areas of 20 patients, RCM revealed keratinocytes disorderedly arranged in an irregular honeycomb pattern, with some keratinocytes exhibiting mild atypia. Thirty-four AK patients underwent dynamic RCM monitoring before and after 1, 3 and 6 months of ALA-PDT treatment, which showed gradual regularization of arrangements of keratinocytes and reduction of atypical cells, as well as reappearance of atypical keratinocytes upon recurrence.Conclusions:The incidence of field cancerization was relatively high in elderly AK patients. Dermoscopy and RCM are helpful for the early identification of AK and field cancerization, especially in patients with multiple lesions and with difficulties in multi-site biopsy.

Objective:To analyze the epidemiological characteristics and spatiotemporal distribution of hepatitis C in Henan province from 2012 to 2022.Methods:The case report data on hepatitis C from counties and districts in Henan between 2012 and 2022 were collected. The distribution characteristics were analyzed by descriptive epidemiological methods, and GeoDa1.2 software was used to perform spatial autocorrelation analysis. The spatiotemporal epidemiological analysis was conducted using SaTScan 10.1 software.Results:A total of 274 485 hepatitis C cases were reported in Henan from 2012 to 2022. The reported annual average incidence rate was 25.84/100 000 and showed an overall downward trend from 2012 to 2022 ( Z=-4.05, P<0.001). More cases were reported in women. The cases were mainly aged 40-69 years and farmers. Spatial autocorrelation analysis showed that the reported cases of hepatitis C present spatial clustering during 2012—2022, and the areas with high incidence were mainly distributed in counties or districts of Zhengzhou, Zhumadian, Xuchang, Zhoukou, and Nanyang. One class I clustering area was detected by spatiotemporal scanning, which mainly covered Xuchang, Pingdingshan and the surrounding counties ( LLR=16 117.73, RR=1.81, P<0.001). Conclusion:The reported cases of hepatitis C in Henan Province show an overall downward trend from 2012 to 2022 and present spatiotemporal clustering. The seasonal regularity of the hepatitis C epidemic is not obvious. People aged 40-69 years old and farmers are the key population for prevention and control.

Objective:To analyze the epidemiological characteristics and spatiotemporal distribution of hepatitis C in Henan province from 2012 to 2022.Methods:The case report data on hepatitis C from counties and districts in Henan between 2012 and 2022 were collected. The distribution characteristics were analyzed by descriptive epidemiological methods, and GeoDa1.2 software was used to perform spatial autocorrelation analysis. The spatiotemporal epidemiological analysis was conducted using SaTScan 10.1 software.Results:A total of 274 485 hepatitis C cases were reported in Henan from 2012 to 2022. The reported annual average incidence rate was 25.84/100 000 and showed an overall downward trend from 2012 to 2022 ( Z=-4.05, P<0.001). More cases were reported in women. The cases were mainly aged 40-69 years and farmers. Spatial autocorrelation analysis showed that the reported cases of hepatitis C present spatial clustering during 2012—2022, and the areas with high incidence were mainly distributed in counties or districts of Zhengzhou, Zhumadian, Xuchang, Zhoukou, and Nanyang. One class I clustering area was detected by spatiotemporal scanning, which mainly covered Xuchang, Pingdingshan and the surrounding counties ( LLR=16 117.73, RR=1.81, P<0.001). Conclusion:The reported cases of hepatitis C in Henan Province show an overall downward trend from 2012 to 2022 and present spatiotemporal clustering. The seasonal regularity of the hepatitis C epidemic is not obvious. People aged 40-69 years old and farmers are the key population for prevention and control.

Objective:To investigate the diagnostic value of heparin-binding protein (HBP), pro-adrenomedullin (pro-ADM), and N-terminal pro-brain natriuretic peptide (NT-proBNP) in assessing the severity of pulmonary infection in patients with chronic heart failure (CHF).Methods:A cross-sectional study was conducted on 100 patients with CHF and pulmonary infection who were admitted to Shaanxi Rehabilitation Hospital between April 2021 and April 2023. According to clinical pulmonary infection score, the patients were classified into mild ( n = 43), moderate ( n = 31), and severe ( n = 26) groups. Additionally, 50 CHF patients without pulmonary infection, who were admitted during the same period, were included in the control group. General demographic data, as well as levels of HBP, pro-ADM, and NT-proBNP were compared among the groups. Logistic regression analysis was performed to identify the factors associated with the occurrence of pulmonary infection in CHF patients, while Pearson correlation analysis was used to assess the correlations among these indicators. Results:The levels of HBP, pro-ADM, and NT-proBNP in the severe group were (36.59 ± 4.15) μg/L, (3.69 ± 0.85) nmoL/L, and (9.63 ± 1.61) μg/L, respectively. In the moderate group, the levels were (33.09 ± 3.67) μg/L, (3.24 ± 0.58) nmoL/L, and (8.15 ± 1.42) μg/L, respectively. In the mild group, the levels were (29.12 ± 3.38) μg/L, (2.65 ± 0.37) nmoL/L, and (6.67 ± 0.68) μg/L, respectively. Significant differences were found in the levels of HBP, pro-ADM, and NT-proBNP among the three groups ( F = 34.41, 26.27, 48.53, all P < 0.05). The levels of HBP, pro-ADM, and NT-proBNP in patients with CHF and pulmonary infection were (32.29 ± 3.25) μg/L, (3.09 ± 0.41) nmoL/L, and (7.89 ± 0.92) μg/L, respectively, which were significantly higher than those in healthy controls [(26.54 ± 2.47) μg/L, (2.32 ± 0.32) nmoL/L, (5.65 ± 0.82) μg/L, t = 12.05, 12.61, 18.17, all P < 0.05]. Logistic regression analysis showed that a history of smoking, New York Heart Association (NYHA) functional classification, the presence of diabetes, as well as levels of HBP, pro-ADM, and NT-proBNP, were all factors influencing the occurrence of pulmonary infection in patients with CHF (all P < 0.05). Pearson analysis revealed that the levels of HBP, pro-ADM, and NT-proBNP in patients with CHF were significantly positively correlated with clinical pulmonary infection score ( r = 0.581, 0.540, 0.653, all P < 0.05). Conclusions:Serum levels of HBP, pro-ADM, and NT-proBNP have good predictive value for the severity of pulmonary infection in patients with CHF.

Objective:To investigate the application value of dermoscopy and reflectance confocal microscopy (RCM) in identifying field cancerization in actinic keratosis (AK) in the elderly.Methods:A retrospective analysis was conducted on clinical, dermoscopic, and RCM features of elderly (> 60 years old) patients, who were confirmedly diagnosed with AK and had complete medical records at Shanghai Skin Disease Hospital from January 2022 to December 2023.Results:A total of 132 elderly patients with AK were included. Dermoscopy showed brownish-gray pseudonetwork pigment patterns, follicular horn plugs, irregular branched vessels, and rosette signs in AK lesions. Histopathological examination in 51 patients revealed that 47 (92.16%) were confirmedly diagnosed with AK. Field cancerization was observed in 106 patients (80.3%), among whom 66 (62.26%) had irregular branched vessels, 88 (83.02%) predominantly exhibited brownish-gray pseudonetwork pigment patterns, and 83 (78.30%) showed scattered brown pigment networks/fingerprint-like patterns. Post-treatment follow-up of 63 patients showed varying degrees of changes in vascular and pigment structures by dermoscopy, with significant reductions in follicular horn plugs and superficial yellow-white scales or keratin masses. RCM examinations in 41 AK patients all showed disordered arrangements of keratinocytes presenting as atypical honeycomb patterns, with atypical cells in the AK lesions; in the field cancerization areas of 20 patients, RCM revealed keratinocytes disorderedly arranged in an irregular honeycomb pattern, with some keratinocytes exhibiting mild atypia. Thirty-four AK patients underwent dynamic RCM monitoring before and after 1, 3 and 6 months of ALA-PDT treatment, which showed gradual regularization of arrangements of keratinocytes and reduction of atypical cells, as well as reappearance of atypical keratinocytes upon recurrence.Conclusions:The incidence of field cancerization was relatively high in elderly AK patients. Dermoscopy and RCM are helpful for the early identification of AK and field cancerization, especially in patients with multiple lesions and with difficulties in multi-site biopsy.

Objective:To investigate the diagnostic value of heparin-binding protein (HBP), pro-adrenomedullin (pro-ADM), and N-terminal pro-brain natriuretic peptide (NT-proBNP) in assessing the severity of pulmonary infection in patients with chronic heart failure (CHF).Methods:A cross-sectional study was conducted on 100 patients with CHF and pulmonary infection who were admitted to Shaanxi Rehabilitation Hospital between April 2021 and April 2023. According to clinical pulmonary infection score, the patients were classified into mild ( n = 43), moderate ( n = 31), and severe ( n = 26) groups. Additionally, 50 CHF patients without pulmonary infection, who were admitted during the same period, were included in the control group. General demographic data, as well as levels of HBP, pro-ADM, and NT-proBNP were compared among the groups. Logistic regression analysis was performed to identify the factors associated with the occurrence of pulmonary infection in CHF patients, while Pearson correlation analysis was used to assess the correlations among these indicators. Results:The levels of HBP, pro-ADM, and NT-proBNP in the severe group were (36.59 ± 4.15) μg/L, (3.69 ± 0.85) nmoL/L, and (9.63 ± 1.61) μg/L, respectively. In the moderate group, the levels were (33.09 ± 3.67) μg/L, (3.24 ± 0.58) nmoL/L, and (8.15 ± 1.42) μg/L, respectively. In the mild group, the levels were (29.12 ± 3.38) μg/L, (2.65 ± 0.37) nmoL/L, and (6.67 ± 0.68) μg/L, respectively. Significant differences were found in the levels of HBP, pro-ADM, and NT-proBNP among the three groups ( F = 34.41, 26.27, 48.53, all P < 0.05). The levels of HBP, pro-ADM, and NT-proBNP in patients with CHF and pulmonary infection were (32.29 ± 3.25) μg/L, (3.09 ± 0.41) nmoL/L, and (7.89 ± 0.92) μg/L, respectively, which were significantly higher than those in healthy controls [(26.54 ± 2.47) μg/L, (2.32 ± 0.32) nmoL/L, (5.65 ± 0.82) μg/L, t = 12.05, 12.61, 18.17, all P < 0.05]. Logistic regression analysis showed that a history of smoking, New York Heart Association (NYHA) functional classification, the presence of diabetes, as well as levels of HBP, pro-ADM, and NT-proBNP, were all factors influencing the occurrence of pulmonary infection in patients with CHF (all P < 0.05). Pearson analysis revealed that the levels of HBP, pro-ADM, and NT-proBNP in patients with CHF were significantly positively correlated with clinical pulmonary infection score ( r = 0.581, 0.540, 0.653, all P < 0.05). Conclusions:Serum levels of HBP, pro-ADM, and NT-proBNP have good predictive value for the severity of pulmonary infection in patients with CHF.

Objective To investigate the active ingredients of Zizyphi Spinosae Semen(ZSS)in relieving benzodiazepine(BDZ)dependence and its molecular mechanism based on the integrated Traditional Chinese Medicine and chemical drugs idea of"enhancing effect and reducing toxicity"via the approach of network pharmacology and the technique of molecular dynamics simulation.Methods First,literature search was undertaken to find the main components of ZSS.Then,the major effective constituents of ZSS in relieving BDZ dependence and its target of action were explored on the basis of network pharmacology and molecular docking.Finally,the relationship between core components of ZSS and key proteins was further verified through the technique of molecular dynamics simulation.Results After literature search,a total of 24 chemical components in ZSS were found to act on 731 targets.Through establishing the network of"ingredients-targets-pathways",topology analysis was performed to obtain nine core components such as linoleic acid,palmitic acid,oleic acid,tetradecanoic acid,spinosin,oleanolic acid and jujuboside A,as well as five key targets including AR,PTGS2,PPARG,RXRA and CYP19A1.Bioinformation enrichment analysis was made to obtain critical pathways such as calcium signaling pathway,cAMP signaling pathway,IL-17 signaling pathway and TNF signaling pathway.The results of molecular docking revealed that there was a good combination between core components of ZSS and key targets,and it was mainly dominated by hydrogen bonding.Furthermore,the molecular dynamics simulation experiments indicated that the combinations between jujuboside A and RXRA,oleanolic acid and RXRA,spinosin and PPARG were stable,and these three active ingredients played an important role in improving BDZ dependence.Conclusion The active components in ZSS may exert multi-target and multi-pathway intervention effects on BDZ dependence by means of processes such as immunoregulation,anti-anxiety,and anti-insomnia.

From June to September 2021, residents aged 15-65 years from 18 provincial cities and 10 directly administered counties (cities) in Henan Province were collected for a questionnaire survey, so as to understand the status quo of the knowledge and related influencing factors of hepatitis C prevention and treatment. Among 11 627 subjects, the adjusted awareness rate of knowledge about hepatitis C prevention and treatment was 59.2% (95% CI: 58.3%-60.1%). The awareness rate was higher among people aged 15-24 years [63.7% (95% CI: 61.4%-66.1%)] and those with education level of college or above [72.8% (95% CI: 70.8%-74.8%) (both P<0.05). The multivariate logistic regression model analysis showed that compared with urban and aged 15-24 years residents, rural, aged 25-34 years, 35-44 years, 45-54 years, and 55-65 years residents had lower awareness rates, with OR (95% CI) values of 0.825 (0.754-0.902), 0.733 (0.624-0.863), 0.746 (0.626-0.889), 0.766 (0.643-0.912), and 0.580 (0.484-0.695), respectively; compared with unmarried, junior high school and below residents, marriage/cohabitation, high school or vocational school, college or above residents had higher awareness rates, with OR (95% CI) values of 1.523 (1.315-1.764), 1.624 (1.474-1.789) and 2.212 (1.945-2.516), respectively.

From June to September 2021, residents aged 15-65 years from 18 provincial cities and 10 directly administered counties (cities) in Henan Province were collected for a questionnaire survey, so as to understand the status quo of the knowledge and related influencing factors of hepatitis C prevention and treatment. Among 11 627 subjects, the adjusted awareness rate of knowledge about hepatitis C prevention and treatment was 59.2% (95% CI: 58.3%-60.1%). The awareness rate was higher among people aged 15-24 years [63.7% (95% CI: 61.4%-66.1%)] and those with education level of college or above [72.8% (95% CI: 70.8%-74.8%) (both P<0.05). The multivariate logistic regression model analysis showed that compared with urban and aged 15-24 years residents, rural, aged 25-34 years, 35-44 years, 45-54 years, and 55-65 years residents had lower awareness rates, with OR (95% CI) values of 0.825 (0.754-0.902), 0.733 (0.624-0.863), 0.746 (0.626-0.889), 0.766 (0.643-0.912), and 0.580 (0.484-0.695), respectively; compared with unmarried, junior high school and below residents, marriage/cohabitation, high school or vocational school, college or above residents had higher awareness rates, with OR (95% CI) values of 1.523 (1.315-1.764), 1.624 (1.474-1.789) and 2.212 (1.945-2.516), respectively.

Objective:To compare the clinical effects robot navigation assisted and conventional proximal femoral nail antirotation (PFNA) implantation and fixation in the treatment of elderly femoral trochanteric fractures.Methods:A total of 86 elderly patients with tuberosity fracture of the femur were admitted as research samples from January to March in 2022 in the Department of Trauma Orthopaedic, Xi′an Honghui Hospital Affiliated to Xi′an Jiaotong University, including 37 males and 49 females, who aged from 63 to 92 years, with an average age of (79.6 ± 6.9) years. All patients were treated with intramedullary nails (PFNA), 32 with dimensity robotic-assisted therapy (robot group) and 54 with traditional methods (conventional group). The length of incision, the number of intraoperative fluoroscopy, the amount of intraoperative blood loss, and the operation time were recorded. The occurrence of postoperative complications in the two groups was observed. The rate of excellent hip Harris score at 3 month after surgery was compared between the two groups. Measurement data with normal distribution were represented as mean ± standard deviation( ± s), and the comparison between groups was conducted using the t-test; the comparison of count data were represented as [ n(%)], and was conducted by Chi-square test or Fisher exact probability between groups. Results:All patients were followed up for 9 to 12 months, with an average of (10.6 ± 0.9) months. The incision length and tip apex distance (TAD) of the robot group were (3.40±0.82) cm and (21.85±1.44) mm, which were smaller than (4.82±0.75) cm and (26.83±1.75) mm in the conventional group ( P<0.05 for all). The number of intraoperative fluoroscopy and guide needle adjustment [(14.53±3.26) and 0 times] in the robot group were less than those in the conventional group [(20.67±4.84) and (2.83±1.42)] ( P<0.05). The intraoperative blood loss and drainage rate of the robot group were (87.03±9.41) and (46.40±8.91) mL, which were smaller than that of the conventional group [(110.00±12.52) and (69.62±10.22) mL] ( P<0.05). There was no significant difference in the number of days of hospitalization and operation time between the two groups ( P>0.05). The postoperative complication rate in the robot group was 9.4%, which was lower than that in conventional group (42.6%), and the difference was statistically significant ( χ2=11.88, P=0.036). The excellent rate of postoperative hip joint function in the robot group was 75.0%, and the conventional group was 66.7%, and there was no significant difference between the two groups ( χ2=0.66, P=0.416). Conclusion:Robot-assisted navigation downward PFNA surgery can have good clinical effect in the treatment of femoral tuberosity fracture in the elderly, which can reduce the number of surgical incisions and intraoperative fluoroscopy, and reduce the incidence of postoperative complications, which is helpful to achieve minimally invasive surgery and rapid recovery of elderly patients with femoral tuberosity fracture.