Objective:To analyze the real-world effectiveness and safety of tofacitinib in the treatment of alopecia ophiasis, and to compare characteristics of patients with different clinical responses.Methods:A retrospective study was conducted on patients with alopecia ophiasis who visited the Department of Dermatology, China-Japan Friendship Hospital from March 1, 2022, to July 31, 2023. All patients received tofacitinib in combination with topical minoxidil or glucocorticoids, intralesional glucocorticoid injections, oral isotretinoin, antidepressants, antihistamines, traditional Chinese medicine, etc., and were followed up for 36 weeks. The primary outcome was the number of patients achieving complete remission and partial remission at week 36; secondary outcomes included the number of patients achieving a severity of alopecia tool (SALT) score of ≤ 20 points and those with a response rate of ≥ 50% in scalp hair regrowth (SALT50) . Clinical characteristics were compared between patients who achieved and did not achieve a SALT score of ≤ 20 points. Comparisons among groups were performed using the two-independent-sample t test, Mann-Whitney U test, and Fisher's exact test. Results:A total of 21 patients with alopecia ophiasis were collected, and all received oral tofacitinib citrate at a dose of 5 mg twice daily for at least 36 weeks. After a 36-week follow-up, 2 patients (9.5%) achieved complete remission, 16 (76.2%) achieved partial remission, and 3 (14.3%) showed no response. SALT50 was achieved in 12 patients (57.1%) , and 13 (61.9%) had a SALT score of ≤ 20 points. Adverse reactions included mild liver transaminase elevation (1 case) , headache (1 case) , and folliculitis (2 cases) . At week 36, the patients achieving a SALT score of ≤ 20 points exhibited significantly decreased proportions of patients with body hair loss (7/13) and of patients with childhood-onset alopecia ophiasis (7/13) compared with those having a SALT score of > 20 points (both 8/8, both P = 0.046) . However, there were no significant differences between the above two groups in gender, age, body mass index, total disease duration, baseline SALT scores, positivity rates of thyroid antibodies or prevalence of total allergen-specific IgE abnormalities (all P > 0.05) . Conclusion:Combination therapy with tofacitinib showed generally good efficacy and safety in the treatment of alopecia ophiasis, and poorer outcomes were likely to be observed in patients with body hair involvement and childhood-onset alopecia ophiasis.

Objective:To analyze the real-world effectiveness and safety of tofacitinib in the treatment of alopecia ophiasis, and to compare characteristics of patients with different clinical responses.Methods:A retrospective study was conducted on patients with alopecia ophiasis who visited the Department of Dermatology, China-Japan Friendship Hospital from March 1, 2022, to July 31, 2023. All patients received tofacitinib in combination with topical minoxidil or glucocorticoids, intralesional glucocorticoid injections, oral isotretinoin, antidepressants, antihistamines, traditional Chinese medicine, etc., and were followed up for 36 weeks. The primary outcome was the number of patients achieving complete remission and partial remission at week 36; secondary outcomes included the number of patients achieving a severity of alopecia tool (SALT) score of ≤ 20 points and those with a response rate of ≥ 50% in scalp hair regrowth (SALT50) . Clinical characteristics were compared between patients who achieved and did not achieve a SALT score of ≤ 20 points. Comparisons among groups were performed using the two-independent-sample t test, Mann-Whitney U test, and Fisher's exact test. Results:A total of 21 patients with alopecia ophiasis were collected, and all received oral tofacitinib citrate at a dose of 5 mg twice daily for at least 36 weeks. After a 36-week follow-up, 2 patients (9.5%) achieved complete remission, 16 (76.2%) achieved partial remission, and 3 (14.3%) showed no response. SALT50 was achieved in 12 patients (57.1%) , and 13 (61.9%) had a SALT score of ≤ 20 points. Adverse reactions included mild liver transaminase elevation (1 case) , headache (1 case) , and folliculitis (2 cases) . At week 36, the patients achieving a SALT score of ≤ 20 points exhibited significantly decreased proportions of patients with body hair loss (7/13) and of patients with childhood-onset alopecia ophiasis (7/13) compared with those having a SALT score of > 20 points (both 8/8, both P = 0.046) . However, there were no significant differences between the above two groups in gender, age, body mass index, total disease duration, baseline SALT scores, positivity rates of thyroid antibodies or prevalence of total allergen-specific IgE abnormalities (all P > 0.05) . Conclusion:Combination therapy with tofacitinib showed generally good efficacy and safety in the treatment of alopecia ophiasis, and poorer outcomes were likely to be observed in patients with body hair involvement and childhood-onset alopecia ophiasis.

Objective To explore the effects of Shaoyao Gancao granule on hair growth,behavior,and the hypothalamic pituitary adrenal(HPA)axis in mice with alopecia areata(AA).Methods Forty-two C3H/HeJ mice were randomly divided into control,model,Shaoyao Gancao granule high-,middle-,low-dose,corticotropin-releasing hormone receptor 1(CRHR1)antagonist,and compound glycyrrhizin tablet(CGT)groups.Photography,dermoscopy,weight analysis,and behavioral measurement were performed.Corticotropin-releasing hormone(CRH),adrenocorticotropic hormone(ACTH),cortisol,glucocorticoid receptor(GR),and brain-derived neurotrophic factor(BDNF)were also assessed.Results Compared with the model group,high-dose Shaoyao Gancao granules improve hair regeneration and weight gain(P＜0.05),increased the percentage of total exercise distance and central area exercise distance in an open field test(P＜0.05),reduced the immobility time in the forced swimming and tail suspension experiments(P＜0.05),reduced peripheral blood levels of CRH,ACTH,and cortisol(P＜0.05),and increased expression of GR and BDNF in the hippocampus(P＜0.05).Conclusions Shaoyao Gancao granule promotes hair growth and improves behavioral performance in mice with AA.These effects may be related to downregulating CRH,ACTH,and cortisol expression,upregulating GR and BDNF expression,and inhibiting excessive activation of the HPA axis.

Objective:To explore the mediating effect of professional identification between compassion fatigue and death coping ability of nurses in the oncology department, and to provide a basis for strengthening their professional identification, reducing their compassion fatigue and improving their death coping ability.Methods:From October to December 2022, a questionnaire survey was conducted among 350 nurses in the oncology department from 12 hospitals in Hebei Province using the convenience sampling method. General Data Questionnaire, Professional Identification Scale for Nurse, Compassion Fatigue Self Test and Death Coping Ability Scale were used to conduct an online survey. The relationship among the three was statistically analyzed with SPSS 25.0, and the structural equation model was established using the AMOS 23.0 software to analyze the mediating effect of professional identification between compassion fatigue and death coping ability.Results:A total of 326 valid questionnaires were collected. Among such 326 nurses in the oncology department, including 12 males and 314 females, 121 were aged 21-30 years old, 153 were aged 31-40 years old, 42 were aged 41-50 years old, and 10 were aged 51-60 years old. The professional identification score of oncology nurses was (108.96 ± 20.29) points, the empathy fatigue score was (81.30 ± 9.00) points, and the death coping ability score was (112.39 ± 23.52) points.Pearson correlation analysis showed that compassion fatigue was negatively correlated with professional identification and death coping ability( r = - 0.428, - 0.326, both P<0.01), while occupational identity was positively correlated with death coping ability ( r = 0.565, P<0.01). Professional identification played a partial mediating role between compassion fatigue and death coping ability of nurses in the oncology department, and the mediating effect was - 0.34, accounting for 52.3% of the total effect. Conclusions:In this study, the professional identification score of nurses in the oncology department was at a moderate level, the compassion fatigue score was at the moderate to severe level, and the death coping ability score was at a moderate level. Professional identification is an important mediating variable between compassion fatigue and death coping ability of nurses in the oncology department that improve their professional identification, reduce their compassion fatigue and improve their death coping ability.

Objective:To explore the effects of life events, family environment and coping style on self-injury behavior in adolescents with first-episode depression.Methods:From July 2019 to December 2022, a total of 110 adolescent patients with first-episode depression were selected in the Psychiatry Department of the First Affiliated Hospital of Zhengzhou University. According to whether the patients had self-injury behavior, the patients were divided into group without self-injury( n=54)and group with self-injury( n=56).Patients in the two groups were evaluated by a general clinical data questionnaire, adolescent self-rating life events checklist (ASLEC), family environment scale-Chinese version(FES-CV), simplified coping style questionnaire (SCSQ), 24 items Hamilton depression scale (HAMD-24), Hamilton anxiety scale (HAMA) and 90 symptom checklist-90 (SCL-90). Statistical analysis including t-test, χ2 test and binary Logistic regression analysis were performed on the enrolled data by SPSS 25.0 statistical software. Results:Among 110 patients, there were 56 patients(50.9%) exhibited self-injury behavior.The scores of ASLEC(51.04±5.99, 48.02±6.86), intimacy(3.70±1.85, 4.59±1.60), emotional expression(3.84±1.80, 4.69±1.96), positive coping styles(15.84±5.85, 18.22±4.84), negative coping styles(12.50±3.23, 11.06±3.64), and HAMA(20.63±2.86, 19.48±2.55) showed statistically significant differences between the group with and without self-injury ( t=-2.46, 2.72, 2.36, 2.32, -2.20, -2.21, all P<0.05). Binary Logistic regression analysis showed that life events ( B=0.079, OR=1.083, 95% CI=1.008-1.163, P=0.030), negative coping style ( B=0.173, OR=1.188, 95% CI=1.033-1.367, P=0.016), HAMA ( B=0.225, OR=1.252, 95% CI=1.057-1.482, P=0.009) were risk factors for self-injury, while intimacy ( B=-0.264, OR=0.768, 95% CI=0.593-0.995, P=0.046) and positive coping styles ( B=-0.092, OR=0.912, 95% CI=0.834-0.997, P=0.044) were protective factors for self-injury. Conclusion:The self-injury behavior of adolescents with first-episode depression may be related to negative life events, early adverse family environment and coping style.

Objective:To explore the effects of depressive symptoms on sleep quality in adolescents with depressive disorder, and the mediating roles of cognitive fusion and sleep belief.Methods:A sample of 210 adolescents with first episode depressive disorder aged 12-18 years were recruited to complete 17-item Hamilton depression scale (HAMD-17), Pittsburgh sleep quality index (PSQI), cognitive fusion questionnaire (CFQ), and dysfunctional beliefs and attitudes about sleep scale (DBAS-16) from November 2021 to July 2022. SPSS 26.0 software was used to perform descriptive analysis and correlation analysis. The mediating effect was tested by Bootstrap analysis using PROCESS V 3.4 Macro program.Results:The incidence of low sleep quality in adolescents with depressive disorder was 69.0%(145/210). HAMD-17 score was (22.4±7.9), PSQI score was (9.7±3.7), CFQ score was (51.6±7.8), DBAS-16 score was (43.5±8.4).PSQI was positively correlated with the scores of HAMD-17 and CFQ( r=0.613, 0.463, both P<0.001).HAMD-17 was positively correlated with CFQ score ( r=0.488, P<0.001).DBAS-16 was negatively correlated with scores of PSQI, HAMD-17 and CFQ( r=-0.326, -0.284, -0.354, all P<0.001). The direct effect of depression on sleep quality was 0.230(95% CI=0.169-0.293). The indirect effect of depression on sleep quality through two pathways, the separate mediating effect value of cognitive fusion was 0.041 (95% CI=0.011-0.074), and the chain mediating effect value of cognitive fusion and sleep beliefs was 0.008(95% CI=0.001-0.020). Conclusion:Depressive symptoms can directly affect sleep quality of depressive disorder adolescents and indirectly through cognitive fusion and sleep beliefs.

Objective:To investigate the characteristics of obesity in adolescents with major depressive disorder (MDD) and its association with the depressed severity.Methods:A total of 278 adolescents with MDD were recruited according to the inclusion and exclusion criteria. Their demographic data were collected and 24-item Hamilton depression scale (HAMD-24) was used to evaluate their severity of depression. According to the body mass index (BMI) classification standard of adolescents in China, all subjects were classified into four groups(wasting group, normal BMI group, overweight group and obesity group). SPSS 26.0 statistical software was used for data analysis. The Kruskal-Wallis test and the Chi-square test were separately used for the comparison of the four groups.Spearman correlation was used to explore the relationship between BMI and HAMD-24 scores and severity.Results:Among 278 adolescents with MDD, the prevalence of body abnormality was 32.4% (90/278), among which wasting, overweight and obesity were 9.0% (25/278), 14.4% (40/278) and 9.0% (25/278) respectively. There were statistically differences in gender ( χ2=17.018, P<0.001), HAMD-24 scores ( H=9.427, P=0.024) and depressed severity( H=8.508, P=0.037) among the four groups. Multiple comparisons showed that there were only statistically differences between obesity group and normal BMI group, that was the prevalence of obesity in males was higher than that in females ( χ2=13.631, P<0.001), and the level in HAMD-24 scores ( Z=2.956, P=0.003) and depressed severity ( Z=2.832, P=0.005) was lower in obesity group than that in normal BMI group.Spearman correlation analysis showed that BMI was negatively correlated with HAMD-24 scores ( r=-0.162, P=0.007). Conclusion:There is gender difference in obesity rates among the adolescent patients with first-episode untreated MDD. And the obese patients are less depressed than those with normal BMI.

Objective:To evaluate the effect of two-step irradiance schedule on pain control during and clinical efficacy of aminolevulinic acid (ALA) -based photodynamic therapy (PDT) for moderate to severe acne.Methods:Sixty patients with moderate to severe acne were enrolled from the Department of Dermatology, the Central Hospital of Enshi Tujia and Miao Autonomous Prefecture from January 2018 to March 2019, and equally divided into 2 groups according to the order of treatment: control group receiving conventional irradiation at a light output intensity of 65 mW/cm 2 for 20 minutes, and observation group irradiated at an initial light output intensity of 40 mW/cm 2 for 8 minutes until the irradiation energy reached 20 J/cm 2, followed by irradiation at a light output intensity of 65 mW/cm 2 for 15 minutes until the total irradiation energy reached 78 J/cm 2. During the treatment, the irradiation intensity was appropriately adjusted according to the patients′ response, and all the patients were treated once every 2 weeks for 3 consecutive sessions. The time to onset of pain and pain scores at 5, 10, 15, 20, 25, 30 and50 minutes after the start of irradiation were recorded and compared between the two groups; clinical efficacy was evaluated 1 month after the end of the treatment; other adverse reactions were recorded during the treatment and 3-month follow-up after the end of treatment. Results:The time to onset of pain was significantly different between the observation group (10.40 ± 1.13 minutes) and the control group (3.95 ± 0.77 minutes; t = 25.919, P < 0.05). During the treatment, the pain score significantly changed over time ( F = 323.631, P < 0.01), and significantly differed between the observation group and control group ( F = 89.338, P <0.01). Additionally, there was a significant interaction between the treatment duration and treatment methods ( F = 24.059, P < 0.01). At 5, 10 and 15 minutes after the start of irradiation, the pain score was significantly lower in the observation group than in the control group ( t = 21.714, 28.407, 28.286 respectively, all P < 0.05) ; at 20 minutes, there was no significant difference in the pain score between the two groups ( t = 1.505, P > 0.05) ; at 25 minutes (that is, 2 and 5 minutes after the end of irradiation in the observation group and control group respectively), 30 minutes, 50 minutes (that is, the end of the cold compress), there was also no significant difference in the pain score between the two groups ( t = 0.606, 1.038, 0.344 respectively, all P > 0.05) ; at the end of irradiation (that is, 23 and 20 minutes after the start of irradiation in the observation group and control group respectively), there was still no significant difference in the pain score between the two groups ( t = 1.968, P = 0.149). One month after the 3 sessions of treatment, there was no significant difference in the response rate between the observation group (90%, 27/30) and control group (83.3%, 25/30; χ2 = 0.577, P = 0.706). Moreover, there was no significant difference in the incidence of blisters, erythema, edema, skin dryness, desquamation, pruritus, reactive acne or pigmentation between the two groups (all P > 0.05) . Conclusion:The two-step irradiance schedule can effectively control related pain during the treatment of moderate to severe acne with ALA-PDT, especially in the initial stage of treatment, making patients successfully complete 3 sessions of ALA-PDT treatment and ensuring the clinical efficacy.

Objective:To assess the effectiveness of influenza vaccine in children aged 6-72 months.Methods:The cohort study was conducted based on community child vaccination clinics in Yiwu and Yongkang counties of Zhejiang province. From October 2017 to December 2017, a total of 1 752 children aged 6-72 months were enrolled from 10 child vaccination clinics. The questionnaire survey was conducted after the written consents were obtained from the parents or legal guardians of the children. Then, a follow up was conducted for enrolle children until 30 April 2018, the influenza vaccination status and the number of influenza-like illness (ILI) cases, hospital visit due to ILI, self-medication due to ILI were observed and recorded every month. Vaccine effectiveness (VE) was estimated by using the generalized linear model (GLM) where dependent variables were the number of ILI cases, hospital visit and self-medication respectively.Results:Of the 1 752 children, 925 (52.80%) were boys and the median age was 30.00 months. The cumulative observation was 308 166 person days at the end of 2017-2018 season, with 5.27 ILI cases per 1 000 person days, 3.41 hospital visit due to ILI per 1 000 person days, 1.45 self-medication due to ILI per 1 000 person days. Of the 1 752 children, 643 received the influenza vaccination in 2017-2018 season. Compared with unvaccinated children, the VE was 23.5% against ILI case number (95% CI: 15.1%-31.1%), 19.3% against hospital visit due to ILI (95% CI: 8.2%-29.1%) and 25.8% against self-medication due to ILI (95% CI: 9.3%- 39.3%). Modeling splitting 643 children with 2017-2018 vaccination into those before and after vaccination, the influenza VE was 31.9% against ILI case number (95% CI: 12.7%-46.9%), 32.6% against hospital visit due to ILI (95% CI: 8.6%-50.3%) and 44.3% against self-medication due to ILI (95% CI: 11.9%-64.8%) in children aged 36-72 months. However, the children aged 6-35 months showed no significant VEs. For the VE analysis in children with different vaccination status, the VEs were significant if they received vaccination in both 2016-2017 season and 2017-2018 season or only in 2017-2018 seasons. The VE was not demonstrated among the children who were immunized only in 2016-2017 season. Conclusion:Influenza vaccination is moderate effective in preventing the incidence of ILI and hospital visit and self-medication in children in influenza season, the protection effect in children aged 36-72 months is better than that in children aged 6-35 months.

Objective: To assess the effectiveness of seasonal influenza vaccine among children aged 6 to 72 months. Methods: The test-negative case control study was conducted based on available surveillance data which was from China Influenza Surveillance Information system (CSIS). From October 2016 to April 2017 and from October 2017 to April 2018,1 161 cases aged 6-72 months with influenza-like illness in Yongkang and Yiwu city, were selected as the study subjects, and the cases with influenza test-positive were selected as the case group (403 cases). Test-negative subjects were selected as control group (758 cases). The etiology and immunization data of the subjects were obtained from CSIS and Immune Information and Management System (IIMS) respectively. Vaccine effectiveness was estimated using multivariate logistic regression model,and the mixed effects of non-randomized control in TNCC study were equalized by using the propensity score (PS) method in the statistical analysis. Results: The age of the subjects was (2.44±1.60) years,and there were 681 boys (58.66%). The age of case group was (2.62±1.58) years, and there were 246 boys (61.04%). The case group was including of 237 cases (58.81%) of influenza A (H3N2), 92 cases (22.83%) of influenza A (H1N1) pmd09, 62 cases (15.38%) of influenza B(Victoria) lineage, 11 cases (2.73%) of influenza B (Yamagata) lineage and one case (0.25%) co-infection of influenza [A(H₃N₂)+B (Victoria)]. The mean age of the control group was (2.35±1.61) years,and there were 435 boys (57.39%). Overall vaccine effectiveness (VE) against all type influenza for two seasons combined was 58% (95%CI: 31%-74%). An analysis by age groups showed 68% (95%CI:41%-82%) of the VE estimate among children aged 36-72 months while it was 28%(95%CI:-80%-71%)of the VE estimate among children aged 6-35 months. The VE estimate value was 54% (95%CI:16%-75%) against all type influenza and 65% (95%CI:24%-83%) against influenza A (H₃N₂) during the 2016-2017 season. During the 2017-2018 season, the VE estimate value was 69% (95%CI:18%-88%) against all type influenza. Conclusion Influenza vaccine is effective in preventing influenza virus infection during the flu season,especially the effect among children aged 36-72 months is higher compared to that among children aged 6-35 months.