This paper summarizes professor BAI Yanping's clinical experience in treating rosacea. It is believed that stagnant heat in cutaneous collaterals serves as the core pathogenesis of rosacea， and the interbinding of static blood and heat as well as blockage of cutaneous collaterals constitute the key pathological links. The core therapeutic principles consist of nourishing blood， activating blood circulation to resolve stasis， clearing heat， relieving stagnation and unblocking collaterals. In clinic， Wenqing Decoction （温清饮） is adopted as the basic formula， with flexible modifications according to distinct clinical syndromes and stages of rosacea. Based on clinical syndromes， for erythematotelangiectatic rosacea， the treatment should focus on activating blood to unblock collaterals， clearing heat and cooling blood； for papulopustular rosacea， the treatment should focus on clearing heat and resolving toxins， and resolving stasis and dissipating masses； for hypertrophic phymatous rosacea， the treatment should simultaneously softening hard masses， dissipating stagnation， nourishing blood and moisturizing the skin； for ocular rosacea， the treatment should prioritize clearing liver heat to improve eyesight， unblocking orifices and eliminating heat. Based on the stages， in acute phase， heat-clearing， detoxifying and blood-cooling therapies are emphasized； for protracted chronic phase， concurrent regulation of static blood and heat plus blood-nourishing and collateral-unblocking methods are applied； the consolidation stage targets invigorating the spleen and replenishing qi to strengthen vital resistance and eliminate pathogenic factors. Meanwhile， precise compatibility of aromatic medicinals， blood-level medicinals and channel-guiding medicinals is highly valued. The therapy should balance systemic regulation and local lesion care， and combine internal and external treatment， which may provides clinical references for TCM intervention of rosacea.

This paper summarizes professor BAI Yanping's clinical experience in treating rosacea. It is believed that stagnant heat in cutaneous collaterals serves as the core pathogenesis of rosacea， and the interbinding of static blood and heat as well as blockage of cutaneous collaterals constitute the key pathological links. The core therapeutic principles consist of nourishing blood， activating blood circulation to resolve stasis， clearing heat， relieving stagnation and unblocking collaterals. In clinic， Wenqing Decoction （温清饮） is adopted as the basic formula， with flexible modifications according to distinct clinical syndromes and stages of rosacea. Based on clinical syndromes， for erythematotelangiectatic rosacea， the treatment should focus on activating blood to unblock collaterals， clearing heat and cooling blood； for papulopustular rosacea， the treatment should focus on clearing heat and resolving toxins， and resolving stasis and dissipating masses； for hypertrophic phymatous rosacea， the treatment should simultaneously softening hard masses， dissipating stagnation， nourishing blood and moisturizing the skin； for ocular rosacea， the treatment should prioritize clearing liver heat to improve eyesight， unblocking orifices and eliminating heat. Based on the stages， in acute phase， heat-clearing， detoxifying and blood-cooling therapies are emphasized； for protracted chronic phase， concurrent regulation of static blood and heat plus blood-nourishing and collateral-unblocking methods are applied； the consolidation stage targets invigorating the spleen and replenishing qi to strengthen vital resistance and eliminate pathogenic factors. Meanwhile， precise compatibility of aromatic medicinals， blood-level medicinals and channel-guiding medicinals is highly valued. The therapy should balance systemic regulation and local lesion care， and combine internal and external treatment， which may provides clinical references for TCM intervention of rosacea.

The neurotoxicity related to immune checkpoint inhibitors (ICI) is rare, and the clinical experience remains limited. This paper reported an elderly male patient with advanced small cell lung cancer (SCLC). Following two circles of chemotherapy combined with immunotherapy (serplulimab, 200 mg), the patient developed fatigue, cognitive impairment, motor apraxia, and ataxia. Based on the examination of blood neurotransmitters and brain magnetic resonance imaging, the patient was diagnosed with ICI-associated encephalitis, and his symptoms improved after hormone treatment.

Objective: To investigate the nutritional status and influencing factors among Tibetan and Mongolian children and adolescents aged 7-18 years in high-altitude regions, so as to provide evidence for early prevention and control of malnutrition in this population. Methods: From May to June 2022, a cluster sampling method was employed to recruit 1 019 Tibetan and Mongolian children and adolescents aged 7-18 years from two primary and secondary schools in Golmud City. Physical examinations, dietary frequency questionnaires, and physical activity assessments were conducted. Nutritional status was classified as obesity, combined overweight/obesity, underweight, or central obesity according to national standards including Screening for Overweight and Obesity among School-age Children and Adolescents, Screening Standard for Malnutrition of School-age Children and Adolescents, Blue Book on Obesity Prevention and Control in China. Chi-square tests, t-test and Logistic regression analyses were performed to identify factors associated with different nutritional statuses. Results: The detection rates of obesity, combined overweight/obesity, underweight, and central obesity were 8.0%, 18.1%, 5.2%, and 19.7%, respectively. The height of children and adolescents across all age groups was generally lower than the national standard values. Tibetan participants exhibited significantly lower height-for-age Z-scores (HAZ)(9-10, 13-17 years, Z =2.01, 2.78, 4.16, 3.38, 4.12, 3.63, 3.00) and BMI-for-age Z-scores (BAZ) compared to Mongolian participants ( Z =-2.95, -2.47, -2.31, -2.89, -2.14, -2.17)( P < 0.05 ). Multivariate Logistic regression revealed that Mongolian children and adolescents had higher risks of obesity ( OR =2.20) and combined overweight/obesity ( OR = 2.18 ) ( P <0.05). Additionally, insufficient moderate-to-vigorous physical activity (MVPA) was associated with an increased risk of central obesity ( OR =1.48, P <0.05), compared with children and adolescents who meet the standard of MVPA. Conclusions The rates of overweight and obesity among Tibetan and Mongolian children and adolescents in Golmud City are higher, influenced by multiple factors. Nutrition interventions and physical activity strategies tailored to ethnic characteristics should be implemented, with emphasis on promoting MVPA to improve nutritional outcomes in this population.

OBJECTIVE: We aimed to investigate the patterns of fasting blood glucose (FBG) trajectories and analyze the relationship between various occupational hazard factors and FBG trajectories in male steelworkers. METHODS: The study cohort included 3,728 workers who met the selection criteria for the Tanggang Occupational Cohort (TGOC) between 2017 and 2022. A group-based trajectory model was used to identify the FBG trajectories. Environmental risk scores (ERS) were constructed using regression coefficients from the occupational hazard model as weights. Univariate and multivariate logistic regression analyses were performed to explore the effects of occupational hazard factors using the ERS on FBG trajectories. RESULTS: FBG trajectories were categorized into three groups. An association was observed between high temperature, noise exposure, and FBG trajectory ( P < 0.05). Using the first quartile group of ERS1 as a reference, the fourth quartile group of ERS1 had an increased risk of medium and high FBG by 1.90 and 2.21 times, respectively (odds ratio [ OR] = 1.90, 95% confidence interval [ CI]: 1.17-3.10; OR = 2.21, 95% CI: 1.09-4.45). CONCLUSION An association was observed between occupational hazards based on ERS and FBG trajectories. The risk of FBG trajectory levels increase with an increase in ERS.
Humans ; Male ; Adult ; Blood Glucose/analysis* ; China ; Prospective Studies ; Occupational Exposure/adverse effects* ; Risk Factors ; Middle Aged ; Steel ; Fasting/blood* ; Metal Workers ; East Asian People

Objective:To investigate the changes of the epidemiology and clinical characteristics of human metapneumovirus (hMPV) among children with acute lower respiratory tract infection (ALRTI) before and after the discontinuation of non-pharmaceutical interventions (NPI) during coronavirus disease 2019 epidemic.Methods:This was a retrospective cohort study. Children hospitalized at The Second Affiliated Hospital and Yuying Children′s Hospital of Wenzhou Medical University between January 2021 and December 2023, who were diagnosed with ALRTI by nasopharyngeal secretion testing for respiratory pathogens nucleic acid were enrolled. Clinical and laboratory data were collected. Children admitted between January 1, 2021 and January 7, 2023 were classified as the pre-NPI withdrawal group (abbreviated as pre-withdrawal group), while those admitted from January 8, 2023 afterward were classified as the post-NPI withdrawal group (abbreviated as post-withdrawal group). Nasopharyngeal secretions from the enrolled children were tested for 13 respiratory pathogens using polymerase chain reaction-capillary electrophoresis fragment analysis, and bacterial cultures were also performed. Statistical analyses were performed using the Mann-Whitney U test or chi-square test. Results:A total of 30 855 ALRTI cases were enrolled, with 1 679 of hMPV-positive. In the pre-withdrawal group, there were 861 cases with an age of onset of 2.0(1.0, 3.0) years, and the highest proportion was in the 1 to <3 years age group, accounting for 35.3%(304/861). In the post-withdrawal group, there were 818 cases with an age of onset of 3.0(2.0, 4.0) years, and the highest proportion was in the 3 to <5 years age group, accounting for 39.2%(321/818).The age of onset in the post-withdrawal group was significantly older than that in the pre-withdrawal group ( Z=7.69, P<0.001) .The hMPV detection rate was higher in the pre-withdrawal group than that in post-withdrawal group (5.75%(861/14 984) vs 5.15%(818/15 871); χ2=5.25, P=0.022). In the pre-withdrawal group, the epidemic peaks occurred in winter and spring, with the highest rates in January 2022(25.2%(224/890)) and March 2022 (21.6%(186/860)). In the post-withdrawal group, the epidemic peak shifted to spring and summer, and the detection rate became increased since April 2023(10.8%(136/1 258)). The post-withdrawal group showed lower rates of wheezing, shortness of breath, cyanosis, respiratory support, severe pneumonia, intensive care unit admission, and shorter hospital stays compared to the pre-withdrawal group ( χ2=69.09, 31.63, 12.97, 57.96, 55.73, 5.48 and Z=7.11, respectively, all P< 0.05).In the pre-withdrawal group, 412 cases (47.9%(412/861)) had other pathogens detected, compared to 445 cases (54.4%(445/181)) in the post-withdrawal group, indicating a significantly higher rate of co-infections in the post-withdrawal group ( χ2=7.20, P<0.05). The most commonly detected pathogens in both groups were Mycoplasma pneumoniae (MP), rhinovirus, and Streptococcus pneumoniae. However, the post-withdrawal group showed significantly higher detection rates of MP and influenza virus, but lower bacterial detection rates compared to the pre-withdrawal group ( χ2=39.41, 9.70, 5.63, respectively, all P<0.05). The detection rate of Haemophilus influenzae was 2.1%(17/818) in the post-withdrawal group which lower than that (6.7%(58/861)) in the pre-withdrawal group, and the difference was statistically significant ( χ2=21.32, P<0.001). Conclusions:In 2023, following the withdrawal of NPI, the epidemic peak of hMPV in Wenzhou area is delayed to spring and summer. The age of children with hMPV-associated ALRTI increases, with the majority being 3 to <5 years old. The overall severity of the disease decreases. However, the detection of mixed pathogens increases, with MP being the most common, while bacterial detection decreases.

Aim To establish the pyroptosis model of rat chondrocytes induced by tumor necrosis factor α(TNF-α)in order to study the effect of lysine acetyl-transferase 7(KAT7)on pyroptosis of chondrocytes.Methods Chondrocytes of rat knee joint were isolated by type Ⅱ collagenase digestion,and were identified by toluidine blue staining and Col Ⅱ immunofluorescence.CCK-8 was used to evaluate cell viability.Western blot was used to detect the expression of pyroptosis-related proteins NLRP3,GSDMD,caspase-8 and KAT7 in cells intervened with TNF-α,adenovirus overexpression of KAT7(KAT7-oe)and KAT7 inhibitor WM-3835.The microstructure of the cells was observed by scanning e-lectron microscopy.Pyroptosis was detected by TUNEL staining,and the expression of pyroptosis-related pro-tein and KAT7 was detected by immunofluorescence.Results Compared with the empty virus group,KAT7-oe inhibited cell viability,promoted the expression of pyroptosis-related proteins,and TNF-α enhanced this effect.At the same time,the expression of KAT7 and pyroptosis-related proteins in the TNF-α stimulation group increased,and WM-3835 reduced the related proteins expression.Electron microscopy showed that KAT7-oe caused cell swelling,deformation,membrane perforation and rupture,while WM-3835 could restore cell morphology.TUNEL staining and immunofluores-cence results also confirmed that KAT7-oe induced chondrocyte pyroptosis,and WM-3835 could down-reg-ulate the fluorescence of pyroptosis-related proteins.Conclusions The expression of KAT7 increases in rat chondrocyte pyroptosis model,and the intervention of KAT7 expression affects signal molecules related to py-roptosis pathway,suggesting that KAT7 may be related to chondrocyte pyroptosis.

Objective To investigate the potential profile of self-management behavior in patients with sudden deafness,the characteristics and influencing factors of different categories of patients,and provide reference for clin-ical management.Methods A total of 205 patients with sudden deafness who were hospitalized in the Department of Otology of a Grade 3 hospital in Beijing were selected by convenience sampling method from August 2023 to June 2024.Date were collected using the general situation questionnaire,self-management status assessment scale for sudden deafness patient and social support rating scale.Mplus 8.0 was used for potential profile analysis,and SPSS 26.0 was used for single factor analysis and multiple logistic regression analysis.Results A total of 200 valid ques-tionnaires were collected.Patients were divided into 3 categories according to their self-management level,which were respectively named as"high management—good self-efficacy group"(n=52,26.00％),"moderate manage-ment—symptoms of special concern group"(n=101,50.50％),and"low management-lack of information acquisi-tion group"(n=47,23.50％).Multiple logistic regression analysis showed that education level,sleep disorder and social support level were the influencing factors of different self-management categories in patients with sudden deaf-ness.Conclusion The overall self-management ability of patients with sudden deafness is at a moderate level and with significant heterogeneity.Education level,sleep disorders,and social support serve as stratification criteria for categorizing different patient groups and formulating corresponding intervention strategies.Priority should be given to providing information support to the"low-management group with information deficiency",implementing targe-ted interventions for the"moderate-management group with symptom focus",and fully leveraging the self-efficacy of the"high-management group with good self-efficacy"to regulate their self-management level.

Objective To compare the anesthetic effect of different doses of esketamine combined with propofol in elderly patients underwent endoscopic retrograde cholangiopancreatography(ERCP),and explore the appropriate dose.Methods 105 elderly patients were selected for ERCP.The patients were divided into 3 groups with 35 cases in each group by random number table method.E1 group,E2 group and E3 group were given esketamine 0.15,0.35 and 0.50 mg/kg,respectively,and were given propofol 1.00 mg/kg intravenous injection 15 s later.Heart rate(HR),mean arterial pressure(MAP),and percutaneous arterial oxygen saturation(SpO2)were recorded after left lateral position(T0),at successful induction(T1),endoscope through larynx(T2),sphincter insertion or incision(T3),and at recovery(T4).Operation duration,intraoperative propofol dosage,anesthesia recovery time,visual analogue scale(VAS)score 15 min after anesthesia recovery and occurrence of adverse reactions were recorded.Results Compared with T0,HR and MAP decreased at T1,T2,T3 and T4 time point in E1 group,HR and MAP increased at T1,T2,T3 and T4 time point in E3 group,the differences were statistically significant(P<0.05);HR and MAP had no significant changes at T1,T2,T3 and T4 time point in E2 group(P>0.05);Compared with group E3,HR and MAP decreased at T1,T2,T3 and T4 time point in E1 group and E2 group,and E1 group was lower than E2 group,the differences were statistically significant(P<0.05);There were no significant difference in SpO2 at different time points between the three groups(P>0.05);Compared with E1 group,the dosage of propofol in E2 group and E3 group was decreased,and E3 group was significantly less than E2 group,with statistical significance(P<0.05).Compared with E3 group,the recovery time of E1 group and E2 group was shorter,and E2 group was shorter than E1 group,the differences were statistically significant(P<0.05).Compared with E1 group,pain VAS score 15 min after recovery in E2 group and E3 group was lower,and E3 group was lower than E2 group,the differences were statistically significant(P<0.05).There was no significant difference in operation time among 3 groups(P>0.05).The incidence of hypoxemia,respiratory depression and hypotension in E1 group were higher than that in E2 group and E3 group,the difference was statistically significant(P<0.05).The incidence of psychomimetic symptoms and visual disturbance in E3 group was higher than that in E1 group and E2 group,the difference was statistically significant(P<0.05).There were no significant differences in the incidence of dizziness and nausea vomiting among the 3 groups(P>0.05).Conclusion 0.35 mg/kg esketamine combined with propofol in the operation of ERCP in elderly patients,respiratory circulation is more stable,and adverse reactions do not increase.

Objective : To explore the impacts and fundamental mechanisms of the PU. 1 inhibitor DB2313 on the immune function in MRL/lpr mice. Methods: A total of thirty MRL/lpr lupus mice were randomly distributed into three separate groups : the model control group , the PU. 1 inhibitor DB2313 treatment group ( administered at a dose of 17 mg/kg) , and the positive drug control Telitacicept (TACI_Ig) group (administered at a dose of 7. 5 mg/ kg) . Furthermore , a group of ten BALB/c mice were assigned as the normal group. The DB2313 administration group was treated with intraperitoneal injections of the drug on three occasions per week , while the TACI_Ig group received subcutaneous injections every second day; both treatment protocols were maintained for a duration of five weeks. Both the control group and the model group were administered intraperitoneal injections of a volume of saline that was equivalent across groups. After the drug was given , mice were sacrificed by dislocation after orbital vein blood collection. The thymus and spleen were aseptically excised , individually weighed , and subsequently utilized to compute the thymus index and spleen index. The relative distribution of T lymphocyte subsets within the spleen was ascertained through flow cytometry. Serum concentrations of anti_nuclear antibodies ( ANA) and antidouble_stranded DNA antibodies were quantified using an enzyme_linked immunosorbent assay (ELISA) . The levels of inflammatory factors interleukin_6 (IL_6) , tumor necrosis factor_α (TNF_α) , interferon_γ(IFN_γ) were meas ured by CBA method. Hematoxylin and eosin ( HE) staining was employed to examine pathological alterations in the spleen. The expression of PU. 1 and IL_9 in spleen tissue was detected using immunohistochemistry. Additionally , the expression level of PU. 1 protein in the spleen tissue was ascertained through Western blot analysis. Results: The administration of DB2313 significantly ameliorated spleen lesions in MRL/lpr mice and decreased the levels of anti_ds_DNA , ANA , TNF_α , IL_6 , and IFN_γ . It also reduced the proportion of total T cells , TFH cells , Th17 cells , and Th9 cells in the mouse spleen , while increasing the proportion of Treg cells. Furthermore , it lowered the level of PU. 1 protein in the spleen. Immunohistochemistry results demonstrated that DB2313 treatment significantly diminished the expression of PU. 1 and IL_9 in spleen tissue. Conclusion The PU. 1 inhibitor DB2313 can improve spleen lesions in MRL/lpr mice and slow the progression of the disease , and its mechanism is related to the regulation of immune cell functions.