Objective:To investigate the efficacy and safety of dupilumab in the treatment of elderly patients (≥ 60 years old) with atopic dermatitis (AD), with particular attention paid to rare adverse reactions.Methods:A single-center retrospective analysis was conducted on data collected from 281 elderly AD patients who received the standard regimen of dupilumab at the Department of Dermatology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine from January 2020 to May 2024. Clinical characteristics such as gender, disease duration, skin lesion manifestations, and itch severity were analyzed. Changes in skin lesions and itch severity, as well as related adverse events were recorded during the follow-up period of 0 - 16 weeks. The efficacy and safety of dupilumab in the treatment of elderly AD patients were evaluated.Results:Among the 281 elderly AD patients, 214 were males (76.16%) and 67 were females (23.84%), with the age being 71.13 ± 7.91 years and the age at onset being 59.92 ± 15.72 years. The disease duration ( M[ IQR]) was 5.00 (13.00) years. After standard-regimen dupilumab treatment, the improvement rates of clinical outcome indicators SCORing Atopic Dermatitis (SCORAD) and pruritus numerical rating scale (NRS) scores gradually increased. At week 16, the improvement rates of SCORAD and NRS scores ( M[ IQR]) reached the maxima of 72.37% (23.89%) and 75.00% (29.72%), respectively. The overall incidence of adverse events was relatively low, with only 16 patients (6.05%) reporting adverse events. Common adverse reactions such as conjunctivitis (2 cases, 0.71%) and facial erythema (1 case, 0.36%) were mild and well-tolerated. Phenotype switching occurred in 10 cases (3.56%) . Conclusion:Dupilumab was an effective and safe treatment for elderly AD, but phenotype switching may occur.

Objective:To investigate the efficacy and safety of dupilumab in the treatment of elderly patients (≥ 60 years old) with atopic dermatitis (AD), with particular attention paid to rare adverse reactions.Methods:A single-center retrospective analysis was conducted on data collected from 281 elderly AD patients who received the standard regimen of dupilumab at the Department of Dermatology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine from January 2020 to May 2024. Clinical characteristics such as gender, disease duration, skin lesion manifestations, and itch severity were analyzed. Changes in skin lesions and itch severity, as well as related adverse events were recorded during the follow-up period of 0 - 16 weeks. The efficacy and safety of dupilumab in the treatment of elderly AD patients were evaluated.Results:Among the 281 elderly AD patients, 214 were males (76.16%) and 67 were females (23.84%), with the age being 71.13 ± 7.91 years and the age at onset being 59.92 ± 15.72 years. The disease duration ( M[ IQR]) was 5.00 (13.00) years. After standard-regimen dupilumab treatment, the improvement rates of clinical outcome indicators SCORing Atopic Dermatitis (SCORAD) and pruritus numerical rating scale (NRS) scores gradually increased. At week 16, the improvement rates of SCORAD and NRS scores ( M[ IQR]) reached the maxima of 72.37% (23.89%) and 75.00% (29.72%), respectively. The overall incidence of adverse events was relatively low, with only 16 patients (6.05%) reporting adverse events. Common adverse reactions such as conjunctivitis (2 cases, 0.71%) and facial erythema (1 case, 0.36%) were mild and well-tolerated. Phenotype switching occurred in 10 cases (3.56%) . Conclusion:Dupilumab was an effective and safe treatment for elderly AD, but phenotype switching may occur.

Objective To evaluate the effect of Internet-based psychosocial intervention for primary caregivers of patients with terminal stage cancer.Methods The relevant randomized controlled trials of Internet-based psychosocial intervention for primary caregivers of patients with terminal stage cancer were systematically searched from 10 databases,such as Chinese Biomedical Literature Database,CNKI,PubMed,Embase and CINAHL and etc.The search period was from the establishment to December 18,2023,and 2 investigators screened the literature according to inclusion and exclusion criteria and extracted data.Cochrane Manual 5.1.0 was used to assess the quality of the literature.Meta-analysis was performed using Revman 5.4 software.Results A total of 9 pieces of the literature including 592 primary caregivers were included.Meta-analysis showed that Internet-based psychosocial intervention reduced the level of anxiety and depression for primary caregivers of patients with terminal stage cancer[MD=-1.64,95％CI(-2.68,-0.59),P=0.002]and the burden of care[SMD=-0.39,95％CI(-0.60,-0.18),P＜0.001],and improved quality of life[SMD=0.25,95％CI(0.01,0.48),P=0.040];further research is needed to explore the effect of reducing the level of distress[MD=-0.88,95％CI(-1.91,0.16),P=0.100].Conclusion The Internet-based psychosocial intervention is effective in improving the anxiety,depression and the burden of care of the primary caregivers of patients with terminal stage cancer,and it can improve the quality of life;further research is needed to explore the level of distress reduction.

Objective:To understand the cognition of the family caregivers of terminal cancer patients on digital health intervention, to clarify their actual needs, and to analyze the obstacles to their acceptance of digital health intervention, so as to develop a digital health intervention plan for the family caregivers of terminal cancer patients.Methods:From February 2024 to March 2024, the family caregivers of 16 patients with terminal cancer in Hunan Cancer Hospital Pain Hospice Ward were selected by objective sampling, who met the inclusion and exclusion criteria were interviewed in a semi-structured manner about the cognition and needs of digital health intervention, and the interview contents were sorted and analyzed using the Colaizzi7 step method.Results:A total of 16 family caregivers of terminal cancer patients, 4 males and 12 females, aged 26-55 years, were interviewed. Four themes were distilled from the interview results: family caregivers of terminally cancer patients agree on the importance of digital health interventions; lack of awareness of digital health interventions; expectations of digital health interventions; and possible confounders affecting digital health interventions.Conclusions:The family caregivers of terminal cancer patients had insufficient awareness of digital health intervention, but all showed affirmation of the development of digital health intervention services. It is recommended to actively improve the basic conditions of digital health services, strengthen publicity, raise the level of awareness of the family caregivers, and positively overcome the relevant interfering factors, so as to gradually promote the development of digital health services.

Objective To investigate the mechanism of sanguinarine(SA)for alleviating ulcerative colitis(UC)induced by dextran sodium sulfate(DSS)in mice.Methods Male C57BL/6 mouse models of 3.5%DSS-induced UC were randomized for treatment with 1,5 and 10 mg/kg SA by gavage,400 mg/kg sulfasalazine by gavage,or 10 mg/kg SA combined with intraperitoneal injection of 30 mg/kg ML385(a Nrf2 inhibitor).The changes in intestinal inflammation was assessed by monitoring weight changes,disease activity index(DAI)score,colon length measurement,and HE staining.After the treatments,the colon tissues were collected for detection of malondialdehyde(MDA)content using colorimetry,mRNA expressions of inflammatory factors using RT-qPCR,and the expressions of Nrf2,HO-1,Keap-1,p-p65,p65,occludin,and ZO-1 proteins were detected using Western blotting.Results SA treatment obviously alleviated weight loss,colon length shortening and DAI score increase and ameliorated structural destruction of the colon glands and colonic crypts in mice with DSS-induced UC.SA intervention significantly decreased the levels of TNF-α,IL-1β and IL-6 mRNA and lowered ROS and MDA levels in the colon tissue of UC mice.The mouse models receiving SA treatment showed significantly increased expressions of Nrf2,HO-1,occludin and ZO-1 and lowered expressions of Keap-1 and P-P65 in the colon tissue without significant changes of p65 expression,and these changes were SA dose-dependent.Treatment with ML385 obviously attenuated the effect of high-dose SA for improving UC in the mouse models.Conclusion SA can improve UC-like enteritis in mice possibly by activating the Nrf2 pathway and inhibiting the NF-κB pathway in the colon tissue.

Objective To investigate the effect of sanguinarine(SAN)on proliferation and ferroptosis of colorectal cancer cells.Methods SW620 and HCT-116 cells treated with different concentrations of SAN were examined for cell viability changes using CCK8 assay to determine the IC50 of SAN in the two cells.The inhibitory effects of SAN on proliferation,invasion and migration of the cells were evaluated using colony-forming assay and Transwell assays.ROS production in the treated cells was analyzed with flow cytometry,and lipid peroxide production was assessed by detecting malondialdehyde(MDA)level.Glutathione(GSH)levels in the cells were detected,and Western blotting was used to detect the expressions of ferroptosis-related proteins STUB1 and GPX4.Results SAN significantly inhibited the proliferation,invasion and migration of SW620 and HCT-116 cells.SAN treatment significantly promoted ROS production,increased intracellular MDA level,and lowered GSH level in the two cells(P<0.05).Western blotting showed that SAN significantly upregulated the expression of STUB1 and down-regulated the expression of its downstream protein GPX4(P<0.05).Conclusion SAN induces ferroptosis in colorectal cancer cells by regulating STUB1/GPX4,which may serve as a new therapeutic target for colorectal cancer.

This study explored the ideas and methods of acupuncture for Guillain-Barré Syndrome （GBS） with the core principle of “to treat flaccidity， select the yangming （阳明） channel only”. The main pathological mechanism of GBS is deficiency of qi and blood in the yangming channel， malnutrition of all sinews， diminished spleen and stomach function leading to the production of pathogenic damp-heat qi， which obstructs the meridians， and gradually affects the liver and kidneys， consuming essence and damaging blood. Concurrently， dysfunction of the dumai （督脉） pivotal mechanism and lack of moisture in sinews and vessels result in symptoms such as skin numbness， paralysis， and muscle wastage. In clinical diagnosis and treatment， a combination of syndrome and channel differentiation is taken. Treatment primarily focuses on acupoints of yangming channel， aiming to supplement qi and blood， and acupoints of du mai are combined to open the vessel and fill the marrow. Specific acupoints are selected based on syndrome differentiation， providing comprehensive regulation to promote harmonization of qi and blood， relieve meridians， and the smooth generation and circulation of whole body fluids. This， in turn， enhances the strength of muscles and bones， and fosters a robust and freely moving body.

Objective To investigate the mechanism of sanguinarine(SA)for alleviating ulcerative colitis(UC)induced by dextran sodium sulfate(DSS)in mice.Methods Male C57BL/6 mouse models of 3.5%DSS-induced UC were randomized for treatment with 1,5 and 10 mg/kg SA by gavage,400 mg/kg sulfasalazine by gavage,or 10 mg/kg SA combined with intraperitoneal injection of 30 mg/kg ML385(a Nrf2 inhibitor).The changes in intestinal inflammation was assessed by monitoring weight changes,disease activity index(DAI)score,colon length measurement,and HE staining.After the treatments,the colon tissues were collected for detection of malondialdehyde(MDA)content using colorimetry,mRNA expressions of inflammatory factors using RT-qPCR,and the expressions of Nrf2,HO-1,Keap-1,p-p65,p65,occludin,and ZO-1 proteins were detected using Western blotting.Results SA treatment obviously alleviated weight loss,colon length shortening and DAI score increase and ameliorated structural destruction of the colon glands and colonic crypts in mice with DSS-induced UC.SA intervention significantly decreased the levels of TNF-α,IL-1β and IL-6 mRNA and lowered ROS and MDA levels in the colon tissue of UC mice.The mouse models receiving SA treatment showed significantly increased expressions of Nrf2,HO-1,occludin and ZO-1 and lowered expressions of Keap-1 and P-P65 in the colon tissue without significant changes of p65 expression,and these changes were SA dose-dependent.Treatment with ML385 obviously attenuated the effect of high-dose SA for improving UC in the mouse models.Conclusion SA can improve UC-like enteritis in mice possibly by activating the Nrf2 pathway and inhibiting the NF-κB pathway in the colon tissue.

Objective To investigate the effect of sanguinarine(SAN)on proliferation and ferroptosis of colorectal cancer cells.Methods SW620 and HCT-116 cells treated with different concentrations of SAN were examined for cell viability changes using CCK8 assay to determine the IC50 of SAN in the two cells.The inhibitory effects of SAN on proliferation,invasion and migration of the cells were evaluated using colony-forming assay and Transwell assays.ROS production in the treated cells was analyzed with flow cytometry,and lipid peroxide production was assessed by detecting malondialdehyde(MDA)level.Glutathione(GSH)levels in the cells were detected,and Western blotting was used to detect the expressions of ferroptosis-related proteins STUB1 and GPX4.Results SAN significantly inhibited the proliferation,invasion and migration of SW620 and HCT-116 cells.SAN treatment significantly promoted ROS production,increased intracellular MDA level,and lowered GSH level in the two cells(P<0.05).Western blotting showed that SAN significantly upregulated the expression of STUB1 and down-regulated the expression of its downstream protein GPX4(P<0.05).Conclusion SAN induces ferroptosis in colorectal cancer cells by regulating STUB1/GPX4,which may serve as a new therapeutic target for colorectal cancer.

Objective:To evaluate the calf muscle cross-sectional area (CSA) and fat fraction (FF) in amateur marathon runners based on T 2WI-Flex fat-suppression sequence and iterative decomposition of water and fat with echo asymmetrical and least-squares estimation quantitation sequence (IDEAL-IQ) technique, and to explore the correlation between them and age, body mass index (BMI), running age, speed exercise, and monthly exercise. Methods:From September to November 2022, 37 amateur marathon group (marathon group) and 12 healthy volunteers (control group) who did not often exercise were recruited in Shijiazhuang. T 2WI-Flex fat-suppression sequence and IDEAL-IQ sequence were performed on all subjects. The anterior group of the right calf (tibialis anterior, extensor hallucis longus, extensor digital longus), external group of the calf (peroneus longus, peroneus brevis), soleus, medial head and lateral head of the gastrocnemius were delineated along the edge of the muscle contour as regions of interest, and the CSA and FF values of the muscles were obtained. Twelve subjects matched with the clinical data of the control group were selected from the marathon group (marathon matched group), and the differences in CSA and FF were compared by independent sample t test or Mann-Whitney U test. Spearman correlation analysis was used to evaluate the correlation between CSA and FF values of the right calf and running-related indicators including age, BMI, running age, speed exercise, and monthly exercise in 37 amateur marathon runners. Results:The CSA of the right calf soleus muscle in the marathon matched matched group was larger than that in the control group ( t=-2.09, P=0.048). There was no significant difference in CSA of other calf muscles between the two groups ( P>0.05). The FF values of the right calf anterior group, the outer group, the soleus muscle, the medial head and the lateral head of the gastrocnemius muscle in the marathon matched group were lower than those in the control group ( P<0.05). The BMI of 37 amateur marathon runners was positively correlated with the CSA and FF values of the anterior group, the outer group, the soleus, the medial head and the lateral head of the gastrocnemius muscle (CSA: r=0.628, 0.468, 0.680, 0.566, 0.615, respectively, all P<0.05; FF value: r=0.395, 0.567, 0.631, 0.482, 0.516, respectively, all P<0.05). The FF values of the anterior group, the outer group, the soleus, the medial head and the lateral head of the gastrocnemius muscle were negatively correlated with monthly exercise ( r=-0.337, -0.405, -0.437, -0.338, -0.446, respectively, all P<0.05). Conclusions:Long-term running training can reduce the FF value of each calf muscle group, and the FF value of calf muscles is negatively correlated with the amount of running each month. Long-term running training has the greatest effect on the CSA of soleus muscle.