Objective:To evaluate the efficacy and safety of baricitinib combined with ruxolitinib cream in the treatment of progressive nonsegmental vitiligo.Methods:Clinical data were retrospectively collected from patients with progressive nonsegmental vitiligo in Boao Super Hospital. All the patients were treated with oral baricitinib daily (2 mg/day for patients weighing ≤ 50 kg; 4 mg/day for those > 50 kg) in combination with topical application of ruxolitinib cream twice daily for 24 consecutive weeks. Disease severity was assessed using the facial vitiligo area scoring index (F-VASI) and total body VASI (T-VASI) at baseline, week 12, and week 24. Adverse reactions were monitored throughout the treatment course.Results:Six patients with progressive nonsegmental vitiligo were collected, including 3 males and 3 females, aged 26 - 42 years, with the disease duration ranging from 0.5 to 25 years. At week 12, 3 patients achieved a 50% ~ < 75% improvement in facial vitiligo lesions (F-VASI 50), 1 patient achieved F-VASI 75 (75% ~ < 90% improvement), and 1 patient achieved T-VASI 50; at week 24, 4 patients achieved F-VASI 50, 1 patient achieved F-VASI 75, 1 patient achieved F-VASI 90 (≥ 90% improvement), and 3 patients achieved T-VASI 50. During the treatment, upper respiratory infection occurred in 1 patient, acne in 1 patient, pruritus in 2 patients, elevation of total cholesterol levels in 2 patients, and increase of high-density lipoprotein levels in 2 patients. No severe adverse events were observed during the treatment.Conclusion:The combination therapy with baricitinib and ruxolitinib cream may have potential efficacy and safety in the treatment of progressive nonsegmental vitiligo.

Objective:To evaluate the efficacy and safety of baricitinib combined with ruxolitinib cream in the treatment of progressive nonsegmental vitiligo.Methods:Clinical data were retrospectively collected from patients with progressive nonsegmental vitiligo in Boao Super Hospital. All the patients were treated with oral baricitinib daily (2 mg/day for patients weighing ≤ 50 kg; 4 mg/day for those > 50 kg) in combination with topical application of ruxolitinib cream twice daily for 24 consecutive weeks. Disease severity was assessed using the facial vitiligo area scoring index (F-VASI) and total body VASI (T-VASI) at baseline, week 12, and week 24. Adverse reactions were monitored throughout the treatment course.Results:Six patients with progressive nonsegmental vitiligo were collected, including 3 males and 3 females, aged 26 - 42 years, with the disease duration ranging from 0.5 to 25 years. At week 12, 3 patients achieved a 50% ~ < 75% improvement in facial vitiligo lesions (F-VASI 50), 1 patient achieved F-VASI 75 (75% ~ < 90% improvement), and 1 patient achieved T-VASI 50; at week 24, 4 patients achieved F-VASI 50, 1 patient achieved F-VASI 75, 1 patient achieved F-VASI 90 (≥ 90% improvement), and 3 patients achieved T-VASI 50. During the treatment, upper respiratory infection occurred in 1 patient, acne in 1 patient, pruritus in 2 patients, elevation of total cholesterol levels in 2 patients, and increase of high-density lipoprotein levels in 2 patients. No severe adverse events were observed during the treatment.Conclusion:The combination therapy with baricitinib and ruxolitinib cream may have potential efficacy and safety in the treatment of progressive nonsegmental vitiligo.

Objective To evaluate the efficacy and safety of laser-assisted balloon angioplasty(LABA)in treating patients with infrapopliteal arterial occlusion complicated by critical limb ischemia(CLI).Methods The clinical data of patients with infrapopliteal artery occlusion complicated by CLI,who were admitted to the Fuwai Central China Cardiovascular Hospital to receive LABA(LABA group)or balloon angioplasty alone(BA group)between January 2019 and December 2021,were retrospectively analyzed.The incidence of perioperative complications and postoperative clinical efficacy were compared between the two groups.Results A total of 32 patients received LABA therapy and 40 patients received BA alone.The technical success rate,the postoperative ankle-brachial index(ABI),the numerical value of postoperative ABI value deducting preoperative ABI value,the postoperative 24-month continuous improvement rate of clinical symptoms and the primary patency rate of target vessels in the LABA group were remarkably higher than those in the BA group(all P＜0.05).No procedure-related target vessel perforation,amputation,or death occurred in both groups.No statistically significant differences in the target vessel dissection,distal embolism,remedial stenting,and postoperative 24-month amputation-free survival existed between the groups(all P＞0.05).Conclusion For the infrapopliteal arterial occlusion complicated by CLI,LABA therapy is clinically safe and effective,and its mid-term efficacy is superior to BA alone.

The new generation of artificial intelligence technology,represented by deep learning,has emerged as a crucial driving force in the advancement of new drug research and development.This article creatively proposes a workflow named"Molecular Factory"for the design and optimization of drug molecules based on artificial intelligence technology.This workflow integrates intelligent molecular generation models,high-performance molecular docking algorithms,and accurate protein-ligand binding affinity prediction methods.It has been integrated as a core module into DrugFlow,a one-stop drug design software platform,providing a comprehensive set of mature solutions for the discovery and optimization of lead compounds.Utilizing the"Molecular Factory"module,we conducted the research of second-generation inhibitors against Menin that can combat drug resistance.Through the integration of computational and experimental approaches,we rapidly identified multiple promising compounds.Among them,compound RG-10 exhibited the IC50 values of 9.681 nmol/L,233.2 nmol/L,and 40.09 nmol/L against the wild-type Menin,M327I mutant,and T349M mutant,respectively.Compared to the positive reference molecule SNDX-5613,which has entered Phase Ⅱ clinical trials,RG-10 demonstrated significantly enhanced inhibitory activity against the M327I and T349M mutants.These findings fully demonstrate the unique advantages of the"Molecular Factory"technology in practical drug design and development scenarios.It can rapidly and efficiently generate high-quality active molecules targeting specific protein structures,holding significant value and profound implications for advancing new drug discovery.

Objective:To investigate the efficacy of excimer laser atherectomy (ELA) combined with drug-coated balloon (DCB) in the treatment of femoropopliteal arteriosclerosis obliterans (ASO) and its influencing factors.Methods:The clinical data of patients with femoropopliteal ASO treated by ELA combined with DCB from July 2019 to March 2022 were retrospectively analyzed, including technical success rate, ankle-brachial index(ABI), primary patency rate and freedom from target lesion revascularization (TLR) rate. Cox regression was applied to analyze the risk factors affecting the decline in the rate of primary patency and freedom from TLR.Results:All 82 patients were treated with ELA+DCB. The technical success was 91.5%. The post-operative ABI (0.73±0.13) was significantly higher than preoperative ABI (0.39±0.11) ( t=35.26, P<0.001). The 24-month cumulative primary patency and TLR-free rates were 64.1% and 76.8%, respectively. Lesion length>15 cm ( HR=2.57, P=0.047) and severe calcification ( HR=3.26, P=0.021) were associated with loss of primary patency. Having diabetes ( HR=5.24, P=0.010) and a single postoperative outflow tract ( HR=4.18, P=0.008) were associated with a decrease in TLR-free rates. Conclusions:ELA combined with DCB for femoropopliteal ASO is safe and has good intermediate efficacy. Lesion length>15 cm and severe calcification were independent risk factors for primary patency rate, and diabetes and a single postoperative outflow tract were independent risk factors for TLR-free rate.

Objective:To analyze the efficacy of gasless unilateral axillary endoscopic approach, transoral vestibular endoscopic approach and open thyroidectomy for papillary thyroid carcinoma (PTC).Methods:A retrospective analysis was made on 98 PTC patients who underwent surgical treatment at our hospital from Aug 2020 to Dec 2022,including 29 cases of transaxillary non pneumatic endoscopic surgery (group A), 33 cases of oral vestibular non pneumatic endoscopic surgery (group B), and 36 cases of traditional open neck surgery (group C). The operation related indicators, neck function, immune function, scar condition and postoperative complications of the three groups were compared.Results:The intraoperative blood loss (18.3±2.8),(30.2±4.2)ml in group A and group B was lower than that in group C (37.0±13.6)ml, the operation time (126.4±9.2) min,(191.0±60.1) min was longer than that in group C (73.8±6.3)min, and the drainage volume (91.8±5.4)ml,(85.2±6.1)ml was higher than that in group C (52.7±7.3)ml ( F=37.431, 94.144, 357.922, all P<0.05). The scores of dysphagia index (6.8±2.5,7.0±2.6) in group A and B were lower than those in group C (12.6±3.5) ( P<0.05). After treatment, surface antigen differentiation cluster 4 + (35.5±7.3,35.0±7.3,31.6±5.4), surface antigen differentiation cluster 4 +/surface antigen differentiation cluster 8 +level(1.4±0.4, 1.4±0.4, 1.0±0.3) decreased, and surface antigen differentiation cluster 8 +level (26.4±3.4 ,26.8 ±3.4, 29.5 ±3. 8) increased in the three groups,and the change amplitude in groups A and B was higher than that in group C ( P<0.05). At 3 months after operation, the VSS scores in group A and group B (6.0±1.0, 6.4±1.0) were lower than those in group C (8.5±1.2) ( F=18.925, P<0.05). Conclusions:Compared with open thyroidectomy for PTC, application of endoscopic thyroidectomy via gasless unilateral axillary or transoral vestibular approach has the advantage of a less swallowing impact and better patient satisfaction with cosmetic appearance, making it a safe and effective surgical procedure for clinical treatment of PTC.

Objective:To analyze the efficacy of gasless unilateral axillary endoscopic approach, transoral vestibular endoscopic approach and open thyroidectomy for papillary thyroid carcinoma (PTC).Methods:A retrospective analysis was made on 98 PTC patients who underwent surgical treatment at our hospital from Aug 2020 to Dec 2022,including 29 cases of transaxillary non pneumatic endoscopic surgery (group A), 33 cases of oral vestibular non pneumatic endoscopic surgery (group B), and 36 cases of traditional open neck surgery (group C). The operation related indicators, neck function, immune function, scar condition and postoperative complications of the three groups were compared.Results:The intraoperative blood loss (18.3±2.8),(30.2±4.2)ml in group A and group B was lower than that in group C (37.0±13.6)ml, the operation time (126.4±9.2) min,(191.0±60.1) min was longer than that in group C (73.8±6.3)min, and the drainage volume (91.8±5.4)ml,(85.2±6.1)ml was higher than that in group C (52.7±7.3)ml ( F=37.431, 94.144, 357.922, all P<0.05). The scores of dysphagia index (6.8±2.5,7.0±2.6) in group A and B were lower than those in group C (12.6±3.5) ( P<0.05). After treatment, surface antigen differentiation cluster 4 + (35.5±7.3,35.0±7.3,31.6±5.4), surface antigen differentiation cluster 4 +/surface antigen differentiation cluster 8 +level(1.4±0.4, 1.4±0.4, 1.0±0.3) decreased, and surface antigen differentiation cluster 8 +level (26.4±3.4 ,26.8 ±3.4, 29.5 ±3. 8) increased in the three groups,and the change amplitude in groups A and B was higher than that in group C ( P<0.05). At 3 months after operation, the VSS scores in group A and group B (6.0±1.0, 6.4±1.0) were lower than those in group C (8.5±1.2) ( F=18.925, P<0.05). Conclusions:Compared with open thyroidectomy for PTC, application of endoscopic thyroidectomy via gasless unilateral axillary or transoral vestibular approach has the advantage of a less swallowing impact and better patient satisfaction with cosmetic appearance, making it a safe and effective surgical procedure for clinical treatment of PTC.

Objective To conduct a retrospective study on the clinical efficacy with endoscopic linea alba plication (ELAP) in the treatment of postpartum diastasis recti abdominis muscles. Methods Clinical data was collected to study the patients with postpartum diastasis recti abdominis muscles treated by ELAP in our hospital from January 2018 to December 2021. The operation was performed successfully in 48 cases. One case was lost follow-up and 47 cases were included in this study. Mean age was (34.9±4.2) years with body mass index (BMI) (20.1±2.0) kg/m2. The index of patients included general data, intraoperative data and postoperative recovery. Follow-up was done through out-patient examination and B-mode ultrasonography until to March 2022. Results The inter-rectus distance (IRD) in umbilical area (M3) shown by ultrasound examination was (41.6±8.2) mm. There were 10 cases combined with umbilical hernia and 2 cases with linea alba hernia. ELAP was performed under general anesthesia. All hernia rings were closed by suturing. The operative time was (130.9±36.0) min. Visual analog scale was (1.2±0.6) on the 1st postoperative day with postoperative hospital stay (1.5±0.9) d. Two cases had mild seroma postoperatively with puncture and absorption under B-ultrasound guiding. Remaining cases were without operative complications such as bleeding and infection of incision. Followed up of 47 cases was completed in the period of median 15(12, 26) months. One case had mild pain in the operative site and cured after non-operative treatment. Ultrasound examination in the other case showed 57.0 mm of IRD in M3 area preoperative and normal in the follow-up of 1 month postoperative. However, there was mild recurrence on 3 months of follow-up showing IRD 21.0 mm. Conclusions ELAP could be considered safe and effective in the treatment of postpartum diastasis recti abdominis muscle.

Objective:To investigate the risk factors for retrograde type A dissection (RTAD) associated with thoracic endovascular aortic repair (TEVAR) which provided the basis for clinical risk stratification and treatment decision.Methods:The clinical data of 1 688 patients with thoracic aortic disease who underwent TEVAR in our center from January 2004 to December 2019 were retrospectively analyzed. The pathological classification included aortic dissection (1 592 cases) and other thoracic aortic diseases (96 cases). Univariate analysis and categorical multiple logistic regression analysis were used to explore the risk factors for the development of RTAD during or after TEVAR.Results:A total of 18 cases of RTAD were found, with an overall incidence of 1.1% (18/1 688), all of which occurred in aortic dissection group. After adjusting for confounding factors, multivariate logistic regression analysis showed that the incidence of RTAD was significantly decreased(OR=0.27,95%CI 0.07-0.96, P=0.043) when the oversize of stentgraft was 11%-20%, the oversize of stentgraft was ≤10% as the control group, and the difference was statistically significant( P<0.05). The ascending aorta diameter was <40 mm as the control group, and there was no significant difference in the incidence of RTAD between the ≥40 mm group and the control group(OR=2.71,95%CI 0.94-7.84, P=0.065). Conclusions:Aortic dissection is more likely to develop RTAD than other thoracic aortic diseases. A proper stentgraft oversizing ratio could reduce the probability of RTAD. That is to say that a too low stentgraft oversizing ratio is not recommended.

Objective To evaluate the efficacy and safety of chocolate balloon assisted drug-coated balloon(DCB)angioplasty for the treatment of TASC Ⅱ type C/D femoropopliteal artery lesions.Methods The clinical data of 58 patients with TASC Ⅱ type C/D femoropopliteal artery lesions treated with chocolate balloon +DCB or plain balloon+DCB at Fuwai Central China Cardiovascular Hospital from January 2021 to October 2022 were retro-spectively analyzed.A total of 27 cases were assigned to the observation group(chocolate balloon + DCB)and 31 cases tothe control group(plain balloon + DCB).The rate of dissection and the clinical outcomes between the two groups were compared.Results The technical success rates of the observation and control groups were 88.9%and 80.6%,respectively.The rates of dissection,flow-limiting dissection,and bailout stenting were significantly lower in the observation group than of the control group(all P<0.05).Postoperative clinical symptoms of patients in both groups improved significantly compared with the preoperative period.The 12-month cumulative primary patency rate of the observation group was significantly higher than that of the control group(P<0.05).There was no significant difference in the 12-month cumulative freedom from clinically driven-target lesion revascularization rate between the two groups(P>0.05).Conclusion Chocolate balloonassisted DCB angioplasty was safe and effective for TASC Ⅱ type C/D femoropopliteal artery lesions.It reduced the rates of dissection and bailout stenting,and had better near-term outcomes than plain balloon + DCB.