Keloid is a benign skin fiber proliferative disease caused by abnormal repair of skin injury, characterized by lesions that often exceed the boundaries of the original injury and infiltrate into the surrounding adjacent normal skin. Keloid scars not only cause pain, itching and other symptoms, but also cause aesthetic defects, bringing great psychological burden to patients. The treatment of keloid is divided into surgical treatment and non-surgical treatment. The non-surgical treatment is most commonly used with drug injection, which has the advantages of less traumatic, simple operation, low recurrence rate, and high patient tolerance compared with surgical treatment. In recent years, with the deepening of the research on the pathogenesis of keloid, the drug injection treatment of keloid has also made great progress, including glucocorticoids, botulinum toxin type A, antitumor drugs, verapamil, interferon, vitamin D, platelet-rich plasma, and other drugs under development, including adipose-derived stem cells, mTOR signaling pathway inhibitors, renin-angiotensin system modulators, and lipocalins. In this article, the types of injectable drugs and mechanisms for the treatment of keloid are summarized, with a view to providing some reference for clinical treatment.

BACKGROUND:Quercetin has anti-inflammatory,anti-cancer,anti-oxidation,anti-aging,anti-depression and other pharmacological effects,and has high medicinal value.Quercetin can promote wound healing in normal rats,but few drugs with quercetin as the main component have been developed,which limits its wide application in clinical practice. OBJECTIVE:To investigate the application effect of quercetin-carboxymethyl chitosan hydrogel on diabetic wound in rats by loading quercetin with hydrogel material. METHODS:(1)Carboxymethyl chitosan hydrogels and quercetin-carboxymethyl chitosan hydrogels were prepared respectively,and the micromorphology and in vitro drug release properties of the hydrogels were characterized.(2)Cell experiment:Mouse L929 fibroblasts were cultured in four groups.The blank control group was cultured conventionally.Carboxymethyl chitosan hydrogel,quercetin solution and quercetin-carboxymethyl chitosan hydrogel were added to pure hydrogel group,drug group,and drug-loaded hydrogel group,respectively,to detect cell proliferation and migration ability.(3)Animal experiments:Diabetic models were established in 80 SD rats.After successful modeling,full-layer skin defect wounds with a diameter of 2 cm were made on the back of rats,and these models were randomly divided into four groups.Normal saline,carboxymethyl chitosan hydrogel,quercetin solution,and quercetin-carboxymethyl chitosan hydrogel were injected into the wounds of blank control group,pure hydrogel group,drug group,and drug-loaded hydrogel group,respectively.Each group contained 20 animals,which were bound with sterile gauze.Wound healing,pathological morphology,expression of inflammatory factors,and angiogenesis were observed after operation. RESULTS AND CONCLUSION:(1)Under scanning electron microscope,the microstructures of the two hydrogels were similar,both showed loose porous network structure,and quercetin-carboxymethyl chitosan hydrogels had good drug release performance in vitro.(2)Compared with blank control group,the cell proliferation and mobility of the other three groups were increased(P<0.05).The cell proliferation and mobility of drug-loaded hydrogel group were higher than those of pure hydrogel group and drug group(P<0.05).(3)The wound healing rate of the drug-loaded hydrogel group was higher than that of the other three groups at 5 and 11 days after operation.The wound healing rate of rats in the hydrogel group,pure hydrogel group,and drug group reached 100%18 days after operation,which was higher than that in the blank control group(P<0.05).Hematoxylin-eosin staining showed that intact skin and skin appendages were visible on the wounds of rats in the drug-loaded hydrogel group 18 days after surgery,while intact skin and skin appendages were visible on the wounds of rats in the blank control group,pure hydrogel group,and drug group 25 days after surgery.The levels of tumor necrosis factor α and interleukin-6 in the drug-loaded hydrogel group were lower than those in the blank control group at 5,11,and 18 days after surgery(P<0.05),and the levels of transforming growth factor β1 at 11 and 18 days after surgery were lower than those in the blank control group(P<0.05).The mRNA expressions of CD31 and vascular endothelial growth factor α in the drug-loaded hydrogel group were higher than those in the other three groups at 11 and 18 days after operation(P<0.05).(4)These findings indicate that quercetin in quercetin carboxymethyl chitosan hydrogel can regulate inflammatory response,accelerate angiogenesis,promote the proliferation and migration of fibroblasts,and enhance the healing of diabetic wounds in rats.

Keloid is a benign skin fiber proliferative disease caused by abnormal repair of skin injury, characterized by lesions that often exceed the boundaries of the original injury and infiltrate into the surrounding adjacent normal skin. Keloid scars not only cause pain, itching and other symptoms, but also cause aesthetic defects, bringing great psychological burden to patients. The treatment of keloid is divided into surgical treatment and non-surgical treatment. The non-surgical treatment is most commonly used with drug injection, which has the advantages of less traumatic, simple operation, low recurrence rate, and high patient tolerance compared with surgical treatment. In recent years, with the deepening of the research on the pathogenesis of keloid, the drug injection treatment of keloid has also made great progress, including glucocorticoids, botulinum toxin type A, antitumor drugs, verapamil, interferon, vitamin D, platelet-rich plasma, and other drugs under development, including adipose-derived stem cells, mTOR signaling pathway inhibitors, renin-angiotensin system modulators, and lipocalins. In this article, the types of injectable drugs and mechanisms for the treatment of keloid are summarized, with a view to providing some reference for clinical treatment.

Objective To investigate the status of oral frailty(OF)in patients who underwent chemotherapy for lung cancer,identify key factors influencing OF,and develop a risk prediction model.Methods Using convenience sampling,431 lung cancer inpatient were recruited from three Tier-IIIA hospitals in Jiangsu Province between September and November 2024 as the training cohort.The patients were divided into OF and non-OF groups.Relevant data were compared between the two groups.Multifactorial logistic regression analysis was performed to determine factors that associated with OF,and a risk prediction model was created accordingly.Receiver operating characteristic(ROC)curve analysis was used to predict model performance.In December 2024,additional 185 patients from one other Tier-IIIA hospitals were recruited to validate the developed model.Results The prevalence of OF among lung-cancer patients undergoing chemotherapy was 58.93%.Following listed items were identified as the risk factors of OF(all P<0.05):older in age(OR=3.420),poor education(OR=0.030),brain metastasis(OR=7.880),high nutritional risk screening 2002 score(OR=1.550),elevated C-reactive protein(OR=1.100),and elevated lactate dehydrogenase(OR=1.010).ROC area under the curve(AUC)of the model was 0.860(95%CI:0.830-0.900)in modelling cohort and 0.840(95%CI:0.780-0.900)in validation cohort.Hosmer-Lemeshow goodness-of-fit test yielded χ 2=4.870,P=0.770 for the training set and χ 2=2.770,P=0.950 for the validation set.Conclusion The risk prediction model for OF developed in this study demonstrates a good predictive performance and can facilitate early identification of high-risk patients,thereby providing a scientific basis for clinical interventions.

Objective To investigate the status of oral frailty(OF)in patients who underwent chemotherapy for lung cancer,identify key factors influencing OF,and develop a risk prediction model.Methods Using convenience sampling,431 lung cancer inpatient were recruited from three Tier-IIIA hospitals in Jiangsu Province between September and November 2024 as the training cohort.The patients were divided into OF and non-OF groups.Relevant data were compared between the two groups.Multifactorial logistic regression analysis was performed to determine factors that associated with OF,and a risk prediction model was created accordingly.Receiver operating characteristic(ROC)curve analysis was used to predict model performance.In December 2024,additional 185 patients from one other Tier-IIIA hospitals were recruited to validate the developed model.Results The prevalence of OF among lung-cancer patients undergoing chemotherapy was 58.93%.Following listed items were identified as the risk factors of OF(all P<0.05):older in age(OR=3.420),poor education(OR=0.030),brain metastasis(OR=7.880),high nutritional risk screening 2002 score(OR=1.550),elevated C-reactive protein(OR=1.100),and elevated lactate dehydrogenase(OR=1.010).ROC area under the curve(AUC)of the model was 0.860(95%CI:0.830-0.900)in modelling cohort and 0.840(95%CI:0.780-0.900)in validation cohort.Hosmer-Lemeshow goodness-of-fit test yielded χ 2=4.870,P=0.770 for the training set and χ 2=2.770,P=0.950 for the validation set.Conclusion The risk prediction model for OF developed in this study demonstrates a good predictive performance and can facilitate early identification of high-risk patients,thereby providing a scientific basis for clinical interventions.

During the Jin dynasty,the two major academic schools of Hejian and Yishui emerged in northern China.At this time,the Song dynasty migrated southward,accompanied by the southward movement of the Han ethnic culture and economic center.The dissemination of medicine also showed a trend of spreading from the north to the south.The late Yuan dynasty was an important period for the academic dissemination of the Yishui school to the south.On the one hand,ZHU Danxi,GE Yinglei,HUA Shou,and other clinicians studied the academic works of LI Dongyuan,comprehended his academic ideas,and further disseminated them through their disciples and Confucian scholars.On the other hand,academic works such as Jisheng Bacui and Weisheng Baojian carrying the study of Yishui were published in the south,playing an essential role in disseminating Yishui's study in the south.The dissemination of Yishui's learning to the south adopted a combination of book learning and mentorship,effectively breaking down the academic barriers between the Hejian and Yishui schools.The network formed by the interaction between medical scholars and Confucian scholars was an essential medium for academic dissemination.The study of Yishui was transmitted to the south and integrated with the original spleen and stomach theory in the south,promoting the further development of traditional Chinese medicine spleen and stomach theory.

During the Jin dynasty,the two major academic schools of Hejian and Yishui emerged in northern China.At this time,the Song dynasty migrated southward,accompanied by the southward movement of the Han ethnic culture and economic center.The dissemination of medicine also showed a trend of spreading from the north to the south.The late Yuan dynasty was an important period for the academic dissemination of the Yishui school to the south.On the one hand,ZHU Danxi,GE Yinglei,HUA Shou,and other clinicians studied the academic works of LI Dongyuan,comprehended his academic ideas,and further disseminated them through their disciples and Confucian scholars.On the other hand,academic works such as Jisheng Bacui and Weisheng Baojian carrying the study of Yishui were published in the south,playing an essential role in disseminating Yishui's study in the south.The dissemination of Yishui's learning to the south adopted a combination of book learning and mentorship,effectively breaking down the academic barriers between the Hejian and Yishui schools.The network formed by the interaction between medical scholars and Confucian scholars was an essential medium for academic dissemination.The study of Yishui was transmitted to the south and integrated with the original spleen and stomach theory in the south,promoting the further development of traditional Chinese medicine spleen and stomach theory.

During the Jin dynasty,the two major academic schools of Hejian and Yishui emerged in northern China.At this time,the Song dynasty migrated southward,accompanied by the southward movement of the Han ethnic culture and economic center.The dissemination of medicine also showed a trend of spreading from the north to the south.The late Yuan dynasty was an important period for the academic dissemination of the Yishui school to the south.On the one hand,ZHU Danxi,GE Yinglei,HUA Shou,and other clinicians studied the academic works of LI Dongyuan,comprehended his academic ideas,and further disseminated them through their disciples and Confucian scholars.On the other hand,academic works such as Jisheng Bacui and Weisheng Baojian carrying the study of Yishui were published in the south,playing an essential role in disseminating Yishui's study in the south.The dissemination of Yishui's learning to the south adopted a combination of book learning and mentorship,effectively breaking down the academic barriers between the Hejian and Yishui schools.The network formed by the interaction between medical scholars and Confucian scholars was an essential medium for academic dissemination.The study of Yishui was transmitted to the south and integrated with the original spleen and stomach theory in the south,promoting the further development of traditional Chinese medicine spleen and stomach theory.

Objective:To investigate the sense of coherence, job stressors and mental health status of nurses practitioners, and analyze the correlation among them.Methods:In September 2020, nurses practitioners in Chengdu City, Sichuan Province were selected as the research objects by convenience sampling method. The Sense of Coherence Scale, Nurses' Job Stressors Scale and SCL-90 were used to investigate their sense of coherence, job stressors and mental health status, respectively. Pearson correlation test was used to analyze the correlation among them, and the structural equation model was constructed to explore the mechanism of them.Results:A total of 1693 nurse practitioners were included. The total scores of sense of coherence, job stressors and SCL-90 were (65.00±14.01) points, (69.08±18.38) points and (129.68±52.99) points, respectively. The mean scores of all dimensions of sense of coherence of nurse practitioners were negatively correlated with the mean scores of all dimensions of job stressors and SCL-90 ( P<0.001). And there were positive correlations between the mean scores of all dimensions of job stressors and the mean scores of all dimensions of SCL-90 ( P<0.001). The structural equation model fitted well. The path coefficient between job stressors and sense of coherence was -0.372 ( P<0.001), and the path coefficient between sense of coherence and SCL-90 score was -0.647 ( P<0.001) . Conclusion:The sense of coherence plays a significant buffering role in job stressors and mental health of nurses practitioners. Nursing managers should be committed to improving the level of sense of coherence of nurses, enhance the happiness of nurses at work, and improve their mental health level.

During the Jin dynasty,the two major academic schools of Hejian and Yishui emerged in northern China.At this time,the Song dynasty migrated southward,accompanied by the southward movement of the Han ethnic culture and economic center.The dissemination of medicine also showed a trend of spreading from the north to the south.The late Yuan dynasty was an important period for the academic dissemination of the Yishui school to the south.On the one hand,ZHU Danxi,GE Yinglei,HUA Shou,and other clinicians studied the academic works of LI Dongyuan,comprehended his academic ideas,and further disseminated them through their disciples and Confucian scholars.On the other hand,academic works such as Jisheng Bacui and Weisheng Baojian carrying the study of Yishui were published in the south,playing an essential role in disseminating Yishui's study in the south.The dissemination of Yishui's learning to the south adopted a combination of book learning and mentorship,effectively breaking down the academic barriers between the Hejian and Yishui schools.The network formed by the interaction between medical scholars and Confucian scholars was an essential medium for academic dissemination.The study of Yishui was transmitted to the south and integrated with the original spleen and stomach theory in the south,promoting the further development of traditional Chinese medicine spleen and stomach theory.