Alzheimer's disease (AD) is the major form of dementia in the elderly and is closely related to the toxic effects of microglia sustained activation. In AD, sustained microglial activation triggers impaired synaptic pruning, neuroinflammation, neurotoxicity, and cognitive deficits. Accumulating evidence has demonstrated that aberrant expression of deubiquitinating enzymes is associated with regulating microglia function. Here, we use RNA sequencing to identify a deubiquitinase YOD1 as a regulator of microglial function and AD pathology. Further study showed that YOD1 knockout significantly improved the migration, phagocytosis, and inflammatory response of microglia, thereby improving the cognitive impairment of AD model mice. Through LC-MS/MS analysis combined with Co-IP, we found that Myosin heavy chain 9 (MYH9), a key regulator maintaining microglia homeostasis, is an interacting protein of YOD1. Mechanistically, YOD1 binds to MYH9 and maintains its stability by removing the K48 ubiquitin chain from MYH9, thereby mediating the microglia polarization signaling pathway to mediate microglia homeostasis. Taken together, our study reveals a specific role of microglial YOD1 in mediating microglia homeostasis and AD pathology, which provides a potential strategy for targeting microglia to treat AD.

Objective:To investigate the safety and efficiency of depilation with intense pulsed light (IPL) in congenital microtia patients during different phase of reconstruction treatment sessions.Methods:The hairy skin was treated with the M22TM system (Lumenis, German) using a filter of 695-1 200 mm. A three pluses mode of the radiant setting with a pulse width of 3.5 ms, a delay of 60 ms, and an energy density of 16-18 mJ/cm 2 was applied in the expanded patients. Depilation efficacy was evaluated as follows: excellent (hair density reduction >75%), good (50%-75%), fair (25%-50%), and poor (<25%). The depilation effect was compared between different phases. And the adverse effect was observed. Results:A total of 131 cases were included. There was no difference of the hair density reduction between patients with different expander volume after same IPL depilation treatments [15 (13-19) vs. 16 (15-19) root/cm 2, Wilcoxon rank analysis]. The hair density reduction in the expansion group was lower than the non-expansion group after two IPL depilation treatments [15 (13-19) vs. 17 (15-21) root/cm 2, P<0.05, Wilcoxon rank analysis]. The depilation efficacy was highly related with the numbers of IPL depilation treatments the patients received [Kendall′ stat b=0.74 (95% CI: 0.71-0.77), P<0.05]. There were 3 cases of folliculitis, 2 cases of blisters occurred in this study, and no expander exposure and cartilage absorption were observed. Conclusions:Hair removal with IPL is a safe and effective photo-epilation method during all stages of ear reconstruction using tissue expander. The volume of the expander does not significantly affect the hair removal efficiency. Depilation in the expansion phase is more efficient than that in the non-expansion phase, and the ideal result of " hair-free" or " less hairy" reconstructed ears can be achieved in 5 treatments, with suboptimal results in 3 treatments.

Objective To analyze the influencing factors of postoperative subsyndromal delirium in elderly patients undergoing abdominal surgery,and to develop a nomogram risk prediction model.Methods A convenience sampling method was used to select 497 elderly patients who underwent abdominal surgery in a tertiary hospital in Sichuan Province from February to October 2022.The risk prediction model and nomograms model were constructed using Logistic regression analysis and R software.The area under the subject's working characteristic curve(AUC)and Hosmer-Lemshow test were used to evaluate the discrimination and calibration of the model.Results The results of Logistic regression showed that age(OR=1.066),functional activities(OR=1.143),patient controlled intravenous analgesia(OR=5.811),transanal drainage tube(OR=2.276)and postoperative blood transfusion(OR=4.322)were independent influences on the occurrence of postoperative subsyndromal delirium.The p-values of the prediction model in both the training and validation sets were greater than 0.05;the area under the ROC curves were 0.734 and 0.691;the model was presented in the form of nomogram.Conclusion The prediction model developed in this study has good discrimination and accuracy.It can be used to assist clinical staff in identifying patients at high risk of developing postoperative subsyndromal delirium and provide the reference for developing preventive and intervention measures.

Objective:To explore the effect of health education based on outcome-based concept on self-management ability and glycemic control in hospitalized patients with type 2 diabetes melittus (T2DM).Methods:A total of 103 T2DM patients admitted in the Endocrinology Department of 903 Hospital of PLA from March 2022 to September 2022 were recruited and randomly divided into study group ( n=52) and control group ( n=51). Routine health education was given to all patients, while additional outcome-based health education was provided by diabetes specialist nurses for the study group during hospitalization. At 12 weeks after discharge, the self-management ability and glycemic control were compared between the two groups. Results:At 12 weeks after discharge, patients in the study group had significantly better self-management ability (dietary control: (4.06±0.75) vs. (3.70±0.88), t=2.50, regular exercise: (3.88±0.62) vs. (3.52±0.94), t=2.30, medical compliance: (4.47±0.51) vs. (4.12±0.64), t=3.14, self blood glucose monitoring: (3.43±0.87) vs. (2.94±0.95), t=2.71, foot care: (3.56±0.57) vs. (2.77±0.87), t=5.42, and management of hyper or hypoglycemia:(3.65±0.72) vs. (3.24±0.96), t=2.48); glycemic control (fasting blood glucose: (6.31±0.90) vs. (6.88±1.37)mmol/L, t=-2.46, 2-h postprandial blood glucose: (8.39±1.64) vs. (9.27±2.50)mmol/L, t=-2.11, HbA1c: (6.76±0.98)% vs. (7.17±0.93)%, t=-2.22). The control rate of HbA1c in the study group was significantly higher and the incidence of hypoglycemia was significantly lower than those in the control group (78.8%(41/52) vs. 58.8%(30/51), χ 2=4.82 and 11.5%(6/52) vs. 29.4%(15/51), χ 2=5.07, respectively). Conclusions:The outcome-based health education can effectively enhance self-management ability and glycemic control in hospitalized type 2 diabetic patients.

In recent years, researchers have found that patients with nonalcoholic fatty liver disease (NAFLD) often have urolithiasis, and the incidence of urolithiasis increases gradually with the severity of NAFLD. Meanwhile, the detection rate of NAFLD was higher in patients with urolithiasis than in normal controls. In this paper, we reviewed the domestic and international studies on the correlation between urolithiasis and NAFLD and described the related pathogenesis, such as insulin resistance, oxidative stress, abnormal lipid metabolism and impaired glyoxalate detoxification. Meanwhile, this paper proposed preventive measures to reduce the risk of development and recurrence of NAFLD-associated urolithiasis by addressing the common risk factors of both diseases, including metabolism-related diseases, lifestyle and diet.

Objective:To evaluate the clinical effect of total-model fractional CO 2 laser in the treatment of atrophic acne scar. Methods:A retrospective analysis was performed on the clinical data of patients with atrophic acne scar treated by total-model fractional CO 2 laser(Deep FX+ Active FX+ CW) in Laser Aesthetic Center of Plastic Surgery Hospital, Chinese Academy of Medical Sciences from January 2017 to September 2019. CW mode and/or Active FX mode was used to fine grinding of the scar edge, and Active FX mode and Deep FX mode were used to scan the whole area acne scar involved. The treatment was performed 3-5 times with an interval of more than 3 months. Two attending physicians who were not involved in the study evaluated the photos of patients before treatment and 3-5 times after treatment with the Global Aesthetic Improvement Scale (GAIS) and the Echelle d’Evaluation Clinique des Cicatrices d’acne (ECCA). Acne scar and overall facial skin quality were assessed with GAIS, a total score of 1 to 3, with a score 1 indicating deterioration and a score 3 indicating significant improvement. The severity and density of acne scarring were assessed with ECCA, with the higher the score, the more severe it is. The international numeric rating scale (NRS) was used to rate the pain immediately after treatment (0-10 points), with 0 indicating no pain and 10 indicating extreme pain. Side effects such as the occurrence of crusts, erythema, pigmentation and acne-like rash were observed. SPSS 24.0 was used for statistical analysis, and the measurement data were expressed by Mean±SD. Paired t-test was used for ECCA scores before and after treatment, and P<0.05 was considered as statistically significant difference. Results:A total of 75 patients were included in this study, including 16 males and 59 females, aged 27.2±6.2 years (19-49 years). Among them, the improvement in acne scar and overall facial skin quality were excellent in 12 cases, significant in 34 cases, median in 24 cases and poor in 5 cases. GAIS score was 1.62±0.77. The ECCA score was 157.20±18.89 before treatment and 138.93±23.62 after treatment, showing significant difference ( t=9.41, P<0.001). The pain score was 4.65±1.52 and disappeared spontaneously about 2-4 hours after operation. The scab stage was 6.65±0.89 days, and the erythema stage was 3.09±0.70 weeks. The post-inflammatory hyperpigmentation case occurred in 1.3% (1/75) and lasted for 4 months. Acne-like rash occurred in 16.0% (12/75), which relieved by external smear of fusidic acid. No blisters, hypopigmentation, bacterial or viral infection, scar formation and other adverse reactions happened. Conclusions:The total-mode fractional CO 2 laser is effective and safe in the treatment of facial atrophic acne scar.

Objective:To evaluate the clinical effect of total-model fractional CO 2 laser in the treatment of atrophic acne scar. Methods:A retrospective analysis was performed on the clinical data of patients with atrophic acne scar treated by total-model fractional CO 2 laser(Deep FX+ Active FX+ CW) in Laser Aesthetic Center of Plastic Surgery Hospital, Chinese Academy of Medical Sciences from January 2017 to September 2019. CW mode and/or Active FX mode was used to fine grinding of the scar edge, and Active FX mode and Deep FX mode were used to scan the whole area acne scar involved. The treatment was performed 3-5 times with an interval of more than 3 months. Two attending physicians who were not involved in the study evaluated the photos of patients before treatment and 3-5 times after treatment with the Global Aesthetic Improvement Scale (GAIS) and the Echelle d’Evaluation Clinique des Cicatrices d’acne (ECCA). Acne scar and overall facial skin quality were assessed with GAIS, a total score of 1 to 3, with a score 1 indicating deterioration and a score 3 indicating significant improvement. The severity and density of acne scarring were assessed with ECCA, with the higher the score, the more severe it is. The international numeric rating scale (NRS) was used to rate the pain immediately after treatment (0-10 points), with 0 indicating no pain and 10 indicating extreme pain. Side effects such as the occurrence of crusts, erythema, pigmentation and acne-like rash were observed. SPSS 24.0 was used for statistical analysis, and the measurement data were expressed by Mean±SD. Paired t-test was used for ECCA scores before and after treatment, and P<0.05 was considered as statistically significant difference. Results:A total of 75 patients were included in this study, including 16 males and 59 females, aged 27.2±6.2 years (19-49 years). Among them, the improvement in acne scar and overall facial skin quality were excellent in 12 cases, significant in 34 cases, median in 24 cases and poor in 5 cases. GAIS score was 1.62±0.77. The ECCA score was 157.20±18.89 before treatment and 138.93±23.62 after treatment, showing significant difference ( t=9.41, P<0.001). The pain score was 4.65±1.52 and disappeared spontaneously about 2-4 hours after operation. The scab stage was 6.65±0.89 days, and the erythema stage was 3.09±0.70 weeks. The post-inflammatory hyperpigmentation case occurred in 1.3% (1/75) and lasted for 4 months. Acne-like rash occurred in 16.0% (12/75), which relieved by external smear of fusidic acid. No blisters, hypopigmentation, bacterial or viral infection, scar formation and other adverse reactions happened. Conclusions:The total-mode fractional CO 2 laser is effective and safe in the treatment of facial atrophic acne scar.

Objective:To explore the effect of self-designed fixed support in the postoperative nursing of abdominal flap repair.Methods:From January 2016 to December 2019, 47 patients with hand tissue defects undergoing abdominal skin flap repair in Shajing People′s Hospital, Guangzhou Medical University were divided into control group (23 cases) and observation group (24 cases) by random digits table method. The control group was treated with traditional methods, and the observation group was treated with self-designed fixed support. The wound healing of abdominal flap, the wound tearing after flap operation, pedicle ulcer after flap operation and the patients' nursing satisfaction were compared between the two groups.Results:There were 7 cases of primary healing and 16 cases of secondary healing in the control group, 18 cases of primary healing and 6 cases of secondary healing in the observation group. The difference between the two groups was statistically significant ( χ2 value was 9.368, P<0.01). The incidence rate of the wound tearing after flap operation was 26.1% (6/23) in the control group and 0 (0/24) in the observation group. The difference between the two groups was statistically significant ( χ2 value was 7.177, P<0.05). The incidence rate of pedicle ulcer after flap operation was 69.6% (16/23) in the control group and 33.3% (6/23) in the observation group. The difference between the two groups was statistically significant ( χ2 value was 6.170, P<0.05). The patients' nursing satisfaction was (76.8±8.4)points in the control group and (90.4±6.5) points in the observation group.The difference between the two groups was statistically significant (t value was -4.640, P<0.01). Conclusions:The use of fixed support after the operation of abdominal flap is helpful to the wound healing, reduce the occurrence of wound tear and pedicle ulcer, and improve the satisfaction of nursing, which is worth popularizing.

Objective:To assess the implementation of injection-related risk management based on WeChat platform for type 2 diabetic patients with the insulin self-injection.Methods:A total of 124 diabetic patients, who would receive insulin therapy by self-injection at home after discharge from the PLA 903 hospital during April 2017 to July 2018, were divided into the control group( n=62)and the study group( n=62). All patients were given routine education on insulin injection during the hospitalization,while the study group( n=62)received additional video and text education based on WeChat platform after discharge. The skill of self-injection and the status of blood glucose control were evaluated in both groups 4 weeks and 8 weeks after discharge, respectively. Results:The insulin injection skill, including skin disinfection [36(58%) vs. 11(18%),χ 2=21.42, P<0.01], exhaust before injection [62(100%) vs. 51(82%),χ 2=12.07, P<0.01], stay 10s after injection [60 (97%) vs. 47(76%),χ 2=11.52, P<0.01], disposal of used needle[49(79%) vs. 18(29%),χ 2=31.20, P<0.01], rotation of injection site [48(77%) vs. 35(56%),χ 2=6.16, P=0.01], insulin storage [62(100%) vs. 57(92%),χ 2=5.21, P=0.02], and the ability of correctly dealing with hypoglycemia [52(84%) vs. 38(61%),χ 2=7.94, P=0.01] in the study group were significantly better than those in the control group after 4 weeks of injection-related risk management. The fasting plasma glucose [(6.41±0.76) vs.(7.19±0.81)mmol/L, t=5.61, P<0.01], glycosylated hemoglobin A1c [(6.71±0.64)% vs. (7.37±0.78)%, t=5.18, P<0.01], incidence of hypoglycemia [6(10%) vs. 15(24%),χ 2=4.64, P=0.03] in the study group were significantly lower than those in the control group after 12 weeks of the management. Conclusion:The risk management based on WeChat platform can improve insulin self-injection skill and the ability of dealing with hypoglycemia,also promote effective blood glucose control for diabetes patients.