Psoriasis is an incurable chronic inflammatory disease that requires new interventions. Here, we found that fibroblasts exacerbate psoriasis progression by promoting macrophage recruitment via CCL2 secretion by single-cell multi-omics analysis. The natural small molecule celastrol was screened to interfere with the secretion of CCL2 by fibroblasts and improve the psoriasis-like symptoms in both murine and cynomolgus monkey models. Mechanistically, celastrol directly bound to the low-density lipoprotein receptor-related protein 1 (LRP1) β-chain and abolished its binding to the transcription factor c-Jun in the nucleus, which in turn inhibited CCL2 production by skin fibroblasts, blocked fibroblast-macrophage crosstalk, and ameliorated psoriasis progression. Notably, fibroblast-specific LRP1 knockout mice exhibited a significant reduction in psoriasis like inflammation. Taken together, from clinical samples and combined with various mouse models, we revealed the pathogenesis of psoriasis from the perspective of fibroblast-macrophage crosstalk, and provided a foundation for LRP1 as a novel potential target for psoriasis treatment.

Objective:To explore the application effect of the intervention model based on hospital elder life program (HELP) in patients after hip fracture surgery.Methods:A total of 98 patients who underwent hip fracture surgery in the First Affiliated Hospital of Zhengzhou University from January 2019 to February 2021 were selected. According to the time of admission, 49 postoperative patients from January 2019 to January 2020 were set as the control group and they were given routine orthopedic nursing. A total of 49 postoperative patients admitted from February 2020 to February 2021 were set as the observation group and they were given the intervention model based on HELP . The out of bed activity time, postoperative complications and falls were recorded in the two groups after the intervention. Activity of Daily Living (ADL) Scale, Harris Hip Score (HHS) and self-made Rehabilitation Exercise Compliance Questionnaire were used to evaluate ADL, hip function and rehabilitation exercise compliance of patients in the two groups. Before and after the intervention, the self-made Early Rehabilitation Training Cognitive Questionnaire was used to evaluate the cognitive status of early rehabilitation training in the two groups.Results:After the intervention, the postoperative ambulation time of the observation group was shorter than that of the control group, and ADL score, HHS score and compliance score were higher than those of the control group, and the differences were statistically significant ( P<0.05) . After intervention, the scores of bed rehabilitation training, correct functional exercise, hip dislocation prevention, and lower extremity deep vein thrombosis prevention scores in the observation group were higher than those in the control group, with statistical significance ( P<0.05) . The incidences of constipation, DVT in the observation group were lower than those in the control group and the differences were statistically significant ( P<0.05) . Conclusions:The intervention model based on HELP is beneficial to early postoperative ambulation for patients with hip fractures, reducing the incidence of postoperative adverse event, and improving the patients' ability to take care of themselves in daily life.

Objective: To explore the related factors of subependymal hemorrhage (SEH) and cerebral hemodynamic changes. Methods: From October 2012 to October 2017, 200 cases of children with subependymal hemorrhage diagnosed by ultrasound in our department of pediatrics were selected as the observation group , and a total of 150 children who were admitted to the Department of Pediatrics in the same period due to craniocerebral diseases and other serious diseases were selected as control group. The independent risk factors of the children in the observation group were analyzed, and the difference of the maximum systolic blood flow velocity (SV), the diastolic maximum flow velocity (DV), the systolic and diastolic velocity ratio (S/D), the resistance index (RI), and the pulsatile index (PI) were compared between the two groups. Results: Neonatal asphyxia, preterm birth, acidosis, neonatal respiratory distress syndrome (NRDS), patent ductus arteriosus and coagulation dysfunction were independent risk factors for subependymal hemorrhage. The bleeding side SV and DV of the observation group were higher than those of the control group, with statistically significant difference (P<0.001). In the observation group, the bleeding side SV and DV were higher than those of the healthy side, with statistically significant difference (P<0.001). There was no significant difference in bleeding side SV, DV, S/D, RI and PI in 110 cases of single side ependymal hemorrhage (P>0.05). Conclusions Children with ependymal hemorrhage can observe the hemodynamic indexes of anterior cerebral artery (ACA) dynamically by craniocerebral ultrasound, and judge the therapeutic effect by evaluating the systolic and diastolic blood flow velocity, so as to prevent the further aggravation of subependymal hemorrhage

Objective:To explore the diagnostic value of endoscopic ultrasonography (EUS) for duodenal accessory papilla.Methods:Data of 122 cases of duodenal accessory papilla diagnosed by EUS at the endoscopy center of the First Affiliated Hospital of Zhejiang University School of Medicine from February 28, 2006 to February 28, 2018 were analyzed and summarized.Results:Of the 122 duodenal accessory papilla cases, the age was 52.1±12.9, with more males than females. The most common site of duodenal accessory papillae was the descending part above the papilla (88/122, 72.13%), followed by the junction of duodenal bulb and descending part (29/122, 23.77%), and a small proportion of lesions located in the duodenal bulb (5/122, 4.10%). Duodenal accessory papillae were all solitary, whose diameter mostly ranged 0.5-1.0 cm (88/122, 72.13%), a smaller proportion of diameter larger than 1.0 cm (23/122, 18.85%), and only a few with diameter less than 0.5 cm (11/122, 9.02%). Most duodenal accessory papillae were hypoechoic (71/122, 58.20%) or moderate to low echogenic (35/122, 28.68%), and the echoes were mostly homogeneous. The mucosa layer was smooth, with a sphincteroid structure in the submucosa and below. The boundary of the duodenal accessory papillae was mostly clear (121/122, 99.18%) and characteristic lacunar cavity structures were often seen in the center (83/122, 68.03%). The surrounding intestinal wall was normal and no associated enlarged lymph nodes were found around the intestine.Conclusion:EUS can clearly show the structure of duodenal accessory papilla and adjacent organs, and is of high value for the diagnosis of duodenal accessory papilla.

Objective To study etiology screening role of transrectal ultrasonography in male obstructive azoospermia infertility.Methods The clinical data of 328 cases who suspected of being obstructed sperm disease were retrospectively analyzed.TRUS detection was conducted,at the same time,the sperm amount,sperm and semen pH,pure berries quantitative,neutral sugar alpha glycosidase enzymes quantitative,elastic hard protease were tested.Results In 328 cases with male obstructed no sperm,by TRUS detection results,216 cases (65.8％) could find the causes,ejaculatory duct expansion,seminal vesicle gland lesions,prostate midline cyst were the top three causes respectively;112 patients(34.2％) had no obvious abnormal ultrasonic testing.Sperm was not seen in semen of obstructive azoospermia patients and semen pH ＜ 7,pure berries sugar quantitative and quantitative value neutral alpha glycosidase enzymes were very low,hard elastic protease was low.Conclusion The main causes of obstructive azoospermia were ejaculatory duct expansion,seminal vesicle gland lesions,prostate midline cyst,sperm TRUS detection used for diagnosis of high sensitivity,and easy to operate,noninvasive,and combined with seminal plasma biochemical examination,the diagnostic effect is much better.