ObjectiveTo explore the potential mechanism of Changji'an Formula （肠激安方） on intestinal permeability for rats with diarrhea-predominant irritable bowel syndrome （IBS-D） of liver depression and spleen deficiency syndrome by the microRNA-29b-3p （miR-29b-3p）/tumor necrosis factor receptor-associated factor 3 （TRAF3）/nuclear factor-κB （NF-κB）/myosin light chain kinase （MLCK） axis. MethodsTwenty-four 1-day-old male Sprague-Dawley （SD） suckling rats were selected， and the IBS-D rat model of liver depression and spleen deficiency syndrome was established via a three-factor method，i.e. maternal separation plus acetic acid stimulation and restraint stress， for 6 consecutive weeks. After successful modeling， the rats were randomly divided into a model group， pinaverium bromide group， low-dose and high-dose Changji'an Formula groups， with 6 rats in each group. Another 6 age-matched non-modeled SD rats were included as the control group. The low-dose and high-dose Changji'an Formula groups were given intragastric administration of Changji'an Formula solution at doses of 16.74 g/（kg·d） and 33.48 g/（kg·d）， respectively； the pinaverium bromide group received intragastric administration of pinaverium bromide tablets at 0.018 g/（kg·d）； and the control group was given distilled water at 10 ml/（kg·d） via intragastric gavage. The intervention was conducted once daily for 14 consecutive days. After the gavage treatment， the fecal water content of rats in each group was measured. Enzyme-linked immunosorbent assay （ELISA） was used to detect the serum levels of intestinal permeability indicators， including D-lactic acid （D-LA）， diamine oxidase （DAO）， and lipopolysaccharide （LPS）. Quantitative real-time polymerase chain reaction （qRT-PCR） was conducted to determine the mRNA expression levels of miR-29b-3p， TRAF3， tumor necrosis factor-α （TNF-α）， p65， p50， and MLCK in colonic tissues. Western Blot analysis was employed to detect the protein expression levels of TRAF3， TNF-α， p65， phosphorylated p65 （p-p65）， MLCK， myosin light chain （MLC）， phosphorylated MLC （p-MLC）， and tight junction proteins including junctional adhesion molecule-A （JAM-A）， Occludin， and Claudin-1 in colonic tissues. ResultsCompared with the control group， the model group exhibited significantly increased fecal water content and serum levels of D-LA， DAO， and LPS， along with decreased protein expression levels of JAM-A， Occludin， and Claudin-1 in colonic tissues （P＜0.05 or P＜0.01）. Additionally， in the model group， the mRNA expression levels of miR-29b-3p， TNF-α， p65， p50， and MLCK in colonic tissues were up-regulated， while the mRNA and protein expression levels of TRAF3 were down-regulated； the protein levels of TNF-α and MLCK， as well as the ratios of p-p65/p65 and p-MLC/MLC， significantly elevated （P＜0.01）. Compared with the model group， all treatment groups showed reduced fecal water content and serum levels of D-LA， DAO， and LPS， along with down-regulated mRNA expression levels of miR-29b-3p， TNF-α， p65， p50， and MLCK， and up-regulated TRAF3 mRNA expression in colonic tissues. Moreover， the pinaverium bromide group and high-dose Changji'an Formula group presented increased protein levels of Occludin， Claudin-1， and TRAF3， as well as decreased protein levels of TNF-α and MLCK， and reduced ratios of p-p65/p65 and p-MLC/MLC in colonic tissues （P＜0.05 or P＜0.01）. Compared with the low-dose Changji'an Formula group， the high-dose group had lower fecal water content and serum levels of DAO and LPS （P＜0.01）. In comparison with the pinaverium bromide group， the high-dose Changji'an Formula group showed a significant decrease in serum DAO level （P＜0.01）. ConclusionsChangji'an Formula can reduce intestinal permeability and restore intestinal barrier function in IBS-D rats of liver depression and spleen deficiency syndrome by regulating the miR-29b-3p/TRAF3/NF-κB/MLCK axis.

Objective:To investigate clinical efficacy and safety of dupilumab in the treatment of moderate to severe atopic dermatitis (AD) complicated with asthma.Methods:A self-controlled study before and after treatment was conducted to retrospectively analyze 45 patients with moderate to severe atopic dermatitis combined with asthma who received dupilumab in the respiratory allergy clinic of North Theater Command General Hospital from January 2021 to May 2024, which age ≥12 years, including 27 males, 18 females. The treatment period was 4 to 12 months. All patients were treated with dupilumab combined with inhaled glucocorticoids and long-acting beta2-receptor agonists, as well as symptomatic drugs for atopic dermatitis. Analyze the clinical data of the patients before and after treatment, including lung function, asthma and AD-related assessment scales. Generalized estimation equation was used to analyze the simple effect of time on the repeated measurement data following non-normal distribution, and Wilcoxon signed rank test was used to compare the differences of each observation index before and after treatment.Results:Among 45 patients with moderate to severe atopic dermatitis complicated with asthma, after treatment with dupilumab, the FEV 1 increased from 2.39 (1.87, 2.83) L at baseline to 2.50 (1.84, 2.97) L 3 months after treatment ( Z=2.417, P=0.016), 2.60 (1.95, 3.14) L 6 months after treatment ( Z=2.896, P=0.004); the FEV 1pred% increased from 74.10% (67.70%, 78.75%) at baseline to 77.09% (68.40%, 80.24%) at 3 months after treatment ( Z=2.574, P=0.010), and 77.20% (71.10%, 80.72%) at 6 months after treatment ( Z=2.861, P=0.004). Meanwhile, there were statistically significant differences in the ACT and Mini-AQLQ scales at 3, 6, and 12 months after treatment compared with those before treatment (ACT score Z=3.170, 4.216, 5.723; Mini-AQLQ score Z=3.231, 4.133, 5.826; all P<0.05). The EASI scale decreased from baseline 25.90 (18.95, 33.45) to 6.20 (1.15, 8.35) at 4 months after treatment ( Z=5.842, P<0.05) and 4.90 (2.75, 8.35) at 6 months after treatment ( Z=5.841, P<0.05), 4.00 (3.15, 5.05) at 12 months after treatment ( Z=5.841, P<0.05); The scores of each scale of IGA, NRS and DLQI decreased significantly compared with the baseline after 4 months, 6 months and 12 months of treatment, and this trend became more obvious with the extension of treatment time. The differences were statistically significant (IGA score Z=6.247, 6.070, 5.946; NRS score Z=5.960, 5.893, 5.879; DLQI score Z=5.880, 5.850, 5.848; all P<0.05). During treatment, 1 patient had local adverse reactions at the injection site and 1 patient had conjunctivitis. Conclusion:Dupilumab may have a positive effect on improving the clinical efficacy of patients with moderate to severe atopic dermatitis complicated with asthma. During the 12-month observation period, this biological agent generally demonstrated good safety characteristics.

Objective:To investigate clinical efficacy and safety of dupilumab in the treatment of moderate to severe atopic dermatitis (AD) complicated with asthma.Methods:A self-controlled study before and after treatment was conducted to retrospectively analyze 45 patients with moderate to severe atopic dermatitis combined with asthma who received dupilumab in the respiratory allergy clinic of North Theater Command General Hospital from January 2021 to May 2024, which age ≥12 years, including 27 males, 18 females. The treatment period was 4 to 12 months. All patients were treated with dupilumab combined with inhaled glucocorticoids and long-acting beta2-receptor agonists, as well as symptomatic drugs for atopic dermatitis. Analyze the clinical data of the patients before and after treatment, including lung function, asthma and AD-related assessment scales. Generalized estimation equation was used to analyze the simple effect of time on the repeated measurement data following non-normal distribution, and Wilcoxon signed rank test was used to compare the differences of each observation index before and after treatment.Results:Among 45 patients with moderate to severe atopic dermatitis complicated with asthma, after treatment with dupilumab, the FEV 1 increased from 2.39 (1.87, 2.83) L at baseline to 2.50 (1.84, 2.97) L 3 months after treatment ( Z=2.417, P=0.016), 2.60 (1.95, 3.14) L 6 months after treatment ( Z=2.896, P=0.004); the FEV 1pred% increased from 74.10% (67.70%, 78.75%) at baseline to 77.09% (68.40%, 80.24%) at 3 months after treatment ( Z=2.574, P=0.010), and 77.20% (71.10%, 80.72%) at 6 months after treatment ( Z=2.861, P=0.004). Meanwhile, there were statistically significant differences in the ACT and Mini-AQLQ scales at 3, 6, and 12 months after treatment compared with those before treatment (ACT score Z=3.170, 4.216, 5.723; Mini-AQLQ score Z=3.231, 4.133, 5.826; all P<0.05). The EASI scale decreased from baseline 25.90 (18.95, 33.45) to 6.20 (1.15, 8.35) at 4 months after treatment ( Z=5.842, P<0.05) and 4.90 (2.75, 8.35) at 6 months after treatment ( Z=5.841, P<0.05), 4.00 (3.15, 5.05) at 12 months after treatment ( Z=5.841, P<0.05); The scores of each scale of IGA, NRS and DLQI decreased significantly compared with the baseline after 4 months, 6 months and 12 months of treatment, and this trend became more obvious with the extension of treatment time. The differences were statistically significant (IGA score Z=6.247, 6.070, 5.946; NRS score Z=5.960, 5.893, 5.879; DLQI score Z=5.880, 5.850, 5.848; all P<0.05). During treatment, 1 patient had local adverse reactions at the injection site and 1 patient had conjunctivitis. Conclusion:Dupilumab may have a positive effect on improving the clinical efficacy of patients with moderate to severe atopic dermatitis complicated with asthma. During the 12-month observation period, this biological agent generally demonstrated good safety characteristics.

Objective:To explore the effects of the toolkit program for managing symptom clusters of adverse reactions to chemotherapy for ovarian cancer based on the comprehensive symptom management model on the symptom status, self-care ability and quality of life of ovarian cancer patients, and to provide guidance for clinical guidance on symptom management of adverse reactions to chemotherapy for ovarian cancer patients.Methods:A non-simultaneous before-and-after control was used to facilitate the selection of 45 ovarian cancer chemotherapy patients from the Department of Gynecology, Fenyang Hospital, Shanxi Province, from August 2022 to January 2023 as the control group, and 45 ovarian cancer chemotherapy patients from February to July 2023 as the experimeatal group. Routine care was used in the control group, and the experimental group used the Symptom Cluster Management Toolkit program based on the control group. Before intervention and after the end of the first, second, and third chemotherapy cycles, two groups of patients were evaluated using the Functional Assessment of Cancer Therapy-Generic scale and Exercise of Self-Care Agency Scale; after the end of the first, second, and third chemotherapy cycles, Adverse Reaction Events Evaluation Criteria 5.0 was used to evaluate the two groups. The symptom status, self-care ability, and quality of life between two groups of patients were compared.Results:Finally 43 cases in control group and 41 cases in experimental group were included, age of control group was (59.37 ± 8.61) years old and experimental group was (57.10 ± 9.97) years old. After intervention, at the end of the first, second, and third chemotherapy cycles were assessed for side effects, respectively: the nausea rating of the experimental group were 1 (1, 2), 1(1, 2), 2(1, 2), and the control group were 2 (1, 2), 2(1, 2), 2(1, 2); the vomiting rating of the experimental group were 1 (1, 2), 1(1, 2), 1(1, 2), and the control group were 2 (1, 2), 2(1, 2), 2(1, 2); peripheral sensory nerve disorder rating of the experimental group were 1 (1, 1), 1(1, 1), 1(1, 2), and the control group were 1 (1, 1), 1(1, 2), 2(1, 2); peripheral motor nerve disorder rating of the experimental group were 1 (1, 1), 1(1, 1), 1(1, 1), and the control group had a 1 (1, 1), 1(1, 2), 2(1, 2); the cognitive impairment rating of the experimental group were 1 (1, 1), 1(1, 1), 1(1, 1), and the control group were 1 (1, 1), 1(1, 2), 1(1, 2). All the differences were all statistically significant (Wald χ2 were from 4.41 to 6.54, all P<0.05); the control group′s self-care competence scores at the end of the first, second, and third cycles of chemotherapy for patients with ovarian cancer were (106.30 ± 13.03), (109.53 ± 13.85) and (111.95 ± 13.49) points, and (113.68 ± 11.33), (118.95 ± 11.39) and (123.66 ± 11.67) points in the experimental group, and the level of self-care ability of the experimental group was higher than that of the control group when comparing the two groups ( F = 8.61, P<0.05); and the level of quality of life at the end of the first, second, three chemotherapy cycles were (65.35 ± 7.58), (68.58 ± 7.61) and (70.95 ± 7.56) points in the control group, and (70.51 ± 5.89), (74.10 ± 5.70) and (77.00 ± 5.55) points in the experimental group, and the level of quality of life in the experimental group was higher than that of the control group in the comparison between groups ( F = 10.16, P<0.05). Conclusions:The application of the toolkit intervention program for the management of symptom clusters of adverse reactions to chemotherapy in patients with ovarian cancer can reduce the symptom load of patients, improve self-care ability, and improve the quality of life.

Objective:To explore the effects of the toolkit program for managing symptom clusters of adverse reactions to chemotherapy for ovarian cancer based on the comprehensive symptom management model on the symptom status, self-care ability and quality of life of ovarian cancer patients, and to provide guidance for clinical guidance on symptom management of adverse reactions to chemotherapy for ovarian cancer patients.Methods:A non-simultaneous before-and-after control was used to facilitate the selection of 45 ovarian cancer chemotherapy patients from the Department of Gynecology, Fenyang Hospital, Shanxi Province, from August 2022 to January 2023 as the control group, and 45 ovarian cancer chemotherapy patients from February to July 2023 as the experimeatal group. Routine care was used in the control group, and the experimental group used the Symptom Cluster Management Toolkit program based on the control group. Before intervention and after the end of the first, second, and third chemotherapy cycles, two groups of patients were evaluated using the Functional Assessment of Cancer Therapy-Generic scale and Exercise of Self-Care Agency Scale; after the end of the first, second, and third chemotherapy cycles, Adverse Reaction Events Evaluation Criteria 5.0 was used to evaluate the two groups. The symptom status, self-care ability, and quality of life between two groups of patients were compared.Results:Finally 43 cases in control group and 41 cases in experimental group were included, age of control group was (59.37 ± 8.61) years old and experimental group was (57.10 ± 9.97) years old. After intervention, at the end of the first, second, and third chemotherapy cycles were assessed for side effects, respectively: the nausea rating of the experimental group were 1 (1, 2), 1(1, 2), 2(1, 2), and the control group were 2 (1, 2), 2(1, 2), 2(1, 2); the vomiting rating of the experimental group were 1 (1, 2), 1(1, 2), 1(1, 2), and the control group were 2 (1, 2), 2(1, 2), 2(1, 2); peripheral sensory nerve disorder rating of the experimental group were 1 (1, 1), 1(1, 1), 1(1, 2), and the control group were 1 (1, 1), 1(1, 2), 2(1, 2); peripheral motor nerve disorder rating of the experimental group were 1 (1, 1), 1(1, 1), 1(1, 1), and the control group had a 1 (1, 1), 1(1, 2), 2(1, 2); the cognitive impairment rating of the experimental group were 1 (1, 1), 1(1, 1), 1(1, 1), and the control group were 1 (1, 1), 1(1, 2), 1(1, 2). All the differences were all statistically significant (Wald χ2 were from 4.41 to 6.54, all P<0.05); the control group′s self-care competence scores at the end of the first, second, and third cycles of chemotherapy for patients with ovarian cancer were (106.30 ± 13.03), (109.53 ± 13.85) and (111.95 ± 13.49) points, and (113.68 ± 11.33), (118.95 ± 11.39) and (123.66 ± 11.67) points in the experimental group, and the level of self-care ability of the experimental group was higher than that of the control group when comparing the two groups ( F = 8.61, P<0.05); and the level of quality of life at the end of the first, second, three chemotherapy cycles were (65.35 ± 7.58), (68.58 ± 7.61) and (70.95 ± 7.56) points in the control group, and (70.51 ± 5.89), (74.10 ± 5.70) and (77.00 ± 5.55) points in the experimental group, and the level of quality of life in the experimental group was higher than that of the control group in the comparison between groups ( F = 10.16, P<0.05). Conclusions:The application of the toolkit intervention program for the management of symptom clusters of adverse reactions to chemotherapy in patients with ovarian cancer can reduce the symptom load of patients, improve self-care ability, and improve the quality of life.

Enterotoxigenic Escherichia coli（ETEC）infection can induce watery diarrhea，leading to dehydration，electrolyte disturbance，and even death in severe cases. Recombinant B subunit/inactivated whole-cell cholera（rBS/WC）vaccine is effective in preventing ETEC infectious diarrhea. On the basis of the latest evidence on etiology and epidemiology of ETEC，as well as the effectiveness，safety，and health economics of rBS/WC vaccine，National Clinical Research Center for Child Health（The Children’s Hospital，Zhejiang University School of Medicine）and Zhejiang Provincial Center for Disease Control and Prevention invited experts to develop expert consensus on rBS/WC vaccine in prevention of ETEC infectious diarrhea. It aims to provide the clinicians and vaccination professionals with guidelines on using rBS/WC vaccine to reduce the incidence of ETEC infectious diarrhea.

Placental growth factor (PLGF) is isolated and purified from human placental complementary DNA (cDNA) library, and syncytiotrophoblast cells are the main synthesis site. PLGF can bind to tyrosinase receptors located in trophoblast cells and vascular endothelial cells, and regulate trophoblast cell proliferation through autocrine and paracrine regulation of angiogenesis, respectively. PLGF plays an extremely important role in the formation and development of the placenta during pregnancy. The abnormal secretion of PLGF is closely related to the occurrence and progression of pregnancy complications (such as pregnancy complicated with diabetes, hypertension in pregnancy, preeclampsia, etc.). In this paper, the structure, receptor, biological activity of PLGF and its relationship with normal pregnancy and pregnancy complications were reviewed to provide references for clinical guidance and auxiliary diagnosis of pregnancy complications.

OBJECTIVE: To establish reuse process of positive pressure powered air-filter protective hoods during coronavirus disease 2019 (COVID-19) epidemic. METHODS: The procedure of pretreatment, storage, recovery, cleaning, disinfection and sterilization process of positive pressure powered air-filter protective hoods, which were used in the treatment of COVID-19 infection patients was established in Central Sterile Supply Department of the hospital. The cleaning and disinfection effects of the protective hoods after treatment were examined by magnifying glass method, residual protein detection method, real-time PCR, and agar pour plate method. RESULTS: Twenty five used protective hoods underwent totally 135 times of washing, disinfecting and sterilizing procedures. After washing, all the protein residue tests and COVID-19 nucleic acid tests showed negative results. After sterilizing, all the protective hoods met sterility requirement. All the tested protective hoods were undamaged after reprocessing. CONCLUSIONS The established reuse procedures for used positive pressure powered air-filter protective hoods are safe.
Air Filters/virology* ; Betacoronavirus ; COVID-19 ; Coronavirus Infections/prevention & control* ; Disinfection/standards* ; Equipment Reuse/standards* ; Pandemics/prevention & control* ; Pneumonia, Viral/prevention & control* ; SARS-CoV-2 ; Sterilization/standards*

Objective: To explore the surgical methods for children with contracture deformity on hands after burn. Methods: From January 2014 to January 2018, 33 pediatric patients, a total of 42 hands with scar contracture deformities were reviewed. There were 24 males and 9 females, aged from 11 months to 6 years and 7 months. Among them, 20 hands were volar metacarpophalangeal joint contractures, 9 were volar interphalangeal joint contractures, 7 were dorsal metacarpophalangeal joint contractures (3 claw-shaped hands), 3 were hand back contractures, and 3 were palm contractures. Of the 42 hands, 36 hands were repaired with full-thickness skin grafts or split-thickness skin grafts, after the removal of contracted scar, and 6 hands were repaired with abdominal skin flaps, due to the tendon or bone exposure after the scar removal. Results: Skin grafts on 31 hands were all survived after 2 weeks. However, the survival area of 3 skin grafts was about 90%, and 2 skin grafts survived about 80%. All of them healed well after dressing changing. The 6 hands repaired with abdominal skin flap healed well too. After 1-2.5 years of follow-up, finger scar contracture occurred in 4 hands with skin grafting, and they were performed scar excision and sheet skin grafting. Three hands were treated with Z-plasty, due to web space contracture. The function of other hands were normal, without contracture or deformity. The skin color and texture were similar to the surrounding skin, with limited pigmented. Scars on the edge of skin grafts was not obvious. Patients and their families were satisfied. Conclusions The sheet skin graft is the main method for postburn scar contracture in children′s hands. The abdominal skin flap should be considered, if tendon or bone is exposed, especially for large wound or multiple sites.

Objective To investigate the MRI manifestations of pilomyxoid astrocytoma (PMA)at unusual sites and differential diagnosis in children.Methods The clinical and MRI data from 6 cases of PMA with atypical locations confirmed by surgery and pathology were analyzed retrospectively.Results 2 cases located at cerebral hemisphere,1 case at tegmentum mesencephali,1 case at medulla and 2 cases at cerebellar hemisphere.There were 4 cases of solid tumor and 2 case belonged to cystic-solid mass.5 cases were round or oval and 1 case was shallow lobulated.In addition,there were 2 cases with hemorrhage and 2 cases with peritumoral edema.T1WI showed hypointensity,isointense or slightly hyperintense while T2WI and fluid attented inversion recovery (FLAIR)exhibited isointensity or hyperintensity.After contrast administration,there were 3 cases of obvious multi-ring enhancement,of which 1 case showed astral enhancement of the mural nodules and the other 3 cases showed mild homogeneous or inhomogeneous enhancement.4 cases showed non-enhanced areas in the solid parts.No signs of leptomeningeal dissemination were found in all 6 cases.Conclusion The PMA at unuaual sites in children is primarily solid or cystic-solid,and the image manifestations of plain scan are varied.After enhancement,the tumors show obviously multi-circular enhancement and mild homogeneous or inhomogeneous enhancement could be observed,no enhancement areas are visible in the solid parts.It is noteworthy to distinguish this astrocytoma from other lesions.