Based on the results of the latest basic research on vitiligo, this article elucidates the significance of reconfiguration of glucose metabolism, lipid metabolism, amino acid metabolism, and metabolism of gut microbiota in the pathogenesis of vitiligo, attempts to delineate a panoramic picture of metabolic reconfiguration in vitiligo, and discusses the importance of dialectically and uniformly grasping the crosstalk between multiple metabolic pathways, and of thinking about the mechanisms of action of multiple metabolic pathway reconfiguration in the occurrence of vitiligo in individuals from a holistic perspective in future basic studies, in order to promote the understanding of the vitiligo pathogenesis and explore potential treatment methods for vitiligo.

Objective:To observe and analyze depression-like behavioral performances of mouse models of vitiligo.Methods:Fifteen female C57BL/6 mice aged about 9 weeks were modeled for vitiligo. Whether the mouse models of vitiligo were successfully constructed or not was determined by macroscopy and full-thickness epidermal immunofluorescence staining of mouse tail tissues on day 23 after the start of the experiment; on day 8 (pre-modeling stage) and day 21 (early modeling stage), the elevated plus maze test and the open field test were used to evaluate the behavioral performances of the mice, including the number of entry into the open arms, percentages of time spent in the open arms, percentages of time spent in the central area and total distance traveled, aiming to assess whether depression-like behaviors were exhibited in the mouse models of vitiligo. To further clarify the degree of the impact of vitiligo modeling on the depression-like state in mice, 20 female C57BL/6 mice were equally divided into 2 groups: vitiligo modeling group and vitiligo modeling + chronic restraint stress group; the mice in the vitiligo modeling + chronic restraint stress group were subjected to chronic restraint stress on day 9, that is, these mice were placed in centrifuge tubes and restrained for about 6 hours every day for 28 consecutive days; on days 7, 22, 29 and 38 after the start of vitiligo modeling, the above-mentioned behavioral indicators were determined by the elevated plus maze test and open field test in the 2 groups. Repeated measurement data in a single group were compared before and after treatment by using paired t-test, and repeated measurement data at multiple time points were compared by using two-way repeated measures analysis of variance. Results:By macroscopy, the mice gradually developed well-defined white patches on the tail skin during vitiligo modeling, which were similar to the clinical manifestations of vitiligo patients; on day 23, full-thickness epidermal immunofluorescence staining of the mouse tail tissues was conducted and showed obvious infiltration of CD8 + T cells and a decrease in the number of Melan-A-positive epidermal melanocytes under a laser confocal microscope, which were consistent with typical pathological characteristics of vitiligo; based on the macroscopic results and immunofluorescence findings, a total of 12 mouse models of vitiligo were successfully constructed on day 23. The elevated plus maze test showed that the number of entry into the open arms and the percentages of time spent in the open arms were significantly lower in the 12 mouse models of vitiligo on day 21 (2.33 ± 1.78 times, 5.01% ± 5.27%, respectively) than in those on day 8 (10.75 ± 2.30 times, 29.20% ± 12.48%, t = 9.63, 6.36, respectively, both P < 0.001) ; the open field test showed that the percentages of time spent in the central area and total distance traveled were also significantly lower in the mouse models on day 21 (2.31% ± 1.53%, 2 518.31 ± 528.38 cm, respectively) than in those on day 8 (4.47% ± 2.65%, 3 533.45 ± 465.47 cm, t = 2.40, 5.47, P = 0.036, < 0.001, respectively). In the chronic restraint stress test, a total of 14 mouse models of vitiligo were successfully constructed on day 23, including 5 in the vitiligo modeling group and 9 in the vitiligo modeling + chronic restraint stress group. There were no significant differences in the number of entry into the open arms, percentages of time spent in the open arms, percentages of time spent in the central area, and total distance traveled between the vitiligo modeling group and the vitiligo modeling + chronic restraint stress group on days 7, 22, 29, and 38 ( F = 0.21, 0.20, 0.46, 2.35, P = 0.889, 0.893, 0.719, 0.134, respectively) ; moreover, all the above indicators significantly changed over time (all P < 0.001), except for the total distance traveled ( P = 0.422) . Conclusion:The mouse models of vitiligo developed depression-like behavior at the early modeling stage, and the degree of depression could not be further deepened by chronic restraint stress on the basis of vitiligo modeling.

Atherosclerosis(AS)is a common cardiovascular disease,and its treatment and prevention have been the focus of medical research.AS an emerging technology,nanotechnology has unique advantages and plays an important role in the prevention,diagnosis and treatment of AS.This paper reviews the latest research on the application of nanotechnology in AS diseases,systematically discusses the role of nanotechnology in the diag-nosis and treatment of AS,and comprehensively analyzes the effects of nano-drug carriers based on different sur-face trimmers,loading diagnostic and therapeutic drugs so as to monitordisease progression of AS and its targeted treatment.The aim is to provide new thought for the clinical treatment of AS.

Objective:To summarize the clinical features of 8 cases with intramycardial hematoma(IMH) following congenital cardiac surgery in children.Methods:We retrospectly searched 8 patients with intramycardial hematoma after congenital cardiac surgery in Guangzhou Women and Children’s Medical Center from 2008 to 2024.Results:Mean age and mean weight at surgery were(13±15) months and(7.8±3.5)kg respectively. 6 of 8 cases were interventricular septal hematoma. In the other 2 patients, intramycardial hematoma was located in left ventrical free wall. All IMH were postoperatively detected by transthoracic echocardiaography. Two patients were managed with ECMO intraoperatively. Finally, all patients were discharged successfully with good clinical results. Mean time to IMH resolution in six patients was(33.5±4.6) days and mean left ventricular ejection fraction(LVEF) was 0.60±0.09. Another patient was followed up for 3 months and the IMH was not absorbed. One patient was lost to follow-up.Conclusion:IMH is a rare complication after congenital heart disease. The absorption of hematoma is a dynamic process and mean time to IMH resolution is about 1month. In IMH patients with hemodynamic instability, ECMO can be a good treatment to create opportunities for hematoma absorbtion.

Objective To investigate the predictive value of serum 25-hydroxyvitamin D[25(OH)D]level in early renal transplantation for acute rejection(AR).Methods A total of 324 renal transplant recipients from January 2019 to August 2022 in the Second People's Hospital of Shanxi Province were selected.The clinical data of the recipients were collected.The levels of serum 25(OH)D,parathyroid hormone(PTH),and calcium,phosphorus in early(within 1 month)transplantation were detected by chemiluminescence immunoassay and colorimetry,respectively.The detection season was recorded,and the occurrence of AR within 1 year after renal transplantation was observed.The 25(OH)D level ≥ 20ng/ml was defined as normal,≥ 12 ng/ml～＜20 ng/ml as insufficient and＜12ng/ml as deficient,they were divided into of 25(OH)D normal group(n=106),insufficient group(n=112)and deficient group(n=106).According to the occurrence of AR,they were divided into AR group(n=51)and non-AR group(n=273).The basic situation of serum 25(OH)D level was analyzed.The differences in serum PTH,calcium,phosphorus levels and seasons as well as AR incidence among the three groups of 25(OH)D were compared.Multivariate logistic regression was used to analyze the influencing factors of AR,and receiver operating characteristic(ROC)curve was used to analyze the predictive value of serum 25(OH)D level for AR.Results The incidence of serum 25(OH)D deficiency or insufficiency was 67.28％(218/324).In the 25(OH)D normal group,insufficient group and deficiency group,the serum PTH levels were 75.44(46.42,113.23)pg/ml,78.29(58.27,152.10)pg/ml and 86.84(54.64,127.3)pg/ml,and the incidences of AR were 2.47％(8/324),6.17％(20/324)and 7.10％(23/324),respectively.All of them were the highest in the deficiency group and the lowest in the normal group,and the differences were significant(H=6.784,x2=8.580,all P＜0.05).Additionally,25(OH)D deficiency(OR=3.340,95％CI:1.409～7.916),25(OH)D insufficiency(OR=2.442,95％CI:1.006～5.925)and human leucocyte antigen(HLA)mismatch(4～6)(OR=2.117,95％CI:1.027～4.363)were independent risk factors for AR(all P＜0.05).The area under the curve(AUC)of serum 25(OH)D level in predicting AR was 0.702(95％CI:0.625～0.779),the optimal cut-off value was 13.59 ng/ml,the specificity and the sensitivity were 66.7％and 65.6％,respectively.Conclusion In this study,25(OH)D deficiency(＜12ng/ml)or insufficiency(≥ 12～＜20ng/ml)was an independent risk factor for AR,and serum 25(OH)D level may have a certain predictive value for AR.

Vitiligo is an immune memory skin disease. T-cell factor 1 (TCF1) is essential for maintaining the memory T-cell pool. There is an urgent need to investigate the characteristics of peripheral memory T-cell profile and TCF1⁺ T-cell frequencies in patients with vitiligo. In this study, 31 patients with active vitiligo (AV), 22 with stable vitiligo (SV), and 30 healthy controls (HCs) were included. We measured circulating memory and TCF1⁺ T-cell frequencies using flow cytometry. The Spearman's rank test was used to evaluate the correlation between cell frequencies and disease characteristics. Receiver operating characteristic curves (ROC) were constructed to investigate the discriminative power of the cell subpopulations. Circulating CD4⁺ and CD8⁺ terminally differentiated effector memory T-cell (T_EMRA) frequencies were significantly higher in the AV group than in HCs (P < 0.05). TCF1⁺ T-cell subpopulations were widespread increased in patients with vitiligo (P < 0.05). After adjusting for potential confounders, CD8⁺ and CD4⁺ central memory (T_CM) cells, and CD8⁺ T_EMRA were correlated with disease activity (P < 0.05). The combined diagnostic value of the four (naïve, effector memory, T_CM, and T_EMRA) CD8⁺TCF1⁺ T-cell subsets was relatively high (area under the ROC curve (AUC) = 0.804, sensitivity = 71.70%, specificity = 83.34%), and the CD8⁺ T-cell subsets combination performed well in discriminating disease activity (AUC = 0.849, sensitivity = 70.97%, specificity = 90.91%). We demonstrated an altered circulating memory T-cell profile and increased TCF1⁺ T-cell percentage in patients with vitiligo. T-cell subpopulations had a strong value for vitiligo diagnosis and activity evaluation. This evidence presents a potential new pharmacological target for inhibiting autoimmunity that leads to vitiligo.

Vitiligo is an immune memory skin disease.T-cell factor 1(TCF1)is essential for maintaining the memory T-cell pool.There is an urgent need to investigate the characteristics of peripheral memory T-cell profile and TCF1+T-cell frequencies in patients with vitiligo.In this study,31 patients with active vitiligo(AV),22 with stable vitiligo(SV),and 30 healthy controls(HCs)were included.We measured circulating memory and TCF1+T-cell frequencies using flow cytometry.The Spearman's rank test was used to evaluate the correlation between cell frequencies and disease characteristics.Receiver operating characteristic curves(ROC)were constructed to investigate the discriminative power of the cell subpopulations.Circulating CD4+and CD8+terminally differentiated effector memory T-cell(TEMRA)frequencies were significantly higher in the AV group than in HCs(P＜0.05).TCF1+T-cell subpopulations were widespread increased in patients with vitiligo(P＜0.05).After adjusting for potential confounders,CD8+and CD4+central memory(TcM)cells,and CD8+TEMRA were correlated with disease activity(P＜0.05).The combined diagnostic value of the four(naive,effector memory,TcM,and TEMRA)CD8+TCF1+T-cell subsets was relatively high(area under the ROC curve(AUC)=0.804,sensitivity=71.70％,specificity=8334％),and the CD8+T-cell subsets combination per-formed well in discriminating disease activity(AUC=0.849,sensitivity=70.97％,specificity=90.91％).We demonstrated an altered circulating memory T-cell profile and increased TCF1+T-cell percentage in patients with vitiligo.T-cell subpopulations had a strong value for vitiligo diagnosis and activity evaluation.This evidence presents a potential new pharmacological target for inhibiting autoimmunity that leads to vitiligo.

The Health-Related Quality of Life (HRQoL) pertains to patients' subjective contentment concerning their physical, psychological, and social well-being throughout disease treatments. Predominantly employed HRQoL metrics in spinal metastases comprise the 36-item Short-Form Health Survey (SF-36), EuroQoL Five Dimensions Questionnaire (EQ-5D), European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30), and the Functional Assessment of Cancer Therapy-General (FACT-G). In clinical applications, due to their broad application and diverse disease types, combined with the lack of specificity in the scale content and the prolixity of their questionnaires, these tools often fail to capture the nuanced experiences of patients, thereby compromising the reliability and validity of the results. The Spine Oncology Study Group Outcomes Questionnaire (SOSGOQ), developed by the Spine Oncology Study Group, offers a tailored metric for spinal metastases, encapsulating both specificity and inclusivity. Its proven robust reliability and validity make it invaluable for decision-making and therapeutic efficacy appraisals. The Patient-Reported Outcome Measurement Information System (PROMIS), a novel metric suitable across many medical disciplines, facilitates cross-sector data acquisition, substantially augmenting the precision, sensitivity, and credibilityof assessments, and is pivotal in clinical investigations and interventions. As it continually evolves, PROMIS consistently outperforms traditional metrics in evaluative capacities, exhibiting impressive and consistent proficiency in prognostications, preoperative assessments, and therapeutic outcome evaluations within the spinal metastasis domain. Presently, Chinese research on the HRQoL of spinal metastasis patients remains scant, and choosing an apt, precise, and dependable metric holds significant clinical relevance. Drawing upon extant scholarly publications, this review concluded the current global HRQoL tools for spinal metastases, aiming to furnish insights for the clinical management and research pertaining to spinal metastases.

Background: Symptoms of irritable bowel syndrome with diarrhea (IBS-D) are known to be influenced by circadian oscillation; however, the pathophysiological mechanism is still unclear. Aims: To investigate the role and underlying mechanism of colon circadian clock gene Bmal1 involved in the occurrence of symptoms in IBS-D patients. Methods: Forty-six patients with IBS-D and 34 normal controls from Army Medical Center of PLA during September 2018 to February 2021 were recruited in this study. IBS-severity scoring system (IBS-SSS) was used to evaluate the severity of IBS-D symptoms. A colonoscopy was performed to obtain biopsy specimens from rectosigmoid colon. The concentration of 5-hydroxytryptamine (5-HT), and expressions of Bmal1 and chromogranin A (CgA), a biomarker of enterochromaffin cells (EC cells), in colonic mucosa were detected by ELISA and double-labeled immunofluorescence, respectively. Results: Both the 5-HT concentration and number of EC cells in colonic mucosa of IBS-D patients were significantly higher than those of the normal controls (all P< 0.05). Bmal1 was mainly expressed in intestinal epithelial cells and was highly expressed in EC cells. Co-expression of Bmal1 and CgA was observed. Compared with the normal control group biopsied at the same time point, expression of Bmal1 was significantly higher in specimens taken at 9 a.m., and expression of Bmal1 was significantly lower in specimens taken at 17 p.m. in IBS-D patients (all P< 0.05). Spearman correlation coefficient analysis showed that Bmal1 expression at 9 a.m. was positively correlated with the total score of IBS-SSS and subscore of abdominal pain and discomfort (r

Objective:To evaluate the effect of medical compression elastic stockings or intermittent pneumatic pressure pumps on intraoperative hemodynamics in patients in the lithotomy position under general anesthesia.Methods:A total of 100 patients, aged 30-59 yr, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, scheduled for elective colorectal surgery or gynecological surgery in the lithotomy position under general anesthesia, with expected operation time>60 min, were divided into 2 groups ( n=50 each) using a random number table method: pressure pump group (group PP) and elastic stocking group (group ES). After entering the operating room (T 0), immediately after anesthesia induction (T 1), at 5 and 30 min of the lithotomy position (T 2, 3) and at the end of surgery (T 4), systolic and diastolic blood pressure (SBP, DBP) and heart rate (HR) were measured, and the requirement for vasoactive agents was recorded. Results:Compared with the values at T 0, SBP was significantly decreased at T 1-3 in group PP and at T 1 in group ES ( P<0.05). Compared with group PP, SBP was significantly increased at T 2, 3 in group ES ( P<0.05), no significant change was found DBP and HR at each time point ( P>0.05), and the intraoperative consumption of ephedrine was reduced ([16±9]mg vs.[8±5]mg, P<0.05). Conclusion:Medical compression elastic stockings produces less interference in intraoperative hemodynamics in patients in the lithotomy position under general anesthesia, and its safety is better than intermittent pneumatic pressure pumps.