Objective:To compare the efficacy and safety of crisaborole ointment 2% versus pimecrolimus cream 1% in the treatment of mild to moderate atopic dermatitis in children aged 2 years or older.Methods:A multicenter, randomized, open-label, controlled clinical trial was conducted. A total of 120 pediatric patients aged 2 - 17 years with mild to moderate atopic dermatitis were enrolled from departments of dermatology of 8 hospitals in China between March 2022 and February 2023. The participants were randomly assigned in a 1∶1 ratio to the crisaborole group and the pimecrolimus group, and received the treatment with crisaborole ointment 2% and pimecrolimus cream 1% respectively, twice a day for 4 weeks. Visits were scheduled at baseline/on day 1, as well as on days 8, 15, and 29. The primary efficacy outcome was the percentage of patients achieving the Investigator's Static Global Assessment (ISGA) success (defined as clear [0] or almost clear [1] on the ISGA scale, combined with ≥ 2‐grade improvement from baseline) on day 29. The secondary efficacy outcomes included changes in the Eczema Area and Severity Index (EASI) total scores from baseline to day 29, percentages of patients achieving ISGA improvement (defined as clear [0] or almost clear [1] on the ISGA scale), as well as changes in the Peak Pruritus Numerical Rating Scale (NRS) scores, Dermatology Life Quality Index (DLQI) /Infants' Dermatology Life Quality Index (IDLQI) /Children's Dermatology Life Quality Index (CDLQI) scores, and in the Dermatitis Family Impact (DFI) scores. Drug safety was evaluated according to the incidence of adverse events. Categorical data were compared using the chi-square test. Since measurement data did not follow a normal distribution, the rank sum test was used for comparisons of measurement data between groups.Results:A total of 106 children with mild to moderate atopic dermatitis were included in the per-protocol analysis set, with 52 in the crisaborole group (26 males and 26 females) and 54 in the pimecrolimus group (27 males and 27 females). There were no significant differences in age, disease duration, ISGA and EASI scores at baseline between the two groups (all P > 0.05). On day 29, 22 patients (42.31%) in the crisaborole group and 25 (46.30%) in the pimecrolimus group achieved ISGA success, with no significant difference between the two groups ( χ2 = 0.17, P = 0.68) ; 35 patients (67.31%) in the crisaborole group and 45 (83.33%) in the pimecrolimus group achieved ISGA improvement, also with no significant difference between the two groups ( χ2 = 3.68, P = 0.06) ; additionally, there were no significant differences in the EASI, pruritus NRS, DLQI/IDLQI/CDLQI, or DFI scores between the two groups (all P > 0.05). Adverse reactions to the two topical agents were mainly local reactions such as mild to moderate pain, itching, or worsening of itching, and no obvious systemic adverse reactions occurred. The incidence of drug-related adverse reactions was 46.15% (24 cases) in the crisaborole group and 37.04% (20 cases) in the pimecrolimus group, with no significant difference between the two groups ( χ2 = 0.91, P = 0.34) . Conclusion:The efficacy of crisaborole ointment 2% was comparable to that of pimecrolimus cream 1% in the treatment of mild to moderate atopic dermatitis in children aged ≥ 2 years, and it yielded early and rapid improvement in the quality of life of patients and their families, with good safety and tolerability profiles.

Objective:To compare the efficacy and safety of crisaborole ointment 2% versus pimecrolimus cream 1% in the treatment of mild to moderate atopic dermatitis in children aged 2 years or older.Methods:A multicenter, randomized, open-label, controlled clinical trial was conducted. A total of 120 pediatric patients aged 2 - 17 years with mild to moderate atopic dermatitis were enrolled from departments of dermatology of 8 hospitals in China between March 2022 and February 2023. The participants were randomly assigned in a 1∶1 ratio to the crisaborole group and the pimecrolimus group, and received the treatment with crisaborole ointment 2% and pimecrolimus cream 1% respectively, twice a day for 4 weeks. Visits were scheduled at baseline/on day 1, as well as on days 8, 15, and 29. The primary efficacy outcome was the percentage of patients achieving the Investigator's Static Global Assessment (ISGA) success (defined as clear [0] or almost clear [1] on the ISGA scale, combined with ≥ 2‐grade improvement from baseline) on day 29. The secondary efficacy outcomes included changes in the Eczema Area and Severity Index (EASI) total scores from baseline to day 29, percentages of patients achieving ISGA improvement (defined as clear [0] or almost clear [1] on the ISGA scale), as well as changes in the Peak Pruritus Numerical Rating Scale (NRS) scores, Dermatology Life Quality Index (DLQI) /Infants' Dermatology Life Quality Index (IDLQI) /Children's Dermatology Life Quality Index (CDLQI) scores, and in the Dermatitis Family Impact (DFI) scores. Drug safety was evaluated according to the incidence of adverse events. Categorical data were compared using the chi-square test. Since measurement data did not follow a normal distribution, the rank sum test was used for comparisons of measurement data between groups.Results:A total of 106 children with mild to moderate atopic dermatitis were included in the per-protocol analysis set, with 52 in the crisaborole group (26 males and 26 females) and 54 in the pimecrolimus group (27 males and 27 females). There were no significant differences in age, disease duration, ISGA and EASI scores at baseline between the two groups (all P > 0.05). On day 29, 22 patients (42.31%) in the crisaborole group and 25 (46.30%) in the pimecrolimus group achieved ISGA success, with no significant difference between the two groups ( χ2 = 0.17, P = 0.68) ; 35 patients (67.31%) in the crisaborole group and 45 (83.33%) in the pimecrolimus group achieved ISGA improvement, also with no significant difference between the two groups ( χ2 = 3.68, P = 0.06) ; additionally, there were no significant differences in the EASI, pruritus NRS, DLQI/IDLQI/CDLQI, or DFI scores between the two groups (all P > 0.05). Adverse reactions to the two topical agents were mainly local reactions such as mild to moderate pain, itching, or worsening of itching, and no obvious systemic adverse reactions occurred. The incidence of drug-related adverse reactions was 46.15% (24 cases) in the crisaborole group and 37.04% (20 cases) in the pimecrolimus group, with no significant difference between the two groups ( χ2 = 0.91, P = 0.34) . Conclusion:The efficacy of crisaborole ointment 2% was comparable to that of pimecrolimus cream 1% in the treatment of mild to moderate atopic dermatitis in children aged ≥ 2 years, and it yielded early and rapid improvement in the quality of life of patients and their families, with good safety and tolerability profiles.

Objective:To study the clinical application of jejunal feeding tube (J-tube) for early enteral nutrition after surgical treatment of upper digestive tract malformation in newborns.Methods:From January 2019 to December 2021, newborns with upper digestive tract malformation received stage Ⅰ small bowel resection and anastomosis in our hospital were enrolled in this prospective randomized controlled study. According to different types of postoperative nutritional support, these patients were randomly assigned into J-tube group and control group using block randomization method. The J-tube group were given enteral nutrition vis J-tube within 48-72 h after surgery and the control group were given oral feeding after the recovery of gastrointestinal function. Calories and proteins intake, growth indicators, duration of hospital stay and parenteral nutrition, time needed for full oral feeding and complications were compared between the two groups.Results:A total of 24 patients were in J-tube group and 28 in controlled group. No significant differences existed on the general status between the two groups ( P>0.05). The average daily intake of calories and proteins in j-tube group in the first week after surgery were significantly higher than control group [(108.7±8.3) kcal/(kg·d) vs. (97.9±7.0) kcal/(kg·d), (3.4±0.3) g/(kg·d) vs. (3.1±0.2) g/(kg·d)] ( P<0.05). No significant differences existed in the average daily intake of calories and proteins during the second postoperative week between the two groups ( P>0.05). Compared with control group,J-tube group showed increased growth velocity in head circumference and weight over time ( P<0.05), while the trend over time in length growth was not significant ( P>0.05). No significant differences existed in the duration of hospital stay and parenteral nutrition, time needed for full oral feeding and complications between the two groups ( P>0.05). Conclusions:Enteral nutrition via J-tube 48-72 h after surgery is safe and feasible in the postoperative nutritional management of newborns with upper digestive tract malformation. This strategy may promote physical growth after surgery without increasing the incidences of complications.

Objective:To evaluate the optimization efficacy of pressure-volume (P-V) curve-based individualized lung-protective ventilation strategy combined with pressure-controlled ventilation-volume guaranteed (PCV-VG) mode (LPVS+ PCV-VG) for one-lung ventilation (OLV) in elderly patients undergoing radical resection of lung cancer.Methods:Seventy American Society of Anesthesiologists Physical Status classificationⅡ-Ⅲ patients, aged 65-74 yr, with body mass index of 18-24 kg/m 2, undergoing elective thoracoscopic radical resection of lung cancer, were divided into 2 groups ( n=35 each) using a random number table method: PCV-VG group and LPVS+ PCV-VG group. Blood samples were collected from the radial artery for blood gas analysis before induction of general anesthesia (T 0), at 5 min of two lung ventilation after endotracheal intubation (T 1), at 30 min of OLV (T 2), at the end of OLV (T 3), and at 5 min of two lung ventilation in supine position (T 4). Ppeak, mean airway pressure (Pmean) and dynamic lung compliance (Cdyn) were recorded. The use of antibiotics, lung-related complications and rehabilitation were recorded within 7 days after operation. Results:Compared with PCV-VG group, PaO 2, PaCO 2 and Cdyn were significantly increased at T 2-4, Ppeak was decreased at T 2, 3, Pmean was increased at T 3, the requirement for antibiotics within 7 days after operation was decreased, the incidence of 1 grade lung-related complications was decreased, and the thoracic drainage tube indwelling time and length of hospital stay were shortened in LPVS+ PCV-VG group ( P<0.05). Conclusions:Individualized LPVS based on P-V curve combined with PCV-VG mode provides better efficacy for OLV in elderly patients undergoing radical resection of lung cancer.

Objective:To analyze the efficacy of dienogest combined with traditional Chinese medicine(TCM) in the treatment of endometriosis (EMs) and its influence on pregnancy and recurrence.Methods:A total of177 patients with EMs admitted to Affiliated Hospital of Shandong University of Chinese Medicine and Linyi Hospital of Traditional Chinese Medicine from December 2018 to June 2019 were divided into the observation group (88 cases) and the control group (89 cases) according to the random number table method. The control group was treated with dienogest 25 mg once a day, and the observation group was treated with dienogest combined with TCM decoction. They all were treated for 6 months. The clinical efficacy, pregnancy and recurrence of the two groups were compared, and EMs health profile-5 (EHP- 5) of the Chinese version was used to evaluate patients′ quality of life of the two groups.Results:The total effective rate in the observation group was higher than that in the control group: 92.04%(81/88) vs. 79.78%(71/89), and the difference was statistically significant ( χ2 = 5.492, P<0.05). The time of ovulation recovery and menstrual recovery in the observation group were shorter than those in the control group: (13.38 ± 3.60) d vs. (14.69 ± 3.15) d, (26.48 ± 4.23) d vs. (28.72 ± 3.40) d, and the differences were statistically significant ( P<0.05). There was no statistically significant difference in the 1-year pregnancy rate between the two groups ( P>0.05). The 1-year recurrence rate in the observation group was lower than in the control group: 1.14%(1/88) vs. 10.11%(9/89), and the difference was statistically significant ( P<0.05). The scores of pain, emotional state, sense of control, sexual life, doctor-patient relationship , infertility, and treatment effect in EHP-5 in the observation group after the treatment were lower than those in the control group, and the differences were statistically significant ( P<0.05). Conclusions:Compared with dienogest treatment alone, the combination of TCM treatment can further improve the efficacy. It is beneficial to pregnancy. It can reduce the recurrence rate, improve the quality of life more significantly, and has great safety.

Objective To investigate the antimicrobial resistance of Streptococcus pneumoniae strains isolated from multiple medical institutions across Hebei Province in 2015.Methods The bacterial data were collected from 53 member hospitals of Hebei Antimicrobial Resistance Investigation Net (HEBARIN) according to the unified surveillance program in Hebei province.WHONET 5.6 was used to review,analyze and summarize the surveillance data.The results were interpreted according to CLSI guideline 2014.Results A total of 2 408 strains of S.pneumoniae were included in this analysis.S.pneumoniae was the third most frequently isolated gram positive bacteria.More than 95％ of these S.pneumoniae strains were susceptible to vancomycin and moxifloxacin.However,96.4％,89.3％ and 67.4％ of these strains were resistant to erythromycin,clindamycin,and trimethoprim-sulfamethoxazole,respectively.The antimicrobial susceptibility profile was similar between the strains isolated from adults and those isolates from children.Conclusions The antimicrobial resistance profile ofS.pneumoniae isolates in Hebei Province is generally consistent with the nation-wide data,except higher resistance level to a few antimicrobial agents.We should be alert to and control the emergence of resistant S.pneumoniae.

OBJECTIVE:To study the relationship between cisplatin-resistant of human ovarian cancer cells (SKOV3) and Toll-like receptor 9 (TLR9) under hypoxia. METHODS:Immunofluorescence method was used to detect the TLR9 expression in rupture and intact membranes SKOV3. SKOV3 was taken,adding cisplatin,then CCK-8 was used to detect cell inhibition rate af-ter 6,12,24 h of added into TLR9 specific agonists CpG-ODN 2006 (group A) and its isotype control CpG-ODN 2006 control (group B). SKOV3 or SKOV3 pretreated by 0(not added),1,10,102,103 μmol/L TLR9 specific antagonist chloroquine for 3 h were taken,adding cisplatin,cell inhibition rate was detected after 24 h of added into SKOV3 normoxia(21% O2),hypoxia(1%O2)incubating 6,12,24 h,HICR under hypoxia in pretreatment was calculated. Western blot method was used to detect the multi-drug resistance associated protein(MRP)expression in SKOV3 under the conditions of normoxia 24 h cell supernatant(group C), hypoxia 24 h cell supernatant(group D),hypoxia 24 h cell supernatant+10 μmol/L chloroquine(group E). RESULTS:TLR9 was expressed in both cell membrane and cytoplasm of SKOV3. Compared with group A,cell inhibition rate in group B was decreased (P<0.01). Compared with normoxia cell supernatant,cell inhibition rate was decreased after hypoxia cell supernatant (P<0.05). Compared with not added chloroquine,adding 10,102 μmol/L chloroquine can obviously decrease HICR(P<0.01),and the most significant decrease was showed when using hypoxia 24 h cell supernatant+10 μmol/L chloroquine. Compared with group C,MRP expression in group D was strengthened (P<0.01);compared with group D,MRP expression in group E was weakened (P<0.01). CONCLUSIONS:TLR9 receptors can be activated under hypoxia,and cause SKOV3 to cisplatin-resistance,the effect may be related with up-regulating MRP expression.

Objective To investigate the impact of movement frequency on gross tumor volume (GTV) of moving tumors and coordinate position of the central point based on three-and four-dimensional CT scans.Methods The respiratory motion platform from Modus and 8 phantoms with different shapes and volumes were used to simulate the movement of lung tumors.Three-and four-dimensional CT scans were performed at movement frequencies of 10,15,and 20 times/min.GTV (GTV10,GTV15,and GTV20) and IGTV (IGTV10,IGTV15,and IGTV20) were delineated,and the coordinate position of the central point was obtained.The Friedman test was performed for GTV10,GTV15,GTV20,IGTV10,IGTV15,IGTV20,and the coordinate position of the central point.Results GTV10,GTV15,and GTV20 at the three movement frequencies were 12.41±14.26 cm3,10.38±11.18 cm3,and 12.50±15.23 cm3,respectively (P=0.687),and the positional values were-8.2±96.2 mm,-8.6±96.1 mm,and-8.6±95.7 mm in x-axis (P=0.968),108.2±25.0 mm,110.4±22.5 mm,and 109.0±24.2 mm in y-axis (P=0.028),and 65.2±13.7 mm,65.4± 13.4 mm,and 65.4± 13.2 mm in z-axis (P =0.902).IGTV10,IGTV15,and IGTV20 at the three movement frequencies were 17.78± 19.42 cm3,17.43± 19.56 cm3,and 17.44± 18.80 cm3,respectively (P=0.417),and the positional values were-7.7±95.9 mm,-7.9±95.6 mm,and-7.9±95.1 mm in x-axis (P=0.325),109.4±24.5 mm,109.6±24.1 mm,and 109.2±24.3 mm in y-axis (P=0.525),and 65.5±13.3 mm,65.6±13.4 mm,and 65.5±13.3 mm in z-axis (P=0.093).Conclusions During simulated positioning of thoracic tumors,respiratory movement frequency has no significant impact on target volume established by four-dimensional CT scan.There are no significant differences in three-dimensional target volume established at different respiratory frequencies,but respiratory frequency has a significant impact on the position of the central point of the target volume in y-axis.

BACKGROUND:Periprosthetic infection after artificial joint replacement is a disastrous complication for a patient. Currently, during treating for the periprosthetic infection, most of patients need two-stage revision, which bring about enormous physical and psychological pain for patients, and a heavy burden for the families and society. To make matters worse, the effect is not very perfect, and some of these cases require multi-stage revision, even amputation. OBJECTIVE:To investigate the therapeutic effect of vacuum sealing drainage combined with iodophor douche for the infection after artificial joint replacement. METHODS:Nine cases (six knees and three hips) of infection after artificial joint replacement were col ected, with an average age of 63.4 years. Infection occurred at 7 days-14 months, and a median time of 1 month after replacement. Al patients suffered from purulent or purulent blood secretion. Fistula formed in two cases and incision and drainage sites were not healed in one case. According to the bacterial culture results, above symptoms were accorded with clinical diagnosis of prosthesis infection. The prosthesis was remained for debridement. Vacuum sealing drainage was performed. Iodophor douche (30-50 mL) was conducted every day. The drainage tube at proximal end was occluded for 30 minutes, and then vacuum sealing drainage was performed. Al patients were regularly fol owed up to assess the therapeutic effects of vacuum sealing drainage combined with prosthesis infection after replacement. RESULTS AND CONCLUSION:(1) Except that one case was stil in treatment, one case was dead, and one case of tumor prosthesis was failure and final y amputated, the remaining six patients were healed. (2) The time of vacuum sealing drainage and iodophor douche was 10 to 84 days, with the median time of 57 days. No adverse reactions or complications occurred. Al healed patients were fol owed up for 12-60 months, without recurrence. (3) These results indicated that vacuum sealing drainage combined with iodophor douche retained the prosthesis to the greatest degree, is simple, safe, and effective for the infection after artificial joint replacement, needs a low cost, and is a kind of therapy for prosthesis infection after artificial joint replacement.

Objective To investigate the clinical value of the probe melting curve analysis‐based PCR assay for the detection of three types of αT .Methods A total of 149 blood and prenatal archival DNA samples (6 of which were amniotic fluid samples)with three knownαT genes ,which included 63 carriers with Hb CS ,22 cases with Hb QS ,43 individuals with Hb WS and 1 double heter‐ozygote with Hb CS and Hb WS) as well as 20 samples with normalα‐globin gene sequence that had been confirmed by RBD com‐bined with DNA sequencing were selected to test the specificity of probe melting curve analysis by blind analysis .Results The probe melting curve analysis accurately detected 100 of the DNA samples previously characterized by S RBD combined with DNA sequencing .Conclusion Probe melting curve analysis‐based PCR assay for the detection ofαT is featured with rapidity and accuracy and can be applied to clinical and prenatal diagnosis .