OBJECTIVE To explore the mechanism of action of Qingre huatan huoxue decoction against atherosclerosis （AS）based on macrophage polarization. METHODS Using atorvastatin served as the positive control， the drug-containing serum of the Qingre huatan huoxue decoction was prepared to treat RAW264.7 macrophages. Macrophage viability， apoptosis rate， and the fluorescence intensities of CD86 and CD206 were measured， along with the levels of tumor necrosis factor-α （TNF-α） and interleukin-1β （IL-1β）. Apolipoprotei n E-deficient （ApoE －/－ ） mice （AS model mice） fed with a high-fat diet were randomly assigned to model group， atorvastatin group （2.6 mg/kg）， and low-， medium- and high-dose groups of Qingre huatan huoxue decoction （90， 180， 360 mg/kg）， respectively. C57BL/6J mice fed with a standard diet served as the normal control group， with 10 mice per group. The treatment group mice were administered the corresponding drugs intragastrically， once daily， for 8 consecutive weeks. Serum levels of TNF-α and IL-1β were measured in all groups. Lipid deposition in the aorta （assessed by the percentage of plaque in the entire aorta and aortic root） and morphological changes in the aortic root were observed. Expression levels of CD86 and CD206 in aortic tissue， as well as the protein expression levels of inducible nitric oxide synthase （iNOS）， arginase-1 （Arg-1）， AMP-activated protein kinase （AMPK）， phosphorylated AMPK （p-AMPK）， and peroxisome proliferator-activated receptor γ （PPAR-γ） in aortic tissues were all detected. RESULTS Cell experiment results showed that， at concentrations of 5-100 μg/mL， the drug-containing serum of the Qingre huatan huoxue decoction significantly increased RAW264.7 cell viability （ P ＜0.05）. The drug-containing serum of the Qingre huatan huoxue decoction at concentrations of 10， 50， and 100 μg/mL， along with atorvastatin， significantly reduced apoptosis rates， CD86 fluorescence intensity， and TNF-α and IL-1β levels in RAW264.7 cells， while markedly enhancing CD206 fluorescence intensity （ P ＜0.05）. Animal experiment results showed that， compared with the model group， all dosage groups of Qingre huatan huoxue decoction and the atorvastatin group showed significantly reduced/down-regulated levels of TNF-α and IL-1β in serum， along with decreased aortic total and root plaque percentages， CD86 expression， and iNOS protein expression. CD206 expression and Arg-1， p-AMPK/AMPK， PPAR-γ protein expression were significantly up-regulated （ P ＜0.05）. Pathological morphology of the aorta showed varying degrees of improvement. CONCLUSIONS The formula of Qingre huatan huoxue decoction exerts its anti-AS effects by regulating macrophage polarization， increasing the proportion of M2 macrophages， thereby effectively inhibiting AS plaque formation and reducing inflammatory responses.

Objective:To characterize COVID-19-associated skin diseases and explore their influencing factors.Methods:A cross-sectional survey was conducted via the online platform Wenjuanxing in Changsha area from February 16, 2023, to March 16, 2023. The convenience sampling method was employed to conduct a survey of outpatients with a history of COVID-19 infection from the Second Affiliated Hospital of Hunan University of Chinese Medicine, as well as individuals in certain areas of Changsha who met the inclusion criteria for past COVID-19 infections. Demographic characteristics, COVID-19 infection details, and the occurrence of skin conditions after COVID-19 infection were collected. The chi-square test was used for inter-group comparisons of categorical data, and multivariate logistic regression analysis was performed to investigate factors associated with skin diseases following COVID-19 infection.Results:A total of 357 valid questionnaires were collected, and 357 patients with a history of COVID-19 infection were involved, including 246 females (68.9%) and 111 males (31.1%). Among these patients, 260 (72.8%) were aged ≤ 35 years. After COVID-19 infection, skin diseases occurred in 96 patients (26.9%), with urticaria (27 cases, 31.0%), rosacea (27 cases, 31.0%), hair loss (18 cases, 20.7%), and Henoch-Sch?nlein purpura (15 cases, 17.2%) being the most common diseases. Additionally, 96 patients (26.9%) had a history of pre-existing skin diseases, among whom 36 experienced exacerbation of their pre-existing skin diseases due to COVID-19 infection. Univariate analysis showed that gender, history of chronic diseases, history of allergic diseases, COVID-19 vaccination, duration of COVID-19 infection, and exacerbation of pre-existing skin diseases were significantly associated with the development of new skin diseases following COVID-19 infection (all P < 0.05). Multivariate logistic regression analysis revealed that gender (compared with females, males: OR = 0.235, 95% CI: 0.113, 0.490), history of allergic diseases (compared with patients without a history of allergic diseases, those with the history: OR = 2.159, 95% CI: 1.239, 3.761), and duration of COVID-19 infection (compared with the duration of < 5 days, duration of 6 - 7 days: OR = 3.043, 95% CI: 1.495, 6.193; duration of 8 - 14 days: OR = 2.364, 95% CI: 1.105, 5.506; duration of ≥ 15 days: OR = 4.406, 95% CI: 1.972, 9.849) were influencing factors for skin diseases after COVID-19 infection (all P < 0.05) . Conclusions:COVID-19 infection may lead to skin diseases such as urticaria, rosacea, hair loss, and Henoch-Sch?nlein purpura. Females, individuals with a history of allergic diseases, and those with a relatively long duration of COVID-19 infection were more prone to develop skin diseases after COVID-19 infection.

Objective:To characterize COVID-19-associated skin diseases and explore their influencing factors.Methods:A cross-sectional survey was conducted via the online platform Wenjuanxing in Changsha area from February 16, 2023, to March 16, 2023. The convenience sampling method was employed to conduct a survey of outpatients with a history of COVID-19 infection from the Second Affiliated Hospital of Hunan University of Chinese Medicine, as well as individuals in certain areas of Changsha who met the inclusion criteria for past COVID-19 infections. Demographic characteristics, COVID-19 infection details, and the occurrence of skin conditions after COVID-19 infection were collected. The chi-square test was used for inter-group comparisons of categorical data, and multivariate logistic regression analysis was performed to investigate factors associated with skin diseases following COVID-19 infection.Results:A total of 357 valid questionnaires were collected, and 357 patients with a history of COVID-19 infection were involved, including 246 females (68.9%) and 111 males (31.1%). Among these patients, 260 (72.8%) were aged ≤ 35 years. After COVID-19 infection, skin diseases occurred in 96 patients (26.9%), with urticaria (27 cases, 31.0%), rosacea (27 cases, 31.0%), hair loss (18 cases, 20.7%), and Henoch-Sch?nlein purpura (15 cases, 17.2%) being the most common diseases. Additionally, 96 patients (26.9%) had a history of pre-existing skin diseases, among whom 36 experienced exacerbation of their pre-existing skin diseases due to COVID-19 infection. Univariate analysis showed that gender, history of chronic diseases, history of allergic diseases, COVID-19 vaccination, duration of COVID-19 infection, and exacerbation of pre-existing skin diseases were significantly associated with the development of new skin diseases following COVID-19 infection (all P < 0.05). Multivariate logistic regression analysis revealed that gender (compared with females, males: OR = 0.235, 95% CI: 0.113, 0.490), history of allergic diseases (compared with patients without a history of allergic diseases, those with the history: OR = 2.159, 95% CI: 1.239, 3.761), and duration of COVID-19 infection (compared with the duration of < 5 days, duration of 6 - 7 days: OR = 3.043, 95% CI: 1.495, 6.193; duration of 8 - 14 days: OR = 2.364, 95% CI: 1.105, 5.506; duration of ≥ 15 days: OR = 4.406, 95% CI: 1.972, 9.849) were influencing factors for skin diseases after COVID-19 infection (all P < 0.05) . Conclusions:COVID-19 infection may lead to skin diseases such as urticaria, rosacea, hair loss, and Henoch-Sch?nlein purpura. Females, individuals with a history of allergic diseases, and those with a relatively long duration of COVID-19 infection were more prone to develop skin diseases after COVID-19 infection.

Objective:To observe any clinical effect of supplementing ultrasound stimulation with balloon-guided injection of botulinum toxin into the upper esophageal sphincter in the treatment of cricopharyngeal achalasia.Methods:Forty patients with cricopharyngeal achalasia were randomly divided into an observation group and a control group, each of 20. Both groups were given routine swallowing rehabilitation training, while the observation group additionally had botulinum toxin injected into the upper esophageal sphincter guided by ultrasound and with the aid of balloon dilation. Before the experiment and after 2 weeks, both groups were evaluated videofluoroscopically and flexible endoscopic evaluation of swallowing was performed. Moreover, 2 weeks before the treatment and 2, 4 and 24 weeks afterward, everyone′s eating, leakage and aspiration, and oral and pharyngeal secretions were assessed using the functional oral intake scale (FOIS), the penetration-aspiration scale (PAS), the fiberoptic endoscopic dysphagia severity scale (FEDSS) and the Murray secretion scale (MSS).Results:After 2 weeks the average PAS, FEDSS and MSS scores of both groups had improved significantly, but the observation group′s averages[3(2, 5), 3(2, 5) and 2(1, 2)] were significantly better than those of the control group. 2, 4 and 24 weeks after the experiment the average FOIS scores of both groups also showed significant improvement, with the observation group′s average[3(2, 4), 4(2, 6) and 6(3, 7)] again significantly better than that of the control group.Conclusions:A botulinum toxin injection into the upper esophageal sphincter can effectively improve the swallowing of persons with cricopharyngeal achalasia with adequate safety and significant long-term benefits. Therefore, such treatment is worthy of clinical promotion and application.

Objective:To explore the application value of multiple indexes of high-frequency ultrasound in the diagnosis of shoulder stiffness, and to provide data support and theoretical basis for the diagnosis and treatment of shoulder stiffness.Methods:Clinical data of 261 patients with unilateral shoulder pain with limited mobility admitted to the Orthopedic Trauma, Hebei Medical University Third Hospital from January to December 2023 were retrospectively analyzed. With the results of shoulder arthroscopy as the gold standard, the patients were divided into 127 patients with shoulder stiffness (observation group) and 134 patients with non-shoulder stiffness and shoulder pain (control group). The fluid accumulation of long head of the biceps tendon (LHBT), echo of rotator interval (RI) and blood flow signal, thickness of coracohumeral ligament (CHL), thickness of subacromial-subdeltoid bursa (SASD), fluid accumulation and blood flow signal, fluid accumulation of posterior glenohumeral joint capsule (PJ), the inferior capsule thickness (ICT) and the thickness of inferior glenohumeral ligament (IGHL) were observed and measured in the two groups in addition, the CHL difference, ICT difference and IGHL difference between the affected side and the contralateral side were calculated, and the difference between the two groups of ultrasound indicators was compared and the multivariate logistic stepwise regression analysis was performed, and the receiver operating characteristic (ROC) curve was drawn to evaluate the diagnostic value of each indicator for shoulder stiffness.Results:RI hypoecho with increased blood flow signal, SASD thickening, SASD effusion, SASD blood flow signal detection rate, IGHL thickness, IGHL difference and ICT difference in observation group were significantly higher than those in the control group (all P<0.05). Multivariate logistic stepwise regression analysis showed that SASD thickening, SASD effusion and IGHL difference were independent predictors of shoulder stiffness (all P<0.05). The area under the curve of SASD thickening, SASD effusion and IGHL difference in the diagnosis of shoulder stiffness were 0.550, 0.540 and 0.636, respectively. The diagnostic sensitivity was 89.8%, 10.2% and 60.6%, and the specificity was 20.1%, 97.8% and 67.2%, respectively. The area under the curve was 0.676, the diagnostic sensitivity was 59.8%, and the specificity was 75.4%. Conclusions:High-frequency ultrasound is an effective imaging method to assist clinical diagnosis of shoulder stiffness. SASD thickening, SASD effusion and IGHL difference may be independent predictors of shoulder stiffness. The combined application of these three indicators has higher clinical application value and provides favorable ultrasound indicators for clinical differential diagnosis of shoulder stiffness.

BACKGROUND: LY01005 (Goserelin acetate sustained-release microsphere injection) is a modified gonadotropin-releasing hormone (GnRH) agonist injected monthly. This phase III trial study aimed to evaluated the efficacy and safety of LY01005 in Chinese patients with prostate cancer. METHODS: We conducted a randomized controlled, open-label, non-inferiority trial across 49 sites in China. This study included 290 patients with prostate cancer who received either LY01005 or goserelin implants every 28 days for three injections. The primary efficacy endpoints were the percentage of patients with testosterone suppression ≤50 ng/dL at day 29 and the cumulative probability of testosterone ≤50 ng/dL from day 29 to 85. Non-inferiority was prespecified at a margin of -10%. Secondary endpoints included significant castration (≤20 ng/dL), testosterone surge within 72 h following repeated dosing, and changes in luteinizing hormone, follicle-stimulating hormone, and prostate specific antigen levels. RESULTS: On day 29, in the LY01005 and goserelin implant groups, testosterone concentrations fell below medical-castration levels in 99.3% (142/143) and 100% (140/140) of patients, respectively, with a difference of -0.7% (95% confidence interval [CI], -3.9% to 2.0%) between the two groups. The cumulative probabilities of maintaining castration from days 29 to 85 were 99.3% and 97.8%, respectively, with a between-group difference of 1.5% (95% CI, -1.3% to 4.4%). Both results met the criterion for non-inferiority. Secondary endpoints were similar between groups. Both treatments were well-tolerated. LY01005 was associated with fewer injection-site reactions than the goserelin implant (0% vs . 1.4% [2/145]). CONCLUSION: LY01005 is as effective as goserelin implants in reducing testosterone to castration levels, with a similar safety profile. TRIAL REGISTRATION ClinicalTrials.gov, NCT04563936.
Humans ; Male ; Antineoplastic Agents, Hormonal/therapeutic use* ; East Asian People ; Gonadotropin-Releasing Hormone/agonists* ; Goserelin/therapeutic use* ; Prostate-Specific Antigen ; Prostatic Neoplasms/drug therapy* ; Testosterone

AIM: To analyze and evaluate the use of pentoxifylline injection in a hospital, and explore effective supervision mode, so as to provide some reference for clinical rational drug use. METHODS: A total of 197 inpatients with pentoxifylline injection who were discharged from October 2021 to June 2022 were randomly selected from HIS system. Referring to drug-label and collecting evidence-based medical evidence to judge the rationality of use of pentoxifylline injection in the hospital. RESULTS: Among the 197 medical records extracted, 140 medical records were unreasonable, accounting for 71.07% of the total medical records. Among them, 111 cases (79.29%) were no indication for use, 13 cases (9.29%) were off-label, 2 cases (1.43%) were inappropriate for indications, 13 cases (9.29%) were inappropriate for usage and dosage, and 1 case (0.71%) was inappropriate for solvent. CONCLUSION: The irrational use of pentoxifylline injection in this hospital is serious. It is necessary to standardize its clinical application through the intervention of smart pharmacy management mode, improving system, strengthening medication education and other ways.

Antipyretic-analgesics are currently one of the most prescribed drugs in children.The clinical application of antipyretic-analgesics for children in our country still have irrational phenomenon, which affects the therapeutic effect and even poses hidden dangers to the safety of children.In this paper, suggestions were put forward from the indications, dosage form/route, dosage suitability, pathophysiological characteristics of children with individual differences and drug interactions in the symptomatic treatment of febrile children, so as to provide reference for the general pharmacists when conducting prescription review.

ObjectiveTo investigate the clinical features of patients with severe alcoholic hepatitis (AH) with different underlying liver diseases and the influencing factors for short-term prognosis. MethodsA retrospective analysis was performed for the clinical data of 170 patients with severe AH who were admitted to Tianjin Third Central Hospital from August 2004 to August 2018, and according to the underlying liver disease, they were divided into group A (27 patients without liver cirrhosis), group B (52 patients with compensated liver cirrhosis), and group C (91 patients with decompensated liver cirrhosis). Related scores were calculated, including Maddrey’s discriminant function (MDF) score, Chronic Liver Failure-Sequential Organ Failure Assessment (CLIF-SOFA) score, Model for End-Stage Liver Disease (MELD) score, age-bilirubin-international normalized ratio-creatinine (ABIC) score, and Glasgow alcoholic hepatitis score (GAHS). An analysis of variance or the Kruskal-Wallis H test was used for comparison of continuous data between multiple groups, and the chi-square test was used for comparison of categorical data between multiple groups. Univariate and multivariate Cox regression analyses were used to screen out the independent influencing factors for the short-term prognosis of patients with severe AH. The Kaplan-Meier method was used to plot survival curves, and the log-rank test was used for comparison of survival rate between groups. The receiver operating characteristic (ROC) curve was used to calculate the area under the ROC curve (AUC) and 95% confidence interval (CI), sensitivity, and specificity for each predictive model, and the DeLong method was used for comparison. ResultsThe 28-day survival rates of patients in groups A, B, and C were 88.9%, 80.8%, and 51.6%, respectively, with a significant difference between the three groups (χ2=1983, P＜0.001). The AUCs (95% CIs) of MELD score, MDF score, GAHS score, ABIC score, and CLIF-SOFA score were 0.584 (0.493-0.676), 0.696 (0.605-0.786), 0.644 (0.554-0.735), 0.745 (0.662-0.827), and 0.795 (0.726-0.863), respectively, in predicting 28-day mortality rate, and there were significant differences between CLIF-SOFA score and MDF, MELD, and GAHS scores (all P＜0.05); CLIF-SOFA score had a sensitivity of 79.0% and a specificity of 67.9% at the optimal cut-off value of 850 points in predicting 28-day mortality rate. Different underlying liver diseases (hazard ratio ［HR］=2.296, 95% CI: 1.356-3887, P=0.002) and hepatic encephalopathy (HR=1.911, 95% CI: 1.059-3.449, P=0.031) at disease onset were risk factors for 28-day prognosis. ConclusionPatients with severe AH with different underlying liver diseases have different clinical features and short-term prognoses. Different underlying liver diseases and hepatic encephalopathy at disease onset are closely associated with the 28-day prognosis of patients with severe AH. CLIF-SOFA score can predict the 28-day prognosis of patients with severe AH.