The classification of stoma skin barriers varies based on their specific features. The curvature design of convex skin barriers provides a secure and effective seal for patients with flat, retracted stomas or peristomal skin folds. The secure sealing ability of convex skin barriers is attributed to several critical structural components. Although convex skin barriers offer many clinical advantages, there is currently no unified standard for measuring their characteristics, resulting in confusion among healthcare professionals when selecting stoma care products. To address this issue, the 2021 International Stoma Care Expert Meeting proposed the Expert Consensus on Characteristics of Convex Skin Barriers and Clinical Application, which clearly defines five essential properties and clinical application guidelines for convex barriers. However, as most consensus contributors are from Europe and North America, its applicability in Chinese healthcare settings may be limited. Therefore, this paper provides a detailed interpretation of the five characteristics and clinical application statements of convex skin barriers, aiming to offer practical guidance to clinical nurses in selecting appropriate convex products and managing stoma-related complications.

After ostomy surgery, patients lose the ability to control their anal sphincter, relying on ostomy pouches for excretion. Convex baseplates offer several advantages, including preventing leakage, reducing the risk of stoma and peripheral skin complications, and adapting to the dynamic stoma shapes caused by peristaltic expansion and contraction of the stoma. This article reviews the structure and features of convex baseplates, usage considerations, existing challenges, and future prospects, aiming to provide a reference for the standardized clinical use of convex baseplates and to improve patient health outcomes.

After ostomy surgery, patients lose the ability to control their anal sphincter, relying on ostomy pouches for excretion. Convex baseplates offer several advantages, including preventing leakage, reducing the risk of stoma and peripheral skin complications, and adapting to the dynamic stoma shapes caused by peristaltic expansion and contraction of the stoma. This article reviews the structure and features of convex baseplates, usage considerations, existing challenges, and future prospects, aiming to provide a reference for the standardized clinical use of convex baseplates and to improve patient health outcomes.

The classification of stoma skin barriers varies based on their specific features. The curvature design of convex skin barriers provides a secure and effective seal for patients with flat, retracted stomas or peristomal skin folds. The secure sealing ability of convex skin barriers is attributed to several critical structural components. Although convex skin barriers offer many clinical advantages, there is currently no unified standard for measuring their characteristics, resulting in confusion among healthcare professionals when selecting stoma care products. To address this issue, the 2021 International Stoma Care Expert Meeting proposed the Expert Consensus on Characteristics of Convex Skin Barriers and Clinical Application, which clearly defines five essential properties and clinical application guidelines for convex barriers. However, as most consensus contributors are from Europe and North America, its applicability in Chinese healthcare settings may be limited. Therefore, this paper provides a detailed interpretation of the five characteristics and clinical application statements of convex skin barriers, aiming to offer practical guidance to clinical nurses in selecting appropriate convex products and managing stoma-related complications.

The traditional Chinese medicine （TCM） in pediatric care has a long history，proven efficacy，and distinctive characteristics.The China Association of Chinese Medicine has organized a series of youth salons to discuss the clinical advantages of treating diseases.Experts at this seminar proposed that the superior disease categories in pediatric TCM are significant for showcasing the unique strengths and advantages of TCM in the treatment of pediatric diseases，enhancing diagnostic and treatment levels，inheriting TCM knowledge，promoting the integration of TCM and Western medicine，and meeting patients' needs.The strengths of pediatric TCM are summed up as "having what others do not，excelling at what others have，being special in what others excel at，and ensuring safety in what others specialize in." The scope of superiority in pediatric TCM covers multiple systems，including respiratory，digestive，endocrine，psychological，and dermatological systems.This article summarized the advantages of TCM in treating 13 diseases discussed in the salon，such as upper respiratory tract infections，coughs，pneumonia，allergic rhinitis，bronchial asthma，atopic dermatitis，functional dyspepsia，functional constipation，enuresis，marginal short stature，simple obesity，attention deficit hyperactivity disorder，and tic disorders.The overall advantages were reflected in three aspects：First，the holistic concept and treatment based on syndrome differentiation in TCM highlight the advantage of treating the root causes of diseases，making the treatment methodical and precise.Second，most traditional Chinese herbs are natural and have strong safety profiles.Third，TCM treatment methods are abundant，especially the external treatment methods，which are widely used in pediatrics，highly accepted by parents，and have definite efficacy，as well as good safety and compliance.

Objective To observe the morphological changes of levator hiatus in patients with gestational diabetes mellitus(GDM)after spontaneous delivery with ultrasonography.Methods A total of 302 pregnant women in the first trimester(6-8 weeks)were prospectively observed,and the parameters of pelvic floor muscle hiatus were measured with ultrasound during the first trimester,also 12 weeks,6 months and 1 year after delivery at resting-state(resting period),anal contraction state(systole period)and Valsalva maneuver(tension period),respectively.Blood glucose was measured at 28 weeks of gestation,GDM was diagnosed,and the pregnant women enrolled were divided into GDM group and non-GDM group.The ultrasonic parameters and postpartum pelvic floor muscle tension were compared between groups.Spearman correlation analysis was used to evaluate the correlations of pelvic floor muscle tension grade and anal levator hiatus parameters in GDM group.Results Totally 153 pregnant women were enrolled and assigned into GDM group(n=51)and non-GDM group(n=102).Transversal diameter of levator hiatus(LH-TD),anteroposterior diameter of levator hiatus(LH-APD)and levator hiatus area(LHA)in different periods 12 weeks postpartum in both groups were higher than those in early pregnancy(all P＜0.05).Six months and 1 year postpartum,in GDM group,LH-APD and LHA in systole period,also LH-TD,LH-APD and LHA in tension period were higher than those in early pregnancy(all P＜0.05),while in non-GDM group,LH-APD and LHA in tension period were higher than those of early pregnancy(all P＜0.05).One year after delivery,LH-APD and LHA in systolic period,as well as LH-TD and LHA in tension period in GDM group were all higher than those in non-GDM group(all P＜0.05),whereas the proportion of pelvic floor muscle tension of grade Ⅱ-Ⅲ was higher,of grade Ⅳ-Ⅴ was lower in GDM group than those in non-GDM group(P＜0.05).One year after delivery,pelvic floor muscle tone grade in GDM group was negatively correlated with LH-TD,LH-APD and LHA in resting,systole and tension period(all P＜0.05).Conclusion The morphology of levator hiatus changed greatly in GDM patients after spontaneous delivery,and rehabilitation training should be carried out early.

Objective To explore the clinical significance of serum cytokine expression in the hepatitis B surface antigen(HBsAg)sero-clearance in patients with severe hepatitis B.Methods A nested case-control trial was conducted on 14 inpatients with severe hepatitis B admitted in our hospital from 2006 to 2020.Of them,7 patients(aged 36.57±3.15 years)achieved HBsAg sero-clearance within 1 year after the onset of hepatitis B flares(with abrupt rise of ALT level to＞5 times the upper limit of normal during HBV infection)and were assigned into HBsAg clearance group,while the other 7 patients(aged 34.14±2.97 years)only obtained HBsAg decreased less than 1 g within 1 year after the onset(HBsAg non-clearance group).Then,multiplex liquid-chip assay based on Luminex xMAP was used to detect the expression levels of 48 cytokines such as IFN-γ and IL-2 in serum samples of these 14 patients.Results The serum levels IFN-γ,IL-2Ra and SDF-1α were significantly lower in the HBsAg clearance group than the HBsAg non-clearance group(P＜0.05),but no statistical differences were observed in other 39 cytokines between the 2 groups.And there were 5 cytokines having no mutual expression in both groups.The copy number of HBV DNA was positively correlated with serum HGF(r=0.675,P=0.008)and SDF-1α levels(r=0.587,P=0.027),while negatively with IP-10(r=-0.600,P=0.023)and MIG level(r=-0.640,P=0.014).Meanwhile,a positive correlation was found between HBsAg titer and IL12-p70 level(r=0.593,P=0.025),and a negative correlation between HBsAg titer and TNF-α level(r=-0.609,P=0.021).In addition,the serum total bilirubin level was positively correlated with the expression of SCGF-β(r=0.543,P=0.045).Conclusion Three differentially expressed cytokines and some cytokines related to HBV DNA level and HBsAg titer are found,which may provide new insights into the underlying immunological mechanism of HBV virus clearance caused by hepatitis flares.Meanwhile,it also provides potential biomarkers for HBsAg serological clearance in patients with severe hepatitis B.

Objective:To obtain hepatitis B virus capsid-like particles (CLPs) displaying B-cell linear epitopes of SARS-CoV-2 spike protein and evaluate their immunogenicity.Methods:Four recombinant plasmids expressing fusion proteins (M1-HBc, S1-57-HBc, S14P5-HBc and S21P2-HBc) were constructed by separately replacing codon of alanine at position 80 of hepatitis B virus core protein (HBc) with four genes coding for four B-cell linear epitopes (M1, S1-57, S14P5 and S21P2). These four recombinant proteins were expressed in E. coli BL21 Star (DE3) strains. The expression products were identified using SDS-PAGE, Western blot and native agarose gel electrophoresis (NAGE). CLPs were purified by sucrose density gradient ultracentrifugation, verified for antigenicity by Western blot and used to immunize BALB/c mice. Serum antibody titers were detected by ELISA. Results:The recombinant fusion proteins M1-HBc and S1-57-HBc self-assembled into M1-CLP and S1-57-CLP. The titer of antibody against S1-57 polypeptide in S1-57-CLP-immunized mouse serum approached 1∶1 000 000.Conclusions:Hepatitis B virus CLPs displaying SARS-CoV-2 M1 or S1-57 linear epitopes are successfully expressed in a prokaryotic system and purified. S1-57-CLP has good immunogenicity. This study provides a new idea for the development of novel diagnostic reagents and vaccines for SARS-CoV-2.

Objective:To investigate the correlation between Helicobacter pylori ( H.pylori) infection and albuminuria inphysical examination population. Methods:It was a cross-sectional study. All the adults who received physical examination and underwent 13C-urea breath test at the Physical Examination Center in Tongji Hospital in 2021 were selected as the study subjects. General data (such as demographic information and past medical history) were documented. The physical measurement and blood biochemical indicators were checked too. Multivariate analysis was used to analyze the relationship between H. pylori infection and albuminuria. Results:A total of 30 311 subjects were included in this analysis. There were 17 123 males and 13 188 females with an age of (44.51±12.17) years. The positive rate of H. pylori infection was 27.3%. The incidence of albuminuria in subjects with H. pylori infection was 6.7%, and it was 6.1% in the subjects without H. pylori infection ( P=0.031). After adjusting for the confounding factors such as gender, age, diabetes and hypertension, H. pylori infection was independently associated with the risk of albuminuria (odds ratio ( OR)=1.133, 95% CI: 1.018-1.261, P=0.022). Conclusion:H. pylori infection is positively correlated with the occurrence of albuminuria in the physical examination population.

OBJECTIVES: This work aimed to investigate the molecular mechanism of cyclic tensile stress (CTS) stimulating autophagy in human periodontal ligament cells (hPDLCs). METHODS: hPDLCs were isolated and cultured from normal periodontal tissues. hPDLCs were loaded with tensile stress by force four-point bending extender to simulate the autophagy of hPDLCs induced by orthodontic force du-ring orthodontic tooth movement. XMU-MP-1 was used to inhibit the Hippo signaling pathway to explore the role of the Hippo-YAP signaling pathway in activating hPDLC autophagy by tensile stress. The expression levels of autophagy-related genes (Beclin-1, LC3, and p62) in hPDLCs were detected by real-time quantitative polymerase chain reaction. Western blot was used to detect the expression levels of autophagy-related proteins (Beclin-1, LC3-Ⅱ/LC3-Ⅰ, and p62) and Hippo-YAP pathway proteins (active-YAP and p-YAP) in hPDLCs. Immunofluorescence was used to locate autophagy-related proteins (LC3-Ⅱand p62) and Hippo-YAP pathway proteins (active-YAP) of hPDLCs. RESULTS: CTS-activated autophagy in hPDLCs and expression of autophagy-related proteins initially increased and then decreased; it began to increase at 30 min, peaked at 3 h, and decreased (P<0.05). CTS increased the expression of active-YAP protein and decreased the expression of p-YAP protein (P<0.05). When XMU-MP-1 inhibited the Hippo-YAP signaling pathway (P<0.05), active-YAP protein was promoted to enter the nucleus and autophagy expression was enhanced (P<0.05). CONCLUSIONS The Hippo-YAP signaling pathway is involved in the regulation of autophagy activation in hPDLCs under CTS.
Humans ; Hippo Signaling Pathway ; Periodontal Ligament/metabolism* ; Beclin-1/metabolism* ; Cells, Cultured ; Autophagy