Objective:To determine whether the transepidermal water loss rate (TEWL) is correlated with the stratum corneum (SC) hydration level.Methods:Healthy children aged ≤ 17 years were enrolled from Medical Center for Public Health of Puning, 2 kindergartens and 2 primary schools, from October 2021 to June 2022. TEWL and SC hydration levels were measured on the left forearm and right anterior shank using a device for measuring skin physiological funcitons. Pearson correlation analysis was used to determine the correlations between TEWL and SC hydration levels in children of different ages and genders.Results:A total of 1 396 healthy children were enrolled, aged from 1 month to 17 years. Among them, 783 were male children and 613 were female children. In children aged 1 to < 12 months, no correlation was observed between TEWL and SC hydration levels on the forearms of male children, while TEWL was positively correlated with SC hydration levels on the anterior shanks of male children, as well as on the forearm and anterior shanks of female children ( r = 0.283, 0.404, 0.420, respectively, all P < 0.05) . In children aged 1 to 2 years, positive correlations were observed between the above two indicators on the anterior shanks of male children and forearms of female children ( r = 0.370, 0.419, respectively, both P < 0.01) , while there were no correlations between the two indicators on the anterior shanks of female children or forearms of male children. Positive correlations were observed between TEWL and SC hydration levels on both the forearms and anterior shanks of female children and the forearms of male children aged 3 to 5 years and 6 to 11 years ( r values ranging from 0.172 to 0.293, all P < 0.05) , but not on the anterior shanks of male children aged from 6 to 11 years. The group aged 12 to 17 years exhibited significantly positive correlations between TEWL and SC hydration levels on both the anterior shanks and forearms of male and female children ( r values ranging from 0.269 to 0.485, all P < 0.001) . Conclusion:SC hydration levels are positively correlated with TEWL on the anterior shanks and forearms of healthy children, and the degree of correlation tends to increase with age.

The clinical manifestations of subacute combined degeneration of spinal cord (SCD) in children are complex and vary greatly. Due to the fact that some patients with SCD may be complicated with autoimmune diseases, the high early misdiagnosis and missed diagnosis rates are observed. One case of 13-year old female with severe anemia, multiple joint swelling and pain in left limbs and paralysis of bilateral lower limbs with the extremely low level of serum vitamin B12 and poly-glandular involvement as well as a variety of positive auto-antibodies (anti-intrinsic factor antibody, anti-parietal cell antibody, thyroid peroxidase antibody, thyroid globulin antibody and perinuclear anti-neutrophil cytoplasmic antibody) was retrospectively analyzed. The patient was diagnosed as SCD with autoimmune disease (undifferentiated connective tissue disease and autoimmune polyglandular syndrome). The patient′s condition gradually alleviated after high-dose intravenous methylprednisolone, immunoglobulin, naproxen (then changed to hydroxychloroquine 1 month later), vitamin B12 and levothyroxine sodium tablets supplementation, blood transfusion and rehabilitation. SCD with autoimmune diseases is rare in children, and the clinical manifestations vary greatly. Early recognition and early treatment can improve the prognosis of SCD. The clinical data of this child were retrospectively analyzed, so as to improve the understanding of the disease by clinicians.

Objective:To explore the application of virtual patient in the reexamination of clinical medical professional masters (hereinafter referred to as "clinical masters"), and to provide reference for the reform of clinical masters reexamination.Methods:The correlation between the clinical thinking scores of 97 candidates (Western medicine) in the reexamination of clinical masters in a university in 2019, the scores of comprehensive ability of clinical medicine (Western medicine) in the initial test and the interview scores in the reexamination was analyzed, and the differences between the clinical thinking scores of current and previous candidates were compared. SPSS 21.0 software was conducted for t test, chi-square test and Pearson correlation analysis. Results:The Person correlation analysis showed that the correlation coefficient between the scores of clinical thinking and the scores of comprehensive clinical medicine (Western medicine) and the scores of interview in the reexamination were 0.09 and -0.05 respectively( P>0.05). At the same time, there was no statistically significant difference between the clinical thinking scores of current and previous candidates ( P >0.05). Conclusion:There was a poor correlation between the scores of clinical thinking and the scores of comprehensive clinical medicine (Western medicine) and the scores of interview in the reexamination. The consideration is concerned with the difference in the purpose of the three assessment forms. It can provide references for other medical colleges to optimize the evaluation content of postgraduate reexamination.

It has been speculated that dry skin results from dysfunction of epidermal permeability barrier. But so far, there is no sufficient evidence to support this speculation. In fact, dry skin indicates low levels of stratum corneum hydration. Stratum corneum hydration levels are primarily determined by the content of natural moisturizers in the skin, while epidermal permeability barrier is mainly regulated by intercellular lipids and structural proteins in the stratum corneum. If dry skin is due to a defective permeability barrier, stratum corneum hydration levels should be inversely correlated with transepidermal water loss (TEWL) , an indicator of epidermal permeability barrier function. But no negative correlation has been demonstrated between stratum corneum hydration levels and TEWL in either normal human skin, ichthyoses lesions of patients, or sebaceous gland-deficient mice in a number of studies. In contrast, a positive correlation between stratum corneum hydration levels and TEWL was observed in normal human skin. Taken together, a line of evidence suggests that dry skin unlikely indicates epidermal permeability barrier dysfunction.

Objective To evaluate the safety and efficacy of transcatheter arterial embolization (TAE) in the management of refractory hematuria of prostatic origin (RHPO). Methods This retrospective study from 6 hospitals in china consisted of 31 patients (mean age 75.0±7.5 years, range 58 to 84 years) who underent transcatheter arterial embolization (TAE) for RHPO between February 2011 and January 2017. Patients with RHPO who had complete imaging and clinical data were enrolled. Patients with incomplete clinical data, inability to assess hemostasis, and contraindications to TAE were excluded. The cause of RHPO was benign prostatic hyperplasia (BPH) in nine patients, prostate cancer in twelve, transurethral resection of prostate in four, open prostatectomy in two and prostatic sarcoma in four. Superselective arterial embolization, non-superselective arterial embolization or intra-arterial infusion chemotherapy was performed according to the etiology and angiography. Angiographic findings, technical success rate, clinical success rate, complications were recorded. Results Of the 31 patients, 6 patients (19.4％) were with active bleeding, 4 (12.9％) with aneurysm and 27 (87.1％) with abnormal neovascularization on the angiogram. The 31 patients underwent a totle of 37 TAE, the technical success rate was 100.0％(37/37) and the recent hemostasis success rate was 90.3％(28/31). The incidence of mild complications was 38.7％(13/31), there was no serious complication associated with TAE. Conclusion TAE is a safe and effective method for the treatment of refractory hematuria of prostatic origin.

Raman spectroscopy is amplified by surface-enhanced Raman scattering nanoparticles(SERS-NPs),and Raman signal can be enhanced by SERS-NPs,which can achieve high-resolution imaging of tumors.Meanwhile,SERS-NPs have high molecular specificity and sensitivity,showing a good prospect of tumor diagnosis and treatment.The advantages of SERS-NPs and its application in tumor diagnosis and treatment,and related experimental studies are reviewed in this article.

Objective To analyze the effects of Xueshuantong and alprostadil combined with hyperbaric oxygen ( HBO ) on clinical efficacy, hemodynamics and serum inflammatory indexes in elderly patients with lower extremity arteriosclerosis occlusion. Methods One hundred and eighteen patients with lower extremity arteriosclerosis occlusion admitted into the surgical department of the hospital from May 2017 to January 2019 were randomly divided into the combined medication group (n=59) and the control group (n=59). The control group was just treated with alprostadil injection, while the combined medication group was treated with Xueshuantong and alprostadil combined with HBO treatment. Clinical efficacy after treatment, changes in atherosclerosis indexes, hemodynamic indexes ( whole blood viscosity, plasma viscosity and fibrinogen), the levels of serum inflammatory indexes, such as hs-CRP, interleukin-6, interleukin 8 and tumor necrosis factor-α( TNF-α) before and after treatment were compared between the patients of the 2 groups. Results The total effective rate of the combined medication group was 93. 22％, which was significantly higher than 79. 66％ of the control group(P<0. 05). The blood flow of dorsal pedal artery, ankle-brachial indexes and toe-brachial indexes in the patients of the 2 groups after treatment were all significantly higher than those before treatment (P<0. 05), and the combined medication group was obviously superior to the control group, with statistical significance (P <0. 05). The whole blood viscosity, plasma viscosity and fibrinogen (FIB) levels in the patients of the 2 groups after treatment all significantly decreased as compared with those before treatment (P<0. 05), and the indexes of the combined medication group were significantly lower than those of the control group, also with statistical significance(P<0. 05). The levels of TNF-a, hs-CRP, IL-6 and IL-8 in the patients of the 2 groups after treatment were significantly lower than those before treatment (P<0. 05), and the combined medication group was also obviously superior to the control group, with statistical significance (P<0. 05). Conclusion Xueshuantong and alprostadil combined with HBO in the treatment of elderly patients with peripheral arterial disease ( PAD) could achieve significant clinical effects, and in the meantime could evidently delay the occurrence of lower extremity arteriosclerosis, improve hemodynamics, relieve inflammation reactions. For this reason, it is worth further clinical extension.

Objective To analyze the effects of Xueshuantong and alprostadil combined with hyperbaric oxygen ( HBO ) on clinical efficacy, hemodynamics and serum inflammatory indexes in elderly patients with lower extremity arteriosclerosis occlusion. Methods One hundred and eighteen patients with lower extremity arteriosclerosis occlusion admitted into the surgical department of the hospital from May 2017 to January 2019 were randomly divided into the combined medication group (n=59) and the control group (n=59). The control group was just treated with alprostadil injection, while the combined medication group was treated with Xueshuantong and alprostadil combined with HBO treatment. Clinical efficacy after treatment, changes in atherosclerosis indexes, hemodynamic indexes ( whole blood viscosity, plasma viscosity and fibrinogen), the levels of serum inflammatory indexes, such as hs-CRP, interleukin-6, interleukin 8 and tumor necrosis factor-α( TNF-α) before and after treatment were compared between the patients of the 2 groups. Results The total effective rate of the combined medication group was 93. 22％, which was significantly higher than 79. 66％ of the control group(P<0. 05). The blood flow of dorsal pedal artery, ankle-brachial indexes and toe-brachial indexes in the patients of the 2 groups after treatment were all significantly higher than those before treatment (P<0. 05), and the combined medication group was obviously superior to the control group, with statistical significance (P <0. 05). The whole blood viscosity, plasma viscosity and fibrinogen (FIB) levels in the patients of the 2 groups after treatment all significantly decreased as compared with those before treatment (P<0. 05), and the indexes of the combined medication group were significantly lower than those of the control group, also with statistical significance(P<0. 05). The levels of TNF-a, hs-CRP, IL-6 and IL-8 in the patients of the 2 groups after treatment were significantly lower than those before treatment (P<0. 05), and the combined medication group was also obviously superior to the control group, with statistical significance (P<0. 05). Conclusion Xueshuantong and alprostadil combined with HBO in the treatment of elderly patients with peripheral arterial disease ( PAD) could achieve significant clinical effects, and in the meantime could evidently delay the occurrence of lower extremity arteriosclerosis, improve hemodynamics, relieve inflammation reactions. For this reason, it is worth further clinical extension.

Objective To study the clinical efficacy of Dyna computer tomography (Dyna CT) guided radiofrequency ablation (RFA) followed immediately by transcatheter arterial chemoembolization (TACE) in the treatment of large solitary hepatocellular carcinomas (HCC),and to provide the basis for the rational use of Dyna CT.Methods A retrospective analysis was performed on 23 patients with a large solitary hepatocellular carcinoma (tumor diameter ≥5 cm) who were admitted to Chinese PLA General Hospital from January 2014 to October 2015 and treated with Dyna CT guided RFA followed immediately by TACE.After treatment,the success rate of the combined technique,the treatment time,the radiation dose received by the patient,the complication and the efficacy of the combined therapy were evaluated.Results The success rate of the combined technique was 100％.The treatment time was (45.3 ± 4.8) min.The radiation exposure dose was (730.5 ± 78.8) mGy.There was no serious complication after treatment.The complete remission rate of the targeted lesion was 91.3 ％ (21/23),the partial remission rate was 8.7 ％ (2/23).On follow-up,5 patients had died.The 6,12,18 month survival rates were 100％,81.5％ and 48.0％,respectively.Conclusions Dyna CT guided RFA for a large solitary HCC was efficacious and safe.The immediate combination of TACE with RFA provided a new alternative strategy for the treatment of a large solita-ry HCC.Dyna CT has important clinical values.