Objective:To retrospectively analyze the changes in the proportion of refined lymphocyte subsets in peripheral blood of patients with Graves disease (GD), and their correlation with the clinical characteristics and efficacy of GD, and to explore the immunological pathogenesis of Graves disease for seeking new therapeutic targets.Methods:A total of 97 newly diagnosed GD patients (GD group), 27 patients after treatment (treatment group), and 31 healthy individuals (control group) who visited the Fifth Medical Center of the PLA General Hospital from 2018 to 2021 were included in this study. The data of refined lymphocyte subsets, thyroid function, blood routine and clinical treatment of the three groups were compared and analyzed. The t-test and rank sum test were used to compare the proportions of lymphocyte subsets among different groups, and Pearson correlation analysis was used to analyze the correlation between the proportions of lymphocyte subsets and thyroid function indicators.Results:The proportion of B cells in GD group was higher than that in the control group [16.2%(11.8%, 21.8%) vs 10.2%(8.1%,13.6%)], while the proportion of natural killer (NK) cells was lower [9.4%(4.9%, 13.6%) vs 14.6%(12.1%,18.8%)], and the differences were statistically significant ( P<0.05). Abnormal T cell differentiation: the proportions of functional cells, including activated T cells, memory T cells, clustering antigen(CD)4+memory T cells, Th1 cells, and Tc1 cells, were lower than that in the control group [3.2%(2.1%, 5.7%) vs 5.8%(3.0%, 9.3%), P<0.05; 36.7% (29.9%, 48.1%) vs 48.0%(39.2%,57.7%), P<0.05; 23.1%(17.4%, 30.1%) vs 28.9%(23.3%,34.6%), P<0.05; 16.4% (11.8%, 23.6%) vs 24.3%(16.9%,28.5%), P<0.05; 28.5% (14.7%, 39.2%) vs 46.3%(21.6%,69.2%), P<0.05]. The proportion of activated T cells in the treatment group was higher than that in the GD group [6.5% (4.6%, 13.6%) vs 3.2% (2.1%, 5.7%), P<0.05]. The total triiodothyronine results showed positive correlations with B cells ( r=0.356, P<0.01) and negative correlations with NK cells ( r=?0.416, P<0.01), while the total thyroxine values showed negative correlations with NK cells and activated T cells ( r=?0.318,?0.335; P<0.01). Thyroid stimulating hormone and CD8+initial T cells were positively correlated ( r=0.382, P<0.01). The proportion of B cells, cytotoxic T cells and suppressor T cells in CD8+cells of patients with complications [such as Graves orbitopathy (GO), thyroid toxic cardiomyopathy, etc.] was significantly different from that of the simple GD patients [18.3% (14.1%, 27.1%) vs 14.6% (10.8%, 21.4%), Z=2.54, P<0.05; 73.4%(65.6%,83.6%)vs 65.0%(50.3%,79.3%), Z=2.93, P<0.05; 26.6%(16.4%, 37.5%)vs 35.0%(20.7%,49.7%), Z=?2.74, P<0.05]. The proportion of suppressor T cells in GO patients was lower than that in non-GO patients [6.1% (3.4%, 8.1%) vs 8.5% (4.9%, 13.6%), Z=?3.20 P<0.05]. Conclusion:There are significant alterations in the circulating immune cells of GD patients, suggesting that immunological abnormalities play a crucial role in the onset and progression of the disease.

BACKGROUND:Lifespan of prosthetic joint was being influenced by periprosthetic infection after total hip arthroplasty. Combination of debridement,antibiotics,and implant retention with the replacement of assembled components represents a novel approach in the management of acute prosthetic joint infection after total hip arthroplasty.OBJECTIVE:To observe the efficacy of debridement,antibiotics,and implant retention combined with the replacement of assembled components in the treatment of acute prosthetic joint infection after total hip arthroplasty.METHODS:Twenty-two patients with acute prosthetic joint infection after initial total hip arthroplasty at the Department of Orthopedics,Huangshi Central Hospital,China,between July 2018 and February 2022 were enrolled. The infection time of all patients was less than 3 weeks after the initial arthroplasty. Intraoperative joint fluid extraction and bacterial culture of infected synovium proved to be acute stage infection. They were treated using debridement,antibiotics,and implant retention combined with the replacement of assembled components. Infections were assessed using leukocyte count,erythrocyte sedimentation rate,and C-reactive protein levels before,3 and 6 months after surgery. Improvements in hip joint function were evaluated using Harris hip score. Pain relief was assessed using visual analog scale score. Paired sample t-test was used to analyze the improvement of each index before and after operation.RESULTS AND CONCLUSION:(1) One patient died of non-periprosthesis infection and was subsequently lost to follow-up,which was excluded. The remaining 21 patients received clinical follow-up,and the follow-up time was more than 1 year,with a mean follow-up time of (19.52±3.88) months. Among them,20 patients were successfully treated with surgery and 1 patient failed,and the infection control rate was 95％. (2) The levels of leukocyte count,erythrocyte sedimentation rate,and C-reactive protein were lower in 3 and 6 months after surgery (P<0.05);Harris hip function scores were higher than those before surgery (P<0.05);pain visual analog scale scores were lower than those before surgery (P<0.05),and the differences were significant (P<0.05). (3) It is indicated that debridement,antibiotics,and implant retention combined with the replacement of assembled components after total hip arthroplasty in patients with acute prosthetic joint infection can effectively control prosthetic joint infection,improve hip function,and relieve hip pain caused by infection.

BACKGROUND:Lifespan of prosthetic joint was being influenced by periprosthetic infection after total hip arthroplasty. Combination of debridement,antibiotics,and implant retention with the replacement of assembled components represents a novel approach in the management of acute prosthetic joint infection after total hip arthroplasty.OBJECTIVE:To observe the efficacy of debridement,antibiotics,and implant retention combined with the replacement of assembled components in the treatment of acute prosthetic joint infection after total hip arthroplasty.METHODS:Twenty-two patients with acute prosthetic joint infection after initial total hip arthroplasty at the Department of Orthopedics,Huangshi Central Hospital,China,between July 2018 and February 2022 were enrolled. The infection time of all patients was less than 3 weeks after the initial arthroplasty. Intraoperative joint fluid extraction and bacterial culture of infected synovium proved to be acute stage infection. They were treated using debridement,antibiotics,and implant retention combined with the replacement of assembled components. Infections were assessed using leukocyte count,erythrocyte sedimentation rate,and C-reactive protein levels before,3 and 6 months after surgery. Improvements in hip joint function were evaluated using Harris hip score. Pain relief was assessed using visual analog scale score. Paired sample t-test was used to analyze the improvement of each index before and after operation.RESULTS AND CONCLUSION:(1) One patient died of non-periprosthesis infection and was subsequently lost to follow-up,which was excluded. The remaining 21 patients received clinical follow-up,and the follow-up time was more than 1 year,with a mean follow-up time of (19.52±3.88) months. Among them,20 patients were successfully treated with surgery and 1 patient failed,and the infection control rate was 95％. (2) The levels of leukocyte count,erythrocyte sedimentation rate,and C-reactive protein were lower in 3 and 6 months after surgery (P<0.05);Harris hip function scores were higher than those before surgery (P<0.05);pain visual analog scale scores were lower than those before surgery (P<0.05),and the differences were significant (P<0.05). (3) It is indicated that debridement,antibiotics,and implant retention combined with the replacement of assembled components after total hip arthroplasty in patients with acute prosthetic joint infection can effectively control prosthetic joint infection,improve hip function,and relieve hip pain caused by infection.

Objective:To retrospectively analyze the changes in the proportion of refined lymphocyte subsets in peripheral blood of patients with Graves disease (GD), and their correlation with the clinical characteristics and efficacy of GD, and to explore the immunological pathogenesis of Graves disease for seeking new therapeutic targets.Methods:A total of 97 newly diagnosed GD patients (GD group), 27 patients after treatment (treatment group), and 31 healthy individuals (control group) who visited the Fifth Medical Center of the PLA General Hospital from 2018 to 2021 were included in this study. The data of refined lymphocyte subsets, thyroid function, blood routine and clinical treatment of the three groups were compared and analyzed. The t-test and rank sum test were used to compare the proportions of lymphocyte subsets among different groups, and Pearson correlation analysis was used to analyze the correlation between the proportions of lymphocyte subsets and thyroid function indicators.Results:The proportion of B cells in GD group was higher than that in the control group [16.2%(11.8%, 21.8%) vs 10.2%(8.1%,13.6%)], while the proportion of natural killer (NK) cells was lower [9.4%(4.9%, 13.6%) vs 14.6%(12.1%,18.8%)], and the differences were statistically significant ( P<0.05). Abnormal T cell differentiation: the proportions of functional cells, including activated T cells, memory T cells, clustering antigen(CD)4+memory T cells, Th1 cells, and Tc1 cells, were lower than that in the control group [3.2%(2.1%, 5.7%) vs 5.8%(3.0%, 9.3%), P<0.05; 36.7% (29.9%, 48.1%) vs 48.0%(39.2%,57.7%), P<0.05; 23.1%(17.4%, 30.1%) vs 28.9%(23.3%,34.6%), P<0.05; 16.4% (11.8%, 23.6%) vs 24.3%(16.9%,28.5%), P<0.05; 28.5% (14.7%, 39.2%) vs 46.3%(21.6%,69.2%), P<0.05]. The proportion of activated T cells in the treatment group was higher than that in the GD group [6.5% (4.6%, 13.6%) vs 3.2% (2.1%, 5.7%), P<0.05]. The total triiodothyronine results showed positive correlations with B cells ( r=0.356, P<0.01) and negative correlations with NK cells ( r=?0.416, P<0.01), while the total thyroxine values showed negative correlations with NK cells and activated T cells ( r=?0.318,?0.335; P<0.01). Thyroid stimulating hormone and CD8+initial T cells were positively correlated ( r=0.382, P<0.01). The proportion of B cells, cytotoxic T cells and suppressor T cells in CD8+cells of patients with complications [such as Graves orbitopathy (GO), thyroid toxic cardiomyopathy, etc.] was significantly different from that of the simple GD patients [18.3% (14.1%, 27.1%) vs 14.6% (10.8%, 21.4%), Z=2.54, P<0.05; 73.4%(65.6%,83.6%)vs 65.0%(50.3%,79.3%), Z=2.93, P<0.05; 26.6%(16.4%, 37.5%)vs 35.0%(20.7%,49.7%), Z=?2.74, P<0.05]. The proportion of suppressor T cells in GO patients was lower than that in non-GO patients [6.1% (3.4%, 8.1%) vs 8.5% (4.9%, 13.6%), Z=?3.20 P<0.05]. Conclusion:There are significant alterations in the circulating immune cells of GD patients, suggesting that immunological abnormalities play a crucial role in the onset and progression of the disease.

Objective:To analyze the clinical characteristics of and risk factors for cutaneous adverse reactions to cosmetics, and to provide evidence and recommendations for the scientific prevention and management of these reactions.Methods:A retrospective study was conducted based on data from outpatients diagnosed with cutaneous adverse reactions to cosmetics at the People's Hospital of Xinjiang Uygur Autonomous Region from January 2016 to December 2019. Clinical data and patch test results were recorded, and a comprehensive analysis was performed to analyze the clinical characteristics of and risk factors for these reactions.Results:A total of 674 patients were included, accounting for 0.15% (674/450 000) of all outpatients; there were 25 male patients and 649 female patients, with ages of 35.29 ± 12.42 years. Among them, 95.40% (643/674) were diagnosed with contact dermatitis to cosmetics, which typically occurred within 3 days after using cosmetics (80.27%, 541/674). Among all the patients, 56 underwent patch tests with the cosmetics they used, resulting in a positive rate of 57.14% (32/56), while 243 completed the patch tests with European Standard cosmetic ingredients, showing a positive rate of 69.96% (170/243). Among the 674 patients, 97.33% (656/674) had facial lesions, with erythema (86.94%, 586/674), papules (36.65%, 247/674), and edema (35.01%, 236/674) as the main clinical signs, and with itching (86.80%, 585/674), dryness (63.20%, 426/674), and burning sensation (62.46%, 421/674) as the common subjective symptoms. The types of cosmetics were related to the symptoms of cutaneous adverse reactions and the morphology of skin lesions. Compared with the patients using special cosmetics, those using ordinary cosmetics had a higher incidence rate of dryness ( P = 0.001), but lower incidence rates of erosions ( P = 0.001), scabbing ( P = 0.005), and exudative lesions ( P = 0.01). p-Phenylenediamine was the most common registered ingredient in hair dyes (72.22%, 13/18), with a relatively high positive rate in the ingredient patch testing (4.53%, 13/243) . Conclusion:In Xinjiang region, contact dermatitis was the most common type of cutaneous adverse reactions to cosmetics, with itching, dryness, and erythema as the predominant symptoms; allergic constitution and special cosmetics appeared to be key risk factors; p-phenylenediamine was an important hazardous substance in hair dyes.

Objective To systematically review the efficacy and safety of dapagliflozin combined with sacubitril valsartan in the treatment of heart failure after acute myocardial infarction.Methods PubMed,Embase,Web of Science,Cochrane Library,CNKI,WanFang Data and VIP databases were electronically searched to collect randomized controlled trials(RCTs)on dapagliflozin combined with sacubitril valsartan(combination treatment group)vs.sacubitril valsartan(monotherapy group)for the treatment of heart failure after acute myocardial infarction from inception to June 18,2024.Two reviewers independently screened the literature,extracted data and assessed the risk of bias of the included studies.Meta-analysis was performed using RevMan 5.4 software.Results A total of 11 RCTs involving 1 060 patients were included.Meta-analysis results showed that compared with the monotherapy group,the efficiency of clinical treatment(OR=5.08,95％CI 2.81 to 9.16,P＜0.001),left ventricular ejection fraction(MD=5.02,95％CI 4.08 to 5.95,P＜0.001),6-minute walking distance(MD=56.45,95％CI 32.83 to 80.07,P＜0.001)significantly increased in the combination treatment group,and the levels of N-terminal brain natriuretic peptide precursor(MD=-249.28,95％CI-414.78 to-83.78,P=0.003)and the incidence of major adverse cardiovascular events(OR=0.24,95％CI 0.15 to 0.41,P＜0.001)significantly decreased in the combination treatment group.However,there was no statistically significant difference between the two groups in terms of reducing the incidence of adverse effects(OR=0.66,95％CI 0.31 to 1.38,P=0.27).Conclusion Current evidence shows that the use of the combination of dapagliflozin and sacubitril valsartan for heart failure after acute myocardial infarction is more effective clinically and does not increase the incidence of adverse drug reactions compared with the treatment of sacubitril valsartan alone.Due to the limited quality and quantity of the included studies,more high-quality studies are needed to verify the above conclusion.

Objective:To analyze the clinical characteristics of and risk factors for cutaneous adverse reactions to cosmetics, and to provide evidence and recommendations for the scientific prevention and management of these reactions.Methods:A retrospective study was conducted based on data from outpatients diagnosed with cutaneous adverse reactions to cosmetics at the People's Hospital of Xinjiang Uygur Autonomous Region from January 2016 to December 2019. Clinical data and patch test results were recorded, and a comprehensive analysis was performed to analyze the clinical characteristics of and risk factors for these reactions.Results:A total of 674 patients were included, accounting for 0.15% (674/450 000) of all outpatients; there were 25 male patients and 649 female patients, with ages of 35.29 ± 12.42 years. Among them, 95.40% (643/674) were diagnosed with contact dermatitis to cosmetics, which typically occurred within 3 days after using cosmetics (80.27%, 541/674). Among all the patients, 56 underwent patch tests with the cosmetics they used, resulting in a positive rate of 57.14% (32/56), while 243 completed the patch tests with European Standard cosmetic ingredients, showing a positive rate of 69.96% (170/243). Among the 674 patients, 97.33% (656/674) had facial lesions, with erythema (86.94%, 586/674), papules (36.65%, 247/674), and edema (35.01%, 236/674) as the main clinical signs, and with itching (86.80%, 585/674), dryness (63.20%, 426/674), and burning sensation (62.46%, 421/674) as the common subjective symptoms. The types of cosmetics were related to the symptoms of cutaneous adverse reactions and the morphology of skin lesions. Compared with the patients using special cosmetics, those using ordinary cosmetics had a higher incidence rate of dryness ( P = 0.001), but lower incidence rates of erosions ( P = 0.001), scabbing ( P = 0.005), and exudative lesions ( P = 0.01). p-Phenylenediamine was the most common registered ingredient in hair dyes (72.22%, 13/18), with a relatively high positive rate in the ingredient patch testing (4.53%, 13/243) . Conclusion:In Xinjiang region, contact dermatitis was the most common type of cutaneous adverse reactions to cosmetics, with itching, dryness, and erythema as the predominant symptoms; allergic constitution and special cosmetics appeared to be key risk factors; p-phenylenediamine was an important hazardous substance in hair dyes.

BACKGROUND: Immunotherapies such as adoptive immune cell infusion and immune-modulating agents are widely used for cancer treatment, and the concomitant symptoms, including cytokine release syndrome (CRS) or immune-related adverse events (irAEs), are frequently reported. However, clinical manifestations induced by mismatched donor granulocyte colony-stimulating factor mobilized peripheral blood mononuclear cell (GPBMC) infusion in patients receiving microtransplant (MST) have not yet been well depicted. METHODS: We analyzed 88 cycles of mismatched GPBMC infusion in patients with acute myeloid leukemia receiving MST and 54 cycles of chemotherapy without GPBMC infusion as a comparison. Clinical symptoms and their correlation with clinical features, laboratory findings, and clinical response were explored. RESULTS: Fever (58.0% [51/88]) and chills (43.2% [38/88]) were the significant early-onset symptoms after GPBMC infusion. Patients possessing less human leukocyte antigen-matching loci with the donor or those with unrelated donors experienced more chills (3 [2-5] loci vs. 5 [3-5] loci, P  = 0.043 and 66.7% [12/18] vs. 37.1% [26/70], P  = 0.024). On the other hand, those with decreased CD4 + /CD8 + T-cell ratio developed more fever (0.8 [0.7-1.2] vs. 1.4 [1.1-2.2], P  = 0.007). Multivariable analysis demonstrated that younger patients experienced more fever (odds ratio [OR] = 0.963, 95% confidence interval [CI]: 0.932-0.995, P  = 0.022), while patients with younger donors experienced more chills (OR = 0.915, 95% CI: 0.859-0.975, P  = 0.006). Elevated ultra-sensitive C-reactive protein levels in the absence of cytokine storm were observed following GPBMC infusion, which indicated mild and transient inflammatory response. Although no predictive value of infusion-related syndrome to leukemia burden change was found, the proportion of host pre-treatment activated T cells was positively correlated with leukemia control. CONCLUSIONS Mismatched GPBMC infusion in MST induced unique infusion-related symptoms and laboratory changes, which were associated with donor- or recipient-derived risk factors, with less safety and tolerance concerns than reported CRS or irAEs.
Humans ; Leukocytes, Mononuclear ; Hematopoietic Stem Cell Transplantation/adverse effects* ; Leukemia, Myeloid, Acute/therapy* ; Unrelated Donors ; Granulocyte Colony-Stimulating Factor ; Graft vs Host Disease

Ferroptosis, as a newly discovered cell death form, has become an attractive target for precision cancer therapy. Several ferroptosis therapy strategies based on nanotechnology have been reported by either increasing intracellular iron levels or by inhibition of glutathione (GSH)-dependent lipid hydroperoxidase glutathione peroxidase 4 (GPX4). However, the strategy by simultaneous iron delivery and GPX4 inhibition has rarely been reported. Herein, novel tumor microenvironments (TME)-activated metal-organic frameworks involving Fe & Cu ions bridged by disulfide bonds with PEGylation (FCSP MOFs) were developed, which would be degraded specifically under the redox TME, simultaneously achieving GSH-depletion induced GPX4 inactivation and releasing Fe ions to produce ROS

Objective To study the effect of carbamazepine and ENP in the treatment of epilepsy and its influence on intelligence and electroencephalogram .Methods Eighty-six patients with epilepsy were enrolled . According to the random number method,they were divided into observation group and the control group ,43 cases in each groups.The observation group was given carbamazepine combination with ENP ,while the control group was given carbamazepine.The duration of epileptic seizure and the number of seizures ,intelligence,P300 wave amplitude and wave latency,and adverse effects were compared between the two groups .Results The total effective rate in the observation group was significantly higher than that in the control group [93.02%(40/43) vs.74.42%(32 /43)] (χ2 =5.460,P <0.05).The duration of seizure of the observation group was shorter than that of the control group [(2.31 ±0.26)times /min vs.(3.16 ±0.38)times /min](t =12.106,P <0.05),and the frequency of seizures of the observation group was shorter than that of the control group [(0.82 ±0.11)time/year vs.(1.34 ±0.15)time/year](t =18.332,P <0.05).The ability of self-discernment,analogical comparison,comparative reasoning,series relation and abstract reasoning ability of the observation group were significantly higher than those of the control group (t =7.557,13.075,2.082,7.615,9.903,all P <0.05).The improvement of SPM level in the observation group was better than that in the control group (t =4.705,P <0.05).The amplitude of P300 wave of the observation group was significantly higher than that of the control group [(6.87 ±0.68)μV vs.(5.24 ±0.51)μV](t =12.575,P <0.05). The latency of P300 wave of the observation group was significantly lower than that of the control group [(305.32 ± 17.34)ms vs.(326.45 ±19.15)ms](t =5.363,P <0.05).There was no statistically significant difference in the incidence rate of adverse reaction between the observation group and the control group (P >0.05).Conclusion The combination of carbamazepine and ENP in the treatment of epilepsy can reduce the duration and frequency of seizures,and improve the intelligence level and electroencephalogram .The clinical efficacy is good and the safety is high .