BACKGROUND:Collagen combined with microneedling therapy has gradually become an important means of improving skin photoaging.OBJECTIVE:To summarize and explore the main mechanism and clinical application status of collagen combined with microneedle therapy.METHODS:PubMed,China National Knowledge Infrastructure,and ScienceDirect databases were searched for Chinese and English literature published before August 2024.Chinese and English search terms were"ultraviolet radiation,photoaging,collagen,microneedling,clinical applications."Finally,74 articles were included for summary.RESULTS AND CONCLUSION:Collagen treats skin photoaging through mechanisms such as inhibiting matrix metalloproteinase expression,retaining skin moisture,and reducing melanin formation.Microneedles can better promote the penetration of collagen into deep layers of the skin,breaking down the skin's barrier and increasing the absorption rate.Collagen combined with microneedles has various beneficial effects for treating skin photoaging,such as whitening,anti-wrinkle,improving skin elasticity,shrinking pores,and repairing skin barriers.It also has the advantages of easy operation,significant effects,and high safety.Currently,the research on collagen combined with microneedling therapy is still in its early stages,and achieving clinical application may become a key research direction in the future.The clinical application of collagen combined with microneedles for the treatment of photoaging still faces many challenges,such as exploring the optimal mechanical structure and materials of microneedles,selecting appropriate microneedle types,and insufficient clinical evidence that collagen combined with microneedles can further delay the treatment of skin photoaging.

BACKGROUND:Collagen combined with microneedling therapy has gradually become an important means of improving skin photoaging.OBJECTIVE:To summarize and explore the main mechanism and clinical application status of collagen combined with microneedle therapy.METHODS:PubMed,China National Knowledge Infrastructure,and ScienceDirect databases were searched for Chinese and English literature published before August 2024.Chinese and English search terms were"ultraviolet radiation,photoaging,collagen,microneedling,clinical applications."Finally,74 articles were included for summary.RESULTS AND CONCLUSION:Collagen treats skin photoaging through mechanisms such as inhibiting matrix metalloproteinase expression,retaining skin moisture,and reducing melanin formation.Microneedles can better promote the penetration of collagen into deep layers of the skin,breaking down the skin's barrier and increasing the absorption rate.Collagen combined with microneedles has various beneficial effects for treating skin photoaging,such as whitening,anti-wrinkle,improving skin elasticity,shrinking pores,and repairing skin barriers.It also has the advantages of easy operation,significant effects,and high safety.Currently,the research on collagen combined with microneedling therapy is still in its early stages,and achieving clinical application may become a key research direction in the future.The clinical application of collagen combined with microneedles for the treatment of photoaging still faces many challenges,such as exploring the optimal mechanical structure and materials of microneedles,selecting appropriate microneedle types,and insufficient clinical evidence that collagen combined with microneedles can further delay the treatment of skin photoaging.

Leukemia is a common malignant tumor of the blood system,and the accuracy of ICD coding plays a key role in medical record management and DRG grouping.Currently,in clinical practice,both French-American-British(FAB)classifi-cation and World Health Organization(WHO)classification are used for leukemia classification.With the introduction of MICM(morphology,immunology,genetics and molecular biology)technology,the leukemia classification system has become more re-fined,which also increases the complexity of medical record coding.Therefore,medical record coders need to keep up with the forefront of medical development,thoroughly understand the latest classification standards of leukemia,systematically summarize the coding points and ideas for myeloid leukemia,lymphoid leukemia and unclassified leukemia,and clarify the situation where leukemia is coded as the main diagnosis.In the context of DRG payment reform,clinical doctors should accurately fill in the dis-ease diagnosis and surgical operation information on the medical record cover,and when coding the medical record cover,the co-der needs to comprehensively consider the three principles of selecting the main diagnosis and the local DRG grouping rules to en-sure the accurate selection of the main diagnosis,thus improving the accuracy of DRG admission and providing a reliable basis for the rational allocation of medical resources.

Leukemia is a common malignant tumor of the blood system,and the accuracy of ICD coding plays a key role in medical record management and DRG grouping.Currently,in clinical practice,both French-American-British(FAB)classifi-cation and World Health Organization(WHO)classification are used for leukemia classification.With the introduction of MICM(morphology,immunology,genetics and molecular biology)technology,the leukemia classification system has become more re-fined,which also increases the complexity of medical record coding.Therefore,medical record coders need to keep up with the forefront of medical development,thoroughly understand the latest classification standards of leukemia,systematically summarize the coding points and ideas for myeloid leukemia,lymphoid leukemia and unclassified leukemia,and clarify the situation where leukemia is coded as the main diagnosis.In the context of DRG payment reform,clinical doctors should accurately fill in the dis-ease diagnosis and surgical operation information on the medical record cover,and when coding the medical record cover,the co-der needs to comprehensively consider the three principles of selecting the main diagnosis and the local DRG grouping rules to en-sure the accurate selection of the main diagnosis,thus improving the accuracy of DRG admission and providing a reliable basis for the rational allocation of medical resources.

TCM monomer and its compound preparation have significant effect in the treatment of breast cancer, with unique advantages of multi molecule, multi targeting, less adverse reactions, etc. TCM components such as Carthamus tinctorius polysaccharides, peimine, andrographolide, and Bupleurum saponin D can inhibit the malignant progression of breast cancer by modulating signaling pathways including PI3K/Akt, MAPK, Wnt, and JAK/STAT.

Objective To explore the five-circuit and six-qi features of birth time and onset time of children with acute lymphoblastic leukemia(ALL).Methods A total of 877 cases of children with ALL from Children's Hospital of Soochow University from June 2021 to February 2023 were collected,and their five-circuit and six-qi features of birth time and onset time were analyzed.And then the correlation of five-circuit and six-qi features of birth time and onset time with ALL was explored preliminarily,and the pathogenic characteristics of congenital factors and acquired pathogenic factors were revealed.Results(1)The children who were born in the year with the heavenly stems being bing(the 3rd of the ten heavenly stems)and ding(the 4th of the ten heavenly stems)and with the earthly branches being shen(the 8th of the twelve earthly branches)and you(the 9th of the twelve earthly branches)are prone to suffer from ALL,and the birth year of children with ALL had the five-circuit and six-qi features of the joining of guest circuit with dominant circuit being rebellious.ALL is commonly seen in the year with the heavenly stems being geng(the 7th of the ten heavenly stems)and xin(the 8th of the ten heavenly stems)and with the earthly branches being zi(the 1st of the twelve earthly branches)and chou(the 2nd of the twelve earthly branches),and the onset year of ALL in children had the five-circuit and six-qi features of the yearly circuit being gold-circuit and water-circuit,sitian-zaiquan yearly circuit qi being shaoyin monarch-fire with yangming dryness-gold,taiyin damp-earth with taiyang cold-water,and the qi-circuit assimilation relationship being celestial correspondence,same celestial correspondence,celestial correspondence in convergent year,disharmony,mildly-rebellious,and celestial restriction.Conclusion Gold-dryness and water-cold are the congenital factors and acquired pathogenic factors of ALL.The onset of ALL in children is closely related to qi insufficiency and qi stagnation of wood and fire in five-circuit and six-qi theory.

The Department of Thoracic Surgery of Shanghai Chest Hospital has performed esophageal function testing for over 30 years, being the only department of its kind in China with this capability. The pressure testing and 24-hour pH/impedance monitoring of the esophagus is of great help to assist in the diagnosis and treatment of benign and malignant esophageal diseases related to it. Thanks to the esophageal function test, in addition to the routine various endoscopic anti-reflux procedures, our hospital has taken the lead in China in recent years to carry out a series of clinical and research work for benign esophageal diseases, such as the development of magnetic ring, double nedoscopic combination and new anti-reflux endoscopic techniques. In recent years, we have carried out high-resolution esophageal manometry and 24-hour pH/impedance monitoring for patients with interstitial pneumonia and pulmonary fibrosis suspected to be caused by gastroesophageal acid reflux. We can better assess the correlation between gastroesophageal reflux and pulmonary fibrosis, and to provide the different clinical treatments and even surgical interventions. The Bravo capsule is used more often in the United States, and it has obvious advantages over traditional approach for acid measurement. We strongly call for the collaboration between industry and academic institutions in this field, and the development of our own related products with independent intellectual property rights.

T-cell acute lymphoblastic leukemia (T-ALL) is a highly aggressive hematologic malignancy with a poor prognosis, despite advancements in treatment. Many patients struggle with relapse or refractory disease. Investigating the role of the super-enhancer (SE) regulated gene ubiquitin-specific protease 20 (USP20) in T-ALL could enhance targeted therapies and improve clinical outcomes. Analysis of histone H3 lysine 27 acetylation (H3K27ac) chromatin immunoprecipitation sequencing (ChIP-seq) data from six T-ALL cell lines and seven pediatric samples identified USP20 as an SE-regulated driver gene. Utilizing the Cancer Cell Line Encyclopedia (CCLE) and BloodSpot databases, it was found that USP20 is specifically highly expressed in T-ALL. Knocking down USP20 with short hairpin RNA (shRNA) increased apoptosis and inhibited proliferation in T-ALL cells. In vivo studies showed that USP20 knockdown reduced tumor growth and improved survival. The USP20 inhibitor GSK2643943A demonstrated similar anti-tumor effects. Mass spectrometry, RNA-Seq, and immunoprecipitation revealed that USP20 interacted with hypoxia-inducible factor 1 subunit alpha (HIF1A) and stabilized it by deubiquitination. Cleavage under targets and tagmentation (CUT&Tag) results indicated that USP20 co-localized with HIF1A, jointly modulating target genes in T-ALL. This study identifies USP20 as a therapeutic target in T-ALL and suggests GSK2643943A as a potential treatment strategy.

The overall health condition of patients significantly affects the diagnosis,treatment,and prognosis of endodontic diseases.A systemic consideration of the patient's overall health along with oral conditions holds the utmost importance in determining the necessity and feasibility of endodontic therapy,as well as selecting appropriate therapeutic approaches.This expert consensus is a collaborative effort by specialists from endodontics and clinical physicians across the nation based on the current clinical evidence,aiming to provide general guidance on clinical procedures,improve patient safety and enhance clinical outcomes of endodontic therapy in patients with compromised overall health.

Objective:To study the operational efficiency of township health centers in poverty-lifted and non-poverty counties in Hubei Province in the new era of rural revitalization, so as to provide a reference for further promoting township health centers to make up for their shortcomings and improve their service capabilities.Methods:Data was sourced from databases such as the Health and Health Statistics Annual Report, Health Finance Annual Report of Hubei Province for the year 2022. The number of health technicians, business premises area, actual bed count, and the number of equipment worth more than 10 000 yuan in 1 010 township health centers from 36 poverty-lifted counties and 47 non-poverty counties in Hubei Province were taken as input variables. The number of discharged patients, total outpatient visits, the number of people aged 65 and above receiving health management, and the number of hypertensive and type 2 diabetes patients receiving standardized management were taken as output variables. The number of permanent population, per capita regional GDP, population density, urbanization rate, and local general public budget investment were taken as environmental variables. The three-stage data envelopment analysis(DEA) method was applied to measure the operational efficiency of township health centers in poverty-lifted and non-poverty counties in Hubei Province.Results:Environmental variables had different impacts on the operational efficiency of township health centers in poverty-lifted and non-poverty counties ( P<0.01). After removing the impacts, the comprehensive technical efficiency, pure technical efficiency, and scale efficiency of township health centers in poverty-lifted and non-poverty counties in Hubei Province were 0.894, 0.960, 0.931 and 0.840, 0.919, 0.911, respectively; there were 22 pure technical efficiency township health centers in poverty-lifted counties, accounting for 61.10%, with 13 having a scale efficiency of 1, accounting for 36.00%, and 19 with increasing returns to scale, accounting for 52.78%; there were 22 pure technical efficiency township health centers in non-poverty counties, accounting for 46.80%, with 13 having a scale efficiency of 1, accounting for 27.66%, and 22 with increasing returns to scale, accounting for 46.81%. Conclusions:The operational efficiency of poverty-lifted counties was better than that of non-poverty counties. The main reason for the poor operation efficiency of township health centers in poverty-lifted counties was the low scale efficiency, and the poor operation efficiency of township health centers in non-poverty counties was mainly due to insufficient investment in technology development and scale. It is suggested that township health centers in poverty-lifted counties should seize the strategic opportunity of rural revitalization and expand reasonably. Township health centers in non-poverty counties should innovate development methods while improving the capacity of basic medical services.