ObjectiveTo investigate the therapeutic effect and potential mechanism of thymosin β4 （Tβ4） on carbon tetrachloride （CCl₄）-induced hepatic fibrosis by regulating the expression of platelet-derived growth factor （PDGF） and inducing the apoptosis of hepatic stellate cell （HSC）， and to provide new experimental evidence for anti-hepatic fibrosis treatment in clinical practice. MethodsA total of 30 male C57 mice were randomly divided into normal control group， model group， low-dose Tβ4 treatment group （3 mg/kg）， middle-dose Tβ4 treatment group （6 mg/kg）， and high-dose Tβ4 treatment group （12 mg/kg）， with 6 mice in each group. The mice in the normal control group were fed with a normal diet ad libitum， and those in the other groups were given intraperitoneal injection of 50% CCl₄ mixed with olive oil to establish a model of hepatic fibrosis. After successful modeling confirmed by ultrasound and histopathology， the mice in each treatment group were given subcutaneous injection of Tβ4 for 4 consecutive weeks. Liver tissue was collected at the end of the experiment， and HE staining and Masson staining were used to observe histopathological changes； quantitative real-time PCR was used to measure the mRNA expression level of PDGF； TUNEL assay was used to assess the apoptosis of HSC. A one-way analysis of variance was used for comparison of continuous data between multiple groups， and the least significant difference t-test was used for further comparison between two groups. ResultsCompared with the model group， the middle- and high-dose Tβ4 treatment groups had varying degrees of alleviation of hepatic fibrosis. Quantitative real-time PCR showed that Tβ4 could significantly downregulate the mRNA expression level of PDGF in liver tissue， with a significant difference between the treatment groups （P>0.05）， and there was no significant difference in the mRNA expression level of PDGF between the high-dose Tβ4 treatment group and the normal control group （P>0.05）. TUNEL assay showed that the middle- and high-dose Tβ4 treatment groups had a significantly higher number of apoptotic HSCs than the model group. ConclusionTβ4 may improve CCl₄-induced hepatic fibrosis in mice by downregulating the expression of PDGF and promoting the apoptosis of HSC， suggesting that it has a potential application value in the treatment of hepatic fibrosis.

Hepatic angiomyolipoma （HAML） is a rare benign mesenchymal tumor frequently observed in middle-aged women. Due to the absence of prominent symptoms in the early stage and the lack of specific imaging findings， the diagnosis of this disease can be challenging， leading to a high rate of misdiagnosis. This article reports a case of giant HAML with subcapsular rupture that was misdiagnosed as hepatocellular carcinoma and introduces the characteristics of the case and its diagnosis and treatment process， in order to provide a reference for the diagnosis and treatment of this type of disease.

Objective:To describe the safety of using the Chinese-made robotic laparoscopic surgery system for laparoscopic sacrocolpopexy in the treatment of severe pelvic organ prolapse.Methods:A pilot descriptive clinical study was conducted, enrolling 16 severe pelvic organ prolapse patients at Peking University First Hospital from April 2023 to January 2024. Patients who consented to participate in this study underwent laparoscopic sacrocolpopexy for severe pelvic organ prolapse using Chinese-made robotic laparoscopic surgery system. Preoperative clinical basic data and perioperative data of the patients were collected, summarizing the data on perioperative bleeding and complications, and reviewed the surgical learning experience. The evaluation indicators related to the learning experience included: (1) efficiency evaluation: including equipment docking time, total surgery time, suturing time, mechanical arm operation time and hysterectomy time, which were timed and recorded during surgery; (2) equipment operability evaluation: including equipment operation task load assessment and intraoperative operation feeling score. The cumulative sum analysis method was used to quantify surgery time and fit the learning curve.Results:Sixteen patients were successfully enrolled and underwent surgery, including total hysterectomy with bilateral salpingo-oophorectomy or salpingectomy plus sacrocolpopexy, or sacrocolpopexy alone (for one case without uterus). The age of 16 cases was (56.7±7.6) years (ranged from 44 to 67 years), with body mass index of (25.4±2.5) kg/m2. Concurrent procedures included anterior vaginal wall repair in 12 cases (12/16), posterior vaginal wall repair in 13 cases (13/16), tension-free vaginal tape obturator system in 1 case (1/16), and recto-uterine pouch hernia repair in 4 cases (4/16). The total surgery time was (355.8±91.1) minutes, with docking time at (6.7±4.9) minutes, robotic operative time at (267.6±81.4) minutes, robotic suturing time at (155.6±53.9) minutes, and hysterectomy time at (112.0±45.3) minutes. Learning curve analysis revealed inflection points at 6 cases for total surgery time ( P<0.001, R2=0.944) and robotic operative time ( P<0.001, R2=0.982), 5 cases for docking time ( P<0.001, R2=0.989), and 6 cases for robotic suturing time ( P<0.001, R2=0.907). Hysterectomy time had an inflection point at 5 cases ( P=0.023, R2=0.700). Median blood loss was 30 ml (range: 10-1 000 ml), with severe bleeding in one patient (1/16). No conversions to open surgery or laparoscopy occurred, and no severe perioperative or postoperative complications were reported. Conclusion:The Chinese-made robotic laparoscopic surgery system demonstrates excellent short-time safety and ease of operation for laparoscopic sacrocolpopexy.

Objective The study aimed to explore the factors influencing individual variations in the therapeutic efficacy of botulinum toxin type A(BoNT-A)in the treatment of benign essential blepharospasm(BEB).Methods A retrospectively analysis was performed on the general information of 40 BEB patients who received BoNT-A injections at our center between 2018 and 2023.The information included gender,age,education level,disease duration,number of injections,injection dose,severity of clinical symptoms,injection methods,and other relevant factors.All patients received both the pretarsal(PT)injection and the PT combining with preseptal(PS)injection(PT-PS).A multivariate linear regression analysis was used to statistically analyze the factors affecting the duration of therapeutic effect(DOT).Results Multiple regression analysis showed that gender,age,education level,clinical symptoms and injection method were closely related to the DOT[F(8,71)=4.372,P<0.001],with the injection method being the strongest predictor.Specifically,the mean DOT for the two injection methods was 136.00(123.00,156.50)days,with the PT-PS method significantly longer than the PT method[144.50(132.25,161.75)vs.125.00(114.00,145.25),P<0.001].Conclusion Gender,age,educational level,clinical symptoms,and injection method are predictive indicators for the DOT of BoNT-A in BEB patients.Specifically,DOT is positively correlated with age but negatively correlated with educational level and severity of clinical symptom.Additionally,the DOT is longer in male patients compared to female patients and in those treated with the PT-PS injection method compared to the PT injection method.

Objective:To describe the safety of using the Chinese-made robotic laparoscopic surgery system for laparoscopic sacrocolpopexy in the treatment of severe pelvic organ prolapse.Methods:A pilot descriptive clinical study was conducted, enrolling 16 severe pelvic organ prolapse patients at Peking University First Hospital from April 2023 to January 2024. Patients who consented to participate in this study underwent laparoscopic sacrocolpopexy for severe pelvic organ prolapse using Chinese-made robotic laparoscopic surgery system. Preoperative clinical basic data and perioperative data of the patients were collected, summarizing the data on perioperative bleeding and complications, and reviewed the surgical learning experience. The evaluation indicators related to the learning experience included: (1) efficiency evaluation: including equipment docking time, total surgery time, suturing time, mechanical arm operation time and hysterectomy time, which were timed and recorded during surgery; (2) equipment operability evaluation: including equipment operation task load assessment and intraoperative operation feeling score. The cumulative sum analysis method was used to quantify surgery time and fit the learning curve.Results:Sixteen patients were successfully enrolled and underwent surgery, including total hysterectomy with bilateral salpingo-oophorectomy or salpingectomy plus sacrocolpopexy, or sacrocolpopexy alone (for one case without uterus). The age of 16 cases was (56.7±7.6) years (ranged from 44 to 67 years), with body mass index of (25.4±2.5) kg/m2. Concurrent procedures included anterior vaginal wall repair in 12 cases (12/16), posterior vaginal wall repair in 13 cases (13/16), tension-free vaginal tape obturator system in 1 case (1/16), and recto-uterine pouch hernia repair in 4 cases (4/16). The total surgery time was (355.8±91.1) minutes, with docking time at (6.7±4.9) minutes, robotic operative time at (267.6±81.4) minutes, robotic suturing time at (155.6±53.9) minutes, and hysterectomy time at (112.0±45.3) minutes. Learning curve analysis revealed inflection points at 6 cases for total surgery time ( P<0.001, R2=0.944) and robotic operative time ( P<0.001, R2=0.982), 5 cases for docking time ( P<0.001, R2=0.989), and 6 cases for robotic suturing time ( P<0.001, R2=0.907). Hysterectomy time had an inflection point at 5 cases ( P=0.023, R2=0.700). Median blood loss was 30 ml (range: 10-1 000 ml), with severe bleeding in one patient (1/16). No conversions to open surgery or laparoscopy occurred, and no severe perioperative or postoperative complications were reported. Conclusion:The Chinese-made robotic laparoscopic surgery system demonstrates excellent short-time safety and ease of operation for laparoscopic sacrocolpopexy.

Objective The study aimed to explore the factors influencing individual variations in the therapeutic efficacy of botulinum toxin type A(BoNT-A)in the treatment of benign essential blepharospasm(BEB).Methods A retrospectively analysis was performed on the general information of 40 BEB patients who received BoNT-A injections at our center between 2018 and 2023.The information included gender,age,education level,disease duration,number of injections,injection dose,severity of clinical symptoms,injection methods,and other relevant factors.All patients received both the pretarsal(PT)injection and the PT combining with preseptal(PS)injection(PT-PS).A multivariate linear regression analysis was used to statistically analyze the factors affecting the duration of therapeutic effect(DOT).Results Multiple regression analysis showed that gender,age,education level,clinical symptoms and injection method were closely related to the DOT[F(8,71)=4.372,P<0.001],with the injection method being the strongest predictor.Specifically,the mean DOT for the two injection methods was 136.00(123.00,156.50)days,with the PT-PS method significantly longer than the PT method[144.50(132.25,161.75)vs.125.00(114.00,145.25),P<0.001].Conclusion Gender,age,educational level,clinical symptoms,and injection method are predictive indicators for the DOT of BoNT-A in BEB patients.Specifically,DOT is positively correlated with age but negatively correlated with educational level and severity of clinical symptom.Additionally,the DOT is longer in male patients compared to female patients and in those treated with the PT-PS injection method compared to the PT injection method.

Hereditary endocrine and metabolic diseases , caused by genetic factors, exhibit complex and diverse symptoms, including the possibility of concurrent sensorineural deafness. Currently, there is a limited clinical understanding of hereditary endocrine and metabolic diseases that manifest with deafness, the pathogenesis remains unclear,and there is a lack of effective diagnostic and treatment methods. This article summarizes the research progress of hereditary endocrine and metabolic diseases complicated with deafness from the pathogenesis, clinical phenotype, diagnosis and treatment. Understanding the current research progress and integrating genetic analysis into clinical practice are crucial for accurate diagnosis and treatment, evaluating clinical efficacy, and providing effective genetic counseling for these diseases.
Humans ; Deafness/genetics* ; Hearing Loss, Sensorineural/diagnosis* ; Phenotype ; Metabolic Diseases/genetics* ; Genetic Counseling

Objective To investigate the effect of cognitive-behavioral intervention under the family-centered care(FCC)model on continuing care of patients after aortic dissection surgery.Methods One hundred and six patients undergoing aortic dissection in the Department of Cardiac Surgery of the hospital from January 2021 to December 2022 were evenly divided into control group and observation group by using random number table method,with 53 cases in each group.The control group was given routine continuing care,and the observation group was treated with continuing care with the cognitive behavior intervention under the FCC mode based on the control group,and both groups intervened for 8 weeks.The control group was treated with routine continuity care,while the observation group received continuity care with cognitive-behavioral intervention based on the FCC model in addition to routine continuing care,with a intervention duration of 8 weeks for both groups.The two groups were compared in terms of blood pressure,body mass index(BMI),self-care ability(measured using the Self-Care Ability Scale-ESCA),quality of life(measured using the Short Form-36 Health Survey-SF-36),and levels of depression and anxiety(measured using the Hospital Anxiety and Depression Scale-HADS)before and after the intervention.Results The level of blood pressure,BMI,and level of depression and anxiety after the intervention were all significantly lower than before the intervention(P<0.05)and the scores by ESCA and SF-36 were signifi-cantly higher than before intervention(P<0.05).The blood pressure and BMI in the observation group were both significantly better than in the control group[(116.47±28.23)mmHg vs.(124.48±29.81)mmHg and(25.33±1.11)kg/m2 vs.26.18±1.35)kg/m2,t = 7.193,2.454,P<0.01,respectively].The scores of self-care ability and quality of life in the observation group were higher than in the control group[(121.15±29.69)vs.(106.68±24.71)and(67.92±13.69)vs.(60.81±10.77),t = 8.243,7.436,P<0.01,respectively].The scores of depression and anxiety in the observation group were significantly lower than in the control group[(11.07±4.00)vs.(12.20±4.28)and(12.39±3.59)vs.(13.45±4.15),t = 3.873,2.852,P<0.01,respectively].Conclusion The cognitive-behavioral intervention under the FCC mode can significantly improve blood pressure,BMI,and psychological condition,as well as enhance patients'self-care ability and quality of life,when applied in the continuity of care for patients after aortic dissection.Therefore,it is worth promoting and applying in clinical practice.

BACKGROUND:Periodontitis is an inflammatory and destructive disease with plaque biofilm as the main pathogenic material,which occurs in the gingiva,periodontal ligament,alveolar bone and cementum.The antigen of bacterial complex and its secreted toxin and enzyme directly lead to the destruction of periodontal tissue and trigger the host's immune response,causing indirect damage to the body tissue.Silence information regulatory factors(Sirtuins,SIRTs)play an important role in anti-aging,anti-oxidative stress,regulating inflammation,and mediating autophagy,and are closely related to the occurrence and development of periodontitis. OBJECTIVE:To review the research status of Sirtuins in periodontitis. METHODS:The first author used the computer to search the relevant research regarding the role of Sirtuins in periodontitis in PubMed,Web of Scene,CNKI and WanFang databases.The key words were"Sirtuins,Sirtuin1-7,periodontitis"in English and Chinese.After literature screening,57 articles were included for review and analysis. RESULTS AND CONCLUSION:SIRT1,SIRT2,SIRT3,and SIRT6 participate in regulating the occurrence and development of periodontitis.Inhibition of SIRT1 expression may be the target of periodontitis treatment,while overexpression of SIRT1 can inhibit periodontitis and protect periodontal tissue.The activator of SIRT1 can reduce the inflammation of periodontal tissue and improve the systemic pathological changes caused by periodontitis.SIRT2 is involved in nicotinamide phosphoribosyltransferase-mediated periodontal inflammation and plays a role in the treatment and prognosis of periodontal diseases.SIRT3 can improve age-related periodontal disease.Gastrodin promotes the osteogenic differentiation of periodontal ligament stem cells through the up-regulation of SIRT3.The activator of SIRT3 reduces the damage of periodontitis to periodontal and renal tissues by regulating the level of autophagy in the cells.SIRT6 can inhibit the inflammatory reaction of periodontal tissue and inhibit the differentiation and mineralization of cementoblasts.SIRT6 is beneficial to the prognosis of periapical periodontitis.The relationship between SIRT4,SIRT5,SIRT7 and periodontitis is rarely reported.

Botulinum toxin(BoNT)is currently the first-line method for treating focal dystonia,which causes muscle paralysis by chemical denervation.Recent neuroimaging studies have found that BoNT treatment could alter neuroplasticity in the brain of patients with focal dystonia.However,the specific central nervous system mechanisms have not been fully elucidated.To this end,here we review the neuroimaging studies on BoNT treatment for dystonia from three aspects:functional magnetic resonance imaging,structural magnetic resonance imaging,and positron emission tomography imaging.It suggests that BoNT may improve the symptoms of dystonia patients by affecting functional connectivity,microstructure,and metabolic levels of the cortex,basal ganglia,thalamus,and cerebellum,etc.Therefore,this review will provide a theoretical reference for further exploring the mechanism and developing potential therapeutic targets of dystonia.