OBJECTIVE To systematically evaluate the real-world effectiveness and safety of belimumab in the treatment of lupus nephritis （LN） in Chinese adult patients. METHODS Retrieved from PubMed， Embase， Web of Science， Cochrane Library， Wanfang data， CNKI， VIP and CBM， real-world studies on belimumab in the treatment of LN in Chinese adult patients were collected from the inception to July 7th， 2023. Two reviewers independently screened the literature， extracted data， and assessed the quality of the included studies. Meta-analysis was then performed using RevMan 5.3 software. RESULTS A total of 10 real- world studies were included， involving 253 Chinese adult patients with LN. The results of the meta-analysis demonstrated that the complete renal response rate， partial renal response rate， and the incidence of adverse reaction rate in Chinese adult patients with LN treated with belimumab were 61% （95%CI was 46%-76%， P＜0.000 01）， 23%（95%CI was 2%-44%， P＝0.03）， and 30% （95%CI was 16%-43%， P＜0.000 01）， respectively. Belimumab could reduce the 24-hour urinary protein （MD＝－1.71， 95%CI was －3.02-－0.40， P＝0.01）， urine protein-creatinine ratio （MD＝－1.76，95%CI was －2.06-－1.46，P＜0.000 01）， the systemic lupus erythematosus disease activity index （MD＝－8.63， 95%CI was －12.12-－5.13， P＜0.000 01）， and glucocorticoids dosage （MD＝－18.65， 95%CI was －31.82-－5.48， P＝0.006）. In addition， it could elevate the levels of complement C3 （MD＝0.19， 95%CI was 0.08-0.30， P＝0.000 6） and complement C4 （MD＝0.06， 95%CI was 0.02-0.09， P＝0.001）. However， belimumab could not improve the levels of serum creatinine and estimated glomerular filtration rate （P＞0.05）. CONCLUSIONS Belimumab has good efficacy and safety in Chinese adult patients with LN.

Objective: Subthreshold attention-deficit/hyperactivity disorder (ADHD) has been suggested to be a “morbid condition” which also needs medical attention. Methods: The present study recruited 89 children with subthreshold ADHD (sADHD), 115 children with diagnosed ADHD (cADHD), and 79 healthy controls (HC) to explore the clinical manifestation, executive functions (EFs) of sADHD, and the caregiver strain. The clinical manifestation was evaluated through clinical interviews and parent-reports. Executive functions were assessed both experimentally and ecologically. Caregiver strain was measured by a parent-reported questionnaire. Results: For the clinical manifestation, both sADHD and cADHD indicated impairments when compared with HC. The comorbidities and the scaled symptoms indicated that the externalizing behaviors were relatively less serious in sADHD than cADHD, whereas the internalizing behaviors between two groups were comparable. For ecological EFs, sADHD scored between cADHD and HC in inhibition and working memory. For experimental EFs, sADHD was comparable to cADHD in inhibition, shifting, and was worse than cADHD in verbal working memory. For the caregiver strain, all scores of sADHD were between that in cADHD and that in HC. Conclusion Our present findings supported the suggestion of subthreshold ADHD as “morbid condition,” which should be treated with caution in clinical practice, especially for the internalizing behaviors and some key components of EFs.

Major infectious disease epidemic continues to pose a threat to human health and society, and the effective establishment and implementation of an early warning system plays a key role in addressing public health security risks. At present, the research on early warning of infectious diseases in the academic community mainly focuses on early warning information system, early warning mechanism, laws and regulations of early warning of infectious diseases, and some studies lack specific suggestions on operation methods. By collating and summarizing the literature from 2002 to 2022, regarding the early warning system and mechanism of major infectious diseases, this paper focused on analyzing the public health ethical dilemmas existing in the early warning process and discussing how to strengthen the construction of the early warning system of infectious diseases, so as to lay the foundation for creating more scientific early warning schemes of infectious diseases.

Objective:To explore the mediating role of illness perception in the relationship between fear of disease progression and sleep quality in patients with ovarian cancer during chemotherapy, and to provide a theoretical basis for improving sleep quality in patients with ovarian cancer during chemotherapy.Methods:From January to August 2022, 300 patients with ovarian cancer undergoing chemotherapy in Shandong First Medical University Affiliated Provincial Hospital, Qilu Hospital of Shandong University, Shandong Cancer Hospital were included by convenient sampling. A cross-sectional questionnaire survey included the Chinese version of the Fear of Progression Questionnaire Short Form for cancer patients, the Brief Illness Perception Questionnaire, and the Pittsburgh Sleep Quality Index. Bivariate factor analysis, Spearman correlation analysis, and the Bootstrap confidence interval evaluation method were used.Results:A total of 287 valid questionnaires were collected. The scores of fear disease progression, illness perception, and sleep quality were 30.00 (22.00, 36.00), 37.00 (32.00, 44.00), and 6.00 (3.00, 11.00), respectively. Sleep quality was positively correlated with fear disease progression ( r=0.250, P<0.001) and illness perception ( r=0.326, P<0.001). Illness perception played a partial mediating role in the relationship between fear of disease progression and sleep quality, accounting for 41.4% of the total effect. Conclusions:Ovarian cancer patients during chemotherapy reported poor sleep quality. In clinical practice, health care providers including nurses can take interventions aimed at reducing fear of disease and improving illness perception level to improve the sleep quality of ovarian cancer patients during chemotherapy.

Pancreatic cancer stroma plays a critical role in tumor progression, invasion, metastasis and resistance.Targeting tumor cell alone could not meet the demand for prolonging patients'' survival.Growing studies have laid emphasis on developing combined regimens between targeting pancreatic cancer stroma and chemotherapy, radiotherapy and immunotherapy.We are faced with some new opportunities in spite of the great challenges brought to the research and development of targeting drugs owing to the complicated stroma components, crosstalking signal pathways and abnormal angiogenesis of pancreatic cancer.In this article, recent advances in therapeutic strategies of targeting pancreatic cancer stroma are reviewed and analyzed from the aspects of extracellular matrix (ECM), cancer associated fibroblasts (CAFs) and vessels, in the hope of providing some novel ideas for targeting therapy against pancreatic cancer.

Objective: To investigate the curative effect of auricular deformity repaired by concha cartilage. Methods: From January 2017 to June 2018, 15 cases with auricular deformities were repaired using the autologous concha cartilage which combined with the retroauricular flap or retroauricular fascia with skin grafting. 9 males and 6 females, aged 10-40 with an average age of 19; 3 cases of upper 1/3 traumatic auricle defect, 2 cases of congenital Stahl's ear, 5 cases of congenital cup-shaped ear and 5 cases of congenital cryptotia. Results: Total 15 patients were followed up for 12-18 months after the surgery. The area of concha cartilage resection was about 0.5 cm×1.0 cm. The shape and size of the repaired ears were similar to the healthy ear. The transplanted cartilages were not absorbed or deformed. The incision was healed well and retroauricular flap, retroauricular fascia, and skin grafting were preserved well without complications like hemorrhage, necrosis, and infection. Conclusions This method is harmless and simple, which has reliable and satisfactory effects on various auricular deformities.

Objective: Bioinformatics methods were used to annotate the suspicious pathogenic genes of congenital microtia in detail, and construct the protein-protein interaction (PPI) networks to clarify the function and interaction of pathogenic genes, so as to predict the potential pathogenic genes. Methods: The pathogenic genes of congenital microtia were searched using the mouse genome informatics (MGI). The results were summarized into the STRING database to construct PPI networks. The Gene Ontology (GO) enrichment analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis were carried out. Results: Sixty-eight congenital microtia-related pathogenic genes such as FGF8, EYA1 and HOXA2 were searched by MGI. The PPI network contained 65 nodes and 174 edges. The average node degree was 5.35. The clustering coefficient was 0.437 and the PPI enrichment P = 0. The key node proteins were screened in PPI networks. The top ten were CTNNB1, FGF8, EGFR, BCL2, PAX6, FGF3, FGF10, WNT5A, FGFR1 and MAPK1. GO analysis and KEGG pathway analysis showed: the pathogenic genes were involved in the biological process of ear morphogenesis, ear development and embryonic organ morphogenesis. They also get involved in the molecular regulation, including sequence-specific DNA binding and regulatory region DNA binding. Expression of different genes were located in nucleus and other sub-microscopic cell components. Pathogenic genes were also involved in cancer pathway, melanoma, MAPK signaling pathways, RAS signaling pathways and other signaling pathways. Conclusions By using bioinformatics tools, we constructed the PPI networks of the congenital microtia pathogenic genes, and obtained detailed GO enrichment and KEGG pathway data. The key nodes contained the confirmed pathogenic genes of congenital microtia, which preliminarily proved the feasibility of the bioinformatics method in this study. We found some nodes were closely linked with FGF and WNT, which may be potential mutant genes of congenital microtia, although further study is needed.

Family environment plays an important part of the occurrence,development and outcome of attention-deficit/hyperactivity disorder (ADHD).Family and parenting interventions focus on the inter environment,aiming at forming an effective behavioral management,a better communication strategy,which will be conductive for child's symptoms as well as functions.Parents'emotion and self-efficacy as well as family functioning will be affected also.Common family and parenting skills include parent training and systematic family therapy,which respectively focus on behavior management and the whole family in view of system.The Multimodal Treatment Study of Children with ADHD (MTA) may have potential effects compared with single medical treatment and behavioral treatment.In China,parent training and structural family therapy have been proved to be effective.However,further consideration and experiments are necessary,especially on the long-time ending and individual management.

Objective: To identify a pig model with bilateral external ear defects accompanied by aural atresia and investigate its application in plastic surgery. Methods: Erhualian×Shaziling F₂ pig inbreeding population was introduced, and examination of external ear morphology was conducted in all individuals. Temporal computed tomography scanning and mutational detection of HOXA1 gene were conducted in one affected and one normal individuals. Results: In Erhualian×Shaziling F₂ pig inbreeding population, there were 57 normal and 18 affected individuals among the 75 pigs. Affected subjects presented bilateral external ear defects accompanied by aural atresia; temporal computed tomography scanning showed bilateral aural atresia and dysplasiaof middle ear; and gene detection identified homozygous mutation of HOXA1 gene. Conclusions Pig model with HOXA1 gene homozygous mutation resembles human microtia at different levels. Our findings provide the theoretical basis for its application to study further pathological mechanism for human microtia.

There are many factors that may affect the microenvironment of acute and chronic wounds.This article reviews the relationship between temperature factor in the external microenvironment of wound surface and wound healing.The temperature changes in different types and stages of wounds are closely related to the wound healing status.Therefore,wound temperature monitoring provides timely,reliable,and non-invasive method in the evaluation of wound status.As low temperature affects the physiological state of wound,relieving the low temperature state and maintaining normal temperature of the microenvironment of wound can promote wound healing.Further research is needed on the wound repair related effector cell proliferation and the mechanism of regulatory function to determine the optimal constant temperature and heat treatment duration needed for wound healing.