Steroid-induced avascular necrosis of femoral head（SANFH） is a bone and joint disease caused by prolonged and excessive steroid use. Its typical pathological features involve progressive circulatory disorders in the blood supply system of femoral head， leading to osteocyte apoptosis and bone tissue necrosis. As the disease progresses， it ultimately results in structural collapse and necrotic lesions of the femoral head， severely affecting patients' limb function and quality of life. Glucocorticoids mediate pathological damage through dual mechanisms， on the one hand， they disrupt the dynamic equilibrium between bone formation and resorption by suppressing osteoblast differentiation activity and activating osteoclastogenesis， on the other hand， they induce lipid metabolism disorders， inhibit angiogenesis， and impair endothelial cell function， thereby triggering microcirculatory disorders. Epimedii Folium and its active components exhibit multidimensional regulatory effects in SANFH prevention and treatment. Literature review reveals that it is rich in multiple active ingredients， primarily including total flavonoids of Epimedii Folium， icaritin， icariin， kaempferol， icariside Ⅱ， etc. These compounds exert multiple pharmacological effects（regulating bone metabolic homeostasis， modulating angiogenesis， correcting lipid metabolism disorders， and controlling cellular autophagy processes） through multiple signaling pathways， including Wnt/β-catenin， transforming growth factor（TGF）-β/bone morphogenetic protein（BMP）/Smad， mitogen-activated protein kinase（MAPK）， phosphoinositide 3-kinase/protein kinase B（PI3K/Akt）， osteoprotegerin/receptor activator of nuclear transcription factor-κB ligand/receptor activator of nuclear transcription factor-κB（OPG/RANKL/RANK）， etc. Based on existing research findings， this paper systematically elucidates the intervention mechanisms of active components in Epimedii Folium on key pathological processes of SANFH through the above pathways. It also deeply analyzes their regulatory roles in key nodes of different signaling pathways， aiming to provide valuable references for future clinical treatment and experimental research.

Objective To explore the experience of robot-assisted laparoscopic surgery in the treatment of residual malformation of urachus with children.Methods The clinical date of 10 children with urachal remnants malformation treated by Da Vinci Robot Assisted Laparoscopic Surgery in Wuhan Children's Hospital from July 2021 to July 2023 were retrospectively analyzed.Robot-assisted laparoscopic surgery was used to analyze the intraoperative situation,postoperative complications,surgical effect and pathological results.Results All 10 cases were treated by Da Vinci Robot Assisted Laparoscopic Surgery without Laparotomy and complete excision,while maintain the umbilical integrality,8 cases with symptoms were resected after preoperative imaging diagnosis,1 case was asymptomatic and resected due to continuous enlargement of the cyst,and 1 case was found to be resected during other operations.The average operation time was(140.70±17.66)min,the median blood loss was 7.5(4.5,27.5)ml,the postoperative urethral catheterization was(6.2±1.26)d,the hospital stay was(9.9±0.94)d and the average cost was(46378.92±2777.13)yuan.All the urachal remnants were confirmed by Pathology as 9 cases of urachal cysts and 1 case of urachal fistula.Conclusion Robot-assisted laparoscopic surgery is safe and effective in the treatment of urachal remnants malformation in children,the surgical procedure for resected repair of the anterior abdominal wall has unique advantages.

OBJECTIVE To mine and analyze the adverse drug events （ADE） signals of two camptothecin topoisomerase 1 inhibitors， i.e. irinotecan and topotecan， and to provide reference for clinical medication safety. METHODS Based on the U.S. Food and Drug Administration Adverse Event Reporting System （FAERS） database， ADE report data for the aforementioned two drugs were extracted from January 1， 2004 to March 31， 2023. After processing the data， signal mining was conducted by using the reporting odds ratio in conjunction with the Bayesian confidence propagation neural network， followed by analysis. RESULTS A total of 14 738 relevant ADE reports were screened， among which 11 483 were associated with irinotecan and 3 255 with topotecan. The ADE reports for irinotecan were predominantly male， whereas for topotecan， they were predominantly female； the age of patients using the two drugs mainly concentrated in 45-＜75 years old. A total of 847 signals were detected， involving 24 system organ classes （SOCs）. Among them， 565 signals of irinotecan were detected， involving 24 SOCs， primarily concentrating on gastrointestinal disorders， general disorders and administration site conditions， blood and lymphatic system disorders； the most frequently reported ADE was diarrhea， and the ADE with the strongest signal intensity was cholinergic syndrome. A total of 282 signals of topotecan were detected， involving 22 SOCs， primarily concentrating on general disorders and administration site conditions， investigations， blood and lymphatic system disorders， and gastrointestinal disorders； the most frequently reported ADEs were death and anemia， and the ADE with the strongest signal intensity was febrile bone marrow aplasia. ADE signals for irinotecan such as metastatic colorectal cancer， peripheral sensory neuropathy， steatohepatitis， and those for topotecan such as iris atrophy， retinal degeneration， vitreous hemorrhage， were not documented in their respective drug instruction. CONCLUSIONS ADEs of irinotecan and topotecan primarily involve the digestive and hematologic systems， warranting close clinical monitoring. Cholinergic syndrome caused by irinotecan should be concerned. In addition， patients receiving irinotecan should also be monitored for ADE such as metastatic colorectal cancer， peripheral sensory neuropathy， steatohepatitis， and proteinuria； for patients using topotecan， enhanced surveillance of ocular diseases is recommended to ensure medication safety.

Objective To explore the experience of robot-assisted laparoscopic surgery in the treatment of residual malformation of urachus with children.Methods The clinical date of 10 children with urachal remnants malformation treated by Da Vinci Robot Assisted Laparoscopic Surgery in Wuhan Children's Hospital from July 2021 to July 2023 were retrospectively analyzed.Robot-assisted laparoscopic surgery was used to analyze the intraoperative situation,postoperative complications,surgical effect and pathological results.Results All 10 cases were treated by Da Vinci Robot Assisted Laparoscopic Surgery without Laparotomy and complete excision,while maintain the umbilical integrality,8 cases with symptoms were resected after preoperative imaging diagnosis,1 case was asymptomatic and resected due to continuous enlargement of the cyst,and 1 case was found to be resected during other operations.The average operation time was(140.70±17.66)min,the median blood loss was 7.5(4.5,27.5)ml,the postoperative urethral catheterization was(6.2±1.26)d,the hospital stay was(9.9±0.94)d and the average cost was(46378.92±2777.13)yuan.All the urachal remnants were confirmed by Pathology as 9 cases of urachal cysts and 1 case of urachal fistula.Conclusion Robot-assisted laparoscopic surgery is safe and effective in the treatment of urachal remnants malformation in children,the surgical procedure for resected repair of the anterior abdominal wall has unique advantages.

Objective:To evaluate the efficacy and safety of SPOT (GI Supply, USA), a new carbon-based permanent marker approved by the Food and Drug Administration (FDA), in the endoscopic marking for gastrointestinal lesions.Methods:A total of 115 patients with gastrointestinal lesions who underwent endoscopic treatment or surgery in Beijing Friendship Hospital or Beijing Chao-Yang Hospital from April 2019 to November 2019 were enrolled in the study. SPOT was used to mark the lesions, and marking points were found during endoscopic treatment or surgery to calculate the effective marking rate by single-group target value method. Adverse events after marking were recorded, and the changes of blood routine test, liver and kidney functions before and after marking were compared.Results:The effective rate of endoscopic marking with SPOT was 99.13% (114/115). The longest marking time was 57 days. There was no puncture of intestinal wall or injection into abdominal cavity during the marking process. One patient developed mild fever after marking. The incidence of adverse events was 23.48% (27/115), which were all unrelated to the test equipment. There was no significant difference in blood routine tests or liver and kidney functions before and after marking ( P>0.05). Conclusion:SPOT produced by GI Supply can effectively mark gastrointestinal lesions without serious adverse events, which meets the requirements of clinical use.

Objective To analyze the composition of bacteria and fungi on the facial skin of healthy women aged 20-25 years in Beijing by using high-throughput sequencing technology,and to compare the composition and diversity of microbes among 4 kinds of subjective skin types.Methods Totally,31 female undergraduates were enrolled from Beijing Technology and Business University,and classified into 4 groups,including dry skin group (n =6),neutral skin group (n =8),mixed skin group (n =9) and oily skin group (n =8),according to their subjective feeling of facial skin greasiness and dryness.On 24th December 2017,the facial skin water content,transepidermal water loss (TEWL),sebum content and pH value were determined for these undergraduates,and these physiological parameters of the skin were compared among the 4 kinds of subjective skin types.Skin samples were collected with swabs from the cheeks of these subjects.After DNA extraction and PCR amplification,the bacterial 16S rRNA regions V1-V2 and fungal internal transcribed spacer regions 1 and 2 (ITS-1-ITS-2) were sequenced separately,and sequences were grouped by OUT cluster analysis at 97％ sequence similarity followed by classification and annotation of species.One-way analysis of variance was used for intergroup comparison,and least significant difference (LSD)-t test for multiple comparison.Results The sebum content and bacterial diversity of the facial skin both significantly differed among the 4 kinds of subjective skin types.The skin sebum content in the dry skin group,neutral skin group,mixed skin group and oily skin was 5.50 ±4.60 μg/cm2,7.69±5.26 μg/cm2,10.56 ± 5.42 μg/cm2,22.81 ± 8.53 μg/cm2 respectively (F =11.685,P ＜0.001),and the Shannon index of bacterial diversity in the above 4 groups was 3.49 ± 0.70,2.97 ± 1.43,2.49 ± 0.63 and 1.59 ± 0.59 respectively (F =5.634,P =0.004).Propionibacterium,Staphylococcus and Streptococcus were the main bacterial florae on the face.The relative abundance of Propionibacterium was significantly higher in the oily skin group (68.24％ ± 14.78％) than in the dry skin group (18.83％ ±14.49％,P ＜ 0.001),neutral skin group (32.18％ ± 36.29％,P ＜ 0.001) and mixed skin group (35.22％ ±22.58％,P ＜ 0.001).In addition,the relative abundance of Staphylococcus was highest in the mixed skin group,and the relative abundance of Streptococcus was highest in the neutral skin group.There was no significant difference in the fungal diversity (Shannon index) or richness (Chao index) among the 4 groups (both P ＞ 0.05).The fungi on the facial skin of these subjects mainly consisted of Ascomycota and Basidiomycota,and no significant difference in their relative abundance was observed among the 4 groups (both P ＞ 0.05).Moreover,there was no significant difference in the composition of fungal genera at relative abundance ＞ 1％ among the 4 groups (all P ＞ 0.05).Conclusion The physiological parameters and bacterial diversity of the cheek skin differed among young women of different subjective skin types,while there was no difference in the fungal diversity or richness,suggesting that the colonization of skin bacteria is associated with subjective skin types.

BACKGROUND: Studying the relationship between flexibility and body composition of college students is of great significance for enhancing the levels of physical health and sports. OBJECTIVE: To investigate the relationship between sit-and-reach and body composition of college students in Guangxi Zhuang Autonomous Region and differences between sexes. METHODS: Totally 2 175 students from a Guangxi university were randomly selected. Body composition was determined by the MC-180 body composition tester. The students were divided into four groups: ≤ 12.10 cm group,＞ 12.10-16.40 cm group,＞ 16.40-20.70 group and＞ 20.70 group according to quartile of sit-and-reach measured in accordance with the National Physical Health Test Standard. All data were processed by SPSS 22.0 software. RESULTS AND CONCLUSION: Sit-and-reach was significantly correlated with body mass index, percentage of body fat, fat-free mass index, upper limb lean mass and lower limb lean mass (P ＜ 0.05), and percentage of body fat was negatively correlated with sit-and-reach (P ＜ 0.05). The body mass index, fat-free mass index, upper limb lean mass and lower limb lean mass in the ≤ 12.10 cm group were significantly lower than those in the other groups. Fat-free mass index and upper limb lean mass were correlated with sit-and-reach in male college students (P ＜ 0.05). The fat-free mass index and upper limb lean mass in the＞ 16.40-20.70 cm group were significantly higher than those in the ≤ 12.10 cm group. Therefore, there is a positive correlation between the flexibility and fat-free mass index and upper limb lean mass in college students.

Compared with people with non-sensitive skin,people with sensitive skin are more likely to have some undesirable feelings and symptoms in response to stimuli from the external environment,such as itching and pain sensations,and even erythema after chemical stimulation of the skin.Few reviews are related to evaluation methods for sensitive skin in China and other countries.This review introduces subjective,semi-subjective and objective evaluation methods for sensitive skin,summarizes evaluation methods suitable for different types of sensitive skin,and analyzes advantages and limitations of various evaluation methods.

Objective: To investigate the clinical features of childhood epilepsy with occipital paroxysms. Methods: The clinical data of 33 children admitted to our hospital from 2015 to 2019 were retrospectively analyzed. Results: The children were divided into three groups: idiopathic group (n=20), structural group (n=10) and genetic group (n=3). Among the structural etiology group, there were 1 case of megagyrus malformation, 1 case of focal cortical dysplasia type Ⅱ (FCDⅡ), 1 case of gestational age infant with enlarged ventricle, and 7 cases of perinatal ischemic-hypoxic encephalopathy (HIE). In the genetic group, there were 1 case of PCDH19 gene mutation, 1 case of cyclin-dependent kinase like 5 (CDKL5) deficiency disorder and 1 case of Wolf-Hirschhorn syndrome. All three groups had ocular motor symptoms and secondary motor symptoms. Compared with the structural group, patients of the idiopathic group had more autonomic symptoms, less visual symptoms, longer ictal duration, less episodes, less abnormal background rhythm, and more epileptic discharges in the frontal lobe or Rolandic area. The genetic group had frequent seizures and the CDKL5 deficiency disorder patient had slowed background and spasms. Compared with the other two groups, patients of the idiopathic group had fewer MRI abnormalities, better seizure control effect, and better prognosis. Conclusions There are many causes of childhood epilepsy with occipital paroxysms. The idiopathic group accounts for a large proportion. The visual symptoms and autonomic symptoms are different between groups. Background abnormalities are detected more often in the structural group and the genetic group, which is also helpful for differential diagnosis. The treatment options and prognosis of different groups vary greatly. The overall therapeutic effect and prognosis of the idiopathic group are better than those of the structural group and the genetic group.

Objective To investigate the clinical effects of mucosolvan on the respiratory tract in elderly patients with long-time tracheal intubation for upper abdominal operation.Methods A total of 88 elderly patients to receive upper abdominal surgery were randomly divided into 2 groups:the treatment group (n=41,treated with antibiotics and mucosolvan 90 mg,iv,bid,for 7 consecutive days) and the control group (n=39,with the same antibiotics but without mucosolvan).Patients indwelling endotracheal tube≤3 hours were excluded.Lung function [forced vital capacity (FVC),forced expiratory volume in 1 second (FEV1),FEV1/FVC ratios (FEV1％)],blood gas analysis (pH,PaCO2,PaO2) and lung condition changes were compared between the two groups before and after surgery.Results There was a significant difference in blood gas analysis between the two groups 3 days after surgery (P＜0.05).There were differences in FEV1 and FEV1％ between the two groups 5 days after surgery (P＜0.05),but no differences were found in FVC in the two groups before versus after surgery.There were significant differences in the incidences of pulmonary infection and atelectasis between the treatment group and the control group [4.9 ％ vs.23.1％ (2 cases vs.9 cases),0％ vs.10.3％ (0 cases vs.4 cases),respectively,both P＜0.05].Conclusions Mucosolvan has a better protective effect on the respiratory tract in elderly patients undergoing upper abdominal surgery and the synergies can be achieved in combination with antibiotics.