Hypertrophic scar is a fibrous hyperplastic disorder that arises from skin injuries. The current therapeutic modalities are constrained by the dense and rigid scar tissue which impedes effective drug delivery. Additionally, insufficient autophagic activity in fibroblasts hinders their apoptosis, leading to excessive matrix deposition. Here, we developed an active microneedle (MN) system to overcome these challenges by integrating micromotor-driven drug delivery with autophagy regulation to remodel the scar microenvironment. Specifically, sodium bicarbonate and citric acid were introduced into the MNs as a built-in engine to generate CO₂ bubbles, thereby enabling enhanced lateral and vertical drug diffusion into dense scar tissue. The system concurrently encapsulated curcumin (Cur), an autophagy activator, and triamcinolone acetonide (TA), synergistically inducing fibroblast apoptosis by upregulating autophagic activity. In vitro studies demonstrated that active MNs achieved efficient drug penetration within isolated scar tissue. The rabbit hypertrophic scar model revealed that TA-Cur MNs significantly reduced the scar elevation index, suppressed collagen I and transforming growth factor-β1 (TGF-β1) expression, and elevated LC3 protein levels. These findings highlight the potential of the active MN system as an efficacious platform for autonomous augmented drug delivery and autophagy-targeted therapy in fibrotic disorder treatments.

Novel coronavirus has brought great threats to the people and challenges to the health systems around the world. Compared with general population, lymphoma patients are more vulnerable to novel coronavirus infection(COVID-19) and have poorer prognosis. So the clinical management of COVID-19 in lymphoma patients in more difficult and the great importance should be attached. This article reviews the clinical characteristics and current management strategies of lymphoma patients with COVID-19, to provide reference for the clinical treatment of lymphoma patients with COVID-19.

Objective:To evaluate the efficacy of embedding suture in pterygium excision combined with autologous conjunctival transplantation, and to compare the differences between embedding suture, continuous suture and intermittent suture.Methods:A randomized controlled study was conducted.One hundred and twenty patients (120 eyes) with primary pterygium, who underwent pterygium excision combined with autologous conjunctival transplantation in Shanghai Aier Eye Hospital from May to July 2020, were enrolled.The patients were randomly divided into the embedding suture group, continuous suture group and interrupted suture group, with 40 eyes in each group.The operation duration was recorded and the patients received follow-up visit at 0.5, 1, 3, 7, 10, 14 days and 1, 3 and 6 months after the operation.The five-point method was used to record the postoperative pain score.The corneal epithelial healing was evaluated by sodium fluorescein staining.The complications such as graft detachment, graft displacement or pterygium recurrence were observed with a slit lamp microscope.This study adhered to the Declaration of Helsinki.The study protocol was approved by an Ethics Committee of Shanghai Aier Eye Hospital (No.SHAIER2020RB03). Written informed consent was obtained from each subject before any medical examination.Results:The operation time of continuous suture, interrupted suture and embedding suture was (14.45±2.78), (16.28±2.24) and (16.58±2.22) minutes, respectively, and the overall difference was statistically significant ( F=8.98, P<0.05). The operation time of continuous suture was significantly shorter than that of interrupted suture and embedding suture (both at P<0.017), and there was no significant difference between embedding suture and interrupted suture ( P>0.017). There was a statistically significant overall difference in pain scores among the three groups at various time points after the operation ( P<0.05). At 0.5, 1, 3, 7 and 10 days after the operation, the pain scores of embedding suture were lower than those of continuous suture and interrupted suture (all at P<0.05). On the 7th day after the operation, there was no significant difference in the unhealed rate of corneal epithelium among the three groups ( P=1.000). On the 10th day after the operation, the corneal epithelia of the three groups were all healed.During the six months after the operation, no complications such as displacement, detachment, necrosis, infection of graft and eye movement disorder occurred in the three groups.There was no significant difference in the recurrence rate of pterygium ( P=1.000). Conclusions:Embedding suture method can effectively reduce the irritation symptoms after pterygium conjunctival transplantation, and has stable fixation of implants.Compared with the traditional interrupted suture, it does not increase the recurrence rate, incidence of adverse reactions, operation time and economic burden of patients.

Immune effector cell-associated neurotoxicity syndrome (ICANS) is a common adverse reaction of chimeric antigen receptor T-cell (CAR-T) immunotherapy. Its mechanism is mainly related to the destruction of brain mural cells, increase of cytokine level, the inflammation mediated by natural killer cells, and the activation of endothelial cells. The main clinical manifestations of ICANS are aphasia, tremor, dysgraphia, drowsiness, and epilepsy. In severe cases, asphyxia, coma, or brain edema may occur, and sometimes it is even life-threatening. The factors affecting ICANS include age, peak value of CAR-T amplification, product type, and disease type, etc. American Society for Blood and Marrow Transplantation recommends symptomatic and supportive treatments for mild ICANS and hormonal shock therapy for severe cases.

Immune effector cell-associated neurotoxicity syndrome (ICANS) is a common adverse reaction of chimeric antigen receptor T-cell (CAR-T) immunotherapy. Its mechanism is mainly related to the destruction of brain mural cells, increase of cytokine level, the inflammation mediated by natural killer cells, and the activation of endothelial cells. The main clinical manifestations of ICANS are aphasia, tremor, dysgraphia, drowsiness, and epilepsy. In severe cases, asphyxia, coma, or brain edema may occur, and sometimes it is even life-threatening. The factors affecting ICANS include age, peak value of CAR-T amplification, product type, and disease type, etc. American Society for Blood and Marrow Transplantation recommends symptomatic and supportive treatments for mild ICANS and hormonal shock therapy for severe cases.

Objective:To investigate the current application of colonoscopy at hospitals in China.Methods:From November 2019 to January 2020, an online questionnaire survey was conducted among gastroenterologists and colonoscopists in hospitals of different levels. The contents of questionnaire survey included basic information of colonoscopy at the respondent′s hospital, protocols and patient education of bowel preparation, implementation of colonoscopy quality control, and colonoscopists′ understanding of polypectomy techniques and post-polypectomy follow-up.Results:A total of 236 valid questionnaires were collected, involving 187 hospitals, and 143 (76.5%) had an annual operation capacity of more than 5 000 cases. In terms of bowel preparation, split-dosed polyethylene glycol electrolyte powder (PEG) was the most commonly used (60.4%, 113/187) and the most common volume of PEG was 3 L (67.4%, 126/187). Verbal (90.9%, 170/187) and written (79.7%, 149/187) instructions were given more often than other methods for patient education of bowel preparation. Antifoaming agent was routinely used in 124 (66.3%) hospitals. In terms of quality control, only 11.5% (20/174) hospitals implemented all four measures. In terms of polypectomy techniques, 98.1% (203/207) colonoscopists chose hot snare polypectomy or endoscopic mucosal resection for lesions of diameter>1 cm, while options varied for lesions of diameter<1 cm. The interval of follow-up after polypectomy recommended by colonoscopists was shorter than that by guidelines.Conclusion:Several problems are found in the survey in the application of colonoscopy in China, i. e., patient education of bowel preparation is not diversified; quality control of colonoscopy still needs to be strengthened; polypectomy techniques and follow-up after polypectomy need to be further standardized.

Objective: To evaluate the clinical value of a commercial low-residue diet (LRD) for bowel preparation of colonoscopy. Methods: This study was a prospective, endoscopist-blind, and randomized controlled trial. Participants were randomly assigned to two groups according to administration of LRD: the experimental group and the control group. Bowel preparation quality, compliance and tolerability of the two groups were compared. Results: A total of 61 patients were enrolled, with 32 in the experimental group and 29 in the control group. The outcomes were as follows: Boston Bowel Preparation Scale (BBPS) (7.8±1.0 VS 7.1±1.3, P=0.037), the rate of bowel preparation adequacy (87.5% VS 79.3%, P=0.388), compliance rate of dietary restriction (78.1% VS 55.2%, P=0.057), preparation completion rate (93.8% VS 93.1%, P=0.919), cecal intubation rate (both were 100.0%) and cecum arrival time (9.1±2.9 min VS 9.8±3.7 min, P=0.417), incidence of adverse (3.1% VS 3.4%, P=0.944), and hunger rate before colonoscopy (34.4% VS 48.3%, P=0.102). Conclusion The LRD for bowel preparation of colonoscopy significantly improves BBPS, but its effect on improving the bowel preparation adequacy, patient compliance and tolerability needs to be confirmed by further larger-scale trials.

Objective To study the effect of multi-disciplinary teamwork (MDT) nursing mode on perioperative care to breast cancer patients. Methods One hundred and twenty breast cancer patients undergoing surgical operations were evenly randomized into the observation and control groups by random digit number table. The control group was treated with routine nursing care and the observation group with MDT nursing mode. Result The rate of complications (like subcutaneous effusion, lymphatic edema and skin flap necrosis) in the observation group was significantly lower than that of the control group and the hospital stay was significantly shorter than that of the control group as well (all P<0.05). Conclusion The MDT nursing mode can reduce the rate of complications, shorten the hospital stay and relieve patient′s depression.

Objective To analyze the magnetic resonance imaging ( MRI ) appearances of spontaneous intracranial hypotension syndrome ( SIHS) ,in order to improve the understanding of this disease .Methods The clini-cal data of 7 patients with SIHS confirmed by lumbar puncture were retrospectively analyzed .MRI was performed in all cases,in which there were 6 cases with contrast-enhanced MRI.Results All of them showed diffusely thickening of dural.6 cases with brain contrast-enhanced MRI demonstrated linear ,non-nodular and diffusely dural enhancement . The dilation of sinus and great vein were observed in 5 cases,subdural hydroma in 2 cases,brain sagging in 3 cases, pituitary gland plumpness in 2 cases,subdural hematoma in 1 case and 1 case with linear spinal dural enhancement . Conclusion The MRI manifestations of SIHS are characteristic ,and it will be helpful for the diagnosis by combining clinical data.